Hospitals Of Lahore Research Articles

Factors Affecting Delivery Health Service Satisfaction of Women and Fear of COVID- 19: Implications for Maternal and Child Health in Pakistan.

ObjectiveHigh maternal and neonatal mortality rates in developing regions like Pakistan are linked to low rates of institutional deliveries. One way to improve rates of institutional deliveries is through improving institutional delivery service satisfaction in women. The aim of this research is to identify which factors influence delivery service satisfaction during the period of COVID-19 and which socio-demographic characteristics of women are associated with greater fear of catching COVID-19 during institutional deliveries.MethodsA total of 190 women who had given birth between May to June, 2020, were sampled from two private and two public sector hospitals in Lahore, Pakistan. A standardized tool was modified for use and a combination of descriptive statistics and multivariate regression was applied.ResultsThe results reveal that a majority of women, at 74.7%, are afraid of contracting COVID-19; specifically, women delivering at public hospitals, those who are illiterate or semi-literate, with more than four children, with low household income, and who are unemployed. Regression models are used to identify factors related to higher satisfaction, including the following: (i) pre-delivery care (explanatory power of R2 = 0.651); (ii) during delivery care (R2 = 0.716); (iii) after delivery care for women (R2 = 0.525); and (iv) after delivery care for newborn (R2 = 0.780). The main areas which influence satisfaction include the following: service quality of staff and administration; maintenance of hygiene and sanitation; involvement in decision-making; provision of necessary information; and advice for breastfeeding, immunization and family planning.Conclusions for PracticeBased on our findings, we recommend improved regulation of delivery services in both public and private hospitals and increased protection for disadvantaged women groups to maintain service quality during the pandemic.Supplementary InformationThe online version contains supplementary material available at 10.1007/s10995-021-03140-4.

Isolation of non-tuberculous mycobacteria among tuberculosis patients, a study from a tertiary care hospital in Lahore, Pakistan

BackgroundThere is scarce knowledge on the prevalence of diseases caused by non-tuberculous mycobacteria (NTM) in Pakistan. In the absence of culture and identification, acid-fast bacilli (AFB) causing NTM disease are liable to be misinterpreted as tuberculosis (TB). Introduction of nucleic acid amplification testing for Mycobacterium tuberculosis complex (MTBC) offers improved diagnostic accuracy, compared with smear microscopy, and also assists in differentiating MTBC from other mycobacteria. This study aimed to investigate the prevalence of NTM among patients investigated for TB and describe NTM disease and treatment outcomes at a tertiary care hospital in Pakistan.MethodsThis is a retrospective study, data on NTM isolates among culture-positive clinical samples over 4 years (2016–19) was retrieved from laboratory records. Information on clinical specimens processed, AFB smear results, and for the AFB positive isolates, results of species identification for MTBC, and for NTM isolates, results of species characterization and drug susceptibility testing was collected. Additional clinical data including patient characteristics, treatment regimens, and outcomes were collected for patients with NTM disease treated at Gulab Devi Hospital, Lahore.ResultsDuring the study period, 12,561 clinical specimens were processed for mycobacterial culture and 3673 (29%) were reported positive for AFB. Among these 3482 (95%) were identified as MTBC and 191 (5%) as NTM. Among NTM, 169 (88%) were isolated from pulmonary and 22 (12%) from extrapulmonary specimens. Results of NTM speciation were available for 60 isolates and included 55% (n = 33) M. avium complex and 25% (n = 15) M. abscesses. Among these patients, complete clinical records were retrieved for 12 patients with pulmonary disease including nine infected with M. avium complex and three with M. abscessus. All 12 patients had a history of poor response to standard first-line anti-TB treatment. Ten patients were cured after 18 months of treatment, whereas, one with M. abscessus infection died and another was lost to follow up.ConclusionIn TB endemic areas, NTM can be misdiagnosed as pulmonary TB leading to repeated failed anti-TB treatment and increased morbidity, emphasizing the need for improved diagnosis.

