National Journal of Health Sciences
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Frequency of Different Stages of Pelvic Organ Prolapse and Factors Leading to it
No full textAbstract: Introduction: Pelvic Organ Prolapse (POP) is an important gynecological morbidity. An increasingly popular classification system for this disease is the Pelvic Organ Prolapse Quantification System (POP-Q). This study was intended to initiate an information campaign, preventive care management and early treatment to reduce this public and social health problem. Subject and Methods: A Cross sectional study was carried out on 197 women with complaints of something coming out of vagina or heaviness in pelvis. General physical and standard pelvic examination in dorsal lithotomy position was performed for the diagnosis of pelvic organ prolapse. Results: Frequency of various stages of pelvic organ prolapse using Pelvic Organ Prolapse Quantification System (POP-Q) in women was observed as stage 0 (10.2%); stage I (9.69%); stage II (52.55%) and stage III (27.55%). Rate of stage of pelvic organ prolapse was also not significant with parity, menopausal status and hormone replacement therapy while effect of increase abdominal pressure on the POP-Q stage was also statistically significant (p=0.0005). Conclusion: In conclusion, increased abdominal pressure and overweight clearly confers a risk for pelvic organ prolapse. Risk factors (age,parity, menopausal status and hormone replacement therapy) may influence the stages of POP, however the relationship between these factors and different stages has not been clearly understood
Academic Use of Smart Phone and Correlation of its Addiction with Sleep Disturbances among Medical Students
No full textAbstract: Objective: To assess the positive academic usage of smart phone to determine the correlation of its potential addiction with sleeping disturbances among medical students in Karachi, Pakistan. Methods: A standard scale based questionnaire was constructed and reviewed by a panel of expert for content reliability and validity. The questionnaire consisted of 3 parts: Part “A” for demographic parameters, Part “B” was designed to evaluate Smart phone addiction and Part “C” for assessment of sleep disturbance. The study was conducted in July 2017 which comprised of medical students of the Liaquat National Hospital & Medical College, Karachi, Pakistan.ts: A total of 212 students participated in which Males were 31.1% (n=66), Females were 68.9% (n=146). Out of 212, within which 93.3% (n=198) had Smart Phones, 4.71% (n=10) had Mobile phones other than smart phones and 1.88 %( n=4) did not had mobile phone. Majority of students were found to be using Smart phone for academically beneficial use 86.4 %( n=171). Among 198 smart phone users 51.5% (n=102) were found to be addicted with respect to our scale. A positive significant correlation was found between the scores obtained from the Modified Smart phone addiction scale and Sleep disturbance Scale (rs=0.536; p<0.001). Conclusion: Despite many beneficial uses of Smart phone in the modern era, students are developing smart-phone addiction which may result in sleep deprivation
Correlation of Neurological Deficits in Patients with Myelomeningocele on the Basis of Anatomical Location and Size of Base of Defect
No full textAbstract: Aims and Objectives: To analyze data regarding relationship of myelomeningocele at different anatomical locations along vertebral canal and size of base defect.Study Design: Descriptive analytic study.Setting: Department of pediatric surgery, King Edward Medical University / Mayo Hospital Lahore.Duration of the study: 2 years from October 2017 to September 2018.Methodology: During study period a total of 60 patients (n=60) with myelomeningocele at different anatomical locations along the vertebralcolumn were admitted. Inclusion criteria was:• All patients under 3 months of age with myelomeningocele.• Patients with intact myelomeningocele membrane.• None infected cases.A detailed research performa was made having all variables and data was collected regarding total number of patients, gender, location of myelomeningocele along vertebral canal, presence or absence of neural tissue in sac, size of base of defect, associated neurological deficits, treatment and outcome were noted and statistical analysis was done by using SPSS version 24. Results: A total of 60 patients with myelomeningocele meeting the inclusion criteria were admitted. Most common age of presentation was 1 to 2 month 26 (43.3 %). There were 43 (71.6%) males and 17 (28.3%) female patients. Regarding anatomical locations of myelomeningocele along vertebral canal, there were 4 (6.6 %) cases of cervical, 2 (3.3 %) cases with thoracic, 5 (8.3%) cases with thoracolumber, 38 (63.3%) cases with lumbosacral and 11 (18.3%) cases with sacral myelomeningocel. No neural tissue was found in cervical and thoracic myelomeningocele, but was found in 3 (60%) cases of thoracic lumber myelomeningocele, in 37 (97%) cases of lumbosacral myelomeningocele, in 11 (100%) cases of sacral myelomeningocele. No neurological deficit was found in cervical, thoracic and thoraco lumber myelomeningocele. Paralysis of lower limbs was found in 8 (13.3%) cases of lumbosacral myelomeningocele and in 2 (3.3%) cases of sacral myelomeningocele. Paresis of lower limbs was found in 7 (11.6%) cases of lumbosacral myelomeningocele and in 2 (3.3%) cases of sacral myelomeningocele. Fecal incontinence