A. Latif, S. Yaqub, Qudsia Anwar Dar, Umer Sultan Awan, Hina Farhat, M. A. Khokhar
Objective: This study aims to determine level of stress, resilience and moral distress among health care providers during covid-19 pandemic. Methods: This is a cross-sectional study performed using an online questionnaire. Data was collected from Health Care Providers, working in various tertiary care hospitals of Lahore, using an online questionnaire. Perceived stress scale (PSS), Connor-Davidson Resilience Scale (CD-RISC 10) and Moral Distress Thermometer were used to determine level of stress, resilience and moral stress respectively among the HCPs. Scores on the PSS can range from 0 to 40 with scores of 0-13, 14-26 and 27-40 being considered as low, moderate and high stress respectively. The Moral Distress Thermometer has scores ranging from 0-10 with value of ≥4 considered high. Data was analyzed using SPSS version.23.Descriptive variables were reported as means and frequencies. Intergroup analysis was done using Chi square test with p<0.05 taken as significant. Results: A total of 278 (n=278) HCPs participated in study. According to the PSS (Perceived Stress Scale) scores, 5.03% (14) reported low, 86.69% (241) moderate and 8.27% (23) high stress levels. The mean stress score is 21.56+/-4.32. Providing patient care (mean = 2.28+/-1.15 SD) and transmitting infection to others (mean = 3.02+/-1.10 SD) were deemed major causes of stress. The mean CD-RISC score was 23.14+/-7.81 SD. Only 10.8% (30) had a score of ≥ 32. The mean Moral Distress score was 4.2+/-2.98 SD, with 53.2% (149) participants reporting high Moral distress (score ≥4). Conclusion: The high level of stress among HCPs during COVID-19 pandemic highlights the need of urgent measures to overcome this psychological issue which if left un-addressed can affect performance of HCPs. Key Words: Stress, Resilience, HCPs How to cite: Latif A., Yaqub S., Dar A.Q., Awan S.U., Farhat Hina., Khokhar A.M., Stress, Resilience and Moral Distress among Health care Providers during COVID-19 pandemic. Esculapio 2021;17 (01):79-82
{"title":"Stress, Resilience and Moral Distress among Health Care Providers During COVID-19 Pandemic","authors":"A. Latif, S. Yaqub, Qudsia Anwar Dar, Umer Sultan Awan, Hina Farhat, M. A. Khokhar","doi":"10.51273/ESC21.2517116","DOIUrl":"https://doi.org/10.51273/ESC21.2517116","url":null,"abstract":"Objective: This study aims to determine level of stress, resilience and moral distress among health care providers during covid-19 pandemic. Methods: This is a cross-sectional study performed using an online questionnaire. Data was collected from Health Care Providers, working in various tertiary care hospitals of Lahore, using an online questionnaire. Perceived stress scale (PSS), Connor-Davidson Resilience Scale (CD-RISC 10) and Moral Distress Thermometer were used to determine level of stress, resilience and moral stress respectively among the HCPs. Scores on the PSS can range from 0 to 40 with scores of 0-13, 14-26 and 27-40 being considered as low, moderate and high stress respectively. The Moral Distress Thermometer has scores ranging from 0-10 with value of ≥4 considered high. Data was analyzed using SPSS version.23.Descriptive variables were reported as means and frequencies. Intergroup analysis was done using Chi square test with p<0.05 taken as significant. Results: A total of 278 (n=278) HCPs participated in study. According to the PSS (Perceived Stress Scale) scores, 5.03% (14) reported low, 86.69% (241) moderate and 8.27% (23) high stress levels. The mean stress score is 21.56+/-4.32. Providing patient care (mean = 2.28+/-1.15 SD) and transmitting infection to others (mean = 3.02+/-1.10 SD) were deemed major causes of stress. The mean CD-RISC score was 23.14+/-7.81 SD. Only 10.8% (30) had a score of ≥ 32. The mean Moral Distress score was 4.2+/-2.98 SD, with 53.2% (149) participants reporting high Moral distress (score ≥4). Conclusion: The high level of stress among HCPs during COVID-19 pandemic highlights the need of urgent measures to overcome this psychological issue which if left un-addressed can affect performance of HCPs. Key Words: Stress, Resilience, HCPs How to cite: Latif A., Yaqub S., Dar A.Q., Awan S.U., Farhat Hina., Khokhar A.M., Stress, Resilience and Moral Distress among Health care Providers during COVID-19 pandemic. Esculapio 2021;17 (01):79-82","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":"47037353","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. Abbas, Tazeen Nazar, Bilal Aziz, Furqan Saeed, K. Nawaz, M. Nabeel
