Objective: To study the spectrum of sudden death cases at Combined Military Hospital (CMH), Quetta Pakistan. Study Design: Case series study. Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Jun 2014 to Jun 2019. Methodology: The study included all the autopsies/postmortems carried out on the cases due to sudden death from June 2014 to June 2019 at Combined Military Hospital, Quetta Pakistan. Detailed postmortem, internal and external examination, and histomorphology of vital organs were done in all cases of sudden death. Results: A total of 40 cases of sudden deaths were studied. The age of the study subjects ranged from 24 to 45 years. Maximum deaths occurred in the age group between 30 to 45 years. The cause of death in 22 cases (55%) was attributed to cardiac events,the most common cause being coronary artery disease (59.0%). The remaining 18 cases (45%) were due to other non-cardiac causes. Conclusion: Sudden death is the most common cause seen in young adults, most of which are attributed to cardiac causes.This study highlights serious health issues in our setup and the necessity to create awareness among the young adults at risk so that sudden deaths can be averted and life expectancy can be improved.
Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan. Study Design: Prospective observational study. Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019. Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study. Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders. Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.
Objectives: To determine frequency of multidrug resistant (MDR) and extensive drug resistant (XDR) strains of Salmonella typhi (S. typhi) and Salmonella paratyphi (S. paratyphi) in Quetta, Balochistan of Pakistan Study Design: Descriptive Cross-Sectional Place and Duration: Department of Microbiology, CMH Quetta, Pakistan. from March 2019 to March 2020 Materials and Methods: A total of 2760 (n) suspected cases of typhoid fever, irrespective of age and gender, reporting at the hospital in this duration and underwent blood culture. Isolates were cultured and identified using standard microbiological procedures. Antimicrobial sensitivity against typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2018) and all the XDR isolates were confirmed by Vitek 2 system. Results: A total of 173 (6.3%) cultures showed positive results. with mean age of 18.9 ± 11.1 years, out of which 136 (78.6%) were male and 37 (21.1%) were female patients. Antibiotic susceptibility results showed that 166 (96%) of isolates were S. typhi. MDR strains were observed in 104(60.1%) and XDR strains were observed in 81 (46.8%) cases. Conclusion: A significant proportion of S. typhi isolates from confirmed cases of enteric fever demonstrated MDR (60.1%) and XDR (46.8%) strains in Quetta, Balochistan. We recommend empiric therapy with azithromycin in patients with uncomplicated and therapy with carbapenem for complicated cases of enteric fever acquired in Karachi or Quetta. Large scale population-based studies are recommended to get better information about antibiotic susceptibility pattern of S. typhi and S. paratyphi in other areas.
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