Objective: To study the frequency of hypocalcemia in neonates receiving phototherapy with indirect hyperbilirubinemia Materials and Methods: Descriptive case series study was conducted from September 5, 2018, to March 5, 2019, in the NICU of the Paediatric Department Benazir Bhutto Hospital, Rawalpindi. Approval was sought from the hospital’s ethical committee. Neonates fulfilling inclusion criteria were enrolled in the study after obtaining informed consent from the parents. Before giving phototherapy, serum calcium levels were checked. Phototherapy was given for 48 hours. Serum calcium levels were reassessed after 48 hours of phototherapy. Data was entered on a structured proforma and statistical analysis of data was performed. Results: Out of 150 patients enrolled in the study 83(55.33%) were male and 67(44.67%) were female. The mean age of patients was 52.52 hours with minimum and maximum ages of 26 hours and 80 hours. The mean Indirect serum bilirubin level was 15.59 ± 2.36. A total of 50(33.33%) cases had hypocalcemia after 48 hours of phototherapy, all of these neonates had normal calcium levels before phototherapy. When hypocalcaemia was stratified for gestational age, birth weight and serum bilirubin levels at baseline, there was no significant difference in the frequency of hypocalcaemia concerning these effect modifiers. Conclusion: It is concluded that the frequency of hypocalcemia is higher in neonates with indirect hyperbilirubinemia after receiving phototherapy. One needs to be vigilant in dealing with neonates in this context, while serial measurements of calcium levels and monitoring for complications of hypocalcaemia should be included in every institution’s policy
{"title":"Effects Of Phototherapy On Serum Calcium Level In Neonates With Hyperbilirubinemia","authors":"Q. Javaid, Salma Aziz, Noor-ul-Ain, Uzma Abid, Ayesha Afzal, Umer Javaid","doi":"10.37939/jrmc.v27i2.2052","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2052","url":null,"abstract":"Objective: To study the frequency of hypocalcemia in neonates receiving phototherapy with indirect hyperbilirubinemia Materials and Methods: Descriptive case series study was conducted from September 5, 2018, to March 5, 2019, in the NICU of the Paediatric Department Benazir Bhutto Hospital, Rawalpindi. \u0000Approval was sought from the hospital’s ethical committee. Neonates fulfilling inclusion criteria were enrolled in the study after obtaining informed consent from the parents. Before giving phototherapy, serum calcium levels were checked. Phototherapy was given for 48 hours. Serum calcium levels were reassessed after 48 hours of phototherapy. Data was entered on a structured proforma and statistical analysis of data was performed. \u0000Results: Out of 150 patients enrolled in the study 83(55.33%) were male and 67(44.67%) were female. The mean age of patients was 52.52 hours with minimum and maximum ages of 26 hours and 80 hours. The mean Indirect serum bilirubin level was 15.59 ± 2.36. A total of 50(33.33%) cases had hypocalcemia after 48 hours of phototherapy, all of these neonates had normal calcium levels before phototherapy. When hypocalcaemia was stratified for gestational age, birth weight and serum bilirubin levels at baseline, there was no significant difference in the frequency of hypocalcaemia concerning these effect modifiers. \u0000Conclusion: It is concluded that the frequency of hypocalcemia is higher in neonates with indirect hyperbilirubinemia after receiving phototherapy. One needs to be vigilant in dealing with neonates in this context, while serial measurements of calcium levels and monitoring for complications of hypocalcaemia should be included in every institution’s policy","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":"43017110","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.v27i2.2249
F. A. Siddiqi, Bilal Saeed, Mehmood Hussain, Wasif Anwar, S. Riaz, Naveed Abbas
Abstract: Background: Drug adherence to medications in diabetes is very necessary for strict glycemic control. Many factors in diabetics are associated with low adherence to drugs resulting in complications. Methods: This research was conducted as an observational study with cross-sectional study design. It was scheduled between July 2022 to December 2022 in medical outpatient department of Combined Military Hospital, Peshawar Results: 115 individuals were inducted over a period of 6 months from medical OPD ex Combined Military Hospital Peshawar. Five patients failed to follow-up with research team resulting in a total of 110 participants included in results. Average age across the study sample was 50.25 ± 11.97 years with 58 (52.73%) males and 52 (47.27%) females. Most participant in our study sample were educated up to matriculation with BMI <25kg/m2. Average duration of diabetes across the sample was 6.1 ± 3.69 years. In treatment options, 53 (48.18%) individuals were only managed with oral therapy, 16 (14.55%) on insulin only while 41 (37.27%) were prescribed with both oral hypoglycemic drugs and insulin. Most common comorbid across study population was hypertension, seen in 59 (53.94%) diabetic patients, followed by cataract in 41 (37.47%) and IHD in 33 (30%) patients. In all 110 individuals, only 29 (26.36%) individuals had good glycemic control i.e., HbA1c <7% with average glycosylated hemoglobin percentage measuring 8.29% ± 1.59%. As per MMAS-8 score, 25 (22.73%) patients reported good adherence, 31 (28.18%) patients reported fair adherence while rest 54 (49.09%) were found to have bad adherence. Average MMAS-8 score was 5.17. Conclusion: There is a correlation between medication adherence as measured by MMAS-8 score with control of diabetes as measured by HbA1c score in the range of 1.824% across the range of MMAS-8 score from 0-8. Sleep quality, BMI and multiple comorbid conditions were also linked with raised HbA1c. Key words: Drug adherence, Morisky Medication Adherence Scale, Diabetes, Non-diabetes, diabetic medications
