bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Maternal and Fetal Complications Between Teenage Pregnancies and Pregnancies of the age of 20-26 Years
Authors: Naeem Maryam , Ilyas Ayesha , Nawaz Faiza , Afzal Nayab , Ambreen Raheela , Asghar Samina
Published: May 2022

Objective: To compare maternal complications between teenage pregnancies and pregnancies of the age of 20-26 years. Material & Methods: This cohort study was carried out in DHQ/GMC Teaching Hospital Gujranwala during March 2021 till August 2021. Non probability purpose sampling technique was used. Total 200 patients were included in study and divided into two groups. Teenage patients assigned as Group A and group B assigned to patients of age 20-26 years. Both groups assessed for maternal outcomes, antepartum, intrapartum and postpartum complications noted and compared. Results: The following complications were observed among teenage compared with adult pregnancy; anemia (39% versus 18%), hypertension (15% versus 6%), preterm labor (21% versus 9%), prolonged labor (8% versus 29%), and postpartum hemorrhage (13%versus 13%). The results were statistically significant (p-value < 0.05). Conclusions: The complications related to teenage pregnancy are high. These can be avoided by establishing contraceptive strategies. Keywords: Teenage pregnancy; maternal complications; anemia.
Synthesis, Characterization and preliminary Anti-Microbial Evaluation of New Ibuprofen Hydrazide Derivatives
Authors: Kamms Zainab Dhia , Hadi Mohammed K.
Published: May 2022

To create a novel series of aryl propionic acid with better antimicrobial properties, new Ibuprofen (2-(4-isobutylphenyl) propionic acid) hydrazone was prepared from the reaction of Ibuprofen ethyl ester and hydrazine hydrate in the presences of different aromatic aldehyde. Anti -microbial activity was tested for all compounds against gram positive (S. pyrogen, S.aureus), gram negative (E. coli, Klebsiella pneumoniae) bacterial strains and fungal strains (candida albicans). Compound (3f) display the highest anti-bacterial activity against gram positive bacteria while compound (3e) display highest anti-bacterial activity against gram negative one, the compound (2b) showed highest anti-fungal activity compare with the other prepared compound. All the final compounds were characterized by FT-IR and 1H-NMR spectroscopy. Keywords: Ibuprofen, hydrazine hydrate, anti-microbial activity.
Frequency of Adverse Perinatal Outcome in Women Undergoing Emergency Lower Segment Cesarean Section at Term Due To Non–Reassuring CTG at Tertiary Care Hospital
Authors: Khan Sharin , Shaikh Hiba Arshad , Kunbhar Tahira , Mushtaque Marya , Mustafa Ayesha , Akbar Rashida
Published: May 2022

Objective: To determine the frequency of adverse perinatal outcome in women undergoing emergency lower segment cesarean section at term due to non–reassuring CTG at Tertiary Care Hospital. Study Design: Descriptive case series-longitudinal. Study Setting: Study was conducted at Department of Gynaecology and Obstetrics, Aga Khan University Hospital. Duration of Study: Six months from 1st July, 2018 till 31st December 2018. Subjects and Methods: Data was prospectively collected from patients after taking a consent. A total of 211 patients were included. Demographic data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables were presented as frequency and percentages. Post stratification chi square test was applied taking p-value of ≤ 0.05 as significant. Results: Mean age in group A and B was 33.56±3.91 and 34.71±4.01 years respectively. Adverse fetal outcome showed that birth weight < 2500 gm (20.4% vs 12.3%), APGAR score < 7 (16.6% vs 12.3%), Umblical cord ph < 7.1 (14.2% vs 9%), NICU admission (11.8% vs 8.5%) and still birth patients (4.3% vs 1.9%) who were in decision to delivery group of < 30 minutes and > 30 minutes respectively. Conclusion: This study showed that there are still avoidable delays in emergency caesarean section. Improving health care delivery so as to eliminate the identified causes would go a long way in reducing these delays. But given the results of this study, adverse fetal outcomes appears to be less in DDI > 30 minutes group when compared with DDI < 30 minutes group. Keywords: Elective lower segment cesarean section, decision to delivery time, birth weight, APGAR score, NICU admission, umbilical ph and still birth.
Incidence of Cardiogenic Shock Among Acute STEMI Cardiac Patients
Authors: Ullah Zia , Ullah Aman , Khan Mujeeb Alam
Published: May 2022

Coronary Artery disease is a serious health issue affecting both men and women thus becoming the leading cause of death globally. Aims: To determine the frequency of cardiogenic shock in patients with acute ST elevation myocardial infarction. Study Design: Cross-sectional comparative study. Methodology: All newly diagnosed acute ST elevation MI patients were included. Detailed history followed by detailed clinical examination was done. ECG and urinary output were measured to detect ICS. All this information was recorded on Performa. Statistical analysis: Data was analyzed using SPSS version 25. Cardiogenic shock was stratified among age and gender by applying chi square test. Results: Age as mean ± SD was 60 ± 1.26 years. Males were 68% while females were 32% enrolled in present study. Results showed that only 10% patients had cardiogenic shock while 90% were without it. Conclusion: It was concluded that the frequency of cardiogenic shock was low (10%) in patients with acute ST elevation myocardial infarction. Keywords: Cardiogenic Shock, Myocardial Infarction and Mortality.
Maternal Outcome of Primigravida Patient with Term Pregnancy with Engaged Versus Unengaged Foetal Head at Onset of Labour
Authors: Hussain Samar , Qurban Saima , Tahseen Huma , Javed Kiran , Khurshid Hafiza Naveeda
Published: May 2022

