bluuebunny/crossref_metadata_2025 huggingface dataset:
MUSCULAR DYSTROPHIES
Authors: Naseem Nadia , Mahmood Saqib , Hussain Afzal , Hussain Mumtaz , Munir Miss Ayesha , Latif Waqas , Nagi A.H.
Published: September 2021

Objectives: Muscular dystrophies are classified into different types based ontheir age of onset, clinical severity, rate of progression, distribution of muscles weakness,pattern of inheritance and the genes involved. As muscular dystrophies are relativelyuncommon disorders, very little work has been done in Pakistan. This study has classified (forthe first time in Pakistan) the patients with different types of muscular dystrophies by clinicaland biochemical correlation. Study Design: Observational, descriptive study. Setting:Departments of Morbid Anatomy and Histopathology and Human Genetics and MolecularBiology at University of Health Sciences Lahore. Period: Three years’ (March, 2012-March2015). Methodology: A total of 100 patients comprising of all age groups and both gendersand with strong clinical suspicion of muscular dystrophy, with or without positive family history,were included. Detailed clinical history and physical examination findings were recordedfollowed by estimation of serum Creatine Phosphokinase (CPK), Lactate Dehyrogenase(LDH) and Aldolase levels. Results: A total of 77 males (M) and 23 females (F) were included.Mean age of the patients was 12.1990 + 6.69913 years. Parents of 76 patients reported withconsanguineous marriages while positive family history was reported in 31 patients. Eightytwo cases managed to ambulate with support of other persons while n= 14 patients weretotally non ambulatory. Symmetrical muscle involvement (lower limb followed by upper limb)was shown by 87 cases (including all males and n=22 females). Involvement of the lowerlimbs as a primary weakness followed by symmetrical and severe involvement of the upperlimb girdle and lower limb girdle suggested limb girdle muscle dystrophy (LGMD) in 9 (6F,3M)patients. Involvement of shoulders and upper limbs as a primary weakness followed by facialmuscles and infrequent involvement of lower limbs suggested fascioscapulohumeral muscledystrophy (FSHMD) in 2 cases. Involvement of upper limbs as a primary weakness followedby lower limbs with a moderate rise in CPK levels and mild phenotype was seen in two femalepatient which was quite suggestive of dysferlinopathy. Only two male patients reported onsetof weakness and ambulation loss before 1 year of age that may represent congenital muscledystrophy (CMD), dystroglycanopathy or congenital onset of LGMD (cLGMD). Mean serumCPK, LDH and Aldolase levels were 2376.6364 + 910.78963 U/L, 1030.7800 + 180.1620 U/Land 10.089 + 1.525 U/L respectively that demonstrated significant association (p<0.05) withcharacteristic clinical features. Conclusion: Muscular dystrophies are not only restrictedto dystrophinopathies in our population. Apart from clinical and biochemical parameters,appropriate histological and/or gene mutation analysis is mandatory for precise classificationof these disorders.
SUBCLINICAL INFLAMMATION
Authors: Hussain Mazhar , Ghafoor Muhammad Bilal , Hussain Muhammad Shahbaz , Akhtar Lubna
Published: September 2021

Objectives: To evaluate the anti-inflammatory effects of sitagliptin in type 2diabetic hyperlipidemic patients. Period: 25 August 2015 to 25 November 2015 (12 weeks).Study Design: Randomized clinical trials. Setting: Outdoor of diabetic clinic of Sheikh ZayedMedical College/Hospital, Rahim Yar Khan. Materials and Methods: Diabetic patients (n=46)with poor glycemic control(HbA1c > 7.2%) and deranged lipid profile were selected. The patientreceived sitagliptin 50mg twice daily for 12 weeks. Results: A total of 46 patients completed thestudy. After 12 weeks treatment with sitagliptin, there was a significant reduction in the value ofHbA1c from 8.26±0.73% at baseline to 7.33±0.62% (p <0.01). Body mass index also decreasedsignificantly from 31.90±1.57 kg/m2 at baseline to 27.31±1.60 kg/m2 at 12 weeks (p<0.01).There was also significant reduction in the serum level of total Cholesterol (TC), triglycerides(TG) and Low density lipoprotein cholesterol( LDL-C) were detected( TC: 255.35±13.89to 220.76±14.65 mg/dl, TG: 188.80±11.62 to 153.39±9.24 mg/dl,; LDL-C 169.89±12.06 to147.11±8.1 mg/dl with p-value <0.01. High density lipoprotein cholesterol (HDL-C) increasedsignificantly from 41.21±3.11 mg/dl at baseline to 50.21±2.37 mg/dl (p <0.01) at 12 weeks.There is also significant reduction in the value of inflammatory markers after 12 weeks treatmentwith sitagliptin, ESR: 27.04±4.07 vs 11.43±1.74 mm/hr, WBC count: 6.90±0.51 vs 5.65±0.34109/L and hs-CRP: 4.21±0.37 vs 2.16±0.23 mg/L with p-value <0.01. Conclusion: Seeing themultiple benefits of sitagliptin on risk factors and markers of inflammation it is concluded that itshould be started early in diabetic patients to prevent micro and macro vascular complicationsin future.
ADOLESCENCE
Authors: Arshad Muhammad , Aslam Muhammad , Tanvir Nazia
Published: September 2021

