Annals of Punjab Medical College

Evaluation of Patient Satisfaction with Regional vs General Anesthesia Postoperatively in Lower Abdominal Surgeries

Tue, 31 Dec 2024 00:00:00 +0000

Background: The selection of anesthesia for procedures involving the lower abdomen is an important decision that balances the need for effective pain control with patient safety and satisfaction. Objective: Finding the factors that influence patient satisfaction following lower abdominal surgery under regional anesthesia as opposed to general anesthesia was the aim of this study. Study Design: Comparative Cross-sectional Study. Settings: Department of Anesthesia & Surgery, Mardan Medical Complex, Mardan, Pakistan. Duration: Six months from September 2023 to February 2024. Methods: A total of 384 patients aged 18-75 years were categorized between General Anesthesia (GA) and Regional Anesthesia (RA). Data on surgical techniques, postoperative complications, patient education satisfaction, gender and ASA status were acquired. Statistical analysis was used to evaluate the association (Chi square Test) between these variables. Results: The RA group experienced a decreased rate of postoperative complications and was statistically significant at (p = 0.002), while the GA group experienced greater rates of vomiting (54.2%), nausea (62.5%) and pain (50.4%). In the RA group, 22.9% of respondents were fully happy, compared to 21.9% in the GA group (p = 0.003). RA highlighted the value of making well-informed decisions by reducing complications and increasing satisfaction. Conclusion: RA has several benefits, including improved pain management, quicker recovery periods, fewer problems and more patient comfort. Subsequent research endeavors ought to centre on the enduring consequences of distinct anesthetic varieties and their influence on certain surgical procedures and tactics to augment patient comprehension.

Knowledge and Awareness of Dentists about Hypochlorite Emergencies and their Management during Endodontic Treatment

Tue, 31 Dec 2024 00:00:00 +0000

Objective: This study aims to evaluate and compare dentists' knowledge and awareness of hypochlorite emergencies during endodontic treatment and their management. Study Design: Cross-sectional study. Settings: de ’Montmorency College of Dentistry, Lahore Pakistan. Duration: From July 2023 to January 2024. Methods: The study involved 206 dentists from various dental institutes in Punjab, Pakistan. A meticulously self-developed 21-item questionnaire assessed demographics, knowledge, and awareness of hypochlorite accidents. Data were analyzed using SPSS version 25, with non-parametric tests applied due to non-normal data distribution. Results: Female participants demonstrated significantly higher knowledge scores than males (p=0.012). No significant differences in knowledge scores were found between participants from public and private institutes (p=0.859). Assistant Professors and above had the highest mean knowledge scores (p<0.001). Participants taught about hypochlorite emergencies scored significantly higher (p<0.001). Irrigation beyond the apex was the most frequently reported emergency, particularly among those with more than five years of practice (p=0.004). Conclusion: The study highlights the need for comprehensive training and continuous education to manage hypochlorite emergencies effectively. Addressing knowledge gaps, especially in public institutes, and ensuring the availability of emergency kits can significantly improve patient safety and outcomes. Future research should focus on developing standardized training modules and assessing the long-term impact of enhanced educational interventions.

Impact of Socio-Demographic Factors in Under-Five Children with Acute Diarrhea in Tertiary Care Hospital

Tue, 31 Dec 2024 00:00:00 +0000

Objective: To determine the impact of socio-demographic factors linked to an increased incidence of acute diarrhea among children under five years of age. Study Design: Descriptive-Cross sectional study. Settings: This study was carried out at the Pediatric emergency department of Nishtar Hospital, Multan Pakistan. Duration: Six months From August 2022 to January 2023. Methods: After obtaining Ethical approval from the Institutional review board, a self-designed questionnaire was used to obtain information from parents/caregivers of 147 participants selected through a non-probability convenient sampling technique. Data entry and analysis were done using SPSS statistics 26. Results pertaining to rates were reported as frequencies and percentages. The Chi-square test was used to measure the association, and a factor was considered to be significant if its p-value was less than or equal to 0.05. Results: In the present study, the frequency of acute diarrhea among children was 87 (59.2%). Socio-demographic factors significantly associated with acute diarrhea were joint family system (p=0.01), incomplete EPI vaccination (p=0.00), lack of exclusive breastfeeding (p=0.01), previous history of diarrhea (p=0.04), poor sewerage system (p=0.00) and quality of drinking water (p=0.00). Conclusion: The possible reasons for diarrhea seem to be multifactorial, so a high-risk approach should be commenced to mitigate the issue of the lower health status of children, and the primary aim of policies should be the reduction of social, economic, educational, and health disparities within the country.

