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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.

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.

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 inter-canine 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.

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.

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

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

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.

Objective: The purpose behind this study was 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.

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

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.

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 accroding 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 statistially significant. Results: Age of diabetics taking oral hypoglycemic agents (OHA) and diaebtic 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.

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.

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.

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.

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.

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.

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

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. 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.

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.

Cardiovascular disease and its complications are mainly causes of coronary artery disease (CAD). The distribution width of red blood cells (RDW) is a quantitative measurement of the variance in circulating erythrocyte size. Various research publications have shown that patients with previous history coronary artery disease having greater levels of Red cell distribution width are on risk of mortality and cardiovascular events. 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.

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

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

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 pre-designed 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 stage-II 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.

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

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.

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.

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

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.

Objectives: The aim of study was to determine vitamin d deficiency in age and sex groups associated with different regions. Therefore, this diagnostic method has played an important role in the prevention of various medical conditions. 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. Exclusion criteria were signs and symptoms of any chronic disease, active injury, abnormal liver function or any chronic kidney and pregnancy problem. 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.

Objectives: To analyze the antioxidant activity of Resveratrol and Ascorbic Acid against hydrogen peroxide (an oxidant) mediated cell injury of human trabecular meshwork cells. Study Design: Experimental study. Setting: Molecular Biology Laboratory at Medical Research Centre, Liaquat University of Medical & Health Sciences, Jamshoro. Period: Six months. Materials and Methods: Human Trabecular Meshwork cells were purchased from ScienCell Research Laboratories, USA. TM cell metabolism, TM cell viability and Reactive oxygen species were detected by standard methods in co- and pre- treated TM cells. Results: A significant reduction in TM cell metabolism was observed approximating 61% at 1.0 mM H2O2 compared to Ascorbate – 99% and Resveratrol 99% (p=0.0001). Resveratrol was more effective than Ascorbate even at 4.0 mM H2O2, the TM cell activity was noted 76%. Compared to H2O2- treated TM cells, resveratrol improved mitochondrial function upto 4.0 mM H2O2 (76%). Compared to co-treatment, the pretreatment shows similar results except at 4.0 mM H2O2. At 4.0 mM H2O2 the pre-treat TM cell metabolic activity was found as 11%, 31% and 47% compared to co-treat as 9%, 31% and 76% in controls, ascorbate and resveratrol groups respectively (p

Background: A hydrocele is a fluid - filled sac surrounding a testis that results in the swelling of scrotum. They can develop due to inflammation or injury within the scrotum. Objective: This study aimed to evaluate the efficacy and adaptation of different surgical procedures in the repair of hydrocele. Study design: Comparative, Retrospective study .Place and duration of Study: The study was conducted at Fauji Foundation Hospital Karachi , Al-Tibri Medical College, Karachi and Civil Hospital Karachi from January, 2000 to December, 2013. Patients and methods: Patients with primary vaginal hydrocele registered during the period of thirteen years in the out patient department of surgery were selected. A total of 300 patients were assessed clinically, diagnostically and radiologically about the status of hydrocele before the surgical procedures and anesthetic opinion. The different surgical technique were carried out in different group of patients asJaboulay's technique in 70 patients, Lord's procedure in 70 patients, Aspiration and Sclerotherapy in 05 patients, Window operation technique in 05 patients and the Hydrocelectomyby supra pubic procedure were carried out in 150 patients out of total 300 registered patients. The data collected and analyzed statistically in SPSS version 19.00. Results: The different procedures have been adopted surgically in patients with primary vaginal hydrocele. The results showed that among the different operative techniques adopted, the best procedure regarding hydrocelectomy is the supra pubic approach line of treatment. It showed better result and recovery with very minimum complications and side effects as compared to other surgical procedure. Conclusions: The data thus concluded that hydrocelectomy done via supra pubic approach in number of patients proved to be the best procedure because of having very little complications.

