Pub Date : 2023-12-30DOI: 10.51253/pafmj.v73i6.10323
Mariam Sarwar, Fuad Ahmad Siddiqi, Salman Riaz, Ammad Hasan Chaudhry, Muhammad Hassan, Ashfaq Hussain
Objective: To investigate rates of multidrug-resistant organisms (MDRO) infection, their antimicrobial resistance (AMR) patterns, and risk factors for acquisition of such infections at a Tertiary-Care Hospital ICU. Study Design: Cross sectional study. Place and Duration of Study: Adult Intensive Care Unit of Tertiary Care Hospital, Peshawar Pakistan, from Jan to Dec 2022. Methodology: All patients admitted to adult ICU who developed signs/symptoms of infection after 48 hours of admission were investigated. Microbiological diagnosis was done via standard microbiological practices, and if the patient had acquired an MDRO infection, it was included in the study. Results: During the study, 92 patients acquired MDRO infection in total. The most common source was blood (43.5%). The most common organisms isolated were Klebsiella pneumoniae (21.7%), Acinetobacter baumannii (20.7%) and Pseudomonasaeruginosa (17.4%). The highest percentage of resistance among Gram-positive organisms was exhibited to Penicillin and Co-amoxiclav (91%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. The least frequency of resistance was recorded for Tigecycline (1%) against Klebsiella pneumoniae and 33% against Escherichia coli, while 32% Acinetobacter baumannii and 25% Pseudomonas aeruginosa were Colistin/Polymyxin resistant; none of the Klebsiella pneumoniae showed Colistin resistance. Conclusion: Antimicrobial resistance in our setup was high among Gram-negative and Gram-positive organisms. The most common risk factor was central line placement among the patients, highlighting the importance of infection control measures and the need to implement infection control bundles to circumvent infections due to invasive devices.
{"title":"Multidrug-Resistant Organisms and Their Association with Risk Factors; A Study at the Intensive Care Unit of Tertiary Care Hospital, Peshawar","authors":"Mariam Sarwar, Fuad Ahmad Siddiqi, Salman Riaz, Ammad Hasan Chaudhry, Muhammad Hassan, Ashfaq Hussain","doi":"10.51253/pafmj.v73i6.10323","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.10323","url":null,"abstract":"Objective: To investigate rates of multidrug-resistant organisms (MDRO) infection, their antimicrobial resistance (AMR) patterns, and risk factors for acquisition of such infections at a Tertiary-Care Hospital ICU. Study Design: Cross sectional study. Place and Duration of Study: Adult Intensive Care Unit of Tertiary Care Hospital, Peshawar Pakistan, from Jan to Dec 2022. Methodology: All patients admitted to adult ICU who developed signs/symptoms of infection after 48 hours of admission were investigated. Microbiological diagnosis was done via standard microbiological practices, and if the patient had acquired an MDRO infection, it was included in the study. Results: During the study, 92 patients acquired MDRO infection in total. The most common source was blood (43.5%). The most common organisms isolated were Klebsiella pneumoniae (21.7%), Acinetobacter baumannii (20.7%) and Pseudomonasaeruginosa (17.4%). The highest percentage of resistance among Gram-positive organisms was exhibited to Penicillin and Co-amoxiclav (91%). Gram-negative isolates exhibited high overall resistance to all used antibiotic classes. The least frequency of resistance was recorded for Tigecycline (1%) against Klebsiella pneumoniae and 33% against Escherichia coli, while 32% Acinetobacter baumannii and 25% Pseudomonas aeruginosa were Colistin/Polymyxin resistant; none of the Klebsiella pneumoniae showed Colistin resistance. Conclusion: Antimicrobial resistance in our setup was high among Gram-negative and Gram-positive organisms. The most common risk factor was central line placement among the patients, highlighting the importance of infection control measures and the need to implement infection control bundles to circumvent infections due to invasive devices.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140064","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.6064
Abdul Waheed Khan, Hassan Jaffar, Tarique Ahmad Maka
Burns in epileptic patients are not uncommon, but it is difficult to manage in remote areas of third-world countries. Despite the reduction in burn injuries secondary to a seizure, such injuries still lead to significant morbidity and mortality. In Darfur, Sudan, we managed such an epileptic patient having a full-thickness burn endangering the limb and life. Since these patients should adhere to a specific medication, controlling it remains to be difficult. The patient was managed with serial debridement, dressings, antibiotics, anti-epileptics and a protein diet. Therefore, preparation for preventive strategies consists of lifestyle modification and patient education that is further warranted.
