bluuebunny/crossref_metadata_2025 huggingface dataset:
Pattern of Skullhurt and Injuries among Victims with Motorcycle Crashes with or without Safety Elements and Helmets
Authors: Jalal Malik Liaqat Ali , Anwer Muhammad Sohaib , Ali Faisal , Hussain Wajahat , Abbas Huda
Published: April 2022

Aim: Pattern and severity of skullhurt and injuries in victims involved in bike crashes, whether or not they were wearing a hat. Methodology: A cross-sectional study was performed from January to December 2021. The sample size was 151. Cases with impeded GCS and brain malformations on CT scan were included. On the basis of GCS, 3–8, 9–12, and 13–15, we classified skull injuries as severe, moderate, or mild. SPSS 22 was used to analyze the data. The chi-square test was used. Results: The research included 151 people, with 66(43.7%) of them being between the ages of 20 and 29. There were 139 males (92.1%). At the scene of the collision, 120(79.5%) of the victims in bike crashes were travelling the bike. Brain edema was found in the greatest proportion of victims 40 (26.5%), accompanied by cuts and bruises i.e. 36(23.8%). There were 65 victims who were with proper safety elements and helmets at the time of the accident (43.1%). The intensity of skull trauma in relation to helmet use revealed that 42 (82.4%) of the 51 individuals with symptomatic fractured skull were not n proper safety at the scene of the collision. Conclusion: Skull injuries were always more prevalent in the boys and the extent of the damage was greater in victims who were not wearing a helmet. Keywords: Skullhurt, motorcycle crash, helmets, skull trauma
Alkaline Phosphatase as Serum Tumor Marker in Osteosarcoma
Authors: Bhatti Zuhair , Kiran Khadija , Shoaib Muhammad , Nisa Seerat Un , Arif Ahmar
Published: April 2022

Aim: To reassess the high specificity of alkaline phosphatase as a serum tumor marker in patients with osteosarcoma Study type: Retrospective cohort study Study place and duration: Department of Orthopedics, DHQ Hospital Gujranwala from January 2013 to June 2021 Methods: The medical record of 140 osteosarcoma patients were reviewed retrospectively, who received treatment for osteosarcoma during January 2015 and June 2021. According to clinical factors at diagnosis, the difference in prevalence of increased ALP was assessed using Fisher`s extract test and χ2 test. In the groups with normal and high level of serum ALP at presentation, the disease-free survival (DFS) and overall survival (OS) were compared using The Kaplan–Meier estimate. At presentation the prognostic ability of increased ALP was examined using Cox regression analyses. For determination of therapeutic steps and survival related changes in levels of ALP during therapy and survival related response of ALP to therapy, Linear Mixed model (fixed model) was used. Results: Sensitivity, specificity , Positive predictive value, negative predictive value, PLR, NLR and DOR of ALP in Metastatic osteosarcoma at 15 months follow up was 55.4%, 80.3%, 62.1%, 74.2%, 3.14, 0.864 and 5.241 respectively. Similarly, Sensitivity, specificity , Positive predictive value, negative predictive value, PLR, NLR and DOR of ALP in Metastatic osteosarcoma at 3 years follow up was 56.4%, 92.5%, 83.1%, 70.1%, 6.321, 0.632 and 8.543 respectively. Conclusion: ALP has been found to be a very important tumor marker having high specificity in patients with osteosarcoma. MeSH words: Osteosarcoma, Tumor, Biomarker, Alkaline Phosphatase, Metastasis, Sensitivity, Specificity
Causes of Abnormal Uterine Bleeding in Females of Reproductive Age Group attending Gynaecology Dept of UOL Hospital
Authors: Saleem Amina , Anjum Safoora , Mahmood Arjamand , Kosar Razia , Naveed Fatima , Noor Hazia
Published: April 2022

Background: Abnormal uterine bleeding is a prevalent problem that prompts a female to seek medical help. The most common symptom of abnormal uterine bleeding is heavy menstrual bleeding. The impact of abnormal uterine bleeding on one's quality of life is important. Aim: To determine the causes of abnormal uterine bleeding. Methods: This cross-sectional study was conducted at Department of Gyneacology University of Lahore Teaching Hospital Lahore over a period of one year from Nov 2020 to Nov 2021. Eighty females of reproductive age with Abnormal Uterine Bleeding were selected. All females were examined for the etiology of abnormal uterine bleeding. The females with menstrual blood loss lasting >8 days, passage of blood clots or haemoglobin concentration < l0 gm/dl were enrolled. The exclusion criteria includes the females less than 20 years of age, or with pubertal menorrhagia or postmenopausal females. Results: Out of total eighty females, 25% females belong to 42 years age group. The most prevalent etiology of abnormal uterine bleeding was fibroid uterus i.e. 62.5% cases, followed by adenomyosis (15%), endometrial polyp (10%) and endometrial hyperplasia (12.5%). Fifty females (50%) were multipara, 20 (25%) were grand multipara and 10(12.5%) were great grand multipara. Severe anemia was noted in almost 10 females (12.5%), moderate anemia in 56 cases (70%) and mild anemia in 14 cases (17.5%). Transabdominal scan was done to confirm the diagnosis of fibroid uterus, adenomyosis, endometrial hyperplasia and endometrial polyp. Conclusion: Fibroid uterus was the commonest cause in females presenting with abnormal uterine bleeding to University of Lahore Teaching Hospital affecting quality of life in females and causing psychological problems. Keywords: Abnormal uterine bleeding, Menorrhagia, Metrorrhagia, Fibroid uterus, Endometrial polyps.
Frequency of Electrolyte Imbalance and Hypertension in patients with Atrial Fibrillation
Authors: Raza Muhammad Asad , Ather Ch. Adnan Ahmed , Nasir Maria , Sajad Qamar , Ch. Saadia , Bhatti Hammad ur Rehman
Published: April 2022

