Journal of Muhammad Medical College ( J Muhammad Med Coll)
Not a member yet
90 research outputs found
Sort by
Pattern of acute diarrhea and its management among children at DHQ Hospital, Attock city from July-August 2014.
Full text linkIntroduction: Acute diarrhea is the 2nd most common cause of death among children under 5 years age countrywide. It is the passage of watery or loose stools 3 or more times in 24 hours and lasting less than 14 days.
Methodology: This Comparative study was carried out at DHQ Hospital Attock City from July-August 2014 by using a close ended questionnaire.
Results: From July 2014-August 2014, a total of 40 children having acute diarrhea were hospitalized in the DHQ Hospital Pediatric ward. There were more males n=24(60%) then females n=16 (40%) and the male to female ratio was 1.5: 1. 50% of the patients presented in 2nd half of 1st year. n=32 (80%) children presented with 4 days of illness. All patients had passed 8-10 stools per day. One had passed 15-20 stools per day. n=9 (22.5%) child pass small amount of blood/ mucous in stools. Exclusive breastfeeding was reported in n=8 (20%) of the patients. n=18 (45%) children did not show any signs of dehydration, n=15 (37.5%) showed some dehydration and n=7 (17.5%) showed severe dehydration. Symptoms associated with diarrhea were fever n=31 (77.5%), cough n=17 (17.5%), vomiting n=8 (20%), oral thrush n=1 (2.5%). Blood CP n=39 (97.5%), ESR, Stool Examination n=31 (77.5%), X-Ray Chest n=8 (20%) were the investigations done in children. ORS/OEM use rate was 40 (100%) while rate of antibiotic (ceftriaxone) was n=7 (17.5%), n=33 (82.5%) received Zinc Sulphate in syrup form, n=31 (77.5%) received Syrup Paracetamol.
Conclusion: Diarrhea is a common illness among children under 1-year age. Fever is the most common associated symptom with diarrhea. Parenteral diarrhea due to abdominal infections is also predominant condition.
Key Words: Diarrhea, Abdominal infections, Oral rehydration salt
Post-operative surgical site infection in Inguinal Hernia.
Full text linkIntroduction: Surgical site infection is defined as microbial contamination of surgical wound within 30 days of operation; most common complication occurs after surgery and increase the mortality and morbidity rate.
Objective: To find prevalence of post-operative surgical site infection and it’s causing organism.
Methodology: This descriptive study was conducted between Feb 2014 to July 2017, 100 cases operated in Bhurgri Hospital Matli, were included after taking informed consent. The surgical site when found infected, swab sensitivity was sent.
Result: The age range was from one month to 70 years. A Total number of 100 patients with primary and recurrent inguinal hernia were subjected to hernia repair with proven mesh and anatomically repair.
Conclusion: Escherichia Coli is the most common pathogens involved in post-surgical infection.
Keywords: Inguinal hernia, mesh repair, wound infection, microorganism infection rate
Evaluating the impact of baby-friendly Hospitals on mother’s knowledge and practices regarding breastfeeding in Karachi, Pakistan
Full text linkIntroduction: Breastfeeding is a natural way of feeding to a new born baby. World Health Organization launched a Baby Friendly Hospital initiative in 1992, to strengthen maternity practices to support breast-feedings. Currently, about 19250 hospitals world wide have achieved Baby Friendly Status. To evaluate the role of Baby Friendly Hospital Initiative on feeding and weaning practices of mothers in improving health status of children under five years of age
Methodology: Cross sectional comparative study was done at baby friendly hospital (BFHI) and non-baby friendly hospital (Non BFHI) Karachi. A total of 784 mothers were selected through convenient sampling and grouped according to place of birth.
Results: Feeding practices in BFHI group was better in some respects. Among them 81% mothers did not give any pre-lacteal feeds, 79% mothers reported that their babies were exclusively breast fed up to four months of age and 31% reported that they initiated breast feeding within one hour after the delivery.
Conclusions: Baby Friendly Hospital initiative has a beneficial effect on feeding practices of mothers and duration of exclusive breastfeeding. But some areas of optimal breastfeeding practices are not taken care well. Initiation of breastfeeding within ½ to 1 hour needs attention.
