1.
Outbreak Investigation Of Dengue Fever In Disteict Swat Khyber Pakhtunkhwa
by Saeed ahmad | Dr. Mamoona Chaudhry | Prof. Dr.Mansut-ud-Din ahmad.
Material type: ; Format:
print
; Literary form:
drama
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1884,T] (1).
2.
Prospective Study To Assess Risk Factors Responsible For The Spread Of Avian Influenza H9N2 In Conmmercial Poultry
by Maqbool ahmad | Dr. Mamoona chaudhry | Prof. Dr.Mansur-ud-Din ahmad.
Material type: ; Format:
print
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1896,T] (1).
3.
Epidemiological Investigation Cf Crimean Congo Hemorrhagic Fever In Reported Cases And Its Associated Risk Factors
by Muhammad Sohail | Dr. Mamoona Chaudhry | Prof. Dr.Mansur-ud -Din ahmad.
Material type: ; Format:
print
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 1897,T] (1).
4.
Epidemiological Study Of Zoonotic Leishmaniasis In Humans And Dogs In District Jhelum
by Behzad kayani | Dr. Mamoona chaudhry | Dr. Muhammad | Dr. Muhammad hassan mushtaq.
Material type: ; Format:
print
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2000,T] (1).
5.
A Cohort Study On Surgical Site Infectuins (Asnosocomial Infections) In Animal And Human Side
by Atia noreen | Dr. Mamoona chaudhry | Prof. Dr. Mansur ud din ahmad.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2021,T] (1).
6.
Incidence Of Animal Bite Injuries In Three Tehsil Headquarter Hospitals Of District Swat
by Munibullah | Dr. Mamoona Chaudhry | Dr. Muhammad Hassan Mushtaq.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2133,T] (1).
7.
Epidemiological Outbreak Investigation Of Fmd In District Bihsud And Sarkhorod Nangarhar Afghanistan
by Abdul Wajid | Dr. Mamoona Chaudhry | Prof. Dr. Mansur ud Din.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2015Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2138,T] (1).
8.
Evaluation Of Vaccine Effectiveness Of Foot And Mouth Disease In District Dera Ghazi Khan
by Muhammad Fahed | Dr. Mamoona Chaudhry | Dr. Muhammad Hassan Mushtaq.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2163,T] (1).
9.
Active Surveillance Of Wild Birds For Avian Influenza In The Wetlands Of Azad Jammu & Kashkmir
by Adnan Altaf | Dr. Mamoona Chaudhry | Dr. Ali Ahmad | Dr. Hassan Mushtaq.
Material type: ; Format:
print
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2176,T] (1).
10.
Molecular Epidemiological Analysis Of Pbi-F2 Protein Of Influenza A Virus Reported From Pakistan
by Muhammad Usman Basharat | Dr. Muhammad Hassan Mushtaq | Dr. Aqeel | Dr. Mamoona Chaudhry.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2014Dissertation note: Abstract Availability: Items available for loan: UVAS Library [Call number: 2179,T] (1).
11.
Incidence Of Dog Bite Injuries Reported In Tertiary Care Hospitals
by Ambreen Shahzadi (2012-VA-440) | Dr. Mamoona Chaudhry | Dr. Shakera Sadiq Gill | Dr. Muhammad Ijaz.
Material type: ; Literary form:
not fiction
Publisher: 2014Dissertation note: Animal bites people should be considered an important public health problem. Moreover, the number of pets, specifically the dog, is increasing. (Palacio J et al., 2003).Animal bites, particularly dog bites, are a major public health problem throughout the world (Morgan and Palmer, 2007). Animal bites and scratches, even when they are minor, can become infected and spread bacteria to other parts of the body.
Dog attacks, by street or domestic dogs, with injuries from very minor to significant and severe to fatal, are not uncommon. According to WHO report, ten million people are bitten by animals (especially Dogs) around the world, considered for prophylaxis and treatment against rabies and almost (55,000) people die from this disease annually (Mohdjunaid et al., Oct 2012).
6.2 Hypothesis:
The incidence of dog bite injuries is high in densely populated towns of Lahore when compared to less populated towns of Lahore.
