Care Hospital In Lahore Research Articles

Family History of Diabetes: An Important Risk Factor for Developing PCOS

Background and Aim: Polycystic ovary syndrome (PCOS) is a new rising disorder of reproductive, metabolic, and endocrine disorders of young females of reproductive age suffering from insulin resistance, increased levels of androgens, and altered morphology of ovaries with multiple cysts, and oligoanovulation. The burden of disease is significantly high with a global prevalence of 5% - 10% of reproducing females. Literature has reported a positive correlation between diabetes mellitus in the family and the resultant risk of developing PCOS among the female population. This study will aim to assess the correlation between the familial history of diabetes mellitus and concurrent risk of developing PCOS in a tertiary care hospital in Lahore, Pakistan. Methodology: A cross sectional study was conducted in the Medicine and Gynecology department of Sir Ganga Ram Hospital, Lahore for duration of four months from October 2021 to January 2022. Participants were recruited following inclusion and exclusion criteria. Sample population was estimated to be 150 females. Participants were recruited by convenient sampling. After recruitment participants underwent physical, clinical, and serological assessment. Diagnosis of PCOS was made by following Rotterdam criteria. Data collection was done by 14 points questionnaire and history interview. Results: This study showed that all participants diagnosed with PCOS have a history of early menarche, increased level of heartbeats, a large volume of ovaries, and a lesser volume of uterus. Patients also showed increased peripheral follicles. Serologic outcomes of participants showed a generalized increase in TT levels and a generalized decrease in SHBG levels with 1.71 (1.04-2.23) nmol/L and 45.39 ± 24.44 nmol/L respectively. About 56.2% (n= 83) of the participants gave a history of the abnormal menstrual cycle and 70.3% (n= 104) of the population agreed to abnormal hair growth on the body. When assessing the history of diabetes mellitus prevalence among families of the participants, the results showed that 19% of the population (n= 28) gave a positive history of diagnosed diabetes mellitus of both mother and father, 21.1% of the participants (n= 31) suggested that their parents were never tested for diabetes mellitus before, whereas remaining 43.8% (n= 89) gave no familial history of diabetes mellitus. Conclusion: The study concludes that the most common characteristics of PCOS among the population of Pakistan is increased weight followed by abnormal hair growth, participants present with increased TT and decreased SHBG levels. Familial history of diabetes mellitus is considered a risk factor for developing PCOS. Keywords: Familial diabetes, Diabetes mellitus, Polycystic ovary syndrome, Risk factors of PCOS

Outcome of Laparoscopic Repair for Perforated Peptic Ulcers in a Resource-Limited Setting.

BackgroundPerforation of peptic ulcers is a common cause of emergency surgery and has significant morbidity and mortality. The use and range of laparoscopic surgery have greatly increased over the past three decades. Laparoscopic approach is an option for perforated peptic ulcers because of the simple nature of the intervention. The aim of this study was to evaluate the outcome of laparoscopic approach for peptic ulcer repair in emergency setting by means of operative time, post-operative pain, mean hospital stay, and post-operative complications.MethodsIn this study, we enrolled patients presenting with perforated peptic ulcers in the emergency department of a tertiary care hospital in Lahore, Pakistan. Approval from the hospital ethical committee and informed consent were taken from all patients. After resuscitation, the patient underwent laparoscopic repair of perforation. Post-operative course of patients was monitored. Duration of surgery, post-operative pain, length of hospital stay, and post-operative complications were noted for all patients.ResultsBetween December 2018 and December 2021, 31 patients with perforated peptic ulcers underwent laparoscopic repair at our hospital. Mean age of patients was 37.25 ± 7.80 years. Most of the patients were male (70.76%). The mean operation time was 109.35 ± 17.02 minutes for laparoscopic repair. Mean duration of hospital stay was 5.10 ± 0.87 days. Mean post-operative pain was 3.55 ± 0.85 assessed using the Visual Analogue Scale. There were no mortalities during the 30-day post-operative window.ConclusionWith proper patient selection, laparoscopic surgery offers better results as compared to open surgery in patients undergoing emergency surgery for perforated peptic ulcers.

The Molecular Characterization of Virulence Determinants and Antibiotic Resistance Patterns in Human Bacterial Uropathogens.

