Pub Date : 2023-06-24DOI: 10.37939/jrmc.v27i2.2239
Noreen Atzaz, Mehnaz, F. Zuhra, S. Muneer, Haider Ali, Sami Saeed
Objective: To assess impact of stringent Internal Quality Control (IQC) checks on performance of proficiency testing Material and methods: This was a Prospective study conducted between September 2020 and April 2021 at Chemical pathology lab of Fauji Foundation Hospital Rawalpindi. External quality control data (EQC) from the month of September was evaluated. As part of corrective action plan IQC checks were enforced, internal quality control (IQC) data of the month of September 2020 and April 2022 were assessed. Performance characteristics of routine chemistry analytes coefficient of variance (CV), standard deviations (SD)and Bias were calculated and compared using paired –T- test. Results: Proficiency testing report (NEQAPP) of cycle 10 round 1 showed 11% External Quality Control (EQC) failure among 18 biochemical parameters. Serum Creatinine and Total Protein failed acceptability criteria with Z-score of greater than 2. As part of corrective action IQC checks were done, which led to improvement in CV (SD) of these parameters. The next EQC lab report for routine chemistry analytes met the acceptability criteria with z-scores of all anaytes being less than 2. Conclusion: Precise & accurate IQC results lead to better performance in EQC results
{"title":"Stringent Internal Quality Control Procedures in Chemical Pathology Lead to Better Performance in External Proficiency Testing","authors":"Noreen Atzaz, Mehnaz, F. Zuhra, S. Muneer, Haider Ali, Sami Saeed","doi":"10.37939/jrmc.v27i2.2239","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2239","url":null,"abstract":"Objective: To assess impact of stringent Internal Quality Control (IQC) checks on performance of proficiency testing \u0000Material and methods: This was a Prospective study conducted between September 2020 and April 2021 at Chemical pathology lab of Fauji Foundation Hospital Rawalpindi. External quality control data (EQC) from the month of September was evaluated. As part of corrective action plan IQC checks were enforced, internal quality control (IQC) data of the month of September 2020 and April 2022 were assessed. Performance characteristics of routine chemistry analytes coefficient of variance (CV), standard deviations (SD)and Bias were calculated and compared using paired –T- test. \u0000Results: Proficiency testing report (NEQAPP) of cycle 10 round 1 showed 11% External Quality Control (EQC) failure among 18 biochemical parameters. Serum Creatinine and Total Protein failed acceptability criteria with Z-score of greater than 2. As part of corrective action IQC checks were done, which led to improvement in CV (SD) of these parameters. The next EQC lab report for routine chemistry analytes met the acceptability criteria with z-scores of all anaytes being less than 2. \u0000Conclusion: Precise & accurate IQC results lead to better performance in EQC results","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":"44567608","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.v27i2.1910
Aaiza Tahir, Muhammad Waqas Nisar Ahmed, Summaya Khan, Omar Zafar, M. Sarfraz, Muhammad Shahid Tarar
Objective: To evaluate the frequency of depression, anxiety, and stress scores among glaucoma patients and assess factors attributing to severe scores. Methodology: This Analytical, Cross-sectional study was conducted at the Armed Forces Institute of Ophthalmology from June 2020 to July 2021. Data was collected through nonprobability consecutive sampling. Individuals with diagnosed primary open-angle glaucoma were selected irrespective of age and gender. Dass-21 (self-assessment scale) was used in Urdu to document patient scores for anxiety, depression, and stress. Results: The frequency of males (n=204, 54%) and females (n=173, 45.8%) in the two groups was almost the same (p=0.164). The mean age in the mono-drug group (mean= 48.81±10.58 years) was slightly lower than the polydrug group (mean=53.67±11.16years) (p=0.000018). Overall depression score of the sample fell in the severe category (score=21-27), with individuals showing more depression scores in the poly group (n=99, 26%) than in the mono drug group (n=76, 20%) (p=0.000002). Individuals on polydrug therapy showed severe scores for depression, anxiety, and stress. Conclusion: Among the glaucoma patient, those on polydrug therapy have higher incidences of anxiety among young patients and depression among older patients. This not only causes poor compliance to treatment but also increases the risk of progression of glaucoma hence augmenting the crippling effects of the disease. Keywords: Depression, anxiety, DASS-21, Glaucoma
{"title":"Depression and anxiety in glaucoma patients using mono drug therapy vs polydrug therapy","authors":"Aaiza Tahir, Muhammad Waqas Nisar Ahmed, Summaya Khan, Omar Zafar, M. Sarfraz, Muhammad Shahid Tarar","doi":"10.37939/jrmc.v27i2.1910","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1910","url":null,"abstract":"Objective: To evaluate the frequency of depression, anxiety, and stress scores among glaucoma patients and assess factors attributing to severe scores.\u0000Methodology: This Analytical, Cross-sectional study was conducted at the Armed Forces Institute of Ophthalmology from June 2020 to July 2021. Data was collected through nonprobability consecutive sampling. Individuals with diagnosed primary open-angle glaucoma were selected irrespective of age and gender. Dass-21 (self-assessment scale) was used in Urdu to document patient scores for anxiety, depression, and stress.\u0000Results: The frequency of males (n=204, 54%) and females (n=173, 45.8%) in the two groups was almost the same (p=0.164). The mean age in the mono-drug group (mean= 48.81±10.58 years) was slightly lower than the polydrug group (mean=53.67±11.16years) (p=0.000018). Overall depression score of the sample fell in the severe category (score=21-27), with individuals showing more depression scores in the poly group (n=99, 26%) than in the mono drug group (n=76, 20%) (p=0.000002). Individuals on polydrug therapy showed severe scores for depression, anxiety, and stress.\u0000Conclusion: Among the glaucoma patient, those on polydrug therapy have higher incidences of anxiety among young patients and depression among older patients. This not only causes poor compliance to treatment but also increases the risk of progression of glaucoma hence augmenting the crippling effects of the disease.\u0000Keywords: Depression, anxiety, DASS-21, Glaucoma","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":"45496138","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.v27i2.2056
