Pub Date : 2023-10-17DOI: 10.35787/jimdc.v12i3.1020
Usman Ali Rahman, None Muhammad Adil Iftikhar, None Khalil Ahmed, None Mohammad Zia Ul Miraj, None Maliha Javaid Butt, None Iftikhar Ahmed
INTRODUCTION
Laparoscopy surgical procedures are increasing day by day.Laparoscopic lens contamination is most common problem occurring in laparoscopic surgery. This lens fogging results in increase per operative time. Many techniques are available to improve vision during laparoscopy. These include anti fog solutions, touching a visceral organ, use of warm water or scope warmer, sterile cloth can be used which can be dry or wet.
MATERIALS AND METHODS
It was a cross sectional study conducted in general surgery department Gulab Devi Hospital Lahore from January 2022 to July 2022. A total of 70 patient undergoing laparoscopic surgery were recruited in this study. Operative time, duration of time lens remained cleaned or dirty, time wasted during cleaning, methods used for cleaning of lens and there time duration and causes of lens contamination were the variables of this study.
RESULTS
Total operative time in all 70 laparoscopic procedures was found to equate to 53 hours and 13 minutes with a mean of 43.8 ± 8.3 minutes. A total of 288 lens contamination events were observed in all these operations with an average of 4.11 lens contamination events per case. According to study an average, 60.9% of the operational time lens remained clear, 31.2% of the operational time lens remained contaminated and 7.92% of the operative time was spent in cleaning the laparoscope.
CONCLUSION
Our study demonstrates that a significant period of a laparoscopic surgery is performed with foggy display. A lot of time is wasted in lens cleaning which can be saved by reducingcontamination using perfect techniques to clean lens.
{"title":"Does Laparoscopic Lens Contamination Effect Operative Time? A study on the Frequency and Duration of Lens Contamination and Commonly Used Measures to Maintain Clear Vision","authors":"Usman Ali Rahman, None Muhammad Adil Iftikhar, None Khalil Ahmed, None Mohammad Zia Ul Miraj, None Maliha Javaid Butt, None Iftikhar Ahmed","doi":"10.35787/jimdc.v12i3.1020","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1020","url":null,"abstract":"INTRODUCTION
 Laparoscopy surgical procedures are increasing day by day.Laparoscopic lens contamination is most common problem occurring in laparoscopic surgery. This lens fogging results in increase per operative time. Many techniques are available to improve vision during laparoscopy. These include anti fog solutions, touching a visceral organ, use of warm water or scope warmer, sterile cloth can be used which can be dry or wet.
 MATERIALS AND METHODS
 It was a cross sectional study conducted in general surgery department Gulab Devi Hospital Lahore from January 2022 to July 2022. A total of 70 patient undergoing laparoscopic surgery were recruited in this study. Operative time, duration of time lens remained cleaned or dirty, time wasted during cleaning, methods used for cleaning of lens and there time duration and causes of lens contamination were the variables of this study. 
 RESULTS
 Total operative time in all 70 laparoscopic procedures was found to equate to 53 hours and 13 minutes with a mean of 43.8 ± 8.3 minutes. A total of 288 lens contamination events were observed in all these operations with an average of 4.11 lens contamination events per case. According to study an average, 60.9% of the operational time lens remained clear, 31.2% of the operational time lens remained contaminated and 7.92% of the operative time was spent in cleaning the laparoscope. 
