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Abstract Introduction Thyroid nodules are common globally in almost one fifth of the adult population. The gold standard treatment for thyroid nodule is thyroid lobectomy or total thyroidectomy depending upon the diagnosis. Thyroidectomy has a few known complications but, as per the ATA consensus statement, it is a safe surgery to be done as a day care procedure. Objective To access the feasibility and safety of thyroid lobectomy as a day care surgery and its effect on decreasing overall financial burdens. Methods This retrospective chart review was done from 2006 to 2022. A total of 736 patients underwent thyroid lobectomy among which only 56 were done as day care surgery. Data analysis was done using the IBM SPSS Statistics for Windows, Version 23.0 (IBM Corp., Armonk, NY, USA). Results A total of 40% of the population was male. The mean age of the study population was 42 years. Bethesda II was the most encountered diagnosis, with a rate of 69%. The majority of patients were discharged after 6 hours of postoperative observation. The only complication encountered was seroma, which was seen in two patients. Conclusion Thyroid lobectomy appears to be a safe procedure with a drastic difference in overall cost as a day care procedure. We recommend switching the practice of inpatient thyroid lobectomy to a day care procedure in carefully selected candidates. The major hurdle in day care lobectomy can be approval from insurance.
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ABSTRACT: Citrus is one of the major exported fruits of Pakistan. Especially Kinnow cultivar is famous across the globe because of its aroma and taste. The overall production of citrus is reported as half of the potential because of the non-adoption of research-based practices and lack of agricultural extension services and training of the citrus growers. In the last few years, the department of agricultural extension has started training programs called Farmer Field Schools (FFS) for citrus growers in the major citrus growing zone of the Punjab province, i.e., Sargodha region. This research was conducted in the Sargodha district to evaluate the knowledge and skills gained by the farmers from the FFS. The interview schedule was designed for the purpose of data collection. The data was collected from 120 farmers randomly selected from 15 FFS in the study area. All the respondents were participants of the FFS. The data was analyzed using Statistical Package for Social Sciences (SPSS). The Results of the study showed that 40% of the farmers learned about citrus verities, one-third of respondents learned about the management of new plants/orchards, 28% of the respondents got knowledge about the cultivation of fruits, and one-fourth of respondents acquired knowledge and skills about layout and management of citrus orchards. These findings conclude that training course has a positive influence on farmers' farm management skills; hence emphasize on its persistence and further improvement by the concerned authorities.
RESUMO: Os citros são as principais frutas exportadas do Paquistão, especialmente, a cultivar Kinnow é famosa em todo o mundo por causa de seu aroma e sabor. A produção geral de citros é relatada como a metade do potencial devido a não adoção de práticas baseadas em pesquisas e a falta de serviços de extensão agrícola e treinamento dos citricultores. Nos últimos anos o departamento de extensão agrícola iniciou programas de treinamento chamados Farmer Field Schools (FFS) para citricultores na maior zona de cultivo de citros da província de Punjab, no distrito de Sargodha. Esta pesquisa é conduzida no distrito de Sargodha para avaliar o conhecimento e as habilidades adquiridas pelos agricultores da FFS. O cronograma de entrevistas foi elaborado para fins de coleta de dados. Os dados foram coletados de 120 agricultores aleatoriamente de 15 FFS na área de estudo. Todos os entrevistados eram participantes da FFS. Os dados foram analisados por meio do programa estatístico "Statistical Package for the Social Sciences (SPSS"). Os resultados do estudo mostraram que 40% dos agricultores aprenderam informações importantes sobre citros, um terço dos entrevistados aprenderam sobre o manejo de novas plantas / pomares, 28% dos entrevistados aprenderam sobre o cultivo de frutas e um quarto dos entrevistados adquiriu os conhecimentos e habilidades sobre layout e manejo de pomares de citros. Essas descobertas concluem que o curso de treinamento tem uma influência positiva nas habilidades de gestão das propriedades; portanto, suporta a necessidade de sua persistência e melhorias adicionais pelas autoridades para alavancar ainda a produtividade essa atividade no futuro.
