The Professional Medical Journal

Evaluating the effectiveness of BISAP score in predicting severity of acute pancreatitis.

2024-11-26T03:13:54-08:00

Objective: To assess the efficacy of the BISAP score in predicting the severity of acute pancreatitis. Study Design: Cross Sectional, Retrospective. Setting: Surgical Unit, Mardan Medical Complex, KPK. Period: June 2022 to October 2024. Methods: A sample size of 192 was determined. The study included patients aged 18-60 years, of both genders, diagnosed with acute pancreatitis based on the American Pancreatic Association criteria. Data was collected using a standardized form and analyzed with SPSS version 22. Results: Among the 192 patients, males and females’ ratio was 1.4: 1. with mean age of 35.89 ± 13.39 years. 31.2% had severe acute pancreatitis (score >3), while 68.75% had mild pancreatitis (p value < 0.001). The area under curve was 0.98, indicating strong diagnostic power. The study had a sensitivity 96.67%, specificity 93.2%, positive likelihood ratio (PPV) 86.6%, and true negative rate (NPV) of 98.43%. Overall diagnostic effectiveness for severity and mortality was 94.3% and 80.7%, respectively. Conclusion: The BISAP score is reliable, rapid, and cost-effective means for assessing severity, enabling effective patient stratification and prompt initiation of intensive management of severe patients to reduce mortality and morbidity.

To determine the frequency of prostate cancer in patients of suspicion of prostate cancer.

2024-11-28T06:10:41-08:00

Objective: To determine the frequency of prostate cancer among patients with clinical suspicion and analyze the impact of age and symptom duration on diagnostic outcomes. Study Design: Cross-sectional study. Setting: Bilawal Medical College for Boys, Liaquat University of Medical and Health Sciences (LUMHS), Jamshoro. Period: October 1, 2023, to March 31, 2024. Methods: The study included 101 male patients aged 50 years and older who presented with elevated prostate-specific antigen (PSA) levels, abnormal digital rectal examination (DRE) findings, or relevant symptoms. Data were collected retrospectively from medical records, including demographic details, PSA levels, symptom duration, DRE findings, prostate volume, and biopsy results. Prostate cancer diagnosis was confirmed through histopathological examination. Stratified analyses by age groups (50-60 years and >60 years) and symptom duration (1-3 months and >3 months) were conducted using chi-square tests. Results: Prostate cancer was diagnosed in 16.8% of patients. Age and symptom duration were not significantly associated with prostate cancer frequency (p=0.828 and p=0.264, respectively). The mean age was 63.8 years, and the mean prostate volume was 54.7 ml. Conclusion: Age and symptom duration do not significantly influence prostate cancer risk among suspected patients. Comprehensive diagnostic strategies incorporating multiple risk factors are recommended to improve detection and management.

Ultrasonography in the diagnosis of acute pancreatitis keeping computed tomography as a gold standard: Multi-center study.

2024-10-18T03:36:44-07:00

Acute pancreatitis is considered as a major risk towards the health of the patient as the sudden incidence of the inflammation in the pancreas develops sufficient impacts on the physiological functionality of the adjacent tissues or the organs. Study Design: Cross-sectional study. Setting: PAF Hospital Islamabad. Period: November 2021 to February 2022. Methods: This study, conducted at PAF Hospital Islamabad, evaluated the diagnostic efficacy of ultrasound and CT imaging in 150 patients with acute pancreatitis. Following ethical approval and informed consent, patients aged 15-70 years with serum amylase levels above 400 U/L were included. Ultrasounds and CT scans were performed by experienced radiologists, and data were analyzed using MS Excel and SPSS. The study assessed sensitivity, specificity, predictive values, and diagnostic accuracy of both imaging modalities. Results were stratified by age, gender, BMI, and disease duration, with true positives and negatives identified based on consistent imaging results, ensuring a thorough evaluation of imaging effectiveness for acute pancreatitis diagnosis. Results: Patients were predominantly aged 36-55 (127 patients) and male (115 patients). USG showed limited diagnostic accuracy (37.6%) with a sensitivity of 41% and specificity of 35.1%. The study evaluated the diagnostic accuracy of ultrasound (USG) compared to CT scans in identifying acute pancreatitis. The positive predictive value (PPV) was 35%, and the negative predictive value (NPV) was 41%. With an overall diagnostic accuracy of 37.6%, the findings highlight USG’s limited reliability for diagnosing acute pancreatitis when compared to CT. The significance value was 0.072, influenced by a high rate of false positives. The results underscore the varying reliability of USG across different demographics. Conclusion: Ultrasonography (USG) shows limited reliability in diagnosing acute pancreatitis compared to CT, with a sensitivity of 41%, specificity of 35.1%, and overall accuracy of 37.6%. The high rate of false positives highlights that while USG can be a preliminary tool, CT remains essential for accurate diagnosis and effective clinical management.

