Military Hospital Research Articles

Haemorrhoids among Patients Visiting the Department of Surgery in a Tertiary Care Military Hospital of Nepal: An Observational Study

Introduction: Haemorrhoids is a common issue in the anorectal region and involves venous engorgement in the region. It greatly diminishes the overall quality of life of affected individuals by disrupting their physical and mental health. This descriptive cross-sectional study aimed to ascertain the prevalence of haemorrhoids and the associated risk factors among patients visiting a tertiary care center's surgery department. Methods: A descriptive cross-sectional study was conducted in the Department of Surgery of a tertiary care center from July 2023 to November 2023 after obtaining ethical approval. Convenience sampling method was used. The total sample size included in the study was 385. The data was analyzed in IBM SPSS Statistics software. Point estimate was calculated at 95% confidence interval. Results: Among 385 patients included in the study, haemorrhoids was prevalent in 53 (13.76%, 95% CI: 8.76%-18.76%). Internal haemorrhoids was most prevalent with 30 (56.60%) cases. 22 (41.51%) cases presented with Grade 1 haemorrhoids. The most prevalent symptoms were bleeding in 29 (54.72%) cases, perianal pain in 25 (47.17%) cases, itching in 28 (33.96%) cases and burning sensationin 15 (28.30%) cases. Conclusions: The prevalence of haemorrhoids in our center was found to be higher as compared to similar studies done in Southeast Asian region but similar with studies done in other region.

Comparison of Intraocular Pressure Measurement by iCare Tonometer and Goldman Applanation Tonometer

Objective: To compare the Intraocular Pressure measured by the Goldmann Applanation tonometer with by iCare ic100 tonometer in normal human eye to determine the accuracy and reliability of both methods. Study Design: Comparative cross-sectional study. Place and Duration of Study: Ophthalmology Department, Combined Military Hospital, Quetta Pakistan, from Oct 2022 to Apr 2023. Methodology: Approval was secured prior to enrolling every individual, protecting their privacy throughout the process. All instruments adhered to the manufacturer's guidelines for calibration. A single ophthalmologist assessed the intraocular pressure of all participants. In our study we included 400 eyes (200 right and 200 left) among 200 patients. Initially, study eyes were inspected using a slit lamp. Subsequently, iCare tonometer and Goldman applanation tonometer were employed to gauge the intraocular pressure. Results: Out of 200, 87 patients (43.5%) were male and 113(56.5%) were females. Median age of the patients was 51.00(45-58) years range from 22-77 years. Mean IOP measured by iCare was 19.01±7.86 mmHg and by Goldman applanation tonomter was 20.14±8.15 mmHg. The correlation coefficient value between the readings of two instruments was r=0.866 with significant p value (p< 0.001). Conclusion: The iCare ic100 consistently provides high intraocular pressure measurements (2-3mmHg) compared to the Goldmann Applanation tonometer across various sub Groups.

Comparison of Awake Craniotomy with Craniotomy Under General Anesthesia for Resection of Tumors in Eloquent Areas of Brain

Objective: To compare awake craniotomy with craniotomy under general anesthesia for early post-operative parameters in patients undergoing resection of tumors in eloquent areas of brain. Study Design: Quasi experimental study. Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Rawalpindi Pakistan Apr 2021 to May 2022. Methodology: All the patients who underwent resection surgeries for brain tumors in eloquent areas of brain were included in the study. They were divided into two Groups via lottery method. Group A underwent awake craniotomy while Group B underwent craniotomy under general anesthesia. Relevant intraoperative and early post-operative parameters were compared in both the Groups. Results: A total of 60 patients who underwent resection of eloquent area brain tumors in our hospital during the study period were included in the final analysis. Out of these 40(66.7%) underwent craniotomy under general anesthesia while 20(33.3%) underwent awake craniotomies. Mean age of the study participants was 45.61±7.889 years. Frontal lobe tumors were the most encountered brain tumors in our study participants. Patients who underwent awake craniotomy had statistically significantly lower KORNAFSKY score, lesser days of post-operative admission days and lesser neurological deficits (p-value <0.005) as compared to those who underwent craniotomy under general anesthesia. Conclusion: Awake craniotomy emerged as superior option as compared to craniotomy under general anesthesia in terms of early post-operative parameters. Lower KORNAFSKY score, lesser days of post-operative admission days and lesser neurological deficits were seen in patients undergoing awake craniotomy.

