bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-operative outcomes of endoscopic dacrocystorhinostomy without intubation at holy family hospital, Pakistan.
Authors:   Holy Family Hospital., Ayub Nayyer , Ashfaq Ahmed Hasan ,   Benazir Bhutto Hospital., Akash Haitham ,   Holy Family Hospital., Khan Muhammad Sheharyar ,   Rawalpindi Medical University., Arshad Muhammad ,   Benazir Bhutto Hospital., Faisal Malik Jawad ,   Pakistan Institute of Medical Sciences.
Published: August 2021

Objective: This study aims to present the outcomes of the patients who underwent endoscopic dacryocystorhinostomy (DCR) without intubation at a tertiary care hospital. Study Design: Observational Study. Setting: Holy Family Hospital, Rawalpindi, Pakistan. Period: October 2018 to November 2019. Material & Methods: Endoscopic dacryocystorhinostomy operation was performed in a total of 52 patients presenting with chronic epiphora. Silastic tubes were not used to maintain the patency. Patients were prescribed antibiotic eye drops, oral painkillers, decongestant eye drops, and regular nasal douches. Results: Fifty patients (96.2%) presented with successful post-operative outcomes on the 12th week for follow-up. Post-operative canal patency was evaluated by endoscopic examination and syringing. Patients were also evaluated for the presence of epiphora. Conclusion: Our results of 52 patients who underwent endoscopic DCR without stenting are as promising as those with stenting. Hence, the procedure without intubation is recommended.
Cardiac biomarkers in patients with epilepsy.
Authors:   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot., Hanif Sadia , Siddiq Shazia ,   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot., Zaib Jhangir ,   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot., Ali Syed Azhar ,   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot., Tahir Rabia ,   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot., Ahmad Nisar ,   Sheikh Khalifa Bin Zaid Hospital/ Poonch Medical College Rawlakot.
Published: August 2021

Objective: To determine the frequency of deranged cardiac biomarkers and associated socio-demographic factors among patients of epilepsy presenting at our hospital. Study Design: Cross-sectional study. Setting: Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan Hospital Rawalakot. Period: August 2019 to September 2020. Material & Methods: We evaluated 85 consecutive patients who presented at Department of Medicine, Sheikh Khalifa Bin Zyed Al-Nyhan hospital. Cardiac Biomarkers (Troponin I, CK-MB and pro-BNP) and EKG were requested in all patients. The questionnaire used for interview consisted of demographic details and disease related parameters (duration of epilepsy and number of antiepileptic drugs). Results: Out of 85 patients included in the study, 35 (41.2%) were male while 45 (58.8%) were female. Out of these 85 patients of epilepsy, 15 (17.6%) had one or more cardiac biomarker positive while 70 (82.4%) had no change in ECG or any positive cardiac biomarker. All ECG changes were non-specific. After applying the logistic regression, we found that long duration of illness and poly-pharmacy had significant association with the presence of positive cardiac biomarkers among the patients of epilepsy. Conclusion: Less than 1/5th of the patients with epilepsy had positive cardiac biomarkers or ECG changes in our study. Patients with longer duration of epilepsy or those whose epilepsy has been managed with more than one drug were found more at risk of having abnormal cardiac biomarkers in our target population.
Frequency of diabetic retinopathy in patients of acute ST elevated myocardial infarction (STEMI).
Authors:   Kuwait Teaching Hospital, Peshawar., Sanaullah  , Shah Syed Tahir ,   Kuwait Teaching Hospital, Peshawar., Khan Abdul Salar ,   DHQ Hospital Landi Kotal, KPK., Hadi Noor ul ,   Mardan Medical Complex, Mardan., Ahmad Naveed ,   Kuwait Teaching Hospital, Peshawar.
Published: August 2021

Objective: To determine the frequency of diabetic retinopathy in patients of acute ST elevated Myocardial Infarction (STEMI) in our population. Study Design: Cross Sectional study. Setting: Department of Cardiology, Lady Reading Hospital, Peshawar. Period: 20th November 2018 to 19th May 2019. Material & Methods: Detailed history was taken and previous records were reviewed to look for diagnosis of DM, followed by complete examination and investigations including FBC, LFTs, RFTs, ECG and echo to fulfill exclusion criteria. Fundoscopy was performed by two experienced cardiology trainees with riester ophthalmoscope. Consensus was made on ophthalmoscopy findings regarding the presence or absence of Diabetic Retinopathy (DR). Results: In this study a total of 189 patients were observed. Mean age was 43 years with SD ±11.23. Sixty six percent patients were male while 34% patients were female. More over 5% patients had diabetic retinopathy while 95% patients did not have diabetic retinopathy. Conclusion: Our study concludes that the frequency of diabetic retinopathy was 5% in patients of acute ST elevated MI in our population.
Frequency of different symptoms in patients with COVID-19.
Authors:   MBBS, FCPS Assistant Professor Medicine Bahria University Medical and Dental College., Shafique Sehrish , Faraz Naveed ,   MBBS, M.Phil, MAS Professor Pathology Bahria University Medical and Dental College., Wasti Hina ,   MBBS, M.Phil Assistant Professor Pathology Bahria University Medical and Dental College.
Published: August 2021

