bluuebunny/crossref_metadata_2025 huggingface dataset:
Utu
Authors:   , Tunui Benjamin
Published: September 2021

Contemporary Māori architecture in Aotearoa is rapidly becoming ‘mainstreamed’ within a New Zealand architectural idiom. However, Māori architecture has been narrowed down to surface ornamentation, a handful of motifs and exhausted narratives. This dissonance is owing to the fact that Mātauranga Māori is not at the iho (core) of Māori architecture at a formal and spatial level. Consequently, this thesis aims to expand Māori architectural theory and practice by proposing that elements of tikanga Māori can be understood both formally and spatially in ways that generate new architectural possibilities. The research was conducted as an iterative design process. Three parts of the pōwhiri process are mapped for their underlying spatiality, both in the physical and meta-physical worlds. The ephemera are translated through a design methodology which reveals what these patterns could mean for contemporary Māori architecture. The three rituals: karanga, wero and hongi are explored as a series of design experiments which follow the same workflow. Each design experiment developed a range of different architectural techniques for expressing tikanga Māori. The use of speculative drawing/ mapping techniques is the principal way in which the spatiality of the ephemera is excavated and interrogated. The following research is not tied to an architectural site. The architecture is not based within a specific context, rather it is born of context, conceiving an architecture of the ephemeral and atmospheric qualities of ritual. This research acknowledges the Māori concept of tuakana-teina (elder sibling-younger sibling) knowledge exchange and draws a parallel with architectural design methodology. This thesis suggests a method of speculation for future generations of architectural designers in Aotearoa to build upon with their own whakaaro (thoughts).
Patterns of referral from health centres to hospitals in Riyadh region
Authors: Khoja Tawfik A. M. , Al Shehri Ali M. , Abdul Aziz Abdul Aziz F. , Aziz Khwaja M. S.
Published: September 2021

Patterns of attendance and referrals in hospitals and health centres in Riyadh region, Saudi Arabia, studied before and after implementing a referral system showed a 40.6% total decrease in patients attending hospital outpatient clinics;an 11.9% increase in patients attending primary health centres;a 19.2% increase in referrals;a 33.2% increase in patients attending emergency departments;and a 17.3% increase in inpatients. It is clear that the referral system has, and will have, an impact on primary and secondary health care services. In order to optimize positive and minimize negative aspects of this impact, communication between primary health centres and hospitals should be of high standard. Regular reviews and studies of referral systems are recommended
Effect of methoxyverapamil, diltiazem, morphine and their combination on the formation of irreversibly sickled cells: an in vitro study
Authors: Ahmed Jawad H. , Al Diwan Manal S. , Jawad Abdullah M.
Published: September 2021

The effect of methoxyverapamil and diltiazem [calcium antagonists] and morphine [calcium antagonist activity] on the formation of irreversibly sickled cells [ISCs] was investigated. Methoxyverapamil at therapeutic concentration and 10 times that level resulted in a 12% and 21% reduction in the formation of ISCs respectively, which was statistically significant. Diltiazem also produced a significant reduction in ISCs but morphine produced no significant reduction. Combination of these drugs produced a net effect similar to their individual effects. These drugs might be useful in decreasing the intensity of sickling crises and vaso-occlusive events. Thus in vivo trials in patients with sickle-cell disease are suggested
Epidemiology of cutaneous leishmaniasis in the endemic area of Jericho, Palestine
Authors: Al Jawabreh A. , Barghuthy F. , Schnur L. F. , Jacobson R. L. , Schonian G. , Abdeen Z.
Published: September 2021

Thistudy of cutaneous leishmaniasis in Jericho city and the adjacent Aqbat-Jaber refugee camp investigated the seroprevalance of Leishmania major and the risk factors associated with acquiring the disease. Clinical and parasitology identification of cases showed children and young men were more affected, with the head most affected in children. Enzyme-linked immunosorbent assay [ELISA] was used to test sera from 190 individuals. The overall seroprevalence of cutaneous leishmaniasis was 26.3%. A case-control study of 247 individual in 37 households showed that a higher level of education of the head of the household and having children sleep under bed nets were significantly related to a lower incidence of cutaneous leishmaniasis
Новые данные о строении α-транс-[Pd(NH3)2Cl2]
Authors: Наумов Д.Ю. , Храненко С.П. , Куратьева Н.В. , Панченко А.В. , Громилов С.А.
Published: September 2021

Методом рентгеноструктурного анализа монокристалла уточнена кристаллическая структура α-транс-[Pd(NH3)2Cl2]. Показано, что в отличие от имеющихся в литературе представлений структура является разупорядоченной. Такая модель не требует наличия избыточного по сравнению со стехиометрией палладия. На примере двух кристаллов, полученных в условиях одного опыта, показаны возможные вариации в упаковке комплексов.
Morphometric and Morphotectonic characteristics of Sürgü and Çardak Faults (East Anatolian Fault Zone)
Authors: Balkaya Musa , Ozden Suha , Akyüz Hüsnü Serdar
Published: September 2021