6.3 Methodology:
General information about patients and possible causes was collected on a structured questionnaire. All the dog bite victims that were come to emergency ward during three months period were included in the study. Questionnaire include closed questions about the demographics of the victims, circumstances of bite incidents, body parts injured and the degree of injury, type of dog, history of previous bites, the level of knowledge about rabies, post bite home treatment (washing of bite wound etc.) prior to visited the hospital for medical treatment and post exposure treatment at hospital. The densely populated area (ravi town, data ganj bakhsh, shalimar town, samanabad etc) and less populated area (gulberg, azizbhati town, wagah, Allama iqbal town, & nishtar) was be compared.
6.4 Statistical Design
Cumulative incidence was calculated as described by Leon Gordis (2008). Chi square test was applied on the data by using SPSS (version 19.0).
6.5 Results
In this study, cumulative incidence is 4.653 per 1000 popluation, most of the dog bite victims were male 79.9 % as compare to female 20%.5.7% cases visited Mayo Hospital’s emergency department during the study period, 4.5% cases were reported in Services Hospital and 89.9% cases from IPH Lahore. In this the higher percentage was the patients who were illiterate (47%) and very few patients were those who had intermediate and above education (6%). The occupation of the patients who were attended Hospitals, were farmers (31.56%). The 24% patients were those who had bitten once before in previous years. In those 24% patients 19.2 % those who were bitten by dog and 5% were bitten by others (cats, horse, donkeys, etc). Most of the victims were bitten in rural area (65%) and most of the injuries were from stray dogs (65.9%). Most of the victims had provoked bite (74%) and the high frequency were recorded that the cases had type II wound category (deep scratch but no bleeding) 82%. The cases received treatment in different hospitals were RIG (18%), Tetanus toxoid (32%), Antibiotic (78%) and Suturing (7.9%).
Most of the patients were from Ravi town Lahore that is one of the highly densely populated areas of Lahore (38%) and very few cases reported from Nishtar town Lahore (0.5%). The demographic location and the hospitals had no association as the results were insignificant (p-value>0.05). Most of the cases who were bitten by dog and they already bitten by dog in previous years, significant in relation as p-value <0.05. The association between dog status and biting animal was significant, as mostly biting dogs were stray dogs and most of the bite was provoked, there was significant association between biting animal and biting type (p-value<0.05).
Availability: Items available for loan: UVAS Library [Call number: 2285-T] (1).
12.
Prevalence Of Newcastle Disease In Backyard Poultry In District Mardan
by Muhammad Saeed (2013-VA-439) | Dr. Mamoona Chaudhry | Dr. Abdul Sajid | Prof. Dr. Mansur Ud Din Ahmad | Dr. Jawad Nazir.
Material type: ; Format:
print
; Literary form:
not fiction
Publisher: 2015Dissertation note: Newcastle disease (ND) is very important viral diseases of poultry industry in the rural areas of Pakistan It is caused by Avian Paramyxovirus serotype 1 (APMV-1) of the genus Rubulavirus belonging to the family Paramyxoviridae. The outbreaks of ND are usually associated with various factors e.g. confinement of birds, mode of disposal of diseased birds, cadavers and poultry fecal matter; dry seasons in the dry zones just before the rains; wind conditions; short irregular temperature changes and the refilling of farms with chickens from the markets. The present study was conducted in randomly picked 30 clusters in three Union councils of Tehsil Takht Bhai District Mardan to investigate the seroprevalence of Newcastle Disease virus and its potential risk factor in non-vaccinated chicken raised under backyard management system. Serum were observed through Haemagglutination inhibition test for the confirmation of prevalence of Newcastle Disease. 165 were found seropositive and 45 were seronegative (antibody titres of 4 or less) for ND out of 210 sera samples. Overall weighted seroprevalence was found as 76.836%, 95% Cl (66.238-87.433) using R software. This means that NDV was circulating in backyard poultry of district Mardan, while data on risk factor were obtained through a detail predesigned questionnaire from the owner in a face to face interview translated into local language (Pushto) after taking written consent from the owner.
To identify the risk factors for Newcastle Disease seroprevalence, multivariable logistic regression were performed. The result showed that live birds market stall near houses was strongly associated with NDV seroprevalence. Source of water from both type (public water supply and street channels) were also found strongly associated. A strong association was also observed between NDV seroprevalence and water source of street channels. Result also showed that cleaning of backyard premises was a protective factor against NDV with OR < 1. Another
Summary
38
strong risk factor was live birds market stall near houses (OR 33.64, 95 % Cl: 6.49-174.28). The largest confidence interval showed less precision which could be due to less no. of samples. The identified estimate of seroprevalence of ND and its associated potential risk factor will be communicated to concerned persons through publication. Availability: Items available for loan: UVAS Library [Call number: 2292-T] (1).
