bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparative Analysis of Outcome Between Extravesical and Transvesical Repair for Vesicovaginal Fistula
Authors: Ali Adnan , Shehzad Khubaib , Mirza Zahoor Iqbal , Ahmed Hussain , Tabassum Shazia , Changezi Nisarefatima
Published: February 2023

Objective: To compare the surgical outcome of extravesical and transvesical repair of Vesicovaginal fistula.

Study Design: Prospective comparative study.

Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi Pakistan, from Jul 2019 and Jul 2020.

Methodology: Forty-two patients with vesicovaginal fistula were included in the study. The causes of the development of vesicovaginal fistula were evaluated. Half of the patients underwent extravesical and remaining transvesical repair. The results were compared regarding operative time, mean blood loss, complications and recurrence.

Results: The vesicovaginal fistula was secondary to prolonged obstructed labour 27(66%), with an iatrogenic cause 15(34%).Mean operative time for extravesical repair was 83.00±20.00 minutes and for transvesical repair was 60.00±20.00 minutes.71% patients undergoing extravesical repair experienced bladder spasms compared to 47% in the transvesical Group. Three cases suffered prolonged illeus in case of extravesical repair. The mean hospital stay for extravesical repair was 6.00±1.08 days,relatively more than transvesical, which was statistically significant (p-value <0.001)

Conclusion: Transabdominal approach for managing vesicovaginal fistula is the most preferred successful technique.
Determination of Lipid Derangements in Human Immunodeficiency Virus Patients Undergoing Anti-Retroviral Therapy
Authors: Bashir Qamar , Haroon Zujaja Hina , Asif Naveed , Alam Khan Muhammad Qaiser , Ghani Eijaz , Jaffar Syed Raza
Published: February 2023

Objective: To determine lipid derangements in HIV-positive patients receiving anti-retroviral therapy (ART).

Study Design: Comparative cross-sectional study.

Place and Duration of study: Chemical Pathology Department, in cooperation with the Department of Virology at Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Mar 2019 to Mar 2020.

Methodology: In this study, two groups were made. In Group-1, lipid profile estimation was done in HIV patients without treatment. In contrast, lipid profile estimation was done after one year of treatment with anti-retroviral drugs in Group-2.

Results: One hundred and two HIV-positive subjects were included in our study. Of these patients, 88(86.27%) were males,and 14(13.73%) were females. Independent sample t-test revealed a statistically significant difference (p-value<0.05) in serum cholesterol, serum triglycerides, serum high-density lipoprotein (HDL-c), low-density lipoproteins (LDL) and very lowdensity lipoproteins (VLDL) between the two groups.

Conclusion: Hyperlipidemia in HIV patients getting anti-retroviral therapy (ART) exposes them to a high risk of coronary artery diseases and myocardial infarction. Hence lipid profile of patients getting ART must be regularly monitored, and hyperlipidemia, if present, should be managed.
Evaluation of Gram Stain Error Rates of Clinical Specimens
Authors: Sajjad Rabia , Zaman Gohar , Mirza Irfan Ali , Hussain Wajid , Khurshid Umar , Shehzad Asim
Published: February 2023

Objective: To determine important errors in initial Gram staining of clinical specimens and evaluate the types of Gram-stain errors.

Study Design: Cross-sectional study.

Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019.

Methodology: Gram staining and culture inoculation of all specimens were performed per recommended guidelines. The Gram stain results on day-0 were compared with the results of the culture on day-2. There was no discrepancy if similar organisms were obtained on culture as on Gram stain. Nevertheless, if the Gram stain and culture results were not similar, it was termed a discrepancy. The consultant microbiologist reviewed all discrepant slides, and if not resolved, possible causes of error were sought, and the results documented.

Results: Of the total 300 clinical specimens, errors were observed in the initial gram staining of 29 specimens (9.7%), whereas 271(90.3%) specimens were error-free. Upon evaluating these 29 errors, 11(38.0%) were observer errors which were resolved when reviewed by a consultant microbiologist. 14(48.0%) were technical errors, and 4(14.0%) results were discrepant due to the presence of anaerobic organisms, missed on initial aerobic cultures.

Conclusion: The frequency of Gram stain errors in our study (9.7%) is not very high; nevertheless, it can have severe consequences in critical samples from seriously ill patients if wrong empirical antimicrobial treatment is begun based on a wrong initial Gram stain result.
Comparison of Recurrence of Wrist Ganglion Following Aspiration and Injection of Steroid Versus Surgical Excision
Authors: Shah Syed Naqeeb Ullah , Panni Adnan , Bhatti Tanveer , Awan Malik Saeed , Ahmed Umair , Khattak Faheem
Published: February 2023

Objective: To compare the frequency of recurrence after surgical excision versus aspiration and injection of Steroids of wrist ganglion

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Department of General Surgery at Combined Military Hospital, Kohat Pakistan, from Sep 2018 to Aug 2019.

