bluuebunny/crossref_metadata_2025 huggingface dataset:
FALCIPARUM MALARIA
Authors: Khan Inamullah , Rehman Hassan , Naz Shafaq , Haya Zafar
Published: August 2021

Objective: To determine how Falciparum Malaria can present clinically in various ways. A study conducted on 150 admitted patients. Subjects and Methods: This descriptive case-series, single center study was conducted in Medical B Unit, Khyber Teaching Hospital, Peshawar from November 2012 to June 2013. A total of 150 patients admitted with falciparum malaria were studied. A detailed history and clinical examination was performed. The falciparum malaria was diagnosed by examining peripheral blood film. All patients were thoroughly investigated to find out the complications of falciparum malaria. Results: Out of 150 patients, 95 (63.33%) were males 55 (36.67%) were females with mean age of 30 years. Fever was present in all patients, rigors and chills in 93%, headache and vomiting in 60%, jaundice in 50%, confusion in 37 %, abdominal pain in 26% were main presentations. Other presentations were Oliguria, hypotension, cerebral malaria, dyspnea and cough, hypoglycemia and seizures. Clinical examination showed splenomegaly (58%), hepatomegaly (46%), hepato-splenomegaly (22%) of patients. Laboratory investigation showed Hemoglobin < 10gm% in 22% and leukocytosis > 12000/μl in 10% of patients. Conclusions: As Falciparum Malaria presents in multiple ways clinically, it should be considered as a possibility in all febrile illnesses.
SURGICAL SITE INFECTION;
Authors: Alam Syed Iftikhar , Khan Muhammad Yunas , Gul Ayaz , Jan Qutbi Alam
Published: August 2021

Objective: To assess the post operative wound complication after opencholecystectomy for uncomplicated Cholelithiasis. Design: Cross sectional descriptive. Setting:Surgical unit of Khyber Teaching Hospital Peshawar Pakistan. Patients: 223 patients underwentelective open cholecystectomy January 2011 to July 2012. Results: 90% patients had normalhealing (grade 0 or I) ,7.5% had minor complications (grade II or III), 2.5% patients had majorcomplication (grade IV or V) recorded during hospital stay. On follow-up in out-patientdepartment 81%patients found to have normal healing (grade 0 or I), 15% patients had minorcomplications (grade II or III) and 4% patients had major complications (grade IV or V). There wasan increase noted in wound grades during follow up for surgical site infections as compared totheir record during hospital stay. Conclusions: Southampton wound scoring system is a usefultool for detection of surgical site infection and standardization. Auditing of surgical site infectionby Southampton wound scoring will help the patient, surgical team and sterilization protocol tobe improved.
ACUTE MYOCARDIAL INFARCTION;
Authors: Jaffery Mukhtiar Hussain , Shaikh Khalida , Baloch Ghulam Hussain , Shah Syed Zulfiquar Ali
Published: August 2021

Objective: This descriptive case series study evaluates the frequency ofhypomagnesemia in patients with acute myocardial infarction. Patients and methods: Thismultidisciplinary conducted at Liaquat University Hospital Hyderabad and a private hospitalHyderabad from May 2010 to October 2010. All patients diagnosed as acute myocardialinfarction were further evaluated for type of myocardial infarction and serum magnesium level.Results: Out of 100 diabetic patients, 77 were males and 23 patients were females. The meanage and standard deviation of patients of male and female was 54.78 ± 8.82 (SD) and 53.64 ±10.82 (SD), respectively. The mean ± SD for serum magnesium in overall subjects was 1.24±0.48. Regarding the type of AMI inferior wall in 22 (29%), lateral wall in 17 (22%), anteroseptal in12 (16%), anterolateral -V1 in 07(09%), right ventricular in 10 (13%) and posterior wall in 07 (09%).The mean duration of acute MI in male and female population was 8.71±6.73 hours and17.70±14.57 hours (p<0.01) where as the mean duration of acute MI in hypomagnesemic andnormomagnesemic patient was 5.16±2.49 hours and 26.60±8.27 (p = 0.02) respectively. Themean serum magnesium level in male as well as female population was 1.32 ±0.21 mg/dl and1.46± 0.53 mg/dl p = 0.05, respectively. Regarding the hypomagnesemia in male and femalepopulation was 34(75.6%) and 16(53.3%) p=0.04, respectively. The hypomagnesemia was morepredominant in inferior 18(36.0%) and lateral 16 (32.0%) wall MI. Conclusions: Thehypomagnesemia was observed in patients with acute myocardial infarction with statisticalsignificance
HIRSCHSPRUNG’S DISEASE;
Authors: Ishfaq Muhammad , Manzoor Saima , Khan Muhammad Azim , Ahmad Umar Farooq
Published: August 2021

Objective: To determine the frequency of Hirschsprung’s Disease associatedenterocolitis in pre and post operative patients. Place and Duration of Study: Nishtar Hospitaland Ibn-e-Sina Hospital, Multan from January 2008 to June 2012. Methodology: A total numberof 114 patients aged from less than 6 months to more than 5 years were diagnosed and treated forHirschsprung’s Disease after rectal biopsy and internal sphinterotomy. Results: In total of 114patients 32 (28%) developed enterocolitis before and 5 (18.5%) after definite surgery.Conclusions: The results of this study implicates that the early diagnosis and to make measuresto decrease the post pull-through anastomostic anorectal stenosis can reduce the frequency ofpre and post operative Hirschsprung’s disease associated enterocolitis.
CAROTID DOPPLER ULTRASONOGRAPHY
Authors: Abid Rizwan
Published: August 2021

