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Introduction: Needle prick pain is a distressing event for a pa?ent receiving spinal anaesthesia. A ‘Needle piercing the spine’ might be physically and mentally trauma?zing for many pa?ents. This may lead to unwanted panic and anxiety during the procedure of spinal anaesthesia. To avoid this distressing needle prick pain, many clinicians have resorted to the prac?ce of giving injec?ons of local anaesthe?c or local applica?on of EMLA cream or patch at the site of spinal puncture beforehand for anaesthe?zing the skin and subcutaneous ?ssues. Methods: A prospec?ve cohort study was done. Those enrolled pa?ents were assessed by an expert anesthesiologist, who was not part of the research team, and he prescribed pa?ents either EMLA cream or regular standard lignocaine infiltra?on anaesthesia and labelled them as Group E and Group L respec?vely. The pain score was assessed using a Visual Analogue Scale. Result: A total of 64 pa?ents were enrolled in the study33 in Group E and 31 in Group L. Both groups had an almost similar number of pa?ents who had a similar extent of surgery. Univariate analysis showed that the mean pain score (VAS) was significantly higher in Group E pa?ents compared to that in Group L, p<0.001. The mul?variate analysis had similar findings a?er controlling confounding factors in mul?ple regression analysis. Conclusion: Local 2% lignocaine injec?on achieved significantly more pain reduc?on during spinal needle inser?on compared to the applica?on of an EMLA patch before spinal anaesthesia.
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Central nervous system tumors are identified as tumors of the brain and spinal cord. The associated morbidity and mortality of cerebrospinal tumors are disproportionately high compared to other malignancies. While minimally invasive techniques have initiated a revolution in neurosurgery, artificial intelligence (AI) is expediting it. Our study aims to analyze AI’s role in the neurosurgical management of cerebrospinal tumors. We conducted a scoping review using the Arksey and O’Malley framework. Upon screening, data extraction and analysis were focused on exploring all potential implications of AI, classification of these implications in the management of cerebrospinal tumors. AI has enhanced the precision of diagnosis of these tumors, enables surgeons to excise the tumor margins completely, thereby reducing the risk of recurrence, and helps to make a more accurate prediction of the patient’s prognosis than the conventional methods. AI also offers real-time training to neurosurgeons using virtual and 3D simulation, thereby increasing their confidence and skills during procedures. In addition, robotics is integrated into neurosurgery and identified to increase patient outcomes by making surgery less invasive. AI, including machine learning, is rigorously considered for its applications in the neurosurgical management of cerebrospinal tumors. This field requires further research focused on areas clinically essential in improving the outcome that is also economically feasible for clinical use. The authors suggest that data analysts and neurosurgeons collaborate to explore the full potential of AI.
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Purpose@#This multi-center, retrospective study was conducted to evaluate the long-term survival in patients who underwent surgical resection for small cell lung cancer (SCLC) and to identify the benefit of adjuvant therapy following surgery. @*Materials and Methods@#The data of 213 patients who underwent surgical resection for SCLC at four institutions were retrospectively reviewed. Patients who received neoadjuvant therapy or an incomplete resection were excluded. @*Results@#The mean patient age was 65.29±8.93 years, and 184 patients (86.4%) were male. Lobectomies and pneumonectomies were performed in 173 patients (81.2%), and 198 (93%) underwent systematic mediastinal lymph node dissections. Overall, 170 patients (79.8%) underwent adjuvant chemotherapy, 42 (19.7%) underwent radiotherapy to the mediastinum, and 23 (10.8%) underwent prophylactic cranial irradiation. The median follow-up period was 31.08 months (interquartile range, 13.79 to 64.52 months). The 5-year overall survival (OS) and disease-free survival were 53.4% and 46.9%, respectively. The 5-year OS significantly improved after adjuvant chemotherapy in all patients (57.4% vs. 40.3%, p=0.007), and the survival benefit of adjuvant chemotherapy was significant in patients with negative node pathology (70.8% vs. 39.7%, p=0.004). Adjuvant radiotherapy did not affect the 5-year OS (54.6% vs. 48.5%, p=0.458). Age (hazard ratio [HR], 1.032; p=0.017), node metastasis (HR, 2.190; p < 0.001), and adjuvant chemotherapy (HR, 0.558; p=0.019) were associated with OS. @*Conclusion@#Adjuvant chemotherapy after surgical resection in patients with SCLC improved the OS, though adjuvant radiotherapy to the mediastinum did not improve the survival or decrease the locoregional recurrence rate.
