CURRENT ISSUE

VOL. 21, ISSUE NO.3

EDITORIAL

Artificial Intelligence (AI) in Healthcare: Prospects and Limitations for Pakistan at the Blurry Cross roads

Zarabia Pervaiz Butt

https://doi.org/10.59058/jaimc.v21i3.180

ORIGINAL ARTICLES

FIB-4 value before DAA therapy as a predictor of Esophageal varices progression after SVR12 with DAA therapy

Attique Abou Bakr, Amtiaz Ahmad, Tayyab Shazad, Madeha Akram, Fawad Iqbal Janjua

https://doi.org/10.59058/jaimc.v21i3.27

Background and Objective: The objectives of this study were to assess the effect that direct-acting antivirals (DAAs) have on portal hypertension once a sustained viral response (SVR) has been achieved. Therefore, it is important to look at economical and noninvasive predictors. We looked into the factors that contributed to the emergence of EVs in hepatitis C infected patients after SVR with DAAs.
Methods: It was an Open-Label Single-Arm clinical trial conducted at department of Gastroenterology, AIMC/ Jinnah Hospital, Lahore during the period of 3 years and 4 months ( from June 2017 to October 2020). Total of 99 patients who attained SVR post DAA therapy were enrolled in this study and their pre- and post- treatment esophagogastroduodenoscopy (EGD) findings were compared. EV progression and non- progression were assessed. Additionally, EV cumulative advancement rates were examined.
Results: Before DAA treatment, the fibrosis-4 index (FIB-4) was the only substantial predictor of EVs progression after SVR ( 95% confidence intervals: 1.25-1.54, odds ratios: 1.45, p = 0.02). Based on ROC curve analysis, patients with a FIB-4 of 8.5 or higher had a higher risk of EVs (sensitivity = 0.69, specificity = 0.91, positive predictive value = 0.36, negative predictive value = 0.98).
Conclusion: EV development is possible in patients with FIB-4≥ 8.5, so EGD surveillance should continue after SVR.

FREQUENCY OF WORM INFESTATION AMONG PREGNANT FEMALES PRESENTING WITH ANEMIA TO DOCTORS TRUST TEACHING HOSPITAL SARGODHA

Zunaira Bajwa, Asifa Alia, Maria Hussain, Adnan Afzal, Zil-e-Huma Afzal, Maimoona Javed

https://doi.org/10.59058/jaimc.v21i3.103

Background and Objectives: Anemia is one of the major contributors to low fetal birth weight as well as maternal mortality in developing countries. Various studies have associated anemia with helminthic infestation. Hence with the elimination of such infestation, anemia may be reduced which will have a positive impact on the delivery outcomes.
Methods: This cross-sectional study was conducted at Doctors Trust Teaching Hospital Sargodha from 1st August 2019 to 31st July 2020 for which we enrolled 130 pregnant females. Blood hemoglobin levels and stool examination for parasite infestation were performed for all these women and recorded on a structured questionnaire. Data was analyzed using SPSS version 24.0.
Results: Among 130 pregnant females, the mean age observed was 29.86 ± 6.61 years while the range was 18 years to 40 years. It was seen that 45.4% of the patients had mild, 26.9% of the patients had moderate while 27.7% had severe anemia. 17.7% of these females who presented with anemia to a tertiary care hospital had worm infestation. Effect modifiers have a significant influence except for age and monthly income. Analysis revealed that BMI was significantly related to worm infestation (p-value = 0.005).
Conclusion: The frequency of worm infestation was found as 17.7% in pregnant females presenting with anemia to a tertiary care hospital. A significant association was found between BMI and worm infestation while no significant association was found in age and income with worm infestation.

