bluuebunny/crossref_metadata_2025 huggingface dataset:
EFFICIENCY OF WAX REMOVAL
Authors: Malik Sofia , Choudhry Ziaullah , Ahmed Muhammad Adeel , Amin Muhammad , Hussain Azmina , Waseem Farzeen
Published: August 2021

Objectives: To Determine the efficiency of wax removal from denture baseresin using hot water at a range of temperatures with added detergentand to Study the effectsof mechanically modified surfaces of denture base resin on the efficiency of dewaxing usingthe above techniques. Settings: Eastman Dental Institute University Of London UK. Period:Jan 2007 to June 2007. Material and Methods: In this study cast acrylic rods 13 mm longand 6 mm in diameter were used. Three different surfaces were prepared for each rod,described as Polished, Abraded & Grooved. Nine experimental groups, each consisting of tenspecimens were mechanically modified were contaminated with modeling wax, and then thosein each group were subjected to agitation in hot water with detergent at different range oftemperatures. The surfaces were then examined for traces of wax using Raman spectroscopy.Results: The spectrum for each specimen demonstrated peaks at different wavelengths andvarying intensities, the spectra demonstrated traces of wax on abraded surfaces showedleast wax when dewaxed at 100°C as compared abraded surfaces dewaxed at 65°C and 85°C temperatures respectively. Conclusion: The rough surfaces (abraded or grooved) showedmore wax retention as compared to polished surfaces. These surfaces are usually prepared bythe dental technician in a belief that modifying the ridge-lap area of the teeth will increase thebond strength between the teeth and the denture base. Residual wax can still remain on thetooth surface even after dewaxing it at 100˚C with detergent added to the water.
VITAMIN D AND PNEUMONIA
Authors: Shamaoon Muhammad , Maryam Dr , Ahsan Muhammad , Ahmad Rahman
Published: August 2021

Background: Pneumonia is lower respiratory tract infection (LRTI) andrepresents inflammatory conditions of the lungs i.e of the lower respiratory tracts, air sacs andlung parenchyma.1 Objectives: To determine the role of vitamin D supplementation in reducingmorbidity in children with pneumonia. Study Design: Randomized Controlled trial. Place andDuration of Study: Pediatric Department, Mayo Hospital Lahore from December 2014 to May2015. Patient & Methods: Two hundred children of age 2 – 59 months with pneumonia (fever,cough, tachypnea, and subcostal recessions) and low vitamin D level (< 20 ng/ml) were includedin the study. One Hundred pneumonia patients received antibiotics (group A) and vitamins D(100,000 IU) while another group of hundred patients received only antibiotics without vitaminsupplementation (group B). When respiratory distress settled, length of stay in hospital wascalculated at the time of discharged. All patients were followed in pediatric OPDs for 3 monthsafter in-hospital treatment to pick recurrence of pneumonia symptoms (if any). Results: Themean recovery time for vitamin D group (5.7 +2.8 days) and non-vitamin D (6.1+2.8 days)was almost same with P=0.29. But the frequency of repeated episodes of pneumonia within30 days of treatment was lower in intervention group n=4 (2%) than the non-intervention groupn=18 (9%) (P = 0.002). Conclusion: 100,000 IU of vitamin D given once during treatment ofpneumonia decreases the chances of recurrence in the next 30 days.
IMMUNIZATION OF CHILDREN
Authors: Ahmad Ali , Ain Noor Ul , Nasir Jamal Abdul , Mir Waleed Ahmed , Anwar Sumair , Haider Syed Tahseen
Published: August 2021

Objectives: To ascertain the level of awareness and the preliminaryunderstanding about the importance and the practice of immunization of children among themothers hailing from an adjoining slum area while visiting a nearby tertiary care hospital atLahore. Study Design: Cross-sectional study. Setting: The respondents of this study werethe mothers coming from an urban slum area and visiting the pediatrics outpatient departmentof a nearby tertiary care hospital in Lahore city. Period: May 2016 to July 2016. Methods: 60mothers of reproductive age and all having children in the ages needing routine immunizationcoverage through expanded programme on immunization. Convenient sampling techniquewas adopted to select the respondents. Data was collected through a questionnaire which wasfilled during face-to-face interview of each voluntary participant. Results: 34.3% respondentshad general awareness about immunization of children, and out of them, only 6% mothers hadadditional understanding of the rationale for the immunization. 45% mothers had only partialawareness about immunization with no understanding of its rationale. 20% respondents had nosignificant awareness. Overall 10% of all the respondents had the knowledge about the need ofbooster doses of certain vaccines administered in expanded programme on immunization. Theawareness about the names of diseases prevented through the routine and free vaccinationprogramme was associated with the literacy level and socio-economic status of the respondingmothers. Conclusion: Inadequate awareness and basic understanding about immunizationwas found by this small study conducted among the mothers coming from an adjoining slumarea of a tertiary care hospital in Lahore city.
STERILIZATION & CROSS INFECTION IN DENTISTRY
Authors: Zahid Sadaf , Rafiq Anam , Zahra Saman , Ilyas Muhammad
Published: August 2021

