Journal of Ayub Medical College, Abbottabad : JAMC最新文献

{"title":"Impact Of Severity Of Covid-19 On Haematological Parameters In Patients Reporting To Saidu Group Of Teaching Hospitals, Swat.","authors":"Javeria Rauf Saeed,&nbsp;Amreek Lal","doi":"10.55519/JAMC-01-11188","DOIUrl":"https://doi.org/10.55519/JAMC-01-11188","url":null,"abstract":"<p><strong>Background: </strong>In 2019 novel coronavirus was discovered in Wuhan, China and declared pandemic by world health organization. The disease caused by this virus called coronavirus disease 2019 (COVID-19). Among the corona family the actual virus responsible for COVID-19 is Severe Acute Respiratory Syndrome Corona Virus 2 (SARS-CoV-2). Objective of the study was to determine the pattern of blood parameters in corona virus disease (COVID-19) positive cases and the association of these parameters with severity of COVID-19.</p><p><strong>Methods: </strong>This cross-sectional descriptive study was conducted on 105 participants who were confirmed positive by SARS-CoV-2 through real-time reverse transcriptase PCR, both genders, and Pakistani nationals. The participants who were below 18 years age and missing data were excluded. Haemoglobin (Hb), total leukocyte count (TLC), neutrophil, lymphocyte, monocyte, basophil and eosinophil counts were calculated. Comparison of blood parameters was done among various severity classes of COVID-19 by running one way ANOVA. The level of significance was p≤0.05.</p><p><strong>Results: </strong>The mean age of the participants was 50.6±6.26 years. Males were 78 (74.29%) and females were 27 (25.71%). In critical type COVID-19 the mean haemoglobin was least (10.21±1.07 g/dl) and highest in mild cases (15.76±1.16 g/dl) and these differences were highly statistically significant (p<0.001). TLC was highest in critical COVID cases (15.90±0.51x103 /μl) followed by moderate (12.44±0.65x103/μl). Similarly, neutrophil count was highest in critical (89±2.1) followed by severe (86±1.12).</p><p><strong>Conclusions: </strong>There is significant decrease in mean haemoglobin level and platelet count but increase in TLC in patients infected from COVID-19.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"80-83"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9313406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness Of Saddle Block Vs Spinal Anaesthesia In Turp: An Open Label Randomized Control Trial.","authors":"Nida Shahid,&nbsp;Muhammad Wajid Iqbal,&nbsp;Syed Nurul Haque,&nbsp;Asim Masroor Rashid,&nbsp;Salman Shaukat","doi":"10.55519/JAMC-01-11451","DOIUrl":"https://doi.org/10.55519/JAMC-01-11451","url":null,"abstract":"<p><strong>Background: </strong>One of the most frequent diseases among male gender is benign prostatic hyperplasia. Transurethral resection of the prostate (TURP) is a minimally invasive procedure for resection of prostate through endoscopic technique. Recently there was a debate on role of saddle block in TURP. There we aimed to determine the effectiveness of spinal anaesthesia versus saddle block in terms of hemodynamic stability and vasoprbessor requirement in TURP.</p><p><strong>Methods: </strong>This open label randomized control trial was performed at Hamdard University Hospital, Karachi, Pakistan, during 1st October, 2021 to 31st March, 2022. Male patients of age 45-65 years requiring TURP, with well controlled diabetes and hypertension of ASA grade I-II were included into the study and randomly assigned into two study groups. Patients' parameters including blood pressure, heart rate, mean arterial pressure and oxygen saturation (SPO2) were measured at baseline and intraoperative at every fifth minute interval till surgery completion. Patients' other parameters including age, surgery duration and comorbidity were also recorded.</p><p><strong>Results: </strong>Total 60 patients with 30 patients in each group were enrolled into the study. Maximum fall in systolic blood pressure, diastolic blood pressure, pulse rate and mean arterial pressure from baseline was significantly lower in patients receiving saddle block anaesthesia than spinal anaesthesia. Maximum fall in SPO2 was not significantly different among two study groups. Maximum fall in all parameters excluding SPO2 was significant between two groups for initial 20 minutes of the procedure. No statistically significant maximum fall was seen for all of the parameters beyond 20 minutes of the procedure. Vasopressor consumption was significantly lower in saddle block group than spinal anaesthesia.