Objective: To detect carotid atherosclerosis in symptomatic patients with riskfactors noninvasively using carotid Doppler ultrasonography in Divisional Head Quarter HospitalMirpur Azad Jammu & Kashmir. Study design: Prospective Observational study. Place andduration of study: Kashmir institute of cardiology Div. Headquarters Teaching Hospital AzadJammu & Kashmir AJK (Mohi-ud-Din Islamic Medical College Azad Kashmir) conveniencesampling of all the patients presenting with symptoms suggestive of carotid stenosis fromNovember 2011 to November 2012. Approval was taken from ethical committee of DivisionalHeadquarters Teaching Hospital Mirpur AJ&K. Methodology: These patients were sent toconsultant radiologist for carotid ultrasound and detailed characteristics were calculated withtheir frequencies, means and standard deviation using spss version 16. Frequency would beused for qualitative variables while means and standard deviation would be used for quantitativevariables. Descriptive statistics were computed. Conclusions: Carotid Artery Stenosis isprevalent in Azad Kashmir and can be easily diagnosed earlier by Carotid Duplex Ultrasound, todocument the presence of Atherosclerosis and prevent from future complications of stroke.
SUBSTANCE ABUSE
Authors: Mansoor Shehzad Adil , Muazzam Muhammad , Hasan Imam Humayun Suqrat
Published: August 2021

Objectives: To study the prevalence of substance abuse among prisoners and itseffects on other inmates. Study design: A cross sectional study. Place and duration of study:Central jail Faisal Abad Pakistan during Jan. 2012 to Feb 2012. Methodology: All the convictedand condemned prisoners were included in the study and those exclusively charged for drugsabuse crimes were excluded. A snow ball convenient sampling technique was adopted. Samplesize was not predetermined. The study population was (1080) male and above the age of 18years. Results: About one hundred and eighty four (184) prisoners were found using differentdrugs. Among them seventy six 76 (41.3%) started using drugs on entering the prison and onehundred and eight 108 (58.7%) were using drugs before coming to prison. The 91(49.5 %)belonged to rural area and 93 (50.5%) belonged to urban areas. The most commonly used drugwas heroin 181(96.7%) and 3(.6%) used different drugs like injections or pills. Conclusions:Substance abuse among prisoners was increasing day by day leading to increased crimes,health issues, and significant economic constrains in every country especially among poornations. Strong political will and public motivation was the need of time to deal with the issue.
FAITH HEALING
Authors: Ateeq Mohammad , Jehan Shazia , Mehmmod Riffat
Published: August 2021

Objectives: To observe the frequency and various modes of faith / spiritualhealing adopted by patients admitted with surgical diseases and their effects on course ofdisease. Study design: Prospective, observational. Setting: Surgical Department Aziz BhattiShaheed (Teaching) Hospital Gujrat, & Surgical department Islam Medical& Dental CollegeSialkot. Duration of study: January 2013 to June 2013. Material& Methods: Patients of both sexand all age groups admitted surgical wards of in both study setting during the study period wereincluded in the study. Unattended/non cooperative and patients with trauma were excluded.Their surgical problems were evaluated and recorded. Various techniques of spiritual/ faithhealing being adopted by the patients either as primary or /and an adjuvant modality were notedand resulted formulated. Results: A total of 953 patients with surgical problems were admitted inboth study settings. 788 patients (82.68%) were found to be using one or another technique offaith /spiritual healing as a primary or/ and an adjuvant to medical treatment. Out of total 788patients 414 (52.53%) were female, no much difference of adaptation of various spiritual/faithhealing was found in literate and illiterate population. This practice of adopting spiritual/faithhealing was more common in rural population (n=493 62.56%). Conclusions: Trust on faith/spiritual healing techniques is a common phenomenon in society, but it is a commonest knownreason of late presentation, diagnosis, treatment of the diseases leading to poor outcome. Onemust trust Allah, and it is consistent to apply every remedy that comes with in the range of one’sknowledge, and then to ask Allah to sanctify that application to the healing of ailment. Religiousscholars, electronic as well as print media can play a vital role in making people aware of this factthat will eventually lead to early diagnosis, treatment and better outcome of various bodyailments.
STROKE
Authors: Naeem Abid , Masood Choudhary Tariq , Ali Ijaz
Published: August 2021

The objective of the present study was to determine the risk factors of stroke, itsclinical features and response to treatment in Mirpur Azad Kashmir. Study Design: Prospectiveobservational study. Place and Duration of study: This study was conducted at Medical Wardsof DHQ Teaching Hospital Mirpur Azad Kashmir from March 2012 to January 2013. Patients andMethods: Two hundreds patients with established diagnosis of stroke were selected. Aquestionnaire was prepared in accordance with the objectives of the study. Questionnairecontained detail history, general physical examination, and neurological examination.Association of risk factors with stroke was also studied. Different clinical features were also notedand response to the given treatment was checked by morbidity and mortality ratio. The data thusobtained was subjected to statistical analysis. Results: One hundred and thirty two(66%) hadhypertension, fifty five(27.5%) were smoker, fifty three(26.5%) had diabetes, twenty five(12.5%)had ischemic heart disease. In clinical features one hundred and two (51%) had headache, ninetynine (49.5%) had hemiplegia, ninety four patients (47%) had loss of consciousness. On CT scanfinding one hundred and forty four patients (72%) had infarction while fifty six (28%) hadhemorrhagic stroke. After recommended treatment patients discharged were one hundred andeighty two (91%) while eighteen(9%) died within a month. Conclusions: Hypertension, smoking,diabetes are major modifiable risk factors, headache, hemiplegia, loss of consciousness aremajor clinical features, chances of ischemic stroke are much more as compared to hemorrhagic.Response to treatment is good.
CELIAC DISEASE;
Authors: Bhand Sikandar Ali , Shaikh Farzana , Korejo Hussain Bux , Raza Syed Jamal
Published: August 2021

