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Objectives: To review the strategies for controlling COVID-19 transmission among doctors involved in aerosol generating procedures. Methods: A cross-sectional study was conducted in Pakistan Institute of Medical Sciences, Islamabad from September to November 2020, using a 21-itemed initially piloted self-administered questionnaire designed on Google forms. It was shared with doctors involved in Aerosol generating medical procedures (AGMPs) by using social media applications. After the data was collected, it was analyzed using SPSS version 21. Results: A total of 136 doctors participated in the study that included 59 female and 77 male participants. Our 67 (49.3%) participants screened their patients for signs and symptoms of COVID-19 before a routine checkup. The most common disinfectant used for reusable medical equipment by 62 (45.6%) respondents was alcohol swab, 57 (41.9%) did not disinfect reusable equipment and 17 (12.5%) used Dettol water spray. Conclusion: Majority of the doctors involved in AGMPS are not following the guidelines provided by international and national bodies. As such adherence to guidelines can help prevent COVID19 transmission in frontline doctors especially those involved in aerosol generating procedures.
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OBJECTIVE: To determine the motivational factors of medical students for selecting medical career as a profession. METHODS: This was a survey based cross-sectional study. Medical students of first and second year from private and public medical colleges of Rawalpindi and Islamabad were recruited via convenient sampling and a self-based questionnaire was distributed to them. Besides demographics, questions were based on factors influencing medical students to pursue medical career. Data was collected and descriptive analysis was done using SPSS 21. RESULTS: A total of 300 medical students participated in the study; 129 (43%) of them were males and 171 (57%) were females with mean age of 19.35 years. Among Humanitarian based questions; Serving Humanity gained highest percentage, followed by sympathies for mankind and health for everyone sequentially. In Societal factors, Prestigious Profession and in Scientific factors based questions Challenging Field ranked first. Amongst all the questions Prestigious Profession takes the lead. CONCLUSION: Major motivation behind selecting medical field was prestigious profession followed by altruism. By understanding medical students' motivational factors for pursuing medical field we would be able to analyze the future trend of professionals.
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BACKGROUND/AIM: In the current study, the role of plexin B1 in breast cancer metastasis was explored. MATERIALS AND METHODS: Freshly-excised tumours along with background tissues of affected patients (n=121) were collected from Pakistani hospitals and processed for RNA isolation and cDNA synthesis. Using quantitative polymerase chain reaction, expression of plexin B1 was evaluated and correlated with clinicopathological parameters. Furthermore, involvement of plexin B1 in metastasis was explored by generating gene knockdown in MDA-MB-231 and MCF-7 breast cancer cells. RESULTS: Poorly-differentiated tumours showed low plexin B1 expression in comparison to well-differentiated ones. Similarly, reduced plexin B1 expression correlated positively with advanced tumour stage and metastasis. Loss of plexin B1 significantly reduced cell adhesion in comparison with respective control cell lines (p<0.05). Knockdown of plexin B1 in MDA-MB-231 cells led to a remarkable increase in cell motility in contrast to the respective control. CONCLUSION: Loss of plexin B1 expression might play a pivotal role in enhancing the metastatic potential of breast cancer cells.
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Neoplasias de la Mama/genética , Neoplasias de la Mama/patología , Proteínas del Tejido Nervioso/genética , Receptores de Superficie Celular/genética , Adulto , Anciano , Adhesión Celular/genética , Línea Celular Tumoral , Movimiento Celular/genética , Femenino , Expresión Génica , Técnicas de Silenciamiento del Gen , Humanos , Metástasis Linfática , Persona de Mediana Edad , Clasificación del Tumor , Metástasis de la Neoplasia , Estadificación de Neoplasias , Adulto JovenRESUMEN
Mucocele of the appendix is an uncommon disease in which there is cystic dilatation of the appendix caused by mucus secretion and usually associated with benign or malignant causes. Preoperative diagnosis is difficult as the patient presents with non-specific clinical symptoms. We report a case of mucocele of the appendix with elevated serum carcinoembryonic antigen (CEA) - a condition sparsely reported in literature. Patient presented with pain in the right iliac fossa for 7 months. On exploration, a cystic mass of the appendix without perforation was found in right iliac fossa. There was no lymph nodes enlargement. Appendicectomy was performed with subsequent normalization of CEA level and histopathology confirmed the diagnosis of mucinous neoplasm of the appendix. Patient is feeling well after one year of follow up.
