bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Vaginal Infections in Preterm Labour
Authors: Khan Rakhshinda Inam , Bashir Bushra , Sultan Shahnaz , Rafique Hajra , Alia Asifa , Gul Sanila
Published: September 2022

Objective: The purpose of this study is to determine the association of vaginal infection in preterm deliveries. Study Design: Retrospective/prospective study Place and Duration: Gynaecology and Obstetrics department of MSF Women’s Hospital Peshawar and King Abdullah Teaching Hospital, Mansehra for the duration of six months form August 2021 to January 2022. Methods: Total 76 females with ages 18-(42) years were presented in this study. After receiving informed written consent, detailed demographic information about the enrolled patients, such as age, body mass index, domicile, and educational status, was recorded. Gravidity status and history of preterm deliveries were also assessed among all cases. Association of microorganisms was diagnosed by taking high vaginal swab and sent for test in bio lab. Prevalence of vaginal infections and risk factors were calculated. SPSS 23.0 was used to analyze all data. Results: Among all, 40 (52.6%) were ages between 18-28 years, 22 (28.9%) had age 29-38 years and 14 (18.4%) patients were aged between 39-48 years. Majority females 55 (72.4%) had BMI <25kg/m2 and 21 (27.6%) had BMI >25kg/m2. As per socio-economic status, 44 (59.2%) cases had poor, 20 (26.3%) cases had middle and 12 (15.8%) patients were from upper class. There were 27 (35.5%) patients had history of preterm deliveries. Frequency of vaginal infections was found in 28 (36.8%) cases. UTI was found in 22 (28.9%) patients. Among HVS culture test, candida found in 25 (35.9%) patients. E.coli was the most common micro-organism found in 10 (13.2%) patients. Conclusion: This study led us to the conclusion that vaginal infections greatly contribute to the unnecessary causes of premature labour. Screening for asymptomatic genitourinary infections in pregnant women is always a good idea. Early diagnosis and timely treatment of vaginal infections help reduce preterm labour and the related neonatal morbidity and mortality of premature newborns. Keywords: Vaginal Infections, UTI, Preterm Delivery, E.coli
The Frequency of Elderly Patients with Diabetes Type II Having Risk of fall and Impaired Balance; A Cross Sectional Survey
Authors: Alam Ayesha , Anjum Usman Zahoor , Idrees Kinza , Rahman Hamna , . Malia , Arif Rabia
Published: September 2022

Background: Diabetes Mellitus type 2 causes multiple complications like peripheral neuropathy, retinopathy and vestibulopathy. Diabetic neuropathy was one of the very common and long-term complications of DM which worsen throughout time. Postural variability and balance illness were mutual findings in DN due to lessened proprioception. Objective: The objective was to determine the frequency of elderly patients with diabetes type II having risk of Fall and impaired Balance. Methods: It was a cross sectional study. The Sample size was 133 participants surveyed through convenient sampling technique. Total time from May to October 2021 was utilized for study. Berg Balance Scale was used to determine the risk of fall in older adults having diabetes mellitus type 2. Participants were appearing for assessment for once. Data was analyzed on SPS S version 25. Results: The result showed that 76.7% patients were independent in their daily life activities. The results of our study were that total 23.3% patients were at the risk of fall. The means and standard deviation of total score of Berg Balance Scale was found to be 44.49±10.48. Conclusion: Based on findings of study it was concluded about one fourth of patients were at risk of fall and impaired balance. The adverse effects associated with diabetes mellitus like retinopathy, vestibulopathy and diabetic neuropathy may contribute to worsening balance and fall risk. Keywords: Vestibulopathy, Berg Balance Scale, Diabetic Neuropathy, Balance Impairment, Retinopathy
Factors of Depression and its Prevalence among Pregnant Females Attending Antenatal Clinics in Pakistan
Authors: Farooq Rizwan , Afsar Saima , Mehdi Muntazir , Jaffar Muhammad Ali , Ashfaq Sara , Hotiana Usman Amin
Published: September 2022

Depression is a disorder that affects the persons mood and its incidence is one in four females occurs at any time in their lives, so it's no wonder that pregnant women are also affected by this condition. However, depression during pregnancy is often misdiagnosed as fluctuations in a woman's hormone levels are believed to be the cause of many of these changes. In the hope that a diagnosis can, be made at a very early stage and that preventive measures can be taken later, the first step is to govern the pervasiveness of depression in pregnant females. The available evidence of depression in pregnancy varies widely. We need relatively short estimates to determine the severity of a depressive illness and develop a coping strategy for disorders of depression. Aim: To access the depression prevalence among pregnant females admitted to the gynecology department. Place and Duration: In the Psychiatry department of Behavioral Sciences PGMI/AMC/LGH, Lahore and Timergara Psychiatry Clinic in Pakistan for the duration of six months from September 2021 to February 2022. Methods: Data were gathered from 250 pregnant women by randomly collecting samples during their antenatal visits. The Depression Standard Scale named the "Hamilton Rating Scale for Depression," was used and depression was labelled if score greater than 7 on the Standard Rating Scale. The analysis of the result was performed using the SPSS program and chi-square test. Results: The incidence of depression in gravid females was 82%. The study found 45 (18%) completely normal, 100 (40%) mild depression, 65 (26%) moderate depression, 28 (11.2%) had severe depression, and 12 (4.3%) were very severe depression. 0.013 was a statistically significant value of P. Conclusion: The data showed increased prevalence of depression among pregnant females in Pakistan, reaching 82%. Depression is much common in younger females, those with fewer births and pregnancies, and those living in a shared family system. Keywords: Depression; Prevalence; Pregnancy and Prenatal period; Psychiatric disorders and Mood disorders.
Post-Operative Outcome of Open Cholecystectomy in Patients Receiving Spinal Versus General Anesthesia
Authors: Hafeez Imran , Siddiqui Maqsood Ahmed , Ali Imran , Kumar Kelash , Soomro Ahmed Uddin , Qayoom Aqil
Published: September 2022

