Journal of Saidu Medical College, Swat最新文献

{"title":"Bariatric Surgery: The Current Perspective","authors":"Anwar Ul Haque","doi":"10.52206/jsmc.2023.13.2.791","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.2.791","url":null,"abstract":"Obesity and overweight are defined as abnormal or excessive fat accumulation that may impair health.1 The WHO definition of overweight is a BMI > 25 and for obesity is > 30kg/m2. The National Institute of Health defines morbid obesity as a BMI of 40kg/m2 or more or a BMI of 35kg/m2 or more in the presence of obesity related comorbidities.2 Obesity has emerged as a global health crisis, affecting millions of individuals and significantly increasing the risk of chronic diseases such as diabetes, cardiovascular disorders, and certain types of cancer. As traditional methods of weight loss often prove ineffective for severely obese individuals, bariatric surgery has gained prominence as a life-altering solution. This editorial explores the transformative impact of bariatric surgery on patients' lives, shedding light on its effectiveness, safety, and long-term benefits.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130879882","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":"Extended Spectrum B-Lactamase (ESBL) and Metallo B-Lactamase (MBL) Production in Gram-Negative Bacteria isolated from Urinary Tract Infection Patients.","authors":"Husna Shams, Muhammad Suliman, U. Noor, Asad Aziz, Sabiha Khanum, Najma Naz, Shazia Rehman","doi":"10.52206/jsmc.2023.13.2.738","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.2.738","url":null,"abstract":"Background: The rate of infections caused by Morganella species is reported to be affected by difficulties in their isolation. Enterobacter, species, Citrobacter freundii, Serratia marcescens, and Morganella morganii are the major pathogens involved in hospital acquired infections. All of them are extensively reported in the infections of urinary tract, respiratory tract, cutaneous disorders, catheter associated infections and infections of the central nervous system.Objective: To investigate the frequency of ESBL producing bacteria in Urinary Tract Infection. Material and Methods: A cross-sectional study of 200 urine samples was collected from the outdoor patient departments of Khyber Teaching Hospital Peshawar through consecutive sampling technique during April, 2019 to June 2019. The urine samples were collected and then cultured on selective media i.e., Cysteine Lactose Electrolyte Deficient Agar (CLED) and on MacConkey agar plates. Isolates were identified by conventional morphological and biochemical tests while antibiotic susceptibility was analyzed by “Agar disc diffusion method” using different antibiotics and their zone of inhibition was measured. Results: Total 200 samples processed, 125 (62.5%) isolates, including 67 (53.6%) females, tested positive for the growth of Gram-negative bacteria. Among the identified species, 76 (60.8%) isolates produced ESBLs, with Escherichia coli accounting for 32.6%, Enterobacter for 23.2%, and Morganella species for 12.0%. Moreover, 77 (61.6%) of the isolates were found to be MBL positive, with 30 (24.0%) of them being E. coli, 28 (22.4%) being Enterobacter, and 19 (15.2%) being Morganella spp. The isolates formed a zone of inhibition like a clover leaf and demonstrated a sensitivity of 85 (68%) to antibiotics in the carbapenem class, such as imipenem and meropenem. Cefoparazone/Sulbactam 80 (64.0%), Ofloxacin 79 (63.2%), and Amikacin 78 (62.4%) were the next three antibiotics with high sensitivity. Ampicillin 106 (84.8%) showed the highest resistance, followed by Nitrofurantoin 84 (67.2%) and Ceftriaxone 79 (63.2%), in that order. Conclusion: The study indicated that ESBL-producing bacteria were present frequently among UTI patients. Most of the isolates exhibited strong carbapenem class antibiotic sensitivity. The findings of this study may contribute to the formulation of tactics to lower the incidence of ESBL-producing UTI.Keywords: Antibiotics resistance, Gram Negative bacteria, Plasmid-mediated enzymes, UTI.