Objective: To determine the effect of serum potassium levels on short term mortality outcomes in patients with acute myocardial infarction. Methods: This Descriptive Case Series was conducted in the CCU of Mayo Hospital Lahore from 15th November, 2017 to 15th May, 2018. A total of 156 patients of either sex between the age group of 30-60 years and diagnosed as cases of myocardial infarction with symptoms of less than 24 hours duration and serum potassium level of <3.5 mEq/L were included in the study. Patients were then followed up for 7 days and adverse outcome was recorded. Data was analyzed using computer software SPSS Version 22.0. Results: Out of the 156 patients, 119 (76.3%) were males and 37 (23.7%) were females. Mean age of the patients was 47.88±6.24 years, mean weight 85.31±13.14 Kg, mean duration of presenting complaints was 10.269±4.51 hours and mean Serum Potassium levels were 3.05±0.25 mEq/L. Adverse outcome in the form of mortality due to arrhythmias was seen in 15 (9.6%) patients. Conclusion: Low serum potassium level (<3.5mEq/L/L) was significantly associated with increased adverse outcome in acute myocardial infarction patients. Keywords: Acute myocardial infarction, Low serum potassium levels, Adverse outcome How to cite: Abbas R., Nazar T, Aziz B., Saeed F., Nawaz K., Nabeel M. serum potassium levels and adverse outcomes in patients with acute myocardial infarction. Esculapio 2021;17(01):5-8
{"title":"Serum Potassium Levels and Adverse Outcomes in Patients with Acute Myocardial Infarction","authors":"R. Abbas, Tazeen Nazar, Bilal Aziz, Furqan Saeed, K. Nawaz, M. Nabeel","doi":"10.51273/ESC21.25171-1","DOIUrl":"https://doi.org/10.51273/ESC21.25171-1","url":null,"abstract":"Objective: To determine the effect of serum potassium levels on short term mortality outcomes in patients with acute myocardial infarction. Methods: This Descriptive Case Series was conducted in the CCU of Mayo Hospital Lahore from 15th November, 2017 to 15th May, 2018. A total of 156 patients of either sex between the age group of 30-60 years and diagnosed as cases of myocardial infarction with symptoms of less than 24 hours duration and serum potassium level of <3.5 mEq/L were included in the study. Patients were then followed up for 7 days and adverse outcome was recorded. Data was analyzed using computer software SPSS Version 22.0. Results: Out of the 156 patients, 119 (76.3%) were males and 37 (23.7%) were females. Mean age of the patients was 47.88±6.24 years, mean weight 85.31±13.14 Kg, mean duration of presenting complaints was 10.269±4.51 hours and mean Serum Potassium levels were 3.05±0.25 mEq/L. Adverse outcome in the form of mortality due to arrhythmias was seen in 15 (9.6%) patients. Conclusion: Low serum potassium level (<3.5mEq/L/L) was significantly associated with increased adverse outcome in acute myocardial infarction patients. Keywords: Acute myocardial infarction, Low serum potassium levels, Adverse outcome How to cite: Abbas R., Nazar T, Aziz B., Saeed F., Nawaz K., Nabeel M. serum potassium levels and adverse outcomes in patients with acute myocardial infarction. Esculapio 2021;17(01):5-8","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":"47045893","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}
Syeda Tahira Zaidi, R. Kausar, M. Malik, Javeria Sarfraz, Abdullah Shafiq, S. Chiragh
Objective: To compare the anti-inflammatory effects of berberine and dexamethasone in ovalbumin sensitized guinea pigs. Methods: This experimental controlled study was conducted in April, 2016 at Postgraduate Medical Institute, Lahore. Twenty- four healthy guinea pigs were selected for study. Six of these were assigned randomly in each group; normal control, ovalbumin (OVA) sensitized, berberine treated and dexamethasone treated groups. Airway inflammation was induced on day 0 and 14 by OVA injections via peritoneal route and by inhalation on 25th, 26th and 27th day in each group excluding the normal control. Berberine (1.8 mg/kg) and dexamethasone (20 mg/kg) were introduced via peritoneal route 30 minutes earlier to each trial in berberine treated and dexamethasone treated groups respectively. Results: Total leukocyte count (TLC) in blood sample of berberine treated group (9990±1346 mm3) and dexamethasone treated group (9054±1432 mm3) was significantly low than OVA sensitized group (14261±3151 mm3). TLC of broncho-alveolar lavage (BAL) fluid in berberine treated group (384±26 mm3) and dexamethasone treated group (306±86) mm3 was significantly low than OVA sensitized group (598±110 mm3). Eosinophil percentage in blood of berberine treated (21.50±3.08) and dexamethasone treated (13.33±5.65) groups were significantly low than OVA sensitized group (30.33±6.74), while eosinophil percentage in BAL fluid was 26.00±6.69 and 21.00±7.46 in berberine treated and dexamethasone treated groups respectively with significant difference from OVA sensitized group value of 40.00±7.79. Conclusion: Berberine and dexamethasone both had reduced TLC and eosinophil percentage in both blood and BAL fluid as compared to OVA sensitized group but berberine is less effective than dexamethasone. Keywords: berberine, dexamethasone, asthma, airway inflammation How to cite: Zaidi T.S., Kausar R., Malik M., Sarfraz J., Shafiq A., Chiragh S. Comparison of berberine and dexamethasone on blood and bronchial inflammatory cells of ovalbumin sensitized guinea pigs. Esculapio 202;17(01):34-38
