Objective: Our goal is to share our two decades of experience with implantable electrical device explanation at our electrophysiology centre at Hayat Abad Medical Complex in Peshawar. Methodology: After baseline patient were brought nil by mouth to catheterization laboratory (Cath: lab). A temporary pacemaker (TPM) implanted for backup. In case of box change, a new device is attached after checking the integrity of the lead and device placed in the same pocket. But if of lead extraction was also needed, then stylet was put inside the lead and with twisting movement and mild traction the lead removed and new lead implanted with Seldinger,s technique, battery attached and wound closed in layers. Results: Out of 1670, there were 1535 (91.9%) new implantations and 135 (8.08%) repeat procedures. The pulse generator was replaced without lead replacement in 59 (3.5%) patients. In 36 (2.15%) patients, the ventricular lead or atrial lead was successfully reposition. A total of 32 (1.9%) successful explanations were performed in the study period. Conclusion: The explanation of devices like implantation needs special gadgets and training for the safe and successful procedure.
{"title":"Our Nuts and Bolts in The Permanent Pacemakers’ Explanation Techniques","authors":"Shahab Saidullah, Bakhtawar Shah, Salman Habib, Asma Rauf","doi":"10.48036/apims.v18i2.490","DOIUrl":"https://doi.org/10.48036/apims.v18i2.490","url":null,"abstract":"Objective: Our goal is to share our two decades of experience with implantable electrical device explanation at our electrophysiology centre at Hayat Abad Medical Complex in Peshawar.\u0000Methodology: After baseline patient were brought nil by mouth to catheterization laboratory (Cath: lab). A temporary pacemaker (TPM) implanted for backup. In case of box change, a new device is attached after checking the integrity of the lead and device placed in the same pocket. But if of lead extraction was also needed, then stylet was put inside the lead and with twisting movement and mild traction the lead removed and new lead implanted with Seldinger,s technique, battery attached and wound closed in layers.\u0000Results: Out of 1670, there were 1535 (91.9%) new implantations and 135 (8.08%) repeat procedures. The pulse generator was replaced without lead replacement in 59 (3.5%) patients. In 36 (2.15%) patients, the ventricular lead or atrial lead was successfully reposition. A total of 32 (1.9%) successful explanations were performed in the study period.\u0000Conclusion: The explanation of devices like implantation needs special gadgets and training for the safe and successful procedure.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"21 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127643465","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.722
Maqbool Hussain, Sonaina Maqbool, Maryam Masood, Mishal Maqbool, Abrar Ul Haq Satti, Raza, Hussain Shah, Ravale Tashfeen, S. Abbasi
Objective: The aim of this study is to report the clinic-pathological profile of children with TBM and their treatment outcome. Methodology: A retrospective observational study was conducted in the Pediatrics Department over 6 months period. Medical records of children admitted with TBM from November 2017 to May 2018 were reviewed for data collection. Data regarding clinical presentation, laboratory investigations were recorded. Patients were treated with a standard ATT regimen, and their outcome was noted. The study was approved by hospital ethics committee. Data was entered in SPSS for statistical analysis. Results: Females were predominant 39 (55.7%) and age ranged from 4 months to 13 years in this study. Only 28 (42.0%) children were fully vaccinated and had BCG scar presence. Most TBM cases were of stage II 24 (42.8%) or stage III 29 (42.8%). The frequent symptoms were fever 61 (87.1%), rigidity/irritability 35 (50.0%), and seizures 26 (37.1%). WBCs count in CSF was found below 500 in 64 (91.4%) children. There were 55 (78.5%) children with lymphocytosis and 14 (20.0%) with polymorph nuclear cells. A CT scan was suggestive of TBM in 51 (72.8%) children. Only 21 (30.0%) cases had a complete recovery whereas 17 (24.2%) recovered with sequelae and 10 (14.2%) deaths were noted. Conclusion: TBM presents with a poor clinical and pathological state in the advanced stage of the disease, and the therapy outcome is also non-satisfactory with high mortality and sequelae posing constant challenges.
