Knowledge and perception of Sepsis among Doctors in Karachi Pakistan

2021 ◽  
Vol 38 (ICON-2022) ◽  
Author(s):  
Faiza Ahmed ◽  
Lubna Abbasi ◽  
Fivzia Herekar ◽  
Ahsun Jiwani ◽  
Muhammad Junaid Patel

Objectives: To assess knowledge and perception among Pakistani physicians towards sepsis. Methods: This cross-sectional study was conducted in Indus Hospital and Health Networks from September 2020 to March 2021. The International Sepsis Survey questionnaire was adapted, and its link was sent to trainee physicians as well as specialists, and consultants practicing in various hospitals via social media. Knowledge and perception were scored and 50% was considered the cut-off score for adequacy. Data was analyzed using SPSS version 26. Results: Analysis was done on 222 respondents who completed the survey. 37.9% of the participants had adequate knowledge. Knowledge regarding sepsis was significantly associated with specialty, ICU/CCU/HDU, and work experience (P-value <0.0001). More recent trainee physicians and those with more experience in critical care areas demonstrated better knowledge. Over 2/3rd of the respondents strongly agreed that sepsis remains one of the unmet needs in critical care today. Conclusion: A common belief exists that sepsis remains a challenge to treat among doctors. Moreover, there is consensus that it is the most frequently miss diagnosed condition in critical care and a dire need exists for its early diagnosis. Additionally, prompt management of presumed sepsis is imperative to improve outcomes. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 How to cite this:Ahmed F, Abbasi L, Herekar F, Jiwani A, Patel MJ. Knowledge and perception of Sepsis among Doctors in Karachi Pakistan. Pak J Med Sci. 2022;38(2):380-386. doi: https://doi.org/10.12669/pjms.38.ICON-2022.5775 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 36 (5) ◽  
Author(s):  
Rashida Parveen ◽  
Mehnaz Khakwani ◽  
Munazza Latif ◽  
Ayesha Uzaima Tareen

Objective: To determine maternal and perinatal outcome after Ramadan fasting during pregnancy Methods: This cross sectional study was conducted at The Department of Obstetrics and Gynaecology, Nishtar Hospital, Multan from May to October 2019. A total of 226 women attending labour room, aged 18–35 years, having gestational amenorrhoea 15 – 40 weeks of gestation were included. Women who fasted for more than 15 days were compared with those who did not fast or fasted for less than 15 days in the month of Ramadan. Demographical profile along with maternal and perinatal outcomes were compared between the study groups considering p value less than 0.05 as significant. Results: Out of 226 women, 58 (25.7%) fulfilled the criteria to be included in the fasting group while remaining 168 (74.3%) were slotted in the non-fasting group. There was no difference (p value > 0.05) in between the both group with respect to demographical characteristics except significantly less women were employed in the fasting group (p value=0.0246). No statistical difference was found in terms of maternal or perinatal outcomes between both the study groups. Conclusion: Fasting women were not found to have poor maternal and fetal outcomes when compared to non-fasting women. doi: https://doi.org/10.12669/pjms.36.5.2612 How to cite this:Parveen R, Khakwani M, Latif M, Tareen AU. Maternal and Perinatal outcome after Ramadan Fasting. Pak J Med Sci. 2020;36(5):---------. doi: https://doi.org/10.12669/pjms.36.5.2612 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.