M. Asrar, S. Nazir, S. Haider, Huzaifa Sajid
Objective: This study was carried out in resource-restricted settings receiving patients predominantly from middle- or lower-income classes, to highlight the indications, outcomes, and multiple factors affecting the outcome of mechanical ventilation in neonates.Materials and Methods: A retrospective study was conducted in level 3 NICU. Neonates ventilated from January 2018 to July 2021 were included in this study. Primary disease as an indication of ventilation along with outcomes in comparison to various parameters (clinical and laboratory) was listed as predictors of mortality. Thrombocytopenia was defined as platelet count<150,000/ μl and thrombocytopenia present was recorded as positive and negative for normal platelet count. C Reactive Protein levels of > 6 mg/dl were taken as positive.Results: A total of 320 ventilated neonates were included in the study. Among them 65.6% were males and 41.3% survived. Respiratory distress syndrome (RDS ) (28.7%), Hypoxic Ischaemic Encephalopathy (HIE) (26.6%), and Neonatal sepsis (NNS) (14.1%) were the three most indications for ventilation. The disease-specific outcome shows mortality was 64.4% in NNS, 64% in RDS, and 56.4% in HIE. Out of the total enrolled babies for the study, 62.1% were received outdoors and 37.8 % were indoors 74.4% of babies with HIE were received outdoors. Low birth weight, prematurity, mode of admission, first CRP at the time of presentation, thrombocytopenia, and duration of ventilation were portending factors of mortality Conclusion: Prematurity associated with RDS, HIE and NNS were the major indications for ventilation. Outdoor babies have poor survival due to late referrals and late presentations. Thrombocytopenia and early sepsis were found to be bad prognostic factors.
{"title":"Indications And Outcomes In Neonates Requiring Mechanical Ventilation In Level III Neonatal Intensive Care Unit, Wah Cantt, Pakistan","authors":"M. Asrar, S. Nazir, S. Haider, Huzaifa Sajid","doi":"10.37939/jrmc.v27i2.2056","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2056","url":null,"abstract":"Objective: This study was carried out in resource-restricted settings receiving patients predominantly from middle- or lower-income classes, to highlight the indications, outcomes, and multiple factors affecting the outcome of mechanical ventilation in neonates.Materials and Methods: A retrospective study was conducted in level 3 NICU. Neonates ventilated from January 2018 to July 2021 were included in this study. Primary disease as an indication of ventilation along with outcomes in comparison to various parameters (clinical and laboratory) was listed as predictors of mortality. Thrombocytopenia was defined as platelet count<150,000/ μl and thrombocytopenia present was recorded as positive and negative for normal platelet count. C Reactive Protein levels of > 6 mg/dl were taken as positive.Results: A total of 320 ventilated neonates were included in the study. Among them 65.6% were males and 41.3% survived. Respiratory distress syndrome (RDS ) (28.7%), Hypoxic Ischaemic Encephalopathy (HIE) (26.6%), and Neonatal sepsis (NNS) (14.1%) were the three most indications for ventilation. The disease-specific outcome shows mortality was 64.4% in NNS, 64% in RDS, and 56.4% in HIE. Out of the total enrolled babies for the study, 62.1% were received outdoors and 37.8 % were indoors 74.4% of babies with HIE were received outdoors. Low birth weight, prematurity, mode of admission, first CRP at the time of presentation, thrombocytopenia, and duration of ventilation were portending factors of mortality Conclusion: Prematurity associated with RDS, HIE and NNS were the major indications for ventilation. Outdoor babies have poor survival due to late referrals and late presentations. Thrombocytopenia and early sepsis were found to be bad prognostic factors.","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":"48863177","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.v27i2.2046
F. Zuhra, Mehnaz, Noreen Atzaz, Shabana, A. Iqbal, Sami Saeed
Objective: To assess and correlate changes in vitamin D levels in three trimesters of pregnancy. Material and methods: This longitudinal study was conducted in collaboration with the Gynecology & Obstetric and Pathology department of Fauji foundation hospital, Rawalpindi. Eighty pregnant females were included in the study and tested for vitamin D at three points of time i.e. first trimester gestational age: (7-13 weeks), second trimester (20-26weeks), and third trimester (33 weeks till term). Pregnant females at their first visit and healthy nonpregnant females (controls) were analyzed for vitamin D, vitamin B12, folate, ferritin, and Hemoglobin (Hb) levels and compared using the Mann- Whitney U test for vitamin D and independent sample t-test for other parameters. Vitamin D and Hemoglobin (Hb) testing was done during the first, second, and third trimesters among pregnant females and compared between three groups using the Kruskal Wallis test and paired t-test respectively. Results: Mean age of the pregnant females was 35 years. Mean vitamin D levels showed a significant decline from 30.7 ng/ml vs 19.5 ng/ml vs 18.6 ng/ml for the first, second, and third trimesters respectively (p-value<0.05). The frequency of vitamin D deficiency was 15.1% for pregnant females at their first visit which progressed to 20% and 25% in the second and third trimesters respectively. Conclusion: Increased vitamin D deficiency and insufficiency rates exist in pregnant females, which progresses to further decline in the ensuing trimesters.
