bluuebunny/crossref_metadata_2025 huggingface dataset:
Medical Ethics: Insights from Ancient Indian Tradition
Authors:   MBBS Student,  School of Medical Science & Research  Sharda University, Gr Noida, Kakkar Manas
Published: January 2023

Since the development of the Ayurvedic holistic science more than 5000 years ago, India has had a strong standard for medical ethics. Ancient guidelines for medical practise serve as the foundation for modern ideas about healthcare policy, advice on how to interact with patients, and expectations for professional conduct. These "codes of conduct" placed a strong emphasis on the sanctity of life and went beyond satisfying physical requirements. They were greatly influenced by religious and spiritual rituals. But as time went on, changes in educational priorities and political influences influenced how medical care was provided. While malpractice concerns have continuously increased, references to these once-cherished "rules of conduct" have decreased. A candid conversation about the reasons for the rise in medical misconduct in a nation that used to condemn it and how improving ethics, limiting the role of profits, and returning traditional philosophies to the medical ethics curricula could help.
Identification and molecular classification of passeriform birds in Kabul province
Authors:   Department of Biology, Faculty of Education, Paktia University, Paktia Province, Afghanistan, Arianmal Mohammad Sharif , Aliabadian Mansour ,   Department of Biology, Faculty of Sciences, Ferdowsi University of Mashhad, Mashhad, Iran, Salari Hedayatullah ,   Department of Horticulture, Faculty of Agriculture, Paktia University, Paktia Province
Published: January 2023

It is thought that the passiform order of bird has monophyletic origin.. However, new studies show that many passerine families are not monophyletic in traditional classifications, and a more complete understanding of Passeriform phylogeny is possible only by conducting extensive molecular studies. Therefore, this molecular study was conducted to evaluate the passiform birds of Kabul Province, Afghanistan. Samplings were collected from ten already marked stations during three stages in Kabul province in 2019 and 2021 years, including Deh Sabz, Bagrami, Sarubi, Khak Jabar, Shekar Dara, Gol Dara, Paghman, Char Asiyab, Andrabi Road and Kafroshi. Totally 190 samples were taken using a net. Miss net was collected and 110 samples were taken to the laboratory. After the morphological studies, it was identified by the identification key that all the species belong to the Passeriform order. These species belong to 13 families, 23 genera and 35 species, of which the family of yellow-winged moths is the most diverse with 7 species and the family of sparrows is the most abundant with 45 individuals. After performing morphometry, the samples were transferred to the laboratory for molecular studies and DNA extraction and COX1 gene sequencing to identify the species in the tree drawn by Bayesian method which shows the position of genera and species within families and superfamilies. In this study, genus Passer with four species, genus Motacilla with one species, genus Carduelis with one species, genus Emberiza with six species and genus Serinusa with one species were included in the superfamily Passerioiodea. The genus Corvus with one species and the genus Lanius with one species were included in the Corvida clade. Two species of the genus Luscinia with one species of the genus Muscicapa and one species of the genus Acridotheres were included in the superfamily Muscicapoidea. Two species of the genus Hirundo, one species of the genus Phylloscopus, one species of the genus Ripria, one species of the genus Sitta, one species of the genus Sylvia and one species of the genus Eremophila were included in the superfamily Sylvioidea.
Enhancement of soil fertility and yield of Capsicum frutescens (Green chilli) through application of bagasse Ash in soil
Authors:   M.Sc. Student, Department of Environment Sciences, Bareilly College, Bareilly, U.P., India, Bhushan Gaurav ,   Assistant Professor, Department of Environment Sciences, Bareilly College, Bareilly, U.P., India
Published: January 2023

A pot experiment was conducted during 2022-23 at the research area of the Department of Environmental Science, Bareilly College, Bareilly to evaluate the effect of bagasse ash on growth, yield and quality of Capsicum frutescens (Green chilli) and also on soil fertility sugarcane. To achieve the current research work , sugar industry bagasse ash was applied to capsicum frutescens crops in pots having 1 kg soil @ 20% , 40%, 60%, 80% , 100,% respectively . When we compare the control sample. The physicochemical properties of soil under the investigation was having a pH (7.6), low in organic matter (8300 mg kg-1), and low content of Nitrogen (337 mg kg-1), Phosphorus (4.0 mg kg-1), Zinc(5.7 mg kg-1) and Iron (5.2 mg kg-1) . Bagasse ash was a rich source of micronutrients like Fe, Mn, Zn and Cu and also contained sufficient amounts of Potassium and Phosphorus. Consequently, total porosity of soil, presence P, K, Fe, Mn, Zn and Cu content in soil, increased with the levels of bagasse ash application. On the other hand, dry bulk density declined which shows a positive effect on plant growth. ECe and pH of the soil was minutely increased. After the application of bagasse ash in pots yields of capsicum frutescens crop also enhanced. It is recommended that application of 40-60% bagasse ash will result in enhanced yield of capsicum frutescens.
Pakistan train terrorists in the Afghanistan region for the common goals
Authors: Mashaal Shafiqullah
Published: January 2023

