bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dry Eye Syndrome and Associated Risk Factors among Computer Users in Karachi, Pakistan
Authors: Naveed Mansoori  , Nabeel Qamar  , Syed Muhammad Mubeen  
Published: February 2023

Objective: To assess the frequency of presence of dry eyes and its associated risk factors among employees working in call centres and software houses in Karachi.
Methods: A cross-sectional study was done during July to October 2014 at Hamdard College of Medicine and Dentistry, Karachi. By convenient sampling technique, data was collected from employees aged 20 to 40 years of call centres and software houses. Demographic information was recorded on pre-designed questionnaire and Schirmer's test strips were used to measure production of tears. De- scriptive analysis was done for categorical variables using SPSS version 20. Cross-tabulation of different variables was done with dryness of eyes experienced. The frequency of various eye complaints was determined and Chi square test was used to observe the association with Schirmer's test. P- value<0.05 was considered as significant.
Results: Out of 150 employees 42 (28%) were found to have dry eyes. Mean age was 27 ± 3.5 years. The majority of employees 117 (78%) were males and 77 (51.3%) were using corrective spectacles for refractive errors. The most common eye complaints among the computer users were burning of eyes (44%), redness of eye (41.3%), dryness of nose (36%), dryness of mouth (34.7%), discharge from eye (10.7%) and foreign body sensation (10%). Statistically significant (p<0.05) relationship has been observed between presence of eye burning and positive Schirmer's test.
Conclusion: This study indicated that 28% of the individuals had dry eye, along with other symptoms of eyes among computer users in call centres and software houses.
Caffeine Consumption and Academic Performance among Medical Students of Dow University of Health Science (DUHS), Karachi, Pakistan
Authors: Muhammad Sami Khan  , Nighat Nisar  , Syed Arsalan Ahmed Naqvi  
Published: February 2023

Objective: To determine the frequency of caffeine consumption and its effect on academic perfor- mance among medical students of DUHS, Karachi, Pakistan.
Methods: A cross-sectional study was conducted at Dow Medical College, DUHS. About 400 medical undergraduate students from first to final year MBBS were included through systematic sampling. Those students who were on leave on the day of interview and addicted to substance abuse other than caffeine and those who were on drug use rehabilitation were excluded from the study. The dura- tion of study was from January 2016 to May 2016. The data was collected by self-administered struc- tured questionnaire which included the information regarding socio-demographic characteristics, perceptions regarding caffeine consumption on academic performance. The data were entered and analysed by using SPSS version 16. Frequency and percentages were calculated and multivariate analysis was performed to determine the association of caffeine consumption and academic perfor- mance of medical students.
Results: The mean age of the medical students were 20.83 ± 1.57 years. About 58.5% were females, 46.3% of the students scored less than 3 Grade Point Average (GPA). Majority (94%) of the students consume caffeine in any form such as tea, coffee. About 68% students reported that caffeine use in- creases their academic performance. On multivariate analyses, caffeine consumption did not show any significant association with academic performance.
Conclusion: High proportions of medical students were found to be consuming caffeine due to the misconception that caffeine increases academic performance. This study found no significant asso- ciation with academic performance and caffeine consumption.
Assessment of Vitamin D Levels in Healthy Infants: A Cross-Sectional Survey Highlighting the Relationship of Vitamin D with Feeding Habits
Authors: Shujauddin Quazi  , Jalaluddin Akbar  , Syed Zafar Mehdi  
Published: February 2023

