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  • 1
    Online Resource
    Online Resource
    Miracle medicine for prevention of migraine attack: Metformin.
    Independent Medical Trust ; 2020
    In:  The Professional Medical Journal Vol. 27, No. 04 ( 2020-04-10), p. 812-819
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 27, No. 04 ( 2020-04-10), p. 812-819
    Abstract: Objectives: In search of effective and economical option for prophylaxis of Migraine evaluating the prophylactic role of Metformin in migraine. Study Design: Single blind placebo controlled trial. Setting: Department of Pharmacology BMSI, JPMC, in collaboration with Sindh services Hospital Karachi. Period: April 2017 – August 2018. Material & Methods: A total 105 patients with diagnosed migraine were included in this trial. Total patients were equally divided into 3 groups designated Groups A, B, and C that were representative of Placebo, Metformin and Propranolol groups respectively. Total study duration was 6 months, which were equally divided into 2 phases. First 3 month phase was baseline period and later one was treatment period. The primary parameters for evaluating the prophylactic role of Metformin in Migraine were Migraine integral Burden scale (MIBS), HIT-6, MIDAS, MPQ-5, frequency of migraine attack per month. Results: At baseline there were statistically non-significant differences found for MIBS (F (2,102) = 0.346, p = 0.708), MIDS (F (2,102) =0.248, p=0.781), MPQ (F (2,102) =0.188, p=0.828) and severity of headache (F (2,102) =0.247, p=0.782) among all treated groups. But at final follow up there was highly significant difference were found among all treated groups for all parameters. Pairwise comparison showed significant differences between group A and B and group A and C was recorded for all parameters. Nevertheless there was no difference seen in group B and C (mean difference (MD) = -0.171 ± 0.149, p= 0.485) ,(MD= -0.143±0.132,p=0.526), (MD = - 2.057±0.301, p 〈 0.001), (MD = -0.314±0.360, p=0.658), (MD = -0.514 ± 0.288, p = 0.179), (MD= 0.00±0.149, p=1.00) for MIBS, migraine frequency, HIT-6, MIDS, MRQ, headache severity respectively. Conclusion: This study demonstrated that Metformin is valuable, safer and economical option for preventive measure of Migraine.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2020.27.04.3892
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2020
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  • 2
    Online Resource
    Online Resource
    Factors associated with caregiver burden among caregivers of cerebral palsy children.
    Independent Medical Trust ; 2020
    In:  The Professional Medical Journal Vol. 27, No. 08 ( 2020-08-10), p. 1555-1559
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 27, No. 08 ( 2020-08-10), p. 1555-1559
    Abstract: Cerebral palsy(CP) is the term for a group of brain disorders, caused by damage to parts of the developing brain that control muscle movement, balance, and posture before birth, during birth, or immediately after birth. Caregivers of children with CP often experience high levels of caregiving burden. Objectives: The aim of this study was to explore correlation of factors with the presence of burden on primary caregivers of CP children. Study Design: Cross-Sectional study. Setting: Department of Physiotherapy, Children Hospital, Lahore. Period: March 2017 to June 2017. Material & Methods: Was conducted among caregivers of CP children to measure caregiver burden. The study sample consisted of a total of 100 caregivers was selected using non probability convenient sampling technique. Primary caregivers of a CP child (aged less than 18 years) were included. Caregiver Difficulties Scale (CDS) as used to measure caregiver burden. The data was analyzed and interpreted to measure the caregiver burden. Results: The mean age of caregivers participated in the study was 34.15± 6.76 years while mean age of their CP children was 6.35±4.52 years. Geographical area, socioeconomic status, caregiver’s age, total number of children and CP child’s age and gender showing correlation with caregiver burden by having significant p- value 〈 0.05. Conclusion: Geographical area, socioeconomic status, caregiver’s age, total number of children and CP child’s age and gender have significant association with caregiver burden while types of cerebral palsy and degree of disability has no correlation with caregiver burden.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2020.27.08.3781
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2020
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  • 3
    Online Resource
    Online Resource
    Variations of facial nerve distribution in the parotid gland.