Objective: To assess the maternal outcome of primigravida patient with term pregnancy with engaged versus unengaged foetal head at onset of labour Design of the Study: It was a cohort study. Study Settings: The study was conducted at Department of Obstetrics & Gynecology Rashid Latif Medical College, Lahore from January 2021 to June 2021. Material and Methods: This study involved 160 primigravida at term (as per dating scan) aged between 18-35 years who were divided into cases (women with unengaged fetal head) and controls (those with engaged fetal head). Outcome variable were frequency of cesarean delivery, low birth weight, poor APGAR score at 1 and 5 minutes and NICU admission which were noted and compared between the groups. Results of the Study: The mean age of the patients was 23.9±3.8 years while the mean gestational age was 39.0±1.3 weeks. The frequency of poor APGAR score at 1 minute (25.0% vs. 5.0%; p-value<0.001; 95%CI RR=5.00) and cesarean delivery (38.8% vs. 16.3%; p-value=0.001; 95%CI RR=2.39) was significantly higher in women with unengaged fetal head at term. However, there was no statistically significant difference between the groups in terms of poor APGAR score at 5 minutes (5.0% vs. 2.5%; p-value=0.405; 95%CI RR=2.00), NICU admission (10.0% vs. 8.8%; p-value=0.786; 95%CI RR=1.14) and low birth weight (7.5% vs. 3.8%; p-value=0.303; 95%CI RR=2.00). Conclusion: In the present study, unengaged fetal head at term was associated with poor APGAR score at birth and increased risk of cesarean delivery which advocates that women with unengaged fetal head at term should be considered as high risk so that anticipated management may improve the fetomaternal outcome Keywords: Primigravida, Unengaged Fetal Head, Fetomaternal Outcome
Frequency of Successful Resolution of ST T Changes after Thrombolysis with Streptokinase in Patients of Acute St Segment Elevated Myocardial Infarction
Authors: Ahmad Zeeshan , Shah Noor Ul Sabah , Latif Abdul , Shakir Anas
Published: May 2022

Objective: To determine the frequency of successful resolution of ST T changes after thrombolysis with streptokinase in patients of acute ST Segment elevated myocardial infarction Design of the Study: Cross sectional study Study Settings: The study was conducted at Cardiology Department, Lady Reading Hospital, Peshawar from 22/10/2019 to 22/4/2020. Material and Methods: Over the course of the investigation, researchers kept tabs on 165 patients. FBC, ECG (cardio fax), and echocardiography (Siemens' Acuson cv-70) are all included in the evaluation and investigations. Every patient had an ECG done 90 minutes following the initiation of SK injection to see if the ST segment abnormalities had gone down. Results of the Study: 35 patients (20%) were between the ages of 30 and 45, while 130 patients (79%), were between the ages of 46 and 60. The average age was 57, with a standard deviation of 12.11. There were 72% male patients and 28% female participants in the study. Seventy-three percent of patients had successful resolution of ST T alterations, while 27 percent of patients did not. Conclusion: Our study concludes that the frequency of successful resolution of ST T changes after thrombolysis with streptokinase was 73% in patients of acute ST Segment elevated myocardial infarction Keywords: successful, resolution of ST T changes, thrombolysis, streptokinase, acute ST segment elevated myocardial infarction
Impact of Ethical Leadership and Caring Work Climate on Turnover Intention of Health Care Professionals Mediating Role of Emotional Exhaustion
Authors: Ali Anum Nawazish , Shahid Sehrish , Kanwal Maria , Rasheed Qurat-Ul-Ain , Usman Muhammad
Published: May 2022

Objective: To examine the mediating relation of emotional exhaustion as well as moderating function of caring climate in such relationships. Study Setting: Health care providers in government hospitals (such as Lahore General Hospital, Mayo Hospital, Services Hospital, Nishtar Hospital, Multan) as well as private hospitals (such as Fatima Memorial Hospital, Shalamar Hospital, Doctors Hospital, National Hospital, Bakhtawar Amin Hospital, Multan) and health care centres in Lahore (such as the latter two) are included in this group. The health care providers are also included in this group. Study Duration: This study was conducted from period of 1st September to 1st December, 2020 in the selected Hospitals. Materials and Methods: In order to acquire data, a sampling method was used. Google forms were used to collect data online. A total of 105 health care professionals from Lahore's health care organisations participated in the survey. Process macro model 8 shows that ethical leadership is critical to assessing the variations in emotional tiredness and turnover intention, whereas the ethical environment has a negligible moderating impact on the changes in turnover intention. Exhaustion mediated the influence of ethical leadership on turnover intention, according to the findings. Results: The findings show that the ethical conduct of higher management is critical because workers' perceptions of an ethical leadership are based on the ethical beliefs of managers, and their sincere and truthful conduct is an important influence in shaping the organisational environment and thus influencing the employees' turnover intention. Aside from future research directions, the theoretical and practical consequences and constraints of the discussion are also contested. Conclusion: According to the findings of this study, the influence of ethical leadership on employee turnover is totally mediated by emotional weariness. There is a correlation between ethical leadership and the desire to leave the company. The association between ethical leadership and emotional weariness is also diminished. Furthermore, this study indicated that emotional irritation and turnover intention are linked in a positive manner. Keywords: Emotional weariness; ethical leadership; purpose to replace; ethical climate; climate of turnover
Incidence of Congenital Talipes Equinovarus among Children Reporting at Tertiary Care Hospital
Authors: Ain Qurat-Ul- , Muzadar Saadia , Naheed Kishwar , Malik Aimen , Afzal Muhammad , Riaz Farhan
Published: May 2022

