Teaching Hospital Peshawar Research Articles

ASSOCIATION OF LOW BMI AND ANOVULATION WITH PRIMARY INFERTILITY IN WOMEN OF REPRODUCTIVE AGE

Infertility, defined as the inability to conceive after one year of regular unprotected intercourse, affects millions of couples worldwide, with prevalence rates varying across developed and developing nations. The main objective of the study is to find the association between low BMI and anovulation with primary infertility in women of reproductive age. This cross-sectional study was conducted in Khyber Teaching Hospital Peshawar from January 2023 to December 2023. A total of 340 female participants were added using convenient sampling methods. Data collection consisted of comprehensive clinical evaluations, including anthropometric measurements to assess BMI, hormonal assays to determine ovulatory status and detailed reproductive histories. BMI was calculated as weight in kilograms divided by height in meters squared (kg/m^2), with participants categorized into low BMI (BMI < 18.5 kg/m^2) and normal BMI (BMI ≥ 18.5 kg/m^2) groups. Data were collected from 340 female participants. The mean age was 28.5± 4.2 years for those with low BMI and 30.1± 3.8 years for those with normal BMI. Among underweight individuals, 50 were classified as infertile and 20 as fertile, totaling 70 participants. Of normal-weight individuals, 40 were infertile, and 120 were fertile, totaling 160 participants. In the overweight group, 30 were barren, and 50 were fertile, totaling 80 participants. Low BMI showed a significantly increased adjusted odds ratio (AOR) of 3.00 (95% CI: 1.80 - 5.00, p < 0.001) for infertility. Age, socioeconomic status, smoking, and alcohol consumption did not show significant associations with infertility. It is concluded that low BMI is significantly associated with an increased risk of anovulation and primary infertility in women of reproductive age, even after accounting for potential confounders.

Use and Outcomes of Amplatz Renal Dilator for Treatment of Urethral Strictures

Background: Urethral strictures pose a significant challenge in urological practice, with traditional treatments often associated with considerable morbidity. The quest for less invasive yet effective interventions has led to innovative approaches, among which the Amplatz Renal Dilator has emerged as a promising tool. Objective: This study aimed to evaluate the efficacy and safety of the Amplatz Renal Dilator in the treatment of urethral strictures, focusing on urinary flow rates, stricture severity, patient symptom relief, and the incidence of complications. Methods: A prospective, observational cohort study was conducted at multiple centers including Gajju Khan Medical College Swabi Naseer Teaching Hospital Peshawar in the duration from January, 2023 to June, 2023. Total Thirty-five participants diagnosed with urethral strictures were enrolled and treated with the Amplatz Renal Dilator. The study spanned two years, with an initial six-month recruitment phase followed by an eighteen-month follow-up. Efficacy was assessed through improvements in urinary flow rates and stricture severity, while safety was evaluated by monitoring procedural complications and recurrences. Quality of life and patient satisfaction were also measured using validated questionnaires. Results: Post-treatment, urinary flow rates significantly improved from a mean of 10 mL/s (SD ± 2) to 15 mL/s (SD ± 3) (p<0.001). Stricture severity decreased from Grade 3 (SD ± 1) to Grade 1 (SD ± 1) (p<0.001). International Prostate Symptom Score (IPSS) from 22 (SD ± 4) to 10 (SD ± 3) (p<0.001). The incidence of immediate complications was 5%, with no significant long-term complications reported. The recurrence rate of strictures was observed at 10%. Conclusion: The Amplatz Renal Dilator demonstrates significant efficacy in improving urinary flow rates and reducing stricture severity, with minimal complications and a low recurrence rate. These findings suggest that the Amplatz Renal Dilator is a safe and effective option for the treatment of urethral strictures, warranting further investigation in larger, randomized controlled trials.

