2024-03-28T10:59:11Z
https://annalskemu.org/journal/index.php/annals/oai
oai:ojs2.localhost:article/3
2022-09-12T07:54:35Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/3
2022-09-12T07:54:35Z
King Edward Medical University
Vol. 14 No. 4 (2008); 129
Approach to Managing Diabetic Foot Complications. A Study of 200 Cases
Khan, Ahmad Hassan
Bajwa, Ghulam Rasool
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/3
en_US
Objective: Diabetic foot complications result mostly from uncontrolled diabetes and it has become an increasingly significant public health concern in both developed and developing world. The aim of this study was to evaluate the surgical management in diabetic foot patients presenting with different complications. Design: A descriptive study. Place & Duration of Study: From April 2007 to March 2008 for a period of one year in Surgical unit I at DHQ Hospital Sargodha. Patients & Methods: This descriptive study was conducted on a total of 200 diabetic patients with different severity of foot infections who presented in causality and surgical outpatient department in DHQ Hospital Sargodha. Patients under the age of twelve years were excluded from this study; it included patients of both sexes. A detailed history was taken followed by the clinical examination. Routine investigations including complete blood examination, complete urine examination, renal parameters, X ray foot, CXR, ECG and pus for culture and sensitivity were recorded. Lesions were graded according to Maggit Wagner classification and appropriate medical and surgical treatment was carried out. Results: This study was carried out on 200 diabetic patients, out of which one hundred and sixty (80.0%) were male and forty (20%) were female. Male to female ratio was 4:1 Majority of the patients (n=116) were between the age group of 50 to 60 years. In majority of these patients forefoot was involved, mostly big or little toe. Patients were grouped into five grades according to the severity of infection. Forty three (21.5%) patients were managed with antibiotics and dressings, ninety seven (48.5%) patients needed debriedment and skin grafting while sixty (30.0%) needed amputations of different types. Staphy-lococcus aureus was the commonest organism isolated. Conclusion: There is a high occurrence of foot ulcers with in the population of people with diabetes. Majority of the diabetic foot lesions in our study were in grade II to V. lesser grade lesions responded well to conservative management with anti-biotics, dressings and debriedment. While those with higher grades needed amputations. In order to diminish the detrimental consequences associated with diabetic foot, a high standard of care must be provided. Delayed and improper treatment leads to osteomyelitis resulting in amputation and permanent disability or deformity. Key Words: Diabetic foot disease, Infection, Complication.
oai:ojs2.localhost:article/4
2022-09-12T07:54:35Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/4
2022-09-12T07:54:35Z
King Edward Medical University
Vol. 14 No. 4 (2008); 133
Sonographic Accuracy in Determining Acute Appendicitis in the Children in a Tertiary Care Hospital
Qazi, Abdus Sami
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/4
en_US
Objective: The purpose of this study was to determine the accuracy of sonographic diagnosis in patients with suspected acute appendicitis in a tertiary care hospital, utilizing commercially available 3.75 MHz curved array probe. Most of the stu-dies on this subject have used high frequency probes and therefore report very high sensitivities and specificities. Material and Methods: 220 paediatric patients (range 3-14 years, mean age 11.3 years) attending the Emergency Depart-ment Of Lahore General Hospital Lahore with clinical suspicion of acute appendicitis were evaluated by the author. Children with vague abdominal pain or without suspicion of acute appendicitis were not in included in the study. Four criteria i.e. enlarged appendix (diameter more than 6 mm), lack of compressibility, a blind ending loop without peristalsis and localized fluid collection were taken into consideration before declaring a patient to be having acute appendicitis. Results: Sonography confirmed the diagnosis in 39 out of 54 patients whereas 15 patients, falsely reported to be normal on sonography, were found to be having acute appendicitis on surgery. False positive diagnosis was made in 6 patients, all of whom underwent appendectomy. 160 patients declared normal on sonography proved to be normal on observations during hospital stay and follow up. Sensitivity of 72% achieved in this study was lower than reported in current literature employing high frequency probes. Specificity 96%, accuracy 91%, negative and positive predictive values of 92 and 87% respectively fall within described range of quoted results. Conclusion: Though sensitivity achievable with the medium frequency ultrasound probe is a little lower than that declared in recent similar studies, author believes that given the availability of this probe and considering the cost effectiveness, use of standard commercially available 3.75 MHz probe is quite effective in making a diagnosis of acute appendicitis and should be encouraged so that a sizeable portion of unnecessary appendectomies can be avoided. Key words: Acute appendicitis, sonography, children, tissue harmonic imaging.
oai:ojs2.localhost:article/5
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/5
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 138
Histo-Pathological Study: Skin Cancer Varieties Due to a Compound of Coal Tar & of Vinegar
Ahmad, Tauqir
Aziz, Nasar
Ahmad, Azhar
Mughal, Muhammad Sharif
Ullah, Aziz
Khan, Nawab Muhammad
Khalid, Atiya
Ahmed, Farooq
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/5
en_US
Objectives: To see skin cancer varieties due to coal tar & vinegar, the present studies, using mice as a model, evaluated histo-pathological and certain biochemical changes induced in skin by repeated topical application of their compounds, DMBA and TPA. Materials & Methods: Hundred mice distributed into four groups of twenty five mice each were utilized. Two separate control groups were maintained. In the first experimental group, DMBA alone and in the second experimental group, TPA after single application of DMBA were applied on the skin of mice. Histo-pathological characterizations and cellular DNA, RNA and proteins molecules concentrations’ estimation of the lesion’s cells were evaluated through the comparative optical density change of the absorbance for DNA, RNA and Proteins molecules of different samples with that of their control throughout this twenty weeks study. Results: It was observed that the repeated application of DMBA alone and repeated application of TPA after single application of DMBA produced both epidermal and dermal tumours like papilloma, dysplasia, keratoacanthoma, squamous cell carcinoma in situ, extensive squamous cell carcinoma, and fibrosarcoma. The malignant varieties of skin tumors were 30 % more with the repeated application of DMBA alone than that by repeated application of TPA after single application of DMBA. The statistical analysis of cellular DNA, RNA and proteins concentrations estimates were found comparatively significant in experimental groups. Conclusion: The contact of DMBA (a compound of coal tar) can act as initiator as well as promoter for skin tumourigenisis. Abbreviations: ¤ DMBA (Dimethyl Benz anthracene) is derived from anthracene i.e. poly-aromatic hydrocarbon found in commonly used coal tar.¤¤ TPA (tetradecanyl phorbol acetate) is derived from acetate that is salt or ester of ethanoic acid manufactured by oxidation of ethanol and commonly used for production of vinegar.
oai:ojs2.localhost:article/6
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/6
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 143
Kinetics and Kinematics of Loading Response in Stroke Patients (A Review Article)
KEMU, Mudassar Ahmad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/6
en_US
With the advancement in the field of assessment and treatment individualization, gait analysis is considered a routine matter in the health care settings during rehabilitation of walking. Gait analysis refers to the specialized assessment of walking which includes past medical history, objective examination of various characteristics of gait and the impact of disease on the pattern of walking. Kinematics and kinematics are the most useful parameters used to assess the disabilities associated with gait cycle. Infrared video cameras are normally used during gait analysis to define the three dimensional positions and movements of various lower limb joints. By analysing the kinetics and kinematics of the loading response; an important phase of the gait cycle, various deficits can be assessed in stroke patients including decreased musculoskeletal coordination, weakness and spasticity of the lower limb muscles. The detailed assessment of the kinetics and kinematics during loading response can enable the physiotherapists and rehabilitation specialists to design better treatment programs for the Neuro compromised stroke patients. This review article will address the kinetics and kinematics during loading response in stroke patients, but the technique can be used in a number of conditions. Key Words: Loading response, kinetics and kinematics, gait analysis
oai:ojs2.localhost:article/7
2022-09-12T07:54:36Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/7
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 148
Etiology, Presentation and Management of Liver Abscesses at the Children’s Hospital Lahore
Cheema, Huma Arshad
Saeed, Anjum
2010-02-28
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/7
en_US
Background: Liver abscess is a common problem among children. The purpose of this study is to describe the etiology, different management strategies and outcome of children with liver abscess in Children’s Hospital Lahore. Patients and Methods: This study included 38 children with liver abscess seen during two-year period, from September 2004 to September 2006 at the Children’s Hospital and Institute of Child Health, Lahore. Diagnosis was made on history, examination and investigations. Ultrasound and CT scan were the main diagnostic tools. Results: Out of 38 patients, 33 children underwent aspiration and remaining 5 were managed conservatively. Eight aspirates yielded positive culture for various organisms. Three patients were positive for E.Coli, 2 for Staph Aureus, and 1 each case of Klebsiella and Pseudomonas. One patient had multiple micro-abscesses and was also positive for typhidot IgM. Another patient was positive for acid fast mycobacterium tuberculosis. All patients recovered from their abscesses. There was no mortality reported. Conclusions: In our pediatric population, liver abscess are mostly caused by pyogenic organisms. Amebic etiology was not proven in any case. Majority of liver abscesses can be satisfactorily treated by aspiration and /or percutaneous image guided drainage with satisfactory outcome. Key Words: Liver abscess, children.
oai:ojs2.localhost:article/8
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/8
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 151
Neurosarcoidosis: Stranger Than Fiction
Bilal, Muhammad
Syed, Adeel
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/8
en_US
Please refer to the full text.
oai:ojs2.localhost:article/9
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/9
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 154
Fetus Papyraceous : Rarity Among Rarities
Rasheed, Farhat
Amjad, Nazia
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/9
en_US
A 28 years old G3 P2 A0 with previous two cesarean sections presented for routine antenatal care at 10 weeks of gestation. She had family history of twin pregnancy in her real sister. Ultrasonography showed viable monochorionic, diamniotic twin gestation. She was advised regular antenatal visits. Ultrasound at 16 weeks showed intrauterine death of one of the fetuses with normal growth parameters of the second twin. Vigilant feto-maternal monitoring was done throughout the rest of her pregnancy and elective Cesarean section at 38 weeks yield a male baby of 3.4 kg. Examination of the placenta showed two cords one of which was attached to fetus papyraceous. Key Words: Twin pregnancy, Fetus Papyraceous, Vanishing twin.
oai:ojs2.localhost:article/10
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/10
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 156
Anorexia Nervosa in a Pakistani Adolescent Girl A Case Report with Literature Review of Anorexia Nervosa in Asia
Imran, Nazish
Ashraf, Asma
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/10
en_US
A case of Anorexia Nervosa in a Pakistani Adolescent girl is reported. This is in the background of impression that due tochanges in cultural norms and concepts of feminine beauty, illnesses previously thought to be rare in Asian societies might bebecoming more prevalent. Various similarities to presentation of Anorexia Nervosa in western countries were found. A briefoverview of Anorexia Nervosa in Asia is also described.
oai:ojs2.localhost:article/11
2022-09-12T07:54:36Z
annals:ED
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v2
https://annalskemu.org/journal/index.php/annals/article/view/11
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 14 No. 4 (2008); 125
Basic Guidelines for Data Analysis Technique(s)
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/11
en_US
oai:ojs2.localhost:article/12
2022-09-12T07:54:36Z
annals:ED
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v2
https://annalskemu.org/journal/index.php/annals/article/view/12
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 44
The Planning, Organization, Management and Quality Assurance of National Education Systems
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/12
en_US
oai:ojs2.localhost:article/13
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/13
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 48
Association of Type 2 Diabetes Mellitus with Biometric Variables: A study in Sir Ganga Ram Hospital, Lahore
Hussain, Seemeen
Hussain, Iram
Sana, Bushra
Waheed, K
Qaisera, Saleema
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/13
en_US
Introduction: Diabetes mellitus is closely linked to obesity as measured by body mass index (BMI) and is especially related to abnormal fat distribution as indicated by an increased waist/hip ratio and waist/thigh ratio. Central obesity is known to be associated with diabetes mellitus type 2; however limb circumferences may also have a strong association. Objective: To compare various biometric variables in type 2 diabetics and non-diabetics. Design: Cross-sectional analytical study. Place and Time: Once a week, Outpatient Clinic, Department of Internal Medicine, Sir Ganga Ram Hospital, Lahore, from June 2007 to June 2008. Statistical Tests: SPSS 12 (Statistical Package for Social Sciences) used. Includes student’s t-test and logistic regression analysis. Methodology: One hundred and sixty type 2 diabetics out of which eighty eight are women are compared with one hundred and fifty non-diabetics matched for age, sex and socioeconomic status. Diabetics in this study are known diabetics and those with 2 hour post-prandial blood glucose levels in excess of 140mg/dl. Anthropometric measurements, including waist, hip, thigh, calf and upper arm circumferences, BMI, waist/hip and waist/thigh ratios, of all subjects were taken and the student’s t-test was applied to find out if they were significant differences between the measurements in diabetics and non-diabetics. Logistic regression analysis was used to show association of these biometric variables/anthropometric measurements with blood glucose levels. Results: The mean blood glucose level in the diabetics group is 251mg/dl, with mean duration of disease more than five years. Type 2 diabetes mellitus is associated with thinner thighs and calves in both men and women (p value < 0.05). On regression analyses a negative association of thigh and calf circumference is demonstrated with high blood glucose. Thigh and calf measurements show an inverse linear correlation (r = - 0.45) and (r = - 0.68) respectively. The coefficient of determi-nation (r2 = 0.2 and r2 = 0.5) suggests that thigh and calf circumferences have a 20% and 50% dependence on blood sugar respectively. Diabetic biometric measurements were found to be: mean waist circumference of 102 ± 16 cm in men and 92 ± 16 cm in women, mean BMI of 28 ± 5 kg/m2 in men and 28.7 ± 7 kg/m2 in women and mean waist/hip ratio of 0.99 and 0.93 in men and women respectively. However there was no significant difference in waist, hip circumference, body mass index, waist/thigh and waist/hip ratio between diabetics and non-diabetics. Discussion: Our focus is on how the biometric measurements of diabetics differ from non-diabetics in the South Asian population. The significant inverse relationship between thigh and calf circumference and high blood glucose level can be used as an observational clinical screening tool to quickly identify patients with poorly controlled blood sugar in a typical out-patient setting. Further study is required to determine whether these biometric changes are due to the diabetes itself; or whether having a certain body shape predisposes to diabetes mellitus; and also whether these changes can be reversed with good glycemic control. Conclusion: In our study sample type 2 diabetes mellitus is associated with significantly thinner thighs and calves than non-diabetes whereas central adiposity is prevalent in both diabetics and non-diabetics. Key Words: Type 2 diabetes mellitus, biometric variables, anthropometric measurements, BMI, thigh, calf, waist, waist/hip ratio. waist/thigh ratio.
oai:ojs2.localhost:article/14
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/14
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 54
Histopathological Evaluation of 432 Cases of Goiter
Rehman, Aman Ur
Lodhi, Sidrah
Anwar, M Imran
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/14
en_US
Background: Classically, multinodular goiter (MNG) has been considered to be a safer form of goiter with minimal risk of malignancy. However, recent literature advocates that prevalence of malignancies in solitary thyroid nodule (STN) and MNG is comparable. Objective: To ascertain the frequency and pattern of malignancy in MNG and STN. Materials and Methods: It was a prospective study conductive from Feb 2006 to Nov 2008 in histopathology department at Shaikh Zayed Hospital Lahore. In this period, 432 cases including 310 cases of MNG and 122 cases of STN who underwent thyroid surgery were studied. Histopathology was carried out following surgery in all these cases. Histological diagnosis in each case was analyzed. Results: Among 310 cases of MNG, 12 (3.87%) were malignant and M:F was 2.53:1. Out of 122 cases of STN, 14 (11.47%) cases were found malignant with M:F of 1:1.76. Conclusion: The prevalence of malignancy in STN is higher than that in MNG; however, multinodularity should no longer be considered as an indicator of benign disease. Surgical intervention should be considered in all cases of nodular goiter. Key Words: Solitary Thyroid Nodule, Multinodular Goitre, Papillary Carcinoma.
oai:ojs2.localhost:article/15
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/15
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 57
Morphological Pattern of Posterior Cranial Fossa Tumors
Rehman, Aman Ur
Lodhi, Sidrah
Murad, Sohail
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/15
en_US
Background: Posterior cranial fossa tumors are potentially fatal tumors since they can result in brainstem compression. These tumors constitute 54-70% 0f childhood brain tumors and 15-20% of adult brain tumors. Objective: To analyze the histological types and to determine the frequency of posterior cranial fossa tumors in children and adults at INMOL hospital Lahore. Method: It was a retrospective study in which 62 consecutive cases of posterior cranial fossa tumors were studied from Feb’2008 to Nov’2008. In this period, files of patients presenting with posterior cranial fossa tumors were retrieved from hos-pital record. The data of patients along with histopathological reports were studied. Results: Among 62 patients, 43 (69.35%) were male and 38 (61.29%) patients were adult. The morphological distribution of the posterior cranial fossa tumors was as follows: Meningioma – 7 cases (11.2%), Schwannoma – 12 cases (19.3%), Acoustic Neuroma – 20 cases (32.25%), Medulloblastoma – 9 cases (14.5%), Pilocytic Astrocytoma – 2 cases (3.22%), high grade Astrocytoma – 3 cases (4.83%), Metastatic carcinoma – 5 cases (8.06%) and malignant round blue cell neoplasm – 4 cases (6.45%). Conclusion: Acoustic neuroma was the commonest benign tumor and medulloblastoma was found to be the predominant malignant tumor in this study. Medulloblastoma was also seen the commonest posterior cranial fossa tumor in children. Key Words: Meningioma, Acoustic Neuroma, Medulloblastoma, Astrocytoma.
oai:ojs2.localhost:article/16
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/16
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 60
Assessment of the Vitamin D Levels in the Patients Presenting with Different Medical Conditions and its Correlation with Symptomatology
Haque, Israr ul
Salam, Tanvir us
Hussain, Muhammad
Iqbal, Waseem
Zafar, Shumail
Tayyab, Ghias-un-nabi
Javed, Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/16
en_US
Background: Vitamin is the important micronutrient that acts like hormone and its deficiency is related to various diseases1. Limited Data is present for the Pakistani population for vitamin D. Objectives: Assess the vitamin D levels in the patients presenting with different medical conditions and its correlation with symptomatology. Methods: We randomly took 400 patients visiting the outpatient department for the various diseases and complaints. They were asked about various complains, diet, drugs and food fortification. Blood samples for the vitamin D was collected and results were analyzed statistically. They were divided into four grades; Normal (30-100 ng/ml), Mild deficiency (20-29 ng/ml), Severe deficiency (less than 20 ng/ml) and Toxic levels (more than 100 ng/ml).the correlation between vitamin D levels and symptomatology was also calculated. Results: Out of 400 patients, 304 (76%) were female and 96 (24%) were male. Mean value for the vitamin D was 20.70 (for male 20.50 and for female 20.20). Mean value for the age was 45.50. Among 400 subject, 53 (13.25%) had normal values, 80 (20%) had mild deficiency and 264 (66%) had severe deficiency, where as 3 (0.75%) were having toxic levels. The frequency of major symptoms was Generalized body weakness 360 (90%), Bone and joint pains 88 (22%), Diabetes 64 (16%), history of Pathological fracture/falls 45 (11.25%), Depression/anxiety 240 (60%), Blood pressure 132 (33%), Hair loss 8 (02%), Shortness of Breath 60 (15%), Ch. Diarrhea 40 (10%), Weight loss 40 (10%), Fever 20 (5%). Almost all patients having severe deficiency were symptomatic 262 (99.2%). Conclusion: Pakistani Urban, Well feed population is grossly deficient of vitamin D and majority of patients with severe deficiency are symptomatic.
