bluuebunny/crossref_metadata_2025 huggingface dataset:
Impact of Topical v/s Systemic Steroids on Regaining Olfaction in Post Covid-19 Patients; A Randomized Controlled Trail
Authors: Cheema Usama Naveed , Zeb Shahi , Irfan Laiba , Sikandar Mirza Zeeshan , Ashraf Syed Arslan , Munir Khalid
Published: December 2022

Background: Covid-19 is a spectrum of infection not only causing fever and respiratory changes but including alteration in chemosensory functions including; olfactory dysfunction and gustatory dysfunction. In covid-19, olfactory dysregulation could be treated with either systemic steroids or with topical steroids. Objective: To assess and compare role of systemic and topical steroids in regaining normal olfactory functions. Materials & Methods: A Randomized control trial was conducted at Central Park Teaching Hospital Lahore after getting ethical approval and prior written informed consent from participants. A total of 35 patients were recruited were segregated into two groups; Group 1 who were treated with topical steroids (n=17) and Group 2 who were given and treated with systemic steroids (n=18). Time frame of regain of olfaction was compared between the groups using Mann Whitney U test. A p value less than 0.05 was considered as significant. Results: A total of 35 participants participated in this randomized controlled trial who were segregated into two groups with the mean ages of 47.12 + 11.94 and 43.72 + 13.74 with no significant mean difference. On appliance of Mann-Whitney U test in Group 1 and group 2 (52 + 39 v/s 4 + 2) it was observed that systemic steroid patients regain olfaction earlier as compared to group 1 (topical steroids) with the p value of .0001. Practical implication: Systemic Steroids will help in prompt regaining of normal olfaction and should be part of COVID-19 infection management. Conclusion: Olfaction management till the regaining of normal olfactory functions should be part of covid-19 management and role of steroids in crucial yet unavoidable. Systemic steroids play a key role in early regain of normal olfactory response so should be encouraged under the physician observation. MeSH Words: Covid-19, olfaction, steroids, respiratory disorders, randomized controlled trial.
Prevalence of Post-traumatic Stress Disorder in Medical Students
Authors: Habib Osama , Javed Munaza , Mahmood Khalid , Qureshi Muhammad Atif , Butt Nauman Ismat , Ashfaq Fahmina
Published: December 2022

Objective and background: Previous studies have reported a high prevalence of depressive and anxiety disorders in medical students. The aim of the current study was to investigate the prevalence of PTSD symptoms among 1st to 3rd year MBBS students. Place and duration: The study was conducted at Azra Naheed Medical College, Superior University, Lahore, Pakistan from 15th of August o 15th of September 2022. Methodology: A Google form was developed by authors of the study that comprised demographic questions as well as items of post-traumatic stress disorder checklist-Civilian version (PCL-C). The form was posted in the official WhatsApp group of each class and the rationale and purpose of the study were communicated to students. Confidentiality of the data was ensured and anonymity of the participants maintained at all stages. The study was formally approved by the Institutional review board of Azra Naheed Medical College, Lahore. Descriptive statistics, independent samples T-test and the ANOVA test were employed to analyze and report the findings. SPSS version 26 was used for reporting and analyzing the data. Results: A total of 223 medical students (45.4% males) participated in the study. Nearly three quarters of medical students (73.4%) had either moderate, (29.1%) or severe (44.3%) PTSD symptoms. No significant difference was found between the students with regards to gender, age group and year of study. Students who belonged to a mixed rural/urban background had significantly higher PTSD symptoms as compared to students from a predominantly rural or urban background. Practical Implication Medical students should be routinely assessed for the presence of anxiety/depressive disorders, as successful treatment of these disorders may improve the quality of life as well as the academic performance of the students. Conclusions: The prevalence of PTSD symptoms in medical students participating in this study is very high. Future studies should investigate the reasons as well as the risk factors associated with PTSD in medical students. Keywords: Post Traumatic stress disorder, Medical students, Anxiety
Residual Syntax Score as a Predictor of 30-Day Mortality after Primary Percutaneous Coronary Intervention for Acute ST-Elevation Myocardial Infarction
Authors: Satti Khawar Naeem , Mohsin Muhammad , Ijaz Amina , Nazir Atif
Published: December 2022

Objective: To evaluate residual SYNTEX score as a predictor of 30-day mortality after primarypercutaneous coronary intervention (P-PCI) in ST-elevation myocardial infarction (STEMI) patients. Methodology: It was a quasi-experimental study conducted in the Emergency department of Rawalpindi Institute of Cardiology from September 2019 to September 2020. After the study approval from the ethics committee and informed consent, 200 patients presenting with acute STEMI were included by convenient sampling. Primary PCI was done in all patients by theconsultant cardiologists, and then the residual SYNTEX score (rSS) was calculated for each patient. Patients were allocated the case or control group based on rSS: patients with complete revascularization were included in controls and those with incomplete revascularization were labeled as cases. All patients were followed after primary PCI for 30-day mortality. The analysis of data was carried out by the Statistical Package for Social Sciences (SPSS) version 25. Results: The 30-day mortality occurred in 11(5.5%) patients. Mortality occurred in 9(4.5%) patients in the case group and 2(1%) patients in the control group with a significant p-value of 0.03There was a significant association between diabetes mellitus & 30-day mortality (0.032) and a family history of ischemic heart disease & 30-day mortality (0.026). This shows that rSS can be used as a reliable predictor of 30-day mortality after P-PCI in STEMI patients. The patients with high rSS score and risk factors of diabetes mellitus and history of ischemic heart disease are at higher risk of 30-day mortality. Conclusion: The residual Syntax score is a simple, reliable and significant marker of 30-day mortality after P-PCI in STEMI patients. It provides an accurate assessment of the extent of revascularization needed to prevent coronary artery disease and enhance the prognosis following P-PCI. It may also serve as a guide for additional PCI decisions. Keywords: Residual Syntax score; rSS; Primary percutaneous coronary intervention;Acute ST-elevation myocardial infarction; STEMI; P-PCI
Incidence of Herbal Use among Pregnant Women Attending Family Care Center
Authors: Ahmad Saleh Omar Bassam , Nasir Anam , Fatima Najma , Aamir Sobia , Jamal Tooba , Zulfiqar Iqra
Published: December 2022

