bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between Degree of Compliance to Antihypertensives with Severity of Stroke
Authors: Hirra Mumtaz  , Ramish Riaz  , Haris Majid Rajput  , Anum Akhtar  
Published: February 2023

Objective: Study was conducted to find out correlation between degree of compliance to antihypertensives with severity of stroke.
Methods: This correlational study was conducted in department of neurology, Pakistan Institute of Medical Sciences, Islamabad from December 2017 to May 2018. A total of 74 patients with clinically and radiologically confirmed diagnosis of stroke, having history of hypertension, were included in the study. According to the Modified Rankin Scale (MRS), scores were assigned from 0 to 6 in increasing order of severity. Quantitative assessment to drug compliance was calculated via Brief Adherence Rating Scale (BARS). According to BARS, scores were assigned from 1 to 4 in decreasing order of non-compliance or increasing order of compliance. Compliance was defined according to BARS as patients taking more than 76% of their prescribed dosage. Compliance of drug was checked for last 6 months. Data was finally analysed by SPSS v. 20. Appropriate statistical tests were applied.
Results: Mean age of the stroke patients was 58.8 ± 14.91 years. Total 33 patients i.e. 44.6% were compliant and 41 were noncompliant. Strong negative correlation (r= -0.494, p-value= 0.00008) was found between degree of compliance according to BARS scale and severity of stroke according to MRS. Regression analysis showed R2 value of 0.41 and p-value of 0.0004. Most common cause of drug noncompliance according to patients was improper counselling followed by fear of getting used to medication, forgetting, cost, side effects, and dissatisfaction with treatment. Among other risk fac- tors for stroke, 18.9% had positive history for smoking, 43.2% for hyperlipidaemia, 18.9% for coronary artery disease, and 5.4% for atrial fibrillation.
Conclusion: Adherence to antihypertensives can help in reducing severity of stroke which will result in better prognosis and reduced morbidity and mortality. Most important factor contributing to noncompliance is lack of awareness regarding disease and importance of antihypertensive medications.
Evaluation of Household Perception about Polio Immunization, Prior and After the Direct Supervision of District Administration in Karachi
Authors: Syed Saif-ur-Rehman  , M. Abu Zar Wajidi  
Published: February 2023

Objective: To compare the change in the household perception about supplementary polio immuniza- tion to eradicate polio, prior and after taking special interest of the district administration Karachi from 2012 to 2016.
Methods: The study was conducted in the District Central, Karachi, about household perception of polio immunizationon May, 2015 and April 2016. A total of 350 participants were enrolled in this study through non-probability consecutive sampling technique by healthcare workers visiting the household for supplementary polio immunization activities (SIAs). The perception of head of the families whether male or female with children were participated in this study. Study participants were enrolled after in- formed consent, inquired about the polio immunization team visits, access to immunization informa- tion (means of knowing health information), belief in the vaccination and knowledge of polio. The study participant's confidentiality and anonymity were maintained throughout the research process. The data collected was analyzed using SPSS version 21 (10 BM).
Results: The results were analyzed and compared with before and after the direct supervision of district administration of Karachi i.e 2012 and 2016, the results of the study indicated that the polio im- munization team visits has been increased by 14% (67% to 81%); polio immunization information access increased by 5% (67% to 72%) as responded by respondents. Moreover, according to respon- dents the knowledge and awareness in polio vaccination has increased by 13% (55% to 68%), while the belief on polio vaccine has increased to 11% (63% to 74%).
Conclusion: In the central district of Karachi the household perception regarding polio immunization team visits, information access, knowledge and belief on Polio vaccine has increased significantly after the direct supervision of district administration Karachi.
Comparison of Step-Down Versus Step-Back Hand Preparation Technique of Root Canals
Authors: Mehwish Munawwar  , Muhammad Badar Munir  , Mustafa Sajid  
Published: February 2023

