Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University最新文献

{"title":"Determining the Rate of COVID-19 Infection in Post-Vaccinated Individuals and Its Severity","authors":"Azmat Ali, Abdur Rahman Butt","doi":"10.48036/apims.v18i4.673","DOIUrl":"https://doi.org/10.48036/apims.v18i4.673","url":null,"abstract":"Objective: To assess the incidence of Covid-19 infection in people who were vaccinated and to categorize disease severity.\u0000Methodology: This cross sectional study was carried out at the Department of Medicine, KRL Hospital, Islamabad from September 2021 to February 2022. Individuals above 18 years of age, and fully vaccinated were included in the study. Using a pre-validated interview based close ended questionnaire data was collected, informed consent was obtained, and data was analyzed using SPSS Statistics 23. The severity of COVID-19 was determined by applying the WHO severity definitions.\u0000Results: The study included 362 individuals. 55.00% were males and 45.00% were females. The minimum age was 20 years and maximum 76 years with a mean of 45.73 ± 14.919. 27.1% of the participants had co morbidities, of which diabetes was the most frequent (59.18%). Majority (37.84%) individuals received Sinopharm vaccine. This was followed by Pfizer (24.58%) and Moderna (13.82%). 158 patients (43.65%) reported infection with covid-19. Out of 158, 41 (25.94%) had severe infection and 9 (5.70%) had critical infection on WHO criteria.\u0000Conclusion: A substantial proportion of fully vaccinated individuals suffered from Covid-19 infection (43.64%). Pfizer was the most effective vaccine in preventing infection (79.77%). While Sinopharm was the least effective (41.60%). However, vaccination was effective in preventing severe and critical infection in a significant number of patients (86.18%).","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125671351","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":"Role of Red Cell Distribution Width as a Prognostic Marker in Neonatal Sepsis","authors":"R. Asghar, Javera Tariq, Sundas Ali, M. Saeed, Lubna Naseem, M. Tariq","doi":"10.48036/apims.v18i4.677","DOIUrl":"https://doi.org/10.48036/apims.v18i4.677","url":null,"abstract":"Objective: To determine the prognostic value of red cell distribution width (RDW-CV%) in predicting the outcome in neonatal sepsis.Methodology: It was an observational study conducted at the Pakistan Institute of Medical Sciences, Islamabad, from December 2018 to April 2020. A total of 136 neonates at term with clinical suspicion of neonatal sepsis were equally divided based on RDW into two groups as normal and raised RDW. A complete blood count and C-reactive protein were done on the day of admission and repeated on Day 3. Outcomes were observed in terms of discharges, expiries and length of hospital stay.Results: The mean RDW of Group 1 (normal RDW) was 14.71±0.65 on Day 1 and 17.14±0.14 on Day 3 with a significant p-value of <0.001. In group 2 (Raised RDW) on Day 1 it was 17.14±1.46 and at day-3 was 17.8±1.90 with a p<0.001. Discharged neonates in group 1 were 57 (83.8%) and in group 2 were 46 (67.6%). (p=0.458). Expired neonates in Group-1 were 11(16.2%) and in group-2 were 22(32.4%) with significant p-value of 0.028. Neonates shifted to ventilator in group-1 were 10 (14.7%) and in group-2 were 24(35.3%) with p-value (0.006). Length of hospital stay in terms of days in group1 with mean 5.85± 4.03 and group-2 it was 7.63± 4.82 with a significant p-value of <0.001.Conclusion: Raised RDW in clinically septic neonates was associated with poor outcomes in terms of length of hospital stay, mechanical ventilation and deaths compared to neonates with normal RDW.Keywords: Red cell distribution width, Sepsis, Neonatal","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"80 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114883938","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":"Postoperative Analgesia After Inguinal Herniotomy in Children; A Comparison of Combination of Intravenous Paracetamol and Rectal Diclofenac with Caudal Bupivacaine","authors":"A. Pak, Inst Med Sci, Verdah Sabih, J. Zahir, Hassam Zulfiqar, Ammar Ali Shah, Arshad Shahani, Yasmeen Azeem","doi":"10.48036/apims.v18i4.701","DOIUrl":"https://doi.org/10.48036/apims.v18i4.701","url":null,"abstract":"Objective: To compare the efficacy of intravenous paracetamol and rectal diclofenac combination with caudal block using 1ml/kg of 0.25% bupivacaine in the management of post-operative pain following paediatric inguinal herniotomy.