Journal of Gandhara Medical and Dental Science
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Sehat Sahulat Program Effect on Patients Presenting to Secondary Level Hospital in Mardan
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The aim was to find the difference between government and private hospitals at the Mardan secondary level for sehat sahulat card effect on patients for their selection of hospital, dates, and time issues for elective and emergency cases with department facilities.
METHODOLOGY
This quantitative cross-sectional study was conducted to see the difference between the government and private hospitals for sehat the sahulat program effect on patients. Patients care is important on both sides but to find out the difference where more work should be done to achieve universal global health under the Khyber Pakhtunkhwa government for the benefit of their people’s health.
RESULTS
Total patients 10112 visited District Head Quarter (DHQ) hospital from February 2021 to February 2022 while 5672 were in a private hospital in which the ratio for gynaecology was 19 % (854 pts. DHQ) and 31% (1652) private hospital. Medical admissions were 2224 (50%) for a government hospital and none for private while surgical admissions were 1379 (31%) for government and 2665 (50%) for private hospitals. The significant ratio for chi-sq was P<0.5
CONCLUSION
Government hospital flow of patients is more than the private sector in admission ratio for medical cases then surgical while private has more flow for surgical admission than medical with all facilities provided on the desk and timely managed at the time of admission. Seniorm consultant’s ratio of surgeries in private is more than in government hospitals
Hypovitaminosis D Causing Idiopathic Musculoskeletal Pain in Children
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To determine the frequency of hypovitaminosis D in children presenting with Idiopathic musculoskeletal pain IMSP).
METHODOLOGY
The cross-sectional research was carried out at Peshawar’s Hayatabad Medical Complex’s Department of Pediatrics. The study duration was 6 months. The study comprised 151 patients with non-specific musculoskeletal pain who were tested for vitamin D levels to diagnose hypovitaminosis.
RESULTS
The age range of the participants was 3 to 15 years with a male predominance of 72.8%. The sample’s average the weight was above the 25 percentile. Hypovitaminosis D was found in 23.2%. Decreased sun exposure was documented in 82.85% of cases with hypovitaminosis. Hypocalcemia, hypophosphatemia and increased alkaline phosphatase were documented in 71.4%, 11.4% and 42.8% participants respectively with hypovitaminosis.
CONCLUSION
Hypovitaminosis D Is one of the risk factors for non-specific musculoskeletal pain but the current study revealed only 23.2% of participants had hypovitaminosis and inadequate sun exposure was a major risk factor for hypovitaminosis
Perception of the Most Esthetically Pleasing Incisal Embrasure Design
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To determine the frequency of female dentate patients' most appealing incisal edge embrasure designs.
METHODOLOGY:
The sample consisted of 385 female dentate patients between 18 to 40 years of age visiting Sardar Begum Dental College and Hospital, Peshawar, from January 2021 to June 2021. The subject's perception was recorded by having the subjects visualize a set of five photographs showing different categories of incisal edge embrasure designs classified by Foulger and Tredwin. The labels of these different photograph categories were obscured using a non-transparent tape, and A, B, C, D, and E; names were assigned to them, respectively, to avoid bias. Means and standard deviations were calculated for quantitative variables like age, while the frequency was calculated in percentage for categorical variables for the most appealing incisal edge embrasure design.
RESULTS:
The most attractive incisal edge embrasure design amongst the female dentate patients was the "Ideal" design with 33.8%. The second most attractive design displayed "Equal" incisal edge embrasures with 31.4. The "Reversed" and "None" categories had 12.2% and 9.9% percentages. The least attractive design amongst these females was with "Exaggerated" incisal edge embrasures.
CONCLUSION:
Female dentate patients' most appealing incisal edge embrasure design displays the "Ideal" incisal edge embrasure form
Efficacy of Manual Vacuum Aspiration Vs Conventional Evacuation and Curettage
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To evaluate the safety and efficacy of Manual Vacuum Aspiration (MVA) compared to Conventional Evacuation and Curettage (E & C) in managing first-trimester miscarriage.
METHODOLOGY:
A total of 160 patients were enrolled in this comparative study. Patients were categorized into two groups (Group A undergoing MVA) and (Group B undergoing E&C). Each group had 80 cases randomly selected. Stable patients with miscarriages < 12 wks of gestation and no comorbid were included in the study. Data was recorded on pre-designed proforma, and analysis was done by SPSS Software.
RESULTS:
Efficacy of MVA was 97.5% and 92.5% in E&C, with a 7.5% vs 30% complication rate in MVA and E&C Group, respectively. The mean duration of the procedure was 9 minutes in the MVA group versus 18.8 minutes in the E&C group. The hospital stay was 14.2 hours vs 20.3 hours in MVA and E&C Group. 16.25% vs 46.25% of women in MVA vs E&C Group reported post-op pain. 93.75% of women were satisfied with MVA, whereas only 50% of women were satisfied with E&C. 81.25% 91.25% required Anesthesia/Analgesia in MVA and E&C Group, respectively.
