bluuebunny/crossref_metadata_2025 huggingface dataset:
DIABETIC NEPHROPATHY
Authors: Bukhari Hassan , Shaukat Asim , Mahes Amir Hayyat
Published: September 2021

Objectives: To determine diagnostic accuracy of spot urine Protein to creatinineratio for detection of diabetic nephropathy taking 24-hour urinary protein as gold standard.Study Design: cross sectional. Settings: Medical and Radiology department of Allied hospitalFaisalabad. Duration: 12-12-2013 to 12-06-2014. Sample size: 134. Material & Methods: Itwas a cross-sectional study done in Medical Unit I, Allied Hospital Faisalabad. 134 patients withsuspicion of diabetic nephropathy were included. 24-hour urine sample collected by instructingpatients to begin collection immediately after completion of first voiding in morning and tocollect all urine into same container having 5mL of 10% thymol in iso-propanol as a preservativefor 24-hours. This was thoroughly mixed, 2mL was taken for evaluation of proteins. P.C ratiowas calculated by dividing Urinary Protein concentration by Urinary Creatinine concentration.Results: The mean age of patients was noted as 55.11±6.79 years. There were 62.7% maleand 37.3% female patients. Mean PC ratio of the patients was noted as 0.21±0.07. Sensitivityof PC ratio was noted as 95.2%, whereas specificity was 76.5%, PPV 86.8%, NPV 90.7% withdiagnostic accuracy of 88.1%. Conclusion: The study results showed that PC
TESTICULAR MORPHOLOGY OF ALBINO RAT
Authors: Hijazi Muhammad Mazhar , Ahmed Muhammad Rashid Ahmed , Imran Ul Haq Hafiz Syed , Hassan Naqvi Syed Naeemul , Parveen Rehana
Published: September 2021

Withdrawal effects of chronic androgenic anabolic steroid on hormonal andtesticular morphology were studied .Forty five male albino rats were divided into 1) Control 2)Chronic group and 3) Withdrawal group. Testoviron was injected at a dose of 400mg/kg bodyweight intramuscularly once in two weeks for 14 weeks, and then drug was withdrawan foranother 14 weeks. Testes were removed and fixed in 10% formalin and processed. Followingwithdrawal of AAS, testicular and relative testicular weight was restored to control. Increasedtubular count also returned near to normal while decreased diameter of seminiferous tubules,thickness of germinal epithelium, count and diameter of leydig cells were also restored nearto normal in withdrawal group when compared with the chronically treated group. Histologicalobservations also revealed that degenerated spermatogenic cells were returned to their normalappearance and oedematous vacuoles were reduced. Moreover, decreased level of reproductivehormones, i.e. FSH, LH and testosterone also returned to control level in withdrawal group.These results indicated that chronic AAS has substantial harmful effects on hormonal andtesticular morphology. However, these adverse effects gradually restored to normal followingwithdrawal from AAS.
MYOCARDIAL PERFUSION IMAGING (MPI)
Authors: Zohaib Ali , Hamid Saeed Muhammad , Shahid Shaukat Ali , Shahbaz Muhammad , Iqbal Mudassar , Ehsan Faisal
Published: September 2021

Objective: Myocardial perfusion imaging (MPI) with superior quality of imagesin least acquisition time is imperative for diagnostic purpose. The objective of this study wasto compare the Filter Back Projection (FBP) and half time Astonish reconstruction techniquesin diagnosis of coronary artery disease using cardiac catheterization as gold standard. Placeand period of study: Study was conducted in nuclear cardiology department, at Faisalabadinstitute of cardiology, Faisalabad from November 2014 to July2015. Material & Methods:A total of 60patients (56 + 19years) underwent gated MPI with Tc-99m Sestamibi and 30patients of these underwent cardiac catheterization as well. Images were reconstructed withhalf time Astonish and FBP algorithms. CAD detection, LVEF, perfusion defect comparisonusing polar maps and diagnostic performance were calculated. Results: Perfusion defectscalculated through Astonish and FBP techniques were compared and correlated with coronaryangiogram. The sensitivity, specificity and accuracy for detection of CAD in vascular territories(LAD, LCX & RCA) of the patients were 72%, 41% and 57% with FBP and 86%, 54% and 71%with Astonish. The calculated LVEF showed good correlation (r = 0.8773) between Astonishand cardiac catheterization. Conclusion: There were no significant changes in image quality ofHalf-time Astonish compared to full-time FBP. Astonish reconstruction showed equal resolution,reduced background noise and radiation dose. Reduced scanning time will improve patientscan quality due to less chance of attenuation.
VISUAL OUTCOME IN DIABETIC MACULAR EDEMA AFTER GRID LASER TREATMENT
Authors: Shahid Muhmmad Jameel , Ahmad Faheem , Asif Muhammad , Sultan Muhmmad Nabeel
Published: September 2021

