bluuebunny/crossref_metadata_2025 huggingface dataset:
PRIMARY VAGINAL HYDROCELE;
Authors: Jatt Nazim , Bano Farhat , Memon Iqbal Ahmed , Memon Mohammad Saleh , Azmi Mohammad Ahmed
Published: August 2021

Background: A hydrocele is a fluid - filled sac surrounding a testis that resultsin the swelling of scrotum. They can develop due to inflammation or injury within the scrotum.Objective: This study aimed to evaluate the efficacy and adaptation of different surgicalprocedures in the repair of hydrocele. Study design: Comparative, Retrospective study .Placeand duration of Study: The study was conducted at Fauji Foundation Hospital Karachi , Al-TibriMedical College, Karachi and Civil Hospital Karachi from January, 2000 to December, 2013.Patients and methods: Patients with primary vaginal hydrocele registered during the periodof thirteen years in the out patient department of surgery were selected. A total of 300 patientswere assessed clinically, diagnostically and radiologically about the status of hydrocele beforethe surgical procedures and anesthetic opinion. The different surgical technique were carriedout in different group of patients asJaboulay’s technique in 70 patients, Lord’s procedure in 70patients, Aspiration and Sclerotherapy in 05 patients, Window operation technique in 05 patientsand the Hydrocelectomyby supra pubic procedure were carried out in 150 patients out of total300 registered patients. The data collected and analyzed statistically in SPSS version 19.00.Results: The different procedures have been adopted surgically in patients with primary vaginalhydrocele. The results showed that among the different operative techniques adopted, the bestprocedure regarding hydrocelectomy is the supra pubic approach line of treatment. It showedbetter result and recovery with very minimum complications and side effects as compared toother surgical procedure. Conclusions: The data thus concluded that hydrocelectomy donevia supra pubic approach in number of patients proved to be the best procedure because ofhaving very little complications.
H2 RECEPTOR ACTIVITY
Authors: Baloch Naseer Khan , Jafri Nusrat , Danyal Ahmed
Published: August 2021

… Histamine can stimulate the heart by directly interacting with cardiac histaminereceptors. In the present study we have investigated the H2 receptor activity in isolated rabbitheart. Cimetidine, a specific H2 receptor antagonist was used. The isolated heart was mountedin langendroff apparatus. The heart was perfused at a constant pressure with oxygenatedRinger‘s Locke solution. H2 receptor antagonist produces negative inotropic effect in thepresence of histamine. This indicates that H2 receptors are present in rabbit heart, and plays arole in mediation of positive inotropic effect produced through CAMP by histamine.
NEONATAL SEIZURES;
Authors: Mahmood Arshad , Zaman Syed Qamar , Mahmud Shahid
Published: August 2021

Objective: To study the types, etiology and long term neurodevelopmentaloutcome in neonates with seizures. Study Design: A descriptive cross-sectional study. Placeand Duration of Study: PNS Shifa Naval hospital Karachi from Jan 2011 to Feb 2014. StudyPopulation: Ninety six neonates of either gender presented with seizures at NICU PNS ShifaNaval hospital Karachi were studied. Method: All neonates with seizures were evaluated.The seizures were classified according to the simiology. They were investigated according toNICU protocol to confirm the underlying diagnosis and timely management. The patients afterdischarge were regularly followed up for one year to assess the long term neurodevelopmentaloutcome. Results: A total of 96 neonates with seizures were studied and it was observedthat 60 (62.5%) were male babies and 56 (58.33%) were term with a male to female ratio of1.6:1. Majority of the neonatal seizures were seen in 1stweek of life (85%). The most commontype of seizures was clonic 40 (41.67%) followed by subtle 20 (20.84%), mixed 16 (16.67%),tonic 10 (10.41%), myoclonic 5 (5.20%) and unclassified 5 (5.20%). Antiepileptics were usedin 82 (85.41%) patients. Phenobarbitone 49 (59.76%) was most commonly prescribed drug.The most common cause of seizures was birth asphyxia 48 (50%) followed by metabolic 16(16.68%), sepsis 10 (10.41%), intracranial hemorrhage 6 (6.25%), bilirubin encephalopathy 4(4.16%), inborn errors of metabolism 2 (2.08%), birth trauma 2 (2.08%) and unknown etiology 5(5.20%). 25 (26.04%) patients develop adverse neurodevelopmental outcome i.e. cerebral palsywith epilepsy 10 (40%) and cerebral palsy without epilepsy 05 (20%), developmental delay 10(40%). Mortality in the study was 12 (12.5%). Conclusions: Clonic seizures are commonestin neonates apart from infants and children who have GTCS. The most common etiology ofseizures in neonates is birth asphyxia. Phenobarbitone is still the most commonly prescribedantiepileptic. Quick assessment, timely diagnosis and aggressive management according tothe etiology are necessary to prevent the morbidity and mortality associated with neonatalseizures. Long term neurodevelopmental outcome is worse in patients with birth asphyxiaespecially with low Apgar score at 5 minutes. Normal delivery and birth asphyxia were the majorrisk factors for cerebral palsy
CAN WE REDUCE MATERNAL MORTALITY
Authors: Channa Shehla Raza , Anjum Farhana , Rauf Sumaira
Published: August 2021