</p><p><strong>Conclusions: </strong>Application of saddle block anaesthesia is effective for TURP procedure with controlled hemodynamic status than spinal anaesthesia. Moreover, saddle block requires less vasopressor consumption than spinal anaesthesia technique.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"127-132"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367925","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Patients' Characteristics And Non-Surgical Treatment Results For Hypopharyngeal Cancer In Southeast Of Iran: A 13-Year Study.","authors":"Mohammad Hasan Larizadeh,&nbsp;Aliasghar Arabi Mianroodi,&nbsp;Hadi Eslami","doi":"10.55519/JAMC-01-11408","DOIUrl":"https://doi.org/10.55519/JAMC-01-11408","url":null,"abstract":"<p><strong>Background: </strong>Various modalities have been used to treat hypopharyngeal cancer. Non- surgical modalities include radiotherapy alone, sequential chemoradiation and concomitant chemoradiation or bio radiation. This study was conducted to evaluate the primary non-surgical treatment.</p><p><strong>Methods: </strong>A total number of 67 patients treated from March 2009 to January 2022 were enrolled in this study. The 2-year and 5-year survival rates were estimated using the Kaplan-Meier method. Log-rank test was used to compare the survival outcomes according to various factors. To define independent prognostic factors, we used Cox regression analysis.</p><p><strong>Results: </strong>The mean age of the patients was 56.2 years, and 55.2% of them were male. These patients were treated by radiation alone (9 patients) or induction chemotherapy followed by either radiation (4 patients), chemoradiation (33 patients), or bio-radiation (21 patients). The mean follow-up time was 18.12 months. The 2-year and 5-year overall survival rates were estimated to be 43% and 18%, respectively. Multivariate analysis showed that T stage, N stage, and treatment modality had a statically significant relationship with overall survival.</p><p><strong>Conclusions: </strong>The results of non-surgical treatment for hypopharyngeal cancer are not satisfactory. More studies are needed to investigate the role of salvage surgery.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"118-122"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367929","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect Of Lead On The Skin And Health Of Female Dermatitis Patients Through Cosmetics.","authors":"Hassan Imran Afridi,&nbsp;Asim Ali,&nbsp;Murk Bhatti,&nbsp;Ahsanullah Unar,&nbsp;Ghulam Qadir Chanihoon,&nbsp;Farah Naz Talpur,&nbsp;Tasneem Gul Kazi,&nbsp;Faisal Ali Arain","doi":"10.55519/JAMC-01-11442","DOIUrl":"https://doi.org/10.55519/JAMC-01-11442","url":null,"abstract":"<p><strong>Background: </strong>Cosmetics have been a part of routine body care not only for the upper classes but also for the middle and lower classes since the dawn of civilization. Cosmetic formulations are in more demand as the public's interest in skin whitening grows. The contamination of cosmetics with heavy metals is a major concern as they containing heavy metals and pose a major risk to human health. This study looks in to the effects of Lead on human skin.</p><p><strong>Methods: </strong>In this cross sectional study different products were examined. The matrices (scalp hair, blood, serum and nails) of reference and dermatitis cosmetic female patients (seborrhoeic dermatitis, rosacea, allergic contact dermatitis, and irritant contact dermatitis) and cosmetic samples were used in a 2:1 mixture of HNO3 (65%) and H2O2 (30%), and oxidation was performed using a microwave. The oxidized beauty and biological specimen underwent electrothermal atomic emission spectrophotometry after microwave-assisted acid digestion. The validity and precision of the methodology were verified using certified reference materials. Cosmetic products (lipstick, face powder, Eye Liner and Eye shadow) of different brands contain Pb concentrations in the ranges of 50.5-120 μg/g, 14.6-30.7 μg/g, 2.87-4.25 μg/g and 15.3-21.6 μg/g, respectively.</p><p><strong>Results: </strong>In the present study, cosmetic products (lipstick (N=15), face powder (N=13), eye liner (N=11), eye shadow (N=15) and female patients with dermatitis (N=252) residing in Hyderabad city, Sindh, Pakistan, was investigated. The outcome of this investigation showed significantly higher levels of Pb in biological samples (blood and scalp hair) of different types of female dermatitis patients than in reference subjects (p<0.001).