Sir Ganga Ram Hospital Research Articles

KNOWLEDGE, ATTITUDE AND PRACTICES REGARDING SURGICAL SITE INFECTION PREVENTION AMONG STAFF NURSES IN SIR GANGARAM HOSPITAL, LAHORE

Surgical site infections (SSIs) are a significant contributor to healthcare-associated infections, leading to increased morbidity and prolonged hospital stays. Effective prevention strategies rely on healthcare professionals’ knowledge, attitudes, and practices (KAP), particularly among nurses directly involved in patient care. Objective: To assess the knowledge, attitudes, and practices regarding SSI prevention among staff nurses at Sir Ganga Ram Hospital, Lahore. Methods: A descriptive cross-sectional study was conducted among 120 nurses using a pre-validated structured questionnaire. Data were analyzed using SPSS version 26, with results presented as frequencies and percentages. Results: The majority of nurses (85%) had adequate knowledge about SSIs, with high awareness of blood sugar control (83.3%) and aseptic techniques (80.8%). Positive attitudes were prevalent, with 81.9% scoring well, and most participants agreeing on the importance of sterile materials (98.3%) and frequent dressing changes (92.5%). Adherence to good practices was noted in 87.7% of nurses, particularly in areas like skin preparation with alcohol and chlorhexidine (90%). However, gaps were identified in knowledge of specimen collection methods (64.2%) and in organizing training sessions for SSI prevention (25%). Conclusion: Nurses at Sir Ganga Ram Hospital demonstrated good KAP regarding SSI prevention, but gaps in specific practices highlight the need for targeted training and systemic improvements. Enhanced education and resource allocation can improve adherence to evidence-based guidelines, ultimately reducing the burden of SSIs in healthcare settings.

ULTRASONOGRAPHY VERSUS COMPUTED TOMOGRAPHY FOR DETECTION OF UROLITHIASIS

Urolithiasis, or urinary stone disease, is a common condition with potentially severe health implications if undetected or untreated. While computed tomography (CT) is the gold standard for detecting urolithiasis, ultrasonography (USG) is often preferred in clinical practice due to its accessibility, non-invasiveness, and lower cost. Evaluating the diagnostic accuracy of USG compared to CT can help guide its use in diagnosing urolithiasis. Objective: To determine the diagnostic accuracy of ultrasonography in detecting urolithiasis, using computed tomography as the gold standard. Methods: This cross-sectional study included 320 patients suspected of urolithiasis, aged 18-70, who were examined at the Department of Radiology in collaboration with the Department of Urology at Sir Ganga Ram Hospital, Lahore from January 2024 to July 2024. CT scans were conducted using the Toshiba Aquilion TSX-101A/4 slice CT Scanner, while ultrasound imaging was performed with the Toshiba Aplio 500, using a 3.5 MHz curved transducer. Data analysis focused on diagnostic accuracy, sensitivity, and specificity of USG compared to CT. Results: The mean age of the patients was 42.08±15.38 years, with a male predominance of 54.4% (174/320). The average body mass index (BMI) was 24.48±4.57 kg/m², and the mean stone size detected was 18.18±10.86 mm. Ultrasonography demonstrated a sensitivity of 95.8%, specificity of 100%, and overall diagnostic accuracy of 96.5% in detecting urolithiasis when compared to CT. Conclusion: Ultrasonography shows high sensitivity (95.8%) and excellent specificity (100%) in detecting urolithiasis, with an average detected stone size of 18.18±10.86 mm. These findings support the use of USG as a reliable, accessible diagnostic tool for urolithiasis, especially when CT is not readily available.

