Pub Date : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8047
Haroon Yousaf, Aiman Zia, Abdus Samad Khan, Maria Ahmad, Ammar Ahmad, Mohammad Iftikhar Adil
Objective: To assess the efficacy of intra-articular PRP injections in patients with knee osteoarthritis. Study Design: Cross Sectional. Setting: Orthopedic Department of Mardan Medical Complex. Period: 13th August to 14th December 2023. Methods: Involving 50 diagnosed osteoarthritis patients at demographic data, grades of osteoarthritis, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded pre-treatment. Patients received PRP injections at three intervals, and post-treatment WOMAC scores were assessed. Statistical analysis included mean, standard deviations, and a paired t-test. Results: The study comprised 66% female patients, with a mean age of 50.08±5.82 and mean BMI of 27.16±3.53. Regarding grades of osteoarthritis, grade 1, grade 2 and grade 3 comprised of n=14(28%), 19(38%), 17(34%) respectively PRP treatment significantly reduced WOMAC scores from a pre-treatment mean of 56.62±5.70 to 27.54±4.79 (p < 0.001). Conclusion: The significant reduction in WOMAC scores post-treatment suggests that intra-articular PRP injections may serve as a valuable intervention in the short term management of knee osteoarthritis.
{"title":"Efficacy of platelet rich plasma (PRP) injection in the treatment of knee pain in patients with osteoarthritis knee.","authors":"Haroon Yousaf, Aiman Zia, Abdus Samad Khan, Maria Ahmad, Ammar Ahmad, Mohammad Iftikhar Adil","doi":"10.29309/tpmj/2024.31.07.8047","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8047","url":null,"abstract":"Objective: To assess the efficacy of intra-articular PRP injections in patients with knee osteoarthritis. Study Design: Cross Sectional. Setting: Orthopedic Department of Mardan Medical Complex. Period: 13th August to 14th December 2023. Methods: Involving 50 diagnosed osteoarthritis patients at demographic data, grades of osteoarthritis, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores were recorded pre-treatment. Patients received PRP injections at three intervals, and post-treatment WOMAC scores were assessed. Statistical analysis included mean, standard deviations, and a paired t-test. Results: The study comprised 66% female patients, with a mean age of 50.08±5.82 and mean BMI of 27.16±3.53. Regarding grades of osteoarthritis, grade 1, grade 2 and grade 3 comprised of n=14(28%), 19(38%), 17(34%) respectively PRP treatment significantly reduced WOMAC scores from a pre-treatment mean of 56.62±5.70 to 27.54±4.79 (p < 0.001). Conclusion: The significant reduction in WOMAC scores post-treatment suggests that intra-articular PRP injections may serve as a valuable intervention in the short term management of knee osteoarthritis.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"6 8","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141705186","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8180
Fatima Ismail, Muhammad Ashfaq, Saneeda Bibi, Aijaz Ahmed, Dr. Fatima Ismail Pediatric Medicine
Objective: To evaluate the clinical spectrum and immediate outcomes of acute flaccid paralysis (AFP) in children presenting at National Institute of Child Health, Karachi, Pakistan. Study Design: Cross-sectional study. Setting: Department of Pediatrics, NICH, Karachi, Pakistan. Period: August 2023 to January 2024. Methods: A total of 121 children of either gender, aged 1-15 years, and presenting with AFP were analyzed. AFP was diagnosed by nerve conduction study. Causes of AFP, like Guillian Barre Syndrome (GBS), transverse myelitis, traumatic neuritis were noted. Outcomes were noted in terms of discharged from hospital, left against medical advice, and mortality. Results: In a total of 121 children, 75 (62.0%) were boys. The mean age was 6.00±2.88 years, ranging between 1-12 years. There were 74 (61.2%) children who were fully vaccinated as per age. The most common cause of AFP were GBS, transverse myelitis, and hypokalemic paralysis, noted in 49 (40.5%), 19 (15.7%), and 15 (12.4%) children, respectively. Ninety (74.4%) children were discharged after the treatment, 10 (8.3%) left against medical advice, whereas mortality was noted in 21 (17.4%) children. Children leaving against medical advice were left out from the analysis to compared final outcomes with respect to various study variables. Incomplete vaccination status (p=0.0006), and presentation with sensory loss (p=0.0003) were found to have significant association with mortality. Conclusion: Guillian Barre Syndrome was found to be the most common cause behind acute flaccid paralysis in children. Incomplete vaccination history, and presenting with sensory loss were associated with poor outcomes.