Objectives: of the present study was examined the relationship between bullyingand psychological problems among adolescents. Study design: 200 participant include maleand female student from 9th to 12 grades were selected from different school of Faisalabadcit. Period: Begin from4th March 2014 to 10 August 2014. Setting: The age of the sampleranged from 13 to 18 years randomly selected. Illinois Bullying Scale (Espelage, 2002) andDASS by (Lovibond, 1995) were used to measure the constructs. Results: This relationshipwas significant with bully(r = -.67, p< .001), depression (r = -.18, p< .05), and stress (r =-.22, p < .01). Construct of bullying and behavior problems demonstrated positive correlation.Movement product Multiple regression analysis displayed bully as significant positive predictorof depression (β = .25, p< .01) anxiety (β = .32, p< .001) and stress (β = .27, p< .01), whereasfight behavior significantly and positively predicted anxiety (β = .24, p< .01) and stress (β =.19, p< .05). Victim behavior was also found to be significant predictor of depression (β = .16,p< .05) and stress (β = .28, p< .01.
UPPER GASTROINTESTINAL BLEED;
Authors: Shakeel Salman , Hasan Khan Muhammad Imran , Nabi Ghias Un , Ullah Ehsan , Mehmood Asif , Zulfiqar Maryam
Published: September 2021

Acute Upper Gastrointestinal Bleed (UGIB) is a globally prevalent medicalemergency and is a major cause of mortality. It may manifest as Hematemesis, Melena orHemetochezia. The most common causes of UGIB are Esophageal Varices (EV) and PepticUlcer Disease (PUD). Upper GI endoscopy (EGD) is the preferred procedure for investigation.Objectives: This study was carried out to identify patterns of endoscopic findings in patientswith UGIB and its frequency according to age, gender and symptoms in our setup. StudyDesign: It was a single centered retrospective analysis. Setting: Endoscopy floor of LahoreGeneral Hospital, Lahore for evaluation of Upper GI Bleed. Period: January 2010 to December2013. Material & Methods: 3910 patients were brought to the GI Endoscopy. Data wascollected from the endoscopy records on demographics (age and gender) and history of UGIB.The endoscopic findings were then evaluated. Results: 58.3% were male and 41.7% werefemale; male to female ratio was (1.4:1). The mean age was 43.4 years for males and 46.9 yearsfor females. (58%) had hemetemesis, (21%) had melena, (19%) had both hemetemesis andmelena. (2%) had hemetochezia. EV (69.2%) was the commonest cause of UGIB followed byPUD (20.6%). 4.3% of patients had a normal endoscopy and 2.5 % had Growth in upper GI tract.Conclusions: EV was the commonest cause of UGIB in our setup, as compared to the westernworld, where PUD was more common. Probable reason could be the high prevalence of livercirrhosis in our population. A good number of patients had a normal endoscopy, suggestingphysicians to obtain detailed history prior to the procedure.
HAND WRITTEN ASSIGNMENTS
Authors: Rehman Rehana , Rehan Rabiya
Published: September 2021

Medical educationists tend to explore short comings of teaching methodologieswith the aim to modify and bring improvement for learning of the students. Structuredassignments were introduced on account of unsatisfactory performance of students in shortessay questions of respiratory, cardio- vascular module. The pass percentage of studentsenhanced from 35.5 to 69 percent as a result of this intervention.
PHARMACOVIGILANCE
Authors: Ali Huma , Zafar Farya , Hasnain Hina , Ahmed Sana , Mallick Neelam , Tariq Anum , Saleem Saima , Zubair Saba
Published: September 2021

The solution for safe and rational medication use to improve patient care aswell as to enhance public health status is Pharmacovigilance (PV). Optimal care of patientand appropriate medication utilization in secure way with respect to various conditions is animperative function of pharmacovigilance system. PV mainly involves in the adverse drugreactions (ADRs) identification, system of reporting, scrutinizes the effectiveness of treatment,reduces the adverse consequences to utmost level and guarantees the patient wellbeing.The safety of drug is highly essential factor when it comes from the healthcare provider to thepatient. For a drug to be successful in market, it is crucial for it to be efficacious as well as safeand secure for the patients. Hence, adherence toward pharmacovigilance activities and systemis now based on a paradigm change from care to safety.
DENTOALVEOALR INJURIES
Authors: Hassan Syed Ghazanfar , Shahzad Muhammad , Panjabi Suneel Kumar , Shams Salman , Kumar Anand
Published: September 2021

Objectives: To analyze frequency, gender, age distribution, cause of injuryand type of dento alveolar injury among patients at Liaquat university hospital Hyderabad.Setting: This research done in Oral and Maxillofacial Surgery department at Liaquat UniversityHospital Hyderabad. Period: June 2013 to December 2014. Material and Methods: A dataof 114 patients who had been suffered with dentoalveolar trauma was reviewed. Patientshistory including age, gender, etiology of injury, type of injury like (intrusion, extrusion, luxation,subluxation, avulsion, crown fracture, root fracture were analyzed. Results: 36 female patientsand 78 male patients were affected with dentoalveolar trauma. The injury was frequent in agebetween 11-20 years. Mainly etiology of injury was fall in 54 cases followed by RTA in 35 cases.Intrusion of teeth was seen in 51 cases and crown fracture in 29 cases. Conclusion: The resultsof this study illustrate that fall is most common etiology of dentoalveolar trauma in this area.Intrusion of teeth was the most common types of dentoalveolar traumatic injury. Precautionaryeducational programs relating to traumatic dental injuries are required to be held in our countryto reduce the number of such injuries.
MANUAL VACUUM ASPIRATION (MVA)
Authors: Anjum Muhammad Usman , Yasmin Surriya , Razzaq Qamoos
Published: September 2021

