bluuebunny/crossref_metadata_2025 huggingface dataset:
SPINAL ACCESSORY NERVE IN SUDANESE SUBJECTS;
Authors: REZIGALLA ASSAD A. , ALI QURASHI M. , ALI ELTAHIR O.
Published: September 2021

Objective: the aim of this article was to study the spinal accessory nerve in Sudanese subjects. Method: dissection of formalinfixedcadavers' necks. Results: in Sudanese the SAN exits as one trunk from the jugular foramen anterior to IJV then crosses lateral to it.Rarely SAN exits as two branches. Usually the nerve passes beneath SCMM and supply it by direct or side branch. Muscular branches of SANhave connections from the cervical plexus mainly C2, 3. Conclusion: There are some differences in the course, branches and connections ofthe spinal accessory nerve in Sudanese from what is described in standard textbooks of anatomy.
PLEURAL EFFUSION;
Authors: MUSHTAQ AZAM , AYYAZ Salman , AHMED KHAN SHAKEEL
Published: September 2021

Objective: To determine the frequency of various diseases presenting with pleural effusion. Setting: Department of ChestMedicine, Nishtar Hospital, Multan. Period: March 2010 to September 2010. Material and methods: A total of 100 patients both sexes, morethan 12 years old, with clinically and radiologically confirmed pleural effusion underwent diagnostic thoracocentesis. Pleural fluid wasexamined grossly and for sugar, protein, LDH, total and differential white cell count and malignant cells. Pleural fluid culture and pleural biopsywas done in case of exudative effusion. Results: Tuberculosis was the most common cause (28%) of exudative pleural effusion followed byparapneumonic effusion (25%) and malignant effusion (9%). Congestive cardiac failure (13%) and liver cirrhosis (8%) were the commonestcause of transudative pleural effusion. Renal failure (5%), nephritic syndrome (2%), pancreatitis (2%), systemic lupus erythmatosus (2%) werethe other significant causes of pleural effusion. Conclusion:- Tuberculosis, paraneumonic effusion and malignancies are the common cause ofexudative pleural effusion while congestive cardiac failure, liver cirrhosis and nephritic syndrome are common causes of transudative effusion.
ANALGESIC EFFICACY;
Authors: HUSSAIN KHOSA ABRAR , AHMED KHAN NADEEM , DURRANI HAQ DAD , Wadoo Zahra
Published: September 2021

Aim: To compare the analgesic efficacy of a single dose preoperative intramuscular Ketorolac versus diclofenac sodium forprevention of postoperative pain after third molar surgery. Design: This Experimental comparative study. Setting: Department of Anesthesia,Pakistan Atomic Energy Commission, Al-Zahra Hospital, Geo Care, and Maryam Maternity Hospital, DG Khan. Period: October 2011 to March2012. Material and Method: Patients undergoing elective third molar surgery were randomly assigned into one of the two groups. In eachgroup, 60 patients completed the study properly. Group-I received diclofenac sodium 75 mg IM 20 min preoperatively and group-II receivedKetorolac 30 mg IM 20 min preoperatively. Result: Patient in Ketorolac group reported significantly lesser pain intensity scores in the 3rd hourpain than the Diclofenac group (p-value lesser than 0.0001). Patient also reported significantly longer mean time to rescue analgesic 7.5 hversus 4.8h (p lesser than 0.001., student t test) that is approximately 2.5 h longer duration of preventive analgesic consumption (p=0.006,student t test). Conclusions: Preoperative intramuscular injection of Ketorolac 30 mg is more effective than Diclofenac 75 mg in the preventionof post operative 3rd molar pain.
ULTRASONOGRAPHIC EVALUATION;
Authors: SIDDIQUI EJAZ HUSSAIN , SIDDIQUI SAAD , RASOOL Ghulam , Shah Noreen
Published: September 2021

Objectives: To assess common presenting complaints and the role of ultrasound in evaluating neck masses in pediatric andadult population. Design: Cross sectional. Setting: Khyber X-Ray, 7 Khyber Medical Centre, Dabgari Gardens, Peshawar. Period: July 2011to December 2011. Material and Methods: Data from patients presenting for evaluation of a neck mass was analyzed for presentingcomplaints and ultrasound findings according to objectives of the study. Results: In total 105 cases were included in the study. The mean ageof patients was 36.8 years with a male to female ratio of 1:2.1. The age wise categorization included pediatric population (10.5%) adultpopulation (89.5%). Both painful and painless neck swellings were common presenting complaints in pediatric population with cervicallymphadenopathy being the most common ultrasound finding. Among Adult males painless neck swelling was the most common presentingcomplaint with cervical lymphadenopathy followed by Multinodular goiter being most common ultrasound findings. Most common presentingcomplaint in Adult females was painless neck swelling with Multinodular goiter being most common ultrasound finding. Conclusions: NeckMasses are commonly encountered in all age groups especially pediatric population and adult females, Ultrasound is a useful and safemodality in evaluation of neck masses.
POLYCYSTIC OVARIAN SYNDROME;
Authors: BUTT KIRAN , DEEBA FARAH , ATTIQUE HAVAIDA
Published: September 2021

