Pub Date : 2023-08-10DOI: 10.21649/akemu.v29i2.5453
Dilshad Ahmed, H. Javed, Wajiha Kanwal, Warda Fatima, Nida Qadir
Background: Pseudomonas aeruginosa (PA) is a major public health community-acquired threat around the globe due to the growing rate of antimicrobial resistance. It is one of the most common trending causes of nosocomial infections. Objective: The current study aimed to check the rate of multidrug-resistant (MDR) and extended drug-resistant (XDR) PA and to analyze the invitro activity of different antimicrobial agents against clinically isolated bacterial samples. Molecular Detection and amplification of L lipoprotein (OprL gene) were also done to determine the frequency and species of different strains of Pseudomonas aeruginosa (PA2192, C3719, PA01, PA14 and PACS2). Method: This cross-sectional study was conducted at at the Department of Pathology, King Edward Medical University/ Mayo Hospital Lahore. Total 140 patients were included in the study. Biochemical characterization, molecular identification, antimicrobial susceptibility profiling and DNA sequencing of the desired gene were done to confirm different strains' identification. Results: MDR and XDR Pseudomonas aeruginosa infection are more common among males 81(57.5%) and high among the 31-45 age group, i.e., 55 (39.3%). After antibiotic susceptibility testing, 60% of strains were found to be MDR PA, while 40% were categorized as XDR PA. Doripenem showed the highest sensitivity, 93 (66.4%) among all carbapenems. Polymyxin B showed the highest activity against Pseudomonas aeruginosa multi and extensively drug-resistant strains, i.e., 108 (77.1%). Conclusion: The present study suggests that doripenem can be the only active agent for combating infections, and the Carbapenem drug appears effective against highly resistant strains of Pseudomonas aeruginosa.
{"title":"Determination of Multidrug Resistance and Extended Drug Resistance Pattern of Pseudomonas aeruginosa in Clinical Isolates of Tertiary Care Hospital Lahore","authors":"Dilshad Ahmed, H. Javed, Wajiha Kanwal, Warda Fatima, Nida Qadir","doi":"10.21649/akemu.v29i2.5453","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5453","url":null,"abstract":"Background: \u0000Pseudomonas aeruginosa (PA) is a major public health community-acquired threat around the globe due to the growing rate of antimicrobial resistance. It is one of the most common trending causes of nosocomial infections. \u0000Objective: \u0000The current study aimed to check the rate of multidrug-resistant (MDR) and extended drug-resistant (XDR) PA and to analyze the invitro activity of different antimicrobial agents against clinically isolated bacterial samples. Molecular Detection and amplification of L lipoprotein (OprL gene) were also done to determine the frequency and species of different strains of Pseudomonas aeruginosa (PA2192, C3719, PA01, PA14 and PACS2). \u0000Method: \u0000This cross-sectional study was conducted at at the Department of Pathology, King Edward Medical University/ Mayo Hospital Lahore. Total 140 patients were included in the study. Biochemical characterization, molecular identification, antimicrobial susceptibility profiling and DNA sequencing of the desired gene were done to confirm different strains' identification. \u0000Results: \u0000MDR and XDR Pseudomonas aeruginosa infection are more common among males 81(57.5%) and high among the 31-45 age group, i.e., 55 (39.3%). After antibiotic susceptibility testing, 60% of strains were found to be MDR PA, while 40% were categorized as XDR PA. Doripenem showed the highest sensitivity, 93 (66.4%) among all carbapenems. Polymyxin B showed the highest activity against Pseudomonas aeruginosa multi and extensively drug-resistant strains, i.e., 108 (77.1%). \u0000Conclusion: \u0000The present study suggests that doripenem can be the only active agent for combating infections, and the Carbapenem drug appears effective against highly resistant strains of Pseudomonas aeruginosa. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"41 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81305139","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 : 2023-08-10DOI: 10.21649/akemu.v29i2.5435
N. Imran, Bakhtawar Khalid, Zubia Afzal, S. Azeem, Osheen Fatima, I. Haider, M. Azeem, A. Javed
Background: Despite calls for the much-needed involvement of physicians in leadership, very few medical colleges in Pakistan provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. Objective: To explored Pakistani medical students’ perceptions, attitudes, and interests regarding Leadership training in medical education. Methods: Participants were asked about their perceptions and attitudes towards medical leadership on a 5-point Likert scale. Students also self-rated their leadership competencies noted as per Medical Leadership Competency Framework. Survey also assessed the perceived need and topics for a leadership curriculum for physician leaders, the teaching format, and barriers to leadership training in medical schools. Data were analyzed using SPSS 26. Results: 60.6% of the total 1204 respondents rated their leadership training in medical college as “very poor” or “poor” and 80.3% of them endorsed their interest and need for it. 77.4% of the participants agreed that clinicians should influence leadership decisions in a clinical setting. Only 25% of respondents were aware of the demands of a leadership rank in medicine. Leadership competencies endorsed for training included problem-solving, leading a team, confronting problematic employees, and communication skills with a multimodal teaching approach, including teaching methods like small group discussions. The main barriers to leadership training were identified as time constraints (66.1%), lack of available curriculum (69.0%), and disinterest by faculty (67.0%). Conclusion: Our study suggests that medical students in Pakistan appreciate the importance of leadership training in undergraduate education. There is a need for dedicated leadership teaching and study data to specify the possible content and delivery methods to serve as goals for an undergraduate leadership curriculum in Pakistan.
