bluuebunny/crossref_metadata_2025 huggingface dataset:
ACUTE CORONARY SYNDROME;
Authors: Zeeshan Ahmed , Ahmad Zaheer , Tahir Ghulam Abbas , Yaqoob Yasir
Published: September 2021

Microalbuminuria is a strong and independent indicator of increased cardiovascularrisk among individuals with and without diabetes and hypertension. The pathophysiologicmechanism underlying the association between albumin excretion and cardiovascular disease(CVD) is that microalbuminuria can be a predictor of CVD risk as it reflects the vascular damagein kidneys. It also shows endothelial damage predicting CV disease risk. Based on this theory,periodic screening for microalbuminuria could allow early identification of vascular diseaseand help stratify overall cardiovascular risk, especially in patients with risk factors such ashypertension or diabetes. Therefore microalbuminuria can be used for stratification of risk forcardiovascular disease. Once microalbuminuria is present, cardiovascular risk factor reductionshould be aggressive. Objectives: The objective of the study was to determine the role ofmicroalbuminuria as an atherosclerotic risk factor and its association with coronary arterydisease. Study Design: Cross-sectional study. Duration of Study: Duration of study was6 months with first patient enrolled on 16-03-2007 and last patient enrolled on 15-09-2007.Setting: Medical Unit-III and CCU Allied Hospital, Faisalabad. Subjects: 300 patients withacute coronary syndrome, admitted in Allied hospital Faisalabad were enrolled. Methods: 300patients diagnosed as having acute coronary syndrome admitted in Allied hospital Faisalabad,were included in the study. Early morning urine as well as 24 hour urine had been collectedin sterilized urine bags and microalbuminuria was tested. Results: In this study 300 patientshaving acute coronary syndrome were enrolled. Microalbuminuria was positive in 66 (22%)patients and 234 (78%) patients had no microalbuminuria. There was significant associationbetween microalbuminuria and atherosclerotic coronary artery disease. Conclusion: It isconcluded that microalbuminuria is an atherosclerotic risk factor and it is strongly associatedwith coronary artery disease.
BREAST CANCER SCREENING;
Authors: Bukhari Hassan , Shaukat Asim , Ahmad Nosheen
Published: September 2021

Objectives: To compare the efficacy of Magnetic resonance imaging andMammography for Breast-Cancer Screening in high risk Women with a Familial or GeneticPredisposition. Study Design: Cross-sectional study. Setting: Department of Radiology AlliedHospital, Faisalabad. Duration: From January 2012 to December 2014, Sample size: 299.Methods: A total of 299 females at high risk of breast cancer were included in this study andthey underwent screening rounds of Mammogram and contrast enhanced dynamic breastMRI once a year with independent readings. Both the imaging modalities were interpreted byexperience radiologist and all the images were categorized using Breast Imaging Reportingand Data System. In each patient, histopathology results were considered the standard criteriafor the calculation of the sensitivity, specificity for both Mammogram and Breast MRI lesions.Results: Mean age of the patients was 46.69±11.86 years. Mammography revealed 11 (3.68%)true positive breast lesions, 22 (7.36%) false positive lesion, 247 (82.61%) true negative and19 (6.35%) false negative lesions yielding the sensitivity of 36.67% and diagnostic accuracy of86.3%. Dynamic breast MRI revealed 28 (9.36%) true positive breast lesions with 5 (1.67%) falsepositive, 264 (88.29%) true negative and 2 (0.67%) false negative lesions yielding sensitivity of93.3%,specificity of 98.14%,PPV=84.85%,NPV=99.25% and diagnostic accuracy of 97.66%.MRI breast was significantly more sensitive (93.3 vs. 36.67%) and accurate (97.66 vs. 86.3%)than mammography. Conclusion: MRI is more sensitive than mammography in detectingtumors in women with an inherited susceptibility to breast cancer.
ELECTRONIC HEALTH RECORD SYSTEMS;
Authors: Mehmood Hamid , Aslam Muhammad , Aslam Sadia , Waqar Ammara , Khan Athar , Hassan Yasir , Cheema Faryal Murtaza , Mujtaba Hassan , Maham Noor-e-
Published: September 2021

Introduction: e-Health is a combination of medical informatics, public health,business and information technology. Health information technology has increased theproductivity by reengineering of health care but it requires new measurement tools to monitorthe impact of it .e-health is not only for the development of technologies but also it includesproper planning, thinking, broad thinking to improve healthcare services with the help ofinformation and communication technology. Objectives: 1) To assess the perceptions ofphysicians towards the use, effectiveness and efficiency of EHR 2) To identify the differencesbetween electronic and paper based records 3) To evaluate the usage of Electronic HealthRecords.4) To analyze satisfaction and challenges face by the physicians using EHR. ResearchDesign: This is an Exploratory and Descriptive Research. In this study hybrid research methodis used which includes qualitative and quantitative research methods. Sampling technique:For this study, a purposive sample of 43 physicians was selected. The sample size was 60but 17 responses were incomplete so they were excluded and the final sample size was 43.Data was collected from two different hospitals of Pakistan which include the physicians fromShaukat Khanum Memorial Cancer Hospital and Research Centre, and Indus Hospital. Of the43 participants, 51% were from Indus Hospital and 49% were from Shaukat Khanum MemorialCancer Hospital and Research Centre. Instrument: A structured questionnaire was used tocollect data and it was collected by email responses and direct interview. EHR Questionnaire:A questionnaire was used in the study. The EHR Questionnaire has comprised of 24 items. Thisquestionnaire was developed by Msukwa. B.K.Martin.1 Data Analysis: Data analysis was doneby Statistical Package for Social Sciences (SPSS) and Microsoft Excel. Procedure: The sampleconsisted of physicians from Shaukat Khanum Memorial Cancer Hospital and Research Centre,and Indus Hospital from Karachi. EHR is a new technology and hospitals are moving towardsit, some are under process and very few like the above mentioned hospitals are using it. Thequestionnaire was not complicated. It was a structured questionnaire with easy questions withmultiple options to fill in. Respondents were also acknowledged for their cooperation andparticipation in the study. Conclusion: EHR should be used effectively, proper training is neededto ensure that physicians are able to operate the system and can have maximum benefits fromthe technology by utilizing all its applications. The government should encourage adoption ofElectronic Health l Records in Pakistan by developing a public-private partnership. The studyfocused also on EHR effectiveness by checking the working of EHR its quick and satisfactoryresults its accuracy, adequacy, timeliness, user- friendliness, availability and reliability.
SURGICAL SITE INFECTIONS;
Authors: Surahio Abdul Rashid , Talpur Altaf Ahmed , `Memon Abdul Salam , Junejo Afzal , Laghari Abdul Aziz
Published: September 2021

