bluuebunny/crossref_metadata_2025 huggingface dataset:
HEPATITIS C VIRUS
Authors: NAQVI S. M. ABBAS , Khan Muhammad Shiraz , KHASKHELI QURBAN ALI , Talpur Muhammad Saeed , ANSARI SHAHID HABIB
Published: September 2021

`To find out the prevalence of antibody to HCV in serum of blood donorpopulation in our Community (Karachi). To estimate level of serum ALT in blood donors as possible marker of liverinfectivity and hence increasing awareness among the people about the prevention and spread of HCV in Communityand to give suggestions in the formulation of blood transfusion policies. Setting: At Microbiology Department, BasicMedical Sciences Institute, Jinnah Postgraduate Medical Centre Karachi. Period: From September 2001 to January2002. Material and Methods: 150 subjects, consisting of volunteer blood donors and 50 subjects selected from healthypopulation who had never received or donated blood. Results: Among 150 blood donors, 07 subjects (4.66%) werefound to be anti HCV positive. Mean age of anti HCV positive donors was 32.85±7.35 years with male predominance.Conclusion: It is concluded that HCV is notorious for its infectivity, chronocity and complications. Hence HCV spreadshould be controlled by screening blood donors for anti HCV antibodies and observing Universal rules in medicalpractice.
ABSENCE OF SCAR FORMATION IN INFANTS AFTER BCG VACCINATION
Authors: SHERJIL AHMAD , IQBAL COL JAVAID
Published: September 2021

Objective: To determine proportion of infants who do not developBCG scar after vaccination. To highlight importance of evaluation and follow up for these infants. Study Design:Observational Cross-sectional study. Setting: In Vaccination Centre Military Hospital Rawalpindi. Duration: From 1stJanuary 2003 to 15th March 2003. Materials & Methods: 50 to 70 infants are vaccinated in the hospital every day.Infants fulfilling the inclusion criteria averaged ten per day during this study. It took two and a half month, to completea random sample of 250 infants. Sample Size: 250 vaccinated infants. Results: Of all the infants, first 250 infants whofulfilled the laid down criteria were documented. Two hundred and one infants, males and females showed presenceof scar. Forty-nine infants, males and females showed no response to BCG vaccination. Conclusion: This descriptivestudy concludes that a significant proportion of infants does not show tuberculin reactivity after vaccination and needmonitoring and evaluation for causes of poor reactivity e.g. poor technique, quality of vaccine, improper storage as wellas underlying undiagnosed immunological disorders.
STROKE
Authors: MASOOD UMAIR , QADRI ANJUM ANWAR , MAQSOOD MUHAMMAD ANSAR
Published: September 2021

Objective: To document seasonal variations invarious types of stroke and to identify possible precipitating/aggravating factors. Design: Analytical. Place andDuration of Study: Military Hospital Rawalpindi and Combined Military Hospital Rawalpindi, for one year, from IstOctober 2001 to 30th September 2002. Patients and Methods: 116 adult stroke patients diagnosed on the basis ofhistory, clinical examination and CT Scan and admitted during this period were included in the study. The findings weredocumented and analyzed using SPSS and frequency of stroke in relation to seasons was calculated. Chi square testwas used to determine significance of differences in frequency of different types of stroke in the winter and summer.Results: The age of the patients ranged from 20-87 years.83 were males while 33 were females. Sixty-nine out of 116cases presented in summer and the rest 47 in winter. In summer out of 69 subjects, 48(69.56%) had ischaemic strokesand 21(30.44%) had hemorrhagic strokes, of which 19 had Intra Cerebral Hemorrhage (ICH) and 2 subarachnoidhemorrhage (SAH). In winter, out of 47 subjects, 28(59.57%) had ischaemic strokes and 19(40.43%) had haemorrhagicstrokes (all ICH). Two definite seasonal peaks one in extreme summer (June, July) and the other in extreme winter(December, January) were seen. Conclusions: There is a significant variation in frequency of stroke and its differenttypes in different seasons of the year with higher occurrence in peak summer (June, July) and extreme winter(December, January).
INGUINAL HERNIA REPAIR IN A PERIPHERAL HOSPITAL
Authors: BHATTI IFTIKHAR AHMED
Published: September 2021

Objective: To know the results of two commonly employed surgical proceduresi.e., Darning and used of Mesh for inguinal hernia repair in adults, considering the cost effectiveness and bettercompliance. Design: Case descriptive study. Place and duration of study: Combined Military Hospital, Chunian - DisttKasur, from November 2004 to April 2006. Patients and Methods: Sixty adult males with the mean age of 48 yearshad inguinal hernia repair. Only two surgical procedure adopted. Group I includes 10 patients (16.3%) who hadprosthetic Mesh repair. Operative time and hospital stay was almost same in both groups. Results: Out of 60 cases,38 patients (63%) had right sided, 19(32%) had left sided and 03(05%) had bilateral inguinal hernia. 42(70%) hadindirect hernia, 17(28.3%) had direct hernia and only 01 patient (1.7%) had both types of hernia. In group-1, 04 patients(8%) had postoperative discomfort in the groin, 02 patients (4%) had scrotal haematoma and 01 patient (2%) hadsuperficial wound sepsis. In Group - II, 01 patients (10%)had postoperative discomfort and only 01 patient (10%) hadwound sepsis. Not even a single case of recurrence developed in ant of the groups, during the periods of follow up andalso no case of chronic residual neuralgia. Conclusion: Based on my study, it is concluded that Darning with proleneis a safe and cost effective procedure than the use of prosthetic mesh.
CHRONIC HEPATITIS B VIRUS INFECTION
Authors: AHMED EJAZ
Published: September 2021

