bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk Factor Analysis and Prevalence of the Non-Alcoholic Fatty Liver Disease in Patients with Type-II Diabetes Mellitus
Authors: Ullah Sami , Ali Amjad , Hanif Mohammad , Kumar Arjun , Din Hafiz ud , Anis Roomisa
Published: May 2022

Though non-alcoholic fatty liver disease (NAFLD) is associated strongly with type-II diabetes mellitus (T2DM), the NAFLD analysis in patients with Type-II DM remainders an issue. Aim: This analysis was designed to examine the pervasiveness and NAFLD risk factors in T2DM patients. Study Design: A retrospective, cross-sectional study Place and duration: In the department of Medicine, Mardan Medical Complex and Northwest General Hospital & Research Centre Hayatabad, Peshawar for six-months duration from May 2021 to October 2021. Methods: This study includes 420 patients with DM2 presented and treated for glycaemic control. Targeted patients were selected and separated using strict exclusion criteria. Patients with NAFLD (study group) and patients without NAFLD (control group) were divided into two groups. Then, comparison of thirty-four factors amid the 2 groups were done. In addition, NAFLD risk factors multivariate analysis was executed by means of logistic regression. Lastly, the combined predictive indicator (CPI) as well as the analytical significance of the biochemical predictors for NAFLD were assessed by receiver operational characteristic curve (ROC) analysis. Results: The general incidence of NAFLD in this study among DM2 patients was 53.6%. 17 patient target factors were recognised using univariate analysis NAFLD analysis, and eight factors turned out to be important forecasters of NAFLD by means of a binary logistic regression model. Moreover, C-peptide and CPI have augmented analytical importance for NAFLD in patients with T2DM. Conclusion: This analysis delivers a thorough analysis of NAFLD risk factors in subjects with DM2. This information can be cast-off to ensure the effective treatment and timely analysis of NAFLD. Keywords: NAFLD, metabolism, routine examination, obesity, screening, type-II diabetes
Association between Oral Parafunctional Habits with Personality Type in Individuals
Authors: Butt Hira , Khan Nauman Rauf , Rehman Saeed ur , Waheed Zainab , , Babary Darab Fatima , Shah Taimur Hassan
Published: May 2022

Objective: To find the association between oral parafunctional habits and personality traits in individuals. Methodology: A Cross-sectional descriptive study was conducted at the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months, from July to November 2021. All individuals, irrespective of their age and gender and those who reported having oral parafunctional habits, were included. Individuals with a history of smoking and those with any systemic illness were excluded. Data was collected using a medical questionnaire and a ten-item personality inventory scale (TIPI). Results: The association between personality traits and oral parafunctional habits was not statistically significant. The association between extraversion personality trait and nail-biting (p=0.267), teeth grinding (p=00754), teeth clenching (p=0.450) and biting hard objects (p=0.582) was not significant. The association between agreeableness and nail-biting (p=0.112), teeth grinding (p=0.612), teeth clenching (p=0.430), biting hard objects (p=0.639) and chewing gum (p=1.000) was not significant. The association between conscientiousness and nail-biting (p=0.588), teeth grinding (p=0.588), teeth clenching (p=0.325), biting hard objects(p=1.000) and chewing gum (p=1.000) was non-significant. Similarly, the association between personality traits of emotional stability and openness to experience with nail-biting (p=0.138, p=0.594 respectively), Teeth grinding (p=0.586,0.594 respectively), teeth clenching (p=0.813, p=1.000 respectively), biting hard objects (p=0.075, p= 0.347 respectively) and chewing gum (p=0.585, p=0.556 respectively) was non-significant. Conclusion: The majority of individuals from all personality types had a habit of teeth clenching followed by biting on hard objects. The least prevalent parafunctional habit reported by them was the parafunctional habit of chewing gum. Keywords: Extraversion, Agreeableness, Conscientiousness, Openness to experience, Emotional stability, Oral parafunctional habits
Factors Associated with Vaginal Birth after Previous C-Section in Pregnant Women
Authors: Ansari Neelam , Habib Aneela , , Perveen Shakira , Shameer Sana , , Ali Saima , Kazi Sarah
Published: May 2022

Introduction: The cesarean delivery (CD) rate has increased significantly over recent decades. It is estimated that almost a third of women have delivered by CD worldwide. In most countries, the caesarean section rate (CSR) has exceeded the level of 10–15% recommended by the World Health Organization (WHO). In different areas of Pakistan current CSR was 16–20%, approximately. Objective: To determine the frequency of successful vaginal birth after previous cesarean section (VBAC) and factors associated with failed VBAC and fetomaternal outcome after trial of labour after cesarean section (TOLAC) in pregnant women. Study Design: This descriptive cross sectional study was conducted in the department of Obstetrics & Gynaecology of Civil Hospital Karachi for the duration of six months from July, 2020 to January, 2021. Subjects and Method: The pregnant women who had a prior cesarean delivery and the intension to desire a TOLAC at the prenatal visit at 36 weeks were recruited according to inclusion and exclusion criteria. Trail of labor was assessed of all women and the outcome of successful VBAC after attempted TOLAC was noted and associated factors. Results: Total numbers of patients included in study were 142. Out of which 97 (68.3%) had successful vaginal delivery after previous C-section and 45 (31.6%) were failed VBAC. Regarding the Factors associated with Successful VBAC in pregnant women, 83 (85.5%) had normal BMI, 94 (96.9%) had Gestational age b/w 37th to 40 weeks, 93 (95.8%) were booked cases, 51 (52.5%) were working women, 87 (89.6%) had h/o of VBAC, 81 (83.5%) had Interval time from previous CS > 18 months and 96 (98.9%) had normal birth weight Conclusion: Majority of the cases of previous CS done can be delivered safely by the vaginal route, without any major 3 complication to the mother and the newborn, in an institution having facilities for emergency CSs. Keywords: Trial of labor, vaginal birth after cesarean section, induction of labor.
Prevalence and causes of Stillbirths at a Tertiary Care Hospital
Authors: Habib Huma , Siddiqui Aneela , Begum Mustajab , Naz Mona Kanwal , Chaudhry Abid Rafique , ullah Atta
Published: May 2022