2018 ◽  
Vol 35 (1) ◽  
Author(s):  
Iqra Arshad ◽  
Sara Mohsin ◽  
Sana Iftikhar ◽  
Tahseen Kazmi ◽  
Luqman F. Nagi

Background and Objective: Initiation of Insulin therapy during earlier stages has proved to significantly improve health outcomes among diabetics in comparison to oral medications. Not only patients but physicians are also often resistant to early initiation of insulin therapy. The objective was to assess misconceptions and barriers to early initiation of insulin therapy among diabetic patients coming to a diabetic clinic. Methods: This cross sectional study was conducted on 300 patients selected by convenience sampling arriving in Diabetes Outdoor Clinics of Mayo and Services Hospitals, Lahore during August 2017 to May 2018. The data was entered and analyzed by using SPSS version 17. Results: Out of 300 patients included in study, 39% (n= 117) were males and 61% (n=183) were females. The mean age of the participants at presentation was 48.46±13.15 years with a range of 13 to 80 years. Study participants considered it embarrassing to inject insulin in public place (p-value 0.01). The fear associated with lifelong commitment to insulin therapy once it is started, was also found statistically significant (p-value 0.001)particularly in subjects who have long duration of DM (>5 years). Conclusion: Perceptions of diabetic patients about insulin therapy are still barriers to early initiation of therapy and tend to prevail in Pakistan and around the globe. How to cite this:Arshad I, Mohsin S, Iftikhar S, Kazmi T, Nagi LF. Barriers to the early initiation of Insulin therapy among diabetic patients coming to diabetic clinics of tertiary care hospitals. Pak J Med Sci. 2019;35(1):---------. doi: https://doi.org/10.12669/pjms.35.1.237 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 9 (2) ◽  
pp. 69-72
Author(s):  
Zulfiqar Ali Shaikh ◽  
Afifa Yaseen ◽  
Amna Yaseen ◽  
Subhana Akber

Background: Panoptic knowledge of dental professionals is required to provide care for patients with any dental problem which ranges from screening, emergency care or referral to alleviation of pain symptoms. Ideally to provide dental care, dental practice should be based on current clinical concepts originating from evidence-based dentistry which clearly demarcates a level between a tooth that is able to be restored so that intervention is done on it for esthetic and functional stability, or ready for extraction. Dental professionals' knowledge regarding tooth restorability is very crucial in restorative and preventive dentistry. The aim of this study was to assess the knowledge of dental professionals regarding tooth restorability. Methods: Knowledge regarding tooth restorability of dental professionals of Dow University of Health Sciences was assessed through a multi centered cross sectional study. A sample size of 140 participants was calculated using through open Epi version 3, and a convenient non-probability sampling technique was used. The study was conducted in May-June, 2018. An informed consent prior to the study was taken. The dental professionals were evaluated through a self- administered, structured questionnaire in English. The SPSS-23 was used to obtain results. The knowledge of the students was graded as adequate if >12 and inadequate if<12. Results: Out of 140 study participants, 113 (81%) dental professionals had significantly adequate knowledge (p-value <0.05); while 27 (19%) had inadequate knowledge. Among the respondents, 56% said that the traumatic dental injury must be treated by dentist whereas the others considered it to be treated by private doctor or by nearest hospital casualty. Conclusion: The knowledge of dental professionals working at teaching institutes is adequate; and as per their knowledge they might be taking right decisions regarding tooth restorability.


Author(s):  
Esther Nambala ◽  
Jayne Byakika-Tusiime ◽  
Yahaya Gavamukulya

Aim: To determine nutritional knowledge and practices among patients with Non-Communicable Diseases (NCD) attending Mbale Regional Referral hospital, in Eastern Uganda. Study Design: A mixed methods cross sectional study design was used. Place and Duration of Study: Mbale Regional Referral Hospital among patients attending the NCD clinic from May to July 2017. Methodology: Two hundred sixty clients were recruited for the study. Quantitative data was collected through structured administered questionnaires. Quantitative data was analyzed at univariate, bivariate and multivariate levels. Chi square test and logistic regression were used to determine the association between nutrition knowledge and utilization. Qualitative data was coded first and summarized according to the themes. Results: The mean age of the respondents was 55 years (SD= 14) and hospital was the main source of nutrition information (n=156, 60%). Most respondents (n=156, 60%) had a high level of nutrition knowledge, however only 48.8% (n=127) were utilizing the knowledge. Those who had attained secondary level of education were 2.308 more likely to utilize the nutrition knowledge than those who had never studied P value of .028, 95CI (1.093-4.874). Those with tertiary education were even 9.261 times more likely to utilize the knowledge P value <.001 95CI (2.721-31.522). Those with adequate knowledge were about 1.6 times most likely to utilize the nutrition knowledge compared to those with inadequate knowledge level, however, with the adjusted odd ratio of 1.573 at 95% CI (0.923- 2.868) the results were not statistically significant (P value .098). Conclusion: NCD patients had adequate knowledge, with a few of them utilizing the knowledge. High education level was associated with better nutrition practices.


