Tehmina Tariq, A. Noor, S. Akram, Muhammad Ahmad Khan, Nabeel Ibad, Faraha Tariq, Muhammad Fahim-Ul-Haq, Samiah Shahid
Background: Bipolar disorder (BD) is a mental disorder with mood swings that fluctuate between mania, hypomania, and depression. C-reactive protein (CRP) levels in bipolar patients have been studied across the globe, but the results are variable. A very limited research has been conducted in this area in Pakistan. Therefore, the goal of the current investigation was to evaluate CRP in bipolar illness. Moreover any link between CRP and gender was also investigated. Materials and methods: In this cross-sectional study, 112 subjects (82 bipolar patients and 30 controls) were included. The patients were randomly selected from Punjab Institute of Mental Health (PIMH) and Sheikh Zayed Hospital, Lahore. After the consent of the subjects, venous blood samples were collected. CRP levels were semi-quantitatively estimated by agglutination method. The data obtained was analyzed through SPSS. Results: The difference in the mean CRP level among bipolar and control groups was statistically significant (p = 0.001). Moreover, males had higher CRP levels than females but the difference was non-significant (p=0.134). Comparison of CRP levels among various stages of BD and control showed a significant difference between the groups (p=0.009). Increased CRP levels give an idea about the inflammation and severity of the disease. CRP levels could be of help in the diagnosis and prognosis of BD. Conclusions: The present study suggests a significant association of CRP with bipolar disorder. No significant relation of CRP and gender was depicted. Keywords: Bipolar Disorder, C-reactive protein, Gender
{"title":"Association of C-Reactive Protein (CRP) with Bipolar Disorder & Gender","authors":"Tehmina Tariq, A. Noor, S. Akram, Muhammad Ahmad Khan, Nabeel Ibad, Faraha Tariq, Muhammad Fahim-Ul-Haq, Samiah Shahid","doi":"10.53350/pjmhs221610233","DOIUrl":"https://doi.org/10.53350/pjmhs221610233","url":null,"abstract":"Background: Bipolar disorder (BD) is a mental disorder with mood swings that fluctuate between mania, hypomania, and depression. C-reactive protein (CRP) levels in bipolar patients have been studied across the globe, but the results are variable. A very limited research has been conducted in this area in Pakistan. Therefore, the goal of the current investigation was to evaluate CRP in bipolar illness. Moreover any link between CRP and gender was also investigated. Materials and methods: In this cross-sectional study, 112 subjects (82 bipolar patients and 30 controls) were included. The patients were randomly selected from Punjab Institute of Mental Health (PIMH) and Sheikh Zayed Hospital, Lahore. After the consent of the subjects, venous blood samples were collected. CRP levels were semi-quantitatively estimated by agglutination method. The data obtained was analyzed through SPSS. Results: The difference in the mean CRP level among bipolar and control groups was statistically significant (p = 0.001). Moreover, males had higher CRP levels than females but the difference was non-significant (p=0.134). Comparison of CRP levels among various stages of BD and control showed a significant difference between the groups (p=0.009). Increased CRP levels give an idea about the inflammation and severity of the disease. CRP levels could be of help in the diagnosis and prognosis of BD. Conclusions: The present study suggests a significant association of CRP with bipolar disorder. No significant relation of CRP and gender was depicted. Keywords: Bipolar Disorder, C-reactive protein, Gender","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120928487","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}
Jamshed Bashir, Mushtaque Ahmed Abbasi, S. Bhatti, S. Khatti, A. Soomro, M. Ahsan
Objective: To determine the frequency of the clinical pattern and diagnosis of various types of solid testicular swellings and its management outcomes. Materials and methods: This prospective cross-sectional study was done at the surgery department of Muhammad Medical College, Mirpur Khas. Cases with different presentations raising suspicion about the disease were admitted to the hospital from OPD after recording the detailed history and clinical examination. All the patients presenting with solid testicular swellings underwent inguinal exploration through an incision above the inguinal ligament, regardless of age, were included. After taking verbal informed consent, all the cases underwent testicular biopsies, and specimens were sent to the diagnostic laboratory for histopathological diagnosis. Patients having neoplastic testicular changes were referred, and patients with non-neoplastic testicular swellings lesions were treated conservatively or surgically as per indications. The data and records of all the patients were taken and maintained by the study proforma. Results: A total of 50 cases of solid testicular swellings were studied; their mean age was 48.45+7.23 years. Painless enlargement was present in 70% of cases, enlargement was usually gradual with a feeling of heaviness, followed by painful enlargement in 10.0% of cases. 20(40%) patients were diagnosed as neoplastic testicular swellings, and 30(60%) patients had non-neoplastic swellings. Among 30 cases of testicular swellings, 40.0% had orchitis, 8.0% had trauma, Epididymo-orchitis 12.0%, testicular tuberculosis was in 4.0%, and 1 (2%) had mumps orchitis. All the non-neoplastic lesions were treated successfully and neoplastic lesions cases were referred for further treatment. Conclusion: As per the study conclusion, painless enlargement (usually gradual with the feeling of heaviness) was observed to be the most common clinical feature. However, orchitis, epididymo-orchitis, and tuberculosis of the testis seemed to be the most common diagnoses among non-neoplastic cases. Neoplastic lesions were frequently high. Keywords: Testicles, swelling, features, diagnosis