When Pakistan was liberated from British India in the year 1947, under the name of a freed state only, for the illegal and nefarious purposes of some countries and for instability and insecurity in the region, military fundamentalists, extremist groups and Thus, the pakistan is under the supervision of the ISI, and all the power and authority of the said country is in the hands of these terrorist groups and organizations. and it plays a major role in determining the foreign policy. now it has been proven to the whole world and in front of the neighboring countries, that the change of government in Pakistan or the coming to power of one or the other party has no meaning. The request of the intelligence organization and the military fundamentalists of this country is fulfilled and they want to promote terrorists and terrorist groups in the region and in Afghanistan and to make Afghans so hard in the matters of terrorism that they become their own and Unlawful goals and desires are reached.
Suburban agriculture, immigrant farmers, and access to agricultural services and resources
Authors: Xie Lin , Qiu Zeyuan , Fu Mei
Published: January 2023

While agricultural services are shrinking, the num­ber of nontraditional farms run by immigrant farm­ers is rising in U.S. suburban regions. This study attempts to understand Chinese immigrant farmers’ experience accessing agricultural services and resources in the New York metropolitan area and explores the need for changes in agricultural ser­vices to meet changing demand. Thirteen Chinese immigrant farmers in the region were recruited to participate in a semi-structured interview to under­stand their shared experiences of accessing agricul­tural services and resources. The study identified diverse ways of accessing agricultural services and resources in four critical areas of farming opera­tions: agricultural technology, financial services, farm labor, and farming machinery; and also revealed the existence of “liability of newness” among those new immigrant farmers in operating farms. Most participants felt that they were iso­lated, with limited access to available services as new immigrant farmers, which constitutes the lia­bilities to their success in farming. Language barri­ers, cultural differences, distrust, and isolation were the main obstacles to access adequate services and resources. As farms and farmers are becoming more diverse in U.S. suburban regions, the provi­sion of agricultural services needs to adapt accord­ingly to meet the growing needs of groups of farm­ers with varying farming experiences and demographic backgrounds and help them to over­come the liabilities as new immigrant farmers. This study contributes to understanding the farming experiences of minority farm groups, which help develop more inclusive agricultural services.
The Epidemiology of Various Intestinal Obstruction Causes in Children and Teenagers: A Multi-Center Study
Authors: Shah Nazir , Muhammad Amir , Khan Atta Muhmmad , Jan Naeem , Rehman Sijad Ur , Khan Mohummad Qasim
Published: January 2023

Aim: to assess the Epidemiology of intestinal obstruction in children And Teenagers its causes. Study design: This is A Multicenter study. Place and duration of study: This study was conducted in lrh and hmc territory care hospital of kpk . Analysis was completed in 01 year, from Jan 2021 to Jan 2022. Methodology: This study included all children aged 13 to 18 years hospitalized in the pediatrics department who had an exploratory laparotomy for intestinal blockage and met the inclusion criteria. During an exploratory laparotomy, adhesions, intussusceptions, roundworms, and an obstructed hernia were identified as possible reasons for intestinal blockage. Software SPSS version 24 was used to analyze the data that was collected. We calculated percentages, means, and standard deviations. Results: 85 patients in all, including 30 cases (35% females) and 55 points (65% males), were analyzed. From [01] to [12] years was the range of ages, with a mean age of [04.3602.06] years. Adhesions were the most frequent cause of intestinal obstruction, followed by intussusception in 36 (42% of cases) and 27 (31% of cases), respectively. Conclusion: The prevalence of the etiological reasons for intestinal blockage in children And Teenagers varies by age group, although adhesions are the most frequent cause, with intussusception coming in second. Keywords: Children ,Teenagers, etiological causes, intestinal obstruction, adhesion, and intussusception
Epley's Maneuver Alone Vs. Epley's Maneuver with Betahistine for Mild“Paroxysmal Positional Vertigo” A Tertiary Care Hospital Study
Authors: Ali Muhammad , . Tanveer , Awan Arshad Saeed , Khan Azam , Zaki Ali , Mudassir Muhammad
Published: January 2023

Objectives: This study aimed to compare the effectiveness of Epley's and Epley's maneuvers plus betahistine for treating benign paroxysmal positional vertigo in a Peshawar tertiary care hospital. Method: The study took place from January 15th, 2018, to January 15th, 2019, at a tertiary care hospital for evaluation. There are two types of patients we are aiming for. In group A, patients with benign paroxysmal positional vertigo underwent Epley's technique alone, whereas those in group B received both the procedure and betahistine. Results: Forty-seven participants participated in the research. There were 15 women in Group A (60%) and ten men (10%) in Group B (55%-45%). Patients had a mean age of 35 years. The combination of Epley's maneuver and betahistine was more successful than either treatment alone Group B had a 75% success rate in treating benign paroxysmal positional vertigo. In contrast, Group A had a 60% success rate. Conclusion: “Epley's” operation solitary is effective for treating benign paroxysmal positional vertigo, but when combined with betahistine, the results are much better. Keywords: Benign paroxysmal positional vertigo, “Epley's” manoeuvre, “Epley's” manoeuvre + “betahistine”.
Analyzing the Efficacy of Topical Ciprofloxacin Ear Drops vs. Oral Tablets and Topical Ciprofloxacin Ear Drops Together for the Treatment of Patients with Chronic Suppurative Otitis Media (CSOM-Tubotympanic Type)
Authors: . Tanveer , Ali Muhammad , Awan Arshad Saeed , Khan Azam , Zaki Ali , Mudassir Muhammad
Published: January 2023