Objectives: To determine the safety and effectiveness of manual vacuumaspiration (MVA) in treating first trimester pregnancy loss. Place & duration of study: Departmentof Gynecology, Shahina Jamil Teaching Hospital, Abbottabad, Pakistan, from September2013 to December 2014. Study design: Descriptive cross-sectional study. Materials andmethods: All the patients who were less than 12 weeks of gestation and diagnosed with missedabortion, incomplete abortion, having retained products of conception after normal deliveryand anembryonic pregnancy were included in the study. Diagnosis was made on the basis ofhistory, physical examination and ultrasonography. Urine pregnancy test and β-HCG were donein selected patients. Last menstrual period and USG were used to determine the gestationalage. Manual vacuum aspiration was carried out under Para cervical block using “Ipas EasyGrip” cannula with a 60ml syringe attached to it to create a negative pressure. Completenessof the procedure was determined and products of conception were sent for histopathologicalexamination. Results: There were 165 patients enrolled in this study. All study subjects weremarried. Mean age of the patients was 27.60± 4.86 years. Fifty patients had a previous historyof abortion. Mean parity was 2.98± 2.22 and mean gestational age was 8.23±1.6 weeks.The maximum number of patients, 80%, belonged to age group of 20-30 years. There were37 patients who were presented with first pregnancy. The number of multigravida and grandmultigravida patients were equal, 64 cases in each group. The main reason for undergoingMVA in our study subjects was missed and incomplete abortion followed by retained productsof conception and anembryonic pregnancy. Conclusion: MVA is a preferred mode of treatingfirst trimester pregnancy loss as it is a simple, safe and cost-effective procedure. MVA should beused preferentially in rural areas where there is a limited access to health care facilities, powerout-breaks are common and advanced medical equipment is not available.
LEIOMYOMA
Authors: Rathore Altaf Hussain , Rafiq Faiza , Malik Sadaf
Published: September 2021

A rare case of leiomyoma of round ligament is reported. It presented as irreducibleright inguinal hernia. Its shape and size was of a normal kidney for which peroperative I.V.U wasdone to exclude the ectopic kidney. No. such case has been reported in the literature so for.
PNEUMONIA SEVERITY INDEX (PSI)
Authors: Khan Maqsood Ahmed , Shyum Naqvi Syed Baqir , Alam Shazia , Shafiq Yousra , Hassan Mudassar , Fayyaz Muhammad
Published: September 2021

Morbidity and mortality due to community acquired pneumonia has beenincreased in our country. Children and old age patients are mostly effected due to communityacquired pneumonia Study design: Cross sectional study. Setting: Patients hospitalized forCommunity acquired pneumonia in four different hospitals located at different areas werestudied. Period: Three years period from August 2011 to August 2014. Objectives: To assessdemographic profile, pneumonia severity index and length of stay of community acquiredpneumonia patients hospitalized at different hospitals in Karachi. Method: 800 patients bothmale and females patients were included in this study. Results: It was found that 480 (60%)were males and 320 (40%) were females, males were significantly more frequent (c2=0.48,p˂0.05) than the females patients. There was a significance difference in numbers of differentage group patients. According to the age distribution, there were 222(27.75%) from 1-5 years,which was the highest among the patients and there were 44(5.5%) from 81-90 years of agegroup patients, which was least among the different age group patients. According to thecomorbidity most of the patients were found without comorbidity there were 456(57%) patientspossess no comorbidity. Patients with comorbidity were 344(43%), and comorbidity was foundin patients with hypertension were 131(16.4%) and patients with diabetes were 105(13.1%) thesewere the two most commonly comorbidity disease found. According to the socioeconomicstatus (SES) status there were 482(60.25%) patients from lower SES class, 270(33.8%) patientfrom middle SES class and 54(6.8%) patients from high Socioeconomic class. patient with lowSES were much higher at hospital C and hospital D.(c2=127.88,p˂0.05). CAP is more frequentin married patients, married patients status were much higher at hospital C and hospital D(c2=60.31, p˂0.05). According to the PSI segregation there were 424(53%) patients from PSIclass I, 168(21%) were from PSI class II, 128(16%) patients were from PSI class III, 44(5.5%)were from class IV and 36(4.5%) were from PSI class V. Mean length of stay (LOS) was greaterat hospital C and D as compare to other two hospitals. Conclusion: CAP is frequent amongmales, low socio-economic, hypertensive individuals and patients from 1-5 years of age. Theshortest mean length found was 3.6days at hospital A and the longest mean length of stayfound was 7.6 days at hospital D.
LOW FLOW ANESTHESIA
Authors: Raza Hamid , Ahmed Bashir , Kamlaish Mr
Published: September 2021

Objectives: The aim of our study is to determine the incidence of complicationswhen using Laryngeal mask airway and compare it with endotracheal tube intubation, duringadministration of low flow anesthesia. Study Design: A randomized control trial. Period: 3months from February 2015 to April 2015. Setting: Tertiary Care Hospital in Karachi Pakistan.Materials and Methods: The study population consisted of n= 100 patients who underwentelective operative procedures of the eye. Patients who belonged to the ASA classification typeI and II were allocated into two groups using a random number generator. Group A consistedof all the patients on whom endotracheal tube was used as airway and group B included all thepatients on whom Laryngeal mask airway was used. The complications were noted on a predesignedproforma. Data was analyzed using SPSS version 23. Results: The study populationconsisted of n= 100 patients out of which n= 43 were males and n= 57 were females, 42%of the patients belonged to ASA classification I and 58% belonged to the ASA classificationII. Leakage of air was observed in 7% of the patients, postoperative shivering was observedin 20%, sore throat was observed in n= 22 patients, of which n= 18 patients belonged to theETT group and n= 4 patients belonged to the LMA group. Endotracheal carbon dioxide levelsdid not show any significant difference. Conclusion: According to the results of our study,Laryngeal mask airway has a lower incidence of post-operative complications, provided that itspositioning and cuff pressure are noted and maintained regularly, and it can be used as a safealternative to endotracheal intubation when using low flow controlled anesthesia respectively.
MAXILLOFACIAL FRACTURES
Authors: Punjabi Suneel Kumar , Talpur Altaf Ahmed , Memon Abdul Rauf , Priya Miss`
Published: September 2021

