bluuebunny/crossref_metadata_2025_split huggingface dataset:
Transportation Difficulties Faced by Female Students of Karachi Medical and Dental College (KMDC) and University of Karachi (UoK)
Authors: Afreen Humayun  , Hira Saleem  , Rimsha Raza  
Published: February 2023

Objective: To determine the frequency of different modes of transportation used by female students of KMDC and UoK, and to study the difficulties faced by them while commuting to their universities and the subsequent effect on their studies.
Methods: An institutional and questionnaire-based study was conducted among the female students of KMDC and UoK aged 17-25 years from May to December 2016. The study was approved by the Ethical Review Board of Karachi Medical and Dental College. A total of 600 students were included in the study by probability (simple, random) sampling method. Students responded to a series of questions regarding mode, convenience and difficulties related to transportation and the impact transportation difficulties had on their education. The data was analysed by using SPSS Version 20.0. Written consent was obtained from the students prior to filling the questionnaire.
Results: Out of 600 students, 50.8% used transport provided by the university/college, 53.8% did not consider any means of transportation safe, 54.5% students reported that their studies were affected due to indirect factors such as stress, trauma, fatigue, pollutants, congestion and the consequences were fewer study hours and delayed arrival in class. The frequency of physical along with verbal ha- rassment faced by the students while commuting was reported as 31.3%.
Conclusion: Majority of participants complained that their studies were affected by stressful travelling and other transport issues but those travelling by the transport provided by the institute had fewer problems. Efforts should be made to overcome these problems affecting female education.
Rubber Dam: Is it a Popular Method of Field Isolation among Dentists in Karachi?
Authors: Asaad Javaid Mirza  , Maaz Asad Javaid  , Shama Asghar  
Published: February 2023

Objective: To find out the frequency of rubber dam usage among clinical students, interns and dental practitioners and the barriers they come across to place it routinely in their practices.
Methods: An observational cross-sectional study was performed from October 2016 to January 2017 using non-probability convenience sampling. A questionnaire was meticulously designed based on questionnaires used in similar studies in the past. The target population in this study was clinical dental students, interns and the faculty members working in various teaching institutions in Karachi and involved in general dental practice. Data from completed questionnaire was analysed using SPSS version 20.
Results: With the healthy response rate of 81%, this study shows that the majority (76%) of clinical students, interns and practicing dentists in Karachi, Pakistan continue to ignore the rubber dam placement in their routine practices. Total 89% of non-users did not use it as they find it time con- suming and 66% of them mentioned that it is difficult to place. Couple of other reasons for which more than 50% of respondents avoid using rubber dam are frequent tearing of the sheet and patient's fear or abhorring attitude towards placement of rubber dam.
Conclusion: This study suggests that use of rubber dam is an unpopular method for isolation of op- erative site among clinical students, interns and clinicians working in Karachi.
Anaemia Frequency and its Socioeconomic and Dietary Determinants among Teenage School Girls of Karachi
Authors: Zaira Batool  , Saadiya Aziz Karim  , Amna Begum  
Published: February 2023

Objective: To assess the frequency of anaemia and to determine its socioeconomic and dietary de- terminants among teenage school girls of Karachi.
Methods: A cross-sectional study was carried out from January to July, 2015. The study subjects were chosen from four schools, two each from high socioeconomic and poor neighbourhoods of Karachi. Our study was conducted on 497 school girls aged 13 to 18 years, who were enrolled by employing convenient sampling, after informed consent of parents and principal of the school. All study subjects were interviewed using a questionnaire, clinically examined for signs of anaemia and measurements taken for anthropometric and haemoglobin estimation.
Results: The primary study outcome was the anaemia status of the study participants as determined by their haemoglobin level using a cut off of 11 gm/dl. The study results showed that only 167 (36.5%) of the participants were anaemic and majority of them was negative for signs of skin pallor (66.6%), conjunctival pallor (79.8%), koilonychia (95.8%) or brittle hair (86.4%). The factors found to be significantly associated with anaemia included lower socioeconomic status (p<0.0001), paternal illiteracy (p=0.022) and paternal unemployment (p<0.0001). Furthermore, the study findings also re- vealed infrequent consumption of eggs (p=0.015), milk (p=0.019), spinach/green leafy vegetables (p=0.004) and chocolates/candies/biscuits/cakes (p=0.039) to be significantly associated with anaemia.
Conclusion: The study suggest that frequency of anaemia in teenage school girls was significantly associated with lower socioeconomic status, paternal illiteracy, unemployment, infrequent consump- tion of eggs, milk, spinach/green leafy vegetables and chocolates/candies/biscuits/cakes. Hence, urgent needs of improving paternal illiteracy, decreasing unemployment and increasing educational awareness in teenage girls regarding the consumption of iron rich foods.
Correction of Serum Potassium Level in Hypokalaemic Patients with Hypomagnesaemia	and	Normomagnesaemia
Authors: Azfar Athar Ishaqui  , Muhammad Liaquat Raza  , Iyad Naeem Muhammad  
Published: February 2023

