Journal of Gandhara Medical and Dental Science
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Determinants of Vaccine Hesitancy and Refusal in Children of District Swabi Khyber Pakhtunkhwa, Pakistan
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The objective of the study was to evaluate factors associated with vaccine hesitancy and refusal at District Swabi, Khyber Pakhtunkhwa.
METHODOLOGY:
This cross-sectional study was conducted at a teaching hospital of Khyber Pakhtunkhwa District Swabi over a period of four months. Children between the ages of 9 months to 10 years from the local population admitted to the children ward/daycare centre were included in the study. Parents were inquired about vaccination status and in case of no vaccination or partial vaccination; then the reason was inquired after proper informed consent. Data were collected by using a structured proforma and analyzed using SPSS-24.
RESULTS:
A total of 828 children were included in this study. Out of these 492 (59.4%) were male and 336 (40.6%) were females. Of the total 828 children, 753 (90.9%) were vaccinated up to date, 48 (5.8%) were not vaccinated and 27 (3.3%) were partially vaccinated. Under vaccinated were 75 patients, 52% were left out due to misconception/beliefs, 6% patients were having issues due to living far away, 2.7% patients could not be vaccinated due to presence of other diseases and 37.3% due to lack of knowledge regarding vaccination. A significant correlation was found between the vaccination status of children and aforementioned reasons (p-value ≤0.001).
CONCLUSION:
The most common cause of not vaccinating children with polio vaccines was misconceptions/beliefs and lack of knowledge of the parents
Comparative Study of Critical View of Safety vs Infundibular Technique in Laparoscopic Cholecystectomy
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The purpose of this study is to compare the critical view of safety technique with the infundibular technique in laparoscopic cholecystectomy in terms of mean operative time and bile duct injuries (BDI).
METHODOLOGY:
Between 2018 and 2020, 220 patients had laparoscopic cholecystectomy in the Surgical "A" unit at Hayatabad Medical Complex in Peshawar, Pakistan. The patients were divided into two groups, with the first receiving a critical view of safety and the second receiving an infundibular procedure. Operation time and bile duct injury were compared between the two groups.
RESULTS:
The operative time was significantly reduced with the critical view of safety (CVS) approach, with a mean time of 35.07 minutes for CVS and 40.58 minutes for infundibular technique, with a significant P-value (0.013). About 17 (7.7%) cases required open cholecystectomy; the conversion rate was higher in the infundibular group, with a significant P-value (<0.001).
CONCLUSION:
Although the "critical view of safety" requires more patience during dissections than the infundibular approach, it is proven to be faster and is considered a safe procedure in laparoscopic cholecystectomy.
KEYWORDS: Critical View of Safety (CVS), Infundibular Technique (IT), Bile Duct Injury (BDI
A Comparison between Type-2 Diabetics and Non-Diabetics in Terms of Papillary Bleeding Index (PBI)
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The purpose of this study was to compare the Type 2 diabetes mellitus patients and non-diabetics in terms of Papillary bleeding index (PBI) of periodontal disease.
METHODOLOGY:
This comparative cross-sectional study was conducted during the period of November 2020 to February 2021 in three (3) tertiary care hospitals of Peshawar. The sampling technique was purposive sampling. The sample comprised 105 individuals, 56 participants in Type–2 diabetes group and 49 in non-diabetes group. Male and females, having age between 40-65 years were recruited. Each diabetic and non-diabetic were clinically examined for periodontitis. Age and sex-matched participants suffering from periodontitis without a history of diabetes as well as with good glycemic control (HbA1c) were considered as controls subjects. Glycated hemoglobulin (HbA1c) was carried out for all the participants free of cost by using Human Gmbh-Max-Planck-Ring 21-65205 Wiesbaden-Germany kit. The study was approved by the ethical committee of the Peshawar Medical College. Data was analyzed using software package SPSS version 20.
RESULTS:
Out of 56 diabetics, 24 subjects brushed once daily, 15 brushed twice daily, 11 brushed occasionally and 6 didn’t brush whereas in 49 non diabetics, 20 subjects brushed once daily, 13 brushed twice daily, 11 brushed occasionally and 5 didn’t brush. The clinical parameter mean (PBI) was recorded in our study. Score was 2.09 (±0.82) in diabetics and 1.02 (±0.47) in non-diabetics. P-value measured by the chi square test was significant. Spearman correlation test was performed to explore the association between the type 2 diabetes and Papillary bleeding index (PBI).
CONCLUSION:
We concluded that a significant difference exists between the mean PBI scores of Type 2 diabetics and non-diabetics
Comparative Risk of Surgical Site Infection With Open Cholecystectomy Vs Laparoscopic Cholecystectomy
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This study aimed to compare the risk of surgical site infection with open vs laparoscopic cholecystectomy.
