Effectiveness of Pulmonary Rehabilitation in Patients with COPD

Background: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs. Objective: The objective of this analysis was to determine the effectiveness of respiratory services provided in the hospital or community by respiratory therapists (RTs) in reducing health care utilization and improving patient outcomes. The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease. Methodology: All 65 Pakistani patients who met the inclusion criteria with ages between 40 to 65 years, including both male and female, with mild to severe COPD were enrolled in the study on the basis of convenient sampling. Informed consent was taken from each patient starting about the study and their rights to withdraw from study. A demographics detail (name, age, sex) was noted along with the necessary medical history. A questionnaire was made to see the effects of pulmonary rehabilitation in patients with COPD. All necessary tests were performed to evaluate the patient betterment completely. Results: The mean FEV1 in the subjects was 1.29 ± 0.47 L/min, 64.8 ± 23.0% of predicted. Clinically there is a little effect on CXR pattern, FEV1 and FEV1/FVC after pulmonary rehabilitation. But overall quality of life improved after pulmonary rehabilitation. Mainly improvement occurs in peak expiratory flow rate, BORG dyspnea scale, 6 mint walk test distance (meters) and Oxygen saturation after rehabilitation. Conclusion: These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity

In Vitro Antifungal Potential of Vanillic Acid against Sclerotium rolfsii

The worldwide demand for making agriculture greener, safer, and more efficient can be met aptly by the application of biopesticides. Vanillic acid is a naturally occurring versatile phenolic molecule with promising antifungal activity, however, there have been no studies of the possible use of vanillic acid for its antifungal activity against a serious soil-borne fungal plant pathogen namely Sclerotium rolfsii. This study was performed to assess the antifungal potential of vanillic acid by analyzing growth, morphological, and biochemical changes in S. rolfsii under laboratory conditions. The results revealed that vanillic acid (0.003-0.10 %) significantly reduced fungal growth, distorted fungal morphology (hyphae, and sclerotia), altered activity of enzymes (catalase, peroxidase, polyphenol oxidase, and phenylalanine ammonia-lyase). However, 0.05 and 0.10 % concentrations caused complete inhibition in the fungal growth. The results explained in this work serve as a basis for further research to formulate fungicides using vanillic acid

Sonographic Association of Cholelithiasis with Obstructive Jaundice in Adult Patients

Background: Cholelithiasis is the commonest cause of obstructive jaundice and for the investigation of cholelithiasis and obstructive jaundice ultrasound is a gold standard modality. Obstructive jaundice is generally due to biliary obstruction, which is a blockage of the common bile duct or any duct that carries bile from the liver to the gallbladder and then enters into the small intestine. Objective: To determine sonographic association of cholelithiasis with obstructive jaundice in adult patients. Methodology: A cross sectional study was conducted among 138 individuals. All were young adults within the age range of 18-35 years. Data was collected from Civil Hospital Gujranwala city, by using simple random sampling technique. The examination was done with Toshiba Xario 3.5-5MHz curvilinear transducer. Gallbladder scan was started with the patient in the supine position from both subcostal and intercostal approaches. It was analyzed through SPSS version 24.0 and presented through frequency and percentages. Results: Total 138 individuals were included in this study. Out of 138 subjects, 69 individuals with cholelithiasis out of 69, 24 individuals with obstructive jaundice. And other 69 individuals without cholelithiasis in which 26 subjects presented with jaundice. It was found that females (51.4%) were more commonly affected than males (48.6%).Conclusion: It was concluded that cholelithiasis is one of the main causes of obstructive jaundice and ultrasound can easily diagnose the cases of cholelithiasis. It was found that females were more commonly affected than males. Keywords: cholelithiasis, obstructive jaundice, jaundice, ultrasound. DOI: 10.7176/JHMN/72-04 Publication date:March 31st 202

AN ASSESSMENT OF OVARIAN CANCER FEMALE PATIENTS' DEATH AND SURVIVAL RATE AFTER SURGICAL INTERVENTION: NEOADJUVANT CHEMOTHERAPY VERSUS PRIMARY DEBULKING SURGERY

Objective: The main purpose of the study is to determine the survival and death rate of the female after surgical operation. This is determined by the two different methods of treatment between the females suffering from ovarian cancer. Methods: The study arranged was of a retroactive type and it was held at Mayo Hospital, Lahore from February to September 2017. The study was associated with the data obtained in 1999 and 2008 about the female’s treatment suffering from ovarian cancer. The clinical data obtained during the previous analysis was again studied and revised. And similar knowledge was obtained about the environmental, medical, therapeutically, pathological aspects of studies. Overall existence of patients was compared with growthfree existence. The comparison was made between patients who went either debulking surgery or neoadjuvant chemotherapy before surgery. Mathematical identification was performed by using SPSS. Results: Total 118 patients were undergone surgical cure. Out of which 66% gained the primary debulking surgery and rest of the 34% received neoadjuvant chemotherapy. The average age and tumour antigen 125 level before treatment was same. In the debulking group, two stages of patients were identified. That group had 94.8% patients with stage 3 carcinoma and 5.1% stage 4 carcinoma. While in other groups the percentage of patients in stage 3 and 4 were 80% and 20% correspondingly. The most favourable occurrence of debulking was 56.8% in the earlier group as compared to 79.4% in the second group. At the time of surgery, the total loss of blood was recorded as 1500 ml. The loss of blood was almost the same in the different exhaustive care unit. In addition to the loss of blood, the rate of urinary swathe, bowel grievance and bowel reactions were also analogous. The growth free existence was also comparable in both groups. Conclusion: Equivalent existence rates and peri-operative difficulties can be created by neo-adjuvant chemotherapy followed by intermission debulking. Keywords: Ovarian epithelial cancer, Chemotherapy, Gynecological surgical procedure, Survival analysis

