Journal of Bahria University Medical and Dental College
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Towards Competency Based Undergraduate Curriculum In Pakistan
Get PDFKnowledge in the biomedical field has grown exponentially, and is likely to keep on growing exponentially. Not only has the quantum of knowledge in the traditional subjects grown, but completely new subjects have been added in biomedical science. Thus, it is impossible for any one person to know everything about a subject. Hence,the need towards specialization has emerged in narrower and narrower sub-specialitie
A Case of Subhyaloid Haemorrhage Managed with ND:YAG Laser Hyaloidotomy
Get PDFSubhyaloid hemorrhage is rarely seen in ophthalmological practice in young males. We managed one such case in our set-up. A youngmale presented with sudden decreased vision. Fundus showed large collection of darkish red colored blood in subhyaloid space of theposterior pole in front of the macula, typical of sub-hyaloid hemorrhage. Treatment includes, amongst others, Nd: YAG laserhyaloidotomy. Prognosis, if treated on appropriate lines, is usually good. This case was being reported for general awareness.Key-words: Nd: Yag laser hyaloidotomy, premacular sub-hyaloid haemorrhag
Comparison Of Vitamin B12 Level Among Vegetarian And Non Vegetarian Apparently Healthy Individuals In District Tharparkar
Get PDFObjective: Subjects adopting a vegetarian diet are liable to vitamin B12 deficiency. The current work was undertaken to investigate vitamin B12 status in apparently healthy vegetarians in Mithi, district Tharparkar, Sindh.
Subjects and methods: This cross sectional study was conducted in the department of Biochemistry, BMSI, JPMC Karachi and blood samples were collected from Mithi district Tharparkar, Sindh, during the period of Febuary 2012 to June 2012. One hundred vegetarian (74 males and 26 females) and one hundred non- vegetarians (72 males and 28 females), age ranging from 20-40 years were enrolled for this study. Hemogloblin concentration, means corpuscular volume and serum vitamin B12 levels were measured, using conventional methods.
Results: Mean serum vitamin B12 level and mean hemoglobin concentration were significantly lower (p<0.001) while mean corpuscular volume (MCV) was significantly higher (p<0.001) in vegetarian as compared to non-vegetarian. In vegetarian group 51(51%) subjects had vitamin B12 level less than cut off value (200 pg/ml), in this group, 38 out of 74 (51.3%) and 13 out of 26 (50%) were males and females respectively. In non vegetarian group 21(21%) subjects had vitamin B12 deficiency and 09 out of 72 (12.5%) and 12 out of 28(43%) were males and females respectively.
Conclusion: Vegetarians seems to be more prone to develop vitamin B12 deficiency so they should take vitamin B12 supplement and/or B-12 fortified products to avoid its deficiency consequence
Prescribing Patterns in Hospital Inpatients
Get PDFObjective: To evaluate the prescribing patterns by an audit of prescriptions in hospital inpatients.
Materials and methods: After a written informed consent from the medical ward incharge & hospital administrator 32 case notes of adult patients discharged from a private hospital in Malir were collected from 1st to 30th April 2012. Patients demographics, disease & prescription details (number, type, dose, route, frequency, duration of drug use, tendency of polypharmacy, cost of drugs & discharge notes) were entered in a specially designed performa.
Results: Mean age of patients was 27.18years with 14 males & 18 females. They were diagnosed to have enteric fever (10), gastroenteritis (5), RTI & others (13). Average hospital stay period was 2.5 days.Total number of drugs used were 120, of which only 5 (4.17%) were prescribed by generic name. 25.83% drugs were from National Essential drug List of Pakistan (NEDLP). Mean number of drugs per patient was 9.35. Antibiotics & analgesics each was given to 29 (90.63%) patients. Anti -ulcer drugs were given to 27(84.38%) & nebulization to 11 (34.38 %) patients without need. Average cost of drugs per patient was 1200 rupees. None of the prescription was complete for the above mentioned parameters.
Conclusion: Audit of prescribing patterns in hospital inpatients of a private setup showed irrational use of drug
Finding Factors Causing Postdural Puncture Headache In Obstetric Patients After Spinal Anaesthesia
Get PDFObjective: Among various recognized factor of spinal headache the single most important causative factor is size of spinal needle. The aim of this study was to determine incidence of spinal headache with 27 GQuincke Babcock spinal needle in Caesarean section patients.
Materials and Methods: This observationalcross sectional study was carried out in the Combined Military Hospital Gujranwala and Pakistan Naval Shipping Rahat Hospital Karachi from Jan 2011 to Jan 2013. In 500 Caesarean section (C section) cases preloaded with 1000 ml Ringers Lactate, 27 G QuinckeBabcok spinal needle was used in sitting as well as left lateral position for spinal anaesthesia in all patients using local anaesthesia plain lidocaine 2% 1-2ml.In interspace L 2-3 / L3-4 eitherBupivacaine hydrochloride hyperbaric 0.75 % or 0. 5% was injected. All Caesarean cases were included except contraindicated. Spinal needle Quincke Babcock 27 G alone was used.The results were presented in percentages, mean and standard deviation.
Results: A total of 500 patients of c-section were evaluated. Overall incidence of true spinal headache was 2%, failed spinal anaesthesia 4%, spinal needle was changed in 3 %, success rate of 96 % and maternal acceptance 47.4 %. Single pricks were 59.4 % while 2-3 pricks were 40.6 % .
