Background: Although scar thickness is been used for predicting vaginal birth among women with previous one cesarean section but which women are good candidates for VBAC, the value of applying sonographic LUS thickness measurement in the management of VBAC remains unclear and there are no clear guidelines in this regard. Objective: To determine the frequency of successful vaginal birth after previous one cesarean section and to compare the frequency of vaginal birth after previous one cesarean section in women with scar thickness >3.5 mm compared to those with scar thickness ≤3.5 mm. Study Design: Descriptive, Case-series study. Settings: Department of Obstetrics & Gynecology, DHQ Hospital, Faisalabad. Duration: Six months from December 15, 2017 to June 15, 2018. Methodology: The Non probability, consecutive sampling technique was used in this study. A total of 151 patients in spontaneous labor at term presented to labor room and fulfilling the inclusion criteria were enrolled in this study. After taking informed written consent, the patients were placed randomly into two groups. Group A included all the women with scar thickness >3.5 mm on ultrasonography while Group B included all the women with scar thickness ≤ 3.5mm on ultrasonography. All cases were followed till delivery and outcome variables like vaginal birth was noted. Data was entered and analyzed through SPSS version 21. Results: Mean age was 27.53 ± 4.93 years. Mean gestational age was 39.09 ± 1.13 weeks. Frequency of successful vaginal birth after previous one cesarean section was found in 131(86.75%) patients, whereas there was no VBAC in 20(13.25%) patients. The results of the study showed that women with scar thickness > 3.5 mm were more likely to have vaginal birth (96.65%) versus those with scar thickness ≤3.5mm (79.27%) (P = 0.003). Conclusion: This study concluded that the frequency of vaginal birth after previous one cesarean section in women with scar thickness > 3.5 mm is much higher as compared to those with scar thickness ≤3.5mm.
{"title":"Comparison of Success Rate of Vaginal Birth after Cesarean Between Women with Lower Segment Uterine Scar Thickness more than and less than 3.5mm","authors":"Robina Ali","doi":"10.29054/APMC/2021.1123","DOIUrl":"https://doi.org/10.29054/APMC/2021.1123","url":null,"abstract":"Background: Although scar thickness is been used for predicting vaginal birth among women with previous one cesarean section but which women are good candidates for VBAC, the value of applying sonographic LUS thickness measurement in the management of VBAC remains unclear and there are no clear guidelines in this regard. Objective: To determine the frequency of successful vaginal birth after previous one cesarean section and to compare the frequency of vaginal birth after previous one cesarean section in women with scar thickness >3.5 mm compared to those with scar thickness ≤3.5 mm. Study Design: Descriptive, Case-series study. Settings: Department of Obstetrics & Gynecology, DHQ Hospital, Faisalabad. Duration: Six months from December 15, 2017 to June 15, 2018. Methodology: The Non probability, consecutive sampling technique was used in this study. A total of 151 patients in spontaneous labor at term presented to labor room and fulfilling the inclusion criteria were enrolled in this study. After taking informed written consent, the patients were placed randomly into two groups. Group A included all the women with scar thickness >3.5 mm on ultrasonography while Group B included all the women with scar thickness ≤ 3.5mm on ultrasonography. All cases were followed till delivery and outcome variables like vaginal birth was noted. Data was entered and analyzed through SPSS version 21. Results: Mean age was 27.53 ± 4.93 years. Mean gestational age was 39.09 ± 1.13 weeks. Frequency of successful vaginal birth after previous one cesarean section was found in 131(86.75%) patients, whereas there was no VBAC in 20(13.25%) patients. The results of the study showed that women with scar thickness > 3.5 mm were more likely to have vaginal birth (96.65%) versus those with scar thickness ≤3.5mm (79.27%) (P = 0.003). Conclusion: This study concluded that the frequency of vaginal birth after previous one cesarean section in women with scar thickness > 3.5 mm is much higher as compared to those with scar thickness ≤3.5mm.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114550272","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}
Background: Laparoscopic Cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.
