bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Nandrolone Decanoate and Exercise on Histological Structures of Soleus Muscle of the Female Rat
Authors: . Usmanullah , Waqar Muhammad , Khan Dost Muhammad , Zaman Nayyer Uz , Hanif Muhammad , Khan Jamshed
Published: December 2022

Nandrolone Decanoate (ND) as most frequently used as performance enhancing drug, the present study was conducted to investigate the histological changes produced by ND alone and in combination with exercise on soleus muscle. Forty female rats were divided equally by randomized control trial (RCT)i.e BI (control), BII (ND5mg/kg intramuscular twice weekly) BIII (Exercise/swimming) BIV (ND & Exercise) for 12 weeks at the animal house of PGMI, Lahore during the year 2010. Data was recorded on various microscopic parameters viz; internalization of nuclei, splitting in muscle fibers, rounded or angular muscle fibers and diameter of fibers for control and experimental groups.Results regarding internalization of nuclei revealed significant (P≤0.006, 0.013) differences among the groups receiving ND in comparison to control and exercise and highly significant (P≤0.001)differences were observed in animals subjected to ND and exercise in comparison to control. Splitting of muscle fiber was observed in group BIII and BIV (P≤0.001) in comparison with control. Significant increase in diameter of muscle fiber was observed in group BIII (P≤0.005) and BIV (P≤0.001) in comparison to control.Similarly, minimum degenerative changes were observed showing angular or rounded fibers in group BIII andBIV in comparison to control. The instant results suggest that significant hypertrophy was observed in animals subjected to ND and exercise. Keywords: Soleus, splitting, diameter, internalization of nuclei, female
Determine the Frequency of Silent Cardiac Ischemia in Type II Diabetes Mellitus Patients
Authors: Sadiq Tahira , Khalid Zurqa , Theba Fareha Kashan , Naz Kanwal , Tareen Mujeebullah , Saleem Aniqa
Published: December 2022

Objective: The purpose of this study was to ascertain the prevalence of silent cardiac ischemia in diabetic patients with type II diabetes. Study Design: Cross-sectional Place and Duration: This study was conducted at Fazaia Medical College, Islamabad from January, 2022 to June, 2022. Methods: Total 115 patients of type-II diabetes mellitus were presented in this study. After taking a thorough medical history, the patient had electrocardiography (ECG) both before and after exercise tolerance testing. This was done in addition to recording their height, blood pressure, weight, and fasting blood sugar levels (ETT). Changes in the electrocardiogram were analysed, and the patient was classified as having silent cardiac ischemia or not depending on the results of the ECG. SPSS 22.0 was used to analyze all data. Results: There were 75 (65.2%) males and 40 (34.8%) females in this study. The mean age was 51.13± 10.29 years and had mean BMI 26.7±8.44 kg/m2. Mean fasting blood sugar was 171±22 mg/dl. Frequency of hypertension was found in 47 (40.9%) cases and 38 (33.04%) patients were smokers. We found that 50 (43.5%) cases had silent cardia ischemia. There was a strong correlation between silent cardiac ischemia and factors such as increasing age, prolonged duration of diabetes mellitus, a smoking history, a history of hypertension, and an increased body mass index (p-value 0.05). Conclusion: We observed that silent cardiac is quite frequent in our population, which necessitates immediate measures to diagnose this issue early for the sake of improved results in the future. Keywords: Type II diabetes mellitus, BMI, Silent cardiac ischemia, Hypertension
Efficacy of Calcium Phosphate Composite Bone Graft in Treatment of Periodontal Intrabony Defects: Clinico-Radiographic Study
Authors: Shirazi Bilal Haider , Ali Syeda Sahar , Aminwala Muhammad Salman , Zafar Shaista , Ali Aleezah , Arbaaz Syed Ahmed , Fazal Sabeen
Published: December 2022

Background: The loss of alveolar bone support is the main symptoms of the destructive periodontal disease. Periodontitis leads to formation of the interbony defects. For resolution of the infection, the elimination of IBD is highly needed. For the filing of the IBD and regeneration of the bone in the periodontal therapy, different bone grafts are used. Objective: The study aimed to evaluate the efficacy of calcium phosphate composite bone graft in patients suffering from periodontal intrabony problems. Study Design: It is a randomized and interventional study conducted at Multan Medical & Dental College, Multan and DOW University of Health Sciences, Karachi for the duration of six months from December 2021 to May 2022. Material and Methods: The study was conducted on 16 patients that fulfilled the inclusion criteria. All the patients completed the follow-up. The radiographic parameters were also evaluated. The baseline data from six months and three months was analyzed and data was plotted. Results: It was found that the primary closure was carried out for all the patients. There was no statistical significance found between the groups related to depth of the defect and the walls number groups before operation. There was a prominent reduction in plague concentration and gingival index. In case of test group there was a greater statistical reduction in the test group as compared to the control. The recession of gingival parameter was seen in both the groups. There was no statistical difference observed here. Conclusion This study helps to provide significant results and evidence that the easy graft crystal can be used for the treatment of periodontal intrabony issues. Keywords: Intrabony defects and calcium phosphate composite bone graft.
Comparison of the Surgical Outcomes of Free Flap Reconstruction in Head and Neck Cancer Patients
Authors: Babar Mehreen , Usman Fatima , Shinwari Wajih Ud Din , Nagra Sajid Rashid , Ahmed Salman Aftab , Nadeem Khurram
Published: December 2022