Objective: To determine the extent of increase in potassium level after intravenous infusion of potassium chloride in hypokalaemic patients with hypomagnesaemia and normomagnesaemia and to overview the impact of different concentrations and dilutions of potassium chloride infusion for rapid correction of hypokalaemia.
Methods: A prospective, cohort study was conducted in Abbasi Shaheed Hospital, Karachi from January to March 2016. Convenience sampling was done, 46 patients were included who had a Serum Potassium level less than 3.5 meq/L at the time of admission to the hospital. Protocols of potassium chloride infusion such as such as 20 mEq/200 ml, 30 mEq/300 ml, 40 mEq/400 ml and 50 mEq/500 ml were given to three groups of hypokalaemic patients having hypomagnesaemia, normomagnesaemia and hypermagnesaemia to figure out the correlation of potassium correction with serum magnesium level. The pre and post-infusion serum potassium levels were checked along with the outcome of the extent of increase in potassium levels.
Results: For 46 patients (mean age 60 ± 3 (r= 21-96 years), the mean pre-infusion serum potassium and magnesium levels were found to be 3.12 ± 0.04 (r= 2.30-3.5) mmol/L and 0.81 ± 0.03 (r= 0.52- 1.58) mmol/L respectively. The difference in the pre/post-infusion serum potassium levels in hypokalaemic patients with hypomagnesemia (n= 46) was not found be significant (p>0.05) whereas the pre/post-infusion serum potassium level was significant (p<0.05) in hypokalaemic patients with normomagnesaemia or hypermagnesaemia.
Conclusion: Serum magnesium level needs to be concurrently monitored and corrected in mild to moderate hypokalaemic patients as low magnesium levels were found to have profound effect on serum potassium level in patients receiving potassium supplement for correction of potassium level back to normal.
Obesity-An Impactful Risk Factor for Gastro-Oesophageal Reflux Disease
Authors: Ajeet Kumar  , Syeda Urooj Riaz  , Syeda Urooj Riaz  
Published: February 2023

Objective: To determine over-weight and obesity as risk factors for Gastro-oesophageal reflux dis- ease (GERD) in the outpatient department (OPD) of a tertiary care hospital.
Methods: One hundred patients of both genders, presenting with symptoms of GERD were selected as cases and one hundred controls from attendants of various patients not suffering from GERD by random sampling during October 2016 to April 2017. Both the cases and controls were weighed (kilo- grams) and their heights (centimetres) were measured. Their BMIs (body mass index) were calcu- lated. The cases and controls were then categorised into normal weight, over weight and obese subjects on basis of BMI by WHO criteria. Subjects, with ischaemic heart disease, hypertension, diabetes, peptic ulcer disease those taking NSAIDs (non-steroidal anti-inflammatory drugs), and steroids were excluded.
Results: In this present study, the frequency (the percentage) of male and female was 48.5%, 51.5% respectively. It was found that there were about 52.0% and 48.0% males and females respectively in controls while 45.0% and 55.0% in case. Mean and SD of weight of cases and controls were as 73.17 ± 9.853 kg and 68.78 ± 6.738 kg respectively. The p-value=0.000 showing that there was a significant association between BMI and outcomes i.e. occurrence of GERD (cases and controls).
Conclusion: This study showed that over-weight and obesity were associated with a statistically significant increase in the risk for GERD symptoms i.e. increased by 3 times in all patients, 2 times in males and 7 times in females.
Analysis of Optic Nerve Types in Relation to Posterior Paranasal Sinuses: A Computed Tomographic (CT) Study
Authors: Mubina Lakhani  , Muhammad Ali  , Madeeha Sadiq  
Published: February 2023

