Pub Date : 2024-08-10DOI: 10.36570/jduhs.2024.2.2193
Khyal Muhammad, Kalsoom Kalsoom, Amna Khan, Anis Ur Rehman, Khadija Bibi
Objective: To evaluate the efficacy of azithromycin as a first-line therapy and the combination of meropenem and azithromycin as the second-line therapy in treating pediatric patients with extensively drug-resistant (XDR) Salmonella Typhi in Abbottabad, Pakistan. Methods: This retrospective cross-sectional study was conducted at Department of Pediatrics, Abbottabad International Medical Complex, Pakistan from May 2022 to January 2024. Children aged 1-15 years clinically diagnosed with typhoid fever were enrolled if subsequent blood cultures confirmed XDR Salmonella Typhi infection. Initial treatment comprised azithromycin. If there was no response to azithromycin, patients received a combination therapy of meropenem alongside continued azithromycin. Primary outcomes were clinical recovery, recurrence within 30 days post-treatment, and treatment-related adverse effects. Results: Of total 67 pediatric patients, the mean age of the patients was 10.02 ±2.76 years. The overall mean duration of defervescence was 6.01 ±2.98 days. Initially, all patients were treated with azithromycin alone. Most patients recovered clinically 57 (85.1%). For the 10 (14.9%) who did not respond, meropenem was added to azithromycin, resulting in recovery for all. The mean duration of defervescence found significantly low in patients who received azithromycin monotherapy as compared to patients who received combination therapy i.e., 4.80 ±0.58 days vs. 12.90 ±1.10 days (p-value <0.001). Mild nausea was the only adverse event observed in 29 patients (43.3%) during treatment. Conclusion: Azithromycin monotherapy demonstrated a high clinical recovery rate, with a significant reduction in fever duration compared to combination therapy with meropenem. Mild nausea was the only treatment-related adverse effect observed.
{"title":"Efficacy of Azithromycin and Meropenem in Pediatric XDR Salmonella Typhi: A Retrospective Study from Abbottabad, Pakistan","authors":"Khyal Muhammad, Kalsoom Kalsoom, Amna Khan, Anis Ur Rehman, Khadija Bibi","doi":"10.36570/jduhs.2024.2.2193","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2193","url":null,"abstract":"Objective: To evaluate the efficacy of azithromycin as a first-line therapy and the combination of meropenem and azithromycin as the second-line therapy in treating pediatric patients with extensively drug-resistant (XDR) Salmonella Typhi in Abbottabad, Pakistan. Methods: This retrospective cross-sectional study was conducted at Department of Pediatrics, Abbottabad International Medical Complex, Pakistan from May 2022 to January 2024. Children aged 1-15 years clinically diagnosed with typhoid fever were enrolled if subsequent blood cultures confirmed XDR Salmonella Typhi infection. Initial treatment comprised azithromycin. If there was no response to azithromycin, patients received a combination therapy of meropenem alongside continued azithromycin. Primary outcomes were clinical recovery, recurrence within 30 days post-treatment, and treatment-related adverse effects. Results: Of total 67 pediatric patients, the mean age of the patients was 10.02 ±2.76 years. The overall mean duration of defervescence was 6.01 ±2.98 days. Initially, all patients were treated with azithromycin alone. Most patients recovered clinically 57 (85.1%). For the 10 (14.9%) who did not respond, meropenem was added to azithromycin, resulting in recovery for all. The mean duration of defervescence found significantly low in patients who received azithromycin monotherapy as compared to patients who received combination therapy i.e., 4.80 ±0.58 days vs. 12.90 ±1.10 days (p-value <0.001). Mild nausea was the only adverse event observed in 29 patients (43.3%) during treatment. Conclusion: Azithromycin monotherapy demonstrated a high clinical recovery rate, with a significant reduction in fever duration compared to combination therapy with meropenem. Mild nausea was the only treatment-related adverse effect observed.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"7 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920581","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2158
Plernta Ethisan, Nawal Naeem, Abdul Jabbar Bhutto, Ayesha Khan, David Chinaecherem Innocent, Ramesh Kumar
Objective: To determine the factors affecting the quality of life (QoL) among aging population during the Corona Virus Disease-19 (COVID-19) crisis. Methods: This cross sectional study was conducted at Central, Northern, Northeastern, and Southern regions of Thailand from June to November 2021. Elderly persons aged 60 and above with Thai nationality included in the study. The QoL was measured with the WHO Quality of Life (WHOQoL-BREF-THAI) instrument which consisted of 26 items. QoL scores ranged from 26 to 130 points, classified as poor (26-60), moderate (61-95), and good (96-130). Results: Of total 400 participants, the mean age was 68.32 ±6.93 years. Not good QoL was observed in 3 (0.8%) participants, moderate QoL was observed in 213 (53.2%) participants, and good QoL was observed in 184 (46.0%) participants. A significant association of QoL found with education level (p-value 0.002), alcohol drinking (p-value 0.003), exercise (p-value <0.001), comorbidities (p-value <0.001), and hearing/knowing about COVID-19 (p-value 0.015). The chances of good QoL was 2 times significantly higher in participants who did exercise as compared to participants who did not perform exercise (cOR 2.03, 95% CI 1.35 to 3.07, p-value <0.001). Conclusion: The study concluded that exercise, higher education, avoiding alcohol, and good health significantly improve the QoL among the elderly during the COVID-19 pandemic. Moreover, regular exercise notably doubles the likelihood of better QoL.