The high rates of bacterial infections affect the economy worldwide by contributing to the increase in morbidity and treatment costs. The present cross-sectional study was carried out to evaluate the prevalence of bacterial infection in urinary tract infection (UTI) patients and to evaluate the antimicrobial resistance rate (AMR) in a Tertiary Care Hospital in Lahore, Pakistan. The study was conducted for the period of one year from January 2020 to December 2020. A total of 1899 different clinical samples were collected and examined for bacterial cultures using standard procedures. Samples were inoculated on different culture media to isolate bacterial isolates and for identification and susceptibility testing. A total of 1107/1899 clinical samples were positive for Staphylococcus aureus (S. aureus), Pseudomonas aeruginosa (P. aeruginosa), Escherichia coli (E. coli) and other bacterial isolates. Methicillin-resistant S. aureus (MRSA) prevalence was 16.93% from these positive cases. MRSA strains were found to be highly resistant to amikacin, clindamycin, fusidic acid, gentamicin and tobramycin, while highest sensitivity was noted against vancomycin (100%) and linezolid (100%). MRSA and high rates of multidrug resistance (MDR) pose a serious therapeutic burden to critically ill patients. A systematic and concerted effort is essential to rapidly identify high-risk patients and to reduce the burden of AMR.

The role of ocular coherence tomography angiography in the diagnosis of diabetic retinopathy and a comparison with the current gold standard fundus fluorescein angiography

Background: Diabetic retinopathy is a leading cause of preventable blindness in the world. Efficient and effective diagnosis and surveillance of diabetic retinopathy is of crucial importance to preserve the vision of patients. The FAZ (Foveal Avascular Zone) area is enlarged in patients of diabetic retinopathy. The purpose of this study was to evaluate the accuracy of OCT-A (Optical Coherence Tomography-Angiography) in delineating the FAZ area in cases of diabetic retinopathy and make a comparison with the findings of FFA (fundus fluorescein angiography) - the current gold standard.Subjects and methods: This was a comparative analytical study carried out at a tertiary care hospital in Lahore, Pakistan. A series of 50 patients, 30 males and 20 females with a mean age of 40 years were selected from the hospital outpatient department with history of five years of diabetic retinopathy. They were classified according to the ETDRS classification system into NPDR and PDR groups. The patients were booked for OCT-A, the scans were then observed for findings with a specific focus on the area of the FAZ at the level of the superficial capillary plexus. The patients then underwent same day FFA the current gold standard modality for diabetic retinopathy, thereafter a comparison between the mean area of the FAZ in both the modalities was made & documented. Data was analyzed using SPSS version 25.0. Results: The FAZ was easily distinguished by both FFA and OCT-A. The mean FAZ area was 0.62 mm2 on FFA and 0.69 mm2 on OCT-A. There was a statistically significant difference between the two means (p=0.002). Both the modalities had a Sensitivity of 100% at 0.44 and 0.48 cut-offs. OCT-A had a specificity of 91.9% and FFA had a Specificity of 89.2%.Conclusions: OCT-A proved to be an effective and accurate modality in delineating the FAZ area and detecting macular ischemia in patients of diabetic retinopathy in comparison to the current Gold-Standard FFA.

Exploiting the power of Gamification in Journal club.

To compare the effect of individual versus team competition gamification on trainees' engagement in journal club. The quasi-experimental study was conducted at two tertiary care hospitals in Lahore, Pakistan, from December, 2019 to May, 2020, and comprised all plastic surgery residents in training years 3-5 who had attended non-gamified journal club sessions. They were divided into two groups. Initially, two journal club sessions were run in a gamified manner. Group 1had an individual competition whereas group 2 had a team competition. In the second phase, the group orientation was reversed. Engagement scores were measured using the student engagement survey tool at baseline, at the completion of the first part, and at end of the intervention. Data was analysed using SPSS 22. Of the 44 participants, 23(52.3%) were in group 1 and 21(47.7%) in group 2. Overall, there were 27(61%) females and 17(39%) males. The mean age of the sample was 31±2 years. Gamification resulted in significant increase in the level of residents' engagement in journal club activities compared to the baseline scores(p<0.05). There was no significant inter-group difference in the post-intervention engagement scores (p>0.05). Gamification designs used in the journal club activity increased student engagement level compared to the pre-intervention score, but gamification design was not a significant factor in this regard.

