Objective: To find out the frequency and determinants of burnout among healthcare workers and staff working in a labour room of a Gynaecology unit of a tertiary care hospital in South Punjab, Pakistan. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Shaikh Zayed Hospital, Rahim Yar Khan, Pakistan, from Mar to May 2022. Methodology: A total of 93 healthcare workers, including doctors and nurses from the labour room of the study centre, were included. Possible causes of burnout were noted. The 16-item instrument OLBI was utilized. Results: Of the 93 study participants, 35(37.6%) were post-graduate residents. High exhaustion was reported by 61(65.6%) study participants, while high disengagement was noted in 44(47.3%). Burnout was reported by 38(40.9%) study participants. Age (p=0.006), marital status as married (p=0.004), designation as post-graduate resident (p<0.001), patient expectations unfulfilled (p<0.001), litigation anxiety (p<0.001), lack of control of processes (p=0.017), role conflict (p=0.001) and communication gap among workers (p<0.001) were found to have a significant association with burnout. Conclusion: The frequency of burnout among healthcare professionals and nurses working in the labour room of a tertiary care hospital in a developing country was high. Age, marital status as married, post-graduate residents, patients' expectations unfulfilled, litigation anxiety, lack of control of processes, role conflict and communication gap among workers were found to have a significant association with burnout.
{"title":"Determinants of Burnout Among Healthcare Professionals Working in the Labour Room of a Tertiary Care Hospital in South Punjab, Pakistan","authors":"Sadia Zahoor, Mamoona Zahoor, Faiza Javed, Mahwish Najam, Shahida Aslam, Iffat Yasmeen","doi":"10.51253/pafmj.v73i5.8962","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.8962","url":null,"abstract":"Objective: To find out the frequency and determinants of burnout among healthcare workers and staff working in a labour room of a Gynaecology unit of a tertiary care hospital in South Punjab, Pakistan. Study Design: Cross-sectional study. Place and Duration of the Study: Department of Obstetrics and Gynaecology, Shaikh Zayed Hospital, Rahim Yar Khan, Pakistan, from Mar to May 2022. Methodology: A total of 93 healthcare workers, including doctors and nurses from the labour room of the study centre, were included. Possible causes of burnout were noted. The 16-item instrument OLBI was utilized. Results: Of the 93 study participants, 35(37.6%) were post-graduate residents. High exhaustion was reported by 61(65.6%) study participants, while high disengagement was noted in 44(47.3%). Burnout was reported by 38(40.9%) study participants. Age (p=0.006), marital status as married (p=0.004), designation as post-graduate resident (p<0.001), patient expectations unfulfilled (p<0.001), litigation anxiety (p<0.001), lack of control of processes (p=0.017), role conflict (p=0.001) and communication gap among workers (p<0.001) were found to have a significant association with burnout. Conclusion: The frequency of burnout among healthcare professionals and nurses working in the labour room of a tertiary care hospital in a developing country was high. Age, marital status as married, post-graduate residents, patients' expectations unfulfilled, litigation anxiety, lack of control of processes, role conflict and communication gap among workers were found to have a significant association with burnout.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"17 2","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.6762
Sarah Fatimah, None Irfan Khan, None Amjad Khan, None Amina Latif, None Ghulam Hussain Ibrahim, None Sara Zaidi, None Muhammad Abid Faroque
Objective: To determine the clinical effects of COVID-19 on patients and families after diagnosis at regular intervals of 30 days and 90 days respectively. Study Design: Prospective longitudinal Study. Place and Duration of Study: Combined Military Hospital, Hyderabad Pakistan, from Mar 2020 to Feb 2021. Methodology: Two hundred patients and their families who were symptomatic and RT-PCR positive for COVID-19 with mild and moderate disease were included in the study. The patients listed in our COVID-19 registry were called on Day 30 and Day 90 after the appearance of the first symptoms and were assessed on various parameters. Results: In our study, 200 patients were included and assessed on days 30 and 90. On day 90, the median number of symptoms per person was almost 3, reduced from a median of 7 on day 30. However, at the time of presentation, the median number of symptoms per person was 12. The patients had persistent symptoms that hindered their routine lives and reduced their working capacity. Conclusion: The persistence of clinical symptoms post-COVID-19 requires assessment and longitudinal monitoring. Persistence of symptoms reflects a worse clinical progression and delay in attaining 100% fitness.
