Journal of Peoples University of Medical & Health Sciences Nawabshah. (JPUMHS) 2024-06-03T08:25:49+05:00 Dr Anwar Ali Jamali Open Journal Systems <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> ASSESSING THE ANGER-PROVOKING FACTORS IN MEDICAL STUDENTS: A CROSS-SECTIONAL STUDY. 2024-05-21T07:15:30+05:00 Maleeha Iqbal1, Rashid Ahmad2, Shama Iqbal3, Humera Gabeen4, Yasir Khan5, Muhammad Bilal6 <p>BACKGROUND: The psychological welfare of medical students holds significant importance in their academic pursuits and<br>prospective professional trajectories. The emotion of anger is an intricate and diverse phenomenon that has the potential to<br>exert a substantial influence on the psychological well-being of individuals pursuing medical education. This influence may<br>extend to their academic achievements and the quality of care they provide to patients. Gaining insight into the determinants<br>that elicit anger among medical students is imperative for the development of focused interventions and support mechanisms.<br>OBJECTIVE: The primary objective of this study is to examine the factors that elicit anger among medical students. This<br>research aims to acquire a deeper understanding of the origins of anger and any potential differences between male and female<br>medical students. The goal is to utilize this knowledge to develop effective strategies that can improve the emotional resilience<br>and overall well-being of medical trainees. METHOD: The study utilized a qualitative methodology, to gather data and was<br>carried out at Peshawar Medical College, Peshawar. The study encompassed a heterogeneous cohort of medical students, who<br>were selected to ensure representation of different educational backgrounds and stages of training. The frequency and intensity<br>of anger-provoking factors were evaluated using a structured questionnaire. This questionnaire covered various aspects, such<br>as academic pressures, interpersonal relationships, and clinical experiences. The study was conducted with careful attention to<br>ethical considerations. RESULTS: The survey results unveiled a diverse range of factors that incite anger, encompassing<br>feelings of frustration, setbacks in academic pursuits, personal losses, and everyday inconveniences. Significantly, disparities<br>based on gender were observed about these triggers. Female medical students encountered distinct difficulties associated with<br>gender roles and societal expectations, resulting in an impact on their experiences of anger. The utilization of qualitative<br>interviews yielded intricate and detailed narratives regarding these experiences, thereby illuminating the intricate emotional<br>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<br>treatments and support networks play a crucial role in fostering the emotional well-being and resilience of medical students,<br>regardless of their gender. By embracing continuous learning and practical application of Islamic teachings, individuals can<br>effectively manage and overcome anger, fostering a composed and harmonious disposition</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 ASSESSMENT OF DRINKING WATER QUALITY AND ASSOCIATED HEALTH RISKS AMONG RESIDENTS IN A COSMOPOLITAN CITY OF PAKISTAN. 2024-05-09T13:09:31+05:00 Umer Saeed1, Faheem Mahmood2, Mudassar Ali Khan3, Jamil Ahmed4, Hifza Noor5, Saman Saeed6 <p>ABSTRACT <br>BACKGROUND: Lahore is a congested metropolitan area in the Punjab province, and large segments <br>of its population obtain drinking water from various sources. The drinking water quality is not addressed <br>according to the Environmental Protection Agency (EPA) standards. Thus, it becomes imperative to <br>analyze this city's drinking water quality. Bacterial contamination of drinking water, notably from <br>enteric microorganisms, has shown alarming health effects such as bacillary dysentery, Typhoid, <br>Hepatitis A &amp; E, Poliomyelitis, gastroenteritis (commonly termed food poisoning), etc. The primary <br>purpose of this study is to analyze and detect the presence of fecal coliform bacteria in drinking water <br>samples obtained from different areas. METHOD: The sampling locations were conveniently selected <br>from 20 regions of Lahore. The samples were transported to the lab in specific ice boxes within 4-6 <br>hours of the collection. Testing for fecal coliforms employed inoculation of EMB agar (Eosin Methylene <br>Blue Agar), followed by incubation at 44.5 °C for 24 hours. Samples free from fecal coliforms were <br>labeled as FFC (fit for consumption), whereas the samples detected for the presence of coliforms were <br>labeled as NFFC (not fit for consumption). RESULTS: A total of 457 samples were collected and<br>analyzed for the presence of fecal coliforms from December 2022 till August 2023. Among these, 53.5% <br>water samples were found to be fit for human consumption (FFC), whereas, 46.5% were not suitable <br>for consumption (NFFC). CONCLUSION: The current study identified that half of the population <br>consume unsafe water, hence vulnerable to waterborne diseases. A higher percentage of contamination <br>was reported in densely populated and less privileged city areas</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 ASSOCIATION BETWEEN SLEEP QUALITY AND WORK PRODUCTIVITY AMONG THE DIABETIC POPULATION 2024-05-09T13:14:44+05:00 Ahtisham Younas1, Aamir Gul Memon2, Zohaib Hassan3, Rizwan Ali Talpur4, Jawed Iqbal5, Aamir Hussain6, Ahmed