oai:ojs2.localhost:article/17
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/17
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 64
Comparative Analysis between Weight Based Insulin (WBI) and Sliding Scale Insulin Orders
Salam, Tanvir us
Haque, Israr ul
Hussain, Muhammad
Iqbal, Waseem
Javed, Muhammad
Zafar, Shamail
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/17
en_US
Purpose: This evidenced based practice initiative was piloted on admissions to Medical and Surgical unit populations to evaluate the blood glucose control based on administration of insulin utilizing weight based order sets as compared to sliding scale insulin order sets. Design of study: Randomized selection of patients to receive either WBIO or Non-WBIO, National Hospital and Medical Center, Lahore, Pakistan. July to December of 2008. Material and Method: Patients with uncontrolled Diabetes Mellitus who were admitted to medical and surgical unit for all causes were inducted in the study except patients who were already under control on either Insulin or oral hypoglycemic agents. Finger stick glucometer reading were used and patients were randomized to be either on weight based insulin orders or Non-weight based insulin order, the order forms were freely available for use. Results: Over the period of 6 months 155 patients were assigned to receive WBIO and 154 were assigned to receive Non-WBIO. The patients were kept in the study for a maximum of 5 days. There was significant difference in episodes of Hyperglycemia more marked in patients receiving Non-WBIO versus WBIO. There was no significant difference in episodes of Hypoglycemia. Conclusion: WBIO had better glycemic control and equal hypoglycemic episodes as compare to Non-WBIO. Recommends usage of weight based insulin order sheets (WBIO) while the patients are hospitalized. Key word: WBIO (Weight Based Insulin Order), Non-WBIO (Non Weight Based Insulin Order).
oai:ojs2.localhost:article/18
2022-09-12T07:54:36Z
annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/18
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 68
Reasons for Non-Use of Contraception in Patients with Induced Abortion
Majeed, Tayyaba
Majeed, Naeem
Mahmood, Zahid
Habib, Sabahat
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/18
en_US
Introduction: Induced abortion is a dilemma for obstetricians working in developing countries. A vast majority of induced abortions are due to non use of contraception for a variety of reasons. Study Design: Descriptive, cross sectional. Materials and Methods: 32 married women who had induced abortions were from October 2006 to March 2007 were inter-viewed along their husbands. Spontaneous miscarriages, therapeutic terminations and illegal pregnancies were excluded. Results: Frequency of induced abortion was 5% of total deliveries. 93.7% of the cases were illiterate and belonged to low socioeconomic class. 43.7% cases were managed by TBAs, 25% by LHVs and 31.2% by doctors. Reasons for non use of contraception included failure of method (37.5%), husband dislike (25%), fear of side effects (12.5%), lack of access (6.25%), lack of awareness (6.25%) and misconceptions (6.2%). Contraception failure was more common in cases with condom use (50%), followed by withdrawal method (33.3%) and IUCDs (16.7%). In 87.5% cases, both partners were invol-ved in decision making. Discussion: Conclusion: Non use and less effective methods of contraception lead to unwanted pregnancies and hence induced abor-tions. Measures should be taken to prevent unwanted pregnancies. Key Words: Induced abortion, contraception, family planning.
oai:ojs2.localhost:article/19
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annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/19
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 2 (2009); 71
Radiological Pattern of Pulmonary Tuberculosis in Diabetes Mellitus
Qazi, Masroor Ali
Sharif, Naveed
Warraich, Mustansar Mahmood
Imran, Ali
Haque, Israr ul
Haque, Mazhar ul
Gardezi, Muhammad Arshad
Chaudhary, Ghulam Muhyuddin
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/19
en_US
Background: Tuberculosis is one of the most serious public health problem globally. About one third of the population has been infected with mycobacterium tuberculosis. Post primary tuberculosis has been classically considered as a disease causing patchy opacity or with cavitatory or calcified lesion, in one or both upper lung lobes. On the other hand, diabetes mellitus is also a major public health problem. Worldwide prevalence of diabetes is 4%, while in Pakistan prevalence of diabetes is 4.5 - 11% making Pakistan 6th in world ranking of diabetes mellitus prevalence. When two diseases are common, these can effect each other in terms of clinical presentation and course of the disease. In pulmonary tuberculosis with diabetes mellitus radiological pattern of may be different from patients without diabetes mellitus. Objective: To determine the radiological pattern of pulmonary tuberculosis in diabetes mellitus. Study Design: A prospective-observational study. Place of Study: The study was conducted in B.V. Hospital, Bahawalpur. Duration of Study: The study was conducted from January 2004 to December 2006. Material and Methods: One hundred and fifty patients with diabetes mellitus (both type 1 and type 2) and pulmonary tuberculosis were included in the study. Pulmonary tuberculosis was diagnosed on the basis of AFB positive sputum, history and radiological findings suggestive of pulmonary tuberculosis. Two physicians (including one chest physician) and a radiologist reviewed the chest radiographs. Those x-rays were selected in which there was no difference of opinion. Diabetic patients were either known diabetics or they were newly diagnosed based on WHO criteria. Results: A total of 150 patients were analyzed in which there was 105 were male and 45 females. The age range was 18 years to 75 years. The mean age was 49.81 and standard deviation was +12.28. Out of 150 films 69 (46%) showed the typical pattern (patchy infiltration / nodular pattern with or without cavitation) involving upper zone. While 81 (54%) pts showed the atypical pattern with lower lung field involvement. Out of 150 films, in 84 right lung was involved, in left lung about 39 and bilateral lesion found in 27 films. In 75 films x-rays showed non homogeneous opacity, cavity in 31 and homogeneous shadows in 22 and multiple shadows in 22 films. Among lower lung field involvement with pulmonary tuberculosis 50.6% were above the age of 50 years. Conclusion: Atypical pattern of pulmonary tuberculosis is the common mode of presentation in elderly and diabetic patients. Keywords: Pulmonary tuberculosis, Diabetes Mellitus, Typical pattern, Atypical pattern.
oai:ojs2.localhost:article/20
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/20
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King Edward Medical University
Vol. 15 No. 2 (2009); 75
Clinical and Echocardiographic Predictors of Left Atrial Thrombus in Rheumatic Mitral Stenosis
Ali, Muzaffar
Abid, Abdul Rehman
Mallick, Nadeem Hayat
Sheikh, Saqib Shafi
Ahmad, Sajjad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/20
en_US
Objectives: To evaluate various clinical and echocardiographic predictors of left atrial (LA) thrombus in patients with severe mitral stenosis and to determine the utility of transesophageal (TEE ) as compared to transthoracic echocardiography (TTE) in detection of thrombus in LA. Place and Duration of Study: Department of Echocardiography and Out Patient Department of Punjab Institute of Cardiology, Lahore from January 2007 to April 2007. Study Design: It was an observational analytical study. Patients and Methods: In this study left atrial (LA) thrombus and spontaneous echo contrast were evaluated by both TTE and subsequent TEE in 100 patients with rheumatic mitral stenosis. The study population was divided into two groups: Group I consisted of 38 (15.2%) patients having thrombus in LA and Group II consisting of 212 (84.8%) patients with no thrombus in LA. Various clinical and echocardiographic variables were compared in these two groups. Results: Two hundred and fifty consecutive patients having tight rheumatic mitral stenosis were studied. The mean age of the study population was 26.9 ± 7.5 years. There were more female 128 (51.2%) patients than males 122 (48.8%). Atrial fibrillation (AF) was present less frequently in the study as 33 (13.2%) patients had AF as compared to 217 (86.8%) patients having sinus rhythm. AF was more significantly associated with thrombus formation with 23 (60.5%) patients having thrombus as compared to 15 (39.5%) patients in sinus rhythm having thrombus p < 0.0001. Thrombus in LA was more commonly visualized on TEE as compared to TTE (X2=242.3, p=0.0001) and was mostly detected in left atrial appendage (X2=211.2, p=0.0001). Spontaneous echo contrast was visualized more frequently on TEE as compared to TTE in both the groups p<0.001. Conclusion: TEE is better than conventional TTE in detecting left atrial thrombi in patients with severe mitral stenosis having AF. Patients with rheumatic mitral stenosis having atrial fibrillation, large left atrial size and old age are more prone to have LA thrombus. Key Words: Atrial thrombus, transesophageal echocardiography (TEE), transthoracic echocardiography (TTE).
oai:ojs2.localhost:article/22
2022-09-12T07:54:36Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/22
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 1
The Planning, Organization, Management and Quality Assurance of Health Care Systems
Awais, Syed Muhammad
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/22
en_US
oai:ojs2.localhost:article/23
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/23
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 5
Seroprevalence of Surrogate Markers for Hepatitis B, Hepatitis C and HIV in Healthy Blood Donors at Shaikh Zayed Medical Complex, Lahore
Shah, Shahida Amjed Riaz
Ehsan, Ayesha
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/23
en_US
Introduction: This project was aimed to determine the seropositivity status for Hepatitis B surface antigen (HBsAg), antiHepatitis C (HCV) antibodies and antibodies to Human Immune Deficiency Virus (HIV) I and II in healthy blood donorsdonating blood at Shaikh Zayed Hospital Lahore.Material and Methods: The relevant data was collected during a period of 28 months from 1st January 2006 till 31st March2008. It was a cross sectional study which entailed screening of 60719 healthy donors. The donors were aged between 16years to 45 years. There were 93.43% males and 6.57% females.Results: The seroprevalence of Anti HCV antibodies was 3.870%; for HBsAg it was 1.407%; for HIV antibodies it was0.00658%. Our study demonstrated a higher seropositivity for HIV in healthy donor population than all of the previousreports except one with which it matched precisely. HBsAg showed a definite downwards inclination when compared withsimilar previous studies carried out in the last 7 years. Seroprevalence of anti HCV antibody was found to be similar whencompared with previous studies and demonstrated a higher trend in large cities with a multiethnic population.Key Words: MeSH: Blood donors, seroprevalence, HbsAg, antiHCV, HIV.
oai:ojs2.localhost:article/24
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/24
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 11
Assessment of Nutritional Status of Adolescent College Girls at Rawalpindi
Shahid, Afshan
Siddiqui, Farah Rashid
Bhatti, Mohammad Ayaz
Ahmed, Mahmood
Khan, Mohammad Wasif
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/24
en_US
Objectives: To assess the nutritional status of adolescent college girls by assessing the dietary intake in terms of carbohydrates,proteins, Estimating the hemoglobin levels in the study group and studying the clinical signs of malnutrition withspecial emphasis to vitamin A, iron and iodine deficiency.Design of Study: A cross-sectional study.Settings: Two Post-Graduate women colleges of Rawalpindi.Study Duration: 9 Months (From Jan 2006 to September 2006).Materials and Methods: Nutritional status of 508 adolescent girls was assessed with a questionnaire, clinical examinationand biochemical estimation (hemoglobin). The data thus collected was analyzed in July 2006 on computer with the help ofStatistical Package for Social Sciences (SPSS) and Excel.Results: Results revealed that 20%of girls were having BMI <18.5, 77% above 18.5% and 3% were obese. 57.09% of thegirls had goiter out of which 52.96% had palpable goiter and 4.13% had visible goiter. Pallor conjunctiva was seen in 1%girls. No clinical signs of Vitamin A deficiency were seen. Biochemical results indicated that 32.87% of the girls was sufferingfrom Iron deficiency anemia.Conclusions: Large longitudinal and cross-sectional studies, regarding nutrient consumption, dietary habits and nutritionalintervention are required in the adolescent girls. These studies can be thought provoking for the policy maker at thegovernment level. Nutritional education and health promotion can be used as tool to improve the health status of the nation.Key Words: Adolescent Health, Nutrition, Nutritional Assessment.
oai:ojs2.localhost:article/25
2022-09-12T07:54:36Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/25
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 17
Clinical Pattern of Urinary Stone Disease in Our Setting
Memon, Jan Muhammad
Athar, M. Amin
Akhund, Anwar Ali
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/25
en_US
Objectives: To study the basic clinical pattern of urinary stone disease in our setting.Study design: Descriptive study.Setting: Department of surgery of Nawabshah Medical College Nawabshah over a period of 4 years between August 2003to August 2007.Subjects: A total of 257 urolith patients with different stone burden enrolled in the study.Methodology: Structured and standardized history and clinical investigations collected in all of urolith patients. Thediagnosis of stone disease was based on history, physical examination followed by KUB x-ray, ultrasonography and IVU .Allpatients subjected to open stone surgery. The data were analyzed prospectively with outcome measures of gender, stonelocation, clinical presentation and operative procedures.Results: Out of 257 patients 181 (70.42%) were male and 76 (29.56%) female with male to female ratio of 2.3:1.The ageranged from 1 year to 80 with the mean of 25.8 years. The peak incidence of upper urinary tract stones was in 20-30 yearswhile lower urinary tract stones in both sexes were under 10 years (Table 1). Anatomical distribution of stone showed 116(45.16%) renal, 21 (8.17%) ureteric, 108 (42%) bladder and 12 (4.66%) urethral calculi (Table 2). The commonest clinicalpresentation was that of pain in 67.31% of patients associated with haematuria in 26.7% of cases. Clinical urinary tractinfection (UTI) was in 15% and 8.9% of patients had spontaneous stone passage (lithuria). The symptoms of bladder outletobstruction (BOO) including retention of urine were in 7% of cases. Calculus anuria was in 1.9% of cases and 8.1% patientshad asymptomatic stones. Bilithiasis (chole-nephrolithiasis) was in 5% of cases (Table 3). Open stone surgery included 84(32.68%) simple pylolithotomies, 15 (5.83%) extended pylolithotomies, 6 (2.33%) pylolithotomy and pyloplasty, 5 (1.94%)nephrolithotomy, 6 (2.33%) nephrectomies, 21 (8.17%) uretrolithotomy, Cystolithotomy was 113 (43.96%) cystolithotomy, 2(0.77%) urethrolithotomy and meatotomy in 5 (1.94%) of patients.Conclusion: Urolithiasis is increasing problem with high frequency of bladder stones and male predominance in our part ofSindh province. Open surgery is still needed to treat the patients where modern and minimally invasive therapeutic modalitiesare out of reach and non-availability in public sector. Establishment of modern stone clinics in rural setup is the need oftoday’s medical practice.Keywords: Urinary calculi, Clinical profile, Open stone surgery.
oai:ojs2.localhost:article/26
2022-09-12T07:54:36Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/26
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 21
Extracorporeal Shockwave Lithotripsy: Initial Experience at Bahawalpur
Rasool, Mumtaz
Tabassum, Shafqat Ali
Sheikh, Abid Hameed
Mumtaz, Fariha
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/26
en_US
Place of Study: American Kidney Stone Centre (AKSC), Bahawalpur, a private setup.Duration of Study: January 2005 to June 2007.Design of Study: Prospective, Observational.Material & Methods: A total of 250 patients were evaluated for ESWL results. The one session comprised of 1500-2500shocks with intermittent fluoroscopy with X-Ray focusing. A period of 7 – 10 days was given between two sessions. Theprocedure was repeated till the clearance of stone no matter what was the number of sessions. The complications like pain,colic, hematuria were addressed adequately and immediately. The development of steinstrasse was initially observed and fewrequired manipulation. The stone size is the only matter of concern in few patients especially lower pole stones.Results: The stone clearance was achieved in 89% of patients. Auxillary procedures were required in 10.8% before ESWLand 9.6% of patients after ESWL. Which include Endoscopic stenting and manipulation with uretero-renoscopy andintracorporeal lithotripsy. Prophylactic insertion of DJ stenting reduced complication rate and incidence of steinstrasse.Conclusion: ESWL can be safely recommended for patients of urolithiasis irrespective of age and stone size with promisingresults of stone clearance and patient acceptance.Key Words: ESWL-Extracorporeal shock wave lithotripsy, URS-Ureterorenoscopy. ICL-Intracorporeal lithotripsy.
oai:ojs2.localhost:article/27
2022-09-12T07:54:36Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/27
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 27
The Versatility of Temporalis Muscle Flap in Reconstruction of Maxillofacial Region Defects
Ahmad, Shakeel
Warriach, Riaz Ahmad
Abid, Hina
Ali, Sadiq
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/27
en_US
Introduction: The temporalis muscle flap is an axial pattern flap based on the anterior and posterior deep temporal arteries.It is most commonly utilized after maxillectomy. The temporalis flap splits into anterior and posterior halves, or the entiremuscle used as a flap.Objectives: The purpose of this study was to: 1. Evaluate the esthetic and functional outcome by using temporalis muscleflap for reconstruction of intraoral defect. 2. Assess the effectiveness of temporalis muscle flap in intraoral defects.Study Design: It was a Descriptive studySetting: The study carried out at department of Oral and Maxillofacial Surgery King Edward Medical University / MayoHospital Lahore.Subjects and MethodsDuration: The study was completed in six months from 1st June 2005 to 30th Nov 2005.Sample size: 30 patients who presented with intraoral defect were included in this study.Sample Technique: Nonprobability Sampling (Purposive).Results: Success rate was ninety percent in this study. Failure of flaps encountered in 10% cases especially in older andimmunocompromised patients.Conclusions: Temporalis muscle flap is a good choice for most of the intraoral defects especially those in palatal and buccalregion.Key Words: Temporalis muscle flap, Palatal reconstruction, oral cavity, Mucosalisations.
oai:ojs2.localhost:article/28
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/28
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 31
Evaluation of the Treatment of Frozen Shoulder by Hydraulic Distention Under
Ghauri, Shakeel Khan
Anwar, Muhammad Aftab
Hanif, Asif
Akram, Muhammad
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/28
en_US
Objective: To evaluate the result of treatment of frozen shoulder by Hydraulic Distention under local anesthesia with steroid and intra-articular steroid alone. Study Design: It was a prospective and comparative study. Samples size: 60 patients were taken in this study and were divided into two groups. Duration and Setting: The study was conducted in 2000 - 2001 treated in the department of Orthopaedic, Mayo Hospital Lahore. Methodology: The patients were divided into two groups. Group-I were treated by hydraulic distension of glenohumeral joint with 50 ml normal saline under local anesthesia with steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Patients in group-II were treated by intra-articular steroid followed by medicines (oral analgesics and muscle relaxants) and exercises. Results: The average age of patients in group I was 52 ± 2.16 years and 50 ± 2.03 in group II. There were 37 (63%) females and 22 (37%) males in our study. Female to male ratio was 1.7:1. All patients in group-I noted immediate pain relief with excellent return of range of motion (ROM) and resumption of normal sleep. At the end of 45 days of follow up all patients had returned to their normal daily activities. Most of them got excellent ROM and pain relief. All patients in group-II noted immediate pain relief and resumption of almost normal sleep. At the end of 45 days of follow up most of the patient presented with good relief of pain but could not return to most of their normal activities because of less improvement in ROM. Conclusions: Hydraulic distension technique is a quick, safe and gives early results, so it should be considered first for the treatment of frozen shoulder. Key Words: Frozen Shoulder, Hydrologic Distention, Intra articular steroid.
