ISSN(Print) 2076-2860 ISSN(Online) 2958-5945 Email: Editorial@jaimc.org Phone: +924299231453 PMDC & UHS (IP-0043)
CURRENT ISSUE
EDITORIAL
Naegleria Fowleri is Eating Brains of Our People: Are we Aware of That?
Shahid Mahmood Sethi, Muhammad Arslan Tariq
https://doi.org/10.59058/jaimc.v21i2.169
ORIGINAL ARTICLES
Health Care Seeking and Infertility: A Cross Sectional Comparative Study Amongst Females of Dyal Village Lahore
Rozina Shahadat Khan, Samina Waseem, Romaisa Siddique, Rohma Saqib, Hafiz Umar Farooq
https://doi.org/10.59058/jaimc.v21i2.129
ABSTRACT
Background: Female infertility ends up in long term health implications especially in Pakistan where combined family ëystem and=social set-up pressurizes the newlywed couples for child bearing age. But proper diagnosis and effective management is only possible through health care seeking. Objective: To assess the actual magnitude of different types of infertility and its associated health care seeking amongst females of Dyal Village Lahore. Methods: This cross sectional comparative study was conducted in rural female population of Dyal Village Lahore. The sample size was118 and data collection was done through Simple Random Sampling. Data was gathered using Personal Self-Concept Questionnaire containing information related to socio demographic, economic, female medical, family , gynecological and Health Care seeking history. Results: Out of 118 only 42 (35.59%) had Primary infertility. only 24.58% had Menorrhagia, 40.68% had Oligomenorrhea and 22.88% experienced Dysmenorrhea. Only 7% reported male factor. Majority females had ovulatory problems (38.3 %) and 11.8 % with=tubal blockage 9.7 % reported uterine problems. Only 68(57.63%) visited hospitals, 67 (56.78%) sought medical treatment and 48(40.68 %) had both medical and surgical interventions. Surprisingly 29(24.58%) Üad received Instrumentation and medication by Dai and 10 (8.47) had medic~tion following relatives advice. Study has also shown a significant relation with higher educational and economical status. Conclusion: The higher Primary infertility levels and trends of seeking health care services other than professional experts especially from Dai is alarming. Future research study can be focused for determining the predictors of such health care services for infertility.
Feeding Practices in Children Aged Less than 3 years and its Relevant Knowledge Among Young Mothers
Samina Waseem, Rozina Shahadat Khan, Saba Sharif
https://doi.org/10.59058/jaimc.v21i2.130
ABSTRACT
Background & Objectives: It is highly important for the parents to be aware of the proper feeding practices so that their children can have better health condition and immunity. In this aspect, regular assessment is must regarding the awareness of the parents so that necessary interventions can be done viz-a-viz healthy feeding practices. The objective of this study is to assess the feeding practices being currently undertaken by the parents of children less than three year age in some rural and urban localities of Rahimyar Khan. Methods: Cross Sectional survey of 213 young mothers less than 35 years of age having at least one child of age below 3 years, who presented at Pediatrics outdoor indoor, Gynecology outdoor indoor and Vaccination center of Sheikh Zayed Hospital Rahimyar Khan, were selected through Convenient Sampling. Data were collected througha self-administeredquestionnaire&analyzedthrough a software SPSS. Results: This Cross Sectional survey was conducted amongst 213 Mothers Knowledge related to feeding practices of their children of less than 3 years of age has shown that 140(65.7%) mothers were Exclusively Breast Feeding their children and 130(61.0%) considered using Cow's milk instead of formula Milk. 102 (47.9 %) introduced solid food to their child at 6 months. Majority 119 (55.87%) were not aware of any food allergies or intolerances in their children and majority 91 (42.7%) believes in normal ways followed by 63 (29.6%) who use rewards to ensure their child takes meal. Another important finding is that 180 (84.5%) were allowing their child consume processed or fast food while 22 (10.3 %) were consuming it on daily basis while 114 (53.5 %) were not aware of the appropriate portion sizes for child's age and 158 (74.2%) were offering sugary snacks or desserts to the child. Conclusion: Initiation of breast feeding within one hour has shown improvement but still 40 % not knowing this basic knowledge. Moreover on one hand 80% were practicing addition of variety of protein sources and almost 100% believed in fruit consumption but at the same time more than 50% were not having idea of the portion size and almost 100% were allowing Processed or fast food consumption. These statistics emphasize comprehensive educational programs for the mothers. Future research can be focused on impact of educational programs on Nutritional practices:
Bacterial Profile and their Antimicrobial Susceptibility Pattern in Pediatric Septicemia from Tertiary Care Hospital
Farhan Rasheed, Iqra Jamil, Tahira Tehseen, Abeera Sikandar, Saba Anwar, Sajjad Rafique
https://doi.org/10.59058/jaimc.v21i2.83
ABSTRACT
Background and Objectives: Blood stream infection is a life-threatening infection, leading to increased morbidity and mortality in pediatric population. Antimicrobial drug resistance is a major therapeutic challenge and may result in treatment failure. Therefore, the present study was designed to assess the bacterial profile causing septicemia along with their antimicrobial resistance pattern in pediatric population. Methods: This retrospective study was conducted in pathology department of Hameed Latif Hospital, Lahore, over a period of two years, from 1st January 2021 to 31 December 2022. Blood samples were aseptically collected and were transferred into Bact/Alert blood culture bottle. After the detection of microbial growth by Bact/Alert 3D system, bacterial isolates were identified by standard microbiological procedures. Antimicrobial sensitivity pattern was determined by Modified Kirby-Bauer disc diffusion method on Mueller Hinton agar. Data was entered and analyzed by using Microsoft Excel 2010. Results: In our study, out of 1306 blood culture samples, 217(16.6%) were positive for bacterial growth. Among positive cases, Gram negative organisms were predominant isolates 181(83.4%), while Gram positive organisms were isolated in 36(16.6%) samples. Most common bacterial isolates were S. typhi (24%), A.baumanii (19%), P.aeruginosa (9%), while S.aureus and MRSA were 8% each. Highly resistant class of drugs for Gram-positive bacteria were found to be Aminopenicillin (69.1%) and Macrolides (68.6%), while Gram-negative organisms showed maximum resistance against Tetracycline (72.9%), Fluoroquinolones (62.1%) and Cephalosporins (61%). Conclusion: Bacterial isolates clinically suspected cases of septicemia were high. Majority of bacterial isolates showed maximum drug resistance against different classes of antibiotics. To prevent antibiotic resistance, strict guidelines of antibiotic utilization and infection control programs should be implemented.
A Study to Assess Relationship between Depression and Osteoarthritis According to the Severity of Pain and Loss of Function
Fatima javed, Fatima Ibrahim, Shanzae Naeem, OmarAhmad, Sadaf Sehar,
Talha Muzamil
https://doi.org/10.59058/jaimc.v21i2.118
ABSTRACT
Background & Objective: As there is increase in the obesity and elderly population worldwide, Osteoarthritis(OA) diseaseisunfortunatelyontherise.Whenthedurationofdiseaseincreases,thereis achancethat the psychological morbidity evolves into depression .The objective of this study is to assess a relationship betweendepression and osteoarthritis according to the severity of pain and loss of function. Methods: This cross-sectional study was conducted at Orthopedic and Rheumatology department of Combined Military Hospital, Lahore from October 2022 to March 2023. All the patients reporting to the outpatient department of either gender aged more than 45 years with a diagnosis of OA based on X-ray findings and a consultant review were included in our study. Severity of OAwas studied using the WOMAC (Western Ontario and McMaster Universities) Osteoarthritis Index. Depression was measured using the Personal Health Questionnaire (PHQ-9) scale in these patients simultaneously. (12) It was translated in Urdu for the ease of our participants. Results: Out ofthe 196 participants of ourstudy, 71 (36.2%)weremaleswhile 125 (63.8%)were females.Mean age of the participants of our study was 55.49 Years + 8.98. Mean WOMAC index score was 61.02 + 19.11. 3 (1.5%) patients of OA had mild disease in our study and no depression was found in them. In the moderate disease group, 34 (17.3%) had no symptoms of depression, 62 (31.6%) had minimal depression, none had mild,moderate orsevere depressionwhile only 1 (0.5%) hadmoderately severe depression.Out of 96 (48.9%) of the OApatients with severe disease as per the WOMAC index, 3 (1.5%) had minimal depression, 47 (23.9%) had mild depression, 15 (7.6%) had moderate depression, 27 (13.8%) had moderately severe depression and 4 (2.0%) had severe depression. Conclusion: OAis a debilitating disease. Quality oflife of patientsisseverely affected asthe duration increases due to pain, stiffness and loss of function of joints. Long term disease leads to depression of variable degrees. . Thus early diagnosis and timely intervention in such patients with an individualized management plan can improve the outcome and quality of life of patients.
