Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS)

ASSESSING THE ANGER-PROVOKING FACTORS IN MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY.

2024-03-31

BACKGROUND: The psychological welfare of medical students holds significant importance in their academic pursuits and
prospective professional trajectories. The emotion of anger is an intricate and diverse phenomenon that has the potential to
exert a substantial influence on the psychological well-being of individuals pursuing medical education. This influence may
extend to their academic achievements and the quality of care they provide to patients. Gaining insight into the determinants
that elicit anger among medical students is imperative for the development of focused interventions and support mechanisms.
OBJECTIVE: The primary objective of this study is to examine the factors that elicit anger among medical students. This
research aims to acquire a deeper understanding of the origins of anger and any potential differences between male and female
medical students. The goal is to utilize this knowledge to develop effective strategies that can improve the emotional resilience
and overall well-being of medical trainees. METHOD: The study utilized a qualitative methodology, to gather data and was
carried out at Peshawar Medical College, Peshawar. The study encompassed a heterogeneous cohort of medical students, who
were selected to ensure representation of different educational backgrounds and stages of training. The frequency and intensity
of anger-provoking factors were evaluated using a structured questionnaire. This questionnaire covered various aspects, such
as academic pressures, interpersonal relationships, and clinical experiences. The study was conducted with careful attention to
ethical considerations. RESULTS: The survey results unveiled a diverse range of factors that incite anger, encompassing
feelings of frustration, setbacks in academic pursuits, personal losses, and everyday inconveniences. Significantly, disparities
based on gender were observed about these triggers. Female medical students encountered distinct difficulties associated with
gender roles and societal expectations, resulting in an impact on their experiences of anger. The utilization of qualitative
interviews yielded intricate and detailed narratives regarding these experiences, thereby illuminating the intricate emotional
aspects of medical education. CONCLUSION: The study highlights the significance of acknowledging and resolving angerinducing factors among medical students, as well as the potential disparities in these provoking circumstances. Tailored
treatments and support networks play a crucial role in fostering the emotional well-being and resilience of medical students,
regardless of their gender. By embracing continuous learning and practical application of Islamic teachings, individuals can
effectively manage and overcome anger, fostering a composed and harmonious disposition

ASSESSMENT OF DRINKING WATER QUALITY AND ASSOCIATED HEALTH RISKS AMONG RESIDENTS IN A COSMOPOLITAN CITY OF PAKISTAN.

2024-03-31

ABSTRACT
BACKGROUND: Lahore is a congested metropolitan area in the Punjab province, and large segments
of its population obtain drinking water from various sources. The drinking water quality is not addressed
according to the Environmental Protection Agency (EPA) standards. Thus, it becomes imperative to
analyze this city's drinking water quality. Bacterial contamination of drinking water, notably from
enteric microorganisms, has shown alarming health effects such as bacillary dysentery, Typhoid,
Hepatitis A & E, Poliomyelitis, gastroenteritis (commonly termed food poisoning), etc. The primary
purpose of this study is to analyze and detect the presence of fecal coliform bacteria in drinking water
samples obtained from different areas. METHOD: The sampling locations were conveniently selected
from 20 regions of Lahore. The samples were transported to the lab in specific ice boxes within 4-6
hours of the collection. Testing for fecal coliforms employed inoculation of EMB agar (Eosin Methylene
Blue Agar), followed by incubation at 44.5 °C for 24 hours. Samples free from fecal coliforms were
labeled as FFC (fit for consumption), whereas the samples detected for the presence of coliforms were
labeled as NFFC (not fit for consumption). RESULTS: A total of 457 samples were collected and
analyzed for the presence of fecal coliforms from December 2022 till August 2023. Among these, 53.5%
water samples were found to be fit for human consumption (FFC), whereas, 46.5% were not suitable
for consumption (NFFC). CONCLUSION: The current study identified that half of the population
consume unsafe water, hence vulnerable to waterborne diseases. A higher percentage of contamination
was reported in densely populated and less privileged city areas