{"title":"Impact of Long COVID-19 on Patients and Their Families","authors":"Sarah Fatimah, None Irfan Khan, None Amjad Khan, None Amina Latif, None Ghulam Hussain Ibrahim, None Sara Zaidi, None Muhammad Abid Faroque","doi":"10.51253/pafmj.v73i5.6762","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.6762","url":null,"abstract":"Objective: To determine the clinical effects of COVID-19 on patients and families after diagnosis at regular intervals of 30 days and 90 days respectively. Study Design: Prospective longitudinal Study. Place and Duration of Study: Combined Military Hospital, Hyderabad Pakistan, from Mar 2020 to Feb 2021. Methodology: Two hundred patients and their families who were symptomatic and RT-PCR positive for COVID-19 with mild and moderate disease were included in the study. The patients listed in our COVID-19 registry were called on Day 30 and Day 90 after the appearance of the first symptoms and were assessed on various parameters. Results: In our study, 200 patients were included and assessed on days 30 and 90. On day 90, the median number of symptoms per person was almost 3, reduced from a median of 7 on day 30. However, at the time of presentation, the median number of symptoms per person was 12. The patients had persistent symptoms that hindered their routine lives and reduced their working capacity. Conclusion: The persistence of clinical symptoms post-COVID-19 requires assessment and longitudinal monitoring. Persistence of symptoms reflects a worse clinical progression and delay in attaining 100% fitness.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"267 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136132653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.5419
Madiha Hashmi, None Ghulam Haider, None Muhammad Danish, None Anusha Hassan, None Razia Irshad, None Khalil Ahmed
Objective: To evaluate raised alpha feto-protein levels for socio-demographic and clinicopathological features in hepatocellular carcinoma. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan 2019 to Jan 2020. Methodology: Two hundred and thirty-six patients of age more than 20 years, of either gender diagnosed with hepatocellular carcinoma were included. Detailed demographic data, information regarding addiction and medical history were collected. According to The National Comprehensive Cancer Network, Hepatocellular carcinoma was diagnosed using a multiphasic liver protocol CT scan with intravenous contrast. The alpha-fetoprotein levels were checked after confirmation of hepatocellular carcinoma on a multiphasic CT scan. The cut-off value for elevated alpha feto-protein was ≥20 ng/mL. Results: The median alpha protein levels were reported as 411 ng/mL. About 183(78%) patients had elevated alpha protein levels. In univariate analysis, age, gender, diabetes mellitus, hepatitis B, hepatitis C, portal vein thrombosis, number of lesions, cirrhotic liver, features of portal hypertension, anti-viral treatment status, cigarette smoking, and segment of the liver showed a statistically significant relationship with elevated alpha protein levels (p<0.05). On the multivariate model, age, hepatitis C, number of lesions, portal vein thrombosis, and Child Pugh score showed statistically significant association with elevated alpha protein (p<0.05). Conclusions: The elevated alpha protein levels level was found to be higher among hepatocellular carcinoma and associated with age, hepatitis C, number of lesions, portal vein thrombosis and Child Pugh score.
