LIAQUAT MEDICAL RESEARCH JOURNAL

Enhancing geriatric care in Low- and Middle-Income Countries

Binafsha Manzoor Syed — 2024-12-06

Geriatric population is increasing worldwide, thus resulting in rise of healthcare issues. The advancing age has default rise in chronic illnesses, disabilities and mental health issues. Developed countries have improved their health care system by catering the needs of older population. However, low-middle- income countries (LMICs) have not yet addressed this major public health issue. Elderly population living in rural areas has multifaceted problems including lack of social support, financial dependence and insufficient healthcare facilities. Lack of specialized trained healthcare experts in geriatrics is also a major health issue in LMICs. The introducing geriatrics as a sub-specialty, specialized training of lady health workers and lady health visitors, community support groups can solve the issue of growing geriatric population in LMICs.

Gonioscopy versus anterior segment ocular coherence tomography for anterior chamber angle assessment- A comparative study

Ghulam Mujtaba Sohu — 2024-12-06

This study was conducted to determine the anterior chamber angle to improve the diagnostic accuracy, treatment modalities and health outcomes in individuals with angle-closure glaucoma. This was a comparative cross-sectional study at the Institute of Ophthalmology Liaquat University of Medical and Health Sciences, Jamshoro, Sindh, Pakistan. Patients with various ocular conditions presented at Glaucoma clinic, aged 20 years old or above of either gender were included. After obtaining written informed consent, the gonioscopy and anterior segment optical coherence tomography (AS-OCT) imaging was done in all participants. A trained ophthalmology resident presented the Questionnaire in the local language, while a consultant ophthalmologist performed the complete general ocular evaluation, slit-lamp examination, gonioscopy and anterior segment optical coherence tomography. Out of 178 participants, 146 (82%) patients were male patients, and 32 (18%) were females. The majority of patients, 79 (44.4%), were aged between 41 to 50 years, while 51 (28.7%) were over 60 years old. AS-OCT has shown to enhance health outcomes, diagnostic accuracy, and treatment modalities compared to gonioscopy in patients with angle-closure glaucoma. The findings from anterior segment OCT were significant (p < 0.001) in comparison to gonioscopy.

In conclusion this study revealed that both gonioscopy and AS-OCT imaging identified the upper quadrant as having the highest prevalence of angle closure. However, the relative incidence of closed angles in the other quadrants varied depending on the modality utilized. Some of these variations may be explained by specifics in how each technique’s ACA configuration is assessed and interpreted.

Susceptibility pattern of Ceftazidime-Avibactam against multi drug resistant gram-negative rods

Mehwish Sajjad mehmood — 2024-12-06

This study was conducted to evaluate the susceptibility pattern of ceftazidime avibactam against multi drug resistant gram negative rods. This prospective study cross sectional study conducted in Microbiology Section of Dow Diagnostic Reference and Research Laboratory, Dow University of Health Sciences, Karachi, Pakistan. Identification of isolates was done in accordance with the standard bacteriological technique, and were distinguished based on gram staining, colony morphology and biochemical tests. Antibiotic susceptibility testing (AST) was performed on Muller-Hinton agar by Kirby-Bauer Disk Diffusion method in accordance with the Clinical Laboratory Standard Institute (CLSI) guidelines. Good sensitivity of Lactose fermenters (Escherichia coli, Klebsiella pneumoniae and Enterobacter) were observed against Ceftazidime avibactam. Pseudomonas aeruginosa exhibited 42% resistance in all clinical samples. Proteus species and Serratia have shown high resistance in our study. Our observations showed the persistence of high ceftazidime avibactam activity against pathogenic and multi drug resistant strains of Enterobacterales and Non lactose fermenting bacteria.

Prevalence Of Sensorineural Hearing Loss Among Stroke

Zarafshan Ahsan — 2024-12-06

This study was designed to determine the prevalence of sensorineural hearing loss among stroke patients. A cross-sectional analytical study was conducted. Medicine department of HMC Peshawar and lady reading hospital (LRH) in Peshawar. Total 224 diagnosed stroke patients were selected by non-probability purposive sampling technique. 20 and above age group male and female were included. Transient ischemic, psychological, and congenital stroke patients were excluded. Pure Tone audiometry (PTA) was done using pure tone audiometer to identify type of hearing loss. The Study was conducted at audiology Department of The University of Lahore for the duration of six months from 22^nd March2023 to 22^nd August2023. Out of 224 stroke patients, 168 were ischemic and 56 were hemorrhagic type.15 patients had conductive hearing loss,111 had sensorineural hearing loss,21 had mixed hearing loss while 66 were having normal and 11 were having high frequency sensorineural hearing loss. This study showed that there was no significant association between sensorineural hearing loss and stroke.

Evaluation of SARS-CoV-2 seroprevalence among clinical laboratory workers and its association with past exposure to infection and vaccination