{"title":"Pattern and Diagnosis of Solid Testicular Swellings and it’s Management Outcome","authors":"Jamshed Bashir, Mushtaque Ahmed Abbasi, S. Bhatti, S. Khatti, A. Soomro, M. Ahsan","doi":"10.53350/pjmhs221610453","DOIUrl":"https://doi.org/10.53350/pjmhs221610453","url":null,"abstract":"Objective: To determine the frequency of the clinical pattern and diagnosis of various types of solid testicular swellings and its management outcomes. Materials and methods: This prospective cross-sectional study was done at the surgery department of Muhammad Medical College, Mirpur Khas. Cases with different presentations raising suspicion about the disease were admitted to the hospital from OPD after recording the detailed history and clinical examination. All the patients presenting with solid testicular swellings underwent inguinal exploration through an incision above the inguinal ligament, regardless of age, were included. After taking verbal informed consent, all the cases underwent testicular biopsies, and specimens were sent to the diagnostic laboratory for histopathological diagnosis. Patients having neoplastic testicular changes were referred, and patients with non-neoplastic testicular swellings lesions were treated conservatively or surgically as per indications. The data and records of all the patients were taken and maintained by the study proforma. Results: A total of 50 cases of solid testicular swellings were studied; their mean age was 48.45+7.23 years. Painless enlargement was present in 70% of cases, enlargement was usually gradual with a feeling of heaviness, followed by painful enlargement in 10.0% of cases. 20(40%) patients were diagnosed as neoplastic testicular swellings, and 30(60%) patients had non-neoplastic swellings. Among 30 cases of testicular swellings, 40.0% had orchitis, 8.0% had trauma, Epididymo-orchitis 12.0%, testicular tuberculosis was in 4.0%, and 1 (2%) had mumps orchitis. All the non-neoplastic lesions were treated successfully and neoplastic lesions cases were referred for further treatment. Conclusion: As per the study conclusion, painless enlargement (usually gradual with the feeling of heaviness) was observed to be the most common clinical feature. However, orchitis, epididymo-orchitis, and tuberculosis of the testis seemed to be the most common diagnoses among non-neoplastic cases. Neoplastic lesions were frequently high. Keywords: Testicles, swelling, features, diagnosis","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133117935","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}
K. Saeed, Agha Momin, Aqeel Moazzam, Muhammad Akhtar, N. Mughal
Objective: To assess the functional outcomes of noninvasive treatment for proximal humerus three parts and four parts fracture. Study Design: Prospective-cohort study Place and Duration of Study: Department of Orthopaedics, Sialkot Medical College, Sialkot from 1st January 2021 to 31st March 2022. Methodology: Fifty patients between 56-65 years and radiograpically both anterior and lateral views were taken. There was a follow up plan in each patient at half month, three months, six months and a year with repeated imaging. Oxford-Shoulder Score and EuroQol-5 Dimensions-3 Levels was used for finding primary functional results while secondary functional outcomes were score through Visual Analog Scoring and University of California at Los Angeles Shoulder Score. Results: The mean of the patients was 62.3±5.6 years with more females (70%) than males. Majority of the cases had a high incidence of fall due to feeling low in energy. The comparison of Oxford-Shoulder Score (OSS) and EQ 5D 3L method showed a high significance within each variable. Comparative imaging at follow ups have showed timely fixation of the humerus with non-invasive procedure with improved OSS values. One-year scores for Oxford-Shoulder Score were 33.1 with 95% confidence of interval while it was 0.59 for EQ-5D-3L. Considering the secondary outcomes it was noticed that mean outcomes score of treatment was 32.1 while visual analogue scale (VAS) pain score was 32.1 with 59.2 as VAS satisfaction score. Conclusion: Good functional outcome of displaced 3-part and 4-part fracture of proximal humerus. Keywords: Noninvasive treatment, Proximal humerus fractures, Osteoporosis Neers classification, Related functional aftermath, Functional outcome