{"title":"Comparison of Berberine and Dexamethasone on Blood and Bronchial Inflammatory Cells of Ovalbumin Sensitized Guinea Pigs","authors":"Syeda Tahira Zaidi, R. Kausar, M. Malik, Javeria Sarfraz, Abdullah Shafiq, S. Chiragh","doi":"10.51273/ESC21.251717","DOIUrl":"https://doi.org/10.51273/ESC21.251717","url":null,"abstract":"Objective: To compare the anti-inflammatory effects of berberine and dexamethasone in ovalbumin sensitized guinea pigs. Methods: This experimental controlled study was conducted in April, 2016 at Postgraduate Medical Institute, Lahore. Twenty- four healthy guinea pigs were selected for study. Six of these were assigned randomly in each group; normal control, ovalbumin (OVA) sensitized, berberine treated and dexamethasone treated groups. Airway inflammation was induced on day 0 and 14 by OVA injections via peritoneal route and by inhalation on 25th, 26th and 27th day in each group excluding the normal control. Berberine (1.8 mg/kg) and dexamethasone (20 mg/kg) were introduced via peritoneal route 30 minutes earlier to each trial in berberine treated and dexamethasone treated groups respectively. Results: Total leukocyte count (TLC) in blood sample of berberine treated group (9990±1346 mm3) and dexamethasone treated group (9054±1432 mm3) was significantly low than OVA sensitized group (14261±3151 mm3). TLC of broncho-alveolar lavage (BAL) fluid in berberine treated group (384±26 mm3) and dexamethasone treated group (306±86) mm3 was significantly low than OVA sensitized group (598±110 mm3). Eosinophil percentage in blood of berberine treated (21.50±3.08) and dexamethasone treated (13.33±5.65) groups were significantly low than OVA sensitized group (30.33±6.74), while eosinophil percentage in BAL fluid was 26.00±6.69 and 21.00±7.46 in berberine treated and dexamethasone treated groups respectively with significant difference from OVA sensitized group value of 40.00±7.79. Conclusion: Berberine and dexamethasone both had reduced TLC and eosinophil percentage in both blood and BAL fluid as compared to OVA sensitized group but berberine is less effective than dexamethasone. Keywords: berberine, dexamethasone, asthma, airway inflammation How to cite: Zaidi T.S., Kausar R., Malik M., Sarfraz J., Shafiq A., Chiragh S. Comparison of berberine and dexamethasone on blood and bronchial inflammatory cells of ovalbumin sensitized guinea pigs. Esculapio 202;17(01):34-38","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":"42901922","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 Hassan, N. Rana, B. Rana, A. Iqbal, Ali Javaid Chughtai
Objective: Prominent resolution in the ST segment elevation on electrocardiogram(ECG), thrombolysis at the infarction site restoring perfusion determines the effectiveness of the streptokinase therapy. Hyper- coagulable states and lack of efficacy with streptokinase is seen in diabetics. This study aimed to assess the thrombolytic efficacy of streptokinase in diabetic vs non-diabetics patients. Methods: A cross-sectional study was conducted at Cardiology Department of Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st September 2019 to 30th April, 2020. Total 504 patients of which 185 diabetics and 319 non-diabetic were selected. All the patients presenting with first episode of acute ST- elevation myocardial infarction were thrombolysed with 1.5million units of streptokinase within 12hours from the onset of their typical chest pain symptoms. A complete record of ECG changes was kept before and 90 min after thrombolysis with streptokinase. Chi- square test was applied and p value <0.05 was considered significant. Results: 89.19% diabetic patients had >70% resolution of ST segment changes in comparison to 95.61% non-diabetics. 16.76% of the diabetic patients had increased ST-segment elevation post thrombolysis (P- value 0.001). 8.11% and 10.81% reinfarction rates during hospital stay and at one month post-thrombolysis were recorded in diabetics. Reduced left ventricle Ejection Fraction was seen in 62.16% and 58.62% of the diabetic and non-diabetic patients(P-value<0.005). Conclusion: Comparatively decreased efficacy of streptokinase is seen in diabetic patients with reduced resolution of ST-segment. In correspondence with reduced left ventricle EF, re-infarction and stroke episodes. Key Words: Streptokinase, acute myocardial infarction, STEMI, diabetes mellitus, hypercoagulability, atherosclerosis. How to Cite: Hassan Z., Rana N., Rana B., Iqbal I., Chughtai J.I. A comparative study to assess the efficacy of streptokinase in diabetic versus non-diabetic acute ST elevation myocardial infarction patients. Esculapio 2021;17(01):88-92
