Pub Date : 2023-06-24DOI: 10.37939/jrmc.v27i2.2064
Muhammad Inaamullah Younas, Faizan Rauf, Muhammad Mustafa, Sarmad Nasir Janjua, Shaheen Iqbal, Khurram Habib
Objective: To determine the efficacy of tranexamic acid in reducing blood loss in primary total knee replacement. Material and Methods: A total of 96 patients having a diagnosis of primary knee osteoarthritis made up the population sample. The Total Knee Replacement patients were separated into two groups. Patients in Group B used Intra venous tranexamic acid, but those in Group A did not use tranexamic acid during the course of the operation or afterwards. Results: Mean age of the patients recorded in group A 63.79±6.60 (years) and in group B 62.96±7.89 (years). The majority of the patients in both groups were females. After surgery, Group B patients who received tranexamic acid reported less blood loss and less haemoglobin reduction as compared to the control group. Conclusion: From our study, we conclude that Tranexamic acid used intravenously during total knee arthroplasty considerably lowers postoperative blood loss.
{"title":"Efficacy Of Tranexamic Acid in Reducing Blood Loss in Primary Total Knee Replacement","authors":"Muhammad Inaamullah Younas, Faizan Rauf, Muhammad Mustafa, Sarmad Nasir Janjua, Shaheen Iqbal, Khurram Habib","doi":"10.37939/jrmc.v27i2.2064","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2064","url":null,"abstract":"Objective: To determine the efficacy of tranexamic acid in reducing blood loss in primary total knee replacement. \u0000Material and Methods: A total of 96 patients having a diagnosis of primary knee osteoarthritis made up the population sample. The Total Knee Replacement patients were separated into two groups. Patients in Group B used Intra venous tranexamic acid, but those in Group A did not use tranexamic acid during the course of the operation or afterwards. \u0000Results: Mean age of the patients recorded in group A 63.79±6.60 (years) and in group B 62.96±7.89 (years). The majority of the patients in both groups were females. After surgery, Group B patients who received tranexamic acid reported less blood loss and less haemoglobin reduction as compared to the control group. \u0000Conclusion: From our study, we conclude that Tranexamic acid used intravenously during total knee arthroplasty considerably lowers postoperative blood loss.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43128820","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.2050
Faiza Batool, Kausar Z. Malik, Lubna Meraj, K. Tariq, Tooba Iqbal, Neelum Zaka
To determine the frequency of raised Mean Platelet Volume (MPV) in patients with acute coronary syndrome (ACS) in HIT Hospital Taxila. Materials and Methods: A case-control study was at HIT Hospital Taxila. All the patients presented with chest pain who fulfilled the inclusion criteria were recruited into the study. Patients with acute coronary syndrome were included in the case group (ACS group). The patients included in the control group (non-ACS group) had chest pain without having ischemic heart disease or risk of ischemic heart disease. Data were analyzed using SPSS version 28. To find out the correlation between the type of chest pain and mean platelet volume chi-square test was applied. Results: Total 93 patients were included in this study. 51 patients were included in the ACS group while 42 were in non- ACS group. To find out the correlation between the type of chest pain and mean platelet volume chi-square test was applied. The results show a significant association between raised MPV and acute coronary syndrome. Conclusion: Patients with raised MPV are at higher risk of acute coronary disease and complications related to it. It could be used as a predictor of ischemic heart disease and its complications.
