Pub Date : 2023-07-04DOI: 10.21649/akemu.v29i1.5335
S. Afzal, M. Nasir
NGOs, or non-governmental organizations, are a kind of non-profit private sector provider of the health system. Global health issues include health inequity. Inequity exists in healthcare, vaccinations, and research for developing nations. There are disparities in healthcare access even between nations. NGOs typically focus on underprivileged groups or specific diseases that the government sector frequently ignores. But maintaining financial stability is a significant problem for NGOs. Donors account for the majority of an NGO's funding. The availability of health care can be expanded through NGOs. By 2030, the World Health Organization hopes to have universal health coverage.
{"title":"Role of Non-Governmental Organizations as Developmental Partners in Health Care","authors":"S. Afzal, M. Nasir","doi":"10.21649/akemu.v29i1.5335","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5335","url":null,"abstract":"NGOs, or non-governmental organizations, are a kind of non-profit private sector provider of the health system. Global health issues include health inequity. Inequity exists in healthcare, vaccinations, and research for developing nations. There are disparities \u0000in healthcare access even between nations. NGOs typically focus on underprivileged groups or specific diseases that the government sector frequently ignores. But maintaining financial stability is a significant problem for NGOs. Donors account for the majority of an NGO's funding. The availability of health care can be expanded through NGOs. By 2030, the World Health Organization hopes to have \u0000universal health coverage.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"8 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90570169","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 : 2023-07-04DOI: 10.21649/akemu.v29i1.5354
Fakiha Bukhari, H. H. Ahmed, Kanwal Irshad, M. Jamaluddin
Bochdalek hernia results due to failure of pleuroperitoneal membranes to fuse completely before birth, resulting in a defect in left posterior diaphragm through which abdominal organs can herniate into thorax. It is a congenital condition and is common in infants and children. It is rarely present in adults. We present a case of a twenty five year old adult male presenting with a 2 day history of sharp epigastric and left hypochondriac pain and 1 month history of non-bloody, non-projectile vomiting. An X-ray Abdomen was done showing signs of small bowel obstruction (SBO) with eventration of diaphragm and mediastinal shift. Upon surgical approach, a Bochdalek hernia defect was seen in left posterolateral diaphragm. Patient was successfully treated with laparotomy and mesh repair without any perioperative and postoperative complications.
{"title":"An Adult Male with Bochdalek Hernia– A Case Report","authors":"Fakiha Bukhari, H. H. Ahmed, Kanwal Irshad, M. Jamaluddin","doi":"10.21649/akemu.v29i1.5354","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5354","url":null,"abstract":"Bochdalek hernia results due to failure of pleuroperitoneal membranes to fuse completely before birth, resulting in a defect in left posterior diaphragm through which abdominal organs can herniate into thorax. It is a congenital condition and is common in infants and children. It is rarely present in adults. We present a case of a twenty five year old adult male presenting with a 2 day history of sharp epigastric and left hypochondriac pain and 1 month history of non-bloody, non-projectile vomiting. An X-ray Abdomen was done showing signs of small bowel obstruction (SBO) with eventration of diaphragm and mediastinal shift. Upon surgical approach, a Bochdalek hernia defect was seen in left posterolateral diaphragm. Patient was successfully treated with laparotomy and mesh repair without any perioperative and postoperative complications.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"210 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85511252","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 : 2023-07-04DOI: 10.21649/akemu.v29i1.5395
M. Qamar, Ayesha Basharat, Qurba Kiran, A. Nazir, Waqas Ahmad, Shahnai Basharat
Abstract Background: Rotator cuff tendinitis and shoulder impingement are regarded as the frequent intrinsic reasons for shoulder discomfort and disability. Objective: A study was conducted to compare the effects of conventional physical therapy and progressive overload training in patients with shoulder impingement syndrome. Methods: Thirty patients with shoulder impingement syndrome were included. These patients were randomised into two groups. One group received structured, progressive resistance training, and the other received conventional therapy. The intervention group participants participated in progressive resistance training three days per week for six weeks. The numeric pain rating scale was used to assess pain intensity and the range of motion measured by the goniometer. The statistical package for social sciences (SPSS), version 21 for Windows, was used for data analysis. An independent t-test was used to compare the effects between the two groups. Result: Out of 30 participants, there were twenty-four females and six males. The mean age of the participants was 44±5.1 years. Participants from the intervention group had better pain control (P < 0.05) and improved range of motion (P < 0.05) compared to the control group. Conclusion: We conclude in this group of patients, progressive overload training was more effective in alleviating pain and improving the range of motion in patients with shoulder impingement syndrome.