Within the framework of this study, morphotectonic and structural characteristics of the Sürgü and Çardak faults, the northern branch of the East Anatolian Fault Zone (EAFZ) between Çelikhan and Göksun, were investigated with scrutiny. Further, the results obtained with morphotectonic assessments supported and fortified with a thorough literature review and field studies; thereby, geological features of the region have been analyzed immaculately. The Sürgü and Çardak faults were mapped with special attention to the lithological, structural, and geomorphological features of the study area. Investigations along the Holocene river valleys along the approximately E–W trending Sürgü and Çardak faults evidently indicate that these faults represent sinistral active fault morphology. In terms of morphometric assess-ments, mountain front sinuosity (Smf), the Valley Floor Width-to-Valley Height ratio (Vf) and Stream Length-Gradient Index (SL) were employed along the mountain-piedmont junction and on the drainage network. Recorded Smf values range from 1.21 to 1.48, and average Vf rates are between 0.20 and 1.12, which typically indicate high tectonic activity for the Sürgü and Çardak faults. SL indice exercised along the 10 valleys in the study area, the recorded values vary between 5.8 and 1330.0; besides, the higher anomalies are recorded adjacent to the Sürgü and Çardak faults. Implemented morphotectonic investiga-tions and evaluations indicate that the Sürgü and Çardak faults play a key role in the morphotectonic evolution of the region.
СТРАТЕГІЇ РОЗВИТКУ ШТУЧНОГО ІНТЕЛЕКТУ В ЄВРОПЕЙСЬКОМУ СОЮЗІ (НА ПРИКЛАДІ КРАЇН ВИШЕГРАДСЬКОЇ ГРУПИ)
Authors: Pistrakevych Olena
Published: September 2021

У статті досліджено національні стратегії розвитку штучного інтелекту в країнах Вишеградської групи, прийняті за рекомендаціями Європейської Комісії в контексті Стратегії розвитку штучного інтелекту в ЄС. У 2018 р. Європейська Комісія на конференції Digital Day 2018  об’єднала міністрів та представників країн ЄС для заохочення співпраці у галузі штучного інтелекту, блокчейну, охорони здоров’я та інновацій, спираючись на прогрес, досягнутий на шляху створення єдиного цифрового ринку, на якій зокрема європейські країни підписали Декларацію про співробітництво в галузі штучного інтелекту. Польща, Чехія, Угорщина та Словаччина прийняли спільну позицію щодо штучного інтелекту та його потенціалу для розвитку економіки Європейського Союзу, розробивши та впровадивши національні стратегії, аналіз яких дає змогу виявити основні тенденції та механізми реалізації цифрової політики окремих країн ЄС. Кожна з зазначених країн, починаючи з 2018 року почала свій шлях у сфері штучного інтелекту, розробляючи та реалізуючи національні стратегії розвитку штучного інтелекту, враховуючи власні реалії та пріоритети. Разом з тим ці країни спільно працюють на досягнення загальноєвропейських цілей, що передбачає успішну цифрову трансформацію Європи; перехід до кліматично нейтральної, кругової та стійкої економіки з цифровим суверенітетом ЄС; проведення цифрової політики, яка надає людям та бізнесу змогу рухатися назустріч орієнтованому на людину, стійкому та процвітаючому цифровому майбутньому.
ІСТОРИЧНІ ЕТАПИ РОЗВИТКУ ТУРИЗМУ В ЄГИПТІ
Authors: Kopachinska Galina , Mandryk Iryna , Suhak Ivan
Published: September 2021

В статті було вивчено Єгипет як одну з провідних туристичних дистанцій сучасного світу. Обґрунтована необхідність дослідження та аналізу основних етапів становлення туризму в Єгипті. Було розглянуто характерні риси державотворення Єгипту. Доведено, яким чином історія становлення державності в Єгипті впливала на особливості зародження та еволюції туризму в ньому. Вивчено основні праці вітчизняних та зарубіжних науковців щодо аналізу розвитку туризму та становлення туристичної галузі в державі. Розглянуто наукові методи, застосування котрих дозволяє комплексно вивчити та проаналізувати історичні етапи становлення туризму в державі. На основі отриманих результатів дослідження в статті було запропоновано виокремлення 3 основних етапів історичного розвитку туризму в Єгипті, а саме: 1) початковий (IV ст. до н. е. - початок ХХ ст.), що характеризується появою перших подорожей до Єгипту та з нього на основі торгових, пізнавальних, освітніх та військових мотивів, нарощенням культурно-пізнавального потенціалу держави, будівництвом всесвітньовідомих культурно-історичних пам’яток; 2) зародження та еволюція організованого туризму (поч. ХХ ст. – кінець ХХ ст.), що характеризується організацією перших туристичних подорожей, а також їх активізацією, закладанням основ для розвитку туристичної індустрії, появою масового туризму, нарощенням туристичного потенціалу держави; 3) сучасний (поч. ХХІ ст. - дотепер), що характеризується активним розвитком Єгипту як одного з найвідоміших туристичних центрів Африканського туристичного регіону. В статті було розкрито основні характеристики кожного з досліджуваних етапів. Обґрунтовано доцільність їх виділення в таких часових рамках, які представлені в статті. Було проаналізовано основні види подорожей до Єгипту та з нього до початку ХХІ ст., а також основні види туризму, які  представлені в державі на сучасному етапі. В статі було вивчено політико-правові, соціально-економічні та культурні чинники розвитку туризму в державі на кожному з запропонованих історичних етапів. Було розглянуто основні характеристики розвитку туризму в Єгипті на сучасному етапі та обґрунтовано основні перспективи подальших досліджених з обраної наукової тематики.
POST PARTUM HAEMORRHAGE PROPHYLAXIS
Authors: ISLAM ALIYA , SIRAJ ASIFA , ARIF NADIA
Published: September 2021