as found in 12 (20%) cases of lumbosacral myelomeningocele and in 4 (6.6%) cases of sacral myelomeningocele. Urinary incontinence was found in 12 (20%) cases of lumbosacral myelomeningocele and in 4 (6.6%) cases of sacral myelomeningocele. In most of cases wound closure was done by simple skin closure, in 12 (20%) cases defect was closed by raising S- shaped rotational flap. Wound infection was noted in 4 (6.6%) cases while there was complete wound dehiscence in 3 (5%) cases. In 2 (3.3%) cases there was post operative leakage of CSF from wound and post operative ventriculitis was observed in 01 (1.6%) case. Hydrocephalus observed in 16 (26.6%) cases of myelomeningocele was treated with ventriculo _ peritoneal shunting.Conclusion: Myelomeningocele is very serious congenital anomaly leading to future disability in children. It can be prevented by prescribing folic acid in pregnancy. A detailed neurological evaluation of patient before and after surgery is important in planning for surgery and rehabilitation
Frequency of Tumor Lysis Syndrome in Acute Leukemia
No full textAbstract: Introduction: Acute leukemia is characterized by the presence of 20% or more blasts in peripheral blood and/or bone marrow biopsy. It includes both AML & Acute ALL. However the diagnosis of AML can also be made when the blast percentage in peripheral blood or bone marrow is < 20 % if there is an associated t (8;21), inv (16), or t (16;16) chromosomal abnormality or PML-RAR fusion gene [1-3]. Tumor lysis syndrome is the most common disease related emergency in patients with leukemia & requires immediate management. Objective: To ascertain the Frequency of TLS in Acute Leukemia. Study design: Cross sectional study.Setting: NIBD & BMT, Karachi. Duration of study: The duration of study was 6 months i.e. from May 2016 to November 2016.Results: 111 patients were enrolled in this study. 41 (36.9%) patients were female & 70 (63.1%) were male, with mean age of 42.8±15.5 years. 66 (59.4%) patients were found to have AML & ALL was seen in 45 (40.6%) patients. Tumor lysis in AML was seen in 21 patients (18.9%) of which 15 patients (13.5%) had LTLS & 06 patients (5.4%) had CTLS. Tumor lysis in ALL was seen in 23 patients (20.7%) of which 16 patients (14.4%) had LTLS & 07 patients (6.3%) had CTLS. Conclusion: TLS is a frequently common disease related complication in patients with acute leukemia. LTLS is found to be more common than CTLS both in AML & ALL
Factors Affecting the Academic Performance of Undergraduate Student Nurses
No full textAbstract: Background: The nursing school undergraduates’ performance influences the quality production of graduates. These in turn will be the future leaders and workforce for the country in improving the health care system. Thus it is imperative that the students do achieve good performance standards. Academic achievement or performance is the degree in which a learner, instructor or organization have accomplished their short term or long term learning objectives. Objective: The main purpose of this study was to explore the factors (e.g., student related, school related, home related, teacher related) that may affect the academic performance of Undergraduate Nursing Students (UNSs). Material and Methods: In this descriptive research study, a cross-sectional survey design was used to conduct this research study. Through simple random sampling technique, a sample of 129 Undergraduate Nursing Students was selected from the BSN (Bachelor of Science in Nursing) and Post RN BScN (Registered Nurse Bachelor of Science in Nursing) Students of the Lahore School of Nursing, The University of Lahore, Pakistan. A modified version [1] of the research scale was used to collect the relevant data from the research subjects. Result: One hundred and twenty-nine student nurses participated in this research study; the majority of the participants were females 110 (85.3%). Four types of factors such as teacher-related with an overall mean (3.90), school-related (3.88), student-related (3.83), and home-related factors (3.48) were studied to explore their effect on the academic performance of student nurses. It was found that teacher related factors were at the top with overall mean score of 3.90 and family-related factors were at the lowest level with an overall mean score of 3.48. Conclusion: The result shows that identified factors have influence on academic performance of student nurses. Finding can be used by administrators, educators and evaluators in designing and implementing an educational programs geared to developed academic performance among student nurses
Etiology and Predisposing Factors for Electrical Current Injury in Children
