Journal of Gandhara Medical and Dental Science
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Paraquat Poisoning In Children – A Case Report
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Accidental poisoning in children is a serious public health problem in developing countries, especially where chemicals used in agriculture are ingested. Paraquat is a herbicide which is still used in Pakistan. We report a case of fatal unintentional paraquat ingestion by 3 years old child who could not survive. Lack of care in the storage of paraquat lead to the poisoning but initial inappropriate management was also one factor in the fatal outcome. Detailed history and provision of poison containers are important in the proper management of patients with poisoning
An Association of Dietary Diversity with the Nutritional Status of Cardiovascular Diseased Patients in the Private Tertiary Care Unit of District Peshawar
No full textOBJECTIVES
The aim of this study was to analyze the effect of socio-demographic and dietary intake patterns on the nutritional status of cardiovascular disease (CVD) patients and to determine the dietary diversity of the households.
METHODOLOGY
This cross-sectional study was conducted from May 2018 to June 2018 at the Rehman Medical Institute, Peshawar. Based on written consent, a sample of 250 adult CVD patients was selected through a convenient sampling method. The data was collected through a structured questionnaire containing demographic, anthropometry, biochemical, clinical data, and a dietary record.
RESULTS
In a sample of 250 patients mean age was 55.41±12.558. On the basis of BMI, almost 52.8% were overweight and 0.8% of the patients were obese. Overweight was the major trend among the patients where this tendency was more common in males (57.5%) as compared to females (41%). Diabetes and hypertension were the major complications among these patients. Daily and per week food frequency and dietary diversity scores showed high intake of meat, milk, saturated fats, high glycemic index fruits, intake of processed foods along with goodconsumption of vegetables. The regression coefficient of DDI showed whole milk, cream, meat and processed meat as a strong predictor of obesity, overweight and CVD.
CONCLUSION
The overall dietary diversity of the patients showed a trend toward western dietary patterns with a focus on meat, whole milk, and processed foods. Among the financially stable families of Khyber Pakhtunkhwa, this dietary trend may pose a serious health concern in the context of non -communicable diseases in this region and demand for nutrition education at all levels of the society
Management of Shoulder Dislocation by Prakash Method
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The objective of the study is to evaluate the effectiveness and safety of shoulder reduction developed by Prakash.
METHODOLOGY:
This descriptive study was carried out at Rehman Medical and Surgical Center District Buner and Naseer Teaching Hospital Peshawar from June 2017 to December 2019. All patients with a history of trauma to either shoulder were subjected to anterior-posterior shoulder radiograph. Those having shoulder dislocation were enrolled in the study. Data including age, gender, previous dislocation history, duration of dislocation and associated fracture, and fracture type were recorded in patient case sheet. Patients having recurrent dislocation, polytrauma, low GCS, fracture-dislocations, and more than a week history of dislocation were excluded from the study.
RESULTS:
This study was performed on 30 patients. The mean age of the patients was 36.46±11.58 years. Among them, 83.3% (n=25) were male and 16.7% (n=5) were female. While dislocation occurred on the right shoulder in 63.3% (n=19) and in 36.7% (n=11) on the left side. All the patients have dislocation for the first time. The reduction was performed using Prakash’s method. The success rate was 90% (n=27) and 10% (n=3) the reduction failed, which was then reduced under anesthesia using the Hippocratic method.
CONCLUSION:
The Prakash's method for reducing anterior shoulder dislocation requires minimum assistance with no anesthesia, it is safe, less time consuming, has a high success rate, less pain, and has minimal complications.
 
Aphthous Ulceration – Risk Factors Among Dental Students at Khyber College of Dentistry, Peshawar
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The aim of this study was to assess the risk factors of aphthous ulceration (AU) among dental students.
METHODOLOGY:
This cross-sectional study was conducted at Khyber College of Dentistry, Peshawar in March 2021 among dental students of all four professional years. It was a questionnaire-based study. Questionnaire comprised of demographics and questions about aphthous positivity, risk factors. Risk factors were stress, family history, menstruation (hormonal changes), food allergy, gastrointestinal diseases and medication. Most questions were closed ended. Hospital Anxiety, and Depression Scale (HADS) was used to assess anxiety and depression.