Methodology: Seventy patients reported to the Outpatient Department, Combined Military Hospital, Kohat Pakistan, with complaints of ganglion and wanted treatment. Patients were randomly allocated into two Study Groups 1 and 2, by lottery method. Group-1 was treated by aspiration of the cyst contents followed by Steroid injection, while Group-2 was by excisionof the ganglion surgically under a local anaesthetic agent. The patient was followed up after three months to look for recurrence in both groups.

Results: The frequency of recurrence was 34.29% in Group-1 and 5.71% in Group-2, (p-value was less than 0.001).

Conclusion: Surgical excision results in lesser recurrence when compared with simple aspiration and Steroid injection for ganglion of the wrist.
"Your Diet is a Bank Account; Good Food Choices are Good Investment"; COVID-19 and Dieting
Authors: Siraj Asifa , Kashif Zainah , Urooj Uzma , Saleem Uzma
Published: February 2023

Objective: To gain insight into the relationship between dieting and unhealthy eating habits with COVID-19 infections and complications.

Study Design: Cross-sectional survey.

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan during the month of Jan 2021.

Methodology: This study was carried out through a web-based survey. Google forms were used. It included questions exploring dietary habits, weight changes, weight loss methods, COVID-19 status and severity of symptoms, including ten Open-ended questions and seven closed-ended questions.

Results: A total of 314 participants responded to the survey. They were divided into two groups, Group-A and Group-B. The mean age of the participants was 24.3±4.9 years. Group-A participants were doing dieting during last three years off and on as well as had more severe symptoms of COVID-19. On the other hand, Group-B had mild symptoms of COVID-19. Regarding COVID-19 status, 294(92%) participants in the study recovered from COVID-19, and 30(9.5%) participants suffered from COVID-19 at the time of the survey. The results concluded a positive correlation between the type and duration of dieting and severity of COVID-19 symptoms as well as in weight loss of more than 8kg with COVID-19 symptoms.

Conclusion: Among various factors contributing to the extension and severity of COVID-19, dieting represents one of the possible causes of the severity of symptoms of COVID-19. Understanding its importance is of paramount significance and needs further evaluation.
Effectiveness of Short Message Service (SMS) based Glycaemic Control
Authors: Tariq Maria , Nisar Shazia , Anwer Ayesha , Ellahi Ahtesham , Khan Muhammad Shahid , Hussain Muhammad Zahid
Published: February 2023

Objective: To find out the effectiveness of short message service (SMS) on glycaemic control among patients with diabetes at a tertiary care hospital in Rawalpindi.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Endocrinology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jul 2020.

Methodology: A total of 218 patients with diabetes were included in the study. Patients were randomized into two groups by lottery method. Group-A received a tailored SMS package daily for six months along with printed dietary instructions, while Group-B was given only printed dietary instructions. After six months, HbA1c levels and other sociodemographic factors were compared among the two Groups A and B.

Results: In Group-A (SMS-Group) mean HbA1c levels reduced from 9.3±2.0 to 7.0±0.4 compared to Group-B (non-SMSGroup) with mean HbA1c levels from 9.7±1.8 to 8.8 ±1.4. Before SMS intervention, all variables, including HbA1c levels between the two groups, were insignificant. However, the use of structured SMS-based intervention in Group-A showed a statistically significant reduction in HbA1c levels compared to Group-B (p-value <0.05). The mean difference was 1.77(95% CI:-2.44 to -1.10).

Conclusion: This study showed Short Message Service (SMS) effectiveness by significantly reducing glycaemic levels (HbA1c)among people with diabetes compared to conventional methods of diabetic education for glycaemic control.
Role of Methylprednisolone for Covid-19 Patients Admitted to a Tertiary Care Hospital
Authors: Arshad Komal , Humayun Zill e , Kamran Sultan Mehmood , Ifikhar Raheel , Yousaf Ali , Sajid Muhammad Usman
Published: February 2023

Objective: To determine the role of Methylprednisolone in managing COVID-19 patients.

Study Design: Cross-sectional study.

Place and Duration of Study: Pakistan Emirates Military Hospital (PEMH), Rawalpindi Pakistan, from Jan to Feb 2021.

Methodology: This study was carried out at the Department of Medicine. Medical records of all moderate, severe and critical COVID-19 patients admitted and receiving Methylprednisolone were reviewed. Methylprednisolone was used in all patients at doses 0.-2 mg per kg.

