Pub Date : 2023-10-16DOI: 10.35787/jimdc.v12i3.1018
Angabeen Anjum, None Prof.Dr. Nauman Sheikh
Advanced technology in the form of computer aided design and computer aided manufacturing (CAD/CAM) was introduced to the dental profession in 1987.
Dental providers can utilize digital technology in various practice settings, including private offices and public health centers. Learning how to use new technologies broadens dental and dental hygiene practitioners’ skill sets, strengthens job marketability, expands roles in comprehensive care delivery, and provides opportunities to improve patient comfort and enhance preventive patient education. Implementing advanced technology into clinical practice is essential in order to continually raise the level of care and fuel the evolution of future workforce models.
{"title":"editorial Title: The Paradigm Shift in Dentistry: Embracing Digital Innovations for Enhanced Patient Care","authors":"Angabeen Anjum, None Prof.Dr. Nauman Sheikh","doi":"10.35787/jimdc.v12i3.1018","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1018","url":null,"abstract":"Advanced technology in the form of computer aided design and computer aided manufacturing (CAD/CAM) was introduced to the dental profession in 1987. 
 Dental providers can utilize digital technology in various practice settings, including private offices and public health centers. Learning how to use new technologies broadens dental and dental hygiene practitioners’ skill sets, strengthens job marketability, expands roles in comprehensive care delivery, and provides opportunities to improve patient comfort and enhance preventive patient education. Implementing advanced technology into clinical practice is essential in order to continually raise the level of care and fuel the evolution of future workforce models.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"35 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":"136115146","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.v12i3.963
Iqra Jamil
ABSTRACT
Introduction: Antibiotic resistance is a major problem in staphylococcal infections. Resistance against methicillin in S. aureus is due to the transfer of mobile cassettes of specific genes in S. aureus called Staphylococcal Cassette Chromosome mec (SCCmec). 13 types of SCCmec have identified till now. Various clinical syndromes are associated with presence of PVL gene. Therefore, the current study was designed to check the prevalence of PVL gene and SCCmec types in CA-MRSA and HA-MRSA.
Materials and methods: This cross-sectional descriptive study was done in LGH/PGMI, Lahore. MRSA isolates were phenotypically confirmed by Cefoxitin (30) disc on Mueller- Hinton agar. DNA extraction was done by using Genomic DNA purification kit. Detection of PVl gene and SCCmec types were done with PCR using specific primers.
Results: Out of 89 isolates, maximum isolates were from pus swabs (45%), followed by wound swabs (15.5%). It was found that 55 (61.8%) were HA-MRSA isolates while 34 (38.2%) were CA-MRSA isolates. PVl gene was found in 37% isolates. Among PVl positive samples, 36.4% were HA-MRSA while 63.6% were CA-MRSA. Most common SCCmec in HA-MRSA was type III (69%), while in CA-MRSA SCCmec type IVa was predominant (35.4%).
Conclusion: The present study provides an insight about the prevalence of PVl gene and different SCCmec types in CA-MRSA and HA-MRSA. Most common SCCmec type linked with HA-MRSA
{"title":"Association of PVL gene with SCCmec typing in MRSA (both community associated and hospital acquired) from a tertiary care hospital, Lahore","authors":"Iqra Jamil","doi":"10.35787/jimdc.v12i3.963","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.963","url":null,"abstract":"ABSTRACT
 Introduction: Antibiotic resistance is a major problem in staphylococcal infections. Resistance against methicillin in S. aureus is due to the transfer of mobile cassettes of specific genes in S. aureus called Staphylococcal Cassette Chromosome mec (SCCmec). 13 types of SCCmec have identified till now. Various clinical syndromes are associated with presence of PVL gene. Therefore, the current study was designed to check the prevalence of PVL gene and SCCmec types in CA-MRSA and HA-MRSA.
