bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Structured Counselling on Women's Ch< oice of Anaesthesia for Elective Repeat Caesarean Section (ERCS) At Abbasi Shaheed Hospital: A Cross Sectional Comparative Survey
Authors: Rahila Imtiaz  , Samia Husain  , Rubina Izhar  
Published: February 2023

Objective: To evaluate the effect of structured counselling on women's choice of obstetrical anaesthesia for elective caesarean section.
Methods: This was a cross-sectional comparative survey conducted at department of gynaecology (unit II), Abbasi Shaheed Hospital, Karachi, from 1st January, 2017 to 30th June, 2017. The study included 250 pregnant women at term ( ³37 weeks) with a prior caesarean section, planned for elective caesarean having no contraindications to spinal or general anaesthesia. Excluded from the study were women with obstetric emergencies like antepartum haemorrhage, cord prolapse, eclampsia, disseminated intravascular coagula- tion, vertebral column deformities, foetal distress and obstructed labour. They were asked about the technique of anaesthesia they would prefer for their caesarean section. The women then received structured counselling and the choice was assessed again. Chi-square statistic was applied to assess the association between both choices taking p-value of £ 0.05 as statistically significant. Data were analysed using the SPSS software program, version 15.0 (IBM, Armonk, USA).
Results: Out of 250 women recruited, before counselling 116 (46.4%) chose general anaesthesia, 94 (37.6%) women chose spinal anaesthesia whereas 40 (16%) had no particular preference. After receiving structured counselling 68 (27.2%) women chose general, 170 (68%) women opted for spinal and 12 (4.8%) women still remained undecided. The effect of structured counselling was assessed by cross-tabulating pre- counselling choice and post-counselling choice. The Chi-square test statistic was significant at p < 0.001 showing a significant association of structured counselling on the choice of anaesthesia.
Conclusion: Women's choice is significantly altered by the counselling. Majority of women's beliefs are shaped by past experience and the information they receive. Significant improvement can be expected in near future if more consistent information is provided. Consistency can be ensured by use of patient informa- tion leaflets.
Diagnostic Accuracy of Doppler Ultrasonography in the Antenatal Diagnosis of Abnormal Placental Invasion Secondary to Placenta Praevia
Authors: Huda Sajid  , Syed Mubarak Ali  , Roomi Mahmud  , Asma Javed  , Ameet Jesrani  
Published: February 2023

Objective: To determine the diagnostic accuracy of Doppler Ultrasonography in a tertiary care hospital, for the antenatal diagnosis of abnormal placental invasion secondary to placenta praevia, taking operative findings of caesarean section as gold standard.
Methods: This is a cross-sectional study carried out in the Department of Radiology, Liaquat National Hospital, Karachi, from 1st August 2013 to 31st July 2014. A total of 591 pregnant women (multipara) having placenta praevia were included in this study. The diagnosis of abnormal placental invasion was made by Doppler USG and compared with operative findings of caesarean section as gold standard. A predesigned pro forma was used to document findings. SPSS version 17 was used for all sta- tistical analysis.
Results: Sensitivity, specificity, positive and negative predictive value as well as accuracy of Doppler ultrasonography (USG) in the detection of abnormal placental invasion was found to be 84.8%, 93.9%, 91.8%, 88.5% and 89.95%, respectively.
Conclusion: Any persistent placenta praevia, will benefit from antenatal Doppler USG studies to identify abnormal utero-placental vascular flow patterns and these findings clearly aid in the management of this most challenging obstetric complication.
Assessment of Pressurised Metered Dose Inhaler Technique of Nursing Staff in Different Government Hospitals of Karachi
Authors: Sundeep Sahitia  , Syed Imtiaz Ahmed Jafry  , Syed Muhammad Zulfiqar Hyder Naqvi  , Nargis Anjum  , Adnan Anwar  
Published: February 2023

