bluuebunny/crossref_metadata_2025 huggingface dataset:
ACUTE STEMI
Authors: Sachdewani Raj Kumar , Dingra Lal Chand , Memon Aijaz Hussain
Published: August 2021

Objectives: To find a relationship between acute ST elevation myocardialinfarction (STEMI) and two major risk factors i.e. diabetes type 2 and hypertension in adultpatients admitted in cardiology department of Ghulam Muhammad Mahar Medical CollegeSukkur. Study Design: Cross-sectional study. Study Setting: Department of Cardiology,Ghulam Muhammad Mahar Medical College Sukkur. Period: October 2016 to March 2017. 6months. Material and Methods: Total of 764 patients aged 18-80 years were included in thestudy population on bases of history of chest discomfort and sudden ST elevation MI (STEMI).Those patients with unstable angina and those cases which presented with Q waves wereexcluded from study population. Blood pressure and blood sample were taken and analyzedin the institution laboratory. Results: Off 764 anterior wall Myocardial infarction (includingextensive) was seen in 367(48%) while inferior wall Myocardial infarction (including RV andposterior) was recorded in 397(52%) of the study population. 118 (15.44%) were hypertensiveand also had diabetes off which 8.11% were female and chi square test reveals a relationshipbetween sex and diabetes and hypertension in the study population. Conclusion: A relationshipof hypertension and diabetes with STEMI is there. Primary prevention and proper screenprogram needs to be in place to identify the submerge part of the iceberg.
COAGULASE NEGATIVE STAPHYLOCOCCUS SPECIES
Authors: Syed Eiman , Satti Faiza Nawaz , Mubasher Sumaira , Rasheed Farhan , Ilyas Muhammad , Anwar Ambereen Imran , Zaman Waheed uz
Published: August 2021

Objective: Department and sample wise distribution along with drug-resistantpattern and best therapeutic choice of drugs against Coagulase-negative Staphylococcusspecies (CoNS). Study Design: Cross-sectional study. Setting: Department of MicrobiologyAIMC Lahore Pakistan. Period: 1st January 2016 to 25th May 2017. Methodology: About4597 samples were collected from various departments and processed for antimicrobialresistant testing. Results: Of 4597 samples, culture positive were 40.4% CoNS were 9.0%and 22.3% of total and total culture positive specimens respectively The highest rate isolationrate of CONS was found in ICU 32.4%, Sample-wise 34.1% in blood samples.0% resistantto Linezolid, Teicoplanin, and Vancomycin, while very high resistant rate against penicillin77.8%, Cotrimoxazole 60%, Methicillin 59.8%,Co-amoxiclav 54%,Clindamycin 48.7%,FusidicAcid 463%, Doxycycline 45.1%, Erythromycin 44.9%, Amikacin 42%, Ciprofloxacin 41.8% andGentamycin 23%. Conclusion: Linezolid, Vancomycin, and Teicoplanin are the best choice ofdrugs while emergence of drug-resistant to other basic drugs is alarming
ACUTE CORONARY SYNDROME
Authors: Majid Abdul , Babar Muhammad Zafar Majeed , Shahzad Kashif
Published: August 2021

Introduction: Chest pain is one of the most common presentations to theemergency and cardiology clinics and most serious of these is acute coronary syndrome (ACS)is a life threatening acute emergency.1 There are a number of complications, which can causedeath immediately in patients of ACS which include arrhythmias, cardiogenic shock, progressiveheart failure, mechanical cardiac complications and repeat MI.2-3 Objectives: To determine thefrequency of different arrhythmias in patients with acute coronary artery syndrome in the first24 hours of hospitalization. Study Design: Cross sectional study. Period: 1st July 2016 to 31stJanuary 2017. Setting: Department of Cardiology, Sheikh Zayed Medical College/Hospital,Rahim Yar Khan. Methodology: 379 consecutive cases of ACS of either gender, with age rangeof 30 to 60 years were included. Socio-demographic data and other clinical data was taken.These patients were then attached with ECG monitors in department of cardiology, and ECGwas recorded for 24 hours and then the type of arrhythmias if detected (PVCs / AF / VF / nonsustained VT / sustained VT / first degree heart block/ second degree heart block/ third degree)and duration of develop arrhythmias was noted according to operational definitions. Results: Inthis study there were total 379 cases out of which 193 (50.92%) were males and 186 (49.08%)females with mean age of 48.80±4.51 years. Arrhythmias were detected in 175 (46.17%) cases.The most common arrhythmia was PVCs seen in 44 (11.61%) out of 379 cases. Arrhythmiasaffected more to age groups 30-45 years affecting 66 (58.9%) cases with p= 0.002 and thosewith BMI more than 30 (p= 0.01). The cases with DM and NSTEMI had it more with p= 0.02and 0.01 respectively. On stratification of different types of arrhythmia, the male gender wassignificantly associated with sustained VT and female with second degree HEART BLOCK. Theage group of 46-60 years was significantly associated with AF and sustained VT. Regardingdifferent type of ACS, NSTEMI as compared to STEMI was found significantly associatedwith VF, non-sustained VT, sustained VT and third degree heart block with p= 0.0001, 0.02,0.01 and 0.001. Conclusion: Acute coronary syndrome with arrhythmia is a well-encounteredcomplication presenting to the chest pain and coronary care units. Age group 30-45, higherBMI, and DM have significant association with different types of arrhythmias seen in patientsadmitted with ACS and PVC is the most common arrhythmia seen in ACS.
ACUTE ST ELEVATION MYOCARDIAL INFARCTION
Authors: Ahmad Munir , Yasir Muhammad , Rahmat Asif
Published: August 2021