{"title":"Clinical spectrum of acute flaccid paralysis among pediatric patients at the National Institute of Child Health, Karachi, Pakistan.","authors":"Fatima Ismail, Muhammad Ashfaq, Saneeda Bibi, Aijaz Ahmed, Dr. Fatima Ismail Pediatric Medicine","doi":"10.29309/tpmj/2024.31.07.8180","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8180","url":null,"abstract":"Objective: To evaluate the clinical spectrum and immediate outcomes of acute flaccid paralysis (AFP) in children presenting at National Institute of Child Health, Karachi, Pakistan. Study Design: Cross-sectional study. Setting: Department of Pediatrics, NICH, Karachi, Pakistan. Period: August 2023 to January 2024. Methods: A total of 121 children of either gender, aged 1-15 years, and presenting with AFP were analyzed. AFP was diagnosed by nerve conduction study. Causes of AFP, like Guillian Barre Syndrome (GBS), transverse myelitis, traumatic neuritis were noted. Outcomes were noted in terms of discharged from hospital, left against medical advice, and mortality. Results: In a total of 121 children, 75 (62.0%) were boys. The mean age was 6.00±2.88 years, ranging between 1-12 years. There were 74 (61.2%) children who were fully vaccinated as per age. The most common cause of AFP were GBS, transverse myelitis, and hypokalemic paralysis, noted in 49 (40.5%), 19 (15.7%), and 15 (12.4%) children, respectively. Ninety (74.4%) children were discharged after the treatment, 10 (8.3%) left against medical advice, whereas mortality was noted in 21 (17.4%) children. Children leaving against medical advice were left out from the analysis to compared final outcomes with respect to various study variables. Incomplete vaccination status (p=0.0006), and presentation with sensory loss (p=0.0003) were found to have significant association with mortality. Conclusion: Guillian Barre Syndrome was found to be the most common cause behind acute flaccid paralysis in children. Incomplete vaccination history, and presenting with sensory loss were associated with poor outcomes.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"78 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141695330","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8150
Laparoscopic Cholecystectomy, Afnan Amjad, Muhammad Ismail, Ahmad Khan, Farees Ahmad Khan, Rahida Karim, Momnah Ahmad, Muhammad Batoor Zaman
Objective: To evaluate dexamethasone’s effect on serum glucose concentration in diabetic versus non-diabetics patients undergone laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesiology, Lady Reading Hospital, Peshawar. Period: January 2022 to December 2022. Methods: One hundred and eight patients presenting for laparoscopic cholecystectomy were included. Patients were divided in two groups, fifty four patients in diabetic group and fifty four in non-diabetic group. Dexamethasone was administered in both groups prior the anesthesia induction. Blood glucose levels were recorded at baseline, at 6th and 12th hours in both groups. Results: Total 108 patients divided in two groups, 54 in diabetic group, and 54 in non-diabetic group. Patient’s mean age was 38.67±13.66 years in diabetic group while 42.31±12.58 years in non-diabetic group. Mean BMI was 25.27±2.34 kg/m2 in diabetic group while 24.96±2.20 kg/m2 in non-diabetic group. The gender distribution of the patients in both groups is presented in Figure-1. No noteworthy significance in the rise of blood glucose levels was discerned between the two groups from baseline to the 6th hour. However, a substantial increase in blood glucose levels at the 12th hour was evident in the non-diabetic group (P = 0.0001). Conclusion: We conclude that 8 mg dexamethasone triggers a significantly elevated hyperglycemic surge in non-diabetic patients as compared to diabetics.
