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Objective: To study the epidemiological trends and risk factors during the dengue outbreak among population of East Karachi, Pakistan. Study Design: Retrospective Analysis and Review. Setting: Dengue Control and Prevention Center, East Karachi. Period: September 2020 to November 2020. Methods: We retrospectively analyzed the data of 1012 patients from East Karachi who were tested positive for dengue virus during the study period. Patients demographics, travel history, vector source, and outcomes were recorded. Statistical analysis was done using IBM-SPSS, version 26.0. Results: Most of the patients were male (60.6%), with the majority (21.0%) belonging to the 30- to 39-year-old age group. Majority (81.2%) were from Gulshan Town. Overall, UC14 and Faisal Can't have the highest number of cases (18.3%) followed by UC 5, Gulshan-1 (8.5%), and UC 10, Pehalwan Goth (8.3%). A total of 80% of the patients were alive, and 20% expired. The majority (40%) were found to have a vector-prone area in vicinity, primarily a botanical nursery. An abrupt surge in cases can be seen for the month of October. The number of dengue cases showed rapid increase in Karachi East, Pakistan. Conclusion: There is a need to educate the population about the preventive measures against the spread of viruses. The concerned authorities should devise an adequate and effective plan to flatten the infectivity curve. If necessary changes are not made, future outbreaks could be more serious, disastrous, and uncontrollable. [ABSTRACT FROM AUTHOR]

Objective: To compare and evaluate the efficacy of platelet-Rich-Fibrin and zinc Oxide Eugenol in pain relief management patients presenting Alveolar Osteitis. Study Design: Prospective study. Setting: Department of Oral diagnosis, liaquat university of medical and health sciences Hyderabad. Period: 1st March 2021 to 31st August 2021. Methods: Total 80 patients with alveolar osteitis were involved in the study. Patients were equally randomly categorized into two groups A and B, the intensity of pain was measured by VAS scale on prospective days Platelet-rich-fibrin treatment was given to group A, while Zinc Oxide Eugenol was given to group B. VAS score was recorded on every prospective day and results were recorded on an MS Excel sheet. Results: Out of 80 patients of AO, 28 were male and 52 were female patients, the mean age of females was 34.25 while the male mean age was 38.5. The mean pain score on 1st prospective day was 3.8 ± 1.3 for group A while group B Was 7.5 ± 1.7. On 3rd prospective day of the trial, the mean pain score was Group A was 2.9 ± 1.1 and Group B was 4.7 ± 1.3. On day 5th the mean pain score of Group A was 1.1 ± 0.9 and Group B was 3.0 ± 1.0 and on the last 7th prospective day the mean score of Group A was 1.0 ± 0.6 and Group B was 1.8 ± 0.8. Conclusion: The study observed PRF is more effective than ZOE in pain management patients presenting AO. [ABSTRACT FROM AUTHOR]

Objective: To observe the effects of moringa oleifera on lipid parameters of rabbits. Study Design: Experimental Trial. Setting: was carried out on healthy animal models using adult male rabbits in indoor Patient Ward of Pakistan Veterinary Clinic and Pet Centre Nawabshah. Period: January 2023 to June 2023. Methods: Thirty adult male rabbits age ranging from 16 to 24 months having weight between 2 to 3 kg were selected and randomly divided in to three groups comprising 10 rabbits in each group. Data was analyzed by using SPSS version 25.0. Results: The mean Cholesterol, LDL, HDL and Triglycerides level of the rabbits were compared between Group A (Control), Group B (250 mg/Kg MO) and Group C (500 mg/Kg MO) and data was collected on four scheduled days (Day 0, 15, 30 and 45). Statistical significant test repeated measure ANOVA was applied and there was statistically significant difference among means Cholesterol level in each time period in both Group B and C with P-value 0.002 on groups, mean LDL level with P-value 0.014 and 0.000 on both groups and mean HDL level with P-value 0.000 and 0.015on both groups. There were no statistically significant differences between means in Serum Triglyceride level in both groups with P-value 0.063 and 0.149. Conclusion: It was concluded in our study that Moringa Olifera has potential role in lowering serum Cholesterol, LDL and HDL level with regular use. But we cannot find any significant difference in lowering triglyceride level. [ABSTRACT FROM AUTHOR]

Objective: To determine the influence of serum ferritin levels on glycemic control in patients with type 2 diabetes mellitus (T2DM) patients. Study Design: Cross-sectional study. Setting: Department of Medicine, Liaquat University Hospital, Hyderabad, Pakistan. Period: July 2021 to December 2021. Material & Methods: A total of 180 patients of 30-60 years of age and either gender, and known cases of diabetes mellitus for =3 year duration were included. Demographic, clinical and laboratory data was recorded. HbA1c below 7% was labeled as good glycemic control while HbA1c above or equal to 7% was designated as poor glycemic control. The serum ferritin =307 µg/L was considered as raised. Association of glycemic control with respect to serum ferritin levels was noted. Results: In a total of 180 patients of T2DM, the mean age, duration of diabetes, and HbA1c were 53.62 ± 5.82 years, 11.91±4.92 years, and 12.41 ± 5.73% respectively. The mean serum ferritin was 512±22.53 ug/L, whereas serum ferritin was raised in 109 (60.5%). The serum ferritin levels were significantly higher in patients with poor glycemic control than those having good glycemic control (56.0% versus 44.0%, p=0.044). Conclusion: In contrast to individuals with good glycemic control, patients with poor glycemic control more frequently had elevated serum ferritin levels, according to the current study. In order to properly manage diabetes patients and prevent the negative effects of elevated serum ferritin levels, serum ferritin should be included in the usual screening protocol of diabetic patients while monitoring their glycemic status. [ABSTRACT FROM AUTHOR]

Objective: To investigate the relationship between transfusion frequency, serum ferritin levels, and hepatomegaly in beta-thalassemia major patients. Study Design: Cross-sectional study. Setting: Thalassemia Center, Liaquat University Hospital, Hyderabad. Period: January 2023 to June 2023. Material & Methods: Among 158 patients, age until 19 years, and ß-thalassemia type major was considered as inclusion criteria. Data regarding hematological parameters and hepatomegaly was collected after informed consent. Data was analyzed using SPSS (version 22). Chi-square test was used to investigate the association between ferritin levels and hepatomegaly while Pearson's correlation was used assess the correlation between ferritin levels and transfusion frequency. P-Value = 0.05 was considered as statistically significant. Results: Majority of the participants were males (58.22%) as compared to females (41.77%). The mean age of the study participants was 9.31±4.47 years, and the mean age at first transfusion was 8.98±0.93 years. Majority of the participants were underweight 107(67.72%). Monthly transfusion rate was 1.95±0.31. The mean serum ferritin levels among the study participants were 2033.06±1309.36 ng/mL. Hepatomegaly was found to be present in 99 (62.65%) of the study participants. Statistically significant positive correlation between the frequency of transfusion and serum ferritin levels (r = 0.71, p<0.05) was observed. The difference of hepatomegaly in low-ferritin vs high-ferritin was also found to be statistically significant (p<0.05). Conclusion: It was concluded that higher transfusion rates were associated with elevated ferritin levels, and there was a significant association between higher serum ferritin levels and the presence of hepatomegaly. [ABSTRACT FROM AUTHOR]

Objective: To assess the correlation of vitamin cholecalciferol and serum calcium with left ventricular hypertrophy (LVH) in essential hypertension patients presenting at a tertiary care hospital. Study Design: Cross Sectional Comparative study. Setting: Department of Cardiology and Medicine, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh. Period: July 2019 to January 2021. Material & Methods: 100 diagnosed LVH+ Essential Hypertenison cases and 100 diagnosed essential hypertension (controls) were selected through non-probability purposive sampling. Echocardiography, serum cholecalciferol, calcium, phosphate, parathyroid hormone (PTH), alkaline phosphatase (ALP), urea and creatinine were measured form sera. Devereux’s formula measured the LV thickness LVH. SPSS ver. 21.0 analyzed the descriptive statistics and compared the variables at 95% Confidence interval (P≤0.05). Results: Serum calcium, phosphate and parathyroid hormone were found elevated in LVH cases compared to control (P=0.0001). Cholecalciferol in LVH cases was low noted as 27.3±7.84 ng/dl compared to 39.5±0.43 ng/dl in controls (P=0.0001). Cholecalciferol in mild, moderate and severe LVH cases was descending order as 30.67±7.84, 24.76±7.72 and 14.96±6.12 mm respectively (P=0.0001). Serum cholecalciferol proves inverse association (r= -0.180) with LVH (p=0.003). Conclusion: The present study reports vitamin cholecalciferol deficiency increases the chances of left ventricular hypertrophy through increased secretion of parathyroid hormone that induces de – novo protein synthesis of ventricular myocardium. [ABSTRACT FROM AUTHOR]

