bluuebunny/crossref_metadata_2025 huggingface dataset:
Association of Hypertension with serum ferritin level in local population of Mirpurkhas.
Authors: Habib-ur-Rehman Chohan  , Syed Hafeez-ul-Hassan  , Syed Farhan-ud-din  , Muhammad Tariq  , Rehana Habib Chohan
Published: January 2024

Introduction: Raised serum ferritin causes disturbance in the body metabolism leading to dyslipidemia, adiposity and hypertension.

Objective: is to investigate the ferritin level and its possible effects on arterial blood pressure of local population.

Methodology: This prospective, case control study was conducted during June 2017 to November 2018 in the Department of Physiology, Muhammad Medical College; Mirpurkhas Sindh after taking approval from ethical review committee. 50 hypertensive patients without any comorbid of either genders and an equal number of healthy age and sex matched controls were included in the study. Arterial pressure was measured by mercuric sphygmomanometer using standard method while serum ferritin was estimated by ELISA.

Results: The mean age of patients was 55.2 ±11.14, and of controls was 47.12 ±14.29. The mean BMI of patients was 24.27 ±3.347 and of controls was 24.71±2.57. The difference in mean systolic blood pressure of patients (129.90 ±17.2mmHg), and controls (118.80 ±11.89) was statistically significant (p=0.013). Similarly, the mean diastolic blood pressure of patients was 83.60 mmHg ± 10.83 and for controls it was 76.40 ±7.63 with significant difference (p=0.025). The difference between mean serum ferritin level of patients (226.32±99.83) and controls (224.0 ±69.62) was also statistically significant (p=0.001). The correlation coefficient was statistically significant showing r value of ferritin with diastolic pressure r ═ 0.14, with systolic pressure r = 0.16 and with hypertension (both systolic and diastolic pressures) r = 0.21.

Conclusion: This study showed significant association of Hypertension with serum ferritin.

Keywords: Ferritin, BMI, Hypertension.
Importance of ellipsoid zone line in the treatment of diabetic macular edema.
Authors: Mahtab Alam Khanzada  , Sharjeel Sultan  , Azfar Ahmed Mirza  , Ghulam Hyder Sahito  , Mona Liza Mahesar  , Imtiaz Ahmed Gilal
Published: January 2024

Introduction: Diabetic macular edema (DME) is a worst manifestation of diabetic retinopathy (DR). Current advanced techniques may reverse DME, usually evaluated by the improvement in visual acuity (VA). In clinical practice VA is not improved even after marked decrease in the macular thickness. Structures abnormalities for example to ellipsoid zone (EZ) may account for post treatment visual outcome.

Objectives: To evaluate the relationship between Ellipsoid Zone line (EZ Line) and best corrected visual acuity (BCVA) after treating diabetic macular edema in type II diabetic patients.

Methodology: For this prospective and observational study patients of type II diabetes mellitus with clinically significant macular edema (CSME) without proliferative diabetic retinopathy were recruited. The BCVA was recorded by Snellen Acuity Chart and discriminant values of macular thickness and EZ line defect were evaluated using Ocular Coherence Tomography at the time of presentation and during follow-up period. SPSS 22 version was used for results analysis

Results: At 6th months follow-up, overall improvement in interruption of EZ line was good but statistically significant (P≤ 0.001) was found in sub class II a. The mean reduction in central sub foveal thickness (CSFT) was found significant (P≤ 0.001) in all class of EZ line but the mean value of BCVA in class I EZ line (70±SD18, P≤ 0.001) was better than class II (45±SD18, P-value = 0.021); and we did not find any correlation between the BCVA and level of interruption of EZ line after progressive decrease in CSFT (r = 0.210, P-value = 0.021).

Conclusion: It has been concluded the by the quantitative measurement of retinal layer with OCT we can say that EZ line continuity is closely linked to visual outcome in eyes with macular edema.

Keywords: Ellipsoid Zone Line, CME, Integrity of IS OS junction, CSFT
The metabolic consequences of energy drink consumption in Wistar Albino rats- A cross sectional study.
Authors: Fatima Rehman  , Sadia Rehman  , Zia-Ul-Islam  , Tabinda Urooj  , Huma Salahuddin  , Madiha Mushtaque
Published: January 2024

Introduction: Energy drinks (EDs) are caffeinated beverages, consumed mostly by the young individuals for the sake of getting an instant energy. They also contain some herbal extracts like guarana, ginseng and ginkgo biloba along with B-vitamins and taurine. The undesirable effects are mostly due to a high content of caffeine and glucose in it, which have both the short as well as long term implications. The increase usage of caffeinated beverages among the young population is a matter of concern. 

Objectives: To estimate the metabolic consequences of energy drink consumption in Wistar albino rats.

Methodology: For this cross-sectional experimental study, thirty adult male Wistar Albino rats weighing between 250-300 grams were obtained from the animal house of BMSI. Three groups of equally divided number were made and labeled as A, B and C. Animals of Group A served as controls and were fed on a regular laboratory diet and water ad libitum. Animal of B & C groups, in addition to laboratory diet were also feed a Energy Drink in different dose orally via a gastric tube for a period of thirty days on daily basis. Fasting blood glucose and serum insulin were measured in control and treated groups at the end of experimental period.

Results: Fasting blood sugar was found to be significantly elevated in both the low-dose treated (126.80±8.69) as well as high dose treated animals (147.60±8.93) as compared to the control group animals (90.10±13.37). A dose dependent decrease in serum insulin was also observed in the experimental groups. The insulin concentration of group B & C was found to be 7.45±0.82 and 5.66 ±0.36 respectively as compared to 13.61±1.77 in group A animals.