{"title":"25 0H Vitamin D Levels in Pregnant Females: The Hidden Time Bomb","authors":"F. Zuhra, Mehnaz, Noreen Atzaz, Shabana, A. Iqbal, Sami Saeed","doi":"10.37939/jrmc.v27i2.2046","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2046","url":null,"abstract":"Objective: To assess and correlate changes in vitamin D levels in three trimesters of pregnancy. \u0000Material and methods: This longitudinal study was conducted in collaboration with the Gynecology & Obstetric and Pathology department of Fauji foundation hospital, Rawalpindi. Eighty pregnant females were included in the study and tested for vitamin D at three points of time i.e. first trimester gestational age: (7-13 weeks), second trimester (20-26weeks), and third trimester (33 weeks till term). Pregnant females at their first visit and healthy nonpregnant females (controls) were analyzed for vitamin D, vitamin B12, folate, ferritin, and Hemoglobin (Hb) levels and compared using the Mann- Whitney U test for vitamin D and independent sample t-test for other parameters. Vitamin D and Hemoglobin (Hb) testing was done during the first, second, and third trimesters among pregnant females and compared between three groups using the Kruskal Wallis test and paired t-test respectively. \u0000Results: Mean age of the pregnant females was 35 years. Mean vitamin D levels showed a significant decline from 30.7 ng/ml vs 19.5 ng/ml vs 18.6 ng/ml for the first, second, and third trimesters respectively (p-value<0.05). The frequency of vitamin D deficiency was 15.1% for pregnant females at their first visit which progressed to 20% and 25% in the second and third trimesters respectively. \u0000Conclusion: Increased vitamin D deficiency and insufficiency rates exist in pregnant females, which progresses to further decline in the ensuing trimesters.","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":"46419071","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.v27i2.2182
B. Salman, Fatima Jehangir, Aroosa Jahan, Saira Aslam, Nadra Ansari
ABSTRACT: Background: There is substantiatial corroboration that diabetes (both T1DM and T2DM) plays an essential role in predisposition to cognitive decline thus leading to dementia in both human and animal studies. (1,2,3). Hypoglycemia has been associated with the increased risk of developing cognitive impairment. (4). There is lack of data from our community to support this. We aim to observe occurrence of cognitive impairment in individuals aged 65 or above with poor glycemic control and compare it with similar age group individuals with no DM or good glycemic control. Frailty independently contributes to the cognitive decline. We also assessed frailty index and incorporated it into our result interpretation. Methods: We conducted a case control study in the primary health care center of Ziauddin University from 1st December 2021 to 30th June 2022. Cases included 83 individuals 65yrs with HbA1c =7 and above and controls included 91 individuals 65yrs and above with HbA1c <7. Both groups were assessed for cognitive decline using MMSE score and CFS score determined their dependency status. Results: Moderately uncontrolled Diabetes had highest association with severe cognitive decline(50%) p-value 0.000 and those who could not manage to do IADLS were severely dementic in our study( p-value 0.046). We also found DM to be associated with high frailty scores. Severely uncontrolled DM was associated with CFS of 5 meaning those who were dependent on others for instrumental activities of daily living. Those who managed well independently was associated with Pre DM in our study.( p-value 0.041) Conclusion: Severe cognitive decline has high association with uncontrolled glycemic control. Keywords: IADLS (instrumental activities of daily living), CFS (chronic frailty scale), MCI (Mild Cognitive Impairment)
{"title":"Occurrence of severe cognitive impairment in elderly individuals with poor glycemic control Vs elderly individuals with good glycemic control or no DM: a case control study”","authors":"B. Salman, Fatima Jehangir, Aroosa Jahan, Saira Aslam, Nadra Ansari","doi":"10.37939/jrmc.v27i2.2182","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2182","url":null,"abstract":"ABSTRACT: \u0000Background: There is substantiatial corroboration that diabetes (both T1DM and T2DM) plays an essential role in predisposition to cognitive decline thus leading to dementia in both human and animal studies. (1,2,3). Hypoglycemia has been associated with the increased risk of developing cognitive impairment. (4). There is lack of data from our community to support this. We aim to observe occurrence of cognitive impairment in