Objective: The aim of this study was to compare the frequency of flare-up in terms of post-operative pain and/or swelling, after step down and step back root canal preparation technique.
Methods: A randomized clinical trial was conducted from 28th October 2011 to 27th April 2012 in de'Montmorency College of Dentistry, Lahore.150 patients with irreversible pulpitis were randomly al- lotted in two equal groups (Group A and B) and root canals were prepared with step-down andstep- back technique respectively. Pain was recorded using visual analogue scale on 1st, 7th and 14th post-operative day. Data was analysed using SPSS version 17.0.
Results: In Group A, 67 patients had no flare-up and 8 patients had flare-up on 14th postoperative day. In Group B, 57 patients had no flare-up and 18 patients had flare-up on 14th postoperative day. Out of 150 patients 26 (17.33%) showed flare-up and 124 (82.66%) showed no flare-up. The overall flare-up in Group A was 10.6% and in Group B was 24% after 14 days.
Conclusions: Step-down technique is better for root canal preparation as evaluated by the comparison of flare-up by step-down and step-back techniques.
Congenital Cystic Lesion In Extra Hepatic Biliary Tract
Authors: Imran Ishaque  , Durr - e - Sameen Kamran  , Muhammad Kashif Nisar  , Nadeem Baig  , Obaidullah Khan  , Naheed Gohar  
Published: February 2023

Objective: To illustrate congenital cystic lesions of the extra hepatic biliary tract on the idea of information of embryologic development through the magnetic resonance cholangiopancreatography (MRCP).
Methods: Patients that were suspected to have been suffering from biliary disease were referred to the MRI units, there the patients were narrowed done to confirm with the inclusion and exclusion cri- teria, thereafter written and informed consent was obtained from them and the procedure was ex- plained to them in detail. MRCP was performed on a 1.5 Tesla in MR unit, using phased-array coil for signal detection. Heavily T2 weighted images were obtained with SSF-SE technique. The axial sec- tions were used for pancreatic and bile ducts whereas the coronal sections were used for the pancreatobiliary tract, axial and coronal source images and reformatted images were evaluated to- gether for the possibility of any anomaly in extra hepatic biliary tract. This was an observational, cross sectional, prospective study with a sample size of 377 patients. Statistical analysis was done by SPSS version 16.
Results: Choledochal cyst was found in 11 of the 377 patients with a gender separate frequency of 6 out of 196 females and 5 out of 181 males, with a total frequency of 2.9% and a p-value at <0.001 which was significant.
Conclusion: By identifying the inherent anomalies that present themselves during the visualization of the biliary tract through MRCP and MRI, while coupled with information regarding the clinical signifi- cance of every entity, is vital for establishing an accurate diagnosis and in guiding acceptable clinical intervention and management.
An Uncommon and a Rare Presentation of Acute Appendicitis with Calculus Cholecystitis in a 12-Year-Old Girl: A Case Report
Authors: Hajrah Hilal Ahmed  , Muhammad Jamaluddin  , Wajeeha Khalid  
Published: February 2023

Acute appendicitis is very common general surgical emergency in teenagers while cholecystitis is common in middle-aged females but cholecystitis at the age of twelve year is very rare and along with acute appendicitis is even rarer. We describe a case of 12-year-old female who came to the outpa- tient department of Abbasi Shaheed Hospital with the complain of on and off pain in the right iliac fossa for the last one year. Abdominal examination was positive for rebound tenderness in right iliac fossa at the McBurney's point. Computed Tomography scan of whole abdomen showed gallstones with normal looking appendix. Impression of acute calculus cholecystitis with recurrent acute appen- dicitis was made. Laparoscopy along with laparoscopic cholecystectomy was planned. On Laparoscopy appendix was found to be inflamed so laparoscopic cholecystectomy along with laparoscopic appendectomy was done via the same ports. Acute appendicitis along with cholecystitis due to cholelithiasis is very uncommon and very few cases have been reported in literature.
Comparison of Irrigation with Povidone-Iodine Versus Normal Saline on Wound Infection After Open Appendectomy
Authors: Muhammad Abid Owais  , Syed Ali Haider  , Sidra Abbas  , Khalid Ahmed  , Saeed Ahmed  , Akram Rajput  
Published: February 2023