Conclusion: Energy drink consumption can contribute to increase the risk of developing metabolic disorders by interfering the regular glucose metabolism.

Keywords: Energy drinks, glucose metabolism, metabolic disorders, serum insulin
Prevention and management of prostate cancer: A review.
Authors: Anila Faisal Memon  , Aliya Zaman  , Afsheen Qazi  , Aqeela Memon  , Aqsa Noureen  , AlFarah Rehmatullah
Published: January 2024

The purpose of this review article is to critically assess the prevention and management strategies of prostate cancer. There is also a marked decrease in the mortality rates of prostate cancer in developed countries, the reason is largely unknown, but it is being suggested that it could be due to the early identification of prostate cancer through prostate specific antigen screening and early aggressive therapy. The resistance spills over to the complemen-tary medications such as the androgen inhibiting drugs, abiraterone, and enzalutamide, resulting in the form of cross-resistance. It is an obligation by care providers to counsel the people living with aging male prostate cancer on the importance of consuming healthy foods that will raise the odds of suppressing cancer development. The basis for settling on a restorative life-style prevention measure is because it is not associated with any risks com-pared to other alternatives. Regardless of the positive experience in using Prostate Health Index (PHI), the search for new biomarkers for the aggres-siveness assessment of prostate tumors is still needed.

Keywords: Prostate Cancer, Biomarkers, Tumors, Prevention, Management, Prostate Health Index.
Knowledge, practices and barriers in family planning.
Authors: Rabia jamil  , Fiza Ali Khan  , Shabana Ramzan  , Lubna Ali  , Raishem Ali  , Nazia Hakeem
Published: January 2024

Objectives: To assess the knowledge, practices and barriers of family planning in child bearing age women.Methodology: This cross-sectional study was conducted at Department of Obstet-rics and Gynecology unit II Dr. Ruth K.M Pfau civil hospital Karachi from April 2019 to June 2019. During this period 399 women after being discharged from hospital were assessed for knowledge, practices of contraception and presumed barriers for using contraception. The responses were documented on self-designed question-naire.Results: Mean age of candidates was 29.72 ±4.72 years. 66% women were not for-mally educated. 88.7% of women had knowledge about family planning methods and the major source of information was friends and relatives (42%). Only 40.6% women were practicing contraception and majority of them were using barrier method (24.6%). Any method was not used by 59.4% of women due to multiple reasons. The major barrier was fear of side effects (27.6%).Conclusion: Our study population was well aware about contraceptive methods but underutilized due to family pressures .Women education and counseling along with husband and mother in law can improve family planning measures. The government and media should do active measures in spreading information about various availa-ble methods of contraception and their side effects.

Keywords: Knowledge, Practices, Barriers, Contraception
Indications and rate of cesarean section after induction of labor.
Authors: Koshila  , Geeta Bai  , Sajida Muneer  , Pushpa Goswami  , Hemlata  , Farhana Rajpar
Published: January 2024

Introduction: Frequency of cesarean delivery has exceeded 10 to 15 percent whichis optional by World Health Organization. Not necessarily required cesarean deliveries might be related to augmented danger of neonatal as well as maternal mortality.Objectives: To assess indications and rate of cesarean section after induction oflabor at Liaquat University Hospital, Jamshoro.Methodology: This descriptive study was carried at Liaquat University of Medicaland Health Sciences (LUMHS), Jamshoro at Department of Obstetrics and Gynecology. All pregnant ladies aged between 18 to 35 years who were undergoing inductioneither at term or after term were included.Results: Labor induced by prostaglandin in 41.7%, by Foley’s in 23.5% while in34.8% women, both aforementioned procedures used for augmenting labor. Subsequent to induction of labor, cesarean section was needed in 28.3%. Bishop scorewas from 0 to 5 in 43% & ≥ 6 in 57%. Cesarean section performed in 29.5% laborinduced women. In 40% of labor induced women, the ground behind performingcesarean section was fetal distress while in 34% was extended labor.Conclusion: C-section needed in 28.3% labor induced ladies. Fetal distress and prolong labor are most common indications for C-section.

Keywords: Cesarean section, Indications, Induction, Labor.
Perception of covid-19 vaccine among healthcare workers in Pakistan and Saudi Arabia.
Authors: Hira Ashfaq  , Sabin Zafar  , Sundas Dastagir  , Bushra Kiran Naeem  , Imrana Zulfikar  , Raheel Ahmed
Published: January 2024

Introduction: COVID-19 vaccine was approved in late 2020 for healthcare workersand were made available for public in early 2021. Healthcare workers opinions andknowledge about vaccine safety directly impacts public perception about the vaccine.Objectives: The aim of this study is to assess the perception of health care workerstowards administration of COVID-19 vaccine and to access the awareness of COVIDvaccine among healthcare workers in Pakistan and Saudi Arabia.Methodology: This survey based study was conducted between February 2021 toApril 2021. Total 405 health care professionals approached electronically and datacollected, after taking consent, using a questionnaire. Analysis was done by SPSSversion 21.Results: 405 health care professionals participated in current survey. Female outnumber male participants. Although majority were willing to be vaccinated, thoserefusing were afraid of the side effects of the vaccine.Conclusion: Healthcare workers, both from Pakistan and Saudi Arabia, have highacceptance ratio for COVID-19 vaccine. Fear of adverse effects and myths are themajor factors for refusal of vaccine..

