Pub Date : 2023-05-31DOI: 10.48036/apims.v19i2.746
A. Pak, Inst Med Sci, Anum Ilyas, Hina Saghir, Zunera Jahanzeb, F. Syed, Yagana Iqbal
Objective: To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease. Methodology: This randomized trial was conducted in the Pulmonology Department, PIMS, Islamabad, between August 2018 and February 2019. Patients were screened from the OPD department, and before randomization, their sputum was collected over 24 hours in a solid, sterile plastic (60 mL) bottle at room temperature. They were randomized equally into two treatment groups using a lottery method. Group A received Moxifloxacin 400 mg orally once daily for five days, and group B received Ceftriaxone 1 g (IV infusion) once daily for five days. All the measurements (dyspnea grading, sputum volume, and character) were taken after five days of antibiotic therapy. Results: The mean age was 60.79 ± 13.34 years in Moxifloxacin and 59.86 ± 12.72 years in the Ceftriaxone group. In Moxifloxacin group, there were 49(68.06%) male and 23(31.94%) females and in the Ceftriaxone group, there were 49(68%) males and 23(31.94%) female cases. In Moxifloxacin, a total of 68(94.4%) cases recovered, while 4 (5.6%) cases did not achieve efficacy, whereas, in the Ceftriaxone group, 54 (75.0%) cases achieved efficacy and 18 (25.0%) were therapy failures. The efficacy of the oral Moxifloxacin group was significantly better than the oral Ceftriaxone group (p-value, < 0.05). Conclusion: The efficacy of Moxifloxacin was better than Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease.
{"title":"Comparison of Efficacy of Moxifloxacin and Ceftriaxone in Acute Exacerbation of Chronic Obstructive Pulmonary Disease","authors":"A. Pak, Inst Med Sci, Anum Ilyas, Hina Saghir, Zunera Jahanzeb, F. Syed, Yagana Iqbal","doi":"10.48036/apims.v19i2.746","DOIUrl":"https://doi.org/10.48036/apims.v19i2.746","url":null,"abstract":"Objective: To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease. Methodology: This randomized trial was conducted in the Pulmonology Department, PIMS, Islamabad, between August 2018 and February 2019. Patients were screened from the OPD department, and before randomization, their sputum was collected over 24 hours in a solid, sterile plastic (60 mL) bottle at room temperature. They were randomized equally into two treatment groups using a lottery method. Group A received Moxifloxacin 400 mg orally once daily for five days, and group B received Ceftriaxone 1 g (IV infusion) once daily for five days. All the measurements (dyspnea grading, sputum volume, and character) were taken after five days of antibiotic therapy. Results: The mean age was 60.79 ± 13.34 years in Moxifloxacin and 59.86 ± 12.72 years in the Ceftriaxone group. In Moxifloxacin group, there were 49(68.06%) male and 23(31.94%) females and in the Ceftriaxone group, there were 49(68%) males and 23(31.94%) female cases. In Moxifloxacin, a total of 68(94.4%) cases recovered, while 4 (5.6%) cases did not achieve efficacy, whereas, in the Ceftriaxone group, 54 (75.0%) cases achieved efficacy and 18 (25.0%) were therapy failures. The efficacy of the oral Moxifloxacin group was significantly better than the oral Ceftriaxone group (p-value, < 0.05). Conclusion: The efficacy of Moxifloxacin was better than Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"53 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139372317","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 : 2023-05-31DOI: 10.48036/apims.v19i2.790
A. Pak, Inst Med Sci, U. Saeed, Z. Khan, M. Mahmood, Muhammad Ali, Asad Ramzan, Marryam Anwar
effectiveness of arthroscopic capsular release (ACR) with manipulation under anesthesia (MUA) versus MUA alone in patients with resistant frozen shoulder, specifically focusing on patient-reported outcome measures (PROMs) and postoperative pain levels at 6 months. Methodology: This retrospectively analyzed study was conducted at Allied Hospital, Faisalabad, from June 2019 to August 1st, 2022. The data of 50 patients who underwent ACR with MUA (Group A) and MUA alone (Group B) were analyzed retrospectively. Patients were assessed preoperatively using the VAS pain scale, ASES, OSS, and range of motion (ROM). Preoperative results were compared to postoperative results taken 6 months postoperatively. The results were analyzed using SPSS. Independent t-tests and paired sample t-tests were used to assess significant differences between the two groups. Results: The mean age was 57 years with a mean duration of symptoms prior to surgery of 23 months. Both groups experienced a significant difference in the VAS pain scale, ASES, OSS, and ROM (p < 0.05). Patients treated with ACR and MUA (Group A) experienced significantly lower postoperative pain compared to patients treated with MUA alone (Group B) (16.68 vs. 23.72), as well as higher ASES (71.40 vs. 66.64) and OSS (37.68 vs. 34.04) scores, respectively (p < 0.05). The ROM was slightly higher in Group A; however, it was statistically insignificant. Conclusion: ACR with MUA and MUA alone are effective treatments for adhesive capsulitis. ACR with MUA provides better pain relief and functional shoulder outcomes in the early postoperative period and at 6 months. Further studies are needed to confirm these results.