Aims: To determine the frequency of electrolyte imbalance and hypertension in patients with atrial fibrillation Method: A cross-sectional study was conducted on 163 patients in the Accident and Emergency department of Mayo Hospital Lahore from July 30, 2020 to January 30, 2021. Venous blood samples were taken from patients presenting with atrial fibrillation and sent to the Pathology department in Mayo Hospital to check for serum sodium and potassium levels. Patients were selected using non-probability consecutive sampling, with inclusion criteria of both genders of all ages, diagnosed with atrial fibrillation on the basis of electrocardiogram findings. Patients were excluded on the basis of patient’s history of prior use of anti-arrhythmic medications, congenital heart disease, valvular disease, chronic obstructive pulmonary disease or severe infections. Informed consent was taken from the patients after explanation of the study. Results: The study was conducted on a total of 163 patients of AF out of which 54 also had electrolyte abnormalities, and 22 were hypertensive. 15 of the patients with AF had coexisting hypertension and electrolyte imbalance (p value = 0.00001). Conclusion: The results show a high incidence of electrolyte imbalance and hypertension in patients of atrial fibrillation. Keywords: Atrial fibrillation, electrolyte imbalance, hypertension
Association of Bone Mineral Density Status with Ethnicity and Parity in females of Karachi
Authors: Sadiq Madeeha , Lakhani Mubina , Sidhwani Santosh Kumar , Khan Rosheena Nabeel , Rasheed Nabila , Hassan Nuzhat
Published: April 2022

Aims: To assess the association of BMD (bone mineral density) with ethnicity and parity in females of Karachi, Pakistan. Study design: Cross Sectional. Place and duration of study: Department of Anatomy & Nuclear Medicine, Ziauddin Hospital, Clifton Campus, Karachi, Pakistan between March and August 2016. Methods: 200 females aged 40 years and above were included. Average age was 60.7 years (±10.52). BMD assessment was done on DXA scans. Participants were interviewed to obtain baseline demographic characteristics. Statistical Package for Social Sciences (SPSS) version 20 was used to analyze data. Results: No significant association was found between BMD and the different ethnicities or parity in our study population. Conclusion: Bone mineral density is not affected by the number of pregnancies or ethnicity. Keywords: bone mineral density, ethnicity, parity, Karachi.
Morbidity Patterns and Health Needs of the Geriatric patients in a Tertiary Care Hospital
Authors: Mahwish Rabiah , Ali Muhammad , Hussain Arham , Manzoor Kanwal
Published: April 2022

Background: The aged population of the world is increasing. Old age is associated with increased risk of morbidity and mortality. This puts burden on health services, both financially and in terms of workload. Aim: To determine the morbidity patterns and health needs of this age group. Methods: A descriptive cross¬-sectional study was conducted among the geriatric patients presenting in the outdoor department of services hospital Lahore. The sample size was 220, calculated using the WHO statistical software S size. Nonprobability convenient sampling technique was used. The confidence interval was 95% and relative margin of error was 10%. Chi-square test was used to check the statistical significance. Results: Out of 220 study subjects, 13 had only 1 morbid condition and 137 were suffering from more than 3 morbidities. Hypertension was the most prevalent morbidity (65.9%), followed by eye cataract (61.18%). Other morbid conditions in descending order were diabetes mellitus (47.27%), osteoarthritis (43.63%), coronary heart disease (38.18%), obesity (35.45%), respiratory diseases (30.90%), hearing impairment (25%). Significant association of morbidities with body mass index was observed. Almost 37.7% of respondents reported feeling of loneliness. Most of the geriatric patients were involved in religious activities (88.2%). Spectacles (55%) were the most frequently used supporting aids followed by walking sticks (26.4%). Conclusion: A high proportion of geriatric patients have more than 3 morbidities with hypertension being the most common. Body mass index and smoking were significant risk factors. Geriatrics showed prevalent psychological problems. Keywords: Geriatrics, Morbidity, Pattern, Health needs.
Isolation and Identification of Microbes from Mobile Phones in Orthopedic Operation Theatre
Authors: Umbreen Shehla , Rasheed Abdul , Jabbar Shumaila , Farooqi Faheem Mubashir
Published: April 2022

Background: Post-operative infection in orthopedic surgery is an emerging problem for the orthopedic surgeons and patients. Mobile phones are the most common object brought in theatre by the health professionals and are contaminated by different strains of bacteria which may be the cause of surgical site infection. Objective: To isolate and identify the microbes on the surface of the mobile phones of the hospital staff in orthopedic operation theatre. Methods: Samples were taken from the mobile phones of the health care professionals (Surgeons, assistants, Anesthetists, Staff nurses and paramedical staff) entering the operation theatre of the LIHAS (Lahore Institute of Hand and Arm Surgery). All the samples were taken using the culture swab sticks on both sides of the mobile phones of the health care staff of operation theatre on the same day. Results: The total numbers of mobile phone sampled were 45. 97.3% of the cell phones were contaminated with one or more bacteria and the most common bacteria isolated was Staphylococcus Epidermidis (62.22%) followed by Staphylococcus Aureus (42.2%), Micrococcus (37.77%), Bacillus (33.33%), E.Coli (31.11%), Pseudomonas Aerugonosa (22.22%) and others including Proteus Mirabilis, Enterobacter and Acinetobacter Baumannii (8.88%). Conclusion: It is concluded that the mobile phone can be the major source of contamination in operation theatre, so the use of mobile phone in the theatre should be minimized and should encourage to clean the phone regularly. Key words: Orthopedic operation theatre, contamination, Mobile phones.
High Value Care Cost conscious: practicing habits and awareness among the doctors during clerkship
Authors: Hussain Talib , Hussain Ashfaq , Hameed Sohail , Arshad Muhammad , Haque Mazhar Ul , Hameed Farheen
Published: April 2022

