Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e. 19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI : 10.7176/JMPB/53-03 Publication date :March 31 st 2019
{"title":"Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients","authors":"S. Zaidi, M. Raouf, Talha Tariq","doi":"10.7176/jmpb/53-03","DOIUrl":"https://doi.org/10.7176/jmpb/53-03","url":null,"abstract":"Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e. 19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI : 10.7176/JMPB/53-03 Publication date :March 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"77 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85502592","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}
Background; Breast cancer is most frequently diagnosed cancer in females. It has a major impact on health of women. According to a World Health Organization [WHO] estimate, more than 1.2 million people are diagnosed with breast cancer worldwide every year. This study was conducted to determine the frequency of breast cancer in patients presenting with breast lumps in our population. OBJECTIVE; To determine frequency of breast cancer among young females presenting with breast lumps at a tertiary care hospital. Material and Methods; Consecutive 160 young ladies presenting with breast lumps were taken. Young females with breast lumps were taken and diagnosed for breast cancer. All the data was entered and analyzed using SPSS-20. Results; Of these 160 study cases, 98 (61.2 %) were un-married female patients while 62 (38.8 %) were married female patients. Mean age of our study cases was 23.23 ± 3.85 years (with minimum age of our study cases was 18 years while maximum age was 32 years). Our study results have indicated that majority of our study cases i.e. 123 (76.9 %) were aged up to 25 years. Mean body mass index of our study cases was 26.23 ± 1.92 kg/m 2 and obesity was present in 48 (30.0 %). Mean disease duration was 2.98 ± 2.54 months and 111 (69.4%) had duration of illness up to 3 months. Breast cancer was noted in 40 (25.0%) of our study cases. Conclusion; High frequency of breast cancer was noted in our study among young females presenting with breast lumps. Breast cancer was significantly associated with marital status, increasing age, residential status, socioeconomic status and family history of breast cancer. These findings suggest that females at every age group with breast lumps need specialized care for diagnosis and management. Keywords; Breast Cancer, Breast Lumps, Young Females. DOI : 10.7176/JMPB/54-18 Publication date : April 30 th 2019
{"title":"ASSOCIATION OF POSITIVE FAMILY HISTORY WITH BREAST CANCER IN YOUNG FEMALES WITH BREAST LUMPS.","authors":"M. Tariq, Huma Javaid, M. A. Fiaz","doi":"10.7176/jmpb/54-18","DOIUrl":"https://doi.org/10.7176/jmpb/54-18","url":null,"abstract":"Background; Breast cancer is most frequently diagnosed cancer in females. It has a major impact on health of women. According to a World Health Organization [WHO] estimate, more than 1.2 million people are diagnosed with breast cancer worldwide every year. This study was conducted to determine the frequency of breast cancer in patients presenting with breast lumps in our population. OBJECTIVE; To determine frequency of breast cancer among young females presenting with breast lumps at a tertiary care hospital. Material and Methods; Consecutive 160 young ladies presenting with breast lumps were taken. Young females with breast lumps were taken and diagnosed for breast cancer. All the data was entered and analyzed using SPSS-20. Results; Of these 160 study cases, 98 (61.2 %) were un-married female patients while 62 (38.8 %) were married female patients. Mean age of our study cases was 23.23 ± 3.85 years (with minimum age of our study cases was 18 years while maximum age was 32 years). Our study results have indicated that majority of our study cases i.e. 123 (76.9 %) were aged up to 25 years. Mean body mass index of our study cases was 26.23 ± 1.92 kg/m 2 and obesity was present in 48 (30.0 %). Mean disease duration was 2.98 ± 2.54 months and 111 (69.4%) had duration of illness up to 3 months. Breast cancer was noted in 40 (25.0%) of our study cases. Conclusion; High frequency of breast cancer was noted in our study among young females presenting with breast lumps. Breast cancer was significantly associated with marital status, increasing age, residential status, socioeconomic status and family history of breast cancer. These findings suggest that females at every age group with breast lumps need specialized care for diagnosis and management. Keywords; Breast Cancer, Breast Lumps, Young Females. DOI : 10.7176/JMPB/54-18 Publication date : April 30 th 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76143737","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}