Background: A suppurative Middle ear infection is the most frequent kind of otitis externa in low-income regions of the world (CSOM). Suppurative otitis media (CSOM-tubo tympanic type) affects both young and old alike. The condition has been treated using a wide range of approaches. Objectives: The purpose of this study was to evaluate the efficacy of oral and topical ciprofloxacin against topical ciprofloxacin drops alone in the treatment of CSOM-tubo tympanic ear discharge. Methods: Randomization was used in our study Patients with chronic suppurative otitis media were seen between September 2020 and September 2021 at tertiary care hospital in Peshawar. SPSS version 24 was used to evaluate hospital and pathology lab data. Results: Overall, 75 patients were included in the study's findings. They split themselves into two categories. There were 38 people [group A] and 37 people [ group B]. each Group was classified into two age groups, the younger [ages 01–12] and the older (ages 13–60). (age 13-16 years). Patients' ages ranged from 1 to 12 years old, with 28 [group-A] at 72% and 25 [group-B] at 65%. Ten people 27% in [group-A] and thirteen patients (35%) in [group B], were between the ages of thirteen and sixteen (group B). Conclusions: As a result, we found that the combination of oral and topical ciprofloxacin was superior to topical ciprofloxacin alone in resolving ear discharge in patients with middle ear CSOM (tubo-tympanic type). Keywords: Topical and oral ciprofloxacin, treat chronic suppurative, otitis media
Pediatric Traumatic Brain Injury; Experience in Tertiary Care Hospitals of KPK, A Multi- Center Study
Authors: Khan Muhammad Idris , Ullah Akram , Haq Naeem Ul , Haq Main Ifthakar Ul , Hussain Ramzan
Published: January 2023

Objective: The present study examined the epidemiology, clinical features, and outcome of pediatric traumatic brain injuries (TBI) in tertiary care hospitals in Khyber Pakhtunkhwa (KPK) . Duration and Place of the Study: Duration of study was From February 2020 to February 2022.It was conducted in Neurosurgery Department, Khyber teaching hospital MTI, and Hayatabad medical complex Peshawar. Material and Methods: A total of Six hundred and forty-three pediatric patients, ages 01 to 11years, who had suffered traumatic brain injury were included in the study. All children were first seen at an emergency room, where they had a series of diagnostic tests and a physical examination. All necessary radiological studies were carried out under the watchful eye of the senior consultant neurosurgeon. In addition to demographic information, the pattern, treatment, and outcome of children with head injury were also recorded. Results: Among the 643 kids examined, 411 (or 65%) were boys, and 232 (or 35%) were girls. At presentation, the average age was 4.062 years. Among the children surveyed, 525 (82%) lived in an urban setting, while the remaining 117 (18%) lived in a rural region. Three hundred and seventy-eight (60%) of the children suffered a head injury secondary to fall, whereas just 207 (33%) had been involved in automobile accidents. 58% (374) had mild head injury and 185 29% had moderate head injuries, 84 (13%) had severe head injury. 12% (74) of patients underwent craniotomy for extra-dural hematoma. 46 (7.1%) of the children had depressed skull fracture which was surgically treated. 23 (3.5%) patient had acute sub-dural hematoma for which craniotomy was done. Rest of the 27(4.1%) children had traumatic sub-arachnoid hemorrhage and intracerebral bleed which were treated. Out of the total 76(11.6%) children did not recover and died, most of them presented with severe head injuries Conclusion: Most common cause for head injury in our setup was fall from height which was followed by motor vehicle accidents. Over half of the children presented mild to moderate head injuries. Over half were treated conservatively with good outcome. We had mortality of 11.6% with most having severe head injuries. Keywords: Mortality, Brain Injury, fall, Car Accidents, depressed skull fracture, extra-dural hematoma, acute sub-dural hematoma.
Simulation in Urological Training: The Hybrid Model of Institute of Kidney Diseases Peshawar A Comparative Study
Authors: Ali Liaqat , Shah Muhammad , Shahzad Mohammad , Hayat Faiza , Hanif Mohammad , Orakzai Nasir
Published: January 2023

Background:"I fear the man who has practised one kick 10,000 times." Lee Bruce This aphorism highlights the growing importance of simulation in postgraduate urology training, especially during the COVID 19 pandemic, when all teaching and training activities were stopped, jeopardising postgraduate residents' education. Postgraduate residents must perform hours of surgical training to overcome urological learning curves. According to study, residents educated on simulators boost their summative scores. By introducing simulation to urology training in a way comparable to the well-known Halsted apprenticeship model, the current study emphasises the hybrid model of IKD. Objective: to compare the formative assessment results between residents taught on simulators and residents in the conventional apprenticeship model on factors of communication skills, technical competence, and overall capacity to conduct procedure on OSAT and DOPS. Material & Methods: from 2019 to 2021 this comparative study was conducted in the Department of Urology by Team C at the Institute of Kidney Diseases Peshawar. Group A (10 residents) and Group B (10 residents, 5 from the second and third years) received STEPS method OT instruction in the first phase. These simulators were used to impart knowledge to Group "B" Harvey for counseling and medical examinations Simulator for PCNL The second phase included a six-month training assignment swap between the two groups. A standard QSAT and DOPS proforma was used to evaluate each resident. Data analysis was done using SPSS 24.0. Results: Residents in Group A, who were originally exposed to the conventional technique, considerably outperformed Group B on Harvey (mean: 50.5; standard deviation: 2.21.1) in terms of communication skills, professionalism, and ethical concern during the first phase (p 0.001). However, the Group p0.05 shown considerably higher technical proficiency and overall process performance capacity. The mean technical skill and overall capacity to finish the process had a somewhat positive association in phase 1 in favour of group B (r=0.630, p 0.01). All QSAT and DOPS metrics significantly improved in the second phase. However, both groups did not vary significantly (p> 0.05). According to Pearson coefficient correlation, both groups considerably overcame their gaps in technical proficiency, communication skills, and procedural competence. (P= 0.001) Results are shown in Figures 1 through 06 and Tables 1 through 2. Conclusion: To improve the standard of urology residency in Pakistan, a hybrid paradigm that includes both simulation and actual performance is necessary. Keywords: simulation, education, learning, skills, innovation, urology
Comparison of Infra Orbital Nerve Outcome in Zygomaticomaxillary Complex Fractures Treated Surgically and Conservatively
Authors: Ullah Nahmeed , Khan Nighat , Hammad Jahangir , Mulk Nizam Ul , Javed Anum , Khanda Gul , Ullah Assad
Published: January 2023

