Incidence of urinary tract infection [UTI] during pregnancy among Pakistani women was examined. Midstream urine was collected from 250 pregnant and 100 control women and streaked on blood agar and incubated. Growth was considered significant if > / = 10[5]/mL bacteria were present. Among the pregnant women, 28.5% had UTI; 30.0% of controls had UTI. Among the pregnant and control women, 24.4% and 20.0% respectively had UTI symptoms, such as incontinence, nocturia and urgency. Symptoms did not correlate with incidence. Socioeconomic status, personal hygiene, education level, pregnancy duration, postcoital washing, contraceptive use and use of underclothing had no significant association with UTI occurrence. A history of past urological problems was associated with an increased incidence of UTI in pregnancy
Objective:To determine knowledge, attitude and practice (KAP) regarding management of Gestational Diabetes Mellitus (GDM) among Health Care Providers in major cities of Pakistan.Methods:A knowledge, attitude and practice (KAP) questionnaire based study was conducted in major cities in Pakistan from health care providers in public and private hospitals and clinics. Questionnaires were provided to the health care providers regarding screening, diagnosis and management of patients with GDM. Data analysis was done using IBM SPSS 20.Results:A total of 210 doctors took part in the study. 55 (26%) reported using fasting blood glucose as screening test for GDM whereas 129(61.4%) respondents used Oral Glucose Tolerance based WHO criteria for diagnosing GDM. Thirty six (17%) and 98(46.7%) doctors referred their patients to Gynecologists. For treating GDM, 64(30.5%) doctors prescribed insulin (NPH/Regular, 70/30 Mix). 112 (53.5) doctors used combination of capillary glucose by glucometer and plasma blood glucose tests for monitoring of glycemic control of patients with GDM.Conclusion:There is lack of agreed screening tests and criteria for diagnosis and management of GDM patients. Doctors need to be educated to follow evidence based diagnostic and management guidelines so that GDM patients can be effectively managed. Recently released South Asian Federation Societies and Pakistan Endocrine Society guidelines could be much needed consensus guidelines for doctors to apply in their daily practice to improve GDM diagnosis and treatment.
The role of Suprathel, a synthetic skin substitute, for superficial and deep dermal burns in children was evaluated. 65 children (25 females, 40 males: mean age 4.9 years, (range 04 months to 11 years) with dermal burns were treated with Suprathel. Flame burns were 14 and 51 were scalds. The burns were superficial dermal (n= 16), mid-dermal (n=34) and deep dermal (n=15); the median %TBSA was 23.6% (range 08-45%). Suprathel was applied after debridement, followed by Vaseline gauze, dry gauze and crepe bandage. The outer dressings were changed every 4-5 days unless clinical problems indicated otherwise. Median healing time was 15 days (range 10-35 days). 20 patients took longer than 21 days to heal, of whom 13 were flame burns and developed hypertrophic scarring, which was strongly associated with wound infection. Healing time of superficial dermal and mid-dermal burns was not significantly different. Suprathel is an effective skin substitute for the treatment of superficial and deep dermal burns in children. The majority of burns in children are mixed depth, and Suprathel has the advantage that it may also be used to treat deep dermal burns. It behaves like a biological dressing but is not animal derived, so is acceptable to all religious and ethnic groups. Suprathel significantly reduced pain. Its easy handling and patient comfort was superior compared to other materials. The Suprathel membrane adhered rapidly to the wound thus protecting against infections and promoting wound healing. No allergic reactions were observed. The ability of the material to resorb ensured pain-free removal after complete healing of the wound. We observed that the material effectiveness contributes to the reduction of overall treatment costs. Further studies to evaluate the efficacy and cost effectiveness of Suprathel compared to other dressings in children are needed.
Background: Acute pancreatitis is the inflammatory disorder which can be mild or severe. Early diagnosis and proper assessment of the disease severity have a critical role in its treatment. Objective: Determine the correlation of C-reactive protein and computed tomography severity index in acute pancreatitis. Methods: This cross-sectional study took place at department of General surgery, Pakistan Institute of Medical Sciences hospital Islamabad (PIMS), from September 2019 to February 2020. Patients of age between 15-70 years, presenting with acute severe epigastrium pain spreading to back, diagnosed as acute pancreatitis by serum amylase of 1000 units or more and either gender were included. CT scan was performed within 24 hours following presentation using axial slices of dome in diaphragm up-to pelvis by IV contrast. Slice had 3 mm of thickness in pancreas region. Various parameters of pancreatic inflammatory response, ratio of pancreatic parenchymal necrosis and additional pancreatic complications are included in the updated CT severity index measured on CT, with various points given for each parameter. A score over 5 is rated as severe pancreatitis. A blood sample was taken from each patient for CRP level. A CRP level of >10 mg/L was considered as positive. All the information was recorded via self-prepared proforma. Data analysis was done by SPSS version 20. Results: Total 67 patients of acute pancreatitis were selected for this study. Out of them, 59.7% were males and remaining were females. Most common age group was 46-60 years 43.3%. According to the pancreatic grading most of the patients presented with grade C as 29.9% and grade B as 23.9%, followed by grade D 20.95, grade E14.9% and 10.45 were normal. According to the pancreatic necrosis majority of the cases 41.8% had < 30%. There was a strong positive correlation between CT severity index and CRP level, r-value 0.346. Conclusion: C reactive protein is a reliable and non-invasive diagnostic tool for acute pancreatitis and its severity, which showed strong positive correlation with CT severity index of acute pancreatitis.
The primary goal of the rehabilitation services offered to patients with lower limb burns is to enhance gait function. Exercise on a treadmill and conventional overground gait training are the two most widespread gait-training methods. Numerous studies have been published in the literature that claim treadmill training helps people walk more easily. Therefore, it would be intriguing to investigate whether treadmill gait training affects the progress made by post-lower limb burn patients compared to traditional overground gait training. The goal of the current study was to compare the effectiveness of treadmill training and traditional physical therapy therapies for improving gait after lower limb burn injury. A comparative study, was conducted between January to August 2022 at a burns care unit,in Islamabad. All the participants were informed about the study procedure and consent was taken before initiating the study. All the participants received the set standard of Burn Rehabilitation by the American Burn Association (ABA). The program consists of ROM exercises, mobilization, functional mobility, stretching, balance training,and resisted exercises for enhancing muscle power. Statistical analyses were performed using IBM SPSS 24.0 software. The study subjects selected were 30 burn patients, aged above 18 years, vitally stable and had lower limb burn injuries with an average TBSA (total burn surface area) of 20-30%.The mean for Experimental is 18.86 and control group is 21.13. Patients were randomly either assigned to an experimental group or a control group. The Experimental group had a lower Time Up and Go test score of 11.86±3.58 (9.50-24.07)as compared to the control group’s TUG score(of 12.78±4.41(6.30-24.07). Functional mobility significantly improved as the p<0.05. The total mean scores calculated on the Tampa Kinesiophobia scale for the Experimental group were 35.66±6.32 which was less compared with those of the control group 37.93± 6.36. It demonstrates that fear of movement was reduced for treadmill training participants. Comparison of pre-distance (350.9±86.82) , pre-velocity (62.78±20.20) and post distance (385.02±32.29), post-velocity 40.48±21.91 of the experimental group with the control group pre-distance (339.26±98.17, pre-velocity (55.07±22.63) and post-distance (383.07±36.914) post-velocity (40.57±21.95) showed significant changes in results. In contrast to traditional gait training, treadmill training significantly improves walking ability in burn patients with lower limb damage.
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