Objective: Surgical site infections (SSIs) pose a continued problem to operating surgeons. It adds to the healthcare cost, increases morbidity and mortality and sometimes culminates in re-explorations. Rate of SSIs can be ameliorated by removing damaged or non-viable tissue, metabolic waste and wound exudates; this can be achieved by irrigation of surgical wound intraoperatively. Surgical wound irrigation can also be performed postoperatively. Even after giving prophylactic antibiotics and august aseptic measures, post-appendectomy wound infection remains soaring. The efficacy of povidone-io- dine on non-incised skin is well known but its application as an intraoperative irrigation solution in open surgical wounds is not a mundane practice. Likewise prophylactic irrigation with normal saline solution to prevent wound infection has also turned out to be effective in some studies. The objective of this study is to compare the percentage of superficial SSI post-appendectomy, with intraoperative irrigation of subcutaneous plane using 1% povidone-iodine solution versus normal saline.
Methods: 200 cases of open appendectomy for acute appendicitis at Baqai Medical University, Kara- chi were randomly distributed into two arms. In group A, 0.9% Normal Saline was employed to irrigate subcutaneous tissue before skin closure while in group B irrigation with 1% diluted povidone-iodine solution was undertaken. The cases were assessed for infection in surgical wounds in line with Southampton wound grading system for five days after surgery and followed for thirty days.
Results: Mean age of participants of this study was 18.65 years. There were 100 patients in both groups and the groups were not different statistically in terms of age, gender and operative findings. A total of 38 (19%) out of 200 patients had Southampton grade 2 and above, signifying wound infection. Out of these, 29 (29%) were from Group A and 9 (9%) from Group B (p=0.001).
Conclusion: 1% diluted povidone-iodine irrigation of subcutaneous plane after appendectomy remark- ably lowers the rate of SSI when compared with normal saline irrigation.
An Analytical Approach to Estimate Prevalence of Depression from a Non-Probability Sample of College Students in Karachi Using Beck Depression Inventory
Authors: Akram Nuzhat Aisha , Jameel Nazia , Faiz Samira , Hussain Mudassir , Qadir Abdul , Raza Amina 
Published: February 2023

Objective: To estimate and compare the prevalence of depression among college students in Karachi. The analytical approach was aimed to minimize biases produced by profession, gender, and age of samples on the prevalence rate.Methods: A cross-sectional study design was employed. Two hundred and sixty students were chosen from January 2018 to March 2019 through a purposive non-probability sampling technique from different professional colleges in Karachi. Beck Depression Inventory, a self-report questionnaire comprising 21 items was used as a study tool. After taking informed consent, each sample was inquired about the profession, age, gender, and personal and family history of psychiatric illness. Diagnosed cases of any psychiatric illness were excluded. Samples were stratified on the basis of profession, gender, and age. A minimum sample size of 70 students was extracted from the total sample through quasi randomization. Statistical software SPSS version 16 was used for data entry, sample randomization and analyses.Results: Overall prevalence rate was 26.15%. Profession based stratification of samples showed prevalence rates of 21.81% and 29.33% in business and medical college students, respectively. Substrata of medical colleges i.e. public and private medical college students showed prevalence rates of 38.66% and 20%, respectively. Gender-based stratification showed a prevalence rate of 33.33% in female and 17.24% in male students. Age-based stratification showed a prevalence rate of 15.49% in teens (17-19 years) and 21.69% in the post-teen group (20-25 years). Independent sample t-tests showed a statistically significant difference between the strata of the profession, gender, and age and substrata of public and private medical colleges. A prevalence rate of 25.71% was estimated in quasi-randomized samples.Conclusion: Randomization, stratification and large sample sizes are employed to minimize biases in prevalence studies. The present study showed the importance of sample stratification based on age, gender, and profession in estimating the prevalence of depression. Results also showed the validity of the minimum sample size is calculated appropriately.
To Determine the Frequency of Endometriosis in Sub-Fertile Women Undergoing Laparoscopy
Authors: Hassan Nazia , Jamil Rabia , Ali khan Fiza , Ali Lubna 
Published: February 2023

It is a cross sectional study conducted in department of obs and gynae civil hospital karachi from 1 january 2016 to 30 june 2016 . There were 96 women were selected in this study .
Results The average age of the women was 27.44+_3.69 years . frequency of endometriosis in subfertile women undergoing laparoscopy was found in 32(33.33%) women.
Evaluating Sensitivity and Resistance Pattern of Cefazolin and Ceftriaxone Against Different Pathogenic Organisms- A Comparative In-Vitro Analysis.
Authors: Perveen Feroza , Shyum Naqvi Syed Baqir , Khaliq Asif 
Published: February 2023

