Journal of Islamabad Medical & Dental College
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Nasopharyngeal Angiofibroma
Get PDFNasopharyngeal angiofibroma (NA) is a rare, highly vascular, benign lesion typically affecting young males. It is prone to spontaneous bleeding even after minor trauma. Reported here is a case of an 18 years old male with almost 8x8cm swelling in the left cheek. There was nasal obstruction due to mass in the left nostril and he had a history of obstructive sleep apnea and frequent epistasis. Surgery was done through Weber- Ferguson approach
Mitotic Index and Immunohistochemical Expression of Ki-67 in Pleomorphic Adenoma of Salivary Glands
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Background: Pleomorphic adenomas (PAs) are the most common type of salivary gland tumors (SGTs) which may undergo malignant transformation to Carcinoma ex PA (CaExPA). The purpose of this study was to determine mitotic index (MI) and expression of Ki-67 in Pleomorphic adenomas of salivary gland tumors.
Methodology: This study was carried out on sixty patients of pleomorphic adenoma. Slides with specimens were stained with Hematoxylin & Eosin to count Mitotic index. Labeling Index (LI) of Ki-67 was determined immunohistochemically. Mitotic figures (MF) were counted in 10 HPF selected in the proliferative area. MI was scored as 1 (0 to 4 MF per 10 HPF); 2 (5-9 MF per 10 HPF) and 3 (> 9 MF per 10 HPF). Immunoexpression of Ki-67 was scored as ‘0-negative’ when <5% of neoplastic cells stained, ‘1-weak positive’ when 5-19% of neoplastic cells were stained, ‘2-moderate positive’ when 20-49% of neoplastic cells were stained, and ‘3-strong positive’ when >50% of neoplastic cells were stained with Ki-67. Data was, entered in SPSS 21.
Results: Mean age was 38.7 ± 12.86 years. Out of 60 cases, 26 (43.33%) were of males while 34 (56.67%) were of females. Expression of Ki-67 was negative in 50% while remaining weak positive. Only score 01 of MI observed.
Conclusion: Ki-67 is more sensitive marker than mitotic index in pleomorphic adenomas even in small sized tumors and it can help in detection of malignant transformation of PAs.
Keywords: Adenomas, Immunohistochemistry, Ki-67 Antigen, Parotid Neoplasms, Pleomorphi
High Resolution Computed Tomography Chest Findings Among Post-COVID Patients
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Background: HRCT chest has proven to be a helpful radiological modality to assess the course of disease. The main objective of the study was to analyze the pattern of lung involvement on HRCT chest among post-Covid patients.
Methodology: This cross-sectional study was carried out in the post Covid patients (30 days after discharge) from Nov 2020 to July 2021 in Sahiwal Teaching Hospital, Pakistan. Total 180 patients were selected through non probability consecutive sampling technique. Whole body Multi Slice CT scan 128 Slices by GE discovery was used to get HRCT of chest and to document various patterns and stages of pulmonary fibrosis in the post-COVID patients. The data was analyzed using the IBM SPSS 28.0.0 2021. Various radiological findings were expressed in percentages.
Results: A total of 77.8% patients had bilateral lung involvement, while 22.2% had unilateral lung involvement after one month of disease.
Ground Glass Haze was the commonest radiological pattern, found in 140 (77.8%) cases. Other radiological patterns were Air Space Opacification (47.2%), Septal Thickening (20%) and Fibrotic Bands (26.1%). Traction Bronchiectasis (10%) and Honey Combing (7.8%) were among the lesser ones reported. About 62% patients had mixed findings on HRCT Chest. Diagnosis of Organizing Pneumonia was made in 166 (92.22%) patients while 14 (7.78%) patients were labelled as UIP (Usual Interstitial Pneumonia) with honey-combing in HRCT chest. The involvement of Right Lower Lobe was in 165 (91.7%) of cases. Right Middle Lobe remained fairly spared and was seen in 120 (66.7%) cases.
Conclusion: Patchy ground glass haze seen bilaterally in lower lung lobes are the commonest abnormalities in HRCT chest of post-COVID patients.
Keywords: Covid-19, Pneumonia, Radiolog
The Attitude of Physical Therapy Students Towards their Profession and Education in Punjab: physical therapy students towards their profession
No full textBackground: The quality of medical teaching can be refined based on the attitude of the students towards their clinical and teaching environment. The objective was to determine student attitudes towards their profession and education in Punjab.
Methodology: This cross-sectional survey was conducted from 20th July to December 2021 after taking ethical approval. The data was collected through an online google document from physical therapy undergraduates and post graduates from different institutes of Punjab. The outcome was measured using “physical therapy student attitudes questionnaire (PSAQ)”.It had four sections, section A is about the knowledge of the profession, section B includes beliefs about future, section C is about patient exposure in clinical trainings and section D is about level of satisfaction from the learnings. The data was encoded and analyzed using SPPS V.23. The descriptive statistics and mean+ standard deviations were used to present the scores. The independent sample t-test was used to find the difference in mean scores of males and females with p value ≤ 0.05 taken as significant.
