District Headquarters Research Articles

Prevalence of Medicolegal Cases During Covid-19 Pandemic Lockdown; A Local Experience

Medical examinations are essential in legal cases, providing critical evidence that influences judicial outcomes. The COVID-19 pandemic impacted various societal aspects, including the nature and frequency of medical examinations. Objective: To compare the prevalence and types of medicolegal cases reported at District Headquarters Hospital, Rawalpindi, during the pre-pandemic and pandemic periods. Methods: A retrospective comparative cross-sectional study was conducted using data from March 2019 to August 2019 (pre-pandemic) and March 2020 to August 2020 (pandemic). Demographic details, including age and gender, as well as the types of cases (e.g., physical assault, sexual assault, trauma), were analyzed using SPSS version 24.0. Results: The total number of cases increased significantly from 389 in the pre-pandemic period to 441 during the pandemic (P < 0.01). During the pandemic, physical assault cases increased from 122 (31.36%) to 151 (34.24%), and sexual assault cases rose from 39 (10.02%) to 54 (12.24%) (P = 0.013). Blunt trauma cases increased from 79 (20.31%) to 101 (22.9%) and sharp trauma cases from 67 (17.22%) to 89 (20.18%). However, cases involving road traffic accidents (RTA) decreased significantly from 41 (10.54%) to 16 (3.63%) (P = 0.04). Poisoning incidents saw slight changes and the occurrence of burns, particularly chemical burns, increased from 3 (0.77%) to 5 (1.13). Conclusions: The COVID-19 pandemic lockdown has had a profound impact on the prevalence and nature of medicolegal cases. These findings emphasized the need for targeted interventions to address the specific medicolegal challenges exacerbated by pandemic conditions and to support vulnerable populations, particularly in urban areas and among women.

Epidemiology of malaria and hematological analysis in district Dir (lower), Pakistan

Background: Malaria is considered as a tropical disease, in developing countries. Among all parasitic infections malaria is most widespread and devastating disease. According to WHO malaria is endemic in 24 countries. Methods: This cross-sectional study was conducted at Department of Medical Laboratory Technology University of Haripur. Total 995 samples were collected at District Head Quarter Hospital (DHQ), Tehsils Hospitals (THQs), and other private laboratories in District Dir (Lower). These samples were processed to observe the shape of RBCs as well as plasmodium species in the smear microscopically, and for hemoglobin estimation. Data was analyzed through SPSS version-21. Results: Highest percentage of malaria was recorded in Munda (35.17%) followed by Timergara (19.59%) whereas the lowest number of cases were found in Khall (5.02%). Prevalence of P. vivax was (98.0 %) and P. falciparum was (2 %) in district Dir Lower. Mean red blood cell count (RBCs) was 4.2±0.64 mm3 while mean Hb was 11.0±1.99g/dl. Based on different age categories, the highest RBCs and Hb levels were found in age group 41-50 years, whereas the lowest RBCs were found in age group 11-20 years while the lowest Hb levels were recorded in group 1-10 years. In associated diseases, the upper respiratory tract infections (URTIs) were the most frequent (20%) followed by diarrhea (18%). Mean Hb of males was 11.8±1.53 g/dl while the mean Hb of female was 11.5±5.384 g/dl. Hb in both males and females were low as compared to the standard. However, as compared to females, Hb of males were significantly lower with p-value <0.001. Conclusion: We concluded that males are more commonly infected from malaria as compared to females. Males and children were found to have low Hb as compared to females and higher age group patients. URTIs and diarrhea were the most common associated illness.

Quality of life in cutaneous leishmaniasis patients in Khyber Pakhtunkhwa, Pakistan.

