Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Frequency of Different Etiologies in Patients of Upper GI Bleed
No full textObjectives: To find out the frequency of different etiologies of upper GI bleed, based on endoscopic findings.
Methodology: It was a retrospective study done over a period of 6 months in gastroenterology department of Federal Government polyclinic (FGPC), hospital from 1st January 2023 to 30th June 2023.
Results:A total of 229 patients presented with Upper gastrointestinal bleed.Chronic liver disease manifesting as variceal bleed or portal hypertensive gastropathy was found in significant number of patients as compared to peptic ulcer disease.The predominant age group for most of causes of bleed was 5th decade of life with a significant female predominance.
Conclusion:Viral hepatitis along with other causes of portal hypertension seem to be the major predisposing factor as a cause of upper GI bleed. There is an increased need for future awareness campaigns about viral hepatitis in order to reduce the risk of upper GI bleed. It is further suggested to study the impact of such awareness programson incidence of upper GI bleed through future studies
Reticulocyte Haemoglobin Equivalent a Useful Indicator of Iron Deficiency in Patients with Iron Deficiency Anaemia and Anaemia of Chronic Disease
Get PDFObjective: To find an association between RET-He and iron deficiency (ID) and evaluate its usefulness in detection of iron deficiency in patients with iron deficiency anaemia (IDA) and anaemia of chronic disease (ACD).Study Design: Cross sectional study.Place and Duration: Department of Pathology, Army Medical College (NUMS), Rawalpindi in collaboration with Pak Emirates Military Hospital (PEMH), Rawalpindi.Methodology: A total of 95 participants were selected and divided into three groups control, IDA and ACD after taking informed consent and obtaining ethical approval. Patients were selected according to WHO diagnostic criteria for IDA and ACD and subjected to testing for RET-He by using sysmex XN 3000 which quantifies haemoglobin content of reticulocytes via fluorescent flow cytometry. Blood counts were collected and analyzed by using SPSS version 22.Results: Mean age of total population was 44.62 years and ranged from 16-85 years. Anemia was significant in female population in the IDA group. Mean value of RET-He in CG was 31.35 ± 1.5 4.16pg, in IDA group was 20.6 ± 4.16 and in ACD group was 26.3 ± 4.9 pg. RET-He was significantly low in the IDA group and in ACD it was moderately low. RET-He detected ID in both groups and a significant p-value of ˂0.001 was obtained.Conclusion: RET-He is a useful indicator of ID which is not affected by inflammation and readily detects iron deficiency
Risk Factors Analysis of Vascular Invasion in Hepatocellular Carcinoma
Get PDFObjective: HCC carries a high recurrence rate after resection and transplant. This depends on the extent of vascular invasion. Preoperative detection of vascular invasion affects the management of patient and determines the prognosis. Vascular invasion may have to be looked for in tumors that show certain risk factors. This study analyzes those risk factors.
Methodology: This retrospective observational study was carried out by retrieving data between 2017 to 2020. Tumors with more than 90% necrosis or those treated by chemoembolization were not included in this study. A total of 78 patients were included in the study. Multi-slice CT and 3 Tesla MRI were used as imaging tools. Vascular invasion was cross-tabulated against risk factors including size, location, morphology and encapsulation of tumor.
Results: Minimum age of patients was 22 and maximum 77 years with a mean age of 56.76 ± 10.857. Mean size of tumors was 7.29 ± 4.761 cms. Forty one patients (53%) showed vascular invasion in one or more branches of portal vein. Large tumors (p=0.002), multifocal tumors (p=0.040), unencapsulated tumors (p=0.001), infiltrative tumors (p=0.000) and those with raised serum AFP levels (p=0.016) were more likely to invade multiple vessels.
Conclusion: Larger size and multifocality of HCC are associated with more vascular invasion.
Keywords: Hepatocellular carcinoma; Vascular invasion; Imaging
Regional Disparities in Maternal Blood Parameters during Pregnancy: A Comparative Analysis across Four Provinces of Pakistan
Get PDF Objective: A comparative analysis of hemoglobin (HB), mean corpuscular volume (MCV), and ferritin levels among pregnant women from all four provinces in Pakistan: Punjab, Sindh, Khyber Pakhtunkhwa, and Balochistan.
