Background: Hyperlipidemia is considered a modifiable risk factor for cardiovascular disease and atherosclerosis. Drugs of first choice, Statins, despite being well tolerable, are accompanied by many adverse effects. To tackle the shortcomings of standard drugs, there is dire demand to make an agent which equates to a better response. This study evaluated the anti-hyperlipidemic and comparative effects of Zinc complex of Betulinic acid (Zn+BA) with simvastatin (SIM), on high-fat diet-induced hyperlipidemia in rats, and the safety profile of the two treatments was also assessed. Methodology: Hyperlipidemia was induced by giving a high-fat diet. BA +Zn 10 mg/kg and SIM 20 mg/kg were given orally for four weeks. On the final day terminal sampling was done and serum lipid profile (TG, TC, LDL, HDL) and hepatic enzymes (ALT) for assessing hepatotoxicity were estimated. Results: Our results showed that BA+Zn significantly increased HDL levels and significantly reduced serum TC, TG, and LDL (p<0.001) as compared to Simvastatin. Correspondingly serum ALT levels also showed significant reduction (p<0.001) in comparison with Simvastatin. Conclusion: Our study suggests that BA+Zn effectively attenuates high-fat diet-induced hyperlipidemia while preserving hepatic function and could serve as a better alternative to simvastatin in treating hyperlipidemia.
{"title":"Anti-Hyperlipidemic Effect of Zinc complex of Betulinic acid in High Fat Diet- Induced Hyperlipidemia","authors":"M. Tayyab, Adnan Jehangir, Farhana Ayub, Nimrah Ijaz, Sameer Ahmed`, Attiya Munir","doi":"10.37939/jrmc.v27i1.2066","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2066","url":null,"abstract":"Background: Hyperlipidemia is considered a modifiable risk factor for cardiovascular disease and atherosclerosis. Drugs of first choice, Statins, despite being well tolerable, are accompanied by many adverse effects. To tackle the shortcomings of standard drugs, there is dire demand to make an agent which equates to a better response. This study evaluated the anti-hyperlipidemic and comparative effects of Zinc complex of Betulinic acid (Zn+BA) with simvastatin (SIM), on high-fat diet-induced hyperlipidemia in rats, and the safety profile of the two treatments was also assessed.\u0000Methodology: Hyperlipidemia was induced by giving a high-fat diet. BA +Zn 10 mg/kg and SIM 20 mg/kg were given orally for four weeks. On the final day terminal sampling was done and serum lipid profile (TG, TC, LDL, HDL) and hepatic enzymes (ALT) for assessing hepatotoxicity were estimated. Results: Our results showed that BA+Zn significantly increased HDL levels and significantly reduced serum TC, TG, and LDL (p<0.001) as compared to Simvastatin. Correspondingly serum ALT levels also showed significant reduction (p<0.001) in comparison with Simvastatin.\u0000Conclusion: Our study suggests that BA+Zn effectively attenuates high-fat diet-induced hyperlipidemia while preserving hepatic function and could serve as a better alternative to simvastatin in treating hyperlipidemia.\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45806142","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.1977
A. Hussain, Q. Malik, Farooq Ikram, N. Ullah, M. Nadeem, Murtaza Hussain
Background: Thalassemia is a set of inherited hematological illnesses caused by mutations in the genes that code for globin. Regular blood transfusions extend the lives of thalassemia patients, but they also increase the danger of blood-borne illness infections. Objective: The current study was conducted to check the frequency and risk factors of hepatitis B virus (HBV) infections among β thalassemia major patients. Methods: The study was conducted over a period of 3 months that is from November 2021 to February 2022 in the department of Thalassemia center CMH Rawalpindi. The study consists of thalassemia patients aged 6 months to 15 years including both male and female patients. Their venous blood was taken and transmitted to the laboratory, Armed force institute of pathology CMH Rawalpindi, for hepatitis B surface antigen test (HbsAg). Their demographic information was gathered, including their age, gender, number of blood transfusions received each year and Hepatitis B virus (HBV) vaccination status. Results: Out of 100 patients there were 45 patients who were male and 55 patients who were female. The patients' ages span from 6 months to 15 years, with a mean age difference of 11.20 years and a standard deviation of 5.56. In three months, the mean difference in the number of blood transfusions received by patients was 22.7 6.6 SD. Patients under the age of ten were 50 percent of the time, and patients beyond ten were also 50 percent of the time (50 percent). Five (5%) of the total 100 patients tested positive for hepatitis B. In three months, the mean difference in the number of blood transfusions received by patients was 18.2 5.6 SD. Thirty (30%) patients out of a total of 100 were not immunized. Conclusion: Frequency of hepatitis B in beta thalassemia major patients is minimal (less than 5 per 100) is seen in our study. To reduce the future risk of TTI, development of strong national and regional policies on safe blood transfusion procedures, VNRD-based transfusions, and universal quality-assured donor screening are recommended.