Umair7, Sarma Khurshid8 <p>BACKGROUND: Diabetic Mellitus (DM T2) is an epidemic health condition in the Pakistan that has enormous <br>impacts on heath, consequent effects on Health-Related Quality of Life (HRQOL) and has effects on work <br>productivity. OBJECTIVE: To determine the association between sleep quality and work productivity among <br>diabetes. METHODOLOGY: This cross-sectional study was conducted in various hospitals in Lahore from April <br>2023 to July 2023, utilizing a nonprobability convenience sampling technique to recruit 123 participants <br>diagnosed with diabetes. Inclusion criteria comprised individuals of both genders, aged between 35 and 65 years, <br>with a minimum diabetes duration of 2 years. Exclusion criteria encompassed the presence of chronic kidney <br>disease, liver disease, severe heart disease, active thyroid disorder, a history of trauma, and women in their 2nd <br>and 3rd trimesters. Data collection, involving the administration of informed consent, employed the Work <br>Productivity and Activity Impairment Questionnaire, Pittsburgh Sleep Quality Index, and EuroQol-5 Dimensions <br>survey. Statistical analysis was performed using SPSS-23, providing a comprehensive approach to investigate the <br>relationships and outcomes associated with diabetes in the specified population. RESULTS: The mean and <br>standard deviation for various scales, including PSQI, EQ-5D, and different aspects of work and activity <br>impairments. Notably, PSQI exhibited a mean of 9.46 with a standard deviation of 2.39. Table 8 illustrates <br>correlations, with PSQI showing a significant correlation (p &lt; 0.05) with EQ-5D and work-related impairments. <br>Additionally, age demonstrated correlations with several scales, emphasizing its relevance in the study. These <br>findings provide valuable insights into the relationships among sleep quality, health status, and work-related <br>outcomes. CONCLUSION: This study reveals a significant positive correlation between sleep quality and healthrelated quality of life in type 2 diabetic patients</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 A CROSS-SECTIONAL STUDY ON FREQUENCY AND FACTORS ASSOCIATED WITH FIBROADENOMA AMONG YOUNG FEMALE (18-35 YEARS) OF NAWABSHAH,SBA SINDH PAKISTAN. 2024-05-09T13:18:15+05:00 Ruqayya Ayoob Chandio, Gotam Kumar, Yasir Ayoob, Ms.Kashish Ganeso Ram, Jyoti Kella. Veena Kumari, Nargis Ahmed <p>ABSTRACT<br>BACKGROUND: Fibroadenoma (FA) or benign breast tumoru is common painless lesion of breast that is usually <br>unilaterally,non-cancerous present among young women, It can occur at any age but commonly found in 14-35 <br>years age-group. Fibroadenoma are usually smooth, mobile, no tender and rubbery in consistency, They are <br>assumed to be aberrations of normal breast development or the product of hyperplastic processes, rather than true <br>neoplasm recently resreacher had been proved through differenet evidence or resreache studiets in developing and <br>developed countries that there is association of benign tumor or mass with different modifiable and non-modifiable <br>factors. This study will help to enhane the awareness among community or health care staff regarding early <br>detaction of fibroadenoma so that can able to decreases the cases of breast cancer among high risk female. This <br>studly was planned to assess the frequency and asscoicated factors related among females of Nawabshah.<br>OBJECTIVE: This research study was aimed to measure Frequency and factors of Fibroadenoma among young <br>adult female (18-45 years) visiting at Tertinary care hospital, DESIGN OF STUDY: Descriptive Cross-Sectional <br>study. PLACE AND DURATION: Surgical OPD of People Medical College, Hospital (PMCH),from August <br>2023 to November 2023. MATERIAL &amp; METHODS: This cross cross-sectional study was conducted during <br>August-November 2023 on 310 females,Tertiary care hospitals in Nawabshah , with age group of 18-15 years <br>filtered at opd from females who are visiting at tertiary hospital. The data collection instrument consisted of a <br>section on demographic information and relavant variable . The analysis of data was done through SPSS v 23, and <br>Data analysis involved in the use of descriptive statistics and chi square test were used. RESULTS: In this study, <br>11.6 % found fibroadenoma amng young females age group were 23-26 yeas as compare to other age. <br>CONCLUSION: The frequency of fibroadenoma or non-cancerous leasion was high among young adult females <br>visiting in tertiary care hospital in Nawabshah.However, analytic studies examining causes associated with it are <br>needed</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 INCIDENCE OF SURGICAL SITE INFECTIONS FOLLOWING SURGERY AT A TERTIARY CARE HOSPITAL IN PUNJAB, PAKISTAN. 