Journal of Islamabad Medical & Dental College
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Diagnostic Accuracy of IVU Compared to Unenhanced CT KUB for Detection of Urinary Tract Calculi
Get PDFObjective: To compare the diagnostic Accuracy of IVU to unenhanced CT KUB for detection of urinary tract calculi. Patients and Methods: This cross-sectional study was carried out at department of Radiology, Aziz Fatimah Hospital Faisalabad, from October 2016 to July 2017. All the patients having suspected Urolithiasis or ureteric colic indicating urolithiasis and referred to the Radiology department for IVU or CT KUB were selected in study sample. All the patients were briefly described about the study and informed written consent was obtained. A sample of 83 suspected patients of urolithiasis were included in the study sample. All patients in study sample who were referred for CT KUB or IVU were offered the other test free of cost. All the information including demographics, IVU and CT KUB were recorded on a predesigned performa. The data was entered and analyzed on SPSS version 21. Results: There were 48 (57.83%) males and 35 (42.17%) female patients. The mean age of the patients was 46.58 ± 9.42 years, ranging from 25 to 60 years. The final diagnosis showed that there were 59 (71.10%) positive patients for renal or ureteric stone. On the basis of IVU screening test 45 (54.21%) patients were positive, 38 (45.78%) were negative and 21.69% (16/83) patients had inconclusive results. CT KUB diagnosed 58 (69.87%) positive and 25 (30.12%) negative patients. The diagnostic parameters of IVU were considerably poor as compared with the CT KUB having sensitivity (72.08%), specificity (91.67%), PPV (95.56%), NPV (57.89%) and accuracy of 78.31%. The sensitivity, specificity, PPV, NPV and accuracy of 96.61%, 95.83%, 98.28%, 92.00% and 96.39% respectively. Conclusion: CT KUB provides more efficient information about the patients, presenting with acute renal colic. It has significantly higher rate of diagnosing urolithiasis in comparison of IVU. 
Comparison of Peritonsillar Injection of Lignocaine-Adrenaline and Normal Saline (placebo) Before Tonsillectomy in Terms of Mean PerOperative Blood Loss
Get PDFObjective: To compare peritonsillar injection of lignocaine-adrenaline and normal saline (placebo) before tonsillectomy in terms of mean peroperative blood loss. Patients and Methods: This randomized controlled trial was carried out at Department of ENT Head and Neck Surgery, Pakistan Institute of Medical Sciences, Islamabad study in six months’ time. A total of 60 patients were included in the study, their demographics data and clinical findings were noted. Subjects were randomly divide in two groups (30 in each group). Group A received injection of lignocaine-adrenaline in peritonsillar region and group B received normal saline (placebo), prior to tonsillectomy. Blood loss in both groups during surgery was measured by means of gauze pieces used and suction bottle. Results: Both groups were assessed for intraoperative blood loss. Despite marked reduction of blood loss in group A, the difference in two groups was not statistically significance (p-value=0.213) after applying independent sample t test. Post-stratification student t test showed a statistical significance in the age groups 15 – 20 years (p-value=0.018). Conclusion: Our study concludes that the group injected with lignocaine-adrenaline in the peritonsillar area had a marked reduction in peroperative blood loss as compared to the group that was injected with normal saline (placebo)
Effect of Losartan in Comparison with Pioglitazone on Lipid Profile in a Rat Model of Type 2 Diabetes Mellitus
Get PDFObjective: To evaluate the effect of losartan in comparison with pioglitazone on lipid profile in a type 2 diabetic rat mode. Materials and Methods: This case control study was conducted in Postgraduate Medical Institute (PGMI), Lahore from June to August 2011. Forty-five Sprague-Dawley rats of 5 weeks of age were randomized into three groups. All the rats were fed a high fat and sucrose diet. Pioglitazone or Losartan were given along with this diet to the rats in groups HFDPIO and HFD-LOS respectively, while group HFD was kept as control. At the end of 12 weeks, serum samples were obtained from all the animals and total cholesterol, HDL-cholesterol and triglyceride levels were obtained using kit method. LDL-cholesterol was determined using the Friedewald formula. Results: At the end of study period, lipid profile parameters were statistically improved between HFD-PIO and the control HFD group. The difference in the lipid profile parameters between the HFD-LOS and the control HFD group as well as between the HFD-PIO and HFD-LOS groups was not significant. Conclusion: The ARB losartan has a small but insignificant effect on lipid profile. 