To determine the impact of leishmaniasis on the quality of life of patients visiting the district headquarter hospital in District Khyber, Khyber Pakhtunkhwa, Pakistan. A cross-sectional exploratory study was conducted in District Headquarter Hospital of Khyber District, Khyber Pakhtunkhwa from November 2019 to April 2020. In this study, 349 participants who consented were included by using a non-probability consecutive sampling technique. A validated questionnaire "Dermatology Life Quality Index" (DLQI) was used for data collection. Independent sample t-test and one-way ANOVA were used for mean scores comparison. The mean DLQI score of cutaneous leishmania patients was 11.83 ± 3.94. Cutaneous leishmaniasis (CL) patients experienced a huge impact on their quality of life. The highest effect was observed for symptoms and feelings while the least impact was for the treatment. Statistically, no significant difference in mean DLQI score was found for gender, age, marital status, lesion activity, lesion appearance, and treatment history (p > 0.05). However, statistically, a significant difference was observed for the education, occupation, lesion location, and lesion type (p < 0.05). CL had a significant impact on the patient's quality of life and mental health. Further research is required to assess the impact of the treatment on QOL in CL patients. and for a better understanding of the issue and its mechanistic basis.

Ethnography of The Traditional Dhaka Makers: A Case Study of Terathum District

Ethnography of The Traditional Dhaka Makers: A Case Study of Terathum District

The efficacy of Merit-based Recruitment in Amolatar district in Northern Uganda

Purpose: This study aimed to assess the success of merit-based recruitment in Amolatar District Local Government Administration, Uganda. Methodology: A case-study research design was adopted backed by quantitative and qualitative analysis that involved a careful and in-depth investigation of a particular unit or events under study for the purposes of generalization. It was conducted in Amolatar District. We chose this area because merit-based recruitment had failed as a result of weak decision-making processes by the district service communion and the influence-peddling by political leaders in the district. We took a sample of 60 respondents and interviewed 52 respondents living within the District Headquarters and in Amolatar Town Council. Findings: The results revealed that the success of merit-based recruitment in Local Government Administration is very essential in terms of stakeholder responsibility, enhancing citizen confidence in the local government institution, and enabling the district service commission to recruit the best human resources for the provision of quality service. Contribution to Theory, Policy and Practice: This study is central as it strengthens the merit-based recruitment model over and above other models of recruitment as well as enabling local governments to prioritize meritocracy over political patronage in every staff recruitment cycle.

ISOLATION AND CHARACTERIZATION OF ESCHERICHIA COLI IN UTI PATIENTS OF DISTRICT D.I.KHAN AND TO PROBE THEIR ANTIBIOTIC RESISTANCE

Background: Globally urinary tract infections are present predominantly and mostly UTIs are present or noticed in the developing countries like Pakistan, Bangladesh etc. There are multiple factors in spread of UTIs like microbes, taking certain medicines, sexual activities, poor hygiene, not taking enough water etc. Objectives: The prevalence of UTIs and development of resistance against the antibiotics is due to unjustified use of antibiotics. Methodology: We performed a study in a remount area of Khyber Pakhtunkhwa i,e Dera Ismail Khan. We conducted a research study consist of a three months duration. Hundred (100) urine samples were collected from the patients who visited District Head Quarter (DHQ) teaching hospital Dera Ismail Khan. Patients having different age groups were included in study, Results: After processing samples, the number of samples having E.coli i,e positive samples were 73 in number, which were confirmed on the basis of different tests. The prevalence of UTIs due to E. coli organism was noticed increased in female patients (69 %) as compared to male patients and its prevalence was 31%.When the isolated E. coli strain were tested against different antibiotics, showed that those strains which were isolated from urine samples of the male patients of age group 61 to 80 years showed higher sensitivity against PTZ, NF, FOS, AK, IMP, and SCF, while in female high rate of sensitivity against PTZ, NF, FOS, AK, IMP, and SCF antibiotics was observed against E. coli strains which were isolated from the patients having age from 21 to 40 years Likewise E.coli isolates were sensitive against Imipenem, Peracillin + Tazobactam, Cefoperazone + sulbactam, Fosfomycin, Amikacin, Nitrofurantoin, Peracillin and Tambactam irrespective of age of the patients from which bacteria were isolated. Conclusion: Furthermore, present study also revealed, that the E. coli has developed resistance against commonly used antibiotics which is a serious concern to worry about and serious steps should be taken by the authorities to stop frequent use of antibiotics without proper prescription to avoid this issue.

Comparison study of genexpert MTB / RIF assay versus sputum smear microscopy results in presumptive tuberculosis cases in district Ghotki, Sindh.

