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JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2018; 28 (3): 252-253
in English | IMEMR | ID: emr-170962
Esculapio. 2017; 13 (3): 151-156
in English | IMEMR | ID: emr-193571


Objectives: .To know the mothers preferences about breast feeding, weaning foods and its association with nutritional status of their children

Methods: A cross sectional descriptive study was carried out with 73 mothers having children aged between 6-1 8 months. Questions about weaning practices and weaning foods were asked. Children weight and height were taken

Results: 69.9% of mother belonged to poor class having household income less than Rs 20,000. Only 24.7% were post matric while rest of mother's education was less than metric. 74% mothers think that recommended age of weaning should be between 6-7 months and 68.5% mothers started weaning of their present child at 6 months of age.97.3% started weaning gradually and 75.3% preferred home prepared food for weaning of their child.54.4% mothers used hand to give weaning food to their child, while45.2% mothers used plate/cup and spoon for feeding.41.1 % mothers preferred khithcri as initial weaning food and 21.9% preferred custard to. start with weaning. Children who were breastfed have significant relationship with normal weight for age [p<0.05] shown In fig 3. 9.6% children were under weight and 9.6% were stunted in our sample

Conclusion: Mothers belonging to the walled city of Lahore demonstrated good weaning practices which are reflected by normal weight and height for age of almost 90% children in this study. The role of health professionals in advising mothers about good weaning practices is not remarkable. Mostly decisions about type of weaning food and time of initiating weaning are based upon self/previous experiences and advice from friends and family

JPMI-Journal of Postgraduate Medical Institute. 2016; 30 (2): 107-109
in English | IMEMR | ID: emr-182389
Medical Forum Monthly. 2016; 27 (2): 17-20
in English | IMEMR | ID: emr-182412


Objective: To observe the various aspects of allergic fungal rhinosinusitis [APRS]

Study Design: Prospective Study

Place and Duration of Study: This study was conducted at Department of Head and Neck Surgery, Civil Hospital Quetta and Chaudhary Rehmat Ali Memorial Trust Hospital, Lahore from 1[st] January 2015 to 30[th] June 2015

Materials and Methods: Sixty seven patients suffering from chronic rhinosinusitis with polyps were included in this study

They were assessed clinically, computed tomography and histopathologic and mycologic monitoring. Depending on the presence or absence of allergic mucin and mycelial elements in the sinus, the patients were studied for different parameters

Results: The mean age of 36.4 years with ranged from 14 to 51 and male to female ratio was 1.6:1. Out of these presumed 67 APRS patients, 8 had positive fungal cultures. Remaining 59 patients with EM either had negative fungal cultures and these patients were thought to have insufficient evidence for a pathologic diagnosis of APRS

Conclusion: For the diagnosis of APRS, the detection of fungal elements and allergic mucin should be considered

Pakistan Journal of Pharmaceutical Sciences. 2016; 29 (5): 1579-1586
in English | IMEMR | ID: emr-183639


Present investigation concern with combination of two drugs for the treatment of gout. One of these drug [naproxen sodium] is pain killer which is sustain their action within the body for 12 hours and the other drug [colchicine] is anti-gout, which release as conventional dosage. After oral administration naproxen will act as sustain release dosage and increase patient compliance about six batches of tablet were developed and evaluate .For the sustain release action polymers Methocel K4M and HPMCK15were used. These polymers were used in combination used with other inactive ingredients. Two methods were used for proration of final tablets. In 1[st] method only naproxen sodium granules were prepared which are sustained released. In second method these granules were mixed with colchicines powder and other all inactive ingredients. This method is easy and cost effective characterization of pallets and final tablets were performed. Final tablets were evaluated for all tests like appearance, friability, dissolution, hardness, assay, weight variation and in-vitro release study performed. The results obtained were satisfactory and complies with USP specification. Formulation containing combination of Methocel K4M and HPMC K15 showed good sustain release profile for 12 hours

Medical Forum Monthly. 2016; 27 (11): 19-23
in English | IMEMR | ID: emr-184079


Objectives: The study aimed to determine the frequency and risk factors for Extra Hepatic Manifestations among patients with Hepatitis B and C related Chronic Liver Diseases

Study Design: Cross Sectional Study

Place and Duration of Study: This Study is conducted at the Department of Medicine [Both indoor and outdoor patients] of Civil Hospital, Karachi from 2012 to 2016