https://doi.org/10.59058/jaimc.v21i3.84

Background and Objective: Ischemic heart disease is currently the largest cause of mortality, disability, and human misery worldwide. South Asians have an increased chance of suffering from coronary disease. The objective of this study was to assess the prevalence and risk factors for myocardial infarction in young population.
Methods: A Descriptive, cross-sectional study was carried out over a six-month period from 17th January 2020 to 16th July 2020 in the Medical Unit-II of Services Hospital, Lahore. A total population of 149 young patients irrespective of their gender with age range from 15 to 45 years and suffering from myocardial infarction were included in this study. Relevant information comprising of presence or absence of Hypertension, Diabetes, Smoking, Dyslipidemia, Obesity, Hyperuricemia, and Family history of these selected cases were recorded in the data collection proforma and patients' confidentiality was ensured.
Results: 101 men (67.79%) and 48 women (32.21%) among a total of 149 patients recruited in the study yielded a male to female ratio of 2.1:1. Age range in this study was from 15 to 45 years with mean age of 34.68
± 6.93 years. Majority of the patients; 80 (53.69%) were between 30 to 45 years of age. Hypertension was reported in 57 (38.26%), Diabetes Mellitus in 28 (18.79%), smoking in 61 (40.94%), dyslipidemia in 80
(53.69%), obesity in 20 (13.42%), hyperuricemia in 21 (14.09%) and positive family history was seen in 30
(20.13%) patients.
Conclusion: Hypertension, Diabetes, Smoking and Dyslipidemia constitute the common and most important contributing factors of Myocardial Infarction (MI) in young patients aged between 15 to 45 years

The DELAY IN TURNAROUND TIME IN REPORTING SMALL BIOPSY SPECIMENS; AN EXPERIENCE FROM A TERTIARY CARE HOSPITAL IN LAHORE

Fakeha Rehman, Sadia Anwar, Rozina Shahadat khan, Rohma Saqib, Samreen Hameed

https://doi.org/10.59058/jaimc.v21i3.131

Background & objectives: Turnaround time (TAT) is defined as time lapse between receiving of a specimen at laboratory reception till dispatch of the final histopathological diagnosis. TAT is not only an efficient indicator of laboratory performance but is the most important concern of practicing physicians dealing with histopathology report. The aim of this study was to analyse the delay in turnaround time of different types of small biopsy specimens in histopathology section.
Methods: A cross sectional analysis was done on 218 different types of small biopsy specimens reported by histopathology section. Delay in turnaround time involving different phases of testing was observed and data was entered using SPSS version 26.
Results: The mean turnaround time in this study was 6.66 days. Majority of the reports were reported after a delay of 4-7days (n=83). Causes in delay mostly included recuts 69 (31.65%), re-orientation 22 (10.09%), intradepartmental consultation 52 (23.85%) and troubleshootings in LIS 16 ( 7.33%). Inappropriate supervision and training of newly hired technical staff was a major factor in ordering of recuts, reorientation and restains.
Conclusion: Turnaround Time, a measure of quality assurance, is essential to the efficient operation of a successful histopathology laboratory. The patient's anxiety is reduced and timely treatment is assisted by proper TAT.

EFFECT OF IRON REPLACEMENT THERAPY IN PREGNANT BETA THALASSEMIA CARRIERS WITH COEXISTING IRON DEFICIENCY ANEMIA

Irem iqbal, ayesha khalid, kiran iqbal, Tooba Fateen; shaila Anwar

https://doi.org/10.59058/jaimc.v21i3.159

Background and Objective: Iron deficiency anemia (IDA) and β -Thalassemia trait are two prevalent etiologies of microcytic hypochromic anemia. Pregnant women with IDA face significant risk of short-term and long-term complications for mothers and newborns. The incidence of concurrent thalassemia trait and iron deficiency was reported to be quite high but despite the high prevalence of these two conditions, the diagnosis is often underestimated and not properly managed. The present study was conducted to determine effect of iron therapy in pregnant beta thalassemia carriers with iron deficiency anemia.
Methods: Study Group constitutes 60 beta thalassemia trait pregnant women with iron deficiency anemia (IDA) with Hb less than 11g/dl, HbA2 levels >3.5% on HPLC and low serum ferritin (<30 ng/mL). After the initial investigations, participants received iron supplementation as 60 mg elemental iron three times daily for duration of 8 weeks. After completing therapy, complete blood count and serum ferritin were performed.
Results: Iron replacement therapy results in effective increment in hemoglobin, red cell indices and Serum ferritin.
Conclusion: Pregnant women with beta-thalassemia minor combined with IDA can receive Iron replacement therapy for improvement in Hemoglobin effectively.