    Independent Medical Trust ; 2022
    In:  The Professional Medical Journal Vol. 29, No. 05 ( 2022-04-30), p. 618-622
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 29, No. 05 ( 2022-04-30), p. 618-622
    Abstract: Objective: To study anatomical variations of facial nerve encountered during parotid gland surgery. Study Design: Observational Study. Setting: Anatomy Department with the Collaboration of General Surgery Department at Dow University of Health Sciences and Dow Hospital (Ojha Campus Karachi). Period: December 2020 to May 2021. Material & Methods: Dissection of parotid gland was done in 50 cases including 10 cadavers (20 parotid glands) in anatomy department and 40 patients (40 parotid glands) admitted in general surgery ward undergoing parotid gland surgery for any pathology of the gland. Total 60 parotid glands were studied. Mean age of the cases was 31.6 ± 2.14 years with age range of 20-60 years. There were 10 female and 40 male cases. Results: In this study 60 parotid glands were dissected in 50 cases and facial nerve configuration was studied. In 46(92%) cases facial nerve pattern could be classified into main five types of the nerve pattern but in 04(08%) cases facial nerve pattern did not fit into any category of the classification. Type-III pattern of facial nerve distribution was commonly seen in 21(35%) glands. Conclusion: It is very important to keep knowledge of anatomical variations in facial nerve branching pattern in parotid gland to avoid its Injury during surgery.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2022.29.05.6799
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2022
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  • 4
    Online Resource
    Online Resource
    Predictive accuracy of Apache-II for mortality in Poly Trauma patients.
    Independent Medical Trust ; 2020
    In:  The Professional Medical Journal Vol. 27, No. 11 ( 2020-11-10), p. 2314-2319
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 27, No. 11 ( 2020-11-10), p. 2314-2319
    Abstract: Objectives: The objective of our study was to find diagnostic accuracy of APACHE-II score to predict mortality in poly trauma patients within first 24 hours of hospitalization. Study Design: Cross Sectional study. Setting: Department of Emergency Lahore General Hospital. Period: 25 March, 2016 to 25 September, 2016. Material & Methods: A total of 230 patients who fulfilled inclusion criteria were enrolled in the study from emergency department of Lahore General Hospital, informed consent was taken from all patients or their attendants to take their demographic profile (name, age, gender and contact no) and other necessary clinical data. To calculate APACHE-II score, vital signs, blood / serum profile, GCS, age and prolong health problems were measured on patients’ arrival. Patients were classified as per their APACHE-II score. After calculating APACHE-II score patients were managed according to trauma severity and followed up till 24 hours to note the in- hospital mortality. All the data was recorded on a Performa. Statistical analysis was carried out using SPSS 20. Results: Out of 230 patients, 147 (63.91%) were male and 83(36.09%) were female; mean age was 38.53 ± 11.67 years. Out of 230 cases, in hospital mortality occurred in 84(36.5%) while other 146(63.5%) were alive within 24 hours of admission. According to APACHE-II score, 84(36.5%) cases had 〉 11.5 score and rests of 146(63.5%) had APACHE-II ≤ 11.5. The sensitivity, specificity, PPV, NPV and diagnostic accuracy of APACHE-II was 89.16%, 93.2%, 88.1%, 93.84% and 91.74% respectively. Conclusion: According to the findings of this study, we found APACHE-II highly accurate for indicating in-hospital mortality. Using APACHE-II in future we can devise an efficient treatment plan for poly trauma patients to reduce the probability of hospital mortality.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2020.27.11.4460
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2020
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  • 5
    Online Resource
    Online Resource
    DEFENSIVE MEDICINE; : TO DETERMINE THE PREVALENCE OF DEFENSIVE MEDICINE AMONG DOCTORS OF CIVIL HOSPITAL AND JINNAH HOSPITAL KARACHI AND TO INTRODUCE IT TOWARDS THE COMMUNITY OF DOCTORS
    Independent Medical Trust ; 2014
    In:  The Professional Medical Journal Vol. 21, No. 06 ( 2014-12-10), p. 1191-1199
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 21, No. 06 ( 2014-12-10), p. 1191-1199
