Journal of Rawalpindi Medical College
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Emergency Management Of Dental Injury; Preparedness Among School Teachers In Swabi Khyber Pukhtunkhwa - A Cross-Sectional Study
Full text linkObjective: Dental trauma poses a significant threat to the oral health and well-being of school-aged children worldwide. Prompt and appropriate management of dental trauma is crucial to prevent infection, abscess formation, and pulp necrosis.
Methods: The descriptive cross-sectional study was carried out among 320 male and female teachers via cluster random sampling from October 2023 to May 2024 to assess the level of knowledge among school teachers regarding emergency management of dental injuries, to evaluate the preparedness of school teachers in handling dental injuries in the school setting and to determine the association between demographics with knowledge and preparedness regarding emergency management of dental injuries. Data was collected about socio-demographic characteristics and emergency preparedness for dental trauma.
Results: Out of 320 individuals, the level of the teachers' knowledge was moderate (53.3%). Only a few teachers were found to have undergone first-aid training in TDI (19.4%) and to have encountered TDI incidents (21.9%) before. 93(50.5%) females correctly identified fracture (p-value 0.014). A significant association was observed for identifying fractured teeth and managing avulsed teeth with first aid training with a p-value of 0.017 and 0.008 respectively. A significant association was observed between the age group 41-50 years and the Importance of seeking emergency management for dental trauma (p-value 0.018) and knowledge status (p-value 0.007).52.3% of teachers correctly identified a solution for washing a re-implanted tooth(p-value 0.000).46% of teachers whose service span was more than 19 years, had better self-rated knowledge( p-value 0.002)
Conclusion: A moderate number of teachers had adequate knowledge among school teachers regarding dental trauma management. While a substantial proportion of teachers exhibit a commendable understanding and readiness to address dental emergencies, there remains a notable gap between certain aspects of knowledge and preparedness.
Keywords: Emergency management, Preparedness, School teachers
The Comparison Of The Success Rates Of The Prostaglandin E2 (PGE2) Versus Foley Catheter In Females With Postdate Pregnancy
Full text linkObjective: Postdate pregnancies, defined as pregnancies that extend beyond the 40th-week gestation, are associated with an increased risk of adverse maternal and fetal outcomes. Consequently, there is a clinical need to manage these pregnancies effectively to prevent complications. Two common methods for inducing postdate pregnancies are the use of Foley catheters and prostaglandins. To determine the success rates of the Foley catheter and prostaglandin E2 (PGE2) in females with postdate pregnancy.
Methods: 162 female participants were randomly divided into two groups through the lottery method. Group A utilised a Foley catheter, where after speculum examination, a 16F standard Foley catheter was aseptically inserted above the internal cervical os and inflated with 30ml of sterile water. In Group B, PGE 2 gel was administered, with nulliparous women receiving an initial dose of 2 mg per vaginum (PV) and parous women receiving 1mg PV. The gel was inserted into the posterior vaginal fornix. Success was defined as female giving within 24 hours. The data was analyzed using SPSS version 25.
Results: The mean age of patients was 30.35 ± 6.89 years. Success was observed in 87(53.7%) patients, while 75(46.2%) patients did not achieve success. The study findings revealed that success was attained by 30(34.4%) individuals in group A and 57(65.5%) in group B. A statistically significant difference was observed between groups regarding the success of patients. i.e., p-value (<0.05)
Conclusion: A study concludes that Prostaglandin E2 (PGE2) showed significantly higher success rates for achieving vaginal delivery within 24.0 hours when compared to Foley catheters in female individuals with postdate pregnancies.
Key words: Pregnancy, Prostaglandins E2; Cervical Ripening; Pregnancy Outcome; Labour
Frequency of Glucose-6-Phosphate Dehydrogenase (G6PD) Deficiency in Neonates with Jaundice
No full textObjective: To determine the frequency of glucose-6-phosphate dehydrogenase deficiency among neonates presenting with jaundice.