Methods: It was a Cross-sectional Observational study. The study was conducted at four centers in Karachi, Quetta, Kharian and Mardan Pakistan for 1 year from 1St Feb 2022 to 31st Jan 2023. Maternal blood parameters were measured and compared across different regions of Pakistan to identify potential regional differences due to factors such as ethnicity, socio-economic status, and other factors.
Results: The mean hemoglobin levels were 10.95 g/dL in Balochistan, 11.04 g/dL in KPK, 10.82 g/dL in Punjab, and 10.36 g/dL in Sindh. The mean MCV values was 80.56 FL in Balochistan, 79.70 FL in KPK, 77.94 FL in Punjab, and 80.89 FL in Sindh. The mean serum ferritin levels were 16.00 ng/mL in Balochistan, 23.84 ng/mL in KPK, 33.92 ng/mL in Punjab, and 20.93 ng/mL in Sindh.
Conclusions: Overall, the results showed significant variation in the mean values for the different variables across the four provinces. We also noticed that gestational anemia is very common health issue all over Pakistan. This study provides valuable insights into regional differences in maternal blood parameters during pregnancy in Pakistan and may help in the development of regionally targeted interventions to address maternal anaemia.
Keywords: Gestational Anaemia, Pregnancy, Iron Deficiency Anemia, Maternal Health
 
Assessment of the Efficacy of Orally Administered Lycopene in Improving the Mean Maximum Incisal Opening in Individuals Suffering from Oral Submucous Fibrosis
Get PDFObjective: To compare the effectiveness of orally administered lycopene versus a placebo in increasing mean maximum incisal opening in patients with oral submucous fibrosis (OSF).
Methodology: This randomized controlled trial, conducted at the Oral and Maxillofacial Surgery Department of Lahore Medical and Dental College from January to July 2020, enrolled 68 eligible patients. Two groups were formed: Group 1 (received oral lycopene) and Group 2 (received placebo). A block size of 4 was utilized for patient allocation, alternating between groups until the sample size was met. Both groups underwent a comprehensive 3-month treatment plan, including habit cessation and daily physiotherapy involving tongue spatula insertion between teeth (with spatula replacement). Only Group 1 received an additional 40mg oral lycopene daily. Follow-up appointments occurred monthly for 3 months, measuring maximal incisal opening with a Vernier Caliper.
Results: Baseline incisal opening was 25.39 ± 2.92 mm in Group 1 and 25.23 ± 3.03 mm in Group 2. At the 3-month mark, Group 1 showed an incisal opening of 31.71 ± 2.84 mm, while Group 2 had 28.31 ± 2.98 mm. The mean change in incisal opening was 6.32 ± 0.96 mm for Group 1 and 3.08 ± 0.90 mm for Group 2. Group 1 exhibited a significantly higher mean change in incisal opening compared to Group 2 (p=<0.001).
Conclusion: Lycopene administration is more effective than a placebo in improving mouth opening in OSF patients. Therefore, lycopene should be considered as a treatment option to enhance maximal incisal opening and improve the quality of life for individuals with OSF.
Keywords: Maximum incisal opening, Oral submucous fibrosis, lycopene orally, Nutt eating
 
Comparison Between Myoinositol and Metformin on Biochemical Profile in Women with Polycystic Ovarian Syndrome
Get PDFBackground: The most common endocrine disorder in women during their reproductive years is polycystic ovary syndrome. Metformin is one of the effective oral insulin sensitizing agent it is also considered first line agent in the treatment of this syndrome. Myoinositol is a new emerging agent in the treatment of polycystic, evidences are showing myoinositol is the good addition for the treatment of polycystic syndrome.
Objectives: To compare the outcome of myoinositol and metformin on biochemical profile in women with polycystic ovarian disease.
