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Knowledge and Attitude Regarding Organ Donation in Undergraduate Medical Students of District Peshawar, Khyber-Pakhtunkhwa 开伯尔-普什图省白沙瓦地区医科本科生对器官捐献的认识和态度
Pub Date : 2023-09-27 DOI: 10.52206/jsmc.2023.13.3.786
Maryam Khan, Bibi Aliya, Khadija Nowaira Abdullah, Adeela Mustafa, Brikhna Tariq, Sawera Tahir
Background: Organ transplant can serve as a lifesaving option for end-stage organ failure. Worldwide, with growing number of cases of organ failure, both the need & demand for the donation of organs has also increased.Objectives: To assess the level of knowledge and explore attitude of undergraduate medical students of Peshawar towards organ donation.Material and Methods: A cross-sectional study was carried out among 4th & 5th year students of a Public and Private Medical Colleges of Peshawar, KPK from January to April 2018. The 350 participants were approached through convenient sampling method. The data were collected through self-administered validated questionnaire. The data analysis was done for descriptive statistics on SPSS 21.Results: Out of 350 participants, 324 (93%) students have filled out the questionnaire. Only 210 (64.8%) of the students had adequate cumulative awareness scores while 114 (35.2%) students had inadequate awareness scores regarding organ donation. Only 12% of the participants were motived positively for organ donation whereas 13% has refused for organ donation. The main reason for not promoting organ donation was found to be religious beliefs corresponding to 48.6%. Statistically significant correlation (P<0.001) was observed between religious beliefs and the attitude regarding organ donation promotion. Conclusion: Though, medical students are found to have adequate knowledge but a gap is found between their knowledge and attitude towards phenomenon of organ donation. Effective actions are required to improve the awareness regarding organ donation in young doctors and medical students to translate their knowledge into definite actions. This requires modification in our educational system with the involvement of social media and religious scholars. Keywords: Attitude, Knowledge, Medical students, Organ donation, Transplantation,
背景:器官移植是终末期器官衰竭患者的救命选择。在世界范围内,随着器官衰竭病例的增加,器官捐献的需求也在增加:评估白沙瓦医科本科生对器官捐献的了解程度,并探讨他们对器官捐献的态度:2018年1月至4月,在克钦邦白沙瓦市一所公立和私立医学院的4年级和5年级学生中开展了一项横断面研究。通过方便抽样的方法接触了 350 名参与者。数据通过自填式有效问卷收集。数据分析采用 SPSS 21 进行描述性统计:在 350 名参与者中,有 324 名(93%)学生填写了问卷。只有 210 名学生(64.8%)对器官捐献有足够的累积认识,而 114 名学生(35.2%)对器官捐献的认识不足。只有 12%的参与者有积极的器官捐献动机,而 13%的参与者拒绝器官捐献。不提倡器官捐献的主要原因是宗教信仰,占 48.6%。据统计,宗教信仰与促进器官捐献的态度之间存在明显的相关性(P<0.001)。结论虽然医学生对器官捐献有足够的认识,但他们对器官捐献的认识和态度之间存在差距。需要采取有效行动,提高年轻医生和医学生对器官捐献的认识,将他们的知识转化为明确的行动。这就需要在社会媒体和宗教学者的参与下,对我们的教育体系进行修改。关键词态度 知识 医学生 器官捐献 移植
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引用次数: 0
Effectiveness of Nifedipine in the Treatment of Threathened Preterm Labour 硝苯地平治疗早产威胁的有效性
Pub Date : 2023-09-27 DOI: 10.52206/jsmc.2023.13.3.774
Sadia Ali, Rabeea Sadaf, Bushra Rauf, Kulsoom Iqbal, Umaiyma Farhad, Nasreen Kishwar
Background: Preterm birth is one of the most important and major causes of perinatal morbidity and mortality wordwide. Strategies should be adopted to decrease the incidence of pre-term labour and delivery to avoid the associated drastic fetal and neonatal consequences. Objective: To evaluate the effectiveness of Nifedipine in the treatment of spontaneous preterm labour. Material and Methods: This is a Randomised control trial which was conducted in the department of Obstetrics and Gynecology, Hayatabad Medical Complex, from 1st June 2022 to 30th November 2022. Total 50 pregnant women with singleton pregnancy with threatened preterm labor between 28 and 34 weeks of pregnancy on LMP were included.Results: Total 10 (20.0%) patients had a delay in delivery up to < 2 days while 40 (80.0%) patients had a delay in their deliveries for > 2 days, therefore, effectiveness of Nifedipine in the treatment of spontaneous threatened preterm labor was achieved in 40 (80%) patients in terms of delay in their deliveries. Conclusion: This study demonstrated that Nifedipine successfully delayed spontaneous preterm labor for > 48 hours and thus gave sufficient time for in utero transfer and corticosteroid effect.Keywords: Nifedipine, Preterm labor, Tocolysis.
