Ibrahim Asghar, S. Fatima, A. Shaikh, Nargis Shaikh, K. Qureshi
Objective: to critically analyze the leakage after open surgical repair of peptic ulcer perforation. Methods: All patients who fulfilled the inclusion criteria and visited to surgical department SMBBMU, Larkana from September, 2018 to March, 2021 were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. X-ray abdomen erect posture, leukocyte count, and serum amylase were performed. After surgery, site of perforation and type of surgery were recorded. Patients were followed for 30 days in order to assess the leakage. Results: Mean ± SD of age was 42.6±8.5 years. Out of 203 patients included in the study, 145 (71.4%) were male while 58 (28.6%) were female, Leakage was noted in 13 (6.4%) patients. Conclusion: It is to be concluded that leakage was less likely prevalent after peptic ulcer perforation repair, but we cannot rule out residual confounders. Practical implication Keywords: Leakage, Peptic Ulcer Perforation, Repair, Peritonitis, Laparoscopy, Surgery.
{"title":"Surgical Audit of Leakage after Open Surgical Repair of Perforated Peptic Ulcer","authors":"Ibrahim Asghar, S. Fatima, A. Shaikh, Nargis Shaikh, K. Qureshi","doi":"10.53350/pjmhs221610288","DOIUrl":"https://doi.org/10.53350/pjmhs221610288","url":null,"abstract":"Objective: to critically analyze the leakage after open surgical repair of peptic ulcer perforation. Methods: All patients who fulfilled the inclusion criteria and visited to surgical department SMBBMU, Larkana from September, 2018 to March, 2021 were included in the study. Informed consent was taken after explaining the procedure, risks and benefits of the study. X-ray abdomen erect posture, leukocyte count, and serum amylase were performed. After surgery, site of perforation and type of surgery were recorded. Patients were followed for 30 days in order to assess the leakage. Results: Mean ± SD of age was 42.6±8.5 years. Out of 203 patients included in the study, 145 (71.4%) were male while 58 (28.6%) were female, Leakage was noted in 13 (6.4%) patients. Conclusion: It is to be concluded that leakage was less likely prevalent after peptic ulcer perforation repair, but we cannot rule out residual confounders. Practical implication Keywords: Leakage, Peptic Ulcer Perforation, Repair, Peritonitis, Laparoscopy, Surgery.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"322 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":"123324286","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}
S. Hassan, Muhammad Amim Anwar, Syed Nouman Ahmed, Aqil Qayyum, M. Arshed
Background: Anesthesia is essential in the treatment of postoperative pain. Epidural analgesia and trans versus abdominis plane (TAP) block are possible options for analgesia for abdominal surgery. Objective: The main objective of the study is to evaluate and compare the efficacy of epidural bupivacaine and trans versus abdominus plane (TAP) block to provide better post-operative pain relief in total abdominal hysterectomy. Study design and place of study: This study was a prospective randomized control trial conducted at Department of anesthesiology, Liaquat National Hospital, Karachi for the period July 2017- July, 2018. Methods: Total 101 patients were enrolled thorough pre anesthetic assessment before surgery and an informed and written consent was obtained. Patients were allocated in group A and B after taking all ASA monitoring, participants in group A had an epidural catheter passed while Group B patients were given transversus abdominis plane block intra-operatively. A Visual Analogue Scale (VAS) score was used to assess anxiety levels. Statistical test like the chi-square test was used, with a p-value of 0.05 being considered statistically significant Results: Total 101 participants enrolled, the average age was 45.48 ± 1.06 (Age Rang 30-60years). The mean age of patient in Epidural Group was 47.02± 7.62 as ccompared with TAP Block Group was 43.56± 13.35 with p-value 0.007. Majority of the patients has ASA II, 39(61.9%) and 24(38.1%) respectively with p-value 0.240. Pain score at 10 minutes in epidural and TAP Block was reported as 2.16±2.1o and 3.0±2.94 (mild pain) with p-value 0.000 while after 6 hours, the VAS pain score showed mild pain in epidural group as 1.96±1.67 