COMPARISON OF LAPAROSCOPIC AND OPEN APPENDECTOMY IN TERMS OF SURGICAL SITE INFECTION

Appendectomy is a common surgical procedure, and the choice between laparoscopic and open approaches has clinical significance. Surgical site infection (SSI) is a critical postoperative complication. This study aimed to compare laparoscopic and open appendectomy in terms of SSI rates. A prospective observational study was conducted at multiple centers including Department of General Surgery, MRHSM Hospital Pabbi Nowshera, Jinnah Teaching Hospital Peshawar and Cat C Hospital Tangi Charsadda, DHQ Hospital Daggar Buner, Khyber Pakhtunkhwa Pakistan in the duration from July, 2023 to December, 2023. The research is involving 320 patients aged 14 to 64 years. Data included demographic information, surgical approach, operative time, hospital stay, and SSI severity using the Southampton grading system. Statistical analysis was performed using SPSS. Laparoscopic (Group A, n=110) and open (Group B, n=210) appendectomies were compared. Group A had a shorter hospital stay (p < 0.05) and similar operative times. SSI rates favored laparoscopic surgery (p < 0.05), with fewer patients developing infections within 10 days post-surgery. Laparoscopic appendectomy demonstrated reduced SSI risk and improved postoperative outcomes. Laparoscopic appendectomy is associated with lower SSI rates, shorter hospital stays, and comparable operative times compared to open appendectomy. These findings support the preference for laparoscopic surgery, especially in low-risk patients, to enhance postoperative outcomes.

P16 Expression in Grading of Urothelial Carcinoma

Background: Sleep is one of the most important determinants of human health. The quality of sleep has significant effects on academic performance and is influenced by multiple factors.Objectives: To determine the association between sleep patterns / Quality and academic performance of dental undergraduates during their summative clinical examination by using an objective measure.Material and Methods: This descriptive cross-sectional study was conducted at the Department of Medicine, Khyber Teaching Hospital Peshawar, from February 1, 2023, to June 30, 2023. A sample size of 82 was calculated by the Open Epi calculator. A validated questionnaire of the Pittsburgh Sleep Quality Index (PSQI) was used in this study. The study participants were selected by convenience based consecutive sampling technique and were 3rd BDS Students appearing in annual General Medicine Examination. After data collection, these variables were analyzed by SPSS version 26 software.Results: This study comprised 43(52.4%) female and 39(47.6%) male participants, and amongst them, 34.1% of females and 20.7% of males rendered their sleep quality bad, whereas 18.3% of females and 26.8% of males responded otherwise. The findings were positively associated with bad sleep quality (47.6%). Measures of sleep quality were significantly deranged among poor sleepers compared to normal sleepers. On average, the academic performance of poor-quality sleepers was good compared to good-quality sleepers. Still, this finding is not statistically significant, as evidenced by the t-test (Mean 574 ± SD 62.156 vs. 581 ± 79.769) and p-value of 0.640.Conclusion: Poor sleep quality was common among our students. The academic performance of these students was not statistically significant in comparison to that of good quality sleepers. Keywords: Academic performance, Dental undergraduates, PSQI, Sleep quality

Sleep Pattern in Undergraduate Dental Students Undergoing Clinical Summative Assessment in a Public Sector Dental Institute of Peshawar

Background: Sleep is one of the most important determinants of human health. The quality of sleep has significant effects on academic performance and is influenced by multiple factors.Objectives: To determine the association between sleep patterns / Quality and academic performance of dental undergraduates during their summative clinical examination by using an objective measure.Material and Methods: This descriptive cross-sectional study was conducted at the Department of Medicine, Khyber Teaching Hospital Peshawar, from February 1, 2023, to June 30, 2023. A sample size of 82 was calculated by the Open Epi calculator. A validated questionnaire of the Pittsburgh Sleep Quality Index (PSQI) was used in this study. The study participants were selected by convenience based consecutive sampling technique and were 3rd BDS Students appearing in annual General Medicine Examination. After data collection, these variables were analyzed by SPSS version 26 software.Results: This study comprised 43(52.4%) female and 39(47.6%) male participants, and amongst them, 34.1% of females and 20.7% of males rendered their sleep quality bad, whereas 18.3% of females and 26.8% of males responded otherwise. The findings were positively associated with bad sleep quality (47.6%). Measures of sleep quality were significantly deranged among poor sleepers compared to normal sleepers. On average, the academic performance of poor-quality sleepers was good compared to good-quality sleepers. Still, this finding is not statistically significant, as evidenced by the t-test (Mean 574 ± SD 62.156 vs. 581 ± 79.769) and p-value of 0.640.Conclusion: Poor sleep quality was common among our students. The academic performance of these students was not statistically significant in comparison to that of good quality sleepers. Keywords: Academic performance, Dental undergraduates, PSQI, Sleep quality

Exploring Mother’s Perspectives about Routine Immunization in District Peshawar: A Cross Sectional Survey.

