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1.
BMC Infect Dis ; 21(1): 622, 2021 Jun 30.
Artigo em Inglês | MEDLINE | ID: mdl-34193071

RESUMO

BACKGROUND: Cutaneous Leishmaniasis (CL) is a neglected tropical disease, which mainly affects poor communities. It is one of the major vector-borne disease and endemic in Pakistan. METHODS: A case-control study to evaluate potential risk factors of human-CL was conducted in Khewra region, District Jhelum, Pakistan from January-April 2014. Case data about 90 cases registered during October 2012 to November 2013 was retrieved from Municipal Hospital. Controls were matched (1,1 ratio) on the date of registration with cases from same hospital. Both cases and controls were invited to participate and data was collected in a face-to-face interview. A prospective study of canine leishmaniasis (canine-CL) was also conducted at Civil Veterinary Hospital in the same area. Suspected dogs with skin ulceration signs were included in the study and blood samples were collected. Statistical analyses were conducted to determine association between various parameters and outcome of interest. RESULTS: The ages of cases ranged from 1 to 76 years (median = 15 years) and proved to be protective factor i.e. increase in each year in age reduced the likelihood of being infected with human-CL [Odds Ratio (OR) = 0.4, 95% Confidence Interval (CI) = 0.25-0.76]. People sleeping outsides in an open area were more likely to become a case (OR = 8.7, 95% CI = 2.90-26.37) than a control. Poor sanitary condition inside the house (OR = 3.3, 95% CI 1.03-10.56) and presence of other animals in house (livestock, poultry) (OR = 3.6, 95% CI = 1.07-12.12) also identified as risk factors of high significance. The proportion of positive dogs with canine-CL was 21.05% and was significantly associated with human-CL cases in the same area (p < 0.05). CONCLUSIONS: We concluded that adopting self-protections measures against sand-fly, and maintaining good hygiene may lower the risk of human-CL. One-Health Strategy is suggested to control leishmaniasis in human and dog population.


Assuntos
Leishmaniose Cutânea/epidemiologia , Doenças Negligenciadas/epidemiologia , Adolescente , Adulto , Distribuição por Idade , Idoso , Animais , Estudos de Casos e Controles , Criança , Pré-Escolar , Cães , Feminino , Humanos , Lactente , Leishmaniose Cutânea/veterinária , Masculino , Pessoa de Meia-Idade , Doenças Negligenciadas/veterinária , Saúde Única , Paquistão/epidemiologia , Estudos Prospectivos , Fatores de Proteção , Psychodidae , Fatores de Risco , Saneamento
2.
J Coll Physicians Surg Pak ; 30(7): 786-791, 2021 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-34271777

RESUMO

OBJECTIVE: To determine the high risk-human papillomavirus (HR-HPV) prevalence, genotype distribution, and associated risk factors in women with general gynaecological problems. STUDY DESIGN: Descriptive, cross-sectional study. PLACE AND DURATION OF STUDY: Lady Wallingdon Hospital, Lahore from August 2018 to May 2019. METHODOLOGY: One hundred females with general gynaecological problems constituted the sample. Real-time polymerase chain reaction and liquid base cytology were performed for HR-HPV detection, genotyping, and cytological changes in cervical samples. RESULTS: The overall prevalence of HR-HPV was found to be 57%, with the most frequent HR-HPV genotypes HPV 16 (18%), HPV 18 (6%), and HPV 45 (1%). The total prevalence of single HR-HPV infection was 25%; whereas, multiple co-infection of HR-HPV was seen in 32% of cases. In total, 81% of these women had normal cytology and 19% had cytologic abnormalities. A significant association was observed between HR-HPV infection and general gynaecological complaints and between HR-HPV infection and cytological abnormalities (p < 0.001). CONCLUSION: The HR-HPV prevalence was 57% with the most prevalent genotypes were HPV 16 and HPV 18. The results will also aid the identification of HR-HPV 51 and 31 genotypes, which should be added in the multi-type HPV vaccines. Key Words: Cancer of cervix, Human papillomavirus, Papanicolaou test, Pakistan.


