National Journal of Health Sciences
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Screening of Probiotics Efficiency to Inhibit Persistent Biofilm-Related Infections
No full textAbstract: Probiotics are live bacteria. They are administered in food, with beneficial effects to the host, help to prevent or treat diseases, the majority of which are gastrointestinal. The isolation and utilization of Lactobacillus spp. as probiotics from dairy or some other items has been exhibited to be health promoting. Modification in Gut flora contribute in different sorts of disease conditions, and distinctive Microorganisms developing in a biofilm are related with constant and chronic human diseases which are resistant to antimicrobial agents. The biofilm producing organisms are E.coli, Pseudomonas, Klebsiella, Staphylococcus and many more. Objective: The aim of study is to screen the efficiency of probiotics in the inhibition of bacterial biofilm. Methodology: Two methods used for screening of biofilm production are, Tube method and Congo red method. Three species of Lactobacilluswere isolated and screened for biofilm inhibition. Four commercial isolates of E. coli were obtained and among those, three were efficiently able to produce biofilm. All species of Lactobacillus were able to counteract the biofilm production. Results: Lactobacillus species were identified to be L. plantarum, L. casei and L. bulgaricus on the basis of sugar test and microscopy, which inhibited the biofilm formation of intestinal bacteria. Conclusion: After this study there is no doubt in believing that the Probiotics are definitely new hope towards treatment of infections that are prevailed among people. Conventional dairy items are great source of bacterial strains and bioactive compound discharged by these three identified strains could be utilized in pharmaceuticals for recovery from bacterial diseases
Bedsores Incidence in ICU Patients: A Tertiary Care Experience
No full textAbstract: Introduction: The aim of this study was to see the incidence of bedsores in our hospital and determine relating factors.Material and Methods: This cross sectional study was performed on 71 consecutive ICU admissions at Ziauddin hospital ICU from March to May 2015. Data was analyzed on SPSS version 16 by independent sample t-test and chi square test. In 71 patients, 12 developed bedsores, of which seven were males and five were females. Available data in Performa included: demographics, functional class, comorbidities, category(surgical, medical or trauma patient), primary cause of ICU admission, total day of ICU stay, total period of mechanical ventilation, requirement of dialysis, albumen level and if bedsore developed than its details and grade. Result: In this study, 71 patients were admitted in ICU; 40 patients, which is 56.33%, were male and 31 patients, which is 43.66%, were female. Twelve patients that are 16.90% were affected with bedsores of which seven were males and five were females and this was found to be statistically significant. The mean age of patients with bedsores was 66.75 years ± 18.29 as compared to 52.42 years ± 18.20 in group with no bedsore development. Total mechanical ventilation required in the group that developed bedsore was 4 days ± 1.67 to group with no bedsore development, which was 2.36 days ± 1.21. The patients who developed bedsore had serum albumen levels 2.54 ± 0.26 and group that did not develop bedsore had albumen levels 3.14 ±0.77 and the result was found to be statistically significant. Duration of Study: From June 2017 to June 2018. Conclusion: Development of bedsore was found to be statistically significant to the poor functional class, high mean age, total hospital stay,mean mechanical ventilation and low level of albumin
A Review of Hemostasis in Normal Pregnancy and Puerperium
No full textAbstract: Significant alterations are seen in hemostatic system during normal pregnancy and puerperium. Overall, it is a state of hypercoagulability and hypofibrinolysis mitigating the risk of severe bleeding during placental separation at delivery. On the flip side, it threatens a pregnant woman for thrombosis with the risk being four to six folds more in comparison to a non-pregnant woman. It is important to understand the hemostatic changes in normal pregnancy by all health care providers who manage pregnant women in obstetric wards, trauma, anesthesia and other circumstances. This review describes the changes in qualitative and quantitative changes in platelet, clotting factors, anticoagulants and fibrinolysis during normal pregnancy and puerperium
Frequency of Pulmonary Mycobacterium Tuberculosis among Patients of Civil Hospital New Darband