 Materials and methods: This cross-sectional descriptive study was done in LGH/PGMI, Lahore. MRSA isolates were phenotypically confirmed by Cefoxitin (30) disc on Mueller- Hinton agar. DNA extraction was done by using Genomic DNA purification kit. Detection of PVl gene and SCCmec types were done with PCR using specific primers.
 Results: Out of 89 isolates, maximum isolates were from pus swabs (45%), followed by wound swabs (15.5%). It was found that 55 (61.8%) were HA-MRSA isolates while 34 (38.2%) were CA-MRSA isolates. PVl gene was found in 37% isolates. Among PVl positive samples, 36.4% were HA-MRSA while 63.6% were CA-MRSA. Most common SCCmec in HA-MRSA was type III (69%), while in CA-MRSA SCCmec type IVa was predominant (35.4%).
 Conclusion: The present study provides an insight about the prevalence of PVl gene and different SCCmec types in CA-MRSA and HA-MRSA. Most common SCCmec type linked with HA-MRSA","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"20 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":"136112267","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.v12i3.814
Syed Hashim Raza, Rehamana Waris, Ramish Riaz
Background: Autism Spectrum Disorder is a developmental disorder characterized by difficulties in social interaction, initiating conversations, delay in language skills, play skills and stereotypic behaviours. Children with severe developmental delay and those with global developmental delays are needed to be identified as they may have long term problems and disabilities.
Materials & Methods: All children below age of 5 years coming first time for assessment of ASD and diagnosed using ADI-R and ADOS-2 were included in the study. Total 334 children met the criterion. All children having performance deficit below 2SD on age appropriate mean were considered as having developmental delay. Those having delay in two or more than two domains were labelled as having global developmental delay. Detailed clinical and developmental assessment was performed. Data was entered and analysed via SPSS v26.
Results: Mean age of children at time of presentation was 3.6±1.10 years with male to female ratio of 3.5:1. According to developmental assessment using Schedule for growing Scales II, most affected area was speech and language (51.5%) followed by cognitive skills (50.7%), social interactive skills (49.9%), visual skills (46.9%), hearing and language skills, (38.3%), self-care social skills (26.2%), manipulative skills (13.5%) and gross motor skills (0.4%). Global Developmental Delay was found to be present in half of the children for which there was no other possible explanation.
Conclusion: Most of the children with Autism Spectrum Disorder from developmental delay of some sort. Therefore, every child with Autism Spectrum Disorder must be evaluated for Developmental Delay and supported.
{"title":"Patterns of Developmental Delay in Children with Autism Spectrum Disorder: A Perspective from a Developing Country.","authors":"Syed Hashim Raza, Rehamana Waris, Ramish Riaz","doi":"10.35787/jimdc.v12i3.814","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.814","url":null,"abstract":"Background: Autism Spectrum Disorder is a developmental disorder characterized by difficulties in social interaction, initiating conversations, delay in language skills, play skills and stereotypic behaviours. Children with severe developmental delay and those with global developmental delays are needed to be identified as they may have long term problems and disabilities.
 Materials & Methods: All children below age of 5 years coming first time for assessment of ASD and diagnosed using ADI-R and ADOS-2 were included in the study. Total 334 children met the criterion. All children having performance deficit below 2SD on age appropriate mean were considered as having developmental delay. Those having delay in two or more than two domains were labelled as having global developmental delay. Detailed clinical and developmental assessment was performed. Data was entered and analysed via SPSS v26.
 Results: Mean age of children at time of presentation was 3.6±1.10 years with male to female ratio of 3.5:1. According to developmental assessment using Schedule for growing Scales II, most affected area was speech and language (51.5%) followed by cognitive skills (50.7%), social interactive skills (49.9%), visual skills (46.9%), hearing and language skills, (38.3%), self-care social skills (26.2%), manipulative skills (13.5%) and gross motor skills (0.4%). Global Developmental Delay was found to be present in half of the children for which there was no other possible explanation.
