Pub Date : 2022-03-31DOI: 10.46903/gjms/20.01.1094
Waseem Ahmad, Saqibah Rehman, M. Aamir, Dastgeer Waheed
Background: All patients with chronic renal failure need vascular access for hemodialysis that is possible with CVP line but it can be retained for only 02-03weeks due to infection. The most suitable and effective vascular access on long term basis is the creation of arteriovenous fistula (AVF). The objective of this study was to compare the patency rate of Radiocephalic vs Brachiocephalic AVFs in population of D.I.Khan division, Pakistan. Materials & Methods: This randomized controlled trail was conducted in the surgical unit at District Headquarter Teaching Hospital D.I.Khan, Pakistan from January 2017 to January 2020. Two hundred and sixty six patients were randomly allocated by toss method into two groups, one for Brachiocephalic AVF (BCAVF) and second for Radiocephalic AVF (RCAVF). Sex & patency rates were our nominal while age grouping was our ordinal variable. The data for the sample was described by count & percentages & was analyzed for the population as confidence interval at 80% confidence level. McNemar chi-square test was used to test hypothesis to compare the patency rate of Brachiocephalic AVF vs. Radiocephalic AVF at alpha 0.05 with Yates continuity correction using online statistical calculator. Results: The patency was present in 129 (97%, 80% CI 94.45-98.39%) cases & absent in 4 (3%, 80% CI 1.61-5.55%) cases in Brachiocephalic AVF group while it was present in 107 (80.5%, 80% CI 76.04-84.86%) cases & absent in 26 (19.5%, 80% CI 15.52-24.32%) cases in Radiocephalic AVF group. McNemar chi-square test showed p-value of <.0001 (less than alpha). So, the null hypothesis was rejected, showing significant difference between two groups. Conclusion: Brachiocephalic AVF creation is more ideal in terms of patency and maturation as compare to Radiocephalic AVF because of increased vessel diameter and increased arterial pressure at proximal site below elbow joint.
背景:所有慢性肾衰竭患者都需要血管通路进行血液透析，这是CVP系的可能，但由于感染，只能保留02-03周。最合适和有效的长期血管通路是建立动静脉瘘(AVF)。本研究的目的是比较巴基斯坦dii khan地区人群中放射性头型和臂头型avf的通畅率。材料与方法:该随机对照试验于2017年1月至2020年1月在巴基斯坦dii khan区总部教学医院外科进行。采用抛掷法将266例患者随机分为头臂性AVF (BCAVF)组和桡头性AVF (RCAVF)组。性别和通畅率是我们的名义变量，而年龄分组是我们的顺序变量。样本的数据用计数和百分比来描述，并以80%置信水平的置信区间对总体进行分析。采用McNemar卡方检验检验假设，在alpha 0.05下比较头臂部AVF与桡头部AVF的通畅率，并使用在线统计计算器进行Yates连续性校正。结果:头臂型AVF组有129例(97%，80% CI 94.45 ~ 98.39%)通畅，无4例(3%，80% CI 1.61 ~ 5.55%)通畅;放射性头头型AVF组有107例(80.5%，80% CI 76.04 ~ 84.86%)通畅，无26例(19.5%，80% CI 15.52 ~ 24.32%)通畅。McNemar卡方检验显示p值< 0.0001(小于)。因此，零假设被拒绝，两组之间存在显著性差异。结论:由于肘关节以下近端血管直径增大，动脉压增高，头臂侧AVF的通畅和成熟程度较头桡侧AVF更理想。
{"title":"PATENCY RATE OF BRACHIOCEPHALIC VS RADIOCEPHALIC AVF IN CHRONIC KIDNEY DISEASE PATIENTS IN POPULATION OF D.I.KHAN DIVISION, PAKISTAN","authors":"Waseem Ahmad, Saqibah Rehman, M. Aamir, Dastgeer Waheed","doi":"10.46903/gjms/20.01.1094","DOIUrl":"https://doi.org/10.46903/gjms/20.01.1094","url":null,"abstract":"Background: All patients with chronic renal failure need vascular access for hemodialysis that is possible with CVP line but it can be retained for only 02-03weeks due to infection. The most suitable and effective vascular access on long term basis is the creation of arteriovenous fistula (AVF). The objective of this study was to compare the patency rate of Radiocephalic vs Brachiocephalic AVFs in population of D.I.Khan division, Pakistan.