Psychosocial Predictors of Quality of Life in Patients With Vitiligo

The present study was designed to examine psychosocial predictors of quality of life (QoL) such as body image, self-esteem, impact of Vitiligo (psychologically and socially), and perceived stigmatization in patients with Vitiligo. The sample (N =120) comprised of individuals with Vitiligo recruited from dermatology units of different hospitals in Lahore. Body Image State Scale (Cash, Fleming, Alindogan, Steadman, & Whitehead 2002), Rosenberg Self-Esteem Scale (Rosenberg, 1965), Vitiligo Impact Scale (Rammam, Khaitan, Mehta, Sreenivas, & Gupta, 2014), Perceived Stigmatization Questionnaire (Lawrence, Fauerbach, Heinberg, & Thomas, 2006) and Dermatology Life Quality Index (Finlay & Khan, 1994) were used as assessment measures. Results revealed that most of the individuals with Vitiligo reported poorer perception of QoL; while, men with Vitiligo expressed better perceived QoL as compared to women. Individuals with both types of Vitiligo (lesions on exposed/unexposed regions) expressed poor body image, negative impact of Vitiligo on their psycho-social functioning, and higher levels of perceived stigmatization. Individuals with exposed Vitiligo affected regions exhibited lower self-esteem. In addition, body image, impact of Vitiligo (psychologically and socially), and perceived stigmatization (absence of friendly behavior) significantly predicted QoL. It was concluded that Vitiligo had a greater impact on individual’s psychological health and social functioning rather than physiological complications.

Burnout in Postgraduate Trainees and Consultants working in Psychiatry Departments of Teaching Hospitals in Lahore, Pakistan

Objective: To gauge the prevalence of burnout among postgraduate trainees and consultants working in psychiatry department, Services Hospital Lahore, Pakistan. Methods: 31 trainee and consultant psychiatrists in Services Hospital Lahore, Pakistan participated in this cross-sectional study. Abbreviated Maslach Burnout Inventory (aMBI) measured burnout. It consisted of 9 items, relating to emotional exhaustion, depersonalization and personal accomplishment. Each item is scored on a seven-point Likert scale. For Emotional Exhaustion and Depersonalization, higher scores predicted greater burnout; Personal Accomplishment demonstrated the opposite, hence its scores were inverted. Participants with moderate scores in 2 or more dimensions were identified as suffering from burnout syndrome. Data was analyzed by SPSS 25.0. Result: Mean age of participants was 34.87 ± 8.06 years. 52% were female. 58% were consultants, with average experience of 7 years; 61% practiced in more than one place. 32.3% of participants had burnout syndrome. Emotional Exhaustion subscale showed the highest scores i.e. 7.06 ± 3.43. 71% of participants demonstrated moderate or high burnout in this scale. Average Depersonalization score was 2.94 ± 2.42, while that for Personal Accomplishment was 3.29 ± 2.25. Conclusion: A significant portion of the sample reported moderate and high level of emotional exhaustion. On the contrary, we found low levels of depersonalization in the sample. Most psychiatrists reported adequate levels of personal achievement. These results are reassuring because, despite the presence of emotional burnout, psychiatrists still have capacity to empathize and provide adequate patient care.

Prevalence of Thumb Pain Among Physiotherapists Perform Manual Techniques During Clinical Practice

