bluuebunny/crossref_metadata_2025 huggingface dataset:
SUPRACONDYLAR FRACTURES
Authors: TARIQ MUKHTAR AHMAD , ShAFI MUHAMMAD , ALI ASGHAR
Published: September 2021

Objective:- To determine the surgical approach most suited in our setup and evaluate the results based on the functional and cosmetic outcome especially in the range of motion,the subsequent defromity, if any, and the carrying angle. Setting Orthopaedic surgery, Nishtar Hospital, Multan. Duration Two years, Study design Quasi experimental type of study. Material & Methods Thirty patients. Sampling technique Non-probability technique. Results The age of the patients included in our study ranged from 4-10 years with a mean age of 5.93 years in group A and 6.66 years in group B. Out of 30 patients in group-A and 11 (73.3%) males and 4(26.6%) in group B had fracture on right side where as 12(80%) in group-A and 11(73.3%) in group-B got injured due to fall from height. One (6.66%) patients from group-A and B had superficial wound infection. Pin tract infection was found in 1(6.66%) in group A and 2(13.33%) patients in group-B. Conclusion: This technique was easy to perform and proved to be safe, although hospitalization time was minimum in both groups. So we recommend medial approach for open reduction and internal fixation of all displaced supra-condylar fractures of humerus in children with appropriate indications.
THERAPEUTIC ABORTIONS
Authors: ALTAF FARIHA , IQBAL NAILA , (R) NADRA SULTANA
Published: September 2021

Objectives: The study was conducted to compare intravaginal misoprostolwith extra amniotic prostaglandin F2 alpha (PGF2") for labour induction in therapeutic abortions from 10-28 weeksgestation. Design: A prospective study experimental. Setting At Military Hospital, Rawalpindi. Period: FromMarch–December 2002. Materials & Methods: 68 patients with indications for therapeutic termination. Groups wereassigned through non-probability convenient sampling procedure. In one group 200:g of misoprostol in the form ofTab Arthrotec 50 was administered every two hours up to three doses. Other group of patients had received extraamnioticPGF2" solution. Main outcome measures were induction-abortion interval, cost-effectiveness and thefrequency of side effects. Induction was considered successful where abortion was achieved within 24 hours. Results:The average induction-abortion interval in the misoprostol group was 16.09±9.38hours.Successful abortions wereachieved in 79.41 percent(27/34).Total failures were seven of 34 cases. In the PGF2" group, all women aborted within20.24±11.57 hours, 76.47 percent (26/34) of which aborted within 24 hours. Conclusion: The acceptable expulsiontime, clinically insignificant side effects and the abortion rate obtained, showed that misoprostol by vaginaladministration may be an alternative method for interrupting gestation of 10-28 weeks.
OBSTETRICS AND PERINATAL OUTCOME
Authors: AWAN SHABNAM NASEER , ASHRAF NADEEM , NAYYAR SHAZIA
Published: September 2021

Objectives: To identify and assess the risk factor for transmission of HBV and HCV in pregnantladies and perinatal outcome, presenting to obstetric OPD at CMH Lahore. Design: Case control study. Setting:Combined Military Hospital Lahore. Period: From May 2003 to April 2004. Patients and Methods: All the patientspresenting to obstetrical OPD during one year were randomly screened for both hepatitis B and C using ELISA.Perinatal outcome was compared with control group. The risk factors for HBV and HCV were studied in 30 patients,who were positive for either HBV or HCV. A detailed history was taken followed by a questionnaire and screening forHBV and HCV. The results were compared with control group who were negative for hepatitis B and C but had samesocioeconomic back ground and similar living conditions (wives and soldiers). Results: In the study group 20 patientsgave history of surgical operation or dental procedure. These surgical operations included major or minor operations.In control group positive history of surgical or dental procedure was obtained in 12 patients. The odds ratio was foundto be 3.00 with a P value of 0.038. History of blood transfusion was found in 12 patients in study group and 4 patientsin control group with 0.019. Positive history of jaundice was found in 3 patients of study group and 1 patient in controlgroup with p value of P>0.05. History of drug abuse or multiple sexual partners was negative in both groups.Conclusion: The study concludes that HCV infection is three times more common than HBV infection. Surgicalprocedures are the leading risk factors for acquisition of these infections.
RESISTANT OEDEMA IN NEPHROTICS
Authors: ZAFAR FAUZIA , AZAM MUHAMMAD , KHAN PERVEZ AKBAR
Published: September 2021

Introduction: Hypoalbuminemic nephrotics often have sufficient fluid accumulation to mandatediuretic therapy but are often resistant to diuresis. Furosemide is one of the most effective and least toxic diuretics usedin pediatric practice. In children with different diseases who received orally or intravenously 1 to 2 mg/kg doses offurosemide. In a country like Pakistan, such a treatment is not always afforded, albumin being quite costly. Objective:To compare the efficacy of albumin furosemide combination infusion to the infusion of furosemide alone in patients ofnephrotic syndrome with resistance oedema. Study design: Two way crossover study. Setting: Paediatric Medicine,Nishtar Medical College, Multan. Duration: From January 2004 to June 2005. Patients and Methods:10 children.Results: There was marked improvement in the symptoms like respiratory distress and oedema in both the groups.Urine output was markedly increased without any significant changes in the BUN, serum creatinine, serum electrolytesand serum calcium. These values were slightly higher in group-I but not statistically significant. No adverse effects likedrowziness confusion, hypotension and seizures were observed in any group. Conclusion: During the clinicalmanagement of resistant oedema in nephrotics, furosemide infusion alone is as efficacious in reducing the oedemaas albumin furosemide mixtures without any adverse effects and is much more economical.
RECURRENT ABDOMINAL PAIN
Authors: NADEEM MUHAMMAD TARIQ , ABBAS MAZHAR , HASSAN TAQI , Masood Shahid
Published: September 2021