背景:早产是全世界围产期发病率和死亡率最重要和最主要的原因之一。应采取策略降低早产和分娩的发生率,以避免对胎儿和新生儿造成严重后果。目的评估硝苯地平治疗自发性早产的效果。材料与方法:这是一项随机对照试验,于 2022 年 6 月 1 日至 2022 年 11 月 30 日在 Hayatabad 综合医院妇产科进行。共纳入了 50 名单胎妊娠孕妇,这些孕妇的 LMP 值在妊娠 28 至 34 周之间,有早产的危险:结果:共有 10 名(20.0%)患者的分娩延迟时间小于 2 天,而 40 名(80.0%)患者的分娩延迟时间大于 2 天。结论本研究表明,硝苯地平可成功延迟自发性早产超过 48 小时,从而为宫内转运和皮质类固醇作用提供了充足的时间:硝苯地平 早产 催产素
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引用次数: 0
Prevention of Neonatal Respiratory Distress Syndrome by Antenatal Steroid Administration 产前服用类固醇预防新生儿呼吸窘迫综合征
Pub Date : 2023-09-27 DOI: 10.52206/jsmc.2023.13.3.771
Rabeea Sadaf, Ghazala Shams, Bushra Rauf, Nasreen Kishwar, Umaiyma Farhad, Samreen
Background: Exposure to antenatal steroids (A.N.S.) decreases the incidence of neonatal respiratory distress syndrome and other morbidities in premature infants. If left untreated, death may occur from progressive hypoxia and respiratory failure. In survivors, resolution begins between 2 to 4 days.Objective: To determine the efficacy of antenatal steroids in preventing respiratory distress syndrome in premature neonates. Material and Methods: A randomized trial, analytical study with a sample size of 152 was conducted in the Department of Obstetrics and Gynecology, Hayatabad Medical Complex, Peshawar. The study duration was from 16th July 2022 to 18th June 2023. The study included neonates born at 24 to 34 weeks of gestation. Neonates born at fewer than 34 (24 to 34 weeks) weeks gestation were given 3 or 4 mL of surfactant from lipids taken from calf lung lavage. The proteins were decreased from more than 10% to less than 1% of the phospholipid weight using the lipid extraction procedure. The chi-square test was used.Results: Analysis was performed for the 152 VLBW infants the infants who received antenatal corticosteroids was 37 to 45% were gestational age 2434 weeks. While infants who received surfactant decreased gradually as gestational age increased. A significant decrease in surfactant used in the late period, with a 510% reduction in each gestational group.Conclusion: This study reaffirms the value of administering antenatal steroids to premature neonates. This study showed the potential use of ante natal steroids has effectively mitigated respiratory distress syndrome. These findings underscore the significance of antenatal corticosteroid therapy in reducing respiratory morbidity in preterm neonates and emphasize its role in enhancing lung maturation and neonatal outcomes.Keywords: Antenatal corticosteroids, Preterm infants, Respiratory distress syndrome, Surfactant, Very low birth weight.
