Muhammad Kazim Bashir, Afaq Naeem, Muhammad Haseeb Masood, Hira Farooq, Iqra Ijaz, Najma Fatima
Background and Aim: Stroke is the most prominent cause of morbidity and mortality worldwide especially in developing countries. The stroke outcome mainly related to the presence of complications and severity. Stroke associated pneumonia is the post stroke infection significantly associated with a longer hospitalization, increased risk of hospital mortality, and functional outcomes. There is scarcity of data regarding stroke associated pneumonia on a local basis in the developing countries. Therefore, present study aimed to find out the prevalence and effect of stroke associated pneumonia on in-hospital stay, mortality, and function outcome. Methodology: This observational prospective study was conducted on 500 stroke patients in the Department of Neurology and Medicine, Jinnah Hospital, Lahore from April 2021 to March 2022. Prior to study conduction, written informed consent and ethical approval was taken. All the participants were recruited for this study. Stroke was diagnosed based on relevant clinical history, brain imaging either by CT scan or MRI, and focused physical examination. Stroke patients of either gender above 18 years age with acute ischemic or hemorrhagic stroke and given written consent were included. All those patients who are already having disability due to previous stroke and other neurological or non-neurological issues were excluded from study. Baseline characteristics were recorded. SPSS version 25 was used for data analysis. Results: Of the total 500 stroke patients, there were 232 (46.4%) male and 268 (53.6%) females. The overall mean age was 62.4 ± 12.6 years. The prevalence of ischemic and hemorrhagic stroke was 334 (66.8%) and 166 (33.2%) respectively among 500 stroke patients. Hemiparesis was the most prevalent neurological findings 464 (92.8%) followed by facial palsy 432 (86.4%) and swallowing disturbance 262 (52.4%). About 186 (37.2%) stroke patients were complicated by stroke associated pneumonia. Multivariate regression analysis was used and revealed that stroke associated pneumonia could be developed in older age patients > 70 years Adjusted odd ratio AOR= 3.862 (1.21-12.86) (p=0.031) who suffered from swallowing disturbance AOR= 4.728, (2.415-9.102) (p<0.001), epileptic seizures AOR= 2.749 (1.315-5.681) (p<0.001), and moderate to severe stroke AOR= 6.183 (2.036-17.647) (p<0.001) (NIHSS=16-21). Conclusion: The present study concluded that prevalence of SAP was 37.2%. Stroke associated pneumonia is a significant medical issue or complications in stroke patients. Furthermore, older stroke patients with epileptic seizure, swallowing disturbance, and stroke severity from moderate to severe were the risk factors for increasing stroke associated pneumonia. Close monitoring and effective intervention might be needed for high risk SAP in stroke patients. Keywords: Stroke associated pneumonia, Functional outcome, Mortality, Hospital stay, Stroke
{"title":"Prevalence and Effect of Stroke Associated Pneumonia on in-Hospital Stay, Mortality and Functional Outcome at Discharge from Hospital","authors":"Muhammad Kazim Bashir, Afaq Naeem, Muhammad Haseeb Masood, Hira Farooq, Iqra Ijaz, Najma Fatima","doi":"10.53350/pjmhs221610402","DOIUrl":"https://doi.org/10.53350/pjmhs221610402","url":null,"abstract":"Background and Aim: Stroke is the most prominent cause of morbidity and mortality worldwide especially in developing countries. The stroke outcome mainly related to the presence of complications and severity. Stroke associated pneumonia is the post stroke infection significantly associated with a longer hospitalization, increased risk of hospital mortality, and functional outcomes. There is scarcity of data regarding stroke associated pneumonia on a local basis in the developing countries. Therefore, present study aimed to find out the prevalence and effect of stroke associated pneumonia on in-hospital stay, mortality, and function outcome. Methodology: This observational prospective study was conducted on 500 stroke patients in the Department of Neurology and Medicine, Jinnah Hospital, Lahore from April 2021 to March 2022. Prior to study conduction, written informed consent and ethical approval was taken. All the participants were recruited for this study. Stroke was diagnosed based on relevant clinical history, brain imaging either by CT scan or MRI, and focused physical examination. Stroke patients of either gender above 18 years age with acute ischemic or hemorrhagic stroke and given written consent were included. All those patients who are already having disability due to previous stroke and other neurological or non-neurological issues were excluded from study. Baseline characteristics were recorded. SPSS version 25 was used for data analysis. Results: Of the total 500 stroke patients, there were 232 (46.4%) male and 268 (53.6%) females. The overall mean age was 62.4 ± 12.6 years. The prevalence of ischemic and hemorrhagic stroke was 334 (66.8%) and 166 (33.2%) respectively among 500 stroke patients. Hemiparesis was the most prevalent neurological findings 464 (92.8%) followed by facial palsy 432 (86.4%) and swallowing disturbance 262 (52.4%). About 186 (37.2%) stroke patients were complicated by stroke associated pneumonia. Multivariate regression analysis was used and revealed that stroke associated pneumonia could be developed in older age