Objective: The objective of the present study was to determine the changes in the glucose level and lipid profile in patients withpolycystic ovarian syndrome (PCOS). Study Design: Descriptive study. Place and Duration of the study: This study was conducted atInstitute of Molecular Biology and Biotechnology, The University of Lahore from June 2009 to June 2010. Patients and Methods: Total 50patients with PCOS were included and 50 age-matched control subjects were also selected for comparison. Their glucose levels and lipidprofile were assessed using commercial kits. The data thus obtained was subjected to statistical analysis. Results: Significant differences(P<0.05) in fasting blood glucose level and individual parameters of lipid profile were observed in women with PCOS. A higher prevalence ofhypertriglyceridemia, hypercholesterolemia, higher LDL, lower HDL and higher fasting blood glucose levels was explored in PCOS womenthan controls. Conclusions: Abnormal glucose level and lipid profile in PCOS women showed that these women are at an increased risk ofdeveloping diabetes and subsequently cardiovascular diseases.
PROTEINURIA IN HIV POSITIVE PATIENTS;
Authors: FARRUKH SYED ZEA-UL-ISLAM , AURANGZEB Muhammad , ALAM MUHAMMAD TANVEER , Imran KHALID , Rehan Muhammad , Masroor Muhammad , Kumar Pawan
Published: September 2021

objective: To determine the frequency of proteinuria in HIV positive patients at a tertiary care hospital in Karachi. Studydesign: Cross-sectional. Place and duration of study: This study was carried out in Infectious diseases wards and all medical wards of CivilHospital Karachi, from Jan 2011 to the Dec 2011. Methodology: A total of 170 patients from infection diseases wards and all medical wards ofCivil Hospital Karachi. Age more >12 years of either sex who were newly diagnosed cases of HIV based on positive HIV serology by ELISA andWestern blot in Infection diseases ward were Included. Patients having known kidney disease. urinary tract infection, serum creatinine morethan 1.5 mg/dl, diabetes mellitus, high blood pressure and old diagnosed cases of HIV who have already taken or who are taking HIV infectiontreatment were excluded from this study. Spot urinary sample was taken to measure the proteinuria by urine dipstick. To minimize bias allspecimen sent to same laboratory of the hospital. Results: 170 newly diagnosed cases of HIV were included in this study. Gender distributionshowed male preponderance (Male: Female = 6.4:1). Majority of cases 120 (70.6%) had age between 26 – 50 years. Mean age of women was30.3 ±7.4 years (min – max = 18 – 45 years) and for males was 34.3 ±9.6 years (min – max = 15 – 56 years). Out of 170 HIV positive casesfrequency of > 1+ protein in urine on urine dipstick analysis was found in 27 (15.9%) cases. Out 27 cases, 16 (59.3%) cases had age between26-50 years (mean ±SD = 32 ±10.1 years, min – max = 18 – 55 years). Proteinuria was high in increasing age groups. Proportion of proteinuriawas high in married and depressed patients , out of 27 cases, 18 (66.7%) were married and 9 (33.3%) unmarried. Frequency of proteinuria washigh in labor class, 11 of 27 (40.7%) were labors followed by house wife 6 (22.3%), while 5 (18.5%) were private job holder. Conclusions: In thisstudy I found a high prevalence of proteinuria in HIV positive patients. Such subjects show male preponderance distribution. We conclude thatHIV positive patients should be screened for proteinuria and if they found to have proteinuria, they should be subjected to appropriate treatmentto retard the progression of nephropathy and associated complications.
DIFFERENCE IN LIPID LEVELS;
Authors: RASHEED TAZEEN , IMRAN KHALID , ALAM MUHAMMAD TANVEER , Aurengzeb Muhammad , Qamar Rana , Kumar Pawan
Published: September 2021

Objectives: To determine the frequency of dyslipidemias in patients with stroke and to compare the lipid levels in ischemic andhemorrhagic stroke patients. Study design: An observational study. Setting: Medical wards of Civil Hospital Karachi. Period: January 2010 toJune 2011. Methodology: A total of three hundred and fifty- five patients above the age of 18 years with clinical evidence of stroke. CT scanbrain and fasting lipid levels were done in all patients. The lipid levels were compared between the ischemic and hemorrhagic stroke patients.Data was analyzed with SPSS version 16.0. Results: Out of the 355 patients 161 (45.4%) had dyslipidemia. Among the dyslipidemic patients,there was not a statistically significant difference in serum cholesterol, triglycerides, and LDL and HDL levels between ischemic andhemorrhagic stroke. (p- value > 0.05). Conclusions: There is a high frequency of dyslipidemia in stroke patients. While comparing ischemicand hemorrhagic strokes there was not a significant difference between the various lipid fractions.
IMPACT OF LAUNDERING ON BACTERIAL PENETRATION IN SURGICAL GOWNS
Authors: KISHWAR FARZANA , HANIF ASIF , ALAM SHAHZAD
Published: September 2021

Objectives: The objective of this study was to compare the mean bacterial penetration % in surgical gowns at differentlaundering cycles which were used in three different categories of Hospital. Material & Methods: Fifty, locally available reusable surgicalgowns were collected from all the major teaching hospitals of Lahore as sample. Samples were analyzed and compared against internationalstandards. Samples were tested at different laundering cycles (after 0, 5, 10, 15, & 20 washings). The gowns were laundered at Mayo hospitallaundry services. The surgical gowns were subjected to multiple laundering cycles. The bacterial penetration test was performed atMicrobiology Lab., PCSIR (Pakistan Council of Scientific & Industrial Research) Laboratories Complex, Lahore. Data was analyzed by usingSPSS 16 versions and for comparison Repeated measurement ANOVA was used. A p-value less or equal to 0 .05 will be considered assignificant. Results: Overall the mean ± S.D penetration of bacteria in all samples was as under, at 0 Washing (86.47±2.91%), 5th washing(91.53±1.72%), 10th washing (95.60±0.91%), 15th washing (08.53±0.34%) and at 20th washing (99.47±0.13%). While comparing ondifferent laundering intervals or times the penetration of bacteria (%) was statistically increased from 86.47±2.91% to 99.47±0.13 %, p-value0.001. Conclusions: When studied for change in porosity after laundering reusable surgical gowns set up of hospitals in Pakistan resulted inincreased porosity and hence more penetration of bacteria across the fabric used for manufacture of surgical gowns. The loss of barrier effect ofsurgical gown is further compounded by lack of standardization of laundering technique, infra-structure use of improper detergent and othercleaning agents. This loss of fabric characteristics results in more bacterial contamination of surgical wound risk of infection to the patient.
HEPATITIS AND AIDS FEAR AND MISCONCEPTIONS;
Authors: ZAMAN KHAN MUHAMMAD LAIQ UZ , JAWAID MASOOD , HAFEEZ KAMRAN , Shaikh Ubedullah
Published: September 2021