背景:使用产前类固醇(A.N.S.)可降低早产儿新生儿呼吸窘迫综合征和其他疾病的发病率。如果不及时治疗,新生儿可能会因进行性缺氧和呼吸衰竭而死亡。在幸存者中,病情会在 2 到 4 天内开始缓解:目的:确定产前类固醇对预防早产新生儿呼吸窘迫综合征的疗效。材料与方法白沙瓦市 Hayatabad 综合医疗中心妇产科进行了一项随机试验分析研究,样本量为 152 份。研究时间为 2022 年 7 月 16 日至 2023 年 6 月 18 日。研究对象包括妊娠 24 至 34 周出生的新生儿。妊娠不足 34 周(24 至 34 周)出生的新生儿可获得 3 或 4 毫升从小牛肺灌洗液中提取的脂质制成的表面活性物质。使用脂质提取程序将蛋白质从磷脂重量的 10%以上降至 1%以下。结果采用卡方检验:对152名超低体重儿进行了分析,接受产前皮质类固醇治疗的婴儿占37%至45%,胎龄为2434周。随着胎龄的增加,使用表面活性物质的婴儿逐渐减少。晚期使用表面活性物质的婴儿明显减少,各胎龄组减少了510%:本研究再次证实了对早产新生儿使用产前类固醇的价值。这项研究表明,产前使用类固醇可有效缓解呼吸窘迫综合征。这些发现强调了产前皮质类固醇治疗在降低早产新生儿呼吸系统发病率方面的重要性,并强调了其在促进肺成熟和新生儿预后方面的作用:产前皮质类固醇 早产儿 呼吸窘迫综合征 表面活性物质 极低出生体重儿
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引用次数: 0
Even Young Healthy Looking Adults are not Spared 即使是看起来健康的年轻成年人也不能幸免
Pub Date : 2023-09-27 DOI: 10.52206/jsmc.2023.13.3.811
Abdul Hadi
Every year 29th September is observed as World Heart Day. The purpose of observing this day on yearly basis is to create awareness among the general population regarding the preventive aspects of ischemic heart diseases (IHD), and motivate them to seek early medical care.
每年的 9 月 29 日是世界心脏日。每年纪念世界心脏日的目的在于提高公众对缺血性心脏病(IHD)的预防意识,并鼓励他们及早就医。
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引用次数: 0
Career Choices of Junior Doctors: Faculty Perspective 初级医生的职业选择:学院视角
Pub Date : 2023-09-27 DOI: 10.52206/jsmc.2023.13.3.807
Jibran Umar Ayub, Abdul Wahab, Ayesha Qaisar
There has been tremendous increase in population of doctors and mushrooming of medical institutions that has a colossal impact on the quality of medical education. There is more time, financial, resources and logistic constraints that has added to manifold headache of all the vital stakeholders including the medical students, junior doctors, administration and faculty. Flexner in his report has excellent recommendations for improving the standards and one of them was to increase the essential prerequisites for entering into medical training and train the physicians in a scientific manner.