Comparing the Frequency of Left Main Stem Disease Among Patients with ST Elevation in AVR Lead
Mariam Tahir Siddiqi, Kamran Dawood Ahmad, Muhammad Ijaz Bhatti, Shahid Hameed, Rajia Liaqat, Khawaja Muhammad Usama
ABSTRACT
https://doi.org/10.59058/jaimc.v21i2.170
Background: Coronary artery disease (CAD) is one of the leading causes of mortality worldwide with similar prevalence in Pakistan. The main objective of the study is to compare the frequency of left main stem disease among patients with STelevation in aVR. Methods:This cross-sectionalstudywas conducted inDepartment of cardiology,Punjab institute of cardiology, Lahore. Sample size of 151 cases is calculated with 95% confidence level,7%margin of error and taking expected percentage of LMS is 74.2%. The data was collected through non probability consecutive sampling technique. Results: Mean age of the study population was 55.54±10.1 years. Majority of the cases were male 117(77.5%) and 34(22.5%) were female which were less in quantity. Mean body mass index was 28.61±2.58. Conclusion: Majority of the cases developed left mainstem disease who have been diagnosed with ST elevation in aVR. A significant difference of the diabetic versus non diabetic was observed who have been noted for LMS disease.
Prevalence of SARS-COV-2 in End Stage Renal Disease Patients on Hemodialysis & Dialysis Providers during SARS-COV-19 Spike in Lahore, Pakistan
Sidra Shafiq Cheema, Hozaifa Habib, Manal F Cheema, Shafiq Cheema
https://doi.org/10.59058/jaimc.v21i2.120
ABSTRACT
Background and objective: The global pandemic of Coronavirus Disease 2019 (SARS-COV-2) poses a significant threat to both hemodialysis staff and patients. However, the prevalence of SARS-COV-2 among asymptomatic end-stage renal disease (ESRD) patients on chronic hemodialysis (MHD) and healthcare staff including nurses and technicians in dialysis unit remains uncertain. Given that hemodialysis patients and dialysis nurses are particularly prone in congregate settings, the objective of this study was to investigate how widespread SARS-COV-2 was within two specific hemodialysis units located at Jinnah Hospital Lahore (JHL). Methods: This cross-sectional study involved the participation of 198 maintenance hemodialysis patients with end-stage renal disease (ESRD) and 83 dialysis staff members. These patients or staff members did not have any symptoms at the time of testing. Testing was conducted using qualitative reverse transcriptionpolymerase chain reaction (RT-PCR) on nasal & pharyngeal swabs collected from June 18th to June 23rd, 2020. Results: Out of the total 281 participants, 45 dialysis patients from a total of 198 (22.7%) and 10 dialysis staff members from a total of 83 (12%) were found to be SARS-COV-2 positive. Combining both staff and patients, the overall prevalence of SARS-COV-2 was 55(19.8%). The mortality rate among the infected patients was 6.6% (3 out of 45). Conclusion: This study demonstrate a significant frequency of SARS-CoV-2 among hemodialysis staff and patients in Lahore, Pakistan.
