bluuebunny/crossref_metadata_2025 huggingface dataset:
UPPER URETERIC STONES
Authors: Hussain Khalid , Khan Attiqur Rehman , Tariq Maria , Ameen Imran , Butt Muhammad Khalid
Published: August 2021

Objectives: Compare the efficacy of Extracorporeal Shock Wave Lithotripsy withPneumatic Lithotripsy in the management of upper ureteric stones. Settings: Department ofUrology, Lahore General Hospital, Lahore. Duration of Study: From November 2008 to August2009. Results: In our study, the patients were divided into two groups ie; Extracorporeal ShockWave Lithotripsy group (ESWL) and Pneumatic Lithotripsy group (PnL). The mean age inPneumatic Lithotripsy (PnL) was 39+15.23 years, whereas mean age was 40.6+14.62 years inExtracorporeal Shock Wave Lithotripsy group (ESWL). In Extracorporeal Shock Wave Lithotripsygroup (ESWL), 38(76%) patients were male and 12(24%) patients were female while numberwas 34(68%) and 16(32% in Pneumatic Lithotripsy group (PnL) respectively. In both groups,there was male preponderance. In ESWL group, majority of patients were treated as outdoorpatients. 95% of them received intramuscular analgesia where as 5% required intravenoussedation. All patients were followed at two weekly interval up till 6 weeks. Fifty patients requiredmore than 125 sessions of ESWL with mean shock waves 2960+222.23 at at mean energy6.46+0.503kv, 2952+327.77 at 6.45+0.504 kv and 2842+410.03 at 6.76 0.436 kv at 2, 4 and 6weeks respectively. The partial clearance was achieved in 34 patients at 2 weeks, 26 patientsat 4 weeks and 5 patients at 2 weeks. Stone free status at 2 weeks, 4 weeks and 6 weeks were18%, 40% and 84% respectively. In Pneumatic Lithotripsy group (PnL) all of the 50 patientswere given general anesthesia. DJ stent was placed in all patients after the procedure for sixweeks follow up. 42(84%) of patients received shots of Pneumatic Lithotripsy on pulse modewhile in 8(16%) patients, shots were on continuous mode. The partial clearance was achieved in5(10%), 3(6%) and 2(4%) patients at 2, 4 and 6 weeks respectively. Stone free status was 48%,52% and 54% at 2, 4 and 6 weeks respectively. In 20(40%) patients, stone migrated into calyces.Only in 1(2%) patients, there was no effect on stone. All patients in both groups were neededtwo weekly follow up till six weeks. Stone clearance was 84% in Extracorporeal Shock WaveLithotripsy (ESWL) group while it was 54% in Pneumatic Lithotripsy group (PnL), p<0.001.Conclusion: Extracorporeal Shock Wave Lithotripsy offers higher stone free rates with minimalinvasiveness and high safety compared to Pneumatic Lithotripsy, which provides immediatehigh stone free rates, but with high risk of treatment failure.
APPENDICECTOMY SPECIMENS
Authors: Jan Abdul Waheed , Khan Hanifullah , Rehman Gul
Published: August 2021

Objectives: To determine the frequency of unusual findings in routinehistopathological examination of appendicectomy specimens. Setting: Surgical Department ofGovt: City Hospital, Lakki Marwat. Study Design: Descriptive study (cross sectional). Period:One year (01/01/2016 to 31/12/2016). Methodology: A total of 497 patients (both male andfemale) in age range of 18-60 years were studied. A complete history with clinical examinationand relevant investigations were performed in all patients. After Establishment of diagnosisstandard appendicectomy either open or Laparoscopic depending upon availability was done.Appendicectomy specimen was sent to Pathology Department of the hospital. Histopathologyreports were collected by patient or his/her relatives and a copy was provided to the researcherby Pathology Department. All the relevant data received from histopathology report was recordedon predesigned proforma. Results: In this study mean age was 27 years with standard deviation± 1.26. Forty two percent patients were male and 58% patients were female. Histopathologyfindings among 497 patients was analyzed as appendix was negative in 20% patients whilepositive appendix was found in 80% patients, in which 34% patients had lymphoid hyperplasia,61% patients had fecolith, 4% patients had parasitic infestation (specify), 0.8% patients hadtuberculosis and 0.5% patients had neoplasia. Conclusion: Although unusual pathologicalfindings are seldom seen during an appendectomy, all appendectomy specimens should besent for routine histopathological examination.
MIDSHAFT CLAVICLE FRACTURE
Authors: Rasheed Nusrat , Kumar Jagdesh
Published: August 2021

Introduction: Fracture of clavicle is common, occurring most commonly inmales accounting for approximately 2.5%of all fracture presenting to orthopedic surgeon.1 Thisstudy has been conducted to compare the broad arm sling and figure of eight bandage in thefirst 21 days of treatment with primary outcome measure of pain and disability. Study Design:Comparative study. Setting: Department of orthopedic surgery, Dow International MedicalCollege, Dow University hospital. Period: February 2015-2016. Material and Methods: 60eligible patients with a mean age of (15-60 years) were randomized to conservative treatmentwith either a broad arm sling or figure of eight bandage. After detailed counseling taking informedconsent we did non stratified randomization in blocks of two using the sealed envelope method.Patients were kept in strict follow up to complete the outcome measures the next day and onday seven, fourteen and twenty one. On each visit a Performa was filled known as SPADI havingtwo components of pain and disability and VAS on day one, seven, fourteen and twenty one.Results: Seventy patients were enrolled initially, out of them ten patients were dropped outdue to different reasons. Of the remaining 60 patients 30 were treated with broad arm sling and30 were treated with figure of eight bandage. The two groups were randomized fulfilling theinclusion criteria. The Mean VAS on the first day of treatment in the broad arm sling group was5.433 SD 1.04 (p= 0.034, 95% CI 0.10 -2.46) where as in figure of eight group was 8.9 (SD 10.8).On subsequent visits (Day 7,14,21) VAS of broad arm sling was 3.83, 1.40,1 whereas figure ofeight was 5.76, 4.3, 3.469. This result clearly shows good pain control in broad arm sling groupas compared to the figure of eight group. The mean SPADI on the first day of treatment was94.52(SD 2.273) in broad arm sling group, on the other hand it was 93.87(SD 2.239) in figure ofeight group. In follow up visits of day 7, 14 and 21 score was as follows in broad arm group 3.83(SD 0.79), 1.4(SD 0.49), 1(SD 0.0), it was 5.76(SD 1.04), 4.3(SD 0.740), 3.4(SD0.68) in figure ofeight group. It also shows better result in terms of pain and functional outcome. Conclusion:Fracture clavicle is still managed conservatively in majority of the cases, either with the figure ofeight bandage or polyarm sling. Patient’s outcome in terms of pain management and functionalrange of motion in poly arm sling is better than figure of eight bandage.
DIABETES
Authors: Gul Ambreen , Sharif Naveed , Ullah Zahoor , Ahmed Sajjad
Published: August 2021

