bluuebunny/crossref_metadata_2025 huggingface dataset:
Role of T2 Textural Analysis of Prostate Lesion: A Retrospective Study
Authors: Ali A Alali Meshari
Published: May 2022

Introduction: Prostate cancer is diagnosed in two-thirds of instances in the world's more developed regions. Prostate cancer was detected in 180,890 new cases in the United States in 2016, according to the American Cancer Society. One out of every six men is projected to develop prostate cancer at some point in their lives. The study's major purpose was to develop a textural analysis-based classifier to differentiate between benign and malignant prostate tumors using MRI-T2WI. Materials and method: The retrospective study was conducted in the department of radiology in KKUH. Total 93 lesions from prostate cases were performed in KKUH from 2015 to 2017. About 75 lesions of 48 patients were included in this study. Eleven haralick features from region of intrests (ROIs) were extracted. After matching them with traces done by consultants in Profuse software, which was utilized for image-guided biopsy, digital rectal examination (DRE), prior biopsy (Prior bx) lesions were traced using ImageJ (MRI-ultrasound fusion). Weka software used this to create a classifier that distinguishes between malignant and benign tumors. Result: The age of total 48 patients was in the interquartile range of 59.0-70.0, with an average of 64.4 years. The PSA was observed an average of 22.5 with an SD of 50.5 and an interquartile of 10.0. The mean size of the prostrate was 3.2 cm with SD 1.9. Among 48 patients Digital rectal examination (DRE) 8 (16.7%) and 40 (83.3%), Prior biopsy (PRIOR BX) 2 (4.2%) and 46 (95.8%), PI-RADS 22 (45.8%) and 26 (54.2%) were observed positive and negative respectively. In DRE, 88% sensitivity 55% specificity with PSA 9.75 (p-value 0.008) were observed. 100% of sensitivity, 41% specificity with PSA 8.19 (p-value 0.897) were found in PRIOR BX, but in MRI, 55% of sensitivity 69% specificity with PSA 10.70 (p-value 0.107) were observed. Conclusion: T2 texture analysis is good in classifying prostate lesions with acceptable sensitivity and specificity. T2W MRI-based textural analysis agreed with pathological findings from many institutions and was sensitive to underlying pathological differences between low- and intermediate/high-grade prostate cancers. Actors in the diagnostic performance, such as DWI/ADC and perfusion, histogram parameters, and other features with distinct orientations and lengths, could help doctors discriminate benign and malignant prostate nodules, allowing for more efficient and precise clinical decisions. Keywords: Prostrate lesion, MRI, textural analysis, cancer
Use of Lidocaine Analgesia Prior To Steroid Injection in Reducing Post-Traumatic Hypertrophic Scars
Authors: Mal Jameeat , Adnan Muhammad Ali , Hussain Majid , Awan Asadullah , Baloch Masroor Ahmad , Zia Muhammad Khurram
Published: May 2022

Background and Aim: Hypertrophic scars are painful and can develop after surgery or trauma, with symptoms varying from an intractable allodynia to minor itch. Extraneural and intraneutral structures could be involved in painful scars issue. The standard treatment for hypertrophic scars is intralesional steroid injections. The present study aimed to investigate the lidocaine analgesia for pain relief in post-traumatic hypertrophic scars. Place and Duration: Burn Centre Dr Ruth K.M. Pfao Civil Hospital, Karachi and the department of Plastics and Burn Surgery, Bolan Medical Complex Hospital, Quetta during the period from October 2020 to September 2021. Methodology: Thirty-five patients with post-traumatic hypertrophic scars were enrolled in this study. Steroids were injected through scars with or without Lidocaine (-10°C) applications for 15 seconds. Ethical approval was taken from the institutional ethical committee. In this experimental protocol, two arms were used. In the first arm, two scars on the same patient's body were randomly assigned as control or experimental scars. Patients were used as their own controls because everyone experiences pain differently. Scars were injected into patients once a month, and pain intensity scores were recorded after each injection. A visual analog score (VAS) was used for the evaluation of pain severity or degree in each individual. Results: Of the total 35 hypertrophic scars patients, about 23 (65.7%) and 12 (34.3%) were females and male respectively. The overall mean age was 32.67±5.83 years. All the hypertrophic scars patients with age ranges from 20 to 65 years were enrolled. Of the total lesions, the presence of hypertrophic scars on the arms, shoulder, back, and chest were 7 (20%), 3 (8.6%), 9 (25.7%), and 16 (45.7%) respectively. The visual analogue score for control and pretreated was 2.8±1.42 and 7.91±1.29 respectively. The VAS pain score was significantly associated (p<0.1) with difference in VAS score of control and pretreated scars. Conclusion: The present study found that lidocaine analgesia provides significant pain relief in post-traumatic hypertrophic scars prior to steroid injection. It also provides a safe and effective way for enhancing the management of disease and patient compliance. Keywords: Hypertrophic scars, Lidocaine Analgesia, Pain relief, Steroid Injection.
Assessing Plantar Pressure and Feet Pain in Females during the Third Trimester of Pregnancy
Authors: Ahmad Tariq , Shafi Parveen , Khan Rahim , Khokhar Abdul Nabi Ghulam Akbar , Zeb Syed Alam
Published: May 2022