Assuntos
Alphapapillomavirus , Infecções por Papillomavirus , Neoplasias do Colo do Útero , Colo do Útero , Estudos Transversais , DNA Viral/genética , Feminino , Genótipo , Humanos , Paquistão/epidemiologia , Papillomaviridae/genética , Infecções por Papillomavirus/diagnóstico , Infecções por Papillomavirus/epidemiologia , Prevalência , Neoplasias do Colo do Útero/epidemiologia
3.
J Coll Physicians Surg Pak ; 31(7): 104-108, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34271805

RESUMO

OBJECTIVE: With the spread of COVID-19 in Pakistan, Balochistan province with its unique problems of lowest literacy rates in the country, limited resources and a flail health care system is reporting an increasing number of cases of COVID-19. This study discusses the epidemiological and clinical characteristics of COVID-19 patients from the Balochistan province. STUDY DESIGN: Situation report Place and Duration of Study: The study was conducted in Balochistan province of Pakistan. The completion date for the study was April 30, 2020. METHODOLOGY: The data was retrieved from the daily situation report from the Health Department, Government of Balochistan. Descriptive statistics (proportions, mean ± SD) were used for data analysis. RESULTS: A total of 1136 patients were confirmed to have COVID-19. The highest rate was found in cases with ages >60 years. About 78% of COVID-19 cases were males and majority of the cases (78.56%)were asymptomatic. Out of these, 183 recovered and 16 died. The case fatality rate was 1.3%. CONCLUSION: COVID-19 cases and case fatality ratio is low in Balochistan. Whether this is due to inability to carry out more tests is still to be ascertained. Males and elderly are more affected and fatalities were higher in cases with co-morbid conditions. Balochistan having a weak healthcare system and with the majority of cases being asymptomatic, needs more stringent actions to practice social distancing to avoid further spread of COVID-19.


Assuntos
COVID-19 , Idoso , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , SARS-CoV-2
4.
J Pak Med Assoc ; 71(4): 1118-1122, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-34125754

RESUMO

OBJECTIVE: The study aimed to explore the association of endometriosis risk factors with single nucleotide polymorphisms rs6166 and rs6165 (Asn680Ser and Ala307Thr) of follicle stimulating hormone receptor (FSHR) gene in Pakistani women. METHODS: This study was conducted from 2013 to 2016. The sampling and extraction of DNA was done in Department of Zoology GC University, Lahore, while the sequencing was performed at Yale University, USA. This case control study consisted of 364 subjects including 156 women diagnosed with endometriosis and 208 conveniently recruited controls. Subjects diagnosed at stage II-IV endometriosis with infertility were pooled for study. The women with adenomyosis, ovarian cancer and leiomyoma were excluded. The whole blood leukocytes were used for DNA extraction. Two important polymorphisms of exon 10 of FSHR gene were analyzed by direct DNA sequencing both in endometriosis and controls. Results: Genetic variant SNP rs6166 in the affected endometriosis subjects exhibited high incidence of allele "A" (Asn/Asn) 68.3% as compared to controls 33.7% (OR= 4.240; P =0.001). Similarly, the allele "A" of SNP rs6165 (Thr/Thr) was more frequent in endometriosis 67.3% than in control subjects 37.5% (OR =3.430, P =0.001). The occurrence of haplotype AA (Asn/Thr) was 45.5% in endometriosis and 11 % in control subjects (P= 0.001). Remarkably, the incidence of haplotype GG (Ser/Ala) was contrary to previous observations, since only 9.9% occurred in endometriosis as opposed to 45.2% in controls (P= 0.001). CONCLUSIONS: Investigation of FSHR gene polymorphisms rs6165and rs6166 (Ala307Thr and Asn680Ser) in the current study showed that haplotype AA (680Asn/307Thr) was associated with endometriosis in Pakistani women.


