Journal of Bashir Institute of Health Sciences

Triphasic Computed Tomography for Characterization of Liver Lesions Identified on Ultrasonography

2024-12-11T18:00:59+00:00

Background: Liver disease is the leading cause of death in Pakistan and Asia. Liver carcinoma is the most prevalent cancer in the world. Identification of cancer at an early stage can help in better management of the disease and improved prognosis. Computed tomography can perform scans at different phases after contrast is administered. It is the most effective tool for the diagnosis of tumors and different types of lesions. Our objective of the study was to characterize the liver lesions identified on ultrasonography and differentiate between benign and malignant lesions at Bilal Hospital Rawalpindi. Methods: This cross-sectional quantitative study was conducted at Bilal Hospital, Rawalpindi, Pakistan, to evaluate liver lesions using triphasic CT. Data from 50 reports were analyzed, focusing on hepatic lesions, hepatomegaly, cirrhosis, and portal hypertension identified through ultrasonography. Patients over 30 were included, while those under 30, pregnant, contrast-allergic, or with abnormal renal function tests were excluded. Triphasic CT scans were performed with a 64-slice scanner, capturing arterial, portal venous, and delayed phases after contrast injection. Radiologists reported the scans, and data were analyzed using SPSS-25, ensuring patient consent, confidentiality, and privacy. Results: In this study, 28% of patients had benign liver lesions, with focal nodular hyperplasia (14%) being the most common, followed by hepatic cysts (4%) and hemangiomas (10%). Malignant lesions were observed in 62% of patients, with hepatocellular carcinoma (36%) being the most prevalent, followed by secondary metastases (10%), cholangiocarcinoma (8%), and focal hepatic lesions (8%). The most frequently observed condition was hepatocellular carcinoma. Conclusions: The study concludes that there is a significant prevalence of both benign and malignant liver lesions in patients over 30 years, with hepatocellular carcinoma being the most common malignancy and focal nodular hyperplasia, the most frequent benign lesion. The findings emphasize the crucial role of triphasic CT in accurately diagnosing and differentiating liver lesions, aiding in effective treatment planning.

Frequency of Upper Cross Syndrome and Its Association with Physical Activity in Undergraduate Students

2024-11-08T05:05:04+00:00

Background: Upper Cross Syndrome is a most common postural disorder characterized by various muscle imbalances in the upper body that lead to altered alignment and potential musculoskeletal pain. As undergraduate students often face these risk factors due to long hours of studying, sedentary behaviors, and academic pressures, it is essential to investigate the frequency of Upper Cross Syndrome (UCS) in this population and explore its association with physical activity. This study aimed to determine the frequency of upper cross syndrome and to find its association with physical activity. Methods: This was a descriptive cross-sectional study utilizing a non-probability convenience sampling method. A total of 384 undergraduate students, aged between 18 and 25 years, were included in the study. Data collection took place at different universities in Rawalpindi and Islamabad. Postural grid assessment, inclinometer, and International physical activity questionnaire were used as diagnostic criteria. The data collected was then analyzed using SPSS version 21. Results: The results obtained show that there is a significant correlation between physical activity and UCS. It was revealed that 120 participants, or 31.3% of the population, had the upper cross syndrome. All the affected participants were found to be minimally or insufficiently active, making them more prone to musculoskeletal conditions such as upper cross syndrome. 13.8 were active and had no UCS, 80.7 were minimally active and had UCS, and 5.5 were insufficiently active, of which 16 had UCS. Conclusion: The findings of the current study concluded a significant relation between physical activity and upper cross syndrome. Students who were minimally or insufficiently active exhibited a higher prevalence of upper cross syndrome than those who were physically active. This study indicates the importance of physical activity in reducing the risk of developing musculoskeletal conditions such as upper cross syndrome. These results suggest that a sedentary lifestyle and prolonged sitting can lead to postural imbalances and increased musculoskeletal discomfort.

Assessment of Quality of Life and Range of Motion of Lower Extremity in Chronic Burn Patients