Objective: To assess pressurised metered dose inhaler technique of the nursing staff in different government hospitals of Karachi.
Methods: A cross-sectional study was carried out in four randomly chosen government hospitals of Karachi. After checking for study criteria and obtaining written informed consent, a total of 120 nurses were interviewed and then given a placebo inhaler to demonstrate their inhaler technique. The reference for assessment was the 12-step inhalation technique suggested by the American College of Chest Physicians.
Results: The study results revealed that out of the 12 steps of the inhaler technique, only 3 steps were followed by a majority of the study participants i.e. taking the cap off (64.2%), putting the metered dose inhaler in mouth with lips sealed (59.2%) and breathing in slowly by pressing down the metered dose inhaler (62.5%). The mean inhaler technique score of the study participants was 3.18 ± 2.34 out of 12 and only 1 (0.8%) of them had correct inhaler technique. Furthermore, the mean inhaler technique score was significantly higher for higher education level (p=0.001) and greater experience (p<0.001).
Conclusion: The study results demonstrated the acute deficiency of knowledge about the correct in- haler technique among the study nurses. Appropriate resources should be directed towards educat- ing nurses to make sure that their needed knowledge and skills stay updated.
Assessment of the Predictability of Pipelle Biopsy in Detecting Endometrial Pathology
Authors: Amna Begum  , Saadiya Aziz Karim  , Mehwish Wajid  
Published: February 2023

Objective: To assess the predictability of pipelle biopsy in detecting endometrial pathology in patients with heavy menstrual bleeding and its verification by uterine histopathology at hysterectomy.
Methods: A validation study inclusive of 50 patients, aged 35-55 years, sampled through convenience sampling technique, diagnosed with abnormal uterine bleeding and belonging to the peri-meno- pausal age group was carried out in obstetrics and gynaecology department Karachi, from January 2015 to June 2015. The patients included in the research investigation, were scheduled for hysterec- tomy, and got their endometrial sampling done through pipelle technique. The data collected were then sent for histopathology analysis. The final findings of histopathology were then verified by means of histopathology report. Patients having previous experience of D&C within the last four weeks or with uterus size greater than sixteen weeks were excluded. Inferential analysis was performed using Wilcoxon signed sum rank test. Kappa analysis was also done to measure the degree of agreement between pipelle and histopathological outcomes.
Result: The results of the study showed the mean age of sample as 45.94 ± 7.92 years. Medical his- tory for the sample has been shown and revealed that 14% of the sample had menopause. KAPPA analysis was conducted to compare the degrees of acknowledgement for histopathology and pipelle outcomes. The analysis showed that there was a 76.6% positive agreement observed in between the two techniques, with p-value results significant (<0.01). The study reported 14% cases of proliferative endometrium, while 4% cases of endometrial hyperplasia and 4% cases of endometritis and en- dometrial polyps have been diagnosed in the given sample.
Conclusion: The results of the study has shown that pipelle biopsy is a significant methodology used to assess the endometrial pathology among the patients with heavy menstrual bleeding, as verified by histopathology reports after assessment through hysterectomy.
Prolongation of QT Interval in ECG: A Hidden Complication of Cirrhotic Liver Disease
Authors: Ajeet Kumar  , Syeda Urooj Riaz  , Rajesh  , Syed Hussain Mehdi Kazmi  , Rajesh Kumar  , Muhammad Ishaq Ghauri  
Published: February 2023

Objective: To determine frequency of QT interval prolongation in ECG of patients with decompensated liver cirrhosis in a tertiary care hospital of Karachi, Pakistan.
Methods: A total of 60 patients with cirrhosis were included in this study. Clinical examination to see the presence of ascites, liver span and encephalopathy, and related investigation such as liver func- tion tests, serum albumin, prothrombin time and ultrasound abdomen for portal vein size was done and they were labelled as suffering from cirrhotic liver disease. Two 12 lead ECG was done >5 min- utes apart, when found same and QT interval calculated.
Results: The average age of the patients came out to be 45.37 ± 6.59 years. There were 36 (60%) were male and 24 (40%) female. Frequency of QT prolongation in patients with decompensate liver cirrhosis was observed in 12 (20%) cases.
Conclusion: This study demonstrates that cirrhotic cardiomyopathy is a common occurrence. The fre- quency of QT prolongation was 20% in patients with cirrhosis.This study demonstrates the direct rela- tionship of cirrhotic cardiomyopathy with the severity of liver disease. Therefore patients with cirrhosis should be investigated for prolonged QTc and the proper diagnosis and treatment.
Association of Posterior Nasal Spine (PNS) to Sella Turcica Measurement and Skeletal Malocclusions
Authors: Tahira Kulsoom  , Syed Shah Faisal  , Syed Sheeraz Hussain  
Published: February 2023