Objective: To evaluate effectiveness of treating previously untreated patients withceliac disease with both a gluten free diet and bisphosphonate in order to significantly increasetheir BMD’s to a greater extent than a gluten free diet alone. Patients and methods: The studywas conducted in National Institute of Child Health (NICH) Karachi to evaluate the effectiveness oftreating previously untreated patients with celiac disease with a gluten free diet andbisphosphonate in terms of increase in bone mineral density in comparison to a gluten free dietalone over a period of three months (January 2013 – March 2013). The study includes 30 childrenpatients below fifteen years of age either sex. All study subjects were untreated celiac patientsdiagnosed by clinical presentation, small bowel histology and serologic testing. On day dexascan was done. Fifteen patients kept on Gluten Free Diet (GFD) and remaining 15 patients keptGFD plus tablet of bisphosphonate. After three months dexa scan was repeated. The patientswith other disease of bone or mineral metabolism, as well as subjects taking systemicglucocorticoids or high doses of thyroid hormones, were excluded. Results: A total of 30 patientswith celiac disease were included in this study. Out of 30 patients 18 (60%) were female and 12(40%) male (M: F = 1:1.5). Thirty patients were divided in two equal groups (15 patients in eachgroup). In group-I we gave gluten free diet and in group-II we gave gluten free diet and one tabletof bisphosphonate. Mean± SD of Bone Mineral Density (BMD) in group-I was 0.402± 0.081gm/cm2 (range=0.234 – 0.503 gm/cm2), and in group-II was 0.543± 0.098 gm/cm2 (range=0.402 – 0.743 gm/cm2), mean difference of bone mineral density was significant between twogroups (P-value=0.0002). Conclusions: At three months DEXA scan showed a significant rise inBMD in group-II as compared to group-I
COMPARISON OF ANTIBIOTICS;
Authors: Mahmood Shahid , Tariq Asma
Published: August 2021

Objective: To determine if granulocyte colony-stimulating factor (G-CSF) withempirical antibiotics therapy accelerates febrile neutropenia resolution compared with antibioticswithout it. Study design: Experimental study. Place and Duration of Study: Study wasconducted for a period of one year from march 2012 to february 2013 in oncology/haematologydepartment Children Hospital Lahore (PAKISTAN). Subject and Methods: A total of 56 childrenwith febrile neutropenia due to chemotherapy were included in the study. Two groups were madeA and B. Twenty eight patients were included in each group. Patients included in the group Awere given granulocyte colony stimulating factor with the dose of 5 microg/kg/day for five daysand the patients included in group B were not given granulocyte colony stimulating factor.Subcutaneous administration was recommended. Patients remained on study until absoluteneutrophil count (ANC) >500/microl and > or =48 hr without fever. Every child in both groupswas given antibiotic treatment in the hospital whenever there is need, antibiotics changedaccording to the blood culture sensitivity. Admitted patients were followed daily for fever andsigns of sepsis. Number of days of admission in hospital and number of days of treatment wascalculated in both groups and compared with each other. Duration of febrile neutropenia andmortality was also analysed for both groups. Results: Out of 56 patients 46 had acutelymphoblastic leukemia (ALL), 06 patients were of wilm tumour and 04 patient were havingrhabdomyosarcoma. Twenty eight patients were given only antibiotics(GROUP B) and 28patients were given G-CSF plus antibiotics(GROUP A). Addition of G-CSF significantly reducedneutropenia and febrile neutropenia recovery times. Median days to febrile neutropeniaresolution was 4.3 days earlier with G-CSF (5.3 vs. 9.6 days) (P < 0.0001). Resolution of fever wasone day earlier in patients who were given G-CSF (GROUP A). Hospitalization was 2.1 daysshorter with G-CSF (6.1 vs. 8.2 days) (P = 0.02). (Table II). There was difference of 2.2 days in theduration of IV and oral antibiotic treatment. Addition of antifungal therapy was done in 4 patientsin group B and only in one patient in group A. All the patients recovered and no death occurred inthe study. Conclusions: It is concluded that addition of G-CSF to empiric antibiotic therapyaccelerates chemothserapy-induced febrile neutropenia resolution by 4.3 days in pediatricpatients with malignancy. It is a significant difference in duration of hospitalization. By bearingexpenses of G-CSF we can decrease the expenses of hospitalization and antibiotics
RETENTION IN MANDIBULAR OBTURATORS
Authors: Hussain Mehmood , Hassan Syed Imran , Naqvi Syed Kashif , Khan Mohammad Yawar , Khan Moin , Tanveer Waqas
Published: August 2021

Objective: To provide various means of retention in fabrication of mandibularobturators for patients visited Hamdard University Dental Hospital, Karachi. Study Design: It wasa descriptive type of study. Place and Duration of study: The study was carried out at HamdardUniversity Dental Hospital, Karachi. Total duration of this study was two years. Materials andMethods: Nine patients were selected by purposive non-probability sampling technique. Aftertaking consent, self designed Proforma was filled. Age ranged from 13-72 years. Six of them weremales and three females. One of them was already using obturator. With the help of obtainedinformation, various means of retention in maxillary obturator were provided. Results: InterimObturators were fabricated for six patients while definitive obturators were fabricated for threepatients. In eight patients conventional means of retention were employed while implantsupported obturator was provided for one patient. Seven patients were satisfied with theperformance of obturator. In one patient sectional tray was used for impression while in onepatient artificial teeth were arranged by neutral zone technique. Regular follow up was carried outtill one year. Conclusions: Utilization of various means of retention brings better compliance inmandibular defect patients provided with obturators.
SEROPREVALENCE OF HEPATITIS C
Authors: Khan Umar Hayat , Ali Ahmad , Akram Mohammad , Khattak Aziz Marjan
Published: August 2021