Hepatitis B virus is a major health dilemma causing an enormous burden on the health care systemand a major source of patient’s suffering. Over the last decade, far-reaching research has not only led to theenhancement of present management of chronic hepatitis B, but has also revealed new options for the treatment ofthis appalling disease. Presently interferon alpha- 2b, lamivudine, adenofovir dipivoxil and tenofovir are being employedfor the management of chronic hepatitis B infection. However, extensive research is being carried out to assess theefficacy of peg- interferon, emtricitabine, entecavir and telbivudine in treating chronic hepatitis B infection.
CRIMEAN- CONGO HAEMORRHAGIC FEVER;
Authors: PIRKANI GHULAM SARWAR , JOGEZAI ESSA KHAN
Published: September 2021

Crimean- Congo Haemorrhagic Fever (CCHF) is a zoonotic disease caused by the bite of infected ticks, widely distributed in Asia and endemic in northern and western areas of Pakistan, In Pakistan first human outbreak reported from Rawalpindi in 1976. In Balochistan first outbreak occurred in 1987. Since than every year outbreaks of CCHF occur in northern parts of Balochistan. We are reporting our experience in detail, of these outbreaks and information about clinical picture, treatment ant preventive measures for CCHF cases.
BIABHIG PATIENTS;
Authors: GHAZI, MUHAMMAD AHMAD , AKRAM YASIR , CHEEMA MUHAMMAD ARSHAD
Published: September 2021

Objective: Diabetics develop complications as a result ofinfection, microangiopathic and neuropathic changes. All these complication can be anticipated andprevented with good glycemic control and maintaining good podiatric care. This study was conducted todetermine the presentation and out come of diabetics in general surgical ward. Design: Observational crosssectional study Setting: Emergency and out patient department of South Surgical Ward, Mayo HospitalLahore. Period: Six months (1st June to 30th November 2004), Material and methods: 51 patients withdiabetes mellitus presenting, it included all the patients with diagnosed diabetes mellitus presenting withsurgical complications relating to their diabetes. All other patients who were normoglycemic or knowndiabetics without any surgical complications were excluded. Patients presenting with ulcerations on foot andlegs were classified on the basis of Wegners classification. Results: Out of 51 patients, 43.1%( 22) had adiagnosis of diabetic foot, 33.3%( 17) had an abscess and 23.5%( 12) had an abscess. According to theWagener's classification*. Class 2 was most common at presentation 34.8% and 23.5% of the patientspresenting with diabetic foot had to undergo an amputation thus suffering from a permanent disability.Conclusion: Good surgical debridement and proper use of antibiotics is required as well as good glycemiccontrol for early and safe recovery.
THYMECTOMY IN MYASTHENIA GRAVIS
Authors: FIRDOUS ROBINA
Published: September 2021

Background Anaesthetic management for thymectomy in myasthenia gravis (MG) presents a significant challenge to the anesthesiologist due to neuromuscular involvement. One of the recommended techniques of general anaesthesia is to avoid the use of muscle relaxants and rely on propofol anaesthesia or a combination of propofol and an analgesic. Objectives: This study was undertaken to investigate the efficacy and safety of propofol-tramadol anaesthesia for transsternal thymectomy in MG and to find out whether it allows early extubation. Design of Study: Quasiexperimental/ before-after type Setting: PMC, District Headquarter Hospital, Faisalabad. Period: From February 2004 to July 2005 Methods: Twelve consecutive myasthenic patients undergoing transsternal thymectomy were included in this study based on temporal sampling. Anaesthesia was induced with propofol-tramadol, without muscle relaxants and maintained with propofol infusion and toradol and tramadol boluses as required, together with ventilation with oxygen and nitrous-oxide. Results: Propofoltramadol anaesthesia allowed early extubation of all the patients without any anaesthesia related complications. Conclusions: Propofol-tramadol anaesthesia is safe and allows early extubation.
BACTERIOLOGICAL INVESTIGATION
Authors: AHMAD ISHTIAQ , ANASRI NAVEED IQBAL
Published: September 2021

Adequate supply of fresh and clean drinking water is a basic need for all human beings on the earth. Although we as humans recognize this fact, we disregard it by polluting our water source. In order to combat water pollution, we must understand the problems and become part of solution. Thousands of persons come to Mayo hospital & KEMC daily and they consume the water from a single source, this study was therefore designed to note any contamination of water in different departments. Samples were takenfrom 15 different departments including the source. Analysis was done both physically and bacteriologically by E. coli count, adapting the procedure by Monica Cheeshbrough. It was revealed in our study that source of water supply was alright, but the contamination in some of the departments category B (acceptable) 5, 33.33% & category C (unacceptable) 8, 53.33% is most probably due to old rusted water pipes which are running along the drainage pipes.
EARLY COMPLICATIONS OF INGUINAL HERNIA REPAIR
Authors: BEG MIRZA ASADULLAH , MEHDI SYED HUSSEIN , SIDDIQUI SHEERAZ SHAKOOR
Published: September 2021

Introduction: Although most complications are of a mild variety, some severe, potentially life-threatening complications have also been reported such as bleeding from the femoral vessels. Period: From January till July 2005. Materials& Methods All adult patients admitted for inguinal hernia repair on an elective basis were included. Records of hernioplasties done were also incorporated in the database. Exclusion criteria Age under 14 years, emergency surgery and incomplete records. Results: A total of 205 elective inguinal hernioplasties were performed. The complications wereencountered classified into three categories; Pei-operative, Anesthesia-related & Post-operative. Conclusion: We propose that all future research categorize the complications according to the proposed causes so as to better streamline the future guidelines.
DARNING VS BASSINI REPAIR FOR INGUINAL HERNIA
Authors: GULZAR MUHAMMAD REHMAN , IQBAL JAVED , IKRAM UL HAQ MUHAMMAD , Afzal Muhammad
Published: September 2021