{"title":"Leadership in Undergraduate Medical Education: A Study of Pakistani Medical Students’ Perceptions, Attitudes, and Interest","authors":"N. Imran, Bakhtawar Khalid, Zubia Afzal, S. Azeem, Osheen Fatima, I. Haider, M. Azeem, A. Javed","doi":"10.21649/akemu.v29i2.5435","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5435","url":null,"abstract":"Background: Despite calls for the much-needed involvement of physicians in leadership, very few medical colleges in Pakistan provide explicit training on the knowledge, skills, and attitudes necessary to be an effective physician leader. \u0000Objective: To explored Pakistani medical students’ perceptions, attitudes, and interests regarding Leadership training in medical education. \u0000Methods: \u0000Participants were asked about their perceptions and attitudes towards medical leadership on a 5-point Likert scale. Students also self-rated their leadership competencies noted as per Medical Leadership Competency Framework. Survey also assessed the perceived need and topics for a leadership curriculum for physician leaders, the teaching format, and barriers to leadership training in medical schools. Data were analyzed using SPSS 26. \u0000Results: \u000060.6% of the total 1204 respondents rated their leadership training in medical college as “very poor” or “poor” and 80.3% of them endorsed their interest and need for it. 77.4% of the participants agreed that clinicians should influence leadership decisions in a clinical setting. Only 25% of respondents were aware of the demands of a leadership rank in medicine. Leadership competencies endorsed for training included problem-solving, leading a team, confronting problematic employees, and communication skills with a multimodal teaching approach, including teaching methods like small group discussions. The main barriers to leadership training were identified as time constraints (66.1%), lack of available curriculum (69.0%), and disinterest by faculty (67.0%). \u0000Conclusion: \u0000Our study suggests that medical students in Pakistan appreciate the importance of leadership training in undergraduate education. There is a need for dedicated leadership teaching and study data to specify the possible content and delivery methods to serve as goals for an undergraduate leadership curriculum in Pakistan. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"87 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74645503","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}
Background: Streptococcus mutans is considered as a major microorganism causing tooth decay, affecting individuals globally. Different types of chewing sticks possess anti cariogenic properties, traditionally been consumed in maintaining dental hygiene. Usage of these sticks can be economical in developing and rural regions where dental caries is a major health concern. Objective: The current study aims to evaluate antibacterial action of different type of chewing sticks extract on Streptococcus mutans. Methods: Aqueous extracts of Azadiracta indica (Neem), Melia azedarach (Bakain), Mangifera indica (Mango), Salvadora persica (Peelu), Terminalia chebula (Harhar), Dalbeigia sissoo (Tali) and Juglans regia (Akhrot) plants which have justified folk use were prepared in Punjab University College of Pharmacy, Punjab University. Next, in vitro antimicrobial activity was studied by broth dilution method in Post Graduate Medical Institute, Lahore. Moreover, minimum inhibitory concentration (MIC) as well as the minimum bactericidal concentration (MBC) were quantitatively evaluated on basis of turbidity index. Results: There is a significant effect of aqueous extracts of plants on the bacterial inhibition. MIC and MBC values were in the range of 6.125 to 100 mg/mL against S. mutans. The notable effect occurred with aqueous extracts of Azadiracta indica showing MIC and MBC values as 6.25mg/mL and 12.5 mg/mL, respectively. Alternatively, Salvadora persica demonstrated 8.33mg/mL and 16.66 mg/mL values of these parameters Conclusions: Each plant studied exhibited moderate to high antibacterial activity against tested bacterial strain. However, Azadirachta indica and Salvadora persica aqueous extracts showed promising effect against Streptococcus mutans
{"title":"Antibacterial Effects of Chewing Stick Extracts on Streptococcus Mutans","authors":"Naureen Sarwar, Sadia Sharif, Saira Aslam, Bushra Nisar, Shahab Sarwar, Attika Batool","doi":"10.21649/akemu.v29i2.5454","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5454","url":null,"abstract":"Background: Streptococcus mutans is considered as a major microorganism causing tooth decay, affecting individuals globally. Different types of chewing sticks possess anti cariogenic properties, traditionally been consumed in maintaining dental hygiene. Usage of these sticks can be economical in developing and rural regions where dental caries is a major health concern. \u0000Objective: The current study aims to evaluate antibacterial action of different type of chewing sticks extract on Streptococcus mutans. \u0000Methods: Aqueous extracts of Azadiracta indica (Neem), Melia azedarach (Bakain), Mangifera indica (Mango), Salvadora persica (Peelu), Terminalia chebula (Harhar), Dalbeigia sissoo (Tali) and Juglans regia (Akhrot) plants which have justified folk use were prepared in Punjab University College of Pharmacy, Punjab