bluuebunny/crossref_metadata_2025 huggingface dataset:
WEIGHT REDUCTION;
Authors: Abid Rizwan , -Rehman Bashir-ur , Hameed Humera
Published: August 2021

Objective: Obesity is a serious disease and a precursor to other morbiditiessuch as CVD and type 2 DM. Lifestyle modifications are recommended to control obesity alongwith pharmacological and surgical interventions. In this study, we evaluate the beneficial effectsof orlistat in BMI reduction of obese patients in an OPD setup of Azad Jammu Kashmir. StudyDesign: It is a quasi-experimental placebo controlled trial. Setting: Divisional HeadquartersHospital Mirpur Azad Kashmir. Period: October 2013 to March 2014. Methods: 75 patients wereenrolled having BMI of more than 27 using BMI machine model 2012. 38 Patients were randomlyselected to receive orlistat 120 mg B.D for two months. 32 patients were given placebo and thereduction in BMI between the two arms was analyzed using SPSS 20. Results: After two monthsof study, significant reduction of 2.78 kg +/-1.718 kg in weight was observed in the study group.The reduction in average BMI in study group was 1.867 with -5.21 % reduction in BMI vs controlgroup which had an average BMI reduction of 0.46 with -1.411% reduction in BMI. The p value is0.001. 37.71% of patients taking orlistat reported side effects such as flatulence, fatty stools andmyalgia which were 8%, 18.91% and 10.8% respectively. Conclusions: Orlistat along with lifestyle modification is effective in BMI reduction of patients significantly as compared to placeboand may be helpful in reducing the morbidity and mortality in the long term. However, cautionshould be administered with orlistat because of high incidence of associated side effects.
LIPID PROFILE;
Authors: Javed Ambreen , Khan Shakir , Shabbir Faizania , Rajput Tausif Ahmed , Naveed Abdul Khaliq
Published: August 2021

Objectives: To study the effect of maternal high-fat, high-cholesterol diet on thelipid profiles of rat offspring. Study Design: Randomized control trial (RCT). Place and durationof study: Department of Biochemistry, Army Medical College, Rawalpindi in collaborationwith Chemical Pathology Laboratory (CPL), Army Medical College, Rawalpindi and NationalInstitute of Health (NIH), Islamabad. The study was completed in six months. Material andMethods: Sixty adult female albino rats of Sprague-Dawley strain were divided into two groupsof 30 each. Male rats of the same strain were used for breeding. Ten days before expectedmating experimental group was shifted to a high-fat, high-cholesterol diet, keeping the controlgroup on normal rat diet. Lipid profiles of pregnant dams of both groups were done at day20 of gestation. Offspring of both groups from weaning onwards were fed the normal rat diet.One male and one female offspring from each litter of both groups (30 male and 30 femalesfrom each group) were selected and their lipid profiles were evaluated at post-weaning andadult stage. Results: At day 20 of gestation, high-fat and cholesterol fed dams showed highlysignificant increase in TC, LDL-c, HDL-c and LDL-c / HDL-c ratio than the control dams (p <0.01). Maternal high-fat, high- cholesterol diet was found to raise some parameters of lipidprofiles of the offspring. Conclusions: Maternal high fat and cholesterol diet in pregnancy andlactation causes hyperlipidaemia in the rat offspring.
HAEMODIALYSIS;
Authors: Afzal Aurangzeb , Ashraf Sania , Raheel Abubakar , Chattah Fateh Sher , Zafar Faiqa , Zafar Adnan , Lilla Amjad , Shehzad Anjum , Iqbal Sajid
Published: August 2021

Background: Hepatitis C is an important health issue in chronic kidney diseasepatients especially those on regular hemodialysis. The cause of this high prevalence remainsmulti-factorial. Despite of various infection control measures adopted worldwide, hepatitis chigh seroconversion rates among dialysis patients remain a major health concern. Objectives:The objective of this study was to determine the frequency of seroconversion of hepatitis C inpatients on maintenance hemodialysis in our set-up and also to find the various risk factorsattributing to it. Study Design: Retrospective study. Place and duration of study: Hemodialysisunit of LAHORE GENERAL HOSPITAL since August, 2016. Methods: Forty seven patients onroutine hemodialysis who were initially sero negative for hepatitis C at the time of registrationin Lahore general hospital dialysis centre and frequency of seroconversion to positive for antiHCV was calculated using SPSS 20. The various variables were analyzed on basis of p-value(significant <0.05). Results: Out of total 47 patients, 6 patients (12.80%) were found to besero converted to hepatitis C during the dialysis treatment in our centre. History of surgicalprocedure (major/minor) (83.3%, p value:0.006) and presence of hepatitis C in spouse (66.7%,p value :0.0001) were found to be statistically significant risk factors. Conclusion: The currentstudy indicates the high rates of hepatitis C seroconversion in hemodialysis patients and thevarious contributing risk factors for it. Because of the immunodeficiency in these patients,intense education to medical staff as well as patients themselves will be beneficial in controllingthe spread.
RISK FACTORS FOR GALLSTONES;
Authors: Jaleel Frahat , Rashid Khalid , Bakhtiar Nighat , Jawaid Masood
Published: August 2021