Comparison of The Postoperative Outcomes of Surgical Lateral Internal Sphincterotomy and Botulinum Toxin Injection in Patients Presenting With Chronic Anal Fissure At CMH, Rawalpindi

Objective: To compare the postoperative outcomes in Lateral Internal Sphincterotomy Group and in Botulinum toxin injection Group in patients managed for chronic anal fissure. Study Design: Quasi-experimental study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Aug 2021 to Feb 2022. Methodology: All patients of either gender, aged 30 to 70 years, who had presented to CMH, were included in this study. Block randomization was done to allocate half of them to Lateral Internal Sphincterotomy and half to Botulinum toxin injection. Patients in both Groups were followed for four weeks to assess and compare various short and long term post-surgical outcomes. Results: There were 82 patients in total with 41 in each treatment arm. In the Lateral Internal Sphincterotomy Group, 35 85(37%) of the patients reported postoperative pain relief at 24 hours, 39(95.12%) patients healed, only 2(4.88%) patients had a recurrence. In the Botulinum toxin Group, 29(70.73%) reported postoperative pain relief at 24 hours, 35(85.37%) patients healed, whereas 6(4.63%) had a recurrence. There was no statistical difference in any parameter between either Group. Conclusion: Both methods did not show any statistically significant difference in post-operative outcomes thus other parameters like patient’s choice, cost and expertise may be considered in treatment of chronic anal fissure.

Outcomes of Type-1 Tympanoplasty with and without use of Topical Nasal Steroids; a Comparative Study

Objective: To compare the outcome of Type-1 tympanoplasty procedure in patients given intranasal steroids post-operatively versus those not given intranasal steroids after procedure. Study Design: Quasi-Experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi. Pakistan from May 2021 to May 2023. Methodology: A total of 464 patients, 232 of which were given intranasal steroids (Group-A), and 232 who were not given intranasal steroids (Group-B) were made part of this research. Upon inclusion, all pre-operative demographics were documented. Patients in post-operative follow up period were assessed for condition of tympanic membrane and improvement of hearing ability. Results: In current study, post-operatively, in patients who were given intranasal steroids, graft take-up frequency was 227(97.84%) and residual perforation was 5(2.16%) was better than in patients who were not given intranasal steroids, which came to 224(96.55%) and 8(3.45%), respectively (p=0.399). In terms of post-operative WHO grade of hearing impairment distribution (p<0.001) and post-op hearing status (p=0.005) difference between patients who were given intranasal steroids and those not given intranasal steroids was statistically significant. Conclusion: Addition of intranasal steroid spray to the treatment regimen following tympanoplasty is provides better outcomes in terms of higher graft take-up frequency and an improvement in hearing from preoperative levels.

The Linkage of Grand Multiparity with Associated Risks During Pregnancy and Childbirth: A Cross-Sectional Study at Tertiary Care Hospital

Objective: To investigate the risk factors associated with grand multiparityn during pregnancy and childbirth. Study Design: Cross-sectional study. Place and Duration of Study: Gynaecology and Obstetrics Department, Pakistan Emirates Military Hospital, Rawalpindi, Pakistan from Dec 2022 to Oct 2023. Methodology: Three hundred twenty-two (n=322) women from the Pakistan Emirates Military Hospital, labor ward, Rawalpindi, Pakistan, gynecology and obstetrics department participated in this research. Primiparous, Multiparous, and grand multiparous females were included in the study for various demographic, maternal, and neonatal factors. Results: Primiparous women were higher in number than multiparous and GMP women [202(62.7%), 109(33.8%), and 11(3.4%), respectively). Among the risk factors associated with GMP, there was a greater incidence of miscarriage, i.e., 59.1% in GMP, and Gestational diabetes (27.2% in GMP) and spontaneous preterm delivery (45.4% in GMP) were the two most common problems linked with pregnancy in GMP women. The primary neonatal consequence observed was low birth weight (32.1% in PM), with a prevalence of 32.1%. However, the percentage of infants with an APGAR score below 7 at 5 minutes was higher in the GMP (36.3%). Conclusion: When compared to other parity groups, grand multiparous Pakistani women face the same risks of maternal and newborn problems. In GMP, advanced age may have a significant impact on pregnancy outcomes. Nonetheless, grand multiparty may not be outlawed, given that women receive adequate prenatal care.

