scholarly journals Impact of pregnancy on cancer survival: Experience at a tertiary care hospital

2021 ◽  
Vol 37 (2) ◽  
Author(s):  
Dur-e- Shahwar ◽  
Sheikh Irfan Ahmed ◽  
Zaheena Shamsul Islam ◽  
Lumaan Sheikh

Objectives: To assess the overall survival of pregnant women diagnosed with cancer during pregnancy or became pregnant thereafter. Methods: A retrospective medical record review of 90 patients who were diagnosed with cancer when pregnant or who became pregnant thereafter between 1996 and 2015 in Aga Khan University Hospital, Karachi. Results: A total of 90 patients were analyzed. The malignancies that expectant mothers had were, breast cancer 38 (42.2%), hematological cancers 29 (32.2%), brain cancer 10 (11.1%), and other malignancies 13 (14.4%) that included thyroid cancers, gestational trophoblastic disease and synovial tumor of foot. We observed only four deaths out of 90 patients and mean survival time in pregnant patients with malignancies was 17.98 years [CI 16.35-19.31]. Conclusions: The diagnosis of most cancer types before or during pregnancy does not influence on overall survival of patients. doi: https://doi.org/10.12669/pjms.37.2.3525 How to cite this:Dur-e-Shahwar, Irfan S, Islam ZS, Sheikh L. Impact of pregnancy on cancer survival: Experience at a tertiary care hospital. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3525 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Abdul Aziz ◽  
Syed Ahsan Ali

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world. Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c. Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%. Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c. doi: https://doi.org/10.12669/pjms.37.1.2814 How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145.  doi: https://doi.org/10.12669/pjms.37.1.2814 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2019 ◽  
Vol 35 (4) ◽  
Author(s):  
Sonia Rafiq ◽  
Wajeeha Syed ◽  
Simi Fayaz Ghaffar

Background and Objective: Maternal death measurement is essential to a country’s wellbeing and development status. In emerging countries like Pakistan, it remains an intimidating and failed public health challenge. Objectives of our audit were to estimate trends and causes of maternal demise in Lady Reading Hospital, Peshawar, Pakistan. Methods: Between January 2013 to December 2017, a retrospective study was carried out at Medical Teaching Institute, Lady Reading Hospital, Peshawar. A structured proforma was used to collect data from the medical records. To detect trends in mother demise maternal mortality ratio was calculated for each year and for all five years, Spss version 23 was used for data analysis. Results: In the five-year periods 134 deaths were recorded. The maternal mortality during the study period was 431/100,000 live births. An unstable trend in mortality with two crowning periods in 2013 and 2017 was observed. Hemorrhage persisted as the foremost cause of maternal death over the five years period, accounting for 47.76% deaths followed by hypertension, accounting for 25.37% deaths. An increased risk of 35.08% was observed among women aged 25-29 years, followed by 26.11% in 20-24 years and 23.88% in >30 years. Conclusion: There is a decreasing trend of maternal death from 2013 to 2016 but a slight increase was noted in 2017. Hemorrhage was the top cause responsible for the maternal death. doi: https://doi.org/10.12669/pjms.35.4.1091 How to cite this:Rafiq S, Syed W, Ghaffar SF. Trends and causes of maternal mortality in a tertiary care hospital over five years: 2013-2017. Pak J Med Sci. 2019;35(4):---------. doi: https://doi.org/10.12669/pjms.35.4.1091 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Syed Ghazanfar Saleem ◽  
Saima Ali ◽  
Nida Ghouri ◽  
Quratulain Maroof ◽  
Muhammad Imran Jamal ◽  
...  

