Objective: To determine role of lung Ultrasound in Early Diagnosis of ILD in Patients with RA. Study Design: Observational Prospective study. Setting: Madina Teaching Hospital (MTH), University Medical and Dental College Faisalabad (UMDC). Period: July 2022 to December 2022. Methods: Adults with a diagnosis of RA and signs and symptoms of ILD in RA who were included. Lung function testing and diagnostic imaging were carried out. Results: The research comprised a total of 141 participants, consisting of 55 (39%) males and 86 (61%) females, with an average age of 51.92±12.15 years. The majority of the participants were positive for Rh factor, namely 112 out of 79% of the individuals examined. Mean duration of rheumatoid arthritis was 15.8 ± 10.4 years. Analysis of the patients' medical records revealed that 51.1% individuals had a documented history of smoking. Of all the patients, 60 people (42.6%) were using glucocorticoids. ILD was detected by HRCT in 108 of the 141 patients in the study group, representing a 76.6% prevalence. The LUS detected symptoms of ILD in 101 out of 141 individuals, representing a percentage of 71.6%. Concordance among LUS and HRCT was 66.7%. The sensitivity for LUS was 75%, while the specificity was 39.39%. Conclusion: The results show that LUS is a valuable method for identifying ILD in RA patients and is capable of accurately predicting the occurrence of ILD in these patients. Larger cohorts, the test's cost-efficiency, and the usefulness of LUS in the follow-up of patients who have already been diagnosed with ILD should all be assessed in future research.
Objective: To compare mean postoperative pain with and without rectus sheath block in patients undergoing midline laparotomy. Study Design: Randomized Controlled Trial. Setting: Department of Surgery, Allied Hospital Faisalabad. Period: April’24 to September’24. Methods: We enrolled 84 patients aged 13–60 years undergoing elective or emergency midline laparotomy who were randomly assigned to two groups: Group A (RSB group) and Group B (non-RSB group). RSB was performed using a landmark-based technique with 0.25% bupivacaine. Pain intensity was measured at 1, 4, 12, and 24 hours following surgery using the Visual Analogue Scale (VAS).Rescue analgesic requirements were also recorded. Results: The RSB group showed significantly lower VAS scores at 1 hour (2.46 ± 0.73 vs. 4.56 ± 0.69, p = 0.000) and 24 hours (4.51 ± 0.62 vs. 4.82 ± 0.74, p = 0.041). Mean rescue analgesic doses were also significantly lower in the RSB group (1.12 ± 0.77 vs. 2.74 ± 1.13, p = 0.000). Demographics were comparable across groups, with 63.1% males and 50% ASA I status. Findings align with 12 supporting studies, suggesting consistent benefit of RSB in terms of pain control and opioid-sparing effects. Conclusion: Landmark-guided rectus sheath block significantly reduces postoperative pain and opioid use in midline laparotomy. Its efficacy is comparable to ultrasound-guided methods and may be enhanced through preoperative timing and adjuvant use. RSB is a valuable tool, especially in settings lacking advanced imaging.
Objective: To evaluate the incidence of surgical site infections (SSI) with and without the use of suprafascial intrawound vancomycin powder in instrumented posterior spinal fusion. Study Design: Randomized Controlled Trial. Setting: Department of Neurosurgery, Allied Hospital-I, Faisalabad. Period: 01-01-2026 to 30-06-2026. Methods: We randomly assigned 74 patients from each group to undergo posterior spinal instrumentation; the patients' ages ranged from 18 to 65. In addition to the usual prophylactic intravenous antibiotics, Group A also got intrawound vancomycin powder. In contrast, Group B only received intravenous antibiotics. Over the course of three months, patients were monitored for the occurrence of SSI, as defined by the CDC. A chi-square test was used to compare the SSI rates between the groups, and the data were analyzed using SPSS version 25.0. Results: The overall frequency of SSI was 13.5% (20/148). Group A showed a significantly lower rate of SSI (6.8%) compared to Group B (20.3%) (p = 0.016). Among infections, 8.8% were superficial and 4.7% were deep. Stratified analysis demonstrated a consistent reduction in SSI in the vancomycin group across most subgroups. Conclusion: Suprafascial intrawound application of vancomycin powder significantly reduces postoperative SSI in instrumented posterior spinal fusion and may be considered an effective, safe, and cost-efficient adjunct to standard antibiotic prophylaxis.
Objective: To determine the frequency and efficacy of empirical antibiotic therapy used for treatment of pediatric typhoid fever in a tertiary care hospital. Study Design: Cross-sectional study. Setting: Department of Pediatric Medicine, Fatima Memorial Hospital Lahore. Period: 12 September 2025 to 12 March 2026. Methods: A total of 140 children aged 1-15 years, diagnosed with typhoid fever confirmed by blood culture, were included. Data on demographics, clinical features, and empirical antibiotic prescriptions were collected. Antibiotic sensitivity was assessed for the prescribed empirical antibiotics. Results: The study included 140 children with a mean age of 8.0 years; 51.4% were male. The most commonly prescribed empirical antibiotic was ceftriaxone (52.9%), followed by cefixime and ciprofloxacin (19.3%). Imipenem and azithromycin were prescribed to 4.3% of patients. Sensitivity rates were 70% for ciprofloxacin, 28% for ceftriaxone, 62% for cefixime, 50% for azithromycin, and 100% for imipenem. Only 43% of patients were sensitive to the empiric antibiotic prescribed. Conclusion: The study highlights dependence on ceftriaxone in the treatment of treating pediatric typhoid fever, despite moderate sensitivity rates. The findings demonstrate that there is a need for antibiotic stewardship program that guide appropriate empirical therapy and can also counter the increase of antibiotic resistance in pediatric populations.
Objective: To find out the outcomes of mechanical thrombectomy (MT) for acute ischemic stroke and risk factors associated with mortality. Study Design: Retrospective study. Setting: Department of Neurology, National Institute of Cardiovascular Disease (NICVD), Karachi, Pakistan. Period: October 2022 till January 2025. Methods: A total of 136 acute stroke patients management unit started functioning to caters patients requiring ntravenous thrombolysis (IVT) and MT. All patients who underwent MT for LVO from October 2022 till January 2025 were included. Inclusion criteria for MT was age >18 years, National Institutes of Health Stroke Scale (NIHSS) >6, ischemic cerebral signs on computed tomography (CT) scan by using Alberta Stroke Program Early CT Score (ASPECT) >6 and time from onset < 8 hours were included. Baseline demographics, risk factors, type of stroke, endovascular procedure and outcome were noted. Primary aim was to evaluate outcome (mortality and functional recovery). Secondary aim was predictors of mortality. Results: There were 136 patients who underwent MT, and baseline modified Rankin scale (MRS) and NIHSS were 4 and 14 respectively. Overall, 77.2% patients did achieve successful recanalization and we observed in hospital mortality of around 30.1%. Factors leading to poor recanalization were older age and high MRS score. Predictors of mortality were higher baseline MRS score, failed to achieve recanalization, procedural complication and reocclusion. Conclusion: This study demonstrates the important role of mechanical thrombectomy in the treatment of acute ischemic stroke. Older age, high MRS and ASPECT score remain factors associated with poor recanalization resulting in higher mortality.