Objectives: This study aims to assess the knowledge, perception and attitudeof patients towards sterilization and cross Infection and to assess the effects of education onperception and behavior towards sterilization and cross infection. Cross infection control ismost important in dentistry as it is considered one of the main reasons of rapid spread ofinfectious diseases now a days. Setting: Major public sector hospital of Punjab Pakistan, PunjabDental Hospital Lahore. Material & Method: We surveyed patients in OPDs of Punjab DentalHospital Lahore. Survey questions covered demographics as well as 15 questions related tosterilization and cross infection in dentistry. Questionnaires were given to educated peopleand interviews were taken from uneducated or less educated people. Data was collected andanalyzed. Results: patients have some knowledge about sterilization and cross infection buttheir concepts need a lot of improvement. Patients know that microbial contamination occursbut they are unaware of the diseases that are transmitted. Similarly on other perspective thereis discrepancy in knowledge and practice, as they do not take it seriously or they are unawareof the consequences of cross infection or long term effects of HIV, Hepatitis B & C. Disposableinstruments are very important for controlling cross infection. Only 60% people said they wouldprefer disposable instruments over reusable instruments when option is given to them. Mostpeople are reluctant to be treated with disposable instruments due to extra cost on treatment.92% were well aware of significance of hand washing of dentist before and after dental checkup,but when they go through dental examination they are either careless or hesitant to ask dentistto wash hands. Conclusion: Besides the knowledge there are other factors like patientsattitude and concerns also play vital role in preventing infection transmission in them. We haveto educate them about infectious diseases and their root of transmission and their long termeffects on health.
PRETERM LABOUR
Authors: Ropeta Sunela , Ali Habiba Sharaf
Published: August 2021

Background: Spontaneous preterm labor that is labor before 37 weeks ofgestation is the main cause of preterm delivery. With increasing gestation the level of Serummagnesium levels decreases. Magnesium inhibits uterine contractions by antagonizing calcium.Hypomagnesaemia also causes hyper excitability of neuromuscular junction bringing in musclecramps and uterine hyperactivity. Objectives: To determine the mean serum magnesium levelsin women presenting with preterm labor. Study Design: Cross Sectional Study. Location andduration of study: Ziauddin University Hospitals, Karachi from 8th December 2015 to 7th June2016. Methodology: Total 40 women of age 18-40 years having singleton pregnancy between28-36 weeks gestation with established preterm labor having cervical dilatation less than 3cm.were included. 5ml blood was collected and analyzed. Outcome in terms of Mean StandardDeviation were noted. Descriptive statistics were applied. Stratification was done using studentt-test and ANOVA where appropriate. The p-value ≤0.05 was considered as significant. Results:The mean age was 26.25±2.38 years. Mean gestational age was 32.77±2.11 weeks. Meancervical dilatation was 1.85±0.39 cm. Mean serum magnesium level was found 1.43±0.25 mg/dl. The results showed that there was significant difference in mean serum magnesium level forgestational age but not significant for age, cervical dilatation, parity and gravida. Conclusion:The results showed that serum magnesium level reduced with increased gestational age.Preterm labor can be predicted by serum magnesium levels.
PCOS
Authors: Tariq Ayesha , Mir Muhammad Azeem , Babar Saba , Akhtar Rahat
Published: August 2021

Objectives: The objective is to compare the efficacy of Pioglitazone andMetformin for ovulation in patients of polycystic ovarian syndrome. Study Design: Randomizedcontrol trial. Setting: Department of Obstetrics and Gynecology, Nishtar Hospital Multan. Period:January 2017 to June 2017. Methodology: Total number of 66 patients was recruited for thisstudy. These patients were admitted through or outpatient department. Group A and Group B,33 patients each. In Group-A patients received metformin while in Group B pioglitazone wasadministered. Sample size was calculated using the reference study by Chaudhry I et al (9)using sample size calculator for two proportions (power of study 80% and confidence interval95% where prevalence (P1) was 52.17% and (P2) 75%). In group-A patients, Metformin withdose of 1500 mg per day in three divided doses were given for 6 months. In group B patients,Pioglitazone 15mg was administered for 6 months. At the end of 6 months, all the patients wereevaluated for efficacy. Results: Total no. of 66 patients was included. The mean age and BMIof the patients was 29.35±4.01 years and 29.74±2.75 kg/m2 respectively. The age distributionnoted as 66.7% (n=44) patients between 18-30 years and 33.3% (n=22) between 31-37 years.BMI distribution observed as 45.5% (n=30) patients between 24-29 kg/m2 and 54.5% (n=36)patients between 30-34 kg/m2. These 100% (n=66) patients were divided into 2 groups equally,33 in each, i.e. group A and group B. The mean age and BMI of the patients of group Awas 29.42±4.32 years and 29.87±2.58 kg/m2 respectively, while the mean age and BMI ofthe patients of group B was 29.27±3.75 years and 29.60±2.94 kg/m2 respectively. Ovulationwas noted as 42.4% (n=14) and 45.5% (=15) for groups A and B respectively. No associationwas found between efficacy and ovulation (p=0.849). Efficacy was notes as 69.7% (n=23) and72.7% (n=24) for group A and group B respectively. No difference was found between efficacyand groups i.e. between pioglitazone and metformin for ovulation in patients of polycystic ovarysyndrome (p=0.786). Similarly, no association was found between efficacy with age (p=0.442)and BMI (p=0.728), after applying the chi-square. Conclusion: This study concludes thatPioglitazone is as much effective as metformin for ovulation induction in women with PCOS.
2ND TRIMESTER PREGNANCY
Authors: Tabassum Sobia , Sabir Arshia , Haq Hafiz Muhammad Anwar ul , Haq Hafiz Muhammad Ejaz ul
Published: August 2021

