bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of Compartment Syndrome in Patients Presenting with Fractures of Tibia in A Tertiary Care Facility
Authors: Saeed Ahmed Shaikh  , Mushtaq Saeed Qureshi  , Muhammad Qasim Ali Samejo  
Published: February 2023

Objective: To determine the frequency of compartment syndrome in patients presenting with fracture of tibia in a tertiary care facility.
Methods: In our descriptive cross- sectional studied conducted from January 2018 to June 2018 at the Department of Orthopaedics, Jinnah Postgraduate Medical Centre, Karachi, we included 136 pa- tients in this study with age range between 18 to 45 years of either gender presenting with closetibial shaft fracture within 24 hours of injury. Brief history regarding the duration of fracture and comorbid like HTN was obtained. Patients with diabetes mellitus, chronic bleeding and renal disorders and I.V drug abusers were excluded from the study. Presence of any one or more of the following within 24 hours of injury were labelled as compartment syndrome: severe pain: VAS score 7 or more, limb pa- ralysis: unable to move limb, paraesthesia: mild or no sensation on pin prick, pallor, as compared to contralateral limb and pulselessness: absence of pulse on Doppler.
Results: Mean age of the patients was 35.01 ± 9.34 years.More patients (n=72, 52.9%) were found older than 35 years of age while 64 (47.1%) patients with ?35 years of age. There were 99 (72.8%) males and 37 (27.2%) females. Mean weight, height and BMI of the patients were 60.11 ± 5.12 kg, 1.53 ± 0.06m and 27.23 ± 5.02kg/m2 respectively. Average duration of fracture was 21.85 ± 1.63 hours. Majority (n=114, 83.8%) of the patients presented with >20 hours. Compartment syndrome was found in 9 (6.6%) patients out of 136 cases. A significant association of compartment syndrome was found with age (p- value 0.025), and BMI (p-value 0.043) of the patients. Out of nine patients with compartment syndrome, eight patients were older than 35 years. In contrast, BMI in eight patients diagnosed with compartment syndrome were less than 30. However, no significant findings were noted in relation to duration of frac- ture (p-value 0.201), smoking status (p-value 0.097) and HTN (p-value 0.108).
Conclusion: Compartment syndrome is a surgical emergency, which needs timely diagnosis and im- mediate decompression to avoid complications including limb loss.
Clinical Efficacy of Probiotics as An Adjunct to Scaling and Root Planning in The Treatment Of Chronic Periodontitis
Authors: Sana Ikram  , Muhammad Arsalan Raffat  , Saeeda Baig  , Shazia Akbar Ansari  , Kevin Joseph Jerome Borges  , Nuzhat Hassan  
Published: February 2023

Objective: The objective of this study was to assess the clinical efficacy of scaling and root planing (SRP) alone and SRP along with adjunctive probiotic containing Lactobacillus reuteri (L.reuteri) in the management of chronic periodontitis (CP) and comparing the efficacy of two treatment modalities.
Methods: Twenty-eight systemically healthy participants, clinically diagnosed with CP on the bases of pocket depth were enrolled from the outpatient department of Periodontology, Ziauddin College of Den- tistry, Ziauddin University, Clifton, Karachi, Pakistan. After complete periodontal examination all clinical periodontal parameter i.e., Probing Pocket depth (PPD), Clinical attachment level (CAL), percentage sites for plaque accumulation (PI) and bleeding on probing (BOP) were measured and recorded at baseline, 6 weeks and 12 weeks after therapy. Patients meeting the inclusion criteria underwent non- surgical periodontal therapy i.e. SRP both with hand instruments and with ultrasonic scalers. After SRP oral hygiene measures were reassured and then participants were randomly allocated to one of two groups i.e., Probiotics (N=14) or Placebo (N=14). Both L. reuteri and placebo were given twice daily for 12 weeks and patients were recalled for assessment.
Results: At baseline both groups were similar clinically. Intra-group comparison of clinical periodontal parameters showed improvement in the participants of both groups. Inter-group comparison showed greater reduction in PPD and BOP and more gain in CAL in probiotic group on each follow up visits and statistically significant difference was observed in two groups. Whereas for PI the difference between two groups at follow-up visit was insignificant i.e. both treatment strategies were equal in reducing per- centage sites of plaque accumulation.
Conclusion: The results of our study concludes L.reuteri containing probiotic along with SRP is superior when compared to SRP alone in terms of resolving inflammation and improving periodontal health. Probiotics can be used as a promising alternative adjunctive therapy with minimal or no side effects in the treatment of chronic periodontitis.
Knowledge of Community Physicians Regarding Ischemic Stroke: Interesting Results
Authors: Shazia Jatoi  , Syeda Urooj Riaz  , Shariq Mukarram  , Aijaz Ali  , Ajeet Kumar  , Muhammad Ishaq Ghauri  
Published: February 2023

