bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy Evaluation of DENTE91 Anti-Stain Toothpaste: Review of In-Vitro Studies
Authors: Shah Harsh , Singh Ankit
Published: May 2023

Background: Tooth stains on the front teeth are a common esthetic issue caused by tooth discoloration. Good oral hygiene habits, such as brushing your teeth twice daily with fluoride toothpaste and after meals, flossing daily, and using a whitening toothpaste, can help reduce staining and prevent cavities. Material & Methods: Many in-vitro studies has conducted to develop Dente91 Anti-Stain Toothpaste that can help in resolving the issue of demineralization, hypersensitivity, microbial strains, plaque, dental caries/tooth decay, and dental stain more effectively than other marketed products. Its composition includes ingredients such as Sodium Hexametaphosphate (SHMP), Polyvinylpyrrolidone (PVP), Tetrasodium Pyrophosphate, Covarine Blue, Zinc Citrate, Potassium Citrate, and Xylitol. Results: DENTE91 Anti-Stain toothpaste has over 99.9% significant antimicrobial efficacy and effectively reduces demineralization while enhancing the remineralization process. It also provides protection against acid attacks, promotes cell proliferation in NIH/3T3 cells, and shows significant healing activity on dental cavities. Additionally, it has the ability to occlude dentine disc lesions and reduce hypersensitivity. The findings of this study suggest that the toothpaste after using it twice a day for three days removes 63.02 % stains and also shows 80.33% improvement in teeth whitening from baseline.Conclusion: These in-vitro studies of dente91 anti-stain toothpaste concluded that toothpaste helps in resolving demineralization, hypersensitivity, plaque, dental caries/tooth decay, and dental stains. It has antimicrobial activity and teeth whitening effect too.
Demographic and Clinical Profile of Patients with Low Vision: A Hospital Based Study
Authors: Bala Saroj , Kaur Prempal , Bhatia Mohanpreet Singh , Singh Karamjit , Kaur Manveen , Bhutia Chewang Uden
Published: May 2023

Background: Vision impairment is a significant problem in our country. The purpose of this study was to evaluate the causes and to record the demographic profile of patients with low vision. Material & Methods: After taking permission from ethical committee, the study was conducted on 250 patients presenting in low vision clinic of Regional Institute of Ophthalmology punjab in north India .A detailed examination and information regarding the demographic and clinical characteristics of the patients were recorded .the visual acuity of all the patients were determined using Snellen chart followed by anterior and posterior segment examination using a slit-lamp bio microscope and direct and /or indirect ophthalmoscope.Refraction was done in all the subjects and Best corrected visual acuity was recorded. Their demographic and clinical profile were analyzed using SPSS software. Results: Majority of the patients presenting with low vision were found to be above 56 years of age with higher prevalence in rural (54.40%) than in urban (45.60%) population. Male (65.60%)were predominant than females(34.40%) .Major etiological causes were Diabetic retinopathy 76 (30 .40%) followed by Pathological Myopia (21.20%), ARMD (14.80%), Retinitis pigmentosa (6.80%) and Glaucoma (6.00%). Conclusion: Diabetic retinopathy and pathological myopia were the predominant causes of low vision. Patients from rural background were more affected than urban areas.
A Follow up Study Among Patients on Opioid Substitution Therapy (OST) in Terms of Relapse Rate, Factors Affecting Relapse Rate and HCV Incidence
Authors: Bala Neeru , Naib Gaurav , Singh Manjit , Kaur Manmeet , Singh Amarbirpal , Kaur Sumanjeet
Published: May 2023

Background: Many countries are facing a serious problem with opioid dependence. Opioid Substitution Therapy (OST) is prescribed to dependent opioid users to diminish the use and effects of illicitly acquired opioids. The high relapse rate has been affecting the effectiveness of anti-drug work all over the world.Material & Methods:In this study, 200 patients were taken by simple random sampling technique. 100 patient on Buprenorphine substitution therapy and 100 on Methadone maintenance treatment were studied. Patients diagnosed as cases of Opioid dependence as per ICD-10 were selected within the first 3 months and followed up to 1 year at 3, 6 and 9 months. The study was conducted after approval from the institutional ethics and thesis committee. A 14-item questionnaire based on a four-point scale describing the number of times certain events had occurred in the previous week for relapse was used to find factors affecting relapse.Results:The relapse rate among patients in the BPN group at 3, 6 and 9 months relapse was 29.33%, 20.34% and 19.51% while in the Methadone group, it was 24.05%, 15.87% and 12% respectively. The overall HCV Incidence was 75% among patients on Opioid Substitution Therapy. Conclusion:The findings of the study highlight the role of multiple determinants in opioid dependence and relapse. The obtained results showed that HCV infection was an alarming problem among IV opiate drug users in Punjab.
MRI as a Diagnostic Tool for the Determination of Acute Ischaemic Stroke: A Study in a Tertiary Care Hospital
Authors: Arafat Md Tanshed , Alam Syed Zuherul , Liza Tanjima Yeasmin , Afrin Tanshina , Bhuiya Muhammad Minhaz Rashid
Published: May 2023

