Pub Date : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.855
Sadia Ali Khan, Fatima Imran, Junaid Ali Khan
Background: Premature rupture of membranes complicates 5 to 10 % of the singleton pregnancies and is a major contributor of maternal morbidity and neonatal morbidity and mortality in terms of sepsis and prematurity, even in the today's era of antibiotics. Most of these complications can be prevented provided timely, targeted management is initiated.Objectives: To provide a comprehensive understanding of the fetal and maternal outcome with premature rupture of membranes at term, for a better management.Material and Methods: This descriptive Cross Sectional study was conducted in department of Obstetrics and Gynecology HMC, from 15th of September 2022 till 15th of February 2023. Random sampling method was adopted in this study and a total of 241 patients presented with spontaneous rupture of membranes after 37 weeks till 41 weeks. A detail history, physical and gynecological examination was performed, and all the information gathered from the patient by the doctors was then recorded on a pre-designed proforma.Results: Out of 241 patients of PROM 60 cases of maternal and 145 cases of fetal complications were observed. As per maternal outcomes, 28(46.7%) patients had wound infection,16(26.6%) patients developed oligohydramnios, 07 (11.7%) patients were recorded with Puerperal Pyrexia secondary to endometritis, and 09 (15%) patients developed chorio-amnionitis. About 56% of the mothers had cesearen deliveries. As per fetal outcomes, 78(53.8%) cases were recorded with RDS, 35(24.1) with hyperbilirubinemia, 23 (16%) babies developed neonatal sepsis, and 09(6.2%) had necrotizing Enterocolitis. Conclusion: Premature Rupture of Membrane at term has a risk of both fetal and maternal complications. Prolonging pregnancy as in conservative management adds to the fetal and maternal morbidity more in terms of sepsis. In this study, we concluded that conservative management to prolong pregnancy carry risk both for mother and baby and is recommended only under strict monitoring.Keywords: Chorioamnionitis, Latency period, Maternal outcome, Perinatal outcome, Sepsis.
{"title":"Review of Feto-Maternal Outcome in Patients with Premature Rupture of Membranes at Term","authors":"Sadia Ali Khan, Fatima Imran, Junaid Ali Khan","doi":"10.52206/jsmc.2024.14.2.855","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.855","url":null,"abstract":"Background: Premature rupture of membranes complicates 5 to 10 % of the singleton pregnancies and is a major contributor of maternal morbidity and neonatal morbidity and mortality in terms of sepsis and prematurity, even in the today's era of antibiotics. Most of these complications can be prevented provided timely, targeted management is initiated.Objectives: To provide a comprehensive understanding of the fetal and maternal outcome with premature rupture of membranes at term, for a better management.Material and Methods: This descriptive Cross Sectional study was conducted in department of Obstetrics and Gynecology HMC, from 15th of September 2022 till 15th of February 2023. Random sampling method was adopted in this study and a total of 241 patients presented with spontaneous rupture of membranes after 37 weeks till 41 weeks. A detail history, physical and gynecological examination was performed, and all the information gathered from the patient by the doctors was then recorded on a pre-designed proforma.Results: Out of 241 patients of PROM 60 cases of maternal and 145 cases of fetal complications were observed. As per maternal outcomes, 28(46.7%) patients had wound infection,16(26.6%) patients developed oligohydramnios, 07 (11.7%) patients were recorded with Puerperal Pyrexia secondary to endometritis, and 09 (15%) patients developed chorio-amnionitis. About 56% of the mothers had cesearen deliveries. As per fetal outcomes, 78(53.8%) cases were recorded with RDS, 35(24.1) with hyperbilirubinemia, 23 (16%) babies developed neonatal sepsis, and 09(6.2%) had necrotizing Enterocolitis. Conclusion: Premature Rupture of Membrane at term has a risk of both fetal and maternal complications. Prolonging pregnancy as in conservative management adds to the fetal and maternal morbidity more in terms of sepsis. In this study, we concluded that conservative management to prolong pregnancy carry risk both for mother and baby and is recommended only under strict monitoring.Keywords: Chorioamnionitis, Latency period, Maternal outcome, Perinatal outcome, Sepsis.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678583","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.951
Syed Muzammil Shah
Implementing comprehensive quality control measures in Regional Blood Center (RBC) laboratory services is indispensable for ensuring the accuracy, reliability, and consistency of transfusion-transmitted infectious screening results. These measures not only identify and address potential issues but also uphold the highest standards in analysis and testing. Below, we explore deeper into the critical aspects of quality control in laboratory services especially in the Regional Blood Center laboratory followed by American association of blood banking.