Objective: To know and assess the levels of Vitamin D in healthy infants without having the signs of Vitamin D deficiency on radiological and clinical aspects.
Methods: This was a cross-sectional study carried out at Baqai Medical University Hospital Karachi. The sampling technique used was non-probability consecutive. Total 145 infants were included in this cross sectional study that were apparently healthy and showed no features of Vitamin D defi- ciency clinically and radiologically within the age of two to six month. Sample size calculated was 145. Infants on Vitamin D supplementation, with renal, hepatic or congenital heart disease, gastrointesti- nal problems, low birth weight and intrauterine growth retardation were excluded from the study.
Results: The feeding habits were breast feeding, formula feeding and mixed feeding as 62 (72.7%), 41 (28.3%) and 42 (29%) respectively. Vitamin D level were defined in three categories in which 57 (39.3%) were deficient, 39 (27%) were insufficient and 49 (33.8%) were found to be sufficient. Vitamin D levels were compared with weight to know the significance. It was discovered that Vitamins D and weight had a significant association with p-value of 0.02. There was no difference observed in length and Vitamin D levels with a p-value of 0.155 and OFC (occipital-frontal circumference) and Vitamin D levels with p-value of 0.491.
Conclusion: Frequency of Vitamin D deficiency and insufficiency is quite common even in apparently healthy infants. The levels of Vitamin D in normal healthy infants of two to six month of age were defi- cient. Furthermore, Vitamin D deficiency was related to the feeding habits of the infants. The infants on breast feeding had sufficient Vitamin D levels in most cases whereas it was deficient in formula and mixed feed of infants.
Exercise-Induced Headache - A Case Report
Authors: Qudsia Anjum  
Published: February 2023

Headache is one the commonest presentation in primary care settings and it presents a challenge to the treating physician. As the complaint becomes chronic, it affects quality of life of the patient. Individuals and patients experiencing headaches take medications undergo meditations and non-invasive investigations and yet no complete cure is attained. Various factors have been identified as to the cause of headache, and classification of headache has been identified in medical literature. Case re- ports in literature have discussed sports-related headache, and avoidance has been the short term preventive management offered. Keeping in view the diversity of the common complains of headache, we came across an interesting case and which has been reported. A 43 years old male Gulf Co-op- eration Council (GCC) Member, experiencing intermittent frontal headache after gym exercises with no constitutional symptoms. He was an average built healthy adult, non-smoker and no associated co- morbidity. Counselling and warm up before gym exercises was advised.
Split Cord Malformation - A Diagnosis Missed
Authors: Nimrah Mairaj  , Abdul Ali  , Zainab Juzer  
Published: February 2023

In this report, we describe the case of an 8 year old female child who presented with complaints of swelling in sacral region since birth and left leg weakness since 2 years of age. She presented with left clubbed foot to an orthopaedic surgeon and was treated at 1 year of age with serial plasters. The child was presented for club foot, rather than identifying the cause of deformity. When child was presented to our tertiary care hospital her workup was done and an incidental finding of split cord malformation on Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) myelogram was revealed along with left gluteal sebaceous cyst. The child underwent surgery and tethering of cord by the fibrous septa was relieved along with excision of left gluteal sebaceous cyst. The post-operative course was uneventful. Spinal cord malformations usually present with number of presentations for example hypertrichosis, lipoma, dermal sinus or tail. Therefore, a thorough examination can result in early diagnosis of the malformation and the complications can be prevented. In our case hypertrichosis at the back was missed, prior to child being referred to us. Hence, this case is being reported as a diagnosis missed of split cord malformation due to lack of complete head to toe evaluation of child by a subspecialty expert.
Impact of Measles Vaccination on the Acquisition and Frequency of Measles Infection in Province of Sindh
Authors: Ammarah Jamal  , Yousuf Yahya  , Agha Muhammad Ashfaq  
Published: February 2023

Objective: To determine the status of vaccination among confirmed measles cases and to determine the association of vaccination status with the occurrence of measles infection.
Methods: A cross-sectional survey was carried out in the province of Sindh from January 2016 to April 2016. The study included patients of both gender, ³9 months of age, fulfilling the case definition of measles by World Health Organization (WHO), who were reported to and/or picked by the measles
surveillance officers. A sample of 3-5 ml of blood was collected from each registered patient between day 4 and day 28 of the rash to test for measles IgM antibodies. The samples were labelled and sent to National Measles Laboratory, National Institute of Health (NIH) Islamabad in reverse cold chain. Patients who tested positive for IgM antibodies were grouped as confirmed measles while patients negative for measles IgM antibodies were grouped as suspected measles. Data of both the groups was analysed using windows SPSS 21 for vaccination status, for frequency of measles infection against the number of doses of measles vaccine received. Frequencies of vaccination among confirmed measles cases were compared with suspected measles for statistical significance using Chi-square. P-value of <0.05 was taken as significant.
Results: A total of 572 out of 915 study subjects were confirmed measles cases, of which 258 (45%)were never vaccinated against the disease as compared to 72 (12.6%) who were completely vaccinated. Overall, 128 (37.3%) were fully vaccinated amongst suspected measles. Vaccination sta- tus was not known in a quarter of patients in both groups. A significant association was found be- tween the vaccination status and measles infection with higher frequency of measles in unvaccinated as compared to the vaccinated (p<0.001).
Conclusion: We conclude that the vaccination rate among measles patients was significantly lower than among non-measles patients. A sizable 12.6% got the disease in spite of completing measles vaccination.
Comparison of the Mean Serum Ferritin Levels in Thalassaemia Major Patients after Giving Deferasirox and Deferoxamine
Authors: Seema Aftab  , Amber Kamran  , Shahina Hanif  
Published: February 2023

