ABSTRACT
Himalrandia tetrasperma and Wendlandia exserta medicinal plants belong to family Rubiaceae commonly known as coffee family were investigated by quantitative analysis of major bioactive compounds and analgesic effect. The analgesic potential was accessed using different parts of H. tetrasperma and W. exserta by induced acetic acid writhing and hot plate test method. Methanolic extracts of these two plants satisfactorily possesses analgesic activity. All the extracts showed good results as compared to standard drug, i.e. aspirin. Seeds of H. tetrasperma possess maximum, i.e. 86.73% inhibition at first phase where as aspirin possesses 52.73%. In second phase, leaves possess 99.8 % inhibition respectively. Hot plate analgesic activity of bark extract displayed maximum activity at 4.5h stage, i.e. 8.6 +/- 0.40. W. exserta methanolic extract of bark possesses 97.3% inhibition respectively in first phase and 99.8% in second phase. Bark extract displayed maximum activity at 4.5h stage, i.e., 9.7 +/- 0.5. Quantitative analysis of bark of H. tetrasperma possesses highest value of saponins, i.e. 30.21 +/- 0.8 where as flavonoids 17.50 +/- 1.2, phenolic compounds 23.25 +/- 0.5 and tannins 12.32 +/- 0.4. The leaf extracts of H. tetrasperma contains maximum value of phenols, i.e. 15.10 +/- 0.7 where as W. exserta bark possesses significant value of alkaloids, i.e. 16.41 +/- 0.4 and leaf extracts possesses flavonoids, i.e. 14.51 +/- 0.3, saponins 12.22 +/- 0.1 and phenolic compounds 11.31 +/- 0.4. The seeds of both plants possess significant value of tannins, i.e. 07.60 +/- 0.3
ABSTRACT
Objective: To determine the commonest stage of hypopharyngeal and upper esophageal carcinoma at presentation, common complications after surgery, perioperative mortality, and one-year survival rate after surgery. Study Design: A descriptive prospective study. Place and Duration of Study: Combined Military Hospitals, Rawalpindi, Lahore, and Malir, from Oct 2008 to Oct 2016
Material and Methods: Through consecutive sampling, 25 individuals were sampled after staging disease through TNM classifications provided by the 1983 American Joint Committee on Cancer Classification for hypopharyngeal cancers. Total laryngopharyngoesophagectomy and gastric pull-up reconstructive surgery was performed by two teams. The total operation time in hours and the approximate blood loss in ml during the procedure was documented. The patients were monitored post-operatively for pulmonary [respiratory failure requiring ventilatory support, atelectasis, pneumonia, pulmonary embolism, pleural effusion/hemothorax, etc.], cardiac [arrhythmias, myocardial infarction, and congestive cardiac failure], and surgical complications [wound infections, anastomotic leak, and fistula formation]. The patients were also followed-up for survival at 1[st], 6[th], and 12[th] month
Results: There were 18 males and 7 females [mean age: 53 +/- 14 years]. Majority presented with T4N2M0-stage disease. The operation lasted for a mean time of 7.7 +/- 1.3 hours [range: 6.3-11 hours] and a mean 1218 +/- 338 ml [range: 590-2020 ml] blood was lost during the operation. The patients remained in the hospital for a mean 26 +/- 16 days [range: 1-56 days]. The commonest complication following operation was pleural effusion/hemothorax present in 72% of the patients. The perioperative mortality was 12% and one-year survival rate was 36%
Conclusion: Majority of our sampled patients presented with T4N2M0-stage disease. The mean operation time in our sample was longer with an increased incidence of anastomotic leaks when compared to the international data. The other complications and perioperative mortality were comparatively similar while one-year survival rate was lower
ABSTRACT
Introduction: Stress has been recognized as serious health problem among nurses. It declines the quality and standard of living with a great deterrence in health of its victims
Objectives: To determine prevalence, severity and various stressors related to nurses everyday life
Methods: Hospital based analytical cross-sectional study was conducted from January 2015 to December 2015 in two tertiary care teaching hospitals of Karachi. The study was carried out on 265 registered nurses, having valid license by Pakistan Nursing Council. The subjects were approached by convenient nonprobability method. After taking written consent, semi-structured and pre-tested occupational stress questionnaire was used to obtain the data about various stressors related directly to nurse's everyday life. Significant level was considered at a p value of 0.05
