Aysha Rashid, Umair Mudassar, Ismail Tariq, Adil Zaheer, M. Iftikhar, N. Mazhar
Due to Covid-19 pandemic the psychological health of individuals is disturbed globally. There is a dire need of looking into details about the effects of mental health issues on quality of life (QOL). Objectives: To determine correlation between depression, anxiety, stress, and quality of life among adults in Covid-19 and evaluate the impact of demographics on quality of life. Methods: It was a cross-sectional study carried out at a tertiary care hospital. Patients presenting in the psychiatry outdoor of age 18 to 60 years, of both genders and scoring ≥21 on Depression, Anxiety, and Stress Scale (DASS) were enrolled in the study and depression, anxiety and stress severity was assessed and Quality of Life Scale (QOLS) was applied on all to assess their quality of life. All findings were then subjected to statistical analysis. Results: The mean age of the patients was 21.78±3.204, mean depression score on DASS was 8.58±4.510, mean anxiety score on DASS was 11.68±4.160 and the mean stress score on DASS was 14.84±3.192. There were 63.5% males and 36.5% females. Depression, anxiety and stress had a negative correlation with quality of life. Depression and stress were significantly correlated negatively with quality of life (p=0.000). No demographical factor was significantly associated with poor quality of life. Conclusion: Depression, anxiety and stress were negatively correlated with poorer QOL and depression and stress had significant association with poor QOL. Key words: Anxiety, Depression, Covid-19, Quality of life How to cite: Rashid A., Mudassar U., Tariq I., Zaheer A., Iftikhar M., Mazhar N. Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic. Esculapio 2021;17(02):195-199.
{"title":"Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic","authors":"Aysha Rashid, Umair Mudassar, Ismail Tariq, Adil Zaheer, M. Iftikhar, N. Mazhar","doi":"10.51273/esc21.2517218","DOIUrl":"https://doi.org/10.51273/esc21.2517218","url":null,"abstract":"Due to Covid-19 pandemic the psychological health of individuals is disturbed globally. There is a dire need of looking into details about the effects of mental health issues on quality of life (QOL). Objectives: To determine correlation between depression, anxiety, stress, and quality of life among adults in Covid-19 and evaluate the impact of demographics on quality of life. Methods: It was a cross-sectional study carried out at a tertiary care hospital. Patients presenting in the psychiatry outdoor of age 18 to 60 years, of both genders and scoring ≥21 on Depression, Anxiety, and Stress Scale (DASS) were enrolled in the study and depression, anxiety and stress severity was assessed and Quality of Life Scale (QOLS) was applied on all to assess their quality of life. All findings were then subjected to statistical analysis. Results: The mean age of the patients was 21.78±3.204, mean depression score on DASS was 8.58±4.510, mean anxiety score on DASS was 11.68±4.160 and the mean stress score on DASS was 14.84±3.192. There were 63.5% males and 36.5% females. Depression, anxiety and stress had a negative correlation with quality of life. Depression and stress were significantly correlated negatively with quality of life (p=0.000). No demographical factor was significantly associated with poor quality of life. Conclusion: Depression, anxiety and stress were negatively correlated with poorer QOL and depression and stress had significant association with poor QOL. Key words: Anxiety, Depression, Covid-19, Quality of life How to cite: Rashid A., Mudassar U., Tariq I., Zaheer A., Iftikhar M., Mazhar N. Correlation of Depression, Anxiety and Stress with Quality of Life in COVID-19 Pandemic. Esculapio 2021;17(02):195-199.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44773221","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}
Rubina Waheed, Nadia Ashraf, Nadia Sabeen, M. I. U Allah, Qaiser Javed, A. Khalid
Objective: To compare the frequency of caesarean section due to fetal distress with Isosorbide mononitrate versus PGE2 for the induction of labour in primigravida at term. Methods: It was Randomized Control Trial conducted in Unit I, Department of Obstetrics & Gynaecology, Lahore General Hospital, Lahore from 11th April 2015 to 10th October 2015. 230 primigravida were randomized into two groups i.e. Prostaglandin E2 and Isosorbide mononitrate for induction of labour. The difference in the frequency of caesarean section due to fetal distress with Prostaglandin E2 and Isosorbide mononitrate for induction of labour in the primigravidas at term was calculated as outcome. Results: The mean age of 27.62 ± 3.909 ranging from 21 to 34 years. The frequency of cesarean section was 12.2%in Prostaglandin E2 group while 0% in Isosorbide mononitrate. There was no effect of gestational age, age of mother and number of doses on outcome. Conclusion: There is no difference in frequency of cesarean section in primigravida groups induced by either Isosorbide mononitrate versus prostaglandin E2. Wherever applicable and feasible we should opt for Isosorbide mononitrate for induction of labour. Keywords: Cesarean section, Prostaglandin E2, Isosorbide mononitrate, Dinoprostone, Induction of labour, Primigravida How to cite: Waheed R., Ashraf N., Sabeen N., U Allah I.M., Javed Q., Khalid A. Induction of Labour with Isosorbide Mononitrate Versus Prostaglandin E2 (PGE2) in Primigravidas (PGs) at term. Esculapio 2021;17(02):166-169
