Pub Date : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.7983
Sarwat Jahan, Manzoor Khan, Salman Zahir, Khansa Khan, Sarah Saleem
Objective: Sphingosine 1 Phosphate (S1P) is a key regulator of inflammation, angiogenesis, vessel permeability, and immune processes, acting through S1P receptors. Fingolimod (FTY720), an S1P receptor analog Fingolimod, was initially approved for multiple sclerosis treatment and has shown potential for application in infectious and inflammatory disorders, including COVID-19. Study Design: Comprehensive Literature Review. Setting: Northwest School of Medicine. Period: 1st March 2023 to 3rd July 2023. Methods: Examining S1P pathways, S1P receptor analogs, and their potential in treating inflammatory and infectious disorders, particularly COVID-19, utilizing Fingolimod. Results: S1P analogs have demonstrated therapeutic benefits in autoimmune diseases. In COVID-19, these analogs modulate the inflammatory response, reduce tissue damage, and promote viral clearance. Fingolimod, in particular, affects S1PR1, S1PR4, and S1PR5, blunting the inflammatory response and mitigating lung tissue injury. Early administration may prevent excessive inflammation without interfering with viral clearance. Potential risks include disturbance of cytokine homeostasis and delayed administration. Limited human studies and concerns about off-target effects need addressing. Conclusion: Fingolimod shows promise in treating COVID-19 by reducing inflammation and lung damage. Further research is needed to address limitations and ensure safety for clinical application. Sphingosine 1 Phosphate (S1P) plays a key role in regulating inflammation and immune responses, with Fingolimod being a potential treatment option.
{"title":"Role of fingolimod in acute respiratory distress syndrome.","authors":"Sarwat Jahan, Manzoor Khan, Salman Zahir, Khansa Khan, Sarah Saleem","doi":"10.29309/tpmj/2024.31.05.7983","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.7983","url":null,"abstract":"Objective: Sphingosine 1 Phosphate (S1P) is a key regulator of inflammation, angiogenesis, vessel permeability, and immune processes, acting through S1P receptors. Fingolimod (FTY720), an S1P receptor analog Fingolimod, was initially approved for multiple sclerosis treatment and has shown potential for application in infectious and inflammatory disorders, including COVID-19. Study Design: Comprehensive Literature Review. Setting: Northwest School of Medicine. Period: 1st March 2023 to 3rd July 2023. Methods: Examining S1P pathways, S1P receptor analogs, and their potential in treating inflammatory and infectious disorders, particularly COVID-19, utilizing Fingolimod. Results: S1P analogs have demonstrated therapeutic benefits in autoimmune diseases. In COVID-19, these analogs modulate the inflammatory response, reduce tissue damage, and promote viral clearance. Fingolimod, in particular, affects S1PR1, S1PR4, and S1PR5, blunting the inflammatory response and mitigating lung tissue injury. Early administration may prevent excessive inflammation without interfering with viral clearance. Potential risks include disturbance of cytokine homeostasis and delayed administration. Limited human studies and concerns about off-target effects need addressing. Conclusion: Fingolimod shows promise in treating COVID-19 by reducing inflammation and lung damage. Further research is needed to address limitations and ensure safety for clinical application. Sphingosine 1 Phosphate (S1P) plays a key role in regulating inflammation and immune responses, with Fingolimod being a potential treatment option.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"54 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141014001","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To achieve consensus on opinions of expert medical educationist on utilization of simulation-based interprofessional education as teaching strategy for evidence based practice teaching in undergraduate medical education. Study Design: Qualitative Case study. Setting: Bahria University Health Sciences Campus. Period: March 2023 to August 2023. Methods: Research using modified Delphi technique was done under ERC 16/2023-BUMDC. Communities of practice and transformative learning theory were used for guiding research design. Non-probability, snow-ball sampling technique was used to select expert panel as participants. Inclusion criteria were medical educationist with masters in health professional education and ten year of experience in department of medical education. Content analysis was used for analyzing data and atlas ti-9 was used for organizing data collected through online email interviews. Results: Final consensus of participants was attained on, third year, Simulation-based interprofessional education/ Assignments/ Journal Clubs/Case-based discussions, Fourth year, Simulation-based interprofessional education/ Journal Clubs/Case-based discussions, Content: Final year, Simulation-based interprofessional education/ Clinical setting/ Journal Clubs. Conclusion: Expert showed ninety percent consensus that simulation-based interprofessional education is good teaching strategies for teaching evidence –based practice in undergraduate medical.