\u0000\u0000Materials & Methods: This randomized controlled trail was conducted in the surgical unit at District Headquarter Teaching Hospital D.I.Khan, Pakistan from January 2017 to January 2020. Two hundred and sixty six patients were randomly allocated by toss method into two groups, one for Brachiocephalic AVF (BCAVF) and second for Radiocephalic AVF (RCAVF). Sex & patency rates were our nominal while age grouping was our ordinal variable. The data for the sample was described by count & percentages & was analyzed for the population as confidence interval at 80% confidence level. McNemar chi-square test was used to test hypothesis to compare the patency rate of Brachiocephalic AVF vs. Radiocephalic AVF at alpha 0.05 with Yates continuity correction using online statistical calculator.\u0000\u0000Results: The patency was present in 129 (97%, 80% CI 94.45-98.39%) cases & absent in 4 (3%, 80% CI 1.61-5.55%) cases in Brachiocephalic AVF group while it was present in 107 (80.5%, 80% CI 76.04-84.86%) cases & absent in 26 (19.5%, 80% CI 15.52-24.32%) cases in Radiocephalic AVF group. McNemar chi-square test showed p-value of <.0001 (less than alpha). So, the null hypothesis was rejected, showing significant difference between two groups.\u0000\u0000Conclusion: Brachiocephalic AVF creation is more ideal in terms of patency and maturation as compare to Radiocephalic AVF because of increased vessel diameter and increased arterial pressure at proximal site below elbow joint.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42282384","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 : 2022-03-31DOI: 10.46903/gjms/20.01.1075
G. Meena, Mashal Afridi, A. Shah, Aatikah Javaid, Muhammad Saood, Syed Suleman Shah
Background: Research has shown that cranial base length, flexure and inclination play a role in the skeletal malocclusion in sagittal and vertical dimensions. The objectives of this study were to compare the two cranial base lengths and four angles among three sagittal skeletal bases in adult population of district Peshawar, Pakistan. Material & Methods: This cross-sectional study was conducted in the Department of Orthodontics, Khyber College of Dentistry, Peshawar, Pakistan from February 2020 to March, 2020. Ninety lateral cephalograms were selected for the year 2019 from the database of department, with 30 from each group; Skeletal Class I, II and III. SN length (mm), SBa length (mm), N-S-Ba, N-S-Ar, SN-FH and SBa-FH were our ratio variables and were described by mean, range and SD with 95% CI for mean. Twelve hypotheses were tested each by one-way ANOVA and when it showed significant difference, then by post hoc Dunnett’s t test. Results: Results: The sample included 90 cephalograms; 30 each in Class I, II and III, including 38 men and 52 women with mean age 22.54±5.70 years. SN length (mm) was similar in Class II 68.1±2.15 and Class III 68.7±2.01 to Class I (control) 68.4±1.56 (p=.487). SBa length was similar in Class II 45.5±2.48 and Class III 44.9±2.23 to Class I 44.6±1.76 (p=.281). N-S-Ba angle was similar in Class II 126.7o±2.26 and Class III 127.3o±2.70 to Class I 127.1o±2.22 (p=.614). N-S-Ar angle was significantly greater (p<.0001) in Class II 128.2o±2.45 than Class I 123.3o±1.97, and significantly greater (p=.030) in Class III 124.6o±1.70 than Class I. SN-FH angle was similar (p=.193) in Class II 7.9o±1.32 to Class I 7.4o±1.40 and similar (p=.356) in Class III 7.0o±0.94 to Class I. SBa-FH angle was similar in Class II 57.3o±2.19 and Class III 56.8o±1.45 to Class I 56.1o±1.90 (p=.058). Conclusions: Anterior cranial base length (SN length), posterior cranial base length (SBa length), N-S-Ba angle, SN-FH angle and SBa-FH angle were similar in Skeletal Class II to Class I and in Class III to Class I. N-S-Ar angle was greater in Skeletal Class II than Class I and in Class III than Class 1.
