Objective: This study was conducted to study pattern of clinical, hematological and biochemical parameters in children with dengue fever. Method: A prospective comparative analysis of 120 suspected febrile children was done at social security teaching hospital in Lahore from September to November 2021. The study participants satisfying the inclusion criteria were registered for further assessment. Clinical findings were logged, hematological and biochemical parameters tests were performed. Results: In this study, there were 56.66 % male participants and 43.33 % female participants. The most common clinical manifestation was fever (100%) followed by vomiting 85.4%, abdominal pain 68.75% and body pain / myalgia in 52.08% cases. Most frequent hematological parameter wasthrombocytopenia (93.75%) followed by leucopenia 70.83% and the elevated levels of liver transaminases were seen in 68.75% subjects. Conclusion: This study focuses on the patterns of laboratory parameters of pediatric dengue viral infections .This might prove helpful for the pediatricians to suspect, diagnose and manage the dengue virus infection.
{"title":"Pattern of Haematological and Biochemical Parameters of Dengue Virus Infection in Children","authors":"Shumaila Shahzeen, Khalid Mehmood Awan, Muhammad Azhar Farooq, Sidra Sonia Chaudhary, Mohsin Ali, Mehwish Ejaz","doi":"10.51273/esc23.2519213","DOIUrl":"https://doi.org/10.51273/esc23.2519213","url":null,"abstract":"Objective: This study was conducted to study pattern of clinical, hematological and biochemical parameters in children with dengue fever. Method: A prospective comparative analysis of 120 suspected febrile children was done at social security teaching hospital in Lahore from September to November 2021. The study participants satisfying the inclusion criteria were registered for further assessment. Clinical findings were logged, hematological and biochemical parameters tests were performed. Results: In this study, there were 56.66 % male participants and 43.33 % female participants. The most common clinical manifestation was fever (100%) followed by vomiting 85.4%, abdominal pain 68.75% and body pain / myalgia in 52.08% cases. Most frequent hematological parameter wasthrombocytopenia (93.75%) followed by leucopenia 70.83% and the elevated levels of liver transaminases were seen in 68.75% subjects. Conclusion: This study focuses on the patterns of laboratory parameters of pediatric dengue viral infections .This might prove helpful for the pediatricians to suspect, diagnose and manage the dengue virus infection.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Abbas, Zeemal Hayyat, Shazia Naz, Abeer Qadir, Hassan Abbas, Roshnak Azam, Muhammad Ali Khan
OBJECTIVES: To determine the role of zinc supplementation in children with watery diarrhoea. The objective was to compare the mean change in frequency of stool with zinc supplementation versus placebo in children with acute diarrhoea in addition to standard treatment. METHOD: It was a randomized controlled trial conducted in Paediatric Department, Punjab Rangers Teaching Hospital, Lahore over 6 months. 68 children of both genders aged under 5 years who presented with acute diarrhoea were sub-divided into two equal groups; Group -A received oral zinc with standard management while those in Group-B received standard management alone. Frequency of stools was recorded after 72 hours, mean change calculated and then compared between the groups. RESULTS: Mean duration of acute diarrhoea was 3.81±1.56 days. Both the study groups were comparable in terms of mean frequency of stools at presentation (7.71±2.76 vs. 7.79±2.67; p-value=0.894). However, after 72 hours, the mean frequency of stools was significantly lower in children receiving additional zinc supplementation as compared to placebo (3.94±2.84 vs. 5.50±2.77; p-value=0.025). The mean change in the frequency of stools was significantly higher in the zinc group as compared to placebo group (3.76±0.89 vs. 2.29±0.63; p-value<0.001). CONCLUSION: In this study, zinc supplementation was found superior to conventional management of children presenting with acute diarrhoea evident from considerably greater reduction in the mean frequency of stools. The low cost, wide-spread availability and ease of administration advocate the preferred use of zinc in the management of such patients.