{"title":"Quality Control in Regional Blood Center QC Laboratory","authors":"Syed Muzammil Shah","doi":"10.52206/jsmc.2024.14.2.951","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.951","url":null,"abstract":"Implementing comprehensive quality control measures in Regional Blood Center (RBC) laboratory services is indispensable for ensuring the accuracy, reliability, and consistency of transfusion-transmitted infectious screening results. These measures not only identify and address potential issues but also uphold the highest standards in analysis and testing. Below, we explore deeper into the critical aspects of quality control in laboratory services especially in the Regional Blood Center laboratory followed by American association of blood banking.\u0000 ","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678076","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.845
Faiza Rehman, Nasreen Kishwar, Rukhsana Karim, Shazia Khattak, Saman Mudassir
Background: The “term pregnancy” is defined as the pregnancy that ends between 259 and 294 days (37-42 weeks) of pregnancy from the 1st day of last menstrual period. If the pregnancy continues beyond this mentioned period, it is called prolonged pregnancy. Post-term Pregnancy is one of the commonest obstetric conditions which associated with an increased risk of fetal and neonatal mortality and morbidity as well as an increased maternal morbidity.Objectives: The aim of this study is to determine the frequency of mode of delivery and fetal outcomes in prolonged pregnancy.Material and Methods: It is a Descriptive cross sectional study, conducted from 28th Aug, 2019 to 28thFeb, 2020 at Department of Obs & Gynae, MTI-HMC Peshawar. Sample size was 125 keeping 11% proportion of patients having poor apgar score with 95% confidence interval, 5% level of significance.5% margin of error. Sample collection was accomplished by non-probability, consecutive sampling technique. All patients between 18-40 years of age with 42 weeks of gestation or more by dates or dating scan admitted to Gynae Ward/Labour room, having regular cycles were included in the study.Results: As per descriptive statistics, mean and SDs for age was 25±4.90. Mean and SDs for gravidity was recorded as 2±0.58. Mean and SDs for parity was 2±0.58. Mean and SDs for Apgar score was recorded as 8±0.89. 28 (22.4%) patients were obese. In this study 14 (11.2%) neonates had poor apgar score. Normal vaginal delivery 66(52.8%) was the Frequent mode of delivery followed by assisted vaginal deliveries 48(38.4%) and Caesarean section11(8.8%).Conclusion: In this study, we have concluded that pregnancy should not be allowed to go post-term due to association of higher neonatal morbidity and mortality rate, and should be managed before 42 weeks of gestation.Keywords: Fetal outcome, Post term pregnancy, Poor Apgar Score
{"title":"Impact of Prolonged Pregnancy on Mode of Delivery and Fetal Outcome","authors":"Faiza Rehman, Nasreen Kishwar, Rukhsana Karim, Shazia Khattak, Saman Mudassir","doi":"10.52206/jsmc.2024.14.2.845","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.845","url":null,"abstract":"Background: The “term pregnancy” is defined as the pregnancy that ends between 259 and 294 days (37-42 weeks) of pregnancy from the 1st day of last menstrual period. If the pregnancy continues beyond this mentioned period, it is called prolonged pregnancy. Post-term Pregnancy is one of the commonest obstetric conditions which associated with an increased risk of fetal and neonatal mortality and morbidity as well as an increased maternal morbidity.Objectives: The aim of this study is to determine the frequency of mode of delivery and fetal outcomes in prolonged pregnancy.Material and Methods: It is a Descriptive cross sectional study, conducted from 28th Aug, 2019 to 28thFeb, 2020 at Department of Obs & Gynae, MTI-HMC Peshawar. Sample size was 125 keeping 11% proportion of patients having poor apgar score with 95% confidence interval, 5% level of significance.5% margin of error. Sample collection was accomplished by non-probability, consecutive sampling technique. All patients between 18-40 years of age with 42 weeks of gestation or more by dates or dating scan admitted to Gynae Ward/Labour room, having regular cycles were included in the study.Results: As per descriptive statistics, mean and SDs for age was 25±4.90. Mean and SDs for gravidity was recorded as 2±0.58. Mean and SDs for parity was 2±0.58. Mean and SDs for Apgar score was recorded as 8±0.89. 28 (22.4%) patients were obese. In this study 14 (11.2%) neonates had poor apgar score. Normal vaginal delivery 66(52.8%) was the Frequent mode of delivery followed by assisted vaginal deliveries 48(38.4%) and Caesarean section11(8.8%).Conclusion: In this study, we have concluded that pregnancy should not be allowed to go post-term due to association of higher neonatal morbidity and mortality rate, and should be managed before 42 weeks of gestation.Keywords: Fetal outcome, Post term pregnancy, Poor Apgar Score","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678530","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.809
Zahir Khan Khalil, Shafqat Ali Shah, Amir Naseem, Saman Mudassir, Asif Mehmood Orakzai