Keywords: Covid-19; SARS CoV-2; Healthcare workers; Vaccine
Knowledge and Awareness of Forensic Odontology among Dental Professionals of Karachi, Pakistan.
Authors: Sono Mal  , Jaweria Munir  , Mirza Farhat Hussain , Mukkaram Ali
Published: January 2024

Introduction: Forensic dentistry is a challenging and fascinating branch of forensic science that involves the application of dental sciences in the identification of deceased individuals through the comparison of ante and postmortem records. (1)

Objective: The research will not only highlight the need of implementing Forensic Odontology training in undergraduate and postgraduate curriculum in the country  by investigating knowledge and awareness of dental professionals towards Forensic Odontology specially related to identification, age, mass disasters and child abuse

Methods:A cross-sectional descriptive study was conducted in 8 private and public dental colleges after approval from institutional authorities to assess knowledge and awareness of forensic Odontology among dental professionals in Karachi

Results: Most of the research participants (84.9%) denied having any experience related to medico-legal cases. For both genders of respondents, 69% thought their knowledge was not sufficient to give medico-legal opinion. In addition, approximately 79.3% of them did not receive any formal training for collecting and preserving dental evidence. However, a vast majority of respondents (75 %) dentists want Forensic Odontology to be included as a separate subject in the undergraduate curriculum

Conclusion:By including Forensic Odontology as a separate subject in the undergraduate curriculum and as a speciality in postgraduate curriculum, dentists will gain knowledge of theoretical and practical aspects of analysis and preservation of dental evidence.

Key words:  Forensic Odontology, Medicolegal, Under & Postgraduate Studies
AUTOPSY: Knowledge and Perception of undergraduate medical students in current teaching system
Authors: Ramlah Naz  , Mehreen Fatima  , Smbreen Zameer  , Summaiya Tariq  , Rukhsana Rubeen  , Aysha Ahmed  , Abro Fiza Qambar , Amna Ahmed
Published: January 2024

Objective: To evaluate their acquaintance about autopsy, appropriate way of teaching and to appraise their views for the procedure of autopsy and recognition of Forensic as profession.

Methodology: A cross sectional questionnaire-based study was done in 2015 to 2016, in a public university running modular system. Data were collected by convenient method, from students of 3rd year and ahead. More than 250 forms were distributed and only 193 completed and analyzed by SPSS 17.

Results: Out of 193 students, 165 students claimed to recognize the “autopsy” and 28 not understand the procedure. Only 20 students observed more than 4 autopsies. Out of 193, 179 believed that Forensic education should not be scrapped from the medical syllabi. For teaching methodology 123 preferred a live autopsy and 64 students appreciated watching videos and only 6 favoured books. About 167 students stated autopsy as mandatory in all unsuspected deaths, and 172 agreed for usefulness in medical education but 111 found it disrespectful to the dead body. Around 166 students consider forensic not a prospective profession and 93 suggested its limited scope in Pakistan.

Conclusion: Students were aware of the value and necessity of autopsy as a medicolegal procedure. Adequate time must be fixed for viewing autopsy procedures to insure their complete competency. There is need for continuing efforts to improve the teaching of autopsy within a modular system.

 Keywords:  Autopsy, Undergraduate Medical Education, Forensic Medicine, Forensic Education
Prevalence of anxiety and depression among Medical Students in MMCH, Sindh, Pakistan
Authors: Syed Abdul Razzaq , Hassan Asghar  , Hafiz Aqeel Irshad  , Noor Ali Samoon  , Syed Razi Muhammad
Published: January 2024

Introduction: Medical education is stressful. High levels of stress have been seen in medical students in various studies. The academic stressors include the volume of material to be learned, academic performance and evaluation, examination and continuous assessment, mental tension and too much work load. All this can result in decreased life satisfaction among students.  Stress during medical school can lead to problems later in professional life compromising patient care.

Objectives: To know the prevalence of anxiety and depression among medical students of Muhammad Medical College, Mirpurkhas, Sindh, Pakistan 

Methodology: A Cross-sectional study was done on the students of Muhammad Medical College, Mirpurkhas, Sindh, who had spent more than six months in the medical college. Self-administered questionnaire was given to the students, present in the class and willing to participate in the study. The instrument used to assess the anxiety and depression levels was the, Aga Khan University Anxiety and Depression Scale (AKUADS). Additional quotations regarding socioeconomic variables were also included in them survey instrument, such as student’s age order, family monthly income, and gender, marital status.

Results: Using anxiety and depression scale it was found out that 318 (96.36%) students had anxiety and depression. Among them 215 (67.61%) were females and 103 (32.38%) males. Prevalence of anxiety and depression in students of Final, 4th year and 3rd year 2nd and 1st years was 13%, 15%, 20% and 21%, 28% respectively. It was significantly higher in 1st year and 2nd year students, as compared to final and 4th year and students.

Conclusions: Most of medical students have anxiety and depression due to study burden and a busy schedule. It is also seen that anxiety and depression is more among female medical students, and more among in 1st year and 2nd year MBBS students, as compared to the final and forth year students.

 

Keywords: Anxiety, depression, Medical students, prevalence
Spectrum of Diseases in Patients with Non-Traumatic Acute Abdomen.
Authors: Syed Abdul Razzaq  , Hassan Asghar  , Hafiz Aqeel Irshad  , Syed Razi Muhammad
Published: January 2024

Introduction: Acute Abdomen is the most common presenting complaints about 20% of all emergency department, due to its varied etiology it poses significant diagnostic challenges for emergency surgeons. The proper management of patients with acute abdominal pain requires a timely decision about the need for surgical operation.