Background: The centre of gravity is altered in pregnant females resulting in hyperextended knees and resulting pain in the lower back and feet due to postural changes to adapt and recreate balance. The frequency and prevalence of back pain in the second and third trimesters are around 43.6% and 34.8% respectively, whereas the frequency of foot swelling is found to be around 32.6% of pregnant females in the third trimester. Similar trends are observed in overweight non-pregnant females with prevalence trends as the frequency of ankle and feet pain, and knees pain found to be in 68.7% and 53.3% respectively. Aims: This study will aim to assess plantar pressure and feet pain in pregnant females in the third trimester. The study will further assess and compare the severity of symptoms between pregnant females and females who are overweight or obese using a visual analogue scale. Materials and methods: A cross-sectional study was conducted during the period of November 2020 to October 2021. The study was conducted at the Orthopaedic department of Mardan Medical Complex/BKMC, Mardan and Obs and Gynae department of Swabi Medical Complex /GKMC, Swabi. It consisted of 90 females which comprised the study group and control group. The study group consisted of 45 females who were in the third trimester of pregnancy. All the recruited control participants had BMI in the overweight category. The control group consisted of 45 females and the recruitment criteria for the control group as females with Body Mass Index (BMI) ranging between overweight and obese. Both study and control groups were assessed for plantar pressure and foot pain by employing a visual analogue scale for pain severity. Result: The readings showed that the study group 37.7% (17 participants out of 45) complained of an 8/10 severity of pain during the third trimester whereas control participants 24.4% (11 out of 45) showed a 6/10 severity of pain. 91.1% of study group females showed the severity of pain to be 6/10 or more. Results showed that a maximum number of pregnant females had plantar pressure and feet pain similar to or more than that of the control group. Moreover, the control group showed 57.7% of females having symptom severity similar to or greater than 6/10 on the visual analogue scale. Conclusion: The results suggest the prevalence of severe feet pain and plantar pressure is significantly greater in pregnant females in the third trimester with 91.1% as compared to 57.7% of non-pregnant obese females. The severity of pain was also recorded to be higher in pregnant females than in control counterparts. Keywords: Plantar pressure, Feet pain, Pregnancy, Obesity, Visual analogue scale.
To Determine The Risk Factors and Indications of Emergency Peripartum Hysterectomy
Authors: Hafeez Amina , Yasin Shumaila , Fatima Saba , Umer Sabeena , Roman Shazia , Irshad Faiza
Published: May 2022

Objective: To determine the frequency of factors leading to emergency peripartum hysterectomy Introduction: The emergency peripartum hysterectomy (EPH) is a dreadful complication and to determine its risk factors is very important to early and prompt management. Objective: My objective is to determine the frequency of factors leading to emergency peripartum hysterectomy. Main outcome: EPH is the main outcome which is surgical removal of uterus due to severe postpartum hemorrhage Study design: Descriptive case series Setting: Obstetrics and Gynaecology Department, District Headquarter Hospital, Gujranwala Duration of study: 1 July 2019 to 31 December 2019 Material and methods: Seventy patients undergoing emergency peripartum hysterectomy were selected from the Obstetrics and Gynecology emergency department of District Headquarter Hospital, Gujranwala. Hospital registration numbers was noted and for all enrolled women. The major risk factors like uterine atony, uterine rupture and abnormal placentation was noted down from detailed history and clinical and ultrasound examinations and surgeon notes was collected. All patients will be efficiently managed throughout a per standard guidelines. Data was analyzed using SPSS version 20. The quantitative variables were age, gestational age and BMI. Mean and standard deviation was calculated for quantitative data. Frequency and percentages were calculated for qualitative data like parity and risk factors. Effect modifiers like age, parity and BMI was controlled by stratification. Post stratification Chi square test was applied. P value ≤ 0.05 was considered as statistically significant. Results: The mean age was 28.64 ± 6.836 years. The mean gestational age and BMI were 31.61 ± 3.576 weeks and 23.66 ± 2.904 kg/m2 respectively. The frequency of parity groups was as follows; for parity 1, 2, 3, 4 and ≥5 was 13 (18.6%), 10 (14.3%), 11 (15.7%), 25 (35.7%) and 11 (15.7%) respectively. The main causes of EPH were uterine rupture, abnormal placentation and uterine atony with proportions of 30%, 44.3% and 12.9% respectively. The data was stratified according to age, gestational age, parity and BMI. The results showed that there was no significant impact of age, gestational age, parity and BMI as all p values were >0.05 Conclusion: The emergency peripartum hysterectomy has various causative factors and uterine rupture, abnormal placentation and uterine atony are the most significant factors which can be minimized to reduce its incidence. Keywords: Emergency Hysterectomy Obstetric Outcome Postoperative Complications Postpartum Hemorrhage/epidemiology/surgery Pregnancy
Antibiofilm and Antimicrobial Effectiveness of Chlorhexidine Hexametaphosphate Nanoparticles as a Coating for Orthodontic Miniscrews
Authors: Hasan Selma Merza , Alhuwaizi Akram Faisal
Published: May 2022