PREVALENCE OF NASAL COLONIZATION OF METHICILLIN-RESISTANT STAPHYLOCOCCUS AUREUS (MRSA) IN PATIENTS ON CHRONIC HEMODIALYSIS

Falak Shan, Ahmad Ijaz, Husham Ahmad, Adil Manzoor, Irsa Andleeb, Altaf Ahmad

https://doi.org/10.59058/jaimc.v21i3.116

Background and Objective: Staphylococcus aureus (S. Aureus) is a major pathogen which is often colonized in the haemodialysis patient group which later on cause a widespread infection. Hence, leading to increased morbidity and mortality among these patients. This study was conducted to check the occurrence of nasal colonization of MRSA in patients undergoing chronic hemodialysis through different vascular accesses and its association with different risk factors such as diabetes, previous hospitalizations, antibiotic use and duration of hemodialysis.
Methods: This study was conducted at a dialysis center of a quaternary care hospital with a sample size of 109 involving non-probability consecutive sampling technique. Data was collected over the period of one month in January and February 2022. A swab was rotated four times 1.5cm deep inside in the anterior nares of each patient. All data was analyzed through SPSS version 22. p-value of <0.05 was considered significant with a confidence interval of 95%.
Results: 73% of the patients were male and 25% were diabetic. The participants were divided into different age groups. The occurrence of staphylococcus aureus was found out to be 26% out of which 11% were MRSA positive and 15% were MSSA positive. There was no association between the presence of these pathogens with duration of dialysis and type of vascular access along with presence of comobidities, previous use of antibiotics and episode of recent hospitalizations.
Conclusion: It can be concluded that approximately one fourth of the patients had nasal colonization of staphylococcus aureus with considerable patients having MRSA or MSSA positive. There was no significant association between the incidence of MRSA with age, gender, AV access, history of diabetes, previous hospitalizations or antibiotic use. These findings are contrary to the expected association with these risk factors.

AN AUDIT OF INCIDENCE, INDICATIONS AND COMPLICATIONS RATE FOR CAESEREAN HYSTERECTOMIES IN A TERTIRARY CARE HOSPITAL

Qurra Mehmud, Sadaf Zahra Syed, Rubina Mustafa, Sadiya Butt, Naheed akhter, Sofia Manzoor

https://doi.org/10.59058/jaimc.v21i3.105

Background and Objective: Caesarean hysterectomy is usually done as a life-saving procedure for post- partum hemorrhage but is associated with considerable mortality and morbidity. Thus, this study was conducted to analyze all caesarean hysterectomies in terms of rate of incidence, indications and morbidity performed in gynecology unit during one year period at one of the largest specialized healthcare care public hospitals in Lahore.
Methods: A retrospective observational study was conducted in the department of gynecology and obstetrics Unit I, Sir Ganga Ram hospital, Lahore from June 2019 till June 2020 including all women who underwent caesarean hysterectomy. Data was abstracted from the medical record and was entered and analyzed in SPSS version 21.0. The outcome was presented as frequency and percentages for incidence, indications and complications related to caesarean hysterectomy.
Results: During the study period total deliveries were 5804 with 2979 were delivered through caesarean section out of which 64 women underwent caesarean hysterectomy, resulting in an incidence of 2.1%. Placenta accreta was found to be the most common indication for cesarean hysterectomy. There were 2 (3.12%) maternal deaths among these females who underwent caesarean hysterectomy.
Conclusion: The rate of caesarean hysterectomy was considerably high which is a leading factor requiring adequate attention to help reduce maternal and fetal mortality not only from caesarean hysterectomies but also from other preventable complications.