Methods: It was a Descriptive cross-sectional study using non-probability consecutive sampling conducted in the Department of Pediatrics, Saidu Group of Teaching Hospitals, Saidu Medical College, Swat, Pakistan, from 22nd July 2023 to 22nd January 2024. A total of 130 neonates aged 1–28 days with clinical jaundice were enrolled. Baseline demographic and clinical data were collected. Laboratory evaluation included serum bilirubin, hemoglobin, reticulocyte count, and glucose-6-phosphate dehydrogenase activity by decolorization test. A decolorization time exceeding 60 minutes was considered diagnostic for enzyme deficiency.
Results: Of the 130 neonates, 70% were aged 1–14 days, and 30% were 15–28 days. Term neonates constituted 68%, while 32% were preterm. Male-to-female ratio was 1.3:1 (58% vs. 42%). Glucose-6-phosphate dehydrogenase deficiency was detected in 10% of neonates with significantly higher frequency in males (16%) compared to females (2%) (p=0.0077).
Conclusion: Glucose-6-phosphate dehydrogenase deficiency was observed in 10% of neonates with jaundice, with a marked male predominance. Early screening is essential to prevent complications such as severe hyperbilirubinemia and kernicterus in high-risk populations.
Keywords: Anemia, Hemolytic; Glucose-6-Phosphate Dehydrogenase Deficiency; Hyperbilirubinemia, Neonatal; Infant, Newborn; Jaundice
Pharmacogenomic Insights Into The Response To Imatinib In Chronic Myeloid Leukaemia: The Role Of CYP3A4 Polymorphisms
Full text linkObjective: To investigate the effect of CYP3A4 polymorphisms rs2740574 and rs2242480 on the response to Imatinib Mesylate in treatment-naïve patients with chronic myeloid leukaemia (CML).
Methods: It was a prospective, non-interventional observational genetic association study involving 106 treatment-naive CML patients genotyped for rs2740574 and rs2242480. According to the Helsinki Declaration, the study was conducted in compliance with current good clinical practices and was approved by the Ethical Review Committee. Blood samples and clinical data were collected in the pathology department between March 2018 and March 2020. Informed consent was obtained from all participants. Treatment response was evaluated at 3 months based on complete hematologic response (CHR) and plasma Imatinib levels.
Results: Patients with wild-type homozygous genotypes for both polymorphisms exhibited higher CHR rates (75% vs. 50% and 30% for rs2740574; 80% vs. 55% and 35% for rs2242480).
Conclusions: CYP3A4 polymorphisms rs2740574 and rs2242480 predict Imatinib response. Early detection of non-responders based on polymorphism analysis before treatment initiation allows timely initiation of second-generation Tyrosine Kinase Inhibitors (e.g., dasatinib, nilotinib), thereby avoiding ineffective Imatinib therapy and facilitating earlier achievement of treatment-free remission.
Keywords: Tyrosine Kinase Inhibitors, Leukaemia, Imatinib Mesylate, Cytochrome P-450 Cyp3A4, Pharmacogenetic
Modelling Mortality of patients with Acute Exacerbation of Chronic Obstructive Pulmonary disease
Full text linkBackground/aim: Dyspnea, Eosinopenia, Consolidation, Acidemia and Atrial Fibrillation (DECAF) score is considered better predictor of mortality than other predictive tools. Mortality models are fitted to determine the better prediction of mortality in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) having DECAF score of 1-6 and within 7 days of hospital admission keeping actual mortality as gold standard. The data is collected from Chest Department, Fauji Foundation Hospital, Rawalpindi, Pakistan; 15 may 2017 to 15 Nov. 2019.
Materials and methods: 146 Patients with COPD were selected from emergency and OPD of Fauji Foundation Hospital Rawalpindi, Pakistan. The procedure began after taking informed consent of the patients. Clinical features documented and investigations were carried out. The expense of all the tests was on hospital administration and not on the patient. A specially designed questionnaire was used for data collection.
Results: Total 146 patients were included according to the inclusion criteria of study. The mean age (years) of patients is 64.90+0.93. Patients with DECAF score of 1 to 3 are 64%, the cases with DECAF score of 4 are 26.7% and the cases with DECAF score of 5 and 6 are 8.9%. The two fitted binary logistic regression models indicate that among the independent variables DECAF score and duration of smoking significantly contribute to mortality. The accuracy of the fitted model is 96.6% and 90.2% respectively and the values of sensitivity, specificity, positive and negative predictive values (i.e PPV and NPV) are found to be appropriate for fitted model.