Introduction: Inflammation around miniscrews can be responsible for about 30% of failures of these devices that associated with miniscrews insertion transgingivally, which straightly accessible to all forms of microorganisms existing in the oral cavity. Chlorhexidine hexametaphosphate has been described as a material that offers persistent, slow release of active chlorhexidine over time when nacked to an aqueous conditions. Aims of study: To test the antibiofilm and antimicrobial effects of OMS coated with antimicrobial nanoparticle (Chlorhexidine hexametaphosphate). Materials and Methods: The sanitized orthodontic minisecrews coated by nanoparticles, to establish the effectiveness of nanoparticles against formation of biofilm for S. mutans, A. actinomycetemcomitans and C. albicans. The agar method was used to evaluate the antimicrobial validity of the nanoparticles coated OMS. Gram-positive bacteria including S. mutans and S. gordonii gram negative like A. actinomycetemcomitans, p. gingivalis and Candida were used to test the antimicrobial activity of the titanium and stainless steel coated orthodontic miniscrews. After incubation for 24 hours at 37℃, the agar plates were distant from the incubator and the zone of inhibition was examined for each OMS in mm using a ruler around each disc. The zone of inhibition was measured in terms of length (mm), breadth (mm), and area (mm2) due to linear shape of samples. Area of the ellipse was calculated as π (l/2 × b/2). Results: The inhibition areas around stainless steel coated orthodontic miniscrews were larger than those around the titanium ones for all types of microorganisms. It were statistically significant for S. mutans and A. Actinomycetumcomitance but not significance for S. Gordonii, P. gingivalis and candida. The inhibition areas for all bacteria were comparable but notably larger than that for candida. Chlorohexidine hexametaphosphate nanoparticles exhibited powerful antibiofilm activity against the selected S. mutans, A. Actinomycetumcomitance and candida. Conclusion: This study revealed that OMS coated by CXH-HMP nanoparticles as antimicrobial agent can provide significant antimicrobial activity that inhibit bacterial growth and aid in biofilm reduction. Keywords: Orthodontic miniscrew, CHX-HMP nanoparticle, Antimicrobial and antibiofilm.
Comparative Study of Histopathological and Immunohistochemical Features of Biopsies of Patients of Lung Cancer
Authors: Islam Sadia , Anwar Ayesha , Tahir Shamila , Kazi Asma , Aziz Aisha , Farooq Hassan
Published: May 2022

Introduction: When it comes to pollution, smoking, infections, tuberculosis (TB), and allergies, the lungs are the most sensitive organs to damage. Pleural fluid is a fluid that fills the parietal and visceral layers of the pleura that surround the lungs and helps to keep them moist. An investigation of the link between age, gender, and immunohistochemistry findings in lung and pleural biopsy samples was conducted. Materials and procedures: This is a four-year retrospective study that will take place between May 2017 and May 2021. In the current study, a total of 112 cases were submitted for histological investigation, with 100 instances using lung biopsy and 12 cases involving pleural biopsy being the most prevalent. Immunohistochemical testing was carried out as and when it was necessary. Results: A total of 100 lungs were examined. There were 56 cases of neoplastic tumours, 35 cases of non-neoplastic tumours, and nine cases of inconclusive tumours. The most common type of cancer was squamous cell carcinoma. The most prevalent non-neoplastic lesion was angioedema, which was the most common type of lesion (4 percent ). Patients with lung tumours who have malignancy outweigh those who have inflammatory illnesses at our institution. Seven of the 11 pleural biopsy cases were malignant, whereas the other eleven were not. Adenocarcinoma was the most common kind of neoplastic pleural lesion, followed by tuberculosis. Conclusion: The use of histopathology in the diagnosis of lung and pleural lesions is essential. It is possible to increase the accuracy of histological diagnosis with the use of immunohistochemistry. Keywords: Lung biopsy, pleural biopsy, histopathological examination.
Therapeutic Effect of Antioxidant Extract of Ocimum Gratissimum on Liver Toxicity Model in Rats
Authors: Javed Muhammad Shahid , Iqbal Sohail , Hayat Nida Qasim , Zaheer Attya , Qaiser Fatima , Irshad Faiza , Shaukat Amal
Published: May 2022

Background:Lead harms haematological, biochemical, and hepatic parameters, hence studies have concentrated on antioxidants with therapeutic potentials. Objective: Induced hepatotoxicity and hemato-biochemical parameters in adult Wistar rats with Ocimum Gratissimum extract. Methodology: 42 adult Wistar rats were divided into seven groups of five. Group A was the control, Group B had 120 mg/kg lead, and Group C got 300 mg/kg OG. D and E had 120 mg/kg lead before 300 mg/kg and 600 mg/kg OG. Group F had 300 mg OG extract, then 120 mg lead, whereas Group G got 120 mg lead and 1000 mg ascorbic acid. The animals were then slaughtered and blood and liver tissues were taken for biochemical and histological investigation. Results: The outcome revealed a rise in Control but a drop in B. ALT, AST, GGT, and ALP levels were higher in Group B than in Control and other treatment groups (p≤ 0.05). As in Groups D, E, F, and G, histological investigation of liver tissues revealed degenerative alterations with localised necrosis and aggregated inflammatory cells in B. Conclusion: The extract of OG has the potential to be employed as a medicinal agent in the treatment of lead poisoning. Keywords: Hepatobiochemical; Lead; Liver; Ocimum gratissimum; Wistar rats; Parameters
Effectiveness of Health Insurance Project; Women Satisfaction Regarding Quality of Ante-natal Services
Authors: Elsehrawy Mohamed Gamal , Elemam Fatma El Emam Hafeze , Mohamed Heba Ali Hamed , Eltayeb Mudathir Mohamedahmd , Ebrahim Elturabi Elsayed , Moussa Maha  Moussa Mohamed
Published: May 2022

Objective: This study aimed to evaluate the effectiveness of the universal health insurance project regarding the quality of health care with antenatal care services. Materials and methods: A descriptive comparative study carried out at ten Primary Health Care (PCH) centers affiliated to Port-said and Damietta governorates. Multi-stage sampling probability technique used for selecting these centers, simple random sample of 460 women chosen. Data was collected through two tools; women's satisfaction questionnaire, and Support Tool for Improving Quality of Antenatal Care. Results: the study results revealed that 69.1% of women were unsatisfied with the antenatal care services and available resources provided by the traditional insurance. On the other hand, 79.1% of women receiving universal health insurance were satisfied with the services provided. Conclusion: level of satisfaction was higher among women using universal health insurance regarding the recent health care services, cleanness, arrangement of medical facilities, availability of resources and criteria of service. Keywords: Antenatal care, Satisfaction, Quality measures, Universal Health Insurance System.
Biosocial Determinants of Age at Menarche among Secondary School Girls in Benin City, Nigeria
Authors: O, Lokor , D. G Yovwin , C. A Okonkwo
Published: May 2022