FREQUENCY OF BONE MARROW INVOLVEMENT IN PYREXIA OF UNKNOWN ORIGIN

Sarah Farrukh, Ambareen Hamid, Sobia Ashraf, Rafeeda Maab, Arsala Rashid, Raana Akhtar

https://doi.org/10.59058/jaimc.v21i3.100

Background and Objectives: This study has been conducted to highlight the frequency of involvement of bone marrow in Pyrexia of unknown origin (PUO) and delineate the existing spectrum of diseases involved in PUO. The results would facilitate the clinician in making the right choice of patient for bone marrow biopsy.
Methods: A total 121 cases of pyrexia of unknown origin were included in the study. Patients with known systemic illness, hematological disorders, who had taken radiotherapy or chemotherapy or with known malignant disorders were excluded to avoid selection bias. Bone marrow was aspirated from posterior iliac crest in all the patients along with trephine biopsy using disposable trephine biopsy needle of 11 gauge. Wright-Geimsa stain was used to stain the smears prepared from concentrated marrow cells. The involvement of bone marrow was categorized into four major etiologies of PUO and assessed by observing bone marrow aspirate along with trephine biopsy slides using light microscopy.
Results: The mean age was 34.72 ± 14.66 years with minimum and maximum age 18 and 65 years. .Out of 121 patients, a total of 94 (77.7%) cases showed involvement of bone marrow and 27(22.3%) cases showed no involvement. Post stratification Chi-square test revealed significant. P-value: 0.000.
Conclusion: Our results identified a large number of cases of PUO with involvement of bone marrow which can serve as a diagnostic aid in further workup. We believe that implementing invasive procedures such as bone marrow biopsy can help to find the underlying cause and prevent the delay in diagnosis of such patients

COMPARISON OF ANGULAR MEASUREMENTS IN CEPHALOMETRIC AND PHOTOGRAPHS

Atif Riaz, Ayesha Ashraf, Shazia Ramzan, Samina Kadir, Farhan Ashraf, Nedal Iqbal

https://doi.org/10.59058/jaimc.v21i3.114

Background and Objectives: The evaluation of the facial profile is an important factor in any current orthodontic diagnosis and accurate treatment planning is dependent on it. The aim and objective of the study is to find out differences in angular measurements between photographic and cephalometric measurements whether photographic measurements can be used in place of cephalometric measurements.
Methods: The study comprised 100 volunteers (50 males and 50 females) ranging in age from 12 to 16 years. The respondents were chosen at random throughout the sampling process. Cephalometric and photographic profile analysis was used, with angular measurements based on standard cephalometric and photographic records taken in natural head position in lateral view. Lateral cephalogram was used for cephalometric analysis and photograph taken in lateral view was used for evaluation. The study included four factors in total.
Results: There was no significant difference in facial angular measurements between the cephalometric and photographic analysis.
Conclusion: This study concluded that photographic measurements can be used in place of lateral cephalogram as there are negligible differences between them