Results: A total of 200 cases were included. The most common presenting symptoms were cough (77.5%), fever (67.5%) and shortness of breath (63.5%). Most patients (85%) presented within the first week of their illness. One or more comorbidities were present in 75% of patients. Most common being hypertension in 70(35%) and diabetes mellitus in 63(31.5%).Complications seen in the study were Cytokine release storm 92(46%) and acute respiratory distress syndrome 44(22%). The median time for initiation of corticosteroid therapy was 4 hours (range 1-96 hours). Overall survival (OS) in the study was 83.5%. OS for patients with moderate, severe and critical diseases was 97.8%, 86.2% and 62%, respectively (p<0.001).Conclusion: Corticosteroids are useful in COVID-19-admitted patients and provide excellent survival outcomes.Keywords: Acute respiratory distress syndrome, COVID-19, Cytokine release storm, Methylprednisolone.
Impact of Screen Media Usage on Early Childhood Development
Authors: Malik Muneeba , Maqbool Shazia , Ali Anam , Azhar Hina , Ullah Ehsan , Khan Aisha Farid
Published: February 2023

Objective: To see the impact of screen media usage on early childhood development.

Study Design: Cross-sectional study.

Place and Duration of study: Developmental Behavioural Paediatrics Department, Children’s Hospital and Institute of Child Health, Lahore Pakistan, from Oct to Dec 2020.

Methodology: This study included 100 children with an age range between 15-36 months and divided into two groups. Group-1 was children with communication behaviour disorders (CBD) (n=50), and Group-2 was typically developing (TD)children (n=50). ShaMaq Developmental Screening Tool (SDST) was administered to children to screen their development.Childhood behaviours were rated on a scale of 0-10 on a Behaviour rating scale.

Results: Children with CBD had poor eye contact, response to names, poor imitation, poor pointing and poor one-step command following (p<0.001) compared to typically developing children. Children with CBD had poor eating habits (p<0.01),were more restless (p<0.001), and had a developmental delay (p<0.001) on SDST as compared to the other group. In children with CBD, the extent of screen media exposure was significantly correlated with restlessness (p<0.05) and poor pointing(p<0.01).

Conclusion: Exposure to screen media at an early age and prolonged use of screens can lead to adverse developmental outcomes and behaviour issues in children. This is more evident in children with CBD than in typically developing children.
Comparison of Intramuscular Versus Rectal Diclofenac Sodium in Post Caesarean Pain Relief
Authors: Altaf Beenish , Kashif Sanum , Sial Shagufta Saeed , Noreen Humera , Pervaiz Erum , Awan Shazia Mahmood
Published: February 2023

Objective: To compare the mean post-operative pain after intramuscular versus rectal Diclofenac Sodium in post-caesarean patients.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Obstetrics & Gynaecology, Benazir Bhutto Hospital, Rawalpindi Pakistan, from May to Nov 2017.

Methodology: A total of 60 women, aged 18-45years, undergoing elective caesarean section were selected. Patients in Group-A were given, Diclofenac 75mg intramuscularly in the gluteal area every 8 hours, while patients in Group-B received a Diclofenac Sodium suppository every 8 hours post-operatively. All patients were followed for pain post-operatively, and final post-caesarean pain was noted at 24 hours post-operatively using a visual analogue scale.Results: The mean age of patients in the Group-A was 29.27±4.68 years, and in Group-B was 30.57±4.80years. The range of gestational age in the study was from 37 to 41 weeks, with an average age of 39.07±1.26 weeks. Mean post-operative pain in Group-A (Intramuscular Diclofenac Sodium-Group) was 1.13±0.43 minutes, whereas in Group-B (Rectal Diclofenac SodiumGroup), was 2.16±0.83 (p-value = 0.001).

Conclusion: Mean post-operative pain after using intramuscular Diclofenac sodium is less than Diclofenac Sodium administered rectally in post-operative patients in caesarean sections.
Trends of Erythrocyte Alloimmunization in Transfused Women
Authors: Ghaffar Sunia , Uddin Nasir , Ghaffar Samia , Haq Hala , Nawab Izza , Ghaffar Bushra
Published: February 2023

Objective: To identify the trends of red cell alloimmunization in multi-transfused females using red blood cell panels.Study design: Cross-sectional study.

Place and Duration of Study: Army Medical College and Armed Forces Institute of Transfusion with the collaboration of Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Aug 2018.

Methodology: Blood samples of 75 females with prior history of blood transfusion were collected from Pak Emirates Military Hospital, Rawalpindi Pakistan, selected by a non-probability consecutive sampling technique. After pilot diagnostic tests for ABO and Rh D blood grouping, samples were screened by three cell panels to identify the presence of RBCs alloimmunization. Positive results were further recognized by 11 cell panels.

Results: Seventy-five women with a history of at least one blood transfusion were selected for the screening of red cell alloimmunization. The frequency of alloantibodies in transfused women was 1(1.3%). The only alloantibody identified was anti-e, which was a rare alloantibody.