Objective: The objective of this study is to find out the maternal mortality ratein our setup and found the preventable causes of maternal mortality rate. Design: Descriptivestudy. Place and duration of study: In obstetric ward of Liaquat university hospital Hyderabadfrom 10th Feb 2011 to 10th Jan 2014. Patients and Methods: All the women who were died dueto pregnancy complications were included in the study while women who were not died due topregnancy complications and maternal deaths due to accidental or incidental causes duringpregnancy were excluded from the study. Details of patient’s history especially age, parity,socioeconomic condition, reason of death, antenatal status, and distance from hospital wererecorded on predesigned proforma. Results: Total 48563 deliveries were conducted during thestudy period. Out of these, 103 women died, so the maternal mortality rate was 212.09/ 100,000live birth. Majority of women i.e. 43(41.74%) died; belong from age group of 31-40 years.Majority of women i.e. 78(75.72%) belonged to poor socioeconomic group and 83(80.58%)women had not received antenatal care. Most common cause of maternal mortality in thisstudy was hypertensive disorder which was seen in 43(41.74%) followed by APH in 39(37.86%)and PPH seen in 6(5.82%) patients .The most common cause of delay in seeking health carefacility was lack of transport reported by 43(41.74%) patients and familial taboos reported by36(34.95%) patients. Conclusions: Most important cause of maternal mortality in our studywas hypertensive disorders, APH and PPH. Maternal mortality was highest in advancing age,increased parity and in unbooked patients.
PLACENTA PREVIA ACCRETA;
Authors: Khan Saima Mustafa , Khan Bushra , Khan Mehjabeen
Published: August 2021

Objective: To compare outcome of antenatal diagnosed cases of placentaprevia accreta in previous caesarean scar with undiagnosed cases of placenta previa accretain previous caesarean scar. Study Design: Cohort Study. Setting: The study was carried outin department of Obstetrics and Gynecology Nishtar Hospital Multan. Population: Method:Total 206 cases were included in the study divided into two groups. Group A had 103 antenataldiagnosed cases of placenta previa accreta in previous caesarean scar and Group B comprised103 cases un-diagnosed having placenta previa accreta in previous caesarean scar. OutcomeMeasure: Outcome was determined in terms of morbidity (i.e Hysterectomy) and mortality.Results: It was found that hysterectomy was performed in 47 (45.6 %) vs 36 (35 %) diagnosedand un-diagnosed cases respectively. 9 (8.7%) vs 2(1.9%) cases died in diagnosed andundiagnosed Cases respectively. Conclusions: No significant difference in term of morbiditywas found between diagnosed and un- diagnosed cases of placenta previa accreta in previouscaesarean scar. Mortality was high in diagnosed cases of placenta previa accreta in previaouscaesarean scar.
HEPATITIS–B VIRUS INFECTION;
Authors: Zulqarnain Arif , Iqbal Imran , Anjum Naveed
Published: August 2021

Objective: To describe the clinical presentations of hepatitis B virus infectionin children. Methodology: Children presenting with symptoms of liver diseases and otherdiseases who were found to be HBsAg positive by screening or ELISA method were enrolled.Children suffering from thalassemia, hemophilia and hemolytic anemia, which need multipletransfusions, were excluded. On the basis of history, examination and investigations the clinicalpresentation of the patient was categorized. Basic demographic data, relevant clinical history,physical examination, lab investigations and clinical presentations category were entered in thepredesigned proforma. As this is the descriptive study, no hypothesis were required. Design:Descriptive case series. Setting: Paediatric unit-2 NishtarHospital Multan. Period: 16th May2012 to 15th November 2012. Results: Study results consist of relative frequencies of differentclinical presentations of HBsAg positive patients. Fifty children who were HBsAg positive wereenrolled in a six month period. Out of 50 patients, 21 (42%) were of hepatic encephalopathy,14 (28%) were with acute hepatitis, 12 (24%) were cirrhosis, 2 (4%) were asymptomatic carrierand 1 (2%) was presented with chronic hepatitis B. There were 40 (80%) males and 10 (20%)females. The overall male to female ratio was 4:1. Conclusions: Most common presentationwas hepatic encephalopathy which has a very bad prognosis, next comes the acute hepatitisand then cirrhosis. There is another inference that males are more and severely affected byhepatitis-B virus infection.
DYSLIPIDEMIA;
Authors: Karim Imran , Zardari Ahmed Khan , Shaikh Muhammed Khalid , Baloch Zulfiqar Ali Qutrio , Shah Syed Zulfiquar Ali
Published: August 2021

Objective: To determine the frequency of dyslipidemia in Helicobacter pyloriinfected patients. Patients and methods: This cross sectional descriptive study of six monthsstudy was conducted at Liaquat University Hospital Hyderabad from 01-03-2012 to 31-08-2012. All the patients between 19 to 60 years of age present with symptoms of dyspepsia,bloating or epigastric discomfort for more than 01 week duration were admitted and evaluatedfor Helicobacter pylori infection. Thereafter the positive cases (Helicobacter pylori infectedpatients) were further evaluated for dyslipidemia. Results: During six month study period,total 144 patients (95 males and 49 females) with Helicobacter pylori infection were evaluatedfor dyslipidemia (lipid profile). Majority of patients were from urban areas 110/144 (76%).The mean ±SD for age of patients with Helicobacter pylori infection was 35.94±10.77. Themean age ±SD of dyslipidemic patient was 32.62±6.52. The dyslipidemia was identified in 87(60.4%) patients, of which 51(58.6%) were males and 36(41.4%) were females. Regarding thepattern of dyslipidemia, ten (11.4%) patients had raised serum triglycerides level, twenty eight(32%) had raised LDL-C level, twenty six (28.9%) had raised serum cholesterol level, seven(8.7%) had low HDL-C level and sixteen (18.3%) had mixed dyslipidemia. The mean ±SD ofhypertriglyceridemia, ↑HDL-C, ↑LDL-C and hypercholesterolemia in dyslipidemic Helicobacterpylori infected was 280.72±22.85, 24.21±2.63, 180.63±12.98 and 285.21±23.63 respectively.Conclusions: The H. pylori infected patients are prone to acquire dyslipidemia, therefore thepresent study observed 60.4% prevalence of dyslipidemia with male predominance (58.6%)
SERUM IRON LEVEL
Authors: Shaikh Muhammed Khalid , Akhtar Saeem , Zardari Ahmed Khan , Arwani Suneel , Shah Syed Zulfiquar Ali
Published: August 2021