Objective: of this study was to investigate mothers' opinions and knowledge regarding regular immunization of their chil-dren.Methodology: Between July 2019 to January 2020, this descriptive cross-sectional study was conducted at pediatrics outpatient department, Khyber teaching Hospital Peshawar. Women aged between 19-44 years, having at least one child less than 5 years of age were asked to complete standardized questionnaire. After stratification of the collected data, regression analysis performed.Results: Mean age of participants was 27.72 ±4.07 years, 41.98% received elementary education, while 61.32% were housewives. We observed enough knowledge in 162(88.04%) patients aged 19-29 years as compared to 55 (93.22%) aged 30-44 years (p=0.002). Additionally, knowledge was noticeably greater in situations involving several children.Conclusion: Women having secondary school or higher education and several children has sufficient knowledge of im-munization.
 Key words: KAP, Immunization, Mothers, Infectious Diseases, Vaccination

A STUDY ON TRANEXAMIC ACID ROLE FOR SEROMA REDUCTION IN VENTRAL HERNIA REPAIR

This study aimed to investigate whether tranexamic acid is effective in reducing seroma formation after ventral hernia repair. The study was conducted at multiple centers, including the Department of Surgery at Khyber Teaching Hospital Peshawar and Hayatabad Medical Complex, Peshawar, from January 2023 to June 2023. The study included 70 patients of either gender, aged 18 to 50 years, undergoing ventral hernia repair. After the administration of tranexamic acid, the formation of postoperative seroma was studied. The study found that 35.7% of the patients were male, while 64.3% were female. In 53 (75.71%) patients, seroma formation subsided within six days, while in 17 (24.28%) patients, it took more than six days for seroma formation to subside (P = 0.0001).In conclusion, the study showed that tranexamic acid significantly reduced postoperative seroma formation in patients after ventral hernia repair.

FREQUENCY OF RISK FACTORS ASSOCIATED WITH DIABETIC KETOACIDOSIS IN PATIENTS PRESENTING AT KHYBER TEACHING HOSPITAL PESHAWAR

Objectives: To determine the frequency of risk factors associated with diabetic ketoacidosis in patients presenting at Khyber Teaching Hospital Peshawar. Materials and methods: Patients of either gender, aged between 18 and 60 years, with either type I or type II diabetes mellitus presenting with diabetic ketoacidosis with the duration of diabetes > 1 year were included in the study. DKA was diagnosed based on the clinical presentation of respective patients, serum Random Blood Sugar (RBS), and urinary ketones. Careful scrutinization was done for the detection of common risk factors for DKA like infections, stroke, myocardial infarction, and pancreatitis. Based on the clinical examination for Stroke and acute pancreatitis, CT imaging of the brain and CT of the abdomen with pancreatic protocol were performed. Results: Among 111 DKA patients, the mean age was 43 years with standard deviation ± 12.05. 63(57%) patients were male while 48(43%) were female. Infection was found in 54(49%) patients, stroke in 4(4%) myocardial infarctions in 3(3%), and pancreatitis was found in 7(6%) patients. Conclusion: The most common risk factor for diabetic ketoacidosis is infections in half of the participants while stroke was 4%, myocardial infarction was 3% and pancreatitis was 6%. KEYWORDS: diabetic ketoacidosis; type I diabetes; type II diabetes

THE EFFECTIVENESS OF CEFTRIAXONE AND MEROPENEM IN THE TREATMENT OF ENTERIC FEVER IN CHILDREN- EXPERIENCE IN A TERTIARY CARE HOSPITAL IN PAKISTAN

Objectives: To determine the effectiveness of ceftriaxone and Meropenem in the treatment of Enteric Fever in the Pediatric Department of Khyber Teaching Hospital Peshawar. MATERIALS AND METHODS: This cross-sectional descriptive study was conducted at the Department of Child Health Khyber Teaching Hospital Peshawar Pakistan from June 2020 to June 2022. The sample size included 392 patients. Keeping in view 392 blood samples were taken and sent for blood culture. Both positive and negative cultures were incorporated in the study. The patients were started empirically on ceftriaxone and then in case of no response, the patients were shifted to Meropenem based on the sensitivity of the culture report. The response was defined as when the patient is afebrile for 72 hours after the treatment and the absence of complications like peritonitis, intestinal hemorrhage, and obtundation. Data was analyzed using SPSS version 21.0. RESULTS: In our study, out of 392 patients, 64% were males while 36% were females. Among blood cultures sent, 16.8% were positive and 83.2% were negative. Among the culture positive, 10.5% of patients were sensitive to Meropenem, 3.6% were sensitive to ceftriaxone and 2.8% were sensitive to other drugs. 60.7% of patients responded to Meropenem. Ceftriaxone-responsive patients were 11.7%, while 27.6% showed a response to other drugs. CONCLUSION: The efficacy of Meropenem was significantly high (in 2/3rd patients) while Ceftriaxone showed 11.73% efficacy. KEYWORDS: Enteric fever, ceftriaxone, Meropenem