but moderate to severe pain was observed in TAP block patients as 4.28±1.56 with insignificant p-value 0.162. Study findings will help care taker staff for Post-Operative Pain Relief after the surgery , the benefits of single shot TAP block could be of advantage in situations where epidural analgesia is contraindicated or not desired. Conclusion: The study concluded better pain relief in patients with epidural bupivacaine when compared with TAP block. Keywords: TAP Transversus Abdominus Plane ASA Physical Status Score VAS Visual Analogue Scale Epidural block, postoperative pain relief, Total Abdominal Hysterectomy, Transversus Abdominis Plane Block
{"title":"A Comparison between the Post-Operative Pain Relief in Total Hystrectomy with Epidural Bupivacaine and TAP Block","authors":"S. Hassan, Muhammad Amim Anwar, Syed Nouman Ahmed, Aqil Qayyum, M. Arshed","doi":"10.53350/pjmhs221610230","DOIUrl":"https://doi.org/10.53350/pjmhs221610230","url":null,"abstract":"Background: Anesthesia is essential in the treatment of postoperative pain. Epidural analgesia and trans versus abdominis plane (TAP) block are possible options for analgesia for abdominal surgery. Objective: The main objective of the study is to evaluate and compare the efficacy of epidural bupivacaine and trans versus abdominus plane (TAP) block to provide better post-operative pain relief in total abdominal hysterectomy. Study design and place of study: This study was a prospective randomized control trial conducted at Department of anesthesiology, Liaquat National Hospital, Karachi for the period July 2017- July, 2018. Methods: Total 101 patients were enrolled thorough pre anesthetic assessment before surgery and an informed and written consent was obtained. Patients were allocated in group A and B after taking all ASA monitoring, participants in group A had an epidural catheter passed while Group B patients were given transversus abdominis plane block intra-operatively. A Visual Analogue Scale (VAS) score was used to assess anxiety levels. Statistical test like the chi-square test was used, with a p-value of 0.05 being considered statistically significant Results: Total 101 participants enrolled, the average age was 45.48 ± 1.06 (Age Rang 30-60years). The mean age of patient in Epidural Group was 47.02± 7.62 as ccompared with TAP Block Group was 43.56± 13.35 with p-value 0.007. Majority of the patients has ASA II, 39(61.9%) and 24(38.1%) respectively with p-value 0.240. Pain score at 10 minutes in epidural and TAP Block was reported as 2.16±2.1o and 3.0±2.94 (mild pain) with p-value 0.000 while after 6 hours, the VAS pain score showed mild pain in epidural group as 1.96±1.67 but moderate to severe pain was observed in TAP block patients as 4.28±1.56 with insignificant p-value 0.162. Study findings will help care taker staff for Post-Operative Pain Relief after the surgery , the benefits of single shot TAP block could be of advantage in situations where epidural analgesia is contraindicated or not desired. Conclusion: The study concluded better pain relief in patients with epidural bupivacaine when compared with TAP block. Keywords: TAP Transversus Abdominus Plane ASA Physical Status Score VAS Visual Analogue Scale Epidural block, postoperative pain relief, Total Abdominal Hysterectomy, Transversus Abdominis Plane Block","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"27 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":"126449433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study is done to compare the fistulotomy and fistulectomy for the treatment of fistulas in ano. This study is designed for the comparison of these surgical procedures to find out their results. Materials and methodology: this study was done at the surgery department of Sir Ganga Ram hospital Lahore during Jan 2021 to Dec 2021. 60 patients were included in this study and they were divided in two groups each of 30 participants. The group 1 patients were treated with fistulotomy while those of group 2 were selected for fistulectomy surgeries. The patients aged 20 years to 65 years were part of this study who were admitted to the department of surgery for planned fistulas operations. Before surgery Consent was taken from the patients themselves or by their close relatives.
