Group Mean Age Research Articles

Conjunctival Impression Cytology and Tear Film Changes in Sarcoidosis: A Subjective and Objective Diagnosis Study.

To evaluate sarcoidosis-induced tear film changes using subjective and objective diagnostic tests, particularly conjunctival impression cytology (IC), and to compare the results with healthy individuals. This study evaluated clinical data collected between January 2019 and January 2021 from 57 right eyes of 57 sarcoidosis patients without ocular involvement (Group 1) and 33 right eyes of 33 healthy individuals with similar demographic characteristics (Group 2). The Schirmer I test, tear break-up time (TBUT), fluorescein staining, and conjunctival IC were all performed as part of the conjunctival and corneal examinations following a thorough ophthalmological examination. The Ocular Surface Disease Index (OSDI) was used to assess subjective ocular symptoms. The mean ages in Groups 1 and 2 were 49.26±3.18 and 51.91±2.89 years, respectively (p=0.720). The mean Schirmer I test, TBUT, and OSDI scores differed significantly (p<0.05 for all), with Group 1 having a significantly higher percentage of dry eyes than Group 2. Group 1 had significantly higher Nelson's grading system grades than Group 2 based on conjunctival IC analysis (p=0.001). There were no significant differences in visual acuity (p=0.17) or intraocular pressure (p=0.14) between groups. Sarcoidosis patients had significantly higher Nelson grades in conjunctival IC, as well as significantly higher percentages of dry eye as determined by the Schirmer I test, TBUT, and OSDI. Reduced tear quantity and quality may destabilize the tear film layer, resulting in a variety of ocular symptoms.

Correlation of monocytopenia with aging in COVID-19 infected patients.

Objectives: To observe the effect of aging on monocyte count in COVID-19 infected patients. Study Design: Observational study. Setting: Rawal Institute of Health Sciences Islamabad, Pakistan Institute of Medical Sciences Islamabad. Period: April 2021 till July 2021. Material &amp; Methods: Adult humans of total 100 in numbers, suffering from corona virus with positive PCR test were selected. They were divided in two groups with 50 patients in group A and 50 patients in group B. Inclusion criteria was COVID-19 infected patients belonging to both genders without any blood disorder. All adults below the age of 18 years with blood disorder diseases were excluded. The age limit in group A was below 50 years and in group B was above 50 years. Monocyte count of all the patients was noted from the record in the laboratory of Rawal institute of health sciences and Pakistan institute of Medical sciences Islamabad. The age of the patients was confirmed from their CNIC. Results: Data was checked for normality by using Shapirowilk test of normality and comparison of monocyte count in between two groups was done by using Mann Whitney U test a significant difference was seen. Monocyte count in group A was 172/ µl and in group B was 122/ µl of blood. The mean age in group A was 32.3 years and in group B was 65.9 years. The p value of 0.00 shows a significant correlation of aging with monocytopenia. Conclusion: Corona virus infected patients with increased age (&gt; 50) years showed more reduction in monocyte count as compared to patients with lower age (&lt; 50) years.

Investigation of the choroidal structure in non-neovascular age-related macular degeneration patients with reticular pseudodrusen

BackgroundThis study aimed to compare choroidal thickness, total choroidal area (TCA), luminal area (LA), stromal area (SA) and choroidal vascularity index (CVI) in patients with reticular pseudodrusen (RPD) and drusen. MethodsA total of 100 eyes of 100 patients with non-neovascular age related macular degeneration (AMD) with five or more medium drusen (63–125 µm) and RPD in two or more quadrants were recruited to the study. 48 eyes of 48 patients with RPD were assigned as Group 1 and 52 eyes of 52 patients with drusen were assigned as Group 2. 40 right eyes of 40 healthy subjects were included as controls. Patients with neovascular AMD or advanced non-neovascular AMD were excluded from the study. After a detailed ophthalmic examination, infrared reflectance images and OCT with enhanced depth imaging mode was obtained from all patients. TCA, SA, LA and CVI were calculated using the Image J program. The data were analyzed for statistics using SPSS software. ResultsThe female/male ratio was 56/44 in the patient groups and 20/20 in the control group. The mean age was 73.63±6.14 (61–91) years for Group 1 and 69.43± 6.97 (59–87) years for Group 2 (p=0.005). The mean age of Group 3 patients was 71.14±8.17 (60–79) years and was statistically similar to Groups 1 and 2 (p=0.09 and p=0.12, respectively). Choroidal thickness, TCA, SA and LA were significantly lower in Group 1 (p<0.001). CVI and foveal thicknesses were not significantly different between Group 1 and 2 (p=0.214 and p=0.384 respectively). CVI was significantly lower in Group 3 (p<0.01). RPD was most commonly seen in the superior quadrant followed by temporal, nasal, and inferior quadrants. ConclusionsTCA, SA and LA, which reflect choroidal vasculature, were decreased in patients with RPD. These parameters can help evaluate the pathophysiology of the disease.