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128175941","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":"How Common is Aspiration Pneumonia in Patients Presenting with Acute Stroke and Fed by Using Nasogastric Tube?","authors":"Imtiaz Ali, Muhammad Bilal, Adeela Masood, Yaseen Khan","doi":"10.52206/jsmc.2023.13.2.753","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.2.753","url":null,"abstract":"Background: Stroke is the leading cause of fatalities and years lost due to incapacity. Due to the possibility of pneumonia developing, aspiration has long been recognized as a substantial cause of morbidity after a stroke. Objective: To determine the frequency of aspiration pneumonia in nasogastric-tube fed stroke patients.Material and Methods: This descriptive cross-sectional study was conducted in the department of Medicine, Lady reading hospital, Peshawar from 01-12-2020 to 30-05-2021.A total of 230 patients presenting with stroke and subjected to NG tube for enteral nutrition were included in the study in a consecutive manner and checked for aspiration pneumoniaResults: The mean age of the patients was 58.7 + 9.1 years. 64.3% were males and 35.7% females. The mean duration of symptoms at presentation was 35.6 + 7.6 hours. On CT brain, 56.2% patients had ischemic stroke and 43.9% had hemorrhagic stroke. Aspiration pneumonia was recorded in 20.4%.Conclusion: Aspiration pneumonia is fairly common in our stroke patients who are on NG tube for enteral nutrition.Keywords: Acute hemorrhagic stroke, Aspiration pneumonia, Hemorrhagic stroke, Ischemic stroke, Nasogastric tube.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130829552","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":"Do not let the deaf to be deaf","authors":"Mahid Iqbal","doi":"10.52206/jsmc.2023.13.1.776","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.776","url":null,"abstract":"","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116557262","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":"Spectrum of Congenital Heart Disease in Children with Down's Syndrome","authors":"Sijad Ur Rehman, Wahid Ali, Abid Iqbal, Romana Bibi","doi":"10.52206/jsmc.2023.13.1.752","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.752","url":null,"abstract":"Background: Down syndrome is the most common chromosomal disorder and most common genetic cause of mental retardation.Congenital heart disease (CHD) is an important cause of morbidity and mortality in children with Down's syndrome.Objective: To determine the frequency and types of congenital heart diseases in children with Down syndrome and to relate it withconsanguinity.Material and Methods: This Cross-sectional study was carried out at Bacha Khan Medical Complex / Gajju Khan Medical College,Swabi, from January 2019-December 2020. Children less than 12 year's age with Down syndrome were enrolled in the study.Echocardiography of all these children was done and presence and type of CHD was noted.Results: Our study included 95 children with diagnosis of Down syndrome. The mean age was 56.12±41.89 months. 40% weremales. Mother's mean age was 33.04±4.2 years. Mothers having age = 35 years old were 30.5%. Parents having consanguineousmarriage were 33.7%. The diagnosis of major congenital heart defect was in 37.9%. Out of 36 CHD patients the type of congenitalheart lesion was as follows: 36.11% hadAVSD, 25% hadASD; 30.5% had VSD; 5.55% had tetralogy of Fallot and 2.78% had PDA.Children with down syndrome with CHD had older mothers <0.05. Mothers with consanguineous marriages had a greaterproportion of CHD children; p<0.05.Conclusion: Approximately 1/3rd Down syndrome children had congenital heart disease. The commonest lesion was AVSDfollowed by VSD, ASD, tetralogy of Fallot and PDA. Consanguineous marriages are associated with a greater frequency ofCHD in Down children.Keywords: Down syndrome, congenital heart disease, Echocardiography.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131645214","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 Laryngeal Mask Versus I-Gel Airway Devices","authors":"Asad Zaman, Ameer Hamza, Kaleemullah, Abdul Wahab Dogar, Zahoor Ahmed, Azhar Hussain","doi":"10.52206/jsmc.2023.13.1.712","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.712","url":null,"abstract":"Background: Adequate ventilation is the primary goal of general anesthesia. A variety of supra-glottic airway devices wereintroduced to simplify airway management and minimize complications.Objective: To compare the Laryngeal mask airway versus I-Gel in terms of insertion time, number of successful insertion attempts,and changes in hemodynamic parameters in patients getting general anesthesia.Material and Methods: This comparative study was performed at the Anesthesia department, Pir Abdul Qadir Shah Institute ofMedical Sciences, Gambat from 1st July 2020 to 31st December 2020. Patients achieving the inclusion criteria were divided into twogroups. In Group-A, the I-Gel device was used for airway maintenance; while in