bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFECT OF TRANSCUTANEOUS ELECTRICAL NERVE STIMULATION IN PAIN REDUCTION AND VENOUS BLOOD FLOW AUGMENTATION IN VARICOSE VEIN PATIENTS
Authors: Munir Hina , Ali Shazia , Siddique Abubakar , Safdar Saira , Waqas Sobia , Kiani Jameel Ahmed
Published: July 2024

Background: Patients with varicose veins experience pain in affected leg which is due to venous blood stasis in the lower limb therefore it is essential to determine the severity of pain along with venous blood flow in the affected area. For this purpose the study was conducted to observe the effect of Transcutaneous Electrical Nerve Stimulation for pain reduction and venous blood flow augmentation. Methods: In this study, 80 subjects were included which were divided into Group A (Healthy controls) n=40 and Group B (Varicose vein patients) n=40 which was further subdivided into Group 1 (Varicose vein controls) and Group 2 (Transcutaneous Electrical Nerve Stimulation application). Numeric Rating Scale was used to measure pain score and Duplex Ultrasound was done to measure popliteal vein peak flow velocity (Cm/Sec) and blood flow (mL/min) in both Group A, Group 1 and Group 2 (before and after experiment). Results: The Mean±SD of Numeric Rating Scale (NRS) in Group 2 (5.56±0.651) was statistically significantly reduced (p=0.004) as compared to Mean±SD in Group 1 (7.36±0.757).  Similarly the Mean±SD of popliteal vein peak flow velocity (15.20±1.42) and popliteal vein blood flow (93.08±5.049) was statistically significantly raised (p=0.001) as compared to mean±SD of popliteal vein peak flow velocity (10.06±1.31) and popliteal vein blood flow (71.04±2.894) in Group 1. Conclusion: TENS can be used as an effective adjunctive treatment modality in patients suffering from varicose veins.
Pak J Physiol 2021;17(2):31–4
DEMOGRAPHIC AND CLINICAL FEATURES OF CHILDHOOD IDIOPATHIC EPILEPSY AT TERTIARY CARE HOSPITAL OF PAKISTAN
Authors: Shah Sajid Hussain , Aalia Bibi , Raza Mohammad Ali , Najeeb Shahzad , Gillani Saima , Aitazaz Fauzia
Published: July 2024

Background: Recent increase in number of children diagnosed with epilepsy raised the need to find out and report the demographic and clinical features of childhood idiopathic epilepsy at a tertiary care hospital. Methods: Cross sectional study conducted at Ayub Teaching Hospital from July 2018 to June 2020. Patients aged 1–14 years of either gender diagnosed as idiopathic epilepsy were included from paediatric outpatients, admitted cases and private clinics. Patients with cerebral palsy, dysmorphism and microcephaly were excluded. Demographic data, birth and developmental history details, age of onset of seizures, family history of epilepsy and febrile seizures were documented. Electroencephalograms (EEGs), brain imaging (CT scans and MRIs), where available. Data was analysed at SPSS-20. Results: For total 83 (65% males), Mean±SD of age was 6.60±3.64 years. Majority (63.9%) were older than 5 years. Family history of epilepsy and febrile convulsions was positive in 30.1% and 14.5% respectively. Most commonly used drug for seizure control was valproic acid (84.3% patients). Brain CT scan was done in 25.3%, MRI in 16.9% patients, and EEG in 57.8%. Positive family history of febrile seizures was significantly associated with (p<0.05) idiopathic epilepsy in males. Conclusions: Idiopathic epilepsy affects mostly children above 5 years of age. EEG is the most common investigation performed. When done brain imaging was normal. Valproic acid remains the most commonly used solo antiepileptic in both genders. Male patients are at higher risk of developing idiopathic epilepsy especially if family history of febrile seizures is present.
PROGNOSTIC SIGNIFICANCE OF TUMOUR THROMBUS CONSISTENCY ON CANCER-SPECIFIC SURVIVAL IN RENAL CELL CARCINOMA PATIENTS
Authors: Farid Tauheed , Farid Nayab , Izhar Muhammad , Asmat Sara , Humayun Sidra , Ali Mohsin
Published: July 2024

Background: Different studies have focused upon patients suffering from renal cell carcinoma (RCC) with inferior vena cava tumour thrombus. One biotic feature of renal RCC is venous system invasion. Both renal vein and inferior vena cava may be involved. The aim of current study was to evaluate the prognostic significance of the extent of thrombus in renal cell carcinoma patients with involvement of inferior vena cava. Methods: A total of 413 individuals were recruited in the study. All collected data were analysed retrospectively. Radical nephrectomy along with tumour thrombectomy was performed in all the participants. The pathological specimens were analysed for morphological feature, i.e., solid vs friable thrombus. To established clinicopathological predictor, Kaplan-Meier estimate and Cox regression analyses were done. Results: Friable and solid venous tumour thrombus (VTT) were found in 188 (46%) and 225 (54%) patients, respectively. For solid VTT, the Median Cancer Specific Survival (CSS) was 50 months while for friable VTT, the median CSS was 45 months. Thrombus consistency had no significant association with clinical features such as metastatic spread, pathological stage, perinephric fat invasion, and higher Fuhrman grade. Both survival analysis and Cox regression failed to be considered as a prognostic marker for CSS. Conclusion: Thrombus consistency appears not to be independently associated with survival in patients suffering from RCC.
COVID-19 VACCINES BOOSTERS: A DOOR WAY OF TREATMENT?
Authors: Hassan Taimoor , . Saleha , Saeer Sana
Published: July 2024