{"title":"Post-Burn Sceptic Limb in Epileptic Sudani Young Man","authors":"Abdul Waheed Khan, Hassan Jaffar, Tarique Ahmad Maka","doi":"10.51253/pafmj.v73i6.6064","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.6064","url":null,"abstract":"Burns in epileptic patients are not uncommon, but it is difficult to manage in remote areas of third-world countries. Despite the reduction in burn injuries secondary to a seizure, such injuries still lead to significant morbidity and mortality. In Darfur, Sudan, we managed such an epileptic patient having a full-thickness burn endangering the limb and life. Since these patients should adhere to a specific medication, controlling it remains to be difficult. The patient was managed with serial debridement, dressings, antibiotics, anti-epileptics and a protein diet. Therefore, preparation for preventive strategies consists of lifestyle modification and patient education that is further warranted.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 44","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138119","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.9633
S. Khurshid, Hafsa Khalil Toor, Farrah Pervaiz
Objective: To determine the depression, suicidal ideation, and future concerns among domestic violence spectators. Study Design: Exploratory study design. Place and Duration of Study: Shelter Homes and Community Centres, in Rawalpindi/Islamabad Pakistan, from Aug to Nov2022. Methodology: In-depth interviews with 30 participants aged 12 to 17 years were conducted to assess the future apprehensions and worries of domestic violence spectators. Interviews were recorded and transcribed for thematic analysis. Transcribed data were critically reviewed, and themes were identified. Inter-rater reliability was calculated with the help of Cohen Kappa and was found to be in substantial agreement. Results: The study findings identified major themes related to psychological issues and future apprehensions among participants who witnessed domestic violence. Maladaptive relationships with parents and intensification of social problems such as isolation, self-harm, social withdrawal, suicidal ideation, difficulty in making friends, and apprehensions about the future relationship with a partner were also perceived as serious future concerns among domestic violence spectators. Conclusion: Domestic violence takes a toll on the mental and physical well-being of not only its victims but also its spectators. Early detection and prevention of violent exposure are essential to mitigate its long-term psychological impact.
{"title":"Violence behind the Closed Door: Depression, Suicidal Ideation and Future Concerns Among its Spectators","authors":"S. Khurshid, Hafsa Khalil Toor, Farrah Pervaiz","doi":"10.51253/pafmj.v73i6.9633","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9633","url":null,"abstract":"Objective: To determine the depression, suicidal ideation, and future concerns among domestic violence spectators. Study Design: Exploratory study design. Place and Duration of Study: Shelter Homes and Community Centres, in Rawalpindi/Islamabad Pakistan, from Aug to Nov2022. Methodology: In-depth interviews with 30 participants aged 12 to 17 years were conducted to assess the future apprehensions and worries of domestic violence spectators. Interviews were recorded and transcribed for thematic analysis. Transcribed data were critically reviewed, and themes were identified. Inter-rater reliability was calculated with the help of Cohen Kappa and was found to be in substantial agreement. Results: The study findings identified major themes related to psychological issues and future apprehensions among participants who witnessed domestic violence. Maladaptive relationships with parents and intensification of social problems such as isolation, self-harm, social withdrawal, suicidal ideation, difficulty in making friends, and apprehensions about the future relationship with a partner were also perceived as serious future concerns among domestic violence spectators. Conclusion: Domestic violence takes a toll on the mental and physical well-being of not only its victims but also its spectators. Early detection and prevention of violent exposure are essential to mitigate its long-term psychological impact.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 49","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: To discern the relationship of height and weight with body composition in healthy attendants of cancer patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Oct to Dec 2022. Methodology: A total of 226 healthy adults aged 19-47 years having similar daily physical activity levels were included. The body composition of study participants was evaluated using a bioelectric impedance analysis (BIA) machine. The weight of all participants was recorded with the help of a weighing machine. The participants' height was measured using a Harpenden Stadiometer and recorded. Results: Our study showed that weight had a significant positive correlation with body fat mass (rs value=0.83), skeletal muscle mass (rs value=0.763), total body water (rs value=0.704), fat-free mass (rs value=0.75) and per cent body fat (rs value 0.716). On the other hand, height had a negative but non-significant association with fat mass (rs value= 0.025) and a negative significant association with per cent body fat (rs value=-0.16). Height had a positive and significant association with fat-free mass (rs value=0.553), total body water (rs value=0.501) and skeletal muscle mass (rs value=0.505). Conclusion: Weight, if used alone, is not a good indicator of obesity or emaciation, and height has a negative association with fat mass.
