bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimalisasi Peran Peradilan Agama dalam Penyelesaian Sengketa Ekonomi Syariah: Perspektif Hukum Progresif
Authors: Muhammad Isa Abdil Aziz Yanatama
Published: December 2024

Peradilan Agama memiliki peran strategis dalam menyelesaikan sengketa ekonomi syariah, namun masih menghadapi tantangan berupa ketidakefisienan kewenangan, tumpang tindih yurisdiksi, dan kurangnya kompetensi sumber daya manusia. Penelitian ini bertujuan untuk mengembangkan model optimalisasi kewenangan Peradilan Agama dalam menyelesaikan sengketa ekonomi syariah secara efektif, adil, dan berbasis hukum progresif. Penelitian ini menggunakan metode hukum normatif dengan pendekatan perundang-undangan, konseptual, dan historis untuk menganalisis regulasi, doktrin, dan prinsip hukum terkait. Hasil penelitian menunjukkan bahwa penguatan kelembagaan Peradilan Agama dapat dilakukan melalui pelatihan hakim di bidang ekonomi syariah, penerapan teknologi digital untuk meningkatkan efisiensi proses persidangan, dan pembentukan unit khusus untuk menangani sengketa ekonomi syariah. Selain itu, revisi peraturan perundang-undangan diperlukan untuk mengharmonisasi yurisdiksi antara Peradilan Agama dan lembaga arbitrase, seperti BASYARNAS, guna menghilangkan ketidakpastian hukum. Pendekatan maqasid syariah menjadi landasan normatif yang memastikan bahwa penyelesaian sengketa memenuhi prinsip keadilan substantif dan relevansi sosial-ekonomi. Implikasi penelitian ini adalah terciptanya sistem hukum yang lebih terintegrasi, terpercaya, dan mampu mendukung pertumbuhan ekonomi syariah di Indonesia. Rekomendasi yang dihasilkan dapat menjadi rujukan bagi pembuat kebijakan dan praktisi hukum dalam memperkuat kapasitas Peradilan Agama sebagai institusi utama penyelesaian sengketa ekonomi syariah.
Frequency of Hyperglycemia in Acute Stroke Patients at Tertiary Care Hospital, Bannu, KPK, Pakistan
Authors: Hafiz Ullah Khan  , Saqib Ahmad  , Rafi Ud Din  , Muhammad Shoaib  , Atif Ahmad  , Arif Ullah  , Ilyas Khan
Published: December 2024

Objective: To find the frequency of hyperglycemia in acute stroke patients, District Headquarter Teaching Hospital, Bannu
Material & Methods: Prospective Cross-sectional study conducted on acute stroke patients at District Headquarter Teaching Hospital, Bannu for frequency of hyperglycemia. Socio-demographic data was collected using structure questionnaire. Blood sample for FBS and RBS were collected in BD vacutainer™ bottle having sodium fluoride anti-coagulant. Blood glucose estimation was done using MicrLab-300 at Pathology lab of DHQ Teaching Hospital, Bannu.
Result: Total 121 subjects were selected for study in which males 66.1% while females were 33.9%. Patients living in rural area were 73.6% while urban duelers were 26.4%, married individuals were 95.9 % while unmarried were 4.1%. Educated individuals were 64.3% while un-educated were 53.7%, mean age was 60.26 + 7.52. Hyperglycemic patients having mean FBS was 131 + 46.68 while RBS was 202 + 97.36. Hypertension was present in 85.1 %, mental disability was in 16.5%, physical disability was in 89.3% and Swallowing difficulty was found in 44.6 % acute stroke patients. Hyperglycemia was present in 28.92 % (35/121) patients in which males were 85.71% and female were 14.29% while 71.08% were free of hyperglycemia. The result was statistically significant with p-value < 0.004 at 95% Cl.
Conclusion: It has been concluded that hyperglycemia may be risk factor for patients that leads to acute stroke along with hyper tension and other complications.
Treatment Cost of Diabetic Patients in PIMS Hospital, Pakistan: A Case Study in Islamabad
Authors: Mustafa Raza  , Aamir Afzal  , Mariyam Sarfraz
Published: December 2024

Objective: To determine the total cost of diabetic care from provider’s perspective in a public hospital; Pakistan Institute of Medical Sciences (PIMS)
Materials and Methods: Descriptive study based on retrospective selection 01 year (July, 2014 to June, 2015) of medical records of admitted diabetic patients, Medical Ward-6 of General Medicine at Pakistan Institute of Medical Sciences (PIMS), Islamabad. A step down cost accounting approach was used to estimate the costs. Costs included personnel, equipment, direct and indirect costs. Data about 1,580 admitted diabetic patients. Moreover, information about personnel cost, indirect cost and equipment cost were collected by reviewing of file records and related files by using Health Management Information System (HMIS) and by consulting with finance and administration department of the hospital.
Results: Total budget of PIMS hospital for the year 2015 was PKR. 2,385 million ($ 22,362,869) in which 3.5% (PKR. 83,475,000; $782,700) were allocated for Department of Medicine. In total 1,580 admitted patients of diabetes mellitus were included in the study period. The total annual burden of cost on the treatment of admitted patients of diabetes mellitus was PKR.58, 962,361 ($220,858) which was 70.6% of the total budget allocated for Department of Medicine. Direct costs were RKR. 858,046 (01%; $8,045). The total indirect cost were PKR. 6,588,260 (11%; $61,774) whereas personnel cost were PKR. 43,623,415 (74%; $409,033) while equipment cost absorbed PKR. 7,892,640 (13% of the total costs on RTA, $74,005).
Conclusion: The study concludes that measuring the hospital cost for providing diabetic care is useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions. This could help build a large model based on the economic burden of diabetes care for the people living in the capital city.
Isolation Of Common Bacterial Pathogens from Wounds of Burns Patients at District Bannu Khyber Pakhtunkhwa, Pakistan
Authors: Arif Ullah  , Mohammad Shoaib Khan
Published: December 2024