ASSOCIATION BETWEEN SLEEP QUALITY AND WORK PRODUCTIVITY AMONG THE DIABETIC POPULATION

2024-03-31

BACKGROUND: Diabetic Mellitus (DM T2) is an epidemic health condition in the Pakistan that has enormous
impacts on heath, consequent effects on Health-Related Quality of Life (HRQOL) and has effects on work
productivity. OBJECTIVE: To determine the association between sleep quality and work productivity among
diabetes. METHODOLOGY: This cross-sectional study was conducted in various hospitals in Lahore from April
2023 to July 2023, utilizing a nonprobability convenience sampling technique to recruit 123 participants
diagnosed with diabetes. Inclusion criteria comprised individuals of both genders, aged between 35 and 65 years,
with a minimum diabetes duration of 2 years. Exclusion criteria encompassed the presence of chronic kidney
disease, liver disease, severe heart disease, active thyroid disorder, a history of trauma, and women in their 2nd
and 3rd trimesters. Data collection, involving the administration of informed consent, employed the Work
Productivity and Activity Impairment Questionnaire, Pittsburgh Sleep Quality Index, and EuroQol-5 Dimensions
survey. Statistical analysis was performed using SPSS-23, providing a comprehensive approach to investigate the
relationships and outcomes associated with diabetes in the specified population. RESULTS: The mean and
standard deviation for various scales, including PSQI, EQ-5D, and different aspects of work and activity
impairments. Notably, PSQI exhibited a mean of 9.46 with a standard deviation of 2.39. Table 8 illustrates
correlations, with PSQI showing a significant correlation (p < 0.05) with EQ-5D and work-related impairments.
Additionally, age demonstrated correlations with several scales, emphasizing its relevance in the study. These
findings provide valuable insights into the relationships among sleep quality, health status, and work-related
outcomes. CONCLUSION: This study reveals a significant positive correlation between sleep quality and healthrelated quality of life in type 2 diabetic patients

A CROSS-SECTIONAL STUDY ON FREQUENCY AND FACTORS ASSOCIATED WITH FIBROADENOMA AMONG YOUNG FEMALE (18-35 YEARS) OF NAWABSHAH,SBA SINDH PAKISTAN.

2024-03-31

ABSTRACT
BACKGROUND: Fibroadenoma (FA) or benign breast tumoru is common painless lesion of breast that is usually
unilaterally,non-cancerous present among young women, It can occur at any age but commonly found in 14-35
years age-group. Fibroadenoma are usually smooth, mobile, no tender and rubbery in consistency, They are
assumed to be aberrations of normal breast development or the product of hyperplastic processes, rather than true
neoplasm recently resreacher had been proved through differenet evidence or resreache studiets in developing and
developed countries that there is association of benign tumor or mass with different modifiable and non-modifiable
factors. This study will help to enhane the awareness among community or health care staff regarding early
detaction of fibroadenoma so that can able to decreases the cases of breast cancer among high risk female. This
studly was planned to assess the frequency and asscoicated factors related among females of Nawabshah.
OBJECTIVE: This research study was aimed to measure Frequency and factors of Fibroadenoma among young
adult female (18-45 years) visiting at Tertinary care hospital, DESIGN OF STUDY: Descriptive Cross-Sectional
study. PLACE AND DURATION: Surgical OPD of People Medical College, Hospital (PMCH),from August
2023 to November 2023. MATERIAL & METHODS: This cross cross-sectional study was conducted during
August-November 2023 on 310 females,Tertiary care hospitals in Nawabshah , with age group of 18-15 years
filtered at opd from females who are visiting at tertiary hospital. The data collection instrument consisted of a
section on demographic information and relavant variable . The analysis of data was done through SPSS v 23, and
Data analysis involved in the use of descriptive statistics and chi square test were used. RESULTS: In this study,
11.6 % found fibroadenoma amng young females age group were 23-26 yeas as compare to other age.
CONCLUSION: The frequency of fibroadenoma or non-cancerous leasion was high among young adult females
visiting in tertiary care hospital in Nawabshah.However, analytic studies examining causes associated with it are
needed

INCIDENCE OF SURGICAL SITE INFECTIONS FOLLOWING SURGERY AT A TERTIARY CARE HOSPITAL IN PUNJAB, PAKISTAN.

2024-03-31

Abstract
BACKGROUND: Post-operative surgical wound infection is basically, any infection that develops in a wound
following surgery. Urinary tract infections are the most frequent hospital-acquired infections, followed by surgical
site infections (SSIs). SSIs are a major lobal public health concern and contribute significantly to patients’
morbidity and mortality. The antibiotic resistance linked to surgical site infections is also a global therapeutic
problem for healthcare providers. METHODS: Patients admitted to surgery and surgical allied wards of the
Lahore General Hospital were included in this cross-sectional study. Using a non-probability convenient sampling
strategy, 83 patients in total were enrolled for the study. The relevant points for including SSIs were: Pus or
purulent discharge from an incision accompanied by pain, any two distinguishing symptoms of inflammation, and
surgeon's diagnosis of SSI. RESULTS: The patients' average age was 36.82 ± 18.91 years. Out of 83 patients, the
SSI rate has been found to be 27.71 %, with 23 of them experiencing SSIs. Out of nine patients over 60 years old,
four (44.4%) had SSIs, indicating a higher incidence of SSIs in older people. Compared to patients in rural areas,
those in urban areas had a greater likelihood of SSIs. Similarly compared to patients operated with an emergency
surgery (27.77%), patients operated under an elective surgery had a higher prevalence of surgical site infections
(SSIs; 37.93%). Of the 19 patients, seven (36.8%) had SSIs; these individuals were more likely to be obese.
CONCLUSION: According to the findings, patients admitted to Lahore General Hospital had a high incidence
of SSIs. Co-morbidities, advanced age, obesity, duration of surgery, major operations, and anemia were the main
risk variables that were found. It is important to take action to reduce SSIs in these high-risk populations.