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Appendicular diverticulosis is one of the very rare diseases which is also difficult to diagnose, especially clinically, due to its silent course and non-specific symptoms. It comes under the notation usually due to its complications like diverticulitis or perforation, but sometimes it also presents with acute appendicitis. This report describes a 44-year male patient who presented with the complain of right iliac fossa pain and was clinically diagnosed as acute appendicitis; but intraoperatively, it was found that the appendix also had diverticulosis along with appendicitis
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To study the demographic and clinical features of Retinopathy of Prematurity in urban Punjab. The cross-sectional study was performed at Hameed Latif Hospital, Lahore, from April 2010 to October 2013 and comprised neonates born with birth weight less than 2000g, gestational age less than 37 weeks, or those who were considered high risk for Retinopathy of Prematurity. Variables recorded included history, birth weight, gestational age, oxygen supplementation, development of Retinopathy of Prematurity, and laser treatment. Data was analysed using SPSS 17. There were 285 neonates in the study with a mean birth weight of 1280.34 +/- 350.43g and mean gestational age being 29.38 +/- 3.14 weeks. Overall, 167[58.6%] received supplemental oxygen, 86[30.2%] were anaemic and 44[15.4%] received blood transfusion. Besides, 47[16.5%] premature babies were product of multiple gestation, 34[11.9%] were having respiratory distress, 25[8.8%] had sepsis and received intravenous antibiotics, 70[24.6%] developed Retinopathy of Prematurity, and 22[7.7%] developed threshold disease and received laser treatment at mean gestational age of 32.11 +/- 2.53 weeks. Screening is key to preventing childhood blindness caused by Retinopathy of Prematurity. Prematurity, low birth weight and supplemental oxygen therapy are significant risk factors for the condition
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Humans , Male , Female , Retinopathy of Prematurity/diagnosis , Tertiary Care Centers , Cross-Sectional Studies , Gestational AgeABSTRACT
The jejunum is the longest part of the small intestine and its lumen is mainly involved in the absorption of the nutrients. The present study was conducted to evaluate the effects of metronidazole, ceftriaxoine sodium and their combination on the stenotic index of the end to end jujunal anastomotic site. To accomplish this, 20 healthy stray dogs were subjected to end to end jejunal ansastmosis. Dogs in Group A (control) underwent jejunal anstomosis with no antibiotic prophylaxis, while those in Group B received surgery and metronidazole alone at 50 mg/kg, those in Group C received ceftriaxone sodium intravenously at 30 mg/kg body weight prior to surgery and dogs in Group D were given metronidazole in combination with ceftriaxone sodium at 50 mg/kg and 30 mg/kg, respectively, 2 h before surgical intervention. No significant difference (p > 0.05) in the stenotic index was observed at 14 days after jejunal anastomosis. These findings indicate that prophylactic administration of metronidazole and ceftriaxone sodium alone or in combination had no significant effect on the stenotic index of the jejunum.
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Animals , Dogs , Absorption , Antibiotic Prophylaxis , Body Weight , Ceftriaxone , Intestine, Small , Jejunum , Metronidazole , SodiumABSTRACT
To assess students' opinion regarding group working, quality of learning and assessment in newly introduced case based learning at Army Medical College, Pakistan. Descriptive study. Army Medical College, 03 months. In this study, students from the second year MBBS class at Army Medical College were given a questionnaire on completion of their second year of medical school [2012] regarding their opinion about CBL. The questionnaire used in this study consisted of 18 statements with Likert-tyep responses ranging from Strongly Agree [1] to Strongly Disagree [5]. Statements were grouped using 3 categories: Group working, Quality of Learning and Assessment. Process of learning through group work and problem solving as a learning tool was appreciated by >80% of students. Also, >84% acknowledged that CBL has promplted them to come well prepared in the session and has helped them in improving their understanding of key concepts .>83% students opine that their efforts in CBL discussions are being evaluated fairly. Feedback from the students clearly asserts superiority of CBL in imparting knowledge, cultivating the habit of self-learning and inculcating skills of group discussions which is in consistence with the published literature. At the same time, weak point highlighted by the students need rectification
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Humans , Male , Female , Students, Medical , Learning , Educational Measurement , Surveys and QuestionnairesABSTRACT