patients > 70 years Adjusted odd ratio AOR= 3.862 (1.21-12.86) (p=0.031) who suffered from swallowing disturbance AOR= 4.728, (2.415-9.102) (p<0.001), epileptic seizures AOR= 2.749 (1.315-5.681) (p<0.001), and moderate to severe stroke AOR= 6.183 (2.036-17.647) (p<0.001) (NIHSS=16-21). Conclusion: The present study concluded that prevalence of SAP was 37.2%. Stroke associated pneumonia is a significant medical issue or complications in stroke patients. Furthermore, older stroke patients with epileptic seizure, swallowing disturbance, and stroke severity from moderate to severe were the risk factors for increasing stroke associated pneumonia. Close monitoring and effective intervention might be needed for high risk SAP in stroke patients. Keywords: Stroke associated pneumonia, Functional outcome, Mortality, Hospital stay, Stroke","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"22 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":"125434664","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}
F. Khatoon, Reem A Alshammari, Aasma Batool, A. Elhaj, F. Alreshidi, G. Elhussein, R. A. Abdalla, A. B. M. Elhag, Z. Balouch
Objective: The aim of this study is to explore the role of molecular DNA, DNA Phenotyping and Polymerase Chain Reaction in samples relevant to genetic investigation. The Deoxyribonucleic Acid (DNA) is a macromolecule which has propelled our capacity of understanding the function of an organism at the cellular level, how organism reproduce and replicate, and pass their subjective genetic information from one generation to the other. DNA is also referred to as the genetic “Blueprint” of an organism and found to possess all information pertaining to the specific being. Nuclear DNA is present within the nucleus and is significant in developing immunity for the cell and depends on the information incorporated within its framework. Mitochondrial DNA exists in varying locations in frequencies of two to ten copies within mitochondria. The most familiar body fluids come across in molecular medicine laboratories is blood, semen and saliva and further more are vaginal fluids, urine and sweat. Bones, teeth, soft tissues etc. are also essential biomarkers for DNA-phenotyping. Methodology: The methods for research for this particular study is to demonstrate a review of relevant literature to examine the molecular genetics and the application of genome and DNA-amplification into molecular medicine investigations. To conduct a literature review a qualitative research design is the most suitable research design. It provides the rationale for assessing the human behaviour and assists to legalize and authenticate the data which is selectively collected from the secondary sources. Results: Every individual’s DNA consists of minor alterations a change in these restriction places would result in different profile of restriction fragments. Genome wide population substructure is large enough to determine ancestry with large number of Autosomal SNPs at the level of continental resolutions. Conclusion: The advances in human genomics and molecular genetics have provided success and advances by determining the cellular origin and estimating the age of sample and disposition time. The Phenotypical characteristics like hair and eye color demonstration in criminal cases has yielded better inferences however, DNA phenotyping illustrates a limited approach wherein incorporated into biological material analysis. The accuracy of DNA technology is incredibly useful for professionals like lawyers, anthropologists, homicide detectives etc. in the field of molecular medicines and is expected to improve in years to come. Key Words; Deoxyribonucleic Acid (DNA) , Polymerase Chain Reaction (PCR), Mitochondrial DNA (mtDNA) sequencing and Short Tardem Repeat (STR)
{"title":"Systematic Review on Implication for DNA Assisted Technology into Molecular Medicine and the useful is the application of Genome Wide Studies","authors":"F. Khatoon, Reem A Alshammari, Aasma Batool, A. Elhaj, F. Alreshidi, G. Elhussein, R. A. Abdalla, A. B. M. Elhag, Z. Balouch","doi":"10.53350/pjmhs221610217","DOIUrl":"https://doi.org/10.53350/pjmhs221610217","url":null,"abstract":"Objective: The aim of this study is to explore the role of molecular DNA, DNA Phenotyping and Polymerase Chain Reaction in samples relevant to genetic investigation. The Deoxyribonucleic Acid (DNA) is a macromolecule which has propelled our capacity of understanding the function of an organism at the cellular level, how organism reproduce and replicate, and pass their subjective genetic information from one generation to the other. DNA is also referred to as the genetic “Blueprint” of an organism and found to possess all information pertaining to the specific being. Nuclear DNA is present within the nucleus and is significant in developing immunity for the cell and depends on the information incorporated within its framework. Mitochondrial DNA exists in varying locations in frequencies of two to ten copies within mitochondria. The most familiar body fluids come across in molecular medicine laboratories is blood, semen and saliva and further more are vaginal fluids, urine and sweat. Bones, teeth, soft tissues etc. are also essential biomarkers for DNA-phenotyping. Methodology: The methods for research for this particular study is to demonstrate a review of relevant literature to examine the molecular genetics and the application of genome