Objective: To assess the association between the Helicobacter Pylori (H.pylori) infection andrecurrent abdominal pain (RAP) by documenting the frequency of Helicobacter pylori infection in children aged 5 to 15years in our setup. Design: A comparative study. Place and Duration of Study: The study was conducted in pediatricunit Military Hospital Rawalpindi over one year period from 1st Apr 200 to 31st Mar 2002. Subject and Methods: Wedivided the patients into two groups; group A or the study group and the group B or the control group. In group A, atotal of 87 Children aged 5 to 15 years presenting with RAP in which no underlying cause was found on initialassessment underwent upper gastrointestinal tract (GIT) endoscopic examination. In group B (control) we included 68children in whom upper GIT endoscopy was done for any reason other than the RAP. In both the groups thegastroduodenal biopsy samples were sent for culture and histological examination for the diagnosis of H. pyloriinfection. The signs and symptoms of these patients were analyzed in detail. Results: In group A, out of 87 patientswho were endoscoped there were 44 female and 43 male. 54(62%) were found positive and 33(38%) were foundnegative for H.pylori on histopathology and culture examination of biopsy samples. In the control group (B) thefrequency of H.pylori infection was 35% (24 of 68) which was significantly lower than the study group (p-value .001).The frequency of H.pylori increased significantly with advancement in age (p-value .003) and lowering of thesocioeconomic status (p-value.002). The commonest endoscopic finding was antral gastritis (31 of 87; 35.6%). Antralnodularity was observed in 8(26%) out of 36 cases of antral gastritis and in 23(74%) cases there was antral erythemawithout nodularity. The remaining endoscopic findings were pan-gastritis (14 of 87;16%), duodenal ulcer (10 of87;11.5%), duodenitis (4 of 87;4.6%) and gastric ulcer (2 of 87;2.3%). The less frequent findings were gastric andduodenal erosions and esophagitis (about 1% each).Their was no abnormal finding in 22(25.3%) cases. Childrenpredominantly (52%) had the symptoms characteristics of ulcer-like dyspepsia. Recurrent epigastric pain wassignificantly more common in the H.pylori positive than the H. pylori negative children (44 of 87 vs 16 of 33 [p-value.001]). There was no difference for other symptom characteristics when comparing infected with non-infected children.Conclusion: The frequency of H.pylori infection is high in children with recurrent abdominal pain and there is a high degree of association between recurrent abdominal pain, endoscopic findings (chronic gastritis, duodenitis, gastric andduodenal ulcer) and the H. pylori infection.
FAMILY PLANNING SERVICES
Authors: USMANI RABIA ARSHED , MANZOOR SHAHEENA
Published: September 2021

Objective: To identify the role of some socio-economic factors on the utilization of Family Planningservices. Design: Cross-sectional, descriptive study. Place & Duration of Study: A defined urban community ofDistrict Lahore, - from February 2004 to May 2004. Materials & Methods: 375 reproductive age married womenresiding with their husband were interviewed with the help of a semi structured data collection instrument. Results:The study showed that contraceptive use was 45.6% amongst the illiterates; it rose to 61.3% for the respondents witheducation up to matric and 71.3% in those with education above matric. It was 43.2% in respondents belonging tofamilies with income less than Rs.3000; and 68.6% with income level of Rs.6000+. It was also found that contraceptiveuse amongst working women was 82.8%, whereas 54.3% housewives were using contraception. Conclusion: Thestudy was able to establish positive influence of some important socio-economic factors on the utilization of familyplanning services.
URETHROPLASTY
Authors: AKMAL MUHAMMAD , SIAL SAFDAR HASSAN JAVED , WASEER MUHAMMAD HUSSAIN
Published: September 2021

Objectives: To assess the results of Tubularized incised plate urethroplastyfor hypopadias repair and to find out the causes of failure. Design: Prospective randomized study. Place & Durationof Study: Department of urology, Allied Hospital Faisalabad. From May 2001 to April 2003. Patients & Methods: 20consecutive patients of Hypospadias were included in this study. All cases were managed by Tabularized incised platUrethroplasty (TIPU). Results: 12 cases presented with distal Hypospadias. 08 patients came with proximalHypospadias. Common age at presentation was below 5 years. Orthoplasty was done by Nasbit technique in 04patients. Overall success of tabularized incised plate urethroplasty for distal Hypospadias repair was seen in10(83.60%) cases. 01(8.30%) patients developed fistula and 01(8.30%) patient presented with total disruption. Meatalstenosis was observed in 01(8.30%) patient which responded well to regular dilatation. Overall success of TIPU forproximal Hypospadias repair was seen in 05(62.50%) patients. Fistula occurred in 02(25%) patients and total disruptionin 01(12.5%) patient. 01(12.5%) patient developed meatal stenosis which was managed by regular dilatation.Conclusion: TIPU can be applied as a valid option to treat all types of Hypospadias. Most of the complications canbe minimized by proper technique, prevention of hematoma formation and infection.
LACTATING WOMEN
Authors: NAQVI SYED HASNAIN MOHAMMAD
Published: September 2021