2019 ◽  
Vol 35 (6) ◽  
Author(s):  
Misbah Ali ◽  
Mulazim Hussain Bukhari ◽  
Faiza Hassan ◽  
Maria Illyas

Objective: To study the clinocopathological factors and presence of Human Pappiloma Virus in ameloblastoma by immnohistochemistry. Methods: It was a cross sectional study on 50 surgical specimens of ameloblastoma, completed in six months. These were selected and processed for initial screening by H&E and then by immunohistochemistry (IHC) for detection of Human Papilloma Virus (HPV). The questionnaire was designed to study the clinicopathological factors associated in these patients. Sections of 4µm were cut, placed on special positive charged glass slides in the Department of Pathology, King Edward Medical University. It was then examined by the histopathologists for grading and scoring of these lesions. Chi Square test was used to assess the differences found in types of ameloblastomas. The p-value was smaller than 0.05 (p < 0.05). Results: The mean age of the patients (12-80 years old) was 38.6±15.1 years, with male-female ratio 2.84: 1. HPV was positive in 9 (18%), whereas negative in of 41 (82%) patients. Among the positive, reactive HPV with score-1 was 8 and score-2 was 1. According to histological variant, follicular was present in 78%, Plexiform pattern in 8%, Conventional and Desmoplastic variants in one patient each; and Cystic and Acanthomatous were seen in two and three patients respectively. The mandible was involved in 39 patients, maxilla and right maxilla involved in 4 patients each, right retromolar, cheek and angle of mandible was seen in one patient each. About 16% patients had anterior, 66% had posterior and 18% had both anterior and posterior regions involved. Among the HPV positive reactive statistically, no significant difference was found with smoking, Paan and exposure to pesticides, factory or mine (p-value > 0.05). Among HPV positive reactive patients, eight had ameloblastoma whereas, 1 had ameloblastomic fibroma. There was no statistical significance of type, location and region of tumor in HPV positivity. Conclusion: Mandible and posterior region was more commonly involved. Follicular pattern was most common. There was no effect of exposure to pesticides, factory or mine, smoke and human papilloma virus in the etiology of ameloblastoma because only 18% of patients showed the association of HPV16 doi: https://doi.org/10.12669/pjms.35.6.909 How to cite this:Ali M, Bukhari MH, Hassan F, Illyas M. Clinicopathological study of ameloblastoma and detection of human papilloma virus by immunohistochemistry. Pak J Med Sci. 2019;35(6):1691-1696. doi: https://doi.org/10.12669/pjms.35.6.909 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 71 (1) ◽  
pp. 249-54
Author(s):  
Rehana Feroze ◽  
Muhammad Tariq ◽  
Abdul Wasay Toor

