bluuebunny/crossref_metadata_2025 huggingface dataset:
ILEOSTOMIES AND COLOSTOMIES
Authors: Hussain Shabab , Aslam Viqar , Khan Sajjad Muhammad , Jan Waqar Alam
Published: September 2021

Background: An intestinal stoma is an opening of intestine on the anteriorabdominal wall made surgically. The commonly performed procedures include colostomy andileostomy. The purpose of the present study was to identify indications for commonly performedintestinal stomas and to study complications related to it. Objective: To identify indications forcommonly performed intestinal stomas and to study complications related to it. Study Design:Observational study. Setting: Department of General Surgery, Unit- B, Lady reading Hospital,Peshawar. Period: 1st Jan 2013, to 31st Dec 2013. Subjects and Method: A total of 106 patientswho underwent surgery and ended up in intestinal stomas, ileostomy or colostomy, were includedin the study. Indications, immediate and late complications of stomas were recorded. Results: Abreak up of 106 patients of different intestinal stomas. Majority (61.32%) of patients were males.There were 49 ileostomies and 57 cases of colostomy making a total of 106 patients. Mainindications of Ileostomy were enteric perforation (55.10%), and intestinal tuberculosis (20.40%).Main indications of colostomy were penetrating injuries (50.88%), and intestinal obstruction. Ina total of 106 stomas local complications appeared in 23 (21.69%). Skin excoriation, ulceration,lap and wound infection were the most common respectively. Seventy eight stomas including 36ileostomies and 42 colostomies were closed on an average of 3 months after primary operation.There were 7 cases of wound infection, 2 anastamotic leak-ages and one mortality (1.3%) in thestoma reversal group. Conclusion: Common indications for intestinal stomas were abdominalpenetrating trauma, enteric perforation, intestinal obstruction and intestinal tuberculosis. Maincomplications included local skin problems, wound infection and retraction.
BREAST FEEDING
Authors: Khan Saadia , Iqbal Imran , Arshad Reema , Ishfaq Kamran
Published: September 2021

Background: Breast feeding is the most natural way of feeding the infants and help to reduce child mortality and morbidity and millions of deaths could be prevented each year if mothers were aware of benefits of exclusive breast feeding for 4 -6 months and early initiation of breast feeding. Objective:To evaluate the awareness regarding breast feeding and complementary feeding in mothers of severely malnourished children. Study Design: This is a descriptive /cross sectional study. Place and duration of study: This study was conducted at the department of preventive pediatrics Children hospital and institute of child health, Multan from March 2013 to September 2013. Materials and Methods:This study included a total of 100 females that were the mothers of malnourished children visiting the follow up room of department of preventive pediatrics Children hospital and institute of child health, Multan. A questionnaire was designed and others were interviewed in detail after taking proper consent. Results:In this study, the mean age of the sample was25years +/_3 years. 70 % females (70/100) were from urban areas while 30 %(30/100) were from rural areas. Of the 100 respondents 54%( 54/100) of mothers were illiterate and this study showed that 99% (99/100) considered breast milk safe and effective than other feeds but practically only 23%(23/100) babies were breast fed while 77%(77/100) were bottle fed. Pre-lacteal feed was given by 82% (82/100). According to 58% (58/100) mothers there should be a early initiation of breast feeding, while 57% (57/100) were un aware of the facts that clostrum should be given while 43 %(43/100)of then considered it unhealthy and non effective,82%(82/100) considered 4 months a period of exclusive breast feeding,61% (61/100) were counseled by doctors regarding the benefits of breast feeding,50%(50/100) were aware of the use of exclusive breast feeding as a contraceptive tool and 34 % (34/100) were aware of its importance for the prevention of breast cancer. Conclusion:The findings of the study indicated the various important policy implications for the intervention of breastfeedig. Strategies to encourage mothers to follow breastfeeding recommendations should concentrate on improving their knowledge.
UPPER GASTROINTESTINAL ENDOSCOPIC BIOPSY
Authors: Memon Farzana , Baloch Kanwal , Memon Ameer Afzal
Published: September 2021

Background: Upper GI endoscopy is an established procedure for investigatinga wide range of upper GI conditions especially inflammatory and malignant diseases ofstomach and esophagus. A good correlation in diagnosis can be achieved by complementingendoscopic findings with histology of biopsy specimens. Aims and objectives: 1) To evaluatemorphological patterns of upper GI conditions. 2) To correlate endoscopic characterization ofupper GI lesions with histopathological assessment of biopsy specimens. Study design: Aretrospective descriptive study. Period: Four year period from January 2010 to December 2013.Setting: Department of Pathology, LUMHS and were histologically assessed. Material andmethods: A total of 433 upper GI endoscopic biopsies were received. Patient’s age, gender andpresenting complaints were noted. Results: Stomach was the most frequent site of endoscopicbiopsy (51.3%) followed by esophagus (39%) and duodenum (9.7%). Majority of patients (51%)presented with dysphagia and abdominal pain. Mean age of presentation was 40 years; agerange, 9-90 years and male: female ratio is 1:1.6. Esophageal malignancy was the commonestneoplastic lesion with squamous cell carcinoma being the dominant histological type.Interestingly, inflammatory conditions were more common in the stomach. In the duodenum,celiac disease was clinically suspected and histopathological grading confirmed the diagnosiswith majority of the cases showing grade-II pathology. Conclusion: This large retrospectiveinstitutional based study showed a good correlation between endoscopic and histologicaldiagnosis. It further shows that esophagus is the predominant site of upper GI malignancy withstrong female predominance. Further studies are needed to identify the underlying risk factors.
HIV/AIDS AWARENESS
Authors: Nasir Jamal Abdul , Imran Muhammad , Zaidi Syed Arif Ahmed , Rehman Najeeb Ur , Ahmad Fiaz
Published: September 2021