Assuntos
Endometriose , Receptores do FSH , Estudos de Casos e Controles , Endometriose/epidemiologia , Endometriose/genética , Feminino , Genótipo , Humanos , Paquistão/epidemiologia , Polimorfismo de Nucleotídeo Único , Receptores do FSH/genética , Centros de Atenção Terciária
5.
Sci Prog ; 104(2): 368504211023282, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34152874

RESUMO

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.


Assuntos
COVID-19/epidemiologia , Controle de Infecções/organização & administração , Pandemias , Cirurgiões/organização & administração , Centro Cirúrgico Hospitalar/organização & administração , Adulto , Ansiedade/psicologia , COVID-19/diagnóstico , COVID-19/psicologia , Teste para COVID-19 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Equipamento de Proteção Individual/ética , Equipamento de Proteção Individual/provisão & distribuição , Saúde Pública , SARS-CoV-2/patogenicidade , Cirurgiões/psicologia , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos/organização & administração
6.
J Coll Physicians Surg Pak ; 30(6): 638-643, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-1262739

RESUMO

OBJECTIVE: To assess disease severity, based on clinical presentation and laboratory investigations. STUDY DESIGN:  Observational study. PLACE AND DURATION OF STUDY: COVID-19 Isolation Unit of Mayo Hospital, Lahore from 15th March to 31st May, 2020. METHODOLOGY: Four hundred and forty-five COVID-19 RT-PCR positive patients of either gender in age group of 18-80 years, admitted in isolation wards, high dependency units (HDUs) and intensive care units (ICUs) of the Hospital, were selected for the study via simple random sampling. Clinical presentations and laboratory investigations were recorded for all patients. Kruskal-Wallis test, Pearson Chi-square test, boxplots and ROC curve were used to analyse the data. A p-value ≤0.05 was considered statistically significant. RESULTS: Out of the 445 cases, a male predominance 286 (64.3%) was observed with majority of patients 324 (72.8%) having mild disease, 73 (16.4%) moderate, 25 (5.6%) severe and 23 (5.2%) having critical disease. D-dimer was considered to be the best discriminatory marker to assess disease severity with an overall accuracy of 92.1%. CONCLUSION: Fever, sore throat, shortness of breath, body aches, abdominal pain, anosmia and aguesia were the predominant symptoms in majority of patients belonging to different categories based on disease severity. Inflammatory markers like D-dimers and ferritin levels determined the overall disease severity with a high accuracy. Key Words: Disease severity, Clinical presentation, Laboratory investigations, RT-PCR.


Assuntos
COVID-19 , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Hospitais , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , SARS-CoV-2 , Índice de Gravidade de Doença , Adulto Jovem
7.
PLoS One ; 16(6): e0253367, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34138956

RESUMO

The COVID-19 has caused the deadliest pandemic around the globe, emerged from the city of Wuhan, China by the end of 2019 and affected all continents of the world, with severe health implications and as well as financial-damage. Pakistan is also amongst the top badly effected countries in terms of casualties and financial loss due to COVID-19. By 20th March, 2021, Pakistan reported 623,135 total confirmed cases and 13,799 deaths. A state space model called 'Bayesian Dynamic Linear Model' (BDLM) was used for the forecast of daily new infections, deaths and recover cases regarding COVID-19. For the estimation of states of the models and forecasting new observations, the recursive Kalman filter was used. Twenty days ahead forecast show that the maximum number of new infections are 4,031 per day with 95% prediction interval (3,319-4,743). Death forecast shows that the maximum number of the deaths with 95% prediction interval are 81 and (67-93), respectively. Maximum daily recoveries are 3,464 with 95% prediction interval (2,887-5,423) in the next 20 days. The average number of new infections, deaths and recover cases are 3,282, 52 and 1,840, respectively, in the upcoming 20 days. As the data generation processes based on the latest data has been identified, therefore it can be updated with the availability of new data to provide latest forecast.


