bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence, and Pattern of Hypoxic Ischemic Encephalopathy on Magnetic Resonance Imaging among Pediatric patients
Authors: Hameed Marya , Bozdar Hayat , Khurshid Sadia , Sohail Humera , Siddiqui Fatima , Jesrani Ameet Kumar , Fatima Noor
Published: March 2023

Background: Hypoxic Ischemic Encephalopathy is a frequently encountered occurrence in a pediatric setting and more prevalent in the low middle income countries. Magnetic resonance imaging (MRI) is considered a reliable source of investigation. Our study determined the imaging findings and cause of Hypoxic ischemic encephalopathy in children referred for MR Imaging to our radiology department. Study design: A prospective cross-sectional study. Place and duration of study: Our prospective cross-sectional study was conducted at a pediatric tertiarycare hospital, of Karachi Pakistan from 1st November 2021 to 30th October 2022. Methods: Our study included children from newborns to 16 years of age who either had a history of fits, abnormal APGAR score, delayed cry or delayed milestones. The brain MRI was performed on 1.5 tesla scanner with a standard protocol and interpreted by Experienced Radiologists Findings were recorded on anExcel Sheet and data was analyzed on SPSS version 26. Our study included children from newborns to 16 years of age who were at risk of hypoxic insult and were born to mothers who had hypertension, diabetes milletus, history of maternal substance abuse and maternal history of fits history of fits and children who had a history of fits, abnormal APGAR score, delayed cry and/or delayed milestones. Children who were born via instrumental delivery were excluded from our study. Result: A total number of 187 patients were included in our study with 98 males and 89 females. The most common age group involved was from age >1 year to 5 years (50.3%). The most common presenting complaints included delayed milestones (63.6%) and fits (59.9%), delayed cry (52.4). On examination 42.2% had microcephaly. One-third of the patients had a positive maternal history for diabetes mellitus, hypertension and anemia. APGAR score was checked at 1 minute and 5 minute which showed the most common APGAR score of 3-6 which was seen in 81.8% of the patients. On MR Imaging 54.5% had periventricular leukomalacia, 35.3% had deep gray matter involvement, 3.7% had germinal matrix hemorrhage, and only 1.6% had watershed infarcts. A statically significant association was seen between gestation at birth and periventricular leukomalacia (P=<0.5). Conclusion: Hypoxic Ischemic Encephalopathy is a common occurrence in our society and MRI is the recommended modality due to its sensitivity and superior soft-tissue resolution. In developing countries due to a lack of proper facilities and awareness, there is an increased incidence of HIE which leads to increased morbidity therefore increasing awareness and early diagnosis is of utmost importance. Keywords: Hypoxic ischemic encephalopathy, Magnetic Resonance Imaging, Pediatric population
Knowledge of Breast Feeding Positioning among Primigravida Mothers
Authors: Farooq Ragheesa , Khalid Mehwish , Murtaza Saba , Aziz Mubashra , Khalid Anum , Hassan Zainab
Published: March 2023

Background: Breastfeeding is the natural procedure of feeding a baby with mother’s milk which is important for healthy life of a baby Most common breastfeeding positions for nursing a newborn are cross cradle hold, cradle hold, side-lying and football hold Study design: Descriptive cross-sectional study. Methodology: Non- probability convenient sampling technique were used for this study. The number of primigravida women participated in this study was 350. Instrument used for the study was the standardized questionnaire which gathered details on socio-demographic factors and maternal traits of primigravida women such as their knowledge about postures, positioning, hold practice and latch-on practice. Data was evaluated by using SPSS v.23. Qualitative data was presented as percentage and frequency. Results: Almost, 56.6% participants had good knowledge while and 43.3% had a poor knowledge of breastfeeding positioning. 68.6% practiced advisable breastfeeding posture. Cross cradle hold (56.9%) was the most common breastfeeding technique with 18.6% cradle hold, 17.7% football hold and 6.9% side-lying position. About 75.7% mothers had baby to breast latch-on practice. Practical Implication: This study brought attention towards the assessment of knowledge regarding different breastfeeding positions. Moreover, this study helped physiotherapists to evaluate the musculoskeletal problems in early stage so that they can provide awareness to mothers related effective breastfeeding positioning. Conclusion: It was concluded that primigravida mothers showed the good knowledge of breastfeeding positioning. As all the mothers practiced advisable breastfeeding postures, adopted sitting on the side of bed to breastfeed, worked on cross-cradle hold and baby-to breast latch-on. Keywords: Breastfeeding Positioning, Knowledge and Primigravida mothers.
Etiological Profile of Hereditary Hemolytic Anemia among Patients Presenting in Tertiary Care Hospital of Lahore
Authors: Rizwan Nida , Kaleemi Shizra , Kareem Sadaf , Chaudary Sidra Sonia , Zafar Saad , Syed Sehr
Published: March 2023