{"title":"Relationship of Body Composition with Height and Weight in Attendants of Cancer Patients","authors":"Muhammad Sohaib Nadeem, Ujala Ali, Bushra Riaz, Tallat Noreen, Mansoor Wahid, Lubna Gohar","doi":"10.51253/pafmj.v73i6.9597","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9597","url":null,"abstract":"Objective: To discern the relationship of height and weight with body composition in healthy attendants of cancer patients. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Oct to Dec 2022. Methodology: A total of 226 healthy adults aged 19-47 years having similar daily physical activity levels were included. The body composition of study participants was evaluated using a bioelectric impedance analysis (BIA) machine. The weight of all participants was recorded with the help of a weighing machine. The participants' height was measured using a Harpenden Stadiometer and recorded. Results: Our study showed that weight had a significant positive correlation with body fat mass (rs value=0.83), skeletal muscle mass (rs value=0.763), total body water (rs value=0.704), fat-free mass (rs value=0.75) and per cent body fat (rs value 0.716). On the other hand, height had a negative but non-significant association with fat mass (rs value= 0.025) and a negative significant association with per cent body fat (rs value=-0.16). Height had a positive and significant association with fat-free mass (rs value=0.553), total body water (rs value=0.501) and skeletal muscle mass (rs value=0.505). Conclusion: Weight, if used alone, is not a good indicator of obesity or emaciation, and height has a negative association with fat mass.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 32","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138755","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.9142
Saba Riaz, T. Mazhar, Sumbal Riaz, A. Batool, Awishbah Khan, Sadia Khan
Objective: To find the correlation bwteen hand grip strength with thumb muscle strength, flexibility and thumb pain in manual therapists and to find out the variation of these variables in healthy manual therapists. Study Design: Comparative cross-sectional Study. Place and Duration of Study: Pakistan Society of Rehabilitation and Disability, Jinnah Hospital, Ittefaq Hospital, and Riphah University Pakistan, from Nov 2021 to Jan 2022. Methodology: One hundred thirty-five manual therapists were enrolled. Informed consent was taken from participants meeting inclusion and exclusion criteria. The questionnaire was filled out using a Dynamometer for Handgrip strength check, a Manual Muscle testing technique for Thumb muscle strength check, a Numeric pain rating scale for Pain intensity, and Goniometry for Flexibility of the Thumb muscles. Results: Results showed that most manual therapists had no wrist pain (99,73.3%) or thumb pain (104,77%). The majority of therapists (116 ,85.9%), had less than normal grip strength of hand, and 58(43%) had maximum thumb strength. There was a positive correlation between grip strength and thumb strength (r=0.234). There was a negative correlation between grip strength and thumb pain (r=-0.077). Conclusion: The study concluded that most manual therapists did not suffer from wrist and thumb pain. The majority had good thumb muscle strength but poor hand grip strength. Thumb strength positively correlates with grip strength, while thumb pain negatively correlates with handgrip strength.
