ABSTRACT
Objective: To determine the efficacy of 0.2% brimonidine eye drops on control of intraocular pressure following Neodymium: Yttrium-Aluminum-Garnet [Nd: YAG] laser posterior capsulotomy. Study Design: Quasi experimental study. Place and Duration of Study: Study was conducted in department of Ophthalmology, Combined Military Hospital Peshawar of six months duration from Oct 2013 to Mar 2014
Material and Methods: A total of 182 patients were included in this study. One drop of 0.2% brimonidine one hour prior to laser treatment was instilled in the eyes of patients. Cornea was anaesthetized with topical 0.5% proparacaine hydrochloride. "Ocular instruments ® Abraham Capsulotomy YAG contact lens" was used along with Q-switched Zeiss VISULAS YAG III [Nd: YAG] laser system to make a hole of 3-4mm in the posterior capsule using minimum amount of total laser energy. Data were analyzed using SPSS version 15.0. Mean and standard deviation was calculated for numeric variables like age and intraocular pressure at different occasions. Frequency and percentage was calculated for categoric variable i.e. gender. Efficacy was stratified among age and gender to see effect modifiers
Results: The mean age of participants was 63.3 +/- 7.7 years. Out of 182 patients, 109 [59.9%] were male while remaining 73 patients [40.1%] were female. Brimonidine 0.2% eye drops proved effective in 162 patients [89.0%]. Stratification of age and sex with regard to efficacy of 0.2% brimonidine eye drops was carried out
Conclusion: The use of 0.2% brimonidine has been proven effective to counteract the IOP increase following Nd: YAG laser capsulotomy in this study
ABSTRACT
Objective: To calculate frequency and grades of undocumented anxiety and depression in patients having unilateral sciatica due to single prolapsed lumbar inter-vertebral disc [PLIVD]. Study Design: Cross-sectional study. Place and Duration of Study: Combined Military Hospital Lahore, from Mar 2013 to Jun 2014
Material and Methods: Cross-sectional study conducted at Combined Military Hospital Lahore, from March 2013 to Jun 2014, with non-probability consecutive sampling. Cases were taken from neurosurgery department, having sciatica due to single PLIVD. Controls were selected from healthy personnel with neither any current major/minor ailment nor any diagnosed mental or physical health issue. First hundred individuals meeting the inclusion and exclusion criteria were enrolled as controls and cases [100 each]. Independent variables were multiple demographic factors; dependent variables were grades of anxiety and depression. Standardized Beck Anxiety Inventory-Udru [BAI-U] and Beck Depression Inventory-Urdu [BDI-U] were selected. Authors assisted the subjects to fill inventories. Statistical analysis was done via descriptive statistics [SPSS-15], data expressed in frequencies, percentages and mean +/- SD [standard deviation], cross-tabulation done via chi-square; p-value <0.05 was considered as significant
Results: Out of 200 subjects, frequencies of males and females were 72.0% and 28.0% respectively; mean age 39.15 +/- 15.001 years, education grades 9.27 +/- 5.87 and income/month 43510.00 +/- 53305.32 PKR. Among cases, higher frequencies of anxiety [84%] and depression [55%] were found as compared to controls [anxiety 24%, depression 8%]. Anxiety [p-0.03] was more significant than depression [p-0.131]; while severe anxiety, severe depression and suicidal ideation were present in 27.0%, 19.0% and 4% respectively. Females were more prone to have anxiety [p-0.003]; patients aged 25-60 years had significant depression [p-0.02]
Conclusion: Considerable number of patients with chronic unilateral sciatica were diagnosed to have significant anxiety/depression. Multidisciplinary approach involving psychiatrists must be adopted to timely screen and aptly manage these patients
ABSTRACT
Objectives: To analyze prevalence of anxiety and depression among doctors serving in a tertiary care hospital in Lahore, with a study of impact of relevant demographic features
Methods: A cross sectional study was conducted at Combined Military Hospital, Lahore, from February 2014 to Jan 2015. Participants were doctors serving in subject hospital for at least six months duration. Standardized Hospital Anxiety Depression Score [HADS] inventory was selected as inventory. Formal approval from hospital ethical committee and written informed consent from participants were obtained. Demographic characteristics of participants were recorded as independent variables; anxiety and depression scores being outcome variables. Data analysis was done via descriptive statistics [SPSS-20], qualitative data expressed as frequencies, percentages; quantitative as mean +/- standard deviation[SD]. Cross tabulation was done via chi-square, p-value < 0.05 considered as significant
Results: Out of 203 volunteers, 97[47.78%] responded. Score of anxiety was 7.04 +/- 4.470, maximum being 19, scores of depression was 4.94 +/- 3.605, maximum score being 15. Mild to moderate anxiety and depression were revealed in 33[34%] and 24[24.8%] respectively, while 7[7.2%] and 1[1.0%] had severe anxiety and depression respectively. There was strong positive relation between anxiety and depression[p<0.001]. There was significant impact of service years on depression[p-0.011] and gender on anxiety[p-0.002],9[17.31%] males and 24[53.33%] females had mild to moderate anxiety while 4[7.69%] males and 3[6.66%] females revealed severe anxiety and other variables did not reveal significant impact on HADS scores
Conclusion: Doctors showed high grades of anxiety and depression. They must be promptly screened and managed at all medical institutions
ABSTRACT
Objective: To compare the results of permeatal approach without raising the tympano-meatal flap to end-aural or post-aural approach in myringoplasty
Methods: This Quasi-experimental study was carried out in CMH [Combined Military Hospital] Peshawar, from August 2006 to July 2013. Three hundred fifty patients of chronic suppurative otitis media [CSOM] with dry central; small, medium and large perforations were selected
