Objective. To assess the knowledge and perception of primary school teachers regarding autism in private and public schools of Karachi, Pakistan. Methods. A cross-sectional survey was conducted on primary school teachers in different districts of Karachi. A sample size of 170 teachers was selected by purposive sampling. Primary data was collected using self-administered questionnaires. These questions assessed the teacher's knowledge and perception of Autism. Data was entered on SPSS version 20. Frequencies and percentages were taken out for categorical variables. Results. Of the total 170 teachers, 85 were from the Private and 85 from Public sector schools. 55% (n = 94) of the teachers knew about Autism through the media and only 9% (n = 15) had formal training through workshops on Autism. 62% (n = 105) of the teachers were of the opinion that Autism is treatable. Majority of the teachers (57%) said that proper training is required for teaching autistic children. Conclusion. The knowledge related to Autism in our existing sample has mostly come from the media. Although we cannot undermine the role of media, there is a need to give formal training to teachers regarding the differentiating features of Autism, which in turn will aid in early diagnosis of the disease.

Background: The etiology of sleep disruption in intensive care unit is poorly known and often ignored complication. It is caused by the environmental factors especially pain, noise, diagnostic testing and human interventions that cause sleep disruption. Light, medications and activities related to patient care interfere with patient’s ability to have good sleep. There are multi-factorial environmental etiologies for disruption of sleep in ICU. Objective: The objective of this study was to evaluate the factors disturbing the sleep quality in intensive care unit (ICU) admitted patients. Methodology: A cross sectional study was designed involving 150 patients admitted in intensive care unit and high dependency unit of Gulab Devi Chest Hospital. The duration of study was from September 2015 to March 2016. The questionnaire was made and filled with the help of patients. The data was analyzed using SPSS version 16.00. Results: Mean age of patients was 50.46+10.96 with maximum age of 65 and minimum age of 30 years. There was 53.33% male patients and 46.67% females participating in this study. The sleep quality was significantly poor in ICU than at home. After analysis, 54.67% patients were with poor quality of sleep due to pain and 48.67% were due to noise of environmental stimuli. The other factors were alarms, light and loud talking. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable.

Objective: To compare the frequency of Surgical Site Infection ( SSI ) and mean length of hospital stay between the Purse-string closure and conventional primary closure techniques for stoma reversal. Methods: The study was carried out in Surgical Unit-III, Lahore General Hospital Lahore from January 5, 2018 to July 5, 2018. The study designed as a Observational Study. Patients undergoing surgery for Ileostomy were randomly divided into two groups, Group-A (Purse-string closure) and Group-B (Conventional primary closure). All the patients were called for follow up checkup on 14th days after operation and after one month. Both of the groups were checked and recorded for SSI after operation and hospital stay. The data was statistically analyzed by using SPSS v23.0.t test (independent sample) used for the comparison of hospital stay mean. Chi-square was also used for the comparison of the frequencies of SSI. Data were stratified for gender and age. A p-value ≤0.05 was considered as significant. Results: A total of 140 patients were enrolled for this study. Patients were divided into two groups i.e. Group- A (Purse-string closure) and Group-B (Conventional primary closure). In group-A, mean duration of hospital stay was 5.7±1.0 days, while 7.3±1.1 days in group-B, which is statistically significant with a p-value of 0.000. In group-A, surgical site infection was in 4(5.7%) patients, while 11(15.7%) patients of group-B, which is statistically significant with a p-value of 0.046. Conclusion: The frequency of surgical site infection and mean length of hospital stay after stoma reversal, purse-string suturing technique is significantly less than conventional primary closure technique. Key Words: Surgical stoma; Ileostomy; Closure; Infection. How to cite: Nofal S., Arif A., Khan A., Saif. S., Khan W.A., Arif A. Comparing SSI in Purse-String Versus Conventional Primary Closure Following Stoma Reversal. Esculapio 2021; 17(01): 15-19

Objective: The aim of this study is to compare the efficacy of oral ibuprofen versus paracetamol for PDA closure in preterm neonates. Study Design: Randomized Control trial Place and Duration: The study was conducted at Neonatology department North West General Hospital, Peshawar for duration of three years from April 2018 to March 2021. Methods: Total one hundred and fifty preterm neonates were included in this study. Patients’ detailed demographics including gestational age, gender; birth and diameter were recorded after taking informed written consent from the parents. Patients were equally divided into two groups, I and II. Group I had 75 patients and received paracetamol for closure for patent ductus arteriosus and group II received oral ibuprofen for closure of PDA. Outcomes among both groups were calculated in terms of effectiveness, mortality and post-operative complications. Data was analyzed by SPSS 22.0 version. Results: Mean gestational age of the patients in group I was 29.12±7.44 weeks and in group II mean gestational age was 30.09±4.66 weeks. 45 (65%) male in group I and in group II 40 (53.3%) were male babies. Mean ductal diameter in group I was 3.02±1.13 and in group II mean diameter was 2.98±0.16 mm. In group I cesarean birth was found in 50 (66.7%) and in group II 48 (64%) cesarean birth was found. Mean duration of closure was lower in group I 4.24±1.03 days as compared to group II 5.01±0.03 days. PDA closure rate was higher in group I 62 (82.7%) and in group II its frequency was 58 (77.3%). Re-opening of ductus was found in 6 (8%) in group I and 8 (10.7%) in group II. Adverse outcomes were renal failure, hyperbilirubinemia and gastrointestinal bleeding among both groups. Mortality rate in ibuprofen group was higher 7 (9.3%) as compared to group I 4 (5.3%). Conclusion: We concluded in this study that the use of drug paracetamol is effective for the closure of PDA in preterm neonates as compared to oral ibuprofen with less adverse outcomes and mortality rate. Keywords: PDA, Neonates, Paracetamol, Ibuprofen, Complications, Mortality