{"title":"Raised Alpha-Fetoprotein Level and its Association with Hepatocellular Carcinoma","authors":"Madiha Hashmi, None Ghulam Haider, None Muhammad Danish, None Anusha Hassan, None Razia Irshad, None Khalil Ahmed","doi":"10.51253/pafmj.v73i5.5419","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.5419","url":null,"abstract":"Objective: To evaluate raised alpha feto-protein levels for socio-demographic and clinicopathological features in hepatocellular carcinoma. Study Design: Cross-sectional study. Place and Duration of Study: Department of Medical Oncology, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Jan 2019 to Jan 2020. Methodology: Two hundred and thirty-six patients of age more than 20 years, of either gender diagnosed with hepatocellular carcinoma were included. Detailed demographic data, information regarding addiction and medical history were collected. According to The National Comprehensive Cancer Network, Hepatocellular carcinoma was diagnosed using a multiphasic liver protocol CT scan with intravenous contrast. The alpha-fetoprotein levels were checked after confirmation of hepatocellular carcinoma on a multiphasic CT scan. The cut-off value for elevated alpha feto-protein was ≥20 ng/mL. Results: The median alpha protein levels were reported as 411 ng/mL. About 183(78%) patients had elevated alpha protein levels. In univariate analysis, age, gender, diabetes mellitus, hepatitis B, hepatitis C, portal vein thrombosis, number of lesions, cirrhotic liver, features of portal hypertension, anti-viral treatment status, cigarette smoking, and segment of the liver showed a statistically significant relationship with elevated alpha protein levels (p<0.05). On the multivariate model, age, hepatitis C, number of lesions, portal vein thrombosis, and Child Pugh score showed statistically significant association with elevated alpha protein (p<0.05). Conclusions: The elevated alpha protein levels level was found to be higher among hepatocellular carcinoma and associated with age, hepatitis C, number of lesions, portal vein thrombosis and Child Pugh score.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"113 ","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136070211","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.9324
Amir Ali Khan, Zeeshan Ayub, Syed Tehmina Rehman, Syed Aoun Abbas Mehdi, Usman Afzal Malik, Muhammad Ahmed Khan
Objective: To determine the efficacy of interventions undertaken to manage common causes of halitosis based on organoleptic scoring. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Pano Aqil Pakistan, from Sep 2021 to Aug 2022. Methodology: Three hundred patients with halitosis fulfilling the inclusion criteria were treated as per their root cause of halitosis and evaluated by organoleptic scoring method on a fortnightly basis for one month. Pre-treatment organoleptic scoring was compared with post-treatment organoleptic scores. Results: Among 300 patients, 177(59%) were females and 123(41%) were males. Halitosis due to poor oro-dental hygiene was seen in 92(30.66%) cases, food-related halitosis in 90(30%), periodontal diseases in 47(15%) cases, while 33 patients (11%) have halitosis due to ENT diseases. A comparison of pre-treatment and post-treatment organoleptic scores revealed a marked decrease in the number of patients having persistent halitosis (p-value 0.001). Conclusion: The most common etiological factor is poor oral hygiene. An organoleptic scoring system is a simple and quick method to recognize and grade halitosis without requiring costly gadgetry.
{"title":"Evaluation of Common Interventions to Manage Halitosis Based On Organoleptic Scoring","authors":"Amir Ali Khan, Zeeshan Ayub, Syed Tehmina Rehman, Syed Aoun Abbas Mehdi, Usman Afzal Malik, Muhammad Ahmed Khan","doi":"10.51253/pafmj.v73i5.9324","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.9324","url":null,"abstract":"Objective: To determine the efficacy of interventions undertaken to manage common causes of halitosis based on organoleptic scoring. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Pano Aqil Pakistan, from Sep 2021 to Aug 2022. Methodology: Three hundred patients with halitosis fulfilling the inclusion criteria were treated as per their root cause of halitosis and evaluated by organoleptic scoring method on a fortnightly basis for one month. Pre-treatment organoleptic scoring was compared with post-treatment organoleptic scores. Results: Among 300 patients, 177(59%) were females and 123(41%) were males. Halitosis due to poor oro-dental hygiene was seen in 92(30.66%) cases, food-related halitosis in 90(30%), periodontal diseases in 47(15%) cases, while 33 patients (11%) have halitosis due to ENT diseases. A comparison of pre-treatment and post-treatment organoleptic scores revealed a marked decrease in the number of patients having persistent halitosis (p-value 0.001). Conclusion: The most common etiological factor is poor oral hygiene. An organoleptic scoring system is a simple and quick method to recognize and grade halitosis without requiring costly gadgetry.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"47 15","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.6698