Objectives: To compare the effectiveness of prostaglandin F2á by extra amnioticroute and I/V oxytocin infusion for induction of labor in 24 hours. Study Design: This wasa randomized control study. Place and Duration of the Study: This study was conductedat the department of Obstetrics & Gynaecology, Civil Hospital, Bahawalpur from March 2017to October 2017. Materials and Methods: A total number of 104 patients (52 given PGF2áand 52 increasing infusion rate of I/V oxytocin) between 13 to 26 weeks of gestation wereenrolled using non-probability purposive sampling technique. Two groups ‘A’ and ‘B’ wereformed having patients of comparable age, parity and gestational age to minimize the effectof confounders. Both the groups were compared for induction delivery interval (hours), andcomplications. Chi square test was used as test of significance and any value <0.05 was takenas statistically significant. Results: The ages of patients ranged from 16-45 years (28.93 + 8years). Gestational ages were between 13-26 weeks (mean 16.48 + 6.43 weeks). The parityranged from 0-9 (mean 3.9 + 2.87). Missed abortion was the major reason for TOP, seen in 71(68.3%). In Gorup-A, all patients aborted / delivered within 28 hours from the start of the infusionso got successful induction in 100% patients whereas 5 (9.6%) patients failed in Group B. InGroup A, successful induction of delivery was done in significantly less interval (11.27+6.2hours) as compared to Group B (18.4+10.8 hours) with a statistically significant p value of0.016.There were 3 (5.8%) patients in Group A and 10 (19.2%) in Group B who developed oneor more complications and this difference turned out to be statistically significant (p=0.038).No major complications developed in any of the groups. Conclusion: Extra amniotic PGF2á ismore effective than I/V Oxytocin for termination of pregnancy.
ASTHMATIC PREGNANT FEMALES
Authors: Khan Abdul Basit Ali , Ashraf Madiha , Jamil Uzma , Waquar Sulayman , Aslam Nighat , Malik Arif
Published: August 2021

Objectives: To evaluate the expression of MMPs and oxidative stress markers inpregnant Asthmatic females. Period: July 2015 to Dec 2015. Design: Cross sectional. Setting:Jinnah Hospital Lahore. Background: Maternal asthma throughout pregnancy unfavorablyalters pregnancy outcomes but evaluation of the causes, and the ability to assess interventions,is restricted having inadequate knowledge of complex interactions between underlyinginflammation, oxidativestress and structural changes in asthmatic airways. Methods: Total 100patients were included in study. Fifty ascontrols. Clinically diagnosed asthmatic pregnant femalescoming to GyneaUnit of Jinnah hospital were included.Females on any medication or sufferingfrom any congenital disease were excluded out of the current study. Matrix metalloproteinase’s,TNF-α, 8OHdG, 4-HNE and Isoprostanes are measured by ELISA. Results: Results shows thatMMP- 7 and MMP-9 have positive correlation with proinflammatory cytokine TNF-α but MMP-8 have significantly positive correlation with it (TNF-α Vs. MMP-8 r=0.946. On the other handMMP-7 has significant correlation besides other MMPS (MMP-7 Vs.8OHdG r=0.719) indicatinga positive correlation between proteinases and marker of DNA damage indicating epithelialshedding in case of Asthma. Conclusion: The sole objective of effective asthma managementin pregnancy is to prevent exacerbations. Antioxidants should be added in diet so to ovoidoxidative stress caused to airway epithelial and structural cells and MMP inhibitors may be usedas therapeutic agents as well as measuring MMP levels as diagnostic or prognostic markers.
LAPAROSCOPIC VENTRAL HERNIA REPAIR
Authors: Deen Qaim , Kaiser Muhammad Adeel , Farooq Qasim , Intisar Uzma , Mazhar Amna
Published: August 2021

Introduction: The common practice in laparoscopic ventral hernia repair (LVHR)is to place a dual mesh to prevent visceral adhesions, as majority of the patients are not ableto afford the expense of these meshes. We use prolene mesh to repair hernia. Objectives: Theaim of this study was to determine the frequency of success of laparoscopic ventral hernia repair(LVHR) using omentum as a barrier in patients presenting with ventral hernia. Study Design:Descriptive case series. Setting: Surgical Unit 3, Services Hospital Lahore, Pakistan. Period:6 months duration from 16th of July 2015 to 15st January 2016. Methods: 60 patients wereselected fulfilling the criteria from Department of General Surgery. 10mm telescope angled at 30degree was employed. Hernial contents were reduced but the peritoneal sac was left as such.The prolene mesh was inserted into the abdominal cavity through a port of 10mm diameterand fixed. Omentum was then sandwiched between abdominal wall and viscera. Patients werefollowed-up in OPD for 12 months. Results: Majority of the patients were females (56.7%) withthe mean age of 46.40 years and mean weight of 68 kg. The patients were averagely foundobese with a mean BMI of 25.40kg/m2. Majority of the patients (n=50, 83.3%) had success inhernia repair. Stratification of patients by age, gender and BMI showed (p-value was >0.05 in all3 cases) statistically insignificant difference between various subgroups. Conclusion: LVHR is auseful technique and simple proline mesh with omental barrier is a safe and low-cost alternativeto dual mesh technique.
NO SAC NO RECURRENCE
Authors: Toor Habib ur Rehman Khan , Memon Gulshan Ali , Ghumro Ali Akbar
Published: August 2021

Objectives: To determine the frequency of recurrence after hydrocelectomy.Study Design: Descriptive. Place & Duration: Study was conducted at surgical department ofPeoples University of Medical and Health Sciences Nawabshah from June 2012 to December2016. Patients & Methods: This study was conducted at surgical unit 1 of Peoples Universityof medical and health sciences Nawabshah from June 2012 to December 2016. 150 malepatients with primary hydrocele were included. Diagnosis of hydrocele was confirmed byclinical examination, Trans illumination test and scrotal ultrasound. After preliminary workup allpatient underwent spinal anesthesia. Transverse incision made, fluid is sucked out, most of thehydrocele sac is excised and edges are sutured under run or diathermized. Post operatively 6to 8 doses of antibiotics were given and patients were discharged after a short hospital stay. Onearly follow ups wound infection and hematoma were noted, managed and recorded. Up to 3years on long follow ups were made to detect recurrence of hydrocele. Data was analyzed bystatistical package of social sciences (SPSS)-24. Results: Study was extended for 54 monthsand included 150 adult male patients with primary hydrocele. Mean age was 45 years, SD±4 and a range of 14-79 years. Mean operating time was 25 minutes, SD±5 and arrange of15-50 minutes. Mean post hospital stay was 24 hours. Post-operative hematoma was noted in16(10.6%). There was no any recurrence of hydrocele was found up to three years follow up.Conclusion: Complete removal of sac of hydrocele eliminates almost any chance of recurrenceso that one can claim for “no sac no recurrence”.
SUPRASELLAR TUMORS
Authors: Zulfiqar Farrukh , Khan Atiq Ahmed , Imran Muhammad , Ahmed Syed Ijlal , Bareeqa Syeda Beenish , Ali Muhammad Faaiq , Ghori Shiraz Ahmed , Shera Muhammad Tayyab
Published: August 2021