{"title":"Correlation of Handgrip Strength with Thumb Flexibility, Strength and Pain in Manual Therapists","authors":"Saba Riaz, T. Mazhar, Sumbal Riaz, A. Batool, Awishbah Khan, Sadia Khan","doi":"10.51253/pafmj.v73i6.9142","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9142","url":null,"abstract":"Objective: To find the correlation bwteen hand grip strength with thumb muscle strength, flexibility and thumb pain in manual therapists and to find out the variation of these variables in healthy manual therapists. Study Design: Comparative cross-sectional Study. Place and Duration of Study: Pakistan Society of Rehabilitation and Disability, Jinnah Hospital, Ittefaq Hospital, and Riphah University Pakistan, from Nov 2021 to Jan 2022. Methodology: One hundred thirty-five manual therapists were enrolled. Informed consent was taken from participants meeting inclusion and exclusion criteria. The questionnaire was filled out using a Dynamometer for Handgrip strength check, a Manual Muscle testing technique for Thumb muscle strength check, a Numeric pain rating scale for Pain intensity, and Goniometry for Flexibility of the Thumb muscles. Results: Results showed that most manual therapists had no wrist pain (99,73.3%) or thumb pain (104,77%). The majority of therapists (116 ,85.9%), had less than normal grip strength of hand, and 58(43%) had maximum thumb strength. There was a positive correlation between grip strength and thumb strength (r=0.234). There was a negative correlation between grip strength and thumb pain (r=-0.077). Conclusion: The study concluded that most manual therapists did not suffer from wrist and thumb pain. The majority had good thumb muscle strength but poor hand grip strength. Thumb strength positively correlates with grip strength, while thumb pain negatively correlates with handgrip strength.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138934","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.8649
Sikandar Hayat Khan, N. Kureshi, Muhammad Sohail Aslam, Sibtain Rafique
Using the balanced scorecard approach, Strategic Management Initiative (SMI) driven Key Performance Indicators (KPIs) have allowed measurable data regarding various clinical, medical, patient and logistic outputs for healthcare leadership to managean ongoing improvement system in real-time. We underwent a comprehensive search to have 168 articles with the keywords "Balanced Scorecard in healthcare". We applied filters for the last ten years only. We shortlisted 14 studies. The study highlighted various KPIs utilised in different healthcare settings, with most authors favouring BSC methodology as a comprehensive strategy to deal with multi-dimensional hospital processes. The most utilised KPIs included service quality, patient safety, increased healthcare literacy, empowering patients, developing the empathic attitude and social skills in medical staff, professional human resource management and financial management and interests of stakeholders. In short, the BSC strategy is suggested for implementation to improve healthcare-related processes.
{"title":"Balance scorecard (BSC): Incorporating \"Key performance indicators\" (KPI) in the Evaluation of the Healthcare System","authors":"Sikandar Hayat Khan, N. Kureshi, Muhammad Sohail Aslam, Sibtain Rafique","doi":"10.51253/pafmj.v73i6.8649","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8649","url":null,"abstract":"Using the balanced scorecard approach, Strategic Management Initiative (SMI) driven Key Performance Indicators (KPIs) have allowed measurable data regarding various clinical, medical, patient and logistic outputs for healthcare leadership to managean ongoing improvement system in real-time. We underwent a comprehensive search to have 168 articles with the keywords \"Balanced Scorecard in healthcare\". We applied filters for the last ten years only. We shortlisted 14 studies. The study highlighted various KPIs utilised in different healthcare settings, with most authors favouring BSC methodology as a comprehensive strategy to deal with multi-dimensional hospital processes. The most utilised KPIs included service quality, patient safety, increased healthcare literacy, empowering patients, developing the empathic attitude and social skills in medical staff, professional human resource management and financial management and interests of stakeholders. In short, the BSC strategy is suggested for implementation to improve healthcare-related processes.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139141002","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 study the effects of estrogen administration on histomorphology of avascular necrosis of the femoral head in male rats. Study Design: Lab-based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, National University of Medical Sciences, Rawalpindi (NUMS), in collaboration with the National Institute of Health Islamabad, (NIH) Pakistan from Aug to Nov 2021. Methodology: Thirty male Sprague Dawley rats, three months of age, weighing 200-300 gm, were selected. Rats were equally divided into three groups. Group-A served as a control group in which no intervention was made, and the rats were fed on a standard lab diet. Groups B and C served as experimental groups. In Groups B and C, avascular necrosis was induced by steroids for the first week of the study. Group C along with steroids also received tab estrogen by oral gavage for eight weeks, starting from the fifth week of the study till the twelfth week of the study. All the rats were sacrificed after the completion of the experimental period. The microscopic parameters like cortical thickness and percentage of the empty lacunae were counted. Results: Histomorphological changes were observed when the comparison was made between Group B, Control Group A, and Experimental Groups B and C with statistically significant results (p-value 0.001). Conclusion: Estrogen helps in fracture healing and shows improvement in cortical and trabecular strength. It has shown improvement in the cortical thickness measurement after avascular necrosis causes a decrease in the thickness.