Conclusion: Study confirmed that Rh alloantibodies are the most prevalent antibodies, regardless of age, ABO blood grouping, Rh grouping and ethnicity. Our study also confirmed that multiple transfusions are associated with the development of red cell alloimmunization.
Patients' Experience of PET-CT Scan at Armed Forces Institute of Radiology and Imaging Rawalpindi
Authors: Bilal Rizwan , Ahmad Mudassar , Slehria Atiq ur Rehman , Mehdi Syed Ali , Bilal Muhammad , Jamal Ali
Published: February 2023

Objective: To evaluate the patients' feedback for potential improvements in the patient management of PET-CT Department.

Study Design: Cross-sectional survey.

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Sep to Dec 2020.

Methodology: A total of 350 participants were investigated in the study. Structured proforma was utilized for collecting patient feedback, and the ages ranged from 4 to 89 years. The collected data were arranged systematically to apply statistical tests using Microsoft excel.

Results: Explicitly, 14(4%) patients communicated their reservations about further development in PET-CT scan practice. In this regard, 4(1.14%) patients suggested overall improvement in the department. Further, 4(1.14%) and 3(0.86%) patientss’ suggestions were towards staff behaviour and building of the department, respectively. Additionally, 2(0.57%) patients were not contented with the available prerequisite equipment, and 1(0.29%) patient suggested a reduction in scanning charges.

Conclusion: More than 95% patients were satisfied with their experience. The studied data can be utilized to establish patient management protocols for similar PET-CT departments.
Evaluation of Serum Vitamin-D Levels in Patients with Alopecia Areata
Authors: Khalid Aniqua , Rehman Farid ur , Javed Asma
Published: February 2023

Objective: To evaluate serum vitamin-D levels in patients with Alopecia areata compared to healthy controls.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Dermatology Outpatient Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Nov 2019 to Apr 2020.

Methodology: The study included 70 patients with Alopecia areata (Group-1) and 70 healthy controls (Group-2). Complete blood count, TSH, urea and creatinine, fasting plasma glucose, liver function tests, serum Calcium and vitamin-D levels were performed.

Results: The mean vitamin-D levels of Group-1 were 38.28±22.07ng/mL, and the mean vitamin-D levels of Group-2 were 39.61±18.36ng/mL. In Group-1, deficient vitamin-D levels were seen in 14(20.0%) of Group-1, and insufficient in 19(27.1%) and 37(52.9%) had normal levels. In Group-2, 10(14.3%) had deficient levels, 16(25.0%) had insufficient levels and 44(62.9%) had normal levels. No statistically significant difference seen between Group-1 and Group-2.

Conclusion: There is no association between vitamin D level and Alopecia Areata.
Evaluation of Serum Vitamin D Levels in Patients with Vitiligo
Authors: Khalid Aniqua , Rehman Farid ur , Javed Asma
Published: February 2023

Objective: To evaluate serum vitamin D levels in patients with vitiligo and compare them to the healthy controls.

Study Design: Comparative cross-sectional study.

Place and Duration of Study: Dermatology Outpatient Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Nov 2019 to Apr 2020.

Methodology: The study included 75 patients with vitiligo (Group-1) and 75 healthy controls (Group-2). Complete blood count, urea and creatinine, liver function tests, TSH, fasting plasma glucose, vitamin B12 levels, serum calcium and vitamin D levels were performed. In addition, vitamin D levels were compared in both groups.

Results: The mean age of Group-1 was 32.81±20.59 years, and Group- 2 was 40.13±16.09 years. In Group-1, deficient vitamin D levels were seen in 17(22.7%) of cases, insufficient in 25(33.3%) and 33(44.0%) had normal levels. In Group-2, 10(13.3%) had deficient levels, 10(13.3%) had insufficient levels and 55(77.3%) had normal levels. Patients with vitiligo had low serum 25(OH)D levels compared to controls, and this difference was statistically significant (p=0.001).

Conclusion: Low serum vitamin D levels are seen in patients with vitiligo compared to controls.
Efficacy and Safety of Intralesional Vitamin D3 in the Treatment of Plantar Warts
Authors: Javed Mahrukh , Tahir Moizza , Hanif Sumera , Sufyan Muhammad , Ahmed Najia , Rahman Atiya
Published: February 2023

Objective: To explore the effectiveness and safety of intralesional cholecalciferol (vitamin D3) for the treatment of plantar warts.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Tertiary Care Hospital, Multan Pakistan, from Sep 2019 to Aug 2020.

