ABSTRACT
Background@#Catheter-related bladder discomfort (CRBD) is a frequent complaint after awakening from anesthesia in patients receiving perioperative bladder catheterization. Overactive bladder (OAB) and CRBD show similar symptoms; thus, drugs used for the management of OAB influence symptoms of CRBD. Trospium chloride has been found effective in managing resistant cases of OAB. We evaluated the efficacy of oral trospium on CRBD in the postoperative period. @*Methods@#Sixty-four male and female adult patients, with planned spinal surgery and requiring urinary bladder catheterization, were randomly divided into two groups of 32 each. Group T patients received 60 mg extended-release oral trospium (extended-release) 1 h before induction of anesthesia and Group C patients received a similar-looking placebo. The anesthetic technique was identical in both groups. The CRBD score was evaluated in the postoperative ward using a 4-point scale (1 = no discomfort, 2 = mild, 3 = moderate, 4 = severe). Readings were recorded on arrival (0 h), and 1 h, 2 h, and 6 h postoperatively. All patients received fentanyl for postoperative pain relief. @*Results@#The incidence of CRBD was significantly higher in group C than in group T at 0 h (66% vs 22%, P=0.001) and 1 h postoperatively (72% vs 28%, P=0.001). The incidence of moderate to severe CRBD was higher in group C at postoperative 2 h (82% vs 14%, P=0.004). There was no significant difference in postoperative fentanyl requirements. @*Conclusions@#Pretreatment with 60 mg ER trospium reduced the incidence and severity of CRBD in the early postoperative period.
ABSTRACT
CRISPR Cas9 is highly advanced genome editing technology extensively used for the modifications of genetic components in various sectors of living organisms. This technology has been adapted from the prokaryotic immune system, where it plays a vital role in protecting bacteria and archaea from virus attacks. This robust technology has currently been proven efficient in selective and precise editing, the genome of different living organisms for different purposes ranging from therapeutic, diagnostic to programmable gene regulation. This technology has been continuously upgraded, enhancing its performance thus reducing unfavorable outcomes. Customizing this technology is not a piece of cake. Hundreds of thousands of experiments have been conducted all around the world to optimize this highly intellectual technology to make it an error prone programmable technology to serve each and every living kind. In this review, we have summarized the modifications that have been made in different components of CRISPR cas9 system, engineering of CRISPR Cas9 for specific purposes, different external factors that has to be considered to obtain the best possible outcome minimizing the hazards
ABSTRACT
Objective: To determine the correlation between Psoriasis Area Severity Index [PASI] and Dermatology Life Quality Index [DLQI] in patients of psoriasis
Study Design: Cross sectional study
Place and Duration of Study: Both outdoor and indoor patients of Dermatology Department, Military Hospital [MH] Rawalpindi for duration of 6 months i.e. from 6th Oct 2014 to 5th Apr 2014 were selected
Material and Methods: A total of 155 patients of chronic plaque psoriasis diagnosed clinically, ranging from 20 to 80 years of age and of either gender were included in the study. A careful history and clinical examination was done and for each case PASI and DLQI were calculated and registered in the designed proforma. Data were entered and analyzed in SPSS version-17.0. Mean and standard deviations were calculated for quantitative variables like age, PASI and DLQI. Frequencies and percentages were calculated for qualitative variables like gender. Pearson's correlation coefficient [r] [+1,-1] was calculated between mean PASI and mean DLQI. A p-value <0.05 was considered as significant. Stratification was done for age and gender and post stratification correlation was calculated
Results: Out of 155 patients studied, 110 [70.97%] were males and 45 [29.03%] were females. Ages of the patients ranged from 20-80 years [mean age 49.5 +/- 15.6 years]. Mean PASI score was 27.92 +/- 5.83 and DLQ1 was 11.46 +/- 4.22. The value of Pearson correlation coefficient [r] was 0.1324 which showed weak correlation between PASI and DLQ1 with p-value of 0.100. Weak correlation [r=-0.3394] in age 51-80 years while very weak correlation [r=-0.0651] in age 20-50 years was noted. PASI and DLQ1 showed weak correlation in males [r=0.132] and in females [r=0.461]
Conclusion: This study concluded that there is a weak correlation between PASI and DLQI
ABSTRACT
