Journal of Bahria University Medical and Dental College
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Effect of Metformin Versus Diet and Exercise on Ovulation & Menstrual Regularity in PCOS
Get PDFTo compare the effects of metformin with diet & exercise on ovulation & menstrual regularity in PCOS infertile women .Study Design: Randomized clinical trial.Place & Duration of study: Private hospital infertility clinic at Karachi from 2001-2004.Patients & Methods: One hundred & eleven PCOS women with primary infertility were enrolled. and divided into group A & B with 57 & 54 patientsrespectively. Group A received tablet metformin 500mg thrice daily along with diet & exercise advice while group B was kept on diet & exercise alone(30-60 minutes walk daily & avoidance of oily foods, red meat & bakery products) for a period of 90 days. Menstrual regularity & plasma progesteronelevel were evaluated at day-0 and day-90. Fasting serum glucose, insulin, follicle stimulating hormone, luteinizing hormone, prolactin, testosterone &ultrasound pelvis were done at day- 0 for diagnosis of PCOS.Results: 100 patients completed the study. 50 patients in each group.In group A, 44 (88%) patients developed regular cycles with statistically significantincrease in serum progesterone whereas in group B only 3(6%) patients developed regular cycles with non-significant increase in serum progesterone levelfrom day-0 to day-90. Group A showed ovulation in 82% patients in comparison to Group B where ovulation occurred in only 6% of patients.Conclusion: Metformin produced beneficial effects in comparison to diet & exercise alone in PCOS infertile women
CementalTear Predisposing Factors, Clinical Signs Symptoms, Diagnosis and its Management
Get PDFA cemental tear is a rare condition in which a total or partial detachment of the cementum occurs along the root surfaceat the cemento-dentinal junction and is associated with moderate to severe periodontal attachment loss. Literature regarding this article was searched fromPub Med, Medline and Google during the period of Jan 2008- Dec 2012.Cemento-dentinal tear is more frequently seen in older men above 60 years, single-rooted vital or nonvital teeth, particularly the incisors and premolars areinvolved. Other significant etiological factors are traumatic occlusion, poor ability of tissue healing due to age and structural weakness of the cementum. Its diagnosis can be confirmed by clinical signs and symptoms,(presence of localized periodontal pockets with exudates and localized pain) by radiographic findings(as a radiopaque fragment) and surgical inspection. The treatment of cemental tears involves scaling and root planning, open flap debridement, bone graft, regenerative tissue guide, apical surgery and dental extractio
Giant Parotid Tumor
Get PDFMalignant parotid tumors are uncommon tumors. Although pleomorphic adenoma is the commonest benign tumor of the parotid accounting for 65% of tumors but malignant tumors are also seen frequently in parotid gland. Normally these tumors are slow growing with a long history of lump in the parotid gland. The rapid growth phase in these tumors indicate malignant transformation. The involvement of facial nerve is a late symptom and denote advance stage. We are presenting a giant malignant tumor of the parotid gland measuring 22cm x 15cm in a lady of 50 years. To the best of our knowledge this is the biggest tumor reported so far in Pakistan
Association Of Vitamin D Status And Diabetes Mellitus
Get PDFTo evaluate the association of 25-hydroxyvitamin D3 (25OHD)inadequacyand hyperglycaemia in a Pakistani adult population.Study Design:Case control studyPlace & Period of Study:Department of Pathology, PNS SHIFA Hospital, Karachi; Aug 2011 to Nov 2011.Method and Material:Plasma Glucose levels were measured in 86 patients divided on the basis of their 25-hydroxyvitamin D3(25OHD)levels in three groups, normal (>31 ng/ml), insufficient (20-31ng/ml) and deficient (<20ng/ml). Vitamin D insufficiency (VDI)and Vitamin D Deficiency (VDD) are collectively called Vitamin D inadequacy. 25OHD was measured by electrochemiluminescenceusing Roche Elecsys® Systems while glucose was estimated by routine methods on Roche Hitachi® Autoanalyser.Results:.Vitamin D levels were inversely correlated with plasma glucose levels(r=-0.38;p<0.01) with an Odd Ratio of 3.59(95%confidence interval 1.29 to 8.70).Fasting plasma glucose was significantly higher in VDD patientsas compared to patients withnormal vitamin D status (p<0.05).Conclusion:Higher glucose levels were found more frequent in patients with Vitamin D deficiency
Reflection As An Essential Component of Medical Education
Get PDFMedical education has taken many turns in the last 2 decades. For centuries the teaching and learning of the science and art of Medicine as a discipline has been pedagogic. A figure of authority taught from personal experience and knowledge, garnered in time, most of it from former teachers and passed on verbatim to students. There was no need for proof, experimentation, change or the challenge of inquiry or skepticism on the part of the learne
Study On Pattern Of Obsessive Behaviors And Thoughts In A State Of Anxiety In Teenagers
Get PDFObjective: To determine pattern of obsessive behaviors and thoughts in a state of anxiety in teenagers (14-18 years) of age.
Study Design: Cross sectional
Methodology: We conducted research on teenagers of different cities of Pakistan. We selected about 100 student s of age 14-18 years, out of which 55 were girls and 45 were boys of schools, colleges and academies. DASS (depression anxiety stress scale) was used as instrument.
Results: Our study showed that 30 students (30%) felt that everything was alright and nothing bad will happen at any time. Similarly same number of teenagers was never afraid for any reason in their day to day lives. We found that about 24(24%) never had any frightened feeling whereas about same number had flushing of face in embarrassing situation sometimes. About 18(18%) teenagers complained of worrying thoughts sometimes at night whereas about same number had a good night sleep all of the time. About 38 teenagers (38%) neither faced difficulty in swallowing in a tense situation nor did they avoid eating in public places in a similar situation. Many students felt afraid of participating in extracurricular activities i.e. about 24 students (24%). However they willingly participated in group discussions. About 55 students (55%) were neither afraid of participating in group discussion nor in extracurricular activities.