Aim: The purpose of this study was to analyze the postoperative outcome of open cholecystectomy in patients receiving spinal versus general anesthesia. Study design: Analytical cross-sectional study Place and Duration: this studay was conducted in King Abdullah Medical City Makkah Kingdom of Saudi Arabia from January 2020 to January 2021. Methodology: A total of 180 patients that had the surgery of open cholecystectomy under spinal as well as general anesthesia were included in this research. All patients who had pancreatitis, contraindication to spinal anesthesia or general anesthesia, or severe cardiopulmonary diseases were excluded from the study. Patients were randomly distributed into two groups which are SA and GA groups, with each group having 90 patients. The sample size was determined via open epi. After the surgical procedure, patients were followed and analyzed for postoperative outcomes. Results: A total of 140 patients were female while 40 patients were male. Patients in the SA group did not face post-operative pain till 8 hours. But patients in the GA group complained of postoperative pain after an hour of open cholecystectomy. The postoperative outcome included nausea or vomiting which was common in both groups and post-Dural headaches which were more common in patients of the SA group and was cured without giving any medication. The sore throat was more common in patients of the GA group. However, no respiratory depression was found in patients of both the SA as well as GA groups. Conclusion: Spinal anesthesia as compared to general anesthesia reveals longer pain-free hours and fewer adverse effects after open cholecystectomy. Nausea or vomiting was common in both groups, and no respiratory depression was found in patients from SA as well as the GA group. Open cholecystectomy needed training due to the factors that lead to conversion to laparoscopic surgery, such as incorrect anatomy and the onset of complications. Keywords: open cholecystectomy, anesthesia, spinal anesthesia, general anesthesia, postoperative outcome
Clinical Characteristics of Pediatric Thoracolumbar Spinal Injuries: A Retrospective Study
Authors: Shah Syed Aamir , Ullah Saeed , Memon Musadique Latif , Ujjan Badar Uddin , Sharif Muhammad Mujahid , Qureshi Amjad Ali
Published: September 2022

Aim: To determine the clinical characteristics of pediatric thoracolumbar spinal injuries Study design: A retrospective study Place and Duration:This study was conducted at Pakistan Institute of Medical Sciences Islamabad from Jan 2021 to Jan 2022 Methodology:An analysis of pediatric thoracolumbar (TL) injuries was conducted to determine the epidemiology, risk factors, mechanisms, patterns, and management of pediatric TL injuries. A plain radiograph (anteroposterior and lateral view) was taken on all patients for diagnosis. In the case of surgical intervention or doubtful skeletal abnormalities observed on plain radiographs, thin-slice computerized tomography (CT) scans were obtained. In patients with neurological deficits or those who were scheduled for surgical intervention, magnetic resonance imaging (MRI) was performed. Results:A total of 90 children were treated at our institute for TL spine injuries, representing 2% of all spine injuries. Males predominate (3:1) with a mean age of 15.9 plus 3.2 years (range: 2–18 years). Falling from a height was the most common mode of injury. Most children (71.1%) sustained injuries after falling from height, 18/90 (20%) after a motor vehicle accident, and the rest after a heavy object fell over their neck. A total of 27.8% of the patients (the majority) had Grade A injuries. The most common spinal level injured was the lumbar spine (53.3%), and fractures accounted for 93.3% of all injuries. A total of 18/90 (20%) children underwent surgical fixation. There were 21 children available for follow-up, of which 13 (62%) were ambulant. Conclusion:The lumbar area is most affected by TL injuries, which are uncommon and most often occur in youth older than 10 years. When necessary, a surgical fusion of the affected vertebrae is a secure and reliable procedure. Keywords: Pediatrics, epidemiology, spine, thoracolumbar, injury
A Comparison Thyroid Function Test Between Patient Group and Control Group Among Women Had Thyroid Disorders
Authors: Abood Bushra Hassan , Alhussaynei Ahmed Jasim
Published: September 2022

Background: Thyroid disorders are more common in women, and it is associated with infertility, menstrual irregularities, and pregnancy loss among women of childbearing age. Objectives: Comparison thyroid function test between patient group and control group among women had thyroid disorders. Materials and methods: A sample of a case-control study consisting of (100) clients from two hospitals in Salah al-Din Governorate/Iraq. The study was conducted during the period from(31th of October 2021 to 2th of August 2022) included obtaining a blood sample for thyroid function tests. Data were analyzed using SPSS software v.25.0 and Microsoft office 2010.
Sonographic Findings in patients of Hepatitis B & C
Authors: Ali A. Raza, N. , Qayyum S. , Farooq S. M. Y. , , Jillani A. , Nauman M. , , Ghazi A. R. , Mushtaq H. Imran, S. , Abidin M. Z. Ul
Published: September 2022