Objective: To find out the common symptoms in COVID -19 patients in association with age and gender. Study Design: Cross Sectional study. Setting: Study was conducted by approaching patients with COVID 19 positive in clinics, hospitals and those isolated at homes. Period: May 2020 to August 2020. Material & Methods: This study was conducted in Karachi by filling up the proformas from patients diagnosed as COVID 19 during a period of 4 months. All the patients with 25 -75years of age, and diagnosed with COVID 19 positive were considered as a part of study. Data was written in a form of questionnaire.95% confidence interval was taken. For entry of data SPSS version 20 was used. Results: A total of 150 cases were included after considering inclusion and exclusion criteria, among which 80(53.3%) were males and 70 (46.6%) were females. Most of the COVID -19 patients in our study between the age group of 61-75yrs (57%) followed by 46- 60yrs age group (30 %). This study also showed that fever and cough was among the commonly occurring symptoms in COVID-19 patients. Conclusion: Patient with different symptoms present in COVID-19 although cough and fever were the most common symptoms seen although few patient were symptoms free although COVID-19 positive.
Root morphology of maxillary 1st premolar teeth in orthodontic extraction cases presenting in a tertiary care hospital: Taxilla Cantt.
Authors:   Dental College-HITEC (IMS)-Taxilla Cantt., Siddiq Maimoona , Shakeel Junaid ,   Sir Syed College of Medical Sciences for Girls, Karachi., Khan Bushra Naeem ,   Shifa College of Dentistry., Mehdi Syed Zuhair ,   Dental College-HITEC (IMS)-Taxilla Cantt., Hameed Shoaib ,   Dental College-HITEC (IMS)-Taxilla Cantt., Chaudhary Farooq Ahmad ,   School of Dentistry-SZABMU Islamabad.
Published: August 2021

Objective: To observe pattern and variation of root morphology of maxillary 1st premolar teeth in orthodontic extraction cases among local population. Study Design: Prospective Observational study. Setting: Dental College-HITEC Institute of Medical Sciences-Taxilla Cantt. Period: 1st January 2017 to 31st December 2019. Material & Methods: A total of 120 patients and 320 maxillary 1st premolars were studied clinically for gross root morphology after orthodontic tooth extraction, variation of gross root morphology was studied among extracted teeth, frequency distribution was observed on basis of gender and both quadrants in each patient, a critical analysis is also made about variation of root morphology among various populations across the world. Result: Out of 160 patients, 49 were males and 111 were females. 151 patients had bilateral similar root morphology, out of 320 clinically examined teeth 206 had two roots, and 123 teeth had fused root morphology, 83 teeth had two bifurcated (separate) roots while 114 teeth were single rooted. Conclusion: Maxillary 1st premolar is unique in terms of wide variation in root morphology which is evident among various population studies. Two roots with fused root morphology is most prevalent in Pakistani population.
Vitamin D testing: Comparison and limitations of currently employed immunoassay with a novel liquid chromatography and tandem mass spectrometry (LCMS/MS) technique.
Authors:   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan., Naz Sehrish , Aamir Muhammad ,   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan., Haroon Zujaja Hina ,   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan., Irum Sobia ,   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan., Ain Qurat ul ,   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan., Ahmad Farooq ,   AFIP, Rawalpindi-National University of Medical Sciences, Pakistan.
Published: August 2021

Objective: To compare analytical method for 25 hydroxy vitamin D2 and D3 on LC/MS-MS and with routine vitamin D Immunoassay method. Study Design: Cross Sectional study. Setting: Department of Chemical Pathology and Endocrinology, Pakistan. Period: March 2019 to March 2020. Material & Methods: Samples were extracted and a mass spectrometer coupled to high performance liquid chromatography was adopted for quantitation of 25-hydroxyvitamin D2 and D3 in human samples (serum). After validation it was then applied to 120 serum samples from healthy individuals for method comparison. Results: The method was validated in terms of accuracy, precision, linearity on calibration curve, Limit of Detection and Limit of Quantitation. Our study showed a statistically insignificant difference in results among both the methods (p=0.715). Limit of detection (LOD) was 2.49 ng/ml and limit of quantitation (LOQ) was 3.9 ng/ml for both the metabolites. Percentage RSD was 0.8% and 1.3% for D2 and D3 respectively. This method has an advantage of minimal cross-reactivity with 24,25 hydroxy vit D and 25,26 di- hydroxy vit D metabolite than the routinely used assays. Conclusion: This methodology will be helpful in guiding patient management and assess possibility of malabsorption syndrome in patients on D2 therapy. It can give highly cost effective reliable results of Vitamin D at a tertiary care setting which has an already installed LCMS/MS with huge workload, as compared to costly Immunoassay method.
Outcome of fecal incontinence in the two-staged seton fistulotomy for complex fistula in ANO.
Authors:   Shaikh Zayed Hospital Lahore., Ikram Rabia , Rehman Shafique ur ,   Shaikh Zayed Hospital Lahore., Majid Haroon Javaid ,   Shaikh Zayed Hospital Lahore., Javed Arif ,   Shaikh Zayed Hospital Lahore., Jamil M. Aamir ,   Shaikh Zayed Hospital Lahore., Dar Harun Majid ,   Shaikh Zayed Hospital Lahore., Shafi M. ,   Shaikh Zayed Hospital Lahore.
Published: August 2021