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Abstract: The aim of this research was to determine the probiotic potential and safety of lactic acid bacteria (LAB) isolated from raw goat milk. Gram positive and catalase negative bacteria were isolated from raw goat milk (n = 61) and identified as LAB. LAB isolates were screened for antimicrobial, probiotic and technological characteristics. LAB isolates showed antimicrobial activity against foodborne pathogens (Staphylococcus aureus, Escherichia coli and Salmonella Typhimurium) and high survival rate at pH 2 (93.54-100.38% after 4h), in the presence of 0.3% bile salts (100.85-108.96% after 4h) and simulated gastric fluid (74.16-80.13% after 3h). Three LAB isolates (1, 3 and 13) with high antimicrobial activity against all foodborne pathogens and probiotics characteristics were subjected to 16S rRNA sequencing and identified as Enterococcus faecium strains. Enterococcus spp. exhibited milk coagulation potential, amylolytic activity, susceptibility to antibiotics and no evidence of hemolysis. Enterococcus spp. isolated from goat milk showed probiotic and technological characteristics and can be used as a starter culture after further safety evaluation.
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Objective@#This study aimed to evaluate the tumor doubling time of invasive lung adenocarcinoma according to the International Association of the Study for Lung Cancer (IASLC)/American Thoracic Society (ATS)/European Respiratory Society (ERS) histologic classification. @*Materials and Methods@#Among the 2905 patients with surgically resected lung adenocarcinoma, we retrospectively included 172 patients (mean age, 65.6 ± 9.0 years) who had paired thin-section non-contrast chest computed tomography (CT) scans at least 84 days apart with the same CT parameters, along with 10 patients with squamous cell carcinoma (mean age, 70.9 ± 7.4 years) for comparison. Three-dimensional semiautomatic segmentation of nodules was performed to calculate the volume doubling time (VDT), mass doubling time (MDT), and specific growth rate (SGR) of volume and mass. Multivariate linear regression, one-way analysis of variance, and receiver operating characteristic curve analyses were performed. @*Results@#The median VDT and MDT of lung cancers were as follows: acinar, 603.2 and 639.5 days; lepidic, 1140.6 and 970.1 days; solid/micropapillary, 232.7 and 221.8 days; papillary, 599.0 and 624.3 days; invasive mucinous, 440.7 and 438.2 days; and squamous cell carcinoma, 149.1 and 146.1 days, respectively. The adjusted SGR of volume and mass of the solid-/ micropapillary-predominant subtypes were significantly shorter than those of the acinar-, lepidic-, and papillary-predominant subtypes. The histologic subtype was independently associated with tumor doubling time. A VDT of 465.2 days and an MDT of 437.5 days yielded areas under the curve of 0.791 and 0.795, respectively, for distinguishing solid-/micropapillary-predominant subtypes from other subtypes of lung adenocarcinoma. @*Conclusion@#The tumor doubling time of invasive lung adenocarcinoma differed according to the IASCL/ATS/ERS histologic classification.
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Percutaneous transthoracic needle biopsy (PTNB) is one of the essential diagnostic procedures for pulmonary lesions. Its role is increasing in the era of CT screening for lung cancer and precision medicine. The Korean Society of Thoracic Radiology developed the first evidence-based clinical guideline for PTNB in Korea by adapting pre-existing guidelines. The guideline provides 39 recommendations for the following four main domains of 12 key questions: the indications for PTNB, pre-procedural evaluation, procedural technique of PTNB and its accuracy, and management of post-biopsy complications. We hope that these recommendations can improve the diagnostic accuracy and safety of PTNB in clinical practice and promote standardization of the procedure nationwide.
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Objective: To identify the acceptance of the vaccine based on factors influencing the vaccination program and the side effects from vaccinated people. Methods: A cross-sectional online survey of 1 529 Bangladeshi adults (≥18 years) was conducted between 17 April, 2021 and 26 April, 2021. Statistical analysis of the data included Chi-square test and multinomial logistic regression analysis. Results: In total, 67.04% of the participants were willing to accept a COVID-19 vaccine, and 45.00% of them in our study had already received. Overall Bangladeshi people were more likely to accept COVID-19 vaccine if the vaccine reduces risk of infectious disease and has no associated health risk after receiving it. Among the respondents, religions, education level, living area (urban), belif that vaccines protect against infectious diseases and vaccines do not have health-related risk and vaccination was significantly associated with the acceptance of COVID-19 vaccines. Conversely, people's perception on development of natural immunity rather than receiving vaccines was also positively reflected. More than half (57.41%) reported minor side effects such as fever, muscle pain and headache after getting vaccine shots. Conclusions: This study revealed that the acceptance rate was influenced by socio-demographic and health-related characteristics and people are not afraid of this vaccine if they faced minor side effects after receiving it. These findings might help the government and policymakers of Bangladesh to implement necessary steps to accomplish this vaccination program effectively.