{"title":"Frequency of Hepatitis B in Thalassemia Major Patients","authors":"A. Hussain, Q. Malik, Farooq Ikram, N. Ullah, M. Nadeem, Murtaza Hussain","doi":"10.37939/jrmc.v27i1.1977","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1977","url":null,"abstract":"Background: Thalassemia is a set of inherited hematological illnesses caused by mutations in the genes that code for globin. Regular blood transfusions extend the lives of thalassemia patients, but they also increase the danger of blood-borne illness infections.\u0000Objective: The current study was conducted to check the frequency and risk factors of hepatitis B virus (HBV) infections among β thalassemia major patients.\u0000Methods: The study was conducted over a period of 3 months that is from November 2021 to February 2022 in the department of Thalassemia center CMH Rawalpindi. The study consists of thalassemia patients aged 6 months to 15 years including both male and female patients. Their venous blood was taken and transmitted to the laboratory, Armed force institute of pathology CMH Rawalpindi, for hepatitis B surface antigen test (HbsAg). Their demographic information was gathered, including their age, gender, number of blood transfusions received each year and Hepatitis B virus (HBV) vaccination status.\u0000Results: Out of 100 patients there were 45 patients who were male and 55 patients who were female. The patients' ages span from 6 months to 15 years, with a mean age difference of 11.20 years and a standard deviation of 5.56. In three months, the mean difference in the number of blood transfusions received by patients was 22.7 6.6 SD. Patients under the age of ten were 50 percent of the time, and patients beyond ten were also 50 percent of the time (50 percent). Five (5%) of the total 100 patients tested positive for hepatitis B. In three months, the mean difference in the number of blood transfusions received by patients was 18.2 5.6 SD. Thirty (30%) patients out of a total of 100 were not immunized.\u0000Conclusion: Frequency of hepatitis B in beta thalassemia major patients is minimal (less than 5 per 100) is seen in our study. To reduce the future risk of TTI, development of strong national and regional policies on safe blood transfusion procedures, VNRD-based transfusions, and universal quality-assured donor screening are recommended.\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44463625","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2035
R. Shahid, Rabbia Kahlid, M. Umar, Sadia Khan
Objectives: To compare 360-degree evaluation scores of postgraduate residents during 1st and 2nd cycles of evaluation to analyze the acquisition of core competencies. Materials & Methods: A cross-sectional analytical study was done to compare the acquisition of core competencies as per ACGME by MS/MD residents in 3 public sector teaching hospitals of Rawalpindi. The enrolled residents undergone 1st and 2nd cycle of 360-degree evaluation from Jan-June 2018 and July 2018 -Jan 2019 respectively. The data was gathered from supervisors, faculty, nursing staff, patients and their attendants by structured proforma. Data was analyzed by SPSS version 25.0. Specialty-wise scores were statistically presented with 95% CI. Differences in scores of core competencies during both cycles were determined by independent sample t-test. P < 0.05 was considered significant. Results: About 93 and 113 trainees were evaluated during 1st and 2nd cycle of evaluation respectively. Most (41.70%) of them were 1st year residents. 2nd cycle of evaluation revealed statistically significant improvement (P<0.00001) in all 6 core competencies. Feedback from the patients also illustrated significant difference in scores of both cycles (P = 0.01). Trainees of MS Surgery & Allied programs were determined as highly competent with 250.06 ± 38.57 score followed by those of MD Medicine & Allied (247.59 ± 42.15) and Gynecology & Obstetrics (246.71 ± 46.26) out of total score of 331. Residents of HFH and DHQ Hospital had statistically significant enhancement of competencies (P<0.0001) than those of BBH (P=0.003). Conclusion: There was substantial enhancement of core competencies among postgraduate trainees.