Background: Role of Ultrasound into Acute Viral Hepatitis is inadequate for excluding jaundice surgical reasons. Though, here are definite features of ultrasound that may assist us for expect acute viral hepatitis in preliminary only some days previous to clinical jaundice onset. Aim: To determine the sonographic findings in patients of Hepatitis B and Hepatitis C. Methodology: A descriptive study was conducted at The university of Lahore Teaching Hospital Lahore after Ethical Review Board approval at university of Lahore faculty of Allied Health sciences, Lahore. On the basis of diagnosis inclusion criteria were included adult patients of both genders for abdominal ultrasound. And patients who are willing to participate. In exclusion Criteria excluded the Patient present with any known pathologies. Collection of data was done by the help of convenient technique of sampling according to gender, age as well as sonographic findings of patients with acute viral hepatitis B & C. Results: Out of total number of 162 patients, 129(79%) were males and 33(20%) were females, 94(58%) patients had fever and 68(42%) had no fever. Out of total number of 162 patients, 57(35%) patients had positive Hepatitis B, 105(64%) had negative, 73(45%) patients had positive Hepatitis C, 89(54%) had negative, 67(41%) patients alter liver parenchymal echotexture, 68(42%) had coarse liver echotexture and 27 (16%) had normal homogenous echotexture. 63(38%) patients had irregular margins of liver and 99(61%) had regular margins of liver. 63(39%) had chronic liver disease, 25(15%) had hepatomegaly and 74(45%) had normal size. Conclusion: From our study, we concluded that cirrhosis of liver related with Hepatitis B and Hepatitis C virus more ordinary within man than woman. Cirrhosis of liver related with Hepatitis B and Hepatitis C virus are majorly affect the rural areas. Keywords: Hepatitis B & C, Ultrasonography, Chronic liver disease, Jaundice, liver parenchymal disease.
Comparative Effects of Neurodynamics With and Without Wrist Splint in patients with Carpal Tunnel Syndrome
Authors: Shabbir Sidrah , Naeem Farah , Aroob Aqsa
Published: September 2022

Aim: To compare effectiveness of neurodynamics with and without wrist splint in patients with carpal tunnel syndrome.Study design: Randomized controlled trial. Settings: Farooq Hospital & Akhtar Saeed Trust teaching hospital,Lahore. Methodology: In present study 34 patients were randomly allocated into two groups in which each group contains 17 patients. Group A received combined treatment approach of neurodynamics and wrist splint while group B received only neurodynamics for two weeks .Improvement in functions and pain were recorded after 2 weeks .Initially baseline measurements were taken on DASH questioner and VAS. Present RCT study was carried out at Akhtar Saeed Trust Hospital,Lahore. Analysis was established through SPSS. Results: Independent sample t test was applied in present study of 34 patients as the mean difference was greater in group A in which combined treatment approach of wrist splint and neurodynamics were applied as compared to other group B in which only neurodynamics were applied.The p value is < 0.05 which shows results were significant. Results were more significant and superior in group A as compared to group B. Conclusion: Group A in which neurodynamics and wrist splint were used found to be more effective as compared to group B in which only neurodynamics were used. Keywords: Carpal tunnel syndrome; neurodynamics; wrist splint.
Incidence of Dysphagia after Acute Stroke
Authors: Ansar Sidra , Ahmed Muhammad , Zaman Saira , Azmat Rabia , Khan Azam
Published: September 2022

Background: It has been reported that dysphagia is a commonly documented morbidity after stroke, but its reported frequencies are widely discrepant. There is emerging evidence that early detection of dysphagia in patients with acute stroke reduces not only these complications but also reduces length of hospital stay and overall healthcare expenditures. Aim: To determine the incidence of dysphagia after acute stroke. Methods: This is descriptive observational study was conducted between October 2013 to January 2014 at CMH Lahore.A total of 40 patients with stroke were included in this study.Incidence of dysphagia after acute stroke was determined by collecting data from the patients with stroke by using a questionnaire. The questionnaire constituted the questions regarding dysphagic issues. Results: Result indicated that out of 40 subjects 32(80%) were male and 8(20%) were female and the mean age of patients was 30.0± 88 years. The data on clinical findings of the patients with stroke showed that almost 27(67.5%) had swallowing problem and 13(32.5%) didn’t have swallowing problem. The evaluation of these patients with dysphagia showed that 3(7.5%) were diagnosed with swallowing problem at oral stage, 20(50%) at pharyngeal stage and 4(10%) at esophageal stage and level of their swallowing difficulty was 6(15%) mild, 10(25%) moderate and 11(27.5%) severe. Further investigation revealed that 10(25%) had coughing , 10(25%) choking and 7(17.5%) difficulty in swallowing and difficulty in swallowing reported by the patients was 14(35%) in liquids, 2(5%) in semi-solids and 11(27.5%) having problem in swallowing solids. Conclusion: It is concluded from the above study that incidence of dysphagia depends upon the severity of stroke and type of stroke. Keywords: Stroke, Dysphagia, Odonophagia.
Severity of Depression in Mothers of children suffering from Cerebral Palsy
Authors: Goheir Ayesha , Jadoon Alamzeb , Fayyaz Syeda Shazmina , Kiran Nazma , Akhtar Naveed , Qamar Zia
Published: September 2022

Background: Cerebral palsy (CP) is the most common cause of motor disability in children with worldwide having incidence of 2 per 1000 live births. Children with CP have motor disability, decreased ability to walk, poor feeding and limited exposure to sunlight. Malnutrition, behavior challenges and motor deficits in CP children are common causes of depression in their mothers. Aim: The present study focused to estimate the severity of depression in mothers, looking after the children suffering from severe CP and to compare their depression scoring with the scores of mothers having healthy children. Methods: The cross-sectional comparative study included 21 mothers having children suffering from severe CP and 21 controls (Mothers of normal children). Depression was calculated by the Beck Depression Inventory (BDI). Results: A statistically significant difference was observed between the mean scores of BDI II between the two groups Conclusion: Results revealed that mothers having CP children are more depressed than mothers having healthy children. It imitates the importance of psychiatric, social and family support to mother along with the treatment of the child. Keywords: CP, depression, BDI II.
Ivermectin A Potential Treatment In Covid-19, Related to Critical Illness
Authors: Qadeer Rashid , Kashif Syed Muhmmad , Kumar Darshan , Mehmmood Madiha , Lal Jawahar , . Faizan
Published: September 2022

