Journal of Gandhara Medical and Dental Science
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Association of Malnutrition with Weaning Practices among Infants In Pakistan
Full text linkOBJECTIVES
To determine the association between weaning practice and malnutrition among infants.
METHODOLOGY
This descriptive cross-sectional study was conducted at the Department of Pediatrics in Saidu Group of Teaching Hospitals, Swat, with 133 participants selected using a non-probability consecutive sampling technique. Infants of both genders, aged one year or younger, and Pakistani nationals with mentally sound mothers were included, while premature infants (born before the 37th week of gestation) and those with congenital diseases were excluded. Demographic information, height and weight measurements, weaning practices, and the age at which regular weaning was initiated were collected. Weaning practices (at <6 months, 6 months, and >6 months) were recorded by questioning mothers. The association between weaning practices and malnutrition was determined using the chi-square test at a significant level of p<0.05.
RESULTSThe male-to-female ratio was 1.2:1, with 50.9% wearing a prosthesis for less than a year and the minimum range being 3-6 years (13.66 %). Only 31 had stereognosis positive but were completely satisfied with their prosthesis, while 85 who were unsatisfied were found to have positive sensory perception. Statistical analysis for all groups shows a p-value of 0.000 for patient satisfaction with denture wear which is statistically significant. Most patients with the least duration of wear found their stereognosis positive and were unsatisfied with the prosthesis and vice versa. The chi-square test shows a statistically significant value for both groups of stereognosis i-e 0.0001..
CONCLUSION
Early initiation of weaning (before six months of age) was associated with a lower incidence of malnutrition among infants
Perinatal Outcome in Premature Rupture of Membranes (PROM) and Pre-Prom (PPROM)
Full text linkOBJECTIVES
This study aimed to evaluate the maternal and fetal outcomes in PROM and PRE-PROM at tertiary care hospitals.
METHODOLOGY
This Cross-sectional study was carried out in the department of obstetrics and gynaecology at Khyber Teaching Hospital Peshawar after ethical approval of the institutional ethical board. Patients who fulfilled the inclusion criteria were selected. On arrival, detailed history was taken, physical and obstetrical examination and per speculum examination were done, patients were managed conservatively, and steroid cover was given for fetal lung maturity.
RESULTS
A total of 150 pregnant women who met the inclusion criteria and were complicated by PROM or PRE-PROM were followed. Out of the total patients, 104 presented with PROM, while 46 presented with PPROM. PROM and PPROM patients were identical regarding placental abruption. 104(69.3%) patients presented with PROM and PPROM 46(30.7%). Patients who delivered were 72(52%) normal vaginal delivery (NVD), 57(38%) C-Section, 15(10%) NVD with episiotomy. In NVD 54(63%) spontaneous, 18(12%) induced, while in C-Section 6(4%) elective and 51(34%) emergency C-Section. In PROM, 18(12%) were complicated by chorioamnionitis, fetal distress meconium stained liquor 18(12%), whereas 100 were uneventful, while in PPROM, 122(81.3%) had no complications, 10(6.7%) chorioamnionitis and 40.7% of the neonates had NICU admission. The personal effects of NVD on the duration of PROM/ PRE-PROM in days with p-value 0.027. The p-value of Complications of PRE-PROM was 0.037.
CONCLUSION
PROM and PPROM presented with increased maternal and fetal morbidity, vaginal infection, and urinary tract infection should be promptly screened and treated on time to prevent maternal morbidities and improve fetal outcomes
Frequency of Sustained Virologic Response in Hepatitis C Positive, Treatment Naïve Patients on Sofosbuvir and Daclatasvir
Full text linkOBJECTIVES
To measure the frequency of sustained virologic response in Hepatitis C positive, treatment naïve patients on Sofosbuvir and Daclatasvir.METHODOLOGY
This descriptive study was conducted in the Department of Medicine, Khyber Teaching Hospital Peshawar from 15th May 2020 to 14th November, 2020. A sample size of 93 was calculated by using sustained virologic response in 96% patients using Sofosbuvir and Daclatasvir with the confidence level as 95% and 4% margin of error under WHO formula for sample size determination in health studies. Consecutive non probability sampling technique was used in the study.RESULTSNinety Three treatment naïve hepatitis C patients were included in the study containing 53 males (57%) and 40 females (43%) with mean age of 43 + 0.23. 84 (90%) patients were in Child A class according to Child Pugh score. Overall 89 (95.7%) patients showed sustained virologic response following 12 weeks treatment of naïve HCV patients with combination of sofosbuvir and daclastavir. 5 patients developed side effects to the drugs; 2 patients developed anemia with one patient having anemia severe enough to require blood transfusion. 4 patients did not respond to the treatment regime in terms of sustained virologic response for 12 week treatment and were continued for 24 weeks on the same regime.