YOUNG ADULTS' INTERNET ADDICTION LEVELS AND ITS CONTRIBUTING FACTORS.

Qamar Yasmeen — 2024-03-31

ABSTRACT
INTRODUCTION: Using the internet has become essential in our daily lives as technology advances with each
passing day. Every age and gender needs access to the internet for various purposes in their daily lives.
OBJECTIVE: The purpose of this study was to determine the Level of Internet addiction among medical students
and its contributing factors. METHODS: Between March and June of 2023, a cross-sectional study was carried
out among students. In order to gather data, students were given a structured questionnaire, and the Internet
Addiction Test (IAT) was used to measure internet addiction. Addiction was defined as a score ≥ 50.To find the
variables connected to internet addiction, linear logistic regression analyses were performed. RESULTS: Out of
a total of 555 medical students in different medical colleges, 323 were males and 232 were females. The level of
Internet addiction from moderate/severe was 44% and 18% respectively. Linear regression analysis showed
Gender, year of study, average sleep duration, time frame for frequent internet use, and primary purpose of internet
use were the main factors that independently continued to be significantly (p < 0.05) associated with internet
addiction. CONCLUSION: This study's greater incidence of IA could have detrimental effects on people's social,
mental, and physical well-being in addition to financial ramifications

ASSOCIATION OF EFFECTIVE COMMUNICATION BARRIERS WITH SOCIO-DEMOGRAPHIC CHARACTERISTICS OF NURSES WORKING AT A TERTIARY CARE HOSPITAL IN KARACHI.

Naseer Ahmed1, Tanseer Ahmed2, Rashid Hussain3, Bahadur Ali4, Inayatullah5 — 2024-03-31

BACKGROUND: Good communication between healthcare professionals and the patients can positively lead to
a successful treatment. Moreover, the quality of nursing care is highly needed for the well-being of patients, which
can only be achieved if the patients are satisfied with the nurses’ interaction and care provided. OBEJCTIVE: To
determine the association of demographic characteristics with effective communication barriers among nurses
working at a tertiary care hospital in Karachi. METHODS: This analytical cross-sectional study was conducted
through adopting purposive sampling among nurses working at Dr. Ruth Pfau Civil Hospital Karachi from 1st
September 2019 to 31st December 2019. An ethical approval was obtained, and a written informed consent was
obtained from each participant of the study. The data were collected by using demographic information sheet and
a Likert-scale tool including 44 questions related to barriers of effective communication among nurses. The SPSS
Version-23 was used for data analysis. Frequency and percentages were used for demographic variables.
Furthermore, a Mann-Whitney and Friedman tests were used to check the association between demographic
characteristics and barriers of effective communication. RESULTS: A total of 213 samples of nurses were
included in this study with a mean+SD of age was 30.49±8.65. Moreover, 69.0% of the participants were male
and 57.3% were married, 58.6% holding Diploma education, 34.7% were found with professional experience
between 3-5 years, 55.3% had regular job and 69% had rotations in nature of duty. The study results showed that
there were no significant mean differences found in number of barriers with respect to gender, nature of job and
nature of duty. However, a significant association was observed with respect to marital status p=0.01, education
p=0.01, and professional experience p=0.001 of the study participants. CONCLUSION: The findings of this
study suggest that marital status, education level and professional experience play a significant role in shaping
communication barriers. Strategies and interventions designed to meet the particular needs of nurses based on
their demographic characteristics can be developed to mitigate these barriers and enhance communication skills
in nursing practice.

THE DUAL CHALLENGE: EXPLORING THE ASSOCIATION BETWEEN DYSLIPIDEMIA AND THYROID HORMONE IMBALANCE IN TYPE-II DIABETIC PATIENTS.