Background and Aim: Numerous investigations around the globe verified the increasing trend of medicine and complementary use in pregnant women. Pregnant women are not informed of potential teratogenic effects from traditional medicines; some herbal products may cause birth defects in humans. Pregnant women's use of traditional medicine has not yet been evaluated in Pakistan. The present study aimed to determine the incidence of herbal use among pregnant women attending family care centers. Material and Methods: This hospital-based cross-sectional study was conducted on 320 pregnant women attending Family care centers in Jamshoro Hyderabad and Mirpur AJK for the duration of six months from January 2022 to June 2022. Pregnant women attending antenatal care and volunteering to respond were enrolled and those with mental illness and were unwilling to respond were excluded. Herbal medicine self-medication was a dependent variable whereas gestational age, sociodemographic details, and herbal medicine history were independent variables. A questionnaire was designed for determining prior history of herbal use, types of herbal medicine, herbal used in current pregnancy. SPSS version 26 was used for data analysis. Results: Of the total 320 pregnant women, the incidence of herbal use was 86 (26.9%). Based on age, pregnant women were grouped as follows: 64 (20%) in 17-25 years, 148 (46.2%) in 26-35 years, and 108 (33.8%) 35-45 years. The prevalence of herbal usage in the first, second, and third trimesters was 62 (72.1%), 9 (10.5%), and 8 (9.3%), respectively, among 86 herbal-using pregnant women. About 7 (8.1%) pregnant women used herbs in all trimesters. Garlic (Allium sativum) 32 (37.2%), Ginger (zingiberofcinale) 40 (46.5%), Eucalyptus 6 (7%), and tenaadam 8 (9.3%) were different types of herbs used by pregnant women. Conclusion: The present study found that about 26.9% pregnant women used herbal medicine during pregnancy. Majority of women used herbal medicine in the first trimester followed by second and third. Ginger was the most commonly used herbal medicine followed by garlic and tenaadam. Nausea, morning sickness, and vomiting was the most prevalent clinical indications. Keywords: Herbal Medicine, Prevalence, Trimester, Pregnant women
Comparison of Hypertonic Saline vs Salbutamol in Normal Saline Nebulization in Children with Bronchiolitis
Authors: Ali Anjum , Naeem Hafiz Muhammad Muaaz , Rafique Arshad , Hussain Sijjad , Rasheed Makhdoom , Uzair Muhammad
Published: December 2022

Background: Main stay of treatment of acute Bronchiolitis is general supportive care, such as oxygenation, aspiration of respiratory tract secretions, and hydration therapy. Recent research indicates that breathed hypertonic saline is a potential treatment. Objective: To compare the mean length of hospital stay and clinical bronchiolitis score of salbutamol nebulized in normal saline versus hypertonic saline in children with acute bronchiolitis. Material and methods Study Design: Randomized controlled design Setting: Department of pediatrics, Fatima Memorial Hospital, Lahore. Duration of Study: 6 months after approval of the study i.e. from 12th April 2017 to 12th October 2017. Data Collection Procedure: Relevant parameters were identified, and the CBSS was computed. Using random tables, cases were divided among two groups and given salbutamol or hypertonic saline nebs. The length of stay was determined. The Clinical Bronchiolitis Severity Score (CBSS) was recorded based on various variables. Version 17 of the statistical package for social sciences was used for statistical analysis. Result: Patients in the salbutamol group had a mean age of 13.56.66 months, while those in the hypertonic saline group had a mean age of 12.46.58 months. In the group receiving salbutamol, there were 29 males and 31 females. There were 32 men and 28 women in the hypertonic saline group. After 24 hours, the mean CBSS in the salbutamol group was 6.132.47, whereas in the hypertonic saline group, it was 4.881.75. After 24 hours of treatment, the difference in CBSS was significant between the two groups (P0.05). The mean duration of hospitalization was 3.920.81 days with salbutamol and 3.050.77 days with the hypertonic group. In both groups, there was a marked difference in duration of hospital stay (P0.05). Conclusion: Thus, hypertonic saline was more effective than salbutamol in reducing the CBSS score and duration of hospital stay. Keywords: Hospital Stay, Clinical Bronchiolitis Score, Nebulized Salbutamol, Normal Saline, Hypertonic Saline, Children, Acute Bronchiolitis.
Urinary Tract Infections: Epidemiology, Mechanisms of Infection, and Treatment
Authors: Shahzad Muhammad , Khan Ehtesham Malik , Khan Omar Quddus , Tariq Umer Bin , Sabahat Arooj
Published: December 2022