Background: Primary open angle glaucoma and age related cataract are ocular comorbidities which can occur in some individuals at different times. Phacoemulsification is carried out for restoration of vision decreased by cataract while trabeculectomy is a procedure to decrease the intra ocular pressure. To save the time, money and stay in the hospital, phacotrabeculectomy is a single procedure which can fulfill both the restoration of vision and decrease intraocular pressure. Objectives: To determine the efficacy of phacotrabeculectomy in decreasing the intraocular pressure in patients having both primary open angle glaucoma and age related cataract.Materials and Methods: This study was conducted at the Eye department, Hayatabad Medical Complex, Peshawar, from 1st August, 2022 to 1st February 2023 after getting the permission from Ethical Committee to do this study. Patients both males and females, from 40-80 years of age, who had coexisting age related cataract (ARC) and Primary open angle glaucoma (POAG), whose intraocular pressures (IOP) was 21mm Hg or above, with and without using anti-glaucoma treatment.Patients who had secondary or rosette shaped cataract, past ocular trauma (including ocular surgery along with its intraoperative or post-operative complications) and trauma after phacotrabeculectomy procedure during the follow up period were excluded from this study.Results: All 121 patients underwent Phacotrabeculectomy. Follow up was done for 5 months. Preoperative mean intraocular pressure (IOP) was 23.53 ± 4.22SD which reduced to 12.90 ± 2.09SD postoperatively which was highly significant with p- value=0.001Conclusion: Phacotrabeculectomy reduced Intraocular pressure by >10 mm Hg in our study which showed that this procedure is very effective in coexisting age related cataract and primary open angle glaucoma.Keywords: Age related cataract, Angle closure glaucoma, Combined phaco-trabeculectomy, Glaucoma, Intraocular pressure, Open angle glaucoma, Trabeculectomy.
{"title":"The Efficacy of Phacotrabeculectomy in Reducing Intraocular Pressure","authors":"Zahir Khan Khalil, Shafqat Ali Shah, Amir Naseem, Saman Mudassir, Asif Mehmood Orakzai","doi":"10.52206/jsmc.2024.14.2.809","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.809","url":null,"abstract":"Background: Primary open angle glaucoma and age related cataract are ocular comorbidities which can occur in some individuals at different times. Phacoemulsification is carried out for restoration of vision decreased by cataract while trabeculectomy is a procedure to decrease the intra ocular pressure. To save the time, money and stay in the hospital, phacotrabeculectomy is a single procedure which can fulfill both the restoration of vision and decrease intraocular pressure. Objectives: To determine the efficacy of phacotrabeculectomy in decreasing the intraocular pressure in patients having both primary open angle glaucoma and age related cataract.Materials and Methods: This study was conducted at the Eye department, Hayatabad Medical Complex, Peshawar, from 1st August, 2022 to 1st February 2023 after getting the permission from Ethical Committee to do this study. Patients both males and females, from 40-80 years of age, who had coexisting age related cataract (ARC) and Primary open angle glaucoma (POAG), whose intraocular pressures (IOP) was 21mm Hg or above, with and without using anti-glaucoma treatment.Patients who had secondary or rosette shaped cataract, past ocular trauma (including ocular surgery along with its intraoperative or post-operative complications) and trauma after phacotrabeculectomy procedure during the follow up period were excluded from this study.Results: All 121 patients underwent Phacotrabeculectomy. Follow up was done for 5 months. Preoperative mean intraocular pressure (IOP) was 23.53 ± 4.22SD which reduced to 12.90 ± 2.09SD postoperatively which was highly significant with p- value=0.001Conclusion: Phacotrabeculectomy reduced Intraocular pressure by >10 mm Hg in our study which showed that this procedure is very effective in coexisting age related cataract and primary open angle glaucoma.Keywords: Age related cataract, Angle closure glaucoma, Combined phaco-trabeculectomy, Glaucoma, Intraocular pressure, Open angle glaucoma, Trabeculectomy.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678421","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: Cesarian section, an increasingly popular obstetric procedure, can be performed under general and regional anesthesia. Spinal anesthesia, a form of regional anesthesia has gained popularity over time due to its overall safety.Objectives: To study the maternal experience after going through cesarian under spinal anesthesia.Material and Methods: This was a cross sectional study carried out on admitted patients in Lady Reading Hospital, MTI, Peshawar. About 196 post-op admitted patients were selected by non-probability convenience sampling from 1st November 2023 till 15th December 2023. They were assessed with the help of questionnaire on their experience of spinal anesthesia on 3rd post cesarian day. Patents having had surgery under general anesthesia, primarily or secondarily, and those who had any additional procedure post operatively after cesarian were excluded. Data was analyzed on SPSS v23. Frequency and percentages were determined for categorical variables. Chi square test was applied for categorical variables with p value of <0.05 taken significant.Results: Of 196 patients, mean age of the participants was 29 ± 6 years, of whom 74 (37%) had elective and 122 (63%) had emergency cesarian section. Parity ranged from 1 to 13, with most parturients having parity in the range of 1-6. 90% of patients were satisfied with preoperative information provided. About 55% had nausea, 15% had dyspnea while 39% (n=77) had palpitation during the surgery. Nearly 18% did not like the feeling of being aware intraoperatively. However 98% (n=193) of patients were satisfied with responsiveness of anesthesia staff to their situation. About 105 (53%) patients affirmed that would like to have spinal anesthesia again in future if needed, 39% were unsure and 14 (7%) patients did not like it.Conclusion: Spinal anesthesia is an effective way of providing surgical anesthesia while maintaining high level of maternal satisfaction.Keywords: Cesarian section, Maternal satisfaction, Spinal anesthesia.