Hepatitis B Positivity among children screened at a tertiary care hospital and assessment of risk factors.

2024-10-18T03:47:01-07:00

Objective: To determine the frequency of hepatitis b surface antigen (HBsAg) positivity and associated risk factors among children screened before surgical procedures. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, National Institute of Child Health (NICH), Karachi, Pakistan. Period: 1^st February 2024 to 30^thJuly 2024. Methods: A total of 188 children of either gender, aged between 3 months to 15 years, and admitted for any surgical procedure were screened. Demographic information like gender, age, and weight were noted. Information regarding risk factors of HBV infection included evaluation of vaccination status, history of hospital admission, history of injection, blood transfusion, surgical procedure, body piercing, and family history of HBV. HBV infection was labeled on the basis of the presence of surface antigen tested using ELISA. Results: In 188 children, 122 (64.9%) were male, and the mean age was 7.23±7.00 years. HBsAg was positive in 57 (30.3%) children. HBsAg seropositivity was significantly associated with female gender (p=0.001), higher mean age (p=0.001), and higher mean weight (p<0.001). Absence of HBV vaccination (p<0.001), history of hospitalization (45.6% vs. 30.5%; p=0.046), injections (19.3% vs. 8.4%; p=0.033), blood transfusions (31.6% vs. 9.9%; p<0.001), family history of HBV (p=0.015), maternal HBV positivity (p<0.001), and body piercing (33.3% vs. 13.0%; p=0.001) were significantly associated with HBsAg positivity. Conclusion: The frequency of HBsAg positivity among children undergoing surgical procedures was high. Key risk factors associated with HBV seropositivity included absence of vaccination, maternal HBV positivity, family history of HBV, blood transfusions, hospital admissions, and body piercing.

Severity, complications and outcome of meconium aspiration syndrome in neonates.

2024-11-13T06:06:58-08:00

Objective: To determine the severity, complications, and outcomes of meconium aspiration syndrome (MAS) in neonates. Study Design: Cross-sectional study. Setting: Neonatal Intensive Care Unit (NICU) of the National Institute of Child Health, Karachi, Pakistan. Period: January 2024 to June 2024. Methods: Neonates aged 1-28 days of either gender, and having MAS were analyzed. Vital signs were noted and necessary laboratory investigations were done. Presenting clinical features and associated complications of MAS were noted. Outcome was noted in the form of discharged, admitted to pediatric unit, or mortality. Results: In a total of 92 neonates, 66 (71.7%) were male. The mean age was 12.47±6.55 days. Evaluation of MAS severity revealed mild, moderate, and severe cases among 2 (2.2%), 16 (17.4%), and 74 (80.4%) neonates, respectively. The most frequently noted complications were sepsis 65 (70.7%), hyperinflated lungs 55 (59.8%), respiratory distress 34 (37.0%), and pulmonary hypertension 31 (33.7%), were the most commonly associated complications of MAS. Two neonates left against medical advice so those were excluded from the final outcome analysis. In the remaining 90 neonates, mortality was reported in 6 (6.7%). Mortality had significant association with bluish skin at presentation (p=0.044), severe MAS (p=0.001), and pulmonary hypertension (p=0.001). Conclusion: Vast majority of the neonates (80.4%) presented with severe MAS which should raise alarm about the time identification of these high risk neonates. The most frequently noted MAS associated complications were sepsis, hyperinflated lungs, respiratory distress, and pulmonary hypertension. At presentation, bluish skin, pulmonary hypertension, and severe MAS were significantly associated with mortality.