Background: Wound infection has been a major problem in the surgical fieldsince long time. Significant improvements in sterilization, preoperative preparation of patient forsurgery, surgical techniques & prophylactic usage of preoperative antibiotics have not been ableto eradicate wound infections. Development of wound infection increases the hospital stay, costof treatment & increase morbidity & mortality associated with surgery. Objectives: To assesstype of organism responsible for postoperative wound infection & its drug sensitivity patterns atPublic & private sector hospitals of Hyderabad. Study Design: Prospective, descriptive study.Setting: Public & Private Sector Hospitals of Hyderabad, Pakistan. Period: June 2013 to May2014. Materials & Method: All patients of either sex above the age of 13 years who underwentsurgery & developed wound infection were included in the study. Samples to assess culture &sensitivity pattern of organism were taken from infected wounds. Subject’s data was collectedon preformed proforma for age, sex, diagnosis, co morbid illness, type of surgery, presence orabsence of wound infection, grade of infection, and culture & sensitivity pattern of organismisolated. Results: During this 1 year period total of 424 patients of different pathologies relatedto General surgery were finally included in analysis. Mean age was 27.35 years with 61.08%were male and 38.91% female. Inguinoscrotal operations were the commonest proceduresperformed in 113(26.65%) patients followed by Appendicectomy in 102(24.06%) patients.Surgical site infection was noticed in 54(12.74%) patients with 47(13.27%) had this of grade II& above. It includes 23(22.55%) patients of Appendicectomy followed by 09(33.33%) patientsof Laparotomy. 47(13.27%) samples were sent for Culture & sensitivity with 41(11.58%) ofthem showed positive yield. E. coli noticed as commonest organism isolated in 26(63.41%)patients followed by Staphylococcus Aureus in 08(19.51%). Most sensitive antibiotics againstnoted were Meropenem & Pipracillin with Tazobactum which showed sensitivity to E.coli in25(96.15%) patients & 24(92.31%) patients respectively while their sensitivity against S.Aureus was 07(87.5%) & 06(75%) patients respectively. Vancomycin was found sensitiveagainst Staphylococcus Aureus in 07(87.5%) patients. Sensitivity of Ampicillin to most ofthese organisms was found significantly low. Conclusion: Wound infection is responsible forsignificant morbidity in developing world with the frequency of 15.53% in this study. It puts upsignificant economic burden on the hospitals.
TIBIAL SHAFT FRACTURES;
Authors: Amin Muhammad Qazi , Ahmed Ashfaq , Imran Muhammad , Ahmed Naeem , Javed Shahzad , Aziz Amer
Published: September 2021

Background: Tibia is the most commonly fractured bone because of itsstructure and position. Tibial fractures are increasing with time to time and hence the morbidityand mortality are increasing despite proper public health efforts. There is a lack of nationalepidemiological data on the characteristics of patients with tibial shaft fractures. Therefore,epidemiological assessment is crucial for fracture. The purpose of this study was to provide upto-date information about patients baseline demographics, distribution of fracture classification,trauma mechanism and to formulate the preventive measures. Study Design: Retrospectivestudy. Setting: Emergency or OPD at Orthopaedics and Spine Centre, Ghurki Trust TeachingHospital, Lahore. Period: 1st January 2011 to 31st December 2015. Material and methods:Any type of diaphyseal tibial fracture. The data were taken from hospital database and includeclinical, epidemiological and radiological records. The results were analyzed using SPSS 20.Results: A total of 2120 patients were included in the study. 1980(93.4%) were male and 140(6.6%) were females. Male to females ratio were 14.14:1 with mean age of 33.28 ± 21.02.Between 0-20 years, 519(24.5%) of patients were admitted, 1021(48.2%) of patients werebetween 21-40 years, 467(22.0%) were between 41-60 years and only 113(5.33%) were above60 years. Type A2 in 444(20.9%) were the most common pattern of fracture found. The traumaswere most common in months of May, June and July and Motorbike accidents were the maincause. The mid shaft of tibia is the most commonly fractured i-e 1038 (49.0%) followed bydistal part i-e 611(28.8%) and the least is the proximal i-e 471(22.22%). Conclusion: Thisstudy shows AO-type 4A2 was the most common fracture type, representing 20.9% of all tibialshaft fractures. The individuals between 21-40 years were mostly affected and the motorbikeaccidents were found the main cause for such traumas.
NEEDLE STICK INJURIES;
Authors: Punjabi Suneel Kumar , Banglani Munir Ahmed , - Priya , Mangi Nayab
Published: September 2021