{"title":"Comparison of Early and Delayed Laparoscopic Cholecystectomy in Acute Cholecystitis","authors":"Muhammad Nasir","doi":"10.29054/APMC/2021.1099","DOIUrl":"https://doi.org/10.29054/APMC/2021.1099","url":null,"abstract":"Background: Laparoscopic Cholecystectomy is now accepted as being safe for acute cholecystitis. However, it has not become routine, because the exact timing and approach to the surgical management remains ill define. Careful selection of patients, the knowledge of typical procedure-related complications, and their best treatment are the key points for a safe Laparoscopic Cholecystectomy. Objective: To compare the early and delayed Laparoscopic Cholecystectomy in the acute phase in terms of frequency of conversion to open cholecystectomy. Study Design: Randomized clinical trial. Settings: Department of Surgery, Divisional Headquarter Hospital, Faisalabad. Punjab Medical College, Faisalabad Pakistan. Duration: Study was carried out over a period of six months from June 2018 to May 2019. Methodology: A total of 152 cases (76 cases in each group) were included in this study. All patients were randomly allocated to either group i.e., group -A early Laparoscopic Cholecystectomy and group-B delayed Laparoscopic Cholecystectomy. Results: Mean age was 39.09 + 8.8 and 37.05+ 8.5 years in group- A and B, respectively. In group-A, male patients were 48 (63.2%) and female patients were 28 (36.8%). Similarly, in group-B, male patients were 41 (53.9%) and female patients were 35 (46.1%). Conversion to open cholecystectomy was required in 6 patients (7.9%) of group-A and 16 patients (21.0%) of group – B. Significant difference between two groups was observed (P= 0.021). Conclusion: Early laparoscopic cholecystectomy for acute cholecystitis is safe and feasible in terms of less frequency of conversion to open cholecystectomy.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117165867","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}
Background: Thyroid cancer is the leading cause of death both in developing and developed countries. Patients present with enlarged thyroid. Radiology shows hot and cold nodules. Thyroidectomy or lobectomy is done to rule out malignancy. Objective: To determine the incidence of thyroid carcinomas and other pathologies in thyroidectomy specimen of different age group patients presenting with clinically enlarged thyroid. Study Design: Cross-sectional study. Settings: Department of Histopathology, Foundation University Medical College (FUMC), Islamabad and Department of surgery, Fauji Foundation Hospital (FFH), Rawalpindi Pakistan. Duration: from Jan 2012 to March 2019. Methodology: All the thyroidectomies specimens send from Surgery department of FFH to Histopathology Department of FUMC during study period and fulfilling the pre-set criteria were included in the study. All the data and results were analyzed using SPSS version 17.0. Results: Out of 500 total patients, 89% (n=445) were diagnosed as having multinodular goiter, 2.6% (n=13) thyroiditis, 2.2% (n=11) follicular adenoma, 0.8% (n=4) Hurthle cell adenoma, 0.2%(n=1) hyalinizing trabacular adenoma and thyroid carcinomas. The carcinomas comprised 2.6%(n=13) papillary carcinoma, 0.8%(n=4) poorly differentiated carcinoma,0.8%(n=4) anaplastic carcinoma,0.6%(n=3) medullary carcinoma and 0.4%(n=2) follicular carcinoma. In 445 patients of multinodular goiter 158 patients were in the age range of 41-50 years, in 13 cases of thyroiditis 7 were in the age range of 31-40 years, in 11 cases of follicular adenoma 4 patients were in the age range of 31-40 years, in 4 cases of hurthle cell adenoma 3 patients were in the age range of 41-50 years, in 13 cases of papillary thyroid carcinoma 5 patients were in the age range of 31-40 years, in 4 cases of poorly differentiated carcinoma 2 patients were in the age range of 41-50 years and in 4 cases of anaplastic carcinoma 2 patients were in the age range of 61-70 years. Conclusion: The study concluded that thyroid carcinomas collectively constituted 5.20% of the study cases. Papillary carcinoma was the most frequent malignant neoplasm constituting 2.6 % and occurring mostly in the age range of 31-40 years, while anaplastic carcinoma comprised of 0.8% of malignant lesions occurring in the age range of 61-70 years. The most frequent cause of thyroid enlargement was multinodular goiter (89%) with majority of the patients in the age range of 41-50 years.
{"title":"Incident of Thyroid Carcinomas and Other Pathologies with Age Correlation in Patients Presented with Palpable Thyroid Masses Undergoing Thyroidectomies","authors":"M. Niaz","doi":"10.29054/APMC/2021.733","DOIUrl":"https://doi.org/10.29054/APMC/2021.733","url":null,"abstract":"Background: Thyroid cancer is the leading cause of death both in developing and developed countries. Patients present with enlarged thyroid. Radiology shows hot and cold nodules. Thyroidectomy or lobectomy is done to rule out malignancy. Objective: To determine the incidence of thyroid carcinomas and other pathologies in thyroidectomy specimen of different age group patients presenting with clinically enlarged thyroid. Study Design: Cross-sectional study. Settings: Department of Histopathology, Foundation University Medical College (FUMC), Islamabad and Department of surgery, Fauji Foundation Hospital (FFH), Rawalpindi Pakistan. Duration: from Jan 2012 to March 2019. Methodology: All the thyroidectomies specimens send from Surgery department of FFH to Histopathology Department of FUMC during study period and fulfilling the pre-set criteria were included in the study. All the data and results were analyzed using SPSS version 17.0. Results: Out of 500 total patients, 89% (n=445) were diagnosed as having multinodular goiter, 2.6% (n=13) thyroiditis, 2.2% (n=11) follicular adenoma, 0.8% (n=4) Hurthle cell adenoma, 0.2%(n=1) hyalinizing trabacular adenoma and thyroid carcinomas. The carcinomas comprised 2.6%(n=13) papillary carcinoma, 0.8%(n=4) poorly differentiated carcinoma,0.8%(n=4) anaplastic carcinoma,0.6%(n=3) medullary carcinoma and 0.4%(n=2) follicular carcinoma. In 445 patients of multinodular goiter 158 patients were in the age range of 41-50 years, in 13 cases of thyroiditis 7 were in the age range of 31-40 years, in 11 cases of follicular adenoma 4 patients were in the age range of 31-40 years, in 4 cases of hurthle cell adenoma 3 patients were in the age range of 41-50 years, in 13 cases of papillary thyroid carcinoma 5 patients were in the age range of 31-40 years, in 4 cases of poorly differentiated carcinoma 2 patients were in the age range of 41-50 years and in 4 cases of anaplastic carcinoma 2 patients were in the age range of 61-70 years. Conclusion: The study concluded that thyroid carcinomas collectively constituted 5.20% of the study cases. Papillary carcinoma was the most frequent malignant neoplasm constituting 2.6 % and occurring mostly in the age range of 31-40 years, while anaplastic carcinoma comprised of 0.8% of malignant lesions occurring in the age range of 61-70 years. The most frequent cause of thyroid enlargement was multinodular goiter (89%) with majority of the patients in the age range of 41-50 years.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131230935","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}
