bluuebunny/crossref_metadata_2025 huggingface dataset:
Requency of Over Weight and Obesity and its Determinants Among Adult Population of District Swat Khyber Pakhtunkhwa Pakistan
Authors: . Naeemullah , Khan Nadia , Khan Muhammad Jibran , Wazir Anwar Khan , Iqbal Arif , Ishtiaq Muhammad , Khan Said Akbar , Ali Jawad
Published: September 2022

Background: In both emerging and wealthy nations, the epidemic of overweight and obesity has exploded in the last several decades, becoming a huge public health concern. Objective: To estimate the frequency of overweight and obesity and its important determinants among the adult population of Selected Districts of Khyber Pakhtunkhwa Pakistan Methods: A descriptive cross sectional study was conducted by the Department of Community Medicine, Saidu Medical College, Swat Khyber Pakhtunkhwa Pakistan; from January to April 2022. A total of 410 adults were selected and a structured questionnaire was used to collect relevant information. Results: Results showed that 67.07% had age above 30 years; 72.44% were males, 37.32% were illiterate; 51.95% had monthly income less than 25000/ PKR; 54.39% were married; and 26.34% had family history of overweight and obesity. Moreover, 52.93% had sedentary life; 37.56% watch television; and 15.85% & 17.80% had diabetes mellitus & hypertension respectively. Furthermore, 26.34% prefer carbohydrates; and 44.15$ prefer soft drinks. 63.66% and 58.05% didn’t prefer vegetables and fruits respectively. Conclusions: It was concluded that prevalence of overweight and obesity showed moderate to high frequency among adults, and showed relationship was age, gender, marital status, tobacco smoking, dietary habits, and social habits. Thus effective educational, behavioral and social strategies are needed to prevent and control overweight and obesity in the population. Keywords: Prevalence, Determinants, Developing, Adults, Obesity, Overweight, Pakistan
Role of Salivary Glucose in the Diagnosis and Monitoring of Type 2 Diabetes Mellitus
Authors: Abid Humaira , Khan Muhammad Nadim Akbar , Qayyum Shazia , Noureen Fakhra , Shafi Rubina , Kanwal Amina
Published: September 2022

Objectives: To determine the correlation of fasting salivary glucose with fasting plasma glucose (FPG) and glycated hemoglobin A1c (HbA1c) for the diagnosis and monitoring of type 2 diabetes mellitus (T2DM). Methods: A case - control study was carried out from 11th March to 30th August 2021, involving 88 participants out of which 44 were healthy controls and 44 participants were known T2DM who had FPG ≥ 126 mg/dl or 7.0 mmol/L. FPG was measured by Glucose oxidase method and HbA1c by National Glycohemoglobin Standardization Program (NGSP) certified chromatography. Results: T2DM group had significantly higher FPG, HbA1c and salivary glucose values. Both diabetics and healthy controls showed a positive correlation of fasting salivary glucose with FPG. The correlation coefficient (r) was 0.689 and 0.477 for cases and control groups respectively. Similarly, a positive correlation of fasting salivary glucose with HbA1c was observed with the value of r 0.433 and 0.498 for diabetic and healthy control groups respectively, when measured separately. For both groups linear regression equations were derived and scatter dot plots were plotted. P value < 0.001 Conclusion: A positive correlation of fasting salivary glucose with FPG and HbA1c was found. As a result, fasting salivary glucose can be utilized instead of plasma glucose for T2DM patients’ screening, diagnosis, and monitoring thereby eliminating the repeated pricks and mental trauma of patients. Keywords: Blood glucose, glycemia, glycated hemoglobin, salivary glucose, Type 2 diabetes mellitus
Vitamin D Deficiency among Well Nourished and Malnourished Children of School Going age at District Tharparkar
Authors: Kapoor Aneel , Fatima Fasiha , Ahsan Naveed , Shaikh Ghulam Serwar , Solangi Dildar Ali , Shanker Bhawni
Published: September 2022

Objective: The most frequent type of nutrient shortage is Vitamin D deficiency, which affects about of half of the world’s population. Vitamin D deficiency responsible for numerous acute and chronic conditions not only in malnourished children but also in well-nourished children. Our objective was to determine vitamin D levels among malnourished and well-nourished school going children at district Tharparkar Pakistan. Design: Cross-sectional study Setting: This study was conducted in Mithi, District Tharparkar among school age-children (between 10-18 years). Vitamin D was estimated by Cobas e411 analyzer Roche (made in Japan). Results were descripted as mean ± SD. Students t test was used to find out the significant of results. A 0.05 or lower p -value was judged as meaningful. Results: 300 children were divided in malnourished and well-nourished groups. Vitamin D deficiency affected 74% of school age children. Boys accounted for 30% of the group, while girls made up 44%. We noticed that 4 girls had severe vitamin D deficiency. Conclusion: Vitamin D deficiency is more prevalent in school going children. Even well-nourished girls are more vitamin D deficit than boys. Children are seen as important members of society and are regarded as the country's future architects. As a result, investing in children's health is the most important factor in improving Pakistan's economic, political, and social conditions, because malnutrition has a significant impact on mental and physical inadequacy. Keywords: Vitamin D, Malnutirion, school going children
Comparison of Effects of Intravenous Lignocaine and Magnesium Sulphate on the Cardiovascular Response to Laryngoscopy and Intubation
Authors: Wadud Roheena , Baloch Muhammad Haseeb Moin Ud Din , Haq Imran Ul , Khan Muhammad Kamran , Farid Khayyam , Firdous Tanzeela
Published: September 2022