Objectives: To find out the frequency of already recognized risk factor ofGallstones in population of Pakistan. Methods: A total of 50 patients diagnosed as cholelithiasison ultrasonography were included in the study. Data collection through interview included age,sex, marital status, parity, height and weight. On the basis of height and weight Quetelet’s bodymass index (weight in kg/height in m2) was calculated. Data collected also included Lipid profileData was analyzed by SPSS version 17 for descriptive statistics. Setting and Period: Thisstudy was done at Department of Surgery, Dow University Hospital for a period of 6 monthsfrom February to July 2015. Results: 70% of patients were above 40 years of age, 88% werefemale, and 83.3% were multiparous while only 32% had BMI above 23. Conclusion: Femalegender, fertility, middle age and flatulence are the common risk factors of gallstone formationwhile obesity is not a definite risk factor in Pakistan.
PHYSICAL INJURIES;
Authors: Arif Mariam , Rasool Syed Hamad
Published: August 2021

Introduction: Injury is one of the leading causes of mortality and morbidityworldwide. Objectives: The aim of the study was to determine the pattern of physical injuriesin medicolegal cases presented to Services hospital, Lahore. Study Design: Descriptive study.Setting: Accident and emergency department of Services hospital, Lahore. Period: 1stJanuary2014 and 31stDecember 2014. Method: All cases presenting for medico legal examination withphysical injuries were included. Data was collected regarding age, gender, types of injuries,body area involved, causative weapon and whether certification of injuries was done accordingto Qisas and Diyat Ordinance. Results: A total of 86.4% cases were of physical injuries. Out ofthese cases, 73% of blunt weapon, 11% of firearm weapon, 10% of sharp weapon, 4%of roadtraffic accidents and1.5 % of bomb blast presented in the medico-legal clinic. Males (87.4%)outnumbered females (12.5%) Almost two-third of victims (64.2%) were between 21 and 40years of age. The head and neck were the areas most commonly injured in cases of blunttrauma 48.3% while limbs were more likely to be involved in other physical injuries. All caseswere certified according to Qisas and Diyat Ordinance. Conclusion: It is the hour of need thatboth public and private sectors work together in devising and implementing effective injuryprevention programs.
CONTRAST-INDUCED NEPHROPATHY;
Authors: Asghar Naeem , Ali Liaqat , Anees Wasiq
Published: August 2021

Introduction: Contrast induced nephropathy (CIN) is a disorder characterizedby the onset of acute renal failure within 24 to 72 hours after the administration of iodinatedcontrast medium after coronary angiography. CIN is associated with prolonged hospitalizationand adverse clinical outcomes. The objective of this study is to determine the frequency ofcontrast induced nephropathy in patients of coronary artery disease undergoing coronaryangiography in local population. Setting: Department of Cardiology, Faisalabad Instituteof Cardiology. Period: 16-04-2016 to 15-10-2016. Subjects and Methods: 200 patients ofcoronary artery disease booked for coronary angiogram. Study design was Cross-sectional.Baseline characteristic and history of risk factors of coronary artery disease were noted. Serumcreatinine level was recorded at baseline and after 48 hours of angiography by sending bloodsample to the hospital pathology department and were noted. Contrast induced nephropathywas assessed. Results: Mean age of the patients was 53.61±12.48 year. Patients with agebetween 30-50 years were 76(38%) and patients with age 51-70 years were 124 (62%). Outof 200 patients, 130 (65%) were males while remaining 70 (35%) were females. In the studypopulation 14 (7%) developed contrast induced nephropathy (CIN). Mostly patients of 51-70years of age group developed CIN. CIN was reported in 9(6.92%) male patients and 5(7.1%)female patients. Among diabetic 4 (3.57%) patient developed CIN. Among hypertensive patients2 (2.77%) patient developed CIN. Similarly in patients presented with acute coronary syndrome8 (7.61%) patient developed CIN. Conclusion: In conclusion, contrast induced nephropathy inpatients with coronary artery disease undergoing coronary angiogram was found in 7%. CIN isa relative common finding following coronary angiography in patients especially in elderly andmale patients. More incidences of CIN were noted in patients presented with acute coronarysyndrome and in diabetic patients.
NEEDLE STICK AND SHARPS INJURIES;
Authors: Farrukh Nagi Muhammad Luqman , Haider Kazmi Syed Tehseen , Saleem Aziz Anwar , Khan Dawar , Afsar Hafiz Haseeb , Akhtar Hafiz Sohaib
Published: August 2021

Background: This study, therefore aims to assess the frequency and the factorscontributing to the needle stick injuries among health care workers of a tertiary care privatehospital of Lahore. Setting: Shalamar Hospital Lahore, Pakistan a tertiary care private institution.Period: July and August 2015. Study Design: Cross-sectional study. Methods: A modifiedstructured pre-tested questionnaire containing both open and close-ended questions wasadministered to 160 study participants. The selected candidates were thoroughly briefed aboutthe study and informed consent was obtained. Confidentiality and anonymity of the participantswas maintained. Data entry was done on SPSS version 20 for Microsoft Windows. Results: Theresponse rate was 97%. Among all respondents (n=122), almost 41% (n= 63) were medicaldoctors and 34% (n= 53) were nursing staff. A small proportion of 4% (n= 6) belonged to thedental surgical background as well. Of all the surveyed participants, 45% (n=69) had eversuffered from needle stick/ sharps injury during their medical job and career, whereas, 34%(n=53) had suffered from a needle stick injury during the last year. Nearly 63% (n=47) reportedthat the cause of injury was accidental, 16% (n=25) acknowledged lack of awareness, 7%(n=10) acknowledged improper equipment and 4% (n=6) accused lack of training as the majorcause of needle stick injuries. A hefty 34% (n=53) believed that there existed no protocols in theinstitution regarding needle stick injuries, while another 50% (n=78) stated that they were notaware of the hospital protocols regarding needle stick injuries if there existed any. A disturbing34% (n=53) assume that they should recap the needles after using them. There was a strongstatistical association p<.001 between establishment of hospital protocols regarding needlestick or sharps injury and an event of needle stick injury suffered by the health care workersduring last year. Conclusion: The needle stick injuries can be prevented by the eradication ofhazard causing equipment’s, prevention through engineering measures, administrative controlsand last but not the least personal protective measures.
DRUG INDUCED LIVER INJURY;
Authors: Talpur Mozna , Palli Asadullah Yousfani , Qureshi Shagufta Shaheen
Published: August 2021