Objectives: To determine the serum & milk progesterone level in lactational amenorrhea and tocompare this with the menstruating women (both the lactating & non-lactating). Setting: This study was carried outamong the relatives, friends’ families and some volunteers. As such, subjects do not usually visit Hospital. Period:one year. Method: The study was conducted on 35 women , 25 lactating & 10 non-lactating (control) , none of themwere taking hormonal contraceptive. Progesterone estimation was carried out in milk & serum of lactating and in theserum of non-lactating. Results: Significantly low level of serum & milk progesterone was found in nonmenstruatinglactating . Conclusion: During lactational amenorrhea , serum & milk progesterone level remains low.
LAGENDORFF'S HEART PREPARATION
Authors: ISLAM FAREEDA , SHAMIM SYED MUHAMMAD , AHSUN M. IQBAL
Published: September 2021

Doxourbicin (Dox) is an effective anticancer chemotherapeutic agent, for the treatment of several different human cancers, causes an insidious and delayed cardiotoxicity. Its use is limited, as cardiac toxicity occurs above a cumulative dose 450 mgrrr2 and incidence of this toxicity increases markedly at dose2 greater than 550 mgrrr2. Pre-clinical investigations are attempting to elucidate the doxorubicin induced cardiotoxcity drugs are used to scavenge the toxicity or to determine the possible mechanisms of this cardiac toxicity. Role of autonomic nervous system in this regard has extensively been investigated. We have tried to find the physiological interactions of DOX with muscarinic receptors in presence of Atropine (Antagonist) and evaluated the effects for up and down regulation of muscarinic receptors. The results showed synergistic activity of DOX with atropine and hence DOX is said to be a muscarinic, antagonist.
INDUCTION OF LABOUR
Authors: HAFEEZ MAIMOONA , TALIB WASEEM , SIDDIQUE SAADIA
Published: September 2021

Objectives: For selecting the topic was to compare the efficacy of different methods of induction of labour. Design: Prospective observational study. Setting: Department of Obstetrics and Gynaecology Unit 11, Ghurki Trust Teaching Hospital Lahore. Period: One year, From 1st Jan 2004 to 31st Dec 2004. Subjects and methods. This study included pregnant ladies, irrespective of parity who were selected for induction of labour for different indications, after 28 weeks of gestation. Patients having abnormal presentation such as breech and patients with suspected cephalopelvicdisproportion were not included. Induction method was selected according to parity, indication for induction and Bishop scoring. Results. Total no of patients admitted in the said ward during the study period was 3500, 205 were induced with different methods. This gives prevalence of induction of labour in the study group as 5.86%. Age of the patients ranged from 17-45 years/with parity varying from 0-8. Five patients with previous caesarean section were also induced. Conclusion. The most common indication for induction of labour was pregnancy induced hypertension. Success rate of method used depends on Bishop scoring, PGE2 helps in cervical ripening and gives good results in patients with poor Bishop score.
STAGE III A & B NON-SMALL CELL LUNG CANCER
Authors: YAR SHAHAR , SHAH IJAZ HUSSAIN , JAVED ABRAR AHMED , Jamil Abid , Shahid Abubaker , Hafeez Muhammad , Perveen Shaheena , Masood Ahmed Ijaz , Shabbir Khalid , Rasool Shahid
Published: September 2021

Stage IIIA Non- Small Cell Lung Cancer (NSCLC) is characterized by the presence of ipsilateral mediastinal and / or sub carinal nodal involvement (N2) associated with a T1 or T2 primary lesion or a T3 lesion associated either with positive hilar nodes (N1) or with N2 nodal disease. Stage IIIB disease is characterized by scalene, supra-clavicular, contra lateral mediastinal, or contralateral hilar lymph node involvement (N3) associated with any T category or a T4 primary tumor associated with any N category1. Patients with stage IIIA disease can be stratified into those with bulky and nonbulky disease, based upon the presence of lymph nodes >2 cm in short-axis diameter, or groupings of multiple smaller lymph nodes 2. Patients with bulky stage IIIA or those with stage IIIB disease are generally considered inoperable.
ECTOPIC PREGNANCY
Authors: QURESHI SAIMA , ROOHI MAHNAAZ , TAHIRA TASNIM
Published: September 2021

Objective: 1-To know the common presentation of ectopic pregnancy attended during the study period. 2- To find out that how clinical presentation helps in early diagnosis of ectopic pregnancy. Settings: Department of Obstetrics & Gynecology Unit # 1 Allied Hospital Faisalabad. Period: From 01-01-02 to 01-01-04. Patients, Methods, Results: Eighty five patients were included in study attended the emergency or outpatients of Allied Hospital Faisalabad. Detailed history, clinical examinations and investigations like urine for & ultrasonography used for diagnosis. 52% cases were presented in acute way. 48% were sub acute presentations. 96% patients required salpingectomy. Conclusion: Management of Ectopic Pregnancy is by far salpingectomy because our patients usually attend late that is in acute way.
GLOMUS TUMOURS
Authors: RAFIQUE USMAN , HASNAIN SYED ALI ZUL , UL HAQ NADEEM , MALIK Kamran Zamurad
Published: September 2021