Introduction: Diabetes is one of the most common non-communicable diseasesglobally. Number of methods has been proposed for early detection and monitoring of diabetes.Glycated hemoglobin (HbA1c) is one of the indices used for long-term hyperglycemic control.Recently another method used for evaluation of hyperglycemia is measurement of glycatedalbumin (GA). The purpose of this study was to compare HbA1c and serum GA levels in diabeticpatients in Peshawar. Settings: Study Design: Prospective cross sectional study. Period: Julyto August 2014. Setting: Teaching Hospitals of Peshawar Medical College (Mercy and KuwaitTeaching Hospitals). Material and Methods: This study consisted of whole blood samples of47 diabetic individuals. GA estimation was done by Enzyme-Linked Immuno-Sorbent Assay(ELISA) whereas HbA1c estimation was performed by Fast Ion-exchange Resin SeparationMethod. Results: The mean age of diabetics was 55 ± 10.3 years. According to HbA1c levels,25.5% subjects had good glycemic control and 74.5% subjects had poor glycemic control.While the GA estimation showed 42.6% patients having glycemic levels within normal rangeand 57.4% subjects had uncontrolled glycemia. Conclusions: According to this study, GA is amarker of medium term glycemic control which can be considered to include in routine workupof diabetes mellitus management.
ASYMPTOMATIC BACTERIURIA
Authors: Zulfiqar Anam , Zulfiqar Sadaf , Rahat Shahana
Published: August 2021

Objectives: To record the rate of asymptomatic bacteriuria in pregnant females.Period: November 2015 to February 2016. Settings: Holy Family Hospital, Rawalpindi.Material & Methods: 200 pregnant females for regular pre-natal visits during 2nd and 3rdtrimester of pregnancy between 18-50 years of age were included. Sterile bottles were used tocollect the urine sample from the patients and sent to the hospital laboratory for the evaluationof asymptomatic bacteriuria in pregnant females. Results: We recorded most of the casesbetween 18-30 years of age i.e. 56%(n=112) whereas 44%(n=88) were between 31-50 yearsof age, mean+sd: 28.76+5.42 years. Frequency of asymptomatic bacteriuria was recordedin 22%(n=44). We found 21(23.86%) out of 88 cases had lower class, 15(23.44%) out of 64cases had middle class, 7(17.95%) out of 39 cases had upper middle class while 1(11.11%)out of 9 cases had higher class. Conclusion: Asymptomatic bacteriuria is not an uncommoncomplication during pregnancy, however, regular screening may help to prevent and reducethis morbidity at early stage.
HFE GENE MUTATIONS
Authors: Ali Nadir , Ahmed Bashir , Akram Humaira , Akhtar Junaid , Williams Ross , Dixon Ron
Published: August 2021

Objectives: To determine the frequency of two common HFE Gene Mutations(C282Y & H63D) in an immigrant population (British Pakistanis) in UK. Study Design: Crosssectional study. Setting: University of Lincoln UK. Duration: Duration of study was 12 monthsfrom 01/09/2012 to 31/08/2013. Material and Methods: Two hundred immigrant Pakistani (BP)chromosomes (100 samples; 50 male and 50 female) from major cities of UK and 200 ancestralorigin Pakistani chromosomes (100 samples; 50 male and 50 female) were analysed by PCRRFLPfor the presence of the H63D and C282Y mutations. Results: Eight individuals were foundto be heterozygous for the H63D mutation and one individual was found to be homozygousfor the H63D mutation, therefore, the H63D mutation was observed to have a frequency of 8%in immigrant Pakistani (BP) population sample and similar results were observed in ancestralorigin population from Pakistan. The C282Y mutation was not detected at all. Conclusion: Wefound that our results are close to Saudi-Arabian and Indian population (8.5% & 9.1% H63Dmutation, respectively) and in accordance with the global spread of the H63D mutation.
RESTORATIVE DENTAL MATERIALS
Authors: Khurram Maleeha , Zafar Khurram Jah , Qaisar Aneela , Atiq Tahmeena , Khan Sohail Abbas
Published: August 2021