Materials and Methods: In this study of 548 patients, who were positive for HBV or HCV, fulfill the selection criteria and were suffering from Chronic Hepatitis, Cirrhosis or HCC were examined for Extra Hepatic Manifestations clinically and if required appropriate tests were done to confirm the diagnosis and finding. Frequency and risk factors were determined for extra hepatic manifestations. Test of statistical significance were applied where p value of <0.05 was considered to be statistically significant cut-off

Results: Majority of patients 432 [78.8%] were HCV Positive and 116 [21.2%] were found to be HBV positive. Overall frequency of extra hepatic manifestations was found to be 54.7 %. Patients with chronic hepatitis C and B. The Extra Hepatic Manifestations of 60.6 % in HCV and 32.8% in HBV respectively. Diabetes Mellitus [DM] is the most common extra hepatic manifestation found in both, chronic HCV [19.0%] and chronic HBV patients [5.2%] whereas hypertension is the second commonest extra hepatic manifestation among HBV patients [12.1%]. Disease duration > 5 years, age> 45 years, Viral PCR, Raised ALT and Hepatocellular Carcinoma associated with chronic HCV and HBV were found to be significant risk factors for extra hepatic manifestations

Conclusion: Extra Hepatic Manifestations are more common in HCV associated liver diseases than HBV. Diabetes and hypertension are the main extra hepatic manifestation among HBV and HCV positive patient. Disease duration > 5 years, age> 45 years, Viral PCR, Raised ALT and HCC associated with chronic HCV and HBV were found to be significant risk factors for Extra Hepatic Manifestation

Pakistan Journal of Medical Sciences. 2016; 32 (5): 1146-1151
in English | IMEMR | ID: emr-183244


Objectives: This study was designed to determine the comparative efficacy of different scoring system in assessing the prognosis of critically ill patients

Methods:This was a retrospective study conducted in medical intensive care unit [MICU] and high dependency unit [HDU] Medical Unit III, Civil Hospital, from April 2012 to August 2012. All patients over age 16 years old who have fulfilled the criteria for MICU admission were included. Predictive mortality of APACHE II, SAP II and SOFA were calculated. Calibration and discrimination were used for validity of each scoring model

Results:A total of 96 patients with equal gender distribution were enrolled. The average APACHE II score in non-survivors [27.97+8.53] was higher than survivors [15.82+8.79] with statistically significant p value [<0.001]. The average SOFA score in non-survivors [9.68+4.88] was higher than survivors [5.63+3.63] with statistically significant p value [<0.001]. SAP II average score in non-survivors [53.71+19.05] was higher than survivors [30.18+16.24] with statistically significant p value [<0.001]

Conclusion:All three tested scoring models [APACHE II, SAP II and SOFA] would be accurate enough for a general description of our ICU patients. APACHE II has showed better calibration and discrimination power than SAP II and SOFA

JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2016; 26 (12): 947-949
in English | IMEMR | ID: emr-183356
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2015; 25 (7): 536-537
in English | IMEMR | ID: emr-166841


Idiopathic spontaneous intraperitoneal haemorrhage is a rare and potentially fatal condition. Pre-operative diagnosis is difficult or rarely possible. Urgent surgical exploration is the treatment of choice. We report a case of spontaneous intraperitoneal haemorrhage that was observed undergoing sudden deterioration of her condition while in a hospital ward. She was attending to her child admitted in the ward. She developed lower abdominal pain and extreme weakness. Hospital staff recognized her to be gradually undergoing a state of shock. She was resuscitated and urgent ultrasound abdomen revealed free fluid in the abdomen and pelvis. Immediate laparotomy confirmed the diagnosis of spontaneous intraperitoneal bleeding, however, no significant cause of bleeding was found except for a very small area of breached peritoneum in the pouch of Douglas. Haemostasis was secured by two stitches of vicryl. Postoperative CT scan of abdomen and pelvis did not reveal any abnormal finding. Patient was followed-up in the OPD for 6 months and she was symptom-free and in a healthy state

Professional Medical Journal-Quarterly [The]. 2015; 22 (8): 1091-1095
in English | IMEMR | ID: emr-168700