Assuntos
Teorema de Bayes , COVID-19/diagnóstico , Previsões/métodos , Modelos Lineares , SARS-CoV-2/isolamento & purificação , Algoritmos , COVID-19/epidemiologia , COVID-19/virologia , Humanos , Paquistão/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2/fisiologia
8.
Front Public Health ; 9: 588537, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1285353

RESUMO

Background: Outbreak of COVID-19, in many countries, has imposed a lockdown on their residents. The usefulness of extenuative actions is extremely reliant on society's knowledge, attitudes, and practices (KAP) toward pandemic control. Objective: This study aimed to explore the awareness, attitudes, and practices of the general Pakistani population to COVID-19. Methods: From June 13, 2020, until June 30, 2020, a cross-sectional online KAP survey was conducted among the Pakistani public. For data collection, a validated self-administered questionnaire was used. The survey instrument consisted of six demographic characteristics, 14 items on knowledge, four on attitudes, and six items on practices, modified from a previously published questionnaire on COVID-19. Results: The present study included 2,307 participants, 58.3% males and 41.7% of females. The majority (86.7%) sought information from social media (SM) and television, 95% had good practices, 89.9% had positive attitudes, and two-thirds (67.4%) of the respondents had adequate knowledge. The students and people from younger age groups had more positive attitudes compared with others. Highly educated w with other groups (p < 0.001). In logistic regression analysis, the odds ratio indicated that the private job was negatively associated, and high monthly income was positively associated with adequate knowledge (OR = 0.595). Old age was the predictor of negative attitude, and high school degrees and master's degrees were associated with good practice scores. Conclusion: The Pakistani general population has an overall positive attitude and proactive practices against COVID-19, but their knowledge is inadequate. The most important source of information was SM, followed by television. These are playing a crucial role in educating the Pakistani public.


Assuntos
COVID-19 , Pandemias , Controle de Doenças Transmissíveis , Estudos Transversais , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Paquistão/epidemiologia , Pandemias/prevenção & controle , SARS-CoV-2
9.
Sci Prog ; 104(2): 368504211023282, 2021.
Artigo em Inglês | MEDLINE | ID: covidwho-1277842

RESUMO

The surgical theatre is associated with the highest mortality rates since the onslaught of the COVID-19 pandemic. However, Operating Department Practitioners (ODPs) are neglected human resources for health in regards to both professional development and research for patient safety; even though they are key practitioners with respect to infection control during surgeries. Therefore, this study aims to describe challenges faced by ODPs during the pandemic. The secondary aim is to use empirical evidence to inform the public health sector management about both ODP professional development and improvement in surgical procedures, with a specific focus on pandemics. A qualitative study has been conducted. Data collection was based on an interview guide with open-ended questions. Interviews with 39 ODPs in public sector teaching hospitals of Pakistan who have been working during the COVID-19 pandemic were part of the analysis. Content analysis was used to generate themes. Ten themes related to challenges faced by ODPs in delivering services during the pandemic for securing patient safety were identified: (i) Disparity in training for prevention of COVID-19; (ii) Shortcomings in COVID-19 testing; (iii) Supply shortages of personal protective equipment; (iv) Challenges in maintaining physical distance and prevention protocols; (v) Human resource shortages and role burden; (vi) Problems with hospital administration; (vii) Exclusion and hierarchy; (viii) Teamwork limitations and other communication issues; (ix) Error Management; and (x) Anxiety and fear. The public health sector, in Pakistan and other developing regions, needs to invest in the professional development of ODPs and improve resources and structures for surgical procedures, during pandemics and otherwise.