目的:确定锌补充剂在儿童水样腹泻中的作用。目的是比较在标准治疗的急性腹泻患儿中，补锌组与安慰剂组大便频率的平均变化。方法:在拉合尔旁遮普邦游骑兵教学医院儿科进行为期6个月的随机对照试验。68名5岁以下出现急性腹泻的男女儿童被再分成两组;a组患者口服锌并给予标准管理，b组患者单独给予标准管理。记录72 h后大便次数，计算各组平均变化量，并进行比较。结果:急性腹泻的平均持续时间为3.81±1.56 d。两个研究组在就诊时的平均大便频率方面具有可比性(7.71±2.76 vs 7.79±2.67;假定值= 0.894)。然而，在72小时后，与安慰剂相比，额外补充锌的儿童平均大便频率显著降低(3.94±2.84 vs 5.50±2.77;假定值= 0.025)。锌组大便频率的平均变化明显高于安慰剂组(3.76±0.89 vs 2.29±0.63;p-value< 0.001)。结论:在这项研究中，锌补充剂被发现优于急性腹泻患儿的常规治疗，从平均排便频率显著降低可见。锌的低成本，广泛的可获得性和易于管理提倡优先使用锌在这类患者的管理。
{"title":"Comparison of Mean Change in Frequency of Stool with Zinc Supplementation versus Placebo in Children with Acute Diarrhoea","authors":"Mohammad Abbas, Zeemal Hayyat, Shazia Naz, Abeer Qadir, Hassan Abbas, Roshnak Azam, Muhammad Ali Khan","doi":"10.51273/esc23.251929","DOIUrl":"https://doi.org/10.51273/esc23.251929","url":null,"abstract":"OBJECTIVES: To determine the role of zinc supplementation in children with watery diarrhoea. The objective was to compare the mean change in frequency of stool with zinc supplementation versus placebo in children with acute diarrhoea in addition to standard treatment. METHOD: It was a randomized controlled trial conducted in Paediatric Department, Punjab Rangers Teaching Hospital, Lahore over 6 months. 68 children of both genders aged under 5 years who presented with acute diarrhoea were sub-divided into two equal groups; Group -A received oral zinc with standard management while those in Group-B received standard management alone. Frequency of stools was recorded after 72 hours, mean change calculated and then compared between the groups. RESULTS: Mean duration of acute diarrhoea was 3.81±1.56 days. Both the study groups were comparable in terms of mean frequency of stools at presentation (7.71±2.76 vs. 7.79±2.67; p-value=0.894). However, after 72 hours, the mean frequency of stools was significantly lower in children receiving additional zinc supplementation as compared to placebo (3.94±2.84 vs. 5.50±2.77; p-value=0.025). The mean change in the frequency of stools was significantly higher in the zinc group as compared to placebo group (3.76±0.89 vs. 2.29±0.63; p-value<0.001). CONCLUSION: In this study, zinc supplementation was found superior to conventional management of children presenting with acute diarrhoea evident from considerably greater reduction in the mean frequency of stools. The low cost, wide-spread availability and ease of administration advocate the preferred use of zinc in the management of such patients.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Saba Sikandar, Naseer Ahmad Chaudhry, Muhammad Imran Rahbar, Asim Riaz, Muhammad Mohsin Kamal, Farhan Ali
Objectives: To evaluate the cervical inclination and craniocervical posture (CCP) in a sample of Class II Division 1 malocclusion with different vertical patterns among adult population in Lahore. Methods: A total of 70 adult skeletal Class II division 1 cases (ANB0 > 4) with Dental Class II malocclusion (molar relation half cusp or full cusp Class II) and Overjet > 5mm, were enrolled in this study. Clinical examination and lateral cephalograms taken in natural head position were traced to classify the malocclusion, determine vertical pattern and evaluation of craniocervical posture Results: Results of the study showed that extended craniocervical posture (forward cervical inclination with backward head rotation) was found in 47.1 % of the study group and was significantly correlated to the vertical pattern of the face (r = 0.496, p =0.000). This indicated that the CCP is not only related to sagittal craniofacial relations but also vertical pattern of the face and as the vertical pattern of face increased the cervical spine inclined forward and the head rotated backwards on spine. Flexed head posture was found to be the least prevalent. Subjects with high vertical pattern of facial development had extended CCP whereas subjects with normal vertical pattern mainly had normal CCP Conclusion: Results of this study suggest a significant relationship between Type of malocclusion and craniocervical posture. There was a moderately strong relationship between vertical pattern of the patient and cervical inclination and craniocervical posture which was highly significant.