Results: The study results revealed that majority of studied nurses 160[60.4%] were female and 148 [55.8%] were married. 201[75.8%] had completed the diploma in nursing while 62[23.4%] had graduated their Post RN BSN. Out of total sample, 26 [9.8%] nurses were working as a head nurse while 239 [90%] as staff nurse. The study reveals through the participants' data that everyday life stress falls into three dimensions with their varying percentages as mild stress was found in 25.3%, moderate in 39.6% and severe stress in 35.1% of the participants
Conclusion: The study result concluded that majority of nurses irrespective of their demographic characteristic have moderate or severe everyday life stress which may put negative effects on their both personal and professional responsibilities
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Objective: To compare the benefits of ventilated nasal packing with traditional vaseline guaze nasal packing
Study Design: Randomized controlled trial
Place and Duration of Study: This study was conducted at CMH Multan, from Jun 2014 to Dec 2014
Material and Methods: In this study, sample size of 80 patients was calculated using WHO calculator. Patients were divided in two groups using lottery method endotracheal tube and piece of surgical glove filled with ribbon guaze was utilized for fabricated ventilated nasal pack and compared with traditional nasal packs. Nasal obstruction and sleep disturbance were studied at eight hours and twenty-four hours following surgery using visual analog scale
Results: Mean nasal obstruction with ventilated nasal pack was 45.62 +/- 6.17 and with Vaseline nasal pack was 77.67 +/- 4.85 which was statistically significant [p=0.001] in both the groups. Mean sleep disturbance in both the groups was 46.32 +/- 5.23 and 68.75 +/- 2.70 respectively which was statistically significant [p=0.001] in both the groups
Conclusion: Patients with ventilated nasal packs were found to have better tolerance to nasal packs due to less nasal obstruction and sleep disturbance
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Objective: To determine the frequency of Rheumatoid Factor [RF] in patients with Hepatitis C infection [HCV] associated polyarthropathy at Combined Military Hospital Quetta
Study Design: Cross-sectional study
Place and Duration of Study: Department of Medicine, Combined Military Hospital Quetta, from 1st Oct 2012 to 31st Mar 2013
Material and Methods: Two hundred and seven patients having confirmed Hepatitis C infection [positive anti HCV antibodies and positive HCV RNA by Qualitative PCR] with polyarthropathy were included in this study. These patients were screened for RF by immunonochromatography based RF Latex assay kit
Results: Out of 207 patients, 138 [66.67%] were males and 69 [33.33%] were females. The age among all subjects ranged from 21-55 years and mean age of all subjects was 44.29 +/- 4.61 years, the youngest patient was 21 years old and eldest was 55 years old. Most of the patients 97 [47%] were in the age group of 36-45 years. RF was positive in 88 [42.51%] patients and it was negative in 119 [57.49%] patients suffering from hepatitis C infection associated polyarthropathy. The frequency of RF in female patients was 66 [48%] and in male patients was 22 [32%] and it was significantly [p-value=0.0367] greater in female patients as compared to male patients
Conclusion: The detection of Rheumatoid Factor [RF] is of little utility as a diagnostic tool for concurrent RA in patients of chronic HCV infection because a high percentage of them were having serum RF reactivity
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Objective: To determine the decrease in mean duration of diarrhea and normalization of stool consistency by smectite in children with acute gastroenteritis
Methods: A total of 300 patient children aged 1-12 years old fulfilling inclusion criteria were sorted in two groups; 150 cases in each group. Four parameters were considered, i] Age distribution, ii] Gender distribution, iii] Duration of normalization of stool consistency and iv] Duration of diarrhea
