Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS) <table> <tbody> <tr> <td width="716"> <p><strong>About the Journal</strong></p> <p><strong>JPUMHS </strong>is an official journal of Peoples University of medical and Health Sciences, Pakistan. JPUMHS came into existence in 2011. It is a quarterly published, multi- disciplinary, peer reviewed journal. We have a team of highly qualified editorial board members who are dedicated to meet and improve the standards of Journal as per the laid International guidelines. In addition, we are in process of maintaining a multidisciplinary reviewer’s bank, which comprises of dedicated national and international researchers and subject specialists, who strive their best to evaluate the manuscript in the shortest possible time the journal has its own dedicated website, where all previous, current issues are available with an <strong><u>open </u></strong><strong><u>access</u></strong> permitted to everyone.</p> <p>The journal is devoted to provide updates and advancements to health care providers in the field of basic as well as applied medical sciences. It is committed to rapidly publish the high quality research work in the form of original research articles, review articles, meta-analysis reviews, letter to the editor, case reports, case series report and short communication.</p> <p>We are striving to promote the quality research papers along with its free online availability to the readers all over the world for reference and awareness purpose. It is a forum for communicating the health related issues around the Globe. Moreover the <strong><u>ethical considerations</u></strong> and <strong><u>conflicts of interest</u></strong> amongst the co-authors are observed strictly to maintain the research protocols.</p> <p>Regardless of the employment status, journal accepts the quality research and updated authentic / evidence based information from any source. From patient's perspectives, this evidence based research will ultimately be a step forward to improve the health care facilities at National and International levels.</p> <p><strong>Checklist for authors</strong></p> <p>All corresponding and co-authors must ensure a complete protocol of submission processing order to avoid delay in publishing process of their papers. Incomplete submission will not be considered for the publications.</p> <p>Please complete the following requirements with following</p> <p>♦ <strong>Covering letter</strong> duly signed by all authors.</p> <p>♦ <strong>Undertaking/Certificate</strong> duly signed by all authors.</p> <p>♦ Copy of <strong>ethical permission</strong> letter issued to be signed by the Chairman/Head of Institutional Review Board/Ethical Committee, where research has been conducted.</p> <p>♦ Complete article with tables, figures and references.</p> <p>♦ Identification of <strong>corresponding author</strong> with full name, degree, affiliated institute, institutional title, e-mail address, corresponding address and phone numbers.</p> </td> </tr> </tbody> </table> <ul> <li>Details of <strong>ALL AUTHORS</strong> including full names, degrees, affiliated institute, institutional title, e- mail address, corresponding address and phone</li> <li>The journal will only correspond with the assigned corresponding</li> <li>Contributions of all authors in accordance with <strong>ICMJE guidelines</strong>.</li> <li>Declaration of <strong><u>Conflict of interest</u></strong> and funding information</li> </ul> <p>Before proceeding for submission of this manuscript, please follow the link:</p> <p>Complete the checklist and make sure that the manuscript is prepared according to the checklist. After completing the checklist, email the duly signed checklist by corresponding author, to editor thru email:</p> <p><a href=""></a></p> <p><strong>Important note: </strong>Delay in compliance and incomplete documentation may lead to delay in the processing of your manuscript.</p> <p><strong>Review Process</strong></p> <p>JPUMHS has a uniform and structured, <strong>blind peer-review</strong> process during which all manuscripts go through certain steps before a manuscript is accepted for publication. A manuscript goes through following steps during JPUMHS review process.</p> <ol> <li>After receiving a manuscript will be sent for initial <strong>Editorial review</strong>, to assess whether the submitted manuscript is written according to <strong><u>ICMJE authors guidelines</u></strong> and format and suitable for review or If manuscript is found suitable for further processing the correspondence author is informed within <strong><u>02 weeks</u></strong> regarding acceptance for further processing otherwise the author is asked to re-submit his manuscript after making necessary amendments as per <strong><u>ICMJE</u></strong> guidelines and format.</li> <li>After acceptance for processing a unique Ref will be allotted to the manuscript which will be used for future correspondence.</li> <li>After Editorial Review, the manuscript will checked thru <strong><u>TURNITIN Plagiarism Checker</u></strong> and sent to the Plagiarism Committee for judging Similarity Index (SI). The Technical assistant will submit its report within 02 weeks regarding Similarity If the report has similarity index &lt;=17%, then benefit of doubt may be given to the author but, in case, any single source has similarity index</li> </ol> <p>&gt;=5% without citation then it needs to be revised and will be sent back to the author for revision to bring similarity index down to permissible limit.</p> <ol start="4"> <li>In next step, the manuscript will be sent to reviewers of concerned specialty who will review the manuscript meticulously keeping in view all technical The reviewers will submit their review report within <strong><u>six weeks</u></strong>.</li> <li>After receiving the reviewers comments, the correspondence author will be informed immediately about the reviewers comments and asked to make necessary amendments in manuscript in the light of reviewers comments or give their comments where he don't agree with the reviewers comments within two</li> <li>After receiving the amended version from author, the manuscript will be evaluated by the Editorial Committee to see whether necessary amendments advised by reviewers were incorporated in the manuscript properly or not and whether the manuscript needs further review or This process will take <strong><u>two weeks </u></strong>to complete.