目的:评价拉合尔地区成人不同垂直形态ⅱ类1类错颌的颈椎倾度和颅颈位(CCP)。方法:70例成人骨骼II类1分病例(ANB0 >4)牙齿II类错颌(磨牙关系半尖或全尖II类)和Overjet;5mm，被纳入本研究。结果:研究结果显示，研究组中有47.1%的患者出现颈前倾、头部后旋的颅颈伸展体位(颈椎前倾、头部后旋)，且与面部垂直体位有显著相关性(r = 0.496, p =0.000)。这表明CCP不仅与颅面矢状面关系有关，而且与面部垂直模式有关，随着面部垂直模式的增加，颈椎向前倾斜，头部在脊柱上向后旋转。头屈是最不常见的姿势。结论:本研究结果提示错颌类型与颅颈体位之间存在显著的关系。患者的垂直模式与颈椎倾斜度和颅颈姿势之间存在中等强度的关系，这是非常显著的。
{"title":"Relationship Between Craniocervical Posture and Vertical Face Pattern in Class II Division 1 Malocclusion","authors":"Saba Sikandar, Naseer Ahmad Chaudhry, Muhammad Imran Rahbar, Asim Riaz, Muhammad Mohsin Kamal, Farhan Ali","doi":"10.51273/esc23.2519221","DOIUrl":"https://doi.org/10.51273/esc23.2519221","url":null,"abstract":"Objectives: To evaluate the cervical inclination and craniocervical posture (CCP) in a sample of Class II Division 1 malocclusion with different vertical patterns among adult population in Lahore. Methods: A total of 70 adult skeletal Class II division 1 cases (ANB0 > 4) with Dental Class II malocclusion (molar relation half cusp or full cusp Class II) and Overjet > 5mm, were enrolled in this study. Clinical examination and lateral cephalograms taken in natural head position were traced to classify the malocclusion, determine vertical pattern and evaluation of craniocervical posture Results: Results of the study showed that extended craniocervical posture (forward cervical inclination with backward head rotation) was found in 47.1 % of the study group and was significantly correlated to the vertical pattern of the face (r = 0.496, p =0.000). This indicated that the CCP is not only related to sagittal craniofacial relations but also vertical pattern of the face and as the vertical pattern of face increased the cervical spine inclined forward and the head rotated backwards on spine. Flexed head posture was found to be the least prevalent. Subjects with high vertical pattern of facial development had extended CCP whereas subjects with normal vertical pattern mainly had normal CCP Conclusion: Results of this study suggest a significant relationship between Type of malocclusion and craniocervical posture. There was a moderately strong relationship between vertical pattern of the patient and cervical inclination and craniocervical posture which was highly significant.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"311 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Ribavirin because of its genotoxic quality causes adverse effects on the gonads in a temporary way that has been studied on the testicular tissues of various experimental animals. Objectives: To study the changes in mean testes weight of albino rats after treatment with Ribavirin in different doses at different time points. Methods: The research lab and the animal house of the Anatomy Department of Postgraduate Medical Institute, Lahore was the place of this experimental study where 72 adult male albino rats were divided into 4 groups: A, B, C and D; with 18 rats each. Intraperitoneal injections of distilled water were given to control groupAand Ribavirin in the doses of 20mg, 100mg and 200mg/kg body weight, as a single dose for 5 days was administered to experimental groupsB,Cand D. Every group wasfurthersplit up into 3 subgroups according to the sacrificial days 20th, 40th and 60th since after administration of the last dose of the drug. On each sacrificial day, 6 rats were randomly selected from a group and sacrificed. Their testes were dissected out and weighed after the removal of the epididymis. The mean testes weight was also calculated. Results: In comparison with the control groups on the 20th and 40th sacrificial days all experimental groups showed a decrease in the values of mean testes weight (MTW) which was more in medium and high-dose treated groups due to the toxic effects of Ribavirin on rat's testes. On the 60th sacrificial day, only low-dose treated groups showed the values of MTW very close to that of controls due to the reversibility of changes induced by Ribavirin on rat's testes. On the same time point medium and high dose treated groups still had reduced values of MTWin comparison with controls due to the late recovery. Conclusion: Apatient on Ribavirin therapy must be informed by a physician regarding its toxic effects on his reproductive health and the reversibility of its gonadotoxicity after discontinuation of this drug.