In Vitro Assessment of Antifungal Property of Azadirachta Indica (Neem) Modified Heat-Cured Polymethyl Methacrylate Resin Denture Base Material After Water Storage

Nida Saeed, Mehreen Imran, Salman Khan, Hina Rehman, Imran Khan, Kamran Khan — Tue, 31 Dec 2024 00:00:00 +0000

Objective: The study's objective was to compare the antifungal properties of conventional and 2.5wt% neem-impregnated heat-cured PMMA through an adherence assay performed after 48 hours and 30 days storage time at room temperature in distilled water. Study Design: Laboratory-based experiment. Settings: Acrylic resin specimens were prepared in the Dental Materials Laboratory, Peshawar Dental College, and their antifungal tests were performed at the Department of Microbiology, Peshawar Medical College, Peshawar Pakistan. Duration: The study was completed within six months from 01-05-2021 to 30-10-2021. Methods: For this study, a total of 20 samples were made using a stainless-steel master Mold (10 x 10 x 2mm) for the fabrication of test specimens for antifungal properties prepared according to ISO 179A1:2005 specifications. Control groups were prepared according to manufacturer instructions with no neem extract. Experimental groups were reinforced with 2.5% neem extract. The antifungal property was assessed through adherence assay. Statistical analysis was done using one-way ANOVA and Post hoc Tukey’s test. P ≤0.05 was considered significant. Results: The incorporation of neem to acrylic denture base resin significantly decreased the number of colonies, as evidenced by one-way ANOVA that shows a significant result (P = 0.011). The highest number of colonies were found in the control group for 30 days of water storage followed by 48 hours of water storage samples. Conclusion: Antifungal property was significant with 2.5% neem extract, incorporated in PMMA after water storage for 48 hours and 30 days.

Incidence of Surgical Site Infections in Laparoscopic VS Open Primary Ventral Hernia Repair

Tue, 31 Dec 2024 00:00:00 +0000

Background: The ventral hernias found along the midline in anterior abdominal wall, known as “primary midline ventral hernias”, are frequent in the general population. These hernias can be addressed through two primary surgical methods: laparoscopic ventral hernia repair, which involves “intraperitoneal onlay mesh hernioplasty (IPOM)”, and traditional open herniorrhaphy or hernioplasty. Objective: This study was performed to compare the incidence of surgical site infections between the traditional open repair method and the laparoscopic repair technique of ventral hernia. Study Design: Prospective randomized control study. Settings: Surgical Unit-II, Department of Surgery at Benazir Bhutto Hospital in Rawalpindi Pakistan. Duration: January 2020 to 2022. Methods: A total of 60 patients participated, with 30 undergoing “laparoscopic ventral hernia repair (LVHR)” and 30 undergoing “open ventral hernia repair (OVHR)”. Non-probability consecutive sampling technique was employed, and the outcome variable was surgical site infection. Data analysis was conducted using SPSS (Statistical Package for Social Sciences) version 25.0, with the significance determined using the Chi-square test. A p value of ≤ 0.05 was considered as significant. Results: Out of 60 patients, surgical site infection (SSI) was present in a total of 10 patients (16.6%). Out of these 10 patients, 6.6%(n=2) had SSI in the laparoscopic group and 26.6 %(n=8) in open repair. The distribution of these frequencies was significant (p=0.001). Conclusion: Laparoscopic ventral hernia repair has a lower rate of surgical site infection as compared to open ventral hernia repair.