ASSESSMENT OF STRESS AMONG STAFF WORKING IN EMERGENCY DEPARTMENT OF A TERTIARY CARE HOSPITAL

Meher Muzafffar, Muhammad Shafqat, Muhammad Nasir Rana

https://doi.org/10.59058/jaimc.v21i3.112

Background And Objective: Stress is a state of emotional exhaustion that is widely experienced by health care professional. It is commonly known that hospitals and health care providing institutes absorbs stress more than any other field. The doctors, nurses and paramedics have to be on their toes to provide quality lifesaving services. Thus it turns to be hectic both physically and emotionally and instigate stress among the staff. Objective of study is to assess the prevalence of stress among emergency department staff and to determine associated factors and complexity.
Methods: This study was conducted at Emergency department of The Children's Hospital and the university of child health sciences, Lahore during January 2022 to April 2022. Total 96 participants were enrolled into the study. All professionals working in ER department including medical, paramedical (nurses, health managers and health care assistant), administration and technical staff (receptionist), hospital senior agents, social worker were interviewed. Consecutive non-probability sampling technique used. Data was collected by filling predesigned questionnaires by every individual on level of stress through behavioral, emotional, and psychological aspects. Data was analyzed by using SPSS 21 which was based on themes and codes formulated from collected data. Before conducting the study, a preliminary coding was done from previous researches, which incorporated four levels of controlling aspect namely, behavioral, psychological, emotional and cognitive.
Results: Out of 96 participants, 57 (59.38%) were doctors, 36 (37.50%) were nurses and 3 (3.13%) were paramedical staff. 63 (65.63%) participants were female. In the ER Department of Children's Hospital, the Doctors and Nurses are overburdened, 39.4% strongly agree, while in females 44.4% agree with it. Nurses were busy most in doing non-nursing task, 21.2% strongly agree, with respect to female gender 46.0% agree, which increased their stress levels. Married and Female staff had faced more stress as compared to unmarried and male staff.
Conclusion: In the ER department of children Hospital, the doctors and nurses were overburdened. Nurses were most of the time busy in doing non-nursing activities (e.g. Clerical work) which increased their stress levels. Programs for Stress management of the Nurses, working in the emergency services is utmost necessary in Pakistan. The High job-related stress levels suggest possible future research work in this significant area for the benefit of patient care in emergency unit of tertiary care hospitals of Pakistan.

Efficacy of nausicaa compression sutures in terms of PPH management

Yasmeen Muhammad Din, Shamila Ijaz Munir, Sodat Alqai, Sofia Iqbal

https://doi.org/10.59058/jaimc.v21i3.104

Background and Objective: Postpartum haemorrhage(PPH) is still the most important cause of maternal death in Pakistan. Over 125,000 maternal deaths have been reported each year due to PPH worldwide. Major causes of PPH include uterine atony and haemorrhage from the placental bed. The recent increase in the rate of cesarean section has increased the incidence of the Placenta previa accreta spectrum. Apart from medical measures, there are various conservative surgical interventions before imparting hysterectomy such as uterine compression sutures, hemostatic sutures, and stepwise devascularization of the pelvis which effectively control hemorrhage and save the mother from life-threatening morbidities. The Nausicaa compression suture is a novel technique that effectively controls PPH in patients with uterine atony, placenta previa, and accrete spectrum. The objective of this study is to determine the efficacy of Nausicaa compression sutures in patients with PPH undergoing cesarean section.
Methods: This study was conducted in the Obstetrics and Gynaecology department of Sir Ganga Ram Hospital, Lahore from 1st September 2020 to 30th June 2022. A total of 80 patients who had PPH during cesarean section due to uterine atony or placenta previa spectrum were enrolled after informed consent. Nausicaa compression suture was applied to the anterior, posterior, and both uterine walls where required. Successful procedures were those where only the Nausicaa compression suture was sufficient to control PPH.
Results: The average age of patients was 30.3±4.2 years. There were 24(30%) primigravidas, 28(35%) G2P1+0 and 28(35%) were multigravidas. The mean gestational age of patients was 37 weeks. In 09 cases, Nausicaa sutures were applied to the anterior uterine wall while in 71 patients to both anterior and posterior uterine walls. Out of 80 patients, 62 patients were saved from interactable haemorrhage due to Nausicaa Compression sutures.
Conclusion: The Nausicaa compression suture is an effective and new suture to control postpartum hemorrhage in patients with placenta previa spectrum and atonic uterus. It is most effective when applied to anterior and posterior both uterine walls separately.