Omparative Study Between Pulsed and Continuous Itraconazole for the Treatment of Onychomycosis

Objective: To compare efficacy of pulsed versus continuous daily oral Itraconazole in the treatment of onychomycosis. Study Design: Randomized Control Trial (ClinicalTrials.gov: NCT05567484). Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Abbottabad, Pakistan, from May to Dec 2021. Methodology: We enrolled 60 patients whose toenails showed signs of onychomycosis (crumbling nail plates, thicker nail beds, and yellowing). They were randomly divided into Group-A and Group-B, with 30 patients each. Group -A (Pulse Therapy) took two capsules of oral Itraconazole 100 mg twice weekly for one week every month for three months while Group-B (Continuous Therapy) received continuous oral 100 mg of Itraconazole once daily for 12 weeks continuously. Patients were subjected to an Onychomycosis Severity Index-based clinical evaluation. Results: In Group-A (Pulse Therapy), 25(83.3%) patients showed mycological cure whereas in Group-B (Continuous Therapy), 23(76.7%) patients showed mycological cure but difference in the efficacy of both drugs was not statistically significant (p-value=0.519). Conclusion: Pulsed therapy with Itraconazole and continuous Itraconazole therapy have comparable efficacies in treating dermatophyte toenail onychomycosis.

Comparison of Peripheral Neurotoxicity of Weekly Paclitaxel Versus Thrice Weekly Paclitaxel Chemotherapy Among Cancer Patients

Objective: To compare peripheral neurotoxicity of weekly Paclitaxel vs thrice weekly Paclitaxel chemotherapy among cancer patients. Study Design: Quasi-experimental study. Place and Duration of study: Oncology Department, Combined Military Hospital, Rawalpindi, Pakistan from Feb to Nov 2021. Methodology: We enrolled 200 patients with diagnosed malignancies taking Paclitaxel chemotherapy for more than three months and less than one year. They were divided into two groups: Group-A received Paclitaxel weekly while Group-B received this medication thrice weekly. Peripheral neurotoxicity was assessed by consultant oncologist on the basis of Eastern Cooperative Oncology Group score and patients in both groups were categorised into four grades from 0 to 3, on the basis of clinical symptoms described in ECOG score. Results: Out of 200 cancer patients prescribed Paclitaxel, 67(33.5%) were male while 133(66.5%) were female, 107(53.5%) received Paclitaxel weekly while 93(46.5%) received thrice weekly, 65(32.5%) had Grade 0 neuropathy, 90(45%) had Grade-I, 42(21%) had Grade-II while 03(1.5%) had Grade-III neuropathy. Dosage schedule was not associated with presence and severity of neurotoxicity. Conclusion: A significant number of cancer patients using Paclitaxel had presence of neuropathy in our study, regardless of weekly or thrice weekly dosing of Paclitaxel.

Children with Developmental Dysplasia of Hip - Our Experience of Outcome at a Tertiary Care Centre

Objective: To assess the operative outcome of children who underwent surgical management for developmental dysplasia hip at a tertiary care center. Study Design: Case series. Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Oct 2021. Methodology: This case series included 25 children who underwent triple procedure encompassing open reduction, femoral shortening and Salter’s pelvic osteotomy. Post-operative analysis of the clinical outcome was done using McKay’s classification and radiological assessment done using Severin’s classification. Results: Age of enrolled participants ranged from 02 to 07 years, mean age being 4.3±1.45 years, of which 8(32%) were male and 17(68%) were female. Mean pre-operative acetabular index was 40.3±3.38 while the mean post-operative acetabular index was 25.1±3.10. On follow-up, one child had subluxation while another had complete dislocation of the hip joint. Conclusion: Triple procedure with open reduction, femoral shortening and Salter’s osteotomy gives satisfactory results in patients aged 2 to 7 with substantial reduction in post-operative acetabular index.