 Conclusion: Most of the children with Autism Spectrum Disorder from developmental delay of some sort. Therefore, every child with Autism Spectrum Disorder must be evaluated for Developmental Delay and supported.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"21 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":"136115383","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.v12i3.958
Sidra Tul Muntaha, Dr Sadaf Asma Asma, Dr sara Hayat, Dr Farhan Hassan Muntaha
ABSTRACT:
Background: The precise management of obstetrical crisis like preterm premature rupture of membrane is necessary to be designed for an optimum outcome. Both maternal and fetal morbidity and mortality rate can be decreased by accurate approach of clinical management as it is not still established yet. This study was designed to compare the maternal or fetal outcome in conservative management with active management of prelabor premature rupture of membranes at 34 – 37 weeks of gestation. STUDY DESIGN: Randomized control trial SUBJECTS & METHODS: The patient’s data was collected from the department of Gynecology and Obstetrics, F G Polyclinic Hospital and PIMS Islamabad from July 2019 to March 2020. Two groups were made and 90 cases were included in each group on the basis of active or conservative management accordingly. Fetal and maternal morbidity and mortality was judged on the basis of number of fetal distresses, chorioamnionitis and mode of delivery. RESULTS: 180 fetuses, a total of 140 survived. In group A, with conservative management, of the 17 (18.89%) mortalities, 9 (10%) developed fetal infections, 2 (2.22%) delivered prematurely, 3 (3.33%) had RDS. In group B, the active management was observed, 23 (25.55%) babies were expired, 5 (5.55%) contacted infections and died, 9 (10%) were diagnosed to have RDS, 6 (6.66%) deaths were due to prematurity with low birth weight. In conservative management group days of admission was significantly (p-value < 0.05) higher compared to active group. The duration of NICU stay was significantly (p-value < 0.05) higher in active management group (8.88% vs. 15.55%) as compared to conservative group (table 7). The rate of respiratory distress was also significantly (p-value < 0.05) in active management group (5.55% vs. 20%) as compared to conservative group. The mortality rate (25.5%) was bit higher in active management group as compare to (18.89%) in conservative management group but this difference was not statistically significant (p-value >0.05).
Conclusion: Conservative management of premature preterm rupture of membranes is more appropriate choice of management than active treatment if decided earlier
文摘:& # x0D;背景:对早产、胎膜早破等产科危象的精确处理是获得最佳结局的必要措施。准确的临床管理方法可以降低孕产妇和胎儿的发病率和死亡率，但尚未建立。本研究的目的是比较在妊娠34 - 37周采用保守治疗和积极治疗的产前胎膜早破的母婴结局。研究设计:随机对照试验受试者;方法:患者数据收集于2019年7月至2020年3月在F G综合医院和伊斯兰堡PIMS妇产科。根据积极或保守治疗方法分为两组，每组90例。胎儿和产妇的发病率和死亡率是根据胎儿窘迫的数量，绒毛膜羊膜炎和分娩方式判断的。结果:180胎，140胎成活。A组采用保守治疗，17例死亡(18.89%)中发生胎儿感染9例(10%)，早产2例(2.22%)，RDS 3例(3.33%)。B组患儿积极管理，死亡23例(25.55%)，接触感染死亡5例(5.55%)，诊断为RDS 9例(10%)，早产低出生体重死亡6例(6.66%)。保守治疗组入院天数显著(p值<0.05)，高于活性组。新生儿重症监护病房住院时间显著(p值<0.05)，积极治疗组呼吸窘迫发生率显著高于保守治疗组(8.88% vs. 15.55%)(表7)。0.05)，与保守组相比，积极管理组(5.55% vs. 20%)。积极治疗组的死亡率(25.5%)略高于保守治疗组(18.89%)，但差异无统计学意义(p值0.05)。结论:如果及早决定，保守治疗比积极治疗更为合适
{"title":"The Comparison of Fetal and Maternal outcome in Active vs Conservative Management of Prelabor Premature Rupture Of Membranes ( PPROM) at 34 to 37 weeks of gestation.","authors":"Sidra Tul Muntaha, Dr Sadaf Asma Asma, Dr sara Hayat, Dr Farhan Hassan Muntaha","doi":"10.35787/jimdc.v12i3.958","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.958","url":null,"abstract":"ABSTRACT:
 Background: The precise management of obstetrical crisis like preterm premature rupture of membrane is necessary to be designed for an optimum outcome. Both maternal and fetal morbidity and mortality rate can be decreased by accurate approach of clinical management as it is not still established yet. This study was designed to compare the maternal or fetal outcome in conservative management with active management of prelabor premature rupture of membranes at 34 – 37 weeks of gestation. STUDY DESIGN: Randomized control trial SUBJECTS & METHODS: The patient’s data was collected from the department of Gynecology and Obstetrics, F G Polyclinic Hospital and PIMS Islamabad from July 2019 to March 2020. Two groups were made and 90 cases were included in each group on the basis of active or conservative management accordingly. Fetal and maternal morbidity and mortality was judged on the basis of number of fetal distresses, chorioamnionitis and mode of delivery. RESULTS: 180 fetuses, a total of 140 survived. In group A, with conservative management, of the 17 (18.89%) mortalities, 9 (10%) developed fetal infections, 2 (2.22%) delivered prematurely, 3 (3.33%) had RDS. In group B, the active management was observed, 23 (25.55%) babies were expired, 5 (5.55%) contacted infections and died, 9 (10%) were diagnosed to have RDS, 6 (6.66%) deaths were due to prematurity with low birth weight. In conservative management group days of admission was significantly (p-value < 0.05) higher compared to active group. The duration of NICU stay was significantly (p-value < 0.05) higher in active management group (8.88% vs. 15.55%) as compared to conservative group (table 7). The rate of respiratory distress was also significantly (p-value < 0.05) in active management group (5.55% vs. 20%) as compared to conservative group. The mortality rate (25.5%) was bit higher in active management group as compare to (18.89%) in conservative management group but this difference was not statistically significant (p-value >0.05).
 Conclusion: Conservative management of premature preterm rupture of membranes is more appropriate choice of management than active treatment if decided earlier","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"41 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":"136116359","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.v12i3.1047
None Dr. Usman Waheed (Ph.D.), Rizwan Aziz
.
．
{"title":"Establishment of Surgical Oncology Services at ANTH: Challenges & Outcomes","authors":"None Dr. Usman Waheed (Ph.D.), Rizwan Aziz","doi":"10.35787/jimdc.v12i3.1047","DOIUrl":"https://doi.org/10.35787/jimdc.v12i3.1047","url":null,"abstract":".","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"80 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":"136112425","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 : 2023-07-06DOI: 10.35787/jimdc.v12i2.943
Sarah Shah, Dr savida ilyas dar Dar, DR Faridullah Shah Shah, Dr farhan aslam Aslam, Dr hareema saeed khan Khan, Dr anber saleem Saleem
Background: Coronavirus disease-2019 (COVID-19) has been labelled as a global pandemic and a cause of documented high mortality rates among severe or critical patients. This has been linked with hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. Our study aims to evaluate the relationship between inflammatory markers and disease outcomes in COVID-19. Methodology: This cross-sectional study was conducted at Federal Government Polyclinic (FGPC) Hospital, Islamabad for a period of 3 months. All the patients who had either RT-PCR for COVID-19 or HRCT findings suggestive of COVID were included in the study. The inflammatory markers like C-reactive protein (CRP), D-Dimers, and Lactate dehydrogenase (LDH) were done and a combined score DLC was calculated. The need for Oxygen (litres/min), Bilevel positive airway pressure (BIPAP), or Mechanical Invasive Ventilation was documented. Results: The study was conducted on 213 patients which included 119(56%) male patients and 94(44%) female patients. COVID-19 PCR was positive in 193(90.6%) while 20 patients (9.4%) had a negative PCR but HRCT suggestive of COVID. HRCT was done in a total of 46 patients out of the 213 patients and 45 had features suggestive of COVID-19. The AUROC was 0.686(0.61-0.75) for D dimers, 0.688(0.61-0.75) for LDH, and 0.649(0.517-0.72) for CRP respectively, and Spearman rho values of (0.326, 0.328 and 0.266) respectively with a p-value (0.000). Conclusion: D-dimer, LDH and CRP individually as well as a combined score of the inflammatory markers (DLC) and Oxygen requirement had a significant correlation with the mortality of the COVID-19 patients. Key words: COVID-19, CRP, LDH, D dimers, DLC score.