</p><p><strong>Conclusions: </strong>The cosmetic products, especially with regard to heavy metals adulteration, are in use by the female population.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"88-94"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367930","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect Of Cotton Dust Exposure On Respiratory Health Outcomes Among Textile Workers.","authors":"Afreen Sadia,&nbsp;Yousaf Ali,&nbsp;Hasan Nawaz Tahir,&nbsp;Natasha Shaukat,&nbsp;Muhammad Irfan,&nbsp;Asaad Ahmad Nafees","doi":"10.55519/JAMC-01-10901","DOIUrl":"https://doi.org/10.55519/JAMC-01-10901","url":null,"abstract":"<p><strong>Background: </strong>Cotton dust is generated during various textile manufacturing processes. Only a few studies from Pakistan assessed cotton dust exposure and explored the relationship of duration of work in the textile industry with respiratory health outcomes. We aimed to assess cotton dust exposure and its association with lung function and respiratory symptoms among textile workers in Pakistan.</p><p><strong>Methods: </strong>We report findings from the baseline survey of the larger study, MultiTex, among 498 adult male textile workers from six mills conducted between October 2015-March 2016 in Karachi, Pakistan. Data collection included the use of standardized questionnaires; spirometry, and area dust measurements through UCB-PATS. Multivariable logistic and linear regression models were developed to assess the association of risk factors with respiratory symptoms and illnesses.</p><p><strong>Results: </strong>We found the mean age of workers to be 32.5 (±10) years; around 25% were illiterate. The prevalence of COPD, asthma, and byssinosis was 10%, 17%, and 2%, respectively. The median cotton dust exposure was 0.33 mg/m3 (IQR: 0.12-0.76). Increased duration of work among non-smokers was associated with a decline in lung function, FVC (-245 ml; 95% CI: -385.71, -104.89) and FEV1 (-200 ml; 95% CI: -328.71, -841.1). Workers with certain job titles (machine operators, helpers, and jobbers), those with greater duration of work, and higher dust exposure, were more likely to report respiratory symptoms and illnesses.</p><p><strong>Conclusions: </strong>We report a high prevalence of asthma and COPD and a low prevalence of byssinosis. Cotton dust exposure and duration of employment were associated with respiratory health outcomes. Our findings highlight the need for preventive interventions in the textile industry in Pakistan.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"104-109"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9367931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lower Limb Salvage For Tumours Around The Knee Using Oncological Resections And Megaprosthetic Reconstructions.","authors":"Faridullah Khan Zimri,&nbsp;Muhammad Saaiq,&nbsp;Muhammad Noman,&nbsp;Faisal Qayyum","doi":"10.55519/JAMC-01-10628","DOIUrl":"https://doi.org/10.55519/JAMC-01-10628","url":null,"abstract":"<p><strong>Background: </strong>This descriptive case series documented the clinical presentation of tumours around the knee in our population and explored the outcome of lower limb salvage with oncological resections and megaprosthetic reconstructions. The variables analysed included return of knee function, disease free survival and any complications observed over a follow up period of 5-years.</p><p><strong>Methods: </strong>The study spanned over a period of 13-years. It included adult patients of all genders who presented with tumours around the knee and underwent tumour resections followed by megaprosthetic reconstructions at our institute.</p><p><strong>Results: </strong>Out of 73 patients, there were 43 (58.90%) males and 30 (41.09%) females. Their ages ranged between 16-53 years with a mean of 32.97±10.68 years. The tumours included giant cell tumours (n=41), osteosarcomas (n=24), Spindle cell sarcoma (n=5), chondrosarcoma (n=2) and Ewing's sarcoma (n=1). The average postoperative musculoskeletal tumour society (MSTS) score was 84.65%. Various complications encountered included superficial infections/ delayed wound healing among 9 (12.32%) patients, local recurrence in 6 (8.21%), deep infections among 5 (6.84%) and transient palsy of peroneal nerve in 3 (4.10%) cases. There was aseptic loosening and traumatic disruption of extensor mechanism one each (1.36%). There were 7 (9.58%) mortalities in our series.