Pakistan Journal of Health Sciences https://thejas.com.pk/index.php/pjhs <p><strong>Title of Journal: </strong><strong>Pakistan Journal of Health Sciences</strong></p> <p><strong> (ISSN Online: 2790-9352, Print: 2790-9344)</strong></p> <p><strong>Frequency: </strong><strong>Monthly (w.e.f July-2022)</strong></p> <p><strong>Affiliated with:</strong> Lahore Medical Research Center</p> <p><strong>Website:</strong> (<a href="http://www.lmrc.com.pk">www.lmrc.com.pk</a>)</p> <p><strong>Published By:</strong> CrossLinks International Publishers (CLIP), Lahore, Pakistan</p> <p><strong>Website:</strong> (<a href="http://www.clip.com.pk">www.clip.com.pk</a>)</p> <p><strong>Address:</strong> Allama Iqbal Town, Lahore, Pakistan</p> <p>Lahore Medical Research Center has published <strong>"Pakistan Journal of Health Sciences</strong><strong> (PJHS)</strong>"; A Monthly, Double Blind peer-reviewed open access Journal. The aim of the Journal is to provide a platform for allied health professionals to publish their research work. All materials, articles and information published in <strong>PJHS</strong> will be peer-reviewed.</p> <p>Research papers, Short communications, Review or mini-reviews, Commentaries, Perspectives, opinion, Meta-analysis, Case reports, Case studies, Case-control studies</p> <p>Reviews on recent progress in Health Sciences are commissioned by the editors. The purpose of the <strong>PJHS</strong> is to publish scientific and technical research papers to bring attention of international researchers, scientists, academicians, health care professionals towards recent advancements in Health Sciences. The articles are collected in the form of reviews, original studies, clinical studies etc. It may serve as a global platform for scientists in relevant fields to connect and mutually share ideas. This journal is open to all the research professionals whose work fall within our scope. </p> <p><strong>Aim &amp; Scope</strong></p> <p>The Pakistan Journal of Health Sciences (PJHS) provides a platform for research and discussion across a broad spectrum of disciplines. Its scope encompasses Medical and Clincal Sciences, Public Health, Physical Therapy, Dentistry, Pharmacology, Nursing and Medical/Health Professions Education. Through comprehensive coverage, PJHS aims to foster collaboration and advance knowledge in these vital areas of healthcare and academia.</p> <p><span style="text-decoration: underline;"><strong>Accreditation:</strong></span></p> <p><strong>Approved by Higher Education Commission of Pakistan for the year 2023-24</strong></p> <p><span style="text-decoration: underline;"><strong>Fee &amp; Subscription Charges</strong></span></p> <p>Article Processing Fee: Rs 5000/ Article (w.e.f 1st May, 2024) <strong>(Non-Refundable)</strong></p> <p>Article Publication Fee (National) Rs 30000 / Article</p> <p>Article Publication Fee (International ) 200 USD / Article</p> <p>Printed Version (Selected Articles on Authors Request) : Rs 2500/per copy (For InLand Delivery)</p> <p><span style="text-decoration: underline;"><strong>Annual Subscription for Printed Versions</strong></span></p> <p>For Institutes: Rs 20,000/ Annually</p> <p>Single Copy (Selected Articles): Rs 2500/-</p> <p><span style="text-decoration: underline;"><strong>Bank Details</strong></span></p> <p style="margin: 0cm;">Account Title: Lahore Medical Research Center LLP</p> <p style="margin: 0cm;">Bank Name: Meezan Bank</p> <p style="margin: 0cm;">IBAN: PK36MEZN0002840105377903</p> <p style="margin: 0cm;">Account # 02840105377903</p> <p><span style="text-decoration: underline;"><strong>Waiver Policy</strong></span></p> <p>If an author has no funds to pay such charges, he may request for full or partial waiver of publication fees. The decision may however vary from case to case.</p> <p>We do not want charges to prevent the publication of worthy material.</p> <p><strong><u>Submissions</u></strong></p> <p>Submission are welcome and may be submitted here: <u><a href="mailto:editor@thejas.com.pk">editor@thejas.com.pk</a></u></p> en-US <p>This is an open-access journal and all the published articles / items are distributed under the terms of the <a href="http://creativecommons.org/licenses/by/4.0/">Creative Commons Attribution License</a>, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments</p> <p><a href="mailto:editor@tjas.lmrc.com.pk">editor@thejas.com.pk</a></p> editor@thejas.com.pk (Khurram Mehboob) oric@lmrc.com.pk (Khurram Mehboob) Sun, 30 Jun 2024 00:00:00 +0000 OJS 3.3.0.7 http://blogs.law.harvard.edu/tech/rss 60 After 20 Years of Treatment with Aprepitant for Chemotherapy-Induced Nausea and Vomiting, Should the Therapeutic Indications for Aprepitant be Expanded? https://thejas.com.pk/index.php/pjhs/article/view/1915 <p>The drug aprepitant, a selective antagonist of the neurokinin-1 receptor (NK-1R), was approved in 2004 by the FDA for the treatment of CINV, blocking the activation of the receptor by substance P (SP). Oral aprepitant (day 1:125 mg; days 2-3: 80 mg) (low doses) was coadministered with dexamethasone and a serotonin 5-HT3 receptor antagonist. The aprepitant triple regimen is effective for the prevention of CINV in patients being treated with moderately or highly emetogenic chemotherapy [1]. Furthermore, activation of the SP/NK-1R system has been reported to mediate also pruritus and cough. A study published on 17 patients with skin T-cell lymphomas (CTCL) with refractory pruritus was treated with aprepitant administered according to the standard of 125–80–80 mg either in a weekly or a biweekly repetition regimen. They show that aprepitant was safe, well tolerated and effective for the treatment of severe chronic pruritus in patients with CTCL [2]. In addition, two randomized clinical trials have clearly demonstrated that aprepitant (day 1:125 mg; 2-7/2-3: 80 mg) suppresses treatment-refractory cough in patients with lung cancer [3,4]. Regarding safety, NK-1R antagonist aprepitant was safe and well tolerated. In a placebo-controlled trial in patients with moderate-to-severe major depression, a dose of 300 mg/day (moderate doses) of aprepitant was well tolerated and no statistically significant difference in the frequency of adverse events was observed as compared with placebo. Additionally, aprepitant was as antidepressant as paroxetine [5]. Furthermore, in the las 20 years has been reported many papers about the involvement of SP/NK-1R in cancer progression and the use of NK-1R antagonist aprepitant counteract all the pathophysiological functions of SP related to cancer. In fact, aprepitant is a broad-spectrum antitumor drug. Obviously, the concentrations or doses of aprepitant to have antitumor activity are higher (20-40 mg/kg/day) (high doses) [6].</p> <p>In conclusion, based on the safety (low and moderate doses) and efficacy of aprepitant, its use in refractory pruritus with CTCL and treatment-refractory cough in patients with lung cancer should be approved. Regarding cancer treatment (high doses) we suggest the initiation of a Phase I clinical trial to see what safe doses are and Phase II clinical trials to evaluate the efficacy of aprepitant alone or in combination therapy with chemotherapy or radiotherapy at least in tumors with the poor prognosis.</p> Riffat Mehboob, Miguel Munoz Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1915 Sun, 30 Jun 2024 00:00:00 +0000 Diagnostic and Prognostic Potential of Biochemical and Hematological Markers in Tobacco Users with Oral Pre-Cancer Lesions https://thejas.com.pk/index.php/pjhs/article/view/1708 <p>Oral Pre-Cancer Lesions (OPLs) including leukoplakia, erythroplakia, and submucous fibrosis denote biochemical and histopathologically altered changes in the oral mucosa marked by subcellular and structural anomalies evocating of potential for a malignant transformation, which is primarily caused by tobacco exposure. Early diagnosis is of paramount importance to halt the progression of premalignant lesions to high-grade dysplasia and even oral cancer. <strong>Objective: </strong>To find the diagnostic and prognostic potential of biochemical and haematological markers in Tobacco Users (TU) with OPL. <strong>Methods</strong>: PRISMA guidelines were followed to perform this systematic review. After retrieving 170 epidemiological studies published from 2013 to 2023, through multiple databases (PubMed<em>,</em> Google Scholar<em>,</em> Sci-hub, and Science Direct), 21 were included to determine the potential of biochemical and haematological markers in risk stratification and early detection of OPL. <strong>Results:</strong> According to the following systematic review, extracted data showed specific biochemical and haematological indicators that could serve as markers in risk stratification and early detection of OPL. The OPL group exhibited significantly higher levels of biochemical markers IL-6, IL-8, TNF-α, HCC-1, PF-4, FRR, TP, MDA, MMP-12, and Ceruloplasmin and hematological markers NLR, PLR, CRP, ESR, WBC, and low Hb as compared to the control group. Following risk stratification, a group with older age, tobacco association with OPL, and elevated levels of markers were categorised as a higher-risk group. <strong>Conclusions: </strong>The biochemical and haematological markers are potential promising markers in the early detection of OPL from malignant lesions with diagnostic and prognostic significance.