bluuebunny/crossref_metadata_2025 huggingface dataset:
PATTERN OF CANCER
Authors: SALEEM KHURUM , Ahmed Hafiz Sohail , IQBAL JAVAID , Ehsan Muhammad , SAQIB KHURRAM
Published: September 2021

Objective: To detect the types of cancer. Design: Retrospective cross sectional survey. Settings: Department of ClinicalOncology (Liaqat Ward) Allied Hospital Faisalabad. Period: From January, 1s t 2005 to December, 31s t 2005. Materials and Methods: Thedata was obtained from the hospital record and then was tabulated with respect of age, sex, and the type of cancer. This survey includesthe patients who presented in the department of oncology with one type of cancer or other. Results: A total of 1087 patients met inclusioncriteria for this survey. There were 526(48.2419%) male and 557(51.2419%) female patients, And 594 (54.65%) Urban and 493 (45.35%)Rural patients. Out of the total 1087 patients, 201 patients (18.4219%) presented with breast cancer, 60 patients (5.579%) presented withsquamous cell carcinoma of the face and 58 patients (5.335%) were found to be suffering from brain tumor.
CORONARY HEART DISEASE
Authors: AHMED MUNIR , TAYYIB MOHAMMAD
Published: September 2021

O b j e c t i v e s : This study was conducted to perform serum lipid profile in off springs of premature coronary heart disease(CHD) patients and age and sex matched normal controls and compare the results of two groups. S t u d y d e s i g n : A cross sectional study.Patients a n d m e t h o d s : 250 off springs of diagnosed premature CHD patients were selected from Punjab institute of cardiology, Lahoreand Services hospital, Lahore. 50 age and sex matched normal controls were selected from different areas of Lahore. Serum totalcholesterol (TC), serum triglycerides (TG) serum low density lipoprotein-cholesterol (LDC-c) and serum high density lipoprotein cholesterol(HDL-c) was performed. Results: Serum TC, TG, LDL-c of off springs of premature CHD patients was increased as compared with normalcontrols. Serum HDL-c of all the subjects of off springs of premature CHD patients was decreased as compared with normal controls.C o n c l u s i o n : Off springs of premature CHD patients are more prone to develop lipid abnormalities as compared with normal controls.
STABLE ANGINA
Authors: AHMED SHAFIQUE , AHSAN MUHAMMAD BILAL , ULLAH EHSAN , Abbas Raees
Published: September 2021

Objective: To see the frequency of coronary artery stenosis in the patients of stable angina having left bundle branchblock, and to see the effects of gender and age on this correlation. Design: Experimental case series. Setting: Bahawal Victoria Hospital,Bahawalpur. Period: June 2006 to May 2008. Methods: One hundred and forty one (141) patients of Stable Angina presenting with atypicalchest pain, both male and female of 30—70 years age, positive for LBBB and with normal Cardio-Thoracic Ratio, normal echocardiographyand negative for conventional risk factors and family history of Coronary Artery Disease were taken. All patients were angiographied .Results: A total of 141 patients were investigated through coronary angiogram to see the frequency of coronary artery stenosis in thesepatients. Ninety five (67.4%) patients proved to have coronary artery stenosis. The male patients showed higher frequency (87.4%) ofharboring coronary vessel blockade as compared to that (35.2%) in females (P value <0.0005). There was no relation between age and thefrequency of coronary stenosis (P value >0.05). Conclusions: There is significant difference (P value <0.0005) in coronary artery stenosisamong men and women having LBBB.
RHEUMATIC HEART DISEASES
Authors: KHAN HAMZULLAH
Published: September 2021

O b j e c t i v e s : To determine the frequency of rheumatic heart diseases in a hospital based study in Peshawar. D e s i g n : Across sectional observational. Setting: Cardiology department, Lady-Reading Hospital Peshawar. Period: From July 2005 to July 2006.M e t h o d : Relevant in formations were recorded from patients and treatment chart of the patients, on a questionnaire designed in accordancewith the objectives of the study. Results: A total of 88 patients with established diagnosis of rheumatic hear diseases (RHD) were randomlyselected. Out of total 70.45% were females and 29.54% males, with males to females ratio of 1:2.38. The age range of the patients wasfrom 8 years to 64 years with mean age of 47 years. The mode of age was 35 years. The frequency of rheumatic heart diseases was: MitralStenosis 13.63%, Mitral Regurgitation 60.22%, Mitral Stenosis /Mitral Regurgitation 21.59%, Aortic Stenosis/Aortic Regurgitation 2.27%,Aortic Stenosis 1.13% and Tricuspid Valve Stenosis 1.13%. We observed that RHD were more common in lower social class people(42.04%) with income less than 5000/month. C o n c l u s i o n : In our setup RHD are more common in female gender and especially in theyounger age, Mitral Stenosis was recorded as major type of RHD in our patients.
DOUBLE LUMEN INTUBATION
Authors: AHMED SHAFAQ , Tariq M. , JANJUA SARFRAZ , Raza Hasan , ISHAQ M.
Published: September 2021

Introduction: Auscultation is well established and most commonly used method for checking of correct placement ofDouble Lumen Tube(DLT). Now with widespread availability of fibre optic bronchoscope, confirmation of DLT placement by fibre opticbronchoscope is recommended by many and considered mandatory by some anaesthetist. Objective: To discuss method of insertion andreliability of auscultatory method to confirm correct placement of double lumen tubes. S t u d y d e s i g n : Observational. Place a n d d u r a t i o n:Combined Military Hospital Rawalpindi from 16th Nov 2003 to 13th July 2007. Material & M e t h o d s . We have performed about one thousandone hundred and fifty double lumen intubation without use of fibreoptic bronchoscope. Results: 85% of patients did not need any tubeadjustment during surgical procedure. Only 15% cases required tube adjustment intra-operatively. None of procedures were abandoneddue to double lumen tubes problems. C o n c l u s i o n : We conclude that auscultation is not that unreliable though not perfect method of DLTplacement. Use of fibreoptic bronchoscope is recommended but not mandatory for DLT placement. Anatomical malpositioning detected byfibre optic bronchoscope which according to some studies is 70 to 80% does not necessarily translate into physiological malfunctioning.
LAPAROSCOPY
Authors: AZEEM MUHAMMAD QASIM , HASSAN HAMID
Published: September 2021