{"title":"Assessment of Clinicopathological Status and Outcome of Children with Tuberculous Meningitis at a Tertiary Care Hospital","authors":"Maqbool Hussain, Sonaina Maqbool, Maryam Masood, Mishal Maqbool, Abrar Ul Haq Satti, Raza, Hussain Shah, Ravale Tashfeen, S. Abbasi","doi":"10.48036/apims.v18i3.722","DOIUrl":"https://doi.org/10.48036/apims.v18i3.722","url":null,"abstract":"Objective: The aim of this study is to report the clinic-pathological profile of children with TBM and their treatment outcome. \u0000Methodology: A retrospective observational study was conducted in the Pediatrics Department over 6 months period. Medical records of children admitted with TBM from November 2017 to May 2018 were reviewed for data collection. Data regarding clinical presentation, laboratory investigations were recorded. Patients were treated with a standard ATT regimen, and their outcome was noted. The study was approved by hospital ethics committee. Data was entered in SPSS for statistical analysis. \u0000Results: Females were predominant 39 (55.7%) and age ranged from 4 months to 13 years in this study. Only 28 (42.0%) children were fully vaccinated and had BCG scar presence. Most TBM cases were of stage II 24 (42.8%) or stage III 29 (42.8%). The frequent symptoms were fever 61 (87.1%), rigidity/irritability 35 (50.0%), and seizures 26 (37.1%). WBCs count in CSF was found below 500 in 64 (91.4%) children. There were 55 (78.5%) children with lymphocytosis and 14 (20.0%) with polymorph nuclear cells. A CT scan was suggestive of TBM in 51 (72.8%) children. Only 21 (30.0%) cases had a complete recovery whereas 17 (24.2%) recovered with sequelae and 10 (14.2%) deaths were noted. \u0000Conclusion: TBM presents with a poor clinical and pathological state in the advanced stage of the disease, and the therapy outcome is also non-satisfactory with high mortality and sequelae posing constant challenges.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"46 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121509287","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.674
Mehwish Iqbal, Athar Razzaq, Fiaz Ahmad Malik, Muhammad ali, Muhammad Imran, Maham Shahzadi
Objective: To compare the nucleated red blood cell (NRBC) counts of healthy and asphyxiated newborns as a key clinical indicator of the severity of birth asphyxia and short-term outcome. Methodology: This case control study was conducted at the paediatric department of neonatology of Recep Tiyyap Erdogan Hospital Muzaffargarh from June 2020 to November 2020. Study A total of 112 term newborns, including 56 cases (with birth asphyxia) and 56 controls (normal babies) aged <24 hours, were included. After obtaining informed consent, blood samples were taken immediately after birth for the measurement of the NRBC count. All the enrolled cases were admitted to the NICU as per indication and observed for the severity of birth asphyxia. The relationship between the cord blood NRBC count and the severity of birth asphyxia was assessed. All the information was recorded using a self-structured study proforma, and SPSS version 26 was used for the purpose of data analysis. Results: The overall average age of the neonates was 6.18+2.66 hours. Mean age, birth weight, and gestational age were statistically insignificant in accordance to cases and controls. Males were in the majority (75.0%), and females were 25.0% of the case group. The mean NRBCs in the cases were 16.62 + 17.10, which was significantly higher than the controls at 1.69 + 2.42 (p- 0.0001). The neonatal NRBs average was statistically insignificant according to gender in both cases and controls, while it was significantly associated with the severity of perinatal hypoxia (p 0.0001). The average NRBC count was also significantly higher in cases of cardiomegaly, those having ventilation needs and respiratory distress. Conclusion: The mean NRBC was observed to be significantly higher in cases compared to controls. The NRBC was considered to be a non-invasive, simple prognostic marker for neonatal asphyxia, may indicate substantial severity of perinatal hypoxia and its related complications.