Objectives: Analyzing the efficacy of ascorbic acid (AA) against azathioprine(AZA) induced liver injury in rabbit model. Study design: Experimental study. Place andDuration: Isra University in collaboration with the animal house of Sindh Agriculture University;Tando Jam from July 2010 to November 2011. Materials and Methods: A sample of 80 rabbitswas divided into; Group A – control rabbits, and Experimental group B - (AZA 15 mg/kg), groupC- (AZA 15 mg/kg + AA 100 mg/kg) and group D- (AZA 15 mg/kg + AA 200 mg/kg). Bloodsamples were taken and sera were used for liver function test. Liver tissue sections 5μ thickwere stained for light microscopy examination. Data was analyzed on statistical software (SPSS21.0, IBM Incorporation, USA) (P≤ 0.05). Results: Azathioprine induces severe liver injury(group B vs. group A) that was ameliorated by the ascorbic acid in group C and D (p=0.0001).Microscopy showed hepatocyte necrosis, cholestasis, sinusoidal dilatation, peri-sinusoidalfibrosis, veno-occlusive disease, peliosis hepatis and loss of tissue array in azathioprine treatedrabbits. Conclusion: Azathioprine causes severe liver injury that was ameliorated by theascorbic acid in present experimental study.
ASTHMA;
Authors: Abdullah Muhammad , Ahmed Zaheer , Fareed Hassan
Published: August 2021

The aim on the study was to compare the efficancy of salmeterol and formoterolin persistent asthama. Study Design: Randomized-Controlled-Trial(RCT). Setting: Departmentof Medicine, Allied Hospital, Faisalabad. Period: June 2014 to December 2014. Methodology:Patients of both genders with ages between 18 and 70 years having persistent bronchial asthmawhile Pregnant or lactating mothers, patients with upper or lower respiratory tract infections,acute asthma exacerbations within 4 weeks of first visit, Oral corticosteroids within 4 weeks ordepot steroids within 12 weeks of first visit and Smoking history of more than 10 pack yearswere excluded from study. Patients were randomly divided into two groups (Group A & GroupB) using computer generated random number table. Salmeterol/Fluticasone combination wasgiven to group A with a dose of 50/250μg, 2 actuations with ABEL SPACER DEVICE twice aday for a period of 24 weeks. Formoterol/Budesonide combination was given to group B with adose of 400/6μg with Rotahaler twice a day. Follow up was done by patient’s outdoor visits at6th,12th,18h and 24th week. Results: 180 patients were enrolled in the study. 79 (44%) weremales and 101 (56%) were females. Mean age of study population was 45.25+13.382 years.Patients in Group B experienced lesser number of exacerbations than patients in Group B.Group B showed better response to treatment than Group A using chi square test. (P-Value0.001). Conclusion: It has been concluded that budesonide/Formoterol is more effective incontrolling asthma symptoms than fluticasone/Salmeterol.
MALIGNANT THYROID DISEASE;
Authors: Talpur Altaf Ahmed , Kumar Bheesham , Laghari Ahsan Ali , Shikh Abdul Qadeer , Junejo Afzal , Ghumro Ali Akber
Published: August 2021

Objectives: To determine frequency of Transient & permanent hypocalcemiaafter Thyroid Surgery for Malignant thyroid disease. Study Design: Observational study.Setting: Public & Private Sector Hospitals of Hyderabad. Period: December 2008 to April 2016.Materials and Methods: All patients of Thyroid pathology who fulfilled the inclusion criteriawere admitted in the ward. They were evaluated preoperatively & surgery was performed.Postoperatively patients were assessed clinically & biochemically for Hypocalcaemia. Patient’sdata was recorded & analyzed for variables like age, sex, diagnosis of thyroid disease on FNAC,Type of thyroid Malignancy, type of thyroid surgery, Transient & permanent hypocalcemia inrelation to type of type of thyroid surgery performed & the hospital stay. Results: Total 254patients were operated for different thyroid pathologies. It includes 91(35.82%) male & and163 (64.17%) female patients making ratio of 1: 1.79. Mean age was 37.29 ±7.4 years.Amongst them 33 patients were diagnosed as Malignant Thyroid diseases. Most commontype of thyroid malignancy detected was papillary carcinoma in 48.48% patients followed byfollicular carcinoma in 42.42% patients. Most common surgical procedures performed includescompletion thyroidectomy in 57.57% patients with 01(3.03%) of them underwent cervicalneck dissection followed by total thyroidectomy in 36.36% patients with 02(6.06%) of themunderwent cervical neck dissection. Postoperative hypocalcemia was noted in 45.45% patientswith 36.36% patients developed hypocalcemia within 24 hours of operation, 6.06% within 24to 48 hours & 3.03% patients after 48 hours of surgery. Transient hypocalcemia was noticed in13/33 (39.39%) cases & permanent hypocalcemia in 02/33(6.06%) patients. Mean hospital staywas 4.13± 0.32 days. Conclusion: Hypocalcaemia was noted in 15(45.45%) patients operatedfor thyroid Malignancy. Revision surgery & cervical lymph node dissection were noted as riskfactors.
KNEE BIOMECHANICS AND PHYSICAL PERFORMANCE;
Authors: Haider Khan Hafiz Muhammad Manan , Masood Tahir
Published: August 2021