Objective: To determine the incidence of congenital talipes equinovarus among children reporting at tertiary care hospital. Study setting & Duration: The study was conducted at Watim Medical & Dental College Rawat, Rawalpindi in the departments of Anatomy, Medical education & Dentistry from January 2021 to December 2021. Materials and Methods: There were 988 participants in this study. An easy questionnaire was used to gather information on children with CTEV who presented themselves to the outdoor department. Both consanguineous and non-consanguineous relationships were considered. Results: A total of 96 (9.7%) children presented with congenital talipes equinovarus or club foot and out of these children 56 (5.7%) patients were males and 40 (4.04%) were female. Conclusion: Clubfoot or congenital talipes equinovarus is one of the most common abnormalities of the foot and idiopathic talipes equinovarus is most common in the studied population. It is more common in males and is mostly bilateral. It should be detected at birth and treated early to prevent permanent disability. Keywords: Children, CTEV, idiopathic, consanguinity
Quality of Life among Substance Use Disorder Patients in Khyber Pakhtunkhwa, Pakistan
Authors: Zada Bakht , Shah Muttahid , Saleem Aimen , Ashraf Rabbia , Hameed Asma , Yousaf Aasma
Published: May 2022

Objectives: This study aimed to evaluate the quality of life (QoL) of substance use disorder (SUD) patients in Khyber Pakhtunkhwa, Pakistan. Design: A cross-sectional study Setting and Participants: 500 substance use disorder patients were selected from the seven drugs rehabilitation centers of Khyber Pakhtunkhwa, Pakistan. Methods: This study was carried in seven drugs rehabilitation centers of Khyber Pakhtunkhwa, Pakistan between August 08, 2019, and December 2020. A cross-sectional study design was used to assess the QoL among 500 substance use disorder adult patients who were taking initial rehabilitation treatment via a convenient sampling technique. The WHOQOL-BREF Field Trial Version was used to measure the QoL. Results: This study found that more than 75% (very poor: 27.8%, poor: 49.8%) substance use disorder patients had a poor perception of the QoL, 81% (very dissatisfied: 33.8%, dissatisfied: 47.2%) patients were dissatisfied with the overall perception of the health. The four domains of QoL of SUDs patients were also disturbed. Conclusion: The current finding of this study illustrated that people with SUDs need more attention for their QoL and well-being. Keywords: Substance Use Disorder, quality of life, perception of the health, well-being
Current Status of Knowledge and Preventive Practices among Hepatitis C patients in Twin Cities of Pakistan
Authors: Asim Naeem , Mangrio Khuda Bux , Malik Anwar Ali , Nisa Zaka Un , Mallah Manthar Ali
Published: May 2022

Objective: To determine the knowledge and preventive practice adopted by hepatitis C patients and the impact of hepatic C infection on their lifestyle. Methods: A cross-sectional survey was conducted in hepatic wards of tertiary care hospitals of Islamabad and Rawalpindi. A validated and reliable questionnaire was used comprised of 23 questions was administered to 370 patients admitted in the hepatic ward in tertiary care hospitals. For qualitative variables, frequencies and percentages were calculated. The inferential results were obtained using the Chi-square test. All analyses were performed using SPSS version 25.0 (IBM Corporation, Armonk, New York, USA). Statistical significance was defined as a two-tailed p value < 0.05. Results: Among 370 respondents, 350 responded to the questionnaire providing a response rate of 94.6%. The majority of the respondents, 306 (87.4%), were practicing infection control practices while 44 (12.6%) were not practicing the infection control practices. A significant association was seen between patients' age, education, sex, and preventive practice. Among respondents, 162 (46.3%) had poor knowledge of the HCV infection, while 188 (53.7%) had good knowledge about Hepatitis C. Moreover, the study also reveals that knowledge of Hepatitis C has a significant relationship with preventive practices. Conclusions: In conclusions, most of the respondents showed a high level of hepatitis C knowledge and practiced infection control practices. It is also determined from this study that Hepatitis C negatively impacted the psychological status of patients. Keywords: Hepatitis C, Infection, Knowledge, Practice, Patients
Prevalence of Intraventricular Hemorrhage in Preterm Neonate
Authors: Ahmed Saleem , Ahmad Qazi Mumtaz , Ullah Habib , Saleem Furqan , Zubair Hassan , Rehman Sobia Al
Published: May 2022

Objective: This study was conducted to explore the incidence of Intraventricular Hemorrhage in preterm neonate. Method: The study was conducted in the neonatal unit of the department of Pediatrics. It included all the preterm neonates under 36 weeks of gestational age who were admitted in neonatology unit. The study included both male and female babies. The age of babies at time of admission was <24 hrs. Cranial USG was done at the age of 1, 3, and 7 days. Results: The incidence of IVH in these patients turned out to be 55%. According to age, patients less than 24hrs were 30(54.54%), patients between 24hrs to 72hrs were 17(30.90%) whereas patients between 72hrs to 7days were 7(12.72%). Conclusion: The incidence of IVH in these patients turned out to be 55%.
Effects of Low Level Laser Therapy on Knee Pain and Functional Status among Patients with Knee Osteoarthritis
Authors: Ashraf Abeel , Riaz Saima , Arslan Hafiz Muhammad , Khan Rehan Ramzan , Naeem Rashid , Malik Ammara
Published: May 2022