Key words: Breast feeding, Baby Friendly Hospital Initiative, weaning, exclusive breast feedin
Spectrum of Diseases in Patients with Non-Traumatic Acute Abdomen.
Full text linkIntroduction: Acute Abdomen is the most common presenting complaints about 20% of all emergency department, due to its varied etiology it poses significant diagnostic challenges for emergency surgeons. The proper management of patients with acute abdominal pain requires a timely decision about the need for surgical operation.
Objective: To identify the spectrum of diseases in patients of non-traumatic leading to Acute abdomen, presenting in a surgical unit.
Methodology: During Jan 2012 to Dec 2014, this retrospective study conducted at Surgical Department of Muhammad Medical College, all patients presenting with non-traumatic acute abdominal pain were included in this study. Gynecological and urological causes were excluded. The patient diagnosis and management were recorded from the case files and OT registers.
Results: During the period, a total of 216 patients presented with non-traumatic acute abdomen; of which there were 145 (67.12%) males and 71 (32.87%) females, with a male to female ratio of 2:1. The highest incidence of acute abdomen 72 (33.33%) was found in patients of 22-32 years age group followed by under 21 years age group i.e. 51 (23.61%) and 33-42 years age group 43 (19.90%). There were 31 (14.35%) cases in 43-52 years and 19 (8.79%) cases in 53-70 years.
The most common cause of acute abdomen was acute appendicitis 105 (48.61%) admissions. These patients were mostly young males in twenties. Intestinal obstruction was second cause 45 (20.83%) cases and this affected more commonly the middle-aged persons. Two hundred and seven (95.83 %) patients were treated successfully and discharged home while 5 (2.31 %) left against medical advice, while 4 expired giving a mortality of (1.85) % in patients with gut perforation
Conclusion: The most common cause of acute abdomen is acute appendicitis affecting young population mostly. Another common cause is intestinal obstruction and gut perforation. Acute cholecystitis commonly affects the middle aged, post-menopausal women. Hepatic abscess and Pancreatitis are rare cause of acute abdomen in this area.
Key Words: Acute abdomen. Non-traumatic Acute appendicitis, Intestinal obstruction
Hemogram indices of healthy lactovegetarian population from Tharparkar village.
Full text linkIntroduction: The evidence of micro nutrients deficiencies related mortalities are emerging all over the globe. Lake of the knowledge of dietary source of vitamin D complex and iron affects the haemogram indices. Aim of this study was to assess the haemogram values of healthy lactovegetarian population of Tharparkar village and to correlate these with WHO parameters.Methodology: This descriptive cross-sectional study was conducted in 2016-17 on 100 apparently healthy subjects of both genders with age 14 to 55 years. Peripheral smears were prepared using Leishman stain at the research field during sampling. Coagulated whole blood samples were collected and transported to the Dow university lab at Karachi under proper temperature.Result: The mean age of the subjects in this study was 30.5 (±8.3) and the male to female ratio was 2.1:1 the mean hemoglobin level was 13.5 (±1.6). Mean NCV level was83.6 (±9.9) mean MCH was found as 63.9 (±3.1).and mean Hematocrit was found as 40.4. (±5.7)Conclusion: The blood indices of lactovegetarian population of Tharparkar village fall within the specified range as set by WHO Parameters accept MCV which was found higher than normal. This may be attributed to the deficiency of vitamin B12 or Folate.Key word: Lacto-vegetarian, Hemogram indices, vitamin B12/Folate deficiency, Anemia
Simple clinical parameters to diagnose Malaria in Outpatient Department.
Full text linkIntroduction: Malaria is the world's most important parasitic infection which poses major health challenges. Best estimates currently describe the annual global burden of malaria as 300-500 million cases and 1-2 million deaths. Traditionally malaria is diagnosed clinically based upon sign symptoms and clinical examination particularly in remote areas where laboratory facilities are not available. However, no universal criteria exist for clinical diagnosis of malaria and presenting features are highly variable region to region. Therefore, we planned to define the simple parameters based on clinical signs and symptoms that predict malaria without laboratory confirmation of parasitemia.