individuals aged 65 or above with poor glycemic control and compare it with similar age group individuals with no DM or good glycemic control. Frailty independently contributes to the cognitive decline. We also assessed frailty index and incorporated it into our result interpretation. \u0000Methods: We conducted a case control study in the primary health care center of Ziauddin University from 1st December 2021 to 30th June 2022. Cases included 83 individuals 65yrs with HbA1c =7 and above and controls included 91 individuals 65yrs and above with HbA1c <7. Both groups were assessed for cognitive decline using MMSE score and CFS score determined their dependency status. \u0000Results: Moderately uncontrolled Diabetes had highest association with severe cognitive decline(50%) p-value 0.000 and those who could not manage to do IADLS were severely dementic in our study( p-value 0.046). We also found DM to be associated with high frailty scores. Severely uncontrolled DM was associated with CFS of 5 meaning those who were dependent on others for instrumental activities of daily living. Those who managed well independently was associated with Pre DM in our study.( p-value 0.041) \u0000Conclusion: Severe cognitive decline has high association with uncontrolled glycemic control. \u0000Keywords: IADLS (instrumental activities of daily living), CFS (chronic frailty scale), MCI (Mild Cognitive Impairment)","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":"44336176","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.v27i2.1963
A. Khan, Aleeza Sana, Zarah Sufian, Ammarah Afreen, Asma Shakoor, Eruj Shuja
Objective: This study aims to identify the prevalence of parafunctional habits and common symptoms of temporomandibular disorders in young individuals reporting to the Watim Dental College Materials and methods: This cross-sectional study was carried out by a survey and clinical examination over a period of six months from September 2021 to February 2022. Data from 103 patients, who fulfilled the inclusion criteria, were collected using a structured questionnaire and clinical examination regarding their parafunctional habits and temporomandibular joint symptoms. Informed consent was filled out by all the participants. Data were analyzed using SPSS version 23. A descriptive analysis was calculated for both quantitative and qualitative variables. Results: The prevalence of oral parafunctional habits among the study sample was quantified on a binary scale (yes/no) where nail-biting was observed to be highly prevalent (38%), followed by mouth breathing (27%). The most frequently reported temporomandibular joint symptom was noise (clicking or crepitation) which was 66%. Difficulty in mouth opening was the least common (20%) of all the symptoms noted. Conclusion: It may be concluded from our study that amongst parafunctional habits nail biting is the most common habit amongst young individuals and amongst the temporomandibular joint disorder clicking and crepitation is the most common symptom persistent with the condition. Keywords: clicking, nail-biting, parafunctional habits, temporomandibular joint symptoms
目的:本研究旨在确定在Watim牙科学院报告的年轻人中颞下颌疾病的副功能习惯和常见症状的患病率。材料和方法:本横断面研究通过从2021年9月到2022年2月为期6个月的调查和临床检查进行。103例符合纳入标准的患者，通过结构化问卷和临床检查收集数据，了解他们的功能习惯和颞下颌关节症状。所有参与者都填写了知情同意书。数据分析采用SPSS version 23。对定量变量和定性变量进行描述性分析。结果:研究样本中口腔副功能习惯的患病率以二元量表(是/否)进行量化，其中咬指甲的患病率很高(38%)，其次是口呼吸(27%)。最常见的颞下颌关节症状是噪音(咔嗒声或咯吱声)，占66%。开口困难是所有症状中最不常见的(20%)。结论:从我们的研究中可以得出结论，在青少年的副功能习惯中，咬指甲是最常见的习惯，而在颞下颌关节紊乱中，咔嗒声和吱吱声是最常见的症状。关键词:咔哒声，咬指甲，功能习惯，颞下颌关节症状
{"title":"Prevalence Of Parafunctional Habits And Temporomandibular Disorder Symptoms In Young Individuals Reporting To Watim Dental Hospital","authors":"A. Khan, Aleeza Sana, Zarah Sufian, Ammarah Afreen, Asma Shakoor, Eruj Shuja","doi":"10.37939/jrmc.v27i2.1963","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1963","url":null,"abstract":"Objective: This study aims to identify the prevalence of parafunctional habits and common symptoms of temporomandibular disorders in young individuals reporting to the Watim Dental College\u0000Materials and methods: This cross-sectional study was carried out by a survey and clinical examination over a period of six months from September 2021 to February 2022. Data from 103 patients, who fulfilled the inclusion criteria, were collected using a structured questionnaire and clinical examination regarding their parafunctional habits and temporomandibular joint symptoms. Informed consent was filled out by all the participants. Data were analyzed using SPSS version 23. A descriptive analysis was calculated for both quantitative and qualitative variables.