Glomus tumours of the temporal bone occur in the region of the jugular bulb and middle ear. Theyare rare, highly vascular, slow growing tumours and most are benign. Tumours that originate from the jugular bulb andextend to involve the middle ear are referred to as glomus jugulare tumours. Those that are found in the middle eararound the otic ganglia in the tympanic plexus are known as Glomus tympanicum. These tumours occur predominantlyin women in the fifth and sixth decades of life. Because of the insidious onset of symptoms, these tumours often gounnoticed and there is often a significant delay in diagnosis. Morbidity in these cases is determined by their size andposition. Objectives: 1. To study the age/sex incidence of patients suffering from glomus tumours of the temporalbone. 2. To see various clinical presentations with which these tumours present and their variation according to theage and sex. Design: Our study design was non-inter-ventional descriptive. Settings: This study was performed atCMH Rawalpindi and Multan from January 2000 to June 2002. Subjects: We included ten patients of glomus tumoursof the temporal bone in our study. 8 out of these were females and two were males. Though most of the patientsbelonged to middle age group yet few were also from the younger and older groups. Interventions: All the patientsunderwent CT scan with and without contrast, MRI of the requisite site and carotid angiography. Results: We foundthat these tumours were predominantly present in females, mostly in the middle age group. Individual symptoms werestudied in detail and their presence was found to be directly proportional to the increasing age of patients. Conclusion:It is concluded that due to the slow growth of this tumour the diagnosis is often delayed until it is extensive. Thereforeclinicians should be more vigilant about this rare disease and must keep it in their differentials.
PREVENTION OF HEPATITIS B
Authors: DAUD SEEMA , MANZOOR IRAM , HASHMI NOREEN RAHAT
Published: September 2021

Objective: To assess the knowledge and practice of first year MBBS students, for the prevention ofHepatitis B. Design: Descriptive study. Place and Duration of study: The study was conducted at Lahore Medical &Dental College, Lahore. The data was collected in two weeks in December, 2006. Methodology: A total of 50 studentswere recruited using a non probability random sampling technique, through the lottery method. A pre-tested structuredquestionnaire was administered to collect information about the knowledge and practice of students about theprevention of hepatitis B. Data was presented in the form of simple tables and graphs. Results: Out of 50 students,majority (96%) responded that it was a disease of liver. Regarding knowledge about the communicability of HepatitisB, 78% said it was communicable, 19% assumed that it was water borne. Other responses included spread via bloodtransfusion (28%), through use of injection (21%), close physical contact (8%) and un-hygienic conditions (18%). Forprevention of Hepatitis B, the more common responses were, provision of clean water (24%), improvement in hygiene(27%), restriction to single sex partner (6%), avoidance of sharing syringes and needles (19%), screening blood beforetransfusion (9%) and vaccination (15%). The high risk group was identified as the poor people living in unhygienicconditions (34%), surgeons (32%), barbers (12%), Intravenous drug users (8%), recipient of blood transfusion (6%)and uneducated people (6%). Only 1 respondent (2%) said that sex workers could be at risk of getting this disease.When inquired about their vaccination status, 66% of students admitted to have been vaccinated against Hepatitis B,while 34% of have not been vaccinated. Conclusion: The present study concludes that there is lack of awarenessamong the medical students entering into the profession about the hazards of Hepatitis B, its routes of spread and itsmodes of prevention. Similarly, all the students were not vaccinated against Hepatitis B, which made them veryvulnerable to this disease.
DIABETIC POLYNEUROPATHY;
Authors: ZANGIABADI, MD NASER , AHRARI, MD MOHAMAD NAEIM , NAKHAEE, MD NOUZAR
Published: September 2021

Introduction: Diabetes mellitus with the prevalence rate of 8.9-12.3% in human population,ultimately leads to the peripheral nervous system involvement in many patients. It causes various types ofpolyneuropathies which may manifest abnormalities such as impaired nerve conduction velocity (NCV) and prolongedF-wave latency. The aim of this study was to investigate the effect of omega-3 fatty acids on NCV and F-wave latency.Material and Methods: This clinical trial was performed on diabetic patients referring to the Diabetes Center of ShahidBahonar Hospital in Kerman/Iran. Subjects were randomly divided to Omega-3 and Control (no treatment) group.Patients in the case group received three capsules of omega-3 daily and for the duration of 12 weeks. NCV and F-wavelatency were determined in all patients before and after the treatment period. The rate of alterations in these variablesin the two groups was analyzed by using statistical tests. Results: Controlling for baseline NCV and F- wave latencymeasures, follow up results showed no significant difference between the Omega-3 and the no-treatment group inaccordance to somatic nerve measures. Conclusion: No significant difference in electro diagnostic indices was foundbefore and after Omega-3 administration. This result may be due to using the combination of docosahexaenoic acid(DHA) and eicosapentaenoic acid(EPA).Short term administration and lack of sufficient time for drug efficacy can beother probable reason. Further studies with the administration of pure forms of EPA or DHA and longer period ofadministration are suggested.
EPIDURAL ANALGESIA IN LABOUR
Authors: TABASSUM HUMAIRA , SHAHZAD SOHAIL , SHERAZ SHAHIDA , Boota Muhammad
Published: September 2021

To evaluate the effects of epidural analgesia on the painrelief and maternal and fetal outcome. Study design: Comparative & analytical study. Place and Duration: In MilitaryHospital Rawalpindi fromOct 1998 to Oct 1999. Patients and Method: 100 full term healthy primigravida admitted forinduction of labour. Fifty patients were given epidural analgesia and 50 served as control to whom no analgesia wasgiven. Outcome measures observed were duration of labour, mode of delivery; Apgar score of the newborn; untowardreaction and intra-partum complications. Results: The data analysis revealed that epidural analgesia significantlyprolonged labour time and was associated with increased instrumental delivery rate. Significant reduction in intra-partumfetal complications was seen, while C-section rate was not effected by epidural analgesia. Apgar scores were higherin analgesia group as compared to control. Conclusion: Although accused of prolonging labour time, it’s benefits interms of great maternal satisfaction and reduced intra-partum complications still makes it an option for labouringpatients.
ULTRASONOGRAPHY
Authors: MALIK TAHIR , AMIN ZAFAR , MALIK TAHIR
Published: September 2021

