Journal of the Pakistan Medical Association, Feb 11, 2024
Objective: To evaluate the quality of sleep in patients hospitalised with coronavirus disease-201... more Objective: To evaluate the quality of sleep in patients hospitalised with coronavirus disease-2019, and its impact on hospitalisation duration, need for intensive care unit admission and mortality. Methods: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from May 2, 2021 to April 30, 2022, and comprised hospitalised coronavirus disease-2019 patients. Data was gathered using the Pittsburgh Sleep Quality Index questionnaire, including demographics, comorbidities, length of hospital stay, need for intensive care unit admission, C-reactive protein and D-dimer values at admission, and the outcome. The patients were divided into group A having good sleep quality score >5 and group B having poor sleep quality score <5. Data was analysed using SPSS 25. Results: Of the 1,250 patients, 559(44.7%) were males and 691(55.3%) were females. There were 560(44.8%) patients in group A with mean age 53.80±14.85 years, and 690(55.2%) patients in group B with mean age 53.71±14.32 years. There were no significant intergroup differences in terms of age and high-resolution computed tomography scan (p>0.05). The difference was significant with respect to gender, comorbid conditions, education status as well C-reactive protein and D-dimer levels (p<0.001). Group B patients had a longer duration of hospitalisation (p<0.001) and a higher need for intensive care unit admission (p<0.001) compared to group A. The outcome was death in 166(13.28%) patients in group B compared to 40(3.2%) in group A (p<0.001). Conclusion: Poor sleep quality was found to be associated with longer hospital stay, increased need for mechanical ventilation, and higher mortality rate in coronavirus disease-2019 patients.
Annals of Pakistan Institute of Medical Sciences, May 30, 2023
To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstruct... more To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease. Methodology: This randomized trial was conducted in the Pulmonology Department, PIMS, Islamabad, between August 2018 and February 2019. Patients were screened from the OPD department, and before randomization, their sputum was collected over 24 hours in a solid, sterile plastic (60 mL) bottle at room temperature. They were randomized equally into two treatment groups using a lottery method. Group A received Moxifloxacin 400 mg orally once daily for five days, and group B received Ceftriaxone 1 g (IV infusion) once daily for five days. All the measurements (dyspnea grading, sputum volume, and character) were taken after five days of antibiotic therapy. Results: The mean age was 60.79 ± 13.34 years in Moxifloxacin and 59.86 ± 12.72 years in the Ceftriaxone group. In Moxifloxacin group, there were 49(68.06%) male and 23(31.94%) females and in the Ceftriaxone group, there were 49(68%) males and 23(31.94%) female cases. In Moxifloxacin, a total of 68(94.4%) cases recovered, while 4 (5.6%) cases did not achieve efficacy, whereas, in the Ceftriaxone group, 54 (75.0%) cases achieved efficacy and 18 (25.0%) were therapy failures. The efficacy of the oral Moxifloxacin group was significantly better than the oral Ceftriaxone group (p-value, < 0.05). Conclusion: The efficacy of Moxifloxacin was better than Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP)... more Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP) with various hydroxychloroquine (HCQ) doses against a placebo among healthcare personnel (HCP) with high-risk exposure to coronavirus disease 2019 (COVID 19). Methods A phase II, randomized, placebo-controlled trial was conducted including 200 subjects with no active or past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (antibody testing and reverse transcription-polymerase chain reaction (RT-PCR) were taken at the time of enrollment). Subjects of experimental groups one to three received HCQ in various doses and the control group received a placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and by the end of week 12 with RT-PCR or serology testing (COVID-19 IgM/IgG antibody testing). Results Out of the total participants, 146 reported exposure to a con...
Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP)... more Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP) with various hydroxychloroquine (HCQ) doses against a placebo among healthcare personnel (HCP) with high-risk exposure to coronavirus disease 2019 (COVID 19). Methods A phase II, randomized, placebo-controlled trial was conducted including 200 subjects with no active or past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (antibody testing and reverse transcription-polymerase chain reaction (RT-PCR) were taken at the time of enrollment). Subjects of experimental groups one to three received HCQ in various doses and the control group received a placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and by the end of week 12 with RT-PCR or serology testing (COVID-19 IgM/IgG antibody testing). Results Out of the total participants, 146 reported exposure to a con...
