Care Hospitals Of Peshawar Research Articles

THE HOUSEHOLD ECONOMIC BURDEN OF HEAD AND NECK CANCER PATIENTS IN PESHAWAR, PAKISTAN

The most prevalent cancer in the world is head and neck cancer. The age of the patients positively associates with the disease's incidence. About 85% of the male patients diagnosed with this condition are older than 45 years of age. The main risk factors for head and neck cancer include tobacco use, smoking, and alcohol consumption. These are especially significant risk factors for male patients with head and neck cancer. The objective of this study is to measure the economic burden of head and neck cancer disease in the male population. Households have a heavy financial burden because of head and neck cancer. To examine the impact of head and neck cancer on patients, we got the list of the patients from the territory care hospitals in Peshawar and interviewed 235 patients to estimate the health cost. The study's methodology is divided into two parts: empirical estimations and descriptive statistics. The Ordinary Least Square (OLS) estimate technique was employed in the study to identify the variables affecting the expense of head and neck cancer. According to the analysis, the stage of cancer and the length of the treatment is increasing the cost of head and neck cancer and the number of cancer patients visiting these hospitals from the KPK, Islamabad, etc. The majority of respondents reported significant intangible burdens, such as fear, pain, mental distress, and family management. Patients with head and neck cancer were more likely to face several psychological issues because of their health condition.

ASSOCIATION OF SERUM VITAMIN D WITH GLYCOSYLATED HEMOGLOBIN LEVELS AND DURATION OF DISEASE IN TYPE-II DIABETES MELLITUS PATIENTS

Objective: To find a possible association between levels of vitamin D and glycosylated hemoglobin levels in patients with type II diabetes mellitus. Materials and Methods: A cross-sectional study was conducted at a tertiary care hospital in Peshawar over six months. Diagnosed cases of Type-II diabetes mellitus were recruited through non-probability consecutive sampling. The levels of glycosylated hemoglobin and serum vitamin D levels were assessed in 219 selected patients enrolled in the study through Cobas Integra 800 and Enzyme-Linked Immunosorbent Assay respectively. Patients were divided into three categories based on increasing levels of glycosylated hemoglobin. The trend in the levels of vitamin D levels in these categories of increasing HbA1c was identified. Results: Out of 219 Type II diabetic patients, 30.1% (66) were men while 69.9% (153) were women. The mean age was 59.48 ± 9.29 years. Similarly, HbA1c and serum vitamin D, were 9.47 ± 2.88 and 18.63 ± 16.54, respectively. Overall, 59% of the patients were Vitamin D deficient. The decrease in Vitamin D levels was associated with an increase in glycosylated hemoglobin levels (p-value 0.002). CONCLUSION: Vitamin D deficiency in Type-II diabetes mellitus patients increases with increasing levels of glycosylated hemoglobin. KEYWORDS: Diabetes Mellitus, Type II Diabetes, HBA1c, Vitamin D.

Community-Acquired Skin and Soft Tissue Infections: Epidemiology and Management in Patients Presenting to the Emergency Department of a Tertiary Care Hospital.

