Pub Date : 2022-06-14DOI: 10.52206/jsmc.2022.12.2.694
Habib Ur Razaq, Dr Khurshid Ali, Aqsa
Background: Myocardial infarction mainly contributes to morbidity and mortality around the globe. Thrombolytic therapy with streptokinase is the primary treatment strategy for patients with the presentation of ST-segment-elevated acute myocardial Infarction. Objective: To assess to assess the correlation between increased NLR and in-hospital outcome in acute anterior MI patients subjected to streptokinase therapy. Material and Methods: The study was a retrospective cohort conducted over a period of six months from 01, 06, 2021 to 30, 11, and 2021. All the patients admitted consecutively during this period received streptokinase therapy. The patients were grouped with respect to NLR, i.e., high NLR ang low NLR. The cut-off point for dividing into these two groups was set as 4.50 as an average of studies previously conducted. The study endpoints in-hospital outcomes and the secondary end point was short-term mortality.Results: A total of 250 patients were presented with acute MI. Complications were reported in 115 patients (46%) whereas 46 deaths (18.4%) were reported. More complications were reported in patients present in the group with higher NLR, (n=83 vs. 27, 62.8 % vs. 22.8 %, p <0.0001), as well as death (n=35 vs. 11, 26.5 % vs. 9.3 %, p<0.0001) in hospital compared to the group with lower NLR. Conclusion: high NLR (using 4.50 as cut-off value) is in association with a higher rate of complicatxions and death during stay in the hospital in acute MI patients which are subjected to streptokinase. Key Words: Myocardial infarction, Thrombolytic therapy, Streptokinase, Neutrophil, Lymphocyte.
背景:心肌梗死是全球范围内发病率和死亡率的主要原因。链激酶溶栓治疗是st段抬高急性心肌梗死患者的主要治疗策略。目的:评价急性前路心肌梗死患者接受链激酶治疗后NLR升高与住院预后的相关性。材料和方法:该研究是一项回顾性队列研究，为期6个月，从2021年1月、6月到2021年30日、11日和2021年。在此期间连续入院的患者均接受链激酶治疗。患者根据NLR进行分组，即高NLR和低NLR。这两组的分界点被设定为4.50，这是之前进行的研究的平均值。研究终点是院内结局，次要终点是短期死亡率。结果:共有250例患者出现急性心肌梗死，其中115例(46%)出现并发症，46例(18.4%)死亡。与低NLR组相比，高NLR组的患者出现了更多的并发症(n=83 vs. 27,62.8% vs. 22.8%， p<0.0001)，以及住院死亡(n=35 vs. 11,26.5% vs. 9.3%， p<0.0001)。结论:高NLR(以4.50作为临界值)与接受链激酶治疗的急性心肌梗死患者住院期间较高的并发症发生率和死亡率相关。关键词:心肌梗死，溶栓治疗，链激酶，中性粒细胞，淋巴细胞。
{"title":"Association of Increased Neutrophil to Lymphocyte Ratio to in-Hospital Outcome of Acute anterior Myocardial Infarction Patients Subjected to Thrombolytic Therapy with Streptokinase","authors":"Habib Ur Razaq, Dr Khurshid Ali, Aqsa","doi":"10.52206/jsmc.2022.12.2.694","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.2.694","url":null,"abstract":"Background: Myocardial infarction mainly contributes to morbidity and mortality around the globe. Thrombolytic therapy with streptokinase is the primary treatment strategy for patients with the presentation of ST-segment-elevated acute myocardial Infarction. Objective: To assess to assess the correlation between increased NLR and in-hospital outcome in acute anterior MI patients subjected to streptokinase therapy. Material and Methods: The study was a retrospective cohort conducted over a period of six months from 01, 06, 2021 to 30, 11, and 2021. All the patients admitted consecutively during this period received streptokinase therapy. The patients were grouped with respect to NLR, i.e., high NLR ang low NLR. The cut-off point for dividing into these two groups was set as 4.50 as an average of studies previously conducted. The study endpoints in-hospital outcomes and the secondary end point was short-term mortality.Results: A total of 250 patients were presented with acute MI. Complications were reported in 115 patients (46%) whereas 46 deaths (18.4%) were reported. More complications were reported in patients present in the group with higher NLR, (n=83 vs. 27, 62.8 % vs. 22.8 %, p <0.0001), as well as death (n=35 vs. 11, 26.5 % vs. 9.3 %, p<0.0001) in hospital compared to the group with lower NLR. Conclusion: high NLR (using 4.50 as cut-off value) is in association with a higher rate of complicatxions and death during stay in the hospital in acute MI patients which are subjected to streptokinase. Key Words: Myocardial infarction, Thrombolytic therapy, Streptokinase, Neutrophil, Lymphocyte.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115613734","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 : 2022-06-14DOI: 10.52206/jsmc.2022.12.2.633
Asna Tahir, Ahrar Sikander, Sabawoon Hayat, Saud Azhar, Kashif ur Rehman Khalil, Saad Zahoor