Objective: To examine the anthropometric, blood sugar, and lipid profiles of healthy adults, including those with and those without a history of type 2 diabetes mellitus. Study Design: Case-control study. Setting: Peoples University of Medical & Health Sciences for Women (PUMHS) in Nawabshah. Period: October 1st 2022 to 31st March 2023. Material & Methods: The research included 110 participants. 55 of them had at least one parent with type 2 diabetes mellitus, and the other 55 did not. Males and females between the ages of 18 and 25 were present in the study. The following measurements were compared: fasting blood sugar, lipid profile, waist height to hip ratio, and body mass index. Results: This case-control study compares offspring with and without a family history of type 2 DM to determine if there are any anthropometric or metabolic differences. Participant with a family history of type 2 DM showed higher BMI, WC, and WHtR according to the anthropometric measurements. Statistically significant differences were found in their BMI (P-value <0.0001). Even though BMI showed a significant difference, the mean value did not fit into the criteria to be categorized as obese. Conclusion: The present research has shown that people with a family history of type 2 diabetes mellitus are overweight and have abnormal lipid profiles even before they manifest overt type 2 DM. [ABSTRACT FROM AUTHOR]

Objective: To evaluate association of E-cadherin with different histopathological grading of oral squamous cell carcinoma in Hyderabad region. Study Design: Cross-sectional study. Setting: Department of Oral and maxillofacial surgery and Oral Pathology, Isra Dental College (IDC) Hyderabad. Period: 25th November 2021 to 25th November 2022. Material & Methods: Total 58 patients of OSCC and 10 normal mucosa samples were enrolled in this study, patient's age, gender, habit and site of lesion was recorded on proforma. Total 68 paraffin embedded tissue fragments were processed and stained with Eosin & Hematoxylin stain. Further the tissue sections were immune-stained with E-cadherin and slide evaluated by pathologists. Results: Total 58 diagnosed patients of OSCC were characterized into three groups well differentiated, moderatly, and poor ly differentiated OSCC. Total 46 (79%) were male and 12 (21%) were female. The cruel age of a female to male was 36.14 VS 43.21 years. The mean age of a female to male was 36.14 VS 43.21 years. Study reported decrease level of E-cadherin appearance with increasing "histopathological grading of OSCC", expression of E-cadherin was high in well differentiated OSCC followed by moderately differentiated OSCC and poorly differentiated OSCC. Conclusion: study concluded that loss of E-cadherin has been associated with incresed invasiveness and metastatic potential in various cancers, including oral cancers. The level of E-cadherin expression recorded decrease with increasing severity and histopathological grading of OSCC. This would be proven a useful marker tool for the prediction of OSCC grading and oral cancers to metastasize, providing valuable information for cancer diagnosis and treatment planning. [ABSTRACT FROM AUTHOR]

Objective: To compare the optimum imaging modality to assess the various kinds of Shajjah hurt in MLE cases of head injuries. Study Design: Cross-sectional study. Setting: Department of Forensic Medicine and Toxicology at Gambat Medical College at Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences, GAMBAT. Period: March 2021 to February 2022. Material & Methods: Medicolegal cases of head injuries of all age groups (infant to old) and of either gender presented to the Emergency department for treatment and medicolegal certification were included. 164 medicolegal cases of moderate to severe head injuries were included based on Glasgow Coma Scale (GCS) score of 12 or less. Injuries were categorized according to age, gender, kinds of Shajjah and modality with which the type of Shajjah hurt was diagnosed. Results: X-Rays failed to detect Shajjah hurt in at least one-fourth of the cases. X-Rays misdiagnosed 5 cases of Munaqillah, 48 cases of Ammah, and 21 cases of Damighah as Shajjah e Hashimah. X-rays also misdiagnosed the 16 cases of Shajjah e Ammah and 7 cases of Shajjah e Damighah as Shajjah e Munaqillah (fracture with dislocation). CT scan accurately diagnosed 16 (9.76%) cases as Shajjah hashimah, 20 (12.2%) as Shajjah Munaqillah, 79 (48.17%) as Shajjah Ammah, and 49 (29.88%) as Shajjah Damighah. Conclusion: In comparison to X-ray, CT scan had superior performance in correctly assigning the type of Shajjah hurt. [ABSTRACT FROM AUTHOR]

Objective: To determine the histo-morphometric effects of energy drink consumption in different doses on the pancreatic tissue of Wistar Albino rats. Study Design: Experimental study. Setting: Department of Pharmacology, Isra University, Hyderabad. Period: April 2021 to September 2021. Material & Methods: Thirty healthy albino Wistar rats of body weight 200±20 were included in the study. Rats were divided equally into three groups. Group I (Control), Group II (Low dose energy drink 7.5 ml/day) and Group III (High dose energy drink 15 ml/day). The body weight of all animals was measured. Blood samples were collected for the biochemical analysis including serum glucose, serum insulin level, and oxidative markers. Histo-pathological and morphometric findings were observed. Results: A statistically significant rise in body weight in groups II and III (p<0.05). Significantly increased serum glucose and declined insulin level was seen in group II and III compared with controls (p<0.05). There was a significantly lower level of oxidative markers observed in group III than in groups I and II (p<0.05). The mean pancreatic acini and islets diameter in groups II and III has decreased significantly compared with group I (p<0.05). The histo-pathological grading reveals that mild to moderate parenchymal changes in the pancreatic tissue of group II rats compared with group I. While moderate to severe changes were observed in group III compared with group I and II rats. Conclusion: Caffeinated energy drink consumption results in oxidative stress and degenerative changes in the potential to seriously alter the exocrine and endocrine pancreas' normal morphology consumption. [ABSTRACT FROM AUTHOR]

Objective: To determine the Paracetamol induced liver enzyme (AST/ALT) changes in dengue fever in a tertiary care hospital of Hyderabad. Study Design: Observational Study. Setting: Emergency Department of Medicine, Isra University Hospital, Hyderabad. Period: May 2018 to May 2019. Material & Methods: A total of 100 patients of age =12 years with dengue fever were included. AST and ALT levels were obtained in the first week and third week of course of illness. Paracetamol was used for anti-pyretic/analgesia purpose was compared of first week with third week. Statistical analysis was done using SPSS. Chi-square test and student's t-test were applied as appropriate. P value =0.05 was considered as significant. Results: Out of total 100 patients, there were 56% males and 44% females and overall mean age was 35.21±15.13 years. The overall mean weight, height, BMI, and mean duration of fever in days was 61.13±17.26 kg, 1.60±0.14 meter, 23.85±6.73 kg/m2, and 4.20±1.43 days, respectively. Independent t test shows significant mean difference of AST/ALT ratio at 1st week (p=0.000) as well as at 3rd week (p=0.020) according to paracetamol dose. Conclusion: In our study, results showed significant improvement in AST, ALT, and AST/ALT ratio at 1st week and 3rd week. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the frequency and association of p53 gene with increase histopathology categorizing of “oral squamous cell carcinoma” patients. Study Design: Comparison Cross-sectional Research. Setting: Isra Dental College Hyderabad. Period: 1 November 2021 to 31 October 2022. Material & Methods: Sixty patients of identified oral squamous cell carcinomas were chosen by consecutive sampling from patients reporting at Oral surgery department Isra dental college, Poly-L-lysine solutions was used over all of the formalin-fixed, paraffin embedded segments, and was prepared for immunostaining. Primary antibody and counter stain hematoxylin was used and dehydrated through graded alcohol dilutions. Sections were mount by Dpx and results interpreted. Results: Sixty instances of oral squamous cells carcinoma divided into histological grading well differentiated OSCC, moderately differentiated OSCC, and poor differentiated OSCC based on their histological characteristics. Fifty-two (87%) of the participants in this study were male, while just eight (13%) were females. Association of p53 were found insignificant with age. Gender and other clinical factors of OSCC, the prevalence of p53 gene countenance was found increase in oral squamous cell carcinoma. But there was no any significant association found with the increase histological grading of OSCC. Conclusion: Prevalence of P53 gene expression found increase in OSCC. While P53 expression was not significantly found with increase histological grading of oral squamous cell carcinoma. [ABSTRACT FROM AUTHOR]

Objectives: To find out the correlation between inter commissural width and maxillary inter canine width. Study Design: Cross-sectional Research. Setting: Department of Prosthodontics Dental OPD LUHMS Jamshoro. Period: June to December 2021. Material & Methods: A total of 100 patients with maxillary impressions of patient were taken in metal perforated stock trays with irreversible Hydrocolloid impored immediately with dental stone type IV for making the study cast. Questionnaire mode of research instrument was used for the data acquisition during patient treatment. In parallel with maxillary anterior teeth selection and inter-commissural width determination by using Vernier calliper, the intercanine distance was also assessed. Results: About 100 patients were assessed maxillary anterior teeth selection, and inter-commissural width. The mean age of the study participants was recorded as 21.52±2.83 years. Whereas 63% patients were male. The overall statistical calculations showed a significant positive correlation (r=0.73; p=0.0005) between and the inter-commissural width and maxillary inter-canine teeth. Conclusion: Based on the findings, the study concludes that there is a significant correlation between inter-commissural width and maxillary inter-canine teeth among the south-west population in Sindh. [ABSTRACT FROM AUTHOR]