{"title":"Simulation-based interprofessional education for teaching evidence-based medical practice.","authors":"Khadija Farrukh, Fareeha Shahid, Fatima Zehra, Samreen Iqbal, Samia Ghulam Mohammad, Muhammad Ahsan","doi":"10.29309/tpmj/2024.31.05.7963","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.7963","url":null,"abstract":"Objective: To achieve consensus on opinions of expert medical educationist on utilization of simulation-based interprofessional education as teaching strategy for evidence based practice teaching in undergraduate medical education. Study Design: Qualitative Case study. Setting: Bahria University Health Sciences Campus. Period: March 2023 to August 2023. Methods: Research using modified Delphi technique was done under ERC 16/2023-BUMDC. Communities of practice and transformative learning theory were used for guiding research design. Non-probability, snow-ball sampling technique was used to select expert panel as participants. Inclusion criteria were medical educationist with masters in health professional education and ten year of experience in department of medical education. Content analysis was used for analyzing data and atlas ti-9 was used for organizing data collected through online email interviews. Results: Final consensus of participants was attained on, third year, Simulation-based interprofessional education/ Assignments/ Journal Clubs/Case-based discussions, Fourth year, Simulation-based interprofessional education/ Journal Clubs/Case-based discussions, Content: Final year, Simulation-based interprofessional education/ Clinical setting/ Journal Clubs. Conclusion: Expert showed ninety percent consensus that simulation-based interprofessional education is good teaching strategies for teaching evidence –based practice in undergraduate medical.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"199 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013442","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.8113
Abdul Khaliq, Muhammad Kashif, Syed Mohsin, Ali Shah, Tabinda Shadab, Romisa Rehman, Faizan Sadiq
Objective: To compare the efficacy of table salt with silver nitrate in the treatment of umbilical granuloma presenting to the neonatal unit/paediatric department KTH. Study Design: Randomized Controlled Trial Setting: Neonatal Unit of Khyber Teaching Hospital. Period: November 2019 to November 2022. Methods: A total of 120 patients who presented to the neonatal unit/paediatric department, aged 15-60 days were enrolled in this study via consecutive sampling. Seventy-five patients each, were allocated to two groups, Group A (common salt) and Group B (silver nitrate). Sixteen patients from Group A whereas, in Group B, 17 patients were lost to follow-up. Results: A total of 58 out of the remaining 117 patients were female whereas 59 patients were male. Treatment response was recorded for both groups. The cure rate was greater among Group B (93%) as compared to Group A (88%) but there was no statistically significant difference between Group A and B in treatment response (p= 0.35). Conclusion: Table salt is a cheaper, easily accessible, and safe alternative to topical silver nitrate in the treatment of umbilical granuloma.
