Pub Date : 2022-04-30DOI: 10.21649/akemu.v28i1.5007
U. Rabbani, Abdulrhman Aldukhayel, Abdulhamid F. Alresheedi
COVID-19 has been associated with coagulation disorders which add further to the morbidity and mortality caused by the disease itself. Ischemic colitis can result from hypercoagulable states. In this report we present a rare case of ischemic colitis induced by COVID-19 in 27-year-old male. Patient presented with severe generalized abdominal pain. CT abdomen showed filling defects, absent enhancement indicating venous bowel ischemia. CT-angiograph revealed complete thrombosis of portal, splenic, superior and inferior mesenteric veins. Patient was shifted to intensive care unit and kept nothing per orum. He was given Heparin, tramadol and paracetamol intravenously. COVID-19 Reverse transcription–polymerase chain reaction (RT–PCR) was positive. He was then given Favipiravir through nasogastric (NG) tube. On 4th day NG was removed and patient was subsequently discharged on 9th day. COVID-19 may lead to hypercoagulable states and gastrointestinal complications. COVID-19 patients with gastrointestinal symptoms should be evaluated carefully for possible ischemia.
{"title":"Ischemic Colitis induced by COVID-19: A Case Report","authors":"U. Rabbani, Abdulrhman Aldukhayel, Abdulhamid F. Alresheedi","doi":"10.21649/akemu.v28i1.5007","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5007","url":null,"abstract":"COVID-19 has been associated with coagulation disorders which add further to the morbidity and mortality caused by the disease itself. Ischemic colitis can result from hypercoagulable states. In this report we present a rare case of ischemic colitis induced by COVID-19 in 27-year-old male. Patient presented with severe generalized abdominal pain. CT abdomen showed filling defects, absent enhancement indicating venous bowel ischemia. CT-angiograph revealed complete thrombosis of portal, splenic, superior and inferior mesenteric veins. Patient was shifted to intensive care unit and kept nothing per orum. He was given Heparin, tramadol and paracetamol intravenously. COVID-19 Reverse transcription–polymerase chain reaction (RT–PCR) was positive. He was then given Favipiravir through nasogastric (NG) tube. On 4th day NG was removed and patient was subsequently discharged on 9th day. COVID-19 may lead to hypercoagulable states and gastrointestinal complications. COVID-19 patients with gastrointestinal symptoms should be evaluated carefully for possible ischemia.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"27 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73487633","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5018
S. Ijaz, I. Ijaz
Background: COVID-19 pandemic has been effecting the world since December, 2019. Front line healthcare professionals faced increased stress level while dealing with overload of patients. Hence it triggered feelings of loneliness, despair and physical mental fatigue. Objective: To determine the immediate psychological impact of COVID-19 pandemic on mental health of pediatric healthcare workers by using Depression Anxiety Stress scoring scale, DASS-21 scale. Methods: This cross-sectional online survey was conducted from 1st July to 30th November 2020 in the department of Pediatric Medicine Unit II, King Edward Medical University/Mayo Hospital, Lahore. A 21-item Depression Anxiety Stress scoring scale was circulated online among Healthcare workers of Teaching hospitals of Lahore. These included Pediatric Specialists, General Physicians, Postgraduate Trainees in Paeds Medicine, House Officers in Paeds Medicine and Pediatric Nurses. 150 Healthcare workers (HCWs) participated. Responses were analyzed with SPSS V.26. Results: Out of 150 healthcare workers, 101(67.3%) were falling in the range of 20-30 years, 76(50.7%) were females, 81(54%) were singles, maximum 59(39.3%) were postgraduate trainees and majority 65(43.4%) had
{"title":"Immediate Psychological Impact of COVID 19 Pandemic on Mental Health of Pediatric Healthcare Workers","authors":"S. Ijaz, I. Ijaz","doi":"10.21649/akemu.v28i1.5018","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5018","url":null,"abstract":"Background: COVID-19 pandemic has been effecting the world since December, 2019. Front line healthcare professionals faced increased stress level while dealing with overload of patients. Hence it triggered feelings of loneliness, despair and physical mental fatigue. Objective: To determine the immediate psychological impact of COVID-19 pandemic on mental health of pediatric healthcare workers by using Depression Anxiety Stress scoring scale, DASS-21 scale. Methods: This cross-sectional online survey was conducted from 1st July to 30th November 2020 in the department of Pediatric Medicine Unit II, King Edward Medical University/Mayo Hospital, Lahore. A 21-item Depression Anxiety Stress scoring scale was circulated online among Healthcare workers of Teaching hospitals of Lahore. These included Pediatric Specialists, General Physicians, Postgraduate Trainees in Paeds Medicine, House Officers in Paeds Medicine and Pediatric \u0000Nurses. 150 Healthcare workers (HCWs) participated. Responses were analyzed with SPSS V.26. Results: Out of 150 healthcare workers, 101(67.3%) were falling in the range of 20-30 years, 76(50.7%) were females, 81(54%) were singles, maximum 59(39.3%) were postgraduate trainees and majority 65(43.4%) had","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"182 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75707397","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5004
