Journal of Gandhara Medical and Dental Science
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Maternal Care Disparities: Impact Of Pregnancy Profiles, Socioeconomic Factors, and Age on Maternal Outcomes
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This study aimed to evaluate the impact of pregnancy profiles, socioeconomic factors, and age on maternal at teaching hospitals in Mardan, Khyber Pakhtunkhwa.
METHODOLOGY
This descriptive-exploratory/qualitative study was conducted at the genealogical outside-patient department of the Mardan Medical Complex, with the approval of the ethics committee. A total of 1187 patients attended the complex between January 2021 and January 2022. Informed consent was obtained, and a comprehensive history and physical examination were conducted using a pre-designed proforma. Patients meeting specific criteria, such as gestational age >36 weeks, singleton pregnancies, and absence of maternal co-morbidities, were included. Exclusion criteria encompassed conditions such as antepartum haemorrhage and fetal anomalies. Data analysis was performed using SPSS-24 version, ensuring the confidentiality and anonymity of participants.
RESULTSOut % of 1187 patients, 48% had previous pregnancies (multiparous), while 52% were experiencing their first pregnancy (primiparous). Gestational age distribution showed that 45% of cases fell within the 36-38 week range, and 55% were between 39-40 weeks. Regarding booking status, 29% of patients were booked, while 71% were unbooked. Finally, the socioeconomic status analysis indicates that 61% of cases were above the poverty line, while 39% were below. These findings highlight important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status that can influence maternal care and outcomes. Among the different age groups, the <20 age group had the highest percentage of spontaneous deliveries (31%), while the >30 age group had the highest percentage of cesarean sections (25%). Induced labour rates were relatively consistent across age groups. Not being in labour was more prevalent in the 25-30 and >30 age groups.
CONCLUSION
The findings highlight that important factors such as previous pregnancies, gestational age, booking status, and socioeconomic status can influence maternal care and outcomes
The Relationship between Iron Deficiency Anemia and the Incidence of Febrile Convulsions
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To determine the role of iron deficiency anemia in patients with febrile convulsions in the 06 to 60 months in a tertiary care hospital.METHODOLOGY
This cross-sectional study was undertaken at Ayub Teaching Hospital, Abbottabad, from January 2020 to February 2022. Patients with typical and atypical febrile seizures were recruited for the study, while patients with neurodegenerative diseases, meningoencephalitis, epilepsy, trauma, nephritic syndrome, and hypertensive seizures were excluded from the study. Iron deficiency was identified concerning a complete blood count. The data were analyzed in SPSS version 21, and the significance value was kept at < 0.005.RESULTSIn the present study, 102 patients were enrolled. The mean age of the sample was 15 months, with an age range of 6-54 months. The male-to-female ratio was 2:1. The mean haemoglobin (HB) of the sample observed was 9.9±1.9, mean corpuscular volume (MCV) 73±13, red cell distribution width (RDW) 16±7.9 white cell count (WBC) 12.9±7.1 and platelets of 312±180. The use of cow milk in febrile seizures was 41%, and only 33% of parents were unaware of proper milk dilution.
CONCLUSION
We concluded that patients with atypical febrile seizures and those with seizures more than once have a significantly higher degree of iron deficiency anemia than those with typical febrile seizures. Moreover, the group with prolonged seizures has severe anemia compared to the group with brief seizures
Occult Hepatitis B in Patients with Decompensated Chronic Liver Disease: A Cross Sectional Study at Tertiary Care Hospital, Peshawar
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The objective of this study was to find the frequency of occult hepatitis B in patients presenting with Decompensated chronic liver disease.
METHODOLOGY
This descriptive, cross-sectional study was conducted at a tertiary care hospital at Peshawar-KP from 31st December 2021 to 31st May 2022.143 patients were enrolled. Informed consent was taken from all patients who were enrolled in this study. We included patients aged 18-60 years of either gender. All patients admitted to medical units or visiting Medical OPDs having decompensated Chronic liver disease were enrolled. A consecutive sampling technique was used to enroll patients for our study. Baseline characteristics, demographics and laboratory data were collected on predesigned proforma. All patients were screened for Hepatitis B infection by performing HBsAg with ELISA, and patients with negative surface antigens were eligible for the study.RESULTSOur study population age range was from 18 to 60 years, with a mean age of 43.30±8.00 years. There were 100 male (69.9%) patients and 43 female (30.1%) patients. Occult Hepatitis B was observed in 40(28%) patients with decompensated chronic liver disease. Among these patients, 26 were male, and 14 were female. Stratification for Occult Hepatitis B was done concerning age & gender to see any significant difference in distribution. There was no significant difference in the distribution of Occult Hepatitis B among different age groups and gender.
CONCLUSION
This study has shown that a significant proportion of decompensated chronic liver disease patients had evidence of occult hepatitis B infection.