As of September 20, 2021, the entire planet has reported 218.5 million COVID-19 cases, with 4.52 million fatalities. Lockdowns and softening measures have been thrown into turmoil throughout the world since the outbreak. Our social life will only return to normal once an appropriate vaccine is produced and proper authorized preventive techniques are implemented. To tackle this pandemic, governments and health experts all around the globe are experimenting with a range of measures and preventative strategies. Certain countries are considered to be more successful than others in terms of providing safety to their inhabitants and increasing their economic activities. A plethora of vaccinations have been produced, and a research anthology has been published. However, medical personnel are still searching for a viable treatment to limit this pandemic.
FOKI VITAMIN D RECEPTOR POLYMORPHISM AS A PREDICTOR OF RESPONSE TO HEPATITIS C ANTIVIRAL TREATMENT
Authors: Al-Aqmer Noora Hassan Hezam , Zulfiqar Soumble , Zulfiqar Sibgha , Shakoori Abdul Rauf , Izhar Mateen
Published: July 2024

Background: FokI vitamin D receptor (VDR) genotype ff has been debated as predictor of response to treatment. This study was designed to find out the association of FokI VDR polymorphism with response to chronic hepatitis C daclatasvir- and sofosbuvir-based treatment. Methods: This case control study was conducted at Federal Postgraduate Medical Institute, Lahore from Jan 2019 to Apr 2021. It included 66 chronic hepatitis C genotype 3 patients who responded to daclatasvir and sofosbuvir-based treatment (with ribavirin for cirrhotic patients) and attained sustained virologic response (SVR) three months after complete treatment, and another 66 gender and age matched chronic hepatitis C genotype 3 patients who did not respond to the treatment. Demographic data was collected and 3 mL of blood was drawn from each participant. DNA extraction was done followed by PCR-restriction fragment length polymorphism. Samples were run on 12% polyacrylamide gel and visualized under UV light. Data was analysed using SPSS-24. Results: Frequencies of FokI VDR genotypes FF, Ff, and ff were 54.5%, 28.8%, and 16.7% in responders, and 60.6%, 36.4%, 3.0% in non-responders. There was a significant association between FokI VDR polymorphism and response to treatment (p=0.03). No significant association was found between FokI polymorphism and cirrhosis. Logistic regression showed FokI genotype ff to be a significant predictive factor for a SVR (p=0.041). Conclusion: FokI VDR polymorphism is associated with response to daclatasvir- and sofosbuvir-based antiviral treatment in chronic hepatitis C genotype 3 patients. FokI genotype ff could be considered as a predictive marker for response to treatment.
HOUSEHOLD CHAOS, MENTAL HEALTH AND SOCIAL ADAPTIVE FUNCTIONING OF ADOLESCENTS
Authors: Rehman Sadia , Aziz Saadia
Published: July 2024

Background: Management of disturbances becomes hard due to level of chaos that promptly affect the mental health and social adaptive functioning of an adolescent. Mental health plays an important role in the cognitive functioning of an individual. Social adaptive functioning is linked with academic performance and personal working of an individual. The immense and enduring effects of these variables among adolescents may cause the psychological and physical impairment. Objective of this study was to observe the relationship among household chaos, mental health and social adaptive functioning.  Method: Correlational study method was used to assess the relationship among all the variables. Convenient sampling technique was used to collect the data. Confusion hubbub and order scale, mental health inventory and child and adolescents social adaptive functioning scale were used to measure the study variables. Results: Correlational analysis showed significant negative correlation of household with mental health and social adaptive functioning. Regression analysis showed that household chaos significantly predicts mental health and social adaptive functioning of adolescents. Significant differences were also observed between boys and girls in perceived household chaos. Conclusion: Adolescents who have high level of chaos at home suffer from mental health issues and lack of social adaptive functions. Findings have implications for parents, health professionals and academicians. Reducing chaos at home can lead to improvement in well being and enhance social adaptive functioning of adolescents.
Pak J Physiol 2021;17(4):72–4
COMPARISON OF EFFECTS OF PROBIOTICS AND SITAGLIPTIN ON SERUM GLUCOSE IN DIABETIC RATS
Authors: Barki Fatima Muhammadi , Waheed Akbar , Rehman Alia , Salim Salma , Iftikhar Rabia , Munawwar Rukhsana
Published: July 2024

Background: Diabetes mellitus has become a major disease having catastrophic effects on health and economy globally. This study was conducted to determine the role of Probiotics in comparison to Sitagliptin in decreasing serum glucose levels in diabetic rats. Methods: Fifty male rats were divided into two groups: Normal control group-A (n=10) and Experimental group-B (n=40). Group-B was administered Streptozotocin to induce diabetes, which was confirmed after one week by measuring Fasting Blood Glucose (FBG) (>7 mmol/L were considered diabetic). Then group B was subdivided into BI (Diabetic Control), BII (Sitagliptin treated), BIII (Probiotics treated) and BIV (Sitagliptin plus Probiotics treated) with 10 rats each. Baseline serum glucose was measured at day zero. Next sampling was done on day 40, after administering Probiotics (250 mg/Kg) and Sitagliptin (10 mg/Kg). Terminal sampling was done on day 60. Statistical analysis was done on SPSS-21. Comparisons between the groups were analysed using one-way ANOVA (post-hoc Tuckey test), and p<0.05 was considered statistically significant. Results: Rats in Probiotic treated group-BIII had significant reduction in fasting blood glucose levels with efficacy comparable to Sitagliptin in group-BII (p<0.05). Synergistic effect of Sitagliptin plus Probiotics in group-BIV was greater (p<0.05) than their individual effects in groups-BII and BIII. Conclusion: Probiotics significantly decrease fasting blood glucose in diabetic rats with efficacy comparable to Sitagliptin. Synergistic effect of Sitagliptin plus Probiotics is greater than their individual effects.
Pak J Physiol 2021;17(4):27?30
TRAUMATIC BRAIN INJURY ASSESSMENT USING GLASGOW COMA SCALE: A LITERATURE REVIEW
Authors: Mustaq Shumaila , Bibi Tahira , Sharif Maria , Yousef Nazia
Published: July 2024