Background: Food faddism may be labeled as an ice-berg phenomenonoccurring in our population; still there is dearth of research work on this issue; therefore weconducted a baseline study on this problem of public health importance in order to explorehidden facts about this practice. Objectives: (1) To assess the food faddism practices amongresidents of Taluka Latifabad, Hyderabad. (2). To determine the risk factors associated with foodfaddism. (3). To determine the association of food faddism to health status of the participants.Study design: Cross sectional study. Place of study & duration: A community based study oftwo months’ duration (from 1st May-30thJune 2013) conducted in Taluka Latifabad units 4, 7 &12, district Hyderabad. Methodology: 450 subjects were selected by convenience type ofsampling & were registered for the study. The sample comprised of 200 women of child bearingage and 250 children of age ≤ 5 years. Results: The frequency of food faddism was found to be58% i.e. 71.5% among women of child bearing age and 47.2% among children at age ≤ 5years.Living in joint families & being illiterate were associated factors for practice of food faddism(p=0.01) & (p=0.04) respectively. Majority (79.31%) of respondents got advice for this practicefrom family elders; while 36.78% got such advice from family physicians. Being malnourished &borne as low birth weight were its major health outcomes among children. Conclusions: Foodfaddism intangibly affects women & children’s health; therefore elders of the families as well asfamily physicians should be taken on-board to control this dietary malpractice in thecommunities.

… Awareness of patients regarding anesthesia & their attitude towards basic types ofanesthesia techniques. Objective: The purpose of this study was to assess the knowledge ofpatients regarding anesthesia, their attitudes towards basic types of anesthesia techniques andeffect of previous experience of anesthesia on the awareness. Study design: Descriptiveobservational study. Place and duration of study: This descriptive, prospective study wasconducted in the isra university hospital Hyderabad, Sindh, Pakistan from 2nd August 2013 upto8th March 2014. Patients and Methods: Two hundred thirty one patients were included in thestudy after taking verbal informed consent. All patients who were scheduled for elective surgerywere interviewed while patients who had refused from participation, have language barrier,psychiatric disease, had lack of sufficient mental capacity due to poor health status and patientsundergoing emergency surgeries were excluded from the study. Patients were interviewed intheir local language upon arrival in the preoperative area of operation theatre. Self madequestionnaire was filled. All the data was entered on SPSS version 16. Frequency andpercentages were calculated to show the results. Mean with SD of patients age was computed.Chi-square test was applied to assess the affect of previous experience of surgery on patient’sknowledge regarding anesthesia. P value less than 0.05 was taken as significant. Results: Total231 patients were included in the study. Mean age of the patients was 36 ± SD 1.01. Fifty one(22.1%) patients were illiterate; while 54 (23.4%) patients were graduate. 103(44.6%) patients hadprevious experience of surgery/ anesthesia while 128(55.4%) patients had no experience. Out of231 patients, 111 (48.1%) patients were aware of different type of anesthesia techniques while120(51.9%) patients were not aware. Out of 103 patients, who had previous exposure ofanesthesia, 64 patients answered correctly about different types of anesthesia techniques while81 patients who had no previous exposure of anesthesia, answered incorrectly (P value = 0.000).Fifty three patients who had previous exposure of anesthesia answered correctly that anesthetistis a qualified doctor, while 62 patients answered incorrectly who had no previous exposure (Pvalue=0.546). Out of 231 patients, 91 (39.39%) patients were in favor of having generalanesthesia while 52(22.51%) patients were in favor of regional anesthesia, while 88(38.0%) hadleft the choice on surgeon. Conclusions: Results of the study show poor knowledge of patientsregarding anesthesia and anesthesiologists. Majority of the patients were in favor of havinggeneral anesthesia rather regional anesthesia. There is need to correct the misconceptions ofpatients and to educate the public.

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

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.

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.

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.

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.