Background: Hereditary hemolytic anemia is a frequent genetic condition that can have varied levels of morbidity and death. These genetic diseases raise the burden on the patient as well as society and pose a serious threat to public health. Aim: To determine the frequency of various causes of hereditary hemolytic anemia among patients in a tertiary care hospital. Methodology: It was a descriptive cross sectional study. Patients (n=252) were enrolled through probability convenient sampling. The study was conducted at Pathology Laboratory, Jinnah Hospital, Lahore. Blood samples were taken from all patients for complete blood count, peripheral smear, reticulocyte count, indirect bilirubin, serum lactate dehydrogenase, and direct antiglobulin test. Median corpuscular fragility (MCF) >4.45g/l NaCl was considered positive. Quantitative enzyme-based assays of Glucose 6 phosphate dehydrogenase were determined spectrophotometrically by using Pointe scientific G6PD reagent. Data were entered and analyzed using SPSS v25.0. A p-value of 0.05 was used to define statistical significance after post-stratification analysis using the chi-square test. Results: age range in this study was from 1 to 60 years with a mean age of 29.3±9.5 years. According to causes of heredity hemolytic anemia distribution, Thalassaemia major 137(54.4%) was the most common cause followed by Thalassaemia intermedia at 41(16.3%), Sickle Cell Anemia at 34(13.5%), Heredity spherocytosis as 31(12.3%) and Glucose-6 phosphatase deficiency as 9(3.6%). Practical Implication: As there is a high incidence of anemia among our population and there is lack of local data that specifically addresses this health issue thus current study was planned. This study highlighted that educating the entire medical community could help lower the prevalence of thalassemia major and emphasise the need of diagnosing the thalassemia trait and provide premarital and prenatal counselling. Conclusion: It was concluded that majority of hereditary hemolytic anaemias were hemoglobinopathies, which place a heavy strain on families and society. The occurrence of these conditions can be reduced in large part by prevention. Keywords: Heredity Hemolytic Anemia, Heredity Spherocytosis, Thalassaemia Trait and Prention.
Perineural Invasion and Histological Grades of Prostatic Adenocarcinoma
Authors: Fatima Ghazia , Iqbal Zafar , Faiz Faiz Ahmad , Ghaffar Hira , Naz Sibgha
Published: March 2023

Aim: Perineural invasion and Histological grades of Prostatic adenocarcinoma Study design: Analytical descriptive cross sectional Study setting: Department of Pathology, KEMU, Lahore in collaboration with other tertiary care hospitals. Duration of study: 6 months Methodology: 60 cases of prostatic carcinoma were enrolled in this study. Detailed demographics of included patients were recorded after taking informed written consent. Formalin fixed, processed and paraffin embedded tissue blocks of prostate adenocarcinoma collected. Results: Out of 60 biopsies, 57(95%) were TURP, 1(1.67%) was a TRUS guided biopsy, 1(1.67%) was a core needle biopsy and 1(1.67%) was a radical prostatectomy specimen. Perineural invasion was identified in 27 cases. There was insignificant association between perineural invasion and histological grades of prostatic carcinoma and p-value = 0.613. Among all high grade tumors with Gleason score (8-10), 23 cases were positive for perineural invasion and 25 were negative. Conclusion: Perineural invasion was identified in 27 cases i.e. 45%. There was insignificant association between perineural invasion and histological grades of prostatic carcinoma. Key words: Prostate, adenocarcinoma, perineural invasion, association, TURP,
Folate Levels in Third Trimester of Pregnancy
Authors: Iqbal Zafar , Fatima Ghazia , Faiz Faiz Ahmad , Ghaffar Hira , Naz Sibgha , Anwer Tahreem
Published: March 2023

Aim: To determine the folate levels in third trimester of pregnancy Study design: Cross-sectional study Place and duration: Conducted at post graduate medical institute, Lahore. Duration was 6 months from June 2022 to December 2022. Methods: Ninety anemic females were selected from the antenatal clinics of different hospitals of Lahore. These incorporated equal numbers of primigravidae and multigravidae and all of them were in the third trimester of pregnancy. They had not taken any hematinic supplements during the pregnancy. Results: Folate deficiency was seen in 44.4% of the primigravidae with peripheral blood macrocytosis and bone marrow megaloblastosis. An association exists between the clinical anemia and the peripheral blood and bone marrow findings with those of serum and red cell folate levels. Conclusion: Folic acid should be included as a routine in hematinic supplements prescribed for pregnant females to protect them from anemia and its consequent complications. Key words: Folate, gestation, trimester, megaloblastic anemia, macocytosis, bone marrow
Frequency of Pre-Eclampsia in Obese pregnant Females taking Metformin during Pregnancy
Authors: Wajid Rabia , Zubair Zainab , Parveen Asia , . Ammara , Masood Somer
Published: March 2023

Background: It has been shown that obesity takes its roots in the womb. Maternal obesity has an association with macrosomia and the risk of obesity late in life.Obese women who have weight loss before pregnancy may have better pregnancy outcomes if excessive weight gain is avoided during pregnancy. Aim: To determine the frequency of pre-eclampsia in obese pregnant females taking metformin during pregnancy. Methods: It was a Descriptive case series conducted at Unit 1, Department of Obstetrics & Gynecology, Lady Willingdon Hospital, and Lahore from 16-11-21 to 16-5-2022. Non-probability, consecutive sampling was done.165 females fulfilling the selection criteria were included in the study. Informed consent in written form was obtained. If BP was 140/90mmHg, a urine sample was obtained and proteinuria was detected by dipstick method. If proteinuria was present with high blood pressure, then pre-eclampsia was labeled (as per the operational definition). All patients were followed till delivery.Proformas were used for collecting data which was analyzed statistically using SPSS version 20. Results: Participants had a mean age of 28.73±6.71 years, 53(24.65%) females were nulliparous. The mean gestational age of the females was 29.91±5.86 weeks. The mean BMI of the females was 33.12±1.75 kg/m2. In our study, preeclampsia was found in 18(8.37%) obese pregnant females using metformin. Practical implications the correction of diabetes would help in the prevention of preeclampsia in our population. Conclusion: According to this study approximately one-tenth (8.4%) of obese females developed preeclampsia taking metformin during pregnancy. Keywords: Metformin, Pregnancy, Obese, and Preeclampsia, nulliparous, macrosomia
Hydrogels for Wound Dressing Applications - A Systematic Review
Authors: Satti Memuna Kausar , Humayun Sadaf , Sajid Muhammad , Asdaq Kunza Naveed , Ashraf Tehreem , Aftab Mahjabeen
Published: March 2023