Objective: To isolate the common bacterial Pathogens from burn wound at District Bannu, Khyber Pakhtunkhwa Pakistan.
Methods: From September 2018 to September 2019, a total of 50 samples were collected from burn patients with a history of various weeks of hospitalization in various public and private hospitals in District Bannu and shifted to the Pathology Department, Bannu Medical College, Khalifa Gul Nawaz Teaching Hospital, MTI Bannu for further processing. Traditional microbiological methods were used for isolation and identification.
Results:  A total of 56% of wounds samples were found positive for the presence of bacterial pathogens, commonly isolated pathogens were Pseudomonas. Auerginosa (42.85%), Staphylococcus. Aureus (35.71%), Escheria. Coli (28.57%) and Salmonella Typhi (25%).
Conclusion: it was concluded that most common isolated pathogens were Pseudomonas. Auerginosa and Staphylococcus. Aureus followed by Escheria. Coli and Salmonella Typhi from burn wound in hospitalized patients.
Threat of Hepatic and Renal Toxicity in Patients with Chronic Suppurative Otitis Media and Possible Drug Response
Authors: Sohail Khan  , Mohammad Iqbal  , Sahibzada Fawad Khan  , Wasim Ahmad
Published: December 2024

Objective: To assess the jeopardy of hepatic and renal toxicity in patients suffering from chronic suppurative otitis media and possible drug’s response to treat the condition.
Methodology: This was a case control trial that was conducted in patients with chronic suppurative otitis media reported to ENT OPD of Khalifa Gul Nawaz teaching hospital Bannu-KP. The duration of the study was from August 2021 to February 2021. Sample size was 160, that was calculated using WHO calculator. Sixty volunteers were included in the study. Negative control group, positive control group, patients treated with Co-amoxiclave, and patients treated with Ciprofloxacin, patients and healthy volunteers were  randomized into four groups.
Results: The results of the study showed a significant increase in direct bilirubin levels, total bilirubin levels, SGPT, GGT and alkaline phosphatase in positive control group in comparison to negative control. The treated groups with antibiotics remained successful in recovering normal liver enzymes excepting SGPT and direct bilirubin. Blood glucose and urea was found to be insignificant in G2 and G3 groups whereas in G4 group, an increased creatinine was seen which was statistically insignificant. 
Conclusion: Our study concluded that in patients suffering from chronic suppurative otitis media, hepatic toxicity might be induced if remained untreated. It is therefore, proper treatment with follow-up is required in these patients.
Serum Ferritin and Hemoglobin Levels in Female Cardiovascular Patients of District Peshawar, Of Khyber Pakhtunkhwa, Pakistan; A Hospital Based Study
Authors: Huma  , Faridullah Shah  , Mohammad Hashir Ahmad  , Attaullaah Khan  , Mudassir Ahmad Khan  , Zahoor Ahmed
Published: December 2024

Objective: The study was conducted to assess iron and hemoglobin levels of female cardiovascular patients.
Material and Methods:  Total eighty-six subjects including equal number of patients and controls were enrolled for the present study fulfilling the predefined selection criteria. About 5 mL blood sample was collected for each subject for determination of serum ferritin hemoglobin concentration. A 24-hr dietary recall method was used for estimation of dietary energy, carbohydrate, protein, fat and iron intake of subjects.
Result: The results showed non-significant difference (p>0.05) in the mean weight, height and body mass index between the cases and controls. The same results were noted for the biochemical parameters including serum ferritin and hemoglobin concentration. However significant (p<0.05) results were obtained for BP. Demographic and socio-economic status demonstrates that both cases and controls had large family sizes between 10-13 members with non-significant difference.
Conclusion: Logistic regression did not reveal any relationship between CVD patients and iron status indicators, rather age and BMI were the only independent variables associated significantly with CVD.
Musculoskeletal Pains Associated with Schoolbag Carriage in Children and Adolescents a Cross Sectional Study in Twin Cities
Authors: Aymen Khawar  , Juwayria Omar  , Aleezae Khan  , Ayesha Kanwal  , Khadija Munir  , Sahar Najam  , Shahzana Zia  , Muhammad Usman Ali  , Nida Khaliq
Published: December 2024

Objectives: To determine the association of musculoskeletal pain in school-going children and adolescents with schoolbag carriage practices and certain sociodemographic variables.
Methodology: An analytical cross-sectional study involving parents of 256 school- going children in Islamabad and Rawalpindi was conducted after IRB approval. Online and in- field distribution of structured questionnaires was done. SPSS Version 23 was used for data entry and analysis. Descriptive analysis was done by calculating percentages, frequencies, and standard deviations, while inferential analysis was done by cross-tabulation and Chi-square testing.
Results: 253 students of mean age 12.50 ± 9.1 were studied, where 68.4% reported musculoskeletal pain due to schoolbag carriage. 78.9% female students and 74.4% government school students reported musculoskeletal pain due to increased duration and frequency of schoolbag carriage along with higher BMIs and bag weight. An increasing trend of pain was seen with increasing age, higher BMI, higher school grades, and increased waiting time for transport. A significant association was found between the development of musculoskeletal pain and gender (0.003), type of school (0.001), duration (0.000) and frequency of carriage (0.016), bag weight-to-body weight ratio (0.026), transport wait time (0.030) and postural changes (0.000).
Conclusion: An association between musculoskeletal pain in school-going children and schoolbag carriage practices as well as sociodemographic variables was observed.
Correlation of Thyroid Disorders with Body Mass Index in Patients presenting to BINOR Hospital, Bannu Khyber Pakhtunkhuwa Pakistan
Authors: Ambreena  , Maryam Zeb Abbasi  , Muhammad Shoaib Khan  , Abdur Raouf
Published: December 2024

