Journal of Ayub Medical College, Abbottabad : JAMC
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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.
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J Ayub Med Coll Abbottabad · Jul 2020
Management Of Segmental Fracture Of Tibia Treated By Ilizarov External Fixation.
Tibial shaft segmental fractures are mostly occurring due to a high-energy trauma that produces a severe soft-tissue injury and resulting an excessive frequency of open and closed segmental fractures, and needs effective stable management. The objective of the study was to evaluate the functional outcome and union time in segmental tibial fracture treated with Ilizarov method. ⋯ Ilizarov is an effective method for the stabilization of segmental tibial fractures because the method allows close reduction without extensive soft tissue damage and is efficient for the stabilization of short distal segmental fractures of the tibia.
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J Ayub Med Coll Abbottabad · Jan 2020
Observational StudyEvaluation Of Modified Alvarado, Ripasa And Lintula Scoring System As Diagnostic Tools For Acute Appendicitis.
Commonest surgical emergency presenting to emergency departments with abdominal pain is acute appendicitis. Thus, to enable quick and accurate diagnosis of the condition various scoring systems have been developed. Among these, Alvarado and its modified version (Modified Alvarado) are the commonest. Whereas Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score showed promising results in Asian population. Similarly, Lintula score, which was initially developed for paediatric population, has now been validated for elderly too. This study is aimed to compare these in our regional population. ⋯ RIPASA demonstrated higher sensitivity, PPV, NPV and diagnostic accuracy than Modified Alvarado and Lintula scores. Hence this study approves use of RIPASA score in the region. However further research on the subject is required to back this inference.
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It was on 31st December 2019, that a cluster of pneumonia cases was reported to the World Health Organization (WHO) by China. The initial investigations revealed the cases to be due to a previously unknown "never before seen strain of coronavirus". Coronaviruses are a group of viruses, which are normally present among animals such as cows, bats, camels and cats. ⋯ Pakistan so far has not reported any confirmed case of COVID-19. Government is showing its commitment towards the threat of importation. This novel coronavirus, called as a "devil" by Chinese Prime Minister, Xi Ping is really an enigma.