{"title":"Relationship of Nucleated Red Blood Cells with Severity of Perinatal Asphyxia and its Short-Term Outcome","authors":"Mehwish Iqbal, Athar Razzaq, Fiaz Ahmad Malik, Muhammad ali, Muhammad Imran, Maham Shahzadi","doi":"10.48036/apims.v18i3.674","DOIUrl":"https://doi.org/10.48036/apims.v18i3.674","url":null,"abstract":"Objective: To compare the nucleated red blood cell (NRBC) counts of healthy and asphyxiated newborns as a key clinical indicator of the severity of birth asphyxia and short-term outcome.\u0000Methodology: This case control study was conducted at the paediatric department of neonatology of Recep Tiyyap Erdogan Hospital Muzaffargarh from June 2020 to November 2020. Study A total of 112 term newborns, including 56 cases (with birth asphyxia) and 56 controls (normal babies) aged <24 hours, were included. After obtaining informed consent, blood samples were taken immediately after birth for the measurement of the NRBC count. All the enrolled cases were admitted to the NICU as per indication and observed for the severity of birth asphyxia. The relationship between the cord blood NRBC count and the severity of birth asphyxia was assessed. All the information was recorded using a self-structured study proforma, and SPSS version 26 was used for the purpose of data analysis.\u0000Results: The overall average age of the neonates was 6.18+2.66 hours. Mean age, birth weight, and gestational age were statistically insignificant in accordance to cases and controls. Males were in the majority (75.0%), and females were 25.0% of the case group. The mean NRBCs in the cases were 16.62 + 17.10, which was significantly higher than the controls at 1.69 + 2.42 (p- 0.0001). The neonatal NRBs average was statistically insignificant according to gender in both cases and controls, while it was significantly associated with the severity of perinatal hypoxia (p 0.0001). The average NRBC count was also significantly higher in cases of cardiomegaly, those having ventilation needs and respiratory distress.\u0000Conclusion: The mean NRBC was observed to be significantly higher in cases compared to controls. The NRBC was considered to be a non-invasive, simple prognostic marker for neonatal asphyxia, may indicate substantial severity of perinatal hypoxia and its related complications.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"10 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124332475","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.640
Mor khan Shar, Sana Ali, M. Farooq, Hanum Sadiq, Muhammad Junaid Junaid, Z. Rana
Objective: To determine the frequency of diabetic patients having Odontogenic Maxillofacial space infections in local population. Methodology: This cross sectional study was carried out from 1-3-2020 to August 2020 in the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad, to assess the frequency and association of diabetics with facial space infection. A total of 70 patients of both genders with Odontogenic maxillofacial infection were included in the study. Patients were stratified into three age groups; Age group 1 was from 18-30, Age group 2 from 31-45 years and Age group 3 from 46-60 years. This form includes demographic data (age, gender, contact information, address), medical history (diabetic or non-diabetic) along with sign and symptoms were noted in the Performa. The SPSS version 20.0 was used to analyze the data. Mean and standard deviation was calculated for age. Frequency and percentages were used for the gender and diabetes mellitus. Results: A total of 70 patients having Odontogenic maxillofacial space infection. Of these 70 study cases, 42 (60%) were females and 28 (40%) were males with mean age of 40.97±10.32 years. Out of 70 patients, 55 (78.57%) were diabetic and 15 (21.43%) patients were non-diabetic patients. Conclusion: Diabetic patients are more prone to Odontogenic maxillofacial space infections and due to poor diabetic control multispace infection along with severe complications may occur.