Objective: To evaluate the performance of GeneXpert MTB/RIF assay by comparing its results with sputum smear microscopy. Study Design: Comparative Cross-Sectional Study. Setting: Department of Outpatient (OPD), Taluka and District Head Quarter Hospitals of District Ghotki Sindh. Period: October 2022 to 2023. Methods: In this study 350 Participants were included and all sputum specimens were tested for both above mentioned diagnostic tools that are sputum smear microscopy and GeneXpert MTB/RIF assay during the period October 2022 to April 2023. All details regarding the study such as Demographic details, sputum smear microscopy results, and GeneXpert MTB/RIF assay test results of patients were collected. A case of pulmonary tuberculosis (PTB) was considered to be a patient having mycobacterium tuberculosis detected in sputum by GeneXpert MTB/RIF assay. Results: In this study, 61 cases (17.4%) out of 350 participants, were detected in GeneXpert MTB/ RIF assay and 35 cases (10%) out of 350 participants were positive in sputum smear microscopy. Male ratio is slightly higher than female among GeneXpert positive cases. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy sputum smear microscopy were 57%, 100%, 100%, 91.7%, and 92.5%, respectively, when GeneXpert test is taken as reference test. Conclusion: Sputum smear microscopy is as specific as GeneXpert but less sensitive test for the diagnosis of pulmonary tuberculosis than GeneXpert MTB/RIF assay.

ISOLATION, CHARACTERIZATION AND ANTIBIOTIC SUSCEPTIBILITY OF KLEBSIELLA SPECIES IN URINE SAMPLES OF UTI PATIENTS VISITING DHQ HOSPITAL D.I. KHAN

Background A gram-negative rod-shaped pathogenic bacterium-Klebsiella, repeatedly causing Urinary Tract Infection. Objectives: Isolation, Characterization and antibiotic susceptibility of Klebsiella species in urine samples of UTI patients. Methodology: For thispurpose, a total of 105 samples were randomly collected from the patients with urinary tract complications visiting District Head Quarter Hospital D.I. Khan, Pakistan. Results: Urine samples with pus cells were inoculated on Cystine-lactose-electrolyte-deficient(CLED) agar and it was revealed that only 12 out of 105 samples were Klebsiella positive on the basis of cultural characteristics.Further confirmation was done using biochemical characterization through Analytical Profile Index (API 10) and out of 12 all the isolates were Klebsiella pneumoniae. Disc diffusion method was used to test the antibacterial susceptibility on Muller Hinton Agar.Klebsiella isolates showed 100% resistance to Cefepime, Cotrimoxazole and Ceftriaxone, 91% to Ampicillin, Doxycyclineand Cefazoline and 83% to Piperacillin/Tazobactam, Imipenem, Ciprofloxacin and Gentamycin. Only two antibiotics Fosfomycinand Nitrofurantoin were two antibioticsKlebsiella isolates showing sensitivity. Conclusion: It is assumed that excessive use ofantibiotics without proper diagnosis is among one of the main reasons responsible for antibiotic resistance.

An Analysis of Marketing Status of BT Cotton Seed in Devbhumi Dwarka District, Gujarat, India

The main objectives of the study were to assess the company’s distribution pattern of quality seed material their market share, marketing channels. Multistage sampling technique were adopted. The total 120 farmers and 20 dealers were selected from four taluka i.e., Bhanvad, Khambhalia, Kalyanpur, Okhamandal (Dwarka) of Devbhumi Dwarka district of Gujarat state. The five wholesaler/distributors were selected from district headquarters. The primary data were collected through personal interview with farmers, dealers, wholesaler/distributors using well-structured questionnaires and interview scheduled. Results revealed that most of Bt cotton growers to be middle aged farmers. The pattern of land holding distribution shows that majority of the Bt cotton growers belonged to the small and marginal land holding category. Social participation of Bt cotton growers shows that they are not members of any organization. The well was found to be the main source of irrigation water and most of Bt cotton growers were reported to attained primary level of education From the study, it was found that Rasi seed (P) Ltd. Occupied major market share in Devbhumi Dwarka district. Among different marketing channels, it was observed that marketing channel-I (MC-I) (Company→ Wholesaler/Distributors→ Dealer→ Bt cotton grower) is the most prevalent channel in the sampling area.

