bluuebunny/crossref_metadata_2025_split huggingface dataset:
Threat of Hepatic and Renal Toxicity in Patients with Chronic Suppurative Otitis Media and Possible Drug Response
Authors: Sohail Khan  , Mohammad Iqbal  , Sahibzada Fawad Khan  , Wasim Ahmad  
Published: December 2024

Objective: To assess the jeopardy of hepatic and renal toxicity in patients suffering from chronic suppurative otitis media and possible drug’s response to treat the condition.
Methodology: This was a case control trial that was conducted in patients with chronic suppurative otitis media reported to ENT OPD of Khalifa Gul Nawaz teaching hospital Bannu-KP. The duration of the study was from August 2021 to February 2021. Sample size was 160, that was calculated using WHO calculator. Sixty volunteers were included in the study. Negative control group, positive control group, patients treated with Co-amoxiclave, and patients treated with Ciprofloxacin, patients and healthy volunteers were randomized into four groups.
Results: The results of the study showed a significant increase in direct bilirubin levels, total bilirubin levels, SGPT, GGT and alkaline phosphatase in positive control group in comparison to negative control. The treated groups with antibiotics remained successful in recovering normal liver enzymes excepting SGPT and direct bilirubin. Blood glucose and urea was found to be insignificant in G2 and G3 groups whereas in G4 group, an increased creatinine was seen which was statistically insignificant.
Conclusion: Our study concluded that in patients suffering from chronic suppurative otitis media, hepatic toxicity might be induced if remained untreated. It is therefore, proper treatment with follow-up is required in these patients.
Serum Ferritin and Hemoglobin Levels in Female Cardiovascular Patients of District Peshawar, Of Khyber Pakhtunkhwa, Pakistan; A Hospital Based Study
Authors: Huma  , Faridullah Shah  , Mohammad Hashir Ahmad  , Attaullaah Khan  , Mudassir Ahmad Khan  , Zahoor Ahmed  
Published: December 2024

Objective: The study was conducted to assess iron and hemoglobin levels of female cardiovascular patients.
Material and Methods: Total eighty-six subjects including equal number of patients and controls were enrolled for the present study fulfilling the predefined selection criteria. About 5 mL blood sample was collected for each subject for determination of serum ferritin hemoglobin concentration. A 24-hr dietary recall method was used for estimation of dietary energy, carbohydrate, protein, fat and iron intake of subjects.
Result: The results showed non-significant difference (p>0.05) in the mean weight, height and body mass index between the cases and controls. The same results were noted for the biochemical parameters including serum ferritin and hemoglobin concentration. However significant (p<0.05) results were obtained for BP. Demographic and socio-economic status demonstrates that both cases and controls had large family sizes between 10-13 members with non-significant difference.
Conclusion: Logistic regression did not reveal any relationship between CVD patients and iron status indicators, rather age and BMI were the only independent variables associated significantly with CVD.
Correlation of Thyroid Disorders with Body Mass Index in Patients presenting to BINOR Hospital, Bannu Khyber Pakhtunkhuwa Pakistan
Authors: Ambreena  , Maryam Zeb Abbasi  , Muhammad Shoaib Khan  , Abdur Raouf  
Published: December 2024

Objective: To investigate the correlation between thyroid disorders and body mass index and to see whether the association is significant in the Pakistani population or otherwise.
Methodology: The cross-sectional was conducted in PAEC- BINOR Hospital, Bannu. Patients’ ages varied from 18 to 70 years. T3 FT4 and TSH were performed from the patients by the RIA technique, and BMI was calculated as per WHO standard criteria. Underweight (18.5), normal weight BMI (18.5–24.9), overweight BMI (25.0–29.9), and obese BMI (30.0 or higher) are the BMI cutoff values. Patients were classified into three categories; Hypothyroid, Hyperthyroid and Euthyroid on the basis of Thyroid function tests.
Results: Out of 200 subjects included in the study, 149 were females and 51 were males. Out of 200 participants, 77 (38.5%) individuals were categorized on the basis of thyroid function test reports into the hyperthyroid group, 53 (26.5%) were categorized as the hypothyroid group and 70 (35%) were categorised as Euthyroid group. Chi square test with each BMI categories showed significance association with thyroid disorders, p<0.005. The three categories of thyroid disorders were also separately correlated through Pearson’s correlation in which the hypothyroid group showed a significant positive correlation (p=<0.001, Hyperthyroid group showed significant negative correlation with p=<0.001 and the euthyroid group showed insignificant weak correlation with BMI. Thyroid hormones T3, FT4, TSH were also correlated with BMI by applying student T-test.
Conclusion: This study showed a significant correlation between thyroid disorders and body mass index, which indicates that obesity might be a risk factor for thyroid disorders. The hypothyroid group have a significant positive association with BMI, and hyperthyroid group has a negative correlation with BMI. In fact, there is no significant association between the euthyroid group and BMI. Thyroid hormones also show a significant correlation with BMI. TSH is positively correlated with BMI, while T3 and FT4 are negatively correlated with BMI.
Patient Satisfaction and Adherence to Treatment in Relation to Communication/ Interaction with Health Professionals a Cross Sectional Study
Authors: Juwayria Omar  , Adam Khan  , Farah Ibrahim  , Neha Farooqi  , Samiya Riaz  , Meenal Ahmed  , Nudrat Farid  , Hatim Shah  
Published: December 2024