and DNA-amplification into molecular medicine investigations. To conduct a literature review a qualitative research design is the most suitable research design. It provides the rationale for assessing the human behaviour and assists to legalize and authenticate the data which is selectively collected from the secondary sources. Results: Every individual’s DNA consists of minor alterations a change in these restriction places would result in different profile of restriction fragments. Genome wide population substructure is large enough to determine ancestry with large number of Autosomal SNPs at the level of continental resolutions. Conclusion: The advances in human genomics and molecular genetics have provided success and advances by determining the cellular origin and estimating the age of sample and disposition time. The Phenotypical characteristics like hair and eye color demonstration in criminal cases has yielded better inferences however, DNA phenotyping illustrates a limited approach wherein incorporated into biological material analysis. The accuracy of DNA technology is incredibly useful for professionals like lawyers, anthropologists, homicide detectives etc. in the field of molecular medicines and is expected to improve in years to come. Key Words; Deoxyribonucleic Acid (DNA) , Polymerase Chain Reaction (PCR), Mitochondrial DNA (mtDNA) sequencing and Short Tardem Repeat (STR)","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":"124226681","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}
Introduction: A multifactorial condition, dental caries is primarily brought on by cariogenic bacteria that are frequently present in the mouth. Caries infections are commonly associated with the acid-producing bacteria Streptococcus mutans. If left untreated, dental caries can result in tooth decalcification, cavities, hypersensitivity, and even tooth loss. Comparative proteomics by Mass spectrometry was carried out to reveal caries-associated metabolic remodeling in S mutans isolates favouring biofilm formation and colonization. Methods: We conducted a differential proteomic analysis to determine the differences in protein expression between S.mutans strains linked to dental caries and those present in a healthy oral microbiome. High-performance mass spectrometry (MS) using Orbitrap, has led to the development of proteomics in larger-scale protein analysis. Five clinical specimens from individuals who had caries disease (Caries active) were compared with two isolates from the healthy oral dental microbiota (Caries free). Protein samples were digested, and a peptide mixture investigation was done. Results and Discussion: 3276 proteins that were expressed at comparable amounts in both groups of bacteria and were found by proteomic analysis. Only 39 of these proteins were unique and distinct to group 1 (those without caries), whereas 444 proteins were specific to group 2. (S.mutans from caries patients). Significant differences in the grouping of the control (Caries free) and caries (Caries active) samples were seen through PCA analysis. 23 Significantly regulated proteins in S. mutans bacteria were discovered (p < 0.05, t-test). Among these, 23 differentially expressed proteins, 10 were upregulated, and 13 downregulated. By Identifying differential peptides and proteins, their quantification, and appropriate bioinformatic analysis, there are insights into formation of biofilm by S. mutans in dental caries and potential targets for intervention using various antagonists/ nanoparticle approaches as alternatives to conventional antibiotics.
{"title":"Comparative Proteomics in Caries Active and Caries Free Associated S. Mutans Strains for Metabolic Remodeling Favouring Colonization","authors":"S. S. Abed, P. Kiranmayi, Venkata R. Kolli","doi":"10.53350/pjmhs221610437","DOIUrl":"https://doi.org/10.53350/pjmhs221610437","url":null,"abstract":"Introduction: A multifactorial condition, dental caries is primarily brought on by cariogenic bacteria that are frequently present in the mouth. Caries infections are commonly associated with the acid-producing bacteria Streptococcus mutans. If left untreated, dental caries can result in tooth decalcification, cavities, hypersensitivity, and even tooth loss. Comparative proteomics by Mass spectrometry was carried out to reveal caries-associated metabolic remodeling in S mutans isolates favouring biofilm formation and colonization. Methods: We conducted a differential proteomic analysis to determine the differences in protein expression between S.mutans strains linked to dental caries and those present in a healthy oral microbiome. High-performance mass spectrometry (MS) using Orbitrap, has led to the development of proteomics in larger-scale protein analysis. Five clinical specimens from individuals who had caries disease (Caries active) were compared with two isolates from the healthy oral dental microbiota (Caries free). Protein samples were digested, and a peptide mixture investigation was done. Results and Discussion: 3276 proteins that were expressed at comparable amounts in both groups of bacteria and were found by proteomic analysis. Only 39 of these proteins were unique and distinct to group 1 (those without caries), whereas 444 proteins were specific to group 2. (S.mutans from caries patients). Significant differences in the grouping of the control (Caries free) and caries (Caries active) samples were seen through PCA analysis. 23 Significantly regulated proteins in S. mutans bacteria were discovered (p < 0.05, t-test). Among these, 23 differentially expressed proteins, 10 were upregulated, and 13 downregulated. By Identifying differential peptides and proteins, their quantification, and appropriate bioinformatic analysis, there are insights into formation of biofilm by S. mutans in dental caries and potential targets for intervention using various antagonists/ nanoparticle approaches as alternatives to conventional antibiotics.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"3 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":"127845664","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. Ali, M. Memon, Farrukh Sami, M. Memon, M. T. Khan, Javaid Sajjad Hashmi
