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Objectives@#Inferior alveolar nerve block (IANB) is commonly used for mandibular dentoalveolar surgery. The objective of this study was to evaluate and compare the effectiveness of coadministration of dexamethasone (4 mg/mL) or adrenaline (0.01 mg/mL) as an adjuvant with lignocaine 2% in IANB during third molar surgery (TMS). @*Patients and Methods@#This double-blind, randomized controlled trial was conducted between March and August 2020. The investigators screened patients needing elective TMS under local anesthesia. Based on strict inclusion and exclusion criteria, patients were enrolled in this study. These patients were assigned randomly into two study groups: dexamethasone group (DXN) or adrenaline group (ADN). Outcome variables were postoperative edema, trismus, visual analogue scale (VAS), perioperative analgesia, onset time, and duration of IANB. @*Results@#Eighty-three patients were enrolled in this study, of whom 23 (27.7%) were eliminated or excluded during follow-up. This study thus included data from 60 samples. Mean age was 32.28±11.74 years, including 28 females (46.7%) in the ADN (16 patients, 57.1%) and DXN (12 patients, 42.9%) groups. The duration of action for DXN (mean±standard deviation [SD], 4:02:07±0:34:01 hours; standard error [SE], 0:06:00 hours; log-rank P=0.001) and for ADN (mean±SD, 1:58:34±0:24:52 hours; SE, 0:04:42 hours; log-rank P=0.001) were found. Similarly, time at which 1st analgesic consume and total number of nonsteroidal antiinflammatory drugs need to rescue postoperative analgesia was found statistically significant between study groups (t (58)=–11.95; confidence interval, –2:25:41 to –1:43:53; P=0.001). Early-hours VAS was also significantly different between the study groups. @*Conclusion@#A single injection of dexamethasone prolongs the duration of action of lignocaine 2% IANB. Additionally, it can be used in cases where adrenaline is contraindicated.
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Background: Self-prescribing among doctors is common. But the General Medical Council (GMC) and American Medical Council recommend that doctors should avoid prescribing for themselves, and close family members. Self-prescribing can lead to serious consequences. The present study reports the prevalence and pattern of self-prescribing among doctors working in various healthcare facilities of Kashmir Valley.Methods: Pre-validated questionnaires were sent to 200 doctors selected by convenience sampling. Only 184 returned the completely filled questionnaires.Results: At which 95.7% male doctors and 97.8% female doctors were self-prescribing. 100% doctors above the age of 40 years were self-prescribing. 100% post graduate students and consultants were practicing self-prescribing. 98.0% of those active as doctors for 1-5 years and 95.1% of those active for more than five years were self-prescribing. 60.7% doctors cited convenience, 40.4% time saving, 27.0% quick relief, 60.7% confidence, 14.6% low cost of treatment, and 15.7% crowd avoidance as a reason for self-prescribing. Major diseases self-treated were: headache (78.7%), respiratory symptoms (79.8%), fever (53.9%) and pain syndromes (31.5%). Major drugs used were: analgesics (80.9%), antipyretics (68.5%), antibiotics (58.4%), decongestants (49.4%) and antispasmodics (33.7%).Conclusions: The observed prevalence of self-prescribing was very high in this study. The issue of self-prescribing is common and requires attention.
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Background: Self-medication with antibiotics is a global problem and increases the risk of antibiotic resistance which impacts morbidity and mortality.Methods: A total of 180 Medical students and the same number of people from general population were given a pre-validated questionnaire. The total respondents were 168 among general population and 173 among medical students. Results: 21.42% respondents from general population and 82.08% medical students practiced antibiotic self-medication. 66.66% respondents from general population practiced antibiotic self- medication to save time and money. 57.04% medical students had previous experience of treating similar symptoms.83.33% respondents from general population and 89.43% medical students used antibiotics to treat fever, cough, cold, sore throat and similar symptoms. 50.00% respondents from general population consulted the chemist/pharmacist before using the antibiotics.38.02% students consulted their textbooks for drug information. Only 16.66% respondents from general population and 24.64% students continued the antibiotics till full recovery.Conclusions: Antibiotic self- medication is more prevalent among medical students as compared to general population. Medical students need to be targeted repeatedly during their education and be taught the value of using antibiotics with caution. Public awareness and strict enforcement of law to control the sale of antibiotics without a valid prescription are needed to minimize antibiotic self- medication and associated risks.