</li> </ol> en-US (Dr Anwar Ali Jamali) (Muhammad Ali Daud Poto) Tue, 13 Feb 2024 07:34:33 +0100 OJS 60 FETAL OUTCOMES IN DELIVERIES WITH MECONIUM STAINED LIQUOR AT TERM PREGNANCY <p>ABSTRACT</p> <p>OBJECTIVE: To determine the frequency of adverse fetal outcomes in deliveries with meconium</p> <p>stained liquor at term. MATERIAL AND METHODS: This research constitutes a descriptive study</p> <p>aimed at investigating the association between meconium-stained amniotic fluid in term pregnancies</p> <p>and adverse fetal outcomes. The study was carried out at the Department of Obstetrics and Gynaecology</p> <p>Hayatabad Medical Complex Peshawar (HMC), spanned from September 2020 to March 2021. A total</p> <p>of 130 participants were included in the study as the sample size RESULTS: Among the cases</p> <p>observed, 40(30.8%) exhibited abnormal fetal heart rates, while the remaining 90(69.2%) demonstrated</p> <p>normal heart rate. Low Apgar score was observed in 26(20%) of newborns, indicating that they needed</p> <p>immediate medical attention and support for a smooth transition to life outside the womb. On the other</p> <p>hand, 104(80%) of newborns scored well on the Apgar assessment. CONCLUSION: Our study has</p> <p>concluded that meconium stained liquor is associated to increased perinatal morbidity.&nbsp;</p> Farah Qaiser1 , Nabeela Wazir2 , Nabeela Rauf3 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 COMPARISON OF EFFICACY OF TOPICAL VS PERIBULBAR ANESTHESIA IN PHACOEMULSIFICATION CATARACT SURGERY <h2 class="label">Abstract</h2> <p>ABSTRACT Objective: The goal was to assess how well peribulbar anesthesia performed in phacoemulsification cataract surgery in comparison to topical anesthetic. Materials and Methods. This randomized controlled experiment was conducted at the Hayatabad Medical Complex in Peshawar's Ophthalmology department. The study was conducted in five months from 1st August 2019 to 1st January 2020. In total, 154 individuals were enrolled in the study, with acuities ranging from counting finger (CF) to 6/12 on the Snellen visual acuity chart and visually significant age-related cataract found on slit lamp binocular microscope examination. Preoperatively, Group A had topical Lidocaine 0.5% eye drops three to five times every five minutes, while Group B received an injection of Xylocaine 2% with adrenaline and injection of Bupivacaine 0.5% in the peri-bulbar region. Using the Visual Analogue Score of less than 2 during the Phacoemulsification procedure preoperatively, the efficacy of both medications was assessed. Results. In this study, participants ranged in age from 40 to 70 years. In group A, the mean age was 57.077 years, the mean number of months with symptoms was 5.766, and the mean pain score was 3.233. In group B, the mean age was 56.064 years, the mean number of months with symptoms was 6.077, and the mean pain score was 32.181. Efficacy was observed in group A at 22.6% versus group B at 54.5% (P=0.001).Conclusion: When utilized for cataract surgery, peribulbar anesthesia dramatically increased patient satisfaction compared to topical anaesthetic.</p> Muhammad Irfan Ullah1, Hammad Tariq2, Kaleemullah3, Salman Zahir4, Nazli Gul5 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 FREQUENCY OF SUCCESSFUL VAGINAL BIRTH AFTER CESAREAN SECTION IN PATIENTS WITH PREVIOUS ONE CAESAREAN SECTION <p>ABSTRACT: OBJECTIVE: To determine the frequency of successful vaginal birth after cesarean section in patients with previous one caesarean section. MATERIAL AND METHODS: This cross-sectional study was carried out in the Department of Obstetrics and Gynaecology Hayatabad Medical Complex, Peshawar. A cohort of 147 participants was thoughtfully selected. The study included women aged 18 to 40 years, each of whom had previously undergone at least one caesarean section. Singleton pregnancy on ultrasound, Cephalic presentation on ultrasound, Gestational age 37-41 weeks LMP, Parity ≥ 1 and previous delivery by caesarean section on medical record were included in the study. Those who had high medical or obstetric risks, unfavorable cervix (with a Bishop score less than 6) and whose medical condition or personal choice led them to refuse participation were excluded from study. RESULTS: Age group was analyzed as 97(66%) patients belongs to age group of 18-30 years while 50(34%) belongs to age group &lt;30 years. Total 76(78.4%) &amp; 4(8%) successful vaginal deliveries after C-section was performed in both 18-30 years &amp; &lt; 30 years age groups respectively. Total 117(79.6%) patients had gestational age of 37-39 weeks and 30(20.4%) had &gt;39 weeks of gestational age. Successful vaginal delivery after cesarean was noted in 65(55.6%) cases in 37-39 weeks gestational age patients and in 15(50%) of &gt; 39 weeks gestational age women’s respectively.CONCLUSION: In conclusion, more than half of the patients who accepted TOLAC had a VBAC.</p> Nabeela Rauf1, Farah Qaiser2, Nabeela Wazir3 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 FREQUENCY OF ANEMIA IN PREGNANT WOMEN RECEIVING ANTENATAL CARE AT PEOPLES MEDICAL UNIVERSITY HOSPITAL NAWABSHAH <p>ABSTRACT OBJECTIVES: To evaluate anemia in pregnant women visiting people’s medical university Hospital Nawabshah AND To evaluate awareness of anemia in pregnant women visiting Peoples Medical University Hospital. Nawabshah. STUDY DESIGN AND STUDY SETTING: It was a cross sectional study conducted at Gynecological and Obstetric Department and outpatient department (OPD) of Peoples Medical university Hospital Nawabshah. METHODS: A Hospital based cross sectional study was conducted in gynecological and obstetric department and OPD at peoples medical university hospital Nawabshah from April to September 2021, the sample size for this study was 377 pregnant women and sampling technique was convenient sampling technique, data was collected using structured questionnaire ,the hemoglobin level of pregnant women was checked on the basis of already available reports at the time of antenatal checkup, Data was entered and analyzed by using SPSS software. RESULTS: In our study the overall calculated prevalence in pregnant women is 87%, from which 11.4% had severe anemia,31.8% had moderate anemia and 44.0% had mild anemia and only 12% women were founded non anemic having hemoglobin level 11 or &gt;11g/dl. CONCLUSION: Our study results conclude that anemia is highly prevalent among pregnant women visiting people’s medical university hospital Nawabshah. Factors such as low socioeconomic status, family type and awareness of anemia were found to be contributory factors in high prevalence rates of anemia.