{"title":"Frequency Of Raised Mean Platelet Volume In Patients With Acute Coronary Syndrome In HIT Hospital Taxila","authors":"Faiza Batool, Kausar Z. Malik, Lubna Meraj, K. Tariq, Tooba Iqbal, Neelum Zaka","doi":"10.37939/jrmc.v27i2.2050","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2050","url":null,"abstract":"To determine the frequency of raised Mean Platelet Volume (MPV) in patients with acute coronary syndrome (ACS) in HIT Hospital Taxila. \u0000Materials and Methods: A case-control study was at HIT Hospital Taxila. All the patients presented with chest pain who fulfilled the inclusion criteria were recruited into the study. Patients with acute coronary syndrome were included in the case group (ACS group). The patients included in the control group (non-ACS group) had chest pain without having ischemic heart disease or risk of ischemic heart disease. Data were analyzed using SPSS version 28. To find out the correlation between the type of chest pain and mean platelet volume chi-square test was applied. \u0000Results: Total 93 patients were included in this study. 51 patients were included in the ACS group while 42 were in non- ACS group. To find out the correlation between the type of chest pain and mean platelet volume chi-square test was applied. The results show a significant association between raised MPV and acute coronary syndrome. \u0000Conclusion: Patients with raised MPV are at higher risk of acute coronary disease and complications related to it. It could be used as a predictor of ischemic heart disease and its complications.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42474140","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.2238
Osama Ijaz, Aurangzeb Khan, Marryam Riaz Farooqui, Hamza Bhatti, F. Rauf, N. Malik
INTRODUCTION: The experience in the operation theatres is pivotal for surgical education. A measure of the educational environment in the operating room as perceived by residents would assist educators and trainees in gauging the quality of the learning occurring within their institute. METHODS: A cross-sectional survey using the surgical theatre educational environment measure (STEEM) 40-item inventory to measure theatre learning environment perception of surgery and allied residents in public sector hospitals of Rawalpindi. Internal reliability of the inventory was assessed using the Cronbach α coefficient. P≤ 0.05 was considered significant. RESULTS: 107 respondents were included in the study. Mean score of the survey was 133.7± 20.2. No significant differences in perception were found among residents at different stages and gender, except in learning subscale of the inventory for both gender and residents and the teaching and training subscale among residents at different levels. The inventory showed a high internal consistency with a Cronbach α of 0.851. CONCLUSION: Surgical training and education have still a long way to go in the public sector. Much needed collaborations with education specialist and senior surgeons is required. Interval collection of feedback and perceptions of the educational environment is also necessary.
{"title":"Residents’ Perception Of Surgical Theatre Educational Environment At Public Hospitals Of Rawalpindi - A Steem Survey","authors":"Osama Ijaz, Aurangzeb Khan, Marryam Riaz Farooqui, Hamza Bhatti, F. Rauf, N. Malik","doi":"10.37939/jrmc.v27i2.2238","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2238","url":null,"abstract":"INTRODUCTION: \u0000The experience in the operation theatres is pivotal for surgical education. A measure of the educational environment in the operating room as perceived by residents would assist educators and trainees in gauging the quality of the learning occurring within their institute. \u0000 \u0000METHODS: \u0000A cross-sectional survey using the surgical theatre educational environment measure (STEEM) 40-item inventory to measure theatre learning environment perception of surgery and allied residents in public sector hospitals of Rawalpindi. Internal reliability of the inventory was assessed using the Cronbach α coefficient. P≤ 0.05 was considered significant. \u0000 \u0000RESULTS: \u0000107 respondents were included in the study. Mean score of the survey was 133.7± 20.2. No significant differences in perception were found among residents at different stages and gender, except in learning subscale of the inventory for both gender and residents and the teaching and training subscale among residents at different levels. The inventory showed a high internal consistency with a Cronbach α of 0.851. \u0000 \u0000CONCLUSION: \u0000Surgical training and education have still a long way to go in the public sector. Much needed collaborations with education specialist and senior surgeons is required. Interval collection of feedback and perceptions of the educational environment is also necessary.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44053757","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.2024
F. Khan, A. Fatima, Hareem Gohar, Mehwish Sajjad, M. Siddiqui, Saima Naseem
Objective: This study aims to determine the frequency of bacterial co-infections in COVID-19-positive patients. Methodology: A prospective cross-sectional study was conducted in the Department of Microbiology, Pakistan, from November 15, 2021, to April 15, 2022. Blood and respiratory tract samples were collected, including sputum, bronchial lavage, and tracheal aspirate. Clinical specimens were inoculated onto a Sheep blood agar plate, Chocolate agar plate (aerobic with 5% CO2), and MacConkey’s agar. Identification was followed by specific and standard microbiological protocols. COVID-19 was confirmed by qualitative PCR. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. Results: A total of 202 clinical samples, including blood, sputum, tracheal aspirates, and bronchial lavage, were collected from COVID-19-positive patients. Male patients were more common in sputum and tracheal aspirates, while female patients were more common in blood cultures. The majority of patients were over 60 years of age. Acinetobacter baumannii was predominantly isolated from blood and tracheal aspirates, exhibiting multidrug resistance, but showing complete sensitivity towards Colistin. Klebsiella pneumonia exhibited high prevalence in sputum, with complete resistance observed in Cephalosporins and Co-trimoxazole. Conclusion: The study concludes a high frequency of superadded bacterial co-infections, caused most prominently by Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa. The majority of these are multidrug-resistant pathogens, therefore, urgent action is required to control the spread of nosocomial infections by resistant strains, which are responsible for the high mortality rate among COVID-19 critical patients.