Objectives: To evaluate the concepts & handling of needle stick injuries amongjunior dentists of city Hyderabad. Study Design: Descriptive Cross Sectional study. Setting:Dental House Surgeons & Postgraduates. Period: June 2015 to January 2016. Methodology:The study population of 200 dentists were included working either in civil or private settingsof Hyderabad, Sindh. Questionnaire designed to obtain information about their concepts andhandling regarding NSIs. Results: 75(37.5%) of them were working in Oral Surgery department,53(26.5%) in Operative dentistry, 35(17.5%) in Orthodontics, 22(11%) in Periodontology, and15(7.5%) in Prosthodontics. 77(38.5%) had idea about transmission of Hepatitis B, 89(44.5%)about Hepatitis C, & 34(17%) about HIV/AIDS by NSI. 168(84%) had knowledge aboutuniversal precautions guidelines, 16(8%) use safety devices to dispose used sharp objects.189(94.5%) had faced NSIs ever. 97(48.5%) had knowledge about post exposure prophylaxisin the management of needle stick injury. 37(18.5%) had said that they will contact to medicalemergency room if they expose to NSI, 32(16%) will contact to oral surgery department,53(26.5%) will consult with their physician & 78(39%) said that they will manage themselves.Conclusion: this study confirm that junior dentists of Hyderabad experience the NSIs but arenot liable to report them, therefore they necessitate the improvement in clinical training forpreventing & reporting all NSIs. Through Support, counseling and tutoring by their OccupationalHealth Department.
POST PARTUM IRON DEFICIENCY ANEMIA;
Authors: Turab Syed Mohsin , Furqan Muhammad , Jamali Shah Nawaz , Zaidi Syeda Amber
Published: September 2021

Objectives: To Analyze and compare the effect of oral vs parenteral iron therapyon various hematological parameters in women suffering from post-partum iron deficiencyanemia. Study Design: Comparative, randomized and prospective study. Setting: Departmentof Pharmacology, HCMD, HU in collaboration with the Dept of Obs/Gynae, JPMC Karachi.Period: January to December 2015. Subjects and Methods: 40 patients divided in two groupsA and B of 20 each. Group A received oral iron (Tab Iberet 525 mg once daily) for a period of 3months while group B was treated with intravenous iron sucrose complex (Inj Venofer 100mg/Amp) the total no of doses were calculated according to Hemoglobin deficit. Hemoglobin,Hematocrit and MCV were observed at day 0, 45 and 90 of the treatment. Results: Group Ashows a mean increase of 25.85% at day 90th of the treatment in comparison to this group Bshows a much better result with a mean increase of 36.71% in Hemoglobin conc. At the end of12 weeks therapy. Conclusion: Parenteral iron therapy was found to be an effective means oftreatment in patients with postpartum iron deficiency anemia.
SYSTEMIC LUPUS ERYTHEMATOSUS;
Authors: Hamdani Muhammad Afzal , Parvez Khalid , Naseeb Faisal , Afzal Umair , - Bashiruddin , Hope Cal Joseph , Hussain Sajjad
Published: September 2021

Systemic lupus erythematosus (SLE), is a multifactorial, complex etiologicaldisorder, characterized by inflammation and involvement of multiple organ systems includinglungs. Objective: 1-To evaluate whether high resolution computed tomography (HRCT) helpsin the diagnosis of pulmonary manifestations of SLE. 2-To study the pattern and extent of lunginvolvement using HRCT. Design: A Prospective cross - sectional clinical study. Period: Fouryears, July 2012 to June 2016. Setting: King Khalid University Hospital (KKUH) King SaudUniversity (KSU), Rheumatology division Department of Medicine. Methods: This study included113 patients attending outpatients or admitted as inpatients having respiratory symptomsand diagnosed as SLE according to American College of Rheumatology (ACR) classificationcriteria. Chest X- ray, pulmonary function tests, and HRCT chest were done. Investigationsto detect other organ involvement were done. Pregnant females and patients having otherconnective tissue or occupational diseases were excluded. Results: Of the total 113 patients102 were female and 11 males. Age of patients was 37.1 ±13.0 years. The HRCT abnormalitieswere pleural effusion, pleural thickening, atelectasis, ground glass opacities including nonspecificinterstitial pneumonitis (NSIP) and usual interstitial pneumonitis (UIP), pulmonaryarterial hypertension, pulmonary embolism and hilar lymphadenopathy. Conclusion: Variouspulmonary manifestations are present in a significant number of symptomatic SLE patients anda variety of HRCT patterns can be seen to diagnose and treat them.
PREGNANCY WITH CARDIAC DISEASE;
Authors: Yousaf Farah
Published: September 2021

Objective: Objective of study was to find out prevalence and fetal and maternaloutcome in pregnancy with cardiac disease. Study design: A retrospective descriptive study.Setting: Services Hospital Department of Obs and Gynae unit-2. Period: 1st January to 31stDecember 2015. Methodology: All cardiac patients who delivered after 28 week gestation wereincluded in the study. Case-notes of cardiac patients were reviewed, patients age, parity andgestational age was recorded. Maternal and fetal outcome was noted in relation with NYHAclassification, data was analyzed. Results: In our study prevalence of cardiac disease was 1.09%. Age of most patients were between 26-30 years, 44.68%. Most of patients were multiparous57.44%. According to NYHA classification, 63.82% had class 3 & 4 cardiac disease. Rheumaticheart disease was present in 91.48%. Thirty patients were delivered by caesarean section. Therewere 3 IUD and 2 perinatal deaths. Maternal mortality was 2.12%. Preterm delivery occurredin 20 patients. Conclusion: Cardiac disease is important cause of maternal and perinatalmorbidity and mortality. It’s important to counsel all women of reproductive age with knowncardiac disease, about increased fetal and maternal risk during pregnancy. Cesarean sectionmay be considered in patients with moderate or severe MS with class 3-4 symptoms.
PUBLIC PRIVATE PARTNERSHIPS (PPPs);
Authors: Tahir Muhammad Shuja
Published: September 2021

