ISSN(Print) 2076-2860 ISSN(Online) 2958-5945 Email: Editorial@jaimc.org Phone: +924299231453 PMDC & UHS (IP-0043)
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Distinguished Reviewer of Current Issue
MBBS, FCPS
Associate professor of Surgery
Sharif medical and dental college/ Sharif medical city, Lahore
OJS Guide Manuscript Submission
CURRENT ISSUE
VOL. 22, ISSUE NO. 2
EDITORIAL
The Pattern of Over-the-Counter Medicines Dispensed in Pakistan
Ali Raza, Shazia Tufail, Zarabia Pervaiz
https://doi.org/10.59058/15661p77
ORIGINAL ARTICLES
Antibiotic Resistance Patterns of Escherichia Coli in Urinary Tract Infections at a Tertiary Care Hospital in Mughalpura, Lahore
Amina Asghar, Saadia Ijaz, Mariam Danish Iqbal, Muhammad Masood Afzal, Asma Ejaz
ABSTRACT
https://doi.org/10.59058/5zw83274
Background and objective: As a chronic nosocomial and community-acquired infections, Escherichia coli (E. coli) has become a major global health concern. Finding the pattern of antibiotic susceptibility in Escherichia coli isolated from urine specimens was the aim of the current study.
Methods: It was descriptive Cross-Sectional study conducted at Shalamar Teaching Hospital in Lahore in the Micro-biology section of the Pathology Department from June 1st, 2020 to November 30th, 2020. Patients exhibiting symptoms and indications of urinary tract infections (UTIs) had urine samples taken. The samples were processed on the Cystine Lysine Electrolyte-Deficient (CLED) Agar and identified as E. coli by biochemical profile. Antibiogram of E. coli was determined by Kirby-Bauer method.
Results: A total of 165 E. coli isolates were available for analysis.. Among the tested antibiotics, Colistin exhibited the highest sensitivity of 164(99.4%), followed by Fosfomycin 156(94.5%), Imipenem 153 (92.7%), and Meropenem 150(90.9%). Nitrofurantoin demonstrated a sensitivity of 141(85.5%), while Gentamicin had a sensitivity of 110(66.7%). Piperacillin/Tazobactam, Cotrimoxazole, Ceftriaxone and Cefotaxime, Ciprofloxacin, Cefuroxime, Amoxicillin-Clavulanic Acid, and Ampicillin exhibited sensitivities of 60(36.4%), 31(18.8%), 28(17.0%), 28(17.0%), 24(14.5%), 13 (7.9%), 11( 6.7%), and
3(1.8%), respectively. Notably, E. coli was isolated more frequently from female patients (72.7%) than from male patients (27.3%).
Conclusion: Current study revealed that antibiotic resistance is emerging in E coli. However, Colistin, Fosfomycin, Imipenem, Meropenem, and Nitrofurantoin are the most effective drugs and, depending on the clinical situation, can be chosen empirically for the treatment of UTI caused by E. coli.
Key words: Urinary tract infections, E. Coli, Sensitivity pattern.
Frequency of Coronary Artery Ectasia as a Cause of Acute Coronary Syndrome in Patients Presenting in Jinnah Hospital Lahore
Madiha Ilyas, Noor Dastgir, Ahmad Muqeet, Inam ur Rehman, Laila Afzal, Amna Iqbal Butt
https://doi.org/10.59058/7pq51p14
ABSTRACT
Background and Objective: In coronary artery ectasia (CAE), coronary angiography reveals a distinctive diffuse dilatation of the coronary arteries. Ectasia due to congenital or acquired reasons results in endothelial dysfunction leading to a turbulent and sluggish blood flow across the affected vessels. As a result, coronary thrombosis or micro emboli occlude the vessels and patients may present with signs and symptoms of the acute coronary syndrome. The objective of this study was to observe the frequency of CAE on coronary angiography among patients presenting with Acute Coronary Syndrome to the cardiology department of Jinnah Hospital, Lahore.
Methods: This cross-sectional study was performed in Jinnah Hospital, Lahore from July 2021 to December 2021. After IRB approval and informed consent, using non-probability consecutive sampling technique, 966 patients who underwent coronary angiography after clinical confirmation of ACS were included in the study. A semi-structured Performa was used to record the data depicting the clinical presentation, presence or absence of CAE, and socio-demographic variables. The data were transferred to SPSS 21 for analysis purposes.
Results: Out of 966 patients who presented with ACS to the cardiology department of Jinnah Hospital, Lahore, only 0.92% had CAE on coronary angiography. The age groups of the participants had a statistically significant association with their CAE status (p < 0.05).