Introduction: Blood born infection is also one of the medical profession hazard which is added due to virus transmission byneedles and medical instruments and Hepatitis and HIV viruses are leading viruses in this hazard. Medical students who are activelyparticipating in clinical practices and due to contact with patients, face exposure of patient’s needles, instruments, and blood and this exposurestarts in clinical posting of third year when their clinical knowledge and professional skills are in early phases. Objective: To assess andevaluate the existing level of knowledge about these blood born infections (Hepatitis B, C and AIDS) to ensure their participation in clinicalactivities during their clinical posting. Design: An observational cross sectional study with prospective data. Setting: Dow InternationalMedical College. Period: from 2010 to 2011. Methodology: This is an observational cross sectional study with prospective data, done through aquestionnaire survey on third year MBBS students. Results: 47% of the students have fear about to be infected by patient’s examination duringclinical posting and majority of students have misconceptions about transmission of these infections. Students have more knowledge aboutHIV compare to hepatitis but there is no relation in knowledge score and student’s fear as shown by p value of 0.3 and 0.73 for HBV and HIV butfor HCV (p= 0.035) during this study. Conclusions: Up to half of the students have fear to be infected by these infections during patient’sexamination and this perceived risk of infection is due to lack of knowledge and these misconceptions and attitude to these patients are thesources to make them reluctant in active participation of clinical activities directly related to patient.
ALVARADO SCORE;
Authors: ALI SHAFAQAT , MALIK ZAKA ULLAH , ASIM NIAZ M. MUTTAHHAR , Ahmed Naveed
Published: September 2021

Objective: To determine the validity of Alvarado score in diagnosing acute appendicitis keeping histopathology of appendixas gold standard. Study Design: Cross sectional (Validation) study. Place and Duration of Study: Department of Surgery CombinedMilitary Hospital Rawalpindi from April 2009 to October 2009. Materials and Methods: 90 patients with clinical suspicion/diagnosis ofacute appendicitis were included in study. All were divided into two groups on the basis of Alvarado score. Group I with score 7-10, whounderwent open appendicectomy. Group II(a) with 5-6, who were observed in hospital. Group II(b) with< 4 were discharged. In alloperated cases appendix was sent for histopathology. Alvarado score was compared with histopathology (gold standard). Results: Maleto female ratio was 3.5 :1. Mean age was 25.34. Alvarado score had overall 88.13% sensitivity, 70.96% specificity, 85.24% PPV,75.86%NPV and 16.90% negative appendicectomy rate. Whereas in male patients it had 90.74% sensitivity, 75% specificity, 92.45%PPV,70.58%NPV and 6.89% negative appendicectomy rate. In female it had 60% sensitivity, 66.66% specificity, 37.5% PPV, 83.33%NPV and38.46% negative appendicectomy rate. Conclusion: Alvarado score is very accurate for acute appendicitis in male patients. Patients withscore 4 can safely be discharged home. USG should be performed routinely in female patients to improve the diagnostic accuracy ofAlvarado score.
BRONCHIOLITIS;
Authors: AHMAD SHAKIL , AAMIR SADIDA , NAWAZ KHURRAM
Published: September 2021

Objectives: To determine the efficacy of oral salbutamol administration for symptomatic relief in children less than twoyears of age with acute mild bronchiolitis. Study Design: Interventional study. Place and duration of study: Outpatient department ofDepartment of Pediatrics, independent university hospital, Faisalabad, Pakistan, from October 2010 to March 2011. Methodology: 160children less than two years of age diagnosed clinically as acute mild bronchiolitis with comparable baseline parameters (age, weight,duration of present illness) were included in the study. They were randomly placed in two groups, Salbutamol Group (SG) (n=80)Placebo Group (PG) (n=80) and were followed daily for first 3 days, then on day 5 and day 7 in outpatient department. Oral salbutamolwas administered (0.1 mg/kg/dose) three times daily for 7 days or till complete resolution of illness, whichever came earlier. Time forresolution of illness (ROI) was primary outcome variable whereas time for resolution of cough, coryza, breathlessness, wheeze,achievement of normal feeding and sleep patterns and salbutamol adverse effects were secondary outcome variables. Results: Meanduration of resolution of illness (ROI) was similar in both groups. (6.1±0.75) days in the salbutamol group and (6.0±0.80) days inplacebo group (p=0.53). There was no significant resolution time difference of secondary outcome variables between the two studygroups. Cough (SG 4.1"0.70, PG 4.1"0.68, P=0.68) Coryza (SG 4.3"0.59, PG 4.2"0.62, P=0.14) Wheeze and Breathlessness (SG3.8"0.60, PG 3.8"0.63, p=0.24) Sleep (SG 4.5"0.40, PG 4.4"0.55, p=0.19) Feeding (SG 4.3"0.59, PG 4.2"0.62, P= 0.14). Salbutamoladverse effects (tremors, irritability) were observed in 13 (16.25%) children in salbutamol group. Conclusions: Oral salbutamoladministration is not superior to placebo in providing symptomatic relief in children with acute mild bronchiolitis.
CHRONIC HEPATITIS C-INFECTED PATIENTS;
Authors: PHULPOTO JAVED AHMED
Published: September 2021

