Journal of Islamabad Medical & Dental College
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Association of Heavy School Bags with Musculoskeletal Discomfort among Primary School Children of Islamabad, Pakistan
Get PDFBackground: Musculoskeletal disorders, an increasing concern among school going children, primarily affect muscles and tendons. They lead to secondary damage to nerves and joints in the neck, upper back, shoulders, arms, and hands, etc. The objective of this study was to determine the association of carrying heavy school bags with musculoskeletal discomfort among primary school children in government schools of Islamabad, Pakistan.
Material and Methods: This cross-sectional survey was conducted in different government schools of Islamabad, Pakistan from June 2018 to November 2018. After an informed consent from parents, 377 healthy school going children aged 6-14 years were included in this study. Data was collected through Backpack Questionnaire. Chi square test was used to compare the frequency of musculoskeletal discomfort with demographic characteristics and backpack-related features. P-value less than .05 was considered statistically significant.
Results: Mean age of the school children was 9.49 ± 1.53 years with 179 (46.9%) male and 203 (53.1%) female students. Majority of students (89.8%) were found with school bags more than 15% of their body weight. Shoulder pain was the most commonly reported complaint (67.3%). There was a significant association between pain and perceived backpack weight (P=.001), and between pain and self-perceived posture (P=.001). Leaning forward (66.2%) was the most commonly adopted posture followed by leaning sideways (15.4%) and stooping (2.9%), respectively. The association between pain and duration of carrying backpack from home to school was insignificant (P=.055) in contrast to pain and duration of carrying bag from school to home (P=.007), respectively.
Conclusions: Musculoskeletal discomfort was found commonly among primary school children with shoulder pain being the most frequent, as maximum students were carrying heavy school bags
Nonsecretory Multiple Myeloma in a Seropositive Hepatitis B Patient with Thrombocytosis: A Case Report
Get PDFNon-secretory Multiple Myeloma is a rare variant of multiple myeloma with similar clinical and radiological findings. It is characterized by the absence/lack of monoclonal M proteins in the serum and/or urine. An early diagnosis can help in alleviating its adverse outcomes. We report a case of a 56-year-old female presenting with generalized body weakness and swelling, pain in right lower chest and anorexia. The patient was a known case of hepatitis B, treated a month ago. There was an incidental finding of thrombocytosis. Serum biochemistry and protein electrophoresis showed no findings in favor of Multiple Myeloma. Bence Jones proteins were negative in the urine. X-ray revealed few lytic lesions on calvaria of the skull. Bone marrow biopsy helped in diagnosing the patient as a case of non-secretory type of multiple myeloma highlighting the important role of this modality in saving the life of a patient through early diagnosis
Evaluation of Clinicopathological Findings and Postoperative Outcomes of Modified Radical Mastectomy in a Tertiary Care Center in Lahore, Pakistan
Get PDFBackground: Modified radical mastectomy (MRM) remains the mainstay of breast cancer surgery in under-developed countries like Pakistan as it reduces the morbidity and mortality associated with radical surgery. This study aims to delineate the clinicopathological findings and postoperative outcomes of patients undergoing modified radical mastectomy for breast carcinoma in a local setting.Material and Methods: This cross-sectional study was conducted in Gulab Devi hospital Lahore, Punjab Pakistan, from January 2016 to December 2019. Patients (n=70) with carcinoma breast planned for modified radical mastectomy were included in the study. Two suction drains were placed (in the axilla and under the flap) and removed when drainage was less than 30 cc in 24 hours. The