Late sequelae of COVID-19 and its effect on the quality of life

Background: COVID pneumonitis presents with symptoms of fever, cough, fatigue, myalgia, inability to smell and shortness of breath. However, certain symptoms have been reported to be persistent in some people or novel post-recovery symptoms have developed. Due to the day today rise in the number of covid-19 cases in Pakistan, it is the need of the hour to determine the long-term consequences associated with this disease, to educate the general population and to establish the long-term management of the patients.Patients and methods: This cross-sectional study was conducted using non-probability purposive sampling, in which a total of 75 patients who had recovered from Covid-19 infection in the past 2-10 months visiting tertiary care hospitals in Lahore for follow up were recruited and filled survey forms bearing different questions regarding their disease, post-recovery symptoms and quality of life. Data collected was then analyzed by SPSS-26.Results: The most common symptoms were fatigue (66.7%), dry cough (46.7%), headache (44%) and joint pains (41.3%), followed by other general, neurological, pulmonary and psychological symptoms. The quality of life was analyzed in different domains exhibiting an average range of 60-68% which shows that covid-19 has significantly affected the quality of life of its victims.Conclusion: Various post disease recovery symptoms have been seen in the covid-19 victims and their quality of life has been deteriorated in physical, psychological, environmental and social domains; therefore, we need a multi-disciplinary team comprising of physicians, nurses, psychologists, social and occupational health workers who should work in liaison to tackle with these issues.

Knowledge of Patients Regarding Self Care Practice with Permanent Colostomy in a Tertiary Care Hospital in Lahore, Pakistan

After surgery patients with intestinal colostomy have some complications and alterations in their life. This is due to lack of information and postoperative care. More over one million patients are living with permanent colostomy and the number is growing by the rate of 100 000 annually. To remove their pouch, clean the stoma and skin surrounding the stoma, empty and dispose of waste matter from the stoma, patients with a new stoma be required to master various psychomotor abilities. This descriptive cross sectional study was carried out with 76 colostomy patients. Out of 76 patients 48.7% of the patients were males and females were 51.3%. According to the findings of this study, it is concluded that 100% patients had Inadequate Self Care which is &lt;70%. Conclusion: For such groups of patients, an education protocol should be held on regular basis, incorporating family and caregivers so that they can engage in the colostomy patient’s care. Study Design: A Descriptive Cross Sectional Study design was used. Settings: Data was acquired from a surgical department of a tertiary hospital in Lahore using a convenient sampling strategy. Study Participants: This study comprised 76 patients who had a permanent colostomy and were between the ages of 24 years to above 60 years. Results: The conclusion of the findings of this study is that 100% patients had Inadequate self care which is &lt;70%. Keywords: knowledge, practice, colostomy, stoma care

Multidrug Resistant E-Coli in Patients with Urinary Tract Infections Presenting to Internal Medicine Clinics of Two Tertiary Care Hospitals in Lahore, Tip of the Iceberg

Background: The commonly presenting infections in medical outpatients’ department are that of Urinary tract. If not treated properly these can lead to hospitalization and can increase the morbidity and mortality. Escherichia coli is found to be the most frequent bacterium causing these infections. The available literature may not under representing the prevalence of E. Coli which is multi drug resistant and is seen in general medical outdoor and internal medicine clinics of our local population, because urine sample is usually sent for culture only in complicated patients. Objective: To determine the prevalence of multi drug resistant E. Coli and its resistance to the most commonly used antimicrobial agents in Internal Medicine Clinics of Bahria International Hospital, and Farooq Hospital, West wood branch, Lahore. Study Design: This is an observational study done retrospectively carried out at Internal Medicine Clinics of Bahria International Hospital Lahore and Farooq Hospital, Lahore from 1st January 2019 to 31st December 2020. Methodology: One hundred and ninety adult patients with urinary symptoms and suspected UTI were enrolled. We analyzed the available urine culture reports and susceptibility against the pathogens. The testing was interpreted according to the European Committee on Antimicrobial Susceptibility Testing (EUCAST) standards. Results: The most common microorganism was E. Coli (70%) followed by klebsiella (17.9%), enterococcus (8.9%) and Acinetobacter (3.2%) in both complicated and uncomplicated urinary tract infections. 75 % females were E. coli positive as compared to the male (58.6%). Patients aged greater than 60 and less than 20 years were mostly affected with E. coli. Most of the isolated pathogens were highly resistant to ampicillin, cotrimoxazole, and cephalexin (70%–95.5%). Conclusion: E. coli is found highly resistant to antimicrobial agents used to treat UTI at family medicine practice. No difference could be appreciated in the apportioning of resistant E. coli in both complicated and uncomplicated UTIs. This study emphasizes that we should collect data at National level and prepares a proper guideline for choosing appropriate antibiotics in patients with UTI presenting to general medical clinics. Key words: E. coli, Multidrug resistance, Urinary tract infection, Antibiotics, Pyelonephritis

