Spinal injury is a critical neurosurgical emergency requiring prompt and highly skilled management. This study was carried out in the Neurosurgery unit of Rajshahi Medical College Hospital on 465 cases of spinal injury over 6 years. The age range of the patients was 4 to 72 years and most commonly involved age group was between 20 to 40 years. Male to female ratio was 5:1. Cervical spines were most commonly (41%) affected by injury followed by thoracic (13%), lumber (36%), cervico-thoracic (4%) and lumbo-thoracic spines (6%). Common causes of spinal injury were fall from height (44.30%), RTA (22.15%), heavy weight bearing (13.11%) and assault with gun shot (7.74%). Paraparesis was the most frequent (55%) clinical presentation due to spinal injury followed by quadriparesis (45%). Two third of the patients were managed conservatively and 9% required operative treatment. Mortality rate was 12% and 8% patient refused to take treatment. TAJ 2002; 15(1): 25-27

Objective: To compare LED fluorescence microscopy and Ziehl-Neelsen staining in terms of their diagnostic performance in diagnosing pulmonary tuberculosis, taking sputum specimens from patients suspected of pulmonary tuberculosis. Study Design: Prospective longitudinal study. Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology Rawalpindi, from Jan 2019 to Dec 2019. Methodology: Sputum samples from patients with clinical suspicion of pulmonary tuberculosis were stained using Ziehl-Neelsen (ZN) stain, fluorescent stain with Auramine O staining (AO) stain and Mycobacterial culture on Mycobacterial Growth Indicator Tube (MGIT 960), to detect Mycobacterium tuberculosis. WHO guidelines were followed to grade positive smears. Results: Among 206 patients with suspicion of tuberculosis, 143 (69%) were male, and 63 (30%) were female patients. The mean age of the patients was 53.67 ± 14.73 years. Out of 206 sputum samples, 64 were negative by all three techniques used. 142 (68%) specimens detected Mycobacterium tuber-culosison MGIT960. Within 142 culture-positive samples, only 40 samples were positive on Ziehl-Neelsen microscopy, whereas 97 samples were detected positive by LED fluorescent microscopy. In culture-negative samples, three were missed on Ziehl-Neelsen staining, which was positive with Fluorescent microscopy. Sensitivity and specificity for Ziehl-Neelsen smear microscopy were 26.7% and 96.8%, respectively. Sensitivity and specificity for Fluorescent smear microscopy were 64.8% and 92.2%, respectively. Conclusion: We concluded that the efficacy of LED fluorescence microscopy has proven to have many potential advantages over conventional Ziehl-Neelsen microscopy.

Objective: To determine the association of breath holding spells with irondeficiency anemia in children. Study Design: Case control study. Place and Duration of Study:Military Hospital Rawalpindi from Jun 2012 to Dec 2012. Study Population: Sixty children ofeither gender meeting inclusion criteria aged 6 months to 5 years with 30 of breath holding spells incase group and 30 in control group as healthy children were included in the study after informedconsent from parents. Method: Complete blood picture and serum ferritin levels were performedof all children in both case and control groups. Tests were carried out at AFIP Rawalpindi. All datawas entered and analyzed using SPSS version 10. Frequencies and percentages were calculatedfor categorical (qualitative) variables like sex and children having iron deficiency anemia in casesand controls. Mean and Standard Deviation (SD) was calculated for numerical (quantitative)variable like Age. Odds ratio was calculated from the data of cases and controls. Regarding irondeficiency anemia p value <0.05 was considered as significant. Results: In this study, werecorded 43.33% (n=13) cases were between 0.6-3 years and 56.67% (n=17) were between 4-5years while 53.33% (n=16) controls were between 0.6-3 years and 46.67% (n=14) were between4-5 years. Mean±SD was calculated as 3.3+1.46 years in cases and 2.93+1.48 years in controlgroup. Male children were 60% (n=18) in patient group and 46.67% (n=14) in controls group.Female children were 40% (n=12) in patient and 53.33% (n=16) in control group respectively.Association of breath holding spells with iron deficiency anemia in children revealed as 56.67%(n=17) in cases and 3.33% (n=1) in control group while remaining 43.33% (n=13) in cases and96.67% (n=29) in control group had no findings of this association. P value was calculated as<0.0001 and Odds Ratio was 37.92 which shows a significant difference between the two groups.Conclusions: The association of breath holding spells with iron deficiency anemia in children issignificantly higher than healthy controls. So, it is recommended that every child who present withbreath holding spells should be evaluated for iron deficiency anemia

Objective: To study the types, etiology and long term neurodevelopmentaloutcome in neonates with seizures. Study Design: A descriptive cross-sectional study. Placeand Duration of Study: PNS Shifa Naval hospital Karachi from Jan 2011 to Feb 2014. StudyPopulation: Ninety six neonates of either gender presented with seizures at NICU PNS ShifaNaval hospital Karachi were studied. Method: All neonates with seizures were evaluated.The seizures were classified according to the simiology. They were investigated according toNICU protocol to confirm the underlying diagnosis and timely management. The patients afterdischarge were regularly followed up for one year to assess the long term neurodevelopmentaloutcome. Results: A total of 96 neonates with seizures were studied and it was observedthat 60 (62.5%) were male babies and 56 (58.33%) were term with a male to female ratio of1.6:1. Majority of the neonatal seizures were seen in 1stweek of life (85%). The most commontype of seizures was clonic 40 (41.67%) followed by subtle 20 (20.84%), mixed 16 (16.67%),tonic 10 (10.41%), myoclonic 5 (5.20%) and unclassified 5 (5.20%). Antiepileptics were usedin 82 (85.41%) patients. Phenobarbitone 49 (59.76%) was most commonly prescribed drug.The most common cause of seizures was birth asphyxia 48 (50%) followed by metabolic 16(16.68%), sepsis 10 (10.41%), intracranial hemorrhage 6 (6.25%), bilirubin encephalopathy 4(4.16%), inborn errors of metabolism 2 (2.08%), birth trauma 2 (2.08%) and unknown etiology 5(5.20%). 25 (26.04%) patients develop adverse neurodevelopmental outcome i.e. cerebral palsywith epilepsy 10 (40%) and cerebral palsy without epilepsy 05 (20%), developmental delay 10(40%). Mortality in the study was 12 (12.5%). Conclusions: Clonic seizures are commonestin neonates apart from infants and children who have GTCS. The most common etiology ofseizures in neonates is birth asphyxia. Phenobarbitone is still the most commonly prescribedantiepileptic. Quick assessment, timely diagnosis and aggressive management according tothe etiology are necessary to prevent the morbidity and mortality associated with neonatalseizures. Long term neurodevelopmental outcome is worse in patients with birth asphyxiaespecially with low Apgar score at 5 minutes. Normal delivery and birth asphyxia were the majorrisk factors for cerebral palsy