</p><p><strong>Conclusions: </strong>Giant cell tumours and osteosarcomas were the most frequent tumours observed around the knee. The tumours affected relatively younger population. Safe oncological resections of the tumours followed by megaprosthetic reconstructions provided reasonable outcome in the majority of patients.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"27-31"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10792711","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising Resistance In Uropathogens With An Indication Of Nitrofurantoin Mic Creep.","authors":"Azra S Hasan,&nbsp;Richa Garg,&nbsp;Sowmya Nasimuddin,&nbsp;Sneha Dey,&nbsp;Ayan Das,&nbsp;Syed Md Moosi Raza Ali,&nbsp;Sumit Rai,&nbsp;Dalip K Kakru","doi":"10.55519/JAMC-01-11050","DOIUrl":"https://doi.org/10.55519/JAMC-01-11050","url":null,"abstract":"<p><strong>Background: </strong>The irrational use of antibiotics has led to the emergence of multi drug resistant pathogens. The phenomenon of MIC creeps occurs when organisms start showing raised MIC but within susceptible range giving an indication of the prevalence of rise in resistant pathogens in an area.</p><p><strong>Methods: </strong>A cross sectional study in a large tertiary care hospital in North India to observe the susceptibility pattern among uropathogens and the possibility of MIC creeps. The Antimicrobial Susceptibility Testing (AST) and Minimum Inhibitory Concentration (MIC) were conducted by Vitek Compact 2. The identification of Extended Spectrum Beta Lactamase (ESBL) producers and Carbapenem Resistant Enterobacteriaceae (CRE) among Escherichia coli were noted. The MIC 50 and MIC 90 for Nitrofurantoin, the most widely used antibiotic for lower UTI, was calculated to investigate the phenomenon of MIC creep.</p><p><strong>Results: </strong>In our study, a total of 2522 urine samples were analyzed: 1538 (61%) were positive with the commonest isolate being E. coli (n=736, 47.8%) followed by Klebsiella spp. (n=178, 11%). Less than 10% of resistance was observed for Fosfomycin, Amikacin, Nitrofurantoin, Imipenem, Meropenem and Colistin. ESBL producers and CRE E. coli were 528 (72% of 736) and 79 (11% of 736) respectively. Overall, 119/736 samples had an MIC ≥128. Amongst the ESBL producers, 96/528 had MIC ≥128 and amongst the CRE, 13/79 had MIC ≥128.</p><p><strong>Discussion: </strong>E. coli can be used to reflect the trends in development of resistance. In the current study, it was observed that E. coli showed a reduced susceptibility for Nitrofurantoin indicated by a creeping increase in MIC albeit within normal range.</p><p><strong>Conclusions: </strong>Trends in rising MIC should alert prescribers to use drugs such as Nitrofurantoin judiciously. Antimicrobial stewardship practices should be strongly implemented in hospitals to curb rising resistance and obtain better treatment outcomes for patients with infectious diseases.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"54-59"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10805653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual Outcomes With Intraocular Trifocal Lens Implant.","authors":"Muhammad Ali Haider,&nbsp;Hussain Ahmed Khaqan,&nbsp;Nida Usman,&nbsp;Arslan Ahmed,&nbsp;Uzma Sattar,&nbsp;Hasnain Muhammad Buksh,&nbsp;Rahila Ikram,&nbsp;Sana Sarfaraz","doi":"10.55519/JAMC-01-11149","DOIUrl":"https://doi.org/10.55519/JAMC-01-11149","url":null,"abstract":"<p><strong>Background: </strong>Cataract surgery has become one of the most common surgeries in the world with one in every four surgeries performed being a cataract extraction and the numbers are expected to increase by 16 percent in the USA alone by 2024 as compared to the current statistics. The aim of the study is to analyze the visual outcomes of intraocular lens implants for various visual ranges.</p><p><strong>Methods: </strong>This non-comparative interventional study was conducted at the Ophthalmology department of Al Ehsan Eye Hospital from Jan to Dec 2021. It included patients who underwent uneventful phacoemulsification with an intraocular lens implant and analysis of the visual outcomes for uncorrected distance (UDVA), uncorrected intermediate distance (UIVA), and uncorrected near distance (UNVA).</p><p><strong>Results: </strong>Independent sample t-test was applied to observe the mean values of recorded far vision on the 1stday, 1 week, and 1 month after the trifocal intraocular lens implantation. It showed a significant difference with a p-value of 0.00 on 1st day, 1 week, and 1 month after was 0.3±0.1, 0.17±0.09, and 0.14±0.08 respectively. Mean improvement in near vision after 1 month was N6 with S.D 1.03 and in intermediate vision was N8±1.4 respectively.