Background and Objective: The patient's heart rate, blood pressure, pulmonary arterial pressure, and capillary wedge pressure will all rise during laryngoscopy and tracheal intubation. These hemodynamic alterations are less noticeable in those with normal blood pressure but have been linked to several diseases. They are well tolerated by those with normal blood pressure. The study's goal is to compare the cardiovascular effects of lignocaine and magnesium sulfate during laryngoscopy and intubation. Methodology: The objective of this randomized controlled trial was to examine the effects of lignocaine and magnesium sulfate on cardiovascular and respiratory responses after endotracheal intubation in ASA I patients. The 60 participants' ages ranged from 15 to 45, and they were all classed as "grade I" by the ASA. Each of these patients underwent elective surgery under general anesthesia voluntarily. The sixty people were divided into two groups of thirty using a random selection method. Neither group was significantly different from the other in terms of demographics or blood-flow parameters. Group L was administered 1.5 mg/kg intravenously of lidocaine three minutes before to induction. Group M received an intravenous injection of magnesium sulfate at a rate of 40 mg/kg over the course of one minute. Results: In both the Magnesium and Lignocaine groups, heart rates increased, but the Lignocaine group's increase was far more dramatic (p value 0.01). Both groups experienced an increase in systolic blood pressure following medication administration (p value 0.05). The results of Group M remained statistically significant for the first minute after the insertion of the tube, but by the fifth minute, they had returned to pre-insertion levels. In Group L, blood pressure increased significantly at 1 and 3 minutes after tube insertion, but by 5 minutes, blood pressure had returned to pre-insertion levels. The SBP of group L individuals increased significantly greater than that of group M participants. (p 0.05). Immediately following intubation, there was a statistically significant (p 0.01) increase in DBP in both groups; however, three minutes later, DBP had returned to pre-intubation levels in both groups (p 0.01). It is five percent as important. (p 0.05). The results revealed that the growth rate of group L members was significantly higher than that of group M members. In the presented situation, p equals 0.01 Conclusion: When it comes to preventing a rise in heart rate, blood pressure, and blood pressure during laryngoscopy and tracheal intubation for patients with an ASA grade I, magnesium sulfate is more beneficial than lidocaine.
Evaluating Role of Arthrocentesis in Management of Internal Derangement of TMJ
Authors: Khan Hijab Farid , Rehman Amna , Malik Samreen , Haque Arifa , Qamar Afshan , Qureshi Navid Rashid
Published: September 2022

Background: Concerning the management of TMJ the complex anatomy of TMJ plays a vital role since it has its components that attached the most versatile part of human body. It has its several components performing and aiding in multitude of functions(1). Each instance of TMD is different and complex, thus diagnosis involves a thorough examination of the individual patient's history and symptoms as well as a range of methods. Objective: The objective of this study was to evaluate the role of arthrocentesis in management of internal derangement of TMJ Methodology: In order to access the relevant research articles a systemic research was conducted via three data bases including PubMed, Google Scholar and web of science.
Outcome of Cataract Surgery on Intraocular Pressure
Authors: Gopang Zakaullah , Bhutto Shabeer Ahmed , Abassi Fayaz Ali , Katpar Naeem Akhtar , Abbasi Safder Ali , Nagdev Partab Rai
Published: September 2022

Objective: To determine the outcome of surgery of cataract on intraocular pressure. Study Design: Observational Study. Setting: Study carried out at Ophthalmology Department, Shaheed Mohtarma Benazir Bhutto Medical University Larkana, from 16-03-2020 to 15-09-2020. Material & Method: Patients with cataract and plan for cataract surgery were randomly taken into two groups, caliberated applanation tonometry was used to asses pre and postoperative ocular pressure. Iop range between 12-40mmHg associated with cataract patients with selected following criteria from out patient department (OPD) with 40-86 years of age, either gender, healthy cornea, having been controlled for diabetes and hypertension. Results: Age range of the patients was between 40 and 86 years, the overall mean ± SD age of the patients was 58.48 ± 9.28 years. Our study observed that female 143 (52.6%) patients were more affected than male 129 (47.4%) patients (male to female ratio was 1:1.1). Preoperative intraocular pressure ranged from 12 to 40 mm Hg; overall mean + SD intraocular pressure was 18.81 + 3.80 mmHg. While intraocular pressure checked within one week after surgery ranged from 8 to 26 mmHg, the overall mean + SD intraocular pressure was 12.41+2.24 mmHg (p value < 0.001) (table no. 2). A significant decrease in intraocular pressure was 10.49+1.020 mmHg observed at one month postoperative follow-up (p value <0.001) Conclusion: It is to be concluded that intraocular pressure decreases significantly after extraction of cataract and so the mild to moderate cataract can be treated through this as a first step in early glaucoma. Keywords: IOP, Cataract extraction, Glaucoma.
Frequency of Hypocalcemia in Patients Undergoing Plasmapheresis
Authors: Ishaq Muhammad , Khan Arif Rahim , Hasan Syed Shahnawaz , Aziz Muhammad Fahad
Published: September 2022