</p> Ruqayya Chandio1, Sadia Ayoob2, Yasir Ayoob3, Jawaid Hussain Ligari4, Gotum Kumar5, Humaira Ayoob6 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 A STUDY ON THE INDICATIONS AND OUTCOME OF RE-LAPAROTOMY: A CROSS SECTIONAL STUDY <p>Abstract OBJECTIVES: The aim of the study was to determine the indications, morbidity and mortality of re-laparotomy. STUDY DESIGN AND SETTING: This retrospective study was conducted at surgical department of MTI- Khyber Teaching Hospital. METHODOLOGY: This study was conducted in duration of nine months from 6th January to 31 September 2023. Patients undergone Re-laparotomies within 60 days of first laparotomy, both gender, and age greater than 18 years were included in the study. Data were collected and entered in Microsoft Excel and further analyzed through SPSS-23. RESULTS: Out of total 95 patients, emergency made 62.1% while elective were 37.9% of the operated cases. Most common surgeries that needed re-laparotomy were small gut perforation (13.7%), firearm injuries (12.6%) and lower GI carcinomas (10.5%), while common indications were intra-abdominal abscess (36.5%), anastomotic leak (22%) followed by haemorrhage and dehiscence (9.5% each). The time duration between primary laparotomy and re-laparotomy ranged from 1st to 60th day with 20% on the 10th postoperative day. The complications encountered were surgical site infections (41.1%), septicemia (21.1%) and hypoalbuminemia (18.9%). CONCLUSION: The most common indications of re-laparotomy were patients of small gut perforation, firearm injuries and lower GI Carcinomas. Peritonitis following leak, laparotomy for malignancy and advanced age were associated with mortality.</p> Muslihuddin1,Zia Ullah2, Maria Mir Jan3, Farah Naz4, Farhan Khan5, Muzzamil Sohail6 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 FREQUENCY OF SUCCESSFUL VAGINAL DELIVERY AFTER INDUCTION WITH VAGINAL MISOPROSTOL IN POSTDATED PREGNANCY <p>ABSTRACT OBJECTIVE: This research aims to provide valuable insights into the efficacy of misoprostol induction in achieving vaginal delivery in post-dated pregnancies. Through a comprehensive assessment of these factors, the study seeks to contribute to the understanding of optimal induction strategies for improved birth outcomes in this specific population. MateriAL AND METHODS: The study was conducted at the Department of Obstetrics and Gynaecology, Hayatabad Medical Complex, Peshawar, Pakistan, over a period of six months, from September 2020 to March 2021. Total 117 pregnant individuals aged 18 to 40 years, with postdated pregnancies (gestational age ≥ 42 weeks), were enrolled in the study. Participants meeting the inclusion criteria received an intervention involving the administration of vaginal misoprostol for labor induction. Specifically, a dose of 50 μg misoprostol was administered vaginally and placed in the posterior fornix of the vagina. RESULTS: Total 117 patients were included. Age range of patients was 18-40 years with a mean age of 29.1±1.86 years. Mean gestational age was 42.2±0.41 weeks, parity 1.57±1.20 and number of doses 2.564±0.49 as shown in Table-1. Age group was analyzed as 86(73.5%) patients belongs to age group of 18-30 years while 31(26.5%) belongs to age group &lt;30 years. Total 61(70.9%) &amp; 23(74.2%) successful vaginal deliveries was performed in both 18-30 years &amp; &lt; 30 years age groups respectively. Conclusion: In the context of post-dated pregnancies, this study sheds light on the frequency of successful vaginal delivery following induction with vaginal misoprostol. The findings underscore the potential effectiveness of misoprostol induction, with a notable success rate of 72%.</p> Nabeela Wazir1, Farah Qaiser2, Nabeela Rauf3 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 UNDERSTANDING THE ORGAN DONATION LANDSCAPE: A STUDY OF MEDICAL STUDENTS' PERSPECTIVES IN PAKISTAN <p>ABSTRACT OBJECTIVES: To assess undergraduate medical students' knowledge, attitude, and practice toward organ donation and to further explore their differences with regard to the students' demographic characteristics. METHODOLOGY: A Cross-Sectional Study design was carried out from June through September 2023. The participants were enrolled from the medical, dental, and paramedic colleges of Punjab. The data was collected on a structured questionnaire. The questionnaire was pre-tested prior to the start of the study. The data was collected online and further analyzed on SPSS version 28. All the data was qualitative, so the variables were reported in frequency and percentages. The Chi-square test was applied to see the association within or between study variables and sociodemographic characteristics. RESULTS: Overall, 152 students were enrolled in our study. Most of our participants represent the MBBS study program (80%). There was inconsistency in knowledge, attitude, and practice domains. Almost half (55.6%) of the students were aware of organ donation. In contrast, less than half of the students showed a positive attitude toward organ donation (45.5%) with regard to donating under special circumstances. The high percentage of willingness and motivation to become organ donors was reported in the group (below 18 years; 45.5%). The data reflects a high level of comfort and positive feelings about posthumous organ donation among a significant portion of participants. CONCLUSION: Our data presents various obstacles and perspectives regarding organ donation. While some participants voiced concerns, such as religious prohibitions, familial objections, and fears of disfigurement or loss of life, others mentioned a variety of "Other" impediments, indicating a broad spectrum of misgivings. However, the majority of respondents demonstrated a clear understanding of the noble purpose of organ donation, with the primary motivation being to save and extend human life. Overall, the findings point to the extent of continued efforts to raise awareness, educate the public, and address concerns to promote organ donation further and save lives.