Etiological profile of precocious puberty in children at a Tertiary Care Hospital.

2024-11-19T04:56:19-08:00

Objective: To determine the etiological profile of precocious puberty in children. Study Design: Cross-sectional study. Setting: Department of Endocrinology, National Institute of Child Health, Karachi, Pakistan. Period: October 2023 to September 2024. Methods: Children of either gender, girls aged below 8 years, boys below < 9 years, and newly diagnosed cases of precocious puberty were analyzed. At the time of enrollment, demographic and clinical features were documented. Radiological and hormonal profiling were performed for the confirmation of etiology and type of precocious puberty. Results: In a total of 48 children, 23 (47.9%) were boys, and 25 (52.1%) girls. The mean age was 5.72±1.78 years. The most frequent clinical features were rapid height growth, adult body odor, and breast enlargement, noted in 48 (100%), 42 (87.5%), and 25 (52.1%) cases, respectively. Precocious puberty type was central, and peripheral among 25 (52.1%), and 23 (47.9%) children, respectively. Among central precocious puberty cases (n=25), the evaluation of etiology revealed that idiopathic in 17 (68.0%) children, hypothalamic hemartoma 3 (12.0%), mitochondrial encephalopathy 2 (8.0%), craniopharyngioma 2 (8.0%), and arachnoid cyst 1 (4.0%). Among 23 peripheral puberty cases, congenital adrenal hyperplasia was identified in 18 (78.3%) children, adrenocorticol carcinoma 2 (8.7%), ovarian teratoma 2 (8.7%), and Mccune-Albright syndrome in 1 (4.3%). Conclusion: Idiopathic central precocious puberty and congenital adrenal hyperplasia emerged as the most common causes of central and peripheral precocious puberty, respectively.

Frequency of positive antenatal scans in neonates with congenital diaphragmatic hernia admitted in NICU of tertiary care hospital.

2024-11-04T05:10:45-08:00

Objective: To determine the frequency of positive prenatal scans in newborns with CDH admitted to a tertiary care hospital, we designed the current study. Study Design: Cross-sectional study. Setting: Neonatal Care Intensive Unit of NICH. Period: March to October 2024. Methods: Neonates admitted with confirmed diagnosis of CDH were included in this study. Neonates born with multiple gestation (like twin or triplet) were excluded from this study. Gestational age at diagnosis, baby age and gender, birth weight and laterality of CDH were noted and documented in a pre-designed proforma. Results: Total 40 patients were included into the study. Mean gestational age was 37.5±2.8 weeks. Majority patients were males (56%). Mean birth weight was 25.3 ± 1.6 grams. Out of 40 patients, 22.5% patients were prenatally identified to have CDH. None of the patients’ features were significantly different among those who were prenatally and post-natally diagnosed for CDH. Conclusion: The present study found that prenatal diagnosis rate of CDH in our settings is low. We should focus on advanced techniques and improving our skills for increasing prenatal diagnosis rate which will be help for parental counselling and planning the management for safe neonatal outcomes.

Quality of life in transfusion dependent thalassemia patients at national institute of child health.

2024-12-03T04:49:36-08:00

Objective: To determine the quality of life of children suffering from transfusion dependent thalassemia. Study Design: Case-control study. Setting: Department of Pediatrics, National Institute of Child Health, Karachi, Pakistan. Period: March 2024 to August 2024. Methods: Children of either gender, aged between 6 months to 14 years, and having transfusion dependent thalassemia were included as cases (n=95). For controls (n=95), healthy volunteers without chronic disease, matched in terms of gender and age were included. At the time of enrollment, demographical data like age, gender, height, and weight were noted. Relevant laboratory investigations were performed and evaluated. Children of both groups along with their parents were interviewed about quality of life administering WHOQOL-BREF questionnaire. Results: In a total of 190 children (95 children in each group), 104 (54.7%) were male and 86 (45.3%) female. Physical health scores were 35.62±6.68 in children with transfusion dependent thalassemia vs. 74.92±7.92 in controls (p<0.001). Psychological health scores were 38.16±8.12 vs. 76.68±6.66 (p<0.001) among transfusion dependent thalassemia children versus controls, respectively. Social relationships were 41.19±6.14 vs. 77.50±7.01 (p<0.001) among transfusion dependent thalassemia children versus controls, respectively. Environmental scores were 43.51±6.93 vs. 71.59±6.06 (p<0.001), among transfusion dependent thalassemia children versus controls, respectively. Conclusion: Our study highlights the significant negative impact of transfusion-dependent thalassemia on the quality of life of affected children across all domains of the WHOQOL-BREF questionnaire.

