bluuebunny/crossref_metadata_2025 huggingface dataset:
OBESITY
Authors: Shabbir Faizania , Hussain M. Mazhar , Rajput Tausif Ahmed
Published: September 2021

Objective: To study the effects of atorvastatin administration on serum IL-6,WBC and platelet count in obese male and female animal models. Study Design: Randomizedcontrol trial (RCT). Place and duration of study: The study was conducted at Department ofPhysiology, Army Medical College, Rawalpindi in collaboration with National Institute of Health(NIH), Islamabad and Centre for Research in Experimental and Applied Medicine (CREAM),Army Medical College, Rawalpindi for funding, blood sampling and biochemical assaysrespectively. Material and Methods: Ninety healthy male and female Sprague Dawley ratswere selected and randomly divided into three equal groups. Group I rats were fed normal dietfor a period of three weeks. Group II rats were fed high fat diet for a period of three weeks toinduce obesity. Group III rats were administered atorvastatin 10 mg/kg/day orally by gavagemethod for three weeks after obesity induction. Terminal sampling by intra-cardiac puncturewas done at the end of study. Whole blood was used to perform blood complete picture by KX21 Sysmex Hematology Analyzer which includes platelet count and WBC count and serum wasused to measure IL-6 levels by Enzyme Linked Immunosorbant Assay (ELISA). Results: Therewas a significant decrease (p<0.05) in serum IL-6 levels and WBC count, whereas platelet countwas not significantly (p>0.05) affected by atorvastatin administration. Conclusions: Althoughatorvastatin reduces obesity related inflammation by decreasing serum IL-6 levels and WBCcount, it has no effect on platelet count in male and female obese animal models.
PROSTATIC CARCINOMA
Authors: Rasool Mumtaz , Iqbal Shafiq Ahmad , Pansota Mudassar Saeed , Tabassum Shafqat Ali , Ahmad Iftikhar
Published: September 2021

Introduction: During the past many years the availability of serum PSAas a screening marker, has encouraged its use to diagnose both prostatic cancer and itsrecurrence. Patients with high S/PSA are at increased risk of advanced carcinoma prostate andscreening at an earlier stage would help to manage it accordingly. The aim of this study wasto determine association between serum prostatic specific antigen (PSA) levels and Gleasongrade in prostatic carcinoma patients. Study Design: Descriptive, case series study. Setting:Department of Urology & Renal Transplantation in collaboration with Institutional laboratoryof Bahawal Victoria Hospital, Bahawalpur. Period: June 2012 to June 2014. Materials &Methods: Total 160 patients of age 50-80 years with biopsy proven prostatic carcinoma wereincluded. Patients with h/o radiotherapy for prostatic carcinoma and anti-androgen therapywere excluded. Histological slides of each patient were reviewed by using the Gleason gradingsystem. Gleason grade of each patient was correlated with his serum prostatic specific antigen(PSA) report which was done before surgery or biopsy. Results: In our study, mean age was66.89 ± 9.28 years. Mean serum PSA was 21.41 ± 13.67 ng/ml. Intermediate grade cancerwas found in 38.75% patients followed by moderate to poorly differentiated cancer in 31.86%patients. Gleason score ≥7 was significantly higher in patients with serum PSA >20 ng/mL thanthose with serum PSA ≤ 20 ng/mL (p-value of 0.000). So, serum PSA was positively correlatedwith gleason grade (OR = 3.67, Cl = 95%, P = 0.0001) Conclusion: This study concludedthat there is statistically significant association between serum prostatic specific antigen (PSA)levels and Gleason grade in prostatic carcinoma patients and patients with high prostatespecific antigen are at increased risk of advanced carcinoma prostate.
LIVER ENZYMES
Authors: Raza Uzma , Khannum Aziza , Jamali Shahnawaz
Published: September 2021

Objective: To study the effect of breast cancer treatment on liver enzymes indiabetic and cardiac breast cancer females. Study Design: Cross-sectional type of study.Setting: Liaquat National Hospital Karachi. Period: January 2008 to January 2010. Patientsand Methods: Total 47 breast cancer patients. Out of these, 22 were diabetic and 25 werecardiac patients, visiting the oncology OPD of the hospital. Patients with metastasis to distantorgans were excluded from the study. Treatment was carried under the supervision of anoncologist. Samples were collected twice during the study. First sample was collected at diseasepresentation before starting any type of treatment and second time, sample was collected14 weeks after the last chemotherapy dose. Statistical analysis: Data was analyzed usingstatistical package (SPSS version 11.0). “Students t-test”and analysis of variance (ANOVA) wasused to analyze the means and standard deviations of quantitative/continuous variables. Inall statistical analysis p<0.05 was considered significant. Results: In all patient groups aftertreatment alkaline phosphatase was significantly high as compared to that before treatment(p<0.05) whereas alanine transaminase increased significantly without including Tamoxifenin the treatment. Variation pattern of liver enzyme was the same in both patient groups.Conclusions: Altered profile of liver enzyme was similar in both patient groups therefor thevariations cannot be attributed to hyperglycemia in diabetic females and the alterations in liverenzymes were attributed to liver damage by chemotherapy and fatty infiltration of liver inducedby Tamoxifen.
HEMODIALYSIS
Authors: Leghari Naeem-Ullah , Amin Rizwana , Akram Bushra , Asadullah Muhammad Ali
Published: September 2021