目的比较食盐和硝酸银治疗新生儿科/儿科脐肉芽肿的疗效。研究设计：随机对照试验随机对照试验：开伯尔教学医院新生儿科。时间：2019 年 11 月至 2022 年 11 月2019年11月至2022年11月。研究方法本研究通过连续抽样的方式，共招募了 120 名 15-60 天大的新生儿科/儿科患者。每组 75 名患者被分配到两组，A 组（普通盐）和 B 组（硝酸银）。A 组有 16 名患者失去随访，B 组有 17 名患者失去随访。结果：剩余的 117 名患者中，女性 58 人，男性 59 人。两组患者均有治疗反应。与 A 组（88%）相比，B 组的治愈率更高（93%），但 A 组和 B 组在治疗反应方面没有显著的统计学差异（P= 0.35）。结论在治疗脐肉芽肿时，食盐是一种比局部硝酸银更便宜、更容易获得、更安全的替代品。
{"title":"Comparison between silver nitrate and table salt in the treatment of umbilical granuloma.","authors":"Abdul Khaliq, Muhammad Kashif, Syed Mohsin, Ali Shah, Tabinda Shadab, Romisa Rehman, Faizan Sadiq","doi":"10.29309/tpmj/2024.31.05.8113","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.8113","url":null,"abstract":"Objective: To compare the efficacy of table salt with silver nitrate in the treatment of umbilical granuloma presenting to the neonatal unit/paediatric department KTH. Study Design: Randomized Controlled Trial Setting: Neonatal Unit of Khyber Teaching Hospital. Period: November 2019 to November 2022. Methods: A total of 120 patients who presented to the neonatal unit/paediatric department, aged 15-60 days were enrolled in this study via consecutive sampling. Seventy-five patients each, were allocated to two groups, Group A (common salt) and Group B (silver nitrate). Sixteen patients from Group A whereas, in Group B, 17 patients were lost to follow-up. Results: A total of 58 out of the remaining 117 patients were female whereas 59 patients were male. Treatment response was recorded for both groups. The cure rate was greater among Group B (93%) as compared to Group A (88%) but there was no statistically significant difference between Group A and B in treatment response (p= 0.35). Conclusion: Table salt is a cheaper, easily accessible, and safe alternative to topical silver nitrate in the treatment of umbilical granuloma.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"34 S5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141014044","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.8055
Sohail Bashir Sulehria, Hina Wajid, Abdul Wasae, Aqeel Asghar, Mushtaq Ahmad Shahid, Mariam Tahir
Objective: To determine the frequency of triple vessel coronary artery disease in patients less than 40 years of age undergone diagnostic coronary angiography and were admitted with acute coronary syndrome Study Design: Cross Sectional study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 3rd Sep 2018 to 2nd March 2019. Methods: It was consisted of 90 patients Results: Total 90 cases were enrolled in the study. All presented with central or left sided chest pain clinically diagnosed to be having acute coronary syndrome. All patients undergo diagnostic coronary angiography for the first time. 36.7 % of the presenting cases included in the present study were females while 63.3 % were males who had acute coronary syndrome. Average age of patients included in present study was 30.1±5.9 Data was stratified according to age, gender, type of ACS present. Post stratification chi-square test was applied. It showed that 23.29 % patients had triple vessel coronary artery disease whereas 76.71% did not have triple vessel coronary artery disease. Conclusion: TVCAD was observed in 23.29% of patients presented with acute coronary syndrome in patients less than 40 years of age.
{"title":"To determine the frequency of triple vessel coronary artery disease in patients admitted with acute coronary syndrome.","authors":"Sohail Bashir Sulehria, Hina Wajid, Abdul Wasae, Aqeel Asghar, Mushtaq Ahmad Shahid, Mariam Tahir","doi":"10.29309/tpmj/2024.31.05.8055","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.8055","url":null,"abstract":"Objective: To determine the frequency of triple vessel coronary artery disease in patients less than 40 years of age undergone diagnostic coronary angiography and were admitted with acute coronary syndrome Study Design: Cross Sectional study. Setting: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Period: 3rd Sep 2018 to 2nd March 2019. Methods: It was consisted of 90 patients Results: Total 90 cases were enrolled in the study. All presented with central or left sided chest pain clinically diagnosed to be having acute coronary syndrome. All patients undergo diagnostic coronary angiography for the first time. 36.7 % of the presenting cases included in the present study were females while 63.3 % were males who had acute coronary syndrome. Average age of patients included in present study was 30.1±5.9 Data was stratified according to age, gender, type of ACS present. Post stratification chi-square test was applied. It showed that 23.29 % patients had triple vessel coronary artery disease whereas 76.71% did not have triple vessel coronary artery disease. Conclusion: TVCAD was observed in 23.29% of patients presented with acute coronary syndrome in patients less than 40 years of age.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"75 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013390","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.7828
Shafquat Hussain Khuwaja, S. Soomro, Khurram Anwar, Naveed Irfan, Arsalan Ahmed, Kundan
Objective: To determine the effect of hyaluronic acid as an adjuvant to root planning and scaling for the management of chronic periodontitis patients. Study Design: Prospective Randomized-controlled Clinical study. Setting: Department of Periodontology, Faculty of Dentistry Isra Dental College Hyderabad. Period: 1st July 2022 to 31st June 2023. Methods: A total of 50 diagnosed patients of chronic periodontitis and assigned into two groups according to the treatment given. Group A received Hyaluronic acid+Scaling and Root Planning whereas group B patients received Scaling and Root Planning alone. Patients were clinically evaluated before receiving treatment. Periodontal Depth (PD), Clinical Attachment level (CAL), Blood on Probe (BOP), and Plague Index (PI) were recorded at Baseline appointments, 3rd-month appointments, and 6th-month appointments after receiving treatment. The results were analyzed by SPSS version 21. Results: in both groups, significant improvement was observed in the mean value of PD, and CAL after receiving treatment, while comparing both groups, Group A patients found more significant results (<0.05) as compared to Group B. The study also found a significant reduction in BOP and PI of both groups of patients after receiving treatment but there was not any significant difference found in the mean value of BOP and PI in both groups. Conclusion: The study was conducted to determine the effectiveness of Hyaluronic acid as an adjuvant therapy that may affect chronic periodontitis along with SRP. The current study concluded hyaluronic acid gel is an effective adjuvant therapy with SRP.