Individual human tumors arise through a combination of genetic and epigenetic changes that facilitate immortality. Cancer occurs when there are changes to genes that control the way our cells grow and divide.. The increase in the prevalence of cancer with lack of specific treatment options became public health problem particularly in middle and low income nations. Activation of the immune system by products of viral oncogene prevents viral induced cancers. The in vitro stimulation of Dendritic cells with tumor or tumor antigen in the presence of cytokines for cross activation of CD8+ and CD4+ T cells or restoration of T cells functions by blockade of immune blockers or modification tumor microenvironment or adoptive transfer of immune cells and stem T cells are promising cancer therapies. Compared with the convectional cancer therapies, immunotherapies are most tumors targeted without harmful side effects. DOI : 10.7176/JMPB/59-03 Publication date :September 30 th 2019
{"title":"Exploitation of Cell Mediated Immune Responses to Cancer Immunotherapy","authors":"T. Ashine","doi":"10.7176/jmpb/59-03","DOIUrl":"https://doi.org/10.7176/jmpb/59-03","url":null,"abstract":"Individual human tumors arise through a combination of genetic and epigenetic changes that facilitate immortality. Cancer occurs when there are changes to genes that control the way our cells grow and divide.. The increase in the prevalence of cancer with lack of specific treatment options became public health problem particularly in middle and low income nations. Activation of the immune system by products of viral oncogene prevents viral induced cancers. The in vitro stimulation of Dendritic cells with tumor or tumor antigen in the presence of cytokines for cross activation of CD8+ and CD4+ T cells or restoration of T cells functions by blockade of immune blockers or modification tumor microenvironment or adoptive transfer of immune cells and stem T cells are promising cancer therapies. Compared with the convectional cancer therapies, immunotherapies are most tumors targeted without harmful side effects. DOI : 10.7176/JMPB/59-03 Publication date :September 30 th 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"550 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78019173","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}
M. Khattak, Muhammad Mudasir Husnain, Rukhsar Shaheen
Background; Stroke is a global health problem. Stroke is responsible for major disabilities in adult population, and is 2 nd leading cause of deaths all over the world. Different studies have reported dyslipidemia as major cause of stroke in different populations. Objective; To determine the association of non – modifiable risk factors such as diabetes, hypertension and obesity with dyslipidemias in patients with ischemic stroke at Nishtar Hospital Multan. Material and methods; All the cases of stroke (n=240) Patients having finding on CT scan brain (plain) consistent with ischemic stroke of either sex aged less than 80 years were enrolled in this cross-sectional study from department of Medicine, Nishtar Hospital, Multan. Complete history about onset of illness, diabetes, hypertension and cardiac illness of the patients was taken. Baseline laboratory investigations including lipid profile and Hb A 1 c were done. Results; Of these 240 study cases, 155 (64.6 %) were male patients and 85 (35.4%) were female patients. Mean age of our study cases was 68.37 ± 14.55 years (with minimum age was 34 years while maximum age was 79 years). Out of these 240 study cases, 138 (57.5 %) were from poor families, 53(22.1 %) were diabetic and only 11 out of 53 (20.75%) had controlled glycemic levels. Hypertension was present in 182 (75.8%) of our study cases and 39 (16.3 %) were obese. Smoking was present in 101 (42.1%), previous history of stroke was present in 35 (14.6%) and 83 (34.6%) were Saraikis. Mean duration of illness was 2.24 ± 0.53 months and 135 (56.3%) had disease duration more than 1 month. Mean serum cholesterol level was 202.06 ± 45.36 mg/dl, mean serum LDL level was 91.13 ± 10.24 mg/dl, mean serum triglyceride level was 147.51 ± 20.21 mg/dl and mean serum HDL level was 42.92 ± 3.85 mg/dl and dyslipidemia was present in 85 (35.4 %). Conclusion; Frequency of dyslipidemia was high among patients having ischemic stroke in our study. Dyslipidemia was significantly associated with diabetes, hypertension, obesity, smoking, previous history of stroke and ethnicity. Early diagnosis followed by timely management can help reduce disease morbidity and improve clinical outcomes in these patients. Keywords; ischemic stroke, dyslipidemia, frequency. DOI : 10.7176/JMPB/58-03 Publication date : August 31 st 2019
