ABSTRACT
Clobazam belongs to benzodiazepine class and is preferably used against anti-epileptic disorders. However, when used in reduced doses, its ability for improving cognitive functions becomes explicitly evident. This study objectively undertook the task of using the reduced doses of clobazam for proving potentials effects on cognitive functions. The drug, clobazam was administered in "active group? which contained 15 young healthy volunteers. The "placebo group? also entailed 15 subjects and each was administered with placebo drug. The controlled group? also included 15 subjects. All these 45 young healthy subjects were subjected to tests for perceptual learning, creativity, selective memory, visual memory and intelligence. Results clearly demonstrated significant impact of clobazam at the dose of 5mg/day on perceptual learning [P=0.0380], creativity [P=0.0787], memory function [P=0.4920], visual memory [P=0.4816] and intelligence of the subject [P=0.4920]. The outcomes highlighted in the studies reviled the positive effects of clobazam when used at reduced doses
ABSTRACT
This study was schemed to comprehend the latest kaleidoscopic trends of bacterial resistance in neonatal pathogens against all those antibiotics commonly employed as empirical therapy in neonates. The methodological approach included; isolation and subsequent identification of those pathogens having caused bacterial infections in neonates, application of antibiotic sensitivity testing and finally construing the conclusion depicting patterns of antibiotic resistance by various pathogens, isolated from neonatal biological samples. Antibiotic resistance patterns was evident in gram-positive as well as in gram-negative bacteria in all the eight species identified in this study. Even antibiotic drugs which are being commonly relied upon for treating multi-resistant bacterial infections, found to be in effective against many newly emerged resistant bacteria, when used alone. Resistance Antibiotics drugs against which most prominent resistance pattern emerged include; Amikacin sulphate, Linezolid, Piperacillin / Tazobactam, Amoxicillin / Clavulanic acid, Vencomycin, Cefoperazone / Sulbactam, Ceftriaxone sodium, Ciprofloxacin, Cefixime trihydrate and Imipenem. The inferred upshot suggests that antibiotic resistance is emerging fast and ever-changing phenomenon of antibiotic resistance has significantly reduced the therapeutic space to maneuver, particularly, in treating neonatal infections
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Objective: To determine the knowledge and perception of doctors and paramedical staff about hand hygiene of a tertiary care military hospital
Study Design: Cross sectional descriptive study
Place and Duration of Study: Study was conducted at tertiary care military hospital, from Aug 2016 to Jan 2017
Material and Methods: The sample size 196 was calculated using World Health Organization sample size calculator. Permission from administrative authorities was taken. Purposive sampling technique was used. World Health Organization's knowledge and perception structured self-administered questionnaire was used with minor amendments for the data collection. The percentage's in knowledge and perception domain of >75 Percent determined good, 50-75 Percent fair and <50 Percent poor
Results: There were 88 [45 Percent] paramedical staff, 49 [25 Percent] doctors and 59 [30 Percent] nurses while overall 103 [52.5 Percent] were male and 93[47.5 Percent] female. The age of 160 [81.5 Percent] study participants ranged 21-40 years. The overall mean score of knowledge was 64.1 Percent and perception 72.5 Percent. The paramedical staff presented with lowest mean score in knowledge 60.6 Percent and perception 74.9 Percent. While doctors scored highest 64.6 Percent in knowledge domain and nurses scored highest in perception domain 82.2 Percent. There was no statistical significant difference of knowledge and perception of hand hygiene between and within doctors, nurses and paramedical staff knowledge [p-value 0.799 and p-value 0.515 respectively]
Conclusion: The overall knowledge and perception of study participants about hand hygiene was fair. However, doctorsand nurses' perception of hand hygiene was good
ABSTRACT
Objective: To determine the outcome of helicobacter pylori eradication in the treatment of GERD