Objectives: Our aim was to analyze the postoperative visual status in patientswith suprasellar tumors with preexisting preoperative visual deficit after surgical resection.Study Design: Comparative cross section study. Setting: Civil Hospital Karachi. Period:March 2013 to August 2016. Methods: A total of 107 patients with suprasellar tumors withpreoperative visual deficit who were operated. Either via transsphenoidal (43) or transcranial(64) approaches, were included in this case series. Sixty six patients had pituitary adenomas,24 had craniopharyngiomas, 13 had meningiomas, 3 had chordomas and 1 had epidermoidcyst. Twenty five patients had uniocular visual deficit and 82 had binocular. Visual acuity wasrecorded preoperatively, postoperatively at discharge and at four weeks follow-up. Results:Postoperatively 46% of eyes improved, while 34.4% and 19.6% remained same and deterioratedrespectively. Patients underwent transsphenoidal technique got significant 65% improvement,and those who underwent transcranial had 37.5% improvement (p-valve=0.005). Pituitaryadenomas showed the greatest visual improvement of 65% (p-value=0.000), followed bycraniopharyngiomas (33.5%) and meningiomas (7.6%). In total 52 patients (48.6%) showedimprovement in vision and the visual acuity of remaining 55 (51.4%) did not improve. Conclusion:Patients experience significant benefit in vision after decompressive surgery for suprasellartumors, especially those who have pituitary adenoma and who undergo transsphenoidaltechnique.
VITAMIN-D LEVELS AND LOW BACK PAIN
Authors: Akhtar Rahman Rasool , Khan Junaid , Zahid Tehreem , Ahmed Riaz
Published: August 2021

Objectives: To determine the number of patients with low back pain who havelow serum Vitamin-D levels along with associated risk factors in our local population. StudyDesign: Descriptive Study. Place and Duration: At the Department of Orthopedics, BenazirBhutto Hospital, Rawalpindi, for a duration of 01 year from 20th March 2016 to 19th March 2017.Patients and Methods: 600 patients were included in the study who met the inclusion criteria,i.e. patients presenting to the Out Patient Department (OPD) with low back pain for a duration ofless than six months aged between 15 to 55 years. Venous blood withdrawn and serum levelsof Vitamin-D measured. According to serum Vitamin-D levels, categorized as deficient, sufficientor excess. Results: Mean age of patients included in the study 44.21 ± 11.92 years. Out of thetotal, 337 (56.17%) were males and 263 (43.83%) females. Out of the total, 20.67%, 26.17%and 28.83% had mild, moderate and severe Vitamin-D deficiency, respectively. Predominantlypatients with severe Vitamin-D deficiency presented in winters (October – February) (17.16%)as compared to other seasons. The most pre-dominant risk factor in patients with low Vitamin-Dlevels was smoking (21.33%). Conclusion: Vitamin D plays a crucial role in the musculoskeletalframework of the body. The deficiency is more prevalent in the youth due to sedentary lifestyleand indoor preference.
ANTIDIABETIC EFFECT OF GUAIACUM OFFICINALE
Authors: Ibrahim Sadaf , Naqvi S.N.H. , Perveen Rehana , Abrar Hina , Akram Zuneera
Published: August 2021

Introduction: Diabetes is the most genetically transmitted disease all over theworld. It badly affects the vital organs and manifest the reduction of pancreatic amylase andlipase. Objectives: This study has been designed to investigate the role of Guaiacum officinaleextract in controlling of diabetes in streptozotocin (STZ) induced type 2 diabetes male albino(Wistar) rats. Study Design: Experimental. Setting: Baqai Medical University. Period: January2017- June 2017. Method: Bark extract of Guaiacum officinale (500mg/kg) was administeredto STZ induced rat. Glibenclamide (GLB) was used as standard drug. The approach of thestudy was to observe the effect of Guaiacum officinale on pancreatic amylase and lipase and itstissue architecture by histopathology. Rats were divided in four groups i-e control, STZ treated,STZ + GLB treated and STZ +extract treated group. Results: Guaiacum officinale significantlyimprove the level of pancreatic amylase and lipase as compared to the STZ induced group.Similarly the pancreatic architecture was significantly affected by STZ alone. These changeswere considerably reversed by Guaiacum officinale and GLB. Conclusion: It was concludedthat Guaiacum officinale herb useful to cure the diabetes and it is effective in protecting pancreasfrom diabetes induced damages.
COMPOUND DEPRESSED FRACTURES;
Authors: Imran Muhammad , Khan Atiq Ahmed , Ahmed Syed Ijlal , Ghouri Shiraz Ahmed , Khan Alizay Rashid , Farooqui Muhammad Osama
Published: August 2021

Background: It is defined as fracture in which fractured fragment is elevatedabove the level of the intact skull. Objectives: To assess the outcome of patients with delayedrepair of compound depressed fractures. Study Design: Retrospective comparative crosssectional study. Setting: Civil Hospital, Karachi, Pakistan. Period: 01-01-2015 to 31-12-2016.Methodology: Sample size was calculated and sampling technique was non probability. Datawas recorded from patients files to computer and analyzed on SPSS version 21. Results: Themean age of study participants was 21 years ± 5. There were 14 (77.7%) male and 4 (22.2%)female patients in our study. The maximum time from injury to intervention was 84 hours. Mostpatients presented to the emergency department with compound depressed fractures due to fallor hit by blunt object (40%) followed by road traffic accidents (33.3%) and assault (26.7%). Mostcommon location of the compound depressed fracture was frontal bone involving right sideof the skull. All the patients were successfully managed with satisfactory outcome without anymajor complications. Conclusion: The authors conclude that repair of depressed compoundfractures in adults, if managed properly shows good outcome with less complications even withdelay of 6 hours to 84 hours from injury to intervention.
EVALUATION RISK FACTORS OF NECROTIZING ENTEROCOLITIS
Authors: Malik Abdur Rehman , Quddusi Ahmed Iqbal , Iqbal Imran , Bhatti Mukhtar Hussain
Published: August 2021