Th u m b p a i n a m o n g t h e physiotherapists is common occupational hazards. The physiotherapists working in their fields perform repetitively manual techniques, massage, mobilization and glides etc. This occupation needs tofind out the number of physiotherapists having thumb pain due to manual work they perform during clinicalpractice in different rehabilitation centers. Objective: To determine the frequency of thumb pain among physiotherapists perform manual techniques in clinical practice; a cross sectional study Methodology: A cross-sectional study design with convenient sampling technique was used, with sample size 190 to determine the frequency of thumbpain among physiotherapists in Lahore and data was analyzed by SPSS, mean and standard deviation wascalculated for the quantitative variable while qualitative variable was presented in the form of frequency and percentage.Results: In the present study a self-made questionnaire was distributed among 190 physiotherapists. Among 190 participants 58(30.5%)were male and 132(69.5%) were Females. 40(21.1%) felt pain while performing ischemic pressure release from thumb. 38(20.0%) felt pain while giving massage. 12(6.3%) felt pain while holding an objectbetween thumb and index finger. 2(1.1%) felt pain in circumduction. (5.3%) felt pain while making snuff box. 24(12.6%) felt pain in isometric exercises of thumb. 27(14.2%) felt pain in hyper flexion at DIP. 17(8.9%) felt pain in hyper flexion at PIP. 51(26.8%) rated 3 pain and 15(7.9%) rate 5 pain on VAS. Conclusions: Study concluded that frequency of thumb pain among physiotherapists working in different hospitals of Lahore was found to be 35.26%. This thumb pain was due to their professional techniques including, manual therapy, ischemic pressure release, massage, mobilization, and gliding etc.

Impact of Restless Leg Syndrome on Fatigue and Quality of Life Among Hemodialysis Patients

Abstract:Restless Legs Syndrome (RLS) is a sensorymotor sleep disorder which his very common in hemodialysis (HD) patients. It is called also as uremic RLS and it is affecting almost 30%of the HD population. Objective: To find out impact of Restless Leg Syndrome on fatigue and quality of life in patients of hemodialysis.Methadology: 131 hemodialysis patients (male, female) were approached from different hospitals in Lahore. Demographic data of the patients were collected. Questionnaires were included Fatigue Severity Scale, Restless Legs Syndrome Questionnaire (Rating Scale) and health quality questionnaire SF-12®. All responses entered in SPSS version 21.Results: In this survey SF12 was used to nd about health related quality of life in patients with RLS and undergoing hemodialysis and fatigue was observed in (n-75%) patients with exercise, (n34%) reported fatigue interference with work and (n-22%) reported fatigue was constant problem. Quality of life was overall poor as (n-72 %) patient's complaint that they cannot do any kind of work with full focus and 34 % reported their moderate activity level was limited.Conclusion: RLS was frequent in patients with hemodialysis. it had an association with fatigue and poor quality of life. As hemodialysis patients spend most of their time on bed RLS has negative impact on the sleep. Health Related Quality Of Life affects both physical and mental health.Keywords: Restless Leg Syndrome, Fatigue, low quality oflife, Hemodialysis patients

Prevalence of Compression Neuropathies During Pregnancy

Abstract Background: It is a common perception that Pakistani women suffer from compression neuropathies during pregnancies which may lead to functional limitations. To know the frequency of common neuropathies during pregnancy, nerves commonly involved and common causes of compression neuropathies. Methodology: The design of this study was cross sectional study. Duration of the study was 3 months after approval of synopsis. Convenient sampling was used. This study was conducted at private hospitals of Lahore (Iqra medical complex, Saira Memorial hospital and UOL teaching Hospital). A total of 35 female pregnant women were evaluated for s igns and symptoms of compression neuropathies. A Performa was used for each patient, which was fillrdlled out based on their symptoms. Results: Data from the 35 multigravida pregnant women, compression of sciatic nerve and median nerve are common during the 3rd trimester. The increased body weight during pregnancy and bad posture are significant causes. Among them,51.42% took physiotherapy treatment.Conclusion: The result of this study showed that compression of sciatic and median nerves are most commonly involved during pregnancy in multigravida women. The compression neuropathies occur commonly in the 3rd trimester of pregnancy. The increased weight during pregnancy, poor economic status and bad posture are significant causes of compression neuropathies. Keywords: Neuropathy, Prevalence, Pregnancy

Comparison of social support, depression and anger in diabetic and cardiac patients

