bluuebunny/crossref_metadata_2025 huggingface dataset:
A Study on the Outcome Parameters of Benign Prostate Hyperplasia Patients with Prostatic Inflammation after Turp
Authors: Ahmad Tanveer , Alam Numan , Ullah Sami , Ali Sikandar , Shaikh Abdullah , . Shahjehan
Published: December 2023

Aim: To assess the outcome parameters of benign prostate hyperplasia patients with prostatic inflammation Material and methods: An observational study was conducted on 60 patients at different centres including Urology Unit, Waseem Medical Centre Batkhaila District Malakand, KPK and Department of Surgery, DHQ Hospital Mardan, KPK in the duration from October, 2022 to March, 2023. Patients presented with BPH with prostatic inflammation undergoing TURP were assessed for various clinical parameters. Paired samples T test was applied to assess pre and postoperative clinical parameters. Results: The mean age of the patients was 64.88±6.48 years. Significant improvement was observed in the outcome clinical parameters before and after surgery using the paired samples T test. Conclusion: Transurethral resection of the prostate in patients with BPH with prostatic inflammation yields significantly improved post-operative outcomes. Keywords: Transurethral resection of the prostate, Benign prostatic hyperplasia, prostatic inflammation.
Critical View of Safety: A Pathway for Safe Execution of Laparoscopic Cholecystectomy
Authors: Alam Syed Hayder , Chishti Danish Abdus Samad , Raza Mirza Masoom , Talat Fawad , Saeed Rahab , Habib Lubna
Published: December 2023

The best method for treating gall bladder lithiasis is laparoscopic cholecystectomy. This original study objective was to assess the safety pathway's critical viewpoint from a standpoint of laparoscopic cholecystectomy implementation safety. Material: Data was collected from patients who underwent laparoscopic cholecystectomy in the surgical divisions of Karachi. To gather information on the preoperative evaluation, surgical maintenance, and postoperative care of patients, as well as to determine whether the elements were isolated following the CVS after the process, a questionnaire was forwarded to the Digestive Pathologist Community. Records about icons were acquired and eventually examined by an auditor. Results: Information from 300 patients was analyzed. The selection of participants was separated into 2 groups based on the proof (A; n = 5) or lack (B; n = 295) of bile duct injury and intraoperative hemorrhage. The non-use of CVS was detected in 56.6% of operations in group A, and 26.8% in group B, and analyzing the operator-related factors the implementation of CVS was linked with a considerably reduced occurrence of bile duct injury and perioperative hemorrhage. Conclusion: The CVS has been proven that it is the safest method for identifying the Calot triangle's components, and when used appropriately, it has a considerable effect on reducing intraoperative problems. To prevent extreme circumstances that might necessitate extra treatments, it would be beneficial to offer more instructional sessions on how to correctly apply CVS in medical care. Keywords: Cholecystectomy, laparoscopic, bile duct injury, surgery, bleeding, safety, gallbladder
Prevalence of Leprosy in District Buner, Khyber Pakhtunkhwa, Pakistan
Authors: Ulfat Sana , Khan Bashir , Khubaib Muhammad , Saeed Kausar , Shah Faridullah , Azam Hafiz Mahmood , Masud Samrah , Bukhari Syed Zain Zaffar , Rehman Hameed Ur , Ullah Assad
Published: December 2023

Background: Leprosy, commonly referred to as Hansen's disorder, is caused by the obligatory intracellular acid-fast bacilli Mycobacterium leprae and is predominantly transmitted by inhalation macrophages. It causes infection of the skin and nerves, as well as neurological damage due to inflammation. Aim: The current study was conducted to determine the prevalence of leprosy disease in District Buner, Khyber Pakhtunkhwa, Pakistan.During the investigation, we reported different types of leprosy. Methods: The current study investigates 467 patients from 1965-2000 in six Tehsil and 74 from 2000-2021. In the reported five types of Leprosy, Lepromatous Leprosy is more common than other types. Leprosy has five subtypes which 2 are Tuberculoid (TT), Lepromatous Leprosy (LL), and 3 are borderline types Leprosy Borderline tuberculoid (BT), Borderline (BB),borderline lepromatous (BL).
Risk Factors Associated with Ventricular Peritoneal Shunt Infections and their Clinical Outcome in Children: A Case-Control Study of the Past 5 Years
Authors: Ahmed Waqar , Nathwani Ms. Apsara Ali , Abro Falak , Hussain Wajid , Yasir Ayesha , mir fatima
Published: December 2023

Objectives: To determine the risk factors associated with the development of ventricular peritoneal shunt infection and time to infection, as the number of days from most recent shunt intervention to the diagnosis of the infection and clinical outcomes and the antimicrobial susceptibility pattern in children admitted with the ventricular peritoneal shunt. Study Design: Retrospective case-control study Place and duration of study: Aga Khan University Hospital Karachi, Pakistan between January 2015 to December 2020 Results: A total of 460 patients of ages 0-20 years with ventricular peritoneal shunt were selected. Out of 460, 52 individuals met the criteria of the case and were recruited for the study. The findings from multivariable logistic regression, after accounting for potential confounding factors, indicated that the odds of shunt infection were extremely high for patients undergoing surgery in the current admission (adjusted OR 167.3, 95% CI: 8.96 – 3130.86). Likewise, the odds of infection were approximately 12 times more for patients with fever (95% CI: 1.28 – 113.26) and tory of shunt removal (95% CI: 2.06– 67.20). Conclusion: Through a thorough analysis of medical records, the study revealed that several risk factors, such as younger age, previous shunt infections, surgery in current admission, shunt removal/replacement, previous revisions, current complication and fever were associated with a higher risk of shunt infection. Keywords: Risk factors, ventricular peritoneal, shunt infections, clinical outcome,
Knowledge and Self-Care Practices on Diabetic Foot among Diabetic Patients in Public Hospitals of Lahore, Pakistan - A Descriptive Study
Authors: Asim Fatima , Sharif Sumaira , Asghar Rozina , Shahzadi Ayesha , Hafeez Aqsa , Mehnaz Sobia
Published: December 2023