METABOLIC SYNDROME AMONG PATIENTS OF HEPATITIS C PRESENTING TO A TERTIARY CARE HOSPITAL

Attiya Arif, Muhammad Asad Saeed, Anas Ahmed Qureshi, Samia Arif, Adeeba Arif, Sana Abbasi, Ayesha Afzal

https://doi.org/10.59058/jaimc.v21i3.181

Background and objectives: Hepatitis C has evolved to become a global pandemic, equally affecting Pakistan as well. According to one WHO report the estimated prevalence of chronic hepatitis C is 1% worldwide (71 million people) while Pakistan alone contributes more than 12 million people to this figure, with Punjab reporting the highest prevalence of 6.7%. This infection does not only affect the Liver but also produces extrahepatic manifestations in various organs like skin, blood, and gastrointestinal tract as well as leads to many autoimmune conditions. There are many more linked to hepatitis but still remains unclear hence in this study we aim to assess the frequency of metabolic syndrome and the distribution of its features among patients of hepatitis C.
Methods: Conducted from 01.08.2019 to 02.01.2020 at Sheikh Zayed Hospital Lahore this cross-sectional study enrolled a total of 110 patients with hepatitis C presenting to the Outpatient Medicine Department. After informed consent, the demographic profile was noted in the proforma. The blood pressure and BMI of the patients were assessed using a standard protocol. A sample of 3ml of blood was taken for fasting lipid profile. Information regarding the study variable was recorded in the proforma and confidentiality of the data was ensured. SPSS was used to analyze the data.
Results: Of the total 110 hepatitis C patients enrolled, 54.5% were male, the mean age was 41.06 ± 14.78 years and the mean duration of having hepatitis C was 6.76 ± 3.27 months. Metabolic syndrome was present in 31.8% of the total study participants. Further analysis revealed that metabolic syndrome was not significantly associated with age (p-value = 0.955), gender (p-value = 0.970), or duration of hepatitis C (p-value = 0.125).
Conclusion: Metabolic syndrome affects 1 in every 3 patients of Hepatitis C presenting to the tertiary care hospital. Hence screening for metabolic syndrome must be performed among all patients suffering from hepatitis C from an early disease period and all such patients must be educated regarding prevention and control of this syndrome.

VARIATIONS OF MALONDIALDEHYDE, HYDROXYNONENAL, ISOPROSTANE AND 8-HYDROXYDEOXYGUANOSINE IN SERUM, SALIVA AND URINE IN INDIVIDUALS WITH AND WITHOUT OSTEOARTHRITIS

Zoya Muzzafar, Mehreen Zaidi, Shazia Ramzan, Neelum Bilal, Tania Ahmad Shakori, Fahim Hadi, Tahir Maqbool, Muhammad Tahir, Shabana Akhtar

https://doi.org/10.59058/jaimc.v21i3.113

Background and Objective: Osteoarthritis is a clinical and pathological outcome of a sequence of disorders that ultimately lead to synovial joint structural and functional failure. The aim of this study was to determine the expression of oxidative stress markers like malondialdehyde (MDA), 4- hydroxynonenal (HNE), isoprostane, and 8-hydroxyguanosine in body secretions and mediums like serum, saliva, and urine between patients of OA and non-diseases group.
Methods: The calculated sample size is 50. The age of the participants is ranged from 30-39,40-49,50-59, and 60-69 with a mean score of 54.5+/-9.3 years. Our study design is crossed sectional and comparative. In this study, oxidative stress markers in the body fluids of osteoarthritic patients were compared with the control group of 50healthy individuals in same age group. The levels of stress markers were determined by commercially available quantitative ELISA kits.
Results: Our findings indicate that the highest levels of these oxidative stress markers were detected in serum, followed by urine. The saliva overall presented lower levels of oxidative stress markers in individuals with and without OA. In addition to this, the detection of MDA in serum samples was found to be the most important tool in the detection of OA.
Conclusion: The current study provides an understanding to detect and diagnose the inflammatory markers in the patient's secretions and to treat OA before the disease has pronounced progress. It also helps clinicians in decision making to choose most appropriate test for the early detection of OA.