医生人数的大幅增加和医疗机构的如雨后春笋般涌现,对医学教育的质量产生了巨大影响。更多的时间、资金、资源和后勤限制让包括医学生、初级医生、行政人员和教师在内的所有重要利益相关者倍感头痛。弗莱克斯纳在其报告中就提高标准提出了很好的建议,其中之一就是增加进入医学培训的基本前提,并以科学的方式培训医生。
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引用次数: 0
The Hearing Impaired Child- Pattern of Tympanograms in Otitis Media with Effusion 听力受损儿童-渗出性中耳炎的鼓室图模式
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.772
Adnan Yar Muhammad, Khurshid Anwar, Saeed Khan
Background: Otitis media with effusion (OME) is a common cause of treatable hearing loss in children. Tympanometry is an objective tool for assessment of this condition. Of the various tympanometric curves, Type B flat curve is commonly associated with OME. The study aims to determine the various curves associated with OME and find the commonest one.Objective: To determine the frequency of various types of curves obtained on tympanogram in children suffering from otitis media with effusion.Material and Methods: This descriptive cross sectional study involving 350 ears with OME was conducted in ENT Department of Medical Teaching Institution, Hayatabad Medical Complex, Peshawar. Non-probability convenience sampling technique was used to select children with OME.History, Clinical examination, otoscopy, audiometry and tympanometry were used to diagnose OME. Tympanometry was performed to determine the type of curves using Jerger classification. The frequency of the various types of curves obtained was calculated.Results: The age range of the patient was 3-15 years with mean age of 8.25±3.22 years. The male: female ratio was of 1.22:1. Type B curves were the commonest inall age groups. The overall frequency for Type B curve in the study was 81.4%. Chi square test showed that Type B tympanogram significantly occurred in the lower age groups ranging from 3 to 11 years.Conclusion: Type B tympanogram is the commonest type of curve in children suffering from otitis media with effusion. It is significantly associated with OME in the younger age groups as compared to Type C & Type A. Therefore it can be used for in the diagnosis and follow-up of younger children with OME.Keywords: Audiometry, Glue, Otitis Media with Effusion, Paediatrics, Tympanometry.
背景:渗出性中耳炎(OME)是儿童可治疗听力损失的常见原因。鼓室测量法是评估这种情况的客观工具。在各种鼓室曲线中,B型平坦曲线通常与OME相关。该研究旨在确定与OME相关的各种曲线,并找到最常见的曲线。目的:探讨中耳炎伴渗出性中耳炎患儿鼓膜上各种曲线图的出现频率。材料与方法:本描述性横断面研究在白沙瓦Hayatabad医疗综合医院医学教学机构耳鼻喉科进行,涉及350耳OME。采用非概率方便抽样技术选择OME患儿。病史、临床检查、耳镜检查、听力学和鼓室测量用于诊断OME。鼓室测量法采用Jerger分类确定曲线类型。计算了得到的各类曲线的频率。结果:患者年龄3 ~ 15岁,平均年龄8.25±3.22岁。男女比例为1.22:1。B型曲线在所有年龄组中最常见。研究中B型曲线的总频率为81.4%。卡方检验显示,B型鼓室图在3 ~ 11岁年龄组明显发生。结论:B型鼓膜图是儿童中耳炎伴积液最常见的曲线类型。与C型和a型相比,在年龄较小的年龄组中与OME显著相关,因此可用于年龄较小的OME患儿的诊断和随访。关键词:听力,胶水,渗出性中耳炎,儿科,鼓室测量。
{"title":"The Hearing Impaired Child- Pattern of Tympanograms in Otitis Media with Effusion","authors":"Adnan Yar Muhammad, Khurshid Anwar, Saeed Khan","doi":"10.52206/jsmc.2023.13.2.772","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.2.772","url":null,"abstract":"Background: Otitis media with effusion (OME) is a common cause of treatable hearing loss in children. Tympanometry is an objective tool for assessment of this condition. Of the various tympanometric curves, Type B flat curve is commonly associated with OME. The study aims to determine the various curves associated with OME and find the commonest one.Objective: To determine the frequency of various types of curves obtained on tympanogram in children suffering from otitis media with effusion.Material and Methods: This descriptive cross sectional study involving 350 ears with OME was conducted in ENT Department of Medical Teaching Institution, Hayatabad Medical Complex, Peshawar. Non-probability convenience sampling technique was used to select children with OME.History, Clinical examination, otoscopy, audiometry and tympanometry were used to diagnose OME. Tympanometry was performed to determine the type of curves using Jerger classification. The frequency of the various types of curves obtained was calculated.Results: The age range of the patient was 3-15 years with mean age of 8.25±3.22 years. The male: female ratio was of 1.22:1. Type B curves were the commonest inall age groups. The overall frequency for Type B curve in the study was 81.4%. Chi square test showed that Type B tympanogram significantly occurred in the lower age groups ranging from 3 to 11 years.Conclusion: Type B tympanogram is the commonest type of curve in children suffering from otitis media with effusion. It is significantly associated with OME in the younger age groups as compared to Type C & Type A. Therefore it can be used for in the diagnosis and follow-up of younger children with OME.Keywords: Audiometry, Glue, Otitis Media with Effusion, Paediatrics, Tympanometry.