…Objective: To determine the serum iron level in Helicobacter pylori infectedpatients. Patients and methods: This cross sectional descriptive study was conducted atLiaquat University Hospital (a tertiary care teaching hospital) Hyderabad from July 2013 toDecember 2013. All the patients with history of presented with acute abdominal pain, dyspepsia,bloating and epigastric discomfort were evaluated for Helicobacter pylori infection by serology.Thereafter the Helicobacter pylori positive individuals were further evaluated for serum ironlevel. The data was collected, saved and analyzed in SPSS version 11.00. Result: During sixmonth study period total one hundred patients of H. pylori infection was recruited, of whichsixty three (63%) were males and thirty seven were females. Sixty six (66%) patients belongedto urban areas while thirty four (34%) were rural population. The mean age ±SD for overallpopulation was 37.35±14.0 where as the mean age ±SD of male and female population was38.88±6.77 and 35.67±8.87 respectively. The serum iron was low in 68% Helicobacter pyloriinfected patients, of which 48 were males and 20 were females (p=0.02). The overall mean±SD for serum iron level in study population was 49.17±37.86 mmol/L whereas the mean ±SDof serum iron for male and female Helicobacter pylori infected population was 42.69±34.15and 60.18± 41.66 (p=0.03). Conclusions: An association was identified between Helicobacterpylori and iron deficiency
THE ROLE OF PUNJAB RURAL SUPPORT PROGRAMME IN PROVIDING HEALTH FACILITIES TO RURAL WOMEN;
Authors: Riaz Ayesha , Muhammad Sher , Ashraf Ijaz , Siddique Aisha , Mahmood Ch Khalid
Published: August 2021

Despite the fact that women account for more than half of the total worldpopulation, they are still not considered equal to men. The health of rural women in Pakistanis very poor because of the lack of health services and competent health workers. Besidesgovernment health centres, hospitals and many Non-Governmental Organizations (NGOs)are also working in the rural areas for providing social services to rural women. Punjab RuralSupport Programme is also working for socio-economic empowerment of rural women. PRSPbegan to provide health facilities to the poor people in villages through Basic Health Units(BHUs). Objectives: To analyze the role of PRSP in providing health facilities to women in ruralarea. Design: A multistage simple random sampling technique was used for the study. Setting:District Faisalabad. Material & Methods: The population for the study consisted of rural womenonly who were members of the Community Organizations (COs) of PRSP. Out of the eight townsof district Faisalabad, four towns which cover rural areas (Samundri, Iqbal town, Jaranwala,and Chak Jhumra) were selected. Four field units of PRSP are working in these four towns i.e.Salarwala in Chak Jhumra, Satiana in Jaranwala, Khidarwala in Samundri, and Dijkot in IqbalTown. These field units had 214, 203, 170 and 238 female COs, respectively. A sample of 10%COs was selected from each field unit randomly. Thus the total selected COs were 82. Fivemembers from each CO were selected at random. In this way the total sample size for the studywas 410 respondents. A reliable and validated data collection instrument consisting of openand close ended questions was used. The data were analyzed using SPSS. It was concludedthat respondents were satisfied with certain facilities like availability of female doctors in BHUs,availability of medicines and availability of competent and qualified paramedics. Provision ofbasic tests (blood, sugar, pregnancy and haemoglobin etc.) was very weak area which neededmuch improvement. Conclusions: It was also concluded that respondents were satisfied withthe behaviour of staff at BHUs. However, provision of basic medical equipment needed attentionfrom the authorities.
GESTATIONAL HYPERTENSION
Authors: Alam Kinza , Snover Ayesha , Navid Sarwat , Tasneem Shahida
Published: August 2021

… Objective: Aim of the study was to ascertain prospectively the prognostic value of serum uric acid for fetal and maternal outcomes in women with gestational hypertension. Patients and Methods: This prospective study was conducted at department of Gynae & Obs, Maternal and Child Health Center, PIMS Islamabad, from January to December 2003. A total of 200 women with a gestational age >20 weeks, and blood pressure >130/90 mmHg were inducted in the study. At presentation serum uric acid, creatinine, hemoglobin, and platelets were measured along with blood pressure. All patients were divided into group A (uric acid <4.5 mg/dl) and group B (>4.5 mg/dl) and were followed for one month after the delivery to record pregnancy and neonatal outcome. Results: A significant difference (p<0.05) in the levels of uric acid, hemoglobin, platelet count, creatinine and blood pressure was noted between patients of group A and B. A significant decrease (p<0.05) in preterm delivery, baby birth weight and increase in fetal mortality was noted in patients of group B as compared to those of group A. Regarding maternal outcome preeclampsia (p=0.005, CI: 0.143-0.689), deranged liver functions (p=0.000, CI: 0.062-0.397), and disseminated intravascular coagulation (p=0.005; CI: 0.049-0.626) was noted in patients of group B as compared to group A. The patients of Group B showed a significant low birth weight, increased fetal mortality rate (p=0.005, CI: 0.030-0.622) and more chances of shifting neonates to NICU (p=0.002, CI: 0.164-0.667) as compared to those of group A. Conclusions: Hyperuricaemia in setting of gestational hypertension was associated with adverse fetal and maternal outcome.
LABOUR INDUCTION;
Authors: Ameen Samar
Published: August 2021