{"title":"ASSOCATION OF NON – MODIFIABLE RISK FACTORS (DIABETES, HYPERTENSION AND OBESITY) WITH DYSLIPIDEMIA IN STROKE PATIENTS AT A TERTIARY CARE HOSPITAL","authors":"M. Khattak, Muhammad Mudasir Husnain, Rukhsar Shaheen","doi":"10.7176/jmpb/58-03","DOIUrl":"https://doi.org/10.7176/jmpb/58-03","url":null,"abstract":"Background; Stroke is a global health problem. Stroke is responsible for major disabilities in adult population, and is 2 nd leading cause of deaths all over the world. Different studies have reported dyslipidemia as major cause of stroke in different populations. Objective; To determine the association of non – modifiable risk factors such as diabetes, hypertension and obesity with dyslipidemias in patients with ischemic stroke at Nishtar Hospital Multan. Material and methods; All the cases of stroke (n=240) Patients having finding on CT scan brain (plain) consistent with ischemic stroke of either sex aged less than 80 years were enrolled in this cross-sectional study from department of Medicine, Nishtar Hospital, Multan. Complete history about onset of illness, diabetes, hypertension and cardiac illness of the patients was taken. Baseline laboratory investigations including lipid profile and Hb A 1 c were done. Results; Of these 240 study cases, 155 (64.6 %) were male patients and 85 (35.4%) were female patients. Mean age of our study cases was 68.37 ± 14.55 years (with minimum age was 34 years while maximum age was 79 years). Out of these 240 study cases, 138 (57.5 %) were from poor families, 53(22.1 %) were diabetic and only 11 out of 53 (20.75%) had controlled glycemic levels. Hypertension was present in 182 (75.8%) of our study cases and 39 (16.3 %) were obese. Smoking was present in 101 (42.1%), previous history of stroke was present in 35 (14.6%) and 83 (34.6%) were Saraikis. Mean duration of illness was 2.24 ± 0.53 months and 135 (56.3%) had disease duration more than 1 month. Mean serum cholesterol level was 202.06 ± 45.36 mg/dl, mean serum LDL level was 91.13 ± 10.24 mg/dl, mean serum triglyceride level was 147.51 ± 20.21 mg/dl and mean serum HDL level was 42.92 ± 3.85 mg/dl and dyslipidemia was present in 85 (35.4 %). Conclusion; Frequency of dyslipidemia was high among patients having ischemic stroke in our study. Dyslipidemia was significantly associated with diabetes, hypertension, obesity, smoking, previous history of stroke and ethnicity. Early diagnosis followed by timely management can help reduce disease morbidity and improve clinical outcomes in these patients. Keywords; ischemic stroke, dyslipidemia, frequency. DOI : 10.7176/JMPB/58-03 Publication date : August 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"24 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74660372","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}
Background: One of the goals of therapy for diabetes mellitus is to maintain normal glucose levels. Therapy can be in the form of pharmacology and non-pharmacology. In addition, in the community many use traditional medicine or often known as herbal medicine for the treatment of diabetes. Traditional medicine that has many uses for treatment is ginger. The main ingredients of ginger are essential oils (1-5%), sesquiterpenoids and monoterpenoids, gingerols, shogaols, paradols and zingerones. The effects of ginger therapy are anti-inflammatory, analgesic, hypotensive and diabetic which is associated with gingerol and shogaol which are abundant in fresh ginger and ginger. Objectives: The aim of the study was to analyze the effectiveness of red ginger extract in preventing damage to s-pancreatic cells in wistar strain white rats (rattus norvegicus) Methods: This study was laboratory experimental study with randomized post-test only control group design. The independent variable was the administration of red ginger extract, the dependent variable was blood sugar levels and the control variables were rat type, rat sex, rat age, rat body weight and rat health. The samples were 25 male Wistar strain white rats aged 8–12 weeks. The samples were divided into 5 groups randomly. One group not induced by diabetes was the healthy control group (K1). The other four groups were induced by diabetes: (K2) control of diabetes; (K3) given 500 mg/kgBW of red ginger extract; (K4) given 750 mg/kgBW of red ginger extract and (K5) given 1,000 mg/kgBW of red ginger extract. ANOVA test with α=0.05 was used to determine the effect of treatment. Furthermore, an effect size test analysis was conducted to determine the effectiveness of red ginger extract Results: all of the treatment (500 mg/kgBW, 750 mg/kgBW and 1,000 mg/kgBW of red ginger extract) had strong effect on fasting blood sugar control of the mice (effec size> 1) Conclusions: the treatment where 750 mg/kgBW of red ginger extract was administered has the highest value of effectiveness (3,632), while that in which 1,000 mg / kgBB of red ginger extract was administered has the lowest value of effectiveness (1,195). Keywords: Effectiveness, red ginger, s-pancreatic cells DOI : 10.7176/JMPB/55-01 Publication date :May 31 st 2019