Abstract Objective: The present study explores the role of social support, depression and anger among diabetic and cardiac patients. Method: This cross sectional study comprised of 200 patients who were selected through purposive sampling strategy from outpatient departments (Cardiology and Endocrinology) of Government hospitals of Lahore (Jinnah Hospital and Services Hospital) and Muridke (Tehsil Headquarter Hospital) from April 2015- September 2015. Cardiac patients were 101(Men=51, Women=50) and diabetic type II patients were 99 (Men= 50, Women= 49). Siddiqui-Shah Depression scale (SSDS), Interpersonal Support Evaluation List (ISEL) and Trait Anger and Expression Scale (TAES) were administered on the patients. Result: The findings revealed that cardiac patients exhibit higher level of depression and receive more social support than diabetic patients. Furthermore, results reveal that low social support is a significant negative predictor of anger and depression among diabetic and cardiac patients. Conclusion: On the basis of findings, it is concluded that social support is a significant factor in the treatment of diabetes and cardiac diseases. This research is helpful for hospital administration in the counseling/management of such patients. Continuous...

Effect of maternal tolerance on behavioural problems in children with enuresis.

To determine the effect of maternal tolerance on behavioural problems in children with enuresis. The cross-sectional descriptive study was conducted from January to November 2018 at the outpatient departments of three hospitals in Lahore and Sialkot district of the Punjab province in Pakistan. The sample comprised of mothers aged 23-50 years having children with enuresis visiting one public-sector tertiary-care hospital and two private-sector secondary-care hospitals. Data was collected using the Tolerance Scale and the Children Behavioural Questionnaire and was analysed using SPSS 21. There were 80 mothers with a mean age of 34.53±4.89 years and as many children with a mean age of 8.16±2.36 years. Maternal intolerance was positively and significantly correlated with rule-breaking (p=0.02) and aggressive behaviour (p=0.01) in children with enuresis. Maternal intolerance was a significant and positive predictor of rule-breaking behaviour (p=0.02), aggressive behaviour (p=0.001) and attention problems (p=0.01) in the affected children. Maternal intolerance and hostile attitudes towards children with enuresis was seen to be leading to secondary behavioural and emotional difficulties.

Frequency, intensity and duration of routine rehabilitation exercises practiced by patients with coronary artery disease.

To determine the frequency, intensity and duration of routine rehabilitation exercises practiced by patients with coronary artery disease. The cross-sectional descriptive study was conducted from February to June 2019 in different hospitals of Lahore, Pakistan, and comprised coronary artery disease patients of either gender aged 35-65 years. Data was collected using an interview-based questionnaire. Data was analysed using SPSS 25. Of the 186 subjects, 105(56.5%) were males and 81(43.5%) were females. Overall, 72(38.7%) subjects were aged 52-62 years. Of the total, 117(62.9%) subjects practiced brisk walking as their routine rehabilitation exercise; 57(48.7%) doing it 3 times per week. All of these 117(100%) subjects practiced it for 10-20 minutes. Brisk walking was mostly practiced by coronary artery disease patients for 10-20 minutes 3 times per week.

Incidence of Acute Endophthalmitis After Intravitreal Bevacizumab Injection at a Tertiary Care Hospital in Lahore.

Objective: We aimed to assess the incidence, management, and visual outcome of acute endophthalmitis in patients following intravitreal bevacizumab injection in a tertiary care setup. It was a prospective and single-center database study.Patients and methods: Patients receiving intravitreal bevacizumab injections for various retinal vascular diseases from January 2019 to September 2020. The study was carried out at the Institute of Ophthalmology, Mayo Hospital, Lahore over a period of 21 months. Preformed bevacizumab injections were administered intravitreally on patients of various retinal vascular diseases under strict aseptic measures and by following the standard guidelines. The patients were put on follow-ups for a duration of four weeks to see any signs of acute endophthalmitis.Results: A total of 3051 injections were administered in 1104 eyes of 743 patients during the above-mentioned study period. The incidence of endophthalmitis was found to be 0.0328% (1/3051). The patient, who developed endophthalmitis, was treated with topical and intravitreal antibiotics followed by vitrectomy that resulted in clinically significant improvement in vision.Conclusion: Incidence of acute endophthalmitis following intravitreal bevacizumab injection was low and could be prevented by taking strict aseptic measures during administration.