Objective: To assess the variations in the course of optic nerve (ON) in relation to sphenoid sinus with the help of CT scan.
Methodology: A cross-sectional study was carried out using computed tomographic (CT) paranasal sinus scans of two hundred and seventy study participants between January 2017 and May 2017. Non-probability consecutive sampling technique was used and data was entered on SPSS version 23. Inclusion criteria comprised of adults coming for CT head and brain who did not have bony abnor- mality of sphenoid and ethmoid sinuses or adjacent structures. However, individuals with sinonasal tumors, chronic rhinosinusitis, prior sinus surgery, facial fracture, nasal polyposis and congenital craniofacial anomaly were excluded from this study. Analysis of optic nerve was carried out according to DeLano's classification.
Results: Type 1 ON was found to be the most frequent type; 55.93%, followed by type 2 with a frequency of 26.85%. However, type 3 and type 4 appeared less frequently, that is 11.1% and 6.11%, re- spectively. When comparing right and left sides it was noted that the frequency of type 1 optic nerve was found to be higher on both right and left sides with a value of 56.30% and 55.5%, respectively. Type 2 showed a frequency of 26.67% on right side and 27% on left side. Type 3 was identified to be 11.4% and 10.7% on right and left sides, respectively. Type 4 optic nerve was found to be the least common type in our study on both sides, i.e. 5.56% on the right side and 6.67% on the left side.
Conclusion: The combined percentage of type II and type III ON that is 37.96% in our sample brings us to this conclusion that fairly high percentage of our population is exposed to increased potential risk of iatrogenic optic nerve injury thus emphasising the need for careful evaluation of ON in relation to sphenoid sinus anatomy on CT scan prior to endoscopic sinus surgery.
Detecting Anatomical Variations of Coeliac Trunk Branching Pattern in the Population of Karachi Using 3D Multidetector Computed Tomographic Angiography	(MDCTA)
Authors: Rosheena Nabeel Khan  , Muhammad Ali  , Madeeha Sadiq  
Published: February 2023

Objective: To find out the frequency of variations in coeliac trunk branching pattern by Using 3D Multidetector Computer Tomographic Angiography (MDCTA),in patients referred to Radiology Department of Ziauddin University Hospital with abdominal pain, altered bowel habits, kidney or adrenal pathologies
Method: For this study, 160 individuals aged 20-60 years, without any abdominal vascular or upper ab- dominal visceral disease who presented to Radiology Department, Ziauddin University Hospital, Clifton Karachi, for abdominal 3D-MDCTA (3-dimensional multidetector computed tomographic angiography) from March 2017 to August 2017 were recruited in this study. It was a cross-sectional study and samples were collected through non-probability convenience sampling technique. Recruitment of study participants was done from patients who were referred to radiology department of Ziauddin University Hospital for abdominal contrast MDCTA examination due to various indications such as abdominal pain, altered bowel habits, kidney and adrenal pathologies. Persons having serum creatinine levels <1.4 mg/dl with no hepatobiliary pathologies, pancreatic or abdominal vascular lesions were included while patient having, abdominal malignancy distorting vascular anatomy, vasculitis and atherosclerosis were ex- cluded from the study. Patients having history of liver transplant or upper abdominal surgeries or those having history of allergic reaction to contrast agents and pregnant ladies were also excluded from the study. Coeliac trunk variations were categorised according to Uflacker's classification into 8 types. Statis- tical analysis was done on SPSS version 20. Data is presented in percentages and frequencies.
Results: Classical coeliac trunk (type I) was present in 134 out of 160 (83.9%) individuals while 26 (16.1%) individuals showed coeliac trunk variations. Type II and type V variations were second most fre- quent variations i.e. in 9 (5.6%) individuals each, followed by type VII in 5 (3.6%) individuals. Type III, IV and VI showed variations in 1 (0.6%) individual each. Type VIII was not found in our sample.
Conclusion: The present study reports normal configuration of coeliac trunk i.e, classic or type I coeliac trunk in 83.9% individuals and coeliac trunk variations in 16.1% individuals.
Liver Dysfunction in Hypothyroid Non-Pregnant Women
Authors: Mohammad Yousaf  , Zahoor Ahmad  
Published: February 2023

