Care Hospital In Lahore Research Articles

The Pharmacotherapy Practices and Clinical Outcomes of Pre-eclampsia/Eclampsia: An Observational Study

Background: This study observes fetal, pregnancy, and maternal outcomes with different regimens of Magnesium sulphate (MgSO4), used for prophylaxis and treatment of convulsions in eclampsia. Methods: In this observational study, the current prescribing practice and management outcomes of pre-eclampsia/eclampsia were observed in three tertiary care hospitals in Lahore, Pakistan. Data were collected by using data collection form, containing information related to patient demographics, history, laboratory findings, drug administration record, and therapeutic outcomes for pregnancy, fetus, and mother. Results: Of the 50 patients studied, most (74%) were of eclampsia. The mean age of the patients was 25.7 (+5.05) years with the majority (36%) in the age range 21–25 years. Forty-one patients received MgSO4, of which most received the Pritchard regimen (n = 35), whereas only 5 patients were managed with Zuspan regimen. Liner logistic analysis revealed better fetal outcomes (OR 0.217, CI –0.283 – 1.543) and pregnancy outcomes (OR 0.186, CI –0.164 – 0.635) with Zuspan regimen as compared to Pritchard. Whereas, both regimens showed no difference in maternal outcomes (OR 0.044, CI –0.129 – 0.170). Conclusion: Zuspan regimen proved to be better in morbidity and mortality associated with eclampsia. Additionally, national as well as institutional guidelines should be developed, implemented, properly monitored, and evaluated for management of preeclampsia/ eclampsia. Mandatory in-service training and expertise should be provided for health professionals at all levels of the healthcare system, especially those working in gynecological setup.

Persistently high plasma procalcitonin levels despite successful treatment of tuberculous pleuritis and tuberculous lymphadenitis patients

In a prospective cohort study, we evaluated plasma PCT levels in 48 TB lymphadenitis (TBLN) and 41 TB pleuritis (TBPE) patients. Measurements of PCT were done in unstimulated plasma of microbiologically and clinically confirmed TBLN and TBPE patients registered for anti-TB treatment at a tertiary care hospital in Lahore, Pakistan. Plasma levels of PCT were found to be raised in 89% of the patients at baseline with a median of 1.5 ng/ml. Levels were higher (p = 0.001) in TBLN as compared to TBPE (2.69, 0.96 ng/ml). PCT levels were not related to the bacterial burden depicted by culture positivity in these patients. PCT showed a negative correlation with the severity of constitutional symptoms (rho = − 0.238, p = 0.034), and inflammatory biomarkers; ferritin (rho = − 0.43, p < 0.001), INF-γ (rho = − 0.314, p = 0.003), TNF-α (rho = − 0.220, p = 0.039), IL-6 (rho = − 0.224, p = 0.035), and several chemokines of CCL and CCXL group. Raised plasma levels of PCT did not decrease with anti-TB treatment, indicating it is not a good biomarker to monitor treatment response in TBLN and TBPE patients. More studies with a larger number of confirmed EPTB cases are needed to define the role of PCT and its interaction with other biomarkers in EPTB.

Long-Term Safety and Efficacy of Janus kinase (JAK) Inhibitors in the Treatment of Rheumatoid Arthritis

Background: Janus kinase (JAK) inhibitors are a new class of drugs for the treatment of rheumatoid arthritis (RA); however, the long-term consequences of using these drugs are still not well understood. Objective: The primary objective of this research was to examine the effectiveness and safety of JAK inhibitors for the management of rheumatoid arthritis (RA) patients. Methodology: Clinical raw data of 150 RA patients receiving JAK inhibitors was collected in different tertiary care hospitals in Lahore, Pakistan from March 2023 to June 2024. till were conducted. The anti-inflammatory effect was evaluated by the Disease Activity Score in 28 joints (DAS28) and the safety profile through adverse events, laboratory markers, and patients self-reported outcomes. The SPSS version 27 applied for raw data analysis which used the paired t-tests and multiple regression models to establish the factors that determine favorable outcomes and complications. Results: JAK inhibitors also reduced the DAS28 scores from baseline to 24 months by a mean of 3. 2 ± 1. 1 (p&lt;0. 001). The findings stated that 12 percent of the patients at baseline and 45 percent of the patients at 24 months had achieved remission. The reported side effects were infections, 25%; gastrointestinal problems, 18%; and abnormal liver function tests, 10%. Severe adverse reactions were noted in 5% of the patients and no new safety issues were observed over the course of the treatment. Conclusion: JAK inhibitors have been shown to be useful in decreasing the activity of RA for the long-term use with reasonable side effects. The results provided evidence that JAK inhibitors were best treatment of rheumatoid arthritis (RA) but for best efficacy results closely monitoring and specific approach should be applied.