Objective: To determine the frequency of in-hospital outcomes in patients ofacute ST elevation myocardial infarction (STEMI) within five days of hospitalization with .70ST segment resolution 90 minutes post thrombolysis. Study Design: Case series. Place andDuration of Study: Department of Cardiology, Faisalabad Institute of Cardiology, Faisalabad,from April, 2016 to October, 2016. Methodology: In 370 patients fulfilling the inclusion andexclusion criteria a baseline 12 lead electrocardiogram was recorded before initiation ofthrombolysis and at 90 minutes thereafter. Conventional contraindications to thrombolysis wereobserved and streptokinase 1.5 mu was administered by intravenous infusion over 60 minutes.Successful thrombolysis was taken as 70% or more ST elevation resolution at 90 minutes frombaseline electrocardiogram measured 80ms from J-point. Patients with successful thrombolysiswere observed for in-hospital clinical outcomes of recurrent angina, congestive cardiac failure,ventricular arrhythmia and death within five days of hospitalization. Results: Out of 370 cases,51.35 %( n=190) were male while 48.65 %( n=180) were female, 25.14 %( n=93) were between30-50 years of age while 74.86 %( n=277) were between 51-65 years of age, the mean agewas 54.98+5.96 years. Frequency of in-hospital outcome was recorded as 10.67 %( n=38) forcongestive cardiac failure, 14.59 %( n=54) for ventricular arrhythmia, 5.40 %( n=20) for mortalitywhile no case had recurrent angina. Conclusion: In-hospital outcome is better in patients of.70% ST resolution at 90 minutes post thrombolysis .This might assist in identification of lowrisk patients who can be discharged early and should not be considered for early invasivestrategy.
SURGICAL INCISION;
Authors: Asghar Mohammad Touseef , Khan Rizwan Ahmad , Ishaque Sadaf , Imtiaz Danish , Basit Salman Abdul
Published: August 2021

Objectives: To compare the outcome variables among patients undergoinglaparoscopic cholecystectomy using horizontal and vertical incisions for epigastric port incision.Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery,Shalamar Hospital, Lahore from July 2016 to December 2016. Methodology: A total of 100patients undergoing laparoscopic cholecystectomy were selected and equally divided intotwo groups. Epigastric port insertion was done using horizontal incision (group A) and verticalincision (group B). Electrocautery use, incision extension, use of secondary intervention forbleeding control, blood loss and patient satisfaction regarding scar were noted in both groupsand compared. Results: In this study, we found that 15 out of 50 required electrocautery ingroup A while only 4 patients required in group B. Incision extension was needed in 8% ofpatients in group A while only 2% patients needed it in group B. Blood loss was 4.62 ± 2.64ml in group A while in group B, it was 1.70 ±0.81 ml. Also 80 % patients were satisfied withhorizontal scar while 76 % patients in vertical group. Conclusion: Vertical incision for epigastricport insertion is better than horizontal incision in terms of blood loss, bleeding control whencompared in laparoscopic cholecystectomy.
MARJOLIN’S ULCER AND BURN SCARS
Authors: Ali Hyder , Afzal Yusra , Ahmed Syfyan , Pervaiz Mujtuba , Rao Masood Hussain , Ali Syed Muhammad
Published: August 2021

Background: Marjolin’s ulcer (MU) represents malignant degeneration thattypically ensues over a period of time in the post-burned lesions and scars or any other chronicwound. The worldwide incidence of MUs in such lesions is reported to be 0.77%-2%. Objectives:To determine the frequency of malignancy in post burn scars. Study Design: Descriptive, crosssectional. Place & Setting: Department of Plastic & Reconstructive Surgery, Dow Universityof Health Sciences & Dr Ruth KM Pfau Civil Hospital Karachi. Duration: December 2014 toNovember 2017. Materials & Methods: A selection criterion was defined and via non probabilityconsecutive sampling. Sample Size: 80 patients. Results: The mean age of the patients was48.6 ± 9.2years with range (30 to 60 years). The mean duration of scars was found in ourstudy to be 20.4+5.1 years. Out of 80 patients, 33 (41%) were male and 47 (59%) were female.Malignancy was recorded in 66(82.5%) patients with post burn scar. The most common typeof malignancy was squamous cell carcinoma in 27 patients (33%). Conclusion: A high indexof suspicion is required when dealing with chronic non-healing ulcers. In our environmentearly recognition and aggressive treatment of Marjolin’s ulcers and close follow-up are vital forprevention and also to improve outcome.
CLIPPED OR CLIPLESS CHOLECYSTECTOMY
Authors: Akhtar H. Sabiha , Farooq Zia , Rathore Hassan , Farooq Muhammad Umar , Ahmad Arooj
Published: August 2021

