Journal of Akhtar Saeed Medical & Dental College

Editorial, BEST PRACTICE FOR GLOBAL IMPACT; FOSTERING COMMUNITIES OF PRACTICE THROUGH MEANINGFUL NETWORKING

2024-03-13T08:04:42+00:00

BEST PRACTICE FOR GLOBAL IMPACT; FOSTERING COMMUNITIES OF PRACTICE THROUGH MEANINGFUL NETWORKING

Case Reports, PHEOCHROMOCYTOMA WITH NEUROFIBROMATOSIS TYPE 1

2024-03-09T07:32:12+00:00

Patients with early onset hypertension should be evaluated for secondary causes so that the underlying pathology can be ruled out effectively, we present a case of 25 years old female having pheochromocytoma with neurofibromatosis type 1. The patient presented in OPD with complaint of episodic hypertension with palpitations and tremors for 7 months, patient had this problem for almost 6 to 7 years. Patient was admitted in hospital, examination and initial workup was done leading to a diagnosis of pheochromocytoma. Patient’s episodic complaint was treated with anti- hypertensive medications.

Original Articles, DIAGNOSTIC ACCURACY OF MICROSCOPY VERSES PCR TECHNIQUE FOR THE DETECTION OF PLASMODIUM SPECIES IN PAKISTAN

2024-03-25T03:16:57+00:00

Background: According to latest data available Plasmodium vivax and Plasmodium falciparum are the most common species of plasmodium present in Pakistan. This study focuses on the current status of malaria specie distribution across different provinces of Pakistan.

Material & Methods:

This is a cross sectional study which is community based it was carried out in endemic areas of 04 provinces of Pakistan. The study was conducted stepwise by first microscopically confirming Plasmodium-positive blood samples and later these samples were reconfirmed by polymerase chain reaction (PCR) specie specific for detecting four species of human malaria.

Results: Total of 450 positive samples were collected amongst these 29 (6.4%) were P. falciparum, 386 (85.8%) were P. vivax, and 35 (7.8%) were mixed P. falciparum and P. vivax. Total 39 (8.7%) P. falciparum, 393 (87.3%) were P. vivax and mixed infections were (18%) positive in microscopically. There were no positive cases of Plasmodium malariae and Plasmodium ovale.

Conclusions: According to the study findings P. vivax and P. falciparum are most prevalent plasmodium species in in Pakistan, in addition mixed infections were also contributing to malaria prevalence in Pakistan. Regional variation in the prevalence and species composition was also found in the study.

Original Articles, IS DOING A COMPLETE AUTOPSY AIDING IN REACHING THE CAUSE OF DEATH IN PAKISTAN?

2024-03-09T07:25:11+00:00

Background: One of the primary objectives of a forensic autopsy is to establish the cause of death. Various approaches may be taken to decide the extent of the autopsy required for a particular case. In Pakistan, all bodies found under suspicious circumstances are mandated by law to undergo a complete autopsy after registration of a first information report (FIR) by the police. This study aimed to compare and analyze the cause of death recorded in the police FIR before the autopsy is performed and the final autopsy report after complete, 3-cavity autopsy has been done.

Materials and Methods: This retrospective study analyzed records of postmortem examinations carried out at a single, tertiary level autopsy center between June 2009 to July 2018. The study included 769 reports of complete autopsies performed and compared the cause of death stated in the final autopsy report to the FIR recorded by the police.

Results: Of the 769 autopsies included, based on comparison of cause of death between police FIR and autopsy report, five different groups were established. 504 (65.5%) cases were categorized as “similar”, 74 (9.6%) cases as “dissimilar”, 72 cases (9.4%) had no cause of death mentioned in the FIR, 65 cases (8.5%) had no cause of death mentioned in the autopsy report and in 54 cases (7%) neither the FIR nor the autopsy report stated any cause of death. The leading cause of death noted to be similar in FIR and autopsy was from firearm injuries.

Conclusion: A large proportion of the cases included in the study had similar cause of death recorded in the FIR, documented before autopsy is done and the autopsy report. Value of doing a complete autopsy stands questioned and it may be advisable to look into adopting alternate practices as seen in other parts of the world. Moreover, outdated, or absent guidelines for the actual carrying out of autopsies must be looked into and policies/ legislations surrounding it reviewed.

Original Articles, FUNCTIONAL BOWEL DISORDERS AFTER COVID-19

2024-03-09T06:13:28+00:00

Objective: To assess gut-brain interaction disorders and gastrointestinal symptoms after COVID-19 hospitalisation.