Objective: To compare the efficacy of misoprostol 50ug (sublingual) incomparison with oxytocin infusion than for induction of labour in cases of PROM (prematurerupture of membrane at term). Design: Prospective randomized study. Setting: Mujahid TrustHospital, Faisalabad. Duration: Conducted from Dec 2006 to April 2008. Methods: Womenwere randomized to receive either 50 microgram of sublingual misoprostol every 4 hours withRinger’s lactate solution or oxytocin infusion 10 lU in one litre of Lactated Ringer’s solution witha sublingual placebo. Main outcome measures: The number of women delivering vaginallywithin 24 hours of labour induction. Results: Fifty two women (83%) in misoprostol group and48 (77 %>) in oxytocin group delivered vaginally within 24 hours [relative risk (RR)1.1. However,the induction to vaginal delivery was significantly shorter in the misoprostol group 15+3.7 hourscompared with the oxytocin group 18+4.1. The incidence of tachysystole was more than threefolds higher in misoprostol than in the oxytocin group (14%) versus 4.3%) RR3.3) but this wasnot statistically significant. There was no significant difference in the incidence of hypertonusor hyperstimulation syndrome, mode of delivery intervention for fetal distress or neonataloutcomes between the two groups. Conclusions: The group of women received misoprostolfor labour induction were found more successful in achieving vaginal delivery in comparativelyshorter time and more acceptable to patients. Further studies on safety with large numbers ofwomen need to be conducted before routine use.
POLIO VACCINATION;
Authors: Mehmood Khalid , Hashmi Inaam Qadir Javed , Rashid Asif Zaman , Bashir Riaz Anwar , Khosa Zubair Ahmed , Khalid Shizza , Hashmi Khadeeja Tul Kubra
Published: August 2021

Objective: To assess knowledge, attitude and practice (KAP) about poliomyelitis(polio) vaccination in District Abbottabad, province Khyber Pakhtunkhwa (KPK), Pakistan,to identify reasons of failure of polio vaccination/ eradication campaign and to makerecommendations in the light of the study. Setting: District Abbottabad, province KPK, Pakistanincluding both urban and rural areas. Period: Three months from 1st June to 31st August2012. Methods: This cross-sectional descriptive explorative study was conducted in DistrictAbbottabad, of province KPK, Pakistan. A structured questionnaire was submitted to people inthe urban and rural population using convenient sampling. Out of 200, only 142 questionnaireswere filled by interviewing parents and guardians of the children followed by focused groupdiscussions with the community heads and the parents of the children. Results: Majority(61.78%) of respondents were of low income category with the mean age of 31 years. Amongstthose (75%) were earning Rs.7,000-12,000 per month. Literacy rate was low with 45.77%. Outof which 40.67% fathers and 59.33% mothers were illiterate. Therefore a few respondentswere aware about the mode of transmission of polio. Majority (80%) said that polio could beprevented by polio drops and about 86% said that this vaccine had no side effects. About45% respondents refused to cooperate with polio teams, and 28% respondents believed, thatAbbottabad Operation had bad effect on anti-polio campaign. Regarding the use of boileddrinking water, 95.8% respondents knew that it was good for health. While only 4.20% were usingboiled water for drinking. Advice of the health professionals (69.71%) and other family members(7.74%) was respected in making health care decisions, therefore it was an opportunity forthe government to involve these persons as well as media men in conveying message to thecommunity to achieve ultimate goal of polio free Pakistan. Conclusions: Unawareness amongthe population of District Abbottabad, especially the knowledge about the disease, mode oftransmission and its prevention are the most deficient areas. Secondly misconceptions aboutthe nature of polio drops, and religious misinterpretations in masses, created by general publicand religious leaders, are the major obstacles in the real success of vaccination campaign.
HIV INFECTION;
Authors: Mansoor Shehzad Adil , Muazzam Muhammad , Hasan Imam Humayun Suqrat
Published: August 2021

Background: Human immune deficiency virus ( HIV) infection was a major healthproblem all over the world. The infection had become pandemic and no country was immune.The main burden of disease was shared by developing countries and their crippled economieswere unable to deal with it. As a result the number of HIV patients were increasing day by day.Treatment was expensive and preventive measures were not effective. The intravenous drugusers (IDUs) were major contributors in its spread. Objectives: To assess the prevalence ofHIV infection by determining the frequency of HIV infection in intravenous drug users. StudyDesign: Cross-sectional study. Place and duration of study: Rehabilitation center for IDU,sin District Headquarter Hospital Faisalabad (DHQ), a Tertiary Care Hospital, Affiliated withPunjab Medical College during Jan.2013 to Dec.2013. Subjects and Methods: All I. V. drugusers attending the rehabilitation center of D.H.Q. hospital were included in the study. All weresubjected to be screened for HIV/AIDS infection. Total 352 patients attended the center. Eachpatient was given a code number to hide the identity and results of tests were kept secret.The blood samples were collected and labeled with respected code on it. Results: Total 352intravenous drug users were enrolled at rehabilitation center and 96 were tested positive forHIV infection. Another 62 belonged to urban area and 34 belonged to rural area. About 80were living with their families and 16 were living out of their families. The 78% were not havingsufficient earnings for their living. Conclusions: Intravenous drug users were threat to publichealth in transmitting HIV infection by sharing needles.
NATURAL SEXUAL OFFENCES;
Authors: Arif Mariam , Ahmed Mushtaq , Hanif Farah
Published: August 2021