University. Next, in vitro antimicrobial activity was studied by broth dilution method in Post Graduate Medical Institute, Lahore. Moreover, minimum inhibitory concentration (MIC) as well as the minimum bactericidal concentration (MBC) were quantitatively evaluated on basis of turbidity index. \u0000Results: There is a significant effect of aqueous extracts of plants on the bacterial inhibition. MIC and MBC values were in the range of 6.125 to 100 mg/mL against S. mutans. The notable effect occurred with aqueous extracts of Azadiracta indica showing MIC and MBC values as 6.25mg/mL and 12.5 mg/mL, respectively. Alternatively, Salvadora persica demonstrated 8.33mg/mL and 16.66 mg/mL values of these parameters \u0000Conclusions: Each plant studied exhibited moderate to high antibacterial activity against tested bacterial strain. However, Azadirachta indica and Salvadora persica aqueous extracts showed promising effect against Streptococcus mutans \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"3 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73352896","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 : 2023-08-10DOI: 10.21649/akemu.v29i2.5433
Attique Abou Bakr, Shahid Sarwar, N. Aslam, M. Ghias, Imran Mehfooz
Background: Sofosbuvir-Velpatasvir has a high efficacy in adult patients with chronic hepatitis C infection .In this study, we reported treatment outcome with this drug in children and younger adults in Pakistani population. Objective: To assess the efficacy and safety of Sofosbuvir-velpatasvir in treating HCV-infected children and young adults. Methods: This Interventional(Clinical trial) was done in Hepatitis clinic Jinnah Hospital, Lahore from April 10, 2021 to January 9, 2022.A total of 45 patients aged 6 to 18 years with detectable HCV RNA by PCR were registered. They were evaluated clinically. HCV genotyping was not done as Sofosbuvir – Velpatasvir is pangenotypic. All of the patients were given a single oral dose of Sofosbuvir-velpatasvir per day. Ribavirin was included for patients with compensated cirrhosis and for those who were treatment-experienced .Clinical assessment, CBC, LFT, RFT, and PT were performed monthly to determine side effects and safety. To evaluate treatment efficacy, HCV RNA was measured by PCR at 12 weeks (end of treatment) and 12 weeks post-treatment (sustained virological response). Treatment lasted for 24weeks for those with compensated cirrhosis. (Child Turcotte Pugh score 5 and 6; Child class A) or those who were treatment experienced. SPSS 24 was used for data analysis. Results: Non cirrhotic patients had a mean age of 13.6±1.45 years, while those with compensated cirrhosis had 14.1±2.15 years. There were 63.6% males (28) and 36.4% female (17). 41 patients (91.11%) had undetectable HCV RNA by PCR ,12 weeks after treatment (Sustained virological response), indicating treatment effectiveness. Nine patients had HBV co-infection and took HBV medications as well during HCV treatment. At 12 weeks post-treatment, all HBV-coinfected patients had undetectable HCV RNA by PCR and lower HBV titers. Some of the patients experience minor side effects. However, none of the patients stopped their treatment due to these side effects Thus, this treatment was safe and effective. Conclusion: Sofosbuvir/ velpatasvir has effectiveness and safety in treating HCV in children and young adults.
{"title":"Sofosbuvir-Velpatasvir for Chronic Hepatitis C Virus-Infected Children and Young Adults: Efficacy and Safety","authors":"Attique Abou Bakr, Shahid Sarwar, N. Aslam, M. Ghias, Imran Mehfooz","doi":"10.21649/akemu.v29i2.5433","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5433","url":null,"abstract":"Background: Sofosbuvir-Velpatasvir has a high efficacy in adult patients with chronic hepatitis C infection .In this study, we reported treatment outcome with this drug in children and younger adults in Pakistani population. \u0000Objective: To assess the efficacy and safety of Sofosbuvir-velpatasvir in treating HCV-infected children and young adults. \u0000Methods: This Interventional(Clinical trial) was done in Hepatitis clinic Jinnah Hospital, Lahore from April 10, 2021 to January 9, 2022.A total of 45 patients aged 6 to 18 years with detectable HCV RNA by PCR were registered. They were evaluated clinically. HCV genotyping was not done as Sofosbuvir – Velpatasvir is pangenotypic. All of the patients were given a single oral dose of Sofosbuvir-velpatasvir per day. Ribavirin was included for patients with compensated cirrhosis and for those who were treatment-experienced .Clinical assessment, CBC, LFT, RFT, and PT were performed monthly to determine side effects and safety. To evaluate treatment efficacy, HCV RNA was measured by PCR at 12 weeks (end of treatment) and 12 weeks post-treatment (sustained virological response). Treatment lasted for 24weeks for those with compensated cirrhosis. (Child Turcotte Pugh score 5 and 6; Child class A) or those who were treatment experienced. SPSS 24 was used for data analysis. \u0000Results: Non cirrhotic patients had a mean age of 13.6±1.45 years, while those with compensated cirrhosis had 14.1±2.15 years. There were 63.6% males (28) and 36.4% female (17). 41 patients (91.11%) had undetectable HCV RNA by PCR ,12 weeks after treatment (Sustained virological response), indicating treatment effectiveness. Nine patients had HBV co-infection and took HBV medications as well during HCV treatment. At 12 weeks post-treatment, all HBV-coinfected patients had undetectable HCV RNA by PCR and lower HBV titers. Some of the patients experience minor side effects. However, none of the patients stopped their treatment due to these side effects Thus, this treatment was safe and effective. \u0000Conclusion: Sofosbuvir/ velpatasvir has effectiveness and safety in treating HCV in children and young adults. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"131 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86356712","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 : 2023-08-10DOI: 10.21649/akemu.v29i2.5434