Aim: To discuss the currently available hydrogel wound dressings and their clinical effectiveness. Method: PubMed/Medline, HEC Digital Library, Wiley Online Library, Wolter Kluwer, Elsevier, and Google Scholar from the year 2013 to 2021 were searched to identify relevant clinical trials and studies. Results: Forty-three studies that assessed hydrogel vs. non-hydrogel dressings were identified. Compared to the latter, hydrogel dressings associated with a significantly shortened healing time of degree II burn (superficial and deep) wounds, diabetic foot ulcers, traumatic skin injuries, radioactive skin injuries, dog bites, and body surface ulcers. In addition, hydrogel dressing obviously increased the cure rate of diabetic foot ulcers, surgical wounds, dog bites, and body surface ulcers. Moreover, hydrogel dressing significantly relieved pain in degree II burn (superficial and deep) wounds, traumatic skin injuries and laser treatment-induced wounds. However, no significant differences obtained between hydrogel and non-hydrogel dressings in the healing time of surgical wounds, the cure rate of inpatients' pressure ulcers, and phlebitis ulcers. Conclusion: This comprehensive systematic review of the available evidence reveals that the application of hydrogel dressings advances the healing of various wound types and effectively alleviates the pain with no severe adverse reactions. These results strongly indicate that hydrogel products are effective and safe in wound management. Keywords: Hydrogels, wound dressing, surgical wounds, diabetic ulcer, burns.
Investigating the Caring Behaviors of Undergraduate Nursing Students: A Cross-Sectional Study
Authors: Bibi Afrooz , Khan Muhammad Najeeb , . Haseena, , Anwar Nasir , Sultan Amir
Published: March 2023

Background: Caring is a state of "feeling and demonstrating concern and empathy for others, showing or having compassion”. Care is practiced by nurses and nursing students in clinical settings, so clinical education is an essential and integral part of nursing education. Aim: To identify the caring behaviors of undergraduate nursing students of KPK. Methodology: The design was cross-sectional descriptive conducted in the private and public sector nursing institutes of KPK from august 2022 to September 2022. The sample size was 259 using simple random sampling, while the instrument used was a caring behavior inventory (CBI-24) having a Chronbach alpha of 0.96. Mean and standard deviation was calculated for continuous variables while the chi-square test was applied for the association between demographic variables and caring behaviors through SPSS 20. Results: The finding reveal that males were in the majority (86.9%) compared to female students (13.1%). The overall mean score of assurance was higher 39.5±7.6, followed by respecting 22±4.8, while the knowledge and skills mean score was 19.3±4.7, and connectedness 10.8±3.12. The overall caring behaviors of females were 95 ± 4 higher than male 91.3±1.7. The students of 8th semester caring behaviors were 98.7±1.5 higher than other semesters mean score. Implications: The study will help the nursing institutes and nursing instructor that how nursing students perceived, barriers in caring and how to improve the caring behaviors of undergraduate nursing students in clinical settings. Conclusions: Our study suggests that caring behaviors are perceived by students from the 1st semester of the nursing program. The caring behaviors of the students were significantly associated with gender and semester. Keywords: Care, nursing students, clinical duties, caring skills
Comparison of 4.5% Versus 8% Sevoflurane for Inhalational Induction in Adults
Authors: Sardar Afroza , Azam Muhammad , Bashir Aamir , Rehman Ali , Akram Mehreen
Published: March 2023