Enrichment and animal age, not biological variables, predict positive welfare indicators in zoo-housed carnivores

The development of evidence-based zoo animal welfare science and the use of the 'five domains' have inspired zoos to increase animal welfare, particularly recognising positive welfare states. We tested whether natural biology (number of habitats, latitudinal range, sociality, body weight) or husbandry variables (mean age of group, group size and presence of extra enrichment) predict rates of positive welfare indicators (activity, play and engagement with the environment) in the Order Carnivora from collecting data from previously published articles. For each behaviour, species (n = 23) medians were analysed using phylogenetically informed mixed-model regression. Activity data were from 136 animals (n = 23 species), environmental interaction from 55 animals (n = 15 species) and play from 27 animals (n = 7 species). Biological variables did not predict rates of behaviour at a species or an individual animal level, but husbandry variables did. At an individual level, activity and play decreased in older animals. Activity and interaction with environment also increased with additional enrichment. This study is the first to quantify positive behaviours performed by zoo housed Carnivora and shows that they display indicators of positive welfare, if appropriate husbandry including environmental enrichment is provided.

Outcome and mortality rate of COVID-19 infection among health workers and general population

Objective: To determine the outcomes and mortality rate of Covid-19 infection among health workers and general population. Material and methods: An observation study was conducted in Department of Pulmonology Pak Red Crescent Medical College &amp; Teaching Hospital,Dina Nath, Kasur, Punjab. Total 210 Covid-19 patients which were divided in two groups equally, group A healthcare workers and group B general population. Outcomes and mortality rate were assessed between both groups using Chi Square and Independent Samples T-test. Results: Mean age in group A was was 41.29±11.37 years while 42.61±16.15 years in group B. ICU admissions was significantly lower in group A 7 (6.7%) while 22 (21.0%) in group B. Mechanical ventilation need was significantly lower 6 (5.7%) in group A than group B 19 (18.1%). Mortality rate was significantly lower in group A than group B 4 (3.8%) vs 15 (14.3%). The mean hospital stay in group A was significantly shorter 9.41±3.333 days than in group B 13.18±3.956 days. Conclusion: From our study we conclude that the mortality rate was higher in the general population as well as the admission to ICU and need for mechanical ventilation as compared to the healthcare workers.

Epidemiological Characteristics and Trends of Primary Hip Arthroplasty in Five Tertiary Hospitals: A Multicenter Retrospective Study.