13.
Cross Sectional Study Of Newcastle Disease Virus In Wild Captive Peacocks (Pavo Cristatus) In Zoological Gardens Of District Lahore
by Faisal Sher (2007-VA-11) | Dr. Mamoona Chaudhry | Dr. Shakera Sadiq Gill | Dr. Asim Khalid Mehmood.
Material type: ; Literary form:
not fiction
Publisher: 2015Dissertation note: Newcastle disease virus (NDV) is RNA virus.It is the member of avian paramyxovirus type 1 (APMV-1).Its genus is Avulavirus genus. The incubation period ranges from 2-15 days. NDV strains are classified into velogenic, mesogenic and lentogenic categories. Newcastle disease is a virus disease of birds characterized by variable combinations of gastroenteritis respiratory distress and nervous signs.
A cross sectional study was conducted for the duration of 3 months in order to identify the prevalence of Newcastle disease in five zoological gardens of Lahore district. Peacocks were restrained by the trained persons and oropharyngealsamples were collected from apparently healthy Peacocks present in the zoological gardens in Lahore. Sampling of 200Peacocks was done by convenience sampling and stored in freezer at -80°C for further analysis.Virus isolation by egg inoculation was performed to isolate virus and confirmationof (NDV) Newcastle disease virus was done by conducting HI test with specific antisera.Samples were inoculated in 10 days embryonated hen’s eggsand allantoic fluid was collected and tested for haemagglutination (HA) activity. Positive samples were confirmed by haemagglutination inhibition (HI) test.
Frequency distribution through age, sex, breed, origin, date and site of collection were examined by standard statistical methods to determine the prevalence by virus isolation method in that specified population. The data was analyzed by using two way contingency tables with Chi-square test for association. Test was performed to check the association of NDV with age, sex, breeds, origin, and specimen type. The significance level was kept at p<0.05. 2 samples were found positive. Overall prevalence in wild captive peacocks was 1% (95 CI=.1-3.6). 200 samples were screened by spot HA test and 198 samples were found negative in four zoological gardens while 2 samples that were positive found in private zoo samples. Significant association was found between positive samples for NDV and zoological gardens.
Prevalence estimates of (NDV) Newcastle disease virus was generated for Peacock population. Associated factors were identified through this study. Results were shared with international community working for the control and eradication of Newcastle disease.
Availability: Items available for loan: UVAS Library [Call number: 2411-T] (1).
14.
Seropravelance And Assosiated Risk Factor Of Avian Influenza Among Poultry Farm Workers/Handlers In District Lahore And Kasur
by Aneela Ilyas (2014-VA-512) | Dr. Mamoona Chaudhry | Prof. Dr. Mansur-ud-Din Ahmad | Dr. Hamad Bin Rashid.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Avian Influenza is one of the most important zoonotic diseases which are a major concern for public health. Avian Influenza Virus (AIV) is a potential source for the emer¬gence of human influenza pandemics (Fouchier et al., 2005; Olsen et al., 2006; Webster et al., 1992). The outbreaks of Avian Influenzas are usually associated with various factors e.g. do not wash hands after handling sick poultry and mortality, do not use of PPE’s (personal protective equipment), no dipping area, eating and drinking during working with poultry, confinement of birds, mode of disposal of infected birds, carcasses and poultry fecal matter; dry seasons in the dry zones just before the rains; wind conditions; short intermittent temperature changes and the restocking of farms with chickens from the markets.
Hypothesis:
Avian Influenza A, H9 virus was prevalent and potential risk factors are associated with AIV disease.
Parameter/Methodology:
A cross sectional survey in poultry farm workers of district Lahore and Kasur would be conducted in order to determine seroprevalence of Avian Influenza. A study population was the apparently healthy poultry farm workers/handlers of District Lahore and Kasur of Province Punjab. Stage one cluster sampling technique was adopted and with the help of formula and 525 blood samples of poultry workers were taken from 38 selected clusters.