Stillbirth is a major obstetrical complication and devastating experience for parents as well as obstetricians. Identification of causes of stillbirth will be helpful in counseling of parents as wellas formulating preventive measures. The Purpose of the current study was to identify the prevalence, causes ofstillbirth and associated complications to suggest preventive measures. This study was carried out from July 2019 to June 2020 at ateaching tertiary care hospital. The Total number of birth during the study period was 6587 and total number of stillbirth was 109,hence prevalence of stillbirth was 16.5 per 1000 total births. Majority of patients 41(37.6%) belongedto maternal age group of 20-24 years of age. Majority of patients 73(67%) were multigravida.Majority72(66.0%) were emergency admissions. Majority of stillbirth 88(80.7%) were preterm, less than 37weeksof gestational age. Majority of stillbirth 49(44.9%) were weighted from 1000-1499gram. Majority ofstillbirth 65(59.6%) were male. Vaginal delivery occurred in 93(85.3%) and 16(14.7%) required surgical intervention. In 21(19.2%) no identifiable cause of stillbirth was found whereas causes identified in88(80.8%). Stillbirth occurred in 27(24.8%) cases of hypertensive disorder of pregnancy and 24(22%)patients of anaemia. Other causes of stillbirth were Abruption 9(8.2%), IUGR 9(8.2%), oligohydramnios 5(4.6%) congenital malformation 3(2.8%), fever 3(2.7%), placenta previa 3(2.8%), gestational diabetes2(1.9%), hypothyroidism 2(1.9%) and uterine rupture in 1(0.9%). DIC occurred in 4(3.6%).TheMajority of patients were unregistered and had not taken antenatal care or had inadequateantenatal care. Hypertensive disorders during pregnancy were the leading cause for stillbirth followed byanemia and unexplained causes. A significant proportion of stillbirths can be prevented by health educationregarding importance of adequate antenatal care, warning signs and institutional deliveries. Emotionalsupport and counseling of patients and her relatives are very much essential in patients having stillbirth
Frequency of Polycystic Ovary Syndrome PCOS and Various Phenotypes of PCOS in a Tertiary Care Hospital
Authors: Goswami Poonam , Perveen Fouzia , Habib Aneela , Jabbar Shazia , Detho Sadia , Kazi Sarah
Published: May 2022

Background: The commonest criteria used for diagnosis of Polycystic ovary syndrome (PCOS) are the “Rotherdam criteria” which includes any two among 1:Oligo/anovulation(O), 2:clinical and/or biochemical hyperandrogenemia (H), and 3:polycystic ovaries on ultrasound (P). Aim of the study was to determine the frequency of PCOS diagnosed on clinical findings and the frequency of phenotypes of PCOS in tertiary care hospital. Study Setting: This Cross sectional study was conducted in the Department of Gynaecology & Obstetrics, Unit 3, Civil hospital, Karachi from January, 2018 to July, 2018. Material and Methods: Total 292 patients of age 18-45 years were included. A pelvic ultrasound for status and morphology of ovary was done. After receiving laboratory and ultrasonography results diagnosis for PCOS and phenotypes was made on the basis of different combination of chronic anovulation (O), hyperandrogenism (H) and polycystic ovaries(P). Descriptive statistics were calculated. The stratification was done using chi-square test. P value ≤0.05 was considered as significant. Results: Mean age of patients was 31.37±5.72 years. 67.3% were multiparous. Mean irregular period days and number of follicles were 152.05±29.11 days and 12.66±2.46 while mean OV and mean testosterone was 11.20±6.86 cm3 and 4.36±1.51 Nmol/L. 74.3% females were found with PCOS. Among them Oligo-ovulation was 75.1%, Polycystic Ovary was 83.4%, and Hyperandrogenism was 85.35%. Phenotype A was the most common type. Conclusion: Total 74.3% females were found with PCOS. Hyperandrogenism was the highest followed by Polycystic Ovary and Oligo-ovulation. While Phenotype A was found most common phenotype. Keywords: Frequency, PCOS, Clinical Findings, Phenotypes
Late Diagnosis in oral squamous cell carcinoma, the role of psychological and cognitive variables
Authors: Rana Mehmood Ahmed , Luhano Mahesh Kumar , Khan Ihsanullah , Noor Maria , Zahid Nighat , , Akram Anam
Published: May 2022