Objective: To determine the age at menarche among secondary school girls in Benin City and to establish biosocial determinants of menarcheal age. Method: Students at Benin City's secondary schools were the focus of this descriptive study. Self-administered questionnaires that had been pretested were used to gather data. The height, weight, BMI, and mid-arm circumference of the study population were also measured. Menarchal age was compared to several measures of socioeconomic status. Results: Of the 1830 participants, 72.2 percent had already had their first period. The population's average age at menarche was 12.72 1.24 years. When looking at the period from 1979 to 2009, a decrease of 3.3–4.3 months per decade was seen. Depending on the parents' social status, women's menarcheal ages range from as young as 12.3 years old to as old as 14.09 years old (P = 0.000), with 12.3 years old being the lowest and 14.09 years old being the highest. Conclusion: The age at menarche in Benin City school girls is 12.72  1.24 years. There has been a decline in the menarcheal age compared to previous studies. The socioeconomic and nutritional status influence the age of menarche.
Statistical Analysis of Physiological Childbirth and Obstetric Service in Osh Region from 2016 to 2021 Years
Authors: Abdirasulova Zhainagul , Karataev Madaminzhan , Bugubaeva Makhabat , Karimova Nazgul , Begmatova Damira , Turusbekova Akshoola , Nuraliev Azamat , Abbas Syed Ali , Tazhibaev Maksatbek , Abdullaeva Zhypargul
Published: May 2022

This article is investigating physiological childbirth statistics and obstetric service in Osh, Kyrgyzstan during the 2016 to 2021 years. Statistical analyses revealed several patients’ admissions with their hospital stay days for the period from 2011 to 2020 in all departments. Growth in the population analyzed according to Kyrgyz Republic National Statistical Committee; due to spread of coronavirus infection COVID-19 pandemic and the government declared an emergency in certain territories in the Kyrgyz Republic, from March 31 to May 21, 2020, activities of public service centers and registry office by Government Registration Service were delayed. Conclusions: Quality provision in medical care is vital for both women and newborns and for a minority who experience complications in maternity service. Some statistical analyses revealed that average absolute birth number reduced by 92 births and births number variation analysis in Osh oblast for 2016 to 2021 years showed that in the 2021 year total birth number was 29902 and 31000 in 2020, which can be explained by COVID – 19 infection influence on the population. Number of births registered as 182.971 and the average annual number of births was 30.495. Keywords: physiological childbirth, obstetric service, statistical analysis, Kyrgyz Republic National Statistical Committee, birth analysis, COVID 19
Description of Iron Status In Chronic Kidney Disease (CKD) Stadium 5 with Regular Hemodialization at the Hemodialysis Installation of Dustira Hospital
Authors: Maulidya Tara Titian , Nathan Daniel Setiawan , Widanarti Endah Tri , Soenarso Eddy Harjadi , Liliana Anita
Published: May 2022

Introduction: The number of patients with chronic kidney failure in Indonesia continues to increase and is estimated to grow by around 10% every year. Decreased of haemoglobin (Hb) in patients with CKD almost occurs in 80% of cases. Aim: The purpose of this study was to describe the iron status of patients with chronic kidney disease stage 5 undergoing regular hemodialysis. Methods: The study conducted is a descriptive study with a cross-sectional design to describe the iron status of stage 5 CKD patients undergoing regular hemodialysis at the Hemodialysis Installation of the Dustira Cimahi Hospital. Data used are secondary data from the medical records of stage CKD patients. 5 at the Hemodialysis Installation. Univariate analysis is performed by presenting data in terms of frequency and percentage or mean and standard deviation. Result: Patients in this study had a mean age of 46.75 years, a median age of 45 years (range: 18-71 years), and as many as 28 people were in the 37-45 year age group (range: 18-71 years) who underwent regular hemodialysis (35.0 percent ). The majority of CKD stage 5 patients who had regular hemodialysis were female, with as many as 44 out of 80 patients being female (55.0 percent ). In this study, 80 patients with CKD stage 5 were found to have decreased serum iron (66.3%) with a normal value range of 65-165 g/dl, TIBC decreased (43.8%) with a normal value range of 300 -360 g/dl, and transferrin saturation decreased (50%) with a normal range of 20-50%. Based on the serum iron, patients with CKD stage 5 who underwent regular hemodialysis had a mean serum iron of 56.53 g/dl)] and most of them had decreased serum iron, as many as 53 people out of 80 people (66.3%). Conclusion: The percentage of patients with chronic kidney disease stage 5 who underwent regular hemodialysis who experienced iron deficiency was 11.0% and did not have iron deficiency was 89.0%. The mean serum Fe, TIBC and TSAT levels of patients with chronic kidney disease stage 5 undergoing regular hemodialysis were 56.53 g/dL, 277.64, g/dL, and 23.10%, respectively. Keyword: Chronic Kidney Disease; Hemodialysis; Iron Status
Role of Segmentation in Lung Nodules CT Scan Images for High Performance: Case of Recent Findings
Authors: J, Madhura , Raviraja S. , Babu D R Ramesh
Published: May 2022