Blood sample from apparently healthy poultry workers were collected from brachial veins. Blood (4-5ml) was collected in vacutainers and allowed to clot for separation of serum. Collected sera were stored in freezer at -70°C for further laboratory analysis.
Haemagglutination assay (HA) and Haemagglutination Inhibition (HI) test was applied on samples as per protocol of world health organization (WHO, 2013).
I had to work on H5, H7 and H9 strains according to my topic but due to the non-availability of H5 and H7 live viruses I could not perform lab analysis. So, I worked only on H9 strain of AIV.
Statistical Design:
The proportion estimate with 95% Cl (Confidence Intervals) of the overall seroprevalence would compute by using “R” software. Descriptive analysis was conducted by using SPSS (version 20). Logistic regression (univariable and multivariable) was conduct to estimate the effect of each study variable on the outcome (Hosmer and Lemeshow 2000).
Outcomes:
The current study had provided useful estimates of risk factors related to AIV. The finding of above study will be published. These findings could be utilized by the policy maker to control the epidemics of AIV in population.
Availability: Items available for loan: UVAS Library [Call number: 2585-T] (1).
15.
Prevalence Of Influenza Virus Among Children Of Tehsil Kot Radha Kishen
by Shamsa Rafique | Dr. Mamoona Chaudhry | Prof. Dr. Mansur-ud-Din-Ahmad | Dr. Amir Ghafoor Bajwa.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Influenza belongs to orthomyxoviridae with single stranded RNA genome. Influenza has three types namely A, B and C with further subtypes on the basis of hemaglutinin and neuraminidase surface proteins that are H1, H2, H3, N1 and N2. Influenza infection causes headache, muscle ache, runny nose, sneezing and often fever with cough. Nose, lungs and bronchi are affected by it. Human influenza infection usually follows a period of 10-14 days with no residual effects. However, sometimes it may cause serious respiratory illness and rarely involve other body organs. On the other side, newly evolve strains of influenza have little immunity against them so these may cause serious illnesses and even lead to death. Various strains of influenza have caused epidemics, pandemics and zoonotic diseases at different times all over the world. This cross sectional study was conducted to estimate the prevalence rate of influenza in Pakistan. Study period was 12 months. A cross sectional survey of Kot Radha Kishen, district Kasur was undertaken in children less than 15 years from 35 localities. Data was collected through two stage cluster sampling techniques. After a written consent, questionnaires were filled up. Total sample size was 245.
In this study, Child aged less than 5% were 46%, 5-10 year were 40% and 10-15% were 14% including 50.8% female and 49.2%male children. Vaccination was completed in 86.4% and continued in 4.8%. However, 4.4% children were not immunized at all. These families were mostly shifted in that area after migration. During the survey 22% community showed their knowledge about seasonal influenza vaccination while 78% were ignorant of it.
About 40.8% of community kept bird and 51% kept animal at home. Among those children, 33.2% children suffered from influenza like illness within the week of surveillance.
Summary
53
Influenza contact history was positive in 33.2% of these cases. In case of illness 24.4% regularly took medicine from hospital While 34.8% population moved to traditional doctors for medicine and 17.2% took medicine from pharmacies without any doctor’s prescription. Prevalence estimates of human influenza were generated; associated risk factors were identified through this study. Results were shared with international community working for the control and eradication of human influenza Availability: Items available for loan: UVAS Library [Call number: 2634-T] (1).
16.
Evaluation Of Factors For Refusal Of Polio Vaccination During Immunization Campaigns In Aziz Bhatti Town, Lahore
by Fatima Majeed | Dr. Mamoona Chaudhry | Prof. Dr. Mansour-Ud-Din Ahmad.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Polio is acute and devastating diseases. It has only human host. Joint efforts of international agencies will be very helpful for achieving the target of Global Polio Eradication. We are still lagging behind, as 3 countries of the world including Pakistan, Afghanistan, and Nigeria are polio endemic countries. In poliomyelitis 90-95 % cases have no symptoms, 4-8 % has minor illness, 1-2 % has meningitis, while paralytic poliomyelitis is seen in only 0.1-0.5 % of cases. Polio virus is member of entero virus subgroup of family Picornaviradae. Picorna viruses are small ether-insensitive with RNA genome. There are 3 polioviruses serotypes (p1, p2, p3).