Background and Objective: Maintaining privacy and ensuring confidentiality with patients is paramount to developing an effective patient-provider relationship. This is often challenging in over-crowded Emergency Departments (EDs). This survey was designed to explore patients’ perceptions on maintenance of privacy and confidentiality and their subsequent interactions with providers in a busy tertiary care hospital in Karachi. Methods: Trained nursing staff conducted structured interviews with 571 patients who presented to The Indus Hospital (TIH) ED from January to December 2020. All patients were 14 years of age or older, could speak and understand Urdu, and provide informed consent. Patients were asked about their perceptions of privacy and confidentiality in the ED and whether this affected their interactions with providers. Results: Respondents were primarily men (64%) under the age of 45 (62%) presenting for the first time (49%). The majority of patients felt that privacy and confidentiality were maintained, however 10% of patients reported that they had rejected examination due to privacy concerns and 15% of patients reported that they had changed or omitted information provided to a provider due to confidentiality concerns. There was correlation between privacy and confidentiality concerns and patient-provider interactions (p<0.0001). Conclusions: Despite the often over-crowded and busy environment of the ED, patients generally felt that privacy and confidentiality were maintained. Given the correlation between perception and behavior and the importance of an effective patient-provider relationship, particularly in the acute setting when morbidity and mortality is high, initiatives that focus on maintaining privacy and confidentiality should be pursued. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 How to cite this:Saleem SG, Ali S, Ghouri N, Maroof Q, Jamal MI, Aziz T, et al. Patient perception regarding privacy and confidentiality: A study from the emergency department of a tertiary care hospital in Karachi, Pakistan. Pak J Med Sci. 2022;38(2):351-355.  doi: https://doi.org/10.12669/pjms.38.ICON-2022.5785 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Author(s):  
Fahmida Parveen ◽  
Samia Aijaz ◽  
Sakeena Ahmed Memon ◽  
Hina Akmal

Objective: To determine the awareness, practice, knowledge and attitude toward the Covid 19 among antenatal patients at tertiary care Hospital. Methodology: This was a cross sectional survey which was conducted at Gynae and obstetrics department at Liaquat University Hospital Hyderabad. Study duration was six months from March 2020 to August 2020. All the pregnant women visited antenatal clinic age 18 to 40 years and either of parity were included. All the pregnant females were interviewed by using a questioner regarding awareness, attitude and practice toward the Covid19 after taking informed consent. All the data was recorded via study proforma. Data was analyzed by using SPSS version 20. Results: Total 173 pregnant women were interview regarding COVID-19, their mean age was 29.34+13.12 years. Most of the women were presented with age between 18 to 37 years. 70.5% were multigravida and majority of women were uneducated. Mostly women 75.1% had heard regarding. 72.8% women said, they should stay at home and 25.4% said should wear the face mask, while 38.7% said the women should inform the health care provider in advance before visit to Hospital if developed any symptom. Most of the women had good knowledge and attitude, while preventive practice was found to be unsatisfactory. Conclusion: knowledge and awareness were found to adequate; while preventive practice has been observed unsatisfactory among pregnant women during antenatal clinic. Clinicians should provide appropriate counseling to reassure and elucidate doubts of pregnancy females regarding COVID-19 during antenatal visits.


2017 ◽  
Vol 08 (01) ◽  
pp. 07-10
Author(s):  
Summaya Qazi ◽  
Khalil ahmed Almani ◽  
Rizwanullah Junaid Bhanbhro ◽  
Diya Ram Khatri

Objective: The present study was conducted to determine the frequency of post-operative hypocalcaemia following thyroid surgery at a tertiary care hospital of Sindh Study design: Observational study Place and Duration: Department of surgery, Isra University Hospital from December 2014 to July 2017. Materials and Methods: 100 cases of thyroid swellings were selected according to inclusion and exclusion criteria. Pre- operative patient history, physical examination, thyroid gland examination and laboratory investigations were performed. A serum calcium levels <8 mg/dl was taken as hypocalcemia. Data was analyzed on SPSS 21 version and P value (P< 0.05) was considered significant. Results: Of 100 patients, 67% were female and 33% were male (P=0.0001). Female dominancy was noted with female to male ratio of 2.03:1. Age (mean± SD) was noted as 37.5 ± 9.5 years (19 – 48 years). Frequency of symptomatic hypocalcaemia was noted in 23% subjects post operatively. Mean± SD serum calcium and phosphate in post operative hypocalcemia subjects was noted as 7.31 ± 0.38 mg/dl and 2.95 ± 0.63 mg/dl respectively. Majority of symptomatic hypocalcemia were noted within 72 hours post operatively. Conclusion: The present study reports 23% frequency of post thyroidectomy hypocalcemia noted within 72 hours post operatively. Goiters of long duration, recurrent goiters, hyperthyroidism and goiters with retro sternal extensions were found risk factors for the post thyroidectomy hypocalcemia.


2021 ◽  
Vol 54 (5) ◽  
pp. 311-317
Author(s):  
Orlando Vieira Gomes ◽  
Bianca Alencar Dias de Almeida ◽  
Leonardo Fernandes e Santana ◽  
Mateus de Sousa Rodrigues ◽  
Guilherme Bruno Pires Marques Locio ◽  
...  