The Operative versus Conservative Approaches in the Management and Treatment of Lumbar Spinal Stenosis

Background: Lumbar Spinal stenosis is the narrowing of the spinal canal at any lumber level. Lumbar spinal stenosis has multiple severities and both conservative and operative treatment options. The objective of the current study was to compare the results of operative and conservative approaches in spinal stenosis treatment. Methods: This cross-sectional study was conducted from January 2019 to June 2019. The data was collected from different hospitals in Lahore (Ittefaq, General, Jinnah, and Hameed Latif). Participants (n=121) of both genders, pre-diagnosed with Lumbar spinal stenosis and symptoms history of 10 weeks (confirmed on imaging) were included. Interventions were decompressive surgery and conventional conservative management. The outcome measures were body pain, functional activities, and the Oswestry Disability Index. An independent sample t-test was used to compare the results between the two groups. A p≤ 0.05 was considered statistically significant. Results: The patients undergoing surgery had statistically significant (p=0.00) advantages of surgery compared to the non-surgical group at 3 months. The 25(36%) of patients remained the same after conservative treatment with 51(72%) having pain radiation and 47(66%) with neurological deficit. The effect of treatment for body pain was 7.8 (95%CI, 8.6, 6.9), physical function −1.3 (95%CI, −0.6, −2.2), and Oswestry Disability Index was −3.4 (95%CI, −2.7, −4.1). Conclusion: Patients who had surgery of spinal stenosis showed marked improvements in body pains, functional activities, and Oswestry disability index compared to conservatively treated. Patients, health care providers, and other stakeholders may get benefit from the findings of this study.

Correlation of qSOFA with Severity of COVID-19 Infection Assessed on Admission at Tertiary Care Hospital in Lahore

Introduction: The COVID-19 crisis is continuously taxing the world with a huge impact on mortality, morbidity and disease related mental stress. COVID-19 has a variable presentation encompassing from simple myalgias to development of ARDS. Early detection of patients with severe COVID 19 infection by utilizing simple bed side clinical tool like qSOFA, which has been previously used for detection of severity of sepsis could help us in early triage and subsequent management of these patients in specialized dedicated units of the hospital. Thus help in limiting the mortality and morbidity because of this deadly contagion. 
 Aims & Objectives: To correlate the severity of qSOFA score with the clinical severity and outcome of COVID-19 infection at presentation among admitted patients in tertiary care hospitals of Lahore.
 Place and duration of study: This study was conducted simultaneously at three tertiary care hospitals of Lahore, including Lahore General Hospital, Jinnah Hospital Lahore and Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore.
 Material & Methods: A retrospective descriptive study on 120 RT PCR positive confirmed COVID-19 patients of both genders, more than 18 years of age. Case records of patients admitted in General Corona ward, Isolation wards, HDUs and ICUs were analyzed. The data analysis was done in SPSS version 20. Factors including blood pressure, respiratory rate, and conscious level were used to calculate the qSOFA score. COVID 19 infection was divided into mild, moderate, severe and critically ill. The relationship of qSOFA score was studied with severity of COVID-19 infection, outcome of disease and age by using the Pearson correlation.
 Results: Eighty-four (70%) patients were male and thirty-six (30%) were female, with mean age of 59.42 ± 13.49 years. Sixty-eight, twenty-five, five and 0.8 percent patients had critical, severe, moderate and mild disease respectively. Most frequent comorbids found were hypertension, diabetes, ischemic heart disease. A statistically significant correlation was observed between qSOFA with severity of COVID 19, age, and outcome of infection at the level of 0.01.
 Conclusion: qSOFA is a reliable bedside tool to measure severity and predict outcome of COVID 19 infection.