Unskilled workers, lack of commitment of polio workers, inadequate training, non-professional attitude of polio team and too frequent campaign are common causes for refusal to give polio vaccination to children.
The parents of less than 5 years age children of Aziz Bhatti town, who were approached for the vaccination of polio during immunization campaign, were included in the study. A sample of 260 children‟s was included. The study conducted for a period of one year.
The data was collected from the parents / guardian of the children who were approached for vaccination during the immunization campaign in Aziz Bhatti, town, Lahore. The consent was taken from them
Data was compiled in Excel and entered and analyzed through SPSS. The data was represented through charts, graphs. Rate, ratios and frequencies were calculated. Chi square
69
Summary
test was applied and the test of significance was applied at P values of 0.05. Any value less than 0.05 was considered as significant.
The result of study will be forwarded to health authorities to be used in future to make active measure for successful polio vaccination so that refusal can be brought to zero, and target of polio elimination can be achieved in Pakistan. Availability: Items available for loan: UVAS Library [Call number: 2633-T] (1).
17.
Targeted Survey Of Avian Influenza (H5, H7, H9) In Backyard Poultry In High Risk Area Kasur District
by Shumaila IQbal (2009-VA-83) | Dr. Mamoona Chaudhry | Dr. Muhammad Hassan Mushtaq | Dr. Muhammad Ijaz.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Avian Influenza is the most feared disease of poultry and other birds throughout the world. The segmented, negative strand RNA viruses that form the family Orthomyxoviridae are divided into three types of influenza virus, A, B and C. Only influenza A viruses have been reported to cause natural infections of birds. The outbreak can be mitigated by applying biosecurity measures, controlling poultry movement, using inactivated vaccines and initiating an AI surveillance network throughout the country.
A targeted survey was conducted for a period of 3 months in order to determine prevalence of Avian Influenza H5, H7 and H9 in the villages of Kasur district. Two stage cluster sampling without replacement was adopted in this study. Thirty clusters were selected and in each cluster, seven elementary units (chicken) were sampled, i.e. a total of 210 birds. Tracheal swabs were collected from live and apparently healthy backyard birds then swabs were stored properly at 4°C (24-48hours) until processed. Data were collected from the owner in a face to face interview. A detail predesigned questionnaire was filled after taking written consent from the owner. The sample was collected during the survey of backyard poultry in villages of Kasur district was processed for laboratory analysis. Polymerase chain reaction for Avian Influenza virus isolation was conducted to diagnose sample for AIV.
The weighted proportion estimate with 95% Cl (confidence intervals) of the overall prevalence was computed by using “R” software. Multivariable logistic regression was conducted to estimate the effect of each study variable on the outcome. Variables with significant univariate relationship at p <0.25 was selected for inclusion in the final model. Odds ratios (ORs) and corresponding 95% Cl (confidence intervals) were calculated (Hosmer and Lemeshow, 2000).
CHAPTER 6
SUMMARY
Discussion
53
The management practice risk scores provide a means to quantify the level of risk to avian influenza across villages. However, the utility of such a measure cannot be assessed until these are related to AI status form clinical tests. Nevertheless it is useful to assess what factors are associated with these scores. In particular, specific profiles of farms can be identified with potential high risk and control resources allocate accordingly. For example, this study has found amongst other things that farms with mixed poultry breeds, which have reported diarrhea, or reported high mortality have high risk scores, and these might be targeted for intervention. Prevalence estimate of Avian Influenza was generated. Potential risk factors associated with this prevalence was identified and will be communicated to concerned persons through publication. The poultry birds reared completely outdoor have more chance to contact with wild birds which increase the occurrence of AIV. A strong association between source of water and AIV was found. Water source can play a vital role in transmission of AIV. Another strong association was found in unethical disposal of dead birds and waste poultry farm near to houses with increase the chances of infection. Presence of live bird market stall and visiting of poultry farm vehicle to villages can increase the chances of AIV infection. Elimination or reduction of above mentioned risk factors, use of disinfectant for cleaning and regular vaccination against AI could significantly improve backyard poultry production system in villages. Availability: Items available for loan: UVAS Library [Call number: 2655-T] (1).
18.
