Pub Date : 2023-01-03DOI: 10.35787/jimdc.v11i4.661
F. Batool, A. Ali, S. Lodhi, J. Zahir
Background: The myoclonus after induction of anesthesia with etomidate can lead to increased risk of regurgitation and aspiration. We conducted this study to compare the effectiveness of midazolam and lidocaine for the prevention of etomidate induced myoclonus. Methodology: This randomized controlled trial was done in the Department of Anesthesiology and Intensive Care, Holy Family Hospital, Rawalpindi from January-June 2015 after approval of hospital ethical committee. Informed consent (written) was taken from 224 patients. Patients were allocated into 2 equal groups randomly with the help of computer-generated numbers. Two minutes after induction with etomidate, Group A got 1 ml of 2% lidocaine, and one ml (1 mg) of midazolam was given to Group B. Myoclonus was evaluated in the following one minute, after which 0.5 mg/kg of succinylcholine was given to the patient to facilitate endotracheal intubation. Time of onset of induction was marked by loss of eyelash reflex. Myoclonus was recorded at 20, 40, and 60 seconds. Drug was found to be effective if there was no myoclonus within one minute of etomidate induction. Analysis of data was done using SPSS 17. Results: Lignocaine was effective in preventing myoclonus in 55.40% of patients and Midazolam prevented it in 69.60%. The variation between the results of the groups was found significant statistically. (P< 0.05) Conclusion: Both midazolam and lignocaine are effective in preventing the occurrence of myoclonus associated with etomidate. However, midazolam is the more effective of the two drugs. Keywords: Etomidate, Lignocaine, Midazolam, Myoclonus
{"title":"Effect of Pretreatment of Lignocaine Versus Midazolam in the Prevention of Etomidate Induced Myoclonus","authors":"F. Batool, A. Ali, S. Lodhi, J. Zahir","doi":"10.35787/jimdc.v11i4.661","DOIUrl":"https://doi.org/10.35787/jimdc.v11i4.661","url":null,"abstract":"Background: The myoclonus after induction of anesthesia with etomidate can lead to increased risk of regurgitation and aspiration. We conducted this study to compare the effectiveness of midazolam and lidocaine for the prevention of etomidate induced myoclonus. \u0000Methodology: This randomized controlled trial was done in the Department of Anesthesiology and Intensive Care, Holy Family Hospital, Rawalpindi from January-June 2015 after approval of hospital ethical committee. Informed consent (written) was taken from 224 patients. Patients were allocated into 2 equal groups randomly with the help of computer-generated numbers. Two minutes after induction with etomidate, Group A got 1 ml of 2% lidocaine, and one ml (1 mg) of midazolam was given to Group B. Myoclonus was evaluated in the following one minute, after which 0.5 mg/kg of succinylcholine was given to the patient to facilitate endotracheal intubation. \u0000Time of onset of induction was marked by loss of eyelash reflex. Myoclonus was recorded at 20, 40, and 60 seconds. Drug was found to be effective if there was no myoclonus within one minute of etomidate induction. Analysis of data was done using SPSS 17. \u0000Results: Lignocaine was effective in preventing myoclonus in 55.40% of patients and Midazolam prevented it in 69.60%. The variation between the results of the groups was found significant statistically. (P< 0.05) \u0000Conclusion: Both midazolam and lignocaine are effective in preventing the occurrence of myoclonus associated with etomidate. However, midazolam is the more effective of the two drugs. \u0000Keywords: Etomidate, Lignocaine, Midazolam, Myoclonus \u0000 ","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81667155","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 : 2023-01-03DOI: 10.35787/jimdc.v11i4.903
Dr Muhammad Zeeshan, Professor Dr Shajee Ahmed Siddiqui, Dr Muhammad Azhar Jamil, Dr Ghazal Iftikhar, Dr Adil Farooq
Primary chest wall masses or tumors can be of two types, either benign or malignant. Diffuse large B cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma (NHL). Though an aggressive malignancy, with timely and appropriate treatment, approximately two-third of all patients can be cured. We present a rare case of DLBCL presenting as chest wall mass. This case suggests the possibility of the presence of primary malignant B cell lymphoma, with the presentation as a chest wall lesion. Keywords: Chest mass, Diffuse large B cell lymphoma, Mass, Non- Hodgkin’s lymphoma.