Objective: The goals of this research were to (1) assess the efficacy of free flap reconstruction in patients with early and recurrent head and neck cancers, and (2) investigate the variables associated with these surgeries that increase the risk of problems. Study Design: Retrospective Study Place and Duration: Frontier Medical College, Abbottabad, from March, 2022 to August, 2022. Methods: Total 200 patients of head and neck cancer were included in this study. Patients were both males and females with primary and recurrent cancer types were underwent for free flap reconstruction. After receiving informed written consent, in-depth demographic information about the cases that were enrolled was recorded. Patients were divided in two groups. Hundred patients of recurrent cancers were included in group I and 100 patients of primary cancers were included in group II. Surgical outcomes among both groups were assessed and compared. SPSS 24.0 was used to analyze all data. Results: We found that 87 (87%) patients in group I and 81 (81%) patients in group II were males. Mean age of the patients in group I was 49.8±11.37 years and in group II mean age was 51.4±7.42 years. Majority of the patients had tumor stage 5. Smoking, betel nut and alcohol were the most common causes found in all cases. Anterior lateral thigh (ALT) and anterior medial thigh (AMT) were the most common flap types among both groups. We found that free flap reconstruction had higher success rate in primary cancers found in 96 (96%) as compared to recurrent cancers group in 92 (92%). There was no any significant difference found among both groups in terms of post-surgery complications. Conclusion: This study's findings suggest a greater failure rate for free flap reconstruction in the recurrent group compared to the primary group, however this finding may be attributable to the varied patient characteristics between the two groups.
Effects of Inhaled Corticosteroids on Bone in Asthma Patients
Authors: Ali Saqib
Published: December 2022

Background: Although inhaled corticosteroids are taken into the bloodstream, it is unclear how much damage they do to bones. The issue is crucial because 3% of people consistently use inhaled corticosteroids and could be doing for several decades. Method: In 195 adults (118 women) with asthmatic, aged 25 to 45, we examined the dose-response relationship between total inhaled corticosteroid dosage and bone mineralization concentration at the lumbar region and proximal femur. Participants had received only a little amount of systemic steroids and had routinely used an inhaled corticosteroid for a minimum of six months. Multiple regression analysis was employed to evaluate the total dosage of inhaled corticosteroid's impact on the density of bones from surveys, computerized general practitioners' data, and printed and handwritten general medical documents. Results: Treatment with inhaled corticosteroids lasted an average of 6 years (0–23), with a baseline total dose of 875 mg (87–4370). Both before and after adjusting for the influences of aging and gender, the results showed a negative correlation between the total dose of inhaled corticosteroid and skeletal mineral density at the lumbar region (L2-L4), femoral neck, and trochanter. An increase in inhaled corticosteroid dosage by twofold was linked to a 0•17 SD (95% CI 0•03-0•27) reduction in lumbar spine concentration of bone minerals... The femoral neck and trochanter all showed identical declines. The relationships remained strong after controlling for possible influencing variables such as regular exercise and previous use of oral, intranasal, cutaneous, and injectable corticosteroids. Conclusion: This investigation shows a link between the overall average dosage of inhaled corticosteroids and decreased bone mineralization concentration in asthmatic sufferers. Keywords: Corticosteroids, fracture, bone mineralization, inhaled, dosage, asthma, lumbar region, femur
Frequency of Iron Deficiency Anemia (IDA) Among Patients with Helicobacter Pylori Infection
Authors: Sadiq Afshan , Hameed Jawad Ahmed , Khan Mubashir Razzaq , Mushtaq Mazhar , Yasmin Rifat , Khan Muhammad Shoaib
Published: December 2022

Objective: The purpose of this study is to identify the prevalence of iron deficiency anaemia (IDA) in helicobacter pylori-infected patients. Study Design: Prospective/cross-sectional study Place and Duration: This study was conducted at Benazir Bhutu Hospital Rawalpindi during the period from July, 2022 to September, 2022. Methods: Total 105 patients of Helicobacter pylori infection, who ranged in age from 18 to 65 years included. All patients gave their informed written consent after being asked about their age, sex, body mass index, level of education, and place of residence. Blood samples from the subjects were analysed to determine their levels of serum iron, transferrin saturation, ferritin, and total iron-binding capacity. H. pylori infection can be found by histopathology, stool antigen testing, a fast urease test, or a urea breath test. The entire data set was analyzed using SPSS 24.0. Results: Among all there were majority females. Majority of the patients were illiterate and were from rural areas. 60 (57.1%) had poor socio-economic status. Mean Hemoglobin level was 12.1±0.6 (g/dl) mean serum iron level was 49.8 ±10.33(ug/dl) and mean serum ferritin level was 121.7±42.87 (ng per ml).Frequency of iron deficiency anemia was found in 43 (40.95%) patients. Among 43 cases of IDA, majority of the patients had age >35 years. Conclusion: In this research, we found that patients with helicobacter pylori infection, the majority of whom were adult female patients, had a considerably greater frequency of iron deficiency anaemia. Keywords: Prevalence, H.pylori infection, Iron Deficiency Anemia (IDA), Females
Chemotherapy for Pancreatic Cancer can be Optimized with the Use of Drug Resistance Testing Using Tissue Organoids
Authors: Mehnaz Gul , Khan Tariq Mehmood , Khan Salma Rasheed , Shaukat Asma , Haseeb Abdul
Published: December 2022