目的：研究雌激素对雄性大鼠股骨头血管性坏死组织形态学的影响：研究雌激素对雄性大鼠股骨头血管性坏死组织形态学的影响。研究设计：实验室实验研究。研究地点和时间：拉瓦尔品第国立医科大学（NUMS）陆军医学院解剖学系，与巴基斯坦伊斯兰堡国立卫生研究院（NIH）合作，2021 年 8 月至 11 月。研究方法：选取 30 只三个月大的雄性 Sprague Dawley 大鼠，体重 200-300 克。大鼠平均分为三组。A 组为对照组，不采取任何干预措施，以标准实验室饮食喂养大鼠。B 组和 C 组为实验组。在研究的第一周，B 组和 C 组使用类固醇诱导大鼠发生血管性坏死。C 组在使用类固醇的同时还口服雌激素，为期八周，从研究的第五周开始至第十二周结束。实验结束后，所有大鼠均被处死。对皮质厚度和空腔百分比等显微参数进行计数。结果在 B 组、对照组 A、实验组 B 和 C 之间进行比较时，观察到了组织形态学变化，结果具有统计学意义（P 值为 0.001）。结论：雌激素有助于骨折愈合：雌激素有助于骨折愈合，并能改善骨皮质和骨小梁的强度。在骨皮质厚度因血管坏死而减少后，雌激素能改善骨皮质厚度的测量。
{"title":"Effects of Estrogen on Histomorphology Steroid-Induced Avascular Necrosis of Head of Femur in Male Rats","authors":"Sadaf Iqbal, Shabnam Hamid, Faiza Umbreen, Mahwash Azam, Ayesha Ali, Maroosh Mirza","doi":"10.51253/pafmj.v73i6.8769","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8769","url":null,"abstract":"Objectives: To study the effects of estrogen administration on histomorphology of avascular necrosis of the femoral head in male rats. Study Design: Lab-based experimental study. Place and Duration of Study: Department of Anatomy, Army Medical College, National University of Medical Sciences, Rawalpindi (NUMS), in collaboration with the National Institute of Health Islamabad, (NIH) Pakistan from Aug to Nov 2021. Methodology: Thirty male Sprague Dawley rats, three months of age, weighing 200-300 gm, were selected. Rats were equally divided into three groups. Group-A served as a control group in which no intervention was made, and the rats were fed on a standard lab diet. Groups B and C served as experimental groups. In Groups B and C, avascular necrosis was induced by steroids for the first week of the study. Group C along with steroids also received tab estrogen by oral gavage for eight weeks, starting from the fifth week of the study till the twelfth week of the study. All the rats were sacrificed after the completion of the experimental period. The microscopic parameters like cortical thickness and percentage of the empty lacunae were counted. Results: Histomorphological changes were observed when the comparison was made between Group B, Control Group A, and Experimental Groups B and C with statistically significant results (p-value 0.001). Conclusion: Estrogen helps in fracture healing and shows improvement in cortical and trabecular strength. It has shown improvement in the cortical thickness measurement after avascular necrosis causes a decrease in the thickness.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 29","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138887","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.8107
A. Awan, Muhammad Tariq Nadeem, Bushra Babar, Ammara Iftikhar, Abdul Wahab, Abdul Quddus
Objective: To validate a clinical scoring system for defining the severity of ailment that will assist in developing strategies for management prioritisation. Study Design: Cross-sectional analytical study. Place and Duration of Study: Paediatric Department, Combined Military Hospital Lahore, Pakistan, form Jan 2020 to Jul 2021. Methodology: The paediatric patients who reported to the Medical Reception Centre and were admitted to an Inpatient Facility were enrolled. Demographic profile, temperature, oxygen saturation, pulse, respiratory rate, seizures, and sensorium labelled as “TOPRS” score was recorded with “0 – Normal” and “1 – Abnormal” and scores calculated for each patient with the incorporation of systemic inflammatory response and advanced paediatric life support criteria. Results: A total of 300 paediatric patients with an age range of 1-18 years (mean: 3.86±5.43) were included. Of 300 patients, 237(79%) were discharged after improvement, and the mortality rate was 63(21%). A significant association with the mortality rate was deciphered with temperature, oxygen saturation, and respiratory rate variables. In contrast, pulse rate, sensorium, and seizures were concluded to have an insignificant association. Score “0” mortality was associated with the 4.4% mortality, whereas score “5” enumerated an 80% death rate. Conclusion: The TOPRS clinical scoring system has significant value in the diagnosis of mortality and morbidity of paediatric patients and, hence, can assist in early recognition and triage of patients, consequently aiding in the provision of prioritisation protocols and management in a befitting manner.
