bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of HIV Positivity in Healthy Blood Donors presenting to a Tertiary Care Hospital
Authors: Munir Saria , Asgher Zahid , Ghazanfar Masuma , Qaiser Maria , Jabeen Kokab
Published: July 2022

Background: HIV has been under serious consideration by the World Health Organization as well as the Federal government and Provincial health departments. Strict measures have been taken and protocols implemented to curtail the spread of HIV along with Hepatitis B and Hepatitis C. Data from privately-run blood banks have not been reflected in the last 15 years. Aim: To identify current trends of HIV positivity in Lahore Methods: This prospective cross-sectional study was conducted at the Department of Pathology & Laboratory, Doctors Hospital & Medical Centre, Lahore from August 2021 to January 2022. After fulfilling the selection criteria 3160 non-remunerated blood donors selected through non-probability consecutive sampling, were enrolled. Anti-HIV test was performed using chemiluminescence. Results: 3160 voluntary blood donors were investigated. All subjects were males with mean age 29.7 years ranging from 21 years to 46 years. 2 candidates for blood donation (0.06%) were tested positive for HIV. Conclusion: This study reflects stagnation in HIV control as depicted by the frequency of its positivity. There is need to enhance awareness programs in controlling the spread of blood borne diseases especially HIV. Keywords: HIV, blood donor, blood borne diseases, blood transfusion
Challenges to Online Medical Education during the Covid-19 Pandemic in Medical Colleges of Pakistan
Authors: Khan Qudsia Umaira , Tahir Hamyel , . Muallah , Faisal Danyal , Zafar Aalia
Published: July 2022

Background The Covid-19 pandemic have forced the education sector of every country to adopt a relatively unconventional method of teaching i.e., Online Education. However, it faces many challenges of its own. Aim: To discuss the challenges to online medical education during the Covid-19 pandemic in medical colleges of Lahore, Pakistan. Methods: A cross-sectional type of quantitative study using a self-administered online questionnaire using Google Forms® was administered to 508 students from all the medical colleges of Pakistan. Results: Majority of subjects preferred face-to-face learning (70.9%) before Covid-19 pandemic and had beginner level online exposure (60. 6%). Overall, 85.8% of participants found the impact of shifting to online learning as negative. A variety of challenges were faced by the students with decreased attention span being most common followed by strain on mental health, problem in communication and taking exams. Conclusion: Covid-19 related lockdown led to new culture of education. Medical students had difficulty adapting to this but a faction of student wanted to use and discover online learning more. Key words: Covid 19, Online Medical Education, Challenges
Evaluation of Prevalence and Features of Coronary Artery Anomalies using Multidetector-row Computed Tomography
Authors: Kalsoom Farah , Khalil Muhammad Taha , Siddiqi Mustafa Ali , Khalid Sehrish
Published: July 2022

Aim: To evaluate the course, origin and termination of coronary artery anomalies in subjects demonstrating various symptoms and undergoing multidetector CT coronary angiography for evaluation of coronary disease. Study Design: Retrospective study Place and duration: Ch.Pervaiz Elahi Institute of Cardiology Multan from January 2021 to January 2022. Methodology: The study included patients who were referred to the radiology department because of suspicion of coronary artery disease. The data of these patients were reviewed for the course and origin of coronary artery anomalies. A 64-slice scanner was used for MDCT coronary angiography. At the start of acquisition contrast arriving coronary arteries were synchronised using the bolus tracking technique. The whole heart was imaged during apnea using 80-90ml iodinated contrast material administered intravenously. Coronary arteries were evaluated using 3-D and multiplanar reformatted images Results: Total of 600 patients who were referred for MDCT coronary angiography. The subjects underwent screening because of various risk factors, chest pain, or similar symptoms. Coronary artery anomalies were diagnosed in 21 out of 600 (3.5%) patients, whose mean age was 52.6±10.8 years and 504 (84%) were male. 3(14%) patients had high take-off of RCA (right coronary right) and 4(19%) of LMCA (left main coronary artery). In 5(24%) patients left circumflex artery (LCx) and left anterior descending artery (LAD) originated separately from the left sinus of Valsalva (LSV). In 3(14%) patients RCA originated from the opposite sinus of Valsalva.RCA anomaly in 1 patient had a malignant course. Conclusion: The study shows that evaluation of coronary artery anomalies can viably be done using CT. Right diagnosis and treatment planning are based upon an understanding of the clinical significance and CT characteristics of different CAAs. Keywords: Coronary artery angiography, MDCT, prevalence
Comparison between Intrathecal Dexmedetomidine & Bupivacaine Vs Bupivacaine Alone for Prevention of Shivering in C-Section
Authors: Rehman Abaid-Ur- , Khan Zeeshan , Nadeem Amjad , Butt Muhammad Muazzam , Askri Mohsin Riaz , Butt Zulqarnain
Published: July 2022