The number of primary hip arthroplasty (PHA) has increased sharply in recent years. Whether the epidemiological characteristics and trends of PHA have changed are unknown. This study aims to analyze the epidemiological characteristics and trends of those patients are urgent for public health institutions. The data of patients who underwent PHA in five tertiary hospitals from January 2011 to December 2020 were retrospectively reviewed. A total of 21,898 patients were included, most of whom were aged 60-69 years (25.1% males and 31.5% females). According to the hospitalization date, the patients were divided into two groups (Group A and Group B). The patients admitted between January 2011 and December 2015 were designated as Group A (7862), and those admitted between January 2016 and December 2020 were designated as Group B (14036). The patient data of the two groups, including sex, age, disease causes, body mass index (BMI), comorbidities, surgical procedures, hospital stay duration, and hospitalization costs, were analyzed by Pearson chi-Square test, Student t test or Mann-Whitney U test. More women were included in Group B than in Group A (58.5% vs 52.5%, P < 0.001). The mean age of Group B was less than that of Group A (62.27 ± 14.77 vs 60.69 ± 14.44 years, P < 0.001). Femoral head necrosis was the primary pathogenic factor in both groups, with a higher proportion in Group B than in Group A (55.5% vs 45.5%, P < 0.001). Significant differences were found between the two groups in BMI, comorbidities, surgical procedures, hospital stay duration, and hospitalization costs. Total hip arthroplasty (THA) was the most common surgical procedure in both groups, with a higher proportion in Group B than in Group A (89.8% vs 79.3%, P < 0.001). The proportion of patients with one or more comorbidities was significantly higher in Group B than in Group A (69.2% vs 59.9%, P < 0.001). In addition, Group B had a shorter hospital stay duration and higher hospitalization costs than Group A. Femoral head necrosis was the primary etiology for PHA in this study, followed by femoral neck fracture and hip osteoarthritis. Patients who underwent PHA exhibited a higher percentage of femoral head necrosis; underwent THA more often; and had larger BMIs, more comorbidities, higher medical costs, and younger age in the past decade.

Role of Post-Isometric Relaxation of Quadriceps and Core Stability Exercises in Vertical Jump Performance

Objective: To determine the role of post isometric relaxation of quadriceps and core stability exercises in vertical jump performance. Methods: A Randomized Clinical Trial, conducted in Islamic International University after having the ethical permission from Institutional review Board of Riphah International University Islamabad. Sampling technique was Non-probability convenience sampling with the sample size of 30 athletes, that were divided by sealed and envelop method into core stability exercise treated group (n=17) and Post isometric relaxation treated group (n= 13). Male Athletes within age range of 20-35 years and playing at the domestic level were&#x0D; included and athletes with history of sprain or strain in lower limbs within last 6 month, having neuromusculoskeletal and cardiovascular pathology were excluded from the study. Force plate was used to measure the different parameters of jump. Data were entered and analyzed through SPSS version 22. Results: The mean age of group A and B was 20.35 + 2.01 and 20.03 + 2.42 in years respectively. BMI of core stability exercise treated group and Post isometric relaxation treated group was 22.35 + 2.32, 22.58 + 1.95 respectively in kg/m2. Comparison between core stability exercise treated group and Post isometric relaxation treated group showed that there was no significant immediate effects (F= 1.235; p= 0.852) of treatment on three style of jumps.&#x0D; Conclusion: No significant immediate effects of treatment on three styles of jumps was found.

Comparison of efficacy of methylprednisolone with dexamethasone in moderate to severe COVD-19 patients in a tertiary care hospital

Background: The aim was to compare efficacy of methylprednisolone with dexamethasone in moderate to severe COVID-19 patients in a tertiary care hospital. Method: A retrospective observational study was conducted by collecting data of moderate to severe COVID-19 patients admitted to covid wards of a tertiary care hospital for a period of six months. Demographic data, information about SpO2 changes, duration of hospitalization, marker status and ventilation status were parameters collected and used to compare between two groups. Results: Total number of patients in this study were 130. Out of which 65 patients who were on Methylprednisolone belonged to group A and 65 patients taking dexamethasone belonged to group B. In group A 56 (86.2%) were males and 9 (13.8%) were females. In group B 51 (78.5%) were males and 14 (21.5%) were females. Mean age in group A was 54.75±14.96 (age range b/w 25-80 years) and in group B was 55.43±15.83 (age range between 23-84 years). Patients in group A showed more presence of comorbidity (44.6%) as compared to group B (32.3%). Mean SpO2 level on day 1 in group A was 86.37±7.58 and in group B was 88.11±4.38. On day of discharge mean SpO2 level was 95.05±1.54 in group A and 94.63±2.09 in group B. Mean length of hospital stay in group A was 9.78±7.38 and in group B was 7.88±4.76. Improvement in marker status for group A was 100% and for group B 95.4%. Ventilation status in both groups showed 100% improvement. Conclusions: Both steroids are effective in management of moderate to severe COVID-19 patients.