</p> Muhammad Rafique Tagar, Arsalan Ahmed, Muhammad Mustafa, Muzaffar Qayum Khan Ghauri, Muhammad Aqeel Aslam, Shakeel Ahmed Tagar, Shaharyar Ahsan Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1708 Sun, 30 Jun 2024 00:00:00 +0000 Prevalence of Inflammatory Back Pain (IBP) In Patients with Backache Visiting Rheumatology OPD at Khyber Teaching Hospital, Peshawar https://thejas.com.pk/index.php/pjhs/article/view/1635 <p>Back pain is a prevalent and often paralyzing condition that impacts people of all ages and backgrounds. When it comes to back pain, it is crucial to differentiate between different kinds in order to accurately diagnose and effectively treat the problem. <strong>Objective:</strong> To ascertain the frequency of Inflammatory Back Pain (IBP) in patients presenting with low back pain. <strong>Methods:</strong> This descriptive study was conducted in rheumatology department of Khyber Teaching Hospital, Peshawar, during the period 1<sup>st</sup> September 2023 till 31<sup>st</sup> March 2024. Male and female patients with back ache (VAS &gt;4) were enrolled and evaluated for the presence of inflammatory back pain using ASAS criteria. <strong>Results:</strong> The study included 138 patients, 60 (43.48%) male and 78 (56.52%) female. Mean age was 51.7 ± 5.8 years. Majority of the patients belonged to the age group 46 to 60 years 45 (32.60%). The ASAS criteria for IBP was satisfied by 54 (39.1%) patients. Statistically significant association was observed between IBP and family history of IBP. <strong>Conclusions: </strong>Significant proportion of patients with back pain were found having pain with inflammatory etiology. Male patients aging 46 to 60 years with family history of IBP were more likely having IBP</p> Amjad Ali, . Najibullah, Alam Zeb, . Imranullah, Inamullah Khan Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1635 Sun, 30 Jun 2024 00:00:00 +0000 Failure Factors of Medical Students in Private and Public Sector Medical Colleges of Peshawar, Khyber Pakhtoonkwa https://thejas.com.pk/index.php/pjhs/article/view/1487 <p>In the medical world, stress and anxiety are very communal to manage educational affairs. Motivation is a failure among medical students is a very crucial point of discussion.<strong> Objective: </strong>To find factors that led to failure of medical students in public and private sector medical colleges. <strong>Methods: </strong>Qualitative approach was adopted for this cross-sectional study. Fourteen in depth interviews were carried out. Purposive sampling was implemented for this study that included medical students who failed in any one year of their medical journey, of public and private sector medical colleges in Peshawar.<strong> Results: </strong>Out of total interviewed participants, 64% of the respondents were female while 36% of the respondents were males. Amongst the total respondents, 71% were from private medical colleges whereas, 29% were from public medical colleges. 79% of respondents wanted to continue with same profession whereas 21% of respondents did not wanted to continue with their medical profession. Three main factors were observed that lead towards failure of medical students in public and private medical colleges. These factors include lack of peer support, instructor’s teaching attitude and pressure from institute and family.<strong> Conclusions: </strong>This study identified lack of peer support, instructors' teaching attitude, and pressure from the institute and family as primary factors leading to the failure of medical students in public and private colleges in Peshawar. Despite these challenges, 79% of students remain motivated to continue their medical careers</p> Marina Khan, Palwasha Sajjad, Aalia Zeb, Usama Aurangzeb, Sajid Hussain, Tayyiba Shah Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1487 Sun, 30 Jun 2024 00:00:00 +0000 Disease Patterns of Ankylosing Spondylitis Associated Treatment Patterns and Drug Utilization among Affected Patients https://thejas.com.pk/index.php/pjhs/article/view/1376 <p>Ankylosing Spondylitis is disease with significant morbidity. With biological DMARDs, treatment is revolutionized compared to conventional options. The article will discuss disease pattern, risk factors and treatment response of various drugs on this disease. <strong>Objective:</strong> To evaluate the prevalence, risk factors, treatment patterns, and drug utilization associated with Ankylosing Spondylitis (AS) among patients in clinical practice. <strong>Methods:</strong> This cohort study was done at territory care hospital in Rawalpindi from June 23 to December 23. Data comprised of methods to identify AS, particular tests used to verify diagnosis, numerical and clinical traits of patients included. Study also peruse percentage of patients identified as HLA-B27 positive, Time elapsed between initial symptom appearance and clinical diagnosis of AS, satisfaction of classification criteria and treatment strategies employed, such as advanced therapies for controlling AS disease activity. <strong>Results:</strong> Mean values for current disease occurrences and functional index outcomes were 3.3 ± 2.1 and 1.8 ± 1.09 in the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and Bath Ankylosing Spondylitis Functional Index (BASFI) were used, respectively. Patients in study received treatment with adalimumab (43%) and Infliximab (27%) for an average period of 3.1 ± 2.1 years. Treatment satisfaction showed convenience domain had lowest score (4.2), whereas scores for side effects, effectiveness, and global satisfaction were 93.7, 75.41, and 73.81, respectively. <strong>Conclusions: </strong>Among bDMARDS adalimumab was most administered followed by Infliximab. Better therapeutics have improved patient satisfaction. Research revealed a significant decrease in productivity as a result of AS</p> Muhammad Umer Rashid, Amina Khurshid, Hassan Shaukat, Fahd Farooq Ashraf, Muhammad Haseeb Lodhi, Amir Naveed, Muhammad Farrukh Habib Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1376 Sun, 30 Jun 2024 00:00:00 +0000 Exploring the Link between Obesity and Hypothyroidism https://thejas.com.pk/index.php/pjhs/article/view/1554 <p>The association between obesity and hypothyroidism has garnered significant attention due to their overlapping prevalence and potential bidirectional relationship. <strong>Objectives: </strong>To investigate the link between obesity and hypothyroidism in local population of Pakistan. <strong>Methods: </strong>A cross-sectional study conducted at Medical Unit DHQ Teaching Hospital in Dera Ismail Khan from 2022 to 2023 involved 550 participants. Demographic characteristics, age, gender, clinical parameters, body mass index (BMI), comorbidities, and thyroid blood tests (TSH, T4) were collected through systematically designed questionnaire. Lifestyle factors, dietary habits, physical activity and medication history were also recorded. Electronic medical records were reviewed to collect demographic information and medication history. <strong>Results: </strong>Data from 550 participants, meeting inclusion/ exclusion criteria, showed that individuals with hypothyroidism had a lower mean age (42.5 ± 8.6 years) than obese counterparts without hypothyroidism (45.2 ± 9.8 years). The odds ratio (OR) for the association between obesity and hypothyroidism was 2.45 (95% CI: 1.75 - 3.42), indicating a significant positive correlation (p &lt; 0.001). Family history of thyroid disorders was present in 24.0% of individuals with subclinical hypothyroidism and 20.5% without. Mean BMI was higher in individuals with subclinical hypothyroidism (29.3 ± 3.5 kg/m<sup>2</sup>) than those without (27.8 ± 2.9 kg/m<sup>2</sup>). <strong>Conclusions: </strong>Our study confirmed obesity's strong link to hypothyroidism, especially in females, stressing the need for thyroid evaluation in obese individuals, particularly in clinical settings</p> Salman Khan, Abdur Rehman, Muhammad Zubair, Naseeb ur Rehman Shah, Nisar Khan Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1554 Sun, 30 Jun 2024 00:00:00 +0000 Effectiveness of Endoscopic Sinus Surgery for Chronic Rhinosinusitis with Nasal Polyps: Follow-Up on Nasal Obstruction and Recurrence Rates https://thejas.com.pk/index.php/pjhs/article/view/1642 <p>Chronic rhinosinusitis with nasal polyps is a significant health issue linked with considerable morbidity and reduced life quality. Endoscopic Sinus Surgery (ESS) is a broadly accepted technique for nasal polyp’s treatment. <strong>Objective:</strong>To assess and compare nasal obstruction in chronic rhinosinusitis patients with nasal polyp’s pre and post-ESS and to evaluate recurrence rates at 3<sup>rd</sup> and 6<sup>th</sup> month post-surgery. <strong>Methods:</strong> The study was conducted as an observational study at Lahore General Hospital ENT