Objective: To determine the predictors of morbidity and mortality during hospitalization caused by cerebrovascular accident. Study Design: Cross Sectional study. Setting: Emergency Department of Medicine, Isra University Hospital, Hyderabad. Period: October 2017 to May 2018. Material & Methods: We have evaluated a total of 124 patients who presented and were admitted with signs and symptoms of stroke and confirmatory diagnosis was made based on CT scan. All baseline and clinical variables recorded in a structured questionnaire and the data were evaluated in Statistical Package for the Social Sciences (SPSS) version 21.0. Outcome of these patients were observed based on the number of patients died during hospitalization and poor outcome associated predictors. Results: A total of 124 patients were selected for this study. The mean age of patients was 58.52 years (13.44 ± SD). In this observational study we have observed hypertension (N = 106, 85.5%) was the most common predictor of hospitalization among patients with stroke. The overall mortality associated with stroke was 16.13% (20 cases out of total 124). Infection of urinary tract during hospitalization, patients presented with unconsciousness, area of thalamic infarction, involvement of middle cerebral artery, and posterior cerebral artery infarction were the most common predictors of stroke related in-hospital mortality. Conclusion: Overall, corrected stroke related in hospital mortality rate was 16.13% and patients who presented with loss of consciousness, infection of urinary tract, thalamic infarction, and area involving the middle cerebral artery were associated with higher in-hospital stroke related mortality. [ABSTRACT FROM AUTHOR]

Objective: To estimate serum uric acid in essential hypertension and its correlation with left ventricular hypertrophy (LVH) in patients presenting at a tertiary care hospital. Study Design: Cross Sectional study. Setting: Department of Cardiology and Medicine, BMC Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad and NICVD Hyderabad, Sindh. Period: July 2018 to January 2021. Material & Methods: A sample of 100 diagnosed cases of essential hypertenison (group A), 100 essential hypertenison with LVH cases (group B) and 100 age matched healthy control (group C) was selected through non-probability convenient sampling. Echocardiography findings of cases and control were noted. Serum uric acid, urea and creatinine were measured form sera. LVH was defined by Devereux's formula. Continuous variables were analyzed Student's Independent samples t - test and Pearson's correlation was used for essential hypertension and LVH on SPSS ver. 21.0 at 95% Confidence interval (P≤0.05). Results: Serum uric acid in EH, EH+LVH and controls was noted as 5.5±1.0, 5.8±1.9 and 3.81±1.2 mg/dl (P-0.0001). LV in EH, EH+LVH and controls was measured as 10.8±2.3, 16.4±3.3 and 9.6±0.2 mm in 3 study groups (P-0.0001). Uric acid proves statistically significant linear correlation in EH+LVH revealing positive correlation (r=0.475), (P=0.0001). Conclusion: The present study reports serum Uric acid is found elevated in essential hypertension and essential hypertension with left ventricular hypertrophy. Uric acid shows positive correlation with left ventricular hypertrophy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of oral zinc supplementation in cirrhotic patients with hepatic encephalopathy. Study Design: Retrospective Cohort study. Setting: Department of Gastroenterology, Liaquat University of Medical and Health Sciences, Jamshoro. Period: 15th February 2019 to 15th August 2019. Material & Methods: Adult patients of either gender suffering from hepatic cirrhosis and presenting with hepatic encephalopathy of any grade were included. Zinc acetate in a dose of 600 mg was given orally to the patients for two weeks duration. Standard lactulose treatment was also given alongside. Blood ammonia measurement was done at baseline and also after 2 weeks of treatment. Performance was assessed by utilization of number connection test (NCT) at week 1 and week 2 weeks post treatment. Results: Study included of 135 patients among which majority 95 (70.4%) of the patients were males. The mean age of the patients were 55.72 + 10.32 years. 40 (26.62%) patients were seen in Child Pugh class A, 65 (48.14%) were seen in Child Pugh class B and 30 (22.2%) were seen in Child Pugh class C. Serum ammonia levels were reduced in 110 (81.48%) patients and improved performance in NCT was seen in 90 (66.66%) patients. There was significant reduction of ammonia levels and significant improvement of NCT test in male patients (p value <0.05) and in Child Pugh class A and B patients (p value <0.05). Conclusion: In addition to standard therapy, inclusion of oral zinc acetate resulted in normalization of blood zinc and ammonia levels with improved performance in NCT and overall hepatic encephalopathy. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the allergic effects of the residual monomer by using auto polymerised acrylic resins amongst dentists. Study Design: Cross Sectional study. Setting: Department of Prosthdontics, Isra Dental College, Hyderabad. Period: June 2019 to October 2019. Material & Methods: The study consists of 50 participants included Prosthodontist specialists, general dental practitioners and dental students. All contributors that filled a questionnaire regarding the allergic effects after using auto polymerised poly methyl methacrylate resin, identity of all participants will be kept private after taking consent. In questionnaire asked the questions from the contributors regarding the designation, qualification, usage duration, organs affected by allergy by using poly methyl meth acrylate resin, any medical treatment acquired for allergy and what kind of precautions used for prevention of allergy. Data was analyzed thru SPSS version 21. Descriptive statistics such as frequency distribution, percentage were included in Data analysis. The level of significance was set at <0.05%. Results: This current study discovered that out of 50 participants, 64% were students, 25% general dentists and 10% specialists. Out of 50 participants, maximum participants 45% found the skin allergic reaction and minimum 8% found respiratory tract. Only 10 participants acquired the treatment and consults the doctor for allergic reactions and 25 participants did not acquired any treatment. Conclusion: Conclusion of this study was that the maximum contributors had allergic effects to the skin while many participants did not acquired or followed any therapeutic service to avoid surplus effects. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of Chemotherapy and Radiation Therapy on the swallowing of Patients with Head and Neck Cancer. Study Design: Cross Sectional study. Setting: Jinnah Hospital Lahore. Period: August 2020 to April 2021. Material & Methods: It was performed on forty-nine adults of age range 19-58 years in having head and neck cancer and Glasgow coma scale score above 10. and purposive sampling technique was used. Patients who have received 50-70 Gy dosage and have completed at least 10 fractions of radiation therapy treatment or received 500-1000 Mg dosage and have completed at least 2 cycles of oral chemotherapy treatment were included. Sydney Swallow Questionnaire consisting of 17 questions, each with a 100mm long visual analogue scale for marking response except question 12, was filled by all participants and their responses were recorded. After 2 months of initial recordings same patients were asked to fill the same questionnaire. During therapy and post therapy results were recorded and paired sample T test was done on the data by using SPSS. Results: The results of SSQ shows 10.20% had scores depicting no swallowing difficulty. 40.82% scored 235-500 on SSQ scale showing mild symptoms of dysphagia, 30.61% show moderate swallowing impairment, 16.33% had moderately severe and 2.04% claimed severe dysphagia before the chemo and radio therapy. It represented that after chemo-radiation treatment, 4.06% had normal swallowing, 12.24% had mild issues, 24.49% had moderate, 32.65% patients claimed moderately severe dysphagia and 26.53% have severe dysphagia. Conclusion: Severity of swallowing difficulty was increased after the Chemotherapy and Radiation therapy. [ABSTRACT FROM AUTHOR]

Objective: To assess thyroid functions in individuals having non-alcoholic fatty liver disease. Study Design: Cross Sectional, Comparative Study. Setting: Indus Medical College Hospital, Tando Muhammad Khan. Period: March 2018 to August 2018. Material & Methods: All diagnosed cases of non-alcoholic fatty liver disease (NAFLD) ≥ 18 years of age, of either gender enrolled via OPD. Age and gender matched healthy controls also included for comparison. Thyroid stimulating hormone (TSH) and thyroid hormones (T3 and T4) levels were measured in study participants by cobas e411(Roche). Data analyzed on SPSS version 18.0. The p value<0.05 was taken statistically significant. Results: When TSH of NAFLD patients were compared with that of healthy controls; highly significant difference found amongst both groups with (p value <0.01). Out of 83 NAFLD patients, 36.8% were euthyroid, 53.0% were subclinically hypothyroid and 10.8% were hypothyroid. While in healthy controls (n=47); 45 (97.9%) were euthyroid and only one found with subclinical hypothyroidism. When thyroid status compared among the patient suffering from NAFLD and healthy controls, (p-value <0.01). Conclusion: It is concluded that that there is substantial difference of TSH in the NAFLD group besides control healthy population. [ABSTRACT FROM AUTHOR]