Purpose: The main purpose of this study was to determine the mechanism of infection and the response of preferred antibiotic treatment during this study. Study: This study was conducted from February to March 2022. The approval for this randomized study was taken by the Ethical Committee of the concerned hospital. Written informed consent was signed by all participants. Total of 110 participants who reported problems with UTIs were part of this study. Levofloxacin 750 mg per day for five days and ciprofloxacin 500 mg twice per day for ten days were given to patients for treatment. Results: The total number of patients was 110, 65 (59.09%) males and 45 (40.90%) females having a mean age of 28 ± 5, urinary tract abnormalities were observed in 28 (25.45%) patients including obstruction in 16 (14.54%) patients, stone in 8 (7.27%)cases, the neurogenic bladder was in 4 (3.63%) patients and poly-microbial etiology was in 25 (22.72%) and catheterized patients was 35 (31.81%) in which chronic catheter cases were 15 (13.63%), intermittent catheter cases were 20 (18.18%), and Complicated UTIs was found in 22 (20.02%). 55 patients were treated with levofloxacin 51 (46.36%) reported a positive response and 51 (46.36%) were not cured with a p-value of 0.05. 55 patients were treated with ciprofloxacin of which 48 (43.63%) patients were cured and 7 (6.36%) were not cured with a p-value of 0.05. The number of patients treated with levofloxacin had a higher cured percentage 46.36% than those treated with Ciprofloxacin. Conclusion: Eventually, this study demonstrated that UTIs of all the microorganisms detected during the study can be cured with levofloxacin and ciprofloxacin. While ciprofloxacin was slightly less effective in a few cases than levofloxacin. Keywords: Urinary tract infection (UTIs), Ciprofloxacin, levofloxacin, infection treatment
Laparoscopic Vs Open Surgery for Colorectal Cancer: Comparing Short-Term Results
Authors: Khan Zakir Ahmad , Khan Ajmal , Khan Muhammad Bilawal , Khan Kamran , Khan Muhammad Waqas , Rehman Karishma
Published: December 2022

Background: In developed countries, colorectal cancer continues to rank as the third-most prevalent cancer to be reported and the third-most popular reason for cancer mortality in both genders. Objective: The purpose of the retrospective research was to compare the operational parameters and short-term oncological effects of laparoscopic surgery (LS) with traditional open surgery (OS) in colorectal cancer patients in our hospital. Methods: In this study, 148 patients who underwent CRC surgery between January 2020 and January 2022 at the Medical Teaching Institute (MTI) Peshawar, Pakistan's Khyber Teaching Hospital and Hayatabad Medical Complex Hospital were included. 64 people who had all had LS were included in the study. On the other hand, 84 people who had had OS were randomly selected from groups of people who were of the same gender and age. Result: In the group undergoing OS, the median of dissected lymph nodes was 22.8 (9–35) and 3 (0–14), whereas, in the group undergoing laparoscopy, the median number was 21.56 (8–32) and 6.2 (0–9). For 13 (15.47%) patients undergone through and 9 patients (14.06%) undergone through laparoscopy, blood transfusions were necessary. Although the LS group's procedure took longer than the OS group, their time in the ICU, time to start feeding and duration of stay at the hospital were all shorter. Practical implication Importance Laparoscopic surgery has not been proven to be more effective than open surgery for patients with low rectal cancer. Conclusion: LS provides the benefits of a shorter hospital stay and fewer problems and delivers relatively adequate lymph node dissection. Keywords: laparoscopic surgery, open surgery, colorectal cancer, oncological outcomes, developing countries
Analyzing the Prevalence of Serum Electrolyte Disturbance in Children with Acute Diarrhea and Dehydration
Authors: Shah Syed Junet Hussain , Ali Iqra , Tanvir Amna , Shahzad Qamar U Zaman , . Ibrahim , Chaudhry Abid Rafiq
Published: December 2022

Objective: To study serum electrolyte derangements among children with acute diarrhea presenting with dehydration. Study Design: Cross-sectional and descriptive study. Place and Duration of Study: This study was conducted at Poonch Medical College, Rawlakot and Shalamar Medical & Dental College, Lahore in the duration from January, 2022 to June, 2022. Methods: There were 132 children with severe acute diarrhea and severe dehydration. The ages of the children ranged from one year to twelve. Children's comprehensive demographic information was gathered after written consent was obtained from parents. We took a blood sample of 5 ml and estimated the serum Sodium and potassium levels. All of the data was analyzed with SPSS 23.0. Results: There were majority male children 82 (62.1%). The Mean age of the cases was 2.2±3.11 years. Frequency of severe dehydration was noted in 52 (38.6%) cases, mild dehydration was in 60 (45.5%) and moderate dehydration in 20 (15.2%) cases. Frequency of hyponatremia and hypokalemia was 85 (64.4%) and 53 (40.2%) children. Conclusion: Our results show that children with acute diarrhea and dehydration have an increased risk of developing hyponatremia and hypokalemia. Significant correlations were found between hyponatremia, hypokalemia, and age, gender, and degrees of dehydration. Keywords: Hypokalemia, Dehydration, Acute Diarrhea, Children
Comparison of Serum Albumin Level in Stable & Hospitalized Patients of Chronic Obstructive Pulmonary Diseases (COPD)
Authors: Salam Abdul , Ahmed Ishfaq , Shah Syed Amanullah , Husain Shirjeel , Shah Madiha , Haque Zeeshan Ul
Published: December 2022