Association of Maternal Hyperhomocysteinemia with Preeclampsia: A Hospital Based Case-Control Study

Introduction: Preeclampsia is among the leading causes of feto-maternal morbidity and mortality throughout the world, especially in developing countries like Pakistan. The exact pathophysiology of preeclampsia is still unclear but recent research on homocysteine shows its important role.
 Aims & Objectives: The aim of this study was to determine association of high serum homocysteine level with preeclampsia among antenatal women.
 Place and duration of study: Tertiary Care Hospitals of Lahore (Services, Lahore General Hospital and Sir Ganga Ram Hospitals) from 1st January 2019 to 30th June 2019.
 Material & Methods: A matched case-control design was employed. Sixty-six diagnosed pre-eclamptic antenatal women were selected as cases and they were age and gestational weeks matched with sixty-six normotensive antenatal women as control, with a case to control ratio of 1:1. Serum homocysteine level in fasting sample was estimated by Enzyme linked immuno assay. Data was entered and analyzed through SPSS version 20.
 Results: The mean plasma homocysteine was significantly higher in cases (16.05 ± 2.25) as compared to controls (9.44±2.83) with a p value <0.001. Highly Significant statistical association was found between Hyperhomocysteinemia and Preeclampsia (p-value < 0.001 with adjusted Odds Ratio of 4.72).
 Conclusion: Homocysteine levels a high in preeclamptic women as compared to normotensives showing that hyperhomocysteinemia is significantly associated with preeclampsia in antenatal women.

Association of FSHR gene polymorphisms with endometriosis in women visiting tertiary-care hospitals of Lahore, Pakistan.

The study aimed to explore the association of endometriosis risk factors with single nucleotide polymorphisms rs6166 and rs6165 (Asn680Ser and Ala307Thr) of follicle stimulating hormone receptor (FSHR) gene in Pakistani women. This study was conducted from 2013 to 2016. The sampling and extraction of DNA was done in Department of Zoology GC University, Lahore, while the sequencing was performed at Yale University, USA. This case control study consisted of 364 subjects including 156 women diagnosed with endometriosis and 208 conveniently recruited controls. Subjects diagnosed at stage II-IV endometriosis with infertility were pooled for study. The women with adenomyosis, ovarian cancer and leiomyoma were excluded. The whole blood leukocytes were used for DNA extraction. Two important polymorphisms of exon 10 of FSHR gene were analyzed by direct DNA sequencing both in endometriosis and controls. Genetic variant SNP rs6166 in the affected endometriosis subjects exhibited high incidence of allele "A" (Asn/Asn) 68.3% as compared to controls 33.7% (OR= 4.240; P =0.001). Similarly, the allele "A" of SNP rs6165 (Thr/Thr) was more frequent in endometriosis 67.3% than in control subjects 37.5% (OR =3.430, P =0.001). The occurrence of haplotype AA (Asn/Thr) was 45.5% in endometriosis and 11 % in control subjects (P= 0.001). Remarkably, the incidence of haplotype GG (Ser/Ala) was contrary to previous observations, since only 9.9% occurred in endometriosis as opposed to 45.2% in controls (P= 0.001). Investigation of FSHR gene polymorphisms rs6165and rs6166 (Ala307Thr and Asn680Ser) in the current study showed that haplotype AA (680Asn/307Thr) was associated with endometriosis in Pakistani women.

Rare Variant of Adult Rhabdomyosarcoma Presenting as a Palatal Swelling

A 26-year-old male was referred to the Department of Oral and Maxillofacial Surgery of a tertiary care hospital in Lahore with chief complaint of painless swelling on the right palate of 40 days duration. Clinical differential diagnosis included squamous cell carcinoma, Ewing sarcoma, fibrosarcoma, neuroblastoma and rhabdomyosarcoma. Computed tomography scan revealed hypodense mass with necrotic changes. Histological examination of the excised tumor revealed malignant neoplasm arranged in fascicles and bundles comprising of spindle cells with pleomorphic, hyperchromatic nuclei and increased atypical mitosis. Immunohistochemical analysis showed negative staining with Cytokeratin, S100, CD34, Stat6, h-Caldesmon and EMA while the tumour cells were positive for desmin, myogenin, smooth muscle actin, CD-99 and MyoD1 thus confirming the diagnosis of spindle cell rhabdomyosarcoma.

