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Classification of Guillain-Barré syndrome based on electrophysiological features
Get PDFObjective: Our study aimed to identify the most common subtypes of Guillian Barre Syndrome in our sample group and evaluate their electrophysiological features to better understand the disorder. Materials and methods: Between January 2020 and February 2021, we gathered information from patients diagnosed with Guillian Barre Syndrome and referred to the Neurology department at Lady Reading Hospital. Results: We enrolled 39 people with Guillian Barre Syndrome; 26 were male (67%), whereas 13 were female (33%). Based on electrophysiological analyses, axonal diversity is most common (AMAN followed by AMSAN). The average age of a patient with AMSAN was 39.2 21.8 years, but those with the demyelinating form were only 28 14.5. Springtime was the greatest incidence of GBS with 13 cases (33%), followed by fall with 12 cases (31%). Conlusion: A significant incidence of the axonal variety of [Guillain-Barré Syndrome] was found in our research, which was conducted in Khyber Pakhtunkhwa, Pakistan
A comparative study of ohmic and conventional pasteurization on camel milk
Get PDFThe present study was about the comparison of effect of ohmic and conventional pasteurization on camel milk. The objectives were to analyze the pasteurization effect of both methods on microbial and nutritional quality of camel milk. Camel milk was pasteurized by both methods, conventional heating as well as ohmic heating by maintaining the temperature of milk at 63°C and changing the time of pasteurization for 3.75, 7.5, 15 and 30 minutes. After pasteurization the milk was tested for microbes by total plate count (TPC) and nutritional profile of milk by different analysis. The pasteurized milk by ohmic heating showed a reduction of bacterial count from 2.35 to 1.83 log CFU/ml of TPC. The pH obtained was 6.54, moisture content was 88.19%, fat content was 3.09%, protein content was 2.43%, lactose content was 3.25% and ash content was 0.85% by pasteurization of camel milk with ohmic heating. The pasteurized milk by conventional heating showed a total plate count value of 2.37 to 1.87 log CFU/ml. The pH obtained was 6.6, moisture content was 87.66%, fat content was 2.99%, protein content was 2.33%, lactose content was 3.16% and ash content was 0.84% with conventional heating of pasteurization. 
Improvement in organ failure in acute on chronic liver failure (ACLF) upon liver transplantation
Get PDFBackground &Aim: The prognostic factors determining the outcome of patients with cirrhosis and multi-organ failure are currently under evaluation. Reversal of organ failure pattern in response to Liver Transplant has not been studied much. It is an understood phenomenon that different organs that failed as consequence of ACLF will ultimately recover from injury upon liver transplantation. The aim of the study was to determine the mean number of days a failing organ in a pre-transplanted patient will take to recover after liver transplantation. Methods: Data was collected from April 2013 till February 2020 in the department of Liver Transplantation, Hepatobiliary and Pancreatic Services, Shifa International Hospital, Islamabad. In this cross-sectional retrospective study, 82 ACLF patients of both genders of age >15 years who fulfilled EASL-AASLD definition and underwent liver transplantation were included in the study. And patients who fulfilled APASL criteria but did not fulfilled EASL-AASLD criteria of definition of ACLF or those who required ventilator support or triple inotropic support before surgery were excluded. Patients with serum creatinine level >1.5mg/dl were labeled as having renal failure. Those with total bilirubin level of >12 mg/dl were labeled as hepatic failure and those with INR >2.5 were having coagulation failure. 