{"title":"COMPARISON OF TWO CRANIAL BASE LENGTHS AND FOUR ANGLES AMONG THREE SAGITTAL SKELETAL BASES IN ADULT POPULATION OF DISTRICT PESHAWAR, PAKISTAN","authors":"G. Meena, Mashal Afridi, A. Shah, Aatikah Javaid, Muhammad Saood, Syed Suleman Shah","doi":"10.46903/gjms/20.01.1075","DOIUrl":"https://doi.org/10.46903/gjms/20.01.1075","url":null,"abstract":"Background: Research has shown that cranial base length, flexure and inclination play a role in the skeletal malocclusion in sagittal and vertical dimensions. The objectives of this study were to compare the two cranial base lengths and four angles among three sagittal skeletal bases in adult population of district Peshawar, Pakistan.\u0000\u0000Material & Methods: This cross-sectional study was conducted in the Department of Orthodontics, Khyber College of Dentistry, Peshawar, Pakistan from February 2020 to March, 2020. Ninety lateral cephalograms were selected for the year 2019 from the database of department, with 30 from each group; Skeletal Class I, II and III. SN length (mm), SBa length (mm), N-S-Ba, N-S-Ar, SN-FH and SBa-FH were our ratio variables and were described by mean, range and SD with 95% CI for mean. Twelve hypotheses were tested each by one-way ANOVA and when it showed significant difference, then by post hoc Dunnett’s t test.\u0000\u0000Results: Results: The sample included 90 cephalograms; 30 each in Class I, II and III, including 38 men and 52 women with mean age 22.54±5.70 years. SN length (mm) was similar in Class II 68.1±2.15 and Class III 68.7±2.01 to Class I (control) 68.4±1.56 (p=.487). SBa length was similar in Class II 45.5±2.48 and Class III 44.9±2.23 to Class I 44.6±1.76 (p=.281). N-S-Ba angle was similar in Class II 126.7o±2.26 and Class III 127.3o±2.70 to Class I 127.1o±2.22 (p=.614). N-S-Ar angle was significantly greater (p<.0001) in Class II 128.2o±2.45 than Class I 123.3o±1.97, and significantly greater (p=.030) in Class III 124.6o±1.70 than Class I. SN-FH angle was similar (p=.193) in Class II 7.9o±1.32 to Class I 7.4o±1.40 and similar (p=.356) in Class III 7.0o±0.94 to Class I. SBa-FH angle was similar in Class II 57.3o±2.19 and Class III 56.8o±1.45 to Class I 56.1o±1.90 (p=.058).\u0000\u0000Conclusions: Anterior cranial base length (SN length), posterior cranial base length (SBa length), N-S-Ba angle, SN-FH angle and SBa-FH angle were similar in Skeletal Class II to Class I and in Class III to Class I. N-S-Ar angle was greater in Skeletal Class II than Class I and in Class III than Class 1.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42694979","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 : 2022-03-27DOI: 10.46903/gjms/20.01.1026
M. Shahzadi, Muhammad Bilal
Cancer is a fatal hereditary illness produced by an unexpected alteration in genes that has the destructive potential to degrade healthy human cells in a healthy individual. This disease is distinguished by an uncommon molecular alteration that promotes unregulated cell proliferation in the human body, which can quickly spread to other sites in the body. Several variables can cause cancer in humans; these factors might be biological or environmental. Cancer-causing agents are found in biological elements such as viruses, parasites, bacteria, and protozoans, which are responsible for producing carcinogenic agents in human healthy cells. They are also referred to as cancer cell promoters. Carcinogenic agents are those that contribute to the growth of abnormal cells and the eventual death of healthy cells, a condition known as carcinogenesis.