Background: Stroke is a prevalent and potentially fatal medical condition that affects individuals worldwide. Ischemic strokes, caused by arterial blockages, are the most common type, accounting for about 80% of all cases. Hemorrhagic strokes, on the other hand, are less frequent but can have more severe consequences. Accurate and timely diagnosis of stroke is critical for effective treatment and optimal patient outcomes. In this context, diffusion-weighted imaging (DWI) has emerged as a valuable tool for identifying and monitoring ischemic stroke. This article provides an overview of the role of DWI in stroke assessment and management, with a focus on early detection and intervention. The aim of this study is to investigate the reliability of diffusion-weighted MRI (DWI) as an imaging modality in the evaluation of acute ischemic stroke. Material & Methods: This prospective cross-sectional study was conducted at the Department of Radiology and Imaging at the Combined Military Hospital (CMH) in Dhaka, Bangladesh, between June 2020 and June 2021. The study aimed to examine 120 patients clinically diagnosed with acute ischemic stroke. Prior to the study, verbal consent was obtained from all patients. The Study subjects were identified in the emergency and casualty department and had undergone an MRI of the brain in the Department of Radiology and Imaging at CMH, Dhaka. . Data were collected on pre-designed forms, and the relevant information was compiled on a master chart for statistical analysis using SPSS software. Descriptive analysis and frequency of results were presented in the form of tables, pie charts, and bar graphs. The ethical clearance of this study was obtained from the Institutional Ethics Committee of CMH, Dhaka, Bangladesh. Results: The study included 64 males and 56 females with a mean age of 65.2 ± 7.83 years. The majority of patients had an acute ischemic lesion (88.30%) in the MCA (50.0%) with small-sized lesions (41.7%) and low ADC values (90.0%). The most common clinical presentation was hemiplegia (100%), and diffusion-weighted MRI had a high diagnostic accuracy in detecting acute ischaemic lesions (96.3%). Overall, these findings highlight the importance of MRI in the evaluation of stroke patients and can guide clinical decision-making. Conclusion: The present study concluded that DWI in conjunction with ADC map MR imaging is a gold standard diagnostic modality in the evaluation and management of acute ischaemic stroke.
Correlation between Colposcopic Findings and Histopathological Results from Colposcopy Directed Biopsy in VIA(+VE) Cases
Authors: Biswas Mitra , Akter Syma , Begum Beauty , Khatun Salma
Published: May 2023

Background: Cervical cancer is a major global health problem, with a high burden in developing countries. Early detection and management of precancerous conditions, such as cervical intraepithelial neoplasia (CIN), can help to prevent the development of cervical cancer. Colposcopy, which involves the visualization of the cervix through optical instruments, is considered the gold standard for the diagnosis of cervical abnormalities. The aim of the study was to assess the correlation between colposcopy findings and histopathological results in cases where visual inspection of the cervix with acetic acid (VIA) was positive. Material & Methods: This cross-sectional study was conducted at the Department of Gynecology, Institute of Child and Mother Health, Matuail, Dhaka, Bangladesh. The study duration was 1 year, from November 2017 to October 2018. Participants were recruited from the hospital’s gynecology outpatient department and included 95 women who had a positive VIA test. A Purposive consecutive sampling method was followed for the selection of the participants. Results: The study included 95 patients in Bangladesh who had a positive VIA test. The age distribution of the patients ranged from 25 to 60 years, with a mean age of 35.89±8.88 years. The majority of patients (85.3%) had acetowhite areas, followed by 11 (11.5%) punctuation and 3 (3.2%) mixed (acetowhite area and mosaicism). Histopathological findings revealed that one-third (33.6%) of patients had chronic cervicitis, with 36 (378.8%) having moderate dysplasia, 16 (16.8%) having mild dysplasia, 7 (7.5%) having invasive carcinoma, and 4 (4.2%) having chronic cervicitis with sq. metaplasia. Among the cases, the comparison between colposcopy-directed biopsy results and Colposcopy findings. It was observed that more than one-fourth of 24(29.7%) patients were chronic cervicitis in pure acetowhite area, 8(72.7%) in punctuation, and all patients were mild dysplasia in mixed (acetowhite area and mosaicism). Among 81 patients 53 patients presented with pre-cancerous lesions. The difference was statically significant (p<0.05) in the study patients. Conclusion: Colposcopy, which involves the visualization of the cervix through optical instruments, was found to be an effective tool for the diagnosis of cervical abnormalities in these cases. These findings highlight the importance of colposcopy as a diagnostic tool for cervical abnormalities, particularly in resource-limited settings where access to other screening methods may be limited.
Assessment of Bacteriological Pattern and Antimicrobial Susceptibility in Deep Neck Space Abscess
Authors: Islam Muhammad Ariful , Rahman Md. Hasibur , Islam Md. Saiful , Rifat Mahmud Asif , Mamun Md. Abdullah Al
Published: May 2023