Objective: To identify the spectrum of diseases in patients of non-traumatic leading to Acute abdomen, presenting in a surgical unit.

Methodology: During Jan 2012 to Dec 2014, this retrospective study conducted at Surgical Department of Muhammad Medical College, all patients presenting with non-traumatic acute abdominal pain were included in this study. Gynecological and urological causes were excluded. The patient diagnosis and management were recorded from the case files and OT registers.

Results: During the period, a total of 216 patients presented with non-traumatic acute abdomen; of which there were 145 (67.12%) males and 71 (32.87%) females, with a male to female ratio of 2:1. The highest incidence of acute abdomen 72 (33.33%) was found in patients of 22-32 years age group followed by under 21 years age group i.e. 51 (23.61%) and 33-42 years age group 43 (19.90%). There were 31 (14.35%) cases in 43-52 years and 19 (8.79%) cases in 53-70 years.

The most common cause of acute abdomen was acute appendicitis 105 (48.61%) admissions. These patients were mostly young males in twenties. Intestinal obstruction was second cause 45 (20.83%) cases and this affected more commonly the middle-aged persons. Two hundred and seven (95.83 %) patients were treated successfully and discharged home while 5 (2.31 %) left against medical advice, while 4 expired giving a mortality of (1.85) % in patients with gut perforation

Conclusion: The most common cause of acute abdomen is acute appendicitis affecting young population mostly. Another common cause is intestinal obstruction and gut perforation. Acute cholecystitis commonly affects the middle aged, post-menopausal women. Hepatic abscess and Pancreatitis are rare cause of acute abdomen in this area.

Key Words:  Acute abdomen. Non-traumatic Acute appendicitis, Intestinal obstruction.
Pattern of acute diarrhea and its management among children at DHQ Hospital, Attock city from July-August 2014.
Authors: Amna Bibi  , Muhammad Ilyas Riaz  , Muhammad Umar Noor
Published: January 2024

Introduction: Acute diarrhea is the 2nd most common cause of death among children under 5 years age countrywide. It is the passage of watery or loose stools 3 or more times in 24 hours and lasting less than 14 days.

Methodology: This Comparative study was carried out at DHQ Hospital Attock City from July-August 2014 by using a close ended questionnaire.

Results: From July 2014-August 2014, a total of 40 children having acute diarrhea were hospitalized in the DHQ Hospital Pediatric ward. There were more males n=24(60%) then females n=16 (40%) and the male to female ratio was 1.5: 1. 50% of the patients presented in 2nd half of 1st year.  n=32 (80%) children presented with 4 days of illness. All patients had passed 8-10 stools per day. One had passed 15-20 stools per day. n=9 (22.5%) child pass small amount of blood/ mucous in stools. Exclusive breastfeeding was reported in n=8 (20%) of the patients. n=18 (45%) children did not show any signs of dehydration, n=15 (37.5%) showed some dehydration and n=7 (17.5%) showed severe dehydration. Symptoms associated with diarrhea were fever n=31 (77.5%), cough n=17 (17.5%), vomiting n=8 (20%), oral thrush n=1 (2.5%). Blood CP n=39 (97.5%), ESR, Stool Examination n=31 (77.5%), X-Ray Chest n=8 (20%) were the investigations done in children. ORS/OEM use rate was 40 (100%) while rate of antibiotic (ceftriaxone) was n=7 (17.5%), n=33 (82.5%) received  Zinc Sulphate in syrup form, n=31 (77.5%) received Syrup Paracetamol.

Conclusion: Diarrhea is a common illness among children under 1-year age. Fever is the most common associated symptom with diarrhea. Parenteral diarrhea due to abdominal infections is also predominant condition.

Key Words: Diarrhea, Abdominal infections, Oral rehydration salt.
Effects of Hepatitis C on Hematological Parameters in local areas of Mirpurkhas
Authors: Chohan Habib ur Rehman , Hafiza Amna Abbasi  , Hafiza Amina Jahangir  , Humair Javaid  , Hamza Tariq  , Abeer Khan  , Wahaj Khan  , Rida Khan  , Sanam Akhtar
Published: January 2024

Introduction: Various diseases have emerged as a major cause of morbidity and mortality in patients with human immunodeficiency virus (HIV) and hepatitis B virus (HCV) confection, now that antiretroviral therapies become more effective e and has prolonged life expectancy in HIV-infected patients1. One of the most frequently identified extra-hepatic abnormalities often seen at the time of diagnosis of HIV is the hematological abnormalityObjective: To determine possible effects of Hepatitis C in local Population of MirpurkhasMethodology:140 diagnosed patients of Hepatitis C were selected from OPD/Ward MMCH and Civil Hospital Mirpurkhas, Patients of Hypertension, Heart Failure, Renal diseases and respiratory disease were excluded Their ALT, GGT, Alk Sodium was determined by kit method. Their RBC count, TLC, Platelet Count was counted and ESR was determinedResults: It was a prospective study and out of 140 hepatitis C patients 86 were male and 54 were female. The mean age was 54.77 ± 14.046 years. The mean height was 159.42 ± 11.188 cm and the mean weight was 53.69±10.604 Kgs. The mean BMI was calculated as 21.235 ± 5.0607 kgs/m2 (Table.1). The mean Hemoglobin was estimated as 10.639± 2.6924 gm% the mean RBC count was found 3.832 ± .8460 millions/cmm. The mean total leukocyte count was 9111.63 ± 4612.845 per cmm and the mean Platelet count was 160447.67 ± 93788.194 /dl. the mean ESR was 51.70 ± 26.320 (Table.2) The mean Alkaline phosphatase was 273.76± 96.818 IU, the mean GGT was 83.40 ± 102.650 IU and the mean ALT was 74.98 ± 58.614 IU. (Table.3.) The Correlation of hepatitis C was estimated by Pearson’s correlation using SPSS 15 and found that hepatitis has a significant correlation with Hemoglobin, RBC count, TLC and Platelet count (r=.167, .165, .181, 238 and p=.092̽*, .031*, 018* and .002** respectively) and it has an inverse correlation with ESR (r=-.213, p=.005**)Conclusion: Our data shows that hepatitis C has positive correlation with Hb, RBC Count, TLC and Platelet count while the hepatitis has a significant inverse correlation with ESR. More work is required to establish criteria regarding correlation between Hepatitis C and Hematological parameters
Evaluation of anxiety and depression in chronic liver disease patients.
Authors: Anum Akram  , Luqman Anwar  , Muhammad Talha Naeem
Published: January 2024