PREVALENCE OF MISSED NURSING CARE AMONG SENIOR NURSING STAFF

Missed nursing care (MNC) refers to the partial, delayed, or omitted delivery of essential patient care. It is a critical issue in healthcare systems worldwide, directly impacting patient safety, satisfaction, and outcomes. While extensively studied in developed nations, evidence from low- and middle-income countries, particularly Pakistan, remains limited. Objective: To evaluate the prevalence of MNC among senior nursing staff and identify contributing factors in a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study was conducted among 245 registered nurses working in the ICU, ER, and other departments of Sir Ganga Ram Hospital, Lahore. Data were collected using an adapted questionnaire assessing MNC frequency and analyzed using SPSS. Descriptive statistics were calculated, and the reliability and validity of the tool were confirmed through Cronbach’s Alpha and Kaiser-Meyer-Olkin (KMO) measures. Results: The study found a high prevalence of MNC, with discharge planning (Mean = 2.77, SD = 1.14), patient ambulation (Mean = 1.79, SD = 0.99), and mouth care (Mean = 2.26, SD = 1.23) identified as the most frequently missed tasks. Contributing factors included excessive workload, resource shortages, and insufficient staffing. Nurses with less experience were more likely to report missed tasks, highlighting the importance of clinical exposure and training in reducing care omissions. Conclusion: Missed nursing care poses a significant challenge to healthcare quality and patient safety in Pakistan. Addressing these issues requires systemic reforms, including improved staffing ratios, resource allocation, and professional development programs. These findings provide valuable insights for policymakers and healthcare administrators to implement effective interventions aimed at mitigating MNC and enhancing nursing care quality.

ASSESSMENT OF KNOWLEDGE REGARDING EVIDENCE BASED GUIDELINES ON VAP PREVENTION AMONG NURSES

Ventilator-associated pneumonia (VAP) is a serious healthcare-associated infection that increases morbidity, mortality, and healthcare costs, particularly in intensive care units (ICUs). In Pakistan, the high prevalence of VAP in ICUs underscores the importance of adherence to evidence-based preventive practices among nursing staff. However, knowledge gaps and inconsistencies in VAP preventive practices remain a challenge, largely due to limited training resources and high patient-to-nurse ratios. Objective: This study aimed to assess the knowledge of ICU nurses on evidence-based guidelines for VAP prevention at a tertiary care hospital in Lahore, Pakistan. Methods: A descriptive cross-sectional study design was utilized. Data were collected from 140 registered nurses working in the ICU of Sir Ganga Ram Hospital, Lahore, using a structured questionnaire consisting of 17 questions related to VAP prevention guidelines. Convenience sampling was employed to recruit participants who met the inclusion criteria. Data analysis was performed using SPSS, with descriptive statistics applied to summarize findings and identify knowledge gaps. Results: The study revealed varied levels of knowledge among ICU nurses regarding VAP prevention. While the majority demonstrated awareness of core practices, such as semi-recumbent positioning and regular oral care, there were notable gaps in understanding related to the frequency of ventilator circuit changes and the optimal use of suction systems. Approximately 67.9% of nurses were aware of general VAP guidelines, but only 47.1% correctly identified all recommended practices. Additionally, knowledge disparities were observed based on educational background and years of ICU experience.Conclusion: This study highlights critical knowledge gaps among ICU nurses regarding evidence-based VAP prevention practices. The findings underscore the need for targeted educational interventions and standardized training programs to improve adherence to VAP guidelines. Strengthening nurse education on VAP prevention can contribute to reduced infection rates, enhanced patient safety, and better utilization of healthcare resources in Pakistan’s ICUs.

PLACENTA ACCRETA: IS PRIMARY ELECTIVE CAESAREAN SECTION A PREDISPOSING RISK FACTOR?

Background:Placenta accrete spectrum is a fatal obstetrical condition associated with serious feto-maternal morbidity and mortality. It is associated with a variety of risk factors including primary elective caesarean section. To determine the association of placentaaccreta spectrum with primary elective caesarean section.Materials & Methods:This case-control study was conducted over two years (June 2022 to May 2024) at Sir Ganga Ram Hospital, Lahore, including 100 pregnant women with placenta previa. Demographic and obstetric details were noted in all patients and their caesarean section and postoperative management were done as per hospital policy. Intraoperatively type of placenta previa and type of placenta accreta spectrum was noted. Based on intraoperative findings 50 women with placenta previa, adherent placenta, and one or more previouscaesarean sections were enrolled in Group A (cases), while 50 women with placenta previa and previous caesarean sections were enrolled in Group B (controls). Maternal outcomes along with demographic and obstetric details were noted in preformed proforma and analyzed using SPSS. Results were considered statistically significant with a p-value less than 0.05.Results:The number of elective primary lower segment caesarean section (LSCS)werehigher in Group A (cases) 37(74%) than 27(54%) in Group B (controls) (P value= 0.037). Amongst women with placenta accreta spectrum in Group A (cases), the present study found placenta accreta in 64%, placenta increta in 22%, and placenta percreta in 14% of women. Conclusion:Elective primary caesarean section is associated with a higher risk of placenta accreta spectrum.