patients were followed-up weekly for one month and then at monthly intervals for up to one year. Independent t-test and chi-square test were used to study associations between different variables. A P-value less than .05 was considered statistically significant.Results: The mean age of the patients was 48.43 ± 12.3 years. Most of the patients (42.86%) had stage-II, grade-I carcinoma (50%) with invasive ductal carcinoma as the most frequent histological variety (80%). Majority of the patients (n=60; 85.57%) were ER/PR positive. Mean duration of surgery was 124.8 ± 20.33 minutes, the mean duration of drains was 3.5±4.5 days, and the mean length of hospital stay was 4.67 ± 1.07 days. Most common complications of mastectomy were wound infection (23.57%) and seroma formation (20%). Six (8.57%) developed recurrence of disease in one year follow-up. Neoadjuvant chemotherapy increased the mean duration of surgery and drains placement (P<.05) but had no effect on mean hospital stay and complications associated with surgery (P>.05).Conclusions: Grade-I invasive ductal carcinoma with ER/PR positive receptor status was the most frequent variety of breast carcinoma. Neoadjuvant chemotherapy was associated with increased operative time and increased duration of drain placement
Oral Manifestations of a Patient Suffering from a Rare Gilbert’s Syndrome: A Case Report
Get PDFGilbert's syndrome is a rare genetic disorder characterized by abnormal glucuronidation of bilirubin in the liver, presenting as unconjugated hyperbilirubinemia in the absence of hepatocellular injury or hemolysis. Diagnosis of this pathology is primarily made during routine examination described as the presence of a yellowish tinge in the eyes and skin in general. Normally, the oral manifestations of Gilbert's syndrome are present but mostly go unnoticed as the teeth are minimally affected which are visible to the patient and surrounding mucosa in the oral cavity, where yellow discoloration can be appreciated. Dental treatments are smoothly carried out for such patients like extractions, root canal treatment, cleaning prophylaxis. The patient in this case safely underwent the root canal treatment after being diagnosed with irreversible pulpitis without any unusual discomfort. Local anesthesia can also be safely administered to such patients such as infiltration and inferior alveolar block anesthesia
Sero-Prevalence of Brucellosis in Occupationally High-Risk Groups in Three Different Districts of Khyber Pakhtunkhwa, Pakistan
Get PDFObjectives: Brucellosis is a neglected zoonotic disease in Pakistan, but it causes immense impact on livestock and public health. This study was done to determine the prevalence of Brucellosis in occupationally high-risk groups encompassing butchers, milkers, and cattle caretakers in district Swabi, Mardan, and Peshawar of Khyber Pakhtunkhwa, Pakistan.
Methods: In this descriptive cross-sectional study, 300 blood samples were collected through a non-probability purposive sampling technique from occupationally high-risk groups including butchers, milkers, and cattle caretakers at district Swabi, Mardan, and Peshawar from December 1, 2017, to March 31, 2018. All the blood samples were centrifuged and the serum was separated for further testing. Serum agglutination test was used for the detection of Brucellosis and the reagents used for this method were purchased from Biosciences PTE Ltd, Singapore.
Results: Out of 300 blood samples, 111 samples were positive and the overall prevalence of Brucellosis was 37% in occupationally high-risk groups. The overall 37% prevalence of Brucellosis comprised of 70% of B. abortus, 21.6% of B. melitensis, and 8.1% of both B. abortus and B. melitensis simultaneously. The prevalence of Brucellosis in butchers was 27.6%, milkers 13.3%, and cattle caretakers 45.7% while prevalence in males was 33% and in females 39.6%. The prevalence of Brucellosis in district Swabi was 45%, Mardan 33.3%, and Peshawar 30%. The socio demographic factors including age group, occupation, and locality showed statistically significant results.