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Abstract Introduction The prevalence of deafness is high in Pakistan. Knowledge regarding the clinical features of patients with profound hearing loss will not only help identify the cause but will also help in the strategic planning for public health interventions. Objective The present study was conducted to cover in detail the clinical aspects of children with hearing loss, that is, age at presentation, associated deficits and disorders, possible cause of the disease, associated family history, and role of consanguineous marriage. Methods The present study was performed from November 2016 to September 2018. All of the patients under 6 years of age with profound bilateral hearing loss who would benefit from cochlear implantation were included in the study. Detailed history was taken. The developmental skills were assessed for all areas, and the patients were scored regarding their motor, manipulative, visual, language, social and self-care skills according to the Schedule of Growing Skills II. Detailed family history was taken from the parents of the affected children. The Statistical Package for the Social Sciences (SPSS) software, version 20.0, was used for the statistical analysis. Results The mean age of the children to be treated was 3.2 ± 1.25 years. Most patients (51.5%) had a positive family history of disease. Consanguineous marriage was common; the parents of 76.9% of the patients were first-degree relatives. Most patients (90.8%) had associated language impediments. In total, four (Ł3.07%) patients had global developmental delay. Conclusion Consanguineous marriage pattern plays an important role in diseases running in families. Development in these children is strongly linked to their age at the consultation.
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Abstract A feeding trial was carried out to assess the effect of dietary chromium supplementation on apparent nutrient digestibility coefficient (%) of gelatinized and non-gelatinized corn in Cirrhinus mrigala fingerlings for 90 days. Using various levels of chromium chloride hexahydrate six test diets designated as T1 (G/0.0 Cr2Cl3.6H2O mg Kg-1), T2 (NG/0.0 Cr2Cl3.6H2O mg Kg-1), T3 (G/0.2 Cr2Cl3.6H2O mg Kg-1), T4 (NG/0.2 Cr2Cl3.6H2O mg Kg-1), T5 (G/0.4 Cr2Cl3.6H2O mg Kg-1) and T6 (NG/0.4 Cr2Cl3.6H2O mg Kg-1) were prepared. Results showed highest apparent digestibility coefficient (ADC) of nutrients dry matter, crude lipid and gross energy in test diet T5 that was gelatinized and supplemented with chromium 0.4 mg/Kg while, for crude protein higher value of nutrient digestibility was recorded in T3 test diet (G/0.2 Cr2Cl3.6H2O mg/Kg). It was concluded that chromium supplementation with gelatinized corn in fish (Cirrhinus mrigala) diet can improve the nutrients digestibility more efficiently.
Resumo Um experimento referente à alimentação foi realizado para avaliar o efeito da suplementação dietética de cromo, no coeficiente de digestibilidade aparente do nutriente (%) do milho gelatinizado e não gelatinizado em alevinos de Cirrhinus mrigala por 90 dias. Usando vários níveis de cloreto de cromo hexa-hidratado, seis dietas testes foram designadas e preparadas como: T1 (G/0,0 Cr2Cl3.6H2O mg Kg-1); T2 (NG/0,0 Cr2Cl3.6H2O mg Kg-1); T3 (G/0,2 Cr2Cl3.6H2O mg Kg-1); T4 (NG/0,2 Cr2Cl3.6H2O mg Kg-1); T5 (G/0,4 Cr2Cl3.6H2O mg Kg-1) e T6 (NG/0,4 Cr2Cl3.6H2O mg Kg-1). Os resultados mostraram maior coeficiente de digestibilidade aparente (CDA) em matéria seca de nutrientes, lipídios brutos e energia bruta na dieta teste T5, que foi gelatinizada e suplementada com cromo 0,4 mg / Kg; enquanto que para a proteína bruta, foi registrada maior digestibilidade dos nutrientes na dieta teste T3 (G/0,2 Cr2Cl3.6H2O mg/Kg). Concluiu-se que a suplementação de cromo com milho gelatinizado na dieta de peixes (Cirrhinus mrigala) pôde melhorar a digestibilidade dos nutrientes de forma mais eficiente.