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Background: Phenytoin is a widely prescribed anticonvulsant drug. There is a wide interpatient as well as intrapatient variability in serum phenytoin levels despite standard doses. Phenytoin dosing is challenging because the drug exhibits nonlinear kinetics and interacts with a number of drugs. Children metabolize the drug faster as compared to adults. Ageing is also associated with progressive decline in phenytoin clearance. Many CYP450 enzymes show a sex-dependent difference in activity. The objective for this study was to find the effects of sex and ageing on serum phenytoin levels.Methods: The influence of sex and ageing on the serum phenytoin levels was evaluated retrospectively in 96 anonymized epileptic patients who had received phenytoin alone for more than four weeks. These patients were divided into three age groups, up to 18 years (children), 19-60 years (adults) and more than 60 years (elderly).Results: There were 6.25% children, 84.37% adults and 9.37% elderly. The majority (71.87%) of patients were males. Children achieved a mean phenytoin level of 15.71±4.85 µg/ml after a daily dose of 225.00±75.82 mg. Adults attained a mean serum phenytoin level of 16.12±3.90 µg/ml with a mean daily dose of 282.72±69.44 mg. The elderly achieved a mean serum phenytoin level of 15.85±2.19µg/ml after a mean daily dose of 266.67±70.71 mg. As compared to 77.77% females, 84.05% males had phenytoin levels in therapeutic range. 50.00% children, 82.71% adults, and 100.00% elderly had phenytoin levels in therapeutic range. There was a correlation between sex, age and serum phenytoin levels (r = 0.003 to 0.762).Conclusions: There was a correlation between sex, age and serum phenytoin levels in this study. A better understanding of the effects of sex and age on the clinical pharmacology of phenytoin would enhance the quality of prescribing.
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Background: PACS (Picture archiving and communication systems) and digital imaging (DI) has revolutionized radiology bringing about a paradigm shift in the way radiodiagnosis is perceived and practiced with a slew of benefits like elimination of the need for manual handling of films, helping in long term storage of digital images, easy transfer and retrieval of radiographic images. The objective of this study was to analyse the influence of PACS and digital imaging on the workflow in the radiology, performance of the radiographer and image storage and retrieval capabilities.Methods: It was a questionnaire-based study in which questions were asked to the radiographers working in our hospital at five different working sites. Each questionnaire was aimed to evaluate the effect of digital imaging on radiology workflow, improvement in the performance of radiographers, reduction in the work-related frustration levels due to use of digital imaging and finally the utility of digital imaging in image storage, query and retrieval.Results: Among the 50 questionnaires 41 were completed and retrieved. Among the respondents, 90.24% indicated that digital imaging has obviated the need for repeat examinations, 95.12% agreed with the fact that it resulted in the reduction of the number of reject images, 95.1% said it helped them in improving their performances, 92.6% of the respondents said they did not face any issue with its use and 95.1% of the participants agreed that the image query and retrieval could be accomplished in a hassle-free manner.Conclusions: The digital imaging technique not only improves the performance of the radiographers but also increases the workflow of the health care hospitals or clinics. The digital imaging reduces the number of rejected images thus reducing radiation exposure to the patients. Further, it is highly cost-effective and time-saving.
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Background: Information and Communication Technology (ICT) has a potential to improve teaching and learning process. There are conflicting reports on the effect of ICT on student`s outcome. Though there is an early indication of positive impact, but the technology has a potential to have a detrimental effect. The present study was taken up to explore the effects of ICT on medical student’s academic performance.Methods: All the second professional students were given the questionnaire. Only 75 students had filled up the questionnaires completely.Results: The study population consisted of 48.00% males and 52.00% females. 97.33% students had smart phones, 44.00% had a laptop too. 10.66% students got less than 50% marks in the second professional examination, 14.66% got 50-59% marks, 62.66% got 60-69% marks and 12.00% got 70% or more marks. A low negative correlation was found between academic performance and possession of a smart phone (r= -0.062), and between academic performance and possession of a laptop (r= -0.029). A moderate negative correlation was found between academic performance and the time spent on a smart phone or laptop (r = -0.309). The correlations between academic performance and gender, and academic performance and the time spent on mobile phones or laptops were found statistically significant (p=0.000 and 0.007 respectively).Conclusions: Though ICT has capabilities of improving student`s academic performance, but it has a potential to have a negative effect if not used rationally. There is a vital need to sensitize the students about the potential academic risks associated with improper use of ICT. Students should be assisted and guided on how to use it judiciously.