Livestock production is of paramount importance in minimizing the vulnerability of poor and marginalized people in remote rural areas. Women play an active role in managing and care taking of the herd by participating in different activities of livestock management. The growing population is exerting pressure on all the resources and in future, it is expected that the livestock demand will also increase for fulfilling the demands of masses. Due to women's crucial role in livestock management activities, they are more susceptible to zoonotic diseases. The zoonotic diseases are becoming a threat by becoming responsible for the death of 2.2 million people every year and majority of the victims belong to developing countries. To find out health related issues while participating in livestock management activities. Survey. 2011-2012. the present study was conducted in rural areas of district Toba Tek Singh. One Union Council [UC] and three villages from the selected UC were selected by using simple random sampling technique. The sample size of the study was 120 respondents of rural females having forty respondents from each village. The study revealed that majority of the respondents was involved in grazing and fodder cutting activities and they are satisfied with their role. It was also noted that the highly educated respondents were more secure from diseases than that of less educated and illiterate respondents. It is the sole responsibility of the government and public sector department to run campaign regarding livestock diseases to whom human are susceptible so that the risks regarding this situation may be minimized

Pakistan Oral and Dental Journal. 2015; 35 (3): 364-369
in English | IMEMR | ID: emr-174222


Oral submucous fibrosis [OSMF] is a chronic, insidious, fibrotic disease that predominantly affects people of South-East Asian origin. The majority of patients present with an intolerance to spicy food, rigidity of lip, tongue and palate leading to varying degrees of limitation of mouth opening and tongue movement. The use ofareca nut has been strongly implicated as the principal etiological factor in the pathogenesis of OSMF which involves cytokine mediated collagen synthesis and deposition and reduced collagen degradation. Various modalities have been proposed for the management of OSMF. Aimed primarily at increasing oral opening, surgical treatments have been hampered by relapse and medical agents have yielded limited success. In this prospective comparative study we tested a hypothesis that a combination ofintralesional steroid and oral antioxidant would prove to be of maximal efficacy than either of the two agents used alone. Forty five patients with a clinical and histologic diagnosis of OSMF were randomly divided into three treatment groups of fifteen patients each. Patients in group [A] received monthly intralesional injections of methylprednisolone acetate, those in group [B] were put on daily lycopene supplements while the ones in group 'C' received monthly intralesional injections of methylprednisolone acetate and concurrently were put on daily lycopene supplements as well. Mouth opening values for patients showed an average increase of 3.46 mm, 2.46 mm and 7 mm for groups A, B and C respectively. The difference in mouth openings at the end of treatment was found to be statistically insignificant between groups A and B [p > 0.05], significant between groups A and C [p < 0.05] while it was very significant between groups B and C [p < 0.01]. We therefore conclude that the most favorable response in terms of clinical efficacy was derived from the combination ofintralesional steroid and oral antioxidant therapy in patients abstaining from areca nut habit and indulging in rigorous physiotherapy. We further suggest that this modality may be used as a frontline therapy for the pharmacologic and physiotheraputic management of oral submucous fibrosis

Professional Medical Journal-Quarterly [The]. 2015; 22 (10): 1367-1372
in English | IMEMR | ID: emr-177033


Medicinal plants are used for the production of different medicines and also for the treatment of different diseases

Study Design: Study is based on a survey

Setting: Traditional medicinal uses of common medicinal plants of Cholistan desert

Objectives: The present investigation is aimed to conserve and create awareness about the ethno medicinal value of the plants and their uses to draw the attention of pharmacologists, phytochemists and pharmaceuticals

Methods: In the study area a total of 33 plant genuses belonging to 21 families are reported. In current study the medicinal plants and their indigenous medicinal uses are only presented by interviewing the local informants and Hakims. The information gained by these sources is presented here. For every plant basic information like family of plant genus, botanical name, local name, plant origin, abundance, status, plant form, part used and medicinal importance are given

Results: Field observations showed that deforestation, over grazing, agricultural expansion and unscientific collection, processing and preservation of natural vegetation are the major threats in the investigated area

Conclusion: There is dire need to conserve plant resources of Cholistan desert

Pakistan Oral and Dental Journal. 2015; 35 (4): 574-577
in English | IMEMR | ID: emr-179578


Pain during mandibular third molar tooth surgery following conventional inferior alveolar nerve block [IANB] is quite common because of sub-optimal analgesia. A double- blind randomized controlled trial was done to evaluate the efficacy of extraoral greater auricular nerve block [GANB] as preemptive analgesia in patient undergoing surgical extraction of mandibular third molar class 2, 3 position B and C. This Study was conducted in minor oral surgical department at Armed Forces Institute of Dentistry from 6th Aug, 2012 to, 5th Feb 2014. A total of sixty patients were divided into two equal groups. Group A received conventional IANB along with GANB while group B was administered IANB only. In group A, 23[76.7%] patients experienced no pain while only 7[23.3%] patients experienced mild pain. While in group B, 6[20.0%] patients experienced no pain, 22[73.3%] experienced mild pain, 2[6.7%] patients experienced moderate pain. The difference was statistically significant [p-value0.0001].Based on this study it was concluded that perioperative pain can be eliminated by preemptive GANB analgesia in deep seated mandibular third molar extractions