Objective: To study anatomical variations of facial nerve encountered during parotid gland surgery. Study Design: Observational Study. Setting: Anatomy Department with the Collaboration of General Surgery Department at Dow University of Health Sciences and Dow Hospital (Ojha Campus Karachi). Period: December 2020 to May 2021. Material & Methods: Dissection of parotid gland was done in 50 cases including 10 cadavers (20 parotid glands) in anatomy department and 40 patients (40 parotid glands) admitted in general surgery ward undergoing parotid gland surgery for any pathology of the gland. Total 60 parotid glands were studied. Mean age of the cases was 31.6 ± 2.14 years with age range of 20-60 years. There were 10 female and 40 male cases. Results: In this study 60 parotid glands were dissected in 50 cases and facial nerve configuration was studied. In 46(92%) cases facial nerve pattern could be classified into main five types of the nerve pattern but in 04(08%) cases facial nerve pattern did not fit into any category of the classification. Type-III pattern of facial nerve distribution was commonly seen in 21(35%) glands. Conclusion: It is very important to keep knowledge of anatomical variations in facial nerve branching pattern in parotid gland to avoid its Injury during surgery. [ABSTRACT FROM AUTHOR]

Objective: To compare depression scores in genitourinary fistula patients according to Glasgow depression scale pre and postoperatively in tertiary care hospital. Study Design: Prospective Cohort study. Setting: Inpatient and Outpatient Department of Gynecology and Obstetrics, Isra University Hospital Hyderabad. Period: December 2018 to December 2019. Material & Methods: Patients with confirmed genitourinary fistulas undergoing corrective surgery were included. Glasgow Depression scale questionnaire was filled in Gynae ward at time of admission, postoperatively at discharge (14-21 days after surgery) and at 6 months follow-up after discharge in Urogynaecological Out Patient Department. In Glasgow depression scale 20 questions were asked from patients scoring 0,1 and 2 according to answers. Those scored greater than 13 were referred to primary mental health care center and Psychologist. Results: Total of 164 patients had successful genitourinary fistula repair. The average age of women was 47.63 (SD = ±17.1) years. Mean of depression scores preoperatively, at time of discharge and after 6 months of discharge was 19.69 (SD= ±2.61), 14.90 (SD= ±2.22) and 11.34 (SD= ±2.01) respectively. Mean decrease in depression score from preoperative to six months after discharge was 8.35 units, considered statistically significant with p-value less than 0.01. Conclusion: There is significant difference in depression scores preoperatively and postoperatively. Psychological symptoms decreases after surgical correction of fistulas. [ABSTRACT FROM AUTHOR]

Objective: To study, analyse and compare the effects of Silymarin on glycemic control and insulin resistance in newly diagnosed type 2 diaebtes mellitus (T2DM) subjects. Study Design: Observational study. Setting: Suleman Roshan Medical College Hospital. Period: March 2019 to February 2020. Material & Methods: A sample of 200 newly diagnosed cases of T2DM were recruited according to inclusion criteria selected by non-probability convenient sampling. Subjects were divided into 2 groups; OHA- oral hypoglycemia agent and OHA+ Sillymarin (200 mg). Baseline fasting (FBG) and random blood glucose (RBG), glycated HbA1 (A1C), fasting insulin (FI) and insulin resitance (HOMA-IR) were detected. Silymarin therapy was continued for 3 months. Study variables were analysed after 3 months. Data was analyzed on SPSS (ver.19) at 95% confidence interval (P≤0.05) considered statistically significant. Results: Age of diabetics taking oral hypoglycemic agents (OHA) and diabetic taking OHA+ Silymarin supplementation was noted as 50.3±13.3 49.9±14.5 years (P=0.91). 3 months Silymarin supplementation improves the fasting blood glucose, random blood glucose, glycated hemoglobin A1 (A1C), fasting insulin and insulin resistance (HOMA-IR) (P=0.0001). Conclusion: Silymarin improves blood glucose levels in type 2 diabetics that is mediated through reduction of insulin resistance. [ABSTRACT FROM AUTHOR]

Objective: To determine frequency of vitamin B12 deficiency and dyslipidemia and calculate atherogenic index of plasma (AIP) in Gestational Diabetes mellitus (GDM). Study Design: Observational study. Setting: Department of Biochemistry, Liaquat University Jamshoro. Period: January 2018 to December 2019. Material & Methods: 216 cases of GDM were selected by inclusion criteria. Venous blood sampling collected blood sample that were centrifuged to get sera. Glucose, vitamin B12, and blood lipids were estimated by standard methods. Atherogenic Index of Plasma (AIP) was calculated as log TAG/HDLc ratio. Data was analysed by SPSS 21.0 ver. at 95% CI (P≤0.05). Results: Vitamin B12 deficiency and Dyslipidemia were noted in 151 (69.9%) and 165 (23.61%) of GDM cases respectively (P=0.0001). Vitamin B12 was found low as 156.62±82.9 ng/mL. TC (244.07±49.11), TAGs (699.4±249.5), and LDLc (137.9±40.84) were found high and HDLc (33.13±5.71) was low. High and medium risk AIP was noted in 17 (7.87%) and 29 (13.4%) of GDM cases (P=0.0001). Vitamin B12 proved negative TC (r= -0.25, P=0.02), TAG (r= -0.23, P=0.02), LDLc (r= -0.79, P=0.0001) and positive correlation with HDLc (r= 0.76, P=0.0001). Conclusion: Vitamin B12 deficiency and Dyslipidemia were noted in 151 (69.9%) and 165 (23.61%) of GDM cases respectively. High and medium risk AIP was noted in 17 (7.87%) and 29 (13.4%) of GDM cases. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the anti-oxidative role of Resveratrol in Cisplatin-induced testicular toxicity in Albino Wistar rats. Study Design: Quasi-experimental study. Settings: Department of Physiology and Postgraduate Laboratory of ISRA University Hyderabad. Period: Six months from March to September 2019. Material & Methods: Twenty-four male albino Wistar rats were distributed equally into; Group-I (Control), Group-II (Cisplatin), Group-III (Cisplatin + Resveratrol). Difference in mean pre and post-experimental body weight was observed while analysis of oxidative markers, semen parameters, and histomorphology was carried out in all three groups. SPSS ver. 22 was used to analyze the data. Results: The mean body weight decreased from 241.7±8.5 gm to 196.50±9.34 gm and from 237±7.4 gm to 210.0 ± 6.50gm in groups II and III respectively. Statistically significant reduction in semen parameters (sperm count, motility and viability) was observed in Group-II compared with Group-C (p<0.05). Oxidative markers were also significantly depleted in Group-II in comparison to Group-C (p<0.05). Histologically, testicular structure was found to be intact in Group-I. Marked changes were observed in testicular histology of Group-II while Group-III displayed less testicular damage. Irregular, regressive and atrophic seminiferous tubules were seen in Group-II. Most seminiferous tubules having normal morphology were observed in Group-III while the number of atrophic and degenerative seminiferous tubules also decreased significantly. Conclusion: Resveratrol therapy is a potent protective regime showing promising results in cisplatin-induced testicular toxicity and oxidative stress. [ABSTRACT FROM AUTHOR]

Cisplatin (Cis) has been proved to be successful in treating cancers but it has several toxicities. Central nervous system toxicity is considered as one of its most common toxic effects. Vitamin E and Green tea are antioxidant with proven results on prevention of life threatening diseases. Objectives: To assess the preventive role of two antioxidants vitamin E and green tea against cisplatin induced neurobehavioral abnormalities in albino mice. Study Design: Experimental Study. Setting: Department of Anatomy, Liaquat University of Medical and Health Sciences (LUMHS) Jamshoro, in collaboration with Sindh Agriculture University TandoJam. Period: Dec 2015 to March 2016. Material & Methods: A total of 60 mice were grouped in to Group A, (control), Group B (Cisplatin), Group C (Cisplatin plus vitamin E) and Group D (cisplatin plus green tea). The weight, gross features and behavior of the animals was monitored before and in between drug administration. Behavioral studies were performed in quiet atmosphere, and included Pain stimulation test, heat Stimulation test, cold Stimulation test, Hearing, Object Recognition test. Results: A significant decrease in weight and body hair of the Cis treated animals was noticed as compared to control animals. Paw edema, mental orientation, object recognition, noise stimulation, heat and cold stimulation, time to move away from the stimulus were also significantly different to control. All features were improved with the addition of vitamin E and green tea. Conclusion: Toxic effects of cisplatin, on morphology and behavior of adult albino mice partially abrogated with antioxidant supplementation. [ABSTRACT FROM AUTHOR]