Objective: To evaluate the risk factors of anxiety and depression in chronic liver disease patientsMethodology: In this longitudinal study seven hundred fifty-five patients (mean age 51+ 5 years, 59% males). All the patients were suffering from chronic hepatitis B, chronic Hepatitis C, Alcoholic liver disease and non-alcoholic fatty stomach disease. Questionnaires were included anxiety, using the Hamilton depressing rating scale (HDRS) and Hamilton anxiety scale (HARS), including socio-demographic, health status and family support. The criteria for inclusion in the study were having liver disease from last 15 months. Clinical functional and psychological assessments were performed.Results: In this study patients with depression was 59.3%, with anxiety 17.4% patients and both anxiety and depression were noted in 36.7% patients. After measuring and calculating all the variables score of depression and anxiety were recorded. A higher HDRS score was noted in patients older than 46 years (p=0.024). Patients with gastrointestinal bleeding had a prominent higher score of anxiety than those without bleeding (p=0.019). A higher HARS score was present in the women (p=0.011), unemployed patients (p=0.009) and those with alcoholic liver disease (p=0.006). There was direct correlation between the duration of disease and the value of HDRA and HARS score.Conclusion: In the chronic liver disease patients’ depression and anxiety are increasingly high with passage of time, gastrointestinal bleeding and unemployment. Increased prevalence of relax by patients are more likely to be due to the low acceptance of disease prognosis.
Association of HbA1c and total cholesterol levels in child bearing age using injectable contraceptives.
Authors: Farooq Javeria , Aamir Kausar , Baig M. Farooq
Published: January 2024

Introduction: Injectables contraceptives are convenient and highly effective methods for fertility regulation, being simple to administer and long acting, but affect lipids by increasing total cholesterol and triglycerides1 , the major health risk of injectables contraceptives are cardiovascular diseases (CVS), particularly heart attacks (myocardial infarction), stroke and venous thromboembolism2 Hormonal contraceptives have traditionally being thought to adversely affect carbohydrate metabolism by increasing insulin resistance and decreasing glucose tolerance.3

Objective: To determine and compare the values of HbA1c and total cholesterol levels in child bearing age using Depot Medroxy Progesterone Acetate (DMPA).

Methodology: This comparative cross-sectional study was conducted at Department of Pharmacology, Basic Medical Sciences Institute, Jinnah Postgraduate Medical Centre, Karachi, from January 2016 to December 2016. Total 200 fertile females in their child bearing age were selected. They were divided into two groups, Group 1 (controls) and Group 2 (DMPA users).  Total cholesterol levels were measured before starting therapy, in the middle and the end of the therapy by using standard procedures on semi- automatic clinical chemistry analyser (Microlab 400). HbA1c levels were measured by using semiautomatic clinical chemistry HbA1c analyser (Microlab 300). Results were analyzed by using Statistical Package for Social Sciences (SPSS) version 21.

Results:  DMPA causes significant increase (p < 0.05) in total cholesterol, but insignificant changes (p > 0.05) in HbA1c levels.

Conclusion: It is suggested that total cholesterol and HbS1c levels should be measured before starting and during the course of injectable contraceptives to the subjects. As deranged cholesterol levels can increase the risk of cardio- vascular disease outcomes.4 Also injectable contraceptives may cause pre- diabetes (increased in levels of HbA1c 5.7-6.4)5.

Key Words:  Depot medroxyprogesterone Acetate (DMPA), Glycated hemoglobin (HbA1c), Total Cholesterol, Statistical Package for Social Sciences (SPSS).
Prevalence of dental erosion in Pakistani children: A cross-sectional study
Authors: Najmi Naheed , Muhammad Nadeem  , Tahera Ayub  , Talha Maqsood
Published: January 2024

Introduction: Dental erosion has remained a topic of interest for more than a decade and now gripping greater attention with the rise in the number of cases being reported in children and young adults. Prevalence of dental erosion varies in different countries according to their different geographical locations, dietary habits and life styles of their people. However, little is known about the prevalence of tooth erosion in Pakistani children particular regarding the associated risk factors. Aims: This study was designed to explore the prevalence of dental erosion and to determine the associated predictors of dental erosion in school children of Pakistan aged 12 to 14 years.