2024-05-09T13:21:49+05:00 Umair Bin Nasir1, Shahzad Naveed Jawaid2, Rai Ahmad Khan Kharl3, Nabeela Riaz4, Muhammad Kareem Ullah5, Inayat Husain Anjum6 <p>Abstract<br>BACKGROUND: Post-operative surgical wound infection is basically, any infection that develops in a wound <br>following surgery. Urinary tract infections are the most frequent hospital-acquired infections, followed by surgical <br>site infections (SSIs). SSIs are a major lobal public health concern and contribute significantly to patients’ <br>morbidity and mortality. The antibiotic resistance linked to surgical site infections is also a global therapeutic <br>problem for healthcare providers. METHODS: Patients admitted to surgery and surgical allied wards of the <br>Lahore General Hospital were included in this cross-sectional study. Using a non-probability convenient sampling <br>strategy, 83 patients in total were enrolled for the study. The relevant points for including SSIs were: Pus or <br>purulent discharge from an incision accompanied by pain, any two distinguishing symptoms of inflammation, and <br>surgeon's diagnosis of SSI. RESULTS: The patients' average age was 36.82 ± 18.91 years. Out of 83 patients, the <br>SSI rate has been found to be 27.71 %, with 23 of them experiencing SSIs. Out of nine patients over 60 years old, <br>four (44.4%) had SSIs, indicating a higher incidence of SSIs in older people. Compared to patients in rural areas, <br>those in urban areas had a greater likelihood of SSIs. Similarly compared to patients operated with an emergency <br>surgery (27.77%), patients operated under an elective surgery had a higher prevalence of surgical site infections <br>(SSIs; 37.93%). Of the 19 patients, seven (36.8%) had SSIs; these individuals were more likely to be obese.<br>CONCLUSION: According to the findings, patients admitted to Lahore General Hospital had a high incidence <br>of SSIs. Co-morbidities, advanced age, obesity, duration of surgery, major operations, and anemia were the main <br>risk variables that were found. It is important to take action to reduce SSIs in these high-risk populations.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 YOUNG ADULTS' INTERNET ADDICTION LEVELS AND ITS CONTRIBUTING FACTORS. 2024-05-09T13:24:47+05:00 Qamar Yasmeen <p>ABSTRACT<br>INTRODUCTION: Using the internet has become essential in our daily lives as technology advances with each <br>passing day. Every age and gender needs access to the internet for various purposes in their daily lives. <br>OBJECTIVE: The purpose of this study was to determine the Level of Internet addiction among medical students <br>and its contributing factors. METHODS: Between March and June of 2023, a cross-sectional study was carried <br>out among students. In order to gather data, students were given a structured questionnaire, and the Internet <br>Addiction Test (IAT) was used to measure internet addiction. Addiction was defined as a score ≥ 50.To find the <br>variables connected to internet addiction, linear logistic regression analyses were performed. RESULTS: Out of <br>a total of 555 medical students in different medical colleges, 323 were males and 232 were females. The level of <br>Internet addiction from moderate/severe was 44% and 18% respectively. Linear regression analysis showed <br>Gender, year of study, average sleep duration, time frame for frequent internet use, and primary purpose of internet <br>use were the main factors that independently continued to be significantly (p &lt; 0.05) associated with internet <br>addiction. CONCLUSION: This study's greater incidence of IA could have detrimental effects on people's social, <br>mental, and physical well-being in addition to financial ramifications</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 ASSOCIATION OF EFFECTIVE COMMUNICATION BARRIERS WITH SOCIO-DEMOGRAPHIC CHARACTERISTICS OF NURSES WORKING AT A TERTIARY CARE HOSPITAL IN KARACHI. 2024-05-09T13:34:00+05:00 Naseer Ahmed1, Tanseer Ahmed2, Rashid Hussain3, Bahadur Ali4, Inayatullah5 <p>BACKGROUND: Good communication between healthcare professionals and the patients can positively lead to<br>a successful treatment. Moreover, the quality of nursing care is highly needed for the well-being of patients, which<br>can only be achieved if the patients are satisfied with the nurses’ interaction and care provided. OBEJCTIVE: To<br>determine the association of demographic characteristics with effective communication barriers among nurses<br>working at a tertiary care hospital in Karachi. METHODS: This analytical cross-sectional study was conducted<br>through adopting purposive sampling among nurses working at Dr. Ruth Pfau Civil Hospital Karachi from 1st<br>September 2019 to 31st December 2019. An ethical approval was obtained, and a written informed consent was<br>obtained from each participant of the study. The data were collected by using demographic information sheet and<br>a Likert-scale tool including 44 questions related to barriers of effective communication among nurses. The SPSS<br>Version-23 was used for data analysis. Frequency and percentages were used for demographic variables.<br>Furthermore, a Mann-Whitney and Friedman tests were used to check the association between demographic<br>characteristics and barriers of effective communication. RESULTS: A total of 213 samples of nurses were<br>included in this study with a mean+SD of age was 30.49±8.65. Moreover, 69.0% of the participants were male<br>and 57.3% were married, 58.6% holding Diploma education, 34.7% were found with professional experience<br>between 3-5 years, 55.3% had regular job and 69% had rotations in nature of duty. The study results showed that<br>there were no significant mean differences found in number of barriers with respect to gender, nature of job and<br>nature of duty. However, a significant association was observed with respect to marital status p=0.01, education<br>p=0.01, and professional experience p=0.001 of the study participants. CONCLUSION: The findings of this<br>study suggest that marital status, education level and professional experience play a significant role in shaping<br>communication barriers. Strategies and interventions designed to meet the particular needs of nurses based on<br>their demographic characteristics can be developed to mitigate these barriers and enhance communication skills<br>in nursing practice.