{"title":"Relationship between Inflammatory Markers and Disease Outcome in COVID-19","authors":"Sarah Shah, Dr savida ilyas dar Dar, DR Faridullah Shah Shah, Dr farhan aslam Aslam, Dr hareema saeed khan Khan, Dr anber saleem Saleem","doi":"10.35787/jimdc.v12i2.943","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.943","url":null,"abstract":"Background: Coronavirus disease-2019 (COVID-19) has been labelled as a global pandemic and a cause of documented high mortality rates among severe or critical patients. This has been linked with hyperinflammation of the innate and adaptive immune systems and the resulting cytokine storm. Our study aims to evaluate the relationship between inflammatory markers and disease outcomes in COVID-19. \u0000Methodology: This cross-sectional study was conducted at Federal Government Polyclinic (FGPC) Hospital, Islamabad for a period of 3 months. All the patients who had either RT-PCR for COVID-19 or HRCT findings suggestive of COVID were included in the study. The inflammatory markers like C-reactive protein (CRP), D-Dimers, and Lactate dehydrogenase (LDH) were done and a combined score DLC was calculated. The need for Oxygen (litres/min), Bilevel positive airway pressure (BIPAP), or Mechanical Invasive Ventilation was documented. \u0000Results: The study was conducted on 213 patients which included 119(56%) male patients and 94(44%) female patients. COVID-19 PCR was positive in 193(90.6%) while 20 patients (9.4%) had a negative PCR but HRCT suggestive of COVID. HRCT was done in a total of 46 patients out of the 213 patients and 45 had features suggestive of COVID-19. The AUROC was 0.686(0.61-0.75) for D dimers, 0.688(0.61-0.75) for LDH, and 0.649(0.517-0.72) for CRP respectively, and Spearman rho values of (0.326, 0.328 and 0.266) respectively with a p-value (0.000). \u0000Conclusion: D-dimer, LDH and CRP individually as well as a combined score of the inflammatory markers (DLC) and Oxygen requirement had a significant correlation with the mortality of the COVID-19 patients. \u0000Key words: COVID-19, CRP, LDH, D dimers, DLC score.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80210254","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 : 2023-07-06DOI: 10.35787/jimdc.v12i2.922
N. Nabi, Umer Mehmood, N. Ahmed
Perianal fistula (fistula-in-ano) is one of the most common anorectal diseases. It is an abnormal connection between the anal canal and the perianal skin and is lined with granulation tissue. Although benign, the condition can cause significant distress and embarrassment to the patient. Major causes of an anal fistula are clogged anal glands forming anal abscesses. Other, much less common, conditions are infections, trauma and tumors. The treatment of an anal fistula depends on the etiology and location of the fistula. Most fistulas are treated surgically, through a variety of different procedures. Actinomycosis which is a gram positive bacteria can rarely cause perianal fistulas which is difficult to diagnose clinically so can result in mismanagement and recurrences leading to repeated surgeries. Key words: Actinomycosis, Fistula in ano, Gram positive bacteria.