Background: Non Communicable diseases like hypertension, diabetes and heart diseases are on rise due to sedentary lifestyle. Exercise is the most import factor that can improve outcome of major communicable diseases.Objective: To evaluate the beneficial effects of exercise on human body as perceived by individuals.Material and Methods: Study was conducted from 1st September 2019 to 28 February 2020 in community of Peshawar KP. A sample size of 300 individuals were selected using non probability convenient sampling technique. Data was collected on a structured questionnaire which was prevalidated through pilot study. Results: Mean age of study participants were 33 ± 5 S.D. Majority of the study participants were male (73%) and remaining were females (27%). 33% reported that they exercise every day,18% once in a week.27% 3 times a week and 22% of study participants reported that they do exercise occasionally.Participants were asked about effect of exercise on blood pressure and other parameters. Those who were hypertensive reported an improvement in blood pressure after starting regular exercise. The study subjects were asked about the effect of exercise on GIT function. Majority reported improvement in gastrointestinal function. Reduction in weight and improvement in other systems were also reported as shown significance with a P-value less than 0.05.Conclusions: Our study concluded that those individuals who started regular exercise have reported significant improvement in their different body functions. Therefore there is significant importance of exercising regularly in maintaining a sound mind and a sound body.Key words: Exercise, BMI, Hypertension, Diabetes
{"title":"Effects of Exercise on various Systems of Human Body in residence of Peshawar Khyber Pakhtunkhwa, Pakistan","authors":"Asna Tahir, Ahrar Sikander, Sabawoon Hayat, Saud Azhar, Kashif ur Rehman Khalil, Saad Zahoor","doi":"10.52206/jsmc.2022.12.2.633","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.2.633","url":null,"abstract":"Background: Non Communicable diseases like hypertension, diabetes and heart diseases are on rise due to sedentary lifestyle. Exercise is the most import factor that can improve outcome of major communicable diseases.Objective: To evaluate the beneficial effects of exercise on human body as perceived by individuals.Material and Methods: Study was conducted from 1st September 2019 to 28 February 2020 in community of Peshawar KP. A sample size of 300 individuals were selected using non probability convenient sampling technique. Data was collected on a structured questionnaire which was prevalidated through pilot study. Results: Mean age of study participants were 33 ± 5 S.D. Majority of the study participants were male (73%) and remaining were females (27%). 33% reported that they exercise every day,18% once in a week.27% 3 times a week and 22% of study participants reported that they do exercise occasionally.Participants were asked about effect of exercise on blood pressure and other parameters. Those who were hypertensive reported an improvement in blood pressure after starting regular exercise. The study subjects were asked about the effect of exercise on GIT function. Majority reported improvement in gastrointestinal function. Reduction in weight and improvement in other systems were also reported as shown significance with a P-value less than 0.05.Conclusions: Our study concluded that those individuals who started regular exercise have reported significant improvement in their different body functions. Therefore there is significant importance of exercising regularly in maintaining a sound mind and a sound body.Key words: Exercise, BMI, Hypertension, Diabetes","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129215056","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 : 2022-06-14DOI: 10.52206/jsmc.2022.12.2.700
Jibran Umar Ayub, Brekhna Jamil, Ayesha Qaisar, Umar Ayub Khan, Azhar Zahir Shah
Background: Despite the world over recognition of bullying it still remains an understudied area which needs further research. Furthermore, the administrations and heads of departments are reluctant to acknowledge that there is occurrence bullying in their institution.Objective: To identify bullying behaviors experienced by post graduate residents in clinical environment and the strategies used for coping with them.Material and Methods: A total of 355 participants were taken. Two tools were used to collect the necessary data, consisted of three parts:Negative Acts Questionnaire,Brief COPE Inventory; and a demographic sheet. Results: There were 125(35.21%) participants who were used to giving up the attempt to cope, I've been getting emotional support from others was told by 116(32.67%), I've been blaming myself for things that happened was reportedby 111(31.26%), I've been criticizing myself was told by 107(30.14%). Others coping strategies (now and then, monthly, weekly daily) were identified as praying or meditating by 295(83.09%) participants, learning to live with it by 291(81.97%) and thinking hard about what steps to take by 291(81.97). The bullying behaviors experienced by residents were having your opinions and views ignored were reported by 259(72.95%), 247(69.57%) told about being ordered to do work below your level of competence, blaming myself for things that happened for 244(68.73%), repeated reminders of your errors or mistakes by 239(67.32%). Conclusion: It is concluded that bullying is major problem and must be minimized in new residents by making it part of curriculum or polices of various institutions. Keywords: Workplace, bullying, mental torture, workload, residents.