Methodology: A comparative cross-sectional Analytical study was conducted at a private school of Karachi, Pakistan from April 2016 till March 2017. The subjects were selected on the basis of non-probability convenient sampling. Children aged 12-14 years were included for this study and children having frequent hospitalizations were excluded. The two previously calibrated examiners participated in the clinical examinations and visited the selected schools. The clinical examinations were performed in well-lit classrooms or in shaded places under natural light using plane mouth mirrors and sterilized cotton to remove debris. The central incisors, lateral incisors, and first molars in the upper and lower jaws were examined.

Results: School children were assessed by O’sullivan index which showed dental erosion of 42.8% on labial or buccal surface, 9.7% on lingual or palatal surface, 7.4% on occlusal or incisal, 4% on labial, incisal/occlusal and 7% on lingual, incisal/occlusal. Grade of severity of dental erosion showed normal enamel in 43.1%, matt appearance of enamel surface with no loss of contour in 20.1%, loss of enamel only in 35.8% and loss of enamel with exposure of dentine in 1%.

Conclusion: The study concludes that dental erosion is a multifactor in origin and with time is becoming increasingly commonly in younger age group. It is important that as health providers we need to identify the possible risk factors and make the community aware of the ways to prevent this condition.

Key words: Surfaces of teeth, enamel surface, Soft drinks and straw.
Procedures for Obesity by Plastic Surgeons.
Authors: Memon Ghulam Ali , Syeda Momina Muhammad
Published: January 2024

Treatment of Obesity is always indirect because there is a generalized fat collection. Many surgeons have devised different methods which are either direct or indirect.Indirect methods: Are abdominal procedures where the size of stomach is reduced by different surgical methods and hence the size of stomach, so the absorption of food becomes limited.Direct Methods: Are insufficient to control the obesity; an attempt is made to show some of the procedures which can be used for not the generalized obesity but for localized collection of fat volumes
Knowledge, Attitude and Practices of Health Professionals towards Nosocomial Infection
Authors: Umair Mustafa  , Sana  , Mubeen Nasir
Published: January 2024

Introduction: A hospital-acquired infection, also known as Nosocomial Infection, is an infection whose development is favored by a hospital environment, such as one acquired by a patient during a hospital visit or one developing among hospital staff, that becomes clinically evident after 48 hours of hospitalization.

Objectives: To assess the knowledge, attitude and practices of Health care professionals towards Nosocomial Infection, to find the gap present between knowledge, attitude and practices and to give suggestions to remove the gap.

Methodology: This cross-sectional study was conducted among the doctors and nurses in different units of Allied Hospital Faisalabad.  Out of 250 only 244 participants replied, and convenient sampling was used. It was an anonymous survey and participation was voluntary. SPSS used for data entry and analysis. Means ± SD were calculated for continuous data and tables and figures used for categorical data. All the tests were performed using alpha=0.05

Results: For this KAP study the response rate was 97.6%, majority of the participants (89.3%)   were females; the mean age was 24.52 ±3.240 years, 79.50% were doctors and 20.5% were nurses, more than half were house officers (60.7%).87.7% had a good idea about nosocomial infection, and majority thought it was either respiratory tract infection (31.6%) or surgical wound infection (31.6%). Most common causative organism is thought to be all 3 of E.coli, Staphylococcus Aureus, and Pseudomonas (38.1%). Immunocompromised adults were the most important risk factor. Among practices of health care professionals, majority denied washing their hands before touching every patient (62.7%), before aseptic procedures (60.2%), after exposure to body fluids (52.5%) or after touching a patient (42.2%). Out of 244, 215 (88.1%) agreed that all equipment should be properly sterilized, while, only about 119 (48.8%) responded that they always used a newly sterilized equipment for every new patient. Only 22.1% of health care professionals kept themselves well updated with latest antibiotics prescribing information.

Conclusion: Knowledge and attitude of doctors and nurses of Allied Hospital towards nosocomial infection is good.  There is lack of obligation towards practices and major factors such as hand washing, ward hygiene, and proper sterilization are frequently ignored.

 

Keywords: Health Professionals, Nosocomial Infection. KAP study. Methicillin-resistant Staphylococcus aureus.
Efficacy of Lactulose Vs Lactulose with Rifaxamin in patients with Hepatic Encephalopathy: A Randomized Control Trial
Authors: Ahmed Raja Shoaib , Muhammad Adnan  , Hira Jabeen
Published: January 2024

Introduction: Hepatic encephalopathy (HE) is one of the deadliest complications of cirrhosis. The basic underlying pathophysiology is the increased production of ammonia which can cross the blood brain barrier and can influence in multiple ways. For managing HE various therapeutic regime have been tried in the past with varying degree of success grate and side effect profiles. Neomycin, Enema, Lactulose, Metronidazole, Vancomycin, Rifaxamin etc. are the various modalities used. Lactulose is the most widely used and Rifaxamin; an antibiotic is recently used with good success rate.

Objective: To compare the outcome of lactulose alone versus lactulose with Rifaxamin in cases with hepatic encephalopathy.

Methodology: A randomized control trial was conducted on indoor patients of medical departments, Mayo Hospital. Lahore from June 2017 to December 2017. The cases of hepatic encephalopathy of any grade within last 7 days of its onset with age range of 20-60 years were included. The cases with end stage cardiac or renal failure were excluded. The cases were divided into two groups; A and B. The group A was treated with lactulose alone in a dose to 20 to 100 ml per day to maintain stool frequency of at least 2 per day and the group B was treated with same amount of lactulose along with Rifaxamin in a dose of 550 mg thrice a day. The efficacy was assessed daily till there were no signs and symptoms of hepatic encephalopathy till day 7 where final outcome was seen to label efficacy or mortality as Yes or No.