Objective:  To investigate the correlation between thyroid disorders and body mass index and to see whether the association is significant in the Pakistani population or otherwise.
Methodology: The cross-sectional  was conducted in PAEC- BINOR Hospital, Bannu. Patients’ ages varied from 18 to 70 years. T3 FT4 and TSH were performed from the patients by the RIA technique, and BMI was calculated as per WHO standard criteria. Underweight (18.5), normal weight BMI (18.5–24.9), overweight BMI (25.0–29.9), and obese BMI (30.0 or higher) are the BMI cutoff values. Patients were classified into three categories; Hypothyroid, Hyperthyroid and Euthyroid on the basis of Thyroid function tests.
Results: Out of 200 subjects included in the study, 149 were females and 51 were males. Out of 200 participants, 77 (38.5%) individuals were categorized on the basis of thyroid function test reports into the hyperthyroid group, 53 (26.5%) were categorized as the hypothyroid group and 70 (35%) were categorised as Euthyroid group. Chi square test with each BMI categories showed significance association with thyroid disorders, p<0.005. The three categories of thyroid disorders were also separately correlated through Pearson’s correlation in which the hypothyroid group showed a significant positive correlation (p=<0.001, Hyperthyroid group showed significant negative correlation with p=<0.001 and the euthyroid group showed insignificant weak correlation with BMI. Thyroid hormones T3, FT4, TSH were also correlated with BMI by applying student T-test.
Conclusion: This study showed a significant correlation between thyroid disorders and body mass index, which indicates that obesity might be a risk factor for thyroid disorders. The hypothyroid group have a significant positive association with BMI, and hyperthyroid group has a negative correlation with BMI. In fact, there is no significant association between the euthyroid group and BMI. Thyroid hormones also show a significant correlation with BMI. TSH is positively correlated with BMI, while T3 and FT4 are negatively correlated with BMI.
Patient Satisfaction and Adherence to Treatment in Relation to Communication/ Interaction with Health Professionals a Cross Sectional Study
Authors: Juwayria Omar  , Adam Khan  , Farah Ibrahim  , Neha Farooqi  , Samiya Riaz  , Meenal Ahmed  , Nudrat Farid  , Hatim Shah
Published: December 2024

Objective: To quantify the satisfaction level of patients in public, private, and semi-government hospitals in relation to their communication with health personnel and its effect on their treatment compliance.
Methodology: This was a cross-sectional analytical study. Convenient sampling was done and the sample size (N=228) was calculated using the Creative Research Systems Survey Software. Population under study included men and women over the age of 18 years with any experience at a hospital/ any interaction with medical staff. People who visit hakim and herbal shops were excluded. Data was collected through structured questionnaire by using Google Docs. After IRB-FMC permission the link of the questionnaire was then randomly distributed to the different known departments of Air University.
Results:  Significant association between younger age, male gender and presence of attendant with satisfaction keeping p value at 0.05 was found. Friendly and easily accessible doctors and perception that the doctor prescribed accurately showed an association with satisfaction. There was association between having a chronic illness and being satisfied with adherence to treatment. No association was found between type of hospitals, monthly income and occupation with satisfaction level and adherence to treatment.
Conclusion: Satisfaction played a significant role in a patient’s adherence to treatment. Therefore, contributing factors like demeanor or IPS (Interpersonal Skills) significantly affected satisfaction and consequently, adherence.
Perineal Tears; Frequency, Severity and Risk factors in a Tertiary Care Hospital
Authors: Abrar Saida , Abrar Tahira , Sayyed Ehsan , Shahzadi Saima Hussain
Published: December 2024

Objective: To observe the frequency, severity, and risk factors of perineal tears during vaginal delivery in a tertiary care hospital. 
Methodology: This was a cohort study of women, aged 15-45 years, of ≥ 36 weeks gestation, with a cephalic presentation, delivered between 1st January and 30th December 2021 at Lady Reading Hospital, Peshawar. A structured proforma was used to gather data on women’s demographic, obstetric, and labour details. Women with perineal tears were grouped into the minor tears group (first and second-degree) and the major tears group (third and fourth-degree). Institutional Ethics Review Committee approval was taken (266/LRH/MTI).
Results: Among the 7304 deliveries, 876 women sustained perineal tears constituting a frequency of 11.99%. About 740 (84.5%) women had minor tears (First degree, n=256, Second degree, n=484), and136 (15.5%) had major tears (Third degree, n=99, Fourth degree, n=37). The mean age, body mass index and gestational age was 30.19+6.10 (range; 15-45), 32.02+2.77 (range; 25-40), and 38.9+1.53 (range; 36-42) respectively. Women with an instrumental vaginal delivery were more prone to have a major tear in comparison to a spontaneous vaginal delivery (p< 0.00). Primiparity, oxytocin, shoulder dystocia, instrumental vaginal delivery, and high birth weight were significantly associated with perineal tears. Women with instrumental vaginal delivery were more likely to have major tears without an episiotomy.
Conclusions: Perineal tear is frequent post-natal morbidity. Perineal tears are significantly high in primiparous women, oxytocin, shoulder dystocia, instrumental vaginal delivery, and high birth weight. Episiotomy should be given only when indicated.
Keywords: Perineal tears, Episiotomy, Risk factors.
Normal Variation in Hepatic Venous Doppler Waveform Post Living Donor Liver Transplant
Authors: Muhammad Salman Rafique  , Rayyan Pervez  , Bushra Aslam  , Tahir Malik  , Sana Kundi  , Ahmad Karim Malik
Published: December 2024