Objective: To identify the various acute and chronic abdominal conditions presenting as non specific abdominal pain inwhich diagnostic laparoscopy was indicated to establish a definite diagnosis and treatment. Design: Descriptive study. Setting: Surgicalunit-l of Rawalpindi General Hospital Rawalpindi. Period: From February 2005 to February 2006. Materials & Methods: All patients whopresented with non specific abdominal pain and fulfilled the inclusion criteria were included in the study. The sample size was 150 cases,out of which 71 (47%) were male and 79 (53%) were female. Mean age was 32.65± 17 years. Fifty five (36%) patients were admitted throughemergency department while 95 (63%) were admitted through OPD. Four main groups were identified who presented with nonspecificabdominal pain in which diagnostic laparoscopy was indicated. These were patients with acute or chronic inflammatory conditions (66%),acute or chronic intestinal obstruction (14%), patients with blunt/penetrating abdominal trauma (11 %), and patients of intra abdominal tumor(9%). Out of these 150 cases, 53 cases (35%) had laparoscopy to confirm the diagnosis (diagnostic laparoscopy) while the remaining 97cases (65%) had both the diagnostic as well as therapeutic laparoscopy. Mean hospital stay was 1.7 Days. Conclusion: The study hasdemonstrated the various acute and chronic abdominal conditions in which laparoscopy in indicated and proved to have higher diagnosticand therapeutic yield, and hence improved the management of these patients.
BRONCHOGENIC CARCINOMA
Authors: SULIMAN MUHAMMAD IMRAN , QURESHI FAYYAZ , AKHTER MUHAMMAD SAEED
Published: September 2021

Background: The Connection between smoking and lung cancer is now generally accepted. The objective of this studywas to observe smoking habits among different histological types of bronchogenic carcinoma. Setting: Bahawal Victoria Hospital,Bahawalpur. P e r i o d : April 2000 to March 2003. M e t h o d s : This was a simple descriptive study comprising of 30 consectivehistopathologically / cytologically confirmed cases of bronchogenic carcinoma that were admitted in different medical units of BahawalVictoria Hospital, Bahawalpur. History regarding smoking was taken in detail including type of smoking, quantity of tobacco smoked andduration of smoking in years. Smoking patterns were observed with their age, gender, living conditions and type of bronchogenic carcinoma.Results: Among eighteen cases of squmous cell carcinoma, history of smoking was present in all males. Only one female who belongedto a village was non- smoker. Cases with small cell carcinoma were six in total and all were males with five smokers, three urban areas andtwo rural areas. Only one was a non- smoker with a rural background. Three females and one male had adenocarcinoma. One male fromcity and one female from a village were smokers, while remaining two females were non-smoker and lived in urban areas. Two men sufferingfrom large carcinoma were smokers residing in urban areas. C o n c l u s i o n : Cigarette smoking is present in 87% of all bronchogenic carcinomaespecially with squamous cell, and large cell varieties. The involvement of smoking cases of adenocarcinoma has been found to be the leastcommon.
TRANSVAGINAL SONOGRAPHY
Authors: ISLAM ALIYA , GHAZALA, GHAZALA
Published: September 2021

O b j e c t i v e : (1) To evaluate predictive values of non-invasive transvaginal sonography in abnormal uterine bleeding. (2)Correlate results of transvaginal sonography with hysteroscopy and biopsy in abnormal uterine bleeding. D e s i g n : Descriptive study. (Validitystudy for TVS). Setting: Gyny/Obs Deptt, Military Hospital Rawalpindi. Period: One year - from January 2006 to December 2006. S u b j e c ts& M e t h o d s : Women of any age presenting with abnormal uterine bleeding. Total number of cases included were two hundred. Patients wereevaluated in OPD by taking detailed gynaecological history. Clinical examination was carried out to find any local source of bleeding fromgenital tract. Pap smear was taken at that time. Transvaginal ultrasound was performed in OPD basis. The results were noted on a predesignedproforma. Routine investigations were performed on outpatient basis at the time of patient selection which included complete bloodpicture, urine analysis, random blood sugar, renal function tests and hepatitis B and C screening. Then the patients were admitted forhysteroscopy and histopathology. Hysteroscopic findings were noted on the proforma. Later histopathology report was also entered intoproforma. Hysteroscopy and biopsy were considered gold standard in our study. Thus the procedure was considered 100% accurate andsensitivity, specificity, PPV and NPV for TVS were calculated. Results. It was found that at less than 14 mm endometrial thickness noserious pathology was found. Sensitivity, specificity, negative predictive value and positive predictive value for TVS was found as follows;1.For endometrial hyperplasia 100%, 93%, 100%, 79% respectively. 2. For endometrial polyp 100%, 97%, 100%, 25% respectively. 3. Forcarcinoma 100%, 99%, 100%, 33% respectively. 4. For proliferative endometrium 79%, 100%, 78% and 100%. 5. For secretary phaseendometrium 100%,96%. 100%,79%respectively. 6.Forsub mucus fibroid 100%, 98%, 100%, 60% respectively. C o n c l u s i o n : .Differencebetween values of hysteroscopy and TVS is not very significant so TVS should be used as 1s t line investigation. At less than 14mmendometrial thickness no major pathology is detected.
MATERNAL MORTALITY
Authors: REHMAN TASNIM TAHIRA , ROOHI MAHNAZ
Published: September 2021