</p> Shafqat Huma1, Syed Abdul Wadood2, Sanullah Kalwar3, Umer Saeed Ansari4, Jamil Ahmed5 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 ASSOCIATION BETWEEN VITAMIN D LEVELS AND CHRONIC MIGRAINE: A COMPARATIVE STUDY OF DIABETIC AND NON-DIABETIC PATIENTS USING ISI AND MIDAS SCALES. <p>ABSTRACT BACKGROUND: Insulin resistance, a pivotal factor in metabolic syndrome, has emerged as a recent link to migraine development. Limited research has explored the connection between migraine and diabetes mellitus. The potential role of metabolic syndrome in linking migraine, cardiovascular disease, and obesity underscores the need to investigate the relationship between migraine and low blood vitamin D levels. OBJECTIVE: to examine the association between vitamin d levels and chronic migraine: a comparative study of diabetic and non-diabetic patients using isi and midas scales. METHODS: This was a cross-sectional study was carried out from time march to September 2022. Participants that are migraine sufferers of both genders aged 20 to 50 years were included. The patients were divided into 2 groups: Group A included diabetic migraine patients and Group B included non-diabetic migraine patients. Vitamin D levels were observed for all patients including a detailed migraine history. The MIDAS (Migraine Disability Assessment) Test was be filled for assessment of patients. The ISI (insomnia severity index) was also taken which is 7-item self-report questionnaire that evaluates the nature, intensity, and effect of insomnia. Data was analyzed through SPSS version 23. RESULTS: In this study of 173 participants, comprising 91 males and 82 females, 37 were diabetic, and 136 were non-diabetic. The primary risk factors associated with migraine were excessive screen time, stress, tea intake, and food allergies. Significant differences were observed in the prodrome and attack phases of migraine between diabetic and non-diabetic groups. Pearson correlations revealed a negative association between Vitamin D levels and the Migraine Disability Assessment (MIDAS) score (r= -.617**, p=0.0496) and a positive correlation between Insomnia Severity Index (ISI) and MIDAS score (r= .717**, p=0.0316). These findings highlight the influence of diabetes on migraine symptoms and emphasize the role of Vitamin D levels and insomnia severity in migraine-related disability. CONCLUSION: Diabetes is associated with increased susceptibility to migraine prodrome and attack phases, while non-diabetic individuals are more likely to experience moderate sleep disturbances. Furthermore, our study revealed a modest negative link between vitamin D levels and migraine-related disability (MIDAS score), as well as a positive correlation between MIDAS score and insomnia severity.</p> Muhammad Babar Siddiqui1, Salma Farukh Memon2, Abdul Rahman Soomro3, Abdul Ghafoor Magsi4, Muhammad Munwar Ali5, Shakil Ahmed6 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 CLINICAL MASQUERADES IN PHYSIOGNOMY OF SEBACEOUS CYSTS UNVEILED ON HISTOPATHOLOGICAL EXAMINATION: A SPECTRUM OF CASES <p>ABSTRACT OBJECTIVE: The aim of our study to eveluate the sebaceous cysts on the histopathological assessment to improve preoperative diagnosis. METHODS: This study was carried out at a tertiary care hospital from January 2023 to June 2023. The study included a total of 50 patients (n=50). Age, gender, cyst location, symptoms, signs, cyst size, diagnostic radiology, serology, preoperative diagnosis, treatment, morbidity, recurrences, and follow-up time were all obtained from the patient. RESULTS: The mean age of patients was 41 (range: 15-50 years). The female and male were 56% and 44%. Mostly patients were belong from rural areas (80%) and non-rural areas (20%). The scalp (32%), cervical region (28%), lower back region (20%), and remaining cysts of leg region (20%) were the most common locations for subcutaneous cysts. The size of the sebsceous cysts was greater &gt;2 cm in 92% of the patients and &lt; 16 cm in 8%. Pain was more common in the scalp and lower cervical region of cysts than in other locations (32% and 28%, respectively). The majority of cysts were 90% mobile in subcutaneous fat tissue. The histopathological examination for the cellular and structural features was performed. Diagnostic radiology was performed, treatment and follow-up. Data was analyzed by SPPS software. CONCLUSION: Sebaceous cysts are distinguished by their histological features, which include a cystic structure lined with stratified squamous epithelium and filled with keratin. Confirming these characteristics can help rule out other possibilities.</p> Zahoor Hussain1, Zulfiqar Ali Shar2, Farman Bijarani3, Sirajuddin4, Azad Ali Lashari5, Sadaf6 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 EFFECTS OF OPTIMIZED PROPORTION OF OMEGA-3 AND OMEGA-6 POLYUNSATURATED FATTY ACIDS ON BLOOD GLUCOSE LEVELS OF TYPE 2 DIABETES MELLITUS ALBINO WISTAR RATS <p>ABSTRACT OBJECTIVE: The purpose of this study was to compare the effects of consuming omega 3, omega 6, and a combination of both omega 3 and omega 6 on blood glucose levels in type 2 diabetic Wistar rats with control and diabetic control group rats. METHODOLOGY. In this investigation, n=50 male Albino Wistar rats weighing 200-250gms were employed. The animals were obtained from the Sindh Agricultural University's Animal House in Tandojam after ethical authorization to use them for testing was granted. A group of ten rats were maintained in clear-sided plastic cages and were named after the groups. RESULTS: A significant reduction was seen in the Diabetic group (Group B). Diabetes rats treated