Methods: This comparative randomized controlled trial was carried out at the Gynecology and Obstetrics Department of Benazir Bhutto Hospital Rawalpindi, from October 2022 to April 2023. The study involved 100 female patients aged 18 to 35 diagnosed with polycystic ovarian syndrome. The participants randomly were assigned to two groups: Group-I received myoinositol (1 gram twice daily) for 24 weeks, and Group-II received metformin (500mg thrice daily) for the same duration. Hormonal parameters, including FSH, LH, LH/FSH ratio, and fasting blood glucose (measured after 8 hours of overnight fasting), were assessed at baseline and after 24 weeks.
Results: The patients mean age was 28.12±4.84 years. The metformin-treated group exhibited mean baseline values of 7.65±2.79, 5.19±1.79, 1.54±0.68, and 90.82±10.72 for LH, FSH, LH/FSH ratio, and fasting blood sugar, respectively. After 24 weeks of treatment, these values decreased to 6.16±2.57, 4.34±1.65, 1.50±0.68, and 85.96±5.72 (p ≤ 0.05). In the myoinositol-treated group, the mean baseline values were 6.37±3.90, 4.66±1.37, 1.51±1.29, and 88.52±11.13 for LH, FSH, LH/FSH ratio, and fasting blood sugar, respectively. After 24 weeks of treatment, these values decreased to 4.54±2.56, 3.71±1.39, 1.37±1.05, and 88.10±4.43 (p ≤ 0.05).
Conclusion: This study concluded that myoinositol demonstrates superior efficacy compared to metformin in enhancing the biochemical profile of individuals with polycystic ovarian syndrome
Prognostic Significance of Baseline Neutrophil to Lymphocyte Ratio and Lymphocyte to C-reactive Protein Ratio in COVID-19 Patients
Get PDFObjective: Neutrophil-to-lymphocyte and lymphocyte-to-C-reactive protein ratios are important prognostic indicators for disease severity measurement among coronavirus patients. To predict the disease severity, CURB-65 scores, and outcome after 14 days of admission using two proxy biomarkers (neutrophil lymphocyte and lymphocyte C-reactive protein ratios) in COVID-19 patients.
Methodology: A prospective study was done at the Department of Medicine, Pakistan Ordinance Factory (POF) hospital, Wah Cantt, Pakistan, from April to August 2022. A total of 123 coronavirus patients were included. Patients with clinical manifestations, decreased lymphocyte and leukocyte counts, imaging characteristics of pneumonia, etiological evidence of a positive real time PCR test of blood or respiratory samples, and viral gene sequencing similar to known COVID-19 were measured. Patients underwent laboratory measurements and imaging analysis for biomarker indications. The analysis of the data was conducted using SPSS version 23.
Results: The patients mean age was 53.83±16.2 years. Among 123 COVID-19 patients, 80 (65%) were males and 43 (35%) were females. It was found to have high NLR and low LCR in severe disease (p = 0.05, p = 0.01). NLR and LCR showed 11% variance for disease severity (β = 0.143, p = 0.00, and β = -0.293, p = 0.01). NLR and LCR showed 29% variance for CURB 65 scores (β = 0.48, p = 0.634, and β = -0.159, p = 0.08). NLR and LCR showed 22% variance for outcome after 14 days of admission (β=-0.53, p=0.562, & β=-0.132, p=0.149).
Conclusion: Neutrophil to lymphocyte and lymphocyte to C-reactive protein ratios are effective prognostic biomarkers for measuring the severity of disease in COVID-19 patients. High neutrophil-to-lymphocyte and low lymphocyte-to-C-reactive protein ratios significantly predict disease severity
Radiographic Assessment Regarding the Pattern of Third Molar Impaction and its Association with Gender in the Population of Islamabad
Get PDFAbstract
Objective: To analyze and document the gender-specific incidence of impacted third molars and elucidate the specific patterns associated with impacted third molars.