Comparison of Self-Esteem in Patients Before and after Chemical Skin Peeling: An Interventional Study

Objective: To evaluate the self-esteem of patients undergoing chemical peeling for therapeutic reasons. Study Design: Pre-post Observational study. Place and Duration of Study: Department of Dermatology Combined Military Hospital, Multan Pakistan, from Mar to Aug 2021. Methodology: Forty-four patients were included in the study. After detailed history and clinical examination, self-esteem of all selected patients meeting the inclusion criteria was determined using RSES (Rosenberg Self-Esteem Score) score. Four sessions of chemical peeling were done using 30% salicylic acid with interval of 2 weeks between each session. (At week 0, 2, 4 and 6) All patients were advised the use of similar sun blocks during the treatment period. Post-peel RSES was re-assessed at 6 weeks. Results: The pre-peel RSES score (17.95±2.29) improved significantly after the sessions of chemical peeling. The post-peel RSES score was (19.47±1.95). p-value<0.001 Conclusion: Our study showed chemical peeling with 30% salicylic acid caused a significant enhancement of patients’ self- esteem, as significant difference in Rosenberg Self-Esteem Scores was seen before and after chemoexfoliation.

Carotid Atherosclerosis in Diabetic Patients and Associated Risk Factors

Objective: To determine the frequency of carotid atherosclerosis in diabetic patients and find out its association with various risk factors. Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Medicine, Combined Military Hospital, Nowshera Pakistan, from May to Jul 2022. Methodology: Patients, from both genders, were included in this study. Demographic information was obtained from all patients. Patients fulfilling the inclusion and exclusion criteria underwent carotid Doppler ultrasound after giving informed consent. High-resolution 7.5 MHz probe B mode ultrasonography and atherosclerosis was classified on the basis of grey-scale imaging. Results: A total of 100 patients were included in the study, out of which 74 were males and 26 were females. Among diabetics, 54% occurrence of atherosclerosis was seen, with a major share of 24% involvement of the left carotid artery, followed by 18% bilaterally, and 12% right carotid artery involvement. Carotid intimal media thickness increased with advancing age, with variable severity of mild in 32%, moderate in 14%, and severe stenosis in 3% of positive cases. Conclusion: There was a high association of carotid atherosclerosis with diabetes mellitus, having significant association with older age, hypertension, hyperlipidemia, and smoking.

Congenital Heart Disease among Neonates in a Neonatal Unit of a Tertiary Care Hospital

Objective: To determine the pattern of Congenital Heart Disease among neonates in a neonatal unit of a tertiary care hospital. Study Design: Cross-sectional study. Place and Duration of Study: The study was conducted at Neonatal Intensive Care Unit of Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2020 to Jan 2021. Methodology: A total of 287 participants were enrolled in the study using non-probability consecutive sampling. Echocardiogram was used as a tool to diagnose congenital heart disease. Results: Among 287 neonates, the mean weight was 2.36±0.73 kg with 49.5% being males and 50.5% females. Most of the neonates were delivered by Lower Segment Cesarean Section (227, 79.1%), while rest (60, 20.9%) were by spontaneous vaginal delivery. Neonates were mostly born at full term (159, 55.4%), followed by preterm (99, 34.5%), and early term (29, 10.1%). Only 34(11.8%) of the neonates showed any Congenital Heart Disease. Ventricular Septal Defect was the most common Congenital Heart Disease defect (15, 44.1%), followed by Patent Ductus Arteriosus (10, 29.4%) and Teratology of Fallot (4, 11.8%), while least common was Pulmonary Atresia (1, 2.9%). The relationship of Congenital Heart Disease with gender, mode of delivery, gestational age, and outcome of the neonate was found to be not significant. Conclusion: A small proportion of the neonates had Congenital Heart Disease with no significant relationship with gender, delivery mode, gestational age, and outcome of the neonate.

Association Between Helicobacter Pylori Infection and Vitiligo

Objective: To determine the association between Helicobacter pylori infection and vitiligo in patients visiting a tertiary care hospital of Punjab, Pakistan. Study Design: Case control study. Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Lahore Pakistan, from Oct 2021 to Mar 2022. Methodology: A total of 60 adult vitiligo patients and 60 healthy controls, of both genders, were included in the study. Their ages ranged from 18-70 years. All study participants underwent stool antigen test to detect the presence of Helicobacter pylori antigen. Results: The mean age of the cases was 43.47±8.16 years whereas it was 40.08±7.42 years in the controls. The mean duration of disease was 4.133±1.21 months. H. pylori Infection was detected in 36(60%) cases as compared to 11(18.3%) controls (p<0.001, OR=6.68); which was found to be statistically significant. Conclusion: Significant association between H. pylori infection and vitiligo was demonstrated in the current study.