Objective: To compare the mean serum ferritin levels in thalassaemia major patients after giving deferasirox and deferoxamine. This is a randomised control trial conducted at the Department of Paediatrics, Civil Hospital, Karachi from 29th January 2014 to 28th July 2014.
Methods: A total of 160 patients of either gender, with age between 1 to 14 years, who received blood transfusion at least once a month for one year and had serum ferritin >1000 mcg/L were included. Each enrolled patient was randomly allocated to group-A (deferoxamine) or group-B (deferasirox). Pre- and post-treatment iron profile was done in both groups to assess the iron status in the body. De- scriptive statistics were applied to calculate mean and standard deviation for the quantitative vari- ables. Frequencies and percentages were calculated for the qualitative variables. Independent sample t-test was applied to compare mean change in serum ferritin level in both groups. Effect modifiers were controlled by stratification. Paired t-test was also applied post stratification and p- value £ 0.05 was considered as significant.
Results: Overall there were 96 male and 64 female patients. The overall mean age of study subjects was 7.54 ± 4.21 years. In the deferasirox group, mean age was 6.35 ± 4.11 years, mean weight wasv18.01 ± 6.74 kg, mean height was 102.04 ± 19.48 cm, and mean duration of transfusion was 7.48 ± 3.99 months/year. In the deferoxamine group, mean age was 8.74 ± 3.97 years, mean weight was 20.44 ± 6.77 kg, mean height was 102.19 ± 20.85 cm, and mean duration of transfusion was 8.14 ± 3.55 months/year. In the deferasirox group, before treatment mean serum ferritin level was 1385.73 ± 117.01 mcg/L. After treatment mean serum ferritin level was reduced to 1047.59 ± 117.08 mcg/L. In the deferoxamine group, before treatment mean serum ferritin level was 1362.58 ± 134.42 mcg/L. Af- ter treatment mean serum ferritin level was reduced to 1124.36 ± 134.52 mcg/L. Post-treatment the serum ferritin level between two groups was significantly different with p<0.01. The mean difference in serum ferritin level in pre- and post-treatment among two groups was highly significant with p<0.01.
Conclusion: Deferasirox is an effective, safe and tolerable chelation therapy for the treatment of thalassaemia major with iron overload due to its ability to provide constant chelation coverage and potential to improve compliance.
Yield of Urinary Pathogens and their Sensitivity Pattern at Paediatric Tertiary Care Facility, Karachi
Authors: Syed Furqan Hasan  , Khemchand Netaram Moorani  , Taj Muhammad Laghari  
Published: February 2023

Objective: To determine the yield of common pathogens isolated from urine specimens and their sensitivity pattern in children at National Institute of Child Health (NICH), Karachi.
Methods: This was a retrospective descriptive study conducted in the department of paediatric neph- rology and pathology, National Institute of Child Health over a period of two years, from January 2014 to December 2015. All urine samples received in our laboratory from children admitted to nephrology and other departments during the study period were processed for culture and sensitivity. All samples were inoculated with cystine lactose electrolyte deficient (CLED) agar plates and biochemical charac- teristics of the specific pathogen were identified on biochemical tubes. The plates and tubes were in- cubated for 24 hours at 37ºC and growth of more than 105 CFU was considered as significant. These colonies were identified by morphology, lactose fermentation, Gram stain and biochemical tests. Anti- biotic sensitivity was performed by Kirby-Bauer method as per CLSI (Clinical and Laboratory Standards Institute) guidelines and sensitivity was recorded after 24 hours' incubation at 37ºC.
Results: Out of 4107 samples processed, 1442 were positive giving a yield of 35% with 66% in girls and 34% in boys. E. coli was the most common pathogen (55%), followed by Pseudomonas (13.6%), Klebsiella (13,5%) and Candida albicans (11%). Majority of pathogens were sensitive to piperacillin- tazobactam (80-100%). Quinolones and aminoglycosides sensitivity was found in 65 to 85% and in 65 to 90% cases, respectively. Most of the pathogens (75%) were resistant to 3rd generation cepha- losporins except Citrobacter species.
Conclusion: A high yield of common pathogens in urine samples and high resistance to common antibiotics was observed.
Quality of Life in Subjects Suffering from Severe Skeletal Malocclusion before Orthodontic Treatment
Authors: Tahira Kulsoom  , Syed Shah Faisal  , Syed Sheeraz Hussain  
Published: February 2023