Comparison of Mean Postoperative Hemoglobin Concentrations in Patients Undergoing Total Knee Arthroplasty With Intravenous Versus Intraarticular Administration of Tranexamic Acid.

Total knee arthroplasty (TKA) may result in significant blood loss, but it is an effective and affordable treatment for severe osteoarthritis in the knees. While intravenous (IV) tranexamic acid(TXA) is a commonly used technique, intraarticular (IA) TXA has just recently started to gain traction in joint replacement procedures. The purpose of this research was to examine the mean postoperative hemoglobin concentration in order to assess the effectiveness of TXAadministered IVvs IAafter TKA. To assess the effectiveness of intraarticular TXA against intravenous administration. The six-month randomized controlled experiment was started from October 5, 2022, to April 4, 2023, at "the Orthopedics Department of Sir Ganga Ram Hospital in Lahore". The experiment included 60 patients undergoing TKA, ranging in age from 30 to 70. All members of the surgical team, including the supervisor (a consultant surgeon), assistants, and researchers, were present throughout the surgery. A high, thigh tourniquet was employed in every case, and a medial parapatellar technique was performed as well. Before the tourniquet was inflated, individuals in the intravenous group received 1 g of TXA intravenously 15-30 minutes beforehand. In the IA group, the "patient received an injection of 2 g of TXA in a 20 mL solution"straight into the joint after the prosthesis was implanted and secured. Data were analyzed using SPSS (version 26), with numerical data (age, BMI, surgical length, and hemoglobin levels) presented as mean ± SD and categorical factors (gender, American Society of Anesthesiologists (ASA) class, anatomical side) shown as frequency and percentage. The mean postoperative hemoglobin levels were compared between groups using an independent sample t-test, with data stratified by various factors and p ≤ 0.05 considered significant. There were 60 patients in this study, ranging in age from 30 to 70. The mean±SD age was 48.73±10.35 years. Patients' mean BMI was 25.51±4.48 kg/m², with representation across underweight, normal, overweight, and obese categories. The procedure took 173.10±32.61 minutes. The overall postoperative hemoglobin concentration was significantly higher in the IA TXA group (12.12±1.32 g/dL) compared to the IV TXA group (11.11±1.10 g/dL), with a p-value of 0.02. Additionally, when stratified by age, the IA TXA group consistently demonstrated higher postoperative hemoglobin levels across all age brackets, with significant differences observed in the 51-60 years (p = 0.001) and 61-70 years (p = 0.011) groups. Gender-based comparisons showed that IA TXA was associated with higher postoperative hemoglobin levels for both males (p < 0.05) and females (p < 0.05) compared to IV TXA. This study demonstrates that IAadministration of TXAis more effective in maintaining higher postoperative hemoglobin concentrations compared to IVTXA in patients undergoing TKA. The IA TXA group consistently achieved significantly higher hemoglobin levels across various age groups and both genders, indicating superior efficacy in reducing blood loss associated with TKA. These findings suggest that IA TXA could be a preferable alternative to IV TXA for enhancing postoperative hemoglobin recovery and potentially improving patient outcomes in knee arthroplasty procedures.

