Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Effects of Decompression Therapy in Leg Pain and Straight Leg Rise in Patient with Lumbar Radiculopathy Due to Disc Protrusion
Get PDFOne among many disc problems is disc protrusion, which has more prevalence in outpatient department physical therapy management Centre globally. The purpose of this study was to compare the effect of lumbar spine decompression therapy and standard physical therapy treatment in patients with lumbar radiculopathy due to disc protrusion. The single-blind randomized control trial of 71 patients was conducted at Max Rehab & Physical Therapy Centre Islamabad, Pakistan. After setting inclusion criteria all the patients were randomly allocated into treatment and control group. Both group received standard physical therapy treatment including, Moist Hot pack, Lumbar Mobilization, Stretching & strengthening exercises. The only difference was that Decompression Group received additional Decompression therapy. The data included demographics and Numeric Pain Rating Scale score in supine lying position for the painful leg and Straight Leg Raise Range for the painful side. The values for leg pain for control group decreased from 6 to 3 and the value for straight leg raise increased from 15° to 49°. The values for leg pain for the Decompression Group decreased from 6 to 2 and the value for the straight leg raise increased from 10° to 48°, the p value for both the variables was <.001 showing statistically significant difference between pre and post values in treating patients leg pain and straight leg raise range of motion. It is concluded that decompression therapy is more effective in managing lumbar radiculopathy
First Report of Phenotype Prevalence of Five Major Rh Blood Group Antigens in the Blood Donor Population of Peshawar, Pakistan
Get PDFObjective: The current study investigated the prevalence of five major Rh blood group antigens in the Peshawar region of Khyber Pakhtunkhwa province, Pakistan.
Methodology: This was a cross-sectional study, conducted at the Peshawar Regional Blood Centre from February to April 2023. A total of 13,148 blood donor samples were analyzed for Rh D, C, c, E, and e antigens using monoclonal reagents. The frequencies were calculated by direct counting on a spreadsheet programme and the Statistical Package for Social Sciences (SPSS for Windows version 25.0. Armonk, NY, USA) was used to conduct a meta-analysis for comparison of results with national and international studies.
Results: The findings of the current study revealed that 92.17% of donors were RhD positive. The e antigen showed the highest frequency of 98.31%, followed by D antigen and the C antigen (92.17% and 78.37%, respectively). Comparative analyses with earlier Pakistani studies and international data indicated significant variations in antigen frequencies, potentially attributed to the diverse ethnic population and geography of the region.
Conclusion: The findings emphasize the importance of local antigen frequency data for efficient blood transfusion strategies, especially for thalassaemia patients requiring frequent transfusions.
Key words: Rhesus, Blood Group, Phenotyp
Radiological Evaluation of Various Complications of Dengue Hemorrhagic Fever
Get PDFAbstract:
Objective: This retrospective study aimed to investigate the spectrum of imaging findings in patients with Dengue Hemorrhagic Fever (DHF) and explore the associated clinical parameters.
Methods: A total of 237 patients diagnosed with DHF confirmed via ELISA were included in the study. Imaging modalities including abdominal and chest ultrasound in every patient, HRCT (n=19), and CT brain scans (n=3)in patients having symptoms related to chest or brain were performed as part of the diagnostic workup. Demographic data, platelet counts, DHF grading, and imaging findings were recorded. Descriptive analysis was conducted using SPSS v26.
Results: The mean age of the patients was 34.50 ± 16.4, with a male preponderance (58.2%). Grade I DHF was observed in 69.2% of patients, followed by Grade II (23.6%) and Grade III (7.1%). Abdominal ultrasound revealed hepatomegaly (19.4%) and splenomegaly (19.6%). Thick-walled gall bladder (34.7%), pericholecystic fluid (7.1%), and gall bladder sludge (5.06%) were also noted. Ascites was present in 19% of cases. Chest ultrasound detected pleural effusion in 11.8% of patients, predominantly mild. HRCT scans showed pleural effusion (89.5%), ground glass opacities and consolidations (36.8%), alveolar shadowing (26.3%), and signs of non-cardiogenic edema (10.5%). CT brain scans revealed intracerebral bleed in 2 out of 3 patients with neurological manifestations.
