International Invention Journal of Medicine and Medical Sciences

62-67

Authors: Kaladada I. Korubo, MB.BS, FMCPath

Thrombotic thrombocytopenic purpura is a rare congenital or acquired disorder either due to mutations in the ADAMTS13 gene or development of antibodies to the ADAMTS13 protein. TTP causes a life-threatening form of thrombotic microangiopathy that is characterized by thrombocytopenia, microangioapathic haemolytic anaemia, fever, neurological symptoms and renal impairment. ADAMTS13 functions to cleave large von Willebrand factor multimers and in its absence there is unregulated VWF-dependent platelet thrombosis. A nineteen year old female presented with a history of menorrhagia, petechiae and purpural haemorrhages, painful right jaw, anaemia of 8.1g/dL and thrombocytopenia of 31 X 109/L. Her blood film showed numerous schistocytes with thrombocytopenia on film. Bone marrow aspirate revealed increased megakaryocytic and erythroid activity. The uric acid and lactate dehydrogenase parameters were elevated but her renal functions and other investigations were essentially normal. At presentation she was initially commenced on high dose prednisolone, however on review of the peripheral blood schistocytes and thrombocytopenia a provisional diagnosis of thrombotic thrombocytopenia was made and ADAMTS13 was done which revealed low ADAMTS13 levels. This is a case report to document this rare disorder for the first time in our environment which was successfully treated without the use of plasma exchange, plasma infusion or blood transfusion but rather with high dose prednisolone.

50-57

Authors: Sibel Atalay1*, İbrahim Tekeoğlu2, Halil Harman2,3, M. Şevki Uyanık4

Association between rheumatological and thyroid disorders has been demonstrated by many studies. Our aim was to evaluate the prevalence of thyroid disorders in patients with autoimmune (ARD) and also autoinflammatory rheumatic disease (AIRD). We evaluated serum levels of thyroid-stimulating hormone (TSH), free triiodothyronine (fT3), and free thyroxine (fT4), and titers of antithyroglobulin (TG-Ab) and antithyroid peroxidase (TPO-Ab) antibodies in 298 patients with ARD and 363 patients with AIRD. We also recruited 137 age-matched controls. Ultrasonography (US) of the thyroid gland was performed in all subjects. Comparisons were done only among participants of the same gender. Hashimoto’s thyroiditis (HT) frequency was significantly more frequent in patients with ARD or AIRD in female population and also it was more frequent in patients with ARD in male population than in controls. In both female and male patients with ARD, mean TPO-Ab levels was lower than those receiving biologics than those receiving disease-modifying antirheumatic drugs (DMARDs), but difference was not significant. Receiving nonsteroidal anti-inflammatory drug (NSAID) was more frequent in female patients with ARD and AIRD and also in controls than those not having HT. Our study shows a significantly higher prevalence of thyroid autoimmunity in patients with ARD and AIRD as compared to controls. Female gender has an important role for HT diagnosis. We suggest that thyroid function tests should be a part of the clinical evaluation particularly in female patients and also male patients with ARD and AIRD.

32-39

Authors: Ibrahim Hegazy1, Monira Taha2, Ahmed Abou Zeid2, Ezzat El-Taher3, Nahla Hassan4*

Disaster can be defined as a sudden extraordinary event that brings great damage, loss, destruction and injury to people and their environment. Interprofessional collaboration can have a positive impact on the quality of patient care. All employees need to be oriented with the disaster management plan of their organization. The aim of the study is to assess the awareness of the health team members about disaster management plan in the Suez Canal University Hospital. The study conducted at Suez Canal University Hospital using a cross-sectional design. It included medical staff and non-medical staff members (doctors, nurses, laboratory, radiology technicians, security officers, registration officers, and housekeepers n=400). The data collection tool is a questionnaire that included 22 questions categorized into seven sections. According to the study, the awareness of various categories of the study candidates about the emergency response plan of the hospital was generally low. There was a low awareness of the meaning of disaster among all categories. There is a high awareness among doctors, nurses, laboratory, radiology technicians regarding infection control section, while the awareness was low among security officers, registration officers, and housekeepers. There is a lack of awareness of hospital staff members regarding emergency response plan and the meaning of disaster at the Suez Canal University Hospital. The study recommends that hospital administrations should give more attention to the problem of disasters, disaster plan. More emphasis should be paid for training programs regarding disaster management for all responsible team in the hospital.