Department from June 2019 to June 2020. A total of 88 patients underwent ESS after medical assessment. Nasal obstruction was evaluated using a visual analog scale during follow-up at 2<sup>nd</sup> week, 3<sup>rd</sup> month and 6<sup>th</sup> month. Data were analyzed using SPSS 24.0 with chi-square tests for categorical variables (p&lt;0.05). <strong>Results:</strong> The mean age of patients was 31.45 ± 11.343 years. At 3<sup>rd</sup> month post-operative, 59.1% had no nasal obstruction, while 34.1% had mild obstruction. At 6<sup>th</sup> month, 54.5% had no obstruction, and 37.5% had mild obstruction. Recurrence rates were 25% at 3<sup>rd</sup> month and 29.5% at 6<sup>th</sup> month. <strong>Conclusions:</strong> Higher nasal obstruction and recurrence rates were noted at 6<sup>th</sup> month compared to 3<sup>rd</sup> month post-ESS, highlighting the need for long-term follow-up</p> Anam Asif, Masoom Mangal, Muhammad sohail Qadir, Usman Aslam, Ghulam Dastgir Khan, Behram Afzal Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1642 Sun, 30 Jun 2024 00:00:00 +0000 Knowledge Regarding Cervical Cancer Screening Among Medical and Non-Medical Undergraduates in Peshawar, Pakistan: A Step towards Preventive Healthcare https://thejas.com.pk/index.php/pjhs/article/view/1700 <p>A major global health concern, cervical cancer primarily affects younger women and those living in less developed areas. Comprehending students' knowledge, attitudes, and practices around cervical cancer screening is essential for future leadership roles in healthcare.<strong> Objectives: </strong>To assess the knowledge, attitude and practices regarding cervical cancer screening among undergraduate medical and non-medical students in Peshawar, Pakistan.<strong> Methods: </strong>A comparative observational cross-sectional study was conducted which lasted eight months. To accomplish a sample size of 474 through non-probability convenient sampling technique was used among undergraduate medical and non-medical students’ population from Peshawar. A standardized questionnaire was used for data collection and SPSS version 26.0 was used for data analysis.<strong> Results: </strong>Among the participants, 62.9% acknowledged the significance of cervical screening in the early detection of lesions and 83.1% correctly identified HPV as the principal cause of cervical cancer. There was a general consensus toward early HPV screening (80.4%), and HPV vaccination (80.6%). However, there were clear differences in practice, 14.1% of participants reported smoking, 18.6% reported having pap smears, and 17.9% reported having had the HPV vaccine.<strong> Conclusions: </strong>The medical students were more knowledgeable about cervical cancer screening as compared to the non-medical. It was also concluded that even though the participants didn’t participate in many preventive measures, most participants had positive attitudes towards early diagnosis, screening and HPV vaccination</p> Khansa Khan, Salman Zahir, Faqir Ullah, Sultan Zeb, Natkai Sulaiman Khail, . Usaram, Uzair Shafiq Ur Rehman, Huma Gul, Somia Mazhar, Jamal Shah Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1700 Sun, 30 Jun 2024 00:00:00 +0000 The diagnostic accuracy of conventional breast ultrasound in Diagnosing Malignant Breast Lesions Taking Histopathology as Gold Standard https://thejas.com.pk/index.php/pjhs/article/view/1657 <p>Breast cancer is a prominent worldwide health issue, with difficulties in detection worsened by the presence of dense breast tissue. Ultrasound and other alternative diagnostic methods have demonstrated potential to enhance detection rates, especially in situations involving thick breast tissue. <strong>Objective: </strong>To evaluate how well conventional breast ultrasonography can accurately differentiate between benign and malignant tumors, using histopathology as the most reliable method of comparison. <strong>Methods: </strong>A cross-sectional study was conducted at a tertiary care hospital to evaluate 185 female patients with breast lesions using sonographic examination. Demographic information, ultrasonography results and histopathological data were gathered and examined using SPSS version 26.0. Calculations were performed to determine the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy. <strong>Results:</strong> The study demonstrated that conventional breast ultrasound has a high diagnostic accuracy rate, with ratings of 91.07%, 83.57%, 89.47%, 85.92%, and 88.11% for sensitivity, specificity, positive predictive value and negative predictive value, respectively. Statistically significant differences in diagnostic accuracy were observed when stratification was performed based on age, duration of disease, parity, and history of breastfeeding. <strong>Conclusions:</strong> The findings indicated that ultrasound is highly effective in differentiating between benign and malignant breast lesions, with substantial diagnostic precision. However, false positives remain a concern, necessitating ongoing research for optimizing ultrasound efficacy, especially in high-risk cohorts.</p> Syeda Quratulain, Sadia Bibi, Sundas Gul, Sabiha Khatoon, Humaira Mahmood, Haleema Sadia Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1657 Sun, 30 Jun 2024 00:00:00 +0000 Effect of Smoking on Retinal Nerve Fiber Layer Alterations and Dry Eye Disease in Chronic Smokers https://thejas.com.pk/index.php/pjhs/article/view/1523 <p>Smoking has an impact on the eyes as well because the toxins it contains cause blood flow to be reduced and obstructions to develop in the ocular capillaries, depriving the eye of nutrients that are crucial to its health. <strong>Objectives:</strong> To evaluate impact of smoking on thickness of the Retinal Nerve Fiber Layer (RNFL) and symptoms of dry eye in chronic smokers. <strong>Methods:</strong> This study was conducted at Madinah Teaching Hospital, Faisalabad in duration of Sep-Dec, 2023. 30 smokers (60 eyes) who had smoked ≥ 25 cigarettes a day for 10 years were enrolled. For comparison, an equal number of healthy non-smoker were participated as controls. Using a self-structured proforma, data were collected using a non-probability purposive sampling technique. In addition to a thorough history evaluation, a comprehensive slit-lamp examination was performed. schirmer test, Tear Film Breakup Time (TBUT), meibomian gland dysfunction grading and Optical Coherence Tomography (OCT) for RNFL examination were performed. SPSS software was used for analyzing the data. <strong>Results: </strong>Average age was 49 ± 1.78 years. Each participant was male. Mean schirmer value for smokers was 8 ± 1.71, while the average for non-smokers was 17 ± 1.36 (p=0.02). Similarly, smokers had a tear breakup time of 6 ± 1.89, while non-smokers had a tear breakup time of 15 ± 1.27 (p=0.00). According to the results, smokers' tear film stability is considerably less than that of non-smokers. RNFL thinning was detected in all quadrants in smokers compared to non-smokers (p=0.00). <strong>Conclusions:</strong> Smoking over an extended period of time is associated with a higher risk of developing dry eye disease and thinning of RNFL.</p> Maryam Jabbar, Khawaja Mohsin Ihsan, Muhammad Ajmal Chaudhary, Faisal Rashid, Muhammad Iftikhar Khattak, Amber Batool Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1523 Sun, 30 Jun 2024 00:00:00 +0000 Cutaneous Tuberculosis: A Clinicopathological Study in A Tertiary Care Hospital https://thejas.com.pk/index.php/pjhs/article/view/1558 <p>Tuberculosis (TB) is a chronic disease that can affect multiple organs including, the skin. Cutaneous TB poses a great challenge to dermatologists due to its varied clinical presentations and non-specific histopathological findings. <strong>Objective:</strong> To determine the frequency of clinicopathological patterns of Cutaneous Tuberculosis in children and adults in a Tertiary Care Hospital. <strong>Methods: </strong>A descriptive cross-sectional study included 63 patients diagnosed with Cutaneous TB at the Department of Dermatology, Dr. Ruth KM Pfau Civil Hospital, Karachi, Pakistan from January 2020 to December 2022. All the patients were clinically evaluated and histopathological features were recorded. <strong>Results: </strong>The common age group was 21-30 years, with male predominance. Lupus Vulgaris was the most common clinicopathological type in 46 cases (73%), followed by Scrofuloderma in 9 cases (14.3%). Tuberculous Verrucosa cutis and Tuberculous Gumma accounted for 4.8% of cases, while Acute Military Tuberculosis and Tuberculous Panniculitis accounted for 1.6% of cases. The most predominant morphology of the lesion was Erythematous Plaque (36.5%) and the most commonly affected site was face (30.2%). Epitheloid Granuloma with langerhans giant cells were typically present in most of the cases, with Caseous Necrosis more predominantly seen in Scrofuloderma (44.4%), TB Gumma (66.6%) and Acute Military TB (100%). <strong>Conclusions: </strong>Lupus Vulgaris is the most common presentation of Cutaneous TB followed by Scrofuloderma. Epitheloid Granuloma with langerhans giant cells, with or without Caseous Necrosis is the predominant histopathological presentation. Clinical and histopathological assessment is crucial for an appropriate diagnosis.