{"title":"360-degree Evaluation of Postgraduate residents at Rawalpindi Medical University: Appraising the achievement of core competencies by comparing the scores of 1st &","authors":"R. Shahid, Rabbia Kahlid, M. Umar, Sadia Khan","doi":"10.37939/jrmc.v27i1.2035","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2035","url":null,"abstract":"Objectives: To compare 360-degree evaluation scores of postgraduate residents during 1st and 2nd cycles of evaluation to analyze the acquisition of core competencies.\u0000Materials & Methods: A cross-sectional analytical study was done to compare the acquisition of core competencies as per ACGME by MS/MD residents in 3 public sector teaching hospitals of Rawalpindi. The enrolled residents undergone 1st and 2nd cycle of 360-degree evaluation from Jan-June 2018 and July 2018 -Jan 2019 respectively. The data was gathered from supervisors, faculty, nursing staff, patients and their attendants by structured proforma. Data was analyzed by SPSS version 25.0. Specialty-wise scores were statistically presented with 95% CI. Differences in scores of core competencies during both cycles were determined by independent sample t-test. P < 0.05 was considered significant.\u0000Results: About 93 and 113 trainees were evaluated during 1st and 2nd cycle of evaluation respectively. Most (41.70%) of them were 1st year residents. 2nd cycle of evaluation revealed statistically significant improvement (P<0.00001) in all 6 core competencies. Feedback from the patients also illustrated significant difference in scores of both cycles (P = 0.01). Trainees of MS Surgery & Allied programs were determined as highly competent with 250.06 ± 38.57 score followed by those of MD Medicine & Allied (247.59 ± 42.15) and Gynecology & Obstetrics (246.71 ± 46.26) out of total score of 331. Residents of HFH and DHQ Hospital had statistically significant enhancement of competencies (P<0.0001) than those of BBH (P=0.003).\u0000Conclusion: There was substantial enhancement of core competencies among postgraduate trainees.\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44721256","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2002
F. Nasir, Shahida Kashif, F. Uddin, M. Khalid, I. Memon, Talat Samreen
Objective: The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined. Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips. Results: Out of 350 urine samples 213 (60.85%) were E. coli. Patients with E. coli had an average age of 38.75 15.01 years. Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%). Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.
{"title":"In vitro efficacy of fosfomycin against E. coli and prevalence of MDR and XDR E. coli isolates from UTI Patients","authors":"F. Nasir, Shahida Kashif, F. Uddin, M. Khalid, I. Memon, Talat Samreen","doi":"10.37939/jrmc.v27i1.2002","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2002","url":null,"abstract":"Objective: The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined.\u0000Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips.\u0000Results: Out of 350 urine samples 213 (60.85%) were E. coli. Patients with E. coli had an average age of 38.75 15.01 years. Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%).\u0000Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist. \u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45841839","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2037
Ruqayya Manzoor, Nuzhat Yasmeen, H. Shaheen, N. Mushtaq
Objectives: Cancer being a serious chronic illness, causes profound effects on physical and mental health of the individual as well as affects their caregivers and family members' mental health. This study aims to find out the burden of emotional distress in patients of childhood cancer as well as their healthy siblings. Methods: It was a descriptive cross-sectional study. Parents of the children undergoing cancer treatment or having completed treatment within past one year were asked to complete an interview proforma (Pediatric Emotional Distress Scale) about their child’s behaviour over past one month, scoring each behaviour on a scale of 1 to 5 according to the frequency of symptoms. The data was then analysed using SPSS 20. The frequency distribution, central tendencies and standard deviations were calculated accordingly. Results: Almost eighty-five% of the patients showed scores above the clinical threshold for emotional distress. Eighteen% of the healthy siblings also had scores above the clinical threshold. Patients as well as their healthy siblings showed high levels of anxiousness in their behaviours. Conclusions Childhood cancer is a cause of major emotional trauma in patients. Age-matched siblings usually cope well with the illness.
