Journal of Islamabad Medical & Dental College
Not a member yet
636 research outputs found
Sort by
Aplastic Anemia Associated with Dengue Fever
Get PDFBone marrow suppression with peripheral blood cytopenias has been reported with various viral infections. Dengue fever is frequently associated with cytopenias particularly thrombocytopenia. This may be due to either bone marrow suppression or due to immunological effect. Bone marrow aplasia however may rarely be seen in patients with dengue fever and needs to be diagnosed early, as these patients have favourable outcome with immunosuppressive therapy. We present a case of a 24 years old male patient with dengue fever who manifested persistent pancytopenia. On bone marrow biopsy, he was diagnosed to have severe aplastic anemia. He was treated with immunosuppressive therapy and steroid with a favourable response
Auricular horn – a Rare Case Report
No full textCutaneous horns are rare conical and hard hyperkeratotic protrusions projecting from the sun-exposed skin like animal horn. These may also be seen on the external aspect of the ear (auricular horns). We report a case of a large auricular horn in an 82 years old female, who presented with a hard conical, yellowish-white colored horn measuring 4.0 x 1.7 cm on left pinna, which was excised along with 5 mm healthy margin, with primary closure of the wound. No recurrence was seen on follow-up. Histopathology of the lesion confirmed the diagnosis with no evidence of granuloma or malignancy. To the best of our knowledge, this is the second reported case of auricular horn from Pakistan. 
Diabetes and the Role of Tertiary Care Hospitals
Get PDFDiabetes mellitus is a worldwide health problem affecting more than 415 million individuals; this estimate is expected to be projected to 642 million individuals by end of the year 2040. Diabetes prevalence, deaths attributable to diabetes, and health expenditure due to diabetes continue to rise across the globe with important social, financial and health system implications.1 In cross-sectional survey conducted in urban and rural areas of four provinces of Pakistan, the overall prevalence of glucose intolerance (Diabetes mellitus and impaired glucose tolerance) was estimated as 22.04% in urban and 17.15% in rural areas. The major risk factors of diabetes mellitus identified were increasing age, positive family history and obesity especially central obesity.2 In another limited survey published from the area of Dir (KPK) in the year 2016, similar rising trends of the disease were verified.
Laparoscopy Versus Laparotomy in the Management of Ectopic Pregnancy
Get PDFObjective: To compare the outcome of laparoscopy with laparotomy in the management of ectopic pregnancy (EP), both ruptured and un-ruptured. Patients and Methods: This cross-sectional study was conducted in Department of obstetrics and gynecology at multiple centers in Sahiwal, Bahawalpur and Multan, during the period from January 2015 to June 2017. Total no. of 167 patients of ectopic pregnancy were included in our study. Of these 167 patients, 32 came with ruptured ectopic pregnancy and other 135 with un-ruptured EP. Following outcome variables were collected; operative time, complications, estimated blood loss and postoperative hospital stay. Mean and standard deviation was calculated for demographic variables while frequency and percentage was calculated for outcome variables and association of these variables with groups was checked using computer software SPSS version 16. p value < 0.05 was considered as significant. Results: Out of total 167 patients, ruptured EP was found in 19.2% and non-ruptured in 80.8% patients. Regarding blood transfusion and need of analgesia, significant association (p=0.000) was found between laparoscopy and laparotomy. As compared to laparotomy, during laparoscopy large number of patients did not require blood transfusion ((95.3%) and analgesia (64.1%). Regarding total operating time, duration of hospital’s stay and estimated blood loss, significant difference (p=0.000) was found between the two groups. Conclusion: Postoperative outcomes suggested that laparoscopy proved to be more efficient regarding blood loss, need for blood transfusion, need for analgesia and duration of postoperative hospital stay as compared to laparotomy. 