Background: Inhalational induction is a frequently used anesthetic technique in pediatric patients. However, it is less frequently used in adult patients undergoing surgery. General anesthesia can be induced either by intravenous injection or inhalation of anesthetic drugs. There are no established guidelines about the usage of 4.5% vs 8% sevoflurane for inhalation induction in adults undergoing elective day care surgery. Aim: To compare mean time to loss of eyelash reflex using 4.5% vs 8% sevoflurane for inhalational induction in adult patients undergoing elective day care surgery. Methodology: This randomized controlled trial was conducted in the department of anesthesia, Mayo Hospital Lahoreover a period of six months from June 2018 to December 2018. A total of 60 patients were enrolled in the study. We included adult patients aged 18-60 years of either gender and ASA status I & II undergoing elective day care surgery. While, patients having history of adverse reaction to inhalational agents and those who were on chronic sedatives, antipsychotic treatment were excluded. Demographic data of age and gender were obtained along with their body weight, height and BMI. They were randomly divided into two study groups using lottery method. After routine pre-op check and attaching standard anesthesia monitoring, patients in group-A and group-B were given 4.5% sevoflurane & 8% sevoflurane respectively at a fresh gas flow of 8 L/min of oxygen and they were instructed to take deep breaths while inhaling gas with help of face mask. Results: The mean age in 4.5% sevoflurane group was 42.27±11.83 years while in 8% sevoflurane group it was 45.43±12.76 years. In 4.5% sevoflurane group there were 12(40%) male and 18(60%) female cases while in 8% sevoflurane group there were 11(36.67%) male and 19(63.33%) female cases. The mean time to loss of eyelash reflex in 4.5% sevoflurane group was 88.57±6.71 seconds and in 8% sevoflurane group the mean time to loss eyelashes reflex was 67.87±5.90 seconds. The mean time to loss eyelashes reflex was statistically less in 8% sevoflurane group, with p-value 0.001. Conclusion: We concluded that mean time to loss eyelashes reflex was considerably lesser with8% sevoflurane when compared with 4.5% sevoflurane for inhalational induction in adult patients for elective day care surgery. Keywords: Inhalational induction, sevoflurane, eyelash reflex, day care surgery.
Apprehensions/ Fear Due To Myths Associated With Scaling among patients attending Tertiary Care Hospital
Authors: Langrial Rizwan Zafar , Batool Syed Midhat , Khan Nousheen , Mahmood Asad , Ali Shamsher , Rasheed Dil , Sajid Mustafa
Published: March 2023

Background: Oral health is thought to be an essential part of general healthiness. Poor oral hygiene can significantly affect the quality of life which may initiate deterioration of overall health. Aim: To find out reasons or misapprehensions that stop the dental patients from getting scaling procedure. Methodology: This questionnaire-based cross-sectional study was conducted in tertiary care dental hospital of Multan from November 2019 to February 2020. Three hundred and six patients filled a questionnaire designed and tested for this study. The ethical approval (MDC-1290) was taken from the Dental Hospital, informed consent was obtained from the participants in the study. Results: Out of 306 participants, 49% participants were males and 51%were females. 24% percent participants reported that we have more than one reasons for avoidance of scaling procedure. Among other fears top-most were 16% participants believed that scaling is a painful procedure and 13% said that scaling increases the mobility of teeth. Conclusion: Now-a-days misapprehensions or fear regarding scaling has been reduced because of self-awareness programs started by social media activists Keywords: Anxiety, Fear, Mobility, Myth, Scaling, Pain, Sensitivity
The Quantitative Study on Psychological Distress of patients regarding Hospital Management
Authors: Shafique Farwa , Qasim Muhammad Fahim , Kamal Asif , Khan Fatima Amir , Nazar Mudassar , Gani Naveed
Published: March 2023

Aim: To examine the effect of elements of emotional distress like diminished quality of life, loss of enjoyment, cognitive changes, embarrassment, psychological trauma and loss of sleep on person’s perception towards illness and how these elements influence self-care management of patients and their adherence to treatment. Methodology: Four number of questionnaires were used to collect data having high reliability and validity from 1000 patients in different areas of Pakistan. Results: The results revealed a significant relationship of psychological distress, illness perception, self care management and adherence to medication. Conclusion: Based on these findings, the greater the psychological distress, the more would be the negative effects on illness perception, self-care management and adherence to medication. Keywords: Psychological distress, illness perception, self-care management and adherence to medication.
Effect of Lifestyle Modification Upon Dysmenorrhea and Pain Severity in University Students of Karachi- Prospective Study
Authors: Rasool Sehrish , Tariq Sana , Razzak Lubna , Shabbir Rabiyya , Shoaib Nida , Hamid Khadija
Published: March 2023

Aim: To evaluate the effect of lifestyle modification upon dysmenorrhea and pain severity in university students of Karachi. Methodology: This is a prospective cohort study, the sample size was 383 participants, and data was collected from the Karachi institute of health sciences. Participants were followed after lifestyle modifications, weight reduction, stress management, physical exercise, and nutrition. Menstruation pain severity was measured by pain visual analog scale score (VAS) score, after 4 weeks and 8 weeks of modification follow-up, participants were asked to fill a validated questionnaire including pain VAS score again to assess the difference in dysmenorrhea and its associated symptoms. Results: Out of 383 study participants, the mean age was 22.2±1.9 years while the mean weight was 72.9±4.7 years, mean age of menarche was 13.4±0.7 years. Pain VAS score was categorized within mild and tolerable, moderate and Uncomfortable, and severe with an immediate need for medical intervention, indicating 82(21.4%), 195(50.9%) and 106(27.6%) frequencies respectively. The effect of lifestyle modification afterthe first menstruation cycle questionnaire was filled again, and results indicated mild, moderate, and severe results as 277(72.3%), 90(23.4%) and 16(4.1%) while on the second cycle 343(89.5%), 34(8.8%) and 6(1.5%) were identified respectively. Conclusion: Lifestyle modification, maintaining a healthy weight, having proper nutrition, and managing stress can sufficiently reduce the chances of dysmenorrhea and decreases the severity of menstrual pain. Keywords:Dysmenorrhea, Pain-vas score, lifestyle modification
Maternal and Perinatal Outcome of Perimortem Caesarean Section
Authors: Khan Fizza Ali , Jamil Rabia , Butt Sofia , Sultan Syed Farjad , Zafar Safia , Anbreen Tayyeba
Published: March 2023