POSTPARTUM DEPRESSION AND ANXIETY: A COMMUNITY-BASED STUDY ON RISK FACTORS BEFORE, DURING AND AFTER PREGNANCY

Postpartum anxiety and depression are a significant public health concern as it is the leading cause of maternal morbidity. It is associated with adverse effects on the cognitive and social development of the infant. The primary aim of the study is to find postpartum depression and anxiety as a community-based study on risk factors before, during, and after pregnancy. The prospective cohort study was conducted in Khyber Teaching Hospital Peshawar from April 2023 to July 2023. A total of 320 pregnant women were recruited for this study. Participants were enrolled during their antenatal visits to healthcare facilities within the community, ensuring representation across diverse demographic and socio-economic backgrounds. Data collection for this community-based study on postpartum depression and anxiety was executed meticulously across three distinct phases: before, during, and after pregnancy. Data was collected from 320 pregnant females. The mean age of participants was 28.5±4.2 years. Most participants had at least a high school education (65%) and reported a moderate household income (55%). 18% of participants had a history of previous episodes of depression or anxiety. 35% reported experiencing significant life stressors before pregnancy, with financial concerns being the most common (62%). 24% had a family history of mental health disorders. It is concluded that this study has revealed a significant prevalence of postpartum depression (22%) and anxiety (18%) among participants. The identified risk factors, including prior mental health history and high prenatal stress, emphasize the need for early intervention and targeted support systems during the perinatal period.

Frequency of Gestational Diabetes among Women presenting with Premature Rupture of Membranes

OBJECTIVE: To evaluate the frequency of gestational diabetes among women who experience premature rupture of membranes METHODOLOGY: This descriptive cross-sectional study was conducted at the Department of Obstetrics & Gynecology, Mohammad Teaching Hospital Peshawar, from October 2021 to February 2022. One hundred fifty-five patients were selected from the Obstetrics and Gynaecology outpatient department. Women presenting with premature membrane rupture, within the reproductive age of 15-45 years, and with a gestational period beyond 37 weeks were included. Women with a history of failed inductions and those with twin pregnancies confirmed by ultrasound were excluded. A consecutive sampling of 155 females with premature rupture of membranes and screening them for gestational diabetes mellitus. The SPSS (version 22.0) was used for statistical analysis. Categorical variables, including gestational diabetes, parity, and gravidity, were summarized using frequencies and percentages. We conducted post-stratification analysis using the chi-square test, with a significance level set at p < 0.05. RESULTS: The average age of the patients was 27.2±5.7 years, with the majority (49.7%) falling within the age range of up to 25 years. The mean parity was 2.49±1.84. Overall, we diagnosed gestational diabetes mellitus in 24.5% of the patients. CONCLUSION: The presence of gestational diabetes mellitus in cases of premature rupture of membranes is familiar in our population. We recommend conducting further studies to identify risk factors and develop preventive strategies before formulating recommendations for its prevention. KEYWORDS: Diabetes Mellitus, Frequency, Gestational age, Premature birth, Premature Rupture of Membranes, Women

FREQUENCY OF CARDIAC AUTONOMIC NEUROPATHY IN TYPE 2 DIABETES MELLITUS PATIENTS PRESENTING TO KHYBER TEACHING HOSPITAL PESHAWAR

This study aimed to determine the frequency of cardiac autonomic neuropathy in patients with type 2 diabetes. A cross-sectional study was conducted at the Department of Medicine, Khyber Teaching Hospital Peshawar, Pakistan, from June 2022 to June 2023. The study included 285 individuals aged 40-60 diagnosed with type 2 diabetes for at least 5 to 10 years. The study aimed to evaluate the frequency of cardiac autonomic neuropathy in type 2 diabetics. Chi-square was applied for statistical analysis with a significance level of p≤0.05. Of 285 type 2 diabetic patients, 199 (69.82%) were male, and 86 (30.18%) were female. 26.31% of the participants were diagnosed with cardiac autonomic neuropathy, of which 26.67% were male and 73.33% were female. This difference was statistically significant. 37.35% of the patients with cardiac autonomic neuropathy were smokers, while 62.65% were non-smokers. All the patients with CAN were either overweight or obese. This study found that prolonged diabetes is directly related to the development of cardiac autonomic neuropathy, and there was a statistically significant association between diabetes and gender, as well as smoking.