{"title":"Non-Operative Treatment of 3-Part and 4-Part Proximal Humerus Fractures and its Related Functional Aftermath","authors":"K. Saeed, Agha Momin, Aqeel Moazzam, Muhammad Akhtar, N. Mughal","doi":"10.53350/pjmhs221610342","DOIUrl":"https://doi.org/10.53350/pjmhs221610342","url":null,"abstract":"Objective: To assess the functional outcomes of noninvasive treatment for proximal humerus three parts and four parts fracture. Study Design: Prospective-cohort study Place and Duration of Study: Department of Orthopaedics, Sialkot Medical College, Sialkot from 1st January 2021 to 31st March 2022. Methodology: Fifty patients between 56-65 years and radiograpically both anterior and lateral views were taken. There was a follow up plan in each patient at half month, three months, six months and a year with repeated imaging. Oxford-Shoulder Score and EuroQol-5 Dimensions-3 Levels was used for finding primary functional results while secondary functional outcomes were score through Visual Analog Scoring and University of California at Los Angeles Shoulder Score. Results: The mean of the patients was 62.3±5.6 years with more females (70%) than males. Majority of the cases had a high incidence of fall due to feeling low in energy. The comparison of Oxford-Shoulder Score (OSS) and EQ 5D 3L method showed a high significance within each variable. Comparative imaging at follow ups have showed timely fixation of the humerus with non-invasive procedure with improved OSS values. One-year scores for Oxford-Shoulder Score were 33.1 with 95% confidence of interval while it was 0.59 for EQ-5D-3L. Considering the secondary outcomes it was noticed that mean outcomes score of treatment was 32.1 while visual analogue scale (VAS) pain score was 32.1 with 59.2 as VAS satisfaction score. Conclusion: Good functional outcome of displaced 3-part and 4-part fracture of proximal humerus. Keywords: Noninvasive treatment, Proximal humerus fractures, Osteoporosis Neers classification, Related functional aftermath, Functional outcome","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"30 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131300784","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}
Farzana Azam Khan, Ramlah Naz, M. Fatima, Zubair ahmed Tarmizi, Qarar Abbasi, Adina Anwar
Background: Road traffic accidents have major contribution in injury related mortality and disability in low income countries. Two-wheelers being a major mode of transportation due to absence of proper public transport system in Karachi hence most often reported accidents are related with two wheelers. In Karachi two wheelers are quite commonly being used as mode of transportation, number of two wheelers has increased to 10 folds since last 10 years because of lack of public transports and high fuel prices and easy availability on low monthly instalments. Objective: To analyze the injury pattern among two-wheeler riders in Karachi. Study Design: Retrospective study Place and Duration of Study: Three major medico-legal centres of Karachi (Civil, Jinnah, and Abbasi Shaheed Hospitals) from 1st January 2017 to 31st December 2021. Methodology: About 11444 two-wheeler incidents occurred on roads with the consent of Police Surgeon Office Karachi were enrolled. The patients' demographics, injuries sustained, date of the injuries, cause of the injuries, types of collision and outcomes were recorded. Results: Most of the riders engaged in accidents were between the ages of 18 and 30 years; 90.99% of the riders were men. The most frequent type of injuries found in two wheeler accidents were abrasions/grazes seen in (56.26%) cases followed by fractures (20.82%), head injuries (11.02%). Conclusion: Greater prevalence in the age group of 18-30 years, with male dominance analyzed. Fatal and non-fatal injuries were observed. Metro services mass transit programme to be encouraged so to decrease the traffic on road which will automatically reduce the number of accidents to wheeler as well as pillion riders strict efforts need to be made at both government and personal levels to reduce accidents in two-wheeler riders Keyword: Riders, Pillion, Road traffic accidents
{"title":"An Audit of Injuries Sustained in Two–Wheeler Accidents in the Metropolitan City of Karachi, Pakistan","authors":"Farzana Azam Khan, Ramlah Naz, M. Fatima, Zubair ahmed Tarmizi, Qarar Abbasi, Adina Anwar","doi":"10.53350/pjmhs221610336","DOIUrl":"https://doi.org/10.53350/pjmhs221610336","url":null,"abstract":"Background: Road traffic accidents have major contribution in injury related mortality and disability in low income countries. Two-wheelers being a major mode of transportation due to absence of proper public transport system in Karachi hence most often reported accidents are related with two wheelers. In Karachi two wheelers are quite commonly being used as mode of transportation, number of two wheelers has increased to 10 folds since last 10 years because of lack of public transports and high fuel prices and easy availability on low monthly instalments. Objective: To analyze the injury pattern among two-wheeler riders in Karachi. Study Design: Retrospective study Place and Duration of Study: Three major medico-legal centres of Karachi (Civil, Jinnah, and Abbasi Shaheed Hospitals) from 1st January 2017 to 31st December 2021. Methodology: About 11444 two-wheeler incidents occurred on roads with the consent of Police Surgeon Office Karachi were enrolled. The patients' demographics, injuries sustained, date of the injuries, cause of the injuries, types of collision and outcomes were recorded. Results: Most of the riders engaged in accidents were between the ages of 18 and 30 years; 90.99% of