Objectives: To examine the awareness regarding HIV/AID and sexual behaviouramong long distance truck drivers (LDTDs) in Bahawalpur division. Study design: A crosssectional population study. Setting: Three districts (Bahawalpur, Bahawalnagar and RYK).Data: Sample of size of 120 LDTDs is taken by using convenient sampling technique. Methods:Descriptive and inferential analysis carried out. Results: Every 6 out of 10 LDTDs have heardaboutHIV/AIDS and believed that sexual intercourse is a major mode of its transmission. Theuse of condom before sex is seldom among truckers. Exactly half of LDTDs have only onesexual partner while nearly quarter (23.3%) of the respondents currently having two sexualpartners. Over half (54.2%) of truckers made payment for sex with commercial sex workers(CSWs) and only 3.3% did so with their helper/conductor. Two models are executed separatelyto explore the association of trucker’s knowledge about HIV/AIDS (Model 1) and those whopaid for sex (Model 2). Pearson chi-square analysis exhibits that respondents having age group25-30 year, those with native of Punjabi language, those who manage to earn more than 15,000Pakistani rupees per month, those having secondary level of schooling and those watchingTV has higher knowledge regarding HIV/AIDS. LDTDs with age thirty years and over, Saraikispeaking, monthly income less than 10,000, illiterate, unmarried, watching TV and remainaway from home during current trip a week are found to be more prone to pay for sex toCSW. Conclusions: The awareness of HIV/AIDS and knowledge of its transmission throughsexual contact is high among LDTDs but still public health strategies are needed to promotethe knowledge of all possible transmission modes of HIV/AIDS and use of condom before sex,ultimately to improve health outcomes.
PEG TUBE
Authors: Hussain Sajid , Ali Kashif , Farhan Rashid Hafiz Muhammad , Khosa Abrar Hussain , Abbas Aushter
Published: September 2021

Objectives: To determine the efficacy of Cephalexin and Co-amoxiclave inpreventing Peristomal infection after PEG tube placement in head and neck and other cancerpatients. Study Design: Prospective, randomized clinical trial. Setting: Internal MedicineDepartment Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore. Period:February 2009 to September 2009. Material and Methods: A total of 160 patients includingboth males and females were selected by Non probability purposive sampling. Patients meetinginclusion and exclusion criteria were registered in the study from outpatient department afterinformed consent. These patients were randomly assigned into two groups. Group A was startedon Cephalexin 500mg q6h Per-orally started 24 hrs before the procedure with the 4th dosegiven one hour before the procedure and continued it as q6h for five days after the procedure.Group B was given Co-amoxiclav 1G Per-orally 12 hrs before the procedure with the seconddose of 1G, one hour before the procedure and then same dose advised q12h for five daysafter PEG tube placement. Results: Male to female ratio in both groups was 2:1 with 63.3%males and 33.8% females. Patients were aged between 19-80years, divided in four age groupswith 38.8% falling in age group 50-64 years. Mean age is 52.11+-13.59 years and median age54 years. The efficacy of Cephalexin and Co-amoxiclave was 84.7% and 78.6% respectivelywith no significant statistical difference among two groups. Conclusion: We concluded thatCephalexin and Co-amoxiclave were both equally effective in preventing peristomal infection.
HEADACHE
Authors: Kumar Santosh
Published: September 2021

Objective and aims: To determines relationship of age, gender, hypertension,diabetes mellitus and obesity with primary and secondary headache in a tertiary carehospital. Study design: A cross-sectional study. Place and duration of study: Medical OPDof Liaquat University of Medical and Health Sciences, Hyderabad from 10January to 10 July2015. Methodology: Patients (male and female) with complaint of headache in medical OPDwere included in this study. Patients with acute emergency, stroke, meningitis, encephalitisand severe infection were excluded. After taking informed consent, history, examination andlaboratory test (like fasting blood glucose, blood urea nitrogen) were sent. Data was recordedin a proforma. Data was entered and analyzed using SPSS version 20. Results: A total of 100patients of headache were included in this study. The mean age of enrolled participants was33.6±2 years. Forty percent were male and 60% female with male to male ratio was 0.7:1. Eightynine percent of patients have normal blood pressure, 82% normal blood sugar and 48% normalbody mass index. Eighty six percent patients had primary and 14% had secondary headaches.Normal blood pressure was observed in 93% cases of primary headache compared to 64.3%in secondary headache (p-0.006). Normal blood sugar was observed in 14% cases of primaryheadache compared to 42.9% in secondary headache (p-0.018).normal body mass index wasobserved in 51.2% cases of primary headache compared to 28.6% in secondary headache (p-0.002). Conclusion: There is strong relationship of primary headache with age, gender, obesitybut not associated with hypertension and diabetes mellitus. Hypertension and diabetes aremore strongly related with secondary headache
OBESITY
Authors: Arif Ali Muhammad , Nasir Faran
Published: September 2021