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Background: Adherence is a key factor associated with effectiveness of all pharmacological therapies. Medication non-adherence is a significant barrier to achieve positive health outcomes especially for patients suffering from chronic diseases. Improving medication adherence is a public health priority and could reduce economic and health burdens. The aim of the present study was to assess medication adherence to some common chronic ailments.Methods: Pre-validated questionnaires were distributed among 300 patients suffering from chronic illnesses, by simple randomization out of which 240 patients returned completely filled questionnaires. The analysis was done by manual calculators, VassarStats, and SPSS V20. Results were calculated using univariate linear regression, with each patient’s adherence score as the dependent variable and each predictor as the independent variable. Results are expressed in frequencies and percentages.Results: In this study, 46.66% patients were males and 53.33% females. The mean age was 56.69 years ranging from 24 to 90 years.65.00% patients were uneducated.40.00% were taking one drug, 53.33% two to four drugs and 6.66% more than four drugs. 63.33% had low medication adherence, 35.00% medium and only 1.66% had high adherence. Compared to 14.28% men, 43.75% women were moderately adherent to medications. 41.02% uneducated patients had medium adherence as compared to 14.28% educated patients. 92.30% young patients had low adherence as compared to 53.25% in adults. 44.79% of patients receiving a single drug had medium adherence as compared to 25.00% in those receiving multiple drugs. Linear regression analysis demonstrated that the level of medication adherence was associated with patient gender, age, educational level, and number of prescribed drugs.Conclusions: There are many challenges in understanding the reasons for non-adherence. In this study medication adherence in chronic diseases was found suboptimal and associated with patient`s socio-demographic characteristics. Patient-tailored interventions are required to achieve sufficient adherence to therapeutic drug regimens.
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Background: Worldwide, Hypertension is estimated to cause 7.5 million deaths, about 12.8% of the total of all deaths. This accounts for 57 million disability adjusted life years (DALYS) or 3.7% of total DALYS. Globally, the overall prevalence of hypertension in adults aged 25 and over was around 40% in 2008.Despite its benefits, treatment of hypertension is costly. Direct medical spending to treat hypertension totalled $42.9 billion in 2010, with almost half ($20.4 billion) in the form of prescription medications. Being, a silent disease, adherence to antihypertensive drugs is poor. One of the important factors of poor adherence to antihypertensives is the cost of the drugs. There is wide cost variation among different brands of the same antihypertensive drug. Clinician’s awareness of cost of therapeutics is poor. The costly brand of same generic drug is proved to be in no way superior to its economically cheaper counterpart.Methods: The minimum and the maximum cost in Rupees (INR) of a particular antihypertensive agent manufactured by various pharmaceutical companies in the same strength were noted. The cost of 10 tablets/capsules was calculated. The cost ratio and percent cost variation were calculated for each brand.Results: The cost variation observed in the present study was as high as 2337.50 % for Hydralazine. Other significantly high cost variations found in the present study were: 1315.25% (Telmisartan+Hydrochlorthiazide), 870.58% (Amlopdipine), 558.34% (Amlodipine+Atenolol), 537.68% (Valsartan), 394.44% (Metoprolol), 344.44% (Enalapril), 316.22% (Propranolol), 300% (Lisinopril), 290.90% (Carvedilol), 289% (Cilnidipine), 271.99% ( Labetolol), 268.04% (Indapamide), 256.31% (Losartan), 255.19% (Irbesartan), 226% (Methyldopa), 223.04% (Frusemide), 209.78% (Nitrendepine), 192.08% (Terazosin), 189.25% (Atenolol), 142.42% (Bisoprolol) and 120.51% (Felodipine).Conclusions: Financial constraints are a reality in almost all aspects of medicine. Doctors must consider drug costs to their patients. Increasing pharmaceutical costs negatively impacts patients. Given the increasing healthcare costs, there is growing interest in rational prescribing, which takes costs of medication into account.