{"title":"Association Between Diabetic Control And Anti-Diabetic Medication Adherence Using 8-Point Morisky Medication Adherence Scale In Local Population Of Khyber Pakhtunkhwa","authors":"F. A. Siddiqi, Bilal Saeed, Mehmood Hussain, Wasif Anwar, S. Riaz, Naveed Abbas","doi":"10.37939/jrmc.v27i2.2249","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2249","url":null,"abstract":"Abstract: \u0000Background: Drug adherence to medications in diabetes is very necessary for strict glycemic control. Many factors in diabetics are associated with low adherence to drugs resulting in complications. \u0000Methods: This research was conducted as an observational study with cross-sectional study design. It was scheduled between July 2022 to December 2022 in medical outpatient department of Combined Military Hospital, Peshawar \u0000Results: 115 individuals were inducted over a period of 6 months from medical OPD ex Combined Military Hospital Peshawar. Five patients failed to follow-up with research team resulting in a total of 110 participants included in results. Average age across the study sample was 50.25 ± 11.97 years with 58 (52.73%) males and 52 (47.27%) females. Most participant in our study sample were educated up to matriculation with BMI <25kg/m2. \u0000Average duration of diabetes across the sample was 6.1 ± 3.69 years. In treatment options, 53 (48.18%) individuals were only managed with oral therapy, 16 (14.55%) on insulin only while 41 (37.27%) were prescribed with both oral hypoglycemic drugs and insulin. Most common comorbid across study population was hypertension, seen in 59 (53.94%) diabetic patients, followed by cataract in 41 (37.47%) and IHD in 33 (30%) patients. \u0000 In all 110 individuals, only 29 (26.36%) individuals had good glycemic control i.e., HbA1c <7% with average glycosylated hemoglobin percentage measuring 8.29% ± 1.59%. As per MMAS-8 score, 25 (22.73%) patients reported good adherence, 31 (28.18%) patients reported fair adherence while rest 54 (49.09%) were found to have bad adherence. Average MMAS-8 score was 5.17. \u0000Conclusion: There is a correlation between medication adherence as measured by MMAS-8 score with control of diabetes as measured by HbA1c score in the range of 1.824% across the range of MMAS-8 score from 0-8. Sleep quality, BMI and multiple comorbid conditions were also linked with raised HbA1c. \u0000Key words: Drug adherence, Morisky Medication Adherence Scale, Diabetes, Non-diabetes, diabetic medications","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":"44055458","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.v27i2.2210
Maliha Sadaf, K. Iqbal, Saira S. Ahmed, Mehak Sehar, Nabeela Waheed
Introduction: Daily oral iron and folic acid intake is recommended as part of antenatal care but adherence to this regimen, due to gastrointestinal side effects, interrupted intake of iron. Weekly oral iron therapy has been introduced as an alternative to the daily iron regimen. Objective: To compare mean hemoglobin and hematocrit in non-anemic pregnant females receiving daily oral iron versus weekly iron supplements in third trimester of pregnancy. Material and Methods This randomized Controlled Trial study was carried out in department of obstetrics and gynecology of holy family hospital, Rawalpindi during 20th November 2019 to 20th May 2020. 70 pregnant females of 15 to 45 years, with singleton pregnancies, at gestational amenorrhea 14 to 22 weeks at the time of inclusion with hemoglobin level 11g/dl and above were included. They were randomly divided into two equal groups using SPSS, Group A (35) received daily oral iron and Group B, 35 received weekly oral iron. Results: There was no statistically significant difference could be detected between both groups as regards the hemoglobin level before starting iron supplementation and duration of supplementation and this can be attributed to proper randomization. Mean post treatment hemoglobin was 13.2±0.93 g/dl in group A and 12.9±0.95 g/dl in group B (0.118), mean change of hemoglobin was 1.07±0.34 g/dl in group A and 0.63±0.56 g/dl in group B (0.000), mean post treatment hematocrit was 35.857±0.87 % in group A and 32.857±0.91 % in group B (p 0.000), mean change of hematocrit was 2.942±0.59 % in group A and 1.000±0.00 % in group B (p 0.000). Conclusion: Weekly iron supplementation as a prophylaxis in non-anemic pregnant women is as good as daily supplementation as regards the hemoglobin level.