Effect of an Artificial Sweetener on Rat’s Pancreas and Body Weight
Get PDFObjective: To observe the effects of an artificial sweetener on rat’s pancreas and body weight.Material and Methods: This Laboratory based randomized control trial was carried out at Anatomy department, Army Medical College Rawalpindi, in collaboration with NIH, Islamabad, from March to May 2014. Forty male and female Sprauge dawley rats were used in the experiment. Ten males and 10 females served as control group C and 10 males and 10 female served as an experimental group E (n = 20 animals in each group). The rats were randomly allocated by using a random selection table. Control group C was given normal diet for two months whereas experimental group E was provided artificial sweetener (sodium cyclamate) 60mg/kg/day through oral gavage tube for two months. Animals were weighed before and at the end of experiment. Pancreas were dissected out, examined and weighed. Histological sections of pancreas were studied under light microscope. Fatty infiltration was calculated in three slides per specimen. Results were analyzed on SPSS version 20.Results: The pancreas of rats showed fatty infiltration and weight of animals were significantly higher in experimental group.Conclusion: Artificial sweetener brings significant fatty infiltrations in rat’s pancreas and also induces weight gain in animals
Effect of Beclomethasone Dipropionate Versus Mast Cell Stabilizer on Mucociliary Clearance in Patients of Allergic Rhinitis
Get PDFObjective: The study was conducted to compare the effect of Beclomethasone dipropionate with mast cell stabilizer on mucociliary clearance in patients of allergic rhinitis.Patients and Methods: A randomized trial was carried out in ENT department of Nishtar Hospital Multan from December 2016 to February 2017. Patients of allergic rhinitis from both genders were included in the study after written consent. Mucociliary transport velocity was measured by saccharine dye test. The collected data was processed and analyzed by SPSS software 23 version and presented in tabulation form. Qualitative variables were analyzed in percentage and frequency form. The main outcome variable, mucociliary transport velocity, age and weight of patients were presented as mean and stranded deviation. Students’ test was applied to calculate p value. P value <0.05 was taken as significant.Results: A total number of 140 patients were included in the study and were divided in two main groups. There were 70 volunteers in each group. One group was provided Beclomethasone and other group was given mast cell stabilizer for one week. After careful analysis and calculation, it was observed that the mean of mucociliary transport velocity after one week of Beclomethasone dipropionate treatment was 7.33±1.27 mm/minute with p value 0.558 and mean of velocity after mast cell stabilizer (Nedocromil sodium) was 7.82±1.2 mm/minute with p-values 0.304.Conclusion: No statistical significance was found with both treatment regimens
Antibiotic Susceptibility Pattern of Gram Negative Bacilli Isolated from Different Clinical Specimens in a Tertiary Care Hospital
Get PDFObjective: To find out the antibiotic susceptibility pattern of gram-negative bacilli isolated from different clinical specimens received in a tertiary care hospital at Wah.Material and Methods: This cross-sectional study was carried out to determine antibiotic susceptibility pattern of gram-negative bacilli, cultured from different clinical specimens received in POF Hospital laboratory at Wah. One hundred and forty-four clinical isolates of gram-negative rods from different clinical specimens from April 2015 to March 2016 were included in the study. All the isolates were processed by standard microbiological methods. The antibiotic susceptibility pattern was carried out by disk diffusion method as recommended by Clinical Laboratory Standard Institute guidelines (CLSI).Results: Out of one hundred and forty-four Gram-negative bacilli, one hundred (69.44%) were from Enterobacteriaceae family and forty-four (30.56%) were from non-Enterobacteriaceae group. The commonest isolated organism was Escherichia coli (47.3%), followed by Pseudomonas aeruginosa (17.36%) and Acinetobacter baumannii (13.19%). These isolates were highly resistant to the most of the commonly prescribed antibiotics. The members of the family Enterobacteriaceae showed better sensitivity for amikacin and cefoperazone-sulbactam. Resistance rate for carbapenems was significantly high for K.pneumoniae and Proteus mirabilis. Among non-Enterobacteriaceae, P.aeruginosa showed better susceptibility for cefoperazone-sulbactam, amikacin, imipenem and meropenem. The multi-drug resistant pattern was observed for Acinetobacter.baumannii.Conclusion: The isolates depict highly resistant patterns to available oral antibiotics as well as commonly prescribed injectable third generation cephalosporins and carbapenems. Establishment and implementation of infection control practices are required to combat this grave situation
