Frequency to Non-Compliance to Oral Iron Therapy in Pregnancy and Common Factors Leading to it

OBJECTIVES: The objective of this study was to determine frequency of non-compliance to oral iron therapy in pregnancy and common factors leading to it. METHODOLOGY: It was a cross-sectional study done in the Department of Obstetrics and Gynecology of Lady Willington Hospital Lahore, Pakistan. The duration of this study was six months i.e., 3rd October 2019 to 2nd March 2020. All antenatal patients between ages of 18 to 45 years presented in the obstetrics outdoors or admitted in the ward were included in this study. A total of 245 patients were included in this study by consecutive non-probability sampling. Patients with gynecological problems, patients dependent on others for their medication cost, patients with psychiatric illness or physical disability were excluded. Post stratification Chi-square test was applied keeping P-value ≤0.05 as significant RESULTS: Among 245 patients, mean age was 27±2.16 years. Iron supplement used by 245 patients was analyzed as 159 (65%) patients had used the iron supplement while 86 (35%) patients didn’t use iron supplements (P-value 0.001). Iron supplement used by 245 patients was analyzed and only 93 (38%) patients had used the iron supplement while 152 (62%) patients didn’t use iron supplements. CONCLUSION: The coverage of antenatal iron and folic acid supplements is very low in the surveyed districts of Pakistan due to lack of parental education and older aged women belonging to poor households

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P < 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure

Objective: To assess the role of abdominal binder in patients with midline wound dehiscence after elective or emergency laparotomy in terms of pain, psychological satisfaction and need for reclosure.&#x0D; Methods: It was a comparative study done at EAST Surgical Ward of Mayo Hospital, Lahore from 1st January 2018 to 31st December 2019. One hundred and sixty-two (162) patients were included in this study with post-operative midline abdominal wound dehiscence and after informed consent by consecutive non probability sampling technique. Patients were divided into two groups by lottery method into eighty-one patients each. Group-A included patients where abdominal binder was applied and Group-B included patients without abdominal binder. In both groups pain score, psychological satisfaction and need for reclosure was assessed and compared.&#x0D; Results: Patients with abdominal binder shows significantly less pain (P value =0.000) and more psychological satisfaction (P value = 0.000) as compared to the patients where abdominal binder was not used. However, there was no difference in reducing the need for reclosure in patients who use abdominal binder (P value = 0.063).&#x0D; Conclusion: Although abdominal binder helps in reducing the pain and improving the psychological satisfaction in patients with midline abdominal wound dehiscence yet it doesn’t help in healing of wound and reclosure of the dehisced abdominal wound is needed.&#x0D; doi: https://doi.org/10.12669/pjms.37.4.3671&#x0D; How to cite this:Ammar AS, Naqi SA, Khattak S, Noumani AR. Outcome of abdominal binder in midline abdominal wound Dehiscence in terms of pain, psychological satisfaction and need for reclosure. Pak J Med Sci. 2021;37(4):1118-1121.  doi: https://doi.org/10.12669/pjms.37.4.3671&#x0D; 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.</jats:p

Comparison of Forensic Value of Biometric Analysis in Face &amp; Ear Recognition in the Punjabi Population, Pakistan