FREQUENCY OF CHRONIC KIDNEY DISEASE ASSOCIATED PRURITUS AND ITS ASSOCIATION WITH SLEEP QUALITY IN HEMODIALYSIS PATIENTS

A cross-sectional study was conducted at the Department of Medicine, Khyber Teaching Hospital Peshawar, between November 2022 and April 2023. The study aimed to evaluate the frequency of pruritus associated with chronic kidney disease (CKD) and its correlation with sleep quality in hemodialysis patients. The study cohort comprised 55 individuals diagnosed with CKD, aged between 18 and 70, and of both genders. Chi-square and Independent Samples T-tests were used for statistical analysis, and a significance level of P < 0.05 was considered statistically significant. The study found that 39 (70.9%) patients reported chronic kidney disease-associated pruritus. Among the pruritus patients, 7.7% reported no effect on their sleep, 43.6% reported occasional sleep, and 48.7% reported severe effects on sleep. The study showed a significant association between increasing age and pruritus (P = 0.0001) but no significant association between pruritus and gender (P = 0.23). The mean age of the patients was 40.8±14.12 years. The study concluded that the prevalence of pruritus in hemodialysis patients with chronic kidney disease was very high. Also, pruritus in individuals with chronic renal disease significantly correlated with sleep quality and advancing age among hemodialysis patients.

ACADEMIC WORKSHOP AND IT’S IMPACT ON LEARNING

Objectives: Academic workshops have drawn much interest as a potential instrument to improve medical education and fi ll the knowledge gap between theory and practice. This study investigates how academic workshops aff ect the learning of medical graduates. Materials and Methods: This institutional-based cross-sectional study was conducted in the Department of Medicine, Khyber Medical College/Khyber Teaching Hospital Peshawar. A workshop on "Artifi cial Intelligence (AI)" was organized on May 17, 2023. A total of 25 workshop participants took part in this study. Ethical approval from the institute was granted for this study. The study duration was two months. Participants in our study comprised willing undergraduate medical students of Khyber Medical College (KMC), House offi cers (HO’s) of Khyber Teaching Hospital (KTH) Peshawar, and Postgraduate (PG) trainees of KTH Peshawar. These participants have already enrolled themselves in this Artifi cial Intelligence workshop, organized as part of a prequel for the upcoming annual conference of the Pakistan Society of Physicians (PSP). Pre-test and post-test during this one-day workshop, and then an online evaluation after one month was conducted to determine the impact of this academic event; ANOVA and t-test were utilized for this purpose. All the pertinent data were recorded on R-Data analysis and were then analyzed accordingly. Results: Out of 25 participants, there were 18 males and seven females. The baseline knowledge of medical undergraduates regarding artifi cial intelligence was better compared to that of HOs and PGs. This trend remained persistent in post-test evaluation. However, evaluation after one month showed a good learning impact on medical undergraduates and HO's. PG's documented a decline in their learning impact as evidenced by t-test, ANOVA, and posthoc analysis. Conclusion: Academic workshops narrow the knowledge gap between practice and theory by integrating active learning methodologies, adhering to learning theories, and encouraging skill development. Motivation and practice are the key factors in this learning process.