THE ASSESSMENT OF SELF-PERCEIVED EDUCATIONAL NEEDS AND COMPETENCY LEVEL OF EMERGENCY NURSES AT TERTIARY CARE HOSPITAL LAHORE

Competency in emergency nursing is crucial for ensuring high-quality patient care in fast-paced healthcare environments. Understanding emergency nurses' self-perceived educational needs and skill competencies is essential for guiding future training and improving patient outcomes. Objective: To assess emergency nurses' self-perceived educational needs and skill competencies at a tertiary care hospital in Lahore. Methods: A descriptive cross-sectional study was conducted using convenience sampling. The study population comprised 125 emergency staff nurses. Data were collected using a structured questionnaire and analyzed using descriptive statistics. Frequency distribution and data normality checks were performed to assess the nurses' educational background and skill competencies. Results: Most respondents (71.2%) held an associate diploma in general nursing, 13.6% had a post-RN qualification, and 15.2% held a Generic BSN. Regarding skill competency, 44% of respondents perceived themselves as highly competent, 40.8% as qualified, and 15.2% as least competent, particularly in areas like defibrillation and neurological assessment. Furthermore, 60% of the nurses needed additional education to enhance their patient care skills. Conclusion: The study concluded that emergency nurses at tertiary care hospitals require further education and training to enhance their knowledge and improve patient care outcomes. Continuous professional development programs focusing on skill enhancement are recommended to bridge the identified competency gaps.

Assessment of psychosocial work environment of doctors

Introduction :Psychosocial work environments pertain to interpersonal and social interactions that influence behavior and development in the workplace.Objective :To test a comprehensive and theory-based psychosocial work environment questionnaire and analyze associations with mental health in a sample of doctors in a tertiary care hospital in Lahore, Pakistan. METHODOLOGY :The design of study is cross-sectional study. It took place at Shaikh Zayed Hospital Lahore, from March 2017 to june 2017.A sample size of 100 working doctors was selected. Technique was non probability. After an informed consent each doctor was given the NRCWE’s Copenhagen short questionnaire consisting of 39 questions. The analysis of data was entered in SPSS 21. . After calculating frequency of data and explaining demographic variables, Independent t test sampling was applied and tables and pie chart was drawn.Results : Results reported worse working conditions in terms of stress, burnout, work family conflict and social support from superiors. High levels of stress and burnout were found. Doctors were almost satisfied with their jobs ( scores near to average but less than average ). Male doctors were found to be more satisfied with their jobs than female doctors.

Ergonomic Practice in Medical Laboratory Workers in a Tertiary Care Hospital in Lahore