Introduction: Inguinal hernia repair is the most common surgical procedure performed after appendicectomy. There are many methods of repair practiced through out the world amongst which are the open hernia repairs and laparoscopic repair, two main types. Aims and Objectives: To find out the early recurrence within one year of the two open conventional methods, darn repair verses Bassini repair for the inguinal hernia. Patients and Methods: This study was carried out in the Surgical Unit 1 Allied hospital Faisalabad. One hundred adult male patients admitted in surgical unit I with clinical diagnosis of incomplete indirect inguinal hernia, were randomized to Bassini or Darning repair. Patients with contraindications for general anaesthesia, coagulation problems and those presenting with strangulated and obstructed hernia were excluded form the study. Results: Out of 100 patients, Fifty underwent Bassini repair with prolene and the other 50 had Moloney's Darn repair with prolene.65% of patients were in 20-24 yrs age group. Sixty four percent patients had right sided inguinal hernia.88 % had reducible inguinal hernia. In post operative complications, six patients with darn and 10 patients with Bassini had pain requiring strong analgesics. Haematoma was formed in 1 patient with darn and 2 patients with Bassini. Wound infection occurred in one patient with darn and three patients with Bassini. Only one patient with Bassini repair came back with recurrence after six months of operation. Conclusion: Bassini repair and Moloney's darn repair are comparable for young patients having primary hernia. However, Moloney's darn repair is superior in terms of post operative pain, need for analgesia and early ambulation.
PERIPHERAL VASCULAR DISEASES
Authors: MALIK GULZAR AHMAD , QURESHI KASHIF KURSHID , AHMAD IMTIAZ , Afzal Muhammad
Published: September 2021

Objectives: To observe the prevalence & presentation and to review the noninvasive approaches for the evaluation and treatment of patients presenting with peripheral vascular diseases at Bahawal Victoria Hospital Bahawalpur. Design: Prospective randomized study. Place and Duration: This study was conducted from July 2003 to June 2005 at the department of Surgery Bahawal Victoria Hospital Bahawalpur. Patients & Methods: Twenty patients, 2 females and 18 males admitted with peripheral vascular diseases (PVD) fulfilling the inclusion criteria were evaluated and treated medically and surgically. A standard noninvasive approach for the evaluation of these patients was adopted by history & thorough clinical examination, Doppler USG of the vessels, Ankle Brachial Indices (ABI), Duplex Scanning and MRI in a few cases. Results: The relative frequency of PVD at BVH Bahawalpur was 1.2%. The majority of patients (60%) were in the 4th decade of life and male (90%). The smoking was exclusively the major predisposing risk factor (90%). The common (90%) presentation of patients was intermittent claudication with 60% gangrenous disease with an average duration of 4years, The lower limbs were involved in 90% cases with 70% bilateral disease. Majority (90%) of the patients was diagnosed clinically and the objective severity of the disease was assessed with Doppler sonography in all the patients. The ABI was <0.5 in 85% cases. The duplex scanning was needed only in 10% patients. The treatment procedures carried out were primary amputation in 45% followed by conservative on medicines 20%, atherectomy in 15%, lumbar sympathectomy in 10% and resection or repair of pseudoaneurysms in 10% of cases. The ultimate rate of amputation at various levels was seen to be 75%. Conclusion: The prevalence of PVD is rapidly increasing in our society which is causing a horrible threat in the form of physical disabilities at a younger age group of poor class mostly. Smoking remains exclusively the only major risk factor. Much time and money can be saved by evaluating and treating these patients by noninvasive approaches but prevention is the besttherapeutic strategy achieving by abstinence from the smoking.
PERIPARTUM DILATED CARDIOMYOPATHY
Authors: KHAN SAFDAR ALI , BUKHSH MUHAMMAD , NAQVI SHAHAB
Published: September 2021

Peripartum cardiomyopathy is a relatively rare but life threatening disease. The etiology and pathogenesis of peripartum cardiomyopathy remains largely theoretical and is generally centered upon viral and autoimmune mechanism. This case report describe the anaesthetic management of a patient suffering from dilated peripartum cardiomyopathy, successfully managed with epidural anaesthesia.
CONVENTIONAL OPEN AND MINI CHOLECYSTECTOMY
Authors: MANAN ABDUL , AHMED IRFAN , AFTAB FARRUKH
Published: September 2021

Introduction: Gall stone disease a second commonest abdominal problem after acute appendicitis,which needs proper and early investigation to reduce the agony and complications of the disease. For acute attacksof cholecystitis in old days, conservative treatment was recommended. Objective: To compare the conventional openand mini-cholecystectomy. Material and Methods: Setting: Nishtar Hospital, Multan. Duration: Six months (From Oct1998 to Mar 1999). Sample Size: 50 cases. Sampling Technique: Purposive, non-probability. Study Design:Comparative, cross-sectional study. Results: Among 50 patients of gall stone, 8 (16%) were male and 42 (84%) werefemale. As regards age, 16 (32%) were of < 40 years, 14 (28%) between 41-50 years and remaining 20 (40%) wereof > 50 years. Out of 50 patients, 32 (64%) patients presenting with pain right hypochondrium, in 14 (28%) patientspresenting complaint was pain epigastrium. In 25 patients of group-A, who were treated conventional opencholecystectomy; the average hospital stay was 8.66 days with shortest stay of 6 days and longest stay of 10 days. Outof 25 patients (16 (64%) patients were discharged after 8th day while 4 (16%) patients were discharged after patientswere discharged after 6 days. In the 25 patients of group-B who were treated by minicholecystectomy, the meanhospital stay was 3.33 days with shortest of 2 days and longest of 5 days. Eight (32%) patients were discharged on 2ndpostoperative day, while 14 (56%) were discharged on the 3rd postoperative day. Conclusion: Mini-cholecystectomyis associated with less patients discomfort and decreased incidence of postoperative complications.
EPIDURAL ANALGESIA
Authors: AHMAD FAROOQ
Published: September 2021