</p> Humaira Talat, Neha Rana, Wafia Sibghatullah, Batool ur Rehman, Reema Mirza, Zuha Saleem Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1558 Sun, 30 Jun 2024 00:00:00 +0000 Evaluating the Efficacy of Combined Surgery for Cataract and Glaucoma: A Comparative Analysis of Visual Acuity, Intraocular Pressure, and Anterior Chamber Depth https://thejas.com.pk/index.php/pjhs/article/view/1882 <p>Glaucoma is characterized by an abnormal increase in intraocular pressure, leading to optic nerve damage and permanent visual impairment. Cataract is characterized by lens opacity that impairs vision but can be reversed. <strong>Objective</strong>: To compare pre and post-operative average visual acuity, intraocular pressure, anterior chamber angle, and anterior chamber depth in patients with cataract and narrow angle glaucoma undergoing combined phacoemulsification, intraocular lens implantation, and trabeculectomy. <strong>Methods: </strong>A quasi-experimental study was carried out at Niazi Welfare Foundation Teaching Hospital Sargodha from June 2022 to December 2023. Total 107 patients with both cataracts and narrow angle glaucoma were included. Post-surgery, average visual acuity, intraocular pressure, anterior chamber angle, and anterior chamber depth were assessed at various postoperative intervals (1 day, 1 week, 1 month, 3 months, and 6 months). The Patient's symptoms improved, with visual acuity and average anterior chamber depth increasing by more than 50% compared to pre-surgery was considered as significant. Data were analyzed by SPSS version 25.0. P-value &lt;0.05 was considered as significant. <strong>Results: </strong>Results of the study yielded significant improvements in average visual acuity, intraocular pressure (IOP), anterior chamber angle, and anterior chamber depth post-operatively with complication rate of 6.52%. <strong>Conclusions: </strong>We concluded that combined phacoemulsification with intraocular lens implantation (IOL) and trabeculectomy may be an effective approach for managing intraocular pressure (IOP) and improving visual acuity in patients with narrow angle glaucoma and cataract.</p> Muhammad Sajid Munir, Mariam Zakia Chaudhary, Muhammad Arshad, Sohail Ahmed Siddiqui, Umair Tariq Mirza, Nusrat Sharif Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1882 Sun, 30 Jun 2024 00:00:00 +0000 Safety of Long Acting Reversible Contraception (LARC) during 3 Months of Follow up At Civil Hospital, Karachi https://thejas.com.pk/index.php/pjhs/article/view/1737 <p>Contraception counseling is an essential component of family planning services. It provides the foundation for delivering correct information on contraceptive methods and eliminating myths regarding risks and negative effects. <strong>Objectives:</strong> To determine the Safety of Long-Acting Reversible Contraception (LARC) for postpartum contraception during 3 months of follow-up. <strong>Methods: </strong>A cross sectional descriptive study comprised on total of 108 women aged 25-35 years who accepted LARC in the postpartum period at Department of Obstetrics and Gynaecology, Civil Hospital, Karachi from 22<sup>nd</sup> February 2021 to 21<sup>st</sup> August 2021, were included. Females with uterine abnormalities and severe anemia were excluded. The demographic information (name, age, registration number) was taken. The women were counseled regarding postpartum contraception LARC such as IUD or Jedelle (implant) during the antenatal period and LARC was placed within 30 minutes of placental delivery. Those women who selected LARC were called for follow-up for 3 months in OPD and at follow-up visits, patients were assessed for their safety of this method. <strong>Results: </strong>The age range in this study was from 25 to 35 years with a mean age of 28.81 ± 3.27 years. The majority of the patients 80 (74.07%) were between 25 to 30 years of age. The mean parity was 3.10 ± 0.72. In this study, the safety of Long Acting Reversible Contraception (LARC) for postpartum contraception during 3 months of follow-up was found in 91 (84.26%) women. <strong>Conclusions: </strong>This study concluded that long acting reversible contraceptives in the immediate postpartum period are very safe.</p> Sidra Tariq, Anum Farhan, Maria Tasneem, Sumaira Meer, Daniya Khan, Sadaf Sabir Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1737 Sun, 30 Jun 2024 00:00:00 +0000 The Role of Cerebrospinal Fluid High-Sensitivity C–Reactive Protein (CSF hsCRP) in Distinguishing Bacterial Meningitis from Aseptic Meningitis https://thejas.com.pk/index.php/pjhs/article/view/1647 <p>One of the most prevalent serious diseases in newborns and infants is meningitis. Aseptic meningitis is generally less severe than bacterial meningitis and often has a better prognosis. CRP level is the most useful criterion for diagnosing feverish children with significant infections. <strong>Objective: </strong>The present study aimed to determine the level of CRP in CSF of bacterial meningitis, and aseptic meningitis for early prediction of meningitis and remove the lapse in its treatment.<strong> Methods</strong>: This cross-sectional study was conducted at the Immunology Department of The Children’s Hospital &amp; the Institute of Child Health from Jan 2022 to Jan 2023. The present study enrolled patients who had meningitis symptoms (fever, headache, vomiting, and neck stiffness), aged between &gt;2 years to 12 years, both male and female gender. The CRP levels of all patients were measured using the agglutination method. Data were analyzed using IBM-SPSS version 26.0.<strong> Results:</strong> Of the total 45 patients, 20 (44.4%) were males and 25 (55.6%) were females. The mean age of patients was 5.98<u>+</u>2.792 years. From total, 29 (64.4%) had bacterial meningitis while 16 (35.6%) had aseptic meningitis. The 09 (31.03%) bacterial meningitis patients had positive CRP (&gt;3.0mg/L). The present study showed a statistically significant association between CSF-CRP results with bacterial and aseptic meningitis (p=0.003).<strong> Conclusions</strong>: While awaiting the results of other confirmatory tests, CSF-CRP can be utilized as an early diagnostic tool for the identification of bacterial and aseptic meningitis. Additionally, it could aid in the early diagnosis of aseptic vs bacterial meningitis.</p> Umaira Ahsan, Faiqa Arshad, Rao Shahzad Abdul Tawwab Khan, Muneeba Naz, Saima Pervaiz, Omer Shahzad Khan Rao, Attiq ur Rehman Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1647 Sun, 30 Jun 2024 00:00:00 +0000 Determining Efficacy of Intracanal Cryotherapy on Post Endodontic Pain in Irreversible Pulpitis https://thejas.com.pk/index.php/pjhs/article/view/1644 <p>Endodontic cryotherapy is a procedure that reduces pain and inflammation by applying cold to tissues, aiming to decrease post-endodontic pain. <strong>Objectives: </strong>To compare the effectiveness of cryo-treated endodontic irrigant in reducing post-endodontic pain in mandibular molars with irreversible pulpitis. <strong>Methods:</strong> This comparative analytical study was conducted from December 2023 to February 2024 in the Department of Operative Dentistry at Lahore Medical and Dental College. It included patients of both genders, aged 18 to 60, with symptomatic irreversible pulpitis in mandibular molars and pre-endodontic pain of VAS 7-10 for 10 days or less. Patients were divided into two groups: Group A (normal saline) and Group B (cryotherapy). Patients were instructed on using the Visual Analogue Scale (VAS) to assess pain. Group B received final irrigation with 20 ml normal saline at 2.5°C for 5 minutes, while Group A received 20 ml normal saline at room temperature. Pain scores were recorded preoperatively and at 24 and 48 hours’ post-treatment via telephone interviews. Data were analyzed using SPSS version 25 and a repeated measures ANOVA test assessed VAS scores across time points. A p-value &lt;0.05 was considered significant. <strong>Results: </strong>45 (46%) were male and 53 (54%) were female patients, with mean age of patients being 35.71 ± 10.71years. At 24 hours postoperatively, the mean VAS score was 1.51 ± 1.2 for the normal saline group and 0.98 ± 0.9 for the cryo-treated saline group. By 48 hours postoperatively, the mean VAS score further decreased to 0.27 ± 0.5 for the normal saline group and 0.12 ± 0.4 for the cryo-treated saline group. The mean differences in VAS scores at 24 hours showed significant difference in mean pain score (P-value&lt;0.05) but at 48 hours between the two groups showed no significant difference (p = 0.104). <strong>Conclusions: </strong>Both saline groups significantly decreased pain, the type of saline, normal or cryo-treated, did not significantly impact overall pain scores differently between the groups.