Early stage of lung cancer detection is being very vital in today’s scenario. Several promising technological diagnostic automated tools developed and are used to predict the patient's survival using intelligent lung nodules analysis in Computed Tomography (CT) images. Recently, the advancement of human health diagnostic technologies, Computer-Aided Detection Systems (CADe) are developed diurnal rhythms to provide higher accuracy and better performance rate. In this research work, we focuses on a documenting the automatic segmentation of lung cancer nodules by various methods developed in recent years of the timeline with respect to the realization. The proposed work is criterion based objectives to establish the performance measures and to propose new solution for Lung nodules segmentation and detection on CT Scanned digital images, which is the fundamental and epochal measure to attain the high level of performance. In analyzing each of these technical execution on detection on lung nodule, and experimented to 4 different kinds of lung nodules CT scanned digital images. The phenomenon show segmentation methods involving convolution neural networks were better when compared to other existing methods. U-Net method gave improved accuracy. Dice score 0.981±0.009 and sensitivity 0.994±0.002 are maximum by using the method Dense R2UNet. F1-score 97% is best achieved by Cascade Convolutional Network. Recall rate is achieved to the maximum 99.1% through Improved 3D-UNet Neural Network. Precision 0.982±0.009 and accuracy 0.988±0.018 are best attained by Dense R2UNet. In the case, semi-transparent nodules segmentation, Watershed method found to be highly appropriate select. Watershed arse nodules segment correspond well to vessels and semi-transparent nodules, and exhibit low sensitivity in solitary or lone nodules. The higher rate of efficient segmentation is directly proportional to higher rate of performance. Keywords: CNN, Lung Cancer, CT Image Segmentation, Watershed, R2Unet.
Benefits of Prostrate Position and Coughing Exercises in the Management of Cardiopulmonary Parameters Alteration among Patients with COVID-19
Authors: Ali Haider Nawaf Abed- , Athbi Hassan Abdullah
Published: May 2022

Method: A sixty patients with COVID-19 were randomly selected to conduct an experimental study to investigate the benefits of prostrate position and coughing exercises upon cardiopulmonary parameters among non-intubated patients with COVID-19. Results: two-thirds of participants were ˃60 years old, 60% and 46.7% of the experimental and control group respectively were males, 36.7% of participants did not have any chronic diseases, but asthma was present in a third of them. The bilateral-peripheral and central area was the affected part of the lung in more than 40% of patients. More than 45% of the lung volume was affected in 80% of the experimental group and 50% of the control group. Finally, 96.7% of the experimental group and 90% of the control group did not take the COVID-19 vaccine. Furthermore, a statistically significant difference was found between the mean of cardiopulmonary parameters for the experimental group, while there was no statistical significance difference that was shown in the control group. Conclusion: the application of prostrate position and coughing exercises have a positive effect on improving cardiopulmonary parameters among COVID-19 patients lasting for more than four hours. Keywords: Prostrate Position, Coughing Exercises, Cardiopulmonary Parameters, COVID-19.
Iontophoretic Transport of Local Anesthesia: A Literature Review
Authors: Tabassum Nafeesa
Published: May 2022

Aim:This study aimed to comprehensively review the literature about the use of iontophoresis for the transportation of local anesthesia to better understand the feasibility of such technique and its benefits compared to other delivery systems. In addition, in the current review we present the challenges compromising the use of this drug delivery system in this area. Material and Methods: This is a literature review which aimed to screen old as well as very recent literature on the technique, methodology, clinical findings, influencing factors of local anesthetics iontophoresis, thus PubMed electronic databases were screened. Indexed articles during the time period extending between 1977 and 2021 were tentatively reviewed. This review was registered by and it only included articles written in English. Research studies conducted in vitro or on animals were excluded in addition to case studies, case series, and pilot studies. Articles that included major forms of bias were also excluded. Pubmed database was screened using the following Mesh terms: Anesthetics, Local / administration & dosage*, Epinephrine / administration & dosage, Ethanol / pharmacology, Humans, Iontophoresis*, Lidocaine / administration & dosage, Regional Blood Flow, Skin / blood supply, Skin / drug effects*Skin / metabolism. Results: A total of 89 studies were screened for possible inclusion after searching for the above mesh terms in PubMed. Eventually, 16 articles were included in this review where 2 studies were related to iontophoretic anesthesia of the ear, 6 were related to skin anesthesia, and 7 related to the oral cavity. The other three studies compared the use of local anesthesia mediated by iontophoresis to other approaches and the change in dosing requirements following iontophoresis administration of local anesthetics. Keywords: Pain management, local anesthesia, drug delivery system, transport, Iontophoresis.
Frequency of Common Causes of Severe Anemia in Children under 5 Years of Age Admitted in Children Hospital, Lahore
Authors: Hafeez Rubab , Amir Sadia , Sardar Ammara , Awan Nagham Nawaz , Jameel Madiha , Abbas Sumbal
Published: May 2022