Aim: To evaluate the potential use of ivermectin with standard therapy among mild to moderate covid-19 illness. Methods: This is a single-centered, prospective observational, randomized, parallel group (1:1 ratio), standard versus controlled ivermectin study recruited 210 confirmed COVID-19 positive patients who were admitted in COVID treatment center of Dr Ruth Kum Pafu Civil hospital Karachi, Pakistan from 1st November 2020 to 30th May 2021. Data were analyzed using SPSS version Results: Total of 210 patients were enrolled in the study and aged matched patients were divided in two groups 105 patients received ivermectin 6 mg twice a day for five days along with standard therapy while remaining 105 patients received standard therapy as per local and international guidelines.
The Aim of Higher Education
Authors: Hashim Muhammad Jawad
Published: September 2022

The aim of higher education is to nurture higher order thinking. College students attain mastery by acquiring expert ways of thinking. Learning is reflecting. Teachers should aim to stimulate curiosity and a desire to learn. A teacher’s enthusiasm drives learning. Teaching should not cover all topics in the curriculum as this is based on a misperception of the teacher’s role. Teaching is inspiring. Learning during higher education ought to extend beyond discipline-specific expertise to include four higher-order competencies: liberated learning, deep thinking, clear communication, and focused resilience. These in turn, are based on five core skills, namely, writing, numeracy, financial acumen, computing expertise, and design skills. Operationalization of these aims can be achieved via careful course planning, matching assessment to learning goals, and teaching strategies such as Lecture Plus. Lecture Plusis a lecture followed by a learning activity. Learning activities include small-group exercises. Course planning should aim for higher order thinking. Keywords: Education, Graduate; Education, Professional; Teaching Methods
Clinico-Pathological Profile of patients Suffering from Chronic Liver Disease Secondary to Viral Hepatitis
Authors: Ali Muhammad Ahsan , Ali Ijaz , Afridi Nazar Muhammad , Arif Syed Irfan Raza , Anjum Muhammad Usman
Published: September 2022

Aim: To analyze clinical, biochemical & treatment profile of patients suffering from CLD secondary to viral hepatitis in our region. Duration & place of study: Descriptive study, January 2021 to July 2021 at Frontier Medical & Dental College, Abbottabad Methods: All patients having chronic liver disease secondary to viral hepatitis with or without complications were enrolled in this study. A diagnosis was made based on clinical findings, biochemical tests, ultrasonography of abdomen and upper GI endoscopy findings. Inclusion criteria further included presence of stigmata suggestive of chronic liver disease and clinical and laboratory parameters which were indicative of portal hypertension. Patients who refused to give consent, pregnant female patients and patients suffering from CLD caused by etiological factors other than hepatitis viruses and who were terminally ill were excluded. Results: Mean age of these patients was 41.25±12.59 years. There were 138 males and only 16 female patients. Majority of the patients, 79.22%, developed anorexia. A large number of patients, 82.47%, had hepatomegaly while 58.44% had firmness in their liver. About 79.87% had splenomegaly, 66.23% had spider naevi, 86.36% had ascites and 87.67% had esophageal varices. Almost half of our patients, 50.65%, used steroid therapy while a large majority of them, 85.06%, were taking antiviral treatment. Mean values of bilirubin, alkaline phosphatase, alanine aminotransferase (ALT), albumin and prothrombin time (PT) were 1.43±1.21 mg/dL, 105.33±51.51 U/L, 85.89±89.65 U/L, 3.82±0.65 g/dL, 62.57±22 seconds respectively. Conclusion: Chronic liver disease secondary to viral hepatitis especially hepatitis B and C virus is quite common in our country. It presents with typical stigmata both clinically and pathologically. There is a need to identify these stigmata and diagnose this condition early to avoid complications in these patients. Keywords: Hepatitis, antiviral, hepatomegaly, liver, bilirubin
To Study the 99th Percentile Upper Reference Limit of High Sensitive Troponin T in adult population of Multan
Authors: Khan Mehreen Aftab , Hafeez Ayesha , Khan Sikandar Hayat , Altaf Mehmooda , Hurr Syed Twanger Hussain
Published: September 2022

Aim: To determine 99th percentile upper reference limit of high sensitive Troponin T in adult population of Multan Methodology: A cross sectional study conducted in the department of chemical pathology, CMH, Multan from September 2021 to March 2022. Approval by the institutional review board was taken. Sample size was 265 cases. Results: Mean age was 46.2 + 12.7 years. 131(49.6%) were females and 134 (50%) were males. In 265 cases, there were 210 (79.24%) cases who had hs-TnT level of >2.99 ng/L and 55 (20.75%) have values of hs-TnT <3.0 ng/L. Cases having a level of <3.0 were assigned a value of 2.9 ng/L for statistical analysis. Kruskal-Wallis test was used to analyze significance in troponin level regarding age and gender. hs-cTnT values were found statistically significant between genders while non significant difference between age groups. Conclusion: hs-cTnT value was 18.20 ng/L in the study cases while these values were 30.46ng/L for males and 16.77ng/L for females. It is concluded that overall 99th percentile values of hs-cTnT are significantly higher among men as compared to women. Key words: High sensitive Troponin T, Adults, percentile
Role of Acute Symptomatic Seizures and Hippocampal Sclerosis in Development of Post-Stroke Epilepsy
Authors: Mahmood Adnan , Khan Muhammad Imran , Imran Rashid , Ahmad Mohsin , Tariq Adnan , Rashed Muhammad Fateen
Published: September 2022