摘要背景:肩袖肌腱炎和肩部撞击被认为是导致肩部不适和残疾的常见内在原因。目的:比较常规物理治疗与进行性负荷训练对肩撞击综合征患者的治疗效果。方法:选取30例肩撞击综合征患者。这些患者被随机分为两组。一组接受有组织的渐进式阻力训练，另一组接受常规治疗。干预组的参与者参加了为期六周的渐进式阻力训练，每周三天。数值疼痛评定量表用于评估疼痛强度和关节计测量的活动范围。使用社会科学统计软件包(SPSS)， version 21 for Windows，进行数据分析。采用独立t检验比较两组间的效果。结果:30名参与者中，女性24人，男性6人。参与者平均年龄44±5.1岁。与对照组相比，干预组患者疼痛控制性较好(P < 0.05)，活动度改善(P < 0.05)。结论:在本组患者中，渐进式负荷训练能更有效地缓解肩撞击综合征患者的疼痛并改善其活动范围。
{"title":"Comparison of the Effects of Conventional Physical Therapy Versus Progressive Overload Training in Patients with Shoulder Impingement Syndrome; A Randomised Clinical Trial","authors":"M. Qamar, Ayesha Basharat, Qurba Kiran, A. Nazir, Waqas Ahmad, Shahnai Basharat","doi":"10.21649/akemu.v29i1.5395","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5395","url":null,"abstract":"Abstract Background: Rotator cuff tendinitis and shoulder impingement are regarded as the frequent intrinsic reasons for shoulder discomfort and disability. Objective: A study was conducted to compare the effects of conventional physical therapy and progressive overload training in patients with shoulder impingement syndrome. Methods: Thirty patients with shoulder impingement syndrome were included. These patients were randomised into two groups. One group received structured, progressive resistance training, and the other received conventional therapy. The intervention group participants participated in progressive resistance training three days per week for six weeks. The numeric pain rating scale was used to assess pain intensity and the range of motion measured by the goniometer. The statistical package for social sciences (SPSS), version 21 for Windows, was used for data analysis. An independent t-test was used to compare the effects between the two groups. Result: Out of 30 participants, there were twenty-four females and six males. The mean age of the participants was 44±5.1 years. Participants from the intervention group had better pain control (P < 0.05) and improved range of motion (P < 0.05) compared to the control group. Conclusion: We conclude in this group of patients, progressive overload training was more effective in alleviating pain and improving the range of motion in patients with shoulder impingement syndrome.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"1997 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90460088","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 : 2023-07-04DOI: 10.21649/akemu.v29i1.5408
S. Zareen, Waqas Ahmad, M. Younus, S. Mursalin, Muhammad Asif, M. A. Naeem, Muhammad Kamran
Background: Rabies is a neglected and underestimated national public health issue in Pakistan. Freeroaming dogs are the principal reservoir and also potentially cause thousands of dog bite injuries in different age groups of people. Objectives: The present study was designed to evaluate the burden and frequency distribution of total dog bite injuries in Punjab. The comparison of total dog bite injuries between 2019 and 2020 were made to understand whether there is significant difference in total number of dog bite injuries in 2019 and 2020. Methods: Total dog bite data from public sector hospitals of Punjab province were collected for the time period between January 2019 to December 2020 with the help of District Health Information System (DHIS) which is a comprehensively designed digital program. Descriptive measures and the graphical representation were used to describe and interpret the said data. A non-parametric test (Mann-Whitney test) was used to compare the median number of dog bite injuries in 2019 to 2020. Results: Results show that more than 0.2 million number of dog bite injuries have been recorded in 2019 and 2020. The medium number of the dog bite injuries in 2019 and 2020 were statistically significant, having pvalue
{"title":"Analysis of Reported Dog Bite Data in Government Hospitals of Various Districts in Punjab, Pakistan","authors":"S. Zareen, Waqas Ahmad, M. Younus, S. Mursalin, Muhammad Asif, M. A. Naeem, Muhammad Kamran","doi":"10.21649/akemu.v29i1.5408","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5408","url":null,"abstract":"Background: Rabies is a neglected and underestimated national public health issue in Pakistan. Freeroaming dogs are the principal reservoir and also potentially cause thousands of dog bite injuries in different age groups of people. Objectives: The present study was designed to evaluate the burden and frequency distribution of total dog bite injuries in Punjab. The comparison of total dog bite injuries