{"title":"Clinical evaluation of 0.8% hyaluronic acid gel adjunctive to scaling and root planning in the treatment of chronic periodontitis in Hyderabad Sindh.","authors":"Shafquat Hussain Khuwaja, S. Soomro, Khurram Anwar, Naveed Irfan, Arsalan Ahmed, Kundan","doi":"10.29309/tpmj/2024.31.05.7828","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.7828","url":null,"abstract":"Objective: To determine the effect of hyaluronic acid as an adjuvant to root planning and scaling for the management of chronic periodontitis patients. Study Design: Prospective Randomized-controlled Clinical study. Setting: Department of Periodontology, Faculty of Dentistry Isra Dental College Hyderabad. Period: 1st July 2022 to 31st June 2023. Methods: A total of 50 diagnosed patients of chronic periodontitis and assigned into two groups according to the treatment given. Group A received Hyaluronic acid+Scaling and Root Planning whereas group B patients received Scaling and Root Planning alone. Patients were clinically evaluated before receiving treatment. Periodontal Depth (PD), Clinical Attachment level (CAL), Blood on Probe (BOP), and Plague Index (PI) were recorded at Baseline appointments, 3rd-month appointments, and 6th-month appointments after receiving treatment. The results were analyzed by SPSS version 21. Results: in both groups, significant improvement was observed in the mean value of PD, and CAL after receiving treatment, while comparing both groups, Group A patients found more significant results (<0.05) as compared to Group B. The study also found a significant reduction in BOP and PI of both groups of patients after receiving treatment but there was not any significant difference found in the mean value of BOP and PI in both groups. Conclusion: The study was conducted to determine the effectiveness of Hyaluronic acid as an adjuvant therapy that may affect chronic periodontitis along with SRP. The current study concluded hyaluronic acid gel is an effective adjuvant therapy with SRP.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"144 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013109","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.7993
Shabana Abbas, M. Khattak, Sanober Hameed, Fatima-tuz-Zahra, Sami Saeed, Rabiya Shabir
Objective: To assess the effectiveness of HbA1c as an indicator of Gestational Diabetes mellitus(GDM). Study Design: Prospective Cases Control study. Setting: Fauji Foundation Hospital Rawalpindi. Period: March 2022 to Oct 2022. Methods: All pregnant females older than 18 years of age having pregnancy confirmed by gynecologist in 1st trimester were included. A 5ml blood sample was obtained from each case to evelaute the HbA1c level. Oral glucose tolerance test (OGTT) was performed on both groups at conception to 12 weeks (1st trimester) as well as at 12 to 24 weeks of gestation (2nd trimester) to evaluate correlation between OGTT and HbA1c test. All the females suffering from GDM were taken in cases group and comparatively in equal number non GDM pregnant women were taken in control group. All the relevant information was collected via study proforma and SPSS version 26 was used for analysis. Results: The number of females suffering from GDM was 45 in number and we took 45 pregnant females as control group. Average level of HbA1c in women with GDM (test group) was higher than in women with Non-GDM (control group). Patients having age groups 35-39 showing greater prevalence of gestational diabetes with 73.2% sensitivity and 66.7% specificity at a cut-off value of 5.6% (31 mmol/mol) for GDM diagnosis. Conclusion: The findings reveal significantly elevated HbA1c levels during both the first and second trimesters in individuals diagnosed with GDM, with a test specificity of 95%. This underscores its ability to accurately pinpoint individuals who truly have GDM. However, HbA1c is observed as a valuable diagnostic tool for the early detection of GDM.