Objective: To determine physician’s compliance to surviving sepsis campaign updated Hour-one bundle incritically ill patients in Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Anaesthesiology, Combined Military Hospital Lahore MedicalCollege, from Jun to Aug 2019. Methodology: This study was carried out among physicians managing critical patients in intensive care units.Participants were asked to fill out a 16-questions survey (work experience, qualification and individual components of surviving sepsis campaign hour-1 bundle. Data was collected using online access to survey and by sending hard copies. Results: Questionnaire was sent to 230 physicians while only 63 responses were received (response rate 27%).Only 45 (71%) respondents were aware of the updated Hour-1 bundle. There was no institutional protocolfor compliance to sepsis bundles in thirty three (55%) responses. 52% respondents used Systemic inflammatoryresponse syndrome (SIRS) criteria to diagnose sepsis while quick Sequential Organ Failure Assessment (qSOFA)was used by 36% respondents. Overall compliance to hour-1 bundle components was only 60%. Lactate levelswas not measured by 35 (55%) respondents while 24 (38%) did not obtain blood cultures before administeringantibiotics. Crystalloid and nor epinephrine was used by all respondents. Overall compliance with all the components of sepsis bundle had strong correlation with post-graduate qualification (p-value 0.001-0.049). Conclusion: Poor compliance to updated sepsis guidelines was one of the major reasons of high sepsis relatedmortality in Pakistan.


2021 ◽  
Vol 18 (38) ◽  
pp. 62-84
Author(s):  
Taufik SURYADI ◽  
Hijra Novia SUARDI ◽  
Hanifah ZAIN ◽  
Zinatul HAYATI ◽  
Budi YANTI

Background: Coronavirus Disease 2019 (COVID-19) has spread throughout the world to become a pandemic, making the entire health sector overwhelmed. Hospitals as health service facilities continuously strive to provide optimal service to patients with the confirmed COVID-19 infection. Resident doctors usually handle COVID-19 patients at the Zainoel Abidin Hospital (ZAH). As the front liner in handling the COVID-19 pandemic, these resident doctors must have adequate knowledge and good attitudes in dealing with COVID-19 patients, especially regarding ethical and medicolegal. Aim: This study aims at finding out the level of knowledge and attitudes of resident doctors in dealing with the COVID-19 pandemic at the ZAH, Aceh. Methods: This was a cross sectional study conducted among resident doctors (n=80) in the ZAH during November-December 2020 with a self-administered online questionnaire. It had been tested for validity by experts with a Content Validity Ratio / CVR of 0.738 and reliability of 0.732. The data were analyzed using the frequency distribution test (univariate) and the Chi square correlation test (bivariate). Results and Discussion: The results show that the majority of respondents had inadequate knowledge of ethical and medicolegal issues in handling the COVID-19 pandemic (70.0%); however, they had a positive attitude in overcoming ethical and medicolegal issues, i.e.77.5%. The chi square statistical test result shows no correlation between knowledge and attitude with a p-value of 0.077 (p-value >0.05). Conclusions: Therefore, it can be concluded that the theoretical knowledge of doctors was not sufficient to identify ethical and medicolegal issues, but the attitude in dealing with ethical and medicolegal issues was satisfactory. This result offers a new opportunity and challenge to increase the awareness of doctors in applying their knowledge and attitudes towards handling the COVID-19 pandemic.


2020 ◽  
Vol 37 (1) ◽  
Author(s):  
Saba Saif ◽  
Samina Fida ◽  
Hala Mansoor

Objectives: To assess the knowledge and confidence of junior doctors and non-specialists in examining and making a diagnosis of patients with musculoskeletal (MSK) diseases. Methods: This was a Cross-sectional study of 121 doctors working in medical clinics at a tertiary hospital between October and December 2019. Data were collected using a questionnaire. Doctor’s awareness regarding different MSK examination methods including gait, arms, leg, spine (GALS), pediatric gait, arms, leg, spine (pGALS) and regional examination of musculoskeletal system (REMS) was noted. Undergraduate teaching of these methods and use in their daily practice was surveyed. Results: Majority of the doctors lacked awareness about different MSK examination techniques. Awareness about GALS, REMS and pGALS was 44.6%, 59.5% and 18.2% respectively. There was significant correlation of GALS/REMS awareness with the undergraduate teaching and doctor’s clinical experience (p-value <0.05). Confidence level of doctors in diagnosing patients with adult MSK pathologies was 55%. Only few doctors were satisfied with their musculoskeletal education (29%). Conclusion: The GALS examination is a useful screening tool for junior doctors and non-specialists in a direct access setting to rule out musculoskeletal problems. doi: https://doi.org/10.12669/pjms.37.1.3148 How to cite this:Saif S, Fida S, Mansoor H. Assessment of knowledge of junior doctors and non-specialists about musculoskeletal medicine. Pak J Med Sci. 2021;37(1):175-179. doi: https://doi.org/10.12669/pjms.37.1.3148 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 37 (2) ◽  
Author(s):  
Fahd Aljarbou ◽  
Sundus Bukhary ◽  
Abdullah Althemery ◽  
Abdullah Alqedairi