Mohammad Abbas Jamil, M. Bashir, R. Noor, Rehan M. Niazi, Nazeer Ahmad, Shahzad Ahmad, Haseeb Ullah Ahmad
Background: Lumbar disc herniation is a common musculoskeletal disorder leading to spinal degeneration. Core stability influences lumbar biomechanics, which improves muscle endurance through decreased pain of the lower back leading to minimal chances of disability. Objective: To determine the effects of Core stabilizing exercises on low back pain, disability and endurance of back muscles in Lumbar Disc Herniation patients. Methods: Randomized controlled trial was conducted on 52 patients . it was conducted 3 times a week for 30 minutes for 6 months. Participants allocated into two equal groups by lottery method. Group A was treated with controlled conventional treatment and core stabilizing exercises. Group B received only conventional treatment. This information was collected using NPRS and ODI. Besides this Biering-Sorenson and trunk flexion endurance tests were used. Probability sampling was used .Settings included AMTH, PSRD and NHMC. The study was conducted for 6 months. Ethical permission by ethical review board. data analysis by SPSS. This included male and female patients, age 20 to 60 years with disc herniation. Participants with recent surgery, inflammatory arthritis, cauda equina syndrome and spinal tumor were excluded. Results: After 8-weeks of core stabilization exercises, values of Group A are 1.93 for pain, 16.08 for disability, 1.27 and 40.54 for endurance whereas Group B showed values of 4.74 for pain, 34.08 for disability, 2.15 and 34.81 for endurance. Independent t-test showed significant difference between 2 groups with p value < 0.05. Results of current study showed considerable reduction in low back pain and disability, and a significant increase in back muscles endurance in the treatment group. Conclusion: Core stabilization exercises were effective in improving function, reducing pain, reducing functional disability and enhancing endurance in patients of lumbar disc herniation and lower back pain
{"title":"Effects of Core Stabilization Exercises on Low Back Pain, Disability and Back Muscle Endurance in Patients with Lumbar Disc Herniation","authors":"Mohammad Abbas Jamil, M. Bashir, R. Noor, Rehan M. Niazi, Nazeer Ahmad, Shahzad Ahmad, Haseeb Ullah Ahmad","doi":"10.21649/akemu.v29i2.5434","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5434","url":null,"abstract":"Background: Lumbar disc herniation is a common musculoskeletal disorder leading to spinal degeneration. Core stability influences lumbar biomechanics, which improves muscle endurance through decreased pain of the lower back leading to minimal chances of disability. \u0000Objective: To determine the effects of Core stabilizing exercises on low back pain, disability and endurance of back muscles in Lumbar Disc Herniation patients. \u0000Methods: Randomized controlled trial was conducted on 52 patients . it was conducted 3 times a week for 30 minutes for 6 months. Participants allocated into two equal groups by lottery method. Group A was treated with controlled conventional treatment and core stabilizing exercises. Group B received only conventional treatment. This information was collected using NPRS and ODI. Besides this Biering-Sorenson and trunk flexion endurance tests were used. Probability sampling was used .Settings included AMTH, PSRD and NHMC. The study was conducted for 6 months. Ethical permission by ethical review board. data analysis by SPSS. This included male and female patients, age 20 to 60 years with disc herniation. Participants with recent surgery, inflammatory arthritis, cauda equina syndrome and spinal tumor were excluded. \u0000Results: After 8-weeks of core stabilization exercises, values of Group A are 1.93 for pain, 16.08 for disability, 1.27 and 40.54 for endurance whereas Group B showed values of 4.74 for pain, 34.08 for disability, 2.15 and 34.81 for endurance. Independent t-test showed significant difference between 2 groups with p value < 0.05. Results of current study showed considerable reduction in low back pain and disability, and a significant increase in back muscles endurance in the treatment group. \u0000Conclusion: Core stabilization exercises were effective in improving function, reducing pain, reducing functional disability and enhancing endurance in patients of lumbar disc herniation and lower back pain \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"8 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78712099","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 : 2023-08-10DOI: 10.21649/akemu.v29i2.5442
Javaria Rasheed, Muhammad Khalid, Barera Maryam, S. Parveen