Conclusion: CAE was rarely found on coronary angiography among patients who presented with ACS in the cardiology department of Jinnah Hospital, Lahore.
Keywords: Coronary angiography, Myocardial infarction, Coronary vessels.
Understanding Motorcycle Accident Injuries: Patterns Observed at a Tertiary Care Hospital Of Swat
Muzammil Ahmad Shah, Sajid Akhtar, Ihsanullah, Saiyad Ali, Ahmad Gul,Shah Faisal, Shafqat Hussain
https://doi.org/10.59058/m5af9m30
ABSTRACT
Background and objectives: Road Traffic accidents (RTA) are the leading cause of death and disability worldwide, with approximately 3,500 deaths occurring on roads every day and tens millions injured or disabled each year. If current trends continue, road crashes are predicted to become the fifth leading cause of death by 2030.The study aims to evaluate the patterns of injuries in patient presenting with motorcycle accident injuries in emergency department.
Methods: It was a cross-sectional study conducted at department of trauma and Orthopedic emergency unit Saidu Group of Teaching Hospital Swat (SGTH) from February 15th, 2023 to February 14th,2024. After obtaining informed consent, 376 patients of both gender presenting with road traffic accidents due to motorcycle were included in the study through consecutive sampling. Data were collected on a structured proforma and analyzed using SPSS-26.
Results: Out of 376 patients, the most common fractures were Tibial Shaft Fracture 69 (18.4%) of patients, followed by Distal Femur Fracture in 48 (12.8%), Tibial Fracture in 43 cases (11.4%) and Distal Tibial Fracture in 33 cases (8.8%). Additionally, it was found that 52 patients (13.8%) presented with spinal, head, and neck injuries, with the majority (46 out of 52) not using protective helmets while driving. Management strategies included closed reduction with back slab support for 162 patients (43.1%), open reduction and internal fixation for 119 patients (31.6%), emergency fasciotomy for 38 patients (10.1%), and amputation for 5 patients (1.3%) to prevent further complications. About 52 patients (13.8%) suffered head and neck and spine injuries and were referred to neurosurgical department.,
Conclusion: motorcycle accidents can cause a range of Injuries, from minor bruises to fatal head injuries. Understanding pattern of injuries and emergency management in victims of motor cycle accidents will able trauma team to preplan the resources accordingly based on evidence which will help them in better management of different injuries.
Key Words: Trauma, Fracture, Closed reduction and back slab support, open reduction and internal fixation, Fasciotomy, Amputation.
A Comparative Assessment Between Gel Card and Conventional Tube Method for Blood Cross Matching at Blood Bank of Tertiary Care Hospital Lahore
Naureen Saeed, Asma Akhtar, Hafiza Fakhra, Ahsen Muzaffar, Zunairah Mughal, Tariq Mahmud Tariq
https://doi.org/10.59058/cpjqce94
ABSTRACT
Background and Objective: Blood grouping and Cross match is a critical procedure in blood banks with significant implications for patient safety during blood transfusions. Cross match plays a pivotal role in safeguarding patients undergoing blood transfusions, ensuring that the transfused blood is compatible, and minimizing the risk of adverse reactions. The Gel card technique, a recent innovation in blood bank practices, is distinguished by its exceptional sensitivity and accuracy in delivering results. The aim of this study was to compare the sensitivity and specificity of the Gel card technique with the traditional saline tube method in the context of blood bank cross matching.
Methods: A cross sectional study was performed at blood bank of Shalamar Hospital Lahore from January 2021 to June 2021. Cross match of 500 samples was performed using both the traditional tube method and the advanced gel card technique. Data were entered in SPSS and the results of both tests were compared.
Results: In this study, 500 blood samples from patients were analyzed. The frequency distribution among males and females showed 42.6% (n=213) and 57.4% (n=287), respectively. ABO blood group distribution revealed B-positive in 38% (n=190), O-positive in 24% (n=120), A-positive in 20% (n=100), AB-positive in 7.6% (n=38), and B-negative in 1.8% (n=09), A -negative in 1.2% (n=06) and O-negative in 7.4% (n=37)of the blood samples submitted to blood bank for cross match . During the cross-match procedure using both Conventional Tube Test (CTT) and gel card technique, 497 recipient samples were found compatible with the donor, while 3 samples were incompatible with the recipient sample. Both the manual cross-match technique (CTT) and the gel card cross-match technique demonstrated 100% sensitivity and 100% specificity, indicating perfect concordance in correctly identifying all compatible and incompatible cases
Conclusion: The Conventional Tube method for cross-match is comparable to the gel card technique in terms of sensitivity and specificity while performing pre transfusion testing in blood bank .However, Conventional Tube testing is economical and can still be utilized in low-budget; resource-limited laboratories with good results, provided performers are trained and skilled.