2024-03-31

ABSTRACT
BACKGROUND: Diabetes Mellitus (DM) is a major worldwide public health issue. The thyroid hormone,
including T3 and T4, controls how the body utilizes energy. It is also crucial in managing your weight, body
temperature, muscle strength, and mood. METHODOLOGY: This cross-sectional analysis encompassed 190
participants, utilizing a non-probability convenience sampling method to categorize them into three groups:
healthy individuals, those with thyroid disorders, and individuals with Type 2 Diabetes Mellitus (T2DM).
Recruitment occurred in the Medicine department of Jamshoro/Hyderabad, where participants were selected based
on a pre-designed form and provided both verbal and written informed consent. Data analysis involved the use of
ANOVA Post hoc (Tukey test) for group comparisons (P<0.05) and the Chi-square test for assessing frequency
data. RESULTS: Significant alterations were observed in the lipid profiles, fasting blood glucose, and HbA1c
levels across both genders when compared to the control group, with a notable difference (p<0.001). In a study
examining thyroid hormone levels, the differences in T3, T4, and TSH levels among normal healthy males, obese
individuals, and those with Type 2 Diabetes Mellitus (T2DM) were found to be statistically significant.
Specifically, T3 levels were 1.44±0.44 nmol/l for healthy males compared to 1.46±0.49 and 1.54±0.39 nmol/l for
obese and T2DM subjects, respectively (P<0.05). T4 levels showed a similar pattern, with healthy males at
7.95±3.7 µg/dl versus obese and T2DM males at 9.6±4.4 µg/dl and 9.92±4.3 µg/dl, respectively (p<0.05).
Additionally, TSH levels were 3.67±1.10 mIU/l for the control group compared to 2.56±2.9 and 2.68±3.8 mIU/l
for the case groups, again showing significant difference (p<0.05). CONCLUSIONS: This study found that
cholesterol and LDL levels were adversely affected in individuals with T2DM and those with thyroid conditions.
However, no link was found between thyroid dysfunction and variations in insulin levels or blood sugar profiles.
It was determined that dyslipidaemia plays a role in the development of T2DM and thyroid issues.

FREQUENCY OF FACTORS LEADING TO UMBILICAL PORT INFECTION IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY.

2024-03-31

BACKGROUND: According in a significant way to laparoscopic surgery (LS), occasionally referred to
as the least invasive treatment, modern attentive attention has undergone a paradigm shift. The goal of this
study was to determine if any variables that contribute to umbilical port contamination in patients
undergoing elective laparoscopic cholecystectomy procedures will reoccur. MATERIAL AND
METHODS: From December 16, 2020, to June 15, 2021, descriptive cross-sectional research was
conducted at the surgical department of the Khyber Teaching Hospital in Peshawar. A total of 233
individuals who met the criteria for cholecystectomy and showed signs of the condition underwent
laparoscopic cholecystectomy. Umbilical port contamination-causing variables were noted and examined
using SPSS Version 16. RESULTS: A total of 233 individuals who had cholecystectomy signs underwent
treatment. With a range of 18 to 60, the normal age was 42.96 years + 12 SD. The ratio of women to men
was 1.94:1. 167 patients (71.7%) were obese, 144 patients (61.8%) had a medical procedure performed on
them, and 147 patients (63%) were being treated by less experienced experts. CONCLUSIONS: The junior
laparoscopic surgeon, weight, and the length of time spent on a medical operation are the risk factors for
umbilical portsite illness.

EXPLORING JAK2 GENE MUTATION (V617F) THROUGH REAL TIME PCR IN POLYCYTHEMIA VERA PATIENTS IN KPK.

2024-03-31

BACKGROUND: Polycythemia Vera (PV) is a chronic myeloproliferative neoplasm, the condition arise when
the excessive number of red blood cell produced within the bone marrow due to the mutation occurs at the myeloid
stem cells in protein named JAK2 kinase particularly within JH2 domain. A somatic point mutation occurs in the
JAK2 gene on chromosome 9 due to the transversion of G-C to T-A which develops the replacement of valine by
phenylalanine at codon 617. According to the WHO JAK2 V617F is responsible for about 95% of PV cases. The
annual incidents for Polycythemia Vera are 1-3 individual per 100,000 populations. The aim of the study was to
investigate the prevalence of the JAK2 gene mutation by using Real-Time PCR among the suspected PV patients
in Khyber Pakhtunkhwa, providing visions into the frequency of this mutation within the province. METHODS:
A total of 300 blood samples were collected from suspected PV patients and various screening test were conducted
to confirm the diagnosis, including: Hematologic parameters such as Red blood cell count (RBCs), Hemoglobin
level (HB), Hematocrit (HCT) and total leukocyte count (TLC) were measured. Peripheral blood smear were
examined to detect the abnormalities in the morphology of red blood cell, differential eosinophil and basophil
counts and presence of blast as well. Bone marrow aspirate and biopsy samples were obtained and examined to
assess cellularity, panmyelosis, megakaryocyte morphology, erythroid and myeloid series cells, bone marrow
eosinophilia, bone marrow iron stores, and reticulin fibrosis grade. Genomic DNA was extracted from the
collected blood samples using the MN kit. Real-Time PCR analysis was then performed to detect the JAK2 V617F
mutation, a hallmark of PV. This molecular analysis provided confirmation of PV diagnosis and enabled precise
identification of individuals carrying the JAK2 mutation. RESULTS: Among the suspected patients, 211 were
confirmed positive through CBC, 144 through special smear, and 102 through bone marrow examination. RealTime PCR analysis of DNA samples revealed the existence of the JAK2 V617F mutation in approximately 97
(95%) of the confirmed PV patients. CONCLUSION: In our study, we consider Real-Time PCR as a sensitive
and accurate method for detecting the JAK2 V617F mutation in Polycythemic (PV) patients based on its
demonstrated performance in previous studies and its widespread adoption in clinical laboratories. The high
prevalence of this mutation, detected in nearly 95% of PV cases, highlights its significance in the pathogenesis of
the disease within the Khyber Pakhtunkhwa population.