Comparison of Upper Lip Bite Test and Thyromental Distance with Other Airway (Malampatti and Inter Incisor Distance) Assessment Tests for Predicting Difficult Endotracheal Intubation

Objective: To study the ability of upper lip bite test and thyromental distance to predict difficult endotracheal intubation when compared to standard assessment tests such as Mallampati and inter incisor distance. Study Design: Cross-sectional validation study. Place and Duration of Study: Department of Anesthesiology, Pak-Emirates Military Hospital, Rawalpindi, Pakistan, Sep 2020 to Mar 2021. Methodology: We studied a total of 50 patients who reported for the administration of general anesthesia. All patients underwent evaluation with modified Mallampati test, upper lip bite test and thyromental distance test. All participants underwent subsequent intubation according to a standard protocol. The researcher documented difficult intubations. Results: We found the upper lip bite test to have a sensitivity of 75.7%, a specificity of 84.2%, and a diagnostic accuracy of 78.6%. Thyromental distance had a sensitivity, specificity, and diagnostic accuracy of 51.4%, 78.9% and 60.7%, respectively while the modified Mallampati had a sensitivity of 64.9%, 89.5%, specificity and a diagnostic accuracy of 73.2%. Conclusion: Upper lip bite test is a useful bedside assessment tool with which to predict the probability of a difficult endotracheal intubation. Height to thyromental distance ratio test is also acceptable for rapid assessment.

Barriers to Bedside Teaching: A Cross-Sectional Comparative Survey of Students and Faculty

Objective: To identify the barriers to bedside teaching among students and clinical faculty. Study Design: Cross sectional comparative study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2019 to Jun 2020. Methodology: The study participants included undergraduate students, postgraduate students and clinical faculty members. A self-designed questionnaire listing 25 common barriers to bedside teaching was distributed after pilot testing. Results: The total number of participants was 160, out of which 78(48.75%) were males, and 82(51.25%) were females. There were 40 respondents in each of the categories of consultants, postgraduate trainees and 80 in the undergraduate student category. Twenty consultants (50%) were from Medicine and Allied specialties, 10(25%) from Surgical and Allied specialties while 10(25%) did not mention their specialty. Majority of postgraduate trainees 33(82.5%) were from Medicine and Allied specialties. Significant difference (p-value=0.004) was revealed among students and faculty regarding barriers to bedside teaching. Bedside teaching was accorded more value by faculty (p-value=0.026). Faculty deemed ambiguity in curriculum as a more important barrier as compared to the students (p-value=0.037). Common barriers identified by students were inadequate time allocation (p-value<0.001), large student groups (p-value<0.001), performance pressure on faculty (p-value=0.004), lack of problem solving skill teaching (p-value=0.028) and insufficient feedback (p-value=0.044). Conclusion: Students as well as faculty value the role of bedside teaching in medical education but are cognizant of significant barriers in its execution. There are a number of common impediments that are narrated by both groups but students accord more importance to larger gro

Comparison of Efficacy of Intralesional Triamcinolone and Combination of Triamcinolone With 5-Fluorouracil in The Treatment of Keloid

Objectives: To study the efficacy of intralesional Triamcinolone and combination of Triamcinolone with 5-Fluorouracil in the treatment of keloid in terms or reduction in height of lesion. Study Design: Cross-sectional analytical study. Place and Duration Of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi, Jul 2020 to Mar 2021. Methodology: A total of 56 patients suffering from keloid formation were included in our study. Patients who had received previous treatment for keloids were excluded. All patients were assessed for volume of keloid before and after 8 weeks of intervention. Group A patients received therapy with intralesional Triamcinolone 4 mg with 5-Fluorouracil 45 mg once weekly while Group B patients received intralesional Triamcinolone 10 mg alone once weekly. Patients were followed up after 8 weeks to ascertain mean reduction in volume of keloid post-intervention. Data was analyzed by SPSS 26.0. Results: The difference in total volume post-treatment between the two groups was significant, (p=0.001), however the difference in total volume reduction across both groups with treatment was not significant, (p=0.382). Treatment was effective in 23(82.1%) of with the combination of Triamcinolone and 5-Fluorouracil, while this figure was only 16(57.1%) with Triamcinolone alone, (p=0.042). Conclusion: The combination of intralesional Triamcinolone and 5-Fluorouracil is superior to intralesional Triamcinolone alone in the treatment of keloids, and may be considered for therapy in patients who do not respond to treatment with single agents.