Objective: To find out maternal mortality ratio (MMR) and to determine major causes of maternal death. S t u d y d e s i g n:A descriptive study. Setting: Department of Obstetric and Gynaecology, Allied Hospital, Faisalabad. S t u d y period: From 01.01.2008 to31.12.2008. Materials a n d m e t h o d s : All cases of maternal death during this study periods were included except accidental deaths. Results:There were 58 maternal deaths during this period. Total No. of live births were 5975. MMR was 58/5975 x 100,000 = 970/100,000 live births.The most common cause of maternal death was hemorrhage (34.5%) followed by hypertensive disorders/eclampsia (31%). Most of thepatients (75.86%) were referred from primary & secondary care level. C o n c l u s i o n : Maternal mortality is still very high in underdevelopedcountries including Pakistan. We must enhance emergency obstetric care (EOC) to achieve the goal of reduction in MMR.
PLACENTA PREVIA
Authors: SAEED ZOONA , Saeed M. , IKRAM M. , Saeed Roohi , TAZIAN SHAZIA
Published: September 2021

Objectives: To analyze the causative factors and short term complications in cases of placenta previa. D e s i g n a ndSettings: A retrospective study carried out in Obstetrics and Gynecology Department of Sheikh Zayed Post Graduate Institute Lahore.P e r i o d : From June 2004 to June 2007.Subject: Fifty patients with placenta previa. M a i n o u t c o m e m e a s u r e s : Age, parity, previouscesarean section, previous history of evacuation/myomectomy, average hospital stay, need for blood transfusions, emergency/electiveLSCS, associated maternal and fetal morbidity and mortality. Results: There were 50 cases of placenta previa over the period of 3 years.Most frequently occurring intra operative complication was postpartum hemorrhage in 19 patients (38%). Highest morbidity was due toanemia which was in 23 patients (46%). Maternal mortality was 2%, while neonatal mortality was 14%. C o n c l u s i o n : Placenta previa is amultifactorial disease. No doubt that the rising incidence of cesarean section is increasing the intraoperative complication associated withthe condition but other risk factors are also important like age, parity, history of evacuation etc.
UNCONTROLLED DIABETES MELLITUS
Authors: MALIK TAYYABA GUL , GUL ROQUYYA , KHALIL MUHAMMAD , Qasim Ali
Published: September 2021

Although there are many causes of orbital cellulitis and odontogenic orbital cellulitis is a rare entity but it is quite commonin patients with uncontrolled diabetes. We present small series of patients with odontogenic orbital cellulitis and review the devastating visualoutcome in patients with uncontrolled diabetes. Purpose of this report is to highlight the significance of ocular complications of dentalinfections which if not tackled promptly can lead to blindness especially if the patient is an uncontrolled diabetic. This case series alsostresses upon the importance of dental hygiene and the proper sterilization of the dental surgical instruments which is not given dueconsideration in the developing countries like Pakistan.
HEPATITIS BANTIGENAEMIA
Authors: NAFEES MUHAMMAD , HAQ IRSHAD UL , ASLAM MUHAMMAD
Published: September 2021

Introduction: The prevalence of hepatitis B virus infection is a global health issue including Pakistan, causingconsiderable morbidity and mortality from its chronic sequelae including chronic chronic hepatitis, cirrhosis and liver cancer particularly whenHBV infection is acquired early in life. Objective: The present study was undertaken with the object to find out the current HBV infectionrate and any age and sex differentiation in the population of Faisalabad. Place a n d Duration: This studied was carried out at MadinaTeaching Hospital, Faisalabad, from May 2005 to April 2007. S t u d y D e s i g n : A descriptive, hospital based study. M e t h o d s : Blood wascollected by approved medical techniques for HBsAg immunochromatographic devices were used to screen blood. Results: HBs antigenpositivity in Faisalabad is currently 1.55%. A significant majority of reactive cases belonged to the male gender (72.91 %) and the young agegroups 2-4 (43.75%). C o n c l u s i o n : Upon analyzing the results of this study, it was revealed that the number of HBV infected subjects isolatedis rather low in this area but the given figure is still notable in view of its high prevalence in the young age groups.
ACUTE MYOCARDIAL INFARCTION;
Authors: HAFEEZ SHAHID , KAYANI AZHAR MAHMOOD , JAVED ASIM
Published: September 2021