Pattern of Antimicrobial Sensitivity and Resistance in Large Series of Indoor Patients at a Tertiary Care Hospital
Get PDFObjective: In the era of increasing antibiotic resistance, associated with increasing hospital stay and morbidity, the purpose was to define guidelines for antibiotics in different clinical situations. Patients and Methods: This study was conducted at Khan Research Laboratories Hospital, Islamabad, Pakistan, from July 2014 to December 2016. 3277 patients admitted in Medical, Surgical, Gynaecology & Obstetrics, ENT, Eye and Dental departments were included. Positive cultures from different sources including blood, urine, pus, central venous lines, bronchial washings and cervical swabs were taken. Age, gender, common pathogens, their sensitivity and resistance to 27 antimicrobial drugs were taken into account. Statistical Package for Social Sciences (SPSS) version 20 was used for data analysis. Results: 53.1% (n=1738) were females while 46.9% (n=1539) were males.2800 samples were available for analysis. Majority of the patients belonged to Medical ward, 56.9% (n=1864). Major source of culture was urine, 38.3% (n=1073). Escherichia coli (E. coli) was the most common isolate 51.3% (n=1436) followed by Staphylococcus aureus 19.9% (n=558). E. coli showed maximum sensitivity to Imipenem i.e. 94% (n=1349) followed by Amikacin, 93% (n=1335). It was resistant to ceftriaxone (77%).Staphylococcus aureus showed maximum sensitivity to Linezolid and Vancomycin i.e. 98% (n=548) followed by Chloramphenicol 84% (n=470), while being resistant to ciprofloxacin and levofloxacin (54%). Klebsiella pneumoniae showed maximum sensitivity to Imipenem i.e. 75%, while showing resistance to Amoxicillin/Clavulanic Acid (95%) and Ceftriaxone (80%).Staphylococcus epidermidis showed maximum sensitivity to Linezolid i.e.99%. Pseudomonas aeruginosa showed maximum sensitivity to Piperacillin and Tazobactam i.e. 76% . Acinetobacter baumannii showed maximum sensitivity to Colistin i.e. 91%.Salmonella typhi showed maximum sensitivity to Ceftriaxone i.e. 99% while resistance to Ciprofloxacin (94%).Enterococcus faecalis showed maximum sensitivity to Linezolid i.e.100% and Salmonella Paratyphi A showed maximum sensitivities to Cefixime and Ceftriaxone i.e 100% Conclusion: Antibiotic resistance is emerging. Rationale use of antibiotics is required to curtail the surge of antibiotic resistance. There is also a need to modify treatment guidelines in different clinical situations based on local sensitivity and resistance patterns in order to reduce hospital stay, morbidity and mortality. 
Association of Childhood Asthma Control with Parental Socioeconomic status
Get PDFObjective: To evaluate association of childhood asthma control with parental socioeconomic status.Patients and Methods: This cross sectional study was conducted in four hospitals of Rawalpindi and Islamabad from 1st February, 2017 to 31st January, 2018. Total 151 patients, aged 6 months to 15 years were enrolled in study through non-randomized, simple consecutive sampling. After informed consent doctor filled the structured proforma by taking short interview of parents about their socioeconomic status, drug compliance and level of asthma control of their child. Data was entered and analyzed on SPSS version 21.0. Chi-square test was applied for association among categorical variables. P-value less than 0.05 was considered significant.Results: Among total of 151 children, 37 (24.5%) children had well controlled asthma while 69 (45.7%) had partially controlled and 45 (29.8) had uncontrolled asthma. Children from low socioeconomic families had poor asthma control than children from high socioeconomic families.Conclusion: There is statistically significant association of poor asthma control with low parental education and income status. Therefore, more asthma education, frequent follow-ups and provision of free of cost medicines are needed in order to achieve good asthma control in such children.Key words: Asthma control, Childhood, Socioeconomic statu
Prevalence of Dyslipidemia among Diabetic Patients in a Tertiary Care Hospital
Get PDFObjective: To identify the frequency of dyslipidemia in diabetic patients. Patients and Methods: A cross sectional study was conducted among the patients visiting Pathology laboratory in Pakistan Institute of Medical Sciences (PIMS). After taking informed consent from the patients, a brief history was taken from the patients with the help of a questionnaire. Lipid profiles for these patients were analyzed using the same samples as of HbA1c to determine diabetic dyslipidemia. Results: A total number of 206 diabetic patients were inducted in this study. Out of the total sample, 179 (72.7%) respondents were on anti-diabetic therapy alone. About 31 (17.3%) were on antihypertensive therapy along with antidiabetic therapy. Only 36 (20.1%) patients were on lipid lowering medication along with anti-diabetic and antihypertensive treatment. Dyslipidemia was more common in patients that were only on anti-diabetic therapy. Conclusion: Annual screening for dyslipidemia and management were not practiced according to guidelines for diabetic patients. Combination therapy comprising anti-diabetic and anti-dyslipidemia medications should be considered by clinicians instead focusing only on diabetes. 