Introduction: Necrotizing enterocolitis (NEC) is a condition where the intestinesbecome infected and can begin to die. Necrotizing enterocolitis is a serious condition that mayrequire surgery, and has a high morbidity and mortality rate. Objectives: To evaluate the riskfactors of necrotizing enterocolitis among neonates at children hospital Multan. Study Design:Descriptive Cross-sectional study. Setting: Neonatal Unit of Children Hospital and Institute ofChild Health Multan. Period: October 2015 to September 2016. Material and Methods: A total of79 neonates presented with necrotizing enterocolitis were enrolled for the possible causes. Theparameters studied included gestational age at birth, birth weight, maternal risk factors, patientrisk factors, age when feeding was started, type of feed, age when signs of NEC appeared,per feed increment, presence of any antecedent associations, clinical features, radiologicalfeatures, blood investigations (complete blood counts, blood glucose, serum sodium, serumpotassium, serum creatinine, liver function tests), ABGs, stool for occult blood and culture,septic screening and blood culture, management(medical or surgical) and outcome. The datawas analyzed using SPSS-20. Results: Out of a total of 79 neonates, 48 (60.8%) were maleand 31(39.2%) female. There were 71% infants who were younger than 32 gestational weeksand 67.7% under 1500 grams. The majority of neonates 62 (78.5%) commenced enteral feedswithin the first 24 hours. First feeding was started at a mean 5.6 ± 3.85 (2-17) days. Prematuritywas the commonest factor and present in 63 (79.9%) neonates. Abdominal distention was thecommonest symptoms 55% followed by bilious vomiting in 15%. Blood culture was positive in22 (27.8%) with predominance of gram negative microorganisms. According to Bell’s staging,54 (68.35%) neonates had stage I, 17 (21.5%) stage II, and 8 (10.1%) neonates were in stageIII. Conclusion: In most of the cases, the causes of necrotizing enterocolitis were presentand prematurity was the main etiological factor. Cautiously introducing enteral feeds usingexpressed maternal breast milk and increasing feed volumes slowly is important in reducingthe incidence amongst high risk individuals.
HABIT DISORDERS
Authors: Farooq Anjum , Bahawal Sadida , Sarwar Imran , Mushtaq Aamir , Butt Muhammad Asghar
Published: August 2021

Introduction: Childhood habit behaviors appear in numerous different forms.Many people engage in some degree of habit like behavior in their lifetime. For example,habits can range from seemingly benign behaviors, such as nail biting or foot tapping, to morenoticeable physically damaging behaviors, such as teeth grinding (bruxism) and hair pulling.Habit disorders, now subsumed under the diagnostic term stereotypic movement disorder,consist of repetitive, seemingly driven, and nonfunctional motor behaviors that interfere withnormal activities or that result in bodily injury. Objectives: To determine the frequency ofdifferent habit disorders in children coming to outpatient department of Pediatrics unit of AlliedHospital Faisalabad. Study design: Cross sectional study. Setting: Pediatric department ofAllied Hospital Faisalabad. Duration of study: 1 year 06 months. (From 01-03-2015 to 01-09-2016). Results: We determined that majority of the patients i.e. 40.68%(n=72) were between49-72 months, mean and sd was 54.23+21.45 months of age, 54.80%(n=97) male and45.20%(n=80) females, frequency of different habit disorders in children coming to outpatientdepartment of pediatrics unit of Allied Hospital, Faisalabad revealed 19.31%(n=34), nail biting,22.03%(n=39) had thumb sucking, 41.81%(n=74) had bruxism, 11.86%(n=21) had hair pullingand 10.17%(n=18) subjects had other habits. Conclusion: We concluded that the frequency ofdifferent habit disorders i.e. nail biting, thumb sucking, bruxism, hair pulling and other is higheramong children coming to outpatient department of Pediatrics unit of Allied Hospital Faisalabadand comparable with other studies.
IRON DEFICIENCY ANEMIA
Authors: Maheshwari Nathumal , Khemani Omperkash , Hingorjo Bilawal , Shaikh Mehmood , Chand Siri , Rehman Anjum
Published: August 2021

Objectives: To evaluate the predictive value of Red blood cell distribution width(RDW) for the iron deficiency anemia in children. Study Design: Cross sectional study. Placeand Duration: Department of Paediatrics, Layari General Hospital Shaheed Muhtrama BenazirBhutto Medical College from December 2015 to March 2016. Methodology: A sample of 100children (53 male and 47 female) was selected through non- probability (purposive sampling). 5ml venous blood was collected, 3 ml was shifted to EDTA containing vacutainers and remainingwas processed and centrifuged to separate sera. Complete blood counts and iron profile wereperformed. Data of cases and controls was analyzed on Statistix 10.0 software (USA) (P ≤0.05).Results: Severe iron deficiency and iron deficiency anemia were noted. Serum Iron, TIBC andFerritin were noted as 63.49±32.94 and 76.06±40.38 μg/dl, 468.7±142.2 and 445.5±135.2 μg/dl, & 36.2±14.12 and 43.2±13.5 ng/dl respectively. RDW proved a sensitivity and specificity of78% and 56% respectively (0.001). Conclusion: We observed severe iron deficiency anemia inchildren and Red blood cell distribution width showed high sensivity in predicting iron deficiencyanemia.
CELIAC DISEASE
Authors: Rasheed Javaria , Khan Tajwer , Khalid Muhammad , Zafar Fauzia
Published: August 2021