 CONCLUSION
 Our study demonstrates that a significant period of a laparoscopic surgery is performed with foggy display. A lot of time is wasted in lens cleaning which can be saved by reducingcontamination using perfect techniques to clean lens.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135994143","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}
Introduction: Polycythemia is increased red cell mass according to age and sex of the individual. It could be primary (Polycythemia Vera), or secondary, due to chronic hypoxia or increased erythropoietic drive. Polycythemia is managed with therapeutic phlebotomy along with treating the underlying cause if determined. Phlebotomy of one unit whole blood should result in fall of Hb of at least 1g/dl. This study was conducted to see the effect of phlebotomy on fall in Hb level.Different parameters which can affect Hb levels in polycythemia patients, like age, JAK-2 mutation status and underlying cause were also studied.Methodology: A cross sectional study was conducted at blood bank of Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad Pakistan January 2020 to December 2020. Data were collected from 121 patients of Polycythemia vera who reported in blood bank for phlebotomy.Results: The average pre phlebotomy hemoglobin of the patients was 17.45g/dl, which dropped to 15.97g/dl after phlebotomy. In total, 89 (73.5%) patients who underwent phlebotomy had a fall in Hb of greater than or equal to 1g/dl, while in 32 (26.4%) patients, Hb drop was less than 1g/dl. One hundred and five patients underwent multiple therapeutic phlebotomies to maintain their hemoglobin within normal range.Conclusion: This study has shown that there is fall in Hb as result of recommended phlebotomy leading to relief in symptoms due to Polycythemia. Phlebotomy is the basis of treating polycythemia, although in secondary polycythemia the underlying cause should also be diagnosed and treated.
{"title":"Analysis of Therapeutic Phlebotomy in Patients of Polycythemia: A Single Center Study","authors":"Nosheena Noreen, Syeda Wajeeha Jalil, Rabeea Irfan, Farah Hanif","doi":"10.35787/jimdc.v12i3.955","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.955","url":null,"abstract":"Introduction: Polycythemia is increased red cell mass according to age and sex of the individual. It could be primary (Polycythemia Vera), or secondary, due to chronic hypoxia or increased erythropoietic drive. Polycythemia is managed with therapeutic phlebotomy along with treating the underlying cause if determined. Phlebotomy of one unit whole blood should result in fall of Hb of at least 1g/dl. This study was conducted to see the effect of phlebotomy on fall in Hb level.Different parameters which can affect Hb levels in polycythemia patients, like age, JAK-2 mutation status and underlying cause were also studied.Methodology: A cross sectional study was conducted at blood bank of Pakistan Atomic Energy Commission (PAEC) General Hospital, Islamabad Pakistan January 2020 to December 2020. Data were collected from 121 patients of Polycythemia vera who reported in blood bank for phlebotomy.Results: The average pre phlebotomy hemoglobin of the patients was 17.45g/dl, which dropped to 15.97g/dl after phlebotomy. In total, 89 (73.5%) patients who underwent phlebotomy had a fall in Hb of greater than or equal to 1g/dl, while in 32 (26.4%) patients, Hb drop was less than 1g/dl. One hundred and five patients underwent multiple therapeutic phlebotomies to maintain their hemoglobin within normal range.Conclusion: This study has shown that there is fall in Hb as result of recommended phlebotomy leading to relief in symptoms due to Polycythemia. Phlebotomy is the basis of treating polycythemia, although in secondary polycythemia the underlying cause should also be diagnosed and treated.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136033693","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}
Uterine fibroids are commonly encountered in clinical practice. Majority of the fibroids are usually asymptomatic during pregnancy, however they may lead to complications in all three trimesters of pregnancy and even in the post natal period, causing a management dilemma. Vaginal prolapse of uterine fibroids is a rare phenomenon during pregnancy, delivery or puerperium. While most of the fibroids are managed conservatively, a few require surgical intervention Despite of multiple publications in the medical literature on the gynecological aspects of fibroids, scanty data is available on management during pregnancy and labor, posing a therapeutic dilemma. We present a case of a G4P3, presenting at 30weeks gestation with large degenerated prolapsed uterine fibroid which was successfully managed by vaginal myomectomy concurrently with cesarean section.