Background: Deep neck abscess is a common clinical entity in developing countries like ours. Despite the widespread use of antibiotics, deep neck infections do not disappear and remain one of the most difficult emergencies encountered in daily clinical practice. The extent and severity of the illness could become life-threatening. Therefore, coping with deep neck abscess remain a challenge to otolaryngologists. This study aimed to analyze the bacteriological pattern and antimicrobial susceptibility in deep neck space abscesses. Material Methods: It was a cross-sectional observational study. 50 patients with deep neck space abscesses fulfilling the inclusion and exclusion criteria admitted to the department of ENT Head Neck Surgery, Rangpur Medical College Hospital, Rangpur, from 1st July 2017 to 30th December 2017 were enrolled in this study. Pus from deep neck space abscess was collected by either aspiration or incision and drainage with proper aseptic measure and sent by sterile test tube to microbiology department immediately. Data were collected by detailed history taking and clinical examination investigations with informed written consent and analyzed by SPSS (version 20). Results: In this study most commonly involved deep neck spaces were Submandibular (38%), Peritonsillar (32%), Retropharyngeal (14%), and parapharyngeal (8%) spaces. Streptococcus viridans was the most prominent organism 14 (28%) followed by Klebsiella pneumonia 9(18%) and Staph. aureus 4 (8%). The most effective antibiotic was Ceftriaxone 34(79%) followed by Cefuroxime 30 (70%) and Erythromycin 23(54%). Aerobic organisms were highly sensitive to Cefuroxime (83%) and Ceftriaxone (83%) followed by Erythromycin (48%). Anaerobic organisms were sensitive to Clindamycin (100%), Metronidazole (100%), and Erythromycin (100%) followed by Ceftriaxone (75%). Conclusion: The most frequently isolated organism in deep neck space abscesses were Streptococcus viridans and Staphylococcus aureus and sensitivity results showed the majority of isolates are susceptible to Ceftriaxone and Cefuroxime.
Perinatal Outcome According to Gestational Age- A study of 50 Cases
Authors: Begum Ferdousi , Sultana Nargis , Begum Yasmin Ara , Akhter Hachina , Sultana Mosammat Rehana
Published: May 2023

Background: Gestational age supports predicting a potential due date, informing obstetrical care and testing, and assessing the baby’s health at birth. It is vital to obtain a gestational age in all pregnancies to offer regular care and medical management for both mother and fetus. The ultimate suitable techniques for calculating gestational age are ultrasonography. The study aims to investigate the perinatal outcome according to gestational age. Material Methods: A Prospective cross-sectional study was carried out in the Department of Obstetrics Gynecology, Bangabandhu Sheikh Mujib Medical University, Hospital, from January 2008 to June 2008. A total of 50 patients were enrolled in this study following the inclusive criteria. Data were collected using the predesigned semi-structured questionnaire. Verbal consent was taken before recruiting the study population. Completed data forms were reviewed, edited, and processed for computer data entry. Results: Among the study population (N=50), one-fifth of the mothers’ (10,20.0%) age was under twenty. The majority of mothers were (34,68.0%) between 20-30 years old with a mean age of 25.4 ± 4.32 years. Twenty-three patients (23,46.0%) came at 40+ weeks of pregnancy, eighteen patients came at (18,36,0%) on 41 weeks of pregnancy and nine patients (9,18.0%) came at41+ weeks of pregnancy. There was no perineal tear and two patients (2,4.0%) had cervical tears which were repaired. In two patients (2,4.0%) there was postpartum haemorrhage, among them two patients (2,4.0%) needed a blood transfusion. Among the healthy babies, the majority of the babies (20,40.0%) were born at 40 completed weeks of gestation, eighteen babies (18,36.0%) at 41 completed weeks and two babies (2,4.0%) were born at 42 completed weeks of gestation. Conclusion: Many childhood and adult diseases are linked with size at birth and are mostly inclined by early postnatal growth is widely accepted. The evolving fetus formulates itself for post-partum life by reporting to metabolic signals in its uterine environment.
Lens Subluxation Following Trivial Trauma
Authors: Sharma Aakanksha , Mohammed Neha , Katoch Kritika
Published: May 2023

Trauma is the main cause of subluxation or dislocation of the lens followed by ocular surgery and spontaneous dislocation due to hypermature cataract. Other causes are Marfan’s, Homocystinuria, Ehler Danlos syndrome and pseudoexfoliation. We report a case of dislocated lens by a trivial trauma with a wooden stick which was left unattended unless patient noticed decreased vision in that eye.
Evaluation of Peripheral Arterial Disease in Patients Presenting with Diabetic Foot Ulcer to Endocrine Clinic
Authors: Usman Khalid , Khan Salman , Muhammad Hamza , Ghaffar Tahir , Tariq Hajra , Rehman Faiz Ur
Published: May 2023