Skin and soft tissue infections are one of the most common diseases presenting to the emergency department (ED). There is no study available on the management of Community-Acquired Skin and Soft Tissue Infections (CA-SSTIs) in our population recently.This study aims to describe the frequency and distribution ofCA-SSTIs as well as their medical and surgical management among patients presenting to our ED. We conducted a descriptive cross-sectional study on patients presenting with CA-SSTIs to the EDof a tertiary care hospital in Peshawar, Pakistan. The primary objective was to estimate the frequency of common CA-SSTIs presenting to the ED and to assess the management of these infections in terms of diagnostic workup and treatment modalities used. The secondary objectives were to study the association of different baseline variables, diagnostic modalities,treatment modalities, and improvement with the surgical procedure performancefor these infections. Descriptive statistics were obtained for quantitative variables like age. Frequencies and percentages were derived for categorical variables. The chi-square test was used to compare different CA-SSTIs in terms of categorical variables like diagnostic and treatment modalities. We divided the data into two groups based on the surgical procedure. A chi-square analysis was conducted to compare these two groups in terms of categorical variables. Out of the 241 patients, 51.9% were males and the mean age was 34.2 years. The most common CA-SSTIs were abscesses, infected ulcers, and cellulitis. Antibiotics were prescribed to 84.2% of patients. Amoxicillin + Clavulanate was the most frequently prescribed antibiotic. Out of the total, 128 (53.11%) patients received some type of surgical intervention. Surgical procedures were significantly associated with diabetes mellitus, heart disease, limitation of mobility, or recent antibiotic use. There was a significantly higher rate of prescription of any antibiotic and anti-methicillin-resistant Staphylococcus aureus (anti-MRSA) agents in the surgical procedure group. This group also saw a higher rate of oral antibiotics prescription, hospitalization, wound culture, and complete blood count. This study shows a higher frequency of purulent infections in our ED. Antibiotics were prescribed more frequently for all infections. Surgical procedures like incision and drainage were much lower even in purulent infections. Furthermore, beta-lactam antibiotics like Amoxicillin-Clavulanate were commonly prescribed. Linezolid was the only systemic anti-MRSA agent prescribed. We suggest physicians should prescribe antibiotics appropriate to the local antibiograms and the latest guidelines.

Frequency of Thyroid Lesions in a Tertiary Care Hospital in Peshawar

Objective: To determine the frequency spectrum of all thyroid lesions in terms of histopathological patterns presented to the Pathology Department of the Combined Military Hospital Peshawar. Methodology: A retrospective observational study was conducted at the Combined Military Hospital, Peshawar, from September 2015 to December 2020. A total of 235 thyroidectomy specimens, over a period of 5 years, were included in the study period. Information was collected on age, gender, clinical presentation, and histopathological diagnosis. Results: A total of 235 cases were studied over a period of five years, of which 188 (80%) were females and 47 (20%) were males, with a male to female ratio of 1:4. The patients’ ages ranged from 14 years to 85 years, with a mean age of 41 years, and the relative peak age of incidence was seen from 21 to 40 years of age. Total 193 cases (82.1%) belonged to the non-neoplastic category out of which adenomatous colloid goiter was the most common (180 cases, 93.3%). The neoplastic lesions (total cases 42) were 17.9% of all of the cases, out of which benign lesions i.e. adenoma comprised 20 cases (47.7%) and malignant lesions were 22 (52.3%). Among the malignant lesions papillary carcinoma was the most common (16 cases) comprising of 73% of all of the malignant lesions. Conclusion: Thyroid lesions are more common in females, with peak incidence in the second and third decades. The non-neoplastic lesions are more common, with the adenomatous goiter being most prevalent. In the neoplastic lesions, follicular adenoma constitutes the main lesion in the group of benign neoplasms and papillary carcinoma being the most common lesion among the malignant neoplasms.

Association of Non-Modifiable Risk Factors with Coronary Artery Disease (CAD) in a Tertiary Care Hospital in Peshawar, Pakistan

Introduction: Coronary Artery Diseases (CAD) have been estimated to be the leading cause of mortalities in developing countries in the year 2010. It is evident from previous studies that healthy life style choices can help in the reduction of CAD risk factors. They are either modifiable risk factors including hypertension, hypercholesterolemia, smoking, diabetes mellitus, obesity, and psychological stress or non-modifiable risk factors such as age, gender, family history and ethnicity. Non modifiable risk factors, however, are not studied in detail regarding their association with CAD. Objective: The objective of this study was to assess non-modifiable risk factors associated with CAD in patients and to devise strategies to deal with these risk factors to reduce the incidence of CAD among local population. Methodology: Retrospective observational study was conducted at Peshawar Institute of Cardiology (PIC). Data was extracted from Electronic Medical Records (EMR) of 98 patients including non-modifiable risk factors associated with CAD i.e., gender, age and family history. Results: The analysis performed indicated that in patients with CAD, non-modifiable risk factors such as age and gender play a significant role (p