Methods: A total of 200 patients fulfilling the inclusion and exclusion criteria were enrolled for study. Informed consent was taken from patients for inclusion in the study. Demographic data was collected. Endoscopy for evidence of GERD was done in Medical Unit-1 of Services Hospital, Lahore for evidence of GERD. Outcome of H. pylori eradication on GERD was assessed according to the symptom improvement defined in material and methods of study
Results: A total of 200 patients fulfilling the inclusion and exclusion criteria were enrolled for study. Informed consent was taken from patients for inclusion in the study. Demographic data was collected. Endoscopy for evidence of GERD was done in Medical Unit-1 of Services Hospital, Lahore for evidence of GERD. Outcome of H. pylori eradication on GERD was assessed according to the symptom improvement defined in material and methods of study
Conclusion: The results of the study showed that there was no statistically significant improvement in the symptoms of GERD after H.pylori eradication
ABSTRACT
The present report is a significant effort to explore detail description of N. Sativa, its pharmacognostic characteristics, morphological characteristics, and mechanism of actions, doses and medicinal uses. Nigella sativa [N. Sativa] is greatest form of healing medicine. It is also known as Prophetic Medicine as its use has been mentioned in Prophetic Hadit, as natural remedy for all the diseases except death. It is recommended on daily basis in Tibb-e-Nabwi [Prophetic Medicine]. Hazrat Abu Hurairah States ''I have heard from Rasool Allah [PBUH] that there is cure for every disease in black seeds except death and black seeds are shooneeze''. Salim Bin Abdullah narrates with reference to his father Hazrat Abdullah Bin Omar that Rasool Allah [PBUH] said, 'Let all the black seed upon you, these contain cure of all diseases except death'. N. sativa claimed to have anti-inflammatory, analgesic, hepato-protective, neuro-protective, gastro-protective and other useful properties. Biological and pharmacological effects are attributed to its two important constituents Thymoquinone [TQ] and Nigella sativa oil [NSO]. TQ has interaction with human serum albumin. Seeds containing volatile oils mainly Melanthin showed toxicity at larger doses. This report is a reference for all pharmaceutical researchers, physicians and biologists researching on N.Sativa and will open a door towards novel agent
Subject(s)
Benzoquinones , Phytotherapy , Plants, Medicinal , Oils, Volatile/pharmacology , Religion and Medicine , Medicine, TraditionalABSTRACT
Objective: To find out prevalence of Diabetic Retinopathy in general population of three districts in Pakistan
Methods:A community based cross-sectional survey was conducted in three large districts of Pakistan namely Rawalpindi in Punjab, Peshawar in Khyber Pakhtoonkhwa and Hyderabad in Sindh between January 2013 and August 2015. Lady Health Workers identified individuals at high risk for diabetes based on predefined criteria. High risk population was tested for dysglycemia. Fundoscopic evaluation for evidence of DR was performed in all individuals with a random blood glucose >190mg/dl. Individuals with the evidence of DR were referred to affiliated tertiary care ophthalmology departments
Results:A total of 42,629 individuals reported at the project sites and 63% [n=26,859] were female. Fifty one percent [n=21,989] individuals met high risk criteria. Out of these 21,989 individuals, dysglycemia was found in 3,869 [17.6%]. Fundoscopy showed evidence of DR in 1,042 [27%] individuals. Amongst high risk population, dysglycemia was significantly more common in females as compared to males. The frequency of DR in dysglycemic patients was comparable across both gender groups
Conclusion:The prevalence of DR in Pakistani population is alarmingly high. This preventable cause of blindness is largely undiagnosed in our population and a simple integrated model based on primary health care facilities can help identify and treat a large population of DR patients
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Background and Objective: Short stature is defined as height below 3[rd] centile. Causes of short stature can range from familial, endocrine disorders, chronic diseases to chromosomal disorders. Most common cause in literature being idiopathic short stature. Early detection and management of remedial disorders like malnutrition and vitamin D deficiency, Endocrine disorders like growth hormone deficiency and hypothyroidism can lead to attainment of expected height. Pakistani data shows idiopathic short stature as the most common cause of short stature. Our study aimed at detecting causes of short stature in children/adolescents at an Endocrine referral center