Aim: To describe characteristics, etiological factors, maternal and perinatal outcome of perimortem Caesarean section. Design: Prospective study Setting: Emergency Room of Department of Obstetrics & Gynecology Unit IDr.Ruth KM Pfau Civil Hospital & Dow Medical College, Karachi. Methodology: This study was carried out in the Department of Obstetrics and Gynaecology, Civil Hospital Karachi from November 2020 to March 2021. All women who were presented in emergency in a collapsed state were included in the study and those women who were brought dead were excluded. Clinical details including age, gestational age, reason for perimortem Caesarean section, perinatal and maternal outcome were recorded on a predesigned proforma. Results: A total of 27 women underwent perimortem Cesarean section. The mean age of women who underwent PMCS was 266.5 years, and mean gestational age was 35±4weeks. Sixteen (59%) women were referred from either primary care or small clinics. Majority 15(55%), underwent PMCS within 5 minutes of maternal collapse and 12(44%) underwent PMCS, after 5 minutes of collapse. Septic shock 21(77%) was the main etiological factor for PMCS, followed by hypertension and cardiomyopathy 2(7%) each. Twenty three (85%) women survived, following PMCS, whereas 4(14%) died. Reasons for maternal death included hepatic encephalopathy(1), peripartum cardiomyopathy(2), eclampsia(1). The perinatal mortality was high, with only 14(51%) live birth and mean APGAR score at 1 and 5 minutes was 3. The mean stay in intensive care was 37 35 hours, whereas mean stay in ward was 5739 hours. Practical implications: This study suggests that if perimortem caesarean section accomplished in a timely manner, it can improve fetomaternal outcome. Conclusion: Perimortem Caesarean section can improve upon maternal survival. Greater awareness among doctors, multidisciplinary approach, proper documentation and information for family members are cornerstone of this emergency procedure. Keywords: Perimortem Cesarean section, septic shock,eclampsia,postpartumhaemorrhage, maternal mortality.
Pre-Operative Evaluation of Petrous Temporal Bone Pathologies by CT and MRI in Cochlear Implant Candidates
Authors: Akhtar Muhammad , Nasir Shoaib , Shoaib Nida , Masood Khalid , Haq Muhammad Mubeenul
Published: March 2023

Aim: To evaluate pathologies of the petrous temporal bone in cochlear implant candidates on CT and MRI preoperatively. Methods: A cross-sectional study was conducted at Combined Military Hospital Lahore from Jan 2014 to April 2016. 163 candidates were evaluated on CT and 149 were evaluated on MRI. All patients belonged to pediatric age group. Pathologies were grouped using classification of Sennaroglu & Saatci and every pathology was sought in all the cases ensuring that the pathologiesare not missed. Results: High-resolution CT scan temporal bone revealed 69.9% normal studies. Chronic otitis media with mastoiditis was major abnormality observed in 16.6% of cases. Unilateral mastoiditis was seen in 6.1% of patients. Bilateral CSOM without mastoiditis was seen bilaterally in 1.8% of cases. While unilateral CSOM was observed 0.6 % of patients. Among inner ear malformations, Mondini malformation was seen in 4 cases (2.5%). A high jugular bulb was seen in 2 cases (1.2%).93.3% of cases were labeled as normal study on MRI. Four cases showed Mondini malformation. Infective process of middle ear showed a cumulative frequency of 2.7%. Inner ear aplasia was found in one patient. Sclerosing labyrinthitis was also found in one case. Conclusion: Both CT and MRI have substantial role in pre-operative evaluation of petrous temporal bone in cochlear implant candidates. Preoperative evaluation of petrous temporal bone by CT scan and MRI successfully identifies pathologies which can be absolute or relative contraindications of the cochlear implant as well as conditions in which surgical procedure needs to be modified. Keywords: Cochlear implants, HRCT temporal bone, MRI cochlea, Mastoiditis, Mondini malformation
ENT Manifestation of Covid-19: An experience at a tertiary care medical teaching institute of Khyber Pakhtunkhwa
Authors: Anwar Khurshid , Muhammad Adnan Yar , Rehman Fazal
Published: March 2023

Aim: To determine the frequency of ear, nose and throat related disorders of covid disease in PCR proven positive Covid-19 patients. Methods: This prospective study included 320 Covid-19 positive patients and was conducted at ENT Department of MTI Hayatabad Medical Complex, Peshawar from May 1, 2021 to April 30, 2022. The acute phase of covid-19 was taken as the time interval between the onsets of symptoms as day 1 today 30th post infection. Questions were asked about the following symptoms; flu, sore throat, sinus involvement, taste disturbances, smell disturbances, hoarseness and hearing loss. Clinical examination and relevant investigations were carried out to make a diagnosis. The data was documented on a proforma & analyzed using SPSS 26.0 for windows to determine the frequencies of signs & symptoms related to ENT. Results: A total of 320 patients were included in the study. The ages ranged from 18-50 years with mean age of 33.96 years. The age group 18-25 years mostly presented with symptoms related to ENT. Upper respiratory tract infection was the commonest symptom (60.6%) followed by sore throat (57.5%). Smell and taste disturbances accounted for in 46.3% & 15.3 % of the patients respectively. Fungal rhinosinusitis was observed in 6.9% of the patients. As there is a wide variation of the ENT symptoms in covid disease, it is important to know the predictive symptoms so that appropriate measures can be adopted. Identification & isolation of patients will prevent spread of disease and focused therapy and investigations. Practical implication Conclusion: The portal of entry for the SARS-CoV-2 is through the upper airway. It is important to know the symptoms related to ENT to make an early diagnosis and therefore, institute measures for management and prevention of further spread of the disease. Keywords: Covid-19, Anosmia, Dysosmia, Dysgeusia, Mucormycosis, Sore Throat
Effects of Covid-19 on Mental Health of Older Adults: Study based on perceptions and experiences of adults suffered from Covid-19
Authors: Ashiq Uzma , Abbas Nargis , Sajid Ibad Ullah , Shafiq Maham
Published: March 2023