Dextromethorphan Role on Cough Suppression and Patient Procedure Tolerance in Flexible Bronchoscopy

Objective: To determine the role of Dextromethorphan on cough suppression and patient procedure tolerance in flexible bronchoscopy. Study Design: Quasi-experimental study. Place and Duration of Study: Pulmonology Department, District Head Quarters Hospital, Faisalabad Pakistan, from Oct 2019 to Mar 2020. Methodology: Patients were divided into Group-1 and Group-2. Group-1 was given syrup Dextromethorphan 20miligram one hour before bronchoscopy and Group- 2 was given a placebo one hour before procedure. During procedure, oxygen saturation and blood pressure were recorded continuously by monitor. 10cm Visual analogue scale was used to chart their cough perception where 0 taken as no cough and 10 as incessant cough. Patients recorded their tolerability of procedure after 2 hours on 10cm visual analogue scale. Results: Mean age of whole study population, Group-A and Group-B was 48.80+11.24, 46.63+11.70 and 47.72+11.43 respectively. Females were 25(41.7%) and males were 35(58.3%). Both groups have same mean SpO2 with supplemental oxygen. Four patients had an oxygen saturation below 90% during flexible bronchoscopy in both groups (p-value 0.647). Similar doses of Midazolam were used in the Dextromethorphan and placebo groups (p-value 0.879). The perception of cough by the patient, assistant staff and bronchoscopist in Dextromethorphan group 1 was significantly low (p-value 0.041, 0.0001, 0.037 respectively). Duration of procedure was also significantly lower in Dextromethorphan group p-value 0.0001. Conclusion: Dextromethorphan use in addition to Midazolam and local anesthetic during flexible bronchoscopy results in

Evaluation of satisfaction level of Sehat Sahulat Programme among patients and doctors in Lahore and Gujranwala districts, Pakistan.

To evaluate the satisfaction level of patients and doctors with a health insurance scheme in two districts of Punjab province. The analytical, cross-sectional study was conducted from June 2022 to November 2022 at Farooq Hospital West Wood Branch, Akhtar Saeed Trust Hospital, Lahore, Pakistan, and the District Headquarter Hospital, Gujranwala, Pakistan. The sample included doctors and adult inpatients receiving treatment under the Sehat Sahulat Programme. Data was collected using a pilot-tested, self-structured questionnaire. Data was analysed using SPSS 25. Of the 565 subjects, 414(73%) were patients and 151(26%) were doctors. Among the 414 patients, 248(59.9%) were from Gujranwala and 166(40%) from Lahore. Overall, 401(97%) patients and 128(85.4%) doctors expressed satisfaction with the health insurance scheme. Quality of hospitals assigned, quality of curative services, quality and availability of medicines, service provision delayed due to the insurance scheme, having to bear additional expenses, lower financial burden, and overall quality of service were the factors that were significantly associated with the satisfaction level of the patients (p<0.05). Among the doctors, the overall satisfaction level was associated with the availability of medicine and the satisfaction with the payment procedure (p<0.05). Overall satisfaction rate among both doctors and patients with the Sehat Sahulat Programme was high.

Diagnostic Accuracy of Magnetic Resonance Spectroscopy and Diffusion-Weighted Mri in Differentiating Between Pyogenic Brain Abscesses and Necrotic Brain Tumors

Objective: To determine the diagnostic accuracy of magnetic resonance spectroscopy plus diffusion-weighted Magnetic Resonance Imaging in differentiating pyogenic brain abscess and necrotic brain tumors, taking histopathology as the gold standard. Study Design: Validation study. Place and Duration of Study: Department of Radiology, District Headquarters Hospital, Sargodha Pakistan, Jun 2019 to May 2022. Methodology: A total of 160 patients presenting with symptoms suggestive of brain abscess or tumor, ranging from 20 to 70 years of age, irrespective of gender, were included. All patients were subjected to Magnetic Resonance Imaging including magnetic resonance spectroscopy and diffusion-weighted image. Patients were referred for biopsy to the department of neurosurgery of tertiary care hospitals. Histopathological diagnosis was taken as the gold standard for the determination of diagnostic accuracy. Results: The values for magnetic resonance spectroscopy plus diffusion-weighted Magnetic Resonance Imaging differentiating pyogenic brain abscess and necrotic brain tumor, taking histopathology as the gold standard were as follows: sensitivity 93(75%); specificity (95.31%); positive predictive value 96(77%); negative predictive value 91(04%); and diagnostic accuracy 94(38%). Conclusion: Diffusion-weighted images plus MRS are non–invasive tools with high-level diagnostic value. The combination of these modalities should be employed for accurate diagnosis, precise management, and prompt follow-up of the patients under suspicion of tumor or brain abscess.