Assuntos
COVID-19/epidemiologia , Controle de Infecções/organização & administração , Pandemias , Cirurgiões/organização & administração , Centro Cirúrgico Hospitalar/organização & administração , Adulto , Ansiedade/psicologia , COVID-19/diagnóstico , COVID-19/psicologia , Teste para COVID-19 , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Equipamento de Proteção Individual/ética , Equipamento de Proteção Individual/provisão & distribuição , Saúde Pública , SARS-CoV-2/patogenicidade , Cirurgiões/psicologia , Procedimentos Cirúrgicos Operatórios/estatística & dados numéricos , Inquéritos e Questionários , Recursos Humanos/organização & administração
10.
J Pak Med Assoc ; 71(5): 1332-1336, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091609

RESUMO

Objectives: To find the association between interleukin-1 receptor-associated kinase 1 rs3027898 gene polymorphism and preeclampsia. METHODS: The case-control study was conducted from October, 2018 to September, 2019 at the Railway General Hospital and the Department of Biochemistry, Islamic International Medical College, Rawalpindi, Pakistan, and comprised patients diagnosed with preeclampsia and healthy controls. The interleukin receptor-associated kinase-1 polymorphism was determined using multiplex tetra primer amplification refractory mutation system polymerase chain reaction. Outcomes were determined in terms of association of interleukin receptor-associated kinase-1 with preeclampsia. Data was analysed using SPSS 22. RESULTS: Of the 160 subjects, 80(50% were cases with a mean age of 30±5.3 years and 80(50%) were controls with a mean age of 27±3.7 years. AC genotype was seen in 45(56.25%) cases and 30(37.5%) controls, AA genotype in 25(31.25%) cases and 30(37.5%) controls, while CC genotype was seen in 10(12.5%) cases and 20(25%) controls (p>0.05). CONCLUSIONS: There was no significant association of interleukin receptor-associated kinase-1 genotypes with preeclampsia.


Assuntos
Pré-Eclâmpsia , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Quinases Associadas a Receptores de Interleucina-1 , Paquistão/epidemiologia , Polimorfismo Genético , Pré-Eclâmpsia/epidemiologia , Pré-Eclâmpsia/genética , Gravidez , Receptores de Interleucina-1 , Adulto Jovem
11.
J Pak Med Assoc ; 71(5): 1341-1344, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091611

RESUMO

OBJECTIVE: To find out the moderating effect of emotion reactivity and several demographic variables following symptoms of post-traumatic stress disorder among individuals having undergone an amputation. METHODS: The cross-sectional study was conducted from March to July 2015 at the Government College University, Lahore, Pakistan, and comprised individuals, enrolled from difference orthopaedic and rehabilitation centres, aged 18-60 years having undergone amputation of upper or lower limb either because of diseases, like diabetes, gangrene, cancer ulcer, or because of traumatic injuries, like road accident, electrical shock. Assessment of the study variables was done using the Emotion Reactivity Scale and the Post-traumatic Stress Disorder Checklist-5. Data was analysed using SPSS 21. RESULTS: Of the 160 subjects, 117(72%) were males and 43(28%) were females. The overall mean age was 38.45±13.17 years. Upper limb amputation cases were 17(10.6%), lower limb 138(86.2%) and both upper and lower limb amputation 5(3.2%). Amputation due to any disease was the case with 76(47.5%) subjects, while traumatic injury was the cause in 84(52.5%). There was a significant positive association of emotional reactivity with symptoms severity of post-traumatic stress disorder (p<0.05). CONCLUSIONS: Post-amputation effects were found to have a significant impact on individual emotions, and traumatic flashbacks had a leading role in the development of post-traumatic stress disorder symptoms severity.