) To determine the role of ultrasonography as the primaryimaging modality in patients of acute abdomen. (2) To evaluate the sensitivity, specificity, positive and negativepredictive value of ultrasonography in acute abdomen. Design: A hospital based descriptive study. Setting: InCombined Military Hospital Lahore which is a tertiary care hospital. Period: From 1 Jan 2003 to 30 Dec 2003. stSubjects: A total of 100 consecutive patients of acute abdomen were selected for the study. There were 61 malepatients and 39 female patients. The patients’ age ranged from 02 years to 70 years. Ultrasonography was done usingALOKA SSD-5500 machine with high resolution probes. Results: During my study of patients of acute abdomen mostcommon conditions encountered were renal colic due to renal and ureteric stones followed by gut perforation,cholecystitis, appendicitis and cholelithiasis. My study revealed a sensitivity of 79.7% and specificity of 88.4% ofultrasonography in patients with acute abdomen. The positive predictive value was 95.1% and a negative predictivevalue was 60.5%. Conclusion: Ultrasonography helped in prompt decision making in most of the cases of acuteabdomen with a high sensitivity and specificity in skilled and experienced hands, as well as high positive predictivevalue. Hence, in our setup it can be used as a primary imaging modality for patients presenting with acute abdomenin any age group, as it is readily available, cost effective and free of any radiation hazards. Ultrasonography not onlyhelps in diagnosing the cause of pain but also ruling out other possibilities.
MANAGEMENT OF THIRD STAGE OF LABOUR;
Authors: AFRIDI NIGHAT , FARIDI MANZOOR AHMED
Published: September 2021

The routine prophylactic administration of an uterotonic agent is an integralpart of active management of the third stage of labor, helping to prevent postpartum haemorrhage (PPH). The two mostwidely used uterotonic agents are: ergometrine-oxytocin (Syntometrine ®) (a combination of oxytocin, 5 internationalunits (iu) and ergometrine, 0.5 mg) and oxytocin, (Syntocinon ®) 10 international units (iu). Objective: To compare theefficacy and safety of intravenous oxytocin, with intramuscularly syntometrine in the management of third stage of labor.Study design: Experimental study. Setting: Department of obstetrics and gynaecology Combined Military HospitalPeshawar. Period: Over one year period from March 2005 to March 2006. Methods: A total 200 women havingsingleton pregnancy and vaginal delivery admitted in maternity ward were divided in two treatment groups by simplerandom sampling using random number tables, 100 patients received 2 ml Syntometrine, (a combination of oxytocin,5iu and ergometrine meleate 0.5mg) intramuscularly and 100 patients received 10iu of intravenous syntocinon at thedelivery of anterior shoulder of the fetus. Results: The use of intravenous oxytocin,, was associated with a reductionin postpartum blood loss (P<0.001) but there was no difference in the risk of post partum hemorrhage, in the need forrepeated oxytocin injections and the drop in peripartum hemoglobin level between the two groups, and need for bloodtransfusion. There was also no difference in the risk of prolonged third stage, or manual removal placenta. The useof syntometrine was associated with a higher risk of hypertension (RR 2.39, 95% Cl 1.00-5.70) other side effects weremild in nature with no differences between the two groups. Conclusions: There are no important clinical differencesin the effectiveness of intramuscular syntometrine and. Intravenous oxytocin for the prevention of post partum bloodloss. Intravenous oxytocin is less likely to cause hypertension and other side effect profiles are low
HEPATITIS C PATIENTS;
Authors: MEHBOOB FATIMA , BABAR ZAFAR MAJEED BABA
Published: September 2021

Objectives: To determine the impact of antiviral treatment of Hepatitis C patients with poor socioeconomic resources. Design: Prospective cohort study. Place and Duration: Department of Medicine, Sheikh ZayedMedical College / Hospital, Rahim Yar Khan, from August 2006 to February 2007. Subjects and Method:One hundredknown cases of hepatitis C were selected. PCR and biochemical tests were performed before the start of therapy.Interferon and Ribavirin therapy was given according to standard therapeutic protocol. Patients were continuouslymotivated and educated for regular treatment. The observations were collected regularly. Results: Out of hundredcases 95 improved symptomatically. One got worse while 4 remained symptomatic. At the end of therapy PCR wasperformed only in 4 cases. Conclusion: In non affording patients although exact status of viral clearance is not knownbut some thing is better than nothing rule was applied for treatment of patients
EPIDURAL ANALGESIA;
Authors: KHAN MUHAMMAD ASGHAR , YASIN BILAL , ZAFFAR MONA , Rehman Shafi ur
Published: September 2021