Post partum hemorrhage (PPH) is defined as the loss of greater than 500ml of blood from the genitaltract in the first 24 hours following delivery. PPH occurs in 2-11% of all deliveries. Objective: To compare the efficacyof misoprostol and ergometrine for the prophylaxis of Post Partum Haemorrhage. Design: Prospective study. Setting:Gynaecology and Obstetrics Department Military Hospital Rawalpindi. Period: From 01 July 2006 to 31 Dec 2006.Patients & Methods: A total of 200 patients were recruited in the study, they were divided in two groups, group – I (n100) included those patients who were administered ergometrine intravenously at the time of delivery of head for theprophylaxis of post partum haemorrhage, Group – 2 (n-100) included those patients who were administered Misoprostol800 microgram per rectally just before the start of cesarean section for the same purpose. Blood loss was calculatedobjectively by squeezing the soaked pads and quantifying the amount of clots in a kidney tray of standard size to beequal to 500ml.Results: In group I (n-100) 15 patients had mild PPH blood loss >500ml, out of them 03 had severePPH requiring bimanual message and 02 patients required blood transfusion, in group II( n-100). 08 patients had PPH,blood loss >500 ml, out of them 01 patient required uterine message and none required blood transfusion. Chi-squaretest was applied to compare the efficacy of the two groups, P>0.05 showed no significant difference in the efficacy ofthe two groups but the side effects were obviously less in the Misoprostol group. No patient in group II had GI symptomswhile 36 patient in group I had retching and, vomiting and 03 patients had raised B.P after the administration ofergometrine. Conclusion: Misoprostol administered per rectally has equal efficacy to ergometrine given intravenouslyfor the prophylaxis of post partum haemorrhage but the side effect profile and patient tolerability is better withMisoprostol.
COMPARISON OF PROSTAGLANDIN E2 WITH MISOPROSTOL FOR INDUCTION OF LABOUR AT TERM
Authors: WASIM TAYYIBA , SIDDIQ SAQIB
Published: September 2021

. Objective: To evaluate the use of vaginal misoprostol compared with vaginal prostaglandin E2(PGE2) for labour induction at term. Design: Experimental. Setting: Gynae Unit III, Department of Obstetrics andGynaecology SIMS / Services Hospital Lahore. Methods: Patients were randomized to two groups with 100 patientsin each group. One group received 50:g of misoprostol vaginally every four hours up till 5 doses , second group wasgiven 3mg PGE2 vaginal tablet every 6hrs up till 3doses. The drug was stopped earlier if active labour started.Results: 96% of patients were successfully induced in misoprostol group verses 84%patients in PGE2 group (P=0.01).Mean induction delivery interval was significantly short in misoprostol group 13.3 + 8.7 hours verses 18.5 + 11.3 hoursin PGE2 group (P=0.01). 35% patients in misoprostol group and 40% in PGE2 group (P=0.46) had C/Sections.Increase Meconium staining and fetal heart rate abnormalities was seen in misoprostol group (P=0.03). 20% of babiesin misoprostol group had low APGR Score and needed neonatal intensive care unit admission, as compared to 12%in PGE2 group but failed to show statistical significance (P=0.12). There was no perinatal death in both groups. Hyperstimulation was seen in only one patient of misoprostol group. Conclusion: Misoprostol is more effective than PGE2in successfully inducing the patient but it does not reduce C/Section rate. Moreover it is associated with increasechances of fetal distress. Despite being cheaper than PGE2, it cannot be advocated superior to PGE2 in terms offetomaternal outcome. Further studies with lower doses of misoprostol are recommended.
SPONTANEOUS BACTERIAL PERITONITIS IN PATIENTS WITH CIRRHOSIS AND ASCITES
Authors: RASHEED ABDUL , QURESHI ZEESHAN ALI , SARWAR MUHAMMAD
Published: September 2021

Objective: To find out the frequency and clinical presentation ofspontaneous bacterial peritonitis (SBP) in cirrhosis with ascites secondary to hepatitis c infection. Design: Descriptivestudy. Place and duration of study: Department of Medicine, Military Hospital, Rawalpindi, from September 2004 toFebruary 2005. Patients and methods: Fifty nine subjects with cirrhosis and ascites secondary to hepatitis c infectionwere included. Frequency of SBP with its presenting clinical features was determined. Mean ascitic fluid protein levelwas compared between SBP and non SBP groups. Child pugh class was determined in SBP subjects. P-value wascalculated by applying test of significance. Results: Out of fifty nine subjects, fourteen were having SBP. Abdominalpain / tenderness and jaundice were common presenting features in 78.57% and 64.28% of subjects respectively.Patients were asymptomatic in 7.14%. Mean ascitic fluid protein content was found to be low in SBP as compared tonon SBP patient's 1.41 gm% vs. 2.20 gm%. Conclusion: Because of heterogeneous clinical presentation, ascitic fluidshould be analyzed routinely in all patients admitted in hospital with cirrhosis and ascites.
BEDSIDE LEARNING IN CLINICAL TRAINING;
Authors: DANISH KHALID FAROOQ , AWAN AZRA SAEED
Published: September 2021

Objectives: To find out the learning preferences of clinical students forbedside learning. Design: cross-sectional, descriptive. Methods: The study was done on medical students of theclinical classes in different Medical Colleges in Rawalpindi, Pakistan. Both male and female students were included inthe study. All students were given a questionnaire consisting of 5 questions regarding their preferences for bedsidelearning. Open-ended comments were also invited. Results: A total of 227 students of clinical classes participated inthe study. Most preferred location for bedside learning was the ward (70%, N=158). Most preferred group size was 5(62%, N=140). For duration of bedside learning session most learners preferred 2 hours (59%, N=134). The opinionregarding the mode of case presentation was divided indecisively. Howevermost responders favored single presenter(28.6%, N=65). The preferred frequency of bedside learning sessions was ‘daily’ (49.7%, N=106). Conclusions:Learners in clinical classes prefer bedside teaching as a daily event. Their preferences indicate that the bedside learningpossesses a clinical relevance and offers contextual learning opportunity. Much remains to be learnt about the learners’preferences regarding instruction method in bedside learning.
PRIMARY PPH;
Authors: SHUJA SAMIA , ANSAR AFIA , LIAQUAT NAGINA FATIMA
Published: September 2021