{"title":"Comparison Of The Effectiveness Of Daily Versus Weekly Oral Iron Supplementation In Preventing Anemia During Pregnancy","authors":"Maliha Sadaf, K. Iqbal, Saira S. Ahmed, Mehak Sehar, Nabeela Waheed","doi":"10.37939/jrmc.v27i2.2210","DOIUrl":"https://doi.org/10.37939/jrmc.v27i2.2210","url":null,"abstract":" \u0000Introduction: \u0000Daily oral iron and folic acid intake is recommended as part of antenatal care but adherence to this regimen, due to gastrointestinal side effects, interrupted intake of iron. Weekly oral iron therapy has been introduced as an alternative to the daily iron regimen. \u0000Objective: \u0000To compare mean hemoglobin and hematocrit in non-anemic pregnant females receiving daily oral iron versus weekly iron supplements in third trimester of pregnancy. \u0000Material and Methods \u0000This randomized Controlled Trial study was carried out in department of obstetrics and gynecology of holy family hospital, Rawalpindi during 20th November 2019 to 20th May 2020. 70 pregnant females of 15 to 45 years, with singleton pregnancies, at gestational amenorrhea 14 to 22 weeks at the time of inclusion with hemoglobin level 11g/dl and above were included. They were randomly divided into two equal groups using SPSS, Group A (35) received daily oral iron and Group B, 35 received weekly oral iron. \u0000Results: \u0000There was no statistically significant difference could be detected between both groups as regards the hemoglobin level before starting iron supplementation and duration of supplementation and this can be attributed to proper randomization. Mean post treatment hemoglobin was 13.2±0.93 g/dl in group A and 12.9±0.95 g/dl in group B (0.118), mean change of hemoglobin was 1.07±0.34 g/dl in group A and 0.63±0.56 g/dl in group B (0.000), mean post treatment hematocrit was 35.857±0.87 % in group A and 32.857±0.91 % in group B (p 0.000), mean change of hematocrit was 2.942±0.59 % in group A and 1.000±0.00 % in group B (p 0.000). \u0000 \u0000 \u0000Conclusion: \u0000Weekly iron supplementation as a prophylaxis in non-anemic pregnant women is as good as daily supplementation as regards the hemoglobin level. \u0000 \u0000 \u0000 ","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":"49585292","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1920
Maimoona Khan, M. S. Abdullah, Fareeha Mushtaq, Faiza Umbreen, M. R. Kiani, A. Shahid
Objective: To investigate the effect of caffeine and Vitamin D3 on the body weight of pregnant BALB/c mice. Design of Study: An RCT (Randomized control trial) in the Lab. Place and Duration of Study: The study was carried out at Anatomy Department, Army Medical College (AMC), Rawalpindi, in collaboration with National Institute of Health (NIH), Islamabad, from Oct 2018 to Oct 2019. Material and Methods: Six-week old pregnant BALB/c mice, thirty (30) in number, weighing 26-28g, were taken and divided into three groups with 10 pregnant mice in each group. The control group G1 was given standard diet with water ad libitum for 21 days. The animals in experimental group G2, in addition to the standard diet, were given 10mg of caffeine per 100g body-weight once a day on alternate days by oral gavage for 21 days. Similarly, mice in group G3, in addition to the diet of group G2, were given 0.1µg of vitamin D3 per day by oral gavage for 21 days. The body-weights on 1st day, 7th day, 14th day and 21st day of gestation in all the groups were measured to determine the influence of caffeine and vitamin D3. Results: Mean body-weights of mice in control group G1 were noted as 26.8 ± 0.789g, 30.7 ± 0.949g, 36 ± 0.667g and 42 ± 1.054g on 1st, 7th, 14th and 21st day of gestation, respectively. The mean body-weights of experimental group G2 were recorded to be 26.7 ± 0.675g, 29.9 ± 0.738g, 34.3 ± 0.823g and 39.5 ± 0.972g on 1st, 7th, 14th and 21th day of gestation, respectively. The mean body-weights of experimental group G3 were determined as 26.8 ± 0.632g, 30.4 ± 0.699g, 34.6 ± 0.516g and 40.5 ± 0.850g on 1st, 7th, 14th and 21st day of gestation, respectively. In comparison to the control group G1, the body-weights of animals in experimental group G2 showed more decrease in accrual of body-weight than noted in experimental group G3. Conclusion: Caffeine intake has decreasing influence on the growth of body-weight in pregnant mice while intake of vitamin D3 somewhat nullifies the harmful effect of caffeine on body-weight.