Objectives: To find out the prevalence of risk factors of heart diseases in obesepatients. Study Design: Descriptive cross-sectional study. Setting: OPD of IndependentUniversity Hospital, Faisalabad. Period: One week duration extending from 4th to 10th May 2015.Patients and Methods: 90 Patients were selected by convenient sampling. A semi-structuredquestionnaire was used to collect the information from the sample. An informed consent wasalso obtained from the respondents under study and the secrecy of information was ensured.Results: Of the 90 patients under study, 33 (36.26%) were Grade 1 Obese, 51 (56.04%) wereGrade 2 Obese, and 7 (7.69%) were Grade 3 Obese. Among the patients 73.62% were nonsmokers,2.19% were former-smokers and 23.07% were smokers. Of the patients 15.38% werenon-diabetic, 12.08% had Insulin Dependent Diabetes Mellitus, 7.69% had Impaired GlucoseTolerance and 63.73% had Non-Insulin Dependent Diabetes Mellitus. Only 2 people of the91 who underwent the study were Alcoholics. Of them 1 had Grade 1 Obesity and the otherhad Grade 3 Obesity. 35.16% of the patients were non-hypertensive, 49.45% had Grade 1Hypertension, 5.49% had Grade 2 Hypertension and 5.49% had Grade 3 Hypertension. 26.37%patients had a sedentary life style while 53.84% had moderate and 18.68% had intense physicalactivity. 70.32% patients had a high fat intake while 28.57% had a low fat intake. Heart diseaseswere present in the fathers of 30.76% of patients, mothers of 13.18% patients and were presentin both father and mother of 7.69% patients. Conclusion: No significant trend in the increasein BMI and increased prevalence of cardiovascular risk factors was observed, however theincidence of some risk factors like diabetes and high fat intake was somehow in direct relationwith obesity.
PAEDIATRIC EMERGENCY CARE
Authors: Ulhaq Intisar
Published: September 2021

Pakistan is an agricultural country and 2/3rd of its population resides in rural areas.1 Total population of Pakistan is estimated to be approximately 18 million with a gross national income (GNI) per capita of $1360 and poverty headcount ratio of $1.25 a day PPP % of population of 12.7 %. 2 A significant data has been ublished in both national and international journals on the issues of common and preventable paediatric  ealth problems. Similarly international health organisations have published extensive statistics on commonpaediatric problems in developing countries such as high infant and child mortality rates.3 Poverty, lack of health education, political instabilities and lack of basic health needs such as clean drinking water and proper sanitation all have been discussed at length as the major contributory factors to the poor state of health in children of developing countries. Although these factors play an important role in improving child healthcare, less emphasis has been put on the factors which are directly related to health professionals,health institutions, health governing bodies and medical training organisations.
TYPE II DIABETICS
Authors: Farogh Azfar , Mahmood Muhammad Arif , Ahmad Khalil
Published: September 2021

Objectives: To determine the frequency of diabetic ketoacidosis in type IIdiabetic patients. Study Design: Cross sectional study. Setting: Department of Medicine,Sahiwal Medical College Sahiwal. Period: September 2014 to March 2015. Material andmethod: Permission was taken from Institutional review board and written informed consentwas taken from every patient. Total 189 patients with type II DM (Un-controlled) having Fastingplasma glucose level ≥126mg/dl either male or female having age 35 years to 65 years wereincluded in the study. Results: Total 189 patients with type II diabetes mellitus were includedin this study. Mean age of the 50.09 ± 9.39 years. Male patients were 79 (42%) and femalepatients were 110 (58%). Insignificant association between gander and Ketoacidosis was seen.No association of family history of diabetes mellitus with Ketoacidosis was found. Conclusion:Results of this study showed that male or female can be equally victim of diabetic ketoacidosis.Diabetic ketoacidosis can be develop equally in younger or older age group. No significantdifference for the development of diabetic ketoacidosis was found between obese/non-obeseand patients with family history of diabetes or without family history of diabetes.
PRE-ECLAMPSIA
Authors: Khan Anwar , Khan Hamzullah
Published: September 2021

Objectives: To determine the relation of leptin, hypertension and body massindex with pre-eclampsia in the 3rd trimester of pregnancy in a hospital based study. Design:descriptive observational study. Setting: three teaching hospital of Peshawar, Khyber teachinghospital, Hayatabad medical complex and lady reading hospital Peshawar. Duration: June2012-dec 2012. Inclusion criteria: all women in their third trimester without any co-morbidity.Exclusion criteria: were all diabetic and first and 2nd trimester pregnant ladies. Procedure:relevant information on height, weight, body mass index (BMI), pulse, blood pressure and leptinwere recorded on a predesigned questionnaire prepared in accordance with the objectivesof the study. Data was analyzed in MS-Excel. Results: A total of 80 pregnant ladies included.Majority of the patients were in the age range of 17-26 years of age. Maximum number 30(37.5%)of patients were in weight ranging 66-75 kg. We observed maximum number of patients werenormotensive systolic BP 110-130mmHg (47%). About 43% of patients had BP>140mmHg upto 200mmHg. 6% had Diasatolic BP between 130-140mmHg. 23.5% had BMI>32.6. 38% hadBMI between 27.62-32.62. We observed that majority of the patients were in the leptin serumrange of 229.57-329.57. 7.75% had serum leptin level above 329 with a maximum of 829.6in one patient at top in data. Conclusion: Serum leptin level in pregnancy increases in thirdtrimester with a determined relation of serum leptin level with gestaional hypertension and preeclampsia.
DORSAL WRIST GANGLION
Authors: Jan Yousaf , Ahmad Waqas , Hussain Shaukat , Shah Muhammad , Din Ahmad
Published: September 2021