World widely, Breast cancer is the most common type of cancer amongst women. External and internal factors both are responsible for beginning, advancement and development of breast cancer and from many studies it is well known that environmental elements have a significant effect in etiology of breast cancer. When it comes to environmental factors, effects of viruses are of great concern. Virus-associated cancer brings up a cancer in which the malicious conversion of the host's diseased cells results due to any viral infection. Until now it has learned that human papillomaviruses [HPV], Epstein-Barr [EBV] and mouse mammary tumor virus [MMTV] are the prime candidate viruses that act as agents of causing breast cancer. The initiator is only one in a sequence of steps essential for malignant cells development. Breast cancer could be a hereditary disease but it is expected to account for a very small percentage of breast cancer cases. From this idea it is obvious that there should be more efforts required in evaluating the role of viruses in carcinogenesis that could be characterized by further confounding and synergistic special effects of carcinogenic aspects still exact role of viruses in tumorigenesis is unclear, but it seem like that these are responsible for causing the disease
ABSTRACT
It is confirmed that early marriage and early childbirth leads to higher rates of adolescent fertility and pregnancy related complications. According to UNICEF [1994] unfortunately the mortality rate of the married girls aged between 15-19 years is twice as compare to the girls who marry after the age of 20 years. As their bodies are immature that's why their health is affected by giving birth to a child. Millions of children are affected by the tradition of early marriage at is being practiced and widespread in many regions of South Asia. Early marriage is also called as child marriage that is marriage below the age of 18 when girls are too weak to shoulder their responsibilities physiologically, psychologically and socially. Early married females are more prone to diseases like HIV/AIDS and obstetrics obstacles. They are also affected psychologically and they may become victim of depression, anxiety and other mood disorders. An observational study was conducted between married and unmarried female to know their perspective about getting married early and to highlight whether it is a positive response according to them. Results showed that in relation to unmarried girls the married females were also not in favor of getting married early as they are equally invaded by health problems. Mental distress and depressive symptoms are more common in married females. Girls prefer doctors for concerning their reproductive health problems while girls can also concerned their mothers but they are in minority. Many health consequences are being reported by early married females and they were hesitated to share them with their in laws. Most of them approached lady doctors whereas few were relying on their mothers for their problems to be solved. Marriages below the age of 18 is not helping the females infract its demolishing their self esteem, their will to study and their physiological well being also
ABSTRACT
A good clinical practice [GCP] is an ethical and scientific quality act from oldest enduring customs in the historic times of medicine. As the guiding ethical code it is primarily known for its edict to do no harm to the tolerant. However, the complexities of modern medicine research necessitate a more elaborate set of guidelines that address a physician's ethical and scientific responsibilities such as obtaining informed consent or disclosing risks of these biohazards. Our country in last decades has excelled so much in terms of offering training programs for these professional to bridge the gap between the therapeutic interventions and knowledge of these working individuals. We have done a survey on both male and female working in specific hospitals in Karachi. They were interviewed about their skills, duties and knowledge about standards of clinical practice. With reference to the patient care and conditions they were inquired about the medical background, awareness of the sufferer's ailment and ethical concerns like patient safety and rights. We have found nearly disappointing results as most of these workers were ignorant of the fact that they lack basic knowledge of related responsibilities of concerned patients. Rest of the data also gave the evidence for a huge breach among the awareness, education and realistic approach in this selected workforce. We suggest that caregivers must be aware of indications and have strong medical foundation of the concerned departments where they are serving. We propose the medical education and clinical workshops of this set of serving individuals at ground levels along with the technical fine tuning with the help of case studies and good clinical practice
ABSTRACT