{"title":"Validation of “TOPRS” Score to Predict Outcome in Paediatric Patients in a Tertiary Care Hospital of Pakistan","authors":"A. Awan, Muhammad Tariq Nadeem, Bushra Babar, Ammara Iftikhar, Abdul Wahab, Abdul Quddus","doi":"10.51253/pafmj.v73i6.8107","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8107","url":null,"abstract":"Objective: To validate a clinical scoring system for defining the severity of ailment that will assist in developing strategies for management prioritisation. Study Design: Cross-sectional analytical study. Place and Duration of Study: Paediatric Department, Combined Military Hospital Lahore, Pakistan, form Jan 2020 to Jul 2021. Methodology: The paediatric patients who reported to the Medical Reception Centre and were admitted to an Inpatient Facility were enrolled. Demographic profile, temperature, oxygen saturation, pulse, respiratory rate, seizures, and sensorium labelled as “TOPRS” score was recorded with “0 – Normal” and “1 – Abnormal” and scores calculated for each patient with the incorporation of systemic inflammatory response and advanced paediatric life support criteria. Results: A total of 300 paediatric patients with an age range of 1-18 years (mean: 3.86±5.43) were included. Of 300 patients, 237(79%) were discharged after improvement, and the mortality rate was 63(21%). A significant association with the mortality rate was deciphered with temperature, oxygen saturation, and respiratory rate variables. In contrast, pulse rate, sensorium, and seizures were concluded to have an insignificant association. Score “0” mortality was associated with the 4.4% mortality, whereas score “5” enumerated an 80% death rate. Conclusion: The TOPRS clinical scoring system has significant value in the diagnosis of mortality and morbidity of paediatric patients and, hence, can assist in early recognition and triage of patients, consequently aiding in the provision of prioritisation protocols and management in a befitting manner.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 96","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139137656","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.10108
Aamir Hussain, Ihsan Ullah Khan, Muhammad Qammar Saeed
Objective: To evaluate the frequency and antimicrobial susceptibility pattern of Acinetobacter baumannii isolated at a tertiary care setting. Study Design: Cross sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from July to Dec 2018. Methodology: All the specimens submitted, which yielded the growth of Acinetobacter baumannii, were included in the study. Isolates were confirmed biochemically by using api 20NE. Antimicrobial susceptibility was done using standard procedures and as per CLSI's latest guidelines. Results: Nine thousand nine hundred thirty-one specimens were submitted to the Microbiology Department AFIP for culture and antimicrobial susceptibility testing during the study period. Amongst these, 1633(16.5%) specimens yielded the growth of different pathogens. Of 1633 culture-positive isolates, 101(6.2%) were identified as Acinetobacter baumannii. Among these,34.6% of the isolates were recovered from respiratory specimens, while 29.7% from pus and pus swab specimens. Minocycline was the most sensitive antibiotic with 59.4% sensitivity, followed by Doxycycline, to which 48.5% of isolates were susceptible. Sensitivity to all other antimicrobials was 24% or less. In vitro, sensitivity to Carbapenems is very low.Conclusion: Acinetobacter baumannii was isolated from 6.2% of specimens submitted for culture and susceptibility testing. Minocycline was the most sensitive antibiotic, followed by Doxycycline. Sensitivity to most of the other antimicrobials was 24% or less. An alarming resistant pattern demands strict infection control practices and judicious use of antibiotics.