Objectives: To investigate the clinical dental students’ knowledge on the proper dental setting during COVID-19. Methods: Using multicenter cross-sectional study, a 10-items questionnaire was distributed in April 2020 among senior dental students from two dental schools. It comprised three main domains: demographic questions, questions investigating student’s access to the proper recommendations of dental settings during COVID-19 and the specific recommendations questions. Results: The questionnaire was sent to 654 clinical dental students and the total number of respondents were 267 representing a response rate of 40.83%. The overall knowledge mean was low (1±0.92). Gender was not a statistically significant factor affecting the knowledge score (P > 0.05). Most of the participants never visited the Saudi Center for Disease Prevention and Control (Saudi CDC) website and received no guidance or advice regarding proper dental practices during COVID-19. A statistically significant relationship was observed between the mean knowledge score and access to knowledge variables (P < 0.05). Conclusion: It was noted that clinical dental students have low knowledge on the proper dental settings during COVID-19 pandemic that was recommended by the Saudi CDC guidelines and they must be equipped with adequate knowledge from reliable sources to overcome their insufficiencies such as a well-structured and dynamic curriculum. doi: https://doi.org/10.12669/pjms.37.2.3768 How to cite this:Aljarbou FA, Bukhary SM, Althemery AU, Alqedairi AS. Clinical dental students’ knowledge regarding proper dental settings for treating patient during COVID-19: A cross-sectional study. Pak J Med Sci. 2021;37(2):---------. doi: https://doi.org/10.12669/pjms.37.2.3768 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):  
Mariam Danish Iqbal ◽  
Tahir Naeem ◽  
Umar Khurshid ◽  
Fatima Hameed

Objective: Globally childhood diarrheal diseases continue to be the second leading cause of death. Cryptosporidium spp are important intestinal parasites that cause diarrhea in humans and animals particularly in developing countries. This investigation was carried out to find out the frequency of cryptosporidiosis in children presenting with persistent diarrhea. Methods: Two hundred stool samples were collected in this descriptive cross-sectional study conducted at Microbiology Department, Combined Military Hospital, Lahore Pakistan between the months of July to Dec 2014. Children aged five years to 12 years who presented with persistent diarrhea were included in the study. Stool specimens were processed using the modified acid-fast staining method, and microscopically examined for Cryptosporidium infection. Results: The average age of study participants was 7.95 with a standard deviation of 2.21 years. Among the participants 66% were males whereas 34% were females. Twenty eight percent had presence of oocysts in stool samples. Conclusions: The frequency of Cryptosporidiosis among children with persistent diarrhea was 28%. This high frequency indicates that this population is uniquely susceptible to infection. It also highlights the need for education about hygiene, accurate diagnosis, and treatment of Cryptosporidiosis. There is also a need for additional studies regarding the occurrence of this pathogen. doi: https://doi.org/10.12669/pjms.37.1.2700 How to cite this:Iqbal MD, Naeem T, Khurshid U, Hameed F. Frequency of Cryptosporidiosis in Children having Persistent Diarrhea. Pak J Med Sci. 2021;37(1):121-124. doi: https://doi.org/10.12669/pjms.37.1.2700 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.


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