Journal of Women Medical and Dental College

Soft Tissue Sarcoma: A Decade of Experience in a South Asian Tertiary Care Hospital with a Review of International Literature

2023-02-24T05:10:38+00:00

Soft tissue sarcoma and its histomorphological sub types is an important for both prognosis and treatment. It deserves an extensive research, as there are good published literature's on the incidence of soft tissue sarcoma in the western population, but there is paucity of data from Asia, particularly on the epidemiology specifically to Southern Asia. We analyzed the Data, collected from the surgical pathology files. This Retrospective study included all the diagnosed cases of soft tissue sarcoma, including gastrointestinal tumor presented during the 10-year period, from July 2008 to March 2019 (10 years, 9 months) and include all age groups. Cases were then characterized according to their histomorphological sub types, age, sex, and the site involved by the sarcoma. The cases where diagnosis was not confirmed like differential diagnosis are not considered and not included in this study. The data was analyzed in SPSS version 26. Total 305 diagnosed cases of soft tissue sarcoma, met our selection criteria. The result shows that the soft tissue sarcoma are increased on yearly basis with eminent male predilection. The most common presented soft tissue sarcoma is GIST, followed by synovial sarcoma, undifferentiated pleomorphic sarcoma, and high-grade sarcoma NOS, in order of preference. The high female predilection is noted for leiomyosarcoma and chondrosarcoma. Most of the soft tissue sarcoma are associated with adult age (25 to 64 year) with total number of n: 206 cases (67.5%) and the most common site is the lower limb. It is also observed that the least common incidence of soft tissue sarcoma is noted in the toddler age group (2-3 years).This study concluded that the risk of soft tissue sarcoma exist throughout the lifespan (infants to elderly age) and continuously increasing in numbers. The adult age group followed by elderly age and male predominance are at high risk. However, the frequency of rhabdomyosarcoma is commonly seen in childhood.

Knowledge, Attitude and Practices of Self-Medication among Medical Students of Women Medical and Dental College, Abbottabad

2023-07-31T09:47:58+00:00

A descriptive cross-sectional study was carried out in Women Medical & Dental College students in all professional years of MBBS to evaluate the tendency towards self-medication practices and the background knowledge of the students about self-medication. A predesigned questionnaire was implemented among two hundred students by simple random sampling. Data were analyzed by SPSS-23 version through descriptive statistics, spearman correlation and binomial logistic regressions. The study's findings indicate that analgesics are the most frequently used self-medication, with antibiotics coming in second. Self-medication awareness was most commonly conveyed through family members and friends (65%), media (20%), books (10%) and miscellaneous (5 %). Self-medication was practiced mostly by 1^st and 4^th year MBBS students, with a higher frequency of (65%) while only 35 % students were from 2^nd, 3^rd and final year MBBS. Adverse effects were: marked headache (40%), GIT disturbances (35%), sleep disturbances (15%) and miscellaneous (10%). Analgesics were available from online drug stores, while muscle relaxants were available through local pharmacies, anxiolytics and antibiotics were mostly received through friends and family, miscellaneous medicines are only available from online pharmacies. Pearson correlation was significant at the 0.0 level and two-tailed at 0.05 level, knowledge of self-medication shows a positive correlation towards the side effects observed and adverse effects. Students below 21 years of age and above 23 years of age were very less vulnerable to using self-medication. Over burning academic activities and easy availability were the most triggering factors to adopt self-medication. Students need health education regarding the pros and cons of self-medication from teachers and administration.

Case Study: Determination of Incidence of Hyperuricemia among Patients Suffering from Acute Coronary Artery Syndrome

2023-05-28T13:30:20+00:00

In the vast majority of nations across the globe, coronary artery disease (CAD) remains the leading cause of mortality. It is among the most widely recognized global health concerns affecting both sexes. The worldwide impact of CAD is severe, and its consequences are particularly pronounced in countries with higher incidence rates. In Western nations, myocardial infarction outcomes are often linked to socioeconomic status, with those in lower socioeconomic positions disproportionately affected by the burden of this disease. Given the high rates of morbidity and mortality associated with acute myocardial infarction (MI), this condition continues to be a major focus of cardiovascular therapy. The present study sheds new light on the issue, as the findings differ from previous research due to demographic, nutritional, and lifestyle differences. The dissemination of these findings to the medical community will be critical to informing future research and better understanding how to recognize and treat hyperuricemia in ACS patients. This study has important implications for public health policy and clinical practice. By improving our understanding of the complex interplay between socioeconomic factors and cardiovascular health, we can develop more targeted interventions and improve outcomes for those at the highest risk of CAD and related conditions. This study was performed at the Cardiology Department of Khyber Teaching Hospital, Peshawar for six months, from 19th July 2022 to 19th January 2023. It was a cross-sectional study in which 360 male and female patients aged between 30-60 years were included with acute coronary syndrome. Clinical history, physical examination, and laboratory investigations, including troponin test and ECG results, were adequately monitored. At the time of admission, all patients’ blood samples were collected and biochemically analyzed to determine serum uric acid (SUA) levels at Khyber Teaching Hospital. Men with uric acid levels over 7 mg/dl and women with uric acid levels exceeding 6 mg/dl have hyperuricemia. This study reveals a mean age of 52 years with a SD ±11.74. 63 % of patients were male, and 37% were female. Moreover, 35% of patients had hyperuricemia, and 65% didn’t. Our study concludes that the frequency of hyperuricemia was 35% in patients presenting with acute coronary syndrome to the Cardiology Department of Khyber Teaching Hospital, Peshawar.