{"title":"CAN A LETHAL PARASITE BE LIFE SAVOR FOR CANCER PATIENTS?","authors":"M. Shahzadi, Muhammad Bilal","doi":"10.46903/gjms/20.01.1026","DOIUrl":"https://doi.org/10.46903/gjms/20.01.1026","url":null,"abstract":"Cancer is a fatal hereditary illness produced by an unexpected alteration in genes that has the destructive potential to degrade healthy human cells in a healthy individual. This disease is distinguished by an uncommon molecular alteration that promotes unregulated cell proliferation in the human body, which can quickly spread to other sites in the body. Several variables can cause cancer in humans; these factors might be biological or environmental. Cancer-causing agents are found in biological elements such as viruses, parasites, bacteria, and protozoans, which are responsible for producing carcinogenic agents in human healthy cells. They are also referred to as cancer cell promoters. Carcinogenic agents are those that contribute to the growth of abnormal cells and the eventual death of healthy cells, a condition known as carcinogenesis.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45534607","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 : 2022-01-18DOI: 10.46903/gjms/19.04.1047
Arvindh Manohar, Periyasamy Manimekalai
ABSTRACTAmong patients with malignancy affecting organs like uterus, breast, stomach, lungs or lymphomas, Sarcoid-like granulomas can often occur. Some tumours like Hodgkin's and non Hodgkin lymphoma have shown such reactions. In parallel, HL is widely distorted by cell-mediated immunity, so immunodeficiency can lead to infections, mainly viral infections due to Epstein-Barr virus, herpes, cytomegalovirus and species of Mycobacterium infections like Tuberculosis could manifest
{"title":"MIMICKING LYMPHADENOPATHY","authors":"Arvindh Manohar, Periyasamy Manimekalai","doi":"10.46903/gjms/19.04.1047","DOIUrl":"https://doi.org/10.46903/gjms/19.04.1047","url":null,"abstract":"ABSTRACTAmong patients with malignancy affecting organs like uterus, breast, stomach, lungs or lymphomas, Sarcoid-like granulomas can often occur. Some tumours like Hodgkin's and non Hodgkin lymphoma have shown such reactions. In parallel, HL is widely distorted by cell-mediated immunity, so immunodeficiency can lead to infections, mainly viral infections due to Epstein-Barr virus, herpes, cytomegalovirus and species of Mycobacterium infections like Tuberculosis could manifest","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46528404","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 : 2022-01-18DOI: 10.46903/gjms/19.04.1050
Manimekalai Periyasamy, P. D. Bharathi, M. C. Vinatha
Systemic lupus erythematosus (SLE) is an autoimmune condition, affecting multiple organs and tissues by autoantibodies and immune complexes. Hematologic manifestations of SLE include anemia, thrombocytopenia and leukopenia. The most common type of anemia seen in SLE is anemia of chronic disease. Thrombotic microangiopathic hemolytic anemia (TMHA) in SLE is very rare. Incidence of TMHA in children with SLE is common compared to adult cases of SLE. Manifestations of TMHA include presence of schistocytes in the peripheral smear, elevated bilirubin levels, elevated LDH and negative coombs test. This case report focuses on 25-year-old female diagnosed concomitantly with SLE and TMHA, and treated with steroids, blood transfusions, megakaryocyte growth factors and antibiotics.
{"title":"THROMBOTIC MICROANGIOPATHIC HEMOLYTIC ANEMIA IN SYSTEMIC LUPUS ERYTHEMATOSUS IN A 25 YEARS OLD FEMALE IN CHENNAI, INDIA","authors":"Manimekalai Periyasamy, P. D. Bharathi, M. C. Vinatha","doi":"10.46903/gjms/19.04.1050","DOIUrl":"https://doi.org/10.46903/gjms/19.04.1050","url":null,"abstract":"Systemic lupus erythematosus (SLE) is an autoimmune condition, affecting multiple organs and tissues by autoantibodies and immune complexes. Hematologic manifestations of SLE include anemia, thrombocytopenia and leukopenia. The most common type of anemia seen in SLE is anemia of chronic disease. Thrombotic microangiopathic hemolytic anemia (TMHA) in SLE is very rare. Incidence of TMHA in children with SLE is common compared to adult cases of SLE. Manifestations of TMHA include presence of schistocytes in the peripheral smear, elevated bilirubin levels, elevated LDH and negative coombs test. This case report focuses on 25-year-old female diagnosed concomitantly with SLE and TMHA, and treated with steroids, blood transfusions, megakaryocyte growth factors and antibiotics.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49557543","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 : 2022-01-18DOI: 10.46903/gjms/19.04.1024
Taimoor Hassan, S. Saeed, Sidrah Naseem, Fiza Saleem
The 2019 Coronavirus disease is a public health emergency of international concern (PHEIC). COVID-19 causes acute respiratory distress syndrome (ARDS) in certain individuals. In such individuals, non-invasive and invasive ventilation methods are used to treat acute respiratory distress syndrome. Non-invasive ventilation approaches must be used initially before introducing intrusive mechanical ventilation techniques. Non-invasive methods used in the therapy of COVID -19 associated acute respiratory syndrome include high-flow nasal cannula, bi-level positive air pressure (BiPAP), and helmet ventilation. Before employing any of these non-invasive methods, the risk of viral aerosol transmission to healthcare and paramedical personnel must be considered. When non-invasive procedures are used, the load on hospital ventilatory equipment can be reduced. If at all possible, avoid intubating the patient too soon. The clinical appearance of the patient, as well as vital indicators such as oxygen saturation and respiratory rate, must be evaluated on a frequent basis in order to determine whether the patient requires ventilation. In COVID-19 patients, the judicious application of non-invasive and invasive breathing methods can minimize the risk of death from acute respiratory distress syndrome.