CONCLUSION:
MVA is a more effective and rapidly performing outpatient procedure with a lower complication rate. In this study efficacy of MVA is 97.5% compared to the E&C group, i.e., 92%. Its safety, cost-effectiveness and efficacy advocate its extended use as an alternative to the conventional surgical method of miscarriag
Association of Sociodemographic Factors with Trends of Self-Medication Practice and Its Hazard Perception for Oral Health Problems among Patient
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To assess the impact of sociodemographic factors with the trends of self-medication practice and its hazard perception among patients
METHODOLOGY:
A cross sectional descriptive study was conducted on the patients visiting Sharif Medical and Dental College from June 2019 to June 2020. Data was collected using a validated questionnaire from 142 patients. Chi-square and fisher exact tests were used to find the association of trends of self-medication practice and hazard perception with sociodemographic factors.
RESULTS:
The patients in the age range of 18 to 29 years practiced self-medication the most. The triggering factor for use of medication was toothache among all ages. The most commonly used drug was reported to be analgesics. The main reason for self-medication was lack of time to visit the doctor. The females practiced self-medication more than the males. The triggering factor for both the genders was toothache and analgesics were mostly used. The patients with tertiary level education and those who were unemployed practiced self- medication the most. The triggering factor was toothache across all levels of education and employed as well as unemployed patients. Drug resistance was stated the main hazard.
CONCLUSION:
The triggering factor for use of medication was toothache, most commonly used drugs were analgesics and the main reason for self-medication was lack of time across all ages, both the gender, married and unmarried patients, levels of education and employment. Un-employed patients and those with tertiary level of education-practiced self- medicated themselves the most. The highest percentage of patients considered drug resistance to be the biggest hazard
Patient Satisfaction in a Tertiary Care Government Hospital
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To determine patient satisfaction in terms of various services such as ease of getting care, in-patient admission, waiting for check-up, staff interaction, medical care, cost of care, and cleanliness in a Tertiary Care Government Hospital.
METHODOLOGY:
The study design was cross sectional observational. A total of 200 patients meeting our inclusion criteria were enrolled through convenient sampling techniques in this research study. A well-designed questionnaire was used for data collection of admitted patients.
RESULTS:
Out of 200 patients, 96 (48%) male and 104 (47%) female patients were interviewed. 72% were satisfied with clinical care services, 14% had mixed views while 14% patients were not satisfied at all.
CONCLUSION:
Patients in general showed their satisfaction in some of the aspects, however, keeping in view the burden a public sector hospital absorbs on a daily basis, and it was imperative to receive unsatisfactory feedback from patients in most of the aspects. Thus, the results of my study recommend to the health care leaders to take practical steps to bring further improvement by developing a proper mechanism for the uplift of public sector hospitals
Frequency and Antimicrobial Susceptibility Pattern of Gram-Negative Bacilli Isolated From Urine Specimens at a Tertiary Care Setting
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To find out the frequency and pattern of conventional antibiotic susceptibility of gram-negative bacilli cultured from urine specimens of patients at a tertiary care setting.
METHODOLOGY:
This study was conducted at the Microbiology Department of Combined Military Hospital Multan from June 2016 to May 2017. The data in this retrospective descriptive study was collected from urine culture records of the Microbiology Department, CMH Multan. Only those urine specimens who revealed positive gram-negative bacilli cultures were included in the study. Drug susceptibility patterns of these isolates were recorded against routinely used antibiotics (e.g. Nitrofurantoin, Imipenem, Sulbactum-cefoperazone, Gentamicin and Ciprofloxacin) and evaluated accordingly.
RESULTS:
A total of 1703 urine specimens were submitted for culture and antibiotics susceptibility testing during the period of study. A total of 128 specimens showed growth of gram-negative rods. Imipenem (95% sensitivity), Sulbactam- Cefoperazone (88% sensitivity) and Nitrofurantoin (87% sensitivity) were highly effective antibiotics against the cultured gram-negative bacilli in the study.
CONCLUSION:
This study showed that E. coli is the commonest cause of urinary tract infection (UTIs), followed by Klebsiella and Enterobacter species among gram-negative bacilli in our set up. In-vitro efficacy of Imipenem, Sulbactam- Cefoperazone and Nitrofurantoin was found to be the highest against these gram-negative bacilli as compared to other antimicrobials. On the contrary, in-vitro efficacy of ciprofloxacin and gentamycin was found to be extremely low
Knowledge of and Attitude towards Primary Healthcare among Undergraduate Medical Students
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To assess undergraduate medical students’ knowledge of and their attitudes towards primary healthcare and to compare the knowledge and attitudes of students in public and private medical colleges as well as between different demographic groups of students.
METHODOLOGY:
A descriptive cross-sectional survey was conducted in public and private medical colleges after an ethical approval was granted. Data was collected from 201 undergraduate medical students through a validated (by Chalmers et al. 1997) Primary Health Care Questionnaire (PHCQ) utilizing an online data collection platform of Google Forms. The link to Google Form was distributed via emails and social media links of participating colleges. Data was exported from Google Form into SPSS version 24 and analyzed.