目的:比较瘘管切开术和瘘管切除术治疗肛瘘的效果。本研究旨在比较这些外科手术的效果。材料和方法:本研究于2021年1月至2021年12月在拉合尔Sir Ganga Ram医院外科完成。60名患者参与了这项研究，他们被分为两组，每组30人。组1患者行瘘管切开术，组2患者行瘘管切开术。年龄在20岁到65岁之间的患者是本研究的一部分，他们在外科接受计划的瘘管手术。手术前征得患者本人或其近亲的同意。
{"title":"Comparison of Surgical Outcomes of Fistulotomy and Fistulectomy for the Management of Simple Low Fistula-In-ANO","authors":"Naeem Ghaffar, Mudassar Ali, Kamran Abbas","doi":"10.53350/pjmhs221610254","DOIUrl":"https://doi.org/10.53350/pjmhs221610254","url":null,"abstract":"Objective: This study is done to compare the fistulotomy and fistulectomy for the treatment of fistulas in ano. This study is designed for the comparison of these surgical procedures to find out their results. Materials and methodology: this study was done at the surgery department of Sir Ganga Ram hospital Lahore during Jan 2021 to Dec 2021. 60 patients were included in this study and they were divided in two groups each of 30 participants. The group 1 patients were treated with fistulotomy while those of group 2 were selected for fistulectomy surgeries. The patients aged 20 years to 65 years were part of this study who were admitted to the department of surgery for planned fistulas operations. Before surgery Consent was taken from the patients themselves or by their close relatives.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"50 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":"116289570","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}
S. Khatoon, Ghazanfer Ali, Sher Ali, Maria Zafer, Amber Ghaffar
Objective: To find our characteristics of adult diabetes mellitus (DM) patients visiting outpatient department (OPD) of a tertiary care hospital. Study Design: Observational, cross-sectional study. Place and Duration: Outpatient department of Medicine, Pakistan Institute of Medical Sciences, Islamabad Pakistan from October 2021 to March 2022. Methodology: We included a total of 200 patients. Inclusion criteria were patients of both genders aged 18 to 70 years having type-1 and type-2 diabetes mellitus with a disease duration history of at least 6 months visiting outpatient department. Socio-demographic data along with DM related characteristics including family history of DM, types of DM, types of medications being used and fasting/postprandial blood glucose levels were recorded. Frequency of various DM related complications at the time of enrollment were also noted. Results: In a total of 200 patients of DM, 129 (64.5%) were male and 71 (35.5%) female. Overall, mean age was 45.03±12.46 years while 91 (45.5%) patients were aged between 31 to 45 years. Mean BMI was 23.33±4.75 kg/m2. Positive family history of diabetes was found in 98 (49.0%) patients. Type-1 diabetes mellitus was reported by 13 (6.5%) patients while remaining 187 (93.5%) patients had type-2 diabetes mellitus. Mean Duration of diabetes was 7.65±7.60 years. There were 91 (45.5%) patients who were using oral plus injectable/insulin medications. Overall, mean fasting blood glucose was 148±49.06 mg/dl while mean 2-hour postprandial blood glucose was 235.07±58.80 mg/dl. Neuropathy was the most common diabetes related complications noted in 91 (45.5%) while gastrointestinal related complications were the 2nd most frequent complications observed in 31 (15.5%). Practical Implications: Vast majority of the DM patients reported hyperglycemia during routine follow ups which arises the need to revisit current management strategies. Conclusion: Majority of the patients with DM were male, middle aged and belonged to urban areas of residence. Nearly half of the DM patients reported neuropathy related complications. Keywords: Diabetes mellitus, neuropathy, hyperglycemia, insulin.
{"title":"Real World Data about the Characteristics of Adult Diabetes Mellitus Patients Visiting Outpatient Department of a Tertiary Care Hospital","authors":"S. Khatoon, Ghazanfer Ali, Sher Ali, Maria Zafer, Amber Ghaffar","doi":"10.53350/pjmhs221610294","DOIUrl":"https://doi.org/10.53350/pjmhs221610294","url":null,"abstract":"Objective: To find our characteristics of adult diabetes mellitus (DM) patients visiting outpatient department (OPD) of a tertiary care hospital. Study Design: Observational, cross-sectional study. Place and Duration: Outpatient department of Medicine, Pakistan Institute of Medical Sciences, Islamabad Pakistan from October 2021 to March 2022. Methodology: We included a total of 200 patients. Inclusion criteria were patients of both genders aged 18 to 70 years having type-1 and type-2 diabetes mellitus with a disease duration history of at least 6 months visiting outpatient department. Socio-demographic data along with DM related characteristics including family history of DM, types of DM, types of medications being used and fasting/postprandial blood glucose levels were recorded. Frequency of various DM related complications at the time of enrollment were also noted. Results: In a total of 200 patients of DM, 129 (64.5%) were male and 71 (35.5%) female. Overall, mean age was 45.03±12.46 years while 91 (45.5%) patients were aged between 31 to 45 years. Mean BMI was 23.33±4.75 kg/m2. Positive family history of diabetes was found in 98 (49.0%) patients. Type-1 diabetes mellitus was reported by 13 (6.5%) patients while remaining 187 (93.5%) patients had type-2 diabetes mellitus. Mean Duration of diabetes was 7.65±7.60 years. There were 91 (45.5%) patients who were using oral plus injectable/insulin medications. Overall, mean fasting blood glucose was 148±49.06 mg/dl while mean 2-hour postprandial blood glucose was 235.07±58.80 mg/dl. Neuropathy was the most common diabetes related complications noted in 91 (45.5%) while gastrointestinal related complications were the 2nd most frequent complications observed in 31 (15.5%). Practical Implications: Vast majority of the DM patients reported hyperglycemia during routine follow ups which arises the need to revisit current management strategies. Conclusion: Majority of the patients with DM were male, middle aged and belonged to urban areas of residence. Nearly half of the DM patients reported neuropathy related complications. Keywords: Diabetes mellitus, neuropathy, hyperglycemia, insulin.