the riders were men. The most frequent type of injuries found in two wheeler accidents were abrasions/grazes seen in (56.26%) cases followed by fractures (20.82%), head injuries (11.02%). Conclusion: Greater prevalence in the age group of 18-30 years, with male dominance analyzed. Fatal and non-fatal injuries were observed. Metro services mass transit programme to be encouraged so to decrease the traffic on road which will automatically reduce the number of accidents to wheeler as well as pillion riders strict efforts need to be made at both government and personal levels to reduce accidents in two-wheeler riders Keyword: Riders, Pillion, Road traffic accidents","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"70 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114011274","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}
Muhammad Ayub Naich, Sagheer Hussain, Hina Zamir, Adeel Qamar, F. Cheema, Z. Mustafa
Objective: To determine the diagnostic accuracy of magnetic-resonance-cholangio-pancreatography (MRCP) in diagnosis of obstructive biliopathy in comparison to endoscopic retrograde cholangio-pancreatography (ERCP) taking as gold standard. Study design: It is a cross sectional study. Place and duration of study: Study was conducted on the patients admitted in the gastroenterology department of Sir Ganga Ram Hospital Lahore. Study was completed in six months duration from January 2022 to June 2022. Methodology: Patients with the suspicion of obstructive biliopathies requiring ERCP were included in this study. Study sample was divided into two groups, in one group ERCP was done while other group underwent MRCP. Resulst of both techniques were reviewed by radiologist and gastroenterologist and compared with each other considering ERCP as gold standard. P-value <0.05 was considered statistically significance. Confidence interval was 95%. Results: Total 130 cases were divided into two groups with equal number of 65 patients in each. There were 75(57.6%) female and 55(42.3%) male cases. Mean age of the patients was 43.7± 3.5 years. Sensitivity of MRCP for obstructive biliopathies was 92.4%, specificity 90.7%, positive predictive value 88.3% and negative predictive value 89.2%. Conclusion: MRCP is a non-invasive investigation of choice in obstructive biliopathies having high diagnostic accuracy avoiding unnecessary complications of ERCPs. Keywords: MRCP, ERCP, Obstructive Biliopathy, CBD Stone, Stricture
目的:比较磁共振胆管胰图(MRCP)与以内镜逆行胆管胰图(ERCP)为金标准诊断梗阻性胆道病的准确性。研究设计:本研究为横断面研究。研究地点和时间:研究对象为拉合尔Sir Ganga Ram医院消化内科收治的患者。研究在2022年1月至2022年6月的六个月内完成。方法:怀疑梗阻性胆道病变需要ERCP的患者纳入本研究。研究样本分为两组，一组行ERCP，另一组行MRCP。以ERCP为金标准，由放射科医师和胃肠科医师对两种技术的结果进行了回顾和比较。p值<0.05为差异有统计学意义。置信区间为95%。结果:130例患者分为两组，每组65例。女性75例(57.6%)，男性55例(42.3%)。患者平均年龄43.7±3.5岁。MRCP对梗阻性胆道病变的敏感性为92.4%，特异性为90.7%，阳性预测值为88.3%，阴性预测值为89.2%。结论:MRCP对梗阻性胆道疾病的诊断准确性高，避免了ercp不必要的并发症，是一种无创的选择。关键词:MRCP, ERCP，梗阻性胆道病，CBD结石，狭窄
{"title":"Diagnostic Accuracy of Magnetic Resonance Cholangiopancreatography in Comparison to Endoscopic Retrograde Cholangiopancreatography in Obstructive Biliopathy","authors":"Muhammad Ayub Naich, Sagheer Hussain, Hina Zamir, Adeel Qamar, F. Cheema, Z. Mustafa","doi":"10.53350/pjmhs221610251","DOIUrl":"https://doi.org/10.53350/pjmhs221610251","url":null,"abstract":"Objective: To determine the diagnostic accuracy of magnetic-resonance-cholangio-pancreatography (MRCP) in diagnosis of obstructive biliopathy in comparison to endoscopic retrograde cholangio-pancreatography (ERCP) taking as gold standard. Study design: It is a cross sectional study. Place and duration of study: Study was conducted on the patients admitted in the gastroenterology department of Sir Ganga Ram Hospital Lahore. Study was completed in six months duration from January 2022 to June 2022. Methodology: Patients with the suspicion of obstructive biliopathies requiring ERCP were included in this study. Study sample was divided into two groups, in one group ERCP was done while other group underwent MRCP. Resulst of both techniques were reviewed by radiologist and gastroenterologist and compared with each other considering ERCP as gold standard. P-value <0.05 was considered statistically significance. Confidence interval was 95%. Results: Total 130 cases were divided into two groups with equal number of 65 patients in each. There were 75(57.6%) female and 55(42.3%) male cases. Mean age of the patients was 43.7± 3.5 years. Sensitivity of MRCP for obstructive biliopathies was 92.4%, specificity 90.7%, positive predictive value 88.3% and negative predictive value 89.2%. Conclusion: MRCP is a non-invasive investigation of choice in obstructive biliopathies having high diagnostic accuracy avoiding unnecessary complications of ERCPs. Keywords: MRCP, ERCP, Obstructive Biliopathy, CBD Stone, Stricture","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121251642","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}
Salman Azhar, Nargis Tasleem, A. Khan, F. Ali, Saima Tabassum