{"title":"Reversible Effects of Ribavirin on the TesticularWeight of Albino Rats","authors":"Alvia Batool, Faizia Batool, Godfrey Paul William, Maryam Fatima, Fozia Farzana","doi":"10.51273/esc23.251924","DOIUrl":"https://doi.org/10.51273/esc23.251924","url":null,"abstract":"Introduction: Ribavirin because of its genotoxic quality causes adverse effects on the gonads in a temporary way that has been studied on the testicular tissues of various experimental animals. Objectives: To study the changes in mean testes weight of albino rats after treatment with Ribavirin in different doses at different time points. Methods: The research lab and the animal house of the Anatomy Department of Postgraduate Medical Institute, Lahore was the place of this experimental study where 72 adult male albino rats were divided into 4 groups: A, B, C and D; with 18 rats each. Intraperitoneal injections of distilled water were given to control groupAand Ribavirin in the doses of 20mg, 100mg and 200mg/kg body weight, as a single dose for 5 days was administered to experimental groupsB,Cand D. Every group wasfurthersplit up into 3 subgroups according to the sacrificial days 20th, 40th and 60th since after administration of the last dose of the drug. On each sacrificial day, 6 rats were randomly selected from a group and sacrificed. Their testes were dissected out and weighed after the removal of the epididymis. The mean testes weight was also calculated. Results: In comparison with the control groups on the 20th and 40th sacrificial days all experimental groups showed a decrease in the values of mean testes weight (MTW) which was more in medium and high-dose treated groups due to the toxic effects of Ribavirin on rat's testes. On the 60th sacrificial day, only low-dose treated groups showed the values of MTW very close to that of controls due to the reversibility of changes induced by Ribavirin on rat's testes. On the same time point medium and high dose treated groups still had reduced values of MTWin comparison with controls due to the late recovery. Conclusion: Apatient on Ribavirin therapy must be informed by a physician regarding its toxic effects on his reproductive health and the reversibility of its gonadotoxicity after discontinuation of this drug.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: The present study was designed to evaluate the extent to which students were benefited from active learning approach of teaching. It was intended to check the usefulness of whiteboard as a teaching medium instead of more commonly used audio-visual aids like PowerPoint. Method: It is a cross-sectional descriptive questionnaire-based study. Interactive teaching strategy was used instead of diagnostic lecture. Instructor used only whiteboard as a teaching medium encouraging interactivity. At the end of the session, 150 students filled the form which comprised of 12 statements regarding evaluation of the instructor. Students were supposed to respond to them according to 5-point Likertscale. Only students≥18 Years and those willing to fill the form were included in the study. Exclusion criteria included students not willing to fill the form and those returning incompletely filled forms. The reliability of form was checked using Cronbach's Alpha which came out to be 0.8 proving it to be reliable. Results: The average overall score for the proforma was 54.5±3.901 out of 60. This showed that there was more positive perception about the instructor than negative after employing active learning approach. Conclusion: From the results of thisstudy, it can be concluded that active learning approach using whiteboard along with enhanced student interactivity is an effective way of teaching
{"title":"Impact of Active Learning Approach on Students Evaluation of Teaching","authors":"Tehreem Zulfiqar, Sadia Maqsood, Maria ., Bisma Fatima Aslam, Mariyam Iftikhar Piracha, Usman Ilyas","doi":"10.51273/esc23.2519222","DOIUrl":"https://doi.org/10.51273/esc23.2519222","url":null,"abstract":"Objective: The present study was designed to evaluate the extent to which students were benefited from active learning approach of teaching. It was intended to check the usefulness of whiteboard as a teaching medium instead of more commonly used audio-visual aids like PowerPoint. Method: It is a cross-sectional descriptive questionnaire-based study. Interactive teaching strategy was used instead of diagnostic lecture. Instructor used only whiteboard as a teaching medium encouraging interactivity. At the end of the session, 150 students filled the form which comprised of 12 statements regarding evaluation of the instructor. Students were supposed to respond to them according to 5-point Likertscale. Only students≥18 Years and those willing to fill the form were included in the study. Exclusion criteria included students not willing to fill the form and those returning incompletely filled forms. The reliability of form was checked using Cronbach's Alpha which came out to be 0.8 proving it to be reliable. Results: The average overall score for the proforma was 54.5±3.901 out of 60. This showed that there was more positive perception about the instructor than negative after employing active learning approach. Conclusion: From the results of thisstudy, it can be concluded that active learning approach using whiteboard along with enhanced student interactivity is an effective way of teaching","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"66 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969200","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the effectiveness of PRP (Platelet Rich Plasma), and to compare with Triamcinolone 40mg (Steroid) on functional activity, stiffness and pain in Grade I & II Knee OA. Method: A comparative cross sectional study was conducted at outdoor departments of Advanced Pain Relief Center, Lifeline Hospital Lahore (Pakistan) from January 2022 to December 2022. The present study included a total of 235 participants, out of whom 190 individuals were deemed eligible for inclusion based on predetermined criteria. The remaining 45 participants were excluded from the study due to non-adherence to eligibility criteria and lack of approval from institutional ethical committee. Out of a total of 190 subjects enrolled in the study, 64 (33%) were characterized as male while 126 (67%) were classified as female. The participants' mean age was 53.5 ± 6.4 years. Alternative patients were treated with intra-articular injection of either triamcinolone 40mg or PRP. Patients randomized in Steroid group (n=95) were gives intraarticular 40mg Triamcinolone acetate (1ml) along with 2ml of Local anaesthetic Lignocaine 1%, whereas patients randomized in PRP group (n=95) were injected 5ml PRP. “The Western Ontario and McMaster Universities Arthritis Index” (WOMAC) Scale was used for functional disability and pain before and after the therapy for the targeted knee joint at the baseline 1 week, 5 weeks, 8 weeks and 20 weeks follow-ups. Visual Analogue Scale (VAS) scores were also recorded for pain. Data analysis was done by using SPSS version 20. Results: There wasn't any serious adverse effect observed during the study and follow-ups. 25 WOMAC functional activity scale showed statistically significant improvement with Intraarticular knee injection of PRP compared to steroids(40.64±1.87vs.27.17±6.01)(p=0.000). WOMACpainscaleresultsalsodemonstrated that intraarticular knee injection of PRP was more effective in reducing knee pain than steroids (p = 0.000) at 20 weeks follow-up. Conclusion: On the basis of the results of our study, we concluded that platelet rich plasma is more effective than intra-articular steroids in terms of improvement in functional activity and reduction of pain in patients with Grade I & II knee osteoarthritis. Both PRPand steroid intraarticular injections are safe.