Keyword: Gel card technology, Conventional tube technique, Blood grouping and Cross match, Blood transfusion
Perceptions & Self-efficacy in Faculty of a Public Sector Medical College on Integrated Versus Conventional Teaching
Abdullah Mian, Ayesha Shahid, Tayyaba Muzaffar, Rakia Fawad, Amina Sharmeen, Javaid Iqbal
https://doi.org/10.59058/f3159w79
ABSTRACT
Background Objectives: The landscape of medical education is evolving, with a shift from conventional to integrated learning. However, the perceptions of teaching faculty towards these pedagogical approaches remain underexplored. This study aims to understand the preferences of the teaching faculty at Sheikh Zayed Medical College towards conventional and integrated learning methods and the reasons behind their preferences.
Methods: A cross-sectional survey study was conducted to gather data on faculty preferences. An online survey was disseminated to the teaching faculty of Sheikh Zayed Medical College, Lahore encompassing 7 basic and 10 clinical departments, and comprising 70 members. In addition to this, the 'Teachers' Sense of Self-Efficacy Scale' was utilized to assess the teachers' self-confidence levels.
Results: The response rate of the survey was 52.85% (37 participants). Despite the study's limitations, the teaching faculty generally expressed a positive outlook towards integrated learning. Sociodemographic factors that were significantly associated with teaching preference included gender (p<0.000) and qualification levels (p<0.001). Of the 35% males, 11 out of 13 preferred integrated teaching. Of the 46% MBBS only degree holders, 13 out of 17 preferred integrated teaching. A significant correlation was found between the self-efficacy scores and the faculty's previous exposure to integrated learning (p=0.027).
Conclusion: This study finds multiple advantages of integrated learning for medical students. However, careful planning, better interdepartmental communication, and consideration of student workload are necessary for successful implementation. Notably, faculty members who are exposed to the integrated system early on seem to have higher levels of self-efficacy.
Key words: Integrated Curriculum, Conventional, Teaching methods, Medical, Self efficacy, perception
The Correlation of Serum Troponin Levels with Age and Gender in Healthy Individuals
Ambereen Anwar, Sadaf Farzand, Shaista Mariam, Saima Mansoor Bugvi
https://doi.org/10.59058/77rmgg75
ABSTRACT
Background and Objectives: Cardiac Troponin (cTn) values play a pivotal role in the diagnosis of ischemic heart disease (IHD). The advent of high sensitivity assays of both cTnI and cTnT have revolutionized the way IHD is diagnosed and managed. These high sensitivity assays have also highlighted some hitherto unknown features of cTns. It is being suggested that healthy individuals have different values depending on their gender and age. This study was planned to study these differences in a healthy population.
Methods: A total of 700 apparently healthy individuals, 350 males and 350 females were included in the study. Their ages were also noted. Their cTnI values were recorded and analyzed to find the effect of age and gender on their cTnI levels. cTn I hs was detected on immunoassay analyser Siemens Atellica® Solution IM 1300 Analyzer, USA. The cut off for normal was taken at 45.2 pg/ml as per the company's manual.
Results: Males had mean=9.39+8.6 cTnI values and females had mean=6.57+5.66.There was a statistically significant difference in cTnI levels between males and females (p-value < 0.0001) with male subjects showing higher levels. Increasing age had a positive correlation with cTnI levels in both genders but it was not statistically significant (correlation coefficient, r, 0.178 for males and 0.246 for females).
Conclusion: The reference ranges for cTn values should be separately defined for males and females. Increasing age may have an influence on the diagnostic performance of cTns.These factors should be taken into consideration so that decision for each patient is individualized instead of assuming that the binary threshold criteria is set in stone.
Keywords: Cardiac troponin, ischemic heart disease, reference range, age, gender
CASE REPORT
Umbilical Discharge due to an Intrauterine Contraceptive Device (IUCD): A Case Report of a Rare Cause in an Adult Woman
Faryal Azhar, Muhammad Mustafa Banoori, Momina Nouman, Fatima Afaq Banoori
ABSTRACT
A 38-year-old female presented to the outpatient department for spontaneous umbilical discharge for the past 1 year. She reported mild periumbilical pain but there were no other abdominal or urinary symptoms. Patient was afebrile. Abdominal examination was unremarkable. A sinogram was attempted but we were unable to cannulate the sinus. After surgical exploration of the umbilicus, a T shaped copper device was discovered which was removed followed by an unremarkable recovery.
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