Statistical analysis of seroprevalence and risk factors of hepatitis C in Nowshera District, Pakistan

Hepatitis C virus (HCV) transmission remains a significant public health concern. It is well documented globally, however, Nowshera district, Pakistan, is lacking such profile. This study aims to explore the relationship between HCV infection and several risk factors, including socio-demographic, clinical and personal life-style factors. This study using a cross-sectional design, examined 606 randomly selected individuals visiting the Pathology department at Qazi Hussain Medical Complex and District Headquarter (DHQ) Hospital Nowshera between May 1, 2022 and Jun 30, 2023. This research investigation employed a methodical approach involving formal interviews in conjunction with structured questionnaires to gather comprehensive information related to socio-demographic characteristics, clinical history, and personal hygiene practices. We collected 10 ml of blood samples and tested the separated serum to identify markers using the Immuno-Chromatographic Test (ICT) and the Enzyme-Linked Immunosorbent Assay (ELISA). IBM SPSS Statistics version 27 was used for data analysis. To measure the association between dependent variable and independent variables, a chi-square and risk analysis was carried out; multiple logistic regression was employed for modeling the risk factors associated with independent variable. A statistical significance level was established at a P-value of less than 0.05. In present study, which included 606 participants, 12% were found to be infected with HCV. Importantly it revealed that facial shave at barber (adjusted odds ratio, aOR = 40.65, p = 0.000) represents the most prevalent mode of HCV transmission. Additionally, a strong association was observed between HCV infection and history of past surgery (RR = 2.98, p = 0.001), HCV infected family member (aOR = 4.28, p = 0.001), workplace injuries (aOR = 6.68, p = 0.000), history of hospital admission (RR = 2.09), practicing ear and nose piercing (aOR = 5.01, p = 0.001), dental treatment (RR = 2.31) and the frequency of injections (aOR = 8.607, p = 0.000). These findings underscore the pressing need for targeted interventions. This study highlights the paramount importance of understanding the modes of HCV transmission and their associated risk factors. The results emphasize the need for educational initiatives, both within the healthcare sector and among the general public, to combat HCV transmission effectively. By implementing sterilization procedures and increasing awareness, we can make significant strides in reducing the burden of HCV infection. Moreover, proactive measures within families can help contain the spread of the virus, ultimately contributing to improved public health.

Griseofulvin Induced Stevens Johnson Syndrome (SJS). A Rare Case Report from District Headquarters Hospital, Chittoor, AP.

Griseofulvin Induced Stevens Johnson Syndrome (SJS). A Rare Case Report from District Headquarters Hospital, Chittoor, AP.

The Interaction Effect of Nitrogen Levels on Growth Characteristic of Wheat Crop (Triticum aestivum L.)

The present research work was carried at the Agronomy Farm, Department of Agronomy, Narendra Deva University of Agriculture and Technology, Narendra Nagar (Kumarganj) Faizabad (U.P.), during Rabi season of 2014-2015. This farm is located at a distance of 42 Km. from Faizabad district headquarters at Faizabad – Raibareilly road. The ANOVA of the research trail used a design: randomized block design (factorial) to evaluate growth traits, comprising of initial plant population, plant height (cm), number of shoots (m-2). The data indeed suggested that initial plant population was not significantly influenced by either variety levels or nitrogen levels. Contrastingly, the data showed that variety levels and nitrogen levels significantly affected plant height at 30, 60, 90 days after sowing (DAS) and at harvest. The number of shoots at 30 DAS was not affected significantly by variety levels and nitrogen levels in the data. In addition, Variety levels showed a significant effect on the shoot number at 60 and 90 DAS and also at harvest stage, while nitrogen levels did not show significant effects in growth attributes of wheat under study.