Objective: To determine the number of patients who experience Hypocalcemia while receiving Plasmapheresis. Study Design: An observational study that is cross-sectional and descriptive. Place and Duration of Study: The research was conducted for one year, from 21th April 2020 to 21th April 2021. Methods: A total of 177 individuals having Plasmapheresis between the ages of 15 and 45 were included in the study. Participants in the study who had recently undergone thyroid or parathyroid surgery, those with renal failure, arrhythmias, and persons who were difficult to comply with, were excluded (1). After that, each patient had a therapeutic plasma exchange, commonly known as Plasmapheresis, performed by skilled medical professionals with comparable levels of expertise. After the process, a venous blood sample was drawn to measure the amount of calcium ionized. Hypocalcemia was either present or not, defined as ionized calcium levels below 4.5 mg/dl. Results: The average age of the eighty-two patients was 38.43 years, and 46.33% were between 36 and 45. Among these 117 patients, 109 of them were men and 68 of them were women, making up 38.42% of the entire population's patients (61.58%), or a ratio of 1:6:1. Hypocalcemia was found in 18 people with a percentage of 10.17%, whereas the disorder was absent in 159 patients with a percentage of 89.83%. Patients in this group are undergoing Plasmapheresis. Conclusion: Therefore, Plasmapheresis should be used to routinely evaluate serum calcium levels to appropriately manage any cases of Hypocalcemia that may emerge since Hypocalcemia often happens in patients getting Plasmapheresis (10.17% of the time). Keywords: Exchange of plasma, calcium level.
To Evaluate the Management of Epididymo-Orchitis at Tertiary Care Hospital
Authors: Ghumro Altaf Hussain , Zardari Inayat Ali , Ayoub Sadia , Khowaja Mashooq Ali , Memon Aijaz Hussain , Memon Zulfiqar Ali Imtiaz
Published: September 2022

Introduction: Epididymo-orchitis is common condition in scrotum found in surgical practice. It is commonly seen in young males. It can occur at any age. The common age is between 2nd to 4th decades of life. Its duration of illness is 6 weeks in acute condition and 12 weeks in in chronic conditions. It mostly occurs associated with sexually transmitted diseases. Chlamydia trachomatis and Neisseria gonorrhea are the common causative organisms. After age 40, the common organisms causing this disease are Escherichia Coli and Coliform bacteria found on G.I.T. There are also other causes of this disease. It is mostly managed conservatively but it can be operated it the condition develops complications. Even Orchidectomy is also done in some conditions. Objective: To evaluate the management options in epididymo-orchitis . Material methods: This is a cross sectional study done at surgical Unit 1 of Peoples Medical Hospital (PMCH) Nawabshah. The duration of study was one year from 10th August 2019 to 9th July 2020. All the patients were admitted through Surgical out Patient Department (SOPD) and emergency department of Peoples Medical College Hospital (PMCH) Nawabshah. Approval of study was taken from Ethical committee. Detailed history and thorough clinical examination was done. Routine investigations were done apart from viral markers including HIV. Urine DR and Culture ,Ultrasound of Scrotum and CT Scan were done. Management was planned accordingly. Results: Total 65 patients were included in this study. Of them, 20 (31%) had left sided pathology, 40 (61%) had right sided and 5(8%) had bilateral. Testicular abscess formation was seen in 8 (12.3%) patients. In 2 (3.07%) patients, testicular infarction was noted. 1 (1.5%) patient became infertile due to bilateral involvement. 3 (4.6%) patients had developed psychosis. Conclusion: It is concluded that most of the patients were treated conservatively and in a few patients, incision drainage and orchidectomy was performed. Keywords: Epididymo-orchitis. Neiserria Gononrhea, E.Coli, Incision Drainage, Orchidectomy.
Gender Prevalence and Management of Small Bowel Tuberculosis at Tertiary Care Hospital Nawabshah
Authors: Zardari Inayat Ali , Ghumro Altaf Hussain , Memon Zulfiqar Ali Imtiaz , Soomro Imtiaz Ali , Ayoub Sadia , , Khowaja Mashooq Ali
Published: September 2022

Introduction: Abdominal tuberculosis has higher incidence particularly in developing countries. The challenge to Surgeon is to diagnose it as its presentation is very vague and diagnostic tools are dubious.1 Biochemical analysis helps a little bit in this regard. The abdominal tuberculosis which is not so commonly seen as pulmonary TB can be a source of significant morbidity and mortality and is usually diagnosed as late due to its non specific clinical presentation. About 15 to 25% of cases with abdominal tuberculosis here concomitant pulmonary TB.2 Any part of GIT can be affected but it is usually small bowel and sometimes a colon which is affected barium study has some role in diagnosing the ileal tuberculosis and then is on laparoscopic examination.3 Patients and Methods: This is a cross sectional study conducted at People Medical College Hospital Nawabshah. It was conducted in Surgical Unit 1 from January 2019 to December 2021. All the patients admitted in the ward came through OPD or through emergency. History was taken and proper examination of abdomen apart from systemic examination was done. Routine investigations were done. specific investigations like Liver function test (LFT) and serum electrolytes were done. Radiological investigations like ultrasound and x ray chest abdomen in erect and supine posture were done. Diagnosis was made and surgical intervention was done. Results: Total 30 patients were included in this study. Age of patients was between 20-50 years. 9(30%) patients aged between 20-3- years. 10 (33.3%) were of age between 31-40 years and 11 were aged between 41-50 years. Higher prevalence was in 4th and 5th decade of life. Patients with acute emergency were treated by Exploratory Laparotomy. Per operative findings showed stricture in 14 (47%) patients that were treated with resection and end to end anstomosis. 13 (43%) patients had single as well as multiple perforations of more than 4-5 cm in sizes with contamination of contents in abdominal cavity. Covering ileostomy was made in these patients. 3 (10%) patients’ perforations were of .5 to 1 cm with lesser contamination of abdominal cavity. Primary repair was made in these patients. Conclusion: It is concluded that Higher prevalence was in 4th and 5th decade of life. Its prevalence in female is higher as compared to male. .Majority of the patients with Abdominal Tb were treated by resection and end to end anastomisis. Keywords: Prevalence , Gender, Abdominal Tuberculosis, Resection, Anastomosis.
Posterior First Infundibular Dissection: Another Safe Approach in Laparoscopic Cholecystectomy
Authors: Nadeem Kashif , Tarar Javed Mirdad , rashid Muhammad
Published: September 2022