The aim of study is to assess the knowledge of community doctors regarding stroke and its prevention. A cross-sectional study at Department of Medicine, Jinnah Medical and Dental College, from Feb- ruary 2018 to August 2018. A total of 263 questionnaires were distributed among medical practitioners along with a proforma regarding physician's information and consent to participate. In this survey 201 participants filled the questionnaire, showing a reasonable response rate of 76.42 percent. Their mean time duration of practice was 13 ± 8 years. Almost 95% of the practitioners were aware of risk factors but a great majority had a misconception regarding high density lipoprotein(HDL), noise pollution and driving. All 201 participants agreed on brain imaging but modalityof choice was variable. Their knowledge regarding treatment and unusual presentation of stroke was not adequate and only 79% believed the need for referral to a neurologist.This survey revealed a wide gap in the knowledgeof practitioners regarding diagnosis and current guidelines of management.
Tooth Size and Arch Widths in Crowded Class I Malocclusion
Authors: Warda Arif Khan  , Syed Shah Faisal  , Syed Sheeraz Hussain  
Published: February 2023

Objective: To examine the extent to which maxillary arch width and tooth size contributes to dental crowding.
Methods: A cross-sectional study was conducted for six months after approval of synopsis by ERC of KMDC with 96 patients at department of orthodontics, Karachi Medical and Dental College, Karachi, Paki- stan. Patients with age 13-21 years with maligned teeth, over-crowding, presence of all fully erupted per- manent teeth and all angle classes were included, whereas patients with history of orthodontic treatment, presence of fractured restorations/crowns with tooth anomalies such as number, size, form and position as confirmed on clinical examination and craniofacial anomalies/syndromes were excluded. Maxillary crowding was calculated as the millimetre difference between arch perimeter and the sum of tooth widths of both second premolars. Arch perimeter was measured from the mesial aspect of the permanent first molar to its antimere with a brass wire. Intermolar arch width was calculated as distance from the central fossa of permanent maxillary first molar to its antimere. Data was analysed using SPSS 23.0. Prior to analysis assumptions were tested; an independent sample t-test was used to compare differences in crowded maxillary arch widths and spearman correlation was used to determine relationship between variables.
Results: Significant differences were obtained in anterior (t(63) = -2.547, p=0.047) and posterior tooth size (t(63)= -2.218, p=0.030) in patients with mild, moderate and severe maxillary crowded arches and an in-verse weak correlation was obtained against maxillary crowding and maxillary arch widths (r=-0.054) and maxillary crowding and anterior tooth (r= -0.201) and posterior tooth size (r= -0.353).
Conclusion: An inverse significant relation was found between crowding and tooth sizes & significantly different tooth sizes were observed in patients with mild, moderate and severe maxillary crowding.
Replacement of congenitally missing maxillary lateral incisor with ipsilateral canine: A case report
Authors: Alnazeh Abdullah 
Published: February 2023