Objective: To find out the association of epidural analgesia duringlabour with long termbackache. Design: A randomized controlled trial. Setting: Combined Military Hospital Rawalpindi.Period: March 2002 to Feb 2003. Material and Methods: 100 randomized to epidural group and 100 randomized tonon-epidural group. In the follow up study 92 women were from the epidural group and 89 from the non-epidural group.Results: There were no significant differences between groups in demographic details or other key characteristics.There were no significant differences in the onset or duration of low back pain. There were no differences in selfreported measures of disability in activities of daily living and no significant differences in measurements of spinalmobility. Conclusions: The incidence of new long term backache was not significantly increased in women whoreceived epidural analgesia in labour. Motor block resulting from epidural local anaesthetic administration was not asignificant factor in the development of backache.
HEPATITIS B MARKERS
Authors: AHMAD AMEER , REHMAN ABDUL , KHICHI GHULAM QASIM KHAN
Published: September 2021

Objective: To determine the transmission of Hepatitis B virus from infectedmother to their newborns. Design: Cross-sectional descriptive study. Setting: Pediatrics Ward-2 and Gynecology &Obstetric Department Bahawal Victoria Hospital/Quaid-e-Azam Medical College Bahawalpur. Period: From August2004 to December 2005 Material and Methods: A total of 300 pregnant ladies admitted in the gynecological andobstetric department for delivery were screened for HBsAG, HBeAG, HBcAB, HBsAB, and HBeAB. The newborns ofthe mothers with HBsAG and HBeAG were tested for the same antigens at the time of birth and the ones who werepositives for the antigens were labeled as having “vertical infection” through placenta. Results were tabulated; incidenceof hepatitis was calculated. RESULTS: HBsAG was positive in 37(12.3%) out of the 300 enrolled mothers. Out of the37 babies born to 37 hepatitis B positive mothers, 4(21%) newborns were positive for HBsAG.In the mothers of theseinfected newborns, HBeAG was present in 3 while one mother did not have HBeAG. CONCLUSION: Universal prenatalscreening for hepatitis B in all the pregnant women and protection of their off springs should be provided both by activeand passive prophylaxis immediately after birth depending upon their serological status.
ROAD TRAFFIC ACCIDENTS
Authors: KHAN MOHAMMAD HUSSAIN , Babar Tariq Sohail , AHMED IFTIKHAR , Babar Khalid Shakeel , ZIA NIAMATULLAH
Published: September 2021

Context : Road traffic accidents are a major yet neglected publichealth problem in developing countries. Trends in motorization indicate an increase in road traffic injuries;furthermore, by 2020, they could rank third in the order of burden of disease Road traffic accidents are an importantyet preventable cause of death and disability in developing countries, like Pakistan. Objective: To explorepreventable aspects of the road traffic accidents. Design: Cross sectional study Setting: Casualty department ofDistrict Head Quarter Teaching hospital Dera Ismail Khan. Patients & Methods: All non-fatal and non-comatosecases of road traffic accidents victims reporting to casualty department were included in the study. The victims ofthe accidents were interviewed to obtain information about circumstances leading to accidents. The informationcollected comprised: time of accidents, nature of injury, narcotic consumption of driver, condition of road andvehicle, safety belts, road signs and vehicle speed beside demographic characteristics of respondents. Results:Age revealed that age group 21-25 years were highly affected 18 % while age group 51-55 years were leastaffected 2 %. Among them were male 76 % and were female 24%. 93 victims belong to rural area ( 62%) while 57were from urban (38%). Among victims, 37% were motorcyclist, 23% bicyclist , 22% motorized two-wheelers and18% bus users. The accidents were more common during the daytime in 100 cases (66%). Fractures of bones wascommon injury in 90 cases (60%) afflicted to the victims followed by multiple injuries like blunt injuries, abrasionsand lacerations. Among victims , only 2% used protective helmets. All helmet users were motorcyclists. No seatbelts were found to have been used by the victims. There was no evidence of any narcotics consumption by thedriver prior to accidents. Conclusion: Road traffic accidents are predictable and preventable but good data isimportant to understand the ways in which road safety interventions can be effective. Cost-effective preventivemeasures can be designed to address this global problem.
EPHEDRINE FOR PREVENTION HYPOTENSION
Authors: CHOHEDRI ABDUL-HAMEED , SHAHBAZI SHAHRBANO , KHOJESTE L , Alahyari Elahe
Published: September 2021