Qudrat Ullah Malik, Ambreen Usmani, Sirajul Haque
Objective: To determine the impact of WhatsApp Messaging on learning paediatrics during clinical rotation of final year MBBS medical undergraduates. Study Design: Quasi-Experimental study Place and Duration of Study: Bahria University Medical and Dental College, Karachi Pakistan, from Apr to Oct 2018. Methodology: Final year MBBS students attending the Department of Paediatrics for three months of clinical rotation were randomly allocated to two Groups. Group-A was the control Group without WhatsApp, and Group-B was the intervention Group with WhatsApp messaging. Both Groups had a pre-test and post-test before and after their clinical rotation. The evaluation was performed before and after clinical rotation using Multiple choice questions (MCQs) for the final evaluation. Results: Of a total of 80 students, 19(23.8%) were males, and 61(76.3%) were females, with a median age of 23(22-23) years. Of 40 students in the WhatsApp Group, active participation was observed in 37(92.5%) students, whereas the quality of the shared content by students was found to be adequate/relevant in 35(87.5%) cases. The median score was significantly higher in both Groups' clinical rotation test than in the pre-clinical rotation assessment (p-value <0.001). However, the median score of the post-clinical rotation test was significantly higher in the WhatsApp Group than in the non-WhatsApp Group (p-value <0.001). Conclusion: WhatsApp was found to be a highly effective tool for learning paediatrics among medical students during their clinical attachment.
{"title":"The Effect of WhatsApp Messaging on Learning Paediatrics During Clinical Rotation of Final Year MBBS Medical Undergraduates","authors":"Qudrat Ullah Malik, Ambreen Usmani, Sirajul Haque","doi":"10.51253/pafmj.v73i5.6698","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.6698","url":null,"abstract":"Objective: To determine the impact of WhatsApp Messaging on learning paediatrics during clinical rotation of final year MBBS medical undergraduates. Study Design: Quasi-Experimental study Place and Duration of Study: Bahria University Medical and Dental College, Karachi Pakistan, from Apr to Oct 2018. Methodology: Final year MBBS students attending the Department of Paediatrics for three months of clinical rotation were randomly allocated to two Groups. Group-A was the control Group without WhatsApp, and Group-B was the intervention Group with WhatsApp messaging. Both Groups had a pre-test and post-test before and after their clinical rotation. The evaluation was performed before and after clinical rotation using Multiple choice questions (MCQs) for the final evaluation. Results: Of a total of 80 students, 19(23.8%) were males, and 61(76.3%) were females, with a median age of 23(22-23) years. Of 40 students in the WhatsApp Group, active participation was observed in 37(92.5%) students, whereas the quality of the shared content by students was found to be adequate/relevant in 35(87.5%) cases. The median score was significantly higher in both Groups' clinical rotation test than in the pre-clinical rotation assessment (p-value <0.001). However, the median score of the post-clinical rotation test was significantly higher in the WhatsApp Group than in the non-WhatsApp Group (p-value <0.001). Conclusion: WhatsApp was found to be a highly effective tool for learning paediatrics among medical students during their clinical attachment.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"34 11","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136105893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.6728
None Zahra Rashid Khan, Ayisha Imran, None N.A.Malik
Objective: To evaluate the utility of immature platelet fraction (IPF) as a marker in immune thrombocytopenia purpura (ITP) patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Haematology, Chughtai Institute of Pathology, Lahore Pakistan, from Aug to Nov 2020. Methodology: Sixty patients (Group-1) of immune thrombocytopenia purpura were selected. Sixty healthy individuals (Group-2) with normal blood count parameters were also included. A complete blood count with simultaneous evaluation of immature platelet fraction was performed for both groups on 3ml peripheral blood collected in K2EDTA. To check the reproducibility of results, each sample was run in duplicate. Results: Group-1 had a mean platelet count of 43.77±32.82 x109 /L (range 2-98x109/L), a mean immature platelet fraction of 12.93±6.11% (range 3–25%) and a mean age 36.68±7.53 years, (range 22–56 years). Group-2 had a mean platelet count of 251.7±83.55 x109 /L (range 150-450 x109 /L), a mean immature platelet fraction of 3.78±1.86 %, (range 1-7.2%) and a mean age of 36.42±6.94 years, (range 22–55 years). ROC curve analysis yielded an immature platelet fraction value of 7.0% as the cut-off between immune thrombocytopenic purpura patients and healthy individuals. Conclusion: Immature platelet fraction, though novel, is a useful marker to diagnose and monitor treatment response, diagnosis and management of immune thrombocytopenic purpura.