{"title":"Effectiveness of Giving Red Ginger Extract in Preventing Damage to ß-Pancreatic Cells in Wistar Strain White Rats (Rattus Norvegicus)","authors":"Wiwiek Wira, Bambang Wirjatmadi, M. Adriani","doi":"10.7176/jmpb/55-01","DOIUrl":"https://doi.org/10.7176/jmpb/55-01","url":null,"abstract":"Background: One of the goals of therapy for diabetes mellitus is to maintain normal glucose levels. Therapy can be in the form of pharmacology and non-pharmacology. In addition, in the community many use traditional medicine or often known as herbal medicine for the treatment of diabetes. Traditional medicine that has many uses for treatment is ginger. The main ingredients of ginger are essential oils (1-5%), sesquiterpenoids and monoterpenoids, gingerols, shogaols, paradols and zingerones. The effects of ginger therapy are anti-inflammatory, analgesic, hypotensive and diabetic which is associated with gingerol and shogaol which are abundant in fresh ginger and ginger. Objectives: The aim of the study was to analyze the effectiveness of red ginger extract in preventing damage to s-pancreatic cells in wistar strain white rats (rattus norvegicus) Methods: This study was laboratory experimental study with randomized post-test only control group design. The independent variable was the administration of red ginger extract, the dependent variable was blood sugar levels and the control variables were rat type, rat sex, rat age, rat body weight and rat health. The samples were 25 male Wistar strain white rats aged 8–12 weeks. The samples were divided into 5 groups randomly. One group not induced by diabetes was the healthy control group (K1). The other four groups were induced by diabetes: (K2) control of diabetes; (K3) given 500 mg/kgBW of red ginger extract; (K4) given 750 mg/kgBW of red ginger extract and (K5) given 1,000 mg/kgBW of red ginger extract. ANOVA test with α=0.05 was used to determine the effect of treatment. Furthermore, an effect size test analysis was conducted to determine the effectiveness of red ginger extract Results: all of the treatment (500 mg/kgBW, 750 mg/kgBW and 1,000 mg/kgBW of red ginger extract) had strong effect on fasting blood sugar control of the mice (effec size> 1) Conclusions: the treatment where 750 mg/kgBW of red ginger extract was administered has the highest value of effectiveness (3,632), while that in which 1,000 mg / kgBB of red ginger extract was administered has the lowest value of effectiveness (1,195). Keywords: Effectiveness, red ginger, s-pancreatic cells DOI : 10.7176/JMPB/55-01 Publication date :May 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91217432","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}
Sidra Mahmood, Syeda Fatima Zahra Gardezi, A. Ahmad
Background; A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children will be hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective; To compare efficacy of N-acetylcysteine nebulization versus salbutamol nebulization in children with acute bronchiolitis. Material and Methods; The study cases were randomly divided into 2 groups by draws methods. Group A, each child was nebulized with 20 mg NAC in 3 ml of 0.9% of saline while group B was nebulized with 2.5 mg salbutamol in 3 ml of 0.9% saline solution. Patients of each group were nebulized three times a day (8 hours apart) for 5 days. These patients were closely monitored for the severity of the disease daily and clinical severity score was employed to record any improvement in both cases. All the data was entered and analyzed using SPSS-18. Results; Of these 390 study cases, 228 (58.5%) were boys while 162 (41.5%) were girls. Mean age of our study cases was 7.92 ± 5.18 months . Most of the study cases i.e. 264 (67.7%) were from poor social background and mothers of most of these children were less educated as 85.6% of the mothers of these children were having their educational status equal/less than matriculation. Mean hospital stay in our study was 4.73 ± 0.829 days. Mean baseline clinical severity score was 5.52 ± 813. Mean clinical severity score after therapy was 1.85 ± 0.812 (with minimum clinical severity score was 1 while maximum was score was 4). Clinical severity score in group A was 1.21 ± 0.405 while in group B was 2.49 ± 0.578 (p= 0.000). Conclusion; Our study results support the use N – acetylcysteine nebulization in children with acute bronchiolitis as compared with salbutamol nebulization. N – acetylcysteine nebulization was found to be more effective in improving clinical severity score and reducing duration of hospitalization. Its use was safe, reliable and no adverse side effects were noted. Keywords; Acute Bronchiolitis, Salbutamol, N – acetylcysteine. DOI : 10.7176/JMPB/55-12 Publication date :May 31 st 2019