Conclusion: The prevalence of Brucellosis is considerably higher in occupationally high-risk groups in district Swabi, Mardan, and Peshawar, Pakistan
Liddle Syndrome in a Six-Year-Old Girl: A Case Report
Get PDFLiddle syndrome is a cause of hypertension among children due to mutation in the epithelial sodium channels (ENaC) located in the kidneys. It typically presents with hypertension, hypokalemia, metabolic alkalosis with low renin and aldosterone levels. Although, most cases are children, but adults also present with this disorder owing to late diagnosis. Amiloride and triamterene efficiently improve the condition. Here we present the case of a 6-year-old girl admitted with history of hypertension, diarrhea, vomiting, weakness and palpitations on and off for the last four years. Laboratory investigations revealed metabolic alkalosis, decreased renin and aldosterone levels, hypokalemia and an inverted T wave, U wave and prolonged QT interval on ECG. Any pediatric case presenting with hypertension and electrolyte imbalance should promptly raise suspicion of Liddle syndrome. Timely diagnosis and management play a key role in reducing morbidity and mortality
Antimicrobial activity by solvents extracted from Ocimum basilicum herb against multidrug resistant gram negative rods.
Get PDFBackground: Failure of treatment with antibiotics occurs due to increase in number of Multidrug resistant gram negative bacteria, worldwide. The objective of this study was to find out the antimicrobial activity of crude ethanolic extract and its further three fractions by Ocimum basilicum leaves against multi drug resistant gram negative rods.
Material and Methods: This descriptive study was conducted in the Department of Microbiology, University of Health Sciences, Lahore from 1st july 2016 to 30th june 2017. Total 80 multidrug resistant gram negative rods were included in this study. Agar dilution method was performed to determine MIC of crude ethanolic extract and different fractions i-e n-hexane, chloroform and ethyl acetate of Ocimum basilicum leaves against multidrug resistant gram negative rods i-e ESBLs and carbapenemase producers. Muti-inoculater was used for inoculation.
Results: The mean MICs of crude ethanolic extract, n-hexane fraction, chloroform fraction, and ethyl acetate fraction of Ocimum basilicum against ESBLs were 100.0±8.00, 168.13±8.00, 176.88±8.00 41.75±8.00 respectively. Similarly, the mean MICs of crude ethanolic extract, n-hexane fraction, chloroform fraction, and ethyl acetate fraction of Ocimum basilicum against carbapenemase producers were 77.50±8.00, 113.75±8.00, 132.50±8.00 and 29.50±8.00 respectively.
Conclusions: Ethyl acetate fraction and crude ethanolic extract from leaves of Ocimum basilicum showed good antibacterial effectiveness against ESBLs and carbapenem resistant organisms than other fractions. This finding may also promote the effective use of O. basilicum herb and its components in modern medicine
Histomorphometric Alterations in Hepatic Tissue from Malathion-Induced Toxicity: An Experimental Animal Study
Get PDFBackground: Malathion, a widely used insecticide readily absorbed through skin and seriously affects different tissues and organs of the body. The main objective of this study was to compare the histomorphometric alterations resulting from hazardous effects of different doses of Malathion on hepatic tissue of male albino Wistar rats.
Material and Methods: This animal experimental study was conducted at the Department of Anatomy and Postgraduate Research Laboratory at the Isra University, Hyderabad, Sindh Pakistan from February to July 2019. Thirty male albino Wistar rats between 250-300 grams weight were distributed equally into group A (control), group B (low-dose Malathion group; 27mg/kg 1/50 of LD50), and group C (high-dose Malathion group; 50mg/kg). Bodyweight of all rats was taken twice, before and after the experiment. The liver was dissected out, washed and weighed. Histopathological examination was done under the light microscope. Grading was done for severity in histopathological changes in each group. Data was analyzed using one-way ANOVA and Post-hoc Tukey test for comparison with the level of significance set at P-value ≤ .05.
Results: Statistically significant (P < .05) decline in body weight was observed in groups B and C in comparison with group A. The relative weight of the liver was increased significantly (P < .05) in the experimental groups, when compared with the control group. Mild-to-moderate histopathological changes were observed in the low-dose Malathion group (Group B) while moderate-to-severe histopathological changes were demonstrated in the high-dose group (Group C).
Conclusions: Malathion is a potent toxic pesticide and its exposure can exhibit damage to the hepatic tissues in a dose-dependent manner