Objective: The purpose of the present investigation was to ascertain how drug resistance in pancreatic cancer organoids affects the efficacy of chemotherapy. Study Design: Retrospective study Place and Duration: Jinnah International hospital, Abbottabad, 15th March- 15th September, 2022 Methods: A total of 72 patients of both genders with pancreatic cancer were presented in this study. After obtaining written consent from participants, we recorded detailed demographic information about them, including their age, sex, and body mass index. Pathological evaluation of tumour regression grade (TRG) was compared to data on the dose and schedule of neoCTx treatment. SPSS 22.0 was used to analyze all data. Results: This study had 43 (59.7%) males and 29 (40.3%) females. 22 (30.6%) patients were aged between 18-30 years, 25 (34.7%) patients had aged between 31-40 years, 15 (20.8%) patients had aged 41-50 years, and 10 (13.9%) patients had aged> 50 years. In a study with 15 CTx-naive PDO lines, 8 showed a distinct response to FOLFIRINOX or Gem/Pac. As much as 34.7 per cent of patients with NeoCTx PDOs experienced an unfavorable reaction to their neoadjuvant treatment. Modified treatments in which the lowest successful individual medicine was eliminated from the full regimen showed no meaningful change in PDO response. Conclusion: It is possible that drug testing on CTx-nave PDAC PDOs and neoCTx PDOs will help determine the optimal neoadjuvant and adjuvant treatment regimens. In order to increase the proportion of patients completing the course of neoadjuvant treatment, it may be beneficial to individualize poly-chemotherapy regimens by removing chemicals with low effectiveness. Keywords: Pancreatic Cancer, Chemotherapy, Drug Resistance, Tissue Organoids
Effectiveness of Full Length and Cut Percutaneus Nephrostomy in Pediatrics Population
Authors: Ahmad Tariq , Shabbir Sohail , Ammar Muhammad Asif , Manan Fazal , Rashid Jamal Muhammad , Khan Zarmast
Published: December 2022

Background: Purpose of the study is to evaluate the safety and efficacy of full length Percutaneous (PCN) versus cut PCN in pediatric population. PCN is performed to establish temporary drainage of obstructed or dilated renal system till definitive management. PCN is well established procedure which is performed under deep sedation, local anesthesia or general anesthesia ultrasound guided or fluoroscopic guided. Methodology: Randomized controlled study carried out in 200 children in the department of urology, Institute of Kidney Disease, Hayatabad Peshawar Pakistan from Jan 2020 to Apr 2022 and analysis was done by using SPSS version 20 to know the efficacy of the cut versus full length PCN in children. Results: This study was carried out over 200 children using cut and full length percutaneous nephrostomy tube, 100 in each group. This study includes 119 males and 81 females of mean age 5.49+ 3.127 years. The cause of obstruction was 61% PUJ obstruction, 55% VUR, 47% obstructed stone and other causes in 37%patients. Effective decompression of hydronephrosis were noted in 89% in cut length vs 82% in full end PCN (p<0.1%). Skin inflammation of 100% with cut end PCN and 20% with full length, 96% of PCN didn’t show any inflammation (p<0.001%). Dislodgment of PCN was noted multiple time in 54%, two times in 38% and 7% in full length PCN where as it is noted two times in 47% and one times in 45% in cut PCN(p<0.001%). PCN exchange was needed multiple times in 51% patients and two times in 39% patients in full length PCN where it was needed two times in 41% and one time in 50% patients in CUT PCN arm (0.001%). Conclusion: This study concludes that cut end PCN is more effective in term of PCN exchange and dislodgement but having more skin inflammation as compared to full length PCN
Predictors of Suboptimal Coronary Blood Flow during Primary Percutaneous Intervention
Authors: Khan Asad , Latif Abdul , . Samiullah , Khalil Muhammad Shahab Uddin , Parvez Muzdalfa , Ikram Zarmina
Published: December 2022

Background and aim: Suboptimal coronary blood flow following first percutaneous coronary intervention (PCI) is a multivariate phenomenon with several causes. Despite substantial research, recognized modifiable risk factors and an effective management plan are lacking. The present study intended to determine the several causes of suboptimal coronary blood flow during primary percutaneous intervention. Patients and Method: A retrospective study was carried out on 486 STEMI patients in the Interventional Cardiology Department, MTI-Hayatabad Medical Complex, Peshawar from June 2021 to May 2022. Patients (age>20 years) presented with initial percutaneous coronary intervention within 12 hours after onset of symptoms were enrolled. Patients’ physical examination, medical history, different risk factors, vital signs assessment, echocardiography, Killip class, laboratory investigation, and post-procedural ECG were recorded along with PCI data and associated catheterization. Clinical outcomes included MACE, ischemia-driven target vessel revascularization, reinfection, cardiac mortality, and post-catheterization were recorded. Descriptive statistics was done in SPSS version 26. Results: Of the total 486 STEMI patients, there were 412 (84.8%) male and 74 (15.2%) females. The overall mean age was 52.62± 8.64 years. The incidence of suboptimal flow (TIMI flow ≤2) and optimal flow (TIMI-3 flow) were 112 (23%) and 374 (77%) respectively. Age [OR 1.041/year: p<0.001], total stent length [OR 1.019 per 1 mm], low SBP [OR 1.021 per mm Hg], thrombus burden grade [OR 1.78], and baseline TIMI flow (≤1) [OR 1.72; p=0.021] were suboptimal flow independent predictors. Cardiac mortality and MACE were significantly higher after 30-days in suboptimal flow as compared to optimal flow. The prevalence of in-hospital mortality in suboptimal flow and optimal flow was 9.1% and 2.1% respectively. Conclusion: The present study found that suboptimal coronary flow after first PCI is substantially associated with higher in-hospital and cardiovascular mortality in STEMI. The most significant predictor of poor coronary flow is predilatation prior to stenting. Keywords: Suboptimal coronary flow, Primary percutaneous intervention, Predictors
Efficacy of Coronary Stenting Versus Ballon Angioplasty in Small Coronary Arteries
Authors: Khan Asad , Khalil Muhammad Shahab Uddin , Latif Abdul , Parvez Muzdalfa , Ikram Zarmina
Published: December 2022