They were divided into two groups depending upon the type of approach. In Group-A [n-200]; permeatal approach without raising tympano-meatal flap was used; while in Group-B [n-150] end-aural or post-aural approach was used. Subjects were followed up for two years; graft take was checked regularly by examinations of ear under microscope. Data was collected on structured Performa and analysed by SPSS-17
Results: Male and female were 74% and 26% respectively; Age ranged from 15 to 46 Years. There was no significant difference in the graft success at the end of two years in Group-A [80%] and Group-B [85%] [p-0.261]. Type of approach had a significant impact on duration of surgery [p<0.001] and post-operative recovery time [p<0.001]
Conclusion: The permeatal approach and end-aural/post-aural approach had almost equal graft success rates, but former is more useful as it causes lesser morbidity, decreased post-operative hospital stay and reduced operative time. It is under-utilized and should be employed more frequently
ABSTRACT
Objective: To analyze desire for sons/daughters among ladies of Peshawar, Pakistan, with a view to rule out son preference and to study impact of various demographic characteristics on the subject
Methods: Cross-sectional descriptive study conducted at Combined Military Hospital, Peshawar, from August 2015 - January 2016; sampling technique was random/probability/non-purposive. Self-designed questionnaire was utilized; carrying questions pertinent to desire for sons/daughters during marital life, and demographic details. Data analyzed via descriptive analysis [SPSS-21], expressed as frequencies/ percentages and mean +/- standard deviation [minimum/maximum]
Sons and daughters desired [dependent variables] were cross-tabulated with independent variables
Results: Response rate was 63.25% [n-506]
Data revealed following: Sons desired 3.05 +/- 2.061[1/12]; Daughters desired 1.15 +/- 0.767[0/4]; 6.1%[n-31] and 0.6%[n-3] desired infinite number of sons and daughters respectively, 18.2%[n-92] did not desire to have even one daughter, while 2.2%[n-11] considered it immaterial to have daughters or sons
There was a significant relation between sons desired and client's education [p<0.001], husband's education [p<0.001] and socioeconomic class [p<0.001]. There was no significant impact of religion [p-0.142] on desire for sons. Impact of independent variables on daughters desired was similar but less pronounced
Conclusion: There was candid son preference among the respondents. Gender discrimination can be attenuated by adequately addressing son preference at all tiers
ABSTRACT
Objective: To analyze trends of use of methods of contraception along with study of impact of various demographic and social factors on contraception in Peshawar, Pakistan
Methods: A cross-sectional descriptive study with random purposive sampling was conducted at Combined Military Hospital Peshawar, from Mar 2015-Nov 2015. Self-designed questionnaire with demographic details and questions pertinent to contraceptive practices was utilized as study instrument. Females reporting to concerned hospital for contraceptive advice and prescription were distributed with questionnaire and written informed consent form. Formal approval was taken from ethical committee of hospital. Data was analyzed via descriptive analysis [SPSS-21], qualitative data was expressed as frequencies and percentages; quantitative as mean +/- standard deviation [SD]. Main outcome variable i-e contraceptive device used; was cross-tabulated with independent variables
Results: Response rate was 53.2% [n-426]. Usage of contraceptive device was as follows; 51.2% Nil, 9.4% barriers, 22.3% oral/injectable hormones, 13.4% IUCDs, 3.8% sterilization. There was a strong relationship between type of contraceptives used and age [p<0.001], client's education [p<0.001], husband's education [p<0.001], number of children [p<0.001], religion [p0.013], socioeconomic class [p<0.001], and religious beliefs about use of contraceptives [p<0.001]. More Muslims considered contraception irreligious than non-Muslims [p 0.02]. There was no significant impact of husbands' pressure to not to use contraceptives on type of contraception practised [p 0.114]
Conclusion: Contraceptive devices are under-utilized in the study participants. Multidisciplinary approach should be applied to enhance client education, awareness and counseling to utilize these devices more appropriately and regularly
ABSTRACT
Objective: To study the level of job satisfaction among doctors serving in a tertiary care hospital in Lahore and ascertain its co-relation with multiple demographic variables which had a profound impact. Methods: This cross sectional study with non-probability purposive sampling was conducted at Combined Military Hospital, Lahore, from February 2014 to November 2014. Subjects were doctors serving in that hospital for minimum six months duration. Pre-formed questionnaires were distributed to volunteers [average filling time was 3 ½ to 7 minutes]. Multiple demographic features were independent variables. Outcome variable was job satisfaction. Statistical analysis was done via descriptive statistics [SPSS 20], data expressed as mean +/- standard deviation [SD]. Results: Out of 263 doctors serving in hospital, 203 [77.91%] volunteered to participate; response rate by depositing the filled forms was 47.78% [97 doctors]. Amongst the respondents, 10 [10.3%] doctors had below average job satisfaction, 32[33.0%], 21[21.6%], 21[21.6%] and 13[13.3%] had average, above average, well above average and outstanding job satisfaction respectively. There was significant relation between job satisfaction and age group of the doctors [p 0.025], education [p 0.015], service years [p 0.013] income per month [p<0.001]. There was no significant impact of gender [p 0.540], marital status [p 0.087], number of children [p 0.153], current employment [p 0.71], nature of job [p 0.204], working hours [p 0.089], additional duties [p 0.421] and socioeconomic class [p 0.104] on outcome variable. Conclusion: A significant number of doctors was found discontented with their job, which may consequently impact their yield/ performance. The job satisfaction can be substantially improved if these contributory factors are aptly addressed at all tiers