Background: Cholecystectomy is the surgical removal of the inflamedgallbladder. Advancement in technology has led to many treatment options and methods ofcholecystectomy but the selection of right method depends upon severity of disease alongwith available resources and expertise. Objective: To compare the frequency of biliary leakagewith clipless versus clipped laparoscopic cholecystectomy for management of cholecystitis.Material & Methods: Study design: Randomized control trial. Setting: Unit 1, Departmentof Surgery, Jinnah hospital, Lahore. Duration: It was conducted for a period of six monthsfrom July 2016 to January 2017. Data collection: A total of 130 patients were included in thestudy using nonprobability consecutive sampling and were randomly divided in two groups byusing lottery method. In group A, clip-less Harmonic scalpel was used along with Ultrasonicshear. In group B, the conventional instruments were used with the application of clips. Patientswere called for follow-up in OPD after 1 week to assess biliary leakage through MRCP. All thedata was collected through a pre-designed proforma. The data was entered and analyzed inSPSS version 20. Results: The mean age of patients was 42.97±10.77 years with 68 (52.31%)patients were male and 62 (47.69%) patients were females. The biliary leakage was noted in29 cases i.e. 9 from clipless group and 20 were from clipped group and the difference wasstatistically significant (p-value=0.020) Conclusion: It can be concluded from this study thatthe frequency of biliary leakage is significantly higher in the clipped LC for management ofCholecystitis. Thus it is encouraging to use clipless method to avoid such complication andimprove surgical outcomes.
HAEMATOLOGICAL DISORDERS
Authors: Khan Muhammad Ihtesham , Ahmad Neelam , Fatima Syeda Hina
Published: August 2021

Objectives: To analyse the pattern of hematological disorders through bonemarrow aspiration, and to compare the final diagnoses with their referral diagnoses made by thereferring physicians.Study Design: Cross sectional descriptive study. Period: 1st January -2016to 30th December-2016. Setting: Department of Pathology, Khyber Teaching Hospital, Peshawar.Materials and Methods: 352 patients were included in the study. Bone marrow diagnosiswas recorded. Data was analysed by SPSS version 18 and results were drawn accordingly.Results: A total of 352 patients underwent bone marrow aspiration during the study period.About 15 patients had diluted bone marrow aspirates. So, they were excluded from the study.The remaining 337 patients were included in the study. The age of the study sample rangedfrom 9 months to 72 years (mean age 36 years ±17.8 SD). There were 185 (55%) male and151 (45%) females. Male to female ratio was 1.2:1. The commonest indication for bone marrowaspiration was “suspected malignancy”, which was suspected in 114(33.85) patients, followedby “pancytopenia”, which was seen in 69(20.55%) patients. About 69 (20.5%) patients werereferred for work up of anemia. Bicytopenia was seen in 69(20.5%). The bone marrow aspirationshowed that megaloblastic anemia was the commonest disorder observed in 37(10%) cases.Second common disorder was acute lymphoblastic leukemia, that was seen in 31 (9%) patients,followed by acute myeloid leukemia, which was seen in 26(7.7%) cases. Hemolytic anemia wasseen in 20 (15.9%) cases. Aplastic anemia was seen in 18 (5.3%) cases. Multiple myeloma andmononuclear infiltration was seen in 17 (5%) patients each. Anemia of chronic disorder wasseen in 16(4.7%) cases. Idiopathic Thrombocytopenic Purpura was seen in 12 (3.6%) patients.Iron deficiencyanemia was seen in 11 (3.3%) patients. Chronic Lymphocytic Leukemia wasseen in 10 (2.9), Mixed deficiency anemia in 9 (2.7%), Myelodysplasia in 6 (1.7%), Malaria in5(1.5%), and Niemann Pick in 4 (1.2%) patients. Gaucher disease and Visceral Leishmania wasseen in 2 (0.6%) patients each. Histiocyticlymphohistiocytosis and Chediak Hegashi syndromewas seen in 1 (0.3%) patients each. Conclusions: Megaloblastic anemia, Acute LymphoblasticLeukemia, Acute Myeloid Leukemia, Hemolytic Anemia and Aplastic Anemia are the commonhematological disorders in our set up. Bone marrow is a reliable procedure to diagnosishematological diseases when routine investigations fail to make diagnosis.
HYPERBILIRUBINEMIA
Authors: Hayat Mohsin , Irshad Mohammad , Taj Wajeha , Ullah Ihsan , Mohammad Amir , Khatak Afzal Khan
Published: August 2021

Background: Neonatal jaundice is a common condition in the early days ofinfant’s life. It clinically manifests in a significant number of full term babies and almost allpremature neonates. Increase in the serum bilirubin during early infancy is multi factorial andmay result in kernicterus. Deposition of unconjugated bilirubin in the brain stem nuclei andbasal ganglion results in permanent brain damage. Objective: To determine the frequencyof common hemolytic causes of hyperbilirubinemia in full term neonates requiring exchangetransfusion. Study Design: Cross-sectional study. Setting: Department of Pediatrics, LadyReading Hospital Peshawar. Period: January to June 2015. Methodology: A total of 449 fullterm neonates requiring exchange transfusion were included in this study on the basis of serumbilirubin level (total, direct, indirect). Hemolytic causes were analyzed by checking blood groups,rhesus factors and measuring glucose 6 phosphate dehydrogenase (G6PD) levels. Results: Inthis study mean age was 10 days with standard deviation ± 1.26. Sixty two percent neonateswere male and 38% were female. Hemolytic causes were analyzed and ABO incompatibilitywas found in 25% neonates, rhesus incompatibility in 15% neonates and G6PD deficiency in32% neonates. Conclusion: In this study, the most common cause of severe jaundice requiringexchange transfusion was G6PD deficiency (33%) with hemolysis.
DERMATITIS
Authors: Maryum Humaira , Ahmed Sadaf , Talat Humaira , Khan Raja Samir , Gitay Mehnaz , Hameed Asim
Published: August 2021