Objectives: To evaluate and compare the effect of aspiration plus methylprednisone injection versus surgical excision of the dorsal wrist ganglions in terms of resolution,complications and recurrence. Study Design: Prospective study. Setting: Surgical wardHayatabad Medical Complex, Peshawar. Period: June 2009 to December 2011. Methodology:After taking permission from ethical and research committee. Included patients were all adult ofboth gender with dorsal wrist ganglion. Patients with cancer, bleeding disorders and diabeteswere excluded from the study. The patients were divided in two groups: Group A includedpatients for aspiration and injection treatment, while Group B included patients underwentsurgical excision. All the patients were followed for complete resolution of ganglion, anycomplications of treatment and recurrence within one year. Follow up arranged at 7th day, 1,3, 6 and 12 months. Results: Total of 80 patients was included in the study. Out of 80, 65%(n=52) were females while 35% (n=28) were males. The mean age was 26.37±5.62 years.Group A and group B patients had overall success rates of 75% and 95%, with recurrence of25% and 5% in group A and group B respectively. In methylprednisolone group, mild pain wasreported by 70% (n=28), while in the surgical excision group, all the patients experienced mildto moderate pain postoperatively which necessitated oral analgesics for few days. Conclusion:Surgical excision is superior to injection-aspiration method for dorsal wrist ganglion treatmentbecause of high success and low recurrence rate. As injection-aspiration treatment
LOWER URETERIC STONES
Authors: Abbas Jafri Syed Saleem , Haidry Mazhar Abbas , Khan Niazi Zafar Iqbal
Published: September 2021

Aims & Objectives: Placement of a ureteral stent is routinely done followed byureteroscopy. Recently, many researchers have questioned routine stenting after ureteroscopyfor management of distal ureteric stones? We report our outcomes of a randomized studycomparing ureteroscopy with and without placement of stents for management of distalureteric stones. Study Design: Randomized controlled trial. Setting: Department of Urology,Jinnah Hospital/ Allama Iqbal Medical College, Lahore. Period: March 2013 to February, 2015.Materials & methods: Total 155 patients were prospectively divided into three groups to receivea double J stent (Group I, 54 patients), ureteral stent (Group II, 50 patients) and no stent (GroupIII, 51 patients), underwent ureteroscopic treatment of distal ureteric stones. Characteristics ofstones, operation time, postoperative pain, lower urinary tract symptoms, and analgesia needfor postoperative pain, hospitalization, stone free rate and late postoperative complicationswere all studied. Results: There were no significant differences in preoperative data. Therewas no statistical significant difference between three groups regarding hematuria, fever, flankpain, urinary tract infection and re-hospitalization. At 48 hours and 1 week, frequency/ urgencyand dysuria were significantly less group III. When comparing Group I and Group III, patientswith double J stent has statistically significant more bladder pain 0, frequency/ urgency 0,dyusuria 0 and need of analgesia 0. All patients of the three groups assessed postoperativelyby imaging did not suffer any obstruction or ureteral stricture. Conclusion: Uncomplicatedureteroscopy without stent placement for treatment of distal ureteral stones is a safe procedure.Patients without stents have significantly fewer irritative bladder symptoms and are not at riskof complications.
ACUTE MYOCARDIAL INFARCTION
Authors: Malik Rafaqat , Begum Shazma , Afridi Muhammad Nazar
Published: September 2021

The frequency of modifiable risk factors of acute myocardial infarction variesgreatly in different countries and populations of the world. Objective: To find out the frequencyof modifiable risk factors in patients with acute myocardial infarction. Design: Cross-sectionalstudy. Setting: Cardiology Department. Ayub Teaching Hospital Abbottabad, Period: 1st Jan2015 and 30th June 2015. Material and Methods: A total of 224 patients of acute myocardialinfarction Patients were enquired about the presence of hypertension, diabetes mellitus,smoking and family history of ischemic heart disease. Fasting blood sugar and lipid profilewere recorded. Results: Out of 224, 90.6% patients had at least one risk factor. Hypertensionwas found to be the most common risk factor (55.4%), followed by smoking (43.8%) andDiabetes Mellitus (27.2%). Dyslipidemia was found to be the least common (23.2%) risk factor.Conclusion: Hypertension is the most common modifiable risk factor in patients of acutemyocardial infarction, followed by smoking and diabetes.
FREQUENCY OF DEPRESSION
Authors: Nouman Shaikh Muhammad , Bawany Muhammad Adnan , Liaquat Jahangir , Bohio Rabail , Pirzado Laila , Memon Shoukat Ali
Published: September 2021

Combine Pegylated interferon therapy and ribavirin is most commonly usedtreatment in chronic hepatitis C patients. Along with other complications, different psychiatricdisorders are observed during combination therapy including depression. Depression is themajor morbidity as it may lead to different destructive ideation including suicide among patientson treatment. We have tried to calculate the frequency of depression along with associatedfactors in our present study. Objectives: To find out the frequency of depression duringPegylated interferon therapy for chronic hepatitis C. Study Design: Descriptive study. Setting:Liaquat University of Medical & Health Sciences, Jamshoro / Hyderabad Duration: The durationof study was six months starting from 01-01-2014 to 31-06-2014. Methodology: Two hundredand fifty two cases of chronic hepatitis C on the basis of anti HCV (ELISA) and PCR positivewere selected in this study. Results: Out of 252 patients, 111 (44%) were males and 141(56%)were females. Most of the patients belonged to 26 to 50 years of age. The duration of treatmentwas 12 weeks. Two hundred & eight (82.5%) patients had ever married while the remaining17.5% were unmarried. Out of 106 (42%) depressed patients, 39 (37%) had mild, 31 (29%) hadmoderate, 20 (19%) had moderately severe and 15 (15%) had severe depression. Conclusion:It was observed that depression is a common during combination therapy with Peg interferonand the ribavirin in chronic HCV patients.
DRINKING WATER
Authors: Imran Abubakar , Manzoor Tariq , Ibrahim Muhammad , Munaf Wasif
Published: September 2021