{"title":"Dexamethasone effect on serum glucose concentration in diabetic versus non-diabetics patients undergone laparoscopic cholecystectomy: A randomized controlled trial.","authors":"Laparoscopic Cholecystectomy, Afnan Amjad, Muhammad Ismail, Ahmad Khan, Farees Ahmad Khan, Rahida Karim, Momnah Ahmad, Muhammad Batoor Zaman","doi":"10.29309/tpmj/2024.31.07.8150","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8150","url":null,"abstract":"Objective: To evaluate dexamethasone’s effect on serum glucose concentration in diabetic versus non-diabetics patients undergone laparoscopic cholecystectomy. Study Design: Randomized Controlled Trial. Setting: Department of Anesthesiology, Lady Reading Hospital, Peshawar. Period: January 2022 to December 2022. Methods: One hundred and eight patients presenting for laparoscopic cholecystectomy were included. Patients were divided in two groups, fifty four patients in diabetic group and fifty four in non-diabetic group. Dexamethasone was administered in both groups prior the anesthesia induction. Blood glucose levels were recorded at baseline, at 6th and 12th hours in both groups. Results: Total 108 patients divided in two groups, 54 in diabetic group, and 54 in non-diabetic group. Patient’s mean age was 38.67±13.66 years in diabetic group while 42.31±12.58 years in non-diabetic group. Mean BMI was 25.27±2.34 kg/m2 in diabetic group while 24.96±2.20 kg/m2 in non-diabetic group. The gender distribution of the patients in both groups is presented in Figure-1. No noteworthy significance in the rise of blood glucose levels was discerned between the two groups from baseline to the 6th hour. However, a substantial increase in blood glucose levels at the 12th hour was evident in the non-diabetic group (P = 0.0001). Conclusion: We conclude that 8 mg dexamethasone triggers a significantly elevated hyperglycemic surge in non-diabetic patients as compared to diabetics.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"9 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141698150","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8163
N. Wazir, Muhammad Saleh Faisal, Mohammad Tamhid, Hafsa Khaliq, Zainab Irshad
Objective: To investigate and assess the efficacy of Vitamin E in preventing or reducing fatty liver changes associated with alcoholic liver injury. Study Design: Experimental study. Setting: Department of Anatomy and Animal Facility of Peshawar Medical College, Peshawar. Period: February 2018 to April 2020. Methods: The study involved eighteen male domestic rabbits (Oryctolagus cuniculus), organizing them into categories based on the time frames specified for the research. Animals in "Category E8" were subjected to an 8-week time period, while those in "Category E4" underwent a 4-week experimental duration. Each category was further divided into three groups: "Control Group A" received standard laboratory food and daily access to normal saline as drinking water, "Experimental Group B" received standard nutrition, a 30% ethanol solution in distal water (30ml per kg/day) and normal saline for drinking, and "Experimental Group C" was treated with the necessary standard diet, a 30% ethanol solution in distal water (30ml per kg/day), and "Vitamin E" (50mg dissolved in 2ml distal water per kg/day) via nasogastric tube. Liver tissue specimens from all animals were stained with H&E and Masson’s trichrome stain for quantification of fatty change. Results: A significant difference in steatosis development was observed among the E4 groups and among the E8 groups having a respective p-values of 0.001 and 0.003. This underscored the impact of alcohol within the context of alcohol-induced liver injury. However, no appreciable differences were noted between BI & CI and BII & CII (p-values > 0.05) indicating no significant distinction in liver steatosis between subjects treated with vitamin E and those not receiving vitamin E. Conclusion: In the context of alcohol-induced liver injury, the study failed to deliver anticipated protective benefits of vitamin E. There is a possibility of adverse effects, potentially rendering its use counterproductive.