No full textAbstract: Objective: The contemporary study conceded out on distribution of Mycobacterium tuberculosis in civil hospital new Darband and its rural areas such as Serri, Shanayia, Sookal, Baghwai and Nika paani. During directing research work the information and data was placid from several villages including new Darband. This demonstrates higher indication of tuberculosis in female as compared to males hence high-risk of disease in females is due to their neighboring contact, poor sanitation, and lack of health education, poor-hygiene and lack of awareness. Methods: During research work Cross sectional study was conducted in civil hospital new Darband during the months of calendar from May to October. All patients were cross-examined by using paper questionnaire comprised questions about the socio-economics, demographic such as Age, gender and area (where they were belonging), previous family tuberculosis history and others while they were examined clinically by qualified medical officer. Additionally ICT serological testation was used to conform the suspected agents which were done by the averageblood serum. They were studied further to conform their suspicions in sputum by applying Ziehl-Neelson staining method to investigate the AFB (Acid Fast Bacilli) in sputum smear which was carried-out in hospital laboratory. AFB (Acid Fast Bacilli) smears were introduced to microscopic examination for fluorochrome stain of specimen. Results: 15 were positive cases out of 374 cases. Greater Incidence of tuberculosis was testified in Sookal 5 (8.33%) while minimum frequency of tuberculosis was demonstrated in Tehsil New Darband 0 (0%). In Gender wise prevalence in which 15 positive cases of tuberculosis 4(2.42%) were male while 11(5.26%) were female. The risk of mycobacterium tuberculosis were established in population of intermediate age people such as 14-40 years (4.54%) although less risk of disease are originated in the children and risk in adult was (2.22%). In calendar ofmonth-wise prevalence the month of October (7.69%) was documented for higher cases Instead of July. In July rare or non-cases are reported mean (0%). Conclusion: For the incidence of TB poverty, poor cleanliness, absence of schooling, less viability of medications and additionally poor pharmaceutical indicating major elements. The TB control program will be effective, convenience to treatment centers and health education, well qualified and active persons are provided, and program must be for gigantic duration. Because well-trained microbiologist can be execute sputum Acid fast staining technique very accurately instead of non-concern partitions. Hence, such thoughtful research work assumes can play vital role for the control of TB in Pakistan, especially in New Darband and its ruler areas that are under review
Vaccination against Hepatitis B Virus through Various Strategies
No full textAbstract: Hepatitis is the inflammation of liver which cause liver cirrhosis. It is the health problem. This may be acute or chronic. The chronic stage of hepatitis leads to liver cancer which is the last stage and ultimately causes death. It is the main cause of liver disease. It is much problematic and about 2 billion people infected from this deadline disease. There are three modes of hepatitis B transmission. One from the mother to infant, another one is the sexual transmission, and the last one is through blood transfusion and most in those people who are drug abusers. In 1995, the vaccination system was introduced to cure this disease. To eradicate HBV virus WHO introduced the vaccination system. Then the vaccination dose was given to infants at their birth to eliminate their HBV. This is a three-dose vaccination system and much other vaccination for adults and to eliminate this problem during pregnancy. For combat with this disease, many therapeutically vaccines have been introduced. WHO (World Health Organization) play a major role to eliminate this problem from the society
Human Immunodeficiency Virus Cases on the Rise in Pakistan
No full textHuman immunodeficiency virus infection leads to acquired immune deficiency syndrome. After horizontal transmission(through unprotected sex, contaminated blood transfusion or sharing contaminated syringes among main line drug addicts)or vertical transmission (from mother to foetus during pregnancy or during deliver / breast feeding), the person remains asymptomatic for years or may develop flu like symptoms. HIV remains quiescent in the monocytes and helper T cells interfering with and knocking out host’s immune system immensely increasing the risk of opportunist and non-opportunist infections as well as various malignancies. There is no cure for HIV or a vaccine available as of today; current antiretroviral treatment slows the course of the disease and may lead to a near-normal life in affected individuals. Treatment is recommended without delay; without treatment, the affected individuals don't survive beyond first decade
Frequency of ß-Thalassemia Trait among Pregnant Women Presenting at Pakistan Institute of Medical Sciences
No full textAbstract: Introduction: Thalassemia is a common inherited disorder in Pakistan with around 5000 new cases diagnosed every year. Despite various preventive measures taken at the national level, the disease burden is still not declining. In this study the incidence of ß Thalassemia trait among pregnant females presenting to a tertiary care hospital is measured. Methods: This study was conducted at Pakistan Institute of Medical sciences. 102 Pregnant females who were referred to us for hemoglobin electrophoresis from July 2017-June 2018 were included. Complete blood count, peripheral film, reticulocyte count and emoglobinelectrophoresis was performed for each patient. Results: The mean age was 25 years and the mean period of gestation was 30.30 weeks. Out of 102 patients, 5 (4.9%) were diagnosed as ß Thalassemia trait. Of these, 2 (40%) did not have a positive family history of Thalassemia. We compared the results of our study with those done at different regions of Pakistan and found variable incidence of carrier state in different regions of the country. Conclusion: Antenatal screening is a forward step towards minimizing incidence of Thalassemia in Pakistan however clinicians should be directed to refer these patients in early pregnancy