Conclusion: This study provides insights into the spectrum of imaging findings in DHF. Abdominal ultrasound demonstrated hepatomegaly, splenomegaly, and gall bladder abnormalities, while chest ultrasound and HRCT revealed pleural effusion and pulmonary manifestations. CT brain scans identified intracerebral bleeding in some cases. These findings highlight the importance of imaging modalities in evaluating DHF complications and guiding appropriate management. Prospective studies with larger sample sizes are warranted to validate these findings and further enhance our understanding of imaging features in DHF
The Frequency of Depression Among Patients with Chronic Kidney Disease on Hemodialysis
Get PDFObjective: To find out the frequency of depression among patients with chronic kidney disease (CKD) on hemodialysis and to know fresh local descriptive statistics and updated analysis of depression in our local population in patients presenting with chronic kidney disease on hemodialysis.
Methodology: In this study, a total of 126 chronic kidney disease patients on hemodialysis presented to Nephrology department, Nephrology Department District Headquarter Teaching Hospital, Kohat were observed from December 10, 2021, to June 9, 2022. Written informed consent was taken and all patients underwent detailed interviews using Beck Depression Inventory (BDI) score in a calm environment in nephrology OPD.
Results: In this study mean patient age was 52 years with SD ± 8.214. Sixty-two percent of patients were male and rest were female. More than 53(42%) patients had depression while 73(58%) didn’t have depression.
Conclusion: Our study concludes that the frequency of depression was 42% in chronic kidney disease patients on hemodialysis. Effective screening and treatment of depression in chronic kidney disease patients are crucial for improving their clinical outcomes and enhancing their overall quality of life.
Key words: chronic kidney disease, depression, hemodialysis
Comparison of Outcomes of Intravenous Dexamethasone Versus Placebo as Adjunct to Local Anaesthetic Brachial Plexus Block for Upper Limb Surgery
Get PDFIntroduction: Dexamethasone has been tested in combination with different local anesthetics with varying degree of results including increase in intensity and duration of block.
Objectives: To compare the outcomes of intravenous dexamethasone versus placebo as adjunct to local anesthetic brachial plexus block for upper limb surgery.
Study design: Randomized controlled trial
Setting: Department of Anesthesia, pain management and intensive care Holy Family Hospital, Rawalpindi.
Study duration: 7th November 2019 till 6th May 2020.
Materials & Methods: A total of 10 0 patients of either gender aged 18 to 60 years admitted for upper limb surgery were included. Patients with pregnancy, DM, block failure and contraindication to brachial plexus block were excluded. Patients in group A received a block injection with 30ml of 0.5% bupivacaine along with 2ml of intravenous dexamethasone. Group B patients received 30ml of 0.5% bupivacaine for block injection and 2ml of normal saline intravenously. Block success was confirmed using the sensory and motor examination of the upper limb. Block duration was recorded in hours, opioid consumption was recorded in intravenous morphine equivalents in first 24 hours, visual analogue scores for pain on scale of 0-10 at upper limb at rest was recorded at 8 and 24 hours.
Results: In our study, duration of local anesthetic brachial plexus block in dexamethasone and placebo group were 16.12 ± 1.33 hrs and 9.77 ± 1.26 hrs respectively with p-value = 0.0001. Opioid consumption in Morphine Equivalents at 24 hrs in local anesthetic brachial plexus block and placebo group were 16.48 ± 2.60 vs 22.68 ± 3.78 with p-value < 0.0001 respectively.