Background: Early neonatal deaths in Pakistan account for 7% of global neonatal mortality rate, with perinatal asphyxia being responsible for 23% of these cases. Controversy exists in the literature regarding role of magnesium sulphate administration on reducing in-hospital mortality in newborns with perinatal asphyxia. Objectives: To determine the effect of intravenous magnesium sulphate on in-hospital mortality in neonates with perinatal asphyxia. Methods: This prospective cohort study was conducted at the Department of Pediatric Medicine, Nishtar Hospital Multan over a period of six months from January 2022 to June 2022. A total of 183 consecutive full-term neonates, weighing ≥ 2500 grams, with Apgar score < 7 at 5-minutes after birth, presenting within 48-hours of life were included in the study. Neonates presenting within 6-hours after birth received intravenous magnesium sulphate (MgSO4) – exposed group and neonates presenting after 6-hours did not get MgSO4 – unexposed group. Baseline characteristics and survival outcome was recorded. Binary logistic regression analysis was run and Kaplan-Meier survival curve is constructed for the assessment of mortality. Results: There were 90 neonates in exposed group and 93 in unexposed group. Males constituted 53% of the study population. Overall mortality rate was 15.8% (n=29). Severe asphyxia (RR 8.5, 95% CI 4.0 – 18.0; p < 0.001) and spontaneous vaginal delivery (RR 1.8, 95% CI 1.1 – 2.9; p = 0.02) were the independent predictors of mortality. Mortality (7.8% vs. 23.6%, p-value 0.003) was significantly higher in unexposed group compared to exposed group. In exposed group the median survival time was 16 days (95% CI- 8.7 – 23.3) compared to 11 days (95% CI 9.9 – 12.0) in unexposed group (Log-rank test: χ2 = 6.03, df -1, p = 0.01). Conclusion: Magnesium sulphate was effective in lowering neonatal mortality due to moderate-severe perinatal asphyxia. In order to further validate its impact on mortality, multi-center studies are suggested.
背景:巴基斯坦新生儿早期死亡占全球新生儿死亡率的7%，其中围产期窒息占23%。关于硫酸镁对降低围产儿窒息新生儿住院死亡率的作用，文献中存在争议。目的:探讨静脉注射硫酸镁对围产期窒息新生儿住院死亡率的影响。方法:这项前瞻性队列研究于2022年1月至2022年6月期间在木尔坦Nishtar医院儿科医学部进行。本研究共纳入183例体重≥2500克、出生后5分钟Apgar评分< 7分、出生后48小时内出现的连续足月新生儿。出生后6小时内出生的新生儿接受静脉注射硫酸镁(MgSO4)暴露组，6小时后出生的新生儿未接受MgSO4暴露组。记录基线特征和生存结果。采用二元logistic回归分析，构建Kaplan-Meier生存曲线评价死亡率。结果:暴露组90例，未暴露组93例。男性占研究人群的53%。总死亡率为15.8% (n=29)。严重窒息(RR 8.5, 95% CI 4.0 - 18.0;p < 0.001)和自然阴道分娩(RR 1.8, 95% CI 1.1 - 2.9;P = 0.02)是死亡率的独立预测因子。未暴露组的死亡率(7.8% vs. 23.6%， p值0.003)显著高于暴露组。暴露组的中位生存时间为16天(95% CI- 8.7 ~ 23.3)，而未暴露组的中位生存时间为11天(95% CI 9.9 ~ 12.0) (Log-rank检验:χ2 = 6.03, df -1, p = 0.01)。结论:硫酸镁可有效降低中重度围产期窒息新生儿死亡率。为了进一步验证其对死亡率的影响，建议进行多中心研究。
{"title":"Effect of Intravenous Magnesium Sulphate on in-Hospital Mortality in Neonates with Perinatal Asphyxia: A Prospective Cohort Study","authors":"Javaria Rasheed, Muhammad Khalid, Barera Maryam, S. Parveen","doi":"10.21649/akemu.v29i2.5442","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5442","url":null,"abstract":"Background: Early neonatal deaths in Pakistan account for 7% of global neonatal mortality rate, with perinatal asphyxia being responsible for 23% of these cases. Controversy exists in the literature regarding role of magnesium sulphate administration on reducing in-hospital mortality in newborns with perinatal asphyxia. \u0000Objectives: To determine the effect of intravenous magnesium sulphate on in-hospital mortality in neonates with perinatal asphyxia. \u0000Methods: This prospective cohort study was conducted at the Department of Pediatric Medicine, Nishtar Hospital Multan over a period of six months from January 2022 to June 2022. A total of 183 consecutive full-term neonates, weighing ≥ 2500 grams, with Apgar score < 7 at 5-minutes after birth, presenting within 48-hours of life were included in the study. Neonates presenting within 6-hours after birth received intravenous magnesium sulphate (MgSO4) – exposed group and neonates presenting after 6-hours did not get MgSO4 – unexposed group. Baseline characteristics and survival outcome was recorded. Binary logistic regression analysis was run and Kaplan-Meier survival curve is constructed for the assessment of mortality. \u0000Results: There were 90 neonates in exposed group and 93 in unexposed group. Males constituted 53% of the study population. Overall mortality rate was 15.8% (n=29). Severe asphyxia (RR 8.5, 95% CI 4.0 – 18.0; p < 0.001) and spontaneous vaginal delivery (RR 1.8, 95% CI 1.1 – 2.9; p = 0.02) were the independent predictors of mortality. Mortality (7.8% vs. 23.6%, p-value 0.003) was significantly higher in unexposed group compared to exposed group. In exposed group the median survival time was 16 days (95% CI- 8.7 – 23.3) compared to 11 days (95% CI 9.9 – 12.0) in unexposed group (Log-rank test: χ2 = 6.03, df -1, p = 0.01). \u0000Conclusion: Magnesium sulphate was effective in lowering neonatal mortality due to moderate-severe perinatal asphyxia. In order to further validate its impact on mortality, multi-center studies are suggested. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"66 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80367178","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 : 2023-08-10DOI: 10.21649/akemu.v29i2.5432
Almas Sabir, A. Jabeen