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"5 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":"114182001","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. Siddiqui, M. Umer, Hiba Moazzam, Sarosh ., Umar Soomro, Shahtaj A Shah
Background: Stressful conditions like surgery and anesthesia trigger neuroendocrine pathway activation, which can have dangerous hemodynamic effects on the patient. One method for minimizing these hemodynamic consequences is maintaining an optimum level of anesthesia. Another option is giving patients a pharmaceutical formulation that modifies how anesthetic agents react. Objective: The current study sought to determine if preoperative oral midazolam could reduce postoperative pain scores and the occurrence of Rescue Analgesia in patients undergoing laparoscopic cholecystectomy. Methods: This is a single-blinded randomized controlled study conducted at the Surgery department of Jinnah Medical College Hospital, Korangi Karachi, on patients undergoing laparoscopic cholecystectomy. Through simple random sampling, participants were divided into two study groups, control (n=32) and 7.5mg receiving preoperative oral midazolam-intervention group. After surgery, the VAS pain score in both group participants was measured at 2, 8, 12, and 24 hours. The frequency of rescue analgesia and duration of hospital stay was also observed. Standard deviation, mean, chi-square test, and T-test was performed to determine the variation in both groups by using SPSS version 26. The P value ≤0.005 was measured significant. Results: No significant difference in the postoperative pain score after oral administration of midazolam in the intervention group compared to the control group at 2, 12, and 24 hrs intervals. Except at 8-hour intervals, a significant change of 0.004 was observed in both study groups. A significant variation of 0.008 was observed in the duration of hospital stay in the intervention group when compared with the control group. Lastly, in the present study, no significant difference in the frequency of rescue analgesics was observed in both study groups. Practical implication: This study will help out to determine the right dosage of oral midazolam which might effectively be used in managing post-operative pain in laparoscopic cholecystectomy patients. Conclusion: Orally administeredmidazolam was not efficient in lowering the pain score in patients undergoing laparoscopic cholecystectomy. Keywords: Midazolam, Post-operative pain, Laparoscopic cholecystectomy, Local anesthetics
背景:手术和麻醉等应激条件会触发神经内分泌通路激活，这可能对患者产生危险的血流动力学影响。减少这些血流动力学后果的一种方法是维持最佳麻醉水平。另一种选择是给病人一种改变麻醉剂反应的药物配方。目的:本研究旨在确定术前口服咪达唑仑是否能降低腹腔镜胆囊切除术患者术后疼痛评分和抢救性镇痛的发生。方法:这是一项在卡拉奇Korangi真纳医学院医院外科对腹腔镜胆囊切除术患者进行的单盲随机对照研究。通过简单随机抽样，将参与者分为对照组(n=32)和7.5mg术前口服咪达唑仑干预组。术后2、8、12、24小时分别测量两组受试者的VAS疼痛评分。观察两组患者抢救镇痛的频率和住院时间。采用SPSS version 26进行标准差、均数、卡方检验和t检验。P值≤0.005为显著性。结果:干预组口服咪达唑仑术后疼痛评分与对照组间隔2、12、24 h无显著差异。除间隔8小时外，在两个研究组中均观察到0.004的显著变化。干预组住院时间与对照组比较差异显著，为0.008。最后，在本研究中，两组患者使用镇痛药的频率没有显著差异。实际意义:本研究将有助于确定口服咪达唑仑的正确剂量，从而有效地控制腹腔镜胆囊切除术患者术后疼痛。结论:口服咪达唑仑不能有效降低腹腔镜胆囊切除术患者的疼痛评分。关键词:咪达唑仑，术后疼痛，腹腔镜胆囊切除术，局麻药
{"title":"Randomized Controlled Clinical Trial to Examine the Efficacy of Oral Midazolam in Post Operative Pain Reduction in Patients Undergoing Laparoscopic Cholecystectomy","authors":"F. Siddiqui, M. Umer, Hiba Moazzam, Sarosh ., Umar Soomro, Shahtaj A Shah","doi":"10.53350/pjmhs221610430","DOIUrl":"https://doi.org/10.53350/pjmhs221610430","url":null,"abstract":"Background: Stressful conditions like surgery and anesthesia trigger neuroendocrine pathway activation, which can have dangerous hemodynamic effects on the patient. One method for minimizing these hemodynamic consequences is maintaining an optimum level of anesthesia. Another option is giving patients a pharmaceutical formulation that modifies how anesthetic agents react. Objective: The current study sought to determine if preoperative oral midazolam could reduce postoperative pain scores and the occurrence of Rescue Analgesia in patients undergoing laparoscopic cholecystectomy. Methods: This is a single-blinded randomized controlled study conducted at the Surgery department of Jinnah Medical College Hospital, Korangi Karachi, on patients undergoing laparoscopic cholecystectomy. Through simple random sampling, participants were divided into two study groups, control (n=32) and 7.5mg receiving preoperative oral midazolam-intervention group. After surgery, the VAS pain score in both group participants was measured at 2, 8, 12, and 24 hours. The frequency of rescue analgesia and duration of hospital stay was also observed. Standard deviation, mean, chi-square test, and T-test was performed