Objectives: To assess the role of lingual flap in encountering lingual nerve injury during the surgical elimination of lower wisdom tooth. Study Design: Cross Sectional Case Control study. Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical & Health Sciences Jamshoro / Hyderabad. Period: January 2016 to September 2016. Material & Methods: Subjects were categorized into two categories: Group-A (lingual flap) & group-B (control group) each having 52 patients by Lottery method. In group A an envelope mucoperiosteal flap followed by lingual flap elevation carried out and in group B only envelope flap was carried out. All patients were reviewed on the first postoperative day and again 1 and 3rd week after surgery. At each postoperative visit, patient was examined for sensory nerve impairment of the lingual nerve by same observer. Results: Total 104 cases were studied, all the cases categorized among two groups 52 in each group. In group-A 34 were males and 18 were females, while in group-B 44 were male and 8 were females. There was no significant difference among both groups according to the pre-operative assessment. According to objective findings, lingual nerve paresthesia was found among 2 cases of group A on 1st visit, while no any case was found with nerve injury in group B. Out of 2 cases, one case was improved and only one had presented with complain at 2nd visit and 3rd visit, no significant difference among both groups, p-values were quite insignificant. Conclusion: It was concluded that lingual nerve injury (LNI) occurred among few cases of lingual flap group which was insignificantly higher as compare to control group, but the nature of injury was temporary.

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.

The postpartum family planning (PPFP) services are offered immediately after delivery (immediate PPFP), within 40 days after delivery (early PPFP) and within 12 month after delivery (extended PPFP). To promote PPFP the counselling during antenatal visit, before discharge from maternity ward, during postnatal visit and visit during immunization of their babies are the opportunities where health providers help them to decide about the post-partum contraception. Objectives: To compare the coverage of immediate and early postpartum family planning to extended postpartum family planning. To analyze the socio demographic barriers for adopting immediate and early postpartum family planning methods. To identify the missed opportunities for immediate and early postpartum family planning. Study Design: Community Based Comparative Cross Sectional study. Setting: Tando Jam and Hali Road Hyderabad, Sindh. Period: Three months from 01-07-2017 to 30-09-2017. Material & Methods: Three Hundred females of reproductive age (15 to 49 years) during immediate, early and extended postpartum period residing in study area were selected through Purposive Sampling Technique. A pre-designed questionnaire was used as a data collection tool. The data was analyzed using SPSS version 16. The participants were inquired about the usage and concerns towards immediate and early post-partum family planning methods. Barriers and opportunities were identified. The association between various socio-demographic variables and family planning method was determined by applying Chi-square test at ≤0.05 level of significance. Results: Highest number of the study participants were practicing extended method of post-partum family planning i.e. 223(74.33%), only 65(21.67%) had adopted early PPFP and 12 (4%) were practicing immediate post-partum family planning. Low socio-economic status, low literacy rate of both partner, young age of women, and permission from husband, fear of health problem due to contraception and previous bad experience with contraceptive methods were identified barriers towards family planning adoption. Deliveries in homes or in maternity home, facilitated by Dais, not going through ante-natal checkups and not bringing the last born for vaccination were reported with non-adoption of immediate post-partum family planning. Conclusion: The coverage of immediate and early postpartum family planning is very low in the community so the barriers and opportunities identified should be addressed to overcome the hindrances.

Typhoid ileal perforation is the common complication of typhoid fever in third week of its phase of progression. It is the most common cause of mortality in developing countries. Small perforations are dealt with primary repair and the more complicated disease is treated by multiple other options. Prognosis is good with primary repair with least postoperative complications. Objectives: To detect the outcome of typhoid ileal perforation treated by primary repair at tertiary care hospital. Study Design: Cross sectional study. Setting: Surgical Department of PMC Hospital Nawabshah. Period: From August 2017 to December 2018. Material & Methods: This study included total 70 patients. All patients were admitted from surgical OPD and emergency department of PMCH Nawabshah. Out of 70, 45 (64.28%) were females and 25 (35.71%) were male patients. Age ranged from 27 to 52 and 24 to 47 in females and males respectively. The common presentation was pain in whole abdomen along with distention and fever, vomiting. Plain X ray chest/ Abdomen and ultra sonography showed gas under diaphragm. Primary repair was done and also other surgical options but our study included only the postoperative outcomes of primary repair of typhoid ileal perforation. A few complications were detected after primary repair of the gut perforation. Results: Total 70 patients were included in this study. 45 (64.28%) were females and 25 (35.71%) were male patients. In females, 25 (55%) were found single perforations of less than 1cm whereas 7 (15.5%) had size of perforation less than 1.5 cm. In 25 males, 11 (44%) had single perforations of less than 1cm in size. 2 (8%) had < 1.5 cm size perforations and 12 (48%). Over all complication rate in this study was 26%. Conclusion: Primary repair is the best surgical option to treat typhoid ileal perforation in selected patients with least postoperative complications.

