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Lahore, Pakistan

Ahmed A.,Fatima Memorial Hospital | Alvi A.H.,Fatima Memorial Hospital | Butt A.,Services Hospital | Nawaz A.A.,Fatima Memorial Hospital | Hanif A.,Gulab Devi
Journal of the College of Physicians and Surgeons Pakistan | Year: 2014

Objective: To assess the utility of liver function tests (LFTs) for early recognition and prediction of severity of Dengue fever in hospitalized patients. Study Design: An analytical study. Place and Duration of Study: Services Institute of Medical Science and Fatima Memorial Hospital, Lahore, from September - December 2010. Methodology: Admitted cases of Dengue fever were divided into 3 groups; mild, moderate and severe increases in aminotransferases. Elevation in LFTs was co-related with good or bad outcome i.e. (survival or complication free stay) or (death or complications). Results were analyzed in SPSS version 18. Results: Out of the 353 patients with mean age of 37.12 ± 15.45 years, 245 (69.4%) were males and 108 (30.6%) were females. Seventy five patients (21.2%) had mild elevation of aminotransferases (2 fold increases), 265 patients (75.1%) had moderate increases (3 to 4 fold) and 13 (3.7%) had severe (> 4 fold increase). ALT was statistically higher in patients with septicemia, hepatic and renal failure (p-value ≤ 0.05). AST was higher in almost all complications. Prolonged hospital stay was associated with raised LFTs and greater complications and mortality. AST was found to be twice as much raised as ALT. Conclusion: AST and ALT were statistically higher in patients with worse outcome thus can lead to early recognition of high risk cases. Source

Iqbal U.,Central Park Medical College | Khan A.,Central Park Medical College | Sheikh F.,Services Hospital
Pakistan Journal of Medical and Health Sciences | Year: 2012

Objective: To investigate whether acupressure (p6) prevents nausea and vomiting in patients undergoing laparoscopic surgery and to compare effect and placebo effect of acupressure (P6) in preventing nausea and vomiting in patients who have undergone laparoscopic surgery. Methods: This was double blind randomized study in which sixty patients were enrolled. They were divided into three equal groups. First group received acupressure with bilateral stimulation of P6 (A), Second group received bilateral placebo stimulation (P) and a third group received no acupressure stimulation and served as a reference group (R). We observed how many patients developed nausea vomiting and needed rescue antiemetics in each group. Results: It is clear from the results that 9,7 and 6 patients in group A,P and R respectively develop nausea only while 1, 1 and 8 patients had nausea (8 Vs 1 with P < 0.05) 24 h after surgery in A,P and R groups respectively. When compared to placebo acupressure (2 patients vomited and 5 needed rescue medication) significantly (P<0.05) fewer needed rescue antiemetic medication after acupressure at P6 (no vomiting and rescue medication) When compared to the reference group (5 vomited and 4 needed rescue medication) significantly fewer vomited after acupressure (P<0.05). Conclusion: It has been concluded from our study that acupressure (p6) has significantly reduced vomiting and need of rescue medication in patients undergoing laparoscopic surgeries. While placebo effect of acupressure decreased nausea 24 h after surgery. Source

Naeem F.,Queens University | Gul M.,Sir Ganga Ram Hospital | Irfan M.,Peshawar Medical College | Munshi T.,Queens University | And 10 more authors.
Journal of Affective Disorders | Year: 2015

Objectives: To determine the efficacy of brief Culturally adapted CBT (CaCBT) for depression when added to Treatment As usual (TAU) - delivered by trained therapists using a manual compared with alone TAU. Methods: This was an assessor-blinded, randomised controlled clinical trial. Particpants with a diagnosis of depression, attending psychiatry departments of three teaching hospitals in Lahore, Pakistan, were included in the study. We screened a total of 280 patients and randomly allocated 137 of them to CaCBT plus Treatment As Usual (TAU) [Treatment group] or to TAU alone [Control group]. Assessments were completed at baseline, at 3 months and at 9 months after baseline. Reduction in depression score (Hospital Anxiety and Depression-Depression Subscale) at 3 months was primary outcome measure. The secondary outcome measures included anxiety scores (Hospital Anxiety and Depression-Anxiety Subscale), somatic symptoms (Bradford Somatic Inventory), disability (Brief Disability Questionnaire) and satisfaction with the treatment. Findings: A total of 69 participants were randomised to Treatment group and 68 to Control group. Participants in Treatment group showed statistically significant improvement in depression (p=0.000), anxiety (p=0.000), somatic symptoms (p=0.005) and disability (p=0.000). This effect was sustained at 9 months after baseline (Except for disability). Participants in Treatment group also reported higher satisfaction with treatment compared with those in Control group. Conclusion: Brief CaCBT can be effective in improving depressive symptoms, when compared with treatment as usual. This is the first report of a trial of Culturally adapted CBT from South Asia and further studies are needed to generalise these findings. © 2015 Elsevier B.V. All rights reserved. Source

Objective: To assess the magnitude of anxiety and depression among cancer patients and to determine their association with age, gender and time since diagnosis. Methods and materials: A cross-sectional study carried out on cancer patients admitted to oncology units in three tertiary care hospitals in District Lahore, Pakistan. A total of 100 cancer patients were interviewed using structured questionnaires to assess the levels of depression and anxiety among them using classification of anxiety and depression disorders in ICD - 10 laid down by WHO. Results: In our study (n=100) the mean age is 42.05 among whom 52(52%) were males and 48(48%) females. Anxiety disorders were present in 79% patients while 86% had depressive disorders. Age with level of anxiety (p=0.0192) and time since diagnosis with levels of depression (p=0.0144) was significantly associated. The p values of age and level of depression was 0.2334 and for time since diagnosis and levels of anxiety was 0.0899. Conclusion: Special concerns should be kept in mind while treating cancer patients in middle-aged groups and with those having a time since diagnosis of less then 6 months, because high levels of depression and anxiety are experienced in cancer patients with a shorter time since diagnosis. Source

Ali S.,Psychology Branch | Bokharey I.Z.,Services Hospital
Educational Gerontology | Year: 2016

With meager resources and lack of awareness in Pakistan, the phenomenon of caregiving poses a great challenge for those living with the frail elderly suffering from chronic illness. This article highlights how the informal caregivers are ingrained in this painstaking process due to sociocultural obligations. The purpose of this qualitative study was to carry out in-depth analyses of the lived experiences of the caregivers of patients with dementia and to explore the emotional and behavioral problems faced by them. On the basis of the emergent themes, the researchers would propose a therapeutic intervention plan for the caregivers that would enable them to provide adequate caregiving. The research strategy employed was Interpretative Phenomenological Analysis (IPA). Eight participants were selected from government hospitals in Lahore, Pakistan through homogenous purposive sampling. After ensuring confidentiality and taking consent, data were collected through semistructured interviews that were recorded and transcribed. In-depth analyses were carried out followed by thematic analyses. Moreover, data were verified through clarifying researcher’s bias, peer review, and rich thick description. The most significant themes regarding maladaptive behaviors came out to be reactivity and self-neglect; whereas significant maladaptive emotions were worry, low frustration tolerance, and anger. This study would be helpful towards devising appropriate therapeutic intervention for the caregivers in the Pakistani sociocultural context. © 2016 Taylor & Francis. Source

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