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Objective: To compare the efficacy of topical Adapalene plus oral Azithromycin versus topical Adapalene plus oral Doxycycline in treating mild to moderate acne vulgaris. Study Design: Quasi-experimental study. Place and Duration of Study: Dermatology Department, Pak Emirates Military Hospital Rawalpindi, from Jun to Dec 2017. Methodology: A total of 60 patients were enrolled in the study and were grouped into two groups, A and B, comprising 30 patients in each group. Random tables were used to allocate patients to each group. In this study, Group A was prescribed topical Adapalene be applied as a thin layer over affected areas at night plus oral Azithromycin 250 mg capsule once daily for 03 months, while Group B was given the same instructions for topical Adapalene plus oral Doxycycline100 mg twice daily for 03 months. Fifty percent reduction of lesions from the baseline was considered an effective therapeutic response. Results: In our patient sample mean age in Group A was 18 years (± 4.77), while the mean age in Group B was 19 years (± 5.12). In Group A, 13 (43%) patients were male, and 17 (57%) patients were female, while in Group B, 12 (40%) patients were male, and 18 (60%) patients were female. Treatment in Group A was effective in 90% of patients, while 73% of patients in Group B showed effective response. Conclusion: This study concluded that a combination of topical Adapalene plus oral Azithromycin was equally efficacious to topical Adapalene plus oral Doxycycline in treating mild and moderate acne vulgaris. [ABSTRACT FROM AUTHOR]

Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries. Study Design: Comparative prospective study. Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018. Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications. Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group. Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure. [ABSTRACT FROM AUTHOR]

Objective: To compare fetomaternal outcomes using amniotic fluid index and single deep vertical pocket for estimating amniotic fluid volume among pregnant women. Study Design: Comparative prospective study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Aug 2019 to Feb 2020. Methodology: Sample of 110 pregnant women was calculated with WHO calculator. We used non probability consecutive sampling as effective sampling technique. Research approval and patient consent were taken before initiation of study. Patients were randomly divided into two groups; group A underwent amniotic fluid index measurement while group B underwent single deep vertical pocket measurement. Feto maternal outcomes were measured in both groups. Results: Total 110 pregnant women were included in our study (55 women in each group). Mean age of women was 26.9 ± 4.6 SD. In Amniotic fluid index group, preeclampsia 14 (12.7%) vs 5 (4.5%) respectively, p=0.04, rupture of membrane 12 (10.9%) vs 4 (3.6%) respectively, p=0.05 was significantly higher as compared to single deep vertical pocket group. Patients with oligohydroamnios were significantly higher in amniotic fluid index group as compared to single deep vertical pocket 15 (13.6%) vs 3 (2.7%), respectively, p=0.04. Conclusion: Amniotic fluid volume assessment could be done with both amniotic fluid index and single deep vertical pocket method. Single deep vertical pocket is safe, effective and better diagnostic choice for amniotic fluid assessment as it is associated with avoidance of unnecessary interventions without affecting peripartum outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare outcomes (plantar fascia thickness, Visual analogue scale scores, role and maudsley scores of satisfaction and complication) of ultrasound guided plasma rich protein injection and steroid injection in chronic plantar fasciitis. Study Design: Quasi experimental study. Place and Duration of Study: Department of orthopedics, Sheikh Khalifa Bin Zayed Al Nahyan/Combined Military Hospital (CMH), Muzaffarabad, from Jun 2018 to Jun 2019. Methodology: Plantar fasciitis patients were selected through non probability consecutive sampling. Patients were randomly divided into two groups, group A received ultrasound guided PRP injection while group B received steroid injection. Both groups were followed for outcomes for 6 months. Results: Total 42 patients were included in study. There were 20 (47.6%) male and 22 (52.4%) female. Mean age of patients was 42.6 years ± 9.5 SD. Plasma rich protein group showed significantly low visual analogue scores (p<0.01), American Orthopedic foot and ankle scores (p<0.01), reduced plantar fasciitis thickness (p<0.01), Roles and Maudsley satisfaction scores (p<0.01). Age and gender showed insignificant association with outcomes (p=0.538 & p=0.653 respectively). Conclusion: Ultrasound guided Plasma rich protein injection is a safe, well tolerated and effective method of plantar fasciitis management with long lasting accuracy as compared to steroid injection. Early diagnosis and management of plantar fasciitis leads to better health outcomes. [ABSTRACT FROM AUTHOR]