{"title":"Identification of Bullying Behaviours and Coping Strategies of Postgraduate Trainees in Clinical Settings","authors":"Jibran Umar Ayub, Brekhna Jamil, Ayesha Qaisar, Umar Ayub Khan, Azhar Zahir Shah","doi":"10.52206/jsmc.2022.12.2.700","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.2.700","url":null,"abstract":"Background: Despite the world over recognition of bullying it still remains an understudied area which needs further research. Furthermore, the administrations and heads of departments are reluctant to acknowledge that there is occurrence bullying in their institution.Objective: To identify bullying behaviors experienced by post graduate residents in clinical environment and the strategies used for coping with them.Material and Methods: A total of 355 participants were taken. Two tools were used to collect the necessary data, consisted of three parts:Negative Acts Questionnaire,Brief COPE Inventory; and a demographic sheet. Results: There were 125(35.21%) participants who were used to giving up the attempt to cope, I've been getting emotional support from others was told by 116(32.67%), I've been blaming myself for things that happened was reportedby 111(31.26%), I've been criticizing myself was told by 107(30.14%). Others coping strategies (now and then, monthly, weekly daily) were identified as praying or meditating by 295(83.09%) participants, learning to live with it by 291(81.97%) and thinking hard about what steps to take by 291(81.97). The bullying behaviors experienced by residents were having your opinions and views ignored were reported by 259(72.95%), 247(69.57%) told about being ordered to do work below your level of competence, blaming myself for things that happened for 244(68.73%), repeated reminders of your errors or mistakes by 239(67.32%). Conclusion: It is concluded that bullying is major problem and must be minimized in new residents by making it part of curriculum or polices of various institutions. Keywords: Workplace, bullying, mental torture, workload, residents.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130352794","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 : 2022-06-14DOI: 10.52206/jsmc.2022.12.2.664
M. Yousaf, M. Shah, Shahid Afridi
Background: Acute cholecystitis, which is typically associated with gallstones, is one of the most common causes of acute abdomen presenting in emergency departments around the world. The aim of this study was to compare the incidence of biliary leak and hospital stay between early and delayed laparoscopic cholecystectomy for acute cholecystitis.Objectives: To compare the incidence of biliary leak and hospital stay between early and delayed laparoscopic cholecystectomy for acute cholecystitis.Material and Methods: Patients with radiologically confirmed acute calculus cholecystitis and ASA grade I/II were selected from the surgical OPD and prospectively randomized into two equivalent classes between August 1, 2015 and July 31, 2017. Early laparoscopic cholecystectomy was performed on patients in group A, while delayed laparoscopic cholecystectomy was performed on patients in group B. The data was collected from the patients using a non-probability sampling technique.Results: The research included 200 patients with radiologically proven acute calculus cholecystitis and an ASA grade I/II. Overall, patients who had an early laparoscopic cholecystectomy had a shorter hospital stay and less billary leak than those who had a delayed laparoscopic cholecystectomy (P=0.01) (0.00 and 0.11). In comparison to Group-II, the number of post-operative complications was lower in Group-I.Conclusion: When compared to delayed laparoscopic cholecystectomy, early laparoscopic cholecystectomy allows for substantially shorter biliary leak frequency and overall hospital stay.Key Words: Acute cholecystitis, Cholecystectomy, Laparoscopic.