{"title":"HbA1c as an early diagnostic marker in gestational diabetes mellitus.","authors":"Shabana Abbas, M. Khattak, Sanober Hameed, Fatima-tuz-Zahra, Sami Saeed, Rabiya Shabir","doi":"10.29309/tpmj/2024.31.05.7993","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.7993","url":null,"abstract":"Objective: To assess the effectiveness of HbA1c as an indicator of Gestational Diabetes mellitus(GDM). Study Design: Prospective Cases Control study. Setting: Fauji Foundation Hospital Rawalpindi. Period: March 2022 to Oct 2022. Methods: All pregnant females older than 18 years of age having pregnancy confirmed by gynecologist in 1st trimester were included. A 5ml blood sample was obtained from each case to evelaute the HbA1c level. Oral glucose tolerance test (OGTT) was performed on both groups at conception to 12 weeks (1st trimester) as well as at 12 to 24 weeks of gestation (2nd trimester) to evaluate correlation between OGTT and HbA1c test. All the females suffering from GDM were taken in cases group and comparatively in equal number non GDM pregnant women were taken in control group. All the relevant information was collected via study proforma and SPSS version 26 was used for analysis. Results: The number of females suffering from GDM was 45 in number and we took 45 pregnant females as control group. Average level of HbA1c in women with GDM (test group) was higher than in women with Non-GDM (control group). Patients having age groups 35-39 showing greater prevalence of gestational diabetes with 73.2% sensitivity and 66.7% specificity at a cut-off value of 5.6% (31 mmol/mol) for GDM diagnosis. Conclusion: The findings reveal significantly elevated HbA1c levels during both the first and second trimesters in individuals diagnosed with GDM, with a test specificity of 95%. This underscores its ability to accurately pinpoint individuals who truly have GDM. However, HbA1c is observed as a valuable diagnostic tool for the early detection of GDM.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"32 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141014095","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.8060
Zahidullah Khan, Wisal Ahmad, Mamoona Zaman, Inamullah Khan, Mohammad Haroon, Hamza Ali Khan, Irfan Ullah, Wadana Zafar
Objective: To determine the frequencies of liver cirrhosis-associated complications in patients with HCV+ diabetic patients and its association with HbA1C. Study Design: Observational Cross-sectional study. Setting: Medical Wards of Khyber Teaching Hospital. Period: October 2019 to November 2020. Methods: After approval from the hospital ethical committee, all HCV positive diabetic patients were enrolled in the study. Informed consent was obtained and relevant examination was performed. Hematemesis was diagnosed clinically, while venous blood was sent for all routine and relevant specialized investigations. Twenty-four-hour urinary output was calculated. Abdominal ultrasounds and Triphasic CT abdomen were done where required. Data were collected on structurally designed proforma. All data were entered into SPSS version 22. Results: A total of 62 patients were enrolled. The mean age was 49. 23 years ± 11.72 SD. Twenty-three patients (37.1%) were males, while 39 patients (62.9%) were females. Forty-nine patients (79%) were PCR-positive for HCV. Most patients (58.1%) had less than five years duration of HCV. Frequency of SBP was 16.1%, hepatic encephalopathy was 22.6%, ascites was 40.3%, hematemesis was 11.3%, portal vein hypertension was 45.2%, and HCC 3.2%. On post-stratification, significant associations emerged with age, where SBP (p <0.01), hepatic encephalopathy (p<0.001), and ascites (p<0.0001), increased with advancing age, while hematemesis (p<0.04) and portal vein hypertension (p<0.04) were more pronounced in younger patients. Conclusion: In conclusion, individuals with both chronic HCV and diabetes mellitus exhibit an increased risk of cirrhosis-related complications. The most common complication was portal vein hypertension followed by ascites and hepatic encephalopathy. The complications like SBP, Hepatic encephalopathy and ascites associated with increasing age.