{"title":"Utility of Immature Platelet Fraction as Diagnostic Biomarker for Isolated Thrombocytopenia","authors":"None Zahra Rashid Khan, Ayisha Imran, None N.A.Malik","doi":"10.51253/pafmj.v73i5.6728","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.6728","url":null,"abstract":"Objective: To evaluate the utility of immature platelet fraction (IPF) as a marker in immune thrombocytopenia purpura (ITP) patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Haematology, Chughtai Institute of Pathology, Lahore Pakistan, from Aug to Nov 2020. Methodology: Sixty patients (Group-1) of immune thrombocytopenia purpura were selected. Sixty healthy individuals (Group-2) with normal blood count parameters were also included. A complete blood count with simultaneous evaluation of immature platelet fraction was performed for both groups on 3ml peripheral blood collected in K2EDTA. To check the reproducibility of results, each sample was run in duplicate. Results: Group-1 had a mean platelet count of 43.77±32.82 x109 /L (range 2-98x109/L), a mean immature platelet fraction of 12.93±6.11% (range 3–25%) and a mean age 36.68±7.53 years, (range 22–56 years). Group-2 had a mean platelet count of 251.7±83.55 x109 /L (range 150-450 x109 /L), a mean immature platelet fraction of 3.78±1.86 %, (range 1-7.2%) and a mean age of 36.42±6.94 years, (range 22–55 years). ROC curve analysis yielded an immature platelet fraction value of 7.0% as the cut-off between immune thrombocytopenic purpura patients and healthy individuals. Conclusion: Immature platelet fraction, though novel, is a useful marker to diagnose and monitor treatment response, diagnosis and management of immune thrombocytopenic purpura.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.7825
None Zeeshan Shoukat, None Muhammad Saeed Awan, None Talha Makshoof, None Mujahid Zulfiqar, None Sohail Ilyas, None Muhammad Zubair
Objective: To study the association of total leucocyte count and acute appendicitis among young patients undergoing emergency appendectomy. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Surgery, Combined Military Hospital, Quetta Pakistan, from Mar to Oct 2021. Methodology: The study included one hundred patients diagnosed with acute appendicitis by a consultant surgeon undergoing an emergency appendectomy. The total leucocyte count was calculated for all the patients at the time of diagnosis. The treating surgeon confirmed acute appendicitis findings based on gross examination of the appendix at the time of surgery. The presence of acute appendicitis and other factors was associated with raised total leucocyte count in all the patients. Results: Out of 100 patients diagnosed with acute appendicitis, 59 were male, while 41 were female. The mean age of the study participants was 28.33±3.673 years. On gross examination, 79 had a confirmed diagnosis of acute appendicitis, while 21 did not have an inflamed appendix. 85 had raised total leucocyte count, while 15 patients had total leucocyte count in the normal range. Statistical analysis revealed that acute appendicitis on gross examination and raised C-reactive protein had a statistically significant correlation with raised total leucocyte count (p-value: 0.001). Conclusion: Total leucocyte count was significantly raised in patients who had confirmation of inflammation of the appendix at gross examination during the surgery. Raised total leucocyte count and C reactive protein should be given more weightage in diagnosing acute appendicitis and planning for an emergency appendectomy.