{"title":"COMPARISON OF EFFICACY OF N-ACETYLCYSTEINE WITH SALBUTAMOL NEBULIZATION IN ACUTE BRONCHIOLITIS","authors":"Sidra Mahmood, Syeda Fatima Zahra Gardezi, A. Ahmad","doi":"10.7176/jmpb/55-12","DOIUrl":"https://doi.org/10.7176/jmpb/55-12","url":null,"abstract":"Background; A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children will be hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective; To compare efficacy of N-acetylcysteine nebulization versus salbutamol nebulization in children with acute bronchiolitis. Material and Methods; The study cases were randomly divided into 2 groups by draws methods. Group A, each child was nebulized with 20 mg NAC in 3 ml of 0.9% of saline while group B was nebulized with 2.5 mg salbutamol in 3 ml of 0.9% saline solution. Patients of each group were nebulized three times a day (8 hours apart) for 5 days. These patients were closely monitored for the severity of the disease daily and clinical severity score was employed to record any improvement in both cases. All the data was entered and analyzed using SPSS-18. Results; Of these 390 study cases, 228 (58.5%) were boys while 162 (41.5%) were girls. Mean age of our study cases was 7.92 ± 5.18 months . Most of the study cases i.e. 264 (67.7%) were from poor social background and mothers of most of these children were less educated as 85.6% of the mothers of these children were having their educational status equal/less than matriculation. Mean hospital stay in our study was 4.73 ± 0.829 days. Mean baseline clinical severity score was 5.52 ± 813. Mean clinical severity score after therapy was 1.85 ± 0.812 (with minimum clinical severity score was 1 while maximum was score was 4). Clinical severity score in group A was 1.21 ± 0.405 while in group B was 2.49 ± 0.578 (p= 0.000). Conclusion; Our study results support the use N – acetylcysteine nebulization in children with acute bronchiolitis as compared with salbutamol nebulization. N – acetylcysteine nebulization was found to be more effective in improving clinical severity score and reducing duration of hospitalization. Its use was safe, reliable and no adverse side effects were noted. Keywords; Acute Bronchiolitis, Salbutamol, N – acetylcysteine. DOI : 10.7176/JMPB/55-12 Publication date :May 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85858754","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}
F. Abbas, Saima Munir, S. Fareed, N. Arshad, K. Khan, Q. Zaman
OBJECTIVE: To determine the diagnostic accuracy of plain radiographs and 3D scan in diagnosis of mid face fractures by taking surgery findings as a gold standard. STUDY DESIGN : Cross Sectional Study SETTING: study was carried out at Department of Oral & Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan. DURATION : Study was completed in 6 months from May, 2017 to November 2017in Nishtar . Methodology: 181 Patients were included from Department of Oral & Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan after taking informed consent and permission from ethical committee and research department. Demographic information of patients (name, age, gender, duration of Fracture had taken. Patients from both gender with age range of 18-35 years having Maxillofacial trauma < 10 days were included in this study and patients in which CT scan was contraindicated and those taken any surgical treatment for facial trauma were excluded in this study. Radiographic examination for the cranio-facial complex had performed for all patients followed by routinely and according to the needs of each individual case. RESULTS: From 181 patients, the minimum age was 18 years and maximum age was 35 years. According to plain radiographs, fracture was detected in 88.4% patients. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, negative predicted value was 50% and diagnostic accuracy was 88.39%. CONCLUSION: Among 181 patients, fracture was detected in 88.4% patients by using plain radiographs. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, and diagnostic accuracy was 88.39%. Keywords: 3D scan, plain radiographs, mid face fractures DOI : 10.7176/JMPB/60-01 Publication date :October 31 st 2019
{"title":"Diagnostic Accuracy of 3d Scan and Plain Radiograph in Diagnosis of Midface Fractures","authors":"F. Abbas, Saima Munir, S. Fareed, N. Arshad, K. Khan, Q. Zaman","doi":"10.7176/jmpb/60-01","DOIUrl":"https://doi.org/10.7176/jmpb/60-01","url":null,"abstract":"OBJECTIVE: To determine the diagnostic accuracy of plain radiographs and 3D scan in diagnosis of mid face fractures by taking surgery findings as a gold standard. STUDY DESIGN : Cross Sectional Study SETTING: study was carried out at Department of Oral & Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan. DURATION : Study was completed in 6 months from May, 2017 to November 2017in Nishtar . Methodology: 181 Patients were included from Department of Oral & Maxillofacial Surgery, Nishtar Institute of Dentistry, Multan after taking informed consent and permission from ethical committee and research department. Demographic information of patients (name, age, gender, duration of Fracture had taken. Patients from both gender with age range of 18-35 years having Maxillofacial trauma < 10 days were included in this study and patients in which CT scan was contraindicated and those taken any surgical treatment for facial trauma were excluded in this study. Radiographic examination for the cranio-facial complex had performed for all patients followed by routinely and according to the needs of each individual case. RESULTS: From 181 patients, the minimum age was 18 years and maximum age was 35 years. According to plain radiographs, fracture was detected in 88.4% patients. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, negative predicted value was 50% and diagnostic accuracy was 88.39%. CONCLUSION: Among 181 patients, fracture was detected in 88.4% patients by using plain radiographs. By using 3D scan, fracture was detected in 96.7% patients. Sensitivity of 3D scan for detection of fracture was calculated as 98.13%, specificity was 14.28%, positive predicted value was 89.71%, and diagnostic accuracy was 88.39%. Keywords: 3D scan, plain radiographs, mid face fractures DOI : 10.7176/JMPB/60-01 Publication date :October 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"22 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83316325","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 association of urinary tract infections and pneumonia among patients with ischemic stroke at a tertiary care hospital. Material and Methods; All the cases of ischemic stroke (181), fulfilling inclusion criteria were recruited in this cross – sectional study. Once registered these study cases was assessed for different complications (UTI, shoulder pain, arrhythmia, pneumonia and hyponatremia) after undergoing baseline investigations like urine test, blood tests and ECG. Data was entered and analyzed by computer program SPSS-18. Results; Of these 181 study cases, 101 (55.8%) were male patients while 80 (44.2%) were female patients. Mean age of our study cases was 50.68± 7.18 years. Of these 181 study cases, 80 (44.2%) were from rural area while 101 (55.8%) from urban areas, 43 (23.8%) were diabetic and 118 (65.2%) were hypertensive. Mean body mass index (BMI) of our study cases was 23.58 ± 3.29 kg/m 2 and obesity was present in 29 (16%). History of smoking was present in 43 (23.8%) of our study cases. Previous history of stroke was present in 21 (11.6%) while family history of stroke was noted in 37 (20.4%) of our study cases and 130 (71.8 %) were illiterate and 51 (28.2%) were literate. Mean serum sodium level was noted to 136.29 ± 2.01 mEq/L, urinary tract infection (UTI) was noted in 87 (48.1%), shoulder pain in 72 (39.8%), pneumonia in 43 (23.8%), arrhythmia in 58 (32 %) and hyponatremia in 51 (28.2%) of our study cases. Conclusion; Our study results indicate high proportion of medical complications in patients with ischemic stroke. Urinary tract infection was the most commonest complication followed by shoulder pain, arrhythmia, pneumonia and hyponatremia. All clinicians treating such patients should carefully monitor such patients to take preventive measure against these complications, this will decrease disease morbidity and hospitalizations in these patients. Keywords; Ischemic stroke, medical complications, Frequency. DOI : 10.7176/JMPB/58-02 Publication date : August 31 st 2019
{"title":"ASOCIATION OF URINARY TRACT INFECTION AND PNEUMONIA AMONG PATIENTS WITH ISCHEMIC STROKE AT A TERTIARY CARE HOSPITAL.","authors":"Javeria Shamim, Rabia Shaukat, Iqra Saleem","doi":"10.7176/jmpb/58-02","DOIUrl":"https://doi.org/10.7176/jmpb/58-02","url":null,"abstract":"Objective; To determine the association of urinary tract infections and pneumonia among patients with ischemic stroke at a tertiary care hospital. Material and Methods; All the cases of ischemic stroke (181), fulfilling inclusion criteria were recruited in this cross – sectional study. Once registered these study cases was assessed for different complications (UTI, shoulder pain, arrhythmia, pneumonia and hyponatremia) after undergoing baseline investigations like urine test, blood tests and ECG. Data was entered and analyzed by computer program SPSS-18. Results; Of these 181 study cases, 101 (55.8%) were male patients while 80 (44.2%) were female patients. Mean age of our study cases was 50.68± 7.18 years. Of these 181 study cases, 80 (44.2%) were from rural area while 101 (55.8%) from urban areas, 43 (23.8%) were diabetic and 118 (65.2%) were hypertensive. Mean body mass index (BMI) of our study cases was 23.58 ± 3.29 kg/m 2 and obesity was present in 29 (16%). History of smoking was present in 43 (23.8%) of our study cases. Previous history of stroke was present in 21 (11.6%) while family history of stroke was noted in 37 (20.4%) of our study cases and 130 (71.8 %) were illiterate and 51 (28.2%) were literate. Mean serum sodium level was noted to 136.29 ± 2.01 mEq/L, urinary tract infection (UTI) was noted in 87 (48.1%), shoulder pain in 72 (39.8%), pneumonia in 43 (23.8%), arrhythmia in 58 (32 %) and hyponatremia in 51 (28.2%) of our study