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Animals , Zea mays , Animal Feed/analysis , Carbohydrates , Nutrients , Chlorides , Chromium , Chromium Compounds , Dietary Supplements , Diet , Animal Nutritional Physiological PhenomenaABSTRACT
Background: Food safety can be defined as the confidence degree that the food will not cause any harm or sickness to the consumer when it is prepared, served and consumed based on its intended use. A secure food is a food that is physically, chemically and biologically ready to be consumed when it is prepared according to its main purpose and does not loses its nutritional value. Aim of Study: The purpose of this study to assess the knowledge and practices regarding food safety among the food handlers. Method: A descriptive cross sectional survey based study was conducted in Food Street, ShahiQilaha, Lahore. Convenience sampling technique was used to collect the data from respondents. Closed ended questionnaire was used. Data was gathered from food handlers working in Food Street, Shahi Qilaha, Lahore. SPSS version 20 was used to analyze the data and descriptive statistics applied. Result: In our study, almost all of the food-handlers were aware of the critical role of general sanitary practices in the work place, such as using gloves (88.0%). On disease transmission, 56.0% of the food- handlers had knew that Salmonella is a food borne pathogens and 74.0% were known that hepatitis A is a food borne pathogen, 44.0% respondents knew about the AIDS transmitted by food. Only 56.0% participants knew the temperature of 65° should keep for ready food and this knowledge with their experience. Conclusion: In generally the food handlers have satisfactory knowledge in the areas of food safety, personal hygiene and sanitation procedures. But they do not use strict hygienic practices during processing and handling food products. The most important issues are the lack of knowledge regarding refrigeration temperatures, lack of knowledge concerning cross-contamination and its control.
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Objective: To determine the efficacy of doxycycline as pleuridising agent in cases of malignant pleural effusions (MPE). Subject and methods: This was a descriptive case series that was conducted at Medical and Pulmonology Department of Combined Military Hospital Lahore from January 2018 to August 2018. In this study, the cases of malignant pleural effusion assessed on history and proven by histopathology on any biopsy of either gender falling in range of 30 years or more were included. The pleural fluid was drained by appropriate size intercostal chest tube (ICT). These cases then underwent pleurodesis with Doxycycline. For pleurodesis 10 capsule of Doxycycline each carrying 100 mg in it were taken and mixed with 50 ml of normal saline. A repeat chest X-ray and USG chest was done to see for presence of fluid, complete absence of fluid was labelled as efficacious pleurodesis. Results: In this study, there were total 60 cases of malignant pleural effusion (MPE) included, out of which 35 (58.33%) were females and 25 (41.67%) females. The mean age of the subjects was 57.32 ± 7.28 years. There were 29 (48.33%) cases with CA breast, 22 (36.67%) with CA lung and 9 (15%) had the other miscellaneous malignancies. The efficacy of pleurodesis with Doxycycline was seen in 26 (43.33%) of cases. There was significant better efficacy (p=0.001) in cases that had pleural effusion less than 1 liter at presentation where it was seen in 14 (63.64%) of cases as compared to 12 (31.58%) cases that had effusion less than 1 liter. There was no significant difference in terms of duration of pleural effusion with p=0.21. Conclusion: Doxycycline is efficacious in almost half of the cases and it is significantly better in cases that had effusion less than 1 liter.
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The present study aimed to screen the Rhazya stricta Decne root for its antihyperglycemic and antioxidants potential through invitro assays along with phytochemical and elemental analyses. The crude extract was prepared through maceration and fractionated using solvent-solvent extraction technique. The spectroscopic studies indicated the presence of various phytochemical classes in the extract and its fractions. The antioxidant assays showed notable results along with a good concentration of phenolic and flavonoid contents. Enzyme inhibition assays demonstrated glucose-lowering effects by inhibiting the enzyme activity which could reduce post-prandial blood glucose level. The Dipeptidyl peptidase-IV (DPP-IV) inhibition assay results showed the novel DPP-IV inhibition activity of the plant extract and all fractions showed noteworthy enzyme inhibition and antihyperglycemic activity. Conclusively, the Rhazya stricta root extract displayed its antioxidant and antihyperglycemic potential due to the presence of various classes of phytochemicals and micro-nutrients.