Introduction: Globally, rape of women is a serious health, social and religiousconcern and is considered as a violation of women basic human right. Objective: The aim wasto ascertain incidence of natural sexual offence (rape) in Punjab and to analyze the data withrespect to sociodemographic characteristics, findings of medicolegal examination and resultsof evidence collected from victims of sexual assault. Material and Method: This retrospectivestudy was conducted on 148 female victims of rape brought to Forensic Medicine Departmentof King Edward Medical University Lahore, Fatima Jinnah Medical College Lahore and NishtarMedical College, Multan from January 2012 to December 2013 for medicolegal examination.Details pertaining to socio-demographic profile of the victim, incident, findings of medicalexamination and results of evidence collected were noted. Data was analyzed using SPSSversion 20. Result: The most affected age group was 11-20 years (60.8 %). Majority of victimswere unmarried (70.9%), non- working (79.72%) and of lower socioeconomic class (71.6%) Allwere Muslims (100%). The highest number of victims was examined on the second day (24.3%).31% cases were of gang rape. Majority knew the assailant (45.9%). The commonest place ofoffence was an isolated place (66.2%) Extragenital injuries were seen in 10.8% cases. Hymenwas intact in 3.3% victims. The tears of hymen were old in 77.6% and fresh in 22.3% cases.Semen was detected in 18.2% cases. 1.3% victims were pregnant and 4% were intoxicated.Conclusions: The study highlights the importance of addressing rape as an important healthissue.
MYOCARDIAL DAMAGEq
Authors: Raza Baig Mirza Ahmad , Iqbal Usman Javed , Murtaza Sher-E- , Ahmed Nosheen
Published: August 2021

Background: Intermittent antegrade warm blood cardioplegia is routinely usedas a mean of myocardial protection since its introduction. There is a considerable debate onthe longest time off cardioplegia interval during aortic cross clamping. Objective: To see thefrequency and extent of myocardial damage in patients undergoing CABG receiving intermittentantegrade warm blood Cardioplegia at LTOC (longest time off cardioplegia) 11-15 minutes(Group I) and 16-20 minutes (Group II). Patients and Methods: A randomized prospectivestudy involving 94 patients was arranged to see the safe periods of intermittency. There weretwo groups of patients having LTOC of 11-15 minutes (Group I) and 16-20 minutes (GroupII). 20 minutes was the upper limit. The duration of study was from 1-09-2013 to 10-02-2014.Data was analyzed using SPSS Version 16. Independent sample t-test and chi-square wereapplied to see the significance. Results: Mean age was 54.1±9.36 years. There were moremales as compared to females. More than 50% of the patients had Hypertension and Diabetes.There was no urgent surgery. Triple vessel disease (TVD) was present in 48.9% patients and40.4% had Double vessel disease (DVD). Average blood flow during CPB was 2.4±0.14 (L/min.m-2). Average body temperatures were 31.7±2.30C. Cardioplegia temperature was 36-370C.According to Left Ventricular Function Classification, 43.6% of the patients were of LV grade IIand 10.6% of LV grade III. There was no significant increase in the levels of CK-MB in two groups.77.8% patient in Group I and 66.7% in Group II gained spontaneous rhythm (p-value 0.16). IABPwas inserted in 5.4% patients in group I and 5.6% in group II (p-value 0.97). There was no failureto wean off from bypass and no peri-operative mortality. The levels of inotropes viz dopamineand epinephrine on weaning were also almost the same. Perioperative MI occurred only in 7patients (ruled out by biochemical evidence). Conclusions: A reasonable margin of safetyexists with intermittent antegrade warm blood cardioplegia in these two groups. So the LTOC(longest time off cardioplegia) up to 20 minutes is unlikely to lead to adverse clinical outcomesand is clinically acceptable.
REPRODUCTIVE CONTROL!;
Authors: Yasir Saadia , Iqbal Muhammad Zafar , Hamid Beenish Samreen
Published: August 2021

The aim of this study was to assess the frequency of various forms of in-lawperpetuated reproductive control asserted on the female and any possible factor such aseducation level or early age of marriage which might be responsible for it as various studieshave demonstrated that violence against women has been documented to be perpetuatednot only by male partners but also by the family members of male partners. This multi-centriccross sectional observational study was carried out on 424 consecutive patients in 6 hospitals.The mean age (+ S.D) was 33.7+7.8 years and age of marriage (+S.D) was 21.3+2.8years.116(27.4%) were uneducated, 142(33.5%) had obtained education till primary level,124(29.2%) had secondary education and 42(9.9%) had higher level of education. Upon askingabout any life time in-law perpetuated reproductive control 205 (48.3%) of the females answeredone or more than question as yes and 142 (33.5%) of the participating females said that thein-laws advised their husbands to go for a second marriage if they did not become pregnant.The more uneducated the participants of the study were, more abuse was faced at the handsof her in-laws (p-value <0.005). The most common form of reproductive control asserted bythe in-laws was telling the husband to go for a second marriage if the female did not becomepregnant and this was most commonly seen in the less educated females (p-value <0.005).Inconclusion increased efforts are needed to involve the in-laws in programs that seek to improvewomen’s reproductive health.
ILEO-COLIC INTUSSUSCEPTION;
Authors: Hasnain Muhammad Ali Zul , Khalid Malik Muhammad , Haq Irfan-Ul-
Published: August 2021