Objective: To determine the outcomes of low level laser therapy on knee pain and functional status among patients with knee osteoarthritis. Methodology: A randomized controlled trial was conducted in physiotherapy department of Allied Hospital Faisalabad. Thirty four patients were randomly divided into experimental group treated with low level laser therapy combined with conventional exercises and control group treated with conventional exercises only. Numeric Pain Rating Scale, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and goniometer were used as data collection tools. All the patients received 9 treatment sessions, 3 sessions per week for 3 weeks.
Self-Efficacy among Type 2 Diabetic Patients
Authors: Madran Dheyaa Mohammed , Jassim Aqeel Habeeb
Published: May 2022

Background: High level of self-efficacy and adherence to self-care activities have a positive impact on the achievement of glycemic goal among diabetic patients. In Iraq, there is a gap in knowledge related to self-efficacy management and its influence on adherence to self-care activities and overall disease control. Therefore, the study aimed to assess self-efficacy among type II diabetes mellitus and its associated socio-demographic variables. Methods: A cross-sectional study was conducted on a sample of 400 patients is selected purposively who are diagnosed with type II DM who attended AL-Zahraa Teaching Hospital in Wasit Province/ Iraq. The reliability of the questionnaire was achieved through a pilot study and then presented to experts to prove its validity. The total number of items included in the questionnaire was 34-items. The data was collected by using the semi-structured interview and analyzed by the application of descriptive and inferential statistical data analysis approach. Results: The results of the study indicated that (72.5%) of the patents exhibit a moderate self-efficacy. The analysis of variance confirmed that there were differences in self-efficacy with regards patients age (p=0.000) and duration of DM (p=0.001). Conclusions: Patients age increased age (≥70 years) and diagnosed for 5 years ago or more significantly associated with low level of self-efficacy. Self-efficacy is considered as a predisposing factor that can be deteriorated in chronic diseases like Diabetes. Increasing in self-confidence levels of diabetic patients can set the stage for glycemic control. Interventions are recommended for glycemic control of patients with longer duration of disease. Keywords: Self Efficacy, Patients, Type II DM.
Effectiveness of Applying Tactical Combat Casualty Care Guidelines on Paramedic's Practices. An Interventional Study
Authors: Ali Mohammed Amen , Abed Rajaa Ibrahim
Published: May 2022

Background: medical services provided by specialized paramedic played a key role in the military conflicts that occurred in Iraq during the last two decades after 2003 by first aid providing to the injured immediately in the battlefields to safe their life and transporting them to health care facilities for additional health care , as well as in the current study , which concerned with paramedics training on tactical combat casualty care standards that include three steps of care ( care under fire, tactical field care, and tactical evacuation care ) Objective(s): The aim of a present study is to determine the effectiveness of applying Tactical Combat Casualty Care (TCCC) guidelines on Paramedic's Practices. Methods: A pre-experimental design study was carried in Baghdad Operations Command in Iraq, at January 14th, to April 2nd, 2022. to find the effect of applying Tactical Combat Casualty Care guidelines on paramedics’ practices. Non-probability "purposive" sample of (40) paramedics are selected from all units in Baghdad Operations Commands. The questionnaire is composed of two main parts (demographic characteristics of the paramedics, and the second part involves four domains which was (71) items concerning paramedics' practices regarding the standards of Tactical Combat Casualty Care , the researcher used SPSS version 20 to analyze the data. Test-retest reliability of instrument was determined through the use of Pearson correlation coefficient and content validity of the instrument was determined through a panel of (fourteen) experts. Data was analyzed through the use of descriptive and inferential statistical analysis. Results: The results of paramedic's practices in overall main domains related to applying TCCC standards was inadequate in pretest , while in posttest I results showed that the paramedics' practices was improved to adequate level after application of the intervention program . Then the posttest II was done, and the results was similar to posttest I. the data show that there were highly significant differences between pre and post test , which emphasis the positive effect of program. Conclusion: The study concluded that there was improvement in paramedics' practices toward the TCCC intervention program. Recommendation: The study recommended to Continuous training for paramedics and engages them in courses, seminars, and conferences to improve their skills and information. Keywords: Tactical Combat Casualty Care, paramedics, Practices, Interventional Study.
An Interventional Program for Nursing Staff about Prevention of Corona Virus Disease
Authors: Tarrar Mohammed Rajeh , Ahmed Sabah Abbas
Published: May 2022

Objectives: The objectives of the study is determining the effectiveness of interventional program on nursing staffs' knowledge about prevention of Covid-19. Methodology: A pre-experimental design (one group design: pre-test and post-test) conducted at Isolation Ward in Al-Diwaniyah Teaching Hospital. The study period from (13th October, 2021 to 4th March, 2022) on a non-probability (purposive) sample consisting of (34 nurses) working in Isolation Ward. Results: The study demonstrated that all the study sample responses at the pre-test were low knowledge with a statistical mean of scores (1.2817). Other than the post-test, the table shows that (100%) of the study sample have high knowledge at the mean of scores (1.8978). Also, the results revealed a highly significant difference between the pre-test and post-test of the study sample after participated in the interventional program at the p-value (0.0001). In addition to, this study indicated that there were significant differences in nursesꞌ knowledge in post-test compared to pre-test (in the post test M= 1.89 versus in the pretest M= 1.28 at p-value 0.0001). Conclusion: The level of nurses’ knowledge was not as required (poor).After giving the interventional program the knowledge of nursing staff was improved. Keywords: Interventional program, Nursing staff, Prevention of COVID-19.
The Average Diameter of Coronary Artery in the Healthy Adult Population of Pakistan: A Cross-Sectional Study
Authors: Hashim Muhammad , Azim Waqar , Rehman Fazal Ur , Ali Ahmed , Muhammad Dost , Sultana Riffat
Published: May 2022

