Journal of Muhammad Medical College ( J Muhammad Med Coll)
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Awareness of sleep hygiene in medical students of Kara-chi: A cross sectional study.
Full text linkIntroduction: Sleep, a neurobiological phenomenon, is very essential component for the behaviours of human beings. Sleep Hygiene is essentially a term which is used to understand lifestyle and environmental factors that influence sleep. A stu-dent when get admission in a university, it’s a turning point in his/her life as previ-ous routine is dramatically altered. This is more so if a student enters a medical college or university. While studying medicine the syllabus, timetables, duties, shifts are all manifold and hence it changes the complete environment and lifestyle of nearly all students. This in turn leads to drastic change in the pattern of sleep hygiene.Objective: This study was conducted to assess the awareness of sleep hygiene among medical students.Methodology: This cross-sectional study was conducted from March –August 2019. The approval of study sought from Ethical Review committee of Isra University. A self- administered questionnaire used to collect data after student’s verbal consent and ensuring their anonymity. Using convenient sampling technique 467 medical students were studied including those from 1st year to 5th year students. The data was analyzed using SPSS version 21.0.Results: Showed that 59.5% of the students have not heard about sleep hygiene, 31.5% have heard it and 9% of them were not sure about it.77% of participants use social media, 72% takes shower and 63% of the students wash their face before going to the bed.Conclusion: We concluded that majority of the medical students are unaware of Sleep Hygiene and a large portion of them uses social media before going to bed.Key Words: Sleep Hygiene, medical students, awareness
Frequency, Management and Outcome of Postpartum Hemorrhage at a tertiary care Hospital.
Full text linkIntroduction: According to WHO, world estimates of 2017, 295 000 maternal deaths were reported all over the world and maternal mortality rate ranged from UI 99 to 243 per 100 000 live births. There has been 35% reduction since year 2000. Similarly, there has been 51% reduction in maternal mortality rate in Pakistan. 94% of all maternal deaths occur in low and lower middle-income countries. The major complications that account for nearly 75% of all maternal deaths are: severe bleeding mostly Post-Partum Hemorrhage (PPH), Postpartum sepsis, pre-eclampsia and eclampsia and other.
Objective: To find out the frequency of patients presenting with PPH among all patients delivered during the study period, their management and subsequent morbidity and mortality.
Methodology: This retrospective study was conducted between January 2018 to December 2019 at the department of Obstetrics and Gynecology PUMHS Hospital Nawabshah, Benazirabad. The demography, parity, gestational age, mode of delivery and type of PPH developed as well as treatment for PPH and subsequent morbidity and mortality were all documented. Data analyzed using SPSS version 20.
Results: During study period frequency of PPH was 32.73 per 1000 deliveries, prevalence of primary PPH was 90.51%. Among the causes of PPH, Uterine atony was the leading cause 42/137 (30.65%). 56 (40.87%) patients were managed in the ICU for ventilatory &, inotropic support and septic shock, management. Mortality was 7(5%).
Conclusion: Majority of patients are of primary PPH and uterine atony remains the most common cause of PPH which requires prompt and timely management as per guidelines.  
Ruptured ectopic pregnancy in the rudimentary horn of a Unicornuate uterus. A case report.
Full text linkEctopic pregnancy in rudimentary horn of a Unicornuate uterus is a very rare phenomenon, and usually presents in second trimester with rupture and hemoperitoneum. Diagnosis before its rupture is very challenging.
We are presenting a case report of ruptured ectopic pregnancy in rudimentary horn of a Unicornuate uterus. A 26 years old gravida 4 para 2 with one early miscarriage, having first vaginal delivery and second delivery by Caesarean section due to fetal distress, presented in emergency with 4 months amenorrhea, severe lower abdominal pain for 2 days and signs and symptoms of shock. There was severe anemia and abdominal tenderness. Ultrasound showed, left ruptured ectopic pregnancy with 16 weeks size dead fetus present in the pelvic cavity and massive hemoperitoneum. After resuscitation laparotomy was performed. There was ruptured left rudimentary horn pregnancy. The horn was reserved and uterus was repaired. Multiple blood transfusions were done. Post-operative period remained uneventful
Major causes of negative and positive impacts on mental health during lock-down due to COVID-19 pandemic.
Full text linkIntroduction: Soon after pandemic of Covid-19; Lockdown across Pakistan led to wide spectrum of problems that includes unemployment, closure of schools & Colleges, shattered economy. Least in focused remained the mental health of the people affected due to different reasons.
Objective: To determine the major causes of negative and positive impact on mental health during Covid-19 pandemic. of lock-down on mental health.
Methodology: This cross-sectional study was conducted at Dow University of Health Sciences during April-May 2020. Using structured online questionnaire, 362 participants took part in the study. The selection criteria were age above 14 years and resident of Karachi in an area under lock down due to pandemic of COVID-19.