Objectives: This study aims to scientifically fill the gap and provide the scientific data regarding frequency of hyperuricemia in the patients with acute myocardial Infarction admitted at Liaquat University of Medical & Health Sciences, Hyderabad. Study Design: Prospective descriptive case series. Setting: Department of Cardiology, Liaquat University of Medical & Health Sciences, Hyderabad. Period: From 7th Feb 2016 to 6th August 2018. Material and Methods: Was conducted on either gender having age ≥35 to ≤70 years presented with ST elevation myocardial infarction was included in the study. ECG and laboratory investigations were carried out. Relevant investigation like serum uric acid was sent to laboratory. Final outcome was assessed at the end of 5th day, hyperuricemia was labeled if serum uric acid levels above 6.5 mg/dl. All the information was noted in proforma and analyzed using SPSS version 21.0. Results: There were 95 male and 50 female patients. The mean age was 49.57 ± 8.53 years, with range 35 (35 - 70) years. The age of 49 (33.8%) patients was ≤45 years and age of 96 (66.2%) patients was >45 years. 17.9% patients were obese and 50.3% patients were hypertensive. The hyperuricemia was present in 27 (18.6%) patients. Among patients who were found with hyperuricemia, the mean age was 49.41 ± 8.34 years. The results showed that significant association of hyperuricemia was observed with obesity. No significant association of hyperuricemia was observed with gender, age, and hypertension. Conclusion: Based on the findings of our study, raised serum uric acid levels are associated with adverse cardiovascular outcome. The prevalence of hyperuricemia is high in a population of patients with acute myocardial infarction. [ABSTRACT FROM AUTHOR]

We tested the hypothesis that Red cell distribution width, Hct, and other red blood corpuscle (RBC) indices are associated with CAD. Hence, we measured RDW, Hct, and other RBC indices in AMI and stable CAD (SCAD) and compared them with age- and sex-matched controls. Objectives: To study the changes in Red cell distribution width and RBC indices in acute myocardial infarction (AMI) and SCAD and compare them with age- and sex-matched controls. Study Design: A comparative study. Setting: Department of Cardiology, Liaquat University Hospital. Period: 1st September 2013 to 28th February 2014. Material & Methods: 128 subjects (39 AMI patients, 24 SCAD patients and 65 controls). Venous samples from AMI subjects were collected in standardized ethylenediaminetetraacetic acid (EDTA) sample tubes on admission (within 6 h of chest pain). Using Sysmex KX21-N autoanalyzer, RDW and RBC indices were evaluated within 30 minutes of blood collection. Arterial blood samples were also obtained from stable CAD patients admitted to angiography and routine inspections. There has been no significant difference. Results: In total 128 patients, Mean ± SD of RDW patients with CAD was 14.12 ± 1.31%) as compared to controls (15.62 ± 6.51%) with insignificant difference (p value > 0.05). Mean ± SD of RDW patients with AMI was 14.36 ± 1.4% as compared to stable CAD (13.7 ± 1.09%) and controls (15.62 ± 6.51%) (p value > 0.05). Mean ± SD of RDW patients with Hct in patients with CAD was 43.16 ± 5% as compared to controls (41.9 ± 6.9%) with insignificant difference (p value > 0.05). Conclusions: There was no association between RWD, Hct, and other RBC indices with CAD, AMI, and stable CAD. [ABSTRACT FROM AUTHOR]

Objectives: To determine the frequency of diastolic dysfunction in patients presenting with type II Diabetes Mellitus. Study Design: Cross sectional study. Setting: Sheikh Zayed Hospital, Rahim Yar Khan. Period: From 01-01-2017 to 30-06-2017. Material & Methods: In this study the cases were selected via non probability consecutive sampling of both male and female gender with age more than 40 years having type II DM of at least more than 2 years were included. The cases suffering from type I DM, gestational DM and those with HTN, end stage kidney and liver failure were excluded. Trans thoracic echocardiography was done to label diastolic dysfunction and was labelled as yes when the E/A ratio was <0.8. The data was analysed using chi square test and p value less than 0.05 was taken as significant. Results: In this study, 100 cases of type II DM were included with mean age of 51.31±7.89 years at presentation. There were 61% males and 39% females. Diastolic dysfunction was observed in 53% of the cases. There was no significant difference in terms of gender where it affected 56.41% of females with p= 0.92. Diastolic dysfunction was more in cases that had duration of DM more than 3 years affecting 48 (70.58%) cases with p= 0.001 and it was also significantly high in cases that had BMI more than 30 where it was seen in 40 (70.17%) of cases with p= 0.001. Conclusion: Diastolic dysfunction seen in half of the cases suffering from type II DM and it is significantly high in cases that had duration of DM more than 3 years and BMI more than 30. [ABSTRACT FROM AUTHOR]

Objective: To determine frequency of endometriosis and its staging found on diagnostic laparoscopy for subfertility among females. Study Design: Cross Sectional study. Setting: Department of Gynecology and Obstetrics, Jinnah Medical and Dental College and Hospital Karachi. Period: August 2020 to January 2021. Material & Methods: Total 120 female cases were enrolled into the study who were admitted in the ward for diagnostic laparoscopy to determine cause of subfertility. All female patients in reproductive age having undiagnosed primary or secondary subfertility were selected using consecutive sampling technique. Those who had previously any abdominal surgery were excluded from the study. Data was analyzed using SPSS-20 software. Results were presented in the form of frequency, percentage, and mean ± standard deviation. Results: Endometriosis was diagnosed on laparoscopy in 29.1% cases as a cause of infertility. Age range of the patients in study group was 16-45 years with mean age of 27.42 ± 2.16 years. Infertility duration was ≤3 years in majority of cases (65%). Primary infertility was present in 65.7% and secondary infertility was found in 34.3% cases in study group. Most of the patients diagnosed for endometriosis were having age > 30 years. Stage-4 endometriosis was found commonly in 42.8% cases. Conclusion: Laparoscopy is a best modality for diagnosing endometriosis and its effect on fertility in future. This facility should be available in all gynecological departments for timely diagnosing endometriosis and to treat it promptly. [ABSTRACT FROM AUTHOR]

Objective: To determine functional outcomes of arteriovenous fistula, its complications and patency rate for one year. Study design: Cross Sectional study. Setting: Department of Urology and Kidney Transplantation Pir Abdul Qadir Institute of Medical Sciences Gambat. Period: January 2020 to December 2020. Material & Methods: Patients with Chronic renal failure were selected using non-probability consecutive sampling technique. Patients candidate for CBRC arteriovenous fistula at wrist were selected and those requiring other vascular access were excluded from the study. Arteriovenous fistula were made by standard method and its function and patency rate was assessed for one year duration. Patients of both gender and any age were included. Results: Total 220 cases were enrolled into the study comprising on 57.3% male and 42.7% female cases. Mean age of patients was 59.4 ± 9.7 years. Most common arteriovenous fistula were radio cephalic in 61.8% cases. Fistula failure in first month was seen in 12.7% cases. Fistula patency rate was 79.1% after three months, 69% after six months and one year patency rate was 61.3%. Most common cause of chronic renal failure was diabetes mellitus in cases. Most common fistula related complication was infection and burst fistula in cases. Conclusion: First six months after fistula formation are critical as one third fistula fail during this period. Most common risk factor of fistula failure is diabetes mellitus. Fistula failure was more common among women than men. [ABSTRACT FROM AUTHOR]

Objective: To determine association of Serum Uric Acid levels (SUA) in subjects suffering Systemic Blood Pressure and to determine its association with systolic and diastolic blood pressure. Study Design: Cross Sectional Study. Setting: Department of Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh, Pakistan. Period: January 2018 to September 2019. Material & Methods: 150 diagnosed cases of systemic hypertension and 150 controls were selected though non-probability purposive sampling according to inclusion and exclusion criteria. 2 ml venous blood was taken, centrifuged and sera were used for uric acid. Data was saved in a pre-structured Performa. Statistical software (SPSS v 21.0, IBM, Incorporation, USA) of data variables was analyzed at 95% CI (P = 0.05). Results: Serum uric acid in controls was 2.93±0.72 compared to cases 4.25±1.44 mg/dl (P=0.0001). Hyperuricemia was observed in 58 (38.6%) cases compared to 23 (15.3%) controls. Uric acid shows strong positive association with Systolic BP (r= 0.52*, p=0.0001) and Diastolic BP (r= 0.46**, p=0.0001). Conclusion: We found hyperuricemia in 58 (38.6%) of systemic hypertension cases. Systolic and Diastolic Blood pressure show positive association with uric acid. [ABSTRACT FROM AUTHOR]