Objective: To determine the frequency of fecal incontinence in the two-staged Seton fistulotomy in complex fistula in ano. Study Design: Prospective Cohort study. Setting: Surgical Out-patient Department at Shaikh Zayed Hospital Lahore. Period: September 2015 till March 2016. Material & Methods: After ethical review board approval, data was collected from 100 patients who fulfilled the inclusion criteria. All the procedures were conducted in the lithotomy position, under spinal or general anesthesia. A rigid sigmoidoscopy and proctoscopy was done prior to intervention. Fistula tract was marked using hydrogen peroxide (H202) for the identification of the internal opening. The external opening was gently probed using a standard 3 mm blunt-tipped probe till the internal opening was reached. The portion of the track outside the sphincter mechanism and any lateral tracts were laid open. A feeding tube of size 5 French was loosely tied around the remaining muscular portion of the sphincter complex. The seton was left in place for six weeks followed by secondary fistulotomy. Patients were evaluated for incontinence one month after the second procedure. Results: In our study, mean age was calculated as 47.38+10.96 years, 73%(n=73) were male and 27%(n=27) were females, frequency of fecal incontinence in the two-staged Seton fistulotomy in complex fistula in ano was recorded in 17%(n=17). Conclusion: The frequency of fecal incontinence in the two-staged seton fistulotomy for complex fistula in ano was acceptable in our study population and in tandem with literature. The procedure may be a suitable alternative to loose-seton placement alone.
Intrauterine fetal death: Five years’ experience in a secondary care hospital.
Authors:   The Agha Khan University, Karachi, Pakistan., Khan Erum Saleem , Jamil Mahwash ,   HITEC IMS Taxila Cantt., Chanderparkash Reeta ,   Aga Khan University Karachi Pakistan., Irfan Sheikh ,   Aga Khan University Karachi Pakistan., Yousf Sana ,   Aga Khan University Karachi Pakistan., Basharat Ayesha ,   Isra Medical College and Hospital Islamabad.
Published: August 2021

Objectives: The objectives of this study were to estimate the prevalence, preoperative, and operative risk factors associated with the higher risk of SSI in gynecologic cancer patients undergoing surgery in a tertiary care facility in a developing country. Study Design: Retrospective Study. Setting: Obstetrics and Gynecology Department, Agha Khan Hospital for Women Garden Karachi, Pakistan. Period: Jan 2012 to Dec 2016. Material & Methods: Retrospective review of medical records of patients over a period of five years from Jan 2012 to Dec 2016 was done. Results: The study consisted of 56 cases of intrauterine fetal demise out of 4813 number of deliveries which occurred during the study duration. Overall estimated rate of intrauterine fetal demise was 11.6 %( 56/4813). Approximately 33.9% of cases did not have a clear cause of fetal death identified and hence were un-explained. In 56 cases, 28.6% had some form of congenital abnormality identified on ultrasound, 7.1% (n=4) had anemia, 23.2% (n=13) IUGR, 5.4% (n=3) placental abruption and 1.8% (n=1) of gestational diabetes and around 83.9% (n=47) had normal vaginal delivery and 8 were delivered by LSCS and only 1 patient had instrumental delivery. Fetal characteristics identified 50% (n=28) were males and 50% (n=28) were females. 4 fetuses were born with tight cord around their neck 58.1% were macerated stillbirths (n=25) while 32.6% were fresh stillbirth. Conclusion: Antepartum intrauterine fetal death or stillbirths in the third trimester, affect the entire family. We conclude from our study that quality antenatal care with health education and timely interventions can reduce the number of intrauterine fetal deaths thus reducing the psychological sequelae.
Wheat Pill Poisoning: Management and outcome in cases reported in DG Khan District.
Authors:   DG Khan Teaching Hospital., Khan Alina Nawaz , Khan Rabia ,   Khyber Medical College, Peshawar., Siddiqui Naheed ,   Khyber Girls Medical College, Peshawar., Rana Salman Pervaiz ,   CMH Lahore Medical College, Lahore., - Faqirullah ,   Northwest School of Medicine, Peshawar., Masood Riffat ,   Foundation University Medical College.
Published: August 2021

Objective: To determine the clinical manifestations and prognosis of victims presenting with wheat pill poisoning. Study Design: Prospective Cohort Study. Setting: Emergency Department in District Headquarter Hospital DG Khan. Period: February 2019 to January 2020. Material & Methods: Patients admitted with history of accidental or suicidal wheat pills poisoning were followed over a period of 3 to 6 months. Symptomatic treatment was initially given for 2-3 hours. The patients were retained in CCU for 24 hours before shifting to ward. Research tool (proforma) was designed for collection and interpretation of data. Acute Physiology and Chronic Health Evaluation Score 2 (APACHE-2) score was used for prognosis and recovery. Result: Out of 96 victims of aluminum phosphide ingestion male/female ratio was 2:1, 64% (n= 64) were females and 36% (n=32) were males. Higher incidence was found in age group (16–25 years (n= 27 victims). Overall mortality was 63 (65.6%). Conclusion: Wheat pill was a poison of choice among teens and adults in Pakistan as it is freely available and cheap. Arrhythmia and metabolic acidosis are the major causes of death after wheat pills ingestion. Coconut oil was found effective in delaying the absorption.
Effect of early and delayed cord clamping on hemoglobin and hematocrit among full term neonates.
Authors:   Mayo Hospital Lahore., Aslam Saqib , Minhas Sadaf ,   Medicsi Hospital., Farooq Muhammad Azhar ,   Services Institute of Medical Sciences (SIMS), Lahore., Mughal Beenish Bashir ,   Mayo Hospital Lahore., Zahoor Farhan ,   Services Institute of Medical Sciences (SIMS), Lahore., Maqbool Tehmina ,   Mayo Hospital Lahore., Ahsan Muhammad ,   Government General Hospital, Faisalabad.
Published: August 2021