Anthropometric Insights: Unravelling the Nexus between Thumb Length and OVD – A Comparative Perspective

Tue, 31 Dec 2024 00:00:00 +0000

Background: Anthropometric proposals of various identification indicators, like limb lengths, skull dimensions, craniofacial measurements, and other body measurements for estimating age, sex, and stature. Thumb length is very less commonly used as an anthropometric indicator, which could be a valuable marker for stature due to its ease of measurement and preservation. Objective: A Novel Approach in the Sargodha region to investigate the correlation of OVD with thumb length measurement, connections, and association among male and female participants. Study Design: An observational cross-sectional study. Settings: Rai Medical College, Sargodha Pakistan. Duration: September to October 2023. Methods: 405 medical students from Rai Medical College, Sargodha, comprising 209 males and 196 females. The institutional review board obtained ethical approval before the commencement of the study. The occlusion’s vertical dimension was gauged from the tip of the nose to the base of the chin with the help of a modified Vernier caliper. Sample t-tests and Pearson’s correlation analysis tests performed on SPSS version 27 were performed to examine associations and correlations. Results: The correlation between the nasal septum base till the chin’s lower border and the thumb measurements is significant in females, suggesting a stronger association between facial and thumb measurements in this group. The significant correlations in females might indicate that thumb measurements are more closely related to facial measurements in this subgroup than in males. Conclusion: Our study concluded that there is a strong relationship between anthropometric measurements and demographic factors. VDO is strongly correlated with thumbs in both genders, especially in females.

Relationship Between Cigarette Smoking with Vitals of Young Male Adults in District Hyderabad, Sindh

Tue, 31 Dec 2024 00:00:00 +0000

Background: Cigarette smoking is one of the significant public health concerns worldwide. Its effect on various physiological systems is well-documented, with evidence strongly indicating its adverse effects on vitals including heart rate, blood pressure, respiratory rate, and temperature. Objective: This study aimed to find the relationship between cigarette smoking and vitals among young male adults of district Hyderabad Sindh, Pakistan. Study Design: It was a cross-sectional comparative study. Settings: Hyderabad district of Sind, Pakistan. Duration: January 2024 to March 2024. Methods: A simple random technique was used to collect the data. Blood pressure was measured by a digital sphygmomanometer in a sitting position; Heart rate was measured by using a digital pulse oximeter. Results: In this study, 365 individuals participated, categorized into two groups, smokers (n=166) and non-smokers (n=199). The mean ages of smokers were 29.65 ± 4.52, and non-smokers were 28.87 ± 4.35. Heart rate was 68.79 ±3.95 in smokers and in non-smokers 65.85 ±3.15 beats per minute, respiratory rate was 16.93 ± 2.31 in smokers and 1.27 ± 0.79 beats per minute, the temperature was 97.30 ± 0.60 in smokers, and in non-smokers, 96.48 ± 0.61 Fahrenheit, systolic and diastolic blood pressure in smokers were 121.35 ± 8.56, 82.35 ±3.75 and in non-smokers were 116.57 ±5.65, 79.68±4.23. All vitals were found to be higher in smokers compared to non-smokers. Conclusion: In this study, the findings concluded the positive association of cigarette smoking with increased vitals among young adults.

Association of Vitamin D with Severity of Rheumatoid Arthritis

Tue, 31 Dec 2024 00:00:00 +0000

Background: Low levels of serum vitamin D is associated with increased risk of Rheumatoid Arthritis, though this finding is controversial. Objective: Study was designed to find out the association of vitamin D with severity of Rheumatoid Arthritis. Study Design: Cross sectional study. Settings: Government Hospital Kot Khawaja Saeed, Lahore Pakistan. Duration: June 2017 to June 2018. Methods: 60 patients with Rheumatoid arthritis (age range 16 to 60 years fulfils the criteria of 2010 Rheumatoid arthritis classification. Patients/controls were comprised as group 1(20 patients with mild arthritis), group 2(20 patients with moderate form of arthritis) and group 3 (20 age, sex matched healthy controls). Results: Mean age of patients was 36 to 37 years. Most of the patients belong to middle class and professional whereas majority of women were house wives with average health status with normal pulse rate and blood pressure. Clinical variables of patients showed the small joint involvement, swelling, tenderness with moderate to severity of disease. By using One-way ANOVAs, it is observed that the level of vitamin D was significantly low in group of patients presented with severe form of arthritis as compared to group of patients who has mild to moderate arthritis. Study also observed that both group of patients with RA has significantly low levels of vitamin D as compared to age matched controls. Conclusion: Vitamin D deficiency may be one of the reasons to develop or worse the disease.