between 2019 and 2020 were made to understand whether there is significant difference in total number of dog bite injuries in 2019 and 2020. Methods: Total dog bite data from public sector hospitals of Punjab province were collected for the time period between January 2019 to December 2020 with the help of District Health Information System (DHIS) which is a comprehensively designed digital program. Descriptive measures and the graphical representation were used to describe and interpret the said data. A non-parametric test (Mann-Whitney test) was used to compare the median number of dog bite injuries in 2019 to 2020. Results: Results show that more than 0.2 million number of dog bite injuries have been recorded in 2019 and 2020. The medium number of the dog bite injuries in 2019 and 2020 were statistically significant, having pvalue","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"1 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79807214","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 : 2023-07-04DOI: 10.21649/akemu.v29i1.5348
Anum Haider
Background: Physical health is incomplete without mental health; despite this fact Psychiatric teaching and training of medical health professionals is an undermined area especially in developing countries like Pakistan. This study is aimed to determine the impact of knowledge, attitude and perception towards Psychiatry and also possible change in the career choice of medical graduates (house job interns) of public sector hospital of Karachi after doing internship in Psychiatry Methods: This Quasi experimental study was conducted in 40 medical graduates house job interns who were doing 12 weeks internship in Psychiatry department of Dow Medical College & Dr Ruth K.M.Pfau Civil Hospital Karachi from April 2020 to March 2021 on quarterly basis. A Self synthesized pretested questionnaire was employed twice at pre internship and post internship levels and two semi structured questions were also administered to qualitatively compare their responses. SPSS-19 was applied to statistically analyze the result and paired sample t-test was used to compare both pre and post internship scores Results: There was found statistically significant impact of psychiatric internship on medical graduates (preinternship; M=52.2, SD=10.8 and post internship M=60.6, SD=8.3); t(39)=-4.6,p=
背景:没有心理健康，身体健康是不完整的;尽管如此，医疗保健专业人员的精神病学教学和培训是一个受到破坏的领域，特别是在巴基斯坦等发展中国家。本研究旨在探讨卡拉奇公立医院医学毕业生(实习医师)在精神病学实习后，对精神病学的知识、态度和认知的影响，以及对职业选择的可能改变。本准实验研究于2020年4月至2021年3月以季度为基础，对40名在陶氏医学院精神科和Ruth K.M.Pfau博士卡拉奇民用医院进行为期12周实习的医学毕业生实习进行了研究。在实习前和实习后的水平上采用了两次自我合成的预测试问卷，并使用了两个半结构化问题来定性比较他们的回答。应用SPSS-19对结果进行统计分析，采用配对样本t检验比较实习前后得分。结果:精神科实习对医学毕业生的影响有统计学意义(实习前;M=52.2, SD=10.8，实习后M=60.6, SD=8.3);t (39) = -4.6, p =
{"title":"Impact of Psychiatric Internship on Medical Graduates: Quasi Experimental Study","authors":"Anum Haider","doi":"10.21649/akemu.v29i1.5348","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5348","url":null,"abstract":"Background: Physical health is incomplete without mental health; despite this fact Psychiatric teaching and training of medical health professionals is an undermined area especially in developing countries like Pakistan. This study is aimed to determine the impact of knowledge, attitude and perception towards Psychiatry and also possible change in the career choice of medical graduates (house job interns) of public sector hospital of Karachi after doing internship in Psychiatry Methods: This Quasi experimental study was conducted in 40 medical graduates house job interns who were doing 12 weeks internship in Psychiatry department of Dow Medical College & Dr Ruth K.M.Pfau Civil Hospital Karachi from April 2020 to March 2021 on quarterly basis. A Self synthesized pretested questionnaire was employed twice at pre internship and post internship levels and two semi structured questions were also administered to qualitatively compare their responses. SPSS-19 was applied to \u0000statistically analyze the result and paired sample t-test was used to compare both pre and post internship scores Results: There was found statistically significant impact of psychiatric internship on medical graduates (preinternship; M=52.2, SD=10.8 and post internship M=60.6, SD=8.3); t(39)=-4.6,p=","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"4 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76369168","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 : 2023-04-04DOI: 10.21649/akemu.v29i1.5357