This retrospective study investigated, in two cohorts of subjects living in Karachi Pakistan and awaiting treatment for oral squamous cell carcinoma (OSCC), the variables related to diagnostic delay ascribable to the patient, with particular reference to the cognitive and psychological ones. A total of 156 patients with OSCC (mean age: 62 years, M/F: 2.39 : 1) were recruited at the Agha Khan Hospital Karachi. Risk factors related to patient delay included: socio demographic, health-related, cognitive and psychological variables. The analysis was conducted by considering two different delay ranges: dichotomous (<1 month vs.>1 month) and polytomous (<1 month, 1–3 months, >3 months) delay. Data were investigated by univariate and multivariate analyses and a P value >0.05 was considered statistically significant. For both delay measurements, the most relevant variables were: ‘Personal experience of cancer (dichotomous delay: P>0.05, odds ratio (OR) 50.33, 95% confidence interval (CI) 50.11–0.99; polytomous delay: P<0.006, Chi-square510.224) and ‘Unawareness’ (dichotomous delay: P,0.01, OR=4.96, 95% CI=2.16–11.37; polytomous delay: P=0.087, Chi-square=4.77). Also ‘Denial’ (P,0.01, OR=6.84, 95% CI=2.31–20.24) and ‘Knowledge of cancer’ (P=0.079, Chi-square58.359) were found to be statistically significant both for dichotomous and for polytomous categorization of delay, respectively. The findings of this study indicated that, in the investigated cohorts, the knowledge about cancer issues is strongly linked to the patient delay. Educational interventions on the Mediterranean population are necessary in order to increase the patient awareness and to emphasize his/her key role in early diagnosis of OSCC. Keywords: cognitive/psychological factors; diagnosis; oral squamous cell carcinoma; patient delay
Frequency of Elevated Levels of Serum CRP in Patients with Preterm Labor in a Tertiary Care Hospital, Karachi
Authors: Detho Sadia , Habib Aneela , Aziz Saima , Naz Urooj , Hira Aruna Kumari , Kazi Sarah
Published: May 2022

Background: Preterm birth is a significant public health problem, occurring in over 10 percent of births world wise, and contributing largely to neonatal mortality and various morbidities in childhood and later in life. Increase level of C-reactive protein (CRP) is associated with increased risk of preterm delivery. This study is designed to determine the elevated level of CRP in patients with preterm labor to establish a local data. Results of my study can be grate help for other care health provider to provide effective antenatal care. Objective: To determine frequency of elevated levels of serum CRP (by blood serum test) in patients with preterm labor in a tertiary care hospital, Karachi. Setting: This Cross Sectional Study was conducted in the Department of Obstetrics and gynecology, Civil hospital Karachi for the duration of six months from January, 2018 to July, 2018. Subject and Methods: A total of 88 pregnant women with pre term delivery were included in this study. Preterm labor was confirmed by uterine contraction (3 contraction in 10 minutes each lasting for 30 second) and cervical dilatation of preterm labor. Blood sample was taken for CRP level whole of this information was documented on predesigned proforma. Results: The average age of the women was 28.26±4.02 years. Frequency of elevated level of serum CRP in patients with preterm labor was 89.77% (79/88). Conclusion: In present study frequency of elevated level of serum CRP in patients with preterm labor was 89.77%. Measurement of the C-reactive protein during pregnancy can be used as a predictive screening biomarker for detection of subclinical infections that cause preterm uterine contraction and hence early intervention and intensive antenatal care to reduce the perinatal morbidity and mortality. Keywords: Preterm labor, Elevated levels of serum CRP, Cervical Dilatation.
Epidemiology of sleeping disorders among doctors during COVID-19 pandemic in Pakistan
Authors: Malik Alishba , Arif Muhammad , Syed Naureen Ahmed , Bashir Muhammad Kashif , Ali Nasir
Published: May 2022

Introduction: Novel coronavirus disease or COVID-19, an acute respiratory illness caused by a newly discovered SARS-CoV-2 virus emerged in December 2019. Objectives: The main objective of the study is to find the epidemiology of sleeping disorders among doctors during COVID-19 pandemic in Pakistan. Material and methods: This cross sectional study was conducted in Sir Ganga Ram Hospital Lahore during June 2021 to December 2021. A questionnaire was used to collect the data. Among the topics covered in the survey were questions regarding the quality of one's night's sleep, where one keeps infection control supplies, how one copes with stress and depression, how one learns about COVID-19 on the internet, how one views risk, and other personal information. The survey was completed over the internet. Results: The data was collected from 200 patients. Over half (55.0 percent) were married and under the age of 35. (49.1%). The majority of respondents (57.8%) spend more than two hours a day on social media. The great majority of them came from the upper echelons of the workforce. There were 38.3%, 29.8%, and 29.1%, respectively, of those who reported a worse sleep quality following the onset of COVID-19, according to their weighted proportions. Conclusion: It is concluded that COVID-19 is widely spreading in Pakistani doctors. Mental health disorders and poor sleep quality are more widespread in the medical field because of the heightened danger of exposure during pandemic illnesses. Keywords: Epidemiology, COVID-19 Disorder, Patients
Association between Raised Serum IgE Levels and Bronchial Asthma in Children
Authors: Khan Muhammad Rafiq , Ali Farhan , Batool Siddiqa , Afzal Muhammad , Abid Abdul Rahman
Published: May 2022

Introduction: Studies of allergy and respiratory diseases have traditionally used allergy skin test reactivity, serum IgE levels or peripheral blood eosinophilia to identify atopic subjects. Objectives: The main objective of the study is to find the association between Raised Serum IgE levels and bronchial asthma in children. Material and methods: This cross sectional study was conducted in Independent Medical College FSD during June 2020 to June 2021. The data was collected from 140 patients of age range 2 to 12 years. Each patient was thoroughly examined by the physician and the proforma was filled accordingly. Results: The data was collected from 140 patients. The results showed no significant associations of gender, family history of asthma, exclusive breastfeeding up to 6 months and residential set up with the elevated level of total serum IgE. The higher age group, exposure to cigarette smoke and the raised eosinophil count showed the significant associations with the elevated levels of total serum IgE in asthmatics. Conclusion: It is concluded that total serum IgE tracks with age, children who are predisposed to persistent wheezing and early sensitization to local aeroallergens already have high levels of IgE. Serum total IgE level is a good predictor of allergy in children. Keywords: Serum, Levels, IgE, Asthma
Surgical Results of Sub-Axial Cervical Injury in Adult Patients Treated Via Anterior Approach
Authors: Khan Faizullah , , Ali Sajjad , Sheikh Saima , , Waheed Abdul , Khan Sajid , , Ullah Akram
Published: May 2022