Objective: This study was conducted to estimate the serum albumin levels in stable & hospitalized patients of COPD. Study Design: Comparative Cross Sectional Place and Duration of Study: This study was jointly carried out at of Pulmonology at Shaikh Zyed Hospital Rahim Yar Khan, Fatima Jinnah Institute of Chest Medicine Quetta and Liaquat University of medical and health sciences, Jamshoro from 1st January 2021 to December 2021. Methodology: A total of 180 cases of COPD were selected and divided into two groups; group A contained 95 cases of COPD as stable cases, and group B included 85 cases as hospitalized cases of COPD with the mentioned inclusion and exclusion criteria. The serum albumin level was estimated by the bromocresol green (BCG) method. The serum albumin level of less than 3.2 g/dl is considered hypoalbumienimia. The statistical data was analysed by SPSS version 22 by applying an independent student T test. Results: The mean serum albumin level in stable cases of COPD was 3.0 ± 0.41 g/dl while in hospitalized patients it was 2.6 ± 0.34 g/dl. The serum albumin level was statistically(P <0.001) declined in hospitalized patients of COPD as compared with stable cases of COPD. Conclusion:This study concluded that serum albumin level declined in the patients of COPD and the severity of COPD directly proportional with reduction of serum albumin level Keywords: COPD, Serum Albumin, Oxidative Stress, Inflammatory mediators
Association of Spastic Paraplegia and Short Stature in Patients of Autosomal Recessive Intellectual Disability
Authors: Khan Jamshed , Hanif Muhammad , Zaman Nayyer Uz , Khan Dost Muhammad , Waqar Muhammad , . Usmanullah
Published: December 2022

Background: Intellectual Disability “ID” is a genetic disorder, which lead to arrested or incomplete development of the brain. It is the limitation of cognitive skills impairment and decline ability of a person in learning process. ID is the most common health problem in worldwide. These patients have decline intellectual functions and at least limitation in their two or more adoptive skills such as reading, writing abilities, social interactions, Behavioral habits, self-care, communication ability etc. The time period for the diagnosis of ID is the onset of disease before the eighteen years of age. Spastic Paraplegia and short stature is a general terminology using for a group of an uncommon inherited diseases that cause stiffness and weakness in the lower limbs muscles. Gradually its symptoms get worse with the passing of time. It's also called as familial spastic paraparesis or Strümpell-Lorrain syndrome. SP is classified clinically as “complicated" (syndromic) or "uncomplicated" (nonsyndromic) Spastic Paraplegia. Methods: This study was started in March 2014 to Aug 2015. The criteria for the selection of families were consanguineous families with two or more than two ID patients. The patients were examined, interviewed one by one in friendly atmosphere. Then the blood samples were taken by aseptic method. Blood samples were processed in laboratory. DNA extraction and PCR was done. After that Exome sequencing was used to find the pathogenic variants. The data was analyzed by CATCH. Sanger Sequencing was applied to see the segregation. Results: In ID-family1 the variant of AP4B1 was segregated with the disease phenotype. These ID patients have short stature and Spastic Paraplegia. Mutation in AP4B1 is known to cause intellectual disability. In ID-family2 the variants of WDR62, EML2 and KCNK6 were co-segregated with disease phenotype. But only mutations in WDR62 are known to cause intellectual disability. ID family2 also identified as short stature. In ID-family3 Exome sequencing data reveal no putative variants. Conclusion: The present study was conducted in three consanguineous families for the determination of the responsible genes for intellectual disability. Exome sequencing revealed putative mutations in AP4B1 and WDR62 in two out of three families. In third family we could not locate any putative mutation. Keywords: Intellectual disability ID, Autosomal recessive disorders, Autosomal recessive nonsyndromic ID, Behavioral Abnormality, Segregation, Exome sequencing, Spastic Paraplegia, Short stature.
Assessing Responsiveness of Elevated Serum Ferritin Levels for Treatment in Patients with Chronic Hepatitis C Infection
Authors: Ullah Waseem , Adeel Bushra , Iqbal Anil , Ayyaz Muhammad , Joher Imran
Published: December 2022

Background: The infection of HCV is recognized worldwide as an important community health problem. There is an optimistic correlation between accumulation of iron in hepatocytes and amplified serum levels of markers, counting ferritin and transferrin. Aim: The goal of this study is to determine the response of serum levels of ferritin after the patient’s treatment with HCV infection. Material and methods: The study included 140 HCV-infected patients. All subjects were evaluated for clinical topographies, including HCV viral load, status of serum iron levels and biochemical data. The obtained outcomes were calculated by means of Microsoft Excel 2013. Results: The results showed that treatment with antiviral drugs interfered significantly the iron deposition in hepatocytes and have association between iron accumulation and HCV treatment. The mean iron value was 20.02 µmol / L for the positive PCR patients; and for a negative PCR reaction, 25.11 µmol / L was the estimated value before treatment. Both values were lower the normal array of 9-31.3 µmol / L. It is estimated that the mean ferritin value for negative PCR (668.55 µmol / L) and positive PCR (913.14 µmol / L) is above normal range which is 221 to 641.35 µmol / L. Conclusions: Patients with chronic HCV are significantly related to serum iron levels. High levels of iron and ferritin were associated significantly with the disease, resulting progressive fibrosis in the liver. There is no considerable change in serum iron markers among subjects with increased or less severity of HCV infection. The severity of the disease can be evaluated easily by measuring the serum transferrin levels along with ferritin levels, which are linked with the progression of fibrosis of the liver and necro-inflammatory activity. Keywords: levels of serum ferritin; iron load; drug; liver cells and HCV infection.
The Epidemiological Characteristics of Diarrheagenic Escherichia Coli among Children with Acute Diarrhea
Authors: Masood Ayesha , Heral Hassan Raza , Masood Fatima , Imran Sehr , Farooq Zuhaib , Naqvi Syed Zeeshan Haider
Published: December 2022