Background and Aim: Diabetes mellitus is an increase in blood glucose levels results in altered fat, protein metabolism, and carbohydrate which leads to cardiac, eye, nervous system dysfunction, and kidney. The major cause of hospitalizations in patients with diabetes mellitus (DM) is diabetic foot ulcers (DFU). The purpose of the present study was to evaluate the peripheral arterial disease in diabetic foot ulcer patients presented to endocrine clinic. Patients and Methods: This descriptive cross-sectional study was carried out on 206 diabetic foot ulcers patients presented to the endocrine clinic in Peshawar from January 2021 to December 2022. Patients were enrolled after taking written informed consent from each individual. Patient’s details such as gender, age, peripheral artery disease (PAD), diabetes types, heart failure, wound size, diabetes duration, end-stage renal disease, DFU history, prior history of amputation, and peripheral neuropathy were recorded. Angiography and revascularization may be required if arterial Doppler ultrasound confirmed PAD. Additionally, wound debridement and topical dressings were applied. In the treatment of wound ischemia, pentoxifylline, and calcium blockers were recommended along with diabetes control procedures and appropriate antibiotics. SPSS version 27 was used for data analysis. Results: Of the total 206 DFU patients, there were 142 (68.9%) male and 64 (31.1%) females. The prevalence of peripheral artery disease (PAD) was 58.3% (n=120). Age-wise distribution of patients were as follows: 31 (15%) in 25-45 years, 107 (52%) in 46-65 years, 60 (29.1%) in 66-85 years, and 8 (3.9%) >85 years. Out of 206 DFU patients, the prevalence of type-I diabetes mellitus and type-II diabetes mellitus was 8 (3.9%) and 198 (96.1%) respectively. PAD prevalence was significantly associated with Type 2 diabetes. The incidence of PAD in plantar foot, non-plantar foot, and heel was 66 (55%), 42 (35%), and 12 (10%) respectively among 120 cases. Out of 206 DFU cases, the incidence of peripheral neuropathy, DFU history, amputation history, heart failure, and chronic renal failure was 142 (68.9%), 104 (50.5%), 54 (26.2%), 46 (22.3%), and 42 (20.4%) respectively. Conclusion: The present study concluded that the prevalence of peripheral artery disease (PAD) was 58.3% among diabetic foot ulcers. Results indicate that DFU and PAD are significantly related. It has been found that male patients with DFU were more likely to suffer from PAD as compared to women with statistically insignificant association. Keywords: Peripheral artery disease, diabetic foot ulcers, type-II diabetes mellitus
Adverse Effects of Covid-19 Vaccine; an Observational Studymainly Focusing on the Cutaneous Reactions in Both Genders
Authors: Tirmizi Syeda Shahmoona , Anwar Adnan
Published: May 2023

Objective: COVID-19 caused a deleterious impact on the health care system globally.The roll out of vaccines seems to be the only effective way to curtail the spread of disease.The purpose of this study is to assess the dermatological adverse effect of post COVID-19vaccination on a gender basis. Methodology: This was an observational,cross-sectional,questionnaire-based survey conducted in Pakistan.The sample comprises 518 participants. The questionnaire was self-designed. The trial lasted six months, from August 1, 2022, until January 31, 2023. We used a non-probability sampling technique.Dermatological adverse effects like burning pain, redness, rashes, and lymphadenopathy at the injection site were recorded.Fever was also noted. All the participants have received booster shots or double doses of any one of CCOVID-19 vaccines, such as AstraZeneca, Pfizer, Sinovac, Sinopharm,Pakvac, etc. A p-value of less than 0.05 was considered statistically significant.Qualitative data was reported as frequency and percentage, and quantitativedata was reported as standard deviation and mean. Results: The study included 518 subjects, of whom 262 were males and 256 were females. The mean age of male is 42.70±14.05 years and female is 39.04±14.6years with a significant difference observed between them (p=0.004). The most common complaint among dermatological adverse effects after first was pain. 106(40.5%) male and 132(51.6%) female reported painwith a significant difference observed between them (p=0.011) followed by swelling which was reported by 92(35.1%) males and 120(46.9%) females with a significant difference observed between them (p=0.006).Burning was reported in 92(35.1%) male and 148(57.8%) female with a significant difference observed between them(p<0.001). Fever was also quite commonly reported in both male 116(44.3%) and female 178(69.5%) with significantdifference observed between them (p<0.001),Likewise post 2nd dose of vaccination, pain was most commonly noted in 90(34.4%) male and female 124(48.4%) female with significant difference observed between them (p=0.001). Moreover, burning was reported by 80(30.5%) malesand 132(51.6%) females with a significant difference observed between them (p<0.001). rashes were reported by76(29.0%) males and 100(39.1%) females with a significant difference observed between them (p=0.016), lymphadenopathy was also significantly associated with genders, (p<0.001). Conclusion: This study concluded that the burning pain,redness,rashes,and lymphadenopathywere the most prevalent side effects in male and female post 1st and 2ndCOVID-19 vaccination.Furthermore fever was also reported in majority of subjects.In addition to this higher percentage of side effects were recorded in females as comparedto males. Keywords: COVID-19 vaccination, vaccine adverse effects, pain, fever.
Diagnostic Accuracy of Endoscopic Findings (Duodenal Fissuring) in Diagnosis of Celiac Disease
Authors: Iqbal Wajid , Khan Noman , Ullah Samid , Saeed Muhammad Ibrahim , Ismail Faisal Wasim
Published: May 2023

Objective: This study aims to determine the diagnostic accuracy of endoscopic findings, specifically duodenal fissuring, in the diagnosis of celiac disease, thus contributing to a more efficient and accurate diagnostic approach in clinical practice. Study Design: A descriptive cross-sectional study was employed to assess the diagnostic accuracy of endoscopic findings in the diagnosis of celiac disease. Setting: The study was conducted at the Endoscopy Suite, Section of Gastroenterology, Department of Medicine, Aga Khan University Hospital, Karachi. Duration: The research was carried out over six months, from 30-06-20 to 30-12-20, following the approval of the synopsis. Methods: A sample of 130 patients presenting with clinical suspicion of celiac disease was recruited for this study. Participants underwent upper gastrointestinal endoscopy, with duodenal biopsies obtained for histopathological analysis. The presence of duodenal fissuring was recorded, and the diagnostic accuracy of endoscopic findings was evaluated against histopathological results as the gold standard. Results: Our findings demonstrate a strong correlation between the presence of duodenal fissuring and the diagnosis of celiac disease. The endoscopic findings revealed a sensitivity of 80.0%, specificity of 92.3%, positive predictive value of 88.9%, negative predictive value of 85.3%, and an overall diagnostic accuracy of 85.4% for celiac disease. Conclusion: The study concludes that endoscopic findings, particularly duodenal fissuring, offer a high diagnostic accuracy in the identification of celiac disease. Incorporating these findings into the diagnostic algorithm can significantly enhance clinical decision-making and contribute to a more efficient and accurate diagnosis of celiac disease. Keywords: celiac disease, diagnostic accuracy, endoscopic findings, duodenal fissuring, upper gastrointestinal endoscopy, histopathology, sensitivity, specificity
Incidence of Cervical Spine Injuries Among Patients with Maxillofacial Trauma
Authors: Mubeen Sonia , Rasheed Maria , Khattak Saddique Aslam , Nadeem Khurram , Tahir Muhammad Mohsin , Manzoor Ikram
Published: May 2023

