bluuebunny/crossref_metadata_2025 huggingface dataset:
Importance of Magnesium Sulphate in Improvement of GCS Score after Severe Traumatic Brain Injury
Authors: Khan Rehmani Muhammad Asim , Ghouri Shiraz Ahmed , Zulfiqar Farrukh , Ali Muhammad Faaiq , Zeeshan Qazi Muhammad , Kumar Ramesh
Published: April 2022

Background: Grounded on a series of studies, magnesium Sulphate (MgSO4) administered after extensive axonal damage has emerged as a valuable neuroprotective mediator. This study was held to investigate whether magnesium Sulphate had therapeutic safety and efficacy in patients with severe diffuse axonal injury and its effect on improving GCS scoring. Methods: This double-blind, randomized and placebo-controlled clinical trial study was held from October 2020 to September 2021, patients with severe extensive damage to the axons were studied who presented to the Neurosurgery emergency of tertiary care hospital, and written knowledgeable permission was taken from all subjects. 42 patients who met the eligibility criteria were randomly assigned to our study. Adult patients with severe diffuse axonal injury within the first hour of closed traumatic brain injury (TBI) and meeting eligibility conditions were divided randomly into 2 groups. The treatment regimens contained preliminary intravenous 50 mg / kg magnesium sulfate as loading dose within one hour of injury, followed by QID 50 mg / kg magnesium sulfate up to 24 hours post-injury. The results were mortality, GCS, and assessment of motor function up to two-months after injury. Results: Magnesium had a substantial optimistic impact on GCS after two-months (P = 0.04). The result of motor function improved more in the MgSO4 group than in the control group, but it was not statistically important (p = 0.52). Finally, it is concluded that direction of magnesium sulfate after severe DAI can play a neuroprotective role. Keywords: Magnesium sulfate; Severe diffuse axonal injury and results.
Efficiency of Intra-Articular Platelet-Rich Plasma Injection in Grade I and Grade II Osteoarthritis in the Knee Joints: A Longitudinal Study
Authors: Khawaja Khadim , Maher Imran Khan , Jatoi Zulfiqar Ali , Zaur Zulifqar Ali , Tago Imtiaz Ahmed , Peracha Muhammad Asif , Keerio Niaz Hussain
Published: April 2022

Aim: To assess the efficiency of intra-articular platelet-rich plasma (PRP) injection in grade I and grade II osteoarthritis in the knee joints Study design: A longitudinal study Place and Duration: This study was conducted at Murshid Hospital and Health Care Center Karachi Pakistan from January 2021 to June 2021. Methodology: The ages of the patients were between 35 years and 65 years. All the patients were diagnosed with osteoarthritis of grade I and grade II. A total of 3 injections of PRP were injected intraarticular in the knees at an interval of 4 weeks. Patients were asked to come for a follow-up in the outpatient department. They were assessed for physical mobility and pain related to arthritis using the WOMAC score. The assessment was done when the treatment was given and after 6 months. Results: A total of 250 patients were considered in the present study. The mean age of the patients was 55.63±5.65 years. The ratio of disease in females to males was 3:1. A total of 178 patients had grade I osteoarthritis and 72 patients had grade II osteoarthritis according to Kellgren–Lawrence classification. A total of 210 patients had reported experiencing symptoms for less than 2 years and the remaining 40 had been experiencing the symptoms for more than 2 years. The mean WOMAC score was 82.9 before the treatment was started and it was 39.15 after 6 months of the treatment. The improvement of WOMAC score was more in the patients having symptoms for less than 2 years. Minor hyperemia was seen in 4 patients and those patients were managed conservatively by ice application and activity limitation. None of the patients showed signs of infection. Conclusion: The intraarticular injection of PRP proved to be beneficial and effective in the treatment of grade I and grade II early osteoarthritis. Keywords: Osteoarthritis, Platelet-rich plasma, PRP, knee joint
Incidence of Surgical Site Infections and its Associated Factors: A Cross Sectional Study
Authors: Saeed Sadaf , Amin Sara Muhammad , Ahmed Irshad , Nisa Zaib Un , Bashir Jamshed , Anwar Muhammad
Published: April 2022

Aim: To determine the incidence of surgical site infections and its associated factors Study design: Cross sectional study Place and duration: This study was conducted at Bolan Medical Complex Hospital Quetta Pakistan from January 2020 to February 2021. Methodology: Patients who underwent general surgical procedures were included in the study. Pus or purulent discharge from the incision, together with pain, any two cardinal symptoms of inflammation were used to assess surgical site infections. For data entry and analysis, SPSS version 21 was utilized. A P-value of less than 0.05 was considered statistically significant. Results: Following the operation, 240 people were included in the current study. The average age of the study participants was 39.33 ± 2.74 years. Infections at the surgical site were found in 9.16 % (n=22) of the patients. As participants' age increases, the surgical site infection rate rises significantly. Diabetes was found to be substantially linked to surgical site infection (P < 0.001). According to wound categorization, infection rates were higher in filthy wounds, 22.22 % versus clean wounds, 3.57%, and this difference was statistically significant (P<0.0001). Conclusion: In this study, 9.16% patients were diagnosed with surgery site infection. Age, diabetes, type, duration of surgery, kind of wound, hospital stay and presence of drain were all risk factors for surgery site infection. Keywords: Diabetes, Infection, Surgical Site infections, operation
To Compare the Efficacy of Nifedipine and Tamsulosin 0.4 mg in Expulsion of Lower Ureteric Stones
Authors: Ahmed Mhammad Zahid , Ahmed Nauman , Asif Muhammad , Shahid Muhammad Waqar , Channa Aftab Ahmed , Cheema Naeem Ahmed
Published: April 2022