Introduction: Zygomaticomaxillary complex fractures are second most common facial injuries. These fracture are managed either by open reduction with rigid fixation or conservatively. Objective: To compare infra orbital nerve outcome in zygomaticomaxillary complex fractures treated surgically and conservatively. Methodology: The current randomized controlled trial study was carried out at Oral and Maxillofacial Surgery Department, Sandeman Provincial Hospital/Bolan Medical College Quetta from 23/04/2018 to 22/10/2018 after the synopsis approval. Total sample size calculated was 100. 50 patients in Group-A were treated by open reduction and internal fixation technique and 50 patients in Group-B were managed conservatively without any intervention. All the data was recorded in a specialized proforma for this study. Data analysis was done by SPSS. Results: The overall mean age (SD) of the patient’s was 36.2±7.1 years. Most of the patients (n=64, 64.0%) were 31-45 years old. The male patients in our study were 65 (65.0%) whereas female participants were 35 (35.0%). For detection of mechanical threshold, the patients proportion with sensations at 3cm filament length was significantly lower in patients who underwent surgical treatment (78.0% vs. 100.0%; p-value<0.001) as compared to the participants managed conservatively. It was also lower significantly at 5cm and 7cm for Group-A in comparison to Group-B (p-value≤0.05). For detection of heat threshold, the patients proportion with sensation at 32°C was no different between Group-A and Group-B (p-value=0.529). However, proportion of patients with sensations at 35oC (64.0% vs. 100.0%; p-value<0.001) and 37oc (90.0% vs. 100.0%; p-value=0.022) was lower significantly in surgically treated patients. Pain threshold detection was significantly lower in patients who underwent surgical treatment (1.26±0.44 vs. 1.58±0.49; p-value<0.001) in comparison to conservative treatment. Conclusion: In patients with zygomaticomaxillary complex fractures, infra orbital nerve outcome was superior in patients managed conservatively than those treated with open reduction and internal fixation which advocates evading unnecessary intervention in such cases in future practice. Keywords: Zygomaticomaxillary Complex Fractures, Conservative Treatment, Infra Orbital Nerve
The Effectiveness and Safety of Percutaneous Cystolithotripsy for Vesicle Calculus in Children: A Single-Center Study
Authors: Opal Samiullah , Tariq Kifayat , Hayat Sikandar , Khan Ihsanullah
Published: January 2023

Background: Primary bladder stones are common among children from developing countries but may be difficult to cure. Transurethral cystolithotripsy, open cystolithotomy, and shock wave lithotripsy are the treatment modalities for vesical calculi in children. Transurethral lithotripsy is less efficient in children because of the small caliber of the urethra. PCCL is a less intrusive and efficient procedure for removing bladder stones in pediatric patients. Objectives: The objective of the study was to determine the safety and efficacy of PCCL in children with bladder stones in third-world nations. Materials and Methods: There was a search for( PCCL) in pediatric individuals diagnosed with vesical calculus. 90% male and 10% female total of 120 patients enrolled in the single-center trial at the Department of Pediatric Urology at the Institute of Kidney Diseases between January 2021 to January 2022. The surgery was performed under a general anesthetic. After a thorough inspection, a suprapubic puncture of the lower urinary tract (by cystoscopy) was done. The tract was only dilated up to 14 Fr. The stone was fragmented using pneumatic lithotripsy after passing the nephroscope. After 36 hours per urethral catheter was removed. Results: In this study, the mean age of the patients was 4.2.14 years. The majority of patients were kids. The average gem was 9.3 millimeters in diameter. Successful stone fragmentation and retrieval took place in an average of 40 min. The only major problems seen during or after surgery were hematuria, infection, and moderate mucosal injury; all three were managed conservatively. In 108 out of 120 cases (90%), ammonium acid urate was found to be the primary constituent of the stones and the core. Conclusion: The success rate of percutaneous cystolithotripsy in the treatment of bladder stones in children is higher, and it is ready for immediate use. The operation is quick and causes minimal discomfort. Keywords: Effectiveness, Percutaneous , Cystolithotripsy, Vesical Calculus, Children
Empathy of Healthcare Professionals During Covid-19 Crisis
Authors: Qaisar Ayesha , Khan Jibran Umar Ayub , Kakar Iftikhar Ali , Khan Umar Ayub , Awalzai Faheem Naeem , Shah Azlan , Ullah Assad
Published: January 2023