</p> Anam Fayyaz Bashir, Ussamah Waheed Jatala, Moeen ud din Ahmad, Muhammad Talha Khan, Saima Razzaq Khan, Aisha Arshad Butt Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1644 Sun, 30 Jun 2024 00:00:00 +0000 Effects of Adrenaline Containing Local Anesthesia on Blood Pressure and Blood Glucose Levels Undergoing Tooth Extractions – A Comparative Study https://thejas.com.pk/index.php/pjhs/article/view/1581 <p>Exodontia, the most common dental procedure for damaged or decayed teeth, often utilizes local anesthesia with vasoconstrictors like adrenaline. Although effective, adrenaline can impact blood glucose levels and hemodynamic parameters, particularly in hypertensive and diabetic patients. <strong>Objectives:</strong> To compare changes in blood pressure and blood glucose levels among healthy, hypertensive and diabetic patients undergoing tooth extraction with adrenaline-containing local anesthesia. <strong>Methods:</strong> A total of 177 participants were split equally into three groups: healthy, hypertensive and diabetic. Prior to and twenty minutes’ post-injection, blood pressure, and blood glucose levels were measured while a local anesthetic containing 2% lignocaine HCL with 1: 100,000 adrenaline was administered. Sample paired t test and one-way ANOVA were employed in the analysis. <strong>Results:</strong> After the procedure, hypertensive patients experienced a significant decrease in random blood glucose levels (p=0.001). Similarly, systolic blood pressure exhibited a significant increase (p&lt;0.001), while diastolic blood pressure significantly decreased (p=0.021), post-procedure.Diabetic patients showed a non-significant decrease in glucose levels (p=0.209) but a significant increase in both systolic (p&lt;0.001) and diastolic blood pressure (p=0.002). Healthy patients experienced a significant increase in systolic blood pressure (p=0.015) but no significant changes in glucose levels (p=0.873) or diastolic pressure (p=0.301). <strong>Conclusions:</strong> Adrenaline in local anesthesia significantly increases systolic blood pressure in all patient groups, with pronounced effects in hypertensive and diabetic patients. Changes in blood glucose were significant only in hypertensive patients, while changes in diabetic patients were non-significant. These findings highlight the need for careful monitoring and personalized management strategies in dental procedures to minimize potential adverse effects and ensure patient safety.</p> Ijaz ur Rehman, Maham Zeb, Malik Adeel Anwar, Arsala Khalid, Tahmasub Faraz Tayyab, Kashif Siddique, Hooria Kushef Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1581 Sun, 30 Jun 2024 00:00:00 +0000 Assessment of Complete Remission Rate in Patients with Acute Myeloid Leukemia Undergoing 7+3 Induction Chemotherapy https://thejas.com.pk/index.php/pjhs/article/view/1570 <p>Acute leukemia is a fast-growing, overpopulated clone of immature proliferating cells that largely predominate in the bone marrow and have the capacity to prolong life indefinitely. Upon inspection and cytologic assessment of bone marrow or peripheral blood, the cells demonstrate quantified uncertainties. <strong>Objective:</strong> To determine the frequency of complete remission after induction 7+3 chemotherapy in patients with acute myeloid leukemia. <strong>Methods:</strong> The nature of this study was cross sectional study at Department of Oncology, Pakistan Institute of Medical Sciences, and Islamabad from 26 November, 2022 to 26 May, 2023. The hospital’s laboratory fulfilled the complete blood count and provided the confirmed baseline bone marrow biopsy reports. All patients who were admitted received treatment with a 7+3 regime, a standard treatment protocol for all the adolescents and adults admitted. Every patient was prescribed for 7+3 induction therapy regimen which consists of 200 mg/m<sup>2</sup> cytarabine for seven days and idarubicin for three days, 12 mg/m<sup>2</sup> on the 1st, 3rd and 5th day. <strong>Results:</strong> The complete remission estimated turns out to be 61.1% and rest need further treatment. The average age of the patients was 48.56 ± 6.91 years. The mean BMI stood at 24.46 ± 1.49 kg/m<sup>2</sup>. gender wise, 74 were male and 21 were female. Our mean CR was 61.1% that is 58 participants all the complete demographic is available. <strong>Conclusions:</strong> This study revealed a Complete Remission (CR) rate of 61.1% in patients with AML undergoing 7+3 induction chemotherapy. However, our findings suggest that older age is associated with lower CR rates, highlighting the need for tailored treatment strategies that balance efficacy with the potential risks of intensive therapies in this population.</p> Nazish Mehboob, Asma Khan, Attiya Munir, Muhammad Tahir, Amanat Ali, Sameer Ahmed Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1570 Sun, 30 Jun 2024 00:00:00 +0000 Clinical Effectiveness of Benzoyl Peroxide and Clindamycin Combination Therapy in the Treatment of Papulopustular Acne https://thejas.com.pk/index.php/pjhs/article/view/1790 <p>Acne is a prevalent inflammatory skin condition affecting 9% of the global population. Its impact on quality of life and self-esteem leads to depression and anxiety. Combination regimen may be effective in treating acne. <strong>Objective: </strong>To assess the clinical effectiveness of a fixed-dose combination of 1% clindamycin and 5% benzoyl peroxide in the treatment of mild to moderate papulopustular acne. <strong>Methods: </strong>An observational prospective study was conducted from June 2023 to December 2023 in the dermatology department of Niazi Welfare Foundation Teaching Hospital, Sargodha. 72 patients with mild to moderate papulopustular acne were monitored. A gel containing a combination of 1% clindamycin and 5% benzoyl peroxide was applied once daily for 12 weeks. Descriptive statistics was used for demographic variables. Chi-square test was used to evaluate the treatment effects at a significance level, p-value&lt;0.05. Adverse effects related to therapy were shown as bar chart. <strong>Results: </strong>Findings of the study showed that during therapy in the period between the 3rd and 6th weeks, the proportion of patients who achieved excellent improvement increased by 25% from 40/72 (55.5%) to 57/72 (79.1%) respectively p &lt; 0.05. <strong>Conclusions: </strong>The study concluded that the combination of 1% clindamycin and 5% benzoyl peroxide was effective in treating mild to moderate papulopustular acne.</p> Saira Niazi, Aneela Gillani, Majid Ali Hingoro, Sadia Majeed, Sommiya Anum, Zahida Perveen Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1790 Sun, 30 Jun 2024 00:00:00 +0000 Postoperative Outcomes And Surgical Complications In Typhoid Ileal Perforation https://thejas.com.pk/index.php/pjhs/article/view/1742 <p>Surgical repair for typhoid ileal perforation is essential to prevent peritonitis and sepsis. Postoperative outcomes, which include survival rates and recovery times, underscore the importance of comprehending surgical complications to refine treatment strategies and enhance patient survival. <strong>Objective:</strong> To determine postoperative outcomes and surgical complications in typhoid ileal perforation. <strong>Methods: </strong>The prospective cohort was conducted at General Surgery Department of Liaquat University Hospital in Hyderabad &amp; Jamshoro. 228 Patients of age 18 years or more and of any gender, who were operated for having single typhoid ileal perforation, were included in the study. While patients with multiple perforations, TB peritonitis or having traumatic perforations, were excluded from the study. <strong>Results:</strong> The most common age group was found to be 18-30 years (40.4%), followed by 31-40 years (28.1%), 41-50 years (19.3%), 51-60 years (7.9%), and &gt;60 years (4.4%). Males comprised 57.9% of the population, while females made up 42.1%. The mean length of hospitalization was found to be 14 ± 5 days. The majority of patients experienced good outcomes, accounting for 158 individuals (69.3%), while 70 patients (30.7%) had adverse outcomes. Among the adverse outcomes, there was a mortality rate of 7.2% (16 patients) and 54 patients (23.7%) experienced complications, some experienced more than one complication. <strong>Conclusions:</strong> The study concluded that though the majority of patients recover well, a significant proportion (7.2%) still faced adverse postoperative outcomes in terms of mortality. 54 patients (23.7%) experienced complications, some experienced more than one complication.