Objectives: To evaluate the zone of inhibition and sensitivity pattern of cefazolin and ceftriaxone against selected pathogenic organisms.
Methodology: This was an invitro experimental study that was conducted on clinical isolates of Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa and Staphlococcus aureus from urine and pus samples. These samples were collected from four pathological laboratories in Karachi and tested against two commonly used cephalosporins, cefazolin and ceftriaxone from the period of 1st January –27th February 2011. The resistant pattern was determined by disc diffusion method (Kirby-Bauer test).The data was analyzed by Statistical Package for Social Sciences version 19. Mean ± SD used for continuous measurements whereas frequencies and percentages were used for categorical variables. Independent sample t-test applied to see antibiotic sensitivity pattern in urine and pus samples.
Results: The result of this study reveal that Escherichia coli is the most common uropathogen that is present in more than 35% of samples. The zone of inhibition of Ceftriaxone is greater than Cefazolin for all types of clinical isolates. Moreover the sensitivity pattern of Ceftriaxone for all the clinical isolates is greater 90.25%, 85.72%,100%,75% and 85% to Escherichia coli, Klebsiella spp., Proteus spp., Pseudomonas aeruginosa, Staphlococcus aureus respectively than does Cefazolin. The pathogenic organisms present in urine are more susceptible to ceftriaxone. The p-value obtained after apply independent sample t-test for ceftriaxone was 0.012. Therefore, there is a significant difference in the sensitivity pattern of ceftriaxone for pathogens present in urine and pus samples.
Conclusion: Ceftriaxone is more effective than cefazolin in most of the cases and there is clear difference in their zone of inhibition. Moreover, resistance to cefazolin develops more easily than does Ceftriaxone. Continuous surveillance, public awareness and health care education can decreases the irrational use of these antibiotics.
Keywords: Pathogenic organisms, Resistance, Sensitivity, Zone of Inhibition, Cefazolin, Ceftriaxone, efficacy.
Laparoscopic –Assisted Orchidopaxy in Non-Palpable Testes in Adult Population
Authors: Mansoor Muhammad , Arain Suhail Dilawar , Choudary Shahzad Ali , Shaikh Arif Ali , Narejo Saeed Ahmed Khan , Hussain Shahid 
Published: February 2023

ABSTRACT:

Objectives: To present our experience of managing impalpable undescended testes in post-pubertal patients with intention of testicular preservation using laparoscopic assisted orchidopaxy.

Study Design: Descriptive Case series.

Place &
Duration of
Study: Department of Urology, Jinnah Postgraduate Medical Center (JPMC) Karachi, between Jan 2015 to Dec 2020 with minimal 6 months follow-up.

Methodology: We included all patients with clinically impalpable testes with aged 12 and above. All patients had ultrasound abdomen performed as initial screening test followed by laparoscopic assessment and definite procedure. Patients with normal or hypo-plastic testes were underwent single staged orchidopaxy, while patients with testicular atrophy were planned for orchiectomy. Intraoperative testicular biopsy and Semen analysis were not routinely performed in our study.

Results: Total 36 patients with 41 impalpable testes underwent laparoscopic localization and management. Mean age of patients was 20.75+ 5.98 years. 50% of testes were on the right side, 36.1% on left sided while 3.88% were bilateral. 5 (12.1%) patients had clinical inguinal hernia.. Diagnostic yield of ultrasound was (75.6%) and 100 % in laparoscopy. 33 testis were true intra-abdominal while 4 were inguinal and 4 were vanishing testes Normal looking testes were observed in 24 testes (64.86%) followed by hypoplastic in 11(29.72%) while 2 testes (5.40%) were atrophic. Two intra-operative complications included urinary bladder injury and vas deferens injury in one patient each. Postoperatively testicular ischemic necrosis in one (2.4%) and wound infection in 2 (4.8%) patients were noted. Late follow up revealed one port site hernia (2.4%) and one testicular atrophy (2.4%). Success rate of orchidopaxy in our study was 94.6%.

