Journal of Islamabad Medical & Dental College
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Effect of Antiepileptic Drugs (Valproate vs Phenytoin) in Patients of Traumatic Brain Injury
Get PDFObjective: To determine the effect of Valproate as compared to Phenytoin in patients with traumatic brain injury to prevent early seizures.Patients and Methods: This randomized controlled trial (RCT) was conducted at Pakistan Institute of Medical sciences (PIMS) Islamabad from March to September 2015. A total of 100 cases of traumatic brain injury were enrolled in this study; which were randomly divided into two groups A and B. Gender distribution was similar in both A & B groups, with 36 (72%) males and 14 (28%) females. Consecutive (non-probability) sampling technique was used. Results: Group A patients received Valproate as anti-epileptic agent, while in group B, Phenytoin was given. In group A there were 45 (90%) patients with no seizures, 1 (2%) with simple partial, 1(2%) with complex partial and 3 (6%) with generalized tonic clonic seizures. In group B there were 40 (80%) patients with no seizures, 1 (2%) with simple partial, 5(10%) with complex partial and 4 (8%) with generalized tonic colonic seizures. In group A seizures were low (10 %) as compare to group B (20%), with statistically insignificant difference (p= 0.161).Conclusion: In this study, Valproate was found to be effective as a prophylactic anti-epileptic agent as compared to phenytoin. New drugs need to be studied on larger scale to find more effective and safe drug for Prophylactic use in post-traumatic seizures
Cryptosporidiosis: An Ignored Cause of Persistent Diarrhea among Children
Get PDFObjective: To evaluate the frequency of Cryptosporidium species among children presenting to a tertiary care hospital with persistent diarrhea.Materials and Methods: This cross-sectional study was conducted from September 2016 to February 2017 at Microbiology Department, Allama Iqbal Medical College, Lahore. Non-probability consecutive sampling technique was used and a total of 71 stool samples were collected from children admitted to Paediatric ward of Jinnah Hospital, Lahore, and full filling the inclusion criteria. Every sample was collected according to standard protocol, brought to the lab within 3 hours, and processed for modified ZN staining. Cryptosporidium oocysts (bright red against a blue background) were identified.Results: Among 71 enrolled children (male=41, female =30) Cryptosporidium was detected in 9.85% (n=7) stool samples via modified ZN stain. Majority of the children with Cryptosporidium species cyst infection were less than 5 years old age. All the children presented with watery diarrhea abdominal pain and fever. Only one case of Cryptosporidium species cyst in diarrheal stools of children below 6 months of age was presented. The frequency of Cryptosporidium infection was twice in males 12.5% as compared to females 6.6 %.Conclusion: The present study highlights the importance of Cryptosporidium detection as a cause of diarrhea, especially in children
Frequency of Preterm Birth in Females Presenting with History of Domestic Violence
Get PDFObjective: To find frequency of preterm birth in females presenting with history of domestic violence.Patients and Methods: This cross sectional study was done at Basic Health Unit, Sakhana Bajwa, District Gujranwala. Total 150 cases were included in the study having mean age of 20-40 years with single pregnancy or of any parity with current pregnancy of gestational age >24 weeks experiencing domestic violence. Domestic violence was defined as physical violence such as beating or hurting or sexual violence. All females were followed in OPD till delivery. During follow-up, ultrasound was performed to check fetal health. Preterm delivery was defined as delivery occurring before completion of 37 weeks.Results: The mean age of females in this study was 33.32±6.42 years (range = 23 - 50 years). The mean gestational age was 37.65 ± 4.3 week with minimum and maximum gestational age was 32 weeks and 41 weeks. Preterm birth was seen in 20(13.33%) cases, while 130(86.67%) females had full term birth.Conclusion: The current study shows high frequency of preterm birth in females experiencing domestic violence. Most of the females and their husbands were less educated, belonged to lower social class and had parity < 2
School Health Services and its Practices in Public and Private Schools of Rawalpindi District
Get PDFObjective: To assess the school health services in public and private schools of Rawalpindi district.Subjects and Methods: A comparative cross-sectional study was conducted in 50 public and private schools of Rawalpindi district for a period of 3 months. Consecutive sampling was done with inclusion criteria of only those teachers who had minimum two years of teaching experience in that particular school were included in the study. Participants were interviewed using a structured, interviewer administered questionnaire and a checklist. Data were entered and analyzed on SPSS version 20.0.Results: Among 50 selected schools, 10% were pre-schools, 28% primary schools and 68% were high schools. Regarding clean drinking water, 64% schools were using filtered water, 14% unfiltered, and 2% mineral water. In 60% schools, water was chlorinated. First aid provision in case of emergency was available in 96% of schools. Only in 24% of schools, sick room was available. First aid was given by teachers in most of the schools.Conclusion: Adequate health education on different aspects including nutrition is provided by most of schools. Majority schools provide health services including provision of first aid but there is lack of placement of health professionals and periodical inspection of students. Maximum number of schools have congested classrooms, uncomfortable seating and shortage of washrooms
Correlation between Salivary Glucose Level and Gingivitis in Patients with Diabetes
Get PDFIntroduction: Type 1 Diabetes has been linked with an increased risk of gingivitis and periodontal disease. Patients with periodontal disease and/or diabetes show differences in the profile of constituents in whole saliva. This profile reflects the nature and amplitude of the host response to a periodontal microbial challenge and /or response to diabetes mellitus.