Objective: To determine the frequency of common causes of severe anemia in children under 5 years of age admitted in children hospital, Lahore Design of the Study: Cross sectional study Study Settings: The study was conducted at Department of Pediatric Medicine, Children Hospital, Lahore from 5 Sep 2018 to 5 March 2019. Material and Methods: Patients were evaluated for the severity of anemia by the Hb level, baseline investigations, CBC with peripheral film and retics count, Hb electrophoresis, osmotic fragility test, G6PD assay, serum bilirubin, coomb’s test and bone marrow biopsy ,if required. The demographic characteristics of patients and WHO criteria for Hb level was noted on the specifically designed study proforma. A blood sample was drawn and was sent to hospital laboratory for analysis of related causes of severe anemia. The collected data was entered and analyzed using SPSS software version 17.0. Results of the Study: The mean age of patients was 30.41 ± 18.60 months with minimum and maximum age as 1 and 60 months. There were 169(46.3%) boys and 196(53.7%) girls with slightly higher female to male ratio. The mean Hb level was 5.15 ± 1.06 g/dL with minimum and maximum Hb as 3.40 and 6.90 g/dL. The common causes of anemia were assessed that showed 232(63.6%) patients had iron deficiency, 7(1.9%) cases had Sickle cell anemia, 37(10.1%) cases had Septicemia and 89(24.4%) cases had malaria Conclusion: According to the findings of current study, the common causes of severe anemia in local children are found to be, iron deficiency anemia in 232(63.6%) cases, Sickle cell anemia in7(1.9%) cases ,septicemia in 37(10.1% ) cases and malaria in 89(24.4%) cases. So during clinical evaluation of patients it must be kept in mind that these factors can contribute to severe anemia. So, preventive and therapeutic strategies must be ensured to minimize the risk of severe anemia in these children Keywords: Anemia, Prevalence, Nutritional status, Risk factors, malaria, iron deficiency, Septicemia, sickle cell anemia
Homology Modeling of Predicted Methyl Transferases (STY 3264): A Protein of Salmonella TYPHI CT18
Authors: Farid Anila , Haider Beenish , Akbar Kehkashan , Mehfooz Ammar , Ahmad Ziyad , Raheem Fazal E , Arshad Furqan , Saeed Bilal , Aslam Umair , . Maheen , Ullah Irfan
Published: May 2022

Background: Salmonella typhi gives rise to typhoid fever which is life threatening illness.It puts end to approximately 600,000 people per annum around the world.Food and water are the leading components through which this disease is passed on and becomes origin of typhoid.It lays out widely where cleanliness is very substandard. Objective: To construct 3 dimensional structure of protein Methyl Transferase of Salmonella typhi CT18 by homology modeling. Materials and Methods: Bioinformatic tools and programs like Comprehensive Microbial Resource (CMR), Interproscan, Basic Local Alignment Search Tool (BLAST), Modellor 9.10, Procheck and Prosa were helpful for the complete homology modeling of methyl transferases (STY 3264).The models were visualized by DS Viever. Results: Homology modeling is an effective method to find structure of methyl transferase protein for future discovery of drugs. Conclusion: Homology modeling is an effective method to find structure of protein which provides good solution for drug discovery. Keywords: Methyl transferase ,Homology modeling, Typhoid fever,Salmonella typhi CT18.
Comparison of Diagnostic Accuracy of Appendicitis Inflammatory Response Score and Alvarado Score in Diagnosis of Acute Appendicitis Taking Histopathology as Gold Standard
Authors: Tariq Tahira , Siddiqui Hina Rehman , Khan Imran Ahmed , Tasneem Ayesha , Majeed Sobia
Published: May 2022

Objective: To compare the diagnostic accuracy of appendicitis inflammatory response score and Alvarado score in diagnosis of acute appendicitis taking histopathology as gold standard. Study Design: It is a Cross Sectional Study Study setting and Duration: This study conducted at the Department of General Surgery, Abbasi Shaheed Hospital, Karachi from September 2018 To March 2019. Methods: Alvarado and Appendicitis inflammatory response scores were used to evaluate all patients. For the Alvarado scoring system, a score of 7 or more was considered a high chance of acute appendicitis, while the AIR scoring system required a score of 9 or higher. The findings of the histopathology lab were compared to the test results. Both tests' results were analysed to determine their sensitivity, specificity, and diagnostic accuracy. Results: For Alvarado score Sensitivity (80.1%), Specificity (92.3%) and accuracy was 81.7%. For AIR score Sensitivity (72.6%), Specificity (94.2%), and accuracy was 75.5%. There were 66.9% male and 33.1% female patients. Right iliac fossa pain was 76.8%, pain migration to right iliac fossa was 63.5%, anorexia was 90.9%. Conclusion: Higher sensitivity and specificity of the Appendicitis inflammatory response score and the Alvarado score were found to outperform the histological findings in appendicitis. Keywords: Appendicitis, Appendicitis Inflammatory Response Score, Diagnostic Accuracy, Acute Appendicitis, Histopathology, Alvarado Score,
Association of Breakfast Routine with Quality Of Life and Sleep Quality in University Students; A Cross Sectional Survey
Authors: Khalid Maham , Jamal Ahmed , Iram Amna , Ilyas Tamknat , Adil Muhammad , Umar Bilal
Published: May 2022

Background: The relationship between certain breakfast consumption habits and mental health has been reported previously, many observational studies showed association between breakfast routine and academic performance. However, few studies regarding sleep quality with breakfast consumption have been carried out. Objective: To determine the association of breakfast routine with quality of life and sleep quality in university students. Methods: This was a cross sectional survey conducted among 490 students of Doctor of Physical Therapy, using the sample of convenience. The included students were both male and female, aged 20-27 years old and studying in their 3rd or above professional year. The students with a diagnosed psychological disorder and on a diet plan for weight reduction were excluded. The questionnaire was comprised of demographics such as age, body mass index, academic year, gender, self -perceived quality of sleep, grade in academic assessment, dietary habits and breakfast consumption frequency. Results: The main results showed that 68.6% students between 20-23 years and rest of 31.4% were between 24-27 years of age and gender majority were female 77.3%. According to self-perceived sleep, there were 82.7% having good sleep quality and 17.3% having poor sleep quality. The findings regarding consumption showed that majority 50.4% were taking breakfast 5-7 days a week, 27.6% occasionally 3-4 days/week and 22% rarely. Chi Square test showed that either food consumption routine or type were not associated with academic performance (p value 0.264, 0.188 respectively) or sleep quality (p value 0.997, 0.959 respectively). Conclusions: Breakfast habits are not significantly associated with academic grades. Also, there is no significant association found between breakfast habits and sleep quality. Keywords: quality of life, sleep quality, breakfast habits, academic grades
Factors Associated with Gestational Diabetes Mellitus and Its Outcome in Pregnancy
Authors: Najam Amna , . Safia , Jamil Mahwash , Akhtar Shamim
Published: May 2022

