bluuebunny/crossref_metadata_2025 huggingface dataset:
SYSTEMIC INFLAMMATORY RESPONSE SYNDROME (SIRS)
Authors: Ansari Shuaib , Shahwani Irfan Murtaza , Ali Zeeshan , Shah Syed Zulfiquar Ali , Shahab Faisal
Published: September 2021

Systemic inflammatory response syndrome (SIRS) is a generalized disorder,immune response to infection which results in disturbed microcirculation, visceral perfusion andultimately visceral failure. Objectives: To determine the frequency of systemic inflammatoryresponse syndrome in patients with liver cirrhosis. Design: Cross sectional descriptive.Period: Six months study. Setting: At Liaquat University Hospital Hyderabad. Patients andmethods: All the patients with liver cirrhosis for 06 months duration admitted in the ward werefurther evaluated for systemic inflammatory response syndrome. The data was analyzed inSPSS 16 and the frequency and percentage was calculated. Results: During six months studyperiod, total 100 cirrhotic subjects were studied for SIRS. The mean ± SD for age in all (100)cirrhotic patients was 45.74 ± 7.537. The mean temperatures was 40.42±0.32 where as it was39.72±0.43 and 38.92±0.11 in male and female population respectively. The mean heart beatwas 128.42±6.74 where as it was 115.83±8.93 and 120.62±5.53 in male and female populationrespectively. The mean respiratory rate was 25.31±3.52 where as it was 23.52±2.31 and26.63±3.21 in male and female population respectively. The mean white blood cell count was28.81±4.51 where as it was 23.74±4.73 and 30.83±5.73 respectively. The SIRS was observedin 70% subjects of which 47(67.1%) were males and 23(32.9%) were females (p=0.04). Majorityof SIRS subjects were 30-39 years of age and male population was predominant (p=0.03). Thegender distribution in relation to severity of liver disease was statistically significant (p=0.05)while the SIRS in relation statical analysis. Conclusions: The systemic inflammatory responsesyndrome occurs in patients with liver cirrhosis.
HAEMANGIOPERICYTOMA
Authors: Longquan Xiang , Mwakyoma Henry
Published: September 2021

Hemangiopericytoma (HPC) in central nervous system is a rare tumor, his tumorhas a high recurrence rate and the characteristics of extracranial metastases. Objectives:To investigate the clinicopathological features, imaging features, immunohistochemicalphenotype of haemangiopericytoma (HPC) of central nervous system. Design: Hospital basedcrossectional prospective study. Period: From 24th October to 26th October 2012. Setting: FirstPeople’s Hospital of Jining City, China. Methods: The clinical manifestations, imaging features,histopathological and immunohistochemical features were analyzed combining the review of theliterature in one case of central HPC. Results: The Gross examination revealed the size of thetumor was 5cm × 4cm× 1.5cm; the section is gray, medium soft texture, and part of the area hadcapsule. The microscopic examination showed that the tumor cells were abundant and the samesize, showing round, oval or short spindle shape. The cytoplasm was eosinophilic, and part ofit was slightly translucent. The nuclei were ovoid, and the nucleoli were inconspicuous.A lot ofcapillaries lined by endothelial cells were seen in the tumor tissue, and the blood vessels weredilated like “staghorn” in some areas. Immunohistochemistry showed that tumor cells expressedVimentin, CD34, CD99, Bcl-2, PR protein. They didn’t express EMA, SMA, and S-100 protein.The proliferation index of ki-67 is about 4%. Conclusions: The central haemangiopericytomais a rare tumor, having no specific clinical manifestations and imaging features. The finaldiagnosis requires a combination of histopathological and immunohistochemical examination,and it should be differentiated from meningioma, solitary fibrous tumor, hemangioblastoma andmesenchymal chondrosarcoma, etc.
COMPUTED TOMOGRAPHY (CT) SCAN
Authors: Shahwani Irfan Murtaza , Dasti Mashooque Ali , Kalhoro Muhammad Amjad , Ali Sajjad , Waseem Bushra , Arwani Suneel , Shah Syed Zulfiquar Ali
Published: September 2021

Ring enhancing lesions are a common neurological problem seen in eithergender and in all age groups. Objectives: To determine the clinical presentations and etiologicalfactors in patients with ring enhancing lesion on CT scan brain. Design: Case series study.Period: One year. Setting: Department of medicine, Liaquat University Hospital, Hyderabad.Patients and methods: Subjects of either sex ≥12 years of age, presented with seizures, fever,focal neurological signs and deficit, headache, weight loss and vomiting and had single ormultiple ring enhancing lesions on computed tomography (contrast CT brain film) were enrolledand entered in the study. CT scan brain was advised to evaluate any identified lesion and thencertain specific biochemical tests were also advised to detect the particular existence etiologicalfactor. The data was analyzed in SPSS 16 and the frequency and percentage was calculated.Results: During one year study period, total 50 subjects were detected as ring enhancing lesionon CT scan. The mean age ±SD of the over all population was 28.87±4.84 whereas the meanage ±SD of male and female population was 27.76±6.53 and 30.76±5.83 respectively. Ringenhancing lesions were right sided in 30 patients (60%), on the left side in 15 (30%) and bilaterallesions were identified in 6 subjects (10%) on brain imaging. Majority of the ring enhancinglesions were single 45 (90%) and the parietal lobe was observed as the commonest site. Theheadache, seizures, fever, pyramidal signs and papilledema was identified the common clinicalfeatures whereas the common etiological factors responsible for ring enhancing impression onbrain CT scan were tuberculoma 17(34%), brain tumor 12(24%), metastasis 05(10%) and brainabscess 04(08%). Conclusions: The male population was predominant while the seizure wasobserved as common clinical feature whereas the tuberculoma, brain tumour and metastasisare the common etiological factors responsible for ring enhancing lesion on brain imaging.
BLOOD
Authors: Ullah Hashmat , Khan Muhammad Farid
Published: September 2021