{"title":"Frequency Of Bacterial Co-Infections Isolated from Covid-19 Positive Patients From Tertiary Care Hospital Of Karachi","authors":"F. Khan, A. Fatima, Hareem Gohar, Mehwish Sajjad, M. Siddiqui, Saima Naseem","doi":"10.37939/jrmc.v27i2.2024","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2024","url":null,"abstract":"Objective: This study aims to determine the frequency of bacterial co-infections in COVID-19-positive patients. \u0000Methodology: A prospective cross-sectional study was conducted in the Department of Microbiology, Pakistan, from November 15, 2021, to April 15, 2022. Blood and respiratory tract samples were collected, including sputum, bronchial lavage, and tracheal aspirate. Clinical specimens were inoculated onto a Sheep blood agar plate, Chocolate agar plate (aerobic with 5% CO2), and MacConkey’s agar. Identification was followed by specific and standard microbiological protocols. COVID-19 was confirmed by qualitative PCR. Antimicrobial susceptibility testing was performed using the Kirby Bauer disc diffusion method. \u0000Results: A total of 202 clinical samples, including blood, sputum, tracheal aspirates, and bronchial lavage, were collected from COVID-19-positive patients. Male patients were more common in sputum and tracheal aspirates, while female patients were more common in blood cultures. The majority of patients were over 60 years of age. Acinetobacter baumannii was predominantly isolated from blood and tracheal aspirates, exhibiting multidrug resistance, but showing complete sensitivity towards Colistin. Klebsiella pneumonia exhibited high prevalence in sputum, with complete resistance observed in Cephalosporins and Co-trimoxazole. \u0000Conclusion: The study concludes a high frequency of superadded bacterial co-infections, caused most prominently by Acinetobacter baumannii, Klebsiella pneumonia, and Pseudomonas aeruginosa. The majority of these are multidrug-resistant pathogens, therefore, urgent action is required to control the spread of nosocomial infections by resistant strains, which are responsible for the high mortality rate among COVID-19 critical patients.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47849503","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.1999
Noreen Atzaz, M. Khattak, F. Zuhra, J. Afzal, S. Khaliq, Sami Saeed
Objective: Iron deficiency anemia (IDA) is the most prevalent hematological disorder in women of child-bearing age. IDA poses a threat to feto-maternal wellbeing. It is the leading cause of morbidity and mortality in pregnancy. IDA in young females can coexist with other nutritional deficiencies such as vitamin B12 (Vit B12). An undetected Vit B12 deficiency carries a greater likelihood of development of maternal neuropsychiatric disorders and neural tube defects in the fetus. Materials and methods: Venous blood samples of non-pregnant female population (N=133) from Fauji Foundation Hospital, Rawalpindi were collected and analyzed for complete blood count (CBC), Vit B12 and serum Ferritin. Population was further subdivided into two groups. Group A, included females with low serum Ferritin and low MCV, group B restricted to normal serum Ferritin and low MCV, whereas control group had females with normal serum Ferritin and MCV levels. Results: Demographic data suggested that only height was slightly lower in IDA patients other than reduced serum Ferritin levels. Group A also showed reduced levels of Vit B12 as compared to group B and control group. CBC analysis indicated marked reduction in all hematological parameters except platelet count in group A. Conclusion: Our findings suggest that IDA and Vit B12 deficiency may coexist in young females. Monitoring Vit B12 along with iron deficiency parameters is essential to treat anemia and prevent gynecological complications. Paucity of information on their coexistence in females of childbearing age require further investigation. Keywords: Vitamin B12, Iron deficiency anemia, Microcytosis, Serum Ferritin.