Objective: To test the efficacy of posterior infundibular dissection during Laparoscopic cholecystectomy Place and duration of the study: Surgical ward of Bakhtawar Amin Trust Teaching Multan for 1 year Study design: A retrospective study Methodology: A total of 150 patients undergoing laparoscopic cholecystectomy were included in the study. Firstly, the bile duct, Calot's node and gallbladder neck were identified along with the lower third of the common duct. An incision was made in the peritoneum anterior to the Calot's node at infundibulum and extended laterally and posteriorly. By retracting the gallbladder cephalad and medially, dissection continued in avascular plane between posterior wall of gall bladder and posterior branch of cystic artery. Anteriorly, a plane is created above the calot’s node and inferior to cystic artery, which was facilitated by posterior dissection of infundibulum. Posterior clipping and division of the cystic artery and duct was done. The rest of the gallbladder was dissected from the liver. Results: 120 patients (80%) had an elective LC status and 30 patients (20%) underwent an emergency LC. 2 patients (1.3%) underwent subtotal cholecystectomy.26 patients (18%) underwent MRCP due to suspicion of stones. Out of these 26 patients, 3 patients (11.5%) underwent ERCP due to the presence of stones.No bile duct injury was recorded. Conclusion: Posterior first infundibular dissection reduces the risk of bile duct injury and ensures safe laparoscopic cholecystectomy. Keywords: Laparoscopic cholecystectomy, infundibular dissection, bile duct injury, cholecystectomy, safe calot’s dissection.
Analysis of the Role of Shear Wave Elastography in Diagnosing Focal Liver Lesions
Authors: Shahid Soban , Javed Sahar , Siddiqi Mustafa Ali
Published: September 2022

Objective: Focal hepatic lesions are the second leading cause of death in men worldwide. However, shear wave elastography (SWE) has proved to help assess liver fibrosis. We aim to demonstrate the role of shear wave elastography in the diagnosis of focal liver lesions. Methods: A prospective study was conducted in the radiology department of CPEIC Multan from April 2021-April 2022. A total of 70 patients with 93 focal lesions were included. Shear wave elastography (SWE) was performed on all the patients, and local lesions and parenchyma stiffness values were calculated. Ten patients were excluded as they failed elastography acquisitions. Contrast-enhanced CT and MRI were performed on the remaining 60 patients. Thirty-two patients underwent liver biopsy. Benign focal lesions were confirmed by analyzing the results of ultrasound biopsy, CT, and MRI. Results: Cholangiocarcinoma was found to have the highest stiffness value (34.2kPa), hence the stiffest malignant lesion. Focal nodular hyperplasia had a stiffness value of 25.4kPa and was the most stiff benign lesion. The average stiffness value between malignant and benign lesions had a significant difference, the value of malignant lesions being significantly high ( p<0.001). Conclusion: Shear wave elastography can efficiently differentiate between malignant and benign hepatic lesions and can individually characterize these lesions accurately. Keywords: Focal liver lesions, malignant, stiffness value, shear wave elastography, benign
Predictors of Ischemic Stroke Among the Patients with end-Stage Renal Disease: A Single Centric Study of Local Population
Authors: Usman Muhammad , Hussain Yasir , Ahmad Sajad , Baig Muhammad Wasif , Munir Talha
Published: September 2022

Objective: The incidence of stroke is greater in patients with end-stage renal disease (ESRD) as compared to the general population. It is thought that there may be a few extra risk factors in ESRD patients suffering from stroke as compared to ESRD patients without stroke. This study aims to better understand the risk factors for stroke that are unique to patients with ESRD. Methods: In order to find out the different causative factors influencing the production of ischemic stroke (IS) in patients with ESRD, we carried out this retrospective study at the DHQ hospital in Faisalabad. In this study total of sixty patients were recruited and further divided into two groups. The first group consisted of 30 patients with ESRD with a history of ischemic stroke, while 30 patients with stroke-free dialysis were selected as the age and gender control group. Patients with and without ischemic stroke were compared in terms of demographic characteristics, stroke risk factors, and lab results. Results: Patients with acute ischemic stroke had an average age of 56.70 ± 8.87 years with 52% male whereas the non-ischemic stroke group had an average age of 58.9 ± 9.20 years. Small vascular obstruction was found to be the most common subtype of IS (42%), followed by atherosclerosis of large vessels (28%). Compared with patients who did not have a stroke, patients who had a stroke had significantly higher rates of hypertension (HTN), higher systolic (SBP) and diastolic blood pressure (DBP) at admission. The group with a stroke had significantly lower total cholesterol and LDL cholesterol. Lower levels of low-density lipoprotein (LDL) and higher systolic blood pressure were found to be the independent risk factor for an ischemic stroke in a multivariate analysis (OR=1.025, 95% CI p=0.045 and OR=1.458, 95% CI, P=0.03 respectively). Conclusion: According to the findings of our study, ESRD patients with hypertension and diabetes have a higher chance of ischemic stroke and the lower LDL levels and higher systolic blood pressure were the independent predictors of ischemic stroke. Keywords: Hemodialysis, Ischemic stroke, risk factors, Hypertension, end stage renal disease,
Frequency of Hyponatremia in Patients with Ischemic Stroke Presenting in Neurology Department Chandika Medical College Larkana
Authors: Shaikh Nagina , Majeed Sameena , Shah Shahnaz , Ali Muhammad Munwar , . Jaysingh , Ali Aijaz
Published: September 2022