Objective: To evaluate the ergonomics practice pattern among medical laboratory professionals to determine the ergonomic deficiencies to improve the workplace quality and safety at a tertiary care hospital in Lahore Methodology: This was a cross-sectional study conducted in department of pathology, King Edward Medical University/Mayo Hospital, Lahore from November 2019 to January 2020. All the workers engaged in all the sections of the clinical laboratory were included in the study. The results were collected using a self-administered questionnaire, which included demographic information, ergonomic practices, workplace layouts and equipment utilization pattern. Individuals were instructed to complete the questionnaires in accordance to their own specific time range and return it after filling. All the data was gathered from the surveys and then coded and securely stored in a database for further analysis and interpretation. Results: Average age of the participants was 26.80±5.70 years. Several participants reported appropriate bench heights (70.7%) and tools within arm’s reach (62.2%), deficiencies were noted in foot and knee clearance, with only 50.0% and 53.7% respectively. Limited provision of foot rails (11.0%) and floor mats (31.7%) for prolonged standing tasks was seen. Seated benches showed similar disparities, with notable deficiencies in adjustable armrests (32.9%) and footrests (29.3%). Microscope usage demonstrated challenges in maintaining neutral posture (65.1%), while pipette use and micro-manipulation tools highlighted the need for improved accessibility and ergonomic support. Conclusion: Study revealed the varying levels of ergonomic appropriateness across the workplace and equipment among medical laboratory workers, with significant inadequacies in foot and knee clearance, the presence of foot rails, floor mats, adjustable armrests, and foot rests. Difficulties in using a microscope, as well as concerns about pipettes and micro-manipulation equipment, underscored the need for improved accessibility and ergonomics.

PREVALENCE AND IMPACT OF WORKPLACE VIOLENCE AMONG NURSES IN TERTIARY CARE HOSPITALS

Workplace violence is a significant issue among nurses, particularly in tertiary care hospitals, impacting their well-being and job performance. Understanding the prevalence and types of violence can help develop effective strategies to mitigate these incidents. Objective: To investigate the prevalence, types, frequency, and impact of workplace violence among nurses in tertiary care hospitals in Lahore. Methods: This descriptive cross-sectional study was conducted in various tertiary care hospitals in Lahore over a six-month period following approval. The study population comprised registered nurses, aged 18-65, employed in these hospitals for over a year. A sample size of 108 nurses was calculated using Salvia's formula, with convenient sampling employed for selection. Data were collected using a self-administered structured questionnaire distributed via Google Forms. The questionnaire covered demographics, experiences of violence, perception of safety measures, coping strategies, and suggestions for improvement. Descriptive statistics were calculated, including frequencies, percentages, means, and standard deviations. Comparisons were made using the independent t-test and chi-square test, with a p-value &lt;0.05 considered significant. Results: Verbal abuse was the most prevalent type of violence, experienced by 62.96% of respondents. Other forms of violence included discrimination (11.11%), physical assault (4.63%), bullying (4.63%), and sexual harassment (1.85%). In terms of frequency, 42.59% of nurses experienced violence rarely, 32.41% frequently, and 25.00% occasionally. The impact of workplace violence included increased stress levels (46.30%), negative impacts on mental health (24.07%), reduced work productivity (16.67%), decreased job satisfaction (11.11%), and physical injuries (1.85%). Conclusion: The study highlights the high prevalence and significant impact of workplace violence on nurses in tertiary care hospitals in Lahore. Verbal abuse was the most common form, with substantial proportions of nurses experiencing frequent violence. These findings underscore the urgent need for targeted interventions to mitigate workplace violence and support affected healthcare workers.

Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore

Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease. Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore. Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance. Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels &gt;6.4% in 68%, high urea levels in 87%, and eGFR &lt;60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p &lt; 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p &lt; 0.001). Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.

The Assessment of Knowledge Regarding Anemia in Primigravida In Tertiary Care Hospital

Background: Anemia remains the most common nutritional deficiency worldwide, particularly among pregnant women. It significantly impacts maternal and fetal health, contributing to both morbidity and mortality. The problem is exacerbated by a general lack of awareness about the condition, its prevention, and management. Objective: The objective of this study was to assess the level of knowledge regarding anemia among primigravida women attending a tertiary care hospital in Lahore, aiming to identify key educational gaps that could be addressed to improve health outcomes. Methods: This descriptive cross-sectional study was conducted at the Gyne Out-Patient Department of a Public Hospital in Lahore. A total of 150 primigravida women were purposively sampled. Participants were excluded if they were visiting the labor room only or had a medical background. Data were collected through self-administered questionnaires, which included sections on demographic information and knowledge about anemia. Ethical approval was obtained from the institutional review boards, and informed consent was secured from all participants. Statistical analysis was performed using SPSS version 25, employing descriptive statistics and chi-square tests for categorical data. Results: Out of the 150 participants, 41.3% demonstrated poor knowledge regarding anemia, 30% had moderate knowledge, and 28.7% exhibited good knowledge. Awareness of dietary sources of iron and the impact of dietary habits on iron absorption was notably low among the respondents. Conclusion: The study revealed a significant lack of knowledge about anemia among primigravida women at the surveyed hospital, highlighting an urgent need for targeted educational interventions. Improving anemia awareness can potentially enhance maternal and fetal health outcomes.