El presente estudio tuvo como objetivo examinar la raíz de Rhazya stricta Decne por su potencial antihiperglicémico y antioxidante a través de ensayos in vitro junto con análisis fitoquímicos y elementales. El extracto crudo se preparó por maceración y se fraccionó usando una técnica de extracción solvente-solvente. Los estudios espectroscópicos indicaron la presencia de varias clases fitoquímicas en el extracto y sus fracciones. Los ensayos antioxidantes mostraron resultados notables junto con una importante concentración de contenido fenólico y flavonoide. Los ensayos de inhibición enzimática demostraron efectos reductores de la glucosa al inhibir la actividad enzimática que podría reducir el nivel de glucosa posprandial en sangre. Los resultados del ensayo de inhibición de Dipeptidyl peptidase-IV (DPP-IV) mostraron la nueva actividad de inhibición de DPP-IV del extracto de la planta y todas las fracciones mostraron una notable inhibición enzimática y actividad antihiperglicémica. En conclusión, el extracto de raíz de Rhazya stricta Decne mostró su potencial antioxidante y antihiperglicémico debido a la presencia de varias clases de fitoquímicos y micronutrientes.
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Plant Extracts/pharmacology , Apocynaceae/chemistry , Hypoglycemic Agents/pharmacology , Antioxidants/pharmacology , Phenols/analysis , Spectrophotometry, Ultraviolet , Flavonoids/analysis , Blood Glucose/drug effects , In Vitro Techniques , Plant Extracts/chemistry , Spectroscopy, Fourier Transform Infrared , Plant Roots/chemistry , Dipeptidyl-Peptidases and Tripeptidyl-Peptidases/antagonists & inhibitors , Phytochemicals , Hypoglycemic Agents/chemistry , Antioxidants/chemistryABSTRACT
Background@#Evidence is lacking on whether the resection of lung parenchymal cancer improves the survival of patients with unexpected pleural metastasis encountered during surgery. We conducted a single-center retrospective study to determine the role of lung resection in the long-term survival of these patients. @*Methods@#Among 4683 patients who underwent lung surgery between 1995 and 2014, 132 (2.8%) had pleural metastasis. After excluding 2 patients who had incomplete medical records, 130 patients’ data were collected. Only a diagnostic pleural and/or lung biopsy was performed in 90 patients, while the lung parenchymal mass was resected in 40 patients. @*Results@#The mean follow-up duration was 29.8 months. The 5-year survival rate of the resection group (34.7%±9.4%) was superior to that of the biopsy group (15.9%±4.3%, p=0.016). Multivariate Cox regression analysis demonstrated that primary tumor resection (p=0.041), systemic treatment (p<0.001), lower clinical N stage (p=0.018), and adenocarcinoma histology (p=0.009) were significant predictors of a favorable outcome. Interestingly, primary tumor resection only played a significant prognostic role in patients who received systemic treatment. @*Conclusion@#When pleural metastasis is unexpectedly encountered during surgical exploration, resection in conjunction with systemic treatment may improve long-term survival, especially in adenocarcinoma patients without lymph node metastasis.
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Purpose@#Data on the distribution and impact of panel reactive antibodies (PRA) and donor specific antibodies (DSA) before lung transplantation in Asia, especially multi-center-based data, are limited. This study evaluated the prevalence of and effects of PRA and DSA levels before lung transplantations on outcomes in Korean patients using nationwide multicenter registry data. @*Materials and Methods@#This study included 103 patients who received a lung transplant at five tertiary hospitals in South Korea between March 2015 and December 2017. Mortality, primary graft dysfunction (PGD), and bronchiolitis obliterans syndrome (BOS) were evaluated. @*Results@#Sixteen patients had class I and/or class II PRAs exceeding 50%. Ten patients (9.7%) had DSAs with a mean fluorescence intensity (MFI) higher than 1000, six of whom had antibodies with a high MFI (≥2000). DSAs with high MFIs were more frequently observed in patients with high-grade PGD (≥2) than in those with no or low-grade (≤1) PGD. In the 47 patients who survived for longer than 9 months and were evaluated for BOS after the transplant, BOS was not related to DSA or PRA levels. One-year mortality was more strongly related to PRA class I exceeding 50% than that under 50% (0% vs. 16.7%, p=0.007). @*Conclusion@#Preoperative DSAs and PRAs are related to worse outcomes after lung transplantation. DSAs and PRAs should be considered when selecting lung transplant recipients, and recipients who have preoperative DSAs with high MFI values and high PRA levels should be monitored closely after lung transplantation.