{"title":"Comparison of Postoperative Complications Early Vs Delayed Laparoscopic Cholecystectomy for Acute Cholecystitis","authors":"M. Yousaf, M. Shah, Shahid Afridi","doi":"10.52206/jsmc.2022.12.2.664","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.2.664","url":null,"abstract":"Background: Acute cholecystitis, which is typically associated with gallstones, is one of the most common causes of acute abdomen presenting in emergency departments around the world. The aim of this study was to compare the incidence of biliary leak and hospital stay between early and delayed laparoscopic cholecystectomy for acute cholecystitis.Objectives: To compare the incidence of biliary leak and hospital stay between early and delayed laparoscopic cholecystectomy for acute cholecystitis.Material and Methods: Patients with radiologically confirmed acute calculus cholecystitis and ASA grade I/II were selected from the surgical OPD and prospectively randomized into two equivalent classes between August 1, 2015 and July 31, 2017. Early laparoscopic cholecystectomy was performed on patients in group A, while delayed laparoscopic cholecystectomy was performed on patients in group B. The data was collected from the patients using a non-probability sampling technique.Results: The research included 200 patients with radiologically proven acute calculus cholecystitis and an ASA grade I/II. Overall, patients who had an early laparoscopic cholecystectomy had a shorter hospital stay and less billary leak than those who had a delayed laparoscopic cholecystectomy (P=0.01) (0.00 and 0.11). In comparison to Group-II, the number of post-operative complications was lower in Group-I.Conclusion: When compared to delayed laparoscopic cholecystectomy, early laparoscopic cholecystectomy allows for substantially shorter biliary leak frequency and overall hospital stay.Key Words: Acute cholecystitis, Cholecystectomy, Laparoscopic.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129605412","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 : 2022-03-12DOI: 10.52206/jsmc.2022.12.1.524
Ali Shahjehan, Sajjad ullah, Usman Haqqani
Background: Dermoid cyst is one of the congenital craniofacial masses, most commonly occurring in pediatric population. This study will help us to know the magnitude of dermoid cysts in midline craniofacial masses in children.Objective: To determine the prevalence of dermoid cysts in midline craniofacial masses in pediatric population in tertiary care hospital. Material and Methods: This case series study was conducted at Department of Neurosurgery, Lady Reading Hospital(MTI) Peshawar, Pakistan from March 2016 to February 2019. A total of 52 patients with midline craniofacial masses were studied. After obtaining permission from hospital ethical committee and taking consent from patients included in the study, dermoid cysts in midline craniofacial masses was diagnosed on the basis of histopathology report done in our hospital laboratory. Results: The mean and standard deviation of age was 4.15±3.84years in patients with midline congenital craniofacial masses. Out of 52 patients with midline congenital craniofacial masses, 33(63.5%) patients were from the age group 1-5 years. Out of 52 patients having midline congenital craniofacial masses, 23(44.2%) were females and 29(55.8%) were males. 33 (63.5%) out of 52 patients with midline congenital craniofacial masses resided in urban areas. Out of 52 midline congenital craniofacial masses, 16 (30.8%) were dermoid cysts on histopathological report. Conclusion: Dermoid cyst is a common congenital midline craniofacial mass and is more common in males and urban population. Key words: Midline craniofacial masses, dermoid cyst.