Objective: To evaluate the pain-relieving effects of duloxetine vs those of amitriptyline in the treatment of diabetic neuropathy. Methodology: In this randomized trial control, 150 cases of diabetic neuropathy by using convenient sampling technique from Medical Department of Madinah Teaching Hospital, Faisalabad were enrolled and divided in 2 equal groups randomly. Group A was assigned to (Duloxetine) and B assigned to (Amitriptyline). Patients received the trial drug in the morning with water for 6 weeks. Group A got 60 mg of Duloxetine and Group B 75 mg of amitriptyline. VAS pain rating. Patient consultations included a diary card. Patients recorded daily improvements on a visual analogue scale for the first three weeks. We administered three weeks of medicine and arranged an examination in week 6. When pain levels were 50% lower than baseline, we rated them as reduced. Patients were phoned. Results: The mean age was 46.19+6.39 years. 41(54.67%) of Group-A and 39(52%) of Group-B were male, whereas 34(45.33%) and 36(48%) were female. Both groups' mean VAS pain ratings were 1.48+0.50; p = 0.746 shows no difference. Group-A (0.48+0.50) and Group-B (0.92+0.69) vary significantly (p=0.0001). Group-A (52%) and Group-B (28%) were effectively treated after 6 weeks, p=0.002. Conclusion: Our research shows that duloxetine is superior to amitriptyline for the management of diabetic neuropathy, especially in terms of minimising the frequency with which patients report experiencing pain. Keywords: Diabetic neuropathy, management, duloxetine, amitriptyline, efficacy
{"title":"Management of Diabetic Neuropathy: A Comparison of Duloxetine with Amitriptyline","authors":"Salman Azhar, Nargis Tasleem, A. Khan, F. Ali, Saima Tabassum","doi":"10.53350/pjmhs221610259","DOIUrl":"https://doi.org/10.53350/pjmhs221610259","url":null,"abstract":"Objective: To evaluate the pain-relieving effects of duloxetine vs those of amitriptyline in the treatment of diabetic neuropathy. Methodology: In this randomized trial control, 150 cases of diabetic neuropathy by using convenient sampling technique from Medical Department of Madinah Teaching Hospital, Faisalabad were enrolled and divided in 2 equal groups randomly. Group A was assigned to (Duloxetine) and B assigned to (Amitriptyline). Patients received the trial drug in the morning with water for 6 weeks. Group A got 60 mg of Duloxetine and Group B 75 mg of amitriptyline. VAS pain rating. Patient consultations included a diary card. Patients recorded daily improvements on a visual analogue scale for the first three weeks. We administered three weeks of medicine and arranged an examination in week 6. When pain levels were 50% lower than baseline, we rated them as reduced. Patients were phoned. Results: The mean age was 46.19+6.39 years. 41(54.67%) of Group-A and 39(52%) of Group-B were male, whereas 34(45.33%) and 36(48%) were female. Both groups' mean VAS pain ratings were 1.48+0.50; p = 0.746 shows no difference. Group-A (0.48+0.50) and Group-B (0.92+0.69) vary significantly (p=0.0001). Group-A (52%) and Group-B (28%) were effectively treated after 6 weeks, p=0.002. Conclusion: Our research shows that duloxetine is superior to amitriptyline for the management of diabetic neuropathy, especially in terms of minimising the frequency with which patients report experiencing pain. Keywords: Diabetic neuropathy, management, duloxetine, amitriptyline, efficacy","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"116 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129155465","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}
Salman Khan, Muhammad Salman, Ijaz Ali, Najma Fatima, M. Mastoor, T. Sayed
Objective: The purpose of this research was to examine the efficacy of Silymarin in treating newly diagnosed cases of type II diabetes mellitus (T2DM), specifically with regard to glycemic control and insulin resistance. Study design: An observational, randomized, placebo- controlled study. Place and duration: Medicine department of Dr. Akbar Niazi Teaching Hospital (ANTH), Islamabad for the duration from August 2021 to January 2022. Methods: The sixty individuals with a recent diagnosis of type 2 diabetes were chosen at random. There were a total of 60 patients, split evenly between 2 groups of 30. For 90 days, those in Group A took a silymarin capsule containing 200 mg, whereas those in Group B had a placebo capsule looking very similar to the real thing. Fasting blood glucose (FBG), random blood glucose (RBG), glycated haemoglobin A1C (A1C), fasting insulin (FI), and homeostasis model assessment of insulin resistance (HOMA-IR) were measured before and after therapy. The data was examined after 90 days. Statistical analysis was performed using SPSS-20.0. If the probability value was less than 0.05, it was considered significant. The Chi-squared test was employed for statistical analysis. Results: Mean age of the patients of group A (silymarin) was 50.5 years while mean age of group B (controlled) patients was 51.0 years. In both the groups, females were more in numbers as 80% in silymarin group and 70% in controlled group. There was no significant difference showed on the basis of age, gender, BMI, education, family history and employment. Silymarin therapy for 12weeks improved the levels of RBG, RBG, HbA1c, FSI and HOMA-IR. A significant difference p-value<0.001 was showed in these variables between the two groups at baseline and after 90days treatment. Conclusion: The treatment of Silymarin supplementation of 200mg three time a day for newly diagnosed type II diabetic patients had a beneficial effect on improving the blood glucose levels and decreased insulin resistance as compared to standard treatment alone.