{"title":"Actinomycosis, A Rare Cause of Perianal Fistula","authors":"N. Nabi, Umer Mehmood, N. Ahmed","doi":"10.35787/jimdc.v12i2.922","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.922","url":null,"abstract":"Perianal fistula (fistula-in-ano) is one of the most common anorectal diseases. It is an abnormal connection between the anal canal and the perianal skin and is lined with granulation tissue. Although benign, the condition can cause significant distress and embarrassment to the patient. Major causes of an anal fistula are clogged anal glands forming anal abscesses. Other, much less common, conditions are infections, trauma and tumors. The treatment of an anal fistula depends on the etiology and location of the fistula. Most fistulas are treated surgically, through a variety of different procedures. Actinomycosis which is a gram positive bacteria can rarely cause perianal fistulas which is difficult to diagnose clinically so can result in mismanagement and recurrences leading to repeated surgeries. \u0000Key words: Actinomycosis, Fistula in ano, Gram positive bacteria.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"45 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78139438","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 : 2023-07-06DOI: 10.35787/jimdc.v12i2.978
Farhat Khurshid
Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems worldwide. Antibiotic resistance of clinically important bacteria, the types and levels of resistance and multidrug resistance (MDR) among pathogens is extremely important. With the rise of infections caused by ESBL-producing Enterobacteriaceae (ESBL-E) and with their co-resistance to many other antibiotic classes, carbapenems have been considered to be the last and life-saving agents against these life-threatening infections. The current study was carried out to determine the frequency, disease burden and therapeutic challenge of infections caused by multidrug resistant strains of Enterobacteriaceae with particular reference to Extended-Spectrum Beta-lactamase-producing Enterobacteriaceae (ESBL-E), Carbapenem-resistant Enterobacteriaceae (CRE) and the emerging infections caused by Extended-Spectrum Beta-lactamase-producing Carbapenem-resistant Enterobacteriaceae (ESBL-CRE) Methodology: This cross-sectional study was carried out in the Microbiology Department of Islamabad Diagnostic Centre over a period of two years, from January 2018 to December 2020. Enterobacteriaceae isolated on culture from clinical samples were identified using appropriate characterization tests including the selective use of API 20E. Antimicrobial susceptibility testing (AST) and ESBL detection was performed on Vitek 2 compact system by Minimum Inhibitory Concentration (MIC) methodology. Isolates that were resistant to more than one carbapenem were identified as Carbapenem-Resistant Enterobacteriaceae ( CRE). Results: Out of 7270 specimens that yielded the growth of Enterobacteriaceae, 2943 (40.5%) were ESBL positive (ESBL-E) and 487 (6.7%) were carbapenem resistant (CRE). Further analysis of CRE revealed 247/487 as non-ESBL-CRE and 240/487 as ESBL-producing CRE (ESBL-CRE). Maximum number of CRE isolates - both non-ESBL and ESBL CRE - were from urine specimens. Klebsiella species followed by Eschcerichia coli and Enterobacter were the dominant ESBL-CRE isolates. Admission to a health care facility was the major risk factor followed by advancing age. Conclusion: Besides ESBL-E, Carbapenum-resistant Enterobacteriaceae (CRE), particularly those co-producing Extended-Spectrum Beta-lactamase (ESBL-CRE), (wherein resistance mechanisms to both carbapenems as well as to beta-lactam antibiotics are concomitantly expressed in the same organism), have emerged as the major pathogens of concern. The later appears to have introduced a new dimension in the resistance profile of infections caused by multidrug-resistant enterobacteriaceae. Key words: Carbapenem Resistant Enterobacteriaceae, Extended-Spectrum Beta-Lactamase, ESBL-producing Carbapenem-resistant Enterobacteriaceae, Escherichia coli, Klebsiella, Multi-drug Resistant Enterobacteriaceae.