Public Private Partnerships (PPPs) is defined as “arrangements betweengovernment and private sector entities for the purpose of providing public infrastructure,community facilities and related services. The partnership must be based on a mutual agreementbetween the public and the private sectors, be in a form that the service provision purpose ofthe public sector and the profit goals of the private sector can agree, and be mutually liable forrisks. The evaluation of the institution of the PPPs along with suggestions for future action aimedat profit maximization, better utilization of the projects and maximization of social benefits aremade, taking under consideration the ever-increasing demands and special socio-economiccircumstances of our contemporary society.
MICROALBUMINURIA;
Authors: Sandhu Ghazanfar Ali , Tahir Ghulam Abbas , Ahmad Zaheer , Anjum Aqeel Maqsood
Published: September 2021

Diabetes Mellitus is a rapidly increasing problem which is contributing tochronic illnesses like Cerebrovascular, Cardiovascular, Diabetic Retinopathy and End StageKidney Disease. These dreaded complications can be prevented if treated early. In patientswith diabetes mellitus type 2, microalbuminuria is an independent and strong risk factor forcardiovascular mortality & morbidity and diabetic nephropathy. If diagnosed early, diabeticnephropathy can be treated at this stage. Angiotensin converting enzyme inhibitors (ACEInhibitors) and Angiotensin Receptor Blockers (ARBs) are effective in prevention and treatmentof microalbuminuria. Material & Methods: Study Design: randomized controlled trial. Setting:medical department, allied hospital, Faisalabad. Duration of study: Feb 2013 to July 2013.Sample size: 60 (30 in each group). Sampling technique: Non-probability consecutivesampling. Results: 60 patients were included in the study. 28(46.7%) were males and 32(53.3%)were females. Mean age of study population was 50.15±7.27 years. Albumin creatinine ratio(mcg/mg) at start of study was 193±67.5 in Losartan potassium group and 209.5±72.00 inlisinopril group (independent sample t-test p value=0.302). Albumin creatinine ratio (mcg/mg) at 12 weeks of study was 36.33±54.68 in Losartan potassium group and 72±83.42 inlisinopril group (independent sample t-test p value = 0.056). Paired sample t test applied toboth treatment groups and p value was found to be 0.0001 which is highly significant for bothgroups and shows that both drugs are effective in reducing microalbuminuria in both groups.Microalbuminuria was reduced significantly in 26 patients (86.7%) in Losartan potassiumgroup and 20 patients (66.7%) in lisinopril group (p-value=0.067). Conclusion: It has beenconcluded from this study that lisinopril and Losartan potassium, both significantly reducemicroalbuminuria in type 2 diabetes mellitus and there is no statistically significant difference inefficacy of these two drugs in reducing microalbuminuria in type 2 diabetes mellitus.
DIABETIC FOOT AMPUTATION;
Authors: Akhtar Naveed , Ahmed Sultan , Tabassum Hassan Mahmood , Lanjar Sadaf
Published: September 2021

Introduction: Diabetic foot lesions have remained a major cause of morbidity inpatients with kidney failure. Foot complications are more than twofolds in diabetic nephropathypatients, and the rate of amputation is 6 to 10 times higher in diabetic nephropathy patientsin comparison to the general diabetic population. Objectives: To determine the frequencyof diabetic nephropathy in patients undergoing diabetic foot amputation. Study Design:Observational cross-sectional study. Setting: Surgical Department Unit-II, Sheikh ZayedMedical College and Hospital Rahim Yar khan. Material and Methods: The duration of thestudy was 2 years from Dec-2013 to Dec-2015. A total number of 73 patients were includedin this study. Patients who were admitted to the department of surgery for amputation of thefoot or the leg having the history of diabetes regardless of their age and sex were selectedfor this study. Data analyses were carried out using SPSS Version17 software. Quantitativevariables were presented as Mean and standard deviations. Frequency and percentages werecomputed for qualitative variables. Results: The mean age of the patients was 57.51±7.61years. Out of 73 cases, there were 43(58.9%) males and 30 (41.1%) females. Previous historyof amputation was observed in 26 (35.62%) cases, 48 (65.75%) patients were hypertensive.Out of 73 patients, Forty (54.79%) had controlled diabetes and 33 (45.21%) had uncontrolleddiabetes. Twenty seven patients (36.99%) were diagnosed for diabetic nephropathy. Theincidence of nephropathy was high in patients with advancing age. This incidence was in 26(56.62%) patients with age 51 to 60 years and 18 (39.13%) in patients having age more than 60years. Conclusions: Lower extremity amputations are strongly associated with nephropathy indiabetic patients. It is very important to check and improve the renal function in patients withdiabetic foot ulcers who are hypertensive, increasing age and long duration of DM to preventlower limb amputations.
SUBCONJUNCTIVAL INJECTION
Authors: Ahmad Faheem , Mushtaq Tayyab
Published: September 2021