Abstract
Congenital missing lateral incisor of maxilla is a common tooth anomaly. Its replacement can have many options. The choice ought to be understandable for patients or guardians hence effectively address the patient's issues. Regardless of canine replacement, solitary inserts, tooth-supported prosthesis are techniques for patients with missing maxillary missing lateral incisors, although numerous confront are engaged with acquiring and holding ideal outcomes.
In this case, report a case of 16 year old boy was discussed which has the diagnosis of Class II division 1 with missing upper laterals and anterior open bite. Plan was to perform space closure by canine lateralization and retraction of upper anterior to reduce the overjet followed by extraction of lower 5s to alleviate anterior crowding, correct molar relationship, maintain lower anterior teeth position, finishing, and alignment followed by retention.
Opinion of Parents Regarding Conjugate Typhoid Vaccine
Authors: M.Hanif Memon  , Farhan Saeed  , Muhammad Iqbal  , Muhammad Athar Khan  , Saboohi Erum Saboohi , Fatima Siraj  , Fatima Siraj  
Published: February 2023

Abstract
Objective : To study the opinion of parents regarding conjugate typhoid vaccine .
Method : 400 parents bringing their kids for vaccination were enrolled for the study at the vaccination clinic of The Karachi Adventist Hospital .A cross sectional survey was done from 18th November to 30th November 2019. All parents attending the vaccination clinic of the hospital with their children during the study period; and who met inclusion criteria were consecutively enrolled. A structured self -administered questionnaire was used to collect information from the parents.Parents whose infants are aged between 9 months to 15 years and mothers whose informed consent were obtained are included in the study. Data was analyzed using SPSS version 21.The Level of significance was set at P = 0.05 and 95% confidence interval reported where indicated.
Result :Opinion of parents regarding new conjugate typhoid vaccine correlated positively with parental age and educational level. Our data showed that majority of the respondents knew the typhoid illness though 75.8% had heard of new conjugate typhoid vaccine . A small percentage believed certain myths and feared its side effects to their child/children . After effective cousnselling and health education , 95.3% agreed for the given vaccination .
Conclusion : Our study showed encouraging opinion of majority of parents regarding new conjugate typhoid vaccine .Few parents have certain misconcepts and vague beliefs which were efficiently resolved by effective counselling regarding health education .

Key Words: Parents,vaccination ,children,new conjugate vaccine
Treatment with Twin-block appliance followed by fixed appliance therapy in a growing Class II Class II Div 1 patient – A case report
Authors: Alsharani Yahya 
Published: February 2023

Intraoral examination revealed poor oral hygiene He was in late mixed dentition. He had Class II Div I malocclusion with excessive overjet
Overjet 9mm ,Overbite: 8mm which is represent 100% of lower incisors overlapped by upper incisors ,Mandibular to maxillary midline is deviated to the left by 2 mm. left Molars: full unit Class II , Canines: N.A Right Molars: 3/4 unit Class II , Mild crowdng upper : - 5 mm and lower : - 6 mm ,overlapped upper central incisors ,Proclined upper incisors .There was no transverse discrepancy . However, during TMJ evaluation, he did not report any muscle pain, joint pain, or other symptoms typically associated with temporomandibular disease.
To evaluate the dimensions of each lobe and total volume of thyroid gland by ultrasonography among pregnant and non pregnant women in local population, Karachi.
Authors: Ahmed Hira , Ahmed Shazia , Rahim Anila , Perveen Khalida , Saeed Talat , Ainuddin Jahan Ara 
Published: February 2023

To evaluate the dimensions of each lobe and total volume of thyroid gland
by ultrasonography among pregnant and non pregnant women in
local population, Karachi.