Conclusion: The study concludes that DECAF score and duration of smoking affect the mortality in patients admitted with acute exacerbation of COPD. Patients admitted in hospital with high DECAF score of and with more years of smoking should be admitted in intensive care unit because they may require invasive ventilation due to respiratory failure and high mortality.
Keywords: Mortality, AECOPD, Risk ratios, Logistic regression, Model accurac
original article Effects of Omega-3 Fatty Acid on Diabetes Mellitus-Induced Histomorphological Changes in Peripheral Nerve
Full text linkObjective: To study the protective effect of Omega 3 fatty acid co-administration in diabetes mellitus induced histomorphological changes in peripheral nerve and nerve fiber diameter and fibrosis in perineurium in rat.
Study Design: Laboratory based experimental animal study.Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi and National Institute of Health (NIH) Islamabad,
Methodology: Ninety male, healthy Sprague Dawley rats weighing between 200-300gms were selected for the study and divided in three groups. Group A was control group, group B was diabetic group and group C was diabetic group which was co-administered with omega-3 fatty acids orally for a period of eight weeks. All rats were sacrificed and peripheral nerve samples were collected for gross and histological examination. Nerve samples were stained with Hematoxylin & Eosin and Masson Trichrome for microscopic examination. At the end of experiment nerves were examined for diameter of the nerve and nerve fibers.
Results: Diameter of nerve and nerve fiber diameter were reduced in diabetic group but there was statistically significant improvement in omega-3 fatty acid group (group C) on intergroup comparison. Fibrosis in perineurium also reduced in omega-3 fatty acid group on intergroup comparison.
Conclusion: Diabetes mellitus causes histomorphological changes in peripheral nerve and fibrosis in the perineuriumwhich showed improvement on co-administration of Omega 3 fatty acid however on intergroup comparison between group A & C these protective effects were not statistically significant
Comparison Of Length Of Antibiotic Regimens For Prophylaxis In Patients Undergoing Cesarean Section
Full text linkOBJECTIVES:
To determine the efficacy of a short-term course of prophylactic antibiotic therapy versus a long-term prophylactic antibiotic course in terms of frequency of surgical site infections and mean length of hospital stay in patients undergoing cesarean section.
METHODS:
This study was conducted in the obstetrics and gynae dept. of PAF Hospital Islamabad, from April 20th to Oct. 2023 i.e. for 6 months. It was a randomised control trial. The height and weight of all patients were recorded and divided into 2 groups via lottery method. Group A (70) received a short-term course of antibiotic therapy while Group B(70) received a long-term course, follow up of both groups was done after 1 month via outpatient Dept. (OPD) on emergency visits or via telephone.
RESULTS:
Our study showed that In Group A 6(7%) patients had surgical site infection (SSI) while In Group B 7(10%) patients had SSI. The Mean hospital stay in group A was 2 ± 1.10 while the Mean hospital stay in group B was 4 ± 1.67.
CONCLUSION
Our study concludes that a short course of prophylactic antibiotic therapy is similar to the long-term prophylactic antibiotics course in terms of reduction in surgical site infection and length of hospital stay in patients undergoing cesarean section.
OBJECTIVES:
To determine the efficacy of short-term course of prophylactic antibiotic therapy versus long-term prophylactic antibiotic course in terms of frequency of surgical site infections and mean length of hospital stay in patients undergoing cesarean section.
METHODS:
This study was conducting in obstetrics and gynae dept. of PAF hospital Islamabad from April 20th to Oct. 2023 i.e. for 6 months. It was a randomized control trial. Height and weight of all patients recorded and divided into 2 groups via lottery method. Group A (70)received Short term course of antibiotic therapy while Group B(70) received the long-term course ,follow up of both groups was done after 1 month via outpatient Dept. (OPD) on emergency visits or via telephone.
RESULTS:
Our study showed that In Group A 6(7%) patients had surgical site infection (SSI) while In Group B 7(10%) patients had SSI. The Mean hospital stay in group A was 2 ± 1.10 while Mean hospital stay in group B was 4 ± 1.67.