Objective: To evaluate the safety outcome of staple hemorrhoidectomy in grade III and IV hemorrhoids. Study Design: Descriptive study Place and Duration of Study: Department of Surgery, Shahida Islam Medical Complex, Lodhran from 1st July 2020 to 30th June 2021. Methodology: Seventy patients were selected who were suffering from third or fourth grade hemorrhoids. The age of the patients was between 21-56 years with both gender been presented. Longos method was opted with spinal analgesic been delivered in lithotomy positioning. The complete surgical protocol was maintained with preoperative antibiotic deliverance. The procedure took 30-50 minutes. Patient was then kept in recovery room for three hours post operation and all postoperative antibiotics were timely administered. Results: Mean age of study participants was 41.2±3.2. Men appeared to be higher in number as compared to women. Grade III patients were more in number as compared to grade IV. Most common complication which was observed in present study is postoperative pain. Majority of the patients (70%) showed no associated complications. Conclusion: Staple hemorrhidectomy is appeared to be a safe and reliable surgical procedure for the treatment of grade III and grade IV hemorrhoids. Keywords: Hemorrhoids, Surgical procedure, Stenosis, Efficacy, Conventional
{"title":"Stapled Hemorrhoidectomy: A Safe Procedure for Third and Fourth Grade Hemorrhoids","authors":"M. Ali, M. Memon, Farrukh Sami, M. Memon, M. T. Khan, Javaid Sajjad Hashmi","doi":"10.53350/pjmhs221610354","DOIUrl":"https://doi.org/10.53350/pjmhs221610354","url":null,"abstract":"Objective: To evaluate the safety outcome of staple hemorrhoidectomy in grade III and IV hemorrhoids. Study Design: Descriptive study Place and Duration of Study: Department of Surgery, Shahida Islam Medical Complex, Lodhran from 1st July 2020 to 30th June 2021. Methodology: Seventy patients were selected who were suffering from third or fourth grade hemorrhoids. The age of the patients was between 21-56 years with both gender been presented. Longos method was opted with spinal analgesic been delivered in lithotomy positioning. The complete surgical protocol was maintained with preoperative antibiotic deliverance. The procedure took 30-50 minutes. Patient was then kept in recovery room for three hours post operation and all postoperative antibiotics were timely administered. Results: Mean age of study participants was 41.2±3.2. Men appeared to be higher in number as compared to women. Grade III patients were more in number as compared to grade IV. Most common complication which was observed in present study is postoperative pain. Majority of the patients (70%) showed no associated complications. Conclusion: Staple hemorrhidectomy is appeared to be a safe and reliable surgical procedure for the treatment of grade III and grade IV hemorrhoids. Keywords: Hemorrhoids, Surgical procedure, Stenosis, Efficacy, Conventional","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"458 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":"116503994","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}
Ayesha Shahjahan, Syed Irfan Ahmed, Syed Muhammad Saqib, Saadia Ejaz
Introduction: Most patients with acute ischemic stroke (AIS) have elevated blood pressure (BP) at presentation, which often declines spontaneously in the following days. Objectives: The main objective of the study is to find the Low blood pressure at presentation and its adverse outcomes in acute stroke. Material and methods: This cross sectional study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during July 2022 till October 2022. The data was collected with the permission of ethical committee of hospital. The data was collected from those patients who fulfill the inclusion criteria. We collect all the data related to age, sex, history of diseases, risk factors, baseline values and stroke history. All suspected strokes who presented to the ED within 24 h of onset of first symptoms were included in this prospective study Results: In our study total 100 patients were enrolled mean age was 47.7± 10 years with minimum age of 18 years and maximum age of 65 years. Lesser patients belong to younger age group (18 years to 40 years) i.e. 54 while 46 belonged to elder age group i.e. 41 year to 65 years 24.1 % and 75.9% respectively. Out of which 62 were male and 38 were female. Practical implication: Hypotension and hypertension both are inter connected and treated simultaneously. Conclusion: It is concluded that hypotension were the commonest non communicable diseases (cardiovascular) risk factors in known hypertensive patients. Low presenting BP, both SBP and DBP, are associated with poor outcome after acute stroke, even after taking account of these patients. Keywords: Hypotension, Blood pressure, Stroke, Hypertension, Outcomes