Objectives: To find out seroprevalence of Hepatitis C among healthy blood donorsin Khyber PakhtunKhwa. Study Design: Descriptive study. Place and Duration of Study: From1st July 2008 to March,2009. The study was conducted by department of Community MedicineKMU Institute of Medical Sciences, Kohat. All healthy blood donors who reported for bleeding inblood banks of Khyber Pakhtunkhwa were screened for Hepatitis C antibodies. The study wasconducted in seventeen (17) districts and three (3) teaching hospitals. The kits used were rapidimmunochromatography kits. The kits were provided by safe blood transfusion project of KhyberPakhtunkhwa. Results: A total of 61170 healthy blood donors were screened during a period of 9months. Out of which 1341 (2.19%)were positive for hepatitis antibody. Conclusions: Hepatitis Cvirus infection has become a major health problem in Khyber Pakhtunkhwa. Blood is one of themain source of infection. Strict monitoring of blood is necessary before transfusion. To limit andprevent the spread of Hepatitis C, public awareness by print, social and electronic media is theneed of time. Resource allocation is necessary
PRIMARY OPEN ANGLE GLAUCOMA;
Authors: Jamil Muhammad , Ahmad Faheem , Sultan Muhammad
Published: August 2021

… Introduction: Glaucoma constitutes a group of ocular diseases characterized byoptic nerve damage and loss of visual field, usually associated with elevated IOP. Although theelevation of IOP beyond normal values is not necessary for the occurrence of glaucomatousdamage, it is currently thought to be a major risk factor. Glaucoma is one of principal causes ofblindness in the world. The primary aim of POAG treatment is to prevent functional visualimpairment with in patient’s life time by slowing the rate of ganglion cell loss closer to that ofnormal population (approximately 5000/year). Medications for glaucoma have changed notablyover the past 2 decades with increase in efficacy, better dosing regimens, improvement in safety,and reduction in side-effects. Purpose of study: The purpose of this study is to compare the IOPlowering efficacy of the (Travatan) Travoprost 0.004%ophthalmic solution and (Alphagan)brimondine 0.2% ophthalmic solution in primary open angle glaucoma. Duration: The durationof study was six months from June 2009 to November 2009. Material and methods: The studywas conducted on 60 patients with primary open angle glaucoma (POAG) divided into twogroups randomly.. Each patient was examined regarding visual acuty, refraction, slit lampbiomicroscopy, IOP with Goldmann Applanation Tonometer, Gonioscopy, fundoscopy andPerimetry. Results: GROUP A had 30 patients with 60 eyes there were 25 male (83.33%) patientsand five females (16.67 %) patients. The eye drops travoprost 0.004 % one drop at night wasused. The average IOP reduction was 7mmhg from base line, GROUP B also had 30 patients with60 eyes there were 27 male (90%.) and 3 females (10 %) The eye drops brimonidine tartarate 0.2% was instilled twice a day one drop in the morning and one drop in the evening. The average IOPreduction was 5.5mmhg from base line. Conclusions: In conclusion both latanop
ANTI-TUBERCULOSIS THERAPY
Authors: Muhammad Khan Fardah Yunus , Qazi Rizwan Aziz , Jadoon Muhammad Yunus , Rajput Tausif Ahmed
Published: August 2021

… Objectives: Tuberculosis (TB) is a major cause of illness and death worldwide,especially in Asia and Africa. An effective control has been achieved by the widespread use ofATT. It has been postulated that hepatotoxicity induced by ATT is not truly idiosyncratic inessence; rather certain genetic and environmental factors are attributed to coincide to producesufficient quantity of toxic metabolites that then cause varied alterations in liver functions.Objective of the study was to determine the frequency of derangement of liver enzymes inpatients taking anti-tuberculous therapy within the first 8 weeks of therapy. Study Design: Adescriptive case series study. Place and Duration of Study: The study was conducted at the inpatientand out-patient department of general medicine of Pakistan Institute of Medical Sciences(PIMS), Islamabad for blood sampling and biochemical assays. Material and Methods: Thestudy was performed on a total of 114 patients of tuberculosis. ATT was started after baseline liverfunction tests. Liver function tests were repeated at 4 weeks and 8 weeks to observe the effects onliver enzymes derangement. Results: 12 patients had deranged LFTs while 102 patients hadnormal LFTs after 4 weeks of treatment while 10 patients had deranged LFTs and 104 patients hadnormal LFTs after 8 weeks of treatment. Conclusions: Anti-tuberculosis drugs inducedhepatotoxicity occurs less frequently. All patients put on anti-tuberculous therapy must befollowed up for at least the initial 4 weeks, and the patient and caregivers should be told how torecognize signs of anti-tuberculous induced hepato-toxicity.
SPONTANEOUS BACTERIAL PERITONITIS
Authors: Ayub Ahsan , Ishfaq Muhammad
Published: August 2021

Cirrhosis of liver is a chronic process characterized by structurally abnormalnodules in the liver, with diffuse generalized increased fibrous tissue in the liver. Spontaneousbacterial peritonitis(SBP) is a serious complication occurring in 10 to 30% of patients hospitalizedwith cirrhotic ascites. Objective: Assess the frequency of SBP in asymptomatic patients of livercirrhosis. Study design: Cross sectional study. Setting: Hepatitis clinic medical unit- 1 Serviceshospital, Lahore. Duration of study: One year. Sample size: Total 100 patients of cirrhoticascites. Results: Ten patients were found to have SBP (10%, 95% CI, 4.1 to15.9) and 90 patientswere found to have no SBP (90%, 95%CI, 84.1 to 95.9). Seven SBP patients (70%) had pyurea(Fisher’s exact test p- value< 0.01), and abnormal liver function tests (Chi square-value<0.01).Conclusions: We concluded that 10% of asymptomatic patients with cirrhotic ascites had SBP.SBP patients had significantly abnormal liver function tests and pyuria.
ISOLATED BILATERAL ZYGOMATIC ARCH FRACTURE;
Authors: Khan Ali Akhtar , Perveen Saima
Published: August 2021