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Objective: To evaluate the curriculum for Doctor of Physical Therapy [DPT] programme based on World Federation of Medical Education [WFME] standards
Methods: A questionnaire was constructed based on WFME Should' and Must' standards. It was validated by five experts in two rounds. It is comprised of Items/ questions with Yes/No options. The questionnaire was filled by the DPT Faculty and final year students at Riphah International University, Islamabad from March 01, to April 30, 2017
Results: The key weakness identified were students participation in program management, evaluation, mission statement, program designing, curriculum committee, students activities and organization, and other matters relevant to students, followed by the use of external examiners, reliability and validity of assessment tools, scrutiny of assessments by external examiners and feedback to the students on assessment. The integration of behavioral and social sciences, readiness of graduates for postgraduate studies, institutional autonomy and academic freedom for curriculum development and designing, and opportunity for the participation of other stakeholders were identified as strengths
Conclusions: As per WFME standards the curriculum for DPT program needs improvements in student's assessments and their participation in program management, evaluation, mission statement and designing, along with facilitation in student's activities, organizations. Strengths of the curriculum were integration of behavioral and social sciences, readiness for postgraduate studies, institutional autonomy and academic freedom for the development and designing of curriculum, and the participation of other stakeholders
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Objective: To assess outcomes in surgically managed patients with depressed skull fractures and associated moderate to severe head injury
Methods: The study was conducted in the Department of Neurosurgery Jinnah Postgraduate Medical Centre, Karachi, from January 2016 to December 2017. We analyzed 90 patients with depressed skull fracture managed surgically from January 2015 to December 2016. The patients selected for this study belonged to all age groups with clinically palpable depressed skull fracture confirmed by CT brain with bone window. Outcome was assessed by Glasgow outcome score
Results: Total 90 patients were included in the study. Sixty [66.7%] were male and 30 [33.3%] were female with mean age of years 27.58+11.329. Among 90 patients, 38.8% were aged between 21 and 30 years. Road traffic accident was seen in 72 [80%] patients. The commonest site of fracture was frontal region in 50 patients [55.6%]. GCS improved post operatively on comparison to preoperative. Five patients expired
Conclusion: Depressed skull fracture is common neuro surgical issue. Timely surgical management gives excellent results by decreasing morbidity and mortality
Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Skull Fracture, Depressed/mortality , Craniocerebral Trauma , Glasgow Outcome Scale , Treatment OutcomeABSTRACT
Objective: To determine the clinical outcome of burr-hole aspiration of brain abscess
Methods: We analyzed 100 cases of intracranial abscess, treated surgically from January 2015 and October 2016 at Jinnah Postgraduate Medical Centre [JPMC]. All patients were treated with burr hole aspiration. Medical records were analyzed for demographics, clinical presentation, predisposing factors, abscess location on imaging and clinical outcomes were charted
Results: The study included 100 patients with 73 [73%] males and 27[27%] females with a mean age of 36.69+10.96 years. Mean duration of signs and symptoms was 8.50+/-4.2 days. The most common presenting complaint was altered sensorium in 70 [70%] patients and commonest source of infection was otitis media een in 27 patients [27%]. The GCS on presentation was 13 in 57 [57%] cases. The parietal region was the most common site in 43 patients [43%], followed by frontal region in 33 patients [33%].Complete resolution of abscess with recovery of preoperative neuro-deficit was seen in 77 [77%] patients and recovery with major neuro-deficit was observed in 10 [10%] cases while 13 [13%] patients expired
Conclusion: Early diagnosis, optimum follow-up and timely burr-hole aspiration are the keys in the proper management of brain abscess
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Treatment Outcome , Brain Abscess/diagnosis , SuctionABSTRACT
Objective: To find out the clinical outcome of posterior decompression with occipitocervical fixation ani fusion in patients with Craniovertebral junction instability