{"title":"Prolapsed Fibroid in Pregnancy","authors":"Mussarat Batool, Ayesha Ahmed, Sidra Rauf, Shirza Sharafat, Shabnum Rasheed","doi":"10.35787/jimdc.v12i3.999","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.999","url":null,"abstract":"Uterine fibroids are commonly encountered in clinical practice. Majority of the fibroids are usually asymptomatic during pregnancy, however they may lead to complications in all three trimesters of pregnancy and even in the post natal period, causing a management dilemma. Vaginal prolapse of uterine fibroids is a rare phenomenon during pregnancy, delivery or puerperium. While most of the fibroids are managed conservatively, a few require surgical intervention Despite of multiple publications in the medical literature on the gynecological aspects of fibroids, scanty data is available on management during pregnancy and labor, posing a therapeutic dilemma. We present a case of a G4P3, presenting at 30weeks gestation with large degenerated prolapsed uterine fibroid which was successfully managed by vaginal myomectomy concurrently with cesarean section.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136034762","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.35787/jimdc.v12i3.1048
Syed Adnan Alam, Rashid Ullah Khan, Muhammad Bilal, Khurram Liaqat, Afia Rahna, Javed Iqbal
Abstract
Background: Propofol (2,6-di-isopropylphenol) is one of the most favored drugs used for induction of anesthesia. Pain on injection is a common problem. Various methods have been tried to alleviate this pain but with conflicting results.
Objective: To compare effectiveness of lignocaine versus fentanyl in patients receiving propofol for general anesthesia in population of Pakistan who come to PIMS hospital in Islamabad.
Materials and Methods: 120 participants of either sex, between 18 and 40 years of age, belonging to ASA physical status I and II, undergoing elective surgery under general anesthesia, were randomized into two equal groups of 60 participants. They received, intravenously, either lignocaine 2 ml (20 mg/ml )or fentanyl 2 ml (50 mcg/mL) as a pretreatment before propofol injection.
Results: The efficacy of lignocaine as a pretreatment drug injection was higher (96.7%) compared to fentanyl (85.0%). In the lignocaine group, 2.3% of the participants experienced pain as compared with 15% in the fentanyl group (P<0.05).
Conclusion: Compared with fentanyl, lignocaine pretreatment was more effective in preventing pain on propofol injection.
KEY WORDS: Comparison, Fentanyl, LIgnocaine, Propofol, Pain.
{"title":"Comparing the Pretreatment with Lignocaine 40 mg and Fentanyl 100 ug as an Adjuvant for Preclusion of Pain Associated with Intravenous Propofol Injection","authors":"Syed Adnan Alam, Rashid Ullah Khan, Muhammad Bilal, Khurram Liaqat, Afia Rahna, Javed Iqbal","doi":"10.35787/jimdc.v12i3.1048","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1048","url":null,"abstract":"Abstract
 Background: Propofol (2,6-di-isopropylphenol) is one of the most favored drugs used for induction of anesthesia. Pain on injection is a common problem. Various methods have been tried to alleviate this pain but with conflicting results.
 Objective: To compare effectiveness of lignocaine versus fentanyl in patients receiving propofol for general anesthesia in population of Pakistan who come to PIMS hospital in Islamabad.
 Materials and Methods: 120 participants of either sex, between 18 and 40 years of age, belonging to ASA physical status I and II, undergoing elective surgery under general anesthesia, were randomized into two equal groups of 60 participants. They received, intravenously, either lignocaine 2 ml (20 mg/ml )or fentanyl 2 ml (50 mcg/mL) as a pretreatment before propofol injection.
 Results: The efficacy of lignocaine as a pretreatment drug injection was higher (96.7%) compared to fentanyl (85.0%). In the lignocaine group, 2.3% of the participants experienced pain as compared with 15% in the fentanyl group (P<0.05).
 Conclusion: Compared with fentanyl, lignocaine pretreatment was more effective in preventing pain on propofol injection.