Aim: To determine the average diameters of the coronary arteries in the healthy adult population of Pakistan Study design: A cross-sectional study Place and duration: This study was conducted at Civil Hospital, BMCH Quetta Pakistan from March 2020 to March 2021. Methodology: A total of 120 participants were included in the study. All the patients included in the study were advised coronary angiography, nonetheless, their angiograms were normal. According to the inclusion criteria, the patients included in the study could be of any gender, above the age of 18 years, and have normal angiograms. The segments of the artery were divided as per the 29-segment model. The segments selected for the study were studied by the method of quantitative coronary angiography (QCA) method. Results: A total of 120 participants were considered in the study. The mean age of the included participants was 54.35±12.39 years. The mean of the Body Surface Area (BSA) was 1.78±0.163. The mean of the Body Mass Index (BMI) was 27.96±3.1 kg/m2. Proximal Left Circumflex (PLCx) and proximal left anterior descending (PLAD) were larger in diameter and the left main stem diameter was smaller. The Mid right coronary (MRCA) was greater in diameter, whereas the diameters of the proximal right coronary (PRCA), left main, distal left circumflex (DLCx), mid (MLAD), and distal (DLAD) were smaller. The MLAD, PLAD, PLCx, and DLAD had larger diameters and MRCA as well as the left main stem had smaller diameters. Conclusion: The diameters of the segments of the left stem of the coronary artery were smaller in the present study. Standardized data is needed for an accurate comparison. Keywords: Pakistanis, Comparison, Coronary Artery, Diameter
Comparative Evaluation of General Oral and Periodontal Health Status of Chronic Kidney Disease (CKD) patients in Various Stages admitted to Sharif Medical and Dental College, Lahore, and Healthy Controls
Authors: Butt Hira , Khan Nauman Rauf , Aman Muhammad , Fatima Syeda Maryam , Jabbar Maria , Maqsood Farooq
Published: May 2022

Objective: To assess the general oral and periodontal health status of chronic kidney disease patients in various stages and compare it to healthy controls. Methodology: A Cross-sectional comparative study was conducted in Sharif Medical and Dental College, Lahore on 50 patients with chronic kidney disease and 58 controls for the time duration of one year. Data collection was based on the Community Periodontal Index of Treatment Needs and Decayed Missing and Filled index. Results: There was a significant association between stage of kidney disease and periodontal health (p= ≤0.001) and general oral health as determined by the DMFT index (≤0.001). There was a significant difference in the scores of decayed teeth between the controls and stage 3 (0.042), stage 5 (≤0.001) and stage 4 (p= 0.001). The difference in the scores of missing teeth was significant between controls and stage 5 (p=≤0.001) and stage 4 (p=0.001). Similar was the case for decayed missing and filled teeth index scores for controls and stage 3 (p=0.013), stage 5 (≤0.001) and stage 4 (≤0.001). Conclusion: Bleeding gums were most common in stage 3 while pocket depths of 4-5mm were highest in stage 4 and 5 patients. Pocket depth of 4 to 5mm was the most prevalent periodontal problem in controls. In the controls, more individuals had a high DMFT score in comparison to low scores. The scores of decayed teeth and decayed missing filled index were significantly different among the controls and stages 3, 5 and 4 while for missing teeth score, the difference was significant between controls and stages 4 and 5. Keywords: Periodontal health, Community periodontal index for treatment needs (CPITN), Decayed missing and filled teeth (DMFT) index, chronic kidney disease.
Physical Assaults assessment concerning their pattern, severity & bone of contention, in rural areas of Punjab
Authors: Ali Nadir , Sajid Sadaf , Farid Noreen , Ahmad Naveed , Javed Asma , , Ahmad Naveed , Javed Asma , Ahmad Usama
Published: May 2022

Background: The rural areas of Punjab have a very high prevalence of physical assault due to illiteracy, pride of cast system, related to agricultural land disputes, illegal breaches in violating the watering system of their crops, political motives of landlords in their area, and social issues related to marriages, love affairs, and illegal interference into the privacy of others. Aim: To analyze different forms of physical assaults related to their pattern, severity, and reasons behind these physical assaults keeping in view their medico-legal aspects. Methods: The data of physical assaults in medico-legal cases were collected from the peripheral rural areas of Faisalabad, Sargodha and Mianwali on specifically designed Performa. The cases were selected from these districts reported in Causality & Accident departments of the district and tertiary care Hospitals during one year June 2020 to May 2021. The inclusion criteria were based on non-probability with random sampling in this retrospective study. In total 200 cases were selected for this study. Association with demographic parameters like age, sex, type of weapon used, the pattern of injury. Results: Physical Assaults had a direct association with male predominance; the age of 20 to 30 years of age, blunt weapons especially fists, kicks, and daggers, wooden sticks were used for offense as determined by the findings in this study. Various social reasons related to cast & clan system, disputes of agricultural land, family issues related to inheritance, illiteracy, pride of cast system, domestic violence, illegal breaches in violating the watering system of their crops, political motives of landlords in their area and social issues related to marriages, love affairs and illegal interference into the privacy of others, were the main bone of contentions. Conclusions: Different variety of weapons used in the rural setting. Males as predominant participants of assault suggest a socially active status of men in the rural setup of Punjab where male dominance is evident. The feudal system of landlords main responsible for social injustice and exploitation of the low class, is determined in this study. There need reforms through social literacy, justice provision for all, reforms in medico legal reporting and social awareness of human rights. Keywords: Physical assaults (PA), blunt trauma, domestic violence, rural areas, and bone of contention
Knowledge, Attitude, and Practice about Fasting in Ramadan among Diabetic Patients
Authors: Iqbal Maleeha , Ahmad Rashid , Iqbal Shama , , Zahid Shamaila , Ali Sajid
Published: May 2022