{"title":"Complications associated with HCV-related liver cirrhosis and their relationship with diabetic control. A tertiary care center study in Peshawar, Pakistan.","authors":"Zahidullah Khan, Wisal Ahmad, Mamoona Zaman, Inamullah Khan, Mohammad Haroon, Hamza Ali Khan, Irfan Ullah, Wadana Zafar","doi":"10.29309/tpmj/2024.31.05.8060","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.8060","url":null,"abstract":"Objective: To determine the frequencies of liver cirrhosis-associated complications in patients with HCV+ diabetic patients and its association with HbA1C. Study Design: Observational Cross-sectional study. Setting: Medical Wards of Khyber Teaching Hospital. Period: October 2019 to November 2020. Methods: After approval from the hospital ethical committee, all HCV positive diabetic patients were enrolled in the study. Informed consent was obtained and relevant examination was performed. Hematemesis was diagnosed clinically, while venous blood was sent for all routine and relevant specialized investigations. Twenty-four-hour urinary output was calculated. Abdominal ultrasounds and Triphasic CT abdomen were done where required. Data were collected on structurally designed proforma. All data were entered into SPSS version 22. Results: A total of 62 patients were enrolled. The mean age was 49. 23 years ± 11.72 SD. Twenty-three patients (37.1%) were males, while 39 patients (62.9%) were females. Forty-nine patients (79%) were PCR-positive for HCV. Most patients (58.1%) had less than five years duration of HCV. Frequency of SBP was 16.1%, hepatic encephalopathy was 22.6%, ascites was 40.3%, hematemesis was 11.3%, portal vein hypertension was 45.2%, and HCC 3.2%. On post-stratification, significant associations emerged with age, where SBP (p <0.01), hepatic encephalopathy (p<0.001), and ascites (p<0.0001), increased with advancing age, while hematemesis (p<0.04) and portal vein hypertension (p<0.04) were more pronounced in younger patients. Conclusion: In conclusion, individuals with both chronic HCV and diabetes mellitus exhibit an increased risk of cirrhosis-related complications. The most common complication was portal vein hypertension followed by ascites and hepatic encephalopathy. The complications like SBP, Hepatic encephalopathy and ascites associated with increasing age.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"101 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013358","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.8043
Lachhman Singh, Mashal Khan, Dr. Lachhman Singh Rajput, Rajput Mashal Khan
Objective: To find out the spectrum of respiratory distress and outcome in neonates admitted to Neonatal Intensive care unit (NICU) of National Institute of Child Health (NICH), Karachi, Pakistan. Study Design: Cross-sectional study. Setting: NICU of NICH, Karachi, Pakistan. Period: June 2022 to May 2023. Methods: We analyzed 148 neonates of either gender presenting with respiratory distress. At the time of enrollment, demographic and clinical information was noted in all neonates along with detailed maternal history. Relevant laboratory and radiological studies were performed. Final outcomes were recorded in terms of discharged, expired or referred. Results: In a total of 148 neonates, 96 (64.9%) were boys. The mean age was 4.04±5.65 days. Tachypnea, nasal flaring, intercostal recession, subcostal recession, grunting, and cyanosis 148 (100%), 146 (98.6%), 138 (93.2%), 133 (89.9%), 97 (65.5%), and 83 (56.1%) were the most frequent clinical presentations among neonates with respiratory distress. The most frequent causes behind respiratory distress were noted to be respiratory distress syndrome, sepsis, and meconium staining of labour in 31 (20.9%), 25 (16.9%), and 24 (16.2%) neonates. Mortality was observed in 21 (14.2%) neonates. Significant association of neonates presenting with congenital pneumonia (p=0.048), or congenital anomalies (p<0.001) were found to with poor outcomes. Mechanical ventilation was found to have significant relationship with poor outcomes (p<0.001). Conclusion: Tachypnea, Nasal flaring, intercostal and subcostal recessions, grunting, and cyanosis were the primary clinical presentations among the neonates with respiratory distress. Congenital pneumonia, and congenital anomalies emerged as key predictors of poor outcomes.