Objective: To determine the frequency of acute renal failure in patients presented with Blackstone poisoning in a tertiary care Hospital. Study Design: Cross sectional study. Setting: Medical wards and ICU at Peoples Medical College Hospital, Nawabshah. Period: September 2017 to March 2018. Material & Methods: All the patients of age 20 to 50 years having Paraphenylenediamine (PPD) poisoning (kala-patthar) during ≥6 hours after ingestion and either of gender were included. AKI was labelled as positive if either of any stage was present on the basses of urine output measurement for 24 hours through urine beg r urine output (UO) criteria. All the data was documented in self-made proforma. Results: The mean age for patients was 24.9±8.9 years, 46(19.08%) subjects were male and 195(80.91%) were female. 18(7.5%) study subjects had acute renal failure, out of them 6 study subjects had ARF of stage I, 5 patients had stage II and 7 study subjects had acute renal failure stage III. Conclusion: Acute renal injury is a common complication following PPD ingestion 7.5%. Paraphenylenediamine toxicity is a threat to the region of Asia and is evolving as a substitute to the poisoning of organophosphorus due to its easy accessibility and low cost.

Objectives: Outcome sclerosing agent for managing the oral pyogenic granulomain terms of post-operative pain, post-operative healing and post-operative infection. Study Design: Cross-section study. Setting: Department of Oral & Maxillofacial Surgery, Institute of Dentistry, Liaquat University of Medical & Health Sciences Jamshoro / Hyderabad. Period: October 2018 to March 2019. Material & Methods: Patients with oral pyogenic granuloma and willing to contribute in study were included. Sclerosing agent (ethanolamine oleate) was taken in 3cc disposable syringe and injected in each lesion once a week and repeated according to need. Patients were fooled for 1 to 3 weeks. Outcome was assessed in terms of post-operative pain, post-operative healing and post-operative infection. Data was recorded in proforma. Results: Total seventy four patients were included; their mean age was 40.67+4.99 years. Males were in majority 59.5%. On 1st week 32 showed mild pain which was markedly decreased on 2nd and 3rd week almost among all patients. On 1st week healing was achieved by all cases. Infection was occurred in 4 patients and fever was noted in 12 cases. On 2nd week infection was occurred in 2 patients and fever was in 04 cases. On 3rd week infection was noted in only one cases and fever not found. Conclusion: It was concluded that sclerosing agent ethanolamine oleate is better treatment option than surgical removal with lower rate of pain, best achievement of post-operative healing and lower rate of post-operative infection for the oral pyogenic granuloma management.

Extra cellular fluid (ECF) Ca++ performs vital functions such as blood clotting, cardiac muscle contraction, second messenger for hormone and neurotransmitter release. Total Ionized serum Ca++ is 4.65 to 5.25 mg/dl Ionized Ca++ performs vital physiological functions such as maintenance of plasma membrane integrity. Objectives: The present study is the first research being reporting on the association of LVH (left ventricular hypertrophy) due to essential hypertension with serum vitamin D3 and serum calcium levels. Study Design: Cross Sectional Research. Setting: Medicine/Cardiology department, Peoples Medical University Hospital, Nawabshah. Period: 1st January 2017 to 30th June 2017. Material & Methods: To assess the correlation of 25-hydroxycholecalciferol and serum calcium with left ventricular hypertrophy in essential hypertension. The thickness of inter ventricular septum (IVS) and posterior wall (PWT) on echocardiography were used to categorize LVH into mild, moderate and severe. Results: Male predominated in the present study. Male to female ratio was 1.65:1. Male and female comprised 62.33% and 37.67% respectively. Chi square value (X2-value) was 14.7 with significant p-value. Mean +SD of 25-hydroxycholecalciferol in mild moderate and severe LVH were noted as 30+7.8, 24.7+7.7 and 14.9+6.1 ng/dl respectively. Mean +SD of serum calcium in mild moderate and severe LVH were noted as 9.20+0.51, 8.93+0.72 and 8.678+0.44 mg/dl respectively. Conclusion: In subjects with left ventricular hypertrophy in essential hypertension the serum levels of vitamin D and calcium were low. There was a negative correlation with left ventricular hypertrophy and serum vitamin D and serum calcium. Thus it could be concluded that in subjects with left ventricular hypertrophy the low levels of serum vitamin D could be an independent modifiable risk factor.