Case Control Study Of Brucellosis And Its Associated Risk Factors At Commercial Dairy Farms
by Amna Riaz (2008-VA-257) | Prof. Dr. Mansur Ud Din Ahmad | Dr. Mamoona Chaudhry | Dr. Muhammad Imran Rashid.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Brucellosis, is a febrile, zoonotic disease caused by bacteria of genus Brucella. It is a second most important zoonotic disease after rabies. (WHO, OIE, FAO). Brucella is gram negative, aerobic, non-spore forming and non-motile coccobacilli. (Gull and Khan, 2007).The main signs are abortion after fifth month of pregnancy, still births, birth of weak calves, infertility, placentitis in females and in male’s epididymitis and orchitis. Due to its zoonotic nature farm labors, butchers, veterinarians and slaughter house workers are at high risk. Signs in human brucellosis are highly variable i.e., flu, rising and falling of temperature and causes many other complications in the body. (Baba et al.2001; Grillo et al. 2006; Shimol et al. 2012). Standard tests for brucellosis are Rose Bengal Precipitation Test (RBPT), Serum Agglutination Test (SAT) and Complement Fixation Test (CFT) (Memish et al, 2002). Its control is very difficult due to its variable incubation period, long survival time in both extracellular and intracellular environments, asymptomatic stages and resistant to the treatment, co-mingling, increasing population size and nomadism (Rahman et al. 2006).
The case study was conducted on the commercial dairy farms situated in the catchment area of University Diagnostic Laboratory, UVAS Lahore which were located Lahore, Kasur and Sheikhupura districts in Punjab. The data about positive and negative farms was obtained from university diagnostic lab, UVAS, Lahore. A predesigned questionnaire was filled from that farm workers in face to face interview. The sample size was calculated by the formula given by Schlesselman, 1982. The parameters for calculation of the sample size were power of study kept at 80% with 95% confidence interval. Total 90 samples were included (cases= 45, controls=45). Data was analyzed using chi-square. All statistical tests were performed at the significance level of 0.05.
In this study, absence of the calving pens at the farm, feeding and water practices, presence of streams and lakes near the farm and breeding practices show the strong association with this disease,by controlling the above factors and improving management at the farm can low the occurrence and spread of the disease in animals.
Availability: Items available for loan: UVAS Library [Call number: 2664-T] (1).
19.
Application Of Euroscore To Predict Risk Of Mortality After Coronary Artery Bypass Grafting In Pakistani Population
by Ali Naeem (2014-VA-780) | Dr. Muhammad Hassan Mushtaq | Dr. Ammar Hameed Khan | Dr. Mamoona Chaudhry | Dr. Muhammad Nasir.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: Coronary artery bypass surgery has become the standard of care for advanced coronary artery disease. It is one of the most audited and closely monitored operations in the history of surgery. Morbidity and mortality associated with this operation is also very closely monitored by surgeons, hospitals, professional bodies and governments at large. Based on the preoperative clinical information available about patients preparing to undergo coronary artery bypass surgery various predictive models for assessment of mortality risk have been developed over the last two decades in various regions across the world. Euro SCORE is one such predictive model which can accurately predict the risk of mortality for large groups of patients for the population in which it was developed. A large number of Pakistanis and nationals from South East Asian countries reside in different European countries and form part of the population on which this score has been developed and validated. We intend to find out the predictive accuracy of this model in our patients living in Pakistan.
Euro SCORE accurately predicts operative mortality in patients from Pakistani population.
This study will be conducted at the Department of Cardiac Surgery Shalamar Hospital Lahore. One hundred consecutive patients admitted to hospital for coronary artery bypass surgery will be enrolled in study. A total of 18 variables as included in EuroSCORE (Appendix 1) will be collected and entered into database. The expected mortality risk will be calculated by the EuroSCORE Calculator software (http://www.euroscore.org/). Actual or observed mortality and morbidity will also be recorded.
Statistical analysis will be performed using SPSS version16. Continuous numerical data will be presented as mean ± Standard deviation, the Student t test will be used to compare means of normally distributed data. The qualitative data will be analyzed using chi square test. The relationship of the observed and the expected rates of mortality will be assessed using ROC curves for the accuracy of prediction of the Euro-SCORE.
This study will indicate how accurately Euro SCORE can predict the risk of mortality after coronary artery bypass grafting in our population and more over it may indicate other patient related variables that can contribute to operative mortality other than Euro SCORE.
Availability: Items available for loan: UVAS Library [Call number: 2713-T] (1).
20.