Study Design:Prospective, controlled study.

Setting: Medical wards and ICUs of Jinnah Hospital Lahore, Mayo Hospital Lahore, DHQ Hospital Gujranwalla, and Hijaz Hospital Lahore.

Study duration: April 1, 2020–December 31, 2021.

Material and Methods:We enrolled 1284 patients (both COVID-19 and non-COVID-19) who met the inclusion criteria and followed them for 1, 6, and 12 months after hospital discharge. Informed verbal consent was obtained, and patients underwent a focused history and physical examination and had their demographic details were recorded. Nasopharyngeal swabs for COVID-19 PCR confirmed infection and excluded non-COVID cases. Positive results were labelled COVID-19 positive. Validated questionnaires measured depression, anxiety, and gastrointestinal symptoms. 881 patients were included in the primary analysis after excluding those with preexisting GI symptoms or surgery. (270 controls, 611 COVID-19).

Results: Out of 1284 hospitalised patients, 249 patients were not included in the analysis because they did not adhere to the study protocol (died), had missing questionnaire data, or were diagnosed with cancer during the course of the follow-up. 805 (62.7%) of the remaining 1035 had COVID-19, and 162 (94 COVID-19 and 68 control) were excluded due to pre-existing gastrointestinal symptoms or surgery. 873 subjects without pre-existing confounders were assessed and followed up for primary and secondary aim analysis. 746 patients completed 6-month and 603 patients completed 12-month follow-up evaluations. In primary aim analysis, mean age was 48.9 ±20.1 years for control group and 52.9±14.2 for COVID patients (p=0.47). 62.1% of control and 58.7% of COVID cases were male (p=0.54). BMI in control group was 24.8±7.5 and in COVID cases it was 23.9±7.6 (p=0.6). COVID-19 patients had more gastrointestinal symptoms at enrollment (65.5% vs 38.5%, p<0.0015). Controls (15.5%) have more constipation than COVID-19 patients (9.1%) at 12 months ( p=0.029 ). ROME IV-defined IBS was higher in COVID-19 patients (4.0% vs. 0.3%, p=0.035). IBS was linked to allergies, dyspnoea, and proton pump inhibitors.At 6 months, the rate of depression among COVID-19 patients was higher than that of controls.

CONCLUSIONS: At 12 months, patients hospitalised with COVID-19 had less constipation and hard stools than controls. COVID-19 patients had significantly more IBS than controls.

Keywords: COVID-19, Nasopharyngeal swab, ROME IV, Irritable Bowel syndrome

Original Articles, ANTIOXIDANT ROLE OF MENTHA (MINT) AGAINST CHLOROQUINE INDUCED OXIDATIVE STRESS IN MALE ALBINO MICE

2024-03-09T07:07:57+00:00

Background: Many drugs, in the world, have been found to induce oxidative stress, when these are given at larger doses or for longer period. Worldwide research work is being carried out to find the antioxidant role of many herbs and plants so that these can be given prophylactically to prevent oxidative damage, done by free radicals.

Objectives: The objective of the study was to determine the antioxidant role of mint against chloroquine induced oxidative stress.

Material and methods: In this randomised controlled study, ninety male albino mice were divided into three groups randomly. Each of the three groups contained 30 mice. Group A was labelled as control group and Group B and C were labelled as experimental groups. Chloroquine (970 mg/kg of body weight) was given orally to the mice of group B, on the 9^th day of the experiment. The mice of group C were given ethanolic extract of mint consecutively for the initial eight days then they were given chloroquine, at the dose of 970 mg/kg of body weight, on the nineth day. The ethanolic extract of mint was then continued to be given from day 10 to day 16 of the experiment. Blood samples of the mice were obtained on the 17^th day of experiment by intracardiac puncture technique. SPSS version 20 was used to analyze the data.

Results: Highly significant (p=0.000) decrease in serum glutathione peroxidase and highly significant (p=0.000) increase in serum malondialdehyde was observed in mice of group B (whom chloroquine was given) as compared to those of group A. Group C mice, to whom ethanolic extract of mint was given before and after the administration of chloroquine, showed highly significant decrease and highly significant increase in serum levels of malondialdehyde and glutathione peroxidase respectively.

Conclusion: Chloroquine, when given at dose higher than the therapeutic dose in mice, can induce oxidative stress. Mint has antioxidant potential against chloroquine induced oxidative stress

Original Articles, FREQUENCY OF THROMBOCYTOPENIA AMONG DIFFERENT AGE GROUPS OF PATIENTS WITH LIVER CIRRHOSIS.