Investigating the Prevalence of Hypothyroidism in Obese &amp; Overweight Individuals in Sir Ganga Ram Hospital, Lahore

Investigating the Prevalence of Hypothyroidism in Obese &amp; Overweight Individuals in Sir Ganga Ram Hospital, Lahore

Investigating the Prevalence of Hypothyroidism in Obese &amp; Overweight Individuals in Sir Ganga Ram Hospital, Lahore

Investigating the Prevalence of Hypothyroidism in Obese &amp; Overweight Individuals in Sir Ganga Ram Hospital, Lahore

Refractive Errors in Thalassemia Patients

Purpose: The objective of this study was to evaluate the frequency of refractive error among thalassemia patients. METHOD: This cross sectional study was performed in duration of six months at Sir Ganga Ram hospital from July, 2023 to August, 2023. A total of hundred (n=100) thalassemia patients, were included in this study between the age range of 17 to 30 years. All subjects with thalassemia were previously diagnosed. Objective refraction was accomplished with Auto-Refractometer (Axis), and vision was examined with Snellen chart/Log Mar chart. SPSS version 26 was used to analyze the results. Chi-Square test was applied to find the significance of data. P-value &lt;0.05 was considered as significant. Results: The mean age of participants was 21.28±3.39 years. In the right eye of thalassemia patients, the result showed that 51% were emmetropic, 11% had hyperopia, 1% had hyperopic astigmatism, 20% had myopia, and 17% had myopic astigmatism. In the left eyes of patients, 52% were emmetropic, 10% had hyperopia, 2% had hyperopic astigmatism, 18% had myopic astigmatism, and 18% had myopia. P-value was 0.043. Conclusion: The cross sectional study results conclude that patient’s vision may not be significantly affected by thalassemia. Thalassemia patients were more effected with Myopia. While hyperopic astigmatism was least effected.

Robson Criteria to Determine the Risk of Cesarean Section in Females Presenting to Sir Ganga Ram Hospital (SGRH), Lahore

Rates of caesareans have increased, resulted in unfavourable outcomes in subsequent pregnancies. Robson categorization enhances standard of care by optimising the use of C-sections and evaluating methods to lower caesarean rates. Objective: To determine the frequency of caesarean section and to determine frequency of Robson 10 group classification system in patients who undergo caesarean. Methods: In this cross-sectional study, 140 pregnant selected via simple random sampling, were enlisted from Gyne department of SGRH, Lahore. According to Robson 10-group categorization those who underwent C-section were divided into ten groups and indication of C-section was studied. Data scrutiny was done using SPSS version 26.0. Mean and SD was used for quantitative variables and frequency for qualitative data. Data were stratified for effect modifiers, p-≤0.05 was taken as significant. Results: Mean age of patients calculated was 31.94 ± 2.14 years. Out of 140, 23.6% had C-section and 76.4% had vaginal delivery. According to class of modified Robson criteria, 12.1% had class 1, 12.1% had class, 2, 21.2% had class 3, 36.4% had class 5, and 3.0% each had class 4, 6, 7, 8, 9, and 10. Conclusions: According to our findings, considerable percentage of C-sections occur with previous C-sections serving as most common indicator. This pattern emphasizes how crucial it is to concentrate on primary preventive techniques in order to lower its rate. Large number of C-sections performed on nulliparous both those in spontaneous labour and those who were not indicates that labour management procedures and decision-making processes need to be closely examined.

Role of Trans Cerebellar Diameter for Gestational Age Estimation in Intrauterine Growth Restriction Fetuses

Background: Determining gestational age is crucial for quality maternal and fetal care. Ultrasonographic measurements of femur length (FL), crown-rump length (CRL), head circumference (HC), and biparietal diameter (BPD) are used for gestational dating. However, these don't correlate well in Intrauterine growth restriction (IUGR) cases. Studies report that trans cerebellar diameter could be used for gestational age estimation in IUGR cases. Objective: To find the correlation between trans cerebellar diameter and gestational age based on the last menstrual period (LMP) in intrauterine growth restriction fetuses. Methods: It was a cross-sectional study. The data was collected from the Department of Obstetrics and Gynecology, Sir Ganga Ram Hospital Lahore from 20 February 2022 to August 2022. After informed consent 60 women aged 18-40 years and parity &lt;5 with suspected Intrauterine growth restriction (IUGR) were included in the study. Gestational age was determined from the LMP while trans cerebellar diameter was by Ultrasonography. The correlation between gestational age and trans cerebellar diameter was determined and compared across subgroups of the study population based on age, parity, and BMI. Results: The mean age of the study participants was 25.6±6.3 years. The majority of the women were primiparous. The mean BMI was 27.8±3.4 Kg/m2. The mean gestational age was 33.35±2.25 weeks. Trans cerebellar diameter range was 36.3 mm to 49.6 mm. A significant correlation was found between gestation age and trans cerebellar diameter (r=0.979, p-value&lt;0.001) in subgroups based on age, parity, and BMI. Conclusion: A significant positive correlation was observed between Trans cerebellar diameter and gestational age among women with IUGR suggesting its routine use in estimating gestational age among high-risk obstetric care patients