Background: Due to the lack of cadaveric livers, particularly in our part of the world, living donor liver transplantation (LDLT) is commonly being performed. Graft failure and the outcome of surgery are most commonly impacted by vascular complications, including thrombosis and stenosis. Ultrasonography (US), including doppler assessment, has emerged as the initial imaging modality of choice for early detection and follow-up screening of vascular complications.
Methodology: This is a retrospective cohort study. It was conducted at Pakistan Kidney and Liver Institute and Research Centre (PKLI) from 01/07/2021 to 31/12/2021. All adult patients above 16 years of age who underwent LDLT were included. Doppler waveform of the hepatic vein was documented intraoperatively and then for 5 consecutive days. Subsequent scans were performed at 2 weeks, 4 months, and 6 months after transplant. Statistical analysis was performed on SPSS version 20.
Results: Ninety one patients included in the study, the minimum age was 17 years and the maximum age was 73 years. The mean age was calculated to be 45 years. About 79% were males and 21% were females. All patients had hepatofugal flow. The hepatic venous waveforms were quite variable, mostly fluctuating between triphasic and biphasic waveforms.
Conclusion: A whole spectrum of waveforms was noted, of which the triphasic pattern was most common. Both biphasic and monophasic patterns were also encountered and were of no predictive value in terms of significant impact on clinical outcomes.
Keywords: Living donor living transplant (LDLT), Doppler ultrasound, Hepatic vein.
Pain Intensity after Laparoscopic Cholecystectomy with Intraperitoneal Irrigation as Well As Periportal Infiltration of Bupivacaine Versus Without Bupivacaine
Authors: Naveed Gul Kazi  , Suhail Ahmed Soomro  , Mushtaq Ahmed Abbasi  , Abid Ali Soomro  , Riaz Hussain Shah  , Masood Ahmed Qureshi
Published: December 2024

Objective: To compare the effectiveness of bupivacaine as intraperitoneal irrigation and local infiltration at port sites in terms of postoperative pain reduction to a control group that did not receive any bupivacaine injection.
Methodology: This study was carried out in the general surgery department of Liaquat University Hospital Hyderabad/Jamshoro from 2018 to 2019. Patients of uncomplicated gallstone disease, aged more than 12 years old admitted through the outpatient department, as well as from casualty department, undergoing laparoscopic cholecystectomies were included. Patients were randomly divided into two groups. At the end of surgery, the study group received bupivacaine as intraperitoneal irrigation and local infiltration bupivacaine in the port sites while the control group didn’t receive bupivacaine, admitted in the department of surgery, who came for uncomplicated gallstone disease as assessed preoperatively. Patients were assessed for postoperative pain up to 48 hours after surgery and pain was evaluated by visual analogue scale.  All the information was collected via study proforma. SPSS version 26 was used for the data analysis.
Results: There was no difference between the two groups preoperatively in terms of demographic and laboratory data. The two groups were observed with similar operation time, blood loss without any postoperative mortality. The pain intensity, as rated by visual analog rating scales, was significantly less in the group receiving bupivacaine than in the control group.  It was observed that there were significantly lower pain scores in the patients undergoing LC with local anesthesia, at different time interval as compared to the control patients (p<0.01). Regarding analgesia, the number of analgesia needed, were lower in patients undergoing LC with local anesthesia infiltration and irrigation than control group (p<0.010). The test group patients had a shorter hospital stay than controls.
Conclusion: It was concluded that irrigation of bupivacaine in peritoneal cavity and infiltration around the ports in LC patients significantly reduces the severity of postoperative pain and the analgesic requirement as compared to the control LC patient whom not received infiltration and irrigation with bupivacaine.
Efficacy of 5% Dextrose+1/2 Saline Versus Ringer Lactate Infusion in Treating Chronic Subdural Hematoma in Terms of Postoperative Pneumocephalus/Subdural Collection after Burr Hole Craniostomy
Authors: Muhammad Anees  , Muhammad Mujahid Sharif  , Waseem Ahmad  , Shabnam Nawaz  , Niaz Ahmad  , Noor Khan
Published: December 2024

Objective: To compare the frequency of post-operative pneumocephalus/residual subdural collection after burr hole evacuation of chronic subdural hematoma with 5% dextrose + 1/2 saline infusion versus ringer lactate infusion
Subjects and Methods: study was conducted in the Department of Neurosurgery, PIMS, Islamabad from 01-08-2019 to 31-01-2020 .A total of one hundred (n=100) patients of either gender presenting with diagnosis of chronic subdural hematoma, requiring surgical evacuation were included in study and were divided into two groups; Group A given 5% dextrose 1/2 saline intra-op and 1L TDS post-op and Group B given ringer lactate intra-op and 1L TDS post-op. Both groups observed for pneumocephalus and residual subdural collection at 24hr post-op.
Results: Results showed that overall frequency of post-op pneumocephalus and subdural collection was significantly lower in patients who were given 5% dextrose+ 12 saline versus ringer lactate group i.e. 14% vs 38% and 4% vs 16 % respectively which was statistically significant with p-value<0.05.
Conclusions: There is significant negative correlation with 5% dextrose + 12 saline infusion and post-op pneumocephalus and subdural collection incidence as compared to ringer lactate infusion.
KEY WORDS: subdural hematoma, chronic subdural hematoma, burr hole, pneumocephalus, residual subdural, 5% dextrose, ringer lactate.
Analysis of indications of caesarean section: A retrospective study in a tertiary care hospital, to curb the rising caesarean section rate
Authors: Fatima Syeda Sitwat , Bawar Shandana
Published: December 2024