\u0000Results: The prevalence of oral parafunctional habits among the study sample was quantified on a binary scale (yes/no) where nail-biting was observed to be highly prevalent (38%), followed by mouth breathing (27%). The most frequently reported temporomandibular joint symptom was noise (clicking or crepitation) which was 66%. Difficulty in mouth opening was the least common (20%) of all the symptoms noted.\u0000Conclusion: It may be concluded from our study that amongst parafunctional habits nail biting is the most common habit amongst young individuals and amongst the temporomandibular joint disorder clicking and crepitation is the most common symptom persistent with the condition.\u0000Keywords: clicking, nail-biting, parafunctional habits, temporomandibular joint symptoms","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":"44494988","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.v27i2.1902
Saman Habib, Aqsa Ikram ul Haq, Shamama Bashir, N. Sadiq, N. Majeed, Nabeela Waheed
Objective: To determine the frequency of PIH amongst elevated beta-hCG levels and non-elevated beta-hCG in the mid-trimester of pregnancy. Materials and Methods: It was Descriptive case series conducted for six months (02-12-2019 to 02-06-2020) in OPD of Gynae Unit-II, Holy Family Hospital, Rawalpindi. A total of one hundred and twenty-two (n=122) normotensive pregnant females at 13-20 weeks gestational age and 18-35 years of maternal age were selected in this study after informed consent from every patient. The frequency of PIH in patients with elevated serum beta-hCG was measured. Data were analyzed using SPSS version 20. Effect modifiers were controlled by stratification. A p-value of ≤ 0.05 was considered significant. Results: Mean beta-hCG levels in the total study population were found to be 7305.09±3900.64 IU/mL. Median b-hCG levels in our study population were noted as 6936.15 IU/mL. Pregnancy-induced hypertension was found positive in 16 (13.1%) patients. Raised beta-hCG levels were present in 10 (8.2%) patients. The frequency of PIH in raised beta-HCG levels was found in 7/10 (70%) of patients. We found a statistically significant (p-value ≤ 0.05) difference in the frequency of PIH among patients with elevated and not-elevated beta-hCG levels. Conclusion: It is evident from my study that patients with raised levels of serum β-hCG during mid-trimester pregnancy are at increased risk to develop hypertensive disorders of pregnancy. We further elaborated that there is a statistically significant difference in various effect modifiers such as maternal age, gestational age, residential status, and BMI for developing PIH among patients with elevated and non-elevated beta-hCG levels.
{"title":"Frequency of pregnancy induced hypertension and its association with elevated serum beta human chorionic gonadotropin levels during mid trimester of pregnancy","authors":"Saman Habib, Aqsa Ikram ul Haq, Shamama Bashir, N. Sadiq, N. Majeed, Nabeela Waheed","doi":"10.37939/jrmc.v27i2.1902","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.1902","url":null,"abstract":"Objective: To determine the frequency of PIH amongst elevated beta-hCG levels and non-elevated beta-hCG in the mid-trimester of pregnancy.\u0000Materials and Methods: It was Descriptive case series conducted for six months (02-12-2019 to 02-06-2020) in OPD of Gynae Unit-II, Holy Family Hospital, Rawalpindi. A total of one hundred and twenty-two (n=122) normotensive pregnant females at 13-20 weeks gestational age and 18-35 years of maternal age were selected in this study after informed consent from every patient. The frequency of PIH in patients with elevated serum beta-hCG was measured. Data were analyzed using SPSS version 20. Effect modifiers were controlled by stratification. A p-value of ≤ 0.05 was considered significant.\u0000Results: Mean beta-hCG levels in the total study population were found to be 7305.09±3900.64 IU/mL. Median b-hCG levels in our study population were noted as 6936.15 IU/mL. Pregnancy-induced hypertension was found positive in 16 (13.1%) patients. Raised beta-hCG levels were present in 10 (8.2%) patients. The frequency of PIH in raised beta-HCG levels was found in 7/10 (70%) of patients. We found a statistically significant (p-value ≤ 0.05) difference in the frequency of PIH among patients with elevated and not-elevated beta-hCG levels.\u0000Conclusion: It is evident from my study that patients with raised levels of serum β-hCG during mid-trimester pregnancy are at increased risk to develop hypertensive disorders of pregnancy. We further elaborated that there is a statistically significant difference in various effect modifiers such as maternal age, gestational age, residential status, and BMI for developing PIH among patients with elevated and non-elevated beta-hCG levels.","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":"47707020","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.v27i2.2015