RESULTS:
Total of 245 dental students responded to questionnaire. Out of 245 dental students, 117 (47.8%) gave a positive history of AU. Mean age in AU positive subjects was 23±1.5 years. AU was seen in males (48.7%) and females (51.3%) with no association between them. Among risk factors, 69 (28.2%) had positive family history, 93 (38%) had stress and 8 (3.3%) reported menstruation. Present study included spice (3.7%), fast food (0.4%), sweets (0.4%), dry fruit (0.4%) and walnut (0.4%) as food allergies related to AU. Only 13 (5.3%) reported a gastrointestinal disease. Medication like NSAIDS and antihypertensive were not involved in any AU case. Anxiety and depression was present in 65% and 38.5% with AU positivity.
CONCLUSION:
Stress was the most common risk factor and positive family history turned out to be the second common risk factor for AU among dental students
Covid-19 Positive Antenatal Patients in Obstetrics and Gynea Unit, Peshawar
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The study aimed to determine the frequency of COVID-19 positive antenatal patients admitted in Obstetrics & Gynecology unit Hayatabad Medical Complex Peshawar with the concerns that pregnant women may be more susceptible to COVID-19 as they may be more vulnerable to respiratory infection.
METHODOLOGY:
This was a descriptive cross-sectional study conducted at Obstetrics & Gynecology units Hayatabad Medical Complex Peshawar from May 12th, 2020, to November 29th, 2020, screening and testing of patients admitted for childbirth was in HMC. Screening consisted of questions related to travel, contacts, and symptoms of COVID-19. All patients without a prior diagnosis of COVID-19 underwent SARS-CoV-2 polymerase chain reaction (PCR) testing of nasopharyngeal swabs, with rapid testing available. Patients scheduled for cesarean birth were screened and tested at preoperative visits
RESULTS:
One hundred eighty-two patients presenting for antenatal visits were screened; 6.5% (12 out of 182) were previously diagnosed with COVID-19. The remaining 170 patients were tested at admission, and 17.6% (30 out of 170) tested positive for SARS-CoV-2. Twenty-two of the 30 who tested positive for SARS-CoV-2 (73.3%) were asymptomatic. The overall prevalence of positive test results among asymptomatic patients was 14.1% (22 out of 156). The prevalence of positive test results among asymptomatic patients increased from 1.29% (2 out of 155).
CONCLUSION:
The evidence on this novel infection is changing almost daily, although it will likely be many months before, we can determine the true impact it will have on both maternal and fetal well‐being. In the interim, our primary responsibility is to ensure all women have access to safe maternity services.
KEYWORDS: Asymptomatic, COVID-19 Positive, Antenatal Patients, Obstetrics & Gynecology, Infectio
Comparison of the Outcome of Drain Vs Pressure Dressing in Ventral Hernia Repair
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The purpose of this study was to compare the outcome of drain vs. pressure in ventral hernia repair.
METHODOLOGY:
A cross sectional comparative study conducted at the Department of General Surgery, Hayat Abad Medical Complex Peshawar from January 2018 till December 2019. One twenty six patients both male and female were admitted as elective cases through OPD and were divided into “A” and “B” groups. Experienced surgeons of the unit performed all surgeries. Postoperative pain, seroma/hematoma formation, wound infection and hospital stay was noted in both groups.
RESULTS:
Out of 126 patients, 32 (25.3%) were males while 94 (74.6%) were females with male to female ratio of 1:3. All types of hernia were more common in the age range of 31-50 years. The common complications in both groups were seroma/hematoma formation (7.1%) and wound infection (6.3%). Mean hospital stay was 2-4 days.
CONCLUSION:
Mesh repair is the standard procedure for ventral hernia repair. Postoperative complications are comparatively lesser in pressure dressing than those with drain placement group.
 
PROFESSIONAL ATTITUDES: A NEGLECTED ASPECT IN MEDICAL EDUCATION
No full textThe medical profession is under increased scrutiny with regards to the undesirable attitudes and behaviors of some of its members. There is a growing level of mistrust amongst the public for the medical profession as one hears cases of negligence, misconduct and unethical practices leading to legal suits and even violence. As a result, there is an increasing public demand for the transparency, accountability and quality assurance among the health professionals1.
Health care in Pakistan is undisputedly identified as one of the country’s most corrupt sectors, according to surveys conducted by Transparency International2. While the commercialization of medical profession is cited as a common reason for dilution of quality, doubts have been raised regarding the quality of training2. Are the graduate doctors well trained to perform their clinical responsibilities?
With the alarming rise of medical negligence and cases of unprofessionalism, there is a dire need for educational leaders to come forward with creative strategies to overcome the crises in medical education and initiate reforms at the earliest3.