{"title":"The frequency of vitamin B12 derangements in females presenting for workup of iron deficiency anemia","authors":"Noreen Atzaz, M. Khattak, F. Zuhra, J. Afzal, S. Khaliq, Sami Saeed","doi":"10.37939/jrmc.v27i2.1999","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1999","url":null,"abstract":"Objective: Iron deficiency anemia (IDA) is the most prevalent hematological disorder in women of child-bearing age. IDA poses a threat to feto-maternal wellbeing. It is the leading cause of morbidity and mortality in pregnancy. IDA in young females can coexist with other nutritional deficiencies such as vitamin B12 (Vit B12). An undetected Vit B12 deficiency carries a greater likelihood of development of maternal neuropsychiatric disorders and neural tube defects in the fetus.\u0000Materials and methods: Venous blood samples of non-pregnant female population (N=133) from Fauji Foundation Hospital, Rawalpindi were collected and analyzed for complete blood count (CBC), Vit B12 and serum Ferritin. Population was further subdivided into two groups. Group A, included females with low serum Ferritin and low MCV, group B restricted to normal serum Ferritin and low MCV, whereas control group had females with normal serum Ferritin and MCV levels.\u0000Results: Demographic data suggested that only height was slightly lower in IDA patients other than reduced serum Ferritin levels. Group A also showed reduced levels of Vit B12 as compared to group B and control group. CBC analysis indicated marked reduction in all hematological parameters except platelet count in group A.\u0000Conclusion: Our findings suggest that IDA and Vit B12 deficiency may coexist in young females. Monitoring Vit B12 along with iron deficiency parameters is essential to treat anemia and prevent gynecological complications. Paucity of information on their coexistence in females of childbearing age require further investigation.\u0000Keywords: Vitamin B12, Iron deficiency anemia, Microcytosis, Serum Ferritin.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45873944","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.1804
M. U. Din, Umer Shahid, A. Qudoos, Romana Ahmed, Muazzama Sohail, S. Javed
Objectives: The study was conducted to determine the Covid-19 vaccine acceptance and hesitancy among the medical students who are more susceptible to be infected being the frontline workers. Methodology: This analytical cross sectional study was conducted in medical students of 1st to final year MBBS of various medical institutions of Faisalabad. Study duration was 3 months (August 2021 to October 2021). The sample size was 391 and divided in 2 age groups i.e. above and below 21 years and 245 (62.7%) comprised of females. The inclusion criteria were those students who gave consent and filled out the questionnaire and the exclusion criteria was who didn't concede. The data was analysed on SPSS 25. Confidence interval was set to be 95% with 5% margin of error. Results: More than half of the participants i.e. 214 (54.7) have got Sinopharm vaccine. Vaccine hesitancy was found in 28 (7.2%) students and major reason was concern about vaccine safety. Significant relationship (p = < 0.05) was found in all factors related to ‘concerns regarding Covid-19 vaccines and trust of official information’; in all except one in factors related to ‘awareness and overall attitude regarding vaccine acceptance’ and in all except one in factors related to ‘perception of vulnerability to COVID-19 and attitude regarding usefulness of vaccine for community’. Conclusion: Covid-19 vaccine hesitancy was found in one out of every 14 medical students. They were concerned about the efficacy of Covid-19 vaccines. Most of the participants also showed concerns regarding severe adverse effects of these vaccine and on vaccine trials also before making it available for general public. At the same time, participants showed trust on information about Covid-19 vaccine from government and public health experts. Although vaccine hesitancy was present in only 7.2% of participants, health education programmes should be arranged to improve awareness and trust on Covid-19 vaccine. Concerns of medical students should be addressed on priority as future health care providers. Keywords: Covid-19, medical students, vaccine acceptance, hesitancy