OBJECTIVE: To examine the indications leading to the overall escalation of  Caesarean Section(CS) rate in our population   and to put forward strategies/interventions where possible practically to curb the escalating rates of CS in a tertiary care hospital.
MATERIAL AND METHODS:
This Retrospective Cross-sectional study was conducted in obstetrics department of Lady Reading Hospital Peshawar, for a period of 1 year from January 2021 till December 2021. The data was collected from hospital’s clinical records of the women who had CS delivery during the study period. Required information was entered into a structured Proforma. Data was analyzed on SPSS version 21.
RESULTS:
During the study period n=7376 women delivered in the obstetrics unit A, of Lady Reading Hospital. Out of these n=1679(22.76%) were Caesarean Sections. The number of Primary CS were n=1021(60.81%) while n=658(39.18%) were repeat CS.  It was found that most of the CS n=1066(63.49%) were Emergency CS while n=613(36.51%) were Elective CS.
The most common indication for CS was Repeat CS in women with history of previous CS deliveries n=658 (39.19%).The 2nd most common indication was fetal distress n=302(18.04%) followed by Labour progress disorders n=235(13.99%).
CONCLUSION:
Majority of the women who underwent CS had the history of previous CS deliveries. It is the need of the day to educate the obstetricians and counsel/encourage women in antenatal period regarding the safety of procedures like externat cephalic version (ECV), trial of labour after caesarean section (TOLAC)and vaginal birth after caesarean section (VBAC), to reduce repeat CS in our setup.procedures like External Cephalic Version (ECV), Trail of Labour after previous Caesarean-Section (TOLAC) and Vaginal Birth after previous Caesarean Section (VBAC), if we want to reduce repeat CS in our setup. Moreover, CTG should be used only in high risk pregnancies/labours. Furthermore, adherence to WHO Labour Care Guide and skills and drills for reviving instrumental delivery in carefully selected cases may curb the escalating rate of CS.
Variation of Normal Hepatic Artery Doppler Indices Post Living Donor Liver Transplant
Authors: Rafique Muhammad Salman , Pervez Rayyan , Kundi Sana , Aslam Bushra , Aqeel Raheela , Malik Tahir
Published: December 2024

Background:  Due to the lack of deceased donors, adult-to-adult living donor living transplant (LDLT) has emerged as the procedure of first choice among liver transplantation procedures in most Asian countries. Hepatic artery complications can lead to graft ischemia and are one of the most frequent causes of graft loss in the immediate postoperative period. Ultrasonography, including doppler evaluation, is the established initial imaging modality of choice for early detection and follow-up screening of vascular complications.
Materials and Methods: This retrospective cohort study was carried out at the Pakistan Kidney and Liver Institute and Research Centre (PKLI)and spanned from 01/07/2021 to 31/12/2021. Patients above 16 years of age who had undergone LDLT were included. Hepatic artery peak systolic velocities (PSV), resistive indices (RI), and acceleration times (AT) were documented intra operatively and then for 5 consecutive days. Follow-up scans were performed at 2 weeks, 4 months, and 6 months after the transplant. SPSS version 20 was used for statistical analysis.
Results: A total of 91 patients were included in the study. The minimum age was 17 years and the maximum age was 73 years with a mean age calculated to be 45 years. Approximately 79% of patients were males and 21% were females. A PSV of as less as 15 cm/s and as high as 267 cm/s was recorded with normal waveforms. A minimum RI of 0.44 and a maximum of 0.89 was observed. A minimum AT of 0.01 seconds and a maximum of 0.07seconds were noted.
Conclusion: A wide range of hepatic arterial velocities can be encountered following LDLT without clinically significant out comes. The hepatic arterial velocities normalized within 4 to 6 months following LDLT. Hepatic artery RI values of 0.44 to 0.89 can be observed without any complications.
Is Salmonella Typhi Becoming a Superbug? A Cross-Sectional Study of the Antibiotic Sensitivity
Authors: Mehr Muhammad Tariq , Zuhayr Ahmad , Nisa Qamar Un , Raza Shehrbano , Iqbal Areeb
Published: December 2024

Objective: To determine the antibiotic sensitivity patterns of Salmonella typhi in blood cultures of the patients attending a tertiary care hospital.
Material & Methods: This cross-sectional study was conducted in the Department of Internal Medicine, Hayatabad Medical Complex, Peshawar, Pakistan for a period of one year from 1st August, 2021 till 30 August, 2022. All adult patients of either sex, belonging to the province of Khyber Pakhtunkhwa, Pakistan between 18 to 70 years of age, whether admitted through casualty or the outpatients, having a history of fever for the past 07 days and no prior history of admission or use of antibiotics in past one month were included.
Results: The mean age of the patients was 47 ± 5.6 years with females 59.2 % (320) and the males 40.7 % (220). A total of 540 blood cultures showed a growth of Salmonella Typhi out of requested 857 cultures representing a positive culture yield of 63%. The total numbers of MDR cases were 83.6% whereas the XDR cases were 3%. The antibiotics sensitivity was 100% to Carbepenems, Tigacycline, Colistin and Polymixin, whereas between 27.7% to 16.4% in the cephalosporin class and only 16.4% to the flouroquinolones.
Conclusion: The antibiotics resistance against Salmonella Typhi is on the upswing and calls for effective programs of antibiotics stewardship, development of indigenous updated antibiotics guidelines in line with the local sensitivity patterns and actions to avert the spread of infection.
Continuous Versus Intermittent Furosemide Dosing Regimen in the Treatment of Acute Decompensated Heart Failure
Authors: Ahmad Hira , Khan Samiullah , Shah Saadullah , Iqbal Sunehra , Niaz Muhammad , Danish Naveed
Published: December 2024