Background: In our region the sensitivity of serum alanine aminotransferase (ALT) levels in predicting the severity ofhepatitis C virus (HCV) infection is unclear. Objective: To compare histologic scoring of liver pathology in patients with chronic HCVinfection with normal or elevated serum ALT. Study Design: Prospective observational study. Place & Duration of Study: Liver clinic,Ghulam Mohammad Mahar Medical College Hospital, Sukkur, between January 2010 and December 2010. Methods: Liver biopsies wereperformed in patients with HCV infection and either normal (n=40) or elevated (n=76) serum ALT levels, and scored for activity andfibrosis using the modified histological activity index. Results: Patients with normal ALT and elevated ALT had similar demographicfeatures. Median (range) histological activity grade was higher in patients with elevated ALT than in those with normal ALT (6 [1-15] vs. 5[0-11], respectively; p=0.001), as was the fibrosis stage (2 [0-6] vs. 1 [0-6]; p=0.02). Two patients with normal ALT and 4 with elevatedALT had liver cirrhosis. Conclusions: Among patients with chronic HCV infection, liver lesions are milder in those with normal serum ALTlevels than those with abnormal ALT levels. However, some patients with normal ALT too may have advanced liver disease.
BIOBRAN MGN-3
Authors: Masood Ahmad Ijaz , SHEIKH RABEETA , ANWER RANA ATIQUE
Published: September 2021

Objective: The aim of study was to assess the effect of Biobran in reducing of chemotherapy induced side effects in termsof tiredness, anorexia, vomiting and hair loss and quality of life in terms of weight loss. Setting: Radiotherapy Department, NishtarHospital Multan. Material and Methods: Fifty patients of breast cancer were enrolled randomly in two groups. Group-A patients weregiven 3 gram dose of Biobran MGN-3 per day one week before and one week after chemotherapy. Group-B patient were givenchemotherapy alone. Total six cycles of chemotherapy were given. No multivitamin or food supplements were given during this study.Chemotherapy induced side effects (tiredness, anorexia, and vomiting, hair loss) were assessed by questionnaire to the patients beforestart of each cycle. Weight was checked before each cycle to assess weight gain or loss. White blood cells were checked by completeblood count just before and one week after chemotherapy. Results: Between six months, 50 patients were enrolled in RadiotherapyDepartment, Nishtar Hospital Multan. There was a significant reduction in tiredness and anorexia in group-A patients. 20 (80%) patients ofgroup-A felt increase in their diet and no tiredness without any appetizer or multivitamin. But group-B patients demanded for appetizer dueto severe anorexia after chemotherapy except 3 (12%) patients who didn’t use any appetizer or food supplement. In group-A, 15 (60%)patients didn’t need any anti-emetic as compared to group-B all patient (100%) experienced severe nausea during and afterchemotherapy. Group-A patients experienced less hair fall 7 (28%) patients as compared to other group which is 25 (100%) patients.Conclusions: The study showed that, by helping to optimize the immune system, Biobran MGN-3 can not only help maximize treatmentsuccess, but also minimize treatment side effects and improve quality of life during treatment and in recovery.
NEONATAL RESUSCITATION;
Authors: ZAFAR FAUZIA , KHAN MUHAMMAD AZAM , FIAZ AHMAD ABDUL GHAFFAR
Published: September 2021

ABSTRACT… Each Year Billions of dollars have been spent on the various programmes for Maternal and child health services incollaboration with international organizations and hundreds of doctors and thousands of skilled (SBAs) birth attendants and lady healthworkers have been trained. Objective: To evaluate the impact of neonatal resuscitation programs on the prevalence of birth asphyxia in ahospital which drains a large population of Punjab. Study design: Cross sectional. Duration & Place of study: Department of PaediatricMedicine, Nishtar Medical College & Hospital, Multan from January 2008-December 2008. Methods: All newborns with a H/o failure toinitiate or sustain respiration at birth or H/o associated convulsions who were admitted (referred or hospital based) with the diagnosis ofBirth Asphyxia and a weight > 1.5 kg were included, still born and those with lethal congenital malformations were excluded. Aquestionnaire was designed after extensive review of literature and data recorded. The data of past 10 years for Birth Asphyxia was alsocollected from the hospital record and compared with the present results. Result: In year 1998 a total of 722 Newborns were admitted inour neonatal unit out of which 210 (29.0%) were diagnosed as Asphyxia Neonatorum. This number has progressively increased over thepast 10 years with a total of 846 out of total 2079 newborns (40.78%) admitted in 2008 with a diagnosis of asphyxia. Out of the total 846patients, there were 69% Male and 31% Female with a M:F ratio of 2.2:1. 46% were delivered by SVD (17.39% in Nishtar Hospital 15.21%by dais, 32.6% by Private doctors and 34.78% by LHV) and 54% were delivered by caesarian section, out of which 46.29% were deliveredin Private hospitals and 54% in Nishtar Hospital. Overall 65% deliveries were in the private sector or at home and 35% in the Governmenthospitals 60% babies had come from Multan and 40% from other town or cities. A H/o one or more antenatal visits was present in 68% ofmothers. Out of total cases of B.A. 26% were in B.A Grade-I 59% in Birth Asphyxia Grade-II 15% in B.A Grade-III. Out of this total 45%th expired. Discussion & Conclusion: As we are moving towards the 4 MDG and Pakistan strives to improve its health indicators and weclaim to decrease the infant mortality, neonatal and perinatal mortality rate. The incidence of birth asphyxia rises with increased burden ofmorbidity. Even though the principles of NRPs are recommended for international application, this program widely used in the developedworld has not been properly disseminated in communities in the developing countries, especially Pakistan.
ACUTE AND CHRONIC IMMOBILIZATION STRESS;
Authors: JUNJUA BASHIR AHMAD
Published: September 2021