目的：比较单硝酸异山梨酯与PGE2在初产妇足月引产中因胎儿窘迫而剖腹产的频率。方法：2015年4月11日至2015年10月10日在拉合尔市拉合尔总医院妇产科一单元进行随机对照试验。将230只初产妇随机分为两组，即前列腺素E2组和单硝酸异山梨酯组进行引产。结果计算了初产妇足月引产时因胎儿窘迫而使用前列腺素E2和单硝酸异山梨酯进行剖腹产的频率差异。结果：年龄21～34岁，平均27.62±3.909岁。前列腺素E2组剖宫产的发生率为12.2%，单硝酸异山梨酯组为0%。胎龄、母亲年龄和剂量对结果没有影响。结论：单硝酸异山梨酯和前列腺素E2对初产妇剖宫产的影响无统计学意义。在适用和可行的情况下，我们应选择单硝酸异山梨酯进行引产。关键词：剖宫产，前列腺素E2，单硝酸异山梨酯，地诺前列酮，引产，初产妇如何引用：Waheed R.，Ashraf N.，Sabeen N.，U Allah I.M.，Javed Q.，Khalid A.单硝酸异山梨醇酯引产与初产妇前列腺素E2（PGE2）的比较。Esculapio 2021；17（02）：166-169
{"title":"Induction of Labour with Isosorbide Mononitrate Versus Prostaglandin E2 (PGE2) in Primigravidas (PGs) at Term","authors":"Rubina Waheed, Nadia Ashraf, Nadia Sabeen, M. I. U Allah, Qaiser Javed, A. Khalid","doi":"10.51273/esc21.2517211","DOIUrl":"https://doi.org/10.51273/esc21.2517211","url":null,"abstract":"Objective: To compare the frequency of caesarean section due to fetal distress with Isosorbide mononitrate versus PGE2 for the induction of labour in primigravida at term. Methods: It was Randomized Control Trial conducted in Unit I, Department of Obstetrics & Gynaecology, Lahore General Hospital, Lahore from 11th April 2015 to 10th October 2015. 230 primigravida were randomized into two groups i.e. Prostaglandin E2 and Isosorbide mononitrate for induction of labour. The difference in the frequency of caesarean section due to fetal distress with Prostaglandin E2 and Isosorbide mononitrate for induction of labour in the primigravidas at term was calculated as outcome. Results: The mean age of 27.62 ± 3.909 ranging from 21 to 34 years. The frequency of cesarean section was 12.2%in Prostaglandin E2 group while 0% in Isosorbide mononitrate. There was no effect of gestational age, age of mother and number of doses on outcome. Conclusion: There is no difference in frequency of cesarean section in primigravida groups induced by either Isosorbide mononitrate versus prostaglandin E2. Wherever applicable and feasible we should opt for Isosorbide mononitrate for induction of labour. Keywords: Cesarean section, Prostaglandin E2, Isosorbide mononitrate, Dinoprostone, Induction of labour, Primigravida How to cite: Waheed R., Ashraf N., Sabeen N., U Allah I.M., Javed Q., Khalid A. Induction of Labour with Isosorbide Mononitrate Versus Prostaglandin E2 (PGE2) in Primigravidas (PGs) at term. Esculapio 2021;17(02):166-169","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48496844","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}
R. p, Muhammad Asim Rana, Mohammad Ahad Qayyum, Ali H. Munawar, S. Tariq, Abdullah Ali Lashari
Objective: As patients refusal has been a major issue in diagnosing the disease, we carried out this study to determine the magnitude of the refusal or denial of suspected COVID 19 cases. Methods: All patients seen with COVID 19 symptoms in medical out doors and emergency in Bahria International Hospital, Lahore in two weeks period from April 15, 2020 to April 30, 2020 were included in study. COVID 19 symptoms were ascertained on WHO guidelines labelling patients as COVID 19 suspected through laboratory tests. Depending upon results individual consultation with each patient was arranged to convince them to carry out nasopharyngeal swab for SARS Co-V-2 PCR. Some patients refused despite counselling for follow up regarding symptoms and advised tests. The public fear was the main barrier for the suspected cases to get tested. Each patient who refused PCR test was labelled as in denial. Results: Of the 40 cases diagnosed as suspected COVID 19. 21 refused to get tested. Majority (15) were male. Fever with chills was common among all with majority presented with shortness of breath (43%) followed by diarrhea (33%) and chest pain (9%). Conclusion: Patients who remain in denial pose a great threat to society as by spreading the virus or deteriorating themselves. An effective campaign on government level should be run to overcome the fear which has made this infection a social stigma to help contain this pandemic in a resource scarce country like Pakistan. Keywords: Coronavirus denial, COVID-19 denial, COVID in Pakistan, Public reaction to COVID 19 How to cite: Pervaiz R., Rana A.M., Qayyum A.M., Munawar A., Tariq S., Lashari A.A. Patient denialism for COVID19 pose difficulty for treating Physicians. Esculapio 2021;17(02):183-186.