H. Rani, Gulwish Salahuddin, Ayesha Naz, N. Majeed, F. Safdar, S. Rafique
Objectives: To find out common causes of reduced fetal movements. The purpose is to reduce perinatal morbidity and mortality. Methodology: This Prospective, Observational study was conducted at Izzat Ali Shah Maternal and child health center, unit III Gynae, Wah medical college Wah Cantt, from January 2019 to December 2019. A total of participants 160, who presented in the antenatal outpatient or emergency department with reduced fetal movements, were included in the study. Patients in the active phase of labor were excluded from the study. Patients were followed up till delivery. All necessary information, investigations, and examination points were noted on the predesigned proforma. Data were analyzed by using SPSS version 22. Results: Out of a total of 160 patients, 144 had alive and stable babies. Regarding the age group, out of 160, six patients were teenagers (3.75%), 98 (61.25%) were between 20-30 years, and 55(34.3%) were in the age group of 30-40 years. Regarding gestational age at presentation, 27 out of 160(16.8%) were between 30-35 weeks, 133(83.12%) was at 36-40 weeks. None of the patients presented below 30 weeks. Concerning the number of pregnancy, primigravida 82(51.25%), 60(37.5%) were multigravida, and 18 (11.25%) was grand multipara. Regarding medical history, anemia was seen in 31 patients (19.37%), pregnancy-induced hypertension in 20(12.5%), and 65 %( 104) has no significant medical history. Concerning past obstetrical history, 107(66.8%) fell under low-risk pregnancies, 18(11.25%) had previously normal deliveries but 08(05%) patients had H/O still births. Regarding placental position, 71(44.37%) had anterior, 71(44.37%) had posterior, and 18 (11.25) had fundal placenta. Regarding UAD, 136(85%) had normal umbilical artery Doppler, 13(8.12%) had altered, 06(3.75%) were Absent and 05 (3.12%) has reversed end diastolic flow. During study, 78(48.7%) had normal AFI, 69(43.12%) has Oligohydramnios, 10(6.25%) anhydramnios, while only 03(1.87%) had polyhydramnios. Regarding birth weight, 122(76.25%) had average weight, 32(20%) were low birth weight and 05(3.12%) were very low birth weight. 61(38.12%) went into NICU, while 99(61.8%) no admission required. Conclusion: Most common risk factor or cause of reduced fetal movements was reduced liquor, (79). Out of which 69 remained alive and stable after birth, while 15 had early neonatal deaths. The second cause found was abnormal umbilical artery Doppler,(24). Out of which, 14 had early neonatal deaths and intrauterine deaths. This study showed the increased obligation of care required by patients with decreased fetal movement. Although the number of live births is more as compared to demise, it results in increased neonatal unit admission rates, higher induction and cesarean section rates, higher surveillance demands, and an increased financial burden on parents. It signifies the need for more vigilance in this area of practice. But we can’t neglect the perception of a mother. Mothe
目的:探讨胎动减少的常见原因。目的是降低围产期发病率和死亡率。方法:本前瞻性观察性研究于2019年1月至2019年12月在华康医学院第三妇科Izzat Ali Shah妇幼保健中心进行。共有160名在产前门诊或急诊科出现胎动减少的参与者被纳入研究。处于产程活跃期的患者被排除在研究之外。患者随访至分娩。所有必要的信息、调查和检查点都记录在预先设计的表格上。数据采用SPSS 22进行分析。结果:160例患者中，144例患儿存活且病情稳定。从年龄组来看，160例患者中，青少年6例(3.75%)，20 ~ 30岁98例(61.25%)，30 ~ 40岁55例(34.3%)。关于分娩时的胎龄，160例中有27例(16.8%)在30-35周之间，133例(83.12%)在36-40周之间。没有患者出现在30周以下。初产妇82例(51.25%)，多次妊娠60例(37.5%)，大多次妊娠18例(11.25%)。病史方面，贫血31例(19.37%)，妊高征20例(12.5%)，无明显病史的65例(104例)。既往产科史中，低危妊娠107例(66.8%)，正常分娩18例(11.25%)，死产08例(05%)。胎盘位置前位71例(44.37%)，后位71例(44.37%)，后位18例(11.25)。UAD 136例(85%)脐动脉多普勒正常，改变13例(8.12%)，缺失06例(3.75%)，舒张末期血流逆转05例(3.12%)。研究期间，AFI正常78例(48.7%)，羊水过少69例(43.12%)，羊水无10例(6.25%)，羊水过多仅03例(1.87%)。出生体重方面，平均出生体重122例(76.25%)，低出生体重32例(20%)，极低出生体重05例(3.12%)。61例(38.12%)进入新生儿重症监护病房，99例(61.8%)无需住院。结论:减少胎动最常见的危险因素或原因是减少酒精，(79)。其中69人在出生后仍然存活并保持稳定，而15人有新生儿早期死亡。第二个原因是脐动脉多普勒异常(24)。其中，14例新生儿早期死亡和宫内死亡。这项研究表明，胎儿运动减少的患者需要更多的护理义务。虽然活产数比死亡数多，但它导致新生儿住院率增加，引产和剖宫产率增加，监测需求增加，父母的经济负担增加。这表明需要在这一实践领域提高警惕。但我们不能忽视母亲的观念。母亲的感受比任何测试都重要。