Background and aim: The most common approach of percutaneous myocardial revascularization is stent placement. In de novo focal lesions found in big native arteries, balloon angioplasty had lower efficacy than coronary stenting. However, the usefulness of stenting in small arteries remains debatable. The purpose study aimed to compare the efficacy of coronary stenting vs. balloon angioplasty in small coronary arteries. Patients and Method: This comparative study was carried out on 132 patients with lesion in small coronary arteries (reference diameter <3mm) in the department of Interventional Cardiology, MTI- Hayat Abad Medical Complex, Peshawar from 16th January 2021 to 15th July 2022. Patients were arbitrarily assigned to stent implantation and standard balloon angioplasty. Study protocol was approved by research and ethical committee. Each individual provided written informed consent. The rates of clinical event were evaluated within 1 year. Descriptive statistics was carried out in SPSS version 26. Results: Of the total patients, there were 80 (60.6%) male and 52 (39.4%) were females. Both groups were assigned 66 patients and had similar baseline characteristics and angiography data. Based on treatment analysis, the major adverse cardiac events (MACEs) and angiographic success rate were similar: 5.2% and 96.8% in coronary stenting versus 5.9% and 92.4% in balloon angioplasty group respectively. About 4.2% patients underwent abrupt closure changes within 30 days. Stenting convened the substantially larger lumen (1.52 mm vs. 1.32 mm, p<0.001) at 6 months and larger post-procedural lumen diameter (2.31 vs. 1.82 mm, p<0.001) as compared to balloon angioplasty. The incidence of restenosis was found 36% and 56% in coronary stenting and balloon angioplasty respectively. The survival rate (event-free) was achieved in 79% and 69% (p=0.021) in coronary stenting and angioplasty respectively. Conclusion: The present study found that optimum balloon angioplasty with preliminary stenting may be a viable therapeutic option for small coronary arteries lesions. Restenosis was found to be 36% and 56% in coronary stenting and balloon angioplasty, respectively. Keywords: Restenosis, Small coronary arteries, Balloon angioplasty, Coronary stenting
Drug-Coated Balloon-Only Angioplasty Outcomes in Diabetic and Nondiabetic Patients with De Novo Small Coronary Vessels Disease
Authors: Rahman Zia Ur , Khan Irfan Ali , Amin Qazi Najeeb Ullah , Shah Kashif Ullah , Ullah Farman , Ullah Sami
Published: December 2022

Background: It is still difficult to use drug-eluting stents for the revascularization of small arteries. For patients with diabetes, treatment with a drug-covered balloon for de novo lesions in small coronary vessels are an appealing restoration option. The cause of this research ends up to evaluate the efficacy of DCB-simplest angioplasty for treating small-vessel sickness. Place of study and duration: Conducted at Cardiology department of Hayatabad Medical Complex Peshawar for the duration from Feb 2019 to Feb 2022. Methods: A fashionable of 1198 patients with small vascular illness treated with DCB-best approach were observed at Hayatabad Medical Complex Peshawar from Feb 2019 to Feb 2022. Patients were classified as each having diabetes or now not having diabetes. Clinical and angiographical follow-up were organise at 12 months. Target lesion failure and non-primary good sized damaging cardiac activities were used as primary outcomes. Results: Diabetic patients had a greater hazard of intention lesion failure (17.9% vs. 11.4%, P=0.006), and the charge of intention lesion revascularization (9.2% vs. 4.5%, P=0.014) emerge as moreover considerably unique many of the 2 companies even as analysed independently. Adjusting for exclusive factors did now not reduce the significance of diabetes mellitus as a predictor of every TLF (HR: 2.712, CI: 1.254-5.864, P=0.011) and intention lesion revascularization (HR: 3.698, CI: 1.112-12.298, P=0.033). However, there had been no vast versions amongst companies for MACE (19% vs. 2.7%, P=0.120) or for intention vessel myocardial infarction (0.6% vs. 0.1%, P=0.110). Conclusion: Reductions in TLF and MACE fees had been seen with drug-coated balloon treatment alone. At three hundred and sixty-five days after treatment with DCBs, diabetes is an independent predictor of intention lesion failure and intention lesion revascularization in small coronary arteries. Within a year, we observed no essential variations in MACE some of the corporations.
Prevalence of Acute Coronary Syndrome among Patients Presenting with Chest Pain
Authors: Sher Akhtar , Bashir Muhammad Ahsan , Humerah Sobia , Khan Muhammad Rehan , Raja Namra Sohail , Hussain Iftikhar
Published: December 2022