{"title":"Spectrum of respiratory distress and outcome in neonates admitted in National Institute of Child Health, Karachi, Pakistan.","authors":"Lachhman Singh, Mashal Khan, Dr. Lachhman Singh Rajput, Rajput Mashal Khan","doi":"10.29309/tpmj/2024.31.05.8043","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.8043","url":null,"abstract":"Objective: To find out the spectrum of respiratory distress and outcome in neonates admitted to Neonatal Intensive care unit (NICU) of National Institute of Child Health (NICH), Karachi, Pakistan. Study Design: Cross-sectional study. Setting: NICU of NICH, Karachi, Pakistan. Period: June 2022 to May 2023. Methods: We analyzed 148 neonates of either gender presenting with respiratory distress. At the time of enrollment, demographic and clinical information was noted in all neonates along with detailed maternal history. Relevant laboratory and radiological studies were performed. Final outcomes were recorded in terms of discharged, expired or referred. Results: In a total of 148 neonates, 96 (64.9%) were boys. The mean age was 4.04±5.65 days. Tachypnea, nasal flaring, intercostal recession, subcostal recession, grunting, and cyanosis 148 (100%), 146 (98.6%), 138 (93.2%), 133 (89.9%), 97 (65.5%), and 83 (56.1%) were the most frequent clinical presentations among neonates with respiratory distress. The most frequent causes behind respiratory distress were noted to be respiratory distress syndrome, sepsis, and meconium staining of labour in 31 (20.9%), 25 (16.9%), and 24 (16.2%) neonates. Mortality was observed in 21 (14.2%) neonates. Significant association of neonates presenting with congenital pneumonia (p=0.048), or congenital anomalies (p<0.001) were found to with poor outcomes. Mechanical ventilation was found to have significant relationship with poor outcomes (p<0.001). Conclusion: Tachypnea, Nasal flaring, intercostal and subcostal recessions, grunting, and cyanosis were the primary clinical presentations among the neonates with respiratory distress. Congenital pneumonia, and congenital anomalies emerged as key predictors of poor outcomes.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"144 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013108","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 : 2024-05-04DOI: 10.29309/tpmj/2024.31.05.8022
Laparoscopic Cholecystectomy, H. Jalal, M. Murtaza, Noor Fatima, A. Khalid
Objective: To evaluate whether local irrigation of Bupivacaine reduces post-operative pain after cholecystectomy. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Surgery, Government Teaching Hospital, Shahdara Lahore. Period: June 2020 to December 2022. Methods: For this study, 86 participants were divided into two groups, each containing 43 participants (Bupivacaine vs. no Bupivacaine). The control group (Group A) received an infiltration of 15 ml of 0.5% bupivacaine in the sub-diaphragmatic region on the right side and at port sites, while normal saline was administered to Group B. The Visual Analogue Pain Score Scale was employed to assess pain levels at 0-3, 3-5, 5-7, and above 7-10 hours post-surgery (VAS). Results: In this study, the total number of included individuals was 86. Moreover, the overall mean and median ages in months for both groups were 47.7 ± 8.97 and 47 (18-60) respectively, with the majority of patients being male (59 individuals, 68.6%). Furthermore, there was a statistically significant mean difference in pain scores on the visual analogue scale at 0–3 hours, 3–5 hours, 5–7 hours, and 7–10 hours (p-value < 0.05). Similarly, there was a statistically significant mean difference in pain scores on the visual analogue scale after more than three to five hours, more than seven hours, and more than ten hours (p-value < 0.05). Conclusion: Consequently, we inferred that intraperitoneal and local infiltration of Bupivacaine following laparoscopic cholecystectomy significantly reduced the level of postoperative discomfort and the requirement for analgesics.