Objective: To determine the nature and frequency of psychosocial stressorsfaced by the patients on hemodialysis admitted in Renal Dialysis Unit of Nishtar Hospital, Multan.Study design: A descriptive study. Place & duration of study: The study was conducted in theRenal Dialysis Unit of Nishtar Hospital, Multan, from 1st May, 2014 to 31st May, 2014. Subjects& methods: The sample consisted of 170 (112 Male, 58 Females) consecutive inpatients onHemodialysis Treatment. They were interviewed and Hemodialysis Stressors Scale (HSS) wasadministrated to know the frequency of Hemodialysis Stressors. Results: Results showed thatall the patients reported Physiological and Psychosocial stressors. Most frequent physicalstressors included feeling tired (92%) and stiffening of joints (91%). In psychosocial stressorsrestriction of fluid (100%), dependence on dialysis machine and/ or equipment (95%), limitationof physical activity (93%), changes in family responsibilities (93%), dependency on nursesand technicians (93%), length of treatment (92%), dependency on physicians (91%), sleepdisturbance (90%) and limitation of food (93%) were the most frequently reported. Conclusions:We concluded that both physiological and psychosocial stressors were present in significantmajority of patients.
PATIENT’S INFLUX AT OUTPATIENT MEDICAL LABORATORY (OPML)
Authors: Ibrahim Muhammad , Jamil Muhammad , Akhtar Abdul Majeed , Mir Zaheer-ul-Hassan , Akbar Safoora , Ahmad Maqsood
Published: September 2021

Objective: Uni-variate time series data analysis has been reported in medicalliterature for prediction the patients volume, emergency overcrowding, stay length in hospitalon surgical procedure and bed occupancy in hospital wards, patients influx or patients arrival,moreover to estimate the cost of hospital stay or any medical or surgical procedure. Design:The present study was designed to fit an appropriate uni-variate ARIMA model (Box-Jenkinmethodology) to forecast the patient’s incoming at OPML, Mayo Hospital, Lahore. Setting:Mayo Hospital Lahore, Period: September 2009 to December 2013 were used for fitting thebest model. Method: Time series data of male, female and peads patients coming/reportingin OPML, OPD. Result & conclusion: The appropriate model for male and female data wasfound as ARIMA (1, 0, 1) and for peads as ARIMA (1, 1, 1) after residuals diagnostic checks. Theestimated number of male patients for Month of January2014 is 632 whereas the actual incomingof male patients in the month of January, 2014 was 649, which shows that the estimated modelhas ability to forecast the number of incoming patients accurately. It is now concluded that thefitted ARIMA model can be used to forecast the patients incoming to OPD Medical Laboratoryfor future planning and management.
PREGNANCY
Authors: Din Shazia Shukar-ud- , Asim Sadaf Ahmed
Published: September 2021

Objective: To determine frequency and pattern of skin changes duringpregnancy. Study Design: Cross sectional study. Setting: Outpatient department ofDermatology and Gynaecology at Dow University Hospital, Ojha campus in Karachi. Period:May 10, 2013 and January 10, 2014. (8 months). Patients & Methods: It comprises 80consecutive pregnant women with skin problem, who presented in outpatient department ofDermatology with referral cases from Obs&Gynae outpatient department.Information wascollected on predesigned questionnaire after taking informed consent. Results: Total 80pregnant women were included in study with different skin problems. The results indicatethatmost of women 72.5% presented during third trimester and 43.8% women were primigravida.Striagravidarum and lneanigra was commonest physiological changes, reported in 54%, 52%women consecutively. Eczema,utricaria and candidiasis were reported in 16.3% and 15% and15% women consecutively. Prurigo of pregnancy was reported in 17.5% followed by pruriticfolliculitis of pregnancy in 6.3% women. Conclusions: This study concluded that skin changesduring pregnancy are frequent in Pakistani women. These changes could be physiological orpathological.
DIETARY PATTERNS
Authors: Yasmeen Bushra , Jamshaid Nermeen , Khan Muhammad Zohaib , Salman Munnaza , Ullah Raza
Published: September 2021

In order to promote healthful trends, insight is needed in the behavioraldeterminants of nutrition behaviors. Most research on behavioral determinants has been linkedwith individuals’ physical health and socio-economic factors. However, health behavior isinfluenced by individual physical health and abilities. Multiple dynamics of chronic illnesseswithin human body influenced the dietary patterns. For disease prognosis, doctors advisedpatients to observe preventive measures. Objective: The researchers tried to identify thechanges in the dietary patterns protective effects of food consumption such as mutton, chicken,beef, snacks and sweets on chronic illnesses that reduce the risk factors and contribute in thepatients’ health behaviors. Setting: The empirical data was collected from three Dialysis Units:Mayo Hospital, Jinnah Hospital, Lahore General Hospital and all admitted patients of PunjabInstitute of Cardiology, Lahore. Methodology: These four hospitals have good turn-over ofthe patients should in this exploratory study, purposive sampling method was used. For thecollection of quantitative data, a hospital-based survey was conducted by using a structuredinterview schedule. Study Subjects: 275 patients (131-cardiac and 144-renal failure) including184 males (67%) and 91 females (33%) between age of 20 to 110 years were interviewed. Agemean ± standard deviation was 44 years; S.D = 15.338. Data Analysis: Descriptive statistics(frequencies, percentages) and multiple response tables were deployed to find out the researchgoals across heart and kidney diseases. Results: Results indicates that before illness, majority238 (86.5%) of the patients took three meals. After illness, 34% patients changed the foodconsumption. In two meals, 96.7% patients used vegetables, 86.2% used pulses along withchapatti, and 98.5% used tap water to drink. In other drinks, 87.6% used tea, 50.5% used milk,and 52% used to drink lassi. A high proportion (65%) of patients for first treatment consultswith GP’s. 10.6% changed their food consumption on the advice of hakeem/homeopathic and10.6% changed on the advices of others. 78% were unable to perform their daily activities andneed help; 89% patients changed food choices; and 86% patients follow doctors’ advices.Conclusion: Change in diet is a contributing factor towards health and well-being duringillness. It reduces risk factors and a good indicator of patients’ health behaviors to cope withthe disease.
CHRONIC LIVER DISEASE
Authors: Rahimoon Abdul Ghani , Maheshwari Sunil Dat , Memon Ndeem , Rajput Muhsin Shafee
Published: September 2021