Background: Diarrhea is known as one of the highly infectious diseases affecting the world population around the globe especially the children community. It is associated with the highest mortality and morbidity rates in children. Objective: The study was carried out to find the characteristic features of diarrheagenic Escherichia coli among children with acute diarrhea under the age of 5 years. Study design: It is a prospective based study conducted for the duration of the one year from September 2021 to August 2022. Material and Methods: There were 130 patients that participated in this study. The samples were collected from each patient. The clinical symptoms and demographic features of each patient were recorded. The SPSS was used for statistical analysis. Results: Some of the features that were commonly observed among children were nausea (n=23), vomiting (n=32), abdominal pain (n=60) and fever (n=12). There were 27% patients that reported diarrhea in spring, 26% in autumn, 33% and 12% in summer and winter respectively. It was found that the isolate rate was decreasing in the order from EPEC, EAEC, ETEC, STEC and EIEC in age group 0-11. Conclusion: This study reported that EPEC is an important phenotype present among children under the age of 5 who are suffering from DEC infection. The drug resistance cases are increasing in DEC strains with time. The antibiotic resistance was shown for ampicillin in both DEC strains and the aEPEC subtype. The data can be used to study the antimicrobial investigation against these strains. Keywords: Escherichia coli.
Halitosis and its Psychosocial Effects Among Patients Reporting at Dental out Patients Department: A Neglected Oral Health Issue in Pakistan
Authors: Siyal Ghulam Ali , Siddiqui Muhammad Ilyas , Ariser Kanwal Naz , Shah Rafaina , Adil Muhammad , Najeeb Muhammad , Kandhro Rehmatullah
Published: December 2022

Objective: To assess the burden of halitosis among dental patients and to explore the psychosocial factors associated with halitosis at Liaquat University Hospital, Hyderabad. Study Design: Cross sectional study Study Setting & Duration: was conducted at Dental OPD of Liaquat University Hospital Hyderabad from March to August 2017. Patients presented with halitosis at Dental OPD of Liaquat University Hospital Hyderabad via convenient sampling technique were selected within duration of six months. Methodology: A group of 239 subjects were included in this study and the simple convenient sampling technique was used to obtain data for the research. Written consent form was taken from each subject. Results: Among 239 participants, 115 were male and 124 were female. 81.59% of patients reported experience of bad breath.62.50% of individuals claimed that having bad breath had made them less social, 65% of respondents said they feared social interaction and public events. Conclusion: The most of participants of the study had halitosis, whether it was real or imagined, and it had an effect on the patients' social and marital lives and produces psychiatric symptoms such as stress, lack of confidence, isolation and avoidance of gathering. Keywords: Halitosis, Socialization, Emotional distress, Self-confidence
A Systematic Review On Complications of Intrahepatic Cholestasis of Pregnancy
Authors: Chaudhary Sadia , Anjum Hafiz Hafeez , Khan , Muhammad Usman , Khurram Amna , Nazim Uzma , Dar Merub Maqsood
Published: December 2022

A potentially dangerous liver condition called intrahepatic cholestasis of pregnancy (ICP) can appear during pregnancy. Primarily manifesting in the third trimester, characteristic symptoms include pruritus (itching) of the soles and palms, elevated blood bile acid levels, and impaired liver function. Several medications have been demonstrated to significantly improve biochemical indicators and gestational age of birth in patients with ICP, and they also alleviate the pruritus experienced by the mother. The use of these drugs during pregnancy may have serious consequences. This systematic review aims to describe maternal and foetal outcomes related to ICP and identify major biochemical and clinical predictors of foetal problems in women diagnosed with ICP. To provide context for the current investigation, Google Scholar and PubMed were searched for articles published between 2012 and 2022. References and bibliographies were employed in manual searches in addition to internet resources. Critical Appraisal Skills Program (CASP) evaluated all selected research papers. Findings were presented using descriptive summary table besides critical analysis. Risks of adverse perinatal outcomes, such as stillbirth and early delivery, were associated with twin pregnancies with ICP. But, premature delivery and neonatal hypoxia are more common in IVF-created twin pregnancies than in naturally conceived twin births. Severe ICP effects are linked with higher risks of stillbirth, admission to a neonatal intensive care unit, and preterm delivery. Some perinatal issues are associated with a mother's serum bile acid levels rising during pregnancy. Congenital disabilities, premature birth, and postpartum bleeding are all associated with ICP. Extreme instances of ICP frequently result in the abrupt and unexpected death of the fetus inside the uterus. ICP and stillbirth develop early in twin pregnancies. Therefore, delivering at 37 weeks may not be desirable. Enhancing fetal prognosis, particularly in twin pregnancies generated through IVF, requires early and correct diagnosis and proper medical intervention. To reduce the likelihood of an indicated preterm delivery, the decision to terminate a pregnancy in pregnancies created through IVF should be made carefully. Despite the fact that there was a clear link between ICP and preeclampsia and GDM, ICP did not raise the risk of stillbirth. Bile acid levels between the mother and fetus correlate, suggesting a causative link between BA levels, prenatal problems, and bad outcomes. Keywords: Intrahepatic cholestasis of pregnancy; pregnancy outcomes; gynecology; women health
Association of Anemia with Postpartum Haemorrhage
Authors: Awan Shazia Mahmood , Khanum Faiza , Rana Nabgha Khan , Afreen Uzma , Karim Faisal Syed Fazal E , Nayyar Shazia
Published: December 2022