Background: The purpose of this study is to examine the degree of knowledge and practise of diabetic foot self-care among people with diabetes mellitus, as well as to determine the variables that influence the level of knowledge and practise in a public hospitals of Lahore, Pakistan. It is also beneficial for raising awareness about foot-care in diabetic patients. Methodology: A descriptive cross-sectional research was done in outpatient diabetes clinics on 153 adult patients with diabetes. Participants were given self-administered questionnaires about their knowledge and practise of diabetic foot self-care. Their responses were used to determine their scores. A total score of >60% was assessed as good and <40% as poor. SPSS was used for analyzing data frequency and percentages. Results: Amongst 153 patients majority of patients 85(55.5%) had poor knowledge about diabetic foot care, 48(31.3%) had average knowledge, and 20(13.2%) had good knowledge about foot care. About 79(51.6%) participants had poor practices regarding diabetic foot care, 49(32%) had satisfactory practices, and 25(16.4%) had good practices of diabetic foot care. Patients with college level education had good level of knowledge about foot care. Knowledge of participants and self-care practices is significantly associated with age and education of participants. Practical Implication: Knowledge and self-care practices of foot care were associated with age and education level of participants. Health-care professionals should concentrate on filling knowledge gaps in foot care, promoting good foot hygiene habits, and enticing patients to take part in diabetes education initiatives. Conclusion: The results of study concluded that majority of participants had poor knowledge and self-care practices about foot care. Keywords: Knowledge; Diabetic Foot; Diabetes Mellitus; Self-Care Practices
A Study on Incidence of Inguinal Hernia in Relation to BMI
Authors: Riaz Sidra , Khan Naveed Ali , Khalique Abdul , Ramzan Raazia
Published: December 2023

Background: Inguinal Hernias (IH) are the most common hernia of abdominal wall. These hernias affect both males and females. There are many factors that are linked with the increased risk of developing these hernias. Obesity is believed to be one of them. However, with current epidemiological advances, increased body mass index (BMI) has proven to have fewer incidences of inguinal hernias. Objective: The aim of this study is to determine the relationship of inguinal hernia both unilateral and bilateral with body mass index (BMI) Study Design: This is a cross-sectional study. Methodology: This study was conducted in the department of General Surgery Unit 2 of Dow University Hospital, Karachi, Pakistan. A total of 60 patients were included in this study using non probability convenient sampling which was conducted from January of 2022 till December of 2022. Results: A total of 60 patients who were clinically diagnosed with inguinal hernia were enrolled in our study. Their mean age was 39.25 ± 14.18 years, mean height was 170.55 ± 5.51 cm and mean weight was 67.28 ± 8.64 kg. Their average BMI was 23.10 ± 2.55 kg/m2. 56 (93.3%) of the participants were males and 4 (6.7%) were females. Only 1 (1.7%) patient with inguinal hernia was underweight, 48 (80%) patients were normal weighted, 10 (16.7%) patients were overweight and 1 (1.7%) patient was obese. Conclusion: According to the research that we conducted, most patients who underwent surgical hernia repair of either right, left or bilateral sides had normal BMI. Keywords: Inguinal Hernia, Body Mass Index (BMI)
Major Trauma and the use of Tranexamic Acid in Children
Authors: Iqbal Javed , Firdous Ghazala , Aziz Hafiz Muhammad Imran , Usman Syed Faisal , Afzal Muhammad , Sharif Muhammad , Naumeri Fatima , Bashir Kashif
Published: December 2023

Objective was to determine reduction in blood loss in children with major trauma with or without using Tranexamic acid Methods: A study included 260 patients admitted to pediatric surgery departments at Mayo Hospital, Children's Hospital, and Jinnah Hospital in Lahore, from September, 2018 to April, 2019. Patients were divided into Tranexamic acid and control groups. Both groups received standard treatment and blood transfusion requirements. Patients were followed for length of stay and final outcomes. Results: Mean injury severity score in case and control groups was 26.61±11.17 and 29.00±11.64 respectively. Mean hospital stay was significantly shorter (p = 0.002], massive blood transfusions were significantly low [3.8% vs. 38.46%, p-value<0.001] and need of surgery [24.6% vs. 46.15%, p <0.001]. Mortality rate 1.54% vs. 7.69%, p =0.018 and discharge rate 98.64% vs. 92.31%,p = 0.018). Blood transfusion requirement and need of surgery were significant predictors for mortality in this study. Conclusion: Results of this study demonstrate that Tranexamic Acid can be effectively used to minimize blood transfusion requirement in children with major trauma. It effectively reduces the need of massive blood transfusion, minimizing mortality and shortens the hospital stay for pediatric patients. Keywords: Tranexamic acid, Effectiveness, Blood loss, Children, Trauma
Frequency of Depression in Migraine Patients: A Multicentre Cross-Sectional Study from Pakistan
Authors: Malik Madiha , Masood Rabbiyah , Rana Mamoona Tanwir , Fatima Sana , Farooq Sana
Published: December 2023