. Objective: To determine the effectiveness and safety of uterine packing in selected cases of primarypostpartum haemorrhage. Study Design: Cross-sectional study. Place and Duration: The study was conducted atJinnah Postgraduate Medical Centre, Karachi, From September 2003 to April 2008. Patients and Methods: Womendeveloping primary PPH due to uterine atony, placenta previa and coagulation failure were selected for uterine packing.Firm packing was done with enormous length of sterile ribbon gauze, using ‘layering technique’ under prophylacticantibiotic cover. Vagina was also packed to give additional pressure. Pack was removed after 12 - 36 hours or earlyin case of failure to control haemorrhage. Pulse, blood pressure, soakage of pads, height of uterine fundus andtemperature were monitored to assess effectiveness and safety. Results: 39 women were included in the study. Causeof PPH was uterine atony in 30 (76.9%), coagulation failure in 5 (12.8%) and placenta previa in 4 (10.3%) cases.Packing was successful in arresting haemorrhage in 32 (82.1%) and failed in 7 (17.9%) cases; 95% Confidence Interval67-91. There was no case of concealed haemorrhage, four patients developed emdometritis and none had delayedhaemorrhage. 13 laparotomies were prevented. The difference between the causes of haemorrhage in successful andfailed cases did not show a definite trend. Conclusion: If employed early, uterine packing is a quick, effective and safemethod for controlling primary PPH in carefully selected cases.
FETOMATERNAL OUTCOME OF PREGNANCY BETWEEN 40 AND 42 WEEKS
Authors: AMJAD NAZIA , IMRAN TAYYBA , AHMED AHSEN NAZIR
Published: September 2021

.Objective:To evaluatewhether serial monitoring of fetuses beyond 40 weeks with biophysical profileand non stress test improves the fetal outcome in terms of morbidity and mortality.Design: Prospective control study.Setting: Department of Obstetrics & Gynaecology at Ittefaq Hospital( Trust) Lahore,. Period: From Jan, 2007 to June2008.Patients and Methods: Two hundred women with singleton uncomplicated pregnancies at 40 weeks were dividedinto two groups; A study group with biweekly biophysical profile and non stress test and a control group with biweeklyantenatal clinical assessment with fetal kick count chart. Main outcome measures were onset of labour, mode ofdelivery, Apgar score, presence of meconium and admission to nursery. Results: The age of patients ranged between18 to 39 years with the mean of 26.33.The range of gravidity was between primigravida to gravida seven. Ninety sixpercent of total patients were delivered by 41 weeks and 6 days.18% of women were induced in study group comparedto 11% in control group ( p value=0.124 ).Cesarean section rate was 8% in study group and 11% in control group. Rateof instrumental deliveries was 6.5% in study group while 11.2% in control group. The difference in mode of delivery wasfound to be insignificant ( p=0.538 ).Weights of the babies ranged between 2.6 to 4.4 kg with a mean of 3.246 kg.Cumulative %age of APGAR score at 5 minutes was more than 6/10 in 92.5% cases ( p=0.665 ).Meconiumwas foundin 18% of cases in study group and 22% of control group( p=0.917 ).12 % of the babies were admitted to nursery instudy group compared to 16% in control group. Perinatal mortality was found to be 10/1000 in control group while therewas no perinatal death in study group. Conclusions: The difference of outcome between two groups was found to bestatistically insignificant which concluded the validity of either mode of management.
INTERLOCKED INTRAMEDULLARY NAILING OF LONG BONES
Authors: ILYAS MANSOOR , IDRESS MOHAMMAD , TAREEN SIAFUDDIN
Published: September 2021

.. Intramedullary interlocking nailing is the recommended procedure of fixation of long bones fracture. This type of fixation allowthe patient to walk independently in few days time, but unlikely there are only few centers in our country which are doing this practice. InMansoor Orthopedic Hospital and Sandeman Civil Hospital Quetta we started this type of fixation from November 2001 and we have done 15femoral (13 closed and 2 open GII) and 15 tibial (11 closed and 4 open GI & GII). Interlocking nails up till now. Our early results revealed 0%infection rate, breakage of nail in one case and bending of one distal locking screw. Inspite this in both cases fracture healed with out anysurgical intervention. Patient had nearly full range of movements of both knee & hip joint. We recommend close Intramedullary in interlockingnailing is an excellent technique to treat long bone fracture regarding good healing minimum complication shorter hospital stay and earlyfunctional rehabilitation.
ESTIMATION OF SIALIC ACID IN CARDIAC PATIENTS
Authors: ZAFAR TASNEEM , IQBAL ZAFAR
Published: September 2021

.Objectives: Lipids are common conjugates of serum lipoproteins while sialic acid is present in combination with lipids andproteins as glycolipids and glycoproteins respectively. This study was aimed to get some preliminary information regarding the possiblecorrelation between serum sialic acid and lipid profile in cardiac patients to investigate the possibility of using these parameters to aid thediagnosis and prognosis. Material and methods: Normal subjects (15) and Cardiac patients (42) were estimated. Total cholesterol , Totallipid, Triglycerides , HDL-C and Serum Sialic acid was measured. Duration and place :One year (Jan-Dec. 2005) at POF Hospital ,Wah Cantt.Results: Total lipids 523.4 ± 136.2 mg/dl, Total Cholesterol 142.7 ± 43.3 mg/dl, Triglyceride 81.5 ± 51.6 mg/dl, HDL-C 25.51 ± 10.3 mg/dl andSialic acid was estimated to be 150.8 ± 41.1 mg/dl in normal subjects, while in cardiac patients (n = 42) the level of total lipid was 747.5 ± 247.8mg/dl, total cholesterol 174.0 ± 43.4 mg/dl, triglyceride 154.5 ± 147.8 mg/dl and HDL-cholesterol was 18.1 ± 10.6 mg/dl while Sialic acid wasestimated to be 216.1 ± 57.0 mg/dl in cardiac patients. Conclusion: Results indicate that all the parameters i.e. total lipid, cholesterol,triglyceride and sialic acid except HDL-cholesterol, studied were significantly higher in cardiac patients (P < 0.01) while HDL-cholesterol wassignificantly lower in these patients (P < 0.01).One possible explanation to this could be the dietary habits of the people of this area who preferto consume vegetable oils which are considered to be rich in polyunsaturated fatty acids, rather than a lower intake of fat rich diet. In additionto this, these people consume substantially large quantities of garlic and onions which again are considered to generate hypocholesterolemiceffects.
GASTROINTESTINAL DISEASES;
Authors: KHAN HAMZULLAH
Published: September 2021