{"title":"Maternal Experience of Spinal Anesthesia for Cesarian Section, A Cross-Sectional Study","authors":"Nazish Hayat, Wajeeha Syed, Laila Zeb, Sidrah Yousafzai","doi":"10.52206/jsmc.2024.14.2.861","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.861","url":null,"abstract":"Background: Cesarian section, an increasingly popular obstetric procedure, can be performed under general and regional anesthesia. Spinal anesthesia, a form of regional anesthesia has gained popularity over time due to its overall safety.Objectives: To study the maternal experience after going through cesarian under spinal anesthesia.Material and Methods: This was a cross sectional study carried out on admitted patients in Lady Reading Hospital, MTI, Peshawar. About 196 post-op admitted patients were selected by non-probability convenience sampling from 1st November 2023 till 15th December 2023. They were assessed with the help of questionnaire on their experience of spinal anesthesia on 3rd post cesarian day. Patents having had surgery under general anesthesia, primarily or secondarily, and those who had any additional procedure post operatively after cesarian were excluded. Data was analyzed on SPSS v23. Frequency and percentages were determined for categorical variables. Chi square test was applied for categorical variables with p value of <0.05 taken significant.Results: Of 196 patients, mean age of the participants was 29 ± 6 years, of whom 74 (37%) had elective and 122 (63%) had emergency cesarian section. Parity ranged from 1 to 13, with most parturients having parity in the range of 1-6. 90% of patients were satisfied with preoperative information provided. About 55% had nausea, 15% had dyspnea while 39% (n=77) had palpitation during the surgery. Nearly 18% did not like the feeling of being aware intraoperatively. However 98% (n=193) of patients were satisfied with responsiveness of anesthesia staff to their situation. About 105 (53%) patients affirmed that would like to have spinal anesthesia again in future if needed, 39% were unsure and 14 (7%) patients did not like it.Conclusion: Spinal anesthesia is an effective way of providing surgical anesthesia while maintaining high level of maternal satisfaction.Keywords: Cesarian section, Maternal satisfaction, Spinal anesthesia.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678707","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.804
Muhammad Usman, Naveed Khan, Shafiq Ahmad, Inayat Ullah, Ubaidullah, Ashfaq Hussain
Back ground: Pain is one of the sequel of tonsillectomy, as reported in various studies. Tonsillectomy can be done by various methods, so aim of the present study is to evaluate pain of tonsillectomy comparing cold steel dissection method with bipolar diathermy method.Objective: To evaluate post-tonsillectomy pain comparing cold steel dissection method with bipolar diathermy method.Material and Methods: This prospective, randomized, controlled trial was conducted in ENT Department, from 18th January 2021 to January 30th 2022. Post tonsillectomy pain was measured by using visual analogue scale which consists of a 10 cm line with score of 10 means worse pain and score of zero means no pain. In this study a total sample size was 186 patients (i.e. 93 in each group), who were observed by taking the following parameters. Mean ± SD of group A (bipolar diathermy group) = 2.27 ± 1.25. Mean ± SD of group B (cold steel dissection group) = 1.59 ± 1.59. Confidence interval (2-sided) =95%. Power=90%. More over consecutive (nonprobability) sampling technique was used for sample collection.Results: In bipolar dissection group (38%) patients were male and (62%) patients were female. Where as in cold dissection group (40%) patients were male and (60%) patients were female. The mean pain score at 24 hours, 2ndpost operative day, 7th post operative day among two groups was analyzed. In bipolar dissection group, mean pain score at 24 hours was 3.5 ± 0.66, mean pain score at 2nd post operative day was 2.93 ± 0.73 and mean pain score at 7th post operative was 1.59 ± 1.02. Where as in cold dissection group, mean pain score at 24 hours was 3.33 ± 0.53 with a p value of 0.0543, mean pain score at 2ndpost operative day was 2.34 ± 0.60 with a p value of 0.0001and mean pain score at 7th post operative was 1.46 ± 0.82 with a p value of 0.3394.Conclusion: Our study concludes that mean pain score is less in cold steel dissection tonsillectomy as compared to bipolar diathermy tonsillectomy.Keywords: Analogue pain scale, Surgical Diathermy, Tonsillectomy.