Comparison between rood inhibitory approach and bobath reflex inhibiting patterns to improve gross motor function and reduce spasticity in hemiplegic children of encephalitis

Objectives: To compare the effects of Rood Inhibitory approach and Bobath Reflex Inhibiting pattern to improve Gross motor Function and reduce spasticity in Hemiplegic Children of Encephalitis. Methods: A randomized clinical trial was conducted comprising of 22 patients recruited from different clinics of Faisalabad. Participants from both genders, in age range from 08-12 years were recruited and randomly allocated into two groups. Treatment group A received Rood inhibitory approach and treatment group B received Bobath Reflex inhibiting pattern. Measurement of Modified Ashworth scale were recorded at pre-treatment and weekly for 4 weeks, while (GMFM-88 and GMFM- 66) was assessed at baseline and at end of 4th week. SPSS version 22 was used to analyze the data. Result: Mean age in Group A was 10.00+1.673 years and in Group B was 9.82+1.537 years. Total 11 were male and 11 were female. There was significant improvement in mean MAS score at 2nd week, 3rd week and 4th week post treatment readings (p value &lt; 0.05). There was significant improvement in mean (GMFM-88 and GMFM- 66) at 4th week post treatment readings (p value &lt; 0.05).

Comparison of patients undergoing revision total hip arthroplasty and patients undergoing re-revision.

The aim of this study is to compare the demographic, clinical, and surgical characteristics of patients who underwent revision hip replacement surgery and those who underwent re-revision surgery. The secondary outcome is the investigation of the factors that play a role in estimating the time between primary arthroplasty surgery and revision surgery.The patients who underwent revision hip arthroplasty in our clinic between 2010- 2020, patients with at least 2 years of follow-up, and who underwent re-revision surgery if needed were included. Demographic and clinical data were investigated.Of the 153 patients who met the study criteria, 120 (78.5%) underwent revision (Group 1) and 33 (21.5%) underwent re-revision (Group 2). The mean age of Group 1 was 53.5 (32-85), and of Group 2 was 67 (38-81) (p=0.003). In both groups, patients who underwent hip replacement due to fracture had more revisions and re-revisions (p=0.794). While 53.3 of the patients in Group 1 did not need additional implants, 72.7% of the patients in Group 2 needed additional implants (p=0.010). Fracture-dislocation, fistula, and the need for debridement after the revision were statistically significantly higher in patients who underwent re-revision. Harris hip scores (HHS) were statistically lower in patients who went for re-revision.The need for reoperation in patients who have undergone revision total hip arthroplasty (THA) surgery is due to the fact that the patient's age is advanced and the indication for surgery is a fracture. While the rate of fistula, fracture, dislocation, and debridement increases after re-revision surgeries, the HHS values that indicate clinical success also decrease. We believe that studies with larger participation and longer follow-up periods are needed to explain this issue better.

LigaSure hemorrhoidectomy vs Milligan morgan hemorrhoidectomy: A Quasi-Experimental Study.

Objective: To explore the efficacy of two surgical procedures by comparing the mean operative time, average blood loss and postoperative pain score during conventional and LigaSure. Study Design: Quasi-experimental study. Setting: Department of Surgery, Aziz Fatimah Hospital, to compare the efficacy of two surgical procedures regarding perioperative and postoperative variables. Period: One Year (1st July 2020 -30th June 2021). Material &amp; Methods: Sixty patients with grade three and four haemorrhoids were randomized into two groups with 30 patients each. A questionnaire comprising all the variables was filled out and analyzed in SPSS 21. Results: Thirty patients were randomized into two groups, with group A comprising 21 (70%) females and, 9 (30%) males and 24 (80%) females, 6(20%) males in group B undergoing conventional hemorrhoidectomy. The study was single-blind, as the patients were unaware of the procedure they underwent. The mean age in group A was 39 years, and in group, B was 43 years. The mean operative time calculated was 38.4±2.77 and 51.7±2.60 in LigaSure and Milligan Morgan Hemorrhoidectomy, respectively, with a P-value calculated &lt;0.00001. The average blood loss in LigaSure was 31.3 ± 5.76 and 49 ± 7.11 in Milligan morgan hemorrhoidectomy. Moreover, the pain assessment score on day one and all other variables were statistically significant, with a P-value of &lt;0.00001. Conclusion: Ligasure hemorrhoidectomy is a safer surgical procedure associated with less operative time, blood loss and postoperative pain with shorter hospital stay and rapid wound healing.