… Zygomatic fractures are the most common facial fractures or second in frequencyafter the nasal fractures. The high incidence of zygomatic fractures probably relates to itsprominent position in the facial skeleton hence it is frequently exposed to fractures. This casereport presents an isolated bilateral zygomatic arch fracture that was been reduced by Gille’stemporal approach and stabilized using foley’s balloon catheter. This study highlights theimportance of early diagnosis and timely treatment to reduce the morbities
FREQUENCY OF THROMBOCYTOPENIA;
Authors: Nawaz Zunaira , Aurangzeb Muhammad , Imran Khalid , Rasheed Tazeen , Alam Muhammad Tanveer , Jaffery Mehwish Fatima , Khero Shumaila , Masroor Muhammad
Published: August 2021

Objective: To determine frequency of thrombocytopenia in patients with Chronic Hepatitis C infection. Methods: A 6 months cross sectional study was carried out to determine frequency of thrombocytopenia in all patients admitted with chronic hepatitis c infection in all medical units at Civil Hospital Karachi, from April 2, 2012 to October 1, 2012. Patients with platelet count <150,000/microL was labeled as having thrombocytopenia and categorized according to the Child-Pugh Scoring. Patients with Child-Pugh score <7 was categorized in Grade A, 7-9 in Grade B and >9 in Grade C. Results: Out of 141 patients, 46(32.6%) were male and 65(46%) were female with 1.17:1 male to female ratio. The average age of patients was 47.25 ± 11.52 years (95%CI: 45.33 to 49.17). Similarly average duration of illness was 3.06 ± 1.78 Years (Range 8 months to 9 Years) and average platelet count was 165156.74± 176324.9. Seventy five patients (53%) had thrombocytopenia (platelet count <150000/microL). The average age of thrombocytopenic patients was 48.53±12.34 years and duration of illness was 3.7 ± 1.81 years. Regarding child Pugh class, 35(24.8%) cases had in class A, 49(34.8%) in class B and 57(40.4%) in class C. Thrombocytopenia was most common in above 60 years of age that is 10.7% (8/75) and 22.7% to 32% in all age groups. Conclusions: In our study the frequency of thrombocytopenia was found to be higher. Patients of age more than 60 years and of child-Pugh class C affected the most.
DIVERSITY OF HEPATITIS C VIRUS
Authors: Mahmood Hamid , Zulfiqar Nasir , Hassan Sitara , Waqar Ammara , Shahzad Naeem , Faroqui Irfan
Published: August 2021

Objective: (1)To understand the diversity in HCV glycoprotein E1 and E2sequences at different stages of infection. (2) Method widely used in evolutionary studies of HIV,as a new gold standard in HCV research.Setting: Department of Biochemistry Sir Syed Institutest of Medical Sciences Karachi. Period. 1 Jan 2012 to 31 Dec 2012. Design: Experimentalanalysis. Methods: The samples derived from a xenomouse model of transmission and severalsamples from naturally occurring transmission as well as sequences from acute stage ofinfection. we utilized single genome amplification (SGA) technique to recover full- length E1sequences. SGA of full-length E1 glycoprotein sequences, followed by direct sequencingminimizes in vitro generated artifacts and experimental biases associated with the standard bulkamplification and cloning approach, giving an accurate representation of investigated intrahostpopulation. Analysis and results: Comparative analyses of sequences derived from threedifferent settings were performed, in conjunction with a range of phylogenetic tests. As full-lengthE1 sequences were utilised. Conclusions: The role of glycoprotein E1 and E2 during theinfection of HCV was Known. The new gold standard in HCV research prove to be of greatimportance.
MAINTENANCE OF MEMORY CD4 CELLS
Authors: Koma Mousa Komai
Published: August 2021

Objective: Ligation of TLR by distinct pathogen components provides essentialsignals for T cell priming, although how individual TLR engagement affects memory T cellsinduction and maintenance in vivo is not well defined. The aim of the present study was toinvestigate the role of TLR2 engagement in the maintenance of memory T cells. Method: Ovaspecific KJ-1 cells from DO-11 mice were adoptively transferred to Balb/c mice. T cells wereactivated with Ova in the host of adoptive cells to induce memory. To examine the function and+ maintenance of memory cells in vivo, CD4 T cells were transferred to mice, which were thenchallenged with Ova-BLP and looked for memory cell proliferation. Furthermore, the memory Tcells harvested from lymph node and spleen of Balb/c mice were treated with Ova and BLP in vitroto establish the effects of TLR2 ligation on proliferation of memory T cells. Two different protocolswere used to confirm the same phenomenon. Results: Two different protocols show thatmemory T cells proliferation in vivo and in vitro can be maintained by TLR2 agonist (BLP). Wedemonstrate that antigen specific CD4 T cells undergo extensive proliferation in the presence ofOva and TLR2 agonist, in fact with TLR2 priming results in greater expansion. Moreover, TLR2agonist priming of ova-specific CD4 T cells resulted in a higher frequency of persisting ova/BLPspecific memory CD4 T cells which facilitated strong secondary responses upon challenge withova antigen. Conclusions: Ligation of TLR2 agonist BLP (Pam3Cys) alone is sufficient to+ maintain the proliferation of Ova specific CD4 T cells without the need of antigen. Which mightsuggest that long-term functional capacities of T cells are set by innate signals during earlyphases of an infection
FOOD FADDISM
Authors: Memon Khalida Naz , Shaikh Khalida , Khaskheli Lal Bux , Shaikh Shazia , Memon Saeeda
Published: August 2021