{"title":"A Comparative Study to Assess the Efficacy of Streptokinase in Diabetic Versus Non-Diabetic Acute ST Elevation Myocardial Infarction Patients","authors":"Zeeshan Hassan, N. Rana, B. Rana, A. Iqbal, Ali Javaid Chughtai","doi":"10.51273/ESC21.2517118","DOIUrl":"https://doi.org/10.51273/ESC21.2517118","url":null,"abstract":"Objective: Prominent resolution in the ST segment elevation on electrocardiogram(ECG), thrombolysis at the infarction site restoring perfusion determines the effectiveness of the streptokinase therapy. Hyper- coagulable states and lack of efficacy with streptokinase is seen in diabetics. This study aimed to assess the thrombolytic efficacy of streptokinase in diabetic vs non-diabetics patients. Methods: A cross-sectional study was conducted at Cardiology Department of Allama Iqbal Memorial Teaching Hospital, Sialkot from 1st September 2019 to 30th April, 2020. Total 504 patients of which 185 diabetics and 319 non-diabetic were selected. All the patients presenting with first episode of acute ST- elevation myocardial infarction were thrombolysed with 1.5million units of streptokinase within 12hours from the onset of their typical chest pain symptoms. A complete record of ECG changes was kept before and 90 min after thrombolysis with streptokinase. Chi- square test was applied and p value <0.05 was considered significant. Results: 89.19% diabetic patients had >70% resolution of ST segment changes in comparison to 95.61% non-diabetics. 16.76% of the diabetic patients had increased ST-segment elevation post thrombolysis (P- value 0.001). 8.11% and 10.81% reinfarction rates during hospital stay and at one month post-thrombolysis were recorded in diabetics. Reduced left ventricle Ejection Fraction was seen in 62.16% and 58.62% of the diabetic and non-diabetic patients(P-value<0.005). Conclusion: Comparatively decreased efficacy of streptokinase is seen in diabetic patients with reduced resolution of ST-segment. In correspondence with reduced left ventricle EF, re-infarction and stroke episodes. Key Words: Streptokinase, acute myocardial infarction, STEMI, diabetes mellitus, hypercoagulability, atherosclerosis. How to Cite: Hassan Z., Rana N., Rana B., Iqbal I., Chughtai J.I. A comparative study to assess the efficacy of streptokinase in diabetic versus non-diabetic acute ST elevation myocardial infarction patients. Esculapio 2021;17(01):88-92","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":"45857043","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}
Hina Bukhari, Tayyeba Komal, R. Akhtar, S. Mumtaz, I. Waheed
Objective: To determine the recent antimicrobial susceptibility patterns of salmonella isolates (typhi and paratyphi) in a tertiary care hospital of Lahore. Methods: It is cross sectional retrospective study conducted out in King Edward Medical University(Pathology deptt)/Mayo Hospital Lahore.The study period is six months from May 2019 to October 2019(Peak months of Typhoid fever).During this six months study period, total of 4284 samples for blood culture were received that were inoculated on the macConkey and blood agar plates.The growths obtained were then processed through biochemical profiling and analytical profile index(API).The Kirby Bauer technique was used for antibiotic susceptibility testing and reporting was done on the basis of clinical laboratory standard institute(CLSI). Results: During these six months, total 4284 blood samples were inoculated, out of which 433 growths were obtained. There were 84 strains of salmonella typhi isolated. Sensitivity pattern of different antibiotics showed that Azithromycin was sensitive to 70 (83.3%) isolates, imipenem in 72 (85.7%), ciprofloxacin to 56 (66.7%), gentamycin to 48 (57.1%), ceftriaxone to 45 (53.6%), cefepime to 20 (23.8%), chloramphenicol to 12 (14.3%) while ampicillin was least sensitive i.e. 8 (9.5%) isolates. There were 24 MDR(multidrug resistant) and 12 were XDR(extensive drug resistant) strains. We also found out that resistance to azithromycin drug is also emerging as 70 out of 84 strains were sensitive while remaining 14 were resistant. Conclusion: According to recent antibiotic susceptibility against salmonella typhi, the most sensitive drugs are Carbapenems (imipenem or meropenem) these days. Second sensitive antibiotic is azithromycin. Key Words: Antimicrobial susceptibility, Salmonella isolates, Carbapenems, Azithromycin. How to cite: Bukhari H., Komal T., Akhtar R., Mumtaz U.S., Waheed I., Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital of Lahore. Esculapio 2021;17(01):45-48