Regarding the causes of blindness, Diabetic retinopathy is a one the majorcause of blindness in all types persons from both industrialized and developing countries.Due to inadequate eating habits, prevalence of diabetic retinopathy is increasing. Both focaland diffuse leakage from retinal capillaries can cause Diabetic macular edema. Varioustreatment modalities for macular photocoagulation are focal laser, Grid laser and modified gridused in patients having diabetic macular edema Study Design: Prospective, interventional,noncompetitive case series. Setting: Department of Ophthalmology, Allied Hospital andDepartment of Ophthalmology, Divisional Headquarter Hospital Faisalabad. Period: One yearfrom April 2012 to April 2013. Materials and Methods: A total of 200 eyes of 200 patientswith clinical significant macular edema that met the inclusion criteria were enrolled. Results: Inthis study, 200 patients with diabetic macular edema were studied. Of these 121 (60.5%) weremales and 79 (39.5%) females with mean age of 38.52 years (SD 7.512, Range 25-50 years).All patients had diffuse, clinically significant macular edema at baseline for which they hadreceived grid laser photocoagulation. Discussion: In recent past number of diabetic patientsall over the world has increased that has caused increase incident of diabetic retinopathy .Soin patients having diabetic retinopathy, macular edema can cause deterioration in visual acuityduring any stage of diabetic retinopathy. The pathogenesis of Diabetic macular edema (DME)is the disruption of inner blood – retinal barrier that is known to be associated with metabolicalteration affecting the retinal pigment epithelium or retinal vascular endothelium. Focal and/orgrid laser photocoagulation is being considered as the treatment of DME. Conclusion: Macularphotocoagulation was found to be an effective method of treatment for CSME among diabeticpatients, which has resulted in a positive visual outcome in 87% of the patients (stable andimproved vision).
ACQUIRED LIP DEFECTS
Authors: Rafique Mirza Muhammad Ali
Published: September 2021

Objectives: To evaluate the functional outcome of large acquired lipdefects requiring flap reconstruction. Study design: Descriptive study. Setting: ShaikhZayed Postgraduate Medical Institute, Lahore. Period: January, 2011 to December, 2014.Methodology: Large lip defects secondary to benign or malignant tumors which could not beclosed primarily or involving more than one tissue layer were included. Patients with historyof trauma or thermal injuries were excluded. Results: Twelve patients were included in thestudy. Mean age group was 57.4 years (34 to 75); male to female ratio 1.4: 1; oral commissuretissue deficiency (5 cases) was corrected with cheek advancement and rotation flaps; upper lipdefects (3 cases) were reconstructed with cheek advancement and lip switch flaps; for lowerlip repair (4 cases), Karapandzic flaps were the primary flaps utilized. Overall complication ratewas 16.6%. Partial wound dehiscence was seen in one patient (8.3%). Significant microstomiarequiring surgical correction was experienced in one patient. Conclusion: Lip reconstruction ofacquired defects can be achieved with good functional results by proper planning and judicioususe of remaining lip and local cheek tissue.
STROKE
Authors: Ahmed Faraz , Danish Ajaz Muhammad , Iqbal Muhammad
Published: September 2021

Objective: To determine the risk factors, clinical manifestations, and diagnosticoutcome of stroke among patients admitted in CMH Jhelum. Study design: Descriptive caseseries. Place and duration of study: Medicine Department Combined Military Hospital JhelumCantonment from January 2013 to February 2014. Material and methods: A sample size of 200was obtained with an equal number of male and female patients. After formal consent a detailedhistory was taken regarding hypertension, diabetes mellitus, smoking, and Performa was filled.Investigations like Fasting blood sugar, serum cholesterol, and CT scan brain were also done,other relevant data like name, age, gender, and address, were collected. Patient admittedwith clinical presentation of stroke later being diagnosed on CT scan brain as ischemic orhemorrhagic were included. Stroke secondary to vascular lesions, space occupying lesions, andblood dyscrasias were excluded from study because these cases would act as effect modifierand interfere with results, thus producing bias in this study. Results: A total number of 200patients were included in this study with an equal ratio of male and female. Range of age groupwas 40 to 80 years while mean age group involved was 70.01 ± 13.02 years old. Most commonclinical manifestations were weakness of right half of the body that is 51.5%, weakness lefthalf 25%, and coma 13.5%. Hypertension found to be leading risk factor of stroke with 58.5%,while diabetes found in 24.5%, smoking 8%, obesity 5%, and high cholesterol in 4% of patients.Diagnostic outcome was ischemic stroke in most of the patients (71%) and hemorrhagic strokein 29%. Conclusion: Modifiable risk factors such as hypertension, diabetes, smoking, obesityand high cholesterol are found to the key risk factors. These can be easily controlled by life stylemodification and effective medication therapy resulting a significant reduction the morbidity andmortality of stroke.
MALARIA
Authors: Qader Khan Abdul , Ali Irshad , Imran Muhammad , Yaseen Muhammad , Abbas Syed Zaheer , Mufti Farees Ud Din , Ali Ghadir
Published: September 2021

Introduction: Malaria is second most life threatening disease in the world. Itshows highest morbidity rate among serious illness including tuberculosis etc. Pakistan is athigh risk of this disease giving very rise high frequency of Malaria victims in rural areas ofFederally Administered Tribal Areas (FATA) of Pakistan. Due to its severe epidemics in specificregions they are termed as malarious areas of a country. Objectives: Main purpose of the studywas to find out prevalence (p-value) of malaria in local community of FR Bannu region visited tobasic health clinics. Study Design: In current survey based epidemiological descriptive study,we analyzed valuable data of malaria epidemic and its prevalence in selected areas of FATA (FRBannu) region in Khyber Pakhtunkhwa via questionnaire & personal interaction. Study Period:The study was conducted in the months of June 2014 to August 2014. Material & Methods:Followed questionnaire against gender, age, seasonal, area & specie wise protocol survey.Results: Results showed (P > 0.05) ranging variables including high number of plasmodiumvivax strain over plasmodium falciparum, gender comparison was dominant by male againstfemales, age wise effect of pathogenic strain upon infants and old aged peoples, seasonaloccurrence and its prevalence was less in cold months and in start of summer season wherethe data of rural areas was at its peak risk. Conclusion: It is concluded that pregnant ladies andinfants are at high risk in such areas, so more care and control programs for malaria eradicationare needed in selected areas of Pakistan.
PRIMARY HYPERLIPIDEMIC PATIENTS
Authors: Siddiqui Naveed Ali , Asadullah Muhammad
Published: September 2021