Background/Aim:. To ameliorate post spinal anesthesia hypotensionin patients undergoing cesarean section. To compare the incidence of maternal hypotension associated withspinal anesthesia for cesarean section when intravenous (IV), intramuscular (IM) or oral prophylactic boluses ofephedrine were used. Design: Prospective randomized double blind study. Setting: Department of anesthesiology,Zainibiae Hospital, Shiraz University, Iran. Period: From: June 2004 to November 2005. Materials and Methods:60 ASA grade I-II pregnant mothers were enrolled. Spinal anesthesia was performed using 60-70 mg of 5% solutionof lidocaine. The patients were divided into three equal groups (n=20). Oral and IM ephedrine (25 mg) wasadministered to the first two groups 30 to 60 minutes before induction of anesthesia (Group A and B, respectively). Inthe last 20 patients, IV Ephedrine (25 mg) was administered immediately after induction of spinal anesthesia (GroupC). Maternal blood pressure and pulse rate was checked every 2 minutes. Hypotension was promptly treated with 10-mg ephedrine boluses. Results: Both IM and IV prophylactic doses of ephedrine significantly decreased the incidenceof hypotension, compared to oral prophylactic dose of ephedrine [4/20 and 0/20 in the IM and IV ephedrine groups,respectively vs. 9/20 in the oral ephedrine group (p < 0.05)]. Conclusion: Oral prophylactic dose of ephedrine is noteffective in preventing hypotension in pregnant women undergoing cesarean section with spinal anesthesia. Therefore,we only recommend a single bolus of IV ephedrine with a dose of 25mg.
ND: YAG LASER CAPSULOTOMY AND COMPLICATIONS
Authors: JAVED EJAZ AHMAD , AHMAD ZIA UD DIN , SULTAN MUHAMMAD
Published: September 2021

Objectives: To evaluate the complications of Nd:Yag laser when applied onpostoperative posterior capsule opacification (PCO), following extra capsular cataract extraction (ECCE) with intraocularlens (IOL). Design: Analytical and descriptive study. Setting: Eye OPD of DHQ Hospital, PMC and Clinic of ProfessorZia ud Din Ahmad, Faisalabad. Period: From Jan 2006 to Jan 2007. Material & Methods. There were 120 patients;age ranged from 15 years to 80 years with post operated extra capsular cataract extraction with posterior capsularopacification. A Proforma was made which included detailed history of diabetes, hypertension, time period of cataractextraction, other relevant surgical or medical history, and examination e.g. Visual acuity, slit lamp examination,intraocular pressure measurement (applanation tonometry) dilated posterior capsule examination and slit lampbiomicroscopy etc. The patients were kept under observation for 5 hour and called for follow up after one week.Results. Out of 120 patients 70 eyes showed visual improvement from 6/18 to 6/6 (58.34%), while 30 Shown visualacuity improvement from count figures to 6/24 (25%), mild anterior uveitis occurred in 8 cases (6.67%), corneal damagein 2 cases (1.6%) while transient raised Intraocular Pressure (IOP) in 7 cases (5.83%). The damage to IOL observedin 3(2.5%), the corneal damage was seen in 2 cases (1.67%). Conclusions: The Nd; Yag Laser is very effective, cheapand easy mode of treatment for PCO with minimal post laser complications.
DIABETES MELLITUS TYPE 2
Authors: AHMED NAZIR , ALI JOHAR , ANWAR WAQAS , Akbar Syed Ali
Published: September 2021

Objective: To assess the body mass index in patients withdiabetes mellitus type 2 in a tertiary care hospital. Study design: Analytical (cross-sectional) study. Place and durationof study: The outpatient clinic at Shahina Jamil Trust Hospital Abbottabad from November 2006 to April 2007. Patientsand methods: One hundred patients seen in the outpatient clinic were enrolled in the study. All patients were 30 yearsof age or above, diagnosed as a case of diabetes mellitus were included. Patients with diabetes mellitus type 1 andpregnant diabetic women were excluded. Results: Sixty-seven percent were females and thirty three percent weremales. Mean age of the patients was 53.4±11.0 years (F: 51.9±12.0, M: 56.5±7.8) and mean duration of diabetesmellitus type 2 was 7.1±6.5 years (F: 7.1±6.4, M: 7.9±6.8), mean height of patients with DM type 2 was 1.5±.09 m (F:1.5±.08, M: 1.6±.08), mean weight was 71.4±14.3 kg (F: 70.1±15.0, M: 74.2±12.6), and mean BMI was 28.3±6.4 (F:28.7±6.9, M: 27.5±5.2). Among all patients, 34% (F: 23, M: 11) had normal weight, 28% (F: 17, M: 11) were overweight,32% (F: 23, M: 9) were obese and 6% (F: 4, M: 2) had morbid obesity. Conclusion: There was strong association ofobesity with type 2 diabetes mellitus with no significant difference of mean BMIs among male and female patients.
RADIAL NERVE INJURIES;
Authors: RASHEED MAQSOOD UL HASSAN , MASHHOOD ASHER AHMAD , AKHTAR MUHAMMAD RIAZ , Khan Muhammad Babar
Published: September 2021

Objective: To highlight etiological factors leading to radial nerve injury resulting in wrist drop, withparticular reference to iatrogenic causes. Design: Retrospection & Descriptive. Material & Methods: One hundredpatients of all ages and both sexes with wrist drop. Data of clinical assessment after detailed history and examinationas well as electro diagnostic studies was recorded on pre-designed assessment proforma. The outcome was charteddown for frequency of etiology of the wrist drop. Setting: Rehabilitation Medicine Department of Combined MilitaryHospital (CMH) Multan and Armed Forces Institute of Rehabilitation Medicine (AFIRM). Results: The major cause ofinjury was splinter/gun shot injury 31%, mis-placed injection at mid-arm 21%fracture of humerus was 21%, compressionneuropathy 16%, and stab wound 11%caused wrist drop. Electro-physiological studies revealed that 85% patients hadinjury to radial nerve at mid-arm, 9% had injury to posterior interosseous nerve while 4% had injury to superficial branchof radial nerve and only 2% had normal study. Electrodiagnostic studies also revealed that majority of the patientssuffered from axonotmesis (44%) and neurapraxia (38%), whereas (16%) were neurotmesis. Conclusion: The mostcommon cause of radial nerve injury is trauma. It is also found that the frequency of radial nerve palsy due to iatrogeniccauses is quite high. In addition to the clinical examination, the nerve conduction studies and electromyography provedto be the better investigation technique in the assessment of the location, severity and extent of the peripheral nerveinjury and subsequently guides in starting the proper treatment option due to early referral of patient to the concernedfields.
IRON STATUS IN PREECLAMPSIA
Authors: ZAFAR TASNEEM , IQBAL ZAFAR
Published: September 2021