{"title":"Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital Lahore","authors":"Hina Bukhari, Tayyeba Komal, R. Akhtar, S. Mumtaz, I. Waheed","doi":"10.51273/ESC21.251719","DOIUrl":"https://doi.org/10.51273/ESC21.251719","url":null,"abstract":"Objective: To determine the recent antimicrobial susceptibility patterns of salmonella isolates (typhi and paratyphi) in a tertiary care hospital of Lahore. Methods: It is cross sectional retrospective study conducted out in King Edward Medical University(Pathology deptt)/Mayo Hospital Lahore.The study period is six months from May 2019 to October 2019(Peak months of Typhoid fever).During this six months study period, total of 4284 samples for blood culture were received that were inoculated on the macConkey and blood agar plates.The growths obtained were then processed through biochemical profiling and analytical profile index(API).The Kirby Bauer technique was used for antibiotic susceptibility testing and reporting was done on the basis of clinical laboratory standard institute(CLSI). Results: During these six months, total 4284 blood samples were inoculated, out of which 433 growths were obtained. There were 84 strains of salmonella typhi isolated. Sensitivity pattern of different antibiotics showed that Azithromycin was sensitive to 70 (83.3%) isolates, imipenem in 72 (85.7%), ciprofloxacin to 56 (66.7%), gentamycin to 48 (57.1%), ceftriaxone to 45 (53.6%), cefepime to 20 (23.8%), chloramphenicol to 12 (14.3%) while ampicillin was least sensitive i.e. 8 (9.5%) isolates. There were 24 MDR(multidrug resistant) and 12 were XDR(extensive drug resistant) strains. We also found out that resistance to azithromycin drug is also emerging as 70 out of 84 strains were sensitive while remaining 14 were resistant. Conclusion: According to recent antibiotic susceptibility against salmonella typhi, the most sensitive drugs are Carbapenems (imipenem or meropenem) these days. Second sensitive antibiotic is azithromycin. Key Words: Antimicrobial susceptibility, Salmonella isolates, Carbapenems, Azithromycin. How to cite: Bukhari H., Komal T., Akhtar R., Mumtaz U.S., Waheed I., Recent Antimicrobial Susceptibility Patterns of Salmonella Isolates in A Tertiay Care Hospital of Lahore. Esculapio 2021;17(01):45-48","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":"42783624","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}
A. Yousaf, Misbah Durrani, Khoala Riaz, U. Kalsoom, H. Parvez
Objective: Various imaging modalities can be employed for the placenta accreta diagnosis like USG and MRI, however, their exact diagnostic accuracy is yet to be established. This study was conducted for determining the accuracy of ultrasonography in diagnosing morbidly adherent placenta in women with a previous scar, taking the per-operative findings as gold standard. Methods: This descriptive cross-sectional study was carried out at department of Radiology, Benazir Bhutto Hospital, Rawalpindi from 6th January 2019 to 5th July 2019. Using non-probability purposive sampling 118 pregnant women with single pregnancy of age 18-40 years were included. Both grey scale and color doppler findings of ultrasound were employed for ascertaining presence or absence of morbidly adherent placenta. Per-operative findings of all patients who underwent cesarean section afterwards in their respective wards were registered. The findings of USG were then compared with the per-operative observations. Results: Among patients in whom USG findings were of morbidly adherent placenta, 60 were true positive while 05 were false positive, whereas, in the patients with no evidence of morbidly adherent placenta on USG, 03 were false negative while 50 were true negative. The sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of USG in diagnosing morbidly adherent placenta in previous scar women, taking per -operative findings as gold standard was 95.24%, 90.91%, 92.31%, 94.34% and 93.22% respectively. Conclusion: It can be inferred from our study that USG is a very sensitive and accurate non-invasive imaging technique for the diagnosis of morbidly adherent placenta. Keywords: morbidly adherent placenta, ultrasonography, sensitivity. How to cite: Yousaf A., Durrani M., Riaz K., Kalsoom U., Parvez H. Diagnostic accuracy of ultrasonography in diagnosing morbidly adherent placenta, taking intra-operative findings as gold standard. Esculapio. 2021; 17(01): 71-74
{"title":"Diagnostic Accuracy of Ultrasonography in Diagnosing Morbidly Adherent Placenta, Taking Intra-Operative Findings as Gold Standard","authors":"A. Yousaf, Misbah Durrani, Khoala Riaz, U. Kalsoom, H. Parvez","doi":"10.51273/ESC21.2517114","DOIUrl":"https://doi.org/10.51273/ESC21.2517114","url":null,"abstract":"Objective: Various imaging modalities can be employed for the placenta accreta diagnosis like USG and MRI, however, their exact diagnostic accuracy is yet to be established. This study was conducted for determining the accuracy of ultrasonography in diagnosing morbidly adherent placenta in women with a previous scar, taking the per-operative findings as gold standard. Methods: This descriptive cross-sectional study was carried out at department of Radiology, Benazir Bhutto Hospital, Rawalpindi from 6th January 2019 to 5th July 2019. Using non-probability purposive sampling 118 pregnant women with single pregnancy of age 18-40 years were included. Both grey scale and color doppler findings of ultrasound were employed for ascertaining presence or absence of morbidly adherent placenta. Per-operative