2024-03-09T06:25:10+00:00

Objectives

Patients with cirrhosis frequently exhibit thrombocytopenia, which might prompt an unnecessary referral for a bone marrow biopsy. The frequency of thrombocytopenia in liver cirrhosis is largely unknown in the study area. The main aim of our study is to evaluate prevalence thrombocytopenia in such patients in the study area.

Methods

A retrospective cross-sectional study was conducted on 268 confirmed liver cirrhosis patients for thrombocytopenia in Khyber teaching hospital, Peshawar. Both, male and female subjects with establish liver cirrhosis were included in the study while Patients having concurrent illness which can induce thrombocytopenia like malaria, dengue fever, ITP, malignancy. This study takes a total of six months duration. Data analysis was done using SPSS software for Windows (Version 20.0, SPSS Inc. Chicago).

Results

Results showed that 74.8% of the studied subjects were diagnosed with thrombocytopenia while 25.2% were normal. Thrombocytopenic patients were also categorized into mild, moderate, and severe. Among different age groups, severe thrombocytopenia was found to be highest in all age groups having 113 (42.2%) subjects. Consequently, Severe thrombocytopenia in age group 51-60 years were diagnosed in 99 (36.9%) cirrhosis patients which is statistically significant with p-value =0.032. In addition, 56 (20.9%) of the age group 31–40 year age were diagnosed for severe thrombocytopenia.

Conclusion

Our study concluded that thrombocytopenia showed be the primary parameter while to check for complications, related to liver cirrhosis.

Original Articles, KNOWLEDGE, ATTITUDE AND PRACTICE REGARDING BLOOD DONATION AMONG MEDICAL STUDENTS OF A PRIVATE MEDICAL COLLEGE, LAHORE

2024-03-18T04:08:45+00:00

Abstract

Background: Blood donation is helpful in saving the lives of millions. Voluntary blood donation is necessary for sustainable blood supply.

Objective: To determine knowledge, attitude and practices of 1st to 5th year medical students about blood donation and their association with the sociodemographic factors in a private medical college.

Materials and method: A cross-sectional study was conducted among medical students from first to final year during April to September 2022 after approval from Ethical Review Board. Data was collected on a pretested self-administered questionnaire from all the students who were present on the day of data collection after taking verbal consent from them. The data was analyzed by SPSS-22. Chi-square/Fisher’s exact was applied to find out the association of sociodemographic factors with knowledge, attitude and practices of blood donation. A p-value of ≤0.05 was considered as significant

Results: Out of 631 students, 601 who filled the questionnaire had 0.5% good, 14.6% satisfactory and 84.9% poor knowledge. The positive attitude was reported by 80% students. However only 28.1% had ever donated blood. There is statistically significant association of overall knowledge (p-value=0.01) and overall attitude (0.013) with the year of class. Practice of donating blood has significant relationship with age (p-value=0.043), gender (0.000) and year of study (p-value=0.009).

Conclusion: The overall knowledge of medical students about blood donation was poor. Majority of the students had positive attitude about blood donation and only more than one quarter had donated blood. There is significant association of academic year with knowledge regarding blood donation.

KEY WORDS: Blood donation, Medical students, Knowledge, Attitude, Practices

Review Articles, HISTORICAL AND CURRENT PERSPECTIVES ON THE HUMAN CONSUMPTION OF NON-NUTRITIVE SWEETENERS (NNS)

2024-03-16T07:37:27+00:00

The trajectory of human introduction to non-nutritive sweeteners (NNS) is marked by scientific discovery, consumer preferences and regulatory concerns. Ever since the discovery of saccharin by chance in the late 19th century, sweeteners such as aspartame, sucralose, and acesulfame potassium were developed in the 20th century having their unique taste profiles with minimal to no caloric impact. As the demand for sugar alternatives grew, driven by health concerns and dietary considerations, NNS found their way into an array of food and beverage products. More recently, the advent of stevia, a natural NNS derived from the leaves of the Stevia rebaudiana plant, has further diversified the market. However, debate about their safety and long-term health effects continue to shape research as well as public discourse. Regulatory bodies worldwide are continually striving to improve guidelines to ensure the safety of these sweeteners. The present review provides historical background, current status and future outlook on the human consumption of NNS and summarizes their evolution in order to identify potential areas for research.