Objectives: Tto compare gingival health between control group and patients with type I Diabetes and to assess whether there is any association between gingivitis/periodontitis and salivary glucose level.
Patients & Methods: Study was conducted on 90 subjects; 30 control and 60 diabetics. Gingival and periodontal status was assessed for both the groups clinically. Then un-stimulated whole saliva samples from diabetics and control group were collected stored and frozen at -200 C. Saliva samples were then thawed, centrifuged and its supernatant portion was analyzed by Dimension Clinical Chemistry System for Salivary glucose levels. SPSS 17.0 was used for statistical analysis.
Results: Results showed that gingivitis was statistically significantly higher among the type I diabetic patients when compared with the control group p < 0.05.
Conclusion: It was concluded that gingival health was compromised in diabetic children. It was also concluded that salivary glucose levels were higher in the patients with type I as compared to control grou
Role of Female Age in Determining Causes of Infertility and Predicting Outcome of in Vitro Fertilization
Get PDFObjective: To look into various causes of infertility according to increasing age, differences in percentage of pregnancy rate after IVF in different age groups and role of various infertility parameters in determining pregnancy rate among these patients Patients and methods: A total of 206 infertile couples were selected and divided into two groups according to female age: Group I (<35 years, n=108) and Group II (≥35 years, n=98). Diagnostic hysterosalpingography or laproscopy was done in order to rule out the tubal blockage and endometriosis. Ovarian dysfunction was excluded on the basis of hormonal analysis. IVF treatment following a long protocol for use of GnRH agonist was given to infertile couple. Analysis was done using SPSS 19 and MedCal software 12. Results: Male causes were frequent in both groups without any significant difference (33%; p=0.882). Tubal factor was significantly raised in older group (33%; p=0.000), whereas ovarian dysfunction was significantly higher in younger patients (33%; p=0.000). Number of embryos transferred and pregnancy rate after IVF were significantly decreased in older couples (p≤0.05). Age of patient and serum FSH levels (p=0.02) have relatively better predictive capability of pregnancy outcome regarding IVF treatment as compared to duration of infertility (p=0.04). Conclusion: Information of infertility factors can help clinician in estimating the chances of pregnancy rate before suggesting ART in old age couples
Arthralgia an indicator of Vitamin D3 Deficiency and Insufficiency
Get PDFObjective: To determine the prevalence of Vitamin-D deficiency and insufficiency in patients complaining of arthralgia. Patients and Methods: This cross-sectional study included a group of 332 individuals complaining of arthralgia, selected by consecutive sampling technique. Vitamin-D blood level was performed by ELISA method. Data were entered and analyzed using SPSS Software (Version 15). Mean and Standard deviation was calculated for Quantitative variables and frequency with percentage was presented for Qualitative variables. Chi-Square test was applied to assess any association between Qualitative variables. P value less than 0.05 was considered significant. Results: Out of 332 individuals who had arthralgia, 9.03% (30).12% (17) and 85.84% (285) had Vitamin-D sufficiency, insufficiency and deficiency. Among total sample population, 75.0% (249) were females and 25.0% (83) were males. In females 8.83% (22), 6.02% (15) and 85.1% (212) had Vitamin-D sufficiency, insufficiency and deficiency (p-value 0.430). Out of 212 Vitamin-D deficient females,48.5% (103), 16.98% (36) and 34.4% (73) had severe, moderate and mild Vitamin-D deficiency(p-value=0.844). In male patients 9.63% (8),2.40% (2) and 87.95% (73) of males had Vitamin-D sufficiency, insufficiency and deficiency (p-value=0.430). Out of 73 Vitamin-D deficient males, 45.20%(33) ,16.43% (12) and 38.3% (28) had severe moderate and mild Vitamin-D deficiency(p-value=0.844). In females Vitamin-D deficiency was found to be most prevalent in age groups of 41-60 years. Whereas in males Vitamin-D deficiency was found to be most prevalent in age groups of 31-40years. Conclusion: Vitamin D deficiency/insufficiency is an important factor leading to arthralgia, keeping the prevalence rate of about 90% in mind. 
Effect of Pre-Operative Education on Level of Anxiety in Patients Undergoing Cataract Surgery
Get PDFObjective: To determine the effects of pre- operative education on the level of anxiety in patients undergoing cataract surgery by comparing the anxiety level among interventional and control group. Study design: Experimental post-test design
Patients and Method: This cross-sectional study was conducted at ophthalmic department of Mayo Hospital Lahore. A total of 100 cataract patients were selected from by purposive non- probability sampling technique and divided into two groups (control & interventional) by dividing the days. Data was analyzed by using Hospital Anxiety and Depression Scale (HADS).
Result: Out of total 100 patients, 50 were included in control group and 50 were in interventional group. In control group there were 26(52%) male and 24(48%) females and in interventional group 25(50%) were male and 25(50%) were females. Among controls, there was no patient with normal score of anxiety level, 8 (16%) patients were with mild score, 38(76%) patients were with moderate score and 4(8%) patients were with severe score. In interventional group, there were 38(76%) patients with normal score, 11(22%) patients were with mild score, only 1(2%) patient was with moderate score and no patient was with severe score.
Conclusion: A good relationship was found between preoperative education and reduction of anxiety level in patients undergoing cataract surgery