A substantial portion of cervical spine injuries occurs due to maxillofacial trauma. A delay in the identification of cervical injuries can result in major neurological issues, paralysis, and even death. Therefore, early detection of cervical fractures in patients with maxillofacial trauma is crucial. Aim: The goal of the study is to assess the incidence of cervico-spinal injuries in patients with oral and maxillofacial trauma. Methods: This cross-sectional study was carried out at the Oral and Maxillofacial Surgery department of Mayo Hospital, Lahore for the duration of one year from January 2021 to January 2022. A total of 120 maxillofacial trauma patients treated at the oral surgery department. By using computed tomography, lateral and anteroposterior X-rays; all patients were evaluated for cervical spine injuries. The dependent and independent variables' information was gathered using a structured questionnaire. Results: In 4 (3.3%) patients, cervical spine and maxillofacial injuries were found. Six males and two women were involved in the ten Cervical-spine injuries. The ratio of men to women was 4:1. Despite the low frequency of cervical injuries related with maxillofacial fractures, suitable and precise recommendations for the diagnosis and treatment of these cervical injuries must be adopted to avoid permanent disability and even death. Keywords: Frequency, Maxillofacial trauma, Cervical spine injury
Alarming use of Psychoactive Drugs Amongst Medical Under and Post Graduate Students
Authors: Shahkar Ali Syed Muhammad , Iqbal Aqeela , , Ali Amanat , Awan Inayatullah , Usman Abid , Fatima Samreen
Published: May 2023

Objective: The purpose of this study was to assess the prevalence and factors associated with the use of psychoactive drugs amongst medical undergraduate and postgraduate students. Study Design: A cross-sectional study was conducted using a self-administered questionnaire to obtain information on the consumption patterns of psychoactive substances. Study Place and Duration: The study was carried out at Department of Psychiatry, Khyber Teaching Hospital Peshawar, Khyber Pakhtunkhwa, over a period of twelve months from January, 2022 to December, 2022. Methods: A total of 2,500 medical students, comprising 1,800 undergraduates and 700 postgraduates, were randomly selected from the participating institution. The questionnaire collected data on demographics, academic performance, substance use, and factors contributing to the consumption of psychoactive drugs. Data were analyzed using descriptive statistics, chi-square tests, and logistic regression models. Results: The overall prevalence of psychoactive drug use among the medical students was found to be 35.8%, with a higher rate among postgraduate students (42.1%) compared to undergraduates (32.6%). The most commonly used substances were stimulants, followed by opioids and sedatives. Factors significantly associated with psychoactive drug use included high levels of stress, academic pressure, and peer influence. Students who reported using psychoactive drugs had a higher incidence of poor academic performance and mental health issues. Gender differences were also observed, with male students showing a higher prevalence of substance use than female students. Conclusion: The study highlights the alarming prevalence of psychoactive drug use among medical undergraduate and postgraduate students, which can adversely impact their academic performance, mental health, and future professional lives. It is imperative for educational institutions and policymakers to implement targeted interventions to address the underlying factors contributing to substance use, such as stress management and peer support programs. Furthermore, fostering a culture of open dialogue and increasing awareness about the consequences of psychoactive drug use can help mitigate this growing public health concern. Keywords: psychoactive drugs, medical students, undergraduate, postgraduate, prevalence, substance use, academic performance, stress, mental health.
Correlation Between Resected Volume of Prostate and Improvement in International Prostate Symptom Score
Authors: . Arshad , Kakakhel Majid Khan , Ahmad Tanveer , Ali Shahid , Malik Muhammad Tahir Bashir , Asif Muhammad
Published: May 2023