Objective: To assess the reliability of the first set of CK-MB in establishing diagnosis of acute myocardial infarction in different subgroups of the patients according to their time of presentation after symptom onset. Material a n d m e t h o d s : Prospective observational study was carried out in Armed Forces Institute of Cardiology/National Institute of Heart Diseases (AFIC/NIHD) Rawalpindi, from April to September 2005. We studied 300 consecutive cases presenting with typical electrocardiographic changes of acute ST Elevation Myocardial Infarction to the Emergency & Reception department of AFIC/NIHD (confirmed later on as acute STEMI with raised serial serum cardiac enzymes levels). We documented values of CK-MB at the time of presentation in different subgroups of the patients according to duration of symptom onset. R e s u l t s : This study was predominantly male dominated (approximately 78%), with a mean age of 58 +11 years. Majority of patients i.e.216 (72%) presented within first 6 hours of onset of symptoms, 60 (20%) within 6-12 hrs, 6 (2%) within 12-24 hrs and 18 (6%) after 24 hrs of onset of symptoms. Overall serum cardiac enzymes sent at the time of presentation revealed that 126 (42%) patients had normal CK-MB (<24U/L) and another 66 (22%) had a minimal rise in CK-MB (25-49 U/L). Only 108 (36%) patients 3 had serum CK-MB levels more than double the normal value. Amongst the patients presenting within the first 6 hours of onset of symptoms, 104 (48%) had normal CK-MB values, 48 (22%) had a minimal rise (<49 U/L) and only 64 (30%) had a significant rise in CK-MB levels i.e. more than double the normal values or more than 5% of CK value. Out of 60 patients who presented within 6-12 hours of onset of symptoms, 54(90%) had more than double the normal value of CK-MB and 6(10%) had mild rise in CK-MB. All the patients (100%) who presented within 12-24 hours of onset of symptoms i.e. 6(2%) and more than 24 hours 18(6%) had significant rise in CK-MB. C o n c l u s i o n : This study shows that the first set of CK-MB alone has very little value in diagnosing acute myocardial infarction especially in the patients who presented within 6 hours of onset of symptoms. Reliability of CK-MB in diagnosing acute myocardial infarction greatly improves to the maximum in those patients who present more than six hours after symptom onset.
ANGINA PECTORIS
Authors: MALIK ISHTIAQ AHMED , MAHMOOD KHALID , KHAN ALI NAWAZ
Published: September 2021

Objective: To assess the clinical efficacy, cost effectiveness and side effect profile of trimetazidine in the managementof stable angina pectoris. Patients a n d M e t h o d s : An open label, uncontrolled study was conducted in 200 patients with stable angina inarmed forces institute of cardiology, Rawalpindi Pakistan. Patients were treated for 4weeks with modified release trimetazidine tablet (35mg)twice daily in addition to their conventional therapy. R e s u l t s : As compared to base line trimetazidine significantly reduced the number ofanginal episodes per week from 10 to 3 (p<0.005), improved exercise duration time on standard exercise tolerance test (ETT) (410 vs. 370sec; p<0.01), time to onset of typical angina (380 vs, 290sec; p<0.05), time to 1mm or more ST segment depression (340 vs. 290 sec;p<0.01)).There was no drop out of patients due to side effects or non compliance. C o n c l u s i o n : These results indicate that trimetazidineis effective and well tolerated when used in combination with existing antianginal therapy in patients with angina pectoris
LAPAROSCOPIC CHOLECYSTECTOMY
Authors: AKRAM MUHAMMAD , FAROOQ UMER , GULZAR MUHAMMAD REHMAN , Khan Muhammad Ajmal , Iqbal Javaid
Published: September 2021

O b j e c t i v e : To determine the frequency of bleeding, surgical site infection and common bile duct injury after laparoscopicCholecystectomy in patients with co-morbidity. S t u d y d e s i g n : Descriptive study. (Case series). S e t t i n g : Department of Allied & D.H.Qhospital Faisalabad. P e r i o d : July 2006 to December 2007. Patients a n d M e t h o d s : It comprised of 30 consecutive patients of cholelithiasiswith co-morbidity presenting in surgical department. Patients having uncontrolled hypertension, chronic obstructive airway disease andmalignancy were excluded. Detailed history and physical examination was carried out as per protocol. It was followed up by relevantinvestigations. All the cases underwent laparoscopic cholecstectomy. R e s u l t s : The age of the patients ranged from 23-68 y, with mean ageof 40-56 y. Among these 14 cases were having D.M (46.66 %), 06 patients were cirrhotic (20%), 06 patients had acute cholecystitis (20%),02 patients were having H.T.N (6.6%), and 02 patients were >70 years (6.6%). All the patients were females. Out of diabetic patientsundergoing laparoscopic cholecystectomy, SSI was noted in 02 (6.66%) patients. While mild postoperative bleeding was noted in 01 (16.6%)of cirrhotic patients after laparoscopic cholecystectomy. No untoward event was noted in patients with H.T.N ac. Cholecystitis & advancedage. C o n c l u s i o n : In high risk patients undergoing laparoscopic cholecystectomy, very few complications were noted. Postoperatively.Morbidity following above procedure was quite low as compared to conventional one. Laparoscopic cholecystectomy should be the preferredoption in high risk patients for better outcome.
TRAFFIC ACCIDENTS
Authors: SAQIB ANWAR SAOOD , GULZAR MUHAMMAD REHMAN , MUGHAL IRFAN AHMED
Published: September 2021

O b j e c t i v e : To find out the correlation between different types of skull fractures and intracranial lesions in traffic accidents.Setting : Patients examined in surgical emergency Allied Hospital, Punjab Medical College, Faisalabad. D u r a t i o n : Two years from 1s tJanuary 1996 to 31 December 1997. Materials a n d M e t h o d s : In this study, the reports belonging to surviving 250 cases that had headinjuries in traffic accidents were examined retrospectively. Data was collected from surgical emergency record office. Collected informationwas analyzed with descriptive and inferential statistics. R e s u l t s : The rate of intracranial lesions among the cases with the skull fracture was39.0%, while the rate of skull fracture among the cases with the intracranial lesion was 50.3% (P < 0.001). Depressed fractures were morein males, while linear fractures were more in females as well as in young males as whole intracranial lesions were less in patients with skullfracture due to lower intra cranial pressure.
MASTALGIA
Authors: RANA NAUMAN ANWAR , WAQAS AHMED , JAVAID RANA HASSAN , Haq Intisar-UI-
Published: September 2021