{"title":"Association of Total Leucocyte Count and Acute Appendicitis Among Young Patients Undergoing Emergency Appendectomy","authors":"None Zeeshan Shoukat, None Muhammad Saeed Awan, None Talha Makshoof, None Mujahid Zulfiqar, None Sohail Ilyas, None Muhammad Zubair","doi":"10.51253/pafmj.v73i5.7825","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.7825","url":null,"abstract":"Objective: To study the association of total leucocyte count and acute appendicitis among young patients undergoing emergency appendectomy.\u0000Study Design: Comparative cross-sectional study.\u0000Place and Duration of Study: Department of Surgery, Combined Military Hospital, Quetta Pakistan, from Mar to Oct 2021.\u0000Methodology: The study included one hundred patients diagnosed with acute appendicitis by a consultant surgeon undergoing an emergency appendectomy. The total leucocyte count was calculated for all the patients at the time of diagnosis. The treating surgeon confirmed acute appendicitis findings based on gross examination of the appendix at the time of surgery. The presence of acute appendicitis and other factors was associated with raised total leucocyte count in all the patients.\u0000Results: Out of 100 patients diagnosed with acute appendicitis, 59 were male, while 41 were female. The mean age of the study participants was 28.33±3.673 years. On gross examination, 79 had a confirmed diagnosis of acute appendicitis, while 21 did not have an inflamed appendix. 85 had raised total leucocyte count, while 15 patients had total leucocyte count in the normal range. Statistical analysis revealed that acute appendicitis on gross examination and raised C-reactive protein had a statistically significant correlation with raised total leucocyte count (p-value: 0.001).\u0000Conclusion: Total leucocyte count was significantly raised in patients who had confirmation of inflammation of the appendix at gross examination during the surgery. Raised total leucocyte count and C reactive protein should be given more weightage in diagnosing acute appendicitis and planning for an emergency appendectomy.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"74 1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069519","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: To determine the frequency and causal relationship of Pneumothorax in prematurely born neonates in a tertiary care hospital. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Paediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2017 to Jul 2019. Methodology: A total of 510 premature neonates fulfilling the inclusion criteria were enrolled in the study. In suspected cases,Pneumothorax was confirmed on a chest radiograph. Hemodynamically stable neonates were closely observed for spontaneous resolution, whereas unstable neonates were managed by needle thoracocentesis or thoracostomy with or without ventilator support. The outcome of the study was either death of the neonate or discharge from the NICU (Neonatal Intensive Care Unit). Results: Of 510 included premature neonates, 43(8.4%) developed Pneumothorax. Pneumothorax was more common in late pre-term (51.2%) and moderate pre-term (46.5%) infants. Underlying diseases causing Pneumothorax were respiratory distress syndrome (RDS) 21(48.8%), meconium aspiration syndrome (MAS) 8(18.6%), transient tachypnoea of the newborn (TTN) 5(11.6%), birth asphyxia syndrome (BAS) 6(14%) and Pneumonia 3(7%). 34(79.1%) patients required thoracostomy, whereas 7(16.3%) required only needle thoracocentesis. Spontaneous resolution occurred in only 2(4.7%) patients. Of 43 patients, 35(81.39%) were discharged, and 8 (18.60%) died. Conclusion: Pneumothorax is not an uncommon complication, especially in premature neonates. A high index of suspicion is required for early recognition and timely management of Pneumothorax, as delay is associated with significant mortality.