{"title":"Post-Tonsillectomy Pain:Is Cold Steel Dissection Method or Bipolar Diathermy Dissection Method is less Painful?","authors":"Muhammad Usman, Naveed Khan, Shafiq Ahmad, Inayat Ullah, Ubaidullah, Ashfaq Hussain","doi":"10.52206/jsmc.2024.14.2.804","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.804","url":null,"abstract":"Back ground: Pain is one of the sequel of tonsillectomy, as reported in various studies. Tonsillectomy can be done by various methods, so aim of the present study is to evaluate pain of tonsillectomy comparing cold steel dissection method with bipolar diathermy method.Objective: To evaluate post-tonsillectomy pain comparing cold steel dissection method with bipolar diathermy method.Material and Methods: This prospective, randomized, controlled trial was conducted in ENT Department, from 18th January 2021 to January 30th 2022. Post tonsillectomy pain was measured by using visual analogue scale which consists of a 10 cm line with score of 10 means worse pain and score of zero means no pain. In this study a total sample size was 186 patients (i.e. 93 in each group), who were observed by taking the following parameters. Mean ± SD of group A (bipolar diathermy group) = 2.27 ± 1.25. Mean ± SD of group B (cold steel dissection group) = 1.59 ± 1.59. Confidence interval (2-sided) =95%. Power=90%. More over consecutive (nonprobability) sampling technique was used for sample collection.Results: In bipolar dissection group (38%) patients were male and (62%) patients were female. Where as in cold dissection group (40%) patients were male and (60%) patients were female. The mean pain score at 24 hours, 2ndpost operative day, 7th post operative day among two groups was analyzed. In bipolar dissection group, mean pain score at 24 hours was 3.5 ± 0.66, mean pain score at 2nd post operative day was 2.93 ± 0.73 and mean pain score at 7th post operative was 1.59 ± 1.02. Where as in cold dissection group, mean pain score at 24 hours was 3.33 ± 0.53 with a p value of 0.0543, mean pain score at 2ndpost operative day was 2.34 ± 0.60 with a p value of 0.0001and mean pain score at 7th post operative was 1.46 ± 0.82 with a p value of 0.3394.Conclusion: Our study concludes that mean pain score is less in cold steel dissection tonsillectomy as compared to bipolar diathermy tonsillectomy.Keywords: Analogue pain scale, Surgical Diathermy, Tonsillectomy.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679220","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.302
Mian Muhammad Naveed, Shabir Ahmed Orakzai, Siyab Ahmad, Mohibullah Khan, Asfandyar Shah Roghani, Humaira Khan
Background: Thalassemia is a frequent hereditary genetic with different clinical manifestations from mild to severe based on its genetic. Beta thalassemia major is the worse form of this disease caused by decreased or absent beta globin chains of hemoglobin. Regular blood transfusion is the main aim leads to iron overload and deposition of iron in different organs.Objectives: To determine different serum distribution levels and correlation of copper and zinc in transfusion dependent thalassemia patients Material and Methods: This was a descriptive cross-sectional study in which a non-probability convenient sampling technique was used for sample collection. This study was conducted in KPK in a total of 137 patients, who were diagnosed cases of thalassemia major by hemoglobin electrophoresis, enzyme linked immunosorbent assay (ELISA) method and receiving iron and folate therapy. SPSS version 22 was used and Pearson's correlation coefficient was applied. P-value 0.05 was considered significant.Results: In this study mean age was 6.7±3.49 years. 77 (56%) percent children were male while 64 (44%) children were female. Mean hemoglobin (Hb) level was 7.43±1.3 gm/dl. Mean SGPT score was 26.28 ± 7.51. Mean blood urea was 21.10 ± 8.49 mmol/l while mean serum creatinine level was 0.56 ± 0.26 mg/dl. Mean serum zinc level was 13.36 ± 11.12mg/dl while mean serum copper level was 1.21± 0.60 mg/dl and mean serum ferritin level was 6682 ± 533 Ug/l.Conclusion: This study showed hypozincemia in thalassemia major patients, but copper deficit was not present. There was no substantial variance between serum ferritin level and mean serum concentration of zinc and copper in this study. Ancillary assessments in this respect is recommended. Keywords: Copper, Thalassemia, Zinc
