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Epidemic of sarcopenia throughout more mature Chinese older people: a deliberate review and meta-analysis.
Achondroplasia is a common form of dwarfism occurring in one out of 25,000 of live births. These patients present many problems during pregnancy and at the time of the delivery. The anaesthetist may also face several difficulties for both general and regional anaesthesia. The aim of this case report is to discuss various obstetric and anaesthetic considerations in such patients and ways to manage the difficulties. A 29-year-old woman expecting her first child, with achondroplasia -height of just 3'2'' (98 centimetres) - at 31 weeks of gestation, presented to our OPD for antenatal visit on May 15, 2018. Her successful elective lower segment caesarean section was performed on June 25, 2018 at 37 weeks in view of contracted pelvis under general anaesthesia. A live male baby was delivered, with no complications, good Apgar score and birth weight of 2.7kg. This shows that a woman with a genetic disorder like achondroplasia can become pregnant and deliver a healthy child at term.A 25-year-old female patient visited our clinic with complaint of cyclic haematuria. She had previous two Caesarean Sections at a secondary care hospital. Her complete urinalysis showed abundant red blood cells. IACS-010759 purchase Through computed tomography a fistula tract between the posterior wall of the bladder and the anterior wall of the lower uterine segment was diagnosed. The Cystoscopy revealed a fistulous opening with a diameter of nearly 1.5 cm localized between the bladder and uterine cavity. Fistulae was repaired by abdominal approach without transection of bladder. Surgery was performed by mobilization of bladder and wide anterior uterine dissection. A 2cm defect in the lower uterine segment was identified and was closed with 0 polyglycolic acid suture. Bladder defect was repaired in two layers and omental tissue flap was placed between the two surfaces. At 6 months follow the up patient was asymptomatic.Stroke, a neurological disorder, leads to long-term disability thereby greatly affecting gait and mobility. The purpose of the current study was to investigate the effects of progressive resistance training in both acute and chronic stroke patients. A quasi interventional study was designed and 46 stroke patients were recruited through convenience sampling technique. Sample size was calculated using epi-tool. Patients who had cognitive problems, balance impairments and contractures were excluded from the study. The study was conducted from January to June 2018, at Rafsan Rehab & Research Centre, Peshawar. Progressive resistance exercises starting at 50 % of one repetition maximum (RM) were performed three days/week and for a total duration of nine weeks. Blind assessor measured readings at baseline and after nine weeks. Gait dynamic index (GDI), Six-Meter Walk Test (SMWT) and Five Times Sit-to-Stand (FTSTS) tools were used to collect the required data. The data was analysed at baseline and after nine weeks on SPSS-20. After nine weeks of intervention significant improvement was recorded in patients on GDI (p less then 0.001), SMWT score (P less then 0.001) and FTSTS (p less then 0.001). Progressive resistance training improves mobility limitations and gait in both acute and chronic stroke patients.In this study, the clinical and laboratory findings, management and follow-up of 32 children with paediatric systemic lupus erythematosus (pSLE) were evaluated to determine the prognostic factors in pSLE. Of the 32 patients, 25 (78.1%) were females. Age at onset of symptoms and diagnosis in the patients were 147.6 ± 49 months and 154.3 ± 48 months, respectively. The most common symptom on admission were joint problems, seen in 25 (78.1%) patients. Haematological alterations were seen in 25 (78.1%) cases during follow-up. Lupus nephritis was diagnosed in 10 (31.2%) patients. Malar rash was seen in a total of 12 (37.5%) patients during follow up, however it had been noted in five (15.6%) patients on admission. Antinuclear antibody and anti-dsDNA were positive in all patients and 31 (96.8%) patients, respectively. Decreased complement 3 and 4 levels were noted in 23 (71.8%) patients. Antiphospholipid antibody was studied in 27 patients and it was found to be positive in 13 (48.1%) patients. In conclusion, based on our findings, we would like to emphasize that pSLE has a large and remarkable clinical and laboratory findings.The study was designed to investigate the quantity and reasons of wastage of blood products. This was an observational study conducted from February 2018 to February 2019 at the National Institute of Blood Disease and Bone Marrow Transplantation (NIBD and BMT), PECHS campus. The study was approved by the institutional review board. Wastage and reasons of wastage for all the blood products were evaluated. Frequencies were calculated by using SPSS version 23.0. A total of 2,880 bags of blood products were available, including 960 each of platelets, packed red cells and fresh frozen plasma. The overall wastage rate was 3.5%. Packed red cells and platelets were fully consumed, yet shortage of supply was observed. However, highest wastage was observed in fresh frozen plasma i.e. 102 bags. Expiry of unused products 60 (59%) followed by broken bags 30 (29%) were two common modes of wastage. Wastage of blood products is a genuine issue in a hospital setup, strategies and plan of action should be discussed and implemented to ensure that they are available when and where they are needed most.The purpose of this survey was to evaluate the level of awareness and practices regarding macular ganglion cell complex (GCC) scans for early detection of glaucoma. The study design was descriptive cross-sectional and the sampling technique was non-probability convenient method. Data was collected through an online survey, from 100 practicing ophthalmologists and optometrists of Pakistan in two weeks, from January 20 to February 03 2019. Data were analysed using Microsoft Excel 2016. From the results it is strongly evident that significant number of respondents recorded the retinal nerve fibre layer (RNFL) to be the first layer affected as glaucoma progresses, which depicts lack of knowledge among eye care practitioners. Furthermore, both the groups (ophthalmologists and optometrists), used macular GCC scan the least as compared to the RNFL (optic nerve head) scan and visual field tests for early diagnosis of glaucoma. It demonstrated lack of knowledge and practices of macular GCC scan for glaucoma among eye care practitioners.
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