Emergence of Tigecycline Resistance among Extended Spectrum Beta Lactamases Producing Gram-Negative Organisms
Get PDFObjective: To highlight the emergence of Tigecycline resistance among ESBL producer gram negative organisms.Material and Methods: This cross-sectional study was conducted in Lahore College for Women University Lahore Pakistan during the period of 1st October 2015 to 20th March 2016. A total of 360 isolates of gram-negative rods were selected and processed for the identification of ESBL producers via double disc synergy technique. In total 100 isolates were identified as ESBL producing gram-negative rods (Escherichia coli, Klebsiella spp., Proteus spp. and Acinetobacter spp.) and were further processed for antimicrobial resistance testing against Tigecycline disks (30ug) via Kirby Bauer Disc Diffusion method.Results: Out of 360 identified gram-negative rods, 100 (27.7%) were ESBL producers. Total 46% samples were from males and 54% from females. A maximum number of ESBL producers were recovered from pus & wound samples (54%). The most common ESBL producer was Escherichia coli followed by Klebsiella spp., Proteus spp. and Acinetobacter spp. Overall susceptibility rate of Tigecycline was 54%. Tigecycline resistance was greatest for ESBL producing Acinetobacter (n=8), followed by Proteus (n=14), Escherichia coli (n=18) and Klebsiella (n=6) (p=0.004).Conclusion: Although tigecycline showed very good results against ESBL producers, emergence of Tigecycline resistant ESBL producers is an alarming situation
Prevalence of Hepatitis B Among Pregnant Women
Get PDFObjective: To study the prevalence of hepatitis B virus infection among pregnant women. Subjects and Methods: A hospital based cross-sectional study was conducted among pregnant women who attended antenatal care clinic for routine pregnancy check-up from July 2016 to February 2017. Sample size was calculated by using WHO sample size calculator and 900 pregnant women were enrolled in the study. Data were collected by face to face interview using a questionnaire. Serum was withdrawn from each study subject and tested for Hepatitis B Surface Antigen (HBsAg) by an enzyme linked immunosorbent assay (ELISA) test kit. Data were analyzed using SPSS version 20. Results: The prevalence of HBV infection among pregnant women attending Benazir Bhutto Hospital, Rawalpindi, was found to be 2.78%. Conclusion: This study determined that the prevalence of HBV infection among pregnant women in Rawalpindi was 2.78%, implying that it is intermediate endemic area. 
Properties and Applications of Biodentine in Restorative Dentistry and Endodontics: A Review
Get PDFRecently, a new calcium silicate based cement known as “Biodentine” or “dentin in capsule” has been introduced. It is a biocompatible and bioactive material. It consists of tricalcium silicates, dicalcium silicates, calcium carbonate and zirconium oxide. It has many promising characteristics including antibacterial activity, high compressive strength and chemical bonding to tooth structure. Additionally, it also has the ability to initiate reparative dentine formation. These properties allow their use for various restorative and endodontic procedures such as management of deep carious lesions, vital pulp therapies, perforation repair, retrograde fillings, apexogenesis, and apexification. 
Clinical Manifestations of Acute Myeloid Leukemia
Get PDFBackground: Acute myeloid leukemias (AML) affect preferentially adults. Clinical manifestations are due to cytopenias and tissue infiltration. Manifestations vary with certain subtypes e.g. bleeding and infections are common with AML-M3, tissue infiltration is more often seen in AML-4 and M5, and bone marrow fibrosis is seen in AML-M7.
Objective: To study demographic features and clinical manifestations of acute myeloid leukemia.
Patients & Methods: A cross-sectional study was conducted at department of Pathology, Pakistan Institute of Medical sciences, Islamabad from July 2007 to July 2009. All the cases of AML (diagnosed on bone marrow biopsy) belonging to all age groups and both sexes were included in the study. Age at diagnosis, symptoms and clinical findings in AML and its various subtypes were noted. Results were entered on SPSS version 14 for statistical analysis.
Results: In a total of 82 cases of AML, 55% were males and 45% females, with mean age of 27.5+19.9 years SD. The most common subtype was AML-M1 (33%) followed by M3 (22%) and M4 (18%), respectively. The common presenting symptoms were pallor, fever and bleeding. Hepatomegaly, splenomegaly, lymphadenopathy and gum hyperplasia were also frequent. Tissue infiltration was the commonest in AML-M5 and M4.
Conclusion: Acute myeloid leukemia is the malignancy of adults; it is more common in males and manifestations vary with its subtype