Objective: To quantify the satisfaction level of patients in public, private, and semi-government hospitals in relation to their communication with health personnel and its effect on their treatment compliance.
Methodology: This was a cross-sectional analytical study. Convenient sampling was done and the sample size (N=228) was calculated using the Creative Research Systems Survey Software. Population under study included men and women over the age of 18 years with any experience at a hospital/ any interaction with medical staff. People who visit hakim and herbal shops were excluded. Data was collected through structured questionnaire by using Google Docs. After IRB-FMC permission the link of the questionnaire was then randomly distributed to the different known departments of Air University.
Results: Significant association between younger age, male gender and presence of attendant with satisfaction keeping p value at 0.05 was found. Friendly and easily accessible doctors and perception that the doctor prescribed accurately showed an association with satisfaction. There was association between having a chronic illness and being satisfied with adherence to treatment. No association was found between type of hospitals, monthly income and occupation with satisfaction level and adherence to treatment.
Conclusion: Satisfaction played a significant role in a patient’s adherence to treatment. Therefore, contributing factors like demeanor or IPS (Interpersonal Skills) significantly affected satisfaction and consequently, adherence.
Perineal Tears; Frequency, Severity and Risk factors in a Tertiary Care Hospital
Authors: Abrar Saida , Abrar Tahira , Sayyed Ehsan , Shahzadi Saima Hussain  
Published: December 2024

Objective: To observe the frequency, severity, and risk factors of perineal tears during vaginal delivery in a tertiary care hospital.
Methodology: This was a cohort study of women, aged 15-45 years, of ≥ 36 weeks gestation, with a cephalic presentation, delivered between 1st January and 30th December 2021 at Lady Reading Hospital, Peshawar. A structured proforma was used to gather data on women’s demographic, obstetric, and labour details. Women with perineal tears were grouped into the minor tears group (first and second-degree) and the major tears group (third and fourth-degree). Institutional Ethics Review Committee approval was taken (266/LRH/MTI).
Results: Among the 7304 deliveries, 876 women sustained perineal tears constituting a frequency of 11.99%. About 740 (84.5%) women had minor tears (First degree, n=256, Second degree, n=484), and136 (15.5%) had major tears (Third degree, n=99, Fourth degree, n=37). The mean age, body mass index and gestational age was 30.19+6.10 (range; 15-45), 32.02+2.77 (range; 25-40), and 38.9+1.53 (range; 36-42) respectively. Women with an instrumental vaginal delivery were more prone to have a major tear in comparison to a spontaneous vaginal delivery (p< 0.00). Primiparity, oxytocin, shoulder dystocia, instrumental vaginal delivery, and high birth weight were significantly associated with perineal tears. Women with instrumental vaginal delivery were more likely to have major tears without an episiotomy.
Conclusions: Perineal tear is frequent post-natal morbidity. Perineal tears are significantly high in primiparous women, oxytocin, shoulder dystocia, instrumental vaginal delivery, and high birth weight. Episiotomy should be given only when indicated.
Keywords: Perineal tears, Episiotomy, Risk factors.
Pain Intensity after Laparoscopic Cholecystectomy with Intraperitoneal Irrigation as Well As Periportal Infiltration of Bupivacaine Versus Without Bupivacaine
Authors: Naveed Gul Kazi  , Suhail Ahmed Soomro  , Mushtaq Ahmed Abbasi  , Abid Ali Soomro  , Riaz Hussain Shah  , Masood Ahmed Qureshi  
Published: December 2024