Objective: To evaluate the success rate of hydrostatic reduction of intussusceptionand incidence of complications in late presenting cases. Study Design: prospective study.Place and duration of study: Study was carried out in Armed Forces Institute of Radiologyand Imaging Rawalpindi and different Combine Military Hospitals during last 5 years. Materialsand Methods: All the children up to 2 years age with diagnosis of ileo-colic intussusceptionand 3 days or less history of onset of symptoms were included in the study. Patients with signsof perforation, suspicion of lead point or long intussusceptum protruding through rectum wereexcluded. After plain film evaluation, thin barium was instilled through Foleys catheter underfluoroscopic guidance. Rule of 3 was followed and reduction was considered successful whencontrast refluxed into terminal ileal segment. Follow up plain x-ray and ultrasound was doneafter 48 hours to rule out recurrence. Results: Hydrostatic reduction was successful in 18 outof 21 patients collected during last five years. Reduction was incomplete in one case whileperforation was observed in 2 cases. These complications were observed in the largest group(52%) of patients reporting on 3rd day of onset of symptoms. A significant number (38%) ofpatients reached the hospital within 48 hours. Only 2 (10%) patients presented in first 24 hrsbut uneventful reduction was possible in later two groups. Conclusions: Careful hydrostaticreduction in cases of ileo-colic intussusception reporting within 72 hrs will reduce hospital stayand patient morbidity in most of the cases.
TYPE 2 DIABETES MELLITUS;
Authors: Malik Jamil A. , Mumtaz Tuba , Haider Samsaam Ali
Published: August 2021

Objectives: The study is aimed to assess emotional problem of patients with Type2diabetes by translating and validating PAID. Associations between PAID and blood glucoselevels, and differences in prevalence of emotional problems across treatment modalities andBMI. Data Sources: Data was collected from various outpatients of Rawalpindi and Islamabad.Sample and Procedure: The sample of study comprised of 300 patients with diabetes bothmale = 135 (45%) and female n=165 (55%). Formal approval was taken from authorities atrespective hospitals and after taking informed consent patients were interviewed. Period:Data collection was completed during Feb to April, 2013. Material and Method: Patients wereasked to fill in demographic sheet along with Translated PAID scale. Latest blood glucose levelswere collected from their medical records whereas BMI was calculated by measuring patients’weight and height. Results: Results showed that emotional problems as assessed by PAID arepositively correlated with blood glucose levels (r=.12 to r=.19, p<.05). Additionally, patientswith IV modality of treatment (i.e., taking insulin shots) suffered significantly high (MD=4.88,p=.01) from emotional problems and patients with normal BMI and Obese Class-II have are athigher risk of emotional problem. Finally, patients rated serious concerns on diabetes-relatedissues like lifelong maintenance, future complications, depression and anxiety, and satisfactionwith physician. Conclusions: PAID is a very effective instrument in identifying emotionalproblems of diabetes patients related to adherence and compliance to their treatment regimeand hence it shall be used by physicians and health professional in routine practice.
FEMORAL NECK FRACTURE;
Authors: Laghari Muhammad Ayub , Pahore Muhammad Khan , Maher Imran Khan , Arain Muhammad Saeed
Published: August 2021

Objective: Objective of this study determines the outcome of unipolarhemiarthoplasty in elderly patients with femoral neck fracture at Liaquat University HospitalHyderabad/ Jamshoro. Materials and methods: Total 50 elderly patients were included in thestudy with femoral neck fracture and all the cases were selected from accident, emergency andOPD. All the patients with the history of pregnancy, those patients who were unfit for anesthesia,malignancy, neurological deficits of lower extremity, rheumatoid arthritis and Parkinson’sdisease regarding with systemically disease were excluded from the study. All the patientsunder went surgical hemiarthoplasty treatment with Austin moor-femoral head prosthesia. In thelast all postoperative complications, functional outcome and mortality were noted on proforma.Results: Total 50 patients were included in the study. Mean age of this study was mean±SD64.98±4.13. Females were found in majority with male/ female ratio 1:1.27. Post operative painwas noted in the 50% of the cases and out of them severe pain was noted only in 4% of thecases. Superficial infection was seen in 4% of the cases and deep infection was not found inthe cases and death was occurred in 10% of the patients. On the outcome, excellent resultswere found in the 44.44% of the study participants, good and fair results were seen in 26.66%and 20% respectively, while poor results were seen in 8.88% of the patients. Conclusions: Itis concluded that unipolar hemiarthoplasty is of the reliable procedure by use of Austin-moorfemoral head prosthesia for the treatment of femoral neck fracture in elderly.
PREVALENCE OF RENAL CALCULI;
Authors: Ahmad Shafiq , Ansari Tariq Mahmood , Aslam Shad Muhammad
Published: August 2021

Renal calculus is a hard mass. It is formed from the crystals that aggregate onthe inner surfaces of the kidney. Small crystals flow to the urinary tract and pass out of the bodyspontaneously along with urine without being noticed. Objectives: The purpose of the presentstudy is to find the type; age and gender related prevalence of the renal calculus disease inSouthern Punjab Pakistan. Study design: The study design is retrospective. Period: Two yearfrom June 2009 to June 2011. Materials and Methods: In this work, 1176 samples of renalcalculi from both male and female patients of the southern Punjab, Pakistan, were collected.Semiquantitative analysis of the renal calculi was carried out using Merckogonost Reagent Kit.Results: Highest prevalence of the renal calculus disease was in the age group 40-49 in malesand in the age group 30-39 in females. The disease was more common in males than females.Calcium oxalate was the predominant renal stone.
LOW GRADE UROTHELIAL CARCINOMA
Authors: Khan Amjad Ali , Shaheed Asghar Dr. Abdul , Ishaq Muhammad , Akhund Israr Ahmed
Published: August 2021