研究目的调查和评估维生素 E 在预防或减轻与酒精性肝损伤相关的脂肪肝变化方面的功效。研究设计：实验研究。研究地点白沙瓦市白沙瓦医学院解剖学系和动物设施。时间：2018 年 2 月至 2020 年 4 月2018 年 2 月至 2020 年 4 月。研究方法研究涉及 18 只雄性家兔（Oryctolagus cuniculus），根据研究规定的时限将其分为不同类别。E8类 "动物的实验时间为8周，而 "E4类 "动物的实验时间为4周。每个类别又分为三组："对照组 A "接受标准实验室食物，每天饮用生理盐水；"实验组 B "接受标准营养、30%乙醇远端水溶液（每千克每天 30 毫升）和生理盐水；"实验组 C "通过鼻胃管接受必要的标准饮食、30%乙醇远端水溶液（每千克每天 30 毫升）和 "维生素 E"（每千克每天 50 毫克溶于 2 毫升远端水）。所有动物的肝组织标本均采用 H&E 和 Masson 三色染色法进行染色，以量化脂肪变化。结果在 E4 组和 E8 组之间观察到脂肪变性的明显差异，P 值分别为 0.001 和 0.003。这凸显了酒精对酒精性肝损伤的影响。然而，BI 和 CI 与 BII 和 CII 之间没有明显差异（p 值 > 0.05），这表明接受维生素 E 治疗和未接受维生素 E 治疗的受试者在肝脏脂肪变性方面没有明显区别：在酒精引起的肝损伤方面，该研究未能实现维生素 E 的预期保护作用。
{"title":"Exploring protective potential of Vitamin E in mitigating liver steatosis in alcoholic liver injury.","authors":"N. Wazir, Muhammad Saleh Faisal, Mohammad Tamhid, Hafsa Khaliq, Zainab Irshad","doi":"10.29309/tpmj/2024.31.07.8163","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8163","url":null,"abstract":"Objective: To investigate and assess the efficacy of Vitamin E in preventing or reducing fatty liver changes associated with alcoholic liver injury. Study Design: Experimental study. Setting: Department of Anatomy and Animal Facility of Peshawar Medical College, Peshawar. Period: February 2018 to April 2020. Methods: The study involved eighteen male domestic rabbits (Oryctolagus cuniculus), organizing them into categories based on the time frames specified for the research. Animals in \"Category E8\" were subjected to an 8-week time period, while those in \"Category E4\" underwent a 4-week experimental duration. Each category was further divided into three groups: \"Control Group A\" received standard laboratory food and daily access to normal saline as drinking water, \"Experimental Group B\" received standard nutrition, a 30% ethanol solution in distal water (30ml per kg/day) and normal saline for drinking, and \"Experimental Group C\" was treated with the necessary standard diet, a 30% ethanol solution in distal water (30ml per kg/day), and \"Vitamin E\" (50mg dissolved in 2ml distal water per kg/day) via nasogastric tube. Liver tissue specimens from all animals were stained with H&E and Masson’s trichrome stain for quantification of fatty change. Results: A significant difference in steatosis development was observed among the E4 groups and among the E8 groups having a respective p-values of 0.001 and 0.003. This underscored the impact of alcohol within the context of alcohol-induced liver injury. However, no appreciable differences were noted between BI & CI and BII & CII (p-values > 0.05) indicating no significant distinction in liver steatosis between subjects treated with vitamin E and those not receiving vitamin E. Conclusion: In the context of alcohol-induced liver injury, the study failed to deliver anticipated protective benefits of vitamin E. There is a possibility of adverse effects, potentially rendering its use counterproductive.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"92 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141694072","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.7774
Rabeea Khan, Bushra Shamim, Raisa Altaf, Rabia Ahmed, Nimra Ali, M. Ali
Objective: To evaluate the significance of high signals in STIR sequences in MRI in patients presenting with non-traumatic knee pain. Study Design: Cross-sectional study. Setting: Department of Radiology, Liaquat National Hospital, Karachi, Pakistan. Period: March 2023 to August 2023. Methods: The patients presented for MRI of knee joint for knee pain unrelated to trauma were analyzed. Data were collected through a proforma based on 9 questions that included demographic data and questions related to the cause of pain. The total calculated sample size was 86 patients Data was analyzed through SPSS. Descriptive statistics were calculated. Association was determined using chi-square test considering p-value ≤0.05 as significant. Results: Our study showed no statistical correlation between knee pain and high STIR signals seen in pre-patellar bursa with 90.9% showing high signals with pain, while 85.3% showed high signals without pain. In our study this signal was found in about 20-30% that were mostly female household help and carpet layers. Conclusion: There is no statistical correlation between knee pain and high STIR signals seen in pre-patellar bursa.