{"title":"Prevelence of dermoid cyst in congenital midline craniofacial masses in paediatric population\"A case series study in tertiary care hospital.","authors":"Ali Shahjehan, Sajjad ullah, Usman Haqqani","doi":"10.52206/jsmc.2022.12.1.524","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.524","url":null,"abstract":"Background: Dermoid cyst is one of the congenital craniofacial masses, most commonly occurring in pediatric population. This study will help us to know the magnitude of dermoid cysts in midline craniofacial masses in children.Objective: To determine the prevalence of dermoid cysts in midline craniofacial masses in pediatric population in tertiary care hospital. Material and Methods: This case series study was conducted at Department of Neurosurgery, Lady Reading Hospital(MTI) Peshawar, Pakistan from March 2016 to February 2019. A total of 52 patients with midline craniofacial masses were studied. After obtaining permission from hospital ethical committee and taking consent from patients included in the study, dermoid cysts in midline craniofacial masses was diagnosed on the basis of histopathology report done in our hospital laboratory. Results: The mean and standard deviation of age was 4.15±3.84years in patients with midline congenital craniofacial masses. Out of 52 patients with midline congenital craniofacial masses, 33(63.5%) patients were from the age group 1-5 years. Out of 52 patients having midline congenital craniofacial masses, 23(44.2%) were females and 29(55.8%) were males. 33 (63.5%) out of 52 patients with midline congenital craniofacial masses resided in urban areas. Out of 52 midline congenital craniofacial masses, 16 (30.8%) were dermoid cysts on histopathological report. Conclusion: Dermoid cyst is a common congenital midline craniofacial mass and is more common in males and urban population. Key words: Midline craniofacial masses, dermoid cyst.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126457337","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 : 2022-03-12DOI: 10.52206/jsmc.2022.12.1.75
M. Ayyaz, Abubakar Saadiq, Zeenat Jehan, Waseem ullah
Abstract: Neonatal malaria is one of the differential diagnoses of sepsis in malaria endemic areas. Neonatal malaria is often ignored as it is considered to be uncommon. Transfusion acquired malaria is among the causes of neonatal malaria, as blood is rarely screened for malarial parasite. Here we present a unique case of neonatal malaria caused by exchange transfusion done for indirect hyperbillirubenemia in a G6PD deficient baby.
{"title":"A case of Neonatal Plasmodium Vivax Malaria Caused by Exchange Transfusion in a G6PD Deficient Baby","authors":"M. Ayyaz, Abubakar Saadiq, Zeenat Jehan, Waseem ullah","doi":"10.52206/jsmc.2022.12.1.75","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.75","url":null,"abstract":"Abstract: \u0000Neonatal malaria is one of the differential diagnoses of sepsis in malaria endemic areas. Neonatal malaria is often ignored as it is considered to be uncommon. Transfusion acquired malaria is among the causes of neonatal malaria, as blood is rarely screened for malarial parasite. Here we present a unique case of neonatal malaria caused by exchange transfusion done for indirect hyperbillirubenemia in a G6PD deficient baby.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115973178","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 : 2022-03-12DOI: 10.52206/jsmc.2022.12.1.210
R. Rehman, Muhammad Asad Qureshi, Ahmed Bilal Khalique, Muhammad Waseem Afzal, Muhammad Talha, Syed Junaid Ismail, Ihsanaullah
Background: The occipitocervical junction is a unique area between the cranium and the upper cervical spine. Treating pathologies of this region require a good knowledge and understanding of the anatomy, biomechanics of this region and nature of the disease. Objective: To evaluate the efficacy of Occipitocervical Fixation (OCF) in patients with craniocervical instability in two tertiary care hospitals. Metrial and Methods: This study was conducted at Combined Military Hospital Rawalpindi and Hayatabad Medical Complex, Peshawar from April 2005 to December 2016. All patients with craniocervical instability were included in our study, and those having occipital bone fractures or previously operated patients with same technique were excluded from this study. The patients were compared using lateral static and dynamic X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. Results: A total of 49 cases with craniocervical instability underwent OCF. The mean age of the patients was 40.5 + 1.2 SD years. There were 31 male patients and 18 female patients. Majority patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.0. At the end of follow-up after surgery, the mean Nurick score was 2.1. Conclusions: Occipitocervical fixation is a reasonable option to have spinal stability, achieve bone fusion and to get neurological improvement. The procedure can be complicated by certain conditions but these can safely be handled in experience hands.