How do trauma nurses play their role and manage their emergency skills of management? A case study at a tertiary care hospital in Lahore

A greater understanding of the connection between a patient's history of trauma and the effects of that trauma on the patient's current mental illness can be gained by nurses who gain experience working in a trauma unit. One of the goals of this discussion is to find ways to provide care to patients without potentially further traumatising them. This educational discussion has the potential to provide nurses with content that describes the interplay of the neurological, biological, psychological, and social effects of trauma, which may reduce the likelihood of retraumatization. [This] discussion can be used to: It is unknown how the multidisciplinary nature of emergency departments (EDs) translates into clinical practise for nurses working in those departments. However, before emergency department nurses can begin working in the field, they must first receive an education that is both meaningful and specific to the role they will play. As a result, the purpose of this discussion was to assess the capabilities of emergency department nurses in terms of emergency management. Methods: This discussion was carried out in the form of exploratory research using a descriptive study layout. The pre-education and post-education questionnaires each had 18 questions, which allowed for the collection of quantitative data. The numbers show that there were a total of 34 emergency department nurses who took part in this education discussion. After the discussion, there was a significant change (p 0.01, r 0.35) in nine of the items in the list of eighteen. The perceived effectiveness of evaluating the role and emergency management skills of ED nurses was the primary point of contention in this argument. The nurses working in emergency departments became more knowledgeable about the impact that traumatic experiences can have on an individual's mental health. However, providing care to trauma patients in an emergency department setting was a significant challenge, and the primary reason for this was the limited amount of time that was available on a daily basis environment of the emergency department (ED) and the high volume of patients who may have multiple and/or complex presentations. Despite this, nurses played an important part in reducing the likelihood of the patients experiencing further trauma.

Frequency of Lumber Disc Degenerative Diseases in Patients with and Without Radiculopathy and Low Back Pain Using Magnetic Resonance Imaging

Degenerative lumbar disc disease is a condition in which an intervertebral disk and surrounding spinal components are weakened. This might be due to age or a pathogenic cause. Individuals may complain of low back pain. Objective: To determine the pattern of lumbar spine and disc degenerative diseases amongst patients having or not having Low Back Pain with or without radiculopathy diagnosed on Magnetic Resonance Imaging. Methods: Data was collected following inclusion criteria using convenient sampling technique. A total of 266 Patients undergone Lumber MRI scans on MRI Machine 1.5T Phillips. Data was collected from Radiology Department of Tertiary Care Hospital in Lahore, Pakistan. Data was entered and analyzed on SPSS version 20. Age Groups, Gender frequencies were mentioned. Cross Tabulation of Lumber Disc Degenerative Diseases with age and Gender was done and Chi square was applied. P-value ≤0.05 was considered significant. Results: The most prevalent age group for disc degeneration was 40-59 having 56.8 %. Females with disc degeneration have the highest frequency of 143 (53.8%) while males were 123 (48.2%). Lumber Disc degeneration was 101 (38%), Disc Herniation 54 (20.3%), and last with lowest presence of Spinal Canal Stenosis 18 (6.8%). Patients with Radiculopathy with Low back Pain was 61 (22.93%) and only LBP was the most common between the patients having 205 (77.1%). Cross Tabulation of Age Groups with Lumber Disc Pathologies was Significant having P value 0.05. Conclusion: In conclusion MRI can detect Disc Degeneration, Disc Herniation &amp; Buldges, and Spinal Canal Stenosis &amp; Nerve Root Compression. It can be considered significant and accurate to avoid any other interventional procedures. It is also concluded the LBP is an important factor in Disc Degenerative changes &amp; radiculopathy is less seen.

Impact of Bad Air Quality on the Morphology of Lungs - A Radiological Cross-Sectional Study Conducted at a Tertiary Care Hospital in Lahore.