Objective: Aim of study was to determine outcomes of patients treated with N-butyl-2-cyanoacrylate. Study Design: Retrospective study. Setting: Department of Gastroenterology at Liaquat University of Medical and Health Sciences, Jamshoro. Period: December 2019 to March 2020. Material & Methods: A Retrospective study was conducted between by viewing medical records and endoscopy reports. Total 31 patients were enrolled with gastric variceal bleed that underwent endoscopic injection of N-butyl-2-cyanoacrylate we examined the mortality rate, hemostasis, Hospital stay, need of blood transfusion, and effectiveness of procedure. Results: A Total of 31 patients, out of which 18 (58.1 %) were male; the mean age was 55.23±8.778 years. Of these patients 23 (74.2 %), had concomitant esophageal varices, Child-Pugh class-A, B, C were seen in 4, 20 & 7 patients (12.9, 64.5 % & 22.6) respectively. Average duration of hospital stay was 5 to 8 days in 22 cases (71.0 %). Less than 3 pints of PRBC were transfused in 17 cases (54.8 %). Hemostasis was achieved in 27 patients (87%). Overall mortality rate was 3 out of 31(9.7%). one patient was referred for TIPSS. No complications from cyanoacrylate injection were observed. Conclusion: Standardized injection technique and regimen ensures the success and safety of N-butyl-2-cyanoacrylate injection for the treatment of gastric fundal varices in experienced hands. [ABSTRACT FROM AUTHOR]

Objectives: High rate of post-surgical infections are reported with scanty effort for controlling them. The objectives were to evaluate frequency of surgical site infections in patients undergoing general surgery. Study Design: Cross Sectional Observational Study. Setting: Naz Memorial Hospital. Period: March 2019 to March 2020. Material & Methods: This study was conducted in general surgery ward for 1 year. All patients over 18 years admitted in surgery ward either as elective or emergency case were included while patients having any wound infection, operated in other hospital or diabetic foot and all those operated for incision and drainage of abscess were excluded. All patients that were operated during the study period were followed for any wound infection development till one qAqmonth. SPSS was used for data entry and analysis keeping p-value of <0.05 as significant. Results: 75 from 200 patients developed surgical site infection, 46 (61.3%) were operated in emergency. Among 24 contaminated surgeries type, 70.8% were reported having SSI (p-0.05) while from 28 dirty types of surgeries 78.6% of patients had a SSI (p-0.03). 25% were anemic, 21% diabetic while (20%) were reported to be hypertensive, 13 (17%) gave positive history of smoking while 12 (16%) were obese. Conclusion: Higher proportion of surgical site infection was observed in patients undergoing contaminated and dirty type of surgeries. Most patients with SSI were operated in emergency setting and anemia and diabetes were the most common risk factor reported in the infected patients. [ABSTRACT FROM AUTHOR]

Objectives: Clinical assessment of OSMF patients visiting Isra dental college Hyderabad Sindh and correlation of trace elements in OSMF pathogenesis. Study Design: Observational Study. Setting: Outpatient Department, Oral Surgery Isra Dental College Hyderabad Sindh. Period: February 2016 January 2017. Material & Methods: Sixty research participants were categorized into control (group-II) and experimental group (group-I). Both clinical and physiological demographics of the research participants were recorded on a predesigned questionnaire. In next phase, estimation of serum copper and serum zinc levels were determined for both control and OSMF patients by using spectrometric analysis. Patient data analysis was done by using Chi-square test and student’s t test. Where Microsoft office 2010 tools were also used for data presentation. Results: Based on clinical presentation 80 % patient were presenting with burning sensation in oral cavity in thirty OSMF patients. Where in control group only 3.3% patients were facing burning sensation in oral cavity. By assessing the functional staging of oral submucosa fibrosis about 50 % patients were presenting stageII OSMF cytology. Where all the thirty participants in experimental group were presenting mucosal blanching. About 36 % patients suffering from OSMF were using Gutka and 33 % patients were using areca nut. Serum Zn mean value estimation in controls (Group II) and cases (Group I OSMF) was noted as 68.06 ± 17.10 and 94.20 ± 15.11 µg/dl respectively (t = 6.27, p=0.001). Conclusion: The present study concludes that increased serum trace element levels has significant correlation in the development and progression of OSMF. [ABSTRACT FROM AUTHOR]

Objectives: To assess the correlation between laboratory markers (C Reactive Protein, White Blood Cells) and treatment failure with Oral Amoxicillin in Bacterial Pneumonia in children aged 2-59 months old at Pediatrics Emergency Department LUMHS Hyderabad. Study Design: Cross sectional study. Setting: Department of Pediatric Emergency LUMHS, Civil Hospital Hyderabad. Period: November 2015 to May 2016. Methodology: A total of 80 children aged 2-59 months old were treated with Oral Amoxicillin 90mg/kg/day for 5 days and response to treatment was assessed on 3rd day of admission. Blood was drawn from the veins over the dorsum of either hand at initial visit for C Reactive Protein and WBC Count. Children who do not improve on 3rd day of admission were declared treatment failure and switched to 2nd line treatment that is Injection Ceftriaxone. Results: In this study overall 78.7% children improved with Oral Amoxicillin 90mg/kg/day BD for 5 days, while 16.3% children had treatment failure on Oral Amoxicillin. 5% children were defaulted due to parents concerns. Conclusion: C Reactive Protein is a valuable marker that can predict the response of Oral Antibiotics in bacterial Pneumonia in children. Cost effectiveness can be determined by further studies, hence to justify that which children with Bacterial Pneumonia should be treated with 2nd line Injectable antibiotics from very beginning of treatment. [ABSTRACT FROM AUTHOR]

Objectives: Efficacy of postoperative Povidone-Iodine prophylaxis and surgical site infection in appendectomy surgery. Study Design: Randomized clinical trial. Place and Duration: Department of Surgery, Liaquat University Hospital Jamshoro/Hyderabad from March 2016 to November 2017. Subjects and Methods: Diagnosed cases of acute appendicitis with classical clinical presentation were included in the study protocol. 60 patients were those, who were applied 1% povidone-iodine solution (cases) to wound post operatively versus 60 patients (control) were those in whom wound not irrigated with Povidone- Iodine. Ethical approval and consent were taken. Data was noted in a proforma and analyzed on SPSS 22.0 (P=0.05). Results: Age (mean ± SD) in control and cases was observed as 25.5 ± 8.5 and 24.5 ± 9.5 years respectively (P=0.76). Male and female were noted as 43 (%) and 17 (%) & 45 (%) and 15 (%) in control and cases respectively (P >0.05). Wound healing score by Southampton classification of wound healing shows lesser frequency of surgical site infection in cases compared to controls (P <0.05). Grade 4 pus discharging wound infection was noted in 2 (3.33%) control versus 3 (5.0%) in cases (P=0.021). Conclusion: It is concluded that the 1% Povidone- Iodine solution is effective in preventing the post appendectomy surgical site infection. [ABSTRACT FROM AUTHOR]

Introduction: Aesthetic is the most important consideration for the replacement of missing teeth. Traditional metal-ceramic fixed dental prostheses are stronger, clinically recognized, and reliable and will therefore persist the first consideration. Study Design: Cross sectional study. Setting: Liaquat University of Medical and Health Sciences, Jamshoro. Period: October 2015 to September 2016. Material and Methods: Using non probability consecutive sampling technique. Data from 120 patients regarding effect of age on appearance after providing metal-ceramic fixed prosthesis were collected using the method of interview and examination. Results: The male to female ratio was 1:1.4 with a mean age of 30 years and standard deviation (SD) 10.88. 120 Patients were divided in four age groups. Out of Sixty-six patients with age range from 19 to 30 years, thirty-eight were found to be completely satisfied. Out of 21 patients of 31-40 years old, eighteen were aesthetically satisfied. In another group comprises of 24 patients with an age range 41-50, seventeen showed completely satisfaction. Another group, age range from 51-60 that showed 9 patients, in which six patients were satisfied with fixed prosthesis. Conclusion: Most of the patients in this study were satisfied after providing prostheses. Middle age (31-40years) patients showed more satisfaction comparative to other age groups. [ABSTRACT FROM AUTHOR]

Objectives: The present prospective observational study was conducted to determine frequency and thyroid conditions as likely risk factors for hypocalcaemia following thyroid surgery. Study Design: Observational study. Place and Duration: Department of surgery, Liaquat University Hospital from December 2011 to December 2015. Materials and Methods: A sample of 201 patients, undergoing thyroid surgery with bilateral exploration, was selected according to criteria. Pre operative clinical work up was conducted for patient history, neck examination, thyroid hormone assay, serum calcium, Technetium99 thyroid scanning, laryngoscopy and sonography. Serum Ca++ was estimated before and after thyroid surgery. Hypocalcaemia was defined as calcium level <8 mg/dl. Data was analyzed on SPSS 22.0 (IBM, incorporation, USA) at 95% confidence interval. Results: Of 201 patients, male and female were noted as 93 (46.2%) and 108 (53.7%) respectively. Female to male ratio was 1: 0.86. Mean± SD age was noted as 42.3 ± 7.4 years. Overall frequency of hypocalcaemia was identified in 23 (11.4%) of subjects. Mean± SD serum calcium in hypocalcemia subjects was noted as 7.1 ± 0.78 mg/dl. Symptomatic hypocalcaemia was noted in 11 (5.4%) of total subjects. Conclusion: In the present study, an overall frequency of hypocalcaemia was identified in 23 (11.4%) of subjects. Large goiters, recurrent goiter, retrosternal goiter, hyperthyroidism and Grave's disease were noted as risk factors. [ABSTRACT FROM AUTHOR]