This evidence based study is to provide the awareness of breast self examination; its outcomes and significance. There is a never matching increase noted in the incidences of breast cancer worldwide. Pakistani women are on top of the list in the region to develop this disease and it has also been observed that they diagnose to have higher grade disease in early age. Early detection followed by timely treatment is the best prognosis for long term survival. This a retrospective study in which the data was gathered through questionnaire for the selected variables. Out of 100 patients 49 were doing BSE while 51 were unaware of breast self-examination. Out of these 49%, 42% were doing BSE randomly,2% were doing monthly,3% were doing weekly while 2% were doing on daily bases, and 24 [49%] patients were found to have microscopically confirmed carcinoma and 12 [24%] were found to have negative microscopic exams remaining 13 [27%] patients who were doing BSE were not gone through microscopic exam. Breast self-examination is the simplest tool that can play an important role in the detection of breast cancer. There is need to encourage BSE practices among the women along with the development of awareness program to make it successful
ABSTRACT
Pre-eclampsia is the elevated blood pressure and excess protein in the urine after 20 weeks of pregnancy in a woman who previously had normal blood pressure, a major cause of preterm birth and an early marker for future cardiovascular and metabolic diseases. The objective of study is to identify the level of awareness regarding pre-eclampsia [pregnancy induced hypertension or gestational hypertension] and its relation with increasing maternal and fetal mortality rate. The questionnaire based survey was conducted including both close and open ended questions and compared with the retrospective data among 160 respondents, in which our target was to investigate women of varying socioeconomic status and the duration of our research is almost 20 days. Statistically we found an overall poor awareness of pre-eclampsia with 26% of women surveyed having heard of it and remaining 74% were unknown to pre-eclampsia, 39% faced pre-eclampsia with its severe consequences and fetal mortality rate data showed 42% deaths stating pre-eclampsia as the major cause of it, in addition to that higher rate of maternal death i.e. 57% occurs due to pre-eclampsia subsiding other reasons as key reasons of maternal mortality. Hence it is concluded that Pre-eclampsia is a disorder of pregnancy with unknown etiology so awareness level is too low to decrease its incident and this lack of awareness translates to worse health outcomes proving pre-eclampsia as a major cause of maternal and fetal mortality and its lack of awareness increasing this risk day by day and making it a hidden threat to pregnancy
ABSTRACT
Aspirin and clopidogrel are usually used individually to prevent adverse cardiovascular events and stroke. They are used in stabilizing the blood pressure in patients of myocardial infarction while combination therapy of aspirin and Clopidogrel [dual anti-platelet therapy] is used for preventing adverse cardiovascular events in myocardial infarction patients. A cross-sectional observational study is conducted through a structured questionnaire from 110 patients of K.I.H.D [Karachi Institute of Heart Disease] hospital, Karachi, Pakistan. Indoor/admitted patients with diagnosis of acute coronary syndrome [ACS], non-ST elevation myocardial infarction [NSTE-MI], ST elevation myocardial infarction [STE-MI], supra ventricular tachycardia [SVT] were included along with those with previous or current onset of angina pectoris or heart attack. Information from the test reports of these patients was included in the data. Patients without proper test reports were excluded from the study. Combination therapy duration is considered as key tool for evaluation. Out of 100 patients [after exclusion criteria applied] almost 18% patients were using combination therapy for 10 to 25 years while 52% of patients were using the combination therapy for 1 to 10 years. Platelet count of 88% patients was found to be in between 1,50,000-3,50,000/ml. Remaining patients had less than 1,50,000 ml to more than 3,50,000 to 4,50,000 ml. Most frequently reported side effects were chest pain, respiratory issues, headache and depression. On the basis of our data analysis it is concluded that long duration dual anti-platelet therapy will not harm platelet count in human blood but it can create drug dependency in patients. Hypertension is not completely cured with this therapy but can help in stabilizing blood pressure
ABSTRACT
Pneumothorax is the collection of air in the pleural cavity that causes failure of the affected lung. Depending on the primary disease, the peak incidence of secondary spontaneous pneumothorax can occur in elder age that is most common in emphysema patients. In such patients air enters in the pleural spaces directly through alveolar rupture by lung interstitium or backward through mediastinal pleura. This study compares the prevalence and recurrence of pneumothorax in male versus female patients. Data of 94 patients was collected from the Aga Khan University Hospital Radiology Information System