{"title":"Relationship of Diabetes Mellitus Among The Patients Reporting With Facial Space Infection","authors":"Mor khan Shar, Sana Ali, M. Farooq, Hanum Sadiq, Muhammad Junaid Junaid, Z. Rana","doi":"10.48036/apims.v18i3.640","DOIUrl":"https://doi.org/10.48036/apims.v18i3.640","url":null,"abstract":"Objective: To determine the frequency of diabetic patients having Odontogenic Maxillofacial space infections in local population.\u0000Methodology: This cross sectional study was carried out from 1-3-2020 to August 2020 in the Department of Oral and Maxillofacial Surgery, Pakistan Institute of Medical Sciences, Islamabad, to assess the frequency and association of diabetics with facial space infection. A total of 70 patients of both genders with Odontogenic maxillofacial infection were included in the study. Patients were stratified into three age groups; Age group 1 was from 18-30, Age group 2 from 31-45 years and Age group 3 from 46-60 years. This form includes demographic data (age, gender, contact information, address), medical history (diabetic or non-diabetic) along with sign and symptoms were noted in the Performa. The SPSS version 20.0 was used to analyze the data. Mean and standard deviation was calculated for age. Frequency and percentages were used for the gender and diabetes mellitus.\u0000Results: A total of 70 patients having Odontogenic maxillofacial space infection. Of these 70 study cases, 42 (60%) were females and 28 (40%) were males with mean age of 40.97±10.32 years. Out of 70 patients, 55 (78.57%) were diabetic and 15 (21.43%) patients were non-diabetic patients.\u0000Conclusion: Diabetic patients are more prone to Odontogenic maxillofacial space infections and due to poor diabetic control multispace infection along with severe complications may occur.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127719125","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.693
Abdul Jabbar, M. Nazir, Maryam Mushtaq, Romesa Khero, Permanand, Muzaffar Qayum Khan Ghouri
and sagittal jaw relationship. Methodology: This Cross-sectional study took place in Orthodontic Department, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, from August 2018 to January 2019. Patients of both genders ranging in age from 18 to 30 years were included. All the subjects, as per ANB angle, were grouped into three categories as (Class I = value between 1° and 4° for ANB angle), (Class II = value > 5° for ANB angle) and (Class III= value <1° for ANB angle). All the data was recorded in the Performa for the purpose of analysis. Results: A total of 90 patients were studied; their average age was 21.12+3.47 years and 52.2% were females. Mean upper posterior alveolus width was significantly higher in sagittal class II as 12.69 ± 5.52 than in sagittal class I and III p-value 0.058. The mean upper anterior alveolus height was found to be significantly greater in class I and III in contrast to class II p-value 0.028. Mean lower anterior alveolus width was insignificantly related with sagittal classification, p-value 0.343. Mean upper anterior alveolus width and lower posterior alveolus width were insignificantly related to sagittal classification, and the p-value were quite insignificant. Sagittal class II and III were significantly associated with female gender 0.021, while class I was linked to male gender p-value 0.021. Conclusion: There was a significant association between dimensions of anterior alveolar among different vertical and sagittal jaw association.
{"title":"Association of Anterior Alveolar Dimensions with Different Sagittal Jaw Relationships","authors":"Abdul Jabbar, M. Nazir, Maryam Mushtaq, Romesa Khero, Permanand, Muzaffar Qayum Khan Ghouri","doi":"10.48036/apims.v18i3.693","DOIUrl":"https://doi.org/10.48036/apims.v18i3.693","url":null,"abstract":"and sagittal jaw relationship.\u0000Methodology: This Cross-sectional study took place in Orthodontic Department, Institute of Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, from August 2018 to January 2019.\u0000Patients of both genders ranging in age from 18 to 30 years were included. All the subjects, as per ANB angle, were grouped into three categories as (Class I = value between 1° and 4° for ANB angle), (Class II = value > 5° for ANB angle) and (Class III= value <1° for ANB angle). All the data was recorded in the Performa for the purpose of analysis.\u0000Results: A total of 90 patients were studied; their average age was 21.12+3.47 years and 52.2% were females. Mean upper posterior alveolus width was significantly higher in sagittal class II as 12.69 ± 5.52 than in sagittal class I and III p-value 0.058. The mean upper anterior alveolus height was found to be significantly greater in class I and III in contrast to class II p-value 0.028. Mean lower anterior alveolus width was insignificantly related with sagittal classification, p-value 0.343. Mean upper anterior alveolus width and lower posterior alveolus width were insignificantly related to sagittal classification, and the p-value were quite insignificant. Sagittal class II and III were significantly associated with female gender 0.021, while class I was linked to male gender p-value 0.021.\u0000Conclusion: There was a significant association between dimensions of anterior alveolar among different vertical and sagittal jaw association.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133173810","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.648