Objective: To evaluate iron status in pregnancy induced hypertension and role of iron in the etiologyand pathogenesis of pre-eclampsia. Design: Coefficient correlation study. Place and Duration. At Department ofBiochemistry, Frontier Medical College, Abbottabad with collaboration of Department of Obstetrics and Gynecology,Ayub Medical Complex, Abbottabad from March 2006-March 2007. Material and Methods: Study was performed onhundred pregnant women of age ranging between 15-35 years and having gestational age between28 to 34 weeks.Fifty obstetric patients were identified as having pre-eclampsia. Fifty healthy pregnant subjects were taken as controls,having uncomplicated pregnancies and were normotensive throughout gestation and without proteinuria. Results:Results depicts that mean age of pre-eclamptic group was significantly low (P<0.001) as compared to control. Bothparameters, Hemoglobin and Haematocrit were significantly higher (P<0.05) in pre-eclamptic as compared to controls.Serum iron, serum ferritin and transferrin saturation were significantly higher (P<0.001) in pre-eclamptic in comparisonwith control group. Total iron binding capacity and unsaturated iron binding capacity were significantly lower (P<0.001)in pre-eclamptic group when compared to control group. Correlation coefficient between serum iron, total iron bindingcapacity (TIBC), serum ferritin, unsaturated iron binding capacity (UIBC) and systolic and diastolic blood pressure inpre-eclamptic group showed no significant positive correlation in any parameter. Conclusion: It is concluded thathemoglobin, haematocrit, serum iron, serum ferritin and transferrin saturation are significantly increased in pregnantwomen that later develops pre-eclampsia. Excess iron is postulated as casual factor in the oxidative stress ie; in itsradical form, which may be involved in the pathogenesis of pre-eclampsia. Therefore, iron status of pregnant womenshould be assessed before giving iron supplements as these may cause more harm than benefit.
CATARACT SURGERY;
Authors: BHATTI ABDUL HAMEED
Published: September 2021

Objective: To compare the effects of spontaneous versus controlled ventilation on IntraocularPressure (IOP) with concomitant haemodynamic changes during cataract extraction and intraocular (IOL) implantsurgery under anaesthesia. Design: Comparative study. Place and Duration of Study: The study was conducted atdepartment of Anesthesiology Combined Military Hospital Jhelum Cantt from Jan 2005 to Oct 2005. Subjects andMethods: 40 ASA I and II patients of both sexes aged 40-68 years, undergoing surgical cataract extraction werestudies. In 20 patients ventilation was controlled while the other 20 patients breathed spontaneously during surgery.IOP was measured preoperatively in non-operated eye.Results: Intraocular pressure (IOP) decreased below the baseline after induction of anaesthesia but it markedly increased after intubation in both group. During operation IOPdecreased more in controlled ventilation group than spontaneous ventilation group. At the end of surgery beforeextubation, IOP increased in both groups with a greater rise in spontaneous ventilation group and extubation wasfollowed by a further rise in IOP in both groups. Heart rate (HR) and arterial blood pressure (BP) changes followedalmost the same pattern as IOP. Conclusion: General anaesthetics decrease IOP in general. Laryngoscopy andintubation are anaesthesia-related events, which cause rise in IOP. In appropriate patients, general anaesthesia withcontrolled ventilation is an acceptable technique for intraocular surgery offering advantages in terms of intraocularpressure and cardiovascular stability compared to spontaneous ventilation.
ACUTE ABDOMEN;
Authors: ASIF MUHAMMAD , HASHMI JAVED SAJJAD , ALMAS DANISH
Published: September 2021

Introduction: The term “acute abdomen” denotes any sudden spontaneousnon-traumatic disorder whose chief manifestation is in the abdominal area. There is frequently a progressive underlyingintra-abdominal disorder, the correct early diagnosis and treatment of which is essential for a favorable outcome.Objectives: (I) To find out the most common causes of acute abdomen. (II) To compare the preoperative assessmentwith postoperative diagnosis. Design: A Non-interventional Analytical (Comparative) study. Setting: Emergencydepartment of Combined Military Hospital Kharian. Period: Oct 2001 to Mar 2002. Patients & Methods: Total of 220patients who presented with acute abdomen. Results: The most frequent cause was found to be Acute Appendicitis,followed by Nonspecific abdominal pain, acute cholecystitis, acute intestinal obstruction and perforated duodenal ulcer.Preoperative diagnosis was wrong in 9.5% (n=21) of cases. Conclusion: Acute appendicitis was found to be the mostcommon cause of acute abdomen and the single most important cause of acute abdominal pain causing greatdiagnostic difficulties. the preoperative diagnostic accuracy can be increased especially in female of child bearing ageby using modern diagnostic tools especially laparoscopy.
DIABETIC FOOT ULCER GRADES
Authors: ALI JOHAR , AKBAR ALI , ANWAR WAQAS
Published: September 2021