{"title":"Patient Denialism for COVID19 Pose Difficulty for Treating Physicians","authors":"R. p, Muhammad Asim Rana, Mohammad Ahad Qayyum, Ali H. Munawar, S. Tariq, Abdullah Ali Lashari","doi":"10.51273/esc21.2517215","DOIUrl":"https://doi.org/10.51273/esc21.2517215","url":null,"abstract":"Objective: As patients refusal has been a major issue in diagnosing the disease, we carried out this study to determine the magnitude of the refusal or denial of suspected COVID 19 cases. Methods: All patients seen with COVID 19 symptoms in medical out doors and emergency in Bahria International Hospital, Lahore in two weeks period from April 15, 2020 to April 30, 2020 were included in study. COVID 19 symptoms were ascertained on WHO guidelines labelling patients as COVID 19 suspected through laboratory tests. Depending upon results individual consultation with each patient was arranged to convince them to carry out nasopharyngeal swab for SARS Co-V-2 PCR. Some patients refused despite counselling for follow up regarding symptoms and advised tests. The public fear was the main barrier for the suspected cases to get tested. Each patient who refused PCR test was labelled as in denial. Results: Of the 40 cases diagnosed as suspected COVID 19. 21 refused to get tested. Majority (15) were male. Fever with chills was common among all with majority presented with shortness of breath (43%) followed by diarrhea (33%) and chest pain (9%). Conclusion: Patients who remain in denial pose a great threat to society as by spreading the virus or deteriorating themselves. An effective campaign on government level should be run to overcome the fear which has made this infection a social stigma to help contain this pandemic in a resource scarce country like Pakistan. Keywords: Coronavirus denial, COVID-19 denial, COVID in Pakistan, Public reaction to COVID 19 How to cite: Pervaiz R., Rana A.M., Qayyum A.M., Munawar A., Tariq S., Lashari A.A. Patient denialism for COVID19 pose difficulty for treating Physicians. Esculapio 2021;17(02):183-186.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47650266","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}
Zeeshan Khan, S. Khaleeq, A. ur Rehman, Aasam Maan, Umer Farooq, Amjad Nadeem
Objective: To compare intravenous paracetamol vs Voltral (Diclofenac) suppositories for post operative pain in gynaecological procedures. Methods: This was a non randomized controlled trial that was carried out at Department of Anaesthesiology, Sheikh Zayed Hospital, Rahim Yar Khan during 01-07-2019 to 31-12-2019 in which all female cases with age range of 20 to 60 year undergoing any gynaecological surgery requiring general anaesthesia were included. The cases were divided into two equal groups and anesthesia was offered in standard doses. Just before reversal the cases in group Awere given intravenous paracetamol in a dose of 1 gm stat and then at 8-hour interval and those in group B were offered diclofenac suppositories in a dose of 50 mg twice a day, 12 hours apart. The pain was assessed at 4,8,12 and 24 hours and was labelled on visual analogue scale (VAS). Results: In this study there were 62 cases (31 in each group). The mean age in group A and B was 45.41±10.21 vs 48.12±11.13 years with p= 0.47. Mean duration of surgery in both groups was 57.51±15.23 vs53.11±14.79 minutes with p= 0.81. There was no significant difference in mean pain score at 4 and 8 hours with p= 0.91 and 0.81 respectively in group A and B. Mean pain score was 4.43±1.67 vs 3.21±1.09 with p= 0.01 at 12 and 4.57±1.71 vs 3.34±1.27 at 24 hours in group A and B with p values of 0.01 each. Mean time taken for rescue analgesia was 9.13±2.11 in group Aand 13.11±1.23 hours in group B with p= 0.001. Conclusion: Voltral (Diclofenac sodium) suppositories are better than paracetamol infusion in controlling pain after gynecological surgeries and this difference is significantly better at 12 and 24 hours. Key words: Gynaecological surgery, Pain, Paracetamol, Voltral suppository How to cite: Khan Z., Khaleeq S., Rehman Ur A., Maan A., Farooq U. Nadeem A. Comparison Between Paracetamol Vs Voltral Suppositories for Post-Operative Pain in Gynaecological Procedures. Esculapio 2021;17(02):191-194.
目的：比较静脉注射对乙酰氨基酚栓剂与复方双氯芬酸栓剂治疗妇科手术后疼痛的疗效。方法：这是一项非随机对照试验，于2019年7月1日至2019年12月31日在拉希姆·亚尔汗谢赫·扎耶德医院麻醉科进行，其中包括所有年龄在20至60岁之间接受任何需要全身麻醉的妇科手术的女性病例。将这些病例分为两组，并以标准剂量进行麻醉。就在逆转之前，a组的病例静脉注射1克的扑热息痛，然后间隔8小时，B组的病例每天两次，间隔12小时，每次50毫克的双氯芬酸栓剂。在4、8、12和24小时对疼痛进行评估，并在视觉模拟评分（VAS）上进行标记。结果：本研究共有62例（每组31例）。A组和B组的平均年龄分别为45.41±10.21和48.12±11.13岁，p=0.047。两组的平均手术时间分别为57.51±15.23和53.11±14.79分钟，p=0.81。A组和B组在4小时和8小时的平均疼痛评分分别为0.91和0.81，无显著差异。A组和B组在12小时和24小时的平均痛苦评分分别为4.43±1.67和3.21±1.09，p值分别为0.01和4.57±1.71和3.34±1.27，p值均为0.01。A组的平均抢救镇痛时间为9.13±2.11小时，B组为13.11±1.23小时，p=0.001。结论：双氯芬酸钠栓剂对妇科手术后疼痛的控制效果优于扑热息痛，且在12小时和24小时时差异显著。关键词：妇科手术，疼痛，扑热息痛，伏曲栓如何引用：Khan Z.，Khaleeq S.，Rehman Ur A.，Maan A.，Farooq U.Nadeem A.扑热息醇与伏曲栓在妇科手术中治疗术后疼痛的比较。Esculapio 2021；17（02）：191-194。