{"title":"Low Blood Pressure at Presentation and its Adverse Outcomes in Acute Stroke","authors":"Ayesha Shahjahan, Syed Irfan Ahmed, Syed Muhammad Saqib, Saadia Ejaz","doi":"10.53350/pjmhs221610480","DOIUrl":"https://doi.org/10.53350/pjmhs221610480","url":null,"abstract":"Introduction: Most patients with acute ischemic stroke (AIS) have elevated blood pressure (BP) at presentation, which often declines spontaneously in the following days. Objectives: The main objective of the study is to find the Low blood pressure at presentation and its adverse outcomes in acute stroke. Material and methods: This cross sectional study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during July 2022 till October 2022. The data was collected with the permission of ethical committee of hospital. The data was collected from those patients who fulfill the inclusion criteria. We collect all the data related to age, sex, history of diseases, risk factors, baseline values and stroke history. All suspected strokes who presented to the ED within 24 h of onset of first symptoms were included in this prospective study Results: In our study total 100 patients were enrolled mean age was 47.7± 10 years with minimum age of 18 years and maximum age of 65 years. Lesser patients belong to younger age group (18 years to 40 years) i.e. 54 while 46 belonged to elder age group i.e. 41 year to 65 years 24.1 % and 75.9% respectively. Out of which 62 were male and 38 were female. Practical implication: Hypotension and hypertension both are inter connected and treated simultaneously. Conclusion: It is concluded that hypotension were the commonest non communicable diseases (cardiovascular) risk factors in known hypertensive patients. Low presenting BP, both SBP and DBP, are associated with poor outcome after acute stroke, even after taking account of these patients. Keywords: Hypotension, Blood pressure, Stroke, Hypertension, Outcomes","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"61 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":"126539408","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}
N. ., Abdul Qayum Khan, Farooque Khan, Shahzad Rashid Awan, Mehran Khan
Background: Chronic urticaria is defined as a pruritic skin disorder that persists daily or about daily for ˃6 weeks. Chronic urticaria is a common problem in Pakistan. The common treatment method is oral histamine. Currently the important treatment method used is autologous serum therapy. The objective of this study was to determine the efficacy of intramuscular platelet rich plasma versus oral antihistamine in the treatment of chronic urticaria Methodology: This study was randomized controlled clinical trial carried out at the Dermatology Department, Qazi Hussain Ahmad Complex Nowshera and alshifa clinic and skin aesthetic, Nowshera from May 2020 to May 2021. 100 patients were included in this research work. They were randomly divided into two groups of 50 patients each. One group was given autologous serum while the other was given antihistamine. The autologous serum group patients were treated by giving 9 intramuscular injection of autologous serum while the antihistamine group patients were treated with oral antihistamine on routine basis. UAS-7 (Urticaria Activity score-7) was used for measuring the effectiveness of both the treatment methods. Results: At baseline in autologous serum group, the Urticaria activity score was 36.1 (±6.7) while in antihistamine group it was 35.2 (±5.4) respectively. At baseline Urticaria activity score was non-significant (p=0.85). At 4th week the mean Urticaria activity score in autologous serum group and antihistamine group was 18.3(±3.6) and 30.2.1 (±5.1) (p=0.01). At 9th week in autologous serum group, the Urticaria activity score was 11.3 (±6.3) while in antihistamine group it was 22.6 (±4.9). (p=0.04) At 12th week the mean Urticaria activity score in autologous serum group and antihistamine group was 7.1(±5.4) and 20.4 (±7.3) respectively (p=0.01). Conclusion: Our study concludes that autologous serum therapy is more effective as compared to antihistamine in the treatment of chronic urticaria Keywords: Chronic Urticaria; Intramuscular platelet rich plasma; Oral antihistamine
{"title":"Efficacy of Intramuscular Platelet Rich Plasma Versus Oral Antihistamine In Chronic Urticaria","authors":"N. ., Abdul Qayum Khan, Farooque Khan, Shahzad Rashid Awan, Mehran Khan","doi":"10.53350/pjmhs221610390","DOIUrl":"https://doi.org/10.53350/pjmhs221610390","url":null,"abstract":"Background: Chronic urticaria is defined as a pruritic skin disorder that persists daily or about daily for ˃6 weeks. Chronic urticaria is a common problem in Pakistan. The common treatment method is oral histamine. Currently the important treatment method used is autologous serum therapy. The objective of this study was to determine the efficacy of intramuscular platelet rich plasma versus oral antihistamine in the treatment of chronic urticaria Methodology: This study was randomized controlled clinical trial carried out at the Dermatology Department, Qazi Hussain Ahmad Complex Nowshera and alshifa clinic and skin aesthetic, Nowshera from May 2020 to May 2021. 