KNOWLEDGE, ATTITUDES, AND PRACTICES OF UNIVERSITY STUDENTS OF LAHORE REGARDING CORONAVIRUS VACCINES

Mahnoor Alam, Taha Alam, Seema Hasnain, Abdullah Safdar, Hareem Sajid

https://doi.org/10.59058/jaimc.v21i3.135

Background and Objective: A new coronavirus SARS -COV-2 is responsible for the disease termed COVID-
19. On 31st December, 2019, several cases of viral Pneumonia were reported to WHO from Wuhan, China. In Pakistan first case was reported on 20th February, 2020. It was declared as Pandemic by WHO on 11th March, 2020. The loss of human life throughout the world along with economic and social interruption was devastating. The aim of this study is to assess knowledge, attitude and practices of university students of Lahore regarding coronavirus vaccines.
Methods: An online cross-sectional study was conducted among 171 university students on a self-administered structured pre-tested questionnaire from 1st July 2021 to 15 August 2021 after approval from Institutional Review Board. A written consent form was filled by each student online. The questionnaire comprised of four sections. First section dealt with sociodemographic profile and second, third and fourth section had questions related to knowledge, attitude and practices respectively. The data was analyzed using SPSS version 27. The knowledge, attitude and practices were graded as good (>70% correct answers), satisfactory (50-70%) and poor (<50%). Chi- square tests were applied to find out any statistical significance between the sociodemographic parameters and knowledge, attitude and practice regarding COVID-19 vaccine. P-value of ≤0.05 is considered to be statistically significant.
Results: The mean age of the respondents was 21.652 ± 2.14 years. Good knowledge, attitude and practices were 36.8%, 88.3% and 52.3% respectively. Willingness towards vaccination was shown by 89.5% students. Only 48% students had received both doses of the vaccine, while only 6.4% knew about all the vaccines that were available in Pakistan. Age was statistically associated with knowledge (p=0.03) and gender with attitude (p=0.048).
Conclusion: It can be concluded from the study that the students had poor knowledge but their attitude and practices were much better. Organizing health education sessions and awareness seminars will help in increasing the knowledge of the students leading to improved attitude and practices towards disease prevention.

EFFECT OF PIPERINE ON HYPOTHALAMIC PITUITARY GONADAL AXIS OF FEMALE ALBINO RATS: A RANDOMIZED CONTROLLED STUDY

Saqib Mansoor, Muhammad Suhail, Ahmad Bilal Suhail, Amina Zia, Ayesha Afzal, Faiza Shafqat

https://doi.org/10.59058/jaimc.v21i3.156

Background and Objective: Piperine is a constituent of black pepper. When administered to female adult albino rats, it might results in increased levels of LH and FSH, and thus causing diminished ability to procreate. The aim of this study is to determine the deleterious piperine influences on LH and FSH levels of adult female albino rats.
Method: It is a randomized controlled trial conducted in the department of Anatomy, FPGMI, Lahore. By random selection from 30 rats, three equal groups were made, each with 10 animals. Control status was assigned to group A which was not given any medicine, but only N/S administered with the dosage 10ml/kg body wt./day by using NG tube for a span of 30 days. Group B was given piperine at dosage of 5mg/kg/day for a period of thirty days. The C group was administered drug at the dosage of 10mg per kg per day for the same period of time as A and B via the same route. At completion of thirty days of the study, the animals of the 3 groups were given euthanasia. Dissection was performed, their ovaries were removed, and then fixed in 10% formalin. 4-5 micrometer sections preparation was done by using the microtome and then H&E staining was carried out.
Results: FSH and LH levels in serum of group B rats were shown to have increased in comparison to control group A. The FSH and LH levels in rats of C group were greater than that in rats of B group. When the two groups were compared, this difference was determined to be extremely of significance having a p-value less than 0.001.
Conclusion: Giving Piperine to female adult albino rats was shown to cause significant increase in levels of FSH and LH which is likely to produce negative feedback on hypothalamic-pituitary-gonadal axis and in this way hamper female fertility during their productive years probably by causing PCOS.