#2003 Genetic association in patients with chronic kidney disease of unknown etiology: an observational study

Abstract Background and Aims Chronic kidney disease (CKD), impacting over 850 million people worldwide, is a diverse group of inherited and acquired nephropathies. While only about 10% of adult CKD is hereditary, predominantly due to mutations in genes like PKD1, PKD2, and PKHD1, the etiology often remains unidentified, leading to challenges in management, especially in transplantation and genetic counseling contexts. This study used whole exome sequencing to investigate CKD of unknown origin, aiming to improve diagnostic yields and establish genetic associations. Our objective was to find the diagnostic yield of Whole exome sequencing in patients with CKD of unknown etiology and to establish genetic association for same. Method The study was conducted in the Department of Nephrology and the Institute of Genetics and Genomics at Sir Ganga Ram Hospital, New Delhi. It was an observational cross-sectional analysis. All patients, both male and female of all age groups with Chronic Kidney Disease of unknown etiology who were willing to participate. All patients, both male and female of all age groups with Chronic Kidney Disease of known etiology were excluded as following: Results In the investigation of 56 chronic kidney disease samples with unknown etiology, genetic testing yielded 45 mutated gene variants in 37 subjects. The variants comprised 32 missense mutations, 8 deletions, 3 nonsense mutations, and 1 splice site mutation. Variant zygosity was as follows: 34 heterozygous, 6 homozygous, and 2 hemizygous. Pathogenic variants were detected in 9 patients (20%), likely pathogenic in 6 (13.33%), and variants of uncertain significance in 29 (64.44%). Eighteen subjects (32.14%) demonstrated no genetic mutations. A genetic diagnosis was established in 15 patients, representing a diagnostic yield of 26.78%. Stratified by disorder, the yield was 40% for glomerular, 100% for tubular, 50% for renal calculi, and 18.42% for undetermined CKD. Genetic testing facilitated a novel diagnosis or an alteration of the existing diagnosis in 6 patients (10.71%). Conclusion The results affirm the efficacy of genetic testing in elucidating the etiologies of chronic kidney disease where traditional diagnostic methods do not yield definitive causation. Genetic alterations were identified in a significant proportion of the patient population, indicating the presence of underlying genetic contributors to the disease. The identification of pathogenic and likely pathogenic variants highlights the potential of genetic testing to impact clinical decision-making and patient care.

Seroprevalence and Hematological Investigation of Toxoplasmosis in Women of Lahore, Pakistan

Background. Toxoplasma gondii is responsible for toxoplasmosis infection. Human beings and most warm-blooded animals are infected by this parasite, though the primary host of this parasite is the felid family. The current study was designed to assess the seroprevalence of toxoplasmosis and to investigate the hematological changes in the female human population of Lahore, Pakistan. Methodology. For this research, 150 blood samples were collected from women being treated at Sir Ganga Ram Hospital Lahore, along with other details. Of these, 90 samples were selected for the analysis of hematological changes by using a hematology analyzer. The serum of these samples was analyzed to estimate the seroprevalence of toxoplasmosis by using the ELISA technique. All the information was collected with the help of a questionnaire and analyzed to find out the risk factors. Results. The overall prevalence of toxoplasmosis in the female human population in Lahore was found to be 27%. The prevalence rate was 31% and 24% among pregnant and non-pregnant women, respectively. Similarly, women who underwent abortion had a high prevalence rate (66.6%) as compared to normal pregnant women (25.6%). In pregnant women, infection was more prevalent in the third trimester of pregnancy (43.7%), as compared to the first (28.5%) and second (20%) trimesters. The prevalence rate was higher in those women who had contact with cats or any other pet animal. The hematological parameters of the samples were also examined. In seropositive women, the levels of Hb and PCV declined, while the counts of lymphocytes and neutrophils considerably increased. Abnormal concentration levels of ALT and AST enzymes were also observed in seropositive women. Conclusion. This study revealed a higher prevalence of toxoplasmosis in pregnant women. Therefore, clinical screening should be encouraged for this infection