Mastalgia is a common clinical symptom experienced by up to 70% of women at some stage of their life. A wide varietyof therapeutic agents are available for the treatment of mastalgia. Both evening primrose oil and non steroidal anti-inflammatory drugs havebeen assessed in randomised controlled trials and demonstrated to be effective. The objective of this Quasi experimental study was tocompare the efficacy and safety of topical nonsteroidal anti-inflammatory drugs with evening primrose oil in the treatment of mastalgia. Westudied 90 female patients presenting with breast pain from 25 July 2006 to 25 July 2007 at the surgical outpatient department of CMHKharian. The patients were divided into three groups. Group-1 was given capsule Effamol (evening primrose oil), group-2 topical brufen geland group-3 topical Vaseline for two months. Patients were followed every two weeks for two months. Response was assessed using Cardiffbreast pain score. Side effects of drugs were recorded at each follow up. Out of 30 patients of group-1,14 (46.6%) had clinically significantresponse at the end of 8 weeks treatment as compared to 27 (90%) in group-2.5 (16.6%) patients of group-1 showed mild side effects whilenone in group-2 had any side effect, p- value was < 0.0001 showing highly significant statistical difference between 2 groups. Topicalnonsteroidal anti-inflammatory drugs are safe and effective as compared to evening primrose oil in the treatment of mastalgia.
NASAL BONE FRACTUR
Authors: RAHIM EJAZ , ASLAM SUHAIL , ALI MUHAMMAD
Published: September 2021

b j e c t i v e : To analyze modes of presentation, types of the nasal fractures and their management. Setting and Period:From 01 Apr 2006 to 31 Mar 2007 at Frontier Corps Hospital, Quetta. Patients and methods: This descriptive study consists of 50 patientsof both sexes and all age groups, managed for nasal bone fractures, presented in emergency as well as in outpatient department. Selectionof cases was non probability, convenient type. All patients were admitted in the hospital for evaluation and further management. Every caseof nasal fracture was properly evaluated, assessed and was managed accordingly. Diagnosis was based on proper history, thorough clinicalexamination and radiological confirmation. Results: From this study it was concluded that adults (80%) were affected more than children.Highest incidence was seen in the age group 18-30 years (46%). The male to female ratio was 3:1. The main aetiological factors in adultswere Sports injuries (30%), personal falls (24%), road traffic accidents (22%) and interpersonal assaults (20%) and in children personal falls(24%). Most of the patients (90%) presented within 2 weeks of the nasal trauma. Epistaxis (92%), nasal deformity (76%), pain andtenderness (72%) and nasal obstruction (70%) were main clinical features. Closed reduction under general anaesthesia (80%) was the mostcommon and effective treatment awarded and complications were minimal. Three cases who presented after 1 year of trauma were treatedby Septorhinoplasty (1), Septoplasty(1 )and SMR(1). 14%(7) patients were treated conservatively. Conclusion: Nasal bone fractures shouldnot be considered minor injuries until they have been thoroughly assessed. Closed reduction under GA is most effective treatment for thepatients presenting within 2 weeks of injury. Prognosis of un-complicated nasal fractures, in general, is good and they heal within 2-3 weekswith good cosmetic and functional results.
SCABIES
Authors: IQBAL JAVED , MANN MUHAMMAD ARIF , SHAHID MUHAMMAD
Published: September 2021

All the conventional scabicidal drugs are used topically and have poor compliance. In several reports and studies,ivermectin, an oral antiparasitic drug, has been shown to be an effective scabicide without any major side effect. Objective: To evaluatethe efficacy and safety of oral ivermectin in the treatment of scabies. D e s i g n : An open, randomized clinical trial (convenience sampling).Settings: Dermatology Department, Divisional Headquarters (DHQ) and Allied Hospitals, Punjab Medical College, Faisalabad, Pakistan,from 1st September 2002 to 28th February 2003. Material a n d m e t h o d s : The study comprised of 100 outdoor patients of scabies, 5-60years of age, diagnosed on history, clinical examination and light microscopy. They and their affected family members were given a singleoral dose of ivermectin 200 mg /kg body weight. Patients were followed up at intervals of 1,2,4 and 8 weeks. R e s u l t s : Fifty-seven patients(57%) had complete recovery at 2 weeks whereas 93 patients (93%) had complete recovery at 4 weeks. Seven (7%) failure cases weregiven a second dose all of which had complete recovery at 8 weeks. No patient developed any major adverse effect. Blood, urineexaminations and liver function tests did not show any significant abnormality. C o n c l u s i o n : Oral ivermectin, in a single dose of 200 mg/kgbody weight, was effective and safe in the treatment of scabies and could be a useful substitute to conventional topical antiscabietics.However further large scale studies are required to further evaluate its safety.
INFANT FEEDING
Authors: SHAHID AFSHAN , KHAN Muhammad Hussain , AHMED MAHMOOD , Arshad Muhammad , KHAN MOHAMMAD WASIF
Published: September 2021

b j e c t i v e s : To evaluate the infant feeding beliefs and practices of mothers in our setup. D e s i g n of S t u d y : A crosssectionalstudy. Settings: Fauji Foundation Hospital. Rawalpindi. P e r i o d : From Jan 2007 to September 2007. Materials a n d M e t h o d s :366 mothers of infants attending Fauji Foundation Hospital were interviewed by using pre-tested questionnaire. Data was collected forMothers beliefs ad practices regarding infant feeding. Descriptive statistics like percentages, mean and range were obtained by using SPSSversion 11. Results: 366 mothers from rural and urban areas attending hospitals were interviewed. 63.9% mothers believed that breast milkshould be given as first feed. Pre-lacteal feeds were given to 56% of infants. Major source of information for giving pre-lacteal feeds wasrelatives. At birth, 43.7% mothers discarded clostrum considering it harmful and useless for baby. Frequency of breast feeding was highinitially at birth but declined rapidly by early supplementation with bottle feeding. Inadequate weaning in terms of timing, quality and quantitywas observed. Cultural beliefs and taboos like hot and cold food influenced 61.5% of mothers due to which they restricted important fooditems. C o n c l u s i o n s : A targeted health education campaign should stress the main advantages of breast feeding. Messages should stressthe protective benefits of clostrum and encourage mothers to start breast feeding immediately after birth. Potentially hazardous practicesincluding pre lacteal feeding should be discarded. Local cultural and traditional practices and beliefs regarding different food items shouldbe identified. This will help to improve the food intake of infants by strengthening the useful beliefs and discontinuing harmful ones.
HBV VACCINATION
Authors: KHOHARO HAJI KHAN , ALVI IRSHAD ALI , AKHUND ISRAR AHMED , Qureshi, Fatima
Published: September 2021