The evaluation of anxiety and depression in spontaneous pneumothorax

Aim: Psychiatric disorders are common in patients with advanced respiratory diseases. The prevalence of primary spontaneous pneumothorax ranges from 1.2-37 per 100,000 population per year, and the risk of recurrence causes anxiety and depression for the patients. &#x0D; Material and Method: The Hospital Anxiety and Depression (HAD) scale was applied to 50 patients with a primary spontaneous pneumothorax that underwent treatment in our clinic and a control group of 50 individuals. The study and control group had similar participants (50 patients, 9 women and 41 men). The control group comprised otherways healthy participans aged between 18-40 who had admitted to the smoking cessation clinic. &#x0D; Results: While the study group's mean age was 25.2, it was 29 in the control group (covariance analysis used for the correction). On anxiety scale, the study group's mean score was calculated as 8.6, while it was 5.7 in the control group. The difference was found to be significantly higher in the patient group. The depression scale score of the study group was 5.8, and the control group's score was 5.7. There was no statistically significant difference between the groups. &#x0D; Conclusion: Since pneumothorax is a sudden, recurring, and severe illness that can cause respiratory distress, it may lead to anxiety or depression in patients. Without treatment, life-threatening consequences such as dyspnea and cardiac collapse may occur. Furthermore, the painful procedure of tube thoracostomy increases the patients' anxiety. Our objective is to identify potential anxiety-depression in pneumothorax patients, leading to improved mental health outcomes, increased satisfaction, lower readmission rates, and reduced care costs.

Effectiveness of Maitland Mobilization Technique in Comparison with Mulligan Mobilization Technique in Management of Frozen Shoulder

Background: Frozen shoulder refers to a common shoulder condition characterized by a general limitation of shoulder range of motion in the capsule model. The capsular pattern of the shoulder is characterized by the greatest limitation of passive lateral rotation and abduction. Physiotherapy is the most important part of the conservative treatment of frozen shoulder. Aim: To find the role of Maitland mobilization technique in treatment of frozen shoulder with Mulligan’s mobilization techniques and its possible effects in early gaining of ROM and pain management. Methods: This was a comparative study conducted at the Department of Physical Therapy and Orthopedic Surgery I, King Edward Medical College/Mayo Hospital, Lahore. Subjects were conveniently divided into her two groups, each group containing her 40 patients. In group A, patients were treated with Maitland manipulative therapy. In group B, patients were treated with mulligan mobilization and movement techniques. Patients in both groups were followed for up to 6 weeks and improvements in motor parameters were recorded at each patient's follow-up visit. SPSS was used for data entry and analysis. Result: A total of 50 patients participated in this study. The mean age of patients in group A was 46.23 years and the mean age of group B was 45.23 years at the onset of the disease at 6 weeks, 11 patients at 10 weeks, and 2 patients at 12-year intervals. Patients had an onset duration of 6 weeks, 10 patients had an onset duration of 10 weeks, and 6 patients had an onset duration of 12 weeks. Abduction was observed to be significantly improved in patients treated with the Mulligan method compared with those treated with the Maitland mobilization method. Practical implication: More specifically, the study will be focused on the examining the shoulder active and passive ROMs and pain reduction before and after the treatment. All measured characteristics of FS patients will be compared with those of the subjects with asymptomatic shoulders. Conclusion: In comparison with Mulligan mobilization technique, Maitland mobilization technique is more effective in the management of frozen shoulder. Keywords: Adhesive capsulitis /Frozen shoulder, Mulligan mobilization technique, Maitland mobilization technique.