{"title":"Primary Diffuse Large B Cell Lymphoma Presenting as Chest Wall Mass: A Case Report","authors":"Dr Muhammad Zeeshan, Professor Dr Shajee Ahmed Siddiqui, Dr Muhammad Azhar Jamil, Dr Ghazal Iftikhar, Dr Adil Farooq","doi":"10.35787/jimdc.v11i4.903","DOIUrl":"https://doi.org/10.35787/jimdc.v11i4.903","url":null,"abstract":"Primary chest wall masses or tumors can be of two types, either benign or malignant. Diffuse large B cell lymphoma (DLBCL) is an aggressive type of non-Hodgkin lymphoma (NHL). Though an aggressive malignancy, with timely and appropriate treatment, approximately two-third of all patients can be cured. We present a rare case of DLBCL presenting as chest wall mass. This case suggests the possibility of the presence of primary malignant B cell lymphoma, with the presentation as a chest wall lesion. \u0000Keywords: Chest mass, Diffuse large B cell lymphoma, Mass, Non- Hodgkin’s lymphoma.","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90246199","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 : 2023-01-03DOI: 10.35787/jimdc.v11i4.645
Rubab Jawed, Dr Ruqayyah Quresh Hashmi, Dr Hafsa Usman, Dr Mehtab, Dr Saba Sabir
Background: Health care professionals come across many ethically difficult situations in their clinical practices and community; the students should be equipped with skills to resolve ethical and professional issues. Methodology: A cross-sectional study was conducted at Baqai dental college, Karachi. All the faculty members and house officers of the dental teaching hospital were included in the study. The tool used for the data collection was a structured questionnaire, for drawing views of the participants on professionalism and ethics teaching. The survey instrument evaluated two domains; attitudes 25 items, and goals 19 items on ethics and professionalism education. Data were recorded and analyzed in SPSS 24. To compare the responses of both the groups, that is, the house officers and the faculty member’s independent t-test was applied to compare the mean scores. A p-value of ≤ 0.05 was considered significant. Results: The questionnaire was circulated to a total of 157 participants (75 faculty members and 82 house officers) with a 100% response rate. The faculty members and the house officers showed a positive attitude regarding ethics, professionalism, and teachings. The participants agreed with the goals that can be achieved by incorporating professionalism and medical ethics in education. The participant strongly affirmed the learning and teaching of professionalism (4.06 ± 0.989). Conclusion: The realization of the need to teach ethics and professionalism by dental professionals is the first step to bringing change in their daily clinical practice and interpersonal qualities. Keywords: Ethics, Professionalism, “Education, Medical”, “Personality development”, “Social Desirability”.