{"title":"Factors Affecting the Quality of Life among the Aging Population during the Coronavirus Disease-19 Pandemic in Thailand","authors":"Plernta Ethisan, Nawal Naeem, Abdul Jabbar Bhutto, Ayesha Khan, David Chinaecherem Innocent, Ramesh Kumar","doi":"10.36570/jduhs.2024.2.2158","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2158","url":null,"abstract":"Objective: To determine the factors affecting the quality of life (QoL) among aging population during the Corona Virus Disease-19 (COVID-19) crisis. Methods: This cross sectional study was conducted at Central, Northern, Northeastern, and Southern regions of Thailand from June to November 2021. Elderly persons aged 60 and above with Thai nationality included in the study. The QoL was measured with the WHO Quality of Life (WHOQoL-BREF-THAI) instrument which consisted of 26 items. QoL scores ranged from 26 to 130 points, classified as poor (26-60), moderate (61-95), and good (96-130). Results: Of total 400 participants, the mean age was 68.32 ±6.93 years. Not good QoL was observed in 3 (0.8%) participants, moderate QoL was observed in 213 (53.2%) participants, and good QoL was observed in 184 (46.0%) participants. A significant association of QoL found with education level (p-value 0.002), alcohol drinking (p-value 0.003), exercise (p-value <0.001), comorbidities (p-value <0.001), and hearing/knowing about COVID-19 (p-value 0.015). The chances of good QoL was 2 times significantly higher in participants who did exercise as compared to participants who did not perform exercise (cOR 2.03, 95% CI 1.35 to 3.07, p-value <0.001). Conclusion: The study concluded that exercise, higher education, avoiding alcohol, and good health significantly improve the QoL among the elderly during the COVID-19 pandemic. Moreover, regular exercise notably doubles the likelihood of better QoL.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"8 10","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920179","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.1987
Hammad Hassan
Objective: To identify the relationship between injection needle threat as a mode of disciplining children and acquired dental phobia in pediatric patients. Methods: This cross-sectional study was conducted at University College of Dentistry, Lahore, Pakistan between December 2021 and November 2022. The study included individuals under the age of 18 years who were presented during the survey and scheduled for pulpotomy or pulpectomy treatment. The study assessed two primary outcomes: dental anxiety and childhood needle threat. Dental anxiety was evaluated using the Modified Children's Dental Anxiety Scale, while childhood needle threat was measured by observing the child's responses to scenarios involving needles. Results: Of total 200 pediatric patients, the mean age was 12.04 ±2.34 years. Mild dental anxiety level was observed in 56 (28.0%) patients, moderate in 122 (61.0%) patients and severe in 22 (11.0%) patients. Childhood needle threat was observed in 94 (47.0%) patients. Patients with mild dental anxiety were 0.86 times significantly less likely to have needle threat as compared to patients with severe dental anxiety (cOR 0.14, 95% CI 0.04 to 0.48, p-value 0.002). Similarly, patients with moderate dental anxiety were 0.83 times significantly less likely to have needle threat as compared to patients with severe dental anxiety (cOR 0.17, 95% CI 0.05 to 0.55, p-value 0.003). Conclusion: The study revealed that most children exhibited moderate dental anxiety, with a notable incidence of dental phobia. Those with higher anxiety levels felt more threatened by needles, underscoring the need to avoid using needles as a mode of discipline.