Aim: To analyze the risk and role of acute symptomatic seizure and hippocampal sclerosis in the development of post-stroke epilepsy. Study Design: Retrospective study. Place and duration of study: Department of Neurology, Gujranwala Medical College, Gujranwala from 1st July 2021 to 31st December 2021. Methodology: One hundred patients were enrolled on the basis of acute ischemia or hemorrhagic stroke occurrence. These two conditions were confirmed through MRI imaging. Atrophy formation, alterations in signals visibility in T1 as well as T2 weighted-sequences in addition to internal architecture loss with atrophy of hippocampal was the MRI criteria for diagnosis of hippocampal sclerosis. A control group was also generated of fifty patients to assess the clinical diagnostics of hippocampal sclerosis patients against normal controls. Results: There were 57% males and 43% females with a mean age of 74.2±13.2 years. Ischemia was seen in 40% of the cases while hemorrhagic stroke was present in 62% of all the patients enrolled. Acute symptomatic seizures were present in 30 cases while it was not observed in 70 other cases. The EEG of hippocampal sclerosis presented fronto-parietal stroke and left parieto-temporal strokes while in controls with majority as cerebral venous sinus thrombosis, in addition to basal ganglia hemorrhage. Conclusion: Acute hemorrhage from stroke in combination with the acute and symptomatic seizure results into epileptic episodes and in many cases to secondary formation of hippocampal sclerosis. Keywords: Acute symptomatic seizures (ASS), Hippocampal sclerosis, Post-stroke epilepsy
Frequency of In-Hospital Outcomes in patients with Acute MI who have had a Premature Coronary Artery Disease
Authors: Raza Muhammad Hussan , Iqbal Zahid , Rashid Munir Ahmed , Saad Abubakr Ali , Shehzad Amir , Dastgeer Saima
Published: September 2022

Background: In underdeveloped nations like Pakistan, a recent estimate showed that the CVD deaths ratio is about 80%. This increasing prevalence of heart disease is partly due to industrial and technical advancements, which are linked to economic and social revolutions that have resulted in lifestyle changes and sedentary behavior. Aim: To determine frequency of in-hospital outcomes in patients with AMI who have had a premature coronary artery disease. Methodology; Study design; Descriptive case series. Setting; Department of Cardiology, D.G. Khan Medical College and teaching hospital, D.G.Khan.Duration; Six months.Results: The findings revealed that male patients made up 96 (66.2%) of the 145 research cases, while female patients made up 49 (33.8%). Our study participants were 47.67± 7.59 years old on average (minimum age 35 years and maximum 63 years). Before arriving at the hospital, the average time was 113.79 ± 54.36 minutes. In our research, 19(13.1%) of the individuals died, 36(24.8%) experienced post-MI angina, and 29(20%) had a cardiogenic shock. Conclusion: According to our findings, patients with early coronary artery disease and acute myocardial infarction had a significantly higher likelihood of poor clinical outcomes. Keywords: Acute myocardial infarction, mortality, and premature coronary artery disease.
Association of Serum 25(OH) D Levels with Gestational Hypertension and Risk of Pre-eclampsia in Our Population
Authors: Ainee Noor-Ul-Ain , Malik Uzma , Nisar Aatka , Abid Hafiza Haleema , Naz Samina
Published: September 2022

Background: Pre-eclampsia is a syndrome of immune system of pregnant females, which causes severe obstetrical complications. Low serum level of 25-hydroxyvitamin-D is common during pregnancy complicated with preeclampsia but local evidence is missing. Aim: To determine the association of pre-eclampsia with decreased vitamin- D levels during two phases of gestation (after 20 weeks) over a period of six months. Study design: Cohort study Place and duration of study: Department of Obstetrics and Gynaecology, Lady Willingdon Hospital, Lahore from 4th February 2019 to 3rd August 2019. Methodology: One hundred and seventy females were enrolled in study at 20 weeks gestational age. They were divided into two groups (85 patients in each group). Those with normal Vitamin D3 levels (>30 ng/ml) were grouped as Low risk group and those with relatively low (insufficient) serum vitamin D3 levels (between 21-29 ng/ml) were grouped as high-risk group with potential risk factor for pre-eclampsia. Both groups were followed from 24+1 weeks to 36 weeks of gestation with every two weeks’ interval, for assessment of development of pre-eclampsia or not. Both groups were followed up and outcome was noted. Results: The mean age of the patients was 26.44±4.08 years and mean gestational age was 35.47±2.34 weeks. One hundred and 42(83.53%) patients appeared with PIH while 28(16.47%) patients appeared with preeclampsia. Among high risk patients, preeclampsia was noted in 26(30.6%) patients while in low risk group patients, preeclampsia was noted in 2(2.4%) patients (p<0.001). Conclusion: A significant association observed between pre-eclampsia and decreased vitamin D level during phases of pregnancy. Keywords: Vitamin D level, Preeclampsia, Hypertension
Frequency of Polyhydramnios among Patients with Preterm Delivery at Lady Reading Hospital, Peshawar
Authors: Jalal Sadaf , Khattak Saima , Firdus Alia
Published: September 2022