{"title":"Comparison of intraperitoneal instillation of Bupivacaine vs Normal Saline for postoperative pain relief after laparoscopic cholecystectomy.","authors":"Laparoscopic Cholecystectomy, H. Jalal, M. Murtaza, Noor Fatima, A. Khalid","doi":"10.29309/tpmj/2024.31.05.8022","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.05.8022","url":null,"abstract":"Objective: To evaluate whether local irrigation of Bupivacaine reduces post-operative pain after cholecystectomy. Study Design: Prospective, Randomized Controlled Trial. Setting: Department of Surgery, Government Teaching Hospital, Shahdara Lahore. Period: June 2020 to December 2022. Methods: For this study, 86 participants were divided into two groups, each containing 43 participants (Bupivacaine vs. no Bupivacaine). The control group (Group A) received an infiltration of 15 ml of 0.5% bupivacaine in the sub-diaphragmatic region on the right side and at port sites, while normal saline was administered to Group B. The Visual Analogue Pain Score Scale was employed to assess pain levels at 0-3, 3-5, 5-7, and above 7-10 hours post-surgery (VAS). Results: In this study, the total number of included individuals was 86. Moreover, the overall mean and median ages in months for both groups were 47.7 ± 8.97 and 47 (18-60) respectively, with the majority of patients being male (59 individuals, 68.6%). Furthermore, there was a statistically significant mean difference in pain scores on the visual analogue scale at 0–3 hours, 3–5 hours, 5–7 hours, and 7–10 hours (p-value < 0.05). Similarly, there was a statistically significant mean difference in pain scores on the visual analogue scale after more than three to five hours, more than seven hours, and more than ten hours (p-value < 0.05). Conclusion: Consequently, we inferred that intraperitoneal and local infiltration of Bupivacaine following laparoscopic cholecystectomy significantly reduced the level of postoperative discomfort and the requirement for analgesics.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"126 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141013161","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 : 2024-04-01DOI: 10.29309/tpmj/2024.31.04.8094
Bushra Ujala, Istikhar Ali Sajjad, Nida Pervaiz
Objectives: To determine the frequency of incidental findings of COVID 19 pneumonia on CT scan chest in patients undergoing CT imaging for some other indications. Study Design: Descriptive, Cross sectional study. Setting: Department of Radiology, Allied Hospital, Faisalabad. Period: 4th August 2021 to 3rd February 2022. Methods: A total of 100 patients referred to radiology department for CT scan chest, individuals ranging from 15 to 65 years old, encompassing both male and female genders were included. Individuals with symptoms of COVID-19 and CRF were excluded. After taking informed consent, demographic features like age, gender, BMI, smoking (yes/no) were noted. Subsequently, all patients underwent a chest CT scan, revealing the inadvertent discovery of COVID-19 pneumonia. Results: In my study, frequency of incidental findings of COVID-19 pneumonia on chest CT scans among individuals undergoing CT imaging were consolidation (55.0%), ground glass opacities (80.0%), reticular pattern (47.0%) and air bronchograms (41.0%). Conclusion: This study concluded that ground glass opacities and consolidation are the commonest incidental observations of COVID-19 pneumonia on chest CT scans.
{"title":"Frequency of incidental findings of COVID 19 pneumonia on CT scan chest in patients undergoing CT imaging for some other indications.","authors":"Bushra Ujala, Istikhar Ali Sajjad, Nida Pervaiz","doi":"10.29309/tpmj/2024.31.04.8094","DOIUrl":"https://doi.org/10.29309/tpmj/2024.31.04.8094","url":null,"abstract":"Objectives: To determine the frequency of incidental findings of COVID 19 pneumonia on CT scan chest in patients undergoing CT imaging for some other indications. Study Design: Descriptive, Cross sectional study. Setting: Department of Radiology, Allied Hospital, Faisalabad. Period: 4th August 2021 to 3rd February 2022. Methods: A total of 100 patients referred to radiology department for CT scan chest, individuals ranging from 15 to 65 years old, encompassing both male and female genders were included. Individuals with symptoms of COVID-19 and CRF were excluded. After taking informed consent, demographic features like age, gender, BMI, smoking (yes/no) were noted. Subsequently, all patients underwent a chest CT scan, revealing the inadvertent discovery of COVID-19 pneumonia. Results: In my study, frequency of incidental findings of COVID-19 pneumonia on chest CT scans among individuals undergoing CT imaging were consolidation (55.0%), ground glass opacities (80.0%), reticular pattern (47.0%) and air bronchograms (41.0%). Conclusion: This study concluded that ground glass opacities and consolidation are the commonest incidental observations of COVID-19 pneumonia on chest CT scans.","PeriodicalId":22991,"journal":{"name":"The professional medical journal","volume":"520 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140775553","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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