Introduction: Normally the cornea in human eye is crystalline clear membranepresent in the anterior most portion of the eyeball. Regarding the various functions of thecornea in human eye it provides protection, clear vision, refractive media the visual systemand maintains itself as an immune privileged site. Neovascularization is mostly associated withan inflammation and always indicate a state of disease. Similarly Corneal Neovascularizationcan cause Graft rejection reaction after keratoplasty the different types of anti-VEGF agentsnow are used to prevent neovascular eye diseases. These different Anti-VEGF inhibitors areLucentis, Macugen and bevacizumab/Avastin and used in case of ocular neovascularization.Objectives: To determine the efficacy of subconjuctival injection of Avastin on patients havingcorneal neovascularization following keratoplasty. Settings: Department of OphthalmologyAllied Hospital, Faisalabad and Independent University Hospital, Faisalabad. Study Duration:The duration of study was 11-02-2015 to 11-07-2015. Results: A total of 86 cases fulfilling theinclusion/exclusion criteria were enrolled to determine the efficacy of subconjuctival injectionof Avastin on patients having corneal neovascularization following keratoplasty. Discussion:Regarding the success of Keratoplasty is determined by many factors especially avascularity ofcornea after surgery. Corneal neovasculrization is disease process secondary to various ocularinsults in which growth of vessels towards central cornea occur from the limbal vascular plexus.But now a days Bevacizumab/Avastin is commonly used in Ophthalmology as “off label” drug inthe treatment of Exudative age related macular degeneration as well as in diabetic retinopathy.Conclusion: We concluded that the frequency of efficacy of subconjuctival bevacizumab ishigher in patients having corneal neovascularization after corneal transplantation.
PREVENTION OF THALASSEMIA;
Authors: Ayub Romana , Khan Hayat Muhammad , Rehman Zia ur , Ahsan Junaid , Gul Rubina , Khan Uzair , Khan Shama
Published: September 2021

Objectives: The study was conducted to determine role of CVS in preventionof thalassemia and its sensitivity and specificity in those families with thalassemia positivehistory. Period: Three months. Study Design: Cross sectional study. Material and Methods:130 women who had thalassemic children and had come to transfusion centers for bloodtransfusion. Questionnaire was used for interview. Results: out of the total 130 women, 101were aware of CVS technique in which 50 had CVS. In 50 CVS, 15 had positive result while 35had negative result. In 15 positive cases 11 had abortion while four positive women refusedto abort. Out of the four women who completed their term, three were true positive while onecase was false positive. In 35 negative case results, 32 were true negative and three werefalse negative. Conclusion: Thalassemia is the commonest genetic disorder worldwide. It istransmitted from those parents who are carrier of thalassemia. Chorionic villous sampling playsimportant role in prevention of thalassemia during 1st trimester of pregnancy.
BACTERIAL VAGINOSIS;
Authors: Saleem Faiqa , Malik Munazza , Shahid Muhammad Sohaib , Tayyab Muhammad
Published: September 2021

In women of reproductive age bacterial vaginosis is a most common polymicrobialdisease and is the leading reason for vaginal discharge in this age group. Additionally itis further linked with sizeable disease burden of community problem in terms of infectiouscomplications. Clindamycin vaginal cream and metronidazole vaginal gel are effective in themanagement of vaginal infections caused by multi bacteria. Objectives: To compare thetherapeutic efficacy of Metronidazole vaginal gel and clindamycin vaginal cream as modality oftreatment for bacterial vaginosis. Study Design: Randomized control trial. Setting: Departmentof Obstetrics and Gynaecology, Unit-3 Jinnah Hospital Lahore. Period: Six months from 02-05-2011 to 01-11-2011. Material & Methods: A total of 300 patients were included in this study.They were divided into two groups. Group A received metronidazole vaginal gel (5 g dailyfor 7 days) while group B administered with clindamycin vaginal cream (5g daily for 7 days).Results: Mean age of the patient was observed 34.3+3.5 and 32.9+ 2.1 years in group –A andB respectively. Vaginal discharge was absent in 104 patients (69.3%) from group A and 127(84.7%) from group-B. Absence of clue cells on microscopy revealed in 112 patients (74.7%)from group A and 137 patients (91.3%) from group B. Absence of amine odour found in 116patients (77.3%) of group A and 134 patients (89.3%) of group B. Significant difference wasfound between two groups with p value of 0.006 in respect of efficacy. Conclusion: Clindamycinvaginal cream is more effective in comparison to Metronidazole vaginal gel for the treatment ofbacterial vaginosis.
DIABETES MELLITUS;
Authors: Bashir Farhat , Rehman Farzana , Ghaznavi Samina , Ara Jamal
Published: September 2021

Diabetes mellitus is a modifiable risk factor for generalized atherosclerosis.Measurement of carotid intima media thickness by Doppler ultrasonography can be used tomeasure the extent of atherosclerosis. Objectives: To determine the association of carotidatherosclerosis in patients with type 2 diabetes mellitus and its relationship with glycemiccontrol. Study Design: Cross-sectional comparative study. Period: 12 months June 2015 toMay 2016. Setting: Creek General Hospital in the Department of Medicine and Radiology,Karachi, Pakistan. Method: The subjects were selected from diabetic patients presenting tothe Out-Patient Department and controls from their attendants. All subjects had a detailedhistory, physical examination and laboratory investigations recorded. The variables includedage, gender, weight, BMI, blood pressures, fasting and post prandial blood sugars, HbA1cand lipid profile. All individuals underwent B-mode ultrasound for carotid Doppler studies. Asingle operator conducted all the Doppler studies. The carotid intima media thickness wasmeasured and the presence of carotid plaque was recorded for each subject. The data wasentered on SPSS ver 20.0. Numbers and percentages were calculated for categorical datawhile mean±standard deviation was calculated for continuous data. The carotid intima mediathickness and its association with diabetes were analyzed by Student’s t test. P-value of <0.05was considered significant. Among the diabetic patients the relationship of glycemic controland carotid intima media thickness was analyzed through student’s t-test. P-value of <0.05was considered significant. The association of presence of carotid plaque for diabetic and nondiabeticsubjects was assessed by Chi-square test. P-value of <0.05 was taken as significant.Association of carotid plaque among diabetic patients with satisfactory and unsatisfactoryglycemic control was also assessed through the Chi-square test and p-value of<0.05 wasconsidered significant. Result: Out of the total study population of 237 subjects, which consistedof 119 diabetic and 118 normal controls, there were 105 male and 132 female patients. Themean fasting blood sugar was 113.3±55.2 mg/dl, mean random blood sugar was 185.9±102.0mg/dl, mean HbA1c was 6.98±2.5 %. Mean ±SD of carotid intima media thickness was0.91±0.17 mm. Results revealed that diabetes has significant association with the thicknessof carotid intima media (p-value<0.000). A total of 28 individuals (11.8%) had a carotid intimamedia thickness that was classified as a localized carotid artery plaque. The presence of carotidplaque also showed a significant association with the presence of diabetes. The degree ofglycemic control showed no relationship with carotid intima media thickness. The presenceof carotid plaque also showed no association with degree of glycemic control. Conclusion:CIMT measured by Doppler ultrasonography was found to be significantly associated with thepresence of diabetes mellitus. There was no relationship of glycemic control with CIMT amongthe diabetic patients.
UPPER GASTROINTESTINAL BLEEDING;
Authors: Ather Mughees , Sarfraz Muhammad , Zakria Muhammad
Published: September 2021