Objective: The objective of this study to detect the vitamin D deficiencyassociated to different risk factors in the patients with CLD. Study Design: Descriptive study.Setting: MMC Mirpur Khas and LUH Jamshoro / Hyderabad. Period: Nov 2013 to Apr 2014.Patients and Methods: All the cases with chronic liver disease and cirrhosis were includedin the study after diagnosis. All the patients with HCC, diabetes and with renal failure wereexcluded from the study. Assessment of CLD causes was carried out by routine investigation,ultrasound of abdomen and patient’s personal history. Furthermore to assessment of vitamin Dstatus, by measuring serum concentration level as 25(OH) of the vitamin D. Blood sample of allthe cases were send to the Diagnostic and research Laboratory of LUMHS. Results: Male werefound in the majority 60.0% and female 40.0%, with the mean age of (mean±SD=49.8±6.5).Deficiency of the vitamin D was calculated according to different causes in according VitaminD classification as; (Mild class 20–31 ng/ml), (Moderate class 7–19 ng/ml) and (Severe class \7ng/ml). In the mild class HBV infected patients 78.95% were most common. In moderate classHBV +HCV infected patients were most common 52.94%. Patients with history of alcohol werefound in majority with severe deficiency of vitamin D 57.14%. Conclusion: In this study weconcluded that vitamin D deficiency increases with increases of liver severity, it’s mostly foundin the HCV infected and alcoholic liver disease, these patients should take vitamin D regularly,and food which contains rich source of Vitamin D.
STROKE PATIENTS
Authors: Kumar Santosh , Aslam Muhammad , Maria Maria , Saleem Saleem
Published: September 2021

Stroke is one of the leading factors of morbidity and mortality worldwide. Toreduce the incidences of stroke, it is essential to identify and modify the risk factors for stroke.Risk factors can be modifiable and non modifiable. The aim of study was to ascertain theoutcome of stroke patient admitted in all Medical Wards in Liaquat University Hospital HyderabadObjective: To see the mortality, morbidity, disability and co-infection in stroke patients. StudyDesign: Prospective study. Period: One year. Setting: Medical Wards of Liaquat UniversityHospital Hyderabad / Jamshoro. Material and Methods: 200 Patients were enrolled in ourstudy to see the excepted outcome like mortality, Disability, Bed Sores, UTI & Pneumonia andDehydration in Stroke patients. All the patients were Young Adults, greater than 12 years inage and old aged patients, with Ischemic & Hemorrhagic stroke. On categorical variable suchas sex, mortality, morbidity chi-square test was applied at 95% confidence interval and the P-value ≤0.05 was considered as statically significant while the mean ±SD will be calculated forquantitative variables. Results: Mean age of the patient in our study was 57.03 years with thestandard deviation of ±7.35 years. Gender distribution shows most of the patients in our studywere male, i.e. 75% while, only 25% of the patients were female. Ischemic Stroke was foundin 126(63%) patients while, hemorrhagic stroke was found in 74(37%) patients. Regardingoutcome, mortality was found in 5% patients, disability 2%, UTI 2%, pneumonia 15%, Coinfection4%, Bed Sores 21.5% and dehydration was present in 50.5% patients. Conclusion:The study concludes that maximum patients had Ischemic Stroke. Among these patientsdehydration was the most common entity followed by bed Sores, pneumonia, mortality, Coinfection,disability and UTI.
ALCOHOLIC LIVER DISEASE (ALD)
Authors: Qureshi Muhammad Saeed , Ahmad Rizwan , Rizwan Razia , Malik Arif , Manan Abdul , Qazi Mahmood Husain , Shaheen Sumaira
Published: September 2021

Objective: The aim of the present study was to investigate the changes inbiochemical parameters including lipid profile, liver and kidney profile as well as oxidative stressprofile, particularly in patients suffering from alcoholic liver disease (ALD). Study design: Fiftychronic alcoholics admitted for treatment to the in-patient wards at Jinnah Hospital, Lahore-Pakistan. Chronic alcoholics with alcohol abuse for more than four to five years, and with orwithout clinical complications, were included. Apparently twenty healthy individuals servedas control. Period: 2012-2013. Materials and methods: Various circulating biochemicalbiomarkers including renal profile, hepatic and lipid profile were evaluated. Moreover, stressmarkers (MDA. SOD, GSH and catalase) were also investigated. Results: A very strong directand indirect correlation of ALP was found with TB, MDA and GSH (r=.950**, r=.929** and r=-.967** respectively, P<0.01). MDA was observed having very strong indirect correlation withGSH and catalase (r=-.909** and r=-.777** respectively, P<0.01). Conclusion: All parametersin combinations may be useful indicator or may be good and reliable biochemical markers foridentification and determination of severity of alcoholic liver diseases (ALD). The damagingof hepatocytes due to the consumption of alcohol disturbs almost all types of biochemicalcoordination in the biological system.
INTRA-ARTICULAR DISTAL RADIUS FRACTURES
Authors: Furquan Qazi Muhammad , Solangi Naveed Ahmed , Chachar Muhammad Bux , Kaimkhani Ghulam Mustafa , Ahmed Malik Wasim , Ishtiyaque Muhammad
Published: September 2021

