Gomal Journal of Medical Sciences最新文献

{"title":"PREVALENCE OF MATERNAL NEAR-MISS AND MATERNAL MORTALITY, THEIR DISTRIBUTION BY GESTATION AND GRAVIDITY AND CAUSES IN WOMEN WITH LIVE BIRTHS IN DISTRICT PESHAWAR, PAKISTAN","authors":"Sonia Rafiq, Sumaira Yasmin, Nazia Liaqat, Ghazala Shams","doi":"10.46903/gjms/19.02.844","DOIUrl":"https://doi.org/10.46903/gjms/19.02.844","url":null,"abstract":"Background: Maternal near-miss (MNM) and maternal mortality (MM) are indicators for quality of health care system. The objectives of our study were to determine prevalence of MNM and MM and their distribution by gestation and gravidity and their causes in women with live births population of District Peshawar, Pakistan.Material Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Lady Reading Hospital, Peshawar, Pakistan from January 2017 to June 2017. From assumed population of 185,676 pregnant women in District Peshawar, 10% prevalence of MNM, 1.0448% margin of error and 95%CL, sample size was calculated 3,115. All women with live birth were eligible. Presence of MNM and MM, causes of MNM and MM, gestational age and gravidity were six variables. Being nominal, all were analysed by count and ratio or percentage with 80%CI. MNM Ratio was calculated per 1,000 live births and MM Ratio per 100,000 live births.Results: Out of 3,115 women with live births, MNM cases were 494 with MNMR 158.59/1,000 (80%CI 150.19-166.97) and MM cases were 16 with MMR 513.64/100,000 population (95%CI 349.50-677.78). There were 232 MNM cases in ≤28 weeks and 262 in 28 weeks gestational age with similar MNMR between these groups. There were 244 MNM cases in primigravida and 250 in multigravida with similar MNMR between these groups. There were five MM cases in ≤28 weeks and 11 in 28 weeks gestational age with similar MMR between these groups. There were five MM cases in primigravida and 11 in multigravida with similar MMR between these groups as their CIs are overlapping. Haemorrhage was most common cause for MNM in 365 (11.7175%) cases and for MM in 8 (0.2568%) cases.Conclusion: The maternal near-miss ratio (MNMR) and maternal mortality ratio (MMR) are relatively higher in population of District, Peshawar, Pakistan. MNMR and MMR both have similar prevalence in ≤28 weeks and in 28 weeks gestational age groups and also similar in primigravida and in multigravida groups. Haemorrhage (antepartum and postpartum) was most common cause both for maternal near-miss (MNM) and maternal mortality (MM).","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41445772","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":"DISTRIBUTION OF HEPATITIS B INFECTED POPULATION BY SEX AND AGE GROUPS IN DISTRICT D.I.KHAN, PAKISTAN","authors":"Imran Ullah, Nisar Khan, F. Shah, E. Ahmad, A. Saeed","doi":"10.46903/gjms/19.02.1017","DOIUrl":"https://doi.org/10.46903/gjms/19.02.1017","url":null,"abstract":"Background: Significant morbidity and mortality is caused by untreated hepatitis B virus infection through cirrhosis and hepatocellular carcinoma. The objectives of our study were to determine distribution of hepatitis B infected population by sex and age groups in District D.I.Khan, Pakistan.Materials Methods: This cross-sectional study was done at District Health Office, D.I.Khan, Pakistan from January 30, 2021 to February 15, 2021. Data was collected for period from March 14, 2013 to January 28, 2021 for 2368 hepatitis B infected cases from population at risk consecutively. Sex and age groups were demographic variables. Data type was nominal for sex and ordinal for age groups. Distribution was analyzed by count, percentage and confidence intervals for proportion for population. Hypotheses for distribution were substantiated by chi-square goodness-of-fit test.Results: Out of 2368 hepatitis B infected population, 1670 (70.52%) were men 698(29.48%) women, and 562 (23.73%) were in age group 0-20 years, 1266 (53.46%) in 21-40 years, 462 (19.51%) in 41-60 years 78 (3.30%) in 60 years. Our distribution by sex (p.00001) and age groups (p.00001) were different than expected respectively.Conclusion: In our study, hepatitis B infection was more common in men than women and most common in age group 21-40 years, followed by 0-20 years, 41-60 years and 60 years. Our observed prevalence of hepatitis B infection in men was higher than expected in women it was lower than expected. Our observed prevalence in the four age groups was not similar to expected.