{"title":"Impact of caffeine and vitamin D3 on the body-weight of pregnant BALB/c mice","authors":"Maimoona Khan, M. S. Abdullah, Fareeha Mushtaq, Faiza Umbreen, M. R. Kiani, A. Shahid","doi":"10.37939/jrmc.v27i1.1920","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1920","url":null,"abstract":"Objective: To investigate the effect of caffeine and Vitamin D3 on the body weight of pregnant BALB/c mice. \u0000Design of Study: An RCT (Randomized control trial) in the Lab. \u0000Place and Duration of Study: The study was carried out at Anatomy Department, Army Medical College (AMC), Rawalpindi, in collaboration with National Institute of Health (NIH), Islamabad, from Oct 2018 to Oct 2019. \u0000Material and Methods: Six-week old pregnant BALB/c mice, thirty (30) in number, weighing 26-28g, were taken and divided into three groups with 10 pregnant mice in each group. The control group G1 was given standard diet with water ad libitum for 21 days. The animals in experimental group G2, in addition to the standard diet, were given 10mg of caffeine per 100g body-weight once a day on alternate days by oral gavage for 21 days. Similarly, mice in group G3, in addition to the diet of group G2, were given 0.1µg of vitamin D3 per day by oral gavage for 21 days. The body-weights on 1st day, 7th day, 14th day and 21st day of gestation in all the groups were measured to determine the influence of caffeine and vitamin D3. \u0000Results: Mean body-weights of mice in control group G1 were noted as 26.8 ± 0.789g, 30.7 ± 0.949g, 36 ± 0.667g and 42 ± 1.054g on 1st, 7th, 14th and 21st day of gestation, respectively. The mean body-weights of experimental group G2 were recorded to be 26.7 ± 0.675g, 29.9 ± 0.738g, 34.3 ± 0.823g and 39.5 ± 0.972g on 1st, 7th, 14th and 21th day of gestation, respectively. The mean body-weights of experimental group G3 were determined as 26.8 ± 0.632g, 30.4 ± 0.699g, 34.6 ± 0.516g and 40.5 ± 0.850g on 1st, 7th, 14th and 21st day of gestation, respectively. In comparison to the control group G1, the body-weights of animals in experimental group G2 showed more decrease in accrual of body-weight than noted in experimental group G3. \u0000Conclusion: Caffeine intake has decreasing influence on the growth of body-weight in pregnant mice while intake of vitamin D3 somewhat nullifies the harmful effect of caffeine on body-weight. ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45204313","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1936
Tabinda Khalid, S. Nawaz, Malik Irfan Ahmed, Saima Malik, Ruqyyah Salim, Shahla Manzoor
Objective: to investigate postnatal depression after emergency peripartum hysterectomy versus controls. Material and methods: This case control study was conducted at District headquarters teaching hospital Rawalpindi between July 2020 and June 2021.We compared postnatal depression among patients who underwent emergency peripartum hysterectomy (EPH)versus control group where surgical procedures other than hysterectomy (B-Lynch, uterine artery ligation or internal iliac artery ligation) were performed. Results: A total of 88 patients were included, 44 in hysterectomy group and 44 in non hystrectomized/control group. The scores on Edinburgh post-natal depression scale were high in hysterectomy group (11.61±2.48) , compared to non hysterectomy group(6.79±2.13) which was statistically significant. ( p=0.001).Uterine atony, Placental abruption, placenta previa and accrete, were identified as main reasons for surgical intervention in both groups. Emergency peripartum hysterectomy is a traumatic birth event with serious physical, emotional and psychological consequences. It is empirical to not only screen the women in immediate postpartum period, but a long term follow up in community is required.