Objectives: To determine functional outcome of percutaneous Kirschner wirefixation and short arm cast in intra-articular distal radius fractures in patients of 20-70 years.Study Design: Descriptive case series. Setting: Department of Orthopedic Surgery, DowUniversity of Health Sciences / Civil Hospital Karachi. Period: 1st April, 2013 to 30th September,2013. Methods: A total of 62 patients with closed type III distal fractures according to Frykmanclassification were included in this study. Patient lying in supine position and after generalanesthesia, closed reduction was done with the forearm in prone position, aiming to restorenormal anatomical position. Two Kirschner wires were inserted from radial styloid process inparallel and oblique fashion to the medial cortex of the radius and one transversely from lateralto medial for intra-articular fragments. Final functional outcome was assessed after 12 weeks ofsurgery and recorded on pre-designed Proforma. Results: Acceptable functional outcome ofpercutaneous Kirschner wire fixation and short arm cast in intra-articular distal radius fractureswas observed in 80.65% (50/62) cases. Conclusions: It is concluded that functional outcomeof percutaneous Kirschner wire fixation and short arm cast procedure is satisfactory in intraarticulardistal radius fractures and it appears to be an easy, technically less demanding andeffective method for stabilization, so this procedure can be applied for patients with thesefractures.
FRACTURE NECK OF FEMUR
Authors: Khan Hanif Ullah , Jan Abdul Waheed , Khan Abdus Samad
Published: September 2021

Fracture neck of femur is a devastating injury. One of its main complicationsis avascular necrosis (AVN) of the femoral head. For the fixation of femoral neck fractures,cannulated screws are now universally used. The aim of the study was to determine thefrequency of avascular necrosis in fracture neck of femur fixed with cannulated screws.Study Design: Descriptive cross sectional study. Setting: Orthopedic unit of Ayub TeachingHospital Abbottabad. Period: 7th March, 2011 to 6th September, 2011. Material and Methods:Recruiting 113 patients of either gender between 15 to 60 years of age with fracture neck offemur who were fixed with cannulated screws. The data was entered and analyzed with thehelp of SPSS 10.Results: There were 113 patients with an overall mean age of 43.51 years+ 11.94SD. Maximum number of patients was 56 (49.50%) from the age group of 46 to 60years. Avascular necrosis was noted in 23 (20.35%) cases. The maximum number of patientswith avascular necrosis was 13 (56.52%) belonging to the age group of 15 to 25. Conclusion:Avascular necrosis was high in younger ages in displaced fractures of neck of femur treatedwith cannulated screws.
KNOWLEDGE AND ATTITUDE OF IRANIAN PARTURIENT WOMEN TOWARDS PAINLESS LABOR
Authors: Dehghanpisheh Laleh , Sabetian Golnar , Faghirzade Zohre , Sahmeddini Mohammad Ali
Published: September 2021

Background: Few studies have addressed Iranian women’s knowledge andattitude about painless labor. Objectives: To assess the knowledge and attitude of Iranianwomen about painless labor and also about the use of pain relief methods among womenattending maternity cares clinic. Study Design: Qualitative survey. Setting: Obstetric Clinic ofthe Hafez training and medical center in South of Iran. Period: Aug 2014 Sep 2014. Materialsand Methods: 232 pregnant women participated in face-to-face interviews after selectionthrough convenience random sampling. A self-administered questionnaire was used to collectbaseline characteristics and information on their knowledge and attitude towards painless labor.Results: We found that 28.9% of the women expressed that they did not have any informationabout painless labor, while 56.5%, 12.1%, 1.3%, and 1.3% had little, moderate, much, andperfect knowledge about painless labor, respectively. Also, 15% disagreed to choose one ofthe painless labor methods for current delivery after achieving the information on the methodsof painless labor, 23.3% were indifferent, and 61.6% agreed to choose one of the painlesslabor methods. We found no association between the level of knowledge and age (P=0.694)and also gravidity (P=0.436). However, the education level of women was directly associatedwith the level of their knowledge (P=0.028). Also, employed women and housewives hadthe highest and lowest level of knowledge, respectively (P=0.002). Conclusion: The level ofknowledge and perception about painless labor is low among Iranian women, suggesting theneed to implement a comprehensive program to inform pregnant women about the benefitsand limitations of painless labor.
MALIGNANT PERIPHERAL NERVE SHEATH TUMOUR IN A 12 YEARS GIRL
Authors: Seseja Samuel , Moshy Jeremiah
Published: September 2021

Malignant peripheral nerve sheath tumours (MPNSTs) are rare, aggressive softtissue sarcomas associated with poor prognosis, that most commonly affect patients aged20 to 50 years, but have also been reported in children. The tumour is usually found in lowerextremities and only 10% to 20% of all lesions occur in head and neck region thus making ita rare entity. Central involvement, particularly in the jawbones is quite unusual. There is littlereported in literature on these tumors in Africa. Here we report a rare case of intraosseousMPNSTS occurring in the mandible in a 12-years old girl. The biological behavior and diagnosticchallenges of this rare malignancy are discussed.
NASOPHARYNGEAL ANGIOFIBROMA
Authors: Muhammad Raza , Hussain Altaf , Zaman Akhtar , Rehman Fazal , Khan Zakir
Published: September 2021