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46371773","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":"FUNGAL NEUROLOGICAL SEQUELAE IN A HYPER IMMUNOGLOBULIN E SYNDROME FROM PESHAWAR, PAKISTAN: AN UNUSUAL PRESENTATION","authors":"Nadeem Ijaz, Humairah Hanif, Imtiaz Ur Rehman, Sohail Daud Khan, O. Khan","doi":"10.46903/gjms/19.02.993","DOIUrl":"https://doi.org/10.46903/gjms/19.02.993","url":null,"abstract":"Hyper IGE syndrome is one of the primary immunodeficiency syndromes characterized by the presence of abnormally raised serum IGE levels (2000 IU/ml) with defective humoral and cell mediated immunity presenting in infancy or early childhood. It is a rare disease with only about 200 cases reported in literature. Usually, it is diagnosed clinically and by raised serum IGE levels. Mostly, it presents with recurrent staphylococcal skin abscesses, sinopulmonary infections, and opportunistic mycotic infections due to the immunodeficient state. Rarely, the central nervous system is involved by this condition.This case study deals with an 11-year-old girl who was diagnosed as a case of hyper IGE syndrome. She presented with low GCS and focal neurological deficits which were attributed to aspergillus fumigatus infection spreading to the brain resulting in multiple abscesses and eventually to death of the patient despite treatment interventions. This case emphasizes the likelihood of dissemination of fungal infections to multiple organs including the brain and the potential role of early neuroimaging to detect such lesions. Moreover, it shows significance of serial imaging in admitted patients particularly with the onset of new and unusual neurological symptoms. With more extensive studies, we may be able to diagnose and treat such infections and their complications on time with better outcomes.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44858592","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":"GJMS Vol 19, No.2, Apr-Jun 2021","authors":"","doi":"10.46903/gjms/19.02","DOIUrl":"https://doi.org/10.46903/gjms/19.02","url":null,"abstract":"","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41987377","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 EDUCATIONAL TRAINING ON NEUROLOGICAL ASSESSMENT SKILLS OF FEMALE NURSES IN EVALUATING TRAUMATIC BRAIN INJURY PATIENTS THROUGH GLASGOW COMA SCALE IN LAHORE GENERAL HOSPITAL, LAHORE, PAKISTAN","authors":"Nazia Yousef, Kabiru Abdullahi, Kousar Perveen, Sadia Khan","doi":"10.46903/gjms/19.03.971","DOIUrl":"https://doi.org/10.46903/gjms/19.03.971","url":null,"abstract":"Background: Traumatic Brain Injury (TBI) is a leading cause of death and disability worldwide. The objective of this study was to determine the impact of educational training on neurological assessment skill of female nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore General Hospital, Lahore, Pakistan.Material Methods: This quasi-experimental one group pre-posttest design study was conducted at Lahore School of Nursing, Faculty of Allied Health Sciences, The University of Lahore, Lahore, Pakistan from April 3, 2021 to May 15, 2021. Pre-test neurological assessment skill of 70 nurses was noted by an observer, two weeks educational training was given and four weeks later on, post-test score was noted. For neurological assessment skill, a 20 items observatory checklist was used. Age groups, marital status, job experience, work experience in recent department and work place were four demographic, while neurological assessment skill score was one research variable. Paired sample t test was used for hypothesis testing.Results: Out 70 nurses, 26 (37.1%) were in age group 25-30 years, 18 (25.7%) in 31-35, 16 (22.9%) in 36-40, six (8.6%) in 41-45 and four (5.7%) in 46-50 years. Marital status was; 36 (51.4%) single, 27 (38.6%) married, three (4.3%) divorced and four (5.7%) widow. Job experience was; eight (11.4%) had 2 years, 33 (47.1%) 2-5 years, 25 (35.7%) 6-10 years and four (5.7%) had 10 years. Work experience in recent department was; 16 (22.9%) had 1 year, 39 (55.7%) 1-3 years, 13 (18.6%) 4-5 years and two (2.9%) had 5 years. Work place was Trauma Unit in 12 (17.1%), neurosurgery ICUs in 38 (54.3%) and surgical units in 20 (28.6%) cases. Mean 16.89±2.52 posttest skills score was significantly higher than mean 12.56±2.67 pretest skills score (p=.0001).Conclusion: Our study confirmed that the effect of educational training was significant in improving neurological assessment skills of nurses in evaluating traumatic brain injury patients through Glasgow Coma Scale in Lahore General Hospital, Lahore, Pakistan. Further studies are suggested with increased sample size and multiple research settings.