{"title":"Comparison Between Paracetamol Vs Voltral Suppositories For Post Operative Pain In Gynaecological Procedure","authors":"Zeeshan Khan, S. Khaleeq, A. ur Rehman, Aasam Maan, Umer Farooq, Amjad Nadeem","doi":"10.51273/esc21.2517217","DOIUrl":"https://doi.org/10.51273/esc21.2517217","url":null,"abstract":"Objective: To compare intravenous paracetamol vs Voltral (Diclofenac) suppositories for post operative pain in gynaecological procedures. Methods: This was a non randomized controlled trial that was carried out at Department of Anaesthesiology, Sheikh Zayed Hospital, Rahim Yar Khan during 01-07-2019 to 31-12-2019 in which all female cases with age range of 20 to 60 year undergoing any gynaecological surgery requiring general anaesthesia were included. The cases were divided into two equal groups and anesthesia was offered in standard doses. Just before reversal the cases in group Awere given intravenous paracetamol in a dose of 1 gm stat and then at 8-hour interval and those in group B were offered diclofenac suppositories in a dose of 50 mg twice a day, 12 hours apart. The pain was assessed at 4,8,12 and 24 hours and was labelled on visual analogue scale (VAS). Results: In this study there were 62 cases (31 in each group). The mean age in group A and B was 45.41±10.21 vs 48.12±11.13 years with p= 0.47. Mean duration of surgery in both groups was 57.51±15.23 vs53.11±14.79 minutes with p= 0.81. There was no significant difference in mean pain score at 4 and 8 hours with p= 0.91 and 0.81 respectively in group A and B. Mean pain score was 4.43±1.67 vs 3.21±1.09 with p= 0.01 at 12 and 4.57±1.71 vs 3.34±1.27 at 24 hours in group A and B with p values of 0.01 each. Mean time taken for rescue analgesia was 9.13±2.11 in group Aand 13.11±1.23 hours in group B with p= 0.001. Conclusion: Voltral (Diclofenac sodium) suppositories are better than paracetamol infusion in controlling pain after gynecological surgeries and this difference is significantly better at 12 and 24 hours. Key words: Gynaecological surgery, Pain, Paracetamol, Voltral suppository How to cite: Khan Z., Khaleeq S., Rehman Ur A., Maan A., Farooq U. Nadeem A. Comparison Between Paracetamol Vs Voltral Suppositories for Post-Operative Pain in Gynaecological Procedures. Esculapio 2021;17(02):191-194.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44057913","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}
Naeem Liaqat, A. Iqbal, Wajeeh Ur Reham, Zulfiqar Ahmed, Fozia Bashir, Sajid Hameed Dar
Objective: To compare diagnostic accuracy of Alvarado score (AS) and Paediatric Appendicitis Score (PAS) for diagnosis of acute appendicitis in children. Methods: This study was conducted at the department of Pediatric Surgery Children Hospital Lahore, over a period of 1 year. All the patients undergoing appendicectomy were included. Alvarado score and Pediatric Appendicitis score (PAS) was evaluated, compared and appendix specimen sent for histopa-thology. All findings were recorded in proforma. The collected data was analyzed by SPSS version 24. The mean Alvarado score and PAS was calculated, and stratified according to the histopathology reports. The sensitivity and specificity of both Alvarado score and PAS for three strata including score 3-5, 5-7 and 8-10 were also calculated. Results: A total of 177 patients were included in the study. The mean age of the patients was 9.16 ± 2.386 years. Among these 118 patients (67%) were male. The mean duration of pain was 21.42 ± 19.05 hours. Biopsy report showed that 18 patients (10.1%) had normal appendix with no signs of inflammations while 159 patients (89.9%) had inflammation on histopathology. We stratified the histopathology reports according to Alvarado score ≤7 and >7 and P-value was found significant. Similarly PAS ≤7 and >7 was stratified and P-value was not significant. The difference in mean Alvarado score between having acute appendicitis and those with normal histopathology was significant (P= 0.000) while this difference in mean PAS was not found significant (P= 0.325). Conclusions: None of the scoring system has adequate diagnostic accuracy and clinical judgment is preferred. Key Words: Alvarado Score; PAS; Appendicitis; Children How to cite: Liaqat N., Iqbal A., Rehman ur W., Ahmed Z., Bashir F., Dar H.S. Comparison of Alvarado score and Paediatric Appendicitis Score for diagnosing appendicitis in children” Esculapio 2021;17(02):175-178.