{"title":"Analyze the Efficacy of Silymarin in Treating Newly Diagnosed Cases of Type 2 Diabetes Mellitus by Contrasting its Effects on Glycemic Control and Insulin Resistance","authors":"Salman Khan, Muhammad Salman, Ijaz Ali, Najma Fatima, M. Mastoor, T. Sayed","doi":"10.53350/pjmhs221610365","DOIUrl":"https://doi.org/10.53350/pjmhs221610365","url":null,"abstract":"Objective: The purpose of this research was to examine the efficacy of Silymarin in treating newly diagnosed cases of type II diabetes mellitus (T2DM), specifically with regard to glycemic control and insulin resistance. Study design: An observational, randomized, placebo- controlled study. Place and duration: Medicine department of Dr. Akbar Niazi Teaching Hospital (ANTH), Islamabad for the duration from August 2021 to January 2022. Methods: The sixty individuals with a recent diagnosis of type 2 diabetes were chosen at random. There were a total of 60 patients, split evenly between 2 groups of 30. For 90 days, those in Group A took a silymarin capsule containing 200 mg, whereas those in Group B had a placebo capsule looking very similar to the real thing. Fasting blood glucose (FBG), random blood glucose (RBG), glycated haemoglobin A1C (A1C), fasting insulin (FI), and homeostasis model assessment of insulin resistance (HOMA-IR) were measured before and after therapy. The data was examined after 90 days. Statistical analysis was performed using SPSS-20.0. If the probability value was less than 0.05, it was considered significant. The Chi-squared test was employed for statistical analysis. Results: Mean age of the patients of group A (silymarin) was 50.5 years while mean age of group B (controlled) patients was 51.0 years. In both the groups, females were more in numbers as 80% in silymarin group and 70% in controlled group. There was no significant difference showed on the basis of age, gender, BMI, education, family history and employment. Silymarin therapy for 12weeks improved the levels of RBG, RBG, HbA1c, FSI and HOMA-IR. A significant difference p-value<0.001 was showed in these variables between the two groups at baseline and after 90days treatment. Conclusion: The treatment of Silymarin supplementation of 200mg three time a day for newly diagnosed type II diabetic patients had a beneficial effect on improving the blood glucose levels and decreased insulin resistance as compared to standard treatment alone.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116806399","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}
Laiba Naseer, Sharoon Sabir, M. Azeem, S. Zaman, A. Mahmood, M. Mastoor
Background and Aim: Hepatocellular carcinoma (HCC) is the primary liver cancer around the world, and it has now become the third leading cause of cancer-related mortality. With an increasing global incidence, HCC is becoming a major health burden. The incidence of HCC varies from 0.3% to 1.6% in Asian countries. The present study aimed to assess the clinical and etiological profile of hepatocellular carcinoma in a tertiary care hospital. Methodology: This retrospective study was conducted on 124 hepatocellular carcinoma patients in the Department of Gastroenterology, Jinnah Hospital, Lahore from June 2019 to May 2022. All the patients of age 10 years to 75 years fulfilling the diagnostic criteria were enrolled in this study. Patient’s cytohistological, clinical, radiological, and etiological data were recorded and analyzed. Individual relevant features were noted in pre-designed proforma. SPSS version 25 was used for data analysis. Results: Of the total 124 HCC patients, there were 78 (62.9%) male and 46 (37.1%) females. The overall mean age was 48.63±6.78 years. Liver cirrhosis was present in 91 (73.4%) patients out of which 14 (15.4%) were asymptomatic. The prevalent signs of hepatic decompensation were ascites 67 (54%) and Jaundice 23 (18.5%). Based on etiological data, the prevalence of the cryptogenic, Hepatitis B, and C were 58 (46.8%), 20 (16.1%), and 6 (4.8%) respectively. Tumor thrombosis was found in 18 (14.5%). Based on biopsy specimens, HCC with steatosis were seen in 19 (15.3%) patients. During surveillance, about 32 (25.8%) cirrhotic HCC patients were diagnosed. Conclusion: The present study found that the most prevalent etiology was hepatocellular carcinoma. Most patients were asymptomatic and had major complaints of abdominal pain with certain specific comorbidities. Hypertension, diabetes, and ischemic heart disease were the specific co-morbidities in hepatocellular carcinoma patients. In our population, the prevalent cause of HCC was Hepatitis B. Keywords: Clinical profile, Etiology, Hepatocellular Carcinoma