{"title":"Perception of Ethics and Professionalism Teaching among Dental Professionals at a Teaching Hospital in Karachi","authors":"Rubab Jawed, Dr Ruqayyah Quresh Hashmi, Dr Hafsa Usman, Dr Mehtab, Dr Saba Sabir","doi":"10.35787/jimdc.v11i4.645","DOIUrl":"https://doi.org/10.35787/jimdc.v11i4.645","url":null,"abstract":"Background: Health care professionals come across many ethically difficult situations in their clinical practices and community; the students should be equipped with skills to resolve ethical and professional issues. \u0000Methodology: A cross-sectional study was conducted at Baqai dental college, Karachi. All the faculty members and house officers of the dental teaching hospital were included in the study. The tool used for the data collection was a structured questionnaire, for drawing views of the participants on professionalism and ethics teaching. The survey instrument evaluated two domains; attitudes 25 items, and goals 19 items on ethics and professionalism education. Data were recorded and analyzed in SPSS 24. To compare the responses of both the groups, that is, the house officers and the faculty member’s independent t-test was applied to compare the mean scores. A p-value of ≤ 0.05 was considered significant. \u0000Results: The questionnaire was circulated to a total of 157 participants (75 faculty members and 82 house officers) with a 100% response rate. The faculty members and the house officers showed a positive attitude regarding ethics, professionalism, and teachings. The participants agreed with the goals that can be achieved by incorporating professionalism and medical ethics in education. The participant strongly affirmed the learning and teaching of professionalism (4.06 ± 0.989). \u0000Conclusion: The realization of the need to teach ethics and professionalism by dental professionals is the first step to bringing change in their daily clinical practice and interpersonal qualities. \u0000Keywords: Ethics, Professionalism, “Education, Medical”, “Personality development”, “Social Desirability”. \u0000 ","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90305058","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.751
Dr. Ayesha Sarwar, Prof. Ashok Kumar Tanwni, Dr. Anum Usman, Khalida Moeed
Background: Tissue margin marking with India ink is important in decision making for surgeons. The present study was conducted to examine the reliability of different shades of locally available poster colours in tissue marking and to evaluate the colour perceptibility microscopically in comparison with similar tissues marked by India ink. Methodology: This experimental study was conducted at Department of Pathology, HBS Medical & Dental College & Hospital, Islamabad from 27th February 2021 to 29th April 2021. Sample size was fifty, collected through convenient sampling technique. Five types of formalin fixed tissue specimens were selected for the study so as to evaluate the effectiveness of poster ink marking on different tissue surfaces. From each specimen, four sections were taken from the margins. Three shades of poster colour (black, blue and green) were used to ink three sections while one section from each tissue type was marked with India ink. After complete tissue processing and routine haematoxylin and eosin (H&E) staining, slides were examined microscopically. Scoring was done on a scale 0 to 3 on the basis of visibility. Results: The present study showed that poster colours inking of the tissues was quite reliable as compared to India ink. Most consistent results were achieved with black and blue colours as compared to green colour. Conclusion: Poster colours are reliable tool for tissue marking when India ink is not available. Their availability in a variety of colours provides them an edge over India ink. Key words: Eosin, India ink, Resection Margins