Background: Fear of missing out is a subcategory of social anxiety and an upsurge issue which may lead university students to experience many detrimental effects on their well-being. Objective: To develop an indigenous scale with sound psychometric properties to measure fear of missing out by highlighting the culture-specific experiences of university students. Method: A mixed cross-sectional research design was used. This study was carried out from October 2020 to May 2021. Data was collected from different government and private universities in Lahore. Initially, 82 items were generated by conducting interviews with university students. After eliminating dubious items, a list of 57 items was generated. These items were given to a committee of experts for empirical validation. After that, a list of 48 items was finalized. Then these items were piloted on 14 university students. Finally, this scale along with the demographic form was administered to a sample of 400 university students (men=194, women=206) in the age range of 18 to 28 years (M=21, SD=2.15) using purposive sampling technique. Results: Exploratory Factor Analysis revealed four-factor structures of fear of missing out scale named, Low Self-Esteem, Lack of Contentment, Apprehensions, and Jealousy. In each subscale, no. of items ranges from 6 to 14 items. Results revealed the newly developed scale has a high internal consistency of a=.73, test-retest reliability r=.89, and good concurrent validity r= .34. Results also revealed that 14.0% of participants have mild, 37.3% have moderate, 32.0% have severe and 16.8% have a very severe level of fear of missing out. Conclusion: As a result of this study a 41-items self-reported measure of fear of missing out for university students, having sound psychometric properties was developed.
{"title":"Fear of Missing Out in University Students: A Psychometric Study","authors":"Almas Sabir, A. Jabeen","doi":"10.21649/akemu.v29i2.5432","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5432","url":null,"abstract":"Background: \u0000Fear of missing out is a subcategory of social anxiety and an upsurge issue which may lead university students to experience many detrimental effects on their well-being. \u0000Objective: \u0000To develop an indigenous scale with sound psychometric properties to measure fear of missing out by highlighting the culture-specific experiences of university students. \u0000Method: \u0000A mixed cross-sectional research design was used. This study was carried out from October 2020 to May 2021. Data was collected from different government and private universities in Lahore. Initially, 82 items were generated by conducting interviews with university students. After eliminating dubious items, a list of 57 items was generated. These items were given to a committee of experts for empirical validation. After that, a list of 48 items was finalized. Then these items were piloted on 14 university students. Finally, this scale along with the demographic form was administered to a sample of 400 university students (men=194, women=206) in the age range of 18 to 28 years (M=21, SD=2.15) using purposive sampling technique. \u0000Results: \u0000Exploratory Factor Analysis revealed four-factor structures of fear of missing out scale named, Low Self-Esteem, Lack of Contentment, Apprehensions, and Jealousy. In each subscale, no. of items ranges from 6 to 14 items. Results revealed the newly developed scale has a high internal consistency of a=.73, test-retest reliability r=.89, and good concurrent validity r= .34. Results also revealed that 14.0% of participants have mild, 37.3% have moderate, 32.0% have severe and 16.8% have a very severe level of fear of missing out. \u0000Conclusion: \u0000As a result of this study a 41-items self-reported measure of fear of missing out for university students, having sound psychometric properties was developed. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"86 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76232334","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 : 2023-07-31DOI: 10.21649/akemu.v29i2.5444
Muhammad Irfan Tahir Khan, A. Hussain, A. Rashid, Zeeshan Malick, Ranal Salman Aslam
Background: Bifurcation angle (BA) is the critical angle that has impact on side branch (SB) occlusion during coronary intervention due to plaque shift. There have been few research studies especially in Pakistan on the role of BA in plaque shift. Objective: To know the impact of bifurcation angle on the side branch occlusion during provisional stenting. Methodology: A retrospective cohort study was conducted at Punjab Institute of Cardiology, Lahore on consecutively enrolled patients between July 2017 and June 2019. The subjects were split into two groups: high angle and low angle using the median BA. Binary logistic regression analysis was performed to identify BA as an independent predictor of occlusion of SB. Results: Occurrence of side branch occlusion was found in 7.7% of the total of 600 bifurcation lesions. SB occlusion rate was found to be significantly higher in higher angle (HA) group compared to lower angle (LA) group i.e. (37/292, 12.7 %) and (9/308, 2.9 %) respectively, (P < 0.001). Binary logistic regression analysis demonstrated high angle to be an independent predictor for the occlusion of side branches (odds ratio [OR]: 1.026 per degree increment, 95% confidence intervals [CI]: 1.016 – 1.045, P < 0.001). Conclusion: Higher branching angle was noted as the independent predictor of the occlusion of side branches following provisional stenting of main vessel.