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Salivary gland neoplasms are a diverse group of tumours and appropriate treatment depends on adequate understanding of the pathophysiologic behaviour of each tumour type. Most (95%) salivary glands occur in adults. Benign tumours are slow growing tumours and attain a considerable size before presenting to surgeon. We report a case of huge tumour of left submandibular gland that presented in our surgical outpatient department, and had developed over last twenty years. It was diagnosed as a benign mixed tumour of salivary gland and was successfully excised. Histopathology confirmed it to be a benign pleomorphic adenoma.
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Adenoma Pleomórfico/cirugía , Neoplasias de la Glándula Submandibular/cirugía , Anciano , Femenino , HumanosRESUMEN
Ewing's sarcoma (ES) primarily affects bones and commonly presents in adolescents and young adults. This paper reports a rare case of extra osseous ES of the scapular region in a 9 years old girl. She was treated by a multidisciplinary approach including surgery, chemotherapy and radiotherapy. She was followed up for two years and remained well.
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Laparoscopic cholecystectomy is now the procedure of choice in all the gall bladder diseases and there is increase in the skills of surgeons with newer equipment. Normally the laparoscopic cholecystectomy is performed by using four ports or three ports. Two ports laparoscopic cholecystectomy is rarely performed as it demands greater expertise and skills. Also this technique is less expensive and less scar formation than four port laparoscopic cholecystectomy. We present a case of a middle aged female who underwent successfully laparoscopic cholecystectomy by using only two ports.
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Colecistectomía Laparoscópica/métodos , Adulto , Femenino , HumanosRESUMEN
Tuberculosis is still very common in developing and under developed countries. Each year, 3 million people die of this disease world wide. Tuberculosis can affect almost any part of body. The commonest presentation of abdominal tuberculosis is ileo-caecal disease, but isolated appendicular involvement is also rarely seen. Although many cases have been reported from neighbouring countries, a search on national literature has shown no such report from Pakistan. We report a case of appendicular tuberculosis that presented in Accident and Emergency Department of Pakistan Institute of Medical Sciences, Islamabad.
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Apendicitis/diagnóstico , Tuberculosis Gastrointestinal/diagnóstico , Adulto , Apendicitis/etiología , Humanos , Masculino , Tuberculosis Gastrointestinal/complicacionesRESUMEN
BACKGROUND: Wound dehiscence/burst abdomen is a very serious postoperative complication associated with high morbidity and mortality. It has significant impact on health care cost, both for the patients and hospitals. The aim of the study was to determine the frequency of wound dehiscence/burst abdomen in patients undergoing emergency and elective laparotomies through midline incisions and to identify the risk factors for wound dehiscence. METHODS: This study was carried out at department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from 1st January 2002 to 31st December 2002. 117 consecutive patients undergoing laparotomy with midline incision were included. They were followed by wound examination from third postoperative day onwards to see their normal or otherwise healing. RESULTS: Seven out of 117 (5.9%) patients developed wound dehiscence. Five of them (4.2%) were operated in emergency and two (1.7%) were operated on elective list. CONCLUSION: It is very clear from our study that frequency of wound dehiscence/burst abdomen is still very high in our hospital. Peritonitis, wound infection and failure to close the abdominal wall properly are most important causes of wound dehiscence. Malnourishment and malignant obstructive jaundice predispose a patient to wound dehiscence by slowing the healing, and increasing rate of wound infection.
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Abdomen Agudo/etiología , Obstrucción Intestinal/cirugía , Laparotomía/efectos adversos , Peritonitis/cirugía , Rotura/etiología , Dehiscencia de la Herida Operatoria/etiología , Heridas no Penetrantes/cirugía , Adolescente , Adulto , Anciano , Enfermedad Crítica , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Medición de Riesgo , Factores de Riesgo , Cicatrización de HeridasRESUMEN
We present a case of leiomyoma oesophagus which was presented in our surgical outpatient department with symptom of dysphagia for the last one year. Patient was investigated and diagnosed as a case of benign oesophageal neoplasm. She was successfully treated by transthoracic enucleation in our surgical unit at PIMS, Islamabad.