目的:比较Alvarado评分(AS)和儿科阑尾炎评分(PAS)对儿童急性阑尾炎的诊断准确性。方法:本研究在拉合尔儿童医院儿科外科进行，为期1年。所有接受阑尾切除术的患者均被纳入。评估和比较Alvarado评分和小儿阑尾炎评分(PAS)，并将阑尾标本送组织病理学检查。所有发现均以形式记录。收集的数据采用SPSS version 24进行分析。计算平均Alvarado评分和PAS，并根据组织病理学报告进行分层。计算了3-5分、5-7分和8-10分三个地层的Alvarado评分和PAS的敏感性和特异性。结果:共纳入177例患者。患者平均年龄为9.16±2.386岁。其中118例(67%)为男性。平均疼痛时间21.42±19.05小时。活检报告显示18例(10.1%)患者阑尾正常，无炎症征象，159例(89.9%)患者组织病理显示有炎症。我们根据Alvarado评分≤7分和bb70分对组织病理报告进行分层，p值有显著性。同样，PAS≤7和>.7分层，p值不显著。急性阑尾炎患者与组织病理学正常患者的平均Alvarado评分差异有统计学意义(P= 0.000)，而平均PAS评分差异无统计学意义(P= 0.325)。结论:没有一种评分系统具有足够的诊断准确性，临床判断是首选。关键词:阿尔瓦拉多乐谱;不是;阑尾炎;李建军，刘建军，李建军，等。小儿阑尾炎的诊断与诊断[j] .中华儿科医学杂志，2013;17(02):175-178。
{"title":"Comparison of Alvarado Score and Paediatric Appendicitis Score for Diagnosing Appendicitis in Children","authors":"Naeem Liaqat, A. Iqbal, Wajeeh Ur Reham, Zulfiqar Ahmed, Fozia Bashir, Sajid Hameed Dar","doi":"10.51273/esc21.2517213","DOIUrl":"https://doi.org/10.51273/esc21.2517213","url":null,"abstract":"Objective: To compare diagnostic accuracy of Alvarado score (AS) and Paediatric Appendicitis Score (PAS) for diagnosis of acute appendicitis in children. Methods: This study was conducted at the department of Pediatric Surgery Children Hospital Lahore, over a period of 1 year. All the patients undergoing appendicectomy were included. Alvarado score and Pediatric Appendicitis score (PAS) was evaluated, compared and appendix specimen sent for histopa-thology. All findings were recorded in proforma. The collected data was analyzed by SPSS version 24. The mean Alvarado score and PAS was calculated, and stratified according to the histopathology reports. The sensitivity and specificity of both Alvarado score and PAS for three strata including score 3-5, 5-7 and 8-10 were also calculated. Results: A total of 177 patients were included in the study. The mean age of the patients was 9.16 ± 2.386 years. Among these 118 patients (67%) were male. The mean duration of pain was 21.42 ± 19.05 hours. Biopsy report showed that 18 patients (10.1%) had normal appendix with no signs of inflammations while 159 patients (89.9%) had inflammation on histopathology. We stratified the histopathology reports according to Alvarado score ≤7 and >7 and P-value was found significant. Similarly PAS ≤7 and >7 was stratified and P-value was not significant. The difference in mean Alvarado score between having acute appendicitis and those with normal histopathology was significant (P= 0.000) while this difference in mean PAS was not found significant (P= 0.325). Conclusions: None of the scoring system has adequate diagnostic accuracy and clinical judgment is preferred. Key Words: Alvarado Score; PAS; Appendicitis; Children How to cite: Liaqat N., Iqbal A., Rehman ur W., Ahmed Z., Bashir F., Dar H.S. Comparison of Alvarado score and Paediatric Appendicitis Score for diagnosing appendicitis in children” Esculapio 2021;17(02):175-178.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47008684","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 gauge the prevalence of burnout among postgraduate trainees and consultants working in psychiatry department, Services Hospital Lahore, Pakistan. Methods: 31 trainee and consultant psychiatrists in Services Hospital Lahore, Pakistan participated in this cross-sectional study. Abbreviated Maslach Burnout Inventory (aMBI) measured burnout. It consisted of 9 items, relating to emotional exhaustion, depersonalization and personal accomplishment. Each item is scored on a seven-point Likert scale. For Emotional Exhaustion and Depersonalization, higher scores predicted greater burnout; Personal Accomplishment demonstrated the opposite, hence its scores were inverted. Participants with moderate scores in 2 or more dimensions were identified as suffering from burnout syndrome. Data was analyzed by SPSS 25.0. Result: Mean age of participants was 34.87 ± 8.06 years. 52% were female. 58% were consultants, with average experience of 7 years; 61% practiced in more than one place. 32.3% of participants had burnout syndrome. Emotional Exhaustion subscale showed the highest scores i.e. 7.06 ± 3.43. 71% of participants demonstrated moderate or high burnout in this scale. Average Depersonalization score was 2.94 ± 2.42, while that for Personal Accomplishment was 3.29 ± 2.25. Conclusion: A significant portion of the sample reported moderate and high level of emotional exhaustion. On the contrary, we found low levels of depersonalization in the sample. Most psychiatrists reported adequate levels of personal achievement. These results are reassuring because, despite the presence of emotional burnout, psychiatrists still have capacity to empathize and provide adequate patient care. Key Words: burnout, psychiatry, trainees, consultants, Lahore, Pakistan How to cite: But. A., Rahman S., Rahman Minahil. Burnout in Postgraduate Trainees and Consultants working in Psychiatry Departments of Teaching Hospitals in Lahore, Pakistan. Esculapio 2021;71(01):83-87