All forms of mercury are global pollutants having no environmental limits.Human exposure to mercury occurs basically through food chain due to accumulation oforganic forms of mercury in fish. Objectives: The purpose of the present study was to analyzethe effect of phenyl mercuric acetate on plasma and cytosolic fraction GSH. Study Design:Experimental Study. Setting: Department of Pharmaceutical Chemistry, Faculty of Pharmacy,Gomal University, Dera Ismail Khan. Period: 29 January 2011 to 11 march 2012 .StatisticalAnalysis: One-way ANOVA followed by Dunnet’s HSD test. Results: For the estimation ofthiols Ellman’s method was used and was found statistically significant (p < 0.001) decreasein plasma and cytosolic fraction GSH which was dose and time dependent. The plasma GSHcontents drop in 0 to 120 minutes by various concentrations of phenyl mercuric acetate were64.45%, 59.33%, 50.89%, 41.56%, 33.63% and 32.99% while drop in cytosolic fraction GSHlevel from 0 to 120 minutes by different concentrations of phenyl mercuric acetate (PMA) was53.86%, 48.60%, 45.41%, 36.11%, 29.38% and 27.06%.Conclusions: It is clear that duringorganic mercury toxicity the blood components are also affected which is proved from ourresults. With the increase of time ,the mercury toxicity would be more harmful so detoxificationof organic mercury should be done on emergency bases at the earliest with the help of suitablechelating agents along with antioxidant therapy.
THE MYOMATOUS ERYTHROCYTOSIS SYNDROME
Authors: Ahmed Ayesha , Dawood Nasira S , Ibrar Faiza
Published: September 2021

Uterine leiomyomas are the most common benign pelvic tumours in females.Rarely they are associated with symptoms of ectopic hormone production. One of thesesyndromes is the myomatous erythrocytosis syndrome, which is a triad of polycythaemia,fibroid(s) and resolution of the polycythaemia after hysterectomy. The case presented is of apost-menopausal lady found to have a Hb of 21 during workup of a pelvic mass. A diagnosis ofsecondary polycythemia due to ectopic erythropoietin production by the fibroid was made. Afterfive sessions of phlebotomiesa target Hb of 15 was obtained for surgery. The haematologicalvalues restored to normal three days post-operatively. It has been postulated that all fibroidsproduce erythropoietin. Recognition and proper management of this condition is importantto differentiate between primary and secondary polycythaemia as primary polycythemiais a thromboembolic condition, to avoid un-necessary investigations and to prevent anycomplications secondary polycythaemia may have per-operatively.
CHOICE OF CONTRACEPTION
Authors: Mansoor Malahat
Published: September 2021

Objective: To observe the relationship of parity with awareness &liberty of useof contraception among married women. Study design: Descriptive study. Period: 1.02.2014to 30.09.2014. Settings: Department of Obstetrics & Gynecology, Bhatti International Hospital,Affiliated Central Park Medical College, LHR. Methods: All Primipara & multipara women deliveringat Bhatti Hospital were included. The women opting for permanentmethod (Tubal Ligation) wereexcluded. A total of 100 women participated in the study. Results: P1=44,P2-7=56,& out oftotal 100 women only 50 (50%) had simple awareness about contraception. Only 27% (all ofgroup 2 i.e P2-7) had used some form of contraception. Among Group 2, 30% used Barrier(male condoms),7% withdrawal, IUCD 5%, Pills 3%,Injections1%. Multipara were more awarethan primiparas with p value 0.043(significant).Both groups were equally dependent on theirhusbands&/or in laws directly or indirectly about their decision &choice of contraception withp value 0.49 (not significant).The decision of contraceptives use depended on couples 36%,Only Husbands 34%,only women 27%& in laws 3%.The Group 2 had a low tendency to usecontraception despite a general expectation with p value 0.36 (not significant) indicating thatthe probability of use in Group 2 was not very high. Conclusions: Both men & women need tobe aware of the benefits of contraception & women’s role in contraception decision making isstill low in Pakistan
GRANDMULTIPARAS
Authors: Bano Saadia , Azhar Tasneem , Aslam Iram
Published: September 2021

Intrapartum complications that are classically associated with grandmultiparasinclude fetal malpresentation, dysfunctional labour, chronic hypertension, abruptio placentae,postpartum haemorrhage and macrosomic babies. Excellent maternal and fetal outcome ispossible in grandmultiparas with improvement in health care system and free provision of healthfacilities to all pregnant women. Objectives: The objective of the study was: to find the frequencyof hypertension, placental abruption and primary postpartum hemorrhage in grandmultiparas.Study Design: It was a prospective study with descriptive pattern. Setting: Gynaecologyand Obstetric unit-I of Allied Hospital, Punjab Medical College Faisalabad. Period: January toJune 2006. Methods: Eighty patients were included in the study. Eighty grandmultiparas wererandomly selected for the study. Detailed evaluation of all patients was done by thorough history,examination and investigation. Patients were analyzed for complications during pregnancy,labour and delivery, especially hypertension, placental abruption and primary post partumhaemorrhage. Results: Hypertensive disorders found to be in 32 (33.8%), placental abruptionin 7(8.8%) and postpartum hemorrhage in 19( 23.8%) of grandmultiparas. Conclusions: It wasconcluded from the result of my study that grandmultiparity is still a major obstetric hazard indeveloping countries like Pakistan with higher incidence of complications. Safe maternal andperinatal outcome is possible in grandmultiparas with improvement in health care system andfree provision of health care facilities to all pregnant women.
LIVER CIRRHOSIS
Authors: Akbar Ali , Jaffery Mukhtiar Hussain , Memon Mushtaq Ali , Arwani Suneel , Memonq Hamid Nawaz Ali , Shah Syed Zulfiquar Ali
Published: September 2021