Objectives: To explore the association of migraine severity and disability with body mass index. Study Design: Cross sectional study. Setting: Department of Medicine and Physiology of Indus Medical College, Tando Muhammad Khan. Period: August 2018 and March 2019. Material & Methods: It included all patients both female and male diagnosed with migraine of age group 18-55 years. Diagnosis of migraine was done according to the guidelines by international headache society. Approval was taken from the ethical review committee of the Institute. Severity of migraine was evaluated according to MIDAS questionnaire obesity was determined from Body mass index (BMI). Patients were divided into four groups according to various body mass index categories as per the revised guidelines into underweight: m2, Overweight: 23.0-24.9 kg/m2, Obesity: >25 kg/ m2. Clinical features of migraine were compared in these groups. The collected data was analyzed in SPSS version 18.00. Results: A total 189 (n=189) participants recruited in this study, meeting selection criteria were included. Out of 189, 73 presented with aura while 116 presented without aura. So the study population divided into two groups one wit aura (n=73) and other without aura (n=116). The overall mean age + SD (range) was 28.80+ 8.54(18 to 48 years). There was no significant difference of age (compare means) between male and female subjects (p value = 0.99). The study participants (n=189) divided into two types, first migraine with Aura n=73 (38.62%) and second Migraine without aura n=116 (61.36%). Mean±SD of MIDAS score, waist hip ratio, age of onset of headache (in years), frequency of headache per month and the duration of headache (in hours), of the study participants were 12.18+4.48, 0.87+.066, 18.89+2.97, 10.93+2.70 and 67.32+12.52 respectively. Mean±SD of MIDAS Score among the miranieuers without aura (n=116) was 12.18±4.48 but among the patients who presented with aura (n=73), it was 16.39±6.39. (P value

Objectives: This study has been conducted in a tertiary care hospital to observe the frequency of congenital birth defects in newborn babies born at, Hyderabad, Sindh. Study Design: Prospective observation study. Setting: The Departments of Obstetrics and Pediatrics, Isra University Hospital, Hyderabad. Period: Two years from 2016 to 2018. Material & Methods: All the pregnant women irrespective of their parity and were included in the study after getting informed and written consent from their family heads and after the approval from Hospital’s ethical committee. We have used SPSS version 21.0 software for both data entering and analysis. All the continuous variables were analyzed using student t test and categorical variables were analyzed using chi-square test. P-value of ≤0.05 was taken as statistically significant. Results: A total of 150 pregnant women were included in our study with their mean age and SD was 26.72 ± 7.07 years and the mean years of marriage were 5.95±6 years. Most of the women were multiparous (47%), as compared to nulliparous and grandmultiparous, 33% and 20%, respectively. The prevalence of congenital birth defect was 11.3%, of these 30% had CNS malformations followed by 30% with gastrointestinal, 24% musculoskeletal, 12% genitourinary and 4% had ear malformations. Conclusion: The interfamily marriages (consanguineous marriages) are more common than outside family in study population. The frequency of birth defects was more than i-e: twice higher in interfamily marriages than outside family marriages.