Background: The elevated risk of premature delivery should be discussed with polyhydramnios patients. It is advisable to measure the cervical length to evaluate whether or not it is necessary to administer steroids to encourage foetal lung maturity. Patients should also be made aware of the dangers associated with unstable labour necessitating caesarean delivery, umbilical cord prolapse, abruptio placentae, and postpartum haemorrhage. Aim: To determine the frequency of polyhydramnios among patients with preterm delivery presenting to Lady Reading Hospital Peshawar. Study design: Cross-sectional study. Place and duration of study: Department of Obstetrics & Gynaecology, Lady Reading Hospital Peshawar from 1st November 2019 to 25th April 2020. Methodology: One hundred and eighty one women with preterm delivery, gestation age of 24-36 weeks and age between 18-45 years were included. The obstetrical records of these patients were evaluated for the presence of polyhydramnios using AFI they were classified as mild, moderate, and severe polyhydramnios based on AFI. Results: The mean age was 30.39±3.53 years, mean weight of 68.33±7.52 Kg and mean height of 1.59±.0.07 meters, mean BMI 27.07±3.71 kg/m2, mean gestational age 32.30±1.89 weeks and mean AFI was 18.38±6.85 cm. Polyhydramnios was seen in 17.7% of patients. Mild polyhydramnios was 28.1%, moderate 40.6%, and severe was 31.3%. Conclusion: Preterm labour appeared to be influenced more by the underlying aetiology of polyhydramnios than by the relative excess of amniotic fluid as identified by this investigation Keywords: Preterm delivery, Polyhydramnios, Severity
Clinical Risk Index Score (CRIB II) as a Predictor of Neonatal Mortality among Premature Babies
Authors: Qasim Sadia , Zahid Sehar , Islam Ashbah , Anwar Muhammad , Siddique Shahzia , Rafique Arshad
Published: September 2022

Aim: To determine predictive accuracy of CRIB II score in predicting mortality among premature with low birth weight neonates. Study design: Cross-sectional study. Place and duration of study: Paediatric NICU, Services Hospital Lahore from 2nd June 2017 to 2nd December 2017. Methodology: Two hundred and forty preterm new-born born before 32 weeks and birth weight from 600-1500grams were enrolled. Temperature was measured using rectal thermometer. Arterial blood gas sample was taken using standard sampling technique for base excess. Premature infants were evaluated for CRIB-II Score within 1 hour of arrival. Neonates were followed for 28 days to assess for their survival status. Results: The mean CRIB-II score was 10.95±2.79, mean gestational age was 29.16±1.58 weeks and mean weight was 1111.13±202.28 grams. There were 123(51.25%) males and 117(48.75%) were females. Actual neonatal mortality was 82(34.17%). Predictive accuracy of CRIB II score in predicting mortality among premature and very low birth weight neonates admitted to NICU was 92.68% for sensitivity, 94.94% specificity, 90.48% positive predictive value and 96.15% had negative predictive value. Conclusion: The predictive accuracy of CRIB II score is higher in prediction of mortality among premature and very low birth weight neonates. Keywords: Neonates, Premature, Very low birth weight, Mortality, CRIB II score, Prediction
Comparative Evaluation of Efficacy of Chemical Versus Surgical Anal Sphincterotomy in patients with Acute Anal Fissure
Authors: Lodhi Junaid Khan , Bokhari Saba Tahir , Malik Aasim , Hameed Fawad , , Zubair Muhammad , Shoaib Muhammad
Published: September 2022

Background: One of the common causes requiring hospital admission on surgical floor is anal fissure. The quality of life is immensely affected due to painful defecation and bleeding per rectum. Due to poor response to chemical management, acute anal fissure is now treated with surgical methods. Lateral internal sphincterotomy has now become definitive surgical procedure in the treatment of anal fissures. Aim: To compare the efficacy of chemical and surgical lateral internal sphincterotomy in patients of acute anal fissure. Methods: This study was conducted in surgical unit 1 from January 2020 to December 2020. A sample size of 100 were segregated in two groups of 50 each. Group-a was treated withlocal application of glyceryl trinitrate 0.2 percent ointment and group-b was treated with surgical lateral internal sphincterotomy. Results: Patients were ranged between 15-60 years of age. Mean age of the patients was 36.64±10.05 and 33.42±11.47 in group-a and b respectively. In group-a, 13 patients (26%) and in group-b 15 patients (30%) were male and 37 patients (74%) in group-a and 35 patients (70%) were female. Efficacy was observed in 16 patients (32%) of group-a and 50 patients (100%) of group-b. The p value of <0.001 was found to be statistically significant. Conclusion: In conclusion, surgical sphincterotomy was significantly more effective in providing postoperative pain relief (p<0.001). However, chemical sphincterotomy is a non-invasive, cost-effective, easier to apply, well tolerated and effective therapy for anal fissure and is a first line treatment especially in patients who are unwilling or unfit for surgery. Key words: chemical sphincterotomy, lateral internal sphincterotomy, acute anal fissure
Faculty and its Impact on Critical Thinking Abilities of Undergraduate Medical Students – A Delphi Study
Authors: Muqeem Ahmad , Sajid Sadaf , Arshad Syma , Khan Sofia Waheed , Ahmad Abdullah , Khan Hoorish
Published: September 2022