{"title":"Emotional Distress Among Pediatric Cancer Patients and their Siblings","authors":"Ruqayya Manzoor, Nuzhat Yasmeen, H. Shaheen, N. Mushtaq","doi":"10.37939/jrmc.v27i1.2037","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2037","url":null,"abstract":"Objectives: Cancer being a serious chronic illness, causes profound effects on physical and mental health of the individual as well as affects their caregivers and family members' mental health. This study aims to find out the burden of emotional distress in patients of childhood cancer as well as their healthy siblings.\u0000Methods: It was a descriptive cross-sectional study. Parents of the children undergoing cancer treatment or having completed treatment within past one year were asked to complete an interview proforma (Pediatric Emotional Distress Scale) about their child’s behaviour over past one month, scoring each behaviour on a scale of 1 to 5 according to the frequency of symptoms. The data was then analysed using SPSS 20. The frequency distribution, central tendencies and standard deviations were calculated accordingly.\u0000Results: Almost eighty-five% of the patients showed scores above the clinical threshold for emotional distress. Eighteen% of the healthy siblings also had scores above the clinical threshold. Patients as well as their healthy siblings showed high levels of anxiousness in their behaviours.\u0000Conclusions\u0000\u0000Childhood cancer is a cause of major emotional trauma in patients.\u0000Age-matched siblings usually cope well with the illness.\u0000\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47292307","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2011
S. Awan, A. Ambreen, N. Zaheer, Asma Sabir, Sara Daud, R. Athar
Objective: To determine the Prevalence & Severity of depression in Chronic Obstructive Airway Diseases (COPD) patients. Background: Chronic Obstructive Airway Disease is a chronic heterogeneous disease that is also progressive. Depression is a common entity in chronic diseases. COPD causes long-term respiratory symptoms and depression is commonly found in these patients. The symptoms of these two diseases are overlapping and depression in COPD patients’ needs to be diagnosed and adequately treated. Untreated patients lead to poor control of respiratory symptoms and further deterioration of the illness. Our study aimed to determine prevalence and severity of depression in COPD patients using HAM-D score. Material and Methods: This study was conducted in Medicine & Pulmonology OPD, Fuji Foundation Hospital, Rawalpindi from August 2019 to February 2021. Using a cross sectional study design, a total of 169 cases of COPD were recruited and tested for the presence of absence of depression using the HAM-D rating scale and observations were recorded. Results: Total 169 patients recruited in this study with female & male percentage of 59% and 47% respectively. The Mean duration of illness was 11.5 years ± 6.48. The incidence of Anxiety & Depression was high (45% and 36%) in moderate to severe disease with total prevalence of 54 % among participants in the study. Conclusion: Anxiety & depression is commonly prevalent in COPD patients. Female patients are found to have more psychological disturbance irrespective to their COPD severity. Psychological impairment must be carefully evaluated in patients having COPD.
