Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Comparison of Ciprofloxacin and Amoxicillin/Clavulanic Acid in the Treatment of Chronic Rhinosinusitis
Get PDFObjective: To compare ciprofloxacin with amoxicillin/ clavulanic acid in the treatment of chronic rhinosinusitis (CRS) in terms of frequency of improvement in symptom score.Patients and Methods: This randomized control trial was conducted at Department of Otorhinolaryngology, Capital Hospital Islamabad, from March 2015 to March 2016. Study population included 190 cases of Chronic Rhino Sinusitis (CRS) of either gender, aged 18 to 50 years and excluding confounders, divided in two groups. Group A received Ciprofloxacin 500 mg BD and Group B received Amoxicillin/ clavulanic acid 625 mg TDS for 10 days. Symptom score was recorded at start of treatment and finally at 16th week. Data analysis was done by SPSS 17.0. Chi Square was used to compare improvement of two groups. P-value ≤ 0.05 was considered significant
Huge Lipoma Involving Left Cheek Region: A Case Report
Get PDFLipomas are very common benign lumps that can be encountered in any part of the body but a small proportion present in the head and neck region. In this case report we have discussed the diagnosis and surgical treatment of an asymptomatic huge lipoma of left cheek. The patient had this swelling present for the last 5 years. Initially there was a slight increase in the size of the swelling but since the last 3 years there is no change in size. There was no history of associated pain and tenderness. The patient had esthetic concerns because of which the lesion was excised. These lipomas continue to grow slowly, showing variable signs including dysphagia, dyspnea, and dysphonia due to the compressing effect on surrounding structures. It can also be a matter of cosmetic concern. With this case report, authors will also highlight the diagnostic modalities and treatment for lipomas occurring in unusual areas in the body. It is a rare finding that occurs anterior to parotid but can be treated successfully by current surgical approach.Key Words:, , 
Comparison of Safety and Efficacy of Potassium Hydroxide versus Combination of Salicylic and Lactic Acid for Molluscum Contagiosum
Get PDFBackground: Molluscum contagiosum (MC) is a contagious cutaneous infection caused by MC virus, affecting mainly the pediatric population. It is characterized by flesh-colored umbilicated papules occurring on the skin surface. Potassium hydroxide (KOH) and salicylic acid plus lactic acid combination being keratolytic agents, are effective treatment options. The objective of the study was to compare the efficacy and safety of 10% KOH solution versus salicylic acid/ lactic acid combination in treating Molluscum contagiosum in pediatric population.
Material and Methods: A total of 80 children (age range 1-13 years) with Molluscum contagiosum lesions were selected from the Dermatology Out-Patient Department, and were randomly allocated into two groups by lottery method. Group A was given topical 10% KOH solution and group B was given Salicylic plus Lactic acid preparations for topical application. Patients were followed after two weeks to see regression in size of the lesion, and development of any side-effects. Final visit was scheduled at 6 weeks. Statistical analysis was carried out using SPSS (version 16) with p value less than 0.05 considered as statistically significant.
Results: Patients with MC (n = 80) were equally divided into group A (treated with 10% KOH) and group B (treated with combination of Salicylic acid and Lactic acid). After 6 weeks, complete remission from Molluscum contagiosum virus was seen in 29 (72.5%) patients of group A and 34 (85%) patients of group B. There were 12 (30%) patients in group A who developed local irritation and 4 (10%) developed local erythema after 6 weeks. None of the patients of group B had any such side effects.