Objective: To compare continuous versus intermittent (bolus) infusion of furosemide in patients with acute decompensate heart failure (ADHF) in terms of length of hospital stay, urine output per day and change in serum creatinine levels.
Duration: Six months (01-09-2021 to 28-02- 2022)
Setting: Cardiology department District Head Quarter Teaching Hospital (DHQ-TH) Bannu.
Subjects and Methods:  Eighty two (n=82) adult patients of either gender, between age 50years to 70 years were enrolled and equally divided into Group A (continuous Furosemide infusion) and group B (intermittent Furosemide dosing).  Outcome of the therapy were duration of hospital stay, changes in serum creatinine and daily urine output.
Results: Mean length of hospital stay was significantly shorter (5.8±2.4 days versus 6.9±2.3, p=0.04), urine output per 24 hours was higher (2796.3 ml ± 365.9 SD and 2720.7 ml ± 647.6 SD, p=0.517) and mean change (rise) in serum creatinine was significantly higher (0.41 mg/dL ± 0.26 SD and 0.27 mg/dL ± 0.32 SD respectively, p=0.027) in continuous infusion group when compared with intermittent dosing group. 
Conclusions: Treatment with continuous infusion of furosemide resulted in higher urine output per 24 hours, a higher rise in mean serum creatinine and a shorter duration of hospital stay as compared to treatment with intermittent dosing regimen.
Prevalence of Metabolic Syndrome in patients with psoriasis
Authors: Azhar Mehwish , Younas Muhammad Tahir , Tahir Muhammad , Masud Maryam , Tahir Muhammad Zuhair , Tahir Muhammad Zubair
Published: December 2024

Objective: The study was planned to determine the frequency of metabolic syndrome in patients with psoriasis.
Place and duration of study: This study was conducted over a period of 6 months at the department of General Medicine, PAF Hospital, Islamabad, Pakistan from 1st January 2022 to 30 June 2022.
Materials and Methods: A total of 100 patients diagnosed with psoriasis using non-probability consecutive sampling were included in the study. Patient’s complete history was taken and thorough clinical examination was carried out at the time of inclusion.  This included the age, height, weight, blood pressure, waist circumference and duration of disease. Patients were advised fasting blood sugar, fasting triglycerides and fasting high density lipoproteins.  Metabolic syndrome was diagnosed if patients had ≥3 out of 5 criteria for the modified version of National Cholesterol Education Program Adult Panel III.
Results: Out of 100 patients of psoriasis, 37 (37%) patients had  metabolic syndrome while 63 (63%) had no metabolic syndrome. The mean±SD of all the parameters of metabolic syndrome were found raised in psoriatic patients than normal values both in male and females. No correlation was found between prevalence of MetS and duration of disease (p=0.16).
Conclusion: There is a high prevalence of metabolic syndrome in psoriatic patients that can lead to high cardiovascular events. Hence the patients having psoriasis must be screened on yearly basis for these controllable risk factors to reduce incidence of CV morbidity and mortality.
Effect of Slimming Drips on Body Mass Index and Physical Appearance of Obese Population
Authors: Tareen Attiya , Rajar Uzma Dost Muhammad , Mashhood Asher
Published: December 2024

Objective: The purpose of this study is to determine the effects of slimming drip approach by mixing cartinex 1g/5ml, Liponex 300gm/12ml and Arginex 5g/10ml with a 500ml of normal saline being administered to patients for twice a week and to determine its effects on Body Mass Index and physical appearance of patients after one month of intervention.
Study Design : A quasi experimental study
Study Setting: Out Patient department of dermatology Clinic of Isra University Hospital, Hyderabad.
Methodology: A total number of n=400 participants were recruited. Informed consent was taken prior to induction and initial body mass index in kg/m2 was monitored.
Results: The findings of this study had revealed that slimming drip had significantly p<0.005 reduced the body mass index of the participants where the mean values of BMI before the start of treatment were 38.12±4.85kg/m2 that had been reduced to 34.49±5.36 after one month of treatment.
Conclusion: The study had concluded that slimming drip treatment had produced a beneficial effects on hormonal levels and patient’s appearance.
Role of Repeat CT Scan Brain in Mild to Moderate Head Injury
Authors: Amir Sohail , Hameed Haris , Ayub Shahid , Begum Farzana
Published: December 2024

Objective: The goal of the research is to determine the responsibility of repeat strategy of CT scan brain from temperate to medium type of injury in the head.
Material and Methods: The situation gives importance to the retrospective examination of the patients who appear in the neurosurgery section at Hayatabad Medical Complex in the Peshawar emergency department. The study comprised 1055 patients with a GCS of 8 or higher who received medical care in the settings of a hospital after passing the repeat strategy of CT scan during patient stay at the hospital. Details about the physical analysis, history of the patient related to their medical terms, and patient demographics were collected, as well as CT scans. The most common symptoms were destruction attributes of neurological conditions, intervention requirements of neurosurgical aspects, and radiological worsening.
Results: The three-year study period highlights the 3456 population of patients associated with the condition of injury in the head and they brought to the emergency area of the hospital, and 1055 patients were able to attain the comprehensive standard. 39.5 years represents the average age of the patients, while 67.7% of the patients were men (n=715). 2743 quantity of Scans were analyzed on 1055 individuals having an average capacity of 2.6 scans in each patient. The result discussed the parameters including the involvement of all the patients who went under the aspect of the 2nd repeat strategy of CT scan after the starting the implantation of abnormal CT scan. The study group contained 95 patients (9.0%) with radiological deterioration, 40 patients (3.7%) with neurological deterioration, and 110 patients (10.4%) with neurosurgical intervention.
Conclusion: The responsibility of the repeat strategy of CT scan for the head is to identify the initial disturbing signs of brain disorder before the destructive nature of the neurological condition. The approaches will aid in supporting the treatment for providing better consequences.
Effect of Chronic Kidney Disease on Thyroid Function
Authors: Spal Furqan Arshad , Fatima Mahnoor , Ali Abid , Waqas Umair , Maryam Hannana , Abbas Zaheer
Published: December 2024