Introduction. The influence of epidural analgesia on the length of labourremains a source of controversy in literature. Objectives. To see the effect of epidural analgesia on the duration ofactive first stage and second stage of labour. Setting: Obstetric Department of CMH Kharian. Period: From 1 January st2005 to 31 March 2006. Material and methods. One hundred pregnant full term, women were included in the study. stFifty primiparous reporting at full term, half were given epidural analgesia the other half were control. Another fiftymultiparous reporting at full term, twenty five women were given epidural the other twenty five were control. Results.The mean duration of active first stage of labour in primiparous women after 3 – 4 centimeter cervical dilatation was5.10 hrs in the epidural group while it was 6.65 hrs in the control group (p less than 0.001). In the multiparous womenthe mean duration of active first stage of labour after 3 – 4 centimeter cervical dilatation was 2.40 hrs in the epiduralgroup while it was 3.43 hrs in the control group (p less than 0.001). In the primiparous women the mean second stagewas 23.76 minutes in the epidural group, and 37.33 minutes in the control group (p less than 0.001). In the multiparousgroup, the mean second stage was 17.58 minutes in the epidural group, and 22.00 minutes in the control group (p lessthan 0.001). Conclusion. Epidural analgesia decreases the duration of active first stage and second stage of labour.
PSYCHIATRIC INPATIENTS;
Authors: MAQSOOD NIAZ , MALIK JAMIL AHMED , AKRAM BUSHRA , Luqman Shoaib , Niaz Naima
Published: September 2021

To explore the pattern and prevalence of inpatient psychiatricmorbidity and to see how it differs from the pattern of psychiatric morbidity in community. Design: The details of all inpatients from the case register developed for a health information system was included in study Setting: In Departmentof Psychiatry and Behavioral Sciences, Bahawal Victoria Hospital, Bahawalpur. Period: From 1998-2003. Results: Atotal of 5426 patients were admitted in the six year. There was a slight difference of 0.8% in total number of males andfemales cases (i.e., 2764 males Vs 2662 females). Overall difference reported in the present study, in mean ages ofmales and females was 3.45 years (i.e., males = 31.85 Vs females = 28.40). Mean stay of patients in ward is 10-12days. Most patients were admitted with Conversion disorder 24% followed by Schizophrenia 23%, Depressive disorder20%, Drug Dependence 10%, Bipolar Disorder 7%. The patients with Neurotic Disorder and Organic Disorder werebelow 5%. Conclusion: The study showed that overall general pattern of inpatient psychiatric morbidity is in line withpattern of psychiatric morbidity in community and the partial variance can be explained in terms of social variables, asthis variance exist even across studies within community samples.
DETERMINANTS OF DEPRESSION IN FEMALE ADOLESCENTS AND YOUTH
Authors: AFZAL SAIRA , RANA TASNEEM FATIMA , MEHMOOD SHAHID
Published: September 2021

Introduction: Adolescents and youth are the main human resource for a nation. Depression is a grave yard for hopes and prosperity making the generation sad, inactive, and having suicidal thoughts. Thus every effort should be made to create awareness and eliminate depression from our youth. Objective: To find out the psychosocial determinants of depression in female adolescent and youth. Design: Case control study. Place and duration: Lahore cant urban area, from March, 2007 to July, 2007. Material and methods: It was a community based case control study. Total 400 young females were selected. 200 cases of depression and 200 in the control group. An interview schedule including a structured, pre-tested and bilingual questionnaire was used after taking consent. SPSS and Epi info were used for data analysis. Chi square test was applied. Results: In this study the depression in adolescent and young females had statistically significant relationship with unemployment, underage marriage, early child bearing, infertility, violence, sexual harassment(p<0.05). The family history of psychiatric ill ness in first degree relatives had no statistically significant association with depression in these females (p>0.05). Conclusion: The statistically significant psychosocial determinants of depression in young and adolescent females should be rectified by creating awareness in the society
DYSPEPSIA AND UPPER GASTROINTESTINAL ENDOSCOPY;
Authors: INAYATULLAH MUHAMMAD , NAZISH ZAHRA , AKHTAR MUHAMMAD SALEEM , Anjum Abdul Hameed , Naqvi Altaf Baqir
Published: September 2021

Objective: To find out causes of dyspepsia on upper gastrointestinal endoscopy. Setting: Endoscopyunit of Nishtar Hospital Multan. Period: May 2005 to August 2007. Material and methods: Patients suffering fromdyspepsia were referred by consultants of Nishtar Hospital Multan and doctors working in the periphery for endoscopy.Results: 502 patients were scoped for dyspepsia; 254(50.6%) were male and 248(49.4%) were female. Mean age was42.5 years and age range was 7-95 years. Most common lesion was gastroduodenitis (20% cases) followed by gastriculcer (5.4% cases). Ratio of duodenal ulcer to gastric ulcer was 1:2. 56% patients had no pathology; females were morelikely to have normal endoscopy. Conclusion: Gastroduodenitis is the most frequent organic cause of dyspepsia.Functional dyspepsia is more common among females.
DIABETIC FOOT INFECTIONS;
Authors: AKHTAR MUHAMMAD SAEED , AHMAD MAQSOOD , BASHIR MUHAMMAD BADAR , Irfan Muhammad , Hashmie Zahid Yasin
Published: September 2021