Background: The incidence of maxillofacial fractures is greater in Pakistan.This research has the crucial aim of achieve and indexing maxillofacial injuries in poly traumapatients. Objectives: To assess the concomitant injuries with maxillofacial trauma. StudyDesign: Descriptive case series. Setting: The department of Emergency and Oral & MaxillofacialSurgery, Liaquat University of Medical and Health Sciences, Jamshoro. Period: Jan 2014 to Dec2015. Methods: Total 489 patients of both genders, aged ≥20 years were included. Results:more injuries 359 (73.40%) occurs among the age of 20-39 years. The mainly documentedetiologic factor for injury was RTA with 69.38%, followed by assault (16.76%), fall (11.04%)and sports injury was (2.87%). With respect to related injuries, a sum of 48 patients introducedhead injuries and other concomitant injuries. The most common fracture noted was mandible296 (60.53) followed by maxillary fractures 191 (39%), Zygomatic bone complex fractures 65(13.29%), Naso-orabital ethmoid fractures was 44 (8.99%), majority of patients 186 (38.0%)were arrived in morning time followed by 176 (35.9%) in evening, 88 (17.9%) in afternoon and 39(7.9%) in night, regarding the day’s most patients came on first working day that was Saturday142 (29.0%). Regarding hospital mortality, 11 (2.2%) people died within less than two days afteradmittance. Conclusion: The results of this study may support the oral surgeons to rule outother injuries at the time of primary survey and may have a key role in awareness of individualsin prevention of road traffic accidents.
PERCEPTION
Authors: Mahmood Hamid , Aslam Mohammad , Gul Wasifa , Waqar Ammara , Khan Athar , Hassan Yasir , Cheema Faryal Murtaza , Mujtaba Hassan , Mujtaba Hassan , Mujtab Hassan , Maham Noor-e-
Published: September 2021

Sex discrimination in a newborn child is still present in Pakistan. It is despite relativewealth, rapid globalization, female education and socioeconomic development. Althoughmother’s education improves quality of childcare, but still it does not reduce discriminationagainst her children. The mental torture a female goes through in a life time for being femalestarts at the time of her birth and ends only with her life. These cultural bounded thinking hasovershadowed a woman’s own perception about a daughter. But some times to a family it doesnot make any difference that the child is a son or a daughter. Aims: The aim of the Researchis to discuss how mothers of a female child feel about having a daughter if they wanted tohave a son. Objectives: To explore what are the feelings of a mother upon having a daughter.To identify why they feel what they feel. To identify what are some of the reasons behindtheir thinking. To discuss how their experiences can be used in planning for interventions offuture this can help in a better understanding of our mothers and daughters requirements.Methodology: The methodology of current research is based on qualitative anthropologicalresearch method. Period: Dec 2014 to Oct 2015. Settings: The sampling is taken from differentsocioeconomic strata. It is divided into low, middle and upper socioeconomic groups. Everystratum is with a different point of view regarding the same question. Results: “In Pakistan 42percent of women accept violence as part of their fate; 33 percent feel too helpless to standup to it; 19 percent protested and 4 percent took action against it. Discussion: It is also foundthat the middle socioeconomic group is the most crushed group of all in Pakistan. This is thestrata who wanted to be modern like upper socioeconomic group but have lesser resourcesand opportunities. Females are educated equally like males in urban areas such as Lahore,Islamabad and Karachi. However, in rural areas, the education rate is substantially lower.Recommendation: For woman there must be a right to life, security and protection fromviolence which can be mental, physical, psychological and verbal. Government should ensureeffective, prompt and impartial investigations into alleged cases of crimes and other incidents,and ensure that particular attention is paid to the investigation of such crimes and incidents andthat those responsible for such acts are effectively brought to justice and, where appropriate,punished in order to avoid impunity.
DENTIGEROUS CYSTS AND AMELOBLASTOMAS
Authors: Anjum Rabia , Naseem Nadia , Nagi A.H
Published: September 2021

Objectives: The aim of study was to observe the expression of MCM2 in dentigerouscyst and ameloblastoma. Introduction: Minichromosome maintenance protein (MCM2) maybe a structurally and functionally complicated replication moiety that synergizes with differentmolecular factors therefore regulate DNA synthesis. MCM proteins play a job in maintaininggenomic integrity and stop re-replication once per cell cycle. It’s absent from chromatin inquiescent cells however abundant in mitotically active cells so making it a helpful marker forcellular proliferation. Dentigerous cyst (DC) is the commonest biological process odontogeniccyst having high proliferative index that may lead to dysplastic changes and developmentof tumours. Ameloblastoma is uncommon, benign and regionally aggressive odontogenicneoplasm with high rate of repetition after surgery. Study design: It was a descriptive study anddesigned to work out the expression of MCM2 in DCs and ameloblastomas. Setting: Departmentof Morbid Anatomy and Histopathology/ Oral Pathology. Period: Six months. Material andmethods: Twenty-five patients presenting with DCs (n=12) and ameloblastomas (n=13) wereselected. Clinical and radiographical findings were recorded and biopsies were submitted forhistological diagnosis. MCM2 immunopositivity was assessed by immunohistochemistry in fourmicroscopic high power fields showing most range of immunopositive cells. Results: Mean agewas 26.5± 11.24 years and 42.07± 9.24 years whereas male to feminine magnitude relationwas 7:5 and 7:6 for DCs and ameloblastomas severally. Most of the patients (58.3%) of DCswere asymptomatic whereas 41.6% patients reportable with painful swelling. Comparing, allpatients with ameloblastomas conferred with painless swelling. Radiographically, all DCs wereunicystic radiolucent lesions. While 46.2% of ameloblastomas were unicystic whereas 53.8%were multicystic radiolucent lesions. Histologically, basal layer atypia was seen in 50% and 23%of DCs and ameloblastomas respectively. High MCM2 immunoreactivity was ascertained withinthe epithelial lining of the DCs and the neoplastic cells of ameloblastomas. Conclusion: MCM2expresses the higher proliferation index that might lead to neoplastic development in DCs whilelocal invasive and recurrence potential in ameloblastomas.
TYPE 2 DIABETICS;
Authors: Shahzad Aamir , Sahto Abdul Aziz , Memon Asif Ali
Published: September 2021