Background: Food faddism may be labeled as an ice-berg phenomenonoccurring in our population; still there is dearth of research work on this issue; therefore weconducted a baseline study on this problem of public health importance in order to explorehidden facts about this practice. Objectives: (1) To assess the food faddism practices amongresidents of Taluka Latifabad, Hyderabad. (2). To determine the risk factors associated with foodfaddism. (3). To determine the association of food faddism to health status of the participants.Study design: Cross sectional study. Place of study & duration: A community based study oftwo months’ duration (from 1st May-30thJune 2013) conducted in Taluka Latifabad units 4, 7 &12, district Hyderabad. Methodology: 450 subjects were selected by convenience type ofsampling & were registered for the study. The sample comprised of 200 women of child bearingage and 250 children of age ≤ 5 years. Results: The frequency of food faddism was found to be58% i.e. 71.5% among women of child bearing age and 47.2% among children at age ≤ 5years.Living in joint families & being illiterate were associated factors for practice of food faddism(p=0.01) & (p=0.04) respectively. Majority (79.31%) of respondents got advice for this practicefrom family elders; while 36.78% got such advice from family physicians. Being malnourished &borne as low birth weight were its major health outcomes among children. Conclusions: Foodfaddism intangibly affects women & children’s health; therefore elders of the families as well asfamily physicians should be taken on-board to control this dietary malpractice in thecommunities.
INTRA-ARTICULAR FRACTURES OF DISTAL RADIUS;
Authors: Alam Waqar , Shah Faaiz Ali , Qureshi Khalid Mahmood , Rehman Shams Ur , Hussain Shahid , Imran Muhammad
Published: August 2021

Objective: To assess the radiological and functional outcome of external fixator inthe treatment of intar-articular fractures of distal radius. Study design: Descriptive case series.Place and duration of study: Orthopaedic unit District Headquarter Hospital Temargarha LowerDir from March 2013 to March 2014. Material and methods: Twenty five patients of intra-articularfracture distal radius fulfilling the inclusion criteria were treated with AO external fixator byligamentotaxis. Preoperative and postoperative radiograph measurements were taken of radialinclination, radial tilt, and radial length, and fractures were classified according to the AO system.The fixator was removed after 6-8 week and functional assessment was done using Gartland andWerely point system at monthly interval for six months. Results: Eighteen male (72%) and 7(28%)females mean age 43.1 years with intra-articular distal radius fractures were treated with externalfixator. Preoperative mean radial inclination(10.5 degree) radial tilt(29 degrees dorsal) and radiallength(6.3 mm) were reported postoperatively as 18.8 degrees,8 degrees volar and 10 mmrespectively at final follow up visit. The functional evaluation by Gartland and Werley's pointsystem reported excellent (60% patients) ,good(20%) and fair(12%) at final follow up visit. One(4%) patient could not achieve union while one (4%) malunion was reported. Conclusions:Bridging external fixator(static) yields excellent radiological and functional results in majority ofintra-articular distal radius fractures.
NEONATAL HYPOGLYCEMIA
Authors: Bhand Sikandar Ali , Sheikh Farzana , Siyal Abdul Rehman , Nizamani Muhammad Akber , Saeed Muhammad
Published: August 2021

… Objective: To determine the presenting features and assessment of the neonateswith hypoglycemia along with maternal and neonatal risk factors for hypoglycemia. Subjects &methods: All consecutive neonates with hypoglycemia admitted were included in the study.Demographic characteristics of the mothers and their babies, past medical history and illnessesduring pregnancy especially that, of diabetes mellitus and duration, details of the management oflabour and place of delivery, birth asphyxia as well as history of feeding prior to admission. All therisk factors and clinical features were documented. Results: From presenting features neonateswere most common temperature instability 32% of the neonates. Maternal risk factors were asMaternal diabetic mellitus, Intrapartum administration of glucose , Maternal drug uses as: (Betablockers, Oral hypoglycemic agents, Valproate), family history of metabolic disorder and withoutany factors with the percentage 13%, 17%, (15%, 08%, 07%) , 27% and 13% respectively.Neonatal risk factors of the patients were found low birth weight 49%, small gestational age 26%,macrosomia 11%, respiratory distress 32%, sepsis 20%, hypothermia 25%, congenital cardiacabnormalities 4%, endocrine disorder 4%, family history of metabolic disorder 7%, inborn errorsof metabolism 4%, rhesus hemolytic disease 5%, erythroblastosis fetalis 1%, inadequate feeding35% and neonates without factors were 6%. Conclusions: The risk factors associate withneonatal hypoglycemia are, low birth weight, small gestational age, macrodome, respiratorydistress, sepsis, hypothermia and inadequate feeding , and maternal risk factors associate toneonatal hypoglycemia was Eclampsia, Maternal diabetic mellitus, and maternal drug uses
DIABETIC PREGNANCY
Authors: Memon Afsheen , Sheikh Aisha Abdullah , Nawaz Shazia
Published: August 2021

Objective: To evaluate perinatal complications in pregnancy complicated withdiabetes mellitus. Patients and Methods: During this study period all pregnant ladies regardlessof age and parity, who were diagnosed as having diabetes whether pregastational or gastationalwere included in this study. Perinatal outcome was observed in terms of birth weight,macrosomia, preterm baby, stillbirth, intrautrine death, neonatal death, respiratory distresssyndrome and congenital anomalies. All informations were recorded on prefromed proforma andanalysed through SPSS version 11. Study design: A descriptive observational study. Place andduration of study: This study was conducted in the department of obstetrics and gynaecologyunit- I at liaquat University Hospital Hyderabad, Sindh- Pakistan, from 12th July 2004 to 11th July2005. Results: Among perinatal complications macrosomia was observed in 44% of fetuses,congenital malformations in 5 infants of diabetic mothers. Stillbirth was noted in 5% and neonataldeaths in 10% babies. 55% of neonates suffered from hypoglycemia and 33% had birth asphaxia.Conclusions: It was observed in our study that perinatal outcome is highly affected in pregnancywith diabetes. For a successful outcome of pregnancy in such patients a tight glycemic controlfrom conception till delivery, antepartum fetal surveillance and neonatal care by trainedpaediatrician must be ensured.
LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Gul Ayaz , Khan Imtiaz , Faraz Ahmad , Ali Irum Sabir
Published: August 2021

