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}
Pub Date : 2023-12-30DOI: 10.51253/pafmj.v73i6.8538
Fayyaz Ahmed Orfi, Shafqat Hussain, Shafaan Orfi, Ali Arslan Munir, Sumbal Rana, Nida Maryam
Objective: To evaluate functional outcomes and complications in gunshot femur shaft fractures treated with intramedullary nailing primarily. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Orthopaedic Combined Military Hospital, Nowshera, Combined Military Hospital Sialkot, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2016 to Dec 2021. Methodology: A total number of 53 cases of open fracture of the femur shaft due to gunshot were included in the study. After initial wound debridement, an X-ray was taken, and fractures were classified according to the Gustilo–Anderson classification. All fractures were fixed with titanium I/M I/L Nail in static mode by the same orthopaedic surgeon. Rehabilitation was instituted immediately after the operation, and the outcome was assessed in regards to infection, range of motion at the knee, full weight bearing and radiological union achieved. Results: Thirty-four (64.15%) patients had Type-1 fractures of the femur shaft, and 19(35.8%) patients had Type-2 fractures. Fracture union was observed in 47(88.67%) patients after three months and 6(11.32%) over the next five months. Complications were wound infections 5(9.44%), leg length discrepancy 4(7.53%), and non-union 2(3.77%) at six months. In these two cases, bone grafting was done, and union was achieved. Conclusion: Primary intramedullary (IM) is the preferred mode of treatment of Type 1 and 2 shafts of femur fractures if early good debridement is done. It avoids secondary procedures, has fewer complications and helps in early mobilization.
{"title":"An Experience in Managing an open Fracture Shaft of the Femur Due to a Gunshot with Intramedullary Interlocking Nailing","authors":"Fayyaz Ahmed Orfi, Shafqat Hussain, Shafaan Orfi, Ali Arslan Munir, Sumbal Rana, Nida Maryam","doi":"10.51253/pafmj.v73i6.8538","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8538","url":null,"abstract":"Objective: To evaluate functional outcomes and complications in gunshot femur shaft fractures treated with intramedullary nailing primarily. Study Design: Prospective longitudinal study Place and Duration of Study: Department of Orthopaedic Combined Military Hospital, Nowshera, Combined Military Hospital Sialkot, Combined Military Hospital, Rawalpindi Pakistan, from Jan 2016 to Dec 2021. Methodology: A total number of 53 cases of open fracture of the femur shaft due to gunshot were included in the study. After initial wound debridement, an X-ray was taken, and fractures were classified according to the Gustilo–Anderson classification. All fractures were fixed with titanium I/M I/L Nail in static mode by the same orthopaedic surgeon. Rehabilitation was instituted immediately after the operation, and the outcome was assessed in regards to infection, range of motion at the knee, full weight bearing and radiological union achieved. Results: Thirty-four (64.15%) patients had Type-1 fractures of the femur shaft, and 19(35.8%) patients had Type-2 fractures. Fracture union was observed in 47(88.67%) patients after three months and 6(11.32%) over the next five months. Complications were wound infections 5(9.44%), leg length discrepancy 4(7.53%), and non-union 2(3.77%) at six months. In these two cases, bone grafting was done, and union was achieved. Conclusion: Primary intramedullary (IM) is the preferred mode of treatment of Type 1 and 2 shafts of femur fractures if early good debridement is done. It avoids secondary procedures, has fewer complications and helps in early mobilization.","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":"139138814","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.v73i6.10056
Taimur Azam Khan, Syed Qasim Ali Shah, Mirza Hamid Beg, Osama Abdul Mateen, Muhammad Huzaifa Sharif, Syed Rafat Ali Hashmi
Objective: To compare the ease of intubation using glide scope video laryngoscope versus direct laryngoscopy for nasotracheal intubation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, Aug 2022 to Feb 2023. Methodology: Patients of either gender with age greater than 18 years with American Society of Anesthesiologists (ASA) Grade I or Grade II planned for elective dental or maxillofacial procedures requiring nasotracheal intubation were included. A total of 60 patients were included, with 30 patients in each group. Recorded variables were time to intubate, glottic grade, use of Magill forceps, first attempt success, failure to intubate and postoperative sore throat. Results: With 60 patients after randomised allocation, 30 were allocated to Group-DL (Direct laryngoscopy) and Group-VL(Video laryngoscopy). The success rate in the first attempt was 27(90%) in Group-DL vs 30 (100%) in Group-VL, and the number of patients who could not be intubated was 1(3.3%) vs 0(0%) in both groups. The glottic grade recorded by the operator under vision, time to intubation, use of Magill forceps and post-operative sore throat in both groups was significant with a p-value of <0.05. Conclusion: Glide scope video laryngoscopy provides a better view of the vocal cords with less time to intubation, greater chances of successful intubation, and fewer post-operative chances of sore throat than direct laryngoscopy.