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42079907","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":"DISTRIBUTION OF DRUG SENSITIVE TUBERCULOSIS BY SEX, AGE GROUPS AND TYPE OF DISEASE IN DS-TB POPULATION OF DISTRICT D.I.KHAN, PAKISTAN","authors":"Abshar Khan, A. Hussain, Mubashir Wahab, A. Rehman, S. Latif, Syed Wasif Ali Naqvi, Mamoon Farooq, M. Zubair","doi":"10.46903/gjms/19.02.1012","DOIUrl":"https://doi.org/10.46903/gjms/19.02.1012","url":null,"abstract":"Background: Tuberculosis (TB) is the 10th leading cause of death globally and is leading cause of death from a single infectious disease. The objectives of our study were to determine the distribution of drug sensitive tuberculosis (DS-TB) by sex, age groups and type of disease in DS-TB population of District D.I.Khan, Pakistan.Materials Methods: This cross-sectional study was conducted in Department of Community Medicine, Gomal Medical College, D.I.Khan, Pakistan from January 5, 2021 to January 25, 2021. The data of 3,916 patients was retrieved from District Health Office, D.I.Khan for the period from January 1, 2019 to December 31, 2020. Sex, age groups and type of disease were categorical variables and analyzed by count and percentage with CI at 95%CL. Distribution of DR-TB by sex, age groups and type of disease was analyzed separately by chi-square goodness-of-fit test at alpha .05. Results: Out of 3,916 patients with DS-TB, women 2,110 (53.88%, 95% CI 52.32-55.44) were more than men 1,806 (46.12%, 95%CI 44.55-47.67), with most common age group of 15-44 years 1,948 (49.74%, 95%CI 48.17-51.31), and with more pulmonary 2,877 (73.47%, 95%CI 72.08-74.85%) than extrapulmonary 1,039 (26.53%, 95%CI 25.14-27.91) cases. Our observed prevalence of DS-TB in men was lower 46.12% than expected 51.72% and in women it was higher 53.88% than expected 48.28% (p.00001). Our observed distribution of DS-TB in different age groups was not similar to expected (p.00001). Our observed prevalence of pulmonary TB was lower 73.47% than expected 80.35% and in extrapulmonary TB it was higher 26.53% than expected 19.65% (p.00001).Conclusions: Drug sensitive tuberculosis was more common in women than men in DS-TB population of District D.I.Khan, Pakistan. It was highest in age group 15-44 years and higher for pulmonary TB than extrapulmonary TB. Our observed prevalence in men was lower than expected and in women it was higher than expected. Our observed prevalence for drug sensitive TB in various age groups was different than expected. Our observed prevalence for pulmonary TB was lower than expected and for extrapulmonary TB it was higher than expected.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48618106","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":"HYPERKALEMIA CAUSING SEVERE MUSCLE WEAKNESS IN A PATIENT WITH RENAL INSUFFICIENCY","authors":"Patel Harshvardhan Anilbhai, N. Anuradha, Viknesh Prabhu, V. Jayaraman, K. Vignesh","doi":"10.46903/gjms/19.03.1034","DOIUrl":"https://doi.org/10.46903/gjms/19.03.1034","url":null,"abstract":"In individuals with renal insufficiency, hyperkalaemia is one of the most common electrolyte imbalances, whereas it is uncommon in healthy people. When potassium is given or combined with a potassium-sparing diuretic, it happens quickly. It usually does not produce any signs and symptoms and is identified with normal blood investigations. Hyperkalemia causes faulty heart conduction and muscle weakness, among other symptoms. Muscle weakness as a clinical manifestation, on the other hand, is infrequent in clinical practise. This could be due to the fact that cardiac symptoms frequently appear earlier than weakness of muscles, necessitating the implementation of suitable interventions even before potassium concentration reaches a level that causes weakness. We present a case in which a patient with renal insufficiency had acute weakness of muscles as a result of extreme hyperkalaemia that acquired fast recovery after potassium and potassium-sparing diuretic administration.