{"title":"INTENSIVE CARE UNIT MANAGEMENT OF SARS-COV-2 PATIENTS: A NARRATIVE REVIEW","authors":"Taimoor Hassan, S. Saeed, Sidrah Naseem, Fiza Saleem","doi":"10.46903/gjms/19.04.1024","DOIUrl":"https://doi.org/10.46903/gjms/19.04.1024","url":null,"abstract":"The 2019 Coronavirus disease is a public health emergency of international concern (PHEIC). COVID-19 causes acute respiratory distress syndrome (ARDS) in certain individuals. In such individuals, non-invasive and invasive ventilation methods are used to treat acute respiratory distress syndrome. Non-invasive ventilation approaches must be used initially before introducing intrusive mechanical ventilation techniques. Non-invasive methods used in the therapy of COVID -19 associated acute respiratory syndrome include high-flow nasal cannula, bi-level positive air pressure (BiPAP), and helmet ventilation. Before employing any of these non-invasive methods, the risk of viral aerosol transmission to healthcare and paramedical personnel must be considered. When non-invasive procedures are used, the load on hospital ventilatory equipment can be reduced. If at all possible, avoid intubating the patient too soon. The clinical appearance of the patient, as well as vital indicators such as oxygen saturation and respiratory rate, must be evaluated on a frequent basis in order to determine whether the patient requires ventilation. In COVID-19 patients, the judicious application of non-invasive and invasive breathing methods can minimize the risk of death from acute respiratory distress syndrome.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43554054","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}
M. Seerwan, Ghazi Khan, M. Ilyas, Dastgeer Waheed, Atta Ur Rehman, Fawad Humayun
Background: Urolithiasis is the third common disease of the urinary tract after UTIs and pathological diseases of the prostate. The objective of this study was to compare the efficacy of doxazosin versus tamsulosin in lower ureteric stone expulsion in adult population of District Dera Ismail Khan, Pakistan.Materials Methods: This non-randomized control trial was conducted in the Department of Urology, Gomal Medical College, Dera Ismail Khan, Pakistan from February 2020 to December 2020. The 252 patients included in our study were divided in to two groups. The patients in experimental group received Tab. doxazosin 4 mg daily for 4 weeks and Tab. diclofenac sodium 50 mg B.D for 5 days and then on need basis. The patients in control group received Cap. tamsulosin 0.4 mg daily for 4 weeks and similarly Tab. diclofenac sodium 50 mg as in experimental group. All the patients were followed regularly for expulsion of ureteric stones for four weeks. Sex, age and stone size were matching, while stone expulsion was a research variable. Hypothesis was verified by McNemar chi-square test.Results: Out of 252 patients, 113 (89.68%) patients in experimental group, while 77 (61.11%) patients in control group passed the stones. There was statistically significant difference in efficacy in doxazosin group as compared to tamsulosin group (p-value=.0001).Conclusion: The use of doxazosin as the medical expulsion therapy for the lower ureteric stone proved to be more effective as compared to tamsulosin as demonstrated by our results.