No full textAbstract: Aims and Objectives: To analyze the data regarding etiological and predisposing factors in pediatric burns and make conclusion for prevention of pediatric burns. Study design: Retrospective hospital based observational study. Setting: Department of Pediatric Surgery, King Edward Medical University, Mayo Hospital Lahore. Duration of Study: From June 2017 to June 2018.Methodology: Children with electric current injuries were admitted in Pediatric Surgery Department, King Edward Medical University, Mayo Hospital, Lahore. As it was a retrospective study so the main source of information was the hospital admission files. A detailed research proforma was made having all variables and data was collected. Data regarding total number of patients, age, gender, mechanism of burn injury, operating findings, treatment and outcome were noted and statistical analysis was done by using SPSS version 20. Results: One hundred and thirty (n = 130) patients with burn injuries caused by electric current in age ranging from 2 to 12 years were treated during one year period. There were 72(55%) males and 58(45%) females. Areas involved were mainly the limbs and face. High voltage electric current was responsible for 90(69%) burn cases and low voltage in 40(31%) cases. Electric current injury caused by direct contact occurred in 100(77%) cases whereas electric flash burn was responsible in 30(23%) cases. Fasciotomy was performed in 78(60%) cases amputations at different levels in 24(18%) and disarticulations of shoulder joint were performed in 6(4.5%) cases. Split thickness skin grafting was done in 80(61.5%) cases whereas 12(9%) cases having minor injury were treated conservatively. 92(71%) cases were discharged home, 23(17.5%) cases expired and in 15(11.5%) cases parents refused for treatment. Conclusion: Burns are caused by human errors and are therefore preventable. Disability due to severe burn adversely affects the life of a growing child and is a huge social issue. Public awareness through print and electronic media as well as education at school level is to be stressed in order to prevent electric current burn injury resulting in high morbidity and mortality. There is a need to establish more state of the art pediatric burn units according to population consensus in our country
Wealth Index, Education, Access to Electronic Media and Awareness about Tuberculosis: Pakistan Demographic and Health Survey 2012-13
No full textAbstract: Objective: To investigate association of education, wealth index and access to electronic media with awareness about TB and its spread among women. Material and Methods: Countrywide Pakistan Demographic and Health Survey (PDHS) 2012-13 data was selected for secondary analysis. From 12,943 occupied households, 13,558 ever-married women and 3,134 ever married men age 15-49 were interviewed. For this study, women interviews record was selected and analysed for TB awareness and its relationship with education attainment, wealth index and electronic media exposure. SPSS logistic regression analyses were performed for statistical significance and to discover association between TB awareness and education attainment, wealth index and electronic media. A p-value of < 0.05 was considered to be statistically significant. Results: The poorest uneducated women had the lowest awareness about TB and its spread by air. Awareness about TB and its spread by coughing and sneezing increased with increase in education level and households’ wealth and living standard. Women from households having radio, in rural areas, had overall more awareness about TB and its spread by coughing and sneezing than women from households having no radio. Women of households having TV, in all regions of the country, had distinctly higher awareness about TB spread by air than women of households who had no TV. Interestingly, there was more awareness among women of households having no radio and TV about TB spread by sharing utensils, touching person and sexual contact than women of households having radio and TV.Education attainment and TV in households were more statistical significant than radio in households and wealth index. Education, wealth index and TV in households have relationship with TB spread by coughing and sneezing. Conclusion: Awareness about tuberculosis and its spread by air among women was associated with increase in wealth, education level and exposure to electronic media. Use of electronic media would be helpful in creating awareness, in minimal time, about all aspects of tuberculosis
A Perspective on Thalassaemia
No full textTS is a varied group of genetic disorder results from reduced rate of synthesis of alpha or beta globin chains. Its inheritanceis autosomal recessive [1]. Thalassaemias are considered most prevalent genetic disorders worldwide; mostly they occur intropics and sub-tropics but now sporadic cases are prevalent in other regions of the globe also, mainly due to resettlementsacross the continents [2, 3]
Post-Operative Intussusception in a Child after Pseudo Cyst of Pancreas Excision
No full textAbstract: Intussusception is commonly seen in pediatric age group. It is rarely present as a cause of post-operative obstruction. Ileus and adhesion band are the common causes of postoperative obstruction. The classical presentation of intussusception is frequently absent in post-operative intussusception, so high degree of suspicious is required for early diagnosis. Timely intervention can give excellent results, so we have to consider it as a differential diagnosis in post-operative obstruction in pediatric age group. We are presenting here a case of post-operative intussusception in one and half year old male child after excision of pseudo cyst of pancreas
Acquired Trisomy 21 - A Unique Cytogenetic Finding in T-Cell Acute Lymphoblastic Leukemia
No full textAbstract: Acute lymphoblastic leukemia (ALL), is a lymphoid neoplasm arising from lymphoid progenitors, broadly classified according to lineage into B-cell and T-cell ALL in which T-cell ALL constitutes a small proportion. We are reporting here a case of young female who was diagnosed as T-cell ALL using flow cytometry with acquired trisomy 21, identified on conventional cytogenetics, as a unique finding in this case