Neurological Presentation of Lead Toxicity: A Case Report

Acute encephalopathy, caused by infectious agents, metabolic or mitochondrial dysfunction, brain tumor, or prolonged exposure to toxic elements, is a significant cause of morbidity and mortality in young children. Lead encephalopathy that occurs due to prolonged lead ingestion or exposure in children is not uncommon, and many such cases have been reported in the past. This report shares the authors’ experience of the missed diagnosis of lead encephalopathy, its red flags, and its relation to pica as a root cause. A 14-month-old boy, resident of Delhi, India, was admitted with vomiting, irritability, and two episodes of abnormal limb movements, with the first symptom starting when he was 11 months old. His case was initially treated as acute disseminated encephalomyelitis, but he showed no improvement. The child was then referred to the Sir Ganga Ram Hospital, New Delhi, India. The boy presented with severe anemia, along with basophilic stippling on the peripheral smear during routine investigations. Suspecting lead poisoning, blood lead levels were checked, and were found to be grossly elevated. The child was then started on chelation therapy. Multiple doses of chelation (dimercaprol and D-penicillamine) were given, and sequential blood lead levels were monitored, which showed a marked decrement. The child was discharged, and is being monitored routinely. Lead poisoning remains a neglected public health issue, especially in children, and delay in identification can cause significant morbidity and mortality. Pediatricians and general practitioners must be aware of this risk, especially in children with iron deficiency anemia exhibiting pica.

Association of serum Sodium with mortality in patients of Congestive heart failure

Objectives: To determine the association of serum Sodium with mortality in patients of Congestive heart failure. Study Design: Prospective observational study Settings and Duration of study: Department of Medicine, Sir Ganga Ram Hospital, Lahore. ( 22-12-2021 to 22-6-2022 ). Methods: Sample size of 100 patients; 50 in each group in calculated with 90% power of study, 5% significance level and taking percentage of mortality i.e. 24.75% patients with low serum sodium level and in 4.21% patients with normal serum sodium level. Sample Selection: Inclusion Criteria: Patients aged between 30-70 years, both genders, Patients with congestive heart failure ,Group I: with serum sodium level &lt;135 mEq/L, Group II: with serum sodium level ≥135 mEq/L. Exclusion Criteria: Liver disorders (AST&gt;25IU, ALT&gt;30IU, hepatitis B or C), renal disorders (eGFR ˂ 30 mL/min/1.73 m2 or creatinine &gt;2.0mg/dl or on hemodialysis), any malignancy, anemia (Hb&lt;9 g/dl), due to inherited hemoglobinopathy such as; sickle cell disease, and thalassemia, Patients with recurrent congestive heart failure or already taking treatment for deranged sodium level , valvular heart disease. Results: Patients in exposed group had 52% mortality rate as compared to unexposed group in which mortality rate was only 18% respective. Value of relative risk showed that patients in exposed group had 2.88 times higher chances of mortality as compared to those patients in unexposed group. Similarly, elderly patients (Relative Risk=3.23), Male patients (Relative Risk= 3.37), Overweight patients (Relative Risk=3.54), non-diabetic patients (Relative Risk=3.50), hypertensive patients (Relative Risk=2.95), ischemic heart disease patients (Relative Risk=4.12), Smoker (Relative risk=4.41) and duration of congestive HF as 0.5-3.5 (Relative Risk= 3.03) had higher risk for mortality. Conclusion: Results obtained from this study showed that low serum sodium level had significant impact on patients of congestive HF in terms of mortality. Keeping its prognostic importance, congestive HF patients should be strictly monitored for electrolyte imbalance. Key Words: Serum sodium, Prognostic, Indicator, Mortality,Congestive Heart Failure.