{"title":"Emergency Peripartum Hystrectomy and Postnatal Depression","authors":"Tabinda Khalid, S. Nawaz, Malik Irfan Ahmed, Saima Malik, Ruqyyah Salim, Shahla Manzoor","doi":"10.37939/jrmc.v27i1.1936","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1936","url":null,"abstract":"Objective: to investigate postnatal depression after emergency peripartum hysterectomy versus controls. \u0000Material and methods: This case control study was conducted at District headquarters teaching hospital Rawalpindi between July 2020 and June 2021.We compared postnatal depression among patients who underwent emergency peripartum hysterectomy (EPH)versus control group where surgical procedures other than hysterectomy (B-Lynch, uterine artery ligation or internal iliac artery ligation) were performed. \u0000Results: A total of 88 patients were included, 44 in hysterectomy group and 44 in non hystrectomized/control group. The scores on Edinburgh post-natal depression scale were high in hysterectomy group (11.61±2.48) , compared to non hysterectomy group(6.79±2.13) which was statistically significant. ( p=0.001).Uterine atony, Placental abruption, placenta previa and accrete, were identified as main reasons for surgical intervention in both groups. Emergency peripartum hysterectomy is a traumatic birth event with serious physical, emotional and psychological consequences. It is empirical to not only screen the women in immediate postpartum period, but a long term follow up in community is required. \u0000 ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43077619","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1670
Erum Afzal, Tanveer Ahmad, M. Iqbal, K. Aftab, Rubeena Muein
Introduction: Cerebral palsy (CP) is the non-progressive disorder of motor and posture with associated delayed development in areas of cognition, perception, behavior and sensation, due to insult to immature brain. Improvement in all developmental domains of CP patients depends upon early institution of rehabilitation programs involving all multidisciplinary approach. The portage early education program (PEEP) is a worldwide, effective and early interventional method, for developmentally delayed children. Objective: To determine the outcome of developmental therapy in children with CP by using PEEP. Study Design: Experimental research design (within group) Settings: The children hospital and the institute of child health Multan. Methodology: 156 patients of 2 to 10 years of age, both gender from January 2020 to December 2020, diagnosed as CP were enrolled for this study. All children were assessed by using PEEP and GMFM (Gross Motor Function Measure) twice 6 months apart. A trained clinical psychologist administered PEEP to all the children. All the Patients were advised regular weekly sessions at hospital by multidisciplinary team and at least 2 hours per day for continuation of these therapies at home. At the end of 6 months we found that all families had not followed this. The patient who visited >2times/month were considered compliant and those visited <2times/month were considered non-compliant. Data was analyzed by using SSPS version 16. Paired t test was used to compare the developmental outcome of compliant and non-compliant groups. Results: Out of 156 participants, 58(37%) were in compliant and 98(63%) non-compliant. Male subjects were prominent 42(72.41%) and 67(68.37%) respectively. Most of the participants belonged to 3-6 years of age in both groups28(48.29%) and 51(52.04%) respectively. Spastic quadriplegia (26(44.83%), 57 (58.16%)), and level 5 on GMFM 24(42.86) and 52(53.06%) respectively was commonly presents in both patient groups. The mean comparison of DQ of Compliant CP Children at initial stage and after six months in areas of GM, C, SH, S, L and GMFM was found statistically significant. Conclusion: CP children should be on regular follow up for developmental therapy for long time for better outcome. PEEP is an excellent system for the assessment, training and rehabilitation of children with delayed development.
简介:脑瘫(CP)是一种非进行性运动和姿势障碍，与认知、感知、行为和感觉领域的发育迟缓有关，是由于未成熟的大脑受到侮辱。所有发展领域的改善依赖于早期康复计划的建立，包括所有多学科的方法。儿童早期教育(PEEP)是一种全球性的、有效的、针对发育迟缓儿童的早期干预方法。目的:探讨应用PEEP治疗小儿脑瘫的疗效。研究设计:实验研究设计(组内)设置:木尔坦儿童医院和木尔坦儿童保健研究所。方法:选取2020年1月至2020年12月诊断为CP的2 - 10岁患者156例，男女均可。每6个月用PEEP和GMFM(粗大运动功能测量)评估2次。一位训练有素的临床心理学家对所有儿童实施PEEP。由多学科团队建议所有患者每周定期在医院接受治疗，每天至少2小时在家继续这些治疗。6个月后，我们发现所有家庭都没有这样做。就诊2次/月为依从性，<2次/月为不依从性。数据分析采用SSPS版本16。采用配对 t 检验比较依从性组和非依从性组的发育结局。结果:156名参与者中，58名(37%)依从性，98名(63%)不依从性。男性以42例(72.41%)和67例(68.37%)居多。两组参与者以3 ~ 6岁为主，分别为28岁(48.29%)和51岁(52.04%)。两组患者普遍存在痉挛性四肢瘫痪(26(44.83%)，57 (58.16%))，GMFM评分5级分别为24(42.86)和52(53.06%)。依从性CP患儿在初始阶段和6个月后的DQ在GM、C、SH、S、L和GMFM方面的平均值比较有统计学意义。结论:慢性阻塞性脑瘫患儿应长期定期随访，以获得较好的治疗效果。PEEP是一种对发育迟缓儿童进行评估、训练和康复的优秀系统。