(SUMMARY) Objective: The study was conducted to determine the HBV vaccination status in health care workers of Muhammad Medical College Mirpurkhas. Study design, Setting & Duration of Study: This was a descriptive study carried out at Muhammad Medical College Mirpurkhas, from December 2007 to February 2008. Subjects & Methods: Total 480 health care workers were included; both male and female. Vaccination status & other data were filled on preformed Questionnaire proforma, if vaccinated or not. And if vaccinated either complete or incomplete. Results: Total 480 health care workers were studied, including 300 (62.5%) male and 180 (37.5%) females. The mean age was 34±8.7 and 36 ± 9.3 years in vaccinated and non-vaccinated subjects respectively. A total of 255 (53.15%) were vaccinated, including 215 males and 40 females. A 225 (44.875%) patients were non-vaccinated including 85 males and 140 females. The prevaccination HBsAg status was checked and found negative in all the subjects. The frequency of vaccination was highest among house officer 55 (91.66%) and lowest in the sanitary workers 3 (11.5%). The most common reason of not being vaccinated was non-affordability (high cost of vaccine). C o n c l u s i o n s : We conclude that a substantial number of health care workers are not vaccinated. So it demands a need for a more aggressive approach to be vaccinated and vaccine must be cost effective.
FRAGILITY HIP FRACTURES
Authors: RAFIQUE HAFIZ MUHAMMAD , AZEEM AZEEM , ALI SARDAR
Published: September 2021

Introduction: Fragility fractures, the major clinical problem have increased in recent decade due to an increase inexpected age. There is a tremendous economic burden to manage this problem. The disability increases from 20% before hip fracture to50% after this even if managed properly. Fragility hip fracture is associated with a 20% reduction in expected survival in best hands.O b j e c t i v e s : To study the incidence; types of fractures; treatment options and their outcome. D e s i g n : A retrospective study. Setting: ArmedForces Hospital Southern Region Khamis Mushayt, Kingdom of Saudi Arabia P e r i o d : From April 1996 to April 2006. Material a n d m e t h o d:300 patients were included in the study, both males and females above the age of sixty years presented in Emergency Room with hipfractures due to minor or trivial trauma. Diagnosis was based on clinical and radiological grounds. Additional investigations were made whenand where indicated to confirm diagnosis and to assess the patient from anaesthesia and surgical point of view. Internal fixation was themain treatment to see the ultimate outcome. R e s u l t s : The incidence of fragility hip fractures increased with age. Sixty percent of the victimswere females. The incidence increased with every passing year being 15% in the last year of study. 93.3% of the fractures were ofintertrochanterictype and fixed with engineered metallic device (DHS). C o n c l u s i o n : Prevention or delaying osteoporosis should be the mainobjective. Once there is fragility hip fracture internal fixation is the appropriate treatment.
PREGNANCY ASSOCIATED BREAST CANCER (PABC)
Authors: TAHIR SHUJA
Published: September 2021

Pregnancy associated breast carcinoma is an entity which is diagnosed during pregnancy or within one year postpartum.Objective: (1) To understand the pathogenesis of pregnancy associated breast carcinoma. (2) To be able to manage this problem mosteffectively in the interest of fetus & mother. (3) To be able to avoid preventable complications of treatment. Conclusions: The pregnancyassociated breast carcinoma can be managed effectively with various treatment modalities during various stages of pregnancy & lactation.Prognosis & outcome: It is not worse than the stage wise carcinoma breast in non pregnant women of the same
LATERAL INTERNAL SPHINCTEROTOM
Authors: HASHMAT AZEEM , ISHFAQ TAHIRA
Published: September 2021

Objective: To evaluate the efficacy of lateral internal sphincterotomy in fissure in-ano. Design: This study is a prospective clinicaltrial. Place a n d Duration: It was conducted initially at D.H.Q./ Allied Hospital (PMC) Faisalabad and then other centers from November 2001to onward for the period of six years. Patients a n d M e t h o d s : 140 patients, in urgency due to sever pain, non-compliance to conservative andpharmacological management, or their preference were treated by lateral internal sphincterotomy. The patients were followed up at 1 st to 12thweeks. The extent of improvement in presenting symptoms and complications were noted on questionnaires. Results: Lateral internalsphincterotomy relieved 140 (100%) patients. Transient incontinence of flatus was present in 64.3%, at 1st week that was resolved at 8-12thweeks. There was no recurrence in other complications included infection 7.1%, abscess 7.1% and anesthesia related problems in 14.2 %.C o n c l u s i o n : Lateral internal Sphincterotomy may be regarded as "The Gold Standard"
ACUTE ANAL FISSURE
Authors: AKHTAR MOHAMMAD RIAZ , KHAN HABIB ULLAH
Published: September 2021