{"title":"A Comparison of Glide Scope Video Laryngoscopy to Direct Laryngoscopy for Nasotracheal Intubation","authors":"Taimur Azam Khan, Syed Qasim Ali Shah, Mirza Hamid Beg, Osama Abdul Mateen, Muhammad Huzaifa Sharif, Syed Rafat Ali Hashmi","doi":"10.51253/pafmj.v73i6.10056","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.10056","url":null,"abstract":"Objective: To compare the ease of intubation using glide scope video laryngoscope versus direct laryngoscopy for nasotracheal intubation. Study Design: Quasi experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, Aug 2022 to Feb 2023. Methodology: Patients of either gender with age greater than 18 years with American Society of Anesthesiologists (ASA) Grade I or Grade II planned for elective dental or maxillofacial procedures requiring nasotracheal intubation were included. A total of 60 patients were included, with 30 patients in each group. Recorded variables were time to intubate, glottic grade, use of Magill forceps, first attempt success, failure to intubate and postoperative sore throat. Results: With 60 patients after randomised allocation, 30 were allocated to Group-DL (Direct laryngoscopy) and Group-VL(Video laryngoscopy). The success rate in the first attempt was 27(90%) in Group-DL vs 30 (100%) in Group-VL, and the number of patients who could not be intubated was 1(3.3%) vs 0(0%) in both groups. The glottic grade recorded by the operator under vision, time to intubation, use of Magill forceps and post-operative sore throat in both groups was significant with a p-value of <0.05. Conclusion: Glide scope video laryngoscopy provides a better view of the vocal cords with less time to intubation, greater chances of successful intubation, and fewer post-operative chances of sore throat than direct laryngoscopy.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 90","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139138277","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.v73i6.9766
Muhammad Shahzad Anwer, Mohsin Hussain, Jehanzeb Ur Rehman, Mehwish Gilani, Syed Mohsin Manzoor, Asif Ali
Objective: To determine the pattern of Vitamin D status in patients presenting with complaints of non-specific bone pains and to correlate the association of sunlight exposure with Vitamin D deficiency/insufficiency Study Design: Cross-sectional study. Place and Duration of Study: Department of Chemical Pathology, CMH, Abbottabad Pakistan, from Aug 2020 to Jul 2021. Methodology: All patients with non-specific bone pain were asked about demographic, clinical and sunlight exposure. Vitamin D assays were performed after history taking. Result: A total of 247 patients were tested for vitamin D levels. 103(41.7%) were male and 144(58.3 %) were females. 56(22.7%) had >60 minutes of daily sunlight exposure, 67(27.1%) had 30 to 60 minutes, and 124(50.2%) had less than 30 minutes of daily sunlight exposure. Vitamin D deficiency was found in 132(53.4%) patients, insufficiency was seen in 74(30.0%) patients and 41(16.6%) patients had normal vitamin D levels. Vitamin D deficiency correlated significantly with low sunlight exposure time. Conclusion: Vitamin D deficiency was seen in 53.4% of patients with non-specific bone pains, while insufficiency was seen in 30.0% of patients. Moreover, our study showed association of Vitamin D deficiency with a decreased duration of sunlight exposure.