Introduction: Maternal anaemia is a common condition. According to the World Health Organization, pregnancy anaemia and postpartum anaemia is very frequent across the world, and confers a number of health risks to mother and child. Maternal symptoms and signs include fatigue, paleness and cardiovascular strain, reduced mental and physical performance and increased risk for blood transfusion. Objectives: To determine the association of maternal anaemia with postpartum haemorrhage in pregnant females presenting for antenatal check-up Study Design: Case control study Setting: Department of Obstetrics and Gynaecology B Unit, Mardan Medical Complex. Duration of Study: Study was carried out over a period of six months from 01-08-2019 to 31-01-2020 Subjects and Methods: A total of 224 patients (112 in each group) were included in the study. Cases were females with PPH and controls were females without PPH. Results: Mean age of the patients was 28.0±4.3 and 28.2±5.1 in group-A and B, respectively. Mean gestational age was (38.7±1.8 vs 38.5±2.4), mean BMI was (27.0±4.2 vs 26.2±4.6) and mean Hb was (9.1±2.1 vs 9.9±1.9). Majority of the patients were between para 1-2 in both cases. Anaemia was found in 59 patients (52.7%) of cases and 36 patients (32.2%) of controls (Odds ratio 2.35; 95% CI 1.36 - 4.04). Stratification for age, gestational age, BMI and parity was also carried out. Conclusion: In conclusion, postpartum anaemia has a high prevalence. Anemia during the third trimester of pregnancy, heavy bleeding perceived by the mother during delivery, younger maternal age was associated with postpartum anemia. Keywords: Anaemia, Blood loss, Postpartum haemorrhage
Speech Therapy for Post Thyroidectomy Patients: A Clinical Audit
Authors: Khan Amir Hamza , Khan Kashif Ullah , Zaman Iqbal , Haq Ihtisham Ul , Shah Syed Majid Ali , Mabood Jawad
Published: December 2022

Objective: We aim to audit the provision of speech counselling to those patients who underwent thyroidectomy for their respective diseases who presented to surgery department in 2021 Methodology: This clinical audit was conducted in surgical D unit department of Surgery, Khyber Teaching Hospital, Peshawar from January 2021 to November 2022. A total of 50 patients each for the audit group and the re-audit group were selected through non-probability consecutive sampling for both genders. A predesigned proforma According to clinical practice guidelines and British association of endocrine and thyroid surgeon’s guidelines (BAETS) was used. Data was entered into Microsoft excel, analyzed through SPSS version 23 and results were presented in the form of descriptive writing and tables. Results: The mean age of the study population was 42.64 +/- 11.51 with relatively more female patients. None of the patients in the audit group were properly given speech counselling irrespective of their disease or surgery status. In the re-audit group, 100% of the patients were given proper post-operative speech therapy which resulted in 84% percent of the patients attaining their usual voice, seven patients having some roughness in their tone and only one patient having occasional problems with breathing. Conclusion: Despite their rarity, voice changes after a straightforward thyroidectomy can be quantified. For ethical and legal reasons, this is significant in the preoperative and postoperative counselling of patients before thyroidectomy.
Association of Dengue Disease with ABO RH Blood Group
Authors: Uddin Badi , Khan Pordil , Saad Ammar Bin , Ali Sajid , Muneer Ayesha , Bibi Mehwish
Published: December 2022

Background: Dengue viral infection is a global public health issue. Several viral and other host factors are the contributed factors including the ABO blood group for transmission of dengue virus (DENV). ABO blood groups have been shown to involve in the intensity of DENV. This study aims to find the association ABO and Rh blood group with DENV infection. Methods: This cross-sectional study was conducted in tertiary care hospital. All DENV NS-1 positive patients were included irrespective of age and gender. The blood group of all DENV-infected patients was determined through ABO and Rh anti-sera (forward blooding grouping). Descriptive data were analyzed through SPSS and Microsoft Excel. Results: Among a total of 105 dengue-infected patients, male were 68 patients and female were 37 patients. The highest number of cases were found in the age group 21-30 years and 11-20 years. The predominant blood group was found A positive in dengue viral infected patients while AB negative blood group was found common in Rh negative blood groups. Conclusion: Blood group A positive and AB negative patients in Rh positive and Rh negative blood groups had more risk of dengue viral infection as compared to other blood groups. Further studies are necessary to find the severity of patients with different blood groups. Based on their differential distribution in the community and their correlation with mosquito performance, it can be deduced that the risk of contracting dengue infection differs with the ABO and Rh blood groups. Additional study is necessary to determine whether HLA, dengue serotype, and ABO are experimental/predictor factors, and whether certain blood subgroups are associated with a disproportionately higher risk of dengue virus infection. Keywords: Dengue viral infection, Serotype, Anti-A, Anti-B, Anti-D, ABO, Rh blood group
Correlation of Vitamin B12 Deficiency with Blood Glucose Level in Pregnant Females of Tertiary Care Hospital, KP
Authors: Yousaf Mohammad Noman , Shaheen Sajida , Fatima Nighat , Bibi Mehwish , Shah Abid Ullah , Khattak Imran Qadir
Published: December 2022