Prevalence of subclinical hypothyroidism in local adult obese population.

2024-07-25T07:39:41-07:00

Objective: To find out the frequency of subclinical hypothyroidism (SCH) in local adult obese population and to determine the risk of cardiovascular events in patients with SCH using the 10-year Atherosclerotic Cardiovascular Disease (ASCVD) risk calculator. Study Design: Cross Sectional & Descriptive study design. Setting: Medicine Ward, PAF Hospital, Islamabad. Period: 20^th July 2023 to 20^th January 2024. Methods: A total of 200 patients of both gender with Body Mass Index (BMI) greater than 28kg/m² were included in the study. Blood samples were Collected from all patients and sent to the hospital laboratory for performing thyroid function tests and fasting lipid profile. Patients found to have SCH (TSH levels more than reference range with normal T3 and T4 levels) had their ten-year risk of cardiovascular events determined using the ASCVD Risk Calculator. A calculated 10 year ASCVD risk of ≥7.5% was concluded significant. Results: Age range in this study was from 20 to 65 years with mean age of 43.295±8.85 years, mean BMI 30.960±1.53 Kg/m², mean TSH 2.904±1.29 mIU/L (normal range 0.27 to 4.2 mIU/ml), mean T3 103.230±6.86 ng/dL (normal range 94 to 170 ng/dL) and mean T4 was 10.092±1.26 μg/dL (normal range 5 to 11 μg/dL). Subclinical hypothyroidism was observed in 16% patients. Amongst these patients, increased cardiovascular event risk was present in 25% patients. Conclusion: Our study has concluded a high prevalence of subclinical hypothyroidism among obese adult patients and increased risk of cardiovascular events in patients with SCH.

Interplay between diabetes mellitus and salivary gland changes with their clinical implications.

2024-11-12T06:27:32-08:00

Objective: Evaluate Clinical Implications of Diabetes Mellitus. Find out the correlation between salivary changes with oral changes. Study Design: Cross-sectional study. Setting: Dental OPDs of BU and JSMU. Period: January 2023 to January 2024. Methods: with sample size of 44 collected through convenience sampling. Data was collected of patients fulfilling the inclusion criteria of diagnosed and under treatment for Diabetes Mellitus, through a performa specially designed for collection of data of the study. Results: Data of 44 patients was included in the study. Out of 44, 8 patients reported with Sialorrhea, 32 with hyposalivation and 4 without any problems. The mean DMFT score was 4.27±0.87. The most common complaint was that of altered taste reported by 4 patients. Correlation test was performed and resulted in showing positive correlation of hyposalivation with dry mouth and altered taste at the level of 0.001 while negative correlation was observed between hypersalivation and dry mouth at the level of 0.05. Conclusion: The results are suggestive of constant monitoring of known cases by dentists every 6 months to help them maintain their oral health and improve their quality of life.

Comparison of outcome of fracture shaft of humerus treated conservatively with a functional brace versus open reduction and internal fixation.