Objectives: To assess the frequency of acute and chronic radio dermatitis inpatients treated for various malignancies, via ionizing radiation. Study Design: Cross-sectionalstudy. Setting: This multi-center, Outpatient Department of Dermatology Al-Tibri Medical College& Hospital Isra University Karachi campus, Departments of Dermatology and Oncology DowUniversity Hospital and Civil Hospital Karachi. Period: June 2015 till December 2016. Methods:Patients belonging to both genders and all age groups, fulfilling the inclusion criteria wereincluded in the study. Selected patients underwent a detailed history and physical examination.Clinical diagnosis of radiation-induced dermatitis was made and relevant investigations wereperformed where needed. All findings were recorded, tabulated and analyzed. Results: Thesample consisted of a 150 patients (35.3% male and 64.6% female). Minimum age was 11years and maximum age was 82 years. Mean age was 46.4 with a SD of 14.5. All patients hadreceived external beam radiation. Radiodermatitis was identified in 65 patients out of whichacute radiodermatitis was encountered in 32.66% (of which 63.26% were male and 36.73%were female) while chronic radiodermatitis was found in 10.66% (of which 18.75% were maleand 81.25% were female). Pigmentation, epilation and erythema were the most commonmanifestations while fibrosis and necrosis were least encountered manifestations. Conclusion:A number of patients develop acute or chronic radiodermatitis with or without associated variablecutaneous manifestations. Theseside effects of ionizing radiation significantly affect patient’squality of life, also disturbs the treatment schedule. In the present study acute radiodermatitiswas found to be more prevalent than chronic radiodermatitis. However, further research isnecessary in order to effectively prevent, manage and reduce such complications.
COPD
Authors: Baloch Saba Ajaz , Zafar Farya , Ali Huma , Sial Ali Akbar , Kumar Ashok , Waseim Ambreen , Bushra Rabia , Nisa Zebun , Khan Maqsood Ahmad , Alam Shazia
Published: August 2021

Introduction: Chronic obstructive pulmonary disease (COPD) is considered asa major public health concern to the medical community. COPD is associated with episodicexacerbations which are evident as enhanced dyspnea, worsening of lung function, coughand production of sputum. Objectives: To assess 126 COPD exacerbated patients in a tertiarycare hospital of Karachi, Pakistan. Study Design: Descriptive study. Setting: Various wardsof tertiary care Ziauddin Hospitals. Period: November 2016 to April 2017. Methods: Patientswere classified into Type I, II and III exacerbation. Consent was taken from patients’ caregivers,while hospital permission was also obtained. At the time of study all the patients were receivingappropriate therapy and patients were clinically in stable condition. Data collection wasperformed by thorough reviewing and recording the data from patients’ medical records. Also,the questionnaire was filled by the principal investigator to collect three evaluation parametersincluding MMRC Dyspnea Scale Score, Bode Index and Dose Index Scoring System. Datawas expressed in terms of percentages.Direct medical costs were also determined in Rupees(Rs.) of these patients. Results: Results indicated that most of the male patients were foundto have exacerbation. It was found that patients having smoking habits were found to havehigher frequency of COPD exacerbation (Type I, 11 (8.730 %); Type II, 36 (28.571 %); TypeIII, 40 (31.746 %)) as compared to non smokers. Major complaints which were found in 126patients were shortness of breath, fever, cough and increased sputum. It was found that mostcommon comorbid diseases found in 126 patients were hypertension, diabetes mellitus andtuberculosis. In this study, the direct cost analysis of 126 COPD exacerbated patients were alsocarried out. Conclusion: Present study indicated multiple indicators for repeated exacerbationsin COPD. Which in terns increase the treatment costs for the patients.
BLOOD DONATION
Authors: Hassan Uzma , Azam Naila , Rahim Sheikh Kashif
Published: August 2021

Objectives: To assess the perception of people about blood donation, todetermine the willingness of people to donate blood voluntarily to blood banks and to identifythe frequency of people who have ever donated blood. Study Design: Cross sectional study.Setting: Rawal General and Dental hospital, Islamabad. Period: Three months from March 2015to May 2015. Methods: 119 people (patient’s attendants) visiting the hospital were included byusing the non-Probability convenience method of sampling. A semi structured questionnairewas filled by interview method by the researcher. The variables were the questions asked abouttheir age, gender, education, occupation, willingness to donate blood and perception aboutblood donation in terms of social obligation and effects on health. The variables of Perceptionand willingness was compared in relation to age, gender, education and occupation of therespondents and then were tested for statistical significance using Chi Square (χ2) test ofindependence. Statistical analysis was done using SPSS 21 version. Results: Regarding blooddonation (70 %) of the respondents were willing to donate blood voluntarily to the blood banks.The percentage of people who had ever donated blood in their life was (36.1%). Regardingperception of blood majority (82.35 %) perceived it as a beneficial thing for health and (91.6%)considered it as a social obligation. (81.5 %) people said that there are no bad effects of blooddonation. More young and male respondents were willing for blood donation. Conclusion: Inthis study, willingness to donate blood was found in majority of people and the intention was ofhelping others and as a social obligation. But few of them had practically donated blood dueto fear of anemia and weakness. Most of the people perceived it as a social obligation and abeneficial thing for health.
DIABETES MELLITUS
Authors: Daidano Jeando Khan , Yusfani Nazia Azam , Daidano Bilqees
Published: August 2021

Objectives: To determine the association of diabetes mellitus in chronic hepatitisC patients. Study Design: Descriptive Cross sectional study. Period: June 2016 to October2017. Setting: Department of Medicine PMCH Nawabshah. Material and Methods: Total 107patients were selected for this study. Informed consent was taken from all the patients, studywas done using questionnaire. Statistical analysis was done by SPSS 15 version. Results:107 patients were enrolled for this study 56 were males 51 were females. Age ranged 48 to 74years, mean age was 52.65+_6.5. Patients selected after blood glucose level anti HCV positiveand PCR positive. Diabetic Foot was present in 33 patients, renal failure noted in 2 patients.Conclusion: HCV infection is major problem in our country, incidence of diabetes in chronichepatitis C patients increases the mortality. We can treat patients early with anti viral drugsfor HCV infection and antidiabetic drugs for Diabetes Mellitus, with counseling morbidity andmortality can be reduced.
CHRONIC KIDNEY DISEASE
Authors: Fatima Tanveer , Afzal Aurangzeb , Ashraf Sania
Published: August 2021