Objectives: The purpose behind this study was to assess the frequency ofvitamin D deficiency in type 2 diabetics. Setting: Medicine Department of People’s MedicalUniversity, Shaheed Benazeerabad. Periods: Six months. Material and Methods: All thediagnosed cases of type 2 diabetes mellitus irrespective of age, gender, time since diagnosed,controlled or not controlled and method of treatments like on oral hypoglycemic agents orinsulin therapy were included in study. Patients attending the OPD of medical department ofPMCH Nawabshah were selected. They were asked to come by morning in fasting conditionand for the collection of their fasting blood sample to ascertain the levels of serum vitamin D.Patients with 25(OH)D concentration <20ng/ml were labeled as hypovitaminosis D. Data werecollected in predefined proforma. SPSS version 20 was used for data entry and for its analysis.Results: Total 126 patients of both gender and age from 30 to 70 years were considered forfinal analysis for the study. There were 83 male patients and 43 female patients. The overallmean age was 48.16±11.44 years, with range of 40 (30–70) years. The overall mean duration oftype 2 diabetes mellitus was 68.02±29.44 months. It was observed that overall 92.1% (N=116)found to have deficiency of vitamin D. Conclusion: More than 90% of the type 2 diabeticpatients had deficiency of vitamin D and it is more common among elderly population withmale predominance.
VACCINATION;
Authors: Faisal Usman Ali , Rubab Alia , Tahseen Shahzadi Asma
Published: September 2021

Introduction: The Expanded Program on Immunization (EPI) is meant for thecontrol of common infectious microorganism. Objectives: To know the awareness amongthe mothers and its relation with their education. Study Design: Cross-sectional study.Setting: Pediatric unit, Civil Hospital Bahawalpur. Period: June 15, 2015 to August 31, 2015.Methods and Material: The mothers were interviewed by the researchers using a structuredquestionnaire. Results: There were 100 mothers included in this study. Their mean age± SDwas 28.02± 7.468 years. Among the studied mothers 20 (20%) were having at least secondaryschool certificate. There were 88 (88%) mothers who were house wives. Only 3 (3%) mothersanswered the correct number of vaccines used in EPI program. The awareness about individualvaccine was in the range of 28%-33% except in polio it was 76% and in measles it was 61%.The 40 (40%) mothers answered that EPI vaccines are safe and 37(37%) replied that theseare effective. The mother’s high education status was associated with better awareness aboutEPI. Conclusion: There is lack of knowledge among mothers about EPI vaccination and themother’s high education status is associated with better awareness about EPI.
WORKPLACE SECURITY;
Authors: Nasreen Irfana , Rathore Kashif , Ali Kashif
Published: September 2021

Introduction: This study is about female nursing staff whose mission is toprovide professional care to ailing patients, but who are also vulnerable to bullying, harassment,and even assault while they perform their duties. Objectives: The study attempts to describethe level of perceived workplace security among the nurses and investigate relationshipbetween theoretically identified predictors and the perceived workplace security of nursesworking in public hospitals in Lahore city. Study Design: Factors such as civility in co-workerbehavior, clarity of norms of communication with co-workers, integrity and trust of the leaders,awareness of law and legal procedure related to harassment at work place and physicalsettings characteristics—including transparency and privacy at the workplace—were modeledthrough a cross-sectional research design as contributing towards workplace security of femalenurses. Study Period: Oct 2015 to May, 2016. Methods: Multi-stage probability sampling wasused to collect data from 317 respondents working in five public sector hospitals in Lahorecity during first quarter of 2016. Zero-order correlation and multiple regression methods wereused to analyze the data. Findings: Results showed that civility (B=.071, p<.000) in co-workerbehavior, integrity (B=.185, p<.000) and trust of leaders (B=.059, p<.000) is the most potentfactor influencing perceived workplace security of female nurses. Moreover, clear norms ofcommunication (B=.169, p<.000) and privacy (B=.133, p<.000) at workplace also significantlyinfluence their perceived workplace security. Transparency (B=.017, p>.05) in physical settingsand awareness (B=-.014, p>.05)of law and legal procedures were found to be insignificant.Conclusion: It was concluded that setting clear work norms and leadership development inthe areas of integrity and trust can play a substantial role in improving perception of workplacesecurity in female nursing staff. Awareness of laws regarding harassment among nurses needto be increased through formal and concerted effort.
UNSTABLE FRACTURE OF THORACOLUMBAR SPINE;
Authors: Alam Waqar , Shah Faaiz Ali , Ahmed Ashfaq , Amin Qazi Muhammad , Ahmed Ijaz , Aziz Amer
Published: September 2021