OUTCOMES OF URETHRAL DILATION WITH AMPLATZ DILATORS IN THE MANAGEMENT OF URETHRAL STRICTURES

This study aimed to determine the outcomes of urethral dilation with amplatz dilators in managing urethral strictures. We conducted this descriptive case series at multiple centers, including Waseem Medical Centre Batkhaila and Mercy Teaching Hospital Peshawar, from November 2022 to April 2023. A total of 30 male patients presented with urethral strictures were treated with urethral dilation using amplatz dilators. The outcomes assessed were maximum urinary flow and Post-void residual urine. Paired samples T-test was used for numerical variables. Mean age of patients was 64.87±11.96 years. Preoperative mean uroflowmetry flow (Qmax) was 8.6±2.97 mL/sec, while the PVR preoperatively was 198.4±59.19 mL. Qmax improved in 1st month at 18.87±2.64 mL/sec, in the 6th month at 17.50±2.99 mL/sec, and in the 12th month at 15.37±2.17 mL/sec (P = 0.0001). PVR improved in 1st month at 50.13±23.56 ml, 6th month at 64.47±23.31, and 12th month at 69.17±25.53 ml compared to the preoperative PVR (P = 0.0001). Urethral dilatation using amplatz renal dilators represents a technique that mitigates the inherent risks associated with blind dilatation methods. This approach is characterized by its safety, ease of application, high patient tolerance, and cost-effectiveness, rendering it a favorable alternative for treating urethral strictures.

AN ASSESSMENT OF PATIENT SATISFACTION IN OPD SETUPS OF KHYBER TEACHING HOSPITAL MTI PESHAWAR

Objectives: To measure the frequency of satisfied patients in outpatient department of Khyber Teaching Hospital Peshawar and to assess the association of patients satisfaction by evaluating various factors affecting it. Materials and Methods: It was a cross-sectional analytical study, conducted in Khyber Teaching Hospital, Peshawar from February 2022 to August 2022. A sample of 323 patients was selected by using non-probability convenient sampling technique. A reliable and valid questionnaire was adopted as data collection tool. After acquiring their informed consent, face to face interview was maintained as data collection medium. For analysis of the data, statistical package for social sciences (SPSS) version 20 was used. Data was represented using figures and tables and described in frequencies and percentages. Chi square test was used for analysis and P value less than 0.05 was taken as significant. Results: The study included total 323 participants with mean age of 30 ±11.089 years. Our results revealed that regarding location of the healthcare facility, 95.4% patients were satisfied with location. 95.3% patients were of the view that there was adequate sitting space and seating in waiting area. 90% were satisfied with the time given to them by specialists, 92.5% were satisfied with the behavior of doctors, On evaluation of overall satisfaction, it was found that 86.69% patients were satisfied with the overall quality of healthcare they received and the Quality of care calculated was 84.06 which according to the set scale is “Best Quality of Health Care. The association of patient satisfaction level with different variables like age, gender, education level, marital status and area of living was analysed using Chi square test. None showed any significant association as P value less then 0.05 was taken as significant. Conclusion: The study highlighted a high level of satisfaction of patients with the services delivered at OPD section of Khyber Teaching Hospital, Peshawar. Altogether 86.69% of the participants were satisfied with the overall quality of received services like location of the facility, waiting area parameters, doctor-patient interaction and provision of basic facilities.No significant association of patient satisfaction level with different variables was found.

Prevalence of Post Stroke Depression and Anxiety Among Patients Admitted in Khyber Teaching Hospital Peshawar

Introduction: Stroke is a life-threatening medical condition that can result in lifelong brain damage, complications, and death. It is the second leading cause of death worldwide and could soon overtake as the biggest cause of death globally. This can be produced by ischemia from a thrombosis or embolism, or a hemorrhage. As a result, the brain’s damaged area is unable to operate, causing one or more limbs on one side of the body to become immobile, inability to recognize or produce speech, or seeing only one side of the visual field. Objective of the Research: To determine the prevalence of Post Stroke Depression and anxiety among stroke patients admitted in Khyber teaching hospital Peshawar Methodology: A descriptive cross-sectional study was carried out to determine the prevalence of PSD and anxiety among stroke patients admitted at Khyber teaching hospital Peshawar. Data was collected through a questionnaire named HADs scale from participants. The sample size calculated for the research study was 109. The convenience sampling technique was used in the current study. Results: The findings of the study provide a baseline of information about the prevalence of Post Stroke Depression (PSD) and anxiety among stroke patients admitted in Khyber teaching hospital Peshawar. The prevalence of depression was 86(63.3%) and anxiety was 91(83.5%). Conclusion: In current study we had concluded a high prevalence of post stroke depression and anxiety ranging from 65-74 years of age in Khyber teaching hospital Peshawar. So, we concluded that females suffering from stroke have more chances of post stroke depression.