Q. Javaid, F. Kamal, M. Iqbal, Rahat Sarfaraz, Asmaa Qureshy, R. Basharat
Background: Breast carcinoma is the most common malignancy in females associated with high mortality rate. Objective: The purpose of present study was to describe the histological grade and histopathological stage of invasive ductal carcinoma of breast among female patients and to determine the association of tumor size and histological grade withnodal metastasis. Methods: This is an analytical cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from September, 2019 till February, 2020. Female patients of all age groups who were diagnosedwith invasive ductal carcinoma and underwent modified radical mastectomy were included in the study. Tissue processed and Hematoxylin and Eosin staining was performed. All the sections were examined under the light microscope by myself and two other consultant pathologists independently. Histological grading of invasive ductal carcinoma was done by following Modified Scarff Bloom Richardson grading system and histopathological staging was done according to CAP protocols. Results: Total of 60 female patients diagnosed with invasive ductal carcinoma were included in the present study. Mean age of the patient calculated was 48.17± 13.12 years with age range from 26 to 90 years. Size of the tumor ranged from 1cm to 10cm. On microscopy, histological grade III was the most frequent grade (36, 60%). Out of total 60 cases n=43(71.6%) were diagnosed with regional lymph node metastasis and T2N1Mx( 17,38.3%) was the most frequent stage of the tumor. Statistically no significant association of tumor size and histological grade was observed with regional lymph node metastasis (p >0.05).
{"title":"Histopathological Grading and Staging of Invasive Ductal Carcinoma in Modified Radical Mastectomy Specimens","authors":"Q. Javaid, F. Kamal, M. Iqbal, Rahat Sarfaraz, Asmaa Qureshy, R. Basharat","doi":"10.21649/akemu.v28i1.5004","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5004","url":null,"abstract":"Background: Breast carcinoma is the most common malignancy in females associated with high mortality rate. Objective: The purpose of present study was to describe the histological grade and histopathological stage of invasive ductal carcinoma of breast among female patients and to determine the association of tumor size and histological grade withnodal metastasis. Methods: This is an analytical cross sectional study, conducted in the Department of Pathology Fatima Jinnah Medical University Lahore, Pakistan from September, 2019 till February, 2020. Female patients of all age groups who were diagnosedwith invasive ductal carcinoma and underwent modified radical mastectomy were included in the study. Tissue processed and Hematoxylin and Eosin staining was performed. All the sections were examined under the light microscope by myself and two other consultant pathologists independently. Histological grading of invasive ductal carcinoma was done by following Modified Scarff Bloom Richardson grading system and histopathological staging was done according to CAP protocols. Results: Total of 60 female patients diagnosed with invasive ductal carcinoma were included in the present study. Mean age of the patient calculated was 48.17± 13.12 years with age range from 26 to 90 years. Size of the tumor ranged from 1cm to 10cm. On microscopy, histological grade III was the most frequent grade (36, 60%). Out of total 60 cases n=43(71.6%) were diagnosed with regional lymph node metastasis and T2N1Mx( 17,38.3%) was the most frequent stage of the tumor. Statistically no significant association of tumor size and histological grade was observed with regional lymph node metastasis (p >0.05).","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"21 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78722332","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5012
A. Asif, Amna Zia, S. Liaqat, F. Afzal