SOCIO-DEMOGRAPHIC FACTORS OF STROKE PATIENTS FOR DELAYING IN HOSPITAL ARRIVAL.

2024-03-31

BACKGROUND: Stroke has a major impact on morbidity, mortality and on economics, particularly of
underdeveloped countries. The pre-hospital delays i.e. delay before the patient reaches the hospital and
thrombolytic treatment are the two main factors affecting the stoke patients morbidity and mortality. The objective
of this study was to determine the sociodemographic factor associated with delayed hospital arrival of such
patients. MATERIAL & METHODS: This cross sectional study on 200 diagnosed patients of stroke with both
genders was conducted in Neurology OPD and Medical wards of PMC hospital Nawabshah. The information
regarding the socio-demographic factors involved in delayed hospital arrival of these stroke patients were
documented in the predesigned Questionnaire and statistical analysis was done. RESULTS: The mean age of the
participants was 58.9 years and stroke was three times more common im males as compared to females. Majority
of the participants were belonging to lower class 157 (78.5%) and 74.5% participants were Illiterate. Out of total
200 patients 67% were hypertensive and approximately 30% patients had history of diabetes. History of Ischemic
Heart Disease found in 32(16%) patients. 161(80.5%) participants 0ut of total 200 reached to the hospital after 6
hours being diagnosed or suspected. Older age of patients, marital status, ethnicity, occupation, failure to recognize
stroke symptoms and decision taken for shifting the patients to hospital were the factors which were found in our
study regarding delayed hospital arrival of stroke patients. CONCLUSION: Our study concluded that most of
the factors which lead to delay in hospital presentation were modifiable and interventions by the concerned health
authorities may have a positive effect on the time taken to report to the hospital.

BLOOD TRACE ELEMENT (ZINC) ESTIMATION IN PATIENTS OF VIRAL HEPATITIS C, LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA IN TERTIARY CARE HOSPITALS OF PESHAWAR

2024-03-31

BACKGROUND: Recent years have shown a significant prevalence of liver ailments in Pakistan, particularly in

Khyber Pakhtunkhwa. Therefore, our aim is to investigate the relationship between blood trace elements and

cirrhosis, hepatocellular cancer, and the Hepatitis C virus. Primary objective of this study is to explore blood zinc

levels in patients with hepatitis C, liver cirrhosis and hepatocellular carcinoma. METHODS: The Khyber

Teaching Hospital (KTH) and other partners collaborated with Lady Reading Tertiary Hospital to undertake this

two-year descriptive cross-sectional study. For this research we selected 90 patients having cirrhosis,

hepatocellular carcinoma or chronic hepatitis C. We equally divided our participants into 3 groups. Group I was

allocated to patients with hepatitis C virus, group II had cirrhosis patients and group III consisted of hepatocellular

carcinoma cases. Results were analyzed by using SPSS version 24. ANOVA test was applied. Significance level

was set as p< 0.05. RESULTS: Comparison of zinc trace element between the three groups reported significant

statistical differences. We observed a high ratio of zinc in Hepatitis C patients whereas a low level of zinc was

found among the cirrhosis and HCC patients. Regarding age, we only found a significant relationship between the

adult age group (41-50 years) with the blood zinc levels. CONCLUSION: Zinc plays an anti-cancerous role for

cirrhosis, HCC, and HCV. Our study concluded that the reduction in the zinc element triggered many liver

complications. Hepatitis C virus becomes more active when the zinc ratio increases.