Objective: To compare the effectiveness of nifedipine and tamsulosin for expulsion lower ureteral stones with size ranging from 4mm-11mm. Study Design: A Randomized controlled trial. Methods: The study was held over a 2-year duration from January 2018 to December 2019 in the Urology department of Islam Medical College/ Teaching hospital Sialkot and Govt. Kot Khawaja Saeed Teaching Hospital Lahore. 72 total patients, 37 patients in each group, were selected for the study. The patients in A group were treated with alpha-1-blocker alone (tamsulosin), patients in B group were treated with calcium channel blockers (nifedipine 30-mg). Data on stone size, transit time, stone removal rate and control of pain were analyzed and collected. The mean ± SD of continuous variables was used to determine the percentage and frequency of categorical variables. The student’s t-test and Chi-square test were applied to compare numerical and categorical variables, correspondingly. Results: 72 total patients were involved and 36 patients in each group were analyzed after randomization. The patients mean age in A group was 36.40 ± 6.98 years, and in B group it was 38.01 ± 9.40 years correspondingly (p 0.76). The mean size of stone was 6.40 ± 1.82 mm in group A and in group B it was 6.51 ± 1.69 mm (p 0.80). Mean time of expulsion in A group was 8.40 ± 2.41 days and for group B; it was 6.71 ± 2.33 days (p <0.001). Patients receiving tamsulosin endured suggestively fewer attacks of pain related with patients receiving nifedipine treatment (p 0.017). Conclusion: The tamsulosin is safe treatment for appropriately sized lower ureteral stones as compared to nifedipine. The tamsulosin monotherapy have clear advantage over nifedipine but more detailed school studies are needed for efficacy and safety. Keywords: Tamsulosin, ureter, nifedipine.
Quality of Life (Psychosocial Domain) of Adolescents with Acute Lymphocytic Leukemia Undergoing Chemotherapy at Hematology Center in Medical City
Authors: Mohammed Asmahan.Q. , Hatab Khatam.M.
Published: April 2022

Background: Measurement of Quality of Life (QoL) in adolescents with acute lymphocytic leukemia and their families is to be an essential indicator of their well-being. Detecting children and families with an expected lower QoL and guiding health providers with focused treatments to enhance it will be aided by measuring multiple QoL aspects. Objectives: To assess the quality of life (psychosocial domain) of adolescents with acute lymphoblastic leukemia receiving chemotherapy. Methods: A descriptive study design was performed on adolescents with acute lymphoblastic leukemia aged 13 to 18 years. The study started from November 20, 2020 to January 1, 2022. A sample of 45 adolescents diagnosed with acute lymphoblastic leukemia who were receiving chemotherapy from a teaching hospital in Baghdad. The researchers adopted the study instrument (questionnaire) based on: Adopted quality of life scale from the world health organization scale (WHOQoL, 1995). Finding: there are significant relationships between quality of life (psychosocial domain) and socio-demographic characteristic of adolescents at p. value ≤ 0.05., except that residence and level of education are no significant relationship with the psychosocial domain. Conclusion: adolescent age from 13 to less than 18 years have moderate to low effects on psychosocial domain of the quality of life. Keyword: quality of life, adolescents with ALL undergoing chemotherapy.
The Effect of 8-Week Core Training on Running Based Anaerobic Sprint Ability of Footballers
Authors: Koçak Mehmet , Küçük Hamza , Albay Faruk , Taşdemir Dila Şeyda
Published: April 2022

Aim: The aim of this study was to examine the effects of 8-week core strength training on the repetitive sprinting ability, anaerobic power, body mass and fatigue indexes of football players. Methods: 15 male football players who play football regularly participated in the study. A core strength training program was applied to the research group using BOSU (Theraband, USA) elastic band (Theraband, USA). Before and after the study, the participants were analyzed with Tanita BC418 and their Body Mass Indexes (BMI) were taken. The height of the participants was measured with a stadiometer with a sensitivity of 0.01 cm. The data were analyzed using the SPSS 22 package program. Paired T Test was used for pre-test and post-test comparison between the two groups as the data showed normal distribution. Results: A high level of significant difference was found in the RAST and BMI values of the participants before and after the training when the averages were compared (p<0.05). A high level of significant difference was found in the Maximal Power and Fatigue Index values of the study participants when the pre- and post-training averages were compared (p<0.05). Conclusion: As a result, 8-week core exercises with Bosu and Tera tape improved the ability of repetitive sprinting, which is one of the important features of football players. As a result of the study, it can be said that the BMI level of the football players increases with the muscle mass developed as a result of core training. Keywords: Repeated Sprint, Fatigue İndex, Core Strength, Anaerobic Power, Maximal Power
Analyze the Effects of Fast Food on the Health of College Going Students
Authors: Abbas Saira , Naz Madiha , Ahmad Gillani Syed Muhammad , Afzal Saima , Jabeen Norina , Manzoor Adeela
Published: April 2022