Objective: To compare chlorhexidine dressing versus simple occlusive dressing in preventing central venous catheter related blood stream infection (CRBSI) in medical intensive care unit. Study Design: Prospective comparative study. Place and Duration of Study: Study was conducted in Medical Intensive Care (ICU) of Pakistan Institute of Medical Sciences, Islamabad, from Jan 2018 to Jun 2018. Methodology: Patients were divided randomly into two groups (1:1 randomization). In group A chlorhexidine dressing was applied and in group B normal occlusive dressing was done. Patients were followed after 2 weeks. Ethical approval and consent forms were taken. Results: Total 48 patients were included in study. There were 21 (43.8%) males and 27 (56.3%) females in study. Mean age of patients was 50.2 ± 11 years. Chlorhexidine dressing had shown statistical significant reduction in catheter related blood stream infection as compare to simple occlusive dressing (p=0.01). Type of dressing is statistical significantly associated with gender (p=0.02). Site of insertion is significantly associated with catheter related blood stream infection infection (p<0.001). Conclusion: catheter related blood stream infection is the most common form of bacterial infections. Chlorhexidine dressing had significant contribution in reduction of catheter related blood stream infection as compare to simple occlusive dressing. Hospital based strategies are required to reduce risk and complications associated with catheter related blood stream infection. [ABSTRACT FROM AUTHOR]

Objective: To compare post-operative pain scores in open and laparoscopic appendectomy Study design: Randomized Controlled trial (RCT) Study sett ings and duration: Study was conducted at department of surgery Pakistan Ordinnace Factory (POF) Hospital, Wah Cantt, for 6 months (January 2018- June 2018). Material and methods: Sample size of 60 patients was calculated using WHO calculator. Non probability consecutive sampling was used. Patients were divided randomly into two groups using lott ery method. Group-A underwent laparoscopic appendectomy while Group-B underwent open appendectomy. Ethical approval and consents form were taken patients were followed for measuring pain scores. Data was analyzed using SPSS version 23. T-Test and chisquare was applied. P value =0.05 was considered significant. Results: Total 60 patients were included in study with 1:1 randomization (30 patients in each group). Th ere were 38(63%) male and 22(37%) female. Mean age of patients was 35.8 years± 11.9 SD. Mean pain scores in laparoscopic appendectomy group 30(50%) were 0.60±0.8 SD while mean pain scores in open appendectomy 30(50%) were 4.9±1.2 SD (t= -15.392, df= 58, p=0.000). Laparoscopic and open appendectomy had significant association with age (p=0.05), DM (p=0.001), HTN (p=0.05), Pain distress (p=0.000) and Pain activity (p=0.03). Conclusion: Effi cacy of laparoscopic appendectomy is bett er in terms of lower pain scores, pain distress and pain activity as compare to open appendectomy. Early diagnosis and treatment of appendicitis leads to bett er patient's related outcome. [ABSTRACT FROM AUTHOR]

Objective: To determine efficacy of antibiotic therapy and appendectomy in acute appendicitis in tertiary care hospital Study design: Randomized controlled trial Study settings and duration: Study was conducted at department of surgery, CMH hospital, Muzaffarabad. Study duration was 6 months (June 2018-Novembet 2018) Material and methods: A sample size of 60 patients was calculated using WHO calculator. Non Probability consecutive sampling was used for patient's selection. Ethical approval and consent forms were taken. Patients were randomly divided into two groups; group-A was given antibiotics while group-B patients were undergone appendectomy. Patients were followed after 8 days. Efficacy of both interventions was measured. Data was analyzed using SPSS version 24. Chi-Square test was applied. P value ≤ 0.05 was considered significant. Results: Total 60 patients were included in study (1:1 randomization 30 patients in each group). There were 38(63.3%) male and 22(36.7%) female. Mean age of patients was 31.9±8.8SD. Efficacy of appendectomy group was higher than antibiotic group (p=0.002). Surgical group had significant less hospital stay(p=0.00), recurrence rate(p=0.04), pain scores (p=0.00) and sick leaves(p=0.000) as compare to antibiotic group. Surgical wound infection 13.3% was most common complication in appendectomy group while appendicular mass 10% was most common complication of antibiotic. Conclusion: Appendectomy is an effective treatment option in adults patients diagnosed with acute appendicitis as compare to antibiotic therapy. Appendectomy had efficacy >50% in terms of low recurrence rate, reduction in pain scores, less hospital stay and sick leaves. Further research in needed to reveal more precise indications on acute appendicitis treatment efficacy [ABSTRACT FROM AUTHOR]