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44347455","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":"A CASE OF NEONATAL OSTEOMYELITIS","authors":"Kalathil Gopalakrishna Pillai Gopikrishnan, Kalaivanan Naveen Chandher, S. Jagadeeswari","doi":"10.46903/gjms/19.03.1032","DOIUrl":"https://doi.org/10.46903/gjms/19.03.1032","url":null,"abstract":"Acute hematogenous osteomyelitis of neonatal origin is very rare in clinical studies. Early diagnosis and treatment are important to decrease the morbidity. The aim is to provide a reference case for medical practitioners for early diagnosis and treatment of cases like this with symptoms, signs, blood investigations, radiological studies and blood culture outcomes. There have not been any adverse sequelae after effective antibiotic therapy. Timely diagnosis and management of neonatal osteomyelitis are of significant importance.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41979008","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":"PAKISTAN’S PERSPECTIVE ON COVID-19 VACCINES","authors":"Taimoor Hassan, Saleha Saleha","doi":"10.46903/gjms/19.03.1016","DOIUrl":"https://doi.org/10.46903/gjms/19.03.1016","url":null,"abstract":"As of May 10, 2021, the entire planet has reported approximately 188 million COVID-19 cases, with 2.54 million fatalities. Initially, lockdowns and softening measures have been thrown into turmoil throughout the world since the outbreak. Our social life will only return to normal once an appropriate vaccine is produced and proper authorized preventive techniques are implemented. To tackle this pandemic, governments and health experts all around the globe are experimenting with a range of measures and preventative strategies. Certain nations are considered to be more successful than others in terms of providing safety to their inhabitants and increasing their economic activities. A plethora of vaccinations have been produced, and a research anthology has been published. However, medical personnel are still searching for a viable treatment to limit this pandemic. Till date, only 5 vaccines have been approved by WHO for emergency use that includes Pfizer-BioNTech, Moderna, AstraZeneca, Sinopharm, Johnson & Johnson. Currently, confusing information about the COVID-19 vaccination is being disseminated across the world. During health emergency, rumors spread and caused panic, insanity, and anxiety. SARS-CoV-2 strains, on the other hand, are constantly appearing over the world. This article provides a Pakistan’s perspective towards COVID-19 vaccines with an updated review.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":"1 1","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41343453","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":"SCRUB TYPHUS PRESENTING AS LOBAR PNEUMONIA: A CASE REPORT ON UNCOMMON PRESENTATION OF SCRUB TYPHUS","authors":"Ravikumar Srinithi, Ramanadhan Ramya, Arumpuliyur Pattabiraman Krithika, Subramanian Sundari","doi":"10.46903/gjms/19.03.1030","DOIUrl":"https://doi.org/10.46903/gjms/19.03.1030","url":null,"abstract":"Scrub typhus is an acute febrile illness which is noted in children increasingly nowadays but it is often underdiagnosed mostly due to its atypical presentation. In this report, we present a case of 10 years old boy, who was initially diagnosed as lobar pneumonia but later confirmed to be suffering from scrub typhus infection. The child had typical clinical as well as radiological features of community-acquired pneumonia. Further investigations were done due to non-response to initial treatment which led to the diagnosis of scrub typhus infection. Specific treatment with doxycycline showed dramatic response and the child improved clinically. So it is absolutely essential for the treating physician to have high index of suspicion of this re-emerging infectious disease.","PeriodicalId":44174,"journal":{"name":"Gomal Journal of Medical Sciences","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2021-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45934772","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}