Introduction: Fast food is a major part of our present life, due to some factors such as the style of life, value and the huge commercial advertisements, it has several effects on human health. Objectives: The basic purpose of this study was to identify the effects of fast food on the health of college-going students. Material and methods: Mixed method research is used for data collection. For qualitative data, 4 key informant interviews were conducted. For quantitative data, a descriptive research design was used and random sampling techniques were selected for sample size. The sample size consisted of 107 respondents. A guideline questionnaire was used for key informants as well as a well-structured questionnaire was used for the purpose of data collection. For analysis of qualitative data thematic analysis was used. Statistical packages for social sciences (SPSS) were used for quantitative data analysis. Results: The main effects of fast food on the health of college-going students like heart problems, obesity, fat, sugar and blood pressure. Majorities (91.6%) of the respondents have information about fast food and (8.4%) did not have any information about fast food disease. A majority (77.6%) of the respondents have information about the controlled use of fast food and 22.4% did not know it. Conclusion: Mass media should spread awareness among students about the side effects of fast food. So, it is a dire need of time to create awareness among the society at youngsters’ level and nutrition programs should be studied as well as the role of mass media should be changed for creating awareness regarding the effects of fast food. Keywords: Fast food, youngsters, Human health, Lifestyle, and Awareness.
Discussion on Modern Knowledge of Negative Impacts in Psychotherapy and Suggestions for Further Studies
Authors: Haider Quratulain , Shamrez Kashaf , Jalil Ansab , Bangulzai Attaullah , Khan Naseem , Gillani Syed Aqeel Akbar Shah
Published: April 2022

Aim: Psychotherapy has been shown to reduce mental suffering and enhance quality of care, but little is recognized around its possible adverse impact as well as how to determine their frequency. To introduce a discussion on modern knowledge of negative impacts in psychotherapy and suggestions for further studies directions. Methods: An unidentified survey should be sent to a small elite team of researchers, who were then evaluated using just a framework known as strengths, weak points, possibilities, and risks. Results: The scientists believe that there has been a growing understanding of detrimental consequences in psychotherapy in recent times, but they also explain a few of the unsettled problems pertaining their description, evaluation, and disclosing. Qualitative methods and naturalism styles are viewed as essential to undertake, spite of the fact that a number of barriers to would use such techniques have been recognized. Conclusion: Psychotherapy's adverse consequences are multidimensional, necessitating positively evaluates in order for them to be controlled and disclosed in study designs and routine procedures. Keywords: Mental Suffering, Enhance Quality of Care, Possible Adverse Impact, Negative Impacts in Psychotherapy.
COVID-19 Vaccine Acceptability in Dental Auxiliaries in Pakistan. are we Ready Yet
Authors: Sana Aleeza , Shakoor Asma , Shafique Hira , Jamil Yousaf , Hassan Hammad , Khan Aleshba Saba
Published: April 2022

Objective: This study provides evidence of the willingness among dental auxiliaries to vaccine acceptance. The data will help in awareness and control of spread of COVID-19. Methodology: This descriptive cross-sectional survey was conducted from February 2021 to April 2021. The sample size was kept at 385, with 95 % confidence and 5% margin of error, out of which 340 responded. The sample population was selected via convenience sampling technique. Dental auxiliaries practicing within Pakistan for more than two years within an age range of 20 to 64, were included in the study. Descriptive statistics were used to summarize the questionnaire's responses, with the results being presented as frequencies and percentages and level of significance was set at P ≤ 0.05. Results: 340 dental auxiliaries participated in the study. 62.4% were in age range 18-34 years. 72.6% were males and 27.4% females.90% participants were educated till grade 11 or above. 66.2% participants were not willing to get vaccinated and 5.3% were not sure if they want it or not. Participants of older age groups were more hesitant in receiving vaccine. Conclusion: The findings of this research show high hesitancy rates for receiving COVID-19 vaccine among dental auxiliaries in Pakistan. Efforts should be made to educate people on scientific evidence basis and social media sites spreading misinformation should be banned. Keywords: COVID-19, Vaccine, Willingness, Hesitancy, Dental Auxiliaries, Dental assistants
Perceptions of Medical and Dental Doctors on Dealing with ‘Google Informed Patients’
Authors: Anjum Abeer , Mustafa Remsha , Rana Sadia , , Malik Khizar Ansar , Ahmad Shakeel , Mahboob Usman , Fahim Ayesha
Published: April 2022

Objective: To explore the perceptions of the health professionals regarding internet health-seeking behaviour of patients and problems faced by recent medical and dental graduates. Methods: Eight General physicians and six dental surgeons from different regions of Sialkot and seven recent medical and dental graduates were selected via purposive sampling technique. Data was collected through semi-structured interviews over the phone with prior appointments. Manual qualitative thematic analysis was performed by transcribing the interviews and then codes, subthemes, and themes were generated. Results: Six themes and sixteen subthemes were identified depicting the perceptions of physician and problems faced by recent medical and dental graduates, namely: doctor-patient relationship enhanced (due to patients presenting better history, improved communication, and consultations in a healthy environment), Time saved in consultations (makes the task easier, informed patients are helpful and give better results), Threat to patient safety (self-medication, on-compliant to medicines and advices and understanding issues) difficult to counsel(information overload), Frustration (patients stick to conclusions, lack of understanding) and Professional disregard (as patients challenge physician authority, defamation, change their doctors, lack of trust) Conclusion: The theatrical increase of patients' access to internet health information has caused unpredictable quality impacts on the doctor-patient relationship. Future recommendations have been suggested to overcome the challenges faced by health professionals due to the online searching behaviour of patients and hence improving the health outcomes. Keywords: doctor-patient relationship; general physician; recent medical graduates; the internet informed patients.
Comparison of Ringer’s Lactate Versus 0.9% Normal Saline Solution in the Management of Diabetic Ketoacidosis
Authors: Sardar Jahan , Baqi Abdul , Nadeem Muhammad , Khan Medrarullah , Khan Kalim Ullah , Omar Sobiya Mohiuddin , Mumtaz Naheed
Published: April 2022