ABSTRACT…Objective: To compare the morphological changes induced by acute and chronic immobilization in vermal cerebellarcortex of young male sprague dawley rats with special reference to Purkinje cells. Study design: It was experimental. Setting:Department of Anatomy CPSP Reional Centre, Islamabad. Period: 2005 to 2007. Material and method: A total of 120 young maleSprague Dawley rats were taken and divided equally in two groups (n=60 in each). Both these groups were divided further into twosubgroups (n=30 in each) control acute (CA), immobilized acute (IA), control chronic (CC) and immobilized chronic (IC). ‘Immobilizedacute’ group IA was kept in restrainer for 24 hours continuously while ‘immobilized chronic’ group IC was kept in restrainer for 2 hoursdaily for fourteen days, one rat per restrainer separately. Sections stained with Hematoxylin and Eosin were studied under lightmicroscope for observations and data was recorded. Results of experimental acute group were compared with those of experimentalchronic’. SSPS version 10 was used for data analysis. Results: Changes in the shape and size of the soma and nucleus of the Purkinjecells were noted. The cells were looking like dried raisins in both experimental groups but these changes were more marked in acuteexperimental group as compared to controls. The size of the soma and nucleus of the Purkinje cells was reduced in both acute and chronicimmobilized stressed groups’ however; this reduction in the size of the soma and nucleus of the Purkinje cells was more pronounced inacute stressed group as compared to animals exposed to chronic stress. Total cell count and cell size was significantly decreased in bothexperimental groups as compared to their controls; however, it was more pronounced in acute stressed group as compared to animalsexposed to chronic stress. Conclusions: Immobilization stress may act as a factor causing an imbalance in the metabolic activity of theneurons which can result in neuronal injury. The Purkinje neurons were affected more under the effect of acute stress as compared tochronic. The lesser effect in chronic stress is probably due to role of the phenomena of adaptation.
SERUM PROSTATE SPECIFIC ANTIGEN (PSA);
Authors: NAZ ZEHRA , ANJUM, SAADIA , RAZA MEHDI
Published: September 2021

ABSTRACT… Objective: To study correlation between age-linked serum prostate specific antigen (PSA) levels in normal subjects andpatients of benign prostatic hyperplasia (BPH) and carcinoma prostate (CaP). Data source: OPDs. Study design: Case-control study.Setting: SIUT; Karachi Study duration: Six months. Methodology: 250 subjects were enrolled for the study and 93 were finally selected(31 each, representing the normal, BPH and CaP groups). Subjects 40 years of age and above were included and those with any urinarytract disorder or those under treatment with 5-á-reductase inhibitors were excluded. Each group was divided into four sub-groups of ages40 – 49, 50 – 59, 60 – 69 and 70 and above years. AxSYM total PSA (tPSA) assay® was used for serum PSA estimation. Values wereexpressed as mean and standard error of mean and Fischer’s test, students’ t test and correlation coefficient were used to determinesignificance and for comparison of data. Results: There was a no significant difference in PSA levels in all age groups when normals werecompared with BPH cases. PSA levels were significant in normal as compared to CaP cases and BPH as compared to CaP. Conclusions:No significant correlation between age-linked serum PSA levels in normal subjects and patients of BPH and CaP could be established. Thestudy, however, found a trend of declining PSA levels at the age of 70 years and above.
STATUS OF HbA1c;
Authors: ZUBERI NUDRAT ANWAR , AHSAN NAVEED , JAFRI ALIYA , Iqbal Tehseen , Parveen Tahira
Published: September 2021

Background: Glycated hemoglobin [HbA1c] is a marker to identify the average plasma glucose level over past threemonths but it is also influenced by the iron deficiency status of an individual. Objective: Research is designed to assess the relationshipbetween HbA1c concentration and iron status among diabetic and non diabetic subjects. Design: Cross sectional comparative study.Setting: Tertiary Care Unit of Karachi, Pakistan. Period: Dec 2010 till June 2011. Material and methods: A total of 75 subjects of bothsexes were taken and divided into three groups. Fasting and random glucose levels, serum iron and TIBC were performed by enzymaticmethod while HbA1c was estimated by fast iron resin separation method and Complete blood count (CBC ) was done by Coulter.Statistical analysis: The data feeding and analysis was on computer package SPSS (Statistical Packages of Social Sciences) version16.0. the results were given in the mean and Standard Deviation (SD) and correlation ( r ) for quantitative data i.e. age, FBS, RBS, HbA1c,Serum Iron , Hb HCT, and TIBC. Using Analysis of Variance (ANOVA) with tukey test for comparison (Controls, Iron deficiency anemia withand without diabetes mellitus). In all statistical analysis only p < 0.01 will be considered significant. Results: HbA1c is a non-specificmarker of Diabetes mellitus in iron deficieny anemia patients. Thus it is reccomended that iron status of diabetic patients must beconsidered while interpreting results. This study showed significantly raised levels of Fasting blood glucose (FBS), random blood glucose(RBS) and HbA1c in diabetic anemic patients when compared to control and nondiabetic anemic subjects (p < 0.01) while total ironbinding capacity (TIBC) and HbA1c in nondiabetic anemic subjects were also significantly raised when compared to control (p < 0.01).Hemoglobin (Hb) , Hematocrit (HCT) and Serum Iron levels were significantly decreased in diabetic and nondiabetic anemic subjectswhen compared to control (p < 0.01). Conclusions: Our study depicted that while diagnosing Diabetes mellitus in iron deficient patientsone should be carefull as HbA1c is not a very reliable parameter to assess glycemic control in iron deficiency anemia patients.
EFFECT OF DRUGS;
Authors: AHMED SAIMA , ASADULLAH MUHAMMAD , REHMAN ATA-UR-
Published: September 2021