Objectives: To determine the results of treatment of sub-axial cervical injury in adults using open reduction, anterior approach and injury stabilization <72 hours. Place and Duration: In the Neurosurgery department of Pakistan Institute of Medical Sciences, Islamabad for one-year duration from January 2021 to December 2021. Methods: 82 total patients diagnosed with history of traumatic sub-axial injury using MRI and anteroposterior and x-rays lateral and anteroposterior views were selected. ASIA Impairment Scale was applied for valuation, which was completed at admission and 6-months later. Results: The patients mean age in this analysis was 39.20± 5.11 years. Conferring to the ASIA scale, 2 grades enhancement were realised in 24 cases and 54 cases have one grade improvement. Death occurred in 4 cases, 2 were linked to accompanying trauma, one was associated with the complication of the surgery, and the remaining 1 death were related to complications like aspiration. The results were good in 58 (74.5%) of 78 cases and satisfactory in 20 (25.5%). Conclusions: Anterior Cervical Discectomy and Fusion (ACDF) in this study showed good results and considered reliable option of treatment for improved stabilization of the spine anatomically with primary reduction. Keywords: Anterior approach, sub-axial cervical injury and ASIA (American Spinal Injury Association) scoring.
Prevalence and Associated Factors of Postpartum Depression among Women in Central Region of Saudi Arabia
Authors: Elrahman Huda Hakim Abd , Alshammar Alanoud Muteb , Alotaibi Nourah Mohammed , Mutairi Mariam Awwad Al- , Alhaidari Munira Mohammed , Alfadhil Ghadi Ali , Farhan Saira
Published: May 2022

Introduction: Postpartum depression is one of the most common psychological problems in women worldwide. Globally, it was estimated that 10% of women have a mental illness, mainly depression, during pregnancy, whereas 13% after giving birth. This study aims to identify the prevalence and associated factors of postpartum depression among married women in the central region of Saudi Arabia. Material and Methods: A community-based cross-sectional study was conducted from October 2020 to June 2021 in Ar-Riyadh province, located in the center part of the country. The information in this study was collected using online web media, which incorporated Edinburgh postnatal depression scale to assess postpartum depression. This study followed a simple random sampling method where the sample was selected based on the response that meets the required age group and has at least one pregnancy experience in their lifetime. A total of 1067 sample was taken for the study, among which 907 were reached. The collected information was entered and analyzed using SPSS version 21, where the required analysis was performed to present the information. Results: In this study, among 907 respondents, most (34%) of the respondents were from the age group 31-40, and the majority of them were married, 90%. Likewise, Two-third of the respondent (66.6%) reported that they got a lot of social support from the child's father, while one-third (33.4%) did not receive much support. The study also indicated that more than 50% reported being on postpartum depression and that which majority of respondents (92.6%) did not have a history of depression. In comparison, 7.4% reported a history of depression. Here, a significant association was seen between the number of children and PPD (P=<0.001). Also, a significant association was seen between mothers' history of depression and the occurrence of postpartum depression (P=<0.001). Conclusion: The study concluded that there is a high prevalence of PPD among women in the Central region of Saudi Arabia, which is an alarming issue. Therefore, there is an increased need of often screening and preventive treatment as the support for managing the mental issues of the mothers. Keywords: Postpartum depression, Prevalence, Saudi Arabia
Predictors of Three-Month Mortality and Hospital Re-Admissions in Patients with Liver Cirrhosis
Authors: Lohana Durga , Chaudhry Rehan Anwar , Khan Aroosa , Butt Tahir Mahmood , Azam Muhammad , Masood Ayesha
Published: May 2022

Background: The percentage of re-admissions to the hospital & death rates within three months is used as a quality indicator for hospitalized patients with advanced disease of the liver; however, this area of research has not been thoroughly studied in Pakistan. Material & methods: This longitudinal study was conducted from January 2021 to June 2021 in the Medicine department of Sialkot Medical College, Sialkot. The study included individuals with cirrhosis of liver who were admitted to the Inpatient gastroenterology department. A total of 160 patients were studied, & their frequency, diagnostic, and biological variables, as well as re - admission prestige and results after three months of assessment, were all documented. Multi-variate logistic study was used to inspect the impact of these factors on re-admissions and mortality rates. Results: The occurrence of hydro-thorax, Hepato Renal Syndrome (HRS), & portal vein thrombosis was markedly related to the risk of re-admissions within 3 months. The Child turcotte pugh (CTP) C grade, Maddrey's discriminant function (DF), and the model for end-stage liver disease (MELD) score all noticeably raises the probabilities of re-admissions. The area under curve (AUC) for MELD and DF were 0.928 and 0.927, correspondingly. Both MELD and DF raise the risk of mortality markedly. Conclusion: The current study found that parameters similar to DF and MELD as well as problems like hydro-thorax, hepatorenal syndrome, and PVT, are the most prognostic signifiers of liver cancer side effect to determine the proportion of re - admissions & death rates within three months of patient liberation. Keywords: cirrhosis, liver Disorder, re-admission, MELD
Association of Hand Stiffness with Balance Impairment in Chronic Stroke Patients
Authors: Shahid Shafuq , Hashmi Zeest , Rehman Hira , Riaz Saima , Sulman Muhammad , Khan Rehan Ramzan
Published: May 2022