Background: Diabetic ketoacidosis (DKA) is a life-threatening diabetic condition characterized by metabolic and homeostatic disturbances. KDA is a common condition in people with diabetes, especially in children and adolescents Objective: To compare ringer’s lactate versus 0.9% normal saline solution in the management of diabetic ketoacidosis Methodology: The study design was randomized control trial carried out at the Medical ‘A’ ward Khyber teaching hospital (KTH) Peshawar for a period of six months after synopsis approval. Patients were divided into two groups, groups A, receive 0.9% normal saline infusion and group B receive ringers lactate infusion. 82 subjects were included in each group. SPSS software version 20 was used for analyzing data. Results: In group B subjects, the serum bicarbonates level was higher than group A subjects (p=0.091). The Anion gap and blood PH level increases non-significantly in both the groups over a period of time (p=0.061). The mean hospital stay in group A and group B was 13.11 hours and 11.5 hours respectively (p=0.0031). The fluid quantity required in group A was more than group B (p=0.0031) Conclusion: When prescribing fluid, clinicians should always be cautious since any fluid may be dangerous if dosed wrongly. The ringer’s lactate was shown to be superior to 0.9 % normal saline in terms of alleviating DKA quicker in our study. Keywords: Diabetic ketoacidosis; 0.9 % normal saline; ringer’s lactate
Effectiveness of Motor Imagery Training to Improve Gait Abilities of Patients with Sub-Acute Stroke
Authors: Anwar Sumreen , Fayyaz Muhammad Usman , Saleem Sumbal , Imran Abdullah , Noman Hina , Shah Syed Saqib Ali
Published: April 2022

Aim: To determine the effectiveness of motor imagery training to improve the lower extremity function and gait in subjects with sub-acute stroke. Methods: Forty four patients with subacute stroke with gait impairment were randomly assigned to one of two groups: motor imagery training group or muscle relaxation group. At the beginning and after six weeks of therapy, the ability to use motor imagery and lower limb performance were assessed. Results: There were substantial differences of scores between both groups, with the motor imagery group progressing more than the muscle relaxation group. Conclusion: Motor imagery may have a beneficial and effective task-specific effect on gait function in sub-acute stroke patients. Keywords: motor imagery; gait rehabilitation; sub-acute stroke patients
Prevalence and Severity of Steatosis in Chronic Hepatitis C patients
Authors: Zahid Pir Muhammad , Shah Farman Ullah , Ullah Najeeb , Hanif Mohammad , Khalid Rabia , Khan Muhammad Ibrahim , Omar Sobiya Mohiuddin
Published: April 2022

Background: Hepatitis C virus infection is a worldwide health issue. The rise in the prevalence of steatosis may be attributed to alterations in eating patterns, changes in the nutritional content of food, and changes in lifestyle, such as decreased physical activity and high sedentary lifestyle, as well as etio-pathogenic variables that influence individuals from infancy. Objective: To determine prevalence and severity of steatosis in chronic hepatitis C patients Methodology: The current study was cross sectional study piloted at the Gastroenterology Department, Hayatabad Medical Complex, Peshawar. The duration of study was six months after synopsis approval from August 2021 to January 2022. Totally 200 patients fulfilling the inclusion criteria were included in our study. Under aseptic conditions, a liver biopsy was done using an 18G lumbar puncture needle. All the Data analysis was done by using IBM SPSS version 24. Results: The overall frequency of steatosis was 80 (40%). On the basis of degree of steatosis, mild steatosis was observed in 53 (58.89%) subjects, moderate steatosis in 31 (34.44%) patients while severe steatosis was observed in 6 (6.67%) subjects. Conclusion: Our study concludes that steatosis is a common histological characteristic in patients with chronic hepatitis C virus infection. Steatosis is more prevalent in female patients than males. Study based on large sample size is recommended to get better findings. Keywords: Prevalence; Severity; Steatosis; Hepatitis C
Item Analysis of Multiple Choice Questions of Anatomy at Aziz Fatimah Medical and Dental College, Faisalabad
Authors: Rehman Quddus Ur , Humayun Farhat , Shah M Adeel Alam , Ghani Sajjad , Afzal Kamran , Humayun Rifat
Published: April 2022