Objective: To compare the effectiveness of bupivacaine as intraperitoneal irrigation and local infiltration at port sites in terms of postoperative pain reduction to a control group that did not receive any bupivacaine injection.
Methodology: This study was carried out in the general surgery department of Liaquat University Hospital Hyderabad/Jamshoro from 2018 to 2019. Patients of uncomplicated gallstone disease, aged more than 12 years old admitted through the outpatient department, as well as from casualty department, undergoing laparoscopic cholecystectomies were included. Patients were randomly divided into two groups. At the end of surgery, the study group received bupivacaine as intraperitoneal irrigation and local infiltration bupivacaine in the port sites while the control group didn’t receive bupivacaine, admitted in the department of surgery, who came for uncomplicated gallstone disease as assessed preoperatively. Patients were assessed for postoperative pain up to 48 hours after surgery and pain was evaluated by visual analogue scale. All the information was collected via study proforma. SPSS version 26 was used for the data analysis.
Results: There was no difference between the two groups preoperatively in terms of demographic and laboratory data. The two groups were observed with similar operation time, blood loss without any postoperative mortality. The pain intensity, as rated by visual analog rating scales, was significantly less in the group receiving bupivacaine than in the control group. It was observed that there were significantly lower pain scores in the patients undergoing LC with local anesthesia, at different time interval as compared to the control patients (p<0.01). Regarding analgesia, the number of analgesia needed, were lower in patients undergoing LC with local anesthesia infiltration and irrigation than control group (p<0.010). The test group patients had a shorter hospital stay than controls.
Conclusion: It was concluded that irrigation of bupivacaine in peritoneal cavity and infiltration around the ports in LC patients significantly reduces the severity of postoperative pain and the analgesic requirement as compared to the control LC patient whom not received infiltration and irrigation with bupivacaine.
Analysis of indications of caesarean section: A retrospective study in a tertiary care hospital, to curb the rising caesarean section rate
Authors: Fatima Syeda Sitwat , Bawar Shandana 
Published: December 2024

OBJECTIVE: To examine the indications leading to the overall escalation of Caesarean Section(CS) rate in our population and to put forward strategies/interventions where possible practically to curb the escalating rates of CS in a tertiary care hospital.
MATERIAL AND METHODS:
This Retrospective Cross-sectional study was conducted in obstetrics department of Lady Reading Hospital Peshawar, for a period of 1 year from January 2021 till December 2021. The data was collected from hospital’s clinical records of the women who had CS delivery during the study period. Required information was entered into a structured Proforma. Data was analyzed on SPSS version 21.
RESULTS:
During the study period n=7376 women delivered in the obstetrics unit A, of Lady Reading Hospital. Out of these n=1679(22.76%) were Caesarean Sections. The number of Primary CS were n=1021(60.81%) while n=658(39.18%) were repeat CS. It was found that most of the CS n=1066(63.49%) were Emergency CS while n=613(36.51%) were Elective CS.
The most common indication for CS was Repeat CS in women with history of previous CS deliveries n=658 (39.19%).The 2nd most common indication was fetal distress n=302(18.04%) followed by Labour progress disorders n=235(13.99%).
CONCLUSION:
Majority of the women who underwent CS had the history of previous CS deliveries. It is the need of the day to educate the obstetricians and counsel/encourage women in antenatal period regarding the safety of procedures like externat cephalic version (ECV), trial of labour after caesarean section (TOLAC)and vaginal birth after caesarean section (VBAC), to reduce repeat CS in our setup.procedures like External Cephalic Version (ECV), Trail of Labour after previous Caesarean-Section (TOLAC) and Vaginal Birth after previous Caesarean Section (VBAC), if we want to reduce repeat CS in our setup. Moreover, CTG should be used only in high risk pregnancies/labours. Furthermore, adherence to WHO Labour Care Guide and skills and drills for reviving instrumental delivery in carefully selected cases may curb the escalating rate of CS.
Variation of Normal Hepatic Artery Doppler Indices Post Living Donor Liver Transplant
Authors: Rafique Muhammad Salman , Pervez Rayyan , Kundi Sana , Aslam Bushra , Aqeel Raheela , Malik Tahir 
Published: December 2024