 KEY WORDS: Comparison, Fentanyl, LIgnocaine, Propofol, Pain.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"224 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136037787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.35787/jimdc.v12i3.1024
None Raiha Fatima, Muhammad Kamran
Medically important mosquito species belonging to genus Aedes are a major public health concern due to their ability to be efficient vectors of dengue, Chikungunya, Zika, and other arboviruses. With limited vaccines available and no effective therapeutic treatments against arboviruses, the control of Aedes mosquito populations is currently the only strategy to prevent disease transmission. The risk of contracting dengue infection has increased dramatically since 190s. This upward trend is due to increases in long-distance travel, population growth and urbanization, lack of sanitation, ineffective mosquito control, and increases the surveillance and official reporting of dengue cases. Traditional control of mosquito vectors using various insecticides has caused toxic effect on environment and living communities, pro magnification, non- target effect and above all developed resistance in vector mosquitoes. Therefore, new tools and strategies are required to control mosquito vectors to control these diseases. Recent studies on midgut and other organs in mosquito vectors indicated the presence of diverse and dynamic microbial flora, known as microbiota. These microbes are mostly containing symbiotic microbiota play a key role in mosquito physiology, reproductive capacity and immunity. The midgut microbiota have also suggested to alter the competency of mosquitoes to transmit various pathogens (arboviruses, malaria parasites etc.). Many of these symbiotic bacteria have been explored for the potential to combat mosquito borne diseases such as dengue, malaria, Zika, yellow fever etc. The possibility to rear mosquitoes in which a particular bacterial species is dominant among the gut microbiota supports the development of strategies based on symbionts that induce antiviral responses or antiviral molecules in Ades mosquitoes
{"title":"Potential of Gut Microbiome in mosquitoes for Dengue Vector Control","authors":"None Raiha Fatima, Muhammad Kamran","doi":"10.35787/jimdc.v12i3.1024","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1024","url":null,"abstract":"Medically important mosquito species belonging to genus Aedes are a major public health concern due to their ability to be efficient vectors of dengue, Chikungunya, Zika, and other arboviruses. With limited vaccines available and no effective therapeutic treatments against arboviruses, the control of Aedes mosquito populations is currently the only strategy to prevent disease transmission. The risk of contracting dengue infection has increased dramatically since 190s. This upward trend is due to increases in long-distance travel, population growth and urbanization, lack of sanitation, ineffective mosquito control, and increases the surveillance and official reporting of dengue cases. Traditional control of mosquito vectors using various insecticides has caused toxic effect on environment and living communities, pro magnification, non- target effect and above all developed resistance in vector mosquitoes. Therefore, new tools and strategies are required to control mosquito vectors to control these diseases. Recent studies on midgut and other organs in mosquito vectors indicated the presence of diverse and dynamic microbial flora, known as microbiota. These microbes are mostly containing symbiotic microbiota play a key role in mosquito physiology, reproductive capacity and immunity. The midgut microbiota have also suggested to alter the competency of mosquitoes to transmit various pathogens (arboviruses, malaria parasites etc.). Many of these symbiotic bacteria have been explored for the potential to combat mosquito borne diseases such as dengue, malaria, Zika, yellow fever etc. The possibility to rear mosquitoes in which a particular bacterial species is dominant among the gut microbiota supports the development of strategies based on symbionts that induce antiviral responses or antiviral molecules in Ades mosquitoes","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"52 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136034760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.35787/jimdc.v12i3.1021
Prof. Dr Iftekhar Ahmed, Dr. Niaz Hussain Soomro, Muhammad Ashhal Iftekhar, Sana Siddiqui
This is a case of a rare tracheal tumor, in a 45year old male farmer who presented with recurrent dyspnea for four years, initially misdiagnosed as asthma. The patient experienced worsening symptoms, including cough, hemoptysis, weight loss, and respiratory failure. Imaging and bronchoscopy revealed a tracheal mass, later identified as leiomyoma. The patient underwent tumor resection via rigid bronchoscopy, resulting in successful removal and tracheal recanalization. Postoperatively, the patient showed improvement, and follow-up examinations confirmed resolution of symptoms and absence of tumors, such as leiomyoma, are rare, often causing airway obstructions. Treatment approaches vary, including surgical resection and endoscopic techniques. In the case of wide-based tumors, surgical intervention is recommended to reduce recurrence risks. Anesthesia management is crucial due to potential airway compromise during the procedure. Although recurrence rates for leiomyoma are unknown, incomplete bronchoscopic resection has been associated with reoccurrence, necessitating surgery and carinal reconstruction.