BURNOUT IN DOCTORS WORKING IN TERTIARY CARE HOSPITAL IN PESHAWAR, PAKISTAN

Objective: To determine the frequency of burnout in postgraduate doctors working in a Tertiary Care Hospital in Peshawar, PakistanMethodology: This cross-sectional study was conducted in tertiary care hospital in Peshawar from June 2019 to December 2019. Using the Non-probability convenient sampling technique 252 doctors from different specialties participated in this study, by filling out the questionnaire. The questionnaires had three parts, questions related to Socio-demographic data, questions related to the workplace, and Maslach Burnout Inventory (MBI). For analysis of data related to MBI, we added up each component (emotional exhaustion, depersonalization, and reduced personal accomplishment). The values obtained were interpreted according to reference values of the Center of Advanced Studies on Burnout Syndrome (NEPASB). Data was analysed using SPSS 20.Results: In this study, out of these 252 doctors 25.39% were having high burnout while 32.93% were found to be at high risk of burnout. On the MBI scale 34.92% % showed a high score for Emotional exhaustion, 95.23 % of doctors scored high in Depersonalization, and 95.63% % scored low in Personal accomplishment. Amongst specialties burnout score was highest in orthopedics (80.14) followed by obstetricians and Gynecologists (75.35). Burnout was reported in 68.85% of young doctors aged 25-30, females (71.58%) were affected with burnout more as compared to male gender.Conclusion: This study concluded that about one-third of doctors were at high risk of developing burnout, while 25% were already affected by burnout.

Impact of Number of Exposed Carious Lesions as Reason for Pain or Tooth Extraction on Quality of Life of Children Aged 7-16 Years Attending Tertiary Care Hospitals in Peshawar

Background: Carious lesions are the record frequent oral health problem among school going kids everywhere the world. In the deciduous teeth, dental caries is the tenth most communal oral problem that affects about nine percent of the population worldwide. Aim: To report impact on quality of life of exposed carious lesion as reason for tooth extraction in 7-16 years children. Study design: Descriptive cross-sectional study. Place and duration of study: Sardar Begum Dental College and Peshawar Dental College, Peshawar from 1st January 2021 to 31st December 2021. Methodology: Three hundred and eight children aged 7-16 years of both genders were enrolled from two dental teaching hospitals of Peshawar. Children were examined clinically at a dental chair. A radiograph advised by the clinician was used to diagnose number of teeth having exposed carious lesions that are causing pain or extracted/filled because of pain were recorded for each participant in a structured data collection sheet. Child oral health impact short form was used to record oral health related quality of children. Results: There were 182(59.1%) males and 126(40.9%) females and mean age was 10.0±2.8 years. The correlation between OHRQoL and number of teeth with exposed carious lesions that are causing pain, filled or have been extracted because of pain is 0.610, which indicates positive correlation, as lesion increases the QoL of an individual will decrease. Conclusion: The positive correlations between OHRQoL and number of teeth having had exposed carious lesions that are causing pain, filled or have been extracted because of pain. It also signifies the negative impact of exposed carious lesion, over oral health related quality of life of 7-16 years old, visiting two tertiary care hospitals of Peshawar. Key words: Quality of life (QoL), Oral health related quality of life (OHRQoL), Peshawar

Analyzing the Efficacy of Topical Ciprofloxacin Ear Drops vs. Oral Tablets and Topical Ciprofloxacin Ear Drops Together for the Treatment of Patients with Chronic Suppurative Otitis Media (CSOM-Tubotympanic Type)