{"title":"Serum Zinc and Copper Levels in Children with Thalassemia Major","authors":"Mian Muhammad Naveed, Shabir Ahmed Orakzai, Siyab Ahmad, Mohibullah Khan, Asfandyar Shah Roghani, Humaira Khan","doi":"10.52206/jsmc.2024.14.2.302","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.302","url":null,"abstract":"Background: Thalassemia is a frequent hereditary genetic with different clinical manifestations from mild to severe based on its genetic. Beta thalassemia major is the worse form of this disease caused by decreased or absent beta globin chains of hemoglobin. Regular blood transfusion is the main aim leads to iron overload and deposition of iron in different organs.Objectives: To determine different serum distribution levels and correlation of copper and zinc in transfusion dependent thalassemia patients Material and Methods: This was a descriptive cross-sectional study in which a non-probability convenient sampling technique was used for sample collection. This study was conducted in KPK in a total of 137 patients, who were diagnosed cases of thalassemia major by hemoglobin electrophoresis, enzyme linked immunosorbent assay (ELISA) method and receiving iron and folate therapy. SPSS version 22 was used and Pearson's correlation coefficient was applied. P-value 0.05 was considered significant.Results: In this study mean age was 6.7±3.49 years. 77 (56%) percent children were male while 64 (44%) children were female. Mean hemoglobin (Hb) level was 7.43±1.3 gm/dl. Mean SGPT score was 26.28 ± 7.51. Mean blood urea was 21.10 ± 8.49 mmol/l while mean serum creatinine level was 0.56 ± 0.26 mg/dl. Mean serum zinc level was 13.36 ± 11.12mg/dl while mean serum copper level was 1.21± 0.60 mg/dl and mean serum ferritin level was 6682 ± 533 Ug/l.Conclusion: This study showed hypozincemia in thalassemia major patients, but copper deficit was not present. There was no substantial variance between serum ferritin level and mean serum concentration of zinc and copper in this study. Ancillary assessments in this respect is recommended. Keywords: Copper, Thalassemia, Zinc","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678416","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.782
Saif Ud Din Awan, Ayesha Naureen Awan, Nadia Haleem, Hina Fayyaz
Background: Laparoscopic surgery is an expanding field which is recognized as gold standard for cholecystectomy, it is being increasingly used by many surgical subspecialties with advantage of being minimal invasive and being both diagnostic and therapeutic. Objectives: This study was done to evaluate the feasibility of laparoscopic appendectomy in a developing world scenario.Material and Methods: This observational cross-sectional study was conducted under department of general surgery from September 2019 to August 2021. The patients presenting to the ER department were evaluated based on Alvarado score. Alternate patients underwent laparoscopic appendectomy (LA) and open appendectomy (OA). Based upon clinical and imaging signs of acute appendicitis (i.e. Alvarado score of 7 or more) and consent to be the part of study, were used as inclusion criteria, while pregnancy, patients who could not tolerate increased intra-abdominal pressure/prolonged anesthesia, patients under 10 years of age and patients with evidence of appendicular mass formation were excluded from the study. The standard surgical techniques were performed for both groups and the patients were followed up in immediate post-operative period, at 6 months and one year. Results: The parameters observed were duration of surgery average 25 minutes (range 15-50 mins) for OA and 70 minutes (range 40-90 mins) for LA (P-Value 1.41E-70), return to preoperative activity level was 13 days (range 10-17 days) for OA and 10 days (range 9-14 days) for LA (P-Value 6.69034E-22), and average cost for OA was PKR 35279.00 while for LA was PKR 72168.00 (P-Value 1.24442E-60). Remaining parameters were not significantly different.Conclusion: The evidence available clearly demonstrates that laparoscopic appendectomy is superior to open appendectomy in terms of hospital stay, post-operative pain and return to work, however in a few situations the procedure needs to be converted therefore the surgeon must be conversant with open appendectomy for complicated case. Moreover, cost is a major factor determining the choice of procedure specially in the developing countries. Keywords: Appendectomy, Developing world, Laparoscopic Appendectomy, Open versus Laparoscopic Appendectomy, Pakistan,