Conclusion: 10% KOH solution is as effective as the combination of Salicylic and Lactic acids for treatment of Molluscum contagiosum in pediatric population, however it is associated with side effects of local irritation and erythema
Mandibular Reconstruction with Free Fibula Flap: Experience at Hayatabad Medical Complex, Peshawar
Get PDFBackground: Mandibular defects may result from trauma, infections, cancer ablation or radiation necrosis. These defects may vary according to the content and nature of the tissues that require reconstruction. The objective of this study was to evaluate the outcome of vascularised free fibula flap for mandibular reconstruction in terms of flap success rate and complications.Material and Methods: This prospective clinical study was carried out at Department of Plastic Surgery, Hayatabad Medical Complex, Peshawar from January 2014 to December 2018. The study included patients of either gender who underwent mandibular reconstruction with free fibula oseteocutaneous flap during the study period. Diabetic patients with underlying vascular pathologies and cachectic patients were excluded from the study.Results: There were 56 patients with 38 males and 18 females. Their age ranged from 24-66 years with a mean age of 36 years. The mandibular defects resulted from various etiologies and included: Squamous cell carcinoma (n=27, 48.21%), Giant cell granuloma (n=3; 5.35%), Ameloblastoma (n=2; 3.57%), Road traffic accidents (n=10; 17.85%), Firearm injury (n=9; 16%), Bomb blast injury (n=3; 5.35%) and osteoradionecrosis (n=2; 3.57%). Primary reconstruction of the mandibular defects was performed in 44 patients, whereas delayed reconstruction was performed in 12 patients. Out of the 56 flaps, 49 flaps survived completely. Our share of complications was as follows: Wound infections (n=13; 23.21%), Skin graft loss at donor site (n=5; 8.95%), Complete flap loss (n=4; 7.14%), Orocutaneous fistulae (n=3; 5.35%), Ankle instability (n=2; 3.57%), Skin paddle necrosis (n=1; 1.78%) and sensory deficit distal to donor site (n=1; 1.78%).Conclusions: Microvascular free fibula is a reliable tool for mandibular reconstruction following tumor resection or trauma. The flap has a high success rate and relatively fewer complications
Successful Pregnancy Outcome in Unicornuate Uterus
Get PDFPregnancy with a unicornuate uterus is an infrequent obstetrical presentation. Unicornuate uterus leads to various complications, including infertility and poor pregnancy outcomes. It may be asymptomatic and remain undiagnosed till the woman is unable to conceive or present with a bad obstetric history. Here we present a case report of a patient with unicornuate uterus diagnosed during caesarean section along with delivery of alive baby.Key Words: Outcome, Pregnancy, Unicornuate uterusAddres
Distribution of Extended-spectrum β-lactamase and Metallo-β-lactamase-producing Pseudomonas aeruginosa in Tertiary Care Hospitals of Lahore, Pakistan
Get PDFBackground: Pseudomonas aeruginosa (P. aeruginosa) is an important bacterial pathogen most frequently associated with nosocomial infections, especially in immuno-compromised patients. Early detection of these life threatening, β-lactamase producing bacteria is essential for infection control and to prevent their dissemination. The aim of our study was to detect the presence of Extended-Spectrum β-Lactamase (ESBL) and Metallo-β-Lactamase (MBL) strains of Pseudomonas aeruginosa.Material and Methods: Eighty-eight identified strains of P. aeruginosa were collected from Chughtai Laboratories, Combined Military Hospital and Children Hospital, Lahore. These strains were sub-cultured and after confirming the cultural characteristics by Gram staining and colony morphology, manual biochemical identification was done. Susceptibility to various antibiotics and production of extended-spectrum β-lactamases (ESBLs) and metallo-β-lactamases (MBLs) were determined using modified Kirby Bauer disk diffusion method, double disk synergy test, combined disk synergy test (CDST) and inhibitor-potentiated disk diffusion test (IPD) respectively.Results: Out of eighty-eight strains tested, three were ESBL producers (3.4%) and eleven strains (12.5%) were found to be resistant to carbapenems. Of these, eight were MBL producers (72.7%). All these β-lactamase producing strains (14 strains) were multidrug-resistant (MDR). Piperacillin and piperacillin/tazobactam proved to be the most effective antibiotics in both types of β-lactamase producing strains.Conclusion: Our study shows noticeable emergence of β-lactamases (ESBLs & MBLs) in P. aeruginosa. All of these strains were MDR. It reveals a correlation of these β-lactamases with multidrug resistant genes
Differences in Brain Waves and Blood Pressure by Listening to Quran-e-Kareem and Music