{"title":"EFFICACY OF DOXAZOSIN VERSUS TAMSULOSIN IN LOWER URETERIC STONE EXPULSION IN ADULT POPULATION OF DISTRICT DERA ISMAIL KHAN, PAKISTAN","authors":"M. Seerwan, Ghazi Khan, M. Ilyas, Dastgeer Waheed, Atta Ur Rehman, Fawad Humayun","doi":"10.46903/gjms/19.04.942","DOIUrl":"https://doi.org/10.46903/gjms/19.04.942","url":null,"abstract":"Background: Urolithiasis is the third common disease of the urinary tract after UTIs and pathological diseases of the prostate. The objective of this study was to compare the efficacy of doxazosin versus tamsulosin in lower ureteric stone expulsion in adult population of District Dera Ismail Khan, Pakistan.Materials Methods: This non-randomized control trial was conducted in the Department of Urology, Gomal Medical College, Dera Ismail Khan, Pakistan from February 2020 to December 2020. The 252 patients included in our study were divided in to two groups. The patients in experimental group received Tab. doxazosin 4 mg daily for 4 weeks and Tab. diclofenac sodium 50 mg B.D for 5 days and then on need basis. The patients in control group received Cap. tamsulosin 0.4 mg daily for 4 weeks and similarly Tab. diclofenac sodium 50 mg as in experimental group. All the patients were followed regularly for expulsion of ureteric stones for four weeks. Sex, age and stone size were matching, while stone expulsion was a research variable. Hypothesis was verified by McNemar chi-square test.Results: Out of 252 patients, 113 (89.68%) patients in experimental group, while 77 (61.11%) patients in control group passed the stones. There was statistically significant difference in efficacy in doxazosin group as compared to tamsulosin group (p-value=.0001).Conclusion: The use of doxazosin as the medical expulsion therapy for the lower ureteric stone proved to be more effective as compared to tamsulosin as demonstrated by our results.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"70653947","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 : 2022-01-18DOI: 10.46903/gjms/19.04.1031
Kalathil Gopalakrishna Pillai Gopikrishnan, Kalaivanan Naveen Chandher, S. Jagadeeswari
Congenital malaria isn’t common even though malaria is endemic in India. Here, we will be reporting about a neonate of age seven days with splenomegaly and fever diagnosed as congenital malaria. On smear study it was found to have malarial parasite incidentally. In a case of neonatal sepsis congenital malaria can be suspected. Early diagnosis and treatment is thus important in preventing neonatal mortality.
{"title":"CONGENITAL MALARIA IN A NEONATE","authors":"Kalathil Gopalakrishna Pillai Gopikrishnan, Kalaivanan Naveen Chandher, S. Jagadeeswari","doi":"10.46903/gjms/19.04.1031","DOIUrl":"https://doi.org/10.46903/gjms/19.04.1031","url":null,"abstract":"Congenital malaria isn’t common even though malaria is endemic in India. Here, we will be reporting about a neonate of age seven days with splenomegaly and fever diagnosed as congenital malaria. On smear study it was found to have malarial parasite incidentally. In a case of neonatal sepsis congenital malaria can be suspected. Early diagnosis and treatment is thus important in preventing neonatal mortality.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48663689","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}
Fawad Humayun, G. Mujtaba, M. Seerwan, Ghazi Khan, N. Javed, Muhammad Adnan
Background: Urinary stone disease is one of the commonest urological diseases worldwide. The objective of this study was to compare the efficacy of alfuzosin versus control group in upper ureteric stone expulsion in adult population of district Lahore, Pakistan.Materials Methods: This trial was conducted in Department of Urology, Sheikh Zayed Hospital, Lahore, Pakistan form January 2017 to June 2017. All adult patients with upper ureteric stone size 5-10 mm were eligible. Those with multiple stones, having fever, severe pain, history of surgery in past two weeks and growth on urine culture or pyuria were excluded. Experimental and control groups each had 30 patients. Experimental group received Tab. alfuzosin 10 mg daily for four weeks and Tab. diclofenac sodium 50 mg SOS for acute pain. The control group received Tab. diclofenac sodium 50 mg SOS for acute pain. We followed all patients for four weeks for expulsion of ureteric stones by X-ray KUB or CT KUB. Sex, age and stone size were matching variables. Stone expulsion (yes, no) was research variable. We compared count of stone expulsion between two groups by using McNemar chi-square test at alpha 0.5 using GraphPad.Results: Out of 30 patients in experimental group, 23 (76.67%) were men and seven (23.33%) women and out of 30 in control group, 20 (66.67%) were men and 10 (33.33%) women, almost similar in both groups. Mean age in experimental group was 39.45±10.33 years and in control group it was 37.38±8.28 years, almost similar in both groups. Mean stone size was 7.45±1.47 (5-10) mm in the experimental and 7.28±1.68 (5-10) mm in control group, being comparable in both the groups. In experimental group, stone expulsion was achieved in 23 (76.67%) cases and not in seven (23.33%) cases and in control group, it was achieved in 16 (53.33%) cases and not in 14 (46.67%) cases. There was statistically no significant difference in efficacy of alfuzosin versus control group (p=.1213).Conclusion: Our study showed no difference in efficacy of alfuzosin versus control group for upper ureteric stone expulsion in adult population of district Lahore, Pakistan.