Background: Shivering is one of the very common side effects of spinal anesthesia. It can be extremely discomforting for parturient undergoing caesarean section. Aim: To compare intrathecal dexmedetomidine and bupivacaine with bupivacaine alone to see whether intrathecal dexmedetomidine can be helpful in preventing shivering in cases undergoing C-section Methodology: This was a prospective randomized controlled trial carried out at Department of Anaesthesiology, Sheikh Zayed Hospital, Rahim Yar Khan. In this study all pregnant females undergoing C section between the age of 18 to 40 years irrespective of their gravida and parity were included. The cases were divided into two equal groups B and D. Group B were offered injection Bupivacaine only and those in group D were offered Bupivacaine along with Dexmedetomidine. Final outcome was seen at 4 hours for shivering after giving spinal anesthesia. Results: In this study there were 120 cases, 60 in each group. The mean age in group B and D was 31.12±4.57 vs 30.67±5.03 years with p value 0.81 and mean BMI was23.19±4.11 vs 23.81±4.23 kg/m2 with P value 0.95 respectively. There were 80% cases in group B and 66.67% in group D belonging to rural population with p value 0.88. Shivering was observed in 24 (40%) cases in group B and 6(10%) in group D with p value 0.01. Conclusion: Combination of intrathecal Bupivacaine and Dexmedetomedine is significantly better than intra thecal Bupivacaine alone in prevention of shivering in patients undergoing C section. Keywords: Bupivacaine, Dexmedetomidine, Shivering, Intrathecal
Relationship of Vit D deficiency with obesity, metabolic abnormalities and Insulin resistance in patients with POS
Authors: Anjum Safoora , Saleem Amina , Noor Shazia , Mahmood Arjumand , Khalid Salma , Sarwa Asma
Published: July 2022

Background: Polycystic ovary syndrome (PCOS) is the leading endocrine disorder that affects women in their reproductive age with global prevalence of 6 to 26%. Many different studies have established a firm relationship between levels of vitamin D and various symptoms of PCOS that includes subfertility, cycle regulation, insulin resistance and hirsutism. Aim: To validate the correlation of insulin resistance and obesity with vitamin D deficiency in women suffering with PCOS. Methodology: A cross-sectional study was conducted including 110 PCOS patients. Anthropometric measures, demographics details, dietary and menstrual history were collected from the patients. Blood samples were also collected and analyzed for parameters of biochemical and hematological nature along with its hormone profile. All the data was analyzed statistically. Results: Low Levels of vitamin D were observed to be greater in people considered overweight/obese as per their BMI. . The vitamin D deficient patients had significantly higher body weight (p = 0.05), BMI (0.01), testosterone (p = 0.03), LH (p=0.03) and serum calcium (p <0.0001). Univariate correlation analysis among all the important parameters and 25-hydroxyvitamin D revealed no significant correlation. Conclusion: Vitamin D deficiency is quite commonly observed in patients dealing with PCOS and aggravates the abnormalities related to metabolism. For the prevention of adverse consequences, screening of PCOS patients for deficiency of 25-hydroxyvitamin D holds importance so that a suitable replacement therapy can be initiated. Keywords: Vit. D deficiency, obesity, polycystic ovarian syndrome, insulin resistance
Frequency of Endometriosis in females presenting with Infertility
Authors: Khalid Salma , Anjum Safoora , Mahmood Arjumand , Aman Sadia , Aman Nadia , Tahir Hira
Published: July 2022

Background: Infertility is an inability to get pregnancy or give birth to a child. Several factors may be involved in development of infertility. The endometriosis is the devastating syndrome which may be a cause of infertility in females. Aim: To assess the frequency of endometriosis in females presenting with infertility in a tertiary care hospital. Methods: This cross sectional study was conducted in the Department of Obstetrics & Gynecology, Services Hospital, Lahore for 6 months. 150 females underwent laparoscopic diagnosis of endometriosis. All this information was recorded on proforma. The collected data was entered and analysed statistically by using SPSS version 20. Results: The mean age of patients was 29.28±6.00years. The mean weight of females was 67.68±10.60kg, mean height was 1.60±0.05meters and mean BMI was 26.60±4.49kg/m2. The mean duration of marriage was 7.41±5.57years. In this study, 71 (47.33%) females had primary infertility while in 79 (52.67%) females had secondary infertility. There were 21 (14%) females who had endometriosis while 129 (86%) females did not have endometriosis. Conclusion: Thus the frequency of endometriosis was low in females with infertility but not ignorable. Key words: Endometriosis, females, infertility, laparoscopy
Impact of Arteriovenous Fistula Creation on Progression of Chronic Kidney Disease
Authors: Asrar Asmara , Rafique Zahid , Afzal Aurangzeb , Nasim Azhar , Talal Ali
Published: July 2022

Background: All guidelines recommend pre-emptive arteriovenous fistula (AVF) formation in late-stage chronic kidney disease (CKD) patients. New evidence shows that pre-emptive AVF can improve estimated glomerular filtration rate (eGFR) as well. Aim: To evaluate the beneficial effect of AVF on improvement of eGFR in pre dialysis patients of CKD stage 5 disease. Methodology: A total of one hundred CKD stage five pre-dialysis patients were included in this prospective cohort research from the Nephrology unit of Services Hospital Lahore (SHL). After receiving approval from the ethical review committee SHL, the study was performed from September 2021 to March 2022. Patients were separated into two groups. Fifty patients with arteriovenous fistula (AVF) were in Group AVF, whereas those in Group Non-AVF were only on conservative therapy as they opted for conservative treatment despite counseling about need for AVF and Renal Replacement Therapy (RRT) in future. Over the course of six months, both groups were monitored. The initial eGFR was measured immediately after the formation of AV fistula and monthly for next six months (Final eGFR). Results: The median age of the study population was 37 years in which the sixty percent of the males. The most common comorbid condition was hypertension (96%) and the main reason for late-stage renal disfunction was diabetic nephropathy (45%). We found statistically significant improved eGFR in AVF group as compared to the non-AVF group (p < 0.01). Conclusion: From the results of our study, it can be concluded that the creation of AV fistula in the pre-dialysis patient has a beneficial effect on improvement of eGFR and delaying the progression CKD. Keywords: End Stage Renal Disease, AV fistula, Pre-Dialysis, e GFR, chronic kidney disease,
Recurrence Rate of Abdominal Tuberculosis in Cases Presenting With Acute Abdomen
Authors: Aleem Sidra , Sarwar Naeem , Naseem Sajida , Abbas Muhammad Arshad , Hameed Sohail , Bukhari Rafay
Published: July 2022