Introduction: Erosion is an escalating problem in all age groups. Dental erosioncan be defined as painless irreversible loss of dental hard tissue due to chemical processwithout the involvement of microorganisms. There are several causes of erosion includingacidic foods and drinks. They are not only harmful to teeth but it is one of the main causes offailure of restoration. Erosion is one of the main challenges to restorative materials. Therefore,the restorative materials used in the mouth should resist or show minimal change in thesesituations. A variety of restorative materials are currently recommended for erosive lesions,including resin modified glass ionomer cement, resin composite and amalgam. Each materialhas its own advantages and disadvantages, which are considered before selecting them asrestorative materials. Objectives: To compare the surface micro-hardness of three restorativematerials when exposed to three acidic beverages and distilled water. Study design: This wasan experimental study. Setting: de’Montmorency College of dentistry in collaboration withPakistan council of scientific and industrial research (PCSIR) Lahore. Period: 6 months, Nov2014- April 2015. Material & Methods: Ninety six disc specimens prepared with resin modifiedglass ionomer, resin composite and amalgam restorative materials. The initial surface microhardnesstest was carried out at 1 day after mixing (before immersion) using micro-hardnesstesting machine. After base line study of micro-hardness the material specimens were subjectedto one of the storage media which was comprised of cola, apple juice, orange juice and distilledwater as control. Quantitative assessment of final surface micro-hardness was done at 2, 5 and7 days after immersion. The values obtained as base line and final vickers hardness number(VHN) for each specimen were subjected to statistical analysis. Results: Exposure to acidicbeverages decreased the surface micro-hardness of all the three restorative materials (P<0.05),while distal water did not affect the surface micro-hardness of any material. The resin modifiedGIC showed greatest reduction in surface micro-hardness as compared to Amalgam and ResinComposite. The cola produced the greatest degradation effect. Conclusion: Selection ofrestorative materials should be considered in patients with tooth surface loss, especially thosewith high risk for erosive conditions. In terms of materials evaluated for this study Amalgam andResin Composite provides the greatest stability under acidic conditions.
CRIMEAN-CONGO HEMORRHAGIC FEVER (CCHF)
Authors: Khan Zahidullah , Fida Zahid , Khan Abidullah , Zaman Fakhar , Ayub Maimoona
Published: August 2021

Background: Crimean-Congo hemorrhagic fever virus (CCHFV) from theBunyaviridae family causes a highly contagious disease in human called as, Crimean-Congohemorrhagic fever (CCHF). Infection in humans leads to a serious pyrexial illness that oftenresults in death of the patient. Objectives: To evaluate the outcome of patients admitted toKhyber Teaching Hospital (KTH), Peshawar-Pakistan with CCHF. Study Design: Cross-sectional,retrospective, epidemiological study. Setting: Khyber Teaching Hospital (KTH), Peshawar-Pakistan. Period: 2016. Methods: On the basis of final outcome; death or recovery, a total of 11patients diagnosed with CCHF in the year 2016 were divided into two groups. The demographicdetails and symptomatlogy of both the groups were evaluated. Continuous variables wereanalyzed using independent sample t-test on SPSS version 16. Results: Fever was commonin patients who recovered. However, shock and coagulapathy were more commonly seen inpatients expired. The mortality rate was 36.36%. Moreover, age and platelet count on admissionwere indicators of worse outcome, P < 0.05. However, total hospital stay did not predict theoutcome, P > 0.05. Conclusion: The case fatality rate in CCHF is high. Moreover, mortalityrate has an inverse relationship with platelet count on admission and a positive one with thepatient’s age.
CHRONIC LIVER DISEASE
Authors: Mobin Ahsan , Manzoor Imtiaz , Shaikh Hafeezullah , Ebrahim Muhammad Ashraf
Published: August 2021

Objectives: Objective of this study is to evaluate the frequency of pancytopeniain patients with viral chronic liver disease. Study Design: Descriptive case series study. Setting:All patients enrolled from OPD and admitted patients having a chronic liver disease either dueto HBV or HCV at Dow university hospital, Chiniot General Hospital and Zubaida MedicalCenter Karachi. Period: One year starting from January 2016 to December 2016. Methods: Allpatients regardless of age and gender with chronic liver disease due to Hepatitis B or HepatitisC were included. Patient’s age, duration of illness and previous treatments were recorded alongwith physical examination. Other investigations included complete blood count (CBC) andultrasound abdomen. Patients with history of alcohol intake, upper gastrointestinal bleeding, orany procedure like sclerotherapy or band ligation, currently taking interferon therapy / historyof receiving interferon in the past six months or hepatoma on abdominal ultrasound wereexcluded. Results: Among 224 patients. Male to female ratio was 3.9:1. Mean age was foundto be 40.2+3.21. Majority of individuals were between ages 36-45 years. The minimum age was25 years whereas the maximum age was 65 years. Pancytopenia was found in 28.57 % patients.Conclusion: We have concluded that pancytopenia is common in patients with chronic liverdisease. Early management can prevent deteriorating outcomes.
HETEROTOPIC SALIVARY GLAND
Authors: Samad Afra , Syed Madiha , Samad Arbaz
Published: August 2021

Background: Salivary glands heterotopia is defined as presence of salivary glandtissue outside its normal location.1 Salivary gland heterotopia in ileum leading to obstruction& intussusception is extremely rare. Only two such cases have been reported previously.Case Report: We report a case of 2 years old male who presented with history of vomiting,constipation and bleeding per rectum for one week. Clinical impression was intestinal obstructionand intussusception. An emergency exploratory laparotomy was performed and intraluminalileal polyp was resected. Histopathological examination of the excised polyp demonstratedsalivary gland tissue. Conclusion: Though extremely rare heterotopic salivary gland should beconsidered in differential diagnosis of intestinal obstruction and intussusception.
NONCLOSURE OF PERITONEUM
Authors: Manzoor Uzma , Jahan Mumtaz , Shahzad Uzma , Qureshi Saima
Published: August 2021

Introduction: This study reflects the comparison between closure Vs nonclosureof peritoneum during Caesarian section. Objectives: The aims of study are: 1. To makea comparative trial between closure versus nonclosure of peritoneum during cesarean section.2. To know the requirement of postoperative analgesia in each group of patients. Study Design:A randomized controlled trial. Setting: Department of Obstetrics and Gynaecology, Arar CentralHospital, North Zone, Kingdom of Saudi Arabia. Duration of Study with Dates: The durationof study was six months from 02-07-2012 to 01-01-2013. Subjects and Methods: A total of170 patients (85 in each group) were included in this study. Parietal peritoneum was closedusing a continuous absorbable suture in closure group. In non-closure group both layers wereremained unsutured. Results: Both groups of patients had equal availability of analgesia, butthe women in the non closure group used significantly less mean number of narcotic analgesicdoses during the first 24 hours after cesarean section. Besides, the operation time and exposureto anesthesia was found less in the non-closure group. Conclusion: Non-closure of peritoneumat caesarean section produces a significant reduction in postoperative analgesic requirement.
THORACIC OUTLET SYNDROME
Authors: Iqbal Khadija , Asim Aisha , Rehman Ibad-ur- , Asif Samra
Published: August 2021