Liver cirrhosis results from prolonged, widespread but patchy hepato-cellularnecrosis due to various reasons. Objectives: To determine the frequency and severity ofhyponatremia in patients with liver cirrhosis. Study Design: Descriptive case series study.Period: Six months. Setting: Liaquat University Hospital Hyderabad. Methods: The cirrhoticsubjects were assessed for hyponatremia and its severity. The data was analyzed in SPSS 16and the frequency and percentage was calculated for hyponatremia and statistically p -value≤0.05 was considered as significant. Result: Sixty five percent males and thirty five percentfemales of liver cirrhosis were studied. The mean age ± SD of overall cirrhotic subjects was40.79±7.83. The hyponatremia was identified in 72% (51 males and 21 females) patients. Themean ±SD for Na+ level in overall population was 129.73±83.51 while it was 119.92±3.61 inhyponatraemic cirrhotic subjects. The sodium level in male and female hyponatraemic cirrhoticpatients was 121.73±8.63 and 118.92±3.31. Conclusions: Dilutional hyponatremia is frequentin patients with liver cirrhosis.
LIVER CIRRHOSIS
Authors: Siddiqui Sadia Niaz , Memon Mushtaq Ali , Baloch Ghulam Hussain , Memon Hamid Nawaz Ali , Arwani Suneel , Shah Syed Zulfiquar Ali
Published: September 2021

Objectives: To determine the frequency and severity of thrombocytopenia inpatients with liver cirrhosis. Study Deisgn: Cross sectional study. Period: 01-03-2013 to 31-08-2013. Setting: Liaquat University Hospital, Hyderabad. Methods: The cirrhotic patients wereassessed for thrombocytopenia and its severity. The data was analyzed in SPSS version 11.00and frequency and percentage was computed. The chi-square test was applied and p -value≤0.05 was considered as statistically significant. Results: Total one hundred patients wereevaluated for thrombocytopenia, 70% males and 30% females. The mean ± SD for age incirrhotic subjects was 41.16±14.24 whereas the mean ±SD for age in male and female cirrhoticpatients was 42.81±10.96 and 40.63±9.85. The thrombocytopenia was detected in 68%, ofwhich 43(63.2%) were males and 25(36.8%) were females. Mean±SD for platelet in all subjectswas 130.85±8.33 whereas it was 68.82±6.52 in thrombocytopenic cirrhotic patients. Mean±SDplatelet count in male and female thrombocytopenic patients was 70.94±7.42 and 64.72±5.84.Out of sixty eight thrombocytopenic cirrhotic subjects 23 had mild thrombocytopenia, 25had moderate thrombocytopenia and 20 had severe thrombocytopenia while in relation toChild-Pugh class B (p<0.01) predominant. Regarding the duration of the liver cirrhosis, thethrombocytopenia was predominant in patients between 6-12 months. The common presentingfeature observed in relation to gender were malaise 21%, fatigue 17, nausea / vomiting 14%and combine feature in 21 cirrhotic patients (p=0.04). Conclusions: The thrombocytopeniawas detected in patients with liver cirrhosis, therefore frequent platelet assessment is one of themost important step to monitor platelet count and reduce severe and life threatening episodesof bleeding.
TUBERCULOSIS
Authors: Ali Muhammad Arif , Rehman Naveed-ur- , Baig Shahbaz , Asghar Muhammad Usman
Published: September 2021

Tuberculosis is one of the major public health problems in Pakistan. Pakistanranks fifth amongst TB high-burden countries worldwide and accounts for 61% of the TBburden in the WHO Eastern Mediterranean Region. Objectives: To describe knowledge,attitudes, and perceptions among the patients of pulmonary tuberculosis about their diseaseattending outpatient department at independent university hospital Faisalabad. Study Design:A descriptive cross-sectional study. Period: August to September 2014. Setting: Out patientsdepartment at Independent University Hospital Faisalabad. Methods: A total of 197 patientsfrom OPD. Systematic random sampling technique. After an informed consent a pretestedquestionnaire were used to collect the information from the patient. SPSS-17were used tocalculate the frequencies and percentages. Results: Out of 197 respondents were 55.3% (109)male, 44.7% (88) female and 63% (125) were earning below 10000 rupees per month. As foras knowledge is concerned 50% of the patients viewed that TB is transmitted through contactwith the patients having tuberculosis, 83%labelled cough of long duration as commonest sign,60% viewed that it can be prevented by avoiding contact with patients, 57% labeled healthcarestaff as their source of information, 65.9% perceived TB as an infectious disease, 55% stressas cause of disease, 85% as not curable disease. Conclusions: Poor knowledge and falseperceptions are the main constrain in the control of TB in Pakistan.
TOBACCO SMOKING
Authors: Aslam Muhammad , Asif Muhammad , Altaf Saima
Published: September 2021

Objective: To assess the risk of different cancer sites among the male smokersof the Southern Punjab, Pakistan. Study Design: Case-control design. Period: March - July2012. Setting: A data set of 596 males, belonging to the Southern Punjab was collectedfrom the Outdoor Ward of Cancer, Oncology Ward of Nishtar Hospital and Multan Institute ofNuclear Medicine and Radiotherapy (MINAR) Hospital. Method: Through a self-administeredquestionnaire, smoking status and respondent’s history and medical record of various typesof cancers were noted. The Chi-square test was used to assess the association betweentobacco smoking and cancer disease. For the risk analysis, odds ratios and attributable riskwere computed. Results: Among the respondents, 49.0% smoked tobacco. From the medicalrecord, 438 respondents were confirmed cancerous. The average age to start tobacco wasnoted to be 23.41 ± 4.85 while the age was 45.29 ± 12.24 years for tobacco cessation. Thepercentage of lung cancer among smokers is 24.01 which is highest among all the statedcancer sites. The risk of a smoker getting all types of the stated cancers is at least three times.The risk of lung cancer attributed to smoking is 17.65 and 50.7% of all the stated cancers.Conclusions: Smokers in the Southern Punjab can greatly reduce their risk (more than 50%)of cancer if they quit smoking.
DIAPHYSEAL FEMORAL FRACTURES
Authors: Memon Abbas , Pirwamni Mehtab , Memon Shakeel Ahmed
Published: September 2021