100 patients were included in this research work. They were randomly divided into two groups of 50 patients each. One group was given autologous serum while the other was given antihistamine. The autologous serum group patients were treated by giving 9 intramuscular injection of autologous serum while the antihistamine group patients were treated with oral antihistamine on routine basis. UAS-7 (Urticaria Activity score-7) was used for measuring the effectiveness of both the treatment methods. Results: At baseline in autologous serum group, the Urticaria activity score was 36.1 (±6.7) while in antihistamine group it was 35.2 (±5.4) respectively. At baseline Urticaria activity score was non-significant (p=0.85). At 4th week the mean Urticaria activity score in autologous serum group and antihistamine group was 18.3(±3.6) and 30.2.1 (±5.1) (p=0.01). At 9th week in autologous serum group, the Urticaria activity score was 11.3 (±6.3) while in antihistamine group it was 22.6 (±4.9). (p=0.04) At 12th week the mean Urticaria activity score in autologous serum group and antihistamine group was 7.1(±5.4) and 20.4 (±7.3) respectively (p=0.01). Conclusion: Our study concludes that autologous serum therapy is more effective as compared to antihistamine in the treatment of chronic urticaria Keywords: Chronic Urticaria; Intramuscular platelet rich plasma; Oral antihistamine","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"88 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":"128140313","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}
Introduction: Sepsis is a major cause of mortality associated with emergency department (ED) visits. In 2018, the Surviving Sepsis Campaign (SSC) recommended the following strategy to improve patient survival rates. Objectives: The main objective of the study is to find the early diagnosis of sepsis in emergency departments, time to treatment and association with mortality. Material and methods: This cross sectional study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during March 2022 till August 2022. The data was collected with the permission of ethical committee of hospital. The inclusion criteria were clinically suspected infection on presentation to an emergency department and at least two systemic inflammatory response syndrome signs, not including high leukocyte counts. Results: Out of 100 patients with sepsis, 97 were included for analysis, exclusions being due to incomplete information. 54% were male and 46% female. The age distribution was similar in both the genders with mean age being 54±2 years in males and 50±2 in females (p=0.30). Diabetes mellitus was the leading co-morbid present in 21 males as opposed to 18 females, followed by hypertension in 22 males and females respectively. Practical implication: This study will help in finding the procedure of sepsis and organ failure. Conclusion: It is concluded that procedures for recognizing sepsis and organ failure in the emergency department were delayed or not carried out in a substantial proportion of patients with sepsis. Keywords: Sepsis, Patients, Failure, Survival, Fluid
{"title":"Early Diagnosis of Sepsis in Emergency Departments, Time to Treatment and Association with Mortality","authors":"K. Rehman, R. Qazi, T. Sayed","doi":"10.53350/pjmhs221610462","DOIUrl":"https://doi.org/10.53350/pjmhs221610462","url":null,"abstract":"Introduction: Sepsis is a major cause of mortality associated with emergency department (ED) visits. In 2018, the Surviving Sepsis Campaign (SSC) recommended the following strategy to improve patient survival rates. Objectives: The main objective of the study is to find the early diagnosis of sepsis in emergency departments, time to treatment and association with mortality. Material and methods: This cross sectional study was conducted in Akbar Niazi Teaching Hospital, Barakahu, Islamabad during March 2022 till August 2022. The data was collected with the permission of ethical committee of hospital. The inclusion criteria were clinically suspected infection on presentation to an emergency department and at least two systemic inflammatory response syndrome signs, not including high leukocyte counts. Results: Out of 100 patients with sepsis, 97 were included for analysis, exclusions being due to incomplete information. 54% were male and 46% female. The age distribution was similar in both the genders with mean age being 54±2 years in males and 50±2 in females (p=0.30). Diabetes mellitus was the leading co-morbid present in 21 males as opposed to 18 females, followed by hypertension in 22 males and females respectively. Practical implication: This study will help in finding the procedure of sepsis and organ failure. Conclusion: It is concluded that procedures for recognizing sepsis and organ failure in the emergency department were delayed or not carried out in a substantial proportion of patients with sepsis. Keywords: Sepsis, Patients, Failure, Survival, Fluid","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"6 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":"128033423","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}