Results: Overall, 95.3% participants agreed that lock down is most appropriate strategy to counter the spread of Covid-19. Stress consequent to lock down was attributed as concern for their loved ones and relative by 47% of the participants, social distancing and restrictions by 44.2% and fall in economic situation by 43.4%. When asked for the probable solutions to these problems; provision of grocery items at door steps was stated by 53%, ease on taxes and/or bills by 52.5%; while 51.7% were of the opinion that people should be keep informed about development regarding Covid-19. The positive impacts on mental health were due to having more time for family (63.5%) and break from busy life (47.5%).
Conclusion: Different causes of negative and positive impacts of lock-down were acknowledged with people experiencing almost similar causes of stress and anxiety. Almost all of the problems are solvable if people’s recommendations are taken into account.
Keywords: COVID-19 19, pandemic, Mental health
Cold Abscess mimicking Goiter.
No full textSoon after Tuberculosis is worldwide health problem, especially in south Asia and Africa. It commonly affects lung, but extra-pulmonary Tuberculosis (TB) is also common. Most common extra-pulmonary tuberculosis present as cervical lymphadenopathy (enlarge cervical lymph nodes, mostly matted, various consistency, induration and cold abscess and sinuses). The present case is a very rare presentation of primary tuberculous cervical lymphadenopathy, the young patient present with tuberculous (TB) cold abscess in burns space only, no other lymph nodes enlarge and no other signs and symptoms of TB
Forensic Evaluation of the patterns of fatal injuries among pedestrians in road traffic accidents in Hyderabad, Pakistan.
Full text linkIntroduction: Road traffic accidents (RTAs) preventable yet responsible for a large number fatalities among children and adults. It is estimated that RTA causes approximately 1.35 million deaths (27.5 deaths per 100,000 population) through out the world.Objective: To evaluate the patterns of fatal injuries among pedestrians due to road traffic accidents brought in emergency unit of Liaquat University, hospital, Hyderabad.Methodology: This cross-sectional study conducted between Jan 2019 to Dec 2019 and all victims of road traffic accidents brought in the emergency due to fatal injuries belongs to either sex or age-group were included. Data collected includes demographic details; type, site, impact, intensity of inju-ries and different types of vehicles involved in the accidents were recorded from history/ autopsy findings of medico-legal officer. Collected data was entered and analyzed in SPSS ver. 23.Results: Motorcars were more involved (31.0%) in road traffic accidents followed by trucks/loaders (29.0%). Males (87.5%) outnumber female. Head and neck region (26.0%) affected most, while abdomen/pelvis were the least(16.0%) affected. Contusions occurred in predominantly (51.0%) while most (60.5%) pedestrians were found dead when received in the emergen-cy unit. Most common cause of death was head injury induced complica-tions.Conclusion: Injuries to head, neck and facial regions are more common while contusions are the predominant type of injuries occur in the pedestri-ans. Skull bone is most commonly fractured bone among the victimsKeywords: Pattern of injuries, Pedestrians, Road traffic accidents
Comparative clinical assessment of working length endo-motor apex locator versus radiographic method in endo-dontic therapy.
Full text linkIntroduction: The technological and therapeutic advancements suggests that, choosing an appropriate endodontic approach is the key parameter to mitigate over radiation exposure and locating precise root canal length.Objective: Current study aims to evaluate the comparative accuracy of working length apex locator versus radiographic apex locator in in endodontic therapy among patients belonging from Sindh, Pakistan.Methodology: Current four-month duration based cross-sectional study focusing endodontic therapeutic techniques was conducted at Bibi Aseefa Dental College Larkana Sindh Pakistan. 124 patients requiring non-surgical root canal therapy were included in the study for working length apex locator and radiographic apex locator techniques. Film positioner were used to assess the morphology and initial working length of tooth by radiographic apex locator technique. Whereas glide path and working length was achieved with #12/02 M3 – Pro Gold File (United Dental) with 00 reading in Endo-Matic apex locator. Further data analysis was achieved with SPSS Version 20 and Microsoft Office 2010 multiple tools.Results: Among 124 patients, 69 (55.6%) were males and 55 (44.4%) were females with mean age of 33.60±12.87 years. We found comparative accuracy of 77 % of working length apex locator in terms of apical limit determination. Whereas, in case of radiographic apex locators 70 % accuracy was recorded.Conclusion: Working length endomotor with built in apex locators provide satisfac-tory control of apical limit of endodontic treatment and better time saving option, however radiographic confirmations remain the confirmatory length measurement tool to identify the dimension of canal and path obtained by endodontic instru-ment.Keywords: EndoMatic, Electronic Apex Locators, Hybrid Endomotors, Radiograph, Working Length
Proton Pump Inhibitors: Pantoprazole is the safe drug as compared to Omeprazole drug during treatment of Dyslipidemia.