\u0000Methodology: This quasi-experimental study was conducted at the Department of Anesthesia, Holy Family Hospital, Rawalpindi, from February 2020 to August 2020. A total of 342 children aged 2-12 years requiring inguinal herniotomy were enrolled after satisfying the inclusion and exclusion criteria. Computer-generated random numbers were used to split the patients into two groups. Group A received intravenous paracetamol (30 mg/kg) and rectal diclofenac (1mg/kg). Group B received a caudal block using 1ml/kg of 0.25% Bupivacaine. Pain was assessed postoperatively in the PACU by modified Objective Pain Scale (OPS) every 15 minutes for the 1st hour and hourly up till 8 hours. Effective analgesia was defined as a modified OPS score of ≤ 3 for upto 8 hours after shifting to PACU. If at any time, the score was >3 and the patient required a rescue analgesic, effective anaglesia was not achieved.\u0000Results: Effective analgesia was achieved in 82.46% of the patients (n=141) in Group-A versus 87.13% patients (n=149) in Group-B (p-value: 0.23). \u0000Conclusion: There is no significant difference in the efficacy of analgesia in paracetamol/diclofenac combination group compared with caudal bupivacaine group.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130011024","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":"Immunogenicity of the BBIBP-CorV Vaccine; An Observational Study from Pakistan","authors":"Zunera Jahanzeb, Arslan Zahid, Hafeez-ud-din, Hina Aslam, Samia Kausar, Muhammad Israr","doi":"10.48036/apims.v18i4.670","DOIUrl":"https://doi.org/10.48036/apims.v18i4.670","url":null,"abstract":"Objective: To determine the levels of anti-spike protein (S) antibody against SARS-CoV-2 among Vaccinated Healthcare workers of Islamabad.Methodology: Cross-sectional Observational study carried out at HBS General Hospital from March 2021 till May 2021 involving healthcare workers from HBS General Hospital, Rawal General Hospital, Polyclinic Hospital and PIMS. The non-probability sampling technique was used. The study included male and female healthcare workers over the age of 18 who had received their second dose of vaccine at least 2 weeks before sample collection and no more than 8 weeks before sample collection.Results: The study included 123 participants, of whom 6.5% did not have a detectable level of the antibody. The Male to Female ratio was 1.277:1 while mean age was 42.93±13.234 years. Side-effects were experienced by 42.3% (n=52) participants. Significantly higher levels of the antibody were observed in participants who had previous SARS-CoV2 infection and those who experienced vaccine side-effects.Conclusion: The BBIBP-CorV vaccine elicited immunogenicity, leading to detectable anti-spike protein S antibody levels in 93.5% of the patients in our study.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"178 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133906219","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":"Frequency of Thyroid Lesions in a Tertiary Care Hospital in Peshawar","authors":"Javaria Ahsan, Naveed Khan, Umm-e-Farwa, Bushra Parveen, Ahsan Masood Butt, Fatima Sana","doi":"10.48036/apims.v18i4.682","DOIUrl":"https://doi.org/10.48036/apims.v18i4.682","url":null,"abstract":"Objective: To determine the frequency spectrum of all thyroid lesions in terms of histopathological patterns presented to the Pathology Department of the Combined Military Hospital Peshawar.\u0000Methodology: A retrospective observational study was conducted at the Combined Military Hospital, Peshawar, from September 2015 to December 2020. A total of 235 thyroidectomy specimens, over a period of 5 years, were included in the study period. Information was collected on age, gender, clinical presentation, and histopathological diagnosis.\u0000Results: A total of 235 cases were studied over a period of five years, of which 188 (80%) were females and 47 (20%) were males, with a male to female ratio of 1:4. The patients’ ages ranged from 14 years to 85 years, with a mean age of 41 years, and the relative peak age of incidence was seen from 21 to 40 years of age. Total 193 cases (82.1%) belonged to the non-neoplastic category out of which adenomatous colloid goiter was the most common (180 cases, 93.3%). The neoplastic lesions (total cases 42) were 17.9% of all of the cases, out of which benign lesions i.e. adenoma comprised 20 cases (47.7%) and malignant lesions were 22 (52.3%). Among the malignant lesions papillary carcinoma was the most common (16 cases) comprising of 73% of all of the malignant lesions.\u0000Conclusion: Thyroid lesions are more common in females, with peak incidence in the second and third decades. The non-neoplastic lesions are more common, with the adenomatous goiter being most prevalent. In the neoplastic lesions, follicular adenoma constitutes the main lesion in the group of benign neoplasms and papillary carcinoma being the most common lesion among the malignant neoplasms.