Objective: The objective of this study was to analyse the Glasgow Coma Scale (GCS) reporting and recognize causes for inaccuracy of GCS implications. Literature selection and critical appraisal: Literature search was carried out by using specific keywords on PubMed, Google Scholar, and Science Direct. The GCS definitions, present status of GCS reporting, frequency and time of assessment, assessment schemes and confounders were critically analysed. Results: More than 90% of the publications using GCS scoring cite the 14-item GCS rather than the 15-item GCS. The timing of the initial GCS assessment is inconstant. GCS components are seldom utilized, contributing to the loss of information. Confounders are often not reported and, if they are, not in a standardized manner. The order of the GCS components is not consistent. Conclusion: The current inconsistent and inappropriate use of GCS diminishes its reliability in both clinical and scientific context. A consensus statement is needed to correct this situation. Citing the correct references, early and repeated GCS assessments at defined intervals, standardized reporting of confounders and GCS component and scores. Utilization of a uniform assessment scheme is recommended.
Pak J Physiol 2021;17(4):75–80
SERUM LEAD LEVELS IN FEMALE AGRICULTURAL FARM-WORKERS FROM BAHAWALPUR, PAKISTAN
Authors: Raziq Muhammad Abdul , Khan Muhammad Imran , Sipra Muhammad Wajid Khurshid , Iqbal Tehseen , Tariq Sundus , Aslam Maria
Published: July 2024

Background: Lead (Pb) is a heavy metal present in our environment in soil, drinking water, air, petroleum products, insecticides and pesticides, and is excreted in body secretions like breast milk, saliva, semen, and sweat. We studied serum lead levels in lactating female farm workers of Bahawalpur who are exposed to various chemicals that contain lead arsenate. Methods: This study was conducted in the Department of Physiology, University of Health Sciences, Lahore after approval from the Ethical Review Committee. After informed consent, blood samples of 2.5 ml each from a total of 91 lactating mothers were collected. Serum lead levels were determined by Inductively Coupled Plasma Spectrophotometry (ICP). Results: High lead levels were detected in 90 out of 91 (98.90%) women. Mean serum lead levels were 61.05±29.59 µg/L. Conclusion: The serum lead level was considerably higher than the WHO allowable level in our study population.
Pak J Physiol 2022;18(1):36?8
CLINICAL PROFILING AND OUTCOME OF ACUTE POST-STREPTOCOCCAL GLOMERULONEPHRITIS IN CHILDREN FROM A TERTIARY CARE CENTRE
Authors: Raza Muhammad Ali , Gillani Saima , Sadaat Shazia , Munazza Bibi , Tauqeer Shazia , Naz Raisa
Published: July 2024

Background: Childhood throat and skin infection caused by group A beta haemolytic streptoccus is very common and is associated with many complications. Objectives of this study were to document the clinical profile of children with Acute Post-Streptococcal Glomerulonephritis. Methods: This cross-sectional study was conducted in Paediatrics Department of Ayub Teaching Hospital Abbottabad from March 2019 to March 2020. Total 56 patients fulfilling inclusion criteria were included in the study, data was recorded and analysed on spss-20. Descriptives recorded and p-values calculated. Results: APSGN was common (53.57%) in 7–11 years age group with a peak at 9 years. It was more common in males (62.5%). Minimum age was 3 years and maximum was 16 years, mean age being 8.72±2.762. Preceding sore throat triggered immune response in 33.9% in comparison with past streptococcal skin infection in 19.7%. ASO titres were raised in 42.9%. Hypertension was most common presentation affecting 96.4% patients followed by oedema in 67.9%. Atypical presentations of seizures and hypertensive encephalopathy were observed in 28.6%. Gross haematuria and microscopic haematuria occurred in 41.1% and 42.9% patients respectively. Majority (87.5%) did not develop acute kidney failure. Conclusion: APSGN in children has a male predominance. Sore throat as antecedent infection affects older children and is more common as compared to skin infection in triggering this immune response. Atypical manifestations, cardiac and neurological complications including emergencies such as status epilepticus should be watched for. 
Pak J Physiol 2022;18(2):43?6
IMPACT OF SARS-COV-2 ON FRONTLINE HEALTHCARE WORKERS IN AZAD KASHMIR: A MULTICENTRE SURVEY
Authors: Ehsan Ambreen , Zubair Maryam , Shabir Nosheena Akhtar , Pirzada Hina , Yaqoob Umairah , Islam Abida , Hanif Shafaq , Azeem Zahid , Awan Zahid Iqbal , Ubaid Muhammad Furqan
Published: July 2024

Background: Healthcare workers (HCWs) are especially prone to contracting SARS-CoV-2 infection due to their work requirements. This study was conducted to analyze the frequency of SARS-CoV-2 infection among frontline healthcare workers and various predictive factors of this infection in healthcare workers. Methods: This was a descriptive cross-sectional study. Data was collected at Obs/Gyn Department, Sheikh Khalifa Bin Zayed Al-Nahyan (SKBZ)/Combined Military Hospital Muzaffarabad, from Main Covid-19 Pandemic Data Collection and Information Centre, Muzaffarabad, from 15th April to 14th October 2021. Screening was offered to healthcare professionals and other supporting staff of all hospitals dealing with SARS-CoV-2 infection. Information was recorded on a structured questionnaire. Categorical variable were explained by frequency. Fischer exact test and ?2 test were used, and p<0.05 were considered significant. Results: There are 4,776 healthcare workers in AJK. A total of 2,219 individuals were COVID positive, out of them 118 were healthcare workers. Males were 53% and females were 47%; 77% of cases were aged 25?50 years. Physicians were 51.7% outnumbering nurses and allied staff. The cumulative incidence was 2.4%. Infection rate among frontline HCWs was 1%; it was 1.6 among HCWs in other departments, and 0.5% in HCWs with no patient contact. The rate of co-morbidities in affected HCWs was 33.05%. Conclusion: The risk of disease was high among frontline healthcare workers as compared to general population. The severity of infection was more in patients with co-morbidities. Among HCWs, the highest number of patients with COVID-19 were physicians.
Pak J Physiol 2022;18(2):58–61
CORRELATION OF SERUM GALECTIN-3 LEVELS WITH EJECTION FRACTIONS IN HEALTHY SUBJECTS AND HEART FAILURE PATIENTS
Authors: Shaukat Sidra , Nadeem Amina , Mazloom Fauzia , Rameez Rubab , Shaukat Sadia
Published: July 2024