Evaluation of Knowledge among Nurses about Pressure Ulcer in a Tertiary Care Hospital, Lahore

Background: Pressure ulcers are a prevalent issue in healthcare settings, leading to significant morbidity and increased healthcare costs. Nurses play a crucial role in the prevention and management of these conditions, yet gaps in knowledge can affect patient outcomes. The study aimed to assess the knowledge of nurses at a tertiary care hospital in Lahore, Pakistan, a setting where pressure ulcer management is critical yet understudied. Objective: This study aimed to evaluate the current level of knowledge among nurses regarding pressure ulcer prevention and management, and to identify any significant differences in knowledge across various critical care settings within the hospital. Methods: A cross-sectional descriptive study was conducted at Shalamar Hospital, Lahore, involving 125 staff nurses and nursing interns selected via simple random sampling. Participants were required to have at least six months of experience in general wards. Data were collected using a validated questionnaire, assessing knowledge of pressure ulcer management. Ethical approval was obtained from the Shalamar College of Nursing's ethical committee. Data analysis was performed using SPSS version 25 and Microsoft Excel, applying descriptive and inferential statistics, including the Chi-square test, with a significance level set at p&lt;0.05. Results: The study revealed that 68.8% (86/125) of nurses had average knowledge, 29.6% (37/125) demonstrated good knowledge, and only 1.6% (2/125) exhibited poor knowledge regarding pressure ulcer management. Notably, nurses in the Surgical Intensive Care Unit (SICU) and High Dependency Unit (HDU) displayed the highest levels of knowledge, whereas those in the Medical Intensive Care Unit (MICU), Cardiac Care Unit (CCU), and Emergency Room (ER) had comparatively lower knowledge levels. Conclusion: The majority of nurses at Shalamar Hospital possessed an average level of knowledge concerning pressure ulcer management. There is a critical need for targeted educational interventions to enhance knowledge and practices, particularly in units where nurses showed lower knowledge levels. Improving nurse education in pressure ulcer management could significantly impact the quality of patient care and reduce the prevalence of these injuries.

Knowledge and Practice Regarding Breast Self-Examination (BSE) among Nursing Students Working in A Tertiary Care Hospital Lahore, Pakistan: An Observational Descriptive Cross Sectional Study

Background: Breast self-examination (BSE) is a simple, quick, and cost-free method crucial for the early detection of breast cancer, which significantly reduces morbidity and mortality. Health Sciences students, particularly those in nursing, are ideally positioned to serve as role models and educators on this practice. Objective: The objective of this study was to assess the knowledge and practice of BSE among nursing students at a tertiary care hospital in Lahore, with a view to identifying gaps that could be addressed through targeted educational programs. Methods: This observational descriptive cross-sectional study engaged nursing students from various academic levels at a tertiary care hospital in Lahore. Participants were selected through convenience sampling. Adherence to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement was ensured. Data were collected via a self-administered structured questionnaire and analyzed using SPSS software version 26, focusing on frequencies and percentages of categorical variables. Results: Of the participants, 63.76% demonstrated a high level of knowledge about BSE, scoring ≥75%. In contrast, 36.23% scored below 75%, indicating a low level of knowledge. Practice of BSE was limited, with only 47% (n=65) of the participants engaging in the practice, and the majority, 53% (n=73), not practicing at all. Conclusion: Although nursing students show a good understanding of BSE, a significant gap exists between their knowledge and actual practice. This discrepancy highlights the need for enhanced educational interventions to encourage regular BSE practice, which is essential for the effectiveness of breast cancer screening and early detection efforts.