Assuntos
Amputados , Transtornos de Estresse Pós-Traumáticos , Adulto , Estudos Transversais , Emoções , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Transtornos de Estresse Pós-Traumáticos/epidemiologia
12.
J Pak Med Assoc ; 71(5): 1345-1349, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091612

RESUMO

Objective: To determine the association of depression with dental caries and periodontal disease. METHODS: The cross-sectional descriptive study was conducted at the Nishtar Institute of Dentistry, Multan, Pakistan, from May 7, 2018 to January 7, 2019, and comprised samples from subjects with dental caries and periodontal disease. Hospital Anxiety and Depression Scale was applied to screen the participants for the presence or absence of depression. Data was analysed using SPSS 21. RESULTS: Of the 296 participants, 125(42.2%) were males and 171(57.7%) were females. The overall mean age was 38.74±12.87 years. Depression was found in 195(65.8%) patients. Significant association of depression in patients of dental caries and periodontal disease was found with female gender, age <50 years, illiteracy, marital status, pre-existing hypertension, coronary artery disease, illicit substance addiction and psychotropic medication use (p<0.05). Conclusion: There was high frequency of depression among patients of dental caries and periodontal disease.


Assuntos
Cárie Dentária , Doenças Periodontais , Adulto , Estudos Transversais , Cárie Dentária/epidemiologia , Depressão/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Doenças Periodontais/complicações , Doenças Periodontais/epidemiologia , Centros de Atenção Terciária
13.
J Pak Med Assoc ; 71(5): 1350-1352, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091613

RESUMO

OBJECTIVE: To assess the relationship between drive for muscularity and muscle dysmorphic tendencies in Pakistani bodybuilders. METHODS: The cross-sectional study was conducted in Lahore, Pakistan, from June to September 2017, and comprised male bodybuilders in their early and middle adulthood. Data was collected using an indigenous Drive for Muscularity Inventory and the Body Dysmorphic Disorder factors of the Yale-Brown Obsessive Compulsive Scale. Data was analysed using SPSS 21. RESULTS: There were 211 subjects with a mean age of 26.25±5.946 years. There was a positive relationship between drive for muscularity and tendencies of muscle dysmorphia (p<0.05). Of the total, 130(62%) bodybuilders had a moderate level of drive for muscularity. Unmarried bodybuilders aged 18-25 years had more drive for muscularity compared to married bodybuilders age 26 years and above (p<0.001). CONCLUSIONS: The drive for muscularity and muscle dysmorphic tendencies were found prevalent in Pakistani culture.


Assuntos
Transtornos Dismórficos Corporais , Imagem Corporal , Adolescente , Adulto , Transtornos Dismórficos Corporais/epidemiologia , Estudos Transversais , Humanos , Masculino , Músculo Esquelético , Paquistão/epidemiologia , Adulto Jovem
14.
J Pak Med Assoc ; 71(5): 1357-1368, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091615

RESUMO

OBJECTIVE: To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. METHODS: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July, 2018, to January, 2019, and comprised patients aged 18-75 years of either gender. Demographic information, comorbidities and previous medications were recorded for each patient. The modified American College of Rheumatology preliminary diagnostic criteria 2010-11 for fibromyalgia diagnosis. If diagnosed, the fibromyalgia impact questionnaire was administered to assess its severity. Data was analysed using SPSS 25. RESULTS: Of the 750 hospital-visiting patients, fibromyalgia was diagnosed in 250(33.3%); 190(76%) of them being females (p<0.0001). Comorbidities, age and increased elevated body mass index were significantly associated with fibromyalgia. Severity was not influenced by comorbidities, marital status, education or economic status (p>0.05). Menarche at a later age and menstrual irregularity were associated with fibromyalgia severity (p<0.05). CONCLUSIONS: The hospital-based prevalence of fibromyalgia was found to be high, especially among females.


Assuntos
Fibromialgia , Estudos Transversais , Feminino , Fibromialgia/epidemiologia , Hospitais , Humanos , Paquistão/epidemiologia , Prevalência , Índice de Gravidade de Doença , Estados Unidos
15.
J Pak Med Assoc ; 71(5): 1384-1387, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091619