The ratio of cardiovascular disease (CVD) in Pakistan is high as compare to westernworld and is one of the chief reasons of disability around the world. When CVD is diagnosed,following preventive measures should be taken which include regular exercise, proper diet,weight control and lipid reducing drugs to overcome the risk of morbidity or mortality. Primaryhyperlipidemia is common factors for the progression and development of atherosclerosis andcoronary heart disease. This study was designed to evaluate the effects of simvastatin and alliumsativum (garlic) on lipid profile and to compare the lipid decreasing efficacy of simvastatin andherbal product of allium sativum in primary hyperlipidemic patients. Objectives: To evaluate thechanges in lipid profile in patients with primary hyperlipidemia using original product of simvastatinand herbal product of the allium sativum (garlic). Study design: Cross-sectional study. Setting:The study was conducted at Surgeon Munawar Memorial Hospital, Karachi in year 2013 -2014.Material and Methods: Total of 60 patients of 30-70 years of age with abnormal lipid profile wasenrolled for this study after a written consent. The patients were divided into group I and II withprimary hyperlipidemia. Patients of group 1 and II were orally treated with simvastatin (20 mg)/dayand allium sativum (garlic) (300 mg/day) for 8 weeks. All patients were evaluated before and aftertreatment with product of simvastatin and herbal product of allium sativum. Results: In this studythe cholesterol, triglyceride (TG), high density lipoprotein (HDL) and low density lipoprotein (LDL)were estimated in the serum of patients before and after treatment with Simvastatin (20 mg)/dayand herbal product of allium sativum (garlic) (300 mg/day). It is observed in the present study thattreatment with simvastatin significantly reduced the level of serum total cholesterol, triglycerides,LDL and increase serum HDL level. Allium sativum significantly reduces serum total cholesterol,serum LDL and increase serum HDL level in primary hyperlipidemic patients but there was noeffect on triglyceride levels. Conclusion: We concluded that simvastatin significantly reducedthe level of serum total cholesterol, triglycerides, LDL and increase serum HDL level and alliumsativum significantly reduces serum total cholesterol, serum LDL and increase serum HDL level inprimary hyperlipidemic patients but there was no effect on triglyceride levels.
CANNABIS (BHANG, CHARAS) CONSUMPTION
Authors: Naz Fauzia
Published: September 2021

Cannabis or marijuana is an illegal drug that is being used mostly by young adultscan have adverse effects i.e., dependence syndrome, impaired respiratory and cardiovascularfunctions, psychosocial and mental health disorders. Objective: The present study examinedthe effects of cannabis (including bhang & charas) consumption on emotional and cognitivedisturbances and depressive symptoms in young adults who use cannabis. The researchfurther explored that cannabis consumption frequency will mediate between emotional andcognitive disturbances and depressive symptoms in young adults. Study Design: Correlationalresearch design. Settings: Lahore city. Method: Sample included 200 young adults who usedcannabis in routine and 200 young adults who did not consume any kind of substance. Theage range of the sample was between 20 years to 27 years. Snowball sampling technique wasused to recruit sample. The comparison group was matched on age, education and socioeconomicstatus. Cognitive Failure Questionnaire1, Emotional Regulation Scale2 and PatientHealth Questionnaire3 were used as assessment measures. Results: Results showed thatyoung adults who use cannabis had higher emotional and cognitive disturbances and hadmore depressive symptoms compared to the normal controls. There was a significant positiverelationship and association between cannabis consumption and emotional and cognitivedisturbances and depressive symptoms. Cannabis consumption had mediating relationshipbetween cognitive and emotional disturbances and depressive symptoms. Implications of thestudy along with strengths and limitations of the current study are discussed.
DIABETIC ALBINO RATS
Authors: Kazi Navaid , Shaikh Din Muhammad , Azmi Muhammad Ahmed
Published: September 2021

Objectives: The present study evaluated the blood glucose, superoxidedismutase (SOD) and glutathione peroxidase (GPX) in Cinnamon cassia bark extract (CCBE)treated alloxan-induced diabetic albino rats. Study Design: Experimental study. Setting: Animalhouse of Al-Tibri Medical College, Karachi was selected for conducting the present study.Period: January 2014 to December 2014. Methodology: A sample of twenty rats was randomlydivided into 4 groups. Rats were grouped as A1 (n=5) – Negative control, A2 (n=5)- Positivecontrols (alloxan treated rats), and experimental groups B1 (n=5) and B2 (n=5) includeddiabetic rats which received 0.3 grams and 0.6 grams of CCBE respectively. Intraperitonealalloxan (120 mg /kg in 0.5 ml dissolved in acetate buffer) was used for induction of diabetes.C. cassia bark extract was prepared under standard protocol. Blood glucose (glucose oxidasemethod), SOD and GPX (Elisa kit) were detected from blood samples after 30 days. Data wasanalyzed on SPSS. Data was analyzed by one- way ANOVA and post-Hoc was used for groupcomparisons. Data was analyzed at 95% CI (p< 0.05). Result: Blood glucose, SOD and GPXshowed statistically significant differences (p<0.036). CCBE treated rats showed low glucoselevels and elevated SOD and GPX enzyme activity (p<0.05).
TEACHING STRATEGIES
Authors: Bhalli Muhammad Asif , Sattar Abdul , Asif Midhat
Published: September 2021