Introduction: A 29-year old male athlete (body mass: 64 kg; height: 172 cm)sustained complete ACL rupture of the right knee. He was a martial-arts player and the injurywas repetitive, overuse in nature due to cyclic unilateral loading and unloading of the rightknee during training sessions. Rupture was diagnosed through detailed patient history, clinicalphysical examination and was confirmed through magnetic resonance imaging (MRI) of theright knee. Surgical reconstruction of the ACL was planned and a patellar tendon graft wasused. His baseline isokinetic data was recorded 4 months after the surgery. Objective: Thiscase study describes the effects of isokinetic strength training on knee biomechanics andphysical function of an ACL-reconstructed martial-arts athlete. Setting: Pakistan Sports BoardIslamabad. Study period: 40 days. Materials and Methods: Biodex System 3 Pro was used totrain the athlete for 15 sessions on alternate day basis. Average peak torque, average power,total work and peak torque to body weight ratio were recorded for hamstring and quadricepsbefore and after isokinetic rehabilitation. The athlete was positioned in the dynamometer withupright back while hip and knee were flexed to 90 degrees. Unilateral isokinetic contractionswere performed according to a premeditated exercise protocol. Both hamstring and quadricepswere tested isokinetically at five different movement speeds (30deg/sec, 90deg/sec, 150deg/sec, 210deg/sec, and 270deg/sec). Five contractions were performed at each speed duringboth knee flexion and extension. At baseline, average peak torque was higher at lower speedsfor both hamstring and quadriceps. Results: As a result of rehabilitation, average peak torquefor hamstring and quadriceps significantly improved at speeds of 150deg/sec and 90deg/secrespectively. Average power, peak torque to body weight ratio, total work was also improved forboth hamstring and quadriceps. Two physical performance tests - agility run test and verticaljump test - were used to assess the effects of training and both performance tests improved 51%and 100% respectively. Conclusion: Isokinetic training improved the strength of quadricepsand hamstring after ACL reconstruction. Hamstring muscle demonstrated greater traininginducedincrements in torque production compared to quadriceps at all contraction velocities.
CEREBRAL ISCHAEMIA AND STROKE;
Authors: Khan Sibghat Ullah , Lashari Naveed Aslam , Lakho Nadia Irum , Faisal Ambreen , Hussain Aamir
Published: August 2021

Introduction: Colour Doppler sonography is a well-established widely available,noninvasive, cost effective and a reliable method for assessing cerebrovascular circulation.It has become a valuable completion of the sonographic workup in patients with cerebralischaemia and infarction. Its accuracy is close to angiography. Objectives: To determine thefrequency of significant carotid artery stenosis in patients of cerebral ischaemia/stroke and itscharacterized sonographic appearance of plaque. Study Design: Cross sectional study, basedon nonprobability convenience sample technique. Setting: Department of Radiology, CombinedMilitary Hospital Lahore, using Colour and Power Doppler Ultrasound machine ALOKA SSD-5500. Period: 14 October 2006 to 15 March 2007. Methodology: Total of 50 diagnosed patientsof either gender, aged 30 to 70 years with cerebral ischaemia and stroke were included in thestudy. Carotid Doppler examination was conducted in each patient and findings were recorded.Results: Among 50 patients who underwent carotid Doppler examination for diagnosis ofclinically significant carotid artery stenosis, 35 patients had carotid plaques. 08 patients werediagnosed to have more than 70 % stenosis, 07 patients with more than 50 % and 20 patientsless than 50 % carotid artery stenosis. 15 patients did not show any carotid artery disease.12 patients had bilateral stenosis while 23 had unilateral disease. Mean age of the patientswith and without carotid artery disease was 52 ± 7.87 years. Conclusion: Majority of patientswith Cerebral ischemia/stroke showed carotid artery stenosis on colour Doppler ultrasound.Common age group who developed cerebral ischemia/stroke was above 50years.
SEROPOSITIVITY OF HEPATITIS C VIRUS;
Authors: Amir Gilani Syed Amir GilaniSyed , Khan Muhammad Athar , Latif Muhammad Zahid , Malik Ahmad Azam
Published: August 2021

Objectives: This study was conducted to find out the occupation basedHCV prevalence in the rural communities of Punjab. Settings: Rural communities of Punjab,Pakistan. Study Design: Epidemiological, descriptive, cross sectional study. Study Period:January 2013 to June 2016. Methods: Punjab was divided into three regions. Three districtswere selected from each region and from each district three rural union councils were selected.After the approval of institutional review committee, non-probability convenience basedsampling technique was adopted and study subjects of different occupations were includedin the study. A structured questionnaire was prepared for data collection. Standard procedurefor HCV screening was observed. The collected data was organized and entered into version22 of SPSS for analysis. Results: A total of 1465 subjects related to ten different occupationsincluded in the study and tested for anti HCV antibodies, out of which 323 (22%) were positive.The prevalence was much higher in the collector of hospital garbage (67.2%) followed by factoryworkers (30.3%) and white wash painters (26.6%) respectively. The lowest prevalence rate wasobserved in black smith workers (10%) and carpenters (5.5%) only. Conclusion: This studyconclude occupation based prevalence rate of (22%) in rural Punjab. This is a high prevalencewhich need the immediate attention of the policy makers. It is recommended to manage anoccupation based hepatitis awareness and screening campaign for the affected and generalcommunity.
PROXIMAL HUMERUS FRACTURES;
Authors: Jabbar Faisal Abdul , Shah Rehana Ali
Published: August 2021