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 THE DUAL CHALLENGE: EXPLORING THE ASSOCIATION BETWEEN DYSLIPIDEMIA AND THYROID HORMONE IMBALANCE IN TYPE-II DIABETIC PATIENTS. 2024-05-09T13:30:22+05:00 Farheen Shaikh1, Shafaq ansari2, Tazeen Shah3, Qurat ul Ain4, Faryal Adnan5, Mujhaid Ali Chandio6 <p>ABSTRACT<br>BACKGROUND: Diabetes Mellitus (DM) is a major worldwide public health issue. The thyroid hormone, <br>including T3 and T4, controls how the body utilizes energy. It is also crucial in managing your weight, body <br>temperature, muscle strength, and mood. METHODOLOGY: This cross-sectional analysis encompassed 190 <br>participants, utilizing a non-probability convenience sampling method to categorize them into three groups: <br>healthy individuals, those with thyroid disorders, and individuals with Type 2 Diabetes Mellitus (T2DM). <br>Recruitment occurred in the Medicine department of Jamshoro/Hyderabad, where participants were selected based <br>on a pre-designed form and provided both verbal and written informed consent. Data analysis involved the use of <br>ANOVA Post hoc (Tukey test) for group comparisons (P&lt;0.05) and the Chi-square test for assessing frequency <br>data. RESULTS: Significant alterations were observed in the lipid profiles, fasting blood glucose, and HbA1c <br>levels across both genders when compared to the control group, with a notable difference (p&lt;0.001). In a study <br>examining thyroid hormone levels, the differences in T3, T4, and TSH levels among normal healthy males, obese <br>individuals, and those with Type 2 Diabetes Mellitus (T2DM) were found to be statistically significant. <br>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 <br>obese and T2DM subjects, respectively (P&lt;0.05). T4 levels showed a similar pattern, with healthy males at <br>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&lt;0.05). <br>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 <br>for the case groups, again showing significant difference (p&lt;0.05). CONCLUSIONS: This study found that <br>cholesterol and LDL levels were adversely affected in individuals with T2DM and those with thyroid conditions. <br>However, no link was found between thyroid dysfunction and variations in insulin levels or blood sugar profiles. <br>It was determined that dyslipidaemia plays a role in the development of T2DM and thyroid issues.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 FREQUENCY OF FACTORS LEADING TO UMBILICAL PORT INFECTION IN PATIENTS UNDERGOING ELECTIVE LAPAROSCOPIC CHOLECYSTECTOMY. 2024-05-09T13:38:40+05:00 Muhammad Imran Khan1, Zia Ullah2, Muhammad Farhan Khan3, Shahzeb Khan4, Izaz Ullah5, Nayab Aziz Khan6, Tayyab Afareen7 <p>BACKGROUND: According in a significant way to laparoscopic surgery (LS), occasionally referred to <br>as the least invasive treatment, modern attentive attention has undergone a paradigm shift. The goal of this <br>study was to determine if any variables that contribute to umbilical port contamination in patients <br>undergoing elective laparoscopic cholecystectomy procedures will reoccur. MATERIAL AND <br>METHODS: From December 16, 2020, to June 15, 2021, descriptive cross-sectional research was <br>conducted at the surgical department of the Khyber Teaching Hospital in Peshawar. A total of 233 <br>individuals who met the criteria for cholecystectomy and showed signs of the condition underwent <br>laparoscopic cholecystectomy. Umbilical port contamination-causing variables were noted and examined <br>using SPSS Version 16. RESULTS: A total of 233 individuals who had cholecystectomy signs underwent <br>treatment. With a range of 18 to 60, the normal age was 42.96 years + 12 SD. The ratio of women to men <br>was 1.94:1. 167 patients (71.7%) were obese, 144 patients (61.8%) had a medical procedure performed on <br>them, and 147 patients (63%) were being treated by less experienced experts. CONCLUSIONS: The junior <br>laparoscopic surgeon, weight, and the length of time spent on a medical operation are the risk factors for <br>umbilical portsite illness.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 EXPLORING JAK2 GENE MUTATION (V617F) THROUGH REAL TIME PCR IN POLYCYTHEMIA VERA PATIENTS IN KPK. 2024-06-03T08:25:49+05:00 Sumbal Hussain1 , Sajid Ali2 , Sajjad Gul3 , Afaq Ahmad4 , Fakhrealam5 , Muhammad Nouman6 , Maryam7 <p>BACKGROUND: Polycythemia Vera (PV) is a chronic myeloproliferative neoplasm, the condition arise when<br>the excessive number of red blood cell produced within the bone marrow due to the mutation occurs at the myeloid<br>stem cells in protein named JAK2 kinase particularly within JH2 domain. A somatic point mutation occurs in the<br>JAK2 gene on chromosome 9 due to the transversion of G-C to T-A which develops the replacement of valine by<br>phenylalanine at codon 617. According to the WHO JAK2 V617F is responsible for about 95% of PV cases. The<br>annual incidents for Polycythemia Vera are 1-3 individual per 100,000 populations. The aim of the study was to<br>investigate the prevalence of the JAK2 gene mutation by using Real-Time PCR among the suspected PV patients<br>in Khyber Pakhtunkhwa, providing visions into the frequency of this mutation within the province. METHODS:<br>A total of 