Background: A suppurative Middle ear infection is the most frequent kind of otitis externa in low-income regions of the world (CSOM). Suppurative otitis media (CSOM-tubo tympanic type) affects both young and old alike. The condition has been treated using a wide range of approaches. Objectives: The purpose of this study was to evaluate the efficacy of oral and topical ciprofloxacin against topical ciprofloxacin drops alone in the treatment of CSOM-tubo tympanic ear discharge. Methods: Randomization was used in our study Patients with chronic suppurative otitis media were seen between September 2020 and September 2021 at tertiary care hospital in Peshawar. SPSS version 24 was used to evaluate hospital and pathology lab data. Results: Overall, 75 patients were included in the study's findings. They split themselves into two categories. There were 38 people [group A] and 37 people [ group B]. each Group was classified into two age groups, the younger [ages 01–12] and the older (ages 13–60). (age 13-16 years). Patients' ages ranged from 1 to 12 years old, with 28 [group-A] at 72% and 25 [group-B] at 65%. Ten people 27% in [group-A] and thirteen patients (35%) in [group B], were between the ages of thirteen and sixteen (group B). Conclusions: As a result, we found that the combination of oral and topical ciprofloxacin was superior to topical ciprofloxacin alone in resolving ear discharge in patients with middle ear CSOM (tubo-tympanic type). Keywords: Topical and oral ciprofloxacin, treat chronic suppurative, otitis media

Frequency of Contrast Induced Nephropathy in Diabetic Patients Undergoing Coronary Angioplasty

Objective: To find out the frequency of contrast induced nephropathy in diabetic patients undergoing coronary angioplasty. Material and Methods: After approval from the Hospital ethical committee, the study was conducted in the department of cardiology Hayatabad medical complex Peshawar from 28th July 2020 to 28th January 2021. A total of 136 patients were followed in this study. Oral anti-glycemic agents (metformin) were stopped before and after two days of cardiac catheterization. Previous medical record was checked including renal profile. Phlebotomist was called to take blood for random blood sugar, HbA1C level and renal functions tests (RFTs). Angioplasty was performed according to the set protocol. Serum creatinine level was checked both pre and post contrast. Results: Our study included 136 individuals, with a median age of 48 (+13.36), and we found that 59% of them were men and 41% were women. Of the 136 individuals, only 7 (5%) had contrast-induced nephropathy. Conclusion: To sum up, we found that five percent of diabetic patients having coronary angioplasty in a tertiary care hospital in Peshawar had contrast-induced nephropathy. Keywords: Diabetes mellitis, Coronary angioplasty, Contrast-induced nephropathy.

THE RELATIONSHIP OF PLACENTA ACCRETA SPECTRUM WITH PREVIOUS CESAREAN SECTION IN PATIENTS WITH PLACENTA PREVIA- A CASE-CONTROL STUDY IN TERTIARY CARE HOSPITAL OF PESHAWAR

Objective: To determine the relation of placenta Acreta Spectrum with previous Cesarean section in patients with placenta previa. Material and Methods: This case-control study was conducted in a tertiary care hospital in Peshawar from 1st July 2019 to 30th June 2021. All the cases with placenta Previa were included. Women with placenta Acreta Spectrum diagnosed on obstetric ultrasound served as cases. Patients with placenta previa without accrete served as controls. Their records were studied in detail and all the data was recorded in a Proforma specially designed for this study. Odds ratios at the end of the study were calculated using SPSS-23. Results: During our study period, a total of 102 patients with placenta previa were enrolled. The ages ranged between 20-45 years. The majority of the patients were > 40 years old (31.3%). On the basis of gravidity, different groups were found i.e. 45 patients (44.1 %) were between G5-G6. A total of 14 women were found with placenta accrete spectrum making an incidence of 13.72%. Of all the patients’ i.e.100% (odd ratio 1.1) were having a history of previous Cesarean birth. 6 out of 14 patients (42.8%) had a history of previous 1 Cesarean section while two patients (10%) had a history of 4 c\s in the past. Nearly all patients had major placenta previa except one patient who had minor placenta previa (7%). Conclusion: Our study highlighted the striking relationship of placenta Accreta spectrum with previous Cesarean delivery in patients with placenta previa however it was not found that increasing the number of previous Cesarean sections resulted in an increased number of placentae Accreta spectrum. Keywords: Placenta Accreta spectrum, Cesarean section.