Objectives: Urine cytology is an easy to perform non-invasive screening test forpatients who are suspected of having urinary tract malignancy. Urothelial carcinoma constitutesapproximately 90% of all primary tumors of urinary bladder.1 High-grade urothelial carcinomasare represented by well characterized cytological features. Whereas cytological features forlow-grade urothelial carcinomas show considerable overlap with features secondary to chronicinflammation, calculi, indwelling catheters or effects of intra-vesical chemotherapy.2 Thepurpose of this study is to find an appropriate set of cytological features of shed urothelial cellsthat will be useful to differentiate low-grade urothelial carcinoma cells from atypical urothelialcells secondary to non-neoplastic conditions. Study Design: Retrospective study. Setting:Charsada Teaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 2010to 2015. Methods: All cases of urine and bladder washing cytology were retrieved for threediagnostic categories namely: low-grade urothelial carcinoma (LGUC), high-grade urothelialcarcinoma (HGUC), and “atypical urothelial cells”; for which histological diagnoses were alsoavailable. These cases were reviewed for cell clusters with smooth or irregular communityborders, cytoplasm texture, nucleomegaly, high nucleus to cytoplasm ratios (N/C ratio),presence of nucleoli, nuclear membrane irregularity, and chromatin texture. Results: Cellclusters with smooth borders were common in reactive changes, whereas irregular communityborders were seen in low-grade urothelial carcinomas and dyscohesive pattern was a featureof HGUC. The increase in N/C ratio ›2:1 was always associated with malignancy. The nuclearmembrane irregularity was also a strong indicator of malignancy. Cytoplasmic homogeneityand nuclear hyperchromasia were more prominent and consistently seen in high-gradeurothelial carcinomas. Conclusions: The study showed that nuclear membrane irregularity,nucleomegaly and high N/C ratio of › 2:1 were the most consistent features found in LGUC.These features can be used with high certainty to differentiate LGUC (malignant) from atypicalurothelial cells (non-neoplastic).
BLOOD DONATION;
Authors: Saqlain Nazish , Ahmed Nisar , Ahmed Aatika , Hareem Sidra
Published: August 2021

The participation of women in blood donation process has been scarce equallyin low & high resourced countries. Every year 3.5 million blood donations are collected inPakistan with very little percentage of females donating blood. Objective: The objective of thestudy was to assess the knowledge, attitude and beliefs of female attendants accompanyingthe patients. Study Design: Cross-sectional study. Setting: The Children’s Hospital & Instituteof Child Health, Lahore, regarding blood donation. Period: 1st June to 31st December, 2015.Material & Methods: 306 females of age 16-50 years accompanying a patient in the hospitalwere randomly selected. After taking informed consent, a self-designed questionnaire validatedby Kappa Statistics program was distributed to the participants. Data was analyzed by usingSPSS 22. Results: The mean age of female attendants was 29.57 years. 31.7% had neverreceived any education. Only 12.7% had donated blood before. 93.8% had the idea that ablood transfusion is a lifesaving procedure but only half of them knew the common bloodgroups. 87.3% knew that both males and females can donate blood but 75.5% thought thatmales are better donors than females. There was a lack of knowledge about certain importantfacts including transfusion transmissible infections, donation frequency, duration and volumeof blood collected during a single session. Majority females were of the view that they are toofragile to donate blood and severe and prolonged anemia can develop after donating blood.Conclusion: There is a need to develop effective interventions for the education & motivationof potential female donors towards blood donation in order to increase the donor turnover rate.
ISONIAZID INDUCED LIVER DAMAGE
Authors: Ahsan Naveed , Jahan Sarwat , Imran Sana , Ahsan Naveed
Published: August 2021

Objectives: To observe healthy effects of silymarin on liver histopathology againstliver damage, caused by isoniazid in rabbits. Study Design: Interventional study. Setting:Animal House of Jinnah Postgraduate Medical Centre, Karachi. Period: April to September2013. Methods: Total 28 rabbits of weight 1-1.5kg of either sex were used in this study. Whichwere divided randomly into four equal groups: Group I was control group. In group II silymarin(50mg/kg/day orally) was administered, in group III isoniazid (50mg/kg/dayorally) was given;and in group IV, effects of combination therapy of isoniazid and silymarin were observed. Beforestarting the drug therapy, at day 0 and one day after the end of study period i.e., at day 19, bodyweight of each animal was recorded. Rabbits were sacrificed on 19th day and the required liversample was taken for histopathological examination. The data feeding and analysis at the endof study was done on computer package SPSS (Statistical packages of social science) version16. Results: No mortality was recorded in any group. In group II (silymarin treated) animals inthis group exhibited no any histological changes in the hepatic lobule except few inflammatorycells 28.5% were seen in the portal tract. The liver microscopic examination in group III(Isoniazid treated), animals showed the disturbed architecture of the lobule. There were no fattychanges, whereas ballooning degeneration was 42.9%, hepatocytes necrosis was 71% andportal inflammation was 71.4% which was very severe. Animals in group IV, given combinationof silymarin and isoniazid showed the intact architecture of the hepatic lobule, in which 14.29%ballooning degeneration, whereas necrosis of hepatocytes and portal inflammation was mildin nature which may be due to hepatoprotective role of silymarin. Conclusion: Silymarin hashepatoprotective effects when given in combination with isoniazid.
ECTOPIC PREGNANCY
Authors: Khaliq Khan Fareeha , Iqbal Rubina , - Zaibunnisa
Published: August 2021