{"title":"Profile of Hepatocellular Carcinoma: An Experience from a Tertiary Care Hospital","authors":"Laiba Naseer, Sharoon Sabir, M. Azeem, S. Zaman, A. Mahmood, M. Mastoor","doi":"10.53350/pjmhs221610399","DOIUrl":"https://doi.org/10.53350/pjmhs221610399","url":null,"abstract":"Background and Aim: Hepatocellular carcinoma (HCC) is the primary liver cancer around the world, and it has now become the third leading cause of cancer-related mortality. With an increasing global incidence, HCC is becoming a major health burden. The incidence of HCC varies from 0.3% to 1.6% in Asian countries. The present study aimed to assess the clinical and etiological profile of hepatocellular carcinoma in a tertiary care hospital. Methodology: This retrospective study was conducted on 124 hepatocellular carcinoma patients in the Department of Gastroenterology, Jinnah Hospital, Lahore from June 2019 to May 2022. All the patients of age 10 years to 75 years fulfilling the diagnostic criteria were enrolled in this study. Patient’s cytohistological, clinical, radiological, and etiological data were recorded and analyzed. Individual relevant features were noted in pre-designed proforma. SPSS version 25 was used for data analysis. Results: Of the total 124 HCC patients, there were 78 (62.9%) male and 46 (37.1%) females. The overall mean age was 48.63±6.78 years. Liver cirrhosis was present in 91 (73.4%) patients out of which 14 (15.4%) were asymptomatic. The prevalent signs of hepatic decompensation were ascites 67 (54%) and Jaundice 23 (18.5%). Based on etiological data, the prevalence of the cryptogenic, Hepatitis B, and C were 58 (46.8%), 20 (16.1%), and 6 (4.8%) respectively. Tumor thrombosis was found in 18 (14.5%). Based on biopsy specimens, HCC with steatosis were seen in 19 (15.3%) patients. During surveillance, about 32 (25.8%) cirrhotic HCC patients were diagnosed. Conclusion: The present study found that the most prevalent etiology was hepatocellular carcinoma. Most patients were asymptomatic and had major complaints of abdominal pain with certain specific comorbidities. Hypertension, diabetes, and ischemic heart disease were the specific co-morbidities in hepatocellular carcinoma patients. In our population, the prevalent cause of HCC was Hepatitis B. Keywords: Clinical profile, Etiology, Hepatocellular Carcinoma","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127303486","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}
Marvi Sangi, A. Shaikh, S. Fatima, N. Bhatti, Muharam Ali, Aasia Aamir
Objective: To critically analyze the frequency and factors leading to hypocalcemia in Total/ Near Total thyroidectomy Methods: This descriptive case series study was conducted over period of one year by taking sample of 138 patients of simple multinodular goiter or carcinoma of thyroid who underwent total/near total thyroidectomy and patients who had serum calcium <8mg/dl postoperatively. Recurrent thyroid surgery or patients undergoing lobectomy were excluded from the study. SPSS version 21 was used for data analysis. Mean ± SD represent the continuous variables & frequencies/ percentages represent the quantitiave results. Chi-square test was applied to analyze effect modification. P value <0.05 was taken as significant. Study was approved by the ethical review committee of the SMBBMU - Larkana. Results: The mean ± SD age of patients was 39.86 ± 11.5 years with a range from 22 to 60 years. The mean ± SD serum Pre-operative calcium was 9.64 ± 0.44 mg/dL. Post thyroidectomy) values of serum calcium were noted as mean ± SD 7.68 ± 2.11 mg/dL. Sixty five percent (n =90) of all patients were females. NTT- were 67.4% (n = 93) while TT- 32.6% (n = 45). Frequency of hypocalcemia was 28.3% (n = 39). More patients after TT developed hypocalcemia (44.4%) than NTT (20.4%) P value = 0.004). Old age, female gender, surgery for thyroid cancer and patient with lower preoperative serum calcium had a higher frequency of hypocalcemia after thyroidectomy. Practical implication Conclusion:The frequency of post thyroidectomy hypocalcemia in this study is 28.3%. Post thyroidectomy hypocalcemia is associated with both NTT and TT, however the frequency is more common (more than twice) after TT. Factors like old age, female gender, patients having thyroid cancer and having lower serum calcium preoperatively are strong effect-modifiers. Keywords: Total thyroidectomy. Near total thyroidectomy,Calcium, Hypocalcemia, .Parathyroid hormone.
{"title":"Critical Analysis of the Frequency and Factors Leading to Hypocalcemia after Total/ Near Total Thyroidectomy","authors":"Marvi Sangi, A. Shaikh, S. Fatima, N. Bhatti, Muharam Ali, Aasia Aamir","doi":"10.53350/pjmhs221610290","DOIUrl":"https://doi.org/10.53350/pjmhs221610290","url":null,"abstract":"Objective: To critically analyze the frequency and factors leading to hypocalcemia in Total/ Near Total thyroidectomy Methods: This descriptive case series study was conducted over period of one year by taking sample of 138 patients of simple multinodular goiter or carcinoma of thyroid who underwent total/near total thyroidectomy and patients who had serum calcium <8mg/dl postoperatively. Recurrent thyroid surgery or patients undergoing lobectomy were excluded from the study. SPSS version 21 was used for data analysis. Mean ± SD represent the continuous variables & frequencies/ percentages represent the quantitiave results. Chi-square test was applied to analyze effect modification. P value <0.05 was taken as significant. Study was approved by the ethical review committee of the SMBBMU - Larkana. Results: The mean ± SD age of patients was 39.86 ± 11.5 years with a range from 22 to 60 years. The mean ± SD serum Pre-operative calcium was 9.64 ± 0.44 mg/dL. Post thyroidectomy) values of serum calcium were noted as mean ± SD 7.68 ± 2.11 mg/dL. Sixty five percent (n =90) of all patients were females. NTT- were 67.4% (n = 93) while TT- 32.6% (n = 45). Frequency of hypocalcemia was 28.3% (n = 39). More patients after TT developed hypocalcemia (44.4%) than NTT (20.4%) P value = 0.004). Old age, female gender, surgery for thyroid cancer and patient with lower preoperative serum calcium had a higher frequency of hypocalcemia after thyroidectomy. Practical implication Conclusion:The frequency of post thyroidectomy hypocalcemia in this study is 28.3%. Post thyroidectomy hypocalcemia is associated with both NTT and TT, however the frequency is more common (more than twice) after TT. Factors like old age, female gender, patients having thyroid cancer and having lower serum calcium preoperatively are strong effect-modifiers. Keywords: Total thyroidectomy. Near total thyroidectomy,Calcium, Hypocalcemia, .Parathyroid hormone.