Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Telemedicine in COVID-19 era: Lessons from Online Co-management of Bone Marrow Transplant Patients
Get PDFRadiographic images
Get PDFAcute Intestinal Obstruction
Retroperitoneal Neurogenic Tumor
Extensive Bilateral Pneumonic Consolidations Leading to ARDS
Haemorrhagic Transformation of Subacute Infarct
Acute Occlusive Portal Vein Thrombosis Extending into Superior Mesenteric and Splenic Vein
Health Capacity and Vulnerability in Context of COVID-19 Outbreak: An Analysis of 185 Countries
Get PDFBackground: The coronavirus disease 2019 (COVID-19) pandemic has affected most countries, afflicting severe damage. Mitigation measures to control the pandemic rely heavily on existing health capacity and vulnerability of each country. The health capacity and vulnerability with respect to COVID-19 outbreak for 185 countries was assessed in this study to identify those where capacity-building needs to be prioritized.
Material and methods: The State Parties Annual Reporting data based on WHO International Health Regulations monitoring and evaluation framework was used to extract an indicator for national health capacity. Another indicator for vulnerability was extracted from INFORM epidemic risk index. These metrics were selected after evaluating their complementarity and availability.
Results: Among 185 countries, 111 (60%) had health capacities at level 4 and 5 with most of them having vulnerability at level 3 and 4. Twenty-two (11.89%) countries had level 2 health capacity in place coupled with moderate to high vulnerability. Among continents, Europe had best while Africa had worst mean functional capacity and vulnerability scores.
Conclusions: The results showed that most countries had sufficient response and reaction capacities to handle the pandemic. However, resources, intensified surveillance, and capacity building should be prioritized in vulnerable countries with ill-equipped national health capacities
Two Case Reports of Hereditary Sensory Autonomic Neuropathy Type IV
Get PDFHereditary Sensory Autonomic Neuropathy type IV (HSAN-IV), previously known as congenital insensitivity to pain and anhidrosis (CIPA), is an uncommon condition that presents in infancy with repeated episodes of fever, loss of pain sensations and self-mutilation. We are reporting two patients from two different families. Both patients had history of recurrent fever, anhidrosis, and pain insensitivity and self-mutilation behavior. Both had delayed motor developmental milestones with cognitive impairment. Clinical diagnosis of HSAN type IV was made on the basis of history, clinical examination and excluding other possible causes. Diagnosis of this rare disease is commonly delayed and patients ultimately develop complications. As there is no definitive treatment, these patients and their families should receive proper education and counselling for rehabilitatio
Refractive Errors: Prevalence and Pattern among Rural Population of Islamabad, Pakistan
Get PDFBackground: Refractive error is the most common cause of correctable visual loss worldwide. Decreased vision due to refractive error can be easily corrected with the help of spectacles, contact lenses and refractive surgery. However, there are 42% of uncorrected refractive errors all over the world. The present study aimed to evaluate different kinds of refractive errors, its prevalence and pattern in patients from rural areas who visited our hospital in the last five years.
Material and Methods: This cross-sectional study enrolled 2,138 patients, who visited eye OPD at Rawal Institute of Health Sciences, Islamabad during a period of five years i.e. from September, 2013 to September, 2018. Patients having only refractive error with an age of five years and above were included in the study. All patients had objective refraction with automated refractometer followed by subjective refraction. Data was entered and analyzed in SPSS version 20.0. Chi-square test was used for comparing groups with a P-value of <0.05 considered as statistically significant.
Results: Compound myopic astigmatism was the most common error found in our study population (n=575; 26.9%). The second most frequent complaint was simple myopia (n=501; 23.4%) followed by presbyopia (n=441; 20.6%) and mixed astigmatism (n=235; 11%). Patients with more than one refractive error included 178 (8.3%) with mixed astigmatism and presbyopia and 78 (3.6%) with simple myopia and presbyopia. Compound myopic astigmatism was more prevalent in younger ages compared to older age groups (46.4% vs 19.9%) (P <0.001). Mixed astigmatism (12.4% vs 8.9%), simple myopia (23.8% vs 22.9%) and presbyopia (21.3% vs 19.5%) were slightly greater in females than males (P=0.07), respectively.
Conclusions: The prevalence of myopia is significantly higher among female population and young individuals. Mixed astigmatism combined with presbyopia is more common among elderly population.