Objectives: The aim of our study is to study the radiological and functionaloutcome of proximal humerus fractures treated via open reduction and internal fixation usingthe proximal humerus internal locking system or PHILOS. Study Design: Case series study.Period 05 years duration from January 2011 to December 2015. Setting: Large tertiary carecentre in Karachi, Pakistan. Materials and methods: The study population consisted of n=50patients all of whom underwent open reduction and internal fixation utilizing the proximalhumeral internal locking system or PHILOS for fractures of the proximal humerus. The inclusioncriterion was all the patients with closed fractures of the proximal humerus and were belongingto 2,3 and 4 part of the Neer system of classification. Physiotherapy was started as soon aspossible for the patients. Serial radiographic imaging in two views was done at 6, 12, 24 and52 weeks postoperatively. For the functional outcome of the procedure Constant and Murleyscoring system was used. Data was analyzed using IBM SPSS version 21. Results: The studypopulation consisted of n= 50 patients of which n= 35 were males and n= 15 were femaleshaving a mean age of 38.50 years. The mean duration of follow up was 24 months. All thepatients in the study had union of fracture both radiographically and clinically, the mean timeduration for the radiographically evident union of the humerus bone was 12 weeks with a rangeof 8 to 20 weeks, the mean Constant Murley score for the functional outcome of the shoulderjoint was 79 at the final follow up with a range of 50 to 100. Complications were found in n= 9patients and varus malunion was the most common complication. In our case series we did notobserve complications such as avascular necrosis, non union or implant failure. Conclusion:According to the results of our study the proximal humerus internal locking system or PHILOSis a good method for open reduction and internal fixation of the proximal humerus fractures andprovides a stable fixation, and has lower incidence of complications such as avascular necrosis.
HIGH DEPENDENCY UNIT;
Authors: Jahan Shazia , Aziz Sajid , Ateeq Mohammad , Asif Mohammad
Published: August 2021

Objectives: To study the impact of “High Dependency Unit” care on outcomeof surgical patients. Study Design: Descriptive, Prospective. Setting: Surgical Departmentof Aziz Bhatti Shaheed (Teaching) Hospital. Nawaz Sharif medical College, University of theGujrat. Study Period: January 1st to December 31th 2016. Results: A total of 275 patients ofall age groups from surgical and allied specialities requiring dedicated continues monitoringwere admitted in High Dependency Unit (HDU) of the surgical department. Out of 275 patients165 were admitted through emergency room after some surgical operation, whereas 115patients are from those who were electively operated and shifted in HDU for management andmonitoring due to some anaesthesia related complications or comorbidities. Conclusion: TheHigh Dependency Unit care promotes efficient and effective care by increasing the flexibility ofpatient triage, utilizing resources efficiently, and providing cost effective timely care to serioussurgical patient admitted in surgical wards.
DIABETES MELLITUS TYPE 2;
Authors: Hassan Khan Muhammad Imran , Mushtaq Junaid , Amjad Ibtesaam , Toor Israr ul Haque , Tayyab Ghias un Nabi
Published: August 2021

Objectives: The objective to identify prevalence of different types of type 2Diabetes in our population and relate them with the Gender and Duration of disease. StudyDesign: Retrospective study. Period: January 2014 to December 2015, 2 years. Setting:Lahore General Hospital, Lahore. Method: On admitted record of 269 patients (171 Men and98 females), known to have complications during ward stay. Data was analyzed on SPSS 20and results calculated. Results: 232 patients (86.2%) showed one or more complications.Most common was diabetic nephropathy 117 (43.5% patients), followed by diabetic foot 94(34.9%), and then others. A comparison between genders exposed, an equal distribution ofcomplications. 233 patients had poor blood sugar control, with 107 having hypertension. Whenduration was considered as a variable over a period of 10 years, maximum complication wasof diabetic foot (66), followed by renal failure (64). Main reason identified was non-complianceto medication and infrequent follow-ups. When a less duration of 5 years was put as variable,there were very few complications, with their total number reduced to 24. Conclusion: Type2 Diabetes causes higher number of complications. Frequency among different genders wassimilar. They were associated with high prevalence of risk factors, such as poor blood sugarcontrol, concomitant hypertension and poor compliance to medication. Duration of disease hasimpact on the complications.
ATRIAL FIBRILLATION;
Authors: Riaz Rehan , Ahmad Nabeel , Abbas Shahid
Published: August 2021

Introduction: Atrial Fibrillation (AF) is one of the most common arrhythmiaafter coronary artery bypass grafting (CABG). Many risk factors have been identified for thedevelopment of postoperative AF with varied level of evidence. AF is associated with increasedrisk of morbidity and mortality causing prolong hospital stay and utilizing more resources.Our study was aimed to identify high risk population for developing post-operative AF andto draw recommendations for its prevention. Objectives: Our objective was to determine thefrequency of Atrial Fibrillation (AF) and its predisposing factors in patients after Coronary ArteryBypass Grafting (CABG). Setting: The study was conducted at Cardiac Surgery Department /Faisalabad Institute of Cardiology, Faisalabad. Duration of Study: 15-12-2014 to 14-07-2015.Study Design: Cross sectional study. Results: The result showed that out of 130 patientsundergoing CABG surgery, 104 (80.3%) male and 26 (19.7%) females, 9(7%) patients sufferedAF in post-operative phase. A significant association was found between postoperative AF andadvanced age (p = 0.011), obesity (p = 0.028), low EF (p = 0.000), and post-operative useof β-blocker (p = 0.007). Significant difference was found between postoperative AF and daysstayed in hospital (p = 0.000) and magnesium level at first day (p = 0.038). On the other handthere was no significant relationship found between AF and prolongs cross clamp and bypasstime. Conclusion: Advance age, obesity, congestive heart failure, low ejection fraction andwithdrawal from beta blockers in post-operative period have been identified as a significant riskfactors for the development of post-operative atrial fibrillation.
PULPOTOMY;
Authors: Saqib Muhammad , Ahmed Muhammad Adeel , Jouhar Rizwan , Hemani Afifa , - Ziaullah
Published: August 2021