cases. Conclusion; Our study results indicate high proportion of medical complications in patients with ischemic stroke. Urinary tract infection was the most commonest complication followed by shoulder pain, arrhythmia, pneumonia and hyponatremia. All clinicians treating such patients should carefully monitor such patients to take preventive measure against these complications, this will decrease disease morbidity and hospitalizations in these patients. Keywords; Ischemic stroke, medical complications, Frequency. DOI : 10.7176/JMPB/58-02 Publication date : August 31 st 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"13 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75139004","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: Purpose of this study is to determine the efficacy of metformin as opposed to insulin in management of gestational diabetes mellitus. Methodology: The study took place in department of Gynecology and Obstetrics, Nishtar Hospital,Multan from May 2017 to March 2019. Study design is experimental prospective comparative study. Ethical approval was obtained from Hospital Ethics Committee. Sample was calculated using non probability consecutive sampling technique. Total 770 Patients were randomly divided into two equal groups, group M (metformin) and Group I (insulin). Glycemic control, mode of delivery and associated medical complication were recognized as possible maternal outcomes while congenital anomalies (if any), macrosomia, hypoglycemia, hyperbilirubinemia were the neonatal outcomes assessed by clinical and laboratory investigations. These outcomes were subjected to statistical analysis by using computer software SPSS version 23. Percentages were calculated for dichotomous variables and range, mean and standard deviation was calculated for continuous data. Chi square and t-test were applied to compare the two groups. P value less than 0.05 was considered as significant. Results: Overall 100% (n=770) female patients were included, in this study; divided into two equal groups 50% (n=385) in each i.e. metformin (Group M) and insulin (Group I). Significant difference was found between age (p=0.000), gravidity (p=0.012), gestational age (p=0.000), BMI in early pregnancy (p=0.000), FBS at entry (p=0.000), FBS after treatment (p=0.000), HBA1c at entry (p=0.000), HBA1c after treatment (p=0.000), in groups. Association was found between Preeclampsia (p=0.000), Pre-term birth (p=0.000), Neonatal birth weight>4 (p=0.002), neonatal hypoglycemia (p=0.000), in groups. Conclusion: This study concludes that metformin is as much effective as insulin in management of gestational diabetes mellitus. Metformin when used securely can prove effective as it does not cause any congenital anomalies or maternal or neonatal complications. But insulin still remains the gold standard for treatment of gestational diabetes mellitus. Keywords: Diabetes Mellitus, Gestational Diabetes, Metformin, Insulin, Pregnancy DOI : 10.7176/JMPB/54-11 Publication date : April 30 th 2019
{"title":"Comparison of Metformin with Insulin in the Management of Gestational Diabetes","authors":"S. Bukhari, M. Awan, Iffat Ayoub","doi":"10.7176/jmpb/54-11","DOIUrl":"https://doi.org/10.7176/jmpb/54-11","url":null,"abstract":"Objective: Purpose of this study is to determine the efficacy of metformin as opposed to insulin in management of gestational diabetes mellitus. Methodology: The study took place in department of Gynecology and Obstetrics, Nishtar Hospital,Multan from May 2017 to March 2019. Study design is experimental prospective comparative study. Ethical approval was obtained from Hospital Ethics Committee. Sample was calculated using non probability consecutive sampling technique. Total 770 Patients were randomly divided into two equal groups, group M (metformin) and Group I (insulin). Glycemic control, mode of delivery and associated medical complication were recognized as possible maternal outcomes while congenital anomalies (if any), macrosomia, hypoglycemia, hyperbilirubinemia were the neonatal outcomes assessed by clinical and laboratory investigations. These outcomes were subjected to statistical analysis by using computer software SPSS version 23. Percentages were calculated for dichotomous variables and range, mean and standard deviation was calculated for continuous data. Chi square and t-test were applied to compare the two groups. P value less than 0.05 was considered as significant. Results: Overall 100% (n=770) female patients were included, in this study; divided into two equal groups 50% (n=385) in each i.e. metformin (Group M) and insulin (Group I). Significant difference was found between age (p=0.000), gravidity (p=0.012), gestational age (p=0.000), BMI in early pregnancy (p=0.000), FBS at entry (p=0.000), FBS after treatment (p=0.000), HBA1c at entry (p=0.000), HBA1c after treatment (p=0.000), in groups. Association was found between Preeclampsia (p=0.000), Pre-term birth (p=0.000), Neonatal birth weight>4 (p=0.002), neonatal hypoglycemia (p=0.000), in groups. Conclusion: This study concludes that metformin is as much effective as insulin in management of gestational diabetes mellitus. Metformin when used securely can prove effective as it does not cause any congenital anomalies or maternal or neonatal complications. But insulin still remains the gold standard for treatment of gestational diabetes mellitus. Keywords: Diabetes Mellitus, Gestational Diabetes, Metformin, Insulin, Pregnancy DOI : 10.7176/JMPB/54-11 Publication date : April 30 th 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80025458","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}