Introduction: The World Health Organization describes a stroke as having "rapidly emerging clinical symptoms of localized or generalized impairment of brain function without obvious non-vascular cause1. Hyponatremia is more likely to impede stroke survivors' ability to recover from the condition. Our research evaluated the incidence of hyponatremia in ischemic stroke. Therefore, the precise size of the issue would be evaluated. Objective: To determine the frequency of hyponatremia in patients with ischemic stroke. Material and Methods: The design of this study was a descriptive cross-sectional study. All in patients and out patients coming in Neurology department of Chandka Medical College Hospital Larkana, and the duration of this study was Six months, from 13 October 2020 to 12 April 2021. A total of 107 stroke patients were included in this study. The purpose, risk and benefits of the study were explained to the patient on a prescribed Proforma, Results: A total of 107 Ischemic stroke patients were included in this study. Most of the patients were above 40 years of age. The average age of the patients was 68 years. Out of 107 patients, 70(65%) were male and 37(35%) were female. Frequency of Hyponatremia in patients with ischemic stroke was observed in 24% cases. Rate of developing Hyponatremia was significantly high in age group of 60 to 80 years. Similarly Hyponatremia was significantly high in hypertensives as compared to non-hypertensive Patients (32% vs. 13% p=0.03) . There was no gender predilection seen, Diabetes increased the risk of developing hyponatremia about two folds. (38% versus 20%). Increased BMI, Obesity increased the risk of developing hyponatremia in the setting of ischemic stroke two folds. (36% vs 18%) Conclusion: The prevalence and frequency of post-stroke hyponatremia was found to be considerable. This is especially concerning because hyponatremia has a worse effect than stroke itself on prognosis and death. Keywords: Hyponatremia, Stroke, Ischemic, Hyponatremia, Cerebral Salt Wasting Syndrome, Syndrome of Inappropriate Antidiuretic Hormone Secretion.
The Effect of Fatigue on Soccer Players’ Coordination Abilities
Authors: Abubshara Jamal
Published: September 2022

Background: Coaches must translate what has occurred in the match into training activities which are linked to these guidelines. This must be done in such a way that they can be executed again in the matches, most coaches do not reach the final step, they do not reach further than creating general training exercises, which hardly have any relation to problems that occurred in the match, fatigue is one of the main problems which effect on performance skills and other variables, nonetheless, co-ordination abilities during matches and high intensity exercise are still controversial. Aim: The aim of this study was to examine the effect of acutely induced fatigue on soccer players ‘coordination skills Methods: The researcher used quasi-experimental method and conducted the study on a purposive sample (S) of (11) eleven experienced elite male soccer players performed three co-ordination abilities tests (dribbling 30 seconds, weight passing correctly to specified distance 15,25,35 m, and short dribbling test) prior to and after the implementation of an intensive and intermittent exercise protocol. In order to process the data T-test was used, the results revealed significant difference between pre-test and post-test values of co-ordination abilities test scores (p<0.01). Heart rate before the shooting test was HR (89.28 ±4.03) bmp, and heart rate after fatigue was measured at (174.39±12.24) bmp. Results: The results confirmed the study hypothesis regarding the negative influence of fatigue on co-ordination abilities (rhythm, differentiation, orientation). Conclusion: It is concluded that coaches should train the players under exertion condition to decrease the effects of fatigue on co-ordination abilities level. Keywords: co-ordination abilities , orientation, Differentiation, Rhythm, fatigue protocol
Challenges of Evidence-Based Practice and Nursing Education in Sub Saharan Africa: An Integrative Review
Authors: Abdullahi Kabir Ozigi , Ghiyasvandian Shahrzad , Hasanpour Marzieh , Nayeri Nahid Dehghan
Published: September 2022

Introduction: This paper was conducted to explore the challenges of evidence-based practice and nursing education in sub-Saharan Africa. Methods: An integrative review study was conducted with a search of PubMed, Web of Science, Scopus and Science Direct, the record so collected were identified, screened and reviewed. Results: The search conducted produced a total of 1,296 records: 1,106 from PubMed; 90 from Web of Science; 54-Scopus and 46- Science direct. Seven themes emerged thus: Resources and infrastructure; Inadequate facilities and capacity building; Funding problem; Collaboration and teamwork; Curriculum reform; professional regulation; and nursing culture. Conclusions: It is evidently apparent that in order to ensure improved quality and quantity of production, and the adoption of EBP in the care, developmental partners and government have to increase the allocation of fund for infrastructural development, teaching and learning materials as well as hospital facilities to create an enabling environment for the smooth running of the evidenced practice in Nursing. Keywords: Evidence-based Practice; Challenges; Nursing education; African, Sub Saharan
Prevalence of Antibiotic Resistant Bacteria among the Clinical Samples from Different Hospitals of Peshawar, Pakistan
Authors: Khan Muhammad Uzair , Khan Abid Ali , Ahmad Shahzad , Kousar Khalida , Ahmed Salman , Khan Zahid Ullah , Atlas Amir
Published: September 2022

Background: Majority of the microorganisms are responsible for causing diseases which can be fatal if left untreated. In Pakistan this might be very critical because of the misuse and/or improper use of antibiotics. Objective: The current study was designed to point out the challenges of antibiotic resistance in Peshawar Pakistan. Methods: A total of 100 samples, 25 each from blood, pus, skin, urine were collected from four different hospitals of Peshawar, Pakistan. The samples were grown on culture media after collection. Results: Out 100 samples, 46 samples showed growth on culture medium. Four main isolates namely Staphylococcus aureus, Escherichia coli, Klebsiella pneumonia, and Pseudomonas aeruginosa. S. aureus and E. coli were found in all tested samples blood, pus, skin, urine. P. aeruginosa was found in pus and K. pneumonia in urine only. The identified strains were subjected to sensitivity testing against 7 different antibiotics i.e., ampicillin, piperacillin tazobactam, doxycycline, aztreonam, ciprofloxacin, levofloxacin and teicoplanin. Conclusion: All of the bacterial species were found resistant against the applied antibiotics except aztreonam. Keywords: Prevalence, antibiotics sensitivity, S. aureus, E. coli, K. pneumonia, P. aeruginosa
Efficiency of Arthrocentesis with Hyaluronic Acid in TMJ Disc Derangement
Authors: Zahid Hurraia , Rauf Nouman , Siddiqi Ameer Muhammad Farooq , Farooq Fariha , Imdad Rabiya , Chaudhry Arham , Khan Zahid Sarfaraz
Published: September 2022