Juvenile nasopharyngeal angiofibroma (JNA) is an uncommon tumor constitutingless than 1% of all head & neck tumors. Tumor has an aggressive local behavior if left untreated.Surgery is the mainstay of treatment with no common consensus on a single approach. Tumourstage and surgical approaches are the major determinants of tumour recurrence. Objectives:To evaluate the influence of stage of tumor in recurrence in nasopharyngeal angiofibroma.Study Design: Descriptive study. Setting: Department of ENT and Head and Neck Surgery,PIMS, Islamabad and Ayub medical institution, Abbottabad. Period: Jan 2010 to Jan 2014.Materials and Methods: Consisting of 34 diagnosed cases of nasopharyngeal angiofibroma.CT-scan was done in all patients and were treated surgically except one patient who wasirradiated. All patients were followed up for one year. Results: Among 34 patients, 24 patientswere classified as stage III, 4 were in stage II and 5 were in stage IVa and one in stage IVb. 17.6%(6/34) of patients had disease recurrence. Stage IVb was treated by radiotherapy while the restwere treated surgically. Patients were followed up for one year both by clinical examinationand imaging. Recurrence was found in 5 operated patients and residual disease in stage IVb. 1 (20%) patient of stage Iva disease and 4 (16%) patients of stage III disease had diseaserecurrence. Conclusion: Disease recurrence/ residual is directly related to the tumour stage innasopharyngeal angiofibroma.
ACUTE ABDOMINAL PAIN IN CHILDREN
Authors: Sheikh Muhammad Ali , Latif Tariq
Published: September 2021

Objective: To determine the clinical outcomes of acute abdominal pain andevaluation of symptoms and signs in children admitted in pediatric surgery department.Design: Cohort study. Place and Duration of study: This study was conducted in Departmentof Paediatric Surgery Shaikh Zayed Hospital, Lahore between August 2010 to August 2012.Patients and methods: Children aged 2 to 14 years who presented to emergency departmentwith complaint of acute abdominal pain of less than 5 days duration and admitted in pediatricsurgery department were included. Presenting symptoms, signs, hospital course of patientsand discharge diagnosis were recoded. Data was analyzed by SPSS. Results: Out of 73104patients who were seen in Paediatric emergency 1420 (1.94%) were referred for surgicalevaluation. Out of these 157 children were admitted. Six patients left against medical adviceso 151 patients were studied. Patients were divided into acute appendicitis, non-specificpain abdomen and miscellaneous categories on the basis of discharge diagnosis. Acuteappendicitis was diagnosed in 61(40.4%) patients. The patients who were admitted and nocause of pain abdomen could be found in them, were included in non-specific pain abdomengroup. NSPA group had 39 (25.8%) patients. Rests of the 51 (33.8%) patients were includedin miscellaneous group. Anorexia, fever, pain in right lower quadrant, tenderness in right iliacfossa, guarding, rebound tenderness and tachycardia were all significantly higher in patientswith acute appendicitis. Conclusion: Most of the children with acute abdominal pain wouldnot require surgery. Detailed history and thorough physical examination are cornerstone of thediagnosis.
IRON DEFICIENCY ANEMIA
Authors: Kishwar Farzana , Ashraf Tahira , Hanif Islam , Hanif Asif , Kalsoom Samia
Published: September 2021

Objective: The objective of this study was to determine prevalence of irondeficiency anemia in children of Lahore. Study Design: Cross sectional survey. Setting:Hospitals in different areas of Lahore. Period: 3 months. Methodology: A total sample of threehundred and sixty children was taken from different areas of Lahore. Simple random samplingtechnique was used. Data collection was done by using a cross sectional survey. An informedconsent was taken from the parents of children selected for including in the study and usingtheir data for research purpose. The complete demographic information like name, age, sex,address was obtained. Venous blood samples were obtained for analysis of their hemoglobin(Hb) level. All the data collected was entered and analyzed by using SPSS version 20. Results:A total of 360 children were selected for the study. The mean age of respondents was 9.87 ±2.67. Among all subjects there were 158(43.89%) male and 202 (56.1%) were female patients.The mean Hb in all subjects was 9.82 ± 3.46. The overall prevalence of iron deficiency anemiawas 224(62.2%). Among anemic patients there 101 (45%) male and 123 (55%) female patientsin this study, we found no significant association between anemia and gender, p-value >0.05.Conclusion: Prevalence of iron deficiency anemia is considerably higher in children of Lahoreunder study. We should take some defensive measure to cope with it as mathematical deficiencyaffect children’s health, mental and physical activities.
TUBERCULOSIS MANAGEMENT
Authors: Jabbar Naila , Ali Muhammad Arif , Sohail Umair
Published: September 2021

Background: Medical practitioners are the main source of health care forpatients in Pakistan due to their availability at all times. Limited information is available related tothe management of Tuberculosis (TB) among the practitioners. Study Design: Cross sectionalstudy. Setting: Through stratified random sampling among the practitioners of Lahore, Punjab.Period: May 2014 to August 2014. Methods: They were presented with a questionnaire andtheir answers examined according to the international designed strategy for TB management.Results: TB management has a positive relationship with experience, awareness, source ofawareness and continuing medical education and a negative relationship with qualification. 95% of doctors agreed to go for further investigation but only 40% knew that 2 sputum sampleswere required for proper diagnosis. Only 32% doctors knew TB resistant drugs were to begiven in drug resistant cases. Conclusion: Most doctors in Pakistan lack sufficient knowledgeregarding tuberculosis management and prompt measures shall be taken to improve it.
SENILE CATARACT PATIENTS
Authors: Mansoor Aniqa , Gul Roquyya , Malik Tayyaba Gul , Khalil Muhammad , Alam Rabail
Published: September 2021