</p><p><strong>Conclusions: </strong>Trifocal Intraocular lens implantation offers an improved vision for near, intermediate, and distant visual ranges without the need for correction.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"76-79"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10805659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Marked Acanthocytosis Associated With Klipple Trenaunay Syndrom.","authors":"Syeda Mah Ali,&nbsp;Naila Raza,&nbsp;Eraj Aftab,&nbsp;Mahnoor Faisal Mohammad","doi":"10.55519/JAMC-01-11307","DOIUrl":"https://doi.org/10.55519/JAMC-01-11307","url":null,"abstract":"<p><p>Klipple-Trenaunay syndrome (KTS) is an extremely rare congenital vascular disorder with poorly defined incidence and prevalence. We report a case of a patient who presented after road traffic accident with primary complaints of poor wound healing and persistent bleeding from wound site. Discernible presence of arteriovenous malformation and skin hypertrophy since birth lead to the diagnosis of Klipple-Trenaunay syndrome (KTS). There was an incidental finding of acanthocytosis on peripheral film of blood which remained elevated even after clinical improvement of the patient. This case report highlights a close association of marked acanthocytosis of red blood cells and Klipple-Trenaunay syndrome.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"182-185"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9351610","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect Of Eight Hours Per Day Of Intermittent Self Prone Positioning For Seven Days On The Severity Of Covid-19 Pneumonia/ Acute Respiratory Distress Syndrome.","authors":"Hamza Javed,&nbsp;Fatima Qayyum,&nbsp;Muhammad Naushad Aslam Khan,&nbsp;Mubashra Ashraf,&nbsp;Awais Elahi,&nbsp;Haseeb Hayat,&nbsp;Sameed Khan,&nbsp;Sidra Qayyum Malik,&nbsp;Khadija Amanullah","doi":"10.55519/JAMC-01-11069","DOIUrl":"https://doi.org/10.55519/JAMC-01-11069","url":null,"abstract":"<p><strong>Background: </strong>Prone positioning improves ventilation-perfusion mismatch, distribution of gravitational gradient in pleural pressure, and oxygen saturation significantly in patients with Covid pneumonia. We aimed to find out the efficacy of eight hours per day of intermittent selfprone positioning for seven days in patients affected with COVID-19 pneumonia/ ARDS.</p><p><strong>Methods: </strong>This Randomized Clinical Trial was conducted in the Covid isolation wards of Ayub Teaching Hospital, Abbottabad. Patients suffering from COVID-19 pneumonia/ ARDS were enrolled with permuted block randomization into a control and an experimental group each consisting of 36 patients. Parameters of Pneumonia Severity Index (PSI) score along with other sociodemographic data was noted on a preformed structured questionnaire. Death was confirmed by requesting the death certificate of patients on the 90th day of enrolment. Data Analysis was done with SPSS Version 25. Tests of significance were applied to calculate the difference in the patients of the two groups with respect to respiratory physiology and survival.</p><p><strong>Results: </strong>The mean age of the patients was 63.79±15.26 years. A total of 25 (32.9%) male and 47 (61.8%) female patients were enrolled. Statistically significant improvement was found in the respiratory physiology of the patients at 7th and 14th DOA between the groups. Pearson Chi-Square test of significance showed a difference in mortality between the two groups at 14th DOA (pvalue=0.011) but not at 90th DOA (p-value=0.478). Log Rank (Mantel-Cox) test of significance, applied on the Kaplan Meier curve and showed no statistically significant difference among the groups based on the survival of the patients. (p-value=0.349).</p><p><strong>Conclusions: </strong>Early transient improvement in respiratory physiology and mortality does occur with 8 hours of self-prone positioning for seven days but there is no effect on the 90-day survival of the patients. Thus, the impact of the manoeuvre on improving survival needs to be explored with studies having an application of the manoeuvre for a longer duration and period.</p>","PeriodicalId":15141,"journal":{"name":"Journal of Ayub Medical College, Abbottabad : JAMC","volume":"35 1","pages":"68-75"},"PeriodicalIF":0.0,"publicationDate":"2023-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10805658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}