U. Malik, S. Munir, Muhammad Umer Mukhtar, Z. Kamal, S. Iftikhar
Cerebral venous sinus thrombosis is a rare disorder characterized by thrombosis in the venous channels of the brain. Nonspecific symptoms such as headache, focal neurologic deficits and seizures make this condition difficult to diagnose. We describe a case of cerebral venous thrombosis in the sigmoid and transverse sinuses which presented as reversible, rapid-onset proptosis and loss of vision in a patient of subclinical hypothyroidism. Such an occurrence of proptosis due to thrombosis of the sigmoid and transverse sinuses has never been reported in literature. The diagnosis of cerebral venous thrombosis in this patient was arrived at in a stepwise fashion. Thus, this case in addition to reporting a novel finding, stresses by example, the importance of acute suspicion on part of the physician for timely diagnosis and treatment of this eluding yet reversible disease.
{"title":"Transverse and Sigmoid Venous Thrombosis Presenting as Proptosis and Acute Loss of Vision: An Unreported Association","authors":"U. Malik, S. Munir, Muhammad Umer Mukhtar, Z. Kamal, S. Iftikhar","doi":"10.21649/akemu.v29i1.5357","DOIUrl":"https://doi.org/10.21649/akemu.v29i1.5357","url":null,"abstract":"Cerebral venous sinus thrombosis is a rare disorder characterized by thrombosis in the venous channels of the brain. Nonspecific symptoms such as headache, focal neurologic deficits and seizures make this condition difficult to diagnose. We describe a case of cerebral venous thrombosis in the sigmoid and transverse sinuses which presented as reversible, rapid-onset proptosis and loss of vision in a patient of subclinical hypothyroidism. Such an occurrence of proptosis due to thrombosis of the sigmoid and transverse sinuses has never been reported in literature. The diagnosis of cerebral venous thrombosis in this patient was arrived at in a stepwise fashion. \u0000Thus, this case in addition to reporting a novel finding, stresses by example, the importance of acute suspicion on part of the physician for timely diagnosis and treatment of this eluding yet reversible disease.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"86 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83757320","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 : 2023-02-25DOI: 10.21649/akemu.v28i4.5309
M. Nasir, Rubeena Zakar
Hospitals need to maintain a high level of preparedness of staff and systems to mitigate the consequences of health emergencies and disasters. Therefore, the knowledge, attitude and practices of the hospital staff are of key importance in strengthening the emergency preparedness of the health system. Objective: The objective of this study was to determine the knowledge, attitudes and practices of healthcare workers regarding emergency preparedness and factors related to them, at the tertiary care hospitals of Punjab Pakistan Methods: This was an analytical cross-sectional study conducted at six tertiary care hospitals in Punjab from February 2022 to August 2022, approved by advanced studies and the research board of the University of Punjab. A self-administered questionnaire was distributed among 450 staff members of these hospitals to identify gaps in the knowledge, reported attitudes and practices of healthcare workers and their willingness to report for duty, selected by multistage sampling. Data were analysed by statistical package for social sciences (SPSS) Version 22. Results: The results found that 49.8% of the participants were aware of disasters that occurred, 50% knew the hospital emergency plan, and 70% agreed that hospitals need written plans yet 72.4% were not aware of the major components of the plan. Regarding attitude of the staff, 73.8% of accepted that it is their duty to take care of patients, 33.6% thought that hospital preparedness is adequate and only 36.7% agreed that the hospital had adequate staff in catering for the increased patient influx. Regarding hospital preparedness practices, only 29.3% stated that hospital conducts exercises and drills and 30.4% reported that the hospital conducts other training sessions and workshops for staff. Conclusion: The majority of the staff at the studied hospitals had a positive attitudes and willingness to report for duties in case of health emergencies. But there were lacks in the knowledge and practices at these hospitals which needs to be addressed by making a written hospital emergency plan, conducting simulation drills and mock exercises and arranging training.