Objective: To compare the mean hemoglobin levels and frequency of polycythemia in full term neonates after early and delayed cord clamping. Study Design: Randomized Controlled Trial. Setting: KRL General Hospital Islamabad (Labor Room/ Neonatology). Periods: December 2017 to June 2018. Material & Methods: 190 full term neonates were selected and divided into 2 equal groups randomly: Early cord clamping group after delivery and late cord clamping group. Two hours after clamping the venous blood samples were taken for the hemoglobin and hematocrit levels. Mean and standard deviation were calculated for gestational age, birth weight, hemoglobin and hematocrit. Frequency and proportions were calculated for gender and polycythemia. Results: Mean gestational age of the mothers was 39.27 ± 1.50 weeks. Of 190 neonates, 91 (47.9%) were males, 99 (52.1%) were females. Mean birth weight was 3.64 ± 0.72 kg while mean Hb and HCT levels were 16.07 ± 2.30 g/dl and 63.26 ± 5.32% respectively. Keeping cut off value of 13.5 g/dl of Hb to label anemia or no, 35 (18.4%) neonates were anemic in this study. The polycythemia (HCT >65%) was present in 72 (37.9%) of neonates. There was no difference between groups in terms of gender, anemia, gestational age and birth weight (p values 0.663, 0.852, 0.700 and 0.491 respectively). The distribution of polycythemia was different among groups (p value 0.007). The mean hemoglobin level in group A was 15.52 ± 1.90 g/dl while in group B it was 16.62 ± 2.53 g/dl (p value 0.001). Mean Hb levels were statistically not different among some of the groups (gestational age <40 weeks, birth weight <4 kg) while HCT levels are significantly different among male group and category of birth weight >4 kg. Rest of the stratification groups showed significant difference. Conclusion: The delayed cord clamping in neonates results in increased mean hemoglobin and hematocrit levels with increased frequency of polycythemia as compared to early cord clamping.
Frequency of chronic diseases in elderly age group.
Authors:   Fatima Memorial College of Medicine & Dentistry, Shadman, Lahore., Mir Arslan , Hassnain Shamaila ,   Fatima Memorial College of Medicine & Dentistry, Shadman, Lahore., Khan Anas ,   Fatima Memorial College of Medicine & Dentistry, Shadman, Lahore.
Published: August 2021

Objective: To determine the frequency of chronic diseases in elder age group of above 60 years along with their regular activities and functional limitations. Study Design: Cross Sectional study. Setting: Thokar Niaz Baig Area of Lahore. Period: January 2017 to June 2017. Material & Methods: A total of 163 respondents, both males and females above the age of 60 years were interviewed using Quota sampling. Data was collected with the help of a pretested structured questionnaire after informed consent. Results: The mean age of our study sample was 69 ± 7.1 years. 63.8% were males while females were only 36.2%. Hypertension was found to be 69.3% followed by Diabetes in 51.5%, Visual disturbance 52.1%. Only 10.4% were dependent in physical activity in which 23.5% depends on paid attendants. Elderly depending among them on their son for any support of income were 90% and 90.2% of the study subjects lived with their family in joint family system while 9.8% lived among them. Out of all participants 75.5% have the decision power. Conclusion: The risk of diabetes, hypertension, and visual problems were more among the selected population of geriatrics.
Ghrelin levels in hypertensive obese and normotensive obese subjects.
Authors:   University Medical & Dental College Faisalabad., Niazi Zehra , Tariq Sundus ,   University Medical & Dental College Faisalabad., Saeed Muhammad Azhar ,   The University of Faisalabad., Akram Sana ,   University Medical & Dental College Faisalabad., Mahmood Sara ,   University Medical & Dental College Faisalabad.
Published: August 2021

Objective: The purpose was to determine the ghrelin level, its effect and relationship with blood pressure levels in obese subjects. Study Design: Comparative Cross Sectional study. Settings: General OPD of Madinah Teaching Hospital (MTH) and District Head Quarter hospital Faisalabad (DHQ). Period: 2019 to 2020. Material & Methods: Blood samples were collected from hypertensive and compared with the normotensive obese (BMI >30). Ghrelin level was measured by Enzyme-linked immunosorbent assay (ELISA). Statistical analysis was done on Statistical Package for the Social Science (SPSS) 20 software. Mean ±SD has been given for quantitative variables. Independent sample t test was used for comparisons. Significance has been chosen as p ≤ 0.05. Results: Total 114 obese patients were selected for this study, of which 57 were hypertensive and 57 were normotensive. Minimum age was 30 years and maximum age was 60 years with mean age 39.35 ± 10.08 years. Mean age of hypertensive obese was 43.42 ± 10.46 years and mean age of normotensive was 35.28 ± 7.87 years. Statistically significant difference of mean fasting ghrelin levels between hypertensive obese and normotensive obese was noted with p value 0.013. Conclusion: Obese persons with elevated circulating concentration of ghrelin may be susceptible to the progression of increasing blood pressure.
Postpartum depression and its accomplices in Peshawar; a metropolitan city of Pakistan.
Authors:   CMH Multan., Afsheen Afeera , Khan Khaula Atif ,   CMH Sargodha., Nosheen Javaria ,   CMH Lahore., Mehreen Sobia ,   CMH Rawalpindi., Anwar Rabiah ,   PNS Shifa Hospital., Iftikhaar Bushra ,   PNS Shifa Hospital.
Published: August 2021