Conclusion: This study concluded that intravenous dexamethasone has better outcomes as compared to intravenous saline as adjunct to local anesthetic brachial plexus block for upper limb surgery
Correlation of Low Back Pain with Pathological Changes of Lumbar Spinal Segment in Young Adults: A Cross-Sectional Study
Get PDFAbstract:
Objectives: The objective of this study was to determine the association of low back pain in young adults with most likely involved spinal level by MRI findings of their lumbar spinal segment.
Methods: The current study was conducted on 120 adults aged 25 to 40 years with low back pain. Lumbar spinal Magnetic Resonance Imaging (MRI) of these subjects was collected from Capital Diagnostic Center, Islamabad. Patients with any trauma, spinal surgery or fracture, active malignancy, metabolic bone disease, rheumatoid arthritis or pregnancy were excluded from the study. Disc and non-disc related parameters were evaluated from L1- L5 spinal levels. Further, gender based difference in magnetic resonance imaging findings was also assessed. Results: All the adults with low back pain showed some degree of disc degeneration on Pfirrmann grading system. The disc related MRI findings were more prevalent at lower lumbar spine levels L4-5 & L5-S1. On gender comparison, no significant difference of spinal level was found in males and females. However, it was revealed that males mostly had asymmetrical disc bulge (p = 0.03) and females were having facet joint involvement (p = 0.005). Conclusion: In young adults with low back pain, lower lumbar spinal levels were involved. Disc degeneration was mostly found in lower lumbar spinal levels without any gender difference. However, other underlying factors of low back pain may differ in males and females.
Key words: Disc Degeneration, Intervertebral Disc, Lumbar spine, Low back pain, MRI, Young adult
Immunohistochemical Expression of Ki-67 in Malignant Salivary Glands Tumors
Get PDFObjective: To determine expression of Ki-67 in MSGTs to evaluate its role in diagnosis of salivary gland tumors (SGTs).
Methodology: Sixty 60 cases of MSGTs were collected from de’Montmorency college of Dentistry, Lahore from period January, 2020 to December, 2021. Ethical permission was taken from institutional review board (DCD No.). The histopathological diagnosis and grading of MSGTs was made by H&E staining. On immunohistochemistry Labeling Index (LI) of Ki-67 was determined. Descriptive statistics were calculated on SPSS 22.
Results: Mean age of subjects was 51.1 ± 16.70 years. Adenoid Cystic Carcinoma (ADCC) is the commonest type of MSGT followed by Mucoepidermoid Carcinoma (MEC), and Acinic Cell Carcinoma (ACC) contrary to the worldwide literature where MEC exceeds ADCC. ADCC is mostly located on palate but its preferential site, in our setup, comes out to be parotid gland followed by buccal mucosa and then palate. In MSGTs, 16.7% were weak positive, 33.3% moderately positive and 50% strongly positive for Ki-67. There was a very highly significant association (P < 0.0001) between tumor-type and Ki-67 LI.
Conclusion: It is concluded that 50 % MSGTs expressed Ki-67 strong positive so is a sensitive indicator of malignancy in salivary gland tumors.
Keywords: Malignant salivary gland tumors (MSGTs), Mucoepidermoid carcinoma (MEC), Acinic cell carcinoma (ACC), Adenoid cystic carcinoma (ADCC), and Polymorphous low-grade adenocarcinoma (PLGA)
The Journey from Basic to Clinical Pharmacology
Get PDFBackground
The subjects of basic pharmacology and clinical pharmacology originate from same concepts but have a clear demarcation yet are so inter-linked and netted together that it is very critical and technical to identify and differentiate one from the other. This write-up is basically aimed to discuss and analyze the demarcations and similarities between basic and clinical pharmacology.
Methodology
Total 10 pharmacologists, pharmacists and medical specialists were recruited to conduct the survey from 1st December 2022 to 15th April 2023 in Northwest School of Medicine. Information was collected via literature search online, consulting Pharmacology books, libraries and discussions with subject experts.