Aim: To evaluate the high value care cost conscious awareness among post administrative staff and doctors clinical. Study design: Cross sectional Survey. Place and duration of study: Shahida Islam Medical and Dental College and Hospital. From Jan 2021 to Dec 2021 Methodology: 50 doctors were recruited for conducting the proposed study and asked them to fill the questionnaire i.e., Maastricht HVCC Attitude Questionnaire (MHAQ) which was divided into three subscales such as high-value care, cost incorporation and perceived drawbacks. Moreover, job demands, and resources related questions were asked to resident respondents followed by the assessment of other stakeholders’ HVCCC attitudes. Data was analyzed using univariate and multivariate analyses. Results: Following results have been noted during the research: HVCCC attitudes of faculty and administrators have been more positive than residents (p ≤ 0.05) whereas patients showed less positive behavior (p ≤ 0.05) than residents. Moreover, residents’ understanding for the HVCCC attitudes of faculty and patients was underestimated (p < 0.001) and overestimated (p < 0.001) respectively. It was observed that the increasing age was directly proportional to the positive attitudes towards HVCCC in both residents and faculty (p ≤ 0.05). While in patients’ lesser positive attitudes towards HVCCC was significantly associated (p < 0.001) with lower perceived health quality. Direct relationship of the autonomy of residents perceived with their attitudes towards the HVCCC was also observed i.e., more independence means more positive attitudes. Conclusions: Attitudes towards HVCCC of the residents during course of residency vary due to their behavior and learning environment. Residents might misinterpret the faculty’s attitudes and patients attitudes as well. Faculty and administrators must be more supportive towards residents to enhance their capabilities through their experiences and knowledge of HVCCC and by giving them freedom in clinical practice. Keywords: HVCCC, residents, cost conscious care, clinical learning environment
Association between Cystatin C, CRP in patients of Diabetic Nephropathy with Type 2 Diabetes Mellitus
Authors: Ain Qurat Ul , Butt R. Zahid , Bari Saba , Sarwar Urwa , Khan W Ullah , Naseem S. T. , Anwar M. Z. , Haq A.U. , Hussain G. , Laique T.
Published: April 2022

Background: Both developed and developing countries are facing the threat of end stage renal disease mainly caused by diabetes mellitus type 2. Aim: To see an association between levels of Cystatin C and CRP in diabetic nephropathy patients. Study design: Randomized controlled trial. Methodology: A total of 285 patients confirmed Type 2 diabetes mellitus were inducted in study. Patients were subjected to standard interview questionnaire regarding age, duration and complications of diabetes. High sensitive latex enhanced immunoturbidimetric method was used to measure the serum levels of Cystatin C and CRP. High density lipoproteins (HDL), Low density lipoprotein (LDL), total cholesterol and glycosylated Hemoglobin (HBA1C) levels were also measured and interpreted. Doppler ultrasound was performed for structural evaluation of renal functions. SPSS 25.0 was used to analyze the whole data. The difference between all the groups was analyzed using One-Way Analysis of Variance (ANOVA). Results: There was no statically Significant difference among age, sex, blood pressure, HDL, LDL, TC, and HBA1C levels among patients of all 3 groups, whereas CRP and Cystatin C levels were found to be raised with patients of moderate to severe nephropathy. Conclusion: It was concluded that albumin to creatinine ratio (ACR), serum Cystatin C and CRP are potential biomarkers of disease progression in patients with diabetic nephropathy. Keywords: Hyperglycemia, Albumin to Creatinine ratio, serum Cystatin-C, CRP and Nephropathy.
Correlation of Sokal Scoring System with Molecular Response in pts of CML Taking CML Specific Tyrosine Kinase Inhibitors
Authors: Shoukat Amna , Nasir Aisha , Matloob Hafiz Muhammad , Asghar Aiza , Iqbal Ayesha , Haroon Amber , Laique Talha
Published: April 2022

Background: Chronic myeloid leukemia (CML) is a clonal myelo-proliferative disorder of a pluripotent stem cell. Aim: To find the frequency of low, intermediate and high risk category in patients of chronic myeloid leukemia and to compare frequency of complete molecular response. Study design: Descriptive case series. Methodology: Present study was conducted at Hematology Department, Sheikh Zayed Hospital Lahore. 260 patients fulfilled the selection criteria were selected. Sokal score was calculated. Low risk, intermediate and high risk category was assessed. Patients were followed up for 3 months. BCR-ABL translocation detection was done after 3months of treatment and complete molecular response was recorded. All this information was recorded on proforma. Data was analyzed using SPSS version 20. The chi-square test was used to compare the groups. A p-value of 0.05 was considered significant. Results: The mean age of patients was 49.18±20.33years. There were 144(55.4%) males and 116(44.6%) females. The mean duration of CML diagnosis was 3.52±1.69months. At baseline, 172 (66.2%) had low risk, 76(29.2%) had intermediate risk and 12 (4.6%) had high risk. In the study, complete molecular response was observed in 0% patients. Conclusion: It was concluded that there is regression in grades of Sokal score in patients of Chronic myeloid leukemia after 3 months treatment with TKIs but there is no complete molecular response observed in any patient after 3 months of treatment with TKIs. Keywords: Chronic Myeloid Leukemia, Low, Intermediate, High Risk and Sokal Score.
Neurological Deficits of Coronavirus Disease-19: A Systematic Literature Review
Authors: Hussain Fawaz Al- , Ghouri Muhammad Hashim , Sarfraz Zouina , Falah Noor Ul , Tabassum Saima , Anjum Ambreen , Rukh Mah
Published: April 2022