{"title":"MRI of knee: high signals in STIR sequences and its relation with anterior knee pain our population.","authors":"Rabeea Khan, Bushra Shamim, Raisa Altaf, Rabia Ahmed, Nimra Ali, M. Ali","doi":"10.29309/tpmj/2024.31.07.7774","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.7774","url":null,"abstract":"Objective: To evaluate the significance of high signals in STIR sequences in MRI in patients presenting with non-traumatic knee pain. Study Design: Cross-sectional study. Setting: Department of Radiology, Liaquat National Hospital, Karachi, Pakistan. Period: March 2023 to August 2023. Methods: The patients presented for MRI of knee joint for knee pain unrelated to trauma were analyzed. Data were collected through a proforma based on 9 questions that included demographic data and questions related to the cause of pain. The total calculated sample size was 86 patients Data was analyzed through SPSS. Descriptive statistics were calculated. Association was determined using chi-square test considering p-value ≤0.05 as significant. Results: Our study showed no statistical correlation between knee pain and high STIR signals seen in pre-patellar bursa with 90.9% showing high signals with pain, while 85.3% showed high signals without pain. In our study this signal was found in about 20-30% that were mostly female household help and carpet layers. Conclusion: There is no statistical correlation between knee pain and high STIR signals seen in pre-patellar bursa.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"2017 14","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707052","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8220
Pashmal Yousaf, Ushna Talat, Hafiz Muhammad Sufyan, H. J. Majid
We present a case of a 70 years old female presenting with a long-standing neck swelling with a recent increase in size and new onset pain. It was initially diagnosed and operated on as a cold nodule of thyroid as her thyroid scan showed left cold nodule and FNAC was inconclusive. However, a final diagnosis of schwannoma with Antoni A structures was made on histopathological attributes. Schwannomas are benign peripheral nerve tumors which grow slowly on parent nerves. The mainstay of treatment is surgical excision. To avoid unnecessary or inappropriate interventions, thorough pre-operative assessment is required in case of thyroid or non-thyroidal lesions as most are hypoechogenic on ultrasonography and fine needle aspiration has low diagnostic yield. The key pre-operative investigations are ultrasound and ultrasound guided cytology and immunohistochemical staining (for example S-100, calcitonin, CEA, thyroglobulin, TTF-1, melan-A, HMB45 and Ki-67). MRI is also a good diagnostic tool in neck swellings where diagnosis is uncertain.
我们介绍了一例 70 岁女性的病例，她的颈部肿物由来已久，最近肿物增大，并伴有新发疼痛。最初诊断为甲状腺冷结节并进行了手术，因为她的甲状腺扫描显示左侧有冷结节，而 FNAC 没有得出结论。然而，根据组织病理学特征，最终诊断为带有安东尼 A 结构的神经纤维束瘤。许旺瘤是一种良性周围神经肿瘤，在母神经上缓慢生长。治疗的主要方法是手术切除。为了避免不必要或不适当的干预，对于甲状腺或非甲状腺病变，需要进行全面的术前评估，因为大多数病变在超声波检查中呈低瘀血状态，细针穿刺的诊断率较低。主要的术前检查包括超声检查、超声引导下细胞学检查和免疫组化染色（如S-100、降钙素原、CEA、甲状腺球蛋白、TTF-1、黑色素-A、HMB45和Ki-67）。对于诊断不明确的颈部肿物，核磁共振成像也是一种很好的诊断工具。
{"title":"Schwannoma masquerading as a thyroid nodule: A diagnostic delimma.","authors":"Pashmal Yousaf, Ushna Talat, Hafiz Muhammad Sufyan, H. J. Majid","doi":"10.29309/tpmj/2024.31.07.8220","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8220","url":null,"abstract":"We present a case of a 70 years old female presenting with a long-standing neck swelling with a recent increase in size and new onset pain. It was initially diagnosed and operated on as a cold nodule of thyroid as her thyroid scan showed left cold nodule and FNAC was inconclusive. However, a final diagnosis of schwannoma with Antoni A structures was made on histopathological attributes. Schwannomas are benign peripheral nerve tumors which grow slowly on parent nerves. The mainstay of treatment is surgical excision. To avoid unnecessary or inappropriate interventions, thorough pre-operative assessment is required in case of thyroid or non-thyroidal lesions as most are hypoechogenic on ultrasonography and fine needle aspiration has low diagnostic yield. The key pre-operative investigations are ultrasound and ultrasound guided cytology and immunohistochemical staining (for example S-100, calcitonin, CEA, thyroglobulin, TTF-1, melan-A, HMB45 and Ki-67). MRI is also a good diagnostic tool in neck swellings where diagnosis is uncertain.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"434 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141708105","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8144
Farzana Batool, Sundus Ghani, Mohammad Asif, Tahir Haroon, Mohammad Ibrahim, Naik Mohammad
Objective: To compare the cold steel method and bipolar diathermy in tonsillectomies in terms of post-tonsillectomy hemorrhage. Study Design: Randomized Controlled Trial. Setting: Department of ENT, Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad. Period: 29th October 2020 to 1st June 2022. Methods: A total of 102 patients of both genders with ages 3 to 59 years undergoing tonsillectomy were included. Patients undergoing antiplatelet therapy, experiencing bleeding diathesis, possessing a high anesthetic risk, having uncontrolled medical conditions, suffering from anemia, or currently dealing with acute infections were not included in the study. Patients were divided into two groups A & B. Group A patients were operated by the Cold steel method and Group B were operated by Bipolar diathermy. All the surgeries were performed by the same surgical team. Both tonsils were fully exposed by Boyl Devi's mouth gag under general anesthesia. Complete removal of both tonsils was done with the Cold steel method in group A and by using Bipolar diathermy in group B. Post-operative hemorrhage (occurring 24 hours after surgery) without the necessity to return to the operation theatre for intervention was assessed. Results: The mean age of patients in group A was 20.0 ± 13.83 years and in group B was 19.12 ± 13.17 years. The majority of the patients 79 (77.45%) were between 3 to 30 years of age. Out of 102 patients, 63 (61.76%) were males and 39 (38.24%) were females with male to female ratio of 1.6:1. Frequency of secondary hemorrhage in Group A (cold steel method) was found in 01 (1.96%) while in Group B (bipolar diathermy) was 06 (11.76%) (p-value = 0.050). Conclusion: This study concluded that the frequency of post-tonsillectomy hemorrhage is higher in patients operated by bipolar diathermy as compared to the cold steel method.