. Objectives: To determine the frequency of gastrointestinal (GI) diseases/symptoms in a tertiary care hospital of Peshawar.Methods: A Cross sectional observational study was conducted in Medical department Khyber teaching hospital Peshawar from August 2005to march 2006. A total of 189 patients with established diagnosis of any gastrointestinal disease were randomly selected. Out of total101(53.43%) were males and 88(46.56%) were females. Relevant information’s were recorded on a pre-designed questionnaire was designedin accordance with the objectives of the study. Results: The age range of the patients was from 8 years to 82 years with mean age of 47.5years. The mode age observed was 45 years. Of total sampling (43.91%) were illiterate, primary passed (24.33%), matric education (15.87%),secondary education (11.11%) and (4.76%) patients had degree level education. The gastrointestinal disease pattern was: acute peptic disease/dyspepsia (15.87%), reflux esophagitis (7.91%), duodenal ulcer (1.5%), gastric ulcer (0.5%), worm infestation (1.5%), esophageal carcinoma(0.5%) and miscellaneous in 136(71.95%) patients. The distribution of the gastrointestinal disease symptoms was: chronic diarrhea (19.04%),vomiting (12.16%), dysentery (6.34%), bleeding per rectum (5.20%), constipation (2.1%), anorexia (1.5%), dysphagia (1.10%) and multiplesymptoms were recorded in (24.33%) patients. Conclusion: acute peptic disease/dyspepsia, chronic diarrhea dysentery, reflux esophagitisare major gastro intestinal (GI) diseases in our setup. Duodenal and gastric ulcers, carcinoma of gastrointestinal tract, worms infestation,dysphagia and anorexia were not as common.
SERUM LIPID PROFILE;
Authors: BURIRO MUHAMMAD ANWAR , TAYYAB MUHAMMAD
Published: September 2021

Objective: To determine the effects of Nigella sativa and sunflower oil diet intake on serum lipid profile in albino rats. Material& Methods: Eighty four albino rats with equal number of males and females were selected for the study, they were divided into six differentgroups, Control groups1,111,V,were given low fat diet(3%),high fat diet(20%), high fat diet supplemented with bile salt (1% colic acid) andantithyroid drug (0.5% propylthiouracil). The Experimental groups were given the above diets with supplemented Nigella sativa. Low fat dietincreased all the lipid fractions significantly when given at12 and 24 weeks duration as compared to 0 week. Results: The high fat diet whengiven at different intervals decreased all lipid fractions significantly as compared to baseline level. The high fat diet with propylthiouracil andbile salt also increased all the lipid fractions and the increase was more as compared to previous groups. The supplements of Nigella sativain the groups decreased all the lipid fractions significantly as compared to the control groups except HDL-c, which was significantly increasedin all the experimental groups as compared to control groups. Conclusion: On the basis of these findings conclusions are made, that Nigellasativa has got TG,TC, and LDL-c lowering and HDL-c raising effects.3% sunflower oil low fat diet has got TG,TC,HDL-c, and LDL-c raisingeffects.20% sunflower oil high fat diet has got TG,TC,HDL-c and LDL-c lowering effects. Both Nigella sativa and sunflower oil have got lowatherogenic index (TC/HDL) and may be recommended in hyperlipidaemic patients or normal individuals.
CHRONIC HEADACHE;
Authors: KHAN QAMAR S , SHAN-E-DIN SHAIKH MOHAMMAD
Published: September 2021

Objective: Radiological imaging modalities are playing vital role for detecting the causes of headache. Unfortunately theseinvestigations are costly and out of reach for common people Conventional radiology is the investigation of chronic headache with ear, noseand throat problem. Water view is most frequently advise for studying the sinuses nasal septum and bony component and is of great help ofpatient with chronic Headache. Setting: Department of Radiology Dow Medical College. Karachi. Period: Three month prospective study fromOctober 2003—December 2003. Result: Both male and female patients of different age group with complaint of chronic Headache was advisedfor water view 19 were male while 12 were female. DNS (78%) (Deflected nasal septum) were found to be the main cause of Headache in maleand (33%) female shows maxillary sinusitis the main cause of chronic Headache. Conclusion: Conventional radiology is still playing importantrole for diagnosing the cause of Headache apart from advance imaging modality which is costly and unreachable for common people ofdeveloping countries.
IMAGING OF AMBIGUOUS GENITALIA
Authors: MEHDI SYED ANJUM , SHAUKAT ASIM , DOGAR IQBAL HUSSAIN , Hussnain Nadia
Published: September 2021