Introduction: Benign prostatic hyperplasia (BPH) is a common disease in ageing men and prostate resection is common surgical procedure for it. The symptoms of the enlarge prostate can be assessed by using International Prostate Symptoms Score (IPSS). Some studies show that the resected volume of prostate correlates with the prostate symptoms while some show no correlation between symptoms and volume resected. Objective: To find the correlation between resected volume of prostate and IPSS after resection. Study Design: Cross-Sectional Study. Study Setting: Department of Urology, Institute of Kidney Diseases, Peshawar, Pakistan. Study Duration: 01-10-2020 to 30-03-2022. Material and Methods: Pre-operatively, weight and height were measured by digital weight machine and inches tap. Patients symptoms assesses with IPSS for mild, moderate and severe symptoms. Prostate tissue resected during surgery was put in a 60cc syringe and sent to pathologist for exact volume. Post-operatively, patients were followed after one month for symptoms. The difference between pre and post-operative IPSS was calculated. Results: Mean age, prostate volume and change in IPSS were 57.89±14.18 years, 41.05±6.28 ml and 14.84±3.20. There were 34.1% patients each in 30-49 and 50-59 years age groups and 31.8% in 70-80 years group. Pre-operatively, 68.2% patients presented with severe symptoms, 22.7% with moderate symptoms and 9.1% with mild symptoms. Post-operatively, severe symptoms were reduced to 11.4% while moderate symptoms were seen in 52.3% patients. Mean prostate resected was 41.05 grams. Correlation of change in IPSS and prostate volume was 0.280. Conclusion: There was positive correlation between change in prostate volume and IPSS but it was very weak. In other words, the strength of association between these two is very low i.e. r = 0.280 or 7.8% (0.2802) and not statistically significant i.e. P = 0.065. Keywords: Benign prostatic hyperplasia, enlarge prostate, BHP, IPSS, TURP.
Medical Students Expectations, Experiences and Use of E Learning Resources in Higher Education
Authors: Saleem Qasim , Khan Muhammad Amin , Mahmud Syed Ahmed , Usman Muhammad , Aslam Fatima , Saifullah Muhammad , Sarfraz Farrukh
Published: May 2023

Introduction: E-learning, defined here as ‘any learning that uses information and communication technologies is seen as one way to support the advancement of healthcare experts. The adaptability and availability of such modes of delivery are seen globally as advertising opportunities to meet key instruction plans counting lifelong learning and extending participation. Technology-enhanced learning in healthcare education ranges instructive to constructivist approaches. The student constructs new information through investigation of information and reference to involvement and understanding. Objective: To study the expectation and experiences of medical students regarding use of e-learning resources in higher education Study Design: Quantitative cross sectional Settings: Bakhtawar Ameen medical & dental college, Multan Duration: Six months i.e. 1st January 2022 to 30th June 2022 Data Collection Procedure: A pre validated questionnaire was used. Study was carried out at Bakhtawar Ameen medical & dental college, Multan. The total numbers of students were 300 who participated after taking the informed consent. The study was done by simple random sampling technique. All the medical undergraduate students of first to final years must be aged between 20-30 years age. Questionnaire consists of demographic profile, expectation and experiences of medical students regarding use of e-learning resources in higher education Results: The total number of patients who participated in the study was 300 in which 140 (46%) were males and 160 (54%) were females. The undergraduate’s student’s age is in between 20-30 years. On inquiring about student’s expectations and experiences about e learning all the parameters were rated high about e learning which shows the significance of study and p value is <0.1 Practical implication Conclusion: In our study two viewpoints contribute strongly to learning accomplishments and course fulfillment: students’ achievement objectives and the instructor. Students who considered gains in competencies are very special and hence experienced higher achievements. Besides, the results of our study emphasize the instructor’s expertise and part as a counselor and facilitator in learning. Keywords: E-learning, health care, higher education, nursing, student engagement, student experiences, technology-enhanced learning
Variation in Anatomical Position of Vermiform Appendix
Authors: Yousaf Maria , Kanwal Shumaela , Ali Anum Nawazish , Ali Ayesha , Ahmad Nadia , Ghafoor Ammara
Published: May 2023

Background: Delaying acute appendicitis diagnosis may cause appendix perforation and abscess or peritonitis. Appendectomy is one of the most common surgeries in Pakistan, however little is known about vermiform appendix variation architecture. Hence, appendix anatomy may improve prognosis, this research identified appendix anatomical locations, length, and age and sex relationships. Objective: This study aimed to identify the anatomical sites of the appendix, the length of the appendix and to examine the associations between these factors and age and sex. Study Design: Retrospective cross-sectional study Study Setting: This study was conducted in anatomy department of Islamic International Medical College, Rawalpindi from August 2022 to January 2023. Methodology: This retrospective cross-sectional research was completed in the (department and hospital name) between (year). This study was approved from Ethical review committee with IRB (no). The patients reports were taken for the completion of the study. The CT scan of both gender from 8 to 60 years with the help radiologist suggestions were included in this study. Together with a radiologist, we analyzed CT axial images, a coronal of 1.5 mm thickness, and a sagittal reconstruction to assess the anatomical findings of the vermiform appendix retrospectively. Results: There were 300 total participants in this research, 165 (55%) were female and 135 (45%) were male between 8years to 60 years of age. In both sexes, the following sites were found Pelvic, Post ileal, Pre ileal, Retro caecal, Retro colic, Retro Para colic, and Sub caecel. Appendix length and site was shown to be significantly different in gender and age (p<0.001). Children less than 10 years old were more likely to have an incomplete mesoappendix. According to our findings, males have a longer appendix than females do. On the other hand, we discovered that the appendix tends to become longer with age. Practical implication: The location of the appendix reportedly varies among ethnic and geographical groups. Preoperative planning requires knowledge of these variations. Although appendectomy is one of the most common operations in Pakistan, very little is known about vermiform appendix variation anatomy in the country. Conclusion: This study's findings showed that the vermiform appendix is most often seen in the pelvic position on CT in the Karachi-based population. In conclusion, the high prevalence of anterior location and full mesoappendix in our group suggests that acute appendicitis may be more easily and quickly diagnosed in our demographic, with fewer instances of sequelae including perforation and gangrene. Keywords: Vermiform Appendix, Pelvic, Post ileal, Pre ileal, Retro caecal, Retro colic, Retro Para colic, and Sub caecel
Evaluation of Skin to Stone Distance by Non-Contrast Computed Tomography as an Independent Predictor of Stone-Free Rate of Extra-Corporeal Shockwave Lithotripsy for Renal Pelvic Stones
Authors: Islam Khalid , Shah Syed Ameroon , Minallah Nasrum , Dad Naseeb , Ullah Faheem , Naz Shabeena
Published: May 2023