Background: The use of face biometrics is very prevalent in forensic investigations for the identification of the perpetrators of crime due to the excessive use of CCTV footage that is usually available at the scene of a crime in urban settings. Ear biometric analysis of ear prints is also in vogue as a result of research advancements in the fields of biometrics. Keeping in view this scenario, it is the need of the hour to analyze the forensic value of this type of forensic evidence and compare these two tools of forensic biometrics. Purpose: To analyze and compare the forensic value of biometric analysis of face and ear print recognitions in the Punjabi population, in Punjab, Pakistan. Study design: This study is conducted by collecting the data from 100 samples of different people belonging to different backgrounds from different cities in Punjab, Pakistan after their informed consent and ethical approval. Their facial photographs and ear prints were collected for proceeding biometric analysis to form a database for comparison and recognition. Method and materials: After collecting data, the comparison is done to see whether we can recognize a person by only using ear print analysis or face biometrics after running a search in our own created database. Moreover, we also calculated the forensic values of this biometric analysis separately on its own and combined these two i.e., face and ear biometrics. . Furthermore, standard deviation, F-statistics, and Chitest p-value were also applied to see the power of discrimination of these two biometric methods of identification Results: In 100 samples, face recognition was proved to be 80 % recognition of identity as compared with only ear prints which showed 56 % accuracy in identifying the individuals who participated in this research. Furthermore, the combined result of both face recognition and ear biometrics showed 90 % recognition of the identity of the individuals. Statistical analysis proved that biometric analysis of the face for recognition of the identity of individuals was more valued as compared with ear print recognition. Also, it was found that if we combine these two methods of biometrics, the forensic value of recognition of individuals has increased and showed good results. Conclusion: The forensic value of biometric evidence of face and ear recognition is a very important tool for the forensic identification of individuals in crime scene investigations. Biometric facial recognition is better as compared to only ear print biometric analysis. Furthermore, using face and ear biometrics enhances the forensic value of biometric analysis. Keywords: Biometric analysis, Forensic value, face recognition, ear print recognition,</jats:p

Frequency to Non-Compliance to Oral Iron Therapy in Pregnancy and Common Factors Leading to it

OBJECTIVES: The objective of this study was to determine frequency of non-compliance to oral iron therapy in pregnancy and common factors leading to it. METHODOLOGY: It was a cross-sectional study done in the Department of Obstetrics and Gynecology of Lady Willington Hospital Lahore, Pakistan. The duration of this study was six months i.e., 3rd October 2019 to 2nd March 2020. All antenatal patients between ages of 18 to 45 years presented in the obstetrics outdoors or admitted in the ward were included in this study. A total of 245 patients were included in this study by consecutive non-probability sampling. Patients with gynecological problems, patients dependent on others for their medication cost, patients with psychiatric illness or physical disability were excluded. Post stratification Chi-square test was applied keeping P-value ≤0.05 as significant RESULTS: Among 245 patients, mean age was 27±2.16 years. Iron supplement used by 245 patients was analyzed as 159 (65%) patients had used the iron supplement while 86 (35%) patients didn’t use iron supplements (P-value 0.001). Iron supplement used by 245 patients was analyzed and only 93 (38%) patients had used the iron supplement while 152 (62%) patients didn’t use iron supplements. CONCLUSION: The coverage of antenatal iron and folic acid supplements is very low in the surveyed districts of Pakistan due to lack of parental education and older aged women belonging to poor households.</jats:p

Histopathological spectrum and outcome of surgery for salivary gland tumors presented in tertiary care hospital of Pakistan.

Objective: This study is aimed to know the histopathological spectrum and outcome of surgery for salivary gland tumors presented in a tertiary care hospital of Pakistan. Study Design: Retrospective study. Setting: Tertiary Care Hospital of Pakistan. Period: July 2018 to June 2020. Material &amp; Methods: After approval from Institutional Review Board. Total 73 patients were selected with preoperative diagnosis of salivary gland tumors with consecutive non probability sampling. All surgical procedures were done by specialist general surgeons who had experience of more than 10 years of head and neck surgery. Results: Male to female ratio was 2:1 with mean age of patients was 46 years. Among males 29 (59.1%) were benign salivary gland tumors while 20 (40.81%) were malignant salivary gland tumors. Among females 13 (54.16%) were benign and 11 (45.83%) were malignant salivary gland tumors Most common benign tumor was pleomorphic adenoma 32 (43.8%) while mucoepidermoid carcinoma was most common malignant tumor 17 (23.28%). Only 9 (12.32%) patients experienced nerve paresis. Conclusion: Male preponderance, a relatively younger age at presentation and single predominant benign tumor (pleomorphic adenoma) were the significant findings. Majority of them were found in parotid gland and found to be benign in nature. Majority of them were found in parotid gland and found to be benign in nature. Although fine needle aspiration cytology and magnetic resonance imaging provide some useful information about the nature of tumor but most of them will acquire a surgical excision in order to find the definitive diagnosis.</jats:p

Comparison of outcome of total thyroidectomy with and without pre-operative calcium and vitamin D supplements in terms of post-operative hypocalcemia.