Objective: To establish the role of imaging in Ambiguous Genitalia. Period: June 2006 to June 2008. Place: RadiologyDepartment, Mayo Hospital, Lahore and Allied Hospital Faisalabad. Patients and Methods:12 cases referred to us with Ambiguous Genitaliawere taken and evaluated with Ultrasound and Magnetic Resonance Imaging. Results: Following findings were observed, incomplete scrotalfusion with Ambiguous genitalia was observed in 41.7% infants. Whereas testis were localized in 33.3% by ultrasound & remaining by MRI.Imaging diagnosed that 66.7% were male & remaining female. Lab tests and surgical evidence prove that imaging results were in agreement.Conclusion: Imaging has a conclusive role in Ambiguous Genitalia and Ultrasound is the first modality to look for Internal Genitalia
OBESITY AND HYPERTENSION
Authors: KHAN ZULFAQAR A. , ASSIRI ADEL M.
Published: September 2021

Objectives: To assess the associations of obesity and hypertension in diabetics and non-diabetics. Patients and Methods:A total of 430 Saudi patients suffering from non-insulin-dependent (type 2) diabetes mellitus comprising of 205(48 %) males and 225(52 %)females were studied. Height and weight were measured for calculating body mass index (BMI). The type 2 diabetics and non-diabeticindividuals were investigated separately to determine the prevalence of obesity and overweight. Systolic and diastolic blood pressure wasrecorded using the standard method in a sitting position. The patients were diagnosed as diabetics and hypertensive on the criteria of the WorldHealth Organization. Results: The prevalence of obesity was 16.7% and 22.9%, and overweight was 27.1% and 22.9% in the total men andwomen studied in healthy non-diabetics; while the prevalence of obesity was 26.8% and 42.7%, and overweight was 45.8 and 38.2% in the totalm 1c en and women, in the diabetics respectively. In diabetic subjects, glycemic status (HbA ) and BMI had coefficient of correlation between 26matched pairs as r= 0.36, but not impressive. In over-all population, irrespective of gender, the diabetic subjects had higher obesity/overweight(ob/ow) ratio value (0.84) than non-diabetics (0.79).The prevalence of HT in non-diabetic group was 4.42% in males compared to 2.1% infemales, while in the diabetic group the prevalence of HT was 24.39% in males and 41.33% in females, respectively. Prevalence of HT indiabetics was higher in females than males, in contrast to non-diabetics. Conclusion: Our study shows that obesity and hypertension are bothcontributing factors in the development of type 2 diabetes mellitus; and the measures should be adopted for control of obesity and hypertensionto reduce the cause of diabetes mellitus.
PARTIAL INFERIOR TURBINECTOMY;
Authors: MANZOOR TAHIR , ASGHAR ADNAN , ASLAM SOHAIL , Ali Muhammad , Ayub Waqas
Published: September 2021

Objective: To assess the effectiveness of partial inferior turbinectomy in relieving the symptoms of nasal obstruction in casesof inferior turbinate hypertrophy and to compare the results in terms of relief from nasal obstruction in response to total inferior turbinectomy.Design: Comparative Study. Setting: Department of Otorhinolaryngology and Head and neck surgery, CMH Rawalpindi. Period: From January2004 to November 2004. Patients and Methods: A total of 60 patients with inferior turbinate hypertrophy were selected by convenientsampling. 30 patients were treated by partial inferior turbinectomy and 30 by total inferior turbinectomy and result in terms of relief of nasalobstruction based on VAS (Visual Analogue Score) was observed with follow up carried out at interval of one week and then two months.Results: All cases of both the groups showed complete relief of nasal obstruction after 02 months, showing 100% results. Out of 30 casesmanaged by total inferior turbinectomy 4 cases (13%) developed atrophic rhinitis. Conclusion: Partial inferior turbinectomy is as good as totalinferior turbinectomy in relieving nasal obstruction with an edge of avoiding complications like atrophic rhinitis
CHOLECYSTECTOMY;
Authors: GHAFOOR ABDUL , SHUKR IRFAN , NASIR ABDUL , Alta Chaudhry
Published: September 2021

Objective: To compare the outcome of cholecystectomy with and without drainage. Design: Descriptive; analytical. Placeand duration of Study: The study was carried out from Jun 2005 to Nov 2006 at Unit III, Department of Surgery, Liaqat University of Medical& Health Sciences, Jamshoro. Material & Methods: All the patients diagnosed as cholelithiasis were treated with open cholecystectomy. Thepatients were randomly divided in group A and B. Number 18 Nasogastric tube was inserted in subheptic space after cholecystectomy in GroupA, and no drain tube was placed in group B patients. Postoperatively patients in both groups were given same antibiotics. Postoperativecomplications and hospital stay were monitored in both groups. Exclusion criteria were cardiopulmonary disease, cirrhosis liver and diabetiesmellitus. Patients with acute cholecystitis and choledocholithiasis were also excluded from study. Z-test is used to test the difference betweenproportions of two groups are statistically insignificant. Results: During the study period a total of 100 patients were operated for cholelithiasis,with 50 patients in each group. The mean age for group A and B were 46 and 45 years respectively. The female to male ratio in the group Aand B were 45:5 and 43:7 respectively. Mortality rate in both groups was zero. Group A had two cases of infected collection in subhepatic spaceand five cases of wound infection. In group B one patient with bile collection, one infected collection and two cases had wound infection. Meanhospital stay was 3.7 in group A as compared to 2.26 in group B. Both groups are statistically insignificant with respect to complications.Conclusion: Routine drainage after cholecystectomy is unnecessary.
APPENDECTOMY;
Authors: KHANZADA TARIQ WAHAB , SAMAD ABDUL , MEMON WASEEM
Published: September 2021