Objective: To determine the association between a measurement from sella turcica to posterior nasal spine (PNS) and skeletal malocclusion with subjects in normal vertical relationship.
Methods: It was analytical, measurement-based, observational design in which samples from 122 patients were collected from department of orthodontics at the dental OPD of Karachi Medical and Dental College and Abbasi Shaheed Hospital, Karachi. Non-probability consecutive sampling technique was used. Sample selec- tion was based on inclusion criteria that included, no previous history of orthodontic treatment, age limit start- ing from 12 years of age till 30 years. The exclusion criteria for study included, any syndromic or cleft lip and palate subjects, patients with history of trauma and patients with facial asymmetry. All the patients were exam- ined by the author. After thorough history and clinical examination for evaluating the inclusion and exclusion cri- teria patients were recruited for the study. Verbal informed consent was taken from the patients then the lateral cephalogram was recorded, taken in centric relation, was surveyed and classified by observation into the three categories of malocclusion on the basis of skeletal classification of malocclusion. All measurements were re- corded under ample light and comfortable position. All the findings were recorded by the primary author.
Result: One-way analysis of variance (ANOVA) was applied to see the association of PNS to sella and malocclusion. Mean value is 44.96, 45.21 and 49.00 for the class I, II and III of skeletal malocclusion patients respectively. P-value is < 0.05 which that there is association between PNS to sella and vertical class malocclusion.
Conclusion: It has been established that there is a positive association between PNS to sellaturcica linear measurement and skeletal malocclusions. It is noted as that mean value of linear measurement from sella to posterior nasal spine (PNS) is 44.96mm, 45.21mm and 49.00mm for the class I, II and III of skeletal malocclusion cases respectively. This can help in diagnosis and treatment planning.
Dental Anxiety and its Associated Factors Among Patients Visiting Outpatient Department of Different Tertiary Care Dental Hospitals of Karachi
Authors: Syeda Zeenat Raza Rizvi  , Syed Muhammad Zulfiqar Hyder Naqvi  , Syed Imtiaz Ahmed Jafry  , Syed Mohsin Abbas Abidi  
Published: February 2023

Objective: To assess dental anxiety and its associated factors among patients visiting OPD of differ- ent tertiary care dental hospitals of Karachi.
Methods: A cross-sectional study was conducted from April 2018 to November 2018 in two public and two private dental colleges of Karachi namely Karachi Medical and Dental College, Dr. Ishrat-ul-Ibal Khan Institute of Oral Health Sciences, Hamdard Dental College and Baqai Dental College. Being aged ³ 18 years of either gender were the inclusion criteria whereas refusal for a written informed consent was the exclusion criterion.After checking eligibility and taking written informed consent, a total of 247 participants were interviewed by the principal investigator using a questionnaire which included Corah's Dental Anxiety Scale and Dental Concerns Assessment. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test and Mann-Whitney U test after checking normality. The significance level was kept at 0.05.
Results: The study findings revealed that 2.4% of the patients interviewed were severely anxious, 8.1% were highly anxious, 37.2% were moderately anxious while 54.3% were not at all anxious. Moreover, patients with younger age and monthly household income between 16000 and 75000 ru- pees had significantly higher mean dental anxiety scores.
Conclusion: The study findings revealed that up to 45.7% patients were anxious up to some degree. There is a need for better understanding of factors potentially increasing anxiety in dental patients in order to avoid them as negative experiences in past are known to trigger dental anxiety in future.
Effect of Obesity and Family History of Cardiovascular Diseases and Diabetes Mellitus on Levels of C-Reactive Protein in Young Male
Authors: Farooq Syed Najamuddin , Ahmed Ammad , S Serafi Abdul Halim , H Halawani Saeed , Mustafa Muhammad Amir , Safi Rizvi Muhammad Irfan 
Published: February 2023