Methods: Eighty consecutive patients of cranio vertebral junction [CVJ] compression were treated the department of neurosurgery, Jinnah Postgraduate Medical Centre [JPMC], Karachi over a periodol 05 years from 1st January 2012 till 31st August 2016. All patients underwent posterior decompression witty occipitocervical fusion [OCF] and fixation. The clinical outcome was assessed by Japanese Orthopedic Association [JOA] score and grading
Results: Out of 80 patients with CVJ instability, 64 [80%] were due to non traumatic causes, while II [20%] were secondary to trauma. All 80 patients [100%] showed post operative relief in pain. Sixty to [80%] patients showed improvement in power post operatively while six [7.5%] had no change, four [51] showed deterioration and six [7.5%] patients expired. Sixty four [80%] patients had improvement of the J01 scores at last follow-up. According to etiology, the JOA score for patients with trauma improved in 12[7S] patients and 52[81.25%] for non traumatic causes while six patients [7.5%] expired. Fusion was achieved 64 [80%] patients at last followup
Conclusion: Posterior decompression with occipitocervical fusion and fixation is safe and can be recommended in cases of CVJ compression
Subject(s)
Humans , Male , Female , Adult , Pain, Postoperative , Treatment Outcome , Postoperative Care , Occipital Bone , Cervical Vertebrae , Skull , SpineABSTRACT
Aim: To ascertain the common causes of LGIB in the elderly and to evaluate sigmoidoscopy and colonoscopy as the initial investigation for diagnosing LGIB in the elderly in the developing world. Materials and Methods: The study was conducted over a period of two years at SMHS Hospital and Government Medical College Srinagar, a tertiary care centre, Jammu & Kashmir. All the patients above the age of 60 years, presenting with symptoms or complaints of LGIB to the OPD’s and casualty services of the said hospital were enrolled in the study. Exclusion Criteria: Cases presenting with LGIB which were proved by any diagnostic procedures or during laparotomy to originate from any source proximal to ligament of Treitz. Results: The commonest cause of LGIB in our study was local anal disease [haemorrhoids and anal fissures] followed by carcinoma colorectum, inflammatory bowel disease [IBD], solitary rectal ulcers [SRUS] and colonic polyps, in the order of decreasing frequency. Colonoscopy was able to detect the cause of LGIB in all our study subjects. Conclusion: Despite the small number of patients in our study group, it can be concluded that the cause of LGIB in the elderly in our part of the world differs from that of the developed world, although the reasons for this remain unexplained and require more research. As such, elderly patients with complaints of LGIB should be offered the benefits of colonoscopy unless contraindicated by their co-morbidities because of the fact that they may be harbouring a sinister cause of LGIB, i.e., colorectal malignancy.
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Background and Objective: Cervical radiculopathy is a common neuro-musculo-skeletal disorder causing pain and disability. Traction is part of the evidence based manual physical therapy management due to its mechanical nature, type of traction and parameters related to its applicability and are still to be explored more through research. Our objective was to determine the Effects of Mechanical versus Manual Traction in Manual Physical Therapy combined with segmental mobilization and exercise therapy in the physical therapy management of Patients with Cervical Radiculopathy
Methods: This randomized control trial was conducted at department of physical therapy and rehabilitation, Rathore Hospital Faisalabad, from February to July 2015. Inclusion criteria were both male and female patients with evident symptoms of cervical spine radiculopathy and age ranged between 20-70 years. The exclusion criteria were Patients with history of trauma, neck pain without radiculopathy, aged less than 20 and more than 70. A total of 72 patients with cervical radiculopathy were screened out as per the inclusion criteria, 42 patients were randomly selected and placed into two groups by toss and trial method, and only 36 patients completed the study, while 6 dropped out. The mechanical traction was applied in group A and manual traction in group B along with common intervention of segmental mobilization and exercise therapy in both groups for 6 weeks. The patient's outcomes were assessed by self reported NPRS and NDI at the baseline and after completion of 06 weeks exercise program at 3 days per week. The data was analyzed through SPSS version-21, and paired T test was applied at 95% level significance to determine the statistical deference between two groups
Results: Clinically the group of patients treated with mechanical traction managed pain [mean pre 6.26, mean post 1.43], and disability [mean pre 24.43 and mean post 7.26] more effectively as compared with the group of patients treated with manual traction [Pain mean pre 6.80, mean post 3.85 and disability mean pre 21.92 and post 12.19]. Statistically the results of both mechanical and manual traction techniques are equally significant in group A and B for pain and disability [p-value less than 0.05]
