Shalamar Medical and Dental College
Shalamar Medical and Dental College
Sohail S.,Shalamar Medical and Dental College |
Dar L.R.,Shalamar Medical and Dental College |
Ismail K.,Shalamar Medical and Dental College
Pakistan Journal of Medical and Health Sciences | Year: 2016
Background: Vesicovaginal fistula (VVF) is an abnormal communication between the bladder and vagina. It results in continuous leakage of urine. This problem has a severe negative impact on quality of life of the sufferer. Aim: To find out the causes of development of VVF. Methods: This retrospective study was conducted Gynae/Obs department of Shalamar Medical and Dental College Lahore from January 2014 to January 2016. Records of the women with vesicovaginal fistula were reviewed and causes of VVF identified. Results: Prolonged obstructed labor is the main cause of VVF in developing countries. Most of the women with VVF belonged to poor socioeconomic status and live in rural areas .VVF effected the social, mental and physical health of patients. Conclusion: Lack of sufficient maternity services is the main cause of VVF .There is need of improved maternity services and obstetric care for the prevention of this problem. © 2016, Lahore Medical And Dental College. All rights reserved.
Hannan A.,University of Health Sciences, Lahore |
Asghar S.,University of Health Sciences, Lahore |
Naeem T.,Shalamar Medical and Dental College |
Ullah M.I.,University of Health Sciences, Lahore |
And 3 more authors.
Pakistan Journal of Pharmaceutical Sciences | Year: 2013
Alternative herbal medicine has been used to treat various infections from centuries. Natural plants contain phytoconstituents having similar chemical properties as of synthetic antibiotics. Typhoid fever is a serious infection and failure of its treatment emerged multi-drug resistant (MDR) bugs of Salmonella typhi. Due to multiple and repeated issues with antibiotics efficacy, it became essential to evaluate biological properties of plants from different geographical origins. Mango leaves have been reported for various medicinal effects like antioxidant, antimicrobial, antihelminthic, antidiabetic and antiallergic etc. Objective of present study was to investigate anti-typhoid properties of acetone mango leaf extract (AMLE) against antibiotic sensitive and MDR S. typhi isolates. A total of 50 isolates of S. typhi including MDR (n=30) and antibiotic sensitive (n=20) were investigated. Staphylococcus aureus (ATCC 25923) and Salmonella typhimurium (ATCC14028) were used as quality control strains. AMLE was prepared and its antibacterial activity was evaluated by agar well diffusion screening method and minimum inhibitory concentration (MIC), by agar dilution technique. Zone of inhibition (mm) of AMLE against MDR and antibiotic sensitive isolates was 18±1.5mm (Mean±S.D). Zone of S. aureus (ATCC 25923) and S. typhimurium (ATCC14028) was 20±1.5mm (Mean±S.D). MIC of AMLE was reported in range from 10-50 mg/ml. The present study described the inhibitory effects of mango leaves against S. typhi.
Hassan Q.,Ziauddin University |
Rakha A.,University of Health Sciences, Lahore |
Zahid Bashir M.,Shalamar Medical and Dental College
Journal of the College of Physicians and Surgeons Pakistan | Year: 2017
Objective: To estimate age through aspartic acid racemization of human dentin for forensic analysis, and to calculate the margin of error between chronological age and estimated age by racemization method. Study Design: Cross-sectional comparative study. Place and Duration of Study: Dental Outpatients' Department, Ziauddin Hospital, Karachi, from 2011 to 2014. Methodology: Patients from dental orthodontics department were selected. Verbal expressed consent was taken from the participants. Preliminary data was entered in a specially designed performa having name, chronological age, gender, socio-economic status. L and D ratio of aspartic acid were quantified in dentin for each tooth by High-Pressure Liquid Chromatography technique. Results of 100 samples with known age were used during study to estimate co-efficient of racemization. Regression equation was derived by plotting 85 samples of known age and KR as independent and dependent variables and least square equation was derived - Age = -4.391 +347.396 (co-efficient of racemization). Results: The estimated co-efficient of determination was 0.74, meaning thereby that the regression equation was 74% correct for estimating age. The calculated correlation between chronological age and co-efficient of racemization was 0.834, which is interpreted as a very strong and positive correlation. The co-efficient of racemization increased with the age. The mean chronological age (38.44 ±13.22) years were statistically similar to the mean calibrated age (37.52 ±12.36) years. The median of actual and calibrated age was found to be 3.4 with inter-quantile value of 13. No statistically significant difference was observed among gender (p=0.837), or socioeconomic status (p=0.35). Conclusion: Racemization of human dentin could be used as one of the reliable method for estimating age. HPLC is a reliable technique to estimate the co-efficient of racemization because it is highly reproducible, cost-effective and convenient. However, the procedure should be optimized and standardized within all laboratories for quality assurance.