Introduction: Thoracic outlet syndrome represents a variety of symptoms rangingfrom neurogenic to vascular. The thoracic outlet syndrome considered as a disputed disorderand management and diagnosis need special attention. Objective: The present study wasdone with the objective was to observe association of thoracic outlet syndrome with cervical riband the treatment and diagnosis options given to the patients once they present in the OPD.Study Design: Observational. Sampling: Convenience. Duration: January 2015-2017 January.Materials and methods: In this study the cervical rib was present in 3 males out of 58 cases.In females 8 had cervical rib out of 150 cases. Results: Out of eleven patients only six wereadvised surgical excision to relieve symptoms of thoracic outlet syndrome. Analgesics were alsoprescribed to all patients. The second category who did not have cervical rib nerve conductionstudies were advised to only 12 males and 10 females. In our study patients presenting withnumbness or and any vascular complaint only 11 cases had cervical rib. The treatment advisedfor relieving symptoms was surgical in only six patients and analgesics in all cases. Thetreatment for patients without cervical rib was analgesics and nerve conduction was advisedonly in 22 patients. Conclusion: The diagnosis and management of TOS is a combination ofneurophysiological testing and clinical examination outcomes. The use of advanced techniquescan lead to better patient management in our hospitals.
POST OPERATIVE BOWEL MOVEMENT
Authors: Iqbal Mubashir , Ali S. A. Sultan , Uzma Khadija Tul , Idrees Farah , Aziz Adnan , Sultan Naheed
Published: August 2021

Objectives: To compare early return of bowel movements in patients withelective stoma closure with or without nasogastric tube. Place and Duration: Single surgicalunit, Civil Hospital, Karachi, from January 2015-August 2016. Methods: This prospective doubleblind randomized control trial of 114 patients for elective stoma (Ileostomy, colostomy) closurein which lottery method was used to divide the patients into control group (with nasogastrictube) and study group (without nasogastric tube). Post operatively total duration from thesurgery till the patient passed first flatus was recorded in hours between the control and studygroups. Result: Comparison between two groups, the passage of first flatus after reversal ofstoma a mean difference of 19.7 was observed in hours between the control and study groups.Conclusion: Prophylactic nasogastric decompression in stoma closure patients can be omittedfrom routine postoperative period without any management problem.
DISTAL FEMORAL SHAFT FRACTURES
Authors: Sarraj Tawfeeq Safi , Shah Jehan Zaib
Published: August 2021

Objectives: To assess the functional outcome in supracondylar femur fracturesfixed with intramedullary tibial nail. Study Design: Prospective case series. Setting: Al Noorspecialist hospital, Makkah, Saudi Arabia. Period: Four years (2009-2013). Methods: 25patients with closed supracondylar femoral fractures operated with tibial intramedullary nail. Thefunctional outcome was measured by Tegner Lysholm criteria during and after 4 years. Results:Out of 25 patients 20 were male and 5 were female. The mean time of healing was 15.80(2.646)weeks. 6(24%) patients showed excellent results, 12(48%) patients showed good results and7(28%) patients showed fair results. There were no poor results in our study. Conclusions:Retrograde tibial nails are cheaper, convenient and lead to good functional outcome in patientswith supracondylar femur fractures.
RETROGRADE FEMUR NAIL
Authors: Shafiq Muhammad , Ahmed Ashfaq , Ullah Kaleem , Akram Rizwan , Zaman Atiq uz , Javed Shahzad , Aziz Amer
Published: August 2021

Background: Retrograde nailing for fracture of distal shaft of femur is commonprocedure but data about post-operative functional outcome in terms of knee range of motion,union and pain at 6 weeks, 6 months and 1 year follow-up is lacking. Objectives: The mainaim of this study was to determine post-operative functional outcome after performing nailingin a retrograde fashion for distal disphyseal femoral fracture in terms of knee range of motion,pain and union at 6 weeks, 6 months and at least 1 year follow-up. Study Design: Descriptivecase series. Setting: Orthopedics and Spine Centre, Ghurki Trust Hospital Lahore, Pakistan.Period: 1st July 2015 to Dec. 2016. Materials and Methodology: 140 patients of either sex andage with fractures of distal disphyseal femoral fracture and were operated using retrogradenailing were included in the study. All the data were analyzed using SPSS 17.0 version.Results: 140 patients were included with mean age of 31.81± 7.117 ranged from 16 to 75years of age.97 patients (69.3%) were male and remaining 43 patients (30.7%) were female.Pain was significantly decrease in all patients on Visual analogue scale. Mean union were 32.3± 5.3 weeks, Knee range of motion after last follow up were more than 1200 in 126 patients.Conclusion: Retrograde Nailing for distal diaphyseal fractures is an excellent option with goodfunctional outcome. It should always be considered while managing such fractures.
VIRAL HEPATITIS
Authors: Iqbal Sohail , Aziz Rao Salman , Mukhtar Rehana , Naqvi Farwa , Rana Maheen
Published: August 2021