Conclusion: If patients of cervical radiculopathy treated with mechanical traction, segmental mobilization, and exercise therapy will manage pain and disability more effectively than treated with manual traction, segmental mobilization, and exercise therapy
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Background and Objective: Chronic mechanical low back pain is common among different age groups and genders. Different manual therapy techniques combined with exercise therapy and electrotherapy modalities play an important role in its management. Our objective was to compare the effects of McKenzie extension exercises program [EEP] versus Mulligan Sustained Natural Apophyseal Glides [SNAGs] for chronic mechanical low back pain [CMLBP]
Methods: This randomized control trial [RCT] was conducted at Riphah Physical Rehabilitation Centre, Pakistan Railways General Hospital Rawalpindi, from 1[st] July to 31[st] December 2014. The inclusion criteria was patients of both gender and age range 30-70 years with minimum 4 weeks history of CMLBP. A total of 37 patients were screened out as per inclusion criteria and randomly placed into two groups. Twenty patients in group A were treated with Mulligan SNAGs and 17 patients in group B with McKenzie EEP for four weeks at two session per week and single session per day. Visual Analogue Scale [VAS], Oswestry Disability Scale [ODI] and lumber Range of Motion [ROM] were used as an assessment tools and were measured at baseline and at the completion 4 weeks intervention. The data was analyzed with SPSS to draw the statistical and clinical significance of both interventions
Results: At the completion of 4 weeks intervention the pre and post statistical analysis revealed that clinically the McKenzie EEP improved pain [mean 9.12 to 1.46] and disability [73.82 to 6.24] slightly more than Mulligan SNAGs [pain: from 8.85 to 2.55, disability 73.75 to 7.05], while the Mulligan SNAGs improved lumbar ROM more effectively than McKenzie EEP in all directions including flexion, extension, side bending and rotation. Statistically there was no significant difference between the effects of two interventions in managing pain and disability, and improving Lumber ROM
Conclusion: McKenzie EEP is clinically slightly more effective in the management of pain and disability as compared with Mulligan SNAGs, while Mulligan SNAGs are more effective in the improvement of lumbar ROM as compared with Mechanize EEP in the management of CMLBP
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Introduction: Operating room [OR] is a key department in any institution and it runs with heavy resources. Improper running carries not only loss of revenue but it also effects patient care. Delays in operating room are deleterious and methods to decrease these delays are important not only for patient care, but to maximize operating room resource utilization
Objective: To determine the causes effecting the OR utilization and efficiency and to find out ways to overcome it. Study Design: Observational Study. Period: 15-01-2011 to 08-06-2011. Setting: King Khalid Hospital, KSA
Patients and Methods: Operating room baseline data was collected for one month and it was compared with historical data of the last six month. Operating room utilization was found to be 41% overall and 34% for elective cases [benchmark 85%]. In patient pathway, on average 17 min were required from call to ward to enter in operating room. First incision time was 11%=8-8:30, 31% = 8:30-9 and 58%= 9+. Cancelation was 9%. Various improvement projects were started including surgical list management, OR rescheduling, start on time dashboard, pre-anesthesia clinic and reinforcement of day surgery program
Results: The results showed 47% improvement in elective OR utilization and OR utilization reaching 69%. There was 76% improvement in emergency case booking and 18% improvement in pre/ post-op process time. There was 64% improvement in 1[st] cases before 9 am
Conclusion: Integrated management working can improve the working and outcome of the operating room resulting in high efficiency and best patient satisfaction
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Quality Improvement , EfficiencyABSTRACT