</p> Ishrat Rahim Katyar, Shah Nawaz Khatti, Ali Raza, Khurram Abbas, Mohammad Basil Rizvi, Zeeshan Ahmad Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1742 Sun, 30 Jun 2024 00:00:00 +0000 Robson Criteria to Determine the Risk of Cesarean Section in Females Presenting to Sir Ganga Ram Hospital (SGRH), Lahore https://thejas.com.pk/index.php/pjhs/article/view/1841 <p>Rates of caesareans have increased, resulted in unfavourable outcomes in subsequent pregnancies. Robson categorization enhances standard of care by optimising the use of C-sections and evaluating methods to lower caesarean rates. <strong>Objective: </strong>To determine the frequency of caesarean section and to determine frequency of Robson 10 group classification system in patients who undergo caesarean. <strong>Methods:</strong> In this cross-sectional study, 140 pregnant selected via simple random sampling, were enlisted from Gyne department of SGRH, Lahore. According to Robson 10-group categorization those who underwent C-section were divided into ten groups and indication of C-section was studied. Data scrutiny was done using SPSS version 26.0. Mean and SD was used for quantitative variables and frequency for qualitative data. Data were stratified for effect modifiers, p-≤0.05 was taken as significant. <strong>Results:</strong> Mean age of patients calculated was 31.94 ± 2.14 years. Out of 140, 23.6% had C-section and 76.4% had vaginal delivery. According to class of modified Robson criteria, 12.1% had class 1, 12.1% had class, 2, 21.2% had class 3, 36.4% had class 5, and 3.0% each had class 4, 6, 7, 8, 9, and 10. <strong>Conclusions:</strong> According to our findings, considerable percentage of C-sections occur with previous C-sections serving as most common indicator. This pattern emphasizes how crucial it is to concentrate on primary preventive techniques in order to lower its rate. Large number of C-sections performed on nulliparous both those in spontaneous labour and those who were not indicates that labour management procedures and decision-making processes need to be closely examined.</p> Shazia Haider, Hafiza Mariam Zahid, Asma Nawaz, Musarrat Fatima, Bushra Jamil, Anum Yousaf, Sibgha Kanwal, Sajjad Ahmad, Seep Kanwal Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1841 Sun, 30 Jun 2024 00:00:00 +0000 Maternal Obesity as a Risk Factor for Preterm Delivery in Dichorionic Twin Pregnancies https://thejas.com.pk/index.php/pjhs/article/view/1634 <p>The prevalence of maternal obesity has been steadily rising in recent decades, posing a significant global health concern particularly in the field of obstetrics. <strong>Objective:</strong> To assess the association between maternal obesity and preterm birth in dichorionic twin pregnancies. <strong>Methods:</strong> This descriptive study was carried at Department of Obstetrics and Gynecology, Khyber Teaching Hospital, Peshawar during the period 1<sup>st</sup> January 2020 till 31<sup>st</sup> December 2021. The study included 122 pregnant women in the age range 18 to 45 years diagnosed as dichorionic twin pregnancy presenting with labor. Gestational age at the time of delivery was calculated to record preterm delivery. Pre-pregnancy BMI was retrieved from medical record taking BMI ≥30.0kg/m<sup>2</sup> as cut off for obesity. Data were analyzed using SPSS version 25.0. <strong>Results:</strong> The mean age was 31.2 years with 49.2% (n=60) fell into the age range of 30-39 years. 52.5% (n=64) of the participants were nulliparous. 42.2% patients (n=52) had a bad previous obstetrics history. Maternal obesity was observed in 49.2% patients (n=60). The spearman r value for preterm delivery and BMI was 0.710. <strong>Conclusions:</strong> Significant proportion of women with dichorionic twins and preterm delivery were found obese. The risk of preterm delivery in dichorionic twins increases with maternal obesity</p> Mubashra Ali, . Javeria, Maryya Haram Bibi Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1634 Sun, 30 Jun 2024 00:00:00 +0000 Comparative Analysis of Functional Outcomes: Extramedullary Versus Intramedullary Fixation in Unstable Inter-Trochanteric Femoral Fractures https://thejas.com.pk/index.php/pjhs/article/view/1736 <p>Unstable trochanteric femoral fractures are challenging to manage. Two options exist for the operative treatment and management of unstable trochanteric fractures; i.e. extramedullary or intramedullary stabilization. However, there is a dearth of good evidence of the clinical efficacy of either of the two methods especially in terms of functional outcomes. <strong>Objective: </strong>To compare the functional outcome following fixation of unstable trochanteric femoral fractures via extramedullary versus intramedullary methods.<strong> Methods: </strong>This prospective cohort was conducted upon 46 adult patients and admitted at Liaquat University Hospital Hyderabad/Jamshoro, after taking written informed consent from parents. Functional outcomes utilizing the Timed Up and Go Test and Harris Hip Score, at 3 months and 6 months post-surgery and radiographic parameters were gathered to evaluate heterotopic ossification and femoral neck shortening at follow-up visits using a pre-structured questionnaire. The data was analyzed with SPSS V.21 and Microsoft Excel 2016.<strong> Results:</strong> The sample predominantly consisted of males, with a mean age of 31 ± 5 years. Intramedullary fixation showed superior early mobility outcomes and maintained better hip function scores compared to extramedullary fixation for unstable inter-trochanteric femoral fractures. Intramedullary fixation also demonstrated lower rates of heterotopic ossification and less femoral neck shortening, indicating potential benefits in reducing complications and preserving anatomical integrity. <strong>Conclusions: </strong>In conclusion, the study findings suggest intramedullary fixation as a favorable option for optimizing functional recovery and radiographic outcomes in such fractures</p> Rasheed Ahmed Bhatti, Ashfaque Hussain Mirjat, Awais Abro, Lachman Das Maheshwari, Agha Mahtab Hussain, Faisal Memon Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1736 Sun, 30 Jun 2024 00:00:00 +0000 Frequency of C-Shaped Root Canals in Permanent Mandibular Second Molars in a Sample of Pakistani Population using Cone Beam Computed Tomography https://thejas.com.pk/index.php/pjhs/article/view/1568 <p>C-shaped root tubes have a challenging design that causes issues in the clinic. Endodontic therapy requires careful consideration of the C-shape root canal design in Pakistan due to the country's high carious rate (about 60%).<strong> Objective: </strong>To determine the frequency of C-shaped root canals in permanent mandible second molars among Pakistani adults. <strong>Methods: </strong>At Karachi's Altamash Dental Hospital, cross-sectional study was conducted between March 2021 and January 2022.We used mandibular CBCT images to analyze 302-second molars. The position of the longitudinal groove and the bilateral predominance of C-shaped root canals were also observed. A chi-square test was used for the statistical analysis.<strong> Results:</strong> 47 teeth (15.54%) out of 302 had a “C-shaped canal” configuration. The breakdown was as follows: 31.91% in Category 1 (C1), 14.89% in Category 2 (C2), 6.38% in Category 4 (C4), and 46.80% in Category 3 (C3). There was no appreciable variation in the prevalence of C-shaped canals between the genders; 32.14% of the patients had them unilaterally and 67.85% had them bilaterally.<strong> Conclusions: “</strong>C-shaped canals are found in 15.54% of the mandibular second molars” in the Pakistani sample group, and a high probability of a matching lingual groove (59.57%) is present in these teeth. The most common type of C-shaped root canals observed in this study is C3.</p> Syed Nabeel Ahmed, Muhammad Mansoor Majeed, Sakina Kazmi, Muhammad Omar Ansari Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1568 Sun, 30 Jun 2024 00:00:00 +0000 Pattern of Fingerprints and Its Association with Gender among Medical Students of Peshawar Medical College https://thejas.com.pk/index.php/pjhs/article/view/1667 <p>Dermatoglyphics is the scientific discipline that studies the patterns and characteristics of fingerprints. When it comes to criminal justice and medical law, fingerprints are crucial. The analysis and comparison of unknown prints found at a crime scene with known prints of witnesses, victims, and possible perpetrators can greatly aid investigators and analysts in their pursuit of justice. <strong>Objectives: </strong>To identify fingerprint patterns and determine its association with gender among medical students of Peshawar. <strong>Methods: </strong>This cross-sectional descriptive study was conducted on students of Peshawar Medical College, Peshawar from 1<sup>st</sup> December 2021 to 1<sup>st</sup> June 2022<strong>. </strong>After a multi-stage proportional sampling process, a total of 300 students were included in the study, with 120 females and 180 males. After obtaining written agreement and adhering to stringent inclusion and exclusion criteria, students' fingerprints were placed on white paper using a stamp pad. The paper already bore the students' names, ages, sexes, and professional years. Statistical analysis was conducted using SPSS v.25, with descriptive and inferential statistics applied as necessary. <strong>Results: </strong>The most common fingerprint pattern was the loop pattern, followed by the whorl pattern at 30.33 percent. The average age of the participants in the study was 21.54 ± 2.33 years, with a male-to-female ratio of 1.5:1. All of the fingerprint patterns showed no significant association with gender. <strong>Conclusions: </strong>The study found that Loop fingerprints were more common than other fingerprints. Also, there is no statistically significant association between gender and fingerprints.