Sir Ganga Ram Hospital Research Articles

Parents’ Perception regarding Nursing Care of their Child in Tertiary Care Hospital, Lahore

Background: The nursing care of child effect the health of the child somehow. As, the health of child is effecting the health of the parents. This research was planned to check the perception of parents related to nursing care of their admitted child in the hospitals. Materials and Methods: This study was a crossectional and conducted at Sir Ganga Ram Hospital, Lahore from Septmeber 2021 to January 2022. After getting approval and review from hospital committee, a total of 120 parent were selected for data collection out of which 100 filled out structured questionnaires. Data was analysed on SPSS version 21.0, and different tables were generated. Results: The average age of parents was 31.19 years, while about 45% of them have some bachelor level education. The level of good perception was maximum in parents having higher eduation while bad perception was in having secondary education. Overall perception rates of good and bad perception was 63% and 37%, respectively. Conclusion: The majority of the parents have a good perception of nursing care of their ill child. More than one-third of the participants agreed that nurses should not be rude, hostile, and unkempt. Nurses’ managers should support the nurses to get a higher level of education and to get admissions in specialization so the number of specifically skilled holders should be increased in the specific ward. Keywords: Perception, Parents, Nursing care

Comparison of Mean Serum Calcium Levels in Pregnancy with and without Pregnancy Induced Hypertension

Aim: To compare mean serum calcium levels in pregnancy, with and without pregnancy induced hypertension. Study design: A Cohort study was done. Place and duration of study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore Unit III, from 1st January 2021 to 30th June 2021. Methodology: Two hundred patients with gestational age between 28 to 40 weeks, were included in the present study, 100 patients in group A (hypertension) and 100 in group B (normotensive). Results: The mean age of patients in group-A and group-B was 28.87 ± 4.32 years and 27.49±4.80 years respectively. The mean gestational age in group-A was 35.86±1.86 weeks and in group B was 35.90±1.36 weeks. The mean serum calcium level was 7.26±0.80mg in group A and 8.94±0.53mg in group B which is statistically significant (p <0.001). Conclusion: It is concluded that serum calcium levels in women with pregnancy induced hypertension (PIH) are lower than in normal pregnant women. The calcium supplementation appears to reduce the risk of pregnancy induced hypertension. Therefore, calcium consumption in pregnancy should be encouraged, especially during the second and third trimester of pregnancy. Keywords: Hypocalcemia, pregnancy induced hypertension, Normotensive patients.

Diagnostic Accuracy of LDH in Detecting Birth Asphyxia: Cross sectional study

Background: Among neonates, lack of oxygen results in multi-organ failure especially causing brain hypoxia resulting in hypoxic-ischemic encephalopathy (HIE). Aim: To determine diagnostic accuracy of LDH in detecting birth asphyxia keeping clinical signs of HIE as gold standard. Study Design: Cross-sectional study. Methodology: Neonates (n=180) fulfilling inclusion criteria were enrolled in this study from the Emergency Neonatal Unit and Neonatology Ward of Sir Ganga Ram Hospital, Lahore. Following informed consent, blood (1cc) was taken and LDH levels were measured. Antenatal scans determined gestational age. Chi-square test was applied with P-value <0.05 taken as significant. Results: Diagnostic accuracy of LDH for detection of perinatal asphyxia in term neonates had 90.20% sensitivity, 92.59% specificity and accuracy rate of 90.56%. Conclusion: It was concluded that the diagnostic accuracy of LDH is higher in detecting birth asphyxia keeping clinical signs of HIE as gold standard, and this test can be performed for evaluation of perinatal hypoxia. Keywords: Perinatal asphyxia, LDH and diagnostic accuracy.