Objective:To determine the eff ectiveness of MELD score in predicting mortality in cirrhotic patients who presented with acute variceal bleeding to our unit Study design: Descriptive Cross sectional Place and Duration of study: Study was conducted at the department of Gastroenterology, Ayub Teaching Hospital, Abbott abad from August 2013 to April 2017. Material and Methods: Two hundred and seven cirrhotic patients who presented with acute variceal bleeding to the department of gastroenterology, Ayub Teaching Hospital, Abbott abad were enrolled in this study. The MELD and CTP scores were calculated at the time of admission and the patients were managed as per department protocols. Patients were followed up for a 4-week period and mortality in patients was recorded on a proforma. Results: Out of 207, 38 (18.4%) patients died during the study period. Hepatitis C (57; 27.5%), Hepatitis B (54; 26.1%), combined Hepatitis B and C infection (51; 24.6%) and other causes (45; 21.7%) were identified as the cause of CLD. Esophageal varices were the most frequent source of bleeding (77; 37.2%). Mean child pug scores were 10.47± 2.SD and mean MELD scores were 25.11±7.3 SD in patients underwent mortality (p=0.000). Conclusion: MELD score were found to be more eff ective as CTP score in predicting mortality following acute variceal bleeding in cirrhotic patients. [ABSTRACT FROM AUTHOR]

Objectives: To determine frequencies of ABO blood group in T2DM in tertiary Care, Pakistan. Study Design: Descriptive, Cross-sectional study. Place: Conducted in the department of medicine, Ghulam Muhammad Mahar Medical Teaching Hospital (GMMMC). Duration: From January 2016 to July 2016. Methods: With consent of patients having T2DM of both genders and 30-70 years of age. Non-probability, Consecutive sampling was used. Total of 196 patients were enrolled during this time period. After taking consent, blood samples taken from peripheral vein for blood grouping were sent to the Central Laboratory GMMMC. Laboratory technician determined blood group using standard techniques. All this information was collected through a self-structured Performa. Results: Participants in our study were from age range 30 to 70 years with mean age of 53.26 ± 7.28 years. Out of the 196 patients, 110 (56.1%) were female and 86 (43.9%) were male. The prevalence of blood group A, B, AB and O in patients with ischemic stroke was found to be as of following; 34 patients having blood group A (17.3%), 74 patients having blood group B (37.8%), 18 patients having blood group AB (9.2%) and 70 patients having blood group O (35.7%) respectively. Stratification was also done on gender basis. 75.5% (n=148) had positive family history. Conclusion: Blood group B +ve was the most prevalent blood group in T2DM in our study. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To determine the impact of biliary etiology on the outcome of acute pancreatitis. STUDY DESIGN: Randomized controlled trial. PLACE & DURATION OF STUDY: Study was conducted at Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad from January 2013 to January 2014. METHODOLOGY: A total of one hundred and sixty (n=160) patients of both genders having age >13 years presented with acute pancreatitis were enrolled and randomly divided in two groups A (biliary etiology) and B (non-biliary etiology). Outcomes in both groups were noted in terms of analgesia requirement, hospital stay, need for assisted ventilation, oxygen inhalation and occurrence of local and systemic complications etc. Student t-test and chi-square test was used to analyze data. P-value <0.05 considered as significant. RESULTS: Oxygen was required in 60% of patients in group A while 48.75% in group B during their stay at hospital. Frequency of patients who discharged within one week of admission, need ventilator support and operative management found to be 37.5%, 30% and 47.5% in group A while 47.5 %, 15% and 15% respectively in group B. CONCLUSION: Fewer complications were associated with non-biliary etiology. Frequency of favorable outcome was lower in the patients with biliary etiology. [ABSTRACT FROM AUTHOR]