Objective: (1) To evaluate the effects of G-CSF in eliminating infection in diabetic foot wound (2) Tocompare the effects with conventional diabetic foot management. Design: Prospective, open, randomized comparativestudy. Setting: Medical&Surgical Department of Allied, DHQ Hospital & Nawaz Medicare Faisalabad. Period: FromJan 2000 to Nov 2000 Patients & Methods: Fifty diabetic patients with foot infections were included in this study. Themean age was 52 years ranging from 27 to 60 years. They were divided into two equal groups(Group A and Group B).Results: The male patients were 41(82%) and female 9(18%). Forty six percent of patients were on oral hypoglycaemicdrugs, and 54% on insulin. The trauma preceding infection was 20%, Peripheral neuropathy 94% and peripheralvascular disease 34%. Thirty two percent of patients were smoker. Group A were subjected to G-CSF ( Neupogen )therapy (n=25) subcutanously daily for 5days in addition to conventional measures. Whereas patients in Group Breceived only conventional therapy. Both groups received similar antibiotic and insulin treatment. G-CSF therapy wasassociated with earlier eradication of pathogens from the infected ulcer (median 5 [range 2-11] vs11 [6-31] days in thegroup B; (p=<O.000I), quicker resolution of cellulitis (6 vs l4 days; p<O.0001), shorter hospital stay (8 vsl6 days;p<O.000l), and a shorter duration of intravenous antibiotic treatment (7 vs l4 days ;p—0.0001).No G-CSF treatedpatient needed surgery, whereas three patients in group B underwent toe amputation and six had extensivedebridement under anaesthesia (p=0.00 1). G-CSF therapy was generally well tolerated. Conclusion: Granulocytecolony stimulating factor (G-CSF) may be used as a good adjuvant therapy along with conventional measures for themanagement of diabetic foot infection, as it promotes the healing of diabetic foot ulcer/cellulitis and consequentlyprevents many hazardous complications like amputation of limbs, long hospital stays, extensive and prolonged antibioticuse and last but not the least the total misery of the patients.
ULTRASOUND, CT-SCAN, AND LAPAROSCOPY
Authors: KANWAL SUMAIRA , ZUBAIR MUHAMMAD , MEHMOOD SULTAN , Dab Riaz Hussain
Published: September 2021

Objective: To evaluate the comparative diagnostic efficacy of Ultrasound,CT-Scan, and Laparoscopy in the diagnosis of non-palpable undescended testes in pediatric patients. Design:Comparative study.Setting: Surgical and pediatric surgical department of B V Hospital (QAMC) Bahawalpur and AlliedHospital Faisalabad. Period: From April 2006 to April 2007. Materials & Method: A total forty boys with non palpabletestis were subjected to Ultrasound, CT-Scan and diagnostic laparoscopy in a period of one year. The patients above12 years and with cardiovascular anomalies were excluded from the study. Laparoscopy was performed under generalanesthesia and findings were compared with Ultrasound and CT-Scan. Sensitivity and specificity of each werecalculated. Results: Diagnostic accuracy of Ultrasound was 25%, CT-Scan was 64% and Laparoscopy was 100%.Sensitivity was found to be 20%, 63% and 100% and specificity was 10%. 50%and 100%forUltrasound, CT-Scan andLaparoscopy, respectively. Conclusion: Diagnostic laparoscopy is far more superior as compared to Ultrasound andCT-Scan in the diagnosis of non palpable testis.
ARSENIC INDUCED MICROSCOPIC CHANGES IN RAT TESTIS
Authors: AHMAD IMRAN , AKTHAR KHALID MAHMOOD , HUSSAIN TASSADUQ
Published: September 2021

The present study was designed to observe the changes in the testis of rats due to arsenic in higherdoses. Distilled water and sodium arsenite were administrated intra-peritonealy to control and experimental groupsrespectively. Animals were sacrificed, their testis were weighed and cut into small pieces. After observing the pluckingand stringing phenomenon of the seminiferous tubules the pieces of tests were embedded in paraffin and then 5µmthick section were made. These sections were stained with PAS-sulfurous acid haematoxylin and examinedmicroscopically for qualitative assessment of germinal epithelium. Results: In the rats of experimental group meanweight and average tissue ratio of the paired testes was 1.140gm and 0.0037 respectively, which was significantly lessthan the control. There was decrease in diameter of seminiferous tubules, thickening of the basement membrane, earlyarrest of spermatogenesis, damaged leydig cells, prominent sertoli cells and collapsed blood vessels, showinggeneralized atrophy of the testes in experimental group. Conclusion: In arsenic toxicity there are atrophic changesin testis due to degenerative changes in spermatogenic and leydig cells
CHILDHOOD TUBERCULOSIS
Authors: REHMAN ABDUL , ULLAH IRFAN
Published: September 2021

This article reviews the treatment of tuberculosis regimens anddosage schedule recommended by different organizations and guidelines.
CUTANEOUS VASCULAR ANOMALIES;
Authors: ASGHAR ANEELA , BUTT MUHAMMAD ASGHAR ` , BUKHARI MUHAMMAD AZAM , Sheikh Saif ullah , Mughal Abdul Razzaq
Published: September 2021

Objectives: To analyze the patterns of cutaneous vascular anomaliesin neonates and infants. To identify the complications arising in various vascular lesions.Design: A descriptive hospitalbased observational study.Setting: Dermatology and pediatric department of DHQ and Allied Hospital PMC, FaisalabadPeriod: From 1 Feb 2005 to 31 January 2006. Material and Methods: 72 consecutive newborns and infants of either st stsex having any vascular anomaly on cutaneous areas were included in the study. The information regarding size, site,type of lesions, sex of patients, with family history and any complication were recorded on a proforma prepared for thisstudy. Results: Out of 72 infants 25 were male (35%) and 47(65%) were females. Family history was present in 12cases (17%). The commonly involved sites were head and neck 45 (62.5%), trunk 18(25%) and upper limb 9(12.5%).In 59 children (82%) it was single and in 13(18%) the lesions were multiple. The complications observed were ulcerationin 13(18%), infection in 8(11%), haemorrhage in 3(4%) and visual impairment in 4(5%), while 56(78%) had nocomplications.
SERUM AND TISSUE MUCOPROTEINS AND SIALIC ACID IN THYROID DISEASES
Authors: IQBAL ZARFAR , ZAFAR TASNEEM
Published: September 2021