{"title":"One-Year Review Of Reduced Fetal Movements In Izzat Ali Shah MCH Center: A Predictor Of Poor Perinatal Outcome","authors":"H. Rani, Gulwish Salahuddin, Ayesha Naz, N. Majeed, F. Safdar, S. Rafique","doi":"10.37939/jrmc.v27i2.2015","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2015","url":null,"abstract":"Objectives: To find out common causes of reduced fetal movements. The purpose is to reduce perinatal morbidity and mortality. \u0000Methodology: This Prospective, Observational study was conducted at Izzat Ali Shah Maternal and child health center, unit III Gynae, Wah medical college Wah Cantt, from January 2019 to December 2019. A total of participants 160, who presented in the antenatal outpatient or emergency department with reduced fetal movements, were included in the study. Patients in the active phase of labor were excluded from the study. Patients were followed up till delivery. All necessary information, investigations, and examination points were noted on the predesigned proforma. Data were analyzed by using SPSS version 22. \u0000Results: Out of a total of 160 patients, 144 had alive and stable babies. Regarding the age group, out of 160, six patients were teenagers (3.75%), 98 (61.25%) were between 20-30 years, and 55(34.3%) were in the age group of 30-40 years. Regarding gestational age at presentation, 27 out of 160(16.8%) were between 30-35 weeks, 133(83.12%) was at 36-40 weeks. None of the patients presented below 30 weeks. Concerning the number of pregnancy, primigravida 82(51.25%), 60(37.5%) were multigravida, and 18 (11.25%) was grand multipara. Regarding medical history, anemia was seen in 31 patients (19.37%), pregnancy-induced hypertension in 20(12.5%), and 65 %( 104) has no significant medical history. Concerning past obstetrical history, 107(66.8%) fell under low-risk pregnancies, 18(11.25%) had previously normal deliveries but 08(05%) patients had H/O still births. Regarding placental position, 71(44.37%) had anterior, 71(44.37%) had posterior, and 18 (11.25) had fundal placenta. Regarding UAD, 136(85%) had normal umbilical artery Doppler, 13(8.12%) had altered, 06(3.75%) were Absent and 05 (3.12%) has reversed end diastolic flow. During study, 78(48.7%) had normal AFI, 69(43.12%) has Oligohydramnios, 10(6.25%) anhydramnios, while only 03(1.87%) had polyhydramnios. Regarding birth weight, 122(76.25%) had average weight, 32(20%) were low birth weight and 05(3.12%) were very low birth weight. 61(38.12%) went into NICU, while 99(61.8%) no admission required. \u0000Conclusion: Most common risk factor or cause of reduced fetal movements was reduced liquor, (79). Out of which 69 remained alive and stable after birth, while 15 had early neonatal deaths. The second cause found was abnormal umbilical artery Doppler,(24). Out of which, 14 had early neonatal deaths and intrauterine deaths. This study showed the increased obligation of care required by patients with decreased fetal movement. Although the number of live births is more as compared to demise, it results in increased neonatal unit admission rates, higher induction and cesarean section rates, higher surveillance demands, and an increased financial burden on parents. It signifies the need for more vigilance in this area of practice. But we can’t neglect the perception of a mother. Mothe","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":"46991349","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.v27i2.2006
Farkhanda Jabeen, Madiha Farhan, M. Amjad, A. Begum, Nadia Gul, Salma Umbreen
Objective: To determine the diagnostic accuracy of the placental thickness measured by ultrasound in detecting IUGR babies keeping actual birth weight as the gold standard. Methods: This cross-sectional validation study was conducted in the Department of Radiology P.O.F Hospital Wah Cantt. The data was gathered over a period of six months, from 06-19-2017 to 12-18-2017. A total of 125 patients were included in this study. All pregnant women were examined by the greyscale and Doppler ultrasonography using a color Doppler scanner with a 5.0 MHz convex probe. Placental thickness was measured as the distance between the echogenic line of the chorionic plate and the hypoechoic myometrium. The pregnant females were followed till childbirth and the weight of the baby at birth was recorded. Results: Patients ranged between 20-35 years of age. The average age of the study participants was 27.6±3.3 years, the mean gestational age was 34.2±3.0 weeks, the mean BMI was 23.5±1.3 (kg/m2), and the mean parity was 1.1±1.0. We found a sensitivity of 65.5%, specificity of 83.3%, Positive Predictive Value( PPV) of 98.7%, Negative Predictive Value (NPV) of 10.8%, and diagnostic accuracy of 66.4% for antenatal prediction of IUGR based on placental thickness measurement. Stratification for age and gestational age was also carried out. Conclusion: Placental thickness on ultrasonography can be used as a reliable marker for detecting IUGR babies with an accuracy of 6.4%.