Background: Empathy is one of the most vital parts of medical ethics that is a prerequisite for good clinical practice, yet the level of empathy of the doctors has not been up to the mark. Objective: To measure empathy of healthcare professionals during COVID-19 crisis Materials and Methods: This was a cross Sectional Study done in almost all public and private tertiary care hospitals of Peshawar. The study duration was 6 months (10 September 2021-10 Febuary 2022) after the approval of research proposal. The sampling method was non probability convenient sampling. The inclusion criteria were health professionals involved in the care of the COVID 19 patients like pulmonogists, physicians, trainee doctors, nurses and chest physiotherapists. Exclusion criteria were the doctors from other specialties who were not taking in the management of such patients. Empathy scale was used to collect responses of the participants .The data was analyzed using SPSS latest version Results: Significant association was seen between Consultants, Nurses and PGRs with that they were not interested in patient’s personal matters as these are not relevant to medical treatment. i.e. p-value <0.001. Significant association was seen between Consultants, Nurses and PGRs they Viewed things from patient’ perspectives might confuse me and make me too distracted to take the right clinical decision (cognitive). I.e. p-value=0. 026 Conclusion: The level of empathy did get affected to a colossal extent during the COVID-19 pandemic as reflected by the above results. Keywords: Empathy, COVID 19, healthcare professionals
Knowledge, Attitude and Perception of Pregnant Women towards Hepatitis E
Authors: Ayub Jibran Umar , Shah Azhar Zahir , Khan Umar Ayub , Gul Ayesha , Awalzai Faheem Naeem , Akhtar Zainub , Ullah Assad
Published: January 2023

Background: Hepatitis E is one of the most common diseases during pregnancy which can cause increased mortality and devastating complications. Objective: To assess the knowledge, attitudes and perceptions of Pregnant Women towards Hepatitis E Materials and Methods: This cross sectional study was conducted in Maqsood Medical Complex General Hospital for a duration of six months. The sampling technique was non probability convenient sampling. The inclusion criteria were pregnant women in first trimester aged between18 and 45 years. Patients with molar pregnancy and those having history of gastrointestinal disorders were excluded from the study. A total of 100 patients were taken Results: Among women 80% heard about Hepatitis E, 81% known a person ever infected with viral infection, 60% don’t know that this infection was caused by virus, only 46% reported that they knew that It was transmitted through contaminated food and water, 56% reported that they knew it was transmitted by blood transfusion, 54% reported that they knew it can be transmitted sexually, 45% knew that it can be transmitted from mother to fetus, 61% reported that they knew that Hepatitis E is more dangerous in pregnancy, only 26% reported that they knew it can cause hepatic failure and only 38% reported that they knew there is vaccination of Hepatitis E. Questions regarding attitude of women towards Hepatitis-E showed that only 45% reported that they were at risk of getting Hepatitis-E infection Conclusion: From the above results one can conclude that there was good awareness of hepatitis E among pregnant women, yet there is a need for more health education and vaccination drive to reduce its mortality. Keywords: Hepatitis E, Pregnancy
Frequency of Celiac Disease in Microcytic Anemia Patients of Nowshera
Authors: Ullah Hamid , Ali Liaqat , Aslam Mujahid , Naeem Muhammad , Ullah Muhammad Imran , Masood Abbas , Ullah Assad
Published: January 2023

Background: Celiac disease a chronic gastrointestinal disorder is caused by an immune response to the gluten. Numerous studies have been conducted worldwide on the relationship between anemia and celiac disease. Objective: To find out the frequency of celiac disease in microcytic anemia patients of Nowshera Methodology: The current study was cross sectional carried out at the Gastroenterology department, Qazi Hussain Ahmad Medical Complex, Nowshera from October 2021 to October 2022. For serological diagnosis of the celiac disease, all the patients were tested for IgA and IgG tTG (anti-tissue transglutaminase). OesophagoGastroDuodenoscopy (OGD) was done for all the patients with raised level of IgA and IgG tTG (anti-tissue transglutaminase). All the analysis of collected data was done by employing IBM SPSS version 24. Results: In this study a total of 300 patients with microcytic anemia were enrolled. There were 165 (55%) female participants while 135 (45%) patients were male. IgA and IgG tTG (anti-tissue transglutaminase) levels were raised in 15 (5%) patients amongst 300 patients with microcytic anemia. In duodenal biopsy of 15 patients with celiac disease, Marsh I was observed in 4 (33.33%) patients, Marsh II in 5 (41.67%) patients, Marsh III in 3 (25%) patients, while 3 (20%) cases showed normal histo-pathological findings. Thus the overall frequency of celiac disease amongst microcytic anemia patients was 15 (5%). Conclusion: Our study concludes that celiac disease is more prevalent amongst the patients with microcytic anemia. The microcytic anemia can be considered as additional gastrointestinal manifestation of the celiac disease. Keywords: Frequency; Celiac disease; Microcytic anemia
Tuberculosis of Bones and Joints in Orthopedic
Authors: Hannan Abdul , Bilal Muhammad , Shakeel Basit Muhammad , Karamat Asifa , Abbas Muhammad Adeel
Published: January 2023

