Journal of Ayub Medical College, Abbottabad : JAMC最新文献

Background: Colorectal cancer is the largest cause of mortality in patients admitted to any Gastroenterology units. Diagnostic colonoscopy is a valuable tool for the disease's diagnosis and proper treatment but its compliance has been historically low. Our main objective was to find out social, cultural, and psychological barriers among those patients who finally did not show up for their colonoscopy appointment and, make a comparative analysis with those who did.

Methods: A cross-sectional study was conducted in the Lady Reading Hospital, Peshawar from October 2021 to March 2022, selecting 224 patients through consecutive sampling.

Results: Out of the 224 patients included, males (48.2%) were more likely to show up for the procedure than females (51.8%) (p<0.05). Overall, the most recurring barrier was a lack of knowledge with 116 (51.7%) for both the groups, but especially more for the non-compliant patients (p<0.05). Fear of results, fear of complications of the procedure, and affordability issues stood out as important differences between the compliant and non-compliant patients.

Conclusion: For the country's healthcare to be able to overcome these problems, and enter an era where screening colonoscopy is a norm, mass education regarding the issue is imperative.

Background: We tested the utility of mini-pool PCR testing for the rational use of PCR consumables in screening for CoViD-19.

Methods: After pilot experiments, 3-samples pool size was selected. One step RT-PCR was performed. The samples in the mini-pool having COVID gene amplification were tested individually.

Results: 1548 samples tested in 516 mini-pools resulted 396 mini-pools as negative and 120 as positive. Upon individual testing, 110 samples tested positive and 9 were inconclusive. 876 PCR reactions were performed to test 1548 samples, saving 43% PCR reagents. Centres with low prevalence resulted in most saving on reagents (50%), while centres with high prevalence resulted in more test reactions. Testing of individual samples resulted in delays in reporting.

Conclusions: Pooling can increase lab capacity, however, pooling delays results and cause degradation of samples.

Background: It is a common observation that the aortic size of Pakistani population is relatively less as compared to western population. Till now there is no study which has measured the dimensions of abdominal aorta in local population.The standard diameter of an artery across the body is critical for clinicians to recognize when an artery has become aneurysmal. This study aims to present the results of a local population's normal diameter of an infrarenal aorta and how it varies by age, gender, weight, height, body mass index (BMI) and body surface area (BSA).

Methods: This cross-sectional observational study was conducted in Vascular Surgery Department, at Combined Military Hospital (CMH), Peshawar, from July 2020 to November 2021.Participants in the study included all patients who underwent a contrast-enhanced computed tomography (CT) scan of the abdomen for any reason other than cardiovascular disease.The infrarenal abdominal aorta's mean internal diameter (anteroposterior and transverse diameter) was assessed. SPSS v 23 was used to analyze the data and present it as frequency and percentages. The Pearson correlation coefficient assessed the correlation between aortic diameters, weight, height, BMI, and BSA.

Results: Recruitment of a total of 250 patients was done in this study. Males were 194 (77.6%), while the rest were female patients. The patients' mean age was 39.6±12.8 years. The mean anteroposterior (AP) diameter of the infrarenal aorta was 16.13±2.32 mm. The mean transverse diameter (TD) was 15.96±2.34 mm. The infrarenal diameter of the aorta was smaller in women when compared to men, and the calibre of the aorta increased with the increasing age of the patients. There was a statistically significant positive relationship between their age and the average diameter of the infrarenal aorta (p<0.001) among both men and women.

Conclusions: Clinicians and vascular surgeons will benefit from the findings in diagnosing and treating abdominal aortic aneurysms. Hence, thoughtful consideration should be made before formulating intervention protocols.

Background: In the Middle East, where most of the higher learning institutions still focus on the teacher-centred approach, implementation of this pedagogical model is an enormous task for educators. This study was designed to assess the role that the flipped classroom modality plays in the knowledge retention of medical students with a background in traditional methods of teaching and learning.