Introduction: Hemodialysis is a process of removal of waste products andtoxic substances from the body using an extracorporeal system. During the procedure, lotsof hemodynamic and metabolic changes occur in the body as a result of which patientsundergoing hemodialysis may suffer from complications both acutely during or just after dialysisas well as in long term. Objective: To determine the frequencies of various acute intradialyticcomplications in our hemodialysis patients. Study Design: Cross sectional survey. Setting:Lahore General Hospital, Lahore. Period: 3 months from May 2017 to July 2017. Method:End stage renal disease patients on regular hemodialysis in the dialysis unit of a tertiary carehospital. A total of 81 patients were included in the study. Patients with acute renal failure andacute on chronic renal failure were excluded from the survey. Results: Common complicationsobserved in our studied population included muscle cramps (70.7%), post dialysis fatigue(57.3%), back ache (56.1%), intradialytic shivering (57.3%), hypoglycemia (21.4%), hypotension(37.8%), hypertension (8.5%), headache (13.4%), vomiting (13.4%) and anaphylaxis in 2.4%.Conclusion: Hemodialysis is a complex procedure and can cause many complications mostof which are not life threatening. With proper monitoring and immediate treatment thesecomplications can be overcome without causing interruption in hemodialysis.
DEPRESSION IN ACNE VULGARIS
Authors: Luqman Naima , Maqsood Niaz , Rehman Wajih-Ur-
Published: August 2021

INTRODUCTION: Acne vulgaris is a chronic inflammatory disorder of pilo-sebaceous glands,which most commonly affect face and trunk. It is most prevalent in adolescent age group. Ithas been seen that acne can have profound social and psychological effects which are notnecessarily related to its clinical severity. Objectives: To determine the frequency and severity ofdepression among acne patients attending the outpatient dermatology department, of a tertiarycare hospital. Study Design: Descriptive study. Place & Duration of Study: Department ofDermatology, Bahawal Victoria Hospital, Bahawalpur from September, 2013 to November, 2013.Subjects & Methods: Informed written consent was taken from patients for the study, seventypatients of acne, diagnosed by consultant dermatologist were inducted. The severity of acnewas determined by Global Acne Grading System. Both genders were included, the age rangewas from 16 to 40 years. Those patients with concomitant dermatological, psychiatric diseasesand those receiving systemic isotretinoin were excluded. The patients fulfilling inclusioncriteria were assessed for depressive symptoms and Hamilton Depression rating scale wasadministered for severity of depression. Results: 70 patients were included in the study, amongthem 14 (20%) were male and 56 (80%) were females. Most of the acne patients were of the age16-20 years [24 (34.3%)]. Mild depression was seen in 26% patients (18%-were females and8%-males). Severe depression was present in 14% of patients, among which 11% were females& 3% were males. Very severe depression was noted in 18% patients among which 16% werefemale and 2% were males. Conclusions: it can be concluded that Dermatologists should paydue attention to the psychological/ mental state of the patient while clinically evaluating andtreating patients suffering from acne vulgaris
VIRAL MARKERS
Authors: Alam Mohammad
Published: August 2021

Objectives: To know the prevalence and predisposing risk factors of HBVand HCV in patients undergoing ocular surgery. Study Design: Descriptive study. Setting:Department of Ophthalmology Khyber Medical University Institute of Medical Sciences / K.D.ATeaching Hospital Kohat. Period: January 2015 to December 2016. Materials and Methods: Alladmitted patients in eye ward for surgery. Informed consent was taken from patients. Detailedhistory including surgical, medical treatment, blood transfusion and other relevant was taken. Allthose patients who were not previously diagnosed as HBV and HCV positive were included in thestudy. ICT method was used for screening. Those who were positive with ICT were confirmed byEliza test. Eliza negative patients were excluded. During these two years total 2547 patients withmean age of 63.4 years were admitted in eye ward. Results: By ICT method 43(1.68%) patientswere HBC positive in which 24(55.81%) were male and19(44.18%) were female. 121(4.75%)patients were HCV positive, out of them 44(36.36%) were male and 77(63.63%) were female.All positive patients were confirmed by ELIZA test. Regarding predisposing risk factors. in HBVpositive, 13(30.23%) patients had history of major surgical procedure, 9(20.93%) patients haddental extraction, 6(13.95%) had blood transfusion, 6(13. 95%) had quackery injection with nondisposable syringes, 2(4.65%) patients had routine face and armpit shave in barber shops andno significant history in 7(16.27%) patients. In HCV positive, 29(23.96%) patients had history ofmajor surgical procedure, 22(18.18%) patients had blood transfusion, 18(14.87%) patients haddental extraction, 16 (13.22%) patients had history of injection by quack using non disposablesyringe, 13(10.74%)had routine face and armpit shave in barber shops and 23(19.00%) patientshad no significant history. Conclusion: HBV and HCV are common among community. HCV ismore prevalent as compared to HBV. Every patient should be screened before surgery.
STRESS LEVELS
Authors: Kausar Uzma , Haider Sonia Ijaz , Mughal Irfan Ahmed , Noor M. Sohail Anjum
Published: August 2021