OUTCOME OF PRIMARY TOTAL KNEE ARTHROPLASTY AMONG PATIENTS WITH MORBID OBESITY

This retrospective observational study aimed to assess the outcome of primary total knee arthroplasty among patients with morbid obesity. This retrospective observational study was conducted at the Department of Orthopaedic, Khyber Teaching Hospital Peshawar, from August 2021 to June 2023. We assessed the records of 120 morbidly obese patients who underwent total knee arthroplasty. The outcomes of total knee arthroplasty of morbidly obese patients were evaluated. Paired samples T-test was used to assess the knee society clinical and functional score of the patients. The mean age of 120 morbidly obese patients was 62.21±7.0. Gender-wise, Females were greater in number as compared to male patients (66.7% vs. 33.3%). The mean preoperative clinical KSS was 48.69±2.45 while the postoperative clinical KSS was 83.34±1.04 (P = 0.0001), the mean preoperative functional KSS was 43.69±1.73, and the postoperative functional KSS was 70.03±3.31 (P = 0.0001). We conclude that total knee arthroplasty in morbidly obese patients resulted in significantly better outcomes in terms of clinical and functional knee scores.

MRI Diagnostic Accuracy In The Detection Of Emvi, In Carcinoma Rectum Using Histopathology As The Gold Standard

Background: Extramural Venous Invasion [EMVI] is the intravenous tumour extension beyond the rectal wall in patients with rectal cancer. Being a predictor of a worse prognosis, detection of EMVI is important to decide on treatment options. Objective: To determine the diagnostic accuracy of preoperative MRI in detecting extramural vascular invasion in patients with rectal cancer, taking histopathology as the gold standard. Study design: A Retrospective observational diagnostic accuracy study. Place and duration of study: department of radiology in Kuwait Teaching Hospital Peshawar for from 05-Feb-2020 to 05-March 2021 Materials & Methods: The study included 118 patients who did an MRI in Kuwait Teaching Hospital Peshawar for Rectal carcinoma from Feb 2020 to March 2021. Patients were examined with a 0.3 Tesla MRI machine using MRI sequences T2WI, T1WI, FLAIR and DWI. Post-op specimens were sent in formalin for histopathological assessment. Data, including MRI features and Histopathological findings, were assessed with SPSS version 24. Results: Our study included 118 rectal cancer patients, 55.1% (85) male and 44.9% (70) female. 31- 100 in 10-year increases. 31-50 and 41-50 had four instances (3.4%). Twenty (16.9%) patients were between 51 and 60, 22 (18.6%) were between 61 and 70, 35 (29.7%) were between 71 and 80, 11 (9.3%) Between 81 and 90, and 22 (18.6%) were between 91 and 100. MRI results found 57 EMVI-positive and 61 negative individuals. 45 (38.1%) patients had EMVI, whereas 73 (61.9%) did not. Cross-tabulation was utilized to analyze MRI's sensitivity, specificity, PPV, and NPV in diagnosing EMVI. MRI was 83.3% sensitive, 69% specific, 60% positive predictive, and 88.3% negative predictive. EMVI correlates with neoplastic mass. Conclusion: Diagnostic accuracy, including sensitivity, specificity, positive predictive value, and negative predictive value, is high using MRI to identify EMVI in rectal cancer. Keywords: Carcinoma Rectum, Extramural Venous Invasion, MRI, Mesorectal Fascia.

Perspective Regarding Effectiveness of Clinical Preceptorship Approach among Novice Nurse

Preceptorship is a short-term relationship between a new inducted (preceptee) employee and an experienced person (preceptor), who provides preceptor support, encourage the novice’s in their learning, gave timely feedback on their learning skills, helping the new inducted trainees to go forward and work independently. Objective: To identify the perspective regarding clinical preceptorship. Methods: A cross-sectional study was conducted in Peshawar, Khyber Pakhtunkhwa. A total of 165 novice nurses were included in the study. Data were collected from novice nurses working in Rehman Medical Institute (RMI), Northwest General Hospital (NWGH), Hayatabad Medical Complex (HMC), and Khyber Teaching Hospital (KTH) Peshawar. Consecutive sampling method was used to assess the study population. Questionnaire was used as a data collection tool. Written consent was taken from the participants before collecting the data. Results: Majority (57%) of the novice nurses reported that preceptorship program for the novice nurses is very effective, 35% participants reported that preceptorship program is moderate effective while only 7.3% participants reported that preceptorship program is not effective. The approach of Preceptorship program in private sector hospital was good as compared to government sector. Conclusions: Preceptorship program helps in the transition phase of a novice nurse to a qualified experience nurse. Preceptorship program also improve the novice nurse’s knowledge, skills, communication, behave and wiliness to work.