Soofia Irfan, M. Yaqoob, S. Randhawa, Muhammad Faisal Bilal Lodhi, M. Akram, Maham Mansoor
Background: Accumulation of seroma in axilla and under mastectomy flaps is a common side effect after axillary lymph nodes dissection in mastectomy, which requires repeated aspirations and prolonged stay of the drain causing discomfort to person. Objective: To determine the effectiveness of axillary exclusion technique versus no axillary exclusion in Modified Radical Mastectomy in terms of mean drain output. Study Design: Randomized control trial. Settings: The study was conducted in department of Surgery, Allied Hospital Faisalabad Pakistan. Duration: 1 year from August 08, 2018 to August 07, 2019. Methodology: After permission from Hospital Ethical Review Committee, 60 Patients presenting for mastectomy were included in the study. They were randomly divided into two equal groups of 30 patients each applying computer generated random number table. Group A (underwent axillary exclusion) and Group B (did not undergo axillary exclusion) after modified radical mastectomy. Total amount of fluid collected in drain bag postoperatively was noted till the removal of drain and compared between the groups. Data was entered in a pre-designed proforma. Results: Comparison of axillary exclusion technique with no exclusion after modified radical mastectomy was done, it showed that the mean of the total drain output (+SD) in Group A was 1112.4ml (+66.78) whereas mean output in Group-B was 2184ml (+117.06). (Table No.1). p-value was <0.001 showing a considerable decrease in the total volume of the seroma fluid drained between the two groups. Conclusion: Study concluded that the axillary exclusion technique significantly reduces drain output in patients following modified radical mastectomy as compared to those who do not undergo axillary exclusion.
{"title":"Comparison of Axillary Exclusion Versus no Exclusion on Seroma Formation after Modified Radical Mastectomy","authors":"Soofia Irfan, M. Yaqoob, S. Randhawa, Muhammad Faisal Bilal Lodhi, M. Akram, Maham Mansoor","doi":"10.29054/APMC/2021.1034","DOIUrl":"https://doi.org/10.29054/APMC/2021.1034","url":null,"abstract":"Background: Accumulation of seroma in axilla and under mastectomy flaps is a common side effect after axillary lymph nodes dissection in mastectomy, which requires repeated aspirations and prolonged stay of the drain causing discomfort to person. Objective: To determine the effectiveness of axillary exclusion technique versus no axillary exclusion in Modified Radical Mastectomy in terms of mean drain output. Study Design: Randomized control trial. Settings: The study was conducted in department of Surgery, Allied Hospital Faisalabad Pakistan. Duration: 1 year from August 08, 2018 to August 07, 2019. Methodology: After permission from Hospital Ethical Review Committee, 60 Patients presenting for mastectomy were included in the study. They were randomly divided into two equal groups of 30 patients each applying computer generated random number table. Group A (underwent axillary exclusion) and Group B (did not undergo axillary exclusion) after modified radical mastectomy. Total amount of fluid collected in drain bag postoperatively was noted till the removal of drain and compared between the groups. Data was entered in a pre-designed proforma. Results: Comparison of axillary exclusion technique with no exclusion after modified radical mastectomy was done, it showed that the mean of the total drain output (+SD) in Group A was 1112.4ml (+66.78) whereas mean output in Group-B was 2184ml (+117.06). (Table No.1). p-value was <0.001 showing a considerable decrease in the total volume of the seroma fluid drained between the two groups. Conclusion: Study concluded that the axillary exclusion technique significantly reduces drain output in patients following modified radical mastectomy as compared to those who do not undergo axillary exclusion.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"86 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131277821","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}
Background: Tinea corporis is a worldwide superficial fungal infection that mimics many other annular lesions. As the Tinea Corporis have a significant impact on patient’s life physically and psychologically. So, physicians must have knowledge about this condition and its treatment options. Objective: To compare the efficacy of terbinafine versus fluconazole in patients of tinea corporis. Study Design: It was a randomized controlled trial. Settings: Research was conducted at Department of Pharmacology Duration: for a period of 6 months from 10 Feb to 10 Aug 2020 at Khalifa Gulnawaz Teaching Hospital, Bannu, Khyber Pakhtunkhwa & DHQ Teaching Hospital, Bannu, Khyber Pakhtunkhwa Pakistan. Methodology: From both the genders 102 patients aged between 20-45 years who presented with tinea corporis were included in the study. Two treatment groups were made by random allocation of patients. Patients in Group-A were treated with oral terbinafine while those in Group-B were given fluconazole. Frequency of efficacy being outcome variable was labeled upon complete resolution of the tinea corporis in 4 weeks (counted from start of treatment) and was compared between the groups. An informed written informed consent was taken from all the patients. Results: The patients had a mean age of 31.66±6.99 years while the mean duration of disease was 5.41±2.16 months. There were 55 (53.9%) male and 47 (46.1%) female patients with a male to female ratio of 1.2:1. The frequency of efficacy was significantly higher in patients treated with terbinafine as compared to fluconazole (90.2% vs. 64.7%; p-value=0.002). This difference was same in all subgroups as well. Conclusion: Oral terbinafine was found more efficacious than conventional treatment with oral fluconazole in patients with tinea corporis regardless of patient’s age, gender and duration of disease which advocates preferred use of terbinafine in the treatment of such patients in future practice.