Objective: To analyze prevalence and severity of postnatal depression among females of a major but socio-culturally traditional city of Pakistan, with an aim to pinpoint eminent demographic and medical accomplices. Study Design: Cross Sectional Study. Setting: Combined Military Hospital Peshawar. Period: Feb 2016 to Feb 2017. Material & Methods: Sample was collected via random probability technique. A self-designed questionnaire was used; encompassing demographic details and information regarding obstetric and family history. Screening tool was Standardized “Edinburgh Postpartum Depression Scale (EPDS)”. Descriptive analysis done via SPSS-21. Outcome variable (EPDS) was cross-tabulated with independent variables, correlations were generated by Pearson 2-tailed bivariate analysis; p-value<0.05 was considered as significant. Results: Response rate was 52.2% (n-402). Low, moderate and high risk patients for developing depression were 27.1% (n-109), 15.4% (n-62) & 12.9% (n-52) respectively. There was a strong relation between outcome and age(p<0.001), education(p-0.001), socio-economic class(p-0.013), bad obstetric history(BOH)( p-0.009), age of Last Child Born(LCB)( p-0.010), mode of delivery(p-0.011), postpartum phase(p<0.001) and postpartum complications(p-0.003). Number of sons was negatively correlated with EPDS-scores (Pearson correlation co-efficient -0.128 and p-0.01). There was no significant impact of years since married (p-0.349; husband’s education (p-0.397), number of children (p-0.966) or daughters (p-0.063) and previous offspring’s death (p-0.076). Conclusion: Considerable risk of developing postpartum depression was detected among the respondents. Sociodemograhic aggravators were identified to be maternal age, less interpregnancy interval, delivery by SVD, gender of children and postpartum complications. Postpartum depression can be detected by screening/diagnosing every postnatal woman and then promptly treating the sufferers. Imperative measures are opined to identify and vigorously address the sociodemographic and medical aggravating factors. Collaboration of psychiatrists/psychologists is highly recommended in obstetric set-ups.
Frequency of abnormal cervical cytology in symptomatic women.
Authors:   PAQSJ Gambat Institute of Medical Sciences Gambat, Khairpur., Khatoon Hafiza , Mushtaq Nousheen ,   Health Department Sindh., - Safia ,   PAQSJ Gambat Institute of Medical Sciences Gambat, Khairpur., Khan Fiza Ali ,   Civil Hospital Karachi., Naz Ambreen ,   PAQSJ Gambat Institute of Medical Sciences Gambat, Khairpur., Awan Tahira ,   Civil Hospital Karachi.
Published: August 2021

Objective: To estimate the frequency of abnormal cervical cytology detected by Pap smear. Study Design: Cross Sectional Study. Setting: Department of Obstetrics and Gynaecology Gambat Institute of Medical Sciences Gambat, Khairpur Sindh. Period: November 2018 to June 2019. Material & Methods: A total of 160 women with the complaint of heavy vaginal discharge and moderate to servere lowere abdominal pain more than 6 weeks were included in this study. Per speculum examination of cervix was carried out with the help of cuscos speculum before PAP smear and finding were noted, After labeling the sample was sent to histopathology for cytological examination. Results: The average age of the patient’s was 37.68±7.46 years. Percentage of normal smears 10%, advance disease 1.3% and percentage of inflammatory smear is 63.8% while frequency of abnormal cervical cytology was observed in 25% in which CIN-1 was 12.5%, CIN-2 was 11.3% and CIN-3 was 1.3%. Conclusion: Our population have large numbers of undiagnosed cervical diseases. Therefore, Pap smear testing should be widely used throughout Pakistan to reduce the incidence of cervical cancer.
To determine the diagnostic accuracy of aspartate aminotransferase to platelet ratio index in detecting significant fibrosis in chronic hepatitis C patients by using histopathology as gold standard.
Authors:   DHQ Hospital Faisalabad., Yasin Mahwish , Muzaffar Huma ,   DHQ Hospital Faisalabad., Zamir M Ahmed ,   DHQ Hospital Faisalabad., Munir Talha ,   DHQ Hospital Faisalabad., Mahmood Arfan ,   Services Hospital Lahore., Khalid Awais ,   DHQ Hospital Faisalabad.
Published: August 2021

Objective: The objective of the study was to: determine the diagnostic accuracy of AST to platelet ratio index in detecting significant fibrosis in chronic hepatitis C patients by using histopathology as gold standard. Study Design: Cross Sectional study. Settings: Department of Medicine, DHQ Hospital, Faisalabad. Period: 1st Oct 2017 to March 2018. Results: In this study, out of 158 cases, 48.73%(n=77) were between 25-40 years while 51.27%(n=81) were between 41-60 years, mean+SD was calculated as 40.94+9.10 years, 55.06%(n=87) were male and 44.94%(n=71) were females, mean AST and platelet count was calculated as 1.68+0.54 and 191.0+43.75, frequency of significant fibroids in chronic hepatitis C patients by using histopathology as gold standard reveals as 53.16%(n=84) while 46.84%(n=74) had no findings of this morbidity. The diagnostic accuracy of AST to platelet ratio index in detecting significant fibrosis in chronic hepatitis C patients by using histopathology as gold standard was recorded which shows 51.27%(n=81) as true positive, 2.53%(n=4) false positive, 1.89%(n=3) false negative and 44.31%(n=70) were recorded as true negative, sensitivity, specificity, positive predictive value, negative predictive value and accuracy rate was computed as 96.43%, 94.59%, 95.29%, 95.89% and 95.57% respectively. Conclusion: The results of the study reveal that diagnostic accuracy of AST to platelet ratio for detection of significant fibrosis in chronic Hepatitis C patients was satisfactory and it may be used for the avoidance of invasive liver biopsy to initiate the antiviral therapy in these patients.
Effect of anemia on HbA1c level in subjects with normal glucose tolerance.
Authors:   Baqai Medical University Karachi., Saeed Muhammad , Siddiqui Iftikhar Ahmed ,   Baqai Medical University Karachi., Fawwad Asher ,   Baqai Medical University Karachi., Butt Anum ,   Baqai Institute of Diabetology and Endocrinology Karachi., Perveen Kahkashan ,   Baqai Medical University Karachi., Nangrejo Ruqaya ,   Baqai Medical University Karachi., Basit Abdul ,   Baqai Institute of Diabetology and Endocrinology Karachi.
Published: August 2021