{"title":"Appendectomy Open Versus Laparoscopic in Developing World Scenario","authors":"Saif Ud Din Awan, Ayesha Naureen Awan, Nadia Haleem, Hina Fayyaz","doi":"10.52206/jsmc.2024.14.2.782","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.782","url":null,"abstract":"Background: Laparoscopic surgery is an expanding field which is recognized as gold standard for cholecystectomy, it is being increasingly used by many surgical subspecialties with advantage of being minimal invasive and being both diagnostic and therapeutic. Objectives: This study was done to evaluate the feasibility of laparoscopic appendectomy in a developing world scenario.Material and Methods: This observational cross-sectional study was conducted under department of general surgery from September 2019 to August 2021. The patients presenting to the ER department were evaluated based on Alvarado score. Alternate patients underwent laparoscopic appendectomy (LA) and open appendectomy (OA). Based upon clinical and imaging signs of acute appendicitis (i.e. Alvarado score of 7 or more) and consent to be the part of study, were used as inclusion criteria, while pregnancy, patients who could not tolerate increased intra-abdominal pressure/prolonged anesthesia, patients under 10 years of age and patients with evidence of appendicular mass formation were excluded from the study. The standard surgical techniques were performed for both groups and the patients were followed up in immediate post-operative period, at 6 months and one year. Results: The parameters observed were duration of surgery average 25 minutes (range 15-50 mins) for OA and 70 minutes (range 40-90 mins) for LA (P-Value 1.41E-70), return to preoperative activity level was 13 days (range 10-17 days) for OA and 10 days (range 9-14 days) for LA (P-Value 6.69034E-22), and average cost for OA was PKR 35279.00 while for LA was PKR 72168.00 (P-Value 1.24442E-60). Remaining parameters were not significantly different.Conclusion: The evidence available clearly demonstrates that laparoscopic appendectomy is superior to open appendectomy in terms of hospital stay, post-operative pain and return to work, however in a few situations the procedure needs to be converted therefore the surgeon must be conversant with open appendectomy for complicated case. Moreover, cost is a major factor determining the choice of procedure specially in the developing countries. Keywords: Appendectomy, Developing world, Laparoscopic Appendectomy, Open versus Laparoscopic Appendectomy, Pakistan,","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678188","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 : 2024-04-21DOI: 10.52206/jsmc.2024.14.2.821
Nisaruddin, Muslim Khan, Saima Rahman, Iqra Muslim
Background: Physiotherapeutic interventions play a crucial role in motor re-learning and functional recovery for stroke patients with upper and lower limb motor impairments. Among these interventions, dual-task training (DTT) has demonstrated significant effectiveness in enhancing the functional recovery of stroke patients. Objective: This study aims to compare the effectiveness of DTT and conventional physical therapy in ambulating right-hemiplegic stroke patients.Material and Methods: A randomized control trial (RCT) was conducted at the Department of Rehabilitation Medicine, Saidu group of Teaching Hospital, 2nd March 2020 to 3rd August 2020. Chronic right-hemiplegic stroke patients meeting set inclusion criteria were randomly assigned to two groups: the treatment group (TG) receiving DTT and the control group (CG) undergoing conventional physical therapy. DTT interventions included walking forward, backward, and sideways on a smooth surface while holding an 80-gram sandbag. The CG received conventional physiotherapy involving mat activities, strengthening, stretching exercises, and ambulation/gait training. Pre- and post-tests collected clinical data analyzed on SPSS 22 included spatial and temporal variables, 10-Meter Walk Test (10MWT), Time Up & Go Test (TUG), step length, cadence, cycle time, and stride length. Results: Out of 18 patients, each group had 50%, comprising 5 males (28%) and 4 females (22%). The mean age in CG was 57.20± 5.20, and in TG, it was 57.27± 6.10 years. Baseline clinical parameters were nearly identical between groups (P>0.05). Post-test scores revealed significant improvements in spatial and temporal gait variables, 10MWT score, cadence, step length, stride, and cycle time in TG compared to CG (P<0.05). Conclusion: Dual-task training and conventional physical therapy both significantly enhance the functional ability of right-hemiplegic patients across all gait temporal and spatial parameters. Keywords: Conventional physical therapy, Dual task training, Gait & ambulation, Stroke.