{"title":"Covid-19 vaccine acceptance and hesitancy among medical students of Faisalabad","authors":"M. U. Din, Umer Shahid, A. Qudoos, Romana Ahmed, Muazzama Sohail, S. Javed","doi":"10.37939/jrmc.v27i2.1804","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1804","url":null,"abstract":"Objectives: The study was conducted to determine the Covid-19 vaccine acceptance and hesitancy among the medical students who are more susceptible to be infected being the frontline workers.\u0000Methodology: This analytical cross sectional study was conducted in medical students of 1st to final year MBBS of various medical institutions of Faisalabad. Study duration was 3 months (August 2021 to October 2021). The sample size was 391 and divided in 2 age groups i.e. above and below 21 years and 245 (62.7%) comprised of females. The inclusion criteria were those students who gave consent and filled out the questionnaire and the exclusion criteria was who didn't concede. The data was analysed on SPSS 25. Confidence interval was set to be 95% with 5% margin of error.\u0000Results: More than half of the participants i.e. 214 (54.7) have got Sinopharm vaccine. Vaccine hesitancy was found in 28 (7.2%) students and major reason was concern about vaccine safety. Significant relationship (p = < 0.05) was found in all factors related to ‘concerns regarding Covid-19 vaccines and trust of official information’; in all except one in factors related to ‘awareness and overall attitude regarding vaccine acceptance’ and in all except one in factors related to ‘perception of vulnerability to COVID-19 and attitude regarding usefulness of vaccine for community’.\u0000Conclusion: Covid-19 vaccine hesitancy was found in one out of every 14 medical students. They were concerned about the efficacy of Covid-19 vaccines. Most of the participants also showed concerns regarding severe adverse effects of these vaccine and on vaccine trials also before making it available for general public. At the same time, participants showed trust on information about Covid-19 vaccine from government and public health experts. Although vaccine hesitancy was present in only 7.2% of participants, health education programmes should be arranged to improve awareness and trust on Covid-19 vaccine. Concerns of medical students should be addressed on priority as future health care providers.\u0000Keywords: Covid-19, medical students, vaccine acceptance, hesitancy","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43994169","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.1954
R. Asghar, M. Sharif, Khalid Saheel, I. Khan, A. Hussain, R. Ashraf
Introduction: Coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was initially identified in Wuhan, China, in December 2019. The virus affects almost all countries of the world. It has infected humans in all age groups, of all ethnicities, both males and females. It is considered that COVID-19, in those with underlying health conditions or co-morbidities, has an increasingly rapid and severe progression, often leading to death. This study is designed to evaluate the impact of co-morbidities on the severity and outcome of COVID-19 infection in children. Methods: This retrospective observational study was conducted at the pediatric department, Benazir Bhutto Hospital Rawalpindi from March 2020 to September 2021. Every confirmed COVID-19 admitted case according to inclusion criteria was enrolled for the study. Data were retrieved from hospital records; data was recorded on a predesigned study questionnaire, entered and analyzed in SPSS version 24 for descriptive statistics and bivariate analysis. Results: 109 children were enrolled with confirmed COVID-19, of these 64(58.7%) were males and 45(41.2%) were females. The age of the patients ranged from infants to 12 years with a mean age of 27.25 months. Comorbidities were present in 70 patients (64.2%).CHD was the most common co-morbid condition (n=18, 16.5%). Most of the patients experienced mild to moderate symptoms (n=64.2%) while severe symptoms were found in (n=35.8%) patients. 27 patients (24.8%) required Ventilatory support, and of these 20 patients (18.3%) had underlying co-morbidity. The total number of patients who expired was 27(24.7%), and 30.3% of patients who expired had co-morbid conditions. the patients with co-morbid conditions had a longer stay in the hospital. 35 patients (32.1%)with underlying co-morbidity remained admitted for more than a week and 13 patients(9%)for more than two weeks. Conclusion: Pediatric patients with co-morbidities have a higher risk of severe COVID-19 and associated mortality than children without underlying disease. Children with underlying conditions need to be carefully assessed and closely monitored. Further data are required to define these associations and adequate guidelines to manage high-risk children with COVID-19. Keywords: Coronavirus, COVID-19, Pediatrics, Co-morbidity, Severity, Outcome
冠状病毒，即严重急性呼吸综合征冠状病毒2型(SARS-CoV-2)，最初于2019年12月在中国武汉被发现。这种病毒几乎影响到世界上所有国家。它感染了所有年龄组、所有种族的男性和女性。据认为，在有潜在健康状况或合并症的患者中，COVID-19的进展日益迅速和严重，往往导致死亡。本研究旨在评估合并症对儿童COVID-19感染严重程度和结局的影响。方法:本回顾性观察研究于2020年3月至2021年9月在拉瓦尔品第贝娜齐尔·布托医院儿科进行。所有符合纳入标准的新冠肺炎确诊入院病例均被纳入研究。数据从医院记录中检索;数据记录在预先设计的研究问卷上，在SPSS version 24中输入和分析，进行描述性统计和双变量分析。结果:纳入确诊COVID-19儿童109例，其中男性64例(58.7%)，女性45例(41.2%)。患者年龄从婴儿到12岁，平均年龄27.25个月。70例患者存在合并症(64.2%)。冠心病是最常见的合并症(n=18, 16.5%)。大多数患者出现轻至中度症状(n=64.2%)，重度症状(n=35.8%)。27例(24.8%)患者需要呼吸支持，其中20例(18.3%)患者有潜在的合并症。死亡患者总数为27例(24.7%)，死亡患者中有30.3%有合并症。合并疾病的患者住院时间较长。伴有潜在合并症的35例患者(32.1%)住院超过一周，13例患者(9%)住院超过两周。结论:与无基础疾病的儿童相比，合并合并症的儿童发生严重COVID-19的风险和相关死亡率更高。有潜在疾病的儿童需要仔细评估和密切监测。需要进一步的数据来确定这些关联，并制定适当的指南来管理感染COVID-19的高危儿童。关键词:冠状病毒，COVID-19，儿科，合并症，严重程度，结局