ABSTRACT... Objective: The aim of this study was to determine head-dipping exploratory test parameter as a measure of strongmodulating effect on brain and behavior. Design: It was an observational animal study. Setting: University of Karachi. Period: Jan 2004 toJuly 2006. Material & methods: In this present study, drugs used reserpine, nux- vomica; anacardium and chlorpromazine were widerange of pharmacological actions. We evaluate the effectiveness of these drugs as agents with modulating effect on brain and behavioraccessed by head dipping parameter. In this study, 25 mice were included belonging to both sexes. The study animals were divided intofive groups of five animals each. Four groups were given drugs and one group was kept as control. Mice (20-35g) of either sex were usedin this study. One group was kept as control for drugs. Mice were kept under room temperature. Tap-water was allowed ad-Libitum.30minutes after giving drugs, animals were observed for 10 minutes with two minutes of interval. Tablet crushed in 10ml of water, 1cc wasgiven. Screening method used was head dipping. Results: Strychnos Nux-Vomica when used in a dose of 0.07mg has strong action oncholinergic system, CNS activity and frequent head dipping (39.8±28.8) was observed. Rauwolfia serpentine is an active alkaloidparticularly present in reserpine (62.2±43.4) no significant head dipping effect was observed. Anacardium (37.2±28.6) &Chlorpromazine (39.4±32.4), show decrease effects. Keeping in view, the medicinal importance of these herbs, our present study wasdesigned to screen these drugs for CNS activity on albino mice.
STAPHYLOCOCCUS AUREUS;
Authors: NAQVI ZULFIQAR ALI , AZIZ QAMAR , MEMON ARIF
Published: September 2021

Objective: To determine the prevalence of Staph. aureus in burn patients. Setting: Department of Microbiology, BasicMedical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi. Period: July 2002 to December 2002. Material and Methods:Out of 52 patients 23 (44%) were found infected by 41 strains of S. aureus in which 10 strains were Methicillin resistant. Results: AllMethicillin sensitive and resistant strains were sensitive to Vancomycin and Chloramphenicol. Other effective drugs against MSSA wereImipenem (93.5%), Cephalothin (77.5%), Clindamycin (68%) while MRSA strains were highly resistant to all other drugs. Conclusions:Gram positive heavily colonize the wound at initial days following burn injury. Once Staph aureus specially MRSA establishing in burn unit,it is very difficult to eradicate these bacteria from burn unit. It is therefore all efforts must made to prevent burn patients from infectionspecially Staph. Aureus infection, by establising infection control team these burn units.
ACCURACY OF THE UPPER LIP BITE TEST;
Authors: ATIF MUHAMMAD , ABDULLAH MUHAMMAD , YOUSAF MUHAMMAD JAVAD , Buland Khalid
Published: September 2021

Objective: To compare the accuracy of Upper lip bite test with modified Mallampati classification for predicting the difficultlaryngoscopic intubation. Study Design: Cross sectional Study. Place and duration of study: The study was carried out at Department ofAnaesthesiology, Intensive Care and Pain management, Combined Military hospital, Rawalpindi from September 2008 to August 2009.Patients and Methods: Four hundred patients undergoing elective surgery meeting the inclusion/exclusion criteria were enrolled afterwritten informed consent. The airways of the patients were evaluated by using the modified Mallampati classification (MMP) and theUpper lip bite test (ULBT). MMP class 3 or 4 and ULBT class 3 were considered as indicators of difficult intubation. The laryngeal view wasgraded by Cormack and Lehane classification (Gold standard). Grade 1 or 2 was considered to represent easy intubation and grade 3 or 4to represent difficult intubation. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy werecalculated for both the tests separately by using the 2×2 table. Results: ULBT had a higher accuracy of 94%, specificity of 99.2% andpositive predictive value 70% compared to MMP accuracy of 82.7%, specificity of 84.4% and positive predictive value of 22.7%.Conclusions: The diagnostic accuracy of the Upper lip bite test was more than the modified Mallampati classification. We suggest that itbe compared with the other prevailing tests as well which are often used to assess difficult intubations.
CARCINOMA BREAST;
Authors: ATEEQ MUHAMMAD , JEHAN SHAZIA , BASHIR MUHAMMAD ABID
Published: September 2021

Objective: To evaluate the factors responsible for the late presentation of carcinoma of breast in Pakistani women. StudyDesign: Prospective, Cross sectional, Interventional. Setting: Women Medical Complex Sialkot and Surgical Unit II. Aziz Bhatti Shaheed(Teaching) Hospital. Nawaz Sharif medical College, University of the Gujrat. Study. Period: January 2009 to June 2012. Results: A total of87 patients of all age groups with carcinoma of breast were enrolled in this study. Mean age of presentation with breast cancer was 43years. Stage III carcinoma breast was the most common presenting stage seen in 56 (64.36%) women. Socio economic status, delay inpresentation and diagnosis, fear of mastectomy and its social consequences found to be major factors in the late presentation ofcarcinoma of breast. Conclusions: There is need to launch cancer public health campaign mechanisms, should include teaching ofBreast Self Examination (BSE) to patients, Clinical Breast Examination (CBE) to health workers. Strenuous efforts should be made tobreak the vicious cycle of late presentation, poor treatment outcome and reluctance of patients to present to health facilities because ofsocial mindset.
TRANS FATTY ACID;
Authors: ALI FATIMA YOUSAF
Published: September 2021