Results: The current study comprised of 82(32.15%) males and 173(67.84%) females with mean age of 22.5+6.5 years. The overall satisfaction level regarding knowledge, future beliefs, clinical exposure and learning was good with total mean± SD of 87.62+17.64 for males and 87.97+18.67 for females. There was no statistically significant difference of satisfaction among male and female students with P >0.05
Conclusion: The student attitude was quite satisfactory regarding their choice of physical therapy profession, good future, patient exposure and learning skills. There was no statistically significant difference based on the gender.
Keywords: Education, Patients, Physical therapy, Satisfaction, Training
Anxiety Experienced By People Searching Internet For Medical Information
Get PDFBackground: A large proportion of people use internet to search for information on medical symptoms. The objective of the study was to assess the frequency of internet use for medical information and its association with anxiety levels.
Methodology: A cross-sectional study was conducted in tertiary care hospitals affiliated with National University of Medical Sciences, Islamabad from August to December 2020. Ethical approval was taken. A total of 414 Participants aged 20 and above, belonging to either gender, and having at least primary level education were included in the study, while participants belonging to medical background were excluded. Non-probability convenient sampling technique was used to collect data through a validated questionnaire. Frequencies and percentages were calculated. Chi-square test of significance was applied. P-value less than .05 was considered as statistically significant.
Results: Majority i.e., 301 (80%) of the participants stated that the health-related searches exacerbated their anxiety. Participants from lower income groups were more prone to anxiety, while participants from higher income groups were more likely to visit a doctor. There was a significant association between age groups and perceptions, that and web searches lead to review of content on serious illness, persistence of query for illness after web search, and increase in web searches related to perceived condition (p<0.05).
Conclusion: There was an increase in Anxiety levels after web searches. It was more pronounced in lowest income group people. Higher income group were more likely to trust web searches results
COVID 19 Vaccination Related Misconceptions and Myths
Get PDFBackground: Mass vaccination is the most effective way to fight against COVID 19 but a significant number of people are unwilling to be vaccinated, mainly due to misinformation and false beliefs, associated with this drive. The objective of this study was to identify these misconceptions and myths and associate them with sociodemographic factors.
Methodology: This cross sectional survey was conducted on 562 residents of Rawalpindi and Islamabad from July 2021 to November 2021. Data was collected through structured questionnaire both in English and Urdu, analysed by SPSS version 23. χ2-test was used to check the association of categorical data with sociodemographic factors.
Results: Out of all the participants, 328 (58.4%) had received COVID19 vaccination. Among these vaccinated individuals, 81.8% were graduates or above and 74.2% had family income more than Rs.50,000. Out of total, 40.7% respondents believed that, vaccine is harmful for diabetics, hypertensive and heart patients, 40.6% agreed that it is not safe for pregnant or lactating women and 40.4% assumed that they have acquired immunity through natural infection. A strong association of misconceptions and myths was found with residence (p value 0.0001), educational level (p value 0.0010) and monthly income (p value 0.0001).
Conclusion: Several misconceptions and myths are related with COVID 19 vaccination, strongly influenced by various socio demographic. Hence, there is a need to launch various campaigns regarding the safety and effectiveness of vaccination.
Key words: COVID-19, Misinformation, Vaccin
Post-procedural Drainage versus no Drainage in Laparoscopic Cholecystectomy at DHQ Hospital Charsadda, Pakistan
Get PDFBackground: Laparoscopic cholecystectomy (LC) is the treatment of choice for symptomatic gall stones but controversy regarding the routine use of drainage after elective LC still exists. The objective of this study was to determine the efficacy of post-procedural drainage versus no drainage after simple laparoscopic cholecystectomy. The postoperative complications were also evaluated in both groups after the LC procedure.Material and Methods: This Randomized controlled trial (RCT) was conducted in patients who underwent Laparoscopic cholecystectomy according to a pre-set inclusion criterion. Ninety-three patients were randomly assigned into group A (with drainage tube) and group B (without drainage tube) using sealed opaque envelopes containing computer‐generated random numbers. Primary (like duration of hospital stay, Postoperative pain) and secondary outcomes (like postoperative complications) were noted in both groups. Chi-square, Fischer exact test and Mann witney U test were applied as appropriate and statistical significance was established at P < .05.Results: The number of patients with hospital stay exceeding two days were more in group A (n=23; 51.1%) than B (n=13; 28.8%) (P < .05). Group A presented with more postoperative complications but differences between the two groups were statistically non-significant. Both Groups experienced a high level of pain at six hours of surgery followed by progressive decrease in severity at 24 and 48 hours, respectively (P=.06).Conclusions: Post-procedural drain placement after laparoscopic cholecystectomy has no advantages as there is no significant difference in post-operative complications and duration of hospital stay in drainage versus no drainage groups
Psychological Impact of COVID-19 Pandemic on Pregnant Women
Get PDFBackground: Covid-19 pandemic has spread throughout the world in a short period of time. It has adversely affected the physical, mental and social well-being of communities including pregnant women. This study is aimed to determine the frequency, severity and associated factors of depression, anxiety and stress among pregnant women during COVID-19 pandemic.