AbstractObjective: Objective of the current study was to investigate the effect of obesity and positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) on plasma C reactive protein (CRP) levels in apparently healthy young individuals.Methods: Young male Saudi students were interviewed for their personal medical and family history of Cardiovascular Disease (CVD) and Diabetes Mellitus (DM). Anthropometric parameters, height, weight, waist and hip circumference were measured. In-addition they answered perceived stress scale(PSS-14) questionnaire; Finally, Plasma C-reactive protein level was examined in all participants.Results: Results showed that the majority of our participants are overweight with mean BMI 27.113 ± 0.343 Kg/m2, but are non-stressed (24 ± 0.29). Around fifty-four per cent of participants have a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM). Average Plasma CRP level was (0.267 ± 0.016 mg/dl) with 26.75% of the participants in the high-risk category. Moreover, participants that are overweight/obese and with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) showed Significantly (P<0.0001) higher levels of Plasma hs-CRP, compared to the normal weight and with negative family history. A significant correlation was also observed between hs-CRP and BMI and WC. However, stress scores were not significantly different among different groups.Conclusion: Obesity, particularly in association with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) or one of the two diseases is a strong predictor of low-grade systemic inflammation indicated by high plasma hs-CRP level.
Pictorial Quiz
Authors: Munir Saquib 
Published: February 2023

A 75-year-old female came to the OPD with the complaint of swelling and discharge from the left breast for two to three years with no known comorbid. On examination, the left breast showed fungating growth of 10×15cm with ulcerating margins and blood-stained discharge. It was hard and fixed to the chest wall. No axillary and cervical lymphadenopathy was found. What is your diagnosis?
Antihyperlipidemic Activity of Hydroxyl Methylglutaryl Coenzyme A Reductase Inhibitor on Lipid Profile in Secondary Hyperlipidemia
Authors: Siddiqui Naveed Ali , Akhtar Naheed , Shahid Ayesha , Bint Taj Fatima , Ayaz Ayesha , Moosa Zulfiqar Ali , Azeem Farooq 
Published: February 2023

Objectives: To observe the variations in lipid profile in patients with secondary hyperlipidemia using HMG-CoA reductase inhibitor.Methods: This study was done at private hospital in patients predominantly suffering from secondary hyperlipidemia. The duration of study was about 4 months. Body weight, height and blood pressure of subjects were assessed. The subjects were asked to answer the related question on cigarette smoking, health related complaints, detailed history of family, drug usage, and nutritional habits. Subjects were requested to make up a permission form before starting the research study. This case control study was performed at local private Hospital, located at Karachi from 1st April 2017 to 30th July 2017. The aim of research was to analyze the effects of HMG-CoA reductase inhibitor on lipid profile in patients of secondary hyperlipidemia. Age between 35 to 65 years and secondary hyperlipidemicpatients were included in the inclusion criteria. Lactating/pregnant women, renal, liver and established coronary artery diseases were included in exclusion criteria.
Results: Sixty patients having deteriorated lipid profile were included in this research (age 30-60 years). Subjects were prescribed simvastatin orally 20 mg/day (international product) for 04 months. The total cholesterol, triacylglycerol, LDL and HDL were analysed using simvastatin (20mg/day) of international standard in the serum of secondary hyperlipidemic patients.Conclusion: During this study it is observed that Simvastatin raises the HDL level and reduces LDL level and cholesterol level.
Effect of Exogenous and Endogenous Glucocorticoids on the Spermatogenesis of Albino Rats; A Comparative Study
Authors: Hameed Uzma , Iqbal Sadia , Rehman Fatima , Hassan Aisha , Memon Ayesha Majeed , Mustafa Sumera 
Published: February 2023