目的:评价富血小板血浆(PRP)的疗效，并比较曲安奈德酮40mg(类固醇)对ⅰ级患者功能活动、僵硬和疼痛的影响;II .膝关节关节炎。方法:于2022年1月至2022年12月在巴基斯坦拉合尔生命线医院高级疼痛缓解中心室外科室进行对比横断面研究。本研究共纳入235名参与者，其中190人根据预先确定的标准被认为有资格纳入。其余45名受试者因不符合资格标准和缺乏机构伦理委员会的批准而被排除在研究之外。在总共190名受试者中，64名(33%)被归类为男性，126名(67%)被归类为女性。参与者平均年龄为53.5±6.4岁。另一组患者关节内注射曲安奈德40mg或PRP。类固醇组(n=95)随机给予关节内注射醋酸曲安奈德酮(1ml) 40mg，同时给予1%局部麻醉剂利多卡因2ml; PRP组(n=95)随机给予PRP 5ml。在基线随访1周、5周、8周和20周时，采用“西安大略省和麦克马斯特大学关节炎指数”(WOMAC)量表对目标膝关节治疗前后的功能残疾和疼痛进行评估。同时记录疼痛的视觉模拟评分(VAS)。数据分析采用SPSS version 20。结果:研究及随访期间均未见严重不良反应。25膝关节内注射PRP组与类固醇组相比，WOMAC功能活动量表改善有统计学意义(40.64±1.87vs.27.17±6.01)(p=0.000)。womacpain scale的结果还表明，在20周的随访中，膝关节内注射PRP比类固醇更有效地减轻膝关节疼痛(p = 0.000)。结论:根据我们的研究结果，我们得出结论，在改善I级患者的功能活动和减轻疼痛方面，富血小板血浆比关节内类固醇更有效;II膝骨关节炎。prp和类固醇关节内注射都是安全的。
{"title":"Efficacy of Intraarticular Knee Injection of PRP (Platelet Rich Plasma) vs Steroid (Triamcinolone Acetate) for the Treatment of Primary Knee Osteoarthritis Grade I & II","authors":"Sarwat Nazir, Noman Tariq, Shahid Rasool Dar, Waqas Ashraf Chaudhary, Waseem Younis, Adeel Shahid","doi":"10.51273/esc23.2519215","DOIUrl":"https://doi.org/10.51273/esc23.2519215","url":null,"abstract":"Objective: To assess the effectiveness of PRP (Platelet Rich Plasma), and to compare with Triamcinolone 40mg (Steroid) on functional activity, stiffness and pain in Grade I & II Knee OA. Method: A comparative cross sectional study was conducted at outdoor departments of Advanced Pain Relief Center, Lifeline Hospital Lahore (Pakistan) from January 2022 to December 2022. The present study included a total of 235 participants, out of whom 190 individuals were deemed eligible for inclusion based on predetermined criteria. The remaining 45 participants were excluded from the study due to non-adherence to eligibility criteria and lack of approval from institutional ethical committee. Out of a total of 190 subjects enrolled in the study, 64 (33%) were characterized as male while 126 (67%) were classified as female. The participants' mean age was 53.5 ± 6.4 years. Alternative patients were treated with intra-articular injection of either triamcinolone 40mg or PRP. Patients randomized in Steroid group (n=95) were gives intraarticular 40mg Triamcinolone acetate (1ml) along with 2ml of Local anaesthetic Lignocaine 1%, whereas patients randomized in PRP group (n=95) were injected 5ml PRP. “The Western Ontario and McMaster Universities Arthritis Index” (WOMAC) Scale was used for functional disability and pain before and after the therapy for the targeted knee joint at the baseline 1 week, 5 weeks, 8 weeks and 20 weeks follow-ups. Visual Analogue Scale (VAS) scores were also recorded for pain. Data analysis was done by using SPSS version 20. Results: There wasn't any serious adverse effect observed during the study and follow-ups. 25 WOMAC functional activity scale showed statistically significant improvement with Intraarticular knee injection of PRP compared to steroids(40.64±1.87vs.27.17±6.01)(p=0.000). WOMACpainscaleresultsalsodemonstrated that intraarticular knee injection of PRP was more effective in reducing knee pain than steroids (p = 0.000) at 20 weeks follow-up. Conclusion: On the basis of the results of our study, we concluded that platelet rich plasma is more effective than intra-articular steroids in terms of improvement in functional activity and reduction of pain in patients with Grade I & II knee osteoarthritis. Both PRPand steroid intraarticular injections are safe.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To assess the ingestion of caustic substances is a medical emergency and esophagogastroduodenoscopy (EGD) is helpful in diagnosis, prognostication and management. Here, we investigated the NLR of patients, to assess the correlation of neutrophil lymphocyte ratio (NLR) with degree of caustic injury and to evaluate whether NLR can predict the degree of caustic endoscopic injury. Method: This cross sectional study was carried out on 180 patients in gastroenterology department of DHQ teaching hospital, Gujranwala from 1st Jan 2021 to 31 Dec 2021. The endoscopy was performed and CBC was sent for analysis of NLR. The esophageal and stomach mucosal injury was graded by Zargar's classification