findings of all patients who underwent cesarean section afterwards in their respective wards were registered. The findings of USG were then compared with the per-operative observations. Results: Among patients in whom USG findings were of morbidly adherent placenta, 60 were true positive while 05 were false positive, whereas, in the patients with no evidence of morbidly adherent placenta on USG, 03 were false negative while 50 were true negative. The sensitivity, specificity, positive predictive value negative predictive value and diagnostic accuracy of USG in diagnosing morbidly adherent placenta in previous scar women, taking per -operative findings as gold standard was 95.24%, 90.91%, 92.31%, 94.34% and 93.22% respectively. Conclusion: It can be inferred from our study that USG is a very sensitive and accurate non-invasive imaging technique for the diagnosis of morbidly adherent placenta. Keywords: morbidly adherent placenta, ultrasonography, sensitivity. How to cite: Yousaf A., Durrani M., Riaz K., Kalsoom U., Parvez H. Diagnostic accuracy of ultrasonography in diagnosing morbidly adherent placenta, taking intra-operative findings as gold standard. Esculapio. 2021; 17(01): 71-74","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":"44545038","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}
Farzana Latif, S. Ilyas, Saeed Mehmood, Hammad Arif, N. Khawaja, Zobia Jawad
Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus.
{"title":"Clinical Audit of Obstetrical Hysterectomies for a Period of One Year in A Tertiary Care Hospital","authors":"Farzana Latif, S. Ilyas, Saeed Mehmood, Hammad Arif, N. Khawaja, Zobia Jawad","doi":"10.51273/ESC20.2516411","DOIUrl":"https://doi.org/10.51273/ESC20.2516411","url":null,"abstract":"Objectives: To audit the obstetric hysterectomies in a tertiary care hospital during one year. Methods: It was an observational retrospective study design, where all the pregnant women were assessed for fetomaternal outcomes, indications and complications for peripartum hysterectomy. The records were retrieved from Jan 2015 to Dec 2015 by using hospital record system. The study duration was of one year. The venue of the study was Lahore General hospital, Lahore. The exclusion criteria included all unmarried women, women with chronic kidney disease or renal failure, past surgical history of heart disease, whereas all the women who delivered in hospital, private clinic or at home after atleast 28 weeks of gestational age and experience hysterectomy at the time of delivery or after delivery in the puerperium, were included in the study. Results: The data over 32 women were retrieved from the hospital record system. The mean age of the women was 30.34+2.23 with range 26-34. The average number of parity was 3 of all females. The range of parity was 2 to 7. The average gestational age was 36.18 weeks. All the deliveries were done by cesarean section whereas 4 (12.5%) were elective and 28 (87.5%) were with emergency indications. 13 (40.6%) of the deliveries were in private clinic, 9 (28.1%) were done by LHV/ mid wife, 5(15.6%) were in private hospitals, 4(12.5%) were in LGH and only 1(3.1%) was at home. 18(56.3%) of the women were having at least one abortion in previous history. Conclusion: We concluded that emergency peripartum hysterectomy is very vital procedure that saves lives and manage life threatening obstetrical hemorrhage when other methods failed to control it.The major indications for emergency peripartum hysterectomy were placental abruption, placenta praevia/accrete, uterine atony and ruptured uterus.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44833027","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}
Nadia Naeem, S. Siddiqui, A. Shehzad, Kehkshan Tahir, Marrium Manzoor
Objective: To assess the outcome of autologous platelet rich plasma(PRP) for the treatment of androgenetic alopecia in male patients. Methods: A total of 61 male patients from Department of Dermatology, Lahore General Hospital Lahore with ages between 18-60 years were included in the study during a period of 6 months. PRP was prepared by double spin method and CaCl2 was used to activate platelets. PRP was injected, with a 30-G needle using Nappage technique. This descriptive case series study was carefully monitored. Protocol included three treatment sessions with an interval of four weeks. Number of hairs, and hair strength was assessed by dermoscopy and hair pull test. SPSS Version-21 was used for data entry and analysis. Results: The mean age of patients was 42.67±8.63 years. Mean number of hair was 21.50±4.57 per dermatoscopic field, Post treatment number of hair was 78.10±16.24. Mean duration of disease was 10.25±3.52 months. Majority of patients were in stage iv 19(31.1%) and in stage ii 16(26.2%). There was significant difference in number of hair before and after treatment. Conclusion: PRP is an effective method to treat the patients with androgen alopecia.