Background: Gestational diabetes mellitus is prevailing among pregnant females and affects the pregnancy outcome both in neonate and mother. As Pakistan is having high incidence of diabetes mellitus so females are at high risk of developing gestational diabetes mellitus (GDM). Other factors that may lead to GDM include age of female, weight, family history, previous history or family history of diabetes, stillbirths, previous history of large gestation and other socio-demographic factors. Whatever the risk factors are, the outcome of pregnancy in females with gestational diabetes is related to increased cesarean section, hyperglycemia and hypertension in mothers. Hypoglycemia is just after birth, macrosomia and large gestation in neonates. In order to determine risk factors and association of GDM with pregnancy outcome we have conducted this study with future implications for better pregnancy outcome. Methodology: An analytical study was conducted at the department of Gynae & Obs, Al-Nafees Medical College and Hospital, Islamabad for a period of one year and 9 months starting from July 2019 to March 2021. All the pregnant females diagnosed with gestational diabetes during their checkup in hospital visits were included in study through convenient sampling. The socio-demographic and laboratory data was obtained from their file record and pregnancy outcome was observed at the time of delivery in the same hospital. The analysis was done for 150 females by using SPSS version 26. Continuous variables were analyzed by mean and standard deviation while categorical variables were determined by frequencies in percentage. Outcome of pregnancy was analyzed by macrosomia, hypoglycemia in neonates and cesarean, hypertension in mothers. The association was determined between GDM and pregnancy outcome by chi-square test of significance where p <0.05. Results: In our study 150 females were of mean age 33.91 with ±3.72 SD. The mean self-reported, pre-pregnancy BMI(Kg/m2) of all pregnant females was 29.89 with ±4.55 SD. The mean number of children born to females was 3.4. There is no significant association of gestational period with neonatal or maternal death p- value was 0.308 and 0.410 respectively by applying chi-square test (p<0.05). The gestational diabetes mellitus is associated with cesarean section as 78(52%) females underwent elective c-section. Among these females 84(56%) developed hypertension and 18(21%) were managed for eclampsia. Neonates born with macrosomia were 48 (32%) and with hypoglycemia just after birth were 89 (59.3%). Keywords: Gestational diabetes mellitus (GDM), Outcome of pregnancy, Macrosomia, Neonatal hypoglycemia, Maternal hypertension.
Role of Manual Vacuum Aspiration Versus Sublingual Misoprotol in First Trimester Miscarriage in a Tertiary Care Hospital PMC, Nawabshah
Authors: Akbar Rashida , . Basma , Sahito Rozina Mujeeb , Ali Raishem , Qureshi Sonia Gul , Memon Saira Parveen
Published: May 2022

Objective: To compare the efficacy of manual vacuum aspiration versus sublingual misoprostol in first trimester miscarriage at people's medical college hospital Nawabshah. Study Design: Randomized Controlled Trial. Settings: Department of Gynaecology and Obstetrics, Peoples Medical University & Hospital Nawabshah. Duration of Study: 7th April 2021 to 6th October 2021. Materials & Methods: A total of 100women with first trimester incomplete abortion, 18 to 45 years of age were included. Patients having allergy to misoprostol or other prostaglandins, contraindication to prostaglandin therapy (asthma, hypertension, glaucoma) and suspected ectopic pregnancy assess on ultrasound were excluded. Group A received a single dose of 600 microgram of sublingual misoprostol every three hours and group B who underwent MVA for evacuation of retained products of conception. Efficacy was noted. Results: The mean age of women in group B was 30.14 ± 4.12 years and in group A was 30.20 ± 3.69 years. Majority of the patients 51 (51.0%) were between 18 to 30 years of age. The mean gestational age in group B was 7.92 ± 2.42 weeks and in group A was 7.48 ± 2.32 weeks. In this study, success was seen in 46 (92.0%) women in group B (manual vacuum aspiration) and 37 (74.0%) women in group A (sublingual misoprostol) with p-value of 0.017. Conclusion: This studyconcluded that manual vacuum aspiration (MVA) is effective and safe procedure as compared to sublingual misoprostol in first trimester incomplete abortion. Keywords: first trimester incomplete abortion, manual vacuum aspiration, misoprostol
Comparison of Graft Uptake by Underlay and Overlay Technique in Myringoplasty
Authors: Akhtar Arsalan , Ikram Aamir , Akaash Haitham , Ali Salman , Babar Mehreen , Umair Mahwash
Published: May 2022