Background: Chronic kidney disease results in downturn of glomerular filtration rate, which brings about nephropathic effect. The intensitifying nephropathy muddles the thyroid functions and turns down the iodide clearance, thus expedites the hypothyroidism.
Objective: The study aimed to link the chronic kidney disease with hypothyroidism.
Material and Methods: Our study design was cross-sectional. Chronic kidney disease patients were selected for thyroid profile (triodothyronine, thyroxine and thyroid stimulating hormone) testing. Statistical analysis was consummated on collected data, to check out the correlation between CKD and hypothyroidism.Chronic kidney disease is refers to by continuing urine defects structural irregularities or reduced excretory renal function connotative a loss of proper working nephrons. 
Results: We enrolled 105 patients suffering from CKD. Of them 62 were male patient and 43 were female. Our analysis concluded that 49, of whome 30 were male and 19 were female, had hypothyroidism. 23; 16 male and 7 female, were having subclinical hypothyroidism and low T3 was seen in 33 individuals, comprising of 16 male and 17 female patients.
Conclusion(s): It is evident, that there is substantial effect of CKD over thryroid function, as hypothyroidism, subclinical hypothyroidism and low T3 syndrome is more frequent in CKD patients. To fend off CKD, the thyroid function is needed to be kept under observation, so that good prognosis could be gained.
Comparison of Dry Eye Syndrome in North West Pakistani Diabetics and Non-Diabetics Population
Authors: Khan Jahanzaib , Rehman Zia Ur , Idris Mohammad , Khan Naeem , Masood Muhammad Zubair
Published: December 2024

Background: Due to rising life expectancy and anticipated older population expansion, the impact of dry eye syndrome (DES) will keep growing. Early investigations have indicated that the most frequent symptoms of diabetic retinopathy, or DR, are connected to problems with the ocular surface in general and dry eye in specific.
Objectives: To compare Dry Eye Syndrome in North West Pakistani Diabetics and Non-Diabetics.
Material and methods: this study is conducted on 50 cases and 50 controls at eye OPD from 5th October, 2018to 5th December 2018 by Convenience sampling technique. After that patient ocular and systemic history were taken and check previous clinical records if present. Anterior segment examination was carried out with a slit lamp. Fluorescein staining and schirmer test was carried out for diagnosing the dry eye syndrome. Patients were classified as having clinically dry eyes if their tear film was less than 10 mm, and as very dry if it was less than 5 mm. To assess the staining, fluorescein stain was utilized as a diagnostic dye. Dry eyes were regarded as having more than three fluorescein-stained cells. Chi-Square analysis, EPI Info 16, and SPSS were used to examine the data.
Results: In this research study, there were 50 cases of diabetes and 50 controls (control), were analyzed to look into the relationship between Dry Eye Syndrome with Diabetes mellitus. Dry Eye syndrome was present in 12 (24%) patients, 05 (33.3%) were males and 07 (66.6%) were females. Dry Eye Syndrome was present in 26(52%) patients, 12 (36.6%) were males and 14 (63.6%) were females. Odd ratio for case and control was calculated by applying Chi-Square test which was 7.90 at 95% of confidence level (Cl) with a P value of 0.004943  assuming a P value of <0.05 level of significance.
Conclusion: Dry eyes and diabetes seem to go together frequently. Type I diabetes is more likely to cause a milder degree of dry eye, but type 2 diabetes is more likely to cause mild to moderate dry eye.
Coincidence of obstructive lung disease and obesity at PAF Hospital Islamabad
Authors: Latif Faiqa , Niaz Asif , Tahir Muhammad , Ishfaq Afsheen
Published: December 2024

Objective: To look for presence of obesity in patients presenting with obstructive lung disease and factors associated with obesity in these patients
Study Design: Comparative Cross-sectional Study
Setting and Duration Of Study: Medicine and Pulmonology Department Pakistan Air Force Hospital Islamabad. From March 2022 to May 2022
Patients and Methods: A prospective study was conducted on 150 patients suffering from obstructive lung disease diagnosed by consultant pulmonologist on the basis of clinical and spirometry parameters. Body mass index was calculated in all the patients by WHO formula and they were classed as normal, overweight or obese depending upon body mass index. Factors like age, gender, tobacco smoking and ethnicity were associated with presence of obesity among the study participants.
Results: Out of 150 patients of obstructive lung diseases,85 (56.7%)were male and 65 (43.3%) were female. Mean duration of illness in our target population was 4.63±7.831 years. Out of total study participants, 47 (31.4%) had obesity while 103 (68.6%) did not show obesity and had body mass index less than 30 kg/m2. Chi-square analysis revealed that tobacco smoking had statistically significant relationship with presence of obesity among the target population (p-value-0.001).
Conclusion: Around 1/3rd of patients suffering from obstructive lung diseases had comorbid obesity as well. Patients who were tobacco smokers were more at risk of having obesity as compared to those who did not smoke tobacco.
Helicobacter Pylori Infection and its Associated Factors Among Adult Clients Attending out-Patient Department in Shashemene Comprehensive Specialized Hospital, Shashemene Town, Southern Ethiopia
Authors: Amenu Motuma , Aman Rameto , Lemma Kebebew , Gebrie Meless
Published: December 2024