Suprapatellar vs Infrapatellar Approaches for Intramedullary Nailing of Distal Tibial Fractures: A Prospective Observational Study

Introduction: Intramedullary nailing is a commonly employed procedure for treating distal tibial fractures. The two primary approaches for this procedure include the suprapatellar and infrapatellar techniques. Despite their widespread use, there is ongoing debate about the relative merits and drawbacks of these two approaches. Aim of the Study: The aim of this study was to assess the comparison between suprapatellar and infrapatellar approaches for intramedullary nailing of distal tibial fractures. Methods: This cross-sectional study was conducted in Department of Orthopaedics Surgery, Brahmanbaria Medical College Hospital, Brahmanbaria, Bangladesh, during the period from December 2020 to December 2022. Total 120 patients with intramedullary nailing of distal tibial fractures were included in this study. All the patients were divided into two groups; Group A comprised of 60 patients treated by suprapatellar approach and Group B comprised of patients treated by infrapatellar approaches. Result: For age, the mean age in Group A is 42.3 years (SD± 9.8 years), and in Group B it is 44.7 years (SD±10.3 years). In terms of sex, male predominance was seen in both groups. Surgical characteristics like surgical time (68.5 vs 74.2 mins), blood loss (58.4 vs 63.7 ml), and fluoroscopy number (15.7 vs 18.9) were significantly less in Group A. Post-operatively, Group B reported more pain (VAS score: 27.1 vs 18.7), while Group A had better range of motion (18.3 vs 17.1) and knee functionality (Lysholm score: 84.6 vs 80.9). Group B showed better foot and ankle functionality (AOFAS score: 94.4 vs 91.3). Fracture healing time was similar (24.5 vs 24.7 months). Fewer patients in Group A experienced complications like fracture deformity, malalignment, and surgical site infections. Conclusion: The suprapatellar approach may be the preferred nailing technique for treating distal tibial fractures compared with infrapatellar approach.

Improving the Outcomes in Oncological Colorectal Surgery

Aim: To evaluate the improvement in the outcomes in oncological colorectal surgery. Study Design: Prospective study, Place &amp; duration of study: Department of General Surgery, LUMHS Jamshoro from 1st January 2020 to 31st December 2022. Methodology: One hundred and fifty cases of colorectal cancer undergoing surgery were enrolled. They were multidisciplinary requiring compliance of surgeons at the operating room with their surgical teams. These interventions were based on sequential implementation of the evidence-based surgical site infection bundle (SSIB) and enhanced recovery after surgery (ERAS) protocols for all the patients undergoing colorectal surgery. Primary outcomes evaluated were duration of hospital stay as well as rate of complication in accordance with wound healing. Inverse proportional-weighting method was used for controlling possible variance within groups. The secondary outcome measures post improvement strategies were mortality within day 30, readmission within same period (30 days) or unplanned return to the operating table as well as numerous related complications. Results: The mean age of the cases in group A (pre-ERAS or pre-SSIB) was 61.2±10.9 years while in group B (pre-ERAS or post-SSIB) was 61.8±9.9 years and the mean age of Group C (post-ERAS or post-SSIB) was 63.7±10.1 years. There were more females within three groups such as 60%, 56% and 54% respectively than males. Hospital stay was highest within group A. The 30 days outcomes showed that the outcomes in group A showed highest number of death, wound infection and blood transfusion however the difference was insignificant for all other variable except wound infection. Conclusion: The subsequent addition of quality improvement within groups added positive outcomes in patients of oncological colorectal surgery with reduction in mortality, hospital stay as well as wound infection. Key words: Outcome, Colorectal carcinoma, Mortality, Hospital stay, Wound infection

A Comparative Study to Assess the Safety and Efficacy between Intravenous Iron Sucrose and Ferric Carboxymaltose in the Treatment of Iron Deficiency Anemia in Pregnancy – A Single Center Prospective Observational Study from a Tertiary Care Center.