Awareness and practice of contraceptive measures among multiparous Pakistani women - A multicenter study

Objective: To determine contraceptive knowledge and practices among multiparous women. Study Design: Cross Sectional, Multicenter study. Setting: Gynae Unit I of Sir Ganga Ram Hospital, Lahore and Gynecology Department of Government Teaching Hospital, Shahdara. Period: 1st July 2019 to 31st December, 2019. Material & Methods: A total of 448 multiparous women were randomly selected from 2 tertiary care hospitals. A structured questionnaire was used to assess the knowledge of women attending antenatal and gynaecology clinics and indoor. Results: Out of 448 women, all were aware of at least one method of contraception and 272 (65%) had used one. The most commonly employed method was male condom (33%) followed by IUCD (24%), oral contraceptive pill (22%) and hormone based injectables (13%). In upper socioeconomic class, 95% were using birth control methods whereas 71% of middle class and 48% of lower class subjects had used any one method of birth control. In the highly educated subjects, 67% had employed a contraceptive method and among the illiterate, only 39% has used any method. Disapproval on part of the husband was the most common (28%) reason of refusing contraceptive services, followed by desire for more children (16%). Health care workers were the most common source of knowledge of contraception (69%) followed by family members (31%) and media (17%). Conclusion: All the subjects were aware of contraceptive methods. The most common used method is condoms followed by IUCD but practices were limited due to high illetracy, lower socioeconomic status, partener refusal, desire for more issues and fear of side effects.

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Proceedings of the 28th European Paediatric Rheumatology Congress (PReS 2022)

Identify the Impact of an Innovative Evaluation Strategy on the Care of Babies Having Neonatal Abstinence Disorder

Aim: The prevalence of neonatal abstinence disorder is increasing, which places a huge strain on the nation's healthcare infrastructure. It's possible that using the usual Finnegan Neonatal Abstinence Scoring System diagnostic technique might result in newborns with NAS receiving needless opioid medication. Researchers came up with a whole new evaluation strategy, and in this paper, we will discuss how it influences the treatment of babies who have NAS. Methods: Researchers took a historical look at the therapy choices made for sixty babies who had been exposed to opioids and were being cared for in the inpatient ward at Sir Ganga Ram Hospital in Lahore. While the FNASS scores of all newborns were monitored and recorded every three to seven hours, the Eat, Sleep, and Console assessment strategy were used to control them. Researchers evaluated the actual medical decisions that have been made using the ESC method with the projected treatment decisions that were based on the recorded FNASS scores. The administration of morphine upon delivery was the main outcome. Results: When employing the ESC method, morphine was administered to 8 newborns, which is a sixteen percent success rate. In comparison, the FNASS method predicted that morphine would be administered to 32 infants, which represents a sixty-four percent success rate (P, .002). When compared to the FNASS method's prediction of 90 days (26.8 percent), the ESC method's prediction of starting or increasing morphine administration was accurate 10 days (3.8 percent) earlier (P, .002). It was noted there were no other possible complications or readmissions that occurred. Conclusion: The frequency with which morphine was administered to infants who were handled using the ESC strategy was much lower than the frequency with which it will be administered if FNASS approach had been used. The ESC method is an efficient strategy for care of newborns diagnosed through NAS. This method restricts the use of pharmacologic therapy and has the potential to result in significant decreases in the amount of time spent in the hospital. Keywords: Neonatal Abstinence Syndrome, Nation's Healthcare Infrastructure.

Indications, Findings and Complications of Endoscopic Retrograde Cholangio-Pancreatograpghy (ERCP); A Study Conducted on the Patients Admitted in a Tertiary Care Hospital

Objective: To highlight the significance of endoscopic retrograde cholangio-pancreatography, its indications, findings and complications. Material and methods: This is a prospective study conducted on the patients admitted in the gastroenterology department of Sir Ganga Ram Hospital Lahore. Study period was of six months from July 2021 to December 2021. Main outcomes in this study were technical safety, indications of ERCP and complications. Study sample was calculated using WHO sample size formula. Results: Total 200 cases were included in this study including 116 (58%) male and 84(42%) female. CBD cannulation was done in 184(192%) cases. CBD stone was found in 35(17.5%), CBD stricture in 44(22%) and CBD stricture with stone found in 17(8.5%) cases. 11(5.5%) cases developed acute pancreatitis out of which 2(01%) cases had severe pancreatitis with collection of fluid. One case (0.5%) had retroperitoneal perforation which was managed conservatively. 03(1.5%) cases had bleeding after the procedure and hemostasis achieved by re-scope with adrenal injection at the bleeding point. Conclusion: ERCP procedure has a high success rate with minimum complications. Keywords: ERCP, Findings, Complications, CBD stone, Pancreatitis

Prevalence Of Neck and Back Pain Among Gynecologists and Obstetrics in Tertiary Care Hospital of Lahore