{"title":"Impact of Comorbidities on the Severity of Disease & Outcome in Children with COVID 19 at a Tertiary Care Pediatric Hospital, Rawalpindi.","authors":"R. Asghar, M. Sharif, Khalid Saheel, I. Khan, A. Hussain, R. Ashraf","doi":"10.37939/jrmc.v27i2.1954","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1954","url":null,"abstract":"Introduction: Coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), was initially identified in Wuhan, China, in December 2019. The virus affects almost all countries of the world. It has infected humans in all age groups, of all ethnicities, both males and females. It is considered that COVID-19, in those with underlying health conditions or co-morbidities, has an increasingly rapid and severe progression, often leading to death. This study is designed to evaluate the impact of co-morbidities on the severity and outcome of COVID-19 infection in children.\u0000Methods: This retrospective observational study was conducted at the pediatric department, Benazir Bhutto Hospital Rawalpindi from March 2020 to September 2021. Every confirmed COVID-19 admitted case according to inclusion criteria was enrolled for the study. Data were retrieved from hospital records; data was recorded on a predesigned study questionnaire, entered and analyzed in SPSS version 24 for descriptive statistics and bivariate analysis.\u0000Results: 109 children were enrolled with confirmed COVID-19, of these 64(58.7%) were males and 45(41.2%) were females. The age of the patients ranged from infants to 12 years with a mean age of 27.25 months. Comorbidities were present in 70 patients (64.2%).CHD was the most common co-morbid condition (n=18, 16.5%). Most of the patients experienced mild to moderate symptoms (n=64.2%) while severe symptoms were found in (n=35.8%) patients. 27 patients (24.8%) required Ventilatory support, and of these 20 patients (18.3%) had underlying co-morbidity. The total number of patients who expired was 27(24.7%), and 30.3% of patients who expired had co-morbid conditions. the patients with co-morbid conditions had a longer stay in the hospital. 35 patients (32.1%)with underlying co-morbidity remained admitted for more than a week and 13 patients(9%)for more than two weeks.\u0000Conclusion: Pediatric patients with co-morbidities have a higher risk of severe COVID-19 and associated mortality than children without underlying disease. Children with underlying conditions need to be carefully assessed and closely monitored. Further data are required to define these associations and adequate guidelines to manage high-risk children with COVID-19.\u0000Keywords: Coronavirus, COVID-19, Pediatrics, Co-morbidity, Severity, Outcome","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48649630","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.2039
Anam Fatima, F. Shah, Hareema Saeed Khan, K. Rauf, Safdar Ali, Shahid Ali Khan
Objective: To determine the frequency of depression in patients with vitamin B12 deficiency. Methodology: This cross-sectional study was carried out from January 2020 to March 2021 on a total sample size of n=100 patients (age 49.84 ± 0.91 years) using a simple random sampling technique, visiting the medical department of the federal government polyclinic hospital, in Islamabad. Patients presenting with macrocytic anaemia secondary to vitamin B12 deficiency were included while the patients with previously diagnosed depression were excluded from the study. Serum vitamin B12 levels were measured through the ELISA technique. Patient Healthcare Questionnaire-9 (PHQ-9) was designed and presented to patients with vitamin B12 deficiency for depression assessment. Patients with PHQ-9 score ≤5 were rated as having no depression and the patients with score ≥5 were rated as having depression. Data were analyzed using GraphPad Prism and the correlation coefficient was measured through non-linear fit and linear regression curves while ordinary ANOVA (non-parametric) was applied for study variables. Results: The average level of vitamin B12 in the serum and PHQ-9 score were recorded as 158 ± 4.94 (pg/uL) and 5.85 ± 0.30, respectively. Vitamin B12 levels and PHQ-9 score depicted an inverse correlation, however, no association was found between gender and PHQ-9 score. Conclusion: Data depicted that the patients presenting low levels of vitamin B12 in their serum have shown corresponding high PHQ-9 scores which is an indicator of depression. However, depression prevails in all age groups without any discrimination of gender.