M. Shaikh, Danish Shakeel, Muhammad Hassan, Nayab Afzal, Natasha Ali, Salman Adil
Objective: To evaluate the diagnostic accuracy of positron emission tomography combined with CT scan (PET-CT Scan) in detecting bone marrow involvement in patients with diffuse large B-cell lymphoma, keeping bone marrow biopsy as gold standard. Methodology: From November 2017 to May 2018, a cross sectional validation study was carried out at the Aga Khan University in Karachi Department of Oncology's Section of Clinical Hematology. The study comprised a total of 112 patients who were identified as having diffuse large B cell lymphoma after a lymph node was implicated was histopathologically examined. All patients had a PET-CT scan and bone marrow biopsy technique as part of the staging workup. With bone marrow biopsy acting as the gold standard, the diagnostic efficacy of a PET-CT scan for identifying bone marrow involvement was evaluated. Results: Of 112 patients, there were 71(63.39%) males and 41(36.61%) females. The mean age was 45.09±17.36 years. The mean duration of diagnosis was 17.19±6.02 days. Through biopsy, bone marrow involvement was identified in 40 (35.7%) cases. Through a PET-CT scan, bone marrow involvement was identified in 47 (41.9%) cases. The PET- CT scan in comparison with bone marrow biopsy for detecting bone marrow involvement in patients with DLBCL had a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 95%, 87.7%, 80.85%, 96.92% and 90.18% respectively. Conclusion: PET-CT scan can accurately detect bone marrow involvement in patients with DLBCL so it can be used in most patients instead of invasive bone marrow biopsy procedure for staging of DLBCL patients.
{"title":"Diagnostic Accuracy of Positron Emission Tomography-Computed Tomography (PET-CT Scan) In Detecting Bone Marrow Involvement in Patients with Diffuse Large B cell Lymphoma","authors":"M. Shaikh, Danish Shakeel, Muhammad Hassan, Nayab Afzal, Natasha Ali, Salman Adil","doi":"10.48036/apims.v18i3.648","DOIUrl":"https://doi.org/10.48036/apims.v18i3.648","url":null,"abstract":"Objective: To evaluate the diagnostic accuracy of positron emission tomography combined with CT scan (PET-CT Scan) in detecting bone marrow involvement in patients with diffuse large B-cell lymphoma, keeping bone marrow biopsy as gold standard.\u0000Methodology: From November 2017 to May 2018, a cross sectional validation study was carried out at the Aga Khan University in Karachi Department of Oncology's Section of Clinical Hematology. The study comprised a total of 112 patients who were identified as having diffuse large B cell lymphoma after a lymph node was implicated was histopathologically examined. All patients had a PET-CT scan and bone marrow biopsy technique as part of the staging workup. With bone marrow biopsy acting as the gold standard, the diagnostic efficacy of a PET-CT scan for identifying bone marrow involvement was evaluated.\u0000Results: Of 112 patients, there were 71(63.39%) males and 41(36.61%) females. The mean age was 45.09±17.36 years. The mean duration of diagnosis was 17.19±6.02 days. Through biopsy, bone marrow involvement was identified in 40 (35.7%) cases. Through a PET-CT scan, bone marrow involvement was identified in 47 (41.9%) cases. The PET- CT scan in comparison with bone marrow biopsy for detecting bone marrow involvement in patients with DLBCL had a sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of 95%, 87.7%, 80.85%, 96.92% and 90.18% respectively.\u0000Conclusion: PET-CT scan can accurately detect bone marrow involvement in patients with DLBCL so it can be used in most patients instead of invasive bone marrow biopsy procedure for staging of DLBCL patients.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"60 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116367168","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.658
A. Pak, Inst Med Sci, R. Tahir, Adnan Manzar, Ammarah Mehmood, Umer Mehmood, Aitzaz Khan
Objective: To determine the Outcome of non-invasive ventilation in patients with severe COVID-19 pneumonia. Methodology: A prospective cohort study was conducted at Pak Emirates Military Hospital, Rawalpindi, from 1st June to 1st Dec 2021. This study included 87 patients between the ages of 45 and 75 who were admitted due to severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection.Infection was confirmed by SARS-COV-2 PCR (polymerase Chain reaction). These patients were symptomatic with radiological evidence consistent with COVID-19 pneumonia requiring non-invasive ventilation (NIV) trial. The primary outcome was to analyze the success and failure of using NIV, the need for invasive ventilation, as well as the mortality rate. SPSS 21 was used to enter and analyze the data. Results: The mean age was 62.89 ±7.55 years. There were 65(74.7%) males and 22(25.3%) females. NIV was successful in 33 (37.9%) patients, while 54 (62.1%) patients required endotracheal intubation (invasive ventilation). Out of these 54 patients, 44 (81.4%) died after intubation. The mean duration of NIV support was observed as 6.2 ± 3.9 days. Conclusion: NIV can prevent intubation in less than half of the patients, according to our findings.