{"title":"Improved PROMs and Less Post-op Pain at 6 months with ACR and MUA compared to MUA Alone in Patients with Resistant Frozen Shoulder","authors":"A. Pak, Inst Med Sci, U. Saeed, Z. Khan, M. Mahmood, Muhammad Ali, Asad Ramzan, Marryam Anwar","doi":"10.48036/apims.v19i2.790","DOIUrl":"https://doi.org/10.48036/apims.v19i2.790","url":null,"abstract":"effectiveness of arthroscopic capsular release (ACR) with manipulation under anesthesia (MUA) versus MUA alone in patients with resistant frozen shoulder, specifically focusing on patient-reported outcome measures (PROMs) and postoperative pain levels at 6 months.\u0000Methodology: This retrospectively analyzed study was conducted at Allied Hospital, Faisalabad, from June 2019 to August 1st, 2022. The data of 50 patients who underwent ACR with MUA (Group A) and MUA alone (Group B) were analyzed retrospectively. Patients were assessed preoperatively using the VAS pain scale, ASES, OSS, and range of motion (ROM). Preoperative results were compared to postoperative results taken 6 months postoperatively. The results were analyzed using SPSS. Independent t-tests and paired sample t-tests were used to assess significant differences between the two groups.\u0000Results: The mean age was 57 years with a mean duration of symptoms prior to surgery of 23 months. Both groups experienced a significant difference in the VAS pain scale, ASES, OSS, and ROM (p < 0.05). Patients treated with ACR and MUA (Group A) experienced significantly lower postoperative pain compared to patients treated with MUA alone (Group B) (16.68 vs. 23.72), as well as higher ASES (71.40 vs. 66.64) and OSS (37.68 vs. 34.04) scores, respectively (p < 0.05). The ROM was slightly higher in Group A; however, it was statistically insignificant.\u0000Conclusion: ACR with MUA and MUA alone are effective treatments for adhesive capsulitis. ACR with MUA provides better pain relief and functional shoulder outcomes in the early postoperative period and at 6 months. Further studies are needed to confirm these results.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114859804","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 : 2023-05-31DOI: 10.48036/apims.v19i2.676
N. A. Ali, Asma Khan, S. Ashraf, Sharaz Ahmed, Maidah Hanif
Introduction: In early phase of irreversible pulpitis, there is normally no clinically significant sings of infections specially bacterial infections but still there are a lot of dental practitioners that prescribe antibiotics in case of irreversible pulpitis, though there is limited data evidence that the antibiotic penicillin cause reduction in percussion sensitivity and pain (Nagle, Reader, Beck, & Weaver, 2000).There is increasing trend by dental prescription regarding over use of antibiotics in treatment of orofacial and endodontic infections and the culture in these dental infections isolated those pathogens that are multi drug resistant towards commonly prescribed antibiotics (Rôças & Siqueira Jr, 2013). Setting: Sandeman Provincial Hospital and Bolan Medical Complex Hospital Quetta. Study Duration: Duration of this study was 6 months that is from March till August 2021. Results: Majority (n=68,55.3%) of respondents were general dental practitioners followed by operative dentistry respondents (n=21,17.1%). Majority (n=54,43.9) of prescribers were having perception that analgesic should be prescribed and perform concurrent pulpectomy while (n=25, 20.3%) of prescribers had perception that in patients with irreversible pulpitis, prescribe antibiotics, analgesics and perform concurrent pulpectomy whereas majority (n= 6) of orthodontics would Immediately prescribes analgesic and schedule for RCT later. Prescribers having experience of 1 to 10 years would prescribe analgesic and perform concurrent pulpectomy. Conclusion This study concluded that majority of dental practitioners had perception of prescribing antibiotics in irreversible pulpitis while there were still a good number of those dental prescribers that had perception of prescribing analgesics and performing concurrent Pulpectomy.