Forward stepwise logistic regression approach for determinants of hepatitis B & C among Hiv/Aids patients

Hepatitis-related liver diseases are a leading cause of mortality and morbidity among people with HIV/ AIDS taking highly active antiretroviral therapy due to shared transmission routes. An estimated 2–4 million HIV-infected persons have chronic HBV co-infection, and 4–5 million have HCV co-infection worldwide and 14,000 new infections each day. The purpose of this study was to determine the prevalence and associated factors of HBV and HCV co-infection in HIV-positive patients. A cross-sectional study was conducted among 235 HIV/ AIDS patients seeking medical care at special clinics of two public hospitals in Lahore, Pakistan, from February 2018 to May 2018. A structured questionnaire was used to collect information on socio-demographic and clinical characteristics of HIV/ AIDS patients after obtaining their written informed consent. Chi-square, Fisher's exact, and two independent sample t-tests as appropriate were used to find the association between risk factors and HBV, HCV co-infection with HIV. Further, a forward stepwise logistic regression model was used to evaluate the predictors of HBV and HCV co-infection with HIV. P-value < 0.05 was regarded as significant. Of 235 HIV-positive patients, 9% were co-infected with HBV, 41 were HCV co-infected, and 6% had HBV-HCV triple infection. The highest prevalence of HBV (55%), HCV co-infection (70%), and HBV-HCV triple infection (85%) were observed in intravenous drug users followed by heterosexual routes. Male, hypertensive, alcohol consumers, and smokers were statistically significantly associated with HBV co-infection $(P-value < 0.05)$. The factors include being male, never married, having $< 1$ year of HIV diagnosis, having $< 200$ CD4 counts (cell/mm3), presence of physical disability, having been infected through sexual routes, injecting drug user, alcohol consumer, and smoker were statistically significantly associated with HCV co-infection $(P-value < 0.05)$. Whereas the factors; heterosexual transmission, intravenous drug use, alcohol use, smoking, and presence of physical disability were statistically significantly associated with HBV, HCV triple infection $(P < 0.05)$. The adjusted odds ratio obtained by fitted logistic regression model showed that HIV transmission routes (both hetero and homo) and never married had lesser odds of HCV co-infection whereas the person with HIV transmission through intravenous drug use, who smoke and aged more than 30 years, had greater odds of HCV co-infection. Co-infection with hepatitis B and C virus is common among this studied sample of HIV-infected patients. The study's finding reaffirms the need for routine baseline screening for this marker and as there is more chance of co-infection with these hepatitis viruses due to enhanced immunodeficiency by HIV and shared routes of transmission. It highlights the need for timely initiation of HAART. Furthermore, those found to be negative should be immunized with HBV and HCV vaccines to improve.

Frequency of Micro-organisms in Different Biological Samples of Patients in a Tertiary Care Hospital of Lahore, Pakistan