{"title":"Assessment of Knowledge, Reported Attitudes and Practices Regarding Emergency Preparedness and Related Factors at Tertiary-Care Hospitals of Punjab Province Amid COVID-19 Pandemic","authors":"M. Nasir, Rubeena Zakar","doi":"10.21649/akemu.v28i4.5309","DOIUrl":"https://doi.org/10.21649/akemu.v28i4.5309","url":null,"abstract":"Hospitals need to maintain a high level of preparedness of staff and systems to mitigate the consequences of health emergencies and disasters. Therefore, the knowledge, attitude and practices of the hospital staff are of key importance in strengthening the emergency preparedness of the health system. Objective: The objective of this study was to determine the knowledge, attitudes and practices of healthcare workers regarding emergency preparedness and factors related to them, at the tertiary care hospitals of Punjab Pakistan \u0000Methods: This was an analytical cross-sectional study conducted at six tertiary care hospitals in Punjab from February 2022 to August 2022, approved by advanced studies and the research board of the University of Punjab. A self-administered questionnaire was distributed among 450 staff members of these hospitals to identify gaps in the knowledge, reported attitudes and practices of healthcare workers and their willingness to report for duty, selected by multistage sampling. Data were analysed by statistical package for social sciences (SPSS) Version 22. Results: The results found that 49.8% of the participants were aware of disasters that occurred, 50% knew \u0000the hospital emergency plan, and 70% agreed that hospitals need written plans yet 72.4% were not aware of the major components of the plan. Regarding attitude of the staff, 73.8% of accepted that it is their duty to take care of patients, 33.6% thought that hospital preparedness is adequate and only 36.7% agreed that the hospital had adequate staff in catering for the increased patient influx. Regarding hospital preparedness practices, only 29.3% stated that hospital conducts exercises and drills and 30.4% reported that the hospital conducts other training sessions and workshops for staff. Conclusion: The majority of the staff at the studied hospitals had a positive attitudes and willingness to report for duties in case of health emergencies. But there were lacks in the knowledge and practices at these hospitals which needs to be addressed by making a written hospital emergency plan, conducting simulation drills and mock exercises and arranging training.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"32 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81156202","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 : 2023-02-25DOI: 10.21649/akemu.v28i4.5312
Lonim Dixita, Hyder M Khurshid, E. Tarin
Objective: To determine the trends in the prevalence of non-communicable diseases associated risk factors and implications for policies and strategies. Background: Non-Communicable Diseases (NCDs) contribute increasingly to disease burden in Nepal. The main drivers to this situation are the NCD related risk factors; and to determine their prevalence the Nepal Ministry of Health and Population conducted WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) surveys in 2007, 2012 and 2019. This paper, by using results of STEPS surveys, explores the trends of NCD related risk factors and their implications for policies and strategies. Methods: This paper relies on the desk review of literature and secondary data, collected from the unpublished grey literature, mainly reports of the STEPS surveys. In addition, to corroborate findings, the evidence and experience from other countries available as published literature was brought. The data were analysed manually. Findings: Overall, during the period from first survey in 2007 to the last survey in 2019, there has been an increasing prevalence of NCDs associated lifestyle and behavioural, physical, and biochemical risk factors. Taking cognisance of these, several policies, and strategic documents, some of which generic, while others targeting the specific risk factors were produced. However, indicators and techniques used, across three STEPS surveys, were not consistent, thus limiting the comparison and analysis of data. Conclusions: The study concludes that different STEPS surveys did not use standard set of indicators and techniques. Yet, an increased prevalence of NCDs associated risk factors was noted. Several policies and strategic documents, generic as well as specific, were produced. But there is a need to define methodology, as to how results feed into the framing of policies and strategic, and their impact is monitored.