Aim: The objective of this conceptual study was to know the effects of COVID-19 on mental health of older adults. Study design: This qualitative study was conducted in October-December 2022 in District Sargodha. Twenty (20) older adults who have been suffered from COVID-19 were taken as respondents selected through snowball-purposive sampling technique. A semi-structured interview protocol was used to collect data through in-depth interviews from the respondents. Thematic analysis method of qualitative methodology of research was used to analyze the data to find the results. Results: The study found that older adults experienced severe mental health issues during COVID-19 period due to loneliness, isolation, anxiety and fear of disease and death. During the quarantine period and hospitalization, loneliness and social isolation affected the mental health of the older adults. Fear of disease & death and losing the loved ones negatively affected the older adults psychologically to great extent. However, respondents who were educated and well aware of causes and consequences of the disease; used this information and awareness as coping strategy and such respondents had less adverse affects on their mental health. Conclusion: COVID-19 virus affected the well-being of older people with regard to mental and emotional. Social isolation and loneliness have been observed as main factors affecting the mental condition of older adults during the pandemic. They experienced grave psychological issues due to loneliness and fear of disease & death during the quarantine/ hospitalization period. Keywords: COVID-19, Older adults, isolation, quarantine, fear, mental, health.
Body related Shame, Guilt, Dissatisfaction and Depression among University Students with Obesity
Authors: Naveed Aqsa , Kazmi Umme Rubab , Haq Tusamma , Bawer Maryam
Published: March 2023

Aim: To explore the relationship among body related shame, guilt, dissatisfaction and depression among university students with obesity. Study design: Correlation research design was used. Place and duration: The sample was selected from four different public and private sector universities of Lahore, Pakistan and the research was conducted from February-June 2022. Methodology: Purposive sampling strategy was used to select sample (n=200). The Weight related Body Shame and Guilt Scale, Depression Scale from DASS-21 and Body Satisfaction Scale were administered on the participants along with demographic sheet. Results: Weight-related body shame has significant positive correlation with guilt (.72**), depression (.77**) and BMI (.72**). Furthermore, weight-related body shame (β=.34), weight-related body guilt (β=.28), general dissatisfaction (β= .81), head dissatisfaction (β=.30), and body dissatisfaction (β=.27) were found to be significant positive predictors of depression among university students with obesity. Female students with obesity had more body-related shame, general dissatisfaction, head and body dissatisfaction. Conclusion: This research is helpful to understand the role of body related shame and guilt in causing depression among students with obesity. Keywords: Obesity, body shame, guilt, dissatisfaction, depression
Comparison in Mean Amniotic Fluid Index with Omega-3 Fatty Acids vs Placebo in Cases of Unexplained Oligohydramnios
Authors: Wajid Rabia , Zubair Zainab , Parveen Asia , Gulzar Nida , Masood Somer
Published: March 2023

Background: Oligohydramnios is hazardous for fetal health for which new treatment modalities are being sought out. The fetus floats in amniotic fluid which takes care of its proper development. Omega-3 Fatty acids protect against inflammation and raised blood pressure. With omega-3, AFI can be improved and the complication scan be reduced leading to an overall better fetal outcome. Aim: To compare the mean amniotic fluid index with omega-3 polyunsaturated fatty acids supplementation versus placebo for management of cases of unexplained oligohydramnios Methods: A randomized control trial was held at Gynecology Unit 2, Lady Willingdon Hospital, Lahore from 21-12-2020 to 21-06-2022. 60 females were recruited to the study and randomly divided into two groups. Group 1 treated with omega-3 once capsule daily contained 1000 mg. of fish oil and group 2 treated with placebo. After 4 weeks, females were subjected to ultrasonography by a single senior sonologist with assistance of researcher. All the collected data was analyzed on SPSS version 21. Mean AFI was compared in both groups by use of independent sample t-test taking p-value<0.05 as significant. Results: Mean age in omega-3 group was 25.63±3.57 years, and in placebo group was 25±2.704 years. 22(36.67%) females were nulliparous. The mean change of AFI with omega-3 was 4.90±1.185 and with placebo group was 2.93±0.944 (p-value=<0.001). Conclusion: it was inferred that by supplementingomega-3 polyunsaturated fatty acids showed better results in terms of mean AFI than placebo for management of cases of unexplained Oligohydramnios. Keywords: Omega-3 Polyunsaturated, Amniotic Fluid Index, Unexplained Oligohydramnios
Comparison of Isometric Hand Grip Strength among Computer Operators and Non-Computer Operators
Authors: Sultan Hiba , Babar Saman , Mukhtar Momin , Siddiq Umair Abu Bakar , Ahmad S. Javaid , Shafiq Mahnoor , Ehsan Alisha , Haris M.
Published: March 2023