Objectives: Diabetes mellitus has been shown to be an independent risk factorfor hepatocellular carcinoma in populations at risk. Different anti-diabetic drugs have beenshown to have different effects on incidence of cancers in diabetic patients. Data Source:Outpatient and inpatient hospital records as well as fresh cases. Design of Study: Hospitalbased retrospective case control study. Setting: DHQ, Sargodha. Period: Fifteen years (10years retrospective, 5 years prospective, from the starting date of study). Materials & Methods:In a hospital based study we recorded the incidence of HCC in patients otherwise consideredto be at risk. We also observed whether anti-diabetic monotherapy has any effects on HCCoccurrence in our target population. Results: We found out that incidence of HCC in diabeticpatients with a concomitant HBV or HCV infection was at least 1.5 times higher than non-diabetichepatitis patients. The incidence of HCC reduced in patients using metformin as compared tosulfonylureas. Conclusion: Diabetes is an independent risk factor for hepatocellular carcinomaand metformin use is correlated with reduced HCC occurrence in risk groups.
CHRONIC HEPATITIS C
Authors: Iqbal Sadia , Waqar Firasat , Javed Aisha , Sajid Nida , Iqbal Tayyaba , Nisa Qamar un
Published: August 2021

Objectives: The objective of this study is to determine the frequency of Occulthepatitis B virus (DNA) in cases of chronic hepatitis C in a tertiary care hospital of Karachi.Study Design: Cross sectional study. Setting: Medical Department of Abbasi ShaheedHospital and Karachi Medical and Dental College after permission of ethical committee.Period: 15 December 2015 to 15 December 2016. Methods: Patients greater than 18 years ofage of either sex were included while those with positive HBsAg, history of alcoholism, bloodtransfusion, intravenous drug abuse and hemodialysis were excluded. After informed consentblood samples were collected and evaluated for HBV DNA by performing qualitative PCR. Datawas analyzed on SPSS version 16.0.p value of <0.05 was taken as significant. Result: Out of377 patients with chronic Hepatitis C Occult hepatitis B virus (DNA) was found in 211 (55.9%)patients. 238(63.1%) were male and 139 (36.9%) were female. Mean age of patient with occultHBV DNA was 56.07 9.19 years. Highest prevalence 99(46.7%) was found in patients withhistory of Hepatitis C for more than three year (p value 0.02). Conclusion: Occult hepatitis Bvirus is found significantly among HCV infected patients. A masked HBV infection may interferewith the clinical outcome of chronic hepatitis C and accelerate the evolution to cirrhosis.
FEMALE INFERTILITY
Authors: Tayyab Muhammad , Yasmin Surriya , Anjum Muhammad Usman
Published: August 2021

Objectives: To find the prevalence and etiology of female infertility as well asto study the associated biochemical abnormalities. Place and Duration of Study: Departmentof Gynecology, Frontier Medical & Dental College, Abbottabad, from July 2016 to June 2017.Study Design: Case-control study. Materials & Methods: All married patients between theages of 18-35 years were included in the study. Sixty patients who met eligibility criteria wereincluded in one group while sixty normal healthy individuals were included in the second groupas controls. Detailed history was taken focusing specifically on age and duration of marriage,menstrual and sexual history and drug history especially use of contraceptives. A thoroughclinical examination was performed by an experienced clinician and body mass index wascalculated. Laboratory investigations included complete blood examination, hormonal assays,ultrasonography in female patients and semen analysis in male partners. Tubal patency wasassessed by hysterosalpingography and laparoscopy was performed, if required. Results: Themean age of infertile patients was 27.4±4.9 years and mean duration of their marriage was6.6±2.9 years. Majority of patients in our study belonged to lower socio-economic status inboth groups. About 50% belonged to lower and 16.67% to poor socio-economic group amonginfertile subjects while 60% belonged to lower and 10% to poor socio-economic group amongcontrols. The chief presenting complaint was oligomenorrhea followed by galactorrhea anddyspareunia. The chiefunderlying condition was luteal phase deficiency, 60%, followed byhyperprolactinemia, 16.66%, and polycystic ovarian disease, 10%, fibroid uterus, 6.7%, andendometriosis, 6.7%. The serum estradiol levels were 114.6±48.7pg/ml and 233.2±70.8 pg/ml in follicular and luteal phase among infertile couples. Similarly, serum progesterone, serumprolactin, serum FSH and LH levels were 3.6±4.2 ng/ml, 18.1±12 ng/ml, 6.7±2.7 mIU/ml, and7±6.6 mIU/ml among infertile patients respectively. Serum estradiol and prolactin levels weresignificantly higher among infertile patients. Conclusion: Infertility is not a very uncommoncondition in our country. It is the need of time to increase awareness and educate massesabout infertility as well as establish infertility clinics for early detection and treatment of infertilecouples. Large scale multi-centric studies should also be conducted to accurately estimate theprevalence and etiology of infertility in our region.
UPPER COMPLETE DENTURE
Authors: Ahmed Shabbir , Das Gotam , Rana Muhammad Haseeb , Reehana Miss
Published: August 2021

Objectives: Retention of maxillary denture is obtained by many factors includingphysical and physiological factors. Effective seal is obtained easily at buccal and labial bordersof maxillarsy. However, it is difficult to obtain peripheral seal at posterior border of upper dentureas there is no soft tissue draping. Fovea palatinae which has been considered as reliableanatomical guide in unmutilated mouth. Fovea palatinae are close to vibrating line and are insoft tissue making them useful as reference points for posterior limit of the denture. Our aim toidentify the relative position of vibrating line with reference to the fovea palatinae for determiningposterior border of the upper complete denture. Setting: Department of Prosthodontics,Lahore Medical and Dental College, Lahore. Method: 160 subjects were included in this study.The patients fulfilling the inclusion criteria, Fovea palatinae was located and marked with theindelible pencil in the soft palate. Subjects were instructed to rehearse the “ah” sound in normal,unexaggerated way. Location of the vibrating line was marked with same indelible pencil.The position of the vibrating line whether in front, at or behind the fovea palatinae was noted.Results: Our study results shows in 72(45%) subjects vibrating line lies in front, 81(50.6%)subjects it lies at and 7(4.4%) subjects lies behind the fovea palatinae. Conclusion: Seal mustbe situated just anterior to the vibrating line and distal to hard palate at compressible tissue ofsoft palate.
WOMEN DURING PREGNANCY
Authors: Akhtar Tazeem , Khan Muhammad Athar , Afzal Saira
Published: August 2021