{"title":"Frequency and Causal Relationship of Pneumothorax in Premature Neonates in a Tertiary Care Hospital","authors":"None Aamir Aslam Awan, None Qudratullah Malik, None Faisal Basheer","doi":"10.51253/pafmj.v73i5.5395","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.5395","url":null,"abstract":"Objectives: To determine the frequency and causal relationship of Pneumothorax in prematurely born neonates in a tertiary care hospital. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Paediatrics, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2017 to Jul 2019. Methodology: A total of 510 premature neonates fulfilling the inclusion criteria were enrolled in the study. In suspected cases,Pneumothorax was confirmed on a chest radiograph. Hemodynamically stable neonates were closely observed for spontaneous resolution, whereas unstable neonates were managed by needle thoracocentesis or thoracostomy with or without ventilator support. The outcome of the study was either death of the neonate or discharge from the NICU (Neonatal Intensive Care Unit). Results: Of 510 included premature neonates, 43(8.4%) developed Pneumothorax. Pneumothorax was more common in late pre-term (51.2%) and moderate pre-term (46.5%) infants. Underlying diseases causing Pneumothorax were respiratory distress syndrome (RDS) 21(48.8%), meconium aspiration syndrome (MAS) 8(18.6%), transient tachypnoea of the newborn (TTN) 5(11.6%), birth asphyxia syndrome (BAS) 6(14%) and Pneumonia 3(7%). 34(79.1%) patients required thoracostomy, whereas 7(16.3%) required only needle thoracocentesis. Spontaneous resolution occurred in only 2(4.7%) patients. Of 43 patients, 35(81.39%) were discharged, and 8 (18.60%) died. Conclusion: Pneumothorax is not an uncommon complication, especially in premature neonates. A high index of suspicion is required for early recognition and timely management of Pneumothorax, as delay is associated with significant mortality.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"47 4","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136069786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.8275
Muhammad Bilal Arshad, None Farooq Ikram, None Muhammad Tariq Nadeem, None Rabia Abbas, None Syed Hassan Nawaz
Objective: To determine the diagnostic value of red blood cell distribution width and red cell distribution width index in differentiating iron deficiency anaemia and beta-thalassemia trait. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to Feb 2022. Methodology: A study population of 110 children with an age limit of 1.5-7 years who reported low haemoglobin wassubjected to serum iron and ferritin levels with further evaluation of red cell count, blood morphology, and comparison of mean corpuscular volume. Red cell distribution width was taken from the lab report, whereas Red blood cell distribution width index value was computed for the samples. Results: A total of 110 patients were enrolled in the study. Seventy-five (68.18%) participants were diagnosed with IDA, 26(23.63%) participants were the candidate of βTT. Nine participants were suffering from anaemia of variable etiologies such as chronic ailment and sideroblastic, etc. βTT patients presented with higher RBC counts with a mean of 5.71±1.2 x1012 /l (6.8- 8.5 x1012 /l) when compared to IDA participants who deciphered values of 3.5±0.5 (2.6-4.3 x1012 /l). Mean MCV in βTT was 52.2±2.7(50.1-56.8) whereas for IDA were 72.5±1.2(61.2–78.3). In IDA low serum ferritin was recorded 4.02±1.1(2.2-9.2) as compared to mean values of βTT patients. Conclusion: Red cell distribution width index and Red blood cell distribution width are authentic variables and inexpensive modalities in differentiating between iron deficiency anaemia and beta-thalassemia trait with reliability.