Background: Acute abdomen is considered as one of the major causes leading to surgical emergencies and intestinal obstruction, perforation and many other underlying causes resulting in surgical consultation. Aim: To determine rate of recurrence of abd. TB in cases presenting with acute abdomen to Sh. Zayed Hospital, Rahim Yar Khan. Study Design: The Cross sectional study Sampling Technique: Consecutive sampling non probability Sampling Technique Methods: This particular study was conducted at teaching hospital Rahim Yar Khan from 10-04-2021 to 31-12-2022 in which the cases of both genders with age ranging from 15 to 60 years having acute abdomen presenting within 24 hours were included. Abdominal tuberculosis (TB) was labeled on histopathology when there was caseating granuloma. Results: There were around 90 cases included in this present study. Out of these 50 (55.55%) were male patients and the rest of 40 (44.44%) were female patients. Approximately 34.91±11.35 was the Mean age in years of the patients and 67.13±21.39 in Kilograms was the mean weight. There were about 22 (24.44%) cases which had previous history of abdominal surgery. The abdominal tuberculosis was diagnosed in 30 (33.33%) of the cases as shown in figure 12. Abdominal TB was observed in 16 (32%) males and 14 (35%) females in their respective groups with p= 0.81. TB was detected in 20 (35.71%) out of 56 cases in age group 15 to 39 years as compared to 6 (25%) out of 24 cases with age 40-60 years with p= 0.44. There was no significant difference in terms of abdominal TB and weight (p= 1.0) and also with cases that had previous surgery with p= 0.57. Conclusion: The abdominal tuberculosis (TB) is detected in one third of all the cases presenting with acute abdomen and there is no significant association of this with any of the confounding variable of the study. Key words: Acute abdomen, abdominal TB, Granuloma, Biopsy
The Determinants of Parental Uptake of Childhood Immunization in Peri-Urban Areas of Karachi - A Cross-Sectional Study
Authors: Nawaz Mawra , Rizvi Sameera
Published: July 2022

Background: Immunization is one of the simplest and cost-effective ways to protect a child from infectious diseases and mortality worldwide, and while global immunization coverage has increased dramatically the impact is low in developing countries like Pakistan, where many children remain unvaccinated or partially vaccinated. Aim: To determine the potential factors related to parents that impact the uptake of immunization in children living in the peri-urban area of Karachi, Pakistan. Methodology: An analytical cross-sectional study was conducted between Oct 2020 to May 2021. Purposive sampling technique based on the inclusion and exclusion criteria was used and a total of 100 parents of children were interviewed using the self-developed structured questionnaire focusing on factors like socio-demographic, parental health-seeking behavior, parental knowledge and perception of immunization and the reasons why a child is partially immunized. The data was collected from two EPI centers from the peri-urban area of Karachi to determine the parental factors associated with child immunization. Results: The results of the study show association between Child immunization and father occupation (p=0.000), parental education (p=0.000) and household income (p-value=0.000). history of sibling’s complete vaccination 35(70%), frequency of maternal antenatal visits 41(82%) accompanied by the husband 37 (74%) and have delivered the child in hospital 50(100%) by an obstetrician 50 (100) and for medical treatment child is always taken to a hospital 47(94%). Parents who consider vaccination important 48 (86%) with the significance of (p=0.001) and they have awareness regarding the total number of immunizations 38(76%) have fully immunized children. Conclusion: According to the study, parental education, occupation, income, health-seeking behavior, father’s involvement, child birth-related factors, parental awareness on immunization, perception of immunization Keywords: Immunization coverage, EPI, Parental factors, Peri-Urban, Sindh, Fully Immunized, Partially Immunized
Prevalence of Bone Mineral Disorder in Hemodialysis patients: A Single Centered Study of Local Population
Authors: Nasim Azhar , Rafique Zahid , Talal Ali , Afzal Aurangzeb , Asrar Asmara
Published: July 2022

Background: Mineral homeostasis deteriorates when kidney function diminishes, manifesting as variations in blood and tissue levels of calcium and phosphate, followed by the change in circulating parathyroid hormone (PTH). Mineral bone disorders (MBD) are a clinical illness caused by chronic renal disease that expresses as a systemic impairment of mineral and bone metabolism. Aim: To find out prevalence of bone mineral disorders in hemodialysis patients presenting in Nephrology Ward, SIMS. Lahore Methodology: This observational analysis included a total of 88 patients, who were on dialysis at the nephrology department of SHL for the period of more than six months. The study was conducted from 17 September 2021 to 10 March 2022 after the approval of the ethical review board of the Department. According to their blood PTH levels, the patients were split into three groups: those with PTH levels less than 150 pg/ml (low bone turnover), those with PTH levels between 150 and 300 pg/ml (normal bone turnover), and those with PTH levels greater than 300 pg/ml (high bone turnover). Results: The prevalence of bone mineral disorder was 87.5% in hemodialysis patients presenting at the nephrology department, in which prevalence of high turnover bone disorder was 73.9% whereas the prevalence of low turnover bone disorder was 13.6%. In the early dialysis period (0.5-5 years) the prevalence of bone mineral disorders was more prominent as compared to the patients on dialysis for more than 5 years. Conclusion: There was a high prevalence of bone mineral disorders, in which patients with high turnover were found to be more prevalent. Similarly, patients in the early years of dialysis are more prone to develop bone mineral disorders. Thus, we should keep these findings in mind while doing the follow up and adjust the medication accordingly. Keywords: Bone Mineral Disorders, Low Turnover Bone Disorders, Hyper Para Thyroid Disorder, Prevalence of Disease
Frequency of Hearing Impairment in Siblings of Hearing Impaired Children
Authors: Nasir Umair , Ahmed Muhammad , Khan Azam , Zaman Saira
Published: July 2022