. Objective: To find the correlation coefficient of serum mucoproteins and sialic acid to thyroid tissuein thyroid diseases. Study Design: The study was carried out at J.P.M.C, Karachi. Materials and Methods: A total oftwenty four thyroid patients and twenty normal subjects were studied. The cases were divided into non toxic goiterfourteen, and toxic goiter ten on the basis of clinical and physical examination, thyroid scanning and hormone analysis.Thyroid hormones were estimated in serum. Mucoproteins and sialic acid were estimated in serum as well as in thyroidtissue. Results: Estimations of thyroid hormones and thyroxine binding globulin (T.B.G.) are useful clinically to evaluatethe functions status and diagnosis of different thyroid disorders. Thyroid tissue is mainly composed of glycoprotein,thyroglobulin, and different studies showed that serum glycoprotein fractions varied in different thyroid diseases.Si 4gnificantly increased levels of T were observed in toxic goiter group. The levels of TBG was significantly increased4in non toxic goiter, toxic goiter patients while T /TBG ratio was significantly decreased in non toxic goiter. Coefficientcorrelation ( r) of serum to tissue mucoproteins shows an inverse relationship in non toxic goiter and toxic goiter patients.In non toxic goiter and toxic goiter patients the serum sialic acid levels to tissue sialic acid levels also shows an inverserelationship. Conclusion: Correlation coefficient analysis showed an inverse relationship of serum mucoproteins andsialic acid to thyroid tissue. It signifies that carbohydrate moieties are increased in the blood when the tissue arehyperactive and in the pathological state. It further concludes that thyrotoxic state might be converted into nodular formeven into cancerous form later on.
Studies in object-oriented programming backbone implementations
Authors: Monday Eze  , Charles Okunbor  , Umoke Chukwudum
Published: September 2021

This work is a combination of conceptual and hands on based study aimed at laying a foundation for practical Object-Oriented software construction. First it presents a conceptual study of a number of backbone concepts of modern Object-Oriented Programming (OOP) languages. Secondly, it attempts to demonstrate real-life implementations of these concepts using Python Programming Language. This work touches on practical issues on Class and Object Creation, especially on the syntax and creation, and demystifies the subject matter using a simple table of rules. The OOP concept of Inheritance was studied, with focus on the three major types of inheritance. The self-argument, and constructors were studied, with focus on the three constructors - default, parameterized, and non-parameterized constructors. A brief discussion, and pictorial illustration was also made on the disparity between normal mathematical functions and OOP method calls. Further areas of studies are the concept of overriding between the parent and child class, as well as the OOP puzzle commonly known as Diamond Problem, including code segment and diagrammatic illustration of Python-based solutions. There are a number of other back-bone concepts in OOP not covered in this study, such as Encapsulation, Abstraction, Meta-Programming, among others, which will form areas of focus in future studies. Effort was made to enhance the overall presentation through practical illustrations using source codes, annotated diagrams, and discussions. It is hoped that this work will be very useful to researchers and other practitioners in Object Oriented implementations.
Mucormycosis: A black fungus – post covid complication, clinical and pathogenic approaches and isolation and characterization of black fungus with correlate its current perspectives of biomedical waste management
Authors: Ajay kumar sahu  , BS Arpita  , Rekita Mohanty  , Subhashree Dash  , Purabi Baral  , Surya Mishra  , Pinki Samal  , Bibekananda Pradhan  , Bhagyashree Nanda
Published: September 2021

The clinically relevant black yeasts and their relatives, i.e., members of the Ascomycete order Chaetothyriales. In order to understand the pathology of these fungi it is essential to know their natural ecological niche. From a relatively low degree of molecular variability of the black yeast Exophiala dermatitidis, potential agent of brain infections in patients from East Asia, it is concluded that this species is an emerging pathogen, currently going through a process of active speciation. It is found to be an oligotrophic fungus in hot, moist environments, such as steam baths. Cladophialophora-Fonsecaea- and Ramichloridium-like strains, known in humans as agents of chromoblastomycosis, are frequently found on rotten plant material, but the fungal molecular diversity in the environment is much higher than that on the human patient, so that it is difficult to trace the etiological agents of the disease with precision, Human to human transmitted disease is the game of corona virus disease (COVID-19) transmission and it had been declared an emergency global pandemic that caused major disastrous in respiratory system to more than five million people and killing more than half a billion deaths across the globe. Besides lower acute respiratory syndrome, there is damage to alveolar with severe inflammatory exudation. COVID-19 patients often have lower immunosuppressive CD4+ T and CD8+ T cells and most patients in intensive care units (ICU) need mechanical ventilation, hence longer stay in hospitals. These patients have been discovered to develop fungal co-infections. COVID-19 patients develop what is known as mucormycosis a black fungal infection which is deadly leading to loss of sight and hearing and eventually death. This chapter will focus on mucormycosis, black fungus caused during post covid complication. This approach has been successful with Cladophialophora carrionii, of which cells resembling muriform cells, the tissue form of chromoblastomycosis, were found to occur in drying spines of cacti. Phagocytosis assays provide a method to distinguish between pathogens and non-pathogens, as the killing rates of strict saprobes proved to be consistently higher than of those species frequently known as agents of disease. therapeutic possibilities for patient chromoblastomycosis. Covid-19 waste is like any other infectious waste and the guidelines for its management are required to be followed in addition to existing practices under regulation. BMWM in context of COVID-19 is a public health concern and is both a legal and social responsibility.