Neck pain is identified as the ache, irritation and discomfort in the area below your head up to third Thoracic vertebrae. It can radiate to shoulders, arms and fingers also. The presenting complaints of cervical patients include headache, stiff neck, stress, muscle pain, fever, and tenderness, radiating pain, weakness in the arm and difficulty in lifting or gripping activities. Patients may also present with numbness, tingling and weakness of the arm. Objective: To determine the prevalence of neck and back pain among gynecologists and obstetrics in different tertiary care hospitals of Lahore. Methods: The cross-sectional study included 310 gynecologist and obstetrics that were recruited using non-probability convenience sampling. The cases of the neck pain were recruited from the obstetrics and gynecology department of different hospitals including: Fatima Memorial Hospital, Shalimar Hospital, Services Hospital, Mayo Hospital and Sir Ganga Ram Hospital, Lahore. Research was completed within six months from 23 October 2021 to 30th April 2022. Results: Among 310 participants, 196 (63.2%) reported neck pain among which; 153 (44.4%) gynecologists reported pain two times per week. Out of total, 306 (98.7%) reported fatigue especially on long days. Results regarding pain area showed that 196 (63.2%) had neck pain, 64 (24.6%) had back pain and 50 (16.1%) had shoulder pain. Results regarding frequency of pain showed that out of 310 (100%), 153 (49.4%) had pain 2 times per week and 105 (33.9%) had pain 0-2 times per month. Conclusions: Prevalence of low back pain was 20.65% whereas prevalence of neck pain in gynecologists was 63.23%. The study suggests that neck pain and fatigue were common in gynecologists and obstetrics. They lack of postural awareness and don’t follow ergonomics principles during surgical procedures.

Sonographic Assessment of Placenta Previa with and without History of Cesarean Section or Abortion

Background: The incidence of placenta Previa has increased with increasing maternal age due to late marriages. Objective: To assess occurrence of placenta Previa in females with and without history of C- section, abortion and both. Methodology: Descriptive cross sectional study conducted in Sir Ganga Ram Hospital Lahore, radiology department. Duration of study was nine months after the approval of synopsis. Main aim was to assess occurrence of placenta Previa in females with and without history of C-section and abortion or both. The examination will start with the patient in the supine position (3.5 – 5 MHz) convex probe will be used .From the anteriorly using urinary bladder as acoustic window ultrasound will be performed in the longitudinal planes. In Transabdominal study (TAS) the bladder will be adequately distended to visualization of the cervix and lower uterine segment and to check the relationship of the placenta to the inner os. If indicated, positioning the patient in a right or left posterior oblique position may be helpful to check the posterior placenta. The diagnosis of placenta Previa will be considered if the lower placental edge covers the internal os.

Efficacy of Oral Azithromycin in Treatment of Uncomplicated Enteric Fever in Children

Background: Enteric fever also known as (typhoid or paratyphoid fever) is a common systemic infection with increased incidence of morbidity and mortality with salmonella typhi and paratyphi. Azithromycin has shown better outcomes in children with uncomplicated disease. Objective: To determine the efficacy of Azithromycin in treatment of uncomplicated enteric fever in children. Study Design: Descriptive case series study Place and Duration of Study: Department of Pediatrics, Sir Ganga Ram Hospital Lahore, Pakistan from 21st August 2015 to 20th February 2016. Methodology: One hundred and sixty five cases were included. Patients received capsule/suspension of Azithromycin (10 mg/kg/day) OD for 7 days. Treatment was labelled as effective if both clinical and microbiological cure were observed. Results: Patients ranged between 2-12 years of age. Mean age of the patients was 6.45±2.39 year. There were 85 males (51.5%) and 80 females (48.5%) in this study. Mean duration of fever was 6.97±1.37 days. Clinical cure, microbiological cure and efficacy was 93.9%. Conclusion: Azithromycin to be effective and safe in treatment of enteric fever. We observed high cure rate of 93.9% without any serious side effects leading to the conclusion that azithromycin is an effective oral agent for treatment for enteric fever. Keywords: Enteric Fever, Azithromycin, Salmonella Typhi/Paratyphi

Shock Index in Patients Undergoing Elective and Emergency General Surgical Procedures: A Predictor of Morbidity Risk and Outcomes