{"title":"Antibiotic Over Prescription In Irreversible Pulpitis- A Perception-Based Study In Quetta, Pakistan","authors":"N. A. Ali, Asma Khan, S. Ashraf, Sharaz Ahmed, Maidah Hanif","doi":"10.48036/apims.v19i2.676","DOIUrl":"https://doi.org/10.48036/apims.v19i2.676","url":null,"abstract":"Introduction: In early phase of irreversible pulpitis, there is normally no clinically significant sings of infections specially bacterial infections but still there are a lot of dental practitioners that prescribe antibiotics in case of irreversible pulpitis, though there is limited data evidence that the antibiotic penicillin cause reduction in percussion sensitivity and pain (Nagle, Reader, Beck, & Weaver, 2000).There is increasing trend by dental prescription regarding over use of antibiotics in treatment of orofacial and endodontic infections and the culture in these dental infections isolated those pathogens that are multi drug resistant towards commonly prescribed antibiotics (Rôças & Siqueira Jr, 2013). \u0000Setting: Sandeman Provincial Hospital and Bolan Medical Complex Hospital Quetta. \u0000Study Duration: Duration of this study was 6 months that is from March till August 2021. \u0000Results: Majority (n=68,55.3%) of respondents were general dental practitioners followed by operative dentistry respondents (n=21,17.1%). Majority (n=54,43.9) of prescribers were having perception that analgesic should be prescribed and perform concurrent pulpectomy while (n=25, 20.3%) of prescribers had perception that in patients with irreversible pulpitis, prescribe antibiotics, analgesics and perform concurrent pulpectomy whereas majority (n= 6) of orthodontics would Immediately prescribes analgesic and schedule for RCT later. Prescribers having experience of 1 to 10 years would prescribe analgesic and perform concurrent pulpectomy. \u0000Conclusion This study concluded that majority of dental practitioners had perception of prescribing antibiotics in irreversible pulpitis while there were still a good number of those dental prescribers that had perception of prescribing analgesics and performing concurrent Pulpectomy. \u0000 ","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125430375","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 : 2023-05-31DOI: 10.48036/apims.v19i2.811
A. Pak, Inst Med Sci, Badar Munir, A. Shami, M. Hanif, Yasir M. Farhan, N. Manzoor, F. Nawaz, Khan, Rizwan Hameed Malik
Objective: To compare the frequency of a good functional outcome in unstable per-trochanteric fractures fixed with a dynamic hip screw and proximal femoral nail using the Harris Hip Score. Methodology: A comparative study was conducted at the Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences, Islamabad, from June to December 2021. A total of 80 patients with per-trochanteric femur fractures were selected and divided into two groups based on the surgical procedure performed: dynamic hip screw or proximal femoral nail. A comprehensive history and thorough examination were performed for all patients during scheduled follow-up visits. Patients were called in for follow-up assessments at 1 month and 3 months to evaluate the functional outcomes using the Harris Hip Score. Results: The mean age of all patients was 58.73±6.78 years. At the 3-month follow-up, the mean Harris Hip Score was significantly higher in the proximal femoral nail group compared to the dynamic hip screw group (84.64±7.05 vs. 73.9±12.53; p = 0.005). The proportion of patients with good functional outcomes (Harris Hip Score ≥ 70 points) was significantly higher in the proximal femoral nail group compared to the dynamic hip screw group (97.5% vs. 72.5%, p = 0.002). Conclusion: In this study, the proximal femoral nail group demonstrated superior functional outcomes compared to the dynamic hip screw group. The use of proximal femoral nail fixation can provide better outcomes and facilitate an earlier return to pre-injury status for patients.