Background: Mycobacterium Tuberculosis (TB) is a major global health concern and burden on developing countries economy. Pakistan ranks in top 10 countries of the world with high load of TB and a big chunk of this disease process is extra pulmonary TB (EPTB). Among extra pulmonary sites, is bone and joint TB is very common yet under reported. Recent literature has found up to 35% of all extra pulmonary cases are bone and joint TB. Purpose: We aim to do an analysis of frequency of bone and joint TB in our institution in all new patients getting registered for treatment of TB. Methodology: This was retrospective analysis 8 years of Data collected in Gulab Devi Hospital Lahore. Data was analyzed using Microsoft excel software and results are tabulated. Findings: Total number of new registered patients of Extra-pulmonary Tuberculosis (EPTB) were 13000 (20%). Out of these EPTB patients, bone and joint TB diagnosis was made in 690(5.3%) patients. Out of these 690 patients, 400 (58%) cases were recorded in Indoor facility and 290 (42%) cases were seen in outdoor facility. Most common site is Spine 340 cases (85%) followed by Hip joint 16 cases (4%), knee joint 12 cases (3%) and upper limb 16 cases (4%). Practical Implication: Regarding management of newly registered cases, Gulab Devi hospital is working in collaboration with world Health Organization TB control program and Provincial TB control Program Punjab (PTP). All new cases are managed by multi-disciplinary team and after initial registration are referred to their relevant specialties. Conclusion: Axial skeleton remains the most common site in al literature and so is the conclusion of our analysis. Detailed research work is still needed in several aspects of this ancient disease to reduce the morbidity and mortality associated with it. Keywords: Bone and joint TB, Pulmonary Tuberculosis, Extra pulmonary Tuberculosis
Comparative Analyses of Physiochemical Parameters of Bottled and Tap Water in Lahore City
Authors: Ali Junaid , Ahmed Nashida , Younis Muhammad , Soomro Tahmina , Nisa Zaka Un , Malik Anwar Ali , Asim Naeem
Published: January 2023

Objective: Drinking water quality is of great concern because of different water borne diseases and negative impacts on the health of humans. Increased trend of bottled water usage is seen around the world. The purpose of this study was to analyze the physiochemical and bacteriological quality of tap and bottled drinking water and campare their parameters. Methods: This study is carried out to determine the physicochemical and microbial properties of the bottled and tap water available in the Lahore city of Pakistan.15 different samples of each bottled and tap water were collected from different areas of Lahore. The investigated parameters were mainly total dissolved solid(TDS), dissolved oxygen (DO), total coliform, Pseudomonas, sodium, arsenic, iron, colour and taste using standard analytical techniques available in the laboratory. The data was analyzed by SPSS software. Results: The results showed that among 15 different bottled water samples, 66.7% samples contain pseudomonas bacteria and 26.7% samples were contaminated with total coliform the other parameters (sodium, arsenic, TDS, iron ) were under safe limit whereas 100% of tap water samples were contaminated. Although some parameters of bottled water in Lahore city were within acceptable range, but most of the bottled water was contaminated with total coliform and pseudomonasthatis not safe to the consumers' health and none of tap water sample was safe. Practical Implication: This study will be made available to readers for the awareness of water quality and its problem concerned. As ill impacts of contaminated water particularly with above mentioned contaminents, include waterborne diseases and other many diseases. Conclusion: It is concluded from this study that the use of bottled drinking water is based on the assumption that it is pure. In thisstudy, 66.7% of bottled water and 100% of tap water samples were contaminated with total coliform and pseudomonas exceeding WHO standards. The findings of our study also suggest that as compared to tap water, the bottled drinking water may be safer to drink. Keywords: water, quality, contamination, bottled water, tap water
Can Serum Lactate Dehydrogenase Levels be used as a Diagnostic Tool for Hemolytic Hyperbilirubinemia in Neonates?
Authors: Tauseef Rauf Muhammad , Fatima Bushra , Khan Mazhar Qadir , Khanum Ayesha , Ahmad Nisar , Waheed Khawaja Ahmad Irfan
Published: January 2023

Background & Objective: Neonatal jaundice is common reason for admission in neonatal units requiring further evaluation to prevent adverse neurodevelopmental outcome. Lactate dehydrogenase levels are high in hemolysis. This study was aimed to explore the diagnostic properties of Lactate Dehydrogenase (LDH)in hemolytic causes of neonatal hyperbilirubinemia. Methods: In this observational cross sectional study, prospective data was collected at Neonatology department of The Children’s Hospital and University of Child Health, Lahore fromFebruary 2020 to March 2022. A total of 364 neonates with the diagnosis of indirect hyperbilirubinemia were enrolled through convenient sampling method after excluding the comorbidities and sick neonates.The neonates were categorized into hemolytic and non-hemolytic group and lactate dehydrogenase levels were compared in both the group. Data was analyzed using SPSS version 24 Results: Out of 364 babies, 123 (33.79%) were diagnosed as having hemolytic jaundice while 241 (66.21%) fell in non-hemolytic group. Out of 123 newborns in hemolytic jaundice group, LDH levels of 101 (82.1%) newborns were raised while only 124 (51.5%) newborns in non-hemolytic group (241) had raised LDH (p-value <0.001). Sensitivity and Specificity of LDH levels as marker of hemolysis was 82.11% and 48.55% and positive predictive value and negative predictive value were 44.89% and 84.17% respectively. The practical implication that there are insufficient test s in common clinical usage that cal reliability make the the diagnosis of hemolysis Conclusion: LDH is an effective diagnostic tool for the diagnosis of hemolytic hyperbilirubinemia in neonates with a higher sensitivity and negative predictive value. Keywords: neonatal hyperbilirubinemia, hemolytic jaundice,lactate dehydrogenase
Role of Vitamin E in the Treatment of Primary Dysmenorrhea
Authors: Rasheed Imrana , Rasheed Shakeela , Mudassar Asma Qamar , Saba Neelam , Javaid Iqra , Saba Irum
Published: January 2023