Diabetic foot is one of the most common complications of diabetes mellitus. The management and out come is very much dependent on proper assessment of foot ulcer severity. Objectives: To asses severity of diabetic foot and to find a correlation between Ankle Brachial Pressure Index (ABPI) and foot ulcer grades. Study design: Prospective study. Period: Jan 2001 to Dec 2003. Patients & Methods and Setting: Patients with diabetic foot ulcers from all the medical and surgical units of Ayub teaching hospital Abbottabad were enrolled in the study. Results: Ankle Brachial Pressure Index (ABPI) levels revealed 5 (5.8%) with ABPI < 0.5 for grade V, 8 patients (9.3%) ABPI 0.5 – 0.89 for grade IV, 18 patients (20.9%) ABPI 0.9-1 for grade III, 44 (51.2%) ABPI 0.9-1 for grade II, and 9 patients (10.5%) ABPI > 1 for grade I diabetic foot ulcer. This data was analyzed via SPSS version 8.0. Conclusions: Ankle brachial pressure index is a good diagnostic tool to assess the lower extremity arterial disease in diabetic foot patients. ABPI readings should be cautiously interpreted as these may be falsely elevated in atherosclerotic patients.
EARLY LAPAROSCOPIC CHOLECYSTECTOMY
Authors: HINDUJA THAKUR K. , SHAIKH SHER MOHAMMAD , JALBAN MALICK HUSSAIN , Shaikh Nisar Ahmed , Soomro Ishaque
Published: September 2021

To assess the clinical out come of laparoscopic Cholecystectomyfor management of acute cholecystitis and to evaluate its safety, frequency of complications. Design: Observationalstudy. Setting: Surgical Units II and III Of Chandka Medical College Hospital Larkana.. Period: From 01.09.2003 upto 31.12.2007 Patients & Methods: A total of 100 consecutive cases of, acute cholecystitis confirmed subsequentlyby abdominal ultrasound scanning, who were admitted for early laparoscopic cholecystectomy. Results: There wasfemale preponderance with male to Female ratio of 1:4.5. Mean age was 45.75, SD 11.99, and most of patients werereceived with in 24 hours from the onset of symptoms. In 51 patients ultrasound reveals Edematous GB in 24(24%),Empyma 8(8%), Contracted 10(10%), Perforated 5(5%) and Gangrenous GB in 4(4%) while 49(49%) have acutecholecystitis with cholelithiasis. The conversion rate was 6%; The minimum time taken during the procedure was 50minutes. No mortality was reported in this series. Conclusion: Emergency / early cholecystectomy is reliable and safemodality cost effective, and timely surgery with modern conception in themanagement of acute cholecysttitis, becauseof accelerated recovery, negligible wound infection or related complication, and less postoperative pain. So Lap Choleshould be preferred technique now days for the treatment of acute cholecystitis at our Institute.
CORONARY HEART DISEASE
Authors: GILANi MUHAMMAD SHAH
Published: September 2021

Objective: To assess the value of coronary events reflected by changesin R-wave amplitude after exercise.Setting: Nishtar Hospital, Multan. Duration. One year. Study Design: comparativestudy.Material and Methods: Sample size 146 patients.Sampling Technique: Convenient probability sampling done.Results: All patients were followed up for 6 months, during which time myocardial infarction and death of cardiovascularorigin were considered endpoints. The incidence of events in patients in whom R-wave amplitude decreased (normalresponse) and in those in whom R-wave amplitude did not change or increase (abnormal response) was compared.The incidence of coronary events in patients with a normal response was 23% and in those with an abnormal response,45.8% (p<0.01). Correlating the results with several non invasive and angiographic variables, an abnormal R-waveresponse showed a significantly higher rate of events in the subsets of patients with prior myocardial infarction, absenceof cardiomegaly, maximal functional capacity lower than 4 METs, maximal heart rate higher than 140 beats/min andabnormal left ventricular function. Conclusion: The changes in R-wave amplitude after exercise is a variable thatshould be taken into account when assessing the risk of future events in patients with coronary heart disease.
HYPOGLOSSAL NERVE;
Authors: SABIR MUHAMMAD , JALIL ASIF , QAMAR ASLAM
Published: September 2021

Objective: To study the neurons contributing sensory fibers to thehypoglossal nerve. Setting: Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Period:From 1992 to 1995. Study Design: Experimental animal study. Material & Methods: Under general anaesthesia therequired hypoglossal nerves of twenty four albino rats were exposed and cut in the neck. Horse radish Peroxidase(HRP) crystals were applied to the central cut ends of the nerves and allowed to travel for about 48 hours. Aftertranscardial fixation with 1.25% gluteraldehyde and 1% paraformaldehyde solution, serial sections of upper cervicalDorsal Root Ganglia (DRG) were made on a freezing microtome, treated with Tetramethylbenzidine (TMB) andcounterstained by 1% neutral red. The number, size and segmental distribution of HRP labeled neurons were observedwith the help of light microscope. Results and Observations: In most of the animals, the HRP labeled sensory neuronsforming the right and the left hypoglossal nerves and their branches were localized ipsilaterally in (Cervical) C1 DRG(more than 90%) whereas in remaining cases labeled sensory neurons were observed in C2 DRG. Size spectrum forsensory neurons of the hypoglossal nerve and its branches ranged from 9 to 52:m, but more than 75% were less than40 microns.Conclusion: Neurons of DRG of C1&2 contribute sensory fibers to the hypoglossal nerve of the same side.
ASSESSMENT OF SOCIO-ECONOMIC STATUS OF PATIENTS
Authors: ASHFAQ AYESHA , FATIMA NOOR , DAUD SEEMA , Ahmed Ahsen Nazir , Imam Zakariya , Shamshai Khayyam , Hussain Salwa
Published: September 2021