PAFMJ-Pakistan Armed Forces Medical Journal. 2015; 65 (4): 453-457
in English | IMEMR | ID: emr-166615


To compare the effect of antibiotic prophylaxis with placebo in prevention of wound infection amongst patients undergoing clean open inguinal herniorrhaphy [without mesh]. Randomized Controlled Trial. Pakistan Air Force Hospital, Faisal Base Karachi from October 2009 to November 2011. One hundred and fifty patients undergoing inguinal herniorrhaphy were included and randomly assigned to one of the two groups using random numbers table. Group A patients were given intravenous antibiotic while those in Group B were given equal volume of normal saline just before the induction of anaesthesia. Patients from both groups were observed for the presence of wound infection. Total seven cases [4.7%] of surgical site infection were detected; two cases [2.7%] occurred in group A whereas five cases [6.7%] occurred in group B. The low frequency of post-operative wound infection was seen in group A as compared to group B but the difference was statistically insignificant. Antibiotic prophylaxis has no significant effect on prevention of wound infection in inguinal herniorrhaphy

Adult , Humans , Antibiotic Prophylaxis , Surgical Wound Infection/prevention & control , Hernia, Inguinal
JCPSP-Journal of the College of Physicians and Surgeons Pakistan. 2015; 25 (3): 159-160
in English | IMEMR | ID: emr-178032
APMC-Annals of Punjab Medical College. 2015; 9 (1): 1-4
in English | IMEMR | ID: emr-186167


Objective: to assess the pattern, causes and frequency of Complication of Ventriculoperitoneal Shunt surgery in Paediatric patients

Material and Method: 404 patients with hydrocephalus were operated between the period of 2004 to 2013 in the Departments of Neurosurgery and Paediatric Surgery at Allied Hospital, Punjab Medical College, Faisalabad. All patients with provisional diagnosis of Hydrocephalus were admitted in the hospital, detailed history was recorded and general physical examination with special emphases on neurological examination. Diagnosis was confirmed on the basis of investigations like Cranial Ultrasonography, CT and MRI scanning. Data analysis was carried using Statistical package of social Sciences [SPSS]

Results: of the 404 patients 176[81.48%] were male and 40[18.51%] female. Shunt infection was the commonest complication [12.9%] followed by Blockage [8.3%]. Shunt related mortality was [1.8%]. The mean age among the patients showing disconnection was 20.7 months compared to mean age of 7.8 months for not having this complication[p<0.04]

Conclusion: infection remains the most significant complication of VP Shunt surgery. Ventriculoperitoneal Shunt operation should be considered a major surgical procedure. Children with VP shunt should receive follow-up through the transition the adult hood

Esculapio. 2015; 11 (1): 32-35
in English | IMEMR | ID: emr-190895


Objective: to determine the frequency and type of pathogens in vaginal discharge

Material and Methods: a descriptive cross-sectional study. The out-patient department of Gynecology and Obstetrics Specialist Unit at Services Hospital, Lahore. After taking informed consent a total of 120 women of reproductive age [ 13 to 49 years] were included in the study by convenient sampling. After detailed history and clinical examination, two high vaginal swabs were taken and data was recorded in proforma. One swab was used immediately to prepare a wet mount with one to two drops of normal saline on a glass slide and was examined by light microscopy for motility of Trichomonas vaginalis. The pus cells, budding yeast cells, pseudohyphal and clue cells were also looked for in the same wet mount. Second swab was immediately sent to the microbiology laboratory for Gram's staining and Culture and Sensitivity. The swab was also inoculated on Sabouraud's agar and incubated at 35 degreeC+/-2 degreeC aerobically for 48 hours for the growth of Candida saprophytes. Data was analyzed through computers software SPSS

