Search

Objective: To find out the incidence of surgical site infection in clean cases of orthopaedic surgery. Study design: Retrospective descriptive study. Setting: Trauma and orthopaedic unit Gulab Devi Hospital. Duration: April 2018 to November 2021 Methodology: Using non probability (purposive) sampling a total of 800 patients who underwent an invasive surgical procedure during the specified time period was included in the study. While all non-invasive procedures such as manipulations, application of plaster casts and image guided intra-articular injections were excluded from study. p-value< 0.05 was considered as significant Results: There were 504(63%) male patients and 296(37%) female patients. Age range was between 01 to 86 years. Mean age was 30±6.7 years. After performing surgery, all patients were followed up for minimum of four weeks to record SSIs. Post-operatively infection was detected in 17(2.12%) of our patients. SSI was 5.8% in clean cases, 23.5% in clean contaminated and 70.5% in dirty cases. The prevalence of SSI were significantly higher in those patients already having dirty wound before procedure as p

Objective: To determine the frequency of Osteoporosis in Chronic Obstructive Pulmonary Disease, (COPD). Study Design: Cross Sectional study. Setting: Husan Ara Unit, Gulab Devi Hospital Lahore. Period: July 2017 to January 2018. Material & Methods: One hundred fifty patients with COPD meeting the inclusion criteria were included in the study. Bone mineral density (BMD) was calculated in each patient. Bone mineral density (BMD) was calculated via Dual Energy X-ray Absorptiometry (DEXA) scan. Osteoporosis was labeled when value for BMD was found < –2.5 SD below the mean for young adults (T-score). Results: The mean age was 56.54+ 8.04 year. The majority (90.7%) of the patients were male and fourteen (9.3%) patients were female. The mean T-score was -2.07+ 0.76 SD. Twenty-two (14.7%) patients had BMD score within normal range, out of which nineteen were males and three were females. Fifty-seven (38.0%) patients were found to have osteopenia of which fifty-four were males and three were females. Seventy-one (47.3%) patients had osteoporosis with sixty-three males and eight females. Conclusion: Majority of the patients with COPD who had osteopenia and osteoporosis correlated with COPD severity stages and were males above 50 year age. The male preponderance highlights towards the increased incidence of smoking amongst them and perhaps the male oriented society in Pakistani culture.

Background and Objective: COVID-19 disease is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) having a wide variety of clinical features ranging from asymptomatic carriers to respiratory failure requiring mechanical ventilation. The objective of the study was to analyze the spectrum of different symptoms, laboratory findings and complications in patients who were admitted in either COVID ward or intensive care unit (ICU) of a local hospital. Methods: A retrospective cohort study of the medical records of 100 COVID-19 disease patients with PCR detected SARS-CoV-2 infection were collected. Participant information was retrospectively obtained from the hospital medical records which included clinical records and laboratory findings. All statistical analyses were done using Statistical Package for the Social Sciences (SPSS) version 21. Results: The mean age of the patients was 50.8 ±5.86 with male predominance (79%). Most frequent co-morbidities were diabetes mellitus (42%) and hypertension (36%). Most frequent symptoms were fever (95.9%) and fatigue (95.9%) followed by dry cough (86.5%), myalgia (85.1) and shortness of breath (70%). Amongst the patients admitted, leukocyte count was 10.95 x 103, C-reactive protein (CRP) was 12.8mg/dl, ferritin was 730.8ng/ml and Lactate Dehydrogenase (LDH) was found to be 1254.7 U/l. Hepatic and renal functions were borderline deranged. Conclusion: COVID-19 disease has a wide spectrum of clinical symptoms. Patients with raised inflammatory markers have severe disease and are more likely in need of an ICU care. By carefully observing these markers may help in better management of COVID-19 disease.