Background: Upper gastrointestinal bleeding (UGIB) is a common medicalcondition requiring mostly hospitalization and resuscitation. Patients with upper GI bleedinghave high morbidity. The investigation of choice in upper GI bleeding is upper GI endoscopy,because endoscopy has good, the complication rate with endoscopy are low, anotheradvantage of using endoscopy is therapeutic interventions as well. The causes of upper GIbleeding are numerous most frequent causes being in decreasing order of frequency pepticulcer, esophageal varices, mallory-weis tears. Other causes include tumors, erosions andarterio-venous malformations.3 Objectives: To determine the endoscopic findings in patientspresenting with UGIB and frequency of various findings among these patients according togender and age in medical ward of Allied Hospital Faisalabad. Study Design: Retrospectivelyreviewed and analyzed. Setting: Medical Unit 2 of Allied Hospital Faisalabad. Period: 06 monthbetween January 2015 to June 2015. Methods: The record of 120 patients who underwentendoscopy for upper gastrointestinal bleeding. Results: Data was collected and entered onSPSS. Statistical data analysis was performed with chi-square. Statistical significance wasdetermined at P< 0.05. Information obtained from upper gastrointestinal endoscopy werethen recorded according to age, gender and presented in form of tables. Conclusions: It hasbeen found that esophageal varices was the most commonest cause of upper gastrointestinalbleeding in the study probably due to the high prevalence of hepatitis infection and chronic liverdisease in our population.
BODY MASS INDEX;
Authors: Kitchlew Rizwana , Chachar Aijaz Zeeshan Khan , Latif Sonia
Published: September 2021

Background: Asians compared to Europeans are known to be at an increasedrisk of cardiovascular disease (CVD) risk factors. Obesity is a global cardio metabolic healthand cancer risk. There is paucity of data regarding obesity in our local population. Aims &Objectives: To evaluate Body Mass Index (BMI). Visceral fat content and body fat percentageusing Bio-impedance body composition monitor. Thus to identify overweight and obeseindividuals with high visceral and body fat content the risk factors for cardio metabolicsyndrome. Study Design: Cross sectional survey. Setting: Outpatient Department of Medicine,Fatima Memorial Hospital Lahore, Pakistan. Period: 15th January to 20th March 2016. Materialand Method: 250 patients above 18 years of age who reported in outdoor department wereenrolled after informed consent in local language according to enrollment criteria. Approved byethical review committee reference number FMS-2-2016-IRB-M-111. Their height and weightwere measured and BMI, visceral fat content and body fat percentage was calculated using bioimpedancebody composition monitor. They were asked questions for pertinent co-morbidities.The statistical analysis was done using SPSS 22.0 version. Results: Out of 250 patients enrolled144 (58 %) were females and 106 (42 %) were males. Mean age was 45 ±13 years. Mean BMIwas 29kg/m2. Above normal BMI was seen in 170 (68%), 98(39%) were obese (BMI>30kg/m2) and 80 (32%) overweight (BMI 25-29.9). Above normal visceral fat content and body fatpercentage was seen in 110(44 %) and 191(76%) respectively. In the later group 100(67%) werefemales. Diabetes and hypertension were present in 63(64%) obese patients among 30(73%)with high visceral fat and in 90(60%) with high body fat percentage. Conclusion: A significantnumber of patients were overweight or obese with above normal visceral fat content and bodyfat percentage with female dominance in later group. They also had higher prevalence ofdiabetes and hypertension. Bio-impedance technique is useful simple inexpensive tool for initialassessment of visceral and body fat content in outdoor facility.
ACUTE CORONARY SYNDROME;
Authors: Aslam Lashari Naveed , Irum Lakho Nadia , Ahmed Memon Sarfaraz , Ahmed Ayaz , Waseem Muhammad Fahad
Published: September 2021

Introduction: ACS is defined as the cluster of symptoms arising due to the rapiddrop of blood flow to the heart because of coronary artery obstruction. It is stated that worldwidearound 17 million people die due to cardiovascular diseases of which half of the deaths arereported due to ACS. Chest pain is known to be the most leading factor associated with ACS.Objectives: To determine the frequency of acute coronary syndrome, its types and commoncontributing factors in patients presenting with typical chest pain in a secondary care hospital.Study Design: Cross sectional study. Setting: Medical Unit, PAF Hospital Mushaf Sargodha.Period: October 2013 to March 2014. Methodology: A total of 280 patients of either gender,aged 20 to 80 years presented with typical chest pain with or without conventional risk factorswere included in the study. Results: Majority (68.9%) was males and 31.1% were female. Acutecoronary syndrome was observed in 131(46.8%) patients. Out of these 131 patients, 55% hadNSTEMI, 28.2% had unstable angina and 16.8% had STEMI. A higher proportion of femaleswere found to have ACS as compared to males (75.9% vs 33.7%, P-value<0.0001). Out of131 patients, 40.5% were diabetic, 29.8% were hypertensive 16% were hyperlipidemic, while13.7% were smokers. Conventional risk factors except smoking were observed more in femalesas compared to males. Conclusion: Majority of patients with acute coronary syndrome werefemales and diabetic. NSTEMI was the most common type of ACS. Prevalence of conventionalrisk factors was found more in females with ACS.
BLOOD DONATION;
Authors: Latif Muhammad Zahid , Riaz Haroon , Mujtaba Syed Waseem Ahmad , Nizami Rahila
Published: September 2021