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124713381","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}
引用次数: 0
Corrosive Esophageal Strictures: Alarming News for Gastroenterologists 腐蚀性食管狭窄:胃肠病学家的警示消息
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.784
Ayesha Qaisar, Jibran Umar Ayub Khan, Azhar Zahir Shah
Dysphagia is a common yet alarming symptom reported by patients during routine visits to outpatient clinics of gastroenterology. Most of them have a chronic history gastroesophageal reflux disease and use of proton pump inhibitors or anti reflux medications for years. The agonising part is that they are not referred by the physicians in the general practice. One of the major reasons behind this is persistent reluctance of patients to go for invasive investigations  Gastroesophgeal reflus disease, achalasia ,hiatal hernia,benign esophgeal strictures, barrets esophagus and esophageal carcinoma are common causes of dysphagia. One of the causes which has been quite prevalent in our country is use of corrosives especially young girls and boys who are emotionaland depressed.  They do something very outrageous in a  moment which becomes a reason for regret for a long time .Corrosive esophgeal strictures isn’t that difficult got gastroenterology experts in normal circumstances but the cases can get complicated rarely including the risk of perforation in early stages of injury.Endoscopic dilatation either by Savory or TTS Balloon has been the cardinal line of management of corrosive strictures. They are done after necessary workup and investigations including barium swallow . The real dilemma is that patent develop complications like tracheoesophageal fistula after repeated dilatations. The length of follow up session are also difficult to determine with some centres opting for one weekly and others for two weekly sessions .Weekly sessions have been reported to ease off symptoms like dyphagia but causes higher risk of complications while in case of two weekly follow up there is enhanced risk of recurrence of symptoms and lesser complications.
吞咽困难是一种常见的但令人担忧的症状报告的患者在日常访问门诊胃肠病学。他们大多有胃食管反流病的慢性病史,并使用质子泵抑制剂或抗反流药物多年。痛苦的部分是,他们不是由医生在一般做法。这背后的主要原因之一是患者持续不愿进行有创检查胃食管反流病,贲门失弛缓症,裂孔疝,良性食管狭窄,巴氏食管和食管癌是吞咽困难的常见原因。其中一个原因在我国已经相当普遍是使用腐蚀剂,特别是年轻的女孩和男孩谁是情感和抑郁。他们会做一些非常离谱的事情,这让他们后悔很长一段时间。腐蚀性食管狭窄在正常情况下对胃肠病学专家来说并不难,但这种情况会变得很复杂,很少包括早期受伤时穿孔的风险。内窥镜扩张,无论是咸味或TTS气球已基本线的管理腐蚀性狭窄。它们是在必要的检查和检查后进行的,包括吞钡。真正的困境是患者在反复扩张后会出现气管食管瘘等并发症。随访时间的长短也难以确定,一些中心选择每周一次,另一些则选择两周一次。据报道,每周一次的随访可以缓解吞咽困难等症状,但会导致更高的并发症风险,而如果每周随访两次,则会增加症状复发的风险,并发症较少。
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引用次数: 0
Pericardial Effusion as Initial Presentation of Malignancy 心包积液是恶性肿瘤的最初表现
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.780
Neelam Akhund
Pericardial effusion describes accumulation of fluid in the pericardial space. When it happens with malignancy, it incurs poor prognosis. Most often lung, hematological or breast carcinomas form the background. It may cause hemodynamic instability and cardiac tamponade and require prompt invasive management. This is elaborated by this article. This is a case report of 55 year old Asian man who presented with a month history of lethargy fever, sweating and worsening dyspnea. He was assessed in the Triage room and some imaging was performed. Pericardial effusion was found and emergency pericardiocentesis performed. The patient was managed through multidisciplinary approach.It is, thus, recommended to set a low threshold for diagnosis and management for pericardial effusion.Keywords: Cardiac Tamponade, Case Report, Pericardial Effusion, Pericardiocentesis.