The current study examines the mental health of patients diagnosed with Covid 19. Descriptive research design was used in this study. Data of 100 patients was collected from Lahore General Hospital through convenient sampling. Pakistan Anxiety and Depression Scale was used to find out mental health of patients in domains of anxiety and depression. According to the findings, mostly patients reported moderate level of anxiety and depression. Results also showed that females experience more depression and anxiety as compared to males. It was also seen that patients living in nuclear family systems show more anxiety as compared to those who live in joint family system. Furthermore, age was positively while family income negatively related with anxiety and depression. These findings can be helpful to highlight importance of need of mental health services to reduce psychological impact of this outbreak

Background: Multiple western studies have focused on anemia in COPD and observed that anemia is more prevalent in COPD patients than Polycythemia. Anemia significantly increases the morbidity and deteriorates the functional status of COPD patients. Objectives: The objective of current study was to determine the frequency of anemia in Chronic Obstructive Pulmonary Disease (COPD) patients present in a tertiary care hospital. Study Design: Retrospective Material and Methods:Two hundred COPD patients fulfilling the inclusion criteria were selected for the study. Hemoglobin (Hb) level test was done on all patients. Hb level was calculated byAutomated Blood Cell Analyzer and anemia was labeled at Hb

Background There is scarce knowledge on the prevalence of diseases caused by non-tuberculous mycobacteria (NTM) in Pakistan. In the absence of culture and identification, acid-fast bacilli (AFB) causing NTM disease are liable to be misinterpreted as tuberculosis (TB). Introduction of nucleic acid amplification testing for Mycobacterium tuberculosis complex (MTBC) offers improved diagnostic accuracy, compared with smear microscopy, and also assists in differentiating MTBC from other mycobacteria. This study aimed to investigate the prevalence of NTM among patients investigated for TB and describe NTM disease and treatment outcomes at a tertiary care hospital in Pakistan. Methods This is a retrospective study, data on NTM isolates among culture-positive clinical samples over 4 years (2016–19) was retrieved from laboratory records. Information on clinical specimens processed, AFB smear results, and for the AFB positive isolates, results of species identification for MTBC, and for NTM isolates, results of species characterization and drug susceptibility testing was collected. Additional clinical data including patient characteristics, treatment regimens, and outcomes were collected for patients with NTM disease treated at Gulab Devi Hospital, Lahore. Results During the study period, 12,561 clinical specimens were processed for mycobacterial culture and 3673 (29%) were reported positive for AFB. Among these 3482 (95%) were identified as MTBC and 191 (5%) as NTM. Among NTM, 169 (88%) were isolated from pulmonary and 22 (12%) from extrapulmonary specimens. Results of NTM speciation were available for 60 isolates and included 55% (n = 33) M. avium complex and 25% (n = 15) M. abscesses. Among these patients, complete clinical records were retrieved for 12 patients with pulmonary disease including nine infected with M. avium complex and three with M. abscessus. All 12 patients had a history of poor response to standard first-line anti-TB treatment. Ten patients were cured after 18 months of treatment, whereas, one with M. abscessus infection died and another was lost to follow up. Conclusion In TB endemic areas, NTM can be misdiagnosed as pulmonary TB leading to repeated failed anti-TB treatment and increased morbidity, emphasizing the need for improved diagnosis.

Objectives Pulmonary embolism (PE) is seven times more common in cancer patients than non-cancer patients. Since the existing clinical prediction rules (CPRs) were validated predominantly in a non-cancer population, we decided to look at the utility of arterial blood gas (ABG) analysis and D-dimer in predicting PE in cancer patients. Methods Electronic medical records were reviewed between December 2005 and November 2010. A total of 177 computed tomography pulmonary angiograms (CTPAs) were performed. We selected 104 individuals based on completeness of laboratory and clinical data. Patients were divided into two groups, CTPA positive (patients with PE) and CTPA negative (PE excluded). Wells score, Geneva score, and modified Geneva score were calculated for each patient. Primary outcomes of interest were the sensitivities, specificities, positive, and negative predictive values for all three CPRs. Results Of the total of 104 individuals who had CTPAs, 33 (31.7%) were positive for PE and 71 (68.3%) were negative. There was no difference in basic demographics between the two groups. Laboratory parameters were compared and partial pressure of oxygen was significantly lower in patients with PE (68.1 mmHg vs. 71 mmHg, p = 0.030). Clinical prediction rules showed good sensitivities (88-100%) and negative predictive values (93-100%). An alveolar-arterial (A-a) gradient > 20 had 100% sensitivity and negative predictive values. Conclusions CPRs and a low A-a gradient were useful in excluding PE in cancer patients. There is a need for prospective trials to validate these results.