Methodology: Sixty-two patients with warts of varying sizes and duration were included in the study. Intralesional lignocaine was used to anaesthetize the skin. About 0.2ml injection of cholecalciferol (vitamin D3) solution (600,000 IU, 15mg/mL) was injected with a 30-gauge needle to the base of the wart under aseptic measures. A maximum of 4 warts were injected per session at 3-week intervals until resolution or for amaximum of 6 treatments. Patients were followed up for six months after the last injection for recurrence.

Results: Sixty-two patients completed the study, including 45(72.58%), patients who had complete clearance of warts following injection 14(22.5%) which showed partial response and 3(4%) cases had no response.

Conclusions: Intralesional vitamin D3 is a safe and effective treatment for plantar warts.
Comparison of 18-FDG SUV Value with Bone Scintigraphy Findings in Diagnosed Cases of Malignancy with Sclerotic Bony Metastasis
Authors: Waqar Sana , Siddiqui Tariq Saeed , Mannan Muhammad , Sadiq Hafsa , Sarfraz Haroon , Sarfraz Kiran
Published: February 2023

Objective: To determine the correlation of 18F-FDG SUV value with bone scintigraphy findings, i.e. uptake of Tc-99m in diagnosed cases of malignancy with sclerotic bone metastasis.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Sep 2020 to Mar 2021.

Methodology: This study included 30 patients of age 18 to 80 years who had sclerotic bone metastasis as confirmed in histopathology. All patients underwent whole-body PET/CT scanning to evaluate sclerotic bone metastasis and determined 18-FDG SUV after 5MBq/kg body weight of 18-FDG was injected. After two weeks of PET/CT scan, Tc-99m bone scintigraphy was carried out, and SUV of Tc-99m was determined after 20-25mCi technetium-99 methylene disphosphonate was injected, and the correlation was assessed between SUV of 18-FDG and Tc-99m.

Results: The mean 18-FDG SUVmax and mean Tc-99m SUVmax, were, 21.31±8.77g/ml and 15.29±6.49g/ml respectively.21(70%) lesions on 18-FDG PET/CT and 8(26.7%) on Tc-99m bone scintigraphy were metastatic in bones. 18-FDG SUV on PET/CET and Tc-99m SUV on bone scintigraphy correlated positively with each other, and this correlation was found to be statistically significant (r=0.491, p=0.006).

Conclusion: 18-FDG SUV PET/CT significantly correlated with Tc-99m SUV on bone scintigraphy and helped detect metastatic lesions earlier and modulate treatment response.Keywords: Bone metastasis, Bone scintigraphy, 18-FDG PET/CT, Tc-99m SUV.
IMPACT OF TYPE OF HEMODILAYSIS ACCESS ON HRQOL ON PATIENT S UNDERGOING HEMODIALYSIS
Authors: Arif Anum , Zafar Misbah , Munir Nayab Malik , Khalid Javeria , Salman Amna , Bhatti Ahsin Manzoor
Published: February 2023

OBJECTIVE

The aim of the study was to  measure the relationship between the type of vascular access and HRQOL in patients undergoing dialysis in a tertiary care hospital

STUDY DESIGN

Cross-sectional study

PLACE AND DURATION OF STUDY

Department of Vascular Surgery and Nephrology from January 2021 till June 2021

PATIENTS AND METHODS

Data was collected by dialysis center nurse and duty doctors  on patients meeting the inclusion criteria . It was a short form survey 36 ( SF -36 )  questionnaire which included health related quality if life in terms of physical symptoms, social functions and access related complications in last 4 weeks  on a score of 0 to 3 .Higher scores means poorer quality of life.

RESULTS

A total of 80 patients were recruited in the study. A total of 80 patients participated in the study. Male predominance was observed ( n = 59, 73.8 % ). Mean age was   53 +/−  13.9 . 2. Mean  HRQOL score  in AVF  3.8  +/− 4.8 which was the lowest followed by  tunnelled dialysis catheter ( TDC)  9.7   +/−4.5     and non tunnelled double lumen catheter( NTDC )   11.8  +/−9.1    .

CONCLUSION

The HRQOL assessment in ESRD patients can inform the medical personnel of the effectiveness of treatment interventions, it also plays an important role in improving patient's care, assessing patient's needs, setting treatment goals and monitoring disease progression.
Novel Presentation of Placenta Accreta Spectrum
Authors: Sajjad Rabia , Ashraf Viqar
Published: February 2023

Placenta accrete spectrum (PAS) previously known as morbid adherent placenta, is a complex obstetric complication that has risen exponentially in the last couple of decades. It carries serious fetomaternal risk in terms of morbidity and mortality, also increasing perinatal mortality owing to prematurity. PAS include three variants depending upon the degree of placental penetration, i.e. accrete, increta and percreta. We highlighted the unique diagnostic criteria of the placenta accrete spectrum,which includes the history of incomplete removal of the placenta, with repeated evacuation, persistent vaginal bleeding and ultrasound evidence of retained products of conception.
Temporomandibular Disorders in Patients with Occlusal Interferences
Authors: Sharif Mubashir , Amjad Amna , Hussain Sajjad
Published: February 2023

Objective: To assess the temporomandibular disorders among patients with occlusal interferences.