Objective: The objective of this research was to determine if arthrocentesis for Temporomandibular Joint (TMJ) issues, with or without hyaluronic acid, is an effective treatment. Study Design: A Prospective study Place and Duration: This study was carried out at the Sardar Begum Dental College from January 2022 to June, 2022. Methods: This research included 40 individuals of both sexes with TMJ disc problems. After informed written consent, patients' age, sex, side, and effusion type were examined. Evenly separate patients into two groups. Group I got arthrocentesis in 20 cases and group II got hyaluronic acid in 20 cases. Standard two-needle arthrocentesis was used. Maximum mouth opening, pain reduction, and complications were compared between both groups. Data was analyzed using SPSS 18.0. Results: Pre-treatment, MMO in group I was 29.7±11.37 mm while in group II maximum mouth opening was 30.4±11.61 mm. Post treatment, we found that in group I MMO was 43.9±7.43 mm and in group II 45.6±23.62 mm but did not found any significantly difference after 1.5 years of follow up 40.6±16.28 in group I and 42.7±4.17 mm in group II. Using VAS, pain scores were reduced 1.3±6.87in group I and 0.5±2.3 in group II, with p value 0.001 after treatment. Conclusion: In this research, we found that arthrocentesis was a successful and safe approach for treating disc derangement in the temporomandibular joint (as measured by an increase in MMO and a decrease in pain score), with arthrocentesis utilizing hyaluronic acid showing marginally improved outcomes. Keywords: Arthrocentesis, Pain score, Temporomandibular Joint disc, MMO
Analyze the Efficacy of the AST to Platelet Ratio (APRI) and the Fibronectin Fibrinolysis-4 (FIB-4) using Transient Elastography (FIB-SCAN) in Patients with Chronic Hepatitis C
Authors: Ullah Rehmat , Raja Kapeel , Hussain Sohail , Huma Zille- , Mukhtar Farhana , Rehman Khalil Ur
Published: September 2022

Objective: The purpose of this study was to compare the effectiveness of AST to platelet index (APRI) and FIB-4 with transient elastography, also known as fibro scan, in patients who suffered from chronic Hepatitis C. Study Design: Retro-prospective/ Cross-sectional Place & Duration: Khalifa Gulnawaz Teaching Hospital Bannu Pakistan, From August, 2021 to May, 2022. Material and Methods: This research included 360 men and women. After obtaining written consent, detailed demographics of all cases were recorded. In 360 HCV infected individuals, the diagnosis comprised CBC, LFTs, ELISA, PCR, and fibro. We compared AST, apric, FIB-4, and fibro scans for detecting HCV fibrosis progression. SPSS 22.0 was used to analyze all data. Results: There were majority males 220 (61.1%) and 140 (38.9%) females. 85 (23.6%) had age 20-30 years 180 (50%) cases had age 31-40 years and 95 (26.4%) patients had age >40 years. We found that 210 (58.3%) patients had fibrosis stage F0-F1, F2 stage was in 28 (7.8%) cases, F3 stage was in 52 (14.4%) patients and F4 stage in 70 (19.4%) cases. Among 360cases, genotype 3a was found in 260 (72.2%) patients, genotype 1b in 70 (20.8%) cases and genotyped 1a in 30 (8.3%) cases. Conclusion: In this study, we found that the AST to Platelet Index (APRI) and FIB 4 were able to successfully identify among cirrhotic and non-cirrhotic phases among HCV-infected patients. Keywords: Liver, Hepatitis C, Fibrosis
Prediction of Complications and Death in Covid-19 Patients with Deranged Liver Function Tests at Time of Admission and Hospitalization
Authors: Kamran Muhammad , Ahmad Mahtab , Farhin Shehla , Khan Sadia Yasir , Zafar Saba , Siddique Tehmina , Asghar Samra , Khalil Sadia , Shabbir Amber , Ullah Irfan
Published: September 2022

COVID-19 pandemic has affected millions of individuals globally over the last three years and is spreading continuously. In view of different studies and clinical findings, patients suffering with COVID-19 frequently have deranged liver function tests (LFTs), but the clinical significance of this finding is debatable. Objective: The present study was aimed to estimate the prevalence, features, and clinical significance of deranged LFTs in COVID-19 infected individuals, who were hospitalized but were not critically ill. Method: We conducted a cross sectional from May 2021 to December 2021 at The Akbar Niazi Teaching Hospital Islamabd. A total of 250 COVID-19 patients were included in the current study. The patient's blood samples were collected to get laboratory results, which included LFTs. LFTs were performed at the time of admission and every 5 ± 2 day throughout the stay. The outcome measure was either death or transfer of the patients to an intensive care unit. Results: At the time of admission, 160 patients (64%) showed deranged LFTs. Individuals with deranged LFTs experienced more severe inflammation, swelling, and organ damage than those who didn’t. Patients with deranged LFTs had a greater proportion of transfer to the ICU (81 vs 17), hospital stay (17 vs 7 days), and death (17 vs 5) than those with normal LFTs. Conclusion: The results of the current investigation demonstrated that LFTs data might forecast the degree of illness in patients with COVID-19 infections at the time of admission and during their hospital stay. Keywords: Covid-19, Liver Function Tests, ICU, Mortality Rate, Pakistan
The Role of Fibroblast Growth Factor 21 as an Endocrine Regulator of Lipid Metabolism: From Progression to Pathophysiology and Physiology
Authors: Naz Raisa , Khurshid Aina , Shuaib Ambar , Khan Malik Shandar , Shoaib Muhammad , Aslam Aqsa , Llah Inam-U- , Bangash Sudhair Abbas , Ullah Irfan
Published: September 2022