Group-B, the Laryngeal Mask Airway(LMA) wasused. The mean insertion time, insertion attempts, and hemodynamic parameters were recorded and compared in both groups.Results: Total number of participants studied was 140; with 70 participants in each group.The mean age was 33.74+6.75 years inGroup-A and 33.16+7.24 years in Group-B. Gender distribution showed 62.86 % (n=44) male in Group-A and 64.29% (n=45) inGroup-B. A comparison of LMA versus I-Gel showed a mean insertion time of 22.81+3.09 seconds in Group-A and 31.53+2.46seconds in Group-B (p<0.0001). The number of successful insertion attempts and the changes in the hemodynamic parameterswas comparable in both groups (p>0.05).Conclusion: This study concluded that the I-Gel device has a significantly low insertion time compared to LMA in elective settings.So, its use can be handy in emergency settings.Keywords: I-Gel, LMA, General anesthesia, insertion time","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133826950","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":"Hepatitis B Vaccination Status among Nursing Students in Karachi, Pakistan","authors":"Javid Ali, Hakim Shah, Khalilullah, Mahboob Ali, Jehanzeb Khan","doi":"10.52206/jsmc.2023.13.1.636","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.636","url":null,"abstract":"Background: Hepatitis B infection is a fatal occupational hazard for health care professionals especially for student nurses. Theycan be easily protected from hepatitis B infection by their HBV vaccination.Objective: To determine the frequency of HBV Vaccination among student nurses in Karachi Pakistan.Material and Methods: This cross-sectional study was conducted in ten nursing institutes (five public and five private) among 529nursing students.Results: Out of 529 nursing students, only 270(50.6%) were vaccinated. Among 270 respondents, 58.8% were completelyvaccinated and68% were vaccinated before clinical exposure. The most common reasons for not being vaccinated included lack ofknowledge about HBV vaccine (31.88%), unavailability of free of cost vaccine (22 %), have no time for vaccination (11.96%), afraidof vaccine side effects/complications (10.14%), afraid of injection (9.42%), have prior immunity (5.43%), not effective vaccine(5.07%) and high vaccine cost (3.99%).Conclusion: There is alarmingly low vaccination coverage of hepatitis B among nursing students of Karachi, leading to a greatprofessional risk of hepatitis B infection. Consequently, policy should be implemented for making hepatitis B vaccination mandatoryfor admission in nursing institutes to prevent nursing students from acquiring this fatal disease.Keywords: Hepatitis B vaccine; Hepatitis B virus; Nursing students; Vaccination; Pakistan.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"132944253","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":"How Common Peripheral Arterial Disease is in Patients Undergoing Coronary Angiography?","authors":"Shama Ayaz, Shah Zeb, Hidayatullah, Fazle Akbar, Muhammad Imran, Kareemullah, Salahudin Kamal, Mahmood ul Hassan","doi":"10.52206/jsmc.2023.13.1.706","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.706","url":null,"abstract":"Background: Cardiovascular disease is the leading cause of death in the world. The detection and treatment of risk factors for CVevents is critical to improving health and longevity1. The most common among cardiovascular diseases is atherosclerotic coronaryartery disease.Objective: To determine the frequency of previously undiagnosed peripheral arterial disease in patients undergoing coronaryangiography.Material and Methods: This Descriptive Cross-sectional study was conducted in Cardiology Department, Hayatabad MedicalComplex Peshawar from 17th June, 2020 to 16th December, 2020. The patients of 40-80 years age of both genders were includedthrough Non probability consecutive sampling. The data was collected through a proforma specially designed for this study andwas analyzed through SPSS 22.Results: A total of 171 patients were included in the study. Age wise distribution among 171 patients was analyzed as 30-40 Years9(5.3%), 41-50 Years 51(29.8%), 51-60 Years 72(42.1%), 61-70 Years 32(18.7 %), 71-80 Years 7(4.1%). Mean age was55.56(±9.23) years. Gender wise distribution among patients, Male were 108(63.2%) Female were 63(36.8%). Distribution ofDiabetes Mellitus was 50(29.2%). Hypertension was documented in 100 (58.5%). Smoking Status 51(29.8%). Distribution ofperipheral arterial disease among 171 patients was analyzed as 22(12.9%). Distribution of Types ofACS was non-ST