COMPARISON BETWEEN CHLORHEXIDINE GLUCONATE AND POVIDONE IODINE IN PREVENTING SURGICAL SITE INFECTION IN LAPAROSCOPIC CHOLECYSTECTOMY

Usman Ali Rahman, Muhammad Adil Iftikhar, Iftikhar Ahmed, Ch. Muhammad Atif Niaz, Maliha Javaid Butt, Humaira Yousaf

https://doi.org/10.59058/jaimc.v21i3.146

Background and Objectives: Surgical site infection is one of the major postoperative complication resulting in an increase in both morbidity and mortality of the patient. Preoperative patients body surface preparation is one of the major factors in preventing surgical site infection. In this study we compared povidone iodine usually used disinfectant with chlorhexidine gluconate for surgical site infection
Methods: It was a randomized control trial conducted at General Surgery ward Gulab Devi Hospital Lahore from January 2021 to December 2022. A total of 200 patients undergoing laparoscopic cholecystectomy were included in this study through purposive sampling and then divided into two groups using lottery methods. In Group A peroperative patients skin preparation was done with 10% povidone iodine while in Group B 4% chlorhexidine gluconate was used for skin preparation. Patients with empyema gall bladder, gall bladder or gut perforation and laparoscopic procedures converted to open were excluded from this study.
Results: In this study mean age of 45.8 ± 10.3 years with range from 25 to 65 years. In Group A mean age was
45.7 ± 10.8 years while in group B it was 45.8 ± 9.8 years. In Group A 12% wound infection was documented while in Group B it was only 4% (P-value 0.03).
Conclusion: Chlorhexidine gluconate solution showed less surgical site infection which implies that chlorhexidine gluconate solution can be safely replaced with povidone iodine solution for skin preparation.

REPORTING HIGH RISK HISTOPATHOLOGICAL FEATURES IN OPHTHALMIC PATHOLOGY

Samreen Hameed , Sadia Anwar, Fakeha Rehman

https://doi.org/10.59058/jaimc.v21i3.161

Background and Objectives: Surgical site infection is one of the major postoperative complication resulting in an increase in both morbidity and mortality of the patient. Preoperative patients body surface preparation is one of the major factors in preventing surgical site infection. In this study we compared povidone iodine usually used disinfectant with chlorhexidine gluconate for surgical site infection
Methods: It was a randomized control trial conducted at General Surgery ward Gulab Devi Hospital Lahore from January 2021 to December 2022. A total of 200 patients undergoing laparoscopic cholecystectomy were included in this study through purposive sampling and then divided into two groups using lottery methods. In Group A peroperative patients skin preparation was done with 10% povidone iodine while in Group B 4% chlorhexidine gluconate was used for skin preparation. Patients with empyema gall bladder, gall bladder or gut perforation and laparoscopic procedures converted to open were excluded from this study.
Results: In this study mean age of 45.8 ± 10.3 years with range from 25 to 65 years. In Group A mean age was
45.7 ± 10.8 years while in group B it was 45.8 ± 9.8 years. In Group A 12% wound infection was documented while in Group B it was only 4% (P-value 0.03).
Conclusion: Chlorhexidine gluconate solution showed less surgical site infection which implies that chlorhexidine gluconate solution can be safely replaced with povidone iodine solution for skin preparation.

CASE REPORT

A 42-Year-old Man with Acromegaly and Related Complications: A Case Report Highlighting the Importance of Early Diagnosis of a Rare Condition and its Further Management

Bilal Yasir Khan, Alisaa K C Tariq, Sumana Kundu, Hazrat Ullah, Lubna Mirza

https://doi.org/10.59058/jaimc.v21i3.182