{"title":"Needle Threat and Acquired Dental Phobia in Pediatric Dental Patients","authors":"Hammad Hassan","doi":"10.36570/jduhs.2024.2.1987","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.1987","url":null,"abstract":"Objective: To identify the relationship between injection needle threat as a mode of disciplining children and acquired dental phobia in pediatric patients. Methods: This cross-sectional study was conducted at University College of Dentistry, Lahore, Pakistan between December 2021 and November 2022. The study included individuals under the age of 18 years who were presented during the survey and scheduled for pulpotomy or pulpectomy treatment. The study assessed two primary outcomes: dental anxiety and childhood needle threat. Dental anxiety was evaluated using the Modified Children's Dental Anxiety Scale, while childhood needle threat was measured by observing the child's responses to scenarios involving needles. Results: Of total 200 pediatric patients, the mean age was 12.04 ±2.34 years. Mild dental anxiety level was observed in 56 (28.0%) patients, moderate in 122 (61.0%) patients and severe in 22 (11.0%) patients. Childhood needle threat was observed in 94 (47.0%) patients. Patients with mild dental anxiety were 0.86 times significantly less likely to have needle threat as compared to patients with severe dental anxiety (cOR 0.14, 95% CI 0.04 to 0.48, p-value 0.002). Similarly, patients with moderate dental anxiety were 0.83 times significantly less likely to have needle threat as compared to patients with severe dental anxiety (cOR 0.17, 95% CI 0.05 to 0.55, p-value 0.003). Conclusion: The study revealed that most children exhibited moderate dental anxiety, with a notable incidence of dental phobia. Those with higher anxiety levels felt more threatened by needles, underscoring the need to avoid using needles as a mode of discipline.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"1 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920842","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2242
Adith V Ram, Eric A. Storch
Even in its most evidence-based practice, medicine is often an inherently subjective field, both in terms of self-reported symptoms on the patient side and clinical reasoning on the provider side. There is arguably no area of medicine as subjective as psychiatry, a specialty which often focuses on emotions, experiences, and realities that are difficult to quantify or “objectively” analyze. Historically, this subjectivity limited progress and treatment options in psychiatry in many ways. Until the mid-20th century, psychiatry was rooted in anecdotal cases within institutions, followed by a largely psychoanalytic framework supported by evidence which was tenuous at best.
{"title":"Objectivity in a Subjective Field: The Current State and Future Directions of “Objective” Diagnostics in Psychiatry","authors":"Adith V Ram, Eric A. Storch","doi":"10.36570/jduhs.2024.2.2242","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2242","url":null,"abstract":"Even in its most evidence-based practice, medicine is often an inherently subjective field, both in terms of self-reported symptoms on the patient side and clinical reasoning on the provider side. There is arguably no area of medicine as subjective as psychiatry, a specialty which often focuses on emotions, experiences, and realities that are difficult to quantify or “objectively” analyze. Historically, this subjectivity limited progress and treatment options in psychiatry in many ways. Until the mid-20th century, psychiatry was rooted in anecdotal cases within institutions, followed by a largely psychoanalytic framework supported by evidence which was tenuous at best.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"4 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920279","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2167
Fahad Kakar, A. Siddiqui, S. Niaz, Syed Afzal ul Haq Haqqi, Zea ul Islam Farrukh, Muhammad Danish Ashraf Wallam, Muhammad Umar Farooq, Sayed Rohail Ahmed Rizvi
Objective: To compare the efficacy and accuracy of the Fibrosis-4 (FIB-4) index with FibroScan in assessing liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods: This cross-sectional study was conducted at Patel Hospital, Karachi, Pakistan, from October 2023 to April 2024. All known cases of NAFLD or non-alcoholic steatohepatitis (NASH) aged ≥18 years, regardless of gender, were included. FIB-4 scores were measured using age, platelet level, aspartate transaminase (AST), and alanine transaminase (ALT). FibroScan categorized liver fibrosis into stages F0 to F4 with specific stiffness ranges: F0 (1–6 kPa), F1 (6.1–7 kPa), F2 (7.1–9 kPa), F3 (9.1–10.3 kPa), and F4 (≥10.4 kPa). Results: Of the 146 patients, the median age was 52.00 (IQR: 47.00–54.00) years. Based on FibroScan results, 61 (41.8%) patients were classified as F1, 35 (24.0%) as F2, 30 (20.5%) as F3, and 20 (13.7%) as F4. The diagnostic performance of FIB-4 showed an area under the curve of 0.83 (95% CI: 0.76–0.90). The optimal cut-off for FIB-4 was 1.28 with sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of 98.0%, 65.6%, 59.7%, 98.4%, and 76.7%, respectively. Spearman's correlation test (ρ) was applied and a significantly moderate correlation was found between FibroScan and FIB-4 (ρ = 0.50, p < 0.001). Conclusion: FIB-4 demonstrated higher accuracy and diagnostic performance in determining liver fibrosis in NAFLD patients compared to FibroScan.