Prevalence And Associated Risk Factors Of Needle Stick Injuries Among Health Care Workers In Government Tertiary Care Hospitals Of Lahore
by Gurdeep Singh (2014-VA-957) | Dr. Mamoona Chaudhry | Dr. Muhammad Hassan Mushtaq | Dr. Ali Ahmad sheikh.
Material type: ; Literary form:
not fiction
Publisher: 2016Dissertation note: In present study, seventy six percent (n=228) of respondents were involved in
sharp injuries and twenty four percent (n=72) were not involved. This study concluded there
was high occurrence of needle stick sharps injuries among healthcare workers in tertiary care
hospitals of Lahore. There are several risks associated with handling healthcare sharps
among healthcare workers which include, needle prick that could be contributed to cases of
occupational infections such as HIV/AIDS. Majority of reported cases were due to following
reasons , inadequate supply of barrier products ,unsafe practice such as recapping of needle
In paramedical staff due to failure in standard guide lines to handle medical sharps and lack
of reporting of sharps incidents and very lower ratio utilization of post exposure
prophylaxis. It was observed that risks of needle stick injuries were reduced with the
experience. Those who have work experience of 5 years or less had higher ratio of sharp
injuries than those who had work experience five to eight years. Respondents with nursing
profession and laboratory technicians were at high risk; their exposure to handle sharps is
greater and due to failure in precautionary measure risk of needle stick injuries in this
category is higher compared to other. While Females were at high exposure risk of sharp
injuries at tertiary care hospitals than male. Respondents with education level of diploma
were more exposed to needle stick injuries as compared with degree holders in paramedical
staff. It was observed that shift of eight hour work is absolute and healthcare workers were
normal with it. If work load increased and time was exceeded then it was difficult to manage
such injuries .while training on infection control and prevention has no effect in government
hospitals of Lahore to decrease the risk of sharps injury among healthcare workers.
Several recommendations which need to be implemented at the hospitals were
identified as discussed below. and special attention need to be given to nurses , cleaners ,
the critical care section and the department of medicines There is need of fully trained
Summary
38
health care workers in critical care units , medical and surgical ward Momentary to
developed infection control department in every government and private hospital of Lahore
and give them special training about the handling of medical sharps. adequate supply of
barrier products (gloves, masks, lab coats etc) Check and balance on proper use of barrier
product , there is need of timely collection of used medical sharps in puncture proof
containers such as safety boxes that should be ¾ full when emptying .Need of safe
transportation in a covered vehicle for incarnation .Administration of hospital need to
developed polices for reporting of needle stick injuries by designing a log form that capture
information on demographic data of the employee. Data and time of injury, type of sharp,
procedure involved, part of body involved where it occurred. So it’s important to analyzed
enter data in an order to understand root cause. It’s important to conduct surveillance and
prevent further injury. Infection control department should need to check post-exposure
prophylaxis status in health care workers go through counseling and are followed up to
enhance post exposure prophylaxis in health care workers it’s not up to individual effort it’s
a team work by involving administration and health care workers.. In government hospitals of
Lahore there is many factors which contribute to needle stick injuries it might be reduced by
strengthening of reporting system is necessary. The responsibility of government is to
strengthen the check and balance on use of barrier products (gloves, pads, lab coats etc.) and
create awareness on standard guidelines on handling of medical sharps. Thus rate of needle
stick injuries could be reduced to acceptable level. Availability: Items available for loan: UVAS Library [Call number: 2748-T] (1).
21.
Burden Of Respiratory Illness Related To Influenza Among Oupatient And Inpatients Healthcare Facility Centers District Sheikhupura
by Ayesha Mukhtar (2014-VA-1052) | Dr. Mamoona Chaudhry | Prof. Dr. Mansur-ud-din Ahmad | Dr. Shafqat Fatima Rehmani.
Material type: ; Literary form:
not fiction
Publisher: 2017Dissertation note: Influenza is a highly contagious, acute illness in humans. Influenza viruses have negative-sense RNA genomes and are placed in the Orthomyxoviridae family grouped into three types A, B and C on the basis of the internal nucleocapsid or the matrix protein. Droplet and airborne are the most common modes of transmission. In Humans infection appears to be direct or indirect exposure to infected person or infected live or dead poultry or contaminated environments.Globally the annual attack rate with influenza viruses ranges between 5 to10% in adults and 20- 30 % in children. The WHO estimates that 3-5 million cases of severe influenza illness occur every year resulting in 250,000 to 500,000 deaths worldwide, with most influenza deaths occurring among adults over 65 years of age.