Objective: To determine the sensitivity, specificity and positive predictive values of simple clinical parameters for the diagnosis of malaria without laboratory confirmation of parasitemia.
Methodology: This observational study was carried out at pediatric department of Karachi Medical and Dental college and Abassi Shaheed Hospital Karachi during 15 April 2015 to 15 February 2015. Children between 6 months to 5 years, who presented with short duration of fever (less than 7 days) were included in study. The diagnosis of malaria was confirmed on identification of parasite (Plasmodium vivax or Plasmodium falciparum) in blood obtained from finger prick sample for thick and thin film. The patients were divided into two groups (+ve MP cases and -ve MP cases). Focal signs and symptoms, pallor (anemia) and splenomegaly were checked in both groups to assess the sensitivity, specificity and predictive values of these simple clinical parameters and co-related with the presence of malaria parasitemia.
Result: Six hundred fifty-seven children were examined. One hundred (15.22%) children out of 657 had malaria confirmed while 84.78% (557 of 657) had illness other than malaria. There were 43 children (43%) with Plasmodium falciparum malaria, 47 children (47%) with Plasmodium vivax malaria and 10 (10%) with mixed infections. Three clinical parameters (No focal features, anemia & splenomegaly) were studied in all febrile patients which were divided into two groups (Malarial parasite +ve and malarial parasite -ve).
Conclusion: Few simple clinical findings can lead to reliable clinical diagnosis of malaria with more logical use of antimalarial drugs in children.
Key words: Malaria, Anemia, Splenomegaly
Human Cystic Echinococcosis: A Neglected Zoonotic Public Health Problem in Pakistan.
Full text linkThis review represents an updated scenario on the epidemiology, transmission cycle, diagnosis and treatment surveillance and one health approach of a cestode parasite Echinococcus granulosus (E. granulosus) infection causing cystic echinococcosis (CE) in humans. It is life-threatening neglected zoonotic disease that occurs in both developed and developing countries including Pakistan and is recognized as a major public health problem. It spread through infected feces of canids and is associated with high morbidity and mortality. In Pakistan, rural lifestyle supports spread of the disease and it often presents with complications posing a high treatment cost. The life cycle of E. granulosus involves a definitive host (dogs and other canids) for the adult E. granulosus that resides in the intestine and an intermediate host (sheep and other herbivores) for the tissue-invading metacestode (larval) stage. Humans are only incidentally infected; since the completion of the life cycle of E. granulosus depends on carnivores feeding on herbivores bearing hydatid cysts with viable protoscoleces, humans represent usually the dead end for the parasite. Community awareness, mandatory reporting and responsible pet ownership are recommended for elimination of the disease.
Key words: Human Cystic Echinococcosis, diagnosis and treatment
Prevalence of anxiety and depression among Medical Students in MMCH, Sindh, Pakistan
Full text linkIntroduction: Medical education is stressful. High levels of stress have been seen in medical students in various studies. The academic stressors include the volume of material to be learned, academic performance and evaluation, examination and continuous assessment, mental tension and too much work load. All this can result in decreased life satisfaction among students. Stress during medical school can lead to problems later in professional life compromising patient care.
Objectives: To know the prevalence of anxiety and depression among medical students of Muhammad Medical College, Mirpurkhas, Sindh, Pakistan
Methodology: A Cross-sectional study was done on the students of Muhammad Medical College, Mirpurkhas, Sindh, who had spent more than six months in the medical college. Self-administered questionnaire was given to the students, present in the class and willing to participate in the study. The instrument used to assess the anxiety and depression levels was the, Aga Khan University Anxiety and Depression Scale (AKUADS). Additional quotations regarding socioeconomic variables were also included in them survey instrument, such as student’s age order, family monthly income, and gender, marital status.
Results: Using anxiety and depression scale it was found out that 318 (96.36%) students had anxiety and depression. Among them 215 (67.61%) were females and 103 (32.38%) males. Prevalence of anxiety and depression in students of Final, 4th year and 3rd year 2nd and 1st years was 13%, 15%, 20% and 21%, 28% respectively. It was significantly higher in 1st year and 2nd year students, as compared to final and 4th year and students.