Background: Migraine is a debilitating neurological disorder often accompanied by comorbid psychiatric conditions, including depression. However, the prevalence and correlates of depression among migraine patients in Pakistan are under-investigated. Study Objective: This study aimed to estimate the frequency of depression among migraine patients and assess its association with the severity and impact of migraine on daily and professional life. Material and methods: This Cross-sectional study was conducted at the Punjab Institute of Neurosciences (PINS/LGH) in Lahore over a period of 12 months from January to December 2022. A total of 1250 adults aged 18-75 years, diagnosed with migraines based on the International Classification of Headache Disorders, 3rd edition (ICHD-3) criteria, were enrolled. Depression was evaluated using the Urdu version of the Beck Depression Inventory-II (BDI-II). Demographic and clinical data were collected and analyzed. Results: The study reported a significant prevalence of depression among migraine patients, with an observed gender disparity favoring females. Notably, a higher duration and severity of migraines, a greater number of attacks per month, and a profound impact on professional and social life were positively correlated with depression. Practical Implication: significant prevalence of comorbid depression in this particular population, it is imperative to incorporate routine mental health screening as an integral component of standard care protocols. This approach may potentially facilitate early detection and intervention, thereby potentially enhancing overall patient outcomes and quality of life. Conclusion: The high prevalence of depression among migraine patients underscores the need for integrated mental health services within the migraine care paradigm in Pakistan. Regular mental health screening can aid in early detection, facilitating comprehensive management and potentially improving patient outcomes. Keywords: Migraine, Depression, Prevalence, Comorbidity, Mental Health Screening, Pakistan.
The Frequency of Maternal Complications after Home Delivered
Authors: Phulpoto Maryam , Kanwal Aisha , Nigar Roohi , Bijarani Suhail Ahmed , Baloch Ifat , Roshan Samiya
Published: December 2023

Objective: To determine the frequency of maternal complications among women delivered at home by Traditional Birth Attended (TBA) Dais presenting at the emergency department of tertiary care hospital. Study Design: Descriptive case series Study setting: The study was conducted at the Emergency Department of Gynecology Unit –III of Liaquat University Hospital, Hyderabad. Study Duration: Six months from 1st May 2018 to 30th November 2018. Methods and Material: A sample of 140 was obtained, participants were selected by using the Non-probability sampling technique and all the women from 20 to 45 years of age either primipara or multiparous who delivered at home by traditional birth attendant (TBA) Dais and presented within 12 hours up to 10 days after delivery at emergency department of Gynecology Unit –III of Liaquat University Hospital, Hyderabad included, after getting informed and written consent from their family members, a questionnaire was used to collect information from the women or her relatives. Data was collected for the complications like post-partum hemorrhage, a retained product of conceptus, perpural sepsis perineal tears injuries. We have used SPSS version 20.0 software for both data entering and analysis. Frequencies and standard deviations were calculated and the chi-square test was used to analyse categorical variables. P values less than 0.05 were considered statistically significant. Result: The total number of women who delivered at home by (TBA’s)/ Dia’s and developed maternal complications presented in the emergency department within 12 hours up to 10 days during the study period was 140. The average age of the patients was SD 29.27±5.21 years. Regarding parity, 58(41.43%) were primigravida and 82(58.57%) multigravida. The postpartum hemorrhage was the commonest maternal complication observed in 62.14% (87/140) cases, retained placental products 27.14% (38/140), purpureal sepsis 7.86% (11/140) and perineal tear injuries 17.14% (24/140). Retained placental product, perianal tear injury and PPH were not statistically significant among different ethnicity while the rate of puerperal sepsis was statistically significant among different ethnicity groups. The frequency of PPH and perianal tear injury was significantly high among those women who had primigravida while the rate of Retained placental products and Puerperal sepsis was high in multigravida but it was not statistically significant. Conclusion: This study concluded that home deliveries conducted by untrained birth attendants were associated with increased maternal morbidity and a high risk of maternal mortality. The postpartum hemorrhage was the most common maternal complication observed in women after home delivery by a Traditional Birth Attended (TBA) Dais.
Fever with Thrombocytopenia in the Pediatric Age Group
Authors: Dilshad Durfisha , Jamal Ammara , Firoz Muniba , Gul Mehak , Raza Mairah , Yasir Ayesha , Nasir Sharmeen , Saeed Sania
Published: December 2023