Objective: To evaluate the effect of iron deficiency anemia (IDA) on HbA1c levels in non-diabetic Pakistani individuals. Study Design: Observational Study. Setting: Baqai Institute of Diabetology and Endocrinology, Baqai Medical University Karachi. Period: March 2019 to May 2019. Material & Methods: After approval by the ethics committee of BMU. A world Health Organization (WHO) criterion was used for screening normal glucose tolerance. Subject with type 1 and 2 diabetes, and gestational diabetes were excluded. Selected subjects were categorized into 2 groups (anemic and non-anemic). Data was collected on a structured questionnaire. Result: Out of 139 subjects, 72 were males and 67, were females. Anemia was more common in males as compared to females (34.7% vs 19.4%). Among males, HbA1c level was found higher in anemic subjects with MCV<76fl than anemic subjects with MCV>76fl and subjects without anemia. While in females, HbA1c level was similar in both anemic and non-anemic subjects. Conclusion: HbA1c as a diagnostic marker should be assessed carefully as the presence of IDA can lead to falsely elevated HbA1c levels in non-diabetic subjects.
Congenital heart diseases in premature newborns.
Authors:   Children’s Hospital & ICH, Multan., Ilyas Sana , Waqar Sana ,   Holy Family Hospital, Rawalpindi., Khurshid Asim ,   Children’s Hospital & ICH, Multan., Arshad Muhammad Sohail ,   Children’s Hospital & ICH, Multan.
Published: August 2021

Objective: To determine the frequency of congenital heart diseases (CHD) in newborns admitted with prematurity. Study Design: Descriptive Cross Sectional study. Setting: Department of Pediatric Neonatology Children’s Hospital & The Institute of Child Health, Multan. Period: August 2019 to January 2020. Material & Methods: A total of 155 preterm infants ≤36 weeks gestation were included. In preterm newborns of either gender, echocardiography was done by hospital Pediatric Cardiologist. Patient’s name, age, gestational age, weight, sex, date, serial number, registration number and echocardiographic results were entered in pre-designed performa. The outcome variable was frequency of congenital heart disease in preterm newborns. Results: Congenital heart disease was detected in 34.8% (n = 54) preterm infants. Nine percent (n=14) were < 1.5 kg, 45.2% (n=70) between 1.5 – 2.0 kg and 45.8% (n=71) were > 2.0 kg in weight. Most frequent lesion was Ventricular Septal Defect (VSD) in 19 (35%) infants followed by patent ductus arteriosus (PDA) in 15 (28%) infants. Atrial Septal Defect (ASD) was seen in 6 (11%) preterm infants. Frequency of CHD was significantly higher (p-value < 0.001) in babies delivered at ≤32 weeks and those infants with with birth weight <1.5 kg. Conclusion: The study highlights the association of congenital heart diseases in premature and low birth weight neonates. So, every preterm and low birth weight neonate must undergo echocardiography to screen for CHD so that earlier diagnosis may be made for earlier intervention.
Hyperferritinemia as independent risk factor and biomarker in COVID-19 to predict severity and mortality.
Authors:   Hayatabad Medical Complex, Peshawar., Khan Shah Taj , Zahoor Saiqa ,   Hayatabad Medical Complex, Peshawar., Khan Hamzullah ,   Hayatabad Medical Complex, Peshawar., Khan Khalid ,   Nowshera Medical College, Nowshera, Farooq Mehreen ,   Hayatabad Medical Complex, Peshawar.
Published: August 2021

Objectives: To determine the role of deranged serum ferritin levels as independent pathogenic risk factor to predict the progression towards a worse clinical outcome in COVID-19. Study Design: Descriptive Cross Section Study. Setting: Hayatabad Medical Complex Peshawar. Period: 1 March to 10 July 2020. Material & Methods: A total of 267 patients were enrolled from COVID-19 isolation units, Hayatabad Medical Complex Peshawar Descriptive statistics were used for numerical variables. Binary logistic regression analysis was used to predict the worst outcome in patients with deranged levels of ferritin. Correlation statistic were used to quantify the correlation of ferritin with mortality and severity of the disease. Kaplan Meir test was used for survival analysis to compare the mortality rate in gender groups in COVID-19 patients with deranged ferritin levels. Results: The mean age of the patients was 53+14years. The median value of the Serum ferritin levels of Covid-19 patients was 978 ug/L the ferritin distribution in gender groups was not normally distributed (Shapiro Wilk test, p-value 0.001). 215/267(80.5%) cases reported >400 ug/Lof serum ferritin. There was a statistically significant uphill positive correlation of serum ferritin levels with an increase in age (rs-0.213, p-0.001) and with disease outcome in terms of mortality (rs-0.29, p-0.05). The probability case fatality in patients with deranged serum ferritin levels was 1.8 times more as compared to patients without hyperferritinemia (p-0.05, OR 1.8). The surviving capability in female gender with deranged ferritin levels in extreme of age was 65% as compared to 20% in male gender. Conclusion: More than 80% of the COVID-19 patients had abnormally higher readings of serum ferritin. The deranged ferritin levels had a statistically significant correlation with an increase in age of patient and with worst outcome in terms of death. Female gender more protective with higher chances of survival with deranged serum ferritin levels in all age groups compared to male gender.
Frequency of gram negative bacterial isolates in chronic suppurative otitis media and their sensitivity pattern.
Authors:   Sahara Medical College., Hassan Saeeda Nabat ul , Farva Khushbu ,   Sahara Medical College., Bhutta Ghulam Asghar ,   Sahara Medical College.
Published: August 2021