{"title":"Comparison of Unstable Per-Trochanteric Fractures Fixed with Proximal Femoral Nail Versus Dynamic Hip Screw Using Harris Hip Score","authors":"A. Pak, Inst Med Sci, Badar Munir, A. Shami, M. Hanif, Yasir M. Farhan, N. Manzoor, F. Nawaz, Khan, Rizwan Hameed Malik","doi":"10.48036/apims.v19i2.811","DOIUrl":"https://doi.org/10.48036/apims.v19i2.811","url":null,"abstract":"Objective: To compare the frequency of a good functional outcome in unstable per-trochanteric fractures fixed with a dynamic hip screw and proximal femoral nail using the Harris Hip Score. \u0000Methodology: A comparative study was conducted at the Department of Orthopaedic Surgery, Pakistan Institute of Medical Sciences, Islamabad, from June to December 2021. A total of 80 patients with per-trochanteric femur fractures were selected and divided into two groups based on the surgical procedure performed: dynamic hip screw or proximal femoral nail. A comprehensive history and thorough examination were performed for all patients during scheduled follow-up visits. Patients were called in for follow-up assessments at 1 month and 3 months to evaluate the functional outcomes using the Harris Hip Score.\u0000Results: The mean age of all patients was 58.73±6.78 years. At the 3-month follow-up, the mean Harris Hip Score was significantly higher in the proximal femoral nail group compared to the dynamic hip screw group (84.64±7.05 vs. 73.9±12.53; p = 0.005). The proportion of patients with good functional outcomes (Harris Hip Score ≥ 70 points) was significantly higher in the proximal femoral nail group compared to the dynamic hip screw group (97.5% vs. 72.5%, p = 0.002).\u0000Conclusion: In this study, the proximal femoral nail group demonstrated superior functional outcomes compared to the dynamic hip screw group. The use of proximal femoral nail fixation can provide better outcomes and facilitate an earlier return to pre-injury status for patients.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124363927","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 : 2023-05-31DOI: 10.48036/apims.v19i2.519
Jahan Zeb Baber, Imran Ali, Z. Qasim, Noore Saba, Sara Akram, Muhammad Nouman, U. Waheed, Akhlaaq Wazeer
Objective: This study aimed to detect rifampicin-resistant tuberculosis cases and assess the frequency of missing probes in different study populations in Azad Jammu and Kashmir (AJK), Pakistan. Methodology: The study was conducted at the State TB Reference Laboratory, District Headquarters Teaching Hospital, Mirpur, AJK. A total of 2,790 specimens collected between March 2016 to August 2019 were analyzed. Pulmonary TB (PTB) accounted for 94% of the cases, while 6% were classified as extra-pulmonary cases. All respiratory and non-respiratory samples underwent fluorescence smear microscopy (AFB) and a real-time PCR test (Xpert MTB/RIF assay) to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance. Results: Among the 2,790 suspected MTB patients, 734 (26%) were confirmed to have MTB using the Xpert MTB/RIF assay, while 564 (20%) tested positive by fluorescence microscopy. Of the MTB-positive patients, 720 (98%) were diagnosed with pulmonary TB, and 14 (2%) had extra-pulmonary TB. Rifampicin resistance (RR) was detected in 66 (9%) cases, with 97% of the resistant cases being pulmonary and 3% extra-pulmonary. The most frequently missing probe was E (Codon 529-533), accounting for 34% of the cases, followed by probe D (Codon 523-529) at 26%. The least frequently missing probe was C (Codon 523-529), observed in 3% of the cases. Probe B (Codon 512-518) was missing in 15.4% of cases, while probe A (Codon 518-523) was missing in 9.4% of cases. Conclusion: The utilization of molecular diagnostic techniques, such as the Xpert MTB/RIF assay, enables rapid identification of MTB and detection of rifampicin resistance. This study provides valuable baseline data on the prevalence of 81 bp mutations in the rpoB gene, highlighting the need for further evaluation of mutation patterns in AJK.
{"title":"Epidemiology of Molecular Probes in Xpert MTB/RIF Assay in AJK, Pakistan","authors":"Jahan Zeb Baber, Imran Ali, Z. Qasim, Noore Saba, Sara Akram, Muhammad Nouman, U. Waheed, Akhlaaq Wazeer","doi":"10.48036/apims.v19i2.519","DOIUrl":"https://doi.org/10.48036/apims.v19i2.519","url":null,"abstract":"Objective: This study aimed to detect rifampicin-resistant tuberculosis cases and assess the frequency of missing probes in different study populations in Azad Jammu and Kashmir (AJK), Pakistan.\u0000Methodology: The study was conducted at the State TB Reference Laboratory, District Headquarters Teaching Hospital, Mirpur, AJK. A total of 2,790 specimens collected between March 2016 to August 2019 were analyzed. Pulmonary TB (PTB) accounted for 94% of the cases, while 6% were classified as extra-pulmonary cases. All respiratory and non-respiratory samples underwent fluorescence smear microscopy (AFB) and a real-time PCR test (Xpert MTB/RIF assay) to detect Mycobacterium tuberculosis (MTB) and rifampicin resistance.\u0000Results: Among the 2,790 suspected MTB patients, 734 (26%) were confirmed to have MTB using the Xpert MTB/RIF assay, while 564 (20%) tested positive by fluorescence microscopy. Of the MTB-positive patients, 720 (98%) were diagnosed with pulmonary TB, and 14 (2%) had extra-pulmonary TB. Rifampicin resistance (RR) was detected in 66 (9%) cases, with 97% of the resistant cases being pulmonary and 3% extra-pulmonary. The most frequently missing probe was E (Codon 529-533), accounting for 34% of the cases, followed by probe D (Codon 523-529) at 26%. The least frequently missing probe was C (Codon 523-529), observed in 3% of the cases. Probe B (Codon 512-518) was missing in 15.4% of cases, while probe A (Codon 518-523) was missing in 9.4% of cases.\u0000Conclusion: The utilization of molecular diagnostic techniques, such as the Xpert MTB/RIF assay, enables rapid identification of MTB and detection of rifampicin resistance. This study provides valuable baseline data on the prevalence of 81 bp mutations in the rpoB gene, highlighting the need for further evaluation of mutation patterns in AJK.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"34 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121612380","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}
Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease Objectives: To determine the outcomes in patients with small-vessel disease (SVD) who underwent percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) and correlate these adverse outcomes with various risk factors. Methodology: The prospective cohort study was conducted at the Rawalpindi Institute of Cardiology (RIC) from January 2020 to December 2022. After being approved by the Hospital Ethics Committee, fifty-four patients who presented with SVD were enrolled using non-probability consecutive sampling. Written informed consent was obtained from the patients. They were treated with DCB and observed clinically on follow-ups at 15, 30, 60, and 90 days, & later after every 6 months for up to 2 years. Only those patients who presented with symptoms underwent repeat angiography. The outcomes assessed were cardiovascular mortality, myocardial infarction (MI), and target lesion revascularization (TLR). Results: Cardiovascular mortality occurred in 2(3.7%), MI in 3(5.6%) and TLR in 2(3.7%) patients. There was a significant association between cardiovascular mortality, MI, and TLR with diabetes mellitus and BMI. Age was only significantly related to cardiovascular mortality. Conclusion: A drug-coated balloon is an effective and feasible treatment modality for small vessel disease. The incidence of outcomes of cardiovascular mortality, MI, and TLR after DCB is low, making it a safe modality. Advanced age, obesity, and diabetes mellitus alone or with hypertension are the predicting factors of adverse outcomes after DCB in patients with SVD. Keywords: Drug-coated balloon, DCB, Small vessel coronary artery disease, SVD
{"title":"Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease","authors":"Mujtaba Ahmed, Khawar Naeem Satti, Asim Javed, Fatima Noor, Muhammad Mohsin, Aimen Javed","doi":"10.48036/apims.v19i2.789","DOIUrl":"https://doi.org/10.48036/apims.v19i2.789","url":null,"abstract":"Long-Term Outcomes of Drug-Coated Balloon Angioplasty in The Treatment of Small Vessel Coronary Artery Disease\u0000Objectives: To determine the outcomes in patients with small-vessel disease (SVD) who underwent percutaneous coronary intervention (PCI) with a drug-coated balloon (DCB) and correlate these adverse outcomes with various risk factors.\u0000Methodology: The prospective cohort study was conducted at the Rawalpindi Institute of Cardiology (RIC) from January 2020 to December 2022. After being approved by the Hospital Ethics Committee, fifty-four patients who presented with SVD were enrolled using non-probability consecutive sampling. Written informed consent was obtained from the patients. They were treated with DCB and observed clinically on follow-ups at 15, 30, 60, and 90 days, & later after every 6 months for up to 2 years. Only those patients who presented with symptoms underwent repeat angiography. The outcomes assessed were cardiovascular mortality, myocardial infarction (MI), and target lesion revascularization (TLR).\u0000Results: Cardiovascular mortality occurred in 2(3.7%), MI in 3(5.6%) and TLR in 2(3.7%) patients. There was a significant association between cardiovascular mortality, MI, and TLR with diabetes mellitus and BMI. Age was only significantly related to cardiovascular mortality.\u0000Conclusion: A drug-coated balloon is an effective and feasible treatment modality for small vessel disease. The incidence of outcomes of cardiovascular mortality, MI, and TLR after DCB is low, making it a safe modality. Advanced age, obesity, and diabetes mellitus alone or with hypertension are the predicting factors of adverse outcomes after DCB in patients with SVD.\u0000Keywords: Drug-coated balloon, DCB, Small vessel coronary artery disease, SVD","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114915261","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 : 2023-05-31DOI: 10.48036/apims.v19i2.791
A. Pak, Inst Med Sci, Kanza Farrukh, Fahad Akhtar, Aiman Noor, Muhammad Arsalan, S. H. Waqar
Adult intussusception is typically less common as compared to paediatric population. Adult intussusception makes 5% of all the cases of intestinal obstruction and it may be primary or secondary in nature. Mostly patients present with abdominal pain in emergency department. CT scan is the preferred diagnostic imaging modality. Unlike in the pediatric population, where conservative management is often attempted, surgical intervention with formal resection is the preferred treatment approach in adults with intussusception because of high incidence of some associated pathology. We present a case report of a middle-aged woman who presented with signs and symptoms of intestinal obstruction and was diagnosed with intussusception and peritonitis. Exploratory laparotomy and formal resection of the affected bowel segment with ileostomy was performed, and no underlying pathology was identified that makes this case an unusual one.