</p> Farzand Iqbal, Naveed Alam, Rubina Salma Yasmin, M.Asghar Khattak, Noreen Farid, Ijaz Aziz Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1667 Sun, 30 Jun 2024 00:00:00 +0000 Gingival Overgrowth In Patients Induced By Calcium Channel Blockers https://thejas.com.pk/index.php/pjhs/article/view/1649 <p>Gingival enlargement can be caused by a number of factors, including inflammatory conditions and the side effects of certain medications. Gingival overgrowth is one of the frequent features of gingival diseases. <strong>Objective: </strong>To find out frequency of calcium channel blockers causing gingival overgrowth. <strong>Methods:</strong> A descriptive cross-sectional study was conducted among cardiac patients visiting the cardiology department at Liaquat University Hospital, Hyderabad by convenience sampling technique for a time duration of six months. SPSS version 23.0, was used for data analysis. Chi-square test was applied with a significance level of P-value &lt;0.05. <strong>Results:</strong> The most commonly used calcium channel blockers were amlodipine and diltiazem at 31.3% and 26.7% respectively, while 15.6% of cases were using nifedipine, 14.4% were on verapamil and 11.9% were on calcium channel blocker drug of bepridil. The severity of gingival overgrowth was significantly correlated with the male gender (p value= 0.001). <strong>Conclusions: </strong>After administration of calcium channel blockers, there is a potential that adverse consequences may occur such as gingival overgrowth, will become more common by prolong use of such drugs as indicated in this study.</p> Muhammad Ali Panhwar, Javaid Unar, Iffat Panhwar, Tarique Hussain Shaikh, Seerat-Ul-Urooj Bhutto, Muhammad Amin Sehito, Rehmatullah Kandhro Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1649 Sun, 30 Jun 2024 00:00:00 +0000 Urinary Neutrophil Gelatinase-Associated Lipocalin: A Biochemical Marker for Early Diagnosis of Urinary Tract Infections in Adults https://thejas.com.pk/index.php/pjhs/article/view/1711 <p><a name="_Toc118269056"></a>Urinary tract infection is an infection of the urinary system. Early diagnosis is helpful in timely treatment. Urinary NGAL is a new method that is used for early diagnosis of UTI. <strong>Objective</strong>: To evaluate the efficacy of urine neutrophil gelatinase-associated lipocalin (uNGAL) as a biochemical marker for early UTI diagnosis. <strong>Methods:</strong> A analytical study was conducted from Oct 2022 to Oct 2023, A total of 90 subjects having signs and symptoms of UTI irrespective of age and gender. The study participants were divided into three groups. Patients with UTI were included in diseased group (n=60) and healthy individuals were enrolled as controls in Group-I (n=30). SPSS v-26 was used for data analysis. Descriptive and Inferential statistics were applied. <strong>Results</strong>: The mean age of the participants was 30.5±6.9 years, 23(26%) were male, and 67(74%) female. These participants were divided into three groups; Group-I (control) had 30(33.3%) participants, group-II (patients with signs and symptoms but negative culture) had 34(37.8%), and group-III (patients with signs and symptoms and positive cultures) had 26(28.9%) participants. No growth was seen in participants of Group-I, II, and Group-III had positive cultures including <em>E. coli</em> (16.7%), <em>S. aureus</em> (10%), <em>Candida Sp</em>. (1.1%) and <em>Klebsiella Pneumonea</em> (1.1%) with significant findings (p&lt;0.001). A significant difference among groups was noticed with uNGAL levels (p&lt;0.001); Group-III had raised uNGAL levels of 361 ± 65.5ng/ml. <strong>Conclusion</strong>: Urinary NGAL is a promising biomarker that can detect UTIs even in the absence of clinical symptoms, enabling early diagnosis and treatment of UTIs. </p> Hafiz Muhammad Ahsan Ayub, Muhammad Nadim Akbar Khan, Saadia Sultana, Shazia Qayyum Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1711 Sun, 30 Jun 2024 00:00:00 +0000 Knowledge of Gestational Diabetes Mellitus Among Diabetic Pregnant Females https://thejas.com.pk/index.php/pjhs/article/view/1789 <p>The prevalence of Gestational Diabetes (GDM) is rising quickly and patients require assistance with decision-making, behavioral control and obtaining the knowledge required for self-care. The knowledge of GDM, together with nutritional guidance and glycemic control education, is crucial to the care of diabetic women. <strong>Objective:</strong> To determine the knowledge among gestational diabetic pregnant females. <strong>Methods</strong>: A cross sectional study was conducted at obstetrics and gynecology outpatient departments in Department of Obstetrics and Gynecology, Niazi Medical and Dental College, Sargodha. 150 pregnant females aged range (18-40) year, with any gravida and diagnosed with GDM were enrolled in current study. A structured questionnaire regarding the knowledge of gestational diabetes was used to collect data. Data were entered and analyzed in Statistical Package for Social Sciences (SPSS) version 21.0. <strong>Results: </strong>Majority of participants were 18-30 years 80 (59.3%) old. 42 (28%) were normal weight, 82 (54.6%) were overweight and 26 (17.3%) were obese while 98 (65.3%) women were housewives. 63 participants know about self-care routine of GD, while 58 know about feto-maternal complications. Majority 90 (60%) females don’t know about the risk and symptoms of gestational diabetes. 101 (67.3%) have poor knowledge about glucose monitoring. When they asked about the management of hypo and hyper glycemia 81 (54%) don’t have enough knowledge about management protocols. Regarding the diagnostic procedures 74 (49.3%) have good knowledge.<strong> Conclusions: </strong>The study concluded that most participants, have lack of knowledge of GDM, management of Gestational Diabetes Mellitus (GDM), its symptoms, fetomaternal complications and diagnostic criteria.</p> Saddiqa Azmat, Nazia Sajjad, Sadia Asghar, Khalil Ahmed, Maria Anwar, Hafiza Ayesha Ishaq Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1789 Sun, 30 Jun 2024 00:00:00 +0000 Association Between Vitamin D Deficiency And Suicide Attempts In Patients With Major Depressive Disorder https://thejas.com.pk/index.php/pjhs/article/view/1743 <p>Major Depressive Disorder (MDD) is significant public health concern that is often associated with an increased risk of suicide attempts. Emerging research suggests that Vitamin D3, a nutrient primarily obtained through sunlight exposure and certain foods, plays a crucial role in brain health and mood regulation and thus affects various psychiatric disorders, including depression. <strong>Objective: </strong>To determine the association between decreased Vitamin-D levels and a history of attempted suicide among patients suffering from Major Depressive Disorder. <strong>Methods: </strong>A comparative cross-sectional study was carried out from December 2020 to June 2021, on a sample of 104 patients diagnosed with Major Depressive Disorder. Half of the samples were with Vitamin-D3 deficiency while half of the sample were without Vitamin-D3 deficiency. This research was carried out at the Department of Psychiatry and Behavioral Sciences, Liaquat University Hospital, Hyderabad, Pakistan. Data were analyzed with SPSS version 21.0. <strong>Results: </strong>The mean age of the sample stood at 44 years (09 ± SD). A majority of the sample comprised of male (55.77%), hailing from an urban background and a middle socioeconomic set-up (60.58%). The mean Vitamin-D level was 18.63 ng/ml, while the mean Vitamin-D3 level was 14.77 ng/ml and 22.05 ng/ml for groups A and B respectively. History of attempted suicide was more prevalent among patients with Vitamin D3 deficiency. <strong>Conclusion: </strong>The research concluded that Vitamin-D deficiency is found to be one of the factor for suicidal attempts in patients with Major Depressive Disorder.