Abstract:
Background: Pregnancy has an anatomical and physiological influence on the thyroid gland and it’s function. It is good to know the normal changes that occur during pregnancy. The size and volume of this gland is increased through the pregnancy and becomes visible due to iodine deficiency (ID) that can lead to goiter or may develop hypothyroidism. Objective of the study were to evaluate dimensions of both lobes and calculation of thyroid volume by using ultrasonography (USG) and to compare these parameters between pregnant and non pregnant in Karachi, Pakistan.
Methodology: It was a clinical cross sectional study that was conducted at Gynae OPD and Radiology Department, Ojha campus, Dow university of health sciences (DUHS), Karachi from October 2016 to December 2018 through consecutive sampling. The study volunteers of reproductive age (14-45 years) were included and divided into two groups (pregnant and non-pregnant women). The dimensions of each lobe and calculation of thyroid volume were taken into the account through their standard protocol after following inclusion and exclusion criteria.
Results: The comparisons were made on thyroid gland dimensions, ultrasound outcomes of right and left lobe length, width, depth and volume of thyroid gland. In pregnant women, right lobe length was 2.91±1.05, width was 1.54±0.41 and depth was 2.31±1.41 whereas in non pregnant women mean right lobe length was 2.50±0.97, width was 1.34±0.51 and depth was 1.68±0.98. The mean difference was considered statistically significant in pregnant women with p-value (< 0.01). In pregnant women thyroid volume was 7.02±3.21 whereas in non pregnant, it was 5.58±2.41 which was significantly increased in pregnant women with p-value (< 0.01).
Conclusion: Therefore our study concludes that, in our population at least half of the apparently healthy pregnant females do have some degree of iodine deficiency. The volume of the gland is increased during pregnancy, suggesting iodine deficiency.

Key Words: Pregnant women, non pregnant women, dimensions of thyroid gland and
volume of thyroid gland.
Adverse Effects of HMG CoA Reductase Inhibitor and Garlic on Renal Function in Patients with Diabetic Dyslipidemia
Authors: Siddiqui Naveed Ali , Ishaque Imran , Rahat Yousra , Akhtar Naheed , Tehreem Umaya , Javed Rafia , Ali Rayyan 
Published: February 2023

Objectives: To analyze the adverse effects of HMG CoA reductase inhibitor (statin) and garlic (Allium sativum) on renal function in diabetic dyslipidemic patients.Methods: This clinical trial was conducted at Surgeon Munawar Memorial Hospital, Karachi from 1st March 2019 to 30th August 2019. Total of 60 patients of 30-70 years of age with abnormal lipid profile were enrolled for this study after a written consent. The study was conducted to assess the side effects of statin (20 mg/day) and garlic (300 mg/day) in diabetic dyslipidemia patients. The study period consisted of six months. Blood pressure, body weight and height of subjects were assessed. The patient answered the questionnaire on health complaints, smoking, social role, drug usage, family history and dietary pattern. The initial inclusion criteria of the patient were 1) Age between 30-70 years old of either sex, 2) Patients with diabetic dyslipidemia. The exclusion criteria were 1) Pregnancy or lactation, 2) Patients with liver diseases, 3) Patients with renal diseases. Detailed medical history and physical examination of all patients were carried out.Results: This study included 60 patients with an abnormal lipid profile of age 30-70 years. Internationalstatin product (20 mg/day) and local garlic product (300 mg/day) for 08 weeks were used for oral administration in patients. Urea and creatinine levels in the serum of diabetic dyslipidemic patients were measured before and after treatment with an international statin (20 mg/day) and a local garlic product (300 mg/day).
Conclusion: According to the findings of this study, statins increase the serum level of urea and creatinine while garlic has no effect on urea and creatinine serum level.
Comparison Of Outcome Between Simple Polypectomy Versus Endoscopic Sinus Surgery
Authors: Kumar Amrat , Waheed Abdul , Mahar Ghulam Shabbir , Mahmood Zafar , Hussain Junaid , Wasee Nosheen , Anwar Adnan 
Published: February 2023