Objective: To evaluate the effects of under secretion of thyroid hormones and its relation with liver markers i.e. alanine transaminase (ALT) and aspartate transaminase (AST) in non-pregnant women.
Methods: This cross-sectional study was conducted in Khyber Teaching Hospital Peshawar from March 2014 to March 2015. The study was performed on 150 non-pregnant women in the age group of 18-70, attending the outpatients departments of Khyber Teaching Hospital for thyroid screening. The exclusion criteria were pregnancy, hypertension, renal impairment and known history of liver ab- normalities. Thyroid and liver function tests were performed for all the patients and control using standard kits and procedure. Normal subjects in the same age group were selected randomly from the local population of Peshawar city and were used as control (N) for the study. Competitive ELISA tech- nique was used for the analysis of T3 and T4 on Dia 710 microplate reader, while sandwich ELISA was used for TSH analysis. Quantitative tests for both ALT and AST were performed according to the international federation of clinical chemist (IFCC) protocols on Erbamannhein chemistry auto-analyser (Germany) using standard Erba kits.
Results: ALT and AST level was found to be lower in the patient groups [Overtly hypothyroid (Oh): 24.35 ± 1.11 IU/L, sub-clinically hypothyroid (Sh): 16.85 ± 0.55 IU/L] than the control group (N: 29.69 ±3.28 IU/L). A significant positive correlation was observed between AST and TSH (thyroid-stimulating hormone) in the control group (N) (p=0.002) and negative correlation in overtly hypothyroid (Oh) and sub-clinically hypothyroid (Sh) groups, respectively. No other significant correlation was observed be- tween ALT, TSH, T3 (triiodothyronine) and T4 (thyroxine) in any other groups.
Conclusion: Both liver enzymes (ALT and AST) were found to be lower in the patients groups (Oh and Sh) as compared to control group (N).
Frequency of Immunisation Status, Complications and Outcome in Children Admitted with Measles in Public and Private Sector Hospitals of Karachi
Authors: Musarrat Ameer  , Sina Aziz  , Shaista Ehsan  , Ume Kulsoom  
Published: February 2023

Objective: To assess the immunisation status, frequency of complications and the outcome in chil- dren admitted with measles in public and private sector hospitals of Karachi.
Methods: In this cross-sectional study a total of 382 patients admitted with measles, of either sex from 3 months to 13 years, who presented from March 2016 to March 2017 were included. A total of 265 (69.3%) children were from Ziauddin University Hospital (ZU) and 117 (30.6%) from Abbasi Shaheed Hospital (AS). Non-probability convenient sampling technique was used. Those with con- genital anomalies and chronic medical illnesses were excluded from the study. Detailed history and physical examination was done, and findings entered in a Proforma. Immunisation status of the pa- tients was recorded. All the patients were observed for complications like encephalitis, pneumonia, diarrhea, otitis media, epiglottis, febrile fits and corneal ulcers. Statistical analysis was done using SPSS version 22. Categorical values were compared by chi-square test, p-value of <0.05 was con- sidered significant.
Results: A total of 382 were patients admitted with measles, 265 (69.3%) from Ziauddin University hospital and 117 (30.6%) from Abbasi Shaheed Hospital. Overall, 57.4% were completely vaccinated in ZU vs. 32.5% in AS. Despite being completely vaccinated, children in ZU; 152/265 (80%) and in AS; 38/117 (30.6%) had complications with a statistically significant (p<0.0001) difference between private and government sector hospitals. Predominantly, in both hospitals pneumonia was common followed by gastroenteritis. Overall mortality was 13/382 (3.4%) in both hospitals combined.
Conclusion: A sizeable number of children admitted with measles in both private and government hospitals were unvaccinated. A significant number developed measles despite receiving two doses of vaccine. Frequency of complications was higher in private versus government hospitals. Mortality from measles was high (3.4%) especially in the unvaccinated.
Correlation between Blood Pressure Levels and Clinical Signs and Symptoms of Hypertensive Patients: A Gender and Age Based Comparison
Authors: Nargis Anjum  , Muhammad Naveed uz Zafar  , Sana  Noor  , Summaiya Iqbal  , Syed Muhammad Zulfiqar Hyder  , Adnan Anwar  
Published: February 2023