Influenza is the cause of outpatient visits and inpatient hospitalization among population of District Sheikhupura.
A prospective study for duration of 3 months (September to october) was performed in Tehsil Muridke District Sheikhupra. Population of Tehsil Muridke is 4, 52,009. We selected Tehsil headquarter hospital randomly as sentinel sites .Our Target population was cases of ILI and SARI. All cases of influenza like illness (ILI) or severe acute respiratory illness (SARI) who meets the inclusion & exclusion criteria was enrolled. Data was obtained by the face to face interview. A detail investigation form was filled after taking written consent form. Throat swab was collected from patient. The sample was stored at -70°C for further laboratory procedure. We will use Reverse transcriptase polymerase chain reaction (RT-PCR) for detection of type of the influenza virus. RT-PCR allows viral template RNA to be reversed transcribed producing complementary DNA (cDNA) which can then be amplified and detected. So in our Study we used RT-PCR for influenza virus detection.
Data analyzed by using SPSS software with 95% confidence interval. Chi-square test used to measure the association of risk factors (age, sex, occupation, exposure, healthcare worker, travelling etc) and the rate of morbidity and mortality was calculated by using standard formulae.
We identified ILI and SARI cases associated with outpatients and inpatients & also provided data to identify and monitor groups at high risk for influenza and will measure trends in morbidity and mortality attributable to influenza.
Availability: Items available for loan: UVAS Library [Call number: 2805-T] (1).
22.
Descriptive Epidemiology And Risk Factors Of Antenatal Depression Among Women Visiting Tertiary Care Hospital In Lahore
by Gulshan Umbreen (2015-VA-415) | Prof. Dr. Mansur Ud Din Ahmad | Dr. Mamoona Chaudhry | Dr. Muhammad Nasir.
Material type: ; Literary form:
not fiction
Publisher: 2017Dissertation note: Mental health is an important but neglected component of reproductive health. Mental health problems among women of reproductive age group (15–45 yrs.) contributes to 7% of Global Burden of Diseases of women of all ages. During pregnancy prevalence of depression ranges from 4% to 20%. Women with perinatal depression experience full-blown major depression during pregnancy or after delivery (postpartum depression). The feelings of extreme sadness, anxiety, and exhaustion that accompany perinatal depression may produce or create difficulties to perform daily care activities for themselves and for their babies. Several risk factors predispose to depression during pregnancy are poor antenatal care, economic deprivation, previous history of psychiatric disorders, previous events during pregnancy like previous abortions, and modes of previous delivery like past instrumental or operative delivery age, marital status, gravidity, whether pregnancy was planned. Antenatal depression was the strongest indicator of postnatal depression. A hospital based cross sectional survey for duration of 4 months (December 2016 to March 2017) was performed in Lady Aitchison hospital Lahore. Pregnant women who visited to the obstetrics and gynecology departments for routine prenatal or perinatal care. Woman belongs to lower middle class was included and women with physical disabilities such as deafness and dumbness as well as those with a history of or ongoing mental illness/retardation was excluded in this study. Sampling was done by using convenience sampling technique and sample size was 300. Information regarding risk factors of antenatal depression was collected by using structured questionnaire and a screening tool, Edinburgh postnatal Depression Scale to assess depression after taking written consent. Data was obtained by face to face interview. Data was analyzed by using SPSS software with 95% confidence
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interval. Descriptive analysis was conducted in terms of who, when and where. Frequency distribution and graphs were be made. Chi- Square test was applied to see the association of risk factors. Depression and various risk factors have been identified among pregnant woman. Association found among various risk factors like age, education of woman and husband, occupation of husband, Husband income, Family type, number of persons living in home, number of children’s, number of daughters, trimester of pregnancy, mode of delivery, pregnancy status, fear from childbirth, Bitter experience/Complication in current /previous Pregnancy and Family Support. Through assessment provide an opportunity in need of intervention to safeguard the well-being of mother and baby and reduce the impact of antenatal depression on the mother, her baby, and her family. Availability: Items available for loan: UVAS Library [Call number: 2903-T] (1).