{"title":"Surgical outcome of Occipitocervical Fixation for Craniocervical Instability","authors":"R. Rehman, Muhammad Asad Qureshi, Ahmed Bilal Khalique, Muhammad Waseem Afzal, Muhammad Talha, Syed Junaid Ismail, Ihsanaullah","doi":"10.52206/jsmc.2022.12.1.210","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.210","url":null,"abstract":"Background: The occipitocervical junction is a unique area between the cranium and the upper cervical spine. Treating pathologies of this region require a good knowledge and understanding of the anatomy, biomechanics of this region and nature of the disease. \u0000Objective: To evaluate the efficacy of Occipitocervical Fixation (OCF) in patients with craniocervical instability in two tertiary care hospitals. \u0000Metrial and Methods: This study was conducted at Combined Military Hospital Rawalpindi and Hayatabad Medical Complex, Peshawar from April 2005 to December 2016. All patients with craniocervical instability were included in our study, and those having occipital bone fractures or previously operated patients with same technique were excluded from this study. The patients were compared using lateral static and dynamic X-ray taken before the operation, after the operation, and during last follow-up. The Nurick score was used to assess neurological function pre and postoperatively. \u0000Results: A total of 49 cases with craniocervical instability underwent OCF. The mean age of the patients was 40.5 + 1.2 SD years. There were 31 male patients and 18 female patients. Majority patients showed improvements in myelopathic symptoms after the operation. The mean preoperative Nurick score was 3.0. At the end of follow-up after surgery, the mean Nurick score was 2.1. \u0000Conclusions: Occipitocervical fixation is a reasonable option to have spinal stability, achieve bone fusion and to get neurological improvement. The procedure can be complicated by certain conditions but these can safely be handled in experience hands. \u0000 ","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114670418","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 : 2022-03-12DOI: 10.52206/jsmc.2022.12.1.628
Muhammad Suliman, Nasreen Ghani, Sohail Muhammad, Pamela G. Reed
Objective: This paper aimed to identify self-transcendence and spiritual well-being among stroke patients and to determine the association between self-transcendence and spiritual well-being among stroke patients. Background: WHO estimated 86% mortality related to stroke world widely occurred in developing countries including, Pakistan. Living a meaningful life after the manifestations of stroke literally demands self-transcendence, which means the reconstruction of life or getting up again with more full potential. Materials and Methods: Analytical cross-sectional study of 210 stroke patients (three months and above inclusion eligibility criteria) were taken from the four rehabilitation centers of SGTH Swat, ATH Abbottabad, LRH and HMC, Peshawar, and responses recorded with validated and reliable questionnaires. Results: The participants’ mean score on the self-transcendence scale was 43.22, and on the spiritual index of well-being mean score were 40.83, respectively. Self-transcendence and spiritual well-being with other demographical variables found statistically significant (p < 0.05) on ANOVA and Post hoc test (Games-Howell). The positive strong correlations between the self-transcendence and spiritual well-being on Pearson correlation (r) were also found statistically significant (r = 0.619, p < 0.000). Conclusion: The results of this study support the theoretical assumptions of Reed’s theory in which during the vulnerability (stroke patients in this study) self-transcendence as an independent variable and protective factor have positive correlations with the outcome and dependant variable, called spiritual well-being. The findings also suggest implications for health care professionals to develop and deliver strategies to enhance vulnerable population self-transcendence for the outcome of spiritual well-being. Keywords: Self-transcendence, Spiritual well-being, Stroke, Care.
目的:探讨脑卒中患者自我超越与精神幸福感的关系，探讨脑卒中患者自我超越与精神幸福感的关系。背景:世卫组织估计，全世界86%与中风相关的死亡率广泛发生在包括巴基斯坦在内的发展中国家。从字面上讲，在中风的表现之后，要过有意义的生活需要自我超越，这意味着重建生活或以更充分的潜力重新站起来。材料与方法:分析横断面研究210例脑卒中患者(3个月及以上)，分别来自sth Swat、ATH Abbottabad、LRH和HMC白沙瓦四个康复中心，并使用有效可靠的问卷记录他们的回答。结果:被试自我超越量表的平均得分为43.22分，幸福感精神指数的平均得分为40.83分。自我超越和精神幸福感与其他人口统计学变量的方差分析和事后检验(Games-Howell)均有统计学意义(p < 0.05)。自我超越与精神幸福感在Pearson相关(r)上呈显著正相关(r = 0.619, p < 0.000)。结论:本研究结果支持Reed理论的理论假设，即脆弱性期间(本研究中的中风患者)自我超越作为自变量和保护因素与结果和因变量精神幸福感呈正相关。研究结果还建议卫生保健专业人员制定和提供战略，以提高弱势群体的自我超越精神福祉的结果。关键词:自我超越，精神幸福，中风，护理。