INSTITUTIONAL BASED FREQUENCY OF DIFFERENT TYPE OF NEOPLASIA OF FEMALE GENITAL TRACT

2024-03-31

Objectives: To Determine the frequency of different types of female genital tract neoplasia in our local population
of KPK, Pakistan METHODS: This retrospective study was carried out between January 1, 2014, and December
31, 2018. The information was gathered from the pathology lab's histopathological records at Peshawar Medical
College and North West General Hospital in Peshawar. The SPSS 19.0 program was used to record and analyse
all pertinent data. RESULTS: This study comprised 1039 female patient cases across all age groups. The most
often impacted organ was the uterus (83.6%), which was followed by the ovary and fallopian tube. Leiomyoma
was the most prevalent benign neoplasia lesion, followed by endometrial polyps, whereas endometrial carcinoma
was the most common malignant neoplasm. Ninety-one instances were malignant, while 948 were benign. The
age range of 41 to 50 had the highest frequency of neoplasia. Peshawar reported the highest number of cases
(33%). CONCLUSION: The most frequent benign tumour in the female genital tract, according to our data, is
leiomyoma, whereas the most prevalent malignant tumour in our community is ovarian cancer. The study's
findings indicate that incidence rises with age.

PREVALENCE OF UROPATHOGENIC BACTERIA AND THEIR ANTIBIOTIC SUSCEPTIBILITY PATTERN AMONG DIABETIC AND NON-DIABETIC PATIENTS IN DISTRICT MARDAN.

2024-03-31

BACKGROUND: Urinary tract infections are a common bacterial condition that can affect individuals
of all ages caused by uropathogenic bacteria. OBJECTIVE: To find out the incidence of uropathogenic
bacteria and their antibiotic resistance in people with diabetes and non diabetics at District Mardan.
METHODS: Five-month prospective cross-sectional research work was done at Mardan Medical
Complex, Mardan. Urine samples are taken and subjected to microbiological analysis. Antibiotic
susceptibility was performed through Kirby-Bauer technique. RESULTS: Among the population
urinary tract infections (UTI) were 17.0% with diabetes and 14.0% without diabetes respectively.
Prominent isolated bacteria were E. coli, which accounted for 82.35% of individuals with diabetes and
57.1% of non-diabetes respectively. CONCLUSION: It highlights the importance of detection and
prompt treatment to prevent complications and life-threatening situations associated with the cooccurrence of UTI and diabetes. This study will greatly assist in managing UTIs among the residents of
District Mardan

FETO-MATERNAL OUTCOME OF EARLY DIAGNOSED GESTATIONAL DIABETES MELLITUS AT PEOPLE UNIVERSITY OF MEDICAL & HEALTH SCIENCES

2024-03-31

BACKGROUND: Diabetes Mellitus is one of the most well-known clinical problems experienced alongside
pregnancy. Clinical acknowledgment of it is significant in light of the fact that opportune mediation by dietary
measures and additionally insulin can lessen the notable maternal and fetal difficulties related to it. OBJECTIVE:
To determine the feto-maternal outcome of early diagnosed gestational diabetes mellitus at People's University of
Medical & Health Sciences. STUDY DESIGN: descriptive cross sectional. METHODOLOGY: We conducted
this study in the Department of Obstetrics & gynecology PUMHS Nawab Shah for a period of six months from
July to December. The data on singleton pregnant women after 24 weeks was analyzed for gestational diabetes
and its consequences on feto-maternal health. Demographic characteristics and complications related to
gestational diabetes were recorded on structured proforma and analysis was done on SPSS version 25. RESULTS:
This study shows that GDM seems to be more prevalent in un-booked patients and with a history of GDM (63.6%)
in previous pregnancy. The mean age observed was 30.6 years ± 6.729 standard deviation, GDM was most
prevalent in parity between 2-4 (47.3%), & in those who belong to urban, 58.2% had normal BMI & 23.6% had
>30 BMI, 43.6% showed polyhydramnios on the scan. Among these patients, 43.6% underwent cesarean section
while 36.4% delivered vaginally. 12.7% had placental insufficiency, around 50% delivered at term and 27.3%
were postdated. 7.3% experience PPH, 3.6% develop septicemia & wound gap. 10.9% develop preeclampsia. 8
newborns needed NICU admission >24 hours, 3 had developmental defects, 7 had respiratory problems, 10
developed hypoglycemia, around 38 babies had weight between 2.5 to 4.5, 10 had >4.5 kg & 7 had < 2.5kg. out
of 55, 48 babies were alive & healthy, 3 died in the first 7 days of life (2 with congenital anomaly), and 2 feti died
in utero. CONCLUSION: After conducting a review, we found that the occurrence of GDM is 11% in PUMHS
Pakistan. It is crucial to analyze and manage gestational diabetes (GDM) properly to prevent dangerous
consequences. Policymakers should prioritize addressing this issue, and pregnant women should schedule regular
antenatal visits.