Abstract
 
Background: Helicobacter pylori infection is a major public health problem with 50% of the global population infected. Millions of people develop the peptic ulcerative disease in their lifetime and many may progress into gastric cancer. It is endemic to developing countries, including Ethiopia.
Objective: To assess the prevalence of H. pylori infection & its associated factors among dyspeptic & non-dyspeptic
adult Clients.
Materials and Methods: A cross-sectional institutional study involving 423 adult clients attending OPD at Shashemene Comprehensive Hospital was conducted from March 3 to April 15, 2021. Data for risk factors were assessed through a structured questionnaire. About 50 mg fresh stool and 1ml of total venous whole blood sample were taken for H. pylori antigen using Wondfo feces test kit & blood, respectively. Data were analyzed by SPSS of version 22. Both bivariate and multivariable logistic regression analyses were carried out to identify the significant variable with a cut-off p-value of less than 0.05.
Results: A total of 423 participants were interviewed giving a response rate of 100%. The mean (± SD) age of respondents was 35.6 (± 10.75) years. The magnitude of H. Pylori infection among participants was 26.7% with 95%CI (22.9, 31.2). Participants who had no formal education (AOR=3.25, CI 95% =1.49-7.04), alcohol consumption (AOR=4.54, CI 95%= 2.41-8.52), family size with ≥6 siblings (AOR= 6.14, CI 95% = 3.21-11.74), dyspepsia (AOR=2.34, CI 95% =1.18-4.61), uncooked food consumption (AOR=2.89, CI 95% =1.24-6.76), and highly perceived stress level participant (AOR= 8.87, CI 95% = 3.95-9.93) were significantly associated with H. Pylori infection
Conclusion: The overall prevalence is high in the study area, where one in four patients were being infected. The study showed significant association of different factors mentioned in results, The results also indicated that the bacterium is common in healthy individuals and is still a public health concern that needs further investigation by future researchers.
Pre-Operative Value of X-Ray Chest in Patients Undergoing Elective General Surgeries
Authors: Raza Mujahid , Abdullah Muhammad Tariq , Shah Syeda Zakia , Hussain Maqbool , Bangash Ishil , Khan Musa , Abbasi Saleem
Published: December 2024

ABSTRACT
Background: Imaging evaluation of patients undergoing general surgeries is routinely done pre-operatively. The indications of radiographic evaluation are only for acute nature of complication. However, sometimes all elective and acute general surgery patients undergo a chest x-ray. Unnecessary exposure of radiation is a significant health threat.
Objective: This study aimed to assess role of pre-operative chest radiographs in patients undergoing general surgeries.
Material and Methods: This retrospective analysis was conducted at the department of Radiology, Pakistan Institute of Medical Sciences, Islamabad spanned over a period of 15 months from October 2021 to January 2023. A total of 7850 adult patients were included. Record of patients coming for x-ray chest from other departments than the general surgery was excluded. Administrative permission was taken from head of department and a verbal consent was taken from patients/caregivers before x-ray. All x-ray films were reported by a senior radiologist. Data were entered and analyzed in SPSS-22.
Results: The mean age was 45.8 ± 11.6 years with a male predominance with 4632 (59.1%). There were 528 (6.7%) cases with positive findings while the remaining 7322 (93.2%) were negative. It was noted that 273 (3.59%) had apical plural thickening, while 105 (1.31%) had right upper lobe fibrosis. Other frequent findings were left upper lob fibrosis 32 (0.41%), blunting of right CP angle 31 (0.40%), blunting of left CP angle 62 (0.79%).
Conclusion: The study found out that more than 90.0% of chest-rays were normal and a very few 7.2% were found abnormal.
Incidence and Characteristics of Scaphoid Fractures in the Adult Population of D.I.Khan, Pakistan
Authors: Nasir Ihsanullah , Naqvi Syed Wasif Ali , Shafiq Muhammad , Zamir Sher , Amanullah Amir , Hamayun Muhammad
Published: December 2024

ABSTRACT
Background: Scaphoid fractures pose significant challenges due to their unique anatomical characteristics and potential complications. This study aims to investigate the incidence and characteristics of scaphoid fractures in the adult population of D.I.Khan, Pakistan.
Objective: To determine the incidence and characteristics of saphead fractures in the adult population of D.I.Khan, Pakistan.
Material and Method: This cross-sectional study was conducted at Department of Orthopedics, DHQ Teaching Hospital, D.I.Khan, Pakistan from January 2022 to December 2023. Sample size was 63. All adult patients (17-50 years old) with saphead fractures were included, excluding old fractures (duration >1 year), open or associated with other injuries. Demographic variables were gender, age groups and presentation time. Research variables were mechanism of injury, laterality, site, treatment modalities, union time and presence of infection.
Results: Out of 63nscaphoid fractures, the prevalence was higher in males 54(85.7%),age group 17-30 years 39(61.9%), presentation time in ≤1week 30(47.6%), mechanism of injury as fall on outstretched hand 42(66.7%), laterality as right hand 45(71.4%), site of fracture as waist 39(61.9%), treatment modalities as ORIF with dorsal approach 23(36.5%).
Conclusion: Early recognition, accurate diagnosis, and tailored management approaches are necessary for optimal caretopreventlong- term complication of saphead fractures which are common in younger males, mostly caused by fallonout stretched hand, and mostly involve righth and waist. Significant number of cases requires sopenr eduction and internal fixation.Unionisachievedmostlyin3-6months.