2024-11-19T02:26:31-08:00

Objective: To determine the frequency of non-union with functional brace versus operative techniques using open reduction and internal fixation in managing mid-shaft humerus fracture. Study Design: Randomized Controlled Trial. Setting: Department of Orthopedics and Traumatology, Lady Reading Hospital Peshawar. Period: 20^th July 2023 to 20^th January 2024. Methods: A total of 156 patients of both genders with mid-shaft humerus fractures were included in the study. Patients in group A were treated surgically. In group B patients were treated non-operatively. At the end of 12 weeks frequency of union/malunion was noted in both groups. Results: The age range in this study was from 18 to 60 years with a mean age of 39.666±12.78 years in Group A and a mean age of 42.423±10.66 years in Group B. Male gender was dominant in both groups (76.9% and 71.8%). Nonunion was observed in 2 (2.6%) patients in group A as compared to 15 (19.2%) patients in group B (P= 0.001). Conclusion: In conclusion, our study emphasizes that surgical intervention using ORIF is more effective than non-operative management.

Functional outcomes, of open reduction and internal fixation of danis-weber type b ankle fractures.

2024-09-23T07:19:21-07:00

Objective: To evaluate the functional outcomes, of open reduction and internal fixation of Danis-Weber Type B Ankle Fractures in adults. Study Design: Descriptive Cross sectional Study. Setting: Surgical Department of a Medical Facility. Period: January 2023 to November 2023. Methods: In all, 152 participants were examined in this study. The OMAS score and Visual Analogue Score were used to categorize the functional results (VAS). Documentation was also done on the age distribution, gender distribution, and kind of trauma. Regarding the length of the fracture, functional outcomes were stratified, and statistical analysis was used to ascertain significance. Results: Out of 152 patients, 63.15% were male and 36.84% was female. The mean age of the patients was 47.57±8.5 years. Out of the 152 patients, 69 (45.39%) patients had an excellent functional outcome, 24 (15.78%) patients had a good outcome, 44 (28.94%) patients had fair outcome, and 15 (9.86%) patients had poor outcome. Falls from height were responsible for 42 (27.63) cases of fractures, while road traffic accidents (RTA) accounted for 110 (72.36%) of them. There were no appreciable variations in functional results when stratification based on fracture duration was applied. Conclusion: Our research results demonstrated that open reduction and internal fixation (ORIF) is an efficacious method in the treatment of Danis-Weber Type B ankle fractures. Most patients treated with ORIF achieved excellent to good functional performance, indicating remarkable regained range of motion and joint stability. This surgical technique provides an opportunity to bring all the fractured bone segments to their desired anatomical positions to promote healing, thus avoiding the risks of malunion or chronic instability. In addition, the results also indicate that ORIF is aimed at restoring normal function and additionally promotes early mobilization of patients which in turn improves their post-surgical outcomes. These findings emphasize that ORIF is effective and the treatment of choice for this category of ankle fractures and it gives very good results in restoring optimal function.

Early Outcomes of Repeat Cardiac Surgery at a Newly Established Cardiac Center in a Developing Country

2024-11-13T06:02:31-08:00

Objective: The primary objective of this study is to evaluate the early clinical outcomes of repeat cardiac surgery performed at a newly established cardiac center in a developing country.

Study Design: This is prospective observational cohort study setting: This study was performed between January 2021 and July 2024 at cardiac surgery department of Peshawar Institute of Cardiology. Methods: A total of 25 consecutive patients aged 18 years or older who had any previous cardiac surgery with and without the use of cardiopulmonary bypass were included. Elective, urgent, emergent, and salvage cases were all there. Patients who had incomplete records were excluded. Our study utilized SPSS (Statistical Program of Social Science) version 20 for analysis of our dataset

Results: The average cardiopulmonary bypass (CPB) time was 193.48 minutes (±72.8), while the average duration of aortic clamp time was 136.20 minutes (±73.6). Regarding complications, 16% of patients (n=4) required re-intubation, 12% (n=3) needed re-exploration, 16% (n=4) experienced renal failure, and 4% (n=1) suffered a stroke. Additionally, 16% of patients (n=4) were readmitted, and 4% (n=1) died within 30 days following surgery.

Conclusion: This study showed that new cardiac centers are safe for commencing complex cases like repeat cardiac surgeries with comparable results to other established centers.

Incidence of eclampsia in low socio economic class.