Objectives: To determine preferences and perceptions of medical studentsabout teaching strategies in basic sciences years. Study design: Mixed method study. Placeand Duration: Khawaja Muhammad Safdar Medical College, Sialkot, from March 2014 toJuly, 2014. Methodology: A total of 77 medical students of 3rd year MBBS were selectedthrough non-probability convenient sampling for this study. A questionnaire to know abouttheir preferences and comments about teaching strategies was distributed to the students.A focus group discussion was also carried out to know in depth opinion of students aboutdifferent teaching strategies. Results: Mean age of the medical students was 22.75 ± 1.05years. Twenty one (27.3%) participants were males and 56 (72.7%) females. Out of 77 students,22 preferred interactive lectures; 16, small group discussion; 20 problem based learning, 10preferred demonstration on models. Only 01 students preferred one-way lecture as the bestteaching methodology.More female students (30.3% vs 23.8%) preferred interactive lecturesand more male (28.6% vs 17.8%) students preferred small group discussion as their teachingstrategies. Conclusion: Majority preferred interactive lectures (28.57%) and problem basedlearning (25.98%) as teaching strategies. Aligning our teaching strategies with preferences ofthe medical students will improve learning and academics.
TYPE 2 DIABETIC PATIENTS
Authors: Umar Khan Muhammad , Tanveer Alam Muhammad , Kumar Darshan , Adnan Muhammad , Adnan Muhammad , Soomro Hala
Published: September 2021

Objectives: To determine the frequency of different types of self-reported sexualdysfunction among male type 2 diabetic patients attending diabetic clinics of National Instituteof Diabetes & Endocrinology (NIDE) at Karachi, Pakistan. Study Design: Descriptive crosssectional.Place and Duration of Study: National Institute of Diabetes & Endocrinology at DowUniversity Hospital, Ojha Campus, Karachi. From August 2014 to January 2015. Methodology:This study was conducted at diabetic clinics of NIDE at Karachi from August 2014 to January2015. Type 2 diabetic males with self-reported complaints of sexual dysfunction were selectedby non-probability convenient sampling after obtaining well informed consent. Inclusioncriteria was married type 2 diabetic males of age between 35 to 65 years with at least fiveyears duration of type 2 diabetes, taking oral hypoglycemic agents, HbA1c levels between6.5% to 9.4% and living in a stable relation with a female partner for at least one year. Patient’sdemographic, anthropometric, biochemical parameters and sexual history was recorded onpre-designed questionnaire. Arizona Sexual Experience Scale and Diagnostic and StatisticalManual of Mental Disorder-5th edition were used for quantification of sexual dysfunction. Datawas analyzed by SPSS-18, to compute mean ± SD, frequencies and percentages. P-value of<0.05 was taken significant. Results: 95 Patients Type 2 diabetic male patients were recruited;who attended diabetic clinics of NIDE with different types of SD complaints. The mean ageof patients was 53.92 ± 8.17 years with 11.59 ± 3.52 years mean duration of type 2 diabetesmellitus. 81% patients had HbA1c levels of more than 7.4% and overweight patients were52.6%. 77.9% of patients were non-smokers. According to ASEX scale, 100% participantshad clinically significant sexual dysfunction with mean score 17 ± 2.3. 58 patients had singlesexual dysfunction and among them 26.3% had erectile dysfunction, while 36 patients haddouble sexual dysfunctions and among them 20% had combination of erectile dysfunction andpremature ejaculation. Data analysis showed no significant differences in age, duration of type2 diabetes mellitus, HbA1c levels and BMI with participant’s sub-groups having single, doubleand triple sexual dysfunctions. Erectile dysfunction was the most common sexual dysfunctionself-reported by 64.2% patients either as a sole complaint or in combination with other typesof sexual dysfunction, premature ejaculation was reported by 38.9% participants, hypoactivesexual desire disorder was found in 22.1% patients while the least common sexual dysfunctionreported was delayed ejaculation by 14.7% participants. Conclusion: The combination oferectile dysfunction and premature ejaculation is most frequent, followed by the combinationof erectile dysfunction and hypoactive sexual desire disorder. All diabetic men should be askedcarefully about the probable existence of any variety of sexual dysfunctions during their medicalevaluation.
CONVULSIVE STATUS EPILEPTICUS
Authors: Kumar Dileep , Larik Awais Bashir , Shahzad Amir
Published: September 2021