Objectives: To explore the effect of pre-exam stress levels of final year medicalstudents on their academic performance. Study Design: Cross sectional study. Setting:Students of final year MBBS class at Independent Medical College Faisalabad. Period: Session2010 to 2015. Methodology: Medical Student Stressors Questionnaire (MSSQ) was used forthis study.1 All male and female students of final year MBBS class of Independent MedicalCollege were included in the study. Collected data analyzed by using SPSS version 18. Meanstress values and chi-square tests were used to compare the levels of stress and its effecton their academic performance. Results: Study results indicate that students who pass weretaking moderate to high degree of stress as compared to students who fail in examination werein mild to moderate degree of stress. In short, high achievers were more stressed as comparedto low achievers. High achievers were more stressed with ARS (Academic Related Stressor)and TLRS (Teaching and Learning Related Stressor). Low achievers were more stressed withGARS (Group Activities Related Stressor) and SRS (Social Related Stressor). Conclusion: Thestudy concludes that stress can be used as a positive factor to improve medical students’academic performance. The most important thing is that not only some stress is necessaryfor good performance but also students should learn how to manage well their stress levelsto improve their academic performance. This study gives guidelines to other medical collegesfor developing coping strategies; so that stress can be used as a positive factor to improvestudents’ academic performance. There is a need for stress management and student supportprograms in medical colleges, So that students may not drop out from medical programs.
TRADITIONAL LECTURE
Authors: Azeem Muhammad , Ali Sabir , Shaukat Ambreen , Haq Arfan ul
Published: August 2021

Introduction: Use of audiovisual aids is not new to improve dental teachingefficiency. Objective: To compare the effectiveness of traditional lecture versus video fororthodontic training of dental interns. Study design: Prospective, Randomized trial. Setting:Orthodontic Dental Section, Faisalabad Medical University. Period: 15.7.2017 to 5.2.2018.Materials & Methods: Two groups of 15 dental interns were selected randomly at OrthodonticDental Section, Faisalabad Medical University. One group was presented with traditional lecturewhile other group was shown a video. The learning objective of both was to train the dentalinterns to bond molar tubes onto extracted human lower first molars. Dental interns bondedmolar tubes and results were assessed by an experienced blinded orthodontist. Resultswere analyzed for accuracy of molar tube bonding. Results: Results showed that there wasinsignificant difference between the two groups for accuracy of molar tube bonding ontoextracted human lower first molars (P value=0.3401). Conclusion: Traditional lecture and videowere equally effective for orthodontic training of dental interns for bonding of molar tubes.
DIABETIC RETINOPATHY
Authors: Jamali Khamiso Khan , Channa Shahnawaz , Azam Muhammad
Published: August 2021

Objectives: To determine central macular thickness (CMT) in Diabeticretinopathy (DR) in type 2 diabetic subjects. Study Design: Cross sectional comparative study.Place & Duration: Department of Ophthalmology, Al- Ibrahim Eye Hospital & Al-Tibri MedicalCollege, Karachi from June 2014 to May 2015. Subjects & Methods: A sample of 200 diabeticswas examined. Ophthalmological examination was performed and included the best correctedvisual acuity (BCVA), anterior and posterior segment examination was performed. A +90dioptre lens was used for the anterior and posterior segment examination. Optical coherencetomography (OCT) was used with Zeiss Cirrus HD– OCT 500. Central macular thickness (CMT)was defined as an average 1 millimeter CMT. Three reading of CMT were taken and average ofthree was calculated. Data was analyzed on SPSS 23.0 ver at 95% confidence interval (P value<0.05). Results: Mean age was found 50.53± 13.75 years. Of 200 study subjects 150 (75%)were male and 50 (25%) were female (M: F ratio 3:1). Hemoglobin A1c was noted as 9.78±3.31.Central macular thickness (CMT) in HbA1c <7.0% and >7.0% was noted as 521.73±33.50 and348.47± 34.33 μm respectively (P=0.0001). Conclusion: Diabetics with retinopathy must befollowed up frequently to examine for central macular thickness to prevent visual loss. Opticalcoherence tomography is best available technique to detect the central macular thickness.
TERMINATION OF PREGNANCY
Authors: Yasmin Shakila , Aziz Rukhsana , Hassan Muhammad , Fatima Mehak
Published: August 2021

Objectives: To compare efficacy of extra-amniotic Foley’s catheter balloon aloneversus combined use of Foley’s catheter balloon and extra-amniotic instillation of prostaglandinF2-alpha in therapeutic termination of second trimester pregnancy. Study Design: Randomizedcontrolled trial. Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital,Bahawalpur. Period: Two years. July 2014 to June 2016. Sample Technique: Non-probability,consecutive sampling technique. Patients & Methods: A total of 256 patients, 16 to 38 years ofage with fetal death or missed abortion on ultrasonography in 2nd trimester (14-24 gestationalweeks) of pregnancy were included in the study. Patients with previous uterine surgery, multiplepregnancies and parity>3 were excluded. Then selected patients were placed randomly intotwo groups i.e. Group A (extra-amniotic Foley’s catheter balloon alone) & Group B (Foley’scatheter balloon along with extra-amniotic instillation of prostaglandin F2-alpha), by using lotterymethod. Outcome variables like efficacy i.e. expulsion of fetus within 24 hours of induction, werenoted. Results: The mean age of women in group A was 24.51 ± 4.77 and in group B was 24.29± 4.48 years. The mean gestational age in group A was 21.65 ± 2.01 weeks and in group Bwas 21.28 ± 1.93 weeks. Efficacy was 103 (80.47%) in group A (extra-amniotic Foley’s catheterballoon alone) and 119 (92.97%) in group B (combined use of Foley’s catheter balloon andextra-amniotic instillation of prostaglandin F2-alpha) with p-value of 0.003. Conclusion: Thisstudy concluded that combined use of Foley’s catheter balloon and extra-amniotic instillationof prostaglandin F2-alpha is better and more efficacious than extra-amniotic Foley’s catheterballoon alone in therapeutic termination of second trimester pregnancy.
DENTAL FEAR
Authors: Fatima Zainab , Rashid Aysha , Abdullah Farakh , Rasheed Bushra
Published: August 2021