FETOMATERNAL OUTCOME IN TEENAGE TERM PREGNANCY

Maria Pervaiz1 , Saima Khattak2 — 2024-03-31

BACKGROUND: Teenage pregnancy, involving women aged 13-19 years, is prevalent in developing
countries like Pakistan due to early marriages, low socioeconomic status, and illiteracy. OBJECTIVE
OF THE STUDY: The study's objective was to assess the outcomes for both the mother and the fetus
in teenage term pregnancies. METHODOLOGY: The Department of Obstetrics and Gynecology at
Lady Reading Hospital in Peshawar conducted this cross-sectional study. The study included 246
adolescent patients who were pregnant and between the ages of 12 and 19 with primary gravida and
gestational ages greater than 28 weeks. The statistical analysis software SPSS version 21.0 was used to
analyze the data. RESULTS: Age range in this study was from 12 to 19 years with mean age of
17.451±1.25 years, mean parity 0.000±0.00, mean gestational age 34.512±2.18 weeks and mean BMI
was 24.390±1.18 Kg/m2. PPH was observed in 10.6% patients, Tears 15.4%, Low Birth Weight 11.8%,
Still Birth 3.3%, Low Apgar Score 19.9% and NICU Admission was 13.4%. CONCLUSION: This
study demonstrated that low birth weight, stillbirth, low Apgar score, and NICU hospitalization are big
issues for babies born to adolescent mothers, while PPH and tears are issues for adolescent pregnant
women. The government should raise the legal marriage age, enhance education, offer excellent
nutrition, prenatal checkups, psychological care, and promote contraception to prevent underage
marriages

SERUM FERRITIN AND C-REACTIVE PROTEIN A CONFIDENT BIOMARKER IN COVID-19 PATIENTS.

2024-03-31

BACKGROUND: Since its initial report in Wuhan, China in December 2019, COVID-19 has spread
throughout the world, with 80,651 cases and 3070 deaths. OBJECTIVE: This study investigates the
correlation between C reactive protein (CRP) and serum ferritin in predicting disease severity in COVID-19
patients. CRP and ferritin levels were correlated with disease severity. MATERIAL & METHODS: With a
sample size of 213, this cross-sectional analytical investigation was carried out at the Khyber Teaching Hospital
in Peshawar, KP, Pakistan. The study included COVID-19 positive patients aged 18 and above, both males and
females. RESULTS: The study found a negative relationship between disease and CRP and serum ferritin levels.
As CRP and ferritin levels increase, then it indicating a severe state. Mean serum ferritin level is 1348.50 ng/ml,
CRP level is 102.1518mg/ml, and mean age is 57.41 years. CONCLUSION: According to the results of this
investigation, serum ferritin levels and CRP may be crucial markers of the severity and course of COVID-19

CONTINUATION RATE OF IMMEDIATE POSTPARTUM INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE.

Sadia Baig1 , Saima Khattak2 * — 2024-03-31

BACKGROUND: Contraception methods are designed to prevent undesired pregnancies on a temporary or
permanent basis. An intrauterine contraceptive device such as Cu-T-380A offers contraception for a duration of
up to 10 years. Traditionally, the initiation of postpartum birth control has been postponed until the 6-week
postpartum visit. Women are typically advised to abstain from sexual activity until the 6-week postpartum period
as part of their discharge instructions from the hospital. OBJECTIVE: To determine the frequency of
continuation rate of postpartum insertion of intrauterine contraceptive device in women delivering at Lady
Reading Hospital, Peshawar. STUDY DESIGN & SETTING: Descriptive study conducted at the Department of
Obstetrics and Gynecology, Lady Reading Hospital, Peshawar. METHODOLOGY: The study was conducted
between September 1, 2021, and February 28, 2022. A total of 104 pregnant women who were counseled for
(PPIUCD) insertion during antenatal care or early labor and expressed willingness to have an IUD inserted after
delivery were recruited for the study. Participants were followed up at six weeks and six months postpartum.
RESULTS: The continuation rate of postpartum insertion of the intrauterine contraceptive devices was noted.
The age range in this study was from 25 to 40 years with a mean age of 30.836±2.91 years and a mean gestational
age was 38.61±1.20weeks. The continuation rate of IUD was observed in 91.3% of patients. CONCLUSION: In
conclusion, the findings of this study indicate highly satisfactory continuation rates for PPCuIUD at 6 months.
The research explores recent developments that have expanded accessibility to all intrauterine devices (IUDs) and
provides detailed descriptions of each IUD's features. Despite the notable increase in IUD usage, potential
complications related to IUD placement may still arise. Therefore, ongoing updates on strategies to mitigate these
IUD-related issues are essential.