Background and Aim: Multiple organ diseases can cause chest pain. One of the most important differential diagnoses is acute coronary syndrome (ACS). The present study aim was to determine the incidence of ACS among patients presented with chest pain. Patients and Methods: This observational study was carried out on 168 patients presented with chest pain in the Department of Cardiology, DHQ Teaching Hospital / GKMC, Swabi and Punjab Institute of Cardiology Lahore. The duration of study was 6 months from October 2021 to March 2022. Chest pain, diabetes, hypertension, and smoking status from each individual were recorded. The incidence of ACS was determined. Patients presented with chest pain and had >16 years age were enrolled. Thoracic patients, traumatic chest pain, and local infectious patients were excluded. Nature of chest pain such as substernal pain, nitroglycerin relieved pain, and exertion provoked pain were assessed. ACS was diagnosed and confirmed by electrocardiograph (ECG), prior history, and cardiac biomarkers. Descriptive statistics was carried out in SPSS version 26. Results: Of the total patients, there were 116 (69%) male and 52 (31%) females. The prevalence of acute coronary syndrome was 62 (36.9%) among patients presented with chest pain. The overall mean age was 46.82±12.1 years with age range from 16 years to 80 years. The incidence of diabetes, hypertension, and smoker were 48 (28.6%), 66 (39.3%), and 38 (22.6%) respectively. Out of 168 patients, the prevalence of non-specific, atypical, and typical chest pain was 88 (52.3%), 50 (29.8%), and 30 (17.9%) respectively. Of the total 62 ACS patients, the incidence of STEMI, NSTEMI, and unstable angina were 28 (45.2%), 19 (30.6%), and 15 (24.2%) respectively. Conclusion: The present study found that the incidence of ACS was 36.9% among patients presented with chest pain. Acute coronary syndrome was the most important differential diagnoses in chest pain patients. If a patient is presenting with chest pain, the diagnosis of ACS needs to be strongly deduced, and prompt action taken so that the patient can undergo proper treatment as soon as possible. Keywords: Acute coronary syndrome, Chest pain, Prevalence
Effects of Different Strategies on High Thrombus Burden in Patients with ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Catheterization
Authors: . Nasrullah, , Solangi Aftab Ahmed , Jamil Amir , . Khalid , Tahir Muhammad , , . Zahirullah
Published: December 2022

Objective: The aim of this study is to evaluate the impact of thrombus aspiration and intracoronary-targeted thrombolysis on myocardial perfusion. The study also analyses the effect of different technological approaches on ST-elevation myocardial infarction (STEMI) patients undergoing primary percutaneous catheterization (IMR and SPECT). Study Design: Randomized control trial Place and Duration: Cardiology Department of Punjab institute of cardiology Lahore from September 2021 to September 2022. Methodology: Sixty six STEMI patients of either gender were enrolled in this study. Detailed demographics were recorded after taking informed written consent. All the patients were equally divided into two groups (TA and IT group) 33 patients in each group. Blood samples from the venous veins were collected for routine laboratory examinations, biochemical tests included blood sugar test, lipid profile test, C reactive protein test, liver and kidney function tests, myocardial indicators as troponin I and blood tests for other organs. Vital sign changes and intracoronary thrombolysis were investigated intensively when the drug was injected. Additionally, patients in the TA group would get an extra 5 or 10mg of Pro-UK if there was a residual thrombus and they had repeated thrombus aspirations utilizing Export AP. SPSS software 24.0 was used for the data analysis. Results: The analysis showed that the IT group has greater values of thrombus burden, TIMI myocardial perfusion %, and TIMI frame count. The statistical analysis revealed that during the 90-day follow-up, there is no change in MACEs or heart function was observed. The values of 12-month follow-up illustrated that there is significant differences in the infarct size assessed by SPECT, the left ventricular ejection fraction evaluated by echocardiography, and the composite MACEs between the 2 groups (P=0.034). Conclusion: Effective therapies include intracoronary-targeted thrombolysis and thrombus aspiration and safe ways to treat STEMI patients with an increased coronary thrombus burden. Keywords: ST-Elevation Myocardial Infarction, Primary Percutaneous Coronary Catheterization, Thrombus Aspiration, Thrombolysis
Ultrasound Assessment of Cesarean Section Scar and its Correlation to Intraoperative Scar Status
Authors: Pario Saba , Omer Sanober , Abbasi Sughra , Pario Anam , Suboohi Sadia , Baig Ramla Javed
Published: December 2022

Background and Aim: In the past decades the rate of cesarean sections has increased enormously, there are many indications for cesarean section like placenta previa, labor dystocia, presumed fetal distress, fetal malpresentation, multiple gestation, and suspected fetal macrosomia, but the commonest reason for performing a cesarean is a previous cesarean birth .The present study aimed to compare the sonographically measured lower uterine scar with actual status of scar at the time of operation. Methodology: The descriptive cross-sectional study was conducted on 150 female patients who presented to Obstetrics department of Creek general hospital, affiliated with UMDC from August 2021 to January 2022. The Inclusion Criteria was: females with singleton pregnancy with history of previous single caesarian section, vertex presentation and gestational age 36-40 weeks. While women with multiple gestations, placenta previa, polyhydramnios or any uterine abnormality were excluded. Results: The overall mean of age, gestational age, parity and fetal weight were 28.22±4.59 years, 37.60±0.78 weeks, 1.73±0.94 and 2.75± 0.47 kg respectively. Significant association was observed between lower uterine segment measurements by Sonographic scar thickness during pregnancy and intra-operative scar findings at the time of delivery (p-value< 0.05). Conclusion: The present study found that sonographically measured lower uterine scar thickness is a solid predictor for scar defect in women with previous cesarean section. As a result, we can conclude that sonographic measurement of lower uterine segment thickness is a reliable tool for assessing scar status and deciding which women should be given a vaginal delivery trial. Keywords: Previous Caesarean Section, Lower uterine scar, Sonography
Seroepidemiology of Dengue Viral Infection in Peshawar
Authors: Khan Pordil , Zafar Mehwish , Muneer Ayesha , Afridi Aizaz , Bilal Muhammad , Shuaib Syed Luqman
Published: December 2022