Objective: To determine whether or not doctors assess the socio-economicstatus of their patients in order to customize treatment and improve compliance. Design: A cross-sectional Setting:Jinnah Hospital and Shalimar Hospital Lahore. Period: From March to June 2005 Methods & Material: Ninety-threepatients were included from each of the two randomly selected tertiary care hospitals (one public, one private) ofLahore. Doctor-patient encounters were observed. Results: No assessment was made for 134/186(72%) patients.51/186(27.4%) received an inadequate assessment. Only 01/186(0.5 %) patient received a thorough assessment ofhis socioeconomic status. Doctors in the private hospital made better effort to assess the socioeconomic backgroundof the patient (albeit inadequately), compared to those in the public hospital (p: < 0.0001). Conclusion: Doctors shouldbe regular and meticulous in patients’ socioeconomic status assessment.
POST MENOPAUSAL BLEEDING
Authors: CHEEMA SADIA ZULFIQAR , IKRAM MUHAMMAD , SAEED ROOHI , Saeed Muhammad
Published: September 2021

Objective: To find out the causes of postmenopausal bleeding and their correlation with medicalillness. DESIGN: Single centre, cross sectional study. Place and duration: The department of obstetrics andgynaecology, Shaikh Zayed Postgraduate Medical Institute and hospital, Lahore from 1 August 2000 to 30 June 2002.st thSubjects and methods: All the patients with post menopausal bleeding diagnosed during the study periods wereincluded, except patients after hysterectomy and premature menopause. Relative informations were filled in a Performaand informations were taken from case records. Results: Total 50 patients were included in the study. Maximumnumber of patients with postmenopausal bleeding were between 56-60 years (32%). Most of the patients were havingparity between 4-6 (48%). Majority of patients (32%) had symptom about 10 years after menopause. Hypertension,diabetes and obesity were commonly found medical illness in these patients, especially when cause is endometrialcarcinoma, ultrasound scan, Pap smear and endometrial biopsy are essential to rule out cause of post menopausalbleeding. 70% patients were having benign cause while 30% patients had malignant cause for post menopausalbleeding. Conclusion: Carcinoma of genital tract is one of the most important cause of postmenopausal bleeding, soearly detection of the cases can be life saving. Detailed medical evaluation, aid of ultrasonography, Pap smear andendometrial biopsy is required to find the cause of postmenopausal bleeding.
ABDOMINAL TUBERCULOSIS
Authors: REHMAN SHEIKH ATIQ-UR- , AHMED GULZAR , YAR AHMED
Published: September 2021

Objectives: To study the different clinical presentations, operative and postoperative course ofabdominal tuberculosis. Design: Case series study. Setting: Surgical units, Bahawal Vicotria Hospital, Bahawalpur .Period: May 01, 2005 to April 30, 2007. Patients & Method: This was a prospective type of case series study. Aselection criterion of patients was that all patients of either sex & age being diagnosed as case of abdominaltuberculosis. The clinical record of the patient’s data, symptoms & signs, biopsy report, biochemical & radiologicalreport, treatment (surgery & chemotherapy) given and a follow-up. Results: Total 96 patients presented with abdominaltuberculosis, 60(62.5%) were male & 36(37.5%) were female. Peritonitis was present in 48(50%) patients, intestinalobstruction(acute & sub-acute) was present in 32(33.33%) patients, mass right iliac fossa was present in 14(14.58%)patients and 2(2.08%) patient presented with mass in the epigastrium. 28(29.16%) patients has concurrent pulmonarytuberculosis. Two patients expired so mortality rate was 2.08%. Conclusion: The control of TB has been a challengingproblem because the natural history of the disease and its varying pattern in which it manifests is in different groups.
Assessment of illiterate mothers’ perceptions on birth control and the control measures practice in Zamfara State, Nigeria
Authors: Munirat Ajoke Abdulrahman
Published: September 2021

This study sought to assess the perceptions illiterate mothers on birth control and the control measures practice in Zamfara State using some selected Local Government Area (LGA) as case study. The descriptive survey research design was adopted. The study population consisted of all nursing but illiterate mothers in Zamfara State. Four hundred (400) illiterate mothers were selected sampled out of the study population using stratified simple random sampling technique. Two research questions and four null hypotheses were formulated and tested at the 0.05 levels of significance. The study made use of questionnaire as research instrument. The instrument was subjected to face and content validity by three (3) medical practitioners from Federal Medical Centre Gusau. The data collected from the study were analyzed using descriptive statistics (mean and Standard deviation) and the t-test statistical analysis was used to test the null hypotheses. Findings from the study revealed that there was a statistically significant difference between the Pre-test findings and the findings after being exposed to measures to be taken in birth control; There was a statistically significant difference between the Pre-test findings and the findings after being exposed to factors that contribute to their not utilizing some birth control measures and advised on the way forward.
Factors influencing place of delivery among women residing in Ifakara Town Council, Kilombero District, Tanzania
Authors: Sylivester Wanyaseleli Mkama
Published: September 2021

Background: This study was done to assess factors influencing place of delivery among women residing in Ifakara Town Council, Kilombero district, Tanzania. Method: A community based descriptive cross-sectional study was conducted in February 2021. A total of 135 child bearing women from 3 randomly selected wards of Ifakara Town Council were involved in the study. Structured pre-tested questionnaire with key information was used to collect desired data. Results: More than half 55.6% of the women had health facility delivery and 44.4% of them had home delivery. The most common reason for home delivery was sudden onset of labor 50.4%. Other reasons for home delivery were age of 26 and above, parity of four, and education of mother. Conclusion: Maternal health services, such as antenatal care, skilled assistance during delivery and post-natal care, adequate equipment in health facilities, play a major role of in the reduction of maternal morbidity and mortality. Therefore, efforts should be made both at community and government levels to increase health facility delivery.