Objectives: To determine the in hospital mortality of convulsive status epilepticusin a tertiary care facility. Study Design: Cross sectional study. Place and Duration of Study:Neurology ward, Jinnah Postgraduate Medical Centre, Karachi, Medicine Department ofPeoples University Of Medical And Health Sciences Nawabshah from July 2015- Dec 2015.Material and Methods: All patients of either gender with age >15 years with status epilepticus,were included in the study. A detailed clinical history and relevant neurological examinationwas performed. All the patients who fulfill the inclusion criteria were enrolled in the study afterinformed written consent and explanation of the study protocol. All the information including inhospital mortality was entered on annexed proforma. All the patients were observed three to fivedays. Results: A total of 108 patients were included in this study fulfilling the inclusion criteria.The overall mean age of these patients was 31.3 ± 13.5 years. The age range of these patientswas 16 to 76 years. History of epilepsy was found in 106 (93.5%) of the patients, 88 (81.5%) ofthe patients had status epilepticus in past, 56 (51.9%) of the patients had drug withdrawal, 20(18.5%) of the patients had febrile illness and 2 (1.9%) of the patients had in hospital mortality.There was no statistical significance proportion difference was observed when comparedgender, history of epilepsy and status of epilepticus in past by in hospital mortality (p-values>0.05). Statistical significance proportion difference (p-value <0.05) was found in age and inhospital mortality. Conclusion: We recommend further studies to reach the firm conclusion.
TRADITIONAL BONESETTERS
Authors: Alam Waqar , Shah Faaiz Ali , Ahmed Ashfaq , Ahmad Saeed , Shah Abdullah
Published: September 2021

Objectives: To analyze the reasons for treatment by Traditional Bone Setters(TBS) and the frequency of complications in patients treated by traditional bone setters in our setup. Study Design: Descriptive case series. Place and Duration of Study: District HeadquarterHospital (DHQ) Temargarah & Lady Reading Hospital Peshawar and, Ghurki Trust TeachingHospital, Lahore from Dec 2014 to Nov 2015. Material and Methods: Patients of either genderor all ages received in outpatient department or accident and emergency of DHQ Temargarah,Lady Reading Hospital Peshawar and Ghurki Trust Teaching Hospital, Lahore with history oftrauma followed by treatment by local bonesetters were included in our study. After properhistory, examinations and investigations, appropriate treatment were given and complicationswere noted. Results: We received a total of 267 patients who were treated by Traditional bonesetters.186 were males and 81 were females. Age ranges from 1.5 years to 87 years. In majorityAdvice or pressure from family/friends taking the lead. 77(28.84%) of patients suffer because offamily or friends. 66(24.72%) of patients affected because of socio cultural beliefs, 46(17.23%)because of low cost, 35(13.11%) because of ignorance, 24(8.98%) because of fear of operation,19(7.12%) because of fear of amputation took their treatment from bone setters. The mostfrequent complication we received was malunion were found in 67(25.10%) and non-union in55(20.60%), Conclusion: Pressure from friends and family was the main reason for consultingTraditional Bone Setters for treatment in our set up and complications caused by their treatmentwere frequent and ranged from immediate compartment syndrome and gangrene of the limb tolate onset mal union, non-union and avascular non-union.
BREAST FEEDING OUTCOME
Authors: Chagan Farida Karim , Fayyaz Sidra Malik , Aamir Iram Saddiqa
Published: September 2021

Objectives: To determine the prevalence of prelacteal feeding among mothers ofPakistan and to find out the various concepts behind this practice and fundamentally to establishthe association of prelacteal feeding with breastfeeding outcomes. Background: In Pakistan,many efforts have been done to emphasize the nutritional importance and adequacy of breastmilk for the newborns. Despite such efforts, it has been witnessed on multiple occasions thatprior to the commencement of breastfeeding, prelacteal feeds are introduced by the mothers totheir young ones. Prelacteal feed (PLF) are food supplements that are given to newborns orally.Design: Qualitative, descriptive, cross sectional Survey. Setting: The Lady Dufferin Hospital(LDH) and Jinnah Medical College hospital (JMCH). Methods: Study includes 400 Mothersincluding young mothers and data was collected with use of a pre-assessed authenticatedquestionnaire. Results: A large group of, both educated and uneducated, mothers knew aboutPLF administration (90.5%). Out of these, 70% mothers routinely give prelacteal feeds, withreadymade ghutti and honey being the most widely used supplements, 19.5% and 37.2%respectively .However their reasons for doing so differed significantly. Family tradition (27.8%)and religious credence (21.8%) are the most popular reasons for practicing prelacteal feeding.The other minor reasons are breast milk insufficiency, prevention of dehydration, hypoglycaemia,preparation of the gastrointestinal tract for digestion and to quench thirst. However, majorityof the subjects were aware of the benefits of breastfeeding and 99% mothers breastfed theirchildren. Conclusions: Regardless of the fact that mothers understand the significance ofbreast milk, most mothers routinely and unnecessarily give prelacteal feeds. Therefore, mothersshould be discouraged for the unsafely administration of prelacteal feeds and re-emphasizedabout the importance and nutritional adequecy of breastfeeding.
MISSED MISCARRIAGE
Authors: Saeed Bushra , Akhtar Musrat , Akram Muhammad
Published: September 2021