and divided into low grade and high grade. Independent sample t test was used for comparison between mean NLR versus low and high grade injury. Results: Patients with high grade damage has remarkably higher values of NLR as compared to low grade. For prediction of grade of damage, ROC analysis was used and AUC (area under curve) value was 0.838 (95% CI (0.783-0.894, p<0.001) and if we take NLR cut-off value as 3.5, the sensitivity will be 96.0% and specificity 63.3%, if we take cut-off value as 4.5, the sensitivity will be 93.1% and specificity 48.1% and if we take cut-off value as 5.5, the sensitivity will be 75.2% and specificity 35.4%. Conclusion: Neutrophil to lymphocyte ratio can predict degree of gastroesophageal injury in patients with caustic ingestion.
目的:探讨食管胃十二指肠镜检查(EGD)在诊断、预后和治疗中的价值。本研究通过研究患者的NLR，评估中性粒细胞淋巴细胞比率(NLR)与烧碱损伤程度的相关性，并评估NLR是否可以预测内镜下烧碱损伤的程度。方法:对2021年1月1日至2021年12月31日在古吉兰瓦拉DHQ教学医院消化内科就诊的180例患者进行横断面研究。进行内窥镜检查，并送全血细胞计数分析NLR。采用Zargar分级法对食管胃黏膜损伤进行分级，分为低分级和高分级。采用独立样本t检验比较平均NLR与低、高级别损伤之间的差异。结果:高级别损伤患者NLR值明显高于低级别损伤患者。对于损伤程度的预测，采用ROC分析，曲线下面积(AUC)值为0.838 (95% CI (0.783-0.894, p<0.001)，取NLR截断值为3.5时，敏感性为96.0%，特异性为63.3%，取截断值为4.5时，敏感性为93.1%，特异性为48.1%，取截断值为5.5时，敏感性为75.2%，特异性为35.4%。结论:嗜中性粒细胞与淋巴细胞比值可预测腐蚀性食入患者胃食管损伤程度。
{"title":"Neutrophil to Lymphocyte Ratio As A Predictor of Endoscopic Damage in Caustic Injuries","authors":"","doi":"10.51273/esc23.251928","DOIUrl":"https://doi.org/10.51273/esc23.251928","url":null,"abstract":"Objective: To assess the ingestion of caustic substances is a medical emergency and esophagogastroduodenoscopy (EGD) is helpful in diagnosis, prognostication and management. Here, we investigated the NLR of patients, to assess the correlation of neutrophil lymphocyte ratio (NLR) with degree of caustic injury and to evaluate whether NLR can predict the degree of caustic endoscopic injury. Method: This cross sectional study was carried out on 180 patients in gastroenterology department of DHQ teaching hospital, Gujranwala from 1st Jan 2021 to 31 Dec 2021. The endoscopy was performed and CBC was sent for analysis of NLR. The esophageal and stomach mucosal injury was graded by Zargar's classification and divided into low grade and high grade. Independent sample t test was used for comparison between mean NLR versus low and high grade injury. Results: Patients with high grade damage has remarkably higher values of NLR as compared to low grade. For prediction of grade of damage, ROC analysis was used and AUC (area under curve) value was 0.838 (95% CI (0.783-0.894, p<0.001) and if we take NLR cut-off value as 3.5, the sensitivity will be 96.0% and specificity 63.3%, if we take cut-off value as 4.5, the sensitivity will be 93.1% and specificity 48.1% and if we take cut-off value as 5.5, the sensitivity will be 75.2% and specificity 35.4%. Conclusion: Neutrophil to lymphocyte ratio can predict degree of gastroesophageal injury in patients with caustic ingestion.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"306 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anek Ammar, Syed Farrukh Nadeem, Khadija Tul Kubra, Mazhar Shafiq, Tariq Mehmood Mirza, Muhammad Arshad
Objective: To determine the positive predictive value of ultrasound in predicting non-alcoholic fatty liver disease taking magnetic resonance imaging as gold standard. Method: 84 patients of both sex groups with ages in the range of 18-60 years suspected to have NAFLD underwent ultrasound examination of the liver and kidney and the ratio of mean gray-scale intensity of the liver / renal cortex calculated. The NAFLD on ultrasound was labelled as per operational definition. The MRI was performed and areas under the water peak and fat peak were recorded. Liver fat content was calculated. The NAFLD on MRI waslabelled as per operational definition.All the data was noted along with demographic details of the patient. Results: The age of the patients ranged from 18 years to 60 years with a mean of 41.4years. Male to female ratio of 1:5 was found. The BMI of the patients ranged from 22.6 Kg/m2 to 34.8 Kg/m2 with a mean of 30.8 Kg/m2 and 71.4% patients were obese. 34.5% patients were diabetic. The diagnosis of NAFLD was confirmed in 96.4% cases on MRI. Taking MRI diagnosis of NAFLD as gold standard, it yielded a positive predictive value of 96.4% for ultrasound in predicting NAFLD. Conclusion: Ultrasound showed a high positive predictive value in the diagnosis of non-alcoholic fatty liver disease irrespective of patient's age, gender, BMI and history of diabetes which advocate its preferred use in future medical practice.