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"54 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121810494","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":"Comparison of Efficacy of Intranasal Midazolam and Conventional Treatment with Intravenous Diazepam for Control of Seizures in Children; A Randomized Controlled Trial","authors":"Zuash Fateh, Nighat Haider, Jai Krishin, Sadia Riaz, Muqadar Shah, Saad Abdullah Fateh","doi":"10.48036/apims.v18i4.708","DOIUrl":"https://doi.org/10.48036/apims.v18i4.708","url":null,"abstract":"Objective: To compare the efficacy of intranasal midazolam and conventional treatment with intravenous diazepam for the control of seizures in children.\u0000Methodology: It was a randomized controlled trial conducted in the Children Hospital, PIMS, Islamabad from January 2022 to June 2022 presenting to the ER department with seizures. The patients were randomly divided into two groups. Group A patients were given a single dose of intranasal midazolam (0.2 mg/kg).Group B patients were treated with a single dose of intravenous Diazepam (0.2mg/kg). We recorded the following parameters: 1) the period elapsed between arrival at emergency and drug administration. 2) The time interval between drug administration and cessation of seizures. 3) The period between admission to the hospital and the end of seizures.\u0000Results: Among 60 enrolled patients, there were thirty-one males and twenty-nine females. The mean age of the patient was 5.27 ± 3.31 years. The mean intervals between arrival at the hospital and treatment given were 3.00±0.91 and 7.03±2.91 mins (p-value 0.000) in groups A and B, respectively. The mean intervals between the treatment given and cessation of seizure were 2.70 ± 1.05 and 2.60 ± 1.13 mins (p-value 0.725) in groups A and B, respectively. The mean intervals between arrival at the hospital and the cessation of seizure were 5.70 ± 1.3 and 9.63 ± 2.58 mins (p-value 0.000) in groups A and B, respectively.\u0000Conclusion: The intranasal Midazolam was shown to be as effective in suppressing seizure as the intravenous Diazepam. This is the best option if you don't have access to an intravenous line.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"124 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128091824","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":"Case Report: Ulcerated Adenomyoma presenting as CA Endometrium","authors":"Z. Usman, Majida Zafar, Syeda Batool Mazhar","doi":"10.48036/apims.v18i1.607","DOIUrl":"https://doi.org/10.48036/apims.v18i1.607","url":null,"abstract":"During this COVID pandemic cancer surgeries are still being carried out via necessary precautions.Endomertial carcinoma is one of the easiest carcinoma to pick and early surgical treatment can completely cure it. Adenomyosis on the other hand is the presence of ectopic endometrial tissue  with in myometrium if it involves the uterus focally it is known as adenomyoma. Radiological findings of adenomyoma can be mistaken for endometrial carcinoma. We present such a case in which radiologically diagnosed endometrial carcinoma turned out to be adenomyoma on histopathology.","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"123 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121020981","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":"Peer Assisted Learning; The Perspective of Peer Tutors","authors":"Aisha Akbar, Muhammad Nasir Ayub, Maliha Atif, Huma Jawad, H. Mumtaz, Taqdees Iftikhar","doi":"10.48036/apims.v18i3.686","DOIUrl":"https://doi.org/10.48036/apims.v18i3.686","url":null,"abstract":"Objective: To determine the perspective of PAL tutors regarding the effectiveness of PAL in promoting knowledge and skills among the undergraduate students using small group discussions in an integrated module.\u0000Methodology:  A prospective qualitative method study was conducted at Rawal Dental College, Islamabad, from April to June, 2021, for 12 weeks. Students from the second year of BDS (n = 50) were divided into five small groups. Five students’ volunteers were chosen from those who completed the previous units with more than 80% summative assessment score and with good communication skills. The group discussion centered on the application of core knowledge and skills in pathology. Responses from the tutors for the qualitative data were obtained using in depth one-on-one semi-structured interviews with audio recorded. The verbatim in the form of audio and notes were transcribed, and the qualitative analysis was performed by two independent investigators, generating codes, themes, and subthemes.