METHODOLOGY:
This randomized control trial was done at the Department of Surgery, Hayatabad Medical Complex, Peshawar, for 12 months from 11/5/2018 to 11/5/2019. 116 patients were recruited for this study, 58 for each group randomly allocated to a group by lottery method and concealed Allocation. Patients in Group A underwent laparoscopic cholecystectomy, while patients in group B underwent open cholecystectomy. According to ward protocol, post-operative analgesia & antibiotics were given to patients in both groups. Expert consultant general surgeons did all the evaluation & procedures; all the patients were followed up to 30 days after the procedure & any surgical site infections, if found, were noted.
RESULTS:
The mean age was 36 years ± 12.19 SD and 38 years ± 11.88 SD in laparoscopic and open cholecystectomy, respectively. In laparoscopic cholecystectomy, 28% of patients were male, and 72% of patients were female, while in open cholecystectomy, 29% of patients were male, and 71% of patients were female. 07% of laparoscopic and 26% of open cholecystectomy patients had surgical site infections.
CONCLUSION:
Our study concludes that the frequency of surgical site infection was found less in laparoscopic cholecystectomy than in open cholecystectomy
Oral Parafunctional Habits in Individuals with The Extravert Personality Type
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To find the association of extraversion personality traits with oral parafunctional habits.
METHODOLOGY:
A Cross-sectional descriptive study was conducted on 200 individuals in the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months from July to November 2021. Data was collected using a pre-validated medical questionnaire and a ten-item personality inventory scale (TIPI). The sampling technique used was Convenience sampling. A sample size of 200 was calculated with the help of WHO sample size determination software.
RESULTS:
There was a statistically significant difference in the scores of extraversion personality traits across the oral parafunctional habit group of nail-biting (p= 0.007). In contrast, that for tooth grinding (0.114), tooth clenching (0.076), biting hard objects (0.74) and chewing gum (p= 0.659) was non-significant. The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting (129.23), tooth grinding (153.63), and tooth clenching (142.61) and biting hard objects (12.07). The highest mean rank score for the parafunctional habit of chewing gum (107.28) was found in individuals who strongly disagreed with having the habit.
CONCLUSION:
The highest mean rank score for the personality trait of extraversion was found in individuals who strongly agreed to have a habit of nail-biting, tooth grinding, tooth clenching and biting hard objects. The highest mean rank score for the parafunctional habit of chewing gum was found in individuals who strongly disagreed with having the habit
Epidemiologic Risk Factors Associated with Malnutrition in Children (3-5 Years of Age) at District Peshawar
No full textOBJECTIVES:
This study was designed to assess the prevalence of malnutrition in terms of wasting and stunting in children between 3- and 5 years of age and to analyze the risk factors associated with malnutrition among them in the district of Peshawar.
METHODOLOGY:
This cross-sectional study was conducted in the district of Peshawar. Multi-staging simple random probability sampling selected a sample of 225 children between 3 and 5 years. The data was collected through a structured questionnaire containing demographic, risk factors and anthropometry.
RESULTS:
In a sample of 225 children, the prevalence of malnutrition was quite alarming. Stunting and wasting were observed in the age group 3-5 years. Low weight- for height was observed at 20%, and leanness through mid-arm circumference among children between 3-5 years of age in Peshawar district was 28%, although the mean values for all the indicators fell at the 50th percentile. About 76.9% were exclusively breastfed, and 29.8% of children were partially vaccinated. The association of low MUAC with breastfeeding (chi-square value of 28.9 & P= <0.001), vaccination (chi-square value (χ2) 80.3 & P=<0.001), weaning (χ2= 31.1 & P= <0.001), mothers’ education (χ2= 5.28 & P= <0.028), family income χ2= 40.79 & P= <0.001), birth defects (χ2= 8.39 & P= <0.009), and frequent infections (χ2= 36.5 & P= <0.001) respectively showed that these confounding factors were the major factors behind these malnourished children. Almost the same association was found in the low w χ2= 31.1 & P= <0.001) and the tested socio-demographic and dietary factors. However, family size failed to show negative impacts in our study.
CONCLUSION:
Malnutrition tends to occur more in children who are not breastfed, started weaning later than 6 months, are not vaccinated, have birth defects and frequent infections, are born to uneducated mothers, and have low family incomes
Frequency of Anastomosis Leak in Primary Repair in Ileal Perforation
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To determine the frequency of anastomotic leak in primary closure patients presenting with enteric perforation.