Background: Primary dysmenorrhea is the common gynecologic problems, particularly among adolescent girls. The pain is severe during the first and/or second day of bleeding & usually lasts up to 72 hours. More than 55 to 80% of post-menarche women are thought to experience primary dysmenorrhea. Both vitamin E and a placebo may lessen dysmenorrhea-related pelvic pain, although vitamin E appears to do more significantly Objective: To find the role of vitamin E in the treatment of Primary dysmenorrhea Methodology: This randomized placebo-controlled trial was conducted at JankiDevi Jamiat Singh Maternity Hospital Lahore and Sir Syed Hospital Karachi from 1stJune 2021 to 31stMay 2022. Sample size 70 with age 16-28 years with unmarried women; regular menstrual cycles; no urogenital disorders; no previous history of abdominal or pelvic surgery. To check severity of pain we used Visual Analog Scale (VAS) & Cox Menstrual Symptom Scale (CMSS) was used for grading the pain duration. Pain duration was categorized as follows: score 1: ≤0-0.5 hours of pain; score 2: 0.5-1 hours of pain; score 3:>1 hour of pain; score 4: >1 day of pain. Two groups were formed from the sample. Vitamin E 400 units/day in two divided doses was prescribed for the first group to begin the treatment course (5 days in a month,), and Placebo was given to the second. Data was entered and analyzed in SPSS. Result: Total 70 were enrolled. There were 35 women given Vitamin E and 35 were given placebo. In Group 1, the mean age was 21.57+ 3.35 and in Group 2, the mean age was 22.0+3.05.Before treatment, the mean of VAS pain score was 49.29 in Vitamin E group ad placebo group was 58.71mm and after treatment, the mean of Vas pain score was reduce to 34.60 in vitamin E group and placebo group was 44.48. A significant difference was found the severity of pain and duration between the pre- and post treatment in both groups. Table: 2,3 As the comparison indicates, no significant differences were found regarding severity of pain and duration between the groups. ( p < 0.05). This study will help the practioners,gynecologist for in the treatement of primary dysmenorrheal further this will also open the doors for further researches in this field. Conclusion: Vitamin E helps to relieve pain in primary dysmenorrhea. It can be considered as a universal medicine in the treatment of primary dysmenorrhea since it is a very simple way for pain control with fewer side effects and is cost-effective. Keywords: Dysmenorrhoea, Vitamin-E, nausea, vomiting, gastrointestinal symptoms
Abnormal Morphology of Blood Vessels in Erythematous Skin from Atopic Dermatitis Patients
Authors: Abbasi Momina Khadija , Abbasi Momina Khadija , Ali Nosheen , Naval Ama Tul , Naz Sehrish , Ali Mehak , Noureen Fakhra
Published: January 2023

Background: Atopic dermatitis is a lesion of skin that affects the blood vessels originated from the vascular plexus. It is a pruritic inflammatory lesion with continuous relapses in between. It has an unknown etiology with no evidence of interaction between environmental and genetic factors. AD has many manifestations including; allergic skin reactions, rhinitis and asthma. This study will illustrate the morphological changes associated with the person suffering from erythematous skin in AD patients. Methods: It is a case control study which has included 40 participants aged between 20-65 years including 20 AD and 20 healthy patients. Study was conducted between the time period of Dec 2021 to Nov, 2022. Cases included all those patients who were diagnosed with AD from a period of at least 3 months whereas controls were taken by matching the age and race with the cases population. Specimens of skin were collected from all the patients and then observed under a photon microscope. Results: Results of the study states that the patients suffering from AD demonstrate thick, complex vessels of blood causing increased flow of blood within the erythematous as well as non-erythematous skin. It suggests that these morphological changes are not observed in all acute and subacute stages but only in chronic stages. In addition, bifurcation was absent in both the lesions either lichenification or erythematous. Practical implication: This study will help the clinicians to understand the morphological changes that occur in atopic dermatitis patients in order to differentiate them from the normal population. Further, it will help the community to differentiate themselves on the basis of the signs and symptoms associated with Atopic dermatitis patients. Conclusion: Study concluded that these results will be helpful in the development of clinical strategies for the treatment of eczema in AD patients. Keywords: Atopic dermatitis, lichenification, flexuous blood vessels, pruritus, eczema, vascular endothelial growth factor.
Medicolegal Importance of Sex Determination with the Help of Lip Prints: Cheiloscopy
Authors: Jawaad Imran , Mushtaq Muhammad , Mushtaq Farazen Sadia , Imran Zoya , Rizwan Samreen
Published: January 2023