Objective: To evaluate the role of topical glyceryl trinitrate (0.2% GTN) on the clinical features of acute anal fissure. S t u dydesign a n d setting: A prospective, open label therapeutic trial was carried out at Combined Military Hospital, Kharian Cantonment during onecalendar year. Patients a n d M e t h o d s : All adult males and females presenting with acute anal fissure were included. Patients with chronic analfissure, associated pathology (hemorrhoids, fistula in ano), age < 15 years, previous surgery of anal canal were excluded. The diagnosis wasbased upon history and physical examination. A detailed history was taken regarding their symptoms like painful defecation, bleeding perrectum, constipation and itching. Then the patients were examined to look for anal fissure, associated mucus discharge and sphincter toneand recorded in the proforma. 0.2% topical GTN ointment was prescribed twice daily for local application in the anal canal with the help of cottonpledget on a stick (soaked completely in ointment). The duration of treatment was four weeks and their symptomatology and healing of analfissure was assessed weekly. Results: A total of 40 patients were treated in this study. Age varied between 22 - 51 years. 36 patients (90%)were male while only 4 patients (10%) were females. Painful defecation (100%), bleeding PR (87.5%), constipation (50%), and itching (40%)were the main complaints. Posterior fissure was seen in 85%, anterior fissure in 12.5%, while both anterior and posterior fissures were seenin 2.5% of patients. Out of 40 patients 21 had complete healing of anal fissure while 03 patients recovered partially. Thus the healing rate was60%.Conclusion: Topical glyceryl trinitrate is an effective treatment modality for acute anal fissure.
WOUND INFECTION;
Authors: BAJWA G.R , KHAN AHMAD HASSAN
Published: September 2021

Objective: The aim of the study was to evaluate the frequency of infection in clean surgical cases (General & Orthopaedic).Study D e s i g n : A descriptive study. Place & Duration of Study: This descriptive study was conducted at department of surgery & orthopaedicDHQ Teaching Hospital Sargodha from July 2007 to Dec, 2008. Patients & M e t h o d s : In this study 1500 clean surgical cases were included.Wounds were examined on third post operative day and then regularly after removal of stitches. Surgical wounds were examined finally onfifteenth post operative days. Description of wound condition and detailed data of patients were collected on preformed performas. Patientswith wound infection developed pain at operation site and fever on third post operative day. Wounds were examined for swelling, redness,discharge; stitch abscess. Routine investigations were done as per protocol ie complete blood examination, complete urine examination, bloodsugar, C-reactive proteins etc. Wounds swab was taken for microscopy and culture sensitivity. Results: This study was carried out on fifteenhundred clean surgical cases (General & Orthopaedic). There were 1064 males and 436 females. Male to Female ratio was 2.4:1. Infectionwas detected in 110 patients (7.3%) while no infection was found in 1390. Infection was maximum in patients more than 60 yrs of age (10.9%).Wound infection was minimum in young patients (3.5%).commonest micro organism isolated from the infected wound was staphylococcusareus. Other organism isolated was streptococcus pyogenes, proteus and pseudomonas. No MRSA was detected. C o n c l u s i o n : In our casestudy clean cases were found generally free of infection especially young patients. Whereas increased incidence of infection was noted in oldpatients. Wound infection is associated with significant morbidity in the form of delayed wound heeling, prolonged hospital stay and increasedeconomical pressure on the patient.
HEPATITIS B, HEPATITIS C a HIV
Authors: TASEER IJAZ-UL-HAQUE , Mirbahar Ahsanullah M. , Mirbahar Ahsanullah M. , HUSSAIN LAIQ , Akbar Muhammad Aftab , SAFDAR SOHAIL
Published: September 2021

Objective: To assess the level of knowledge regarding hepatitis B, hepatitis C and HIV among general public of peripheralareas of Multan. Study design: Cross-sectional study. Setting: Peripheral areas of Multan, village Budhla Sunnat, kusba Ayazabad Marrhaland PMRC Research Centre Nishtar Medical College Multan. Duration of study: From 01.05.2007 to 30.04.2008. Subjects and methods:Medical camps were established in peripheral areas of Multan, village Budhla Sunnat and kusba Ayazabad Marrhal. It was a cross-sectionalstudy which was carried out using non-probability convenient sampling technique. Subjects of both sexes and adult age attending these medicalcamps were included in the study. Informed consent was taken and confidentiality of the personal information was ensured. Specially designedProforma was filled in by the Research Officers and data entered in SPSS-11 and analyzed. Results: Three hundred and eight subjects wereinterviewed. The age of subjects varied from 15-70 years. The mean age was 37.06 years ± 15.59 years. Two hundred and twenty three (72.4%) were familiar with hepatitis B, 196 (63.6%) with hepatitis C and 146 (47.4%) with HIV and 133 (43.2%) were familiar with all three viruseswhile 81 (26.5%) were unfamiliar with these viruses. Most of the subjects 93 (30.2%) knew about the transmission through injection by unsterilizedsyringes, 90 (29.2%) were knowing that infected blood is important source of spread while 87 (28.2%) of the subjects were knowingthat these are spread through infected razors, 84 (27.2%) were knowing unsafe sex as a mode of transmission. Sharing objects can be thesource of spread was known to very less number of people, 9 (2.9%) were aware that these can spread through sharing infected tooth brushes,7 (2.3%) with sharing infected "Miswaks" and only 3 (1 %) were aware that these can spread through infected combs. Electronic media was themajor source of knowledge 82 (26.6%), interpersonal communication 69 (22.4%) and newspapers in only 1 (0.3%). Conclusion: knowledgeabout hepatitis B, hepatitis C and HIV is low in our study population. The results of the study have shown that many people still think that
MALARIAL PARASITE
Authors: SOOMRO FAROOQ RAHMAN , PATHAN GHULAM MURTAZA , KAKAR JUMA KHAN
Published: September 2021