Objectives: The present study assessed the frequency of causes of indirect hyperbilirubinemia (IH) requiring exchange transfusion and its immediate adverse events of exchange transfusion in term neonates. Methods: A prospective, observational study was undertaken at the Neonatal ICU of National Institute of Child Health, Karachi between July 2021 and December 2021. Term neonates arriving at the newborn unit of NICH with indirect hyperbilirubinemia were included in this study. All enrolled neonates were monitored for clinical, biochemical, and hematological adverse events for 7 days following exchange transfusion, and a predesigned performa was used to document observations. Results: Among 730 neonates with indirect hyperbilirubinemia, a total of 63 term neonates underwent exchange transfusion. The most common causes of hyperbilirubinemia were sepsis in 19 (30.2%) patients and ABO incompatibility in 13 (20.6%) patients. The most common adverse events noted were hypokalemia, which occurred in 10 (15.9%) and thrombocytopenia, which occurred in 10 (15.9%) cases. In six patients, sepsis developed. In total, five neonates died while four developed bilirubin encephalopathy. The total serum bilirubin and direct bilirubin among patients were significantly lowered after exchange transfusion (p<0.0001). There were no umbilical catheter-related complications. Bilirubin encephalopathy was present in 4 patients. There were five deaths, but not due to the procedure. Practical implication Conclusion: We highlighted the main causes of indirect hyperbilirubinemia as sepsis and ABO incompatibility in our setting. Furthermore, we also identified the immediate and short-term outcomes of exchange transfusion with a mortality rate of 7.9%. The overall outcome was favorable after the exchange transfusion. Keywords: Hyperbilirubinemia, kernicterus, exchange transfusion, indirect bilirubin, neonates , jaundice
{"title":"Frequency of Indirect Hyperbilirubinemia Requiring Exchange Transfusion, Etiology and its Immediate Outcome in Term Neonates in Neonatal ICU of National Institute of Child Health, Karachi","authors":"Sania Rafique, Mashal Khan, M. Shaikh, M. Hanif","doi":"10.53350/pjmhs221610271","DOIUrl":"https://doi.org/10.53350/pjmhs221610271","url":null,"abstract":"Objectives: The present study assessed the frequency of causes of indirect hyperbilirubinemia (IH) requiring exchange transfusion and its immediate adverse events of exchange transfusion in term neonates. Methods: A prospective, observational study was undertaken at the Neonatal ICU of National Institute of Child Health, Karachi between July 2021 and December 2021. Term neonates arriving at the newborn unit of NICH with indirect hyperbilirubinemia were included in this study. All enrolled neonates were monitored for clinical, biochemical, and hematological adverse events for 7 days following exchange transfusion, and a predesigned performa was used to document observations. Results: Among 730 neonates with indirect hyperbilirubinemia, a total of 63 term neonates underwent exchange transfusion. The most common causes of hyperbilirubinemia were sepsis in 19 (30.2%) patients and ABO incompatibility in 13 (20.6%) patients. The most common adverse events noted were hypokalemia, which occurred in 10 (15.9%) and thrombocytopenia, which occurred in 10 (15.9%) cases. In six patients, sepsis developed. In total, five neonates died while four developed bilirubin encephalopathy. The total serum bilirubin and direct bilirubin among patients were significantly lowered after exchange transfusion (p<0.0001). There were no umbilical catheter-related complications. Bilirubin encephalopathy was present in 4 patients. There were five deaths, but not due to the procedure. Practical implication Conclusion: We highlighted the main causes of indirect hyperbilirubinemia as sepsis and ABO incompatibility in our setting. Furthermore, we also identified the immediate and short-term outcomes of exchange transfusion with a mortality rate of 7.9%. The overall outcome was favorable after the exchange transfusion. Keywords: Hyperbilirubinemia, kernicterus, exchange transfusion, indirect bilirubin, neonates , jaundice","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"8 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":"134114938","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. Bilal, Muhammad Abdul Raziq, Muhammad Ajwad Humayon, T. Hussain, M. Tahir
Objective: To find out the frequency of prediabetes in patients of HIV presenting at tertiary care hospital. Study design: Cross sectional study. Place and duration: Department of Medicine, D.G Khan Hospital, D.G Khan. (January 2020 to December 2020) Methodology: Total 187 patients of HIV infection, age 20 years to 60 years both male or female with duration of HIV 10 years were selected and pre-diabetes was studies. Results: Total 187 patients of HIV infection was recruited for this study and prediabetes was assessed. Mean age and mean HIV infection duration was 37.81 ± 12.81 years and 5.31 ± 2.86 years. Prediabetes was noted in 63 (34%) patients. Male patients and female patients were 122 (65.24%) and 65 (34.76%) respectively. Prediabetes was found in 58 (47.54%) males and in 5 (7.69%) females. Prediabetes was significantly (P=0.000) associated with gender. Conclusion: This study showed a higher percentage of prediabetes among HIV infected patients. Most of the cases were belonged to 3rd and 4th decade of life. Males were more victim of HIV infection as compared to females and most of the males were prediabetics. No association of development of prediabetes with duration of HIV infected was noted. Keywords: Prediabetes, HIV infection, diabetes mellitus, IGT