Gulnaz H.,The University of Lahore |
Majeed N.,Shalamar Medical and Dental College |
Pakistan Journal of Medical and Health Sciences | Year: 2017
Background: Orofacial clefts are very common congenital anomalies and include cleft lip, cleft lip and palate and cleft palate alone. The development of congenital anomalies is multifactorial which include environmental and genetic factors and consanguinity. As consanguineous marriages are commonly practiced, the present study is designedto evaluate the patterns of orofacial clefts in patients with consanguineous parents in local population. Methods: Data was collected from Shalamar Hospital, Children Hospital and Arif Memorial Hospital, Lahore and observed retrospectively. Data was analyzed by using SPSS. Results: Out of 126 patients with facial clefts 103 had positive family history of consanguinity. 25 patientswith consanguineous parents were suffering from cleft lip and 35 from cleft lip and palate. Cleft palate alone was observed in 31 patients and one of the patients was found to have cleft lip and nasal deformity in concert. 11 patients with consanguineous parents were suffering from cleft lip, palate and nasal deformity. Gender disparity among patients with consanguineous parents wasobservable as well; an overall higher frequency of isolated cleft lip (CL) was seen in males than in females with a higher incidence of unilateral cleft lip in males in contrast to a higher incidence of bilateral cleft lip in females. Incidence of cleft palate (CP) and cleft lip and palate (CL+P) showed preponderance in females than in males.Results of the current study elucidate a close association between consanguinity and the development of cleft anomalies. Conclusion: The impact of this practice should be addressed by premarital or at least prior to conception screening with the provision of appropriate counseling to prevent this disorder well-timed.
Manzoor A.,Shalamar Medical and Dental College |
Afridi A.U.,Shalamar Medical and Dental College |
Malik S.G.,Shalamar Medical and Dental College
Pakistan Journal of Medical and Health Sciences | Year: 2017
Aim: To determine the frequency of cases in which clinical and radiological findings detect the same grade of adenoidal obstruction in children. Results: One hundred and fifty children, 115 male and 35female, aged up to 15 years were enrolled. The clinical symptomatology scores correlated significantly with radiological assessment of nasopharyngeal airway obstruction (r=0.419; p=<0.001). The correlation was significant at radiological assessment of minimal obstruction (p<0.05) and severe obstruction (p<0.001). Conclusion: Clinical assessment of adenoidal symptoms in children provides a reasonably reliable assessment of presence and severity of nasopharyngeal airway obstruction. This technique of assessment is easy to use and is particularly valid when obstruction is either mild or severe.
PubMed | University of Karachi, The University of Lahore and Shalamar Medical and Dental College
Type: Journal Article | Journal: Pakistan journal of medical sciences | Year: 2017
To compare the change in interviewers perception of Multiple Mini Interviews (MMI) after MMI training and after actual MMI experience.Six sessions were conducted during two weeks (October 26, 2015- to November 6, 2015) to a total of 87 faculty members. The evaluation dealt with 13 items questionnaire for representation of assessors perception on 5 point rating scale. Assessors rated their perceptions to complete an anonymised questionnaire about rationale behind MMI, the process of MMI, and the use of scoring criteria (rubrics). In addition, assessors were also asked to rate their level of satisfaction on MMI process after training and after interviews. Wilcoxon Signed Ranks Test (two-tailed) was used to compare participants pre- and post-interview ratings.With 81.6% response rate, the positive views of assessors about the MMI selection process and the use of scoring criteria (Rubric) to assess the candidate are not altered after experiencing a MMI selection day (p> 0.001). Assessors (87%) would prefer to be involved in the process of MMI in future.The outstanding consistency of assessors ratings before and after interview concluded that MMI training sessions were helpful in improving knowledge and skills about MMI process and candidates assessment criteria (rubrics).
Munir T.A.,Shifa International Hospital |
Afzal M.N.,Shalamar Medical and Dental College
Journal of the Pakistan Medical Association | Year: 2010
Objective: To assess the predictive ability of leukocyte subtypes for mortality in patients with acute coronary syndrome (ACS). Methods: One hundred and thirty three consecutive patients of ACS were assessed in the study and were followed up for one year. Diagnosis was based on clinical characteristics and the laboratory data. The total leukocytes and its subtypes were counted by Sysmex automated cell counter. The predictive ability for death of total count of leukocytes, neutrophils, lymphocytes and monocytes was assessed using Cox regression analysis. Results: Univariate analysis revealed higher prevalence of total leukocytes (HR= 1.001, p=<0.001) and its subtypes, neutrophils (HR 1.001, p=<0.001) and monocytes (HR 1.006, p= <0.001), in patients of ACS. In multivariate modeling, after entering standard coronary risk factors, count of total and differential leukocytesneutrophils, lymphocytes, monocytes and cardiac biomarkers CK-MB, Trop I; the monocyte count (hazard ratio [HR] 1.004, CI 1.002-1.006, p<0.0001) was found to be independent predictor for ACS. A significance correlation between monocyte count and CK-MB, representing extent of myocardial damage, was also seen (r=0.301, p<0.0001). Conclusion: The increase in monocyte count is an independent predictor of death and prognostic marker of the extent of myocardial damage in patients with ACS (JPMA 60:548; 2010).