Objectives: To assess the efficacy of mineral trioxide aggregate (MTA)pulpotomy in mature permanent teeth with irreversible pulpitis due to carious exposure. Placeand Duration: The study was conducted in the Department of Operative Dentistry, AltamashInstitute of Dental Medicine from 05-01-2016 to 05-07-2016. Methodology: A total of 70 teethof 70 patients with irreversible pulpitis were treated with mineral trioxide aggregate (MTA)pulpotomy. The patients were re-evaluated after 2 months. All patients were asked whether theyhad experienced spontaneous pain, pain on chewing or pain stimulated by hot/cold and thetreatment was counted as successful in case of no post-operative symptoms. Results: Efficacyof pulpotomy treatment with mineral trioxide aggregate in symptomatic mature permanentteeth with irreversible pulpitis and normal periapical periodontium was 88.57%. Conclusion:MTA pulputomy is a good alternative treatment for cases of irreversible pulpitis in permanentteeth with mature roots and normal apical periodontium. However, long term clinical trials andhistological assessment is desirable.
URETHEROPLASTY
Authors: Fakhr Fakhra
Published: August 2021

Objectives: The objective of this study is to compare urethroplasty with vicryl andPDS. Study Design: Comparative prospective study. Setting: Department of Pediatric Surgery,The Children’s Hospital and The Institute of Child health, Lahore. Period: 6 months. Methods:The sample size was twenty patients that were divided into two groups of equal strength. In firstgroup Vicryl was used an in the second group PDS was used. A perfoma was formed whichwas filled by observing the patient’s condition until they discharges after that patients werecalled in OPD and wound nature was observed. Results: There was a significant differencebetween both groups. Results showed that PDS was better than vicryl. Because vicryl is braidedwhile pds is monofilament. So bacteria can easily entrap in vicryl .Tensile strength of PDS isalso better than vicryl. Conclusion: In the current study the most common reason of infectionbecause of vicryl is that it is braided and bacteria can easily entrap and can cause infection.While pds is monofilament. Monofilament suture goes through tissues with less resistance thenmultifilament. Monofilament resists infection. Multifilament suture allow wicking (a method bywhich bacteria can enter the tissue). So pds is better than vicryl.
CIRRHOSIS
Authors: Kazi Afroz S , Abbasi Aftab , Naz Sana
Published: August 2021

Objectives: To investigate the histological changes in gastric mucosa of livercirrhosis patients. Study design: Cross sectional study. Place and Duration: Department ofAnatomy and Medicine, Gastroenterology unit, Isra University Hospital (June to December2012). Subjects and Methods: 85 diagnosed cases of liver cirrhosis were selected accordingto inclusion and exclusion criteria. Specimen of 2 mm thickness was taken by punch biopsyfrom gastric body and antrum by endoscope. Tissues were fixed in 10% formaldehyde, 3-5 μsections were stained with H & E for microscopy. Data was analyzed on SPSS version 21.0.Results: Age (mean ±SD) was noted as 47±11.5 years. Of 85, 56 (65.8%) were male and29 (34.1%) female. Frequency of mild, moderate, severe and no gastropathy were notedin 52.94%, 34.12%, 4.71%, and 8.24% respectively. 9.4% of cases show capillary dilationand edematous lamina propria. Conclusion: Microscopy shows gastropathy in majority ofspecimens. Thick gastric mucosa, increased gland size and mucosa capillary dilation wasnoted.
HEPATITIS DELTA
Authors: Shaikh Hafeezullah , Mobin Ahsan , Manzoor Imtiaz , Ebrahim Muhammad Ashraf
Published: August 2021

Objectives: The objective of this study is to prevalence of hepatitis delta inpatients with chronic hepatitis B infection. Study Design: Cross-sectional study. Period: Oneyear starting from February 2016 to January 2017. Setting: Patients OPD and admitted to Dowuniversity hospital and Zubaida Medical Center Karachi. Methods: Hepatitis B surface antigen(HbsAg) were analyzed for the presence or absence of Hepatitis D antibody (Anti HDV). 368patients with chronic hepatitis B were included to be part of this study. Patient’s age, duration ofillness and previous treatments were recorded. HBV and HDV virus presence was confirmed byusing Polymerase chain reaction (PCR). Results: Out of 368 patients with chronic HBV infection,291 (79.07%) were males and 77 (20.92%) were females. The male to female ratio was 3.7:1.Patients were aged between 35-60 years. 251 (68.2%) were positive for anti HDV. 211 of themwere males (84%) and 40 were females (15.9%). Conclusion: We have concluded that HDVinfection is associated with higher incidence of hepatocellular carcinoma in patients. Effectiveand early treatment of HDV can reduce the frequency of patients advancing to decompensatedchronic liver disease and hepatocellular carcinoma.
COMMON PIGMENTED SKIN LESIONS
Authors: Khan Amjad Ali , Asghar Abdul Shaheed , Akhund Israr Ahmed , Ishaq Muhammad
Published: August 2021