The health sector in Pakistan requires a change right from induction of the medical students till practice at community level. The following listed are proposed suggestions for the improvement in professionalism and ethics among doctors of Pakistan’s health care system.
We should move away from the narrow focus on excellence in examination results towards a more liberal and exhaustive selection process focusing on ‘desirable attributes’ for medicine in addition to examination results.
Professionalism, ethics, communication skills, teamwork and managerial skills should be part of the core curriculum.
There should be proper and effective system of accountability and transparency in the medical field ensuring ethical practices.
There should be more community-based training both at the undergraduate and postgraduate level, strengthening the bond between the doctors and community.
The regulating bodies should play their role effectively safeguarding the integrity of both the doctors and patients
Paradoxical Hypertrichosis after Laser Therapy
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In numerous cultures, unwanted hair is considered a common aesthetic problem. For hair removal, the use of lasers is a common medical procedure that is comparatively safe and has few side effects. Paradoxical hypertrichosis has been reported rarely in previous studies. The aim of this study was to find out the frequency of paradoxical hypertrichosis after laser treatment.
METHODOLOGY:
This cross sectional study was done for a period of one year from January 2020 to January 2021. This study was conducted at Al-Shifa Clinic and Skin Aesthetic, Nowshera, Khyber Pakhtunkhwa. All those patients who go-through the laser hair removal were included in the study. Diode laser with 808nm wavelength was used. All the patients were observed for paradoxical hypertrichosis after laser treatment.
RESULTS:
Total 140 patients underwent laser hair removal during a one-year study. There were 120 females and 20 male in our study. The mean age of male was 28±1.2 while the mean age of females was 26±1.4. Amongst 140 patients, the overall prevalence of paradoxical hypertrichosis after laser treatment was 7.8% (n=11). This side effect was observed dominantly on the neck and face. Skin phototype III and 1V were observed with this side effect.
CONCLUSION:
Our research study concludes that paradoxical hypertrichosis occurs rarely after laser therapy. Study with high sample size and risk factors should be done for better understanding. 
The Impact of Traditional Classroom Based Teaching in Comparison to Online Teaching on the Academics and Attendance of Male and Female Students
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To compare the impact of traditional classroom-based teaching versus online teaching on the academics and attendance of male as compared to female students
METHODOLOGY:
A study was conducted on 51 third year BDS students, College of Dentistry, Sharif Medical and Dental College, Lahore. An aggregate of the scores based on weightage assigned to each test for all the assessments conducted in the regular session and online session was formulated. The attendance record of the months taught in both the sessions was also taken as percentages. Fisher Exact test was used to find the statistical association between the level of academic performance as well as attendance in the regular session and online session with gender of the students. Man Whitney U test was used to find the statistical difference in the scores of assessments in the regular as well as online session of male and female students.
RESULTS:
There was a significant association between gender and academic performance in the online session (p=0.002). Gender and academic performance of students during the traditional classroom-based teaching session had a significant association (p=0.001). The attendance of male and female students was found to be significantly associated with the online teaching system (p=0.009).
CONCLUSION:
It was observed that females had an overall better academic performance in the online teaching as well as traditional classroom-based teaching system. A similar trend was observed in attendance also, where the females had better attendance record in online and traditional classroom-based teaching set up.
 
Psychological Profile of Patients with Chronic Low Back Pain
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To assess the frequency of depression, anxiety, and stress in patients with Chronic Low Back Pain (CLBP) using Depression Anxiety Stress Scale (DASS-42).
METHODOLOGY:
This descriptive study was performed from January 2019 to June 2019. All those patients with chronic low back pain with duration of more than 6 months were included. Patients below 20 and above 60 years were excluded to eliminate the effect of extreme ages. The Depression Anxiety Stress Scale (DASS-42) was used in this study.
RESULTS:
In this study, a total of 127 patients were successfully interviewed. The mean age of the sample was 36.46 (SD±7.38) with a minimum age of 22 years and maximum of 59 years. Out of these 127 patients, 83 (65.4%) were female while 44 (34.6%) were male patients. The minimum duration of chronic low back pain in our patients was 8 months while the maximum was 55 months with a mean of 28 months (SD 9.9). The mean DASS score for depression was 11.8 (SD±4.23), anxiety was 7.5 (SD±2.9), stress was 12.1 (SD±4.0). Similarly, both genders had equal level of depression and anxiety but females were more experiencing the stress.
CONCLUSION:
Abnormal levels of stress anxiety and depression are a common finding in our population with CLBP