Objective: To determine prevalence of acute kidney injury in patients treated with intravenous colistin. Study design: Cross sectional study. Study settings & duration: Study was conducted at Department of Medicine, King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia. Study duration was 6 months (June 2017-November 2017). Material & methods: Sample size of 147 patients was calculated using WHO calculator. Patients were selected using non probability consecutive sampling. Patients received intravenous colistin, were undergone through venous blood samples of creatinine. Patients with creatinine >2mg/dl were diagnosed with acute kidney injury. SPSS soft ware was used for data analysis. Descriptive and inferential statistics were calculated. Chi-square test was applied with p-value =0.05 significant. Results: Total 147 patients were included in study. There were 94(64%) female and 53(36%) males. Mean age of patients was 55±2.4 SD. Among all the patients 147 (100%), 20(14%) patients are at risk of acute kindney injury (AKI), 63(43%) had acute kindney injury while 5(3%) were diagnosed with kidney failure and 59(40%) remained intact with acute kindney injury diagnosis. Males, 40-80 years age group and BMI>30 kg/m2 had high proportion of acute kidney injury (p<0.05). Conclusion: Prevalence of acute kidney injury following colistin administration is very high as compare to previous thought. Further evidence is required for service planning and provision of information to clinicians to prevent deterioration of renal function. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To compare end to end urethroplasty and optical urethrotomy in terms of postoperative urinary flow rate in patients presenting with short segment incomplete urethral stricture. STUDY DESIGN: Randomized controlled trial (RCT). PLACE AND DURATION WITH DATES: The study was conducted in department of Urology, Pakistan Institute of Medical Sciences (PIMS), Islamabad. The duration of study was 1 year. METHODOLOGY: In present study, 47 patients were randomly allocated to each of the intervention groups i.e. Group A underwent end to end urethroplasty procedure and Group B underwent optical urethrotomy. Peak urinary flow rates were measured preoperatively, at one week after the catheter removal post operatively and at 3 months after the catheter removal post operatively. Outcome in both groups was compared using 't' test. RESULTS: Mean age of patients in group A (End to End anastomotic Urethroplasty) was 31.98±11.14SD while mean age in Group B (Optical Urethrotomy) was 34.72±13.76SD. The mean peak urinary flow rate was found to be 21.39 ml/sec ± 1.89 SD in Group A and was 22.11 ml/sec ± 2.05 SD in Group B at one week post operatively after catheter removal (P> 0.05). The mean peak urinary flow rate was found to be 22.48 ml/sec ± 2.12 SD in Group A and was 17.99 ml/sec ± 1.52 SD in Group B at 3 months post operatively after catheter removal (P<0.05). CONCLUSION: End to end anatsomotic urethroplasty was found to be significantly better than optical urethrotomy in terms of peak urinary flow rate at one week and 3 months after catheter removal in the treatment of urethral strictures in men. [ABSTRACT FROM AUTHOR]

Objective: To fi nd out the association between vitamin D3 and infl ammatory bowel disease Study design: Randomized Controlled Trail Place and duration: Th e study was conducted in King Salman Armed Forces Hospital, Tabuk, Kingdom of Saudi Arabia for the time period of 1 years (July 2015-July 2016). Material & Methods: Th e study was a randomized controlled trail with 1:1 ratio of two groups. Th e sample size of 50 patients was achieved. Th e interventional group was provided with 300,000 IU intramuscular vitamin-D while the placebo group is given 1ml of saline and followed for 4 months. Both the groups were measured for PTH, ESR and serum level of 25 (OH)- vitamin D3 before and aft er intervention. Chi square test was performed to observe the association between vitamin D3 and infl ammatory bowel disease (IBD). Results: Total 50 patients were observed 25 in placebo group and 25 in intervention group. Th e study found out that serum hydroxyl vitamin D3 level in interventional group before and aft er was 32.3±0.67, 41.7±6.2 while in placebo group it was 33.9±8.9 and 34.8±9.6 respectively 95% confi dence interval. Conclusion: Higher level of vitamin D3 is associated with prevention of infl ammatory bowel diseases. Vitamin-D is playing a role of immune regulator in body and tends to improve bone and calcium homeostasis. [ABSTRACT FROM AUTHOR]