Abstract Objective: To evaluate the success and complication rates of ultrasound-guided renal biopsy at a tertiary care hospital. Materials and Methods: This was a retrospective analysis of 97 ultrasound-guided renal biopsies, all performed by the same radiologist, between 1 March, 2017 and 31 October, 2019. Results: Of the 97 biopsies evaluated, 87 had a definitive pathological diagnosis. In five cases (5.4%), the biopsy results were inconclusive and a second procedure was required. In seven procedures (7.6%), there were complications, all of which were properly resolved. Conclusion: Ultrasound-guided renal biopsy has proven to be a safe, effective method for the diagnosis of nephropathies, with high success rates.


2019 ◽  
Vol 35 (3) ◽  
Author(s):  
Ayesha Muneer ◽  
Attia Bari ◽  
Arslan Haider ◽  
Agha Shabbir Ali

Objective: To analyze the knowledge of the doctors dealing with pediatric patients about neonatal resuscitation. Methods: This was a cross sectional study conducted at The Lahore General Hospital over one year. Total 137 doctors related to pediatrics with different job descriptions were enrolled and requested to fill a questionnaire proforma regarding their knowledge about basic equipment required and about neonatal resuscitation steps. Data was entered and analyzed using SPSS 20. Results: Out of 137 participants, majority (71%) had >2 years of experience in pediatrics and 52.5% had higher postgraduate qualification. Neonatal resuscitation workshop was attended by 57% doctors. In resuscitation of newborns at the time of delivery, resuscitating doctors were assisted by nurse in 50%, by junior doctor in 35%, paramedic staff 11% and it was done by single doctor in 4% cases. Oxygen (central or O2 cylinder) and warmer facilities were available in 90% and 82% of health facilities respectively. Majority (86%) of participants were of view that every neonate must be attended at birth. Not a single doctor followed all the standard steps of neonatal resuscitation although 90% had knowledge about resuscitation equipment and common resuscitation drugs. Conclusion: Pediatric health care professionals had knowledge about neonatal resuscitation but there are gaps in the practical application. There is a strong need of frequent neonatal resuscitation workshops for improving neonatal outcomes. doi: https://doi.org/10.12669/pjms.35.3.987 How to cite this:Muneer A, Bari A, Haider A, Ali AS. Knowledge of clinicians/pediatricians about neonatal resuscitation in a tertiary care hospital. Pak J Med Sci. 2019;35(3):---------. doi: https://doi.org/10.12669/pjms.35.3.987 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


2014 ◽  
Vol 8 (09) ◽  
pp. 1129-1136 ◽  
Author(s):  
Ali Mohammed Somily ◽  
Hanan A Habib ◽  
Muhammad M Absar ◽  
Muhammad Z Arshad ◽  
Kutubu Manneh ◽  
...  

Introduction: The increasing frequency  and antibiotic resistance among extended-spectrum β-lactamases (ESBLs)-producing bacteria are posing a serious threat. This study sought to investigate the frequency and antibiotic susceptibility of ESBL-producing E. coli and K. pneumoniae at a tertiary care hospital. Methodology: Data were collected from samples sent to the microbiology laboratory between 2006 and 2010 at King Khalid University Hospital, Riyadh. ESBLs were confirmed using Etest strips of cefotaxime/cefotaxime + clavulanic acid, ceftazidime/ceftazidime + clavulanic acid, and cefepime/cefepime + clavulanate. Results: Out of 17,105 samples, 1,076 (6.3%) ESBL-producing isolates of E. coli (808) and K. pneumoniae (268) were confirmed. Among these, 680 (63.2%) isolates were found in urine samples, followed by 287 (26.7%) in superficial swabs, deep wounds swabs, tissues and sterile body fluids, 71 (6.6%) in respiratory, and 38 (3.5%) in blood samples. The overall frequency rates of ESBL E. coli and K. pneumoniae were 6.6% and 5.5%, respectively. The frequency of ESBL-producing E. coli and K. pneumoniae increased significantly during the study period. E. coli resistance against cotrimoxazole was 71.1%, followed by ciprofloxacin (68.2%) and gentamicin (47%). Similarly, 62.7% of K. pneumoniae isolates were resistant to gentamicin, 59.5% to cotrimoxazole, and 49.8% to ciprofloxacin. There was no statistically significant change in antimicrobial resistance over the study period. Conclusions: Although the frequency rates of ESBL-producing E. coli and K. pneumoniae increased, no change in the anti-microbial susceptibility was observed over the study period.


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