Isra Medical Journal最新文献

{"title":"Clinical features and short-term clinical outcomes in Covid-19 infected Adult Population during fourth wave","authors":"Fatima Zahra","doi":"10.55282/imj.oa1359.","DOIUrl":"https://doi.org/10.55282/imj.oa1359.","url":null,"abstract":"Objective: To evaluate the clinical characteristics and comorbidities in COVID 19 patients and analyze its impact on outcome of COVID 19 during fourth wave. Study Design: Prospective observational study. Place and Duration: Department of Medicine of Fazaia Ruth Pfau Medical College for six months i.e. from 1st June 2021 to 1st December 2021 during fourth wave of Covid 19. Methodology: The patients with confirmed nasal swab test in SARI specialized acute respiratory illness unit of hospital (report available within 12 hours) were included in the study who required admission in medical COVID ward or intensive care unit. For data collection two residents were trained and assigned to collect the data by recording history of clinical features, comorbidities. Their physical examination along with vitals, oxygen saturation, and relevant laboratory workup was carried out. They recorded all the investigations carried out in admitted patients and observed them till they got better and discharged or could not survive. Results: A total of 113 patients were enrolled, mean age of recovered patients in our study was 45.99 ± 17.80 years whereas for expired it was 71.38 ± 11.62 years (p value <0.05). In the recovered group 70.10% (68) were males and 29.90 %( 29) were females whereas expired group included 62.50% (10) males and 37.5% (6) females. Fever, cough and body aches were observed in 72.57%, 49.56% and 46.02% respectively in recovered patients and 11.50%, 9.73% and 8.85% respectively in expired patients. Diabetes mellitus, hypertension and ischemic heart disease were found as comorbidities in 5.31%, 8.85% and 2.65% of recovered patients’ whereas18.75 %, 6.25% and18.75 % in expired group respectively. Conclusion: Our findings suggest that patients with COVID-19 who have presented with shortness of breath and have diabetes mellitus or ischemic heart disease are at increased risk of mortality. These patients should be closely monitored and provided with appropriate supportive care. Keywords: Clinical Features, Comorbidities, COVID 19, Outcome. How to Cite This: Zahra f, kidwai SS, Ahmed A, Umar M, Waseem F, et al. Clinical features and short-term clinical outcomes in Covid-19 infected adult Population during fourth wave. Isra Med J. 2023; 15(1): 20-24. DOI: https://doi.org/10.55282/imj.oa1359. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367738","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 Clinical Utility of Interleukin-6 in Congestive Heart Failure","authors":"Mariam Saeed","doi":"10.55282/imj.oa1380","DOIUrl":"https://doi.org/10.55282/imj.oa1380","url":null,"abstract":"Objective: To determine the clinical utility of Interleukin-6 in Congestive heart failure by comparing its association with N terminal-pro brain natriuretic peptide (NT-pro BNP). Study Design: Diagnostic Accuracy Study. Place and Duration: Department of Chemical Pathology, Combined Military Hospital (CMH), Lahore, from 1st September 2022 to 30th November 2022. Methodology: Patients reporting to the CMH Lahore Emergency Department with symptoms suggestive of Congestive Heart Failure (CHF) and Left Ventricular Ejection Fraction (LVEF) < 40% were included in the study after a detailed physical examination. Sample collection was done for analysis of N terminal-pro brain natriuretic peptide and interleukin-6. Standard echocardiography results were obtained from the patients. Their past medical history, the results of the clinical examination, and any additional findings were considered together when evaluating the data for diagnostic reasons. Results: The levels of N terminal-pro brain natriuretic peptide displayed a very weak positive correlation with interleukin-6 (r value=0.016; p value=0.859). Therefore, N terminal-pro brain natriuretic peptide and interleukin-6 were found to have a statistically insignificant association. Interleukin-6 was found to have sensitivity, specificity, and Area under Curve (AUC) (11.11%, 91.18%, and 0.482) respectively at a cut-off level of 65.6pg/ml, for the diagnosis of congestive heart failure. Conclusion: Interleukin-6 has a causative role in the progression and monitoring of congestive heart failure, however; we were unable to show its usefulness as a diagnostic marker of congestive heart failure. The positive correlation of interleukin-6 with N terminal-pro brain natriuretic peptide suggests that interleukin-6 can still be a target for therapeutics. Keywords: Interleukin-6, Diagnostic Accuracy, NT Pro-BNP (Gold Standard), Congestive Heart Failure, Biochemical Markers, Left Ventricular Ejection Fraction. How to Cite This: Saeed M, Rana MZ, Khan N, Anwar H, Awais H, Ahmed S. Assessment of the Clinical Utility of Interleukin-6 in Congestive Heart Failure. Isra Med J. 2023; 15(1): 7-10. DOI: https://doi.org/10.55282/imj.oa1380 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367294","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 