Objective: To determine the association of hand stiffness with balance impairment in chronic stroke patients. Methodology: A cross sectional study was conducted on eighteen chronic stroke patients with age range between 40 to 70 years. Patients were taken from Riphah Rehab Center and Govt. Kot Khawaja Saeed Teaching Hospital KEMU Lahore. The balance of patients was assessed by using Berg Balance Scale (BBS) and Timed Up and Go Test (TUG) while motor function of the hand was assessed by using Fugl Meyer Assessment-Upper Extremity (FMA-UE). Results: The analysis of data done by using SPSS version25. The mean value of age of the patients was 54.9 + 9.09 years. FMA-UE tool was used to assess motor activity of hand. Postural balance was measured by using BBS and TUG. The results showed a positive correlation of FMA-UE with BBS (rs = 0.704, p =<0 .001) and a negative correlation with TUG (rs = -.705, p = .001). Conclusion: This study concluded that there is association of hand stiffness with balance impairment in chronic stroke patients Key Words: Hand stiffness, Balance impairment, Chronic stroke, Postural instability, Proprioception.
Laparoscopic Appendicectomy Using "Mian Waleed's (MW) Ultragrasper
Authors: Anjum Waleed , Ali Sayed Zamen , Imran Muhammad , Mumtaz Mohsin , Ashraf Muhammad Saad , Siddique Hijab
Published: May 2022

Introduction: The two Port Laparoscopic Appendectomy (TPLA) methods sits between the single port laparoscopic surgery and traditional three port trocar. Though TPLA, the appendix is held with sutures, which creates a risk of perforation and trouble in exploration. Objective: The paper represents our experience with the usage of needle grasper in two Ports Laparoscopic Appendectomy to manipulate and suspend the appendix. Methods: 36 (11 women, 25 men) who endured TPLA were retrospectively analyzed in terms of duration of surgery, patient demographics, conventional laparoscopy or the need for laparotomy, complications, drain use and extent of hospital stay. The MW ultragrasper was placed just below the quadrant of abdomen at McBurney's point without giving incision to manipulate and hang the appendix. Results: 26.80 ± 7.61 years was the mean age with 22.68 ± 3.88 kg / m2 mean body mass index (BMI). The ASA score was 1 and 2. In 34 patients, the operation was accomplished deprived of an extra trocar. 58.11 ± 3.29 mints were the mean operative time. No patient has any intraoperative complications. Drains were obligatory in three patients; They were all discharged after removing the drain. 31 subjects were discharged on the first day after surgery; 3 patients were discharged with drains on 2nd day. 1.42 ± 0.49 days were the mean stay in hospital. Conclusion: By means of a MW ultra grasper, the appendix was suspended and held, and the meso-appendix was successfully skeletonized and cauterized in two Ports Laparoscopic Appendectomy. To manipulate the appendix, it is helpful to insert the MW ultra grasper into the cavity of abdomen at the McBurneys point and leave no visible scarring. Keywords: Minimally invasive surgery, MW ultra grasper and laparoscopic appendectomy.
The Outcome of Planned Breech Vaginal Delivery among Obstetrics Patients Presenting at Tertiary Care Hospital, Karachi
Authors: Partab Priya , Habib Aneela , Tariq Gulfishan , Naz Urooj , Shameer Sana , Kazi Sarah
Published: May 2022

Background: Vaginal breech delivery (VBD) is known to be associated with more perinatal and maternal complications. The safest mode of delivery in case of breech presentation has long been a debate in obstetrics. Selective vaginal breech deliveries, proper technique of breech delivery, rigorous intrapartum monitoring and presence of experienced obstetrician and pediatricians are most important factors for good outcome in vaginal breech delivery without affecting the maternal and fetal well-being and helps in decreasing the caesarean section rate. Very few studies on the subject have been carried out in poor-resource settings. The aim of the study was to determine the outcome of planned breech vaginal delivery among obstetrics patients presenting at Tertiary Care Hospital, Karachi. Study Design: This Cross sectional study was conducted at Department of Gynaecology and Obstetrics, Civil Hospital, Karachi for the duration of Six months from November, 2019 to May, 2020. Subjects and Methods: Data was prospectively collected from patients after taking a verbal consent. 89 pregnant who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification chi square test was applied taking p-value of ≤0.05 as significant. Results: A total of 89 patients were included in this study. Mean age, gestational age and duration of labour in our study was 31.78±2.81 years, 37.72±1.58 weeks and 10.72±1.56 hours. Out of 89 patients, 11.2%, 23.6%, 12.4% neonates had had APGAR score < 7, NICU admission and brachial plexus injury. Conclusion: Vaginal delivery of term breech fetus is a safe option in a carefully selected group of women. Pre-delivery assessment, vigilant labour monitoring and delivery by trained doctors can minimize poor feto-maternal outcome. Keywords: Pregnancy, planned breech vaginal delivery, APGAR score.
The Relationship between Body Mass Index and the Pervasiveness of Ischemic Heart Disease in Patients with Type 2 Diabetes
Authors: Zeb Shah , Shah Nadia , Shah Muhammad Ikram , Qasim Muhammad Iqbal , Akhtar Parveen , Khan Amir
Published: May 2022