Background: Most frequently self-reported work-related illness are due to musculoskeletal disorders. Highly repetitive tasks with grasping of the hands, repetitive flexing of the wrist, vibrations and localized mechanical pressure play a role in development of repeated stress injury. Many computer users complain about wrist fatigue, discomfort or pain after typing. Aim: To assess and compare isometric grip strength of computer operators and non-computer operators. Methods: This study was conducted at the Shalimar Institute of Health Sciences. A sample of 30 computer operators and 30 controls (non-computer operators) were recruited after screening hand ultrasonography. Purposive sampling was used. Isometric grip is measured with a hand-held dynamometer. Subjects were asked to hold the dynamometer with full exertion. Each reading is from a maximum contraction period of three seconds with a 30-second pause. Results: Average Hand Grip Strength of computer operators was 27.71±11.19kg and non-computer users was 37.05±11.09kg. The results were statistically significant with the p-value of 0.002. Practical Implications: Continuous computer use reduces hand grip strength therefore those who are having long term use of computers must go for hand grip strength exercises to maintain normal hand grip strength. Conclusion: Computer operators have less isometric hand grip strength than non-computer operators as it was concluded in this study. MeSH words: Isometric hand grip strength, computer operators, non-computer operator
Association of Biochemical & Anthropometric parameters with depressive disorder among adults in a Health care centre
Authors: Batool Tayyaba , Khan Muhammad Amin , Mahmud Syed Ahmed , Ain Qurat-Ul-, , Amjad Naeem , Rehman Anam ,
Published: March 2023

Background: Depression may be a common psychiatric disorder. In spite of the fact that numerous risk factors for sadness have been reported, the affiliations of biochemical and anthropometric records with depressive disorder remain unclear. Depressive disorder is a leading cause of illness around the world. Aim: To access the association between biochemical and anthropometric parameters with depressive disorders among adults Methods: This quantitative cross sectional study was conducted at B.V. Hospital, Bahawalpur from July 1, 2022 to December 31, 2022. A pre validated questionnaire was used. Study was carried out at outdoor patient department of Bahawal Victoria Hospital Bahawalpur. The total numbers of patients were 250 who participated after taking the informed consent. The study was done by simple random sampling technique. Detailed information was given to patient about the current research. Results: The descriptive statistics for anthropometric measures, demographic, baseline variables and CES-D scores for all the subjects are summarized in Table 1. Total number of participants in the study was 250 in which 115 were males and 135 were females. Baseline characteristics were measured include weight, waist circumference and body mass index and others parameters include systolic and diastolic BP, blood sugar fasting, glycemic control and lipid profile was measured both in depressed and not depressed group. Conclusion: Depression and obesity are major wellbeing issues worldwide and may increase metabolic disorders. Obesity, which is related with numerous wellbeing issues related to changes in way of life, can take after depression that happened earlier in life or in early adulthood, a vital time for implementation of health-promoting interventions. Keywords: Depression, Biochemical parameters, Anxiety, Adults, Health Care
Comparison of physical performance measures of flexibility, strength & balance of school students with university students
Authors: Fatima Mishkat , Riaz Saba , Amir Syeda Nimra , Shoaib Sahar , Saleem Maheera , Imran Laiba , Amir Laiba
Published: March 2023

Aim: To find out variation in flexibility, strength and balance of university and school students on their dominant and non-dominant sides. Study Design: A Cross section study. Place and duration of study: Data was collected from Lahore grammar school (LGS), Al’Ala school and university of management and technology (UMT), Lahore. After approval of synopsis (RE-092-2021) the data collection was done from the duration of 10th November 2021 to 15th February 2022. Methodology: A cross section study conducted on healthy school and university students. The data was collected by non-probability convenient sampling. After verbal Informed consent the data was obtained from school students of grade 7-10 from Lahore Grammar school and Al’Ala international Islamic school and undergraduate’s students of UMT by using convenient sampling. Physical performance tests for measuring strength (sit-ups), flexibility (Zipper, sit and reach, dorsiflexion) and balance (Flamingo test) were demonstrated and were asked to perform. Readings were taken of each test. Results: Sit ups excellent results were reported in majority of university students (36%). Sit and reach test was found better in university (32%), zipper test positive results were better in school students. Dorsiflexion test normal values were more in university (18%). Flamingo test showed 45% university students had good balance. There was statistically significant difference in zipper (P=0.004), flamingo (P=0.036) on non-dominant side and sit and reach dominant (P=0.006) and non-dominant side (P=0.031). Practical implication: The normative data of physical performance measures can help prevent injuries, as these can be used as a reference to detect poor health and lethargy at school and university level. These measures can be used as a reference for primary prevention among university going and school going students. Furthermore, to increase awareness about physical fitness among young population. Conclusion: Both groups showed good physical performance measures. Flexibility test showed better results in School students. Strength test showed better result in university students whereas, balance test reported better in school students. Keywords: Balance, Flexibility, Limb dominance, musculoskeletal injuries, Physical activity, Strength,
Mental Health Literacy among Students of Gujranwala Division of Punjab
Authors: Sadiq Yasir , Khalid Kanwal , Imtiaz Zain , Mushtaq Komal , Manan Zarwa , Hafeez Amtul , Laique Talha
Published: March 2023