Background: Celiac disease (CD) is an immune-mediated enteropathy stimulatedby intake of gluten, rye and barley in genetically prone persons. In children, gastrointestinalsymptoms are usual if disease is diagnosed in first two years of life but as the age at onset of theillness advances to late years, extra-intestinal manifestations have been increasingly recognizedaffecting almost all organ systems. Objectives: To determine the prevalence of varied clinicalmanifestations of CD in children. To assess classical and non-classical features in patients withCD. Study Design: Cross sectional study. Setting: Nishtar Hospital Multan. Period: July 2016to July 2017. Material & Methods: Ninety-six patients with celiac disease were analyzed. Thediagnosis was confirmed by serological antibodies and positive biopsy wherever needed. Allthe cases were evaluated for different intestinal or extra-intestinal features. Also the cases werecategorized based on their primary clinical features into two groups. The classical group hadCD patients with usual symptoms. The non-classical group had atypical symptoms. Results:The mean age of CD patients at the time of diagnosis was 5.98 ± 3.19 years. Median valuefor duration of clinical symptoms was 24 months. The common typical clinical presentationsincluded failure to thrive 86 (89.6%), short stature 86 (89.6%), diarrhea 78 (81.3%), unexplainedanemia 78 (81.3%) and clubbing 41 (42.7%). The atypical features noted in our study wereconstipation 21 (21.9%), hypertransaminasemia 38 (39.6 %) and neurological symptoms likeirritability/ behavioral changes 41 (42.7%). Family history of gluten allergy or other autoimmunediseases was present in 29 (30.2%) of patients. Children presented with non-classical symptomswere older than 2 years of age and they showed high prevalence of associated immune andnon immune diseases compared to those in classical group. Conclusion: The knowledge ofvaried behavior of CD may prevent delay in diagnosis. CD must be particularly screened inpatients with unexpected anemia, rickets, clubbing, short stature and in cases with positivehistory in family.
ORTHODONTIC BRACKETS
Authors: Azeem Muhammad , Haq Arfan ul , Iqbal Javed
Published: August 2021

Introduction: Bracket bonding on filled tooth surfaces is sometimes requiredin clinical orthodontic practice. The objective was to compare mean shear bond strength(SBS) of metal brackets on diamond bur roughened versus no treatment composite surfaces.Study Design: In Vitro, Comparative study. Period: January 2017 to October 2017. Setting:Orthodontic Department, Faisalabad Medical University. Materials & Methods: 30 extractedhuman premolars were used. They were randomly divided into two groups of 15 teeth. In group-I,metal brackets were bonded to composite with no surface treatment. In group-II, brackets werebonded after roughening composite surface with diamond bur. SBS was measured usinguniversal testing machine. Results: SBS of metal brackets bonded with no surface treatmentwas significantly lower than diamond bur roughened group. Conclusion: Composite surfacetreatment with diamond bur roughening increased shear bond strength of orthodontic brackets.
ORAL HEALTH
Authors: Ilyas Muhammad , Zahid Sadaf , Rafiq Anam , Bilal Maham , Ishaq Narmeen
Published: August 2021

Introduction: Oral health is considered as being free from any kind of oraldisease. Objectives: To explore the LAYMAN’S PERSPECTIVE regarding oral health, hisawareness about oral diseases. To examine their attitude and beliefs regarding the maintenanceof oral health. Study Design: We conducted mixed study on educated and uneducated people.Study Period: 01 May, 2016 to 01 May, 2017 Study Place: Punjab dental hospital, Lahore.Material & Methods: Qualitative method was used to collect knowledge and perspective ofuneducated people. Quantitative method was used to collect data from educated people. Weinterviewed uneducated people in differenst places of Lahore and questionnaires were filled byeducated people. Results: 58% of educated people and majority of uneducated people thinkthey should visit dentist only at the time of need. 73% educated people said bleeding gumsare indicative of oral disease, while majority of uneducated people said it does not indicateoral disease. Educated people were somewhat more aware of oral health and oral diseasewhile uneducated people were unaware of even maintenance of oral health and its importance.Conclusion: Education makes the difference. Educated people have more awareness aboutoral health. Still awareness is needed a lot.
BOVINE MILK
Authors: Ullah Shafqat , Mahsood Naheed , Imtiaz Ayesha , Hamza Amir
Published: August 2021

Introduction: Milk and dairy products are consumed by the human on dailybasis throughout the globe and constitute a huge business by the dairy farmers due to its highdemand. The consumers of milk and milk products expect its high quality, free from the artificialpreservatives and threatening agents. Objectives: To determine the chemical quality of rawbovine milk sold in open markets of district Peshawar. Study Design: Cross-sectional study.Setting: 4 towns, Town 1(Sikandar Town and Gul Bahar) ,2 (Shahi Bala,Methra and Pajjagi),3(University Road and Hayatabad Area), 4 (Hazaekhawani and Badabair Area) of districtPeshawar. Period: 6 months; from November 2016 to April 2017. Methodology: 158 sampleswere selected. All samples were analyzed for adulteration in the Public Health Laboratory phase5 Hayatabad Peshawar. Study duration was 6 months; convenient sampling technique hasbeen followed. Results: Among all 158 samples; 32.3% of the sample were adulterated withwater. 8.9% of sample showed hydrogen per oxide adulteration. Starch, cane sugar and ureaadulteration was in 7.6%, 2.5% and 1.9% samples respectively. Vegetable oil, formalin andsynthetic milk adulteration was in 1.9%, 5.7% and 5.7% of samples respectively. We have LargeScale Vendors i.e. Rural Area 10% showing low and Urban Area 90% as high adulteration, SmallScale Vendors 30% low in rural Area and 70% high adulteration in urban area respectively.Conclusion: This study results provided a base line data of chemical composition of bovinemilk used in Peshawar. Chemical were present and can play key role in alteration of milk whichwe use on daily basis. Water content was high, it means that most of the shop-keepers prefer tomix water in milk to increase the quantity of milk. Use of starch, Vegetable Oil and Formalin wasminimal. Use of hydrogen peroxide, Urea and synthetic milk was very less in provided sample.
THYROID DISORDERS
Authors: Jahan Shazia , Rouf Abdur , Aziz Sajid , Ateeq Muhammad
Published: August 2021