Objectives: This study was conducted to assess the knowledge, attitude andpractices of students regarding blood transfusion in a medical institute. Settings: Azra NaheedMedical College Raiwind road Lahore. Study Design: Descriptive, cross sectional study. StudyPeriod: May and June, 2015. Methods: After the approval of the ethical institutional reviewcommittee, 168 students of 4th year MBBS and 6th semester DPT were included in this study.The data was collected on a structured questionnaire. This data was entered in the version 16of SPSS and analyzed by the use of statistical tools. Results: Out of the total 168 participants,90 (53.6 %) were the students of MBBS, whereas 78 (46.4 %) were the students of DPT. The ageof the respondents ranges between 19 to 28 years. 81 (48-2 %) were male students whereas87 (51.8 %) were females. The results represent that the medical students are having a goodknowledge regarding blood donation but a clear majority of the respondents (63.7 %) havenever donated blood. However a vast majority (78 %) of the participants responded to donateblood in near future. Conclusion: .The blood donation and transfusion is a safe procedure,but it may affect the health of recipient if the necessary measures are not observed. This studyreflects that medical students have good knowledge about blood donation and are willingto donate in near future. A campaign for awareness and motivation regarding voluntary andunpaid blood donation can help to achieve the target of WHO for safe blood transfusion.
NUTRITION IN SURGICAL PATIENTS;
Authors: Aziz Muzaffar , Jamil Choudhary Tariq , Shafiq Muhammad , Hussain Qureshi Khalid
Published: September 2021

Objectives: The objective of this study was to compare the frequency ofcomplications in postoperative patients with partial parenteral nutrition and total parenteralnutrition in surgical wards. Study design: Randomized Controlled Trial. Setting: Departmentof General Surgery of Nishtar Hospital Multan. Subjects & Methodology: In this study, sixtypatients of either gender with any abdominal surgery like primary repair of enteric perforationand repair of duodenal ulcer perforation were eligible for this study. In PPN group patients weregiven dextrose 10% in Ringer lactate solution just for 4 days. In TPN group patients got TPNsolution that has 25 kcal/kg consistently for 4 days. All supplement preparations were preparedday by day under aseptic conditions. Infusion was performed through a central venous catheterusing an injection micro pump. Information was gathered with respect to expanded hospitalstay (> 7 days) and wound infection. Results: Age range in this study was from 20 to40 years with mean age of 31.333± 3.67 years in PPN group while 32.200± 3.87 yearsin TPN group. Wound Infection was seen 50% in PPN group as compare to 10% in TPNgroup (P=0.000) while Increased Hospital Stay was seen 26.7 % in PPN group as compareto 6.7% in TPN group (P=0.037). Conclusion: PN feeding does not appear to offer beneficialadvantage in rates of complications and it doesn’t seem to diminish the length of hospital stay.TPN instantly taking after major surgery is a reasonable parenteral feeding.
BENIGN PROSTATIC HYPERPLASIA;
Authors: Raza Iffat , Mukhtar Sahrish , Kamran Mahrukh
Published: September 2021

Objectives: To study the effect of anthropometric measures on benign prostatichyperplasia patients in a subset of Karachi population. Study Design: A cross-sectional study.Setting: Ziauddin University Hospital, Radiology Dept, Clifton. Karachi. Method: 103 benignprostatic hyperplasia patients was carried out. These patients were recruited from a urologyclinic. The study subjects were divided on the basis of Age groups, body mass index groupsand waist circumference groups. Result: Mean prostate volume of BPH patients was foundto be was 62.7 ± 12.5 years. Mean BMI was found to 24kg/m2. Mean waist circumferencewas found to be 73.8cms. Prostate volume was found to be doubled in waist circumferenceof greater than 90cm group. Conclusion: Prostate volume greatly enlarges with advancingage. Waist circumference is the only contributing factor among other anthropometric measureswhich causes growth of prostate volume.
DIABETICS IN A LOW SOCIOECONOMIC COHORT;
Authors: Nageen Ayesha , Suhail Kidwai Saera , BashIr Farhat , Ara Jamal , Munir Syed Muhammad
Published: September 2021

Objectives: To study the latest trend of cardiometabolic risk factors in diabeticsin a low socioeconomic group. Design: Cross sectional observational. Place and duration:Three tertiary care hospitals of Karachi. June 2013 – Dec 2014. Methods: 824 type II adultdiabetic patients of both genders were included. History was taken regarding diabetes, ischemicheart disease, hypertension, and cerebrovascular accidents. Blood pressure and BMI wasrecorded. Investigations were done for dyslipidemia. SPSS 16 was used for means, frequenciesand proportions. Results: There were 276 males (33%) and 548 females (67%) with a meanage of 52 years (±9.67). Mean duration of diabetes was 9.36 years (± 6.39). Hypertension waspresent in 375 (45%) diabetics of which males were 124(33%) and females were 251(66.6%).Frequency of hypertension in total diabetic males is 45% (125) and in females 45.6 %( 140).Ischemic heart disease was present in 105 patients (12.7%) in which males were 45(42.8%) andfemales were 60(57.1%). The male percentage of ischemic heart disease was 16.3% (45) of thetotal males and females 11 %( 40). Stroke was found in 19 patients (2.3%) equally distributed inboth genders. Mean Body mass Index was 28.02 (+/- 5.31) with 135 (16.3%) being overweightand 529 (64.2%) obese. Dyslipidemia was present in 250 (42.3%) out of 591 patients. Smokinghistory taken in 614 patients showed that 73 (11.8%) were smokers and/or chewed tobacco.Out of a total of 595 patients, 372 (62.5%) patients had metabolic syndrome. Conclusion:There is a strong association and high prevalence of cardiovascular risk factors in diabetics ina low socioeconomic group. Factors such as hypertension, dyslipidemia, obesity, and smokingfurther multiply the cardiovascular risk ratio in diabetics.
PREVALENCE OF DEPRESSION;
Authors: Malik Uttra Ambreen , Muhammad Uttra Malik Ghulam , Rauf Abdul , Malik Uttra Mehreen , Hasan Umme Habiba , Batool Amna
Published: September 2021