High Risk Myelodyplastic Syndrome with Good Risk Cytogenetics and Somatic Oncogenic Driver Mutation
No full textAbstract: Recurrent cytogenetic abnormalities are manifested in approximately fifty percent cases of Myelodysplastic Syndromes (MDS) found as result of genomic instability verifying the presence of oncogenic genetic mutations. Over the years the molecular diagnosis of MDS, has emphasized the relevance of the molecular pathogenesis of this entity by utilizing the refined technology of next generation sequencing. We herein report a case of Myelodysplastic Syndrome with Excessive Blast 2(MDS EB 2) with isolated deletion 5q and the presence of oncogenic somatic driver mutation ASXL-1 elucidated through next generation sequencing. The reports pertaining the association of MDS with deletion 5q and ASXL 1 are relatively exiguous. This case report points towards the diagnostic and prognostic significance of somatic driver mutations, even in patients exhibiting good risk cytogenetics. This will assist in offering better risk adapted therapies in Myelodysplastic syndrome patients
Frequency of Vitamin D Deficiency in Newly Diagnosed Type 2 Diabetes Mellitus Patients
No full textAbstract: Objective: To determine the frequency of vitamin D deficiency in newly diagnosed patients of type 2 diabetes mellitus.Study Design: Prospective case control study. Place and Duration of Study: Department of medicine, Pakistan Navy Ship (PNS) Shifa Hospital Karachi from January to December 2015. Materials and Methods: A total of 302 study subjects were selected, out of which 151 healthy controls while 151 patients included in the study were newly diagnosed type-2 diabetes mellitus with non-probability, consecutive sampling at medical Out Patient Department (OPD) of PNS Shifa Karachi. All controls and newly diagnosed type-2 diabetics were tested for fasting plasma glucose, HbA1C and 25 hydroxycholecalciferol (25(OH) D3 / vitamin D) levels in pathology laboratory of PNS Shifa Hospital. Patients having serum level of 25(OH) D3 < 25 nmol/L was considered as having vitamin D deficiency. Results: Out of total 302 subjects, vitamin D levels of 36 ± 19nmol/L in newly diagnosed type 2 DM cases and of 65 ± 31nmol/L in controls of similar age groups and gender were found significantly lower in newly diagnosed type 2 DM. Vitamin D deficiency was found in 58 (38.4%) cases and 13 (8.6 %) in controls. In 151 newly diagnosed patients of type 2 Diabetes, 73 (48 %) were males and 78 (52 %) were females with mean age of 53.7 ± 8.7 years in both gender. In cases, mean and SD of fasting plasma glucose was 9.2 ± 1.5 mmol/L, HbA1C 9.4 ± 1.4 % and serum 25(OH) D3 36 ± 19 nmol/L. In cases, low vitamin D levels in different age groups and gender was found significant with advancing age predominantly in females. Significant correlation was found between hyperglycemia (HbA1C) and vitamin D deficiency (p-value < 0.001). Conclusion: Higher frequency of vitamin D deficiency was found among patients newly diagnosed as diabetes mellitus type-2 with advancing age especially in females. Vitamin D levels were inversely related to hyperglycemia. Considering such high frequency, screening of diabetic patients for vitamin D deficiency would be beneficial
Knowledge of Nurses in ENT Related Complications in Non-Dedicated Sub-Specialty Wards
No full textAbstract: Introduction: In our tertiary care hospital, we do not have a specialized ENT in-patient ward. All ENT patients are accommodated in any of the surgical wards or medical wards. In the event of any complications, we were not sure as to how adept are the nurses in all the wards to handle different situations in ENT patients. Objective: To assess whether there is difference amongst nurses in terms of knowledge of potential ENT related complications and patient care between different wards and formal ENT training. Methodology: Nursing staff involved in routine care of adult patients in general ward and special care units were included in the study. A ten-point questionnaire was used to assess knowledge of nurses in ENT patient care. Participants were approached during the working day and were asked to fill out the questionnaire ‘on the spot’. Each questionnaire was checked and evaluated by two ENT residents and rated out of 10. Result: The average scores of nurses across the wards were not same and there was significant differences (p < 0.01); it was found that in ward b1 nurses scored higher marks compared to those from other wards. Trained nurses were evenly distributed in all wards and there were no association between the distributions of trained nurses across the wards. Positive correlation was observed between the scores and experience of ENT trained nurses. Conclusion: It is advisable to have dedicated ENT and subspecialty wards and provide formal nursing training with respect to managing ENT complications to ensure ultimate patient care