Objective: To radiologically examine the impact of bad air quality on the x-ray findings of patients visiting a tertiary care hospital in Lahore. Material and Methods: This cross-sectional study was conducted in the outpatient department of CPTH, Lahore, from 1st of Oct. to 1st of Dec. 2021. A total of 40 patients from age groups between 21 – 60 years and from both genders, who presented with respiratory symptoms, were included in the study for their x-ray findings. As this was a radiological study, there was only one clinical parameter taken into consideration and that was x-ray chest. The patients enrolled in the study were divided into 4 groups, based on the severity of symptoms and findings on x-rays. Only non-smokers were included in the study. Results: Out of 40 patients, 18 showed no changes on x-ray chest, 12 showed minor appearance of unilateral peri bronchiolar shadows, 6 showed a more prominent appearance of peribronchiolar shadows bilaterally whereas 4 showed bilateral signs of lung fibrosis. Conclusion: Exposure to smog filled air can be linked to accelerated development of lung damage, even among people who have never smoked.&#x0D;

Association between Stress and Job Satisfaction in Young Doctors in Tertiary Care Hospitals in Lahore, Pakistan

Association between Stress and Job Satisfaction in Young Doctors in Tertiary Care Hospitals in Lahore, Pakistan

Audit to optimize antibiotics use in neonatal septicemia.

Objectives:To assess appropriate antibiotics use in neonatal sepsis and to highlight the need for developing an Antibiotic stewardship program at local levels.Methods:A clinical audit was conducted in the neonatal ward of the tertiary care hospital of Lahore for one year from May 2019 to May 2020. Reports of blood culture and drugs susceptibility were gathered from the microbiology department, and clinical records were evaluated about the choice of the antimicrobials, dosage, frequency, and clinical prognosis. The statistics were applied using SPSS software.Results:Eighty five neonates with the mean age of five days were treated in tertiary care hospital for septicemia. Every patient received more than one antibiotic empirically. The most prescribed drug combination (90.6%) was Cefotaxime and Amikacin. Optimum antibiotics dose was prescribed in only 70.2% of cases. Blood isolates showed gram-negative bacilli in 69 (81.2%) cases, gram positive cocci in 14 (16.5%) cases, two (2.3%) culture susceptibility reports showed growth of candida. Gram negative organisms were most susceptible to Imipenem (54%), Piperacillin-Tazobactam (48%) and Gentamicin (48%). Gram-positive organisms showed the most susceptibility to Vancomycin (100%), Amikacin (92%), and Co-amoxiclav (85%). Meropenem (39%), Linezolid (28%), and Vancomycin (27%) were the most commonly given alternate antibiotics. All the patients (n=10, 11.8%) whose culture sensitivity reporting showed susceptibility to empirical therapy survived.Conclusion:Due to poor availability of latest data about local antibacterial resistance pattern and lack of knowledge among pediatricians about latest antibiotic prescribing protocols, many inconsistencies were noted in the use of antibiotics in neonatal sepsis which resulted in a poor outcome hence, reflecting in international key health indicators (neonatal mortality rate) of country. Concerning the change in the resistance pattern of microorganisms to antimicrobials, it is high time to collect local data about antibacterial susceptibility and develop an antibiotic stewardship program to stop inappropriate use of antibiotics.

Septicemia in Patients Admitted at Mayo Hospital due to Wound Infection

Septicemia may result due to invasive procedures undertaking in medical sections. Patients are more likely to experience septicemia after endoscopic biliary drainage/stenting. Objectives: To find septicemia in patients admitted at Mayo hospital due to wound infection. Method: In a tertiary care hospital in Lahore, 101 confirmed cases of septicemia were the subject of an observational cross-sectional study. Any case of septicemia, whether it developed before or during a hospital stay, is included in the study. All patients' test results were collected between 24 hours of admission. Patients of both sexes were included, and their ages were broken down into three ranges: 30–50, 51–70, and 71–90. Results: Septicemia due to wound infection was seen in 8 patients out of which 5 were males and 3 were females. Bilirubin was high in 3/5 males but normal in 3/3 females. Blood glucose was high in 4/5 males and normal in 2/3 females. Blood urea was high in 4/5 males and 3/3 females. Creatinine was high in 7/8 patients.&#x0D; Conclusion: Major causes of septicemia were wound infection. Septicemia due to wound infection was seen in majority of patients. ALT, AST and ALP was high while total protein was normal in septicemia due to wound infection