背景:体癣是一种世界性的浅表真菌感染，类似于许多其他环形病变。由于体癣对患者的生理和心理生活都有重大影响。因此，医生必须了解这种情况及其治疗方案。目的:比较特比萘芬与氟康唑治疗体癣的疗效。研究设计:随机对照试验。时间:2020年2月10日至8月10日，在巴基斯坦开伯尔-普赫图赫瓦省班努的Khalifa Gulnawaz教学医院和开伯尔-普赫图赫瓦省班努的DHQ教学医院进行为期6个月的研究。方法:102例年龄在20-45岁之间出现体癣的男女患者被纳入研究。随机分配患者分为两个治疗组。a组患者口服特比萘芬，b组患者口服氟康唑。在4周内(从治疗开始算起)体癣完全消退时，将疗效频次作为结果变量进行标记，并在两组之间进行比较。所有患者均获得知情同意书。结果:患者平均年龄31.66±6.99岁，平均病程5.41±2.16个月。男性55例(53.9%)，女性47例(46.1%)，男女比例为1.2:1。与氟康唑相比，特比萘芬治疗的患者有效频率显著更高(90.2% vs. 64.7%;假定值= 0.002)。这种差异在所有亚组中也是相同的。结论:口服特比萘芬治疗体癣，不论患者年龄、性别、病程长短，均优于口服氟康唑治疗，建议在今后的实践中优先使用特比萘芬治疗体癣。
{"title":"Comparison of Efficacy of Terbinafine and Fluconazole in Patients of Tinea Corporis","authors":"A. Mustafa, S. Hussain, G. Shaheen","doi":"10.29054/APMC/2021.780","DOIUrl":"https://doi.org/10.29054/APMC/2021.780","url":null,"abstract":"Background: Tinea corporis is a worldwide superficial fungal infection that mimics many other annular lesions. As the Tinea Corporis have a significant impact on patient’s life physically and psychologically. So, physicians must have knowledge about this condition and its treatment options. Objective: To compare the efficacy of terbinafine versus fluconazole in patients of tinea corporis. Study Design: It was a randomized controlled trial. Settings: Research was conducted at Department of Pharmacology Duration: for a period of 6 months from 10 Feb to 10 Aug 2020 at Khalifa Gulnawaz Teaching Hospital, Bannu, Khyber Pakhtunkhwa & DHQ Teaching Hospital, Bannu, Khyber Pakhtunkhwa Pakistan. Methodology: From both the genders 102 patients aged between 20-45 years who presented with tinea corporis were included in the study. Two treatment groups were made by random allocation of patients. Patients in Group-A were treated with oral terbinafine while those in Group-B were given fluconazole. Frequency of efficacy being outcome variable was labeled upon complete resolution of the tinea corporis in 4 weeks (counted from start of treatment) and was compared between the groups. An informed written informed consent was taken from all the patients. Results: The patients had a mean age of 31.66±6.99 years while the mean duration of disease was 5.41±2.16 months. There were 55 (53.9%) male and 47 (46.1%) female patients with a male to female ratio of 1.2:1. The frequency of efficacy was significantly higher in patients treated with terbinafine as compared to fluconazole (90.2% vs. 64.7%; p-value=0.002). This difference was same in all subgroups as well. Conclusion: Oral terbinafine was found more efficacious than conventional treatment with oral fluconazole in patients with tinea corporis regardless of patient’s age, gender and duration of disease which advocates preferred use of terbinafine in the treatment of such patients in future practice.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134604533","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}
Background: Oral Submucous Fibrosis is a potent pre-malignant condition of Oral cavity, which is prevalent in South Asian countries, due to social habit of pan, gutka, areca nut and betel quid chewing, which is mostly practiced in South-East Asia. A decreased pattern of lipid profile has been observed in literature in many precancerous conditions, this study is based on observation of lipid profile pattern among Oral submucous fibrosis patients in relation with age, gender, body mass index and duration of disease. Objective: A descriptive study to determine mean lipid profile values among oral sub-mucous fibrosis patients. Study Design: Descriptive (cross-sectional) study. Settings: Department of Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital-Karachi Pakistan. Duration: 1st January 2017 till 30th June 2017, for a period of six months. Methodology: Oral Sub-mucous Fibrosis (OSMF) patients, who also met with inclusion criteria of study were selected. Lipid Profile values of TC (total cholesterol), HDL (high density lipids), LDL (low density lipids) and triglycerides were observed among OSMF patients in relation to duration of disease, their different age groups, gender and body mass index (BMI). Results: Out of 104 clinically diagnosed patients of OSMF, 34 females and 70 were males. Mean age was 38.9, most of the patients were in the age group of 20-40 years. Mean and standard deviation of TC, triglycerides, LDL and HDL was 132.19±13.29, 142.25±8.71, 101.87±17.57 and 30.43±2.56 respectively. Conclusion: Results of this study revealed that there is no significant change in pattern of lipid profile among OSMF patients in relation to their different age groups, gender and BMI, but an inverse relation does exist between lipid panel and duration of disease.