{"title":"Idiopathic Perforated Intussusception in Adult – Case Report","authors":"A. Pak, Inst Med Sci, Kanza Farrukh, Fahad Akhtar, Aiman Noor, Muhammad Arsalan, S. H. Waqar","doi":"10.48036/apims.v19i2.791","DOIUrl":"https://doi.org/10.48036/apims.v19i2.791","url":null,"abstract":"Adult intussusception is typically less common as compared to paediatric population. Adult intussusception makes 5% of all the cases of intestinal obstruction and it may be primary or secondary in nature. Mostly patients present with abdominal pain in emergency department. CT scan is the preferred diagnostic imaging modality. Unlike in the pediatric population, where conservative management is often attempted, surgical intervention with formal resection is the preferred treatment approach in adults with intussusception because of high incidence of some associated pathology. We present a case report of a middle-aged woman who presented with signs and symptoms of intestinal obstruction and was diagnosed with intussusception and peritonitis. Exploratory laparotomy and formal resection of the affected bowel segment with ileostomy was performed, and no underlying pathology was identified that makes this case an unusual one.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"167 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139372390","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 : 2023-05-31DOI: 10.48036/apims.v19i2.809
A. Pak, Inst Med Sci, Fatima Khalil, Nayyar Yaqoob, Omar Ahsan, S. Perveen, Umer Gill
Objective: To assess the magnitude of malnutrition in hemodialysis patients in Pakistan and identify contributing factors in order to facilitate timely interventions and improve their quality of life. Methodology: A cross-sectional descriptive study was conducted at the nephrology inpatient department of Fauji Foundation Hospital Rawalpindi from April to September 2021. The study included patients aged 15–60 years, of both genders, who had been on maintenance hemodialysis twice weekly for at least six months. Data was collected by structured performa, which included patients’ demographic details, including age, gender, level of education, and daily income; the cause and duration of CKD; duration and frequency of haemodialysis Malnutrition was assessed using the Malnutrition Inflammation Score (MIS) and categorized as mild, moderate, or severe. Results: Out of the 107 enrolled patients, 90 were included in the analysis. The study revealed that only one-third of the patients had normal nutritional status, while the rest exhibited varying degrees of malnutrition. Severe malnutrition was observed in 20% of the hemodialysis population. Female gender, lower education level, and lower income were strongly associated with severe malnutrition. Conclusion: The study highlights the need to improve literacy, raise awareness about chronic kidney disease (CKD), and enhance the financial status of hemodialysis patients. These interventions can significantly improve outcomes and quality of life in this population. The findings emphasize the importance of identifying high-risk patients early on and implementing appropriate interventions to improve nutritional status and overall well-being.