{"title":"Comparison of Fibrosis-4 with FibroScan for Liver Fibrosis Assessment in Non-Alcoholic Fatty Liver Disease Patients: A Cross-sectional Study","authors":"Fahad Kakar, A. Siddiqui, S. Niaz, Syed Afzal ul Haq Haqqi, Zea ul Islam Farrukh, Muhammad Danish Ashraf Wallam, Muhammad Umar Farooq, Sayed Rohail Ahmed Rizvi","doi":"10.36570/jduhs.2024.2.2167","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2167","url":null,"abstract":"Objective: To compare the efficacy and accuracy of the Fibrosis-4 (FIB-4) index with FibroScan in assessing liver fibrosis in patients with non-alcoholic fatty liver disease (NAFLD). Methods: This cross-sectional study was conducted at Patel Hospital, Karachi, Pakistan, from October 2023 to April 2024. All known cases of NAFLD or non-alcoholic steatohepatitis (NASH) aged ≥18 years, regardless of gender, were included. FIB-4 scores were measured using age, platelet level, aspartate transaminase (AST), and alanine transaminase (ALT). FibroScan categorized liver fibrosis into stages F0 to F4 with specific stiffness ranges: F0 (1–6 kPa), F1 (6.1–7 kPa), F2 (7.1–9 kPa), F3 (9.1–10.3 kPa), and F4 (≥10.4 kPa). Results: Of the 146 patients, the median age was 52.00 (IQR: 47.00–54.00) years. Based on FibroScan results, 61 (41.8%) patients were classified as F1, 35 (24.0%) as F2, 30 (20.5%) as F3, and 20 (13.7%) as F4. The diagnostic performance of FIB-4 showed an area under the curve of 0.83 (95% CI: 0.76–0.90). The optimal cut-off for FIB-4 was 1.28 with sensitivity, specificity, positive predictive value, negative predictive value, and overall diagnostic accuracy of 98.0%, 65.6%, 59.7%, 98.4%, and 76.7%, respectively. Spearman's correlation test (ρ) was applied and a significantly moderate correlation was found between FibroScan and FIB-4 (ρ = 0.50, p < 0.001). Conclusion: FIB-4 demonstrated higher accuracy and diagnostic performance in determining liver fibrosis in NAFLD patients compared to FibroScan.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"10 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921366","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2055
K. T. Adhi, Ni Luh Putu Suariyani, Ni Putu Widarini, David Hizkia Tobing, Ni Made Elina Sukma Astuti
Objective: This study aims to determine the prevalence and factors associated with the occurrence of stunting in female adolescents in the Bangli Regency, Bali Province, Indonesia. Methods: This cross-sectional study was conducted from May to July 2022 in senior and vocational high schools in Bangli Regency, Bali Province, Indonesia. Adolescent girls aged 15-18 years not experiencing any illness at the time of enrolment were included. Stunting was defined using the WHO's 2007 standards (Height-for-Age z-score <-2SD). Dietary habits were evaluated using the Dietary Diversity Score (DDS), with a score of less than 5 indicating low dietary diversity. Chronic Energy Deficiency (CED) was determined by mid upper arm circumference, with a threshold of <23 cm indicating CED. Sociodemographic factors, dietary habits, and knowledge and attitudes regarding stunting were also assessed. Results: Of total 560 females, the mean age was 16.32 ±0.854 years. Stunting was observed in 66 (11.8%) adolescents. The risk of stunting was approximately 2.55 times significantly higher among adolescents with negative attitude towards stunting prevention (cOR 2.55, 95% CI 1.48 to 4.38, p-value <0.001), 2 times significantly higher among adolescents with low DDS (cOR 1.87, 95% CI 1.10 to 3.22, p-value 0.021) and experienced CED (cOR 1.76, 95% CI 1.01 to 3.04, p-value 0.042). Conclusion: This study identified a stunting prevalence of 11.8% among female adolescents in the Bangli Regency, Bali Province, Indonesia. The findings indicate that a negative attitude towards stunting prevention, poor diet, and continuous energy imbalance are significant risk factors associated with stunting.