{"title":"Mean Lipid Profile among Patients Suffering from Oral Sub-mucous Fibrosis Reporting in a Tertiary Care Hospital of Karachi, Pakistan: A Descriptive Study","authors":"M. Siddiq","doi":"10.29054/APMC/2021.1132","DOIUrl":"https://doi.org/10.29054/APMC/2021.1132","url":null,"abstract":"Background: Oral Submucous Fibrosis is a potent pre-malignant condition of Oral cavity, which is prevalent in South Asian countries, due to social habit of pan, gutka, areca nut and betel quid chewing, which is mostly practiced in South-East Asia. A decreased pattern of lipid profile has been observed in literature in many precancerous conditions, this study is based on observation of lipid profile pattern among Oral submucous fibrosis patients in relation with age, gender, body mass index and duration of disease. Objective: A descriptive study to determine mean lipid profile values among oral sub-mucous fibrosis patients. Study Design: Descriptive (cross-sectional) study. Settings: Department of Oral & Maxillofacial Surgery, Abbasi Shaheed Hospital-Karachi Pakistan. Duration: 1st January 2017 till 30th June 2017, for a period of six months. Methodology: Oral Sub-mucous Fibrosis (OSMF) patients, who also met with inclusion criteria of study were selected. Lipid Profile values of TC (total cholesterol), HDL (high density lipids), LDL (low density lipids) and triglycerides were observed among OSMF patients in relation to duration of disease, their different age groups, gender and body mass index (BMI). Results: Out of 104 clinically diagnosed patients of OSMF, 34 females and 70 were males. Mean age was 38.9, most of the patients were in the age group of 20-40 years. Mean and standard deviation of TC, triglycerides, LDL and HDL was 132.19±13.29, 142.25±8.71, 101.87±17.57 and 30.43±2.56 respectively. Conclusion: Results of this study revealed that there is no significant change in pattern of lipid profile among OSMF patients in relation to their different age groups, gender and BMI, but an inverse relation does exist between lipid panel and duration of disease.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"277 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123428800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. S. Javed, Ghulam Subhani, M. Akmal, M. Munir, S. Javed
Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.
背景:肾结石在世界范围内的发病率很高，尤其是在我国，经皮肾镜取石术(PCNL)是治疗肾结石的金标准手术方式。PCNL术后的疼痛控制是治疗外科医生最重要的任务，因为有效的疼痛控制可以使患者在术后顺利康复。在镇痛方面，有许多药物可供使用，其中曲马多和纳布啡的有效镇痛活性一直是比较的。目的:比较曲马多与纳布啡作为强效镇痛药在PCNL患者中的疗效。研究设计:前瞻性随机研究。环境:费萨拉巴德联合医院/费萨拉巴德医科大学泌尿科和肾移植科;巴基斯坦费萨拉巴德DHQ医院/费萨拉巴德医科大学泌尿科。学习时间:2016年9月至2020年9月(4年)。方法:根据纳入和排除标准纳入286例接受PCNL的患者。患者分为A组(曲马多给药)和B组(纳布啡给药)，患者术后48小时的疼痛评分采用11点数值疼痛评定量表，0-10分，0为无疼痛，1-3轻度疼痛，4-6中度疼痛，7-9重度疼痛，10为最严重疼痛，两组均观察到使用抢救镇痛。获得数据并进行统计评估。结果:286例患者入组，年龄15-75岁，平均年龄40.2岁。286例患者中，男性161例，女性125例。A组和B组各143例。分析显示曲马多优于纳布啡，在PCNL术后给予纳布啡维持镇痛药的患者中，需要镇痛的患者较多(118 vs 31)。结论:曲马多在PCNL术后的镇痛效果优于纳布啡。
{"title":"Tramadol or Nalbuphine; Which One is Superior for Analgesia in Post-Operative Period after Percutaneous Nephrolithotomy","authors":"M. S. Javed, Ghulam Subhani, M. Akmal, M. Munir, S. Javed","doi":"10.29054/APMC/2021.1062","DOIUrl":"https://doi.org/10.29054/APMC/2021.1062","url":null,"abstract":"Background: Kidney stones has got high prevalence worldwide especially in our part of world and per-cutaneous nephrolithotomy (PCNL) is gold standard operative modality for renal stone management. Pain control after PCNL is the most important task for treating surgeon as effective pain control causes smooth patient recovery in post-operative period. For analgesia, many drugs can be used, out of which tramadol and nalbuphine always been in comparison for effective analgesic activity. Objective: To compare efficacy of tramadol and nalbuphine as potent analgesic in patients after PCNL. Study Design: A prospective randomized study. Settings: Department of Urology and Kidney Transplantation, Allied