Objectives: To find out the correlation between the consumption of trans fatty acid and fasting lipid profile & body mass index(BMI) in patients suffering from coronary heart disease. Study Design: Prospective, comparative clinical study. Study Site & Duration:This study was conducted at Shafakhana Sahib az Zaman Medical Hospital Quetta from April, 2007 to May, 2008. Material & Methods:This comparative clinical trial was conducted on 50 patients (n=50) to find out the correlation between the consumption of trans fattyacid and fasting lipid profile & body mass index (BMI) in patients suffering from coronary heart disease. Detail history about the use ofTrans fats containing products was recorded. Patient’s height and weight was recorded by standard calibrated standiometer. The fastingglucose and lipid profile was performed by overnight fasting of 12 hours. The patients was divided into group I (n=18), who used Transfats free oil/ghee and group II (n=32), who used trans fats containing ghee. The results of the two groups were compared and correlationof different variables was determined. Results: The study result shows that mean age 58.428 ±9.67721 years, mean height 5.476±.5899 feet, mean weight 61.5 ±4.8793 Kg and mean BMI was 22.35 ±5.24195 Kg/m2. There was slightly higher value of BMI in groupII. The comparison of serum lipid profile and glucose among the two groups shows that there is a correlation of Trans fatty acid withcertain parameters like high density lipoprotein (HDL) and total lipid with p-value of 0.027 & 0.014 respectively. Similarly serumcholesterol and low density lipoprotein (LDL) correlated with Trans fats lipid having both p- value of 0.000. Conclusions: There is acorrelation of Trans fatty acid with serum cholesterol, LDL, HDL and total lipid. The consumption of Trans fatty acid has shown positivecorrelation of certain parameters with each others like weight shows correlation with serum cholesterol, LDL and total lipid, LDL showscorrelation with diastolic blood pressure, triglyceride shows correlation with systolic blood pressure while BMI shows negativecorrelation with HDL.
HAND HYGIENE;
Authors: DAUD SEEMA , MAHWISH RABIAH , SHUJA HAJRA
Published: September 2021

Background: WHO Guidelines recommends ‘‘My five moments for hand hygiene” for prevention of HCAI. Objective: Toassess the knowledge and practices of medical students about HCAI and hand hygiene. Setting: Lahore Medical & Dental College(LMDC), Lahore. Period: Four weeks, in January and February, 2012. Methods: Descriptive cross-sectional study was conducted usingWHO’s “Hand Hygiene Knowledge Questionnaire”, among MBBS students from 3rd to final years, 2012. Data was entered and cleaned inSPSS 19 and presented in tables and graphs. Descriptive statistics was used in the forms of numbers and percentages. Results: Among227 respondents, 63% were female, 67% were 20 to 22 years old, 38% were from 3rd year, 40% from 4th year and 22% from final year,61% never received hand hygiene training and 67% never used hand rubs. Few students named unclean hands as main route (42%) andsource of HCAI (21%). Hand hygiene was preferred before touching patients (76%) and after body fluid exposure (70%). It was perceivedto be rapid (63%), effective (66%), cause of skin dryness (57%) and it was supposed to be used concomitantly with hand washing (74%),before abdomen palpation (48%), giving injection (31%), after removing gloves (22%) and making patient’s bed (31%). Damaged skin(92%), artificial fingernails (78%) and jewelry (53%) were perceived to increase hand contamination. Conclusions: There were seriousgaps in knowledge of proper hand cleaning techniques and their importance in prevention of health HCAI. Hand hygiene, must be part ofcurriculum and training of all health care providers.
CATARACT;
Authors: AHMAD FAHEEM
Published: September 2021

Introduction: Cataract is the most age related eye disease in most countries. Day care cataract surgery has increasedrapidly, largely because of new surgical techniques Objectives: To evaluate visual acuity and complications in patients havingextracapsular cataract extraction with intraocular lens implantation on day care basis. Design: Prospective study. Setting: Department ofOphthalmology Independent University Hospital, Faisalabad. Period: June 2009 t0 June 2012. Materials and Methods: Cataract patientswho were operated on day care basis. Result: During study period total 130 cases of senile cataract were operated on day care basis.Their ages ranged from 38 years to 110 years with mean age of 70 years. Of these 130 cases 52(40%) were males and 78(60%) werefemales. During surgery routine extracapsuler cataract extraction with lens implantation was performed on all patients. Posterior capsularrent occurred in 6(4.6%) cases during surgery. Posterior chamber IOL was implanted in 124 cases and anterior chamber IOL wasimplanted in 6 cases. Regarding post operative complications 4(3.07%) cases reported with endophthalmitis.While 10(7.6%) patientshad striate keratopathy and 6(4.6%) patients had residual lens matter. Iris prolapsed observed in 4(4.6%) cases which was reposited onnext day. Only 2(1.5%) patients later on developed posterior capsular opacification.cystiod macular edema was noted in two patients(1.5%).Majority of patients(80.7%) regained useful vision of 6/36 or above on first post operative day. All patients were refracted after twomonths. After refraction the best corrected visual acuity of 6/6-6/12 was achieved in 80.7% of cases,15.3% had visual acuity of 6/18-6/36 and poor visual acuity of 6/60 or less was noted in only 3.8% patients. Conclusions: Day surgery is one of modality to treat agerelated cataract. This study show that clinical outcome is not effected by outpatient surgery and there was no any complication that couldbe attributed to day surgery. So day surgery should be done on priority basis especially by experts surgeons and in patients surgeryshould be done only in selected cases.
DENGUE OUTBREAK;
Authors: SHAHZAD MUHAMMAD ASIF , RAUF ABDUL , HASAN IMAM HUMAYUN SUQRAT , Humayun Rameesha
Published: September 2021