300 blood samples were collected from suspected PV patients and various screening test were conducted<br>to confirm the diagnosis, including: Hematologic parameters such as Red blood cell count (RBCs), Hemoglobin<br>level (HB), Hematocrit (HCT) and total leukocyte count (TLC) were measured. Peripheral blood smear were<br>examined to detect the abnormalities in the morphology of red blood cell, differential eosinophil and basophil<br>counts and presence of blast as well. Bone marrow aspirate and biopsy samples were obtained and examined to<br>assess cellularity, panmyelosis, megakaryocyte morphology, erythroid and myeloid series cells, bone marrow<br>eosinophilia, bone marrow iron stores, and reticulin fibrosis grade. Genomic DNA was extracted from the<br>collected blood samples using the MN kit. Real-Time PCR analysis was then performed to detect the JAK2 V617F<br>mutation, a hallmark of PV. This molecular analysis provided confirmation of PV diagnosis and enabled precise<br>identification of individuals carrying the JAK2 mutation. RESULTS: Among the suspected patients, 211 were<br>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<br>(95%) of the confirmed PV patients. CONCLUSION: In our study, we consider Real-Time PCR as a sensitive<br>and accurate method for detecting the JAK2 V617F mutation in Polycythemic (PV) patients based on its<br>demonstrated performance in previous studies and its widespread adoption in clinical laboratories. The high<br>prevalence of this mutation, detected in nearly 95% of PV cases, highlights its significance in the pathogenesis of<br>the disease within the Khyber Pakhtunkhwa population.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 SOCIO-DEMOGRAPHIC FACTORS OF STROKE PATIENTS FOR DELAYING IN HOSPITAL ARRIVAL. 2024-05-09T14:29:54+05:00 Khadim Ali Majeedano1 , Shefa Lakho2 , Muhammad Siddique Rajput3 , Sikandar Ali Siyal4 , Jawed Hussain Lighari5, Mir Tahir Hussain Talpur6 . <p>BACKGROUND: Stroke has a major impact on morbidity, mortality and on economics, particularly of <br>underdeveloped countries. The pre-hospital delays i.e. delay before the patient reaches the hospital and <br>thrombolytic treatment are the two main factors affecting the stoke patients morbidity and mortality. The objective <br>of this study was to determine the sociodemographic factor associated with delayed hospital arrival of such <br>patients. MATERIAL &amp; METHODS: This cross sectional study on 200 diagnosed patients of stroke with both <br>genders was conducted in Neurology OPD and Medical wards of PMC hospital Nawabshah. The information <br>regarding the socio-demographic factors involved in delayed hospital arrival of these stroke patients were <br>documented in the predesigned Questionnaire and statistical analysis was done. RESULTS: The mean age of the <br>participants was 58.9 years and stroke was three times more common im males as compared to females. Majority <br>of the participants were belonging to lower class 157 (78.5%) and 74.5% participants were Illiterate. Out of total <br>200 patients 67% were hypertensive and approximately 30% patients had history of diabetes. History of Ischemic <br>Heart Disease found in 32(16%) patients. 161(80.5%) participants 0ut of total 200 reached to the hospital after 6 <br>hours being diagnosed or suspected. Older age of patients, marital status, ethnicity, occupation, failure to recognize <br>stroke symptoms and decision taken for shifting the patients to hospital were the factors which were found in our <br>study regarding delayed hospital arrival of stroke patients. CONCLUSION: Our study concluded that most of <br>the factors which lead to delay in hospital presentation were modifiable and interventions by the concerned health <br>authorities may have a positive effect on the time taken to report to the hospital.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 BLOOD TRACE ELEMENT (ZINC) ESTIMATION IN PATIENTS OF VIRAL HEPATITIS C, LIVER CIRRHOSIS AND HEPATOCELLULAR CARCINOMA IN TERTIARY CARE HOSPITALS OF PESHAWAR 2024-05-09T13:59:03+05:00 Mohibullah Khan1 , Shabir Ahmed Orakzai2 , Aurangzeb Khan3 , Munaza Khattak4 , Younas Khan5 , Fatima Daud6 <p>BACKGROUND: Recent years have shown a significant prevalence of liver ailments in Pakistan, particularly in</p> <p>Khyber Pakhtunkhwa. Therefore, our aim is to investigate the relationship between blood trace elements and</p> <p>cirrhosis, hepatocellular cancer, and the Hepatitis C virus. Primary objective of this study is to explore blood zinc</p> <p>levels in patients with hepatitis C, liver cirrhosis and hepatocellular carcinoma. METHODS: The Khyber</p> <p>Teaching Hospital (KTH) and other partners collaborated with Lady Reading Tertiary Hospital to undertake this</p> <p>two-year descriptive cross-sectional study. For this research we selected 90 patients having cirrhosis,</p> <p>hepatocellular carcinoma or chronic hepatitis C. We equally divided our participants into 3 groups. Group I was</p> <p>allocated to patients with hepatitis C virus, group II had cirrhosis patients and group III consisted of hepatocellular</p> <p>carcinoma cases. Results were analyzed by using SPSS version 24. ANOVA test was applied. Significance level</p> <p>was set as p&lt; 0.05. RESULTS: Comparison of zinc trace element between the three groups reported significant</p> <p>statistical differences. We observed a high ratio of zinc in Hepatitis C patients whereas a low level of zinc was</p> <p>found among the cirrhosis and HCC patients. Regarding age, we only found a significant relationship between the</p> <p>adult age group (41-50 years) with the blood zinc levels. CONCLUSION: Zinc plays an anti-cancerous role for</p> <p>cirrhosis, HCC, and HCV. Our study concluded that the reduction in the zinc element triggered many liver</p> <p>complications. Hepatitis C virus becomes more active when the zinc ratio increases.