Hospital/Faisalabad Medical University, Faisalabad and Department of Urology, DHQ Hospital/Faisalabad Medical University, Faisalabad Pakistan. Duration: From September 2016 to September 2020 (4 Years). Methodology: 286 patients undergoing PCNL for either gender and sides enrolled in study according to inclusion and exclusion criteria. Patients divided into Group A (Administered with tramadol) and Group B (administered with nalbuphine) and patients evaluated for pain up to 48 hours after surgery using 11-point numerical pain rating scale rating from0-10 where 0 is no pain, 1-3 mild pain, 4-6 moderate pain, 7-9 severe pain and 10 as worst pain and use of rescue analgesia observed in either groups. Data obtained and statistical evaluation done. Results: 286 patients enrolled from age 15-75 years with mean age of 40.2 years. Among 286 patients, 161 were male and 125 were female patients. Both groups A and B having 143 patients each. Analysis showed that tramadol has superiority over nalbuphine and need of analgesia is more in patient given nalbuphine (118 vs 31) as maintenance analgesic agent in post-operative period after PCNL. Conclusion: This study showed that tramadol has superiority over nalbuphine for analgesia after PCNL.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127613226","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}
Background: Corona virus is +ve stranded RNA virus pervasive in most of the atmospheres and towards the end of year 2019 it originated a pandemic as emerging microorganism which started in Wuhan city of China causing mild respiratory illness to severe acute hypoxemic respiratory distress syndrome in humans causing lot of deaths. Thanks to Almighty ALLAH that its virulence has been decreased in recent past in Pakistan due to better government planning and preventive measures. Objective: To manage moderate to severe COVID- 19 patients with pneumonias in HDU/ attached wards with central oxygen supply and to observe peril elements of infection severity, non-improvement and case fatality. Study Design: Descriptive, cross sectional, multicenter and heterogenous study of fifty COVID positive patients. Settings: High Dependency Unit & Isolation (Pulmonology ward) District Head Quarter Hospital Sargodha & Niazi Teaching Hospital (OPD), Sargodha Pakistan. Duration: From 15 May 2020 to 30 June 2020. Methodology: Fifty COVID- 19 patients over eighteen years of age presented with moderate to severe illness were enrolled for management in this study. Patients having +ve RT- PCR test (nasopharyngeal swab) for COVID-19/ CT chest with pneumonias, pyrexia, cough, tachypnoea with or without confusion, coma, dehydration, fits, low oxygen saturation, feeding difficulties, myocardial or renal injuries, raised liver enzymes, dysfunctional coagulation, expeditious disease advancement with respiratory failure (ARDS) were included in this study for management. Results: Every patient was admitted for moderate to severe COVID 19 pneumonias, tachypnoea etc. Eleven patients needed high flow nasal oxygen (HFNO) humidified oxygen or noninvasive ventilation (NIV) and non-rebreather mask and two patients required invasive ventilation, 24 patients (48%) patients had diabetes mellitus with complications, 8 patients (16%) had chronic obstructive airway disease (COAD) or asthma on steroids and hypertension with complications was diagnosed in 6 (12%) patients as well. As a whole two critically ill (one old aged diabetic) patients died over one and a half month of study period. Conclusion: COVID-19 can be a fatal disease especially in patients with old age, chronic illnesses (diabetes, COAD, hypertension and chronic renal failure etc.), immunocompromised states, early detection with management is of great value. This study interprets that early usage of NIV (CPAP and HFNO) diminishes respiratory failure symptoms, worsening of disease and the need for invasive ventilation.