Objective: The primary aim of this research was to study the molecular history of fibroblast growth factor 21 (FGF21) as well as its physiological and pathological functions. Study Design: Observational study Place and Duration: This study was carried out at Hayatabad Medical Complex from December 2021 to April 2022 Methods: There were 77 patients of non-alcoholic fatty disease had age 20-65 years were presented in this study. After obtaining informed written consent details demographics were recorded. Diseases of all the patients were recorded and their relation with the FGF21 levels was observed. SPSS 23.0 was used to analyze all data. Mean standard deviation was use for categorical variables. Results: There were 42 (54.5%) males and 35 (45.5%) females among all cases. Mean age of the patients was 40.11±8.74 years and had mean BMI 27.8±11.34 kg/m2. Majority of the patients 31 (40.3%) had diabetes mellitus, 24 (31.2%) cases had renal failure, 20 (25.97%) cases had cardiovascular disease, mitochondrial disease in 17 (22.1%) cases, energy metabolism disorder in 15 (19.5%), lipid metabolism disorder in 13 (16.9%) and frequency of stroke was 9 (11.7%). We found significantly increased volume of FGF21 among diabetic obese cases which were resistant to insulin with p value <0.005. Conclusion: Pathophysiological functions, potential risk factors, and diagnostic biomarkers for endocrine FGFs in adult metabolic and genetic diseases are all supported by the available evidence. Pharmaceutical research is being conducted on endocrine FGFs. These results provide insight on the pathological and physiological functions of endocrine FGFs and offer new insights into the diagnosis and treatment of metabolic disorders. Keywords: FGF21, Lipid Metabolism, Pathaphysiology, Outcomes
Frequency and Outcomes of Hepatorenal Syndrome in Patients with Chronic Liver Disease
Authors: Khan Sarwar , Raja Kapeel , Malik Muzzamil Riaz , Hussain Sohail , Rehman Khalil Ur , Tahir Hira
Published: September 2022

Objective: To determine the frequency of hepatorenal syndrome in patients presented with chronic liver disease, also examine one month mortality in patients diagnosed with hepatorenal syndrome. Study Design: Prospective/Observation Study Place and Duration: Medical Ward, THQ Hospital Dargai Malakand and Ziauddin University Karachi, From November, 2021 to April, 2022. Methodology: One hundred and five patients of either gender presented with chronic liver disease having ages 18 to 65 years were enrolled. Detailed demographics including age, sex, BMI, duration of disease and etiology of liver cirrhosis were recorded after taking informed written consent. Patients with hepatic encephalopathy being treated with nephrotoxic drugs, acute infection, hypovolemia, sepsis, and fulminant and sub-fulminant hepatic failure were excluded. Serum creatinine was analyzed in all the patients to examine renal failure. Outcomes in term of one month mortality was also examined in HRS patients. Data was analyzed by SPSS 24.0. Results: There were 63 (60%) males while 42 (40%) patients were females with mean age 47.18±11.64 years. Mean BMI was 24.66±3.84 kg/m2. Among 105 patients 15 (14.29%) patients were diagnosed to have hepatorenal syndrome. Out of 15 HRS patients, 4 (26.67%) were died. Conclusion: It is concluded that frequency of hepatorenal syndrome in liver cirrhosis patients was high. And HRS was associated with high rate of mortality. Keywords: Chronic Liver Disease, HBV, HCV, Hepatorenal Syndrome, Mortality
Effectiveness of Obturator Nerve Mobilization for Knee Joint Pain in Young Females
Authors: Maqbool Ayesha , Zafar Marium , Tahir Ramesha , Tariq Komal , Aine Qurat-Ul- , Mehak Amina
Published: September 2022

Background: Medial knee pain is reported due to adductor tightness in young females. Nerve supply of adductors of thigh is obturator nerve. Compression of obturator nerve is one of the reasons to generate medial knee pain. Objectives: To evaluate the effect of obturator nerve mobilization for treating medial knee joint pain in young females. Material and Methodology: A quantitative, randomized clinical trial was conducted comprising of sample of 30 patients. Patients were allocated into control group and treatment group randomly by using lottery method. Hot pack and adductor release was given as baseline treatment in both groups. Treatment group received obturator nerve release in addition. Visual analogue scale, Q angle and lower extremity functional scale was used as outcome measures. Results: Data was analyzed by SPSS V.20. Independent sample t-test was used for inter-group analysis, paired sample t-test and repeated measurement ANOVA test was used for intra-group analysis. Significant decrease in medial knee joint pain, Q-angle and lower extremity functional score was reported in treatment group with p value <0.05. Association of BMI with pain and Q angle was found non-significant with p value >0.05. Conclusion: Obturator nerve neurodyanamics showed significant improvement in treating medial knee joint pain in young females. No association was found of BMI with pain and Q angle. Keywords: Young adult, female, Obturator nerve, Nerve compression syndromes, Neurodynamics
Role of Transamin in Reduction of Seroma in Post-Operative Mastectomy
Authors: Farooq Omer , Muhammad Hafiz Ali , Rasool Arshia , Sibghatullah Qazi Muhammad , Hameed Aleena , Asif Khaula
Published: September 2022