Objective: The objective of this study was to compare the effectiveness of graft uptake by underlay and overlay technique in patients undergoing myringoplasty Design of the Study: It was a randomized controlled trial Study Settings: Research was conducted at Department of Otorhinolaryngology and Head and Neck surgery Holy Family Hospital, Rawalpindi from January 2021 to June 2021. Material and Methods: In this study, 80 patients underwent myringoplasty for tympanic perforation who were randomly divided into two groups. Patients ranged in age from 20 to 40 years old. Those in Group A had an underlay myringoplasty, while those in Group B had an overlay procedure. One of the study's outcome variables was the procedure's effectiveness, which was observed and compared among groups. Results of the Study: There were 1.2:1 men to women patients, with 44 (55.0%) men and 36 (45.0%) women. Patients who underwent underlay versus overlay myringoplasty had a considerably greater rate of hearing improvement (97.5 percent vs. 77.5 percent ; p=0.007) and a significantly lower rate of complications (5.0 percent vs. 32.5 percent ; p=0.002). Conclusion: Underlay myringoplasty was found to be much more successful than overlay myringoplasty in 95.0 percent of patients compared to 57.5 percent of patients who received overlay myringoplasty. Keywords: Underlay Myringoplasty, Overlay Myringoplasty, Tympanic Perforation, Graft,
Antimicrobial Effects of Propolis Incorporated Dental Composite Resin
Authors: Khan Asad , Hussain Sajid , Shah Mamoona , Naim Noureen , Shaukat Zunaira , Siddique Hafiz Muhammad Abu Bakar
Published: May 2022

Aim/Objective: The aim of this in-vitro study is to assess the antibacterial activity of a propolis-modified experimental dental composite resin in terms of reducing and preventing recurrent caries, usually caused by Streptococcus mutans. Materials and methods: Control group specimens were made using the 70/30 (filler/resin) method without the use of EPE. Group 1 specimens were made by mixing 12% EPE with 30% resin in experimental dental composite resin. The experimental dental composite was created by adding 16%EPE and 20% EPE to Group 2 and Group 3, respectively. Antibacterial testing was carried out in the inhibition zone using the minimum inhibition concentration (MIC) and minimum bactericidal concentration (MBC). Surface roughness was assessed using scanning electron microscopy. Results: The results were evaluated using one-way ANOVA and Tukey's high significant difference test (HSD). The EPE displayed antibacterial action against S.mutans, according to the findings. The inhibitory zone of 20% EPE integrated dental composite resin was 2.2mm to 2.5mm. Inhibition zones ranging from 1.2mm to 1.8mm were found in 12% and 16% of the samples, respectively. The results of the minimum inhibitory concentration showed that 20% had stronger antibacterial activity than 12 and 16 %. Scanning electron microscopy research revealed that 20% of EPE samples had decreased surface roughness. Conclusion: The experimental dental composite showed antibacterial activity against S.mutans. Antibacterial activity is increased by increasing the proportion of EPE in the experimental composite. Due to its dark color appearance it is recommended for usage as a lining material under restorative materials. Keywords: Streptococcus mutans, Secondary Caries, Antibacterial activity, Propolis, Ethanolic extract of Propolis, Dental Composite Resin
Frequency of Preeclampsia in Obese Woman Presenting at Civil Hospital Karachi
Authors: Bibi Goolamnobee Jahooran Mariyah , Haq Gulfishan , Sabir Sadaf , Shaikh Saima , Auckloo Sheik Mamode Adeel , Shah Nusrat
Published: May 2022

Objectives: To determine the frequency of preeclampsia in obese women at civil hospital Karachi. Methods: A total 126 patients from March-2020 up to December-2021 were inducted in the study with non-probability consecutive sampling. Women of 18-40 years of age having singleton pregnancy with obesity with gestational age ≥ 20 weeks were included after informed consent. Blood pressure (BP) was measured after 20 weeks of gestation. Urine for protein was checked if BP was found to be ≥140/90 mmHg for diagnosis of pre-eclampsia. Result: The women had a mean age of 28.56 ± 3.848 years. Age at presentation was highest in the group 25-31 years which represented 87 (69.04%). 23.02% of the women were nulliparous, 76.98% were multiparous. The mean ± SD gestational age was 34.52 ± 3.775 and 72 (57.1%) were in their 35-40 weeks of gestation. 91 women representing 72.2% had a BMI of 30-33 kg/m2. Pre-eclampsia was diagnosed in 33 (26.2%) obese patients (Table 2). Conclusion: The frequency of 26.2% of Pre-eclampsia in obese women is significantly high. Women should be counseled before conception to decrease their BMI. Keywords: Obesity, Pre-eclampsia, Blood pressure
Molecular and Epidemiological Evaluation of Liver Function Diagnosis between Different Genotypes of HBV and HCV in Non-Responders of HBV-HCV Co-Infected Patients with Healthy Controls
Authors: Haq Ihteshamul , Zahir Fazli , Haq Mohsina , Zaman Ronaq , Kashif Khan Arbab Muhammad , , Rehman Naumana , Ahmad Ibrar , Jan Hakeem , Nasar Zeeshan , Arif Hassan , Ahmad Zeeshan
Published: May 2022

Hepatitis B and C co-infection may leads to cirrhosis resulting in hepatocellular carcinoma with poorer survival rate. Pegylated interferon and ribavirin treatment is considered as gold standard. Despite of adequate treatment, some patients remained nonresponders. Due to this reason, this study was designed to compare different parameters of liver function tests along with HBV- HCV genotyping in non-responders of HBV-HCV co-infection with normal controls. Study population was divided in two groups. Group A (patient group) includes 30 HBV-HCV co-infected patients and Group B (control group).includes 30 normal individuals. Blood samples of both groups were collected. Samples were analyzed for HBV and HCV genotyping using automated kits of Abbott laboratories and Liver Functions testing (ALT, ALP, Bilirubin, Albumin) using ROCHE COBAS-501 automated system. Statistical analysis using chi-square test for ordinal data and t-test for numerical data was used using p value. Key words: Hepatitis B, Hepatitis C, Viral infection, Viral resistant, Biochemical test, genotyping in retroviruses infected patients