Abstract Objective: To Compare the safety and efficacy between intravenous iron sucrose and ferric carboxy maltose in the treatment of iron deficiency anemia in pregnancy. Methodology: A Prospective study was conducted on 100 antenatal women with iron deficiency anemia in department of Obstetrics and Gynecology of a tertiary care center in northern India from June 2021 to May 2022. Results: The mean age in group A (Iron Sucrose group) was 25+ 2.83 years and in group B (FCM group) was 24.08+4.45 years. In group A (IS group) the average increase in Hb level was about 1.24 ± 0.29 gm/dl at 3 weeks and 2.62 ± 0.2 gm/dl at 6 weeks. In group B (FCM group) the average increase was about 1.74 ± 0.42 gm/dl at 3 weeks and 4.15 ± 1.94 gm/dl at 6 weeks. In IS group the average increase in ferritin was about 18.83 ± 18.18 ng/dl at 3 weeks and 43.54 ± 31.71 ng/dl at 6 weeks. In FCM group the average increase was about 34 ± 19.83 ng/dl at 3 weeks and 96.62 ± 50.7 ng/dl at 6 weeks. P value at both time periods was 0.0001, which is highly significant. 43 patients (86%) in Group B as compared to 19 patients (38%) in group A showed improvement in anaemia in PBS findings over 3 week and 6 week period, which was statistically significant with a P value of 0.024. In Group A (IS group ) only two patients complained of diarrhoea, two complained of headache, 1 patient complained of nausea ,vomiting, one complained of nausea only, In Group B (FCM group) total 3 patients (6%) complained of minor reactions like nausea, vomiting and itching. There were mild side effects only in both the groups. Conclusion: Intravenous FCM is more efficient and better alternative than iron sucrose in the treatment of iron deficiency anaemia in pregnancy. Key Words: IDA, FCM, IS, Ferritin, Haemoglobin.

Comparison of Accuracy of Ultrasound Measurement of Subglottic Diameter Versus Conventional Age Based Formula for Estimating Endotracheal Tube Size for Pediatric Surgical Patients- A Prospective Randomized Controlled Study

Introduction: The main aim of this study is to determine if ultrasonography (USG) based measurement of subglottic diameter is the best size predictor for endotracheal tube (ETT) in pediatric surgical cases over age-based formula with micro cuff tube. Also, to test reintubation percentage and post-operative complications in children. Methodology: This research is double-blind randomized control study with 68 children undergoing elective surgery requiring general anaesthesia with micro cuff tube. They were divided into 2 groups i.e. ETT size by USG (group U) and ETT size by age-based formula group A) (with 34 children in each. Both groups ETT measurement was calculated by independent Samples t-test, and correlation of both groups with actual ET Tube was measured by Pearson’s correlation coefficient. Reintubations or post-op complications was measured by Chi-squared test. Results: Mean age of group A and U are 5.65 ± 2.77 and 5.97 ± 2.77 respectively. Mean weights were from 13.5±2.06 kgs to 27±4.63kgs. Statistical significance with a P-value (P=0.0460) is observed in group U whereas no significance was seen in group A. A strong positive correlation (R=0.960) between USG-estimated ETT size and actual ETT size is observed. The difference in reintubations and post-op complications in group U were statistically significant with P &lt; 0.002. Conclusion: The present study concludes that the sub glottis diameter measured by USG is a good predictor for correct size of micro cuff endo tracheal tube in children.

Acute Coronary Syndrome in Young (≤45 Years) Patients: An Observational Study

Background: Acute coronary syndrome (ACS) is witnessing a demographic transition with increasing prevalence among younger individuals (≤45 years). Hence, this study was designed to evaluate the clinical features, risk factors, and angiographic profile of young (aged ≤ 45 years) patients with ACS and to compare it with the older (aged &gt;45 years) patients with ACS. Materials and Methods: An observational study was conducted at a tertiary care center in India from July 2020 to December 2021. A total of 157 patients were enrolled, among which 90 patients were included in cases (group-I). The inclusion criteria were patients presenting with ACS aged between 18 and 45 years. There were two control groups, including 34 patients with ACS (aged &gt;45 years) in Group II and 33 healthy volunteers in Group III (aged 18–45 years). Baseline demographic details, risk factors, and angiographic profile of patients with ACS in each group were recorded and compared. Results: Mean age of Group I was 39.79 ± 5.15 years and of Group II was 59.74 ± 8.21 years. Smoking (P = 0.027) and family history of coronary artery disease (P = 0.022) were the significant risk factors of ACS in Group I. Compared to non-ST elevation myocardial infarction (16.7%), ST-elevation myocardial infarction (83.3%) was predominant among younger patients with ACS. Single-vessel disease was prevalent among younger patients (62.2%) as compared to older patients with ACS (41.20%). Conclusion: Younger patients with ACS exhibited a distinct clinical and angiographic profile compared to older patients with ACS.