Introduction: Laparoscopic cholecystectomy is the treatment of choice forsymptomatic cholelithiasis. Intraperitoneal instillation of bupivacaine is one of the methods usedto improve pain relief after laparoscopic cholecystectomy. Objective: To compare the mean painscore after intraperitoneal instillation of bupivacaine with placebo during laparoscopiccholecystectomy. Study Design: Randomized Control trial. Setting: This study was carried out asurgical unit PGMI Lady Reading Hospital and Hayatabad Medical Complex, Peshawar.Duration: The duration of study was 6 months from 15th May to 15th December, 2013. Subjectsand Methods: 92 patients in each group were included in study to compare the mean pain scoreof intraperitoneal instillation of bupivacaine (Group A; study group) with 0.9% normal salinesolution (Group B; placebo group) using visual analogue scale after laparoscopiccholecystectomy at 12th hour after surgery. Data was entered in software SPSS version 16.0. Ttest was used to compare the mean pain scores. Results: The mean age of patients in Group Aand B was 41.82 ± 7.34 and 40.95 ± 9.24 respectively (p=0.483). Group A has low mean painscore (3.619 ± 0.676) according to Visual Analogue Scale then Group B (3.837 ± 0.667) with astatistically significant p value (p=0.036). A t test failed to reveal a statistically reliable differencebetween gender (p=0.513) and age (p=0.767) wise distribution of mean pain between group Aand B. Conclusions: Mean pain score of intraperitoneal instillation of bupivacaine is significantlyless than 0.9% normal saline solution at 12th hour after laparoscopic cholecystectomy.
IRON DEFICIENCY ANEMIA
Authors: `Zaman Syed Qamar , Mahmood Arshad , Ahmed Shabbir , Mahmud Shahid
Published: August 2021

Objective: To determine the association of breath holding spells with irondeficiency anemia in children. Study Design: Case control study. Place and Duration of Study:Military Hospital Rawalpindi from Jun 2012 to Dec 2012. Study Population: Sixty children ofeither gender meeting inclusion criteria aged 6 months to 5 years with 30 of breath holding spells incase group and 30 in control group as healthy children were included in the study after informedconsent from parents. Method: Complete blood picture and serum ferritin levels were performedof all children in both case and control groups. Tests were carried out at AFIP Rawalpindi. All datawas entered and analyzed using SPSS version 10. Frequencies and percentages were calculatedfor categorical (qualitative) variables like sex and children having iron deficiency anemia in casesand controls. Mean and Standard Deviation (SD) was calculated for numerical (quantitative)variable like Age. Odds ratio was calculated from the data of cases and controls. Regarding irondeficiency anemia p value <0.05 was considered as significant. Results: In this study, werecorded 43.33% (n=13) cases were between 0.6-3 years and 56.67% (n=17) were between 4-5years while 53.33% (n=16) controls were between 0.6-3 years and 46.67% (n=14) were between4-5 years. Mean±SD was calculated as 3.3+1.46 years in cases and 2.93+1.48 years in controlgroup. Male children were 60% (n=18) in patient group and 46.67% (n=14) in controls group.Female children were 40% (n=12) in patient and 53.33% (n=16) in control group respectively.Association of breath holding spells with iron deficiency anemia in children revealed as 56.67%(n=17) in cases and 3.33% (n=1) in control group while remaining 43.33% (n=13) in cases and96.67% (n=29) in control group had no findings of this association. P value was calculated as<0.0001 and Odds Ratio was 37.92 which shows a significant difference between the two groups.Conclusions: The association of breath holding spells with iron deficiency anemia in children issignificantly higher than healthy controls. So, it is recommended that every child who present withbreath holding spells should be evaluated for iron deficiency anemia
SEROPREVALENCE OF HBsAg (HBS) AND ANTI-HCV
Authors: Salam Abdul , Baloch Bilqis Aslam , Khan Naseer , Sarwar Ghulam , , Masoom
Published: August 2021

Background: Hepatitis is the inflammation of liver caused by infectious and noninfectiousagents. Hepatitis B and C are inflammations of liver caused by the viruses which are themajor public health problems worldwide and the incidence is even more in our country.Objective: Objective of the study was, 1). To estimate the prevalence of hepatitis B and hepatitisC viruses infected persons among the general population coming to BMC Hospital. 2). To pointout the more affected area of Baluchistan. 3). To produce awareness in the people. 4). To bringthis issue in Government notice. Method: The data was obtained from the patients of BMCHQuetta in which one step test kits were used first and the positive cases were confirmed by ELISA.Results: Out of 46319 samples tested (both indoor & outdoor patients), 3078 (6.64%) werepositive. From overall positive samples 1631(3.52%) were HBs positive and 1447(3.12) sampleswere positive for HCV and 2 patients were positive for both HBs Ag and anti HCV. Conclusions:Prevalence of Hepatitis B is more comparing to Hepatitis C in this province. Prevalence of bothHepatitis B and Hepatitis C was high in Naseerabad district of Baluchistan Great care should beexercised during shaving, dental treatment, surgical procedures and blood transfusions. Policymessage: - Media should be used by National Hepatitis Control Programme of Pakistan toeducate the public about hazards of unscreened blood transfusion. Blood screening for HepatitisB and C infections should be made mandatory at all blood banks.
DIABETIC MACULAR EDEMA;
Authors: Niaz Fuad Ahmad Khan , Mirza Bilal Humayun , Niazi Manal , Khan Niaz Muhammad Afzal
Published: August 2021