Aim: To review neurological aspects of patients infected with COVID-19 including neurological dysfunctions and possible pathophysiology. Methods: A systematic review of articlesfrom PubMed, Ovid MEDLIN, DOAJ databases and grey literature included the WHO-COVID-19 database, and medRxiv.Articles published from January 2020 until June 2020 were included in the review. Out of the226 titles and abstracts, 213 were identified after the removing duplicates. With a screening of 119 studies carried by all authors, 83 full-text articles were assessed based on inclusion criteria of the neurological perspectives with COVID-19. Subsequently, 45 texts were removed. A total of 38 studies were included in the last scrutiny.Specifically, case reports, cohort studies, and case series were included Results: Reviewed evidence was presented in textual and tabulated format, which includes methodology, characteristics of included studies and summary of findings. Correlational evidence of COVID-19 disease and neurological dysfunctions with possible pathophysiology isreviewed. Conclusion:The findings provide evidence for physicians and neurologists working with COVID-19 patients about the possible probable complications and clinical presentations due to the SARS-CoV-2 infection. Keywords: COVID-19; SARS-CoV-2; Coronavirus Disease; Respiratory illness; Neurology; Nervous system; Critical Illness;
Effects of Mulligan Pain Release Phenomenon Technique in Management of Patellofemoral Pain Syndrome: RCT
Authors: Anwar Sahreen , Javaid Maham , Malik Sarosh , Asghar Muhammad Uzair , Perveen Wajida , Chaudary Muqadas
Published: April 2022

Background: Anterior knee pain is one of the common musculoskeletal problems seen in children adolescents and adults. Aim: To find the effects of Mulligan PRP technique in the management of patients with patellofemoral pain syndrome. Study design: Randomized Control Trial. Methodology: A randomized clinical trial was conducted with a sample of 45 patients. Equal no. of participants were allocated randomly in 3groups through computer generated random number table i.e. A (compression group), B (distraction group), C (conventional group) and allocation was kept concealed. Mulligan’s pain release phenomena with 3 different modifications were administered to the study groups. The duration of study was. Outcome measures were pain, knee range of motion, functional capability measured through Visual analogue scale (VAS), goniometer, and lower extremity functional scale (LEFS) respectively. Outcomes were measured at baseline and 4 weeks after the treatment. Data was analyzed by SPSS version 19. ANOVA was applied to find the outcomes while P ≤0.05 was considered significant. Results: The results of comparison among groups showed that knee ROM (P= 0.678), LEFS (P=0.027) and for VAS (P=0.163). The results showed that PRP is more effective in improving functional outcomes, whereas pain although improved through PRP; does not prove it a superior treatment when compared to others. Conclusion: We concluded that Mulligan’s Pain Release phenomena is an effective treatment in the management of patellofemoral pain syndrome in terms of functional outcomes. Keywords: Patellofemoral Pain syndrome, Mulligan’s Pain Release Phenomenon, Visual Analogue Scale,
Outcomes of Multidisciplinary Team Approach in Rehabilitation of Patients with Stroke
Authors: Kanwal Shazia , Hashmi Riaz , Perveen Wajida , Ali Misbah Amanat , Akhtar M. , Munawar Arooj
Published: April 2022

Aim: To find the benefits of the multidisciplinary team approach for the rehabilitation of patients with stroke. Methodology: This cohort case series was conducted at physiotherapy department, Syed Medical Complex Sialkot in 2017-18 after ethical approval. Open epi calculator was used for sample size estimation and found 70 patients. Non-probability, consecutive sampling technique was used to enroll the patients after screening for eligibility criteria and taking their consent. FIMFAM scale was used to measure the outcomes at 1st visit, after 4 weeks, and on follow up. Results: Mean ± standard deviation of the age of participants was 62.57±8.02 years. Out of them, 74.28% (52) had left sided while 25.71% (18) had right sided stroke. Mean of total FIMFAM score at 1st visit, after 4 weeks, and on follow up was 42.50±20.58, 77.70±25.56 and 126.83±21.30 respectively (P=0.000). Mean difference of 1st visit and after 4 weeks was 35.20 (p value=0.000), Mean difference after 4 weeks and follow up was 49.13 (p value=0.000). Conclusion: We concluded that multidisciplinary team approach in patients with stroke can produce significant improvement in their functional outcomes, therefore can limit the risk of death and delayed recovery. Keywords: Multidisciplinary Team Approach, Stroke, Rehabilitation and FIMFAM Scale.
Frequency of Extrapulmonary TB among Human Immunodeficiency Virus (HIV) patients at Lady Reading Hospital, Peshawar
Authors: Rehman Abdur , Bilal Muhammad , Khan Yaseen
Published: April 2022