Chlorhexidine for the Prevention of Omphalitis in infants with a single dose

Background: Worldwide, 44% (2,761 million) of the 6 million children who died before the age of five in 2013 did so during the newborn period. Globally, the first week of life is when 75% of newborn fatalities occur. Low-middle income nations account for 99% of newborn death worldwide. A great proportion of these neonatal deaths can be prevented if effective health measures are undertaken during birth giving prime importance to hygiene. Aim: To evaluate the effectiveness of a single application of chlorhexidine in the prevention of Omphalitis in neonates. Methodology: This randomised control experiment was carried out between October 2021 and April 2022, in the paediatrics unit of the Hayatabad Medical Complex in Peshawar. In this study, a total sample size of 64 with 32 in each group was observed. Newborn infants were randomly assigned to two types of cord care regimes, Group-A and Group-B. In Group-A newborns, the umbilical cord was cleansed with a single application of 4% chlorhexidine solution, and newborns in Group-B were instructed to leave the cord dry. The outcome of the study was the presence or absence of Omphalitis for which follow-up was done by the researcher on days 7th, 14th, 21st, and 28th of life in the hospital or through a home visit, whichever was acceptable to parents. The outcome measurement was recorded through proforma. Results: In this study mean age in Group A was 7± 2.77 days. Whereasthe mean age in Group B was 7±3.12 days. In group-A Fifty-six percent of neonates were male and 44% of neonates were female. Whereas in Group B 53% of neonates were male and 47% of neonates were female. 94% of patients responded favourably to additional chlorhexidine solution, whereas 6% did not..whereas Group B dry cord was successful in preventing Neonatal Omphalitis in 78% of cases and failed in 22% of individuals. Practical implication: With the use of chlorhexidine in newborn prevent neonates from sepsis and reduce mortality and morbidity. Conclusion:Our study concludes that a single application of chlorhexidine is more effective than a dry cord in the prevention of Omphalitis in neonates. Keywords: effectiveness, a single application of chlorhexidine, Omphalitis, neonates.

The impact of isotretinoin on platelet and white blood cell count in patient with acne vulgaris

Background: Acne is a multifactorial disease and represents a spectrum of disease severity from a couple of blackheads and pustules to severe nodulocystic fulminant acne. The severity of the disease differs from patient to patient therefore Isotretinoin is a commonly used for treating acne. However, isotretinoin may lead to elevated serum levels of triglycerides and cholesterol, and it may affect liver function tests. Moreover, the effect of isotretinoin on hematological parameters remains controversial and examines changes in the blood chemistry panel, hematological parameters of patients diagnosed with acne and treated with isotretinoin. Methods: This comparative clinical trial carried out at Clinic in the Department of Dermatology in tow hospitals Salahaddin hospital and emergency hospital in Salahaddin city in Iraq. 116 patients were selected. Patients are suffering from acne and divided equally (58 patients each) to one of the two treatment regimens using isotretinoin and doxycycline. Group one was given oral isotretinoin twice daily for seven months and Group two was given doxycycline twice daily for same period. These patients were prepared before the time of study and were followed up during the treatment period. According to female, pregnancy prevented by two contraceptive methods. Both groups are investigated with the same investigations. Results: Among the 116 cases included in the study, (36) were male and (80) were female. The mean age of group one was 21.97±4.87 years and in group two was 21.72±4.95years Mean, platelet count increased, whereas white blood cell count decreased after isotretinoin treatment. But without any statically significant association. Conclusions: The results of this study revealed that no statically significant effect of white blood cells and platelets count after therapy by isotretinoin. Keywords: Acne, Isotretinoin, white blood cells and platelets. Aim of study The aim of this study was to assess and compare the efficacy of oral isotretinoin on WBC and platelet count in acne vulgaris patients.