Results: Age distribution was 56% [n=84] in Group-1 and 51. 33% [n=77] in Group-2 were between 0.5-6 years of age while 44% [n=66] in Group-1 and 48.67% [n=73] were between 7-12 years of age, mean+sd was calculated as 6.04+3.49 and 6.48+3.66 years respectively, Gender distribution was 60.67% [n=91] in Group=1 and 62.67% [n=94] in Group 2 were male while 39.33% [n=59] in Group-1 and 37.33% [n=56] in Group-2 were females. Duration of normalization of stools consistency was 44.24+2.63 hours in Group-1 and 71.56+2.48 hours in Group-2 was recorded, p value was calculated as 0.0001 which shows a significant difference between the two groups. Duration of diarrhea was recorded as60.58+3.70 hours in Group-1 and 88.76+4.02 hours in Group-2, p value was calculated as 0.0001 which shows a significant difference between the two groups
Conclusion: We concluded that administration of diosmectite in children with acute gastroenteritis shows a significant efficacy as compared to placebo with regards to mean duration of diarrhea and normalization of consistency of stools
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Objective: To assess the knowledge of dengue fever among health care professional in three large hospital of Makkah-al- Mukarramah, Saudi Arabia
Methodology: The design of this study was cross sectional and sample size was 188. The sample size was calculated by using epi-info software, keeping level of confidence as 95% and level of significance as 5%. One hundred and eighty eight health care staff including physician, nurses, paramedics and other office employees were interviewed about the knowledge of dengue fever and its prevention. Collected data was analyzed by SPSS version 20
Results: It has been found that among health care professional, physicians have good knowledge of type of vector [p=0.002] but there was lack of knowledge of timing of vector bite, diagnostic criteria and preventive measures by all the participants
Conclusion: The results of the study have demonstrated that although physicians have sound knowledge about the pathogenesis of the disease, they have deficient information about diagnosis and preventive measures, which is common to all health care professionals. However, there is need for one large scale study among health care staff for the assessment of knowledge regarding dengue and its preventive measures
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Introduction to understand the prevalence of stress and identifying the prevalence of different differentials of stress among bereaved parents of died under-five children is of utmost importance. This paper is based on the data from Karachi VASA under-five mortality study. The cases of this study are bereaved parents of deceased under-five children belonging to randomly selected 12 slums of Karachi city
Methodology a total of 321 parents excluded out form enrolment in VASA study were undergone stress assessment using Sadaf Stress Scale [SSS]. It was found that 100% of them were truly stressed in one form or the other and the distribution is equally affecting all the slums [with slight variations]. Females were found highly stressed [72%] than males [28%]. The most prevalent types of stress identified were emotional [67%], traumatic [17.2%] and mental stress [7%]. Out of all the stressed parents, a high proportion belongs to highest severity. The highest prevalence of the severity of traumatic stress shows that the large proportion of stressed parents has gone to Post-Traumatic Stress Disorder [PTSD], especially among mothers
Conclusion the results are quiet disturbing. The data shows that there is a high prevalence of traumatic, physical and emotional stress among bereaved parents [especially mothers] of deceased children. The prevalence of traumatic stress and its severity shows that a high proportion of stressed parents have gone to PTSD, which again have a huge impact on the overall mental health of the affected and the close family members
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Background Pakistan stands along top ten countries responsible for two-third of global child mortality burden. To improve Child Mortality [CM] estimates in Pakistan, there is an exigent need to understand the in-depth reasoning behind mortalities. In Pakistan, the data on cause-of-death [CoD] for a large number of child mortalities in Pakistan is either not available or not suitable for use. Pakistan uses an alternative technique called Verbal autopsy [VA]. Since VA only determines the biological cause of death [BCoD], and does not capture multitude of other modifiable social, cultural and health system determinants, it has a limited importance. Such non-biological determinants are captured by another technique i.e. Social Autopsy [SA]