Objectives: To assess the best results of diaphyseal femoral fractures treatedby closed intramedullary interlocking nail and open intramedullary interlocking nail. StudyDesign: Cross sectional. Period: Jan 2009 to Jan 2011. Setting: LUH Jamshoro / Hyderabad.Methods: Total 40 fractures of shaft of femur in 40 patients were treated with IMILN. All patientshave same post operative follow up. Early range of motion exercises of hip and knee joint wasstarted, pain management and 3rd generation cephalosporin intravenous antibiotics given for5 days followed by oral antibiotics. Patients discharged as early as possible when patient’scondition allowed and removal of stitches after two weeks. Patient’s assessment regardingwound condition, range of movement of proximal and distal joints and fractures assessmentradiologically and clinically was done every month. Results: Majority of the cases were withthe age groups of 37.5% between 21-30 years. RTA was found most common 70% of thecases. According to the AO classification oblique fractures were found most common 45%. Onthe assessment of final results in both close and open methods, 5% infection found in closemethod and 7.5% infection were in open method, less union time was found in closed group,deformity was equally found in both groups and heeling time was also less found in closedgroup. Conclusions: It is concluded that closed intramedullary interlocking nailing method isthe best procedure with excellent union for the femoral fracture.
DIAPHYSEAL FEMORAL FRACTURES
Authors: Akhund Muhammad Azeem , Shah Karam Ali , Abbasi Allah Nawaz , Mastoi Zulfiqar Ali
Published: September 2021

The femur fractures usually happen with oomph forces like motor vehicleaccidents. Objectives: To assess the mode of injury and complications of the management, indiaphyseal femoral fractures, in comparison of close versus open intramedullary interlockingnail (IMN). Study Design: Experimental and comparative study. Period: April 2013 to March2014. Setting: Department of Orthopaedic Surgery, Peoples University of Medical & Healthsciences, Nawabshah. Methods: The cases were divided into two groups A and B. Group Awas treated by open nailing (n = 20) and group B by close nailing (n = 20), all the cases wereoperated within 48 hours of admission. All the data were recorded on well structured proforma.Serial radiographies were performed at 3, 6, 12 weeks, and 6 months; additional radiographieswere performed as needed postoperatively. Knee, ankle, and hip motions were begun andprotected weight bearing was started on the second day postoperatively and increasedgradually to full WB depending on x-ray findings of callus formation. The patients were followedfor two years. Results of open and closed I.M.N were assessed and the complications if anywere observed over a mean follow-up period of two years. Results: The mean age in groupA was 29.40 years and the mean age in group B was 30.45 years. Out of 40 cases, 32(80.0%)were males with male to female ratio 1:4. Mean ± SD hospital stay was 19.80 ± 14.60 days ingroup A, and 17.90 ± 5.95 days in group B (p value 0.55). Average time between injury andadmission was 1.53 days (n = 40), in the group A it was 1.05 days, and in the group B it was2.0 days (p value 0.03). The average of time between injury and operation in the group A was8.75 days, and in the group B, it was 8.20 days, (p value 0.71). The average of time betweenadmission and discharge in the group A was 11.0 days, and in the group B was 9.15 days,(p value 0.55). Mean ± SD union time was 11.70 ± 6.45 weeks, in group A and 11.90 ± 5.77weeks, in group B. (p value 0.91). All the patients had full ranged of hip motion and 2 (10.0%)patients of group A had mild limitation of knee motion with a flexion ranges between 80 and110 degrees. Final functional results based on Thoresen BO criteria16. Excellent results wereobserved in 19 (47.5%) cases, out of them 5(25.0%) were in group A and 14(70.0%) were ingroup B. Good results were found in 13(32.5%) patients, out of these 7(35.0%) were in group Aand 6(30.0%) were in group. Fair and poor results were detected in 4(10.0%) cases of group A.Conclusions: Road traffic accidents by motorcycle was found the commonest (47.5%) causeof femur fracture, a few complications were observed in open interlocking nailing as comparedto closed interlocking nails.
PRESENT TREND IN EVENINGNESS AMONGST MEDICAL STUDENTS IN THE EAST
Authors: Jabeen Surriya , Matloob Aneesa , Maqsood Syed Mohammad
Published: September 2021

Objectives: To analyze individual preference in organizing their behavior within24 hours(Human chronotypes) also referred to as morningness/ eveningness. Setting: DowMedical College, Dow university of Health Sciences Karachi. Period: From September 2012 toDecember 2013. Study Design: Cross-sectional. Methods: Subjects (Medical students) fromfirst semester to final semester were invited to participate in this study, A total of 710 subjectswere included. Their demographic data such as age, gender was obtained. Instrument is anintegrated questionnaire (Horne JA and Ostberg O Morningness- Eveningness questionnaireMEQ original 1976) designed to assess chronotype of young adult population. Results:Out of different existing chronotypes, biggest group which dominated the current study wasintermediate type. Conclusions: Present study determined, chronotype of young population(medical students) of this region. The assessment of individual chronotype is important not onlyfor the diagnosis and treatment of sleep disorders, additionally to evaluate ability to adapt forspecific work schedule.
STROKE PATIENTS
Authors: Maheshwari Sunil G. , Iqbal Muhammad , Hashmi Sayed Fasih Ahmed , Devrajani Bikharam
Published: September 2021