{"title":"Dual-Task Specific Training or Conventional Physiotherapeutic Interventions, Which one is more Effective?","authors":"Nisaruddin, Muslim Khan, Saima Rahman, Iqra Muslim","doi":"10.52206/jsmc.2024.14.2.821","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.821","url":null,"abstract":"Background: Physiotherapeutic interventions play a crucial role in motor re-learning and functional recovery for stroke patients with upper and lower limb motor impairments. Among these interventions, dual-task training (DTT) has demonstrated significant effectiveness in enhancing the functional recovery of stroke patients. Objective: This study aims to compare the effectiveness of DTT and conventional physical therapy in ambulating right-hemiplegic stroke patients.Material and Methods: A randomized control trial (RCT) was conducted at the Department of Rehabilitation Medicine, Saidu group of Teaching Hospital, 2nd March 2020 to 3rd August 2020. Chronic right-hemiplegic stroke patients meeting set inclusion criteria were randomly assigned to two groups: the treatment group (TG) receiving DTT and the control group (CG) undergoing conventional physical therapy. DTT interventions included walking forward, backward, and sideways on a smooth surface while holding an 80-gram sandbag. The CG received conventional physiotherapy involving mat activities, strengthening, stretching exercises, and ambulation/gait training. Pre- and post-tests collected clinical data analyzed on SPSS 22 included spatial and temporal variables, 10-Meter Walk Test (10MWT), Time Up & Go Test (TUG), step length, cadence, cycle time, and stride length. Results: Out of 18 patients, each group had 50%, comprising 5 males (28%) and 4 females (22%). The mean age in CG was 57.20± 5.20, and in TG, it was 57.27± 6.10 years. Baseline clinical parameters were nearly identical between groups (P>0.05). Post-test scores revealed significant improvements in spatial and temporal gait variables, 10MWT score, cadence, step length, stride, and cycle time in TG compared to CG (P<0.05). Conclusion: Dual-task training and conventional physical therapy both significantly enhance the functional ability of right-hemiplegic patients across all gait temporal and spatial parameters. Keywords: Conventional physical therapy, Dual task training, Gait & ambulation, Stroke.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140678858","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: Infertility is a global health issue, with both genders having equal contribution. Approximately 15% of couples having difficulty to conceive after one year of consistent, unprotected sexual activity, infertility. Objectives: To identify the modifiable risk factors of male infertility in patients visiting a private hospital of Peshawar.Material and Methods: The study was a descriptive Cross-sectional of six months duration. A total sample size of 733 married male patients visiting private hospital were included and those who were reluctant to participate were excluded. Structured questionnaire were filled. Non probability convenience sampling technique was used and data was analyzed using SPSSversion 22Results: Out of 733 sample size 397(54%),336 (45.9%) had secondary and primary infertility, respectively. Risk factors, like obesity, smoking, diabetes mellitus, congenital anomalies and varicocele were linked to infertility with p valve < 0.05. The majority 568 (77.5%) had normal semen count, Oligospermia and Azoospermia were 11%.Conclusion: Our study concluded that smoking, diabetes mellitus, obesity, semen abnormalities and congenital anomalies were related to both primary and secondary infertility among men in Peshawar.Keywords: Male infertility, Obesity, Risk factors, Semen analysis, Semen abnormalities, Tobacco use.
{"title":"Preventable Male Infertility: Identifying the Modifiable Risk Factors","authors":"Nighat Musa, Waseeq Ullah, Naeemullah, Rubeena Gul, Aziza Alam, Sherbaz Khan","doi":"10.52206/jsmc.2024.14.2.833","DOIUrl":"https://doi.org/10.52206/jsmc.2024.14.2.833","url":null,"abstract":"Background: Infertility is a global health issue, with both genders having equal contribution. Approximately 15% of couples having difficulty to conceive after one year of consistent, unprotected sexual activity, infertility. Objectives: To identify the modifiable risk factors of male infertility in patients visiting a private hospital of Peshawar.Material and Methods: The study was a descriptive Cross-sectional of six months duration. A total sample size of 733 married male patients visiting private hospital were included and those who were reluctant to participate were excluded. Structured questionnaire were filled. Non probability convenience sampling technique was used and data was analyzed using SPSSversion 22Results: Out of 733 sample size 397(54%),336 (45.9%) had secondary and primary infertility, respectively. Risk factors, like obesity, smoking, diabetes mellitus, congenital anomalies and varicocele were linked to infertility with p valve < 0.05. The majority 568 (77.5%) had normal semen count, Oligospermia and Azoospermia were 11%.Conclusion: Our study concluded that smoking, diabetes mellitus, obesity, semen abnormalities and congenital anomalies were related to both primary and secondary infertility among men in Peshawar.Keywords: Male infertility, Obesity, Risk factors, Semen analysis, Semen abnormalities, Tobacco use.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140679029","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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