Key words: Astigmatism, Hypermetropia, Myopia, Presbyopia, Refractive error
Nasal Colonization of methicillin resistant Staphylococcus aureus in attendants in a tertiary care hospital of Pakistan
No full textBackground: Hospital associated Methicillin-resistant Staphylococcus aureus (MRSA) is a serious health concern, as its infection is associated with high rates of mortality and morbidity. Health care professionals around the globe are concerned by the increased prevalence of these bacteria in the hospital environment. With this background in mind, this study was conducted to determine the frequency of nasal colonization of methicillin-resistant staphylococcus in attendants of admitted patients in a tertiary care hospital in Pakistan.
Material and Methods: A cross-sectional study was conducted in Holy Family Hospital, Rawalpindi, Pakistan from 10th May to 31st August, 2016. Attendants of sixty admitted patients were selected by simple random sampling. Two nasal swabs samples were obtained from these attendants; the first at the beginning of the study with a hospital stay of less than 12 hours, and the second when their stay in the hospital had exceeded 48 hours. The samples were cultured on Cystine lactose electrolyte deficient agar, Mannitol Salt Agar, and Nutrient Agar. The colonies were subjected to Gram staining, catalase test, coagulase test, and methicillin/oxacillin sensitivity using the Kirby-Bauer’s disc diffusion method. Frequencies and percentages were calculated. Chi-Square test was applied and statistical significance calculated for the demographic data.
Results: The first culture report (at <12 hours hospital stay) showed that 46/60 (76.7%) attendants were not found to have any resistant strain of Staphylococcus. These 46 attendants were then subjected to a second culture (after 48 hours hospital stay), which showed that 24/46 (52.2%) were now colonized with methicillin-resistant Staphylococcus species (MRSA; n=7 and MR other than S. aureus; n=17). There was no statistically significant difference between colonization of isolates and relationship to gender, age, residence, and co-morbid conditions.
Conclusions: The frequency of colonization with resistant strains of Staphylococcus aureus in attendants of admitted patients increased after being exposed to the hospital environment for more than forty-eight hours
Comparative effects of Alpha Tocopherol and Ascorbic Acid on Chronic Stress Induced Neuropeptide Y Derangements
Get PDFBackground: Chronic stress decreases resilience of the body mainly due to hormonal imbalance. Neuropeptide Y-ergic system is abnormally regulated in chronic stress due to reduction-oxidation imbalance. The antioxidants such as alpha-tocopherol and ascorbic acid reduce this imbalance with positive effect on neuropeptide Y synthesis and release. This study was aimed to compare the protective effects of alpha-tocopherol and ascorbic acid on plasma neuropeptide Y levels in chronic stress.Material and Methods: This quasi-experimental study was done at Al-Nafees Medical College in collaboration with National Institute of Health Islamabad from January 2015 to January 2016 after taking institutional approval. Sixty male Sprague Dawley rats were obtained and divided equally into four groups; group I (control), group II (restraint stress group - chronic restraint stress six hours daily for 28 days), group III (restraint stress + alpha-tocopherol 50mg/kg body weight /day), and group IV (restraint stress + ascorbic acid 100mg /kg body weight /day). Cardiac puncture was done to obtain blood for biochemical analysis.Results: A significant decrease in plasma neuropeptide Y levels was seen in group II compared to group I, group III and group IV. However, alpha-tocopherol administration in group III showed positive effects on maintenance of plasma neuropeptide Y concentration with better p trend than that of ascorbic acid supplementation in group IV.Conclusions: Alpha-tocopherol supplementation has more potent effect than that of ascorbic acid on chronic restraint stress induced derangements in neuropeptide Y levels. It leads to less imbalance in neuropeptide Y levels during chronic stress.Key words: Ascorbic Acid, Alpha-Tocopherol, Chronic Stress, Neuropeptide
Perceptions of Fellowship Trainees in Public and Private Tertiary Care Hospitals of Karachi
Get PDFBackground: The issues pertaining to postgraduate medical education have been debated for long but there has been little contribution to this literature from developing countries. Therefore, a need to make an accurate assessment regarding current status of postgraduate training in Pakistan was felt and feedback from residents is the cornerstone of such an assessment. The objective of our study was to document perceptions of FCPS trainees of medical and surgical disciplines in private and public tertiary care hospitals of Karachi, Pakistan.Material and Methods: This was a cross sectional survey of the medical and surgical FCPS trainees in three hospitals (1 public and 2 private) of Karachi Pakistan, conducted over a period of two months (1st November 2018 to 31st December 