2024-11-08T04:55:28+00:00

Background: A burn is defined as a wound caused by an exogenous agent leading to coagulative necrosis of tissue. The burn injury represents an assault on all aspects of patients, from physical to psychological. Contractures are problematic scar formations, causing a limited range of motion (ROM) of a joint. They can be disfiguring, severely limit joint function, and may have a substantial impact on quality of life (QoL). The study aimed to assess the quality of life and to assess the range of motion to check how a range of motion impacts the quality of life in post-burn patients. Methods: A descriptive cross-sectional study was performed using demographic data, a Health questionnaire (EQ-5D-5L), and a manual tool goniometer for a range of motion to find out how quality of life is affected among the post-burn patients of involved lower extremity in the Burn Center, PIMS Islamabad. The study participants were post-burn patients aged between 15 and 45 years. Data collection tools used were a health questionnaire (EQ-5D-5L) and a goniometer for assessing the range of motion of the affected part. Data collected was analyzed via SPSS version 26 in terms of descriptive analysis using frequency tables, pie charts, and clustered bar charts. Results: The study at Burn Center PIMS examined the causes, severity, and impact of burns on patients' quality of life (QOL). Flame burns were the most common, and second-degree burns were predominant, with most cases being minor. Burns typically involved ≤10% total burn surface area (TBSA), with limbs frequently affected. The EQ-5D-5L scale revealed significant issues in mobility, self-care, usual activities, pain, and anxiety, with burn severity having a significant negative correlation with QOL (β = -0.561, R² = 0.314, p = 0.000). Most participants rated their health as "Best" or "Better." Range of motion (ROM) analysis showed significant limitations in hip joint movements, particularly in flexion, external rotation, and abduction, underscoring the need for targeted rehabilitation strategies. Conclusion: The study concludes that burn injuries are significantly adversely associated with patients' quality of life, with higher burn severity associated with greater challenges in mobility, self-care, usual activities, pain, and anxiety. The findings emphasize the importance of comprehensive burn care that addresses both physical and psychological aspects, including targeted rehabilitation to improve range of motion and overall recovery. These insights underscore the need for holistic approaches to burn management to enhance patients' long-term outcomes and well-being.

Prevalence of Pes Planus Among Army Soldiers of Rawalpindi and Islamabad Due to Prolong Standing and Heavy Equipment Utility

2024-06-26T04:45:30+00:00

Background: Pes planus, commonly known as flat feet, is a condition where the arch of the foot collapses, leading to a flattened sole. This study aimed to determine the prevalence of pes planus among army soldiers and investigate its association with prolonged standing and heavy equipment utility. Understanding these factors is critical for implementing preventive measures to reduce the risk of this condition among soldiers, who often endure extensive physical demands. Methods: A cross-sectional study was conducted over six months in various army units in Rawalpindi and Islamabad, involving 230 male soldiers aged 25-35 years. Participants were selected using non-probability convenience sampling and had standing duties lasting 4-8 hours while regularly carrying weights of 3 kg or more. Data collection included physical examinations, footprint assessments, and a structured questionnaire. Necessary permissions were obtained from relevant ethical review boards. Data analysis involved SPSS version 27, with frequency charts, and multiple regression analyses to assess the relationship between pes planus and occupational activities. Results: The study population primarily consisted of young soldiers (59% aged 20-30 years). Regarding rank, the largest group was Sepoy (37%), and 53% had served between 6-10 years. Most soldiers (61%) carried heavy equipment weighing 21-25 kg, and 63% had standing duties of 6 hours. The prevalence of pes planus was found to be 15% among soldiers. Symptoms associated with pes planus included pain on use (44.3%), swelling (44.3%), and characteristic calluses (24.3%). Multiple regression analysis revealed that the weight of the equipment carried during standing hours had a significant positive relationship with pes planus development (beta=0.609, R²=0.371, p<0.001), while daily standing hours showed a weaker, non-significant trend (beta=0.109, R²=0.010, p=0.057). Conclusion: The study identified a significant prevalence of pes planus among army soldiers, with heavy equipment utility being a critical factor. Prolonged standing also contributed to the risk, albeit to a lesser extent. These findings underscore the need for preventive measures, such as reducing equipment weight and providing ergonomic support, to mitigate the development of pes planus and enhance soldiers' foot health.