{"title":"The Prevalence & Severity of Depression in patients with chronic obstructive airway disease","authors":"S. Awan, A. Ambreen, N. Zaheer, Asma Sabir, Sara Daud, R. Athar","doi":"10.37939/jrmc.v27i1.2011","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2011","url":null,"abstract":"Objective: To determine the Prevalence & Severity of depression in Chronic Obstructive Airway Diseases (COPD) patients.\u0000Background: Chronic Obstructive Airway Disease is a chronic heterogeneous disease that is also progressive. Depression is a common entity in chronic diseases. COPD causes long-term respiratory symptoms and depression is commonly found in these patients. The symptoms of these two diseases are overlapping and depression in COPD patients’ needs to be diagnosed and adequately treated. Untreated patients lead to poor control of respiratory symptoms and further deterioration of the illness. Our study aimed to determine prevalence and severity of depression in COPD patients using HAM-D score.\u0000Material and Methods: This study was conducted in Medicine & Pulmonology OPD, Fuji Foundation Hospital, Rawalpindi from August 2019 to February 2021. Using a cross sectional study design, a total of 169 cases of COPD were recruited and tested for the presence of absence of depression using the HAM-D rating scale and observations were recorded.\u0000Results: Total 169 patients recruited in this study with female & male percentage of 59% and 47% respectively. The Mean duration of illness was 11.5 years ± 6.48. The incidence of Anxiety & Depression was high (45% and 36%) in moderate to severe disease with total prevalence of 54 % among participants in the study.\u0000Conclusion: Anxiety & depression is commonly prevalent in COPD patients. Female patients are found to have more psychological disturbance irrespective to their COPD severity. Psychological impairment must be carefully evaluated in patients having COPD.\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47328546","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2154
Soban Sarwar Gondal, Saad Javed, Ali Tasaaduq Hussain Minhas, Rana Mohsin Khan, Yasir Shehzad, N. Akhtar
Background:In anterior cervical discectomy and fusion (ACDF), the two most frequently used materials are allografts and polyetheretherketone (PEEK) cages. The aim of the study was to compare the functional and radiological outcomes of polyetheretherketone (PEEK) cages with iliac crest allografts in anterior cervical decompression and fusion (ACDF) in patients of symptomatic Cervical spondylotic myelopathy (CSM).Methods:In this cohort study, we included 70 (35 in each group) patients of symptomatic CSM having degenerative cervical disc disease who were planned for ACDF from Jan-2017 to Jan-2021 in Rawalpindi Medical University. All procedures were performed under general anesthesia in supine position, standard ACDF technique was used in all patients. Anterior cervical locked plates were used for fixation of PEEK cages or the iliac allografts in the inter-vertebral space. Radiologic and functional outcomes were determined till 6 months after surgery. Results:The baseline study characteristics were similar between the groups. Mean Modified Japanese Orthopaedic Association (MJOA) score at 06 months’ follow-up was same between the groups; 14.16±4.30 in group A and 13.54±3.24 in group B (p-value 0.49). Disc space height at 06 months’ follow-up was also similar between the groups; 10.01±0.67 mm in group A versus 10.11±0.70 mm in group B (p-value 0.54). Fusion rate at final follow-up was 31 (88.6%) in group A versus 30 (85.7%) in group B (p-value 0.72).Conclusion:PEEK cages have similar functional and radiologic outcomes in comparison to ileal crest allografts. So, PEEK cages can be used as a successful alternative to ileal crest allografts this will help to reduce donor site morbidity and will reduce longer surgical times associated with graft harvesting.