Comparison of Port-Site Hernia Development With And Without Use of Dilator For Gall Bladder Extraction Site in Elective Laparoscopic Cholecystectomy

ABSTRACT Objective: To compare the incidence of port-site hernia with and without use of dilator for extraction of gall bladder in elective laparoscopic cholecystectomy. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Bahawalpur Pakistan, from Oct 2019 to Oct 2021. Methodology: Sixty patients scheduled to undergo laparoscopic cholecystectomy were included in the study based on the inclusion and exclusion criteria. Patients were divided into two equal groups (n=30). Group-A included patients in whom dilator was used and Group-B had those patients in whom dilator was not used. All patients were followed up by clinical examination for development of hernia at the port-site for extraction of gall bladder for 18-24 months postoperatively. Frequency of clinical development of gall bladder extraction port-site hernia was noted for every group. Result: Mean age of the patients was 42.90±14.12 years with an age range of 22 to 85 years. Of all the patients 9(18%) were male and 51(82%) patients were females. In Group-A, one patient developed port-site hernia clinically whereas in Group-B no patients developed this condition. The p-value was found to be 0.31. These results are statistically insignificant showing that use of dilator in elective laparoscopic cholecystectomy does not increase the incidence of port-site hernia significantly. Conclusion: Use of dilator does not significantly affect the incidence of development of port-site hernia from where gall bladder is extracted.

Current antibiotic resistance of Enterobacteriaceae isolated at Avicenna military hospital of Marrakesh

Enterobacteriaceae are bacteria found in the digestive system, known for causing infections and displaying antibiotic resistance. The World Health Organization (WHO) identifies strains resistant to third-generation cephalosporins and carbapenems as priority pathogens. This study, conducted at Avicenne Military Hospital of Marrakech, aimed to assess the epidemiological and antibiotic resistance profiles of Enterobacteriaceae over a two-year period (May 2020 - April 2022) to inform updated antibiotic use recommendations. This retrospective study analyzed 1,626 positive bacterial isolates from various hospital departments, including medical, surgical, intensive care, emergency units, and external samples. Of these, 1,163 (71.5%) were Enterobacteriaceae, predominantly Escherichia coli, Klebsiella pneumoniae, and Enterobacter cloacae, primarily isolated from urine, pus, and blood cultures. Antibiotic resistance was assessed, revealing that 614 (52.8%) of Enterobacteriaceae were extended-spectrum beta-lactamase producers (ESBL-E), and 115 (9.9%) were carbapenemase-producing Enterobacteriaceae (CPE). The study’s findings align with existing literature, showing a higher prevalence of Enterobacteriaceae in males and frequent isolation of Escherichia coli. The rise in multidrug-resistant Enterobacteriaceae, particularly ESBL-E and CPE, poses risks such as therapeutic failure, increased morbidity and mortality, and significant economic impacts. To address this, the study emphasizes the importance of early detection, infection control measures, responsible antibiotic prescribing, and collaborative efforts across hospital departments to reduce the spread of resistant strains.

Monoclonal gammapathies: Epidemiological, immunochemical and etiological analysis of a series of 50 cases

During the period from September 2022 to January 2023, 50 cases of monoclonal gammopathy (GM) were collected at the Avicenne military hospital in Marrakech. The average age of the patients was 62 years. Thirty patients were male and 20 were female. The etiological diagnosis could be established for the 50 observations: 5 were classified as GM of undetermined significance (GMSI), 42 were classified as myeloma, two case of Waldenström's disease and one case of AL amyloidosis. The clinical symptomatology was dominated by bone pain in 78% of patients with a deterioration in general condition in 43%. The most frequently found biological abnormalities were anemia in 62% of patients, renal failure in 48% of patients and 19% had hypercalcemia. A monoclonal peak was found in the electrophoreses of 45 patients (90%), of whom 6 migrated to the beta zone and 39 migrated to the gamma zone. The IgG Kappa isotype was the most frequent with a rate of 56%, followed by IgG Lambda (27%), IgA Kappa (8%), IgA Lambda (3%), IgM Lambda (3%) and lambda free light chains (3%).

Acinetobacter baumannii: Epidemiological profile and antibiotic resistance in patients from the intensive care unit of Avicenne military hospital in Marrakech

Acinetobacter baumannii: Epidemiological profile and antibiotic resistance in patients from the intensive care unit of Avicenne military hospital in Marrakech