Results: In the present study, 100 cases of hepatic encephalopathy were included. Out of these 50 were in each group.  The maximum cases were in Child Pugh class in both groups comprising 26 (52%) and 25 (50%) in group A and B respectively. The mean age at presentation was 46.73± 9.13 years in A as compared to 51.25± 9.04 years in group B with p= 0.54. The efficacy in group A was seen in 28 (56%) of cases and in group B as 38 (76%) of cases with p= 0.01. This difference was also statistically significant in terms of mortality which was seen I n 22 (44%) of cases in group A and 12 (24%) in group B (p=0.01).

Conclusion: Combination of lactulose plus Rifaxamin is significantly better as compared to lactulose alone for the treatment as well as to reduce mortality in cases of hepatic encephalopathy.

 

Key words: Lactulose, Rifaxamin, Cirrhosis, Encephalopathy
Complications of early Cholecystectomy in acute Biliary Pancreatitis
Authors: Muhammad Adnan  , Ahmed Raja Shoaib , Hira Jabeen
Published: January 2024

Introduction: Pancreatitis, inflammation of pancreas, is an acute emergency having mortality rate 2 to 7%. Acute pancreatitis can be caused by various factors, like drugs, alcohol, toxins, gallstones, trauma, infection etc. and amongst these, gallstones are the most common cause and is seen in around 75% of the cases. Regarding gall stones, the size of it and number are important parameters. Management usually depends upon the clinical scenario, underlying conditions of pancreas, presence of co morbid conditions and cholecystectomy. This can be done immediately or with an interval while the acute episode of pancreatitis is settled; each having their own benefits and complication rates.

Objective: To determine the complications of early cholecystectomy in acute biliary pancreatitis.

Methodology: A descriptive cases series study was carried out at Mayo Hospital Lahore during June through December 2017. The cases of either gender aged 18 years and above of acute biliary pancreatitis diagnosed clinically with epigastric pain, tenderness and vomiting with raised pancreatic enzymes with history of gall stones were selected purposively. The cases underwent open laparoscopic cholecystectomy in the same admission within 5 days of admission. These subjects were then followed to lo ok for duration of surgery, duration of hospital stay and recurrence of pancreatitis. Final outcome was seen at 3 months to look for recurrence.

Results: We took 50 cases of acute biliary pancreatitis. There were 20 (40%) males and 30 (60%) females. The mean age at presentation was 43.56± 4.68 years. The mean duration of surgery was observed as 54.56 ±12.33 minutes. Total complications were seen in 9 (18%) of the cases; few had combination of these. The most common complication seen was prolonged duration of hospital stay (18%), followed by prolonged duration of surgery (10%) and recurrent pancreatitis (8%).

Conclusion: Early cholecystectomy has higher compilations rate and the most common is long duration of hospital stay.

 

Key words: Pancreatitis, Early cholecystectomy
Association of blood lipids, cortisol and Hemodynamics Under stress: A possible role in early Atherogenesis
Authors: Ghulam Mujadid Qureshi  , Zafar Ali Pirzado  , Fayyaz Memon  , Siraj Ahmed Abbasi
Published: January 2024

Introduction: High blood cholesterol is claimed as a risk factor but recently it is accepted that cholesterol is increased under psychological stress. When raised in blood, cholesterol plays role in atherosclerosis formation; a role which is being debated since last many decades but still various questions is un-answered. Role of stress in early atherogenesis with association to alteration in blood lipids has been proposed but the available literature is scanty on the subject.

Objective: To explore the association of alterations in blood lipids, cortisol level and hemodynamics under mental stress in youth with no apparent heart disease.

Methodology: 114 male participants were selected from 397 volunteers as per ‘selection criterion’ approved by scientific committee. The volunteers were examined two times: during stress task as ‘stress-study’ and during non-stress period as ‘control’ according to ‘paired sample’ design. Thus, 56.54% apparently healthy subjects were included with exclusion ratio of 43.58%. All experiments were conducted under standard methods at LINAR-Larkana and Physiology Department of Sindh University, Jamshoro. Blood sample were taken between 9.00 am to 12.00 pm.

Results: Cortisol, systolic and diastolic blood pressures and heart rate were significantly increased during stress session. Different lipid levels were changed with different significant values. Correlations of some altered lipid levels with raised values of hemodynamics and cortisol detected were positive and significant.

Conclusion: Most changes in the level of variables were found prone to be “atherogenic in pattern” due to psychological stress. This work may pave a way for better understanding of relationship in between lipid alterations, mental stress and early atherogenesis. For that further studies are needed.

 

Key Words: Cholesterol, Hemodynamics, Cortisol, psychological stress.
A magyar országgyűlési választási rendszer területi egyenlőtlenségei 2002 és 2022 között
Authors: Vida György
Published: January 2024