Background: High Galectin-3 levels are indicative of severity of heart diseases and are associated with increased risk of major adverse cardiovascular events including heart failure. The objective of this study was to determine correlation between ejection fraction and serum Galectin-3 levels recorded by simple and quick test. Methods: This cross-sectional analytical study was conducted at the Armed Forces Institute of Cardiology (AFIC) Rawalpindi. Thirty (30) healthy adults and 60 heart failure patients were selected through randomised sampling. Diagnosed cases were classified using modified NYHA classification. Group 1 included healthy adults, Group 2 included 30 mild heart failure subjects of NYHA class I and II, Group 3 included 30 severe heart failure subjects of NYHA class III and IV. Ejection fraction was recorded at AFIC with trans-thoracic echocardiography in supine and left lateral positions. Blood samples of the participants were used for estimation of Galectin-3 by ELISA using human serum Galectin-3 ELISA kit Catalogue No.  E1951Hu (Bio Assay technology). Observations were recorded on proforma, Pearson’s correlation test and ANOVA were performed using SPSS-24. Results: The LVEF was 70.7±2.78% in Group-1, 59.3±3.4% in Group-2, and 38.96±12.27% in Group-3. The LVEF showed a substantial negative correlation with serum Galectin-3 levels (r= -0.630, p<0.001). Conclusion: There is a significant negative correlation between Serum Galectin-3 and extent of functional changes of left ventricle recorded by Ejection fraction on echocardiography.
Pak J Physiol 2022;18(2):28–30
EFFECT OF GHRELIN IN ALLEVIATING NICOTINE INDUCED OXIDATIVE STRESS IN BALB/C MICE
Authors: Kiyani Hira Pervez , Ahsin Sadia , Imran Madiha , Ashraf Hira
Published: July 2024

Background: Ghrelin, a hormone released from GIT mucosa is known to have antioxidant properties by increasing the levels of antioxidant enzymes and by preventing lipid peroxidation. The current study was designed to demonstrate the protective role of ghrelin against nicotine induced oxidative stress and lipid peroxidation in BALB/c mice. Methods: Ninety healthy, male BALB/c mice selected through non probability convenient sampling were sorted out into three groups having 30 mice each. Group I (control group) was given intraperitoneal injection of normal saline (i.p.). Group II was given nicotine at a dose of 2.5 mg/Kg body weight (i.p.), while Group III was given nicotine at a dose of 2.5 mg/Kg body weight (i.p.) along with ghrelin at a dose of 10 µg/Kg (i.p.) on alternate days for 4 weeks. On 30th day sampling was done for assessment of serum levels of oxidative stress enzymes (superoxide dismutase, glutathione reductase and catalase levels) and lipid peroxidation marker (malondialdehyde) on ELISA. Data was analysed using SPSS-24. ANOVA followed by post Hoc Tukey test were applied and p?0.05 was considered significant. Results: Nicotine group showed significant decrease in serum antioxidant enzymes along with significant increase in lipid peroxidation marker. Administration of ghrelin significantly raised the antioxidant enzymes and caused decline in levels of lipid peroxidation marker. Conclusion: Ghrelin appears to be an antioxidant due to its ability to increase the levels of antioxidant enzymes and decrease lipid peroxidation marker in nicotine-induced oxidative stress.
Pak J Physiol 2022;18(3):3?6
DIAGNOSTIC ACCURACY OF FOCUSED ASSESSMENT WITH SONOGRAPHY IN TRAUMA FOR VISCERAL INJURIES IN BLUNT ABDOMINAL TRAUMA PATIENTS KEEPING CT AS GOLD STANDARD
Authors: Siraj Syeda Komal , Akram Faiza , Shah Syed Salahuddin , Khan Waheed , Zeb Saima
Published: July 2024

Background: Blunt abdominal trauma is common and is associated with intra-abdominal injury. Focused assessment with sonography in trauma (FAST) is extremely sensitive and specific test for the diagnosis of visceral injury in such patients with added benefit of quick scan and bedside availability. This study was conducted with an aim to establish the diagnostic accuracy of FAST for diagnosing visceral injuries in blunt abdominal trauma patients. Methods: This study involved 247 patients of both genders aged 18–60 years, referred to Department of Diagnostic Radiology with history of blunt abdominal trauma. All these 247 patients underwent FAST and CT abdomen. The results of CT scan were taken as gold standard and those of FAST were judged accordingly as true/false positive/negative. Results: Visceral injury was diagnosed in 167 (67.6%) patients on FAST while CT scan confirmed visceral injury in 165 (66.8%) patients. There were 155 true positive, 12 false positive, 10 false negative and 70 true negative cases which yielded 93.94% sensitivity, 85.37% specificity, 91.09% accuracy, 92.81% positive predictive value and 87.50% negative predictive value for FAST in detecting visceral injury. Conclusion: FAST is fairly sensitive, specific, and accurate in diagnosing visceral injury among blunt abdominal trauma. Its non-invasive, radiation-free nature, and widespread bedside availability advocate its preferred use in place of CT in diagnosis of visceral injury in blunt abdominal trauma cases.
Pak J Physiol 2022;18(3):7?10
MYTHS AND MYSTERIES ABOUT COVID-19: LESSONS FOR PAKISTAN
Authors: Iqbal Tehseen
Published: July 2024