心包积液指的是在心包间隙积聚液体。当它发生在恶性肿瘤时,预后很差。最常见的背景是肺癌、血液癌或乳腺癌。它可能导致血流动力学不稳定和心脏填塞,需要及时的侵入性治疗。本文对此进行了详细阐述。这是一个55岁的亚洲男性的病例报告,他提出了一个月的历史嗜睡热,出汗和呼吸困难加重。他在分诊室接受了评估,并进行了一些影像学检查。发现心包积液并进行了紧急心包穿刺。通过多学科方法对患者进行治疗。因此,建议对心包积液的诊断和治疗设定一个较低的阈值。关键词:心包填塞,病例报告,心包积液,心包穿刺
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引用次数: 0
Unveiling the Frequency of First-Time Pregnancy in Eclamptic Patients 揭示子痫患者首次妊娠的频率
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.754
Azra Salim, Saima Khattak
Background: Primigravida and eclampsia still have not been well studied. This research intends to lighten risk factors and therapeutic care by examining the prevalence of first pregnancies in eclamptic patients. It is essential to comprehend the effects of primigravida in eclampsia to provide better treatment for this vulnerable population.Objective: To determine the frequency of primigravida in patients with eclampsia.Material and Methods: This Cross-sectional study was conducted in the Department of Gynaecology and Obstetrics, Lady Reading Hospital, Peshawar from 06 august 2020 to 06 February 2021.A total of 151 pregnant women with Gestational age > 20 weeks were included in the study. All Basic demographics like age, gestational age, and weight (kg) were recorded. Data regarding eclampsia was noted by the researcher herself and analyzed with a statistical analysis program (SPSS v22). Frequencies and percentages were computed for categorical variables like age groups, history of hypertension and primigravida. Mean, and SD ratios were calculated for quantitative variables like age, gestational age and BMI.Results: The results showed that the mean age was 25.814±2.71 years, the mean gestational age was 32.344±2.94 weeks, and the mean BMI was 24.476±2.24 Kg/m2. A history of hypertension was seen in 9.9% of patients. Primigravida with eclampsia was observed in 33.8% of patients.Conclusion: The study concluded that most pregnant women with eclampsia were primigravida. These results highlight the significance of considering primigravida as a possible risk factor for the onset of eclampsia. Keywords: Eclampsia, Pregnancy, primigravida.
背景:初迁症与子痫的关系尚未得到很好的研究。本研究旨在通过检查子痫患者首次妊娠的患病率来减轻危险因素和治疗护理。重要的是要了解原发在子痫中的作用,为这一弱势群体提供更好的治疗。目的:了解子痫患者初迁症的发生频率。材料和方法:本横断面研究于2020年8月6日至2021年2月6日在白沙瓦雷丁夫人医院妇产科进行。研究共纳入151名孕周> 20周的孕妇。所有基本人口统计数据,如年龄、胎龄和体重(公斤)被记录。有关子痫的数据由研究者自己记录,并使用SPSS v22统计分析程序进行分析。计算了年龄组、高血压史和原发期等分类变量的频率和百分比。计算年龄、胎龄和BMI等定量变量的均值和标准差比。结果:患者平均年龄25.814±2.71岁,平均胎龄32.344±2.94周,平均BMI为24.476±2.24 Kg/m2。9.9%的患者有高血压病史。33.8%的患者伴有子痫。结论:本研究认为妊娠子痫以原发妊娠为主。这些结果强调了考虑原始性作为子痫发病可能的危险因素的重要性。关键词:子痫,妊娠,初迁
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引用次数: 0
In-Hospital Mortality among Patients of Severe Adult Tetanus Presenting with bad Prognostic Factors: A Tertiary Care Hospital Experience 伴有不良预后因素的重症成人破伤风患者的住院死亡率:三级护理医院经验
Pub Date : 2023-06-28 DOI: 10.52206/jsmc.2023.13.2.769
Shafi Ullah Khan, M. K. Farooq, Ejaz Ahmad, M. Khan, I. Alam, Shah Sawar Khan, Nibahat Hameed