Background: Treatment of either physical or mental illnesses is not as effective if the knowledge and awareness of the patient is inadequate. Study design: Descriptive study. Methodology: A total number of 240 students through convenient sampling who responded to the questionnaire. The ethical approval was obtained from review ethical committee, after completing and submitting the research proposal. The research instrument for data collection was, “structured questionnaire” developed by using 2 scales, the mental health literacy scale (MHLS) and modified scale. Data was analyzed by SPSS version 23. Chi-square test was applied for categorical variables to find the differences in knowledge and practices by dental professionals with p-value ≤0.05 as significant. Results: Almost 86.7% of students were able to identify major depressive disorder.8.3% thought such disorders are punishment by God, 38.3% of students considered mental illness as inherited trait. According to 47.5% treatment of mental illness caused addiction, 37.1% were unsure and 15.4% disagreed. Practical Implication: This study helped researchers in exploring role of multiple factors in changing mental health literacy and how it can help in reducing those barriers and promoting mental health literacy in students. This also added to local literature regarding mental health. Conclusion: It was concluded that mental illness needs recognition and awareness campaigns for mental health literacy needs to be conducted. Keywords: Mental Health, Knowledge, Awareness, Attitude and Individual Performance.
Ghrelin Ameliorates Nicotine induced Renal Damage in Balb/c mice: RCT
Authors: Jabeen Aqsa , Jabeen Asma , Nazar Mubashar , Razzaq Sana , Shaukat Zara
Published: March 2023

Background: Kidneys are the major organs responsible for elimination of toxic metabolites from the body. Aim: To determine role of ghrelin in mitigating nicotine induced renal damage in Balb/c mice by assessing serum creatinine levels, renal tissue MDA levels and renal tubular histological changes. Methodology: It was a Randomized Control Trial. Healthy male BALB/c mice (n=27) through non probability convenience sampling were taken from NIH Islamabad and sorted into 3 groups (nine each). Group I was labeled as control group and given intraperitoneal normal saline for 29 days. Group II was labeled as nicotine group and received intraperitoneal nicotine for 29 days. Group III was labeled as ghrelin + nicotine and received intraperitoneal ghrelin on alternate days and nicotine daily for 29 days. On 30th day intracardiac sampling was done for estimation of serum creatinine. After intra cardiac sampling dissection was done to obtain renal tissue sample for lipid peroxidation and histological analysis. Data was evaluated by using SPSS version 23. One way ANOVA and post hoc tukey’s test were applied. Results: In group 2, nicotine administration markedly elevated serum creatinine and tissue MDA levels whereas ghrelin administration along with nicotine in group 3 restored serum creatinine and tissue MDA levels back to normal. Renal tubular changes caused by nicotine in group-2 are also mitigated by ghrelin and nicotine administration in group-3. Practical Implication: Ghrelin a newly discovered peptide has shown to have anti-oxidant properties and nephro-protective effect thus has potential to reduce renal damage. It can restored creatinine levels thus minimizes renal damage. Conclusion: It was concluded that ghrelin protects kidneys against nicotine induced renal damage by restoring serum creatinine, lipid peroxidation marker and histological changes. Keywords: Ghrelin, Lipid Peroxidation, Nicotine, Nephro-Protection, Anti-Oxidant and MDA.
Comparison of Erythrocyte Sedimentation Rate by Vision Principle and Westergren Method
Authors: Mujahid Aayza , Choudry Jawad Zaffar , Iqbal Hamid , Zahra Syeda Bint-E- , Latif Saadia , Habib Zahra
Published: March 2023

Background: Erythrocyte sedimentation rate is a common test used as an assessment tool for inflammation since many years. Aim: To compare erythrocyte sedimentation rate by automated ESR analyzer working on vision principle against conventional manual Westergren method. Study design: Cross sectional study. Methodology: A total number of 120 samples were taken from routine hospital patients whom ESR was requested through non-probability consecutive sampling following ethical approval. Samples were subjected to ESR estimation by manual Westergren and automated methods. Data was analyzed by SPSS version 22. Independent sample t-test used to compare erythrocyte sedimentation rate by automated ESR analyzer working on vision principle against conventional manual Westergren method with p-value ≤0.05 as significant. Pearson correlation was also applied. Results: Mean ± SD for Manual Westergren method was 39.37±25.486 and Automated Vision principle was 25.83±21.015. Levene’s Test for Equality of Variances have p-values for ESR in patients with Manual Westergren method & Automated Vision principle was 0.018 with F-value 5.670. There was a non-linear relationship between the two methods (P value < 0.01). Practical Implication: This study helped in exploring reliability of different ESR estimation methods as ESR results have notable impact on patient diagnosis and follow-up. With increasing demands and burden of patients in labs, new reliable and quick techniques for ESR determination are need of hour. Conclusion: It was concluded that automated methods showed good correlation to manual Westergren method thus are reliable for ESR estimation. However, manual Westergren remained gold standard procedure for ESR estimation. Keywords: Erythrocyte Sedimentation Rate, Reliability, Westergren Method and Automated Method.