Introduction: There are certain factors which are present at workplacesbut cannot be seen as the potential hazards for the health of a normal women but when itcomes to pregnant working women and mothers, these factors can have profound effectson health of women during pregnancy. These factors found are transportation, duty hours,medical and maternity leave policies, and stress at workplace, long standing hours. Supportby supervisor and colleagues. Objectives: Objectives of this study are: 1. To find out theworkplace factors affecting the women at their workplace. 2. To determine the effects of thesefactors on pregnancy. 3. To find out the association between these factors and complicationsof pregnancy. Study Design: Descriptive. Cross-sectional Setting: Teachers of private schoolswho were either pregnant or had at least one child during her job. Material and Methods:A pre-tested questionnaire was filled and sample was calculated by using statistical formula.Results and Conclusion: Study clearly showed association between the workplace factorsand the poor health status of women during pregnancy and many complications of pregnancywere seemed to be related with their workplace factors.
Accidente cerebrovascular de la arteria basilar: cannabis como factor de riesgo en jóvenes
Authors: Tapias-Cáceres Kevin Aarón , Suarez-Plata José Daniel , Quintero-Oliveros Silvia Tatiana
Published: August 2021

Introducción. La arteria basilar se forma de las arterias vertebrales, cursa sobre el puente y se bifurca originando las arterias cerebrales posteriores. Irriga parte del tronco encefálico, cerebelo, tálamo y los lóbulos occipitales y temporales cerebrales. Su obstrucción es rara (1% de los accidentes isquémicos), puede ocurrir en cualquier parte de su trayecto, con cuadro clínico diverso. En jóvenes se añaden otros factores de riesgo distintos a los cardiovasculares, se incluye el consumo de sustancias psicoactivas. El objetivo de este artículo es presentar el caso de un adulto joven, su evolución posterior a la intervención endovascular y la asociación, pasada por alto, al consumo de cannabinoides. Caso clínico.  Individuo de 23 años con 14 horas de parálisis facial periférica derecha, diplopía, disartria, hemiparesia e hiperreflexia izquierda, disfagia, náuseas y emesis. Tomografía Axial Computarizada de cráneo simple sin alteraciones. Posteriormente, al realizarse resonancia magnética nuclear, se evidencia isquemia pontomesencefálica y focos isquémicos agudos lacunares en lóbulos cerebelosos. Se consideró comprometido el territorio de la arteria basilar, por lo que se realizó angiotomografía que evidenció una obstrucción crítica de dicho vaso a nivel del tercio distal. Se realizó trombectomía con stent-retriever con recanalización total de la arteria basilar con flujo en toda su extensión. Al egreso fue clasificado como TOAST idiopático. Conclusiones. Las escalas etiológicas para stroke creadas para adultos mayores sobreestiman la etiología idiopática en pacientes jóvenes, lo cual puede ocasionar que el consumo de cannabis sea pasado por alto como causante pese a la asociación reportada por la literatura.
Percepción de los padres acerca del estado de salud y bienestar de sus hijos adolescentes de 15 a 18 años
Authors: Jaimes-Valencia Mary Luz , Saavedra-Rey Yorlenis , Rincón-Pabón Leidy Tatiana , Argüello-Duarte John Freddy , Fajardo-Natez Socorro , Piratoba-Hernández Blanca
Published: August 2021

Introducción. El término “autopercepción del estado de salud” se refiere a la información brindada por el individuo sobre su estado de salud de acuerdo con sus conocimientos e interpretaciones y, en otras ocasiones, dado por los padres o acudientes. El objetivo de este estudio es describir las percepciones que tienen los padres respecto al estado de salud y el bienestar de sus hijos escolarizados de 15 a 18 años. Metodología. Estudio cualitativo, con la técnica de grupo focal. Con participación de 10 padres de familia de adolescentes escolarizados entre 15 a 18 años de una institución educativa pública de la ciudad de Bucaramanga, Santander. Resultados: Se identificaron 11 categorías y 6 subcategorías. Dentro de las categorías a resaltar se encuentra la tecnología que, según los padres, presenta aspectos positivos y negativos puesto que afecta la salud en dimensiones como los hábitos alimenticios, las relaciones interpersonales, entre otros. Este componente es poco documentado en los estudios que se localizaron. Discusión: En las narrativas se identifican la espiritualidad y la tecnología como aspectos que afectan la salud de manera positiva y negativa coincidiendo con otros autores. Conclusiones: A través de las narrativas de los padres se logra identificar que la salud es multidimensional y que la afectan varios componentes, entre ellos los psicosociales, en especial durante la etapa de adolescencia de sus hijos.
Hiperglicinemia no cetósica neonatal, fenotipo atenuado
Authors: Dellán-Quijada Alexander Jesús , Useche-Sabogal Laura Andrea , Espitia-Segura Oscar Mauricio , Penagos-Vargas Natalia
Published: August 2021