Objective: The objective of this study was to determine the occurrence of oral health impacts among patients with severe skeletal malocclusions and dentofacial skeletal deformities before orthodontic treatment.
Methods: A cross-sectional study comprising of 45 adult patients referred for orthodontic or surgical- orthodontic treatment to the orthodontics department, Karachi Medical and Dental College, Abbasi Shaheed Hospital Karachi were included. The study group consisted of 29 females and 15 males with a mean age of 21.5 ± 5.4 years. Study was conducted for six months from 30th Oct 2016 to 30th April 2017. A purposive sampling was done on the bases of survey base study design. A self-com- pleted Oral Health Impact Profile (OHIP)-14 questionnaire was used to measure the quality of life before orthodontic treatment.
Inclusion criteria were subjects seeking orthodontic treatment at the department of orthodontics, den- tal OPD Karachi Medical and Dental College, Abbasi Shaheed Hospital, Karachi, Pakistan. Patients who had perceived a need for orthodontic treatment and who were about to undergo orthodontic therapy were included.
Subjects with chronic medical conditions, previous orthodontic treatment, and craniofacial anomalies such as cleft lip and palate, untreated dental caries, and poor periodontal health status as indicated by a community periodontal index score of 3 or more were excluded. The frequency, extent, and sever- ity scores were calculated from the OHIP-14. Malocclusions were registered at clinical examination. The frequency and mean extent and severity scores were compared among malocclusion groups and between genders. Descriptive and inferential statistical method was applied.
Results: Frequency of oral impact in malocclusion patient was 27.3% though test value was 56 (p value >0.00). Mean value for male and female patients with malocclusion is 22.06 + 7.1 and 21.34 + 4.4 (p value >0.626), respectively, which shows no significant difference present. Mean value for class I, II and III was 24.5, 28.9 and 30.5 (p value >0.44), respectively, which shows no significant differ- ence.
Conclusion: There was no difference noted in the class of skeleton malocclusion in quality of life of patients and there was no gender difference noted in oral health impact of patients.
Adoption of Robson's Ten Group Classification System (RTGCS) to Analyse Caesarean Section Rates at a Tertiary Care Centre in Pakistan
Authors: Rahila Imtiaz  , Samia Husain  , Rubina Izhar  
Published: February 2023

Objective: To assess the utility of Robson's ten group classification system (RTGCS) as an auditing tool for cae- sarean section rates.
Methods: The present study was conducted by collecting data retrospectively from hospital records of Gynaecology and Obstetrics Unit 3, Abbasi Shaheed Hospital for the years 2013 and 2016. The rates of both years were com- pared in terms of RTGCS. After the initial audit in 2013, a three point strategy was implemented and the audit cycle repeated.
Results: During the year 2013, 1986 women delivered in the hospital, 610 underwent caesarean section. The cae- sarean rate for the year was 30.7%. In the year 2016, 1560 women delivered at the unit, out of which, 412 births were by caesarean section. After the implementation of the three point strategy, which was formulated in the light of RTGCS, the caesarean rate was 26.4% in the year 2016.
Conclusion: The adoption of RTGCS is the first step to analyse the obstetric practice in a standardised manner.
Priapism in Scorpion Stings within the Kingdom of Saudi Arabia: A Case Report
Authors: Shabbir Ahmed Mallick  , Sameer Ahmed  
Published: February 2023