Background Chronic obstructive pulmonary disease (COPD) is a chronic airflow obstructive conditio... more Background Chronic obstructive pulmonary disease (COPD) is a chronic airflow obstructive condition. The mainstay of treatment is to avoid exacerbation and manage the symptoms. Roflumilast is being used as a part of treatment to reduce the inflammatory process in this disease. Method This systematic review and meta-analysis were conducted following the provided guidelines. PubMed, Cochrane Library, and Cinahl were considered for searching the desired studies selected until 19 June 2021. The eligibility criteria for inclusion and exclusion were set before selecting studies. Result Five hundred eighty (580) studies were identified at the beginning. Removal of duplicates was done using Endnote software. The eligibility criteria, including the randomized controlled trial study design and others, were applied for screening the title and abstracts. Six studies were selected for the qualitative analysis. After assessing the data from these studies, it was found that roflumilast is an effective drug to treat COPD. Roflumilast plays an essential role in improving quality of life, inflammatory process, and clinical improvement. The drug's mild to moderate adverse effects were observed, but no significant severe adverse events were reported, and the drug was well tolerated. Conclusion Roflumilast is a valuable drug that can be used for its beneficial effects on COPD exacerbation. The benefits of the drug outweigh its adverse effects.
Background: Pre-exposure prophylaxis (PrEP) is a promising strategy to break the chain of transmi... more Background: Pre-exposure prophylaxis (PrEP) is a promising strategy to break the chain of transmission of novel coronavirus (2019-nCoV). Aims: This trial aimed to evaluate the safety and efficacy of PrEP with various doses of HCQ against a placebo among high-risk healthcare providers (HCPs). Methods: A phase II, randomized, placebo-controlled trial was conducted at a tertiary care hospital. A total of 228 HCPs were screened, we included 200 subjects with no active or past SARS-CoV-2 infection. Subjects of experimental groups 1-3 received HCQ in various doses and those in the control group received placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and also by the end of the 12th week, with PCR or IgM and IgG serology. Results: Overall, 146 of 200 participants reported exposure to a confirmed COVID-19 case in the first month, 189 in the 2nd month and 192 were exposed by the ...
Wheat pill (zinc or aluminum phosphide) is used as rodenticide in wheat and rice storage reservoi... more Wheat pill (zinc or aluminum phosphide) is used as rodenticide in wheat and rice storage reservoirs also known as rice pill. In developing countries like Pakistan there has been an increase in the number of aluminum phosphide (wheat-pill) poisoning with suicidal intent due to easy accessibility. It has high mortality rate, with no antidote available. A young female presented with wheat pill poisoning in June 2019, upon arrival she had classical signs and symptoms of wheat pill poisoning although during her stay she developed cardiac arrythmias leading to shock, Hematuria, Pleural effusion, and hyperglycemia due to acute pancreatitis. Due to the appropriate recognition and management of complications, patient was able to recuperate. felicitous transfer to Intensive Care Unit and prompt recognition of complications can lead to virtuous outcomes. We recommend that there should be nationwide cognizance campaign regarding the lethal consequences of wheat-pill consumption by humans and pr...
Background Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor blocker, emerged as a treatment fo... more Background Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor blocker, emerged as a treatment for cytokine release syndrome (CRS) in patients with severe COVID-19 pneumonia. The main objective of the study is to discuss the treatment response of TCZ in severe and critically ill patients with COVID-19 pneumonia. Patient demographics, laboratory parameters before and after TCZ therapy, and clinical outcomes in 20 patients in a single center were prospectively reviewed. Results Out of 120 patients, 96 (80%) were males and 24 (20%) were females. Only eight (10%) patients did not have any previously known comorbidity. There were 78 (65%) patients with severe disease, while 42 (35%) have critically severe disease. Of the 120 patients, only 36 required a second dose of TCZ in our study based on clinical background. Neutrophils and C-reactive protein (CRP) levels were observed to be raised in all patients, while lymphopenia was observed in 114/120, and D-dimer levels were elevated in 102 (...
To evaluate knowledge of diabetes using diabetes knowledge questionnaire in diabetic patients. Th... more To evaluate knowledge of diabetes using diabetes knowledge questionnaire in diabetic patients. The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from October to December 2017, and comprised subjects aged >20 years with a diagnosis of type 2 diabetes. The modified version of diabetes knowledge questionnaire was used for data collection. It had 24 questions concerning patient's diabetes knowledge and self-care practices. One point was given for each correct answer. The highest achievable score was 24. A total score of ?12 was considered suggestive of adequate knowledge. SPSS 23 was used for data analysis. Of the 401 subjects, 175 (43.6%) were males and 226 (66.4%) were females. The overall mean age was 52.9 }12.3 years, and mean duration of diabetes was 7.95}6.7 years. The mean score on the questionnaire was 9.97}3.93. Only 135(33.7%) patients showed adequate knowledge of the disease. Factors having positive correlatio...