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 INSTITUTIONAL BASED FREQUENCY OF DIFFERENT TYPE OF NEOPLASIA OF FEMALE GENITAL TRACT 2024-05-09T14:10:20+05:00 Zia Ullah1 , Shehzad Faiz2 , Muhammad Imran Khan3 *, Jawad Farooq4 , Izaz Ullah5 , Sibghat Ullah <p>Objectives: To Determine the frequency of different types of female genital tract neoplasia in our local population <br>of KPK, Pakistan METHODS: This retrospective study was carried out between January 1, 2014, and December <br>31, 2018. The information was gathered from the pathology lab's histopathological records at Peshawar Medical <br>College and North West General Hospital in Peshawar. The SPSS 19.0 program was used to record and analyse <br>all pertinent data. RESULTS: This study comprised 1039 female patient cases across all age groups. The most <br>often impacted organ was the uterus (83.6%), which was followed by the ovary and fallopian tube. Leiomyoma <br>was the most prevalent benign neoplasia lesion, followed by endometrial polyps, whereas endometrial carcinoma <br>was the most common malignant neoplasm. Ninety-one instances were malignant, while 948 were benign. The <br>age range of 41 to 50 had the highest frequency of neoplasia. Peshawar reported the highest number of cases <br>(33%). CONCLUSION: The most frequent benign tumour in the female genital tract, according to our data, is <br>leiomyoma, whereas the most prevalent malignant tumour in our community is ovarian cancer. The study's <br>findings indicate that incidence rises with age.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 PREVALENCE OF UROPATHOGENIC BACTERIA AND THEIR ANTIBIOTIC SUSCEPTIBILITY PATTERN AMONG DIABETIC AND NON-DIABETIC PATIENTS IN DISTRICT MARDAN. 2024-05-09T14:13:38+05:00 Umar Aziz1 , Obaid Ullah2 , Shafiq Ur Rehman3 , Umar Farooq4 , Muhammad Haris5 , Muhammad Hilal Jan1 , Muhammad Awais7 , Hidayat Khan 8, <p>BACKGROUND: Urinary tract infections are a common bacterial condition that can affect individuals <br>of all ages caused by uropathogenic bacteria. OBJECTIVE: To find out the incidence of uropathogenic <br>bacteria and their antibiotic resistance in people with diabetes and non diabetics at District Mardan. <br>METHODS: Five-month prospective cross-sectional research work was done at Mardan Medical <br>Complex, Mardan. Urine samples are taken and subjected to microbiological analysis. Antibiotic <br>susceptibility was performed through Kirby-Bauer technique. RESULTS: Among the population <br>urinary tract infections (UTI) were 17.0% with diabetes and 14.0% without diabetes respectively. <br>Prominent isolated bacteria were E. coli, which accounted for 82.35% of individuals with diabetes and <br>57.1% of non-diabetes respectively. CONCLUSION: It highlights the importance of detection and <br>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 <br>District Mardan</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 FETO-MATERNAL OUTCOME OF EARLY DIAGNOSED GESTATIONAL DIABETES MELLITUS AT PEOPLE UNIVERSITY OF MEDICAL & HEALTH SCIENCES 2024-05-09T14:15:47+05:00 Amber Abbasi1 , Mumtaz Begum Phul2 , Bushra3 , Naila4 , Shahneela Karim5 , Raishem Ali6 , Naseem Mallah7 . <p>BACKGROUND: Diabetes Mellitus is one of the most well-known clinical problems experienced alongside <br>pregnancy. Clinical acknowledgment of it is significant in light of the fact that opportune mediation by dietary <br>measures and additionally insulin can lessen the notable maternal and fetal difficulties related to it. OBJECTIVE: <br>To determine the feto-maternal outcome of early diagnosed gestational diabetes mellitus at People's University of <br>Medical &amp; Health Sciences. STUDY DESIGN: descriptive cross sectional. METHODOLOGY: We conducted <br>this study in the Department of Obstetrics &amp; gynecology PUMHS Nawab Shah for a period of six months from <br>July to December. The data on singleton pregnant women after 24 weeks was analyzed for gestational diabetes <br>and its consequences on feto-maternal health. Demographic characteristics and complications related to <br>gestational diabetes were recorded on structured proforma and analysis was done on SPSS version 25. RESULTS: <br>This study shows that GDM seems to be more prevalent in un-booked patients and with a history of GDM (63.6%) <br>in previous pregnancy. The mean age observed was 30.6 years ± 6.729 standard deviation, GDM was most <br>prevalent in parity between 2-4 (47.3%), &amp; in those who belong to urban, 58.2% had normal BMI &amp; 23.6% had <br>&gt;30 BMI, 43.6% showed polyhydramnios on the scan. Among these patients, 43.6% underwent cesarean section <br>while 36.4% delivered vaginally. 12.7% had placental insufficiency, around 50% delivered at term and 27.3% <br>were postdated. 7.3% experience PPH, 3.6% develop septicemia &amp; wound gap. 10.9% develop preeclampsia. 