{"title":"Comparison of Post-Tonsillectomy Hemorrhage rate in patients undergoing two commonly used Tonsillectomy Methods.","authors":"Farzana Batool, Sundus Ghani, Mohammad Asif, Tahir Haroon, Mohammad Ibrahim, Naik Mohammad","doi":"10.29309/tpmj/2024.31.07.8144","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8144","url":null,"abstract":"Objective: To compare the cold steel method and bipolar diathermy in tonsillectomies in terms of post-tonsillectomy hemorrhage. Study Design: Randomized Controlled Trial. Setting: Department of ENT, Head & Neck Surgery, Ayub Teaching Hospital, Abbottabad. Period: 29th October 2020 to 1st June 2022. Methods: A total of 102 patients of both genders with ages 3 to 59 years undergoing tonsillectomy were included. Patients undergoing antiplatelet therapy, experiencing bleeding diathesis, possessing a high anesthetic risk, having uncontrolled medical conditions, suffering from anemia, or currently dealing with acute infections were not included in the study. Patients were divided into two groups A & B. Group A patients were operated by the Cold steel method and Group B were operated by Bipolar diathermy. All the surgeries were performed by the same surgical team. Both tonsils were fully exposed by Boyl Devi's mouth gag under general anesthesia. Complete removal of both tonsils was done with the Cold steel method in group A and by using Bipolar diathermy in group B. Post-operative hemorrhage (occurring 24 hours after surgery) without the necessity to return to the operation theatre for intervention was assessed. Results: The mean age of patients in group A was 20.0 ± 13.83 years and in group B was 19.12 ± 13.17 years. The majority of the patients 79 (77.45%) were between 3 to 30 years of age. Out of 102 patients, 63 (61.76%) were males and 39 (38.24%) were females with male to female ratio of 1.6:1. Frequency of secondary hemorrhage in Group A (cold steel method) was found in 01 (1.96%) while in Group B (bipolar diathermy) was 06 (11.76%) (p-value = 0.050). Conclusion: This study concluded that the frequency of post-tonsillectomy hemorrhage is higher in patients operated by bipolar diathermy as compared to the cold steel method.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"29 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716542","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8174
Itrat Jawaid, M. Asim, Faheem Ahmed Khan, S. Khalid, A. Ashrafi, Asif Uddin Abbasi, Hina Iqbal, Dr. Faheem Ahmed, Khan
Objective: To find out the frequent site of squamous cell carcinoma of oral cavity and pattern of neck node involvement in cross sectional population. Study Design: Prospective Study. Setting: Department of Otorhinolaryngology Head and Neck Surgery, Abbasi Shaheed Hospital Karachi and Karachi Medical and Dental College. Period: 01-06-2023 to 31-12-2023. Methods: Patients who biopsy proven squamous cell carcinoma of oral cavity visited ENT department Abbasi Shaheed Hospital were include in this study. Proforma was made in which detail history and examination were noted. Oral cavity examined to see the size and site of tumor. Neck was palpated to see palpable cervical lymph node. CT scan head and neck with contrast was done. Those patients who fulfilled the inclusion and exclusion criteria included in this. Result: 56 patients were selected in this study who fulfill the inclusion criteria. Male were 37 (66%). Maximum number of patients were between the 41-50 years of age, 24 patients (42.8%). Most common site of carcinoma was buccal mucosa 27 (48.2%). Highest number of patients presented with T3 stage 22 patients (39.2%). The frequency of lymph node involvement noted in 35 (62.5%) patients while 21 (37.5%) came with no lymph node. Level I was the most frequent level involved, it was involved in 28 patients (50%). Conclusion: Oral squamous cell carcinoma usually reported late. Early referral to otorhinolaryngologist and educate patient to consult Otorhinolaryngologist as earliest for early diagnosis and appropriate treatment plan.