Background: The hazards of cigarette smoking and its increasing consumption are well known despite the ongoing tussle between the tobacco industry and global governments. To curb the menace of smoking, anti-smoking laws have been enforced from time to time by various governments. In 2003, Ministry of Health [MoH] Government of Pakistan has imposed certain regulations on cigarette manufacturing industry. The aim of this study was to highlight the compliance of the industry with these regulations. Methods: A cross-sectional study of major cigarette selling shops was conducted in Abbottabad. It was aimed at determining the availability of total cigarette brands and their compliance with the regulations and also to find out attributes of cigarette customers. Results: A total of 39 varieties of 18 cigarette brands are available in Abbottabad city, out of which 71.8% are imported varieties. A total of 38.4% varieties have displayed health warnings [28.2% pictorial health warning, 10.2% have written health warning. Majority of cigarette customers ar between 2040 years of age, while 5.6% customers include youngsters between 1020 years of age. Female customers, accounting for 8% of total cigarette customers, buy only those brands which have not displayed the health warning. Conclusions: Observed compliance with governmental regulation for displaying health warning is 39% which is far less than desired. Sale of cigarette to children is also practiced. Ministry of Health [MoH] should assure the display of these warnings on all the brands so that smokers must be fully aware about the risk involved in smoking Keywords: Cigarette smoking; anti-smoking regulations; protection of non-smoker health
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Systemic Lupus Erythematosus [SLE] is known to be different among people with different racial, geographical and socio-economic back grounds. Asia has diverse ethnic groups broadly, Orientals in the East and Southeast Asia, Indians in South Asia and Arabs in the Middle East. These regions differ significantly from the Caucasians with reference to SLE. The purpose of this study was, therefore, to delineate the clinical pattern and disease course in Pakistani patients with SLE and compare it with Asian data. Patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatism Association admitted at the Aga Khan University Hospital between 1986 and 2001 were studied by means of a retrospective review of their records. The results were compared with various studies in different regions of Asia. Demographically, it was seen that SLE is a disease predominantly of females in their third decade, which is generally consistent with Asian data. There was less cutaneous manifestations, arthritis, serositis, haematological and renal involvement compared to various regions in Asia. The neurological manifestations of SLE, however, place Pakistani patients in the middle of a spectrum between South Asians and other Asian races. This study has shown that the clinical characteristics of SLE patients in our country may be different to those of other Asian races. Although our population is similar to South Asians, but clinical manifestations of our SLE patients are considerably different, suggesting some unknown etiology. Further studies are required to confirm the above results and to find statistically sounder associations
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Humans , Male , Female , Retrospective Studies , Lupus Erythematosus, Systemic/epidemiologyABSTRACT
To find the prevalence of lupus nephritis, delineate its clinical, immunological and therapeutic characteristics and compare them with the data worldwide. Between 1985 and 2001, 198 patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatism Association [ARA] admitted to the hospital were studied by means of a retrospective review of their records. Renal involvement was found in 89 [45%] patients. Biopsy showed lupus nephritis in 42 patients; there were 9 male and 33 females. Mean age at initial presentation was 27 years and mean duration of follow-up was 2.3 years. The histological types [WHO Classification] were mainly class. 4 [n=27], class 3 [n=7] and class 5 [n=6]. Immunoflourescence showed a predominantly granular pattern of IgG, IgA and C3. Renal manifestations included renal failure [50%], microscopic hematuria [67%], active urine sediment [22%], and proteinuria [74%]. Proteinuria was nephrotic range in 45% patients. Treatment was with combinations of prednisolone and cyclophosphamide [n=13], prednisolone and azathioprine [n=27]. 19 patients received high dose methyl prednisolone [1 gm/day for 3 days]. There was no difference in mortality rate between prednisolone and cyclophosphamide and prednisolone and azathioprine treatment groups. The overall mortality rate was 17% [n=7]. Mortality was higher in WHO class 4 and 5 as compared to class 2 and 3 [p<0.001]. The prevalence of lupus nephritis in our population is an intermediate between Caucasians and other Asians. Certain clinical characteristics in our patients with lupus nephritis are different as compared to various other studies. Because of limited resources for treatment in developing countries, we believe that patients with lupus nephritis should be treated with improved ancillary medical therapies and more effective immunosuppressive regimens