Introduction: Ankle joint and foot injuries are among the commonest injuries seen at the Accident and Emergency Department of any hospital. Within the United States it is the second most common musculoskeletal injury seen by physicians. Assessment of these injuries is done clinically and when deemed necessary a radiograph is requested. Studies have shown that radiographs are ordered in over 95% of cases yet the prevalence of fractures is in the range of 15-20%. This means that more than 80% of patients are exposed to unnecessary radiation. The Ottawa ankle rules have been designed to reduce the need for performing X-ray examinations in these patients and thus reduce healthcare costs significantly. The rules have not been utilised or validated in an african set-up within a private institution similar to our setting and yet could significantly reduce costs and time in management of these patients. This study thus aimed to validate the Ottawa ankle rules within our local setting and assess the impact of introduction of the rules.
Materials and methods: The study was a cross sectional study done within the setting of Aga Khan University Hospital Accident and Emergency Department and the orthopaedic outpatient clinics. The Physicians were trained on how to use the rules. After obtaining consent, patients were enrolled in the study, before examination based on the criteria set out in the Ottawa rules was carried out. Subsequently they were sent for radiographs to confirm the presence or absence of a fracture. Data collected was entered into a data sheet and analysed for sensitivity, specificity, positive and negative predictive values when using the Ottawa ankle rules.
Results: The study recruited 175 patients over a six month period. There were 27 fractures with an incidence of 15.0%. The decision rule had a sensitivity of 96.3% (79.1 to 99.8%) and specificity of 57.4% (49.0 to 65.4%). The negative predictive value was 98.8% (92.7 to 99.9%). Application of these rules showed a potential of reducing the requested radiographs by 43.0%.
Conclusion: The study results have shown that implementation of the rules will results in significant savings in cost, time and unnecessary radiation exposure.
مولانا طفیل احمد منگلوری سب سے آخر میں رنج واندوہ کے گہرے جذبات کے ساتھ ہمیں اپنے مخدوم اوربزرگ مولانا سید طفیل احمدصاحب منگلوری کے حادثۂ وفات کاماتم کرنا ہے جو ۳۰؍ مارچ کو پیش آیا، مولانا کی عمر اس وقت تقریباً اسّی ۸۰ برس کی تھی۔ سرسید کے زمانہ میں مدرسۃ العلوم علی گڑھ میں تعلیم پائی تھی۔عربی کی استعداد معمولی تھی لیکن انگریزی اوراردو دونوں زبانوں میں بے تکلف تحریر وتقریر کی قدرت رکھتے تھے ۔مطالعہ نہایت وسیع تھا۔قومی اورسیاسی مسائل میں بڑی بصیرت رکھتے تھے ۔چھوٹے بڑے سینکڑوں مقالات اوررسائل کے علاوہ مرحوم کی ایک عظیم الشان تصنیفی یادگار ’’مسلمانوں کاروشن مستقبل ‘‘ہے۔انگریزی تعلیم یافتہ طبقہ سے تعلق رکھنے کے باوصف صورت وسیرت اوروضع قطع کے اعتبارسے بالکل ٹھیٹ مُلّا معلوم ہوتے تھے۔مزاج میں انتہا درجہ سادگی اورانکساری تھی۔ ساری عمر مسلمانوں کے لیے نہایت ٹھوس اور تعمیری کام کرتے رہے لیکن خودنمائی اور شہرت طلبی کاکہیں آس پاس بھی گزر نہ ہوا تھا۔اخلاق وعادات کے لحاظ سے اسلامی شرافت ونیک نفسی کے پیکر تھے۔ حقیقت یہ ہے کہ اس اخلاق کے بزرگ ہماری نظروں سے بہت کم گزرے ہیں۔ایک زمانہ میں جوازِ سود کے قائل تھے لیکن بعدمیں اس سے رجوع کرکے علمائے حق کے ہی ساتھی ہوگئے تھے ۔ایک عرصہ سے چند درچند امراض کاشکار تھے لیکن اپنے فرائض وواجباتِ زندگی کو ادا کرنے میں آخردم تک جوانوں سے بھی زیادہ باہمت اورمستعدرہے۔ دعاہے کہ اﷲ تعالیٰ ان کی قبر کو عنبریں کرے اور نعمائے جنت سے بہرہ اندوز فرمائے۔ آمین۔ [مئی ۱۹۴۶ء]
Ahmad bin zeni Dahlan was born in Mecca on 1231 AH. He was a great scholar of Tafseer, Hadith, Fiqh and Sirah. His book "السیرۃالنبویۃ "is a wonderful piece of writing on sirah of Holy Prophet (PBUH). This book has got a significant place in sirah literature. In this book, Author discusses almost all the aspects of the life of Prophet Muhammad (PBUH), like his attributes, miracles, incidents and battles etc. One of zeni dahlan’s modes of sirah writing is that he derives juristic implications and lessons from the events of sirah which can be called Fiqh al sirah in modern terminology. This article intends to explore the mode of Fiqh al sirah in respect with “Al sirah al nabawiyyah” written by Ahmad bin Zeni Dahlan.
Human Cytomegaloviruses and Herpes Simplex Viruses are the major cause of serious viral complications in pregnant women. Conventional screening methods that is ELISA for detecting Human Cytomegalovirus (HCMV) and Herpes Simplex virus (HSV) tend to be slow and insensitive. Therefore in this work, a rapid Real Time PCR-based assay was designed to detect CMV and HSV which are responsible for causing various viral infections among pregnant women in Khyber Pakhtunkhwa. The present study aimed to compare the specificity and sensitivity of the PCR-based assay with ELISA based assay in the diagnosis of HCMV and HSV infections in pregnant women in Khyber PakhtunKhwa. In order to check the validity of Real time PCR technique in the early diagnosis of the infection, serologicalresults were compared to the results of Real Time PCR based detection of HCMV and HSV from serum samples. Our study revealed that among the ELISA screened 175 positive sera samples i.e 81 (70%) of CMV and 34(30%) of HSV, while 17 (10%) had positive results for CMV DNA and 7(4%) had HSV DNA through real-time PCR. Real time PCR was more sensitive and reliable method in diagnosis of CMV and HSV infections in pregnant women in this comparative study.