RESUMO

Objective: To investigate the prevalence and severity of lower urinary tract symptoms among calcium channel blocker users, and the impact on patients' quality of life. METHODS: The cross-sectional study was conducted at one hospital and 2 community pharmacies in Lahore, Pakistan, from November 2017 to July 2018, and comprised patients using calcium channel blockers. Data was collected using standardised scales to assess lower urinary tract symptoms and quality of life. Data was analysed using SPSS 22. RESULTS: Of the 410 subjects, 315 (76.8%) were males. The overall median age was 50.84 years, IQR 19 with 126 (30.7%) aged 41-50 years. Of the total, 108 (26.3%) patients were on calcium channel blockers alone, while the rest were taking it in combination with other drugs. Prevalence of lower urinary tract symptoms was 307 (74.9%); mild 103 (25.1%), moderate 201 (49.1%) and severe 106 (25.9%). The symptoms were significantly associated with reduced quality of life (p<0.05). Conclusion: Majority calcium channel blockers users had clinically significant lower urinary tract symptoms which significantly reduced patients' quality of life.


Assuntos
Sintomas do Trato Urinário Inferior , Preparações Farmacêuticas , Bloqueadores dos Canais de Cálcio/uso terapêutico , Estudos Transversais , Feminino , Humanos , Sintomas do Trato Urinário Inferior/epidemiologia , Masculino , Pessoa de Meia-Idade , Paquistão/epidemiologia , Qualidade de Vida
16.
J Pak Med Assoc ; 71(5): 1424-1427, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091627

RESUMO

OBJECTIVE: To analyse the prevalence of stress among doctors serving at various public and private hospitals. METHODS: The cross-sectional study was conducted at four public and private hospitals in Faisalabad, Pakistan, from July to December 2019, and comprised doctors with at least one year of professional service. Data was collected using the Perceived Stress Scale Questionnaire and was analysed using SPSS 20. RESULTS: Of the 162 respondents, 87(53.7%) were males and 75(46.3%) were females. The females had significantly higher (p<0.05) perceived stress scores compared to the males. Age, number of years in job, and number of children had negative correlation with stress scores (p<0.05). Stress was significantly low in doctors who managed to usually get time-out for relaxation (p<0.01) and in those doing private practice (p<0.05). The effect of doctor's marital status, type of specialty and residence was not significant (p>0.05). CONCLUSIONS: Younger doctors, particularly females, in their early career were found to have higher perceived stress scores compared to their senior colleagues with more children and well-established private practice.


Assuntos
Governo , Hospitais Privados , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Estresse Psicológico/epidemiologia
17.
J Pak Med Assoc ; 71(5): 1432-1437, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091629

RESUMO

OBJECTIVE: To determine the reasons of neonatal referrals from secondary-care to tertiary-care setting, and to assess neonatal outcomes for the referred cases. METHODS: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data from July 2015 to June 2019 Related to all neonates born after 32 weeks of gestation at the satellite secondary-care centres in Kharadar, Garden and Karimabad who had been referred to the main tertiary care hospital. The reason for referral, need of mechanical ventilation, referral place and neonatal outcome were noted. Data was analysed using SPSS 22. RESULTS: Of the 348 cases, 211(60.6%) were boys. The overall mean gestational age was 36.42±2.61 weeks and the mean birth weight was 2.54±0.67 kg. The outcome was neonatal mortality in 42(12%) cases. Of the remaining 306(88%) cases, 284(92.81%) were discharged from the hospital and 22(7.18%) left against medical advice. Overall, mechanical ventilation was needed in 63(18.1%) patients. There was a significant association of mechanical ventilation with low Appearance, Pulse, Grimace, Activity, and Respiration score at 1 and 5 minutes (p<0.001), shorter duration of stay (p=0.007), and aggressive resuscitation requirement at birth (p<0.001). CONCLUSIONS: The most common reasons for referral of newborns to tertiary care hospital were respiratory diseases requiring respiratory support and surgical intervention.