Background: Adhesive capsulitis is a common disabling and painful condition that causes limitation of both passive and active ranges of shoulder joint. Division of frozen shoulder can be into primary and secondary categories. Different techniques have been devised in physiotherapy to regain limited range of motion in adhesive capsulitis. Objectives: To compare the effects of anterior and posterior grade III Kaltenborn glides on glenohumeral joint for improving external rotation and functional ability in patients with adhesive capsulitis. Material and methods: This randomized controlled trial was conducted in University of Health Sciences, Lahore and 40 patients were recruited from Mayo Hospital, Lahore from 08-10-2019 to 10-02-2020 and divided randomly into two groups. Group A was given anterior glide and Group B was given posterior glide. Treatment was given for 4 weeks, 3 sessions in each week. Outcomes were measured in terms of external rotation and functional status of shoulder from Goniometry and SPADI scale. Results: Comparison of External rotation and SPADI score of group A (Anterior glider) and group B (posterior glide) has shown that both groups were similar at baseline (p>0.05 for all variables) but post-treatment mean external rotation range in group A was 36.50 ± 7.72 while in group B was 52.80 ± 7.14, with the P value
{"title":"Comparison of Anterior and Posterior Kaltenborn Grade III Glide on Glenohumeral Joint for Improving External Rotation in Adhesive Capsulitis (Frozen Shoulder)","authors":"A. Asif, Amna Zia, S. Liaqat, F. Afzal","doi":"10.21649/akemu.v28i1.5012","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5012","url":null,"abstract":"Background: Adhesive capsulitis is a common disabling and painful condition that causes limitation of both passive and active ranges of shoulder joint. Division of frozen shoulder can be into primary and secondary categories. Different techniques have been devised in physiotherapy to regain limited range of motion in adhesive capsulitis. Objectives: To compare the effects of anterior and posterior grade III Kaltenborn glides on glenohumeral joint for improving external rotation and functional ability in patients with adhesive capsulitis. Material and methods: This randomized controlled trial was conducted in University of Health Sciences, Lahore and 40 patients were recruited from Mayo Hospital, Lahore from 08-10-2019 to 10-02-2020 and divided randomly into two groups. Group A was given anterior glide and Group B was given posterior glide. Treatment was given for 4 weeks, 3 sessions in each week. Outcomes were measured in terms of external rotation and functional status of shoulder from Goniometry and SPADI scale. Results: Comparison of External rotation and SPADI score of group A (Anterior glider) and group B (posterior glide) has shown that both groups were similar at baseline (p>0.05 for all variables) but post-treatment mean external rotation range in group A was 36.50 ± 7.72 while in group B was 52.80 ± 7.14, with the P value","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"15 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78132717","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.4993
Zubaida Rashid, Mommana Ali Rathore, I. Khushk, Syed Fawad Mashhadi, Moneeba Ahmed, Muhammad Shahzeb
Background: Researchers have discovered a vicious loop of increased physical health concerns and online medical information seeking known as "cyberchondria," despite the benefits of widely accessible medical information on the Internet. Despite proposed theoretical models of cyberchondria, research on risk factors for the development ofcyberchondria is lacking in our setup. Anxiety sensitivity and intolerance of uncertainty are two potential risk factors.Objective: This study was conducted to determine the frequency of health related internet researches i.e cyberchondria and to locate and find association between the resultant health anxiety and intolerance of uncertainty among the medical andnon-medical students of different institutions of Islamabad and Rawalpindi. Methods: A cross-sectional study was conducted on a total of 300 students of medical and engineering universities between ages of 18 and 25 from October 2019 to March 2020 by using Cyberchondria Severity Scale, intolerance of uncertainty scale and anxiety sensitivity index scale questionnaires as data collection tool. Data collected was statistically analyzed by SPSSversion-22. Results: Out of 300 participants, 169 (56.3%) students were found positive for cyberchondria and 131 (43.7%) were found negative and majority of the positive participants were medical students. Results revealed significant association between intolerance of uncertainty (0.567, p < 0.000) as well as Anxiety sensitivity (0.805, p < 0.000) and cyberchondria among the medical and non-medical students of Islamabad and Rawalpindi.Conclusions: The current study's findings show that both Anxiety sensitivity and intolerance of uncertainty may have a role in the development of cyberchondria especially in medical students.