Purpose: The current study was aimed at finding out the significance of serumelectrolytes and serum calcium levels in the development of senile cataract. Study Design:Case control study. Setting: Ghurki Trust Teaching Hospital, Lahore, Pakistan. Period: Jan2013 to June 2013. Methods: Total fifty patients with senile cataract and fifty controls wereselected. Clinical history and clinical diagnostic tests were performed by an ophthalmologist.Blood samples were drawn and serum stored at -20o C. Serum potassium and sodiumwere measured by Flame photometry. Serum chloride levels were estimated by quantitativedisplacement of thiocyanate by chloride. The estimation of calcium was done using photometryby CPC method. Statistical analysis was done by Statistical package for social sciences (SPSSversion 16.0). There were 31 females and 19 male (F:M = 1.63:1) patients. In the control group,there were 32 females and 18 males (F:M = 1.77:1). The age was ≥ 40 years in both patientsand control group. Results: Nuclear cataract was the commonest. Among all the analytes,only serum calcium levels were found to be significantly lower in patients (p value less than0.05 as compared to controls). While difference of sodium, potassium and chloride levelsbetween cases and controls was insignificant. (p values 0.49, 0.36, and 0.45 respectively).Conclusions: In Pakistan, serum electrolytes in cataract patients are not significantly differentfrom the controls while serum Calcium of cataract patients is significantly low when comparedwith the control group, indicating the possible role of low calcium level as a risk factor in thedevelopment of senile cataract.
DUAL EFFECT OF ATORVASTATIN ON ENDOTHELIUM
Authors: Shabbir Faizania , Khan Muhammad Alamgir , Rajput Tausif Ahmed
Published: September 2021

Objective: The objective of the study was to observe the effect of lipid loweringtherapy on homocysteine and TXA2 concentration in obese hyperlipidemic Sprague Dawleyrats. Design: Randomized Control Trial (RCT). Place and Duration of study: The study wasconducted in Department of Physiology and Centre for Research in Experimental and AppliedMedicine (CREAM), Army Medical College, Rawalpindi; and National Institute of Health (NIH)Islamabad over a period of 12 months. Methodology: Ninety healthy Sprague Dawley ratsdivided into three equal groups. Group I (n=30) were healthy controls, group II (n=30) weremade obese and group III (n=30) were obese treated (atorvastatin 10 mg/kg/day orally bygavage method for three weeks). Body weight was recorded thrice weekly, lipid profile wasmeasured by colorimetric method on microlab and homocysteine and TXA2 were measuredby Enzyme Linked Immunosorbant Assay. Results: Serum low density lipoproteins and TXA2decreased after three weeks of atorvastatin administration, elevated HCY concentration in obesehyperlipidemic rats however was not significantly affected. Conclusion: Atorvastatin apart fromlowering lipid levels in the body also reduces TXA2 concentration which is a vasoprotective.Elevated HCY concentration which is deleterious to the endothelium however is not affected.
A CEPHALOMETRIC STUDY
Authors: Khan Mohammad Afzal , Chaudhry Muhammad Naeem , Altaf Faris Mohammed Nour
Published: September 2021

Background: Morphological characteristics of various races and populationgroups usually appear in geographical knots and clusters. Standardized cephalometricrecordsare immensely valuable for clinical and forensic purposes.In spite of its clinical significance nodata is available about the cephalic indices and prevalence of cephalic phenotypes in SouthernPunjab. Objectives: This study was undertaken to record baseline cephalometric data, cephalicindices and craniotypes. Study design: A cross-sectional population study. Place and durationof study: The study was carried out at the Multan Medical and Dental College, Multan and tookabout fourteen months to complete. Material and methods: The study was conducted on 672adult individuals (430 males and 242 females) from in and around the city of Multan in SouthernPunjab. Linear measurements of the head including maximum cranial length (glabella-inionlength), maximum cranial breadth (maximum bi-parietal diameter) and maximum auricularhead height were recorded using a digital spreading caliper. Results of measurements wereexpressed as mean ± SD. Comparison of the mean values and various proportions betweensexes was performed. The horizontal, vertical and transverse cranial indices were calculatedusing these measurements. Craniotyping was based on the ranges in various cephalic indices.Results: Differences regarding the mean of cranial length, cranial breadth and height weresignificantly larger in males as compared to females (P<0.001). The mean vertical, horizontaland transverse cephalic indices in the males and females were 79.13 ± 5.56, 78.31 ± 5.19,103 ± 7.78 and 78.32 ± 6.40, 78.32 ± 4.67, 100 ± 8.67 respectively.Most of the samplesdepicted craniotypes as mesocephalic and dolichocephalic both in the males and the females.Conclusion: The study provides baseline cephalometric data from a population of SouthernPunjab that may have its potential in clinical application and future research.
TESTICULAR VOLUME
Authors: Khan Hina , Haque Mazhur-Ul- , Rafique Muhammad , Jiskani Asad Raza
Published: September 2021

