Journal of Ayub Medical College, Abbottabad : JAMC
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J Ayub Med Coll Abbottabad · Oct 2020
Neutrophil-to-Lymphocyte Ratio, derived Neutrophil-to-Lymphocyte Ratio, Platelet-to-Lymphocyte Ratio and Lymphocyte-to-Monocyte Ratio as risk factors in critically ill COVID-19 patients, a single centered study.
A lot remains anonymous about the characteristics and laboratory findings that may evaluate poor outcomes in patients with Coronavirus disease 2019.The aim of this study was to determine the relationship of change in the peripheral blood factors of Neutrophil-to-Lymphocyte Ratio, derived-Neutrophil-to-Lymphocyte Ratio, Lymphocyte-to-Monocyte Ratio, and Platelet-to-Lymphocyte Ratio in hospitalized patients with COVID-19 and its severity. ⋯ NLR, d-NLR, and PLR along with pre-existing co morbidities can be used as an independent biomarker for the poor clinical outcome of COVID-19 illness.
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J Ayub Med Coll Abbottabad · Oct 2020
Comparative StudyImpact of covid 19 pandemic on presentation,treatment and outcome of paediatric surgical emergencies.
During the current pandemic it was observed that factors such as lockdown, campaign to discourage unnecessary visits to hospitals, inadequate clinical evaluation and investigations culminated in serious complications of common paediatric surgical conditions. This observation led to the basis of the idea to statistically and objectively evaluate the impact of the current pandemic on paediatric surgical emergencies. ⋯ Delay in presentation, complications and requirement for extensive surgical procedure are the indirect impacts of the current pandemic on emergency surgical conditions of children.
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J Ayub Med Coll Abbottabad · Oct 2020
Lower extremity reconstruction: utility of smartphone thermal imaging camera in planning perforator based pedicled flaps.
Presence of good size perforators are mandatory to design perforator based pedicelledflaps specially in lower limb as flap failure rate isrelativelyhigh. We have explored the use ofsmartphonebaseddynamic thermal imagingand compared it with doppler to devise a protocol forplanning and executionof pedicled perforator flaps anddescribedits use in deciding delay of flap. We have also compared the time required for detecting dominant perforators. ⋯ Dynamic thermal imaging can be reliably usedin planning of pedicled perforator flaps for lower limb reconstruction. We have found itmore reliable than handhelddoppler in locating dominant perforators.
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J Ayub Med Coll Abbottabad · Oct 2020
Shock Index As A Predictor Of Hyperlactatemia For Early Detection Of Severe Sepsis In Patients Presenting To The Emergency Department Of A Low To Middle Income Country.
Early detection of sepsis in the emergency department is of prime importance and requires tools that are time and cost-effective. The Systemic Inflammatory Response Syndrome (SIRS) has been poorly associated with sepsis. Timothy et al in a retrospective analysis of Emergency Department (ED) visit stated estimate of SIRS at 17.8% accounting to an annual yield of 16.6 million adult visits with SIRS per year, among these only 26% accounted as an infectious aetiology of SIRS, trauma being 10% and other causes being rare. Shock index is found to be independently associated with 30-day mortality in a broad population of ED patients including sepsis. With limited health resources in a low to middle income country, focused utilization is important and so is the need for markers that are non-invasive, readily available, cost effective, and easy to interpret. Shock index can serve this purpose as a surrogate marker of disease severity in patients with severe sepsis and thus resulting in early detection of such patients. ⋯ To conclude the shock index has some very favourable features, including availability, low cost, and direct relevance to sepsis in terms of its high validity. A high SI predicts elevated lactate levels in patients with sepsis.
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J Ayub Med Coll Abbottabad · Oct 2020
Clinical and virological course of SARS-CoV 2 infected patients in a tertiary care hospital in Pakistan.
Acute respiratory illness caused by Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) involved the whole globe within no time. Various studies published globally have shown variable severity of disease and mortality. The objective of our study was to describe clinical and epidemiological characteristics of the disease in our setup. ⋯ Coronavirus disease-19 (COVID-19) can present with wide range of clinical spectrum and disease can be life threatening. Severity of disease, requirement of ICU care and mortality were directly related to age of the patient and underlying comorbidities. Rigorous precautionary measures are of utmost importance particularly in this high-risk population.