{"title":"Efficacy of Autologous Platelet Rich Plasma in the Treatment of Male Androgenetic Alopecia","authors":"Nadia Naeem, S. Siddiqui, A. Shehzad, Kehkshan Tahir, Marrium Manzoor","doi":"10.51273/ESC20.251649","DOIUrl":"https://doi.org/10.51273/ESC20.251649","url":null,"abstract":"Objective: To assess the outcome of autologous platelet rich plasma(PRP) for the treatment of androgenetic alopecia in male patients. Methods: A total of 61 male patients from Department of Dermatology, Lahore General Hospital Lahore with ages between 18-60 years were included in the study during a period of 6 months. PRP was prepared by double spin method and CaCl2 was used to activate platelets. PRP was injected, with a 30-G needle using Nappage technique. This descriptive case series study was carefully monitored. Protocol included three treatment sessions with an interval of four weeks. Number of hairs, and hair strength was assessed by dermoscopy and hair pull test. SPSS Version-21 was used for data entry and analysis. Results: The mean age of patients was 42.67±8.63 years. Mean number of hair was 21.50±4.57 per dermatoscopic field, Post treatment number of hair was 78.10±16.24. Mean duration of disease was 10.25±3.52 months. Majority of patients were in stage iv 19(31.1%) and in stage ii 16(26.2%). There was significant difference in number of hair before and after treatment. Conclusion: PRP is an effective method to treat the patients with androgen alopecia.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45587197","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: Repeated urinary tract infections are significantly related to anatomical abnormalities of urinary tract. Vesicoureteral reflux is quite common, under diagnosed anatomical abnormality, leads to renal scarring and chronic kidney disease. The objective of the study was to determine the frequency of vesicoureteral reflux in children having repeated urinary tract infections. Methods: It is cross sectional survey conducted in department of Pediatric Medicine, The Children's Hospital & Institute of Child Health, Lahore, spanning from 20-5-2014 to 19-11-2014, using non-probability purposive sampling, a total of 140 patients included. Each child was screened and followed with repeated urinary tract infections for frequency of vesicoureteral reflux by detailed clinical examination and relevant investigation as defined in operational definition. To avoid any controversy, all the findings of UTI & vesicoureteral reflux was assessed by a single consultant. Data was managed using SPSS version 20. Results: In this study the mean age of all patients was 5.64±2.35 years. There were 42 (30%) males and 98(70%) females in this study with male to female ration 1:233. The mean number of episodes of urinary tract infections was 5.82±1.95 per years. Frequency of vesicoureteral reflux in these patients was seen in 35(25%) of the patients. When we stratified the data over age, gender and number of episodes of urinary tract infection we found significant association of vesicoureteral reflux with age groups only (p-value < 0.05) while no association between vesicoureteral reflux versus gender and number of episodes of urinary tract infection (pvalue > 0.05). Conclusion: We found significant correlation between vesicoureteral reflux and repeated urinary tract infections. Cases with repeated urinary tract infections should be investigated thoroughly to address underlying cause, in order to prevent renal damage and long-term complications.