A Systematic Review: Clinical Manifestations of Diabetes Mellitus and The Role of Pharmacists in Management of Type II Diabetes

2023-03-18T07:21:46+00:00

Diabetes mellitus is a condition in which the metabolism of carbohydrates, proteins, and lipids is disrupted owing to reduced insulin production, increased glucagon secretion, and the development of insulin resistance in body cells. The prevalence of diabetes in Pakistan varies based on age, gender, and geography. Genetic, behavioral, and environmental factors contribute to the development of type II diabetes. Insulin resistance by the cells and a decreased or inadequate quantity of insulin produced by the beta cells of the pancreas result in type II diabetes, which is characterized by high amounts of proinflammatory cytokines and free fatty acids in plasma. In diabetic individuals, the imbalance between insulin and glucagon production results in an increased amount of glucagon in the blood and hyperglycemia. Insulin resistance develops in response to physical inactivity, steroid use and a high-calorie diet. Glucagon and glucose-dependent insulinotropic polypeptide (GIP) levels also rise. Major consequences of diabetes include diabetic retinopathy, neuropathy, vasculopathy, end-stage renal disease, cardiovascular disease, and stroke. In this review medical therapy including the role of insulin in the management of DM 2 will be discussed. The role of pharmacists in its management will also be focused since tailored patient education is more effective than group sessions in addressing poorly managed diabetes. Among the non-pharmacologic parts of diabetes treatment is teaching patients about the advantages of a healthy diet as well as regular physical activity. In treating type 2 diabetes, bariatric surgery is more effective than medication. Depending on the patient's state, anti-diabetic drugs may either lower insulin resistance or boost insulin secretion.

Efficacy of Sphenopalatine Block in Patients with Post-Dural Puncture Headache after Cesarean Section

2023-07-26T08:06:46+00:00

Our study emphasised the efficacy of sphenopalatine ganglion block (SPGB) in patients with post-dural puncture headache (PDPH) after cesarean section. In this clinical experiment, the effectiveness of the SPGB in treating PDPH in pregnant women was examined. 40 individuals with PDPH were randomly divided into two equal groups for a prospective randomised clinical trial. The group receiving paracetamol (PG) for one day, the patients take 1 gram of paracetamol intravenously three times daily. Rescue analgesia in intravenous ketorolac is administered if sufficient pain relief cannot be found. Block group (SPGBG): Each nostril of the patients received a 3 ml dose of a lignocaine and dexamethasone mixture during bilateral SPGB. Recordings were made of the heart rate, arterial pressure, and mean pain score. Additionally noted were the initiation and end of the analgesic effect, any adverse effects, the amount of ketorolac used, patient satisfaction, and whether the patient stayed in the hospital for an EBP (epidural blood patch) or was discharged after 24 hours. The block group's pain perception (measured by a numeric rating scale [NRS]) was usually less during the research, with only a significant difference until the first two hours following the block when analgesia began more quickly and lasted longer. The hospital stay of the block group for EBP was substantially shorter and had higher patient satisfaction than the control group, which also had a much lower overall dose of the rescue analgesic in milligrams. Trans-nasal SPGB is a non-invasive, safe, simple, and effective treatment for post-dural puncture headache (PDPH) with a low complication rate.

Prevalence of Musculoskeletal Disorders in Type 2 Diabetes Mellitus

2023-04-04T05:47:09+00:00

Type II diabetes is characterized by decreased insulin secretion or insulin resistance in the body. It is the most commonly occurring type that affects obese persons or who have family history of diabetes. Several musculoskeletal disorders are associated with type 2 diabetes. This study was intended to check the prevalence of musculoskeletal disorders in type 2 diabetes mellitus. For this purpose, a descriptive cross-sectional study was conducted in the general population of Abbottabad. A total of 250 subjects of age group 30-90 years. Participants were asked to fill a self-administered questionnaire containing demographics and other questions which included levels of hyperglycemia, pain and its common site, muscle cramps and abnormal sensations. Other questions were about difficulty in getting in and out of chair, opening medicine bottle or jar, bending or kneeling, walking and problems with dressing, eating, bathing or other personal care. All these questions were answered on a 5 points scale. The study employed convenient sampling technique and data was further analyzed using SPSS version 20. According to the results; all patients experienced pain. 24% had no difficulty getting in and out of chair and 4.4% were unable to do. 42.8% participants had no difficulty in opening bottle or jar while 1.6% are unable to do. 13.2% participants had no difficulty in bending or kneeling and 8.4% patients were unable to bend or kneel. 44.8% participants had no difficulty in walking, only 1.6% patients were unable to walk. 19.6% participants were not at all bothered by back problem and 5.6% were extremely bothered by back problem. 45.2% participants were not at all bothered by problems with dressing, eating, bathing or other personal care and 1.2% were extremely bothered. 32.4% were not at all bothered by pain and stiffness and only 2% were extremely bothered. Thus, it was concluded that MSK disorders among diabetics result in pain and disability. Most of the patients were suffering from low back pain and were unable to bend or kneel.