oai:ojs2.localhost:article/29
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/29
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 35
Perinatal Outcome in Pregnancies Complicated by Isolated Oligohydramnios at
Umber, Aneela
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/29
en_US
Objective: To determine the perinatal outcome in pregnancies complicated by isolated oligohydramnios at term. Study Design: Comparative / Cohort study. Place and Duration of Study: This study was carried out in Unit-III at Sir Ganga Ram Hospital, Lahore from 14-05-2002 to15-06-2003. Patients and Methods: During this study 500 patients with singleton pregnancy were selected and Amniotic Fluid Index (AFI) was evaluated within 4 days of delivery in these patients with technique of Phelan et al. All selected outcome variables of these pregnancies were recorded on printed proformas. On the bases of AFI measurements patients were divided in two groups. Those who have AFI > 50 mm and < 50 mm. The significance of difference or comparison of means was measured by Chai square test (by Yats corrections). Perinatal outcomes in pregnancies with oligohydramnios were compared with those with normal amniotic fluid volume. Results: The selected outcomes showed significant variations in both groups. The statistical significance was present between advanced gestational age, presence of meconium, deceleration of fetal heart rate and chances of caesarean delivery. There were increased chances of induction of labor (41% Vs 22%) and caesarean delivery (32% Vs 23%) in oligohydramnios group. Conclusion: Oligohydramnios is associated with an increased risk of caesarean delivery for fetal distress and perinatal morbidity. Key Words: Isolated Oligohydramnios, perinatal outcome.
oai:ojs2.localhost:article/30
2022-09-12T07:54:36Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/30
2022-09-12T07:54:36Z
King Edward Medical University
Vol. 15 No. 1 (2009); 38
Knowledge, Attitude and Practices of the Mothers and Doctors Regarding Feeding,
Seyal, Tallat
Hanif, Asif
2010-03-05
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/30
en_US
Introduction: Since it’s a common observation that most cases of acute diarrhea are not managed according to WHO guidelines. Irrational use of drugs is a major problem of present day medical practice, as well as use of ORS is underesti-mated. The mothers /grand mothers reduce or stop feeding(except for breast feeding) do not know the importance of fluid therapy or ORS and cannot prepare ORS properly. This study was designed to know the exact situation. Objective: To assess the knowledge, attitude and practices of the mothers and doctors in acute diarrhea in children ≤ 5 years of age about feeding, preparation and use of oral rehydration solution (ORS) and drugs. Design: Cross Sectional. Place and duration: ORT corner of Pediatric OPD at Sir Ganga Ram Hospital, Lahore from May, 2007 to September, 2007. Patients and Methods: Nine hundred and fifty children under 5 years of age having acute diarrhea were included in the study. Data was collected on a specified questionnaire by a doctor who entered the required information after interviewing the mothers/grandmothers accompanying the children. The information was collected regarding use of ORS and who prescribed, or they already had knowledge that it should be given, how to prepare ORS, whether or not continued feeding and used drugs during current acute diarrhea episode. The data was entered and interpreted as frequency distribution. Results: ORS was used (given) by only 464 (49.67%) of the mothers, out of which 125(27%) used it by their own know-ledge (through newspaper, television, told by neighbours or previous consultation by the doctor). 400 (42.82%) mothers knew about preparation of ORS. Feeding was continued by 697 (74.62%) of the mothers and 400 (42.82%) used drugs, prescribed by general practitioners, medical officers of government hospitals, few by paediatrician and self during acute diarrhea. Conclusion: It is concluded that ORS was given by 49.67% of the mothers, 42.8% could prepare it properly, feeding was stopped/reduced/diluted by 25% of the mothers. Drugs were used in 42.82% of the cases. Diarrhea control programme needs to be reinforced to improve existing practices regarding management of acute diarrhea in children ≤ 5 years of age. Inappro-priate use of drugs during diarrhea should be discouraged. Key Words: ORS(oral rehydration solution), acute diarrhea, ORT( oral rehydration therapy).
oai:ojs2.localhost:article/36
2022-09-12T07:54:37Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/36
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 15 No. 2 (2009); 80
Comparison of the Response of Oxytocin Versus Prostaglandin E2 Vaginal Pessary for Labour Induction in Prelabour Rupture of Membranes
Amjad, Nazia
Rasheed, Farhat
Imran, Tayyaba
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/36
en_US
Objective: To compare the response of oxytocin versus prostaglandin E2 vaginal pessary for labour induction in prelabour rupture of membranes at term in primigravida patients with poor Bishop score. Design: It was a prospective comparative study. Setting: The study was conducted in the department of Gynae & Obs, Ittefaq hospital (Trust), Lahore during a period of one year i.e from July 2007 to June 2008. Patients and Methods: Fifty primigravidae with prelabour rupture of membranes at term having Bishop score < 5 or 5 were randomized into 2 groups to undergo induction of labour with either oxytocin or prostaglandin E2 vaginal pessary. Main outcome measures were induction-initiaton of labour interval, induction-delivery interval, maternal complications during induction, mode of delivery, fetal outcome and total hospital stay. Results: The induction-initiation of labour interval (P=0.005), duration of improvement in Bishop score, induction-delivery interval (P=0.011) and total hospital stay (P=0.018) were shorter in PGE2 induced patients. Moreover, majority of the patients delivered vaginally, had no maternal complications, did not require augmentation of labour, had less evidence of fetal distress (P=0.011) and better APGAR score at birth in this group. Majority of the neonates in the 2 groups did not require admission in neonatology unit (P=0.666). Conclusion: Prostaglandin E2 vaginal pessaries are very safe and effective to stimulate labour with ruptured membranes and poor Bishop score.
oai:ojs2.localhost:article/37
2022-09-12T07:54:37Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/37
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 15 No. 2 (2009); 85
Operated and Non Operated (Neglected) Fracture Neck of Femur Treated With Intertochanteric Osteotimy
Ghauri, Shakeel Khan
Akram, Muhammad
Hanif, Asif
Shah, Asif Ali
Siddique, Kashif
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/37
en_US
Back Ground: The non union of femoral fracture is a vital problem in young patients. The salvage procedures and ortho-clastic are unsatisfactory in theses patients. Methods to achieve osteosynthesis are more biological. Methods: We included a series of 14 patients from June 2001 to June 2005 in Mayo Hospital, Lahore. Patients were pre-viously treated by quacks and in some patients failure of previous fixation was seen. Results: A total number of 14 cases of fracture neck of femur were studied. In which 10 cases were previously treated by quack and 4 cases presented with failure of fixation. In this study there were 14 patients (eight males and 6 females). The average age of patients was 30 years (14-50 years). Average duration of fracture was 7 months (2 months - 4 years) with Pauwel angel of 32.8. Conclusion: Three cancellous screw fixations with molded and angled narrow DCP plate valgus osteotomy, autogenous bone grafting round the fracture gives good outcome in neglected fracture neck of femur if done properly.
oai:ojs2.localhost:article/38
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/38
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 15 No. 2 (2009); 88
Surgical Aspects and Outcomes of Kidney Transplantation with Multiple Renal Arteries
Jafri, Syed Saleem Abbas
Younas, Muhammad
Chughtai, Muhammad Nawaz
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/38
en_US
Aim: To evaluate the effect of multiple renal artery presence on the success and complication rate of renal transplantation. Patients and Methods: Between January, 1990 and June 2008, 1250 live donor kidney transplants were included in the study. Among the 1250 kidney transplants, there were 930 males and 320 females. We divided the study population in two groups according to their vascular reconstruction: Group A: 1130 grafts with a single artery. Group B: 120 grafts with multi-ple arteries. Intracorporeal in situ anatomotic techniques were used for 100 grafts with multiple arteries, while ex-vivo anas-tomotic techniques were used for 20 patients. We compared the incidence of post transpolant hypertension, acute tubular necrosis, acute rejection, vascular and urological complications, mean creatinine level at 1 and 5 years post transplant and patient and graft survival. Results: The patient and graft survival were comparable in group A and group B. The two groups were omparable regarding complication, including arterial bleeding, hematoma, renal artery stenosis, acute rejection, new onset hypertension, acute tubular necrosis and urological complications. Mean serum creatinine at 1 year was higher in group B than in group A (1.6 + 0.7 versus 1-3 + 0.5 mg/dl). However, this mean serum creatinine level was comparable in two groups at 5 years. Graft and patient survival and the incidence of the described complication were comparable for the ex vivo bench anastomotic tech-niques and intracorporeal in situ technique in group with multiple renal arteries. Conclusions: Although the kidney grafts with multiple renal arteries have been considered a relative contraindication beca-use of increase risk of complications, allografts with multiple arteries were used successfully in kidney transplantation in our study. No significant difference has been observed between single and multiple renal arteries kidneys considering the success and complication rates of renal allotransplantation. Key words: Transplantation; Renal transplantation; arteries.
oai:ojs2.localhost:article/39
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/39
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 15 No. 2 (2009); 93
HIV/AIDS Risk Behaviours Among Injecting Drug Users: Addressing Development of Risk Behaviour Knowledge and Patterns of Risk Behaviour Practices in Context of Demographic Characteristics
Maqsood, Niaz
Malik, Jamil Ahmad
Bhatti, Muhammad Riaz
Ahmad, Ishtiaq
Luqman, Shoaib
Niaz, Naima
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/39
en_US
Objectives: The present study is aimed to investigate patterns of HIV/AIDS risk behaviour practices (sexual and syringe sharing) among injecting drug users by addressing; 1. Factors effecting acquisition of risk behaviour knowledge, and 2. De-mographic and psychosocial characteristics influencing practice of risk behaviour knowledge. Design: This is a cross sectional study, patients admitted for treatment and rehabilitation from injecting drug abuse, were interviewed and statistical testing was conducted using SPSS 10.1 to identify critical factors of risk behaviour practices. Material and Method: 149 male injecting drug users were included in the present study; females were excluded due to in-significant representation. Patients were interviewed on a self-developed structured questionnaire for demographic and psy-chosocial characteristics and another structured questionnaire was used to obtain level of risk behaviour knowledge and frequency of risk behaviour practices. Place and Duration: The study was conducted at Model Drug Abuse Control Center (MDACC), a subdivision of Depart-ment of Psychiatry and Behavioural Sciences, Bahawal Victoria Hospital, Bahawalpur, a teaching hospital affiliated with Quaid-e-Azam Medical College. Results and Discussion: Present study investigated HIV/AIDS risk behaviour practices in injecting drug users. Results sho-wed that only two sources of knowledge Television and Print Media significantly influenced acquisition of risk behaviour knowledge (p=0.05). Among demographic characteristics, of IDUs and their access to sources of knowledge, only socio-economic status (p=0.01) and education (p=0.001) were associated with access to sources of knowledge. Finally, the study concerns with differences in demographic characteristics and their association to risk behaviour practices. Post Hoc analysis of demographic characteristics showed that only middle level of education predicted low syringe sharing risk behaviours with (Mean difference = -1.19, P =0.03). Sexual risk behaviour was predicted by marital status and Living status. Patients living alone showed higher levels of risk behaviour practices than patients living with parents (Mean difference = 1.61, P = 0.001) and patients living with family (Mean difference = 1.31, P =0.02). In addition, high frequency of injections predicted higher levels of risk behaviour practices. Conclusion: The study reveals some flaws in HIV/AIDS risk behaviour preventions programs, as more access to channels of sources didn’t predict low risk Behaviour. Serious efforts are required in awareness campaigns by considering specific needs of injecting drug users. Key Words: HIV/AIDS, Injecting Drug Users (IDUs), Sexual risk behaviours, Syringe sharing risk behaviours, and Demo-graphic and Psychosocial characteristics.
oai:ojs2.localhost:article/40
2022-09-12T07:54:37Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/40
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 82
Health and Biostatistics
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/40
en_US
oai:ojs2.localhost:article/41
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/41
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 86
Argyrophilic Nuclear Organiser Regions (AgNORs) Pattern in Different Grades of Transitional Cell Carcinoma of Urinary Bladder
Khan, Abdul Haseeb
Khan, Saeed Akhtar
Chaudhry, Naseer Ahmad
Tayyab, Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/41
en_US
Objective: To evaluate AgNOR count, size and pattern in different grades of transitional cell carcinoma. Design: Descriptive. Material and Methods: A total of fifty transurethally resected bladder tumour samples (TUR BT) were collected from Mayo Hospital, Lahore and Services Hospital, Lahore and processed for H & E and AgNOR stain. The grading of tumours were made on H&E stain. While AgNOR size, AgNOR count, pAgNOR and AgNOR dispersion were recorded for each case. Results: The AgNOR size in grade II was predominantly of 2+ while AgNOR size in grade III was predominantly of 3+.A significant higher proportion of cases (p < 0.02) with 3+ AgNOR dispersion were seen in grade III carcinoma. Conclusion: AgNOR size and AgNOR dispersion were found to be an easy and reproducible alternative to traditional AgNOR counts in grading of transitional cell carcinoma. The demonstration of AgNOR dispersion is also a simple and cost effective procedure. Key words: Nuclear organizer regions, Transitional cell carcinoma.
oai:ojs2.localhost:article/42
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/42
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 90
Open Reduction For Neglected Posterior Dislocation of The Elbow
Shah, Mohammad Ali
Gandapur, Ikram
Ahmed, Fraz
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/42
en_US
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 415 0;} @font-face {font-family:"ヒラギノ角ゴ Pro W3"; mso-font-alt:"MS Mincho"; mso-font-charset:128; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:1 0 16778247 0 131072 0;} @font-face {font-family:"\@ヒラギノ角ゴ Pro W3"; mso-font-charset:128; mso-generic-font-family:auto; mso-font-pitch:variable; mso-font-signature:1 0 16778247 0 131072 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"ヒラギノ角ゴ Pro W3"; color:black;} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> Objective: To evaluate results of open reduction in 9 patients with neglected posterior dislocation of elbow, regarding Range of motion (ROM), stability and pain. Type of study: Prospective descriptive study. Place and duration of study: District headquarter teaching hospital, Dera Ismail Khan. May 2005- May 2008. Materials and methods: A total of nine patients were included in study with mean age of 31 years (range 15- 55 years). Mean time since injury was 2.8 months (range 1- 7 months). Two patients had associated fractures around elbow. All the patients underwent open reduction using Speeds technique. Mean follow-up was 7.4 months (range 2.5-15 months) in which patients were assessed for pain, stability, range of motion (ROM) and ulnar nerve deficit. Results: All patients showed improved ROM irrespective of duration of dislocation. Mean movement gained was 89° (range 60°-110°). Patients presenting early had better results than those presenting late or with associated fracture. Two patients complained of mild pain after heavy load lifting. All elbows were stable and there was no infection or ulnar nerve deficit. Conclusion: Open reduction is simple and effective method to restore the joint to stable, pain free and functional state. Key words: Dislocated elbow, open reduction.
oai:ojs2.localhost:article/43
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/43
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 93
Effect of Olive Oil and Corn Oil (% Induced Hyperlipidemia State) in Aorta and Coronary Arteries of Albino Rats
Abro, Abdul Khaliq
Tayyab, Muhammad
Chaudhry, Naseer Ahmad
Bukhari, Mulazim Hussain
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/43
en_US
Background: The role of different oils play an important role for the development of atherosclerosis, and hyperlipidemia which is defined as an elevation of plasma lipids which include high level of plasma LDL. The low serum HDL is a powerful risk factor in CHD. The relation ship between the LDL and HDL in the development of CVD is of interest. The level of cholesterol fraction and the changes in aorta and coronary arteries are compared with control and experimental groups in this study. Methods: 48 albino rats of 32 week age, including equal number of male & female were kept at optimum atmospheric and hygienic conditions with food and water available at all times. A ventral mid line abdomino-thoracic incision was made after replacing the albino rats in the ether till death. Heart and aorta was then dissected out and biopsy specimen were kept in labeled jar for fixation, containing formaline and formal calcium. Results: A total 48, 32 weeks albino rats were studied for atheromatus changes in aorta and coronaries. The changes of control and experimental groups were compared. Conclusion: The current study shows that the groups which was given olive oil showed less atheromatus lesions as compare to the groups with corn oil. Thus olive oil has more beneficial potential then corn oil, and at least, it can be recommended for the high risk patients of ischemic heart disease.
oai:ojs2.localhost:article/44
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/44
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 100
The Versatility of Pectoralis Major Myocutaneous Flap in Head and Neck Reconstruction
Abid, Hina
Ahmad, Shakeel
Warraich, Riaz Ahmad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/44
en_US
Introduction: Although different flaps can be used for facial reconstruction but Pectoralis major myocutaneous flap is still considered the workhorse for maxillofacial reconstruction because of simple procedure and high success rate, while other flaps of facial region ranging from pedicled to free flaps require greater surgical skills along with unpredictable results. Objective: To find outcomes of Pectoralis major myocutaneous flap in reconstruction of middle and lower facial regions. Main outcome measures are vitality of the Pectoralis major myocutaneous flap, donor site morbidity and other complications. Study design: Descriptive study. Place and duration of study: Department of Oral & Maxillofacial Surgery, King Edward Medical University/ Mayo hospital Lahore, from April 2005 to June 2006. Patients and methods: This study was carried out on 30 consecutive patients who require soft tissue reconstruction of middle and lower facial regions. Vitality of Pectoralis major myocutaneous flap, donor site morbidity and other complica-tions were studied. Results: In this study, the success rate of was 100%. All of the flaps were vital but 13.3% of the flaps had partial loss of flap. Conclusion: Pectoralis major myocutaneous flap is a versatile flap as it can not only provide skin and mucosal cover simultaneously, but also provide adequate muscle bulk for through and through defects. It doesn’t cause any hindrance in mandibular movements, even when used over mandibular reconstruction plate. Keywords: Oral Reconstruction, Pectoralis major muscle, Myocutaneous flap, Axial pattern flap.
oai:ojs2.localhost:article/45
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/45
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 110
Cardiovascular Drug Interactions of Diclofenac and Dobutamine
Bhatti, Abdul Shabbir Ali
Zahid, Muhammad
Khan, Abdul Hameed
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/45
en_US
Objectives: To find the effects of diclofenac and dobutamine during myocardial ischaemia. Methods: The project has been designed to find out the individual and combined effects of diclofenac and dobutamine on the cardiovascular functions[Heart Rate, Blood Pressure and Coronary Blood Flow] and ECG Parameters (QRS complex, R wave and T wave) in the pentobarbitone anesthetized rabbits before and after coronary occlusion. Results: Diclofenac in the dosage of (500-750ug/kg/min) has stimulant effect on normal heart rate while after coronary occlusion heart rate is significantly suppressed with diclofenac in the dosage of (500-1000ug/kg/min). Moreover diclofenac resulted into suppression of normal blood pressure. After coronary occlusion the combined effect of diclofenac and dobuta-mine resulted into suppression of heart rate though not significant statistically. Diclofenac in the dosage of (250-1000ug/kg/ min) results into significant increase in the normal amplitude of R wave while T wave remains unaffected. Diclofenac with dobutamine after coronary occlusion also leads to significant widening of QRS complex. Conclusion: Diclofenac alone and with dobutamine after coronary occlusion not only slows down heart rate but also aggra-vates myocardial ischaemia. Key Words: Myocardial ischaemia (MI), NSAIDs, Coronary occlusion (C.O), Heart Rate (H.R), Mean Arterial Pressure (MAP), Blood Pressure (B.P).