Objective: The objective of the present study was to compare the earlier possible effects of exogenous and endogenous glucocorticoids on the spermatogenesis of albino rats.Methods: This comparative study was conducted at Baqai Medical University in the Department of Anatomy from June till July 2016. Total of 96 adult Sprague rats were used in this study obtained from Agha Khan University; their ages were between 10-12 weeks and their weight ranged between 180-200 gms. Exogenous glucocorticoids were given through intraperitoneal route (i.p. route) at the dose of 1.2 mg/kg/body weight and for endogenous production of cortisol, they were kept in a plastic box daily which was thermostatically maintained at 44º C for 1 hour. They were divided into three main groups and the main group was further categorized into subgroups according to their number of days. The three main groups were; A (control), B (exogenous glucocorticoid), and C (endogenous glucocorticoid). They were sacrificed at the end of the experiment, testes were removed and the effects of exogenous and endogenous glucocorticoids on the spermatogenesis were observed under the light microscope in H&E and PAS stained sections.Results: Spermatogenesis was assessed by Johnsons scoring which ranges from 10 to 1. In the control group, complete spermatogenesis was observed with a Johnson's score of 10 while in group B and C scores were between 10-2 and 10-3, respectively.
Conclusion: From the present study, we conclude that exogenous glucocorticoids cause earlier damage and effects all stages of spermatogenesis with decreased production of quality sperms. This animal study will help to decrease the infertility rate due to excessive and unnecessary use of glucocorticoids especially in the early years of life and by taking preventive measures when exposed to high temperatures.
The psychological impact of COVID-19 among the undergraduate dentistry students of Sindh and Baluchistan and how they manage it.
Authors: Majeed Muhammad Mansoor , Anwar Madiha , Bhatia Moti Ram , Khan Nabeel , Butt  Mehsal Muhammad Naeem , Tabassum Urooj , Durrani Muhammad Shoaib 
Published: February 2023

Objective: The purpose of the current study was to evaluate the anxiety among the undergraduate dentistry students during the COVID-19 pandemic. It also aimed to find out their stress management strategies.
Methods: A total of 809 undergraduate dentistry students of Sindh and Balochistan contributed to this web-based cross-sectional study. A validated e-questionnaire created using Google form were distributed among the dental college student through social media. Spss 22 was used for statistical analysis.
Results: Significantly higher number of females and private college students were the participants. Majority of the students are dissatisfied with the online education and no significant difference is present among private and public sector dental college (p >0.05). Moderate to severe level of anxiety among both gender is prevalent. Praying and recitation of the holy book is the most common couping strategy followed by sleeping, talking to friends and family.
Conclusion:- Psychological sessions should be arranged to improve the mental health of future dental surgeons. Government need to re-evaluate its policies towards the health care system and administration and teaching faculties should focus to upgrade their skill concerning e-learning
Visual Inspection of Cervix with Acetic Acid (VIA): An Effective Method of Screening for Cervical Cancer
Authors: Ali Fauzia , Munim Tazeen Fatima , Nadeem Shabnam , Khatoon Aisha , Shaukat Naz 
Published: February 2023

Objective: To assess diagnostic accuracy of visual inspection of cervix with 3-5% acetic acid(VIA) as a screening method for early detection of cervical intraepithelial neoplasia and early cervical cancer.Method: This cross-sectional study was conducted at Gynecology & Obstetrics Department Unit-1, Abbasi Shaheed Hospital, Karachi, from April 2017 to September 2018. Participants were included in the study through non-probability convenience sampling technique. Married, non-pregnant and sexuallyactive women aged between 21-50 years were included in the study. Demographic information and relevant history was taken followed by the procedure for VIA. Acetowhite changes were noted after application of 5% acetic acid on the cervix. The result of the test was documented as positive or negative. Colposcopy was done in all VIA positive cases and suspicious cases with abnormal looking cervix. Biopsy of the cervix was taken for histopathology to assess the results of VIA. SPSS version-20 was used for statistical analysis.Results: There were 323 subjects with a mean age of 35.5 ± 7.6.Out of 323 participants only 6 were found VIA positive (1.86). On histopathology, only two cases were found positive (0.62%), one early invasive cervical cancer and one CIN1. Sensitivity, specificity, positive predictive value and negative predictive value of visual inspection of cervix after acetic acid application was 100%, 57%, 40%, 100%respectively and the diagnostic accuracy was 66.7%.
Conclusion: Visual inspection of cervix with 3-5% acetic acid is highly sensitive, screening method for cervical cancer. It is quite simple, affordable and better screening modality for detecting cervical cancer at an early stage.