Comparative analysis of Methicillin-resistant Staphylococcus aureus through whole genome sequencing in the largest tertiary care hospital in Peshawar, Pakistan.

Methicillin-resistant Staphylococcus aureus (MRSA) is a globally disseminated antibiotic-resistant pathogen and causes mild to severe infections. The population structure of MRSA is highly clonal and individual genetic clones harbor specific plasmid, and determinants for antibiotic resistance and virulence, therefore, whole genome sequencing (WGS) of five MRSA isolates of the predominant genetic lineage was performed to gain insight into the most prevalent endemic strains. Sequencing libraries were arranged in accordance with the Nextera XT DNA Library Prep Guide (Illumina). WGS was performed on Illumina NextSeq 500 platform with 2×151bp using a NextSeq Mid-Output Kit. The sequenced genome was characterized for spa type, MLST type, SCCmec type, plasmid, antibiotic resistance gene, and virulence gene by publicly available bioinformatics tools on the website of the Center for Genomic Epidemiology. All the isolates were characterized as ST8/t064-SCCmecIVa(2B) clones of MRSA and, A total of 13 resistance genes, 11 virulence genes, and 6 types of plasmids were identified in the sequenced isolates of MRSA, furthermore, the sequenced isolates showed a similar pattern of distribution for antibiotic resistance genes and virulence genes. WGS revealed that the isolates are genetically closely related and showed a similar pattern of distribution for different genetic markers, therefore, these strains could be an accidental case cluster or cluster of an outbreak.

Knowledge and practices of nurses regarding pain assessment in Intensive Care Units of tertiary care hospitals in Peshawar

Background: Pain is a significant problem experienced by patients, especially in the adult Intensive Care Unit (ICU). Inexorable pain is the most common condition among critical patients that may seriously affect their well-being, health outcomes, and quality of life. Objective: This study aimed to assess the nurses’ knowledge and practices related to pain assessment in critically ill patients. Methodology: A descriptive cross-sectional study was carried out among 58 registered nurses working at different ICUs in public and private hospitals. A non-probability purposive sampling technique was used, and frequency distribution and percentages were used for different variables. The data was collected through a modified adoptive questionnaire and the data was analyzed using SPSS 22.0 version and Microsoft excel 2010. Results: Among all participants, 23 (39.7%) participants were from public hospitals and 35 (60.3%) from private hospitals, 24 (41.4%) were male and 34 (59.6%) were female. The overall knowledge and practice of participants 6.90% had poor knowledge, 53.40% had good knowledge, 39.70%had a very good knowledge, 13.80% of participants had poor practice, 69.0% had a good practice and 17.20% had a very good practice. Conclusions: Nurses have a key role in the assessment and management of pain because pain is a nursing-sensitive indicator. Unfortunately, the treatment of pain is highly insufficient because of inadequate clinical knowledge about the best ways to manage pain; the current study findings reported that the nurses were having good knowledge about pain assessment. Most of the respondents had adequate knowledge about it and have good practice. And the majority of them were using pain assessment tools.

Causes and management of blunt liver trauma in a tertiary care hospital in Peshawar

Trauma is the principal reason of deaths in kids and young adults globally. Objective: To determine the causes and management of blunt liver trauma in a tertiary care hospital in Peshawar. Methods: The present investigation observed a total of 150 individuals through non-probability consecutive sampling to determine the mean hospital stay in patients presented with blunt liver trauma. Results: In this study, age distribution among 150 patients was analyzed as n= 10-20 Years 51 34.0%), 21-30 Years 35 (23.3%), 31-40 Years 16 (10.7%), 41-50 Years 23 (15.3%), 51-60 Years 25 (16.7%). Mean age was 41.56±5.357 years. Gender wise Distribution among 150 Patients was analyzed as Male were 94 (62.7%) and female were 56 (37.3%) Distribution of BMI among 150 patients were analyzed as n=Below 18.5 Underweight 76 (50.7%), 18.5–24.9 Normal weight 35 (23.3%), 25.0–29.9 pre-obesity 21 (14.0%), 30.0–34.9 Obesity class 18 (12.0%). Distribution Mechanism of Injury among 150 patients were analyzed as n= RTA was 57 (38.0%), fall from height was 52 (34.7%), Sport's injury was 18 (12.0%), physical assault was 23 (15.3%). Successful Conservative Management among 150 patients were analyzed as n= Yes was 106 (70.7%) and No was 44 (29.3%), Distribution of Mortality among 150 patients were analyzed as n= Yes was found 66 (44.0%) and No was found 84 (56.0%). Conclusions: The severity of liver damage and concomitant intra-abdominal injuries demonstrated a strong association with the chance of success with conservative therapy. The restricted hospital facilities and lack of agreement on traditional therapy had a detrimental influence on success.