Objectives: This study was conducted to assess the prevalence of depressionand associated risk factors among medical students at different levels (1st to 5th year) of theirMBBS course. Study Design: Cross-sectional study. Setting: Sargodha Medical College,Sargodha. Period: April to September 2016. Material and Methods: A sample of 200 medicalstudents (including 147 female and 53 male) was chosen by random sampling. PHQ-9 scalewas used to evaluate depression among participants. Data was collected on a speciallydesigned questionnaire containing sociodemographic and educational characteristics andwas analyzed using SPSS 16.0. Results: Out of 200 respondents, who participated in study,75.5% reached depression criteria. The age range of majority of students (53%) was 20-22 year.Factors such as female gender, year of medical college, staying in hostel, both pre and postexam depression, academic pressure, high competition, overburdened test schedules andworries about future were found to be significantly associated with depression. Conclusion:The results depict that frequency of depression among MBBS students during their academicyears is very high, making them highly susceptible individuals. This demands the necessityfor pervasive enactment of therapeutic measures by medical college administration, includingassessment, education and provision of mental health services.
COMPLIANCE TO DIABETIC THERAPY;
Authors: Rahim Memon Ashfaque , Randhawa Mohammad Akram , M Alshammari Sami Owaid , Alanazi Ahmed Badah , N Alshammari Abdul Aziz Mayouf , H Alrawaili Yosef Soltan , K Alrawaili Yara Shargi
Published: September 2021

Objectives: Prevalence of diabetes mellitus in Arabian Peninsula has risen toa very high level especially in Saudi Arabia (32%). Compliance of diabetic patients’ towardstherapy is crucial for diabetic management. According to a study conducted at Riyadh,Saudi Arabia 83.4% of uncontrolled glycemic level (HbA1c ≥7%) patients did not follow therecommended dietary plan. Another factor for high rates of un-controlled diabetes was poorcompliance to medication. Present study was aimed to investigate awareness of disease anddrugs, as well as compliance to medication, dietary control and exercise in diabetic patientsreporting to a tertiary hospital at Arar, Saudi Arabia. Study Design: A cross sectional descriptivestudy. Setting: Diabetic center of Prince Abdul Aziz bin Mossaid hospital, Arar, Saudi Arabia.Period: November and December 2015. Methods: Patients’ awareness of disease and drugs,as well as compliance to medication, dietary control and exercise was investigated by using astructured questionnaire. Response to various questions was analyzed using SPSS programversion 16. Data was further correlated between variables via Fisher’s exact and chi-squaredtest. Result: Average awareness about disease and drugs was 56.5% and 23%, respectively.Overall compliance rates to medication, dietary control and exercise were 89.3%, 31% &28.5%, respectively. Positive association was found between awareness to disease/drugs andcompliance to therapy. Conclusion: The results of present study and similar studies conductedelsewhere indicate that patients’ awareness towards their disease and medication is directlyproportional to patients’ compliance. Adequate awareness programs should be arranged forbetter management of diabetes in the community.
ROOT CANAL MORPHOLOGY;
Authors: Khawaja Naveen , Kumar Punjabi Suneel , Ahmed Banglani Munir
Published: September 2021

Morphological features of mandibular 3rd molar are always unpredictable, andshow a discrepancy by way of different individual. Nevertheless, restorative, prosthetic andorthodontic concerns of these mandibular third molars require root canal treatment in turn topreserve functional elements in the jaw. The variation in the root canal anatomy presents clinicalchallenges and difficulties for clinician to undertake endodontic therapy. Therefore it’s veryessential for practitioners must have adequate knowledge of the internal morphology of rootcanal system, use all techniques, equipments is mandatory to treat the entire root canal system.Study Design: Cross-sectional. Setting: Department: Operative Dentistry, Faculty of Dentistry,Liaquat University of Medical & Health Sciences, Jamshoro. Period: February 2014 to March2016. Methodology: Overall 200 patients of mandibular 3rd molar (fully erupted in the jaw)were enrolled with indicative irreversible pulpitis, Were endodontically treated by conventionalmethod using stainless steel hand files, contra-angle small head hand peace by postgraduatetrainee. After opening of access cavity, every canal was positioned radiographically by the handfiles placed within the canals. Results: Among 200 patients of mandibular third molars wereevaluated by conventionally endodontic treatment, Out of 200 patients were found to havea practical errors in the 65 cases and rest of the 135 cases were treated without any errors.Number of canal configuration has found in lower 3rd molar teeth, one canal contained in4(2.0%) teeth, two canals in 33(16.5%) teeth, three canals in 160(80%) teeth and four in 3(1.5%)teeth. Conclusion: Mandibular third molars showed huge anatomic irregularity. Numberof canals has provided by this study to the practitioner with an understanding of the clinicalrecommended for lowers third molars.