Results
The basic pharmacology focuses on the study of the effects of substances on the body following experimental data that is collected via animal studies which defines the basic parameters and helps in derivation of the main foundational principles of the subject. Clinical pharmacology although follows the same basic principles and concepts but is the study of these principles in the human subjects rather than the animal studies. These studies are subjects however the two are inter-connected in many ways and the concepts go to and fro from one t the other.
Conclusion
The basic pharmacology is limited to the animal studies while the clinical pharmacology shelters human clinical trials and the policies, which come with the human studies and therapeutics
Evaluation of the Effects of Magnesium Sulphate versus Normal Saline on Hemodynamics in Patients Undergoing Laparoscopic Cholecystectomy
Get PDFIntroduction: Numerous studies have shown that giving magnesium sulphate intravenously before carbon dioxide pneumoperitoneum is produced reduces the adverse hemodynamic response in patients undergoing elective laparoscopic cholecystectomy.
Objective: To examine the effects on hemodynamics in patients undergoing laparoscopic cholecystectomy between magnesium sulphate and normal saline.
Methodology:The Department of Anaesthesia at the Pakistan Institute of Medical Sciences, SZABMU, Islamabad, conducted a Randomised Clinical Trial. The study involved the enrolment of 108 adult patients, regardless of gender, who were admitted for elective laparoscopic cholecystectomy and ranged in age from 18 to 65. Every patient who was enrolled was in ΑSΑ classes I and II. Patients were randomised equally to Group M, which received an IV slow bolus of magnesium sulphate (28 mg/kg) over a 20-minute period, and Group N, which received a 0.9% normal saline solution. The patient was tilted right and up by 15 degrees.
Results:Both groups' baseline characteristics were comparable. The mean age of groups M and N was 42.2 years ± 7.6SD and 40.5 years ± 8.4SD, respectively (Ρ-value t-test=0.258). 22 (40.7%) men and 32 (59.3%) women made up group M, while 20 (37.0%) men and 34 (63.0%) women made up group N (Ρ-value chi-square = 0.693). Both groups' baseline and pre-pneumoperitoneum hemodyanamic parameters (HR, Systolic, BΡ, Diastolic BΡ, and MAΡ) were similar (Ρ-value t-test > 0.05).
Conclusions:The adverse hemodynamic response caused by pneumoperitoneum was significantly attenuated by pretreatment with intravenous magnesium sulphate. Heart rate, systolic blood pressure, diastolic blood pressure, and MTH were all significantly lower than baseline. Significant hypotension and bradycardia, however, were not seen. 
Outcomes of Purse-string versus Conventional Linear Suture Closure of the Skin Wound Following Ileostomy Reversal
Get PDFObjective: Intestinal stomas are made in a variety of settings and their reversal is also a routine surgery. Due to their clean contaminated nature, there is a high risk of surgical site infection post-operatively. The objective of this study is to determine the difference in outcomes in two different techniques of skin closure after stoma reversal
Methods: The study was conducted at department of general surgery, Pakistan Institute of Medical Sciences, Islamabad over a period of six months. Seventy-one patients who underwent ileostomy reversal surgery in an elective setting were assigned two groups randomly: 34 in Group A and 37 in Group B. The group A patients underwent purse string closure for stoma site skin wound whereas patients in group B underwent conventional linear closure. Time taken for surgery was noted and the patients were followed over one month period for development of any surgical site infection or dog-ear deformity.
Results: The incidence of surgical site infection was 8.8% in the purse string closure group compared to 43.2 % in the linear closure group. Seven patients in group B developed dog ear deformity whereas no such case was noted in Group A.
Conclusions: Purse string closure is an effective and applicable technique for the closure of skin wounds after stoma reversal surgery. It is comparatively better in terms of prevention of surgical site infection as well as dog ear deformity in the closure of skin wounds after ileostomy reversal.
Key words: Purse string suture, linear suture, ileostomy reversal, intestinal stoma, surgical site infection, dog ear deformity