Objective: The aim of our study was to evaluate MCQs in send up exam of 2nd year MBBS. To discard or change poor items with low discriminatory index, very easy and very difficult items and items with more than one non functional distracters. Study design: The cross-sectional study. Place: Department of Anatomy, Aziz Fatimah Medical and Dental College. Faisalabad. Duration of study: One month (December 2021) Methodology: Total 45 MCQs for the subject of Anatomy were constructed for 100 students of 2nd year MBBS send up Examination 2021. The MCQs consisted of one statement with four distractor & one correct option. Data of MCQs attempted by the students was analyzed by using Microsoft Excel 2010. The difficulty index, discrimination index and distractor efficiency were the parameters used for analysis. Results: Total 180 distractors were evaluated. The average number for difficulty index was 55.57 while that for discrimination index was 0.44. Out of 180 distractors, 41 nonfunctional distractors were seen in 26 items. Conclusion: Most MCQs fall within an average to easy difficulty index level i.e. 30 out of 45 MCQs. Most MCQs fulfill the criteria of very good discrimination index i.e. 27 out of 45. Most MCQs have either nil, or one or two non-functional distractors. i.e. 43 out of 45. Key Words: MCQs, Difficulty index, Nonfunctional distractors, Discrimination index, Distractor efficiency.
Students’ and Faculty Perspective about the Challenges in Feedback Process in an Outcome Based Education System
Authors: Zeb Nida Gulzar , Afzal Kamran , Almas Ayesha , Kulsum Syeda Nazia , Hareedy Hemmat H.G. , Abdallah Sawsan Mustafa , Sami Waqas
Published: April 2022

Background: Effective Feedback process is the running blood for learning in an outcome based teaching system and is a powerful tools for improving the future performance of the medical students. Currently almost all medical institutes seem to grapple with the feedback process but the desired results in form of students’ improvement are not considerable. Keeping in view the aforementioned mismatch a structured evaluation of the challenges in its way is necessary. Objectives: The aim of study was to identify the challenges faced by medical students and faculty in feedback process and to compare the discrepancy between students’ and faculty’s perspective about the factors that impede the process in college of medicine Majmaah University KSA. Materials and methods: This was an observational questionnaire based study conducted in 2020-2021 upon students and faculty of medical college of Majmaah University. The participants filled their response about the barriers they face during the feedback process. The data was scrutinized and analysed on SPSS ver 28. Pearson Chi-square and Fisher Exact tests were applied to compare the different responses between faculty and students. A Bonferroni adjusted p-value was reported for multiple comparisons. A p-value of less than 0.05 was considered as statistically significant. Results: It was found that 62% participants said students are afraid of negative comments, 70 % said that students don’t consider the process important, 72 % said it’s a time consuming process comments. Statistically significant results were found in responses between faculty and students about the four variables namely feedback is not taken important, time consuming, increased work load and language barrier. Conclusions: The most significant hurdles in the process of effective feedback in our setup are uninterested pupils, fear of being judged, weak staff skills, time and work constraints, and a language barrier. Key Words: Feedback, Challenges, Barriers, Medical students, Faculty
Effect of External Ventricular Drain Care Guidelines on Nursing Practice and Complications among Patients with Post-Traumatic Hydrocephalus
Authors: Aslam Hina , Afzal Muhammad , Sarwar Hajra , Khan Sadia
Published: April 2022

Background: External Ventricular Drain (EVD) care is considered as an advanced specialized nursing skill for neurological patients. EVD care guidelines plays a vital role in improving nurses’ practices regarding care of patients with EVD. The complications associated with EVD are strongly linked with nursing care as well as their level of practices. Unfortunately, in clinical settings most of nurses have incompetent EVD care practices. So, there is a dire need to adopt EVD care guidelines to improve their practices regarding EVD care. Objective: To assess the effect of external ventricular drain care guidelines on nursing practice and complications among patients with post traumatic hydrocephalus. Methodology: A quasi experimental study included 120 registered nurses and 80 patients selected with a purposive sampling technique. A 10 weeks educational intervention consists of PowerPoint lectures on EVD care guidelines of American Association of Neuroscience Nurses (AANN), audio visual demonstration (AVD) and hands on workshop practice sessions were given by the expert of relevant field to registered nurses on caring of patients with (EVD). Data on nurses’ practices and complications among patients were collected two times before and after the intervention via validated tools. Results: The study revealed a significant (p<0.001) change in nurses’ practices and patients’ complications after External ventricular drain (EVD) care guidelines implementation. The practices had been competent as 79 (65.8%) from 8(6.7%). The complication of meningitis in pre-guidelines implementation was 30 (75%) and post-guidelines implementation it was 13(32.5%).The kinking of tube was reduced from 4 (10.0%) to 3(7.5%). After guidelines implementation the rest of complications of EVD were also reduced among patients. Conclusion: External ventricular drain (EVD) care guidelines of American Association of Neuroscience Nurses (AANN) significantly improve registered nurses practices which ultimately reduced the complications of EVD among patients. Key words: Post Traumatic hydrocephalus, External ventricular Drain care guidelines, Registered Nurses, Practice, Complications, Patients
Epidemiological Features of Cutaneous Leishmaniasis in Hilly and Plot Areas of Tribal Districts, Khyber-Pakhtunkhwa Province Pakistan
Authors: Sajjjad Waseem , Haq Mohsina , Haq Ihteshamul , Khan Hamid Ali , Basir Noor Ul , Mazhar Rabia , Ullah Muhammad Jawad , Rashid Faiza , Ullah Mian Sami , Nafees Jauhar , Ahmad Zeeshan
Published: April 2022

Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania and is spread by vectors. This is a new threat that is endemic to the tropics and subtropics and has a broad geographic distribution. The current research was carried out in all tribal districts of Khyber Pakhtunkhwa province to 2020. The prevalence of Cutaneous Leishmaniasis was found to be higher in children aged 5 to 10 years old in the current research, due to a weakened immune system. In the province, 23 species of phlebotomine sand-flies belonging to the genera Phlebotomus Sergentomyia and grassomiya were discovered. Cutaneous Leishmaniasis is caused by flagellated parasitic protozoans of the genus Leishmania, which are transmitted via the bite of a mosquito. This is an emergent threat and endemic in areas of tropic and sub-tropics and has the epidemiological aspects of Cutaneous Leishmaniasis during the recent epidemic in tribal districts of Khyber Pakhtunkhwa in 2020. The suspected patients of Leishmaniasis from different areas of tribal districts were examined. We came across 700 cases during 3-month period from may to july2020. A major portion G2 ([41.1%; n = 290) of these patients were in age 6 to–10 years. The infection rate was higher in male (75.3%; n = 525) compared to females (25%;n = 125). Both gender and age showed a significant effect on the occurrence of infection. The current study report CL outbreak in the tribal districts of Khyber Pakhtunkhwa which need immediate response from the healthcare authorities. In addition, extensive awareness campaigns are needed for timely prevention of such outbreak. Keywords: Cutaneous Leishmaniasis, outbreak
Severity Patterns of Temporomandibular Disorders in Young Adults with Suspected Clinical Features
Authors: Malik Wajiha , Malik Sadaf , Shakir Sheema , Khan Asifullah , Qadeer Amra , Malik Waqar
Published: April 2022

Objective: Temporomandibular disorders (TMD) being progressive disorder having relatively higher prevalence in young adults necessitates early recognition in order to prevent development of established TMD. Method: Using a structured proforma and the method of interview, data were collected from 162 subjects for the frequency of severity pattern of Temporomandibular joint disorders in young adults with suspected clinical features .TMD were classified as mild ,moderate, severe and individuals having no TMD. According to Fonseca’s questionnaire the severity was determined from collective score earned from the response of the patient. TMD was clinically classified as none if the score ranged between 0-15 points, mild if 20-40 points, moderate if 45-65 points and severe if 70-100 points. Score was obtained from response of the patient. Results: Study revealed that out of 162 patients with symptoms 16.0% were categorized as having no TMD, 40.15% as having mild TMD, 35.2% with moderate TMD and 8.6% representing severe TMD. Conclusion: The most significant category of the TMD severity pattern in the young adults of this study was the mild level of temporomandibular disorder. Subjects with moderate level of TMD according to Fonseca’s questionnaire should be referred to the specialist clinic for the treatment of established TMD. Keywords: Temporomandibular disorder (TMD), Pain, Fonseca questionnaire
Neurological Manifestations and Its Outcome Due to Covid-19 Disease: An Observational Study
Authors: Ahmed Khalil , Malik Muhammad Khan , Ranjha Nasar Iqbal , . Azeem
Published: April 2022

Background: Corona virus has hit the world by the end of year 2019. Within few months it became pandemic and named as COVID-19 (SARS COV 2). Initially it was known as a disease of respiratory tract but with the advance study of clinical symptoms it has shown neurological manifestations, coagulopathies, diabetes mellitus and hypertension. The pathophysiology of disease showed that corona virus proteins bind to ACE receptors and effect multiple organ systems of body. The disease outcome is poor among those who develop such complications. The objective of this study was to determine the association of neurological manifestations with COVID 19 and to find out the health outcome of admitted patients. Methods: A cross-sectional study was conducted on COVID 19 patients through convenient sampling. Patients were admitted to DHQ Hospital, Sargodha with clinical symptoms of disease and with neurological manifestations. Their comorbid factors were also identified along with laboratory investigations (CT- brain, D-dimers. Serum sugar level and base line investigations). Analysis was done on SPSS 20 and association was determined between neurological manifestations and COVID 19 disease by chi- square test of independence with p<0.05 taken as level of significance. Results: Among 276 hospitalized patients male and female were of equal ratio with mean age of 59.22 (SD= 14.3). The death was more among 56-70 years (n=165) of patients with neurological manifestations and 100% in patients with age > 70 years with neurological manifestations. The outcome of disease is not significantly associated with age of patients (p=0.101). CT-scan findings showed 195(92.85%) patients’ outcome was poor with thromboembolic phenomenon. Neurological manifestations of COVID 19 disease were also significantly associated with disease outcome (p=0.000). Only 30 (11.11%) patients with neurological manifestations recovered from disease and were discharged. The severity of disease was also significantly associated with neurological manifestations due to COVID 19 (p=0.000). Conclusion: The neurological manifestations are associated with COVID 19 disease and its outcome is poor due to its neurological complications. The central nervous system involvement might be the result of invasion of virus. The COVID 19 disease is not only involving the respiratory system but it has its effects on multiple organs. The outcome of disease can be managed with early diagnosis and management of neurological manifestations. Keywords: COVID 19, Neurological manifestations, Disease outcome, Severity of covid-19 disease.
Incidence of Chronic Kidney Disease Related Pruritus and its Relation with Sleep Quality among Patients on Hemodialysis in Pakistan
Authors: Ain Qurat Ul , Asghar Muhammad Sheheryar , Saleem Mohiuddin , Majeed Sana , Rameez Rubab , Shaukat Sidra
Published: April 2022