To determine the outcome of strength training programme; with and without hamstring stretching in Patients with Knee Osteoarthritis. A Comparative experimental study. This research study was conducted in department of physical therapy at National Institute of Rehabilitation Medicine [NIRM] Islamabad from 1st January to 31st July 2014. A total of 40 patients were randomly selected and placed into two groups. The inclusion criteria were radiologically diagnosed patients of both genders for knee Osteoarthritis of age ranges from 40 to 75 years. The isometric quadriceps strengthening exercise, hamstring stretching exercises and NSAIDS were applied in group A, while group B was treated with isometric quadriceps strengthening exercise and NSAIDS. Both the groups were treated for 6 weeks at 3 days per week and Visual Analog Scale [VAS], Western Ontario and McMaster Universities Osteoarthritis Index [WOMAC], and knee range of motion were used as assessment tools to assess pain, function, and mobility. The measurements were made at the baseline and at the completion of 6 weeks treatment program to obtain numbered data. The data was analyzed through SPSS-20 and paired t test was applied to assess the statistical significance outcomes at 95% level of significance. The results showed that the patients treated with isometric quadriceps strengthening exercises and hamstring stretching exercises combined with NSAIDS managed pain, function and mobility clinically and statistically more [p=0.011, p=0.021, p=0.001], as compared with group B treated with isometric quadriceps strengthening exercise and NSAIDs [p=0.931, p=0.814, p=0.742], in patients with knee Osteoarthritis, as assessed by visual analog scale [VAS], WOMAC index andgoniometry. It is concluded that isometric quadriceps strengthening exercise, hamstring stretching exercises and NSAIDS will managed pain, function, and mobility more effectively as compared with isometric quadriceps strengthening exercise and NSAIDS in patients with Osteoarthritis
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To determine the effectiveness of Spinal Mobilization with manual traction on pain and disability in patients with cervical Radiculopathy. Randomized control trial [RCT]. The study was conducted at Helping Hand for Relief Rehabilitation Centre Mingore Swat from IstJanuary to 30th June 2014. A total of 40 patients [23 males and 17 females] with mean age 35+8 were randomly selected and placed into two groups A and B. The inclusion criteria was patients with diagnosed cervical radiculopathy on physical examination were included. The Group A was treated with spinal mobilization with manual traction, while group B was treated with spinal mobilization alone for 6 weeks at 3 days per week. The Neck Disability Index [NDI] and Numeric Pain rating Scale [NPRS] were used to measure disability and radiating pain. SPSS version 21 was used for the analysis of data and paired t-test was applied at 95% level of significance to determine the statistical outcomes. The results of both groups were significant but group of patients treated with the spinal mobilization and traction managed pain [from NPRS mean score 6.2 to 2.5] and disability [from NDI mean score 29.18 to 13.45] more than the group of patients treated with the spinal mobilization alone [Pain from NPRS mean score 6.1 to 3.15 and disability from NDI mean score 30.5 to 18.21]. Statistically the group A showed more significant results [p= 0.001] than group B [p= 0.054]. It is concluded that Spinal mobilization combined with manual traction is more effective than spinal mobilization alone for the management of radicular pain and disability in patients with cervical radiculopathy
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To determine the efficacy of cefixime in the treatment of uncomplicated typhoid fever in children. It was a descriptive case series. This study was carried out at the Department of Pediatrics, Teaching Hospital D.G Khan Medical College from April 2013 to September 2013. A total of 110 cases fulfilling the inclusion / exclusion criteria were enrolled in the study. In this study 8.78 +/- 3.87 years was the commonest age, 68[61.82%] male cases and 42[38.18%] female cases, efficacy of cefixime in the treatment of typhoid fever in children was calculated and in 96[87.27%] cases, efficacy was recorded while only 14[12.73%] cases could not treated effectively. The results of the study reveal that cefixime is safe and effective drug for the treatment of typhoid fever in children. The results of the study reveal that cefixime is safe and effective drug for the treatment of typhoid fever in children
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Crude methanolic extracts of selected legumes namely, black gram [Vigna mungo L.], green gram [Vigna radiata [L.] R. Wilczek], soybean [Glycine max [L.] Merr.] and lentil [Lens culinaris Medik.] were investigated for anti-inflammatory effects, using COX-2 producing PGE[2] inhibitory assay. Percentage inhibition observed was 73.93, 79.84, 92.17 and 74.47 for black gram, green gram, soybean and lentil respectively at 20microg/ml extract concentration. The l00 micro g/ml concentration showed increase in the percent inhibition except for soybean. This is the first report on COX-2 inhibitory potential of food legumes