Background: It has been reported that hearing impairment is significantly associated with multiple negative outcomes including depression, loneliness, altered self-esteem, and diminished functional status. The deaf and hard of hearing community is very diverse as for as cause, age of onset and degree of hearing loss. Aim: To determine the frequency of hearing impairment in siblings of hearing impaired children. Methods: This is descriptive observational study was conducted between September 2015 to February 201 at FMH College of Medicine and Dentistry. A total of 100 hearing impaired children aged between 4 to 20 years were included in this study. A self-designed questionnaire was used to assess the parental point of views. The questionnaire was designed as a data collection tool in order to collect the frequency from the HIC regarding their siblings hearing impairment. Results: Results indicated that out of 100 subject 63(63%) were male and 37(37%) were female and the mean age of patients was 12.28±4.13 years. On asking the HIC about total number of siblings 15(15%) responded that they had only 1 sibling, 28(28 %) responded that they had only 2 siblings, 17(17%) responded that they had only 3 siblings, 17(17%) responded that they had only 4 siblings, 14(14%) responded that they had only 5 siblings, 1(1%) responded that they had only 6 siblings and 8(8%) responded that they had only 7 siblings. Conclusion: It was concluded from the above study that frequency of hearing impairment in siblings of hearing impaired children is in high proportion and this high proportion of hearing impairment is because of cousin marriages, pressure due to family structure, genetic change. Keywords: Hearing impairment, hearing loss, frequency, Siblings.
Impact of Different Suturing Techniques used to from Neopharynx on Postop Pharyngocutaneous Fistula Development after total Laryngectomy
Authors: Aleem Zahra , Aziz Bakht , Rehman M. Atiq U , Wahab M. Umair , Malik Irshad , Malik Kashif Iqbal , Haider Hasnain , Umar Maryam
Published: July 2022

Background: Laryngeal cancers are the second most common cancers in aero digestive tract. In advanced laryngeal cancers total laryngectomy is performed and it gives excellent results post operatively as the 5 year survival rate is 95%. One of the most common complication of total laryngectomy is formation of pharyngocutaneous fistula post operatively. Aim: To compare interrupted vs continuous suturing technique in formation of neopharynx after total laryngectomy in order to find out which technique is better in terms of pharyngocutaneous fistula formation postoperatively. Method: A total of 20 patients requiring total laryngectomy were selected. Patients were segregated into two groups. patients in group A underwent continuous suturing technique and those in group B underwent interrupted suturing technique in formation of neopharynx. Patients were then post operatively monitored for pharyngocutaneous fistula formation for 10 post operative days Result: Mean age in group-a patients was 56.90±12.94 year and 54.60±9.31 year in group-b patients. Pharyngocutaneous fistula developed in 2(20%) patients with interrupted suturing technique and in 7(70%) patients with continuous suturing technique used for formation of neopharynx. Conclusion: Hence it was concluded from our research that formation of neophaynx per operatively using interrupted suturing technique has less incidence of pharyngocutaneous fistula formation postoperatively then continuous suturing technique as it provides more strength to the wall of neopharynx and has less chances of dehiscence. Keywords: Neopharynx , Laryngectomy , Pharyngocutaneous fistula
Comparison of External Carotid Ligation and Preope Embolization of Feeding Vessel for Controlling Perop Heamorhage in Angiofibroma Excision
Authors: Aziz, Bakht , Aleem Zahra , Rehman M. Atiq U , Wahab M. Umair , Malik Irshad , Malik Kashif Iqbal , Haider Hasnain , Umar Maryam
Published: July 2022

Background: The prevalence of Angiofibroma of juvenile variety is infrequent tumor of nasopharynx7. It grows aggressively and is locally destructive and extends into the cranium as well. Its symptoms usually involve nasal obstruction with or without nasal bleed. Aims: To compare two methods i.e 1. Carotid artery ligation per operatively and embolization of feeding artery pre operatively in order to assess which method is better in controlling per operative bleeding during its excision. Design: Comparative study Study setting: The study was conducted in the Department of Otorhinolaryngology of Jinnah Hospital, Lahore. The duration of the study is from 01st January 2020 to 31st January 2022. Methodology: A group 20 patients were taken having angiofibroma. 10 patients went for pre operative embolization of the feeding vessel of the angiofibroma after localizing the vessel by having MRA. The other 10 patients had their external carotid artery ligated before excising the angiofibroma. The bleeding which occurred during both procedures was quantified by weighing the gauze pieces soaked per operatively, the blood collected in suction bottle and then comparing the values. Results: Ten patients who had embolization had far more bleeding during excision as compared to the 10 patients who had their external carotid artery ligated per operatively before excision. Conclusion: Results showed that pre operative embolization is not a better procedure to control per op bleeding as compared to external carotid artery ligation during angiofibroma excision. Keywords: Embolization, angiofibroma, per operative ,
Physiotherapy Management in Cardiac Rehabilitation Phase-I
Authors: Tabassum Munaza , Shahid Amna , Zia Wajeeha , Arshad Muhammad Umer
Published: July 2022