METHODOLOGY:
Through a Descriptive case series Study Design, 253 patients with the perforated ilium and subjected to primary closure were included and followed up post-operatively to determine the anastomosis leak.
RESULTS:
The mean age of our sample was 42.2 years with a standard deviation of 8.6 years. Out of 253 patients, 70.8% were males, and 29.2% females were. The mean BMI of the study sample was 24.6 + 2.2kg/m2. 61.3% of patients belonged to urban settings, 41.1% were from lower socioeconomic class, and 36.4% had a middle school level education. On follow up, the anastomotic leak was recorded in 18.2% of patients.
CONCLUSION:
Ileal perforation subjected to primary defect closure is the most performed surgery for treatment, with a significant number of patients developing the anastomosis leak. The frequency of anastomosis leaks is high, and other treatment strategies must be researched to reduce the burden of these complications
Knowledge Attitude and Practice of Dental Professionals Towards Diabetes Mellitus in Islamabad Dental Hospital
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The aim of this study was to determine general dentists and dental students knowledge, attitudes and practices regarding diabetes mellitus, a major public health issue with oral complications.
METHODOLOGY
This cross-sectional study design was conducted in Islamabad dental hospital for three months on House officers and final year BDS students. A convenience sampling technique was used for the sample. A pretested questionnaire was selected from the previous study. After approval of the IRB, the questionnaires were distributed among participants of the research. The descriptive analysis of the collected data was done by using SPSS software version 20.
RESULTS
The overall results of knowledge of dentists towards diabetes scored high (90%), 80% of the respondents had a positive attitude towards diabetes mellitus. Less than half (20%) of the dentists scored poor in the practice of diabetes mellitus, while about three fourth of the respondents had a good score (80%).
CONCLUSION
Dentists in Islamabad dental hospital have good knowledge and practice skills regarding diabetes. The attitude of the dental practitioners in Islamabad dental hospital regarding diabetes is also positive
Presentation And Diagnosis: Pregnancy Induce Diabetes And Hypertension In Medical Doctors At Hospital And Clinics
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The aim of this study was to assess pregnancy induce diabetes and hypertension in medical doctors.
METHODOLOGY
This case-control study was conducted after approval by the ethics committee. A total of 72 physicians who were pregnant and diagnosed with pregnancies causing hypertension or diabetes participated in the study. Daily details of hourly blood glucose levels were recorded at the beginning and end of the day. Use SPSS version 24.0 to analyze the results.
RESULTS
Out of the 33 patients, 23 remained hypertensive at the end of the day, while 10 had normal hypertension at the beginning of the day. Hypotension appeared from the 39th day of which 24 of her ended high, 15 were normal and 10 were diet controlled. The maximum number of pregnancies was 40 in high-care controls and 32 in low-care controls. Out of 30(16) had high FBS at the beginning of the day and 17 of the 42 who had the highest at the end of the day had low FBS. The highest score of 17(42) was presented at the beginning of the day with low FBS and 17 at end of the day with a high ratio and high count of 42.
CONCLUSION
Health care is important for all patients, whether they are health workers or not. Daily Record helps patients and providers understand patient disease management and take appropriate action.
Post Thrombolytic St-Segment Resolution Outcome in Acute Myocardial Infarction Patients
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The main objective of this study was to assess post thrombolytic resolution of ST-segment and its outcome in patients with acute myocardial infarction.
METHODOLOGY:
This Prospective Comparative Study was carried out at the Cardiology Unit of Ayub Teaching Hospital, Abbottabad. All patients irrespective of gender and age with ST-Segment elevation myocardial infarction (STEMI), having no immediate access to angioplasty and thrombolysed with streptokinase, were included in this study. ECG was taken at the beginning and 90 minutes after the administration of streptokinase. Based on ST-segment resolution on ECG taken at 90 minutes these patients were classified into group A and B. Group A included patients with ST-segment resolution while group B showed no resolution of ST-segment after streptokinase administration. These patients were followed during their hospital stay for complications such as arrhythmias, cardiogenic shock, acquired ventricular septal defects (VSD) aneurysm and death.
RESULTS:
Among 115 patients, 94 were male and 21 female. Group A included 102 (89%) patients and group B included 13 (11%). In group A, only 1 (0.98 %) patient developed complications and in group B, 13 patients (100%) developed complications. Arrhythmias were the most common complication among MI patients in group A while cardiogenic shock was the commonest complication in group B.
CONCLUSION:
ST-segment resolution is a practical and applicable indicator of successful thrombolysis and has a significant correlation with clinical outcome in acute myocardial patients after thrombolysis with streptokinase