to determine the variation in both groups by using SPSS version 26. The P value ≤0.005 was measured significant. Results: No significant difference in the postoperative pain score after oral administration of midazolam in the intervention group compared to the control group at 2, 12, and 24 hrs intervals. Except at 8-hour intervals, a significant change of 0.004 was observed in both study groups. A significant variation of 0.008 was observed in the duration of hospital stay in the intervention group when compared with the control group. Lastly, in the present study, no significant difference in the frequency of rescue analgesics was observed in both study groups. Practical implication: This study will help out to determine the right dosage of oral midazolam which might effectively be used in managing post-operative pain in laparoscopic cholecystectomy patients. Conclusion: Orally administeredmidazolam was not efficient in lowering the pain score in patients undergoing laparoscopic cholecystectomy. Keywords: Midazolam, Post-operative pain, Laparoscopic cholecystectomy, Local anesthetics","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"87 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":"114207355","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}
Ahmed Jamal, Usman Iqbal, Aroosa Amjad, R. Iqbal, A. Abdullah
Objective: To assess neurocognitive effects in patients who underwent cardiopulmonary bypass. Study Design & Setting: Using non probability purposive sampling, a prospective study design was used to collect the data from in tertiary care hospitals with 60 beds in ICU. Methodology: Patients who underwent CPB having no history of psychological and mental illness was recruited for the said study. We used a short test of global mental status to measure cognitive performance called the “Mini-Mental State Examination (MMSE)”.Wilcoxon test was used to analyze the pre- and post-operative changes over MMSE. The Folstein test, often known as the mini-mental state examination (MMSE), is a 30-point survey that has been widely used in clinical and research contexts to evaluate cognitive impairment. Different parameters; temporal, spatial, alternate, recognition, and recall were evaluated. P-value ≤0.05 was considered as significant. Results: In this study, a significant fall in spatial, temporal, short term recall, long term recall, object recognition, alternate, reading, writing, read and act, and drawing in post-operative MMSE scores was observed as compared to pre-operative. However, there was no significant change in command so there is little or no effect on command parameters in pre-operative and post-operative cardiopulmonary bypass patients. There was a significant difference between pre-operation and post-operation total scores i.e., a fall in the ‘total’ score of neurocognition occurred after cardiopulmonary bypass. Practical implication Study finding may be used for practical implications in managing neurocognitive outcome in patients undergoing cardiopulomonary bypass. Conclusion: This research concludes that neurocognition is affected in patients who underwent CPB, with CPB itself a bigger risk factor in causing postoperative neurocognitive dysfunction. Keywords: Cardiopulmonary bypass, Mental health, Neurocoagnitive impairment, POCD
{"title":"Assessment of Neurocognitive Effect in Patients Undergoing Cardiopulmonary Bypass: A Prospective Longitudinal Study","authors":"Ahmed Jamal, Usman Iqbal, Aroosa Amjad, R. Iqbal, A. Abdullah","doi":"10.53350/pjmhs221610238","DOIUrl":"https://doi.org/10.53350/pjmhs221610238","url":null,"abstract":"Objective: To assess neurocognitive effects in patients who underwent cardiopulmonary bypass. Study Design & Setting: Using non probability purposive sampling, a prospective study design was used to collect the data from in tertiary care hospitals with 60 beds in ICU. Methodology: Patients who underwent CPB having no history of psychological and mental illness was recruited for the said study. We used a short test of global mental status to measure cognitive performance called the “Mini-Mental State Examination (MMSE)”.Wilcoxon test was used to analyze the pre- and post-operative changes over MMSE. The Folstein test, often known as the mini-mental state examination (MMSE), is a 30-point survey that has been widely used in clinical and research contexts to evaluate cognitive impairment. Different parameters; temporal, spatial, alternate, recognition, and recall were evaluated. P-value ≤0.05 was considered as significant. Results: In this study, a significant fall in spatial, temporal, short term recall, long term recall, object recognition, alternate, reading, writing, read and act, and drawing in post-operative MMSE scores was observed as compared to pre-operative. However, there was no significant change in command so there is little or no effect on command parameters in pre-operative and post-operative cardiopulmonary bypass patients. There was a significant difference between pre-operation and post-operation total scores i.e., a fall in the ‘total’ score of neurocognition occurred after cardiopulmonary bypass. Practical implication Study finding may be used for practical implications in managing neurocognitive outcome in patients undergoing cardiopulomonary bypass. Conclusion: This research concludes that neurocognition is affected in patients who underwent CPB, with CPB itself