Introducción. La Hiperglicinemia no Cetósica (HNC) es un error innato del metabolismo de herencia autosómica recesiva, cuya principal característica es la acumulación de glicina en los fluidos corporales, producido por una falla en el complejo de clivaje enzimático de este aminoácido. Presentación del caso. Presentamos el caso de un recién nacido de 36 semanas, con adaptación neonatal espontánea, sin historia de noxa perinatal ni hipoglicemia documentada, quien tras un corto período de 24 horas presentó deterioro neurológico progresivo, rápida alteración del estado de conciencia hasta el coma y falla ventilatoria. Llamó la atención al ingreso la hipotonía severa generalizada, hiporreflexia, ausencia de reflejos primitivos, con episodios de hipo aislado y movimientos oculares anormales. Ante la sospecha de un error innato del metabolismo se realizó el perfil de aminoácidos donde se evidenció elevación significativa de la glicina, 1417 mmol/L (referencia 94-553 umol/L). Se solicitaron aminoácidos en líquido cefalorraquídeo, glicina muy elevada 1263 mmol/L (referencia 3-7 umol/L), con lo que se confirma la sospecha de hiperglicinemia no cetósica. Se decidió iniciar manejo con benzoato de sodio y dextrometorfano. La resonancia magnética inicial fue normal, en estudio control se encontraron al igual que en el electroencefalograma hallazgos reportados previamente en la literatura para esta patología. Discusión. La mayoría de los niños con HNC se presentan en el período neonatal o en la primera infancia, y solo los casos más leves se presentan al final de la infancia o la niñez. En las presentaciones de inicio neonatal, el 85% tiene HNC grave y el 15% tiene forma atenuada, como este caso. El diagnóstico de la HNC se hace con base en la sospecha clínica, confirmada por los hallazgos de laboratorio, con la alteración característica de la glicina tanto en plasma como en el LCR y soportada por los hallazgos de las neuroimágenes y electroencefalograma (EEG). Conclusiones. La HNC no es una condición tan inusual, aunque sí posiblemente subdiagnosticada por la forma de presentación tan catastrófica, además porque no produce grandes desarreglos metabólicos de rápido diagnóstico. Por este motivo, ante un paciente con cuadro clínico sugestivo, con coma, alteración respiratoria y convulsiones de difícil manejo, y muy característicamente hipo, debe solicitarse el estudio de aminoácidos en plasma, neuroimágenes y EEG, con el fin de instaurar un manejo temprano.
Comprensión del vínculo persona mayor-mascota como alternativa para la promoción de la salud
Authors: Zapata-Herrera Marleny , Sanmartín-Laverde Catalina María , Hoyos-Duque Teresa Nury
Published: August 2021

Introducción: el aumento de personas mayores en Colombia sumado a la pobreza y a la falta de soporte familiar y redes de apoyo para estas personas constituye un reto para el Estado. Ante esta problemática se exploran alternativas como la influencia de las mascotas en su salud. El objetivo de este manuscrito es comprender el vínculo persona mayor-mascota en la vida cotidiana y las implicaciones para su salud. Metodología:  se trata de un estudio cualitativo con perspectiva etnográfica focalizada. Se realizaron 14 entrevistas semiestructuradas y observación a mayores de 60 años que conviven con mascotas en Medellín-Colombia. Participaron 8 mujeres, 6 hombres, entre 60 y 85 años. Mascotas: 17 perros y 7 gatos. Resultados: emergieron cuatro categorías principales: la mejor compañía, un día con la mascota, relación familia-mascota y beneficios de la mascota para la promoción de la salud de los mayores. Discusión: para los mayores lo más satisfactorio de tener mascota es su compañía, comparable a la de un hijo o un ser querido, seguido de la posibilidad que les brinda de expresar emociones placenteras, aumentar su interacción social y sentirse útiles y activos; beneficios que trascienden al resto de la familia. Conclusiones: el vínculo persona mayor-mascota es un coadyuvante para la promoción de la salud.
Rondas interprofesionales de heridas antes y después de Best Practice Spotlight Organization (BPSO)
Authors: Skol Patricia
Published: August 2021

Introducción. El modelo de cuidado a pacientes en el Salvation Army Toronto Grace Health Centre Hospital está basado en los principios de cuidado centrado en el paciente y la familia como parte integral del equipo interprofesional. Dentro de este marco se diseñan y se implementan diferentes programas para que se mejore constantemente y se mantenga un buen nivel de cuidados y calidad de vida de los pacientes, dentro de las limitaciones que conlleva el estar hospitalizado, esto después de convertirse en Best Practice Spotlight. Objetivo. Presentar la experiencia de las rondas interprofesionales de heridas antes y después de Best Practice Spotlight. Síntesis. Antes de ser BPSO los documentos de pólizas y procedimientos que guiaban las prácticas alrededor de úlceras o heridas por presión, en el hospital se utilizaban como referencia las guías basadas en las evidencias de la Asociación de Enfermeras de Ontario (RNAO). Sin embargo, no estaba formalizada la ejecución o aplicación de estas prácticas al punto de cuidado directo al paciente. En este artículo se presenta la transición y los aspectos relevantes para que sea una realidad el cuidado centrado en el paciente y la familia como parte del equipo interprofesional en el componente de las rondas interprofesionales de heridas. Conclusiones. El éxito de la implementación efectiva de las guías ha sido el programa BPSO, que se ha convertido en una identidad colectiva de organizaciones que trabajan en pro de los mejores resultados en las organizaciones de salud en instituciones nacionales e internacionales.
Ivermectina un medicamento de uso indiscriminado en el manejo del Covid-19
Authors: Amaya-Aponte Silvia Camila
Published: August 2021

Los Coronaviridae son una familia de virus ARN que han afectado, a lo largo de la historia, a mamíferos y aves. Estos patógenos, conocidos y estudiados por varias décadas, también han sido los responsables de infecciones que usualmente se presentan en el tracto respiratorio en humanos. Su más reciente variante SARS-CoV-2, fue identificada a finales del año 2019 en la ciudad china de Wuhan donde el virus fue identificado como el causante de múltiples neumonías severas en la población (1). 
Dicho brote tuvo una extensión que superó las expectativas, creando el hito más grande del siglo XXI. El 11 de marzo de 2020 el virus fue declarado pandemia, su transmisión de forma directa de persona a persona jugó un papel muy importante en el rápido esparcimiento de este nuevo coronavirus. Su gran abanico de presentación clínica, que parte desde formas completamente asintomáticas hasta llegar a infecciones de tracto respiratorio más graves e incluso mortales, jamás antes vistas (2), se convirtió en un reto social, político y médico.
Isso não é pornografia de vingança: violência contra meninas e mulheres a partir da explanação de conteúdo íntimo na internet
Authors: Paz Aline Amaral , Da Silva Sandra Rúbia
Published: August 2021

