Annals of PIMS (Pakistan Institute of Medical Sciences)
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Message from the Patron-in-Chief, Bring Brilliant Minds of Transfusion (BBMT) - Pakistan
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W.H.O. Global Database on Blood Safety: Challenges, Impact, and Role of Data Management in Blood Transfusion Service Policy Decision Making
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Comparison of Phenylephrine infusion vs Nor-epinephrine Infusion on Maternal Hemodynamics and Neonatal Outcomes During Elective Lower Segment Caesarean Section under Sub-Arachnoid Block
Get PDFObjective: To compare the efficacy of Phenylephrine and Nor-epinephrine IV infusions in maintaining maternal hemodynamics during EL-LSCS.
Methodology: This randomized control trial study was conducted department of Anesthesia and Critical Care Medicine, Pakistan Institute of Medical Sciences (PIMS), Islamabad from March, 2023 to November, 2023. This study enrolled 62 patients fulfilling the inclusion criteria i.e., patient of age 18-45 years undergoing elective LSCS under SAB were enrolled in the study. While those having hypertension, pre-clampsia, eclampsia, pre-existing bradycardia, fetal distress and hypersensitivity to the medications used in the study were excluded. Enrolled patients were divided into two groups using computer generated random numbers with Group N patients received Nor-epinephrine infusion at rate of 2.5 Mcg/min while Group P patients received phenylephrine infusion at rate of 50 Mcg/min. Intraoperatively maternal hemodynamics were monitored and infusions were titrated to effect. Neonatal outcomes were assessed using APGAR score with umbilical cord ABGS carried out if clinically indicated.
Results: Group P patients had statistically significant lower mean heart rate at 5,10,15 and 20 minutes as compared to group N. Similarly, pressures were significantly higher in group P than group N at 5,10,15,20 and 25 minutes. This required frequent changes in the rate of Phenylephrine infusion with the desired effect being achieved after 25 minutes of induction of Sub-Arachnoid block.
Conclusion: Low dose Nor-Epinephrine infusion is safe and provides a better hemodynamic profile during Caesarean Section
Knowledge and Attitude of Undergraduate Dental Students Regarding Anaphylactic Reaction in Islamabad
Get PDFObjective: To evaluate the knowledge and attitude of undergrad dental students regarding anaphylactic reaction associated with local anesthesia used in the dental procedures.
Methodology: This cross sectional Questionare based study was conducted in School of Dentistry, Islamabad from June 2023 to September 2023. Questionnaire regarding knowledge and attitude of undergrad dental students toward handling the anaphylactic shock/reaction was distributed among these students. Independent T test was employed for statistical analysis where p. value for significance was <0.05.
Results: 250 undergrad dental students that participated in this study ranged between 20-23 years of age on average. These undergrad dental students worked in clinical wards and used local anesthesia for dental treatments of the patients in routine. Local anesthesia Lignocaine was preferred by 112 (91.8%) male undergrad dental students and 120 (93.8%) female undergrad dental students while other type of local anesthesia used by male and female undergrad dental students was 10 (8.2%) and 8 (6.3%). The overall knowledge of these undergraduate dental students regarding anaphylactic reaction was much better in comparison to their practical attitude that involved the adequate management of this disease (p value=0.001).
Conclusions: The current study concluded that undergrad dental students had enough theoretical knowledge regarding anaphylactic shock but lacked in the practical attitude to manage it adequately without any fear of severe consequences. This practical attitude can be enhanced by pursing the undergrad dental students for undergoing manual hands on courses, workshops and awareness programs
Economic Evaluation of the Parents of Malnourished Thalassemia Major Patients
Get PDFObjective: To evaluate economic status of the parents of malnourished thalassemia major patients admitted in hospitals of Quetta
Methodology: This cross-sectional study was conducted at Bolan Medical Hospital (BMCH), and Sandeman Provincial Hospital (SPH), Quetta from July to Sept 2020. A sample size of 100 was calculated by using the sample size calculation formula. Parents of malnourished patients, admitted in the pediatric wards were included while rest of the parents with the problems other than the malnutrition were excluded. Data were collected by preformed structured questionnaire via systematic random sampling. Ethical consideration was taken from Institutional Review Board (IRB) of Health Services Academy (has) and the participants prior to the study. Data were analyzed by using the SPSS version 20. 2 Chi square test was applied, P-value < 0.05 was taken as significant
Results: Among 100 respondents, 65 were males and 35 were females. About half (47%) subjects were accompanied with father. 75% of the respondents having 1 to 11 family members, while 64% of the thalassemia major patients told that their parents were cousins. All participants reported no assets like their own home, car, bank balance, and even the animals. About 61% of the parents of thalassemia major had their monthly income in between 10,000 rupees to 15,000 rupees. There was insignificant relationship between gender, average income per month with level of satisfaction (p-value 0.086, 0.298) respectively.
Conclusion: All the participants said that government should launch a nation-wide program for inexpensive treatment of thalassemia major. All of the parents had no assets and their monthly income was very low, so they have to spent their money to come to hospital
Cassia Angustifolia; A Potential Anti-Inflammatory Agent in Allergic Asthma in Rats
Get PDFObjective: To identify anti-inflammatory effects of Cassia angustifolia in allergic airway disease in comparison to emodin and dexamethasone.
Methodology: This experimental study was conducted at animal house of Postgraduate Medical Institute, Lahore, from February 2022 to March 2022 in which 42 male Sprague dawley rats were divided into 7 groups having 6 rats in each group. Group I (Normal control group), Group II (Diseased control group), Group III (Dexamethasone Control group), Group IV (Emodin Control group), Group V, VI, and VII were low, medium and high dose of Cassia angustifolia leaf ethanolic extract treated groups. Asthma was induced in all rats except the rats of normal control group at the start of the study by sensitizing rats with intraperitoneal injection of Ovalbumin on day 0 and 14. They were challenged with nebulization of 1% w/v ovalbumin solution on days 22, 23 and 24. Respective drugs were given from day 15 to 24 as twice oral daily doses. Blood samples were taken at day 25 via cardiac puncture. TLC, eosinophil count, IgE antibodies and IL-13 were measured using commercially available kits.
Results: High-dose Cassia angustifolia demonstrated significant anti-inflammatory effects comparable to emodin and dexamethasone, effectively reducing TLC, eosinophil count, IgE levels, and IL-13 levels. Low and medium doses of Cassia angustifolia showed weaker anti-inflammatory effects, not significantly reducing TLC or eosinophil counts compared to the disease control group. All treatment groups exhibited significantly lower IgE and IL-13 levels than the disease control, indicating the anti-allergic and anti-inflammatory potential of Cassia angustifolia.
Conclusion: Cassia angustifolia, particularly at high doses, exhibits anti-inflammatory effects similar to standard treatments like emodin and dexamethasone, suggesting its potential as an alternative therapy for allergic asthma. However, it does not surpass the efficacy of dexamethasone in controlling specific inflammatory pathways. Further studies are warranted to explore its therapeutic application in asthma management