{"title":"Self-Transcendence and Spiritual Well-Being among Stroke Patients","authors":"Muhammad Suliman, Nasreen Ghani, Sohail Muhammad, Pamela G. Reed","doi":"10.52206/jsmc.2022.12.1.628","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.628","url":null,"abstract":"Objective: This paper aimed to identify self-transcendence and spiritual well-being among stroke patients and to determine the association between self-transcendence and spiritual well-being among stroke patients. Background: WHO estimated 86% mortality related to stroke world widely occurred in developing countries including, Pakistan. Living a meaningful life after the manifestations of stroke literally demands self-transcendence, which means the reconstruction of life or getting up again with more full potential. \u0000Materials and Methods: Analytical cross-sectional study of 210 stroke patients (three months and above inclusion eligibility criteria) were taken from the four rehabilitation centers of SGTH Swat, ATH Abbottabad, LRH and HMC, Peshawar, and responses recorded with validated and reliable questionnaires. \u0000Results: The participants’ mean score on the self-transcendence scale was 43.22, and on the spiritual index of well-being mean score were 40.83, respectively. Self-transcendence and spiritual well-being with other demographical variables found statistically significant (p < 0.05) on ANOVA and Post hoc test (Games-Howell). The positive strong correlations between the self-transcendence and spiritual well-being on Pearson correlation (r) were also found statistically significant (r = 0.619, p < 0.000). \u0000Conclusion: The results of this study support the theoretical assumptions of Reed’s theory in which during the vulnerability (stroke patients in this study) self-transcendence as an independent variable and protective factor have positive correlations with the outcome and dependant variable, called spiritual well-being. The findings also suggest implications for health care professionals to develop and deliver strategies to enhance vulnerable population self-transcendence for the outcome of spiritual well-being. \u0000Keywords: Self-transcendence, Spiritual well-being, Stroke, Care.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130517014","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: Removal of nasal pack after septoplasty causes pain and anxiety in patients. Xylocaine 4% solution used as topical anesthetic reduces pain and anxiety if infiltrated postoperatively into nasal packing. Objective: To evaluate the effect of xylocaine 4% solution on patient's anxiety infiltrated in to nasal pack after septoplasty. Material and Methods: This prospective case control study conducted at the ENT and Psychiatry departments of Gajju Khan Medical College (GKMC) Swabi from June 2019 to December 2019. A total of 100 patients who underwent septoplasty with bilateral antibiotic ointment soaked nasal packing were randomly divided in to two groups, A & B. Xylocaine 4% solution (5ml in each nostril) was infiltrated into nasal pack in 50 patients in group A while group B including 50 patients were infiltrated with liquid paraffin (5ml in each nostril) fifteen minutes before nasal pack removal. Results: A total of 100 patients were included with age ranging from 18 to 40 years with a mean age of 25.2 years with male predominance. Hamilton anxiety scale scores in Xylocaine group were11.81+3.47, 15.05+2.99 and 10.6+3.51 at 24 hrs before surgery, 24hrs after surgery and 20 minutes after pack removal while 10.4+4.34, 14.21+4.13 and 12.6+4.54 were in the liquid paraffin group which suggests that anxiety was less in the xylocaine group at 20 minutes after pack removal. Conclusion: There was significant reduction in pain and anxiety after infiltration of xylocaine 4% solution into nasal pack post septoplasty. KEY WORDS: Xylocaine, Anxiety, Septoplasty
{"title":"Effect of Xylocaine 4% Solution on Patient's Anxiety with Nasal Packing After Septoplasty","authors":"Raza Muhammad, Asif Kamal, Fazal-i-Wahid, Aftab Ahmad Tarand, Johar Iqbal, Arshad Abbass","doi":"10.52206/jsmc.2022.12.1.525","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.525","url":null,"abstract":"Background: Removal of nasal pack after septoplasty causes pain and anxiety in patients. Xylocaine 4% solution used as topical anesthetic reduces pain and anxiety if infiltrated postoperatively into nasal packing. \u0000 Objective: To evaluate the effect of xylocaine 4% solution on patient's anxiety infiltrated in to nasal pack after septoplasty. \u0000Material and Methods: This prospective case control study conducted at the ENT and Psychiatry departments of Gajju Khan Medical College (GKMC) Swabi from June 2019 to December 2019. A total of 100 patients who underwent septoplasty with bilateral antibiotic ointment soaked nasal packing were randomly divided in to two groups, A & B. Xylocaine 4% solution (5ml in each nostril) was infiltrated into nasal pack in 50 patients in group A while group B including 50 patients were infiltrated