Cardiac diseases are the considered one of the prevalent disease in community nowadays. It involves myocardial infarction, coronary artery disease, valvular disease. Patients suffering from these conditions have taken the surgical treatment. Surgical procedures are common among all the patients and coronary graft bypass surgery to reduce the complications and symptoms such as dyspnea, chest pain, and fatigue is frequently used procedure. These procedures leads towards the post-operative complications and recovery depends upon the early ambulation and physical activity. Physiotherapy is need of the time to improve the symptoms and quality if life of these patients. Multiple techniques of physiotherapy are beneficial and necessary in cardiac rehabilitation phase-I. Keywords: Aerobic training, Chest Physiotherapy, Coughing, Cardiac rehabilitation, Phase-I, Mobility, Post Surgical.
CBCT Based Comparison of Pharyngeal Airway Area and Volume in patients with Angle’s Class I and Class II Malocclusion: A Retrospective Study
Authors: Bokhari Fareeha , Yosaf Usman , Qayyum Fatima , Jamil Ayesha , Jameel Mariam
Published: July 2022

Aim: To ascertain if there was any association between dental malocclusion and narrow/constricted pharyngeal airway. Methods: It was a retrospective study and cross-sectional in design. Oropharyngeal airway volume and regional area for 58 patients having either Class I or Class II Angles malocclusion were evaluated on the CBCT scans. Results: Oropharyngeal airway volume and area among Angles class I and Class II patients was found to have no statistical difference. There was however statistical difference in the oropharyngeal regional area of male and female patients (t=2.395, p=0.020) with male patients having greater oropharyngeal regional area than female patients. Conclusion: In summary, this research concludes that Angles Class I or Class II malocclusion does not influence oropharyngeal airway volume or area. Gender had no impact on the size of airway volume but had significant influence on the oropharyngeal regional area with male patients having greater oropharyngeal area than females. Keywords: Oropharyngeal airway, CBCT, Class I Malocclusion, Class II Malocclusion
Frequency of Pelvic Inflammatory Disease in Infertile Patients
Authors: Saleem Raisham , Mir Saadia , Mir Shafia Zaib , Manzoor Ayesha
Published: July 2022

Aim: Frequency of pelvic inflammatory disease in women presenting with infertility Study design: Cross sectional research Setting: Obstetrics/Gynaecology Deptt., Services Hospital, Lahore from 20-10-2017 to 20-04-2018. Methods: One hundred married females with Infertility (Primary/Secondary) were included in the study. Patients with H/o intrauterine contraceptive devices usage, diabetes, male factor Infertility and H/O pelvic surgery were excluded. All women were taken complete history and detailed physical and gynecological examination and HVS was sent to laboratory for culture. Results: Age was from 20 to 35 years with mean ± SD 29.41±2.35 yrs, mean±SD of weight 70.09±12.66kg, mean±SD height 1.54±0.09 meters, mean ± SD of BMI 29.67±5.09 Kg/m2 and mean±SD duration of Infertility was 2.5±0.97 years. Majority of the patients were from 0-2 parity (92%). Primary infertility was found in 64% women while secondary infertility was 36%. Pelvic Inflammatory Disease was found in 27% patients. Conclusion: Tubal damage before and during the index episode of PID is correlated with infertility. Keywords: Infertility, Pelvic inflammatory disease, Frequency
Comparing the Effect of Stretching and Muscle Energy Technique in the Management of Lower Cross Syndrome
Authors: Khan Nouman , Nouman Munazza , Iqbal Muhammad Affan , Anwar Kinza , Sajjad Abdul Ghafoor , Hussain Syed Ali
Published: July 2022

Aim: To compare the effects of stretching exercises & muscle energy techniques in the management of lower cross syndrome. Methods: In this parallel, randomized controlled trail fifty-eight patients were randomly assigned into two intervention groups. Group A received stretching technique and Group B received muscle energy technique, three sessions per week for total duration of four weeks. Results: Normality test applied and P values were noted by applying Shapiro-Wilk test both groups. Baseline measures for both groups showed no significant difference as the P value > 0.05. The paired t-test within the group of Stretching and Muscle Energy Technique showed significant difference in pre and post Numeric Pain Rating Scale (NPRS), pre and post Oswestry Disability Index (ODI) and pre and post muscle length via inclinometer and goniometer. Independent t-test for post treatment groups between stretching group and muscle energy technique group was not significant i.e. P> 0.05. Conclusion: The study concluded that statistically there is no significant difference in variables of both groups i.e. Numeric Pain Rating Scale (NPRS), Oswestry Disability Index (ODI), bilateral muscle length of iliopsoas, hamstrings and rectus femoris as well as of erector spinae. However, mean values of above mentioned parameters show a little more improvement in Muscle Energy Technique group. Keywords: Stretching, Muscle Energy Technique, Lower Cross Syndrome, Muscle imbalance.
Spotlight on the Adolescent’s Mental Health: Distress and Coping amid the COVID-19 Pandemic
Authors: Dars Jawed Akbar , Iqbal Nadeem , Khoso Zubair Ahmed , Ilyas Muhammad , Lal Chooni , Saifullah Nausheen
Published: July 2022