{"title":"Frequency Of Depression In Patients With Vitamin B12 Deficiency","authors":"Anam Fatima, F. Shah, Hareema Saeed Khan, K. Rauf, Safdar Ali, Shahid Ali Khan","doi":"10.37939/jrmc.v27i2.2039","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2039","url":null,"abstract":"Objective: To determine the frequency of depression in patients with vitamin B12 deficiency. \u0000Methodology: This cross-sectional study was carried out from January 2020 to March 2021 on a total sample size of n=100 patients (age 49.84 ± 0.91 years) using a simple random sampling technique, visiting the medical department of the federal government polyclinic hospital, in Islamabad. Patients presenting with macrocytic anaemia secondary to vitamin B12 deficiency were included while the patients with previously diagnosed depression were excluded from the study. Serum vitamin B12 levels were measured through the ELISA technique. Patient Healthcare Questionnaire-9 (PHQ-9) was designed and presented to patients with vitamin B12 deficiency for depression assessment. Patients with PHQ-9 score ≤5 were rated as having no depression and the patients with score ≥5 were rated as having depression. Data were analyzed using GraphPad Prism and the correlation coefficient was measured through non-linear fit and linear regression curves while ordinary ANOVA (non-parametric) was applied for study variables. \u0000Results: The average level of vitamin B12 in the serum and PHQ-9 score were recorded as 158 ± 4.94 (pg/uL) and 5.85 ± 0.30, respectively. Vitamin B12 levels and PHQ-9 score depicted an inverse correlation, however, no association was found between gender and PHQ-9 score. \u0000Conclusion: Data depicted that the patients presenting low levels of vitamin B12 in their serum have shown corresponding high PHQ-9 scores which is an indicator of depression. However, depression prevails in all age groups without any discrimination of gender.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49172009","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 : 2023-06-24DOI: 10.37939/jrmc.v27i2.2058
Muhammad Tahir Ghani, H. Haq, Ibad Ur Rehman, H. Malik
Objective: systematic review assessed the overall incidence of hypoparathyroidism after Total thyroidectomy (TT) for benign goitres. Methods: A systematic search of PubMed, google scholar, Cochrane, and Pakmedinet under PRISMA (preferred reporting items for systematic reviews and Meta-analyses) guidelines was performed. All studies during the last 50 years where TT was performed for benign goitres and post-operative hypoparathyroidism was assessed were included. The total incidence of both transient and permanent hypoparathyroidism was calculated after TT for benign goitres. The risk of bias was also assessed. Results: Twelve studies were included in total including eight retrospective, three prospective observational studies, and one randomized trial. Three studies were from Turkey, 2 from Pakistan, 2 from Greece, and one each from Saudi Arabia, India, Denmark, Egypt, and the USA. 2809 TT were performed for benign goitres. Overall Transient hypoparathyroidism (THP) was noted in 290 (10%) patients while permanent hypoparathyroidism (PHP) was noted in 33(1.17%) patients. The highest incidence of permanent hypoparathyroidism was 17% in one study while the lowest was 0% in three studies. The highest incidence of transient hypoparathyroidism was 28.5% in one study while the lowest incidence was 2.5%. The risk of bias was high. Conclusion: TT for benign goitres is associated with 1.17 % overall risk (range 0%-17%) of PHP and 10% (range 2.5%-28.5%) of THP.