with liquid paraffin (5ml in each nostril) fifteen minutes before nasal pack removal. \u0000Results: A total of 100 patients were included with age ranging from 18 to 40 years with a mean age of 25.2 years with male predominance. Hamilton anxiety scale scores in Xylocaine group were11.81+3.47, 15.05+2.99 and 10.6+3.51 at 24 hrs before surgery, 24hrs after surgery and 20 minutes after pack removal while 10.4+4.34, 14.21+4.13 and 12.6+4.54 were in the liquid paraffin group which suggests that anxiety was less in the xylocaine group at 20 minutes after pack removal. \u0000Conclusion: There was significant reduction in pain and anxiety after infiltration of xylocaine 4% solution into nasal pack post septoplasty. \u0000KEY WORDS: Xylocaine, Anxiety, Septoplasty","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125980146","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 : 2022-03-12DOI: 10.52206/jsmc.2022.12.1.552
Salah Uddin, Haroon Rashid
Background: The standard surgical procedure for cataract surgery now a days is phacoemulsification with intraocular lens (IOL) implantation, that gives excellent visual results. Stable and adequate mydriasis is equired throughout phacoemulsification surgery. Intraoperative pupil Constriction (miosis) is associated with an increased risk of intraoperative complications especially in difficult cases and it can result in prolonged surgical time. Objective: To compare the effectiveness of prophylactic administration of topical ketorolac tromethamine 0.5% and nepafenac 0.1% on maintaining mydriasis during phacomulsification when instilled for 1 hour (I drop every 15 minutes) before surgery. Material and Methods: In this study a total of 490 eyes were included (that is 245 eyes in each group), using efficacy of Nepafenac equal to 17.32% and that of ketorolac tromethamine equal to 27.89%, in terms of loss of pupil mydriasis from baseline till end of phacoemulsification. Power of test is equal to 80% and level of significance is equal to 5%. Results: In this study mean age in Group A (nepafenac 0.1%) was 62 year. while mean age in Group B (ketorolac tromethamine 0.5%) was 64 year with standard deviation ± 2.87. In Group A (nepafenac 0.1%),(55%) patients were male and (45%) patients were female. Where as in Group B (ketorolac tromethamine 0.5%), (57%) patients were male and (43%) patients were female. Conclusion: Our study concludes that Nepafenac 0.1% is more effective than ketorolac tromethamine 0.5% in maintenance of dilated pupil during phacoemulsification surgery. KEY WORDS: Nepafenac 0.1%, ketorolac tromethamine 0.5%, dilated pupil, phacoemulsification surgery
{"title":"A Comparison of Topical Nepafenac with Ketorolac Tromethamine in Maintaining Pupilary Dilatation during Phacoemulsification","authors":"Salah Uddin, Haroon Rashid","doi":"10.52206/jsmc.2022.12.1.552","DOIUrl":"https://doi.org/10.52206/jsmc.2022.12.1.552","url":null,"abstract":"Background: The standard surgical procedure for cataract surgery now a days is phacoemulsification with intraocular lens (IOL) implantation, that gives excellent visual results. Stable and adequate mydriasis is equired throughout phacoemulsification surgery. Intraoperative pupil Constriction (miosis) is associated with an increased risk of intraoperative complications especially in difficult cases and it can result in prolonged surgical time. \u0000Objective: To compare the effectiveness of prophylactic administration of topical ketorolac tromethamine 0.5% and nepafenac 0.1% on maintaining mydriasis during phacomulsification when instilled for 1 hour (I drop every 15 minutes) before surgery. \u0000 Material and Methods: In this study a total of 490 eyes were included (that is 245 eyes in each group), using efficacy of Nepafenac equal to 17.32% and that of ketorolac tromethamine equal to 27.89%, in terms of loss of pupil mydriasis from baseline till end of phacoemulsification. Power of test is equal to 80% and level of significance is equal to 5%. \u0000 Results: In this study mean age in Group A (nepafenac 0.1%) was 62 year. \u0000 while mean age in Group B (ketorolac tromethamine 0.5%) was 64 year with standard deviation \u0000 ± 2.87. In Group A (nepafenac 0.1%),(55%) patients were male and (45%) patients were female. \u0000 Where as in Group B (ketorolac tromethamine 0.5%), (57%) patients were male and (43%) \u0000 patients were female. \u0000Conclusion: Our study concludes that Nepafenac 0.1% is more effective than ketorolac tromethamine 0.5% in \u0000 maintenance of dilated pupil during phacoemulsification surgery. \u0000 KEY WORDS: Nepafenac 0.1%, ketorolac tromethamine 0.5%, dilated pupil, \u0000 phacoemulsification surgery","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133365368","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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