Objectives: The aim of this study was to compare the medical treatment withsurgical evacuation of uterus in the management of first trimester missed miscarriage. StudyDesign: Randomize controlled trial: Place and Duration of Study: The study was conductedin the Obstetrics and Gynecology department civil hospital Bahawalpur from 1st January 20114to 31 December; 2014. Material and Methods: Total 120 patients were included in the studydiagnosed as a case of first trimester missed abortion. Patients were randomly assignedeither medical or surgical group. In the surgical group (controlled group) dilatation and theevacuation was performed. In the medical group misoprostol was used for medical termination.The criteria for success was complete expulsion of products of conception. Results: Therewas no statistically significant difference regarding demographic and clinical characteristicsbetween the two groups .Complete expulsion of the conceptus was less in medical group(83.3%) than the surgical group (88.3%) but the difference was not significant. Almost 16.7%patients in the medical group had failure of expulsion and underwent surgical evacuation.Duration of bleeding after the procedure was 9±2.6 days in surgical group and 12±3.4 inmedical group. Conclusion: Medical termination of first trimester missed miscarriage usingMisoprostol (800mcg initial dose followed by 400mcg 4 hourly 3 doses if need) is an efficaciousand safe alternative to the surgery.
PREVALENCE OF DEPRESSION;
Authors: Ilyas Baig Mirza Muhammad , Alvi Aftab Haider , Javed Nazeefa
Published: September 2021

With recent availability of Sofosbuvir, Chronic Hepatitis C treatment paradigmhas changed considerably. However for a resource constrained country like Pakistan, still thestandard treatment of Chronic Hepatitis C remains the combination of Interferons and Ribavirin.Depression, sometimes major, is a recognized side effect of this combination. Objective: Theobjective of our study was to analyze the prevalence of depression during treatment with pegylatedinterferon and ribavirin in patients infected with Hepatitis C at two tertiary care hospitals Lahore.Setting: All these patients were selected randomly from outpatient departments at FatimaMemorial Hospital and Alshafi Hospital Lahore. Duration of study: Duration of our study wastwo years and 3 months from January 2010 to April 2012. Patients and Method: We included180 patients in our study. We confirmed the diagnosis of chronic hepatitis C in all these willinglyparticipated patients. All these participants were put on combination of pegylated interferonand ribavirin. Serial follow ups were done for the assessment of development of depressionduring the treatment of Hepatitis C. Results: 46.8 (26%) patients developed depression duringtreatment. Depression was more common in the middle of treatment which gradually improvednear the end of treatment. Conclusion: We reached at a conclusion in our study that there isdefinite correlation of depression with pegylated interferon and ribavirin therapy in hepatitis Cpatients.
CHRONIC KIDNEY DISEASE
Authors: Memon Shagufta , Kazi Navaid , Fahim Amin , Nizamani Ghulam Shah , Qureshi Anila
Published: September 2021

Objectives: This study aimed to determine the platelet count in diagnosedchronic renal failure patients and to find out the association of platelet count with glomerularfiltration rate. Study Design: Case control study. Place of study: Diagnostic and researchlaboratory Liaquat University Hospital Hyderabad and Nephrology Unit, Isra University HospitalHyderabad. Duration of study: January 2015 to July 2015. Materials and methods: Total ofone hundred and twenty subjects (n=120) were divided into two groups. The healthy controls(n=60) were included in group-I whereas patients with chronic renal failure (n=60) were kept ingroup-II. 5 ml of blood was drawn and sent to laboratory for estimation of serum platelet count,blood urea nitrogen and serum creatinine levels. Results: The present study showed highlysignificant difference with marked decrease in the platelet counts seen in the CRF patientswith 223.9±89.1 million/μL in comparison to the 347.60±55.9 million/μl platelets in controlindividuals. Also the results of BUN in CRF patients showed highly significant differences with27.67±7.68 mg/dl when compared to controls having BUN 8.95±1.02 mg/dl. The comparisonbetween GFR with mean platelet count showed negative correlation (r = -0.27) in CRF patients.Conclusion: The present study shows weak negative correlation of platelet count with GFR.
ACUTE STROKE
Authors: Bilal Muhammad Haroon , Tahir Muhammad , Khan Naveed Atif
Published: September 2021

Objectives: To find out the frequency of hyperglycemia in non-diabeticpatients presenting with acute stroke. Study Design: Cross sectional study. Setting:Department of Medicine, Dera Ghazi Khan Hospital, D.G Khan. Period: September 2014 toMarch 2015. Materials & Methods: Total 150 non-diabetics presented with acute strokei.e. <24 hours duration of age 30-70 years either male or female were included. Patientswith known diabetes mellitus, head injury, recurrent attacks and h/o anticoagulantdrugs or steroid use were excluded. After taking relevant history, blood sample of eachpatient was drawn and sent to the pathology laboratory for blood glucose levels andblood glucose levels > 11.1 mmol/l (200 mg/dl) was considered as hyperglycemia andnoted on pre-designed proforma. Results: Mean age was 54.82 ± 11.44 years. Total 32(21.33%) patients found with hyperglycemia. Male patients were 80 (53.33%) and femalepatients were 70 (46.67%) and hyperglycemia was found in 14 (17.5%) male patientsand 18 (25.71%) female patients. Insignificant of hyperglycemia with age, gender, durationof disease and type of stroke was detected. Conclusion: Results of this study reveals thatfrequency of neo-onset hyperglycemia in non-diabetic patients presenting with acutestroke is high. So, we recommend that in every patient of acute stroke, hyperglycemiashould be taken into consideration and its early recognition and management shouldbe done in order to reduce the morbidity and mortality.
FREQUENCY OF CELIAC DISEASE
Authors: Shahzad Amir , Sahto Abdul Aziz , Samina Miss
Published: September 2021