Objective: To determine frequency of gram negative bacterial isolates and their antibiotic sensitivity pattern among patients with chronic suppurative otitis media. Study Design: Descriptive Cross Sectional study. Setting: Department of Pathology Sahara Medical College Narowal. Period: January 2020 to June 2020. Material & Methods: Total 126 bacterial isolates were taken from the patients having unilateral or bilateral ear discharge reporting to OPD or emergency department during study period. After taking detailed history, examination and baseline investigations diagnosis was confirmed. Specimens of ear discharge were taken from all patients and sent to the pathology department of study institution to determine culture and sensitivity pattern of Gram-negative bacterial isolates. Consent was taken from ethical review committee. Data was analyzed on SPSS-24. Chi square test was applied on collected data. Results: Bacterial isolates were taken from 126 cases having age 2-54 years with mean age of 11.45±5.73 years of either gender. Mostly children less than 8 years of age were found with otitis media. Gram positive bacteria were detected in 41.3% and gram negative in 55.6% and candida albicans in 3.2% out of total 126 bacterial cultures. Out of gram negative cultures, pseudomonas aeruginosa was found in 41.4%, proteus mirabilus in 44.3% and E.coli in 14.3% specimens. Conclusion: Gram negative bacteria are common cause of chronic suppurative otitis media in our region, mostly affecting young children. There is variable antibiotic sensitivity pattern depending on cultural, climate changes and previously taken antibiotics.
Comparison of outcome of total thyroidectomy with and without pre-operative calcium and vitamin D supplements in terms of post-operative hypocalcemia.
Authors:   Surgical Unit-I MAYO Hospital Lahore., Ammar Ahmed Siddique , Khattak Shehrbano ,   King Edward Medical University, Lahore., Noumani Ahmed Raza ,   Surgical Unit-I MAYO Hospital Lahore., Saeed Sahar ,   Surgical Unit-I MAYO Hospital Lahore., Inayat Farwa ,   Surgical Unit-I MAYO Hospital Lahore., Naqi Syed Asghar ,   Surgical Unit-I MAYO Hospital Lahore.
Published: August 2021

Objective: The objective of this study is to compare the effect of pre-operative calcium and vitamin D supplements in terms of hypocalcemia in patients with total thyroidectomy. Study Design: Comparative study. Setting: EAST Surgical Ward, MAYO Hospital Lahore, Pakistan. Period: 1st July 2018 to 30th June 2020. Material & Methods: Sample size of 342 patients and duration of 2 years. 2 groups were created including 171 patients each. Group A patients received calcium and vitamin D supplements 1 week prior to total thyroidectomy while Group B patients didn’t receive any supplements. The results of both groups were compared. Data was collected by pre designed proforma and evaluated by SPSS 21. Results: 164 (47.9%) patients were male and 178 (52.0%) were females. Most common age group which undergone total thyroidectomy was between 31 years to 40 years. Total 140 patients (40.93%) experienced hypocalcemia. In group A, 32 (18.71%) experienced hypocalcemia while in group B 108 (63.1%) experienced hypocalcemia. The most common occurrence of hypocalcemia was noted on 1st post-operative day where 52 (37.14%) cases of hypocalcemia were reported. Conclusion: In a country with prevalent calcium and vitamin D deficiency the addition of these supplements one week prior to total thyroidectomy will lead to lesser incidence of hypocalcemia after total thyroidectomy and early discharge of the patient.
Cutaneous pilar leiomyoma completely treatable by surgical resection, a case report.
Authors:   DG Khan Medical College/ Teaching Hospital, DG Khan., Alam Iftikhar , Mujahid Abdul Malak ,   DG Khan Medical College/ Teaching Hospital, DG Khan.
Published: August 2021

Background: Cutaneous pillar leiomyoma (CPL) is a benign skin tumour of errector pili muscles and is rare condition. Clinically it appears as small nodule which are in the form of small groups. These are tender to touch, pressure, cold, and emotional stimuli. Different modalities have been tried to reduce pain and discomfort. Surgery is a treatment of choice in lesion which are very tender and associated with disturbance of social life. The objective of treatment in to achieve complete cure from pain with functional and aesthetic improvement. Case: A case of a male patient age 28 years, with multiple cutaneous leiomyomas on the left anterior chest wall and lateral chest wall. On clinical examination there were multiple nodular skin lesions that manifested as brownish erythematous. The lesions increased gradually during the last 2 years, extending to the left lateral chest wall. Complete surgical excision of tumor was done, followed by coverage with split thickness skin graft taken from the thigh. Patient was followed up fortnightly up to six month. Results: After surgical treatment, there was complete pain relief and acceptable cosmetic outcome, which allowed the social reintegration. Conclusion: Cutaneous pilus leiomyomas is difficult to treat. The radical resection of tumor is important to resolve the symptoms with prevention of tumor recurrence.
Corona virus lowers hemoglobin more in severe infection than mild COVID-19 infection.
Authors:   Rawal Institute of Health Sciences Islamabad., Chaudhry Zunnera Rashid , Rasheed Sana ,   Ameer-ul-din Medical College Lahore., Shakir Sabeen ,   Rawal Institute of Health Sciences Islamabad., Rashid Erum ,   Quetta Institute of Medical Sciences., Ansari Maliha ,   Rawal Institute of Health Sciences Islamabad., Rasheed Faiza ,   Mughal Eye Hospital Lahore.
Published: August 2021