Prevalence of Hyperthyroidism in Patients with Atrial Fibrillation

Background: Hyperthyroidism causes a rise in cardiovascular disease and dysrhythmias, leading to increased mortality. Low serum thyrotropin levels are a known independent risk factor for atrial fibrillation (AF). The frequency of hyperthyroidism in patients with AF is still unknown. Objectives: To determine the prevalence of hyperthyroidism in patients with AF admitted to a tertiary care hospital in Peshawar. Methodology: This was a cross sectional observational study that included 155 patients with AF. The study was conducted in the cardiology department of a tertiary care hospital in Peshawar, Pakistan, from December 2019 to May 2020. Results: Hyperthyroidism was found in 13(8.39%) patients with atrial fibrillation, while 142(91.61%) patients were without hyperthyroidism. There were 94 (60.65%) males and 61(39.35%) females. The ratio of male to female was 1.6: 1. The mean age of the patients enrolled was 50.35 years+14.95SD, with a range of 18-75 years. Patients were divided into three age groups, and atrial fibrillation was common in the 41-60 (years) age group. Conclusion: Hyperthyroidism is a recognized cause of atrial fibrillation. Every new-onset atrial fibrillation should be investigated with serum TSH levels. It can result in cerebral embolic episodes, particularly in the elderly and people with other risk factors. Keywords: Atrial fibrillation, Hyperthyroidism, Arrhythmia

The Relationship between Psychological Disability and Religious Practice and Coping Strategies in Caregivers of Children with Traumatic Brain Injury in Pakistani Population.

Traumatic brain injury (TBI) is a serious issue and a leading cause of death and disability worldwide. Caregivers of TBI patients experience psychological distress and a variety of social and financial issues. The present study aims to investigate the caregiver's burden and the factors that influence this burden. Furthermore, the present study will find out the association of religious practice, religious coping relations and psychological distress among caregivers of children affected with TBI. A cross-sectional survey was conducted on 302 caregivers of children with TBI using Duke University Religion Index (DURL) for religious practice. General Health Questionaire-12 (GHQ-12) was used for anxiety and depression and Brief Religious Coping Scale (RCOPE) was used for coping strategies. The caregivers were conveniently chosen from different regions of Khyber Pakhtunkhwa province and data was collected from different tertiary care hospitals in Peshawar. Forty-nine (49) % of caregivers score ≥ 3 on GHQ suffer from psychological distress with a Mean of 20.957 ± 4.175). Positive coping methods were mostly used by caregivers than negative coping have a low level of distress with a Mean Positive Coping (P-COPE ) of 6.93 ± 0.41, Mean of Negative Coping (N-COPE) 0.486 ± 1.023. In religious practice, caregivers mostly participate in Organized Reliogious Activities (ORA) or some Non-Organized Reliogious Activities (NORA) with a Mean ORA of 4.20 ± 1.27, and NORA Mean of 4.17 ± 1.37 used by the caregivers. Coping methods were related to Caregiver psychological distress (GHQ-12 and P-COPE co-relation scores are (ρ -0.022, p b 0.05); GHQ-12 scores and N-COPE (ρ + 0.221=, p b 0.001). There is a negative correlation between GHQ 12 and PCOPE, while GHQ12 is positively correlated with NCOPE. According to this study, there is a significant association between religious coping methods, religious practice, and psychological distress among caregivers of children with traumatic brain injury.