Objective: To assess the cognitive impairment in stroke patients. Study Design:Observational study. Setting: Department of Medicine, Liaquat University of Medical & HealthSciences Hospital Jamshoro and Hyderabad. Period: 01stAugust 2013 to 1stFeburary 2014.Methods: One hundredpatients with the established diagnosis of cerebrovascular accident(CVA)or stroke were recruited by purposive sampling technique after obtaining a well informedconsent. Socio-demographic data on a semi-structured proforma were recorded. Mini-MentalState Examination test was used to assess the cognitive impairment. Results: Cognitiveimpairment was found in all the patients with stroke. Moderate cognitive impairment was foundin 57%, mild cognitive impairment in 29% and severe cognitive impairment in 14% of strokepatients. Conclusion: Cognitive impairment was present in almost all the stroke patients andwe noticed that moderate cognitive impairment was very common.
HEPATITIS B & C
Authors: Shaheen Shugufta , Mahmood Anila , Khushk Salma
Published: September 2021

Hepatitis B and C are serious global public health problems. Objectives:The objective of this study is to assess the knowledge regarding HBV and HCV transmission,risk factors and prevention among women attending the OBS/GYN clinic. Study Design:Descriptive observational study. Period: 1st January 2012 up to 31st of December 2013.Setting: Gynae Department Lady Dufferin Hospital Karachi and Al Tibiri Medical College IsraUniversity Karachi campus. Methods: Total 123 patients were included in study. All the patientswho were admitted during the study period from gynecological surgery were included in thestudy while gynae patients who were managed conservatively were excluded from the study.Blood testing for HbsAg and Anti HCV were done through ELISA. Data was analyzed throughSPSS version 11. Results: Total 123 women were included in the study. Only 56(45.5%)of women and 61(49.5%) of women knew that hepatitis B and C affects which part of bodyrespectively.59 (47.9%) and 22(17.8%) women knew that hepatitis B and C are major healthproblem respectively. 89(72.3%) and 69(56%) of women knew that Hepatitis B and HCV canbe transmitted by blood and blood products respectively.45 (36.5%) and 54(43.9%) womenanswered correctly regarding transmission of HBV and HCV from mother to child respectively69(56%). 41 (33.3%) women and 35(28.4%) women answered correctly regarding treatment ofHBV and HCV through medicines. Only 51(41.4%) and 56(45.5%) women knew that vaccineis available for HBV and no vaccine is present for HCV28 (22.7%). Source of information wasmedia in 62(50.4%) women, relatives and friends in 40(32.5%) women and literature in 21(17%).Conclusion: Our study found that the knowledge about hepatitis B and C among womenattending OBGYN clinic is inadequate.
RENAL TRANSPLANT RECIPIENTS
Authors: Akbar Ruhina , Kauser Naeem , Hussain Naveed
Published: September 2021

Introduction: Good glycemic control and lipid modification are potentiallyimportant intervention for improving outcome after kidney transplantation. Objective: Todetermine the frequency of dyslipidemia and its types in renal transplant recipients (RTRs),and to observe impact of hyperglycemia on their lipid profile. Design: Case control study.Period: June 2011 to May 2012. Setting: Kidney Dialysis Department of Jinnah HospitalLahore, Urology Department of Mayo Hospital Lahore and Pathology Department AllamaIqbal Medical College Lahore. Patients and Methods: A total of 40 RTR were included in thestudy. An equal number of sex and age matched healthy subjects were considered as controlgroup. The patients were on regular post transplant follow up in Kidney Dialysis Department ofJinnah Hospital Lahore and Urology Department of Mayo Hospital Lahore and had no clinicalor laboratory evidence of graft rejection, post-transplant diabetes mellitus, hypertension or intercurrent infection. Total cholesterol (TC), triglyceride (TG), High density Lipoprotein-Cholesterol(HDL-C), and Glycohemoglobin A1c (HbA1c) were estimated in all subjects. These subjectswere divided into Diabetic and non-diabetic groups, according to level of HbA1c. Results:The mean age of the RTR was 34.5± 9.02 years and the mean duration of transplant was36.70 ± 38.07 months. RTRs showed significantly high mean levels of TG (p< 0.002), TC (p<0.00), LDL-C (p< 0.01), and HDL-C (p< 0.05) as compared to the control subjects. ElevatedTC, TG, LDL-C and low HDL was observed in 32.5%, 72.5%, 52.5%, and 60% of total RTR,respectively. The mean levels of TC, TG and HDL-C were increased in Diabetic transplant groupas compared to non-diabetic RTR. Percentage of elevated TC, TG, LDL-C and decreased HDLin diabetic group of RTR versus non diabetic RTR was 43.7% Vs 25% , 81.2% Vs 66.6%, , 62.5%Vs 44.4%, and 50% Vs 66.6% respectively. There was a positive relationship between HbA1cand lipid profile (TC, TG, and LDL – C) in both Diabetic and Non Diabetic Group. A statisticallysignificant correlation of the mean HbA1c levels with TG level was observed in Diabetic RTR.Conclusion: Dyslipidemia in our RTRs was observed as elevated levels of TC, TG and LDL-C. Indiabetic RTR, a statistically significant positive correlation of the HbA1c levels with TG level wasobserved. More rigorous glycemic control and lipid modification will reduce the development ofmicrovascular complications.
MALNOURISHED CHILDREN WITH DIARRHEA
Authors: Zulqarnain Arif , Jaffar Zeeshan , Iqbal Imran
Published: September 2021