Entre questões que se elaboram nas dimensões do público e do privado na internet, a partir da acessibilidade dos smartphones e da configuração de plataformas que se organizam discursiva e tecnologicamente para que usuárias(os) estejam on-line e ativas(os) nas redes, a exposição não consensual de conteúdo íntimo de meninas e mulheres se configura em um problema potencializado. Nesse sentido, o artigo trata da exposição desautorizada de materiais íntimos, chamada no campo de ‘explanação’, apresentando dados etnográficos de um grupo no Facebook que desenvolve práticas para ajudar meninas, geralmente menores de idade, a se proteger e combater casos de explanação. Percebemos o exercício de uma forma atualizada de poder sobre o corpo e a sexualidade que se dissocia do padrão do que é entendido como pornografia de vingança. Nessa direção, o universo digital funciona como uma extensão do cotidiano, produzindo e estendendo violências contra meninas e mulheres.
Análise da implementação das estratégias de comunicação para as ações de testagem e sua vinculação ao tratamento de HIV/aids em homens que fazem sexo com homens em Curitiba
Authors: Cruz Marly Marques da , Cota Vanda Lúcia , Lincoln Leonardo , Jesus Alan De , Decotelli Paula Vita
Published: August 2021

Há barreiras de acesso enfrentadas por homens gays e homens que fazem sexo com outros homens (HSH) à testagem e ao tratamento de HIV/aids devido a fatores estruturais e simbólicos. Daí, o objetivo do estudo que fundamenta este artigo é analisar a implementação das estratégias de comunicação para ampliar a testagem e vincular seu resultado ao tratamento de HIV/aids, em Curitiba (PR), pelo projeto A Hora é Agora (AHA), realizado de dezembro de 2014 a setembro de 2017, visando à maior aproximação dos que o executam com homens gays e HSH e ao desenvolvimento de meios mais efetivos de comunicação, identificando facilidades e dificuldades. Utilizou-se abordagem qualitativa por meio da análise documental do plano de comunicação e dos relatórios de atividades. As lições aprendidas foram a boa aceitação das campanhas ‘corpo a corpo’ feitas por educadores de pares nos espaços públicos, sobretudo em festas gays, e a necessidade de desenvolver estratégias específicas para HSH que não se identificam como gay.
Bagaimana Pola Asuh Orang Tua dan Kecerdasan Intrapersonal Menjelaskan Prestasi Belajar Siswa?
Authors: Fadhillah Dilla , Novianti Ersa
Published: August 2021

Penelitian ini bertujuan untuk mengeksplorasi pola asuh orang tua dengan kecerdasan intrapersonal terhadap prestasi belajar pada mata pelajaran bahasa indonesia siswa. Penelitian ini menggunakan pendekatan kualitatif dengan desain studi kasus. Subjek dalam penelitian ini adalah 15 orang siswa kelas III pada salah satu Madrasah Ibtidaiyah (MI) di Kota Tangerang, guru, dan orang tua siswa. Teknik pengumpulan data dilakukan melalui interviu terhadap siswa, guru, dan orang tua siswa; pengisian angket oleh siswa dan orang tua siswa; observasi terhadap proses kegiatan pembelajaran yang diikuti oleh siswa; dan dokumentasi terhadap dokumen yang mendukung data prestasi belajar siswa. Validasi penelitian dilakukan melalui metode triangulasi. Hasil penelitian ini menunjukkan bahwa, pola asuh yang berdampak terhadap tingginya prestasi belajar siswa di antaranya berupa gabungan dari pola asuh demokratis dan otoritatif. Pola asuh otoriter turut menjelaskan capaian prestasi belajar siswa, namun dalam kategori sedang. Pola asuh permisif cenderung mendorong siswa kesulitan dalam menghadapi permasalahan, sehingga siswa mencapai prestasi belajar dalam kategori rendah. Prestasi belajar siswa juga berbanding lurus dengan tingkat kecerdasan intrapersonal siswa. Semakin siswa mampu mengenali diri sendiri, merefleksikan tindakan, dan mengendalikan dirinya sendiri maka semakin mampu siswa untuk mencapai prestasi belajar yang optimal.
Pengembangan Media Pembelajaran Flash Berbasis Joyfull Learning bagi Siswa Kelas IV SD
Authors: Azhar Arry Patriasurya , Rahayu Zaenab Fuji
Published: August 2021

Studi ini bertujuan untuk mengetahui kelayakan produk media pembelajaran flash berbasis joyfull learning untuk siswa kelas IV, yaitu pembelajaran IPA dengan materi “Gaya” Tema 7 (Indahnya Keragaman di Negeriku). Studi ini menggunakan metode research and development (R&D). Adapun model yang digunakan mengacu pada model Dick & Carey yang terdiri dari delapan tahap. Hasil penelitian ini menunjukkan bahwa media pembelajaran flash berbasis joyfull learning yang dikembangkan bisa memenuhi kebutuhan belajar siswa, sekaligus menambah variasi media ajar pada proses pembelajaran IPA dengan materi “Gaya” Tema 7 (Indahnya Keragaman di Negeriku). Hal ini didasarkan pada hasil uji validasi: (1) ahli produk media dengan nilai sangat baik; (2) ahli materi dengan nilai baik; (3) guru kelas dengan nilai sangat baik. Adapun pada tahap uji coba perorangan, diperoleh nilai rata-rata skor 4,1 (baik), sementara uji coba kelompok kecil dengan nilai rata-rata 4,6 (sangat baik), dan uji coba kelompok besar diperoleh nilai rata-rata 4,1 (baik). Kata kunci: Media pembelajaran, joyfull learning, multimedia, flash