. OBJECTIVE: To evaluate the effect of Intravitreal Bevacuzimab on Best CorrectedVisual Acuity in patients with clinically significant diabetic macular edema. MATERIAL ANDMETHODS: A prospective uncontrolled interventional case series in which 42 eyes of 31consecutive diabetic patients with clinically significant macular edema and no significantcomorbid ocular association presenting in the outpatients department of Holy Family Hospitaland EYE SURGERY clinic, Rawalpindi Pakistan and opting for the treatment from 1st September2013 to 31st January 2014 were given an intravitreal injection of Bevacizumab. BCVA wasdocumented prior to and four weeks after the injection. Main outcome measure was changes inBCVA. RESULTS: Out of the 31 patients included in the study 14(45.16%) were male and 17(54.83%) female. Average age was 56.1 ± 7.6. All 31 patients (42 eyes) came for follow up andtheir BCVA recorded. 41 (97.61%) eyes showed an improvement of one or more line on Snellen'schart at 4 weeks. 14 (33.33%) eyes showed an improvement of one line, 19 (45.23%) eyes animprovement of two lines, 6 (14.28%) eyes three lines and just 2 (4.76%) eyes had animprovement of four lines on Snellen's chart at 4 weeks. Only 1(2.38%) eye remained same withno worsening. On logMAR conversion scale for Snellen's letters the BCVA improved from 0.76 ±0.27 to 0.47 ± 0.27 (p< 0.001). No significant complications were observed in any of the eyes.CONCLUSION: The use of intravitreal Bevacizumab (1.25mg/0.05ml) is a safe and effective moeof treatment for clinically significant diabetic macular edema.
TUBERCULOSIS
Authors: Rehman Abdul , Tahseen Shahzadi Asma , Chaudhry Tauseef Asma
Published: August 2021

… Objective: The purpose of study is to know the admission rate and spectrum ofthe tuberculosis in children admitted in the pediatric unit of a high endemic country. Methodsand Material: This retrospective study was conducted at the Pediatric unit-I, Bahawal VictoriaHospital Bahawalpur. The records of children older than one month but below 15 years of agediagnosed as tuberculosis (TB) during the years 2007-2011 were reviewed and were includedfor the study. The data (age, sex, history of contact, BCG vaccination, tuberculin test, diagnosis)were entered on a proforma. Data were entered into SPPS version 13 (Statistical Packagefor Social Sciences) package were presented as rates and proportions. Results: There were72765 children (excluding children below the age of one month) admitted during the period offive years (2007-2011), out of which 847(1.16%) were diagnosed as tuberculosis. There was noconsistent fall in admission rate over the years due to TB cases. There were 61% male cases.The maximum cases were reported under the age of 4 years (46%). Out of total 847 TB casesBCG scar was present in only 410 (48.4%) cases. The history of contact with adult TB case wasfound in 243 (28.7%). Tuberculin skin test was positive (≥10mm) in 309 (36.5%) cases. Themost common forms of TB were tuberculous meningitis and pulmonary tuberculosis each accountingfor 37.5% cases. Other forms of tuberculosis included TB pleural effusion 12.5%, TBabdomen 7.1%, miliary TB 3.1% and TB arthritis 2.2%. Conclusions: The most common formof TB is meningitis and pulmonary each accounting for 37.5% cases and the maximum caseswere reported under the age of 4 years.
UTEROVAGINAL PROLAPSE
Authors: Mansoor Malahat
Published: August 2021

Objectives: To follow post-op patients after autologous rectus sheath repair ofutero-vaginal prolapsed. Study Design: Observational study. Place & Duration of study: ServicesHospitals, SIMS, LHR & Bhatti International Hospital, Central Park Medical College LHR.2008-2012. Methods: Pts from 28to38 yrs of age with utero-vaginal prolapse were selected.Due to their younger age group uterus retaining procedure was planned whether they hadcompleted their family or not ,So autologous rectus sheath graft was used with abdominal approachto suspend the uterus along with plication of round ligament These patients were thenobserved for immediate post op complications & 6 months onwards follow up was also noted.Results: 10 pts were included in the study. Only one pt had dysurea & 1 pt had 1st Degreecystocele on discharge. Long term follow up showed that 2 pts had 1st degree cystocele & only1 pt had 1st degree uterovaginal prolapse. Conclusions: An easier procedure for utero-vaginalprolapse that can be easily performed in a regular hospital set-up without the need of Laparoscope,mesh or high surgical expertise.
PLACENTA ACCRETA IN PLACENTA PREVIA
Authors: Majid Farzana , Ali Robina , Shaheen Shazia
Published: August 2021

Objective: To calculate the frequency of placenta accreta in placenta previawith or without scarred uterus and compare clinico demographic features of cases with orwithout placenta accreta. Study Design: Cross sectional study. Place and Duration of Study:Department of Obst & Gynae Allied Hospital, Faisalabad from 1st June 2007 to 31st May 2008.Methodology: 200 patients of placenta previa, 100 with history of previous cesarean sectionand 100 without history of previous C-section fulfilling inclusion criteria were taken. They wereevaluated by history, examination and ultrasound noting placental location and type. Placentaaccreta was diagnosed during delivery. Results: Out of 200 patients, frequency of placentaaccreta was significantly increased with history of previous C-section. It was 20% in patientswith previous C-sections and 6% in patients without previous C-sections. Conclusions: Ourdata suggests that frequency of placenta accreta is greater in patients with previous C-sectionand its frequency increases with increasing number of C-sections especially with anterior andcentral placenta previa.