研究目的确定主诉非特异性骨痛患者的维生素 D 状态模式，并将日光照射与维生素 D 缺乏/不足相关联 研究设计：横断面研究。研究地点和时间：巴基斯坦阿伯塔巴德 CMH 化学病理学部，2020 年 8 月至 2021 年 7 月。研究方法询问所有非特异性骨痛患者的人口统计学、临床和阳光照射情况。询问病史后进行维生素 D 检测。结果：共有 247 名患者接受了维生素 D 水平检测。男性 103 人（41.7%），女性 144 人（58.3%）。56人（22.7%）每天接触阳光的时间超过60分钟，67人（27.1%）每天接触阳光的时间为30至60分钟，124人（50.2%）每天接触阳光的时间少于30分钟。132（53.4%）名患者缺乏维生素 D，74（30.0%）名患者维生素 D 不足，41（16.6%）名患者维生素 D 水平正常。维生素 D 缺乏与日照时间少有明显相关性。结论53.4%的非特异性骨痛患者缺乏维生素 D，30.0%的患者维生素 D 不足。此外，我们的研究还表明，维生素 D 缺乏与日照时间减少有关。
{"title":"Pattern of Vitamin D Status in Patients with Non-Specific Bone Pains- A Single Centre Study","authors":"Muhammad Shahzad Anwer, Mohsin Hussain, Jehanzeb Ur Rehman, Mehwish Gilani, Syed Mohsin Manzoor, Asif Ali","doi":"10.51253/pafmj.v73i6.9766","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9766","url":null,"abstract":"Objective: To determine the pattern of Vitamin D status in patients presenting with complaints of non-specific bone pains and to correlate the association of sunlight exposure with Vitamin D deficiency/insufficiency Study Design: Cross-sectional study. Place and Duration of Study: Department of Chemical Pathology, CMH, Abbottabad Pakistan, from Aug 2020 to Jul 2021. Methodology: All patients with non-specific bone pain were asked about demographic, clinical and sunlight exposure. Vitamin D assays were performed after history taking. Result: A total of 247 patients were tested for vitamin D levels. 103(41.7%) were male and 144(58.3 %) were females. 56(22.7%) had >60 minutes of daily sunlight exposure, 67(27.1%) had 30 to 60 minutes, and 124(50.2%) had less than 30 minutes of daily sunlight exposure. Vitamin D deficiency was found in 132(53.4%) patients, insufficiency was seen in 74(30.0%) patients and 41(16.6%) patients had normal vitamin D levels. Vitamin D deficiency correlated significantly with low sunlight exposure time. Conclusion: Vitamin D deficiency was seen in 53.4% of patients with non-specific bone pains, while insufficiency was seen in 30.0% of patients. Moreover, our study showed association of Vitamin D deficiency with a decreased duration of sunlight exposure.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139764","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.v73i6.8576
Yusra Tayyab, Amir Rashid, Muhammad Javed Yousaf, Adnan Manzar, Asifa Majeed
Objective: To study the correlation of body mass index with inflammatory markers among rheumatoid arthritis patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, RawalpindiPakistan, in collaboration with the Rheumatology Department and laboratory of Pak Arab Emirates Military Hospital (PEMH), Rawalpindi Pakistan from Jan 2020 to Jan 2021. Methodology: The study sample was sixty in number and was divided into two groups. Diagnosed Rheumatoid Arthritis (RA) patients on modifying rheumatic Drugs (DMARDs) therapy constituted Group-I. At the same time, Group-II consisted of 30 healthy individuals. BMI, C reactive proteins (CRP) and erythrocyte sedimentation rate (ESR) of both groups were assessed and compared. The correlation of BMI with inflammatory markers was also assessed in both groups. Results: Sixty subjects with a mean age of 44.90±10 years were distributed evenly among two groups. Mean inflammatory markers for ESR and CRP, were 30.70±16.46 and 11.65±12.97, respectively, of Group-I. There was a significant difference in CRP and ESR (p ≤ 0.05) among the two groups. The mean BMI was 25.20±4.65, which was also raised for Group-I. BMI was positively correlated with inflammatory markers in both groups. Group-I showed a more positive correlation of BMI with ESR (r=0.23) than Group-II (r= 0.143). Conclusion: BMI is positively correlated with inflammatory status among RA patients.