Introduction: Fever with thrombocytopenia refers to a reduction in platelet count below 150,000/L in association with fever. Although febrile thrombocytopenia may occur due to aplastic anemia, malignancy or megaloblastic anemia, its commonest cause in the pediatric age group is infections like Dengue fever, Malaria and Enteric fever. Since infectious diseases are highly prevalent in our region we decided to determine the frequency of diseases associated with febrile thrombocytopenia in the pediatric age group. Objective: To determine the frequency of diseases associated with febrile thrombocytopenia in the pediatrics age group Study Design: Descriptive Cross-Sectional Study Place and Duration: Department of Paediatric Medicine, Civil Hospital, Karachi, Pakistan from November 22, 2018, to May 21, 2019 Methodology: After obtaining informed consent data related to signs, symptoms, clinical and confirmed diagnosis, and relevant lab results were recorded for children who fulfilled the inclusion criteria. Data were analyzed in terms of frequencies and percentages for qualitative variables like age group, gender and outcome variables. Results: Mean ± SD of age was 4.74±3.28. Out of 89 patients, 45(50.56%) were male and 44(49.44%) were female. In distribution for common causes of thrombocytopenia, 19 (21.3%) had malaria, 8 (9%) had dengue, 25 (28.1%) had an enteric fever, 32 (36%) had sepsis, 2 (2.2%) had malignancy and 3 (3.4%) had megaloblastic anemia. Conclusion: Sepsis, dengue, and malaria were the most frequent causes of thrombocytopenia. Therefore, anytime thrombocytopenia is found, more investigations can usually assist us in making the right diagnosis. Keywords: Febrile Thrombocytopenia, Malaria, Sepsis, Dengue, Enteric.
Knowledge and Attitudes of Pregnant Women Towards Dietary Supplements and Alternative Medicine for the City of Mosul
Authors: Luay Eman , Almukhtar Salwah H.
Published: December 2023

Background: Alternative medicine is a term used to describe treatments that may receive along with traditional medicine. Examples of aalternative medicine include massage, meditation, biofeedback, tai chi, reiki, music therapy, guided imagery, herbal medicines and dietary supplements. This study aimed to Determine pregnant women's knowledge and attitudes about dietary supplementation and alternative medicine. Methodology and materials: A Cross-Sectional study design was used to achieve the present study's objectives from the 10th of December 2021 to the 1st of March 2022. A structured interviewing questionnaire was used to collect data from 250 pregnant women at Al Khansa, Al Salam, Al-Batool, and Mosul General hospitals in Mosul city. Results: The majority (62.8%) of pregnant women's age group was (21-30), and the mean age was of mothers (28.4). (51.6%) of the pregnant were homemakers, (31.2%) were employees, and knowledge of pregnant women using supplements was 1.7973, while knowledge of pregnant women using alternative medicine was 1.627. Pregnant women's attitudes about nutritional supplements and alternative medicine are 2.9331 Conclusion: the knowledge level about supplements and alternative medicine was moderate, and this knowledge was associated with their attitudes. There is a significant relationship between demographic information and their knowledge and attitudes, while BMI and husband occupation were insignificant. Recommendation: Ministry of Health must adopt education through health promotion programs about the safe use of dietary supplements and alternative medicine for pregnant women and better understand the reasons and facilitators. Also, encourage pregnant women through different media to consulate the doctors and nurses before using any nutritional supplement or alternative medicine to prevent complications and side effects. Keywords: Knowledge, pregnant, Mosul, Iraq.
Association of Hamstring Tightness with Lower Extremity Injuries in Athletes (Analytical Cross-Sectional Study)
Authors: Imtiaz Rafia , Sattar Asma , Qaiser Anum , Azfar Hanan , Haq Kiran , Bukhari Syeda Amna , Fatima Kanwal , Javed Hafiza Rabia , Rafique Hira , Aslam Intsam
Published: December 2023

Background: Flexibility if muscle is required for normal bio-mechanical functioning. Muscle tightness results from reduced capability of muscle to modify its shape during movement which results in decreased ROM. Hamstring tightness is one of the cause of hamstring injuries in athletes which leads to slowed recovery and compromises performance of athlete in the field. Objective: To find the association of hamstring tightness with lower extremity injuries in athletes. Methodology: The study was conducted on 141 athletes out of those 61 were cricketers and 80 were footballers. This study was conducted from January to May 2023. Convenient sampling was used and participants were selected from different football and cricket clubs of Lahore on the basis of inclusion and exclusion criteria. Nordic questionnaire was used to determine the lower extremity injuries and active knee extension test use to measure the hamstring tightness in athletes. Statistical data was analyzed by using SPSS version 26. Result: The results showed negative correlation between Active knee Extension test and lower extremity injuries as the value of Pearson Correlation coefficient was r = -0.204. The mean±SD for Active knee Extension test was 1.31± 0.456 while that of Lower extremity Injury level was 1.28±0.56. There was significant association between AKE test and Knee pain and LBP as P-value of 0.047 amd 0.048 was obtained respectively, while there was no significant association seen between AKE test and lower extremity Injury level as p- value of 0.34 was obtined. The p-value represented that null hypothesis is accepted. Conclusion: On the basis of results Hamstring tightness is not found to be associated with Lower Extremity Injuries. While hamstring tightness could cause knee pain and low back pain in athletes. So maintaining the flexibility of hamstring in athletes could reduce the knee pain and LBP and will enhance their participation in sports. Keywords: Hamstring tightness,Nordic questionnaire ,active knee extension test.
Is Percutaneous Nephrolithotomy (PCNL) as Safe and Effective in Children as Adults?
Authors: Shaikh Nadeem Ahmed , Kumar Jai , Samad Abdul , Hafeez Abdul , Jamshaid Anila , Zaidi Syed Zafar
Published: December 2023