The pandemic of severe acute respiratory virus (SARS-CoV-2) is characterized by respiratory sympt... more The pandemic of severe acute respiratory virus (SARS-CoV-2) is characterized by respiratory symptoms with serious consequences, mainly associated with pneumonia and extreme ARDS. There is a lack of data about pneumothorax associated with COVID-19 infections in current literature. Radiological features in SARS-CoV-2 include subpleural bilateral ground-glass appearance and many areas of irregular consolidation in the lungs. We here present a case of SARS-CoV-2 that was complicated by acute pneumothorax, and despite prompt treatment, that patient could not be saved. A 55-years-old male with no previous lung disease or any other history confirmed to have SARS-CoV-2 pneumonia developed a large pneumothorax on the third day of his presentation and was immediately intubated via a chest tube but could not be saved. SARS-CoV-2 by RT-PCR was positive. The patient expired around 12 h after chest intubation. Recommended treatment could not be started yet as the patient expired before it could b...
JPMA. The Journal of the Pakistan Medical Association, 2021
OBJECTIVE To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. ME... more OBJECTIVE To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. METHODS The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July, 2018, to January, 2019, and comprised patients aged 18-75 years of either gender. Demographic information, comorbidities and previous medications were recorded for each patient. The modified American College of Rheumatology preliminary diagnostic criteria 2010-11 for fibromyalgia diagnosis. If diagnosed, the fibromyalgia impact questionnaire was administered to assess its severity. Data was analysed using SPSS 25. RESULTS Of the 750 hospital-visiting patients, fibromyalgia was diagnosed in 250(33.3%); 190(76%) of them being females (p<0.0001). Comorbidities, age and increased elevated body mass index were significantly associated with fibromyalgia. Severity was not influenced by comorbidities, marital status, education or economic status (p>0.05). Menarche at...
JPMA. The Journal of the Pakistan Medical Association, 2019
OBJECTIVE To assess the association of red cell distribution width with glycaemic control and the... more OBJECTIVE To assess the association of red cell distribution width with glycaemic control and the presence of complications in diabetes patients. METHODS The cross-sectional study was done at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from September to November 2017, and comprised patients with type 2 diabetes. Clinical and demographical characteristics were documented and they were subjected to complete blood count, red cell distribution width, glycated haemoglobin, fasting and random blood glucose, lipid profile, urea and creatinine. The presence of complications were assessed during clinical examination. SPSS 20 was used for data analysis.. RESULTS There were 349 patients with a mean age of 53.14±11.77 years. The mean duration of diabetes was 8.36±6.64 years and mean glycated haemoglobin was 9.05±1.93. Red cell distribution width was significantly associated with the duration of diabetes, hypertension, macrovascular and microvascular complications and extent...
JPMA. The Journal of the Pakistan Medical Association, 2018
OBJECTIVE To assess diabetes distress and its associated factors in Pakistani population.. METHOD... more OBJECTIVE To assess diabetes distress and its associated factors in Pakistani population.. METHODS The cross-sectional study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July to December 2017, and comprised patients of diabetes type 2. After noting down demographic and clinical parameters, diabetes distress of the subjects was measured by applying the 17-item diabetes distress scale which also assesses sub domains like emotional burden, physicianrelated distress, regimen-related distress and interpersonal distress. SPSS 20 was used to analyse data. RESULTS There were 349 subjects with a mean age of 53.14±11.77 years, mean diabetes duration of 8.36±6.64 years and a mean glycated haemoglobin value of 9.05±1.93%. Mean overall diabetes distress score was 2.55±0.75, signifying moderate distress. Overall, prevalence of diabetes distress was found among 266(76.2%) subjects;164(47%) moderate and 102(29.2%) high level distress. Emotional burden was most ...