{"title":"Intolerance of Uncertainty and Anxiety Sensitivity as Prospective Risk Factors for Cyberchondria in Undergraduate Students","authors":"Zubaida Rashid, Mommana Ali Rathore, I. Khushk, Syed Fawad Mashhadi, Moneeba Ahmed, Muhammad Shahzeb","doi":"10.21649/akemu.v28i1.4993","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.4993","url":null,"abstract":"Background: Researchers have discovered a vicious loop of increased physical health concerns and online medical information seeking known as \"cyberchondria,\" despite the benefits of widely accessible medical information on the Internet. Despite proposed theoretical models of cyberchondria, research on risk factors for the development ofcyberchondria is lacking in our setup. Anxiety sensitivity and intolerance of uncertainty are two potential risk factors.Objective: This study was conducted to determine the frequency of health related internet researches i.e cyberchondria and to locate and find association between the resultant health anxiety and intolerance of uncertainty among the medical andnon-medical students of different institutions of Islamabad and Rawalpindi. Methods: A cross-sectional study was conducted on a total of 300 students of medical and engineering universities between ages of 18 and 25 from October 2019 to March 2020 by using Cyberchondria Severity Scale, intolerance of uncertainty scale and anxiety sensitivity index scale questionnaires as data collection tool. Data collected was statistically analyzed by SPSSversion-22. Results: Out of 300 participants, 169 (56.3%) students were found positive for cyberchondria and 131 (43.7%) were found negative and majority of the positive participants were medical students. Results revealed significant association between intolerance of uncertainty (0.567, p < 0.000) as well as Anxiety sensitivity (0.805, p < 0.000) and cyberchondria among the medical and non-medical students of Islamabad and Rawalpindi.Conclusions: The current study's findings show that both Anxiety sensitivity and intolerance of uncertainty may have a role in the development of cyberchondria especially in medical students. ","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"38 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85707430","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5003
R. Ahmed, Jamshed Akhtar, Naima Zamir, S. Taqvi, Safia Bibi
Background: Parental feedback is important for improving quality of the surgical services provided.Objective: This study was conducted to assess the level of satisfaction of parents with the day-care surgical services so as to find out where improvement is needed. Methods: This was an observational cross sectional study conducted in the Department of Pediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University Karachi from September 2019 to April 2020. The parents of the children who underwent different day-care surgical procedures were included. A validated Parent Satisfaction Scale (PSS) which consist of 11-items was used. The responses were made according to Likert scale. Three groups of satisfied, undecided and unsatisfied study participants were made according to the scores obtained. The socio-demographic variables including age of parents and children, level of education, and income group were compared amongst study groups. Results: Total of 114 parents participated. The most common procedure performed was inguinal herniotomy (n=59). Seven (6%) patients were brought back after discharge due to pain. Eighty-seven (76.30%) parents were satisfied with the services provided while 18 (15.8%) were unsatisfied and 9 (7.9%) undecided. A significant difference in the satisfaction level of the study participants noted with respect to the mean age of parents (p=0.039), level of education (p< 0.001) and income groups (p< 0.001). Conclusion: Majority of the study participants were satisfied with the surgical services provided. Lack of respect given by the hospital staff and delay in getting treatment were the main reasons for dissatisfaction. Socio-demographic characteristics of the study participants were significantly associated with the level of satisfaction.