Background: Percutaneous Nephrolithotomy (PCNL) is an endoscopic procedure of choice for the larger renal stones in both adult and children. Adequate literature is present regarding the efficacy of PCNL in clearing the adult kidney stones but limited data in our part of world is available to show noticeable renal stone clearance after PCNL with minimal complications in pediatric group. We set out to compare the outcomes of PCNL in both groups so we can recommend its efficacy and safety in pediatric group. Methods: The prospective cross-sectional comparative study conducted in 86 patients who underwent PCNL for Renal Calculi. Patients were divided into two groups. Thirty patients were in the pediatric group and 56 patients in the adult group. Both groups were compared for the safety and efficacy of PCNL. Safety will be assessed through post-operative complications and graded according to Modified Clavien grading system. Efficacy was assessed through stone clearance. The aim of study is to determine the safety and efficacy of percutaneous nephrolithotomy in children so it can be done frequently and confidently without fear of complications and incomplete clearance of stones. Results: When we compare children with adults for safety and efficacy of PCNL, no statistical significance was observed in both groups in terms of stone clearance and postoperative complications. Conclusion: Percutaneous nephrolithotomy is as safe and effective in pediatric age as adult age. Keywords: Percutaneous Nephrolithotomy, Renal Stones, modified Clavien grading system.
Diagnostic Accuracy of Ultrasound in Morbidly Adherent Placenta Keeping Histopathology as Gold Standard
Authors: Jamali Abid Hussain , Sherwani Anam , Sheikh Altaf , Farhat Kashmala , Tariq Samreen , Mustafa Iqra
Published: December 2023

Introduction: Morbidly adherent placenta has three varieties, each with varying degrees of invasion according to histopathology. The placenta accreta, increta, and percreta are a few of these. Clinical manifestations can include haemorrhage that is potentially fatal. Therefore, it's critical to make an early and rapid diagnosis of this ailment. Objective: To determine the diagnostic accuracy of ultrasound in morbidly adherent placenta keeping histopathology as the gold standard. Study design: Cross-sectional study Place and Duration: Department of Radiology, Liaquat University of Medical and Health Sciences, Jamshoro from 28th August 2021 till 1st March 2022.
Frequency of Fluoroquinolone and Aminoglycoside Resistance Online Probe Assay in Multidrug-Resistant Tuberculosis Patients
Authors: Nawaz Qasim , Naseer Sajjad , Khan Imran , Ali Asad , Ahmad Akhlaq , Hameed Aima
Published: December 2023

Background: The resistance of tuberculosis to anti-tuberculous therapy is a severe public health concern all over the globe. The most common and important cause of resistance to anti-tuberculous therapy is poor patient compliance with or inappropriate therapy dosing. Objective: In order to evaluate the prevalence of resistance to commonly used 2nd-line anti-tuberculous drugs, an online probe assay was conducted among patients diagnosed with multi-drug-resistant tuberculosis. This study specifically focused on patients who were receiving treatment with fluoroquinolones and aminoglycosides and were seeking care at Lady Reading Hospital, a tertiary care facility located in Peshawar. Methods: This study was conducted at the Department of Pulmonology ward of Lady Reading Hospital, Peshawar, from Jan 2021 to Jan 2022, six months in which a total of 150 patients were observed to determine the frequency of common 2nd-line standard anti-tuberculous drugs resistance online probe assay in patients with multidrug-resistant tuberculosis. flouroquinolones and . Non-probability sequential sampling was the method used for sampling.
Pregnancy Outcome in First Trimester Bleed
Authors: Sayyad Hajra , Jadoon Humaira , Gul Maria , Bibi Maryam , Rehman Salma , Zafar Seemab
Published: December 2023

Background: There is disagreement on the outcome of vaginal bleeding during the first trimester. The purpose of this study was to ascertain the perinatal and maternal outcome for patients who presenting with vaginal bleeding during the first trimester. Methods: Over the course of a year, 1007 women with vaginal bleeding in the first trimester were included in this prospective observational study at a tertiary care hospital in Peshawar. The diagnosis was confirmed by a USG and a thorough history. All of these patients had their outcomes assessed, including spontaneous, threatened abortions, incomplete, and complete abortions, subchorionic hematoma, intrauterine foetal death, missed abortions, bleeding in the second and third trimesters, pre-mature rupture of membranes, intra-uterine growth restriction, and preterm births. Results: 1007 individuals with 11835 confinements had vaginal bleeding in first trimester. The age range of 21 to 30 years saw the highest occurrence (52.3%). First trimester haemorrhage was detected in 63.9 percent of primigravidas compared to 36.1 percent of multigravidas. It was shown that only 7% of patients who attended after 10 weeks had an abortion, compared to 76.9% of patients who presented before 6 weeks. In the 163 patients who continued to be pregnant after experiencing vaginal bleeding in first trimester, 1.8 percent had an abortion in the 2nd trimester, and 15.3% experienced premature labour. 6.75 percent of pregnancies end prematurely, and 1.8% experience antepartum haemorrhage. Conclusions: First trimester vaginal bleeding foretells ancillary maternal and foetal difficulties, according to the findings of the current study. Additionally, as clinical intervention plays a crucial part in preserving pregnancy and lowering foetal problems, careful supervision and planning by the doctor are crucial. Keywords: First trimester bleeding, Abortions, Threatened abortion, Preterm Labor,
The Role of Psychotherapies in the Management of General Health Symptoms among Parents and Teacher of Autism Spectrum Disorders Adolescents
Authors: Khan Saima , Tabassum Sadaf , Rafique Maria
Published: December 2023