Assuntos
Encaminhamento e Consulta , Atenção Secundária à Saúde , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Paquistão/epidemiologia , Estudos Retrospectivos , Centros de Atenção Terciária
18.
J Pak Med Assoc ; 71(5): 1438-1441, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091630

RESUMO

OBJECTIVE: To determine the prevalence and determinants of prediabetes among adolescents. METHODS: The cross-sectional study was conducted at a public-sector medical university in Quetta, Pakistan, from December 2019 to February 2020, and comprised students aged 16-19 years. A self-administered questionnaire was used to gather socio-demographic data. Fasting blood sample was taken to measure the fasting plasma glucose level, lipid profile and glycated haemoglobin levels. Height, weight, neck circumference and waist circumference were also measured. Data was analysed using SPSS 21. RESULTS: Of the 351 subjects, 158(45%) were males and 193(55%) were females. The overall mean age was 18.81±0.41 years. Of the total, 81(23.1%) participants were found to have prediabetes. Neck circumference was identified as the strongest predictor for prediabetes, followed by high level of triglycerides, high systolic blood pressure, low levels of high-density lipoproteins, high levels of low-density lipoproteins, high diastolic blood pressure, waist circumference and body mass index (p<0.05). There was no significant difference in the prevalence of prediabetes among male and female students (p>0.05). CONCLUSIONS: There was no significant difference in the prevalence of prediabetes among male and female medical students. Neck circumference, Waist circumference, Body mass index, systolic blood pressure, Diastolic blood pressure, Triglyceride and High density Lipoprotein were strong predictors of prediabetes in adolescent population.


Assuntos
Epidemias , Estado Pré-Diabético , Estudantes de Medicina , Adolescente , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Paquistão/epidemiologia , Estado Pré-Diabético/epidemiologia , Fatores de Risco , Universidades , Adulto Jovem
19.
J Pak Med Assoc ; 71(5): 1455-1457, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091634

RESUMO

Hepatocellular carcinoma is the sixth common cancer diagnosed and fourth leading cause of cancer-related deaths worldwide. Its incidence is on rise due to increasing prevalence of chronic hepatitis C virus infection. Pakistan is ranked second in countries burdened by hepatitis C virus in the world. Management of hepatocellular carcinoma is complex as it develops on the back of liver cirrhosis, and the risk of mortality is an accumulation of both tumour-related factors as well as liver decompensation. A multidisciplinary tumour board is an ideal approach to improve the outcomes of hepatocellular carcinoma since this ensures assimilation of input from a diverse group of care-providers, including hepatobiliary and transplant surgeons, gastroenterologists, interventional radiologists, oncologists and palliative care specialists. A multidisciplinary tumour board provides tailored approach to individual cases in a timely fashion to avoid treatment delays and communication gaps to improve the overall outcomes.


Assuntos
Carcinoma Hepatocelular , Hepatite C Crônica , Neoplasias Hepáticas , Carcinoma Hepatocelular/epidemiologia , Carcinoma Hepatocelular/terapia , Hepacivirus , Hepatite C Crônica/complicações , Hepatite C Crônica/epidemiologia , Hepatite C Crônica/terapia , Humanos , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/terapia , Paquistão/epidemiologia , Prevalência
20.
J Pak Med Assoc ; 71(5): 1467-1471, 2021 May.
Artigo em Inglês | MEDLINE | ID: mdl-34091636

RESUMO

In December 2016 physicians in Karachi, Pakistan,witnessed an increase in patients presenting with febrile illness and severe polyarthralgia. Subsequently, chikungunya virus (CHIKV)) was isolated from three patients. This virus was sequenced and compared with other isolates of CHIKV obtained in India and Pakistan during recent outbreaks. Phylogenetic analysis indicated that the Karachi isolates were most similar to the East Central South African CHIKV lineage and showed sequence homology to isolates obtained in other parts of Pakistan and India. More importantly, two of the CHIKV isolates had a nucleotide substitution in the E1 gene corresponding to an amino acid change at chain F portion of the E1 protein.


Assuntos
Febre de Chikungunya , Febre de Chikungunya/epidemiologia , Surtos de Doenças , Humanos , Índia/epidemiologia , Paquistão/epidemiologia , Filogenia
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