Assessment of level of Burnout among Health Professionals in Lahore, Pakistan

Objectives: The prime objective of this study is to access the level of burnout among healthcare professionals using BAT tool. Also, the association of job satisfaction and workload factors is tested with burnout. Study Design and setting: A cross-sectional multi-centered study in Lahore during the month of August 2022 to Jan 2023. The data was collected from healthcare professionals in three tertiary care hospitals in Lahore. Methodology: The data was collected from clinicians and staff nurses. The required sample size was calculated as 172. Data was collected using Burnout Assessment Tool (BAT) proposed by Schaufeli (2020). BAT was initially proposed with 33 items. BAT-S was the proposed 33-item version with four core dimensions and two secondary dimensions. The average score for each dimension was calculated and interpreted as given by Schaufeli in user manual for BAT-S. Results: Exhaustion was high among 55.8% of the participants. Mental distance was high among 34.3% of the participants whereas it was normal among 46.5%. Nearly 90% of the participants were satisfied from their jobs, committed to their jobs and accept responsibilities. Job satisfaction was significantly associated with burnout level. Lack of organizational influence and poor internal communication were statistically significantly related with level of burnout. Conclusion: The study was conducted to highlight the level of burnout among healthcare professionals. We found that very high level of burnout was observed in cognitive impairment followed by emotional impairment. The average level of burnout was more common among participants with job satisfaction and good internal communication.

Nurses Knowledge and Attitude Regarding Infection Control Practices

Background: Infection control practices are crucial in minimizing the risk of healthcare-associated infections (HAIs) in hospital settings. Adequate knowledge and positive attitudes among nurses towards these practices are essential for effective implementation and patient safety. Objective: This study aimed to evaluate the knowledge and attitudes of nurses regarding infection control practices at a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted involving 150 registered nurses from various departments including ICU, ER, and pediatric wards. Participants were selected using a convenient sampling technique. Data were collected via a validated questionnaire assessing knowledge and attitudes toward infection control practices. Descriptive statistics, frequency distributions, and reliability analysis (Cronbach’s Alpha) were performed using SPSS version 25. Results: The study revealed that 47.3% (71/150) of nurses had excellent knowledge, 22.0% (33/150) had good knowledge, and 30.7% (46/150) had poor knowledge about infection control. Regarding attitudes, 94.7% (142/150) of nurses exhibited a positive attitude towards infection control measures. The majority of participants were young, with 97.3% (146/150) between the ages of 21-30. Experience levels varied, with 81.3% (122/150) having between 1 to 3 years of experience. Conclusion: The findings indicate that while there is a good level of knowledge and a very positive attitude towards infection control among nurses, continuous education and training are needed to address gaps in knowledge and ensure high standards of practice are maintained.

Knowledge and Practices of Nurses Regarding Aseptic Techniques for Infection Prevention in Operating Room at Tertiary Care Hospital

Background: Surgical site infections (SSIs) remain a significant concern in operating rooms, largely influenced by the adherence to aseptic techniques by healthcare professionals. Despite the critical role of operating room nurses in preventing these infections, gaps in knowledge and practice persist, affecting the overall quality of patient care in tertiary healthcare settings. Objective: This study aimed to assess the knowledge and practices of operating room nurses regarding aseptic techniques for infection prevention in tertiary care hospitals. Methods: A descriptive cross-sectional study was conducted at a tertiary care hospital in Lahore, involving 130 operating room nurses with over a year of service. The study employed purposive sampling to administer a validated questionnaire assessing demographic data, knowledge, and practices related to aseptic techniques. Data were collected from January to March 2023 and analyzed using SPSS version 25, employing descriptive and inferential statistics to explore the relationship between demographic factors and knowledge/practices of aseptic techniques. Results: The study found that 60% of nurses were aware that a gown is considered sterile in specified areas, and 54.6% understood the contamination risks of dropped sterile packages. Approximately 62.3% recognized the importance of maintaining a safe distance during procedures. Despite these knowledge indicators, 94% of nurses routinely practiced sterile techniques, and 91% adhered to proper handwashing protocols. However, the overall level of knowledge concerning aseptic techniques was low, with significant gaps that could potentially impact patient safety. Conclusion: The study highlights a discrepancy between the knowledge and practices of operating room nurses regarding aseptic techniques, indicating a critical need for enhanced training and continuous education to bridge these gaps and improve infection control measures in surgical settings.