Effects of Vitamin D Supplement on Prevention of Preeclampsia in Pregnant Women","authors":"S. Ashraf","doi":"10.55282/imj.oa1370","DOIUrl":"https://doi.org/10.55282/imj.oa1370","url":null,"abstract":"Objective: To evaluate the role of vitamin D supplementation in preventing preeclampsia in pregnant women. Study Design: Randomized controlled trial. Place and Duration: The study was conducted in the Gynecology Department of Nishtar Hospital, Multan, from 1st January 2022 to 31 December 2022. Methodology: A total of 250 (N) pregnant patients with a history of prior pre-eclampsia were enrolled after taking informed consent. Patients in the control group were given a placebo, and in the intervention group, a vitamin-D supplement of 50000 IU after every two weeks was given. Primary variables of the study were systolic and diastolic blood pressure, proteinuria in 24 hours urine, termination of pregnancy results like cesarean section, spontaneous vaginal delivery or abortion, and development of preeclampsia. Results: In the intervention group, 62.4% of females had expected vaginal delivery, 33.6% had a cesarean section, and 4.0% had an abortion. Whereas 49.6% of females had a normal vaginal delivery, 45.6% had a cesarean section, and 4.8% had an abortion in the control group, which was statistically insignificant. The patients in the intervention group have significantly lower 23 (18.4%) presentation of preeclampsia than patients in the control group 31 (24.8%) (p<0.001), which is statistically significant. Conclusion: Vitamin D supplementation during pregnancy helps prevent preeclampsia and gestational hypertension recurrence. Keywords: Vitamin D, Preeclampsia, Gestational Hypertension, Proteinuria, Pregnant Women. How to Cite This: Ashraf S, Khosa AF, Fatima K, Ibrahim M. The Effects of Vitamin D Supplement on Prevention of Preeclampsia in Pregnant Women. Isra Med J. 2023; 15(1): 11-14. DOI: https://doi.org/10.55282/imj.oa1370 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367786","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":"Illuminating the Shadows: Exploring the Causes, Overcoming Challenges, and Advancing Solutions for Skin Cancers in Pakistan","authors":"Berkha Rani","doi":"10.55282/imj.ltr35","DOIUrl":"https://doi.org/10.55282/imj.ltr35","url":null,"abstract":"Skin cancer poses a significant and growing public health concern in Pakistan, with rising incidence rates and a burden that weighs heavily on individuals, families, and healthcare systems. Understanding the causes, addressing the challenges, and implementing effective solutions are critical steps in combating this escalating issue.1 In this editorial, we shed light on the complexities of skin cancers in Pakistan, exploring the underlying causes, the challenges faced, and the pathways to advancing solutions for prevention, early detection, and treatment. The primary cause of skin cancers, including melanoma and non-melanoma types, is excessive and prolonged exposure to ultraviolet (UV) radiation from the sun1. Pakistan's geographical location, with abundant sunshine and a predominantly sunny climate, places its population at a heightened risk of developing skin cancers. Cultural practices, such as limited sun protection measures and a preference for fair skin, further contribute to increased UV exposure and vulnerability to skin cancers.1 Public awareness campaigns and education on the importance of sun protection practices, such as wearing protective clothing, using sunscreen, and seeking shade during peak sun hours, are crucial for reducing UV-related risks. Another significant challenge in combating skin cancers in Pakistan is the lack of comprehensive and consistent data on the incidence, prevalence, and mortality rates. Limited national registries and fragmented data collection systems impede accurate assessment and hinder evidence-based decision-making.2 Strengthening surveillance mechanisms, establishing cancer registries, and promoting data sharing and collaboration among healthcare institutions and researchers are pivotal in obtaining a comprehensive understanding of the burden and trends of skin cancers. Access to healthcare services, particularly in rural areas, poses a significant obstacle to early detection and timely treatment of skin cancers. Limited healthcare infrastructure, inadequate training of healthcare professionals and financial constraints restrict access to dermatological expertise, specialized diagnostics, and appropriate treatment modalities. Investment in dermatology services, the training of healthcare professionals, and the establishment of skin cancer centers can enhance early detection, diagnosis, and treatment accessibility for all individuals across Pakistan.3 Community engagement and health education programs play a pivotal role in raising awareness about skin cancers, dispelling misconceptions, and encouraging early detection behaviors4. Collaboration with community leaders, schools, and local organizations can facilitate the dissemination of information on risk factors, warning signs, and the importance of regular self-examinations4. By