a bigger risk factor in causing postoperative neurocognitive dysfunction. Keywords: Cardiopulmonary bypass, Mental health, Neurocoagnitive impairment, POCD","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"17 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":"125284452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: Estimate to the prevalence of hemorrhoids Signs and Symptoms among pregnancies in maternity teaching hospitals in Mosul city. Material: Descriptive study was conducted in maternity teaching hospital 20to30 September 2022 . A purposive sample that consists of (64) patients , chosen according to the criteria . Their age ranges between (15-44) years. A questionnaire was developed for purposive of study & included 3 parts is consist of part one demographic data and part three is composed of (7) items . The overall questions included (28) items. Results: The age groups is between(20-24) years and constituted Prevalence (29.7%), In addition the age groups is between (25-29) years and constituted (29.7%) Most of samples were females constitute of Prevalence (60%) of the total samples. In regard with residence city Prevalence (76.6%) .In regard with levels of education elementary Prevalence (20.3%) .In regard with occupation housewife Prevalence (65.6%) high percentage. Conclusion: This study concluded that the Age, Residence, occupation a variables are the most socio- demographic variables that were associated prevalence of hemorrhoids Signs and Symptoms among pregnancies and the level of education variable.High percent from total sample were in residence city it constitute of Prevalence (76,6%). With regard to the occupation housewife were living urban areas and constitutes Prevalence (65,6%) and there are many high associations among some variables prevalence of hemorrhoids Signs and Symptoms among pregnancies and the age significant. Keywords: Prevalence, Hemorrhoids, Pregnancies.
{"title":"Prevalence of Hemorrhoids Signs and Symptoms among Pregnancies at Maternity Teaching Hospitals in Mosul City","authors":"Rana Mohammed Jasim","doi":"10.53350/pjmhs221610406","DOIUrl":"https://doi.org/10.53350/pjmhs221610406","url":null,"abstract":"Objective: Estimate to the prevalence of hemorrhoids Signs and Symptoms among pregnancies in maternity teaching hospitals in Mosul city. Material: Descriptive study was conducted in maternity teaching hospital 20to30 September 2022 . A purposive sample that consists of (64) patients , chosen according to the criteria . Their age ranges between (15-44) years. A questionnaire was developed for purposive of study & included 3 parts is consist of part one demographic data and part three is composed of (7) items . The overall questions included (28) items. Results: The age groups is between(20-24) years and constituted Prevalence (29.7%), In addition the age groups is between (25-29) years and constituted (29.7%) Most of samples were females constitute of Prevalence (60%) of the total samples. In regard with residence city Prevalence (76.6%) .In regard with levels of education elementary Prevalence (20.3%) .In regard with occupation housewife Prevalence (65.6%) high percentage. Conclusion: This study concluded that the Age, Residence, occupation a variables are the most socio- demographic variables that were associated prevalence of hemorrhoids Signs and Symptoms among pregnancies and the level of education variable.High percent from total sample were in residence city it constitute of Prevalence (76,6%). With regard to the occupation housewife were living urban areas and constitutes Prevalence (65,6%) and there are many high associations among some variables prevalence of hemorrhoids Signs and Symptoms among pregnancies and the age significant. Keywords: Prevalence, Hemorrhoids, Pregnancies.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"32 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":"129742903","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}
J. Gulzar, S. Zahra, I. Aftab, Nayab Amir, Rana Muhammad Naeem Liaqat, Ayesha Iqbal
Obstetrical haemorrhage is a potentially fatal clinical manifestation of either vaginal delivery or caesarean section. According to reports, it is responsible for almost fifty percent of all pregnancy - related deaths. The prevalence of caesarean section (CS) has dramatically upped in both low income as well as in developed nations, thereby increasing the likelihood of obstetrical haemorrhage. The rationale of this study is that it is important to evaluate the efficacy and safety of TA on blood loss with LSCS. Methods: Cases were separated into two subgroups: case: (A) and control: (B). In the operating theater, participants were given A and B packages to choose from, the contents of whom were only known to the nurse in charge of drug preparation. All meds were injected by an anesthetist who was not in charge of supervising or assessing the patients. Results: Comparison of both %age reduction in Hb levels (>10%) after treatment shows that in Group A 6(20%) and in Group B 15(50%) had >10% reduction in Hb levels after treatment, p-value=0.015. Conclusion: TA administration reduced dramatically the bleeding throughout CS, the proportion of patients who lost more than 1000 mL of blood, and the requirement for supplemental uterotonic substances. As a result, TA can be employed very safely and successfully in patients receiving caesarean section.