Background: Dengue viral infection is the most prevalent infection particularly in the months of September to December in different region of Khyber Pakhtunkhwa. The aim of this study was to determine the prevalence of dengue viral infection in district Peshawar. Methods: A cross-sectional study was conducted and recruited two hundred suspected dengue viral infected patients. Blood were collected for diagnosis of dengue viral infection through immunochromatograpy technique. All the collected data analyzed through Microsoft Excel 2020. Results: A total of 200 suspected dengue viral infected patients participated. Among total, 59.5% were male and 40.5% were female patients. Out of total, 61 were found positive through NS-1 strips. IgG antibodies were more found in male than female. Whereas, IgM antibodies were more prevalent found in female patients. Conclusion: Overall, the prevalence of dengue viral infection is more in our region. The prevalence of dengue viral infection is greater in male patients as compared to female patients. It is important to arrange different prevention programs including seminars, workshops and conference throughout the district. Implementation of control and surveillance programs are highly essential to determine regarding the dengue level. Health policy makers need to pay attention towards the dengue disease and to provide different training session to health care providers and physician. Keywords: Dengue viral infection, Sero-prevalence, Epidemiology
Parasitic Nematodes of Plant Persimmon (Diospyros Kaki, l.) Rhizosphere in District Swat, Kp Pakistan
Authors: Saeed Nadia , Anar Seema , Saeed Qasim , Usman Khalid , Ujjan Javed Ahmed , Jamali Fahim Haider , Hussain Iftikhar
Published: December 2022

Purpose: Different species of plant parasitic nematodes of persimmon (Diospyros kaki, L.) were identified from various localities of District Swat KPK Pakistan namely Chail, Madyan, Piya, Jare, Chikrai, Thesil, Fateh pur, Baghdheri, Naway kalay, Shin, Pirpatay, Sambat and Gurra. Methods: Soil samples were collected from the bases of persimmon trees along with rhizospheres that show stunted growth. The collected samples were then processed by using modified Bearmann funnel technique. Nematode specimens isolated in cavity block were killed by heat and treated with TAF (Triethylamine formaldehyde) solution. Findings and Practical implication: After 24 hours, the specimens were transferred to 1.25 % glycerin with trace amount of picric acid for staining of nematodes. Nine different species of nematodes were reported from these localities were Tylenchus spp, Psilenchus spp, Meloidogyne larvae, Aphelenchus spp, Tylenchus juveniles, Filenchus spp, Pratylenchus spp, Helicotylenchus pseudorobustus and Helicotylenchus dihystera. Helicotylenchus species were more common in the collected samples. Conclusion: It is concluded from analysis of soil samples that plant parasitic nematodes associated with persimmon cause economic loss in district swat. Persimmon plants show stunted and retarded growth in soil which has high nematode population density. Keywords: Nematodes, Persimmon, Swat, Diospyros kaki, Triethylamine formaldehyde.
Prevalence of Coronary Artery Disease at National Institute of Cardiovascular Disease Hyderabad (NICVD) Sindh
Authors: Malik Mushahid , Khan Jawad Ahmad , Kumar Ashok , Hassan Hanozia , Ahmed Shakil , Panhwar Waheed Ali , Mangrio Wali Muhammad , Jamali Yasir Akbar
Published: December 2022

Objective: To determine the prevalence of coronary artery disease at the NICVD Hospital, Hyderabad. Methods: At the National Institute of Cardiovascular Disease, a teaching hospital in Hyderabad, cross-sectional descriptive research was carried out. Total 130 patients were participated in study and all individuals were adults (18-60 years old) who presented at the general checkup clinic with a history or signs of CAD. A self-administered questionnaire designed for the study. Results: Among 130 patients, the proportions of significant risk factors for CAD were: 70% Hypertension, 36.2% Obesity, 36.2% Family history, and 36.9% diabetes mellitus. Signs and symptoms of the patients were Heart attacks 31.5%, heartburn 68.5%, AOT 36.9%, Chest pain 48.5%, and vomiting 7.7%. 80.8% of patients took chest pain tablets under the tongue. Patients currently smoking was 16.2%. Practical implication:- This study will prove very helpful for physician in managenment of coronary artery disease. Conclusion: Diabetes, hypertension, and high cholesterol are all modifiable risk factors that must be appropriately controlled. The community should place a high value on screening programs that may identify diseases before they develop and on adopting healthy habits. Keywords: Coronary artery Disease, Heart disease, NICVD
Evaluation of Herpes, Cytomegalovirus, Rubella, and Toxoplasma Gondii Infections in Swabi, KPK, Pakistan
Authors: Mahmood Fawad , Zafar Mehwish , Noreen Sarwat , Gul Sahiba , Ullah Ikram , Khattak Saima
Published: December 2022

Introduction: Toxoplasma gondii (TG), Rubella virus (RV), Cytomegalovirus (CMV), and Herpes simplex virus (HSV) 1 and 2, globally most neonatal and infant deaths are reported due to this group of infections. Purpose: The objective of this research study is to estimate the Prevalence of TORCH infections. Methods: This research study was carried out at the Hi-Tech clinical laboratory Shewa Adda Swabi KPK Pakistan for a duration of 4 months from April 2022 to July 2022. Data statistics looking at the clinical characteristics of Toxoplasma gondii, CMV, RV, and HSV were filled from n=371. All samples were qualitative and quantitative tested by using Immune chromatographic (ICT) and Chemiluminescence Microparticle Immunoassay (CMIA) techniques. Results: Out of n=317 pregnant women, n=131 (35 %) women were found positive while n=240 (65 %) women were found negative. Prevalence of Toxoplasma gondi 32 %, RV 28 %, CMV 27 %, and HSV 13 % in Swabi, KPK, and Pakistan. Among them, a high-frequency fraction of co-infection was detected for CMV and Rubella 17 (58 %), followed by CMV, Herpes, Rubella virus, and Toxoplasma gondii combined 7(25 %). The highest number of infected individuals 37 % we found in the age-group 21-25 years, followed by the 15-20 years age group 23 %, 26-30 years age group 17 %, 31-35 years age group 23 % while the lowest number of positive individuals found in >36 age group. Conclusion: In brief context, TORCH pathogens have potentially shocking clinical manifestations. Hence, screening before pregnancy, and timely diagnosis of TORCH can reduce disease and death in both kid, and the mother. Moreover, knowing the epidemiology survey is a significant aspect to develop strategies and implementation for the prevention of disease. Keywords: Pregnancy, Prevalence, TORCH, Swabi, Infections.
Identification and Management of Plant Parasitic Nematodes Associated with Walnut (Juglans Regia L.) in Abbottabad
Authors: Saeed Nadia , Anar Seema , Saeed Qasim , Usman Khalid , Ujjan Javed Ahmed , Jamali Fahim Haider , Din Shams Ud , Idrees Muhammad , Sajid Muhammad , Hussain Iftikhar
Published: December 2022