\u0000Results: The results showed the comprehensive understanding of the insights of tutors and the motivational elements for achieving academic goals and improving teamwork and teaching skills. Many factors encouraged their participation as tutors, including the acquisition of knowledge and leadership skills. The students felt that their compassionate attitude encouraged active participation by the fellow students, increasing their confidence and learning. The students perceived that they had attained essential attributes that would benefit them in professional life in the future.\u0000Conclusion: The students enjoyed the Peer-assisted learning experience and recognized its importance for their academic and professional development. While learning in a relaxed environment, the students achieved their basic learning goals, developed leadership skills, improved communication skills, and gained confidence.\u0000Keywords: Peer Group, Integrated curriculum, Near-Peer tutoring.\u0000 ","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128207592","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":"Assessment of the Predictors and Mortality in Patients of Acute on Chronic Liver Failure; A Prospective Study","authors":"Rehmatullah Bhatti, Ubedullah Bughio, Adil Hassan, Abdul Hafeez Soomro, Jawaid Iqbal, Mashooque Ali","doi":"10.48036/apims.v18i3.663","DOIUrl":"https://doi.org/10.48036/apims.v18i3.663","url":null,"abstract":"Objective: To evaluate the predictors of short-term mortality in patients with acute-on-chronic liver failure (ACLF).\u0000Methodology: This prospective study was conducted at the gastroenterology department of the Asian Institute of Medical Sciences Sindh, Pakistan from January 2018 to December 2018. All the patients with acute-on-chronic liver failure (ACLF) aged more than 25 years and of either gender were included. A complete history was obtained including demographic profile and specifics on clinical characteristics (jaundice, ascites, gastro-intestinal bleed, grade of encephalopathy, records of vital parameters etc.). Serum electrolytes, viral serology, autoimmune profile, liver function tests, serum creatinine, prothrombin time, and INR were among the laboratory tests performed on each patient.\u0000Results: A total of 99 patients were studied; their average age was 40.90+13.93 years; and there was a male predominance (73.5%). HCV and HBV+HDV were the most common etiological factors. According to the frequency of organ failure, hepatic failure was in 59.8% of the cases, renal failure was in 43.6% of the cases, CNS failure was in 38.5% of the cases, 41.0% of the cases had circulatory failure, coagulation failure was in 55.6% of the cases, and respiratory failure was seen in 17.1% of the cases. Overall, the 30-day mortality rate was 61.5%. Hepatic failure, renal failure, CNS failure, coagulation failure, SBP, and grading of ACLF were significantly associated with short-term survival rate (p= <0.05). While gender, etiology, circulatory failure and respiratory failure were statistically insignificant (p= >0.05). MELD score >28, CTP score >13, organ failure >3 and ACLF grade II and III were also highly significantly linked to short term survival rate (p-0.0001).\u0000Conclusion: According to the study's findings, hepatic failure, renal failure, CNS failure, coagulation failure, and ACLF grading, CTP score > 13, MELD score > 28, and the presence of hepato-renal syndrome were found to be significant predictors of short-term mortality in patients with Acute On-Chronic Liver Failure (ACLF).","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124814738","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":"Outcome of Kangaroo Mother Care in Preterm, Low Birth Weight Neonates; A Randomized Control Trial","authors":"Nadeem Ahmad, Syeda Shireen Gul, Muhammad Hayat Khan, Fasih Hashmi, Azka Batool, Ambreen Fatima","doi":"10.48036/apims.v18i3.647","DOIUrl":"https://doi.org/10.48036/apims.v18i3.647","url":null,"abstract":"In a recent meta-analysis, based on 13 randomized control trials, the researchers concluded that the neonates care with KMC at least 6 hours per day got significant weight gain as compared to the Non-KMC group with a mean difference 8.99 gm per day. They also concluded that the infants received KMC for less or equal to 02 hours per day not showed a significant difference in weight gain as compared to controls.16","PeriodicalId":184398,"journal":{"name":"Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131949809","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}