{"title":"Positive Predictive Value of Ultrasound in Predicting Non-Alcoholic Fatty Liver Disease taking Magnetic Resonance Imaging as Gold Standard","authors":"Anek Ammar, Syed Farrukh Nadeem, Khadija Tul Kubra, Mazhar Shafiq, Tariq Mehmood Mirza, Muhammad Arshad","doi":"10.51273/esc23.2519210","DOIUrl":"https://doi.org/10.51273/esc23.2519210","url":null,"abstract":"Objective: To determine the positive predictive value of ultrasound in predicting non-alcoholic fatty liver disease taking magnetic resonance imaging as gold standard. Method: 84 patients of both sex groups with ages in the range of 18-60 years suspected to have NAFLD underwent ultrasound examination of the liver and kidney and the ratio of mean gray-scale intensity of the liver / renal cortex calculated. The NAFLD on ultrasound was labelled as per operational definition. The MRI was performed and areas under the water peak and fat peak were recorded. Liver fat content was calculated. The NAFLD on MRI waslabelled as per operational definition.All the data was noted along with demographic details of the patient. Results: The age of the patients ranged from 18 years to 60 years with a mean of 41.4years. Male to female ratio of 1:5 was found. The BMI of the patients ranged from 22.6 Kg/m2 to 34.8 Kg/m2 with a mean of 30.8 Kg/m2 and 71.4% patients were obese. 34.5% patients were diabetic. The diagnosis of NAFLD was confirmed in 96.4% cases on MRI. Taking MRI diagnosis of NAFLD as gold standard, it yielded a positive predictive value of 96.4% for ultrasound in predicting NAFLD. Conclusion: Ultrasound showed a high positive predictive value in the diagnosis of non-alcoholic fatty liver disease irrespective of patient's age, gender, BMI and history of diabetes which advocate its preferred use in future medical practice.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969371","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To investigate the incidence of AKI in stroke patients and its association with 30-day mortality of stroke patients. Method: This descriptive study was conducted in Medical Unit-I, Holy Family Hospital from June 2020 to January 2021. 130 patients with CT-confirmed stroke (both ischemic and hemorrhagic) with symptoms ranging from 1-24 hours were included in the study using consecutive (non-probability) sampling, after informed consent from theattendants. Patients with a history of recurrent stroke, renal dysfunction before stroke (urea > 52mg/dl and creatinine > 1.2mg/dl, eGFR < 90 ml/min, proteinuria, or patients on dialysis as per medical record), uncontrolled hypertension (BP ≥180/110 mmHg), alcohol use, intravenous drug abuse and diabetes (BSR > 200 mg/dl) were excluded from the study. Patients' baseline serum creatinine levels were recorded and were noted again after 72 hours. A > 0.3 mg/dl increase from the baseline was defined as acute kidney injury. Mortality was recorded in patients who died within 30 days of stroke. Results: The mean age of the patients was 55.48 ± 10.85 years. 81 patients (62.3%) were male and 49 (37.7%) were female. 25 (19.2%) patients had acute kidney injury. 25 (19.2%) patients (amongst both with and without acute kidney injury) died within 30 days. There was a significant association between acute kidney injury and 30-day mortality of the stroke patients (p-value<0.001). This association was significant in all age groups, both genders, regardless of present or absent history of smoking and regardless of duration of symptoms prior to arrival (p value <0.001). Conclusion: Acute kidney injury affects a proportion of patients of stroke. There is a significant association between AKI and 30-day mortality after stroke, suggesting there might be a link between them.