The COVID-19 pandemic is an ongoing global pandemic. Although experts first identified coronaviruses in the mid-1900s, they have likely been circulating in human populations for thousands of years. The major countries have been accused by each other of spreading this virus in the world intentionally or by accident. Some studies reported that this virus has a potential to become a bioweapon. Professor Sachs said that origin of COVID-19 should be looked into. Sir Jeremy Farrar suspected that the virus was man-made. During this debate, origin of COVID-19 remains a mystery. The Sane Advice by World Health Organization is that countries need a public health system that can respond to the deliberate release of chemical and biological agents.         Present day war is fought on many fronts. So, all sections of society should be vigilant and respond effectively when need arises.
ASSOCIATION OF GREEN TEA WITH PREMENSTRUAL SYNDROME —AN OBSERVATIONAL STUDY IN YOUNG GIRLS
Authors: Javaid Sana , Abbasi Sana Qanber , Rizvi Iqtadar Ali , Jamil Nazish , Ahsan Rabia , Mansoor Ghazal
Published: July 2024

Background: Premenstrual syndrome (PMS) is a health problem worldwide and involves both physical and psychological/behavioural symptoms. The objective of this study was to find out any association between green tea intake and physical symptoms of PMS among young medical and dental female students. Methods: This cross-sectional observational study was conducted at University College of Medicine and Dentistry, University of Lahore. The study included 100 female medical and dental students, selected with convenience non-probability sampling technique, aged 18–26 years; 78 of them had premenstrual physical symptoms. Data were collected on a self-administered and preformed proforma. All participants were advised to take green tea (3 cups/day) for 3 months. The data were entered and analysed using SPSS-24. Results: Mean age of females suffering from physical symptoms of PMS was 22±1.6 years and the mean weight was 60.5±7.7 Kg. Abdominal bloating was the most common symptom affecting 48.7% of the PMS sufferers. The second most common symptom was acne in 32.1% of the subjects. After three months of green tea intake, the study participants were re-evaluated. There was a significant improvement in all physical symptoms of PMS (p=0.001). Conclusion: Consumption of green tea was associated with a decrease in the physical symptoms of PMS.
Pak J Physiol 2022;18(4):3?6
MATERNAL COPING STRATEGIES AND BEHAVIOURAL PROBLEMS OF CHILDREN WITH DOWN SYNDROME
Authors: Jameel Rabia , Malik Farah
Published: July 2024

Background: Coping strategies are the behaviours, thoughts, and emotions that are used to adjust to the stressful situation and changes that occur in the life. Mothers’ coping can affect the behavioural problems of children with Down syndrome. The present study examined the relationship between maternal coping strategies and behavioural problems of children with Down syndrome. Method: The sample comprised of 54 mothers with age range 25–52 years, and 54 children with age range 6–18 years. This was a correlational research study using purposive sampling strategy from different government and private special education institutes of Lahore. Mothers responded to two instruments, the Cope Inventory and Child Behavioural Checklist. Children responded to Colour Progressive Matrices, and it was used to assess their ability to recognize and think logically. Results: The results revealed significant negative association of emotion-focused coping and children’s behavioural problem, while significant positive association of recently developed coping and children behavioural problem. Additionally, recently developed coping, family size, and mothers’ education were the significant predictors of behavioural problems of the children. However, results showed non-significant gender differences of behavioural problems. Conclusion: Emotion-focused coping and recently developed coping are connected with behavioural problems of children. Recently developed coping, family size, and mothers’ education are the significant predictors of children’s behavioural problems. Behavioural problems are not affected by gender.
Pak J Physiol 2022;18(4):22–6
ULTRASOUND GUIDED ASPIRATION VERSUS ASPIRATION AND ABLATION OF OVARIAN CAVITY WITH METHOTREXATE
Authors: Azmat Sania , Taimoor Alruba , Nazir Aamir , Khan Rakhshanda Inam , Saleem Umme Aimen , Ayub Sadia
Published: July 2024

Background: An ovarian cyst is a fluid filled sac formed in ovaries in 20% of females during their lifetime. The objective of the study was to compare the efficacy of ultrasound guided aspiration and ultrasound guided aspiration with ablation of cavity with methotrexate in treatment of ovarian cysts. Methods: This randomized controlled trial was designed and conducted in the Department of Obstetrics and Gynaecology, Gomal Medical Teaching Hospital, Dera Ismail Khan, Pakistan  from 1st Jun 2019 to 30th Nov 2019. Eighty-eight women with ovarian cysts were randomly included with lottery method. The subjects were divided into 2 equal groups. The subjects in group A were subjected to ultrasound guided aspiration. The subjects in group B were subjected to ultrasound guided aspiration with ablation of cavity with methotrexate. Data was analysed on SPSS-22. Frequencies and percentages were computed for qualitative variables like efficacy. Mean±SD was presented for quantitative variables like age, size and duration of cyst. Chi-square test was applied to compare efficacy in both groups. Post stratification using Chi-square test for both groups was also applied. The results with p?0.05 were considered statistically significant. Results: Efficacy was seen in 81.8% patients in group A as compared to 97.7% in group B (p=0.01). Conclusion: Transvaginal ultrasound guided aspiration and in situ methotrexate injection is simple, non-invasive and effective in the treatment of selected cases of simple ovarian cyst without evidence of malignancy.
Pak J Physiol 2023;19(1):11-13
COMPARATIVE ANALYSIS OF BIODISPOSITION OF DIFFERENT ISOMERS OF TOCOPHEROLS
Authors: Sharif Mahjabeen , Khan Dilshad Ahmed , Farhat Kulsoom , Noor Mudassar , Khan Mohammad Asghar , Rafique Saima
Published: July 2024