Methodology: This was a descriptive, cross sectional study that was conducted at a tertiary care hospital at Peshawar-KP from 31st December 2021 till 31st May 2022.. 143 patients were enrolled in this study. An informed consent was taken from all patients who were enrolled in this study. We included patients having age 18-60 years of either gender. All patients admitted in medical units or visiting Medical OPDs having decompensated Chronic liver disease were enrolled. Consecutive sampling technique was used to enroll patients for our study. Baseline characteristics, demographics and laboratory data was collected on predesigned proforma. All patients were screened for Hepatitis B infection by performing HBsAg with ELISA and patients with negative surface antigen were eligible for the study.
Results: Our study population age range was from 18 to 60 years with mean age of 43.30±8.00 years There were 100 male (69.9%) patients and 43 female (30.1%) patients. Occult Hepatitis B was observed in 40(28%) of patients with decompensated chronic liver disease. Among these patients, 26 were male and 14 were female. Stratification for Occult Hepatitis B was done with respect to age & gender to see any significant difference in distribution. There was no significant difference in distribution of Occult Hepatitis B among different age groups and gender.
Conclusion: This study has shown that significant proportion of decompensated chronic liver disease patients had evidence of occult hepatitis B infection
Recent Advances in Minimally Invasive General Surgery A Retrospective Study
Get PDFOBJECTIVESTo evaluate the outcomes of minimally invasive general surgery (MIGS) and determine the indications for MIGS and its success rate.
METHODS
This retrospective study was conducted at the surgery unit of Hayatabad Medical Complex (HMC) Hospital, Peshawar, from January 2021 to December 2022. All the 200 patients who underwent MIGS were included in the study. Data regarding demographic characteristics, clinical presentation, type of MIGS, and intraoperative and postoperative complications were collected from the medical records and analyzed. The outcome of the study was assessed based on the success rate of the MIGS procedure and the occurrence of any postoperative complications.
RESULTS
The mean age of the patients was 43.3 years (range 10–75 years). The most common indication for MIGS was cholecystectomy (33.5%). Other indications included appendectomy (17.5%), hernia repair (12%), small bowel resection (10%), and gastrectomy (7%). The overall success rate of MIGS was 97.5%. The most common postoperative complication was wound infection (6.5%). There were no deaths due to MIGS.
CONCLUSION
The study findings suggest that MIGS is a safe and effective procedure for managing various surgical diseases and can be performed with minimal morbidity and mortality. Further randomized controlled trials are needed to confirm the safety and efficacy of MIGS in different settings
Online Education and Internet Connectivity Problems: A Perspective of the Teachers and Undergraduate Dental Students
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Assessment of difficulties and glitches regarding internet connectivity faced by undergraduates and teachers during online learning.
METHODOLOGY
This study was conducted using an online questionnaire. 186 undergraduate students and teachers were included from CMH, Lahore. The duration of this study was 3 months. .
RESULTS
There was found to be no statistical difference in reluctance to use online platforms (p=0.17), frequent loss of internet (p=0.181), difficulty in dealing with the loss of connection (p=0.181), disturbance in planned schedule due to loss of connection (p=0.213), lagging behind in schedule (p=0.630), inability to convey the message (p=0.093), lack of internet in remote areas (p=0.302), lack of training to deal with connection problems (p=0.766), poor connection due to technical problems in devices (p=0.089) and poor quality internet (p=0.740) among faculty and students.
CONCLUSION
The problems due to internet connectivity issues in online education were faced more by students as compared to faculty
Comparative Evaluation of Lamina Cribrosa Anatomical Parameters with Retinal Nerve Fiber Layer Thickness Defects In Primary Open-angle Glaucoma Cases And Controls
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To assess the lamina cribrosa (LC) anterior lamina cribrosa depth (ALCD), lamina cribrosa thickness (LCT) and retinal nerve fiber layer thickness (RNFLT) in primary open-angle glaucoma (POAG) cases and age-matched controls and to compare these anatomical variables among POAG cases and age-matched controls.
METHODOLOGY
The case-control study was researched at Al-Ain Eye Institute, Karachi, in four month’s duration (November 2018 till February 2019). Expert eye specialist recruited 57 POAG cases and 46 age-matched healthy controls. Observation of intraocular pressure (IOP) and open angle was done using Goldmann tonometry and Slit-lamp biomicroscopy with stereoscopic ophthalmoscopy respectively. Visual field parameters of mean deviation (MD) and pattern standard deviation (PSD) measured using Humphrey Field Analyzer. Highly sensitive spectral domain ocular coherence tomography with enhanced depth imaging (EDI-OCT) was used to determine ALCD, LCT and RNFLT.
RESULTS
Statistically significant results were produced by RNFLT defects when it is compared in groups of mild with moderate cases of POAG (P-value 0.037). ALCD and LCT did display an association with RNFLT defects but did not produced statistically significant results.