Green practice guideline program regrading waste management on nurses’ knowledge and practice in intensive care units
Get PDFBackground: Hospitals all over the world looking forward to become more sustainable and get rid of medical waste which resulting in environmental pollution, misallocation and increased costs for medical facilities. The study was carried out at Ain shams University Hospitals and which included surgical, medical and cardiac (ICU). A convenient sample of 60 nurses were included. Study tools: A structured self-administrated questionnaire, waste reduction and prevention checklist, and barriers of green practice regarding waste management questionnaire. Results: (91.7%) of the studied nurses have unsatisfactory level of total knowledge about green practice pre guideline program implementation while (93.3%) of them improved to satisfactory level post implementation and slightly decreased to (90%) at follow-up phase. Also, (93.3%) of the studied nurses have unsatisfactory level of total practice pre guideline program implementation while (94.6%) of them improved to satisfactory level post program implementation and slightly decreased to (93.1%) at follow-up phase. mean and standard deviation of the barriers of application of green practice regarding waste management in ICU as; administrative barriers was 1.12 ± 0.87 in the surgical ICU nurses compared to 1.45 ± 1.110 and 1.37±0.94 in the medical and cardiac ICU nurses. 
Stress anxiety and depression level amongst nurses working at tertiary care hospital
Get PDFBackground: Nurses are expected to offer patients with high-quality care in all healthcare settings and are seen as an essential member of the health care workforce. Objective: To assess the stress anxiety and depression level amongst nurses working at tertiary care hospital. Methodology: The current cross sectional study was carried out at Balochistan Institute of Psychiatry and Behavioral Sciences and Bolan Medical Complex Hospital Quetta from November 2010 to May 2020. A pre-designed questionnaire was distributed amongst all the nurses who fulfill the inclusion criteria. Data collection was done by self-completed scale of Depression, Anxiety and Stress Scale 21 (DASS-21). The SPSS version 24.0 was used to input and analyze the data. Results: In the current study, totally 150 nurses were enrolled. The male nurses were 45 (30%) while female nurses were 105 (70%). The mean age with standard deviation in the current study was 36 (±4.12) years. In the current study, 30 (20%) nurses were normal, 18 (12%) were with mild depression, 52 (34.66%) were moderate, 45 (30%) were severe and 5 (3.33%) nurses were observed with very severe depression. 
Outcome of patients with primary sclerosing cholangitis and ulcerative colitis undergoing colectomy
Get PDFBackground and Aim: Patients with ulcerative colitis (UC) are at risk of developing primary sclerosing cholangitis (PSC). As a form of continence preservation, ileal pouch-anal anastomosis or ileorectal anastomosis are used for patients undergoing colectomy. The present study aimed to determine the patient outcomes following colectomy for primary sclerosing cholangitis and ulcerative colitis. Patients and Methods: 64 patients with PSC and UC undergoing colectomy were enrolled and investigated in the Department of Gastroenterology, Lady Reading Hospital, Peshawar from January 2018 to June 2020. Study protocol was approved by the institutional research and ethical committee. Patient’s data regarding clinical information, preoperative liver tests, colectomy date, pathological findings, and follow-up liver tests were reviewed from medical records. The colectomy-leading indications such as colonic dysplasia, bowel perforation, and colonic inflammation etc. were recorded. Several preoperative tests were conducted, including total bilirubin, albumin levels, direct bilirubin and ALP. SPSS version 26 was used for data analysis. Results: The overall mean age was 40.42±3.6 years. Of the total 64 patients, there were 42 (65.6%) male and 22 (34.4%) females. Colectomy was most commonly indicated by severe intestinal inflammation (52%), bowel perforations (4%), and dysplastic colons (38%). The incidence of postoperative complications were 43.8% (n=28)
Design, synthesis, spectral analysis and molecular docking studies of some cyclic imide as potential anti breast and cervical cancer agents