Study Design: Cross-sectional study.

Place and Duration of Study: Prosthodontics Department, Armed Force Institute of Dentistry, Rawalpindi Pakistan, from Jul to Dec 2020.

Methodology: Consecutive patients presenting with symptoms of occlusal interferences, including pain, clicking and limited mouth opening to the prosthodontics department, were included in the study. History was taken from each patient, and a detailed oral checkup was done to evaluate the presence or absence of TMDs in patients with occlusal interferences after informed consent.

Results: The mean age was 30.44±5.95 years. Out of 380 patients with occlusal inferences, 208(54.7%) patients were diagnosed with temporomandibular disorders. No significant difference was found in the distribution of TMDs with regard to age (p=0.559) and gender (p=0.755).

Conclusion: The presence of temporomandibular disorders among patients with occlusal interferences was quite common.This presence is equally common in different age groups and both genders.Keywords: Balancing interferences, Occlusal interferences, Protrusive interferences, Temporomandibular joint, Temporomandibular disorders,
Comparison between the Efficacy of Amlodipine with Captopril in the Management of Uncontrolled Blood Pressure in the Emergency Department
Authors: Mansoor Khurram , Khan Hafiz Waleed , Irfan Khattak Muhammad , Imran Muhammad , Tahir Hasham Bin , Zia Qamar
Published: February 2023

Objective: To compare the efficacy of Amlodipine with Captopril in the management of patients presenting to the emergency department with uncontrolled blood pressure.

Study Design: Comparative prospective study.

Place and Duration of Study: Emergency Department, Combined Military Hospital, Malir Pakistan, from Jul to Dec 2021.

Methodology: A total of 127 individuals presenting to the Emergency Department with two readings of uncontrolled blood pressure (Systolic blood pressure ≥ 160mmHg and Diastolic blood pressure ≥90mmHg) were included. They were administered a tablet of Captopril 12.5mg per oral and a tablet of Amlodipine 10mg per oral on the turn by turn basis. Patients were observed for 3 hours and monitored for the reduction in blood. The efficacy of medication was judged based on the ability to achieve target blood pressure reduction, which was at least a 20-30% reduction in systolic blood pressure.

Results: Out of 127 individuals, 65(51.2%) patients were given a tablet of Captopril 12.5mg orally, and 62(48.8%) were given a tablet of Amlodipine 10mg orally. The mean reduction in systolic blood pressure was 20.73±5.17 in all patients. In addition,target blood pressure reduction was achieved in 35(53.8%) individuals of the Captopril-Group and 33(53.2%) of the Amlodipine-Group, with a total of 68(53.5%) individuals achieving target blood pressure within 3 hours after medication.

Conclusion: Both medications were efficient in achieving target blood pressure levels. However, no drug was superior to another in reducing blood pressure in an emergency.
Effect of Date Fruit Consumption in Later Pregnancy on Length of Gestation, Labour and Delivery of Nulliparous Women
Authors: Hiba Nafeesa , Nisar Salma , Mirza Zainab Abbas , Nisar Sarah
Published: February 2023

Objective: To assess the effect of date fruit consumption in late pregnancy on the onset and progress of labour, the need for induction and augmentation, and delivery outcomes.

Study Design: Randomized controlled trial (NCT05105893).

Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2021.

Methodology: One hundred and forty women were randomized into equal-strength Experimental and Control Groups (70 in each Group). The Experimental-Group included those pregnant females who were advised to consume seven dates per day from 35 weeks onwards till the spontaneous onset of labour. In contrast, the Control-Group comprised primigravidae who did not consume dates in later pregnancy.

Results: Spontaneous onset of labour was reported in 59(84.2%) pregnant women of the Experimental-Group compared to 43(61.4%) of Control-Group. 55(78.5%) pregnant women who consumed date fruit had a spontaneous vaginal delivery,4(5.7%) required instrumental delivery, and 11(15%) ended up having a caesarean section, whereas 43 out of 70(61.4%) women of the Control-Group had a spontaneous vaginal delivery, 6(8.5%) had an instrumental vaginal delivery, and 21(30%) underwent a cesarean section.