Objective by integrating VA with SA, extended set of mortality related determinants will be explored, in addition to strengthening death notification coverage and assigning CoD in such missed out mortalities
Method under the working group of Health Advocacy Council for Women and Children [HACWC] in collaboration with Child Registry of Pakistan [CROP], mixed method [QUAN-QUAL] interventional study will be carried out in urban-slums of Karachi city using VASA-integrated under-five mortality investigative technique. Parents of dead children will be interviewed. Second stage of study will be followed by qualitative interviews with different cadres of stakeholders
Expected Outcomes by focusing the specific determinants related to case-management and care-seeking process [identified by The Pathway to Survival Framework-TPtoSF] an in-depth understanding of related determinants can be achieved, which will help in crafting potential interventions required to limit the barriers that increase the chances of CM in developing nations
ABSTRACT
Papillary fibroelastoma [PFE] is the most common primary tumor of cardiac valves and predominantly located on the left side. Its origin from non?valvular endocardium is extremely rare. We describe a case of an 81?year?old Caucasian male who presented with a mobile right atrial mass at the junction of right atrial wall and superior vena cava [SVC]. Initially it was thought to be a thrombus and the patient was treated with anti?coagulation therapy without any change in size of the mass. Surgical excision was performed to establish the diagnosis and histopathology confirmed the diagnosis of PFE. In conclusion, this case is unique due to location of the tumor and its attachment with superior vena cava. Physicians should consider this unusual location of PFE in the differential diagnoses of an intra?atrial mass
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OBJECTIVES: The objectives of this study are to collect demographic data of survivors for assessing the related common disease, to identify steps in implementation of essential preventive and curative care for flood survivors and to develop health care model for super flood disaster preparedness in Indus valley areas
STUDY DESIGN: It was a cross sectional descriptive Epidemiological Study /survey. Date was collected through structured and designed proforma. This proforma was tested. 4[tth] year MBBS students were filling proforma and survey work supervised by Faculty of department of Community Medicine and public health sciences and LUMHS clinical faculty members. The study was conducted on survivors and internally displaced people [IDPs /survivors] during super Indus river flood in August and September 2010 to observe and evaluate the role of medical university for the preventive and curative health services for flood victims to reduce the morbidity, mortality and miseries in disaster times
PLACE OF STUDY: The flood victim camps on both sides of Indus river bank from Sehwan to Kotri covering districts Dadu, Jamshoro, Matiari and Hyderabad and also tent cities at Sehwan, Sabzi Mandi Hyderabad and Ghulshan-e-Shahbaz Jamshoro
DURATION OF STUDY: 8[th] August 2010 to 31st December 2010
RESULTS: Total 161700 Flood Survivors were provided health care by LUMHS medical teams, Faculty consultant, Doctors, Students and Paramedics through organizing free medical camps in tent cities and mobile camps. There were 113190 [70%] Female survivors and 48510 [30%] were Males survivors. The health teams provided curative care to 59500 [36.79%] and preventive care to 102200 [63.21] super flood survivors. Ten thousands were sheltered at the land of LUMHS campus and tent city. The common diseases were Diarrhea [21%], ARI [16%], Malaria [07%], Skin Diseases [17%], Eye Infections [08%], Ear Infections [04%], Malnutrition [15%], Injuries [02%], Sleep Disorders [0,5%], Heat Stroke [0.3%], Dog Bite [0.1%] and Unspecified [0.1%]
CONCLUSION: Flood survivors need preventive and curative care. The medical university can directly provide emergency health care and can contribute human resources comprising Faculty, Doctors, Students and Paramedics. 161700 were beneficiaries of LUMHS developed health care model which is one of the indigenous and successful model for future flood disaster preparedness in Pakistan. The WHO acknowledged LUMHS services for flood victims. Professor Noshad Ahmed Shaikh, Vice Chancellor, Liaquat University of Medical and Health Sciences, Jamshoro supervised and visited camps regularly