Role of Hypogonadotropic Hypogonadism in Psychosocial Deprivation among Females Patients

Background: Patients with rare diseases such as congenital hypogonadotropic hypogonadism (CHH) are often challenged to be isolated, lack proper medical care and face negative social consequences. Furthermore, pubertal development is the period of rapid and nearly simultaneous transformation of biological, physical, social, and psychological domains of an individual. Hence, the process of personal transformation is also affected in children with pubertal delay. Due to delay in the growth process, the individual looks different from her or his peers and may have negative consequences on the psychological and social interactions. Objective: The disparities in the growth and development may cause an increase in psychosocial problems and negative peer relationship. Hence, this study was designed to observe psychosocial consequences of delayed puberty in female with CHH. Design: Cross sectional study. Place & duration of study: The data were collected from CHH patients visiting public sector hospitals over a period of 18 months. Patients & Methods: The demographic information, complete medical history, psychological and psychosocial symptoms of the 52 female CHH patients were recorded on the questionnaire. Results: The present study demonstrated that most of the patients were frustrated due to poor body image, low self-esteem, feeling themselves behind the peers, and were with complaints of depression and anxiety. The other psychological symptoms include anger, irritability, loneliness, eating and sleeping disturbances. Conclusion: It was concluded that the delayed sexual maturation has resulted in frustration, low self-esteem and increased anxiety and depression in cohort of local females with CHH

Frequency of Hepatocellular Carcinoma in Patients Infected with Hepatitis C Virus visiting a Tertiary Care Hospital in Lahore for Computed Tomographic Evaluation

Background: Hepatitis C virus has been identified as one of the leading causes of chronic liver disease and its complications world-wide. Subsequent development of hepatocellular carcinoma in these patients is a major complication of this infection having serious implications on morbidity and mortality rates. The objective of this study was to find out the frequency of Hepatocellular carcinoma in patients suffering from Hepatitis C visiting Radiology department of a tertiary care hospital for multi-detector computed tomography evaluation.Methods: This cross-sectional analytical study was conducted at Shalamar Hospital Lahore. A total of 195 patients, suffering from Hepatitis C, visiting Shalamar Hospital, Lahore for evaluation by CT during 6 months study interval were included in this study. Abdominal CT was performed using Triphasic contrast enhancement protocol. All images were interpreted by a senior Radiologist. Frequency of Hepatocellular carcinoma was calculated. Statistical analysis was made using MEDCALC.Results: Out of 195, 63(32.3%) patients were seen to have hepatocellular carcinoma. This disease was more common in male, 45(34.6%) as compared to female patients 18 (27.7%). The presence of HCC showed statistically significant association with alcoholism, obesity, diabetes mellitus and cirrhosis.Conclusion: The study concluded that a substantial number of HCV positive patients develop HCC, which is more common in men as compared to women. The presence of HCC is strongly associated with alcoholism, obesity, diabetes mellitus and cirrhosis.Keywords: Hepatocellular carcinoma (HCC); Hepatitis C (HCV); Multi-detector Computed Tomography (MDCT)

Cognitive Impairments in Children with Down Syndrome

This study is designed to determine the cognitive impairments in individuals with Down syndrome. This study was conducted in September to November 2014. Sample of 30 patients was taken by using purposive sampling technique within three months. Observational and Cross-sectional study design was used. This was a hospital-based study in which patients with Down’s syndrome between the age range of 5-18 and both genders were included. A structured questionnaire was developed that was based on Piaget’s theory of cognitive development to assess the cognitive abilities by assessing tasks related to developmental ages. Out of those 30 patients 15(50٪) were male and 15(50٪) were females. Most of the patients were found in age range of 5-10 years according to frequency 16 (53.3٪) followed by 10 (33.3٪) patients in 10-15 years and 4 (13.3٪) in 15-20 years. The preoperational stage of cognitive development showed that the girls were more impaired. Pretend-play (boys (50%), girls(46.7%)),Centration(boys(40.%), girls(33.3%) and irreversibility boys (50%) girls(40.%) are the aspects in which boys were tending to show better than boys. In concrete operational stage and in formal operational stage both genders were tending to show equal impairments in their cognitive aspects. In the children with Down syndrome it is observed that there is high frequency of cognitive impairment and girls are more cognitively impaired than boys. While the tasks which require more accuracy and intelligence such as reasoning, meta-cognition, inductive and deductive reasoning are rarely present in both genders. Keywords: Down syndrome, pre-operational, concrete-operational and formal-operational. DOI: 10.7176/JHMN/71-12 Publication date: February 29th 202

Automatic Speaker Identification System for Urdu Speech

Speaker recognition is the process of recognizing a speaker from a verbal phrase. Such systems generally operates in two ways: to identify a speaker or to verify speaker’s claimed identity. Availability of valuable research material witnessed efforts paid to Automatic Speaker Identification (ASI) in East Asian, English and European languages. But unfortunately languages of South Asia especially “Urdu” have got very less attention. This paper aims to describe a new feature set for ASI in Urdu speech, achieving improved performance than baseline systems. Classifiers like Neural Net, Naïve Bayes and K nearest neighbor (K-NN) have been used for modeling. Results are provided on the dataset of 40 speakers with 82% correct identification. Lastly, improvement in system performance is also reported by changing number of recordings per speaker