Knowledge, Attitude and Practice of Nurses Regarding Therapeutic Communication at Tertiary Care Hospital

Background: Effective communication in healthcare settings is pivotal for enhancing patient outcomes and fostering a cooperative environment between patients and healthcare providers. Therapeutic communication specifically plays a crucial role in establishing a rapport between nurses and patients, which can significantly impact the quality of care provided. Objective: The study aimed to evaluate the knowledge, attitudes, and practices of nurses regarding therapeutic communication within tertiary care hospitals in Lahore, identifying areas for potential improvement. Methods: A descriptive cross-sectional study was conducted over nine months using a validated questionnaire to assess the knowledge, attitudes, and practices of nurses. A total of 154 nurses were randomly selected using Slovin’s formula for sample size determination. Data collection involved demographic and professional experience details, followed by specific questions on therapeutic communication. The Statistical Package for the Social Sciences (SPSS) Version 25.0 was utilized for data analysis, employing descriptive and inferential statistics to interpret the data. Results: The results showed that 33.1% of nurses exhibited low knowledge levels, 39.0% moderate, and 27.9% high knowledge about therapeutic communication. Regarding attitudes, 57.1% of nurses displayed a positive attitude while 42.9% had a negative attitude towards therapeutic communication. In practice, 61.7% of nurses demonstrated good practice of therapeutic communication, whereas 38.3% displayed poor practices. Conclusion: The study concluded that while there is a moderate understanding and positive attitude towards therapeutic communication among nurses, significant portions still require further training and improvement. Enhanced educational programs focusing on therapeutic communication could bridge existing knowledge gaps and refine practices, thereby improving patient care outcomes.

ASSESSMENT OF SURGICAL TREATMENT STRATEGIES OF IATROGENIC GIANT FEMORAL ARTERY PSEUDOANEURYSMS

Iatrogenic giant femoral artery pseudoaneurysms pose significant clinical challenges, necessitating prompt intervention to prevent complications. Despite advancements in endovascular techniques, optimal surgical strategies remain unclear. This study aimed to evaluate surgical treatment's technical and clinical outcomes for these pseudoaneurysms. Objective: To assess the technical success and clinical outcomes following surgical repair of iatrogenic giant femoral artery pseudoaneurysms. Methods: This retrospective cohort study was conducted at a tertiary care hospital in Lahore, Pakistan between July 2022 and July 2023. A total of 60 patients diagnosed with iatrogenic giant femoral artery pseudoaneurysms underwent surgical repair. It was followed up for one, three, and six months using Duplex ultrasound and CT angiography. Data were analyzed to evaluate surgical techniques, technical success rates, and postoperative outcomes. Statistical analysis was performed using descriptive statistics and chi-square tests. Results: All patients (n=60) underwent successful surgical repair with various techniques: primary repair (n=30), repair with vein patch angioplasty (n=15), interposition reversed saphenous vein graft (n=10), and interposition synthetic Dacron graft (n=5). Technical success was achieved in 100% of cases, with no limb loss or intraoperative/postoperative mortality. The presenting symptoms were resolved in all patients, with one case of postoperative groin wound infection being effectively managed with antibiotics and debridement. Conclusion: Open surgical repair of femoral pseudoaneurysms demonstrates excellent technical feasibility and serves as a first-line treatment for iatrogenic giant femoral artery pseudoaneurysm-associated complications. These findings support surgical intervention as a practical approach to managing these challenging cases.