{"title":"Risk Factors Associated with Non-Communicable Diseases: Trends and Policy Implications in Nepal","authors":"Lonim Dixita, Hyder M Khurshid, E. Tarin","doi":"10.21649/akemu.v28i4.5312","DOIUrl":"https://doi.org/10.21649/akemu.v28i4.5312","url":null,"abstract":"Objective: To determine the trends in the prevalence of non-communicable diseases associated risk factors and implications for policies and strategies. Background: Non-Communicable Diseases (NCDs) contribute increasingly to disease burden in Nepal. The main drivers to this situation are the NCD related risk factors; and to determine their prevalence the Nepal Ministry of Health and Population conducted WHO Stepwise Approach to NCD Risk Factor Surveillance (STEPS) surveys in 2007, 2012 and 2019. This paper, by using results of STEPS surveys, explores the trends of NCD related risk factors and their implications for policies and strategies. Methods: This paper relies on the desk review of literature and secondary data, collected from the unpublished grey literature, mainly reports of the STEPS surveys. In addition, to corroborate findings, the evidence and experience from other countries available as published literature was brought. The data were analysed manually. Findings: Overall, during the period from first survey in 2007 to the last survey in 2019, there has been an \u0000increasing prevalence of NCDs associated lifestyle and behavioural, physical, and biochemical risk factors. Taking cognisance of these, several policies, and strategic documents, some of which generic, while others targeting the specific risk factors were produced. However, indicators and techniques used, across three STEPS surveys, were not consistent, thus limiting the comparison and analysis of data. \u0000Conclusions: The study concludes that different STEPS surveys did not use standard set of indicators and techniques. Yet, an increased prevalence of NCDs associated risk factors was noted. Several policies and strategic documents, generic as well as specific, were produced. But there is a need to define methodology, as to how results feed into the framing of policies and strategic, and their impact is monitored.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"35 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85626079","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 : 2023-02-25DOI: 10.21649/akemu.v28i4.5308
A. Aleem, Shahid Sarwar, Yasir Mahmud
Background: Pancreatitis is a potentially fatal complication of ERCP, seen in 5-15% procedures. Factors precipitating its risk and effective pharmacological intervention for its prevention need exploration to improve patient safety. Objective: To identify risk factors for post-ERCP pancreatitis (PEP) and to determine efficacy of intravenous octreotide in preventing PEP. Methodology: A quasi-experimental triple blind placebo-based study included patients undergoing ERCP and randomize them in two groups through simple random sampling. Group A to receive intravenous Octreotide 4μg/kg before attempting cannulation during ERCP and 1cc N/S as placebo for group B. Patients were followed for PEP and data were analyzed using chi square (x2) and logistic regression analysis. Results: Of 203 included patients, 101 (49.3%) received octreotide while 102 (50.7%) were in control group. Post ERCP pancreatitis developed in 32 (15.8%) patients, in 8 (7.9%) patients of octreotide group while in 24 (23.8%) patients of control group (p value 0.002 with odds ratio (OR) for octreotide of 0.33 (95% CI 0.15- 0.71). We identified biliary surgery (p value 0.005), serum bilirubin ≥ 3 mg/dl (p value 0.03), cannulation time > 5 minutes (p value 5 minutes, use of needle knife, PD cannulation and procedure time > 30 minutes are associated with increased risk of PEP. Intravenous octreotide before cannulation reduces risk of post ERCP pancreatitis.