Aim: To identify the individual skills / attitude of faculty which influence fostering of critical thinking in undergraduate medical students Study design: Modified Delphi Study Place and Duration of study: This study was carried out at University of Lahore from October 2018 to April 2019. Methodology: Delphi Study was used to develop consensus. Experts were MME/MHPE/ MCPS HPE qualified faculty members with 03 years of teaching experience. A draft questionnaire was developed on Google Forms after thorough literature review and sent to 05 experts for Pilot Study, construct validation and cognitive pretesting. A Wait Time of 04 weeks, rating of questions on 5 point Likert Scale and consensus criteria of 80% were defined before the start of study. SPSS 25 was used for data analysis. During 1st Round, draft questionnaire was amended in the light of opinion of experts to open ended questions and was sent to all the participants for their response. Results: A total of 27 experts were enrolled in the study. 17 experts (62.96%) responded during the first round. Consensus was achieved for 13 items (65%) out of 20. In the 2nd round, 15 (88.23%) out of 17 responded. Consensus was achieved for all 7 items (100%). The study revealed that majority of our faculty lacks proper training and does not possess knowledge about various educational theories / principles and their application. They do not know how to act as facilitator, conduct tutorials, ask high order questions, reflect and provide constructive feedback. Conclusion: Individual skills / attitude of faculty hamper fostering of CT in undergraduate medical students. They are mainly due to lack of formal faculty training which should be addressed not only in the medical institutions but in the pre-medical schools as well to inculcate higher order critical thinking skills in students. Keywords: Critical Thinking (CT), Undergraduate Medical Students, Faculty, Reflections, Feedback
APACHE II Scoring System and its Probability Impact in Poly Trauma Patients at a Tertiary Care Center
Authors: Akhtar Ahmad Maeem , Farooq Nazia , Qasim Maheen , Gulzar M. Rehman , Rehman Khalil ur , Noor Muhhamd Ammar , Nisa Mehar un
Published: September 2022

Background: Trauma is one of the most significant causes for in hospital mortality. Different predictors are available to predict the patient outcome like revised trauma scoring system (physiological), Injury severity scoring system (Anatomical scoring system), APACHE II, AIS etc. Aim: To assess pobability of APACHE II score in evaluating mortality for poly trauma patients within first 24 hr of hospitalization. Method: Cross sectional study was conducted at surgical unit in Lahore General Hospital, Lahore from Jan, 2019 to Dec, 2020. APACHE II for each patient was calculated with devised software APACHE II Score- MDCalc. After fulfilling the inclusion and exclusion criteria, 300 patients were included in the study from emergency department of a tertiary care hospital. All the data was entered in proforma and was analyzed in SPSS 23. Results: Mean age was 32.53 ± 11.67 years with 205 (68.33%) male and 95(31.67%) were female patients. Out of 300, in hospital mortality occurred in 88(29.33%) while other 212(70.66%) were alive within 24 hours after admission. 88(29.33%) patients out of 300 had probability APACHE II score ≥ 12 and rest 212(70.66%) had ≤ 12. The sensitivity, specificity, PPV, NPV, and diagnostic accuracy of APACHE II was 90.16%, 94.2%, 88%, 92.84% and 90.74%. Conclusion: By using APACHE II scoring system for poly trauma patients we can devise an efficient treatment and resuscitation plan to reduce the probability of hospital mortality. Keywords: Trauma, prediction, mortality, APACHE II.
Efficacy of Pneumatic Lithoclast in Management of Different Metabolic Stones in Lower Ureter
Authors: Umer Muhammad , Ayub Ahsan , Jumadin Aneela
Published: September 2022

Background: Management of ureteral calculi represents one of the complex problems in urological practice. Aim: To study the efficacy of pneumatic lithoclast as a management option for different metabolic ureteric stones. Study design: Descriptive study. Methodology: Study enrolled both male and female patients (n=60) above 12 years of age. Stone size and metabolic type was determined with determining the Hounsfield units of the stone on plain abdominal CT scan and matching them with the predetermined ranges for specific stone types. Renal transplant and cancer patients were excluded. SPSS v.26 analyzed the data. Mean±SD presented quantitative variables. Results: Calcium oxalate stones were most frequent and were observed in 32 (53.3%) patients followed by Struvite (18.3%). Almost 96.7% ureteric stones were cleared with pneumatic lithoclast. Conclusion: It was concluded that pneumatic lithoclast is an efficacious procedure in urology in clearing different metabolic stones in lower ureter thus advocates its routine use. Keywords: Pneumatic Lithotripsy, Metabolic Stones and Ureteric Stone.
National response to the COVID-19 Omicron variant crisis in the ambulatory hemodialysis service in the State of Qatar
Authors: Hamad Abdullah I. , Asim Muhammad , Othman Muftah A. , Abuhelaiqa Essa A. , Shurrab Alaedine , Elmadhoun Ihab T. , Ali Al-Malki Hassan , Alkadi Mohamad M.
Published: September 2022

The coronavirus disease (COVID-19) pandemic has had a significant worldwide impact since its emergence in 2019. End-stage kidney disease patients have been among the most vulnerable population affected and have a higher risk of acquiring infection and developing more severe disease. We have encountered three major COVID-19 waves in Qatar and they have required different strategies to overcome. The most recent wave was due to the Omicron variant characterized by higher transmissibility. The monthly incidence of COVID-19 infection during the Omicron wave in patients with end-stage renal disease peaked at 256 patients compared to 35 and 39 patients during the first and second waves, respectively. In addition, more than one-third of our dialysis staff became infected during this wave. Unlike the previous two waves, COVID-19 due to the Omicron variant was less severe with only 5% of hemodialysis patients requiring admission to the intensive care unit compared to 25% during the previous waves. The Omicron variant wave resulted in a crisis in our country due to the high number of non-hospitalized COVID-19 hemodialysis patients and the severe staff shortage. Several measures were taken to overcome the crisis, such as designating one facility to dialyze all COVID-19 ambulatory patients, reducing dialysis sessions to 3 hours, and introducing a fourth dialysis shift.