{"title":"Frequency and involvement of lymph nodes in squamous cell carcinoma of oral cavity in cross sectional population.","authors":"Itrat Jawaid, M. Asim, Faheem Ahmed Khan, S. Khalid, A. Ashrafi, Asif Uddin Abbasi, Hina Iqbal, Dr. Faheem Ahmed, Khan","doi":"10.29309/tpmj/2024.31.07.8174","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8174","url":null,"abstract":"Objective: To find out the frequent site of squamous cell carcinoma of oral cavity and pattern of neck node involvement in cross sectional population. Study Design: Prospective Study. Setting: Department of Otorhinolaryngology Head and Neck Surgery, Abbasi Shaheed Hospital Karachi and Karachi Medical and Dental College. Period: 01-06-2023 to 31-12-2023. Methods: Patients who biopsy proven squamous cell carcinoma of oral cavity visited ENT department Abbasi Shaheed Hospital were include in this study. Proforma was made in which detail history and examination were noted. Oral cavity examined to see the size and site of tumor. Neck was palpated to see palpable cervical lymph node. CT scan head and neck with contrast was done. Those patients who fulfilled the inclusion and exclusion criteria included in this. Result: 56 patients were selected in this study who fulfill the inclusion criteria. Male were 37 (66%). Maximum number of patients were between the 41-50 years of age, 24 patients (42.8%). Most common site of carcinoma was buccal mucosa 27 (48.2%). Highest number of patients presented with T3 stage 22 patients (39.2%). The frequency of lymph node involvement noted in 35 (62.5%) patients while 21 (37.5%) came with no lymph node. Level I was the most frequent level involved, it was involved in 28 patients (50%). Conclusion: Oral squamous cell carcinoma usually reported late. Early referral to otorhinolaryngologist and educate patient to consult Otorhinolaryngologist as earliest for early diagnosis and appropriate treatment plan.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"65 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141696287","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.8090
Saira Aleem, M. Murtaza, Mumtaz Ali
Objective: To determine the major factors leading to surgical site infection in elective surgeries. Study Design: Retrospective Cross Sectional study. Setting: Department of Surgery, Government Teaching Hospital Shahdara, Lahore. Period: January 2016 to December 2021. Methods: The cases of surgical site infections were collected from well-organized data according to health care commission’s format of recording data in surgical site infection Register. Emergency patients were excluded. Each infected case was thoroughly investigated according to Performa and presented in meeting of infection control committee. Demographics were recorded and the factors were determined in individual case. Frequency and percentages of infected cases and main factors in all cases were analyzed by SPSS version 24. Results: We had 61 cases of SSI out of 2962 cases operated during the study period with calculated rate of 2.06%. Seventy two percent cases had age more than 40 years. 39(63.93%) were female and 22(36/07) were male. Mean age was 43.02 years with standard deviation of ± 8.98. 72% of infected cases. BMI in infected cases was 29.56 mean and Standard deviation ± 2.74 and 27.29 in non-infected cases (significant). Diabetes and Rank of surgeon had significant difference with increased infection in resident level. Smoking and gender of patients had no statistically significant impact. Conclusion: High Body mass index, diabetes, longer duration of procedure, rank of surgeon and use of mesh are the leading factors causing surgical site infection. Smoking, age and gender had no significant effect on SSI.