Objectives: The aim behind this study was to determine the frequency of Celiacdisease in patients presenting with Iron deficiency anemia at tertiary care hospital. StudyDesign: Descriptive cross sectional hospital based study. Setting: Non-probability consecutivesampling technique in a department of medicine at Medical Unit II, People’s Medical University,Shaheed Benazeerabad. Period: Six months from 26th October 2014 to 25th April 2015. Patientsand Methods: A standard sample bottle was used to collect the blood sample from the peripheralvein followed by testing for Anti-tissue transglutaminase antibodies (tTG) and anti-endomysialantibodies (EMA). On these patients upper GI endoscopy for jejunal biopsy was done by anexpert having an experience of >5 years in relevant field. Data regarding Hemoglobin, antitTG antibodies, anti Endomysial antibodies and diagnosis of celiac disease (outcome variable)were collected. Data were entered and analyzed by using Statistical Package for the SocialSciences version 20.0. Results: Out of total 77 patients, the mean age and SD of age andhemoglobin levels were 37.65±11.26 years and 8.81±1.23 g/dl, respectively. Celiac disease(CD) Positive finding was observed in 27.27% cases by anti-tTG antibodies and in 16.88% casesby anti-endomysial antibodies. Prevalenc Frequency of celiac disease in patients presentingwith iron deficiency anemia was observed in Around 12.99% (10/77) of the cases who hadunderlying iron deficiency anemia were observed to have concomitant. Conclusion: There isa high prevalence of Celiac disease in patients presenting with Iron deficiency anemia. Earlydeduction and prompt treatment should be necessary for this disease. Screening of celiacdisease by anti-tissue transglutaminase antibody should be done as a routine investigation inpatient with iron-deficiency anemia.
DEPRESSION
Authors: Farrukh Nagi Muhammad Luqman , Haider Kazmi Syed Tehseen , Qureshi Khadija Zafar , Wasiq Kiran , Sajid Khadija , Butt Khyzer
Published: September 2021

Psychological stress is prevalent in medical schools and is associated withdepression. The personal and social sacrifices young medical apprentices have to makein order to sustain a fine academic outcome in an exceedingly competitive education setsthem under enormous strain. The estimated prevalence of depression among private medicalstudents has been 19% in United States, 49% in India, and 60% in Pakistan. Pakistan boastshighest prevalence of depression globally among undergraduate private medical students.Additionally a lack of any prior study in this institution, this study aimed to find prevalence ofdepression in the undergraduate private medical college of Lahore. Setting: The subjects werestudents of Shalamar Medical and Dental College, Lahore a private institution, in a metropolitanurban population. Study Design: Cross sectional study based on systematic random samplingtechnique. Methods: A modified, self-administered, structured questionnaire based onGoldberg’s depression scale was distributed to a sample of 240 subjects during March 2014,till October 2014. Higher total scores refer to higher depression levels. Prior to the initiation ofresearch permission was sought from the institution’s ethical review committee. The data entryand analyses were done in SPSS for Windows version 20.0. Results: The response rate was80%. The age of students (n= 164) averaged 21.1 ±1.4 years. The prevalence of depressionamong undergraduate medical students of our setting was almost 63% (n= 122). Thirty onepercent (n=59) were possibly mildly depressed, 9% (n=17) borderline depressed, 19%(n=37) mild to moderate cases, 20% (n=39) moderate to severe cases and 3 % (n=6) wereseverely depressed students. Almost 85% (n= 40) of the students from second year sufferedfrom depression the highest prevalence among all undergraduate medical years. A substantial41% (n= 36) and 42 % (n= 37) of students suffering from depression admitted to the use oftaking stimulants like amphetamines and caffeine respectively. Conclusion: The prevalence ofdepression is highest among the students of second academic year. Terminal illness of a familymember and effect of law and order situation of the country also compromise the mental healthof undergraduate medical students.
HbA1c CONTROL
Authors: Hasan Khan Muhammad Imran , Ullah Ehsan , Khan Zohaib Abbas , Shakeel Salman , Qaiser Amina Javid
Published: September 2021

Background: Diabetes Mellitus (DM) is a serious worldwide health concern.Pakistan is among the top 10 countries with the highest prevalence of diabetes in the worldwith estimates reaching as high as 21.6% in adults aged 30–79 years. HbA1C is the most usefuldiagnostic tool to assess the control and progression of disease and related complications.However, the predictors of good and bad control are not well established in our population.Objective: 1). To assess the level of A1C control among type 2 diabetic patients. 2). To find outfactors which can predict uncontrolled A1C. Study Design: Retrospective observational study.Setting: Among type 2 diabetes mellitus patients attending the outpatient of Diabetes Endocrineand Metabolic Centre (DEMC) of Lahore General Hospital, Lahore. Period: June 2012 to Feb2014. Material and methods: Total of 809 patients were randomly selected to assess A1C inthis population. At the same time, we assessed other factors associated with uncontrolled A1C.Chart review of the included patients was done using a data collection sheet, structured for thispurpose. Patient demographic data was gathered. Specific information including complicationsand laboratory results (HbA1C, Triglycerides (TG), Dyslipidemias) was collected. Diabetescomplication data was obtained clinically and through laboratory workup. The outcome wascalculated. Patients with A1C of <7% were considered well controlled. Other lab findings werecategorized with results being controlled according to the accepted cut off points. Results: Atotal of 809 patients were enrolled. Only 32.9% attained A1C control. Analyses showed thatsome factors were significantly associated with uncontrolled A1C. They were diabetes-relatedcomplications like presence of neuropathy, longer duration of diabetes and Dyslipidemias.When multivariate analysis was carried out, the chances of having uncontrolled A1C weresignificantly higher among patients who developed neuropathy and longer duration of diabetes,while triglycerides and other dyslipidemias were not statistically significant. Conclusion: Thelevel of HbA1C is significantly uncontrolled in our population. Uncontrolled HbA1C is morelikely to exist in patients with neuropathy and longer duration of Diabetes. High triglycerides andother dyslipidemia are also present in our population, but not statistically significant.
SUICIDE INTENT
Authors: Siddique Irum , Aijaz Sadaf , Parvez M. Akhter , Dogar Imtiaz Ahmad , Ansari Moin , Haider Nighat
Published: September 2021