This article describes the challenges we faced in the ambulatory hemodialysis service during the Omicron wave and the measures taken in the COVID-19 and non-COVID-19 designated facilities to combat the crisis.
AYDEDE 1922-1
Authors: ÜNAL Yenal
Published: September 2022

Refik Halit’in üzerine bazı değerlendirmeler yaptığımız “Aydede” adlı dergi yine onun mütareke döneminde bizzat yayımlayıp, makale ve fıkralar kaleme almış olduğu bir yayın organıdır. Bir bütün hâlinde değerlendirildiğinde “Aydede” aslında iki farklı yayın döneminde okuyucu ile buluşmuştur. Derginin birinci yayın dönemi 1922 yılında toplam 90 sayı yayımlanmak suretiyle gerçekleşmiştir. İkinci yayın devresi ise Refik Halit’in, ikinci sürgün döneminin bitişinden 10 yıl sonra 1948 yılında başlamış ve 1949’da son bulmuştur. Yani dergi farklı tarihlerde toplam 3 yıllık bir dönemde yayımlanmıştır. Türkolog Prof. Dr. Mustafa Apaydın tarafından Refik Halit’in bu dergide kaleme almış olduğu makale ve fıkralar toplam üç farklı kitapta “Aydede 1922-1”, “Aydede 1948-2”, “Aydede 1949-3” adlarıyla bir araya getirilerek neşredilmiştir.
Bu incelemede Apaydın tarafından yayına hazırlanmış olan “Aydede 1922-1” adlı çalışma hakkında çeşitli değerlendirmelerde bulunulmuştur. Bilindiği üzere içinde bulunduğumuz yıl Büyük Taarruz’un 100. Yıl Dönümü’dür. Büyük Taaruz’la ilgili etkinlik ve yayınların sayısında gözle görülür bir artış beklenmektedir. Bu nedenle Millî Mücadele’nin askerî aşamasının kesin bir zaferle taçlandırıldığı 1922 yılının birçok cepheden yorumlanması gerekmektedir. Bu noktada Refik Halit’in neşrettiği ve ilk yayın devresinde toplam 90 sayı çıkmış olan “Aydede” dergisinin yeniden gündeme gelmesinin son derece faydalı olacağı kanaatindeyiz. Tam 100 yıl önceki dönemde İstanbul münevverlerinin Millî Mücadele’ye bakışı, bu yıl boyunca Anadolu’da ve İstanbul’da yaşanan siyasi ve askerî gelişmelerin anlaşılmasında “Aydede”nin mükemmel bir örnek oluşturacağı aşikârdır. “Aydede” bu yayın döneminde hem Anadolu’da hem de İstanbul’da saray çevresinde sıkı bir biçimde takip edilen bir neşriyattır. Bu da derginin birçok muhit tarafından önemsendiğini göstermektedir.
Analysis of Career Aspiration and Teaching Profession among Women Choices at Graduate Level in Azad Jammu & Kashmir
Authors: Ane Fatima Syeda Zulul , Mushtaq Dr. Muhammad , Khan Dr. Saadia
Published: September 2022

This study intends to make analysis of career aspirations and teaching profession among women choices at graduate level in Azad Jammu & Kashmir. The objectives of this research was to assess the choice of female in selecting teaching as a profession and to find out association between family type and teaching profession of graduate students. Population consisted of  females’ graduate students of  three universities of Azad Jammu & Kashmir.  A sample of 450 female students were surveyed from 3 universities of Azad Jammu & Kashmir through questionnaire, 418 completed questionnaires were returned. The questionnaire was pilot tested producing the reliability value as (α =.726). Data was analyzed by applying regression, chi square. The study found that from total population 203 respondents prefer to choose teaching as a profession. Type of family is significant however family members are insignificant variable. It is also found that majority of female like to work in government department. It is recommended that the female need to be motivated for other professions as well. They should be provided opportunities in other professions with same security and other.
Effect of Role Play on Vocabulary Enhancement, Grammar Acquisition and Syntax Ability at Elementary Level in the Subject of English
Authors: Rahmanullah Rahmanullah , Tabassum Dr. Rabia , Attaullah Dr. Attaullah
Published: September 2022

This is an experimental study which aimed to examine the effect of Role Play method of teaching on vocabulary enhancement, grammar acquisition and syntaxability of the learners. The objectives of the experimental study were: (i) to explore the effect of Role Play on vocabulary enhancement of the students (ii) to investigate the effect of Role Play on grammar acquisition of the students (iii) to examine the effect of Role Play on syntax ability of the students. In order to obtain the above mentioned objectives, it was hypothesized that the effect of Role Play on vocabulary enhancement, grammar acquisition and syntax ability would be negative. All the students studying English in class 8thin the province of Khyber Pakhtoonkhwa constituted the population of this experimental study. The sample of this experimental study constituted the forty eight (48) male students studying English in class8th at The Knowledge School Khall, Dir Lower, KhyberPakhtoonkhwa. The experiment was steered through the Pre-test Post-test Equivalent Group Design. On the basis of the results of the pre-test, two groups i.e. control and experimental groups were made. Each group consisted of twenty four (24) students. Both the groups were taught the 8th class English course. The control group which was selected randomly was taught over routine method, while the students of experimental group were taught through the Role Play method of teaching. The duration of the experiment was six weeks. On a teacher made pre-test and post-test data were collected. Through t-test collected data were analyzed. The outcomes of the data discovered that the experimental group students showed better results in vocabulary enhancement, grammar acquisition and syntax ability than the control group students