Shahzad S.,Shalamar Medical and Dental College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2012
Rapid growth of medical knowledge has created major changes in technology which in turn has created greater demand of the client for better health services, and health sector is constantly under pressure of great internal and external demands. Quality of services, largely depend on to what extent managers are well versed with the concept of evidence based management, team and group approach in achieving organizational objectives. Making an effective health system, addressing the double burden of diseases coupled with resource crunch in developing countries is a big challenge for policy makers and health managers. Comprehensive concepts and application knowledge of leadership is very important for health managers in the present day in order to get best output that satisfies all the stake holders. Present anthropological study was done to assess the perception and knowledge of leadership among the health managers working in tertiary level hospitals. This qualitative study was conducted in two public sector tertiary level hospitals of Lahore chosen randomly out of a total of seven such hospitals in the same city. Convenient sampling technique was used. Observation and in- depth interviews were conducted for data collection. Open ended questionnaire on the lines of MLQ was used. One main domain of leadership was developed and categorisation of the themes was done in the two evolved categories of transformational and transactional leadership. In the domain of leadership 10 of the health managers showed positive themes for transactional leadership, 6 showed positive themes for transformational leadership, and still 1 health manager showed overall negative response for the concept of leadership; he was totally in favour of dictatorship. Health managers with degrees in management/administration had better concept about the key idea of leadership and its variables. Female health managers were more inclined towards transformational leadership behaviour.
Ismail S.,Aga Khan University |
Siddiqui S.,Dow Medical College and Civil Hospital |
Shafiq F.,Aga Khan University |
Ishaq M.,Shalamar Medical and Dental College |
Khan S.,Aga Khan University
International Journal of Obstetric Anesthesia | Year: 2014
Background Increasing awareness of the risks of blood transfusion has prompted examination of red cell transfusion practice in obstetrics. A six-month prospective observational study was performed to examine blood transfusion practices in patients undergoing caesarean delivery at three hospitals in Pakistan. Methods In the three hospitals (two private, one public) 3438 caesarean deliveries were performed in the study period. Data were collected on patient demographics, indications for transfusion, ordering physicians, consent, associations with obstetric factors, estimated allowable blood loss, calculated blood loss, pre- and post-transfusion haemoglobin and discharge haemoglobin. Results A total number of 397 (11.5%) patients who underwent caesarean section received a blood transfusion. The highest transfusion rate of 16% was recorded in the public tertiary care hospital compared to 5% in the two private hospitals. Emergency caesarean delivery and multiparity were associated with blood transfusion (P < 0.05). More emergency caesarean sections were performed in the public compared to the private hospitals (85.4% vs. 41.6%). More multiparous patients underwent caesarean section in the public hospital (57.8% vs. 40.4%). Attending physicians took the decision for transfusion in 98% of cases. In 343 (86%) patients, blood transfusion was given even when the haemoglobin was >7 g/dL. The method for documenting the indication or consent for transfusion was not found in any of the three hospitals. Conclusion Blood transfusion was prescribed more readily in the public hospital. Identification of a transfusion trigger and the development of institutional guidelines to reduce unnecessary transfusion are required. © 2014 The Authors. Published by Elsevier Ltd.
Shahzad S.,Shalamar Medical and Dental College
Journal of Ayub Medical College, Abbottabad : JAMC | Year: 2011
Management in health sector is becoming focus of attention world over being an important subject due to resource crunch particularly in developing countries. Beside sociodemographic factors, poor management in health sector is also an important factor responsible for poor health in developing countries. Moreover, there is gross lack of effective leadership in our national setup. It is necessary for health managers to be well versed with the knowledge about emerging theories, concepts and new philosophies of management/administration and leadership. This anthropological study was done to assess the perception and knowledge of Intellectual stimulation, creativity and innovation among the health managers working in the tertiary level hospitals of Lahore. This qualitative study was conducted in two public sector tertiary care hospitals of Lahore. Observation and in-depth interviews were conducted for data collection. Open ended questionnaire, developed on the lines of Multifactor Leadership Questionnaire was used. One main domain of Intellectual stimulation and its variables were developed and emergence of different themes was noted. In the domain of Intellectual stimulation all the participants of the study showed positive themes for the variable of creativity. Seven of the health managers showed positive themes for the variable of innovation, where as three health managers showed negative responses. Health managers with management/administration qualification had better concept about the key ideas of Intellectual stimulation, creativity and innovation; as compared to those who were working at these managerial posts on the basis of their long term experience only. Female health managers were stronger in building their team members on a broader horizon as a wholesome personality and not just taking the daily routine work.