Journal of the Pakistan Medical Association, Feb 11, 2024
Objective: To evaluate the quality of sleep in patients hospitalised with coronavirus disease-201... more Objective: To evaluate the quality of sleep in patients hospitalised with coronavirus disease-2019, and its impact on hospitalisation duration, need for intensive care unit admission and mortality. Methods: The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from May 2, 2021 to April 30, 2022, and comprised hospitalised coronavirus disease-2019 patients. Data was gathered using the Pittsburgh Sleep Quality Index questionnaire, including demographics, comorbidities, length of hospital stay, need for intensive care unit admission, C-reactive protein and D-dimer values at admission, and the outcome. The patients were divided into group A having good sleep quality score >5 and group B having poor sleep quality score <5. Data was analysed using SPSS 25. Results: Of the 1,250 patients, 559(44.7%) were males and 691(55.3%) were females. There were 560(44.8%) patients in group A with mean age 53.80±14.85 years, and 690(55.2%) patients in group B with mean age 53.71±14.32 years. There were no significant intergroup differences in terms of age and high-resolution computed tomography scan (p>0.05). The difference was significant with respect to gender, comorbid conditions, education status as well C-reactive protein and D-dimer levels (p<0.001). Group B patients had a longer duration of hospitalisation (p<0.001) and a higher need for intensive care unit admission (p<0.001) compared to group A. The outcome was death in 166(13.28%) patients in group B compared to 40(3.2%) in group A (p<0.001). Conclusion: Poor sleep quality was found to be associated with longer hospital stay, increased need for mechanical ventilation, and higher mortality rate in coronavirus disease-2019 patients.
Annals of Pakistan Institute of Medical Sciences, May 30, 2023
To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstruct... more To compare the efficacy of Moxifloxacin and Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease. Methodology: This randomized trial was conducted in the Pulmonology Department, PIMS, Islamabad, between August 2018 and February 2019. Patients were screened from the OPD department, and before randomization, their sputum was collected over 24 hours in a solid, sterile plastic (60 mL) bottle at room temperature. They were randomized equally into two treatment groups using a lottery method. Group A received Moxifloxacin 400 mg orally once daily for five days, and group B received Ceftriaxone 1 g (IV infusion) once daily for five days. All the measurements (dyspnea grading, sputum volume, and character) were taken after five days of antibiotic therapy. Results: The mean age was 60.79 ± 13.34 years in Moxifloxacin and 59.86 ± 12.72 years in the Ceftriaxone group. In Moxifloxacin group, there were 49(68.06%) male and 23(31.94%) females and in the Ceftriaxone group, there were 49(68%) males and 23(31.94%) female cases. In Moxifloxacin, a total of 68(94.4%) cases recovered, while 4 (5.6%) cases did not achieve efficacy, whereas, in the Ceftriaxone group, 54 (75.0%) cases achieved efficacy and 18 (25.0%) were therapy failures. The efficacy of the oral Moxifloxacin group was significantly better than the oral Ceftriaxone group (p-value, < 0.05). Conclusion: The efficacy of Moxifloxacin was better than Ceftriaxone in acute exacerbation of chronic obstructive pulmonary disease.
This article is an open access article distributed under the terms and conditions of the Creative... more This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY
Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP)... more Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP) with various hydroxychloroquine (HCQ) doses against a placebo among healthcare personnel (HCP) with high-risk exposure to coronavirus disease 2019 (COVID 19). Methods A phase II, randomized, placebo-controlled trial was conducted including 200 subjects with no active or past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (antibody testing and reverse transcription-polymerase chain reaction (RT-PCR) were taken at the time of enrollment). Subjects of experimental groups one to three received HCQ in various doses and the control group received a placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and by the end of week 12 with RT-PCR or serology testing (COVID-19 IgM/IgG antibody testing). Results Out of the total participants, 146 reported exposure to a con...
Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP)... more Objective This trial aimed to evaluate the safety and efficacy of pre-exposure prophylaxis (PrEP) with various hydroxychloroquine (HCQ) doses against a placebo among healthcare personnel (HCP) with high-risk exposure to coronavirus disease 2019 (COVID 19). Methods A phase II, randomized, placebo-controlled trial was conducted including 200 subjects with no active or past severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (antibody testing and reverse transcription-polymerase chain reaction (RT-PCR) were taken at the time of enrollment). Subjects of experimental groups one to three received HCQ in various doses and the control group received a placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and by the end of week 12 with RT-PCR or serology testing (COVID-19 IgM/IgG antibody testing). Results Out of the total participants, 146 reported exposure to a con...