{"title":"Correlation of Body Mass Index with Inflammatory Markers in Rheumatoid Arthritis Patients","authors":"Yusra Tayyab, Amir Rashid, Muhammad Javed Yousaf, Adnan Manzar, Asifa Majeed","doi":"10.51253/pafmj.v73i6.8576","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8576","url":null,"abstract":"Objective: To study the correlation of body mass index with inflammatory markers among rheumatoid arthritis patients. Study Design: Comparative cross-sectional study. Place and Duration of Study: Department of Biochemistry and Molecular Biology, Army Medical College, RawalpindiPakistan, in collaboration with the Rheumatology Department and laboratory of Pak Arab Emirates Military Hospital (PEMH), Rawalpindi Pakistan from Jan 2020 to Jan 2021. Methodology: The study sample was sixty in number and was divided into two groups. Diagnosed Rheumatoid Arthritis (RA) patients on modifying rheumatic Drugs (DMARDs) therapy constituted Group-I. At the same time, Group-II consisted of 30 healthy individuals. BMI, C reactive proteins (CRP) and erythrocyte sedimentation rate (ESR) of both groups were assessed and compared. The correlation of BMI with inflammatory markers was also assessed in both groups. Results: Sixty subjects with a mean age of 44.90±10 years were distributed evenly among two groups. Mean inflammatory markers for ESR and CRP, were 30.70±16.46 and 11.65±12.97, respectively, of Group-I. There was a significant difference in CRP and ESR (p ≤ 0.05) among the two groups. The mean BMI was 25.20±4.65, which was also raised for Group-I. BMI was positively correlated with inflammatory markers in both groups. Group-I showed a more positive correlation of BMI with ESR (r=0.23) than Group-II (r= 0.143). Conclusion: BMI is positively correlated with inflammatory status among RA patients.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140313","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.v73i6.9174
Umar Abdul Ali Qureshi, N. Malik
Palmoplantar pigmentation is a rare clinical presentation of alkaptonuria, a rare inborn error of phenylalanine and tyrosine metabolism. Alkaptonuria occurs owing to a deficiency of an enzyme homogentisic acid oxidase inherited as an autosomal recessive disorder. We report a case of alkaptonuria, which presented with palmoplantar pigment pigmentary nail changes and the involvement of the spine and joints. He was advised of ascorbic acid along with symptomatic management and detailed counselling.