{"title":"Frequency and Antimicrobial Susceptibility Profile of Acinetobacter baumannii Isolated at a Tertiary Care Diagnostic Facility","authors":"Aamir Hussain, Ihsan Ullah Khan, Muhammad Qammar Saeed","doi":"10.51253/pafmj.v73i6.10108","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.10108","url":null,"abstract":"Objective: To evaluate the frequency and antimicrobial susceptibility pattern of Acinetobacter baumannii isolated at a tertiary care setting. Study Design: Cross sectional study. Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from July to Dec 2018. Methodology: All the specimens submitted, which yielded the growth of Acinetobacter baumannii, were included in the study. Isolates were confirmed biochemically by using api 20NE. Antimicrobial susceptibility was done using standard procedures and as per CLSI's latest guidelines. Results: Nine thousand nine hundred thirty-one specimens were submitted to the Microbiology Department AFIP for culture and antimicrobial susceptibility testing during the study period. Amongst these, 1633(16.5%) specimens yielded the growth of different pathogens. Of 1633 culture-positive isolates, 101(6.2%) were identified as Acinetobacter baumannii. Among these,34.6% of the isolates were recovered from respiratory specimens, while 29.7% from pus and pus swab specimens. Minocycline was the most sensitive antibiotic with 59.4% sensitivity, followed by Doxycycline, to which 48.5% of isolates were susceptible. Sensitivity to all other antimicrobials was 24% or less. In vitro, sensitivity to Carbapenems is very low.Conclusion: Acinetobacter baumannii was isolated from 6.2% of specimens submitted for culture and susceptibility testing. Minocycline was the most sensitive antibiotic, followed by Doxycycline. Sensitivity to most of the other antimicrobials was 24% or less. An alarming resistant pattern demands strict infection control practices and judicious use of antibiotics.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 40","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138155","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 : 2023-12-30DOI: 10.51253/pafmj.v73i6.8556
Ahsan Ahmad Ghauri, Muhammad Usman Munir, Z. Haroon, Muhammad Younas, Muhammad Anwar, S. Kirmani
Objectives: To check the performance in the pre-analytical phase of testing in the clinical chemistry laboratory of a reference institute using five key performance indicators and to compare these indicators between the morning and night shifts to ascertain the most probable source of pre-analytical errors. Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Apr to Sep 2021. Methodology: Defined key performance indicators (KPIs) were observed for a period of six months. The frequency and percentage of each KPI were calculated. Defects per Million were calculated for deriving Six Sigma (σ) values. KPIs were alsocompared between the morning and night shifts. Results: A total of 272,731 samples were observed in which 2306(0.84%) were found haemolysed (σ=3.5), 604 samples (0.22%) were not received in the Department due to various pre-analytic reasons (σ=4.0), 260 samples (0.09 %) were found having insufficient sample volume for analysis (σ=4.5), 181(0.06%) samples were found having improper/ wrong labelling or bar code errors (σ=4.5) and 161(0.05%) samples were delivered in wrong tubes (σ=4.5). KPI-1, KPI-2, and KPI-3 were found to be significantly higher during the night shift than the morning shift. Conclusion: Haemolysed samples and lost-not-received samples were the main causes of pre-analytical errors Key performance indicators aided as an instrument to screen and improve process execution in the laboratory.
{"title":"Evaluation of Key Performance Indicators in the Pre-analytical Phase of Testing in a Clinical Chemistry Laboratory of a Reference Institute","authors":"Ahsan Ahmad Ghauri, Muhammad Usman Munir, Z. Haroon, Muhammad Younas, Muhammad Anwar, S. Kirmani","doi":"10.51253/pafmj.v73i6.8556","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8556","url":null,"abstract":"Objectives: To check the performance in the pre-analytical phase of testing in the clinical chemistry laboratory of a reference institute using five key performance indicators and to compare these indicators between the morning and night shifts to ascertain the most probable source of pre-analytical errors. Study Design: Comparative cross-sectional study Place and Duration of Study: Department of Chemical Pathology & Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Apr to Sep 2021. Methodology: Defined key performance indicators (KPIs) were observed for a period of six months. The frequency and percentage of each KPI were calculated. Defects per Million were calculated for deriving Six Sigma (σ) values. KPIs were alsocompared between the morning and night shifts. Results: A total of 272,731 samples were observed in which 2306(0.84%) were found haemolysed (σ=3.5), 604 samples (0.22%) were not received in the Department due to various pre-analytic reasons (σ=4.0), 260 samples (0.09 %) were found having insufficient sample volume for analysis (σ=4.5), 181(0.06%) samples were found having improper/ wrong labelling or bar code errors (σ=4.5) and 161(0.05%) samples were delivered in wrong tubes (σ=4.5). KPI-1, KPI-2, and KPI-3 were found to be significantly higher during the night shift than the morning shift. Conclusion: Haemolysed samples and lost-not-received samples were the main causes of pre-analytical errors Key performance indicators aided as an instrument to screen and improve process execution in the laboratory.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" June","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139136887","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：