{"title":"Challenge of Multidrug-resistant Strains of Enterobacteriaceae Isolated from Clinical Samples","authors":"Farhat Khurshid","doi":"10.35787/jimdc.v12i2.978","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.978","url":null,"abstract":"Background: The rising level of antimicrobial resistance among bacterial pathogens is one of the most significant public health problems worldwide. Antibiotic resistance of clinically important bacteria, the types and levels of resistance and multidrug resistance (MDR) among pathogens is extremely important. With the rise of infections caused by ESBL-producing Enterobacteriaceae (ESBL-E) and with their co-resistance to many other antibiotic classes, carbapenems have been considered to be the last and life-saving agents against these life-threatening infections. The current study was carried out to determine the frequency, disease burden and therapeutic challenge of infections caused by multidrug resistant strains of Enterobacteriaceae with particular reference to Extended-Spectrum Beta-lactamase-producing Enterobacteriaceae (ESBL-E), Carbapenem-resistant Enterobacteriaceae (CRE) and the emerging infections caused by Extended-Spectrum Beta-lactamase-producing Carbapenem-resistant Enterobacteriaceae (ESBL-CRE) \u0000Methodology: This cross-sectional study was carried out in the Microbiology Department of Islamabad Diagnostic Centre over a period of two years, from January 2018 to December 2020. Enterobacteriaceae isolated on culture from clinical samples were identified using appropriate characterization tests including the selective use of API 20E. Antimicrobial susceptibility testing (AST) and ESBL detection was performed on Vitek 2 compact system by Minimum Inhibitory Concentration (MIC) methodology. Isolates that were resistant to more than one carbapenem were identified as Carbapenem-Resistant Enterobacteriaceae ( CRE). \u0000Results: Out of 7270 specimens that yielded the growth of Enterobacteriaceae, 2943 (40.5%) were ESBL positive (ESBL-E) and 487 (6.7%) were carbapenem resistant (CRE). Further analysis of CRE revealed 247/487 as non-ESBL-CRE and 240/487 as ESBL-producing CRE (ESBL-CRE). Maximum number of CRE isolates - both non-ESBL and ESBL CRE - were from urine specimens. Klebsiella species followed by Eschcerichia coli and Enterobacter were the dominant ESBL-CRE isolates. Admission to a health care facility was the major risk factor followed by advancing age. \u0000Conclusion: Besides ESBL-E, Carbapenum-resistant Enterobacteriaceae (CRE), particularly those co-producing Extended-Spectrum Beta-lactamase (ESBL-CRE), (wherein resistance mechanisms to both carbapenems as well as to beta-lactam antibiotics are concomitantly expressed in the same organism), have emerged as the major pathogens of concern. The later appears to have introduced a new dimension in the resistance profile of infections caused by multidrug-resistant enterobacteriaceae. \u0000Key words: Carbapenem Resistant Enterobacteriaceae, Extended-Spectrum Beta-Lactamase, ESBL-producing Carbapenem-resistant Enterobacteriaceae, Escherichia coli, Klebsiella, Multi-drug Resistant Enterobacteriaceae. ","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"108 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85797143","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}
Abdominal cocoon syndrome (ACS) is encapsulation of the abdominal organs by thick fibro-collagenous material forming cocoons. On the basis of the part of abdominal organ encapsulated, ACS is classified into three types. Patients with this condition usually present with intestinal obstruction. We present a case who presented to us with features of intestinal obstruction and was diagnosed as a rare case of abdominal cocoon syndrome on CT scan. He was managed operatively where adhenolysis was performed and patient had uneventful recovery. CT scan is found to be the investigation of choice. Laparotomy with excision of membrane overlying bowel loops is the treatment most commonly adopted by surgeons and it has satisfactory results. Key words: Cocoon syndrome, Computed tomography, Intestinal obstruction.