{"title":"OUTCOME OF DEVELOPMENTAL THERAPY IN CHILDREN WITH CEREBRAL PALSY CHILDREN: A PROSPECTIVE COHORT","authors":"Erum Afzal, Tanveer Ahmad, M. Iqbal, K. Aftab, Rubeena Muein","doi":"10.37939/jrmc.v27i1.1670","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1670","url":null,"abstract":"Introduction: Cerebral palsy (CP) is the non-progressive disorder of motor and posture with associated delayed development in areas of cognition, perception, behavior and sensation, due to insult to immature brain. Improvement in all developmental domains of CP patients depends upon early institution of rehabilitation programs involving all multidisciplinary approach. The portage early education program (PEEP) is a worldwide, effective and early interventional method, for developmentally delayed children. \u0000Objective: To determine the outcome of developmental therapy in children with CP by using PEEP. \u0000Study Design: Experimental research design (within group) \u0000Settings: The children hospital and the institute of child health Multan. \u0000Methodology: 156 patients of 2 to 10 years of age, both gender from January 2020 to December 2020, diagnosed as CP were enrolled for this study. All children were assessed by using PEEP and GMFM (Gross Motor Function Measure) twice 6 months apart. A trained clinical psychologist administered PEEP to all the children. All the Patients were advised regular weekly sessions at hospital by multidisciplinary team and at least 2 hours per day for continuation of these therapies at home. At the end of 6 months we found that all families had not followed this. The patient who visited >2times/month were considered compliant and those visited <2times/month were considered non-compliant. Data was analyzed by using SSPS version 16. Paired t test was used to compare the developmental outcome of compliant and non-compliant groups. \u0000Results: Out of 156 participants, 58(37%) were in compliant and 98(63%) non-compliant. Male subjects were prominent 42(72.41%) and 67(68.37%) respectively. Most of the participants belonged to 3-6 years of age in both groups28(48.29%) and 51(52.04%) respectively. Spastic quadriplegia (26(44.83%), 57 (58.16%)), and level 5 on GMFM 24(42.86) and 52(53.06%) respectively was commonly presents in both patient groups. The mean comparison of DQ of Compliant CP Children at initial stage and after six months in areas of GM, C, SH, S, L and GMFM was found statistically significant. \u0000Conclusion: CP children should be on regular follow up for developmental therapy for long time for better outcome. PEEP is an excellent system for the assessment, training and rehabilitation of children with delayed development. ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44849371","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1825
Erum Afzal, Muhammad Aslam Sheikh, Sajjad Hussain Bhaba, T. Ahmed, I. Iqbal, M. Iqbal
INTRODUCTION: Thalassemia is the most common hemolytic autosomal recessive disorder. Pakistan has significant number of thalassemic children .The children with chronic disorders like thalassemia are prone to develop psychosocial illness including depression, anxiety, intellectual and behavioral issues. OBJECTIVE: To assess the psychosocial illness in children with thalassemia and to compare these problems in children with and without Thalassemia PLACE & DURATION: The Children’s Hospital and the institute of child health, Multan. From January to September 2021. STUDY DESIGN: Case-control MATERIAL AND METHOD: In this study 50 children with Thalassemia and 50 normal children were enrolled as case & control according to inclusion and exclusion criteria. After approval from institutional ethical committee, detailed history ,Socioeconomic status, educational status of parent and child, age of diagnosis of disease, and whether thalassemia is well controlled or not and complications were noted. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 22. Mean and standard deviation for quantitative data, while frequencies and percent for qualitative data was calculated. P-value was calculated by Chi square test. Prevalence ratio (ODDS ratio) with 95%confidence interval of all variables were calculated. RESULTS: Out of 100 patients 50 were in case group (Thalassemia) and 50 control (non-thalassemic.Male female ratio was 1.2:1. 60 %( n=30) cases, 78 %( n=39) control patients were age ranges between 5 to 10 years. Educational level of parents of 40%(n=20),and 56%(n=28) was below matric,42%(n=21) and 90%(n=45) patients were going to school in case and control group respectively.82%(n=41) patients belonged to low socioeconomical status in each group. Regarding characteristics of thalassemia 74 %( n=37) patients were diagnosed within 1st year of life, while 26 %( n=13) after 1st year.64 %( n=32) had well controlled and 36 %( n=18) poor controlled disease. 20%(n=10) had developed Diabetes mellitus,2%(n=1) heart failure,74%(37) growth failure,76%(n=38) hemolytic facial features and 72%(n=36)skin discoloration. Psychosocial problems were statistically significant in children with Thalassemia as compared to healthy ones (p-value<0.001).Poorly controlled thalassemia and complications of heart and growth failure were found statistically significant risk factors. CONCLUSION: Psychosocial problems are common in children with thalassemia as compared to healthy ones. So these patients must be referred for detailed psychological evaluation and management along with medical treatment.