Frequency and Gram Categorywise Distribution of Clinical Isolates from Patient samples in tertiary care Hospital of Lahore

Antibiotics form an important tool in the treatment of various bacterial infections but their overuse and misuse are resulting in antibacterial resistance among bacteria. Objective: to outline the frequency and gram categorywise distribution of clinical isolates from patient samples Methods: In this study, 1000 samples were collected from the patients attending the pathology department of Fatima memorial hospital, Lahore, Pakistan. Identification of bacteria was done through conventional culture and biochemical tests Results: one thousand clinical isolated were identified Conclusions: Gram negative bacterial isolates were prevalent, with 55% frequency distribution and Staphylococcus aureus was frequent as it was identified in 410 different samples of patients.

Patient safety culture: a survey of private sector tertiary care hospital of Lahore, Pakistan

Patient safety is a critical component to improving healthcare quality. Due to the potential of growing recognition and importance of establishing a patient safety culture within healthcare organizations, assessing existing patient safety culture is a prerequisite. Despite a vital role in delivering quality care, little attention has been given to describe healthcare professionals' perceptions and expectations of the patient safety culture in Pakistan. Objective:The current study aimed to assess the patient safety culture at a private tertiary hospital in Lahore from the perspectives of doctors and nurses. Methods: This cross-sectional study collected data from 120 nurses and doctors of the private hospital using the Hospital Survey of Patient Safety Culture (HSOPSC).The respondent's demographic characteristics and study variables influencing patient safety culture were presented through descriptive statistics, and a chi-square test was applied to identify the variable influencing patient safety.Results: The current study outcomes revealed a positive score for different dimensions ranging from 32.1% to 86.5%. The dimension of organizational learning-continuous improvement (86.5%) and teamwork within units (81.7%) had the highest scores as compared to teamwork across units (74.7%), feedback and communication about the error (73.7%), management support for patient safety (71.6%), supervisor/ manager expectations and actions promoting patient safety (69.8%), communication openness (65.4%), overall perceptions of patient safety (62%), frequency of events reported (53.7%), handoffs and transitions (49.9%), staffing (33.3%) and non-punitive response to errors (32.1%).Conclusion: The current study's findings highlighted a less positive attitude of doctors and nurses towards patient safety culture within their organizations. The outcomes of the present study could be used for designing and establishing interventions to improve patient safety practices in similar tertiary care settings across Pakistan.

Association between potential risk factors and the occurrence of coronary artery disease

Coronary artery disease is the major reason for high death rates in the United States and other European countries. In Pakistan, men are at greater risk of developing (CAD) in early ages as compared to women. A good deal of people suffering from CAD in Pakistan, belongs to the lower middle socioeconomic level. Aims of the present study were to observe risk factors associated with coronary artery disease e.g. smoking, hypertension, diabetes and obesity. Methods: It was a case control study carried out in Mayo hospital, a tertiary care hospital of Lahore. The study sample was 200, from which 100 were cases and other 100 were controls. In cases 77 were males and 23 were females and in controls 52 were males and 48 females were enrolled by using non-probability sampling. SPSS software was used to analyze the data and for finding out the association between different risk factors and CAD. Results: CAD was 4 times more in hypertensive cases as compared to non hypertensive cases; there is statistically significant association of hypertension with coronary artery disease. 42 were diabetics and 58 were non diabetic, and in controls 16 were diabetics and 84 were non-diabetic. There is statistically significant association of diabetes with coronary artery disease. In CAD patients 49 were smokers and 52 were non smokers. In controls 22 were smokers and 78 were non smokers. There is statistically significant association of smoking with coronary artery disease. In coronary artery disease patients 48 were obese and 52 were non-obese. In controls 27 were obese and 73 were non obese. There is statistically significant association of obesity with CAD. Conclusion: The present research has highlighted the increasing prevalence of CAD and its risk factors e.g. hypertension, diabetes mellitus, smoking and obesity. Development of focused strategies to improve awareness regarding coronary artery disease and its potential risk factors along with stressing on lifestyle modification is need of the hour.