Objective:The purpose of this study to determine the effectiveness of transamin in reduction of seroma in post-operative mastectomy. Study Design:Retrospective study Place and Duration: District Headquarter Hospital Attock and Medicare Hospital, Attock. September 2021-July 2022. Methods: There were 40 females had breast cancer with age 20-65 years were included. Patients were underwent for mastectomy and admitted to hospital. After obtaining informed written consent detailed demographics of enrolled cases included age, body mass index and socio-economic status was recorded. After surgery patients received injection of tranexamic acid. Outcomes among all patients were assessed in terms of reduction in seroma formation, wound infection, amount of drainage and time of drainage. SPSS 22.0 was used to analyze all data. Results: We found that 7 (20%) patients had age 21-30 years, 12 (30%) cases had age 31-40 years, 17 (42.5%) cases had age 41-50 years and 4 (10%) cases had age 51-65 years. 26 (65%) patients had BMI >25kg/m2 and 14 (35%) had BMI <25kg/m2. There were 22 (55%) patients had poor socio-economic status. Mean amount of drainage was 812.7±99.24 ml and mean time of drainage was 7.5±12.40 days. Frequency of seroma formation was found in 5 (12.5%) cases in which mostly had BMI >25kg/m2 and had increased age. Wound infection found in 3 (7.5%) cases. Conclusion:We concluded in this study use of tranexamic acid among patients undergoing mastectomy was affective and useful in terms of reduction in seroma formation and lower number of wound infection. Except this duration and volume of drainage was also seen lower in our study. Keywords: Breast Cancer, Mastectomy, Seroma, Tranexamic Acid, Complications
Comparsion Between the Efficacy of Metformin Plus Clomiphene and Clomiphene Alone in the Treatment of Primary Infertility Due to Polycystic Ovarian Syndrome in Obese Women
Authors: Sadiq Farkhanda , Ghafoor Saira , Sara Bibi
Published: September 2022

Background: Infertility is defined as the inability to conceive after one to two years of unprotected intercourse. It is of two types primary infertility and secondary infertility Polycystic ovary syndrome (PCOS) is one of the most common endocrinopathies affecting 5%–10% of reproductive age women. To compare the efficacy of metformin plus clomiphene and clomiphene alone in the treatment of primary infertility due to polycystic ovary syndrome in obese women Materials And Methods: It was Randomized Controlled Trial, which was conducted in the department of Obstetrics and Gynaecology, Hospital, Peshawar, between 30th May 2019 to 8th January 2022) Sample size will be 380 in each group using P 1 = 15%, P 2 = 22% and power of 80% and 95% confidence interval under WHO Software for sample size determination. Results: A total of 380 patients in each group were observed. Average age of the patients was 26.60 years+ 3.99SD with range of 19-35 years. Group A showed 88(23.2%) efficacies. Similarly Group B showed 68 (17.9%) efficacies. Efficacy was significant in both the groups with p-value=0.044. Conclusion: Metformin plus clomiphene is more efficacious than clomiphene alone in the treatment of primary infertility due to polycystic ovary syndrome in obese women. Keywords: Efficacy, metformin, clomiphene, polycystic ovary syndrome, primary infertility
Assessment of Vitamin D Level in Psoriasis and Psoriatic Arthritis Patients
Authors: Rahman Obaid Ur , Khan Aurangzaib , Khattak Munaza , Orakzai Shabir Ahmed , Naveed Tehseen , Farooq Mohammad
Published: September 2022

Objective: Investigating the relationship between vitamin D status and psoriasis and psoriatic arthritis is the goal of this investigation. Methods: 120 individuals with psoriasis & 38 patients with psoriatic arthritis (PsA) participated in a case-control research; 89 (56.3%) of the patients were men. Every patient with psoriasis had their erythrocyte sedimentation rate (ESR) and disease activity score utilizing 28 joints (DAS28) computed, and every person with PsA had their disease area and severity index (PASI) assessed. 164 volunteers, matched for age and sex (91 men and 73 women), made up the control group. Serum vitamin D levels were measured in both patients and controls. Results: Both patients' and controls' vitamin D levels were 17.4and 28.3 respectively. When compared to patients with disease durations of 10 years or less, the level of vitamin D was lower in patients with disease durations equal to or greater than that. The two patient groupings' vitamin D levels do not significantly differ from one another. Psoriasis and PsA have been associated with elevated PASI and DAS28 levels due to low vitamin D levels. Conclusion: Low blood Vitamin D levels are connected with patients who have psoriasis and PsA. In both PsA and psoriasis, vitamin D insufficiency has been linked to the persistence of the illness. Keywords: vitamin, psoriasis, diseases severity index, psoriatic arthritis
Transaxillary Approach for Thoracic Outlet Syndrome Case Report
Authors: Umar Farasat , Khan Bilal Hassan , Naseer Muhammad Zain , Hussain Haseeb
Published: September 2022

The brachial plexus and subclavian arteries are compressed when the thoracic outlet is expelled, resulting in the clinical disease known as Thoracic Outlet Syndrome (TOS). These disorders have various etiological causes, including cervical rib, and can damage the nervous system or blood vessels. The cervical rib, which develops from the seventh cervical vertebra and is thought to be abnormal, extra, or congenitally overdeveloped, is the main factor contributing to thoracic outlet syndrome (TOS). The transaxillary method developed by Roos, which is conservative and offers great exposure to the neurovascular structures with good aesthetic outcomes, is one of several surgical procedures employed for treating TOS. We present a case of a 43-year-old man with a cervical rib who complained of progressive pain and paresthesias in his left upper limb and presented to us in Ghurki Trust and Teaching Hospital Lahore . We removed the cervical rib and stented the Subclavian to the Brachial artery using a transaxillary approach. Keywords: Cervical Ribs, Transaxillary approach, Thoracic outlet syndrome