Objective: to study the spectrum of various thyroid disorders presentingin peripheral teaching hospitals of Gujranwala region. Study Design: Descriptive, Crosssectional, Interventional. Setting: Department of Surgery Islam Teaching Hospital Sialkot &Surgical Department of Aziz Bhatti Shaheed (Teaching) Hospital. Nawaz Sharif medical College,University of the Gujrat. Study Period: February 2011 to June 2016. Results: A total of 236patients of all age groups with thyroid gland disorders were enrolled in this study. Majority ofpatients were of middle age group with mean age of 43+ years. Male to female ratio was 1:4.Nodular thyroid enlargement was the commonest presentation. Solitary thyroid nodule was thecommonest variant of nodular goitre seen in 48.52% cases. Thyroid carcinoma was found in36.45% cases among the nodular goitres. Conclusion: Thyroid disorders are common in hillyareas of Pakistan, more common in female population. High prevalence thyroid malignancy inpopulation of the Gujranwala Division of Central Punjab is an alarming and worrisome finding inour study. Larger multicenter studies are suggested in this particular region to know the exactincidence, predisposing factors/ carcinogens etc if any responsible for thyroid malignancies inthis region.
PROSTATE AND BREAST CANCER
Authors: Sadiq Sarah , Naveed Abdul Khaliq , Waheed Palvasha , Qaiser Fatima , Hashmi Shoaib. N.
Published: August 2021

Background: CK2, a serine/threonine, protein kinase, targets over and above300 substrates including c-Myc. CK2 expression is elevated in human cancers includingbreast cancer and prostate cancer. c-Myc protooncogene expression is also up-regulated inthese cancers. Objectives: To evaluate the co expression and correlation of CK2 and c-Mycin prostate cancer as compared to their correlation in breast cancer. Study Design: Crosssectional analytical study. Setting: Army Medical College and AFIP, Duration: Two years.Methods: A retrospective study of immunohistochemical analysis, approved by Armed ForcesInstitute of Pathology Ethical Committee. Paraffin embedded tissues of diagnosed prostatecancer, 30 in number, 30 cases of Benign Prostatic Hypertrophy (BPH) and 30 cases of breastadenocarcinoma, were included in the study. We stained tissue sections for CK2 and c-Mycand measured staining intensity for each protein expression. Data analysis was done by SPSSversion 20. Pearson correlation coefficient was used for correlating the expression of bothproteins. P-value was calculated. Results: A strong correlation of CK2 with c-Myc was seen inprostate cancer tissue, in comparison to BPH. There was a very significant correlation presentbetween CK2 and c-Myc, especially in invasive cases of breast cancer. Conclusion: CK2 andc-Myc expressions are highly and significantly correlated in prostate cancer and breast cancerespecially in invasive cases. CK2 has influence over c-Myc and both can be used for forecastingthe cancer phenotype and aggression of disease.
PORCELAIN METAL CERAMIC CROWN VERSUS PORCELAIN VENEER
Authors: Awan M. Rafi Ullah , Asghar Hira , Raza Hamid , Rasul Faiz , Baig Muhammad Safdar
Published: August 2021

Objectives: To evaluate the success of porcelain metal ceramic crown andporcelain veneer in endodontically treated maxillary central incisor having discoloration. StudyDesign: Expermintal study. Setting: Akhtar Saeed Dental Hospital, Bahria Town, Lahore andde’Montmorency College of Dentistry, Lahore. Period: 1st January 2016 to 30th June 2016.Patients and Methods: This study includes 42 patients. All the patients had ages between35-40 years and either gender. These patients had discolored endodontically treated uppercentral incisor. The patients were randomly divided into two groups to receive either the metalceramic crown or the porcelain veneer. The restorations were given to the patients according tothe following standard protocols. Follow-up examination was determined as set format of study.The results were compiled at the expiry of twelve months. Results: There were 27 femalesand 15 males. The result is obtained 1.1629 which is statistically not significant at p<0.05.Conclusion: Being conservative in tooth reduction, veneer should be preferred while maskingdiscoloration of single anterior tooth instead of full coverage metal ceramic crown.
BIRTH WEIGHT
Authors: Din Shahabud , Moeen Aiman , Ullah Ihsan , Mohammad Niaz
Published: August 2021

Objectives: To evaluate the birth weight in infants born to diabetic mothersand to compare it with those born to nondiabetic mothers. Study Design: Descriptive crosssectional study. Setting: Gynae and obstetrics unit Hayatabad Medical Complex Peshawar inassociation with Anatomy Department Khyber Girls Medical College Peshawar. Period: January2015 to June 2015. Material and Methods: This study was carried out on babies born todiabetic as well as non-diabetic healthy mothers. A total number of 100 diabetic mothers and100 nondiabetic healthy mothers were selected for this study. After delivery, the weight andsex of the babies born to diabetic as well as nondiabetic mothers along with the motherfs agewere noted on an observation sheet. The studentfs t test was applied for all quantitative data.A p-value of . 0.05 was taken significant. Results: The mean birth weight of female babiesborn to diabetic mothers was significantly greater than babies of nondiabetic mothers (p=0.05). No significant difference (p=0.11) was noted when the birth weight of all babies bornto diabetic mothers was compared to all babies born to nondiabetic mothers. No significantdifference (p= 0.51) was noted in babies belonging to younger nondiabetic and diabeticmothers but a significant difference (p=0.01) was noted when birth weight of babies from oldernondiabetic mothers was compared with birth weight of babies from older diabetic mothers.Conclusion: The birth weight of female babies born to diabetic mothers was significantly moreas compared to babies born to nondiabetic mothers. A significant difference was also notedwhen birth weight of babies from older diabetic mothers was compared with the babies of oldernondiabetic mothers. This larger weight of babies may be due to maternal diabetes which mayaffect the normal development of fetus leading to an increased morbidity and mortality in babiesas well as mothers.
OVERWEIGHT AND OBESITY
Authors: Tariq Rukiya , Shahid Maryam , Tariq Kalsoom
Published: August 2021