{"title":"Factors leading to surgical site infection (SSI); a 6 years analysis of general surgical cases in a newly developed teaching hospital.","authors":"Saira Aleem, M. Murtaza, Mumtaz Ali","doi":"10.29309/tpmj/2024.31.07.8090","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.8090","url":null,"abstract":"Objective: To determine the major factors leading to surgical site infection in elective surgeries. Study Design: Retrospective Cross Sectional study. Setting: Department of Surgery, Government Teaching Hospital Shahdara, Lahore. Period: January 2016 to December 2021. Methods: The cases of surgical site infections were collected from well-organized data according to health care commission’s format of recording data in surgical site infection Register. Emergency patients were excluded. Each infected case was thoroughly investigated according to Performa and presented in meeting of infection control committee. Demographics were recorded and the factors were determined in individual case. Frequency and percentages of infected cases and main factors in all cases were analyzed by SPSS version 24. Results: We had 61 cases of SSI out of 2962 cases operated during the study period with calculated rate of 2.06%. Seventy two percent cases had age more than 40 years. 39(63.93%) were female and 22(36/07) were male. Mean age was 43.02 years with standard deviation of ± 8.98. 72% of infected cases. BMI in infected cases was 29.56 mean and Standard deviation ± 2.74 and 27.29 in non-infected cases (significant). Diabetes and Rank of surgeon had significant difference with increased infection in resident level. Smoking and gender of patients had no statistically significant impact. Conclusion: High Body mass index, diabetes, longer duration of procedure, rank of surgeon and use of mesh are the leading factors causing surgical site infection. Smoking, age and gender had no significant effect on SSI. ","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"62 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141714817","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 : 2024-07-01DOI: 10.29309/tpmj/2024.31.07.7875
Abubakar Siddiqui, Tariq Ali Bangash, Amer Latif, Asif Naveed, Hussam Ahmed, Muhammad Zeb, Muhammad Abbas
Objective: To find out the pattern and management of Bile Duct Injuries (BDIs) presented to Hepatobilliary unit. Study Design: Descriptive Cross Sectional. Setting: Hepatobiliary Unit, Shaikh Zayed Hospital Lahore. Period: November 1, 2022, to April 30, 2023. Methods: Total of 79 patients with Bile duct injuries were included. Demographic data and relevant investigations were performed. BDIs severity was classified using the Strausberg Classification. Patients underwent appropriate surgical interventions, with follow-up for period of 6 months postoperative complications. Results: The mean age was 39.89±10.01 yrs, primarily females (81%). BDI resulted from laparoscopic cholecystectomy in 44.3%, open cholecystectomy in 51.9%, and conversion to open surgery in 3.8% cases. Jaundice (58.2%), bile leak (38.0%), and itching (3.8%) were common presentations. Surgical procedures included hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). BDI classification revealed E2 (57.0%), E3 (36.7%), and E4 (6.3%) cases. Surgical site infection was observed in 11.4% of cases. Postoperatively 5.1% patients experienced anastomotic leaks and only the site of BDI was a significant factor for leak with the p value of <0.001. Conclusion: In conclusion the majority of BDIs were E2 (57.0%), E3 (36.7%), and E4 (6.3%).Procedure performed were hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). Anastomotic leaks were significantly linked to the site of BDI.
{"title":"Pattern and management of bile duct injuries presented to Hepatobiliary Unit of Shaikh Zayed Hospital Lahore.","authors":"Abubakar Siddiqui, Tariq Ali Bangash, Amer Latif, Asif Naveed, Hussam Ahmed, Muhammad Zeb, Muhammad Abbas","doi":"10.29309/tpmj/2024.31.07.7875","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.07.7875","url":null,"abstract":"Objective: To find out the pattern and management of Bile Duct Injuries (BDIs) presented to Hepatobilliary unit. Study Design: Descriptive Cross Sectional. Setting: Hepatobiliary Unit, Shaikh Zayed Hospital Lahore. Period: November 1, 2022, to April 30, 2023. Methods: Total of 79 patients with Bile duct injuries were included. Demographic data and relevant investigations were performed. BDIs severity was classified using the Strausberg Classification. Patients underwent appropriate surgical interventions, with follow-up for period of 6 months postoperative complications. Results: The mean age was 39.89±10.01 yrs, primarily females (81%). BDI resulted from laparoscopic cholecystectomy in 44.3%, open cholecystectomy in 51.9%, and conversion to open surgery in 3.8% cases. Jaundice (58.2%), bile leak (38.0%), and itching (3.8%) were common presentations. Surgical procedures included hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). BDI classification revealed E2 (57.0%), E3 (36.7%), and E4 (6.3%) cases. Surgical site infection was observed in 11.4% of cases. Postoperatively 5.1% patients experienced anastomotic leaks and only the site of BDI was a significant factor for leak with the p value of <0.001. Conclusion: In conclusion the majority of BDIs were E2 (57.0%), E3 (36.7%), and E4 (6.3%).Procedure performed were hepaticojejunostomy (77.2%), right hepatectomy with hepaticojejunostomy (8.9%), and liver resection + hepaticojejunostomy (13.9%). Anastomotic leaks were significantly linked to the site of BDI.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"39 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141716596","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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