IRON DEFICIENCY ANEMIA IN CHILDREN WITH WORM INFESTATION.

2024-03-31

BACKGROUND: Intestinal worm infestations are common in tropical and subtropical regions, particularly in
areas marked by poverty and inadequate sanitation. Intestinal worms affecting around two billion people, consists
of soil-transmitted helminth infections. The primary species responsible for these infections include Ascaris
lumbricoides, Trichuris trichiura, and Necator americanus/Ancylostoma duodenal. OBJECTIVE: To determine
the frequency of iron deficiency anemia in children with worm infestation. METHODS: This cross-sectional
study was conducted in department of Pediatrics, Mardan Medical Complex, Medical Teaching Institution,
Mardan. This study was conducted from 1st November 2021 to 1st April 2022. A total of 133 children of both
gender with worm infestation were included in the study. Collected a blood sample and shipped to laboratory to
look for iron deficiency anemia set per one of the criteria of iron deficiency anemia. RESULTS: Age range in
this study was from 1 to 12 years with mean age of 3.985±1.77 years, mean weight was 13.090±3.16 Kg and mean
duration of complain was 3.052±1.35 months. Male patients were 68.4% and females were 31.6%. Iron deficiency
anemia was observed in 20.3% patients. CONCLUSION: To conclude, Iron deficiency anemia was observed in
20.3% children with worm infestation. This has to be addressed since parasite infections may harm children's lives
in more ways than simply anemia and can set the stage for other illnesses as well. To halt the emergence and
spread of such diseases, parents and educators should work together to encourage children to practice preventive
and sanitary practices.

COMPARISON OF EARLY RECURRENCE IN PILONIDAL SINUS FOLLOWING EPSIT TECHNIQUE VERSUS OPEN EXCISION.

2024-03-31

BACKGROUND: Pilonidal sinus, a frequently occurring and recurring disease, poses a complex
predicament for both patients and healthcare practitioners. OBJECTIVE: To compare early recurrence in
pilonidal sinus following EPSiT technique versus Open excision. MATERIAL & METHODS: This
controlled trial study was conducted on 60 patients presenting with pilonidal sinus, patients undergoing EPSiT
technique were place in group “A” while patients undergoing open excision will be placed in group “B”. Early
recurrence was compared between both groups. RESULTS: Group A was 37.27±12.48 years. In Group B, the
average age was 40.10±11.23 years. The occurrence of early recurrence in group A was considerably lower
compared to group B (P = 0.004). CONCLUSION: EPSiY technique was more effective with significantly
lower incidence of early recurrence as compared to open excision in pilonidal sinus (P = 0.004).

ADVANCEMENT IN DIGITAL RADIOGRAPHY: ENHANCING IMAGE QUALITY AND RADIATION DOSE OPTIMIZATION.

Farah Kalsoom1 , Shalmeen Tariq2 , Komal Mushtaq3 , Umaima Zafar4 — 2024-03-31

BACKGROUND: With improved exposure optimization and higher image quality, digital radiography
technology has revolutionized medical imaging in recent years. The primary goal of this study is to
determine how digital radiography has advanced through the optimization of radiation dose and image
quality. METHODOLOGY: From June 2023 to December 2023, the Chaudhry Pervaiz Elahi Institute
of Cardiology in Multan was the site of this prospective observational study. Data were collected from
100 patients. Patients undergoing X-ray, CT scan, fluoroscope and any other radiation and imaging
technique were included in the study. Those who do not want to participate were excluded from the
study. Demographic data, imaging techniques, medical history and all related information were included
in a designed questionnaire. RESULTS: Information was gathered from 100 patients in the hospital's
outpatient department. For high-resolution images, digital radiography achieved 90%, which is much
greater than the 40% obtained with traditional radiography. In a similar vein, digital radiography fared
better than conventional techniques, achieving an improved contrast of 80% as opposed to traditional
radiography's 30%. The average radiation dose in digital radiography was significantly lower than in
traditional radiography, at just 0.1 mGy as opposed to 0.2 mGy, or a 50% reduction. Furthermore, digital
radiography reached 95% compliance with the ALARA principle, indicating that it can reduce patient
radiation exposure while preserving diagnostic image quality. CONCLUSION: Compared to
conventional radiography techniques, digital radiography advances provide significant advantages for
improving image quality and minimizing radiation exposure.