{"title":"Outcome of Non-Invasive Ventilation in Severe Corona Virus Disease of 2019 Patients; A Prospective Cohort Study","authors":"A. Pak, Inst Med Sci, R. Tahir, Adnan Manzar, Ammarah Mehmood, Umer Mehmood, Aitzaz Khan","doi":"10.48036/apims.v18i3.658","DOIUrl":"https://doi.org/10.48036/apims.v18i3.658","url":null,"abstract":"Objective: To determine the Outcome of non-invasive ventilation in patients with severe COVID-19 pneumonia.\u0000Methodology: A prospective cohort study was conducted at Pak Emirates Military Hospital, Rawalpindi, from 1st June to 1st Dec 2021. This study included 87 patients between the ages of 45 and 75 who were admitted due to severe acute respiratory syndrome coronavirus 2 (SARSCoV2) infection.Infection was confirmed by SARS-COV-2 PCR (polymerase Chain reaction). These patients were symptomatic with radiological evidence consistent with COVID-19 pneumonia requiring non-invasive ventilation (NIV) trial. The primary outcome was to analyze the success and failure of using NIV, the need for invasive ventilation, as well as the mortality rate. SPSS 21 was used to enter and analyze the data.\u0000Results: The mean age was 62.89 ±7.55 years. There were 65(74.7%) males and 22(25.3%) females. NIV was successful in 33 (37.9%) patients, while 54 (62.1%) patients required endotracheal intubation (invasive ventilation). Out of these 54 patients, 44 (81.4%) died after intubation. The mean duration of NIV support was observed as 6.2 ± 3.9 days.\u0000Conclusion: NIV can prevent intubation in less than half of the patients, according to our findings.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124874189","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.694
Muhammad Naeem Taj, Israr Ahmed, Yasmin Iqbal, Zakia Akbar, Muhammad Aamir Saeed, Muhammad Adnan
Objective: To determine the effectiveness of laparoscopic sleeve gastrectomy for weight loss in morbidly obese patients at Capital Hospital, Islamabad. Methodology: This descriptive case series study was done at Capital Hospital, CDA, Islamabad during a period of one-year from February 2019 to January 2020. All the patients with a body mass index of 35 or greater, with or without comorbidities, aged 18 to 65 years of either gender were included. All the patients underwent laparoscopic sleeve gastrectomy for weight loss. At the 1st, third, and 6th month’s follow-up, postoperative weight loss was noted. Effectiveness was taken in terms of > 10% weight loss maintained at 6 months. Results: The overall study participants' average age was 57±9.77 years, and females were in the majority (62%). Overall, laparoscopic sleeve gastrectomy was effective in 85% of patients and was not effective in 15% of patients. The average BMI was 37.31 kg/m2. Laparoscopic sleeve gastrectomy showed effectiveness in 57 (85%) patients, while 10 (15%) of the patients' weight was not lost. Effectiveness was statistically insignificant according to age, gender, and comorbidities, p-values were quite insignificant (>0.05). Conclusion: Laparoscopic sleeve gastrectomy was observed to be an effective technique for weight loss in morbid obese patients. It did decrease the morbidities and improve the quality of life.