Introduction: World Health Organization, (WHO) estimates that more than 80%of poor health conditions in developing countries, is related to water and sanitation condition.The supply water and sanitary lines often overlap in our water supply system and watercontaminated by fecal contents and become a major cause of GIT infections and outbreaksin human populations. Objective: The Objective of the study was to determine the fecalcontamination level in tube well water across the distributing supply lines. Study Design: Thestudy design was observational. Settings: Fatima Memorial Hospital, College of Medicine andDentistry Shadman Lahore. Period: February 01, 2012 to May 29, 2012. Method: The studydid not engage any ethical issues and conducted in five specific regions of Lahore. A 100 mlof water sample was collected in sterile container, from the tube well and after every 100 meterdistance till 500 meters. The sample size was 250 from 45 tube wells and their distributingsupply lines. It was then observed for fecal coliforms using prescribed scientific methods.Result: The results indicated that bacterial growth at baseline was 42.2%, and at extremity was73.3%. The A Category water obtained at baseline is 60.0% and at the extreme level it is 26.7%.So by increasing distance from source of water the risk of fecal contamination and low qualityof drinking water increases. Conclusion: It is concluded that as the distance increased fromthe main source
DICLOFENAC POTASSIUM
Authors: Ali Huma , Zafar Farya , Baloch Saba A. , Hasnain Hina , Naveed Safila , Raza Naqvi Ghazala
Published: September 2021

Diclofenac potassium is efficiently utilized in treating pain during migraine, episodictension headache, ankle sprain, osteoarthritis and dental pain etc. This review article covers theclinical aspects, pharmacokinetics, different therapeutic applications, drug-drug interactions,related adverse effects, safety and efficacy of diclofenac potassium.
GASTROJEJUNOSTOMY
Authors: Aziz Sajid , Butt Zameer , Jahan Shazia , Ateeq Muhammad
Published: September 2021

Objectives: To assess the efficacy of early Gastrojejunostomy to managecorrosive induced gastric outlet obstruction. Study Design: Prospective, Descriptive, &Interventional. Study Period: February 2011 to April, 2015 Setting: Surgical Department AzizBhatti Shaheed Teaching Hospital Gujrat. Material & Methods: Data of 21 patients presentingwith corrosive induced gastric outlet obstruction during the study period were analysedwith reference to effectiveness of early gastrojejunostomy in symptomatic improvementand nutritional outcome. Results: Total of 21 patients with corrosive induced gastric outletobstruction were managed during the study period. Only 02 patients were male and 19 (90.47%)were female. Mean age was 19.06 years. House hold toilet cleaner was the only corrosive usedin all cases. Suicidal intention was the commonest intention, only one patient was known caseof some psychological illness. Gastrojejunostomy proved to be an effective option in relieving.Conclusion: Early gastrojejunostomy (within 6-8 weeks of corrosive ingestion) is an effectivesurgical procedure to achieve good symptomatic and nutritional outcome in corrosive inducedgastric outlet obstruction.
HYPERTHYROIDISM
Authors: Usman Anjum Muhammad , Durrani Adil Umar , Hussain Talib , Shah Syed Humayun
Published: September 2021

Thyroid disorders are one of the common endocrine disorders. Their prevalenceis affected by many factors, especially environmental and nutritional ones. Objectives: Toascertain the seroprevalence of hyperthyroidism in clinically suspected hyperthyroid patients.Design: Descriptive cross-sectional study. Setting: Frontier Medical & Dental College,Abbottabad. Period: January to August, 2015. Methods: One hundred and twenty patientswere included in the study based on inclusion and exclusion criteria. Thyroid function tests(TSH, fT3 & fT4) were performed using enzyme linked immunoassay (ELISA) method. Results:There was preponderance of males in our study with male to female ratio of 1.4:1. Maximumpatients (56.67 %) were between the ages of 21-40 years of age, with mean age of studypopulation to be 32.09±13.01 years. The prevalence of hyperthyroidism was 15% based on theresults of thyroid function tests. There were 11 males and 7 females with male to female ratio of1.57:1 and mean age of hyperthyroid patients was 25.72± 8.27 years. The mean value of TSH,fT3 and fT4 was 0.038±0.025 mIU/L, 7.08±2.19 ng/mL and 25.25±6.30 μg/dL respectively inhyperthyroid patients as compared to 3.15±2.23 mIU/L, 2.05±0.88 ng/mL and 10.69±2.69μg/dL in euthyroid subjects. Conclusion: Thyroid disorders are not very rare among generalpopulation. TFTs provide a reliable way of ascertaining the thyroid function. As this is a hospitalbased study, field studies should be conducted to ascertain the true prevalence of thyroiddisorders in the community.
HEPATOCELLULAR CARCINOMA
Authors: Fahim Amin , Ahmed Azmi Mohammad , Hanif Muhammad , Qureshi Anila
Published: September 2021