背景:在前路颈椎椎间盘切除术和融合(ACDF)中，两种最常用的材料是同种异体移植物和聚醚醚酮(PEEK)笼。该研究的目的是比较聚醚醚酮(PEEK)笼与髂骨异体移植在症状性脊髓型颈椎病(CSM)患者前路颈椎减压融合(ACDF)中的功能和放射学结果。方法:在这项队列研究中，我们纳入了70例(每组35例)有退行性颈椎间盘疾病的症状性脊髓炎患者，这些患者计划于2017年1月至2021年1月在拉瓦尔品第医科大学进行ACDF。所有手术均在仰卧位全麻下进行，所有患者均采用标准ACDF技术。颈椎前路锁定钢板用于椎间隙内PEEK笼或髂骨异体移植物的固定。术后6个月确定影像学和功能预后。结果:两组的基线研究特征相似。随访6个月时，两组平均改良日本骨科协会(MJOA)评分相同;A组为14.16±4.30,B组为13.54±3.24 (p值0.49)。随访6个月时两组间椎间盘间隙高度相似;A组为10.01±0.67 mm, B组为10.11±0.70 mm (p值0.54)。最终随访时，A组融合率为31 (88.6%)，B组为30 (85.7%)(p值0.72)。结论:PEEK支架与同种异体回肠嵴移植相比具有相似的功能和影像学结果。因此，PEEK笼可以作为回肠嵴同种异体移植物的成功替代品，这将有助于减少供体部位的发病率，并减少与移植物收获相关的较长手术时间。
{"title":"Comparison of Polyetheretherketone (PEEK) Cage versus Iliac Bone Graft undergoing Anterior Cervical Discectomy and Fusion (ACDF): A multicenter experience","authors":"Soban Sarwar Gondal, Saad Javed, Ali Tasaaduq Hussain Minhas, Rana Mohsin Khan, Yasir Shehzad, N. Akhtar","doi":"10.37939/jrmc.v27i1.2154","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2154","url":null,"abstract":"Background:In anterior cervical discectomy and fusion (ACDF), the two most frequently used materials are allografts and polyetheretherketone (PEEK) cages. The aim of the study was to compare the functional and radiological outcomes of polyetheretherketone (PEEK) cages with iliac crest allografts in anterior cervical decompression and fusion (ACDF) in patients of symptomatic Cervical spondylotic myelopathy (CSM).Methods:In this cohort study, we included 70 (35 in each group) patients of symptomatic CSM having degenerative cervical disc disease who were planned for ACDF from Jan-2017 to Jan-2021 in Rawalpindi Medical University. All procedures were performed under general anesthesia in supine position, standard ACDF technique was used in all patients. Anterior cervical locked plates were used for fixation of PEEK cages or the iliac allografts in the inter-vertebral space. Radiologic and functional outcomes were determined till 6 months after surgery. Results:The baseline study characteristics were similar between the groups. Mean Modified Japanese Orthopaedic Association (MJOA) score at 06 months’ follow-up was same between the groups; 14.16±4.30 in group A and 13.54±3.24 in group B (p-value 0.49). Disc space height at 06 months’ follow-up was also similar between the groups; 10.01±0.67 mm in group A versus 10.11±0.70 mm in group B (p-value 0.54). Fusion rate at final follow-up was 31 (88.6%) in group A versus 30 (85.7%) in group B (p-value 0.72).Conclusion:PEEK cages have similar functional and radiologic outcomes in comparison to ileal crest allografts. So, PEEK cages can be used as a successful alternative to ileal crest allografts this will help to reduce donor site morbidity and will reduce longer surgical times associated with graft harvesting.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42726629","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2016
Abdul Rasheed Napar, Naveed Ahmed Solangi, Mehtab Ali Shahni, H. Ghumro, Naveed Ahmed Jumani, Aftab Hussain
Objective: To compare the efficacy of intra-articular injections of prednisolone acetate and platelet rich plasma in cases of moderate knee osteoarthritis. Study design: Prospective comparative study. Place and Duration of study: Department of Orthopedic Surgery, Khairpur Medical College, Khairpur Mirs, from January 2021 till December 2021 Methodology: A total of 100 patients were selected for the study and were randomly divided into two equal groups. Group C patients received intra-articular corticosteroid injection along with local anesthetic (Prednisolone acetate 40 mg + 3 ml of 0.5% bupivacaine) under ultrasound guidance. Group P patients received 3 injections of PRP, each of 8 ml volume given at one week’s interval. Patients with signs of hemodynamic compromise, sepsis, past history of any intra-articular injection in the same joint were also excluded from the study. Follow up of patients was carried out at 1, 3 and 6 months. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scale was used to assess the patients prior to injection and then at each follow up. WOMAC scale consists of three subsets i-e pain, stiffness and physical function. Results: Demographic data was comparable between both groups. Pre-injection WOMAC score in group C and P was 71.54±12.18 and 75.20±8.58 respectively (p-value=0.086); after one month of injections, it was 34.20±10.48 and 35.38±6.31 respectively (p-value=0.580). After 3 months of injection, it was 33.20±8.13 and 31.10±5.50 respectively (p-value=0.195). After 6 months of injection, it was 35.32±10.41 and 32.10±6.63 respectively (p-value=0.68). Conclusion: It is concluded in our study that intra-articular injections of prednisolone acetate and PRP are equally effective in patients of moderate knee osteoarthritis.