{"title":"Frequency of Vesicoureteral Reflux in Children having Recurrent Urinary Tract Infections","authors":"I. Aslam, M. Siddiqui, Fatima Zia, Hafsa Qamar","doi":"10.51273/ESC20.251644","DOIUrl":"https://doi.org/10.51273/ESC20.251644","url":null,"abstract":"Objective: Repeated urinary tract infections are significantly related to anatomical abnormalities of urinary tract. Vesicoureteral reflux is quite common, under diagnosed anatomical abnormality, leads to renal scarring and chronic kidney disease. The objective of the study was to determine the frequency of vesicoureteral reflux in children having repeated urinary tract infections. Methods: It is cross sectional survey conducted in department of Pediatric Medicine, The Children's Hospital & Institute of Child Health, Lahore, spanning from 20-5-2014 to 19-11-2014, using non-probability purposive sampling, a total of 140 patients included. Each child was screened and followed with repeated urinary tract infections for frequency of vesicoureteral reflux by detailed clinical examination and relevant investigation as defined in operational definition. To avoid any controversy, all the findings of UTI & vesicoureteral reflux was assessed by a single consultant. Data was managed using SPSS version 20. Results: In this study the mean age of all patients was 5.64±2.35 years. There were 42 (30%) males and 98(70%) females in this study with male to female ration 1:233. The mean number of episodes of urinary tract infections was 5.82±1.95 per years. Frequency of vesicoureteral reflux in these patients was seen in 35(25%) of the patients. When we stratified the data over age, gender and number of episodes of urinary tract infection we found significant association of vesicoureteral reflux with age groups only (p-value < 0.05) while no association between vesicoureteral reflux versus gender and number of episodes of urinary tract infection (pvalue > 0.05). Conclusion: We found significant correlation between vesicoureteral reflux and repeated urinary tract infections. Cases with repeated urinary tract infections should be investigated thoroughly to address underlying cause, in order to prevent renal damage and long-term complications.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42567168","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}
A. L. Shahid, I. Hussain, Farhadul Alam, Muhammad Nazir Awan, H. Khurshid, Z. Butt
Objectives: To determine outcome in Single Stage Surgery of Both Hips in Bilateral Developmental Dysplasia of Hip in Children after walking age. Methods: This was a retrospective review of 20 hips in 10 patients (7 females and 3 males), operated at the children's hospital and the institute of child health, Lahore between 2014 and 2016. The age of patients was between 2 and 5 years. There were 10 hips in grade IV, 6 in grade III and 4 in grade II according to Tonnis classification. Both hips were operated in single stage. Open reduction of hip joint was done by anterolateral approach in all children. Salter osteotomy was done in every child while femoral shortening was needed in 10 hips. Outcome of single stage surgery was assessed by radiological assessment of Severin's scoring system and functional assessment of MacKay's scoring system at final followup after 2 years of suegery. Results: There was no effect of age, gender, malnutrition, body mass index on outcome. According to Severin's scoring system, 14 hips (70%) were in grade I while 6 (30%) in grade II. Outcome was excellent in 6 hips (30%), good in 13 (60%) and fair in 1 (5%) by applying MacKay's scoring system. Hip spica of one child was changed after one month due to wetting with urine. There was no hip dislocation or subluxation in any case. Conclusion: Single stage surgery of both hips can be done safely in bilateral developmental dysplasia of hip by anterolateral approach in late presented children.
{"title":"Single-Stage Combined Surgery for Treating Neglected Bilateral Developmental Hip Dysplasia after Walking Age","authors":"A. L. Shahid, I. Hussain, Farhadul Alam, Muhammad Nazir Awan, H. Khurshid, Z. Butt","doi":"10.51273/ESC20.2516415","DOIUrl":"https://doi.org/10.51273/ESC20.2516415","url":null,"abstract":"Objectives: To determine outcome in Single Stage Surgery of Both Hips in Bilateral Developmental Dysplasia of Hip in Children after walking age. Methods: This was a retrospective review of 20 hips in 10 patients (7 females and 3 males), operated at the children's hospital and the institute of child health, Lahore between 2014 and 2016. The age of patients was between 2 and 5 years. There were 10 hips in grade IV, 6 in grade III and 4 in grade II according to Tonnis classification. Both hips were operated in single stage. Open reduction of hip joint was done by anterolateral approach in all children. Salter osteotomy was done in every child while femoral shortening was needed in 10 hips. Outcome of single stage surgery was assessed by radiological assessment of Severin's scoring system and functional assessment of MacKay's scoring system at final followup after 2 years of suegery. Results: There was no effect of age, gender, malnutrition, body mass index on outcome. According to Severin's scoring system, 14 hips (70%) were in grade I while 6 (30%) in grade II. Outcome was excellent in 6 hips (30%), good in 13 (60%) and fair in 1 (5%) by applying MacKay's scoring system. Hip spica of one child was changed after one month due to wetting with urine. There was no hip dislocation or subluxation in any case. Conclusion: Single stage surgery of both hips can be done safely in bilateral developmental dysplasia of hip by anterolateral approach in late presented children.","PeriodicalId":11923,"journal":{"name":"Esculapio","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48859960","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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