Background: COVID-19 pandemic globally challenged the healthcare sector as well as posed a serious threat to mental health among both young and adults rendering people with a sense of uncertainty and loss. Objective Aim: To assess the psychological burden among the adolescent population during the pandemic and lockdown. Methodology: A cross sectional study was moderated by the research team at the Department of Psychiatry and Behavioral Sciences, Jinnah Postgraduate Medical Center between April 2020 to October 2021. All individuals between the ages of 13 to 17 years were included. The proforma was circulated among residents of the province of Sindh that assessed the emotional symptoms, conduct problems, hyperactivity-inattention, peer relationship problems, and prosocial behaviors among participants. Results: The mean SDQ score was 24.97 with a standard deviation of 6.62. The mean scores for emotional symptoms, conduct problem, hyperactivity, peer problem, and prosocial Scale were 5.47, 6.82, 5.85, 6.82, and 3.02, respectively. A significant relationship was revealed between mental health stability and witnessing a death of a known person due to COVID-19 infection (p=0.003). Furthermore, the study found that Sindhi individuals had significantly higher scores as compared to other ethnic groups (p=0.002). Conclusion: The young population is as equally stressed as adults and may suffer from substantial anxiety during the pandemic. Therefore, parents should be encouraged to create an atmosphere of support and goodwill. Keywords: Adolescent, coping mechanism, covid19, pandemic, psychological distress
To Determine the Effect of Diabetes Mellitus on the Clinical Course and Outcome of COVID-19 at Jinnah Hospital, Lahore,
Authors: Aleem Muhammad , Salman Sadia , Iqbal Javeid , Khalid Muhammad Zaeem , Riaz Amna , Rauf Hafiz Abdul
Published: July 2022

Background: Diabetes is a common disease known to cause morbidity and mortality. Individuals with diabetes are at greater risk of complications from coronavirus and have recently gains attention of researchers and practitioners. Aim: To assess the effect of diabetes mellitus on clinical course and outcome of coronavirus infection. Study design: Prospective cohort study Place and duration of study: Coronavirus Disease High Dependency Unit Jinnah Hospital, Lahore from 01-01-2021 to03-04-2021. Methodology: Three hundred and seventy six patients of either genders and age range of 15-75 years were enrolled. They were divided into diabetic or non-diabetic groups. The various attributes such as demographic data, medical history, COVID-19 exposure history, symptoms and signs, laboratory findings, chest radiograph findings, the treatment measures and complications of diabetes and in hospital outcome were compared for both the groups. Result: Statistically different from each other in terms of oxygen requirement, lymphocyte %, neutrophil to lymphocyte ratio (P=0.026), alanine aminotransferase (P=0.038), C-reactive protein (P=0.048), ferritin (P=0.031), lactic acid dehydrogenase (LDH) (P=0.011), D-dimer (P=0.024), Quick sequential organ failure assessment score (qSOFA score) (P=0.001) and Chest X-ray (P=0.049), blood sugar random (P=0.000), treatment during hospital stay (P=0.000), insulin dose increase (P=0.000), complications during hospital stay (P=0.042) and shifting to the intensive care unit (P=0.002). Conclusion: Diabetic coronavirus patients have poorer prognosis due to higher risk of severe pneumonia and related complications including mortality than their non-diabetic counterparts. Keywords: Diabetes, Coronavirus, Diabetes mellitus, COVID-19, Co-morbidity, Cytokine syndrome, Diabetic ketoacidosis (DKA)
Evaluation of C-Reactive Protein, Albumin and the C-Reactive Protein/ Albumin Ratio in General Surgical Trauma Patients
Authors: Hashmi Ayesha Siddiqua , Rizvi Syed Ali Haider , Amin Asma , Naz Kiran , Kazim Erum , Mahmood Misbah
Published: July 2022

Aim: To determine the frequency of in hospital mortality and to compare this frequency of mortality with CRP/Albumin ration in patients with surgical abdomen and/or chest trauma. Study Design: Cross-sectional study Place and Duration of Study: Surgical Unit IV, Civil Hospital Karachi from 26th June 2019 to 25th December 2019. Methodology: One hundred and thirty one patients with abdominal and/or chest surgical trauma were enrolled within 24 hours of trauma. Serum CRP level and serum albumin level were done through hospital hematology laboratory and CRP/albumin ration was calculated and relation with in hospital mortality was found. Results: The mean age of patients was 34.24±15.5 years with 74 male and 57 females. Mean height was 167.5±13.9 cm, mean weight was 62.6±8.6 kg and mean BMI was22.4±5.3kg/m2. Mean CRP was 14.3±9.6 mg/dl, mean albumin was 3.76±0.98 g/dl and mean CRP/Albumin ratio was 3.74±2.3.In CRP/Albumin cluster there were 32.1% patients in 0.01-2 cluster, 43.5% in 2.01-4 cluster and 32.1% in 4.01-9 cluster. 12.2% patients were expired among them there were 7.1% expiry rate in 0.01-2 cluster, 10.6% in 2.01-4 cluster and 19% patients expired in 4.01-9. Increased CRP/Albumin cluster was associated with increased mortality rate. Conclusion: An elevated CRP/Albumin ratio in traumatized patient was associated with an increased risk of mortality. Keywords: Surgical trauma, Prognostic marker, CRP/albumin ratio
Soft Drinks Intake is Associated with Obesity and Urine Disorders in Medical Students
Authors: Mughal Irfan Afzal , Parveen Shahida , Faruqi Amna , Azam Muhammad Saqlain , Shahbaz Janjua Muhammad Riaz , Irfan Asma
Published: July 2022