{"title":"Prevalence and Determinants of Stunting among Female Adolescents in Priority Areas of Bali: A Cross-Sectional Study in the Year 2022","authors":"K. T. Adhi, Ni Luh Putu Suariyani, Ni Putu Widarini, David Hizkia Tobing, Ni Made Elina Sukma Astuti","doi":"10.36570/jduhs.2024.2.2055","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2055","url":null,"abstract":"Objective: This study aims to determine the prevalence and factors associated with the occurrence of stunting in female adolescents in the Bangli Regency, Bali Province, Indonesia. Methods: This cross-sectional study was conducted from May to July 2022 in senior and vocational high schools in Bangli Regency, Bali Province, Indonesia. Adolescent girls aged 15-18 years not experiencing any illness at the time of enrolment were included. Stunting was defined using the WHO's 2007 standards (Height-for-Age z-score <-2SD). Dietary habits were evaluated using the Dietary Diversity Score (DDS), with a score of less than 5 indicating low dietary diversity. Chronic Energy Deficiency (CED) was determined by mid upper arm circumference, with a threshold of <23 cm indicating CED. Sociodemographic factors, dietary habits, and knowledge and attitudes regarding stunting were also assessed. Results: Of total 560 females, the mean age was 16.32 ±0.854 years. Stunting was observed in 66 (11.8%) adolescents. The risk of stunting was approximately 2.55 times significantly higher among adolescents with negative attitude towards stunting prevention (cOR 2.55, 95% CI 1.48 to 4.38, p-value <0.001), 2 times significantly higher among adolescents with low DDS (cOR 1.87, 95% CI 1.10 to 3.22, p-value 0.021) and experienced CED (cOR 1.76, 95% CI 1.01 to 3.04, p-value 0.042). Conclusion: This study identified a stunting prevalence of 11.8% among female adolescents in the Bangli Regency, Bali Province, Indonesia. The findings indicate that a negative attitude towards stunting prevention, poor diet, and continuous energy imbalance are significant risk factors associated with stunting.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"5 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921146","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2027
Fahad Ali Mangrio, Penpaktr Uthis, Suwimon Rojnawee, Alicia K Matthews
The study aimed to explore prevalence, risk factors, and intervention approaches related to adolescent smoking in Pakistan. Databases included PubMed, Scopus, Embase, Google Scholar, and ProQuest. Studies were selected on Pakistani adolescents aged 10-21 years, original or secondary articles published in English, and the use of qualitative and quantitative methods. Out of 1300 articles, 300 duplicates were removed. After reviewing titles and abstracts, 980 records were excluded. The full text of the 18 remaining studies was reviewed based on inclusion criteria, with 13 eligible studies included. Data extraction included author, age, setting, design, sample, theory, prevalence, risk factors, findings, and appraisal. Ten eligible studies reported varying prevalence rates of adolescent smoking in Pakistan, ranging from 09% to 61.14%. Individual risk factors associated with smoking included disposition, mood, and substance abuse. Social risk factors included family and peer influences, including father's smoking status, family members' tobacco use, and peer pressure. Environmental risk factors, including attendance at a public school, school-related pressure, exposure to tobacco use on social media, and lower socioeconomic status, significantly increased the likelihood of smoking among adolescents. Three studies evaluating prevention and intervention approaches demonstrated positive outcomes, including increased awareness of smoking harms, attitude shifts, and increased intention to quit smoking. This scoping review identified the influence of individual, social, and environmental risk factors on adolescent smoking. Educational interventions showed positive results on knowledge and attitude; however, none specifically focused on smoking cessation. Future research should focus on addressing these risk factors and implementing theory-guided interventions.