Introduction: Shock index (SI) has gained popularity as a quick and inexpensive screening tool for patients of trauma or obstetric hemorrhage to predict risk of mortality and morbidity especially transfusion requirement. It has further been studied for sepsis in recent times. Though not specific the shock index has been shown to be a sensitive tool in alerting physicians of patients that may require greater medical attention. It has not been studied in patients undergoing general surgical procedures either elective or emergency.
 Aims & Objectives: To assess the utility of shock index in patients undergoing both elective and emergency general surgical procedures and to assess outcomes of these patients.
 Place and duration of study: It was a retrospective cohort study of in-patient records of the Department of General Surgery, Sir Ganga Ram Hospital, Lahore. The duration of study was from 1st September 2021 till 30th November 2021. Material & Methods: From the medical records information was retrieved and the shock index was calculated by ‘heart rate divided by systolic blood pressure’ and was recorded for the following instances: (i)At admission (ii) Prior to induction of anesthesia (iii) In the immediate post-operative phase in the recovery unit (iv) post-operative Day 1 (v) at discharge. Patient’s outcomes and investigations were also recorded. SPSS version 24 was used for data entry and analysis
 Results: SI at admission and on post-operative Day 1 for emergency vs elective surgery was 0.82 and 0.72 vs 0.69 and
 0.68. Shock index prior to induction was higher in the emergency surgery group and this was statistically significant. A shock index value of 0.81 was 71.7% and 72% specific for post-operative morbidities. The optimum value for shock index in ER and Elective surgery varies for each morbidity.
 Conclusion: This is a simple tool and may increase appropriate resource allocation and increased observation for certain patients who are screened to be at higher risk of developing a specific morbidity post-operatively, especially in resource- limited countries like Pakistan.

Poor Apgar Score of Neonates Born to the Females Presenting with Pregnancy Induced Hypertension for Delivery

Background: Pregnancy induced hypertension (PIH) is defined as BP ? 140/90 mmHg, taken after a period of rest on two occasions or ?160/110 mmHg on one occasion in a previously normotensive woman. One of the most important aspects is the outcome of pregnancy with PIH. Poor Apgar score is commonly observed in females with PIH. So we conducted this study to find the extent of problem in local population. Objective: To assess the frequency of poor Apgar score of neonates born to the females presenting with pregnancy induced hypertension at term (37-41 weeks) for delivery.
 Study Design: Descriptive case series. Setting: Unit 4, Department of Gynecology & Obstetrics, Sir Ganga Ram Hospital, Lahore. Duration of Study: 6 months after approval of synopsis i.e. from: 09-11-2021 to 10-05-2022 Patients. Methods: 125 pregnant females with PIH were followed till delivery by researcher herself. After delivery, neonate was assessed for Apgar score at 1 & 5 minutes, if <7, then it was labeled as poor Apgar score. All this information was recorded on proforma. Statistical analysis was done using SPSS version 20.
 Results: The mean age of patients was 30.50±6.22years. The mean gestational age was 39.78±1.66weeks. The mean BMI was 26.99±5.13kg/m2. There were n=59 (47.2%) male neonates while n=66 (52.8%) female neonates. The mean Apgar score at 1minute was 7.29±1.36 while at 5minutes was 7.70±1.29. Poor Apgar score was noted in n=19 (15.2%) neonates while n=106 (84.8%) neonates had normal Apgar score. Conclusion: The frequency of poor Apgar score (at 1 minute and continuously <7 at 5 minutes) was 15.2% in neonates born to females with PIH. The neonates with poor Apgar Score were admitted to NICU and were managed according to standard hospital protocol

Association of underlying comorbidities and progression of COVID-19 infection amongst 2586 patients hospitalised in the National Capital Region of India: a retrospective cohort study.