{"title":"Risk Factors for Post Endoscopic Retrograde Cholangio Pancreatography(ERCP) Pancreatitis (PEP) and Efficacy of Octreotide in its Prevention","authors":"A. Aleem, Shahid Sarwar, Yasir Mahmud","doi":"10.21649/akemu.v28i4.5308","DOIUrl":"https://doi.org/10.21649/akemu.v28i4.5308","url":null,"abstract":"Background: Pancreatitis is a potentially fatal complication of ERCP, seen in 5-15% procedures. Factors precipitating its risk and effective pharmacological intervention for its prevention need exploration to improve patient safety. Objective: To identify risk factors for post-ERCP pancreatitis (PEP) and to determine efficacy of intravenous octreotide in preventing PEP. Methodology: A quasi-experimental triple blind placebo-based study included patients undergoing ERCP and randomize them in two groups through simple random sampling. Group A to receive intravenous Octreotide 4μg/kg before attempting cannulation during ERCP and 1cc N/S as placebo for group B. Patients were followed for PEP and data were analyzed using chi square (x2) and logistic regression analysis. Results: Of 203 included patients, 101 (49.3%) received octreotide while 102 (50.7%) were in control group. Post ERCP pancreatitis developed in 32 (15.8%) patients, in 8 (7.9%) patients of octreotide group while in 24 (23.8%) patients of control group (p value 0.002 with odds ratio (OR) for octreotide of 0.33 (95% CI 0.15- 0.71). We identified biliary surgery (p value 0.005), serum bilirubin ≥ 3 mg/dl (p value 0.03), cannulation \u0000time > 5 minutes (p value 5 minutes, use of needle knife, PD cannulation and procedure time > 30 minutes are associated with increased risk of PEP. Intravenous octreotide before cannulation reduces risk of post ERCP pancreatitis.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"39 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90251916","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 : 2023-02-25DOI: 10.21649/akemu.v28i4.5250
Fatima Naumeri
Background: There is scarcity of literature about factors affecting reflective practices in local context. By focusing on these factors, we can help promote engagement in reflective practices in our culture. Objective of this study was to explore the barriers to and facilitators of reflective practice by post graduate surgical residents. Methods: Using action research study design, qualitative research was conducted in the department of Pediatric Surgery, Mayo Hospital to explore different factors affecting reflective practice in postgraduate surgical residents in their daily practice. A workshop on reflective practices was conducted, followed by weekly morbidity/mortality meetings and case-based discussions deliberating using Gibbs' reflective cycle. After a year, focus group discussion using a heterogenous group of nine residents was conducted to explore the factors affecting reflective practice. It was transcribed and analyzed thematically. Results: Reflective practice was perceived to improve critical appraisal, deeper learning, self-monitoring, and patients' outcomes. There was resistance towards reflective writing. Themes related to factors affecting reflective practice were organization, time allocation, communication, workplace environment, interpersonal relations, guided reflection, and feedback. Involvement of multiple disciplines in 'reflection before action' was identified for future implementation. Conclusion: Provision of guided reflection and constructive feedback were the main facilitators of reflective practice. Generally, improving organization, workplace environment, interpersonal relations, and accommodating individual learning styles can enhance reflective practice in our context, and help developing habit of lifelong learning.
{"title":"Reflective Practice and Factors Affecting it: Perceptions of Pediatric Surgery Residents","authors":"Fatima Naumeri","doi":"10.21649/akemu.v28i4.5250","DOIUrl":"https://doi.org/10.21649/akemu.v28i4.5250","url":null,"abstract":"Background: There is scarcity of literature about factors affecting reflective practices in local context. By focusing on these factors, we can help promote engagement in reflective practices in our culture. Objective of this study was to explore the barriers to and facilitators of reflective practice by post graduate surgical residents. Methods: Using action research study design, qualitative research was conducted in the department of Pediatric Surgery, Mayo Hospital to explore different factors affecting reflective practice in postgraduate surgical residents in their daily practice. A workshop on reflective practices was conducted, followed by weekly morbidity/mortality meetings and case-based discussions deliberating using Gibbs' reflective cycle. After a year, focus group discussion using a heterogenous group of nine residents was conducted to explore the factors affecting reflective practice. It was transcribed and analyzed thematically. Results: Reflective practice was perceived to improve critical appraisal, deeper learning, self-monitoring, and patients' outcomes. There was resistance towards reflective writing. Themes related to factors affecting reflective practice were organization, time allocation, communication, workplace environment, interpersonal relations, guided reflection, and feedback. Involvement of multiple disciplines in 'reflection before action' was identified for future implementation. Conclusion: Provision of guided reflection and constructive feedback were the main facilitators of reflective practice. Generally, improving organization, workplace environment, interpersonal relations, and accommodating individual learning styles can enhance reflective practice in our context, and help developing habit of lifelong learning.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"63 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2023-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82184161","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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