Purpose: Phytonematodes known as the hidden enemies of plants and crops are potential pest of walnut trees in Abbottabad, KP Pakistan. Methods: Soil samples from walnut trees were collected from different localities were processed by using Bearmann funnel techniques. Several nematode species were identified including Meloidogyne incognita, Helicotylenchus dihystera, Psilenchus hilarulus, Tylenchus sp. and Helicotylenchus vulgaris. Findings & Practical implication: Management of plant parasitic nematodes by using castor oil cakes (8kg/tree), cow dung (8 kg/tree) and duck manure (8kg/tree) showed that population was declined after application. Plant growth and yield was also improved. Data plotted in histogram graphs and t-test showed that p values were found significant. Conclusion: The mean and S.D values of initial population, 3 month, 6 month and 12 month for castor oil cakes are 116 ± 1.2, 84 ± 1.0, 60 ± 1.0, 42 ± 0.6, for cow dung 127 ± 5.7, 110 ± 2.4, 87 ± 2.4, 73 ± 1.3 and for duck manure 108 ± 2.4, 92 ± 1.0, 69 ± 0.5, 45 ± 1.0. Keywords: Phytonematodes, walnut, castor oil, cow dung, duck manure.
Genetic Analysis of K-Casein Gene in Milk Protein of Bos Indicus Cattle
Authors: Khushbakht Maria , Ujan Javed Ahmed
Published: December 2022

Purpose: Κ-casein, or kappa casein, is a mammalian milk protein involved in several important physiological processes. Chymosin splits K-casein into an insoluble peptide (para kappa-casein) and a water-soluble glycomacropeptide (GMP). GMP is responsible for increased efficiency of digestion, prevention of neonate hypersensitivity to ingested proteins, and inhibition of gastric pathogens. The gene underlying the production of kappa-casein in cow's Milk shows polymorphisms which affect the amount of protein produced. Higher levels of kappa-casein are associated with increased milk protein and casein content and better cheese yield. Method: The current study aimed to identify the genetic mutations among three indigenous cattle breeds of Sindh, Pakistan. A particular set of primers amplified the targeted area of the K-CASEIN gene after genomic DNA extraction from blood samples of the three cattle breeds, namely Cholistani cattle breed, Tharri, and Sahiwal. Findings: The amplified PCR products were sequenced using the ABI Genetic Analyzer 3500; a BioEdit version 7.2 was used to examine the sequencing data. Using the ensemble gene browser, blast analysis was also performed. Practical Implication: Results revealed 18 mutations in all 03 cattle breeds, including 07 mutations in the Cholistani cattle breed; the Tharri cattle breeds had 06 mutations, and the Sahiwal cattle breeds had 05 mutations. Results of this study of the K-CASEIN gene suggested that Cholistani cattle breeds are more genetically varied than the Sahiwal cattle breeds. Conclusion: Furthermore, the Sahiwal cattle breed is more diverse than the Thari cattle breed for the said gene. Keywords: K-Casein gene, Sahiwal cattle breed, Thari cattle breed, Cholistani cattle breed, Polymorphism
Surgical Outcome and Complication of Penile Fracture
Authors: Khan Shaheer Ahmad , Khan Muhammad Shoaib , Ahmad Zeshan , Shahzad Iqbal , . Abdullah , Ayaz Muhammad Mohsin
Published: December 2022

Objective: The aim of current study is to determine the causes, symptoms of penile fracture and post-operative outcomes. Study Design: Prospective study Place and Duration: This study was conducted at multi centers at DHQ Teaching Hospital, KDA, Kohat and DHQ Hospital Batkhela during the period from February, 2022 to July, 2022. Methods: Total 30 patients had penile fracture were presented in this study. Included cases were aged between 20-50 years. After receiving informed written permission, detailed demographic information about the enrolled patients was compiled, including age, body mass index, place of residence, and marriage status. Causes and clinical features of fracture were assessed. Patients were underwent for surgery and success rate was observed. Post-treatment rate of complications among enrolled cases were also calculated. We used SPSS 22.0 version to analyze complete data Results: Included patients had mean age 35.7±12.32 years with mean BMI 24.7±4.31 kg/m2. Majority of the cases were married 26 (86.7%) and rest were unmarried 4 (13.3%). 12 (40%) patients had urban residency and majority were had rural 18 (60%). Most common cause of fracture was coital 20 (66.7%), followed by masturbation in 6 (20%) and 4 (13.3%) patients had manipulation during sleep. Deformity, swelling, detumescence and crackling sound was the most common symptoms. Right corpus was the most common tunical tear 24 (80%) and most common site was proximal 22 (73.3%). Success rate was found among 26 (86.7%) cases. Post-operatively complications were found among 5 (16.7%) cases in which plaques/ nodules, curvature, erectile dysfunction, pain and swelling were included. Conclusion: For the purposes of this study, we found the penis fracture to be a rather simple condition to diagnose. Cavernosography may be used to confirm a diagnosis if necessary. Penile fractures may be successfully treated with immediate primary surgical repair, resulting in normal erection without substantial sequelae. Short hospital stays and fast restoration of sexual function are common outcomes of this procedure. Keywords: Surgical Outcomes, Penile Fracture, Complications, Causes
A Medico-legal Analysis of Autopsy Cases Due to Poisoning
Authors: Aslam Nadia , Naz Memoona , Memon Muhammad Qasim Ahmed Khan , Kumar Pardeep , Memon Abrar Ul Hasnain , Awan Ejaz Ahmed
Published: December 2022