Objectives: To explore the diagnostic value of mean platelet volume for acute appendicitis among children. Study design: The study design was a case control. Place and duration: The study duration was 6 months (June 2012-November 2012) and conducted in Department of Surgery, P.A.E.C General Hospital, Islamabad. Subject & Methods: A sample size of 140 was achieved using WHO formula with 80% power, SD 1.09, anticipated population 7.55 and 5% significance level with cases to control ratio of 1:1. A simple random sampling (lott ery method) was used for selecting patients. Both groups were compared for continuous variables using t- test. A correlation test was performed to the relationship of MPV with other variables. Results: The study includes 140 participants. Among the 70 (100%) cases, there were 30 (43%) males and 40 (57%) females. While among controls 70 (100%), there were 33 (47%) males and 37(53%) females. The mean age was 8.17±3.47 years (1-15 years) among cases while controls had mean age 8.77±3.62 years (1-15 years). The specificity for elevated WBC and neutrophil values was 89% and 91% and sensitivity was 84% and 77% among cases. The specificity and sensitivity was 54% and 87% for reduction in MPV values. Conclusion: Elevation in WBC and neutrophil counts detection is significantly associated with acute appendicitis. Paying more att ention towards MPV values during blood counting is least expensive and time consuming for diagnosis of acute appendicitis among pediatric patients. The acute appendicitis among children is associated with reduced MPV level. [ABSTRACT FROM AUTHOR]

Objectives: To find out the frequency uric acid levels in Pakistani general population. Study Design: Cross sectional study. Setting: Hira Medical Centre Sukkur. Period: July 1 2018 to July 31, 2018. Materials and Methods: The survey for was conducted in various hospitals and clinics all over Pakistan. 900 numbers of questionnaires were distributed of which 801 numbers responded. Those who agreed to be part of this study were asked. Uric acid levels were assessed by using UASure Blood Uric Acid Monitoring System. Those with greater than 6 mg/dl were classified as hyperuricemia according to American college of Rheumatology. Descriptive analysis was performed with SPSS software version 23. Frequency of patients with hyperuricemia was calculated. Stratification with respect to gender and age was calculated via cross tabulation. Results: Out of 135 patients, 102 (75.5%) were male while 33 (25.5%) were female with mean ± SD age of 56.72 ± 12.24 years. The prevalence of hyperuricemia was 33.33% (n=45). Mean Uric acid levels were 6.12 ± 1.68 mg/dl. 31.3% (n=32) male and 39.3% (n=13) females were hyperuricemic. Conclusion: Prevalence of Hyperuricemia in Sukkur is alarming and efforts should be made to aware patients about the consequences of. [ABSTRACT FROM AUTHOR]

Perovskites are bringing revolutionization in a various fields due to their exceptional properties and crystalline structure. Most specifically, halide perovskites (HPs), lead-free halide perovskites (LFHPs), and halide perovskite quantum dots (HPs QDs) are becoming hotspots due to their unique optoelectronic properties, low cost, and simple processing. HPs QDs, in particular, have excellent photovoltaic and optoelectronic applications because of their tunable emission, high photoluminescence quantum yield (PLQY), effective charge separation, and low cost. However, practical applications of the HPs QDs family have some limitations such as degradation, instability, and deep trap states within the bandgap, structural inflexibility, scalability, inconsistent reproducibility, and environmental concerns, which can be covered by encapsulating HPs QDs into porous materials like metal-organic frameworks (MOFs) or covalent-organic frameworks (COFs) that offer protection, prevention of aggregation, tunable optical properties, flexibility in structure, enhanced biocompatibility, improved stability under harsh conditions, consistency in production quality, and efficient charge separation. These advantages of MOFs-COFs help HPs QDs harness their full potential for various applications. This review mainly consists of three parts. The first portion discusses the perovskites, halide perovskites, lead-free perovskites, and halide perovskite quantum dots. In the second portion, we explore MOFs and COFs. In the third portion, particular emphasis is given to a thorough evaluation of the development of HPs QDs@MOFs-COFs based materials for comprehensive investigations for next-generation materials intended for diverse technological applications, such as CO 2 conversion, pollutant degradation, hydrogen generation, batteries, gas sensing, and solar cells. Finally, this review will open a new gateway for the synthesis of perovskite-based quantum dots., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)