Background: Every year, Muslims fast from dawn to dusk in the Holy month of Ramadan. Mostly, patients with diabetes are unaware of the complications related to fasting including hypoglycemia and dehydration. This study aimed to determine the socio-demographic data of diabetic patients and knowledge, attitude, and practices of diabetic patients toward Ramadan fasting in Peshawar, Khyber Pakhtunkhwa, Pakistan. Materials and Methods: This descriptive cross-sectional study was conducted in tertiary care hospital, Peshawar. A total of 180 diabetic patients have participated in the study. All patients were Muslim-diagnosed diabetic patients irrespective of age, gender, ethnicity, and type of diabetes. Structural self-designed questionnaire related to diabetes and associated information. Questions were asked after taking the consent form from all participants. The questionnaire was related to education, doses timing, glucose monitoring, eating habits, and physical activities. Results: Among a total of 180 diabetic patients, 53.9% were male and 46.1% were female diabetic patients. The minimum age was 15 years and the maximum age was 88 with a mean age of 52.7+14.5 years. The highest number of diabetic patients were identified in the age-group 46-55 years with 26.3%. Diabetic patients were more found illiterate (49.4%) as compared to educated. Type II diabetes mellitus was found in 92.8% of patients. Conclusion: The findings of the present study revealed that knowledge and practice of diabetic patients during fasting in Ramadan is less. Ramadan health education and training in diabetic patients can improve and guide patients to ensure safe and risk-free fasting. Keywords: Diabetes, Ramadan, Fasting, Knowledge, Attitude, Practices
Impact of pesticide residues (chlorpyrifos, cypermethrin, profenophos) on health and liver marker values alkaline phosphate (ALP), alanine amino transferase (ALT) and (AST) among workers of pesticide formulation & packing plants in Pakistan
Authors: Saghir Sumera , Humza Muhammad Shahroz , Sarmad Sana , Akram Shama , Haq Muhammad Fahim ul
Published: May 2022

Objective: To evaluate the impact of pesticide residues (chlorpyrifos, cypermethrin, profenophos) on health and liver marker values alkaline phosphate (ALP), aspartate amino transferase (AST) and alanine amino transferase (ALT) among workers of pesticide formulation & packaging plants in Pakistan Materials and Methods: A hundred workers of the age group between 20-50 years working, for at least a year, at various pesticide formulation & packaging units were included in the present study. One hundred workers, apparently healthy, with no history of pesticide exposure - after matching age, sex and social status - were taken as control. Biochemical tests ALP, AST and ALT, were carried out using chemistry autoanalyzer, Dimension RXL (Dade Behring). Pesticide residues (chlorpyrifos, cypermethrin, profenophos) were carried out employing gas chromatograph electron capture detector GCECD 2010, Shimadzu Japan. Results: In current study 100 workers of pesticide industry were taken and ALP, AST and ALT of 80 workers out of 100 were found to be within the normal limits. However, 20 workers had unusually raised levels of ALP ALT and AST. These twenty workers showed pesticide residues of chlorpyrifos, cypermethrin, profenopos in their blood. Conclusions: the pesticide residual level of all the workers were very low (below the no observable adverse affect level NOAEL) and were not too significant to create health problems. Key Words: Pesticide industrial workers; Residue; Serum; Enzymes
Dermatological Manifestations in Dengue Fever
Authors: Sheikh Mariam , , Riaz Sidrah , Rahim Ikram ur , , Waheed Alia , Khan Abdullah Farooq , Saif Nadia
Published: May 2022

Objective: To assess the frequency of skin & mucosal manifestations in dengue fever patients. Study design: Cross-sectional study. Place and duration of study: Patients admitted in dermatology & medicine departments of Akhtar Saeed Trust Hospital Lahore were included in the study. Method of study: This cross-sectional study was conducted in departments of dermatology & medicine at Akhtar Saeed Trust Hospital Lahore for a period of 3 months from Separation 3021 till December 2021. After taking consent a total of 60 patients of suspected dengue fever were enrolled for this study. Their demographic data was noted down with skin & mucosal findings in a predesigned performa. Their frequencies were calculated & analysed in SPSS version 11. Results: Out of 60 patients, 38 patients (63.3%) were males & 22 patients (36.6%) were females. Mean age of patients was 35.20 years. 13 patients (21.6%) had no skin findings and 47 patients (78.4%) had skin findings. The commonest skin finding was pruritus present in 24 patients (40%), followed by facial flushing in 15 patients (25%). Petechial rash and burning sensation were found in 7 patients (11.6%). Among the mucosal findings, eye involvement was the commonest present in 15 patients (25%). Conclusion: Cutaneous and mucosal manifestations are an important part of dengue fever. These findings also help in assessing the disease progress. Key words: Dengue fever, cutaneous manifestations.
Base Excess or Hyperlactatemia: Identifying the Superior Risk Factor for Increased Morbidity and Mortality in Cardiac Surgery
Authors: Farogh Ajwad , Younas Attaullah , Hassan Asma , Ahmed Naseem , Bashir Tariq , , Iftikhar Sadaf , Afshan Shamila
Published: May 2022