Objective: To determine correlation between systolic and diastolic blood pressure levels and selected signs and symptoms among different gender and age groups of hypertensive patients.
Methods: A cross-sectional study was carried out at urban hospital after taking ethical approval, among patients with self-reported history of hypertension and on anti-hypertensive medication. After taking ethical approval, a total of 372 patients aged 18 or above were included in the study by employing convenient sampling technique. A detailed history was taken from each patient about hypertension associated symptoms with the help of a questionnaire whereas designed specifically for the study. Blood pressure was measured using sphygmomanometer with stethoscope. SPSS version 20 was used to analyse the collected data and the duration of study was 6 months.
Results: Among males older age, belonging to older age group >40 years, having more height and positive history of irregular heartbeat/palpitation were highly correlated with increase in systolic blood pressure (p<0.001 for all), among females, positive history of sleep apnoea was highly correlated with increase in systolic blood pressure (p<0.001) and having more height and positive history of sleep apnoea were highly correlated with increase in diastolic blood pressure (p<0.001 for both), among <40 years old milder change in urinary frequency was highly correlated with increase in systolic blood pressure (p<0.001) whereas among >40 years old positive history of headache, vertigo, sleep apnoea and irregular heartbeat/palpitation were highly correlated with increase in systolic blood pressure (p<0.001 for all) and having more height was highly correlated with increase in diastolic blood pressure (p<0.001).
Conclusion: Among other signs and symptoms, positive history of irregular heartbeat/palpitation was found to be significantly correlated with both high systolic and diastolic blood pressure levels in both males and females as well as in >40 years old patients.
Gestational Trophoblastic Disease and Gestational Trophoblastic Neoplasm - An Experience at Tertiary Care Hospital
Authors: Shakira Perveen  , Shazia Jabbar  , Shafia Nizar  
Published: February 2023

Objective: To determine the frequency of gestational trophoblastic diseases and gestational tropho- blastic neoplasm, its risk factors and prognosis.
Methods: This was a descriptive, cross-sectional study conducted at Civil Hospital, Karachi from March 2015 to September 2015. All cases of gestational trophoblastic disease after necessary inves- tigations like tumour marker b-hCG, ultrasound with classical picture of "bunch of grapes" or "snow storm" pattern and X-ray chest (for lung metastases) under went suction evacuation. In all cases specimen was sent for histopathology to confirm gestational trophoblastic disease. After primary treat- ment, cases were followed with b-hCG till complete remission was achieved. During follow-up, cases were labelled as gestational trophoblastic neoplasm on the basis of International Federation of Gyne- cology and Obstetrics (FIGO) criteria. After risk scoring on World Health Organization (WHO) criteria, chemotherapy was given.
Results: Out of 497 pregnant ladies, 40 were cases of gestational trophoblastic disease (8.05%). Frequency/obstetric case was 1.7% and frequency/delivery was 2.1%. Out of 40 cases 13 (32.5%) were cases of gestational trophoblastic neoplasm. Out of 13 cases of gestational trophoblastic neo- plasm 9 (69.23%) were labelled as low-risk and 4 (30.76%) as high-risk cases. All cases achieved complete remission. One case of high-risk group expired.
Conclusion: All women with gestational trophoblastic disease must be followed as per recommenda- tion with serum b human chorionic gonadotropin measurement until the levels are undetectable, for early diagnosis and optimum treatment of gestational trophoblastic neoplasm.