with Omega 3 and Omega 6 showed a drop in body weight, but it was smaller than the diabetes controls (Group B). However, the Omega-3 and Omega-6 combination therapy group (Group E) demonstrated the greatest results, indicating that the combination therapy greatly reduced body weight loss. CONCLUSION: The benefits of combining omega-3 and omega-6 PUFA were found to be more beneficial in avoiding HbA1C increase than -3 and -6 alone</p> Kazbano Ramsha1, Mumtaz Ali Qureshi2, Sumayya Qazi3, Bakhtawar Qureshi4, Sadia Khan5 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 EFFECT OF POLYUNSATURATED FATTY ACIDS PUFA ON LIPID PROFILE AND GLUCOSE LEVEL AMONG ALLOXAN – INDUCED TYPE – II DIABETES MALE ALBINO RATS <p>ABSTRACT OBJECTIVE The purpose of this study was to determine the effect of polyunsaturated fatty acids on lipid profile and glucose level among alloxan induced diabetes male albino rats.METHODOLOGY: A total 50 male albino rats of Wister strain, weighing from 200 to 250 grams were taken for this experimental study. All the rats were procured from the animal husbandry of Sindh Agricultural University, Tandojam. They were maintained on balanced laboratory – based diet. The rats were also kept in 12 hour light- and 12 hour dark cycle. Water was freely given. All the rats were divided in five respective groups, named as control group-A, Diabetic control group-B and experimental group-C, D and E. Each group contained 10 rats and were kept in separate cages.RESULT: Mean fasting blood glucose in different group before induction showed insignificant difference among the group p=0.996. Mean triglyceride showed significant findings with p&lt;0.001 in different groups showed insignificant findings with p=0.128 whereas mean level of LDL showed insignificant results among the group with p+0.961. CONCLUSION: The present study showed beneficial results of omega 3 fatty acids and omega 6 fatty acids when administered in combination (ratio of 1:1) on dyslipidaemia caused by insulin resistance in type II diabetes mellitus.</p> Sadia Khan1, Mumtaz Ali Qureshi2, Sumayya Qazi3, Bakhtawar Qureshi4, Kazbano Ramsha5 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 COMPARATIVE EVALUATION OF THE EFFECTIVENESS OF CARBAMAZEPINE AND GABAPENTIN IN THE MANAGEMENT OF TRIGEMINAL NEURALGIA <p>Abstract Objective: This study's purpose was to evaluate the effectiveness of carbamazepine and gabapentin for the treatment of “Trigeminal Neuralgia”. Study design: A prospective randomized clinical trial. Study period: Six-month study was conducted from 15 March 2023 to 15 September 2023. Study settings: The study was conducted in the “Department of Oral Medicine”, Faculty of Dentistry and Allied Sciences, Isra University Hyderabad Sindh. Material and method: A total of 60 clinically diagnosed patients of Trigeminal Neuralgia were enrolled after meeting inclusive criteria. Patients were diagnosed by clinical examination and a detailed history of pain. Doubtful patients were evaluated by radiographic examination. The patient's demographical features were recorded in the MS Excel worksheet (2013). Patients were randomly separated into two groups, A and B. Group A patients were treated with carbamazepine whereas Group B patients received Gabapentin. All the patients were advised to follow up on the “7th day”, “15th day”, and 1-month period to evaluate the drug response. Data were analyzed through the SPSS 20 version. Results: A total of 60 trigeminal neuralgia patients were enrolled, 23 (38.3%) out of 60 were male and 37 (61.7%) were female patients. The average age of male participants was 53.61 years and the mean age of female participants was 52.12 years. 31(51.7%). A total of 13 male and 21 female patients had pain in the right side of the face, whereas 10 males and 16 females had pain in the left side of the face. TN was most commonly found in the Maxillary region as compared to the Mandibular area. The study reported an important pain decrease in Group B as likened to Group A.Conclusion: In our research study it was concluded that both drug carbamazepine and gabapentin can be used to treat Trigeminal neuralgia patients, but in this research study we found Gabapentin can be proven effective when compared to carbamazepine in pain relief and management of TN.</p> Aswad Ahmed1, Fida Baloch2, Shahzaman Memon3, Wajid Ali Rajper4, Naveed Irfan5, Muzaffar Qayum Khan Ghauri6 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 UNVEILING THE TERRAIN: A COMPREHENSIVE EXPLORATION OF AFFECTIVE DOMAIN COMPETENCIES FOR MEDICAL EDUCATORS. <p>ABSTRACT OBJECTIVE: To explore the attitudes of teachers and students in medical colleges regarding effective education. METHODOLOGY: Medical teachers and students from two private and two public sector medical colleges in the Punjab province were surveyed using a standard questionnaire. A cross-sectional study was used to evaluate various aspects of teaching in the affective domain. The data was analyzed using descriptive statistics to examine affective education's challenges and the variables influencing its success. RESULTS: The data was collected from 116 medical teachers, and 326 medical students from public and private medical colleges in Punjab were surveyed. T-test was applied, which showed (t=3.15, p =0.002) that senior and junior students have different needs regarding various components of affective teaching and learning, and medical professors incorporating affective learning struggle due to lack of experience in their teaching methods. CONCLUSIONS: The study results revealed that it is essential to reinforce the organizational structure of medical colleges, offer teachers assurances and developments tailored to the needs of instructors of various age groups, and thoroughly enhance teachers' affective literacy. Additionally, the study findings emphasize the need to create affective education goals and systems that are explicit and progressive, and to build an affective education evaluation system using the practical approach.