Background: Tetanus caused by clostridium tetani, despite being a preventable disease, is still posing a significant health hazard to developing countries like Pakistan. Objective: To determine in-hospital mortality among patients of severe adult tetanus presenting with bad prognostic factors.Material and Methods: This cross-sectional study was conducted at the Department of Medicine, Medical Teaching Institution Lady Reading Hospital, Peshawar, Pakistan from July 13, 2017, to January 13, 2018, on 176 patients. All severe adult tetanus patients as per Ablett Classification with bad prognostic factors (incubation period <7 days, persistent fever >40o C, persistent tachycardia of >120/min, and no history of post-exposure prophylaxis) were included in the study. Patients with compromised renal functions (urea >108 mg/dl, reduced urine output <50 ml/hr) and already diagnosed neuromuscular junction disorders were excluded from the study. Written informed consent was obtained and patients were enrolled in the study. All patients were immediately worked up with detailed history and clinical examinations and were managed as per ICU protocols and followed within the hospital for mortality.Results: Mean age of study participants was 47±10.27 years. The majority of study subjects were males (n=102, 58%), un-immunized (n=88, 50%) or partially immunized (n=26, 15%), socioeconomically poor (n=84, 48%), illiterate (n=82, 47%) and from urban areas (n=114, 65%). In-hospital mortality was recorded in 109 (62%) of the study subjects. In hospital mortality was recorded highest in patients with an age range of 41-65 years (n=70/109, 64.22%), males (n=63/109, 57.8%), unimmunized (n=55/109, 50.45%), poor (n=52/109, 47.7%), illiterate (n=51/109, 46.78%) and urban (n=71/109, 65.14%). Conclusion: In-hospital mortality was high in patients with severe adult tetanus presenting with bad prognostic factors.Keywords: Clostridium tetani, Hospital Mortality, Severe adult tetanus, Tetanus, Tetanus Antitoxin, Tetanus Toxoid, Trismus, Prognostic Factors.
背景:由破伤风梭菌引起的破伤风尽管是一种可预防的疾病,但仍对巴基斯坦等发展中国家构成重大的健康危害。目的:了解伴有不良预后因素的重症成人破伤风患者的住院死亡率。材料和方法:本横断面研究于2017年7月13日至2018年1月13日在巴基斯坦白沙瓦医学教学机构Lady Reading医院医学部进行,共有176名患者。所有预后不良因素(潜伏期40℃,持续性心动过速>120/min,无暴露后预防史)的成人重症破伤风患者均纳入研究。肾功能受损(尿素>108 mg/dl,尿量减少<50 ml/hr)且已诊断为神经肌肉连接障碍的患者被排除在研究之外。获得书面知情同意后,患者被纳入研究。所有患者立即进行详细的病史和临床检查,并按照ICU协议进行管理,并在医院内随访死亡率。结果:研究参与者的平均年龄为47±10.27岁。大多数研究对象为男性(n=102, 58%),未免疫(n=88, 50%)或部分免疫(n=26, 15%),社会经济贫困(n=84, 48%),文盲(n=82, 47%)和来自城市地区(n=114, 65%)。109名(62%)研究对象住院死亡。住院死亡率最高的人群为41 ~ 65岁(n=70/109, 64.22%)、男性(n=63/109, 57.8%)、未接种疫苗(n=55/109, 50.45%)、贫困(n=52/109, 47.7%)、文盲(n=51/109, 46.78%)和城市(n=71/109, 65.14%)。结论:伴有不良预后因素的成人重症破伤风患者住院死亡率高。关键词:破伤风梭菌,医院死亡率,重症成人破伤风,破伤风,破伤风抗毒素,破伤风类毒素,牙关,预后因素
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Journal of Saidu Medical College, Swat
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