{"title":"Determining Efficacy of Tranexamic Acid in Reducing Post Partum Haemorrhage in Elective Cesarean Section Patients Evaluating in Referance to Fall in Haemoglobin","authors":"J. Gulzar, S. Zahra, I. Aftab, Nayab Amir, Rana Muhammad Naeem Liaqat, Ayesha Iqbal","doi":"10.53350/pjmhs221610456","DOIUrl":"https://doi.org/10.53350/pjmhs221610456","url":null,"abstract":"Obstetrical haemorrhage is a potentially fatal clinical manifestation of either vaginal delivery or caesarean section. According to reports, it is responsible for almost fifty percent of all pregnancy - related deaths. The prevalence of caesarean section (CS) has dramatically upped in both low income as well as in developed nations, thereby increasing the likelihood of obstetrical haemorrhage. The rationale of this study is that it is important to evaluate the efficacy and safety of TA on blood loss with LSCS. Methods: Cases were separated into two subgroups: case: (A) and control: (B). In the operating theater, participants were given A and B packages to choose from, the contents of whom were only known to the nurse in charge of drug preparation. All meds were injected by an anesthetist who was not in charge of supervising or assessing the patients. Results: Comparison of both %age reduction in Hb levels (>10%) after treatment shows that in Group A 6(20%) and in Group B 15(50%) had >10% reduction in Hb levels after treatment, p-value=0.015. Conclusion: TA administration reduced dramatically the bleeding throughout CS, the proportion of patients who lost more than 1000 mL of blood, and the requirement for supplemental uterotonic substances. As a result, TA can be employed very safely and successfully in patients receiving caesarean section.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"160 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":"127395485","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}
H. Tareen, A. Sher, Fouzia Goher, I. Hussain, Mohsin Saif, M. R. Khan
Background: The limited knowledge is present about the outcomes associated with the patients diagnosed with acute coronary syndrome (ACS). The insufficient data about the sex difference in the post-interventions outcomes and disparities in management is available. Objective: This study aim was to determine the sex-related differences in the patient diagnosed with ACS. This study also aimed to determine how these differences have perished in a time span of one year. Study design: It is a retrospective study with the statistical approaches. Material and Methods: The data of the 1000 patients that visited to AFIC Rawalpindi was collected. The duration of the study was 6 months, from August 2021 to January 2022. The patients were diagnosed with the non-ST-segment elevation acute coronary syndrome were selected. The ethical and review board committee of the hospital approved the study. The patients were further grouped to ACS I and ACS II. Results: Out of the 1000 patients taken, there were 650 patients that had acute coronary syndrome I while there were 350 patients that had acute coronary syndrome II. Among the 650 patients of ACSI there were 430 males and 220 were female patients. And among the 350 ACSII there were 230 males and 120 were female. The study indicate that the older women have the higher cases with reported history of heart failure and hypertension. The higher mortality cases were also observed in the females. The association between coronary angiography in-hospital use and female gender was very weak. The physicians underestimate the risk associated with the diagnosed patients that leads to less use of invasive strategies for treatment of the men and women. Conclusion: Due to underestimation of the risks associated with the ACS patients the conservative methods are used for the treatment of the women. The poor in-hospital outcome are associated with the female gender. It was found that women are less likely to undergo coronary artery angioplasty and other cardiac procedures as compared to the male patients. Awareness is needed for both male and female to eliminate this gender disparity. Keywords: Coronary angiography, acute coronary syndrome, percutaneous coronary intervention, post-interventions outcomes and heart failure.