Hepatotoxic Effects of Anti-Tuberculosis Medications: A Clinical Assessment

2024-06-26T04:26:58+00:00

Background: Tuberculosis (TB) is a contagious disease that is highly prevalent worldwide. Every year, Mycobacterium tuberculosis causes over 2 million fatalities and about 8 million new cases of active tuberculosis. Treatment for adult respiratory TB is a regimen of isoniazid, Rifampicin, and pyrazinamide for 2 months, followed by 4 months of isoniazid and Rifampicin. All these anti-TB medications have the potential to be hepatotoxic, but when used together, the toxicity is amplified synergistically. Drug-induced Liver Injury (DILI) is defined as a liver injury due to Xenobiotics, herbs, or medications that lead to either liver dysfunction or abnormal liver serology in the setting of no other identifiable cause. Serum biomarkers, including ALT AST, ALP, and T. Bilirubin, are routinely utilized in diagnoses and therapeutic outcome assessments of DILI in the clinic. The purpose of the study was to assess the hepatotoxicity effect of anti-tuberculosis medications. Methods: This study was observational. The data was collected from Sayyed Muhammad Hussain Government TB sanatorium, Samli Murree. This study was conducted from October 2023 to December 2023. A non-probability sampling technique was used for this research. Eighty-two random TB patients who were using antitubercular drugs for their treatment and had done their Liver Function Tests (LFTs) were selected. The data is presented in the form of tables and pie charts. Results: About 135 LFT reports of 82 TB patients were found with varying parameters. Throughout their course of therapy, 24% of patients developed ATT-induced hepatitis, 6% of patients merely had elevated bilirubin levels, 1% of patients had elevated ALP, 2% of patients had HCV+, and 1% patients had HbAg+. However, 65.80% of patients maintained normal liver function. This study found that the harmful effects of drugs also come along with treatment, which healthcare professionals shouldn't neglect. It showed the adverse effects of antitubercular drugs on the liver. Therefore, drug therapy must be stopped immediately after noticing any abnormal changes in the liver profile. Conclusion: In conclusion, anti-tuberculosis treatment has a notable impact on hepatocellular injury, with a significant proportion of patients experiencing elevated liver enzymes and bilirubin levels indicative of liver stress or damage. The treatment was associated with drug-induced hepatitis in some patients, reflecting its potential to cause hepatocellular injury, particularly in those with predisposing factors. These findings highlight the importance of regular monitoring of liver function tests during therapy to detect and manage hepatocellular injury promptly, ensuring a balance between effective tuberculosis treatment and the prevention of serious liver complications.

Exploring Loneliness among Geriatric Patients in Critical Care Areas of a Tertiary Care Hospital in Islamabad

2024-06-26T04:52:35+00:00

Background: Loneliness is prevalent among the elderly population. This, in turn, is a significant risk factor for various physical and psychosocial health ailments. Chronic loneliness emerges as a predisposing factor for suicidality, exacerbating cognitive decline and diminishing the overall quality of life. This study investigates loneliness among geriatric patients in critical care at a tertiary hospital in Islamabad, aiming to identify contributing factors and support interventions for improved emotional well-being. Methods: The study applied a cross-sectional quantitative research design that used a convenient non-probability sampling technique. The University of California, Los Angeles Loneliness Scale Version 3 (UCLA-LS V3), a 20-item questionnaire developed by Russell, was used to measure the loneliness and social isolation of geriatric patients. The sample included 100 geriatric patients aged above 65 years with acute clinical loneliness and chronic illnesses and those admitted. The study excluded patients under 65 years of age, unconscious, or on mechanical ventilation. The collected data was analyzed through SPSS version 27, and outcomes were presented in graphs and tables. Results: This study assessed loneliness in 100 geriatric patients, with 63% male and 37% female participants, and a mean age of 75.83 years. The average UCLA Loneliness Scale score was 33.06, indicating moderate loneliness. Gender did not significantly affect loneliness (t = 0.225, p = 0.22), and there was a weak, non-significant correlation between age and loneliness (r = 0.14, p = 0.17). Most participants (65%) experienced moderate loneliness, with males reporting higher levels of severe loneliness. The primary factors contributing to loneliness were perceived lack of support (22%) and social exclusion (12%). Conclusion: The study concludes that there is a significant prevalence of loneliness among geriatric patients, with a majority experiencing moderate loneliness. Gender and age did not have a significant impact on loneliness levels, suggesting that other factors, particularly a perceived lack of support and social exclusion, play a more substantial role. The findings underscore the need for targeted interventions that address the multifactorial nature of loneliness, emphasizing the importance of enhancing social support and emotional connections to improve the well-being of geriatric patients.

Frequency of Risk Factors of Myocardial Infarction among Men and Women at Hayatabad Medical Complex, Peshawar