Objectives: Anxiety towards dental procedures is common problem thatmay be experienced by dental patients all over the world. This study focused on evaluatingthe prevalence of dental anxiety and its relationship with age, gender, religion, residence,previous traumatic experience and family history in patients coming to dental department ofLahore General Hospital, Pakistan. Study Design: Cross-sectional study. Setting: Departmentof Dentistry of Lahore General Hospital, Pakistan. Period: 1st Jan 2017 to 29th Feb 2017.Material and Methods: A total of 110 patients, aged 10- 85 years were selected for the study.A questionnaire comprising the Modified Dental Anxiety Scale (MDAS) and Dental ConcernAssessment was used to measure the level of dental anxiety and concern towards dentalprocedure was used. Data was analyzed using SPSS version 20. Results: The mean anxietyscore of the 110 patients was 10.43 (SD=5.4). The prevalence of dental anxiety among thestudy population was 37.9%. Based on severity of dental anxiety, 13.6% and 24.3% werefound to be moderately and highly anxious, respectively. Independent sample t-test showedmales were “slightly anxious” than females on items of MDAS such as use of drill and injection.Correlational analyses show significant positive relationship between residence, family history,dental concern and dental anxiety. Linear regression revealed that residence (rural) emergedas significant predictor of MDAS in patients with dental anxiety (P>0.05) accounting for 76%of variance. Conclusion: Female patients, patients belonging to rural areas and family historywere associated with increased MDAS score.
ASPERGILLOSIS
Authors: Rasheed Javaria , Hassan Rushan , Khalid Muhammad , Zafar Fauzia
Published: August 2021

Allergic bronchopulmonary aspergillosis (ABPA) is an illness caused byhypersensitivity to colonized Aspergillus fumigatus, mostly involving susceptible adult patientswith history of asthma and cystic fibrosis. Timely given appropriate treatment can reduceclinical symptoms, decrease lung infiltrates and stop progression to chronic lung disease. Inliterature review, treatment strategies used in ABPA children are limited. Herein we present acase of 10-year old asthmatic girl who, on developing ABPA, was successfully treated by theuse of low dose corticosteroids combined with itraconazole for 3 months duration. We suggestthat in financial constraint circumstances, ABPA in children can be successfully treated withoutanti-IgE therapy.
FEMORAL VASCULAR COMPLICATIONS
Authors: Yasir Muhammad , Ahmad Munir , Ali Liaqat
Published: August 2021

Background: Coronary angiography is the most important and reliable test todiagnose coronary artery disease. Bed rest of few hours is advised after angiography to reducevascular complications but there is difference of opinion regarding duration of bed rest afterangiography. Objectives: To compare the frequency of vascular complications after 6 hoursof bed rest versus 3 hours of bed rest in patients undergoing femoral coronary angiography.Study Design: Experimental study. Place and Duration of Study: Angiography Department,Faisalabad Institute of Cardiology, Faisalabad from August, 2017 to January, 2018. Methods:A total of 100 patients were divided in two equal groups, group A (interventional group (n=50),3 hours rest) and group B (routine care (n=50), 6 hours rest). A 6 French sheath was insertedunder local anesthesia by seldinger technique in femoral artery. Coronary angiography wasdone using 6 F angiography catheters. At the end of procedure sheaths were immediatelyremoved and manual pressure was applied for 15 minutes. Puncture site was observed forhematoma formation or bleeding every 30 minutes for 2 hours in angiography ward, afterwardsthese observations were made every hour till time of discharge. Patients were called for checkupin outpatient department next day and after 1 week. Results: Out of 50 patients in group A therewere 35 (70%) male and 15 (30%) female and in group B out of 50 patients there were 40 (80%)male and 10 (20%) female patients. In group A mean age was (51.02 ±9.57) years while in groupB mean age was (51.50±10.19) years. There was no significant difference in patients betweenthe two groups regarding their age, gender, body mass index (BMI), coagulation profile and useof antiplatelets. There was no incidence of pre ambulation bleeding, small or large hematoma inboth groups. Post ambulation bleeding occurred in 1(2%) patient in experimental group (GroupA) and in 1 (2%) patient in the control group (Group B). Small hematoma occurred in 2 (4%)patients in experimental group (Group A) and in 1(2%) patient of control group (Group B).There was no incidence of post ambulation large hematoma in both groups. Conclusion: Shortbed rest of 3 hours after femoral angiography does not increase the frequency of puncture sitecomplications.
PULP STONE
Authors: Memon Mahwish , Kalhoro Feroze Ali , Shams Salman , Arain Saba
Published: August 2021