{"title":"Leiomyoma of the Trachea: A Rare Tracheal Tumor","authors":"Prof. Dr Iftekhar Ahmed, Dr. Niaz Hussain Soomro, Muhammad Ashhal Iftekhar, Sana Siddiqui","doi":"10.35787/jimdc.v12i3.1021","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1021","url":null,"abstract":"This is a case of a rare tracheal tumor, in a 45year old male farmer who presented with recurrent dyspnea for four years, initially misdiagnosed as asthma. The patient experienced worsening symptoms, including cough, hemoptysis, weight loss, and respiratory failure. Imaging and bronchoscopy revealed a tracheal mass, later identified as leiomyoma. The patient underwent tumor resection via rigid bronchoscopy, resulting in successful removal and tracheal recanalization. Postoperatively, the patient showed improvement, and follow-up examinations confirmed resolution of symptoms and absence of tumors, such as leiomyoma, are rare, often causing airway obstructions. Treatment approaches vary, including surgical resection and endoscopic techniques. In the case of wide-based tumors, surgical intervention is recommended to reduce recurrence risks. Anesthesia management is crucial due to potential airway compromise during the procedure. Although recurrence rates for leiomyoma are unknown, incomplete bronchoscopic resection has been associated with reoccurrence, necessitating surgery and carinal reconstruction.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136037617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-17DOI: 10.35787/jimdc.v12i3.1004
Fahad Akhtar, Aiman Noor, Sidra Rauf, Muhammad Arslan, Manzer Mehmood
Acquired jejunal diverticulosis often produces few or no symptoms and is generally picked up incidentally on cross-sectional imaging or intra-operatively. Similar to what is observed in colonic diverticulosis, diverticulitis can lead to more complicated clinical presentations including; perforation, gastrointestinal bleeding or obstruction. Acute diverticulitis is the most common presentation, but other complications can occur, mainly perforation, bowel obstruction and hemorrhage. Diagnosis is often difficult and delayed due to its relative rarity and non-specific clinical symptoms which increase the mortality and morbidity of this pathology. We have discussed a patient who presented to us with features of intestinal obstruction and on investigations and exploratory laparotomy he was diagnosed as a rare case of jejunal diverticulitis. He was managed operatively and patient had uneventful recovery where after CT scan, exploratory laparotomy was done and proximal milking through NG tube was done without resection.
{"title":"Idiopathic Jejunal Diverticulitis: A Rare Case Report","authors":"Fahad Akhtar, Aiman Noor, Sidra Rauf, Muhammad Arslan, Manzer Mehmood","doi":"10.35787/jimdc.v12i3.1004","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1004","url":null,"abstract":"Acquired jejunal diverticulosis often produces few or no symptoms and is generally picked up incidentally on cross-sectional imaging or intra-operatively. Similar to what is observed in colonic diverticulosis, diverticulitis can lead to more complicated clinical presentations including; perforation, gastrointestinal bleeding or obstruction. Acute diverticulitis is the most common presentation, but other complications can occur, mainly perforation, bowel obstruction and hemorrhage. Diagnosis is often difficult and delayed due to its relative rarity and non-specific clinical symptoms which increase the mortality and morbidity of this pathology. We have discussed a patient who presented to us with features of intestinal obstruction and on investigations and exploratory laparotomy he was diagnosed as a rare case of jejunal diverticulitis. He was managed operatively and patient had uneventful recovery where after CT scan, exploratory laparotomy was done and proximal milking through NG tube was done without resection.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"502 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136037619","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-16DOI: 10.35787/jimdc.v12i3.919
Syed Shams Ud Din, Mirza Tassawar Hussain, Erum Khan, Masood Shah, Abdullah Sadiq, Aqsa Syed
Background: Breast cancer is one of the most common cancers worldwide and one of the leading causes of mortality among female population. Modified radical mastectomy (MRM) with Level II axillary lymph node dissection (ALND) is considered as the gold standard treatment. The most common post-operative complication of MRM with ALND is seroma formation.