Objective: The objective of this study is to compare the effect of pre-operative calcium and vitamin D supplements in terms of hypocalcemia in patients with total thyroidectomy. Study Design: Comparative study. Setting: EAST Surgical Ward, MAYO Hospital Lahore, Pakistan. Period: 1st July 2018 to 30th June 2020. Material &amp; Methods: Sample size of 342 patients and duration of 2 years. 2 groups were created including 171 patients each. Group A patients received calcium and vitamin D supplements 1 week prior to total thyroidectomy while Group B patients didn’t receive any supplements. The results of both groups were compared. Data was collected by pre designed proforma and evaluated by SPSS 21. Results: 164 (47.9%) patients were male and 178 (52.0%) were females. Most common age group which undergone total thyroidectomy was between 31 years to 40 years. Total 140 patients (40.93%) experienced hypocalcemia. In group A, 32 (18.71%) experienced hypocalcemia while in group B 108 (63.1%) experienced hypocalcemia. The most common occurrence of hypocalcemia was noted on 1st post-operative day where 52 (37.14%) cases of hypocalcemia were reported. Conclusion: In a country with prevalent calcium and vitamin D deficiency the addition of these supplements one week prior to total thyroidectomy will lead to lesser incidence of hypocalcemia after total thyroidectomy and early discharge of the patient.</jats:p

Global 30-day morbidity and mortality of surgery for perforated peptic ulcer: GRACE study

Background There is little international data on morbidity and mortality of surgery for perforated peptic ulcer (PPU). This study aimed to understand the global 30-day morbidity and mortality of patients undergoing surgery for PPU and to identify variables associated with these. Method We performed an international study of adults (≥ 18 years) who underwent surgery for PPU from 1st January 2022 to 30th June 2022. Patients who were treated conservatively or had an underlying gastric cancer were excluded. Patients were divided into subgroups according to age (≤ 50 and &gt; 50 years) and time from onset of symptoms to hospital presentation (≤ 24 and &gt; 24 h). Univariate and Multivariate analyses were carried out to identify factors associated with higher 30-day morbidity and mortality. Results 1874 patients from 159 centres across 52 countries were included. 78.3% (n = 1467) of the patients were males and the median (IQR) age was 49 years (25). Thirty-day morbidity and mortality were 48.5% (n = 910) and 9.3% (n = 174) respectively. Median (IQR) hospital stay was 7 (5) days. Open surgery was performed in 80% (n = 1505) of the cohort. Age &gt; 50 years [(OR = 1.7, 95% CI 1.4–2), (OR = 4.7, 95% CI 3.1–7.6)], female gender [(OR = 1.8, 95% CI 1.4–2.3), (OR = 1.9, 95% CI 1.3–2.9)], shock on admission [(OR = 2.1, 95% CI 1.7–2.7), (OR = 4.8, 95% CI 3.2–7.1)], and acute kidney injury [(OR = 2.5, 95% CI 1.9–3.2), (OR = 3.9), 95% CI 2.7–5.6)] were associated with both 30-day morbidity and mortality. Delayed presentation was associated with 30-day morbidity [OR = 1.3, 95% CI 1.1–1.6], but not mortality. Conclusions This study showed that surgery for PPU was associated with high 30-day morbidity and mortality rate. Age, female gender, and signs of shock at presentation were associated with both 30-day morbidity and mortality