{"title":"Impact of Bifurcation Angle on Side Branch Occlusion in Provisional Bifurcation Stenting","authors":"Muhammad Irfan Tahir Khan, A. Hussain, A. Rashid, Zeeshan Malick, Ranal Salman Aslam","doi":"10.21649/akemu.v29i2.5444","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5444","url":null,"abstract":"Background: Bifurcation angle (BA) is the critical angle that has impact on side branch (SB) occlusion during coronary intervention due to plaque shift. There have been few research studies especially in Pakistan on the role of BA in plaque shift. \u0000Objective: To know the impact of bifurcation angle on the side branch occlusion during provisional stenting. \u0000Methodology: A retrospective cohort study was conducted at Punjab Institute of Cardiology, Lahore on consecutively enrolled patients between July 2017 and June 2019. The subjects were split into two groups: high angle and low angle using the median BA. Binary logistic regression analysis was performed to identify BA as an independent predictor of occlusion of SB. \u0000Results: Occurrence of side branch occlusion was found in 7.7% of the total of 600 bifurcation lesions. SB occlusion rate was found to be significantly higher in higher angle (HA) group compared to lower angle (LA) group i.e. (37/292, 12.7 %) and (9/308, 2.9 %) respectively, (P < 0.001). Binary logistic regression analysis demonstrated high angle to be an independent predictor for the occlusion of side branches (odds ratio [OR]: 1.026 per degree increment, 95% confidence intervals [CI]: 1.016 – 1.045, P < 0.001). \u0000Conclusion: Higher branching angle was noted as the independent predictor of the occlusion of side branches following provisional stenting of main vessel. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"53 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73101084","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 : 2023-07-31DOI: 10.21649/akemu.v29i2.5443
M. A. Chaudhry, Shireen Rafeeq, D. Khan, Javaria Nosheen, Shahid Munir
Background: Traditional thinking places high Intelligence Quotient (IQ) as the most important predictor of success but its contribution is only half that of Emotional Intelligence (EI), the ability to manage emotions. EI encompasses several skills, all of which need to be mastered for professional and personal success. Objectives: To determine the emotional intelligence level of medical students at a private medical college in Lahore, Pakistan, and to see its association with gender and years of study. Methods: This cross-sectional study was conducted between January and March 2022. Convenience Sampling was used to select 370 medical students at a private college in Lahore, Pakistan, who filled out a questionnaire to measure their emotional intelligence. SPSS 20 was used for data analysis. Results: The majority scored in the middle range of EI, with a mean score of 58.6±7.8 (out of a possible lowest score of 20 and highest of 80). There was a significant association of EI with gender as well as with years of study. Males had higher total EI scores than females (p.002), as well as higher mean EI score of 59.9±8 compared to 56.9±7.3 for females (p.001). Students from higher classes had higher total scores as well as higher mean scores than those from lower classes (p.001) and (p.001) respectively. Conclusions: Half the respondents got mid-range EI scores. While there were very few low scores, only a third scored in the desirable higher ranges indicating a need for counselling.