{"title":"An Uncommon Clinical Presentation of a Rare Disease-Alkaptonuria: Case Report","authors":"Umar Abdul Ali Qureshi, N. Malik","doi":"10.51253/pafmj.v73i6.9174","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.9174","url":null,"abstract":"Palmoplantar pigmentation is a rare clinical presentation of alkaptonuria, a rare inborn error of phenylalanine and tyrosine metabolism. Alkaptonuria occurs owing to a deficiency of an enzyme homogentisic acid oxidase inherited as an autosomal recessive disorder. We report a case of alkaptonuria, which presented with palmoplantar pigment pigmentary nail changes and the involvement of the spine and joints. He was advised of ascorbic acid along with symptomatic management and detailed counselling.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 59","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139568","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.v73i6.8856
Mansoor Ejaz, S. Saulat, Syed Saeed Uddin Qadri, Awais Ayub
Objective: To compare outcomes of combined electromagnetic with ultrasonic lithotripter, pneumatic ballistic lithotripter, and holmium laser lithotripter among patients at a Tertiary Care Hospital. Study Design: Prospective comparartieve study. Place and Duration of Study: Department of Urology at Tabba Kidney Institute, Karachi Pakistan, from May 2020 to Jun 2021. Methodology: Ninety patients were divided into three groups of lithotripsy energies. Group-A (n=30) patients got pneumatic lithotripsy, Group-B (n=30) patients got laser lithotripsy, while Group-C (n=30) patients got trilogy lithotripsy technique. Outcomes such as post-operative pain, post-operative complications, and stone clearance were evaluated in all groups. Results: The overall mean age of the patients was 50.23±9.24 years, ranging from 33-74 years. The majority of the participants were males (n=52,57.8%), and 38(35.6%) of the participants were females. The intra-operative time, severity of post-operative pain, fever and UTI were the same between the three groups. However, the proportion of hematuria (p=0.001) and stone clearance (p=0.025) significantly differed between the three groups. Conclusion: Laser and pneumatic lithotripter were more effective in complete stone clearance than trilogy lithotripter. While laser lithotripter significantly decreases the occurrence of hematuria.
{"title":"Comparison of Outcomes of Pneumatic Ballistic Lithotripsy, Holmium Laser Lithotripsy, and Combined Electromagnetic with Ultrasonic Lithotripsy during Percutaneous Nephrolithotomy","authors":"Mansoor Ejaz, S. Saulat, Syed Saeed Uddin Qadri, Awais Ayub","doi":"10.51253/pafmj.v73i6.8856","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.8856","url":null,"abstract":"Objective: To compare outcomes of combined electromagnetic with ultrasonic lithotripter, pneumatic ballistic lithotripter, and holmium laser lithotripter among patients at a Tertiary Care Hospital. Study Design: Prospective comparartieve study. Place and Duration of Study: Department of Urology at Tabba Kidney Institute, Karachi Pakistan, from May 2020 to Jun 2021. Methodology: Ninety patients were divided into three groups of lithotripsy energies. Group-A (n=30) patients got pneumatic lithotripsy, Group-B (n=30) patients got laser lithotripsy, while Group-C (n=30) patients got trilogy lithotripsy technique. Outcomes such as post-operative pain, post-operative complications, and stone clearance were evaluated in all groups. Results: The overall mean age of the patients was 50.23±9.24 years, ranging from 33-74 years. The majority of the participants were males (n=52,57.8%), and 38(35.6%) of the participants were females. The intra-operative time, severity of post-operative pain, fever and UTI were the same between the three groups. However, the proportion of hematuria (p=0.001) and stone clearance (p=0.025) significantly differed between the three groups. Conclusion: Laser and pneumatic lithotripter were more effective in complete stone clearance than trilogy lithotripter. While laser lithotripter significantly decreases the occurrence of hematuria.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139139851","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.v73i6.7689
Khan Muhammad Yaqub, Muhammad Saeed, Bilal Yasin, Khalid Ameer, Nusrat Noor
Objective: To determine the effects of Tranexamic acid on intraoperative blood loss. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Oct 2021. Methodology: A total of 96 patients from both genders undergoing elective open abdominal aortic aneurysm surgery under general anaesthesia enrolled in the study after random distribution to Drug and Control Groups. The primary determinant was intraoperative blood loss. Additionally, determining variables were intraoperative and postoperative blood transfusions, thromboembolic episodes, and postoperative mortality rate. Results: A total of 96 patients enrolled in the study, out of which 90(93%) were males, whereas 6(7%) were females, with a mean age of 65.37±7.01 (55–75 years). Of 96 participants, 52(54%) patients were from ASA Class II and 44(46%) were from ASA Class III. There was no significant correlation between surgical time (p-value 0.45), clamping time (p-value 0.34), and intraoperative and postoperative transfusions (p-value 0.56 and 0.28, respectively). However, a statistically significant reduction in intraoperative and postoperative blood loss was recorded (p-value <0.001). Conclusion: Tranexamic acid significantly impacts the reduction of intraoperative and postoperative bleeding in elective open abdominal aortic aneurysm surgeries under general anaesthesia.