Methods: This study employed a mixed study design among a sample of 3rd year medical students (n=193) in the neurosciences course block. The students were divided into two groups: experimental and control. A post-test, a questionnaire, and semi-structured interviews as research instruments were used to collect data in this study.

Results: The results revealed a significant mean difference between the post-test scores in traditional (4.1±0.98) and flipped classroom (3.6±1.03) with a p-value=0.01, while no mean difference was found between male and female students (3.9±1.04, 3.9±1.02, p-value=0.77). The students appreciated the flipped classroom modality that helped with information sharing, interaction with peers and learning from others' experiences. Correspondingly, the four main characteristics of flipped classroom emerged from the thematic analysis: (1) positive perceptions of the flipped classroom, (2) challenges of the flipped classroom, (3) the effects of personal characteristics, and (4) lack of administration support.

Conclusion: The performance of students was better in the traditional class than in the flipped classroom, particularly in the cognitive areas that deal with the interpretation and application of knowledge. The students taking responsibility for their own learning in this new modality and the short duration of the study might have had some influence on the study results. Future in-depth studies are recommended.

Background: Alopecia areata is an autoimmune disorder of patchy non scarring hair loss. Steroids, either Intralesional, e.g, triamcinolone or potent topical, e.g, clobetasol are the first line treatment. Platelet rich plasma is an autologous concentrated plasma with growth factors which enhances regeneration of hair follicles. It is simple and effective treatment with no major side effects. Objective was to compare the efficacy of intralesional injection of platelet rich plasma and triamcinolone in patients of alopecia areata. It was a randomized controlled trial (open-labelled), conducted at the Dermatology Department, Combined Military Hospital Abbottabad from 1st May to 31st December 2021.

Methods: Sixty clinically diagnosed patients of alopecia areata of the scalp were enrolled in the study. They were divided into two groups, A and B. Random numbers table was used to allocate 30 patients into each group. Group A patients were given an intralesional injection of triamcinolone while intralesional platelet rich plasma was given to Group B. Both treatments were repeated at one-month intervals for four months. In the study, Chi-square tests were used to compare effectiveness. It was considered significant when the p-value turned out to be <0.05..

Results: There was significant difference in complete response rate between intralesional injection of steroid and intralesional injection of platelet rich plasma. Platelet rich plasma was less effective (p =0.05). Local corticosteroid injection was significantly more effective than platelet rich plasma (p<0.05).

Conclusions: Intralesional injection of steroid is an effective and considerable treatment for alopecia areata. This study also proposes intralesional injection of platelet rich plasma as an alternative therapy for alopecia areata as it is not associated with serious local side effects.

Background: The most frequent cause of paediatric acute abdomen is acute appendicitis. If acute appendicitis is not treated promptly, one third of cases progress to complicated appendicitis. Complicated appendicitis is associated with significant morbidity and its management protocol differs significantly from that of uncomplicated appendicitis. In this study, we assessed the relationship between serum sodium levels and complicated appendicitis.

Methods: We conducted a prospective observational study from July to December 2020 at the Department of Neonatal and Paediatric Surgery, The Children Hospital, Pakistan Institute of Medical Sciences, Islamabad, on a sample size of 140 patients who met inclusion and exclusion criteria. For this study, we divided the patients into two groups. Group 1 had uncomplicated appendicitis and Group 2 had complicated appendicitis. These findings were then compared to preoperative serum sodium (Na) levels.

Results: The median serum sodium level in group 1 (uncomplicated appendicitis) was 137.81 mg/dl, while in group 2 it was 131.35 mg/dl (Complicated Appendicitis). The sensitivity and specificity of serum sodium levels at a cut-off point of less than 135 mg/dl were 84.80% and 89.40%, respectively.

Conclusion: Hyponatremia is currently thought to be a new marker for differentiating between complicated and uncomplicated appendicitis. It is a low-cost, high efficiency predictive marker for diagnosing and differentiating complicated appendicitis in children.