{"title":"Prevalence of Emotional Intelligence in Students at a Medical College in Pakistan","authors":"M. A. Chaudhry, Shireen Rafeeq, D. Khan, Javaria Nosheen, Shahid Munir","doi":"10.21649/akemu.v29i2.5443","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5443","url":null,"abstract":"Background: Traditional thinking places high Intelligence Quotient (IQ) as the most important predictor of success but its contribution is only half that of Emotional Intelligence (EI), the ability to manage emotions. EI encompasses several skills, all of which need to be mastered for professional and personal success. \u0000Objectives: To determine the emotional intelligence level of medical students at a private medical college in Lahore, Pakistan, and to see its association with gender and years of study. \u0000Methods: This cross-sectional study was conducted between January and March 2022. Convenience Sampling was used to select 370 medical students at a private college in Lahore, Pakistan, who filled out a questionnaire to measure their emotional intelligence. SPSS 20 was used for data analysis. \u0000Results: The majority scored in the middle range of EI, with a mean score of 58.6±7.8 (out of a possible lowest score of 20 and highest of 80). There was a significant association of EI with gender as well as with years of study. Males had higher total EI scores than females (p.002), as well as higher mean EI score of 59.9±8 compared to 56.9±7.3 for females (p.001). Students from higher classes had higher total scores as well as higher mean scores than those from lower classes (p.001) and (p.001) respectively. \u0000Conclusions: Half the respondents got mid-range EI scores. While there were very few low scores, only a third scored in the desirable higher ranges indicating a need for counselling. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"154 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77123532","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 : 2023-07-31DOI: 10.21649/akemu.v29i2.5445
W. Chaudhry, Hania Aamir, Amber Mohsin, S. Chaudhry, Samar Ghufran, M. Jamil
Background: Internal haemorrhoids are very common all around the world and the classical surgical treatment is open haemorrhoidectomy for a long time. This procedure has a lot of complications and is very painful for the patient. Doppler guided HAL-RAR has shown satisfactory results in the literature with minimal pain and a significantly lower rate of complications compared to open haemorrhoidectomy . Objective: To assess the outcome of a relatively new surgical procedure (HAL-RAR) using doppler guidance for the treatment of grade-II, III and IV internal haemorrhoids. Methods: This case series was conducted at Surgimed hospital, Lahore, Pakistan, between May 2015 to December 2021. One hundred patients who attended the outpatient department of the hospital were recruited for this study. These patients presented with grade-II, III or IV symptomatic internal haemorrhoids. Surgical intervention in the form of HAL-RAR was performed in all patients and outcome was measured in terms of mean operating time, length of hospital stays, post-operative pain, recurrence of prolapse and bleeding, and early and late post-operative complications with one year follow up for all patients. Results: Out of these 100 patients, 72 were males and 28 were females. On average, seven haemorrhoidal artery ligations and three recto anal repairs were performed in each patient. The average hospital stay was 31 hours with a range between 24 hours to 72 hours. Early post-operative pain was minimum and only twelve patients required narcotic analgesics. Three patients complained of excessive pain lasting for five days. Seven patients had self-limiting bleeding, two patients had post-operative bleeding which was controlled by re-ligation of the bleeding point and one patient developed a perianal fistula. In the long term follow up, one patient had recurrence of prolapse six months after the surgery. Conclusion: HAL-RAR with doppler was a safe and efficient method for treatment of grade-II, III and IV internal haemorrhoids, with very low post-operative pain scores, satisfactory relief of symptoms, and low recurrence rates.
{"title":"Outcome of Haemorrhoidal Artery Ligation and Recto Anal Repair (HAL-RAR) with Doppler Guidance for Symptomatic Grade-II, III and IV Internal Haemorrhoids","authors":"W. Chaudhry, Hania Aamir, Amber Mohsin, S. Chaudhry, Samar Ghufran, M. Jamil","doi":"10.21649/akemu.v29i2.5445","DOIUrl":"https://doi.org/10.21649/akemu.v29i2.5445","url":null,"abstract":"Background: Internal haemorrhoids are very common all around the world and the classical surgical treatment is open haemorrhoidectomy for a long time. This procedure has a lot of complications and is very painful for the patient. Doppler guided HAL-RAR has shown satisfactory results in the literature with minimal pain and a significantly lower rate of complications compared to open haemorrhoidectomy . \u0000Objective: To assess the outcome of a relatively new surgical procedure (HAL-RAR) using doppler guidance for the treatment of grade-II, III and IV internal haemorrhoids. \u0000Methods: This case series was conducted at Surgimed hospital, Lahore, Pakistan, between May 2015 to December 2021. One hundred patients who attended the outpatient department of the hospital were recruited for this study. These patients presented with grade-II, III or IV symptomatic internal haemorrhoids. Surgical intervention in the form of HAL-RAR was performed in all patients and outcome was measured in terms of mean operating time, length of hospital stays, post-operative pain, recurrence of prolapse and bleeding, and early and late post-operative complications with one year follow up for all patients. \u0000Results: Out of these 100 patients, 72 were males and 28 were females. On average, seven haemorrhoidal artery ligations and three recto anal repairs were performed in each patient. The average hospital stay was 31 hours with a range between 24 hours to 72 hours. Early post-operative pain was minimum and only twelve patients required narcotic analgesics. Three patients complained of excessive pain lasting for five days. Seven patients had self-limiting bleeding, two patients had post-operative bleeding which was controlled by re-ligation of the bleeding point and one patient developed a perianal fistula. In the long term follow up, one patient had recurrence of prolapse six months after the surgery. \u0000Conclusion: HAL-RAR with doppler was a safe and efficient method for treatment of grade-II, III and IV internal haemorrhoids, with very low post-operative pain scores, satisfactory relief of symptoms, and low recurrence rates. \u0000","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"3 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87195408","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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