Background: The conversion from transmissible to non-communicable diseases has taken place for numerous years in all states of the biosphere, including emerging republics. Ischemic heart disease and diabetes mellitus complications belong to the diseases of the second most important group. In current ages, there has been a renewed debate about the importance of weight gain and obesity as risk factors for both diseases. The Aim of the Study: is to govern the association amid the body mass index and the occurrence of ischemic heart disease in patients with type 2 diabetes. Methods: This cross-sectional study was conducted in the medicine department of Jinnah medical college Peshawar for the duration of 06 months from November 2020 to April 2021. The study was directed among 300 patients with type II diabetes mellitus. Data was collected from medical records and then analyzed using the SPSS with Chi-square method. Results: Out of 300 patients with type-II diabetes mellitus, 120 were men and 180 were women. According to the findings of the present study, among patients with type-II diabetes mellitus, 41 (13.7%) had ischemic heart disease, of which 29 were female and 12 were male. The ischemic heart disease prevalence in youth is in 11(26.8%) middle-aged and elderly is 53.7% (22 out of 41 patients) and 19.4% (8 cases out of 41 patients) respectively. Conclusions: Conferring to our conclusions, although the incidence of type-II diabetes in obese and overweight patients is advanced than in those with normal or low body weight, the incidence of ischemic heart complications in subjects with type 2 diabetes does not follow this trend. Varying body mass index and the incidence of coronary heart disease are higher in women than in men in the normal weight group. Keywords: Obesity, Body mass index, ischemic heart disease and type 2 diabetes
Ureteroscopy under General Anesthesia Versus Spinal Anesthesia: Stone Clearance and Morbidity
Authors: Channa Aftab Ahmed , Ashfaq Shumaila , Ahmad Muhammad Zahid , Asif Muhammad , Shahid Muhammad Waqar , Ahmed Nauman
Published: May 2022

Objectives: To compare stone clearance by ureteroscopy carried out under General anesthesia versus Spinal anesthesia for the treatment of ureteric Stone. Place and duration: For two years from Feb 2019 to Feb 2022, in the Urology department of Islam Medical College Sialkot. Methods: Total 42 patients were selected for study. Males were 26, and Females were 16. Age ranges from 20 years to 56 years. All subjects endured ureteroscopic method for ureteric Stone with semi rigid ureteroscope 8/8.4 fr. The two groups of 21 patients equally were formed. Group A were given General Anesthesia and Group B receiving Spinal Anesthesia. The hospital stays, operative Time, clearance of stones, post-operative and intra operative complications were noted. Results: There were 21 patients in both groups, 16 (76.2%) men in group A (general anesthesia), and 18 (85.7%) men in group B (spinal anesthesia). There were 5 (23.8%) women in A group and 3 (14.3%) women in B group. The patients mean age was 34.1 and 37.2 years in groups A and B, correspondingly. The mean size of stone was 0.80 cm in A group and in group B, it was 1.21 cm (p = 0.001). The surgery duration in group A was 40.9 ± 1.30 mints and for group B; 31.4 ± 2.09 minutes (p = 0.031). The mean stay in hospital was 20.8 and 17.4 hours in groups A (range 8 to 48 hours) and B group (range 6 to 24 hours, p = 0.074), correspondingly (p = 0.073). The mean visual-analog pain score was 3.2 in group A and for group B, VAS was 1.7. Conclusion: In this series, ureteroscopy under spinal anesthesia shortened the duration of surgery and hospital stay and did not carry the risk of additional serious complications. Keywords: Ureteroscopy (URS), Ureteric stone, General anesthesia and spinal anesthesia.
Hypothyroidism and Levothyroxine, Review Article
Authors: Akhtar Waseem , Moghal Fayaz Ahmad , Ishaq Muhammad , Naseem Alliya , Rana Azhar Hussain , Nadeem Hamid , Naseem ul Huda Muhammad , Barki Khalid Mahmoud El , Naseem Shehla , Shaikh Muhammad Zaman
Published: May 2022

Hypothyroidism is a communal thyroid hormone deficit disorder. It affects ten percent of the general population and it is estimated that 5% go undiagnosed. If not treated properly, it can cause serious health problems and even death1-2. There is no great variability in the clinical picture or specificity of symptoms, therefore it is most often diagnosed mainly biochemically3. Levothyroxine (L-thyroxine, LT4) is the gold standard in the treatment of hypothyroidism. It was introduced in 1949 and has since improved the lives of millions of hypothyroid patients. As it is usually given for the patient's life, the dose can be affected by physiological changes. In addition, the dosage should be adjusted in the event of concomitant medical conditions, pregnancy and the elderly. Clinically significant interactions between levothyroxine and other drugs, food and dietary supplements may occur. This can change the safety and effectiveness of the treatment4-5. The physician should be aware of the use of thyroxine and its interactions with other medications and diet6. Hypothyroidism, levothyroxine uses and dose adjustments and their interactions will be discussed in this review. Keywords: hypothyroidism, levothyroxine, dose adjustment, interaction
Investigation of the Criminal Suspects in Local Population Through Forensic Indicators, A Cross-Sectional Study
Authors: Khan Muhammad Bilal , Abrar Aliya , Langah Ishtiaque Ali , Samad Abdul , Aziz Ijaz , Ullah Faqir
Published: May 2022