{"title":"Nutritional Assessment of Patients on Twice Weekly Maintenance Hemodialysis","authors":"A. Pak, Inst Med Sci, Fatima Khalil, Nayyar Yaqoob, Omar Ahsan, S. Perveen, Umer Gill","doi":"10.48036/apims.v19i2.809","DOIUrl":"https://doi.org/10.48036/apims.v19i2.809","url":null,"abstract":"Objective: To assess the magnitude of malnutrition in hemodialysis patients in Pakistan and identify contributing factors in order to facilitate timely interventions and improve their quality of life.\u0000Methodology: A cross-sectional descriptive study was conducted at the nephrology inpatient department of Fauji Foundation Hospital Rawalpindi from April to September 2021. The study included patients aged 15–60 years, of both genders, who had been on maintenance hemodialysis twice weekly for at least six months. Data was collected by structured performa, which included patients’ demographic details, including age, gender, level of education, and daily income; the cause and duration of CKD; duration and frequency of haemodialysis Malnutrition was assessed using the Malnutrition Inflammation Score (MIS) and categorized as mild, moderate, or severe.\u0000Results: Out of the 107 enrolled patients, 90 were included in the analysis. The study revealed that only one-third of the patients had normal nutritional status, while the rest exhibited varying degrees of malnutrition. Severe malnutrition was observed in 20% of the hemodialysis population. Female gender, lower education level, and lower income were strongly associated with severe malnutrition.\u0000Conclusion: The study highlights the need to improve literacy, raise awareness about chronic kidney disease (CKD), and enhance the financial status of hemodialysis patients. These interventions can significantly improve outcomes and quality of life in this population. The findings emphasize the importance of identifying high-risk patients early on and implementing appropriate interventions to improve nutritional status and overall well-being.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124958688","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 : 2023-05-31DOI: 10.48036/apims.v19i2.782
Rooh Ali Ghumro, Sughra Parveen, Dileep Kumar, Kanwal Hanif, Abdul Wheed, Jahangir Ali Soomro
Objective: To assess the role of metronidazole versus placebo in terms of pain relief post hemorrhoidectomy. Methodology: This randomized control trial was done at the general surgery department of PUMHS from January 2022 to July 2022. The study included adult patients of both genders, aged 18-60, who underwent surgeries for grade III and grade IV hemorrhoids. The participants were divided into two groups: a control group and an intervention group that received oral metronidazole for seven days postoperatively. Both groups received a standardized post-operative analgesic treatment. Post-operative pain and its severity were assessed using the Visual Analog Scale (VAS). Data were collected using a study proforma, and statistical analysis was performed using SPSS version 26. Results: A total of 60 cases of hemorrhoids were comparatively studied; mean age of the case group was 39.36+10.43 years and the mean age of the control group was 35.33+9.35 years (p=0.120). The mean BMI and average disease duration was statistically insignificant according to both groups (p > 0.05). In the cases group, grade III hemorrhoids were 36.7% and grade IV hemorrhoids were 63.3%, while in the control group, grade III hemorrhoids were 46.7% and grade IV hemorrhoids were 53.3% (p=0121). The mean operative time was almost similar in both groups (p=0.515). Average VAS was significantly decreased in the case group after 2 hours, at 24 hours, at 36 hours, and at 48 hours (p=<0.05), while it was statistically insignificant according to both groups at the 7th post-operative day (p=0.091). Conclusion: The use of oral or topical metronidazole in the post-operative period concludes to be more effective in terms of clinically significant early pain relief.
目的:评价甲硝唑与安慰剂在痔疮切除术后疼痛缓解方面的作用。方法:该随机对照试验于2022年1月至2022年7月在PUMHS普外科进行。该研究包括年龄在18-60岁之间，接受过III级和IV级痔疮手术的成年患者。参与者被分为两组:对照组和干预组，术后口服甲硝唑7天。两组术后均给予标准化的镇痛治疗。采用视觉模拟评分法(VAS)评估术后疼痛及其严重程度。数据收集采用研究形式表，统计分析采用SPSS version 26。结果:共对60例痔疮进行了比较研究;病例组平均年龄为39.36+10.43岁，对照组平均年龄为35.33+9.35岁(p=0.120)。两组患者的平均BMI和平均病程差异均无统计学意义(p > 0.05)。病例组中，III级占36.7%，IV级占63.3%，而对照组中，III级占46.7%，IV级占53.3% (p=0121)。两组患者平均手术时间差异无统计学意义(p=0.515)。病例组在术后2小时、24小时、36小时、48小时平均VAS均显著降低(p=<0.05)，而两组在术后第7天差异无统计学意义(p=0.091)。结论:术后口服或外用甲硝唑能较好地缓解早期疼痛。