{"title":"Assessment of Parental Satisfaction with Day-Care Surgical Services in a Tertiary Level Pediatric Hospital","authors":"R. Ahmed, Jamshed Akhtar, Naima Zamir, S. Taqvi, Safia Bibi","doi":"10.21649/akemu.v28i1.5003","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5003","url":null,"abstract":"Background: Parental feedback is important for improving quality of the surgical services provided.Objective: This study was conducted to assess the level of satisfaction of parents with the day-care surgical services so as to find out where improvement is needed. Methods: This was an observational cross sectional study conducted in the Department of Pediatric Surgery, National Institute of Child Health, Jinnah Sindh Medical University Karachi from September 2019 to April 2020. The parents of the children who underwent different day-care surgical procedures were included. A validated Parent Satisfaction Scale (PSS) which consist of 11-items was used. The responses were made according to Likert scale. Three groups of satisfied, undecided and unsatisfied study participants were made according to the scores obtained. The socio-demographic variables including age of parents and children, level of education, and income group were compared amongst study groups. Results: Total of 114 parents participated. The most common procedure performed was inguinal herniotomy (n=59). Seven (6%) patients were brought back after discharge due to pain. Eighty-seven (76.30%) parents were satisfied with the services provided while 18 (15.8%) were unsatisfied and 9 (7.9%) undecided. A significant difference in the satisfaction level of the study participants noted with respect to the mean age of parents (p=0.039), level of education (p< 0.001) and income groups (p< 0.001). Conclusion: Majority of the study participants were satisfied with the surgical services provided. Lack of respect given by the hospital staff and delay in getting treatment were the main reasons for dissatisfaction. Socio-demographic characteristics of the study participants were significantly associated with the level of satisfaction.","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"167 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87670911","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.4989
S. Afzal, Amber Arshad
"Health systems" (also called "health care systems" and "healthcare systems") are organizations that provide health care services to target populations by integrating people, institutions, and resources. A health care system is nothing more than a collection of interdependent pieces and their relationships. People, organizations, and behaviors whose primary goal is to promote, restore, or maintain health are part of a "health system." This system relies on the interdependence of its various components. Numerous components that make up a health care system, like patients, families, communities, health departments, health care professionals, and organizations responsible for funding health care are just a few examples. The duties and functions of each component are intertwined. WHO proposes supporting and building a health care system based on the following framework, the Six Health System Building Blocks? It is possible to produce more equitable and long-lasting gains in health services and outcomes by enhancing the six components of the health system and 1 managing their interrelationships .
{"title":"System within System: World Health Organization Building Blocks and Public-Private Partnership in Healthcare sector of Pakistan","authors":"S. Afzal, Amber Arshad","doi":"10.21649/akemu.v28i1.4989","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.4989","url":null,"abstract":"\"Health systems\" (also called \"health care systems\" and \"healthcare systems\") are organizations that provide health care services to target populations by integrating \u0000people, institutions, and resources. A health care system is nothing more than a collection of interdependent pieces and their relationships. People, organizations, \u0000and behaviors whose primary goal is to promote, restore, or maintain health are part of a \"health system.\" This system relies on the interdependence of its various \u0000components. Numerous components that make up a health care system, like patients, families, communities, health departments, health care professionals, and \u0000organizations responsible for funding health care are just a few examples. The duties and functions of each component are intertwined. WHO proposes supporting \u0000and building a health care system based on the following framework, the Six Health System Building Blocks? It is possible to produce more equitable and long-lasting gains in health services and outcomes by enhancing the six components of the health system and 1 managing their interrelationships .","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"6 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78039037","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5014
K. Junaid, S. Muzaffar, R. Nazim, Amber Arshad, Amjad Khan, Hina Zubair