Introduction: Identification whether of living person or of dead bodies have always been an uphill task for forensic experts. Traditional ways of identification are used commonly due to limited resources and lack of trained personals in the relevant field. Identification becomes very important when victim or assailant is unknown. To establish identification, methods commonly used are finger prints, foot prints, DNA technology. Lip prints a relatively neglected field of identification can be used to establish identification and sex determination producing almost same results as other methods of identification. Objectives: To determine whether lip prints can be used from their configuration to determine the gender identification. Material and Method: 75 medical college students with equal gender distribution, 35 male and 35 females were included in the study. Students were aged between 18 to 25 years. Inclusion criteria: Students with no lip abnormality were included in the study. Exclusion criteria: Students with any abnormality of lips or who have some lip surgery were excluded from the study. Results: The uniqueness of the lips was established by the facts that no two lips matched with each other. Females revealed type I, I’ most abundant, whereas type IV was abundantly observed among males. From the current study, with inexperienced observers it was revealed that from sample of 20 lip patterns from each gender, 18 females and 17 males were easily identified. Conclusion: Identification of a person whether living or dead is a challenging task for forensic experts around the globe. Lip prints are among the cheapest and easily available methods of identification producing almost same results as finger prints. It is a rather neglected area which needs to be focused more as it is cheap and can be equally effective in producing almost same results as other related methods used for identification and sex determination in particular unknown cases. Keywords: Sex determination, Lip prints, Medicolegal importance.
Wound Healing in Diabetic Patients
Authors: Bilal Muhammad , Hanan Abdul , Bashir Muhammad Saleem , Basit Muhammad Shakeel , Abbas Muhammad Adeel
Published: January 2023

Introduction: Diabetes mellitus (DM) is a very common disease that results from the body’s inability to maintain blood glucose level within normal limits. Blood glucose levels are either too high or too low. One study shows that up-to 30% people with DM experience skin problems. If blood sugar levels are well controlled, the rate of wound healing and developing a severe infection is significantly less. Regarding management of wound in diabetic patients, keep wounds dry with meticulous dressing, limb elevation, protect the surgical fixation in splint or braces for an extended period of time and patient education to keep in touch wither consultant and promptly report any unusual discomfort, pain, wound discharge, soaking of dressing and systemic symptoms. Objectives: the objective of this study is to identify the risk of wound infection and rate of healing in diabetic patient. Materials and Methods: The study was conducted at orthopedic department of Gulab Devi hospital. It was a Cross sectional study. The data was collected from September 2021 to February 2022. Non–Probability purposive sampling technique was used. The data was collected from indoor of Gulab Devi Chest Hospital Lahore and informed consent was taken from all the patients. The target populations were those who have diabetes mellitus and treated in orthopedic ward at Gulab Devi hospital Lahore. Diabetic patients enrolled in the presented study n=60. Results: our patient population was 28 to 55 year old with mean age 40years. 83% were in 35 to 40 age group. Wound problems were frequently encountered in patients with uncontrolled diabetes and 50% (n=30) of these patients had at least one wound complication after operation. And 71% (n=43) patients had increased pain and delayed recovery of their surgical wounds. When it comes to the relationship between bone health and diabetes, 63% (n=38) patients had history of previous bone fracture and 61% (n=37) patients had deformity of bone. Due to diabetic neuropathy 68% (n=41) patient were weight bearing on fracture site without concern. And the risk of diabetes include slow wound healing 75%. Practical implication; we aim to raise awareness among treating surgeons and physicians of patients presenting with diabetes and planning to undergo surgical intervention. Meticulous wound care and strict control of blood sugar levels are paramount to successful outcome. Conclusion: Diabetes mellitus is a systemic disease associated with uncontrolled blood sugar levels with systemic manifestations. Our study has proved an association of high wound complication with DM patients. Strict diabetic control as well as extra vigilance and meticulous techniques are needed to prevent complications in this group of patients. Keywords: Diabetes mellitus, infected wound, diabetes complications, wound healing
Risk Factors Causing Unintentional Home Injuries in Children Under 5 Years of Age Presenting to Emergency Department of Ziauddin University Hospital
Authors: Khan Hira , Aiman Hifza , Ehsan Shaista , Qureshi Afreena , Bukhari Syed Ibrahim , Faheem Sana
Published: January 2023

Objective: To determine the predisposing factors contributing to unintentional home injuries in children under 5 years of age presenting to Emergency department of Ziauddin medical university and hospital, Karachi Place and duration of study: The study is conducted at Department of Emergency, Ziauddin Medical University and Hospital, Karachi And the duration of study is 13th October 2019 To 12th April 2020. It is a cross-sectional study design having having 200 patients, in which non-probability consecutive sampling technique is used. Material and Method: There were 200 patients in total with Injuries that happened at home environment. Mothers participated in an interview. After each child received the recommended care, data were gathered.Calculated descriptive statistics were used. Stratification was used to manage effect modifiers. The chi-square test was used after stratification. P-values lower than 0.05 were regarded as significant. Results: There were 46% male and 54% female patients. Mean age was 35.02±13.79 months. Most of the children were injured >3 times in last one month. 57% patients were found with injury due to falling down while most of the injuries (32.5%) were occurred at stairs. In our study, 39% of children caused injury due to lack of care, 11.5% due to availability of hazardous material and 49.5% due to unsafe home environment. Practical implications: From the standpoint of injury prevention, this study suggests that the risk of non-fatal injury in children under the age of five is complicated and multidimensional, and that effective prevention measures must target numerous components. To effectively increase children's comprehension of the safety issue and lower their risk of hazard, health care providers, parents, or both should design alternative strategic teaching methods. Conclusion: Most prevalent cause of injury was falling down. 39% children injured due to lack of care, 11.5% due to availability of hazardous material and 49.5% due to unsafe home environment. Keywords: Unintentional Home injuries, Children, predisposing factors, falling down, Injuries