Background: A developing fetus can be adversely affected by gestational diabetes mellitus (GDM). This condition is prevalent among South Asian women. A contributing factor to GDM is insulin resistance (IR). Only a few B12 and folate markers have been studied in association with GDM and IR, as studies have shown vitamin B12 (B12) and folate status to be associated with GDM. Objective: The current study aimed to determine the association between Vitamin B12 and folate markers and insulin resistance in pregnant women with GDM and NGT. Methods: Pakistani women (29 GDM and 41 NGT) with a mean age of 29 y, BMI, and gestational age of 33 weeks were included in the research. The serum total vitamin B12, and other parameters like folate, methylmalonic acid, plasma homocysteine and 5-methyl tetrachloro folic acid (RCF). The T-tests and chi-squared test and spearman's correlation test were used to determine whether there was any correlation between vitamin B12 and blood glucose levels in pregnant women with and without gestational diabetes. A simple multiple regression analysis was used to see whether B12 and folate status indicators predicted Insulin Resistance (IR). Results: There was no statistically significant difference between NGT and GDM, demonstrating that both groups have the same features. Although a significant difference was found between BMI (p=0.037), Serum Fasting Glucose (p=0.001), HOMA_IR (p=0.001), Serum HDL (p=0.001), Serum TC (p=0.040), and Systolic BP (p=0.001). Women in both groups took iron and folic acid supplements in roughly equal numbers. Still, the GDM group had an excess of women taking multivitamin supplements (P = 0.039) and women taking iron supplements (P=0.001). In Spearman’s analysis HOMA-IR correlated negatively with total serum B12 (P < 0.00). The regression model is statistically significant with (F=1.927, P=0.046) p-value is less than the alpha value. Coefficient of determination R2=0,309, which indicated that 30.9% variation came in the response variable due to the explanatory variable and the rest due to other unknown factors. Practical implication Conclusions: it is concluded that there is a significant correlation between vitamin B12, folate and blood glucose level in Pakistani pregnant women in the third trimester. Moreover, vitamin B12 and folic acid have an impact on fetal health, i.e., weight, length and circumference of the head and chest. Keywords: gestational diabetes Mellitus, HOMA-IR, normal glucose tolerance, Peshawar
Isolation of A Novel Bacterial Strain Planococcus Plakortidi from Ross Broiler Chicken Gut (CECUM) with Combination of Non-Starch Polysaccride Degrading Pectinase Enzyme
Authors: Kanhar Asif Raza , Hussain Syed Fiaz , Shar Abdul Hussain , Ujjan Javed Ahmed
Published: December 2022

Purpose: In many countries, including Pakistan, broiler chickens and the poultry industry are severely affected by bacteria. Broiler chickens are infected with Gram-positive and Gram-negative bacteria. Methods & Findings: The current study successfully isolated non-starch polysaccharide (NSP) degrading a novel strain Planococcusplakortidi (PCB2) from the chicken gut cecum, screened out from 60 samples. Practical Implication & Conclusion: Furthermore, the isolate was taxonomically characterized based on its cellular morphology, physiological, and chemotaxonomic characteristics, as well as the phylogenetic similarity index of the 16S rRNA gene sequence. The bacterium was found to exhibit maximum production of pectinase enzyme on the eighth day of incubation at 37℃. Keywords: Broiler chicken, gut microbiota, cecal bacterial diversity, chicken food digestion, Non-starch Polysaccharides
Immediate Postoperative Complications and Recovery Profile Following Spinal Anaesthesia: A Comparison Between Pethidine and Bupivacaine
Authors: Arjumand Sabeen , . Fareeha , Tariq Hajra , Zahid Wajiha , Irum Zoobia , Fatima Shahnaz
Published: December 2022

Background: Spinal anaesthesia is a less expensive option to general anaesthesia for surgical procedures below the umbilicus in resource-constrained settings with a shortage of medical gases and specialized an anesthetists. The patient’s airway is not harmed by spinal anaesthesia, and both the patient and the doctor benefits from a host of additional benefits. Following the discontinuation of hyperbaric lidocaine for intrathecal injection because it can results in radiculopathy, bupivacaine is frequently used for spinal anaesthesia. For spinal, doctors employ pethidine, a lipophilic opioid with local aesthetic properties. In this study, pethidine bupivacaine were used as the only anaesthetic a gents to perform spinal anaesthesia, and the immediate postoperative problems and recovery profile were compared. Methodology: For quick surgical procedures on the lower body, 52 American Society of Anesthesiologists physical status I and II patients between the ages of 18 and 60 were randomly assigned to receive spinalanaesthesia. The patients' recovery times for pinprick sensation at S2, plantar flexion, big toe proprioception, and full motor recovery (Bromage score 0) were compared after receiving either 2.5mL of isobaric 0.5 percent bupivacaine or 1mg/Kg of preservative-free pethidine. The immediate postoperative period complications of pain, drowsiness, nausea and vomiting, pruritus, and urine retention were compared. Results: The time to return of pinkprick sensation at S2 was 94.6220.25 minutes and 205.9631.05 minutes, respectively, when pethidine and bupivacaine were compared. Pethidine and bupivacaine had a time to return of plantar flexion of 92.8812.01 minutes and viii 1 93.8539.56 minutes, respectively. Between pedthidine and bupivacaine, the mean recovery times f or the big toe’s proprioception were 31.159.41 and 172.5042.70 minutes, respectively, for full motor recovery (Bromage score 0). All recovery time variation were significant (p 0.0001) across the broad. There was no discernible change in the incidence of pain or sedation in the immediate postoperative period. In the Bupivacaine group, four patients (15. 38%) reported having hardly bearable discomfort. Both groups did not experience any instances of nausea or vomiting. Pruritus was experience by five patients (19.22%) in the pethidine group, but none in the bupivacaine group (0.00 %). Urinary retention incidence varied, and this difference was significant (p = 0.048) Conclusion: Compared to bupivacaine, pethidine had a quicker recovery profile and didn't lead to any major complications right after surgery.
Intravenous Oxytocin Vs Vaginal Prostaglandin E2 for Inducing Labour in Prelabor Rupture of Membranes at Term
Authors: Ali Syeda Sana , Aslam Lubna , Memon Fareen , Imran Sajida , Inayat Ayesha , Naseem Hifsa
Published: December 2022