{"title":"Burnout in Postgraduate Trainees and Consultants working in Psychiatry Departments of Teaching Hospitals in Lahore, Pakistan","authors":"A. Butt, S. Rehman, Minahil Rahman","doi":"10.51273/ESC21.2517117","DOIUrl":"https://doi.org/10.51273/ESC21.2517117","url":null,"abstract":"Objective: To gauge the prevalence of burnout among postgraduate trainees and consultants working in psychiatry department, Services Hospital Lahore, Pakistan. Methods: 31 trainee and consultant psychiatrists in Services Hospital Lahore, Pakistan participated in this cross-sectional study. Abbreviated Maslach Burnout Inventory (aMBI) measured burnout. It consisted of 9 items, relating to emotional exhaustion, depersonalization and personal accomplishment. Each item is scored on a seven-point Likert scale. For Emotional Exhaustion and Depersonalization, higher scores predicted greater burnout; Personal Accomplishment demonstrated the opposite, hence its scores were inverted. Participants with moderate scores in 2 or more dimensions were identified as suffering from burnout syndrome. Data was analyzed by SPSS 25.0. Result: Mean age of participants was 34.87 ± 8.06 years. 52% were female. 58% were consultants, with average experience of 7 years; 61% practiced in more than one place. 32.3% of participants had burnout syndrome. Emotional Exhaustion subscale showed the highest scores i.e. 7.06 ± 3.43. 71% of participants demonstrated moderate or high burnout in this scale. Average Depersonalization score was 2.94 ± 2.42, while that for Personal Accomplishment was 3.29 ± 2.25. Conclusion: A significant portion of the sample reported moderate and high level of emotional exhaustion. On the contrary, we found low levels of depersonalization in the sample. Most psychiatrists reported adequate levels of personal achievement. These results are reassuring because, despite the presence of emotional burnout, psychiatrists still have capacity to empathize and provide adequate patient care. Key Words: burnout, psychiatry, trainees, consultants, Lahore, Pakistan How to cite: But. A., Rahman S., Rahman Minahil. Burnout in Postgraduate Trainees and Consultants working in Psychiatry Departments of Teaching Hospitals in Lahore, Pakistan. Esculapio 2021;71(01):83-87","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48534617","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: Rheumatoid Arthritis [RA] is a chronic, systemic, autoimmune disease on an unknown aetiology. It leads to the progressive destruction of joints. It also warrants difficulties in performance of Activities of Daily Living(ADL). This study aimed at determine relationship between activities of daily living [ADL] and functional status of the hand. Methods: This Crossectional Study was conducted at Romatology Department Children Hospital and Sheikh Zayed Hospital Lahore from June 2018 to December 2018. Convenient sampling technique helped in the collection of data. A hand function questionnaire and the Barthel Index were the contributary data collection methods. Rheumatoid Arthritis [RA] patients selected were those experiencing functional impairment in hands, having difficulty in performing ADL. Results: The patients who were able to perform the hand function test were independent in their daily life activities. Whereas, those who were not able to perk the test were dependent on their daily life activities. Conclusion: It was found that children with RA had a significant association between performing the ADL and functional status of hand. Key Words: Activities of Daily Living [ADL], Rheumatoid Arthritis [RA] How to cite: Ikram A.H., Ahad A.W., Huma Fazlia. Hand's functional status of children with rheumatoid arthritis in everyday activities: a cross-sectional study Esculapio. 2021.17(01): 9-14
目的:类风湿关节炎(RA)是一种病因不明的慢性、全身性自身免疫性疾病。它会导致关节的逐渐破坏。这也保证了日常生活活动(ADL)的执行困难。本研究旨在确定日常生活活动[ADL]与手部功能状态之间的关系。方法:本横断面研究于2018年6月至2018年12月在拉合尔儿童医院和谢赫扎耶德医院进行。方便的抽样技术有助于数据的收集。手功能问卷和Barthel指数是辅助数据收集方法。类风湿关节炎(RA)患者是那些手部功能受损，难以进行ADL的患者。结果:能够进行手功能测试的患者在日常生活活动中具有独立性。然而，那些无法通过测试的人则依赖于他们的日常生活活动。结论:发现RA患儿进行ADL与手部功能状态有显著相关性。关键词:日常生活活动[ADL]，类风湿性关节炎[RA]。引用方式:Ikram A.H, Ahad A.W, Huma Fazlia。类风湿关节炎患儿日常活动中手部功能状况的横断面研究[j] .中华临床医学杂志，2016,17(01):9-14
{"title":"Hand's Functional Status of Children with Rheumatoid Arthritis in Everyday Activities: A Cross-Sectional Study","authors":"Hafiza Ayesha Ikram, W. Ahad, Fazila Huma","doi":"10.51273/ESC21.251712","DOIUrl":"https://doi.org/10.51273/ESC21.251712","url":null,"abstract":"Objective: Rheumatoid Arthritis [RA] is a chronic, systemic, autoimmune disease on an unknown aetiology. It leads to the progressive destruction of joints. It also warrants difficulties in performance of Activities of Daily Living(ADL). This study aimed at determine relationship between activities of daily living [ADL] and functional status of the hand. Methods: This Crossectional Study was conducted at Romatology Department Children Hospital and Sheikh Zayed Hospital Lahore from June 2018 to December 2018. Convenient sampling technique helped in the collection of data. A hand function questionnaire and the Barthel Index were the contributary data collection methods. Rheumatoid Arthritis [RA] patients selected were those experiencing functional impairment in hands, having difficulty in performing ADL. Results: The patients who were able to perform the hand function test were independent in their daily life activities. Whereas, those who were not able to perk the test were dependent on their daily life activities. Conclusion: It was found that children with RA had a significant association between performing the ADL and functional status of hand. Key Words: Activities of Daily Living [ADL], Rheumatoid Arthritis [RA] How to cite: Ikram A.H., Ahad A.W., Huma Fazlia. Hand's functional status of children with rheumatoid arthritis in everyday activities: a cross-sectional study Esculapio. 