Methods: A retrospective study was conducted at WILCARE Center for Diabetes, Endocrinology and Metabolism, Lahore on 70 well-nourished children/adolescents. The patients had been evaluated clinically, biochemically and radiologically as needed. Biochemical testing included hormonal testing as well to detect endocrine causes. Data was entered and analyzed in SPSS 20.0
Results: Leading cause of short stature in our population was Growth Hormone [GH] deficiency seen in 48 out of 70 [69%] patients. Second most common endocrine abnormality seen in these patients was Vitamin D deficiency [44 out of 70 patients [63%]]. Primary hypothyroidism; pan-hypopituitarism and adrenal insufficiency were other endocrine causes. The weight for age was below 3rd percentile in 57 [81%] patients, with no association with other major causes
Conclusion: Growth hormone and Vitamin D deficiency constitute one of the major causes of short stature among well-nourished children with short stature in Pakistan
ABSTRACT
Objective: To determine the frequency level of stress among the pilots stationed at a base in Pakistan
Study Design: Cross-sectional descriptive study
Place and Duration of Study: Study was carried out at an air base of Pakistan from April to July 2013
Material and Methods: All aviators on active flying duties with no past psychiatric history were included in this study. After taking consent and permission from authorities each pilot was given two self-reporting forms consisting of life inventory composed of thirty items depicting recent life changes. Life events included in this scale ranged from highest score of 100 for death of spouse to minimum score of 11 for minor violations of law. The stress questionnaire included a symptoms list with five possible responses of never, seldom, sometimes, often and regular. Pilots were to choose most appropriate response that fitted best for the last six months. This questionnaire consisted of 75 items. Items covered almost all physical, psychological and cognitive symptoms that might occur in stress
Results: A total of 74 aviators participated in this study. On stress inventory 31 [42%] pilots had no significant problems in their lives, 22 [30%] had mild stress, and 17 [23%] pilots had moderate stress while only 4 [5%] pilots exhibited to have major stress. Results of stress questionnaire reveal that 35% of pilots had below average stress level, 27% pilots had above average stress levels, 23% of the pilots showed average person's stress level, and 9.45% of the pilots that is only 7 out of 74 exhibited high stress level
Conclusion: Majority of Pakistani pilots have reported low level of stress
ABSTRACT
The purpose of this study was to introduce the technology for the development of rate-controlled oral drug delivery system to overcome various physiological problems. Several approaches are being used for the purpose of increasing the gastric retentive time, including floating drug delivery system. Gastric floating lisinopril maleate and metoprolol tartrate bilayer tablets were formulated by direct compression method using the sodium starch glycolate, crosscarmellose sodium for IR layer. Eudragit L100, pectin, acacia as sustained release polymers in different ratios for SR metoprolol tartrate layer and sodium bicarbonate, citric acid as gas generating agents for the floating extended release layer. The floating bilayer tablets of lisinopril maleate and metoprolol tartrate were designed to overcome the various problems associated with conventional oral dosage form. Floating tablets were evaluated for floating lag time, drug contents and in-vitro dissolution profile and different kinetic release models were applied. It was clear that the different ratios of polymers affected the drug release and floating time. L2 and M4 showed good drug release profile and floating behavior. The linear regression and model fitting showed that all formulation followed Higuchi model of drug release model except M4 that followed zero order kinetic. From the study it is evident that a promising controlled release by floating bilyer tablets of lisinopril maleate and metoprolol tartrate can be developed successfully