oai:ojs2.localhost:article/46
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/46
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 119
Determinants of Wound Dehiscence in Abdominal Surgery in Public Sector Hospital
Afzal, Saira
Bashir, Muhammad Mustehsan
2010-04-01
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/46
en_US
Objective: The objective of this study was to find an association and prevalence of risk factors and wound dehiscence. Study design: Cross-sectional Study. Setting and Duration: Surgical unit IV DHQ hospital, Faisalabad. From January 2002 to June 2003. Material and Methods: Patients who under went exploratory laparotomy through vertical abdominal incisions with one or more risk factors. The main out come measures found significant were wound infection- sepsis, hypoprotinemia, diabetes mellitus, emergency surgery, steroid use and advancing age. Results: 430 patients under went laparotomy through vertical incisions during last one and half years. Complete record of all the patients was maintained on Proforma. Trained surgeons with latest recommended protocol closed their wounds by using monofilament nonabsorbable 1 gauge suture taking 1 cm bite from the edge with 1 cm interstitch interval. All risk factors were made measurable on bases of history, examination, and investigations. Patients were closely observed post operatively on day 3, 7, and 10, special attention being paid to development of wound infection or wound dehiscence. Out of 430 patients, 35 patients had acute wound failure. 32 patients had the catastrophe happening in emergency laparotomies where as only 3 cases were noted in elective laparotomies (P<0.001).In sub group of emergency laparotomies incidence was highest in cases of frank peritonitis (P<0.001). In studying risk factors in dehisced cases, 29 patients under going emergency laparotomy had intra-abdominal sepsis as compared to only one patient of the sepsis in elective laparotomy group (P < 0.001). Diabetes, steroid use, and advancing age were found as statistically significant risk factors only in cases of peritonitis and intra-abdominal sepsis. Conclusion: Wound sepsis is the single most important risk factor for wound dehiscence. All other risk factors contribute to the disaster by aggravating sepsis. Key words: Wound, dehiscence, laprotomy.
oai:ojs2.localhost:article/47
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/47
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 106
Association and Outcome of the Primary Repair of Obstetric Perineal Injuries
Saba, Naseem
Sultana, Anwar
Afridi, Mehnaz
2010-04-01
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/47
en_US
Objectives: To study the association and outcome of the primary repair obstetric perineal injures. Design: Cross sectional study. Methods: Patients presenting with third and fourth degree tears were included, factors associated with injures were studied. Primary repair was performed and outcome was looked after three months of repair. Results: Sixty Four (64) patients were studied in 18 months 59% were having their first pregnancy. Instrumental deliveries an macrosomia are strong associations. Primary repair with end to end approximation was done which was successful. Conclusion: Prevention is important Mediolateral episiotomy and skill of instrumental deliveries can minimize the risk of obstetrics perineal injures. Key Words: erineal tears, feacal incontinence, instrumental deliveries, mediolateral episiotomy.
oai:ojs2.localhost:article/48
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/48
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 3 (2008); 116
Chediak-Higashi Syndrome – A Case Report
Masood, Anoosh
Nadeem, Muhammad
Amin, Shahbaz
Kazmi, Atif Hasnain
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/48
en_US
Chediak-Higashi syndrome (CHS) is an autosomal recessively inherited, rare disorder, characterized by oculo-cutaneous albinism, photophobia, nystagmus and an abnormal susceptibility to cutaneous and respiratory infections. Hematological and serious neurological abnormalities can also occur with progression of the disease. Many similar cases of the disease with additional features have been reported in foreign literature. We describe one case of this disorder along with review of literature. Key words: Oculo-cutaneous, albinism, photophobia
oai:ojs2.localhost:article/49
2022-09-12T07:54:37Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/49
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 42
SCIENCE AND SCOPE OF PEER REVIEW
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/49
en_US
oai:ojs2.localhost:article/50
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/50
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 46
Total Serum Sialic Acid (TSSA) in Selective Patients of Diabetes Mellitus (DM)
Khurrshid, Muhammad Usman
Munir, Naeem
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/50
en_US
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:1; mso-generic-font-family:roman; mso-font-format:other; mso-font-pitch:variable; mso-font-signature:0 0 0 0 0 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> Total serum sialic acid (TSSA) and Fasting Blood Glucose levels were determined in 50 normal and healthy (control) individuals and 100 patients of diabetes mellitus. Diabetic patients were divided into two main groups i.e., with and without retinopathy. An increase in TSSA was found in all diabetic patients. A highly significant relationship of total serum sialic acid was observed in patients with retinopathy where p < 0.01 (p = 0. 0084), whereas no significant relationship of total serum sialic acid with blood glucose could be seen in this study, p > 0.1 (p = 0.186). The data showed a greater increase in TSSA in diabetic patients with retinopathy than those without it, i.e, 2.59 ± 0.47 mM/L (0.81 ± 0.15 G/L) vs 2.02 ± 0.29 mM/L (0.63 ± 0.09 G/L). Whereas, the Fasting Blood Glucose level in diabetic patients with retinopathy was 10.78 ± 0.94 mM/L (1.94 ± 0.17 G/L) and those without it was 9.94 ± 0.78 mM/L (1.79 ± 0.17 G/L) vs 4.83 ± 0.50 mM/L (0.87 ± 0.09 G/L) in the control individuals. Further more, our data also depicted a significant relationship of TSSA with duration of diabetes mellitus and degree of retinopathy and whether it is with or without maculopathy. But, there were non-significant relationships of TSSA with age as well as sex of the patients with p > 0.05 (p = 0.135 & 0.102 respectively).
oai:ojs2.localhost:article/51
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/51
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 50
Evaluation of C-Reactive Protein and Interleukin – 6 as Markers of Coronary Heart Disease
Awan, Zubair Ahmad
Naveed, Abdul Khaliq
Malik, Maujid Masood
Naveed, Ayesha
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/51
en_US
Background: Coronary heart disease (CHD) is the most common and important cause of morbidity and mortality in western population but incidence has much increased in our population also. This manifests as stable angina (SA), unstable angina (UA) myocardial infarction (MI), chronic IHD – with heart failure and sudden cardiac death. This is due to atheromatous narrowing of coronary vessels which results mainly due to hypercholesterolemia, diabetes mellitus (DM), hypertension and cigarette smoking. Current research has revealed that atherosclerosis is an inflammatory disease and not a simply due to accumulation of lipids in coronary arteries. Recent research in the developed countries is focusing on new biochemical and inflammatory markers. Objectives: To compare the levels of hs CRP and interleukin-6 in CHD patients and control individuals, with the aim to evaluate their association with CHD patients. Study Design: This is a case control analytical study. The study was carried out at Armed Forces Institute of Cardiology and Army Medical College Rawalpindi. Material and Methods: Eighty normotensive and non diabetic individuals comprised of 30 controls (group-A) and 50 CHD patients (group - B) were included in this study. Controls were having normal coronary angiograms. Patients were having abnormal coronary angiograms with single, double or tipple vessel disease. Levels of high sensitivity C-reactive protein (hs CRP) and interleukin-6 (IL-6) were measured by chemiluminescent immunometeric method. Serum glucose, cholesterol, triacylglycerol and urea were measured by enzymatic method. Level of serum creatinine was measured by kinetic colori-metric method. Results: We compared the values of serum CRP, IL-6, cholesterol and triacylglycerol of group B with control group-A and significance difference was found with p value < 0.05. Conclusion: Raised levels of hs C-reactive protein and interleukin-6 may have a role in the development of coronary heart disease and can be makers for CHD. Key Words: Coronary heart disease (CHD), stable angina (SA), unstable angina (UA), myocardial infarction (MI), Diabetes mellitus (DM), high sensitivity C-reactive protein (hs CRP) and interleukin-6 (IL-6).
oai:ojs2.localhost:article/52
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/52
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 56
Doppler Study to Evaluate the Effect on Venous Flow of Decubitus
Ahmad, Tauqir
Ahmad, Farooq
Waheed, Imran
Khalid, Attiya
Khurshid, Khawaja
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/52
en_US
Objectives: To determine the decubitus for sleep where venous return would have more forward velocity, the venous flow changes were traced in the Middle Hepatic Vein (MHV) of healthy adults in the right, left and supine recumbent positions by Doppler Sonography. Methods: Total 330 MHV Doppler tracings including 110 for each of the studied decubital (right, left and supine) positions were obtained on 110 fasted healthy adults of both gender. Each MHV Doppler spectrums was analyzed for the magnitude of its forward and backward flow velocity components and then accordingly, the spectrum was scored into HV0, HV1 or HV2 grades. The ratio of flow velocity components and caliber of MHV were also calculated. Statistical significant difference (S.S.D.) of the percentage of HV0, HV1 and HV2 grades correlated with the studied recumbent positions were evaluated by the fisher’s exact test while S.S.D. for velocity’ variables of forward and backward flow velocity waves correlated with the studied decubital positions, age, gender, heart rate, weight, height, body mass index and martial status of the participants were estimated by the chi-square test. Results: 100, 82 and 77 percent of MHV Doppler spectrums in right, left and supine recumbent positions respectively were found of grade Hvo. The result related to comparison of these waves and calibration of MHV in the studied decubital positions revealed that in the right decubitus: the forward flow velocity component (S) were of comparatively high and uniform amplitude along with > 1 S : D ratio; “a” wave (back flow velocity) comparatively was of smaller amplitude and calibration of MHV was only here < 10 mm (i.e. normal). The Statistical significant difference (S.S.D.) evaluated for HV0, HV1 and HV2 grades percentage correlated with the studied decubital positions except of right recumbent were highly significant (p < 0.005). The S.S.D. of ratios of forward and backward velocities’ variables correlated with the studied decubital positions except of right recumbent were of also significant (p < 0.001). The S.S.D. of the velocity variables in relation to age, gender, heart rate, height, weight, body mass index and marital status of the subjects in all studied recumbent positions were not significant. Conclusions: Among the right, left and supine decubital positions of healthy adults, it is the right decubitus where venous return to the heart is more and maximum because its all multiphasic MHV spectrums are characterized with: the comparatively more high forward velocity flow wave; low velocity of back flow wave and calibration of MHV < 10 mm (normal size. Abbreviations: MHV - Middle hepatic vein, S.S.D. - Statistical Significant Difference.
oai:ojs2.localhost:article/53
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/53
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 63
A trial of Bacillus Calmette Guerin (BCG) to cure the Skin Cancer
Ahmad, Tauqir
Ahmad, Farooq
Mughal, Muhammad Sharif
Ullah, Aziz
Khalid, Atiya
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/53
en_US
Objectives: In pursuit of cancer cure, the present studies, using mice as a model, evaluated the BCG. to prevent and revert the structural and biochemical changes that were induced in skin by carcinogens DMBA and TPA. Methods: Eighty mice distributed into eight groups of ten mice each were utilized. Two separate control groups were maintained. In the first experimental group, DMBA alone and in the second experimental group, DMBA and TPA were applied on the skin of mice. In the third and the fourth experimental groups, these carcinogens were applied alongwith the administration of BCG. In the fifth and sixth experimental groups, BCG, was administered after applications of these carcinogens. The development / fate of lesions were evaluated. Results: It was observed that the repeated application of DMBA alone produced more malignant while the repeated application of TPA produced more benign varieties of skin cancer; the repeated application of these carcinogens with the administration of BCG did not result into epidermal tumor, but resulted into only dermal cancer; administration of BCG. also arrested the lesions pre-produced by these carcinogens . The statistical analysis of DNA, RNA and proteins concentrations estimates were found significant. Conclusion: Results of this study point out that repeated application of DMBA, or TPA cause both epithelial and mesenchymal tumorigenesis in the skin. However, exposures to these carcinogens with the administration of BCG do not produce epidermal tumors. Moreover, administration of BCG arrests the epidermal lesions already produced by these carcinogens. Abbreviations:DMBA (Dimethyl Benz anthracene) is derived from anthracene i.e. polyaromatic hydrocarbon found in commonly used coal tar. TPA (tetradecanyl phorbol acetate) is derived from acetate that is salt or ester of ethanoic acid manufactured by oxidation of ethanol and commonly used for production of vinegar.
oai:ojs2.localhost:article/54
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/54
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 68
Alkaptonuria: An Inborn Error of Amino Acid Metabolism
Nafees, Muhammad
Muazzam, Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/54
en_US
Background: Alkaptonuria (AKU) is a rare hereditary metabolic disorder that occupies a unique position in the history of medical and biochemical genetics because it was the first human metabolic disorder to be interpreted as genetically deter-mined. This condition is characterized by deficiency of HGAO, an enzyme that is mainly found in hepatocytes. The medical interest in alkaptonuria stems from its association with ochronosis, arthropathy and homogentisicaciduria. Objectives: The objective of the present study was to screen urine of children, who were less than two years of age for detection of inborn errors of amino acid and carbohydrate metabolism-with particular reference to: 1. Phenylketonuria (PKU), 2. Alkaptonuria (AKU), 3. Galactosemia, 4. Fructosuria and 5. Pentosuria. Place of study: This study was performed in the department of chemical pathology of Postgraduate Medical Institute, Lahore, which is part of the first author’s studies of M. Phil. Degree in Chemical Pathology. Study Design: A cross sectional, hospital based study. Methods: In addition to chemical tests, one dimensional descending paper chromatography was used in this study for the detection of hereditary metabolic disorders. Results: Out of 2,000 children (1194 males and 806 females), only one female child having alkaptonuria was detected. The elder sister of this infant, investigated as part of the family study also revealed the presence of this condition. Conclusion: The present study has established the fact that hereditary metabolic disorders like AKU also exist in Pakistan and the paper chromatography of the urine furnishes a simple technique to identify HGA / urinary sugars and amino acids. Keywords: Hereditary metabolic disorders, Alkaptonuria, Homogentisicaciduria, Ochronosis, Arthropathy, Paper Chroma-tography, Pakistan.
oai:ojs2.localhost:article/55
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/55
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 72
Isolated Sphenoidal Fungal Sinusitis, Presentation But Potentially Life Eatening Outcome
Latif, Sarfraz
Aslam, Naveed
Ahmad, Raheel
Sarfraz, Saulat
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/55
en_US
Objective: The objective of this study is that one should keep high index of suspicion for isolated fungal sinusitis in patients of unexplained headache and visual disturbances. Computed Tomography and Magnetic Resonance Imaging are the best diagnostic tools. Study design: Retrospective, descriptive study. Place and duration of study: Department of ENT and Head and neck surgery sheikh Zayed hospital Lahore from March 2001 to April 2005. Patients and methods: In this study twelve patients with a complaint o f headache and visual disturbance were investigated thoroughly and among all there were isolated sphenoidal fungal sinusitis which were explored endoscopically and proven on culture and histopathologically, in all patients oral itraconazole was given for six months. Results: In all patients headache improved 100% while visual changes like diplopia, improved in 5 patients 71%, cranial nerve palsies improved in 2 patients 40%. Conclusion: It is concluded that isolated sphenoidal sinus pathology should be excluded in patients having un-explained headache and visual disturbance .Computed Tomography / Magnetic Resonance Imaging are the investigations of choice for final diagnosis. Key words: Fungal sinusitis, sphenoid sinus.
oai:ojs2.localhost:article/56
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/56
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 75
Complications with Implanon as Contraceptive
Abid, Shazia
Iqbal, N
Anwar, S
Rao, S I
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/56
en_US
Objective: The objective of the study was to assess the complications with Implanon contraceptive. Study Design: Descriptive. Place and Duration of study: The study was conducted in Gynae unit I in collaboration with family planning centre in Nishtar Hospital Multan, from Jan 2004 to Jan 2007. Patients and Methods: A total of 45 women of reproductive age group were selected and after taking complete history, examination and investigations, all women suitable for Implanon were included and those who had hypertension, diabetes mellitus, obesity and pelvic pathology were excluded from the study. Results: The main complaint in study was menstrual disturbance. Out of 45 women, 20 developed amenorrhoea, 14 complained of irregular vaginal bleeding. And only 6 women presented with frequent periods. However normal menstrual cycle was observed in 6 women. No change was observed in weight in 15 women, while 12 women complained of mild weight reduction. Weight gain upto 2 kg was observed in 18 women. Only 10 women complained of breast tenderness and skin problem was observed in 5 women. Out of 45 women, 39 were satisfied but 6 asked for removal due to menstrual disturbance. Conclusion: Implanon like other systemic progestegens is not free of complications. Amenorrhea and infrequent irregular periods are the main complaints, while weight gain and acne are minor problems. Key Words: Hormonal contraception, Third generation progestogen( etonogestrel), Implanon, Menstrual irregularities
oai:ojs2.localhost:article/57
2022-09-12T07:54:37Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/57
2022-09-12T07:54:37Z
King Edward Medical University
Vol. 14 No. 2 (2008); 79
Pulmonary Tuberculosis in a Patient with Systemic Lupus Erythematosus – A Case Study
Hussain, Nageen
Jaffri, Ghazala
Sabri, Anjum Nasim
Hasnain, Shahida
Mir, Nighat
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/57
en_US
Systemic Lupus Erythematosus (SLE) patients have an increased susceptibility to tuberculosis; such a case was reported in a 28-year old man. It is believed that Methotrexate used to reduce the activity of systemic lupus erythematosus and of rheumatoid arthritis had decreased the activity of his immune system and tends to develop tuberculosis. Key words: Systemic Lupus Erythematosis, tuberculosis, Methotrexate.
oai:ojs2.localhost:article/58
2022-09-12T07:54:38Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/58
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 157
Introducing the Online Version of Annals of KEMU
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/58
en_US
oai:ojs2.localhost:article/59
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/59
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 161
Comparison of Serum Cholesterol Fractions Levels in Albino Rats on Monounsaturated (Olive Oil) Fat Diet
Abro, Khaliq
Bukhari, Mulazim Hussain
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/59
en_US
That dietary fat can significantly affect the atherosclerosis and increased level of low density lipoproteins cholesterol in the serum is a high risk while the increased high density lipoprotein cholesterol level is a low risk for the development of athero-sclerosis. The study was conducted to compare the levels of cholesterol fraction with in experimental animals on different dietary fats. Materials and Methods: The study was comprised of 36 albino rats of 32 weeks age, with equal number of males and females. These were kept under optimum temperature and hygienic conditions with adequate availability of food and water. The blood samples were drawn at the beginning and the end of study. The animals were given different control and experimental diets for 20 weeks. The experimental diets were added with olive oil as 20% olive oil diet. The blood samples were taken at the end of the study and the results were compared. Result: The mean serum HDL-c in the control rats without atherogenic diet at week 0 and 32 are 29.08 ± 2.71 and 24.09 ± 2.11 mg/dl. The difference was highly significant, and the mean serum HDL-c in the control rats with atherogenic diet at week 0 and 32 are 31.66 ± 3.39 and 20.00 ± 2.60mg/dl. The difference is statistically very highly significant. The mean serum LDL-c in control rats without atherogenic diet at week 0 and 32 are 35.00 ± 6.52 and 40.45 ± 5.04 mg/dl. The diffe-rence is statistically significant from the experimental animals. The total serum cholesterol in the experimental group (olive oil) at week 0 and 32 are 88.66 ± 10.43 and 125.09 ± 8.09mg/dl. The difference was statistically highly significant. The mean serum HDL-c at week 0 and 32 are 33.66 ± 3.52 and 66.54 ± 10.02 mg/dl. The difference is statistically very highly signi-ficant (Table 3.2). The mean serum LDL-c at week 0 and 32 are 35.66 ± 7.70 and 35.09 ± 6.77 mg/dl. The difference was statistically non-significant. Conclusion: We concluded that a significant decrease in serum LDL-c level and increase in serum HDL-c level found in animals on diet with olive oils might be a protective sign in the prevention of atherosclerosis. Key words: Atherogenic, Olive oil, low density lipoprotein cholesterol, low density serum lipoprotein cholesterol.