Background: Despite the availability of antiretroviral therapy (ART), HIV is still responsible for substantial illness and death, especially in developing countries. Early start of treatment (ART) is associated with better therapeutic outcome, reduced transmissibility of HIV, reduction in loss to follow-up, and remarkably reduced death rate. Objectives: To find out the factors associated with early and late Initiation of ART among patients affected by HIV in Lahore, Pakistan Methods: From November 2017 to April 2018, researchers conducted an analytical cross-sectional study on 156 HIV patients aged 18 and older that began antiretroviral therapy (ART) at Jinnah & Mayo Hospital, Lahore's HIV clinics. Samples were selected by non-probability convenience sampling and Univariate and multivariate analyses were performed to assess factors related to early and late Initiation of ART. The p-value of less than
{"title":"Factors Associated with Early and Late Initiation of Antiretroviral Therapy among People Living with Human Immunodeficiency Virus in Lahore, Pakistan","authors":"K. Junaid, S. Muzaffar, R. Nazim, Amber Arshad, Amjad Khan, Hina Zubair","doi":"10.21649/akemu.v28i1.5014","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5014","url":null,"abstract":"Background: Despite the availability of antiretroviral therapy (ART), HIV is still responsible for substantial illness and death, especially in developing countries. Early start of treatment (ART) is associated with better therapeutic outcome, reduced transmissibility of HIV, reduction in loss to follow-up, and remarkably reduced death rate. Objectives: To find out the factors associated with early and late Initiation of ART among patients affected by HIV in Lahore, Pakistan Methods: From November 2017 to April 2018, researchers conducted an analytical cross-sectional study on 156 HIV patients aged 18 and older that began antiretroviral therapy (ART) at Jinnah & Mayo Hospital, Lahore's HIV clinics. Samples were selected by non-probability convenience sampling and Univariate and multivariate analyses were performed to assess factors related to early and late Initiation of ART. The p-value of less than","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"62 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80491489","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.4992
Nawaz Rashid, Aliya Noreen, I. H. Dogar, A. Mansoor, K. Hashmi, Fareeha Nawaz
Background: Computed tomography virtual laryngoscopy (CTVL) is favored diagnostic tool in detecting laryngeal carcinoma because it delivers excellent temporal and spatial resolution. Objective: To determine the positive predictive value of computed tomography virtual laryngoscopy in detecting laryngeal carcinoma taking histopathology as gold standard. Methods: A cross sectional survey was conducted at department of Radiology, Mayo Hospital Lahore. The completion of study was done in six months [Feb 16, 2019 till Aug 16, 2019]. After obtaining approval from ethical committee and informed consent from subjects, 64 subjects were included in the study who presented in the Department of the Radiology having carcinoma of larynx on CTVL and then sent to department of ENT of mayo hospital, where they underwent direct laryngoscopy and afterwards biopsy obtained sent to the department of histopathology. All the subjects undergoing CT scan examination on the CT machine of hospital. Contrast injection was given to all subjects undergoing CT scan, through power injector at the rate of 4ml per min and dosage of 0.1ml/kg. Same machine was used to conduct all CT scans and was inferred through same radiologist and all the histopathology was performed by same pathologist to exclude bias. Results: The mean age of patients was 44.38 ± 9.57 years with minimum and maximum age as 22 and 60 years. There were 47(73.4%) male and 17(26.6%) female cases. On histopathology the laryngeal carcinoma was diagnosed in 56(87.5%) of the cases while it was negative in 8(12.5%) of the cases. On CT the laryngeal carcinoma was diagnosed in 59(92.2%) of the cases while it was negative in 5(7.8%) of the cases. The Positive Predictive Value of CT was 89.83%, while its sensitivity was 94.64%, specificity was 25.00%, negative predictive value was 40.00% and diagnostic accuracy was 85.94%. Conclusion: Through the findings of this study it is concluded that positive predictive value of computed tomography virtual laryngoscopy is high (89.83%) in detecting laryngeal carcinoma taking histopathology as gold standard. CT is a precise and non-invasive imaging method in detecting laryngeal carcinoma.
{"title":"Positive Predictive Value of Computed Tomography Virtual Laryngoscopy in Detecting Laryngeal Carcinoma Taking Histopathology as Gold Standard","authors":"Nawaz Rashid, Aliya Noreen, I. H. Dogar, A. Mansoor, K. Hashmi, Fareeha Nawaz","doi":"10.21649/akemu.v28i1.4992","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.4992","url":null,"abstract":"Background: Computed tomography virtual laryngoscopy (CTVL) is favored diagnostic tool in detecting laryngeal carcinoma because it delivers excellent temporal and spatial resolution. Objective: To determine the positive predictive value of computed tomography virtual laryngoscopy in detecting laryngeal carcinoma taking histopathology as gold standard. Methods: A cross sectional survey was conducted at department of Radiology, Mayo Hospital Lahore. The completion of study was done in six months [Feb 16, 2019 till Aug 16, 2019]. After obtaining approval from ethical committee and informed consent from subjects, 64 subjects were included in the study who presented in the Department of the Radiology having carcinoma of larynx on CTVL and then sent to department of ENT of mayo hospital, where they underwent direct laryngoscopy and afterwards biopsy obtained sent to the