This study is conducted to observe the association of diabetes (DM), hypertension (HTN) and chronic kidney disease (CKD) on the prognosis and mortality of COVID-19 infection in hospital admitted patients with above mentioned comorbidities. This is a single centre, observational, retrospective study carried out at Sir Ganga Ram Hospital, Delhi, India. The burden of comorbidities on the prognosis and clinical outcome of COVID-19 patients admitted patients from April 8, 2020, to October 4, 2020. Chi-square and relative risk test were used to observe the association of comorbidities and disease prognosis. A total of 2586 patients were included in the study consisting of 69.6% of male patients. All the comorbidities were significantly associated with ICU admission and mortality. The relative risk showed that CKD is most prone to severity as well as mortality of the COVID-19 infection followed by HTN and DM. Further with the increase in number of underlying comorbidities, the risk of ICU admission and mortality also increases. Relative risk of the severity of COVID-19 infection in younger patients with underlying comorbidities are relatively at higher risk of severity of disease as well as to mortality compared to the elderly patients with similar underlying condition. Similarly, it is found that females are relatively at higher risk of mortality as compared to the males having same comorbid conditions except for the hypertensive patients. Diabetes, hypertension and CKD, all are associated with progression of COVID-19 disease to severity and higher mortality risk. The number of underlying comorbid condition is directly proportional to the progression of disease severity and mortality.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11010-022-04485-2.

Comparison of Pre and Post Tonsillectomy Clinical Assessment of Weight with Increase in Weight in Children

Background: Tonsils and adenoid are part of local immunity near the entrance of respiratory and digestive tracts. However they may become infected and can be a source of chronic or recurrent infections and can lead to OSAS if enlarged. In case of significant morbidity surgical resection is indicated. Aim: To study the relationship between tonsillectomy and increase in weight in children. Setting: ENT Unit II of Fatima Jinnah Medical University and Sir Ganga Ram Hospital Lahore Duration: 1st February 2021 to 31st January 2022. Study design: Quasi experimental study Method: All patients of 5 to 9 years of age with history of recurrent tonsillitis and obstructive sleep apnea syndrome were included. Total of 88 patients selected with non probability convenient sampling. Clinical assessment was done for recurrent and chronic tonsillitis and tonsil hypertrophy causing OSAS. Pre operative weight measured and compared with post operative weight at 3 months follow up. Results: Out of 88 participants 74(84.1%) have recurrent tonsillitis and 75(85.2%) have OSAS. Mean pre operative weight was 16.6591 kg and mean post operative weight was 19.8182 kg. Paired sample t test was applied and p value was calculated which was statistically significant. Conclusion: There is a significant increase in weight after tonsillectomy in children at 3 months follow up that is beneficial in terms of quality of life, school performances, behavior and mental well being. Keywords: Recurrent tonsillitis, Obstructive sleep apnea syndrome, Tonsillectomy, Nocturnal enuresis, Chronic tonsillitis.

Laparoscopic Port Insertion Modifications According to the Surgeons Competency

Objective: The aim of current study is to determine the efficacy and safety of laparoscopic port insertion modifications according to the surgeons competency. Study Design: Retrospective study Place and Duration: Sir Ganga Ram Hospital Lahore. Jan-2019-July 2019 Methods: There were 88 patients of both genders were presented in this study. Patients were aged between 17-55 years. Data on the recruited patients' age, gender, and BMI were compiled after informed written permission was obtained. Indication of surgery was observed first and all of the patients were underwent for laparoscopic surgery port insertion either open or closed . Post-operative efficacy, complication and frequency of mortality was calculated within a duration of 2-months. SPSS 18.0 was used to analyze all data. Results: Among 88 patients, 88 (54.4%) were males and 40 (45.6%) were females. The mean age of the cases were 35.14±11.34 years and had mean BMI 22.6±1.19 kg/m2. Most common indication was inguinal hernia found in 35 (39.8%), appendicitis found in 28 (31.8%) patients, cholelithiasis in 15 (17.05%), varicocele in 6 (6.8%) and benign masses in 4 (4.5%) patients. In 70 (79.5%) patients laparoscopic closed technique was applied and 18 (20.5%) received open technique. Mean time of port insertion was 3.8±5.51 minutes in closed laparoscopy while in open laparoscopy mean time was 2.5±.4.31 minutes. Overall difficult entry was found among 20 (22.7%) cases. Post-operative rate of complications was found among 4 (4.5%) patients in which port site seroma, intraperitoneal injury and infection was the most common. No any mortality found in this study. Patients satisfaction rate was 80 (90.9%). Conclusion: We concluded in this study that laparoscopic port insertion technique was an effective in terms of less operative time, surgeons competency, low rate of mortality and fewer post-operative complications among patients underwent for surgery with different type of diseases. Keywords: Inguinal Hernia, Laparoscopic Port Insertion, Complications, Efficacy