2018). A total of 325 participants selected by convenient sampling technique were included in the study. Data was collected through structured self-developed questionnaire and analyzed by SPSS version 16.0.Results: The percentage of postgraduate trainees in private hospitals working for more than 80hours/week is higher than those working in public sector hospitals (59.4% versus 42.4%). Topic presentation and Academic meetings (Conferences, Workshops and CMEs) were the most preferred teaching strategies in Postgraduate training (77.4% and 77.5%). About 62.7% of the residents believed that their program was in line with CPSP guidelines. Public sector hospitals were better in terms of medical benefits giving partial cover (62.8%) than private sector (P-value <0.001). Majority of trainees at private sector hospitals seemed satisfied with their working environment than at public hospital (77.5% versus 12.5%) (P-value <0.001). Trainees perceived that the security arrangements at both public and private hospitals were not adequate, but in case of emergency private hospitals seemed to have better security response as compared to public hospitals (89% versus 23%) with a significant difference of <0.001.Conclusions: Perception of most of the postgraduate trainees is that they are being adequately trained for the challenges of an independent physician or surgeon.Key words: Postgraduate training programs, Medical education, Trainees perception
 
Comparison of Quality of Life in Breast Cancer Survivors with Lymphoma Survivors
Get PDFBackground: Breast cancer diagnosis and its subsequent treatment, especially surgical removal of the breast(s) cause changes in physical appearance that can be devastating to the Quality of Life (QOL) of cancer survivors. The objective of this study was to assess the effect of surgical intervention on the QOL of breast cancer survivors by comparing it with QOL of Lymphoma survivors.Material and Methods: This was a cross-sectional study, conducted in the Departments of General Surgery and Oncology at Pakistan Institute of Medical Sciences (PIMS) Islamabad, Pakistan from 1st June to 31st December, 2019. Six months’ post treatment patients of breast cancer (n=166) and lymphoma (n=50) were included. A standardized questionnaire was used to assess the Quality of Life in Cancer Survivors (QOL-CSV). Chi square and independent t-test were applied to determine the association of QOL among lymphoma and breast cancer survivors. Linear regression model was applied to determine the confounding variables.Results: All participants responded moderately in reporting overall quality of life in lymphoma survivors (LS) as compared to Breast cancer survivors (BCS) group (100% vs 86.7%; P = .007). Physical wellbeing parameters revealed a better mean score of 75.86 ±10.53 for LS group than the BCS group (P < .001). Psychological wellbeing mean score was similar for both groups (P = .46). Distress associated with illness and treatment was dealt better by LS than BCS group (P < .001), whereas spiritual wellbeing was markedly better in BCS group (P < .001). Fear of recurrence and spread was poor amongst the BCS than LS, while the LS group performed worse in social factors (mean value of 26.88±6.67) (P < .001).Conclusions: Both lymphoma and breast cancer negatively affect the quality of life of the patients, especially the psychological, social and spiritual wellbeing. However, surgical intervention in breast cancer patients led to considerable worsening of the quality of life with respect to physical and social wellbeing and increased distress of illness and fear factor
Comparison of Transosseous Wiring and Miniplates in Management of Mandibular Parasymphyseal Fractures
Get PDFBackground: Mandibular fractures are the most common type of facial fractures in the adult population, accounting for 36%-59% of all maxillofacial injuries and their treatment is one of the most frequent forms of therapy provided by maxillofacial surgeons. The objective of the study was to compare the outcome of transosseous wiring and miniplates in the management of mandibular parasymphyseal fractures in terms of infection and malocclusion.
Material and Methods: This randomized control trial was carried out at Oral and Maxillofacial Department, Ayub Medical College/ Ayub Teaching Hospital Abbottabad. A total of 124 patients were randomly allocated into two groups by lottery method. Patients in group A were subjected to transosseous wiring with maxilla-mandibular fixation. Patients in group B underwent miniplate fixation method. Post-operative wound infection and malocclusion findings at 6 weeks were recorded.
Results: Frequency of post-operative infection and malocclusion at 6 weeks of surgery was slightly more but statistically non-significant in patients of group A undergoing Transosseous wiring method as compared to group B patients experiencing Miniplate technique.
Conclusions: Miniplate osteosynthesis causes slightly less post-operative morbidity in terms of infection and malocclusion as compared to transosseous wiring for the management of mandibular parasymphyseal fractures