2021.17(01): 9-14","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44131536","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 determine the factors for discontinuation of TB medication in patient with TB/HIV co- infection. Methods: A cross sectional study conducted in department of pulmonology DHQ hospital, Faisalabad. We analyze the reasons that lead to co-infected TB/HIV patients to discontinue TB medication and to find out the action of health team. Forty-five professionals participated in the study who serves patients with TB/HIV comorbidity. All patients were informed about the procedure. Result: After compiling the results, it was noted that low socioeconomic conditions, lack of information about the disease, possible side effects are frequent reasons leading to discontinuation. Conclusion: Global progress in implementation of TB/HIV activities is encouraging but still limited and late. The need of the hour is to strengthen the existing strategies to overcome the current issues. Keywords: Tuberculosis. Endemic diseases. Acquired Immunodeficiency Syndrome. Patient's refusal to treatment. Patient care team. How to cite: Usman U., Musharaf S.M., Chaudhary A., Discontinuation of Tuberculosis Treatment in Co-Infected TB with HIV. Esculapio 2021;17(01):60-64
{"title":"Discontinuation of Tuberculosis Treatment in Co-Infected TB with HIV","authors":"U. Usman, Muhammad Saqib, A. Chaudhary","doi":"10.51273/ESC21.2517112","DOIUrl":"https://doi.org/10.51273/ESC21.2517112","url":null,"abstract":"Objective: To determine the factors for discontinuation of TB medication in patient with TB/HIV co- infection. Methods: A cross sectional study conducted in department of pulmonology DHQ hospital, Faisalabad. We analyze the reasons that lead to co-infected TB/HIV patients to discontinue TB medication and to find out the action of health team. Forty-five professionals participated in the study who serves patients with TB/HIV comorbidity. All patients were informed about the procedure. Result: After compiling the results, it was noted that low socioeconomic conditions, lack of information about the disease, possible side effects are frequent reasons leading to discontinuation. Conclusion: Global progress in implementation of TB/HIV activities is encouraging but still limited and late. The need of the hour is to strengthen the existing strategies to overcome the current issues. Keywords: Tuberculosis. Endemic diseases. Acquired Immunodeficiency Syndrome. Patient's refusal to treatment. Patient care team. How to cite: Usman U., Musharaf S.M., Chaudhary A., Discontinuation of Tuberculosis Treatment in Co-Infected TB with HIV. Esculapio 2021;17(01):60-64","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44628839","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}
COVID-19 pandemic has exposed vulnerabilities all across the global healthcare systems including those within the United States. A systematic evaluation of these soft spots has been crucial in order to reengineer the healthcare system for enhanced competences and superior quality of care. One area that has been undoubtedly affected is the diagnosis and management of neoplastic diseases. The healthcare system in the US witnessed an instantaneous implementation of a “social distancing” strategy, which was implemented in an effort to flatten the infectivity “curve”. This required an urgent modification in the general administration of healthcare delivery, independent of COVID-19 infection status of a patient. For the non-COVID patients, it meant a shift from in-person to a virtual administration platform.''(Royce et al., 2020) Neither the healthcare providers, nor the patients, or the hospital management were adequately prepared for this sudden transition. Various healthcare services offered through these healthcare systems were required to be triaged based upon patients' assessment of needs into either emergent, urgent or routine/non- urgent. Patients seeking services that fell in the non- urgent/routine clinical visits were encouraged to stay home until the pandemic simmered down/resolved. This strategy was erroneously predicated on a rather short anticipated duration of the pandemic. As expected, cancer screening visits were deemed non- urgent and thus most healthcare facilities in and outside the US suspended these services, inadvertently compromising the timely diagnosis of neoplastic disorders.