</p> Kainat Javed1, Umair Bin Nasir2, Saman Ansari3, Umer Saeed4, Jamil Ahmed5, Syeda Tehseen Fatima6 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 ASSOCIATION OF DIABETES MELLITUS AND HYPERTENSION WITH MORTALITY IN PATIENTS HOSPITALIZED WITH ACUTE CORONARY SYNDROME AND POSITIVE COVID-19 <p>ABSTRACT OBJECTIVE: To determine the Association of diabetes mellitus and hypertension with mortality in patients hospitalized with acute coronary syndrome and positive Covid-19. MATERIAL AND METHODS: An hospital based prospective observational study was conducted in the department of Cardiology, Isra University Hospital, Hyderabad for a period of one year from from 1st March 2021 to 28th February 2022. All the adult males and females, admitted with ACS and COVID-19 positive, diabetic and hypertensive, and those who consented to participate were included in this study. SPSS version 26.0 was used for data processing and analysis and a p value &lt;0.05 was considered as statistically significant. RESULTS: A total of 108 patients were included for final analysis. Hypertensive (61.11%) were more prevalent than diabetics (38.88%). Overall mean age of admitted patients was 54.36±10.68 years. Most of the patients (53.7%) admitted with COVID-19-ACS were improved and discharged to home. In-hospital complications were observed in 37.96% (n = 41) of the patients and unfortunately, 8.33% (n = 9) of the patients died in hospital. In-hospital complications were significantly observed in hypertensive patients (n = 28, 68.29%) while in-hospital mortality was more prevalent among T2 DM patients (n = 6, 66.66%), p 0.001. CONCLUSION: This study concludes that, older patients with diabetes mellitus were more prevalent and T2 DM was associated significantly with in-hospital mortality while hypertension was assocaited with in-hospital complicatios</p> Bushra Aqeel1, Owais Shams2, Syed Fasih A. Hashmi3, Shazia Kazi4, Mirza Rizwan Baig5, Feroz Memon6. Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 ASSOCIATION OF ACADEMIC STRESS AND SYMPTOMS OF GASTROINTESTINAL DISORDER IN UNIVERSITY STUDENTS: A CROSS SECTIONAL STUDY. <p>ABSTRACT: OBJECTIVE: To find out the link between the academic stress and the GI symptoms among adults. METHODS: A cross-sectional study was conducted in University of Lahore and University of Lahore teaching hospital, Lahore. Total 100 participants were selected through a non probability convenient sampling technique. Pre-tested questionnaires were used for the evaluation of participants. The study was completed in 4 months from October to January. For the data analysis purpose, SPSS version 21.0 was used. In this survey all the individuals aged 18-35 were included. RESULTS: Among 100 students, 28% were male while 72% were female and 56% of them had an awareness about this issue whereas, 44% had no idea. Majority of the students (40%) were facing some serious academic stress, along with the number of GI symptoms: Among 100 participants, 27 participants faced severe loss of appetite, 31 participants experienced mild nausea, 15 participants had the urge to defecate during stress. Out of 100 participants, 42 participants were likely to have severe stress according to Kressler Psychological Distress Scale (K 10). PRACTICAL IMPLICATION: The study sheds light on the early signs of gastrointestinal symptoms linked to academic stress. As a result, students experiencing these symptoms might recognize them as potential indicators of underlying stress. Early detection can prompt students to seek medical attention, adopt stress-reduction strategies, and prevent the escalation of both stress and gastrointestinal issues. CONCLUSION: It was concluded that the majority of participants were suffering from academic stress, and also experienced some of the GI symptoms. Participants reporting higher levels of stress exhibited a greater likelihood of experiencing GI symptoms, reinforcing the notion that psychological well-being has a discernible impact on gut health.</p> Shazeen abbas1, Mahnoor Munir2, Muhammad Imran Hussain3 , Saliha Noo4, Muhammad Arshad 5, Ramisha Ibtisam6, Sania khalid7 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 PREVALNCE OF PHYSICAL ACTIVITY AND BODY MASS INDEX AMONG PATIENTS WITH DIABETES <p>ABSTRACT OBJECTIVE: There is a clear need for more study to acquire a thorough knowledge of these linkages, particularly in the context of the Pakistani community. Although numerous studies have examined the complex correlation between PA, BMI and DM. METHODS: A survey based study conducted in Hyderabad, Sindh, Pakistan. 350 participants in all were included in the study, and a standardised questionnaire was used to collect the data. With the help of the International Physical Activity Questionnaire (IPAQ), this survey was used to compile crucial demographic data, assess PA levels, and calculate BMI using height and weight measurements. The gathered data was then subjected to analysis using SPSS version 25. RESULTS: The Findings shows that the link between elevated BMI and the incidence of Type II Diabetes, with obesity playing a prominent role in this association. Conversely, engaging in physical activity is associated with a lower prevalence of Type II Diabetes. Specifically, among participants with a normal BMI, 7.7% had Type II Diabetes, while this figure rose to 40.2% for overweight individuals and a substantial 74.7% for those categorized as obese. In contrast, only 9.2% of physically active participants were affected by Type II Diabetes, while 61.1% of those not engaging in physical activity were affected. These results highlight a clear association between higher BMI and the prevalence of Type II Diabetes, with obesity being particularly influential, and underscore the beneficial impact of physical activity in reducing the risk of Type II Diabetes. CONCLUSION: In conclusion, significant association between physical inactivity and elevated BMI, particularly in older individuals, with a heightened prevalence of diabetes mellitus (DM). These findings underscore physical inactivity as a distinct risk factor for DM onset.