Get PDFBackground: Quranic recitation and music do not share any features in terms of content besides the use of melodies, but it is a common belief, that both have positive effect on reducing blood pressure and anxiety level of patients. This research investigates and compares the effects of listening to Quranic recitation and soft music on human brain waves especially Alpha and Beta waves by electroencephalogram (EEG) using Power-Lab.Material and Methods: A clinical trial was carried out in the Physiology Department of Islamabad Medical and Dental College. There were 22 participants, divided into two groups (A and B) with 11 participants in each group. Group A included students with ages 20-25 years and Group B comprised of teaching faculty between 40-60 years. All the study participants were Urdu-speaking, Pakistani Muslims having normal hearing. Sample selection was based on non-random convenient sampling. Paired T-test was used to compare means of Alpha and Beta waves amplitude, with p value < 0.05 considered as statistically significant.Results: Listening to Quranic recitation results in greater amplitude of Alpha waves in both younger and older age groups (p=0.01). The cross comparisons of systolic blood pressure at rest and after music for Group A showed significant results (p=0.04) indicating that soft music increases systolic blood pressure in younger people. Diastolic blood pressure comparison proves that it decreases by Tilawat in older age-groups (p<0.05).Conclusion: EEG showed that Quran generates comparatively higher amplitudes of Alpha than Beta waves, which reflects the calmness and relaxation of the participants while listening to Quranic recitation. Furthermore, there was a mild reduction in diastolic blood pressure in older subjects after listening to Quranic recitation
Antimicrobial Sensitivity Pattern for Urine Isolates in Urinary Tract Infection
Get PDFBackground: The increased frequency and management of antibiotic resistance pattern in urinary tract infection (UTI) is a challenging task for the clinicians. Therefore, the current study was planned to identify the microbial etiology of UTI and the most suitable antibiotics used. The objective of the study was to assess the frequency of antimicrobial sensitivity pattern in patients with urinary tract infection.Material and Methods: This cross-sectional study was carried out at Al Sayed Hospital, Kidney Centre, Rawalpindi over a period of seven months i.e. June 30, 2018 to January 30, 2019. A total of 152 patients were enrolled according to the inclusion and exclusion criteria of the study. Urine culture proceedings were done as per latest recommended guidelines of Clinical and Laboratory Standard Institute (CLSI) for UTI.Results: Regarding overall sensitivity of antibiotics for the pathogens of urine culture, highest sensitivity was observed for carbapenems (83.5%), followed by polymyxin B (72.3%), phosphonic acid derivatives (65.8%), aminoglycoside group (65.7%), extended spectrum penicillin (63.1%), imidazolidinedione (59.9%) and tetracycline (59.9%) groups. The least sensitivity was observed for Oxazolidinone (linezolid) (14.5%), teicoplanin (13.8%), tigecycline (10.5%) and first-generation cephalosporins (1.3%).Conclusions: Carbapenems showed maximum sensitivity for all urine isolates. The second and third options were polymyxin B and phosphonic acid derivatives, respectively
Mandibular Third Molars and Lower Anterior Crowding: Comparison of Opinions of Oral-Maxillofacial Surgeons and Orthodontists
Get PDFObjective: To compare the opinion of orthodontists and oral-maxillofacial surgeons on relation between erupting mandibular third molars and lower incisal crowding.Patients and Methods: This descriptive study involved 100 Pakistani clinicians (50 orthodontists, 50 oral-maxillofacial surgeons) to answer online questionnaire regarding their opinions on link between erupting Mandibular Third Molars along with their extraction opinion with reference to development and prevention of lower incisal crowding. Data was analyzed using SPSS version 21.0. Pearson's chi-square test was applied and statistical significance was defined at <=0.05.Results: Statistically insignificant differences were found between oral-maxillofacial surgeons and orthodontists regarding question of erupting mandibular third molars in causing lower incisal crowding. Similarly, statistically insignificant differences between oral-maxillofacial surgeons and orthodontists were found regarding question of recommending preventive extraction of mandibular third molars for developing lower incisal crowding.Conclusion: No opinion differences were observed between Pakistani oral surgeons and orthodontists, regarding the link of lower third molar as a cause of lower incisal crowding
Vitamin D Deficiency in Patients with Diabetic Peripheral Neuropathy
Get PDFObjective: To determine the frequency of vitamin D deficiency in patients presenting with diabetic peripheral neuropathyPatients and Methods: This cross sectional study was carried out in Department of Medicine and Neurology Indus Medical College, Tando Muhammad khan. from March 2017 to August 2017. Total 74 cases of Diabetes Mellitus presenting with peripheral diabetic neuropathy were selected for the study. Evolution of degree of Neuropathy was based on TCSS score as: {no neuropathy: ≤5, severe: ≥12, moderate: 9-11 and mild: 6-8}. Vitamin D level was categorized as (deficiency (0-20 ng/ml), insufficiency (21-30 ng/ml) sufficiency (>30 ng/ml), excess (>50 ng/ml) and toxicity (>100 ng/ml). All the data was entered in SPSS.Results: Total 74 patients with diabetic neuropathy were studied. Vast majority of patients 36(48.6%) were found in age group 51-60 years, Majority were males 45(60.8%). Most of the cases 35(47.3%) were with 1-3 years duration of neuropathy. Majority of patients 42(56.8%) were found with Mild peripheral neuropathy. Vitamin-D deficiency was present in 2(43.2%) cases and insufficiency was observed in 27(36.5%) cases. No significant association was found between vitamin D deficiency and severity of neuropathy.Conclusion: Vitamin D deficiency was found (43.2%) in patients of diabetic peripheral neuropathy. Vitamin screening and intake of supplement is necessary, will help to decrease the complication of peripheral neuropathy in Diabetic cases. Key words: Diabetes, Peripheral neuropathy, Vitamin