Objectives: To evaluate the functional outcome of unstable thoracolumbarfractures fixed with pedicular screws and rods. Study Design: Descriptive case series. Setting:Department of Orthopedics and Spine surgery Ghurki Trust Teaching Hospital Lahore. Period:February 2013 to October 2015. Material & Methods: Patients of either gender or all ageswith thoracolumbar fractures fulfilling the inclusion criteria were fixed with pedicular screwsand rods under general anesthesia. Post operatively patients were reviewed monthly for oneyear and results were analyzed according to modified McNab criteria as excellent, good, fairand poor at final follow up. Results: A total of 281 patients including 193(68.68%) males and88(31.32%) females with mean age 28.32 years (range 18 to 60 years) were included in ourstudy. Majority (91 patients) had fractures of L1 followed by L2 (73 patients) fracture and D12(67 patients) fracture. Pre operatively 95(33.81%) were neurologically graded as Frankle gradeD,73 (25.98%) grade C while 49(17.44%) were graded as Frankle grade E.Post operatively finalfollow up at one year yielded excellent clinical outcome in majority (91.46%,n=257) while goodand fair outcomes were reported in 6.41%(18 patients), and 2.14%(6 patients) respectivelyaccording to modified McNab criteria. No post op neurological detoriation, mortality or othermajor complication was reported in the study. Conclusion: Pedicular screw and rod fixationfor unstable thoracolumbar fractures gave excellent functional results in majority of patient as itreduces complications of recumbency and helps in early mobilization. We recommend it as afirst line treatment for such fractures.
EFFECT OF OBESITY AND STATIN;
Authors: Shabbir Faizania , Hussain M. Mazhar , Rajput Tausif Ahmed , Khan Alamgir
Published: September 2021

Objectives: To observe the effect of obesity and subsequent atorvastatinadministration on MPV in high fat diet induced obese male and female Sprague Dawley rats.Study Design: Randomized control trial (RCT). Setting: Department of Physiology, Army MedicalCollege, Rawalpindi. Animal procurement and blood sampling was done at National Instituteof Health (NIH), Islamabad and biochemical assays were performed at Centre for Research inExperimental and Applied Medicine (CREAM), Army Medical College, Rawalpindi. Period: Thestudy was completed in 12 months. Material and Methods: Ninety healthy Sprague Dawley(male and female) rats were purchased and divided randomly into three equal groups. Ratsin normal control group (Group I) were given normal chow diet for three weeks. Rats in obesecontrol group (Group II) were given high fat diet for three weeks. Rats in obese treated group(Group III) were administered atorvastatin for three weeks in a dose of 10 mg/kg/day orally bygavage method after obesity induction. Terminal sampling was done at the end of the studyby intra-cardiac puncture. MPV is a part of blood complete picture that was analysed by KX 21Sysmex Hematology Analyzer. Results: High fat diet induced obesity resulted in a significant(p < 0.05) increase in MPV. The MPV was significantly (p < 0.05) decreased after atorvastatinadministration. The result was comparable for both genders. Conclusions: Obesity increasesMPV and hence the risk of adverse cardiovascular outcome. Atorvastatin apart from its knownlipid lowering effect, decreases MPV and can play a beneficial role in decreasing cardiovascularmorbidity and mortality.
MATERNAL WEIGHT;
Authors: Zahiruddin Sana , Malhi Pushpa Chetan , Jabeen Nigar , Baloch Raheela
Published: September 2021

Impact of maternal weight on success of VBAC. Introduction: WorldwideCesarean section is the commonest obstetrical procedure to be performed and same situationis in Pakistan. One strategy is to offer vaginal birth after cesarean section to reduce the alarmingcesarean rate. Many factors have been Identified which can affect success of trial of labor.Maternal weight has an important relation with the reproductive health of women, as obesityduring pregnancy is associated with increased maternal and fetal risk. Maternal obesity hasbeen shown to be associated with increased rates of primary cesarean delivery and failed trialof vaginal birth after cesarean delivery. Objectives: To determine the effect of maternal weighton success of VBAC. Study Design: Cross sectional study. Period: May 2012 to October 2013.Setting: Liaquat university hospital, Hyderabad. Material and Methods: a total of 96 womenwhich fulfilled the selection criteria were included in the study. Results: The women included inthe study had a mean age of SD (range), 29.94+ 4.41 (20-40 years) successful vaginal birthswas observed in 57(59.4%) women and 39(40.6%) had an emergency repeat cesarean delivery.Body mass index was noted among all the women, 23(24.0%) were obese and 73 (76.0%)were non-obese. Out of 23(24.0), 7(30.4%) had successful VBAC and 16(69.6%) women hadsuccessful trial of labor and 23(31.5%) delivered by repeat Caesarean delivery. (P.0.002) P value= 0.001 is statistically significant and calculated by Fisher’s exact X2 test. Conclusions: Obesityis associated with decreased chances of successful VBAC, making it a risky option for obesewomen.
DENTAL AESTHETIC;
Authors: Jutt Irum Naz , Bhut Aamir Mehmood , Rehman Atiq Ur , Memon Waqar
Published: September 2021