Conclusions: Most of medical students have anxiety and depression due to study burden and a busy schedule. It is also seen that anxiety and depression is more among female medical students, and more among in 1st year and 2nd year MBBS students, as compared to the final and forth year students.
Keywords: Anxiety, depression, Medical students, prevalenc
Complications of Laparoscopic cholecystectomy at Muhammad Medical College Mirpurkhas: Audit of 100 cases.
Full text linkIntroduction: The main objective was to determine the complications of laparoscopic cholecystectomy (LC) and its cause at Muhammad Medical College Mirpurkhas.Methodology: This is prospective study carried out from February 2008 to January 2016. Data of all patients undergoing elective laparoscopic cholecystectomy during the study period and fulfilling the selection criteria was collected and entered in standard proforma and analyzed on SPSS 10.Result: A total number of ten patients underwent laparoscopic cholecystectomy with an overwhelming majority of females (87 out of 100). The age ranges from 22-60 years mean age being 38 years. The overall complication rate was 9%. The complication included bleeding (4/100, 4%) from cystic artery and gall bladder bed, port site infection (4/100 4%) One patient developed collection in pouch Morrison and one patient was developed stitch granuloma. There was no bile duct injury and colonic injury. The most common cause of these complications was accidental injury to cystic artery and gross spillage of infected bile.Conclusion: Bleeding and port site infections were common post-operative complication; the most common cause of bleeding was cystic artery injury whereas the commonest cause port site infection was gross spillage of infected bile.Key Words: Laparoscopic endoscopy, cholelithiasis, complication
Variations in Serum Ferritin in Different Professionals of Mirpurkhas.
Full text linkIntroduction: Serum ferritin has been shown to be a good biomarker of body iron stores. Iron is essential mineral that functions to bind oxygen as a part of Heme in Hemoglobin and Myoglobin1. Ferritin, a major protein regulating iron homeostasis, is used as a biomarker for iron status and low grade inflammation, which results in free radical damage to cells and tissues18-19. Accordingly, recent studies demonstrated that serum ferritin concentrations are correlated with diabetes mellitus, insulin resistance, metabolic syndrome, ischemic heart disease, cardiovascular disease, and nonalcoholic fatty liver disease (NAFLD) in healthy men and obese patients.
Objective: The study was aimed to evaluate possible variations in serum ferritin levels in different professional of Mirpurkhas.
Methodology: 250 subjects were randomly selected from the local community of Mirpurkhas from OPDs of Civil Hospital Mirpurkhas and Muhammad Medical College Mirpurkhas. Their Serum ferritin was determined by ELISA. And the data was analyzed by SPSS 15.
Results: This was a cross-sectional study. Out of 250 subjects 170 (68%) were male and 80 (32%) were female. The mean age was 55.20 ± 11.046 year the mean height of subjects was 1.6732 ±.09637 meters while the mean weight was estimated as 65.50 ±11.589 kgs. The mean BMI was calculated as 24.2772 ±3.34493 kgs/m2. Serum ferritin was ranged between 46-450 ng/ml of blood with mean serum ferritin 226.32 ± 99.027 ng/ml of blood. Serum Ferritin in male was found 233.59 ±98.366 ng/ml of blood and in female was found to be 210.88 ± 99.268 ng/ml of blood. It was found that the mean serum ferritin in teachers was 181.00 ± 42.312 ng/ml, in doctors 286.67 ±67.788 ng/ml, in farmers 267.91 ±78.188 ng/ml, in laborers 174.40 ±108.939 ng/ml, in house wives 201.14 ±112.797 ng/ml, in Clerks office superintendents 205.50 ±16.338 ng/ml, in peon/ masi/ attendants 233.00 ± 135.262 ng/ml, in unemployed 120.00 ± .000 ng/ml, in retired 304.20 ± 89.084 ng/ml and in Businessmen 193.17 ±89.084 ng/ml. A comparison was made between serum ferritin values of different professionals by applying ANOVA test and found that there is a significant difference between serum ferritin values of different professional with highly significant p=.000 value.
Conclusion: It was found that serum ferritin level was not similar in all profession and different type of work do affect its level inside the body