Assessment of Diabetes Knowledge Among Type 2 Diabetic Patients, A Cross-Sectional Observational Study of Karachi

Irfan Majid, Shakeel Ahmed, Tariq Ali Adnan, Khalil Mobin — Tue, 31 Dec 2024 00:00:00 +0000

Objective: To evaluate the knowledge of Type 2 diabetes mellitus (T2DM) among patients and identify factors influencing their understanding and management practices. Study Design: Cross-sectional observational study. Settings: The research was conducted in the MSc Diabetes & Endocrinology program of the College of Family Medicine Pakistan. Duration: from June 2023 to June 2024. Methods: 323 T2DM patients, collected data using a structured questionnaire assessing demographic information, diabetes knowledge, management practices, and awareness of complications. Statistical analysis included descriptive statistics to summarize demographic characteristics and knowledge levels and inferential statistics such as chi-square tests and logistic regression to identify factors associated with diabetes knowledge. Results: The study revealed that 48.7% of participants had moderate knowledge levels, 28.4% had high knowledge levels, and 22.9% had low knowledge levels. Higher educational attainment and programs program participation were significantly associated with better knowledge scores (p < 0.001). Patients with higher knowledge levels demonstrated better self-management practices, with significant correlations observed between knowledge and adherence to self-care practices (r = 0.58, p < 0.001). Additionally, factors such as education level, income, and duration of diabetes were significant predictors of diabetes knowledge. Conclusion: The findings indicate that while many T2DM patients possess moderate to high levels of diabetes knowledge, significant gaps remain, particularly among those with lower educational levels and limited access to educational programs. The study underscores the need for continuous and targeted educational interventions to improve diabetes knowledge and self-management practices, ultimately enhancing patient outcomes and reducing the risk of complications.

Triggering Factors and Treatment of Scabies in Faisalabad

Sarwat Jahan, Rehan Anjum, Mohammad Furqan Adeel, Shereen Javed — Tue, 31 Dec 2024 00:00:00 +0000

Objective: To study the triggering factors and treatment of scabies in Faisalabad. Study Design: Cross sectional study. Settings: Aziz Fatima Hospital, Faisalabad Pakistan. Duration: 6 months (January to June 2024) after ethical approval from hospital. Methods: Total 149 cases of adults and children (>5 years of age) with the scabies attending various skin OPDs in Faisalabad, were included in study. Demographic details, clinical profile, family and past history was noted in predesigned proforma. Self-designed questionnaire was filled by patients after validation at the start of study, statistical analysis was done using SPSS version 26 software, with significance level as p<0.05. Results: Out of 149 cases, 64.4% male and 35.6 % were female, 31.5% cases were of 21-30 years, 62.4% patients with larger families (>5 members), 68.4% with a positive family history showed significant p-value of 0.001, 63.8% cases belong to poor socioeconomic and educational status. 73.2% cases lived with sharing clothes and articles, were more affected. Most common skin lesion was eczema 32.2% cases followed by 28.2% of vesicle cases. The most affected body parts were "Finger web, axilla and groin" (13.4%), with a significant p-value of 0.001. Treatment profile include 87.9% cases used permethrin 5% lotion, 66.4% taken anti histamine, 34.9% used Ivermectin, 20% were used permethrin lotion/steroids. Conclusion: Scabies is one of the most neglected tropical diseases of young age group, which could get relieved by proper treatment and improving personal hygiene

Comparison of the Effectiveness of Sub Lingual Vs Vaginal Misoprostol in Termination of First Trimester Missed Abortion