Objectives: Psychosocial impact of dental aesthetic in patients visiting OPD ofLiaquat University Hospital Jamshoro. Study Design: Observational study. Place and Durationof Study: This study was conducted at Dental Section, Liaquat University Hospital Jamshoro,from July 2013 to December 2014. Methodology: This study consisted of one hundred andeight cases were selected during this period from orthodontic clinic OPD. Principle investigatorreviewed the patients using structured questionnaire. Psychosocial Impact of Dental AestheticsQuestionnaire’ (PIDAQ) were analyzed to assess the dental aesthetics by using the DentalAesthetic Index (DAI).” Inclusion criteria were patient’s aged 25 years and having no previoushistory of orthodontic treatment. Those patients already on treatment, presence of craniofacialsyndromes or anomalies and “Patients with any mental or behavioral disorders that might havereduced their ability for self-determination were excluded. Malocclusion orthodontic treatmentrecommendations to the priorities assigned to four classes per grade. The first factor is theDental Self-Confidence that consists of 6 items from the Self-Confidence Scale. Results: Atotal of 108 patients, both males and females were included in the study. 69(63.88%) out of108 subjects were males and rest were females 39(36.11%) cases, male to female ratio 1:1.7.The minimum age was 25 years and maximum was 55years but most of the patients werein the range of 25 to 35 years means age was 27+4.7 years. In this study DAI scores wereobserved, grade-I in 53(49.07%), grade-II in 32(29.62 %), grade-III in 14(12.96 %) and grade-IVin 9(8.33 %). Conclusion: Patients who seek orthodontic treatment are anxious to improve theirappearance and approval of the social, more often associated with improved oral work or life.”
PROFILE OF MEDICOLEGAL CASES;
Authors: Arif Mariam , Rasool Syed Hamad , Hammad Ali Syed Muhammad
Published: September 2021

Introduction: The accident and emergency department is the backbone ofevery tertiary hospital because it is providing medical as well as legal services to the patients.Objective: The aim of the study was to determine the pattern of medicolegal cases attendingaccident and emergency department of Services hospital, Lahore. Study Design: Retrospectivestudy. Setting: Accident and Emergency Department of Services Hospital, Lahore. Period: 1stJanuary, 2014 to 31st December, 2014. Materials and Methods: Data of medicolegal caseswas collected regarding age, gender and type of injuries. It was collected on a pre-testedstructured proforma and statistically analyzed using SPSS version14. Results: Total number ofmedicolegal cases was 2166 with male to female ratio 5.1 : 1. Commonest age group affectedwas third decade (37.6%). Blunt weapon injuries (64.77%) were most common followed byfirearm injuries (9.3%) and sharp weapon injuries (8.8%) while the least common were burns(0.2%) and poisoning (0.55%).Sexual assault was predominant in females (63.8%). Conclusion:Documentation of medico-legal cases should be done with great care. Injury related morbidityand mortality can be reduced by improvement in health care facilities.
PROGNOSIS OF ACUTE INFERIOR WALL MI;
Authors: Asghar Naeem , Ilyas Hafiz Muhammad Faiq , Anwar Touseef
Published: September 2021

Introduction: Atrioventricular (AV) block is a common complication of acuteMyocardial Infarction (MI). In pre-thrombolytic era, high (second or third degree) AV blockwas seen in approximately 5-7% of patients presenting with acute MI. In setting of Inferior MI,this was even as high as 28%. Although, the advent of thrombolytic therapy has substantiallydecreased the mortality associated with acute MI, the incidence of AV block, particularly in thesetting of inferior MI, remains high. AV block in the setting of inferior MI is also associated withhigh in-hospital mortality, however, its effect on long-term mortality is uncertain. Objectives: Tocompare the in-hospital mortality of acute inferior wall myocardial infarction with and withoutcomplete Atrioventricular block. Settings: Department of Cardiology Faisalabad Institute ofCardiology, Faisalabad. Duration of Study: Six months From: 01-05-2014 to 30-11-2014. StudyDesign: Cohort study. Results: In our study, out of 80 cases(40 in each group) 42.5%(n=17)in Group-A and 37.5%(n=15) in Group-B were between 20-50 years of age while 57.5%(n=23)in Group-A and 62.5%(n=25) in Group-B were between 51-70 years of age, mean+sd wascalculated as 52.58+9.83 and 55.43+8.06 years respectively, 40%(n=16) in Group-A and47.5%(n=19) in Group-B were male while 60%(n=24) in Group-A and 52.5%(n=21) inGroup-B were females, comparison of in-hospital mortality in both groups was done showing32.5%(n=13) in Group-A and 7.5%(n=3) while 67.5%(n=27) in Group-A and 92.5%(n=37) hadno findings of in-hospital mortality, Relative Risk was calculated as 4.33 while P value:0.005.Conclusion: We concluded that in-hospital mortality is significantly high in acute inferior wallmyocardial infarction complicated by atrioventricular block.
HIGH INTENSITY EXERCISE;
Authors: Mustafa Khan Ghulam , Khan Daniya , Aamir Iram Saddiqa , Ramees Saher , Kanwal Sassi , Abid Fatima , Moazzam Hina
Published: September 2021

Objectives: To clarify the interrelationship of high intensity exercise and durationof time on lipid profile, blood pressure and, body weight in young hyperlipidemic adults andto evaluate the beneficial effects on health in possible shorter duration of time. Study Design:Case control study. Setting: Department of Physiology, BMSI, JPMC, Karachi. Period: January2012 to April 2012. Methods: Total numbers of 60 volunteers moderately active, younghyperlipidemic adults, aged 30 to 50 years, thirty for each A (control), and B (high intensityexercise) group respectively were assigned to participate for 12 weeks exercise programwithout restricted caloric diet at pre–identified track of specific time. Lipids profile and age, sex,weight, BMI, blood pressure, and lab investigations like serum Total cholesterol, Triglycerides,LDL, and HDL, of each participant were recorded at baseline (0 day) and similarly on day30, 60 and 90 respectively. Results: At the end of the 12 weeks program in high intensityexercise group significant effects have been observed by lowering the level of total cholesterol,triglyceride (p <0.05) and lipoproteins variables, with increasing the level of HDL-c. While nosignificant change in blood pressure and weight reduction was observed between indicialand final measurement in control and high intensity exercise groups (p<o.o5). Conclusion:Finding of this study suggest that, high intensity exercise has positive effects on lipid profileby lowering the level of total cholesterol(TC), triglycerides(TGs) low density lipoprotein (LDL-c)and increasing the level of high density lipoprotein (HDL-c) in hyperlipidemic adults rapidlyin short duration of time, thus have beneficial effects by reducing the cardiac risk factors,chronic metabolic disorders and improving the cardio respiratory fitness but reduction in bloodpressure body weight can be achieved in short time by combination of high intensity exerciseand nutritional guidance of caloric restriction.
ANTENATAL DEPRESSION;
Authors: Ali Farasat , Butt Ammara , Hameed Aamir , Furqan Aamir , Ali Farman
Published: September 2021