{"title":"Frequency of Prediabetes in patients of HIV Infection Presenting at Tertiary Care Hospital","authors":"M. Bilal, Muhammad Abdul Raziq, Muhammad Ajwad Humayon, T. Hussain, M. Tahir","doi":"10.53350/pjmhs221610236","DOIUrl":"https://doi.org/10.53350/pjmhs221610236","url":null,"abstract":"Objective: To find out the frequency of prediabetes in patients of HIV presenting at tertiary care hospital. Study design: Cross sectional study. Place and duration: Department of Medicine, D.G Khan Hospital, D.G Khan. (January 2020 to December 2020) Methodology: Total 187 patients of HIV infection, age 20 years to 60 years both male or female with duration of HIV 10 years were selected and pre-diabetes was studies. Results: Total 187 patients of HIV infection was recruited for this study and prediabetes was assessed. Mean age and mean HIV infection duration was 37.81 ± 12.81 years and 5.31 ± 2.86 years. Prediabetes was noted in 63 (34%) patients. Male patients and female patients were 122 (65.24%) and 65 (34.76%) respectively. Prediabetes was found in 58 (47.54%) males and in 5 (7.69%) females. Prediabetes was significantly (P=0.000) associated with gender. Conclusion: This study showed a higher percentage of prediabetes among HIV infected patients. Most of the cases were belonged to 3rd and 4th decade of life. Males were more victim of HIV infection as compared to females and most of the males were prediabetics. No association of development of prediabetes with duration of HIV infected was noted. Keywords: Prediabetes, HIV infection, diabetes mellitus, IGT","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"13 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":"116496832","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. Khalid, K. Iqbal, M. Nadeem, Khalid Khan, Aqeela Kousar, S. Rao, M. Abrar, Fiza Abbas
Background: Hematological disorders, including anemia, thrombocytopenia and leukopenia are quite frequent among malaria patients. Objective: To assess the frequency of thrombocytopenia in malaria patient at tertiary care hospital Methodology: This study was descriptive, cross-sectional study carried out at the medicine department, Qazi Hussain Ahmad Medical Complex, Nowshera for a period of six months from May 2022 to October 2022. Pre-designed proforma was used to collect patient information, such as demographics and medical history. A hematology analyzer was used to calculate the hematological variables from the CBC results. All the collected data was analyzed by using IBM SPSS version 23. Results: There were 83 (55.33%) males and 67 (44.77%) females. The overall frequency of thrombocytopenia amongst 150 patients with malaria was 90% (n=135). Amongst patients with thrombocytopenia, grade 1 thrombocytopenia was observed in 75 (50%) patients, grade 2 in 38 (25.33%) patients, grade 3 in 23 (15.33%) patients while grade 4 thrombocytopenia was observed in 14 (9.33%) patients. Conclusion: Our study concludes that thrombocytopenia is highly prevalent amongst patients with malaria. This leads us to the conclusion that the platelet count is a useful first-stage screening parameter in individuals with acute febrile illness. Keywords: Thrombocytopenia; Malaria; p.vivax; p.falsiparum
背景:血液学疾病，包括贫血、血小板减少症和白细胞减少症在疟疾患者中相当常见。目的:了解三级医院疟疾患者血小板减少的发生频率。方法:采用描述性横断面研究，于2022年5月至2022年10月在诺谢拉卡齐侯赛因艾哈迈德医疗中心内科进行。使用预先设计的形式来收集患者信息，如人口统计和病史。使用血液学分析仪从CBC结果计算血液学变量。所有收集的数据采用IBM SPSS version 23进行分析。结果:男性83例(55.33%)，女性67例(44.77%)。150例疟疾患者中血小板减少的总频率为90% (n=135)。在血小板减少患者中，1级血小板减少75例(50%)，2级38例(25.33%)，3级23例(15.33%)，4级14例(9.33%)。结论:我们的研究表明，血小板减少症在疟疾患者中非常普遍。这使我们得出结论，血小板计数是一个有用的第一阶段筛选参数，个人与急性发热性疾病。关键词:血小板减少症;疟疾;p.vivax;p.falsiparum
{"title":"Frequency of Thrombocytopenia in Malaria Patient at Tertiary Care Hospital","authors":"M. Khalid, K. Iqbal, M. Nadeem, Khalid Khan, Aqeela Kousar, S. Rao, M. Abrar, Fiza Abbas","doi":"10.53350/pjmhs221610362","DOIUrl":"https://doi.org/10.53350/pjmhs221610362","url":null,"abstract":"Background: Hematological disorders, including anemia, thrombocytopenia and leukopenia are quite frequent among malaria patients. Objective: To assess the frequency of thrombocytopenia in malaria patient at tertiary care hospital Methodology: This study was descriptive, cross-sectional study carried out at the medicine department, Qazi Hussain Ahmad Medical Complex, Nowshera for a period of six months from May 2022 to October 2022. Pre-designed proforma was used to collect patient information, such as demographics and medical history. A hematology analyzer was used to calculate the hematological variables from the CBC results. All the collected data was analyzed by using IBM SPSS version 23. Results: There were 83 (55.33%) males and 67 (44.77%) females. The overall frequency of thrombocytopenia amongst 150 patients with malaria was 90% (n=135). Amongst patients with thrombocytopenia, grade 1 thrombocytopenia was observed in 75 (50%) patients, grade 2 in 38 (25.33%) patients, grade 3 in 23 (15.33%) patients while grade 4 thrombocytopenia was observed in 14 (9.33%) patients. Conclusion: Our study concludes that thrombocytopenia is highly prevalent amongst patients with malaria. This leads us to the conclusion that the platelet count is a useful first-stage screening parameter in individuals with acute febrile illness. Keywords: Thrombocytopenia; Malaria; p.vivax; p.falsiparum","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"60 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":"116256556","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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