Burden and Outcomes of Respiratory Diseases in Hospitalized Neonates at a Tertiary Care Hospital in Lahore: A Cross-Sectional Study

Abstract Background: Respiratory diseases constitute a significant contributor to health issues in neonates, leading to admissions to neonatal intensive care units (NICU), and many of these neonates never recover, resulting in high neonatal mortality rates with respiratory diseases. Objective: To assess the burden of respiratory diseases in hospitalized neonates and determine their outcomes, including discharges and deaths, among those admitted to neonatal intensive care units in a tertiary care hospital in Lahore. Methods: An observational analytical cross-sectional study was conducted on 187 neonates admitted to a neonatology department of the tertiary care hospital in Lahore. Demographical data was collected by using a structured questionnaire. The analyses were conducted using R software. The chi-square test was employed to ascertain the associations between significant factors of respiratory diseases in neonates. Results: Among the respiratory conditions requiring admission, pneumonia (n=92, 49.1%) stood out as the most frequently diagnosed respiratory disease in neonates, followed by respiratory distress syndrome (RDS) (n=53, 28.3%), transient tachypnea of the newborn (TTN) (n=18, 9.62%), and meconium aspiration syndrome (MAS) (n=24, 12.8%). In terms of mortality among these respiratory conditions, pneumonia had the highest frequency (40.5%), followed by RDS (39.2%), MAS (20.2%), in neonates. Conclusion: Respiratory disorders proved to be a prevalent reason for neonatal admissions to the NICU, showcasing a significant association with neonatal mortality, especially in pneumonia, respiratory distress syndrome, and meconium aspiration syndrome.

Levofloxacin loaded chitosan and poly-lactic-co-glycolic acid nano-particles against resistant bacteria: Synthesis, characterization and antibacterial activity

BackgroundWith the global increase in antibacterial resistance, the challenge faced by developing countries is to utilize the available antibiotics, alone or in combination, against resistant bacterial strains. We aimed to encapsulate the levofloxacin (LVX) into polymeric nanoparticles using biodegradable polymers i.e. Chitosan and PLGA, estimating their physicochemical characteristics followed by functional assessment as nanocarriers of levofloxacin against the different resistant strains of bacteria isolated from biological samples collected from tertiary care hospital in Lahore, Pakistan. MethodsLVX-NPs were synthesized using ion gelation and double emulsion solvent-evaporation method employing chitosan (CS) and poly-lactic-co-glycolic acid (PLGA), characterized via FTIR, XRD, SEM, and invitro drug release studies, while antibacterial activity was assessed using Kirby-Bauer disc-diffusion method. ResultsData revealed that the levofloxacin-loaded chitosan nanoparticles showed entrapment efficiency of 57.14% ± 0.03 (CS-I), 77.30% ± 0.08(CS-II) and 87.47% ± 0.08 (CS-III). The drug content, particle size, and polydispersity index of CS-I were 52.22% ± 0.2, 559 nm ± 31 nm, and 0.030, respectively, whereas it was 66.86% ± 0.17, 595 nm ± 52.3 nm and 0.057, respectively for CS-II and 82.65% ± 0.36, 758 nm ± 24 nm and 0.1, respectively for CS-III. The PLGA-levofloxacin nanoparticles showed an entrapment efficiency of 42.80% ± 0.4 (PLGA I) and 23.80% ± 0.4 (PLGA II). The drug content, particle size and polydispersity index of PLGA-I were 86% ± 0.21, 92 nm ± 10 nm, and 0.058, respectively, whereas it was 52.41% ± 0.45, 313 nm ± 32 nm and 0.076, respectively for PLGA-II. The XRD patterns of both polymeric nanoparticles showed an amorphous nature. SEM analysis reflects the circular-shaped agglomerated nanoparticles with PLGA polymer and dense spherical nanoparticles with chitosan polymer. The in-vitro release profile of PLGA-I nanoparticles showed a sustained release of 82% in 120 h and it was 58.40% for CS-III. Both types of polymeric nanoparticles were found to be stable for up to 6 months without losing any major drug content. Among the selected formulations, CS-III and PLGA-I, CS-III had better antibacterial potency against gram+ve and gram-ve bacteria, except for K. pneumonia, yet, PLGA-I demonstrated efficacy against K. pneumonia as per CSLI guidelines. All formulations did not exhibit any signs of hemotoxicity, nonetheless, the CS-NPs tend to bind on the surface of RBCs. ConclusionThese data suggested that available antibiotics can effectively be utilized as nano-antibiotics against resistant bacterial strains, causing severe infections, for improved antibiotic sensitivity without compromising patient safety.