Get PDFA number of cyclic imide derivatives were prepared in this study, using Diels- Alder reaction as a first step between maleic anhydride and anthracene. Use the reaction product as a reactant in the second step with different amines. The prepared cyclic imides were characterized by following the known spectroscopic methods to prove the proposed chemical composition of each of them using Mass, FT-IR, 1HNMR and 13CNMR. The biological activity of the prepared cyclic imides was tested theoretically using molecular docking to prove their efficacy as candidate inhibitors of breast and cervical cancer. The efficacy of prepared cyclic imides as inhibitors and antagonists of breast and cervical cancer, a practical candidate using the MTT assay to measure cellular metabolic activity as an indicator of cell viability, proliferation and cytotoxicity in MCF-7 and HeLa cell lines. Cytotoxic effects were in agreement with the molecular docking calculations, as the prepared cyclic imide derivatives showed good activity in inhibiting breast and cervical cancer cells. The results of MTT assay and molecular docking scores proved that the prepared (11R,15S)-13-(3-nitrophenyl)-9,10-dihydro-9,10-[3,4]epipyrrolo-anthracene-12,14-di one derivative a3 is considered as a potential candidate inhibitor for cervical cancer
A prospective study comparing the clinical outcomes of conservative and surgically treated spinal tuberculosis
Get PDFIntroduction: Spinal tuberculosis is a serious form of extra pulmonary tuberculosis which if left untreated can be fatal; neurologic dysfunctions in association with active tuberculosis of spine can be prevented by early diagnosis and prompt treatment. Prompt treatment can reverse paralysis and minimize the potential disability resulting from Pott’s paraplegia. A significant dilemma exists as to which line of management a patient needs to be subjected once diagnosed to have spinal tuberculosis. Objective: Assess the functional and neurological outcome of patients treated with different modalities of treatment and attempts to ascertain the best practise for effective management of a case of spinal tuberculosis. Materials and Methods: 22 adult patients diagnosed with spinal TB and treated with either conservative line of management or CT/USG guided pigtail catheter drainage with chemotherapy or surgery combined with chemotherapy, were considered. Patients were followed up until completion of anti-TB treatment. Clinical outcomes were assessed using Visual analogue scale, Oswestry Disability Index and modified McCormick grade. Results: Patients having milder form were treated conservatively using anti-tubercular drugs alone (n=13). Patients with well-established abscess and without instability were treated using CT/USG guided pigtail catheter drainage along with antitubercular drugs (n=6). 
The influence of Bolton’s analysis and Peck & Peck index on the pre and post-treatment overjet: A retrospective study
Get PDFBackground: To evaluate the relationship between the overjet with pre and post orthodontic treatmentBolton’s analysis and with Peck & Peck index. Materials and Methods: Pre and post-treatment orthodontic study models (n=30) of patients in the age range of 18 to 35 years, who underwent orthodontic treatment were evaluated for overjet, Bolton’s analysis (overall ratio & anterior ratio) and Peck & Peck index (in 31,32,41&42). A digital Vernier caliper was used for all the measurements. The collected data was analyzed in SPSS software using appropriate statistical tests based on normality to compare the pre- and post-treatment mean values and Pearson’s correlation was done between the Bolton’s analysis and Peck & Peck index with overjet. The p value <0.05 was considered as statistically significant. Results: The Pearson’s correlation revealed an inverse correlation between Bolton’s anterior ratio and overjet (pre:-0.226, post:-0.254). The pre-treatment overjet with Peck & Peck index revealed an inverse correlation in PP 31 (-0.230) and positive correlation in other teeth. The correlation in the post-treatment overjet with Peck & Peck index was an inverse correlation in all teeth (-0.347; -0.184; -0.184 & -0.074 in PP31, PP32, PP41 & PP42 respectively). 
Intervention strategy to empower women victims of violence: Experience in three localities in Arequipa-Peru 2018-2020
Get PDFThe study is framed in the Sustainable Development Goals of the United Nations, which commit the countries of the world to eliminate all types of gender violence by 2030, aimed to conceptualize and extract the key elements of an intervention strategy to empower women victims of violence. The paper presents an empirical study in three areas of Arequipa with women victims of violence, from the approach of the risk of femicide, information on Law 30364 enacted by Peruvian State to eradicate violence, and obligations of the police. A quasi-experimental design was carried out, with pre-posttest evaluation to experimental-control groups, including 37 educational sessions simultaneously applied to the experimental group at the three sites, with nurses, lawyers and police during the years 2018- 2020. The sample includes 300 women, chosen by convenience from 3 vulnerable populations, Zamacola, October 4, Miguel Grau, from neighboring police stations, health facilities and community.