{"title":"Peril Elements of Infection Severity, Disease Non-Improvement, Case Fatality and Management of Sars-Cov-2 in Sargodha Region Pakistan","authors":"A. Nazir","doi":"10.29054/APMC/2021.1012","DOIUrl":"https://doi.org/10.29054/APMC/2021.1012","url":null,"abstract":"Background: Corona virus is +ve stranded RNA virus pervasive in most of the atmospheres and towards the end of year 2019 it originated a pandemic as emerging microorganism which started in Wuhan city of China causing mild respiratory illness to severe acute hypoxemic respiratory distress syndrome in humans causing lot of deaths. Thanks to Almighty ALLAH that its virulence has been decreased in recent past in Pakistan due to better government planning and preventive measures. Objective: To manage moderate to severe COVID- 19 patients with pneumonias in HDU/ attached wards with central oxygen supply and to observe peril elements of infection severity, non-improvement and case fatality. Study Design: Descriptive, cross sectional, multicenter and heterogenous study of fifty COVID positive patients. Settings: High Dependency Unit & Isolation (Pulmonology ward) District Head Quarter Hospital Sargodha & Niazi Teaching Hospital (OPD), Sargodha Pakistan. Duration: From 15 May 2020 to 30 June 2020. Methodology: Fifty COVID- 19 patients over eighteen years of age presented with moderate to severe illness were enrolled for management in this study. Patients having +ve RT- PCR test (nasopharyngeal swab) for COVID-19/ CT chest with pneumonias, pyrexia, cough, tachypnoea with or without confusion, coma, dehydration, fits, low oxygen saturation, feeding difficulties, myocardial or renal injuries, raised liver enzymes, dysfunctional coagulation, expeditious disease advancement with respiratory failure (ARDS) were included in this study for management. Results: Every patient was admitted for moderate to severe COVID 19 pneumonias, tachypnoea etc. Eleven patients needed high flow nasal oxygen (HFNO) humidified oxygen or noninvasive ventilation (NIV) and non-rebreather mask and two patients required invasive ventilation, 24 patients (48%) patients had diabetes mellitus with complications, 8 patients (16%) had chronic obstructive airway disease (COAD) or asthma on steroids and hypertension with complications was diagnosed in 6 (12%) patients as well. As a whole two critically ill (one old aged diabetic) patients died over one and a half month of study period. Conclusion: COVID-19 can be a fatal disease especially in patients with old age, chronic illnesses (diabetes, COAD, hypertension and chronic renal failure etc.), immunocompromised states, early detection with management is of great value. This study interprets that early usage of NIV (CPAP and HFNO) diminishes respiratory failure symptoms, worsening of disease and the need for invasive ventilation.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123650572","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}
Background: Radiologists are always questioning the use of an imagine modality as compared to the other, this study helps answer that question for the diagnosis of Hepatocellular carcinoma. Objective: To compare the use of MRI imaging technique with ultrasonography for the diagnosis of hepatocellular carcinoma. Study Design: The type of study is a Prospective Cross-Sectional study. Settings: A large tertiary care hospital in Karachi, Pakistan. Duration: One year from July 2018 to July 2019. Methodology: The inclusion criteria was all the patients who were referred to us with symptoms for concern for hepatic tumors. For the MRI we used a 1.5 tesla machine, and for the ultrasound we used a conventional grey scale ultrasonography with a probe of 5 MHz. We performed multiphasic contrast enhanced MRI’s, with images taken both before the injection of the contrast and afterwards in the various phases such as the arterial phase, portal venous phase and finally the delayed phase respectively. Results: The study population consisted of n=110 patients having a mean age of 46.5 +/- 5.50 years. There were n= 78 (70.90%) males and n= 32 (20.09%) females. N= 101 (91.81%) patients had a diagnosis of hepatocellular carcinoma as per MRI scan, for ultrasound n= 47 (42.72%) patients were diagnosed as true positive, n= 2 (1.81%) were false positive, n= 54 (49.09%) were false negative, while n= 7 (6.36%) cases were truly negative. The specificity was 77.77% the sensitivity was 46.53%, the positive predictive value was 95.91%, negative predictive value was 11.4%, and accuracy was 49.09% respectively. Conclusion: We found that the specificity of ultrasound as a diagnostic modality for hepatocellular carcinoma as compared to the MRI scan is good, however it is only able to correctly identify about half the patients, hence care should be taken when interpreting the results of ultrasound for hepatocellular carcinoma.