Evaluation of the Vitamin B12 Deficiency in Megaloblastic Anemia in Tertiary Care Hospital, Lahore.

Background: Megaloblastic anemia is a hematologic disorder characterized by the presence of large, immature red blood cells due to a deficiency in vitamin B12 or folate. It remains a significant public health issue globally, affecting various populations across different age groups and dietary habits. Objective: The objective of this study was to evaluate the prevalence and implications of vitamin B12 deficiency in the development of megaloblastic anemia in a tertiary care hospital in Lahore. Methods: A cross-sectional analysis was conducted on 85 patients over a period of four months. Ethical approval was secured in line with the Declaration of Helsinki. Participants included both genders with hemoglobin levels &lt;10 g/dl or mean corpuscular volume &gt;95 fL, excluding pregnant women and individuals with primary diseases such as hepatic, renal, or cancerous conditions. Verbal consent was obtained before blood sample collection. CBC parameters were analyzed using a Mindray hematology analyzer, and vitamin B12 levels were measured via ELISA. Statistical evaluation was performed using SPSS version 25.0. Results: The mean hemoglobin levels for males and females were 10.06 ± 3.10 g/dl and 9.61 ± 3.25 g/dl, respectively. The mean MCV for males was 99.94 ± 6.63 fL, and for females, it was 100.25 ± 7.90 fL. Vitamin B12 levels averaged at 489.92 ± 468.10 pg/ml for males and 440.19 ± 419.47 pg/ml for females. Of the patients, 47.05% had normal B12 levels, 25.88% were deficient, and 27.05% had high levels of B12. Conclusion: Vitamin B12 deficiency was prevalent among patients with megaloblastic anemia and was independent of gender or age. The findings suggest a strong need for enhanced nutritional awareness and screening practices to identify and treat this deficiency early in at-risk populations.

Correlation Between Demographic Features and PD-L2 Expression in Mucoepidermoid Carcinoma of Salivary Glands

OBJECTIVE: This study was conducted to determine PD-L2 expression and its association with grading in patients with mucoepidermoid carcinoma METHODOLOGY: : This descriptive study was conducted over a period of 1 year after taking approval from Institutional Ethical Review board. A total of twenty-four cases of MEC were recruited from different tertiary health care hospitals in Lahore and Multan. Data consisting of demographics and clinical features was collected. Histopathological analysis was done according to Seethala's grading system. Immunohistochemistry (IHC) was performed to observe PD-L2 expression. Data was analyzed by using SPSS 25 RESULTS: : The mean age was 30.08±12.8 years and there were 41.7% males and 58.3% females. Most common site of involvement was found to be parotid gland. A total of (54.2%) cases were of low grade. Strong PD-L2 expression was observed in 12(50%) cases while in 5(21%) cases there was week expression. No significant association of PD-L2 expression with grade of tumor was observed. CONCLUSIONS: Among salivary gland tumors, Mucoepidermoid carcinoma is emerging as most frequently diagnosed malignancy. These tumors originate mainly from parotid glands usually during fourth decade of life. As preliminary data generated from current research has highlighted the expression of PD-L2 in malignant MEC. The expression of PD-L2 was observed in all of the tissue specimens in the current study as detected through IHC irrespective of the grade of the tumor KEYWORDS: Programmed cell Death 1 Ligand 2 (PD-L2), Mucoepidermoid Carcinoma (MEC), ImmunohistoChemistry (IHC).