2024-06-26T05:09:20+00:00

Background: Myocardial Infarction is the leading cause of morbidity and mortality all over the world. Its Prevalence is specifically high in the South Asian countries. The developing countries share a large burden of this disease, accounting for more than 80% of the world’s burden. The primary objective of this study was to determine the proportion of male and female patients diagnosed with myocardial infarction (MI) at Lady Reading Hospital, Peshawar. Additionally, the study aimed to identify the most common risk factors associated with MI, analyze their Prevalence across genders, and examine the age-wise distribution of these risk factors. Methods: The study was based on the cardiology and emergency departments of HAYATABAD MEDICAL COMPLEX, Hospital, Peshawar. 205 MI patients were included in the study. Verbal and written informed consents were received from all the participants. SPSS version 23 was used to analyze the data. Results: The study included 205 patients, with 62% males (n=127) and 38% females (n=78). The age group with the highest Prevalence of myocardial infarction (MI) was 46-55 years (32.7%), followed by 66-75 years (28.8%) and 56-65 years (26.3%). Hypertension (69.8%) and dyslipidemia (64.4%) were the most common risk factors, followed by diabetes (49.3%), family history of MI (48.8%), smoking (22%), and obesity (21%). Hypertension was slightly more prevalent in females (73.1%) than males (67.7%), while smoking was exclusive to males (35.4%). Obesity and diabetes were more common in females. Conclusion: The study concludes that there is a high prevalence of myocardial infarction among males, with the most affected age group being 46-55 years. Hypertension and dyslipidemia emerged as the most significant risk factors, with notable gender differences observed. Females showed a higher prevalence of hypertension and diabetes, while smoking was exclusively observed in males. These findings underscore the need for targeted interventions to address gender-specific risk factors and promote early prevention strategies.

Analysis of Factors Contribute to Failure of Dental Restorations and Its Impact on Patient's Life

2024-12-11T16:38:54+00:00

Background: Dental restoration focuses on repairing or replacing damaged or missing teeth, but it has a limited lifespan and leads to significant health issues throughout a patient's life. This study analyzed the potential factors contributing to dental restoration failure and its impact on the patient's life. Methods: This was a descriptive cross-sectional study conducted in 2 hospitals, Lady Reading Hospital, Peshawar, and Ayub Teaching Hospital, Abbottabad, KPK. The study comprised 167 patients, both genders, ages 10 to 60 years. Data was collected through a self-administered questionnaire in 4 months and analyzed by SPSS statistics software version 29. Results: Out of 167 study participants, 70 were male, while 92 were female. The most frequently reported reason was tooth erosion (46.7%), followed by secondary caries (26.3) (p<.001), fractures (in the tooth (1.7%), and restorations (11.3%) (p<.001), resulted in dislodgment (64.6%) (p=.734) and unexpected fallout (55%) of restorations (p=.015). Females experienced a higher failure rate (58%) as compared to males (42%), leading to multiple visits and time-consuming procedures impacting patients' daily routine, work, and personal commitments, reported by (33.5%) of individuals, followed by experiencing severe pain (32.3%) and being costly (27.5%) (p=.021). Conclusion: This study in the KPK region revealed that tooth erosion, secondary caries, and fractures (both in the tooth and restorations themselves) were significant contributors to filling dislodgment and unexpected fallout, leading to the failure of restorations.

Efficacy of Trimetazidine 80mg in Treatment of Stable Angina: A Systematic Analysis

2024-01-05T11:10:37+00:00

Background: Stable angina is a prevalent form of ischemic heart disease characterized by recurrent, predictable chest pain or discomfort associated with physical or emotional stress. Trimetazidine, an anti-ischemic agent, has shown promise in alleviating angina symptoms. This systematic analysis aims to evaluate the efficacy of Trimetazidine 80mg in the treatment of stable angina. Literature research on studies published between 2015 and 2022 was performed on a computerized database through PubMed, Google Scholar, Scopus, and Web of Science. Methods: In this meta-analysis, only the randomized control trial studies published between 2015 and 2022 were selected for quantitative analysis. Four parameters, i.e., mean arterial pressure, number of stable angina attacks per week, nitrate consumption, exercise tolerance test, and Canadian Cardiovascular Society classification of stable angina, were selected for evaluation. A specific criterion was used to assess the quality of trails. The standard statistical methods, pooled odds ratio, 95% confidence interval, and pooled z and p values were applied in the analysis. Results: This systematic analysis included six randomized clinical trial studies clinically examining a total of 10238 patients of stable angina for the efficacy of Trimetazidine 80 mg single dose per day. The data was analyzed through RevMen software 5.4. The outcomes state that the lower number of per week angina attacks, nitrate consumption, and reduction in mean arterial pressure are associated with Trimetazidine 80 mg. However, Trimetazidine 80 mg improves response to exercise tolerance test and Canadian Cardiovascular Society classification. Conclusion: It is concluded through this systematic review that Trimetazidine 80 mg, a single dose per day, is more effective in improving cardiovascular health in comparison to conventional anti-angina therapies and placebo drugs. Patients with stable angina suffer from a limited number of angina attacks by using a single dose of Trimetazidine 80 mg. Therefore, Trimetazidine is the choice of drug against stable angina pectoris.