department of histopathology. All the subjects undergoing CT scan examination on the CT machine of hospital. Contrast injection was given to all subjects undergoing CT scan, through power injector at the rate of 4ml per min and dosage of 0.1ml/kg. Same machine was used to conduct all CT scans and was inferred through same radiologist and all the histopathology was performed by same pathologist to exclude bias. Results: The mean age of patients was 44.38 ± 9.57 years with minimum and maximum age as 22 and 60 years. There were 47(73.4%) male and 17(26.6%) female cases. On histopathology the laryngeal carcinoma was diagnosed in 56(87.5%) of the cases while it was negative in 8(12.5%) of the cases. On CT the laryngeal carcinoma was diagnosed in 59(92.2%) of the cases while it was negative in 5(7.8%) of the cases. The Positive Predictive Value of CT was 89.83%, while its sensitivity was 94.64%, specificity was 25.00%, negative predictive value was 40.00% and diagnostic accuracy was 85.94%. Conclusion: Through the findings of this study it is concluded that positive predictive value of computed tomography virtual laryngoscopy is high (89.83%) in detecting laryngeal carcinoma taking histopathology as gold standard. CT is a precise and non-invasive imaging method in detecting laryngeal carcinoma. ","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"78 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84082013","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 : 2022-04-30DOI: 10.21649/akemu.v28i1.5005
Muhammad Khawar Saeed, Asadullah Khan kakar, A. Z. K. Chachar, Afshan Khanum, H. Khan
Background: Vitamin D deficiency is a global public health problem. Vitamin D deficiency is linked to a number of non skeletal major chronic diseases like cardiovascular disease.Objectives: To determine the frequency of vitamin D deficiency in patients presenting with ST segment elevated myocardial infarction. Methods: During the study period, 150 patients fulfilling the selection criteria of ST segment elevation Myocardial infarction were included in this study. A blood sample for 25-hydroxyl vitamin D level was drawn for each patient. Vitamin D deficiency was defined as less than or equal to 20g/dl. Vitamin D deficiency was stratified with demographics such as age, gender, and Comorbids such as smoking and Diabetes. Results: The mean age of the patients was 51.6±6.7 years. There were 80 (53.3%) male and 70 (46.7%) female patients. There were 52 (34.7%) smokers and 55 (36.7%) patients had diabetes mellitus as Comorbids. The mean serum vitamin D level was 23.46±0.82 ng/ml. Sixty-four patients (49.3%) had vitamin D deficiency with levels below 20ngml, while another 46(30.6%) had insufficient Vitamin D levels in ranges of 21-30ng/ml. There was no association of age, gender, smoking or Diabetes history with vitamin D deficiency (p value >90.05 for all these variables). Conclusion: Vitamin D deficiency is present in over half of patients with ST elevated Myocardial infarction. Only 20% of patients with acute myocardial infarction had normal vitamin D values, with remaining having insufficient levels. The deficiency was not associated with gender, age, or comorbidity such as smoking or Diabetes.
{"title":"Vitamin D Deficiency in Acute Myocardial Infarction and its Association with Diabetes","authors":"Muhammad Khawar Saeed, Asadullah Khan kakar, A. Z. K. Chachar, Afshan Khanum, H. Khan","doi":"10.21649/akemu.v28i1.5005","DOIUrl":"https://doi.org/10.21649/akemu.v28i1.5005","url":null,"abstract":"Background: Vitamin D deficiency is a global public health problem. Vitamin D deficiency is linked to a number of non skeletal major chronic diseases like cardiovascular disease.Objectives: To determine the frequency of vitamin D deficiency in patients presenting with ST segment elevated myocardial infarction. Methods: During the study period, 150 patients fulfilling the selection criteria of ST segment elevation Myocardial infarction were included in this study. A blood sample for 25-hydroxyl vitamin D level was drawn for each patient. Vitamin D deficiency was defined as less than or equal to 20g/dl. Vitamin D deficiency was stratified with demographics such as age, gender, and Comorbids such as smoking and Diabetes. Results: The mean age of the patients was 51.6±6.7 years. There were 80 (53.3%) male and 70 (46.7%) female patients. There were 52 (34.7%) smokers and 55 (36.7%) patients had diabetes mellitus as Comorbids. The mean serum vitamin D level was 23.46±0.82 ng/ml. Sixty-four patients (49.3%) had vitamin D deficiency with levels below 20ngml, while another 46(30.6%) had insufficient Vitamin D levels in ranges of 21-30ng/ml. There was no association of age, gender, smoking or Diabetes history with vitamin D deficiency (p value >90.05 for all these variables). Conclusion: Vitamin D deficiency is present in over half of patients with ST elevated Myocardial infarction. Only 20% of patients with acute myocardial infarction had normal vitamin D values, with remaining having insufficient levels. The deficiency was not associated with gender, age, or comorbidity such as smoking or Diabetes. ","PeriodicalId":43918,"journal":{"name":"Annals of King Edward Medical University Lahore Pakistan","volume":"30 1","pages":""},"PeriodicalIF":0.4,"publicationDate":"2022-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75832554","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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