{"title":"PSYCHOSOCIAL ILLNESS IN CHILDREN WITH THALASSEMIA: A CASE-CONTROL STUDY","authors":"Erum Afzal, Muhammad Aslam Sheikh, Sajjad Hussain Bhaba, T. Ahmed, I. Iqbal, M. Iqbal","doi":"10.37939/jrmc.v27i1.1825","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1825","url":null,"abstract":"INTRODUCTION: Thalassemia is the most common hemolytic autosomal recessive disorder. Pakistan has significant number of thalassemic children .The children with chronic disorders like thalassemia are prone to develop psychosocial illness including depression, anxiety, intellectual and behavioral issues. \u0000OBJECTIVE: To assess the psychosocial illness in children with thalassemia and to compare these problems in children with and without Thalassemia \u0000PLACE & DURATION: The Children’s Hospital and the institute of child health, Multan. From January to September 2021. \u0000STUDY DESIGN: Case-control \u0000MATERIAL AND METHOD: In this study 50 children with Thalassemia and 50 normal children were enrolled as case & control according to inclusion and exclusion criteria. After approval from institutional ethical committee, detailed history ,Socioeconomic status, educational status of parent and child, age of diagnosis of disease, and whether thalassemia is well controlled or not and complications were noted. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 22. Mean and standard deviation for quantitative data, while frequencies and percent for qualitative data was calculated. P-value was calculated by Chi square test. Prevalence ratio (ODDS ratio) with 95%confidence interval of all variables were calculated. \u0000RESULTS: Out of 100 patients 50 were in case group (Thalassemia) and 50 control (non-thalassemic.Male female ratio was 1.2:1. 60 %( n=30) cases, 78 %( n=39) control patients were age ranges between 5 to 10 years. Educational level of parents of 40%(n=20),and 56%(n=28) was below matric,42%(n=21) and 90%(n=45) patients were going to school in case and control group respectively.82%(n=41) patients belonged to low socioeconomical status in each group. Regarding characteristics of thalassemia 74 %( n=37) patients were diagnosed within 1st year of life, while 26 %( n=13) after 1st year.64 %( n=32) had well controlled and 36 %( n=18) poor controlled disease. 20%(n=10) had developed Diabetes mellitus,2%(n=1) heart failure,74%(37) growth failure,76%(n=38) hemolytic facial features and 72%(n=36)skin discoloration. Psychosocial problems were statistically significant in children with Thalassemia as compared to healthy ones (p-value<0.001).Poorly controlled thalassemia and complications of heart and growth failure were found statistically significant risk factors. \u0000CONCLUSION: Psychosocial problems are common in children with thalassemia as compared to healthy ones. So these patients must be referred for detailed psychological evaluation and management along with medical treatment. ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43589985","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1949
M. Lakhani, Iffat Raza, M. Mohiuddin, Ryan Basith Fasih Khan, S. Sidhwani, N. Hassan
Objective: To find out the frequency of protrusion of Internal Carotid artery in sphenoid sinus and dehiscence of carotid canal in a subset of Karachi population. Study design: This was a Cross-sectional study conducted at Radiology department of Ziauddin university. Methodology: We analyzed 270 head and neck CT scans 270 Head and neck CT scans (540 sides) were analyzed. CT was performed on a 16 slice Toshiba Alexion at Ziauddin Hospital, Karachi —removed for blind review---. SPSS version 20 was used for data analysis. Results: Out of 270 CT scans analyzed, 28 (10.3) scans showed protrusion of ICA in sphenoid sinus. Out of 45 (16.6) of the subjects showed dehiscence of carotid canal. Out of total dehiscence present unilateral cases were more frequent as compared to bilateral. Unilateral protrusion was also more common as compared to bilateral protrusion of ICA. Conclusion: Knowledge of dehiscence and protrusion related to ICA and sphenoid sinus anatomy is essential to avoid complications in endoscopic sinus surgery.
目的:了解卡拉奇人群颈内动脉蝶窦内突和颈动脉管裂的发生频率。研究设计:这是一项在齐亚丁大学放射学系进行的横断面研究。方法:我们分析了270个头部和颈部CT扫描(540个侧面)。CT在卡拉奇Ziauddin医院的16层Toshiba Alexion上进行-切除进行盲检。使用SPSS version 20进行数据分析。结果:在分析的270个CT扫描中，28个(10.3个)扫描显示蝶窦ICA突出。45例(16.6例)患者出现颈动脉管破裂。在全裂中，单侧病例比双侧病例更常见。与ICA的双侧突出相比，单侧突出更为常见。结论:了解内窥镜鼻窦手术中与ICA和蝶窦解剖相关的裂孔和突出是避免并发症的必要条件。
{"title":"VARIATION IN INTERNAL CAROTID ARTERY PROTRUSION AND DEHISCENCE IN A SUBSET OF KARACHI POPULATION","authors":"M. Lakhani, Iffat Raza, M. Mohiuddin, Ryan Basith Fasih Khan, S. Sidhwani, N. Hassan","doi":"10.37939/jrmc.v27i1.1949","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1949","url":null,"abstract":"Objective: To find out the frequency of protrusion of Internal Carotid artery in sphenoid sinus and dehiscence of carotid canal in a subset of Karachi population. \u0000Study design: This was a Cross-sectional study conducted at Radiology department of Ziauddin university. \u0000Methodology: We analyzed 270 head and neck CT scans 270 Head and neck CT scans (540 sides) were analyzed. CT was performed on a 16 slice Toshiba Alexion at Ziauddin Hospital, Karachi —removed for blind review---. SPSS version 20 was used for data analysis. \u0000Results: Out of 270 CT scans analyzed, 28 (10.3) scans showed protrusion of ICA in sphenoid sinus. Out of 45 (16.6) of the subjects showed dehiscence of carotid canal. Out of total dehiscence present unilateral cases were more frequent as compared to bilateral. Unilateral protrusion was also more common as compared to bilateral protrusion of ICA. \u0000Conclusion: Knowledge of dehiscence and protrusion related to ICA and sphenoid sinus anatomy is essential to avoid complications in endoscopic sinus surgery. ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43546174","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1447
O. Nasim, Z. Rustam, Z. Khan, Jamil Ahmad
Renal artery aneurysm (RAA) is a rare lesion and occurs in less than 1% of the population. There are multiple available treatment options which depend on the type of aneurysm and the timely diagnoses of the condition. Understanding these options is important; endovascular techniques, renal auto-transplantation and nephrectomy maybe indicated. A case of RAA in the left renal artery which was surgically treated with radical nephrectomy because of the nature of the presentation which was an emergency and was managed swiftly to save the patient’s life.