elevationamong patients was 32(18.7%), STEMI was 62(36.3%) and USA was 77 (45%).Conclusion: The study demonstrated that the frequency of asymptomatic Peripheral arterial disease (PAD) in patients with CADwas 12.9% and was strongly associated with higher incidence of cardiovascular risk factors, and multivessel disease.Keywords: Peripheral arterial disease, coronary artery disease","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127187372","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":"Euryblepharon; A Case Report From Pakistan","authors":"Hafiz Muhammad Jahan Zaib, Amina Khalid, Samra Ahmed","doi":"10.52206/jsmc.2023.13.1.768","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.768","url":null,"abstract":"Euryblepharon is a rare congenital eyelid anomaly characterized by horizontal enlargement of the palpebral fissure. The eyelid is less in size in the vertical dimension as compared with the horizontal dimension. It may be isolated or associated with other ocular anomalies (e.g. strabismus or telecanthus) or systemic anomalies (blepharo-cheilo-odontic syndrome)There can be associated lateral canthal misalignment and as a consequence lateral ectropion. The condition was first described by Desmarres in 1854. The average length of lid fissures is different in different ages as portrayed by Duke-Elder and Cook (1963) and Waardenburg and others (1961) ranging from 18.35mm at birth to 29.68 at 24 years of age. 50% of this increase occurs during first few (3-4) years of life.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122266373","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":"Hepatocellular Damage in the Patients presenting with Dengue Fever","authors":"Nazir Shah, Mian Mufarih Shah, Daneeth Kumar, Imran Qadir Khattak, Imran Khan","doi":"10.52206/jsmc.2023.13.1.765","DOIUrl":"https://doi.org/10.52206/jsmc.2023.13.1.765","url":null,"abstract":"Background: Dengue fever is becoming endemic in Pakistan as shown by its increasing prevalence in the summer seasons foralmost the last decade. Elevation of liver enzymes indicating underlying liver damage, is a common phenomenon and may beassociated with other complications.Objective: To find out the frequency of hepatocellular damage in the patients presenting with dengue fever as evident by elevatedliver enzymes.Material and Methods: This was a descriptive study performed in the medical unit of Hayatabad Medical Complex PeshawarPakistan. Patients were consecutively collected from the wards, outpatients, and emergency department. The patient's collectionwas from the year 2022 epidemic from 10th Jul to 23rd Oct. Patients with consistent clinical features, were diagnosed on the bases ofdengue NS1 test and antibodies titers. Liver enzymes, complete blood counts and ultrasound were performed to find out anyevidence of liver damage and plasma leaks as evident by pleural effusion or ascites. Alanine aminotransferase (ALT) of more than50 U/L was considered as elevated in our study. Patients with elevated liver enzymes due to expected reasons other than denguefever as per clinical records, were excluded from the study. The patient's data was noted on a preformed Performa for furtheranalysis.Results: We consecutively collected 500 patients for the study. The number of male patients was 59% (n=295) while femalepatients were 41% (n=205). The age range was 15 to 75 years (mean 45, SD 21.32). The overall frequency of elevated (ALT) was68.2% (n=341). Stratification of patients according to the ALT level shows that only 13.68% were having anALT level of more than300 U/L. The frequency was 45.45% in patients without complications, 91.60% in patients with warning signs, 85.71% insevere dengue and 100% with acute liver failure. Patients with an alanine aminotransferase (ALT) of =>300U/L werehaving a hospital stay of 5 to 12 days (mean 8.81, SD 2.6) days verses 4 to 9 days (mean 5.8, SD 1.9) in the patients having<300U/LConclusion: Most of the patients with dengue fever have elevated alanine aminotransferase level indicative of underlyinghepatocellular damage. Such patients usually recover without any serious consequences except those having elevation of 300U/lor more whose hospital stay was prolonged, and a smaller percentage was associated with acute liver failure.Keywords: dengue fever, dengue NS1, hepatocellular damage, liver enzymes, hospital stay.","PeriodicalId":326561,"journal":{"name":"Journal of Saidu Medical College, Swat","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129101465","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}