{"title":"Prevalence, Risk Factors, and Intervention Approaches Related to Adolescent Smoking in Pakistan: A Scoping Review","authors":"Fahad Ali Mangrio, Penpaktr Uthis, Suwimon Rojnawee, Alicia K Matthews","doi":"10.36570/jduhs.2024.2.2027","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2027","url":null,"abstract":"The study aimed to explore prevalence, risk factors, and intervention approaches related to adolescent smoking in Pakistan. Databases included PubMed, Scopus, Embase, Google Scholar, and ProQuest. Studies were selected on Pakistani adolescents aged 10-21 years, original or secondary articles published in English, and the use of qualitative and quantitative methods. Out of 1300 articles, 300 duplicates were removed. After reviewing titles and abstracts, 980 records were excluded. The full text of the 18 remaining studies was reviewed based on inclusion criteria, with 13 eligible studies included. Data extraction included author, age, setting, design, sample, theory, prevalence, risk factors, findings, and appraisal. Ten eligible studies reported varying prevalence rates of adolescent smoking in Pakistan, ranging from 09% to 61.14%. Individual risk factors associated with smoking included disposition, mood, and substance abuse. Social risk factors included family and peer influences, including father's smoking status, family members' tobacco use, and peer pressure. Environmental risk factors, including attendance at a public school, school-related pressure, exposure to tobacco use on social media, and lower socioeconomic status, significantly increased the likelihood of smoking among adolescents. Three studies evaluating prevention and intervention approaches demonstrated positive outcomes, including increased awareness of smoking harms, attitude shifts, and increased intention to quit smoking. This scoping review identified the influence of individual, social, and environmental risk factors on adolescent smoking. Educational interventions showed positive results on knowledge and attitude; however, none specifically focused on smoking cessation. Future research should focus on addressing these risk factors and implementing theory-guided interventions.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"6 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921463","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.1981
Nabeela Riaz, Samreen Younas
Ameloblastoma is the second most common odontogenic neoplasm and is locally aggressive. Various treatment approaches exist, with resection involving safe margins associated with the lowest recurrence rates. However, ameloblastoma still has a propensity for delayed recurrences, necessitating lifelong follow-up for patients. Recurrences usually develop at the primary site of the tumor but have also been reported in reconstructive bone grafts. We present a unique case of a very unusual, delayed recurrence of mandibular ameloblastoma in the soft tissues of the neck, 16 years after the primary surgery. The recurrence presented as a large cystic swelling in the neck with a solid component, posing a diagnostic challenge for the team. The final histopathological examination after excision under general anesthesia confirmed it to be ameloblastoma.
{"title":"Delayed Recurrence of Mandibular Ameloblastoma in Soft Tissues of Neck: A Case Report of a Rare Entity","authors":"Nabeela Riaz, Samreen Younas","doi":"10.36570/jduhs.2024.2.1981","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.1981","url":null,"abstract":"Ameloblastoma is the second most common odontogenic neoplasm and is locally aggressive. Various treatment approaches exist, with resection involving safe margins associated with the lowest recurrence rates. However, ameloblastoma still has a propensity for delayed recurrences, necessitating lifelong follow-up for patients. Recurrences usually develop at the primary site of the tumor but have also been reported in reconstructive bone grafts. We present a unique case of a very unusual, delayed recurrence of mandibular ameloblastoma in the soft tissues of the neck, 16 years after the primary surgery. The recurrence presented as a large cystic swelling in the neck with a solid component, posing a diagnostic challenge for the team. The final histopathological examination after excision under general anesthesia confirmed it to be ameloblastoma.","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141920322","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 : 2024-08-10DOI: 10.36570/jduhs.2024.2.2222
Muhammad Arif, Haider Abbas Mandviwala, Syed Wahaj Uddin, Kashif Naeem, Zeeshan Mirza, Aniqa Rehman