Objective: To determinate that male fertility influenced by testicular volumein albino rats. Study Design: Experimental. Place and Duration of study: Institute of BasicMedical Sciences, Dow University of Health Sciences, Karachi, 10 months (November 2009to August 2010). Methodology: Sixty four adult albino rats were obtained from animal houseJinnah Postgraduate Medical Centre for the study and divided into 2 groups. Group A receivedinjection normal saline 1 cc intraperitoneally (IP) daily for 8 weeks. Group B received leadchloride in a dose of 10 mg/kg body weight IP daily. On the day of completion of treatmentthe animals were sacrificed testes along with epididymis removed and place in Petri dish. Thelength, breath and width of testes were measured with help of vernier caliper. The spermatozoawere obtained from cauda epididymis. Results: The mean ± SEM of volume testes in groupA and B after eight week of treatment were 0.77142 ± 0.04778 cm3 & 0.11768 ± 0.01673 cm3respectively. The volume of testes of group B was significantly decreased as compare to groupB (P = 0.000). Mean ±. The mean ± SEM number of sperm cells million / ml in groups A andB after eight week of treatment was 7.65 ± 186706.553 & 1.84 ± 132792.770 respectively.Number of sperms in group B were significantly decreased as compared to group A (P =0.000). Conclusion: There was relationship between volume of testes and male fertility.
SEXUALLY TRANSMITTED INFECTIONS
Authors: Nasir Jamal Abdul , Imran Muhammad , Chohan Abid Ali , Zaidi Syed Arif Ahmed
Published: September 2021

Objectives: This study aimed to uncover the trend regarding knowledge aboutsexually transmitted infections (STIs) among Pakistani women of reproductive age 15-49 as wellas evaluating the socio demographic differentials associated with STIs knowledge. Design:The secondary data sets are used of Pakistan demographic and health survey (PDHS) of evermarried women with sample size 10023and 13558.Period: PDHS 2006-07 and PDHS 2012-13.Setting: The national institute of population studies done this survey with the technical supportfrom ICF International and Pakistan bureau of statistics and the USAID supported the financially.Methods: Descriptive frame work along withbivariate analysis was performed to understandthe trend regarding STIs knowledge and evaluate the significant socio demographic factorsrespectively. Results: The awareness regarding STIs and knowledge to use always condomduring sex to reduce the risk of getting HIV/AIDSafter equating the two PDHS has improvedover time just by 3.85% and 6.50% respectively in PDHS-2012-13 compared to PDHS 2006-07.Early age group (15-19) women have sufficient lack of knowledge about STIs. Urban has moreknowledge regarding STIs compared to rural. Education, wealth index and media awarenesshave positive association with STIs knowledge. Conclusions: Socio demographic differentialssuch as age, education, location and geographical area of residence, media access, wealthindex and women occupation are found to be statistically highly significant with respect tosexually transmitted infections knowledge. These statistical outcomes will enhance thecapability in disease management and control.
THORACOLUMBER VERTEBRAL FRACTURES
Authors: Anwer Muhammad Sohaib , Waqas Muhammad Ali , Ali Muhammad , Safdar Mr. Sohail
Published: September 2021

For spinal injuries, thoracolumbar junction is common site in our population.Surgical management of unstable fractures and fracture dislocations of thoracolumbar spineis still controversial. This study was conducted to document efficacy of short segment fixationof thoracolumbar verterbral fractures. Objectives: To determine the outcome of short segmenttranspedicular fixation of thoracolumbar fractures. Study design: Descriptive cross-sectionalstudy. Sampling technique: Non-probability purposive sampling. Material and Methods: Atotal of 103 study cases with thoracolumbar vertebral fractures were taken in this descriptivecase series study which was conducted at department of Neurosurgery, Nishtar HospitalMultan from February 2014 to June 2015. Informed verbal consent was taken from eachpatient before participation in this study ensuring them confidentiality of the information andexplaining them objectives and procedure of our study. Once registered, detailed history andclinical examination was done by a Neurosurgeon, investigations like X-ray dorsolumbar spine,CT scan and Magnetic resonance imaging (MRI) dorsolumbar spine were also done. Shortsegment transpedicular fixation was done and outcome of surgical management was assessedin terms of improvement in power, hardware failure and infection by consultant neurosurgeon.All the study cases were called for follow up visits after every month till 6 months to record finaloutcome of management. All the information were recorded in the study proforma. Data wereentered and analyzed by SPSS version 22. Results: Out of these 103 study cases, 66 (64.1 %)were male patients and 37 (35.9 %) were female patients and male to female ratio was 1.85:1.Mean age of our study cases 33.92 ± 9.72 years ranging from 20 years to 54 years. Meanages of male patients was 36.68 ± 10.37 years while in female patients it was 29.00 ± 5.89years (p=0.000).Post-surgical management improvement in power was seen in 55 (53.4%)of our study cases, hardware failure in 11 (10.7%) and infection was observed in 20 (19.4%).Conclusion: According to our study short segment transpedicular fixation is safe & effectiveprocedure providing efficient spinal stability. Short segment fixation is associated with minimumblood loss and trauma and leads to early mobilization of the patient and ease in physiotherapy.Transpedicular screw fixation is a useful choice for achieving better neurological recovery andgood pain control in post-traumatic thoracolumbar fractures.
HCV IN PUNJAB
Authors: Ashraf Fouzia , Rasheed Amna , Ullah Sajjad , Shaukat Mahmood
Published: September 2021