{"title":"Comparison of Intra-articular Platelet Rich Plasma versus Corticosteroid Injections for the Treatment of Moderate Knee Osteoarthritis","authors":"Abdul Rasheed Napar, Naveed Ahmed Solangi, Mehtab Ali Shahni, H. Ghumro, Naveed Ahmed Jumani, Aftab Hussain","doi":"10.37939/jrmc.v27i1.2016","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2016","url":null,"abstract":"Objective: To compare the efficacy of intra-articular injections of prednisolone acetate and platelet rich plasma in cases of moderate knee osteoarthritis.\u0000Study design: Prospective comparative study.\u0000Place and Duration of study: Department of Orthopedic Surgery, Khairpur Medical College, Khairpur Mirs, from January 2021 till December 2021\u0000Methodology: A total of 100 patients were selected for the study and were randomly divided into two equal groups. Group C patients received intra-articular corticosteroid injection along with local anesthetic (Prednisolone acetate 40 mg + 3 ml of 0.5% bupivacaine) under ultrasound guidance. Group P patients received 3 injections of PRP, each of 8 ml volume given at one week’s interval. Patients with signs of hemodynamic compromise, sepsis, past history of any intra-articular injection in the same joint were also excluded from the study. Follow up of patients was carried out at 1, 3 and 6 months. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) scale was used to assess the patients prior to injection and then at each follow up. WOMAC scale consists of three subsets i-e pain, stiffness and physical function.\u0000Results: Demographic data was comparable between both groups. Pre-injection WOMAC score in group C and P was 71.54±12.18 and 75.20±8.58 respectively (p-value=0.086); after one month of injections, it was 34.20±10.48 and 35.38±6.31 respectively (p-value=0.580). After 3 months of injection, it was 33.20±8.13 and 31.10±5.50 respectively (p-value=0.195). After 6 months of injection, it was 35.32±10.41 and 32.10±6.63 respectively (p-value=0.68).\u0000Conclusion: It is concluded in our study that intra-articular injections of prednisolone acetate and PRP are equally effective in patients of moderate knee osteoarthritis.\u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42946469","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}
Objective: Learning environment has a great role in students learning, achievement and success. It is also essential for the development of curriculum. The aim of this study is to document the perception of dental students regarding their learning environment. Material and methods: This qualitative research were conducted from Dec 2021 to May 2022, at four dental colleges of Rawalpindi. A total of 16 students from all these college who were regularly enrolled and voluntary participating in the study were included. Focus group interview (n=4 in each group) comprised of students from both basic sciences year (1st and 2nd year BDS) and clinical years (3rd and final year BDS). Data was transcribed verbatim and thematic analysis was done. Result: Students overall expressed a good level of satisfaction with the learning environment but pointed out some issue which were summed up under major themes identified such as issues in lectures, issues in clinical teaching, issue in the dental curriculum and lack of academic motivation. Conclusion: This study suggests that the dental students generally hold a positive perception towards their learning environment, but they pointed out the short comings in their lectures, clinical teaching, dental curriculum and dearth of motivation. Taking students view point regarding their learning environment will help the stake holders and policy makers to provide better learning environment with more facilities and support system for the students to enhance their learning.