{"title":"Incidence of Acute Kidney Injury after Stroke and Its Association with 30-day Mortality of Stroke Patients","authors":"Amber Shahzadi, Saima Ambreen, Aimen Malik, Mubariz Ahmed, Sidra Jahangir, Basil Usman","doi":"10.51273/esc23.2519216","DOIUrl":"https://doi.org/10.51273/esc23.2519216","url":null,"abstract":"Objective: To investigate the incidence of AKI in stroke patients and its association with 30-day mortality of stroke patients. Method: This descriptive study was conducted in Medical Unit-I, Holy Family Hospital from June 2020 to January 2021. 130 patients with CT-confirmed stroke (both ischemic and hemorrhagic) with symptoms ranging from 1-24 hours were included in the study using consecutive (non-probability) sampling, after informed consent from theattendants. Patients with a history of recurrent stroke, renal dysfunction before stroke (urea > 52mg/dl and creatinine > 1.2mg/dl, eGFR < 90 ml/min, proteinuria, or patients on dialysis as per medical record), uncontrolled hypertension (BP ≥180/110 mmHg), alcohol use, intravenous drug abuse and diabetes (BSR > 200 mg/dl) were excluded from the study. Patients' baseline serum creatinine levels were recorded and were noted again after 72 hours. A > 0.3 mg/dl increase from the baseline was defined as acute kidney injury. Mortality was recorded in patients who died within 30 days of stroke. Results: The mean age of the patients was 55.48 ± 10.85 years. 81 patients (62.3%) were male and 49 (37.7%) were female. 25 (19.2%) patients had acute kidney injury. 25 (19.2%) patients (amongst both with and without acute kidney injury) died within 30 days. There was a significant association between acute kidney injury and 30-day mortality of the stroke patients (p-value<0.001). This association was significant in all age groups, both genders, regardless of present or absent history of smoking and regardless of duration of symptoms prior to arrival (p value <0.001). Conclusion: Acute kidney injury affects a proportion of patients of stroke. There is a significant association between AKI and 30-day mortality after stroke, suggesting there might be a link between them.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969199","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Khawaja Ijaz Awais, M. Arslan Rasheed, Zoha Ejaz, Taj Jamshaid, Saim ., Ahmad Latif
Objective: To assess the prevalence and reasons of non compliance to treatment of tuberculosis among the patients of Sharif medical city Hospital Lahore. Material and Methods: 150 patients of tuberculosis were taken as a sample based upon non-probability convenient sampling. The data was collected by the investigators themselves with the use of semi-structured questionnaire that was finalized after pre-testing. Results: The data was analysed by putting into IBM statistics SPSS software. All the respondents(100%) have already heard about tuberculosis. The pooled prevalence of non compliance to TB is 44.4%. Conclusion: Overall level of knowledge about tuberculosis and its practices among the patients of tuberculosis attending Sharif medical city hospital Lahore was found satisfactory (40%). The majority of respondents are not taking medicine because of side effects of drugs (41.3%), fear of drugs (40%), long duration of TB treatment (62.7%) and TB clinic is far from home (66.7%).
{"title":"Reasons of TB Treatment Non Compliance","authors":"Khawaja Ijaz Awais, M. Arslan Rasheed, Zoha Ejaz, Taj Jamshaid, Saim ., Ahmad Latif","doi":"10.51273/esc23.2519217","DOIUrl":"https://doi.org/10.51273/esc23.2519217","url":null,"abstract":"Objective: To assess the prevalence and reasons of non compliance to treatment of tuberculosis among the patients of Sharif medical city Hospital Lahore. Material and Methods: 150 patients of tuberculosis were taken as a sample based upon non-probability convenient sampling. The data was collected by the investigators themselves with the use of semi-structured questionnaire that was finalized after pre-testing. Results: The data was analysed by putting into IBM statistics SPSS software. All the respondents(100%) have already heard about tuberculosis. The pooled prevalence of non compliance to TB is 44.4%. Conclusion: Overall level of knowledge about tuberculosis and its practices among the patients of tuberculosis attending Sharif medical city hospital Lahore was found satisfactory (40%). The majority of respondents are not taking medicine because of side effects of drugs (41.3%), fear of drugs (40%), long duration of TB treatment (62.7%) and TB clinic is far from home (66.7%).","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135969201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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