Objective: This study aimed to compare the efficacy of scalpel and LigaSure dissection with respect to seroma formation in the flaps.
Methods: This randomized controlled trial was conducted in the department of surgery, Federal Government Polyclinic Hospital (FGPC), Islamabad from October 2020 to October 2021. A total of 60 patients were recruited in the study, divided into 2 groups of 30 patients each; Scalpel Dissection Group and LigaSure Dissection Group. Data was gathered, entered and analyzed on SPSS version 22.
Results: Mean age in group I patients was 38.3 ± 11.4 years and it was 39.8 ± 9.4 years in group II patients (p=0.566). Mean duration of surgery in group I patients was 109.9 ± 7.9 minutes and it was 105.1 ± 8.3 minutes in group II patients (p=0.027). Seroma formation observed in both groups was statistically insignificant.
Conclusion: Mean duration of surgery was significantly shorter in LigaSure group as compared to scalpel dissection group. Frequency of seroma formation after surgery, mean duration of flap drain, mean volume of flap drain, and mean duration of hospital stay was similar in both treatment groups.
{"title":"Post Mastectomy Seroma Formation: Scalpel V/S Ligasure Dissection in Modified Radical Mastectomy","authors":"Syed Shams Ud Din, Mirza Tassawar Hussain, Erum Khan, Masood Shah, Abdullah Sadiq, Aqsa Syed","doi":"10.35787/jimdc.v12i3.919","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.919","url":null,"abstract":"Background: Breast cancer is one of the most common cancers worldwide and one of the leading causes of mortality among female population. Modified radical mastectomy (MRM) with Level II axillary lymph node dissection (ALND) is considered as the gold standard treatment. The most common post-operative complication of MRM with ALND is seroma formation.
 Objective: This study aimed to compare the efficacy of scalpel and LigaSure dissection with respect to seroma formation in the flaps.
 Methods: This randomized controlled trial was conducted in the department of surgery, Federal Government Polyclinic Hospital (FGPC), Islamabad from October 2020 to October 2021. A total of 60 patients were recruited in the study, divided into 2 groups of 30 patients each; Scalpel Dissection Group and LigaSure Dissection Group. Data was gathered, entered and analyzed on SPSS version 22.
 Results: Mean age in group I patients was 38.3 ± 11.4 years and it was 39.8 ± 9.4 years in group II patients (p=0.566). Mean duration of surgery in group I patients was 109.9 ± 7.9 minutes and it was 105.1 ± 8.3 minutes in group II patients (p=0.027). Seroma formation observed in both groups was statistically insignificant.
 Conclusion: Mean duration of surgery was significantly shorter in LigaSure group as compared to scalpel dissection group. Frequency of seroma formation after surgery, mean duration of flap drain, mean volume of flap drain, and mean duration of hospital stay was similar in both treatment groups.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"57 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-16DOI: 10.35787/jimdc.v12i3.708
Adil Bin Irfan, Maria Shakoor Abbasi, Naseer Ahmed, Wareesha Naseem, Tayaba Saeed, Maryam Abdul Rahman, Aleesha Faisal
Objectives: The aim of this study was to identify the causes and patterns of partially dentate states with respect to gender and their respective choice of treatment
Methods: A descriptive cross sectional study was conducted on 555 patients visiting prosthodontics department of Altamash Institute of Dental Medicine for a duration of five months. A close ended well-structured questionnaire was used to collect the data. The descriptive analysis was carried out using SPSS-25 and Chi square test was used, to find the effect of gender, number of missing teeth and prevalence of various partially dentate classification. The p value of ≤ 0.05 was considered as statistically significant.