{"title":"A Case Report on Abdominal Cocoon Syndrome","authors":"Sidra Rauf, Fahad Akhtar, Kanza Farrukh, Aiman Noor, Manzer Mehmood","doi":"10.35787/jimdc.v12i2.988","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.988","url":null,"abstract":"Abdominal cocoon syndrome (ACS) is encapsulation of the abdominal organs by thick fibro-collagenous material forming cocoons. On the basis of the part of abdominal organ encapsulated, ACS is classified into three types. Patients with this condition usually present with intestinal obstruction. We present a case who presented to us with features of intestinal obstruction and was diagnosed as a rare case of abdominal cocoon syndrome on CT scan. He was managed operatively where adhenolysis was performed and patient had uneventful recovery. CT scan is found to be the investigation of choice. Laparotomy with excision of membrane overlying bowel loops is the treatment most commonly adopted by surgeons and it has satisfactory results. \u0000Key words: Cocoon syndrome, Computed tomography, Intestinal obstruction.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"125 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73655341","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 : 2023-07-06DOI: 10.35787/jimdc.v12i2.842
M. Rafiq, Amna Arooj, A. Siddiqa, N. Khan, S. Khan, Rabia Saeed
Background: Thyroid disorders are among one the leading causes of endocrine problems worldwide. Hypothyroidism is very common and usually is more prevalent in females. Thyroid function tests (TFTs) play a vital role in the diagnosis and monitoring of thyroid diseases. Methodology: This cross-sectional study was conducted at Sahiwal Medical College, Sahiwal after approval from the Institutional review board. The results of 2281 specimens tested for TFTs in the Pathology laboratory between August 2018 to December 2020 were included. Samples were analyzed by immunochemiluminescent assay method on an Access 2 analyzer by Beckman Coulter. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A chi-square test was applied. P-value <0.05 was considered significant. Results: A total of 2281 patient data was included in the study. The mean age of participants was 38.86±15.30 years and the majority were females. 64.1% of results were within the normal limit (euthyroid) while the remaining 35.9% had abnormal thyroid profiles. Hyperthyroidism was the most common abnormality (9.5%) followed by subclinical hypothyroidism (8.9%). Chi-square test revealed a statistically significant difference in age groups, with p-value of 0.004. Conclusion: Thyroid diseases are quite common. Hyperthyroidism is slightly more prevalent than hypothyroidism in our community. Key words: Hypothyroidism, Hyperthyroidism, Thyroid disorders, Subclinical thyroid disease.
{"title":"The Spectrum of Biochemical Changes in Thyroid Function Tests, Performed at Sahiwal Medical College, Sahiwal","authors":"M. Rafiq, Amna Arooj, A. Siddiqa, N. Khan, S. Khan, Rabia Saeed","doi":"10.35787/jimdc.v12i2.842","DOIUrl":"https://doi.org/10.35787/jimdc.v12i2.842","url":null,"abstract":"Background: Thyroid disorders are among one the leading causes of endocrine problems worldwide. Hypothyroidism is very common and usually is more prevalent in females. Thyroid function tests (TFTs) play a vital role in the diagnosis and monitoring of thyroid diseases. \u0000Methodology: This cross-sectional study was conducted at Sahiwal Medical College, Sahiwal after approval from the Institutional review board. The results of 2281 specimens tested for TFTs in the Pathology laboratory between August 2018 to December 2020 were included. Samples were analyzed by immunochemiluminescent assay method on an Access 2 analyzer by Beckman Coulter. Data were analyzed using Statistical Package for the Social Sciences (SPSS) version 25. A chi-square test was applied. P-value <0.05 was considered significant. \u0000Results: A total of 2281 patient data was included in the study. The mean age of participants was 38.86±15.30 years and the majority were females. 64.1% of results were within the normal limit (euthyroid) while the remaining 35.9% had abnormal thyroid profiles. Hyperthyroidism was the most common abnormality (9.5%) followed by subclinical hypothyroidism (8.9%). Chi-square test revealed a statistically significant difference in age groups, with p-value of 0.004. \u0000Conclusion: Thyroid diseases are quite common. Hyperthyroidism is slightly more prevalent than hypothyroidism in our community. \u0000 Key words: Hypothyroidism, Hyperthyroidism, Thyroid disorders, Subclinical thyroid disease.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78275148","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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