Conclusion: Obsessive behaviors and thoughts were uneasy feelings (like butterflies) in stomach, hot and flushed face, feeling frightened or scared, worrying thoughts at night and difficulty falling asleep
OSPE In Pharmacology - Students Perspective
Get PDFStudents' perspective about OSPE was assessed in 2012. They responded on pre- examination arrangement, time allocation, number of stations; ontent, process, process explanation, quality of questions, marks allocation, faculty behavior, overall atmosphere and comments about OSPE experience and its comparison to conventional pattern. Student`s responses were graded as good (combining agree and strongly agree), poor (combining disagree and strongly disagree) or neutral. Of 102 students, ninety students (88%) responded to questionnaire at the end of all four examinations. 87.65% students found pre-examination arrangement good while 86.5% were happy with explanation of procedure. 89% felt faculty behavior satisfactory, 82.5% considered OSPE process smooth, 86% expressed satisfaction with quality of questions, 79.5% considered number of stations adequate, 86.75% believed time adequate, 87% concluded that content was adequately covered. 86.87% considered atmosphere conducive and 81.25% considered marks justified. Students' overwhelmingly found OSPE in Pharmacology an effective method of assessment
Measuring Patient Satisfaction Parameters: A Cross-Sectional Descriptive Study At PNS RAHAT Hospital Karachi.
Get PDFObjective: To describe patient satisfaction with hospital services and staff dealing.
Materials and Methods: This cross-sectional study was carried out between January to April-2011 at out-patient departments of PNS Rahat. Randomly selected 96 patients entitled to free medical treatment were offered to voluntarily fill the pretested structured questionnaire in URDU(with mathematical scoring for each selected satisfaction index selected) to comment on the various aspects of services offered at the hospital. The four objective satisfaction scores included: 1-seating /waiting facilities, 2-length of waiting time, 3-staff attitude and 4-Cleanliness at the outpatient departments, radiology, laboratory and pharmacy.
Results: The availed mean score was 80.1 + 42.6. Out of the total possible score of 170 of the questionnaires filled. The mean patient score achieved was 57.4 + 33.9. Patients scored less on the satisfaction indices pertaining to waiting time [Average score=4.73/10] and comfortable stay [Average score=6.43/10] in the waiting areas of the hospital OPDs. Patients had a higher satisfaction score on indices related to sanitation/cleanliness issues [Average score=7.52/10] and staff attitude [Average score=7.71/10].
Conclusion: Prolonged waiting time and non-availability of quality stay in waiting areas of outpatient departments and diagnostic centers are the cause of lesser patient satisfaction during a patient's visit to hospital
Transpedicular Decompression And Spinal Fixation In Thoracolumbar Burst Fractures
Get PDFObjective: To evaluate the results of transpedicular decompression and single stage pedicle screw fixation in burst fractures of thoracolumbar spine. Materials & Methods: This study was carried out at PNS Shifa from Dec 2010 to Jan 2013. All consecutive traumatic burst fractures that underwent surgery were included in the study. Twenty three consecutive patients aged 17 to 57 (mean, 41) years who had burst fractures in the thoracolumbar (n=13) and lumbar (n=10) regions and were surgically treated were included in this study. There were 18 males and 5 females. Fractures were classified according to the AO classification. The extent of spinal canal compromise was assessed by computed tomography, and the neurological status by the modified Frankel grading for traumatic paraplegia. All patients underwent posterior transpedicular decompression and same stage pedicle screw fixation. Outcome was assessed on Frankel grading scale.
Results: The extent and level of neurological injury varied. It did not correlate with extent of canal compromise, age and sex of the patient. Neurological injury was greater with T11 and T12 injuries than Lumbar fractures. No worsening of neurological grade was observed after surgery; rather 20 of 23 patients (86.9%) improved to the next higher grade. Screw malposition to the extent warranting readjustment was noted in 2 cases. Hardware failure occurred in 1 case after 6 months, bed sores in 3 cases and deep vein thrombosis in 1 case.
Conclusion: Single stage Transpedicular decompression and spinal fixation from a posterior approach gives good results in burst fractures of thoracolumbar spin
Frequency And Factors Associated With Headache Among People Of Various Occupations
Get PDFObjective: To find out the frequency and factors associated with headache among people of various occupations.
Materials andMethods: This cross sectional study with purposive sampling was carried out in four cities, Karachi, Rawalpindi, Rahim Yar Khan andMuzafarabad from June 2011 to September 2011. Data was collected on a specially designed questionnaire with 21 questions both open and closed ended variety. After a written consent 250 individuals working as doctors, engineers, businessmen, bankers, executives, drivers, teachers, armed officers, laborers and household servants aged between 18 and 60 years were enrolled. Individuals suffering from any acute illness like common cold and gastroenteritis etc and chronic debilitating disease like diabetes, cancers were excluded.
Results: Two hundred and fifty subjects participated in this study. 82.4 % were males while 17.6% were females. Their age range was 18-60 years Majority of subjects 80.8% were married. Overall frequency of headache was 62.8%. Highest frequency of headache was found in bankers & teachers (80%) and lowest was among doctors (48%).Age, anxiety and work place showed statistically highly significant association with headache. Family history, physical activity, high and low blood pressure and daily working hours were significantly associated with headache.
Conclusion: Frequency of headache is found to be high whereas age, family history, physical activity, both high & low blood pressure ,anxiety, daily working hours and work place are found to be associated with headache among people of various profession