empowering individuals to recognize suspicious lesions and seek timely medical attention, we can promote early diagnosis and improve treatment outcomes.4 Furthermore, innovati","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367264","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":"Personality Development – A missing outcome competency that future Doctors will need","authors":"Ghulam Mustafa Lodhi","doi":"10.55282/imj.ed63","DOIUrl":"https://doi.org/10.55282/imj.ed63","url":null,"abstract":"The standard competencies of PM&DC labelled as ‘seven-star doctor’ are followed in designing undergraduate curriculum in Pakistan. The curricula of medical colleges are designed to make the graduates skillful and knowledgeable. Teaching, learning and assessment is designed in this way that our MBBS graduates not only become competent physicians, but we also want to prepare them as virtuous community health promoter. Measures are adopted to develop them as critical thinkers, professionals and scholars. Moreover, it is planned to groom them in such a way that they can act as leaders and role models in health care settings. These attributes are the bare minimum requirements outlined by regulatory body. More or less, same competencies are addressed in CanMEDS competency framework. An important competency which is missed and less frequently addressed in undergraduate and post graduate curricula is “personality development”. This is the domain, which our Holy Prophet Muhammad (peace be upon him) concentrated while training of his companions. The better developed personality is more successful as compared to weak personalities. We also need a physician who is competent professionally with seven star qualities, but along with that must have a personality that can cope life stresses, can manage career issues and the one, who is emotionally stable and can work efficiently in health care settings without any burnout or stress. There is prevalence of anxiety, burnout and stress in doctors all over the world as is evidenced by several studies. The literature shows that a large number of consultants reveal features of burnout even with good monthly income and reasonably low workload. Therefore prevalence of anxiety and depression along with burnout is fairly common in physicians1. Burnout is the term used for the exhaustion, fatigue and anxiety with diminished work output. It usually results from ineffectual management of chronic workplace stress2. This psychological stress, depression, anxiety, burnout and even suicidal tendency is not uncommon in medical students and physicians as mentioned in various studies3, 4. The contributing factors of stress in medical students may be cognitive overload, struggle in grasping the subjects, poor performance in assessments in spite of hard work. Therefore, it is important that these concerns are addressed right from start of the career of medical student. They need to be educated to adopt a healthy life style and attention be paid on their mental health. It can be achieved by incorporating personality development as outcome competency5. The process may start with building of healthy teacher student relationship and students are guided to stay optimistic with self-motivation. Moreover, there is need to inculcate hobbies, regular physical activities, discussion of problems and regular meditation. These measures are expected to groom their personalities as professionals who can cope with stress5. Incorporation of structured","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367755","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":"Impact of Zinc Supplementation in prevention of Chemotherapy Induced Oral Mucositis","authors":"Rabia Tariq","doi":"10.55282/imj.oa1372","DOIUrl":"https://doi.org/10.55282/imj.oa1372","url":null,"abstract":"Objective: To determine the impact of Zinc supplements in prevention of oral mucositis and its consequences in patients receiving chemotherapy. Study Design: Quasi experimental study Place and Duration: Department of Paediatric Oncology, Pakistan Institute of Medical Sciences (PIMS), Islamabad from 1st March, 2023 to 31 July, 2023. Methodology: A total of 60 patients (N) diagnosed of acute lymphoblastic leukemia planned for induction of treatment were included in the study. Patients were randomly divided into two groups of thirty patients each. Group-A received Zinc supplements while group-B received the usual standard of care without any additional supplement. At the end of four weeks of induction therapy, all patients were assessed for presence and severity of oral mucositis. They were also inquired about food intolerance and need for analgesics. Results: Mean age of patients included in the study was 4.723 ± 2.84 yrs. Males were34 (56.6%) and 26 (43.3%) were females. Severity of mucositis (p-Value is 0.017) and food intolerance (p-Value is 0.020) were markedly decreased in the group receiving zinc supplements. Analgesics were required by 21 (70%) patients in the group receiving zinc supplements and by 27 (90%) in the group not receiving zinc supplements. However, p-Value remained non-significant (0.104). Conclusion: Both, severity of oral mucositis and food intolerance are significantly reduced in patients prescribed zinc supplements during the induction phase of chemotherapy. Though, requirement of analgesics was also considerably reduced amongst patients taking zinc supplements, the difference was not statistically significant for this particular variable in our study. Keywords: Acute Lymphoblastic Leukemia, Zinc, Oral Mucositis, Chemotherapy, Childhood Malignancy How to Cite This: Tariq R, Manzoor R, Batool Z, Yasmeen N, Fatima SI, Ayub S. Impact of Zinc Supplementation in prevention of Chemotherapy Induced Oral Mucositis. Isra Med J. 2023; 15(1): 3-6. DOI: https://doi.org/10.55282/imj.oa1372 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"42 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367280","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":"Analysis of pattern and early changes of organs amongst admitted Patients in Intensive Care Unit and their relation to outcome","authors":"Muhammad Mumtaz Ather","doi":"10.55282/imj.oa1366.","DOIUrl":"https://doi.org/10.55282/imj.oa1366.","url":null,"abstract":"Objective: To assess the patterns and changes of organs amongst patients admitted in intensive care unit and to analyze the outcome of respective disease. Study Design: A prospective observational study. Place and Duration: Intensive Care Unit of Bakhtawar Amin Hospital, Multan from 1st March 2022- 31st March 2023. Methodology: A total of 200 patients admitted to the ICU were included in the study for analysis. Demographic information and comorbidities data were collected for each patient on admission. Patients were tested daily for infection and antibiotics were given. Sequential organ failure assessment score (SOFA) was used to assess organ function on admission and then every day after admission. We divided patients into 3 categories: patients who never developed sepsis, patients with sepsis development within 48 hours of admittance, and patients with sepsis development 48 hours after ICU admission. Results: The Simplified Acute Physiology score (SAPS) and SOFA score at admission were 34.5 ± 15.2 and 4.5 ± 2.8 respectively. The overall mortality in ICU was 15% and in-hospital mortality was 20%. During the ICU stay, 80 patients developed sepsis, among which 60 patients (30%) developed it within 48 hours and 20 patients (10%) after the 48 hours of ICU admission. Overall, in-hospital and ICU mortality was lower in patients without sepsis than those with sepsis (p<0.001). Conclusion: Early changes of organ failure is strongly associated with disease prognosis and outcome. Keywords: Intensive Care Unit, Multiple Organ Failure, Sepsis, Simplified Acute Physiology Score, Sequential Organ Failure Assessment Score. How to Cite This: Ather MM, Mukhtar S, Gardazi A, Rasheeq T, Tahir M, Muzammil M. Analysis of pattern and early changes of organs amongst admitted patients in Intensive Care Unit and their relation to outcome. Isra Med J. 2023; 15(1):25-29. DOI: https://doi.org/10.55282/imj.oa1366. This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139366309","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":"Workplace Violence and its contributing factors in healthcare workers of Peshawar Khyber Pakhtunkhwa Pakistan","authors":"Khaliq Jan","doi":"10.55282/imj.oa1369","DOIUrl":"https://doi.org/10.55282/imj.oa1369","url":null,"abstract":"Objective: To find the frequency of various types of violence and its contributing factors among healthcare workers in tertiary healthcare hospitals of Peshawar. Study Design: Cross-sectional study. Place and Duration: Emergency Department, Khyber Teaching Hospital Peshawar, Peshawar, from 1st January 2021 to June 30, 2021. Methodology: A sample size of 400 healthcare professionals from three hospitals was determined using open epi simple size calculator. The selection of participants was conducted using a non-probability convenient sampling approach. Data was collected using a pretested structured questionnaire after the participants' informed permission was acquired. Healthcare professionals include individuals such as physicians and registered nurses. Results: Most healthcare employees, 97.5%, said they did not experience physical abuse. A total of 1.5% of participants reported experiencing being assaulted once, whereas 1.0% reported experiencing physical assault two to three times. The mean and standard deviation for the latter group were calculated to be 1.04±0.232. A total of 37.2% of respondents said they did not experience any verbal abuse during the previous year. A total of 14.8% of respondents reported experiencing verbal harassment at least once, while 31.8% indicated facing verbal abuse two to three times. Additionally, 16.2% reported encountering verbal abuse more than four times during the last year. These findings yielded a mean of 2.27 occurrences of verbal abuse, with a standard deviation of 1.127. Conclusion: Verbal abuse is a pervasive concern in healthcare, often coupled with physical and emotional aggression. Keywords: Aggression, Abuse, Physical Violence, Psychological Violence, Health Care Providers, Medical Staff. How