Introduction: Pakistan is situated in the Afro-Asian stone belt. We come across a vast majority of patients having renal calculi. The treatment of renal stones has evolved from open surgery to extracorporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotomy (PCNL) and retrograde intrarenal surgery (RIRS) in past 20 years. Objective: To determine mean skin to stone distance (SSD) in patients undergoing ESWL for renal pelvic stones and to compare mean SSD between patients with successful ESWL and failed ESWL outcomes for renal pelvic stones. Subjects and Methods: This descriptive case series study was carried out in the Department of Urology, Institute of Kidney Diseases Hayatabad Medical Complex Peshawar from September 2017 to March 2018. A total of 50 patients with renal pelvic stones were enrolled for the study. After consent, non-contrast computed tomography of the kidney ureter and blabber (NCCT KUB) was performed and SSD was measured. All patients underwent ESWL. The patient status either as stone free or having residual stones based on NCCT KUB result was noted on 3rd month. Patients having no stone fragments were defined as stone free and the procedure was defined as successful. Results: The mean age of the patients was 39.02 +/- 12.16 years. 33 (66%) were male and 17 (34%) were female. ESWL was successful in 39 (78%) of patients. 11 (22%) of the patients had residual stones. The mean SSD in patients with successful ESWL outcome was significantly lower than the patients with failed ESWL outcome (10.9 +/- 3.0 vs 14.8 +/- 1.8 cm, p-value = 0.001) Practical Implication: The study results will help the urologists in deciding appropriate treatment modality for patients with renal pelvic stones. Conclusion: We conclude that SSD is lower in patients with successful outcome of ESWL in comparison to those with failed outcome. Therefore pre-treatment NCCT KUB should be used in patients with renal stones to determine the SSD which might predict the outcomes of ESWL. Keywords: Renal calculi, Skin to stone distance, extracorporeal shockwave lithotripsy.
Efficacy and Safety of Coronary Intervention Via Distal Trans-Radial Access (DTRA) in Patients with Low Body Mass Index
Authors: Aslam Muhammad , Ahmad Ijaz , Mangi Sarfraz Ali , Bashar Khair Ul , Khan Muhammad Kamran , Ali Dildar
Published: May 2023

Background: The distal transradial approach (dTRA) is anticipated to improve the benefits of transradial availability, hemorrhagic incidents and the occurrence of radial artery occlusion (RAO) with the dTRA is uncertain. The aim of this study to investigate the puncture time rate, homeostasis and radial artery occlusion related to low BMI in distal artery access (dTRA) vs conventional radial artery access (cTRA). Study design: This cross-sectional study was carried out at NICVD, Nawabshah, for the duration of six months from July 2022 to December 2022. Materials and Methods: The total participants were 160 who diagnosed coronary artery disorder and include 75 participants in dTRA and 85 participants in cTRA. The age group were included >21 years. The demographic data, surgical methods, catheterization, procedure-related data, procedures of puncture, ultrasound follow up and BMI were recorded. All data was analyzed by SPSS 22 version. Results: The mean age of participants in dTRA group was 72.0±10.1 years and cTRA group was 73.0±18.0 years. In gender, age and BMI were non-significant in both groups. The crossover rate, puncture time, one needle puncture rate and radial artery occlusion were shown significantly change in dTRA and cTRA group, p=0.005. Conclusion: Distal radial access is a new facility for cardiovascular interventions that provides several benefits over prior links. The key benefits would be less arterial blockage and faster hemostasis. When compared to traditional radial artery access, the dTRA may be a viable and reliable connectivity site for both diagnostic and interventional coronary methods, with a decreased prevalence of RAO, high crossover rate and time needed for hemostasis. Keywords: Distal transradial artery (dTRA); conventional transradial artery (cTRA); Radial artery occlusion (RAO)
Iron Deficiency in Patients Presenting with Somatic Symptoms and their Outcome with IV Iron Therapy
Authors: Kokhar Iqra , Kumar Aneel , . Irfana , Shaikh Bashir Ahmed , Ansari Imdad Ali , Shah Aftab
Published: May 2023