Bacterial infections are one of the leading causes of illness and death across the world. In this context, the spread of resistant microbes plays a key role. Due to insufficient treatment choices and the sluggish discovery of new antibiotic classes, the rapid emergence of multidrug resistance in bacteria poses a serious threat to global public health. Objective: To determine the frequency of clinical isolates in various samples. Methods: A cross-sectional investigation was undertaken at the Pathology Department of the Fatima Memorial Hospital in Lahore, Pakistan. The study lasted one year. A total of 1,200 samples (sputum, wound swabs, blood, urine, pus, cerebrospinal fluid, and semen) were collected. Each sample was taken in a sterile container. The sample container was labeled with the source, date, and time of collection within one hour of collection and brought to the laboratory for analysis. Bacteria were identified using traditional culture and biochemical testing. Results: A total of 1200 clinical isolates were identified. Positive cultures obtained from 1200 biological samples were mostly from Urine (71.1%). 55.3% of the positive sample were male and 73% of the clinical isolates were gram-negative. Among Gram-negative isolates, the most common pathogen was Klebsiella species (42.9%) and among Gram-Positive isolates, the most common pathogen was Staphylococcus Aureus 68.5%. Conclusions: Gram-negative bacterial isolates were prevalent, with 55% frequency distribution and Staphylococcus aureus was frequent in different samples of patients.

Potential Role of Sesamum Indicum L. Supplementation on Body Mass Index Among Mild to Moderate Hyperlipidemic Patients

Hyperlipidemia is the term used to describe abnormally high levels of lipids (fats) in the blood. Cholesterol and triglycerides are the two main types of fat found in blood. Objectives: To investigate the therapeutic potential of Sesamum indicum L. supplementation on BMI among mild to moderate hyperlipidemic patients. Methods: For the four weeks of the trial, 30 mild to moderate hyperlipidemic patients between the ages of 25 and 40 were chosen. The University of Lahore Teaching Hospital in Lahore served as the source of the sample. In a hot air oven, Sesamum indicum L. seeds were roasted for 15 minutes at 200°C. After roasting, seeds were finely powdered using a professional blender. Patients were instructed to follow a 4-week baseline diet regimen and take a daily supplement of 40 mg of Sesamum indicum L. Data on anthropometric measurements, lipid profile biochemical analysis, BMI and nutritional intake were gathered. Results: The mean age of the hyperlipidemic study participants was 32.66 years, with an SD of 4.89 years. The mean weight of study participants before and after therapy were 75.2 ± 1.31 and 73.5 ± 1.10 with a significant difference of 1.7. A striking difference (24%) in the obesity rate between pre and post-treatment was observed. Conclusions: A significant difference in BMI and obesity was observed upon administration of Sesamum indicum seeds in hyperlipidemic patients.

Association of Family History, Drinking and Transient Ischemic Attach with Coronary Artery Disease in a tertiary Care Hospital of Lahore, Pakistan

Coronary artery disease (CAD) is the most common cardiac disease, caused by the accumulation of a waxy substance called plaque inside the coronary arteries' lumens. CAD is the main cause of cardiovascular death worldwide, accounting for more than 4.5 million deaths in developing countries. Objective: To determine the association of family history, alcohol consumption and transient ischemic attack with coronary artery disease in Pakistani population. Methods: It was case-control research conducted in Lahore's Mayo Hospital, a tertiary medical facility. A total of 200 people were included in the study, with 100 being cases and the other 100 being controls. Non-probability sampling was used to enroll 77 males and 23 females in the cases and 52 males and 48 females in the controls. The data was analyzed with SPSS software, which was utilized to determine the relationship between various risk variables and CAD. Results: Results showed that CAD is more prevalent in males as compared to females (38.5% versus 11.5%). Family history was found to be substantially associated with coronary artery disease patients (p-value=0.000, OR=4.00). 24 had a history of Transient Ischemic Attack (TIA) and 76 did not have TIA, whereas in controls only 3 had TIA, and 97 did not have TIA. There is a statistically significant association of TIA with CAD. In CAD patients, 4 were alcoholics and 96 were non-alcoholics. In controls, 3 were alcoholic and 97 were nonalcoholic. There is no statistically significant association between alcohol and coronary artery disease. Conclusions: The current study has brought attention to the rising prevalence of coronary artery disease (CAD) and associated risk factors, such as gender, family history, and Transient Ischemic Attack (TIA). The development of targeted efforts to raise knowledge about coronary artery disease and its associated risk factors, as well as an emphasis on lifestyle adjustment, is urgently required.