Background: This longitudinal study was conducted during August to December 2011 in District Faisalabad to analyzeepidemiological pattern of dengue outbreak in the district. Weekly trends of all cases (893) reported through Disease Surveillance Systemfrom week No.33 to 54 were monitored. On the basis of this continuous flow of information, different ongoing vector control measureswere adopted simultaneously in different areas of the district and larval indices were calculated. Methods: The Surveillance data was usedto monitor the trends of the outbreak in terms of time, person and place. Teams of 3102 trained workers were formed to conduct varioussurveillance activities like vector surveillance, fogging, larviciding, and indoor residual sprays. During indoor and outdoor vectorsurveillance, teams also calculated the larval indices for vector control. Results: The rural to urban ratio of cases was 1:3. Maximumcases (215) were reported from Jinnah Town in urban area and (102) cases were reported from Tehsil Sadar among the rural areas. Mostcases of dengue fever were observed during the 40-45 weeks of the year 2011. Mean age was 29±14.7 years for rural and 35±16.5years for urban. Male to Female ratio was 1.2:1 in urban and 1.8:1 in rural areas. Majority of the cases belonged to the age group 21-30.The case fatality rate was 6/1000 cases. The house lndex was 1.03%, the indoor container index was 0.26% and the breateu index wasfound 1.21%. Conclusions: Maximum cases occurred during 44th and 45th weeks. Male were affected more as compare to females.Jinnah Town in urban areas and Tehsil Sadar among the rural areas reported maximum number of cases. The different calculated larvalindices like house index, indoor/outdoor container index and breateu index showed moderate larval growth and hence, the outbreak waswithin control.
SUBCLINICAL HYPOTHYROIDISM;
Authors: ASIF MOHAMMAD , ULLAH ATIF , AKRAM MUHAMMAD
Published: September 2021

Chronic kidney disease (CKD) is characterized by progressive destruction of renal mass with irreversible sclerosis andloss of nephrons.Various metabolic, hematological and endocrine abnormalities are known to occur in CKD. Subclinical hypothyroidismis an important endocrine abnormality associated with a greater cardiovascular risk, atherosclerosis and an important factor forprogression of renal disease in such patients. Objective: To calculate the frequency of subclinical hypothyroidism in predialysis CKDpatients. Design: Cross sectional survey. Setting: Pathology Department Post Graduate Medical Institute, Lahore. Period: 06 months(June 2011 to Dec 2011). Results: 210 patients were included in the study. Serum creatinine. TSH and FT4 were measured and therelevant data was entered in predesigned proforma. 19.5 % of CKD population had subclinical hypothyroidism with slightly increasedpreponderance in females as compared to males and also increased frequency as the stage of CKD increased. Subclinicalhypothyroidism is more common in CKD population. Conclusions: Increased frequency of subclinical hypothyroidism was found inpatients with reduced renal function not on dialysis. 19.5% of CKD population on conservative management had labortary evidence ofthyroid dysfunction.
ACUTE CORONARY SYNDROME;
Authors: ANJUM MUHAMMAD SOHAIL , IQBAL SHAHID , KALSOOM NAILA , Manzoor Hira
Published: September 2021

Introduction: Magnesium is the fourth most abundant cation in the body and the second most abundant intracellular cationafter potassium. Magnesium plays a fundamental role in many functions of the cell, including energy transfer, storage, and uses protein,carbohydrate, and fat metabolism; maintenance of normal cell membrane function; and the regulation of parathyroid hormone (PTH)secretion. Objective: To determine the frequency of hypomagnesaemia in patients presenting with acute coronary syndrome (ACS).Design: Cross -sectional study. Place and duration: Coronary Care Units and medical ward in Allied Hospital Faisalabad, from 26-01-2010 to 25-07-2010. Settings: The study was conducted in medical unit II and coronary care unit of Allied Hospital Faisalabad. SampleSize: Sample size was calculated by using WHO sample size calculator taking confidence level 95%, population proportion 7.7% andrequired precision 4%. Sample size n = 171. Sampling Technique: Non-probability consecutive sampling. Method: A total of 171patients fulfilling the criteria of ACS admitted in M-II and CCU were enrolled in the study, demographic details, history and clinicalexamination of the patients were recorded. Blood sample was collected in estimation of serum magnesium level. Results: In this study themean serum magnesium was 1.59 ±8.380 in males and 1.56±7.678 in females. Among the 171 acute coronary syndrome patients, 14(8.2%) were diagnosed with hypomagnesaemia. There were 8 (8.8%) male and 6(7.5%) female patients. 157 (91.8%) patients did nothave hypomagnesaemia out of 83 (91.2%) were male and 74 (92.5%) were female patients. There was male predominance. Male to maleratio was 1.33:1. Conclusions: The results showed that frequency of hypomagnesaemia in acute coronary syndrome was significantlyhigh and comparable to other studies. There was male preponderance. However, there was variation in the occurrence ofhypomagnesaemia in acute coronary syndrome. Early assessment of serum magnesium concentration is needed in acute coronarysyndrome in order to implement proper magnesium supplementation.