Background Chronic obstructive pulmonary disease (COPD) is a chronic airflow obstructive conditio... more Background Chronic obstructive pulmonary disease (COPD) is a chronic airflow obstructive condition. The mainstay of treatment is to avoid exacerbation and manage the symptoms. Roflumilast is being used as a part of treatment to reduce the inflammatory process in this disease. Method This systematic review and meta-analysis were conducted following the provided guidelines. PubMed, Cochrane Library, and Cinahl were considered for searching the desired studies selected until 19 June 2021. The eligibility criteria for inclusion and exclusion were set before selecting studies. Result Five hundred eighty (580) studies were identified at the beginning. Removal of duplicates was done using Endnote software. The eligibility criteria, including the randomized controlled trial study design and others, were applied for screening the title and abstracts. Six studies were selected for the qualitative analysis. After assessing the data from these studies, it was found that roflumilast is an effective drug to treat COPD. Roflumilast plays an essential role in improving quality of life, inflammatory process, and clinical improvement. The drug's mild to moderate adverse effects were observed, but no significant severe adverse events were reported, and the drug was well tolerated. Conclusion Roflumilast is a valuable drug that can be used for its beneficial effects on COPD exacerbation. The benefits of the drug outweigh its adverse effects.
Background: Pre-exposure prophylaxis (PrEP) is a promising strategy to break the chain of transmi... more Background: Pre-exposure prophylaxis (PrEP) is a promising strategy to break the chain of transmission of novel coronavirus (2019-nCoV). Aims: This trial aimed to evaluate the safety and efficacy of PrEP with various doses of HCQ against a placebo among high-risk healthcare providers (HCPs). Methods: A phase II, randomized, placebo-controlled trial was conducted at a tertiary care hospital. A total of 228 HCPs were screened, we included 200 subjects with no active or past SARS-CoV-2 infection. Subjects of experimental groups 1-3 received HCQ in various doses and those in the control group received placebo. The study outcomes in terms of safety and efficacy were monitored. Participants exhibiting COVID-19 symptoms were tested for SARS-CoV-2 during the study and also by the end of the 12th week, with PCR or IgM and IgG serology. Results: Overall, 146 of 200 participants reported exposure to a confirmed COVID-19 case in the first month, 189 in the 2nd month and 192 were exposed by the ...
Wheat pill (zinc or aluminum phosphide) is used as rodenticide in wheat and rice storage reservoi... more Wheat pill (zinc or aluminum phosphide) is used as rodenticide in wheat and rice storage reservoirs also known as rice pill. In developing countries like Pakistan there has been an increase in the number of aluminum phosphide (wheat-pill) poisoning with suicidal intent due to easy accessibility. It has high mortality rate, with no antidote available. A young female presented with wheat pill poisoning in June 2019, upon arrival she had classical signs and symptoms of wheat pill poisoning although during her stay she developed cardiac arrythmias leading to shock, Hematuria, Pleural effusion, and hyperglycemia due to acute pancreatitis. Due to the appropriate recognition and management of complications, patient was able to recuperate. felicitous transfer to Intensive Care Unit and prompt recognition of complications can lead to virtuous outcomes. We recommend that there should be nationwide cognizance campaign regarding the lethal consequences of wheat-pill consumption by humans and pr...
Background Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor blocker, emerged as a treatment fo... more Background Tocilizumab (TCZ), an interleukin-6 (IL-6) receptor blocker, emerged as a treatment for cytokine release syndrome (CRS) in patients with severe COVID-19 pneumonia. The main objective of the study is to discuss the treatment response of TCZ in severe and critically ill patients with COVID-19 pneumonia. Patient demographics, laboratory parameters before and after TCZ therapy, and clinical outcomes in 20 patients in a single center were prospectively reviewed. Results Out of 120 patients, 96 (80%) were males and 24 (20%) were females. Only eight (10%) patients did not have any previously known comorbidity. There were 78 (65%) patients with severe disease, while 42 (35%) have critically severe disease. Of the 120 patients, only 36 required a second dose of TCZ in our study based on clinical background. Neutrophils and C-reactive protein (CRP) levels were observed to be raised in all patients, while lymphopenia was observed in 114/120, and D-dimer levels were elevated in 102 (...