Comparison of the Covid-19 Infection Severity in Known Diabetic Patients vs. Known Hypertensive Patients Admitted in A Tertiary Care Hospital in Peshawar

Objectives: To compare the severity of COVID-19 infection among known diabetic and known hypertensive patients who were admitted in a tertiary care hospital in Peshawar, Pakistan. Methodology: A cross-sectional clinical study was conducted for comparison in diabetic vs hypertensive patients in the department of medicine of Lady Reading Hospital, Peshawar during the period from April-June 2021. All the patients were admitted in COVID ward and COVID ICU, showed their full consent and active participation in this study. Along with patient’s ECG and Echo report, a questionnaire based on Canadian categorization employed for angina grading and NYHA categorization to classify shortness of breath was used. Results: The mean age group taken for the sample was (n=140) with maximum age of 84 years. Majority were 102(72.9%) males and females were 38(27.1%). According to laboratory tests performed on patients of COVID-19 about 48(34.4%) of patients showed positive diabetes mellitus findings. Also, patients with positive hypertension found were 67(47.9%). The average stays of patients, at the hospital, was 15-40 days. About 58.3% of mortality was noted in patients with diabetes mellitus, a bulk of patients expired were from ICU-COVID-UNIT and 55.2% was the mortality rate in patients with positive hypertension according to our clinical findings and assessment. About 7.9% of COVID inpatients had cardiac infraction with severe condition and such patients who faced congestive heart failure expired. Almost 56(40%) of the patients were found with severe condition and 63(45%) were diagnosed with moderate condition during their stay at hospital. Conclusion: Regardless of age, gender and disease the death rate evaluated was 50%. Moreover, in diabetics and hypertensive patients there should be raised awareness for preventing the severity of disease. Keywords: COVID-19, Infection severity, Diabetic patients, Hypertensive patients, Tertiary care hospital, Pakistan

PREVALENCE OF MALARIA IN BLOOD DONORS IN A TERTIARY CARE HOSPITAL IN PESHAWAR

Background: Malaria is a protozoan parasitic infection of humans resulting from one or more of the five species of the genus Plasmodium. A transfusion transmitted infection (TTI) is a virus, parasite, or other potential pathogen that can be transmitted in donated blood through transfusion to a recipient. The aim of this study was to find out the frequency of malaria in blood donors at a tertiary care hospital in Peshawar. Methods: A total of 218 patients were observed in this descriptive cross-sectional investigation from 16 April to 16 October 2021, at Department of Pathology, Hayatabad Medical Complex, Peshawar. Informed consent was obtained from the blood donors justifying the inclusion criteria. Three ml venous blood of each donor was collected in EDTA containing vacutainer. The complete blood count was done on CELL-DYN Ruby® analyzer. Geimsa stained thick and thin blood films were made from each donor blood sample and was examined under ×100 objective lens (oil immersion) using a light microscope for Plasmodium. Results: Mean age of the subjects was 32±11.46 years; 88% donors were male and 12% were female. The frequency of malarial parasite was 4% in blood donors. The transmission of malarial parasite was found significant with a history of fever among the blood donors (p<0.05). Conclusion: The frequency of malarial parasite was 4% in blood donors presenting at a tertiary care hospital of Peshawar, Pakistan. Pak J Physiol 2022;18(3):27?9

Frequency of newly diagnosed diabetes in hemorrhagic stroke patients presenting to a tertiary care hospital in Peshawar.