Objectives: To determine the expression of miR-92-1 in HCC patients and correlatethem with clinicopathological data. Study Design: A Cross sectional study. Place of Study:Samples were collected from Jinnah Postgraduate Medical Center Karachi, Civil HospitalKarachi and Asian Institute of Medical Sciences Hyderabad. Duration of Study: January2014 to December 2014. Materials and Methods: 150 patients of hepatocellular carcinomawere divided into two groups on the basis of etiologic agent. HCC patients with chronic viralhepatitis B were labeled as group-I, whereas those with chronic viral hepatitis C in group-II,compared with 75 healthy control individuals in group-III. Results: The results showed thatmiR-92-1 expression was decreased in patients with HCC when compared with controls. Downregulation was seen more pronounced in HCC cases with chronic viral hepatitis C. A significantcorrelation was found between the expression of miR-92-1 and AFP level 20-200 ng/ml andChild Pugh score B. However no correlation was found between the expression of miR-92-1and age, gender, fibro scan, tumor distribution, tumor size, tumor metastasis and BCLC stage.Conclusion: miR-92-1 is down regulated in HCC patients with significant correlation with serumAFP level between 20-200 ng/ml.
HCV GENOTYPE 3A
Authors: Siddiqui Shomail , Talpur Mozna , Memon Rashid Ahmed , Abbasi Palwasha , Tabbusum Sadia
Published: September 2021

The aim of this study was to see the correlation between hepatic steatosis inchronic HCV infection and HCV genotypes. Study Design: It was a prospective observationalstudy done. Setting: Isra University Hospital and histopathology laboratory. Period: May toNovember 2014. Material & Methods: The study was conducted on 87 liver biopsy specimensof patients infected with chronic HCV. The biopsy samples were collected from department ofPathology, Isra University. H&E stained sections of liver biopsies were evaluated to determineGrade and Stage of chronic hepatitis C and grade of steatosis. Blood samples of those patientswere collected from Isra University hospital and Asian Institute of Medical Sciences (AIMS),Hyderabad to determine the HCV genotype, platelet count and liver function test including ALT,AST and GGT. Results: It was found that majority of the patients 38 (43.6%) had genotype 3ainfection followed by 3b, 1a, 1b and Un-typeable genotypes. Hepatic steatosis was divided intocategories according to Brunt’s classification. It was found that 39 (44.8%) patients had grade0 steatosis while 48 out of 87 patients presented with steatosis. It was found that 29 (33%)presented with grade 1 steatosis followed by grade 2 and 3. Steatosis was most frequentlyseen with genotype 3a (26.4%) and presented with mild to moderate grade. Conclusions: Thepresent study concludes that hepatic steatosis is more frequent in genotype 3a and presentswith mild to moderate grade.
PREVALENCE OF METABOLIC SYNDROME
Authors: Hussain Zeenat , Khan Sherwani Misbah-ul-Islam , Mehmood Saqib
Published: September 2021

Morbidity and mortality due to cardiovascular disease (CVD) and type-2 diabetesmellitus has been increased in our country. Obesity and overweight are indicators of risk forCVD and diabetes mellitus. Study Design: Cross sectional study. Setting: Population of foursuburban villages 25-30 km from Lahore i.e. Kacha, Dera Chahal, Shadawal and Samsani Khui.Objectives: The population was screened for obesity, hypertension, diabetes, dyslipidemia.and hepatitis B & C virus infection. The risk factors of metabolic syndrome were determined.Methods:4319 subjects both male and female were included in this study, Results: Total 4308subjects had complete data for analysis, of these 1793(41.62%) were males and 2515(58.38%)females. Mean age of male subjects was 33.7 ± 16.4 and of females 34.8 ± 14.8. Smokersof cigarette and huqqa were 36.98% males and 3.31% females. More males 945(52.7%) thanfemales 766(30.45%) who received some education. Mean values were significantly higher infemales for waist circumference (p<0.00), hip circumference (p<0.001), BMI (p<0.00) systolicBP (p<0.00), diastolic BP (p<0.00), glucose level (p<0.015) and HDLC (p<0.00). Meanvalues of waist hip ratio (W-H ratio), total cholesterol, triglycerides, LDL-C and VLDL-C werecomparable in both genders. Impaired random blood glucose was found in more 156(6.2%)females than in 86(4.8%) males. More male population was found infected with hepatitis B(6.03%) and hepatitis C (13.61%) viruses than females i.e. hepatitis B (3.3 %) and hepatitis C(11.84%). Overall metabolic syndrome was found significantly higher 68.13% with IDF definitionand 67.53% with ATP-NCEP-III-1, than 55.40% with American Heart Association and 40.43%with WHO. Prevalence of metabolic syndrome was significantly higher in females 55.63%than males 44.36%. Conclusion: Metabolic syndrome risk factors i.e. hypertension, obesity,hyperlipidemia and impaired glucose were far more common in women compared to men.
ISCHEMIC STROKE
Authors: Humaira Mona , Hayat Atif Sitwat , Shaikh Tariq Zaffar , Ghani Hanif , Ansari Shoaib , Sikandar Irum
Published: September 2021