Objective: Determine the frequency of vitamin cobalamin deficiency in macrocytic anemia cases reporting at tertiary care hospital. Study Design: Cross Sectional study. Setting: Faculty of Medicine and Allied Medical Sciences, Isra University, Hyderabad, Sindh Pakistan. Period: January 2017 to October 2018. Material & Methods: 450 cases of both genders, diagnosed as macrocytic- megaloblastic anemia were studied for the vitamin Cobalamin levels. Cases were collected through non- probability convenient sampling by inclusion and exclusion criteria. Consenting volunteers were asked for blood sampling. 5 mL blood was taken from ante - cubital fossa. Samples were centrifuged and sera were collected for the estimation of vitamin cobalamin by ELISA - assay kit. Continuous and categorical variables were entered in SPSS (version 21.0) and analyzed by Student t-test and Chi-square test respectively at 95% CI (P ≤ 0.05). Results: Male and female comprised 225 (43.3%) and 294 (56.6%) of 519 subjects. Male to female ratio was noted 1.30:1. MCV, MCH and MCHC show statistically significant difference between male and female (P<0.05). MCV in male was 96.8±9.92 fl vs. 105.5±12.04 fl in female (P=0.0001). Normal cobalamin was noted in 15.2% (n= 79) and any type of cobalamin deficiency was noted in 84.7% (n= 440) (P=0.0001). Conclusion: The present study reports frequency of 84.7% Cobalamin deficiency in macrocytic anemia reporting at Indus Medical College Hospital. Further studies are recommended by the treating physicians. [ABSTRACT FROM AUTHOR]

\Objectives: COVID-19 ‘Corona Virus Disease-2019’ was declared Public Health Emergency. The objective was to assess knowledge of novel coronavirus (COVID-19) among health care workers. Study Design: Cross Sectional Observational study. Setting: Naz Memorial Hospital. Period: 13th to 21st March 2020. Material & Methods: This study using consecutive sampling technique was done among health care workers including doctors and other health care workers (HCW). After ethical approval from the IRB, data collection was done. Questionnaire was made for assessing knowledge. For data entering, SPSS version 23.0 was used. The responses were reported and expressed as frequency and percentages. Results: 60 doctors, 90 nurses and other health care workers, all doctors and 87 % HCW regarded COVID-19 as problem for all communities. 90 % doctors, 80 % HCW felt work performance being affected. All study participants agreed COVID-19 affected their social and psychological life. 30 % doctors and 80 % HCW regarded all coronavirus patients experience fever, dry cough, tiredness and difficulty in breathing. Almost all participants regarded coronavirus could spread from human-to-human contact; mortality related to co-morbid and age extremes. No participant knew how to handle COVID-19 patient due to unavailability of guidelines. Conclusion: Most doctors were aware of the knowledge regarding novel COVID-19, however some health care workers were not fully aware of consequences and effects of coronavirus. Being the first in line of duty to manage COVID-19 patients it is vital to provide guideline in addition to safety measures for ensuring proper treatment and limit spread of disease. [ABSTRACT FROM AUTHOR]

Objectives: To correlate CK-19 with different histopathological gradings of oral squamous cell carcinomas (OSCCs). Methods: Study Design: Descriptive study. Setting: Department of Outpatient, ISRA Dental College Hospital. Period: January 2014 to November 2019. Material & Methods: In current study 60 suspected patients of oral squamous cell carcinomas were enrolled for cancer diagnosis and histopathological evaluation. Incisional biopsy method was opted for tissue sample collection. Patients from both genders were tested for CK-19 at different histopathological gradings. Ethical approval was properly taken from Institutional review board and patients’ willingness to participate in the study was ensured. For statistical data analysis SPSS version 21.0 and Revman5.30 multiple tools were used. Results: Histopathological grading of sixty suspected cases of OSCCs was done into four different gradings which include, poorly differentiated, moderately differentiated, well differentiated and undifferentiated OSCCs. Fifty-two (87 %) of the included subjects were male, where only 8 patients were female. The mean age of female to male was (36.14 vs. 43.21 years). Out of 12 positive cases of OSCCs. CK-19 was found positive in 10 cases (83.3%) in well differentiated Oral Squamous cell carcinomas, where only 2 cases (16 %) of moderately differentiated OSCCs were positive against CK-19. Conclusion: Our outcomes suggest CK-19 has strong association with well differentiated and moderately differentiated Oral Squamous cell carcinomas. We highly recommend further research standardizing CK-19 as a promising histopathological grading marker. [ABSTRACT FROM AUTHOR]

Objectives: To analyze the effects of Examination stress on heart rate, blood pressure and white blood cells among medical college students. Study Design: Observational study. Setting: Department of Pathology, Indus Medical College, Tando Muhammad Khan Sindh. Period: September 2018 to April 2019. Material & Methods: 200 medical students were selected according to inclusion and exclusion criteria. Heart rate was measured manually. Systemic Blood pressure (BP) was recorded by Sphygmomanometer. Mean arterial BP was calculated as diastolic BP+1/3 of pulse pressure. Blood slides were stained with Leishman's stain and white blood cells were counted using microscope. Data was analyzed by using Statistical Package for Social Sciences (ver 22.0) for windows Microsoft. Results: Age of study subjects was noted as 20.23±1.23 years. Body weight and Body mass index (BMI) were noted as 64.93±7.53 Kg (P=0.0001) and 27.5±5.3 (P=0.67). Of total 200, 109 (54.5%) were male and 91 (45.5%) were female (P=0.0001). Heart rate, Systolic, Diastolic and Mean arterial BP differed significantly before and after examination stress (P<0.05). White blood cells before examination were found as 7310.43±708.5 x10³/µL compared to 8202.39±677.26 during examination stress (P=0.0001). Conclusion: Examination stress perturbs the physiological homeostasis as changes in heart rate, blood pressure and White blood cells are noted among medical students. Psychological and physical strategies for coping the stress should be considered for the young medical students. [ABSTRACT FROM AUTHOR]

Objectives: The aim of study was to determine vitamin d deficiency in age and sex groups associated with different regions. . Study Design: Cross-sectional study. Setting: Department of Obstetrics and Gynaecology, Gambat Institute of Medical Sciences Gambat, Khairpur Sindh. Period: 14 August 2016 to 24 February 2018. Material & Methods: Total 1924 participants were screened and included in the study by fulfilling the inclusion criteria. All participants who met the inclusion and exclusion criteria were interviewed after taking informed consent. Questionnaires for the study were prepared and distributed to the selected population. According to the questionnaire and interviews by the researchers, details of lifestyles, social status, and monthly income were reported. Moreover, marital status, milk in take, and sun exposure hours were also asked. Blood sample of each participant was taken after taking written informed consent form. A total 1924 people screened for Vitamin D levels with help of direct chemiluminescence using ADVIA Centaur assay. Results: 1924 people from five different regions of Gambat. A total of 1153 (59.9%) people with vitamin D deficiency were found, while 724 showed normal rates and 47 found to be larger than normal. Females are more deficient for vitamin D (35.7%) than males (24.4%). Conclusion: The high population without symptoms with low levels Vitamin D is an alarming sign of deteriorating health, while multiple risk factors appear. [ABSTRACT FROM AUTHOR]

Objectives: Evaluate serum bilirubin in adult healthy subjects and its correlation with white blood cells as risk factor for cardiovascular disease. Study Design: Cross- sectional study. Setting: Department of Pharmacology and Medicine, Suleman Roshan Medical College. Period: January - December 2017. Material & Methods: A sample of 100 male and 100 female adult healthy subjects were recruited for study protocol. Blood glucose, Serum creatinine, Blood lipids, liver enzyme levels, White blood cell counts and Serum bilirubin levels were analyzed. Pearson's correlation was used for the correlation coefficient and its statistical significance for the association of serum bilirubin and white blood cells. Data variables were analyzed by statistical software SPSS (ver 21.0) at 95% CI (P ≤ 0.05). Results: Mean± SD age of male and female was found 47.02±8.42 and 48.59±7.80 years respectively (P=0.071). Serum bilirubin shows statistically significant negative correlation with blood glucose (r= - 0.257, P=0.0001) and LDLc (r= - 0.155, P=0.027) and WBC (r= - 0.871, P=0.0001). Conclusion: The present study shows the elevated serum total bilirubin levels within reference range correlated negatively with total white blood cells in adult healthy population. [ABSTRACT FROM AUTHOR]