{"title":"Comparative Benefits of Tissue Marking by Poster Ink in Histopathology","authors":"Dr. Ayesha Sarwar, Prof. Ashok Kumar Tanwni, Dr. Anum Usman, Khalida Moeed","doi":"10.35787/jimdc.v11i3.751","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.751","url":null,"abstract":"Background: Tissue margin marking with India ink is important in decision making for surgeons. The present study was conducted to examine the reliability of different shades of locally available poster colours in tissue marking and to evaluate the colour perceptibility microscopically in comparison with similar tissues marked by India ink. \u0000Methodology: This experimental study was conducted at Department of Pathology, HBS Medical & Dental College & Hospital, Islamabad from 27th February 2021 to 29th April 2021. Sample size was fifty, collected through convenient sampling technique. Five types of formalin fixed tissue specimens were selected for the study so as to evaluate the effectiveness of poster ink marking on different tissue surfaces. From each specimen, four sections were taken from the margins. Three shades of poster colour (black, blue and green) were used to ink three sections while one section from each tissue type was marked with India ink. After complete tissue processing and routine haematoxylin and eosin (H&E) staining, slides were examined microscopically. Scoring was done on a scale 0 to 3 on the basis of visibility. \u0000Results: The present study showed that poster colours inking of the tissues was quite reliable as compared to India ink. Most consistent results were achieved with black and blue colours as compared to green colour. \u0000Conclusion: Poster colours are reliable tool for tissue marking when India ink is not available. Their availability in a variety of colours provides them an edge over India ink. \u0000Key words: Eosin, India ink, Resection Margins","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89850154","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.910
Admin Jimdc, Baba Sheikh
The sustainable development goal 3.8, adopted in 2015 by the United Nations advocated the need for ‘Universal Health Coverage’ (UHC), a roadmap promising that all people, particularly those in need, have access to essential health services when and where they need, without any financial hardship. UHC is not a new lexicon, it was outlined in the founding constitution of the World Health Organization (WHO) that has stipulated health as a fundamental and universal right of every human being without distinction of race, religion and political belief, economic and social condition. WHO defines ‘maximum’ population coverage, health service coverage, and financial protection, as three dimensions of UHC. The first dimension is relatively simpler to understand: what proportion of the people in the catchment of a health facility are covered for health services, and how many are left out. The second dimension delineates the range of essential health services made available to the people e.g. immunization, family planning, antenatal care, delivery by skilled birth attendant, treatment of common ailments, and services for HIV/AIDS, tuberculosis and malaria etc. Third dimension is about the expenditure incurred while seeking the healthcare, especially the out of pocket expenditure or the cost sharing by the patient, which is supposed
{"title":"Universal Health Coverage in Pakistan: A call for Health System Reforms","authors":"Admin Jimdc, Baba Sheikh","doi":"10.35787/jimdc.v11i3.910","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.910","url":null,"abstract":"The sustainable development goal 3.8, adopted in 2015 by the United Nations advocated the need for ‘Universal Health Coverage’ (UHC), a roadmap promising that all people, particularly those in need, have access to essential health services when and where they need, without any financial hardship. UHC is not a new lexicon, it was outlined in the founding constitution of the World Health Organization (WHO) that has stipulated health as a fundamental and universal right of every human being without distinction of race, religion and political belief, economic and social condition. WHO defines ‘maximum’ population coverage, health service coverage, and financial protection, as three dimensions of UHC. The first dimension is relatively simpler to understand: what proportion of the people in the catchment of a health facility are covered for health services, and how many are left out. The second dimension delineates the range of essential health services made available to the people e.g. immunization, family planning, antenatal care, delivery by skilled birth attendant, treatment of common ailments, and services for HIV/AIDS, tuberculosis and malaria etc. Third dimension is about the expenditure incurred while seeking the healthcare, especially the out of pocket expenditure or the cost sharing by the patient, which is supposed","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83164559","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.709