Objective: Cardiopulmonary bypass in cardiac surgery is often associated with metabolic changes. So, we conducted this study in order to find the supremacy between two risk factors base excess and hyperlactatemia in early prediction of morbidity and mortality in ICU after cardiac surgery. Material and Methods: Intraoperative data of total of 100 patients who had cardiac surgery was recorded. Intraoperative and postoperative data of base excess and lactate levels were recorded at 1st, 6th, 12th and 24th hour in ICU. Two perioperative groups for B.E(Group 1 B.E < +/-2.5 mmol: Group 2 B.E >+/- 2.5 mmol) and lactate (Group 1 Lactate < 3 mmol: Group 2 Lactate>mmol ) were created, Two post-operative groups for B.E(Group 1 B.E < +/-5.0 mmol: Group 2 B.E >+/- 5.0 mmol) and lactate( Group 1 Lactate <5mmol: Group 2 Lactate>5mmol )were created to find their correlation with early postoperative complications. Results: In our study ICU morbidity and mortality was more related to the lactate and base excess values in the early 24 hours. Progressive Hyperlactatemia and constant negative base excess values were both significantly associated with ICU complications. In the CPB period subgroup negative base excess was more superior in predicting ICU prognosis than Lactate. (P-value 0.001) similarly patients divided in subgroup BE >+/- 5mmol/l had demonstrated superiority in making such prediction. Both CPB (0.013) and X.C (0.036) time were associated independently with ICU prognosis. .Longer ventilation times were also associated with bad ICU prognosis. Conclusion: Our study found negative base excess values in the early postoperative period to be superior in predicting ICU morbidity and mortality when studied at subgroup level both peri-operatively and postoperatively.
The Effect of Teaching Programme on Knowledge and Caring Practice of Intra-Aortic Balloon Pump Patient Among ICU Staff Nurses
Authors: Ghafoor Yasmeen , Sarwar Hajra , Afzal M. , , Yaqoob Adnan , Khan Sadia , Ghafoor Samreena
Published: May 2022

Background: The intra-aortic balloon is the most commonly used of all circulatory assist device provide the circulatory support for cardiac patients experiencing hemodynamic instability due to cardiogenic shock and myocardial infraction. during angioplasty for those patients on very high risk, and also used during coronary artery bypass grafting (CABG). During this device nurses play a very important role to provide care. nurse knowledge and practices are very helpful to soon recovery and prevent from complication. Educational programme is necessary for upgrading the nurse knowledge and skills. Objectives: Assess the knowledge & practices of nurses regarding IABP in Cardiac patient and introduce the IABP practice standardized guidelines on care of patent with IABP among ICU nurses. Material and Method: A Qausi experimental study design was used from October to December 2018. The data was collected from 40 nurses of ICU, CCU of Punjab Institute of Cardiology, Lahore The sampling technique was used convenient sampling. Data was entered and analyzed by using SPSS version 23, finding presented as frequencies, proportions and comparisons of means using a paired sample t-test will analyze. Differences were considered statistically significant if p < 0.05. Results: In this shown that the majority of had nurses had poor knowledge and practice related to intra-aortic balloon pump before educational programme which has been enhanced after educational session of this study. Conclusion: Empowerment of cardiac critical care nurse’s knowledge and practice would have knowledge and skillful impression upon their knowledge and practices. Keywords: CABG Coronary Artery Bypass Grafting ICU Intensive Care Unit CCU Coronary Care Unit IABP Intra-Aortic Balloon Pump
Common Hematological Abnormalities in patients with Malaria presenting at Saidu Teaching Hospital, Swat Pakistan
Authors: Ahad Abdul , Qadir Saima , Rashid Aleem ur , Swati Amir Zeb
Published: May 2022

Objectives: To determine the frequency of common hematological abnormalities in patients with malaria. Study Design: A cross-sectional study. Place and Duration of the Study: Department of Medicine, Saidu Teaching Hospital, Swat Pakistan from November 2019 to May 2020. Material and Methods: A total of 137 patients of both genders aged between 18-60 years and who presented with malaria in emergency or outpatient department were analyzed. Ten cc blood was taken from all enrolled patients and sent to institutional laboratory for the detection of anemia, thrombocytopenia, leucopenia and disseminated intravascular coagulation (DIC). Frequency of common hematological abnormalities among patients of malaria was noted. For data analysis, SPSS version 26.0 was used. Results: In a total of 137 patients, 95 (69.3%) were male and 42 (30.7%) female. Overall, mean age was 29.2±13.18 while 84 (61.3%) patients were aged between 18 to 30 years. Mean duration of disease was 1.2±1.09 weeks while 89 (65.0%) patients had duration of disease <1 week. Table-1 is showing baseline characteristics of all patients. Anemia was found in 121(88.3%) patients, thrombocytopenia in 67(48.9%), leucopenia in 20 (14.6%) and 35 (25.5%) had DIC. Conclusion: The frequency of hematological abnormalities in patients with malaria was high. Anemia was found in 88.3% malaria cases, thrombocytopenia 48.9%, leukopenia 14.6% and DIC 25.5%. Keywords: Anemia, Leukopenia, malaria, thrombocytopenia.
Comparison of Mean Pain Score with Inguinal Block under Gen. Anes. versus Subarachnoid Block in Adult Pts UIH
Authors: Ali Sheikh Ziarat , Aziz Waqas , Qamar Kiran , Aslam Fariha , Chaudary Mehtab Tipu , Maqbool Nazia Rubab
Published: May 2022