Tue, 31 Dec 2024 00:00:00 +0000

Background: The incidence of spontaneous miscarriages increases with age. In the first trimester, the leading cause of spontaneous abortion is embryonic abnormalities, responsible for 80-90% of all miscarriages. Miscarriage affects 10-20% of clinically recognized pregnancies. Objective: To compare the effectiveness of sublingual versus vaginal routes of misoprostol in termination of first trimester missed abortion. Study Design: Quasi-experimental trial. Settings: Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar Pakistan. Duration: March, 2022 to March, 2023. Methods: The study enrolled 78 participants, equally divided into two groups, Group-A receiving misoprostol sublingually while Group-B receiving vaginal misoprostol. Data collected was analyzed using SPSS version 20, with a p-value <0.05 considered significant. Results: The mean age of participants in the sublingual group was 30 years (SD±4.24), while in the vaginal group, it was 26 years (SD±5.22). The mean gestational age was similar in both groups, about 10 weeks. Women aged 31-45 years experienced significantly higher failure rates in the vaginal group (15.38%) compared to the sublingual group (2.56%) with a p-value of 0.027. Additionally, a shorter induction-to-abortion interval of less than 12 hours was associated with a higher failure rate in the vaginal group (5.12%) vs the sublingual group (20.51%), with a p-value of 0.027. Conclusion: Our study found that misoprostol administration through sublingual route is effective than vaginal route for the medical management of missed miscarriage but the results obtained were not significant statistically.

To Determine the Diagnostic Accuracy of Strain Ultrasound Elastography in Differentiation between Benign and Malignant Breast Lesions, Taking Histopathology as Gold Standard

Tue, 31 Dec 2024 00:00:00 +0000

Background: Advances in ultrasonography have led to the development of strain elastography, a novel imaging technique that assesses tissue stiffness, providing valuable diagnostic insights. Commercially available systems typically display tissue stiffness information as a color-coded map overlaid on real-time greyscale ultrasound images. Research has demonstrated the efficacy of strain elastography in detecting breast cancer. Objective: To determine the diagnostic accuracy of strain ultrasound elastography in differentiation between benign and malignant breast lesions, taking histopathology as the gold standard. Study Design: Cross-sectional (validation) study. Settings: Radiology Department, Allied Hospital, Faisalabad Pakistan. Duration: 02-12-2018 to 01-06-2019. Methods: This study enrolled 132 patients, aged 20-60 years, with palpable breast lesions. Exclusion criteria included prior radiotherapy for breast cancer, pregnancy, and recurrent lumps. All patients underwent ultrasound elastography using a high-resolution linear array probe (7.5 MHz) followed by a biopsy. Histopathology results (benign or malignant) were compared with strain ultrasound elastography findings. Results: Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of strain ultrasound elastography in differentiation between benign and malignant breast lesions, taking histopathology as the gold standard was 91.02%, 83.33%, 88.75%, 86.54% and 87.88% respectively. Conclusion: This study demonstrates that strain ultrasound elastography is a highly sensitive and accurate diagnostic tool for identifying malignant breast lesions.

Role of Nuclear Medicine in Diagnosing Different Patterns of Thyroid Abnormalities in Patients Referred for Thyroid Scintigraphy to Centre for Nuclear Medicine and Radiotherapy (CENAR) Quetta, Pakistan

Tue, 31 Dec 2024 00:00:00 +0000

Background: Nuclear Medicine has been playing a vital role in identifying different patterns of thyroid diseases for functional assessment using thyroid scintigraphy. Objective: This study aimed to diagnose different patterns of thyroid abnormalities using thyroid scintigraphy in our area for their proper management. Study Design: Retrospective study. Settings: study was conducted at the Centre for Nuclear Medicine and Radiotherapy (CENAR) Quetta, Pakistan. Duration: April 2023 and September 2023. Methods: The study population comprised 440 patients, with a mean age of 37± 13 years, who were referred to the CENAR Nuclear Medicine department for thyroid scintigraphy between April 2023 and September 2023. Of these, 357 (81.1%) were female and 83 (18.9%) were male. Results: According to study findings, the highest proportion, i.e., 59.1% (80.4% females and 19.6% males) of total patients, were reported between 21-40 years of age. Out of 440 patients, thyroid scintigraphy findings were normal in 4.5 % (20 patients) and abnormal in 95.5% (420 patients). The scan patterns included, functioning nodule 42 (9.6%), multinodular goiter 34 (7.7%), diffuse goiter 9 (2%), diffuse goiter with increased uptake (Grave’s disease) 145 (33%), multinodular goiter with dominant cold nodule 29 (6.6%), thyroiditis 25 (5.7%), cold nodule 83 (18.9%), extrathyroidal swelling 3 (0.7%), hot nodule 8 (1.8%), recurrent MNG 1 (0.2%), thyroid cancer post-surgical scans 41 (9.3%) and normal 20 (4.5%). Conclusion: This study concluded that radionuclide thyroid scintigraphy is complementary and offers data that can aid in the proper management of a range of thyroid-related disorders.