Background: The prevalence of poisoning has increased, costing many valuable lives, as has the progress in research and technology, agriculture, and the industrial sector. Chemicals created to safeguard agricultural products from pests and rodents helped preserve the environment. People who are starving are becoming a threat to other people's lives. Objective: This research aims to assess the frequency and pattern of poisoning. Design: Retrospective Study. Setting: Peoples Medical College Hospital in Nawabshah, Shaheed Benazirabad, Sindh. Duration: From May 1, 2021, to May 30, 2022. Methodology: The current study was conducted in the past. All suspected poisoning deaths that were presented to Peoples Medical College Hospital in Nawabshah, Shaheed Benazirabad, Sindh for a medical-legal autopsy within the course of a year, from May 1, 2021, to May 30, 2022, would be investigated. Inquest reports, hospital records, autopsy reports, and chemical examiner's analysis reports of viscera and bodily fluids were used to compile information on suspected poisoning instances. Age, sex, religion, place of residence, marital status, education, occupation, financial situation, mental state, date and conditions of poisoning, location of treatment, and the most prevalent agent responsible for deadly poisoning are among the different epidemiological data that are examined. Conclusion: Poisoning is predicted to decline as a result of measures to enhance socioeconomic conditions through changes in employment, health care, education, and economic as well as scientific assistance for farmers. It is anticipated that proper education of the general public and farmers regarding the storage, handling, and usage of pesticides and insects will lower the frequency of poisoning. Keywords: Poisoning, Suicide, Medico-legal
The Role of Postoperative Mechanical Ventilation in Neonates with Tracheoesophageal Fistula
Authors: Hammoodi Ahmed Hashim , Alani Muataz , Ali Alaa Hussein
Published: December 2022

Background: Many advances have been made in managing neonates with esophageal atresia/tracheoesophageal fistula (EA/TEF). This resulted in a progressive decrease in mortality as a result of improved neonatal intensive care and neonatal mechanical ventilation; however, this is not the case in developing countries.

Objectives: We aimed to evaluate the efficacy of postoperative ventilation in neonates with EA/TEF in Iraq as a developing country.

Materials and Methods: It is a prospective study for all neonates with EA and/or TEF admitted to the pediatric intensive care unit (PICU) in Alkhansaa Teaching Hospital between December 2012 to December 2014. Forty operated neonates were randomly divided into two groups according to the record number of presentations (even = G1, odd = G2): Twenty patients (group l) had been assigned to be post-operatively on a ventilator as a routine protocol. While group 2 planned to be extubated in the theater. We evaluated the complications and mortality rates in two groups.

Results: For 24 months, 40 neonates with EA/TEF were admitted to PICU; Thirty-two were operated on within 24 hours of life. There were no significant differences between the two groups regarding fetal maturity (p-value 0.490), gender, and weight. The mean period for mechanical ventilation was four days. Six neonates had tube mal-positioning complications, leading to lung collapse, hypoxia, and pneumonia (p-value 0.250). Anastomotic leaks occur in 10 neonates (five in each group) (p-value 0.642), which sometimes leads to sepsis (p-value 0.347). Trachea-malacia was recorded after weaning in 5 intubated patients (p-value 0.078). The mortality rate in G1 was 35%, while in group 2 was 25% (p-value 0.366).

Conclusions: Although the study’s sample is small, it is recommended to avoid mechanical ventilation in the postoperative care of neonates with EA and/or TEF.
Evaluation of head injuries in forensic autopsies of violent traffic deaths from 2020-2021 at HOGGY
Authors: El Hadji Oumar NDOYE  , Amadou Mouctar DIALLO  , Gilbert Franck Olivier NGONGANG  , Namoudou CONDE  , Gabriel Raymond Marie KONATE  , Ousmane CAMARA  , France Armelle LENDA  , Gabriel Nougnignon Comlan DEGUENEVO  , Dia Sidy Ahmed  , Mouhamed Manibiliot SOUMAH  , Chérif Mohammed Moustapha DIAL  , Mor NDIAYE
Published: December 2022

Introduction: Deaths from head injuries secondary to road traffic accidents are considered a major health problem. The main objective of our study is to determine, with the help of autopsies, the socio-demographic profile and the nature of the cranial injuries observed in fatal road traffic accidents. Materials and methods: In this study, we were interested in the cases of fatal traffic accidents, based on autopsy data, This is a retrospective study based from January 1, 2020 to December 31, 2021. Results: The age group of young adults, those between 15 and 30 years old, stands out from the others with the others with the number of subjects that it gathers, constituting 36.6 % of the of the total number of deaths. As for the distribution of the subjects according to sex, our results showed a clear predominance of the predominance of the male sex, counting 108 cases, i.e. 74% of all deaths. We will explore the various injuries caused by fatal accidents. When we look at the anatomical site of fatal injuries, polytrauma and head trauma stand out, accounting for 50 cases (35% of the total). Representing 50 cases (35%) and 36 cases (25%) respectively. Conclusion: Head injury patients following a head traffic accident constitute a major health problem in Senegal. These head injuries are one of the main causes of morbidity and mortality among young people. Better implementation of traffic prevention policies and respect for traffic rules and good roads would help reduce this threatening problem in our country.