Objectives: To determine frequency of Antenatal Depression by ICD_10diagnostic criteria in patients presenting to a tertiary care hospital and contributing factors forantenatal depression. Study Design: Cross-sectional study. Setting: Department of Psychiatryand outdoor of Gynae & Obs Sir Ganga Ram Hospital / Fatima Jinnah Medical College Lahore.Period: November 2012 to May 2013. Materials and Method: Three hundred and fifty (350)patients were included in this study. SPSS version 12 was used for data analysis. Frequenciesand percentages were calculated to present qualitative variables and mean ± standard deviationwas calculated to present quantitative data. Results: A total of 350 patients were included inthis study. Out of 350 patients, depression was found in 104 patients. Out of these 104 patients,52 patients (50.0%) had mild depression, 37 patients (35.6%) had moderate depression while115 patients (14.4%) had severe depression. Conclusion: Antenatal depression was noted in29.7% of patients. Most common contributing factor was low socioeconomic status (64.4%)a second factor was no partner social support (22.1%) and previous history of psychiatric ofpsychological consultation (13.5%) of antenatal depression.
MICROALBUMINEMIA;
Authors: Alam Muhammad Mahboob , Parvez Muhammad Akhtar , Murtaza Muhammad
Published: September 2021

Objective: to determine the frequency of microalbuminemia in type IIdiabetic patients and to compare lipid profile in type II diabetic patients with and withoutmicroalbuminuria. Settings: Department of Medicine, Allied Hospital, Faisalabad. Durationof study: From: January 2015 to December 2015. Results: In our study, mean age was53.18+9.32 years, 43.90% (n=151) were male and 56.10% (n=193) were females, frequencyof microalbuminuria in type II diabetes mellitus was recorded in 32.56%(n=112). Conclusion:the frequency of microalbuminemia in type II diabetic patients is higher while the frequencyof hypertriglyceridemias, increased LDL-C and decreased HDL-C in Type II diabetic patientsis significantly higher in patients with microalbuminuria when compared them withoutmicroalbuminuria..
Cementitious Composites Containing Multifunctional Sugarcane Fibres
Authors: Guilarduci Viviane , Martelli Patrícia , Gorgulho Honória , Oliveira Pablo , Panzera Tulio Hallak
Published: September 2021

This work investigates the reuse of natural (SCB) and aminopropyltriethoxysilane-modified (MSCB) sugarcane bagasse fibres in cementitious composites. Sugarcane bagasse fibres are pre-used in the treatment of motor oil contaminated effluents. A full factorial design is used to identify the effects of fibre type (SCB and MSCB), fibre length (0.6 and 1.2 mm), fibre amount (1 and 2 wt%) and fibre condition (before and after oil filtration) on apparent density, water absorption, apparent porosity, ultra-pulse velocity, dynamic modulus, flexural strength and modulus. SCB fibres lead to increased apparent density compared to MSCB fibre reinforced composites. MSCB fibres contribute to reduce composite porosity, leading to higher mechanical properties. The smaller area of MSCB fibres promotes a larger amount of cementitious phase per unit volume, thus increasing the strength of the sample. Longer sugarcane fibres (1.2 mm) have a larger surface area, leading to a higher fibre concentration per unit volume, which increases water absorption. The amount of fibre has no significant effect on mechanical and physical responses. Composites made with 2 wt% 0.6 mm long MSCB fibres achieve promising results for non-structural civil engineering applications.
Identification of an Appropriate Formulation for Domestic Water Ceramic Filters from Soukamna Clay (Cameroon)
Authors: Nguiamba Ngiongboung , Yanu Celestine Asobo , Belibi Placide Désiré Belibi , Sieliechi Joseph Marie , Ngassoum Martin Benoît
Published: September 2021

This paper deals with the formulation of ceramic filters having the porosity adapted to domestic potable water treatment. The filters were made from clays and rice husk obtained from the Far North region of Cameroon (Logone Valley). Nine formulations were investigated to choose those that might have the porosity standing between 35 and 50% (the ideal porosity adapted for water treatment) [1]. The nine formulations investigated were as follow: clay:rice husk mixture weight ratio 0.7:0.3; 0.8:0.2 and 0.9:0.1 with the particle size of 100:100 microns. The sintering temperatures of 900°C, 950°C and 1000°C were applied for each of the mixtures. The results showed that only filters with weight ratio 0.7:0.3 sintered at 900°C, 950°C and 1000°C had porosity between 35 and 50% with values of 39.41±0.96; 40.15±1.59; 40.14±1.31 respectively. Mechanical strength, permeability and iron leaching behavior were investigated for these three formulations. The formulation 0.7:0.3 with sintering temperature of 1000°C had the higher permeability and was the more stable for iron leaching so it is the more adapted for water treatment in terms of flow rate and iron leaching behavior, pore size distribution showed that these filters were macroporous and designed for microfiltration with average pore diameter of 0.46µm.