Journal of IMDC- ‘Inaugural Issue’
Get PDFoai:ojs2.jimdc.org.pk:article/1It is a matter of great pleasure and honour for Islamabad Medical and Dental College to launch the inaugural issue of its official journal- Journal of Islamabad Medical College (JIMDC). The main aim of launching this journal is not only to promote the trend of medical writing in the college, but also to effectively support research activities at both faculty as well as students’ levels. JIMDC will publish original (research) articles, review articles, case reports, brief communications, interesting images, abstracts from contemporary journal, and literature related to continued medical education
Comparison of Single Dose with Multiple Dose Antibiotic Prophylaxis with Cefuroxime in Open Cholecystectomy
Get PDFObjectives: To compare single dose with multiple dose antibiotic prophylaxis with Cefuroxime in open cholecystectomy in terms of post operative surgical site infection, hospital stay and cost effectiveness.
Study Design: Quasi experimental study.
Place and Duration of study: The study was conducted in the Surgical Unit of Punjab Employees Social Security Institution Islamabad and Ahmed Hospital Rawalpindi Teaching Hospitals of IMDC Islamabad, from 1st August 2010 to 30th September 2011.
Methodology: A total of one hundred and ten patients requiring elective open cholecystectomy were included. Patients with acute cholecystitis, jaundice, diabetes, malignancy, choledocholithiasis and co morbidity were excluded. Patients were divided in to two groups, 55 patients in each group, Group A received only single dose of Cefuroxime and Group B received multiple doses (six).
Results: In this study, 97 (88%) patients were females and 13 (12%) were males. The mean age was 40.69 years. In Group A, 4 (5.5%) patients, and in Group B, 7 (12.7%) patients developed surgical site infection. Mean hospital stay in Group A was 2.18 days and in Group B 2.43 days. Cost of antibiotics in Group A was six times less than Group B.
Conclusion: There is no difference in single dose and multiple doses prophylaxis with Cefuroxime in low risk patients for elective open cholecystectomy in terms of post operative surgical site infection and hospital stay however single dose is more cost effective
Prognostic Scoring in Patients of Chronic Myeloid Leukemia: Correlation between Sokal and Hasford Scoring Systems
Get PDFBackground: Chronic myeloid leukaemia (CML) is a clonal myeloproliferative disorder of transformed primitive hematopoietic progenitor cells. Chronic myeloid leukaemia is one of the commonest leukemias. Patients of CML are usually subjected to risk stratification according to various prognostic criteria. The Sokal scoring system is popular as a prognostic discriminator for survival in patients treated with chemotherapy. Hasford et al proposed a new CML scoring system referred to as Euro score.
Objective: Correlation of various prognostic risk groups of Hasford scoring system with comparable prognostic groups of Sokal scoring system in chronic myeloid leukemia.
Material and Methods: This descriptive study was conducted at department of pathology, Pakistan institute of medical sciences from March 2003 to October 2006. A total of 59 consecutive freshly diagnosed untreated cases of CML were subjected to Sokal and Hasford scoring systems, and the results were correlated with each other.
Results: In total of 59 cases of CML age range was from 8 to 70 years with mean ± SD of 35.39 ± 17.12 years. Six (10.1%) patients belonged to pediatric age group i.e. <15 years. Male: female ratio was 1.3:1. According to Sokal criteria about half of the patients were found in intermediate risk group; 44% were in high risk group and only 5% in low risk group. Using Hasford scoring system, 44% of patients were placed in intermediate risk, 30.5% in high risk and 15% in low risk groups.
Conclusion: Hasford score identifies more patients still in low risk group as compared to Sokal scoring system and prospective studies should be carried out to see overall survival and disease free survival of these risk groups