Frequency of Serous Fluid Output via Drain after Mesh Repair of Para-Umbilical Hernia with or without Dead Space Obliteration

Tue, 31 Dec 2024 00:00:00 +0000

Background: Seroma development is still a substantial issue following mesh Hernioplasty, and the reason for this is multifaceted. Multiple methods have been tried to combat this problem. Objective: To compare the volume of serous fluid output via drain after mesh repair of a Para-umbilical hernia with or without dead space obliteration. Study Design: Randomized controlled trial. Settings: Department of Surgery, Allied Hospital, Faisalabad Pakistan. Duration: from14th March 2020 to 13th March 2021. Methods: 194 patients with para-umbilical hernia of size between 4-10cm and of any duration, 25 to 65 years of age of either gender were included. Patients with previous repair of para umbilical hernia, pregnant females, and hematoma formation were excluded. A quilting suturing technique was used in group A patients, while in group B patients, a simple closure technique was used. Drain output was noted on the 5th day of surgery. Results: Mean age of patients in group A was 49.89 ± 10.03 years, and in group B was 47.08 ± 10.56 years. Out of these 194 patients, 49 were female, and 145 were male. Serous fluid output >50 ml was seen in 8 (8.25%) patients in group A (quilting suturing technique) and 18 (18.56%) patients in group B (without quilting suturing) with a p-value of 0.035. Conclusion: This study concluded that volume of serous fluid formation is less as measured by drain output after dead space obliterations compared to simple closure technique in para umbilical hernia repair.

Factors Affecting the Academic Performance of Dental Students

Tue, 31 Dec 2024 00:00:00 +0000

Background: Dental students face unique challenges that can impact their academic performance. Factors that affect their academic success can range from personal factors such as motivation and time management to external factors such as the learning environment and curriculum. Understanding these factors can help educators and students create strategies to improve academic performance. Objective: This study aims to identify factors that are crucial for dental students’ academic performance in a dental school. Study Design: Cross-sectional study. Settings: University College of Medicine & Dentistry, University of Lahore, Lahore Pakistan. Duration: Two months from September 2021 to November 2021. Methods: In November 2021, a questionnaire-based study was conducted at the University College of Medicine and Dentistry. Only undergraduate dental students were selected, while postgraduates and demonstrators were excluded. Results: A total of 138 dental students of all four years were included in our study, consisting of 41.3% males and 58.7% females. The majority of surveyed students were single, 95.6%. Forty-five percent of high achievers were males, while 34% of males were low achievers. 55% of females were high achievers, and 66% of females were low achievers. Conclusion: Many factors crucial for the academic excellence of dental students were identified, such as limited use of social media, strong motivation for achieving higher goals, and isolated and conceptual study. However, new, more structured studies needed to reinforce these factors, as academic excellence cannot be verified by only one study.

Cadmium Toxicity: An Experimental Study to Illustrate the Toxic Effects of Cadmium Exposure and the Role of BSA to Develop Autoimmunity in the Kidneys of Albino Mice

Nasim Aslam Ghumman, Farwa Batool Shamsi, Qurat ul Ain Javaid — Tue, 31 Dec 2024 00:00:00 +0000

Background: Cadmium is a toxic heavy metal that causes nephrotoxicity. Chronic exposures lead to cadmium accumulation in kidneys, causing histopathological and physiological dysfunction. Objective: To assess the nephrotoxic effects of chronic cadmium exposure on the kidneys of albino mice. Study Design: Randomized controlled trial. Settings: University of Health Science, Lahore Pakistan. Duration: Six months from 01-03-2014 to 31-08-2014. Methods: In this study, 48 albino mice were randomly divided into 4 groups (12 each): one control and three experimental groups (A, B, and C). Cadmium exposure, such as cadmium chloride (CdCl₂), was administered orally and intraperitoneally on alternate days for 8 weeks at a 10 mg/kg body weight. Bovine Serum Albumin (BSA) was introduced in the control group to observe the early devastating changes in the glomeruli. Results: The findings of present study presented the mesangial hypercellularity causing glomerular swelling, glomerular bonds, increased thickness of the glomerular capillaries, crescentic nephropathy, tubular dilatation, deterioration of renal tubules, interstitial inflammation and accumulation of protein cast in renal tubules along with many other histopathological changes. Biochemical changes were mainly proteinuria and alterations in serum creatinine. However, all the histopathological lesions and biochemical changes depended on the exposure route. Conclusion: In conclusion, the study found significant kidney histopathological and biochemical damage in mice exposed to cadmium chloride, emphasizing the nephrotoxic nature of cadmium. The route of cadmium administration influenced the extent of the kidney damage, accentuating the need to consider exposure routes in evaluating kidney damage.