Effectiveness of Early Feeding versus Conventional Protocol after Stoma Reversal in Adult Surgical Practices.

To compare the effectiveness of early feeding and conventional feeding protocol after stoma reversal in adult surgical practices. Randomised controlled trial. Place and Duration of the Study: Department of General Surgery, District Headquarters Hospital Mardan, Pakistan, from January 2020 to July 2022. A total of 72 patients enrolled in the surgical unit for stoma reversal were included in this study. After applying the exclusion criteria, 68 patients were randomised in two equal groups of 34 patients each. In Group A, patients were allowed oral liquid feed within 24 hours after surgery while in Group B oral liquid feed was allowed after 72 to 96 hours when the nasogastric tube was removed and bowel functions were returned. Efficacy, safety, and tolerability were evaluated from outcomes such as postoperative ileus, anastomosis leakage, infection of the wound, and length of hospital stay. The age range in this study was from 18 to 43 years with mean ± SD of 31.602 ± 6.75 years. There were 41 (60.29%) males while 27 (39.71%) females in this study and the male population was dominant in both groups. The results were significantly in favour of Group A, where 28 (82.35%) patients did not have postoperative ileus compared to 17 (50%) patients in Group B (p = 0.004). Wound healing was also significantly better in Group A compared to Group B, where 30 (88.23%) patients had no wound infection compared to 21 (61.76%), respectively (p = 0.001). There was no difference between both groups regarding anastomotic leakage. Length of hospital stay was significantly shorter in Group A (3.117 ± 0.87 days) compared to Group B (5.617 ± 1.43 days) (p = 0.001). Early feeding after stoma reversal is effective, minimises the postoperative complications, and leads to shortening of hospital stay in adult surgical practices. Anastomosis leakage, Early feeding, Length of hospital stay, Stoma reversal.

INVESTIGATING THE RELATIONSHIP BETWEEN SURGICAL TEAM COMMUNICATION AND PATIENT OUTCOMES

Surgical team plays a vital role in the care of patients during the surgery. For safe patient outcomes, surgical team members must effectively communicate within the surgical site. Communication breakdowns in the complex operating room atmosphere can result in unfavorable outcomes. To reduce risks, avoid errors and provide the best possible care for patients, the surgical team must communicate clearly and effectively with one another. Enhancing the quality of surgical treatment requires an understanding of the connection between communication and patient results. Objective: The purpose of this study was to investigate the connection between patient satisfaction outcomes and surgical communication between teams focusing on how the improved communication practices can enhance the patient safety in terms of care quality and satisfaction level in surgical setting. Method: The study comprised of 187 health care providers between the ages of 18 and 65 who were examined for the association between surgical team communication and patient outcomes after ethical approval from Hospital ethical committee. Descriptive cross-sectional study was carried out in the District Headquarters Teaching Hospital, Kohat Development Authority Kohat from January 2022 to July 2022. Data was Analyzed on SPSS and shown in tables. Results: The analysis shows a strong positive correlation (.595) between team communication and patient outcomes, with healthcare professionals that rates the quality of communication at an average of 3.84 out of 5, which is closely linked to a decrease in surgical complications and an increase in patient satisfaction. Sticking and communicating according to communication protocols was rated at 3.76, underlining its importance in patient safety improvements. Conclusions: The study affirms the crucial impact of effective communication among surgical team members on improving patient outcomes and safety in the operating site. The enhanced communication directly relates with faster patient recovery, lesser complications and higher patient satisfaction.