Due to injured kidneys, CKD is defined as a glomerular filtration rate of less than 60ml/min/1.73m2 for more than 3 months. The lethal stage of chronic CKDs is the last stage of renal disease, and its frequency has increased over the previous 30 years. Pruritus caused by chronic renal disease is an unpleasant illness that causes itching and reduces sleep quality. The goal of this study is to look at the characteristics of pruritus in people with CKD and how they relate with sleep quality among patients on maintenance hemodialysis. Place and Duration: In the department of Medicine & Nephrology of Lahore General Hospital and Islamic International Medical College Trust Railway General Hospital, Rawalpindi for six-months duration from April 2021 to September 2021. Methods: 60 chronic renal disease patients were gathered from the nephrology department. Inclusion criteria included all patients with CKD who had pruritus and had sleep disturbance, while exclusion criteria included all patients who had rashes and pruritus that were not caused by CKD and were caused by other disorders. Age, gender, sleep pattern, disease severity, poor sleep quality, & pruritus location were all investigated by all patients. Results: CKD-associated Pruritus was distributed as follows: 75 percent of all patients were 45 years old or older, whereas 25 percent were 45 years old or younger. Pruritus interfered with sleep in 41.7% of patients, but not in 58.3%, and 30.1 percent of patients were girls and 73.9 percent were men. About 55% of people with pruritus are severely affected, whereas 45% are not. The trunk accounts for 60% of pruritic patients, whereas the rest of the body accounts for 40%. There was a strong link between the degree of pruritus and gender, the afflicted region, and sleep. Conclusion: Pruritus, often known as "uremic pruritus," is the most common skin complaint in people with ESRD. Due to the lack of a clear relationship with uremia, a substantial association occurs in males over the age of 45, disrupts sleep, and predominates in the trunk area. Keywords: Pruritus, Chronic renal disease, Characteristics, Association variables
Sigmoid Volvulus; Frequency of Postoperative Complications of Primary Repair
Authors: Safi Anayat Ullah , Iqbal Khawar , Khan Mohammad Shoaib , Saleem Farah , Chaudary Umair Tahir , Sadiq Muhammad Attique
Published: April 2022

Many regions of the world, including Pakistan, are affected by sigmoid volvulus, which is the most prevalent cause of major gut obstruction. The ingestion of high-fibre bulky foods, which seem to overburden the sigmoid colon, are two of the most common causes of sigmoid volvulus, along with irregular bowl habits. The most common clinical manifestations are abdominal discomfort, distension, constipation, nausea, and vomiting. The surgery of preference is resection and primary anastomosis since it avoids the need for a colostomy and the following reversal. Objectives: The goal of this study was to investigate the prevalence of postoperative complications after primary surgery in individuals with viable or gangrenous sigmoid volvulus. Place and Duration: This descriptive research was done in the surgical department of Sheikh Khalifa Bin Zaid Hospital (PGMI), Quetta and Fauji Foundation Hospital Rawalpindi for the duration of six months from January 2021 to June 2021. Methodology: The researchers looked at patients who had a large gut obstruction and were suspected of having sigmoid volvulus based on clinical and radiographic evidence. In these individuals, laparotomy and sigmoid colon resection were done, followed by single-layer primary anastomosis to restore colon continuity. A total of 90 individuals were included in the research after informed consent. Results: This research covered a total of 90 patients. With a male to female ratio of 2.5:1, there were 63 (70%) men and 27 (30%) females. Patients varied in age from 35 to 70 years old. The mean age of the patients was 50 + 1.30 years. The majority of the patients were between the ages of 41 and 45. All 90 patients (100%) had stomach discomfort, which was predominantly on the left side, followed by constipation in 84 (93.3 percent) and abdominal distension in 81 (90 percent). In 12 (13.3 percent) of the patients, vomiting was present, and in 3 (3.3 percent) of the patients, bleeding per rectum (due to related haemorrhoids) was evident. In 23 (25.6%) of the cases, various post-operative problems developed. Wound infection was found in 12 (13.3%) of the cases, with 9 men and three females being admitted to the hospital for antibiotics and daily dressings until the wounds healed. All of the wounds healed well. Pelvic abscess occurred in 4 (4.4%) of the patients. Three patients (3.3%) developed an enterocutaneous fistula, which was managed conservatively until the fistula healed. Only one patient (one percent) had ileus Conclusion: When the gut is viable or gangrenous, resection with primary anastomosis is the best treatment option for sigmoid volvulus. Keywords: Sigmoid-Diseases-Surgery, Anastomosis, Surgical methods, Colonic-diseases aetiology, Colonic-surgery
Patterns of Cardiovascular Diseases in Covid-19 Patients Admitted to Tertiary Cardiac Care Centre
Authors: Abbas Jawad , Kumar Arjan , Kumar Narindar , Shah Syed Dilbahar Ali , Shah Arshad Ali , Shah Iftikhar Ali
Published: April 2022