8 <br>newborns needed NICU admission &gt;24 hours, 3 had developmental defects, 7 had respiratory problems, 10 <br>developed hypoglycemia, around 38 babies had weight between 2.5 to 4.5, 10 had &gt;4.5 kg &amp; 7 had &lt; 2.5kg. out <br>of 55, 48 babies were alive &amp; healthy, 3 died in the first 7 days of life (2 with congenital anomaly), and 2 feti died <br>in utero. CONCLUSION: After conducting a review, we found that the occurrence of GDM is 11% in PUMHS <br>Pakistan. It is crucial to analyze and manage gestational diabetes (GDM) properly to prevent dangerous <br>consequences. Policymakers should prioritize addressing this issue, and pregnant women should schedule regular <br>antenatal visits.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 FETOMATERNAL OUTCOME IN TEENAGE TERM PREGNANCY 2024-05-09T14:17:51+05:00 Maria Pervaiz1 , Saima Khattak2 <p>BACKGROUND: Teenage pregnancy, involving women aged 13-19 years, is prevalent in developing <br>countries like Pakistan due to early marriages, low socioeconomic status, and illiteracy. OBJECTIVE <br>OF THE STUDY: The study's objective was to assess the outcomes for both the mother and the fetus <br>in teenage term pregnancies. METHODOLOGY: The Department of Obstetrics and Gynecology at <br>Lady Reading Hospital in Peshawar conducted this cross-sectional study. The study included 246 <br>adolescent patients who were pregnant and between the ages of 12 and 19 with primary gravida and <br>gestational ages greater than 28 weeks. The statistical analysis software SPSS version 21.0 was used to <br>analyze the data. RESULTS: Age range in this study was from 12 to 19 years with mean age of <br>17.451±1.25 years, mean parity 0.000±0.00, mean gestational age 34.512±2.18 weeks and mean BMI <br>was 24.390±1.18 Kg/m2. PPH was observed in 10.6% patients, Tears 15.4%, Low Birth Weight 11.8%, <br>Still Birth 3.3%, Low Apgar Score 19.9% and NICU Admission was 13.4%. CONCLUSION: This <br>study demonstrated that low birth weight, stillbirth, low Apgar score, and NICU hospitalization are big <br>issues for babies born to adolescent mothers, while PPH and tears are issues for adolescent pregnant <br>women. The government should raise the legal marriage age, enhance education, offer excellent <br>nutrition, prenatal checkups, psychological care, and promote contraception to prevent underage <br>marriages</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 SERUM FERRITIN AND C-REACTIVE PROTEIN A CONFIDENT BIOMARKER IN COVID-19 PATIENTS. 2024-05-09T14:35:16+05:00 Abid Ali1 , Sohaib2 , Sami Ullah3 , Muhammad Zeeshan4 , Asad Khan5 , Ashfaq Ahmad6 , Hammad Ullah7 , Abid Rahman8 , Muhammad Abbas9 , WasimMuhammad10 <p>BACKGROUND: Since its initial report in Wuhan, China in December 2019, COVID-19 has spread <br>throughout the world, with 80,651 cases and 3070 deaths. OBJECTIVE: This study investigates the <br>correlation between C reactive protein (CRP) and serum ferritin in predicting disease severity in COVID-19 <br>patients. CRP and ferritin levels were correlated with disease severity. MATERIAL &amp; METHODS: With a <br>sample size of 213, this cross-sectional analytical investigation was carried out at the Khyber Teaching Hospital <br>in Peshawar, KP, Pakistan. The study included COVID-19 positive patients aged 18 and above, both males and <br>females. RESULTS: The study found a negative relationship between disease and CRP and serum ferritin levels. <br>As CRP and ferritin levels increase, then it indicating a severe state. Mean serum ferritin level is 1348.50 ng/ml, <br>CRP level is 102.1518mg/ml, and mean age is 57.41 years. CONCLUSION: According to the results of this <br>investigation, serum ferritin levels and CRP may be crucial markers of the severity and course of COVID-19</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 CONTINUATION RATE OF IMMEDIATE POSTPARTUM INSERTION OF INTRAUTERINE CONTRACEPTIVE DEVICE. 2024-05-09T14:22:54+05:00 Sadia Baig1 , Saima Khattak2 * <p>BACKGROUND: Contraception methods are designed to prevent undesired pregnancies on a temporary or <br>permanent basis. An intrauterine contraceptive device such as Cu-T-380A offers contraception for a duration of <br>up to 10 years. Traditionally, the initiation of postpartum birth control has been postponed until the 6-week <br>postpartum visit. Women are typically advised to abstain from sexual activity until the 6-week postpartum period <br>as part of their discharge instructions from the hospital. OBJECTIVE: To determine the frequency of <br>continuation rate of postpartum insertion of intrauterine contraceptive device in women delivering at Lady <br>Reading Hospital, Peshawar. STUDY DESIGN &amp; SETTING: Descriptive study conducted at the Department of <br>Obstetrics and Gynecology, Lady Reading Hospital, Peshawar. METHODOLOGY: The study was conducted <br>between September 1, 2021, and February 28, 2022. A total of 104 pregnant women who were counseled for <br>(PPIUCD) insertion during antenatal care or early labor and expressed willingness to have an IUD inserted after <br>delivery were recruited for the study. Participants were followed up at six weeks and six months postpartum.<br>RESULTS: The continuation rate of postpartum insertion of the intrauterine contraceptive devices was noted. <br>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 <br>age was 38.61±1.20weeks. The continuation rate of IUD was observed in 91.3% of patients. CONCLUSION: In <br>conclusion, the findings of this study indicate highly satisfactory continuation rates for PPCuIUD at 6 months. <br>The research explores recent developments that have expanded accessibility to all intrauterine devices (IUDs) and <br>provides detailed descriptions of each IUD's features. Despite the notable increase in IUD usage, potential <br>complications related to IUD placement may still arise. Therefore, ongoing updates on strategies to mitigate these <br>IUD-related issues are essential.