Objectives: Stroke is continued to rise in developing countries of the world.Early recognition and prompt treatment of poor prognostic factors would reduce mortality andmorbidity. The objective of our study was evaluation of factors affecting prognosis of ischemicstroke patients and to assess thirty days mortality and outcome. Study Design: Crosssectional,prospective study. Setting: Medical wards of Liaquat University Hospital Jamshoro/Hyderabad. Period: August 2009 to February 2011. Material and Methods: 150 patients wascarried out, patients having acute cerebral infarction of either gender, aged equal to or greaterthan 13 years were included while patients of stroke because of hemorrhage, space occupyinglesion and known diabetic were excluded from study. Results: 150 patients were selected,out of them 60% were male. Age of patients ranged from 13- 90 years with median age of51 years. At the end of one month mortality rate was 10% in our study. No improvement wasfound in 16% patients, partial improvement in 62% while only 12% recovered fully. Conclusion:Our study showed high mortality rate in ischemic stroke patients. Males at and after age of50 years develop ischemic stroke more commonly. Patients of ischemic stroke having fever,dysphagia, urinary incontinence, hyperglycemia and altered level of consciousness showedpoor prognosis.
DICLOFENAC POTASSIUM
Authors: Ali Huma , Zafar Farya , Baloch Saba A. , Hasnain Hina , Naveed Safila , Naqvi Ghazala Raza
Published: September 2021

Diclofenac potassium is efficiently utilized in treating pain during migraine, episodictension headache, ankle sprain, osteoarthritis and dental pain etc. This review article covers theclinical aspects, pharmacokinetics, different therapeutic applications, drug-drug interactions,related adverse effects, safety and efficacy of diclofenac potassium.
LAPAROSCOPIC EVALUATION OF TUBAL FACTORS IN INFERTILE PATIENTS
Authors: Aslam Iram , Azhar Tasneem , Awais Nadia
Published: September 2021

Objective: To evaluate tubal factor in infertility by Laparoscopy. Studydesign: Retrospective study. Setting: Department of Gynae and Obstetrics. IndependentUniversity Hospital, Faisalabad. Period: 01-Jan-2013 to 31-Dec-2015. Material and methods.Retrospective collection of data by convenience sample technique. Results: 52 patientsunderwent laparoscopy during the study period. Most patents 19(66%) were in age group of 31-35 yr. 29 (55%) had infertility of 9-15 yrs. 14(27%) had bilateral tubal block. 9(17%) had unilateralblock. 8(15%) had peritubal adhesions. 21(40%) had healthy & patent tubes. Tubal blockadewas more frequent in patients with secondary infertility (48%). Regarding complications, 4(4.6%)had pyrexia, 2(3.8%) had nausea & vomiting. 3(5%) had wound infection while none had anydamage to bowel or blood vessels. Conclusion. Laparoscopy is a safe and effective diagnostictool in evaluating tubal status of infertile patients.
ACUTE LOW BACK PAIN
Authors: Hameed Daula Muhammad Imran , Amin Saima , Bano Asma
Published: September 2021

Objectives: X ray of the lumbosacral spine is widely used in our clinical settingearly on in the management of patients presenting with nonspecific acute low back pain. Thispractice is in contradiction to the clinical practice guidelines however patient satisfaction isusually the main motive declared by clinicians following this practice. This study was conductedto detect the radiologic prevalence of the most commonly diagnosed congenital anomaliesin lumbosacral spine X rays done for patients presenting with nonspecific acute low backpain. Study Design & Setting: Prospective descriptive study at Shalamar Hospital Lahore,Pakistan. Duration of Study: Six months from September 2014 to February 2015. Subjectsand Methods: Radiographs of 400 patients presenting with non-specific acute low back painand fulfilling the inclusion / exclusion criteria were examined. Data was analyzed on SPSSversion 13 and percentage and frequency of patients with non-specific acute low back painwith lumbosacral transitional vertebra (LSTV), spina bifida and spondylolysis was calculated.Results: Out of 400 patients 185 were males and 215 were females. Age of the patients rangedfrom 15 to 36 years with mean age of 28 (SD ±4.84). 145 patients (36.25%) were found to havecongenital anomalies of lumbosacral vertebrae in question. The prevalence of LSTV was 19.5%(78 patients), spina bifida was 10% (40 patients) and spondylolysis was 9% (36 patients). 2%(9 patients) had more than one anomaly. Conclusions: This study shows a higher prevalenceof lumbosacral transitional vertebra (LSTV) and spondylolysis in Pakistani patients presentingwith non-specific acute low backache, compared to that quoted in literature. This arguably mayconstitute a convincing argument in favor of obtaining lumbosacral spine X-rays early on in themanagement of young patients presenting with non-specific acute low backache.
BLADDER CARCINOMA;
Authors: Qureshi Anila , Ahmed Azmi Mohammad , Hanif Muhammad , Hanif Muhammad , Fahim Amin
Published: September 2021

Objectives: To determine the micro-RNA-145 expression in bladder cancerpatients when compared with controls and clinicopathological parameters. Study design: Acase control study. Place of Study: Samples were collected from Jinnah Postgraduate MedicalCenter Karachi and Civil Hospital Karachi. Duration of Study: January 2014 to December2014. Materials and Methods: Total of 180 patients of bladder carcinoma were divided intothree groups according to WHO/1998 classification system. PUNLMP in group-I, PUCLG ingroup-II, PUCHG in group-III were compared with 60 healthy controls in group-IV. Results:The results showed that miR-145 expression was decreased in patients with bladder cancerwhen compared with controls. Down regulation was more obvious in BC cases with increasinggrade. A significant correlation was found between the expression of miR-145 with microscopichematuria, cystoscopy and staging. Whereas no association was found with age, frequency,urgency, flank pain, gross hematuria, urine pH, and ultrasound. Conclusion: miR-145 is downregulated in BC patients with significant correlation with microscopic hematuria, cystoscopyand staging.
STROKE
Authors: Hasan Khan Muhammad Imran , Hameed Asim , Abbas Khan Zohaib , Fatima Sana
Published: September 2021