Background: Due to the lack of deceased donors, adult-to-adult living donor living transplant (LDLT) has emerged as the procedure of first choice among liver transplantation procedures in most Asian countries. Hepatic artery complications can lead to graft ischemia and are one of the most frequent causes of graft loss in the immediate postoperative period. Ultrasonography, including doppler evaluation, is the established initial imaging modality of choice for early detection and follow-up screening of vascular complications.
Materials and Methods: This retrospective cohort study was carried out at the Pakistan Kidney and Liver Institute and Research Centre (PKLI)and spanned from 01/07/2021 to 31/12/2021. Patients above 16 years of age who had undergone LDLT were included. Hepatic artery peak systolic velocities (PSV), resistive indices (RI), and acceleration times (AT) were documented intra operatively and then for 5 consecutive days. Follow-up scans were performed at 2 weeks, 4 months, and 6 months after the transplant. SPSS version 20 was used for statistical analysis.
Results: A total of 91 patients were included in the study. The minimum age was 17 years and the maximum age was 73 years with a mean age calculated to be 45 years. Approximately 79% of patients were males and 21% were females. A PSV of as less as 15 cm/s and as high as 267 cm/s was recorded with normal waveforms. A minimum RI of 0.44 and a maximum of 0.89 was observed. A minimum AT of 0.01 seconds and a maximum of 0.07seconds were noted.
Conclusion: A wide range of hepatic arterial velocities can be encountered following LDLT without clinically significant out comes. The hepatic arterial velocities normalized within 4 to 6 months following LDLT. Hepatic artery RI values of 0.44 to 0.89 can be observed without any complications.
Continuous Versus Intermittent Furosemide Dosing Regimen in the Treatment of Acute Decompensated Heart Failure
Authors: Ahmad Hira , Khan Samiullah , Shah Saadullah , Iqbal Sunehra , Niaz Muhammad , Danish Naveed 
Published: December 2024

Objective: To compare continuous versus intermittent (bolus) infusion of furosemide in patients with acute decompensate heart failure (ADHF) in terms of length of hospital stay, urine output per day and change in serum creatinine levels.
Duration: Six months (01-09-2021 to 28-02- 2022)
Setting: Cardiology department District Head Quarter Teaching Hospital (DHQ-TH) Bannu.
Subjects and Methods: Eighty two (n=82) adult patients of either gender, between age 50years to 70 years were enrolled and equally divided into Group A (continuous Furosemide infusion) and group B (intermittent Furosemide dosing). Outcome of the therapy were duration of hospital stay, changes in serum creatinine and daily urine output.
Results: Mean length of hospital stay was significantly shorter (5.8±2.4 days versus 6.9±2.3, p=0.04), urine output per 24 hours was higher (2796.3 ml ± 365.9 SD and 2720.7 ml ± 647.6 SD, p=0.517) and mean change (rise) in serum creatinine was significantly higher (0.41 mg/dL ± 0.26 SD and 0.27 mg/dL ± 0.32 SD respectively, p=0.027) in continuous infusion group when compared with intermittent dosing group.
Conclusions: Treatment with continuous infusion of furosemide resulted in higher urine output per 24 hours, a higher rise in mean serum creatinine and a shorter duration of hospital stay as compared to treatment with intermittent dosing regimen.
Prevalence of Metabolic Syndrome in patients with psoriasis
Authors: Azhar Mehwish , Younas Muhammad Tahir , Tahir Muhammad , Masud Maryam , Tahir Muhammad Zuhair , Tahir Muhammad Zubair 
Published: December 2024