Objectives: To detect the pulp stone radiographically and to investigate anyassociation between the occurrence of pulp stone with age, gender, tooth type, dental archand tooth status. Study Design: Prospective study. Setting: Department of operative dentistryLUMHS Jamshoro. Period: January 2014 to June 2014. Methodology: A total of 150 patientswere randomly selected who came for treatment. All those patients with age range of 11-50year who had undergone a diagnostic radiographs of premolar and molar region were includedin this study. Results: Out of 150 patients pulp stones were detected in 66 patients (44%). wereported 42 females (48.27%) and 24 males (42.8%). most of the pulp stones were detectedin patients with age 21-30 years (52.9%) followed by 31-40(42.8%). 540 maxillary and 420mandibular teeth out of 960 total teeth and pulp stones were detected in total 124 teeth 76maxillary and 48 mandibular. Conclusion: Pulp stone was found more in sound teeth followedby carious teeth and involved mostly molars.
ORAL HEALTH
Authors: Inayat Naveed , Das Gotam , Rana Muhammad Haseeb , Reehana Dr , Munir Nadia
Published: August 2021

Objective: To compare the percentage decrease in score of Oral healthrelated quality of life in patients provided with removable and fixed partial dentures. Evaluationof Prosthodontic treatment is made on the basis of clinical observations or from the patientsatisfaction1.tooth loss deteriorates the psychological, functional and social status of anindividual. OHRQoL has been considered as a tool for measurement of consequences of toothloss and available treatment options. Quality of life is influenced by use of removable partialdentures or fixed partial dentures which may also deteriorate oral functions. Setting: Departmentof Prosthodontic, de’Montmorency College of Dentistry/Punjab Dental Hospital, Lahore. StudyDesign: Randomized Controlled Trial. Period: 07th May 2011 to 07th November 2011. Method:Total 60 partially dentate subjects with two teeth missing in either dental arch recruited fromOPD of department of Prosthodontic, de’Montmorency College of Dentistry/Punjab DentalHospital, Lahore. They were divided equally into two groups (Group 1=30 subjects for RPR,Group 2=30 subjects for FPD). All the subjects were given OHIP-14 questionnaire to measurethe OHRQoL before treatment and one month after the provision of prosthesis. Before and aftertreatment scores were recorded on 5 points Lickert scale and coded as +0=never,1=hardlyever,3=occasionally,4=fairly often,5=very often. The scores on Lickert scale were inverselyproportional to the improvement in OHRQoL. Results: Subject with FPD group showed markeddecrease in percentage of OHRQoL after the provision of prosthesis. In comparison with FPDpercentage decrease in OHRQoL was less pronounced in RPD group. There was 62.84%reduction in OHRQoL score who were randomized in removable partial dentures while 90.53%reduction was observed in OHRQoL score who were randomized in fixed partial dentures. Thisshowed that fixed partial dentures are more effective in improving quality of life of patients withpartial dentations. Conclusion: Subjects with FPD showed marked decrease in percentageof OHRQoL; suggest that FPD influenced their social, psychological and functional status in amore positive way as compared to the subjects provided with RPD.
ORAL SUBMUCOUS FIBROSIS
Authors: Memon Aisha , Shahid Hassan , Shafique Salman
Published: August 2021

Objectives: To compare the efficacy of topical Triamcinolone 0.1% withClobetasol 0.05% in the known cases of Oral Submucous Fibrosis presenting with burningsensations. Study Design: Cross sectional hospital based study. Setting: Department ofOral & Maxillofacial Surgery, Isra Dental College, Isra University Hospital, Hyderabad. Period:Six months. Materials and Methods: A sample of 50 patients was selected through nonprobabilitypurposive sampling according to inclusion and exclusion criteria. 50 patients withOral Submucous Fibrosis were divided into two groups, Group A and Group B, each having25 patients. The pain was measured by the visual analog scale on the scale of 1-10. Patientswere divided into Groups ‘A’ (Triamcinolone 0.1%) and ‘B’ (Clobetasol 0.05%). Patients wereadvised to use the gel twice a day for 3 weeks on the affected mucosal surfaces and were alsoadvised to avoid swallowing for some minutes and not to drink or eat for at least 1 hour after theapplication of drug. Patients were recalled for follow up to record any improvements in burningsensations after the application of the drug. Results: It was seen that both topical drugs werebeneficial in controlling the burning pain in Oral Submucous Fibrosis in the 3 weeks duration,however Clobetasol was better than Triamcinolone, as measured by more rapid control of painby week 1. Conclusion: It is concluded that the efficacy of both topical oral drugs were usefulin diminishing pain and decreasing the burning sensations. However, Clobetasol has to someextent better effectiveness in reducing the burning sensation in patients suffering with OralSubmucous Fibrosis.
SEMEN PARAMETERS
Authors: Sultan Jahangir , Khan Shafqat Husnain , Ahmed Munir
Published: August 2021

Objective: The objective of this study was to study the semen parameters and its relation to hormonal status in infertile men. Study Design: Cross sectional study. Period: March 2015 to April 2017. Setting: Jinnah Hospital Fertility Centre; Department of Obstetrics and Gynecology, Lahore. Method: A total of 70 infertile men were included in this study. Semen samples for semen analysis and serum for hormonal analysis were obtained and further tests were performed. Results: The results of our study show that 28.57% were Normospermic, 18.56% were azoospermic and 52.85% were Oligospermic. In Oligospermic and azoospermic patients significant low levels of testosterone and prolactin were noticed. The results indicate that along with semen parameters hormonal levels should also be assessed to diagnose the underlying cause of infertility. Conclusion: It is concluded from our study that both quality of semen and hormonal levels cause infertility in men. Therefore the patients should be properly investigated and should be treated accordingly to the underlying abnormality. This is a regional study and further studies should be conducted to have a conclusive evidence at national level.