</p> Aamir Gul Memon1, Romana Pervez2, Moazam Saifullah3, Annosha syed4, Rama Kumari5, Gulzar Usman 6, Sadaf Naz7, Adnan Haider8, Kashaf Inam9, Mawra Urooj Memon10 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 FREQUENCY OF INTRAUTERINE GROWTH RESTRICTION ASSOCIATED WITH HYPERTENSIVE DISORDERS OF PREGNANCY <p>ABSTRACT: OBJECTIVE: To determine the frequency of intrauterine growth restriction associated with hypertensive disorders of pregnancy presenting to Hayatabad Medical Complex, Peshawar MATERIALS AND METHODS: This cross-sectional study was carried out on 89 women with hypertensive disorders of pregnancy between 11-07-2020 and 11-01-2021 to assess the frequency of IUGR at birth at the Department of Gynecology and Obstetrics at Hayatabad Medical Complex, Peshawar. RESULTS: Age ranged between 20-45 years. The mean age was 32.5±12.5 years. Age group was analyzed as 46(51.7%) mothers belongs to age group of 20-35 years, while 43(48.3%) belongs to age group of 35-45 years. Male neo born were 60(67.4%) while 29(32.6%) neo born were females. Family history of hypertension was noted in 29(32.6%), history of previous abortion in 27(30.3%) cases and history of previous Caesarian section (CS) noted in 16(18%) cases CONCLUSION: Women with gestational hypertension are more likely to suffer from IUGR. Research on larger sample sizes is needed to identify factors associated with IUGR before devising future research and prevention strategies.</p> Chandnee Rehman 1, Muhammad Luqman2, Shahzada Fahad3. Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 ASSOCIATION OF PHYSICAL ACTIVITY WITH HAPPINESS AMONG MEDICAL UNIVERSITY STUDENTS <p>ABSTRACT</p> <p>OBJECTIVES: To determine the prevalence of physical activity, happiness and association of physical</p> <p>activity with happiness among Medical University Students in Shaheed Benazirabad.</p> <p>METHODOLOGY: A cross-sectional study was conducted on medical students at Peoples University</p> <p>of Medical and Health Sciences Shaheed Benazirabad. Sample size was 410 and convenient sample</p> <p>technique was used. The study duration was 6 months (March 2022 to July 2022). International physical</p> <p>activity questionnaire short form (IPAQ-SF) to measure the level of physical activity and oxford</p> <p>happiness questionnaire (OHQ) to determine the level of happiness in medical students respectively.</p> <p>Data was analyzed by the use of SPSS version 20. RESULTS: results of this study showed that the</p> <p>mean age of students was 21.78±1.716. Among the total population 31.7% were highly active, 41.2%</p> <p>were moderately active, 27.1% were low active and 46.1% students were pretty happy. Medical students</p> <p>were not significantly happy with respect to physical activity with the p value of 0.579 and r value -</p> <p>0.027. CONCLUSION: this is non-significant effect of PA with happiness on medical students as our</p> <p>most of the population was moderately active and pretty happy.&nbsp;</p> Bhawna Lohana1 , Nafisa Agha2 , Bahadur Ali3 , Raveena Kumari4 , Farhana Lalbux5 , Mir Tahir Hussain Talpur Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 RELATIONSHIP BETWEEN ANTI-HYPERTENSIVE USE AND PARKINSON'S DISEASE RISK: A CROSS SECTIONAL STUDY. <p>ABSTRACT OBJECTIVE: to assessing the relationship between anti-hypertensive use and parkinson's disease risk. MATERIALS AND METHODS: The retrospective case-control study was conducted at the Chandka Medical College, Ladkana. A total of 326 participants were selected through a multi-stage stratified sampling method to ensure the sample represents the diversity of the target population. Participants aged 50-70 years with complete information on antihypertensive use, Parkinson’s disease diagnosis on Modified Hoehn (H) &amp; Yahr (Y) stages. Participants with other diagnosed co-morbid were excluded from the study. Statistical results was analysed via SPSS version 22. RESULTS: The findings revealed no overall significant link between antihypertensive drug use and the risk of Parkinson’s disease (p&gt;0.05). Subgroup analysis, on the other hand, revealed potential differences in risk profiles based on certain antihypertensive medication classes. Individuals on calcium channel blockers had a slightly increased risk of Parkinson’s disease (p=0.06), whereas those taking ACE inhibitors had a lower risk (p=0.08). These relationships were not statistically significant, but they merit additional study. CONCLUSION: According to the findings, antihypertensive drug use may not be a significant risk factor for Parkinson’s disease in the general population. Nonetheless, more research is needed into the potential differential effects of different antihypertensive medication classes on PD risk.</p> Abdul Rahman Soomro1, Muhammad Babar Siddiqui2, Abdul Ghafoor Magsi3, Muhammad Munwar Ali4, Abdul Majid Abbasi5, Haque Nawaz Juj6 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 EXPLORING IRON-DEFICIENCY ANEMIA PREVALENCE AND RISK FACTORS IN PRETERM INFANTS WITH VERY LOW BIRTH WEIGHT AT 1 YEAR OF CORRECTED AGE <p><strong>ABSTRACT</strong></p> <p><strong>OBJECTIVE: </strong>To explore the prevalence and risk factors associated with iron-deficiency anemia (IDA) among preterm infants with very low birth weight (VLBW) at 1 year of corrected age. <strong>MATERIALS AND METHODS: </strong>A cohort of 350 preterm infants with VLBW was included in this study, conducted within the Pediatrics and Gynecology Unit of a tertiary care hospital. Demographic, clinical, and laboratory data were collected and analyzed to determine IDA prevalence and identify potential risk factors. <strong>RESULTS: </strong>The prevalence of IDA among the studied preterm infants with VLBW at 1 year of corrected age was found to be 22.9%. Lower gestational age and birth weight were identified as significant risk factors associated with increased susceptibility to IDA. Additionally, maternal anemia emerged as a substantial risk factor, underscoring the intergenerational impact on infant iron status. <strong>CONCLUSION: </strong>The study highlights the considerable prevalence of IDA in preterm infants with VLBW at 1 year of corrected age. The identified risk factors, including gestational age, birth weight, and maternal anemia, emphasize the need for targeted interventions to prevent and manage IDA in this vulnerable population. Early iron supplementation and improvement of maternal iron status during pregnancy hold promise for enhancing the health outcomes of these infants.