COVID-19大流行暴露了包括美国在内的全球医疗保健系统的脆弱性。对这些薄弱环节进行系统的评估是至关重要的，以便重新设计医疗保健系统，以提高能力和卓越的护理质量。毫无疑问，受到影响的一个领域是肿瘤疾病的诊断和治疗。美国的医疗保健系统立即实施了“社会距离”战略，这是为了使传染性“曲线”变平。这需要紧急修改医疗保健服务的综合管理，而与患者的COVID-19感染状况无关。对于非新冠患者来说，这意味着从面对面到虚拟管理平台的转变。(Royce et al.， 2020)无论是医疗服务提供者，还是患者，还是医院管理层都没有为这种突然的转变做好充分的准备。通过这些医疗保健系统提供的各种医疗保健服务需要根据患者的需求评估进行分类，分为紧急、紧急或常规/非紧急。寻求非紧急/常规临床就诊服务的患者被鼓励呆在家里，直到大流行平息/解决。这一战略错误地基于大流行的预期持续时间相当短。不出所料，癌症筛查被认为不紧急，因此美国国内外的大多数医疗机构暂停了这些服务，无意中损害了肿瘤疾病的及时诊断。
{"title":"Impact of COVID-19 Pandemic on Cancer Screening in the United States","authors":"Sonikpreet Aulakh, Asher Khan","doi":"10.51273/ESC21.2517123","DOIUrl":"https://doi.org/10.51273/ESC21.2517123","url":null,"abstract":"COVID-19 pandemic has exposed vulnerabilities all across the global healthcare systems including those within the United States. A systematic evaluation of these soft spots has been crucial in order to reengineer the healthcare system for enhanced competences and superior quality of care. One area that has been undoubtedly affected is the diagnosis and management of neoplastic diseases. The healthcare system in the US witnessed an instantaneous implementation of a “social distancing” strategy, which was implemented in an effort to flatten the infectivity “curve”. This required an urgent modification in the general administration of healthcare delivery, independent of COVID-19 infection status of a patient. For the non-COVID patients, it meant a shift from in-person to a virtual administration platform.''(Royce et al., 2020) Neither the healthcare providers, nor the patients, or the hospital management were adequately prepared for this sudden transition. Various healthcare services offered through these healthcare systems were required to be triaged based upon patients' assessment of needs into either emergent, urgent or routine/non- urgent. Patients seeking services that fell in the non- urgent/routine clinical visits were encouraged to stay home until the pandemic simmered down/resolved. This strategy was erroneously predicated on a rather short anticipated duration of the pandemic. As expected, cancer screening visits were deemed non- urgent and thus most healthcare facilities in and outside the US suspended these services, inadvertently compromising the timely diagnosis of neoplastic disorders.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41335583","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}
I. Imran, Maryam Mansoor, F. Naqvi, M. Akhtar, W. Arshad, Faiza Khan
Objective: To investigate the protective effect of Ajwa date seed and fruit on renal histological changes in alloxan induced diabetic rats. Methods: This was an experimental study and was conducted in Post Graduate Medical Institute. The duration of study was 6 weeks. In this study random allotment of 32 rats was done in four groups. Group 1 was treated as control. Diabetes was induced in the 2nd, 3rd and 4th group by alloxan injection intra peritoneally. Group 2 was diabetic non treated while group 3 and 4 were treated with Ajwa seed and flesh respectively. After six weeks, animals were anaesthetized and kidneys were then removed without delay and weighed. Kidney paraffin sections were prepared and stained with hematoxylin& eosin (H&E) and with Periodic acid Schiff (PAS) technique. Glomerular diameters were estimated. Glomerular volume determined by stage micrometer. Vascular, tubular injury and glomerular sclerosis were studied semi quantitatively. Results: The data showed that Ajwa date seed significantly reduced hyperglycemia but did not normalize the fasting blood glucose. We found exceedingly significant improvement in kidney weight, glomerular diameter, tubular and vascular injury with Ajwa date seed suggesting reduction in diabetic nephropathy. Ajwa seed diet found more effective in reducing nephropathy than Ajwa fruit diet. Current study displayed that the seed of Ajwa showed significant improvement in renal histological characteristics in diabetic rats. Conclusion: The findings showed that Ajwa date seed and flesh reduce loss of tubular and vascular damage in alloxan induced diabetes. Key Words: Oxidative stress, Kidney, Diabetes, Ajwa, Antioxidant, histopathology How to cite: Imran I., Mansoor M., Naqvi F., Akhtar M., Arshad W., Khan F. Evaluation of protective effect of Ajwa seed and fruit on renal histopathological changes in diabetic nephropathic rats. Esculapio 2021;17(01):104-109
{"title":"Evaluation of Protective Effect of Ajwa Seed And Fruit on Renal Histopathological Changes in Diabetic Nephropathic Rats","authors":"I. Imran, Maryam Mansoor, F. Naqvi, M. Akhtar, W. Arshad, Faiza Khan","doi":"10.51273/ESC21.2517121","DOIUrl":"https://doi.org/10.51273/ESC21.2517121","url":null,"abstract":"Objective: To investigate the protective effect of Ajwa date seed and fruit on renal histological changes in alloxan induced diabetic rats. Methods: This was an experimental study and was conducted in Post Graduate Medical Institute. The duration of study was 6 weeks. In this study random allotment of 32 rats was done in four groups. Group 1 was treated as control. Diabetes was induced in the 2nd, 3rd and 4th group by alloxan injection intra peritoneally. Group 2 was diabetic non treated while group 3 and 4 were treated with Ajwa seed and flesh respectively. After six weeks, animals were anaesthetized and kidneys were then removed without delay and weighed. Kidney paraffin sections were prepared and stained with hematoxylin& eosin (H&E) and with Periodic acid Schiff (PAS) technique. Glomerular diameters were estimated. Glomerular volume determined by stage micrometer. Vascular, tubular injury and glomerular sclerosis were studied semi quantitatively. Results: The data showed that Ajwa date seed significantly reduced hyperglycemia but did not normalize the fasting blood glucose. We found exceedingly significant improvement in kidney weight, glomerular diameter, tubular and vascular injury with Ajwa date seed suggesting reduction in diabetic nephropathy. Ajwa seed diet found more effective in reducing nephropathy than Ajwa fruit diet. Current study displayed that the seed of Ajwa showed significant improvement in renal histological characteristics in diabetic rats. Conclusion: The findings showed that Ajwa date seed and flesh reduce loss of tubular and vascular damage in alloxan induced diabetes. Key Words: Oxidative stress, Kidney, Diabetes, Ajwa, Antioxidant, histopathology How to cite: Imran I., Mansoor M., Naqvi F., Akhtar M., Arshad W., Khan F. Evaluation of protective effect of Ajwa seed and fruit on renal histopathological changes in diabetic nephropathic rats. Esculapio 2021;17(01):104-109","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41886566","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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