Journal of the College of Physicians and Surgeons--Pakistan : JCPSP
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J Coll Physicians Surg Pak · May 2004
ReviewEmerging drug--resistance and guidelines for treatment of malaria.
The increasing prevalence of multi-resistant Plasmodium falciparum malaria worldwide is a serious public health threat to the global control of malaria, especially in poor countries like Pakistan. In many countries choloroquine-resistance is a huge problem, accounting for more than 90% of malaria cases. In Pakistan, resistance to choloroquin is on the rise and reported in up to 16- 62% of Plasmodium falciparum. four to 25% of Plasmodium falciparum also reported to be resistant to sulfadoxine-pyrimethamine and several cases of delayed parasite clearance have been observed in patients with Plasmodium falciparum malaria treated with quinine. In this article we have introduced the concept of artemisinin- based combination therapy (ACT) and emphasize the use of empiric combination therapy for all patients with Plasmodium falciparum malaria to prevent development of drug resistance and to obtain additive and synergistic killing of parasite.
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J Coll Physicians Surg Pak · May 2004
Stroke scale score and early prediction of outcome after stroke.
To evaluate the baseline National Institute of Health Stroke Scale (NIHSS) score as a predictor of functional outcome after ischemic stroke. ⋯ The NIHSS score is a good predictor of patient' recovery after stroke. Assessing the patient's neurological impairment at first presentation of ischemic stroke can guide the physician regarding the prognosis and management plan.
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J Coll Physicians Surg Pak · Apr 2004
Serological profile of incidentally detected asymptomatic HBsAg positive subjects (IDAHS).
To evaluate the serological profile of patients with incidentally detected positive hepatitis-B surface antigen (HBsAg) and to asses the risk factors. ⋯ Twenty-one percent asymptomatic subjects with positive HBsAg were found to be HBeAg positive. A large number of subjects with negative HBeAg had HBV DNA positive suggesting presence of precore mutants. Intramuscular injections and surgery were noted to be frequent risk factors in these subjects.
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To correlate hepatitis B HBV DNA polymerase chain reaction (PCR) results with HBeAg and serum alanine transferase (ALT) in carriers. ⋯ In case of non-availability of facility for HBV PCR, detectable HBeAg should be taken as a surrogate marker for HBV DNA in hepatitis B carriers with raised serum ALT.
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J Coll Physicians Surg Pak · Apr 2003
Comparative StudyA comparison of two fasciocutaneous flaps in the reconstruction of defects of the weight-bearing heel.
To compare the indications, ease of elevation, operative time, complications and durability of two fasciocutaneous flaps i.e. sensate medial plantar artery flap and distally based sural artery neurocutaneous flap, used for the coverage of weight bearing heel in young ambulant adults. ⋯ The medial plantar artery flap provides sensate and the same quality skin cover to the weight-bearing heel as compared to the distally based sural artery neurocutaneous artery flap. The medial plantar artery flap procedure is longer to perform but allows early weight-bearing with less complications than the distally based sural artery neurocutaneous flap.