2024-08-05T04:28:36-07:00

Objective: To find out if there is a relationship among the expectant mother's ‘socioeconomic position’ and eclampsia, and evaluate if various ‘socioeconomic levels’ have an impact on the progression or seriousness of eclampsia. Study Design: Cross-sectional Research study. Setting: Health Net Hospital, Peshawar. Period: Jan 2024 to July 2024. Methods: The Sample size were 147 determined with a ‘95% Confidence Level’ (CL) using the ‘G Power Programme’. There are four parts to the investigation. The data was collected through a structured questionnaire that included questions about ‘individual’, ‘medical’, ‘obstetrical’, ‘clinical examinations’ for the identification of eclampsia, laboratory tests to verify the finding, and ‘socioeconomic status’ details created using the updated ‘Fahmy and El-Sherbini scale 2012’, which consists of ‘seven domains’. Results: There was a ‘significant statistical relationship between the severity of eclampsia and bronchial asthma’ (p=0.029), but there was ‘no significant statistical difference between the severity of eclampsia and maternal age’ (p=0.980), obstetric history, previous history of eclampsia (p=0.086), or other medical conditions like ‘essential hypertension’ (p=0.456) and ‘diabetes mellitus’ (p=0.427). Additionally, there is a ‘statistically significant correlation between the severity of eclampsia and family possessions’ (p=0.032), ‘education level’ (p=0.035), home cleanliness (p=0.025), and financial situation (p=0.041). However, ‘there is no statistically significant correlation between the severity of eclampsia and the family’, health care, or occupation domains (p=0.222, p=0.272, and p=0.328). Conclusion: Academic level, familial goods, house hygiene, and economic standing are all associated with the severity of eclampsia and socioeconomic position. The suggestion is: Pregnant women should be educated about potential risk factors of eclampsia, and workers should be educated about the same. Prenatal care for pregnant mothers in Pakistan should also be improved, and the health of families with low incomes should be improved. This will lower the risk of eclampsia and aid the initial determination, which will lower mortality among mothers and babies.

Preterm births and their associated clinical outcomes in a Tertiary Care Hospital in Lahore.

2024-11-19T05:11:55-08:00

Objective: To assess the frequency of preterm births and their associated clinical outcomes in a tertiary care hospital in Lahore, Pakistan. Study Design: Prospective Observational study. Setting: Tertiary Care Hospital, Lahore. Period: Feb, 2024 to July 2024. Methods: The study included 219 preterm neonates delivered before 37 weeks of gestation. Data were collected on maternal complications, gestational age, birth weight, mode of delivery, APGAR scores, neonatal morbidities, and survival outcomes. Statistical analyses were performed to identify associations between maternal and neonatal factors and clinical outcomes. Significance was set at p < 0.05. Results: Of the 219 preterm neonates, 74.7% were delivered between 33–36 weeks, and 57.1% had a birth weight between 1.5–2.49 kg. The most common maternal complications were hypertension (41.7%) and premature rupture of membranes (34.8%). Neonatal jaundice (58.5%), respiratory distress syndrome (57.1%), and probable sepsis (55.3%) were the prevalent morbidities. Overall, 88% of neonates were discharged home. Survival outcomes were significantly associated with gestational age, birth weight, APGAR scores, feeding initiation, cesarean section, and hypothermia at presentation (p < 0.05). Conclusion: The prevalence of prematurity and associated morbidities was high. Early identification of maternal risk factors and adequate management of preterm neonates significantly improved survival. Enhancing maternal and neonatal care in resource-limited settings is essential to reducing neonatal mortality and morbidity.

Patients’ preference and acceptance towards surgical vs nonsurgical modalities of accelerated orthodontic treatment.