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To determine the risk factors for Deliberate Self-Harm [DSH] in patients presenting to the Emergency Departments [EDs] of three tertiary care hospitals of Karachi, Pakistan. Multicentre matched case control study. EDs of the Aga Khan University Hospital, Karachi, Civil Hospital, Karachi and Jinnah Postgraduate Medical Centre, Karachi, from March 2011 to February 2012. A total of 201 cases and 201 matched controls were taken from three hospitals situated in Karachi. All patients of 16 years and above presenting to the EDs of the hospitals with DSH attempt were invited to participate in the study. Controls were ED patients with complaints other than DSH. A control was matched with case for hospital, gender and age. Two questionnaires were used to collect information on the risk factors of DSH. Conditional Logistic Regression [CLR] was used to assess the association of various risk factors with DSH. Risk factors of DSH in Karachi included current history of mental disorder [OR = 4.53, 95% CI = 1.59 - 12.92], not sharing problems with someone [OR = 4.67, 95% CI = 2.4 - 9.0], living in rented houses [OR = 2.58, 95% CI = 1.37 - 4.84], Pathan ethnicity [OR = 5.05, 95% CI = 1.01-25.38] followed by others [OR = 3.88, 95% CI = 0.77 - 19.69] and Urdu speaking [OR = 2.71, 95% CI = 0.59 - 12.45]. Absence of physical illness in the past month had an inverse association with DSH [OR = 0.17, 95% CI = 0.07 - 0.37]. Mental illnesses, low socio-economic status and loneliness were the risk factors of DSH patients presenting to the three EDs of Karachi. Physical illness in the last month was protective against DSH in these patients. Psychiatric evaluation of DSH patients in the ED is important for early diagnosis and management of mental disorders
Subject(s)
Humans , Male , Female , Risk Factors , Emergency Service, Hospital , Tertiary Care Centers , Case-Control StudiesABSTRACT
This study reviewed the presentations of psychiatric patients admitted through the Emergency Department [ED], The Aga Khan University Hospital, Karachi. Psychiatric patients admitted through the ED to the psychiatry ward were compared to those admitted through the same units other than the psychiatry ward, from 2006 to 2010 using medical records. Psychiatric patients were defined as those in whom psychiatry consult was generated and 1127 cases were included in study. There were 550 [48.8%] female patients. Most common presentations in the ED were sleep-related problems [n=205, 15.9%] followed by aggressive behavior [n=191, 14.8%]. Depression was the most common diagnosis made in the ED [n=331, 29.3%] and at the time of discharge from the hospital [n=354, 29.5%]. Psychiatric patients presenting to the ED had signs and symptoms which one generally disregards. However, these minor indicators can lead to major events in a patient's life
Subject(s)
Humans , Female , Male , Tertiary Care Centers , Depression , Emergency Services, PsychiatricABSTRACT
Objective: To explore the symptoms of conversion disorder in children and young adults admitted in a tertiary care hospital of Karachi
Study design: Descriptive retrospective study
Place and duration of study: Department of Psychiatry, Aga Khan University hospital Karachi. Case note review of all records from January 1990 to December 2009 i.e. 20 years
Methodology: We performed a case note review of all patients less than 25 years of age who had been admitted with a diagnosis of conversion disorder over a 20-year period
Results: A total of 121 case notes were reviewed out of which there were 87 females and 34 males. Motor symptoms were seen in 34.7% [n=42], followed by pseudo seizures in 24.8% [n=30] and unresponsiveness in 14% [n=17] of the patients
Conclusion: Children and young patients who were diagnosed with conversion disorder presents with variable symptoms. Like similar studies from the other countries motor symptoms were most common. The differences in presentation, stressors and duration of illness in this study enunciated a call to explore these phenomena in prospective study design
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To assess awareness about the role of lifestyle changes in the management of diabetes among diabetics. Diabetic clinics of Jinnah Postgraduate Medical Centre and Kidney Centre. Karachi. From April 7, 2008 to August 31, 2008. Cross Sectional. Convenient. Sample Size: 200 diabetic patients. A total of 200 diabetics were interviewed. Their mean age was 48.8 years. Of these 92 [46%] were males and 108 [54%] were females. Diabetes was under control of 38% and 57% were taking regular treatment. Education sessions were attended by only 11%, counseling for lifestyle modification was done with 16%, 30% followed diet chart and 18% of the study participants were doing regular / irregular exercise. Majority of them [68%] needed social and family support to cop up the disease. There was a lack of awareness about the role of lifestyle changes in the management of diabetes among these diabetic patients. There is a need of health education programs for diabetics and general public