Material and Methods: This cross-sectional study was conducted in Sharif Medical City Hospital, Lahore, from August to September 2020.Data was obtained on structured proforma comprised of two sections. Section one consisted of sociodemographic and obstetric components while second two was based on Urdu Version of DASS-21. Data was analyzed using SPSS-23.
Results: Total number of women was 350. Their mean age was 27.47 ± 4.72 while mean duration of their pregnancy was 26.33±9.17weeks. Mean DASS-21 score of depression, anxiety, and stress was 8.00±2.89, 5.80±3.10 and 9.18±2.80 respectively. It was observed that depression was present in 123(35.1%) ranging from mild to moderate, anxiety in 127(36.3%) ranging from mild to very severe and stress in only 20(5.7%) women and was mild.
Education was significantly associated with all three domains. The women who were infected themselves or any other family member affected with COVID-19 showed positive association for depression (p=0.00) and stress (p=0.00). Stress was higher in young age groups (p=0.04) and in women with higher monthly income (p=0.00) while parity also showed association with anxiety (p=001). Anxiety and depression were more in house wives (p=0.00) while stress in working women (p=0.00).
Conclusion: Frequency of depression and anxiety was notable varying from mild to very severe however for stress it was low and mild. Educational level was significantly associated with depression, anxiety, and stress. 
Effects of Dried Aloe Vera Gel and Diclofenac on Sodium and Potassium Homeostasis: An Experimental Study on Hypertensive Rats
Get PDFBackground: Anti-inflammatory role of Aloe vera gel is well established. Diclofenac is extensively used for acute and chronic inflammation. The present study was conducted to compare dried Aloe vera gel and diclofenac effects on sodium and potassium balance in hypertensive rats.
Material and Methods: This experimental study was conducted at Sargodha Medical College from May to November 2016. Twenty-four healthy male Sprague Dawley rats 7-8 weeks of age were included in study. Any unhealthy-looking rat was excluded from the study. Rats were equally and randomly divided into four groups Normal control (group A), Model control (group B), Aloe vera (group C) & Diclofenac (group D). Hypertension was induced by a 20 % sucrose diet in all groups except group A in 8 weeks’ time. Group B, C & D received distilled water and Aloe vera dried gel 400 mg/kg & diclofenac powder 12 mg/kg body weight respectively orally between 8 to 10 weeks. Serum and urine analysis was performed for hematocrit, sodium, and potassium concentrations at zero, eight and ten weeks. Twenty-four-hour urinary sodium excretion was calculated. Data was analyzed using Graph Pad Prism version 6.
Result: After 2-week administration of aloe vera and diclofenac powder, serum potassium significantly decreased in Group C (p <0.001) while increased in Group B and D (p <0.001) as compared to group A. Urinary sodium concentration and excretion increased significantly in Group C (p <0.01) as compared to Group A whereas result of Group D was insignificant. No significant change in serum sodium and hematocrit of any group was observed.
Conclusion: Aloe vera causes less sodium retention than diclofenac but decreases serum potassium contrary to the effect of diclofenac in hypertensive rats
Role Of C-Reactive Protein in Diagnosis of Acute Appendicitis
Get PDFBackground: Appendicitis is a common surgical emergency and diagnostic dilemma. Making the correct diagnosis is often difficult as the clinical presentation varies according to the age of the patient and the position of appendix. The objective of this study was to identify clinical applicability of C- reactive protein, as a diagnostic test for appendicitis.
Methods: This prospective study was carried out in Federal government Polyclinic hospital, Islamabad from January to July 2019, 114 patients underwent appendectomy for clinically diagnosed acute appendicitis. The decision to operate the patient was given by senior registrar. The blood samples for C-reactive protein were drawn before taking the patient to the operating theatre. Removed appendices were sent for histopathological confirmation of diagnosis. The C-reactive protein was then compared with the results of histopathology to determine its validity. The data was entered and analysed in SPSS 23.
Results: The sensitivity, specificity, positive and negative predictive values of C-reactive protein in patients with clinical diagnosis of acute appendicitis were found to be 94%, 78%, 93% and 74 % respectively.
Conclusion: CRP is helpful in making diagnosis of acute appendicitis. It is highly sensitive but has a relatively low specificity.