{"title":"Diagnostic Accuracy Of Placental Thickness Measured By Ultrasonography In The Detection Of Intrauterine Growth Restricted (IUGR) Babies Keeping Actual Birth Weight As Gold Standard","authors":"Farkhanda Jabeen, Madiha Farhan, M. Amjad, A. Begum, Nadia Gul, Salma Umbreen","doi":"10.37939/jrmc.v27i2.2006","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2006","url":null,"abstract":"Objective: To determine the diagnostic accuracy of the placental thickness measured by ultrasound in detecting IUGR babies keeping actual birth weight as the gold standard. \u0000Methods: This cross-sectional validation study was conducted in the Department of Radiology P.O.F Hospital Wah Cantt. The data was gathered over a period of six months, from 06-19-2017 to 12-18-2017. A total of 125 patients were included in this study. All pregnant women were examined by the greyscale and Doppler ultrasonography using a color Doppler scanner with a 5.0 MHz convex probe. Placental thickness was measured as the distance between the echogenic line of the chorionic plate and the hypoechoic myometrium. The pregnant females were followed till childbirth and the weight of the baby at birth was recorded. \u0000Results: Patients ranged between 20-35 years of age. The average age of the study participants was 27.6±3.3 years, the mean gestational age was 34.2±3.0 weeks, the mean BMI was 23.5±1.3 (kg/m2), and the mean parity was 1.1±1.0. We found a sensitivity of 65.5%, specificity of 83.3%, Positive Predictive Value( PPV) of 98.7%, Negative Predictive Value (NPV) of 10.8%, and diagnostic accuracy of 66.4% for antenatal prediction of IUGR based on placental thickness measurement. Stratification for age and gestational age was also carried out. \u0000Conclusion: Placental thickness on ultrasonography can be used as a reliable marker for detecting IUGR babies with an accuracy of 6.4%.","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":"48230494","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: To determine the success rate of myringoplasty based on the site and size of tympanic membrane perforation. Study Design: Cross sectional, Descriptive Study Settings: ENT Department Fauji Foundation Hospital, Rawalpindi Study Duration: 30 July 2019 to 29 December 2021. Material and Methods: After approval of Hospital Ethical Committee, a sample size of 100 patients was calculated by using WHO sample size calculator. Patients were selected through Non probability convenient sampling. Informed consent was obtained from all the patients. All the patients were operated upon through post auricular approach using underlay technique and temporalis fascia was used as a graft in all the cases. Success of myringoplasty was assessed one month after surgery. Myringoplasty was considered successful upon complete closure of the defect as assessed under surgical microscope. Data analysis was done for frequencies and percentages using SPSS version 24. Results: There were 52% males and 48% females. Mean age of patients was 35.5 years and they ranged between 17 to 48 years. Overall myringoplasty was successful in 71% patients. Regarding the size of perforation, it was successful in 100% pinhead size perforations, in 86.7% small sized, 89.5% medium sized, 42% large and 6.7% subtotal sized perforations. Regarding site of the perforations, myringoplasty was successful in 96% anterior, 100% posterior, 40% inferior, 40% middle and 8% subtotal/ large perforations. Conclusion: Myringoplasty is an effective surgery for sealing Tympanic Membrane perforations resulting in better quality of life. Success rate of myringoplasty has a definite association with size and site of perforation. The smaller the perforation, the higher would be the success rate. Similarly, anterior and posterior perforations heal better as compared to inferior and mid position perforations. Key words: Myringoplasty, Size and site of Tympanic membrane perforation, Tympanic membrane, Chronic Suppurative Otitis Media.
{"title":"Successful Myringoplasty - Do The Site & Size Of TM Perforation Matter?","authors":"Areesha Manzoor, Mirza Khizar Hameed, Irshad Ali, Nudrat Khalil, Ansa Umara, Seema Naveed","doi":"10.37939/jrmc.v27i2.2149","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2149","url":null,"abstract":"Objective: To determine the success rate of myringoplasty based on the site and size of tympanic membrane perforation. \u0000Study Design: Cross sectional, Descriptive \u0000Study Settings: ENT Department Fauji Foundation Hospital, Rawalpindi \u0000Study Duration: 30 July 2019 to 29 December 2021. \u0000Material and Methods: After approval of Hospital Ethical Committee, a sample size of 100 patients was calculated by using WHO sample size calculator. Patients were selected through Non probability convenient sampling. Informed consent was obtained from all the patients. All the patients were operated upon through post auricular approach using underlay technique and temporalis fascia was used as a graft in all the cases. Success of myringoplasty was assessed one month after surgery. Myringoplasty was considered successful upon complete closure of the defect as assessed under surgical microscope. Data analysis was done for frequencies and percentages using SPSS version 24. \u0000Results: There were 52% males and 48% females. Mean age of patients was 35.5 years and they ranged between 17 to 48 years. Overall myringoplasty was successful in 71% patients. Regarding the size of perforation, it was successful in 100% pinhead size perforations, in 86.7% small sized, 89.5% medium sized, 42% large and 6.7% subtotal sized perforations. Regarding site of the perforations, myringoplasty was successful in 96% anterior, 100% posterior, 40% inferior, 40% middle and 8% subtotal/ large perforations. \u0000Conclusion: Myringoplasty is an effective surgery for sealing Tympanic Membrane perforations resulting in better quality of life. Success rate of myringoplasty has a definite association with size and site of perforation. The smaller the perforation, the higher would be the success rate. Similarly, anterior and posterior perforations heal better as compared to inferior and mid position perforations. \u0000Key words: Myringoplasty, Size and site of Tympanic membrane perforation, Tympanic membrane, Chronic Suppurative Otitis Media.","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":"42764573","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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