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Background@#Indeterminate pulmonary nodules (IPN) suspected for early stage lung cancer mandate accurate diagnosis. Both percutaneous needle biopsy (PCNB) and surgical biopsy (SB) are valuable options. The present study aimed to compare the efficacy and cost-effectiveness between PCNB and SB for IPN suspected for early stage lung cancer. @*Methods@#During January–November 2018, patients who underwent operation for IPN suspected for early stage lung cancer (SB group, n = 245) or operation after PCNB (PCNB group, n = 113) were included. Patient-level cost data were extracted from medical bills from the institution. Propensity score matching was performed between the two groups from a retrospectively-collected database. @*Results@#Fifteen patients (11.5%) had complications after PCNB; thirteen (11.5%) were not confirmed to have lung cancer through PCNB but underwent operation for IPN. In SB group, 172 (70.2%) and 7 (2.9%) patients underwent wedge resection and segmentectomy for SB, respectively; 66 patients (26.9%) underwent direct lobectomy without SB. After propensity score matching, 58 paired samples were produced. Most patients in PCNB group were admitted twice (n = 55, 94.8%). The average hospital stay was longer in PCNB group (12.9 ± 5.3 vs. 7.3 ± 3.0, P < 0.001). Though the cost of the operation was comparable (USD 12,509 ± 2,909 vs. 12,669 ± 3,334; P = 0.782), the total cost was higher for PCNB group (USD 14,403 ± 3,085 vs. 12,669 ± 3,334; P = 0.006). The average subcategory cost, which increases proportional to hospital stay, was higher in PCNB group, whereas the cost of operation and surgical materials were comparable between the two groups. @*Conclusion@#Lung cancer operation following SB for IPN was associated with lesser cost, shorter hospital stays, and lesser admission time than lung cancer operation after PCNB. The increased cost and longer hospital stay appear largely related to the admission for PCNB.
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Introduction: We conducted this study to determine the awareness of usage of estimated GFR/creatinine clearance formulas while dealing with patients in various wards and outpatient departments of different tertiary hospitals in Lahore in doctors who are not working or trained in nephrology, it was done by using a questionnaire in between January 2019 to May 2019. It was found that good percentage of doctor is not using basic formulas and need education by fellow nephrology colleagues for basic patient management, drug dosing, and referral. Objective: To study the awareness and usage of creatinine clearance calculations in doctors not trained in nephrology. Study design: Descriptive, cross-sectional study. Methodology: The cross-sectional observational study was conducted. A questionnaire was designed which included questions about knowledge of estimated GFR/creatinine clearance, calculation methods, use of these formulas while dealing with patients for defining and diagnosing AKI and CKD, medicine dosage adjustment according to creatinine clearance and referral to nephrologists. Results: A total of 170 doctors working in different specialties were contacted and all of them filled questionnaire. 56 (32.9%) doctors answered that they know and calculate eGFR in routine practice while 114 (67.1%) were not performing eGFR while encountering patients. 80 (47.1%) were confident in staging chronic kidney disease and 90 (52.9%) were unable to stage chronic kidney disease on basis of eGFR. In routine patients dose and adjustment according to GFR was documented by 39 (22.9%) doctors and 131 (77.1%) doctors were not practicing dose adjustments for different medicines after calculating GFR. Referral to nephrologist was being done 99 (58.2%) doctors and 71 (41.8%) were not referring patients to nephrologists. Conclusion: Several considerable challenges remain regarding CKD and AKI early diagnosis and management and referral in Pakistan including inadequate knowledge and training systems, and needs education in this regard.
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Background: The neurosurgical disorders are amongst the leading cause of global mortality and morbidity. Though surgical intervention is thought to be the main management protocol in the neurosurgical setup but drugs are being equally used especially in the outpatient setting. The present study was carried out in view of the sparse data available on prescribing pattern in neurosurgery.Methods: The present study was conducted by the department of pharmacology in outpatient department of neurosurgery in a tertiary care centre to look into the prescription pattern among these patients.Results: In 268 patients analyzed, mean age was 43.02±15.93 years and 52.23% were females. Majority of our participants (44%) were found to be of young to middle age group (21-40 years). The diagnosis among the study population was spread over large number of diseases. Lumbar Disc Prolapse (LDP) was found to be the leading cause of neurosurgical morbidity, amounting to 32%. As far as the prescription of various drugs in the outpatient of neurosurgery is concerned, Analgesics were the most common drugs prescribed constituting about 48% of the total drugs prescribed followed by GABA analogues and multivitamins which equally formed 41% of the total prescribed drugs.Conclusions: Although the prescription pattern studies among the outpatient neurosurgery patients are very scant, the analysis of prescription studies will be helpful to encourage the rational drug prescribing pattern.