We report a 2-year-old Saudi boy who presented with an acute onset of asymmetric pulmonary oedema, moribund state and priapism. He was living in the desert and was referred to our hospital during the summer. He was mislabelled as a patient with sickle-cell disease as a very high number of patients come with a crisis of same presentation, and haemoglobinopathies are not uncommon in the Kingdom of Saudi Arabia. On careful examination of the child, there were multiple tiny lesions on both of his feet and abdomen which led to high suspicion of scorpion stings. The index of suspicion was high due to two reasons;(i) it was the summer, during which the incidence of scorpion stings is high and, (ii) the child was habitated in the desert area where scorpions are common. The child was successfully salvaged with symptomatic support and the specific anti-venom was given. The presen- tation of severe or heavy scorpion intoxication mimics the presentation of sepsis.
A Case Report on Recurrent Dermatofibrosarcoma protuberans (DFSP), Successful Surgical Excision is Treatment of Choice
Authors: Arshadullah Khan  , Sumayya Tajwar  
Published: February 2023

A 23-years-old male patient came to the Surgical Oncology clinic in Saudi National Hospital, Makkah with complaint of non-healing wound present on the medial side of the right thigh since three months. A detailed history wastaken and it was revealed that this was a fast growing lesion and recurred im- mediate after surgical excision. The previous surgery had been carried out three months back in India. On the clinical examination it was revealed that it wasan irregular, ill-defined lesion, hard in consistency, not adherent to the underlying structures, and hence highly suspicious of malignancy. Diagnostic workups were done including biopsy, metastatic workup including computer tomography (CT) scan chest abdomen and pelvis. On the basis of histopathology, it was diagnosed as dermatofi- brosarcoma protuberans (DFSP). The case was presented in the Sarcoma Tumour Board and ac- cording to Tumour Board's recommendation, surgical excision was conducted.Patient was sent for anaesthesia assessment and after complete blood workup, and pre-anaesthesia assessment, pa- tient was booked for elective resection of tumour. The tumour was successfully excised with all negative margins confirmed on the frozen section and finally the sample was sent for histopathology.
Post-excision, patient was followed in surgical oncology clinic for local and systemic recurrence and it was concluded after three years follow-up, that there was no local and systemic recurrence.
The dermatofibrosarcoma has high potential for local recurrence and surgical excision with 2 cm negative margins is the treatment of choice without adjuvant radiotherapy.
Decline in Age of Nutritional Rickets, Need for Routine Vitamin D Supplementation in Young Infants
Authors: Ammarah Jamal  , Hira Raheem  , Samar Sajid  , Wajeeha Batool  
Published: February 2023

Objective: To determine the age at the diagnosis of rickets in children in a tertiary care hospital of Karachi and to assess the association of age at the diagnosis of rickets with serum levels of vitamin D.
Methods: This cross-sectional descriptive study was carried out from January 2016 to July 2017 on 240 patients >1 month to 36 months of age, both genders, admitted in the paediatric ward, Civil Hospital, Karachi for various reasons. Children having clinical signs suggestive of rickets were confirmed to have the disease by radiological evidence, raised serum alkaline phosphatase and reduced serum vitamin D levels. Children with rickets secondary to chronic diarrhoea, non-nutritional aetiologies and those taking anticonvulsants, corticosteroids, or vitamin D supplements were excluded from the study. Data was analysed using SPSS 16 for frequencies of age at the time of diagnosis of rickets and for classification of vitamin D levels into severely deficient, deficient, insufficient and normal. Association of the age at the diagnosis of rickets was tested with serum levels of vitamin D by applying chi- square test of independence. Statistical significance was considered at p-value <0.05.
Results: Mean age was 6.2 ± 5.9 months. A total of 130 (54.2%) subjects were £6 months of age, in- cluding 84 (35%) £3 months. Serum Vitamin D levels were done in 210 (87.5%) cases. Total of 168 (80%) cases were either deficient [141 (67.1%)] or severely deficient [27 (12.9%)] in vitamin D while 42 (20%) had insufficient levels. There was significant association of age at diagnosis of rickets with serum vitamin D levels. Rickets was an incidental diagnosis in most patients.
Conclusion: Nutritional rickets was most common in cases £ 6 months age with a sizable number £3 months. Vitamin D deficiency was the cause in all patients. Significant association was established between serum vitamin D levels and age at diagnosis of rickets. Most of the subjects remained unde- tected until they were investigated on basis of clinical suspicion.