oai:ojs2.localhost:article/60
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/60
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 165
Synchronization of Working Formulation and WHO Classification 2008 for Nodal Non-Hodgkin’s Lymphoma
Rehman, Aman ur
Lodhi, Sidra
Niazi, Farah B
Mushtaq, Sajid
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/60
en_US
Introduction: In Pakistan, nodal Non Hodgkin s Lymphoma (NHL) cases are being reported according to Working Formu-lation (WF). A new and broader classification of lymphomas has been introduced by WHO classification 2008 which inclu-des immunohistochemical markers and cytogenetics of these tumors. This study was carried out to synchronize WF and 2008 WHO classification of nodal NHL. Materials and Methods: This study was done on 50 consecutive diagnosed cases of nodal NHL. The paraffin blocks of these cases were retrieved from laboratory. New sections were cut and immunohistochemical staining was carried out on these sections. Results: These results showed that small lymphocytic lymphoma (SLL) according to WF have been recategorised into (WHO) SLL-T cell and SLL-B cell. Diffuse Large cell lymphoma (WF) classified into (WHO) Diffuse large B cell NOS, Peripheral T cell NOS, Anaplastic large cell lymphoma and Angioimmunoblastic lymphoma. Lymphoblastic lymphoma (WF) revealed T lymphoblastic and B lymphoblastic lymphoma types (WHO). The small cleaved, mixed and large subtypes of follicular lymphoma (WF) have been merged as follicular lymphoma(WHO). Diffuse large B cell lymphoma NOS (WHO) includes immunoblastic lymphoma (WF), diffuse mixed (WF), and some cases of diffuse large cell lymphoma (WF) in this study. Conclusion: The classification of lymphomas has always been a debatable issue for the pathologists and oncologists. Despite of this disparity, WF classification of lymphomas is still being used in Pakistan. However, a revised unified classi-fication would be a better step towards enhanced understanding in this field. Key Words: Non-Hodgkin's, lymphoblastic, immunoblastic, anaplastic.
oai:ojs2.localhost:article/61
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/61
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 168
Review of the Pathologic Diagnoses of Appendectomy Specimens
Zulfikar, Imrana
Khanzada, Tariq Wahab
Sushel, Champa
Samad, Abdul
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/61
en_US
Objective: The purpose of this study is to see the pattern of various histopathological diagnoses in appendectomy specimens. Setting: This retrospective study carried out at Isra University Hospital, Hyderabad and three main hospitals of Hyderabad over a period of two years starting from March 2006 to February 2008. Methods: Hospital records of all patients who were diagnosed as acute appendicitis and underwent appendectomy (either open or laparoscopic) were reviewed retrospectively. Patients' age, sex operative findings and histopathology reports were noted. Histopathology reports were analyzed according to the diagnosis. Results: Hospital records of 323 patients who were diagnosed as acute appendicitis and underwent appendectomy (either open or laparoscopic) were reviewed. 86.3% specimens revealed findings of acute appendicitis, 10.8% were normal, while 3% has tuberculosis, 1.5% had Meckle diverticulitis and 0.6% each of adenocarcinoma and Carcinoid tumour. Among acute appendicitis, lymphoid hyperplasia was the predominant finding seen in 57.8% of cases. Conclusion: Other than acute inflammation, routine histopathological examination of the appendix yields important clinical information like benign and malignant tumours. All appendectomy specimen should be sent for routine histopathological examination so as not to other unusual or co-existing pathologies. Key words: Appendectomy, histopathology, acute appendicitis.
oai:ojs2.localhost:article/62
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/62
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 171
Frequency and Pattern of Oral and Maxillo-facial Carcinomas
Haq, Muhammad Ehsan ul
Abid, Hina
Hanif, Muhammad Kamran
Warraich, Riaz Ahmad
Mahmood, Hafiz Shaker
Saddique, Kashif
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/62
en_US
Objective: To determine the frequency and pattern of carcinomas in Oral and Maxillofacial region, in particular relation to the primary sub site and involvement of the level of lymph nodes in the neck. Study Design: Descriptive study. Place and Duration of the Study: Oral and Maxillofacial Surgery Department, King Edward Medical University/ Mayo Hospital Lahore and Institute of Nuclear Medicine and Oncology Lahore (INMOL), from 1st October 2007 to 30th September 2008. Patients and Methods: Inclusion criteria: patients of all age groups and gender with biopsy (incisional or excisional) proven carcinomas of the oral and maxillofacial region. Exclusion criteria: Irradiated patients and patients with metastatic carcinomas in head and neck region. Results: Squamous cell carcinoma was found in 84.28% (n = 118) patients out of 140 cases, Adenocarcinoma was 5.7% (n = 8), Basal cell carcinoma was 0.7% (n = 1), Acinic cell carcinoma was 1.4% (n = 2), Adenoid cystic carcinoma was 3.6% (n = 5), Mucoepidermoid carcinoma was 3.6% (n = 5) and Verrucous carcinoma was found in 0.7% (n = 1) patients. The levels of lymph nodes involved were as follows; level I 35.7% (n = 50), level II 24% (n = 34), level III 11.4% (n = 16), level IV 6.4% (n = 9) and level V 3.5% (n = 5) in all 140 cases. There were 10% (n = 14) cases of parotid gland tumors, 28.6% (n = 39) tongue carcinomas, 11.4% (n = 16) maxilla, 22.1% (n = 31) buccal mucosa, 15% (n = 21) mandible, 8.5% (n = 12) floor of the mouth and 4.3% (n = 6) cases of palate. Most of the patients with Squamous cell carcinoma presented with T3 and T4 which were 33.9% (n=40) and 43% (n=51) respectively. Histopathologically, SCC with well-differentiated, moderately differentiated and poorly differentiated varieties were 27.12% (n = 32), 33.9% (n = 40) and 38.98% (n = 46) respectively. Most of the SCC patients were of stage stage-III or stage IV 41.5% (n = 49) and 35.5% (n = 42) respectively. Conclusion: Squamous cell carcinoma is the most common cancer of oral and maxillofacial region and most frequent site for squamous cell carcinoma is oral tongue. Key words: Oral carcinoma, squamous cell carcinoma, precancerous lesions, TNM staging.
oai:ojs2.localhost:article/64
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/64
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 176
Single Dose Prophylaxis in Obstetrics and Gynaecological Surgeries
Sadique, Iftikhar
Abid, Shazia
Aleem, Sadaf
Anwar, Saira
Hafeez, Maimoona
Pasha, Mohammad Irfan
Butt, Fauzia
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/64
en_US
Objective: To evaluate the effectiveness of single dose prophylaxis in elective obstetric and gynecologic surgeries. Study Design: Descriptive study. Place and Duration of Study: Department of obstetric and Gynae, Sharif Medical and Dental College/Hospital Lahore from January 2006 to August 2008. Patients and Method: A prospective study comprising of 305 patients undergoing elective obst and Gynecologic surgery during a period of 3 years at department of obstetric and Gynae, Sharif Medical and Dental College/Hospital Lahore. All patients received 1.5 gm parental cefurexime at the time of induction of anesthesia. Hospital and post discharge surveillance for presence of surgical site wound infection was done. Results: In this study, Total 305 patients were enrolled, 249 were obstetric and 56 were gynecologic patients. No intra-operative surgical complication was observed with 54.91mins mean surgical duration. Febrile morbidity was seen in 91 patients (30%) and only 10 patients were developed infectious morbidity irrespective of Hb level. The mean duration of hospital stay was 3.56 days. Conclusion: The use of single dose preoperative cefurexime prophylaxis was as effective as multidose regimes for preventing serious infectious morbidity among our patients. It's the maintenance of standard sterilization techniques of operation room which counts not the nutritional status or Hb level for the prevention of surgical site wound infection. Shortening the duration of antibiotic prophylaxis also helps in reduction of medical costs. Key Words: Antibiotic prophylaxis, cefurexime, gynecologic surgery, surgical site, wound infection.
oai:ojs2.localhost:article/65
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/65
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 180
Factors Related to Adverse Outcome in Asphyxiated Babies:
Seyal, Tallat
Hanif, Asif
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/65
en_US
To determine the selected antenatal and perinatal risk factors (weight, sex, gestational age, maternal age, parity, mode of delivery, place of delivery, age at arrival and stage of hypoxic ischemic encephalopathy) for adverse outcome in babies with birth asphyxia, at Sir Ganga Ram Hospital, Lahore. This was an observational study conducted in a prospective manner in the neonatology unit of the department of Paediatrics, Fatima Jinnah Medical College/Sir Ganga Ram Hospital, Lahore, over a period of six months from 1st August, 2007 to 31st Jan. 2008. This study included 144 consecutive asphyxiated neonates who were admitted in our neonatal unit and fulfilled the inclusion criteria. Detailed maternal information, physical examination and progress of the babies were noted regularly till the time of death or discharge and entered into a specified proforma. Babies were categorized into different stages of HIE (Hypoxic Ischemic Encephalopathy) according to Sarnat and Sarnat staging. On the basis of outcome, they were divided into two groups, group one who survived and were discharged with stable vital signs and group two, who died. Effect of risk factors on both groups were compared and results were expressed as (P<0.05 was taken significant) by using chi-square test. Results: Total admissions during the study period were 650. One hundred and forty four (22%) suffered birth asphyxia. Out of one hundred and forty four asphyxiated babies forty five (31.3%) were females and ninety nine (68.8%) were males. Ninety three (64.6%) weighed >2.5 kg and fifty one (35.4%) 1.5-2.5 kg. 15 (10.4%) babies of birth asphyxia did not suffer HIE, 53(36.8%) had stage I, 46 (32.0%) stage II and 30 (20.8%) stage III HIE. 86 (59.7%) of the babies were discharged successfully and 58 (40.3%) died. Variables (risk factors) found significantly affecting adverse outcome were late arrival and severe birth asphyxia. Conclusion: Referring high risk pregnancies to tertiary care hospitals is not enough because these centers and neonatal units have their own limitations so more attention should be paid to prevention. Key words: Birth Asphyxia, Hypoxic Ischemic Encephalopathy, Adverse outcome.
oai:ojs2.localhost:article/66
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/66
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 185
Prophylaxis of Atonic Postpartum Hemorrhage with Misoprostol in Underdeveloped Countries
Nisa, Mehr un
Zahida, .
Sadia, .
Misbah, .
Nawaz, Riffat
Shazia, .
Shamim, Riffat
Shazia, .
Bushra, .
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/66
en_US
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 415 0;} @font-face {font-family:Calibri; panose-1:2 15 5 2 2 2 4 3 2 4; mso-font-charset:0; mso-generic-font-family:swiss; mso-font-pitch:variable; mso-font-signature:-520092929 1073786111 9 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin-top:0in; margin-right:0in; margin-bottom:10.0pt; margin-left:0in; line-height:115%; mso-pagination:widow-orphan; font-size:11.0pt; font-family:"Calibri","sans-serif"; mso-fareast-font-family:Calibri; mso-bidi-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt; mso-ascii-font-family:Calibri; mso-fareast-font-family:Calibri; mso-hansi-font-family:Calibri;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> Background: In this modern era of 21st century, postpartum hemorrhage is still the leading cause of maternal mortality in poor countries. In 70% cases, the cause is uterine atony. For centuries a therapy was needed which should be effective, cheap, safe, does not need refrigeration and that can be easily administered by untrained staff to control postpartum hemorrhage at primary health care setting in underdeveloped countries where majority of maternal deaths due to PPH occur. Misoprostol is one drug that might fulfill these requirements. Objectives: The objective of this study is to evaluate the efficacy of rectal misoprostol in the prophylaxis and management of atonic PPH and compare it with conventional I/V syntocinon routinely used in hospitals as part of active management of third stage of labor. Study Design: Semi experimental. Materials and Methods: The study was conducted in Services Hospital Lahore, Department of Gynecology unit-2, between Oct 2006 to March 2007.One thousand pregnant females were included in the study and divided into two groups, a control group (500 women who received syntocinon) and a study group (500 women who received rectal misoprostol). Syntocinon (Sandoz Pharmaceuticals) 5u I/V injection and misoprostol (Cytotec, Searle Pharmaceuticals) 600 ug (3 tablets) per rectum were given to women in control and study group respectively, immediately after delivery of the baby. Duration of third stage of labor, blood loss after delivery, and hemoglobin deficit after 24 hours of delivery and frequency of atonic PPH were recor-ded and compared between the two groups. The side effects of both drugs were also noted. Results: There was not a significant difference in blood loss after delivery (control group - 252 ml, study group - 304 ml, p-value - 0.18), duration of third stage of labor (control group-14.74 minutes, study group-16.54 minutes, p-value - 0.17) and hemoglobin deficit (control group - 0.375 gm/dl, study group - 0.404 gm/dl, p-value - o.5) between both groups. The fre-quency of atonic PPH in study and control group was similar ranging between 3 to 4%.Side effects of misoprostol (shivering 25%, fever 15%, vomiting 12% and diarrhea 5%).were significant (p-value <0.05) but all were temporary and not life thre-atening. Conclusion: Misoprostol may be used for managing third stage of labor to reduce atonic PPH, especially in poor countries where facilities to deliver in hospitals and storage of oxytocic ampoules or medically trained persons are not readily avai-lable. Benefits of misoprostol outweigh its side effects. Key Words: Prophylaxis, atonic postpartum hemorrhage, rectal, misoprostol, syntocinon, underdeveloped countries.
oai:ojs2.localhost:article/67
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/67
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 190
Frequency of Genitourinary Tuberculosis in patients with Pulmonary Tuberculosis (Sputum AFB Positive)
Khurshid, Muhammad Adil
Chughtai, Muhammad Nawaz
Siddiqi, Ghulam Mujtaba
Azhar, Anjum
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/67
en_US
Objective: This study was carried out to determine the frequency of Genitourinary Tuberculosis in patients with active Pulmonary Tuberculosis. Design of study: Cross sectional descriptive. Place and Duration: T.B outdoor of Gulab Devi Hospital and Urology outdoor of Jinnah Hospital, Lahore during the period Oct, 2002 to Oct, 2004. Materials and Methods: Two hundred patients with pulmonary tuberculosis, 117 males and 83 females, ranging from 17 to 80 years of age (mean 37.9 years) were included in the study. Hundred patients were freshly diagnosed cases (group - 1) while the remaining hundred patients were already diagnosed cases of pulmonary tuberculosis and had received anti-tuberculous treatment for at least three months (group - 2). Diagnosis of pulmonary tuberculosis was based on sputum smear positive for acid fast bacilli (AFB) by Ziehl Neelsen (ZN) staining technique. 24 hours urine was collected from each patient. Each specimen was examined for presence of mycobacterium tuberculosis by ZN staining and culture on Lowenstein Jensen (LJ) medium. Positive for one or both of these procedures was taken as positive for genitourinary tuberculosis. Results: Eighteen patients (18%) in group-1 and twenty three patients (23%) in group-2 were found positive for genito-urinary tuberculosis. Conclusion: Genitourinary tuberculosis is not uncommon in patients with pulmonary tuberculosis. Therefore, urine samples of patients with pulmonary tuberculosis should be examined for presence of mycobacterium tuberculosis. Keywords: Frequency; genitourinary tuberculosis; pulmonary tuberculosis.
oai:ojs2.localhost:article/68
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/68
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 192
Determinants for transmission of hepatitis B and C
Afzal, Saira
Bashir, Mustehsan
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/68
en_US
Objective: To find out the determinants of transmission of hepatitis B and C in patients admitted in medical wards and to assess the knowledge and practices of the patient regarding transmission of hepatitis B and C infection. Design: A case-control study. Place and Duration of the Study: In Gastroenterology ward Medical Unit 1 Punjab Medical College and Allied Hospital Faisalabad and Plastic Surgery Ward, KEMU, Lahore. Duration of the study is one year and started in May 2006. Patients and Methods: Patients of hepatitis B and C admitted in Gastroenterology ward Medical unit 1 were interviewed and data was collected using a structured proforma. The study controls were selected who were negative for Hepatitis B and C on ELIZA method and were admitted in same ward. At 95% confidence interval the sample size was calculated as 230, 115 cases and 115 controls. Statistical analysis was done using SPSS version 13. Results: Total number of the patients that participated in the study was 230 i.e., 55 with Hepatitis B, 60 with Hepatitis C and 115 in control group. The determinant of transmission of Hepatitis B found statistically significant included age, socioe-conomic status, occupations like health care workers, barbers, business owners with frequent travels, sex workers and sani-tary workers, reuse of syringes, surgical and dental procedures, cesarean section in females, accidents and blood loss, paren-teral drugs and drips, I/V drug abuse, ear and nose piercing, tattooing, getting shave and hair cut from barbers, sharing of tooth brush, contact and family history of hepatitis, extra marital sex, lack of knowledge about transmission of Hepatitis, and non-practicing of active and passive immunization. The variables found statistically significant in Hepatitis C infection inclu-ded reuse of the syringes, blood transfusions, surgical and dental procedures, accidents and blood loss, parenteral drugs and drips, I/V drug abuse, getting shave and hair cut from barbers, sharing of razors, contact and family history of hepatitis. The knowledge and practices regarding spread of Hepatitis B and C were poor. Conclusion: There is a need to create awareness about determinants and transmission of Hepatitis B and C in our com-munity. The professions at risk should be investigated for Hepatitis periodically and both active and passive immunization should be available to them. The vaccination against Hepatitis B should be strongly recommended for high risk groups. Proper screening of the blood products, sterilization of surgical instruments and universal precautions against the spread of infection should be implemented Key Words: Determinants, Hepatitis B, Hepatitis C, transmission.
oai:ojs2.localhost:article/69
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/69
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 198
Morphological Changes in Testes of Rats Exposed to Ethinyl Estradiol in Neonatal Period
Shaheen, Samina
Tazeen, Nadia
Nasir, Iqbal
Khalid, Attiya
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/69
en_US
Introduction: This study was performed to analyze the effects of neonatal exposure of rat testes to synthetic estrogen, ethinyl estradiol. Aims: This study was carried out to assess the role of environmental estrogen on the rat testes. Material and Methods: 63 male neonatal rats were divided into 3 groups: Group A was control group while B and C were given subcutaneous injections of ethinyl estradiol in a dose of 0.37 mg/kg and 0.037 mg/kg body weight respectively on alternate days in the first two weeks of the neonatal period. The animals were sacrificed at the age of 2, 6 and 9 weeks and morphological aspects of effects studied. Results: Mean body weight increased significantly at 6 and 9 weeks in the group given 0.37 mg/kg and 0.037 mg/kg of ethinyl estradiol due to its anabolic effect. However there was a significant reduction in the weight of testes with reduced vas-cularity on prolong exposure to high dose. Conclusion: Ethinyl estradiol adversely affects rat testes even in low doses. Although it was not given after 14 days but its negative effects persist till the age of 9 weeks with high dose and testes showed signs of atrophy. On exposure to low dose the effects were reversed. Key words: Testes, Environmental estrogen, infertility.