Objective: The current article's goal is to emphasize the importance of psycho-therapeutic interventions in the management of general health symptoms (i.e., bodily symptoms, sleep and anxiety-related symptoms, inability to socialize, depression symptoms) among parents and teachers of autistic spectrum disorder adolescents. Method: The current study is based on an experimental design to lessen the general health symptoms of parents and teachers of adolescents with autism spectrum disorders. choosing appropriate friends, appropriate use of humor, entering a conversation, exiting a conversation, get-togethers, good sportsmanship, teasing and embarrassing feedback, bullying and bad reputations, handling disagreements, rumors, and gossip relaxation exercises were all used by clinical psychologists at various schools. The general health questionnaire (GHQ-28) scale was filled by both control and experimental group participants prior to the start of therapy. G power was used to calculate sample size; a total of 140 individuals, parents (N = 40) and teachers (N = 40), were chosen for the experimental group, while the remaining 40 parents and 20 teachers were assigned to the control group (CG), with an age range of 30 to 50 years old. Purposive sampling was used to determine the sample size. The data came from two schools in Islamabad and one in Rawalpindi, Pakistan. To treat their psychological concerns, parents and teachers were taught various therapeutic strategies. The participants filled the measure instruments of general health questionnaire (GHQ-28) after fifteen treatment sessions. SPSS version 25 was used to analyze the data, and the MANCOVA test was used to validate the results.
Efficacy and Safety of External Versus Internal Stenting in Children with Open Pyeloplasty for Primary Ureteropelvic Junction Obstruction. A Single Centre Experience
Authors: Shah Syed Ghafar , Ullah Irfan , Khan Muhammad Kamran , Ali Yasir
Published: December 2023

Background: Ureteropelvic junction obstruction (UPJO), a condition, stops urine from freely passing from the renal pelvis to the ureter. It is a common urological condition, with a male to female ratio of 2:1 and an incidence of 1 in 500 (1). UPJ obstruction may be caused by inherited and acquired diseases. The majority of cases are congenital due to intrinsic or extrinsic causes (2). Objective: To determine the efficacy and safety of external versus internal stenting in children with primary Ureteropelvic junction obstruction. Material and Methods: At the Institute of Kidney Diseases in Hayatabad, Peshawar, Pakistan, a randomized controlled study was carried out from January 2021 to December 2021. Patients were split into two groups based on the kind of stent that was used. All patients with DJ stents were placed in Group A, and patients with PU stents (5–6 Fr feeding tubes) that passed through the kidney parenchyma on their way from the ureteropelvic junction to the skin belonged in Group B. Results: 80 people in total (55 men and 25 women) were enrolled in the study. In groups A and B, the mean ages at surgery were 3.4 and 3.9 years respectively. Table 1 displays the patient's demographics and surgical factors. The two groups' mean operating times (124 ±3.4 for group A and 130 ± 3.1 for group B) were comparable. The DJS group's stent duration ranged from 3 to 4 weeks, with a mean of 27 days, while the PU group's ranged from 1 to 2 weeks, with a mean of 13 days. In DJS and PU stent, the median hospital stay was 1.3 and 2.8 days, respectively. Practical Implication: The surgeon must compare the inconvenience of a second anaesthesia, the cost, and the DJ stent's potential for complications against the longer hospital stay that comes with PU stenting and advise parents accordingly. Conclusion: According to our findings, the complication rates and mean operating time for both types of stents were comparable. Even though the DJS stent requires less recovery time than the PU stent, its removal still required a second anaesthesia Keywords: External Versus, surgical factors, ureteropelvic junction obstruction, urine, Congenital
Preoperative Management of Diabetic Patients Undergoing Abdominal Surgery
Authors: Zeb Muhammad , Khattak Jawadalam , Sikander Shumaila , . Mirwais , Munir Maryam , Jamal Muhammad Asim , Khan Niaz Ali
Published: December 2023

Introduction: The management of diabetic patients undergoing abdominal surgery presents a multifaceted challenge that demands a comprehensive and tailored approach to ensure optimal perioperative outcomes Objectives: The basic aim of the study is to find the preoperative management of diabetic patients undergoing abdominal surgery Material and methods: A retrospective analysis was conducted, utilizing medical records from a cohort of 200 diabetic patients who had undergone various abdominal surgical procedures at Khyber Teaching Hospital Peshawar between August 2018 to March 2019. Ethical approval was obtained from the Institutional Review Board (IRB) prior to the commencement of data collection.Electronic medical records were meticulously reviewed to gather comprehensive patient information. Relevant demographic data, including age, gender, and body mass index (BMI), were documented. Preoperative glycemic status, measured through fasting blood glucose levels, HbA1c levels, and medication regimens, were recorded. Patient comorbidities, particularly cardiovascular conditions, were identified, and details of preoperative cardiovascular risk assessments were documented. Practical Implication: The prevalence of postoperative complications emphasizes the need for comprehensive management. These findings underscore the significance of holistic approaches to ensure safer surgeries and improved patient well-being. Conclusion: It is concluded that glycemic control, collaborative cardiovascular risk assessment, nutritional optimization, and patient education play pivotal roles in enhancing surgical outcomes. The prevalence of postoperative complications emphasizes the need for comprehensive management. Keywords: Diabetic, abdominal surgery, postoperative complications, nutritional optimization, cardiovascular risk, Nutritional Optimization
Aggression Level and its Associated Factors among High School Children in Lahore
Authors: Hameed Lubna , Sarwar Hajra , Afzal Muhammad
Published: December 2023