Aim: To determine the ramifications of soft drinks on Body Mass Index and effects on various renal parameters. Study design: Cross-sectional study Place and duration of study: HBS Medical and Dental College from 1st January 2020 to 31st December 2021. Methodology: One hundred and ten students from first year to final year MBBS were recruited from Medical Colleges of Islamabad. We assessed caffeinated sugar beverage consumption (Sprite, Mountain Dew, Coke, Pepsi & 7-Up). Inclusion criteria consisted of users (n=48) who took caffeinated soft drinks at least 5-7 glasses/week. Those who took less than this drink was labelled non-users (n=62). Questionnaire we used was self-administered about sociodemographic data, height, weight, soft drinks consumption frequency, and a record of urine R/E Combi 10 strip test. Results: There were 41(37.3%) males and 69(62.7%) females. The percentage of underweight, normal, overweight and obese students was 31.8%, 36.4%, 22.7% and 9.1% respectively. Out of total females (62.7%), the group overweight (30.4%) and obese (10.1%) was highly significant. (p=0.008). The user students n=48(43.6%) took caffeinated drinks more than 5-7 glasses/week and were found to be significantly obese p=0.17 as compared to non-users n=62(56.4%).Soft drink consumption was significantly associated with proteins appearance in urine (p=0.00) and leucocytes (p=0.17) and the mean PH of urine of soda users was highly significantly acidic (p=0.00) by using combi-10 test strips. Conclusion: Very high sugar contents and other ingredients in soft drinks can be associated with obesity, metabolic and kidney disturbances in young students which in chronic cases exacerbate the condition. Keywords: Obesity, Urine disorder, Caffeinated drinks
Hypoalbuminemia in COVID-19 Patients: A Predictor of Disease Severity and Guarded Outcome
Authors: Gull Nayab , Arif Bushra , Bibi Tahira , Mahmood Fahad Ullah , Ahmed Muneeba , Anwaar Iqra , Murtaza M. Husnaian , Raza Sitara
Published: July 2022

Background: Pandemic of COVID-19 is spreading in all continents. There have been lots of article published on different aspects of this infection. Finding low Albumin levels in the patients of COVID-19 disease regardless of their degree of severity of infection has surprised us from the beginning. Aim: To review the hypoalbuminemia and its extent in local population presented with COVID-19 and to determine the relationship of degree of hypoalbuminemia with the severity of infection. Place and duration of study: Bahria International Hospital Lahore and Services Institute of Medical Sciences, Lahore from 1st May 2021 to 30th September 2021. Methodology: Medical records 400 COVID-19 patient’s related symptoms such as cough, flu, fever, headache, tiredness, distress in breathing were included. Serum Albumin, AST and ALT as clinical bioindicators in COVID-19 patients were reviewed. Results: A significant decrease in serum albumin levels with the means and standard deviation (2.692±0.302), (χ²=344.69, df=16, p<0.001) was recorded. Whereas, a significant increase AST (U/L) and ALT (U/L) with the means and standard deviations (45.130±31.138), (χ²=214.30, df=72, p<0.001) was also noted. Analysis between survivors and non-survivors shows the level of albumin and AST/ALT was inversely proportional. Conclusion: Low albumin is associated with disease severity and poor outcomes in terms of prolonged admissions and worse respiratory failure due to alveolar endothelial damage in COVID-19. Keywords: COVID-19, Albumin, Transaminases, ALT, AST, Alveolar endothelial damage
Role of Computed Tomography Scan Chest for Management of COVID-19
Authors: Jamal Zeeshan , Bozdar Naimatullah , Sohu Din Muhammad , ullah Inayat , Phul Akhtar Hussain , Hafeez Rabia
Published: July 2022

Aim: To assess the role of chest computed tomography for management of Covid-19. Study design: Prospective study Place and duration of study: Department of Radiology, Peoples University of Medical & Health Sciences for Women, Nawabshah, Shaheed Benazirabad from 1st August 2020 to 30th September 2021. Methodology: Two hundred patients were enrolled within the age range of 18-70 years. The clinical/medical record of all those patients who were moderately to critically ill assessed in detail. These patients visited the hospital with symptoms of cough, fever, hypoxia, dyspnea, diarrhoea, flu, headache and other related symptoms. All patients underwent chest reverse transcription polymerase chain reaction as well as chest computed tomography scan. The reverse transcription polymerase chain reaction was performed through nasopharyngeal swab. Results: The mean age of the patients was 64.5±5.6 years with 120 (60%) males and 80 (40%) females. The specificity was 75%, sensitivity 100%, positive predictive value 79%, negative predictive value 66.67% and diagnostic accuracy 75%. Conclusion: Computed tomography scan imaging is a most reliable with high sensitivity and non-predictive value Key words: Role, Computed tomography imaging, Management, Covid-19
Frequency of Nasopharyngeal Carcinoma in Patients Presenting with Neck Masses
Authors: Shinwari Wajih-Ud-Din , Mustafa Sadaf Raffat , Arif Nighat , Ali Amjad , Mushahid Uzair , Khan Azmatullah
Published: July 2022