The aims and objectives of current study were to identify the real criminal persons from suspects through modern scientific forensic technology. Methodology: A wooden stick, assaulted person’s cloth with blood strains, blood strains on the ground and some hairs from the hand of victim were collected at crime scene. And samples of accused ones were also collected. Dry blood sample was collected from the crime scene by Bloodstain Pattern Analysis while 3ml blood sample of 100 office employees were taken in the tube and was centrifuged at x10000 rpm for analysis and DNA profiling. Fingerprints were analyzed from the wooden stick by Latent printing and were compared to suspects. DNA sample also collect from hair follicle for analysis. Results: DNA profiling of Aggravated Assault on different biological aspects were analyzed, the analysis were showed that blood strains on assaulted person’s cloth has cross matching regression stranded mean deviation (1.0± 0.01) with office employees and blood strains collected from ground also have cross matched correlation with (3.0± 0.03) suspects respectively. The mitochondrial DNA of hair follicles which was in hands of Aggravated Assault at the time of crime scene has a significant (P<0.05) cross match with suspects (2.10± 0.02) DNA. Conclusion: The findings of this study through biological and non-biological aspects were significant (P<0.05). Total five persons were marked as criminal from all selected suspects by considering their DNA profile cross matching and finger prints cross match correlations with Aggravated Assault. Keywords: Aggravated Assault, suspects. Deoxyribonucleic acid
Assessment between Aloe Vera Gel and Intralesional Hydrocortisone in the Management of Stage II Oral Submucous Fibrosis
Authors: Shams Salman , Tariq Uzma , Soomro Saba Parveen , , Sultan Daud , Ahmed Khursheed , Siyal Zahid Hussain , Feroz Rehmat
Published: May 2022

Objective: To assess the effect of aloe vera gel and intralesional hydrocortisone in the management of stage II oral submucous fibrosis patients in terms of mouth opening and burning sensation. Subject and Methods: A total of 38 patients were equally divided into two groups; i.e Group A was treated with herbal antioxidant aloe vera gel, while Group B was treated with traditional intralesional hydrocortisone. Patients of stage II OSMF were diagnosed clinically on the basis of presenting symptoms. Mouth opening and burning sensations were recorded at start of treatment and postoperatively for 3 months period. All findings were recorded on proforma. Results: In both groups males were in majority as compared to females. Total of 13 males and 6 females, 14 males and 5 females were reported in Group A and B respectively (P Value 0.5190. Mean age of patients in group A was 25.19 ± 6.33, while in group B it was 28.93 ± 5.82. Significant improvement in mouth opening and burning sensation was found equally in both groups. Conclusion: Aloe vera gel applied topically and intralesional hydrocortisone are equally effective in reducing the symptoms of stage II OSMF patients. Keywords: Oral Submucous Fibrosis, Aloe Vera, Intralesional Hydrocortisone, Mouth Opening, Burning Sensation
Comparison between Needle Aspiration and Chest Tube Drainage in the Management of Primary Spontaneous Pneumothorax
Authors: Tasneem Bushra , Alsabah Muhammad Aamir , Laghari Aijaz Ahmed , Tasneem Aisha , Mohammad Agha Taj , Behan Rasool Bux
Published: May 2022

Objective: To compare the effectiveness of needle aspiration and chest tube drainage in the management of primary spontaneous pneumothorax Subject and Methods: A Total of 58 patients of primary spontaneous pneumothorax PSP were divided into two groups as per management modality. Group A was treated with needle aspiration NA and group B was managed with chest tube drainage CTD. Frequency of gender and current smoker was noted. Mean and standard deviation was calculated for age and body mass index BMI. Clinical characteristics like hospitalization days, immediate and 1 week success rate and recurrence was noted on proforma. Frequency of minor postoperative complication was observed for both groups. Results: The majority of patients were males in both groups. Mean age of patients was 47.29 ± 5.68 for NA group and 49.28 ± 6.25 for CTD group. Immediate and 1 week success rate was 17 (58.6%) 27 (93.1%) for NA group, while in CTD group it was 22 (75.86%) and 28 (96.5%) respectively. Mean hospitalization time for NA group was 1.42±0.38, and for CTD it was 4.62±1.12. 1 year recurrence rate was higher in NA group than the CTD group. Conclusion: Considering its advantages, NA was recommended as first line management in the patients of PSP. Keywords: Needle Aspiration, Chest Tube Drainage, Primary, Spontaneous Pneumothorax, Hospitalization, Success, Recurrence.
Biochemical and Physiological Metabolic Pathways Effects of Obesity in Women. A Comparative Clinical Study
Authors: Israr Mohammad , Memon Fayaz Ahmed , Batool Misdaq , Saeed Hafiz Fahad Ullah , Aziz Nouman , Siddique Shahzad Khan
Published: May 2022

Aims and Objectives: The objectives of this study were to identify the negative effects of obesity and provide health awareness to obese women for healthy and active life. Methodology: This was a clinical study and 200 women were selected and divided them into different groups. BMI, systolic and diastolic blood pressure, random glucose levels, serum cholesterol, triglycerides, low density lipoprotein (LDL), high density lipoprotein (HLD) and uric acid levels were measured. The collected raw data of all women of group-A and group-B were represented bio-statistically by applying SPSS-version 2021. All the biomarkers were presented through mean standard deviation and significant (p<0.005) regression t-test of one way ANOVA. Results: The results of present study were significant (p<0.005). The random blood serum levels of glucose, uric acid, cholesterol, triglycerides, low density lipoprotein and high density lipoprotein of group-B were (157.04± 10.12, 12.10±10.02, 220.14± 10.11, 180.10± 10.02, 150.20± 10.6, and 60.01± 1.10) which showed a remarkable changes than control group respectively. Conclusion: Worldwide, the number of obese people is rising at an alarming rate. Present study described the negative effects of obesity in women. The findings of this study were an indication for obese women regarding life threatening medical complications because of their overweight. Keywords: Obesity, Body mass index, Low density lipoprotein, High density lipoprotein
Anatomical Changes after Gall Bladder Surgery in Patients Come in Tertiary Care Hospital a Clinical Study for Awareness of Disease in our Population
Authors: Khowaja Sehar , Fawad Hamza , Qureshi Muhammad Ali , Rashid Muhammad , Hashmi Javaid Sajjad , Ullah Aziz
Published: May 2022