{"title":"Effectiveness of Laparoscopic Sleeve Gastrectomy for Weight Loss in Morbid Obese Patients","authors":"Muhammad Naeem Taj, Israr Ahmed, Yasmin Iqbal, Zakia Akbar, Muhammad Aamir Saeed, Muhammad Adnan","doi":"10.48036/apims.v18i3.694","DOIUrl":"https://doi.org/10.48036/apims.v18i3.694","url":null,"abstract":"Objective: To determine the effectiveness of laparoscopic sleeve gastrectomy for weight loss in morbidly obese patients at Capital Hospital, Islamabad.\u0000Methodology: This descriptive case series study was done at Capital Hospital, CDA, Islamabad during a period of one-year from February 2019 to January 2020. All the patients with a body mass index of 35 or greater, with or without comorbidities, aged 18 to 65 years of either gender were included. All the patients underwent laparoscopic sleeve gastrectomy for weight loss. At the 1st, third, and 6th month’s follow-up, postoperative weight loss was noted. Effectiveness was taken in terms of > 10% weight loss maintained at 6 months. \u0000Results: The overall study participants' average age was 57±9.77 years, and females were in the majority (62%). Overall, laparoscopic sleeve gastrectomy was effective in 85% of patients and was not effective in 15% of patients. The average BMI was 37.31 kg/m2. Laparoscopic sleeve gastrectomy showed effectiveness in 57 (85%) patients, while 10 (15%) of the patients' weight was not lost. Effectiveness was statistically insignificant according to age, gender, and comorbidities, p-values were quite insignificant (>0.05).\u0000Conclusion: Laparoscopic sleeve gastrectomy was observed to be an effective technique for weight loss in morbid obese patients. It did decrease the morbidities and improve the quality of life.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"53 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124946579","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.639
V. Raza, Qaiser Mahmood, Iqra Waris, Muhammad Shahwaiz Malik, K. Khan
Objective: To ascertain the role of triamcinolone injection at the base of an anal fissure and its effect on healing and pain relief. Methodology: A quasi-experimental study was conducted from November 2021 to February 2022. Under aseptic measures, a 1ml Triamcinolone 40mg/ml injection was administered at the base of the anal fissure using a 1cc insulin syringe. This was injected in four positions around the base of the fissure. Patients were followed for one week to assess pain relief and improvement in quality of life. Patients were assessed for quality of life improvement and satisfaction with treatment. Patients were offered lateral internal sphincterotomy at the end of one week and again on follow up after two weeks given they were not satisfied with pain relief or symptom recurrence occurred. Results: Twenty five patients were enrolled and analysed. All fissures were seen to have a red inflamed base at enrollment. At one week after treatment, a paler base with less signs of inflammation was observed. Patients reported a mean 70% improvement in their symptoms. A mean change of 16.45 points was seen in Brief Pain Inventory scores at one-week follow up. 25% underwent a lateral internal sphincterotomy. The number needed to treat was 2.5. 5 patients were lost to follow-up after the initial one week follow-up. Conclusion: Injection of Triamcinolone at the base of an anal fissure may have a role as an adjunct to standard management in treatment. It has been shown to decrease pain and enhance healing of the fissure thus decreasing the need for surgical intervention.
{"title":"Modified Kenalog Protocol for Perianal Fissures- A Quasi Experimental Trial","authors":"V. Raza, Qaiser Mahmood, Iqra Waris, Muhammad Shahwaiz Malik, K. Khan","doi":"10.48036/apims.v18i3.639","DOIUrl":"https://doi.org/10.48036/apims.v18i3.639","url":null,"abstract":"Objective: To ascertain the role of triamcinolone injection at the base of an anal fissure and its effect on healing and pain relief.\u0000Methodology: A quasi-experimental study was conducted from November 2021 to February 2022. Under aseptic measures, a 1ml Triamcinolone 40mg/ml injection was administered at the base of the anal fissure using a 1cc insulin syringe. This was injected in four positions around the base of the fissure. Patients were followed for one week to assess pain relief and improvement in quality of life. Patients were assessed for quality of life improvement and satisfaction with treatment. Patients were offered lateral internal sphincterotomy at the end of one week and again on follow up after two weeks given they were not satisfied with pain relief or symptom recurrence occurred.\u0000Results: Twenty five patients were enrolled and analysed. All fissures were seen to have a red inflamed base at enrollment. At one week after treatment, a paler base with less signs of inflammation was observed. Patients reported a mean 70% improvement in their symptoms. A mean change of 16.45 points was seen in Brief Pain Inventory scores at one-week follow up. 25% underwent a lateral internal sphincterotomy. The number needed to treat was 2.5. 5 patients were lost to follow-up after the initial one week follow-up.\u0000Conclusion: Injection of Triamcinolone at the base of an anal fissure may have a role as an adjunct to standard management in treatment. It has been shown to decrease pain and enhance healing of the fissure thus decreasing the need for surgical intervention.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130808294","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}