Their risk of recurrence was analyzed with particular reference to the variables such as age and sex of the patient, initial size of pneumothorax, smoking status of the patient, height and body mass index and the treatment employed
Results showed that males are more prone to pneumothorax and to its recurrences
The incidence of causes included emphysema [64.9% male while 14.9 females], atelectasis [60.6% male while 12.8% females], cystic fibrosis [77.7% male while 18.1 % females], pneumonia [78.7% male while 18.1 % females], pleural effusion [67% male while 11.7% females], embolism [80.9% male while 18.1 % females] tachypnea [80.9% male while 18.1 % females], fracture [78. 7% male while 17% females], and tuberculosis [79 .8% male while 16% females]
Male height was the second most important factor while smoking cessation also significantly influenced the risk of recurrence
ABSTRACT
The purpose of the study is to aware and educated a radiographer of certain pathological conditions seen on chest xray specifically we are dealing with types and severity of pneumothorax and the quality of information a radiographer communicate to his primary team for evaluation. Radiographer can identify or detect pneumothorax by taking x-rays in three positions i-e upright, supine or decubitis with complete awareness of diverse conditions of pneumothorax. For suitable imaging radiographer should know about position, safety of the patient and the techniques of Breath holding during exposure. Whereas ALARA [as low as reasonably achievable] should be kept standard. In our study mostly cases were of tension pneumothorax in which immediate decompression of thorax is mandatory and it requires instant action as on x-ray film as lung marking diminishes in this condition. According to radiological policy for panic conditions the chest x- rays were observed through PACS after every two hours. We evaluated the role of radiographer in observing pneumothorax and how it is his/her utmost responsibility to inform their primary team or the concerned radiologist urgently. We observed 36 panic pneumothorax out of 2865 portable chest x-rays of admitted patients from May 2012 till November 2012. Out of these 36 cases radiographers correctly identified 28 cases while 6 were missed when compared with radiologists detection.We concluded that 77% of radiographers are aware of panic conditions detected on chest x-ray but we find it very necessary to aware and educate radiographers more particularly to detect pneumothorax and related pathologies on chest x-rays in order to improve proper patient care in health care system and maintain required standards
ABSTRACT
Lower awareness of health knowledge, physical growth and development, women bearing children at early ages face higher risk of maternal health problems, disability and death, reinforces risking problems for their newborns as a result, early marriages are always being a very big issue in developing countries specially in primitive uncivilized districts of Asia including India, Pakistan and Bangladesh etc. Moreover it's a controversial fact that in civilized society, evidences of getting married in early ages are greatly increased because of our religious beliefs, norms and social impacts. Due to early marriages young girls don't have the ability to deal with responsibilities, early pregnancy and pregnancy-related mortality and morbidity, causing major physiological and psychological health issues in adolescent girls, resulting in losing relationship confidence and ability to maintain a healthy relationship. Purpose of the study was to evaluate the aspects of psychological disturbances occurring in married young girls along with depression rate and educational withdrawal, with comparison of unmarried young girls of the same age specifically there is a strong correlation between a woman's age at marriage and the education that she receives. Uniformly across the countries, early marriage is associated with lower educational attainment. Observational study was conducted through multi logistic structured questionnaire and girls in b/w age of 13 to 35 were included. On the basis of above study it is concluded that early marriage, multiple responsibilities and early pregnancies are risk factors of depression and it is further evaluated that married girls are at higher level when compared with unmarried.
ABSTRACT
Three cases of congenital abnormalities of the ribs are being presented. This is a very rare condition and to save the patient's life, urgent surgical intervention is required. Of the three, two paitents in whom surgical stabilization with rib grafts was possible, survived whereas the third patient could not be operated upon due to serious pulmonary infection and died