{"title":"RENAL ARTERY ANEURYSM – A CASE REPORT FROM KP","authors":"O. Nasim, Z. Rustam, Z. Khan, Jamil Ahmad","doi":"10.37939/jrmc.v27i1.1447","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1447","url":null,"abstract":"Renal artery aneurysm (RAA) is a rare lesion and occurs in less than 1% of the population. There are multiple available treatment options which depend on the type of aneurysm and the timely diagnoses of the condition. Understanding these options is important; endovascular techniques, renal auto-transplantation and nephrectomy maybe indicated. A case of RAA in the left renal artery which was surgically treated with radical nephrectomy because of the nature of the presentation which was an emergency and was managed swiftly to save the patient’s life.","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41652423","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 : 2023-04-02DOI: 10.37939/jrmc.v27i1.1928
Naqib Ullah, Jamshid Nawaz, M. Shoaib, Asif Khan, N. Din, Tauheed Fareed
OBJECTIVE : Objective of the study is to determine the effectiveness of CISC in management of recurrent urethral strictures after visual internal urethrotomy. METHODOLOGY : This study performed in department of urology Saidu teaching hospital Swat from June 2016 to July 2019 on 215 patients who were diagnosed as having urethral stricture disease. Patients were counseled for CISC after removal of catheter 2 times a day for 8 weeks and at 8th week cystourethroscopy performed along with detail evaluation of symptoms of urethral stricture to know recurrence of stricture. RESULTS: 81.39% patients have no urethral stricture on cystourethroscopy and symptomatic evaluation at 8th week post visual internal urethrotomy while 18.60% patients have recurrent urethral stricture . Length of urethral stricture is the most important prognostic factor, stricture of less than 1 cm has success rate of 62.39% while stricture of more than one cm length has success rate of 20% as shown in table IV. CONCLUSION: In this study it has been confirmed that CISC is safe ,cost effective procedure and most of the patients can do it in home with out any complications.
{"title":"Effectiveness of clean intermittent self catheterization in patients with recurrent urethral stricture post visual internal urethrotomy","authors":"Naqib Ullah, Jamshid Nawaz, M. Shoaib, Asif Khan, N. Din, Tauheed Fareed","doi":"10.37939/jrmc.v27i1.1928","DOIUrl":"https://doi.org/10.37939/jrmc.v27i1.1928","url":null,"abstract":"OBJECTIVE : \u0000 Objective of the study is to determine the effectiveness of CISC in management of recurrent urethral strictures after visual internal urethrotomy. \u0000METHODOLOGY : \u0000This study performed in department of urology Saidu teaching hospital Swat from June 2016 to July 2019 on 215 patients who were diagnosed as having urethral stricture disease. Patients were counseled for CISC after removal of catheter 2 times a day for 8 weeks and at 8th week cystourethroscopy performed along with detail evaluation of symptoms of urethral stricture to know recurrence of stricture. \u0000RESULTS: \u000081.39% patients have no urethral stricture on cystourethroscopy and symptomatic evaluation at 8th week post visual internal urethrotomy while 18.60% patients have recurrent urethral stricture . Length of urethral stricture is the most important prognostic factor, stricture of less than 1 cm has success rate of 62.39% while stricture of more than one cm length has success rate of 20% as shown in table IV. \u0000CONCLUSION: \u0000In this study it has been confirmed that CISC is safe ,cost effective procedure and most of the patients can do it in home with out any complications. ","PeriodicalId":34174,"journal":{"name":"Journal of Rawalpindi Medical College","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42356152","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：