Results: among 120 patients who had vaginal discharge, 5.8% [n=7] were 13-20 years old, 24.2% [n=29] were 21-30 years old, 55.8% [n=67] were 31-40 years old while 14.2% [n=17] were 41-49 years old. On clinical examination, 54.2% [n=65] patients had fungal infection, 18.3% [n=22] had trichomonas and 15.8% [n=19] had bacterial vaginosis while 11.7% [n=14] patients had mixed infection. HVS microscopy/ culture sensitivity, results showed, 48.3% [n=58] had fungal infection, 12.5% [n=15] had trichomonas and 25.0% [n=30] had bacterial vaginosis and 14.2% [n=17] had mixed infection

Conclusion: vulvovaginal candidiasis was a frequent finding in outpatient departments of tertiary care hospitals of our country

Professional Medical Journal-Quarterly [The]. 2014; 21 (6): 1092-1097
in English | IMEMR | ID: emr-162181


Around the world, the right to health and especially reproductive health right are far from a reality for many women. Reproductive health is of growing concern today. Reproductive health therefore implies that people are able to have a satisfying and safe sexual life and that they have the capability to reproduce and the freedom to decide if, when and how after to do so. Reproduction is a dual commitment but so after in much of the world, it is seen as wholly the women's responsibility. There are four major problems commonly encountered by women in family planning and contraceptive use: accessibility to family planning information and services, quality of services, gender responsibilities and spousal communication. These problems become major obstacles preventing women from regularity fertility or exercising the reproductive rights. The importance of good health and education to women's well being and that of her family and society cannot be overstated. Spousal Communication is crucial step toward increasing women's participation in improving their health rights. Therefore the study was conducted to investigate the perception of married women about the role of spousal communication in establishing reproductive health security. For this purpose 200 married women of age group 15-45 with having at least one living child were selected through multistage sampling technique from urban areas of district Faisalabad. The study explored in bi-variate analysis that those women who were educated, younger and had a high economic status had a perception that the spousal communication plays a significant role in the development of women's attitude towards their reproductive health security

Humans , Women , Adolescent , Adult , Middle Aged , Spouses , Marriage , Family Planning Services , Contraception , Decision Making
APMC-Annals of Punjab Medical College. 2014; 8 (2): 164-169
in English | IMEMR | ID: emr-175346


Objective: The study was designed to examine the association between the personality traits and adjustment level of medical students

Method: 190 medical students from Punjab Medical College, Faisalabad participated in this study through purposive convenient sampling technique. Personality traits were measured through Gordon Personal Inventory [GPI] and Gordon Personal Profile [GPP], while adjustment and mal adjustment was assessed through Rotter's Incomplete Sentences Blanks [RISB]. The results were obtained through chi square statistics on SPSS version 17

Results: Results showed that out of 190 medical students 173 students [91%] were well adjusted. While 17 students [9%] obtained RISB scores above the cutoff point hence they were labeled as mal adjusted. Hypothesis testing with Chi square test has shown statistically significant differences in the scores on the trait of responsibility, cautiousness, personal relationship and vigor among adjusted and mal adjusted medical students. Mal adjusted students were seen associated with below average scores on all previously mentioned traits

Conclusion: The traits of responsibility, cautiousness, personal relationship and vigor are crucial for the adjustment in the society. So the parents and teachers should play their part in improving the fabric of the society by the means of building and emphasizing upon the sense of responsibility, cautious behavior, balance in personal relationships, and vigor in daily tasks among their children and students so that they may become well-adjusted in the society

Pakistan Oral and Dental Journal. 2014; 34 (2): 277-280
in English | IMEMR | ID: emr-159505


The objective of the present study was to evaluate the awareness and compliance among dental surgeons working within twin cities about "forensic dentistry". Secondary objective was to evaluate the need of this specialty to be added in BDS curriculum as an independent subject or part of any major subject. This cross sectional Study was done in five teaching dental hospitals of Rawalpindi and Islamabad which are affiliated with Dental colleges. 318 questionnaires consisting of fourteen basic questions were distributed in the dental colleges/ hospitals selected for the study. Data were then compiled, categorized and analyzed using SPSS. The response rate was 93%. Participants who had never studied forensic dentistry at any level were 99.32% and who never got any formal training in forensic dentistry were 100%. Individuals who opted to study forensic as a subject if opportunity of training was given within Pakistan were 60%. Forensic Dentist may play a major role in identification of those individuals who cannot be identified otherwise. Recent tragedies and situations have increased awareness concerning the importance of forensic dentistry in identification of victims especially in current era in Pakistan. Forensic dentistry must be introduced into the BDS curriculum effectively as a subject. Moreover, the likelihood of future disasters due to terrorism, earthquakes and other causes require the dental profession in Pakistan to be prepared for an ex-pended role