oai:ojs2.localhost:article/70
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/70
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 203
Acute Bronchiolitis: Epidemiological and Clinical Study
Iqbal, Syed Muhammad Javed
Afzal, Muhammad Faheem
Sultan, Muhammad Ashraf
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/70
en_US
Background: Bronchiolitis is an acute inflammatory obstruction of small airways in children that occurs in first two years of life and is characterized by fever, rhinitis, cough, tachypnea, expiratory wheeze and increased respiratory effort. Objective: To study epidemiological and clinical features in children with acute bronchiolitis. Study design: Descriptive study. Setting: Department of Paediatrics, King Edward Medical University/ Mayo Hospital, Lahore. Duration: Six months (October 2006 to March 2007). Subjects and Methods: After consent from parents, one hundred and seven children of age between 2months to 2years with the first episode consistent with clinical case definition of bronchiolitis were included by using convenient sampling. Results: A total of 107 children were included. Mean age was 11.3 ± 5 months. Male to female ratio was 1.3. Mean weight 9.3 ± 2.2 kg, mean head circumference 44.1 ± 2.7 cm, and mean length was 71.6 ± 7.5 cm. Forty eight percent children were bottle fed and 38% were breast fed. Thirty eight percent children had family history of acute respiratory tract illness while 14% children had family history of allergy. Among total of 107 children, 91% had respiratory distress at the time of pre-sentation, 76% had nasal flaring, 72% wheezing, 64% had fever, 41% retractions and 32% had decreased feeding. Conclusion: Overwhelming majority of children suffering from acute bronchiolitis was less than one year of age. There was male predominance. Most of the children were bottle fed. Main presenting features of acute bronchiolitis were respiratory distress, nasal flaring and wheezing. Key words: Bronchiolitis, respiratory tract infection, wheezing.
oai:ojs2.localhost:article/72
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/72
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 4 (2009); 206
Reproductive Risk Factors for Female Breast Cancer: A Case – Control Study
Butt, Zeeshan
Shahbaz, Umer
Naseem, Tariq
Ashfaq, Umair
Khan, Umaif Ahmad
Khan, Muhammad Raza
Hashmim, Arsalan Talib
Bukhari, Mulazim Hussain
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/72
en_US
Background: Breast cancer is the most common female cancer in Pakistan. Its incidence in Pakistan is 2.5 times higher than that in neighboring countries like Iran and India. Association of reproductive factors with breast cancer is unclear in our population. Objectives: To find out the association of reproductive factors like parity, age at first live birth and lactation with breast cancer. Design, Setting and Participants: It was a case-control study comprising 150 breast cancer patients and 300 control subjects. The study was done in Mayo Hospital Lahore between October, 2008 and April, 2009. Methods: Both cases and controls were interviewed in wards after taking verbal consent. A short structured questionnaire was used to obtain information regarding basic demographic, menstrual and reproductive characteristics. Results: Breast cancer patients and control subjects did not differ regarding age (p = 0.9), early menarche (OR for menarche at < 12 years vs. ≥ 12 = 1.6, 95% CI = 0.6 - 4.3), and late menopause (OR for menopause at ≥ 50 vs. < 50 = 1.0, 95% CI = 0.5 - 2.0). History of breast cancer in 1st degree relatives did not increase breast cancer risk (OR = 1.0, 95% CI = 0.5 - 2.1). Nulliparous women had significantly higher risk than parous women (OR = 4.7, 95% CI = 1.9 - 11.0). Women with younger age at first live birth (< 30 years) had less breast cancer risk as compared to women with ≥ 30 years of age at first live birth (OR = 0.2, 95% CI = 0.1 - 0.5). Breastfeeding had no effect on the risk of breast cancer in parous women. Conclusion: Nulliparity and more age at first live birth was associated with increased breast cancer risk. Breastfeeding was not protective against breast cancer. Keywords: breast cancer, nulliparity, lactation, risk factors.
oai:ojs2.localhost:article/73
2022-09-12T07:54:38Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/73
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 103
Relationship of Accuracy in Decision Making, Wisdom and Publication in Medicine
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/73
en_US
oai:ojs2.localhost:article/74
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/74
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 107
Importance and Understanding of Bio-Statistics among Post Graduate Students at King Edward Medical University Lahore - Pakistan
Hanif, Asif
Butt, Asim
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/74
en_US
Back ground: The research in medicine has caused concern among both doctors and bio-statistician for many years 1. Fundamental concepts of statistics are dire need for medical doctors. If medical doctors do not understand fully the primary concepts of Biostatistics, then the scientific conclusions they reach will be more likely to be wrong 2. Methodology Study Design: Cross-sectional descriptive study design was used. Total number of respondents: The study was conducted at King Edward Medical University (KEMU) Lahore- Pakistan. A questionnaire was e-mailed to 332 post-graduate medical students (doctors, dentists and physiotherapist) in which only 227 responded. The questionnaire was also manually distributed to 110 medical post-graduate students. Consequently, the total number of respondents was 327 (response rate = 74%). Results: The mean age of respondents was 31 ± 0.37 years along with the S.D = 6.67 years. There were 198 (60.55%) male and 129 (39.440 female respondents. The basic knowledge of biostatistics among students was not satisfactory. The proportion of students was significant (p-value= 0.00) who were agreed that this course is useful for them and every medical institute should start regular courses on Biostatistics during M.B.B.S. Conclusion: Our medical institutes should take a daring step towards the education of Research Methodology and Biostatistics. This subject should be taught in graduation so that the doctors of future may get a significant understanding for exploring, implementing the research and make evidence based decisions. Key Words: Medical-statistics, Research Methods and Medical Research. Words Count: 238.
oai:ojs2.localhost:article/75
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/75
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 111
Microalbuminuria in Angiographically Documented Coronary Heart Disease in Non Diabetic and Normotensive Individuals
Awan, Zubaid Ahmad
Naveed, Abdul Khaliq
Malik, Maujid Masood
Khan, Shakir
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/75
en_US
Background: Coronary heart disease (CHD) is the most prevalent and important cause of death in developed nations. The incidence of this disease has also increased in our country during the last few years. This occurs due to atherosclerotic narrowing of coronary arteries, mainly because of hypercholesterolemia, hypertension, diabetes mellitus, physical inactivity and cigarette smoking. CHD manifests as stable angina (SA), unstable angina (UA) and myocardial infarction (MI). Inspite of the curtailment of these traditional risk factors the disease has not been eliminated from the globe so far. Recent research in the developed countries is focusing now to identify new biomarkers associated with CHD. Microalbuminuria (MA) has implications on the development of CHD and it is emerging as a new risk factor of this disease. Objectives: To compare the levels of microalbuminuria in CHD patients and control individuals with aim to evaluate its association with CHD. Study Design: A case control analytical study conducted at Army Medical College and Armed Forces Institute of Cardiology Rawalpindi. Material and Methods: Thirty controls (groups A) and fifty CHD patients (group B) included in this study were non diabetic and non hypertensive. Microalbuminuria was determined by immunoturbedimeteric method. Serum glucose, choles-terol, triacylglycerol and urea were measured by enzymatic method. Serum creatinine was measured by kinetic colorimeteric method. Results: Microalbuminuria, cholesterol and triacylglycerol of group B were compared with group A. A significanct diffe-rence was found with p value < 0.05. Conclusion: Microalbuminuria may have an association with coronary heart disease. Key Words: Coronary heart disease (CHD), stable angina (SA), unstable angina (UA), myocardial infarction (MI), Micro-albuminuria (MA)
oai:ojs2.localhost:article/76
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/76
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 117
Clinical Features and Angiographic Findings in Premature Coronary Artery Disease; Comparison Between Males and Females
Ahmad, Nisar
Haq, Inam ul
Rashid, Munir A
Sherwani, Mubahir
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/76
en_US
Introduction: Coronary artery disease has emerged as one of the leading causes of premature mortality and morbidity in South Asians. In contrast to males, younger women are ignored due to prevailed social trends. Better characterization of disease presentation in this group will help us in formulating adequate management policies. Objectives: To study clinical features, risk factors and angiographic findings in female patients with premature Ischemic heart disease comparing with men of similar age. Study design: It was Interventional:Quasi experimental study. Setting: Punjab Institute of Cardiology Lahore. Duration: From 19th of January 2002 till 27th of September 2003. Subjects and methods: 100 female patients and 100 male patients age 50 or below were studied, who were referred for coronary angiography. Patients with previous coronary angiogram or revascularization were excluded. Data was collected over prescribed proforma and results analyzed. Results: Prevalence of significant risk factors in women compared with men were hypertension, (50% vs 28%; P<0.01), hyperlipidemia (62% vs 26%; P<0.01) diabetes mellitus (46% vs 8%; P<0.01), sedentary life style (44% vs 24%; P<0.01) and obesity (58% vs 22%; P<0.01). Majority of women (84% vs 54%; P<0.01) presented with angina compared with men. No significant difference was noted in distribution of coronary artery disease between two sexes. Conclusion: Women who developed premature coronary artery disease had significant prevalence of majority of conventional risk factors than their male counterparts and more likely to present with angina than myocardial infarction. However distribution and severity of coronary artery disease was similar between the two sexes. Key words: Females coronary disease chest pain risk factors coronary angiography
oai:ojs2.localhost:article/77
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/77
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 123
Devising New Management Protocol Based on Sonographic Sensitivity for the Detection of Retained Products of Conception
Qazi, Abdus Sami
Sami, Sabahat
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/77
en_US
Objective: To assess the accuracy of ultrasonography for the detection of retained products of conception in post partum and post abortal patients with Trans abdominal sonography using conventional medium frequency probes. Material and methods: Out of 289 patients referred by the Gynaecology Department with strong clinical suspicion of RPOC on clinical examination, 179 patients had D&C after sonographic evidence favouring RPOC. Sonographic criteria used for RPOC were echogenic, echopenic or mixed echogenecity uterine cavity mass with anteroposterior dimension equal to or exceeding 10 mm. We did not take into account the D&C carried out on clinical suspicion as this study was not designed for that and we wanted to know the sensitivity of Ultrasonography alone for detection of RPOC. For statistical analysis patients were divided into three groups depending on the antero posterior measurement of endometrial mass. Group I, endometrial mass thickness 10-12 mm, Group II, endometrial mass measurement 13-15 mm, Group III, anteroposterior endometrial mass thickness of 16-20 mm and Group IV with endometrial mass thickness of 21 mm onwards. Extracted material was sent for histopathology. Record of sonographic findings was matched with retrieved histopathology reports and sensitivity of sonography for the detection of RPOC was calculated. Results: 134 patients were found to have RPOC. This constituted 75% overall accuracy. Remaining 45 patients, wrongly labeled as having RPOC on sonographic evaluation, were mostly within first week of delivery or induced abortion. Blood clots and necrotic material closely mimicked RPOC in these patients but could not be differentiated from residual trophobla-stic tissue, chorionic villi or fetal parts even by experienced radiologist. Sensitivity of sonography was noted to be alarmingly low in Group I and II patients (31% aggregate) whereas in Group III and IV it approached 81% and 95% respectively. Conclusion: 75% sensitivity for detection of RPOC led to 25% patients undergoing unnecessary D&C. Considering the possibility of complications, both minor as well as major, following this interventional procedure, it is recommended that clinical impression as well as sonographic findings should be combined before proceeding on to uterine evacuation and if findings are equivocal on any of these, a waiting period of 24 to 48 hours may be observed and patient reviewed before operative procedure. This protocol should be given very serious consideration in patient with endometrial mass thickness of 15 mm or less.
oai:ojs2.localhost:article/78
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/78
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 129
Diagnostic Accuracy of BNP Levels in Detection of Heart Failure
Ejaz, Nauman
Ahmad, Nisar
Rashid, Munir Ahmad
Sherwani, Mubasher Ali
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/78
en_US
Objective: Evaluation of serum Brain Natriuretic Peptide levels as screening test in the diagnosis of left ventricular failure or congestive heart failure Material and methods: This cross-sectional survey was conducted at the Department of Medicine, Nishtar Hospital and Ch Parvez Ellahi Institute of Cardiology Multan from Feb 2006 to August 2006. A total of 50 patients were studied. Sampling was performed by non probability convenient type sampling technique. Results: Out of the 50 patients, 47(94%) patients had ejection fraction of less than 45% and were diagnosed as cardiac failure, as confirmed by echocardiography. Among these cases BNP levels were found to be elevated in 36(72%) patients, whereas in 11 (22%) cases, BNP levels were falsely negative. Only 3 patients (6%) in whom initial clinical diagnosis was heart failure, were later found to have negative echocardiography (EF > 45%). Two patients (4%) with negative echocardio-graphy (EF > 45%), had the BNP levels also negative i.e. below the cut-off point, whereas BNP was falsely positive in 1 patient Sensitivity and specificity of BNP (by ELISA) was found to be 80% and 66% respectively and accuracy was 80%. Conclusion: BNP measurements in the blood, is a new technique to diagnose heart failure. The clinical sensitivity and specificity of BNP (by ELISA) was although lower than echocardiography but it can be a good alternative for echocar-diography. Key words: Heart failure, B-type natriuretic peptide, Left ventricular failure, Echocardiography.
oai:ojs2.localhost:article/79
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/79
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 134
Analytical study of Ossicular Chain in Middle Ear Cholesteatoma
Ahmed, Salman Aftab
Hameed, Azhar
Khaleel, Muhammad Eyyaz
Munir, Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/79
en_US
Objective: The objective of the study was to detect and analyse frequency of occurrence of different types of ossicular chain defects in chronic suppurative otitis media with cholesteatoma on mastoid exploration and to identify the ossicle most commonly eroded by cholestestoma. Study Design: Analytical study Materials and Methods: A total of 75 cases of chronic suppurative otitis media with cholesteatoma with different age groups were admitted at E.N.T. Unit-1, Mayo Hospital, Lahore from July 2002 to July 2005. Each patient had essentially the work up according to the specific Performa. Results: Ninety seven percent (97%) cases showed the ossicular erosion while 3% cases showed intact ossicle i.e., all ossicle were intact. The Long process of incus was the commonest portion involved and then stapes supra-structure. Cholesteatoma was more common in the males (52%) than in the females (48%). Majority of patients i.e. 52% were in the age group of 16-30 years. It is also revealed that majority of patients belonged to poor communities living in rural or slum areas of the cities. Conclusion: The most common presenting feature of chronic suppurative otitis media with cholesteatoma was ear discharge. Most of the cases showed the ossicular erosion and incus was most commonly involved. Cholesteatoma is more common in males than in females. Cholesteatoma is more common in low socioeconomic groups. Key words: Cholesteatoma, Ossicles, Chronic suppurative otitis media with Osteitis.
oai:ojs2.localhost:article/80
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/80
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 138
Study of Synergistic Effect of Allicin with Antibacterials Against Micro-organisms
Akhtar, Shahnaz
Khalil, Javed
Akhtar, Nasim
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/80
en_US
Background: This study was designed to observe the antibacterial activity of allicin in combination with antibacterials, ciprofloxacin, enoxacin, vancomycin and clarithromycin against microorganisms pseudomonas aureginosa and staph aureus. Study Design: It is an analytical study. Materials and methods: Allicin was extracted from garlic with ethanol and chloroform. It was isolated by filteration technique using 15 mm Hg of pressure. Antibiotic discs were taken and micro-organisms were obtained from pathology lab FJMC LHR, Antibacterial activity of allicin was observed in combination with antibiotics. Results: It was found from the study that there is strong synergistic effect of allicin in combination with ciprofloxacin and enoxacin against pseudomonas aureginosa. Allicin also showed synergistic antibacterial effect with vancomycin and clari-thromycin against staph aureus. Conclusion: Due to the increasing resistance developed by microorganisms against the antibiotics, it may be suggested that the use of allicin along with antibiotics may overcome this resistance. Key words; Allicin, ciprofloxacin, enoxacin, vancomycin, clarithromycin, antibacterial activity.
oai:ojs2.localhost:article/81
2022-09-12T07:54:38Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/81
2022-09-12T07:54:38Z
King Edward Medical University
Vol. 15 No. 3 (2009); 141
Guided Percutaneous Cytology of Pancreatic Masses A Cytohistological Correlation
Asghar, Fareeha
Riaz, Sabiha
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/81
en_US
Objective: To determine the diagnostic accuracy, usefulness and limitations of ultrasound guided FNAC of pancreatic masses. Design: Cross-sectional analytical (comparative study). Place and Duration of Study: Department of Histopathology, Sheikh Zayed Hospital Lahore, Study Period - 2 Years. Materials and Methods: A total of 26 pancreatic masses were subjected to FNAC from January 2000 to December 2001. Adequate aspirates were obtained in all the cases, without any discrimination of age and gender. The smears were stained with Haematoxylin and Eosin (H & E), Papanicolaou staining (PAP) and May Grun-wald Giemsa stain (MGG). Results of FNAC were categorized as benign tumours (group I), malignant tumours (group II) and non-neoplastic/inflammatory lesions (group III). Tissue biopsy specimens from the same 26 patients were also obtained at the time of FNAC and stained with routine H & E staining. Histology was taken as the gold standard. Results: On histological examination 12 of the 26 cases were categorized as malignant tumours, 8 as benign tumours and 6 as non-neoplastic/inflammatory lesions. Out of the 12 malignant cases FNAC picked up 9 cases. Rest of the 3 cases had a false negative diagnosis for malignant tumours. In addition one case had a false negative diagnosis for benign tumour, but no false positive diagnosis was made. Malignant tumours revealed a sensitivity of 75% and diagnostic accuracy of 83.3% while benign tumours showed a 87.5% sensitivity and 92.86% diagnostic accuracy. Non-neoplastic lesions revealed a 100% sensitivity and diagnostic accuracy. A 100% specificity was obtained for both neoplastic and non-neoplastic lesions. The cytological results were statistically evaluated and the diagnostic accuracy was ascertained by calculating sensitivity, specificity, positive predictive value and negative predictive value in accordance with methods employed by Galen and Gambino1. Conclusion: Majority of the pancreatic tumours, both benign and malignant can be categorized on FNAC, with a high degree of accuracy, but since due to a relatively high incidence of false negative diagnosis, good quality preparations, with adequate cellular content, and cytohistological correlation is necessary. Key Words: FNAC, benign, malignant, non-neoplastic
oai:ojs2.localhost:article/82
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/82
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 15 No. 3 (2009); 144
Clinical Experience with Monteleukast in the Treatment of Allergic Rhinitis
Hameed, Azhar
Khan, Maroof Aziz
Iqbal, Javed
Hameed, Zahra Jabeen
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/82
en_US
Background: To evaluate the role of Monteleukast in combination with antihistamines and/or intranasal corticosteroids in the treatment of Allergic Rhinitis (AR). Type of study: A cross-sectional observational study. Methods: 30 diagnosed cases of AR were treated with a combination of Monteleukast and Antihistamines and/or Intranasal Corticosteroids and followed up for seven days. Results: 22 patients reported for follow-up and were included in this study. The average age of these patients was 28 years. There were 9 males and 13 females. Nasal itching was the most common symptom followed by nasal congestion, sneezing and rhinorrhoea seen in 21, 20, 20 and 17 patients respectively. Relief in symptoms was seen in 95% cases of nasal itching, sneezing and nasal congestion and 94% cases of rhinorrhoea. 2 patients reported with complications. Conclusion: Monteleukast in combination with antihistamines and or intranasal corticosteroids is an effective method of treatment of AR. Key Words: Monteleukast, Allergic Rhinitis, antihistamines.
oai:ojs2.localhost:article/83
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/83
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 15 No. 3 (2009); 146
Gynaecological Conditions Presenting to General Surgeon as Acute Abdomen
Khan, Sardar Sohail Ali
Sohail, Nausheen
Mehmood, Zahid
Javed, Khalid
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/83
en_US
<!-- /* Font Definitions */ @font-face {font-family:"Cambria Math"; panose-1:2 4 5 3 5 4 6 3 2 4; mso-font-charset:0; mso-generic-font-family:roman; mso-font-pitch:variable; mso-font-signature:-1610611985 1107304683 0 0 415 0;} /* Style Definitions */ p.MsoNormal, li.MsoNormal, div.MsoNormal {mso-style-unhide:no; mso-style-qformat:yes; mso-style-parent:""; margin:0in; margin-bottom:.0001pt; mso-pagination:widow-orphan; font-size:12.0pt; font-family:"Times New Roman","serif"; mso-fareast-font-family:"Times New Roman";} .MsoChpDefault {mso-style-type:export-only; mso-default-props:yes; font-size:10.0pt; mso-ansi-font-size:10.0pt; mso-bidi-font-size:10.0pt;} @page Section1 {size:8.5in 11.0in; margin:1.0in 1.0in 1.0in 1.0in; mso-header-margin:.5in; mso-footer-margin:.5in; mso-paper-source:0;} div.Section1 {page:Section1;} --> Objectives: To study the pattern of gynaecological emergencies presenting to general surgeons and to highlight problems in their management and to suggest solutions. Study Design: It is a descriptive cross sectional survey. Setting: Surgical Unit-II of Ghurki Trust Teaching Hospital of Lahore Medical & Dental College Lahore. Period: From 1st January 2007 to 31st December 2007 (one year) Materials & Methods: All female patients (107) presenting in surgical emergency with acute abdomen were included. However those women with any pervious gynaecological or obstetric operation who presented to surgical emergency with acute abdomen were excluded from the study. Clinical workup including a detailed physical examination and relevant investigations were carried out in all patients. These patients were managed in the surgical ward. The operative treatment, where required, was performed at the earliest possible time. The surgical procedures were employed according to the circumstances. Results: The total number of female patients in this study was 107. Nineteen (17.75%) of the patients presented with gynaecological emergencies acute abdomen. Age of the patient in this study ranged from 15 years to 35 years. The commonest gynaecological condition encountered was haemorrhagic functional ovarian cysts. Difficulty and errors in diagnosis occurred in these cases and erroneous diagnosis of acute appendicitis was made in seven out of nineteen patients (36.08%). Conclusion: Gynaecological emergencies constitute a significant problem encountered by the general surgeons. The problems of difficulty in diagnosis can be resolved by use of ultrasonography and laparoscopy. The general surgeons can contribute by enhancing knowledge of gynaecological emergencies and their clinical and therapeutic skills. Keywords: Gynaecological conditions. General surgeon, Acute abdomen.
oai:ojs2.localhost:article/84
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/84
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 15 No. 3 (2009); 149
Magnesium Sulfate Versus Diazepam Infusion in Eclampsia
Khan, Ikramullah
Ambreen, .