Objectives: To investigate socio-demographic factors and diseases causingoverweight and obesity among 25 to 60 years women. Study Design: Descriptive crosssectionalstudy. Duration & Setting: Comprised of five months (January 2016 to May 2016);concerning household survey i.e. door to door sampling method was carried out in Lahore,Pakistan. Material and Methods: Multistage sampling technique was used and 3239 womenaging 25 to 60 years; of which 1684 (52%) females were normal weight (excluded from theresearch) and 1555 (48%) overweight/obese women i.e. 1106 (34%) were overweight and 449(14%) women were obese (included in the analysis).Descriptive statistics and Bivariate logisticregression was applied on the achieved data through IBM SPSS Statistics Version 21. Results:Socio-demographic factors and diseases were found significantly associated with overweightand obesity; includes age (p=0.001), marital status (p<0.000), level of education (p=0.000),occupation (p=0.000), father/husband occupation (p=0.000) and monthly income (p=0.001);whereas, diseases such as hypothyroidism (p=0.001), polycystic ovarian syndrome (p=0.000),menstrual period (p=0.001) and depression/stress (p=0.000)as their p-values were less than0.05 (significant). Conclusion: The research findings points out notable explanation of sociodemographicfactors and diseases causing overweight and obesity among 25 to 60 yearswomen with respect to which the study can definitely summarized to countless extent.
END STAGE RENAL DISEASE
Authors: Baloch Muhammad Hussain , Shams Nadia , Mahmood Najia , Zahoor Warda , Seetlani Naresh Kumar , Bashir Farhat
Published: August 2021

Objectives: To study hematological profile in geriatric cases undergoinghemodialysis and compare with non-geriatric. Study Design: Descriptive Cross SectionalStudy. Setting: Department of Nephrology & Medicine, Rawal Institute of Health SciencesIslamabad. Study Duration: 12 months (June 2016-June 2017). Material and Methods: Adultpatients (>18years) diagnosed as end stage renal disease (ESRD), undergoing maintenancehemodialysis for >3 months included after ethical approval and consent. Group A had 88geriatric ESRD cases (>65 years); group B had 88 non-geriatric (<65 years). Data analyzedby SPSS version 17. Hematological profile and other variables compared between two groupsby Chi-Square and t-test (significant p<0.05). Results: Among 166 ESRD cases (69% malesand 31% females), mean age was 54.9+10.6 years. Anemia present in 89% (group A) vs.74% (group B; p=0.012). Mean hemoglobin was 8.57+2.00 (group A) vs. 9.27+2.39 (groupB; p=0.035). Mean platelets count was lower among geriatrics; however leukocyte countscomparable between two groups. Mean eGFR was 7.95+2.68 (group A) vs. 9.16+4.04(group B; p=0.020). Diabetes and hypertension were frequent in geriatric group (p<0.05).No difference in hepatitis B, C and congestive cardiac failure observed. BMI was 26.74+5.87(group A) vs. 22.43+4.83 (group B; p<0.0001). Lack of social support observed in 25% (groupA) vs. 9% (group B). Conclusion: Anemia is frequent observation in ESRD hemodialysis cases.Geriatric ESRD hemodialysis cases have significantly low hemoglobin levels than non-geriatric.Hence, suggested that old age to be considered as an additional risk factor for anemia in ESRDhemodialysis cases. Geriatric ESRD hemodialysis cases should undergo frequent anemiascreening and timely intervention. Iron supplementation, dietary modification, erythropoietinadministration and blood transfusion as per indication needs to be individualized in geriatriccases to improve hematological parameters and quality of life.
SPONTANEOUS BACTERIAL PERITONITIS (SBP)
Authors: Malghani Waseem Sarwar , Chaudhary Farooq Mohyud Din , Ilyas Muhammad , Din Asma Tameez Ud , Din Asim Tameez Ud
Published: August 2021

Background: Spontaneous bacterial peritonitis (SBP) is a bacterial infectionwhich occurs in cirrhosis of liver complicated by ascites. To decrease the high in-hospitalmortality rate of 20 to 30%, rapid diagnosis and antibiotic treatment are essential. Objectives:To ascertain the frequency of causative organisms of SBP. Study Design: Descriptive study.Setting: Gastroenterology Department, Nishtar Medical College/Hospital, Multan using nonprobability, consecutive sampling. Period: Jan 2017 to July 2017. Methodology: The studyincluded 183 patients of liver cirrhosis having SBP. Under aseptic conditions, ascitic fluid tapwas done and sent for bacterial culture. Data was analyzed by computer program SPSS-18.Results: Of these 183 study cases, 103 (56.3%) were male patients while 80 (43.7%) werefemale patients. Mean age of our study cases was 51.73 ± 9.28 years. Mean duration ofdisease (liver cirrhosis) was 26.43 ± 12.32 months while mean duration of SBP was 4.51 ±1.21 days. More than half of cases (56.3%) of liver disease were caused by Chronic Hepatitis C,13.7% were due to Hepatitis B and 16.9% of patients were alcoholics. Among the study cases,E.coli was noted in 135 (73.8%), Staph. Aureus in 17.5% and Klebsiella was noted in 8.7%.Conclusion: Our study indicates that E.coli is the major organism causing SBP in patientshaving cirrhosis of liver followed by Staph. Aureus and Klebsiella.