Conclusions: Laparoscopic has been proved as excellent diagnostic and therapeutic tool for the management of intra- abdominal undescended testes in adolescent and post-pubertal patients.

Key words: Impalpable testes, Laparoscopic-assisted orchidopaxy, Adolescent, Adult
Effects of Different Intensity Aerobic Exercise on Circulating Levels of Neurotrophic Factor in Healthy and Hyperlipidemic Adults in A Local Population
Authors: Mustafa Ghulam , Muhammad Irfan  , Wasee Nosheen , Zia Nuvair , Ramzan Adli , Anjum Nargis 
Published: February 2023

Objective: The present study is to compare the pre and post serum BDNF levels in healthy and hyperlipidemic population at baseline and post 12 weeks of exercise and to correlate the pre and post serum BDNF levels in healthy and hyperlipidemic population at baseline and post 12 weeks of exercise.
Study Design: Two arm follow up non-blinded randomized controlled trial (RCT).
Place and Duration of Study: Physiology department, Basic Medical Science Institute (BMSI), Jinnah Post-Graduate Medical Center (JPMC), Karachi
Methodology: A total 258 participants of any age were divided into two groups: 129 participants in one of the two groups, Group-1 adult hyperlipidemic group and Group-2 healthy adults group. Both groups were additional divided into 3 subgroups with different exercise intensity i.e. light, moderate and high intensity exercise. To evaluate the health status of participants, graded exercise test by using Bruce protocol and the HRmax was performed and given a specific exercise program for 12 weeks. The test was a conducted as per Bruce protocol (Smith 2013), using a treadmill with heart rate monitoring and ECG monitor. Blood sample had been taken for the analysis of total cholesterol and serum levels of BDNF.
Results: Mean levels of brain derived neurotropic factor (BDNF) of healthy and hyperlipidemic participants in all three different intensity exercise group (A, B, and C) at baseline and three follow-ups shown no statistically significant difference between LIEG on BDNF level from baseline (day zero) till three consecutive follow ups (p>0.05). While, in moderate (p<0.05) and high intensity participants (p<0.01) demonstrated an increase in BDNF levels at 90th day when compared from baseline i.e. day zero. Prominently, no significant difference observed at baseline (p>0.05), however a significant difference was found at day 30, 60 and 90 (p <0.05, 20.01, <0.001) respectively.
Conclusion: In light of our findings we conclude that 12 weeks of moderate to high intensity exercise progress cognitive function, serum BDNF levels, and improved lipid profile parameters, while low intensity exercise showed no significant mean difference for healthy participants.
Early Respiratory Symptoms of Water-Pipe (Shisha) Smoking in Medical Students of Karachi
Authors: Komal Kiran Galaria  , Nadia Younus  , Rahat Zubair  , Malik Balaj Khan  , Sameen Adib Rehman  , Safa Shahab  , Syed Muhammad Ishaque  
Published: February 2023

Objective:
Water pipe smoking WPS (Shisha) is becoming increasingly acceptable in the youth and is contributing to the burden of respiratory diseases. The aim of this study was to assess the frequency of early respiratory symptoms in relation to the severity and duration of WPS smoking in the medical students of Karachi.
Methods:
This cross-sectional study was conducted in medical colleges of Karachi. A self-administered questionnaire collected information about smoking habits and respiratory symptoms from students.
Results:
Out of 250 participants, 68.8 % (n=172) were short term smokers. 31.6% (n=79) reported to have smoked shisha monthly. The main reason of smoking shisha for 26% (n=65) was just to fill in the free time with friends. 39.4% (n=88) intend to quit shisha smoking in future. 32.4% (n=81) of the students experienced shortness of breath, 30.4% (n=76) Dry cough, 30.4% (n=76) Scratchy sensation in the throat, 23.6% (n=59) rapid breathing, 20% (n=50) chest tightness and 13.6% (n=34) hoarse voice after shisha consumption. The association of these symptoms with duration and severity of shisha exposure remained insignificant.
Conclusion:
The results of this study show that smoking shisha can bring about the early respiratory symptoms. Education is important in creating awareness about WPS hazards.
Key words:
Water-pipe; Shisha; Smoking; Medical students; Respiratory symptoms