Objectives: “To assess the frequency of serum electrolytes (Na+, K+ & Ca+)disturbances in malnourished children with diarrhea”. Study Design: Cross-sectional.Setting: Pediatrics Department Nishtar Hospital Multan. Period: 01-07-2013 to 31-12-2013.Methodology: Approval from the institutional ethical committee was taken. Malnourishedchildren with diarrhea admitted to Pediatrics Department Nishtar Hospital Multan wereregistered. Children meeting the inclusion and exclusion criteria enrolled in the study. Results:In this study there were 90 patients which were found to be malnourished and having diarrhea.The average age of patients was 3.28±1.2 years and the average duration of diarrhea was4.67±0.821 days. There were 58(64.4%) males and 32(35.5%) female patients. Hyponatremiawas present in 28(31.1%) patients, Hypokalemia was present in 55(61.1%) while Hypocalcemiawas present in 12(13.3%).Conclusion: Serum electrolyte disturbances in malnourished childrenare obvious during diarrheal illness particularly in those patients with Grade III malnutrition andmeasurement of these Serum electrolytes is helpful for immediate therapy to avoid serious lifethreatening situations.
ROAD TRAFFIC ACCIDENTS
Authors: Arif Mariam , Ahmed Mushtaq , Rasool Syed Hamad
Published: September 2021

The specter of road traffic injuries takes a greater toll on human life every dayon our roads. Objectives: To analyze the demographic and injury profile of autopsy caseswith an alleged history of RTA (Road traffic accidents). Design: Retrospective study. Setting:Forensic Medicine Department of Nishtar Medical College, Multan. Period: January 2010 toDecember 2013. Material and Methods: 116 autopsy cases with an alleged history of RTA.Data collected pertaining to history, epidemiology, details of injuries and cause of death etc.was statistically analyzed on SPSS version17. Results: Out of 116 autopsies on RTA victims,46.55% victims were between 21-40 years with male: female ratio of 1.9:1. Maximum numberof accidents occurred during day time between 6 am and 5:59 pm (62.06%). 79.31% died atthe site of accidents. Pedestrians were the commonest victims (81.89%). Four wheelers causedmost of RTA 51(43.96%). The cause of death was opined to be head injury in 45.68% of cases.Conclusion: Addressing road safety in a comprehensive manner necessitates the involvementof multiple sectors, such as health, transport and police.
KNOWLEDGE AND ATTITUDE
Authors: Tarar Muhammad Ali , Akhtar Saira , Manj Yasir Nawaz , Akhtar Manzoom , Zafar Muhammad Iqbal , Hussain Nasir
Published: September 2021

Reproductive health is concerned with the people’s ability to have a satisfyingand safe sex life ensuring their capability to reproduce with a liberty of making a decision that if,when and how often they have to do so. In Pakistan, culturally females are married at a youngage; become mothers and are at risk of health complications i.e. HIV/ STD and STI. There isless utilization of reproductive health services throughout Pakistan that ultimately affects healthstatus of people at very young age. Most of the communities are not aware of reproductivehealth services, thus not availing these facilities. Objective: So the present study was designedto examine the females perceptions, attitude and practices about reproductive health servicesas well as to determine the level of their empowerment to take decisions and make choicesregarding their own reproductive health besides determining the level of the quality, availabilityand accessibility of reproductive health services and to suggest some measures for policymakers to improve the reproductive health state of young mothers in district Faisalabad. StudyDesign: A sample of 600 young married females of age 15-32 years was selected throughmultistage sampling technique. Period: 2009. Setting: Rural and urban area of DistrictFaisalabad. Material and Method: Uni-variate (frequency distribution and percentage) and Bivariateanalysis (Chi square and Gamma Statistics) was carried out. Results: Most (44.0%) ofthe respondents belonged to age category of 26-30 years; 35.5% were married for 18 years;39.3% had been married for 5 years; 71.8% had primary and above level of education. Majority(65.9%) had up to Rs.10,000 per month income, 49.2% possessed 6-10 family members,73.5% had at least 2 and above live children. Majority had the knowledge of reproductive health(67.7%) and HIV/AIDs (54.7%) whereas most of females had no knowledge of STIs (69.8%),RTIs (52.3%) and its development (51.8%). Most of the females experienced headache (62.8%),swelling of different body parts (61%) and back pain (62.7%) during their reproductive life. Bivariateanalysis showed highly significant relation among age at marriage, number of children,cultural hindrance and age of respondents vs. their reproductive health. Conclusion: Althoughmost of the females were young & educated mothers with good reproductive health experiencebut still lacking in knowledge about STIs, HIV/AIDS, RTIs and breast cancer that is because ofcultural hindrance, early age marriage pattern and male dominancy which indicates that weneed to pay more attention towards female education and empowerment and decision makingauthority status at domestic level through community mobilization with the help of NGOs,Religious scholars and existing health system/ Health personnel’s .i.e. doctors/ nurses /LHV/FHW.
ILEOSTOMY STOMA WOUND
Authors: Lodhi Muhammad Faisal Bilal , Javed Farhan , Irfan Sofia
Published: September 2021

Objective: The objective of the study was to compare the frequency of infectionin stoma site skin wound closure done by purse string suture and linear suturing techniques.Study Design: Randomized control trial. Setting: Surgical Unit-I, Allied Hospital, PunjabMedical College, Faisalabad. Duration: From 1st Jan, 2014 to 31st March, 2015 (15 Months).Material and Methods: Total number of sixty patients of both sexes with benign disease wereincluded using non-probability consecutive sampling technique after approval from hospitalethics committee. All patients were admitted through OPD and a written informed consent wastaken. They were divided into two groups (30 each). The two techniques of ileostomy stomawound closure used were linear closure and purse-string closure. Data was analyzed usingSPSS v10. Chi-square test was used to compare the outcome (wound infection) in both groups.P-value less than 0.05 was taken as significant. Results: Comparison of infection in stomasite skin wound closure done by purse string suture and linear suturing techniques was donewhich shows presence of infection in 36.67%(n=11) in Linear closure and 10%(n=3) in Pursestringclosure group while remaining 63.33% (n=19) and 90%(n=27) respectively case had noinfection, p value was calculated as 0.01 which shows a significant difference. Conclusions:The frequency of infection in stoma site skin wound closure done by purse-string suturingtechnique is significantly less than linear suturing technique.
METABOLIC SYNDROME
Authors: Hashmi Syed Fasih Ahmed , Dasti Mashooq Ali , Jaffri Muhammad Sajid Abbas , Raza Syed Ali , Junejo Shoaib Zahoor , Akhtar Saeem , Shah Syed Zulfiquar Ali
Published: September 2021