Objectives: To study the effect of corona virus on blood hemoglobin and the changes this virus causes on hemoglobin in COVID-19 infected patients. Study Design: Observational study. Settings: Rawal institute of Health Sciences and Pakistan Institute of Medical Sciences, Islamabad. Period: Feb 2021 to April 2021. Material & Methods: Total 100 adult patients were included all were suffering from corona virus infection. COVID-19 infected patients belonging to both genders with no other cause of anemia were selected and all adult patients in which anemia was due to diseases other than corona infection were excluded. The blood samples of COVID-19 infected patients was taken in 5cc syringe and was send to the laboratory of Rawal Institute Of Health Sciences Islamabad for hemoglobin estimation. Blood heamoglobin (Hb) at the time of admission was recorded. Changes in their blood Hb was noted. Statistical Analysis: Data was be entered into SPSS version 23, normality of data was checked. For non-normally distributed data kruskal wallis and Mann whitney U test was applied and for normally distributed data Anova and post hoc was used. Spearsman correlation was used to correlate non distributed data and Pearson’s correlation was used for normally distributed data. Results: 100 adult patients were divided in two groups. Group I with mild symptoms of corona virus and group II with severe symptoms of corona virus. Patients with mild corona symptoms their blood hemoglobin level was 12.2 g/dl and those with severe corona symptoms their blood hemoglobin level was 10.0 g/dl. Conclusion: It was observed that patients suffering from severe disease of corona COVID-19 had reduced hemoglobin levels than those suffering from milder form of disease, thus confirming that corona virus effects the hemoglobin level and reduces its serum value causing anemia leading to complication of disease.
Comparison of post-tonsillectomy pain by using tramadol, lignocaine with adrenaline and normal saline swab in tonsillar fossae.
Authors:   KVSS Site Hospital Karachi., Khan Tahir Hussain , Rana Ashfaq Hussain ,   Shahida Islam Medical College, Lodhran., Afzal Mohammad ,   Shahida Islam Medical College, Lodhran., Bhutta Farooq ,   Shahida Islam Medical College, Lodhran., Malik Sohail A ,   Indus Medical College, Tando Mohamamd Khan.
Published: August 2021

Objective: To compare the effects of pain by using tramadol, lignocaine 2% with adrenaline and normal saline (placebo) after tonsillectomy. Study Design: Randomized Controls Trial. Setting: Department of ENT, Social Security Landhi Hospital Karachi. Period: March 2019 to October 2019. Sampling Technique: Non probability. Material & Methods: One hundred and twenty (120) patients with ASA-I status, age between 12 to 22 years were included randomly for this study. Divided the patients into three groups, group-1(L), group-2(T) and group-3(S) and forty (40) patients were in each group. In group-1(L), Lignocaine 2% with adrenaline used. In group-2 (T), Tramadol used and in group-3 (S), normal saline swab (placebo) used in tonsillar fossae at the end of tonsillectomies. Pain assessment done after 30 minutes in PACU and every one hourly for 6 hours post operatively in ward. If recorded VAS for pain was more than 5 analgesic injection given in ward for pain control. Result: The result of our research revealed that there were no significant differences in the mean ages of the patients, weight of patients, sex distribution and the duration of surgeries among the all three groups. Post-operative pain score were significantly higher in (S) group than in the other two groups (p<0.05). In Group-1(L) and Group-2 (T) pain score had non-significant (p>0.05). Duration of first analgesic demand was longer in Group-L and in Group-T versus normal saline (Group-S), it was 134 + 18 minutes in Group-L and in Group -T, it was 135 + 15 minutes while in Group-S, it was 34 + 11 minutes and p < 0.01 significant. Conclusion: Uses of lignocaine 2% with adrenaline swab and Tramadol swab are better choice in tonsillar fossae at the end of tonsillectomies for post-operative pain control versus normal saline (placebo) swab.
Entorno familiar de personas con discapacidad: una intervención desde el Trabajo Social
Authors: Vera Párraga Andrea Mercedes , Moreira Chica Tatiana Katiuska
Published: August 2021

Las personas con discapacidad, representan la lucha entre la inclusión y la justicia social basada en el apoyo que tienen por sus familias, por ello el objetivo de esta investigación fue determinar la incidencia de la intervención del Trabajo Social en el entorno familiar de personas con discapacidad. Se utilizó una metodología de carácter descriptivo, se apoyó con un enfoque cualitativo; utilizó el método bibliográfico, analítico, inductivo-deductivo, se utilizó la técnica de la entrevista, con el instrumento guía de entrevista la cual se aplicó a la Trabajadora Social del Departamento de Talento Humano y a familiares de trabajadores con discapacidad de la Universidad Técnica de Manabí, Matriz Portoviejo. El aspecto emocional es muy importante porque si la familia y la persona con discapacidad, están emocionalmente bien, les permitirá realizar sus actividades cotidianas con normalidad sin ninguna afectación ni desequilibrios, a modo de conclusión en la investigación se evidenció que la intervención de la Trabajadora Social en el entorno familiar de personas con discapacidad contribuye en la dinámica de la familia, atribuyendo en estas responsabilidades en el acompañamiento y cuidados cuando estos presentan inconvenientes en su estado de salud.
Retorno presencial a universidades en México y consecuencias de la salud mental por pandemia
Authors: Alvarado Melitón Diego , Berra Mondragón Sara Elena
Published: August 2021

En los primeros días de cuarentena se notaba escenarios de incertidumbre, momentos de mucho estrés, desmotivación, realmente parecía incierto que se lograran los objetivos educativos en una modalidad a distancia, pero también es cierto que poco a poco se pudo innovar en los procesos de aprendizaje para despejar las dudas de este reto educativo. A pesar de implementar recursos tecnológicos, las consecuencias en la salud mental de los actores sociales de la educación superior fueron más que evidentes antes, durante y actualmente por pandemia, como lo mencionan Cuenca, Robladillo, Meneses y Suyo-Vega (2020), por tal motivo se toman medidas sanitarias y apoyo socioemocional en las universidades públicas y privadas de acuerdo con Pinargote-Baque y Cevallos-Cedeño (2020), así como para evitar la propagación del virus y disminuir los trastornos mentales, teniendo en cuenta que el retorno presencial debe ser de manera voluntaria, escalonada o por necesidades practicas educativas. El propósito en este ensayo es destacar las consecuencias de la salud mental y la intervención oportuna en docentes y alumnos universitarios ante el regreso presencial por medio de profesionales especializados para afrontar las repercusiones de la pandemia.