Objective: To compare the mean pain score with inguinal block under general anesthesia versus subarachnoid block in adult patients undergoing inguinal hernioplasty. Design of the Study: Randomized controlled trial Study Settings: This cross-sectional study was conducted at Department of Anesthesiology, Sir Ganga Ram Hospital, Lahore from January 2021 to June 2021. Materials and Methods: Sample of 200 cases was included through non probability purposive sampling. In group A, patients were given inguinal block and in group B, patients were given subarachnoid block. In Inguinal block group, a 10mL of Bupivacaine (0.5%) will be given at junction of 2/3 form umbilicus and 1/3 from anterior superior iliac spine after administration of general anesthesia with laryngeal mask airway. Patients were followed at 1, 2 and finally on 4 hours after surgery for measurement of pain. Results: The mean age of 39.63±6.50 years. Out of total 200 patients, 186 (93%) were males and 14 (7%) were females. The mean pain score at 1st hour in inguinal group was 0.76±0.87 whereas pain score in Subarachnoid block was 1.18±0.92. Similarly after 2nd hour inguinal group pain score was 0.88±0.84 and with Subarachnoid block was 1.33±1.04. At 3rd hour, with inguinal block mean pain score was 1.02±0.92 and with Subarachnoid block was 1.80±1.20. At 4th hour, with inguinal block mean pain score was 1.59±1.07 and with Subarachnoid block was 3.09±1.60. Statistically there is highly significant difference of mean pain score between both groups i.e. p-value<0.05. There was drastic increase in mean main score at 4th hour with subarachnoid block as compared to inguinal block showing that inguinal block is more effective in reducing pain after 4 hours of surgery. Conclusion: It was concluded from results of this study that inguinal block is more beneficial in controlling pain after inguinal hernia surgery as compared to subarachnoid block Keywords: Inguinal Hernia, Inguinal block, Spinal anesthesia, General anesthesia
A Clinical Study on Thyroid Dysfunction in Pregnancy and its Effect on the Fetomaternal Outcome
Authors: Yasmin Shakila , Nadeem Saba , Javed Aisha , Sehar Najm us , Shakeel Sadia , Anum Amna
Published: May 2022

Background: Thyroid gland is the power house of human body. It provides energy for the various biochemical processes of the body and helps to maintain basal metabolic rate. Objective: To estimate the prevalence of thyroid dysfunction in pregnancy and to evaluate the obstetric and perinatal outcomes in such pregnancies Setting: Department of Obstetrics & Gynecology, Bahawal Victoria Hospital Bahawalpur from 15 January 2021 to 15 JUNE 2021 Study Design: A Descriptive Case Series. Materials and Methods: A total of 292 cases of antenatal patients, irrespective of their period of gestation were enrolled in this study by random sampling method. Patients with multiple pregnancies and having bad obstetrical history were excluded. Detailed history and obstetrical examination, routine blood test and serum TSH were performed. These patients were followed during labour, delivery and puerperium and maternal outcome and neonatal outcomes were noted. Results: In this study we enrolled two hundreds and ninety two (292) antenatal women. Out of total 292 patients only 61 (20.9%) were nulliparous and rest of the patients were multiparous. The prevalence of thyroid dysfunction in pregnancy was 8.2%. Out of this, 2.74 % patients had sub clinical hypothyroidism (SCH). Overt hypothyroidism (OH) was seen in 2.40%, sub clinical Hyperthyroidism in 1.71% & the incidence of overt hyperthyroidism was 1.37%. Maternal complication included: abortion (5.5%), pre-eclampsia (3.4%), abruption-placentae (4.1%), preterm labour (4.5%), PPH (4.2%) and puerperal sepsis (2.8%). Neonatal outcomes included: preterm births (5.4%),LBW (5.1 %), IUGR (6.2%), still birth (4.4%), neonatal death (5.1%), low APGAR score ( <7 at 5 minutes ) (6.9%). Conclusion: Thyroid dysfunction in pregnancy, though has a low incidence, but is associated with adverse maternal and fetal complications. Thus thyroid screening should be done in antenatal period to improve fetomaternal outcome. Keywords: Thyroid dysfunction, Hypothyroidism, Hyperthyroidism, Fetomaternal outcome, Overt Hypothyroidism, Subclinical Hypothyroidism.
Should judges be neutral?
Authors: Hogan Gerard
Published: May 2022

This is a slightly revised version of the MacDermott Lecture delivered (virtually) at Queen’s University, Belfast, on 27 May 2021.
Family provision claims and young children: Re R (Deceased)
Authors: Conway Heather
Published: May 2022

Case commentary on R R (Deceased) [2021] EWHC 936 (Ch).