Microalbuminuria in Newly Diagnosed Hypertensive Patients and its Correlation with Left Ventricular Hypertrophy
Khalid Mahmud Khan, Muzammal Aslam Kataria, Mohammad Saddam Rahman, Hasan Farooq, Meerub Khalid, Saad Salman
https://doi.org/10.59058/jaimc.v21i2.52
ABSTRACT
Background and Objective: One of the most important factors in the development of cardiovascular diseases worldwide is Hypertension. A reliable indicator and a diagnostic modality in early stage of renal diseases and predictor of atrial hypertension (AH) progression is microalbuminuria (MAU) which is also an independent risk factor of cardiovascular mortality and death. We aim to determine the prevalence of microalbuminuria and left ventricular hypertrophy and assess correlation between micro albuminuria and LVH among newly diagnosed hypertensive patients. Methods: Across-sectional study was conducted in Medical Unit IV, Jinnah Hospital Lahore from January to June 2022.About 146 adults newly diagnosed hypertensive patients were included in the study. Blood pressure was measured using a sphygmomanometer with a standard cuff in the sitting position, with two measurements made at least 5 min apart. Microalbuminuria was defined as albumin excretion of 30 to 300 mg/dl in a spot urine sample report. Left ventricular hypertrophy (LVH) was defined as the presence of concentric hypertrophy or diastolic dysfunction determined on Trans Thoracic ECHO by a cardiologist. Data was entered in SPSS Ver: 25.0 for data analysis and graphical presentation. For quantitative variables like age, ACR; the mean and standard deviation were calculated. Prevalence and correlation of MAU and LVH in newly diagnosed hypertensive patients were found using Spearmen's Rank Correlation Analysis. A chi-square test was performed to compare MAU and LVH. The p-value of < 0.05 was considered statistically significant. Results: 146 subjects fulfilling the inclusion criteria were admitted. The mean age was 48.281 + 24.865. 72.6% were male in our study. 30.8% of patients had LVH and microalbuminuria was present in 47.5% of subjects. About 28.6% of patients with LVH had MAU. (p=.030). There was a positive correlation between LVH and MAU. (r=0.135, P=.002). Conclusions: Our study concludes a high prevalence of microalbuminuria and LVH in newly diagnosed hypertensive. There is a positive correlation between microalbuminuria and LVH and can be a predictor of cardiovascular morbidity and mortality
Measuring Anti-Spike IGG Antibody Response to SARS-COV-2 Vaccination in Patients Receiving Hemodialysis at a Tertiary Care Hospital of Lahore
Sidra S. Cheema, Numan Javed, Samreen Gilani, Manal Cheema, Zain Tariq, Zeeshan Butt, Shafiq R. Cheema
https://doi.org/10.59058/jaimc.v21i2.115
ABSTRACT
Background and Objectives: The current state of the evidence is equivocal for IgG antibody response to COVID-19 vaccination in dialysis patients. Here, we assess the antibody concentration in dialysis patients who have received a complete series of vaccines with or without a history of prior COVID infection irrespective of the vaccine administered. Methods: In this cross-sectional study, we obtained serum samples from 101 Hemodialysis patients and compared the antibody level among those patients who had received a two-dosage vaccine regimen within the last six months versus those who had completed the same regimen more than six months ago. Participation in the study was completely voluntary by HD patients who gave informed consent and results were noted in a designed proforma. Results: Our study found that nearly three-quarters of patients (72.2%) received 2 dosages of Sinopharm or Sinovac vaccine, and ninety-seven percent of participants were considered seropositive (COVID Ab titers > 7.1 BAU/ml). The average SARS-COV-2 spike antibody levels were 1892.4 BAU/mL, while the median levels were 971 BAU/mL. Mean and median antibody titers were 1895.8 and 792 BAU/mLin the group who had received the vaccine within the last six months as compared to 1981.1 and 1033 BAU/mLrespectively in the group who had received the vaccine later than six months, with p-value 0.84 indicating no significant difference. Additionally, there were no statistically significant variations in IgG antibodies observed when examining subgroups based on diabetes, hypertension, coronary artery disease (CAD), or gender. However, it was found that older patients (aged >55 years) exhibited significantly higher anti-spike antibody titers compared to younger patients (2417.8 BAU/mLvs. 1377.3 BAU/mL, Pvalue 0.008). Conclusion: The result of this study provides important evidence, which can lead to vaccine efficacy, especially in older populations. Future studies should address whether booster vaccination may play a role in providing an effective and long-lasting protection among vulnerable patients undergoing hemodialysis care.