CONCLUSION
Assessments of ALCD and LCT can provide important prognostic evidence about RNFLT and can assist in future planning of mild and moderate cases suffering from POAG
Burden of Obstetrics and Gynaecological Referrals to Tertiary Health Care System
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This study aimed to assess the burden of obstetrics and gynaecological cases, causes and pattern of referral to tertiary care hospital.
METHODOLOGY
This descriptive cross-sectional study was carried out from May 2022-July 2022 using the data of patients who were referred to the Department of Obstetrics and Gynecology Unit 2 at Isra University Hospital from various primary, secondary, tertiary, and private hospitals for any obstetric or gynaecological emergency were the primary source of data. The confidentiality of each patient was carefully respected. This study evaluated the prevalence, reasons and pattern of referral of various obstetric and gynaecological conditions for which patients were referred to Isra University Hospital within the study duration and the management options provided to these patients.
RESULTS
The gynaecological cases accounted for the majority (71%) of referrals. Patients between 21-30 yrs of age comprised 51% of the total. Most patients (20%) were multipara in their third trimester (18%). High-risk patients (60%) were this study’s most common reason for referral, whereas financial restrictions (4%) were the least common. Only 5% of patients were referred from other tertiary care facilities, whereas 49% of patients came from the primary sector (49%), secondary (33%), and private (13%).
CONCLUSION
There is an imperative need to upgrade health system infrastructure, mainly primary and secondary health care systems and especially in the field of maternal and childcare, to enable prompt and appropriate diagnosis and management of various conditions in all nearby hospitals
Excision of a Chronic Inflammatory Mass Using Diode Lasers: A Case Report
Get PDFPhotobiomodulation (PBM), also known as low level laser therapy (LLLT) or cold laser therapy uses light energy to elicit biological responses from the cell and help regulate cell function. From a clinical point of view PBM offers dental practitioners a non-invasive treatment modality that can be used as an adjunct to the traditional therapies or as a therapeutic tool on its own. This is a case of surgical excision of a fluctuant mass using a scalpel and diode laser 980nm wavelength
Prevalence of Oral Manifestations of Systemic Diseases in Patients Visiting the Dental Outpatient Department of Sindh, Pakistan
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The purpose of the study was to evaluate the awareness of oral health workers in identifying the prevalence of oral manifestations of systemic diseases in patients visiting the Dental Out-Patient Department of Sindh, Pakistan.
METHODOLOGY
A descriptive, cross-sectional survey-based study was conducted in Karachi, Pakistan, from October to December 2021. The study was conducted in various institutes from all over Sindh, Pakistan. An online, well-structured questionnaire was designed using Google Forms and distributed to the participants through social media platforms in the dental community. Using the Open-Epi software regarding a parent article, the sample size of this study was calculated. Keeping the confidence interval at 95% and the desired percentile at 50, the total sample size was calculated to be 100. Around 175 questionnaires were given out to the candidates.
RESULTSThe results showed that 81% male and 19% female participated, including 45% postgraduate trainees, 30% house officers, and 25% general dentists. 80% detected 2-3 systemic diseases in a patient, with 75% observing oral manifestations preceding systemic illness diagnosis. The majority favoured treating underlying ailments (75%), and prevalent conditions included hypertension (90%), diabetes (80%), anaemia (75%), and lichen planus (40.7%).
CONCLUSION
Oral health workers play a vital role in the initial and early identification and multidisciplinary medical management of various systemic diseases. A coordinated approach between physicians and dentists in diagnosing and managing these conditions is necessary to achieve optimal clinical outcomes
Vertical Versus Transverse Incision for the Release of the First Dorsal Compartment of the Wrist for De Quervain’s Tenosynovitis
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The study aimed to compare the clinical outcome of transverse versus longitudinal incision for surgical release of the first dorsal compartment of the wrist to treat de Quervain’s disease.
METHODOLOGY
In this quasi-experimental study, all the patients with resistant de Quervain’s tenosynovitis who had the surgical release of the first dorsal compartment between January 2008 and December 2020 were included. The surgeries were performed under local anaesthesia. The first dorsal compartment of the wrist was approached through either a longitudinal or transverse incision, and the tendons of the abductor pollicis longus and extensor pollicis brevis were released. Patients were followed for a minimum of three months, and the primary outcome measure was the Visual analogue score (VAS) for relief of pain and secondary outcome measures were any immediate or delayed complications.
RESULTS98 patients were included in the study with a female-to-male ratio of 7:1. The cohort’s mean age was 44 years (Range 25-75). Most patients were housewives exposed to manual work with the involvement of the dominant hand. There were no major complications besides wound issues and transient paresthesia in few patients. The longitudinal incision was associated with less transient nerve palsies, less duration of surgery and easier identification of structure and anomalies. The only advantage of transverse incision was less scar formation. The clinical outcome was similar in both groups: 94% of patients had complete pain relief (VAS 0).
CONCLUSION
There was no difference in the outcome of de Quervain tenosynovitis when released with a transverse or longitudinal incision. The longitudinal incision had fewer complications as compared to the transverse incision