Treatment-Resistant Depression: A Comprehensive Insight of Ketamine Infusion Therapy, Transcranial Magnetic Stimulation (TMS), and Psychedelic-Assisted Psychotherapy

Mohammad Ali, Urbah Viqar — Tue, 31 Dec 2024 00:00:00 +0000

Background: The phenomenon of treatment-resistant depression (TRD) remains a problem in the sphere of mental health treatment since the majority of patients do not experience positive effects while receiving traditional treatments. Newer therapies are ketamine infusion therapy for depression, transcranial magnetic stimulation, and psilocybin-assisted psychotherapy give new hope. Objective: To evaluate the efficacy of ketamine infusion therapy, transcranial magnetic stimulation (TMS), and psilocybin-assisted psychotherapy as new treatment strategies in patients with TRD. Ketamine, which belongs to the class of NMDA receptor antagonists, has been seen to have rapid and efficient anti-depressant effects. Study Design: Retrospective review. Settings: Islamabad, Pakistan. Duration: One year and six months from December 2022 to June 2024. Methods: This study employed a systematic review methodology, searching major medical and psychological databases (PubMed, PsycINFO, Embase, and Cochrane Library) using keywords and MeSH terms related to treatment-resistant depression, ketamine infusion therapy, TMS, and psychedelic-assisted psychotherapy. Focus was on clinical trials, meta-analyses, systematic reviews, and observational studies, while excluding animal studies, case reports, and non-peer-reviewed articles. Results: The review yielded 80 studies, comprising 55 clinical trials, 10 meta-analyses, 10 systematic reviews, and 5 observational studies. The results showed that ketamine infusion therapy, Transcranial Magnetic Stimulation (TMS), and psychedelic-assisted psychotherapy demonstrated significant improvements in clinical outcomes for treatment-resistant depression. Conclusion: The review shows that ketamine infusion therapy and psychedelic-assisted psychotherapy are promising treatments for treatment-resistant depression, providing significant clinical improvements

Comparison of Closed versus Open Rhinoplasty in Management of Traumatic Nasal Deformities in Terms of Mean Correction of Nasal Deviation

Tue, 31 Dec 2024 00:00:00 +0000

Objective: The Aim was to contrast the mean correction of nasal deviation between closed and open rhinoplasty in treating traumatic nasal abnormalities. Techniques: An RCT was used. The OPD of ENT Unit-1 Allied Hospital Faisalabad enrolled 60 patients matching the inclusion criteria. Both open (Group A) and closed (Group B) rhinoplasties were done at random using the lottery technique. Under GA, the same consultant carried out the surgeries. Patients were monitored for a month in order to address nasal deviations (at post-operative, second and fourth week). Final evaluation was conducted on 28th day. Results: In Group A 33.33 percent and in Group B 40 percent patients were between the ages of 41 and 60. In Group A (open approach) 66.67 percent (n=20) and in Group B (closed approach) 60 percent (n=18) were between the ages of 18 and 40. The mean and standard deviation were 35.4+11.02 and 37.53+10.91 years, respectively. Males in group A made up 70 percent (n=21) and of Group B 63.33 percent(n=19), whilst females in group A made up 30 percent (n=9) and in group B 36.67 percent (n=11). The bony component was corrected as 16.00+3.59 in A Group and 10.40+2.59 in B Group, with a p-value of .001, while the cartilage component was corrected as 11.63+1.92 in A Group and 7.40+4.45 in B Group, with a p-value of .0001, indicating a significant difference. Conclusion: open rhinoplasty improves mean nasal deviation better than closed rhinoplasty.