Background; A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children was hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective; To Compare outcome of hypertonic saline versus normal saline in children with acute bronchiolitis. Material and Methods; All children fulfilling inclusion criteria were registered in this study from Emergency Department of Pediatric Medicine, Nishtar Hospital, Multan. In Group A, each child was nebulized with 4 ml of 3 % of hypertonic saline while group B was nebulized with 4 ml of 0.9% saline solution for 3 times at interval of 20 minutes. Results; Of these 302 study cases, 178 (58.9 %) were male patients while 124 (41.1 %) were female patients. Mean age of our study cases was 7.60 ± 6.19 months (ranging from 2 months to 24 months). Mean age of the male patients was noted to be 5.71 ± 3.22 months while that female patients was 10.32 ± 8.14 months (p=0.000). Mean baseline clinical severity score was 7.15 ± 1.63 while 228 (75.5%) had baseline severity score up to 8. Of these 302 study cases, need for hospitalization was noted in 122 (40.4%). Need for hospitalization in group A was 41 (27.2%) while in group B it was 81 (53.6%). (p = 0.000). Conclusion; Our study results support the use hypertonic saline solution nebulization in children with acute bronchiolitis as compared with normal saline nebulization. Hypertonic solution was found to be more effective in improving clinical severity score and reducing need of hospitalization significantly. All clinicians treating such patients should employ hypertonic solution to get desired clinical outcomes. Keywords; Hypertonic solution, acute bronchiolitis, normal saline. DOI : 10.7176/JMPB/54-16 Publication date : April 30 th 2019
{"title":"EFFICACY OF HYPERTONIC SALINE NEBULIZATION IN CHILDREN WITH ACUTE BRONCHIOLITIS.","authors":"K. Sadia, A. Akram, A. Hussain","doi":"10.7176/jmpb/54-16","DOIUrl":"https://doi.org/10.7176/jmpb/54-16","url":null,"abstract":"Background; A substantial proportion of children will experience at least one episode with bronchiolitis, and as much as 2-3% of all children was hospitalized with bronchiolitis during their first year of life. Bronchiolitis is the most common reason for hospitalization of children in many countries, challenging both economy, area and staffing in paediatric departments. Objective; To Compare outcome of hypertonic saline versus normal saline in children with acute bronchiolitis. Material and Methods; All children fulfilling inclusion criteria were registered in this study from Emergency Department of Pediatric Medicine, Nishtar Hospital, Multan. In Group A, each child was nebulized with 4 ml of 3 % of hypertonic saline while group B was nebulized with 4 ml of 0.9% saline solution for 3 times at interval of 20 minutes. Results; Of these 302 study cases, 178 (58.9 %) were male patients while 124 (41.1 %) were female patients. Mean age of our study cases was 7.60 ± 6.19 months (ranging from 2 months to 24 months). Mean age of the male patients was noted to be 5.71 ± 3.22 months while that female patients was 10.32 ± 8.14 months (p=0.000). Mean baseline clinical severity score was 7.15 ± 1.63 while 228 (75.5%) had baseline severity score up to 8. Of these 302 study cases, need for hospitalization was noted in 122 (40.4%). Need for hospitalization in group A was 41 (27.2%) while in group B it was 81 (53.6%). (p = 0.000). Conclusion; Our study results support the use hypertonic saline solution nebulization in children with acute bronchiolitis as compared with normal saline nebulization. Hypertonic solution was found to be more effective in improving clinical severity score and reducing need of hospitalization significantly. All clinicians treating such patients should employ hypertonic solution to get desired clinical outcomes. Keywords; Hypertonic solution, acute bronchiolitis, normal saline. DOI : 10.7176/JMPB/54-16 Publication date : April 30 th 2019","PeriodicalId":16339,"journal":{"name":"Journal of Medicine, Physiology and Biophysics","volume":"34 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88118434","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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