. Objective: The purpose of this prospective study was to compare length of hospital stay, in hospital complications andoperative time between laparoscopic appendectomy (LA) and open appendectomy (OA). Setting: This prospective study was carried out atKing Khalid Hospital, Najran, Kingdom of Saudi Arabia over a period of 26 months from July 2002 to August 2004. Methods: Patients wererandomly divided into laparoscopic and open appendectomy groups and length of stay, operative time and in hospital complications were noted.Results:60 patients underwent laparoscopic appendectomy and 65 underwent open. Operating time was longer in laparoscopic group but lengthof stay was shorter in laparoscopic group. Wound infection was the common complication in both group but it was higher in patients whounderwent open appendectomy. Conclusion: Laparoscopic appendectomy can be performed with morbidity similar to open appendectomyand may actually have decreased wound infection rate.
ORGANOPHOSPHORUS COMPOUND POISONING;
Authors: RAJA KHURRAM SOHAIL , FAZAL MUHAMMAD OWAIS , BILAL AHMAD , Qurashi Fraz Saeed , Shaheen Muqqadas
Published: September 2021

. Objective: 1) To have an overview of epidemiological factors. 2) To determine the outcome of victims. Study design:Descriptive study. Setting: MU-III Allied Hospital Faisalabad. Period: From June 2007 to Dec 2008 Materials and Methods: 484 consecutivepatients who were admitted, from June 2007 to December 2008, in Medical unit III with history of having organophosphorus poisoning wereanalyzed for the epidemiological factors, time to arrive in the hospital, conscious level, mode of poisoning (homicidal, suicidal or accidental)treatment given and outcome. Results: The results of the study showed that age 14-30 years is the major group involved in poisoning 87.9%as compared to ages 31-45years (10.5%) and age more then 45 years (12%), also age group 14-30 years is having more suicidal tendenciesas well as accidental poisoning and these tendencies decrease with increasing age (p value=0.000). Male victims are more as compared tofemale victims (52.9% vs. 46.7%) in the study group. Suicidal tendencies as well as homicidal poisoning is more in female (n= 127 and 44,respectively) while accidental poisoning is more in male population (n=106), (p value=0.001). Urban population is more at risk of poisoning inall three, homicidal, suicidal and accidental, as compared to the rural population (p vale=0.018). Importantly in study is showed that out comeof the poisoning from organophosphorus is directly proportional to the interval between poisoning and presentation in emergency ward (p value=0.000), conscious level of the victim (p value = 0.000) and does not depend upon the mode of management (oxime or atropine) (p value 0.026).Conclusions: Younger urban population have increased tendency of poisoning with a dominance of female population. Rapidity of treatment,time to arrival to hospital and conscious level at presentation are the factors deciding outcome of a given patient rather than the mode oftreatment (oximes and atropine both are equally effective).
ANAL FISSURE;
Authors: HASHMAT AZEEM , ISHFAQ TAHIRA `
Published: September 2021

Objective: To evaluate the efficacy of glyceryl trinitrate (GTN) preparation for the treatment fissure in-ano. Design: This studyis a prospective clinical trial. Place and duration: this was conducted initially at PMC Faisalabad and other centers from November 2001 toonward for the period of five years. Patients and Methods: Out of 306 patients, 42 disliked/ refused this modality of treatment and waslaunched on 264 patients. 114 patients never followed up so, were excluded from the study. The remaining 276 patients applied 0.2% glyceryltrinitrate preparation on their anal verge thrice a day for two months. The patients were followed up at 1 to 12 weeks. The extent of st thimprovement in the presenting symptoms, side effects and complications were noted on questionnaires. Results: A healing rate of 64.3%, andrecurrence occurred in 35.7 %. 72 patients demanded surgery after failure/ non-compliance of GTN ointment treatment. Conclusion: glyceryltrinitrate preparation is a safe and effective modality for the treatment of fissure in-ano.
VESICOVAGINAL FISTULA (WF)
Authors: TAHIR M. SHUJA , ROOHI MAHNAZ
Published: September 2021

Vesicovaginal fistula is not an uncommon condition. It gives rise to multiple socio-psychological problems for women usually ofyounger age. It can be prevented by improving the level of education, health care and poverty. Early diagnosis and appropriate treatmentrequired to help the patient. Preoperative assessment, treatment of co-morbid factors, proper surgical approach & technique ensuresuccess of surgery. Postoperative care of the patient is equally important to avoid surgical failure
DAMAGE CONTROL SURGERY
Authors: ATEEQ MUHAMMAD , JAHAN SHAZIA , HANIF M.
Published: September 2021

Objective: To analyze the role of damage control in surgery in severely injured and polytrauma patients. D e s i g n:Descriptive study. S e t t i n g : Surgical unit of District Headquarter (teaching) Hospital, Rawalpindi. P e r i o d : January 2000 to December 2007.Patients a n d m e t h o d s : This study included 28 severely injured patients who presented in the accident and emergency department ofDistrict Headquarters (teaching) Hospital, Rawalpindi. These patients were unstable because of life threatening hemorrhage following someblunt or penetrating trauma. After immediate shifting to operation theater, resuscitation and operative intervention was done simultaneously.Different procedures of damage control surgery like abdominal packing for hepatic and pelvic trauma, major vascular ligation for vascularinjuries of neck and extremities were adopted in phase I. In phase II patients were managed in ITC for coagulopathy and hypothermia.Definitive treatment was done in Phase III after 24-72 hours once patients got stable. R e s u l t s : Total 28 patients included in the study. In18 patients abdominal packing for hepatic injury (n=11) and pelvic fractures (n=7) was done. Major vascular ligations in n=11 and temporaryintestinal clamping in n=1 patient. Planned re-exploration after 24-72 hours in n=16 and unplanned re-exploration within 24 hours in n=5patients was done. Complications included ongoing hemorrhage (n=5), coagulopathy (n=2), controlled biliary fistula (n=1), abdominalcompartment syndrome (n=1), cerebral ischemia (n=1) and gangrene of abdominal wall (n=1). Two patients died.
LATERAL INTERNAL SPHINCTEROTOMY
Authors: SAJID MUHAMMAD , AFZAL MUHAMMAD
Published: September 2021

