A Cross-Sectional Study Determining Pain in Lower Back and Calf Muscles among Females Due to High Heel Shoe Wear

To determine pain in lower back and calf muscles among females due to high heels shoe wear. Methodology: A sample size of 87 females working women and students were recruited on the basis of the purposive sampling technique. Participants were requested to wear 5 cm stiletto high heels and they were asked to walk on treadmill at the pace of 4km/hr for 20 minutes. Modified McGill Questionnaire for pain measurement was used as a tool before and after test data collection. Results: In this study observation of muscular pain was significant in lower limb and lower back muscles due to high heels i.e. 29.6% and 24.7% respectively. Conclusion: Back and lower limbs musculature pain contribute only 8.6% whereas, only back pain had been observed in 9.9%. Paired sample t-test was used to determine pain before and after test was significant with p-value 0.000.

Awake fiberoptic intubation in a patient with known difficult airway due to huge thyroid goiter

Thyroid enlargement or goiter has been considered a risk factor for difficulty in airway management during anaesthesia and surgery. Moderate to huge size along with retro-sternal extension makes it an anticipated difficult airway scenario. In this report, we present a case of huge goiter with compression symptoms and patient cannot be intubated by conventional direct laryngoscopy at a district hospital a week ago. CT scan revealed extension of mass into superior mediastinum compressing right brachiocephalic vein and superior vena cava. We successfully performed awake fiberoptic intubation with local/topical anaesthesia of airway. We have discussed the significance of careful approach, planning and preparation in the management of such a case

clinical experience of patients with heat stroke at Karachi during a devastating heat wave in 2015

Objectives: To review the clinical presentations, management and outcomes of heat stroke patients presented to Hamdard University Hospital, Karachi in summer 2015

Study Design: Observational / descriptive study

Place and Duration of Study: This study was conducted at the Hamdard University Hospital [Taj Medical Complex], Karachi from 15[th] to 30[th] June 2015

Methods: A retrospective analysis of database of 51 patients presented with high grade fever [>1040F] and altered sensorium was performed. All data were transferred to proforma which included patient's demographic features [name, age and sex], clinical and laboratory parameters, treatment given, duration of hospital stay, outcomes [death or alive] and reasons of mortality. The SPSS version 19 was used for statistical analyses

Results: Majority of the patients [63%] were between 61-80 years of age group with mean +/- SD age was 69.24 +/- 11.28 years. Males were affected more than females [60.7% vs. 39.3% respectively]. Out of 51, 41 [80.4%] had co-morbidities and were on regular medications. The mean +/- SD Glasgow Coma Scale at the time of presentation was 10.29 +/- 4.33. The major laboratory derangements were hyponatremia [68.6%], elevated blood urea [52.9%], serum creatinine [41.2%] and alanine transferase [15.6%]. Standard treatment strategies were provided to all patients. Out of 51, 19 [37.3%] patients were expired as a result of multi-organ failure, shock, arrhythmias and rhabdomyolysis

Conclusion: Heat stroke is common in older males especially those who had co-morbidities. It carries a significant mortality due to multiorgan failure and shock

Journal of the college of physicians and surgeons of Pakistan: five years bibliometric analysis

To conduct the bibliometric analysis of the Journal of the College of Physicians and Surgeons Pakistan [JCPSP] from 2012 to 2014. The prime objectives of this report were to determine the number and percentage of articles by year, authorship pattern, gender and geographical affiliation, ranking by subject and citation analysis. A data collection instrument was developed as bibliometric form. The data was analysed using the Microsoft Excel spread sheet. Editorials and letters to editors were excluded. There were 1106 total research documents, including 721 original articles and 385 case reports. A rapid increase in number of articles per year was noticed, more original papers than case reports. Majority of the authors were male. The contribution of Balochistan and Khyber Pakhtunkhwa was less than the other provinces. JCPSP was the most cited document in the reference list of the research documents. The scholars of Khyber Pakhtunkhwa and Balochistan and female researchers should give more attention in writing quality articles eligible for consideration at this Journal. It is also suggested that writers should be compelled to address such fields of medical sciences as neurology, nephrology, anatomy and pharmacology, while writing original articles and case reports

relationship of health literacy, perceived health information need and preventive health related behavior in urban Karachi