Tocopherols are indicated as adjuvant therapy in metabolic disorders, various types of carcinomas and as neuroprotective and cardioprotective agents. Their use is limited due to poor water solubility, variable absorption and low bioavailability. This study was undertaken to compare the biodisposition or pharmacokinetic parameters of different isomers of tocopherol. This systematic review explored the possible underlying causes of poor bioavailability of tocopherols. A computerized database search was done till 11th January 2022 through Pubmed, Google Scholar, PakMediNet, and open Google Search by using MeSH keywords: pharmacokinetics, biodisposition, bioavailability and tocopherol. Boolen operators were also used to retrieve original articles like tocopherol AND bioavailability, tocopherol AND pharmacokinetics. Only original research articles that provided information about pharmacokinetics of tocopherol in healthy human volunteers were included. This systematic review was carried out following the Preferred Reporting Items for Systematic Review and Meta Analysis (PRISMA) guidelines, and 510 original research articles were retrieved from literature. After eliminating the duplicate studies, 20 articles fulfilled the eligibility criteria, 6 original articles were selected for data extraction. Pharmacokinetic parameters of ?-tocopherol in terms of area under curve, time to achieve peak plasma levels, maximum plasma concentration and elimination half-life were found to be better than ?, ? and ? isomers of tocopherols. Bioavailability of ?-tocopherol was highest amongst all the isomers of tocopherols. In various clinical implications ?-tocopherol may be preferred over other isomers due to its greater bioavailability for better therapeutic response.
Pak J Physiol 2023;19(1):37–42
BENEFITS AND DISBENEFITS OF ONLINE TEACHING DURING THE PANDEMIC: STUDENTS’ LEARNING EXPERIENCE
Authors: Khan Samia Perwaiz , Shaikh Maham Sohail , Hamidani Mohammad Arqam Ashraf , Raja Inshrah Hanif , Mubeen Sara , Naqvi Sadaf Fatima
Published: July 2024

Background: Virtual teaching approach includes combination of e-learning technology with traditional instructor-led training as online classes. The study explores the benefits, dis-benefits of online teaching for medical and dental undergraduate students and assesses how to overcome the challenges to online medical education during the pandemic. Methods: It was a cross-sectional study. The sample size was 150 including 100 MBBS and 50 BDS students of Jinnah Medical and Dental College, Karachi. The participants were enrolled in study through convenience sampling technique. Through a questionnaire-based survey conducted in the year 2021 benefits, dis-benefits of virtual teaching and learning of pharmacology as well as the difficulties faced by the participants, were assessed. The questionnaire was developed and pilot testing was done on 20 medical students. The data was analysed using Chi-square test. Results: The overall results of this study were not up to the mark and dis-benefits experienced by the participants in this study were high. This study also highlights certain issues including technical issues of internet interruptions/ bandwidth (92%), disturbances during the online sessions (79%), missing the interactive dialogues with lecturers (75%), missing end of session revision (67%), quality issues of recorded lectures (66%), short duration of online sessions (44%).  Conclusion: The online teaching during COVID-19 pandemic lockdowns had been effective in filling-in the gaps. It also highlights the areas that need to be addressed to overcome the shortcomings in order to further improve the benefits and effectiveness of online learning.
Pak J Physiol 2023;19(1):33–6
COMPLIANCE WITH STANDARD THROMBOPROPHYLAXIS GUIDELINES AGAINST VENOUS THROMBOEMBOLISM IN ACUTE MEDICAL WARDS —A SINGLE CENTRE EXPERIENCE
Authors: Mehr Muhammad Tariq , Humayun Sidra , Nisa Qamar Un , Raza Shehrbano , Jadoon Ali Qaisar , Farooq Ghulam
Published: July 2024

Background: Venous thromboembolism (VTE) prevention in hospitalized patients is primarily based on adequate risk stratification, but the recommended prophylaxis for associated risk factors are not adequately utilized. Objective was to estimate the implementation of the standard international VTE prophylaxis guidelines in acutely ill patients in medical wards of Hayatabad Medical Complex (HMC), Peshawar. Methods: This study was conducted in HMC (1st April to 31st December, 202), to determine the proportion of patients receiving appropriate VTE prophylaxis according to ANZ WP recommendations, based on their risk profiles. The modalities employed for prevention were Compression Stockings alone, Anticoagulation alone or use of both. Random sampling technique allowed inclusion of 600 patients from medicine department, HMC. Results: Out of the 600 patients, 336 were female while 264 were male. Patients stratified as High Risk were 72% while 28% as Low Risk group. Risk factors observed were age >60 years (43.05), past history of stroke with neurological deficits (64.12%), admission with lung disorders (18.05%) and those with active cancers 6.01%. A total of 57.6% were found to be receiving VTE prophylaxis with 54.2% in High Risk group while 45.8% in low risk group. Amongst the patients receiving VTE prophylaxis, 20.80% patients were receiving both modalities, 49.30 were having TED Stockings alone, while 29.90% were receiving anticoagulation alone. Conclusion: The international standard guidelines for thromboprophylaxis were observed to be poorly followed in our hospital which calls for strategies to identify high risk individuals and initiation of appropriate prophylaxis. 
Pak J Physiol 2023;19(1):29–32
EFFECT OF CUSCUTA REFLEXA EXTRACT ON GASTROINTESTINAL MOTILITY
Authors: Iqbal Sohail , Ali Mohsin , Sultana Ulfat , Gul Saddiqa , Malook Irfan , Ali Amjad
Published: July 2024