Objectives: To see the Socio demographic profile of depressive patients whohas current suicide intent coming to the Psychiatry Departments of LUMS, SCJIP, Hyderabadand DHQ Hospital/ PMC Faisalabad. Design: Cross Sectional Study. Place & Duration ofStudy: The study was conducted in six months from 1st April 2014 to 30th September 2014 atLiaquat University of Medical & Health Sciences (LUMHS) & Sir Cowasjee institute of Psychiatryand Department of Psychiatry and Behavioral Sciences, Faisalabad. Subjects and Methods:A total of 117 depressive patients were included in this study having moderate to high SuicidalIntent. Results: Out of 117 depressed patients with suicidal intent, predominantly females (59%)approached psychiatry ward as compared with males (41%). Mean age of the participants wasbetween 31 -40 years. Among patients 56% were married, 28% were housewives and 28% werestudent. Most of them were educated. Suicide intent was found more in middle socioeconomicgroup and more in nuclear family system. 96 patients (82.1%) were taking treatment forDepression or Anxiety at the time of interview. Conclusion: Prevalence of depressed populationwith suicidal intent predominates in students, married females especially housewives belongingfrom middle socioeconomic background and nuclear family system. Most of patients useddrugs of abuse. Past psychiatric history, family psychiatric history, past history of suicide, familyhistory of suicide and suicidal Ideations were present in patients with current suicide Intent.
ETIOLOGY OF DYSPHAGIA
Authors: Nazish Zahra , Inayatullah Muhammad , Khan Muhammad Younus
Published: September 2021

Objectives: To determine the etiology of dysphagia based on upper GI endoscopyin Nishtar Hospital Multan. Study design: Retrospective study. Place and Duration of study:This study was conducted at gastroenterology unit of Nishtar Hospital Multan from Feb 2013 toAugust 2014. Patients and methods: Three hundred and twenty three patients, ≥ 13 years old,who presented with history of dysphagia to the gastroenterology unit of Nishtar Hospital Multan.Results: Out of 323 patients, 43.7% were males and 56.3% were females. Mean age of patientswas 44.37±17.395 years. Most common finding was benign stricture (28.5% cases) followedby no abnormality (21.7%), carcinoma esophagus (20.7%), achalasia (6.5%), esophagealweb (4%), ulcers (3.7%), multiple pathologies (3.1%), pharyngeal cancer (2.2%), esophagealcandidiasis (1.9%), reflux esophagitis (1.5%) and hiatus hernia (1.2%). Uncommon findingswere incompetent LES (0.9%), extrinsic compression (0.9%), vocal cord paralysis (0.6%),barrett’s esophagus (0.6%), herpes simplex esophagitis (0.6%), shatzki ring (0.3%), diverticulum(0.3%) and thick aryepiglottic folds (0.3%.). Conclusion: Esophagogastroduodenoscopy is theinvestigation of choice for patients of dysphagia. Most common finding in our study was benignstricture in young females, followed by carcinoma esophagus, achalasia, web, ulcer, pharyngealcancer, reflux esophagitis, esophageal candidiasis and hiatus hernia. Incompetent LES,extrinsic compression, vocal cord paralysis, barrett esophagus, herpes simplex esophagitis,ring, diverticulum and thick aryepiglottic folds were rare causes. Measures should be taken toavoid the preventable causes by patient awareness and adequate treatment of predisposingfactors.
VIT D DEFICIENCY
Authors: Kumar Santosh , Memon Gaffar , Das Bagwan , Mohan Pushpa
Published: September 2021

Objectives: To determine the outcome of vitamin deficiency in local populationof (Hyderabad), come with complaints of vague symptoms of body ache, bony pain with noco morbidity. Study design: cross-sectional study. Place and duration of study: OutpatientDepartment of Liquat University Medical Science, Hyderabad. Period: 6-2-2013 to 6-2-2015.Methodology: This is observational cross sectional study conducted at out patient’s department(LUMHS) city Hyderabad from 6-2-13 to 6-2-2015. Preliminary data was collected with the helpof self-administered questionnaires which include patient’s history and examination and bloodsample is taken for assessing level of dehydrocholecalciferol with serum calcium and routinetest. Data entered in spss 20 version, analytical software were applied for results in this study.Result: This study is conducted in 300 pts, among these 60% female and 36.7% male and 3.3%missing. Patients selected through (OPD) with consent and preformed proforma. Vitamin ddeficiency found nearly 96%in all the patient from young age to old age 4% were missing, lessthan 10 level found in 24.7%(severe deficiency), 10-20 level seen 54.7%(moderate deficiency)and 20-30 found in 14.7% (mild deficiency). Conclusion: my results shows that ( vitaminD-deficiency) is big dilemma in our community, give rise mild, moderate and severe decreasedlevel which leads complication which causing rickets in children and osteomalcia in adults,increase mortality and morbidity in local population.