Background: Children in school age frequently engage in aggressive activities. Aggression has the greatest detrimental impact on both the child and the surroundings. Aggressive children are more likely to experience long-term behavioral issues and other emotional and social challenges. Violence that results from aggression is an issue that is getting more and more attention.
Evaluation of Post-Tonsillectomy Complications between the Traditional Cold-Steel Dissection and Electrocautery Methods. A Controlled Randomized Trial
Authors: Noor Allah , Mudassir Muhammad , Khan Saadat Ullah , Alam Shahibzada Fakhar
Published: December 2023

Background: One of the most frequent ENT surgical procedures is the tonsillectomy. Comparing electrocautery to the conventional cold-steel dissection technique, it has been indicated that the latter will cause fewer post-tonsillectomy problems. However, there needs to be more randomized controlled studies to compare the two methods. Objectives: This Study's primary goal is to compare the post-tonsillectomy problems caused by the electrocautery technique versus the conventional cold-steel dissection approach. Methods: Between January 2022 and January 2023, this Study was carried out by the department of Ent hmc Peshawar. A prospective randomized controlled trial will include 125 participants in total. Patients will get a tonsillectomy and be randomly allocated to either the electrocautery technique or the conventional cold-steel dissection approach. Pain, bleeding, and infection related to post-tonsillectomy sequelae will be assessed and compared between the two groups. Results: The Study's findings will be utilized to compare the effectiveness and safety of the electrocautery approach versus the conventional cold-steel dissection method for tonsillectomy. Conclusion: This Study will provide otolaryngologists with evidence-based advice on a tonsillectomy procedure. Keywords: tonsillectomy, electrocautery, cold-steel, post-tonsillectomy complications, randomized controlled trial
Contaminated Equipments: A Source of Hospital Acquired Infections among Patients at Critical Areas of Holy Family Hospital, Rawalpindi
Authors: Anwar Irum , Rafiq Shireen , Ahmad Kiran , Haq Taqweem Ul , . Saeeda , Aslam Zobia
Published: December 2023

Introduction: A nosocomial infection is contracted within a period of 48 hours following admission to a hospital or within 48 hours after being discharged from the hospital. Patients in the intensive care unit (ICU) are vulnerable to infections due to various factors, including their pre-existing medical conditions, medical procedures such as surgery, intubation, and catheterization, as well as their potential exposure to microorganisms from fellow patients. In addition to this, the presence of contaminated equipment represents a significant contributor to the occurrence of hospital-acquired infections caused by multidrug-resistant organisms among patients in critical areas. Methods: This cross-sectional study was conducted in coronary care and critical areas of Holy Family Hospital, Rawalpindi. A total of 415 samples were processed at the microbiology laboratory over a 4 month period from which 112 were swabs taken from equipment of the Medical, Surgical and Pediatric intensive care Units (MICU, SICU, and PICU) and the Coronary Care Unit. The remaining 303 samples were blood, urine, tracheal secretions/tips, pus and Foley tip cultures received in the microbiology laboratory from MICU, SICU, CCU and PICU. Samples were cultured on the appropriate media and observed after the required period. Results: High levels of contamination (58.03%) were identified on a wide range of healthcare equipment. The total of infected patients were 37.6%. Most common infection site was the respiratory tract. Acinetobacter spp. was the most predominant isolate among patients in MICU, SICU and CCU while Klebsiella spp. was the predominant isolate from the PICU. Conclusion: A significant degree of contamination is observed across a diverse array of healthcare equipment. Nevertheless, the prevalence of contaminated instruments and the subsequent potential for acquiring a healthcare-associated infection (HAI) can be significantly mitigated through the consistent implementation of cleaning, disinfection, and sterilization protocols for medical equipment. Keywords: hospital acquired infections, Contamination, equipment, pathogens.
Frequency of Congenital Cardiac Conditions in Children Born to Diabetic Moms
Authors: Iqbal Hamid , Rehman Saeed Ur , . Abdurrazaq , Khan Ali Abbas , Ali Mazhar , Haq Fawad Ul
Published: December 2023

Introduction: The foetal cardiovascular system is teratogenically affected by maternal diabetes. Because of this, cardiovascular abnormalities are the most prevalent anomaly in children of diabetes moms. Despite improvements in the medical care provided during pregnancy to diabetic mothers, a cardiac complication in their infants is still more frequent than in infants of the general population. Objectives: to quantify the prevalence of congenital cardiac problems in offspring of diabetes moms. Materials & Methods: this-Cross-sectional-study conducted in the Departments of Paediatrics and Neonatology, Ayub Medical College and Hospital, Abbottabad . from Jan 7 2021, to Jun 6 2021. A total of 111 full-term neonates born to diabetic mothers were included. Premature babies and other congenital anomalies were excluded. After taking consent and detailed history, all the neonates included in the study were sent for (Echocardiography) at the cardiac division of Abbottabad's Ayub Teaching Hospital. In the same department, echocardiography was conducted by the same cardiologist. Neonatal congenital heart disease was treated in hospitals. Results: Mean age was 3.35 ± 1.29 days (Table I). The mean maternal age was 38.64 ± 1.37 weeks. Out of the 111 patients, 79 (71.17%) were male, and Females made up 32 (28.19%), with a male-to-female ratio of 2.5:1. The average newborn weighed 3.93 1.62 kg. In this research, I discovered that 43 (38.74%) children with a mother who has diabetes had congenital cardiac disease. Conclusion: This study has shown the prevalence of congenital cardiac abnormalities, with patent ductus arteriosus being the most prevalent abnormality among children born to diabetic moms. Keywords: congenital heart defects, diabetic mothers, patent ductus arteriosus. Births in the US, whereas just 2% of pregnancies in Faisalabad have diabetes.Teratogenic
Seasonal Variations in Blood Pressure and Increased Incidence of Intracerebral Hemorrhage in Cold Months of the Year
Authors: Khan Samiullah , Khan Gohar Ali , Shah Naseeb Ur Rehman , Maqsood Saeed , Khan Radhia , . Attaullah
Published: December 2023