Objective: To compare the outcomes of transversus abdominis plane (TAP) block versus local wound infiltration (LAI) for postoperative analgesia in patients undergoing total abdominal hysterectomy (TAH). Methods: This randomized controlled trial was conducted at Dr. Ziauddin Hospital & Medical College, Karachi, Pakistan from December 2023 to May 2024. Female patients aged 18 to 50 years, and scheduled for TAH under general anesthesia were included. Patients were randomly allocated to the TAP group or the LAI group using sealed opaque envelopes. The primary outcome was pain score at different time intervals postoperatively. Pain score measured using the Visual Analogue Scale. Secondary outcomes included total analgesia consumption within 24 hours. Results: Of total 100 patients, the median (IQR) age was 50.0 (47.2-55.0) years. At 8 hours postoperatively, the median pain score was significantly lower in the TAP group 0.0 (0.0-1.0) compared to the LAI group 1.0 (0.0-2.0) (p-value <0.001). Similarly, at 12 hours, the TAP group reported a median pain score of 2.0 (1.0-2.0), significantly lower than the LAI group 3.0 (2.0-4.0) (p-value <0.001). At 24 hours, the median pain score remained significantly lower in the TAP group 50.0 (50.0-70.0) compared to the LAI group 130.0 (120.0-140.0) (p-value <0.001). Total analgesia consumption was also significantly lower in TAP group as compared to LAI group i.e., 50.0 (50.0-70.0) vs. 130.0 (120.0-140.0) (p-value <0.001). Conclusion: The TAP block provided superior postoperative pain control compared to LAI in patients undergoing TAH, evidenced by lower pain scores and reduced analgesia consumption. Keywords: Analgesia, Hysterectomy, Postoperative Pain, Visual Analogue Scale
{"title":"Transversus Abdominis Plane Block Versus Local Wound Infiltration for Postoperative Pain Management in Patient Undergoing Total Abdominal Hysterectomy","authors":"Muhammad Arif, Haider Abbas Mandviwala, Syed Wahaj Uddin, Kashif Naeem, Zeeshan Mirza, Aniqa Rehman","doi":"10.36570/jduhs.2024.2.2222","DOIUrl":"https://doi.org/10.36570/jduhs.2024.2.2222","url":null,"abstract":"Objective: To compare the outcomes of transversus abdominis plane (TAP) block versus local wound infiltration (LAI) for postoperative analgesia in patients undergoing total abdominal hysterectomy (TAH). Methods: This randomized controlled trial was conducted at Dr. Ziauddin Hospital & Medical College, Karachi, Pakistan from December 2023 to May 2024. Female patients aged 18 to 50 years, and scheduled for TAH under general anesthesia were included. Patients were randomly allocated to the TAP group or the LAI group using sealed opaque envelopes. The primary outcome was pain score at different time intervals postoperatively. Pain score measured using the Visual Analogue Scale. Secondary outcomes included total analgesia consumption within 24 hours. Results: Of total 100 patients, the median (IQR) age was 50.0 (47.2-55.0) years. At 8 hours postoperatively, the median pain score was significantly lower in the TAP group 0.0 (0.0-1.0) compared to the LAI group 1.0 (0.0-2.0) (p-value <0.001). Similarly, at 12 hours, the TAP group reported a median pain score of 2.0 (1.0-2.0), significantly lower than the LAI group 3.0 (2.0-4.0) (p-value <0.001). At 24 hours, the median pain score remained significantly lower in the TAP group 50.0 (50.0-70.0) compared to the LAI group 130.0 (120.0-140.0) (p-value <0.001). Total analgesia consumption was also significantly lower in TAP group as compared to LAI group i.e., 50.0 (50.0-70.0) vs. 130.0 (120.0-140.0) (p-value <0.001). Conclusion: The TAP block provided superior postoperative pain control compared to LAI in patients undergoing TAH, evidenced by lower pain scores and reduced analgesia consumption. Keywords: Analgesia, Hysterectomy, Postoperative Pain, Visual Analogue Scale","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"2 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141921067","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 : 2024-04-01DOI: 10.36570/jduhs.2024.1.2007
Muhammad Arif
{"title":"Randomized Double Blind Comparison of Prophylactic Tramadol and Tramadol Plus Ketamine for Prevention of Shivering after Spinal Anesthesia in Lower Segment Caesarian Section","authors":"Muhammad Arif","doi":"10.36570/jduhs.2024.1.2007","DOIUrl":"https://doi.org/10.36570/jduhs.2024.1.2007","url":null,"abstract":"","PeriodicalId":34119,"journal":{"name":"Journal of the Dow University of Health Sciences","volume":"193 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140793023","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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