Methodology: This retrospective cross-sectional study analyzed orthopantomograms (OPG) data from 278 patients, covering a total of 445 impacted third molars. A convenient sampling technique was used and the study was completed in three months from September 2023 and December 2023, Inclusion criteria: OPGs of individuals aged 25 years or older with fully formed third molar roots, Exclusion criteria: OPGs of individuals younger than 25, with craniofacial anomalies, prior orthodontic treatment, erupted third molars, or incomplete root formation in third molars.
Results: Both males and females were almost equal in number. The majority 73.2% of OPG showed mandibular third molar impaction while 26.8% showed maxillary third molar impaction. In the maxillary arch, the distoangular type of impaction was observed in the majority, accounting for 48.7%. In the mandibular arch, mesioangular impaction prevailed, comprising 41.7%. In the maxillary arch, a statistically significant correlation (p=0.006) was found between gender and impaction type, with females exhibiting a distinct and more prevalent impaction pattern than males. In the mandibular arch, there was no statistically significant association between gender and impaction type (p=0.23).
Conclusion: In conclusion, our study reveals noteworthy gender variations in the prevalence and types of third molar impactions. Mandibular third molars exhibit a higher prevalence than maxillary counterparts, with mesioangular impaction prevailing in the mandibular arch and distoangular impaction in the maxillary arch
Chronic Dengue Syndrome: A Narrative Review
Get PDFDengue fever (DF) is a dynamic disease. As the disease progresses, the course of treatment changes. Symptoms range from mild (e.g., fever, headache, retroorbital pain, nausea, vomiting, rash, myalgia, arthralgia) to severe body pain (e.g., rash fever), severe (e.g., dengue hemorrhagic fever) (DHF) and dengue shock syndrome. It changes. (DSS). DHF and DSS are associated with poor outcomes. Although there is a classification of dengue into DF, DHF, and DSS, overlap has been observed between the different presentations. In dengue, end organ damage such as liver, kidney, heart, brain, and bone marrow involvements are often reported along with blood plasma or hemorrhage. Order support system. The World Health Organization recognized these unusual symptoms and coined the term "Extended Dengue Syndrome" (EDS) to encompass atypical manifestations of neurological, renal, hepatic or other isolated diseases that occur with or simultaneously with serious diseases. Co-infections or other diseases in the host. EDS is now recognized worldwide as a common cause of dengue fever, and information continues to appear in medical journals. This review discusses this aspect of dengue fever, which covers the spectrum of symptoms in the body. This review article will help increase clinicians' knowledge about EDS and facilitate early detection and intervention
Frequency and MIC-based Antimicrobial Resistance Profile of MDR and XDR Gram Negative Isolates of Blood Culture Specimens in a Tertiary Care Setting
Get PDFThe escalation of antimicrobial resistance (AMR) among Gram-negative bacteria, particularly multidrug-resistant (MDR) and extensively drug-resistant (XDR) pathogens, posed a significant challenge in tertiary care settings. This paper comprehensively analyzed the antimicrobial resistance profile of MDR and XDR Gram-negative isolates from blood culture specimens at Jinnah Hospital, Lahore, a leading tertiary care facility. Over a period of one year, 9600 blood culture specimens were processed, revealing a high incidence of resistance to a wide array of antibiotics, with notable findings including 100% susceptibility to Colistin and over 90% resistance to several commonly used antibiotics such as Ciprofloxacin and Piperacillin/Tazobactam. Among the positive isolates, 33.8% were classified as MDR and 66.2% as XDR. The study emphasized the critical role of Minimum Inhibitory Concentrations (MICs) in guiding therapeutic decisions, highlighting the wide variability in resistance patterns and the necessity for personalized antimicrobial therapy. The prevalence of MDR and XDR isolates underscored the urgent need for advanced treatment modalities, comprehensive surveillance, and robust antimicrobial stewardship initiatives. Additionally, the study pointed to the emergence of colistin resistance as a critical challenge in managing infections caused by these pathogens. Through detailed analysis and discussion, this study illuminated the grave challenge posed by AMR in tertiary care settings. It emphasized the importance of innovative approaches to antimicrobial stewardship, developing new antimicrobial agents, and ongoing surveillance to effectively combat this public health crisis