N. Nabi, A. Ali, M. Fatima, Armaghana Qamar Khan, Henna Azmat, Ashok Kumar Tanwani
Background: Urine cytology is an initial noninvasive screening test done in patients with suspected urothelial carcinoma. The objective of this study was to compare the sensitivity of conventional smear cytology with cell block technique for the diagnosis of malignant cells in urine and to assess the efficacy of p53 immuno-marker in the diagnosis and prognosis of urinary bladder cancer. Methodology: The study was carried out in the department of Histopathology, Pakistan Institute of Medical Sciences(PIMS), Islamabad. Cell blocks and cytology smears and were prepared from urine samples of 80 patients of urothelial carcinoma and p53 stain was applied. Data was analyzed using version 21. Sensitivity of conventional smear and cell block techniques were calculated for both low and high grade urothelial carcinomas. Results:The sensitivity of detecting atypical cells using conventional smear was 31% and 70.6% for low grade and high grade urothelial tumors respectively. The sensitivity increased to 41.4% and 84.3% for low and high grade urothelial carcinomas respectively with cell block technique. Positive p53 stain was seen in 13.8% of cases with low grade tumors and 66.7% cases with high grade tumors. Chi-square test was used to find the association of cytology findings with the histologic grade. Conclusion: Sensitivity of urine cell blocks is higher than the conventional smear method for detecting high grade lesions. It can be used as an efficient non-invasive technique and an adjunct tool for the determination of disease relapse and overall survival in patients. Keywords: Carcinoma, Cytology, P53 Protein, Urine
{"title":"Utility of Cell Block with p53 Immunostain in Diagnosing Urothelial Carcinoma","authors":"N. Nabi, A. Ali, M. Fatima, Armaghana Qamar Khan, Henna Azmat, Ashok Kumar Tanwani","doi":"10.35787/jimdc.v11i3.709","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.709","url":null,"abstract":"Background: Urine cytology is an initial noninvasive screening test done in patients with suspected urothelial carcinoma. The objective of this study was to compare the sensitivity of conventional smear cytology with cell block technique for the diagnosis of malignant cells in urine and to assess the efficacy of p53 immuno-marker in the diagnosis and prognosis of urinary bladder cancer. \u0000Methodology: The study was carried out in the department of Histopathology, Pakistan Institute of Medical Sciences(PIMS), Islamabad. Cell blocks and cytology smears and were prepared from urine samples of 80 patients of urothelial carcinoma and p53 stain was applied. Data was analyzed using version 21. Sensitivity of conventional smear and cell block techniques were calculated for both low and high grade urothelial carcinomas. \u0000Results:The sensitivity of detecting atypical cells using conventional smear was 31% and 70.6% for low grade and high grade urothelial tumors respectively. The sensitivity increased to 41.4% and 84.3% for low and high grade urothelial carcinomas respectively with cell block technique. Positive p53 stain was seen in 13.8% of cases with low grade tumors and 66.7% cases with high grade tumors. Chi-square test was used to find the association of cytology findings with the histologic grade. \u0000Conclusion: Sensitivity of urine cell blocks is higher than the conventional smear method for detecting high grade lesions. It can be used as an efficient non-invasive technique and an adjunct tool for the determination of disease relapse and overall survival in patients. \u0000Keywords: Carcinoma, Cytology, P53 Protein, Urine","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86732582","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.774