Introduction: Medical treatment is the first step in the treatment of ectopicpregnancy (EP) now days. Medical treatment with Methotrexate for EP is safe and effectivemethod without the risks associated with the surgical procedure. Objectives: To determine thesuccess rate of single dose of Methotrexate for medical management of females presentingwith EP. Study Design: Quasi trial study. Setting: Department of Obstetrics & Gynaecology,Fatima Memorial hospital, Lahore. Period: 1 year from September 2014 till August 2015.Material & Methods: Study design was prospective descriptive case series in which a totalof 140 women, age 20-45 years of any parity with confirmed EP, were included. Females wereprescribed Methotrexate 50mg/m2, as a single dose. β-HCG level was measured again at 7thday. If β-HCG was decreased by >15% of baseline levels and decrease in the size of masson USG, then success was labeled. Data was entered and analyzed using computer programSPSS version 20. Results: Mean age of women in this study was 32.38±6.34 years. At 3rd daypost-treatment day, mean level of β-HCG was 2019.51 ± 293.39 and at 7th day, mean β-HCGlevel was 1127.44 ± 403.78. At 7th day, there were 125(89.3%) patients whose β-HCG level wasdecreased by >15% and success was labelled. Conclusion: Based on findings of this study itcan be concluded that Methotrexate can be used as first line management protocol for EP as itwas successful in a high percentage of patients.
ACUTE MYOCARDIAL INFARCTION
Authors: Brohi Gul Hassan , Memon Shahzeb Rasool , Shahani Muhammad Yaqoob , Memon Samreen , Bano Umbreen
Published: August 2021

Objectives: To evaluate the effects of aspiration thrombectomy (AT) using anAspiration Catheter (INVATEC SPA DIVER C.E. MAX, Italy) in patients with acute myocardialinfarction (AMI). Study Design: Cross sectional and Case series study. Setting: Departmentof Cardiology, Liaquat University Hospital, Hyderabad. Period: January 2012 to December2013. Methodology and Results: Measurement of left ventricular ejection fraction (LVEF) byechocardiography was obtained before (acute LVEF) percutaneous coronary intervention (PCI)and 1 week after (late LVEF) the procedure. Most of the patients with full restoration of STsegment elevation following PCI were higher in the aspiration Catheter control group (90 vs68%, P < 0.01), (86 vs 62%, P < 0.01) and (90 vs 64%, P < 0.01) respectively. Minimal changein LVEF was observed in patients between the Aspiration Catheter group and control group at1 week post procedure. Conclusion: Combination of AT using Aspiration Catheter (INVATECSPA DIVER C.E. MAX) with primary stenting can better outcome, while left ventricle (LV) functionhad subtle change in AMI when compared to primary stenting after balloon predilation withoutthrombectomy.
NASAL POLYPS;
Authors: Salam Farhan , Arslan Damish , Qureshi Muhammad Salman Haider , Ahmad Ejaz
Published: August 2021

Introduction: Functional Endoscopic Sinus Surgery (FESS) is now undoubtedlythe procedure of choice for surgical treatment of chronic sinusitis and nasal polyposis afterfailure of medical treatment. In order to present the formation of synechie nasal packing isperformed. Moreover, it also helps in supporting the process of wound healing and preventionof postoperative bleeding. Objectives: To determine the frequency of synechiae formation afterfunctional endoscopic sinus surgery (FESS) in patients presenting with nasal polyps. StudyDesign: Descriptive case series. Setting: Department of Otorhinolaryngology at ServicesHospital Lahore. Period: Six months from 03-10-2013 to 02-04-2014. Methodology: A total of150 cases were included in this study. Patients were treated by functional endoscopic sinussurgery (FESS) and were followed at the end of 1st, 2nd, 3rd and 4th week postoperatively forthe development of synechiae (as per operational definition). Results: The age of majority ofpatients was from 20 to 40 years and minimum patients were < 20 years old. Mean age of thepatients was 35.30±10.54 years. Male patients were 80 (53.3%) while female patients were 70(46.7%). Synechiae formation was observed in 28 patients (18.7%). Conclusion: Synechiaeformation was developed in 18.4% of the patients after functional endoscopic sinus surgery.
IDP’s;
Authors: Marwat Mohammad Imran , Ronis Katrina Amina , Khalil Kashif Ur Rehman
Published: August 2021

Objectives: This article attempts a systematic review of information from conflictareas globally and locally (Pakistan) to identify the gaps and challenges pertaining to the publichealth needs and assistance of IDPs. Study Design: Systemic Review. Setting: Department ofCommunity Medicine Khyber Medical College, Peshawar, Pakistan. Period: 8 months January2016 to august 2016. Material and Methods: A systematic review was undertaken usingvarious databases such as Google scholar, Cochrane library, Pub-Med, UNHCR and WorldHealth Organization Global Health library, global databases of Medline and Pakistan Medicaland Research Council library. Conclusion: In Pakistan, the internally displaced people livingin camp settings remain susceptible to poor health and disease outbreaks. Although someassistance is provided by the government but keeping in mind the alarming situation muchmore coordinated and synchronized efforts is required to fulfil the gaps in health needs, skilledworkforce, infrastructure and supplies.