to Cite This: Jan k, Gul R, Khalil KR, Hassan F, Hameed N, Hamid R. Workplace Violence and its contributing factors in healthcare workers of Peshawar Khyber Pakhtunkhwa Pakistan. Isra Med J. 2023; 15(1): 15-19. DOI: https://doi.org/10.55282/imj.oa1369 This is an Open Access article distributed under the terms of the Creative Commons Attribution-Noncommercial 4.0 International License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"17 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139367500","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":"Oral versus Rectal Diclofenac Sodium: Comparison of efficacy for Perineal pain relief after Episiotomy","authors":"Shabana Kalsoom","doi":"10.55282/imj.oa1329","DOIUrl":"https://doi.org/10.55282/imj.oa1329","url":null,"abstract":"Objective: To compare the efficacy of oral diclofenac sodium and diclofenac suppository for perineal pain relief after episiotomy. Study Design: Prospective randomized clinical trial. Place and Duration: Obstetrics and Gynecology Department of Pakistan Ordnance Factories Hospital, Wah Cantt from 1st Jan 2021 to 30th June 2021. Methodology: The study included 260 patients, who were randomly divided into group A and B through a computer-generated list. Patients in group A were given diclofenac sodium tablet 50mg orally just after the completion of episiotomy repair and it was repeated after 12 hours. Diclofenac suppository 50mg was placed rectally after episiotomy repair in patients of group B and was repeated after 12 hours. Perineal pain was measured at 24 hours after episiotomy repair on Visual Analogue Scale. Results: The mean pain score was 2.93 in diclofenac suppository group and 3.98 in oral diclofenac group. The women in suppository group had less pain than oral group and the difference was statistically significant (p=0.001). Conclusion: Diclofenac suppository was more effective than oral Diclofenac Sodium for perineal pain relief at 24 hours after episiotomy. Keywords: Diclofenac Suppository, Diclofenac Tablet, Episiotomy, Mean Pain Score, Perineal Pain Relief, Visual Analogue Scale How to Cite This: Mushtaq I, Kalsoom S, Nisa K, Jamil M, Safdar F, Majeed N. Oral versus rectal Diclofenac Sodium: Comparison of efficacy for Perineal pain relief after Episiotomy. Isra Med J. 2022; 14(3): 104-107. DOI: https://doi.org/10.55282/imj.oa1329","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115525675","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":"Accuracy of Diffusion Weighted Imaging in the diagnosis and evaluation of Acute Ischemic Strokes","authors":"Sara Qadir Afridi","doi":"10.55282/imj.oa1314","DOIUrl":"https://doi.org/10.55282/imj.oa1314","url":null,"abstract":"Objective: To assess the accuracy of application of diffusion weighted imaging in the diagnosis and evaluation of acute onset ischemic strokes. Study Design: Cross sectional validation study. Place and Duration: Department of Diagnostic Radiology, Mardan Medical Complex, Hospital, Mardan from 15th October 2020 to 15th April 2021. Methodology: Patients whose presentation was highly suggestive of acute stroke, were undergone a non-contrast Computed tomography scan of the brain immediately by Asteion VP single slice. Those found negative for acute hemorrhage on Computed tomography images were subjected to Magnetic resonance imaging on Achieva 1.5 Tesla. Diffusion-weighted imaging technique of MRI scan was done in addition to the conventional T1W, T2W, and FLAIR scans of MRI which were also done. DWI was performed as early as possible not later than 24 hours after symptoms onset. Both DWI imaging technique and conventional routine T1W, T2W and FLAIR scans of MRI were repeated after 7 days. Results: The mean age of the sample was 57.6 + 5.9 years. On Diffusion-weighted imaging, stroke was observed in 60.2% of patients. Later on follow-up conventional magnetic resonance imaging scans were done after 7 days, stroke was recorded in 69.9% of patients confirming the diagnostic accuracy of DWI imaging in sub-acute stroke in early diagnosis. Conclusion: Conventional MRI scans like T1W, T2W and FLAIR have diagnostic accuracy only after some days. It has poor diagnostic accuracy in early onset sub-acute ischemic strokes. On the other hand, DWI imaging scans of MRI can be a useful tool for early detection of ischemic strokes as it diagnosed stroke in 60.2% of patients which were later confirmed by conventional MRI scans done after 7 days. Conventional MRI scans have high accuracy of detection of strokes but only after some days. So DW1 imaging may be applied for early diagnosis of strokes in sub-acute onset strokes. Keywords: Ischemic stroke, Magnetic Resonance Imaging, Diffusion Weighted Imaging, Hemorrhage, Computed Tomography How to Cite This: Afridi SQ, Baig H, Janan Z, Begum T, Shuaib M. Accuracy of diffusion-weighted imaging in the diagnosis and Evaluation of acute ischemic strokes. Isra Med J. 2022; 14(3): 99-103. DOI: https://doi.org/10.55282/imj.oa1314","PeriodicalId":253275,"journal":{"name":"Isra Medical Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122386466","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}