</p> Muslihuddin1, Zia Ullah2, Maria Mir Jan3, Farah Naz4, Farhan Khan5, Muzzamil Sohail6 Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 AWARENESS AND DEVELOPMENT OF COMPLICATIONS IN DIABETIC PATIENTS VISITING IN OPD. <p>ABSTRACT: OBJECTIVE: The objective of this study was to assess the awareness about diabetes and its complications among diabetic patients and to determine the association between diabetic awareness and medication compliance in patients suffering from diabetes. Study Design: Cross-sectional study. Study period: The study was conducted for Four months after ethical approval from IRB. Study Setting: Study data was collected from multisite, which includes Karachi institute of Kidney disease (KIKD), Shine Humanity (Thatta), and a Primary Care Unit located in Karachi and Hyderabad. MATERIAL and METHODS: Total 800 patients were involved in the study; Data was collected during detail interviews from diabetes diagnosed patients on a structured questionnaire, having patient’s demographical details, the complications of diabetes and awareness regarding diabetes were asked and recorded on a questionnaire. Data was examined by SPSS 26. RESULTS: A total 0f 800 patients diagnosed with diabetes were included in our study, in which 374 (46.7%) were male patients and 426 (53.3%) were women patients. The results elaborated 352 (44%) out of 800 patients had a good knowledge of diabetes whereas 448 (56%) had a poor knowledge regarding diabetes. The Data indicating comparison between the knowledge level of diabetes and the compliance to medicines among study participants; based on the findings, majority of the participants have a poor knowledge of diabetes. Furthermore, those with a low medication compliance also had a lack of awareness for diabetes. A statistically significant (p&lt;0.05) relation between knowledge level and medicine compliance was demonstrated among the study participants. CONCLUSION: Study observed lack of awareness regarding diabetes and its complications. The unawareness of diabetes and its complications found a significant relationship with medication compliance among diabetic patients. It was observed that raising awareness about the complications associated with diabetes is intimately linked to medication compliance. Patients who are well-informed about the risks and consequences of non-compliance are more likely to take their medications as directed, leading to better disease management, reduced complications, and improved overall health outcomes</p> Muhammad Ahmer Saleem1, Nadia Kiran2, Marvi Memon3, Ammarah jamil4 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100 IDENTIFICATION OF RISK FACTORS AND EVIDENCE-BASED STRATEGIES TO CONTROL TYPHOID FEVER IN LAHORE: A CROSS SECTIONAL STUDY. <h2 class="label">Abstract</h2> <p>ABSTRACT OBJECTIVES: To identification of risk factors and evidence-based strategies to control typhoid fever in Lahore. METHODOLOGY: The cross - sectional study is conducted in General hospital and Gulab Devi hospital Lahore Pakistan, from April to June 2023. A total 76 patients with the history of continuous history of fever, headache, abdominal pain and discomforts will be included in the study. The data about demographic, hygiene practices, and illness characteristic, treatment, and biochemical parameters, including serum electrolyte, CBC blood culture will be assessed. RESULTS: Results have been evaluated on the basis of the responses and feedback as the result of the survey. There were 76 patients included in this study. Among these patients 45 were female and the remaining were male who responded to the questionnaire. The results of different nutritional indices like BMI, socio economic status and education of patients, their hygiene practices, water and food sanitation, food handling, symptoms, effects and biochemical tests including serum creatinine, RBC and vaccination in these patients. CONCLUSION: The study concluded that personal hygiene, good sanitation, clean water and food, proper food processing, and clean environment can control the spread of typhoid and other fatal diseases. Less educated people should be given the necessary information and measures to defeat the typhoid epidemic. It also needs to be provided to the lower middle class, who have little or no access to clean water.</p> Muhammad Imran Hussain 1, Rumesa Yaseen 2, Hijab Nawaz Khokher 2, Amna Imtiaz2 , Kainat Fatima Aftab2, Malaika Abid3, Sania khalid4 ,Huba khalid5, Copyright (c) 2024 Sun, 31 Dec 2023 00:00:00 +0100 PHARMACOLOGICAL APPROACHES TARGETING INCRETIN HORMONES IN DIABETES MANAGEMENT <p>ABSTRACT OBJECTIVE: Changes in glycemic control, as measured by HbA1c levels, was the main end measures. Changes in body weight was secondary end measures. METHODOLOGY: Baseline evaluations were performed, which included demographic data, glycated hemoglobin levels (HbA1c) and body weight were measured. Comparisons were made with the values obtained after 12 weeks of intervention RESULTS: The value of HbA1C and body weight was determined at baseline and after 12 weeks of intervention and the findings had revealed that at baseline the value of HbA1C of group A was 7.8%±2.2 and body weight was 80.2kg±2.5 that had significantly p&lt;0.001 reduced to 5.2%±2.5 and 74.3kg ± 2.9. The values of HbA1C in group B at baseline was 7.5%±3.2 that had significant p&lt;0.001 reduced to 5.7%±2.4 and average weight that was 79.09kg±3.2 was reduced to 75.4kg±1.85 (p&lt;0.001). In group C also the effects of standardized treatment had provided significant findings and the differences in the mean glycated hemoglobin levels and body weight was found to be significant p&lt;0.001 CONCLUSION : Overall, incretin-based therapeutics provide patients with type 2 diabetes creative and efficient treatment choices, offering promise for improved disease control and quality of life. The advantages and safety profiles of these medicines in a larger patient population will be completely clarified by more study and long-term investigations.</p> Kashif Rasheed Shaikh1, Sadia Kazi 2, Sumayya Qazi3 Copyright (c) 2024 Tue, 13 Feb 2024 00:00:00 +0100