Objective: To determine the frequency of raised serum ferritin level in patientswith metabolic syndrome. Design: Case series study. Setting: Liaquat University HospitalHyderabad. Methods: All the patients with metabolic syndrome for ≥ 01 year duration, ≥20years of age and of either sex were recruited and entered in the study. The metabolic syndromewas detected according to the NCEP-ATP III protocol. After confirmation of metabolic syndrome,the 2cc venous blood sample was taken in a sterilize 5cc disposable syringe, labeled it andsent to laboratory for evaluation of serum ferritin levels. The data was analyzed in SPSS 16and the frequency and percentage was calculated. Results: Total one hundred patients withmetabolic syndrome were evaluated for serum ferritin level during the study period. The mean±SD for age of patients with metabolic syndrome was 52.73±7.83 while the mean age ±SDof patient with raised ferritin level was 50.23±8.21. The majority patients were 30-49 age groupwith female predominance (p<0.01) and exist four component of metabolic syndrome. Theferritin was raised in 60 patients with female predominance (p<0.04). The mean ± SD of raisedferritin level in male and female population was 350.10±19.38 and 270.34±34.39 (p<0.01).Conclusions: The raised serum ferritin level was identified (60%) with female predominance inpatients of metabolic syndrome.
ESSENTIAL HYPERTENSION
Authors: Shah Muhammad Iqbal , Suthar Ramesh Kumar , Soomro Mukhtiar Ahmed
Published: September 2021

Background: Little and sparse information is present in our population onassociation between serum uric acid and essential hypertension .Increased serum uric acid isrelated with elevated blood pressure in different research studies. The relationship betweenserum uric acid level and high blood pressure can be difficult to assess because drugs for highblood pressure usually affect uric acid level. Objectives: The objective of our study is to evaluatethe association of serum uric acid to severity and duration of essential hypertension at LiaquatUniversity Hospital (tertiary care) Hyderabad / Jamshoro Methodology: Study Design: Casecontrol and prospective study. Setting: Medical wards and Out Patient Medicine Department ofLiaquat University Hospital Hyderabad / Jamshoro. Period: One year i.e. from 20th March 2013to 19th February 2014. Methodology: A total of 75 high blood pressure subjects aged 35 yearsand above were included as cases with same number(75) of age & sex matched normal bloodpressure subjects as controls after excluding, Secondary hypertension, metabolic syndrome,Diabetes Mellitus, age <40 ;>70 years, hypothyroidism, hyperparathyroidism, Ischemic heartdisease, congestive cardiac failure,Alcohol abuse, Renal Insufficiency, glomerulonephritis,pyelonephritis, hereditary nephropathy, patients on drugs –, ethambutol,levodopa pyrazinamide,low dose asprin, Cytotoxic drugs, nicotinic acid ,thiazide diuretics.. Qualitative and quantitativedata were evaluated in SPSS version 16.0. Results: The mean serum uric acid level was 6.3± 1.4 mg/dl vs 4.5 ± 1.2 mg/dl in case (n = 75) and control patients (n = 75) respectively. Atotal of 23 (30.6%, n = 75) patients in cases and 8 (10.6%) subjects in control had high serumuric acid (Odds Ratio 2.13, p <0.05). Therefore, the frequency of increased serum uric acidlevel subjects & mean serum uric acid level were significantly greater in hypertensive cases,as compared to those of healthy normal blood pressure Controls. Serum uric acid correlatedpositively with both systolic blood pressure (r=0.132, p<0.01) and diastolic blood pressure(r=0.214; p<0.01). Conclusion: High serum uric acid is frequent in our populace with essentialhypertension and there is relationship between serum uric acid level and blood pressure.Further large scale research studies on the pathophysiologic significance of high serum uricacid in these high blood pressure patients are in further need.
DYSLIPIDIMIA
Authors: Lohano Ashok Kumar , Bhatti Irfan Ahmed , Iqbal Azhar , Jilani Salman Shah
Published: September 2021