Frequency of Obesity in Pregnancy and Outcomes in Normal Weight, Over Weight and Obese Pregnant Females
Rabia Wajid, Saira Fayyaz, Amna Ahsan, Hina Masood
https://doi.org/10.59058/jaimc.v21i2.107
ABSTRACT
Background and Objectives: Obesity is now becoming a significant health problem especially among women of child bearing age. Obesity has a major bearing on pregnancy outcomes, according to latest reports. Especially, during ante and intra partumperiod, obesewomen aremore prone to develop adverse complication in comparison to women with a normal body mass index (BMI).This study aimed to determine the frequency of normal weight, over weight and obese women presenting for antenatal care and to compare the outcomes in these females. Methods: A followup study was conducted from 29th October 2022 to 29 April 2023 .200 subjects were recruited to the study after informed consent. BMI was recorded and weight category assigned. All these women were followed-up till 37 weeks of gestation and till delivery. The indications for Caesarean section included those followed in routine as per labour room protocol. Main outcome variable: Fetal outcome was assessed using C-section, macrosomia and admission of neonate to NICU. Results: Weight of 34% women (n=68) were classified as normal, 40.5% (n=81) were overweight and 25.5% (n=51) as obese. Comparison of outcome in normal weight, over weight and obese pregnant females shows that of 8 cases of macrosomia, 1 in normal and overweight while 6 cases in obese, of 61 cases of C-section 13 in normal, 15 in overweight and 33 were obese, NICU admission cases were 27, out of which 7 in normal, 6 in overweight and 14 were in obese group (p value 0.80). Conclusion: We concluded that on comparison for the outcome in normal weight, over weight and obese pregnant females, obese and overweight females are higher at the risk of macrosomi;, cesarean birth and NICU admission of the neonate.
Frequency of Inhibitors Among Known Hemophilia Patients
Javeria Abdullah, Irem Iqbal, Irem Iqbal
https://doi.org/10.59058/jaimc.v21i2.147
ABSTRACT
Background:Inhibitors are IgG alloantibodies which are directed against exogenous clotting factor VIII that neutralize the function of infused clotting factor concentrate used for the treatment. The prevalence of inhibitors in Hemophilia A is around 30% worldwide. Inhibitors occur as a result of natural immune process of the body as factor concentrates used for treatment are foreign to the body and patient's own body either produces no factor or produces structurally abnormal protein. The objective of this study is to determine the frequency of inhibitors among known hemophilia Apatients. Methods: Cross-sectional survey done including 100 male patients of hemophilia A and on treatment for more than 1 year, from 2 to 60 years of age. All the patients were undergone aPTT based screening for inhibitor, both immediately and two hours after mixing the patients plasma with the normal plasma. Results: Age range in this study was from 2 to 60 years with mean age of 37.21 ± 14.73 years. Frequency of inhibitors among known hemophilia Apatients was 18 (18.0%) of cases. Conclusion: Frequency of inhibitors among known hemophilia Apatients is considerably high
CASE REPORT
Right Renal Mass: A Rare Disease and Diagnostic Dilemma in a Young Female
Faryal Azhar, Mudassar Niaz
https://doi.org/10.59058/jaimc.v21i2.126
ABSTRACT
A 22-year-old female from Afghanistan presented with history of pain right lumbar region along with feeling of heaviness and weight loss. The abdominal examination revealed a mass approximately 10*10 cm in the right lumbarregion which was bimanually palpable.The diagnosis ofRight lumbar mass was made on ultrasound. FinalCTscan confirmed its origin fromright kidney alongwithmetastasisin lung.The ultrasound guided biopsy turned out to be spindle cell tumour of kidney. Right sided nephrectomy along with removal of proximal ureter done. Histopathology confirmed the diagnosis of mesenchymal chondrosarcoma of right kidney. Postoperative outcome of patient was uneventful.