CONCLUSION
This study concludes that combined sofosbuvir and daclatasvir for 12 weeks appear to have sustained virologic response in treatment naïve HCV patients. Child score has statistically significant correlation to sustained virologic response with Child A class showing SVR in all patients. Patients in Child class C did not show SVR. Thrombocytopenia has direct and negative affect on SVR
Effect of Gender on the Outcome of Acute Coronary Syndrome in Type 2 Diabetes Mellitus
Full text linkOBJECTIVES
To determine the frequency of acute coronary syndrome presentations among diabetic patients and in-hospital outcomes based on gender variance.
METHODOLOGY
This observational cross-sectional study was conducted at the cardiology department of the Pakistan Institute of Medical Sciences, Islamabad. 106 consecutive diabetic patients with acute coronary syndrome were enrolled. Patients were assessed for in-hospital outcomes like congestive heart failure, recurrent angina, and mortality. The outcomes were evaluated based on gender. The Chi-Square test was used for significant differences keeping the P value < 0.05. RESULTSThe mean age of the patients was 57.75±8.16 years. Males were 57 (53.8%), and females were 49 (46.2%). Congestive heart failure, re-angina, and mortality were significant in both genders yielding a P value of <0.05.
CONCLUSION
Diabetes is an important predictor of acute coronary syndrome. The complications related to congestive heart failure and mortality are more prevalent in males than females
Exclusive Breastfeeding Knowledge among Primiparous Mothers
Full text linkOBJECTIVES
The study’s objective was to assess the knowledge of primiparous mothers for exclusive breastfeeding to babies for the first six months on their first postnatal follow-up. METHODOLOGY
A cross-sectional descriptive was conducted at Pediatrics Department, KRL Hospital Islamabad, for six months over 100 women from October 2022 to March 2023. A self-administered questionnaire was used to obtain information from the study participants. Females with primi gravida were selected, and interviews were conducted on a specific breastfeeding awareness questionnaire. The participant with correct and incorrect responses scored 1 and 0, respectively. Participants with scores of 0-4 were regarded as having poor knowledge, 4-7 as average and 7-10 as good knowledge regarding breastfeeding. The latest SPSS version analyzed Data. RESULTSResults show that the mean age was 24 years SD ± 1.2. Forty-one per cent of mothers were illiterate, 42% had Primary education, 15% had secondary school education, and only 2 % were university educated. Fifty-nine per cent of mothers were housewives, 29% were students, and 12% were working women. Moreover, 21% of mothers had poor knowledge of breastfeeding, 12% had average knowledge of breastfeeding, and 67% had good knowledge of breastfeeding.
CONCLUSION
Our study concludes that the knowledge of the primiparous mothers about breastfeeding was adequate
Prevalence of Polycystic Ovarian Syndrome, Its Associated Conditions And Complications: an Experience from a Low Socio-Economic Population of Sikandrabad, Karachi, Pakistan
Full text linkOBJECTIVES
To study the prevalence of polycystic ovary syndrome, its associated conditions and complications in the low socio-economic population of Sikandrabad, Karachi.
METHODOLOGY
This cross-sectional study was conducted in a primary health care centre of Ziauddin University, Sikandrabad-Karachi, Pakistan, from January-June 2021. The ethical committee of the university approved this study. All female patients with gynaecological complaints having an age between 18 to 49 years were included. Females with a history of unilateral oophorectomy, uterine abnormality and abnormal karyotype or known malignancies were excluded from the study. A sample size of 118 was calculated using open-epi software. A performed questionnaire was used to collect data from females with gynaecological complaints. PCOS was diagnosed using Rotterdam criteria. Routine examination tests were done at the Primary Health Care Clinic (PHCC) of Ziauddin Hospital, and obesity was labelled through BMI calculation.
RESULTSOf 118 females in the reproductive age group screened, 55.93% reported PCOS as a major gynaecological problem, followed by endometriosis at 16.94%, uterine fibroid at 14.46% and urinary tract infections at 9.32% respectively. Patients had infertility as a major complaint, with 54.54% cases followed by menstrual abnormalities at 21.21%, obesity at 16.66% and others at 7.57%. Most patients (38%) were obese, and 34% were overweight.
CONCLUSION
PCOS is a prevalent complicated endocrine disorder in women in the reproductive age group, and it presents with varying gynaecological complications like infertility, menstrual disturbances, hirsutism, and acne. Obesity, hormonal imbalance and poor dietary intake affect the disease outcomes further. More multi-centred studies are needed to know the exact prevalence and causal relations
Efficacy of Accelerated Streptokinase Infusion in the Treatment of St-Elevation Myocardial Infarction
Full text linkOBJECTIVES
To determine the efficacy of accelerated streptokinase (SK) in patients with acute ST-elevation myocardial infarction (STEMI).
METHODOLOGY
This Descriptive study was done in the Department of Cardiology, Hayatabad Medical Complex over a period of 6 months from august 2020 to February 2021. Age ranged between 35-70 years. Both males and females presenting with acute ST elevation MI, patients within 6 hours of the onset of chest pain were included in the study.