Objective: The present study aimed to determine the frequency of newly diagnosed diabetes in Hemorrhagic stroke patients presenting to a tertiary care hospital in Peshawar.
 Methods: This cross-sectional study was conducted at the Department of Medicine, Lady Reading Hospital, Peshawar, for six months. A total of 210 hemorrhagic stroke patients were recruited. Patient history was obtained following detailed clinical examination and necessary tests such as computerized tomography (CT) brain, Glycated hemoglobin (HbA1c). The data were recorded using a structured questionnaire and analyzed using SPSS version 22.0.
 Results: Out of the total, there were 66.70% males and 33.30% females, with a mean age of 55.90 ± 9.28 years. 53.3% were hypertensive, and only 27.60% had active smoking status. We found 63 (30.0%) new cases of diabetes mellitus. The most common risk factors among the enrolled newly diagnosed diabetic subjects were family history of diabetes, hypertension, and BMI (P<0.05).
 Conclusion: It is concluded that newly diagnosed diabetes mellitus is fairly common in hemorrhagic stroke patients. Therefore, it is recommended that early screening of diabetes mellitus will benefit the patients in terms of good prognosis, reduced morbidity, and mortality.

MATERNAL ADVERSE OUTCOMES OF TEENAGE PREGNANCY: A CROSS-SECTIONAL STUDY FROM PESHAWAR

Objective: To determine the adverse maternal outcome in teenage pregnancies reported to a tertiary care hospital in Peshawar. Methodology: A descriptive cross-sectional study was conducted among 177 females (15-19 years of age) and gestational age of more than 28 weeks was confirmed through ultrasonography. Adverse maternal outcomes such as anemia, eclampsia, pre-eclampsia, preterm deliveries, and lower segment cesarean section (LSCS) were measured as per defined in the operational definition. Maternal outcomes were stratified among residence and educational level to see effect modifiers. Results: In this study, anemia was detected in 45 (25.4%) patients while eclampsia and pre-eclampsia were noted in 44 (24.9%) and 45 (25.4%) patients respectively. Pre-term delivery and LSCS were observed in 79 (44.6%) and 53 (29.9%) patients respectively. Lower educational level was associated with eclampsia, preterm delivery, and lower segment cesarean section. Conclusion: Teenage pregnancy was reported to be related to a high rate of adverse maternal outcomes like anemia, eclampsia, pre-eclampsia, premature birth, and LSCS.

Fetal Macrosomia Among Non-diabetic Women: Our Experience in a Developing Country.

BackgroundThe prevalence of fetal macrosomia varies worldwide. Its trend has increased over the past decades in many developed nations. It is associated with various maternal and fetal complications. The information regarding the frequency of fetal macrosomia among non-diabetic women is limited in resource-limited countries such as Pakistan. Therefore, this study aimed to determine the number of fetal macrosomia cases among non-diabetic women.MethodologyThis was a cross-sectional study conducted in a tertiary care hospital in Peshawar, Pakistan. A total of 119 pregnant women were enrolled in the study. All pregnant women aged 15 to 45 years who had singleton pregnancies with any parity or gravida and a gestational age of ≥37 weeks were included in the study. Pregnant women with underlying chronic systemic disorders such as diabetes mellitus, gestational diabetes mellitus, hypertension, renal or cardiac disorders, and sickle cell anemia were excluded from the study. Women who did not consent to participate and those with a gestational age of ≥42 weeks at the time of delivery were also excluded from our study. Based on a 5.2% prevalence of fetal macrosomia in the general population, the sample size was calculated using the World Health Organization calculator at a confidence interval of 95%, absolute precision of 0.05 with anticipated population proportion, and a 4% margin of error. The required sample size was calculated at 119. The chi-square test was applied. P-values of ≤0.05 were considered significant.ResultsOut of 119 participants, fetal macrosomia among non-diabetic women was seen in 10 (8.4%) cases. The mean age of patients in our study was 29.80 ± 4.33 years. The mean gestational age was 36.05 ± 1.31 weeks, whereas the mean body mass index of participants was 29.17 ± 2.36 kg/m2. Post-stratification, spontaneous vaginal delivery was the only significant variable with a P-value of <0.05 in our study.ConclusionsThe number of fetal macrosomia among non-diabetic women in our study was 10 (8.4%). Because this was a single-center, hospital-based, cross-sectional study, we need to conduct large multi-centered randomized controlled studies to identify the actual prevalence of fetal macrosomia in non-diabetic women in our population.