A térbeliség kitüntetett szerepet játszik azokban a demokráciákban, ahol a választások során a szavazatokat valamilyen földrajzi keretben alakítják át mandátumokká. Magyarországon a rendszerváltozás során létrehozott vegyes választási rendszerben a választókerületek szavazóinak száma nagy egyenlőtlenségeket mutatott. A demográfiai és társadalmi folyamatok jóvoltából idővel tovább nőttek az eltérések és ezért szükségessé vált a kerületek átrajzolása. 2010 után a parlamenti választások keretei átalakultak és a képviselők számát 386-ról 199-re változtatták. Az átalakítások magukban foglalták az egyéni választókerületek számának 176-ról 106-ra történő csökkentését és a határok teljes átrajzolását is. Ebből adódóan aktuálissá vált egy összehasonlító elemzés, ami a magyar választási rendszer korábbi és aktuális térbeli folyamatait taglalja. A könyv arra a fő kérdésre kereste a választ, hogy milyen területi egyenlőtlenségek jellemezték a magyar választási rendszert 2002 és 2022 között. Ebből adódóan e könyv célkitűzése kettős volt. Egyrészt azt tűzte ki célul, hogy a nemzetközi szakirodalom alapján minél pontosabban leírja a magyar választási rendszerben is megfigyelhető térbeli egyenlőtlenségek sokrétűségét, részletezve az összefüggéseket. Másrészt az is célja volt a könyvnek, hogy a 2002 és 2022 között lezajlott magyar országgyűlési választások alapján kimutassa a területi egyenlőtlenségek mértékét hazánkban és az erre ható mögöttes demográfiai és társadalmi folyamatokra is rávilágítson. A könyv elsősorban a magyar szakirodalomban eddig kevésbé vizsgált elméleti koncepciók, összefüggések bemutatását és az angolszász megközelítés adaptálását végezte el. Ezt követően a kutatás különböző társadalmi, demográfiai és választási adatokat felhasználva matematikai, statisztikai és térinformatikai elemzéseken alapult. Az elemzésből kirajzolódott, hogy 2002 és 2022 között a gerrymandering, a malapportionment és a reactive malapportionment hogyan alakította az egyenlőtlenségeket. Bebizonyosodott, hogy a kerületek átalakítása mellett a politikai reprezentációt a választópolgárok is dinamikusan formálták és a térbeli mintázat idővel átalakult. Ebből következik, hogy a választókerületek időtállóbb kialakításánál a települési és a nagyvárosokon belüli demográfiai és választási földrajzi folyamatokat is figyelembe kell venni, hogy ne sérüljön jelentősen az egyenlő szavazat elve.
Conference Proceedings: Southeastern Regional Society of Academic Emergency Medicine Meeting, 2023
Authors: McLean Mary , Gue Shayne , Little Andy , Ganti Latha
Published: January 2024

The Society of Academic Emergency Medicine Southeastern Regional Meeting Research Forum featured a peer-reviewed line-up of emergency medicine research, innovations, and case reports in oral presentation format at the 2023 SAEM Southeastern Regional Meeting on July 8th, 2023, in Orlando, Florida. Dr. Wendy Coates, President-Elect for SAEM, gave the keynote address.

Awards were given to winners in 3 categories: Faculty/Fellow, Resident, and Student.
El ritual de lo habitual: apuntes introductorios sobre un rock nacional peruano
Authors: López Ramírez Gastón José Ignacio
Published: January 2024

La participación del rock en el desarrollo de comunidades musicales en el Perú es un tema no explorado dentro del ámbito académico. En la construcción de los modelos nacionales y regionales de una musicalidad propia, las músicas populares urbanas de origen extranjero no han sido consideradas; tampoco lo han sido como elementos en la formación de una identidad regida por los parámetros del discurso del Estado-nación. En este trabajo, exploramos las confrontaciones y dicotomías que mantienen el tema del rock como ajeno y a las comunidades musicales del rock nacional, como lejanas.
Resignificación en la producción operística peruana: la crítica social y política en Alzira de Verdi
Authors: Macalupú Cumpén Pablo
Published: January 2024

En las últimas décadas, la programación de ópera en los teatros del mundo ha exigido al equipo de producción explorar nuevas formas de representar títulos canónicos y otros no incluidos en el repertorio lírico estándar. En este ejercicio creativo, gestores culturales y directores de escena buscan presentar, desde la ópera, un espectáculo que supere sus funciones de entretenimiento o goce estético y apunte a ofrecer discursos sociales y políticos a través de ella. Ocasionalmente, el proceso de resignificación alcanza altos niveles de experimentación e innovación como ocurrió en el Festival Verdi de Parma en 2017 o, en otros casos, surge para denunciar problemas de la sociedad actual por medio de obras cuyos temas han sido interpretados de manera distinta por generaciones anteriores, tal es el caso de la violencia de género en Carmen, de Bizet. En este artículo, revisamos las tendencias actuales en América Latina y Europa para interpretar una ópera desde la dirección de escena. Como tema de fondo, analizamos la producción de la ópera Alzira de Giuseppe Verdi, creada por Jean Pierre Gamarra y presentada en 2018 en el Gran Teatro Nacional. En ese sentido, proponemos discutir hasta qué punto un arte como la ópera puede promover el debate social, crítico y académico sobre asuntos actuales.
Música y peruanidad en la Lima del siglo XIX: Rebagliati, Alzedo y la Rapsodia peruana
Authors: Kudó Tovar Daniel
Published: January 2024

Claudio Rebagliati fue, por mucho, el músico más destacado e influyente en la Lima del siglo XIX; pese a ello, quedó muy rezagado en reconocimiento en comparación con el celebrado José Bernardo Alzedo. A partir del análisis de una obra musical que los vincula potentemente, tanto entre sí como con el contexto cultural y político de su época, se ofrece un acercamiento crítico a la caracterización de estos personajes y se explora la medida en la que Rebagliati fue uno de los arquitectos de la canonización de Alzedo, así como las motivaciones políticas de este proceso. Esto conduce a una reflexión respecto a la elusiva naturaleza de la peruanidad y su búsqueda, a dos siglos de la independencia nacional.