Background and Aim: Globally public health has been drastically affected by the Coronavirus disease (COVID-19) pandemic. There is a scarcity of data regarding risk factors, cardiac injury, and the treatment of cardiovascular disease associated with coronavirus disease. The present study aimed to assess the pattern of cardiovascular disease in COVID-19 patients referred to Tertiary Care Hospital. Methodology: This retrospective study was conducted on 446 adult patients with new-onset or existing cardiovascular disease patients at the department of Cardiology, PNS Shifa hospital Karachi during the period from February 2021 to July 2021.Demographic details, physical examination, comorbid conditions, and laboratory findings were used for data collection from the patient’s admission file. All the patients above 18 years and positively diagnosed with COVID-19 infections through rapid antigen test were enrolled and admitted with cardiovascular disease. The clinical features, chest X-ray, echocardiography, biochemical parameters, and electrocardiogram (ECG) were analyzed for each individual. Congenital heart disease,coronary artery disease, cardiomyopathy, heart failure, arrhythmias, peripheral arterial disease, and myocarditis were different cardiovascular diseases. Statistical analysis was carried out in SPSS version 23. Results: Of the total 446 cardiovascular disease patients, about 334 (74.9%) were male and 112 (25.1%) were females. The overall mean age was 52.82±10.62 years. Out of 446 CVDs patients, the incidence of preexisting and new cardiovascular disease was 225 (50.4%) and 221 (49.5%) respectively. Acute coronary syndrome was the prevalent (50.7%) cardiovascular manifestation followed by elevation myocardial infarction. The incidence of myocarditis, Rhythm and conduction abnormalities was 45 (10.1%) and 126 (28.3%) respectively. QT prolongation and hospital mortality was seen in 45 (10.1%) and 85 (19.1%) respectively. The prevalence of pre-existing cardiovascular disease, atrial fibrillation, cardiogenic shock, and renal failure were predominantly higher in mortality group compared to survival group. Conclusion: Our study found acute coronary syndrome was the prevalent cardiovascular disease. Elevated serum ferritin, lymphopenia, advanced age, cardiogenic shock, lower haemoglobin, renal failure, pre-existing heart failure, and leukocytosis were significantly related to cardiovascular disease increased mortality.
People Treated Upper Limb Surgery Comparing Positive Patient Outcomes with Regional Anesthetic vs General Anesthesia
Authors: Bhatti Tahmina Karim , Fayyaz Muhammad Aatir , Musarrat Ranna , Bashir Hina , Bangulzai Attaullah , Gillani Syed Aqeel Akbar Shah
Published: April 2022

Aim: Patient loyalty is a crucial indicator of health-care effectiveness. Moreover, there are really only some few researches has looked into this topic. The major goal of our current research was to associate patient satisfaction in people treated upper limb procedures under regional anesthetic vs general anesthesia. The objectives were to compare span of hospital stay also durability of analgesia here among two procedures. Material and Methods: The cross-sectional research remained conducted in the tertiary care teaching hospital. The research comprised individuals seen between ages of 17 and 61 who were receiving upper limb surgery and had a physical state of American Society of Anesthesiologists grade 1–3. A 10-item prefab perioperative scale was used to collect client experience with anesthesia in cases getting GA and RA, having 120 Individual in every set, at least 24 hours following surgery. The Mann–Whitney–Wilcoxon tests remained utilized to associate statistical information among sets, while the Chi-square test has been employed for explanatory data. Results: Participants in the RA condition had substantially greater overall satisfaction than those in the GA group (P 0.002) across all 12 questionnaire items and the overall score. Analgesia frequency remained likewise considerably greater in RA than in GA (P 0.002). The period of hospital admittance in GA remained similarly considerably greater than in RA (P 0.002). Conclusion: For upper limb procedures, RA gives higher client experience than GA, as well as the longer time of analgesia in addition a shorter hospital admittance. Keywords: Individual loyalty, crucial indicator of health-care effectiveness, Regional Anesthetic Vs General Anesthesia.
The value of the Aesthetic Component of the Index of Orthodontic Treatment Need (IOTN) in the Assessment of Subjective Orthodontic Treatment Need
Authors: Zahid Haider , Niaz Aiman , Shehzad Sofia , Saeed Sunniya , Khan Kainat , Khan Palwasha
Published: April 2022

Background: Malocclusion is the most common dental problem. Its correction needs assessment before planning Orthodontic treatment. The index of orthodontic treatment need (IOTN) is one of the most valuable method of grading and evaluating malocclusion. A number of studies stated; using the IOTN have reported that there is limited use of aesthetic component in school going children. Objectives: To estimate whether dental concern expressed by the grade of the AC chosen by subjects is reliable and whether it may be predictive for potential co-operation. Materials and Methods: This study was carried out in school going children of 12 year of age in kpk Pakistan. This study was based on a questionnaire and clinical examination. The questionnaire consists of various items. On the basis of these item questionnaire was filled. Clinical examination was done at the schools each time by the same orthodontist. Statistical analysis was done. Results: Out of total children, 29 were female and 58 were male. Most of the children were satisfied with dental aesthetics. Most of them wanted to change colour of the teeth. Most of the enrolled students were classified in “no treatment need’ category” followed by “need borderline treatment” category. Satisfaction with aesthetic were also evaluated (P-value <0.090). Conclusion: It was concluded that large number of people were in need of the orthodontic therapy as per the aesthetic component of IOTN. Key words: Index of Orthodontic Treatment Need, Aesthetic Component, Scan scale