Objective: To assess the Seasonal variations in Blood Pressure and increased incidence of Intracerebral Hemorrhage in cold months of the year Methods: This cross sectional study was conducted at KGN hospital, during the time period of one year. The months of the year was divided as cold months (November-February) and all other months (March-October) of the year. Ischemic stroke and intracerebral hemorrhagic stroke were the two main categories used to categorize individuals with stroke based on non contrast brain CT scan along with clinical characteristics. Results: In cold months, the incidence of Intracerebral hemorrhage, 98 (65.3%) was significantly greater at p < 0.05 as compared to all other months of the year, 52 (34.7%). Both systolic and diastolic blood pressure of intracerebral hemorrhage patients was higher in cold months as compared to all other months of the year Conclusion: The good reason for increase in both systolic and diastolic blood pressure of intracerebral hemorrhage patients is the peripheral vasoconstriction of the vessels in cold weather. Keywords: Intracerebral hemorrhage, seasonal variations, Ischemic stroke, cholesterol, blood pressure.
Phytochemical-loaded Nanoparticles in COVID-19 Management
Authors: Vuppu Suneetha , Mishra Toshika , Mishra Shatakshi , B Stany , Das Anushka
Published: December 2023

A phytochemical-loaded nanoparticle is an important therapeutic agent that aids in enhancing the bioavailability of phytochemicals of lower water solubility and delivering the phytochemicals to the site of infection in a targeted manner. This strategy has also been developed for the management of COVID-19. They can be used as antiviral medication carriers, causing the direct death of viral particles and imitating the host in order to neutralize viral processes. In the formulation of phytochemical-loaded nanoparticles against SARS-CoV-2, different categories of nanoparticles, including inorganic, lipid-based, and polymeric nanoparticles, are used. Numerous phytochemicals belonging to the classes of alkaloids, flavonoids, terpenes, terpenoids, saponins, glycosides, polyphenols, and lignans, that demonstrate effective antiviral properties are utilized for the phytochemical-loaded nanoparticles. This approach results in increased solubility and stability of the phytochemicals with lower systemic toxicity, in addition to site-specific delivery. The combination therapy delivers multiple therapeutic agents at the site of infection. It can also be administered directly to the respiratory system by inhalation delivery. Therefore, this approach can potentially inhibit the application of phytochemical-loaded nanoparticles for the treatment of COVID-19, which is still in its replication of the SARS-CoV-2 virus and reduces the severity of the disease. The infancy and a number of obstacles must be overcome prior to their widespread use.
The effect of a preservative-free prostaglandin analogue on the condition of the ocular surface in patients with glaucoma
Authors: Arutyunyan L. L. , Anisimova S. Yu. , Anisimov S. I. , Teuvazhukova D. A.
Published: December 2023

PURPOSE. The study aimed to evaluate the antihypertensive effectiveness and the condition of the ocular surface in patients with glaucoma during monotherapy with the drug Traviolan® (travaprost 0.05%).

METHODS. This longitudinal, randomized, prospective study included 27 patients (59.6% women, 40.4% men; mean age 64.1±6.4) with uncompensated primary open-angle glaucoma in early and moderate stages receiving mono-therapy with β-blockers or carbonic anhydrase inhibitors. This was a longitudinal, randomized, prospective, observational study. All patients underwent a complete ophthalmological examination and assessment of dry eye symptoms using a questionnaire (Ocular Surface Disease Index, OSDI). An objective assessment of the condition of the ocular surface was carried out using the Sirius corneal topography device, which is used for assessment of tear film breakup time (TBUT). All patients were re-examined after 12 weeks.

RESULTS. Intraocular pressure was significantly reduced at all study visits and amounted to 5.9±2.8 mm Hg at week

12 (25.9%). There was a significant reduction in symptoms of dry eye, irritation, itching, and foreign body sensation (p<0.05 for each parameter). A significant improvement was also noted in terms of the condition of the ocular surface, and in most patients the symptom complex was classified as mild dry eye syndrome (p<0.05). Additionally, there was also a significant improvement in the OSDI score (p<0.05) with a mean of 17.95±5.35 points. The tear film breakup time by the end of observation increased by 4.1±2.3 sec and amounted to 7.4±3.1 sec.

CONCLUSION. The drug Traviolan® has high antihypertensive effectiveness and good tolerability, and improves the condition of the ocular surface.