6-13

Authors: *Parveen Malhotra, Naveen Malhotra, Vani Malhotra, Ajay Chugh, Abhishek Chaturvedi, Parul Chandrika, Ishita Singh

Hepatitis C virus (HCV) is a major cause of liver disease worldwide. The impact of this infection is just emerging in India. The focus of study was epidemiological profile of patients suffering from hepatitis C and major risk factors associated. The epidemiology of hepatitis C in India has not been studied systematically. The burden of hepatitis C infection in Haryana has reached a significant level. It is more common in the young males belonging to rural areas. Genotype 3 is the most prevalent followed by genotype 4 which has not been reported from Northern India till now to such an extent. There is lack of awareness, hygiene and shortage of health facilities and there is need to organize public awareness and health education campaigns targeting healthcare providers, private practitioners, and the public. The study aim to study Epidemiological profile in patients infected with Hepatitis C Virus reporting to Hepatitis C nodal center in Haryana and to assess the various risk factors, genotypes and geographic foci of the disease. It was an epidemiology based, prospective study conducted at medical gastroenterology department of our institute over a period of five years. The record of each patient was meticulously maintained in the department. In this study 2500 patients confirmed for hepatitis C infection by PCR analysis were enrolled. Majority of the subjects were married male and came from rural residential areas. The age distribution curve showed a sharp peak between the age group 20 to 35 years. The districts bordering Punjab were having more prevalence in comparison to other parts. History of previous surgery and tattooing appeared as major risk factors. Majority of the patients were asymptomatic. Most of them were found to have HCV infection at screening camps followed by screening during preanaesthetic checkups and blood donation. Genotype 3 was the most common followed by genotype 4 and Genotype 1. The burden of hepatitis C infection is more in the young males especially in the rural areas. The reason for this could be lack of awareness, hygiene and shortage of health facilities for which need is to organize public awareness and health education campaigns targeting healthcare providers, private practitioners, and the public. In order of the prevalence of disease we can formulate strategies and prioritize accordingly. The most important risk factors are use of unsterilized needles and other equipment. Tattooing has emerged as a major player here. It is a common practice and it is imperative to make people aware of the risks associated with it. Genotype 3 is the most prevalent. But genotype 4 is also emerging. Keywords: Chronic hepatitis C, Genotypes, Viral load, Blood transfusion, Recycled syringes.

135-138

Authors: Mahmoud A Saleh. MD*, Mhmoud I Gazy. MD, Ahmed I Galhoom. MD, Ahmed E Hodiep. MD , Mohamed El moddather MD, Mostafa F Mohammed MD.

To evaluate the effect of myopic lasik surgery on ocular alignment and binocular vision in patients with manifest or intermittent exotropia. 26 patients (52 eyes) with exotropia (9 patients manifest exotropia and 17 patients intermittent exotropia).Patients seeking myopic refractive surgery with mild amblyopia, ametropia or anisometropia were consecutively included in this study. Amblyopic eyes with visual acuity <20/60 and patients with vertical strabismus were excluded from the study. Myopic LASIK surgery was performed on 44 eyes. Ocular alignment and binocular function remained unchanged postoperatively in all except three patients with high anisometropia who experienced an improvement in binocular function. In these patients, the preoperative manifest deviation became intermittent in two patients and latent in one patient after surgery with improving fusion and stereopsis. Manifest or intermittent exotropia is not a contraindication for myopic LASIK surgery provided some specific recommendations are taken in consideration, such as an adequate preoperative examination and consecutive surgery of both eyes starting with the dominant eye, and aiming at emmetropia for the dominant eye and for the non‐dominant eye. Keyword: LASIK, Manifest exotropia, Intermittent exotropia.