{"title":"The Insight into the Sex Differences in the Patients Diagnosed with Acute Coronary Syndromes Undergoing Percutaneous Coronary Intervention","authors":"H. Tareen, A. Sher, Fouzia Goher, I. Hussain, Mohsin Saif, M. R. Khan","doi":"10.53350/pjmhs221610379","DOIUrl":"https://doi.org/10.53350/pjmhs221610379","url":null,"abstract":"Background: The limited knowledge is present about the outcomes associated with the patients diagnosed with acute coronary syndrome (ACS). The insufficient data about the sex difference in the post-interventions outcomes and disparities in management is available. Objective: This study aim was to determine the sex-related differences in the patient diagnosed with ACS. This study also aimed to determine how these differences have perished in a time span of one year. Study design: It is a retrospective study with the statistical approaches. Material and Methods: The data of the 1000 patients that visited to AFIC Rawalpindi was collected. The duration of the study was 6 months, from August 2021 to January 2022. The patients were diagnosed with the non-ST-segment elevation acute coronary syndrome were selected. The ethical and review board committee of the hospital approved the study. The patients were further grouped to ACS I and ACS II. Results: Out of the 1000 patients taken, there were 650 patients that had acute coronary syndrome I while there were 350 patients that had acute coronary syndrome II. Among the 650 patients of ACSI there were 430 males and 220 were female patients. And among the 350 ACSII there were 230 males and 120 were female. The study indicate that the older women have the higher cases with reported history of heart failure and hypertension. The higher mortality cases were also observed in the females. The association between coronary angiography in-hospital use and female gender was very weak. The physicians underestimate the risk associated with the diagnosed patients that leads to less use of invasive strategies for treatment of the men and women. Conclusion: Due to underestimation of the risks associated with the ACS patients the conservative methods are used for the treatment of the women. The poor in-hospital outcome are associated with the female gender. It was found that women are less likely to undergo coronary artery angioplasty and other cardiac procedures as compared to the male patients. Awareness is needed for both male and female to eliminate this gender disparity. Keywords: Coronary angiography, acute coronary syndrome, percutaneous coronary intervention, post-interventions outcomes and heart failure.","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"31 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":"129845773","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}
Mervat Kamil Kadhim, Alaa Mohammad Hasson Al-Husseini
The goal of this study is to see if there's a link between diabetes type 2 problems and endothelin-1 overexpression (ET-1). Where (90) blood samples from participants were obtained and divided into three groups: a first group representing individuals with (Hypertensive DMT2) and a second group representing (Hypertensive DMT2with CVD,), while the third group was represented by a control group. mRNA was extracted from blood samples then converted to cDNA by using the (qPCR) technique. When comparing the levels of ET-1 in the (hypertensive DMT2 and hypertensive DMT2with CVD groups ) to the control group, the results showed a significant difference (p<0.05), The current study analyzed the ET-1 gene in type 2 diabetes and cardiovascular disease, which could be a new target for early CVD therapy in the future. Keywords: endothelin-1gene, diabetes type II, cardiovascular disease, , endothelial dysfunction
{"title":"Quantification of Endothelin-1 Gene Expression in the Diabetic Patients' Type II (DMT2) with Cardiovascular Disease","authors":"Mervat Kamil Kadhim, Alaa Mohammad Hasson Al-Husseini","doi":"10.53350/pjmhs221610423","DOIUrl":"https://doi.org/10.53350/pjmhs221610423","url":null,"abstract":"The goal of this study is to see if there's a link between diabetes type 2 problems and endothelin-1 overexpression (ET-1). Where (90) blood samples from participants were obtained and divided into three groups: a first group representing individuals with (Hypertensive DMT2) and a second group representing (Hypertensive DMT2with CVD,), while the third group was represented by a control group. mRNA was extracted from blood samples then converted to cDNA by using the (qPCR) technique. When comparing the levels of ET-1 in the (hypertensive DMT2 and hypertensive DMT2with CVD groups ) to the control group, the results showed a significant difference (p<0.05), The current study analyzed the ET-1 gene in type 2 diabetes and cardiovascular disease, which could be a new target for early CVD therapy in the future. Keywords: endothelin-1gene, diabetes type II, cardiovascular disease, , endothelial dysfunction","PeriodicalId":296492,"journal":{"name":"Pakistan Journal of Medical & Health Sciences","volume":"1 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":"130055994","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：