Objectives: To assess the Nutritional Status by measuring Body Mass Index and screening of School going children of Khairpur Mirus Sindh. Study Design: Cross Sectional Descriptive Study. Setting: Department of Pediatrics, Liaquat University of Medical and Health Sciences Jamshoro. Period: From 1st May to 31st May 2015. Material & Methods: Over 2400 children (age 5 to 18 years) studying at schools of Taluka Khairpur Mirus, Sindh. We conducted this study at 40 schools, both from government and private sector. Schools included Primary, Secondary, High and Higher Secondary Schools. Medical History was taken and detailed physical examination done, including Cardiovascular Examination, Eye and Abdominal Examination. History of presence of worms in stool was taken from children. Anemia was checked by palmer inspection. Weight and height was taken by well-trained doctors and paramedical staffs with the help of weight machine and stadiometer. Results: Out of total 2400 children 43.4% were male and 56.6% were female. Mean BMI was 15.97, while mean weight was 30.93 kg and mean height was 136.92 cm. Among 730 children, who were underweight, 54.5% children were mild underweight, while 29.7% children were moderate underweight and 15.7% children were severe underweight. 6% children were overweight, while 4% children were obese. Anemia was present in 63.04% children, Eye Squint was present in 3.1% children, worms infestations were present in 0.2% children and murmur was detected in 0.1% children. Conclusion: We found significant number of children having low BMI (30.4%) and the Mean BMI was 15.97. We also found significant number of children having underweight that is 54.5% children were mild underweight, while 29.7% children were moderate underweight and 15.7% children were severe underweight. On the other hand, overweight and obesity was less common, 6% children were overweight, while 4% children were obese. During Screening, Anemia was (63.04%) and Eye Squint (3.1%) was the most common clinical findings.

Objectives: To determine the frequency of hypothyroidism in type II diabetic patients and to compare the lipid profile of diabetic patients with and without hypothyroidism. Study Design: Cross Sectional Study. Setting: Medicine Unit I Shaikh Zayed Hospital Lahore. Period: 5th August 2016 to 5th February 2017. Material & Methods: A total of 350 patients, aged 35-80 years, of both gender and having type II DM diagnosed at least 1 year ago were enrolled in our study. Fasting (12hr) blood samples were obtained and sent to the laboratory for measurement of serum TSH, total cholesterol, LDL and TGs. Patients with TSH value >10 μg/ml were labeled as hypothyroid. Two groups (hypothyroid diabetic and euthyroid diabetic) were made and lipid profile was compared in both groups. Results: Frequency of hypothyroidism in type II diabetic patients was recorded as 13.42% (n=47). When lipid profile of hypothyroid diabetic patients (group I) was compared with euthyroid diabetics (group II), it was noted that patients in group I had mean total cholesterol of 170.32 ± 12.90 mg/dl whereas in group II, it was 138.81 ± 28.89 mg/dl. Mean triglyceride level in group I was 176.21 ± 15.98 mg/dl, whereas in group II, it was 151.02 ± 27.78mg/dl. Mean LDL in group I was 87.17±15.97mg/dl, and 71.35±20.40 mg/dl in group II. Conclusions: Frequency of hypothyroidism in type II diabetic patients is higher as compared to general population. Moreover, dyslipidemia is significantly higher in hypothyroid diabetics when compared with euthyroid diabetics.

Objectives: To determine the factors those may predict hyperkalemia in cirrhotic patients receiving spironolactone. Study Design: Cross sectional descriptive study. Setting: Medicine Department Shalamar Hospital, Lahore. Period: 15 days from 1st September to 15th September 2017. Materials & Methods: 150 patients with documented liver cirrhosis, receiving spironolactone and fulfilling the inclusion criteria were made part of the study. Five mL blood was drawn in two different vials; 2 mL in EDTA vial to check the prothrombin time (PT) and 3 mL in clotted vial to measure serum potassium, sodium, creatinine, urea, albumin, and bilirubin in serum after centrifugation. Potassium level was measured at baseline (Day-0) and two weeks later after receiving spironolactone. Results: Patients with raised serum creatinine (>1.3 mg/dL) and hyperbilirubinemia (>2.8 mg/dL) were found to have serum potassium more than 5 mmol/L. Increased potassium levels were found in patients receiving high dosage of spironolactone (>100mg/day). These patients had decompensated liver cirrhosis as evident from their child-class C and significant hypoalbuminemia. Conclusion: Decompensated cirrhotic patients with raised serum creatinine, hyperbilirubinemia, hypoalbuminemia and receiving high dosage of spironolactone remain at higher risk of developing hyperkalemia.