Background: Human immunodeficiency virus/acquired immunodeficiency syndrome (AIDS) has now infected nearly 80 million people around the world since it first appeared. The HIV epidemic has had a profound effect on the global tuberculosis (TB) crisis attributing to 20% of all AIDS-related deaths. Less than one-tenth of one percent of Pakistan's population was estimated to have HIV. However, Pakistan has gone from having a low HIV prevalence to a high HIV epidemic. Pakistan is the sixth most problematic country in the world for TB because it accounts for about 63% of the TB load in the Eastern Mediterranean Region. Aim: To determine the prevalence of extrapulmonary tuberculosis among HIV patients. Study design: Prospective, cross-sectional study. Place and duration of study: Department of Medicine, Lady Reading Hospital, Peshawar from 17th April 2020 to 16th October 2020. Methodology: Seventy eight HIV patients were recruited to determine the frequency of extrapulmonary tuberculosis. Results: There were 34.6% males and 65.4% females with mean age was 45.44±5 years. The frequency of extrapulmonary tuberculosis in HIV was found to be 44.9%. Conclusion: Extrapulmonary tuberculosis is a significant problem among human immunodeficiency virus patients. Key words: HIV, Extrapulmonary tuberculosis, Pakistani patients
Collagen Deposition Reduction by Vitamin E in Alcoholic Liver Injury
Authors: Wazir Noman Ullah , Khan Farooq , Ara Nighat , Humayun Ambereen , Wazir Nadeem Ullah , Mumtaz Saima
Published: April 2022

Background: Alcohol encourages fibrotic changes in liver by initiating collagen deposition in liver parenchyma. Vitamin E can slow down progress of fibrosis in alcoholic liver injury and play a defensive part against these changes. Aim To observe difference in fibrotic changes in livers of vitamin E treated and non-treated rabbits exposed to intra-gastric administration of alcohol. Study Design: Analytical experimental study Place and duration of study: Department of Anatomy, Peshawar Medical College, Peshawar Pakistan from 1st May 2019 to 30th October 2019. Methodology: Eighteen domestic type male rabbits (Oryctolaguscuniculus) were included. All animals were divided in two categories on the basis of experiment time frame. “Category E8” animals having 8 weeks’ time period and “Category E4” animals having 4 weeks experimental duration. Each category was then clustered in “Control Group A” (appropriate food as per standard laboratory requirements, and normal saline as drinking water was provided daily), “Experimental Group B” (proper standard nutrition, 30% solution of ethanol made in distal water in the dosage of 30ml per kg/day through nasogastric tube and normal saline for drinking purpose were provided daily) and “Experimental Group C” (treated with suitable standard required diet, 30% of ethanol solution made in distal water in the dosage of 30ml per kg/day via NG tube and “Vitamin E” 50mg dissolved in 2ml distal water per kg/day with same nasogastric tube daily and normal saline for drinking purpose were given). Results: Collagen fibers deposition (fibrosis) in liver stroma was detected and recorded according to Knodel histological activity index. Quantitative difference in the collagen deposition among all groups from both “Category E4” and “Category E8” presented vastly significant “P” values. Conclusion: Alcohol can cause major fibrotic changes in “liver” even if it is consumed for the minor duration of 4 to 8 weeks, and these alterations can be minimised by the proper use of vitamin e through its “antioxidant effect”. Keywords: Alcohol, Liver, Fibrosis, Vitamin E, Hepatocyte, Collagen
Frequency of Profiling of Forensic Autopsies
Authors: Rasheed Aisha , Akhtar Naseem , Langah Ishtiaque Ali , Aziz Ijaz , Mal Sono , Anwar Azra
Published: April 2022

Aim: To identify the profiling of medicolegal autopsies. Study design: Prospective observational study. Place and duration of study: Medicolegal Section, Liaquat University Hospital, Hyderabad from 1st January 2015 to 31st December 2019. Methodology: Nine hundred and eighty two autopsies of medicolegal nature were performed over a period of five years. The data was collected from forensic autopsy reports and was recorded with the consent of close relatives. Results: Majority of the subject was male (78.92%) and belonged to age group of ≥19 to <60 years. The number of subjects reported from urban locality (67.61%) was higher than rural areas (32.39%). The distribution of causes of deaths showed major contribution of road traffic accidents (45.32%) followed by fire arm injury (16.70%), asphyxia (15.31%), train accident (3.46%), and poisoning (1.83%). All of the causes of deaths were higher in males and within age group of adults. Most of the medicolegal nature causalities were reported from urban areas of the region. The number of forensic autopsies was highest in summer season (40.12%). Conclusion: The males outnumbered the females in medicolegal autopsies. The road traffic accidents had highest frequency of causing deaths in both genders and in all age groups irrespective of locality and seasons. Keywords: Forensic autopsy, road traffic accident, fire arm injury, asphyxia, seasons
Comparison of Ayer’s Spatula Versus Cytobrush in Adequacy of Sample Obtained for Pap Smear
Authors: Salahuddin Gulwish , Jabeen Tahira , Naz Ayesha , Afzal Rukhsana Shaheen , Nisa Khairun , Mushtaq Iram
Published: April 2022

Aim: To compare the adequacy of Pap-smear in the same patient obtained by Ayer’s spatula and cytobrush. Study design: Comparative cross-sectional study Methodology: One hundred and fifty patients were enrolled. Each patient was subjected to both the tools i.e. cytobrush and Ayer’s spatula. Results: The mean age was 41.6±10.4 years. 83.3% of patients using Ayer’s spatula while 94.7% was using cytobrush and statistically the significant (P=0.002) results were found. Conclusion: Sampling with cytobrush resulted in better percentage of adequate samples as compared to Ayer’s spatula. Keywords: Cervical cancer, Cervical cancer screening, cervical cancer screening techniques
High Resolution CT Chest Findings in PCR Positive or Clinically Suspected patients of Covid-19 Infection
Authors: Gulshan Maimoona , Ejaz Syeda Khadija , Tahir Mehwish , Maryam Attka , Qadir Sadaf , Rafique Zafar
Published: April 2022