Objectives: To determine the effect of IV iron therapy on patients with Iron deficiency presenting with somatic symptoms. Materials and Methods: The design of this study was The Quasi-experimental study design and this study was conducted in Shaheed Mohtarma Benazir Bhutto Medical University, Larkana. This study was conducted in the duration of 6 months from July 2022–Dec 2022. Totally 90 patients were enrolled. 5ml venous blood sample were collected from of each patient and sent to laboratory of the hospital for complete blood count and serum ferritin level. Patients with iron deficiency were treated with IV iron. Then after eight-week treatment the patients were followed again and 5ml blood were collected in EDTA containing tube. Serum ferritin level was evaluated again at the end of 8 weeks. Somatic scoring scale was used to assess somatic symptom burden before and after IV iron therapy. Results: Out of 90 patients, 40.0% were male and 60.0% were female with mean age of 39.70± 7.30 years. Most of the patients were of age group 41-50 years, followed by the age group of 31-40 years and least number of patients were of age group of 20-30 years. The mean difference of somatic score of our enrolled patients were 7.01±0.33 with P-value of <0.05. The mean serum Ferritin difference between Pre-Treatment and Post-Treatment were found 37.28±-2.6 (ng/ml) with P-value of <0.05. Practical implication: The present study will help the doctors to treat the patients with Iron deficiency presenting with somatic symptoms on priority basis by using IV iron therapy. That will lead to early treatment of the patients and also avoid further complication and miss diagnosis of the patients. Conclusion: It is concluded that patients presenting with somatic symptoms and having iron deficiency improved promptly with IV iron therapy. Keywords: Iron deficiency, somatic symptoms, IV Iron therapy, serum Ferritin, Somatic Scoring scale
Vestibular Disorders and Their Impact on Balance and Mobility
Authors: Majeed Shahid , Farooqi Samina , Jamshed Anum
Published: May 2023

Background: Our sense of balance and spatial orientation is reliant on intricate network of structures in the inner ear called the vestibular system. Any disruption or damage to this system can result in various vestibular disorders that significantly affect an individual's balance and mobility. Objectives: The study highlighted the impact of vestibular disorders on balance and mobility of the body, its importance of early detection and outcome. Methods: The research was conducted at Mufti Mehmood Memorial Teaching Hospital, Dera Ismail Khan, from September 2021 to December 2022, comprising 86 participants having trouble in body balance and mobility diagnosed with vestibular disorders. They were investigated though a balance questionnaire including questions about their history of dizziness and falls for 01 year and a balance test through modified Romberg Test. Results: Mean age of patients was 54.22+10.47 years. It was seen that out of 86 patients, 17 had a history of falling (19.76%), 23 (26.74%) reported experiencing dizziness, 63 (73.26%), 8 (9.3%) patients reported having a history of fainting, while 38 (44.18%) reported mild vertigo, 13 (15.11%) reported moderate vertigo, and 7 (8.13%) reported severe vertigo. The impact of vestibular disorders on balance and mobility measured through Modified Romberg Test revealed that only 15 (17.44%) patients passed Romberg Test and 71 (82.55%) were failed and ranked positive cases for loss of body balance and mobility. Practical implication: Overall, research on vestibular disorders and their impact on balance and mobility has important practical implications for healthcare providers and patients. Early detection, targeted interventions, education, assistive devices, and a multidisciplinary approach can all help improve balance and mobility and reduce the risk of falls. Conclusion: Vestibular disorders can have a significant impact on an individual's balance and mobility. The presence of vestibular dysfunction significantly raises chances of falls, which are among the most debilitating and expensive health conditions affecting elderly individuals. Keywords: Fall injuries; Romberg test; Vertigo; Vestibular dysfunction.
Frequency and Clinical Profile of Cardiac Arrhythmias and its Immediate Outcome in Children at Tertiary Care Hospital
Authors: Raza Ali , Shaikh Abdul Sattar , Korejo Hussain Bux , Sangi Rumana , Ahasan Aliya Kemal , Ahmed Shakeel
Published: May 2023

Objective: To determine the frequency and clinical profile of arrhythmia and its immediate outcome in children presenting to a tertiary care center. Study Design: A cross-sectional study. Duration and place of study: July 2021 to June 2022, the National Institute of Cardiovascular Diseases, Karachi. Methodology: A total of 100 children of both gender , ranging in age from 1 day to 18 years, who presented with the symptoms of syncope, decreased or increased heart rate, chest discomfort, breathlessness were included in this study. Children who presented with cardiac arrhythmias had varying proportions of several criteria of relevance, such as clinical characteristics, age and gender distribution. In patients with unexplained arrhythmias or syncope, a thorough history, general physical exam, and cardiac examinations—including 12-lead electrocardiograms, 2-D echocardiograms, and Holter studies—were conducted. Results: A total of 100 children were included in this study among them 70 children presented with tachyarrhythmia and 30 children presented with bradycardia. The average age was 8.13± 4.45 years. Among the tachyarrythmias group the most frequent initial symptoms recorded in 45 (64.28%) and 15 (21.42%) youngsters, respectively, were palpitation and chest pain. A total of 19 (27.14%) children were discovered to have acyanotic CHDs. SVT was found to be the most common type of arrhythmia in 25 (30.1%) children, followed by ventricular tachycardia and atrial fibrillation in 15 (21.42%) and 10 (14.28%) of the same age groups. A total of 3 (4.28%) of the hospitalized children died. Among the bradycardia group 80% of children were found with complete heart block, 53.3% syncope, 26.7% were asymptomatic, and 20% were with multiple findings of irritability, poor feeding, breathlessness, and syncope. 20% of them developed LV dysfunction. Conclusion: The most frequent presenting symptoms were palpitations and chest discomfort. The other most common types of arrhythmia were supraventricular tachycardia, atrial fibrillation, ventricular tachycardia and bradycardia. Children's hospital stays were generally short and the therapy for arrhythmias had favorable overall results, however, 4.28% of children in the tachyarrhythmia’s group died of heart failure, while there was no expiry in the bradycardia group. Keywords: Arrhythmias, palpitations, supraventricular and ventricular tachycardia, bradycardia and heart Block