Current position of brucella infection among the hospitalized human population

This study aimed to examine the incidence of Brucella infection among hospitalized patients. This study was conducted during February to August 2022 in District Headquarters Teaching Hospital (DHQTH) district Bannu, Pakistan. A 2mL of venous blood was collected from those individuals who visited the hospital with the complaint of joint inflammation and high grade fever. The Brucella infection was detected by Standard Plate Agglutination Test (SPAT) and Serum Tube Agglutination Test (STAT). A total of 150 samples were examined in the present study, 100 (66.66%) of them were found to be negative and 50(33.33%) to be positive for various bacterial infections. Among male positive patients 17 (56.66%) reported to have B. melitensis and 13 (43.33%) had B. abortus while in female patients 9 (45.00%), 11(55.00%) were positive of B. melitensis and B. abortus respectively. The study showed that prevalence of the disease appears to be more common in males as compared to female and age group between 41 to 50 years were more prone to the infection. In Pakistan, brucellosis continues to be a persistent and posing public health risk. Individuals who are exposed to brucellosis at work are more likely to develop infection; therefore all the exposed persons should get themselves screened.

CONCERNS ABOUT FIBROADENOMA EXCISION IN YOUNG FEMALE PATIENTS VIA CIRCUMAREOLAR VERSUS RADIAL INCISION

Fibroadenoma is the most common benign breast tumour in young female patients between 15 to 30 years of age. Lumpectomy is the most common surgical procedure, usually carried out via Circumareolar or Radial incisions depending upon size and location in the breast. Both of these incisions for lumpectomy have advantages and disadvantages of their own. In this study, we compared the outcome in terms of healing of wounds, Aesthetics and patient satisfaction. Objective: The purpose of this study was to evaluate the effectiveness of Circumareolar and Radial incision for lumpectomy, Aesthetic outcome and patient satisfaction in young female patients who opted for surgical excision. Methods: After ethical approval from the Hospital ethical committee and informed written consent from the participants; 189 patients were included and equally divided into Group A for Circumareolar incision and into Group B for Radial Incision participants, who met inclusion and exclusion criteria for this study. Data was collected by the Concerned Surgeon on a Pre-Designed Questionnaire in the District Headquarters Teaching Hospital, Kohat Development Authority Kohat from January 2021 to July 2021. Data was analyzed and shown in Tables. Results: The results demonstrate a significant preference for the circumareolar incision over the radial incision in the excision of large and peripherally located fibroadenomas among young female patients. A higher percentage of young female patients (63.04%) underwent circumareolar incision, reporting shorter recovery times (mean = 2.04 weeks) and greater satisfaction with the surgical outcome (mean satisfaction score = 5.43), compared to those who had a radial incision (37.25% underwent the procedure, with mean recovery time = 0.91 weeks and mean satisfaction score = 0.03). Statistical analysis further supports the efficacy of the circumareolar approach over the radial one, with significant differences in both recovery time and satisfaction levels (p &lt; 0.000 for both measures), indicating its effectiveness and patient preference. Conclusion: Circumareolar incision is the best incision for large and peripherally located fibroadenoma excision in young female patients without any further morbidity or compromising quality of life.

Knowledge, attitude and practices of surgeons regarding venous thromboembolism prophylaxis in tertiary healthcare hospitals of the Rawalpindi Districts.

To assess doctors' knowledge, attitudes and practices regarding venous thromboembolism prophylaxis. The cross-sectional study was conducted from April to September 2021 in three public-sector hospitals affiliated with the Rawalpindi Medical University: Holy Family Hospital, Benazir Bhutto Hospital and Rawalpindi District Headquarters Hospital, Rawalpindi, Pakistan, and comprised physicians of either gender who were actively involved in patient care. Data was collected using a predesigned questionnaire regarding venous thromboembolism. Data was analysed using SPSS 25. All the 220(100%) subjects approached responded positively to the study questionnaire. There were 144(65.45%) general surgeons, 50(22.72%) gynaecologists and 26(11.81%) orthopaedic surgeons. Overall, there were 26(11.81%) senior consultants, 65(29.54%) postgraduate residents and 129(58.63%) house officers. There were 150(68.2%) doctors who reported having witnessed deep-vein thrombosis in their patients, and 113(51.4%) had witnessed deaths related to pulmonary embolism. Among the methods employed for DVT diagnosis, the use of clinical criteria was the most common 136(36.1%), while venography was the least common technique used by 8(2.2%). While 210(95.5%) subjects expressed the desire for adopting an institute-wide regimen for venous thromboembolism prophylaxis, only 66(30%) were currently following such a regimen.