Objectives: The purpose of this study is; firstly, to study the histopathologicalspectrum of the pigmented skin lesions in the community, to signify that not all pigmented skinlesions are malignant melanomas; secondly, to assess the age-wise distribution of the commonpigmented skin lesions; and thirdly, to determine the commonly affected body sites by thesepigmented skin lesions. Study Design: Retrospective/Observational study. Setting: CharsadaTeaching Hospital affiliated with Jinnah Medical College Peshawar. Period: 100 consecutivecases with clinical diagnosis of pigmented skin lesion, starting in the year 2013. Methods: Inthis study, 100 consecutive surgical pathology cases with clinical diagnosis of pigmented skinlesion were retrieved from the archives of Charsada Teaching Hospital affiliated with JinnahMedical College Peshawar. All the specimens were incisional biopsies of skin, fixed in 10%formalin, embedded in paraffin, and stained with Hematoxylin and Eosin stains. Results: Onanalyzing 100 consecutive pigmented skin lesions (n=100) starting from the year 2013, it wasfound thatthe large majority of these lesions were benign. The most common pigmented skinlesion was melanocytic nevus. Moreover, majority of pigmented skin lesions were seen infemales. Seborrheic keratosis and malignant tumors, like basal cell carcinoma and squamouscell carcinomas, were more commonly seen in males in the 6th and 7th decades of life; whereas,dermatofibroma and post-inflammatory pigmentation were more common in females in the 4thand 5th decades of life. Overall, the pigmented skin lesions were more common in the 3rd, 4th, and5th decades of life with peak in the 4th decade. Skin of face was the most common site affectedby melanocytic nevi and malignant epidermal skin tumors. Conclusions: In conclusion, mostof the pigmented skin lesions are benign, encountered in the 4th decade of life, and commonlyaffect the skin of face. Also, most of the melanocytic nevi are encountered in females, whilemost of the malignant epidermal neoplasms are encountered in males affecting the skin of face.
SODIUM TUNGSTATE
Authors: Samad Afra , Shah Munawar Hussain , Mahmood Rana Khalid , Khalid Muhammad Abubakre , Usama Muhammad , Saeed Muhammad Sulaiman
Published: August 2021

Objectives: The purpose of this study was to reveal the effects of sodiumtungstate (ST) on kidneys of diabetic rabbits. Study Design: Rabbits of 30 weeks age weretaken and divided into three groups A, B and C. Each group contained 10 animals. Group A wasselected as control group. Diabetes was induced in groups B and C by injecting streptozotocin(50mg/mL) intraperitoneally. Group C was treated with sodium tungstate orally and group B wasleft untreated. Histology of the kidney was examined in all of these groups using Hematoxylin& Eosin (H & E), Reticulin and Trichrome stains. Blood glucose estimations of all animalswere performed every third day. Blood glucose levels of diabetic rabbits treated with sodiumtungstate were checked before and after treatment. Results were statistically analyzed usingstudents t-test. Place of Work: Post graduate medical institute Lahore. Duration of study:July 2010 to August 2011. Results: Treatment of diabetic rabbits with sodium tungstate (GroupC) lead to lowering of blood glucose levels as compared to untreated diabetic rabbits (GroupB). Microscopic features of kidneys in groups B and C did not reveal any pathological andmorphological changes in comparison with control group A. Conclusion: Sodium tungstate isa good anti-diabetic agent when administered orally and causes no morphological changes inkidneys.
MENINGITIS
Authors: Abbas Shaheen , Khan Lala Rukh , Afshan Gul
Published: August 2021

Objectives: To determine the frequency of meningitis in neonates having late onsetsepticemia. Study Design: Descriptive, cross-sectional study. Place and Duration of Study:Department of Pediatrics, D.H.Q, Faisalabad from August, 2015 to January, 2016. Methodology:105 neonates aged between 3-28 days having late onset septicemia were included in the studythrough non-probability consecutive sampling. Neonates having spina bifida, anencephalyand very sick neonates, after initial stabilization were excluded. For assessment of meningitis1ml blood sample and CSF sample were sent to the hospital pathology laboratory. Meningitiswas labeled if the patient had all of the following criteria: CSF glucose less than the plasmaglucose by ≥50%, CSF white cell count >10/cumm and CSF protein >80 mg/dl. Results: Outof 105 patients, mean age was 13.53±6.99 days. 59 (56.2%) patients were male and 46 (43.8%)patients were females. The prevalence of meningitis was found to be 20 (19%). 11 (18.6%) malepatients had meningitis while 9 (19.6%) female patients had meningitis with p-value = 0.905.Meningitis is more common in patients having age between 4-15 days 17 (26.6%) than the 3(7.3%) patients having age between 16-27 days with p-value = 0.014. Conclusion: Meningitisis a common disorder in neonates having late onset septicemia. By knowing the magnitude ofthis complication preventive measure can be adopted to minimize the burden of this disease.
COLLOID CYST
Authors: Khan Ateeq Ahmed , Ali Faiq , Imran Muhammad , Ghauri Sheraz Ahmed , Zeeshan Qazi Muhammad , Raza Muhammad Sheraz , Ashraf Junaid
Published: August 2021