    Abstract: Objective: To determine the prevalence of defensive medicine among doctors of Civil Hospital and Jinnah Hospital Karachi and to introduce it towards the community of doctors. Material And Methods: 200 doctors from different wards of Civil Hospital Karachi and Jinnah Hospital Karachi played crucial role in filling of Performa which was especially designed for this research. Study Design: Cross sectional study. Site of Study: Civil and Jinnah Hospital Karachi. Duration: January 01, 2013 to December 31, 2013. Results: 47.9% doctors already knew about defensive medicine while 52.1% didn’t. 40.7% doctors avoid invasive procedures while 50.3% don’t. 92.4% of doctors care for high risk patients while 7.6% avoid caring for them. 109 out of 190 doctors agree and 30 doctors strongly agree about the practice of defensive medicine, 34 doctors are neutral and the rest of them disagree with its practice. Mostly ordered tests are CBC 78.9%, urine D/R 3.2%, 1.1% stool D/R, 1.6% MRI, 2.2% CT scan, 1.1% UCE, 2.7% blood cultures, 0.5% LFTs 9.1% other tests and the doctors with experience of 10 or 15 years are found ordering only CBC mostly. Conclusions: The conclusion obtained from the results shows that most of the participants were experienced doctors but many of them were unaware of the defensive medicine and in spite of that too great number of doctors strongly believe in its practice. Majority of the doctors were found caring for high risk patients. However the prevalence and practice of defensive medicine reduced among doctors having experience of more than 5 years.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2014.21.06.2627
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2014
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  • 6
    Online Resource
    Online Resource
    Extended drug resistance in children with typhoid fever.
    Independent Medical Trust ; 2020
    In:  The Professional Medical Journal Vol. 27, No. 03 ( 2020-03-10), p. 581-587
    Details
    In: The Professional Medical Journal, Independent Medical Trust, Vol. 27, No. 03 ( 2020-03-10), p. 581-587
    Abstract: In developing countries, typhoid fever is mostly seen due to poor public health and low socioeconomic indices. Currently Pakistan is going through the largest outbreak of XDR typhoid fever which has resulted in increased morbidity and mortality especially in pediatric population. Objectives: To see the pattern of extended drug resistant typhoid fever in different areas of Karachi. Study Design: Cross sectional study. Setting: Department of pediatrics, Ziauddin Hospital (KDLB, NORTH, CLIFTON campus). Period: 6 months from October 2018 till March 2019. Material & Methods: All patients who presented with history of fever for 3 or more days with signs and symptoms of typhoid fever were recruited. For data collection a self-structured questionnaire was used. Age, gender, socioeconomic status, personal hygiene, water supply and sanitation were taken into account. Blood samples were sent for cultures. Salmonella isolates were tested for antibiotic susceptibility. Tested antimicrobials were ampicillin, TMP/SMX, cefixime, ceftriaxone, aztreonam, ciprofloxacin, azithromycin, meropenem. For data analysis SPSS version 22 was used. Results: Out of 415 patients, 235 had culture proven typhoid fever. Salmonella typhi was isolated in 94.4%of the patients and salmonella paratyphi was isolated in 5.57%. Of the 235, Males were 62% and females were 42.4%. Major determinants associated with acquiring salmonella infection were young age (74%), male sex (62%), middle and low socioeconomic status (83.8%), living in west district of Karachi (54.9%) and drinking line water (79.2%). Extended drug resistance was encountered in 69.5%. Most of the isolates were sensitive to meropenem and azithromycin (96.7 %, and 95.5% respectively). Ceftriaxone resistance was prevelant in all three districts of Karachi (p value 〈 0.001), in different age groups 1-6yrs (98%), 7-12 yrs(91%), 13-18 yrs (100%) and in males(58%) predominantly. Conclusion: Karachi is facing an outbreak of XDR typhoid fever. Risk of acquiring extended drug resistant typhoid fever is increased in younger age group 1-6 yrs, males, west district of Karachi and poor socioeconomic status. Drinking unboiled water is identified as one of the major culprits. Actions should be taken at all health care levels to monitor the judicious use of antibiotics, and preventive strategies like safe water supply, improved sanitation along with typhoid vaccination are suggested to overcome this outbreak.
    Type of Medium: Online Resource
    ISSN: 2071-7733 , 1024-8919
    URL: Article
    DOI: 10.29309/TPMJ/2020.27.03.3695
    Language: Unknown
    Publisher: Independent Medical Trust
    Publication Date: 2020
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