Prevalence of Interstitial Lung Disease in Patients with Chronic Cough Taking Chest X-rays and CT Chest as Diagnostic Tools

Introduction: With well over 200 types of pulmonary disorders, ILD is a growing global health burden with chronic cough being the most frequent symptom. As it hampers the basic respiratory mechanism, it eventually deteriorates the overall quality of life. The diagnosis of ILD is quite challenging and the accuracy rates with conventional tests are quite low.&#x0D; Material and methods: A cross-sectional study on 200 patients was performed in Sir Ganga Ram Hospital, Lahore, Pakistan. The study took place from the period of 15th April to 15th July 2023. Chest X-ray (CXR) and Computed Tomography (CT) Chest were used as diagnostic tools.&#x0D; Results: The chest x-ray detected ILD in 114 (57%) while the chest CT identified in 178 (89%) of the patients. CXR and CT had a sensitivity of 65.05 and 95.65 and a specificity of 45.1 and 85.2 respectively. CXR and CT detected reticular opacity, nodular opacity, and ground glass opacity in 66% vs 81%, 41% vs 78%, and 33% vs 55% of the ILD patients. Dyspnoea (85%), fever (30%), arthralgia (24%), and weight loss (9%) were found as clinical indications.&#x0D; Conclusion: CXR can be used to perform initial preliminary tests to filter out the presence of other diseases in patients with ILD. However, it cannot be solely relied on as a diagnostic tool. CT Chest can be the choice of imaging modality in diagnosing ILD as it outperformed CXR in many aspects of our study, with better precision, accuracy, sensitivity, and specificity.

Frequency of Diabetes Mellitus in Thalassemia Major Patients in Thalassemia Center, Sir Ganga Ram Hospital, Lahore

Background: Diabetes mellitus (DM) represents a significant complication in individuals with thalassemia major (TM),(1) yet the underlying mechanisms and risk factors are not yet completely understood. Aim of this study is to investigate the frequency and associated factors of Diabetes Mellitus in Thalassemia Major patients and describing relationship between genetic predisposition, iron overload and metabolic dysfunction. Objectives: Determining the frequency of Diabetes Mellitus among Thalassemia Major patients presenting at the Thalassemia Center, Sir Ganga Ram Hospital, Lahore. Additionally, the study aims to describe demographic factor, clinical parameters and family history profiles associated with the presence of DM. Methods: A cross-sectional study was carried out from July 2023 to October 2023, involving data collection from medical records of Thalassemia Major patients over a three-month period. Demographic characteristics, including age and gender; clinical parameters such as the number of blood transfusions; and family history profiles of thalassemia and Diabetes Mellitus wereanalyzed. Statistical analysis, including chi-square tests, was used to assess associations and significance levels. Results: The study included 129 Thalassemia Major patients, with a majority falling within the 5-11 years age group (70%) and a slight predominance of males (56%). There wer no significant associations upon analysis between age, gender, or the number of blood transfusions and DM. There was a significant correlation between positive family history of thalassemia (p = 0.0047) and Diabetes Mellitus (p = 0.0026) with the presence of Diabetes Mellitus among Thalassemia Major patients. Conclusion: Despite the lack of significant associations with demographic and clinical parameters, the findings emphasize the need for targeted screening and intervention strategies for high-risk individuals. (2)

Frequency of Hypoglycemia in Neonates with Hypoxic-Ischemic Encephalopathy in the Neonatal Intensive Care Unit of Sir Ganga Ram Hospital, Lahore