Conclusion: Smaller spinal needle has changed the safety profile of spinal anaesthesia in C section cases by very low failure rates and true PDPH a rarity. PDPH will continue as long as dura is punctured but incidence can be decreased by different technique
Family planning awareness and practices among women attending tertiary care hospital at Faisalabad, Pakistan
No full textObjective: To investigate the family planning awareness and practices among women attending tertiary care hospital at Faisalabad, Pakistan.
Methods: A hospital-based cross-sectional study was conducted at Madina Teaching Hospital Faisalabad, Pakistan. Five hundred women of reproductive age (19-40 years) were included in this survey, to check their knowledge and practices regarding contraceptives use.
Results: The results of the study showed that 92% of the women had contraceptive knowledge but practicing women were 39.4% only. Almost 67% women were belonged to rural area and 33% to urban area. Regarding use of contraception, 39.4% were using one of the contraceptive method, 33% were intending to use and 28% did not want to use any method. The most common method used for contraception was condom (male partner) 36%, followed by contraceptive pills (23%) and female sterlization (19%). About 87% of the women had no constraints in using contraceptive method. Only 5.8% did not want to use because of religious constraints. The most common fear regarding use of contraceptive method was weight gain (13%).
Conclusion: There was wide gap in knowledge and practice of contraceptive use. The three common methods of contraception were condom, contraceptive pills, and female sterilization respectively. Because of low literacy rate females had some fear, myths or misconceptions which need to be clarified
Molecular basis of human essential hypertension.
No full textEssential hypertension (HTN) affects over one billion people worldwide. It is a complex, multifactorial, quantitative trait under polygenic control resulting from inheritance of a number of susceptibility genes and involves multiple environmental determinants in different combinations in different individuals. The completion of the draft sequence of human genome and recent advances in the genetics have resulted in identification and characterization of various genetic mechanisms that associate increased blood pressure and cardiovascular risk factors. The possible molecular mechanisms involved in homeostasis, ranging from locally acting vasoactive peptides to components of rennin angiotensin aldosterone system to epithelial sodium channels and sodium chloride transporters have been discussed. Several vasoregulatory systems including sympathetic vasoregulation and cytokines release have been studied extensively. Despite all these efforts of identification of numerous candidate genes in different ethnic populations using different approaches and technologies, the results are still inconsistent and the genetic and molecular basis of HTN remains unclear. In view of rapid availability of useful data on various aspects of Physiology and genetics of HTN, it is pertinent to review such information focusing on association of well known candidate genes with various facets of HTN and their physiological regulatory processes. Thus HTN related risk factors, known to have interactions with genes are highlighted in this article
Objective Structured Clinical Examination an Overview
No full textObjective structured clinical examination (OSCE) is gaining widespread recognition as a means of assessing the clinical skills and other aspects of the experience of health professionals. OSCE is rapidly replacing other forms of assessment at all levels of medical and health professional education. Since its development, its use has become widespread as the standard for performance-based assessment, particularly in the undergraduate examination. OSCE has been in practice in many parts of the world with favorable outcomes and has proven to be a reliable and valid assessment tool. It has been adapted to assess multiple skills like physical examination, history taking, communication skills, technical skills and interpretation of laboratory results, radiographs and ECG etc. The use of more complex cardiovascular simulators and anatomical models has further expanded the skills that can be tested by OSCE. Although it demonstrates certain advantages over other forms of assessment but has proved to be labor-intensive and time-consuming. At present, it is successfully being used in Pakistan for undergraduate and postgraduate examinations at various medical schools.
A rare case of Gyrate atrophy
No full textGyrate atrophy is rarely seen in ophthalmological practice. We diagnosed one such case in our set-up. A middle-aged male presented with decreased vision FUndus showed patches of well-demarcated. scalloped atrophy of the pigment epithelium and choriocapillaris Fundus fluorescein angiography revoked sharp contrast between normal and abnormal tissue which was a typical characteristic of changes of Gyrate atrophy. Treatment includes pyridoxine (vitamin B6) and a special diet. Prognosis usually remains poor and is a cause of disability. This case was being reported for general awareness.
Health Problems of Children in Women Jail (Karachi)
Get PDFObjective:The purpose of this study was to assess the health status & problems of children in women jail Karachi.
Methods:A cross sectional study was carried out in Women Jail which is part of Central Jail, Karachi. Convenient sampling technique was adopted and the data was collected through interview of mothers and anthropometric measurements of the children.
Results: There were 22 children in jail and male to female ratio was same. Analysis of the data indicated that 54.5% children were exclusively on breast feeding up to 4-6 month and were given homemade food at weaning. Eighty two percent of children were born by normal delivery, 68.2% children suffered from different illnesses and most of them had frequent attacks of diarrhea. Children faced a lot of problems Moreover they had no recreational facility and separate area, to avoid mixing with criminals. Hence the living conditions of the children were not acceptable. Most of the mothers (66.7%) were uneducated, 57.1% mother had 3-4 children, 54.5% mothers had received tetanus toxoid vaccination during pregnancy. Sixty eight percent (68.2%) mothers received antenatal care in jail.
Conclusion: It was concluded that the living conditions were not suitable for the physical and the social growth of the children in women jail. Immediate measures should be taken to handle these problem