in the world. The aim of this study was to analyze different characteristics instroke patients in Medical Unit 1 of Lahore General Hospital, which is biggest referral hospital forNeurology patients in Punjab, to identify the risk factors and help in targeting prevention in ourpatients. Study Design: Descriptive study. Setting: Lahore General Hospital, Lahore. Period:January 2016, including data from January to November 2015. Methods: The demographicdata, clinical manifestations, risk factors, side of weakness, cranial nerves involved, neurologicalweakness and Glasgow Coma Scale, duration of stay in hospital and outcome were includedin the data. For the comparison between categorical variables Chi-square test was used. Forother variables, t-test was used. Results: A total of 235 patients with stroke, age 20 to 105(mean ±SD= 58±14.6) were included. 127 (54%) had Ischemic stroke (IS) and 100 (42.6%)had hemorrhagic stroke (HS). 127 (54%) were men and 108 (46%) were women. 17.9% of thepatients with IS and 21.7% of the patients with HS died (OR 0.65 95% CI 0.48-0.89). Hypertension,diabetes and dyslipidemia were the most common risk factors. Conclusion: Burden of stroke ishigh in Pakistan. Mean age of patients with stroke is less. Hypertension, diabetes, dyslipidemiaand smoking are highly prevalent and hypertension is the most common. Ischemic strokes aremore common, mortality of intra-cerebral hemorrhage is higher.
DIABETIC RETINOPATHY
Authors: Rashad Qamar Rao Muhammad , Hussain Sadiq Hussain , Aslam Tariq Rao Muhammad
Published: September 2021

Objectives: The purpose of this study was to evaluate the prevalence andcharacteristics of diabetic retinopathy (DR) in patients attending the free eye camps for cataractsurgery held in southern Punjab, Pakistan. Study Design: It was a cross sectional study. Setting:Free eye camps organized in different regions of the Southern Punjab, Pakistan. Period: July2004 to June 2015. Material and methods: These community-based eye camps were held bythe Department of Ophthalmology in collaboration of department of Pathology, B.V. Hospital,Bahawalpur, Pakistan. Participants were interviewed and examined by the ophthalmologists todetermine their demographic characteristics, presence & duration of medical conditions andthe regularity of their visits to eye care providers. All patients screened to have diabetes mellitus(DM) by pathologists underwent an eye examination through dilated pupils by using direct/indirect ophthalmoscope and slit-lamp bio-microscope to check for any signs of DR. Mainoutcome measure was the presence of diabetic retinopathy and its complications, which wasclassified as mild, moderate, severe NPDR, and proliferative diabetic retinopathy (PDR) basedon the clinical examination. Results: Of the 7989 screened patients, 759 (9.5%) had type-II DM.Of them, 638 patients (84%) underwent eye examination. Mean age of the diabetics was 45.75 ±8.17 years. Diabetic retinopathy was prevalent in 93 (15%) patients followed by non-proliferativeretinopathy was found in 87 (93.5%) patients and proliferative retinopathy was found only in 6(6.5%) patients. More male 52 (20.39%) were effected of DR as compare to female 41 (10.7%).Highly significant association of DR with duration of DM was seen. (P: 0.001). Conclusion: Itis concluded in this study that DR is commonly prevalent in Southern Punjab and the mostcommon type of DR is non-proliferative retinopathy. DR frequently prevalent in male diabeticsas compare to female diabetics and significant association of duration of DM with DR wasfound.
INSULIN TREATED PATIENTS
Authors: Kitchlew Rizwana , Thaver Inayat , Pervez Shehryar , Haq Ikram ul
Published: September 2021

Objective: To determine the trends in insulin injection technique and associatedcomplications in the local diabetic patients. Study Design: Cross-Sectional Descriptive study.Place and Duration of Study: This study was conducted in Department of Medicine at FatimaMemorial College & Hospital Lahore from 25th May 2015 to 25th October 2015. Patientsand Method: Three hundred patients above 18 years of age who presented in outdoor andindoor department of the hospital, gave consent were enrolled. The data was collected throughinterview and relevant physical examination; data was analyzed by using SPSS 20.0 version.Results: 300 diabetics were enrolled; 108 (36%) male and 192 (64%) female. Mean age inmales was 52.8±13.7 and in females was 52.2±11.8. Duration of insulin use was less than5 years in 175 (58%) and 5 years or more in 125 (42%). Insulin syringe of 8 mm gauge wasbeing used by 263 (87%). Abdomen was the injection site in 202 (67%); however, 279 (93%)rotated the injection site. The angle of injection was kept at 90 degrees by 254 (85%). Theneedle was reused for five or more times by 187 (52%) and 216 (72%) were self-injecting. Localcomplications were seen in 105 (35%); out of those pain was most commonly (35 %) reported.Among age groups significant association (p<0.05) was seen in site of insulin delivery, in agemore than 60 years more injected in abdomen. In gender groups more males (83%) wereself-injecting. Significant association (p<0.05) was seen in duration of insulin use and localcomplications. Majority, 126(72%) of those who were on insulin for less than 5 years did nothave complications. Conclusion: Majority of our patients had adopted reasonable techniquehowever repeated reinforcement can further improve appropriate insulin delivery, less wastageof insulin and better glycemic control with less chance of complications.