Success of Endoscopic Surgery in Nasal Polyposis

Background: Endoscopic Sinus Surgery is a minimally invasive procedure that involves the use of an endoscope to improve sinus airflow and drainage as well as the removal of polyps. The extent of surgery varies depending on the severity of the condition and the surgeon's experience. This method has been utilized to treat sinonasal problems for over a decade. Aim: To find the frequency of success of Endoscopic Surgery in patients of Nasal Polyposis. Study design: Descriptive (Prospective) case series. Setting & duration: Department of ENT Unit II, Sir Ganga Ram Hospital, Lahore from 27-01-2021 to 26-07-2021. Methods: In current study, 80 patients of Nasal Polyposis were enrolled. All Patients were undergone Endoscopic Surgery procedure, following the patient at 3 weeks post-operatively as per operational definition addressed by success. Post-stratification chi-square test was applied. Results: Regarding age distribution, mean age was observed 37.60±4.479 years ranged from 30 to 45 years.35 patients were below 38 years of age whereas 45 patients were either 38 years or above. Out of 80 patients, 44 patients (55%) were male while remaining 36 patients (45%) were female. Frequency of patient success after Endoscopic surgery in Nasal polyposis was 64(80%). Conclusion: In conclusion, the success of the patients was considered to be high and comparable to recent literatures both local and international. The percentage of success of patients was higher i.e. 80%. Key words: Success, Endoscopic sinus surgery, Nasal Polyposis.

Comparison between open Haemorrhoidectomy versus closed Haemorrhoidectomy

Objective: The study is about the comparison of open haemorrhoidectomy and closed haemorrhoidectomy. This study is aimed to compare both surgical techniques and to find out the outcomes. Materials and Methods: This study was conducted at sugery department sir Ganga ram hospital Lahore from January 2021 to December 2022. A total of 70 participants were part of the study. The patients of the age group between 20 to 65 years were admitted to the surgery department for planned hemorrhoids surgery. The patients treated with open haemorrhoidectomy were allocated to group 1 while group 2 consists of patients selected for closed haemorrhoidectomy. Before the surgery, consent was signed by the individual patients or their relatives. Exclusion Criteria: The patients suffering from issues like ulcerative colitis, immune deficiency diseases, rectal cancer, Crohns disease, and thrombosed hemorrhoids were omitted from the study. Patients with a previous history of hemorrhoids operation and pregnant women with piles were also excluded from this study. Results: A total of 70 patients were the part of study. 35 of patients for open haemorrhoidectomy considered as group 1 and 35 were the part of close haemorrhoidectomy, considered as group 2. Patients of age 20 to 65 years were included in the study. In group 1, 20 (57.14%) males and 15 (42.85%), females their average age mean was 39. 9 ± 10.11 for both males and females. 27 (77.14%) patients were reported preoperative bleeding, 9(25.71 %) pain and 23 (65.71%) patients had the issue of pruritus. In group 2 the mean age 40 ± 12.2 was reported,22 (62.85%) males and 13 (37.14%) females. Preoperative 25 (71.42%) bleeding cases, 6 (17.14%) with severe pain and 20 (57.14%) had a history of Pruritus. The most common symptom was bleeding. The comparison of open haemorrhoidectomy and closed haemorrhoidectomy is elucidated in Table 2. The operative time for open haemorrhoidectomy was shorter than closed haemorrhoidectomy with a P-value of 0.03. The stay duration at the hospital for the first group was 3 days while 2 days for the second group with non-significant results. The wound healing time was measured less for 2nd group than 1st group. A significant difference was found in wound healing such as for first group,5weeks and for 2nd group,3 weeks. The post-operative pain was observed lesser in group 2 (closed haemorrhoidectomy) than the group 1 (open haemorrhoidectomy). Conclusion: We concluded that a closed haemorrhoidectomy produces less post-operative pain than an open haemorrhoidectomy. Secondly, wound recovery was more quickly in the case of closed haemorrhoidectomy. Keywords: Closed haemorrhoidectomy, open haemorrhoidectomy, haemorrhoids.

Psychometric analysis of cognitive distortions scale-urdu on patients diagnosed with mental disorders.