RESULTS:
The total knowledge score of students ranged from 8 to 17 with the mean knowledge score of 12.62 (SD: 1.398). The total attitude score ranged from 59 to 82 for all the participants with the mean attitude score of 71.12 (SD=4.382). Comparison of knowledge scores showed higher scores in females than males (p=0.004), and significantly higher attitudes scores among private medical students than public (p=0.037).
CONCLUSION:
Medical students’ gender and setting of their medical studies showed significant influence on their knowledge of and attitudes towards primary healthcare.
Role of Tri-Phasic Computed Tomography in Evaluation of Hepatocellular Carcinoma Patients with Liver Cirrhosis
Get PDFOBJECTIVESTo assess the usefulness of Tri-phasic computed tomography in the evaluation of hepatocellular carcinoma in cirrhotic patients.METHODOLOGYThis cross-sectional study was carried out in the Radiology and Imaging Department of Hayatabad Medical Complex Peshawar from October 2020 to September 2021 (01 year). Tri-phasic CT was done in all patients. Patients with suspected hepatocellular carcinoma diagnosed by clinical and ultrasonography and having high serum α-fetoprotein levels were enrolled in the study.RESULTSMalignant cases on tri-phasic CT were 120(82.8%) while benign cases were 25 (17.2%) Fig -I. In malignant tumor cases, 99(82.5%) patients had hepatocellular carcinoma (HCC), 13(10.8%) had metastases and 8(6.7%) had dysplastic nodule respectively. In benign tumour cases, 15(60%) had regenerative nodules, 6(24%) had hepatic adenoma and 4 (16%) had haemangioma. Tri -phasic CT as a tool in the diagnosis of hepatocellular carcinoma in cirrhotic patients showed a sensitivity of 96.8%, specificity of 79.7%, the accuracy of 95%, positive predictive values of 96.2% and negative predictive values of 88.1%.CONCLUSIONTri-Phasic CT can be an ideal diagnostic tool for detecting as well as characterizing hepatocellular carcinoma in cirrhotic patients
Changing Epidemiology: Outbreak of Monkey Pox
Get PDFMonkeypox is a viral illness endemic to African countries. 20 May 2022, W.H.O alarmed all countries on the outbreak of the monkeypox virus1. Symptoms include headache fever swollen lymph nodes lethargy and the development of rash. Two types of clades (strains) are found that is central and West African clades. A central clade is more infectious than a western clade. A western clade is self-limiting within 2-3 weeks with a case fatality rate of 1% while the central clade is a 10% fatality rate. Monkeypox virus causes monkeypox a zoonotic disease which belongs to the poxviridae family2 which is closely related to the smallpox virus. Indicated from historical data smallpox vaccination with vaccinia virus (orthopoxviral) was 85% protective against monkey pox3. Danish laboratory in 1958 discover the virus in monkeys from where its name monkey pox originates4. The first case was discovered in a 9-month baby for the first time in Congo in 19705. A previous systematic review of the summer of 2018 described the epidemiological outbreak of the monkeypox virus6. United Kingdom’s first case was presented on 16 May 24, 2022, after laboratory confirmation7. The incubation period of monkeypox ranges from 6-13 days with possible extension to 5-21 days. The illness consistently ends by 2-4 weeks. Smallpox vaccines provide adequate protection against the monkeypox virus. World health organization suggests that health workers who are treating or exposed to monkeypox patients or their laboratory samples be immunized against smallpox.
Effective laboratory investigation is a significant measure for identification and management. PCR on multiple lesions from various sites can be utilized to diagnose the potential condition. It should be sent to the government public lab and the control & command center must be notified. Refrigerated (2-8c) samples should be sent within 5 days of collection. Sample of swab should be of nylon, polyester, or Dacron swab with plastic, wood, or thin aluminum shaft. International support for increased surveillance and detection is important for monkeypox cases for understanding the changing epidemiology of the resurging disease. In the current environment of pandemic threats, the public health importance should not be underestimated. Outside of African countries appearances of cases highlights the risk of geographical spread. Discontinuation of the smallpox vaccine has created a landscape for monkeypox. Government guidelines for emergency diseases should be used with proper notification of case reports to the directorate. Personal protection equipment with equipped labs should be provided. All children less than 12 should be vaccinated with smallpox vaccines. A combination of standard, contact, droplet and airborne precaution should be used. Place the patient in a single room with a portable HEPA filter or airborne infection isolation room. Staff from equipped laboratories should obtain samples from suspected/confirmed monkeypox virus infection. Appropriate personal protective equipment (PPE) should be provided and disposed of properly before leaving the room. Monitoring and tracing contact must be maintained and recorded. World health organization effective hand hygiene five moments should be performed by healthcare workers frequently. Use guidelines for correct containment and disposal of contaminated waste. Be care full always with the soiled laundry to avoid contact with lesion material and used PPE materials. Ensure procedures are in place for cleaning and disinfecting environmental surfaces in patient care zones. Always use the government of Pakistan’s national health guidelines for emergencies