Results: The results of the study showed the two most common causes of missing teeth was caries (66.3%), and periodontal disease (13.8%). It was also found that Kennedy’s and Mauk’s class 3 to be the most prevalent in maxilla 159 (61.3%), 98(37.1%) and 148 (50%), 120 (41.23%) in mandible. Osborne’s class 2 was most prevalent with 127 (48.65%) in mandible and 171 (58.16%) in maxilla, respectively. Furthermore, both genders were found to have Kennedy’s and Mauk’s class 3 and Osborne class 2. Ironically, majority of the patients choose acrylic partial denture as a treatment option for the replacement of missing teeth.
Conclusion: This study describes that Kennedys, Mauk’s Class 3 and Osborne Class 2 were found in majority of participants. Dental caries and periodontal disease were the common cause of missing teeth with acrylic partial denture remained the most opted treatment option.
目的:本研究的目的是确定部分牙齿状态的原因和模式与性别及其各自的治疗选择有关
方法:对在阿尔塔玛什口腔医学研究所口腔修复科就诊的555例患者进行为期5个月的描述性横断面研究。使用封闭式结构良好的问卷来收集数据。采用SPSS-25进行描述性分析，采用卡方检验，分析性别、缺牙数和各种部分齿状分类的流行程度的影响。p值≤0.05认为有统计学意义。
结果:研究结果显示，龋齿(66.3%)和牙周病(13.8%)是导致牙齿缺失最常见的两种原因。Kennedy’s和Mauk’s 3类在上颌159例(61.3%)、98例(37.1%)、下颌骨148例(50%)、120例(41.23%)中最常见。奥斯本氏2型以下颌骨127例(48.65%)和上颌骨171例(58.16%)最为常见。此外，男女都有肯尼迪和莫克的3级和奥斯本的2级。具有讽刺意味的是，大多数患者选择丙烯酸义齿作为替代缺牙的治疗选择。
结论:本研究描述了大多数参与者存在Kennedys, Mauk 's Class 3和Osborne Class 2。龋齿和牙周病是导致缺牙的常见原因，丙烯酸树脂局部义齿仍然是最常用的治疗方法。
{"title":"Etiology and Pattern of Partially Dentate states with respect to Gender and choice of Treatment","authors":"Adil Bin Irfan, Maria Shakoor Abbasi, Naseer Ahmed, Wareesha Naseem, Tayaba Saeed, Maryam Abdul Rahman, Aleesha Faisal","doi":"10.35787/jimdc.v12i3.708","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.708","url":null,"abstract":"Objectives: The aim of this study was to identify the causes and patterns of partially dentate states with respect to gender and their respective choice of treatment
 Methods: A descriptive cross sectional study was conducted on 555 patients visiting prosthodontics department of Altamash Institute of Dental Medicine for a duration of five months. A close ended well-structured questionnaire was used to collect the data. The descriptive analysis was carried out using SPSS-25 and Chi square test was used, to find the effect of gender, number of missing teeth and prevalence of various partially dentate classification. The p value of ≤ 0.05 was considered as statistically significant.
 Results: The results of the study showed the two most common causes of missing teeth was caries (66.3%), and periodontal disease (13.8%). It was also found that Kennedy’s and Mauk’s class 3 to be the most prevalent in maxilla 159 (61.3%), 98(37.1%) and 148 (50%), 120 (41.23%) in mandible. Osborne’s class 2 was most prevalent with 127 (48.65%) in mandible and 171 (58.16%) in maxilla, respectively. Furthermore, both genders were found to have Kennedy’s and Mauk’s class 3 and Osborne class 2. Ironically, majority of the patients choose acrylic partial denture as a treatment option for the replacement of missing teeth.
 Conclusion: This study describes that Kennedys, Mauk’s Class 3 and Osborne Class 2 were found in majority of participants. Dental caries and periodontal disease were the common cause of missing teeth with acrylic partial denture remained the most opted treatment option.