{"title":"Incidence Of Hypoparathyroidism After Total Thyroidectomy for Benign Goitres. A Systematic Review","authors":"Muhammad Tahir Ghani, H. Haq, Ibad Ur Rehman, H. Malik","doi":"10.37939/jrmc.v27i2.2058","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2058","url":null,"abstract":"Objective: systematic review assessed the overall incidence of hypoparathyroidism after Total thyroidectomy (TT) for benign goitres. \u0000Methods: A systematic search of PubMed, google scholar, Cochrane, and Pakmedinet under PRISMA (preferred reporting items for systematic reviews and Meta-analyses) guidelines was performed. All studies during the last 50 years where TT was performed for benign goitres and post-operative hypoparathyroidism was assessed were included. The total incidence of both transient and permanent hypoparathyroidism was calculated after TT for benign goitres. The risk of bias was also assessed. \u0000Results: Twelve studies were included in total including eight retrospective, three prospective observational studies, and one randomized trial. Three studies were from Turkey, 2 from Pakistan, 2 from Greece, and one each from Saudi Arabia, India, Denmark, Egypt, and the USA. 2809 TT were performed for benign goitres. Overall Transient hypoparathyroidism (THP) was noted in 290 (10%) patients while permanent hypoparathyroidism (PHP) was noted in 33(1.17%) patients. The highest incidence of permanent hypoparathyroidism was 17% in one study while the lowest was 0% in three studies. The highest incidence of transient hypoparathyroidism was 28.5% in one study while the lowest incidence was 2.5%. The risk of bias was high. \u0000Conclusion: TT for benign goitres is associated with 1.17 % overall risk (range 0%-17%) of PHP and 10% (range 2.5%-28.5%) of THP.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46234833","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}
Virtual microscopy for showing histopathological slides have been in use for quite some time. This method of teaching is considered to be a good replacement for conventional microscopy using glass slides. This study was carried out to analyze the perception and performance of dental students regarding the use of conventional microscopic slides and virtual slides in relation to teaching and learning. Material and methods: Eighty undergraduate dental students who had studies the subject of oral pathology as a compulsory subject at Watim Dental college were invited to participate in the study. Students not willing to take part in the study were excluded. The questionnaires were duly filled and test was taken by the students using either virtual slides or glass slides. The data was collected and analyzed using SPSS 20. Results: A total of eighty undergraduate students participated in the study. The results showed that dental students had a higher acceptance rate (all P-value<0.001) for cases taught via virtual microscopy and they out performed in cases shown on virtual slides (p<0.01). Conclusion: In this study the students preferred teaching of oral histopathology via virtual slides over conventional glass slides and it also contributed more to their learning. Keyword: Conventional microscopy, dental students, virtual microscopy, oral pathology
{"title":"Perceptions and Performance of dental students using Conventional and Virtual Microscopy in Oral Pathology","authors":"Gulmina Saeed Orakzai, Waqar-un-Nisa, Saima Irshad, Nabeela Naeem, Ammarah Afreen, Zarah Afreen","doi":"10.37939/jrmc.v27i2.2240","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2240","url":null,"abstract":"Virtual microscopy for showing histopathological slides have been in use for quite some time. This method of teaching is considered to be a good replacement for conventional microscopy using glass slides. This study was carried out to analyze the perception and performance of dental students regarding the use of conventional microscopic slides and virtual slides in relation to teaching and learning. Material and methods: Eighty undergraduate dental students who had studies the subject of oral pathology as a compulsory subject at Watim Dental college were invited to participate in the study. Students not willing to take part in the study were excluded. The questionnaires were duly filled and test was taken by the students using either virtual slides or glass slides. The data was collected and analyzed using SPSS 20. Results: A total of eighty undergraduate students participated in the study. The results showed that dental students had a higher acceptance rate (all P-value<0.001) for cases taught via virtual microscopy and they out performed in cases shown on virtual slides (p<0.01). Conclusion: In this study the students preferred teaching of oral histopathology via virtual slides over conventional glass slides and it also contributed more to their learning. Keyword: Conventional microscopy, dental students, virtual microscopy, oral pathology","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46640223","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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