Aim: HRCT chest findings in PCR positive or clinically suspected patients of COVID-19 infection. Methods: Retrospective study recruited 207 clinically suspected patients of COVID disease with duration of 1-14 days from the radiology department of Shalamar Hospital Lahore. Patients were categorized into two groups on the basis of PCR +ve (123) and PCR -ve group (84). Results: Among 123 PCR +ve patients, 107 patients were CT Positive and 16 were CT negative. While from 84 PCR -ve patients, 38 patients were CT positive. Among PCR Positive patients, most prevalent finding was GGO (84.5%), followed by lymphadenopathy(48.8%), interlobular septal thickening (41.5%), consolidation (5.7%) on HRCT chest. The GGO was mostly bilateral (82.2%) and Peripheral (47.8%). Among 84 PCR negative patients, GGO (45.3%), followed by interlobular septal thickening (28.6%), lymphadenopathy (19.1%). The GGO was mostly bilateral (26.2%) and Peripheral (25%). HRCT Chest has Sensitivity (86%), specificity (54%) and accuracy 74%. Conclusion: GGOs with bilateral and peripheral distribution was the most common finding in both PCR positive and negative patients, whereas lymphadenopathy in PCR positive and Interlobular septal thickening in PCR negative patients was the second common finding. High resolution CT Chest performs a significant role in early diagnosis of patients with COVID-19 due to its high sensitivity and specificity. Keywords: PCR, GGO, COVID-19
Splenic Abscess in Qatar: A Single-Center Experience
Authors: Yousef Khan Fahmi , Elmudathir Ahmed , Abu Bakir Muhammed , Alsawaf Bisher
Published: April 2022

Background & Objectives: Splenic abscess (SA) is a rare clinical entity. There is a lack of information on SA in most Arab and Gulf countries, including Qatar. This study describes the demographics, clinical features, microbiologic etiologies, treatments, and outcomes of patients with SA at the largest tertiary medical center in Qatar over the previous six years.

Methods: This retrospective observational study was conducted at Hamad general hospital. It involved all patients of 18 years old or above who were admitted with the diagnosis of SA for the period between January 1, 2015, and December 31, 2020.

Results: We recruited 25 patients, of which 14 (56%) were males, and 11 (44%) were females. The mean age ( ±  SD) of them was 48.64 ± 19.08 years. The mean illness duration was 22.88 ± 11.88 days. Fever was the most common presenting symptom and was found in 21 (84%) cases, whereas bacteremia was the most predisposing factor found in 15 (60%) patients. The etiology of SA was bacterial in 16 cases (64%), mixed (fungal and bacterial) in one (4%), and tuberculous in one (4%), whereas the etiological agent was unidentified in seven (28%) cases. Intravenous antimicrobial therapy was administered empirically in all patients. However, seven patients (28%) received intravenous antibiotics as the only treatment modality for SA, 15 patients (60%) underwent percutaneous drainage with a pigtail catheter, and two patients underwent splenectomy. The inhospital mortality was three (12%).

Conclusions: This study showed that SA could be caused by various organisms that should be isolated to guide the choice of antimicrobial agents. An abdominal computed tomography is a good diagnostic modality, whereas computed tomography- and ultrasonography-guided percutaneous drainage were efficient therapeutic options that reduce the need for surgery.
Science of quality improvement – from vision to reality: Experience from a leading academic healthcare center in Qatar
Authors: Zahid Muhammad , Ahmad Khan Adeel , Yousaf Zohaib , Ali A A Al-Mohammed Ahmed , Hamad S H Al Mohanadi Dabia
Published: April 2022

Quality improvement and patient safety are cornerstones to the delivery of effective patient care. The introduction of a quality improvement curriculum for medical students and trainee physicians can have a significant effect on their understanding of the science of improvement and its role in improving the quality of healthcare delivery and patient safety. The article describes the development and implementation of a quality improvement curriculum for trainee physicians in the department of internal medicine at a tertiary care center in Qatar through online training courses, workshops, didactic activities, and trainee-led quality improvement projects.
Rare Complication of a Rare Malignancy: Case Report of Cardiac Amyloidosis Secondary to Waldenstrom Macroglobulinemia
Authors: Charles Lobo Aaron , Bhat Vivek , Anandram Seetharam , Devi A.M Shanthala , Rao Sanjukta S. , Vinister Ge-vivin , Lobo Veronica , Reuben Ross Cecil
Published: April 2022

Cardiac amyloidosis is a rare disorder caused by the myocardial deposition of abnormal fibrils. A 52-year-old man was referred to our center with clinical features of heart failure, after cardiac magnetic resonance imaging showed restrictive cardiomyopathy. Abdominal fat pad biopsy showed features of amyloidosis, and after hematological workup, he was diagnosed with Waldenstrom macroglobulinemia (WM). He was initiated on a rituximab-based chemotherapy regimen, and his cardiac function was assessed serially. Because of non-response, he was switched to a bortezomib-based regimen. Unfortunately, three days into this regimen, the patient died. WM is a rare plasma cell dyscrasia with a nonspecific presentation. It uncommonly presents with sequelae of amyloidosis–the IgM subtype of amyloid-light chain (AL) amyloidosis. Diagnostic delays are common, contributing to an already poor prognosis. Amyloidosis in WM requires urgent treatment – clonal chemotherapy, and supportive cardiac care in heart involvement. Bortezomib-based regimens are commonly recommended, with diuretics as the mainstay for cardiac treatment. However, in most advanced cases, the prognosis is poor; thus, a high degree of suspicion is necessary for early diagnosis. This case illustrates the possible presentation of cardiac amyloidosis as a rare malignancy.
ANALISIS KAPASITAS MASYARAKAT UNTUK IDENTIFIKASI TEKNOLOGI SANITASI DI KAWASAN SPESIFIK DAERAH KERING (STUDI KASUS DI KABUPATEN SUMBA BARAT DAYA NTT)
Authors: Durriyyah Samahatud
Published: April 2022