{"title":"EFFICACY OF ALFUZOSIN VERSUS CONTROL GROUP IN UPPER URETERIC STONE EXPULSION IN ADULT POPULATION OF LAHORE, PAKISTAN","authors":"Fawad Humayun, G. Mujtaba, M. Seerwan, Ghazi Khan, N. Javed, Muhammad Adnan","doi":"10.46903/gjms/19.04.904","DOIUrl":"https://doi.org/10.46903/gjms/19.04.904","url":null,"abstract":"Background: Urinary stone disease is one of the commonest urological diseases worldwide. The objective of this study was to compare the efficacy of alfuzosin versus control group in upper ureteric stone expulsion in adult population of district Lahore, Pakistan.Materials Methods: This trial was conducted in Department of Urology, Sheikh Zayed Hospital, Lahore, Pakistan form January 2017 to June 2017. All adult patients with upper ureteric stone size 5-10 mm were eligible. Those with multiple stones, having fever, severe pain, history of surgery in past two weeks and growth on urine culture or pyuria were excluded. Experimental and control groups each had 30 patients. Experimental group received Tab. alfuzosin 10 mg daily for four weeks and Tab. diclofenac sodium 50 mg SOS for acute pain. The control group received Tab. diclofenac sodium 50 mg SOS for acute pain. We followed all patients for four weeks for expulsion of ureteric stones by X-ray KUB or CT KUB. Sex, age and stone size were matching variables. Stone expulsion (yes, no) was research variable. We compared count of stone expulsion between two groups by using McNemar chi-square test at alpha 0.5 using GraphPad.Results: Out of 30 patients in experimental group, 23 (76.67%) were men and seven (23.33%) women and out of 30 in control group, 20 (66.67%) were men and 10 (33.33%) women, almost similar in both groups. Mean age in experimental group was 39.45±10.33 years and in control group it was 37.38±8.28 years, almost similar in both groups. Mean stone size was 7.45±1.47 (5-10) mm in the experimental and 7.28±1.68 (5-10) mm in control group, being comparable in both the groups. In experimental group, stone expulsion was achieved in 23 (76.67%) cases and not in seven (23.33%) cases and in control group, it was achieved in 16 (53.33%) cases and not in 14 (46.67%) cases. There was statistically no significant difference in efficacy of alfuzosin versus control group (p=.1213).Conclusion: Our study showed no difference in efficacy of alfuzosin versus control group for upper ureteric stone expulsion in adult population of district Lahore, Pakistan.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42893105","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 : 2022-01-18DOI: 10.46903/gjms.19.04.1039
Ams Kumar, Subramaniam Suresh Kanna, Dinesh Babu
Scrub typhus is an insect-borne disease caused by Orientia sutsugamushi which may cause disseminated vasculitis and perivascular inflammatory lesions resulting in significant vascular leakage and cause end organ damage. Scrub typhus can lead to severe complications such as acute respiratory distress syndrome (ARDS), myocarditis, hepatitis and meningoencephalitis. Some unusual presentations of scrub typhus are peritonitis, gastric ulceration, duodenal ulcer perforation and acalculous cholecystitis. But acute pancreatitis is a relatively rare complication of scrub typhus. Here we report a rare case of scrub typhus in the form of acute pancreatitis.
{"title":"SCRUB TYPHUS PRESENTING AS ACUTE PANCREATITIS: A RARE CASE","authors":"Ams Kumar, Subramaniam Suresh Kanna, Dinesh Babu","doi":"10.46903/gjms.19.04.1039","DOIUrl":"https://doi.org/10.46903/gjms.19.04.1039","url":null,"abstract":"Scrub typhus is an insect-borne disease caused by Orientia sutsugamushi which may cause disseminated vasculitis and perivascular inflammatory lesions resulting in significant vascular leakage and cause end organ damage. Scrub typhus can lead to severe complications such as acute respiratory distress syndrome (ARDS), myocarditis, hepatitis and meningoencephalitis. Some unusual presentations of scrub typhus are peritonitis, gastric ulceration, duodenal ulcer perforation and acalculous cholecystitis. But acute pancreatitis is a relatively rare complication of scrub typhus. Here we report a rare case of scrub typhus in the form of acute pancreatitis.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43847500","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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