Humera, .
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/84
en_US
Abstract: The anticonvulsant has key role in management of eclampsia but the choice is still controversial. Objectives: To compare the efficacy of magnesium sulfate and diazepam infusion as good anticonvulsant. Study Design The study was conducted at Obst/Gynae Unit -II, Punjab Medical College, DHQ Civil Hospital, Faisalabad from 1st May, 2007 To 30th December,2007. Material and Methods: There were total 3506 deliveries in 8 months among 45 cases of antenatal eclampsia were selected. The cases of postpartum eclampsia, gestational age less than 28 weeks, and dead fetuses were excluded. 25 patients were allocated Mgso4 and 20 patients treated with Diazepam infusion regardless of prior therapy. The dosage of both was monitored clinically. Morbidity was defined in terms of maternal and fetal measures. Results: MGSO4 was the better anticonvulsant than diazepam infusion in terms of total morbidity, the value (P < 0.05), recurrence of fits (16% versus 30%), maternal deaths (Null versus 5%), respiratory depression (Null versus 10%). Mgso4 was associated with better outcomes in terms of total fetal morbidity (28% versus 90%) and perinatal deaths (4% versus 15%) than diazepam the value (P < 0.05). Fewer babies in Mgso4 group had low apgore score at 1 minute (12% versus 25%), at 5 minute (Null l% versus 10%), required less intubations (8% versus 25%) and required less admission in special care unit (4% VS 15%) than diazepam group. Key Words: Magnesium sulfate (Mgso4), Diazepam infusion, Eclampsia.
oai:ojs2.localhost:article/85
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/85
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 15 No. 3 (2009); 152
Correlation Between Non-insulin Dependant Diabetes Mellitus and Serum Sialic Acid
Khurshid, Muhammad Usman
Alvi, Mansoor
Rab, Shabkhez
Munir, Naeem
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/85
en_US
Abstract: Sialic Acid (SA) is a class of important glycemic derivatives that contain 9 carbon atoms.1 N-acetyl neuraminic acid (NANA) is the principal SA found in human tissues.2 SA is a generic term for a family of acetylated derivatives of neuraminic acid and is an essential component of glycoproteins and glycolipids.3 In this study, the relationship between Serum Sialic Acid (SSA) and Non-Insulin Dependant Diabetes Millitus (NIDDM) patients was investigated. One hundred (100) subjects, 32 males and 68 females, were included in the study. They were divided into two groups according to pre-sence or absence of Non-Insulin Dependant Diabetes Mellitus (NIDDM). Group-A was having 24 subjects without Diabetes Mellitus (DM) as a control; whereas, Group-B comprised of 76 patients with NIDDM. Sialic Acid (SA), Glucose, Lipids (Triacylglycerols and Total Cholesterol) levels were measured in serum. While, Glycated Hemoglobin (HbA1C) level was assayed in whole blood. Here we found a highly significant correlation between NIDDM patients and SSA as, NIDDM Patients had higher levels of SSA 2.37 ± 0.42 mmol/L as compared to the control group i.e. 1.48 ± 0.27 mmoI/L where p < 0.05 as well as Triacylglycerols and Total Cholesterol had highly significant correlation with NIDDM.
oai:ojs2.localhost:article/89
2022-09-12T07:54:39Z
annals:ED
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/89
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
TRANSFORMATION OF ANNALS OF KEMC INTO ANNALS KEMU
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/89
en_US
oai:ojs2.localhost:article/90
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/90
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Maternal Plasma Homocysteine Level, 24-Hour Urinary Protein and Haemoglobin in Pre-eclamptic Patients: is there Any Relationship?
Aamir, S
Ahmad, Zamir
Shamsi, A
Sultana, K
Ain, Qurat Al
Bhatti, M S
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/90
en_US
Background: Anemia is very common in developing countries especially during pregnancy. Hyperhomocysteinemia can result from genetic or nutrient-related disturbances in the transsulfuration or remethylation pathway for homocysteine metabolism. Inadequate intake of vitamin B12, B6 or folate may underlie some cases of elevated homocysteine levels. The aim of this study was to investigate the possible relationship between plasma homocysteine level, haemoglobin level and 24-hour urinary protein in pre-eclamptic patients. Folic acid deficiency is one of the major cause of hyperhomocysteinemia which is one of the major risk factor for pre-eclampsia (PET). Severe proteinuria of several grams/day occurs in pre-eclamptic toxaemia. Methods: A cross-sectional comparative study was carried out on 90 primigravidae attending the "antenatal clinic" of Services Hospital, Lahore. Out of these 60 primigravidae 30 were mildly pre-eclamptic and 30 were severely pre-eclamptic at 30-38 weeks of pregnancy.30 primigravida [30-38 weeks of pregnancy] having uncomplicated pregnancy were taken as control. Results: The results show that in mild PET and in severe PET, the plasma homocysteine level shows a significant relationship with 24-hour urinary protein and hemoglobin level. Conclusion: Anemia [folic acid deficiency] is one of the important risk factor in the causation of hyperhomocysteinemia which is one of the major chronic risk factors for eclampsia. Key-Words: Hyperhomocysteinemia, anemia, mild PET, severe PET.
oai:ojs2.localhost:article/91
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/91
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Molecular Pathogenesis, Epidemiology, Risk Factors & Prognosis of Head and Neck Cancers in Relation to Human Papilloma Virus Infection
Butt, Waqas Tariq
Butt, M U
Tariq, S
Ahmad, R
Ali, T S
Bukhari, Mulazim Hussein
Naeem, S
Munir, M
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/91
en_US
Human papillomavirus (HPV) is well known to cause cervical cancer and has now been increasingly implicated as a risk factor for head and neck squamous cell carcinoma (HNSCC). More than 100 types of HPV have been identified but HPV type 16 genome is the one most commonly detected in head and neck cancers, followed by HPV type 18. Two viral oncoproteins E6 and E7 are implicated to play an important role in promoting tumorogenesis by degrading p53 and Rb gene products respectively and thus disrupting the cell cycle. The HPV positive HNSCC patients tend to be younger, non smokers and non drinkers. Oral sex is thought to be the probable mode of transmission for the HPV infection. Patients with HPV positive tumors have at least 50 percent reduced risk of death from HNSCC when compared with HPV-negative patients. Understanding the molecular biology of HPV-positive tumors could lead to the development of diagnostic, therapeutic, preventive and screening measures for HNSCC in the future. Key Words: Head and neck squamous cell carcinoma (HNSCC), Human papillomavirus (HPV).
oai:ojs2.localhost:article/92
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/92
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Clinical and Radiological Performance of Three Endodontic Sealers
Hussain, Khalid
Anwar, F
Tareen, M K
Zubair, S
Tariq, M
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/92
en_US
Calcium hydroxide is commonly used in endodontics as an interappointment root canal dressing. The object of this study was to compare the clinical/radiographic treatment of 3 sealers, 2 of which contain calcium hydroxide. The clinical/radiological performance of three endodontic sealers was assessed in a prospective study of endodontic treatment in 150 roots. The roots were treated by undergraduate students according to a standardized procedure, and were filled with laterally condensed gutta-percha and sealer. The patients were recalled yearly for 4 years for a clinical and radiographic control examination, and the radiographs were scored using the periapical index (PAI) scoring system. The difference was significant after 1 year and persisted through the 4-year observation period. The difference was also evident after stratification of the material with regard to preoperative pulpal and periapical diagnosis. The influence of the sealer on treatment outcome was small. Key words: Gutta-percha, Sealer, Endodontic.
oai:ojs2.localhost:article/93
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/93
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Medical Termination of First Trimester Miscarriages
Khan, F M
Amin, Attiqa
Ahmad, F L
Naeem, N K
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/93
en_US
Objective: To study the success rate of medical termination of first trimester non viable pregnancies with misoprostol 1200µg.The secondary end points were to study the prevalence of unwanted side effects. Study design: Interventional: Quasi experimental study. Setting: Department of Obstetrics & Gynaecology. Fatima Memorial Hospital Lahore. Study duration: 18 months (July 05 to January 07). Sample technique: Non-probable sampling: Purposive. Sample: Eighty one women seeking medical attention for early miscarriages. Method: Women with non viable, first trimester miscarriage were selected for termination with misoprostol 1200µg in divided doses over 24 hours. Main outcome measures: Main outcome measure was the proportion of successful resolution of miscarriage without surgical intervention. Secondary outcomes were incidence of pain, heavy vaginal bleeding (>500ml), infection, pyrexia and gastrointestinal side effects. Results: Eighty-one women were recruited in the study. Treatment was successful in 43 patients (53.1%) with 38 patients (46.9%) requiring surgical evacuation due to failure of treatment. Major side effect experienced by patient was pain (42.0%) requiring analgesia for relief. Nausea and vomiting was seen in (18.5%). Two patients (2.5%) had diarrhea and three patients (3.7%) had pyrexia. Five patients (6.2%) had heavy vaginal bleeding (>500ml). None had PID. Conclusion: Medical treatment of first trimester miscarriage is non-invasive and cost effective method of treatment and a safe alternative to D&C. Our study demonstrated the efficiency and safety of administration of 1200μg of misoprostol orally for management of missed, incomplete and an embryonic miscarriage. Keywords: Misoprostol, medical management, miscarriage.
oai:ojs2.localhost:article/94
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/94
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Hellp Syndrome, A Clincial Variant of Pre-Eclampsia
Ahmad, Farhat ul Ain
Amin, A
Naeem, N K
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/94
en_US
Objective: of study the incidence and effects of complications on maternal and perinatal outcome in pregnancies complicated by HELLP syndrome in severe pre-eclampsia/eclampsia. Material and Method: Retrospective survey of case records of 156 (1.17%) women admitted with pre-eclampsia/eclampsia during last 2 years (March 2005 -march 2007) in department of Obstetrics and Gynaecology, Fatima Memorial Hospital, Lahore was done. Results: The incidence of severe pre-eclampsia/eclampsia was 1.17% (156/13336). Primigravidas constituted 44 and multigravidas 112. HELLP syndrome occurred in 6 primigravidas (13.63%) and 10 multigravidas (8.92%). Maternal deaths were 6.2% (1/16) in HELLP syndrome. Serious maternal morbidity in HELLP syndrome was abruptio placentae (25%), disseminated intravascular coagulation (62.5%), acute renal failure (18.75% of whom 33.3% needed haemodialysis) and postpartum hemorrhage (12.5%). Eighty women developed postpartum eclampsia, three developed adult respiratory distress syndrome. None had cerebral vascular thrombosis. Admissions to intensive care unit were 10, though none of patients required ventilator support. The perinatal mortality was 68.75% (11/16). The overall perinatal morbidity and neonatal ICU admissions were also significant. Conclusion: HLLP syndrome is associated with increase in maternal and perinatal mortality & morbidity. The importance lies in early diagnosis, direct input by clinician with special expertise in the management. So the perinatal mortality and morbidity can be brought down with early reference to tertiary care level hospital. Keywords: Maternal morbidity, perinatal mortality, HELLP syndrome, severe pre-eclampsia, eclampsia.
oai:ojs2.localhost:article/95
2022-09-12T07:54:39Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/95
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Coronary Artery Disease in Young: Faulty Life Style or Heredofamilial or Both
Noeman, Ahmad
Ahmad, N
Azhar, M
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/95
en_US
Objective: To see the frequency of different risk factors for coronary artery disease in our young population (i.e. age ≤ 40 years). Design: A Descriptive study. Place And Duration Of Study: Department of cardiac catheterization, Punjab institute of cardiology, Lahore. From January to December 2004. Sample Size: 459 young patients with documented coronary artery disease were included in this study. Methods and results: The present study comprised of 459 young patients (≤ 40 years) who presented with symptoms suggestive of ischemic heart disease. All patients were evaluated for conventional risk factors for coronary artery disease (like Diabetes mellitus, hypertension, smoking, dyslipidemia, obesity, waist hip ratio (WHR) and by doing coronary angiography. Out of these 459 patients, there were 376 (81.9%) males and 83 (18.1%) females, mostly belonging to 36 + 4 years age group. 63.4% were chronic smokers and all of them were males. 18.8% subjects gave history of premature coronary artery disease in first degree relatives. Some of them had distinct evidence of psychosocial stress preceding a coronary artery disease episode. Hypertension was detected in 51.4% cases. Obesity was observed in 35% cases. Dyslipidemia was seen in 41.66% cases. 7.14% cases were diabetic. Most ominous combination was smoking, obesity, dyslipidemia and hypertension. Conclusion Both heredofamilial as well as faulty life style contribute to the development of coronary artery disease in young people. Key Words: Coronary artery disease, smoking, hypertension.
oai:ojs2.localhost:article/96
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/96
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King Edward Medical University
Vol. 13 No. 2 (2007)
Temporary Access Catheter for Hemodialysis Complications and Follow up
Anees, M
Nazir, M
Sheikh, R
Kausar, T
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/96
en_US
Objective: To determine the acute and chronic complications of temporary access catheter insertion for hemodialysis. Design; Cross-sectional study. Place and duration of the study: This was a hospital based study carried out in the hemodialysis unit of Shalamar Hospital, Lahore. This study was conducted from June 2003 to December 2005. Subjects and Methods: All patients who presented for hemodialysis were included in the study and who were not fit were excluded from the study. Location of the catheters was subclavian vein, internal jugular and femoral vein. Acute complications were noted at the time of insertion of catheter. Patients were followed up for three months for long term complications. A blood sample was drawn for routine hematological and biochemical work up on presentation. Results: A total of 177 patients were enrolled in the study who presented for hemodialysis. 227 temporary double lumen dialysis catheters were passed in these patients. Most common cause of catheter insertion was diabetic nephropathy followed by chronic glomerulonephritis. Acute complications were at the rate of arterial puncture 9 (4%), hematoma 1 (0.4%) and pneumothorax 1 (0.4%). Complications during hemodialysis were, fever at the rate of 19 (8.4%), hypotension 7 (3.1%), blood flow problem6 (2.6%) and miscellaneous 3 (1.2%). Mean duration of catheter insertion was 5 weeks and dialysis sessions were 9.5. Among late complications infection were at the rate of 27 (11.9 %), vascular stenosis 5 (2.2%) and thrombosis 3 (1.3%). Conclusion: Complications at the time of catheter insertion are minimal even it is done blindly. Infections are most common late complication and complication during dialysis. Temporary access catheter insertion is very simple and free of life threatening complications .It is readily used on emergency basis when there is no permanent access for dialysis. Key Words: Temporary access catheter, hemodialysis, complications.
oai:ojs2.localhost:article/97
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/97
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 13 No. 2 (2007)
Comparison of Argyrophilic Nucleolar Organiser Regions (AgNORS) with Proliferating Cell Nuclear Antigen (PCNA) in Different Grades of Transitional Cell Carcinoma of Urinary Bladder
Khan, Abdul Haseeb
Khan, A S
Chaudhary, N A
Tayyab, M
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/97
en_US
Objective: To Compare Argyrophilic Nucleolar Organiser Regions (AgNORs) pattern with Proliferating nuclear antigen (PCNA) in different grades of transitional cell carcinoma. Design: Descriptive and Comparative study. Material and Methods: A total of fifty transurethrally resected bladder tumour samples (TUR BT) were collected from Mayo Hospital, Lahore and Services Hospital, Lahore and processed for H&E, AgNOR stain and PCNA stain. The grading of tumours were made on H&E stain. While AgNOR pattern and PCNA labeling index were recorded for each case. Results: A significant higher proportion of cases (p<0.02) with 3+ AgNOR dispersion were seen in grade III tumours. The AgNOR proliferative index in grade III tumour was significantly higher (p<0.05) as compared with grade II tumours. The cases with AgNOR dispersion of 3+ had significantly higher mean PCNA labeling index (p<0.02) when compared tumours of 2+ AgNOR dispersion. Conclusion: AgNOR and PCNA have significant role in grading of transitional cell carcinoma. The demon-stration of AgNOR dispersion is also a simple and cost effective procedure and could be considered as a substitute for PCNA labeling index. Key words: Nuclear organizer regions, PCNA, Transitional cell carcinoma.