M. Ullah
Background: Laparoscopic Cholecystectomy is a commonly performed surgery and is a gold standard for the treatment of cholelithiasis as it has fewer side effects. This study was conducted to determine indications and complications of this surgery at a tertiary care hospital in Islamabad. Methodology: This retrospective study was conducted in the department of Surgery, Maroof International Hospital from March 2017 to March 2019. A total of 250 patients who underwent laparoscopic cholecystectomy were included through consecutive sampling technique. The data regarding age, gender, mode of presentation, types of presentation, per operative findings, operative complications and duration of hospital stay was collected from patients’ medical record. Statistical Package for Social Sciences SPSS version 23 was used to analyze data. Results: Mean age of the participants was 46.24 ± 14.13 years. Female to male ratio was 2.73:1. Almost 38.4% patients had chronic cholecystitis, 35.2% had symptomatic gallstone disease, 24.8% had acute cholecystitis and 1.6% had gallbladder polyps. No major vascular or common bile duct injury were noted. 27.2% patients had per operative gallbladder perforation. Stone spillage occurred in 8.8% patients with retrieval in all of them. 75.2% patients were discharged on day 1. Per operatively, 98.4% patients had cholelithiasis, 59.6% had adhesions, 9.6% had mucocele, 1.6% had empyema and 0.8% patients had collections. Conclusion: Laparoscopic cholecystectomy is a safe procedure in all types of gallstone disease presentations with low complication rate. Key words: Cholelithiasis, Gallstones, Laparoscopic Cholecystectomy, Per-operative complications
背景:腹腔镜胆囊切除术是一种常用的手术，由于其副作用少，是治疗胆石症的金标准。本研究是在伊斯兰堡一家三级医院进行的，目的是确定该手术的适应症和并发症。方法:本回顾性研究于2017年3月至2019年3月在Maroof国际医院外科进行。通过连续抽样技术，共纳入250例行腹腔镜胆囊切除术的患者。从患者的医疗记录中收集有关年龄、性别、表现方式、表现类型、每次手术发现、手术并发症和住院时间的数据。使用Statistical Package for Social Sciences SPSS version 23分析数据。结果:患者平均年龄46.24±14.13岁。男女比例为2.73:1。慢性胆囊炎38.4%，有症状性胆结石35.2%，急性胆囊炎24.8%，胆囊息肉1.6%。无大血管或胆总管损伤。27.2%的患者术后发生胆囊穿孔。8.8%的患者术后均出现结石溢出。75.2%患者在第1天出院。术后98.4%的患者有胆石症，59.6%的患者有粘连，9.6%的患者有粘液囊肿，1.6%的患者有脓胸，0.8%的患者有积液。结论:腹腔镜胆囊切除术是一种安全的手术方法，适用于所有类型的胆结石疾病，并发症发生率低。关键词:胆石症;胆结石;腹腔镜胆囊切除术
{"title":"An Audit of Laparoscopic Cholecystectomy; at a Tertiary Care Hospital in Islamabad","authors":"M. Ullah","doi":"10.35787/jimdc.v11i3.774","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.774","url":null,"abstract":"Background: Laparoscopic Cholecystectomy is a commonly performed surgery and is a gold standard for the treatment of cholelithiasis as it has fewer side effects. This study was conducted to determine indications and complications of this surgery at a tertiary care hospital in Islamabad. \u0000Methodology: This retrospective study was conducted in the department of Surgery, Maroof International Hospital from March 2017 to March 2019. A total of 250 patients who underwent laparoscopic cholecystectomy were included through consecutive sampling technique. The data regarding age, gender, mode of presentation, types of presentation, per operative findings, operative complications and duration of hospital stay was collected from patients’ medical record. Statistical Package for Social Sciences SPSS version 23 was used to analyze data. \u0000Results: Mean age of the participants was 46.24 ± 14.13 years. Female to male ratio was 2.73:1. Almost 38.4% patients had chronic cholecystitis, 35.2% had symptomatic gallstone disease, 24.8% had acute cholecystitis and 1.6% had gallbladder polyps. No major vascular or common bile duct injury were noted. 27.2% patients had per operative gallbladder perforation. Stone spillage occurred in 8.8% patients with retrieval in all of them. 75.2% patients were discharged on day 1. Per operatively, 98.4% patients had cholelithiasis, 59.6% had adhesions, 9.6% had mucocele, 1.6% had empyema and 0.8% patients had collections. \u0000Conclusion: Laparoscopic cholecystectomy is a safe procedure in all types of gallstone disease presentations with low complication rate. \u0000Key words: Cholelithiasis, Gallstones, Laparoscopic Cholecystectomy, Per-operative complications","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89043514","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.777