One of the specific areas that have received less attention from the government is a specific area with a semi-arid climate conditions, where low rainfall and high evapotranspiration potential causes NTT especially Southwest Sumba Regency has a problem providing sanitation facilities, especially in the domestic waste water infrastructure. Therefore in this study wanted to know the state of the capacity of communities and the factors that affect the sustainability of the waste water sanitation technologies that can be determined in accordance with regional technology studies. Some of the factors that capacity factors examined include institutional, economic, environmental, technical, and socio cultural. To know this, do data collection using questionnaires and field observations. Next, will be analyzed by descriptive, crostab, and Analytical Hierarcy Proscess (AHP) to determine the priority factors and sub- factors that affect the sustainability of sanitation to obtain the most suitable sanitation technologies from the descriptive analysis showed that 50 % of respondents do not have sanitation facilities and conduct defecation gratuitous (BABS) in the garden and clean themselves using leaf litter. Crostab analysis can be seen that there is a relationship between level of education and income against WC ownership, how to clean themselves, and acceptance of the technology offered. AHP analysis which provides results that the most influential factor in the choice of sanitation technology is a technical factor. But the results of advice most appropriate technology for a specific area of dryland communities is cubluk, cubluk twin, and ecosan.From the overall results of the analysis obtained on sanitation technologies for arid areas is cubluk one hole with dry system.Keywords: community capacity analisys, specific dry areas, sanitation technology
PERBANDINGAN HASIL PEMERIKSAAN KONTAMINASI BAKTERI PADA PRODUK TROMBOCYTE CONCENTRATE METODE KONVENSIONAL DAN APHERESIS
Authors: Ariani Resti , Aidina Ria
Published: April 2022

Platelet Concentrate (PC) is one of the blood products that is often used for transfusion. The storage temperature for TC products is in the range of 20-24OC which is the optimal temperature for bacterial growth. TC products contaminated with bacteria can cause a dangerous septic reaction. With the development of blood transfusion, apheresis methods emerged for the manufacture and aseptic collection of TC products. The apheresis method is considered safer than the conventional method which has a high chance of bacterial contamination. This study aims to compare the results of the examination of bacterial contamination in conventional TC products and apheresis methods. This study is a comparative descriptive study with a retrospective approach in the form of examining data on bacterial contamination of TC PMI Semarang City during 2019. The results of the examination of the TC apheresis method product showed that there were no TC products that were contaminated with bacteria (0.0%; 0 of 48), while in conventional method, there is 1 TC product that has bacterial contamination (0.3%; 1 out of 360). Fisher exact test on each TC product obtained p value = 1.00 (> 0.05) so that the difference that appears is not significant. Examination of bacterial contamination in conventional TC products and apheresis gave the same good results.
HUBUNGAN KADAR KARBOKSIHEMOGLOBIN DENGAN HEMATOKRIT DALAM DARAH MAHASISWA TINGKAT AKHIR TERPAPAR KARBONMONOKSIDA DI SEKOLAH TINGGI ILMU KESEHATAN NASIONAL
Authors: Wijanarko Wijanarko , Lestari Mastuti Widi
Published: April 2022

Carboxyhemoglobin is a substance formed due to the bonding of carbon monoxide with haemoglobin, which results in a lack of oxygen in the body, causing polycythemia which leads to an increase in blood hematocrit. motorized. This research method uses quantitative. The subjects of this study amounted to 30 people where the subjects were divided into 2 categories, namely smokers and motorcyclists. Data analysis using Shapiro Wilk and Rank Spearman Based on the research, it was found that the average COHb level was 6.06 while the average hematocrit in the normal range obtained p values > 0.05 for COHb 0.827, 0.836 and 0.827 while the hematocrit was 0.827, 0.836 and 0.827. This study concludes that there is no relationship between carboxyhemoglobin levels and hematocrit levels in final year students who are exposed to carbon monoxide from cigarette smoke and motor vehicle fumes.
UJI EFEKTIFITAS EKSTRAK DAUN PANDAN WANGI (Pandanus amaryllifolius Roxb) TERHADAP PERTUMBUHAN BAKTERI Streptococcus mutans
Authors: Juariah Siti , Wiranda Junia , Sepryani Harni
Published: April 2022

Fragrant pandan leaves (Pandanus amaryllifolius Roxb) is a type of plant that contains flavonoid compounds, alkaloids, saponins and tannins that can function as antibacterial. Streptococcus mutans is one of the bacteria that causes dental caries. Fragrant pandan leaf extract is expected to be an alternative to overcome bacterial infections such as dental caries. Dental caries is a disease caused by damage to the enamel layer that can extend to the nerves of the teeth so that it will cause cavities caused by the bacterium Streptococcus mutans. The aim of this study was to determine the effectiveness of fragrant pandan leaf extract against the growth of Streptococcus mutans bacteria that causes dental caries. This type of research is a laboratory experiment using the disc diffusion method. Fragrant pandan leaves were extracted by maceration method using 96% ethanol as solvent. The results of this study showed that the pandan fragrant leaf extract had an inhibitory effect on the growth of Streptococcus mutans bacteria at concentrations of 25%, 50%, and 75% with an average inhibition zone diameter of 10.3 mm, 13.3 mm, 17.6. mm. Positive control (amoxicilin) ??44.3 mm and negative control (aquadest) had no value to inhibit bacterial growth. The conclusion is that pandan leaves extract (Pandanus amaryllifolius Roxb) can inhibit Streptococcus mutans which is the bacteria that causes dental caries.
Impact of digital marketing on real estate business
Authors: Bansude Sheetal , Hittalmani Vidhya
Published: April 2022