To determine the relationship of health literacy with perceived need of health information and health related behaviors in urban population of Karachi. Cross sectional survey. Community based study carried out on the students of Institute of Business Management and Ojha Institute of Chest Diseases, Dow University of Health Sciences for four months during February to May 2015. A cross-sectional survey was performed in Karachi using a 33 item validated questionnaire on 100 randomly selected subjects using simple random sampling. Descriptive and analytical data analyses were carried out using SPSS version 20. Linear regression was used to find the association between health literacy and perceived health information needs as well as preventive actions. The information regarding demographics was obtained using dichotomous and multichotomous items, health literacy, perceived health information needs and preventive actions was collected using Likert type scales. The participants had a mean age of 27.8 +/- 8.3 years with at least intermediate level education. The mean health literacy score of respondents was calculated to bell.14 +/- 2.84 on 19 point scale [Range 4-16]. On perceived health information needs, the mean score turned out to be 28.27 +/- 8.52 on a 51 point scale [Range 13-47]. As for preventive health actions on a 48 point scale, the mean score was 21.47 +/- 8.61 [Range 8-44]. Linear regression analysis showed a weak positive [r=0.383] relationship between health literacy and preventive health actions [P=9.25 R2=0.147, p< 0.05], however, a weak negative [r= -0.306] relationship between health literacy and perceived information needs [3 38.58 R2=-0.094, p< 0.05]. Health literacy has an association with preventive actions against different diseases, however it also decreases their feeling of need for more health education and may result in a false sense of security. It is important that proper literacy programs must be initiated to increase preventive measures against common diseases in the society, so that the burden and cost of these diseases can be minimized

Multislice computed tomographic patterns of muscle bridging of left anterior descending artery and their relation to atheromatous coronary artery disease

To determine the frequency of atheromatous coronary artery disease in patients with myocardial bridge. Descriptive study. AFIC/NIHD Rawalpindi from September 2010 to November 2010. Patients undergoing MSCT angiography for diagnosis of CAD having an abnormal finding were included. Patients with history of prior coronary artery bypass grafting [CABG], coronary stenting and with chronic total occlusions were excluded. Computed Tomographic [CT] examinations were performed with a dual-source CT scanner. Scanning parameters: detector collimation, 2 x 32 x 0.6 mm; slice collimation, 2 x 64 x 0.6 mm; gantry rotation time, 330 milliseconds; tube current-time product, 350 mAs per rotation and tube potential 120 kV. Reconstructions done and data transmitted to workstations and analyzed. Myocardial bridge [MB] was diagnosed and evaluated when an intramuscular segment of LAD artery was visualized on axial, volume rendered and multiplanar reformation [MPR] images. Out of 232 patients 32% had MB. Males were three times more likely to have Myocardial bridge [MB]. Mid and distal LAD showed 54% and 45% MBs respectively. Fourteen percent had evidence of atherosclerosis proximal to MB segment. Mean length and depth of MB segment was 18mm and 1.8mm respectively. Superficial type was most common [44%], followed by deep type [33%] while RV type was least common [23%].Frequency of patients with myocardial bridge having concomitant atheromatous coronary artery disease was 14%

Frequency of incidental extra-cardiac findings in patients undergoing multi slice computed tomographic (msct) angiography for detection of coronary artery disease

The purpose of this study was to evaluate the frequency of incidental extra-cardiac findings on MSCTcoronary angiography. Patients undergoing MSCT angiography were included. Coronaries were interpreted with limited field of view [FOV] reconstructions. Reconstruction using larger FOV were used to examine and detect extra-cardiac incidental findings. All extra-cardiac structures were reviewed systematically. Patients were divided in two groups on basis of age, younger 50 years. Out of 307 patients included in the study,87 [28%] had extra-cardiac incidental findings. Patients in the older age group i.e., more than 50 years were significantly [p = 0.004] more likely to have incidental findings. Most common finding was pericardial fat pad. Most of the findings were not of clinical significance. Only 2 pulmonary nodules were detected. Extra-cardiac findings are commonly detected on MSCT cardiac scans especially in older patients with larger FOV reconstructions. Most of the findings are of minor clinical significance, only few are important. Routine screening of cardiac scans for extra-cardiac incidental findings is not mandatory