Conclusion: The patients who had consumed date fruit in later pregnancy had an improved Bishop score at the onset of labour, a shorter duration of labour, a lesser need for induction and augmentation of labour and more spontaneous vaginal deliveries.
Haemoglobin and Iron Studies in Chronic Kidney Disease Stage-5 Patients yet Not On Dialysis
Authors: Anum Shahzadi , Khan Javed Ahmad , Siddiqi Fuad Ahmad , Asmat Faryal
Published: February 2023

Objective: To look for the low levels of haemoglobin and ferritin among the patients of chronic kidney disease (CKD) Stage-5 not undergoing dialysis and factors related to the presence of low levels of haemoglobin and ferritin.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Feb 2019 to Jan 2021. Methodology: A total of 800 cases were included in the study, diagnosed as chronic kidney disease Stage-5 in the nephrology outpatient department (OPD) by a consultant nephrologist who did not require hemodialysis. Haemoglobin and ferritin levels were recorded in all patients at the time of assessment in the outpatient department. In addition, the relationship of various factors was assessed with low haemoglobin and ferritin among the study participants.

Results: Out of 800 non-dialysis chronic kidney disease patients in the study, 421(52.7%) patients were males and 379(46.3%) were females. Of the participants, 471(58.9%) had either low ferritin or hemoglobin levels, while 329(41.1%) did not show low haemoglobin and/or ferritin levels. Long duration of illness and female gender was significantly associated with low haemoglobin/ferritin levels among the non-dialysis patients of chronic kidney disease Stage-5 (p-value<0.05).

Conclusion: Low levels of hemoglobin and ferritin were found in most patients suffering from chronic kidney disease Stage-5 and not undergoing hemodialysis. Therefore, special attention should be paid to female patients and patients with a longer duration of chronic kidney disease.
A Comparison of Palpation Technique versus Ultrasound-Guidance for Arterial Line Placement by Residents in a Teaching Institution
Authors: Khan Taimur Azam , Ali Shah Syed Qasim , Riaz Muhammad Mohsin , Mateen Osama Abdul , Beg Mirza Hamid , Sharif Muhammad Huzaifa
Published: February 2023

Objective: To compare the ease of placement of arterial catheters using palpation versus ultrasound guidance under aseptic measures.

Study Design: Quasi-experimental study.

Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Aug 2022.

Methodology: Patients of either gender, aged 18 to 90 years presenting to a paranesthesia clinic that required intra-arterial blood pressure monitoring were included in the study. After induction, under General Anaesthesia, arterial lines were placed following an aseptic technique using ultrasound or palpatory method; in Group-U (ultrasound) or Group-P (Palpation),respectively. Demographic variables of the patient along with hemodynamic readings and success rate at first or multiple attempts, along with the total time of cannulation, were recorded.

Results: Out of the total 74 patients, 59(79.7%) patients belonged to ASA-1 Grade, and 15(20.3%) patients in ASA-2 Grade. The mean age of the patients was 48.3±16.3, while mean BMI was 25.42±2.8kg/m2. In Group-P, the first-pass success was achieved in 19(51.4%) patients as compared to 32(86.5%) in Group-U when ultrasound was used (p<0.05).

Conclusion: The success rate in placing an arterial line using ultrasound was significantly greater than the conventional palpatory method. Therefore, ultrasound should be a preferred modality during intra-arterial line placement.
Faculty Development Initiatives
Authors: Qamar Khadija
Published: February 2023

Teachers have been teaching using traditional strategies and frameworks for generations. Faculty development is a planned activity aimed at improving the performance of departmental faculty members by focusing on the improvement of individual knowledge and skills of faculty in relevant areas.1These skills include teaching, administrative, research, and clinical skills.Continuous medical education is a praiseworthy path to keep the educationist in liaison with the novel trends in their field. Faculty development programs aim to foster excellence and innovation by empowering teachers through innovative teaching methods and sharing evidence-based best practices andexperiences.
Dental Anxiety and Its Determinants in Adult Patients of Gilgit Baltistan
Authors: Kakar Muhammad Siddique , Ishfaq Qamar , Khattak Haroon
Published: February 2023

Objective: To evaluate the frequency of dental anxiety and its relationship with age, gender, marital status, education,occupational status, place of residence and previous dental injury experience in patients belonging to Gilgit-Baltistan.

Study Design: Cross-sectional study.

Place and Duration of Study: Psychiatry Department, Combined Military Hospital, Gilgit and 99 Military Dental Center,Gilgit Pakistan, from Jul to Dec 2017.

Methodology: A total of 270 patients aged 18 to 65 years were selected for the study. The proforma was used to determine basic patient information, including past dental experience. Coral's Modified Dental Anxiety Scale (MDAS) was used to measure the level of dental anxiety.

Results: The mean anxiety score was 8.95±2.53. Dental anxiety was common in 33.1% of the study population. Correlational analyses showed a significant positive relationship between younger age, female gender, single marital status, rural residence and negative past dental experience with dental anxiety.