Digital selling for any product or service has currently become crucial. Realty includes each new building with selling homes and the common class is single-family homes. They are condominiums, co-ops, townhouses, duplexes, triple-deckers, quad lexes, high-value homes, multigenerational and vacation homes. In today's extremely charged and competitive realty market, agents have to be compelled to do a lot of then acquire a license. The thought is to speculate during a home, either for living or to leverage. This call will facilitate individuals lead a financially-stable life, currently and on the far side.Realty is an trade that has greatly benefitted from digital selling. The buildings are often used for analysis, production, storage, and distribution of products.
Smile designing
Authors: Kaur Upneet , Sandhu Gursandeep , Kapila Himani
Published: April 2022

Smile, a person’s ability to express a range of emotions with the structure and movement of the teeth and lips, can often determine how well a person can function in society. Of course, the importance given to a beautiful smile is not new. It is of prime importance that the final result is not dependent only on the looks alone. Our ultimate goal as clinicians is to achieve pleasing composition in the smile by creating an arrangement of various esthetic elements.
Efficiency of prophylactic antibiotic coverage prior dental implant surgery
Authors: Bhagat Priyanka , Singh Deepak Ningombam , Mahesh J , Gopakumar Rethi , Sharma Surbhi , Alwithanani N. , Tiwari Rahul VC
Published: April 2022

Purpose of the present study was to determine whether antibiotic prophylaxis is an effective and popular treatment aid in conjunction with oral implant placement in healthy patients. Observational cross-sectional study was conducted based on a web-survey reported according to the STROBE guidelines. A questionnaire was sent via email to each participant. It contained close-ended and some open-ended questions concerning demographics, antibiotic type, prescription duration and dosage which was analysed statistically using SPSS 25.0. Approximately 84% routinely prescribed prophylactic antibiotics in conjunction with oral implant surgery, 15.6% prescribed antibiotics in certain situations and only 1 did not prescribe antibiotics at all. Overall, 116 respondents prescribed both pre- and postoperative antibiotics, 29 prescribed antibiotics only preoperatively and 14 prescribed antibiotics exclusively after surgery. High range of prophylactic regimens is prescribed and they are not adhering to the new science-based specifications. Guidelines focused on the indications for prophylactic antibiotics among healthy patients are required to prevent bacterial resistance, side effects and costs caused by overtreatment and the irrational use of antibiotics.
Assessment of allograft and bioresorbable xenograft in immediate implant placement
Authors: Kandasamy Baburajan , Sayed Arshad Jamal , Kalra Sandeep , Kharsan Vishwas , Jerry Jeethu John , Varghese Alisha Thankam , Oswal Piyush
Published: April 2022

Background: Use of grafts helps in healing and successful outcome of immediate dental implants. Materials & Methods: The study comprised a total of twenty four individuals in the age groupbetween 20 and 56 years with at least one tooth indicated for extraction. The twenty four subjects were divided into two groups; Group Aallograft with implant and Group B-xenograft with implant. The participantswere evaluated both clinically (plaque, probing depth) and radiographically for 3 months, 6 months, and 1 year. The level ofsignificance was set at P < 0.05. Results: Xenograft in immediate implant site showed excellent osseointegration around the immediate implant site. However, the difference between the groups was not statistically significant. Conclusion: Both synthetic allograft and bioresorbable xenograft are promising and equally potential in bone formation around the immediate implant site.
Two dimension versus three dimension ultrasound assessment of caesarean section scars
Authors: El-Deen Fahmy Sherif Salah , Farouk Hany Ahmed , Maklad Salah Mohamed Ali , Ait-Allah Abdou Saeed
Published: April 2022

Background: Ultrasound (US) is now used as an imaging modality for the evaluation of lower uterine segment (LUS). A number of reports of sonographic evaluation of LUS have appeared in literature. It has been speculated that thickness of the LUS is related to the quality of wound healing. There is strong correlation between the anatomic status of scarred LUS as assessed by USG and its functional status which is tested during labour. Objective: The aim of this work was to investigate the accuracy of two-dimensional and three-dimensional ultrasound in measurement of Caesarean section scar thickness. Patients and methods: This study was cross sectional study, conducted in Aswan University Hospital. The ultrasound examinations were conducted in the Obstetrics and Gynecology department between June 2017 and September 2021. The study included 150 pregnant females with previous one or two cesarean sections (CS) (aged 20-41y; mean 32.5y), underwent TA 2D and 3D US for assessment of the LUS thickness at 37-39 gestational weeks, before planning.
Silicon fertilization in paddy field
Authors: Monika Monika , Malhotra Chanchal
Published: April 2022

Present study has been done to document the effect of silicon fertilization on various yield parameters of rice (Oryza sativa L.) in land farm under natural environmental conditions. In the current study, the comparison of application of 125 kg/hectare silicon fertilizer + basal fertilizer has been done with control (basal fertilizer without silicon). The significant rise of 88.89% in no. of tillers, 20% in effective tiller, 88.89% in no. of tillers per hill, 92.69% in effective tillers per hill ,4.08% no. of spikes per panicle, 99.16% in total spike in plant, 182.22% in total spikelets per hill, 42.98% in weight of grains/1000, 34.88% number of grain per panicle, 160.65% number of grain per hill, 38.96% grain yield, 30.93% husk yield, 3.41% harvest yield has been observed in crop grown in silicon fertilized soil  than control. The results indicates that silicon fertilizer can be used in farm land of rice to increase the yield of paddy.