To assess the reliability and concurrent validity of Cognitive Distortions Scale-Urdu based on Beck's Cognitive Model of psychopathology on patients diagnosed with mental disorders. The correlational study was conducted from June 15, 2019, to January 30, 2020, in Lahore, Pakistan, and comprised psychiatric patients of either gender aged 18-65 years from six government hospitals, including Mayo Hospital, Services Hospital, Punjab Institute of Mental Health, Sir Ganga Ram Hospital, Gulab Devi Hospital and the Combined Military Hospital. The participants completed the demographic information form and the Cognitive Distortions Scale-Urdu. The latter was re-administered after a gap of two weeks to determine its internal consistency and test-retest reliability. Feinstein Paranoia, Subjective Wellbeing and Siddiqui Shah Depression Scales were administered along with the Cognitive Distortions Scale-Urdu to determine its concurrent validity. Statistical analysis was done using SPSS 24. Of the 106 patients, 56(52.8%) were recruited for reliability analysis with an overall mean age of 32.31±10.62 years, and 50(47.2%) for concurrent validity analysis with an overall mean age of 31.30±10.52 years. Correlation analysis indicated good internal consistency (α=0.87), test retest reliability (r=0.86) and moderately high concurrent validity of the scale (range: 0.44-0.89). The Cognitive Distortions Scale-Urdu was found to have sound psychometric properties and was suitable for researchers to obtain quantitative estimates of the frequency and intensity of cognitive distortions in clinical samples.

Frequency of arteriovenous fistula stenosis and access recirculation in patients undergoing maintenance hemodialysis.

Objective: To determine the frequency of Arteriovenous Fistula (AVF) Stenosis and Access Recirculation (AR) among Hemodialysis patients. Study Design: Cross-Sectional Study. Setting: Dialysis Unit, Nephrology Department, Fatima Jinnah Medical University, Sir Ganga Ram Hospital, Lahore. Period: July 2017, to December 2017. Material & Methods: Eighty-four patients on maintenance hemodialysis fulfilling selection criteria were enrolled in the study. All the patients underwent Doppler ultrasonography for AVF stenosis detection and Peak systolic velocity (PSV) of more than 500 ml/sec predicted 50% or greater stenosis of AVF. A two-needle urea-based method was used for the calculation of AR and the AR value of more than 10% was considered significant. Data were analyzed in Statistical Package for Social Science (SPSS) v23.0. Data were stratified according to age, sex, BMI, hypertension, smoking, and duration of dialysis. Post-stratification, Chi-square was used. P-value ≤0.05 was taken significantly. Results: Among ESRD patients, 60(71.4%) were males and 24(28.6%) were females. 65(77.4%) had hypertension and 21(25.0%) were smokers. Among these patients, 6(8.3%) had AV fistula stenosis, and 10(11.9%) had access re-circulation. Statistically, a significant correlation was only present between AVF stenosis and AR (p-value 0.003) Conclusion: The periodic measurement of AVF stenosis and AR have diagnostic implications in maintenance hemodialysis patients because these are important causes of inadequate dialysis.

Epidemiology of sleeping disorders among doctors during COVID-19 pandemic in Pakistan

Introduction: Novel coronavirus disease or COVID-19, an acute respiratory illness caused by a newly discovered SARS-CoV-2 virus emerged in December 2019. Objectives: The main objective of the study is to find the epidemiology of sleeping disorders among doctors during COVID-19 pandemic in Pakistan. Material and methods: This cross sectional study was conducted in Sir Ganga Ram Hospital Lahore during June 2021 to December 2021. A questionnaire was used to collect the data. Among the topics covered in the survey were questions regarding the quality of one's night's sleep, where one keeps infection control supplies, how one copes with stress and depression, how one learns about COVID-19 on the internet, how one views risk, and other personal information. The survey was completed over the internet. Results: The data was collected from 200 patients. Over half (55.0 percent) were married and under the age of 35. (49.1%). The majority of respondents (57.8%) spend more than two hours a day on social media. The great majority of them came from the upper echelons of the workforce. There were 38.3%, 29.8%, and 29.1%, respectively, of those who reported a worse sleep quality following the onset of COVID-19, according to their weighted proportions. Conclusion: It is concluded that COVID-19 is widely spreading in Pakistani doctors. Mental health disorders and poor sleep quality are more widespread in the medical field because of the heightened danger of exposure during pandemic illnesses. Keywords: Epidemiology, COVID-19 Disorder, Patients