Pub Date : 2022-09-11DOI: 10.48036/apims.v18i3.635
Rashida Sultana
Objective: To determine the maternal and foetal outcome in pregnant women with placenta praevia and morbidly adherent placenta praevia Methodology: A prospective case series was carried out in a tertiary care institution between 2019 and 2021. All pregnant women with placenta praevia and placenta accreta spectrum who were over 28 weeks gestation were included, regardless of whether they received their diagnoses during pregnancy or during surgery. Data was collected on structured proforma regarding demographic characteristics, obstetric factors, management options, and intraoperative complications to determine foeto-maternal outcome in women with placenta praevia and morbidly adherent placenta praevia. Results: Total number of patients with placenta praevia was 140; out of which 31 (22.1%) had placenta accreta spectrum. All cases of morbid adherence were found in major degree placenta praevia (p= 0.00). Antepartum haemorrhage in current pregnancy was more associated with placenta praevia as compared to morbidly adherent placenta praevia (p=0.00). Both placenta praevia with and without morbid adherence led to preterm birth (p=0.00). LSCS as mode of delivery in previous pregnancy, step-wise-devascularization, caesarean hysterectomies, bladder injury, blood loss more than 1000ml, number of blood transfusions, and mothers required ICU care were significantly associated (p≤0.05) with morbidly adherent placenta praevia as compare to placenta praevia without morbid adherence. In cases of placenta accreta spectrum; 11(33.3%) babies were admitted in NICU as compare to 29(25.9%) in placenta praevia without placenta accreta spectrum. Conclusion: Placenta praevia is adversely affected by placenta accreta spectrum is associated with higher foeto-maternal morbidity as compared to placenta praevia without adherence.
{"title":"Foeto-Maternal Outcome in Women with Placenta Praevia and Morbidly Adherent Placenta Praevia","authors":"Rashida Sultana","doi":"10.48036/apims.v18i3.635","DOIUrl":"https://doi.org/10.48036/apims.v18i3.635","url":null,"abstract":"Objective: To determine the maternal and foetal outcome in pregnant women with placenta praevia and morbidly adherent placenta praevia\u0000Methodology: A prospective case series was carried out in a tertiary care institution between 2019 and 2021. All pregnant women with placenta praevia and placenta accreta spectrum who were over 28 weeks gestation were included, regardless of whether they received their diagnoses during pregnancy or during surgery. Data was collected on structured proforma regarding demographic characteristics, obstetric factors, management options, and intraoperative complications to determine foeto-maternal outcome in women with placenta praevia and morbidly adherent placenta praevia.\u0000Results: Total number of patients with placenta praevia was 140; out of which 31 (22.1%) had placenta accreta spectrum. All cases of morbid adherence were found in major degree placenta praevia (p= 0.00). Antepartum haemorrhage in current pregnancy was more associated with placenta praevia as compared to morbidly adherent placenta praevia (p=0.00). Both placenta praevia with and without morbid adherence led to preterm birth (p=0.00). LSCS as mode of delivery in previous pregnancy, step-wise-devascularization, caesarean hysterectomies, bladder injury, blood loss more than 1000ml, number of blood transfusions, and mothers required ICU care were significantly associated (p≤0.05) with morbidly adherent placenta praevia as compare to placenta praevia without morbid adherence. In cases of placenta accreta spectrum; 11(33.3%) babies were admitted in NICU as compare to 29(25.9%) in placenta praevia without placenta accreta spectrum.\u0000Conclusion: Placenta praevia is adversely affected by placenta accreta spectrum is associated with higher foeto-maternal morbidity as compared to placenta praevia without adherence.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115253148","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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