RESULTS
Among 144 patients age distribution was analyzed as 50(35%) patients were in age 35-50 years, and 94(65%) patients were in age 51-70 years. The mean age and standard deviation were 61± 8.19. Gender distribution was analyzed as 88(61%) patients were male and 56(39%) patients were female. Status of BMI was analyzed as 69(48%) patients had BMI ≤27 Kg/m2 and 75(52%) patients had BMI >27 Kg/m2.
CONCLUSION
The accelerated SK infusion regimen of 1.5 MU in 20 min is safe and well tolerated with significantly faster and higher clinical reperfusion rates, more preserved LV systolic function, less atrial and ventricular sustained arrhythmias, and less in-hospital and 1-year mortality rates in acute STEMI
Radiolucencies Associated with the Second Molar Adjacent to the Impacted Third Molar in the Maxilla in Comparison to the Mandible
Full text linkOBJECTIVES
To find the frequency radiolucencies associated with the second molar adjacent to an impacted third molar in the maxilla as compared to the mandible.
METHODOLOGY
A cross-sectional descriptive study was conducted on 385 Orthopantomograms (OPG) of patients visiting Sharif Medical and Dental College (SMDC), Services Institute of Medical Sciences (SIMS) and Institute of Dentistry, CMH, Lahore Medical College, Lahore over a period of three months from December 2020 to February 2021. Patients above the age of 21 years were included in this study. Grossly carious third molars with inadequate tooth structure to be evaluated and patients with missing maxillary and mandibular third molars were excluded from the study.
RESULTS
The association between periapical radiolucencies (p=0.140), pericoronal radiolucencies (p=1.000) and external root resorption (p= 0.157) with the arch type (mandible/ maxilla) were not statistically significant but that of caries with the arch was significant (p≤0.001).
CONCLUSION
The periapical and pericoronal radiolucencies, caries and external root resorption associated with the second molar in the presence of an impacted third molar were higher in the mandible as compared to the maxilla
Risk Factors Leading to Meconium Aspiration Syndrome in Meconium-Stained Amniotic Fluid
Full text linkOBJECTIVES
This study aimed to find out the risk factors leading to meconium aspiration syndrome in patients having meconium-stained amniotic fluid.
METHODOLOGY
This comparative study was conducted in the department of Obstetrics and Gynaecology at Hayatabad Medical Complex from January 2022- June 2022. All patients admitted to the labour ward with the diagnosis of meconium-stained liquor (MSL) were included in the study through a convenient sampling technique. Patients were divided into two groups, group 1 having only meconium-stained amniotic fluid (MSAF) without meconium aspiration syndrome while group 2 having babies with the diagnosis of meconium aspiration syndrome (MAS). Both groups were compared for different risk factors for the development of MAS. Differences in the risk factors between the two groups were analyzed using Pearson’s correlation with a p-value of <0.05 considered significant. SPSS vs 20 was used for statistical analysis.
RESULTS
84 patients were included in the study, i.e., 61 in group 1 and 23 in group 2. The mean age of the patients was 25± 3.45. The frequency of meconium-stained amniotic fluid was 3.83%. Meconium aspiration syndrome developed in 23 babies out of 84 MSAF deliveries (27.38%). Low APGAR score (< 0.00), patients handled outside the hospital (<0.001) and prolonged second stage (0.003) were significant risk factors for the development of MAS.
CONCLUSION
In the prolonged second stage, patients handled outside the hospital by unauthorized personnel and low APGAR score at birth were statistically significant risk factors for developing meconium aspiration syndrome
FUNCTIONAL OUTCOME AFTER DECOMPRESSION FOR DORSAL SPINE TUBERCULOSIS SURGREIS
Full text linkOBJECTIVE: functional outcome of improvement after decompression for dorsal spine tuberculosis in terms of frankle grading.
METHODOLOGY: This prospective study was conducted after ethical approval at neurosurgical ward mmc/mti through non-probability sampling. Clinical and radiological examined patients with carriers of dorsal spine tuberculosis were enrolled in study. After surgery they were followed for three months and improvement were measured comparing pre and post op Frankle grading.
RESULTS: Total of 38 patients underwent surgical procedure decompression ± fusion through postero-lat approach (costotransversectomy) in which 42% were male and 58% were female. Mean age was 34±5. Distribution for age group was 18-30(08), 31-40(13), and 51-60 (06). Level of disease D4-D8 were 17(44.8%), D9-D12 were 21(55.2%).
CONCLUSION: decompression and stabilization in spine tuberculosis is safe, effective and results in good outcome clinically. The advantages of surgery include through debridement, decompression and achievement of spinal stabilization.
KEY WORDS: Dorsal spine tuberculosis, corpectomy with fusion, laminectomy, outcome measure