Context: Colloid cyst is a rare tumour of the brain that has a good outcomeupon surgical removal. Aims: We present the outcome of surgical management of colloid cystat our setup based on the experience of last ten years. Study Design, Setting and Period: Thetype of study is a retrospective review of cases of third ventricular colloid cyst operated at theDepartment of Neurosurgery, Civil Hospital Karachi, Pakistan, from January 2005 to December2015. Methods and Material: The patient’s data including the clinical records, radiographicdata, operative and follow up notes were studied. The patient population was divided intogroups based upon the size of the cyst. The surgical approaches utilized were the transfrontaltransventricular and transcallosal approach. All the patients also underwent a series of tests todetermine the function of the somatosensory, motor and memory functions both pre and postoperatively and upon follow up. Statistical analysis used: Data was analyzed using SPSSversion 23. Mean and standard deviation was used for continuous variables, while frequencyand percentage was used for categorical variables. Results: The study population n= 60patient, n= 36 males and n= 24 females. The size distribution of the cyst was, n= 4 (6.66%)were less than 1.5cm, n=47 (78.33%) were 1.5-3cm and n=9 (15%) were >3cm. Headachewas the most common presenting complaint. Papilledema was observed in 71.66% of thepatients, while memory changes were observed in 8.33% of the patients. The surgical excisionof the cyst was performed in n= 52, patients while ventriculoperitoneal shunt was performed inn= 8 patients. Conclusions: According to the results of our study the transcallosal approach, isa safe technique, in which the neurological damage is limited due to minimal callosotomy andmanoeuvring of the fornix.
LOWER CERVICAL FRACTURE AND DISLOCATIONS
Authors: Jabbar Faisal Abdul , Khan Abdul Ali , Shah Rehana Ali
Published: August 2021

Objectives: The aim of our study is to determine the outcome of cervical pediclescrew fixation for fractures/dislocations of the cervical spine at our set up in Karachi, Pakistan.Study Design: A prospective case series. Period: 04 years duration from January 2013 toDecember 2016. Setting: Tertiary Care Centre in Karachi, Pakistan. Method: All the patientswho were included in the study signed a full informed consent. The inclusion criterion was allthe patients who cervical spine fracture/dislocation, presented to us within 24 hours of injuryand were operated at our set up. Data was collected in a predesigned proforma which includeda complete history and physical examination, age, gender, cause of injury, co morbidities, preoperativeradiological findings, past medical and surgical history. Serial X rays, MRI and CTscans were taken at 3, 6, 12 and 24 months post operatively for evaluation of stability, fusion andany complication such as deformity. The American Spinal Cord Injury Association impairmentscale was utilized in all the patients at follow ups to determine the sensory and motor functionimprovement post operatively. Data was analyzed using IBM SPSS for windows version 21.Results: The study population consisted of n= 40 patients of which n= 28 were male andn= 12 were female with a mean age of 45.2 years. The various types of injuries sustained bythe patients were as follows, n= 6 (15%) cases of cases had compression fractures (vertical),n=15 (37.5%) had flexion rotation injury and n=19 (47.5%) had flexion compression fracturesrespectively. While the division of bony injuries in the patient was as follows, n=5 (12.5%) hadcervical spinal burst fracture with dislocation, n= 15 (37.5%) patients had joint facet fracturewith dislocation bilaterally along with compression fracture of the vertebral body, n= 14 (35%)patients had facet joint fracture with dislocation bilaterally and n= 6 (15%) had unilateral fracturedislocation of joint facet. Complications such as injury to the vertebral artery, spinal cord, nerveroot were not observed in any of the patients in this series, all the patients achieved full bonyfusion at the 6 month follow up as observed on radiographic images. We also did not find anyincidence of screw penetration into the pedicle, similarly no incidence of screw breakage orloosening was observed. N=24 patients with incomplete injury of the spinal cord showedimprovements in their ASIA impairment scale, the patients n= 15 who had a complete spinalcord injury failed to show any improvement post operatively, but reported some decrease in painand numbness post operatively. Conclusion: For fractures/dislocations of the cervical spine thecervical pedicle screw is a reliable and effective method and provides good stability and bonyfusion. However the technique is dependent on surgeons experience and the extensive use ofpre-operative imaging to select the best insertion site of the screws as individualized for everypatient accordingly.
CHRONIC LIMB ISCHEMIA
Authors: Farooq Fawad , Shaikh Shams Uddin , Shaikh Shahbaz , Ashraf Tariq
Published: August 2021

Background: The Ankle brachial index (ABI) measurements are commonlyused inscreening and management of Peripheral Vascular Disease. In recent studies, Anklebrachial index (ABI) is utilized as a predictor of future atherosclerotic vascular disease andall-cause mortality. Purpose: The purpose of this study was to investigate utility of pre andpost peripheral vascular intervention ankle-brachial index (ABI) assessmentinpatientswith thechronic limb ischemia. Study Design: Quasi experimental study. Setting: National Instituteof Cardio-Vascular Disease (NICVD), Karachi, Pakistan. Period: January 2013 to June 2014.Methodology: The study included 23 patients hospitalized. According to study inclusion/exclusion criteria, patients of chronic limb ischemia on clinical ground and the vascular lesionsof lower limb according toTrans-Atlantic Inter-Society Consensus (TASC scoreclassification II)were evaluated and recruited. The lesions were further classified into three types, Aortoilliac,Femoropopliteal andTibioperoneal. Ankle brachial index (ABI) was classified according toAmerican Diabetic Association. The study was approved by the ethical committee of NICVD.Data was analyzed using SPSS 20. Inc. Results: The mean age of the enrolled patients was57.86±6.56 years. Majority of the patients were male 18(78.3%). The commonly found peripherallesion was femoropopliteal in 9(39%), TASC grade A was commonwith 8 (62%) of cases. ABIscore done pre and post procedure showed a significant difference with a (p-value<0.05) andthere was an improvement of ABI scores in all the lesions after peripheral vascular intervention.Conclusion: The study results concluded that there was animprovement in ABI score afterintervention of peripheral vascular surgery for lower limb segment and recommended its utilityfor the assessment in Peripheral Vascular Disease intervention.