Humaira Ahmed — 2024-12-06

The pandemic of COVID-19, due to the SARS-CoV-2 virus, has significantly impacted global health. Understanding the dynamics of immunity, both natural and vaccine-induced, is crucial for public health strategies. The study aimed to determine the seroprevalence of SARS-CoV-2 antibodies among clinical laboratory workers and its relationship with previous exposure to infection and vaccination. This was a prospective observational study conducted at the chemical Pathology section of Dow Diagnostic Research and Reference Laboratory (DDRRL), Dow University of Health Sciences, Karachi, Sindh, Pakistan from 1^st January to 30^th December 2021. Following ethical approval, 80 clinical laboratory workers provided informed consent to participate. Blood samples were collected and tested for SARS-CoV-2 IgG antibodies. The baseline demographic and clinical information was recorded, and conducted follow-up antibody tests six months later. The mean age of the participants was 37.7 years, with a standard deviation of 9.42. There were 46 males (57.5%) and 34 females (42.5%) in the study. Half of the participants (50%) had been vaccinated, with 35% receiving a single dose and 15% receiving both doses. 71.3% of the participants had comorbidities. SARS-CoV-2 antibodies were found to be reactive in 50% of the participants. The study also found significant associations between antibody presence and prior COVID-19 infection, vaccination status, contact history with COVID-19 patients, and prior history of hospitalization (p < 0.05). The study compared the initial and post-booster antibody levels among three groups of subjects (vaccinated, vaccinated with no prior COVID-19 infection, and non-vaccinated with prior COVID-19 infection), and found that antibody levels were significantly high in vaccinated subjects and non-vaccinated subjects with prior COVID-19 infection (p-value < 0.05). A significant difference was observed in antibody titers among subjects with prior history of vaccination and COVID-19 infection. In conclusion both natural infection and vaccination may induce antibodies against SARS-CoV-2 infection.

Current position of brucella infection among the hospitalized human population

Feroz Khan — 2024-09-30

This study aimed to examine the incidence of Brucella infection among hospitalized patients. This study was conducted during February to August 2022 in District Headquarters Teaching Hospital (DHQTH) district Bannu, Pakistan. A 2mL of venous blood was collected from those individuals who visited the hospital with the complaint of joint inflammation and high grade fever. The Brucella infection was detected by Standard Plate Agglutination Test (SPAT) and Serum Tube Agglutination Test (STAT). A total of 150 samples were examined in the present study, 100 (66.66%) of them were found to be negative and 50(33.33%) to be positive for various bacterial infections. Among male positive patients 17 (56.66%) reported to have B. melitensis and 13 (43.33%) had B. abortus while in female patients 9 (45.00%), 11(55.00%) were positive of B. melitensis and B. abortus respectively. The study showed that prevalence of the disease appears to be more common in males as compared to female and age group between 41 to 50 years were more prone to the infection. In Pakistan, brucellosis continues to be a persistent and posing public health risk. Individuals who are exposed to brucellosis at work are more likely to develop infection; therefore all the exposed persons should get themselves screened.

Correlation between parenting styles and social communication in children with hearing impaired

Samia Sharif — 2024-09-30

This study aimed to find the correlation between parenting style and social communication in children with hearing impairment. In this correlational study Minnesota Social skills checklist for Deaf/ hard of Hearing children and Parenting Style Questionnaire was used. Through convenient sampling technique data was collected from the parents of hearing impaired children aged between 5 to 15 years. Study was conducted over a period of 6 months (July 2023 to January 2024) at Riphah International University. Sample size was n= 377 calculated by using online sample size calculator. The results of the study showed a strong, significant correlation between parenting style and social communication. In conclusion the three parenting styles analyzed, authoritative parenting has a positive effect on social communication skills, whereas authoritarian and permissive parenting styles have a negative effect.

The Age, parity and stage of cervical cancer among cervical cancer patients attending oncology department- An observational cross sectional study

Sana Hashmat — 2024-12-06

Cervical cancer is one of the common cancers in women worldwide. This study was conducted to determine age, parity and stage of cervical cancer patients in Pakistani population. This was a prospective cross-sectional study, conducted in the Oncology Department of Jinnah Postgraduate Medical Center, Karachi during October 2023 to January 2024. A total of 92 women of age 18 years or above, presenting with biopsy proven cervical cancer were recruited. The mean age of study participants was 53.4 years SD± 10.9 years. The highest proportion of cases were recorded between 47 to 57 years of age with a proportion of 37.0% (n=34). Among the study participants 62% (n=57) had a history of multiparty with at least five or more children and 65% (n=60) were postmenopausal women, while 59.8% (n=55) were found to have Stage-II and Stage-III disease at the time of diagnosis. Histopathologically Squamous Cell Carcinoma was the most frequent histopathological type reported. In conclusion the highest burden of cervical cancer was found to be present among the women of age group 47 to 57 years. Cervical cancer was most prevalent among women with higher parity or having five or more children. Squamous cell carcinoma was the most frequently occurring histopathological type, while most patients were diagnosed at the stage-II disease.

Conquering CMV Viremia with CMV immunoglobulin, triumph in Renal Transplant Patients: A Case Series

Muhammad Tassaduq Khan — 2024-12-06

This case series offers the successful management of cytomegalovirus (CMV) viremia in patients who developed CMV infection post renal transplantation. The patients have been treated with three doses of CMV immunoglobulin and ganciclovir for 21 days. The CMV load in each affected person extensively reduced after treatment, indicating the effectiveness of this regimen in coping with CMV viremia in resource constrains setting

Salt-wasting congenital adrenal hyperplasia: A case report

Muhammad Nasir — 2024-09-30

Salt-Wasting Congenital Adrenal Hyperplasia (SW-CAH) is a rare genetic disorder characterized by enzyme deficiencies affecting the adrenal steroidogenesis pathway, leading to a decrease in cortisol synthesis. Here presented a case of a 28-day-old male infant presented with symptoms of lethargy and feeding difficulties. Initial evaluations revealed severe electrolyte imbalances, including hyponatremia and hyperkalemia. Further investigations, including hormone tests, confirmed a diagnosis of SW-CAH. The management involved intravenous therapy with steroids, including hydrocortisone and fludrocortisone, to restore hormonal balance. Strict monitoring of sugar levels, blood pressure, serum electrolytes, and cortisol levels was crucial. The case highlights the importance of early diagnosis and intervention, particularly in regions with limited access to healthcare services.

This report underscores the need for increased awareness of CAH, particularly SW-CAH, and the potential benefits of implementing newborn screening programs and establishing effective disease databases to improve early detection and management of this condition, potentially saving lives.