Objectives: To determine the serum uric acid levels among the patients of liver cirrhosis. Study Design: Cross Sectional, Descriptive study. Setting: Department of Medicine, Indus Medical College, Tando Muhammad Khan. Period: 6 months (23 April 2019 to 23 October 2019). Material & Methods: Patients of liver cirrhosis attending the medical OPD or admitted in the Medicine ward, meeting selection criteria included in this study. Any diseases other than liver disease, disturbing uric acid levels were excluded from the study. Other exclusion criteria were type 2 and 1 Diabetes mellitus, drugs altering serum uric acid levels, gout, pregnancy and chronic kidney disease. Results: In this study, the causes of liver cirrhosis revealed were hepatitis B 5 (5.15%), hepatitis C 44(45.36%), both hepatitis B and C 4(4.12%), NAFLD 34 (34.05%) and alcohol 10(10.31%) respectively. Mean of the serum uric acid (mg/dl) compared in liver cirrhosis due to different etiologies Mean ±SD of uric acid levels due to hepatitis B, hepatitis C, both hepatitis B and C, NAFLD and alcohol were 2.66±1.4, 2.22±0.3, 2.34±1.0, 7.70±0.9 and 6.69±2.0 respectively; theses all compared by one way ANOVA, (p value <0.01) with df (degree of freedom) 4. Serum uric acid levels are raised among the NAFLD patients in this study that is warning factor for cardiovascular disease. In this research hypouricemia has been observed among the patients of liver cirrhosis due to hepatitis B, hepatitis C, both hepatitis B and C, NAFLD and alcohol as 5.15%, 45.36%, 4.12 %, 2.06% and 8.25% respectively while hyperuricemia has been observed among the cirrhotic patients due to NAFLD. Conclusion: Serum uric acid levels are raised among the liver cirrhosis patients with NAFLD while decreased among cirrhotic patients with viral hepatitis. Further the area is open for further research to determine the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Objectives: To compare the outcome of two protocols (open reduction and closed reduction) in the treatment of mandibular condyle fracture. Study Design: Comparative study. Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical and Health Sciences Jamshoro. Period: January 2016 to September 2016. Material & Methods: After selection of patient into either group, for closed reduction technique, maxillomandibular fixation was applied for 4-6 weeks. For open reduction, a preauricular incision was given and fracture was reduced and fixed with miniplates after achieving the normal occlusion. Post operatively, patients of both the group were recalled after one, two and three months for the assessment of the functional effects such as occlusion and range of motion in both groups. Results: Mean age of the patients was29.80+4.42 years in group 1 (open reduction group), while mean age of the group 2 (closed reduction group) was 23.95+6.63 years. Male were in the majority in both groups 17 in group 1 and 16 in group 2. Out of 20 patients in group 1, 11 patients had condylar neck fracture and 9 had subcondyle fracture. While in group 2, 13 patients had subcondyle fracture and 7 had condylar neck fracture. In both groups again no significant difference was found according to location of the fracture (p-value 0.20). Group 1 (open reduction) had better functional results in terms of occlusion and range of motion after 3 months as compared to the group 2 (closed reduction). P-value 0.19. Conclusion: In dealing with mandibular condyle fractures it was concluded that open reduction and internal fixation is a better technique as compared to the closed reduction with maxillomandibular fixation. [ABSTRACT FROM AUTHOR]

Objectives: The purpose of study is to ascertain the prevalence of malignancy in thyroid single/multiple nodules after ascertaining the features of nodules on different criteria. Study Design: Cross Sectional Study. Setting: Department of Surgical at PMCH Nawabshah. Period: April 2015 to April 2018. Material & Methods: All patients got admission from OPD and they were investigated for the disease. All biochemical examinations were done. Thyroid profile with thyroid scan was obtained. Fine Needle Aspiration Cytology (FNAC) was done to diagnose the type of cells either benign/ malignant. The decision of the surgical procedure was done according to the FNAC report of the thyroid nodule. Results: Total 80 patients were investigated. 55 (68.75%) females, 35 (43.75%) male and 60 (75%) showed the benign cells and 20 (25%) patient's reports had malignant cells. Biopsies were sent for histopathology. 60 (75%) showed thyroid adenomas after biopsy. 10(12.5%) patients papillary carcinoma, 7 (8.75%) follicular, 2 (2.5%) medullary, 1 (1.25%) anaplastic, 0 for thyroid lymphoma, 0 thyroid carcinoma. 0 for squamous cell carcinoma. 40 (50%) were treated conservatively with thyroxine, 20 (25%) were operated for lobectomy. All malignant cases were undergone for total thyroidectomy. Conclusion: it is summed up that the prevalence of malignancy in thyroid nodules in our setup is only 25% that is the lower one as compared to other studies. [ABSTRACT FROM AUTHOR]

Objectives: To correlate the clinically diagnosed prostatic lesion with histopathological evaluation, Gleason scoring andserum prostate specific antigen (PSA) levels in a tertiary care centre. Study Design: Observational Study. Setting: The current study was conducted in multiple centers of Sindh like Department of Surgery Unit-III, Peoples University of Medical and Health Sciences, Nawabshah CMCH Larkana, Jinnah Sindh Medical University and Al-Tibri Medical College and Hospital Karachi. Period: January 2018 to December 2019. Material & Methods: on 112 consecutive cases of clinically diagnosed prostatic disease, all the relevant demographic and clinical details including digital rectal examination (DRE) findings and serum PSA levels were recorded on a proforma designed for the study. PSA values of all these cases were recorded before the surgical procedure. The tissue sample of prostate was collected after surgery and histologically analysed for the confirmation of diagnosis and the Gleason scoring was made. All the results obtained were statistically analysed and tabulated. Results: The age of patients ranged 34-81 years, with mean age of 58+3.4 years. The adenocarcinoma was detected in 05 cases, hyperplasia in 92 cases and hyperplasia with prostatitis in 07 cases. The carcinoma was clinically diagnosed in 17 cases but after histological evaluation, the carcinoma was confirmed in 03 cases and 02 cases of cancer were confirmed among clinically diagnosed cases of hyperplasia. Majority of cases of hyperplasia were having the PSA level < 4ng/ml No any case of adenocarcinoma have PSA level below 4ng/ml, and majority of the cases of denocarcinoma were having PSA level above 20ng/ml. majority of malignant lesions were having PSA level above 20ng/ml and the Gleason score above 6. No any case of malignancy was detected in those patients having PSA level below 4ng/ml. Conclusion: The histopathological evaluation with serum PSA levels is necessary in all cases of prostatic disease to rule out the possibility of malignant pathology. [ABSTRACT FROM AUTHOR]

Objectives: The purpose is to compare two options of management of appendicular lump in order to sort out the better one for the benefit and betterment of populace. Study Design: Cross Sectional study. Setting: Peoples Medical College Hospital Nawabshah. Period: 2016 August to August 2018. Material & Methods: Total 50 patients of appendicular lump were included in this research. All patients were divided into 2 groups. Group 1 included those patients undergoing emergency appendectomy. They were admitted, optimized and the required treatment was initiated. Results: Of total 50, 30(60%) were male and 20(40%) were females. Age was between 14 to 51 years. All patients presented with different clinical presentations. Pain in RIF was in 42(84%) patients whereas 47(94%) patients presented with lump in RIF. 20(40%) patients were operated for appendectomy in emergency and 5(10%) patients for right hemi-colectomy. Histopathological diagnosis was inflammation in 24(48%) patients and 1(2%) resulted in cecal tumor. Infected wound was found in 15 (30%) patients, hematoma in 3 (6%), wound dehiscence in 1(2%) and also cecal fistula in 1 (2%). Conclusion: Conservative treatment is better option to treat appendicular lump with least negative results. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the efficacy of 0.2% chlorhexidine gel placed intra alveolar in the prevention of alveolar osteitis after the surgical extraction of mandibular third molar. Study Design: Randomized Control trial. Setting: Department of Oral and Maxillofacial Surgery, LUMHS, Jamshoro/Hyderabad. Period: January 2016 to July 2016. Material & Methods: This study consisted of 40 patients in control group A and 40 patients of Chlorohexidine gel group B used after surgical extraction. A single dose of 0.2% bio-adhesive gel was introduced in group B while the control group A was left alone. Postoperative complications like pain, swelling, limited mouth opening, and dry socket were seen. Frequency and percentages were calculated. Mean +/- SD were calculated for quantitative variables. Results: On 3rd day patients reported with pain in group A were 24 and in group B were 15. Pain was seen in 4 patients (10%) on 15th day in group A while in group B no patient came with pain. 19 patients reported with dry socket on day 3 in group A and 4 patients in group B, While none of the patient encountered with Dry socket on 15th day in group in both groups. Conclusion: The data presented indicates that the bio-adhesive gel containing 0.2% chlorohexidine, applied post-extraction produced a better patient recovery. [ABSTRACT FROM AUTHOR]