Faiz Rasul
. Background: Pleomorphic adenomas (PAs) are the most common type of salivary gland tumors (SGTs) which may undergo malignant transformation to Carcinoma ex PA (CaExPA). The purpose of this study was to determine mitotic index (MI) and expression of Ki-67 in Pleomorphic adenomas of salivary gland tumors. Methodology: This study was carried out on sixty patients of pleomorphic adenoma. Slides with specimens were stained with Hematoxylin & Eosin to count Mitotic index. Labeling Index (LI) of Ki-67 was determined immunohistochemically. Mitotic figures (MF) were counted in 10 HPF selected in the proliferative area. MI was scored as 1 (0 to 4 MF per 10 HPF); 2 (5-9 MF per 10 HPF) and 3 (> 9 MF per 10 HPF). Immunoexpression of Ki-67 was scored as ‘0-negative’ when <5% of neoplastic cells stained, ‘1-weak positive’ when 5-19% of neoplastic cells were stained, ‘2-moderate positive’ when 20-49% of neoplastic cells were stained, and ‘3-strong positive’ when >50% of neoplastic cells were stained with Ki-67. Data was, entered in SPSS 21. Results: Mean age was 38.7 ± 12.86 years. Out of 60 cases, 26 (43.33%) were of males while 34 (56.67%) were of females. Expression of Ki-67 was negative in 50% while remaining weak positive. Only score 01 of MI observed. Conclusion: Ki-67 is more sensitive marker than mitotic index in pleomorphic adenomas even in small sized tumors and it can help in detection of malignant transformation of PAs. Keywords: Adenomas, Immunohistochemistry, Ki-67 Antigen, Parotid Neoplasms, Pleomorphic
{"title":"Mitotic Index and Immunohistochemical Expression of Ki-67 in Pleomorphic Adenoma of Salivary Glands","authors":"Faiz Rasul","doi":"10.35787/jimdc.v11i3.777","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.777","url":null,"abstract":". \u0000Background: Pleomorphic adenomas (PAs) are the most common type of salivary gland tumors (SGTs) which may undergo malignant transformation to Carcinoma ex PA (CaExPA). The purpose of this study was to determine mitotic index (MI) and expression of Ki-67 in Pleomorphic adenomas of salivary gland tumors. \u0000Methodology: This study was carried out on sixty patients of pleomorphic adenoma. Slides with specimens were stained with Hematoxylin & Eosin to count Mitotic index. Labeling Index (LI) of Ki-67 was determined immunohistochemically. Mitotic figures (MF) were counted in 10 HPF selected in the proliferative area. MI was scored as 1 (0 to 4 MF per 10 HPF); 2 (5-9 MF per 10 HPF) and 3 (> 9 MF per 10 HPF). Immunoexpression of Ki-67 was scored as ‘0-negative’ when <5% of neoplastic cells stained, ‘1-weak positive’ when 5-19% of neoplastic cells were stained, ‘2-moderate positive’ when 20-49% of neoplastic cells were stained, and ‘3-strong positive’ when >50% of neoplastic cells were stained with Ki-67. Data was, entered in SPSS 21. \u0000Results: Mean age was 38.7 ± 12.86 years. Out of 60 cases, 26 (43.33%) were of males while 34 (56.67%) were of females. Expression of Ki-67 was negative in 50% while remaining weak positive. Only score 01 of MI observed. \u0000Conclusion: Ki-67 is more sensitive marker than mitotic index in pleomorphic adenomas even in small sized tumors and it can help in detection of malignant transformation of PAs. \u0000Keywords: Adenomas, Immunohistochemistry, Ki-67 Antigen, Parotid Neoplasms, Pleomorphic","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81275037","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 : 2022-09-28DOI: 10.35787/jimdc.v11i3.793
Taimoor Hassan
Alzheimer's disease is among the most prevalent types of dementia worldwide. Studying mice models, Australian researchers discovered one of the possible origins of Alzheimer's disease. The discovery has been termed a "breakthrough" by some. Scientists have gained a better grasp of why and how Alzheimer's disease arises by researching the blood-brain barrier. Their findings point to possible therapy and preventive strategies for the neurodegenerative disorder.