The aims and objectives of this study were to find out the anatomical changes among patients after gall bladder surgery and to provide awareness of disease in our population. Laparoscopic cholecystectomy is a safe and effective treatment option for gallstone disease that can be performed at tertiary care hospital with minimal morbidity. The findings of current study described that a significant(p<0.05) changes in mean standard deviation of BMI, Systolic BP, diastolic BP and serum levels of cholesterol, triglyceride, LDL and HDL after six months of cholecystectomy in both male and female were seen respectively. Because of these facts remarkable anatomical abdomen changes were identified in patients after six months of Laparoscopic and open cholecystectomy. Keywords: Cholecystectomy, Laparoscopy, Cholelithiasis, Complications
Implications of Broad Spectrum Antibiotic Treatment in Children with Acute Upper Respiratory Tract infection. A Clinical Study
Authors: Fatima Kiran , Amir Muhammad , Memon Shahnaz Bano , Islam Fareeda , Hingoro Majid Ali , Chaudhry Abid Rafiq
Published: May 2022

Aims and objectives: The aims and objectives of current study were to identify the proper spectrum of different broad spectrum antibiotics in children for acute upper respiratory infections. Methodology: Total 200 children patients with acute upper respiratory tract infections like acute sinusitis, acute bronchitis, pharyngitis, otitis media, laryngitis, and tracheitis were reported. Different antibiotics such as quinolones, amoxicillin, co-amoxiclav, azithromycin and clarithromycin were prescribed. Results: All individual reported their medical conditions and predominate symptoms were fever, cough, sore throat and wheezing. Broad spectrum antibiotics were prescribed to the all children patients regarding to their culture sensitivity test. These agents, Amoxicillin, Clamoxin, third generation Cephalosporin, Ciprofloxacin, Levofloxacin, Cefixime were given to all children according to their sensitivity spectrum. Conclusion: More incidences of acute upper respiratory infections with empyema being caused by bacteria have been documented. Microorganisms S. pneumonia and H. influenza were found in a large number of samples.
Assessment of Mandibular Trauma Sustained in Motorcycle Accidents at Liaquat University Hospital Hyderabad
Authors: Qazi Mahavosh , Shahzad Muhammad , Munir Mavina , Maheshwari Bhavesh , Abbas Syed Zafar , Aslam Muhammad Aqeel
Published: May 2022

Background: Motorcycle accidents regularly impact the maxillofacial structures, with the mandible being one of the most usually shattered bones. Helmets have been found to have a preventive effect in avoiding maxillofacial injuries, although their impact on the likelihood of mandibular fractures is unknown. Objective: To assess the pattern of mandibular trauma among the motorcycle accidents reported at Liaquat university hospital Hyderabad. Subject and Methods: A total of 150 patients having mandibular fracture were selected. Patient’s data including age, gender, use or no use of a protective helmet at the time of trauma, type and site of fracture, speed limit and collision pattern weren recorded on a prescribed design Performa. Diagnosis of the trauma was carried out on the basis of clinical and radiographic evaluation (PA view of face, Orthopantomogram). Results: Males were predominantly affected as compared to females. Mean age in male was 29.5 and in females 33. 96 subjects were not using helmets during trauma. Most of the patients were having compound fracture. Collision with car was mostly seen as etiology. Parasymhysis with condyle was most common site involved followed by isolated parasymphysis and symphysis. Conclusion: To reduce the amount of face injuries in such incidents, educational programmes, defensive driving, and the usage of appropriate helmets are required. Keywords: Mandibular trauma, Motorcycle Accident, Helmet, Compound Fracture
The Imminent of General Surgery: Progressing to Encounter a Fluctuating Practice
Authors: Aftab Mansoor , Inzamam Muhammad , Latif Shahid
Published: May 2022

Purpose: As compared to other countries, the practice of General Surgery in Pakistan has gone through a series of important development over the last 30 years, despite major variable training models. There increasing concern is that the current teaching of General Surgery residency does not hold out enough skills that are essential to practice the scope of General Surgery in Pakistan. Procedure: Executed by a National Force on the General Surgery Future, this project directed to advance guidance on the favorable configuration of Training on General Surgery in Multan. A consecutive series of studies based on evidence and a survey was introduced to inform these guidelines. Results: The general results of a procedure in any study show the complexity of the practice in General Surgery. 1 Location matters a lot for a surgeon to practice surgery 2 General surgery accompanies a strong grip for the overall clinical competence as well 3 Today general surgeons experience a subspecialized training too 4 Writing a proper report and guidelines for proper future surgical goals is also a part of training for General surgeons today To be a general surgeon in the 21st century, these are the four recommendations that are necessary to maintain. Conclusion: This project mainly refers to the importance of location for fresh general surgery graduates, emphasizing the impact of variable location in contrast with the implementation of the same objectives of the surgery. The results of this study were sent to the Nishtar College to review the requirements of training and the work on a more precise and comfortable working scheme. Hence, we ensured that the GSRTP General Surgery Residency and Training Programs could work for the wider range of practice all around Pakistan for better training practices.