Background: Motility disorders of the gut are one of the major challenges to the medical profession. The stem of Cuscuta reflexa had been used by traditional practitioners for the treatment of gastrointestinal and bilious disorders. The objective of the current study was to determine the effects of an extract of C. reflexa on carbachol-induced contractions of isolated rabbit ileum. Methods: The study was conducted from January to July 2020 at Department of Pharmacology, Muhammad College of Medicine, Peshawar after approval from the Ethical Committee of the College. The sample size was calculated using the ‘Degree of Freedom in Anova’ formula. The rabbit’s ileum tissues were dissected and divided into two main groups, and each was further divided into three subgroups. Each subgroup consisted of six isolated rabbit’s ileum tissues. After equilibration and stabilization of tissues in an organ bath containing Tyrode’s solution, the effect of atropine and C. reflexa extract on carbachol-induced contractions in isolated rabbit’s ileum was recorded. Results were analysed statistically, and p?0.05 was considered significant. Results: Ethanolic extract of C. reflexa of different concentrations significantly decreased the amplitude of carbachol-induced contractions of rabbit ileum (p<0.05). The most powerful response of ethanolic extract of C. reflexa was observed at a concentration of 0.4 mg/ml. Conclusion: The ethanol extract of C. reflexa produces antimuscarinic effects on smooth muscles of the rabbit ileum.
Pak J Physiol 2023;19(2):10–4
MYOCARDIAL INFARCTION AMONG HOSPITALIZED PATIENTS WITH COMMUNITY ACQUIRED PNEUMONIA: A RETROSPECTIVE OBSERVATIONAL STUDY
Authors: Sultan Nadia , Miran Muhammad Shah , Mushtaq Fahad , Zahra Zainab , Haseeb Shahan , Sultan Shazia
Published: July 2024

Background: Pneumonia combined with influenza is a leading cause of death worldwide. There is an increased risk of acute myocardial infarction in patients with respiratory tract infection during hospitalization and after discharge. This study aimed to determine the frequency of myocardial infarction (MI) in hospitalized patients with community acquired pneumonia (CAP). Methods: A retrospective observational study was conducted at a tertiary care hospital in Islamabad, Pakistan. A total of 209 adult patients admitted from May 2018 to Dec 2020 with primary diagnosis of CAP were identified using local ICD code. Paper chart review for clinical parameters including symptoms, laboratory values, and radiological findings was performed. Severity of pneumonia was determined using CURB-65 score. Acute MI was diagnosed on elevated troponin and electrocardiogram findings. Univariate and multivariable analyses was performed for risk factors, co-morbidities, demographics, CAP severity at the time of admission, lab values and radiological findings and p<0.05 was considered statistically significant. Results: Males were 121 (58%) and females were 88 (42%) in the study. Incidence of acute MI in CAP patients was 10.52%. Only one patient experienced ST-elevation myocardial infarction (STEMI); the rest had non-ST-elevation myocardial infarction (NSTEMI). There was significant association between MI and history of ischemic heart diseases, angina, cardiomyopathy, acute kidney injury and pulmonary oedema (p?0.05). A significant increase in trend of acute MI was observed across the CURB-65 scores. Conclusion: The incidence of acute MI among hospitalized patients with CAP was 10.52%. Early recognition and prompt treatment will improve outcomes.
Pak J Physiol 2023;19(2):36?9
EFFICACY OF ORAL AZITHROMYCIN AND ORAL DOXYCYCLINE IN PATIENTS WITH ACNE VULGARIS
Authors: Iqbal Farah , Alam Muhammad Adeel , Tahir Muhammad , Qasim Muhammad , Ansar Momina , Mustafa Syed Hassan
Published: July 2024

Background: Acne vulgaris is a long-term skin disease characterized by blackheads or whiteheads, pimples, oily skin, and possible scarring. Systemic antibiotics have long been used as a treatment option in patients with acne. The aim of this study was to compare the efficacy of oral doxycycline vs azithromycin in patients with acne vulgaris. Method: It was a randomized controlled trial conducted in the Department of Dermatology, Lady Reading Hospital, Peshawar from 1st February to 30th July 2021. A total of 60 patients were enrolled in the study. Patients were randomized into 2 groups with Group A receiving azithromycin and Group B receiving doxycycline. Patients’ number of lesions was counted and followed for 4 months. A reduction in 80% of lesions was considered effective. Results: The mean age of the patients was 21.24±3.84 years. There were 16 female and 14 male patients in group A and 17 female and 13 male patients in group B. The majority of patients in both groups were found to have responded to the treatment showing good efficacy. Conclusion: Oral doxycycline and azithromycin were highly effective in patients with acne vulgaris. Efficacy of both drugs was similar to each other.
Pak J Physiol 2023;19(2):25–7
PROTECTIVE ROLE OF OLIVE OIL IN THE DOXORUBICIN INDUCED OVARIAN TOXICITY IN FEMALE RATS
Authors: Fareed Shahid , Kabir Muhammad , Hussain Shah , Batool Shahida , Khan Farooq , Badshah Jehan
Published: July 2024