Conclusion: Within the Gilgit-Baltistan population, it was seen that younger patients, single females, people from rural areas and patients with a past negative dental experience had more Dental anxiety.
Comparison of Side to Side Staple Versus Hand Sewn Gastro Esophageal Anastomosis in Cases of Oesophagectomy in CA Esophagus
Authors: Khan Mohammad Abid , Baseer Abdul , Aslam Tahir , Aslam Viqar , Ahmed Asif
Published: February 2023

Objective: To compare outcomes of side to side staple versus hand-sewn esophago-gastric anastomosis in esophagectomy patients with carcinoma of esophagus after subtotal esophagectomy along with gastric tube reconstruction.

Study Design: Retrospective cross-sectional study.

Place and Duration of Study: Lady Reading Hospital, Peshawar Pakistan, from July 2019 to June 2020.

Methodology: After ethical approval, medical records of patients that underwent stapled/hand sewn gastro esophageal anastomosis due to carcinoma esophagus were included. Inoperable Ca esophagus and with thoracic anastomosis were excluded. Each anastomotic technique was applied on 50 patients randomly. The variables of study included demographic,anastomotic leak, anastomotic stricture, operative time, and other complications. All the cases were followed up for 1 year.SPSS version 26.0 was used for data analysis.

Result: From 100 patients, 56 were males and 34 females. Age ranged from 15 to 80 years with mean age of 48.5 and 51.1 respectively in two groups. In 42 cases tumor was present in lower end, middle third in 30 and middle lower third of gastro esophageal junction in 28 cases. Histo-pathologically 58 cases were adenocarcinoma, 31 squamous cell carcinoma and 11 adeno squamous carcinoma. The anastomosis time in group I was 6.8±.22 minutes while in group II was 13.2±1.71 minutes (p0.04). None of the patients in group I, having stapled anastomosis were found to have anastomotic leakage or stricture formation after 1 year of follow up while 04 patients in group II were reported to have anastomotic leakage and 06 patients had anastomotic stricture formation (p-<0.01).

Conclusion: Side by side stapled anastomosis technique was far superior to hand-sewn technique in terms of the time taken for anastomosis to be completed and patient outcomes (anastomotic leakage and stricture formation).
Optimum Timing of Video Assisted Thoracoscopic Surgery in Acute Chest Injury
Authors: Ahmed Anis , Iqbal Yasmeen , Akbar Sidra , Ahmed Mahnoor
Published: February 2023

Objective: To compare the length of hospital stay, duration of chest tube drainage use, conversion to open thoracotomy and post-injury chest infections between the Early VATS and Late VATS groups.

Study Design: Cross-sectional comparative study.

Place and Duration of Study: Department of surgery Benazir Bhutto Hospital, Rawalpindi Pakistan, from Oct 2020 till Sep 2022.

Methodology: Sixty-two patients undergoing VATs for acute chest injury were divided into two groups; early VATs within first 5 days of chest injury and late VATs after 5th day of chest injury. Outcome variables compared between the two groups were length of hospital stay, duration of chest tube drainage, conversion to open thoracotomy and chest infection rate. Numericaldata were compared using the independent sample T-test and categorical variables were compared using the Chi square test. A p-value of < 0.05 was considered statistically significant.

Results: In our study the Early VATS group had a significantly shorter length of hospital stay, lesser days on ventilator, shorter total duration of chest tube drainage as compared to Late VATS group. However, duration of post VATS tube drainage, requirement for secondary VATS and conversion rate to open thoracotomy were similar in both groups. Moreover, infection rate was significantly lower in the Early VATS group.

Conclusion: Early VATS in chest injury is associated with better clinical outcome.
An Obituary-Brigadier Chiragh Hassan Breathes his Last
Authors: Muzaffar Muhammad
Published: February 2023

An eminent senior Pathologist, Brigadier Chiragh Hassan, died in Lahore on 20th October 2022. He wasborn in the Hoshiarpur District and migrated to Lyallpur in 1947.He graduated from King Edward Medical College,Lahore in 1961; had a span of government service, firstas House Physician in Mayo Hospital and later asRegistrar till September 1965. He volunteered for thearmed services in the 1965 war, where he continued toserve till his retirement as Brigadier from CombinedMilitary Hospital, Lahore Pakistan. He did his FCPS in1978 and proceeded to on-the-job training in Tumor Pathology in a specialist unit in London for about a year.He spent a considerable part of his service at Pakistan Naval Ship, Shifa Hospital and did an excellent job in upgrading its laboratory.Dr Chiragh was a keen tennis player. He was very hospitable and loved by his friends and family alike. After retirement, he was an honorary consultantin a Lahore laboratory run by a Non-GovernmentOrganizations (NGO) in Lahore Cantt, Pakistan. The profession will be the loser with the departureof Brigadier Dr Chiragh.May Allah bless the soul!