Background: Patients come in the head and neck clinic most of the time with no obvious symptoms and most of the time with no visible lesion in the head and neck area. The nasopharynx is the area that is hidden from examination as it lies very deep in the skull base. It has a very high blood supply and a very metastatic rate. Study design: Prospective study Place and duration of study: Department of ENT, Pakistan Institute of Medical Sciences, Islamabad from 1st March 2021 to 28th February 2022. Methodology: Eighty six patients with FNAC proven neck masses showing squamous cell carcinoma were included. Pan endoscopy was done in all the patients after thorough clinical examination and CT scan. The patients with visible lesion were biopsied from the lesion site and the patients that had no visible lesion were biopsied from three sites i.e. nasopharynx, oropharynx and hypopharynx. The biopsies were sent to the PIMS histopathology laboratory. Results: There were 52 males and 34 females. The nasopharynx was the common site in the patients with visible lesion in 18 patients. In patients with non-obvious lesions again nasopharynx was the most frequent site in 9 out of 28. Conclusion: The nasopharynx is a very common site for carcinoma and has a very high metastatic rate, so every patient coming to head and neck should be thoroughly examined in the clinic in reference to nasopharynx and any suspicious are should be biopsied. Keywords: Frequency, Nasopharyngal carcinoma, Neck mass
Comparison of Outcome between Drain and No Drain after Elective Laparoscopic Cholecystectomy
Authors: Shams Asif , Falah Sheikh Qais , Alam Aftab , Bashir Iram
Published: July 2022

Background: Laparoscopic cholecystectomy (LC) has been established as the gold standard treatment for gallstone disease. However, there is a debate regarding the post-operative placement of a drain in LC. Aim: To compare the outcome of patients undergoing placement of drain versus patients without a drain following elective LC. Methodology: A quasi-experimental study was conducted at Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan from September 2017 till August 2019. A total of 136 patients of cholelithiasis were randomly allocated to two groups: A (drain placed) and B (no drain placed). Clinical variables such as age, gender, BMI, duration of surgery, duration of hospital stay, vomiting, abdominal fluid collection and wound infection were recorded for all patients in two groups. Results: The mean age of the patients was 38.6±0.2 years. The mean time of surgery in group A was 44.2±10.3 minutes compared to 45.4±10.3 minutes in group B. The mean time of hospital stay in patients of group A was 2.3±1.0 days compared to 2.3±0.9 days in group B. After surgery, 16(23.5%) patients in group A experienced vomiting compared to 22(32.4%) in group B. Seven (10.3%) patients in group A had abdominal fluid collection compared to 12(17.6%) in group B. Moreover, eight (11.8%) patients in group A developed wound infection compared to 11(16.2%) in group B. Conclusion: There is no need to place a subhepatic drain routinely after laparoscopic cholecystectomy in uncomplicated cases. Keywords: Laparoscopic cholecystectomy; cholelithiasis; wound infection; vomiting; fluid collection; drain.
Comparative Effects of Daily Adjustable Progressive Resistance Exercises Technique & Close Kinetic Chain Exercises on Extensor Lag in Post-Operative Knee Stiffness
Authors: Tanveer Shanza , Noor Rabiya , Afzal Hamna , Batool Misdaaq , Iqbal Kiran , Sabir Sarah , Latif Waqas
Published: July 2022

Background: Post-operative knee stiffness is caused by arthrofibrosis and functional limitation. Extensor lag is commonly prevalent after knee surgery. There are different approaches to treat this condition. Close kinetic chain exercises are hypothesized as one of effective treatment. DAPRE technique has remarked effects. Aim: To determine effects of DAPRE technique and close kinetic chain exercises on pain intensity, ROM, function, strength among post-operative knee stiffness. Study Design: Randomized control trial. Methodology: Total of 22 patients with post-operative knee stiffness were recruited and divided in two groups. One group received DAPRE technique and other group received close kinetic chain exercises were participated by using a Non-probability convenience sampling technique. Results: The result showed statistically significant difference in both groups in terms of NPRS, WOMAC index, ROM and strength with P-value less than 0.05. Conclusion: It was concluded that Close kinetic chain exercises was more effective than the Daily adjustable progressive resistance exercises on extensor lag for post-operative knee joint stiffness to improving the pain, physical function, range of motion and strength. Keywords: Knee Stiffness, Extensor Lag, Kinetic Chain Exercise, DAPRE and Resistance Exercises.
Correlation between Oxygen Saturation of patient and Severity Index of Covid 19 Pneumonia on CT
Authors: Mushtaq Samreen , Sattar Abdul , Anjum Sadia
Published: July 2022

Aim: To investigate the correlation between capillary blood oxygen saturation and Computerized tomography (CT) severity index in patients with Covid-19 pneumonia. Study design: A cross sectional study design Setting & duration: Ibne-sina hospital Multan Medical & Dental College Multan, from 1st June 2020 to 1st June 2021 Methods: A cross-sectional analytical study was conducted at the COVID-19 ward of Ibne-sina hospital Multan Medical & Dental College Multan for 1 year. At the time of admission, all capillary oxygen saturation of all the included patients was measured. Pulmonary CT scans were then performed on these patients and CT severity index was calculated. SPSS was used for data analysis. Results: A total of 170 Covid-19 infected patients were included in the study. At the time of admission, the mean oxygen saturation was found to be 88.9%±6.53%. Whereas, the mean severity index was15.01±7.79. 22 patients had hypoxia when presented in hospital and a significantly high iCT severity index was found in these patients (p=0.001). Chronic obstructive pulmonary disease (COPD), hypertension, and diabetes were significantly related to reduced blood oxygen saturation (p<0.05). A significant inverse correlation was found between capillary oxygen saturation and CT severity index (r= −0.41, p< 0.01). Conclusions: The study revealed a significant inverse correlation between capillary oxygen saturation and CT severity index. Moreover, it was found that underlying commodities (i.e., past medical history) can also affect the CT severity index. Keywords: Covid-19, hypoxia, capillary oxygen saturation, Chest CT, CT severity index.