","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"75 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136112262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-10-16DOI: 10.35787/jimdc.v12i3.950
Dr maliha Batool, Dr savida ilyas dar DAR, DR RIZWAN AHMAD, Dr hareema saeed khan Khan, DR SHABIH HAIDER HAIDER, Dr aroosa Farid
Background
Appropriate selection and correct use of inhalation devices is an integral component in the management of asthma and chronic obstructive lung disease (COLD). It is well known that no one device suits all patients. Metered Dose Inhalers (MDIs) and Soft Mist Inhalers (SMIs) are widely used even if benefits to patients are strictly related to their usability. Our aim of the study was to assess the frequency of patients with chronic obstructive lung diseases having improper metered dose inhaler technique.
Methodology
It was a cross-sectional study done at outpatient Department of Medical Department, Federal Government Polyclinic Hospital, Islamabad over a period of 3.All Patients with COLD presenting in OPD were assessed as having either a correct (performed ALL 6 steps correctly) or incorrect (not performed all steps correctly) inhaler technique, data being recorded on proforma.
RESULTS
A total of 250 patients were included in the study ranged between 14-70 years with mean age of patients 46.5±15.7 years. Total of 6 steps of inhalation technique was observed. Mean steps was 3.8±1.4. Incorrect inhaler technique (≤5 steps) was adopted by 220 patients (88%) and correct technique (6 steps) adopted by only 30 patients (12%). Stratification for age, gender, duration of COLD, education, marital status, occupation and BMI was also carried out.
CONCLUSION
Our study demonstrates that incorrect technique during inhalation is common among our patients with COLD hence it emphasizes an essential role of health professionals in regular evaluation of their patients and caregivers to ensure correct application of inhalation devices.
KEY WORDS
Metered dose inhalers (MDI), Chronic obstructive lung disease (COLD), Correct technique
{"title":"ASSESSMENT OF METERED DOSE INHALER TECHNIQUE IN PATIENTS WITH CHRONIC OBSTRUCTIVE LUNG DISEASE","authors":"Dr maliha Batool, Dr savida ilyas dar DAR, DR RIZWAN AHMAD, Dr hareema saeed khan Khan, DR SHABIH HAIDER HAIDER, Dr aroosa Farid","doi":"10.35787/jimdc.v12i3.950","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.950","url":null,"abstract":"Background
 Appropriate selection and correct use of inhalation devices is an integral component in the management of asthma and chronic obstructive lung disease (COLD). It is well known that no one device suits all patients. Metered Dose Inhalers (MDIs) and Soft Mist Inhalers (SMIs) are widely used even if benefits to patients are strictly related to their usability. Our aim of the study was to assess the frequency of patients with chronic obstructive lung diseases having improper metered dose inhaler technique.
 Methodology
 It was a cross-sectional study done at outpatient Department of Medical Department, Federal Government Polyclinic Hospital, Islamabad over a period of 3.All Patients with COLD presenting in OPD were assessed as having either a correct (performed ALL 6 steps correctly) or incorrect (not performed all steps correctly) inhaler technique, data being recorded on proforma.
 RESULTS
 A total of 250 patients were included in the study ranged between 14-70 years with mean age of patients 46.5±15.7 years. Total of 6 steps of inhalation technique was observed. Mean steps was 3.8±1.4. Incorrect inhaler technique (≤5 steps) was adopted by 220 patients (88%) and correct technique (6 steps) adopted by only 30 patients (12%). Stratification for age, gender, duration of COLD, education, marital status, occupation and BMI was also carried out.
 CONCLUSION
 Our study demonstrates that incorrect technique during inhalation is common among our patients with COLD hence it emphasizes an essential role of health professionals in regular evaluation of their patients and caregivers to ensure correct application of inhalation devices.
 
 KEY WORDS
 Metered dose inhalers (MDI), Chronic obstructive lung disease (COLD), Correct technique
","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136115933","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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