Anal fissure is a common anorectal problem, presenting with pain during and after defecation. It is associated withincreased tone of the internal anal sphincter muscle. The relief of this hypertonia is the cornerstone of the treatment of the anal fissure. Thesurgical relief of this hypertonia is very successful in treating the fissure with minor morbidity of the procedure. Patients & M e t h o d s : A studywas conducted in 486 patients,(344-males and 142 females,25-40 range). Setting: Saad Surgi-med hospital Faisalabad. Period: 1999to 2007. Lateral internal anal Sphincterotomy for chronic anal fissure. The therapeutic outcome and complications of the procedure wererecorded. Results: Out of 486 patients, 344 were males and 142 females.frange 25-40) The site of fissure was in posterior midline 6 O' clockin 350 patients.(m=257,f=93);Anterior midline. 12 O'clock in 99 patients.(m=76,f=23);both anterior and posterior in 41 patients.(m=l 5,f=26)Eleven patients had associated peri-anal abscess and 19 patients had associated Fistula in ano. All the patients were discharged after 24hrs with regular follow up at 1,2,6,24 wks. 275 patients had significant relief of pain in 48 hrs, 107 became pain free in 1 wk.37 has had somepain for 2 wks. In 479 patients fissure healed in 3 months, 7 patients has had delayed healing out of which five patients required curettageof the wound under local anaesthesia which healed subsequently in next six wks. 12 patients had minor incontinence whichdisappeared in 4 wks. In one patient the incontinence persisted for six months then it got settled. Conclusion: Lateral subcutaneous internalSphincterotomy is a safe and effective treatment of chronic anal fissure.
MANAGEMENT OF FISTULA IN ANO
Authors: ABBAS TAYYAB , NAZIR ABID , SADIQ WASEEM
Published: September 2021

Aim: The aim of this study was to compare the efficacy and morbidity of two surgical procedures, firm cutting seton andloose seton / fistulotomy in the management of suprasphincteric and high trans-sphincteric fistula in ano. Setting: Jinnah Hospital / AllamaIqbal Medical college, Lahore. Period: June 1999 to January 2008. Methods: This is a prospective, randomized study of 50 consecutivepatients (25 in each group) suffering from suprasphincteric and high trans-sphincteric fistula in ano. Patients were randomly allocated oneof the two methods of treatment. In firm cutting seton, seton was repeatedly tightened with the interval of 15 days till the thread came outwhereas loose seton / fistulotomy was a two staged surgical procedure. Follow up was made for 12months to record the fistula recurrence,anal incontinence, duration of complete wound healing and number of hospitalizations. Comparison was made using standard statisticalmethods. Chi-square and Fisher's Exact test was applied for comparison. Results: There was no significant statistical difference betweenthe groups in age, sex and type of fistula. Patient treated with loose seton / fistulotomy required more than one hospitalization, more offwork and more expenditures as compared to firm cutting seton method. The rate of anal incontinence was more in patients treated withloose seton / fistulotomy. Recurrence rate was almost the same in both groups. Conclusion: Both techniques are equally effective ineradication of fistula but the rate of postoperative anal incontinence and duration of complete healing of the wound is more in patients treatedwith loose seton / fistulotomy.
OBTURATOR NERVE RLOCK
Authors: AHMED NASEEM , Rana Shahid Mahmood , HAIDER SYED MUHAMMAD ZAHEER , Mahmood Arshad , AHMED FAIZAN , Alvi Muhammad Sarwar
Published: September 2021

Objectives: To evaluate the efficacy of obturator nerve block combined with spinal anaesthesia for prevention of adductormuscle spasm and its associated complications during transurethral resection of bladder tumours located at its lateral and inferolateral wall.Study design: A prospective study. Setting: At AFIU Rawalpindi. Period: From January 2005 to December 2006. Material and methodFifty patients who had tumours at their lateral / inferolateral bladder wall of physical status ASA I - IV received spinal anaesthesia at 3r d or4l h lumbar space followed by obturator nerve block with a view to preventing adductor jerk during resection of tumour. Results: There wascomplete suppression of adductor jerk in 45 (90%) patients and surgery was completed smoothly. Two patients (4%) had mild adductorjerk and additional sedation was required. The block failed to work in 3 (6%) cases and required conversion to general anaesthesia. Thusthe procedure was successful in 94% (complete and partial suppression of jerk. Conclusion: We conclude that spinal anaesthesiacombined with obturator nerve block is an effective technique for preventing adductor jerk during TUR-BT, thus avoiding intra-operative andpost operative complication.
TUBERCULOSIS
Authors: MALIK ABDUL SALAM , AHMAD GULZAR
Published: September 2021

Objective: To identify the factors responsible for noncompliance of Anti Tuberculous Treatment in TB patients. StudyDesign: Cross Sectional Descriptive Study. Place & Duration: The study was Carried out at Chest diseases and Tuberculosis unit BahawalVictoria Hospital Bahawalpur from 15th May 2007 to 15th August 2007. Subject & Method: The tuberculous patients who abandoned antituberculoustreatment repeatedly were interviewed for determination of their reasons to be defaulter before completing therapy byquestionnaire method. The patients were AFB positive on every non-compliance episodes. Results: The total number of 100 noncompliantpatients were interviewed. It was noted that 63% were males and 37% were females among them. There were 72% married and 28%unmarried from total patients. The treatment source was asked and found that 92% used government health out let only and 8% used privateservices also from them. Conclusion: TB is curable disease so health education should be imparted through electronic media andcommitted field teams stressing to take regular and complete ATT according to the physician advice removing the social belief against TBdrugs. Decentralized government and private sector coordination is essential to give treatment at doorstep to reduce dropout and defaultertendency. Stigma of TB as a disease of the illiterate & poor still persists.