Objective: The study was planned to determine the frequency of metabolic syndrome in patients with psoriasis.
Place and duration of study: This study was conducted over a period of 6 months at the department of General Medicine, PAF Hospital, Islamabad, Pakistan from 1st January 2022 to 30 June 2022.
Materials and Methods: A total of 100 patients diagnosed with psoriasis using non-probability consecutive sampling were included in the study. Patient’s complete history was taken and thorough clinical examination was carried out at the time of inclusion. This included the age, height, weight, blood pressure, waist circumference and duration of disease. Patients were advised fasting blood sugar, fasting triglycerides and fasting high density lipoproteins. Metabolic syndrome was diagnosed if patients had ≥3 out of 5 criteria for the modified version of National Cholesterol Education Program Adult Panel III.
Results: Out of 100 patients of psoriasis, 37 (37%) patients had metabolic syndrome while 63 (63%) had no metabolic syndrome. The mean±SD of all the parameters of metabolic syndrome were found raised in psoriatic patients than normal values both in male and females. No correlation was found between prevalence of MetS and duration of disease (p=0.16).
Conclusion: There is a high prevalence of metabolic syndrome in psoriatic patients that can lead to high cardiovascular events. Hence the patients having psoriasis must be screened on yearly basis for these controllable risk factors to reduce incidence of CV morbidity and mortality.
Effect of Chronic Kidney Disease on Thyroid Function
Authors: Spal Furqan Arshad , Fatima Mahnoor , Ali Abid , Waqas Umair , Maryam Hannana , Abbas Zaheer 
Published: December 2024

Background: Chronic kidney disease results in downturn of glomerular filtration rate, which brings about nephropathic effect. The intensitifying nephropathy muddles the thyroid functions and turns down the iodide clearance, thus expedites the hypothyroidism.
Objective: The study aimed to link the chronic kidney disease with hypothyroidism.
Material and Methods: Our study design was cross-sectional. Chronic kidney disease patients were selected for thyroid profile (triodothyronine, thyroxine and thyroid stimulating hormone) testing. Statistical analysis was consummated on collected data, to check out the correlation between CKD and hypothyroidism.Chronic kidney disease is refers to by continuing urine defects structural irregularities or reduced excretory renal function connotative a loss of proper working nephrons.
Results: We enrolled 105 patients suffering from CKD. Of them 62 were male patient and 43 were female. Our analysis concluded that 49, of whome 30 were male and 19 were female, had hypothyroidism. 23; 16 male and 7 female, were having subclinical hypothyroidism and low T3 was seen in 33 individuals, comprising of 16 male and 17 female patients.
Conclusion(s): It is evident, that there is substantial effect of CKD over thryroid function, as hypothyroidism, subclinical hypothyroidism and low T3 syndrome is more frequent in CKD patients. To fend off CKD, the thyroid function is needed to be kept under observation, so that good prognosis could be gained.
Comparison of Dry Eye Syndrome in North West Pakistani Diabetics and Non-Diabetics Population
Authors: Khan Jahanzaib , Rehman Zia Ur , Idris Mohammad , Khan Naeem , Masood Muhammad Zubair 
Published: December 2024

Background: Due to rising life expectancy and anticipated older population expansion, the impact of dry eye syndrome (DES) will keep growing. Early investigations have indicated that the most frequent symptoms of diabetic retinopathy, or DR, are connected to problems with the ocular surface in general and dry eye in specific.
Objectives: To compare Dry Eye Syndrome in North West Pakistani Diabetics and Non-Diabetics.
Material and methods: this study is conducted on 50 cases and 50 controls at eye OPD from 5th October, 2018to 5th December 2018 by Convenience sampling technique. After that patient ocular and systemic history were taken and check previous clinical records if present. Anterior segment examination was carried out with a slit lamp. Fluorescein staining and schirmer test was carried out for diagnosing the dry eye syndrome. Patients were classified as having clinically dry eyes if their tear film was less than 10 mm, and as very dry if it was less than 5 mm. To assess the staining, fluorescein stain was utilized as a diagnostic dye. Dry eyes were regarded as having more than three fluorescein-stained cells. Chi-Square analysis, EPI Info 16, and SPSS were used to examine the data.
Results: In this research study, there were 50 cases of diabetes and 50 controls (control), were analyzed to look into the relationship between Dry Eye Syndrome with Diabetes mellitus. Dry Eye syndrome was present in 12 (24%) patients, 05 (33.3%) were males and 07 (66.6%) were females. Dry Eye Syndrome was present in 26(52%) patients, 12 (36.6%) were males and 14 (63.6%) were females. Odd ratio for case and control was calculated by applying Chi-Square test which was 7.90 at 95% of confidence level (Cl) with a P value of 0.004943 assuming a P value of <0.05 level of significance.
Conclusion: Dry eyes and diabetes seem to go together frequently. Type I diabetes is more likely to cause a milder degree of dry eye, but type 2 diabetes is more likely to cause mild to moderate dry eye.