{"title":"Diagnostic Value of Red Cell Distribution Width and Red Blood Cell Distribution Width Index in Differentiating between Iron Deficiency Anemia and Beta Thalassemia Trait","authors":"Muhammad Bilal Arshad, None Farooq Ikram, None Muhammad Tariq Nadeem, None Rabia Abbas, None Syed Hassan Nawaz","doi":"10.51253/pafmj.v73i5.8275","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.8275","url":null,"abstract":"Objective: To determine the diagnostic value of red blood cell distribution width and red cell distribution width index in differentiating iron deficiency anaemia and beta-thalassemia trait. Study Design: Cross-sectional study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2021 to Feb 2022. Methodology: A study population of 110 children with an age limit of 1.5-7 years who reported low haemoglobin wassubjected to serum iron and ferritin levels with further evaluation of red cell count, blood morphology, and comparison of mean corpuscular volume. Red cell distribution width was taken from the lab report, whereas Red blood cell distribution width index value was computed for the samples. Results: A total of 110 patients were enrolled in the study. Seventy-five (68.18%) participants were diagnosed with IDA, 26(23.63%) participants were the candidate of βTT. Nine participants were suffering from anaemia of variable etiologies such as chronic ailment and sideroblastic, etc. βTT patients presented with higher RBC counts with a mean of 5.71±1.2 x1012 /l (6.8- 8.5 x1012 /l) when compared to IDA participants who deciphered values of 3.5±0.5 (2.6-4.3 x1012 /l). Mean MCV in βTT was 52.2±2.7(50.1-56.8) whereas for IDA were 72.5±1.2(61.2–78.3). In IDA low serum ferritin was recorded 4.02±1.1(2.2-9.2) as compared to mean values of βTT patients. Conclusion: Red cell distribution width index and Red blood cell distribution width are authentic variables and inexpensive modalities in differentiating between iron deficiency anaemia and beta-thalassemia trait with reliability.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"47 5","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-30DOI: 10.51253/pafmj.v73i5.9022
None Umar Abdul Ali, Nadia Iftikhar, Muhammad Mamoon Mujahid, Uzma Bashir, Sakina Sadiq Malik, Ishtiaq Ahmed
Objective: To look for migraine headaches and associated factors in patients being managed for psoriasis at a tertiary healthcare setup in Rawalpindi, Pakistan. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Feb 2022. Methodology: One hundred and forty patients of psoriasis being managed at our Dermatology Unit were included in the analysis. All patients were screened with the Migraine Screen Questionnaire (MS-Q), and those having scores equal to or more than four were evaluated by medical specialists, and diagnosis of migraine was established based on the International Classification of Headache Disorders diagnostic criteria for migraine. An association of relevant risk factors was established with migraine among these patients. Results: Out of 140 patients with psoriasis, 75(53.4%) were male, while 65(46.6%) were female. Eighty-five (60.7%) patients had migraine confirmed by clinical criteria, while 55(39.3%) had no migraine. Statistical analysis revealed that more body surface area involvement and longer duration of psoriasis had a statistically significant relationship with migraine among the study participants (p-value <0.05). Conclusion: The study showed that patients with psoriasis had an approximately 3-fold increased risk of migraine headaches compared to the normal population. Most of the patients had migraine without aura. Patients with longer duration of psoriasis and those with more surface area of the body affected with psoriasis were at an increased risk of migraines compared to other patients.
{"title":"Psoriasis and Risk of Migraines in Patients Reporting to a Tertiary Care Setup in Pakistan: A Cross-Sectional Study","authors":"None Umar Abdul Ali, Nadia Iftikhar, Muhammad Mamoon Mujahid, Uzma Bashir, Sakina Sadiq Malik, Ishtiaq Ahmed","doi":"10.51253/pafmj.v73i5.9022","DOIUrl":"https://doi.org/10.51253/pafmj.v73i5.9022","url":null,"abstract":"Objective: To look for migraine headaches and associated factors in patients being managed for psoriasis at a tertiary healthcare setup in Rawalpindi, Pakistan. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Feb 2022. Methodology: One hundred and forty patients of psoriasis being managed at our Dermatology Unit were included in the analysis. All patients were screened with the Migraine Screen Questionnaire (MS-Q), and those having scores equal to or more than four were evaluated by medical specialists, and diagnosis of migraine was established based on the International Classification of Headache Disorders diagnostic criteria for migraine. An association of relevant risk factors was established with migraine among these patients. Results: Out of 140 patients with psoriasis, 75(53.4%) were male, while 65(46.6%) were female. Eighty-five (60.7%) patients had migraine confirmed by clinical criteria, while 55(39.3%) had no migraine. Statistical analysis revealed that more body surface area involvement and longer duration of psoriasis had a statistically significant relationship with migraine among the study participants (p-value <0.05). Conclusion: The study showed that patients with psoriasis had an approximately 3-fold increased risk of migraine headaches compared to the normal population. Most of the patients had migraine without aura. Patients with longer duration of psoriasis and those with more surface area of the body affected with psoriasis were at an increased risk of migraines compared to other patients.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"94 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136106689","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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