Background: HCV is the foremost cause of liver cirrhosis and hepatocellularcarcinoma and its prevalence is increasing in developing countries like Pakistan. Present studyis focusing on its frequency in different districts of the Punjab of Pakistan. Setting: Differentdistricts of Punjab. Period: Jan 2010 to Dec 2010. Material and methods: 5ml venous bloodwas collected from each donor by using disposable syringes. Sample is transferred to vialscontaining anticoagulant, centrifuged and plasma was separated for further analysis.140 ulplasma of every patient was analyzed for HCV RNA Virus by Real time PCR using Artus HCVQuantification kit (Germany).For statistical analysis SPSS 16 was used. Results: A total countof 3262 samples was collected from 32 districts of the Punjab and all these samples were bothrapid HCV screening and Anti HCV by Elisa positive. Out of which 2041 (62.57%) patientswere detected positive for HCV, 1221 (37.4%) were not detected.49.5%patients were malewhile50.5% were female. 30.99% males were detected positive including patients with low viralload. 31.58% were detected positive for HCV including low positive female patients.30.71%females were detected positive for HCV, 37.5% were not detected for HCV. Conclusion: Highestprevalence of HCV among different age groups is found in age group of 36-40 years with12.23% and lowest is found in age group > 15 years with 0.31% (p=0.009).
HEPATITIS B AND C VIRUS INFECTIONS
Authors: Anjum Muhammad Usman , Khan Muhammad Safdar , Afridi Nazar Muhamamd , Shah Syed Humayun
Published: September 2021

Patients with end stage renal disease require haemodialysis as a part of theirtreatment. The incidence of hepatitis B and C virus infection is quite high in patients undergoingmaintenance haemodialysis than in general population. This risk is specifically associatedwith use of blood and its products as well as repeated intravascular access in these patients.Objectives: To determine the seropositivity of hepatitis B and C virus infection in patientsreceiving haemodialysis. Design: Descriptive cross sectional study. Setting: NephrologyDepartment, Ayub Teaching Hospital, Abbottabad, Pakistan. Period: From October 2014 toApril 2015. Methods: Five hundred patients were included in the study based on inclusionand exclusion criteria. Demographic data was recorded and detailed history was taken fromeach patient specifically about the no of blood transfusions received, the frequency of dialysisand the dialysis done in other centers. All patients were checked for the presence of hepatitisB surface antigen (HbsAg) and antibodies to HCV using third generation enzyme linkedimmunoassay (ELISA). Results: Mean age of study sample was 46±5 years with 60.8 % males.Incidence of hepatitis positive cases was 164 (32.8 %), out of which 66 (13.2 %) patients wereHBV positive and 98 (19.08 %) patients were HCV positive. The hepatitis B and C infectionswere more common in males than females. Seropositivity of HBV and HCV was higher (HBV18.1 % and HCV 22.2 %) among haemodialysis patients who have received more than threeblood transfusions. The frequency of HBV and HCV infections increases significantly with theincrease in frequency of dialysis, with 49 (17.11 %) patients were HBV positive and 70 (24.5%) patients were HCV positive cases, who have received haemodialysis for more than fivetimes. There were 48 (15.7 %) HBV positive cases as well as 68 (22.3 %) HCV positive cases inpatients who have received their treatment from a single center. Conclusion: Hepatitis B andC infection is quite common in patients undergoing haemodialysis. The risk of these infectionscan be reduced by following infection control guidelines, proper training of the staff and strictscreening of blood and blood products specifically for hepatitis C virus.
THYROID DISORDERS
Authors: Ali Liaqat , Din Muhammad Tahir Mohy U , Ahmed Imtiaz , Riaz Rehan
Published: September 2021

Background: Thyroid hormones have many effects on cardiovascular function,and deficiency or excess of thyroid hormones can result in cardiac dysfunction. Abnormalitiesof the cardiovascular system are often identified during examination of hyperthyroid andhypothyroid patients. Objective: The aim of this study was to address the effects of thyroidhormones on the cardiovascular system and the clinical relevance of the cardiovascularresponse to thyroid dysfunction. Study Design: Cross sectional study. Setting: The studywas conducted at Allied Hospital / Punjab Medical College Faisalabad and PINUM HospitalFaisalabad. Period: October 2014 to August 2015. Materials and Methods: Total 100 patientswith thyroid disease (Hypo/hyperthyroidism) were enrolled in the study. Any patient age ≥20years, that had documented history of thyroid disease (Hypothyroidism or hyperthyroidism) oron medications for thyroid disorder was recruited in this study. Results: Total 100 consecutivepatients with abnormal thyroid function tests who fulfill the inclusion and exclusion criteriawere enrolled in the study. Mean age was 47.9 ± 23.20 years. 16 % were male and 84%were female. Majority of the patients 37( 37%) were in age group 51 - 60 years. 53 % weresuffering from overt hyperthyroidism and 31 % were suffering from hypothyroidism. Subclinicalhyperthyroidism and hypothyroidism was present in 7% and 9% patients respectively. Goiterwas present in 24 % patients. Atrial fibrillation was observed in 34% hyperthyroid patients.Overall 23% were diabetics and 25% had H/O hypertension. Dyslipidemia was present in20% hyperthyroid and 25% hypothyroid patients. Echocardiography was performed in 19%patients. 7% patients undergone thyroid surgery. Overall 11% patients were suffering from CCF.Pulmonary hypertension was observed in 17% hyperthyroid and 35.48% hypothyroid patients.MeanFT4 in hypothyroid patients was 1.16±022 ng/dl. Mean TSH was 10.92±21.09 (μIU/ml)in hypothyroid and 0.19±0.14 (μIU/ml) in hyperthyroid patients. Conclusions: The outcomeof this study suggests that patients with untreated overt / subclinical thyroid dysfunction are atincreased risk of cardiovascular complications.