{"title":"The role of Tranexamic acid in the Reduction of Bleeding in Abdominal Aortic Aneurysm Surgery","authors":"Khan Muhammad Yaqub, Muhammad Saeed, Bilal Yasin, Khalid Ameer, Nusrat Noor","doi":"10.51253/pafmj.v73i6.7689","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.7689","url":null,"abstract":"Objective: To determine the effects of Tranexamic acid on intraoperative blood loss. Study Design: Quasi-experimental study. Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun to Oct 2021. Methodology: A total of 96 patients from both genders undergoing elective open abdominal aortic aneurysm surgery under general anaesthesia enrolled in the study after random distribution to Drug and Control Groups. The primary determinant was intraoperative blood loss. Additionally, determining variables were intraoperative and postoperative blood transfusions, thromboembolic episodes, and postoperative mortality rate. Results: A total of 96 patients enrolled in the study, out of which 90(93%) were males, whereas 6(7%) were females, with a mean age of 65.37±7.01 (55–75 years). Of 96 participants, 52(54%) patients were from ASA Class II and 44(46%) were from ASA Class III. There was no significant correlation between surgical time (p-value 0.45), clamping time (p-value 0.34), and intraoperative and postoperative transfusions (p-value 0.56 and 0.28, respectively). However, a statistically significant reduction in intraoperative and postoperative blood loss was recorded (p-value <0.001). Conclusion: Tranexamic acid significantly impacts the reduction of intraoperative and postoperative bleeding in elective open abdominal aortic aneurysm surgeries under general anaesthesia.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":" 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139140491","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 determine the efficacy (in terms of avoiding hysterectomy) of the Triple P procedure in managing morbidly adherent placenta. Study Design: Case series. Place and Duration of the Study: Department of Obstetrics & Gynaecology, Combined Military Hospital, Peshawar Pakistan, from Dec 2018 to Mar 2020. Methodology: A total of 56 pregnant women of gestational age ≥32 weeks with the morbidly adherent placenta were included. Caesarean section was done in each patient by the consultant gynaecologist, and then the Triple P procedure was done. Efficacy in each patient was noted. Results: The mean age of the study participants was 30.79±4.42 years. In our analysis, the mean parity was 3.05±0.88. The mean number of caesarean sections was 2.00±1.11. The Triple P procedure was effective (in avoiding hysterectomy) in managing morbidly adherent placentas in 53(94.64 %) participants. Conclusion: This study concluded that the Triple P procedure's efficacy (in terms of avoiding hysterectomy) in managing morbidly adherent placenta is very high.