Background: The pathophysiological effect of chemotherapy on female reproductive system is complex. The current study aimed to determine the protective effect of olive oil extract against doxorubicin induced ovarian toxicity in female rats. Methods: This was an analytical experimental randomized control study carried out in the Department of Anatomy, Peshawar Medical College. Twenty-four female rats weighing 200–250 g were included and were divided into 3 groups, i.e., control group, experimental group-I and experimental group-II. Animals were weighed at the beginning of the experiment and before their sacrifice. The ovaries were obtained after their sacrifice. Five (5) µm thick sections were cut and stained with H & E stain, and Massan Trichome to see the changes the ovarian follicles. Data was entered and analysed on SPSS-20. Independent sample t-test and Chi-square test were used to measure the difference between and within groups, and p?0.05 was considered statistically significant. Results: A significant increase in the mean weight of rats in control group and experimental group-II was observed (p<0.05) while a post-experiment significant decrease in the mean body weight of rats in experimental group-I was seen (p>0.05). There was no significant difference in number of primordial and secondary ovarian follicles within the groups (p>0.05) while a statistical significant difference in number on primary ovarian follicles, atretic follicles and nuclear fragments within the groups (p<0.05). Conclusion: The co-administration of olive oil has shown a protective effects against the doxorubicin induced ovarian toxicity in female rats.
Pak J Physiol 2023;19(3):31–5
STRESS HORMONE LEVELS AMONG CHILDREN BEREAVED BY TERROR ATTACK
Authors: Yousufzai Mohammad Irfan ul Akbar , Adil Raheela , Afaq Erum , Sajid Muhammad , Iqbal Tehseen , Gill Maria
Published: July 2024

Background: Terrorism is characterized by the use of violence against civilians, with the expressed desire of causing terror or panic in the population. Since the Soviet invasion of Afghanistan in 1979, the Khyber Pakhtunkhwa (formerly NWFP) province of Pakistan has suffered the most from unrest and terrorist activities. Terror related bereavement is more stressful and difficult to recover compared from that of bereavement from natural death. Methods: This retrospective study was carried out in the Department of Physiology, IBMS, Khyber Medical University, Peshawar, Pakistan. Salivary Cortisol Levels were estimated in Non-Bereaved and Bereaved Groups of children. Results: Children in the Bereaved Group showed a statistically significant (p=0.005) higher levels of salivary cortisol in the morning sample (Log Cortisol M=14.43) as compared with the children in the Non-Bereaved Group (Log Cortisol M=6.44). Children in the Bereaved Group showed a statistically non-significant (p=0.164) decrease in the levels of salivary cortisol in the post-dexamethasone sample (Log Cortisol M=8.85) as compared with the children in the Non-Bereaved Group (Log Cortisol M=4.25). Conclusion: Terror bereavement causes long-term activation of the Hypothalmo-Pituitary-Adrenal (HPA) axis, elevating the cortisol levels even 3–4 years after the traumatic bereavement. Chronic elevation of cortisol results in the manifestations of depression related signs and symptoms in bereaved children.
Pak J Physiol 2023;19(3):11–4
PERCEPTION OF FIRST-YEAR MEDICAL STUDENTS REGARDING SELF-DIRECTED LEARNING AND CONVENTIONAL LECTURING IN PHYSIOLOGY THROUGH ACTIVITY FEEDBACK
Authors: Naz Raisa , Tauqeer Shazia , Sammar Kinza , Naz Shabana , Ajmal Jaweria , Farhat Sahar , Ayub Muhammad
Published: July 2024

Background: In order to transform the healthcare professionals into lifelong learners, it is important to develop self-directed learning (SDL) skills in their early study years. Students engaged in SDL can complete their learning assignments and can be transformed into lifelong learners. The objective of this study was to evaluate the improvements in perception of students by integrating principles of SDL activity in conventional curricular system in a 4-week first-year MBBS respiratory module. Methods: It was a descriptive cross-sectional survey conducted in Ayub Medical College Abbottabad on First Year MBBS (2020–2021) batch, where the module coordinator assigned respiratory insufficiency case-based studies to 1st Year medical students. Students were asked to give response to 20 questions on standard questionnaire proforma. Students were asked to reflect on how this assignment affected their perception of SDL skills and improvement in learning. Students strongly agreed, agreed, neither agree nor disagree, disagree, and strongly disagree about the 20 responses on Likert scale. For simplification, descriptive parameters were modified to numerical values which were then used to analyze responses on MS Excel. Results: Feedback response rate was 80% (177, 99 males and 78 females). Frequency of responses was recorded both for conventional teaching (CT) and SDL. There was marked variation in responses, both for SDL and conventional method of teaching. Conclusions: The students positively perceived the activity as a valuable learning experience. SDL assignments can be successfully implemented in pre-clinical courses and show improvements in their perception and learning skills.
Pak J Physiol 2023;19(3):46–50
COMPARATIVE EFFECTS OF HIGH FAT AND CAGED CHICKEN DIET ON BODY WEIGHT GAIN IN ALBINO RATS
Authors: Kiran Nafeesa , Beenish Huma , Hashmi Tayba Saleha , Mehmood Muzna , Naheed Kishwar , Chaudhary Erum Rashid
Published: July 2024

Background: Consumption of high fat diet, caged chicken meat and sedentary lifestyle have seriously caused weight gain in developed countries resulting in hyperlipidemias and imbalance in the steroidal sex hormones ultimately. Objective of this study was to compare the effects of high fat and caged chicken diet on body weight of female albino rats. Methods: This randomized control trial was conducted in collaboration with National Institute of Health and Anatomy Department of Islamic International Medical College after approval from the Ethics Review Committee, from Sep 2021 to Sep 2022. This study was performed on 30 Albino Sprague Dawley adult female rats weighing 250–300 gm with no gross abnormality. They were divided into 3 equal groups of 10 rats in each group. Control group A was given standard rat diet. Experimental group B animals were given 60% fat while experimental group C animals were given cubes of caged chicken diet (20 gm/rat in the raw form orally) for 9 weeks. At the end of the experiment, animals were observed for relative body weight changes among groups. Result: The mean weight of the animals increased normally in control group A from 220 to 236 gm. Group B gained weight from 220 to 268 gm, and group C grew from 220 to 333 gm during 9 weeks. The weight gain was significantly higher in group C. Conclusion: Caged chicken diet as compared to high fat diet affects animals’ weight more harmfully, and hence the health.
Pak J Physiol 2023;19(3):43–5