{"title":"Evaluating the learning environment in Dental colleges from students’ perspective; a qualitative exploratory research","authors":"Gulmina Saeed Orakzai, Syeda Munazza Gillani, Saima Irshad, Mahrukh, M. Tiwana, Sidra Shaukat","doi":"10.37939/jrmc.v27i1.2020","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2020","url":null,"abstract":"Objective: Learning environment has a great role in students learning, achievement and success. It is also essential for the development of curriculum. The aim of this study is to document the perception of dental students regarding their learning environment.\u0000Material and methods: This qualitative research were conducted from Dec 2021 to May 2022, at four dental colleges of Rawalpindi. A total of 16 students from all these college who were regularly enrolled and voluntary participating in the study were included. Focus group interview (n=4 in each group) comprised of students from both basic sciences year (1st and 2nd year BDS) and clinical years (3rd and final year BDS). Data was transcribed verbatim and thematic analysis was done.\u0000Result: Students overall expressed a good level of satisfaction with the learning environment but pointed out some issue which were summed up under major themes identified such as issues in lectures, issues in clinical teaching, issue in the dental curriculum and lack of academic motivation.\u0000Conclusion: This study suggests that the dental students generally hold a positive perception towards their learning environment, but they pointed out the short comings in their lectures, clinical teaching, dental curriculum and dearth of motivation. Taking students view point regarding their learning environment will help the stake holders and policy makers to provide better learning environment with more facilities and support system for the students to enhance their learning.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46222667","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 : 2023-04-01DOI: 10.37939/jrmc.v27i1.2061
Beenish Nadeem, N. Malik, Anam Zahoor
INTRODUCTION: Human kidney constitutes an integral organ during the period of embryogenesis. The use of regular ultrasound during antenatal follow ups not only assesses structural aspects of fetal body but can also evaluate functional integrity of developing organs to some extent. Unfortunately, fetal renal hemodynamics has been studied more in western population which have better socio-economic status as well as good antenatal care. Our study aims at establishing a normal reference range for fetal renal artery indices in healthy Pakistani pregnant population which has not been done before. METHODOLOGY: This is a nonprobability convenient study investigating 130 healthy pregnant women during 18-38weeks of gestation. Resistivity and pulsatility indices (RI and PI) of the fetal renal arteries were evaluated dividing the patients in four groups as per their gestational age. Normal reference ranges of RI and PI values were established. P values for RI and PI were also being calculated. RESULTS: Mean values of the RI and PI of the fetal renal arteries were calculated. P value for RI is 0.05 and PI is 0.69. Hence the values remain unaltered with advancing gestational age. CONCLUSIONS: These reference ranges demonstrate the minimal change of the fetal renal hemodynamics during healthy pregnancies pertinent to our reference population. These may be applicable in antenatal practice to identify deviations from these reference ranges and will be beneficial in further studies related to prediction of fetal renal function.
{"title":"Establishing normal range of fetal renal artery RI and PI values in singleton pregnancies during 18-38 weeks of gestation","authors":"Beenish Nadeem, N. Malik, Anam Zahoor","doi":"10.37939/jrmc.v27i1.2061","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.2061","url":null,"abstract":"INTRODUCTION: Human kidney constitutes an integral organ during the period of embryogenesis. The use of regular ultrasound during antenatal follow ups not only assesses structural aspects of fetal body but can also evaluate functional integrity of developing organs to some extent. Unfortunately, fetal renal hemodynamics has been studied more in western population which have better socio-economic status as well as good antenatal care. Our study aims at establishing a normal reference range for fetal renal artery indices in healthy Pakistani pregnant population which has not been done before.\u0000METHODOLOGY: This is a nonprobability convenient study investigating 130 healthy pregnant women during 18-38weeks of gestation. Resistivity and pulsatility indices (RI and PI) of the fetal renal arteries were evaluated dividing the patients in four groups as per their gestational age. Normal reference ranges of RI and PI values were established. P values for RI and PI were also being calculated.\u0000RESULTS: Mean values of the RI and PI of the fetal renal arteries were calculated. P value for RI is 0.05 and PI is 0.69. Hence the values remain unaltered with advancing gestational age.\u0000CONCLUSIONS: These reference ranges demonstrate the minimal change of the fetal renal hemodynamics during healthy pregnancies pertinent to our reference population. These may be applicable in antenatal practice to identify deviations from these reference ranges and will be beneficial in further studies related to prediction of fetal renal function.\u0000 \u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45096937","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：