Relationship between Hyperlipidemia and Periodontal Inflammation among Patients of Hypothyroidism

Objective: The study was conducted to assess the relationship between hyperlipidemia and periodontal inflammation among patients of hypothyroidism Method: Current study was analytical crossectional in nature. Data was collected from 479 patients coming to the dental section OPD of a tertiary care hospital in Lahore. Patients with periodontitis and had hypothyroidism were taken as participants of study. Periodontitis was assessed by clinical examination. Gender and age was taken as demographic variables. Frequencies and percentages were calculated. Chi-square was used to assed. Results: The results of chi-square revealed that there is a significant difference between the levels of cholesterol and occurrence of periodontitis (X2=25.09, P=.001). Participants with normal level of cholesterol and have periodontitis were 65(13.57%), with level of cholesterol at borderline and have periodontitis were 135(28.18%) and participants with high level of cholesterol and have periodontitis were 279(58.25%). Conclusion: Cholesterol levels affect periodontal health in hypothyroidism patients. Keywords: Hyperlipidemia, Periodontitis, Hypothyroidism, Cholesterol

The Usage of Antibiotics by COVID-19 Patients with Comorbidities: The Risk of Increased Antimicrobial Resistance.

Antimicrobial resistance (AMR) is a global health issue that plays a significant role in morbidity and mortality, especially in immunocompromised patients. It also becomes a serious threat to the successful treatment of many bacterial infections. The widespread and irrelevant use of antibiotics in hospitals and local clinics is the leading cause of AMR. Under this scenario, the study was conducted in a tertiary care hospital in Lahore, Pakistan, from 2 August 2021 to 31 October 2021 to discover the prevalence of bacterial infections and AMR rates in COVID-19 patients admitted in surgical intensive care units (SICUs). Clinical samples were collected from the patients and we proceeded to identify bacterial isolates, followed by antibiotic susceptibility testing (AST) using the Kirby Bauer disk diffusion method and minimum inhibitory concentration (MIC). The data of other comorbidities were also collected from the patient’s medical record. The current study showed that the most common pathogens were E. coli (32%) and Klebsiella pneumoniae (17%). Most E. coli were resistant to ciprofloxacin (16.8%) and ampicillin (19.8%). Klebsiella pneumoniae were more resistant to ampicillin (13.3%) and amoxycillin (12.0%). The most common comorbidity was chronic kidney disease (CKD) and urinary tract infections (UTIs). Around 17 different types of antibiotic, the carbapenem, fluoroquinolones, aminoglycoside, and quinolones, were highly prevalent in ICU patients. The current study provides valuable data on the clinical implication of antibiotics consumed by COVID-19 patients in SICUs and the AMR rates, especially with different comorbidities.

Perceptions and practices regarding the process of obtaining informed consent from surgical patients at a tertiary care hospital

BackgroundProper informed consent is essential for patients to have sound knowledge about the indication, risks, and benefits of a proposed surgical procedure. The study aim was to assess the perceptions of postoperative patients about the informed consent process and identify various influential factors in a tertiary care hospital. MethodsA cross-sectional study was conducted from February to August 2018 at a tertiary care hospital in Lahore, Pakistan. A validated questionnaire was used to conduct interviews of 101 patients planning to undergo elective surgery after fulfilling all ethical considerations. A purposive sampling technique was employed to enroll and the data analysis was performed by using SPSS version 23. ResultsOut of total 101 patients, 50 (49.5%) of them were males and the mean age of total sample was 36.98 ± 14.23 years. The majority 92 (91.1%) considered informed consent to be important and that it did not influence their surgical decision 85 (84.2%). Consent was obtained by the consulting surgeon from 41 (40.6%) patients and by the residents/house officer from 60 (59.4%) patients. Fifteen (14.8%) patients signed the consent form themselves, and 86 (85.1%) relatives of patients signed. Ninety-eight (97.0) patients were told about indications of the surgery, and 54 (53.5%) were told about possible complications. Seventy-five (74.3%) patients were informed about alternatives to surgery. Significant reasons for not signing were language (p = 0.03), educational status (p = 0.002), and not being informed by relatives before signing (p = 0.02). ConclusionThe patients had adequate knowledge about the process of informed consent and considered it important. Factors identified as barriers to signing the consent form by the patients themselves included language, better educational status, and not being asked by relatives. It is imperative to involve the patients in the process of consent, especially in signing by them or in their presence by their surrogate.