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Pub Date : 2022-09-28DOI: 10.35787/jimdc.v11i3.823
Palvisha Qadri, S. Tabassum, U. Chhipa
Background: Psoriasis is a common inflammatory dermatosis with significantly challenging clinical needs in patient management. Given its chronicity and social stigmatization, the burden on health-related life quality is substantial. The objective of this study was to assess psychosocial and financial impact of disease severity and treatment modalities on patients’ life quality. Methodology: A total of 93 clinically diagnosed patients with Psoriasis were included in this cross-sectional study. Quality of life was assessed through Dermatology Life Quality Index (DLQI) scoring system and disease severity by Psoriasis area severity index (PASI) respectively. Treatment modalities were evaluated by filling out a brief questionnaire. Descriptive analyses were presented as mean ± SD for symmetrically distributed variables while median with interquartile range (IQR) were reported for non-symmetrically distributed variables. Association was determined by Chi-square test considering p-value ≤0.05 as significant. Results: There were 47.3% male and 52.7% female patients. The Median DLQI score was 6.00 with an IQR of 7. Topical treatment was used in the majority of patients currently (60%). Quality of life ( QOL) for 41.9% of cases was mildly affected. Rest of the cases were affected more severely, consisting of 47.3% with moderate and 10.8% with severe impact on quality of life. Significant association of DLQI scores was found with disease severity and current treatment modalities. Conclusion: Different therapies along with disease severity, remarkably affect QoL among psoriasis patients. KEYWORDS Disease Severity ,Impact, Psoriasis , Quality of Life, Treatment
背景:银屑病是一种常见的炎症性皮肤病，在患者管理方面具有显著的临床挑战性。鉴于其长期性和社会污名化，与健康有关的生活质量负担沉重。本研究的目的是评估疾病严重程度和治疗方式对患者生活质量的心理社会和经济影响。方法:本横断面研究共纳入93例临床诊断为银屑病的患者。采用Dermatology life Quality Index (DLQI)评分系统评价生活质量，采用Psoriasis area severity Index (PASI)评价疾病严重程度。通过填写一份简短的问卷来评估治疗方式。对于对称分布的变量，描述性分析采用均数±标准差表示，而对于非对称分布的变量，采用四分位数范围(IQR)的中位数报告。以p值≤0.05为显著性，采用卡方检验确定相关性。结果:男性占47.3%，女性占52.7%。DLQI评分中位数为6.00,IQR为7。目前大多数患者(60%)采用局部治疗。41.9%的患者生活质量(QOL)轻度受影响。其余病例影响较严重，其中47.3%为中度影响，10.8%为重度影响。DLQI评分与疾病严重程度和当前治疗方式有显著关联。结论:不同治疗方法对银屑病患者的生活质量有显著影响。关键词:疾病严重程度，影响，银屑病，生活质量，治疗
{"title":"The Impact of Disease Severity and Treatment on Quality of Life in Patients of Psoriasis","authors":"Palvisha Qadri, S. Tabassum, U. Chhipa","doi":"10.35787/jimdc.v11i3.823","DOIUrl":"https://doi.org/10.35787/jimdc.v11i3.823","url":null,"abstract":"Background: Psoriasis is a common inflammatory dermatosis with significantly challenging clinical needs in patient management. Given its chronicity and social stigmatization, the burden on health-related life quality is substantial. The objective of this study was to assess psychosocial and financial impact of disease severity and treatment modalities on patients’ life quality. \u0000Methodology: A total of 93 clinically diagnosed patients with Psoriasis were included in this cross-sectional study. Quality of life was assessed through Dermatology Life Quality Index (DLQI) scoring system and disease severity by Psoriasis area severity index (PASI) respectively. Treatment modalities were evaluated by filling out a brief questionnaire. Descriptive analyses were presented as mean ± SD for symmetrically distributed variables while median with interquartile range (IQR) were reported for non-symmetrically distributed variables. Association was determined by Chi-square test considering p-value ≤0.05 as significant. \u0000Results: There were 47.3% male and 52.7% female patients. The Median DLQI score was 6.00 with an IQR of 7. Topical treatment was used in the majority of patients currently (60%). Quality of life ( QOL) for 41.9% of cases was mildly affected. Rest of the cases were affected more severely, consisting of 47.3% with moderate and 10.8% with severe impact on quality of life. Significant association of DLQI scores was found with disease severity and current treatment modalities. \u0000Conclusion: Different therapies along with disease severity, remarkably affect QoL among psoriasis patients. \u0000KEYWORDS \u0000Disease Severity ,Impact, Psoriasis , Quality of Life, Treatment","PeriodicalId":33701,"journal":{"name":"Journal of Islamabad Medical and Dental College","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79639180","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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