Objective: Nasal polyps are smooth, soft tissue, pale or yellow shining bulges that can block nasal cavity, sinuses and brings persistent state of rhino sinusitis influencing quality of life. The objective of this study was to compare outcomes of simple intranasal polypectomy versus Endoscopic sinus surgery after removing nasal polyps.
Methodology: This comparative cross-sectional study was conducted at Department of ENT in Civil Hospital, Hyderabad from April 2020 to June 2020. After ethical approval, 60 adult patients of either gender ranging from 14 to 40 years, with Sino nasal Polyposis were randomly selected. The collected data was analyzed using SPSS version 17. Categorical variables like all complications were presented as frequency and percentage.
Result: Out of 60 patients, 37(61.6%) males and 23 (38.4%) female, and mean age 28.87 ± 7.69 years, the post-operative complications like bleeding was observed in 6.7%, crusting 10%, Synechiae formation 10% of patients after 6 weeks, recurrence in 13.3% after 3 months, while intraorbital complications i.e. orbital swelling in 13.3% patients following simple intranasal polypectomy. In contrast, bleeding 10%, crusting 16.7% with orbital swelling 3.3% was reported up to 2 weeks following surgery. Synechiae formation 16.7% up to 3 months was observed following Endoscopic sinus surgery.
Conclusion: Post-operative complications of endoscopic sinus surgery have been quite lesser as compared to simple nasal polypectomy along with low recurrence rate. Fortunately, intra cranial complications were not observed, only intra orbital swelling was seen in both types of surgeries.
Association between Functional Status of Patients and Cognitive Impairment in End Stage Renal Disease
Authors: Arman Asma , Yaseen Mahjabeen , Ansari Tahir , Billia Natasha , Butt Mehwish Arif 
Published: February 2023

ABSTRACT
Objective: The increased incidence of diabetes, hypertension in third world countries has lead to an increase in end stage renal disease which in turn escalates the burden of dialysis on patients and caregivers. Dialysis is associated with many serious physical and mental disturbances. The aim of this study is to highlight the importance of screening for cognitive impairment and depression in End stage renal disease because cognitive impairment can impair the activities of daily living and overall quality of life.
Methods: 150 patients were included in a study after fulfilling the inclusion and exclusion criteria. They were screened for cognitive impairment by using the Montreal cognitive assessment scale, for depression by using Hospital Anxiety and Depression scale and Barthels index for assessment of activities of daily living.
Results: Of 150 patients most were males (56%) and females were (44%) out of which 36.67% males and 32.67% of females were cognitively impaired. Most patients were hypertensive and unemployed. There was no significant social demographic association observed for cognitive impairment. The patients with cognitive impairment need assistance in feeding, bathing and mobility as compared to patients with no cognitive impairment.
Conclusion: Our study revealed that cognitive impairment is present in patients and it is related with activities of daily living. The presence of depressive symptoms and anxiety is also affecting activities of daily living difficulty in ambulatory hemodialysis patients. Patients especially need help in climbing stairs and minor help in transferring, occasional bladder help, minor help in feeding and minor help during walk.
Key words: Cognitive impairment, End stage renal disease, Dialysis, Activities of daily living.
Effect on Cardiovascular System by Hyperbaric Bupivacaine and Isobaric Ropivacaine Given By Sub-Arachnoid Block in Planned Lower Extremity Surgery
Authors: Pasha Muhammad Naeem , Naeem Pasha Sheeza , Naeem Ayeza , Haque Syed Hurul 
Published: February 2023

Objectives: Efficacy of two local anesthetic drugs such as Ropivacaine and Bupivacaine were compared when they were administered intrathecally during elective lower limb surgery. Furthermore, the side effects of both drugs were also studied in the similar research.
Methods: The study was done double-blinded, un-biased and a randomized control trial. Cardiovascular system parameters such as average heart rate and average systolic blood pressure were monitored after medication given. Decreased BP, nausea, vomiting, shivering and headache were the parameters used to assess the side effects on the patients receiving both the drugs.
Results: Action of these two drugs on cardiovascular system parameters were monitored and there was no valuable dissimilarity seen. No statistical significance was found in the duration of nausea, vomiting and headache. None of the patients reported bradycardia or backache. However, shivering was observed in the patients that were administered Bupivacaine as compared to Ropivacaine.
Conclusion: Ropivacaine is a better drug of choice as compared to Bupivacaine while considering the hemodynamic parameters as well as the different post-operative symptoms.
Clinical Trial Number: Reference number: 0031/14 (Authenticated by Ethical and Scientific Review Committee, Karachi Medical and Dental College)