Awareness Regarding Dangerous Signs in Pregnant Women attending BBH Filter Clinic, Rawalpindi
Full text linkIntroduction: Maternal health relates to the well-being of a woman during pregnancy, childbirth, and the postpartum period. This study aimed to assess the level of awareness of dangerous signs among pregnant women attending the Filter Clinic in Benazir Bhutto Hospital, Rawalpindi. It was also intended to determine the association of awareness levels among pregnant women during pregnancy with sociodemographic factors and to find out the determinants of awareness of dangerous signs during pregnancy.
Materials & Methods: A cross-sectional study was carried out at Benazir Bhutto Hospital filter clinic in Rawalpindi city. A total of 366 pregnant women were selected through non-probability consecutive sampling. Data was collected using a validated tool, Johns Hopkins Program for International Education in Gynaecology and Obstetrics (JHPIEGO's) (MeSH) Maternal and Neonatal Program. Pearson's chi-squared test of Independence and binary logistic regression were applied for univariate and multivariate analysis, respectively.
Results: Among the 366 respondents, the majority them were in the age bracket of 31-40 years (n= 156). Results of the present study showed that slightly more than half of the respondents reported poor awareness regarding danger signs during pregnancy (n= 190). Moreover, major determinants of awareness level among respondents were the education level of women and monthly family income (p value<0.05).
Discussion & Conclusion: The present study indicated that, on the whole, the population revealed somewhat poor awareness regarding dangerous signs. Women’s education and monthly family income play important roles in determining the awareness level among pregnant women regarding dangerous signs.
Keywords: Awareness, Pregnancy, Women, Pakistan
Efficient Communication Skills and Patient Satisfaction
Full text linkObjectives: To compare the patient satisfaction levels before and after conducting a short course of one month on communication skills.
Methods and Materials: A Quasi-experimental study was conducted at CMH Chunian from January till June 2023.Two hundred patients admitted to the hospital for at least 48 hours were selected. All patients provided their feedback by filling out a Feedback was taken from 100 patients before the communication skills course. After the communication skills course, all nurses were advised to follow the instructions and guidelines taught during the course. Feedback was taken from 100 patients after the course. Both groups were compared in terms of age, gender, hospital stay and questionnaire score.
Results: In group A, duration of admission ranged from 2 to 14 days with a mean and standard deviation of 4.69±2.11 days. In group B, duration of admission ranged from 2 to 9 days, with a mean and standard deviation of 4.22±2.13 days (p-value 0.07). Group B patients were more satisfied as compared to the group A patients with scores of 85.31±10.0 and 73.34±9.82 (p-value 0.00).
Conclusion: It is concluded in our study that there was a great improvement in the patient satisfaction level after the conduct of the short-duration course on communication skills for nurses of our institute
Anatomical Insights Into Dry Lumbar Vertebrae In The Pakistani Population: Applications In Modern Spinal Surgery
Full text linkObjectives: The lumbar spine plays a crucial role in weight bearing in human beings. This study focused on determination of different parameters in local Pakistani population to enhance the clinical diagnosis and spinal surgeries.
Methods: This cross-sectional observational study was done in the Anatomy Museum of King Edward Medical University during the year 2024 on a collection of 200 dry lumbar vertebrae. All the vertebrae with intact bony features were included in this study, while damaged or vertebrae with gross abnormality were excluded. All parameters were taken with the help of a Vernier calliper and expressed in millimetres. Vertebral body parameters recorded include anteroposterior length of upper and lower border on both right and left sides, and transverse length of body at superior border, at middle of body and inferior border was recorded. Height or vertebral body in midline anteriorly, along with anteroposterior and transverse dimensions of vertebral canal, was also recorded.
Results: Mean and standard deviation of all parameters were calculated, and a paired t-test was applied on paired dimensions, e.g anteroposterior diameters of the upper and lower borders of both right and left sides. That does not reveal any statistically significant difference. Significant difference was found in the transverse length of the vertebral body at the upper and lower borders with the middle of the vertebral body (p<0.01)
Conclusion: These findings will help precise diagnosis of various clinical conditions arising due to changes in morphology and in designing prostheses for surgical implications.
Key words: Lumbar vertebra, spinal canal, body of vertebr