Subject(s)
Humans , Female , Male , Health Knowledge, Attitudes, Practice , Health Education , Life Style , Disease Management , Cross-Sectional StudiesABSTRACT
To determine the nature and frequency of the exposure of female students to sexual harassment at higher educational institutes; and explore the adverse effects of sexual harassment on the victims and coping strategies implied by them. Sexual harassment, whether at workplace, educational institution, street or leisure is a problem gaining increasing recognition in every society. Despite the widespread nature of the problem, there are still considerable misunderstandings as well as differences of opinion concerning whether particular situations or behaviours are sexually harassing in nature or not. The victim may feel threatened, humiliated, harassed, and would interfere with the performance, satisfaction, commitment, and undermine security, or create an intimidating environment. This study was conducted in ten institutes which included six medical, three engineering and one general colleges/universities of Karachi from January 6 to September 30, 2009. A total 480 female students were conveniently selected from ten different educational institutes, and were provided a self administered questionnaire with their consent. The identify of all the study subjects was kept secret. Out of total 480 female students, 460 i.e. 96% returned the filled questionnaire. Among them, 65% reported of sexual harassment of various degrees / levels irrespective of their residential area, appearance and attire. These females were harassed by the fellow students [37%], faculty [32%], and strangers [64%] who included patients, attendants, visitors and passerby. Although almost all of the participants [98%] wanted a punishment for the harassers, yet they [78%] were reluctant to disclose the name/ identity of those perpetrators because of the fear of exploitation, social taboo, further embarrassment, adverse consequences, and career obstacles. Many females were the victim of sexual harassment in various forms. There is a need to sensitize the society; and mass awareness programs should be carried out through variety of media
Subject(s)
Humans , Female , Academies and Institutes , Students , Prejudice , EducationABSTRACT
To find out group of drugs best to gain time before appendicectomy in patients of acute appendicitis in mass causalities scenario. Quasi-Experimental. Place and Duration of study: A post earthquake, resource constrained hospital taking care of dependant population of three districts at CMH RawlaKot from 15 Jan 2007 to 15 Jan 2008. Ten patients were selected in each group by convenience sampling. Patients were divided into five groups Group I No Antibiotics, Group II Ampicillin / Gentamicin / Metronidazole, Group III Ceftriaxone / Metronidazole, Group IV Ampicillin / Sulbactum, Group V Cefoperazone / Sulbactum. Group I was taken as control where the appendectomy delay was according to the natural history of the disease. Group II, III, IV and V who had to be triaged and placed on antibiotics regimen before operation. Extreme care was taken so that this approach was only adopted in patients where the delay in appendectomy was inevitable. All patients were operated 24 to 72 hours after onset of symptoms. The grade of operative difficulty was assessed objectively and average difficulty scores were compared between the groups In the one year period 431 appendectomies were performed out of which 50 patients were included in the study. These 50 comprised of 10 patients in each group. Overall male to female ratio was 27:23. Overall average age was 25.14 + 7.54. In Group I an average delay before presentation 57.6 + 12.39 hrs. In Group II to V the overall delay from start of symptoms till operation was 55.63 + 8.37 hrs. The cumulative ease to operative was experienced in group V. In scenario of mass / multiple casualty, the antibiotic containing sulbactum will be best empirical therapy to gain time for patients of acute appendicitis. The one having Cefoperazone has got a definitive edge over the rest