To evaluate knowledge of diabetes using diabetes knowledge questionnaire in diabetic patients. Th... more To evaluate knowledge of diabetes using diabetes knowledge questionnaire in diabetic patients. The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from October to December 2017, and comprised subjects aged >20 years with a diagnosis of type 2 diabetes. The modified version of diabetes knowledge questionnaire was used for data collection. It had 24 questions concerning patient's diabetes knowledge and self-care practices. One point was given for each correct answer. The highest achievable score was 24. A total score of ?12 was considered suggestive of adequate knowledge. SPSS 23 was used for data analysis. Of the 401 subjects, 175 (43.6%) were males and 226 (66.4%) were females. The overall mean age was 52.9 }12.3 years, and mean duration of diabetes was 7.95}6.7 years. The mean score on the questionnaire was 9.97}3.93. Only 135(33.7%) patients showed adequate knowledge of the disease. Factors having positive correlatio...
The pandemic of severe acute respiratory virus (SARS-CoV-2) is characterized by respiratory sympt... more The pandemic of severe acute respiratory virus (SARS-CoV-2) is characterized by respiratory symptoms with serious consequences, mainly associated with pneumonia and extreme ARDS. There is a lack of data about pneumothorax associated with COVID-19 infections in current literature. Radiological features in SARS-CoV-2 include subpleural bilateral ground-glass appearance and many areas of irregular consolidation in the lungs. We here present a case of SARS-CoV-2 that was complicated by acute pneumothorax, and despite prompt treatment, that patient could not be saved. A 55-years-old male with no previous lung disease or any other history confirmed to have SARS-CoV-2 pneumonia developed a large pneumothorax on the third day of his presentation and was immediately intubated via a chest tube but could not be saved. SARS-CoV-2 by RT-PCR was positive. The patient expired around 12 h after chest intubation. Recommended treatment could not be started yet as the patient expired before it could b...
JPMA. The Journal of the Pakistan Medical Association, 2021
OBJECTIVE To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. ME... more OBJECTIVE To assess the prevalence and severity of fibromyalgia in hospital-visiting patients. METHODS The cross-sectional study was conducted at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July, 2018, to January, 2019, and comprised patients aged 18-75 years of either gender. Demographic information, comorbidities and previous medications were recorded for each patient. The modified American College of Rheumatology preliminary diagnostic criteria 2010-11 for fibromyalgia diagnosis. If diagnosed, the fibromyalgia impact questionnaire was administered to assess its severity. Data was analysed using SPSS 25. RESULTS Of the 750 hospital-visiting patients, fibromyalgia was diagnosed in 250(33.3%); 190(76%) of them being females (p<0.0001). Comorbidities, age and increased elevated body mass index were significantly associated with fibromyalgia. Severity was not influenced by comorbidities, marital status, education or economic status (p>0.05). Menarche at...
JPMA. The Journal of the Pakistan Medical Association, 2019
OBJECTIVE To assess the association of red cell distribution width with glycaemic control and the... more OBJECTIVE To assess the association of red cell distribution width with glycaemic control and the presence of complications in diabetes patients. METHODS The cross-sectional study was done at the Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from September to November 2017, and comprised patients with type 2 diabetes. Clinical and demographical characteristics were documented and they were subjected to complete blood count, red cell distribution width, glycated haemoglobin, fasting and random blood glucose, lipid profile, urea and creatinine. The presence of complications were assessed during clinical examination. SPSS 20 was used for data analysis.. RESULTS There were 349 patients with a mean age of 53.14±11.77 years. The mean duration of diabetes was 8.36±6.64 years and mean glycated haemoglobin was 9.05±1.93. Red cell distribution width was significantly associated with the duration of diabetes, hypertension, macrovascular and microvascular complications and extent...
JPMA. The Journal of the Pakistan Medical Association, 2018
OBJECTIVE To assess diabetes distress and its associated factors in Pakistani population.. METHOD... more OBJECTIVE To assess diabetes distress and its associated factors in Pakistani population.. METHODS The cross-sectional study was conducted at Pakistan Institute of Medical Sciences, Islamabad, Pakistan, from July to December 2017, and comprised patients of diabetes type 2. After noting down demographic and clinical parameters, diabetes distress of the subjects was measured by applying the 17-item diabetes distress scale which also assesses sub domains like emotional burden, physicianrelated distress, regimen-related distress and interpersonal distress. SPSS 20 was used to analyse data. RESULTS There were 349 subjects with a mean age of 53.14±11.77 years, mean diabetes duration of 8.36±6.64 years and a mean glycated haemoglobin value of 9.05±1.93%. Mean overall diabetes distress score was 2.55±0.75, signifying moderate distress. Overall, prevalence of diabetes distress was found among 266(76.2%) subjects;164(47%) moderate and 102(29.2%) high level distress. Emotional burden was most ...
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