{"title":"Efficacy (In Terms of Avoiding Hysterectomy) of the Triple P Procedure in Managing Morbidly Adherent Placenta","authors":"Sadaf Mumtaz, Nighat Afridi, Salma Nisar, Hira Shafqat, Waseem Yousaf, Nafeesa Hiba","doi":"10.51253/pafmj.v73i6.7590","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.7590","url":null,"abstract":"Objective: To determine the efficacy (in terms of avoiding hysterectomy) of the Triple P procedure in managing morbidly adherent placenta. Study Design: Case series. Place and Duration of the Study: Department of Obstetrics & Gynaecology, Combined Military Hospital, Peshawar Pakistan, from Dec 2018 to Mar 2020. Methodology: A total of 56 pregnant women of gestational age ≥32 weeks with the morbidly adherent placenta were included. Caesarean section was done in each patient by the consultant gynaecologist, and then the Triple P procedure was done. Efficacy in each patient was noted. Results: The mean age of the study participants was 30.79±4.42 years. In our analysis, the mean parity was 3.05±0.88. The mean number of caesarean sections was 2.00±1.11. The Triple P procedure was effective (in avoiding hysterectomy) in managing morbidly adherent placentas in 53(94.64 %) participants. Conclusion: This study concluded that the Triple P procedure's efficacy (in terms of avoiding hysterectomy) in managing morbidly adherent placenta is very high.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"26 19","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139148113","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 : 2023-12-28DOI: 10.51253/pafmj.v73i6.7105
Sonia Iqbal, S. B. Ayaz, Fawad Rahman, Saman Ejaz, Laiba Waheed, Ayesha Amjad
Objective: To compare the quality of life among adolescents with and without diabetes and explore the association of age and gender with diabetes. Study Design: Cross-sectional comparative study. Place and Duration of Study: Different Clinics and Hospitals, of District, Gujrat Pakistan, from Sep 2020 to Mar 2021. Methodology: Adolescents with diabetes who had an HbA1C level of ≥6.5%, and age-matched, healthy adolescents as controls were included. The adolescents with diabetes were sub-grouped into early and late adolescents based on age (10-14 years and 15-19 years, respectively). Youth Quality of Life Questionnaire was used as the investigative tool. Results: Twenty-nine adolescents (mean age: 14.2±2.9 years) were in the Diabetes-Group, and 356 adolescents (mean age: 14.8±2.7 years) were in the Control-Group. The Control-Group had significantly better mean scores in each domain than the Diabetes-Group (p<0.001). Early adolescents with diabetes had better scores in the self-care domain (p=0.014) than late adolescents. The scores remained uninfluenced by gender in adolescents with diabetes (p=0.118, 0.284, 0.185, 0.419, and 0.169, respectively). Conclusion: The quality of life scores among our study adolescents with diabetes was poor as compared to the age-matched healthy adolescents. Age appeared to be a negative factor for the quality of life parameters among adolescents with diabetes.
{"title":"Comparison of Quality of Life among Adolescents with and without Diabetes in Gujrat, Pakistan","authors":"Sonia Iqbal, S. B. Ayaz, Fawad Rahman, Saman Ejaz, Laiba Waheed, Ayesha Amjad","doi":"10.51253/pafmj.v73i6.7105","DOIUrl":"https://doi.org/10.51253/pafmj.v73i6.7105","url":null,"abstract":"Objective: To compare the quality of life among adolescents with and without diabetes and explore the association of age and gender with diabetes. Study Design: Cross-sectional comparative study. Place and Duration of Study: Different Clinics and Hospitals, of District, Gujrat Pakistan, from Sep 2020 to Mar 2021. Methodology: Adolescents with diabetes who had an HbA1C level of ≥6.5%, and age-matched, healthy adolescents as controls were included. The adolescents with diabetes were sub-grouped into early and late adolescents based on age (10-14 years and 15-19 years, respectively). Youth Quality of Life Questionnaire was used as the investigative tool. Results: Twenty-nine adolescents (mean age: 14.2±2.9 years) were in the Diabetes-Group, and 356 adolescents (mean age: 14.8±2.7 years) were in the Control-Group. The Control-Group had significantly better mean scores in each domain than the Diabetes-Group (p<0.001). Early adolescents with diabetes had better scores in the self-care domain (p=0.014) than late adolescents. The scores remained uninfluenced by gender in adolescents with diabetes (p=0.118, 0.284, 0.185, 0.419, and 0.169, respectively). Conclusion: The quality of life scores among our study adolescents with diabetes was poor as compared to the age-matched healthy adolescents. Age appeared to be a negative factor for the quality of life parameters among adolescents with diabetes.","PeriodicalId":31059,"journal":{"name":"Pakistan Armed Forces Medical Journal","volume":"8 18","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139148610","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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