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 IRON DEFICIENCY ANEMIA IN CHILDREN WITH WORM INFESTATION. 2024-05-09T14:24:57+05:00 Inam Ullah1 , Qassim Khan2 , Samad3 , Muhammad Fazil4 , Kiramat Ullah5 , Muhammad Qasim Khan6 , Habib ur Rehman7 <p>BACKGROUND: Intestinal worm infestations are common in tropical and subtropical regions, particularly in <br>areas marked by poverty and inadequate sanitation. Intestinal worms affecting around two billion people, consists <br>of soil-transmitted helminth infections. The primary species responsible for these infections include Ascaris <br>lumbricoides, Trichuris trichiura, and Necator americanus/Ancylostoma duodenal. OBJECTIVE: To determine <br>the frequency of iron deficiency anemia in children with worm infestation. METHODS: This cross-sectional <br>study was conducted in department of Pediatrics, Mardan Medical Complex, Medical Teaching Institution, <br>Mardan. This study was conducted from 1st November 2021 to 1st April 2022. A total of 133 children of both <br>gender with worm infestation were included in the study. Collected a blood sample and shipped to laboratory to <br>look for iron deficiency anemia set per one of the criteria of iron deficiency anemia. RESULTS: Age range in <br>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 <br>duration of complain was 3.052±1.35 months. Male patients were 68.4% and females were 31.6%. Iron deficiency <br>anemia was observed in 20.3% patients. CONCLUSION: To conclude, Iron deficiency anemia was observed in <br>20.3% children with worm infestation. This has to be addressed since parasite infections may harm children's lives <br>in more ways than simply anemia and can set the stage for other illnesses as well. To halt the emergence and <br>spread of such diseases, parents and educators should work together to encourage children to practice preventive <br>and sanitary practices.<br><br></p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 COMPARISON OF EARLY RECURRENCE IN PILONIDAL SINUS FOLLOWING EPSIT TECHNIQUE VERSUS OPEN EXCISION. 2024-05-09T14:26:49+05:00 Shahzeb Khan1 , Muhammad Arsalan Khan2 , Zia Ullah3 , Naveed Ullah4 , Wahaj Ayub5 , Subhanullah6 , Izaz Ullah7 <p>BACKGROUND: Pilonidal sinus, a frequently occurring and recurring disease, poses a complex <br>predicament for both patients and healthcare practitioners. OBJECTIVE: To compare early recurrence in <br>pilonidal sinus following EPSiT technique versus Open excision. MATERIAL &amp; METHODS: This <br>controlled trial study was conducted on 60 patients presenting with pilonidal sinus, patients undergoing EPSiT <br>technique were place in group “A” while patients undergoing open excision will be placed in group “B”. Early <br>recurrence was compared between both groups. RESULTS: Group A was 37.27±12.48 years. In Group B, the <br>average age was 40.10±11.23 years. The occurrence of early recurrence in group A was considerably lower <br>compared to group B (P = 0.004). CONCLUSION: EPSiY technique was more effective with significantly <br>lower incidence of early recurrence as compared to open excision in pilonidal sinus (P = 0.004).</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024 ADVANCEMENT IN DIGITAL RADIOGRAPHY: ENHANCING IMAGE QUALITY AND RADIATION DOSE OPTIMIZATION. 2024-05-09T14:28:19+05:00 Farah Kalsoom1 , Shalmeen Tariq2 , Komal Mushtaq3 , Umaima Zafar4 <p>BACKGROUND: With improved exposure optimization and higher image quality, digital radiography <br>technology has revolutionized medical imaging in recent years. The primary goal of this study is to <br>determine how digital radiography has advanced through the optimization of radiation dose and image <br>quality. METHODOLOGY: From June 2023 to December 2023, the Chaudhry Pervaiz Elahi Institute <br>of Cardiology in Multan was the site of this prospective observational study. Data were collected from <br>100 patients. Patients undergoing X-ray, CT scan, fluoroscope and any other radiation and imaging <br>technique were included in the study. Those who do not want to participate were excluded from the <br>study. Demographic data, imaging techniques, medical history and all related information were included <br>in a designed questionnaire. RESULTS: Information was gathered from 100 patients in the hospital's <br>outpatient department. For high-resolution images, digital radiography achieved 90%, which is much <br>greater than the 40% obtained with traditional radiography. In a similar vein, digital radiography fared <br>better than conventional techniques, achieving an improved contrast of 80% as opposed to traditional <br>radiography's 30%. The average radiation dose in digital radiography was significantly lower than in<br>traditional radiography, at just 0.1 mGy as opposed to 0.2 mGy, or a 50% reduction. Furthermore, digital <br>radiography reached 95% compliance with the ALARA principle, indicating that it can reduce patient <br>radiation exposure while preserving diagnostic image quality. CONCLUSION: Compared to <br>conventional radiography techniques, digital radiography advances provide significant advantages for <br>improving image quality and minimizing radiation exposure.</p> 2024-03-31T00:00:00+05:00 Copyright (c) 2024