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Background: Quality of life (QOL) is a broad, multidimensional concept that usually includes subjective evaluations of both positive and negative aspects of life. Very few studies have been carried out on QOLIE 31 in India and research in this area will identify factors affecting QOL. study was therefore conducted to determine the level of health related QOL of patients of epilepsy in a tertiary care teaching hospital. To evaluate patterns of the use of anti-epileptic drugs (AEDs) and their impact on the Quality of Life (QOL) in patients with epilepsy.Methods: The study was a hospital based cross sectional study conducted by the Department of Pharmacology in association with the Department of Medicine, Government Medical College, Srinagar. A total number of 134 patients, aged >18 years were studied for a period of one and a half years, January 2015-July 2016. QOLIE?31 questionnaire was used for collecting data on health?related QOL.Results: The mean overall QOLIE-31 score was 53 corresponding to a t-score of 44. Amongst the QOLIE-31 subscales, the highest mean score was the cognitive subscale (73.6) followed by medication effects (55.5) and social functions (52).Conclusions: It is evident from our study that there are many factors that influence QOL of people with epilepsy. Among them, type of drug therapy plays an important role. Adding clinical counselling and other interventions to address the physical, mental, psychological, social, and emotional aspects of health wellbeing is likely to achieve better health outcomes for epilepsy patients.
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Background: Adverse drug reactions (ADRs) are an important cause of mortality and morbidity worldwide and reporting ADRs voluntarily is fundamental to medical drug safety surveillance but gross underreporting of ADRs is a cause for a concern. Being key health care professional, physicians, pharmacists and nurses have immense responsibility in reporting of ADRs. Therefore, the sensitization and involvement of undergraduate medical students can reduce underreporting. This study is aimed at evaluating knowledge, attitude and reporting of quality of ADRs by undergraduate medical students.Methods: The study was conducted after sensitizing the second professional year undergraduate students about Pharmacovigilance as part of their internal assessment and asked them to submit reports of ADR observed during their clinical posting.Results: A total of 82 ADR抯 were reported after sensitization with majority of them i.e. 30 related to skin and appendages disorder followed by gastrointestinal tract with antibiotics i.e. 28 and analgesics being most common probable/possible culprits.Conclusions: The response percentage of reporting ADRs was 54.66%. Medical students being future healthcare professionals should be exposed to ADR reporting during their clinical teaching posting as a part of sensitization and make them actively involved in reporting to improve detection rate and make Pharmacovigilance a success.
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Background: Type 2 Diabetes mellitus is a metabolic syndrome that leads to hyperglycemia and complications in many organ systems. There are many ways to control hyperglycemia including diet, exercise, drugs, and insulin. Aim of the study: The purpose of this study was to determine the effects of diaphragmatic breathing exercises on blood sugar levels and to identify the effects of regular diaphragmatic breathing exercise on HbA1c. Subjects and Methods: The study design used was a randomized controlled trial. Random sampling technique was used. Data was collected from working female nurses of Services Hospital Lahore and Jinnah Hospital Lahore who had type-2 diabetes mellitus. By using Ballot method 64 subjects were selected and equally divided into 2 groups randomly (32 subjects were in an interventional group and 32 in the control group). Data were analyzed using SPSS version 20. Mean difference was measured by using independent sample t-test and paired t-test to see the pre and post effects of the same group. Results were summarized as mean and standard deviation. Results: The study results indicated that there was a significant reduction in fasting blood sugar level (p=0.009), post prandial blood sugar level (p=0.002) and post interventional blood sugar level (p=0.000) in the 9th week of the activity (breathing exercise). Pre and post the interventional mean difference in fasting blood sugar level was highly significant in the 12th week of intervention (p=0.000). No significant difference was found in the results of HbA1c (p=0.963). Conclusion: Diaphragmatic breathing exercise has favorable effects in controlling blood sugar levels among diabetes type-2 patients if it is combined with other exercises or therapies. Only breathing component cannot maintain the normal blood sugar level.