2024-11-29T04:56:08-08:00

Objective: To determine patients' preferences toward accelerated orthodontic treatment modalities and evaluate factors that influence the choice of acceleration technique. Study Design: Cross-Sectional Survey. Setting: Department of Orthodontic A Private Dental University. Period: September 2024 to October 2024. Methods: Data was collected after the ethical approval of the study. Participants were provided informed consent before the study began. Adult patients seeking orthodontic treatment were requested to complete a questionnaire that included questions on age, gender, level of education, and basic questions about orthodontic therapy. The questions were relevant to modalities of rapid orthodontics treatment. Before answering questions on the modalities, participants were provided a brief description of the clinical process and images of a real procedure. The orthodontist conducted the description and photography sessions. Result: The median age reported is 20 years (IQR: 3) with 59.6% female and 40.4% males in the sample. Most participants were matric/intermediate qualified (65.5%), while 17.5% were undergraduates and 17% were graduates. A majority (86.4%) preferred non-surgical procedures aimed at being anxiety-free (38.1%). Participants choosing surgical procedures primarily did so to reduce treatment time and achieve faster outcomes. A statistically significant effect was found in opinion about time reduction if accelerated orthodontic surgical or non-surgical treatment modalities are applied (p-value <0.001). Conclusion: The study concluded that non-surgical approaches to accelerate tooth movement are frequently considered by adult orthodontic patients.

Comparison of peer assisted learning versus conventional teaching system among undergraduate Medical students in term of knowledge, skill and attitude.

2024-12-16T05:10:16-08:00

Objective: To compare the effectiveness of peer assisted learning versus conventional learning among the undergraduate students of a medical college in term of knowledge, skill and attitude. Study Design: Descriptive study. Setting: Department of Physiology Shaheed Mohtarma Benazir Bhutto Medical College Lyari. Period: 23 September to 04 November 2024. Methods: Non probability sampling technique was used to divide the group of 100 students from First year MBBS into two equal groups. One group ‘A’ of fifty students selected for Peer learning and the other group ‘B’ of fifty students selected for conventional learning through faculty teaching. Topic of ECG was selected, which included, knowledge about ECG and performance of electrocardiography on the subject. Formative assessments of both the sub groups were taken through BCQs, SEQs and OSPEs. Results: There was no significant difference (P≥ 0.05) in knowledge score, whereas significant difference was found in test scores of skill and attitude of PAL versus CT (P ≤ 0.01). Conclusion: Based on the findings of the current study, it can be concluded that both PAL and CT groups were found to be equally effective in improving knowledge, but PAL can be included in a curriculum to improve the skills and attitude of First year MBBS students regarding ECG.

Dorsal lumbotomy approach for paediatric pyeloplasty.

2024-11-11T03:59:27-08:00

Objective: To assess the outcomes of dorsal lumbotomy approach for paediatric pyeloplasty in terms of duration of surgery, blood loss, hospital stay and postoperative complications. Study Design: Retrospective Review. Setting: Children Hospital, Faisalabad. Period: Aug 2021 to July 2024. Methods: The patients presented with hydronephrosis and followed by confirmed case of pelviureteric junction obstruction with DTPA renal scan, were operated in last five years with this surgical approach were reviewed retrospectively, n=126 cases. Pelviureteric junction was corrected with dismembered pyeloplasty using dorsal incision vertically named dorsal lumbotomy incision. DJ stent was placed in every case of pyeloplasty which was removed cystoscopically after 6 weeks of procedure. Results: There was total 126 patients, 82 patients were males and 44 patients were females. The mean age of patients at the time of surgery was 4.56±2.16 years. Mean duration of surgery was 52.60±8.27 minutes. Mean blood loss was 42.7 milliliters. Mean hospital stay was 3.46±1.38 days. Superficial wound infection was documented in 13 (10.3%) patients, spontaneous expulsion of DJ stent through urethra in 3 (2.4%) patients, ureterovasical junction obstruction (UVJO) was found in 6 (4.8%), incisional hernias were documented only in only 3(2.4%) patients. Cosmetic acceptance by the patients/parents of this incision was documented in 119 (94.4%) cases. After 24-month follow-up there was observed evidence of clinical and radiological improvement in 120(95.2%) patients. Conclusion: Dorsal lumbotomy approach for pediatric pyeloplasty is a safe technique for boys and girls. Post-operative morbidity, wound infection and seroma formation all are low in dorsal lumbotomy approach.

Early interruption of left pulmonary artery: A rare cause of repeated chest infections.

2024-10-02T06:34:22-07:00

To highlight the presence of pulmonary artery interruption as an important cause for investigating repeated chest infections.
To emphasize on the fundamental role of CT chest in the diagnosis.
To manifest the importance of conveying this rare cause of repeated chest infection to the treating team.