Objective: In patients with prelabor membrane rupture at term, evaluate the relative effectiveness of vaginal prostaglandin E2 and oxytocin infusion for induction of labour. Study design: Randomized clinical trial Place and Duration: This study was conducted in the multi centers at the Department of Obstetrics and Gynaecology, Murshid Hospital and Health Care Center Karachi, Sindh and PGMI/AMC/LGH Lahore, Punjab in the period from March, 2022 to August, 2022. Material and methods: Ninety patients with term membrane rupture who were brought through emergency for induction of labour were randomly assigned to either group I (oxytocin) or group II (vaginal prostaglandin E2) and monitored until delivery. We recorded the number of vaginal births that occurred within 24 hours of the induction of labour and the time it took for labour to begin after the induction. All of the data was analyzed with SPSS 23.0. Results: Mean age of the patients in group I was 26.5±6.26 years and in group II mean age was 24.7±5.60. Mean BMI in group I was 25.1±8.16 kg/m2 and in group II mean BMI was 26.1±7.36 kg/m2. Those who were induced with intravenous oxytocin had 22 (48.9%) vaginal deliveries within 24 hours, while patients who were induced with vaginal PGE2 had 32 (71%) vaginal deliveries within 24 hours. Conclusion: The findings of this study led us to the conclusion that vaginally administered PGE2 causes more patients to deliver their babies vaginally within twenty-four hours. Keywords: Oxytocin, Induction of labor, Rupture of membranes, PGE2
Prevalence and Predisposing Factors of Post Renal Transplant Erythrocytosis
Authors: . Mazharulhaq , Khan Aimal , , Tahir Taleah
Published: December 2022

Objective: Aim of current study was to determine the factors and prevalence of post-transplant erythrocytosis after kidney transplantation. Study Design: Retrospective study Place and Duration: Institute of Kidney Diseases Hayatabad Peshawar during June 2021 to December 2021. Methods: Total 118 patients of renal transplant were presented. Participants' full demographic information was recorded after getting written consent from each participant. Association of risk factors and prevalence of post-transplant erythrocytosis were recorded. Hematocrit (Ht) above 52% and haemoglobin (Hb) over 18 g/dl in males and Ht over 50% and Hb over 17 g /dl in females were considered to be indicative of true PTE. We used SPSS 18.0 to analyze all data. Results: The mean age of the patients was 50.6±2.31 years with mean BMI 27.4±11.52 kg/m2. There were majority 76 (64.4%) patients were males and 42 (35.6%) patients were females. Frequency of PTE was found in 23 (19.5%) cases and 95 (80.5%) cases were without PTE. Most common factors for PTE development were endogenous erythropoietin, local renal hypoxia, endogenous androgens, insulin-like growth factors and the renin-angiotensin- aldosterone system. Mean duration of dialysis in PTE group was 25.1±7.48 months and duration of patients without PTE was 51.9±6.75 months. Frequency of diabetes, hypertension, glomerulonephritis, polycystic kidney disease and graft failure were higher in PTE patients as compared to non-PTE. We found higher number of acute rejection in PTE patients as compared to non PTE cases with p value <0.009. Conclusion: We concluded in this study that the shorter duration of dialysis and higher number of acute rejection before kidney transplant were the risk factors for post transplant erythrocytosis. Most common factor for PTE development was renin-angiotensin- aldosterone system. Keywords: Erythrocytosis, Transplantation, Kidney, Dialysis
Pattern of Uterine and Cervical Lesions Marked on Histopathological Examination of Hysterectomy Specimens
Authors: Khalid Henna , Riaz Mariam , Abbasi Momina Khadija , Adeel Bushra , Shoukat Sadia , Fateh Reema
Published: December 2022

Background: In Gynecology, most of the knowledge circles around the female reproductive tract and uterus has been a vital organ playing central role in female reproductive life cycle both in terms of menstrual and ostereous cycles. Uterus is subjected to both mechanical and hormonal stresses so uterine pathologies and diseases are the most common pathologies marked in female reproductive systems. These pathologies range from benign uterine pathology to malignancy in many cases. Most of the uterine and cervical pathologies are diagnosed after hysterectomy on histopathological examination only. Objective: The study was carried out to see histopathological patterns of uterine and cervical lesions in hysterectomy specimens. Study Design: Histopathology department of Women Medical and Dental College, Abbottabad from August 2021 to August 2022. Materials and Methods: It was a retrospective study done on hysterectomy samples findings in histopathological examination of uterine and cervical area on 80 specimens over a 1 year period. SPSS latest version was used for DATA. Results: 80 patients were included based on histopathological reports of the post hysterectomy specimens. Age of patients lies < 30 years to > 60 years. Majority of the cases were between 41-50 years and 51-60 years of the age while patients between 41-50 years age group were 50 %,adenomyosis (09%), atrophied uterus (5%), Hyperplasia (10%), leiomyoma with adenomyosis (18.5%), Leiomyoma (55%) and leimyosarcoma (2.5%),while cervical pathologies show cervicitis, (62%), cervical dysplasia (21%), cervicitis (papillary) in 07 %, and 10% cases were normal. Different uterine lesions based on the age of the patients show that Leiomyoma is maximally found in patients between 46-60 years and above 60 years of patients and only two cases were marked below 30 Years. Conclusion: The commonest benign lesion was leiomyoma in uterus followed by adenomyosis combined with leiomyoma, while in cervical canal commonest finding was cervicitis in Hysterectomy specimen. Keywords: Adenomyosis, Histopathology, Hysterectomy, Leiomyoma, Cervicitis.