Background: Hypoxic-ischemic encephalopathy (HIE) often necessitates admission to neonatal intensive care units (NICUs) for specialized care.– Among the various complications associated with HIE, hypoglycemia is a notable concern due to its potential to exacerbate neurological injury and compromise neurodevelopmental outcomes. However, the frequency of hypoglycemia in neonates with HIE, particularly in resource-limited settings like Pakistan, remains poorly characterized. Objectives: Aim of this study is to determine the frequency of hypoglycemia in neonates with HIE admitted to the NICU of Sir Ganga Ram Hospital, Lahore, Pakistan. By systematically reviewing medical records, this study is aimed to describe the prevalence of hypoglycemia in this population.Methods: Medical records of neonates diagnosed with HIE and admitted to the NICU were reviewed from July 2023 to October 2023. Data on demographic characteristics, perinatal history, clinical presentation, laboratory investigations including blood glucose levels, and neurodevelopmental outcomes were extracted. The frequency of hypoglycemia was determined as the proportion of neonates with documented hypoglycemia among all neonates diagnosed with HIE during the study period. Results: Among the cohort of neonates diagnosed with HIE (n = 120), 20.8% were found to experience hypoglycemic episodes during their hospital stay. Subgroup analyses revealed associations between hypoglycemia and variables such as gestational age, birth weight, and severity of HIE. Descriptive statistics were used to summarize the demographic characteristics of this population, providing context for understanding the prevalence and implications of hypoglycemia in neonates with HIE. Conclusion: This study highlights the prevalence of hypoglycemia as a common metabolic disturbance in neonates with HIE, underscoring the need for vigilant monitoring and prompt intervention in this vulnerable population. Standardized protocols for managing hypoglycemia in neonates with HIE are imperative to optimize clinical outcomes.

Breast Cancer And Self Breast Examination Awareness Amongst Pakistani Female Medical Students and Hospital Employees: Assessing Shortcomings in Health Literacy

Objective: To assess the knowledge, attitudes, and practices related to breast cancer and breast cancer screening among female medical students, healthcare workers, and hospital employees. Methodology: This cross-sectional study was conducted from September 1, 2021, to October 30, 2021. A questionnaire on breast cancer awareness and self-breast examination was distributed to female medical students across all five years at Fatimah Jinnah Medical University, Lahore, and to female hospital employees at Sir Ganga Ram Hospital, Lahore. A total of 404 women participated and were included in the study. Results: Out of the respondents, 71.2% were medical students, and 26.7% were doctors. Approximately 24% reported a family history of breast cancer. Media was identified as the primary source of information on breast cancer by 79.2% of women. Only 64.9% of respondents practiced self-breast examination, with merely 23.8% performing it monthly. Furthermore, only 37.1% correctly identified all the essential steps for conducting a breast self-examination. Conclusion: While the knowledge of breast cancer is satisfactory among healthcare workers and hospital employees, there is room for improvement in attitudes and practices related to early detection and screening. Initiatives should be undertaken by medical undergraduate curriculum coordinators to incorporate breast self-examination, clinical breast examination, and screening guidelines in both pre-clinical and clinical years of medical education. Additionally, information dissemination programs should be implemented in hospitals for all employees.

The Gyan Burman Fellowship in gastrointestinal surgery at Sir Ganga Ram Hospital: A global perspective based on feedback from former fellows

ABSTRACT Background: The 3-month Gyan Burman Fellowship (GBF) in Surgical Gastroenterology and Liver Transplantation at Sir Ganga Ram Hospital in New Delhi has been offered to aspiring surgeons worldwide since 2003. Using a questionnaire, we evaluated whether the experience had been useful to its past candidates. Aims: Our aim was to evaluate how useful the experience had been to its past candidates. Materials and Methods: We sent a standard questionnaire online to 100 of the 138 fellows whom we were able to contact and who had graduated up to 31st December 2022. The data were collected on pre-designed data sheets, entered in a computer and analysed. Results: We received 69 responses. Sixty-one (88.4%) were male, and 8 (11.6%) were female. They came from 15 different developing countries. The GBF was the primary choice for training for 59 (85.5%), and 40 (58%) came because they did not have any equivalent training available locally. They said that overall the 3-month fellowship had had a positive impact on both the careers of the trainees and their respective regions’ healthcare. The experience was reported to have been excellent by 40 (60%). Conclusion: The 3-month GBF has been useful to most of its candidates and has provided them with knowledge on the quality of their surgical care in their local healthcare centres.