{"title":"Comparative Study of Placebo Versus Metronidazole as a Role of Pain Relief Post Hemorrhoidectomy","authors":"Rooh Ali Ghumro, Sughra Parveen, Dileep Kumar, Kanwal Hanif, Abdul Wheed, Jahangir Ali Soomro","doi":"10.48036/apims.v19i2.782","DOIUrl":"https://doi.org/10.48036/apims.v19i2.782","url":null,"abstract":"Objective: To assess the role of metronidazole versus placebo in terms of pain relief post hemorrhoidectomy.\u0000Methodology: This randomized control trial was done at the general surgery department of PUMHS from January 2022 to July 2022. The study included adult patients of both genders, aged 18-60, who underwent surgeries for grade III and grade IV hemorrhoids. The participants were divided into two groups: a control group and an intervention group that received oral metronidazole for seven days postoperatively. Both groups received a standardized post-operative analgesic treatment. Post-operative pain and its severity were assessed using the Visual Analog Scale (VAS). Data were collected using a study proforma, and statistical analysis was performed using SPSS version 26.\u0000Results: A total of 60 cases of hemorrhoids were comparatively studied; mean age of the case group was 39.36+10.43 years and the mean age of the control group was 35.33+9.35 years (p=0.120). The mean BMI and average disease duration was statistically insignificant according to both groups (p > 0.05). In the cases group, grade III hemorrhoids were 36.7% and grade IV hemorrhoids were 63.3%, while in the control group, grade III hemorrhoids were 46.7% and grade IV hemorrhoids were 53.3% (p=0121). The mean operative time was almost similar in both groups (p=0.515). Average VAS was significantly decreased in the case group after 2 hours, at 24 hours, at 36 hours, and at 48 hours (p=<0.05), while it was statistically insignificant according to both groups at the 7th post-operative day (p=0.091).\u0000Conclusion: The use of oral or topical metronidazole in the post-operative period concludes to be more effective in terms of clinically significant early pain relief.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127568653","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 : 2023-05-31DOI: 10.48036/apims.v19i2.838
A. Pak, Inst Med Sci, N. Islam, Shirin Aamir, Aleena Hussain, Syed Mohsin Naveed, Wasim Ahmad
using daclatasvir and sofosbuvir in treatment-naive, non-cirrhotic HCV genotype 3 Pakistani population. Methodology: From January 2017 to February 2019, HCV patients who met the inclusion criteria were included in this open-label, non-randomized, uncontrolled observational trial at HBS General Hospital in Islamabad. A 12-week course of oral daclatasvir and sofosbuvir therapy was administered to each participant. Each patient got 400mg of sofosbuvir and 60mg of daclatasvir. Treatment outcomes included sustained virological response (SVR12 and SVR24), rapid virological response (RVR), and end-of-treatment response (ETR) as primary and secondary respectively. Results: There were 105 participants in the study, of which 72.3% were male and 27.6% were female. RVR for male was 92% (p=0.002), while it was 89.65% for female (p=0.004). 96.05% of the male and 93.1% of the female achieved ETR (p=0.002). Both 93.1% of female and 93.4% of male had SVR12 (p=0.001). A single male patient experienced relapse after achieving SVR12 (p=060). SVR24 rates for male and female were 92.1% (p=0.003) and 93.1%, (p=0.003) respectively. The combination therapy was well-tolerated, with the primary side effect being fatigue (36% in males, 44% in females). Conclusion: The combination therapy of daclatasvir and sofosbuvir demonstrated both safety and efficacy in treating treatment-naïve, non-cirrhotic individuals with HCV genotype 3 in Pakistan. The study underscores the potential of direct-acting antiviral agents in addressing the challenge of HCV infections.
{"title":"Response of Daclatasvir and Sofosbuvir in Treatment-Naïve, HCV Genotype 3, Non-Cirrhotic Pakistani Population: 1 Year Follow-Up Experience","authors":"A. Pak, Inst Med Sci, N. Islam, Shirin Aamir, Aleena Hussain, Syed Mohsin Naveed, Wasim Ahmad","doi":"10.48036/apims.v19i2.838","DOIUrl":"https://doi.org/10.48036/apims.v19i2.838","url":null,"abstract":"using daclatasvir and sofosbuvir in treatment-naive, non-cirrhotic HCV genotype 3 Pakistani population.\u0000Methodology: From January 2017 to February 2019, HCV patients who met the inclusion criteria were included in this open-label, non-randomized, uncontrolled observational trial at HBS General Hospital in Islamabad. A 12-week course of oral daclatasvir and sofosbuvir therapy was administered to each participant. Each patient got 400mg of sofosbuvir and 60mg of daclatasvir. Treatment outcomes included sustained virological response (SVR12 and SVR24), rapid virological response (RVR), and end-of-treatment response (ETR) as primary and secondary respectively.\u0000Results: There were 105 participants in the study, of which 72.3% were male and 27.6% were female. RVR for male was 92% (p=0.002), while it was 89.65% for female (p=0.004). 96.05% of the male and 93.1% of the female achieved ETR (p=0.002). Both 93.1% of female and 93.4% of male had SVR12 (p=0.001). A single male patient experienced relapse after achieving SVR12 (p=060). SVR24 rates for male and female were 92.1% (p=0.003) and 93.1%, (p=0.003) respectively. The combination therapy was well-tolerated, with the primary side effect being fatigue (36% in males, 44% in females).\u0000Conclusion: The combination therapy of daclatasvir and sofosbuvir demonstrated both safety and efficacy in treating treatment-naïve, non-cirrhotic individuals with HCV genotype 3 in Pakistan. The study underscores the potential of direct-acting antiviral agents in addressing the challenge of HCV infections.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"84 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123534094","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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