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"76 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122804518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Usman, Kamil Ziad Rajper, J. Parkash, Ariba Fahim, Saeed Ahmed, Manoj Kumar
Background: The pathologic inhibition of intrauterine fetal growth and in capacity of fetus to develop to its full potential are both considered symptoms of intrauterine growth restriction. Nearly 10% of pregnancies experience impaired fetal growth. Since FGR was discovered to be a cause of neonatal death, approximately 50% of still births have been determined to be FGR, leading to a drop in unexplained still birth from 67–70% to 15%. A retrospective diagnosis of IUGR is made after the fact in roughly 75% of instances, compared to a detection rate of 15% in low-risk pregnancies. Objective: To assess the factors leading to Intra Uterine Growth Restriction among term neonates presenting to a National Institute of child health Karachi. Materials and Methods : A descriptive Cross-Sectional study was conducted at Department of Paediatrics of National Institute of child health Karachi from August2019 to February2020. Using a consecutive sampling method, 116 mothers were included in the study. Data was analyzed using SPSS version 23. Results: Mean age of the patient was 25.15 ±3.49 years. Mean weight, height, and BMI of the patients was 60.17±5.12kg,1.54±0.06 cm and 27.19 ±5.08kg/m2 respectively. Nulli parity was the most highest factor observed in 73 (63%) of the patients followed by low maternal BMI 64(55%), anemia 48(41%) and preeclampsia 37(32%). Conclusion: The finding of the study showed frequency of nulliparity was the found to be higher leading factor for IUGR followed by low maternal BMI, anemia, and preeclampsia among term neonates presenting to a tertiary care hospital. Keywords: Intra Uterine Growth Restriction, preeclampsia, low maternal BMI, anemia, nulliparity
背景:病理性的宫内胎儿生长抑制和胎儿发育能力不足都被认为是宫内生长受限的症状。近10%的怀孕经历了胎儿生长受损。由于FGR被发现是新生儿死亡的一个原因，大约50%的死产被确定为FGR，导致不明原因的死产从67-70%下降到15%。在大约75%的病例中，IUGR的回顾性诊断是在事后进行的，相比之下，低风险妊娠的检出率为15%。目的:评价在卡拉奇国家儿童健康研究所就诊的足月新生儿中导致子宫内生长受限的因素。材料和方法:2019年8月至2020年2月在卡拉奇国家儿童健康研究所儿科进行了一项描述性横断面研究。采用连续抽样的方法，116名母亲被纳入研究。数据分析采用SPSS version 23。结果:患者平均年龄25.15±3.49岁。患者平均体重为60.17±5.12kg，身高为1.54±0.06 cm, BMI为27.19±5.08kg/m2。无胎次是73例(63%)患者中观察到的最高因素，其次是低母体BMI 64例(55%)，贫血48例(41%)和先兆子痫37例(32%)。结论:本研究结果显示，在三级医院就诊的足月新生儿中，未生育频率是IUGR较高的主要因素，其次是母亲BMI低、贫血和先兆子痫。关键词:子宫内生长受限，先兆子痫，母体低BMI，贫血，不孕
{"title":"Factors Leading to Intra Uterinegrowth Restriction in Termneonates","authors":"M. Usman, Kamil Ziad Rajper, J. Parkash, Ariba Fahim, Saeed Ahmed, Manoj Kumar","doi":"10.53350/pjmhs221610477","DOIUrl":"https://doi.org/10.53350/pjmhs221610477","url":null,"abstract":"Background: The pathologic inhibition of intrauterine fetal growth and in capacity of fetus to develop to its full potential are both considered symptoms of intrauterine growth restriction. Nearly 10% of pregnancies experience impaired fetal growth. Since FGR was discovered to be a cause of neonatal death, approximately 50% of still births have been determined to be FGR, leading to a drop in unexplained still birth from 67–70% to 15%. A retrospective diagnosis of IUGR is made after the fact in roughly 75% of instances, compared to a detection rate of 15% in low-risk pregnancies. Objective: To assess the factors leading to Intra Uterine Growth Restriction among term neonates presenting to a National Institute of child health Karachi. Materials and Methods : A descriptive Cross-Sectional study was conducted at Department of Paediatrics of National Institute of child health Karachi from August2019 to February2020. Using a consecutive sampling method, 116 mothers were included in the study. Data was analyzed using SPSS version 23. Results: Mean age of the patient was 25.15 ±3.49 years. Mean weight, height, and BMI of the patients was 60.17±5.12kg,1.54±0.06 cm and 27.19 ±5.08kg/m2 respectively. Nulli parity was the most highest factor observed in 73 (63%) of the patients followed by low maternal BMI 64(55%), anemia 48(41%) and preeclampsia 37(32%). Conclusion: The finding of the study showed frequency of nulliparity was the found to be higher leading factor for IUGR followed by low maternal BMI, anemia, and preeclampsia among term neonates presenting to a tertiary care hospital. Keywords: Intra Uterine Growth Restriction, preeclampsia, low maternal BMI, anemia, nulliparity","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128338457","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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