Objective: To determine the various lipid profile pattern of dyslipidimia in patientsof chronic renal failure. Study design: Cross-sectional study. Place and duration of study:This study was conducted at Nephrology department of Isra University hospital Hyderabadand Medicine Department Civil hospital Nawabshah, from October 2013 to September 2014.Methodology: This study consisted of 237 patients of chronic renal failure asses on detailedhistory regarding chronic renal failure, patients were subject to relevant investigations i.e.fasting lipid profile and venous blood was drawn after 14 hours fasting state in the early morningand sent to laboratory for analysis of fasting lipid profile. Inclusion Criteria were all patients ofchronic renal failure with 1years history, age > 35 to 60 years and either any sex. Diagnosed onthe basis of serum creatinine as define in operational definition. Exclusion Criteria were patientson lipid lowering agents, acute complication of diabetes mellitus such as diabetic keto-acidosis,patients suffering from hypothyroidism, type 1 DM and HTN, lactic-acidosis, hypoglycemia.Results were prepared with help of tables and graphs. Data was analyzed through SPSS software.Results: Out of 237 patients, 113(47.68%) patients were 51 to 60 years of age, 94(39.66%) were41 to 50 years of age and 30(12.66%) were 35 to 40 years as presented in Chart No 1. Theaverage age of the patients was 50.11±6.94 years. There were 54.43% (129/237) male and45.57% (108/237) female. Various lipid profile pattern of dyslipidimia in patients of chronic renalfailure are presented in table-I. Results of fasting lipid profile are Triglycerides high in 86(36.3%),HDL low in 76(32.1%) cases, LDL in high 83(35%) cases, Cholesterol high in 105(44.3%) casesand VLDL-cholesterol high in 68(28.7%). Stratification analysis showed that lipid profile patternof dyslipidemia was insignificant between male and female as presented in table 2. While withrespect to age groups, rate of Cholesterol, triglycerides, LDL-cholesterol was high in above40 years of age groups as compare to 30 to 40 years of age groups. Rate of low HDL wasalso high in above 40 years of age groups as compare to 30 to 40 years as presented in table3. Conclusions: In conclusion, our study demonstrated that dyslipidemia often our patientschronic renal failure. This underscores the need for the first test patients with lipid abnormalitiesearly treatment can prevent cardiovascular events delay chronic kidney disease.
DYSPEPSIA
Authors: Khan Salman , Ghaffar Tahir , Khan Ismatullah
Published: September 2021

The most common single cause of anemia worldwide is Iron deficiency. It resultsfrom other underlying diseases and to look for its cause is very crucial and is of far greaterimportance than restoring the iron stores and hemoglobin levels. Objectives: To determine thefrequency of common upper gastrointestinal endoscopic findings in elderly patients with irondeficiency anemia presenting with dyspepsia. Study Design: Cross sectional descriptive study.Setting: Department of Medicine, Khyber Teaching hospital, Peshawar. Period: March, 2011 toSeptember, 2011. Materials and Methods: 116 patients, all the patients with iron deficiencyanemia presenting with dyspepsia were subjected to upper gastrointestinal endoscopy todetect common findings as gastric erosions, peptic ulcer and gastric carcinoma. StatisticalAnalysis: Data was analyzed with SPSS 10.0. Results: On upper gastrointestinal endoscopy,normal findings were noted 30 (25.86%) patients and abnormal findings were noted in 86(74.14%) patients including 45 (38.79%) patients with gastric erosions, 30 (25.86%) patientswith peptic ulcer and 11 (9.48%) patients were found with gastric malignancy. Conclusions:Upper gastrointestinal lesions are common in elderly patients with iron deficiency anemiapresenting with dyspepsia and must be screened by gastrointestinal endoscopy.
G6PD DEFICIENCY
Authors: Khan Zahra Rashid , Najeeb Shumaila , Amjad Alina
Published: September 2021

Context: Hyperbilirubinemia due to glucose 6 phosphate dehydrogenase(G6PD) deficiency can cause permanent neurological damage and death in neonates.Screening for the enzyme enables timely diagnosis and treatment in cases of G6PD relatedkernicterus. Knowledge of patient G6PD status is also important in treatment of malaria, adisease endemic in Pakistan. World Health Organization recommends mandatoryuse ofprimaquine for radical cure and eradication of malaria. Since, Primaquine, causes hemolysisin G6PD deficient cases, widespread adoption of the drug is viewed with caution. Aims: Thisstudy assessed frequency of G6PD deficiency in Pakistani noenates and examines the need forits screening based on local disease prevalence and malaria endemicity. Settings and Design:A cross sectional study was carried at Hematology Department, Army Medical College (NUST),in collaboration with Military Hospital, Rawalpindi, Pakistan.(January - August, 2011). Methodsand Material: The frequency of G6PD deficiency in newborn population was determined byquantitative (spectrophotometric) method. Cord blood (2.5 ml blood in K3EDTA bottle) sampleswere obtained from 240 newborns (male: female 1.2:1) after informed consent from parents.Statistical analysis used: Data obtained was analyzed using SPSS Windows version 17.Results: Frequency of G6PD deficient cases was 4.2%. Among the ten G6PD deficient patients,six had severe enzyme deficiency (<10% enzyme activity). Conclusions: The local prevalenceof G6PD deficiency and its potential complications qualify it as a disease that must be screenedfor. Also, prior knowledge of patient G6PD status enables the physician to revert to modifiedtreatment regimen for malaria only in enzyme deficient cases and not otherwise.
PSYCHOLOGICAL DISORDERS
Authors: Irshad Muhammad Khurum , Chaudhry Abid Ghafoor
Published: September 2021

Psychological anthropology is one of the most current academic discipline; theintellectual study of the association between the individual and culture debatably instigatedin the late nineteenth century, when W. H. R. Rivers and his contemporaries commenced anexpedition to Melanesia to examine the perceptions of the local people. Objective: objectiveof the study is to find relationship between old age and psychological disorders. StudyDesign: Cross sectional. Study Locale: The study was conducted in Rawalpindi city. Materialand method: A structured questionnaire was designed to investigate all the variables of thestudy. A sample of 500 respondents were drawn from the older population (older persons) ofRawalpindi city by using convenient sampling technique. Data entry and analysis was doneby using SPSS. Results: There was a significant relationship found between old age andpsychological disorders. According to this study, older people are suffering from psychologicaldisorders namely; anxiety, sadness, depression, isolation, insomnia, dementia, and feelingof being useless. Conclusion: Older persons are more vulnerable to the mental illness andpsychological problems. Some problems are prevailed in high proportion among elder personssuch as anxiety, insomnia and feeling of being useless. Good mind is bound with good health,this clearly depicts that older persons are not suffering from poor psychological health but alsothey are facing adverse health conditions. Statistical observations show that some of the olderadults facing more than one psychological problem, their ratio is 6.2% of total sample.