Objectives: To determine the slide positivity rate and to document the different species of malarial parasite at district Shikarpur,Sindh, Pakistan. D e s i g n : A retrospective study. Setting: This study was conducted at district Malaria control centre Shikarur with collaborationof Pathology Department CMC Larkana and Leishmaniaisis/Mosquito Zoology Lab: University of Balochistan Quetta overthe period of one yeari.e. 2006. Patients a n d M e t h o d s : During the study period blood smears were prepared from the suspected cases of malaria. The patients withdifferentiated fever referred from various areas of Shikarpur District by general practitioners, basic health units, rural health centres and talukahospitals were included in the study for confirmation of malaria. The parasites were identified by using Giemsa stained thick and thin smearsfollowing Mansen-Bahar and Bell, 1987. Results: During the study period total of 67550 Blood smears were examined irrespective of age andse and 740 were confirmed for malarial parasites, giving an overall slide positivity rate of 1.09%. Plasmodium falciparum was identified in 267(36.08%) cases and Plasmodium vivax in 473 (63.92%) cases. C o n c l u s i o n : The slide positivity rate of malarial parasite in this study was 1.09%and Plasmodium vivax found as most predominant species in this part of the world
OBESITY
Authors: MALIK ABDUL SALAM , AZHAR MUNIR AHMAD , SHAHID KHALIL AHMAD
Published: September 2021

Objectives: To assess frequency of obesity among college adolescent male and female students on BMI-Prime bases throughanthropometric. Design: Cross sectional study. Setting: At higher secondary colleges located in urban areas of Bahawalpur City. Period: FromFebruary 2009 to March 2009 Materials & Methods: Assessment of obesity among 400 college male & female students equally divided, agesfrom 16 to 23 years was carried out on BMI-Prime bases. Weight categories so achieved were stratified and labeled. Results: There were3(0.75%) severely under weight, 44(11%) under weight, 273(68.25%) normal, 68(17%) over weight, 9(2.25%) obese and 3(0.75%) wereclinically obese. There was no morbidly obese. No statistical gender difference for severely under weight and clinically obese was noted.However females were more under weight (p<0.05) while males were more over weight (P<0.05) and obese (P<0.05) when compared witheach other. C o n c l u s i o n : The adolescent female college students were under weight when compared to their male colleagues. The frequencyof obesity was higher among male students
STRESS
Authors: SIDDIQUI FARAH RASHID , DANISH KHALID FAROOQ , SABIH FAZAILA , Bhatti M. Ayaz
Published: September 2021

Objectives: To assess different level of stress and reaction to those stressors among undergraduate medical students andalso observe an association between different academic years, if any exists. Design of the study: Cross-sectional study. Settings: IslamicInternational medical college- a private medical college in Rawalpindi. Period: From 2006 to 2007. Material & methods: Questionnaire usedwas a stress inventory called students life stress inventory. It was distributed to all registered MBBS students at IIMC in years 1- 5 whovoluntarily participated. 403 out of 500 students completed the questionnaire with response rate 81.6%. Results: Data was analyzed throughSPSS by applying different statistical tests, which were ANOVA, and t test. Results reveal that 21.53% students were mildly stressed, 39.12%students were moderately stressed and 12.64% students were severely stressed. Significant gender differences were found on almost all thesub-scales. The findings reveal that females face more stressors especially conflicts, emotional and behavioral (p < .01), stress was moresignificant between boarders as compare to non-boarders. One Way Analyses of variance (ANOVA) was computed to check the significanceof differences on mean scores. An analysis of variance on Student Life Stress Inventory is significant, F = (3.774), p <.01. Mean differenceindicates that prevalence of stress is higher in first year and final year MBBS students. Conclusion: This study presents pragmatic evidenceregarding the psychological health of students in our college. These findings suggest that high levels of stress exist in our students especiallysignificant during first and final years of their course. It is important for us to know the prevalence and causes of student stress, which not onlyaffects their health, but also their academic achievement. Information from this study can be used to develop appropriate intervention programsfor medical students, in order to decrease their stress leve
CSOM
Authors: GILL ZAFAR IQBAL , BHUTTA ZUBAIR I QBAL , MALIK KASHIF IQBAL
Published: September 2021

Objective: The current study aims to find the extent of ossicular chain damage in patients with chronic suppurative otitis media,associated with cholesteotoma and/or granulation tissue formation. D e s i g n : Descriptive study. Place a n d Duration of Study: The study wasconducted at the department of ENT unit 1, Jinnah hospital/ Allama Iqbal Medical College Lahore from March, 2007 to March, 2008. Patientsa n d Methods: A total of fifty consecutive patients presenting with atticoantral disease of different age groups were included in the study. Allpatients were examined clinically and under microscope. X- rays mastoids and pure tone audiometry was done in all patients. Mastoidexploration was done in all the patients and ossicullar status was assessed peroperatively. Canal wall down procedure was adopted in all thepatients. Results: Among different age groups included, majority (more than 70%) of them, were below 30 years of age, showing thatatticoantral variant of CSOM is a disease of the young people. Males were more in number (70%). Duration of the symptoms was usuallyprolonged. On radiological examination, 39 cases (78%) had sclerotic mastoid. Audiological records of patients showed the air bone gap of morethan 40 dB in most of (78%) of patients. Perforation was marginal in most of the patients (64%). In gross pathologic findings, cholesteotomaonly, was seen in 21 cases (42%), granulations seen in 13(26%) cases, while cholesteotoma and granulations seen in 16 cases (32%). All casesshowed erosion of the ossicles, complete or partial. Incus was a most commonly involved ossicle. C o n c l u s i o n : Chronic suppurative otitis media,atticoantral variant do commonly damage the ossicles and routinely it is multiossicular damage. Incus, is damaged most with involvement ofits long process.