Full text linkIntroduction: Proton pump inhibitors (PPIs) are commonly used to manage ret-rosternal burning to peptic ulcer disease. Dyslipidemia is also very common in Asian population.Objective: To evaluate the effects of different groups of PPIs like omeprazole, Pan-toprazole, esomeprazole on lipid profile.Methodology: This animal study conducted at the Department of Pharmacology with collaboration of Diagnostic & Research laboratory of Liaquat University of Medical & Health Sciences Jamshoro from 16 Nov to 30 Nov 2020. 24 male rabbit were divided in 3 equal groups. The sample for lipid profile were taken twice; first sample was collected before start of PPPIs, while another sample was taken after six weeks of the treatment with different groups of PPPIs. The lipid profile was ana-lyzed by Cobass Auto analyzer (C-311) of Hitachi at Diagnostic & Research Labora-tory LUMHS. The Statistical analysis was performed by student ‘t’ test and chi square test by using SPSS version 21.Result: The results found were statistically significant (p=<0.05) for omeprazole and esomeprazole while it was insignificant (p=0.247) for pantoprazole. TG’s was signifi-cantly more in group A and B animals as compare to group C animals. Low density Lipoprotein found raised among all groups but the rise was statistically insignifi-cant.Conclusion: Omeprazole exerts significant effects over all observed parameters of lipid profile, esomeprazole showed effects over few parameters, while pantopra-zole showed insignificant effects over lipid profile.Key words: Proton Pump Inhibitors, Low density Lipoprotein, Cholesterol
Macrovascular Complications and their risk factors in Type 2 Diabetic Patients in Hyderabad, Pakistan.
Full text linkIntroduction: Diabetes mellitus (DM), is the universally occurring non-communicable disease as well as exemplary health problem affecting peo-ple worldwide.1 The number of cases of DM are rising at an enormous pace irrespective of any age, gender, economic status or ethnicity around the globe.Objective: To evaluate the macro-vascular complications and its correlation with different risk factors among type-2 diabetic patients.Methodology: This cross-sectional study was conducted at Red Crescent General Hospital Latifabad Hyderabad from October 2018 to October 2020. Type 2 diabetics of either gender, between age 20 and 70 years, on diabetic medication visited during the study duration were included in the study. Data related to socio-demographic details and clinical features was collect-ed from the participants using a written questionnaire. Collected data was analyzed using SPSS ver. 22.Results: Significant association (p<0.05) was demonstrated between Coro-nary artery diseases and the risk factors like; age of patient, the duration of diabetes mellitus, diastolic as well as systolic blood pressures, body mass index and serum triglycerides levels. While the statistically significant asso-ciation (p<0.05) of peripheral vascular diseases with the duration of diabe-tes mellitus, systolic blood pressure and serum triglyceride levels. Whereas, cerebrovascular disease was associated (p<0.05) with age, systolic and diastolic BP.Conclusion: The coronary artery disease seems to be most frequent macro-vascular complication among the type 2 diabetic patients. Whereas the risk factors including; advancing age, duration of diabetes mellitus, hyperten-sion, BMI as well as serum triglycerides levels are the most significant fac-tors for these complications.Key Words: Coronary artery disease, Cerebrovascular Disease, Diabetes Mellitus Type 2, Peripheral vascular diseas
Hand Hygiene Practices among Healthcare Professionals based on Theory of Planned Behaviour during Corona Pandemic in Pakistan.
Full text linkIntroduction: In the time of novel corona virus pandemic, the improper hygiene practices have significantly associated with high incidence rate of this dreadful disease spread. Theory of planned behavior is the best cognitive model to understand healthcare professional’s adherence toward hand hygiene practices. Objective: To evaluate the awareness, professional attitude and practices of health care professionals in relation to theory of planned behaviour during COVID-19.Methodology: We studied health care professionals visiting a health care facility. Systematic random sampling method was adapted for data collection with 384 sample size. Awareness, professional attitudes and practices were calculated and using theory of planned behavior, behavioral beliefs, normative beliefs and control beliefs were accessed. Results: In term of awareness and practices more than 70% of professionals were more prospective to follow hygiene of hands. However, using theory of planned behavior 70.1% of healthcare professionals were more into following hand hygiene practices but insisted to be more followed by their seniors and management.Conclusion: During COVID-19 pandemic, behavioral beliefs are strongly responsible to develop adherence toward hygiene, but such compliance is more motivated by peers, disease outbreak and self-efficacy rather than effect of hygiene itself. Awareness through workshops could be helpful to increase likelihood of compliance of hand washing practices. Keywords: Hand hygiene, normative beliefs, behavioral beliefs, control beliefs, COVID-19