{"title":"Is Ultrasound a Viable Imaging Modality for the Diagnosis of Hepatocellular Carcinoma? A Cross-Sectional Study","authors":"R. Rani","doi":"10.29054/APMC/2021.1089","DOIUrl":"https://doi.org/10.29054/APMC/2021.1089","url":null,"abstract":"Background: Radiologists are always questioning the use of an imagine modality as compared to the other, this study helps answer that question for the diagnosis of Hepatocellular carcinoma. Objective: To compare the use of MRI imaging technique with ultrasonography for the diagnosis of hepatocellular carcinoma. Study Design: The type of study is a Prospective Cross-Sectional study. Settings: A large tertiary care hospital in Karachi, Pakistan. Duration: One year from July 2018 to July 2019. Methodology: The inclusion criteria was all the patients who were referred to us with symptoms for concern for hepatic tumors. For the MRI we used a 1.5 tesla machine, and for the ultrasound we used a conventional grey scale ultrasonography with a probe of 5 MHz. We performed multiphasic contrast enhanced MRI’s, with images taken both before the injection of the contrast and afterwards in the various phases such as the arterial phase, portal venous phase and finally the delayed phase respectively. Results: The study population consisted of n=110 patients having a mean age of 46.5 +/- 5.50 years. There were n= 78 (70.90%) males and n= 32 (20.09%) females. N= 101 (91.81%) patients had a diagnosis of hepatocellular carcinoma as per MRI scan, for ultrasound n= 47 (42.72%) patients were diagnosed as true positive, n= 2 (1.81%) were false positive, n= 54 (49.09%) were false negative, while n= 7 (6.36%) cases were truly negative. The specificity was 77.77% the sensitivity was 46.53%, the positive predictive value was 95.91%, negative predictive value was 11.4%, and accuracy was 49.09% respectively. Conclusion: We found that the specificity of ultrasound as a diagnostic modality for hepatocellular carcinoma as compared to the MRI scan is good, however it is only able to correctly identify about half the patients, hence care should be taken when interpreting the results of ultrasound for hepatocellular carcinoma.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130039864","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}
Background: Exclusive breastfeeding (EBF) with colostrum feeding improves the survival of the newborns. This varies with the time of initiation of breast-feeding, its duration and the age of weaning. Knowledge of breast feeding, attitude of mothers and their practices varies with many factors among populations. Objective: (1) To determine the prevalence of exclusive breastfeeding practice among mothers of infants 0–6 months of age presenting in obstetrical out-patient department. (2) To assess the level of knowledge, attitude and practices of new-mothers regarding breastfeeding presenting in obstetrical out-patient department. Study Design: Cross-sectional study. Settings: Department of Obstetrics & Gynecology, Faisalabad Medical University, Faisalabad Pakistan. Duration: One month from August 01, 2020. Methodology: All new mothers of healthy infants 0–6 months old born between 37 and 42 gestation weeks attending the obstetrics OPD were included in the study. A detailed history was taken from all mothers. Parity, current age of infant, weight, height, BMI, BMI category, educational status, exclusive breastfeeding (EBF) and any pre-lacteal feed given, was noted. The independent variables for the study were maternal knowledge and attitudes towards EBF. 15 questions for assessment of knowledge and 12 for maternal attitude were used. Results: Among these 100 women, 66% (n=66) were currently feeding their newborns, but only 17% (n=17) of the total 100 women were practicing exclusive-breast-feeding. 95% were having good and above average knowledge regarding breast feeding practices. Still only half of the mothers had a positive attitude towards breast feeding; only 66% of the women were practicing breast feeding. Among educated mother 47.6% had a positive attitude toward breast feeding. Mothers with knowledge of breast-feeding above average/good were of 25 years or above age group. Conclusion: Education of the mothers can be linked to their high knowledge but is not significantly associated with their positive attitudes. Positive campaigns are required focusing not only un-educated young mothers, but also involving young educated primiparous women. Women should be encouraged from the first pregnancy regarding exclusive breast feeding and colostrum feeding, without the use of any pre-lacteal feeds, whatever the mode of delivery is.
{"title":"Breastfeeding Knowledge, Attitude and Practices of New-Mothers Presenting in Obstetrical Out-Patient Department","authors":"Noor K. Abid","doi":"10.29054/APMC/2021.956","DOIUrl":"https://doi.org/10.29054/APMC/2021.956","url":null,"abstract":"Background: Exclusive breastfeeding (EBF) with colostrum feeding improves the survival of the newborns. This varies with the time of initiation of breast-feeding, its duration and the age of weaning. Knowledge of breast feeding, attitude of mothers and their practices varies with many factors among populations. Objective: (1) To determine the prevalence of exclusive breastfeeding practice among mothers of infants 0–6 months of age presenting in obstetrical out-patient department. (2) To assess the level of knowledge, attitude and practices of new-mothers regarding breastfeeding presenting in obstetrical out-patient department. Study Design: Cross-sectional study. Settings: Department of Obstetrics & Gynecology, Faisalabad Medical University, Faisalabad Pakistan. Duration: One month from August 01, 2020. Methodology: All new mothers of healthy infants 0–6 months old born between 37 and 42 gestation weeks attending the obstetrics OPD were included in the study. A detailed history was taken from all mothers. Parity, current age of infant, weight, height, BMI, BMI category, educational status, exclusive breastfeeding (EBF) and any pre-lacteal feed given, was noted. The independent variables for the study were maternal knowledge and attitudes towards EBF. 15 questions for assessment of knowledge and 12 for maternal attitude were used. Results: Among these 100 women, 66% (n=66) were currently feeding their newborns, but only 17% (n=17) of the total 100 women were practicing exclusive-breast-feeding. 95% were having good and above average knowledge regarding breast feeding practices. Still only half of the mothers had a positive attitude towards breast feeding; only 66% of the women were practicing breast feeding. Among educated mother 47.6% had a positive attitude toward breast feeding. Mothers with knowledge of breast-feeding above average/good were of 25 years or above age group. Conclusion: Education of the mothers can be linked to their high knowledge but is not significantly associated with their positive attitudes. Positive campaigns are required focusing not only un-educated young mothers, but also involving young educated primiparous women. Women should be encouraged from the first pregnancy regarding exclusive breast feeding and colostrum feeding, without the use of any pre-lacteal feeds, whatever the mode of delivery is.","PeriodicalId":319424,"journal":{"name":"Annals of Punjab Medical College","volume":"58 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128024456","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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