</p> Zahoor Ahmed Memon, Syeda Ambreen, Arshad Sattar Lakho, Akbar Gohar Abro, Saba Bashir, Hanozia Shah Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1743 Sun, 30 Jun 2024 00:00:00 +0000 Frequency of Thyrotoxicosis in Patients Presenting with Unilateral Proptosis in District Headquarters Teaching Hospital D.I.Khan https://thejas.com.pk/index.php/pjhs/article/view/1673 <p>Thyrotoxicosis is a medical disorder marked by retraction of the eyelids, resulting in a wide-eyed or gazing appearance. This syndrome can occur in patients with any form of hyperthyroidism as a result of increased activity of the sympathetic nervous system. <strong>Objectives:</strong> To investigate the prevalence of thyrotoxicosis and factors contributing to unilateral proptosis, with a specific focus on early diagnosis and prompt treatment. <strong>Methods:</strong> A cross-sectional study was conducted from January 2023 to January 2024 and categorical variables were presented with the frequency and percentage. The study had a total of 62 patients who exhibited unilateral proptosis. The clinical examinations involved a comprehensive collection of medical history, examination of eyes, analysis of blood samples, evaluation of thyroid function, and utilization of advanced imaging techniques. The associations between thyrotoxicosis and demographic variables were evaluated using chi-square tests. Data were entered and analyzed on SPSS version 26. <strong>Results:</strong> The mean age of participants was 27.84 ± 6.8 years and female comprised 54.8% of the total. It was observed that female had a greater incidence rate (73.5%) compared to male (53.6%) (p&gt;0.05). Additional findings included retrobulbar tumors (16.1%), cavernous sinus thrombosis (12.9%), and idiopathic proptosis (6.5%). The prevalence of thyrotoxicosis was highest among individuals aged 15-30 (p&lt;0.05). The most common symptom linked with thyrotoxicosis was diplopia (33.9%) (p&lt;0.05). <strong>Conclusions</strong>: Thyrotoxicosis has a major role in causing unilateral proptosis, especially in female and younger persons. Being female and experiencing pain may serve as predictors for thyrotoxicosis.</p> Salman Khan, Naseeb ur Rehman, Abdur Rehman, Muhammad Zubair, Rida Naz Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1673 Sun, 30 Jun 2024 00:00:00 +0000 Frequency of Zygomatic Complex Fracture in Patients Presenting to Ayub Teaching Hospital https://thejas.com.pk/index.php/pjhs/article/view/1648 <p>Zygomatic complex fractures are a prevalent type of facial injury. It often results from road traffic accidents (RTA). It poses significant clinical challenges. <strong>Objective: </strong>To find out the frequency of zygomatic complex fractures among patients introduced at the Ayub Teaching Hospital. <strong>Methods: </strong>This cross-sectional study was carried out in the Department of Oral and Maxillofacial Surgery at Ayub Teaching Hospital, Abbottabad, Pakistan after approval from IRB (Institutional Review Board) of the Ayub Teaching Hospital Abbottabad, (IRB-F5/Dent/AMC&amp;ATH) from September 1, 2019, to March 1, 2020. A total of 146 patients, including both genders and revealing oral and maxillofacial injury, were essential parts of the research. Before performing meticulous intra and extra-oral clinical examinations and computed tomography (CT) scans in the Department of Radiology to diagnose zygomatic complex fractures. <strong>Results:</strong> Out of the total number of 146 patients, 33.6% had ZMC fractures. The study involved patients aged 18-60 years. This is consistent with an average age of 31.993 ± 8.00 years and a mean weight of 74.664 ± 9.26 kg. Male patients represented 74.7% of cases and female comprised 25.3%. The primary causes of fractures were road traffic accidents, falls, and sports injuries. <strong>Conclusions:</strong> The research concluded that zygomatic complex fractures occurred due to road traffic accidents (RTA), which are more common in this region. Thus, the examination highlights the basic requirement for procedures to alleviate street mishaps to abridge such terrible facial injuries.</p> Sundus Mumtaz, Tanveer Ahmed Khan, Maria Rasheed, Muhammad Abi Waqas, Ghazanfar Gul, Palwasha Ishaque Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1648 Sun, 30 Jun 2024 00:00:00 +0000 Comparison of Pain Determination Between Celecoxib Tramadol in Third Molar Surgery https://thejas.com.pk/index.php/pjhs/article/view/1532 <p>Selecting a reliable and well-tolerated analgesic to manage pain after surgical extraction of the third molar is still a difficult task. <strong>Objective: </strong>To compare the effect of celecoxib and tramadol in managing post-operative pain following third molar surgery. <strong>Methods</strong>: This cross-sectional research was conducted at the Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro. A total of 100 patients were included and equally allocated into two groups. Group-A received celecoxib, and Group-B received tramadol. Patients were assessed on follow-up visits on the 1st, 3rd, and 5th days post-surgery. <strong>Results</strong>: Data revealed a mean age of 28.72 ± 3.844 years for Group-A (celecoxib), consisting of 30 (60%) males and 20 (40%) females out of 50 respondents. Group-B (Tramadol) exhibited a mean age of 28.28 ±3.511 years, including 29 (58%) males and 21 (42%) females. Preoperational and 1st day post-operational pain scores were similar for celecoxib and tramadol (median 8), with no significant difference (p-value= 0.180 and p-value= 0.874). By the 3<sup>rd</sup> day, celecoxib patients reported significantly lower pain (median 3, IQR 2-4) compared to tramadol (median 5, IQR 4-6), p&lt;0.001. On the 5th day, celecoxib also had significantly lower pain (median 0, IQR 0-1) than tramadol (median 1, IQR 0-2), p&lt;0.001. <strong>Conclusions</strong>: The study concludes that celecoxib is more effective than tramadol in mitigating pain following third molar surgery.</p> Eshnawar Ishaque, Suneel Kumar Punjabi, Mahavosh Qazi, Faiza Hasan, Zunair Akbar Memon, Sadia Hassan, Salman Shams Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1532 Sun, 30 Jun 2024 00:00:00 +0000 Comparative Evaluation of Neck Length, Relative Neck Length and Total Body Height in Cervical Spondylosis Affected and Non-Affected Individual https://thejas.com.pk/index.php/pjhs/article/view/1665 <p>Anthropometric measurements, including neck length, relative neck length and total body height, have been proposed as potential indicators of cervical spine health, yet their association with cervical spondylosis remains relatively understudied. <strong>Objective: </strong>To compare neck length, relative neck length, and total body height between individuals affected by cervical spondylosis and a non-affected control group. <strong>Methods:</strong> This case-control study was conducted at Department of Anatomy Multan Medical and Dental College (MMDC), Multan from April 2023 to September 2023. Cases were diagnosed with cervical spondylosis and controls were selected from the same population without a history of cervical spine pathology or symptoms. The collected data were analyzed using IBM SPSS, version 27.0. <strong>Results:</strong> Gender distribution revealed females in both cases (63, 60.6%) and controls (59, 56.7%). The age of participants ranged from 25 to 75 years. The mean age for cases was 49.2 ± 12.93 years and for controls was 49.7 ± 13.19 years. The mean neck length among cases and controls was 105.2 ± 17.22 mm and 107.7 ± 20.02 mm, respectively. Regarding relative neck length, cases and controls exhibited measurements of 6.41 ± 1.07 mm and 6.42 ± 1.27 mm, respectively. Height-wise, cases measured 164.4 ± 10.27 cm, while controls measured 168.3 ± 8.53 cm. <strong>Conclusions:</strong> In conclusion, while no significant differences were observed in neck length or relative neck length between cervical spondylosis patients and controls, a notable disparity in height was noted.</p> Muhammad Kamran Ameer, Faiza Mehboob, Nadia Ahmad, Khalida Moeed, Hira Ahmed, Faiza Irshad Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1665 Sun, 30 Jun 2024 00:00:00 +0000 Relationship Between the Consumption of Beverage Use and Its Effects on Oral Health https://thejas.com.pk/index.php/pjhs/article/view/1531 <p>The current study of beverages as likely contributors to the prevalence of oral diseases in the general population has initiated interest in investigating the association of beverage use and its impact on oral health.<strong> Objective:</strong> To explore the relationship between beverage consumption and its impact on oral health.<strong> Method:</strong> Data were gathered from 377 college students for a cross-sectional study by using a convenience sampling technique. The study included male and female students, aged 19-25, excluding those who declined or couldn't communicate in Urdu/English. verbal consent was taken and confidentiality was maintained. A 95% confidence interval and a p-value of equal and &lt; 0.05 were used to identify significant findings.<strong> Results:</strong> The study included 377 medical and dental college students of which 273 (72.4%) were females and 104 (27.6%) were males. Soft drinks were correlated with dental caries (65.1%) which was followed by sensitivity (14.2%), calculus/plaque (10.7%), and tooth staining (10.1%). Tea consumption was associated with dental caries (54.5%). The relationship between beverage type and its impact on oral health was highly significant (p-value &lt; 0.001). Furthermore, the frequency of beverage consumption and its effect on oral health showed significant results, with a p-value of 0.006.<strong> Conclusions:</strong> The findings suggest a significant correlation between beverage consumption and various oral health issues, including dental caries, sensitivity, calculus, and staining.</p> Syed Hussain Al Hussaini, Syeda Lalarukh Saba Shah, Nazli Gul Shujaat, Zarish Nasir Copyright (c) 2024 Pakistan Journal of Health Sciences https://creativecommons.org/licenses/by/4.0 https://thejas.com.pk/index.php/pjhs/article/view/1531 Sun, 30 Jun 2024 00:00:00 +0000