oai:ojs2.localhost:article/99
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annals:ED
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https://annalskemu.org/journal/index.php/annals/article/view/99
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King Edward Medical University
Vol. 14 No. 1 (2008); 01
MEDICAL ETHICS AND ISLAM
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/99
en_US
oai:ojs2.localhost:article/100
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/100
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 05
Comparison of Intubating Conditions Produced by Rocuronium and Suxamethonium for Rapid Sequence Induction in Elective Caeserean
Ali, A
Sheikh, N A
Khawaja, S
Saleem, J
Kaul, S U
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/100
en_US
Objective: To find out whether Rocuronium produces intubating conditions as good as Suxamethonium in rapid sequence induction (RSI) in elective caesarean section. Design: Quasi Experimental Study. Setting: Operative rooms of Hameed Latif Hospital Lahore. Subjects: 50 ASA I and II parturients scheduled for elective caesarean section under general anaesthesia: Interventions: Anaesthesia was induced with 5mg/kg Thiopentone and neuromuscular blocking agent using RSI. Group I (n=25) received Suxamethonium 1.5 mg/kg and group II received Rocuronium 1.0 mg/kg. Intubation was done 60s after the administration of muscle relaxant. Main outcome: Intubating conditions using the scoring criteria described by Cooper et al. Results: There was no statistically significant difference in jaw relaxation, vocal cord relaxation and response to intubation in both groups. Overall intubating conditions in group I & II were excellent in 84 %and 76% patients while good in 16% and 24 % patients respectively with no statistically significant difference (p>0.05). Conclusion: Our study showed that Rocuronium 1.0 mg/kg provides equally good intubating conditions when compared to Suxamethonium 1.5mg/kg in elective caesarean section using RSI at 60s. Key words: Neuromuscular blocking agent; Suxamethonium, Rocuronium, intubation; rapid sequence induction caesarean.
oai:ojs2.localhost:article/101
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/101
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 08
Glaucoma Related Morbidity at A Tertiary Care Eye Hospital
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/101
en_US
Purpose: To report pattern and burden of glaucoma related morbidity in terms of visual impairment and structural damage to optic nerve in patients presenting for the first time at glaucoma clinic of a tertiary care eye hospital. Design of Study: A cross sectional observational study. Participants: All patients aged above 16 years reporting for the first time at glaucoma clinic of Al-Shifa Trust Eye Hospital, Rawalpindi from 1st July 2006 to 30th June 2007. Methods: After taking history, a detailed ocular examination of all the patients including visual acuity using snellen chart, refraction trial for best corrected visual acuity, slit lamp examination, applanation tonometry (with tonopen in unco-operative patients), gonioscopy (with four mirror Posner lens), stereoscopic assessment of the cup disc ratio ( with Heidelberg retinal tomogram) and visual field (Humphery static perimetery, 30-2 program and Frequency doubling technique) testing was performed. All data was recorded on a special proforma and then assessed using statistical software SPSS version 12.0. Results: A total number of 800 new patients were examined in the glaucoma clinic from 1st July 2006 to 30th June 2007. Among these 800 patients, 487 (60.9%) were male and 313 (39.1%) were female. 132 subjects (16.5%) were identified as blind with a visual acuity of <3/60 in both eyes while an additional 325 subjects (40.6%) had a visual acuity of <3/60 in one eye. Crude estimate of the frequency of blindness (Table 2) was slightly higher in women as compared to men (OR, 1.07; 95% CI, 0.87-1.27). Blindness was associated with illiteracy (OR, 2.80; 95% CI, 2.15-3.45), age of patients 60 years and above (OR, 1.38; 95% CI, 1.07-1.69) and advanced cupping in both eyes (OR, 2.75; 95% CI, 2.18-3.32). Blindness was more frequent in patients of neovascular and pseudoexfoliation glaucoma. Regarding the structural damage, 33% of the pati-ents presented to us when the cup disc ratio in their better eye had worsened to 0.8 or more. Conclusion: Glaucoma is leading cause of blindness, and warrents detailed investigation of strategies for prevention. As It is a fact that advanced stage of glaucoma at diagnosis has been one of the most important factors for glaucoma caused blind-ness, targeted screening, breaking down barriers to access and a campaign to create awareness among the people regarding importance of regular eye examinations may be effective in reducing the number of patients going blind from glaucoma. Using the available data from the health surveys, improving awareness, case detection, and early treatment of glaucoma are the fields which need our attention. In short, a combined effort by governments, NGOs, ophthalmologists and primary health care providers can be helpful to prevent the world from glaucoma related blindness.
oai:ojs2.localhost:article/102
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annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/102
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 13
Review of Study of Vaginal Birth After Caesarean Section (VBAC)
Taj, Ghazala
Sohail, N
Cheema, S Z
Zahid, N
Rizwan, S
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/102
en_US
Aims and Objectives: To determine the frequency and mode of delivery in women with one caesarean section and to evalu-ate the fetomaternal outcome of trial of labour of previous one caesarean section. Material and Methods: A trial of vaginal delivery was carried out on 100 patients in the Department of Obstetrics and Gynaecology of Lahore General Hospital Lahore, Descriptive study was conducted from September 2006 to September 2007. Selection criteria were subjects with normal pregnancy, adequate maternal pelvic dimensions, vertex presentation and spon-taneous onset of labour with previous one uncomplicated LSCS. Patients with classical caesarean section, medical complica-tions, multiple pregnancy, 1UGR, placenta previa and extensive myomectomy were excluded from the study. Informed con-sent was taken from all patients; trial of scar was given with vigilance. Maternal and fetal monitoring was carried out with facility of operation theatre, anesthesia and pediatrician. Results: Success vaginal delivery was achieved in 70% of the patients and repeat emergency caesarean section was carried out in 30% of the patients. Leading indication for repeat caesarean section was failure to progress, fetal distress and scar ten-derness. No maternal and fetal complication occurred. Conclusion: Trial of scar after one LSCS should be encouraged with vigilant monitoring provided no obstetric contra-indication exists. Key words: VBAC, scar tenderness, maternal mortality, LSCS.
oai:ojs2.localhost:article/103
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annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/103
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 17
Beliefs & Perceptions about Laser Hair Removal Amongst Students of a Private Medical College in Islamabad
Rehman, Farid ur
Niazi, N A K
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/103
en_US
Background: It was hypothesized that misconceptions prevail amongst undergraduate medical students about laser hair removal. Objectives: To determine the extent of misconceptions about laser hair removal amongst undergraduate medical students. Methods: The students of Foundation University Medical College of the first four year classes were included in the study. These students completed a specially designed questionnaire. Results: A total of three hundred and forty five students participated in the study. The age range was from 17-21 years. The male to female ratio was 1:1.75. With respect to the side effects of laser hair removal, 72% believed that laser treatment is harmful to skin, 68% believed that laser treatment causes skin cancers, 64% believed that laser treatment causes eye damage and 10% believed that laser treatment is extremely painful. On the issue of laser hair removal, 19% believed that laser treatment involves the use of a fine needle, 84% believed that laser hair removal is more effective than waxing of hair, 48% suggested that white hair can also be treated by laser, 11% suggested that laser hair removal involves a single treatment session and 9% suggested that laser hair removal alone is sufficient in a female with irregular menstrual cycle. Conclusions: Misconceptions about laser hair removal prevail amongst our undergraduate medical students. An education program on laser hair removal is needed to improve their knowledge about this therapeutic option. Key Words: laser, misconceptions, laser hair removal.
oai:ojs2.localhost:article/104
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annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/104
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 21
Experience of Ureteroscopic Pneumatic Lithotripsy In Management of Lower and Mid Ureteric Calculi
Rasool, Mumtaz
Tabassum, S A
Mumtaz, F
Sheikh, A A
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/104
en_US
Purpose of Study: To formulate results of our experience with ureteroscopy and intracorporeal pneumatic lithotripsy during management of mid and lower ureteric stones. Design of Study: Prospective. Period of Study: January 2004 to April 2006. Setting: American General Hospital, Ahmadpur Road Bahawalpur. Patients and Methods: All patients of mid and lower ureteric stones above 18 years of age were included in this study. Initially 115 patients were selected but 15 patients were lost during follow-up. Patients with previous history of surgery for ureteric stones were not included. Ureteroscopy and intracorporeal pneumatic lithotripsy were used for patients whose stones failed to progress on conservative trial. Results: Intracorporeal pneumatic lithotripsy with ureteroscopy has best results especially in single session with 94.2% stone clearance rates. Conservative management of ureteric calculi is very promising and practicable provided the infection and pain remains under control and stone size is smaller than 06mm. Conclusion: Wait and Watch treatment for ureteric calculi is safe.Ureteroscopy and pneumatic lithotripsy is effective and can be advocated as first line treatment for ureteric calculi if opted by the patient. Key Words: Ureteric calculi, Ureterorenoscopy (URS), Intracorporeal Pneumatic lithotripsy. UreteroRenoscopic Lithotripsy (URSL).
oai:ojs2.localhost:article/105
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/105
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 26
Comparison Between Manipulation under Anesthesia and Hydraulic Distension for Treatment of Frozen Shoulder
Shah, Muhammad Ali
Khan, I
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/105
en_US
Objective: To evaluate and compare the outcome of Manipulation under anesthesia (MUA) and Hydraulic distension as treatment options for frozen shoulder and to see which treatment option is superior in terms of early pain relief and improved range of motion (ROM). Type of study: Prospective, Randomized trial. Place and duration of study: District headquarter teaching hospital, Dera Ismail Khan. July 2005- September 2006. Materials and Methods: A total of 36 patients were randomized to receive either method. Group A included 16 patients who underwent manipulation under anesthesia. Group B consisted of 20 patients who had hydraulic distension. The patients rece-ived supervised physiotherapy after both procedures. Both the groups were then compared regarding early pain relief and range of motion. Results: Regarding pain relief in Group A, 9 out of 16 patients reported no pain within 1 week whereas in Group B, 17 out of 20 patients were pain free within first week of procedure. Regarding active ROM, during first week in Group A, 10 patients had "excellent" while 6 patients showed "good" results. In Group B, 18 patients had "excellent" and 2 patients "good" re-sults. Conclusion: Hydraulic distension gave better results in terms of early pain relief and improved ROM. Moreover it is cost effective and carries less complication rate. Key words: Hydraulic distension, Manipulation under anesthesia (MUA), Shoulder.
oai:ojs2.localhost:article/106
2022-09-12T07:54:39Z
annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/106
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 30
Objective: To evaluate and compare the outcome of Manipulation under anesthesia (MUA) and Hydraulic distension as treatment options for frozen shoulder and to see which treatment option is superior in terms of early pain relief and improved range of motio
Masood, Anoosh
Aman, S
Kazmi, Atif Husnain
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/106
en_US
Lipoid proteinosis is an uncommon, autosomal recessive disorder characterized by infiltration of hyaline material into the skin, oral cavity, larynx and internal organs. The patients of this disease present with hoarseness of voice, beaded papules on eyelid margins, hyperkeratosis of skin and an inability to protrude the enlarged, thickened tongue. Many similar cases with additional features have been reported in foreign literature. We describe two cases of this disorder along with review of literature. Key words: Lipoid proteinosis, hyaline material, macroglossia.
oai:ojs2.localhost:article/107
2022-09-12T07:54:39Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/107
2022-09-12T07:54:39Z
King Edward Medical University
Vol. 14 No. 1 (2008); 38
Re-evaluation of the Effects of NSAIDS on Blood Vessels
Bhatti, Abdul Shabbir Ali
Khan, A H
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/107
en_US
Background: Blood vessels regulate peripheral resistance and hence blood pressure. Their tone is controlled by autonomic nervous system, calcium influx and regulation of cycloxygenase-2 (COX-2). Autonomic nervous system also regulates calcium influx in to the cells. Some of NSAIDs like salicylates block calcium influx across the cell membrane. We have tried to find out effects of diclofenac, piroxicam and celecoxib on isolated blood vessel and their role in hypertension. Methods: We have found effects of diclofenac, piroxicam and celecoxib on the rat aortic ring with intact endothelium and spiral strip of rabbit portal vein. The isolated tissues were stimulated with 1 μM of norepinephrine. Diclofenac 15 and 20μM and piroxicam 15 μM produced significant relaxation in rat aortic ring while there was no significant effect of celecoxib. Diclofenac 10, 15 and 20 μM, piroxicam 5 μM, celecoxib 5, 10 and 20 μM produced significant vasorelaxant effects on rabbit portal vein. Conclusions: It is concluded that only non specific COX inhibitors affect arteriolar tone while venous tone is also decreased significantly not only by nonspecific but also by COX-2 inhibitors. Key Words: Blood vessels, NSAIDs, Endothelium, Hypertension
oai:ojs2.localhost:article/108
2022-09-12T07:54:40Z
annals:ED
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https://annalskemu.org/journal/index.php/annals/article/view/108
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 194
RESEARCH LEADS TO HUMAN PROGRESSION
Awais, Syed Muhammad
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/108
en_US
oai:ojs2.localhost:article/109
2022-09-12T07:54:40Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/109
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 198
Correlation Between Exercise Induced Lactic Acidosis and Leucocytosis
Ali, Shaukat
Bhatti, A
Wazir, F
Shah, S H
Farmanullah, A Ijaz
Ijaz, A
Zameer, S
Khan, M G
Rafeeq, M
Jan, R
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/109
en_US
Background: Short lasting strenuous physical exercise leads to a marked change in peripheral leucocyte number which is assumed to be diagnostically informative and may be a prognostic marker. Lactic acidosis also develops after intense exercise of short duration, at a metabolic rate that is specific to the individual and the task being performed. This study was done to observe the effects of intensity and duration of exercise on blood lactic acid and total leucocyte count. Furthermore to find out the possible correlation between exercise induced lactic acidosis and leucocytosis. Methods: Two groups, each consisting of fifteen normal healthy male adults, were exercised on treadmill. Group-I performed exercise by running for a duration of 2-3 minutes, at 7% grade (4 degree inclination) and at constant speed ranging from 7.5 to 9 km/hour while group-II subjects walked on treadmill for a duration of 7-10 minutes, at zero grade and at constant speed ranging from 5 to 6 km/hour. Blood samples were drawn before and after exercise. Total leucocyte count was determined manually using an improved Neubauer hemocytometer and lactic acid in the blood was determined colorimeterically by Spectronic 21. Results: The total leucocyte count increased significantly (P<0.001) by 83.145% and 59.746% after exercise, in groups I and II respectively; group-I vs group-II P<0.1. While the blood lactic acid significantly increased (P<0.001) by 43.197% and 27.273% after exercise, in groups I and II respectively group-I vs group-II P>0.01. The correlations between post-exercise values of blood lactic acid and total leucocyte count of group-I and group-II subjects were r = 0.278 (P <0.5) and 0.201 (P <0.5), respectively. Conclusion: It is clearly reflected by this study that the magnitude of exercise induced lactic acidosis and leucocytosis is higher in exercise of more intensity and less duration. Although the correlation between post-exercise blood lactic acid concentration and total leucocyte count was weak and non-significant but was found in both groups. So, the exercise induced lactic acidosis may play at least some role in inducing post-exercise leucocytosis. Key Words: Exercise, leucocytosis, lactic acidosis.
oai:ojs2.localhost:article/110
2022-09-12T07:54:40Z
annals:ART
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https://annalskemu.org/journal/index.php/annals/article/view/110
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 202
The Comparison of Hysterosalpingography and Laparoscopy in Predicting Fertility
Waheed, Shahid
Mazhar, R
Khan, N H
Rafi, M
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/110
en_US
Objective of the study was to compare the prognostic significance of Hysterosalpingography (HSG) and laparoscopy for fertility outcome. Materials and Method: Study was conducted in Radiology Departments of Sir Ganga Ram Hospital, Lahore and Lahore General Hospital, Lahore from June to November 2005. Hysterosalpingography was performed on 100 patients being investigated for infertility. Later all study patients were investigated with Laparoscopy. Findings of both these investigations were compared for their ability to demonstrate anatomy and pathology of fallopian tubes, uterine cavity, intrapelvic peritoneal adhesions, and intraperitoneal contrast/ dye spill. Results: On HSG 68% patients showed bilateral intraperitoneal contrast spill demonstrating patency of both fallopian tubes, 22% showed unilateral spill and 10% showed no spill. On laparoscopy, 28% patients showed bilateral intrapelvic spill of dye, 18% showed unilateral spill, while 55% patients showed no intrapelvic spill of dye. Difference in determination of tubal patency was significant (p < 0.001) between both these methods. There was no significant difference between two techniques in demonstrating hydrosalpinx and uterine cavity. On HSG 24% patients showed bilateral peritoneal adhesions, 28% showed unilateral while 50% patients were without such adhesions. Using laparoscopy, the number of patients with bilateral adhesions was 39%, while 16%patients had unilateral and 4% were without peritoneal adhesions. Results with two techniques differed significantly (p<0.05). Conclusion Hystero-salpingography was found to be significantly more accurate in showing patency of fallopian tubes and thus predicting future prognosis in patients being managed for infertility. It is less invasive as compared to laparoscopy and is reliable and almost equally useful method for evaluating internal architecture of female reproductive tract. Utilizing HSG it may be possible to minimize the use of invasive procedures like laparoscopy and hysteroscopy. Laparoscopy was found to be more useful than HSG in demonstrating pelvic adhesions. Key Words Hysterosalpingography (HSG), Laparoscopy, Hysteroscopy, Infertility, Peritoneal adhesions, Tubal patency, Hydrosalpinx.
oai:ojs2.localhost:article/111
2022-09-12T07:54:40Z
annals:ART
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v2
https://annalskemu.org/journal/index.php/annals/article/view/111
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 206
Reproductive Risk Factors, Pregnancy Characteristics and Obstetric Outcome in Female Doctors
Ambreen, Afshan
Hussain, A
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/111
en_US
Objectives: To compare maternal risk factors, pregnancy characteristics and outcome in female doctors, teachers, and the general obstetric population. Design: We analyzed obstetric outcomes among 331 female doctors and 656 teachers with singleton pregnancies who gave birth at Fatima Memorial Hospital from March 2000 to December 2006. The general obstetric population (n = 21, 997) was selected as the reference group and logistic regression analysis was used to assess pregnancy outcomes in each group separately. Results: Reproductive risk factors among female doctors and teachers were similar to those in the general obstetric population with the exception of advance maternal age, number of previous terminations, obesity, infertility treatment and pre-eclampsia. Interestingly, the number of operative deliveries did not vary between the groups. Pregnancy outcome among the doctors and teachers was comparable with that in the general population. Conclusions: Although doctors and teachers appear to represent a group of health-conscious women, obstetricians don't vary their management of pregnant doctors and teachers during pregnancy and labour. Keywords:- Pregnancy, Caesarean Section.
oai:ojs2.localhost:article/112
2022-09-12T07:54:40Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/112
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 220
Why Do Mothers Die?
Hanif, Shamayela
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/112
en_US
Objective: To identify the main causes and associated risk factors contributing to maternal deaths. Study Design: Analysis of retrospective data. Place and Duration of Study: Department of Obstetrics and Gynecology, Fatima Memorial Hospital from January 2001 to December 2005. Method: The medical records of the women dying were reviewed. Demographic record including age, parity, socioeconomic status and antenatal care were analyzed from patient's records. Results: Seventeen maternal deaths were recorded during the study period with the maternal mortality ratio MMR of 58.53/100,000 live births (17/29042). The causes of death in all 17 cases were made on clinical assessment done jointly by Gynaecologist, Anaesthetist and Physician as post-mortem examination was not done. The major causative factor for maternal death was hypertensive disorder 6 (35.29%) followed by coagulation disorder due to intrauterine death 2 (11.76%), amniotic fluid embolism 2 (11.76%) and fatty liver of pregnancy 2 (11.76%). Causes like thromboembolism, haemorrhage, anaesthetic complications and puerperal myocarditis were responsible for a single death each. No cause could be ascertained in one case. The age of the women who died ranged between 21-39 years. There were 7 primigravidas (41.17%), 7 (41.17%) were Para 1-4 (41.17%) and 3(17.64) women had parity more than 4. Most of them had poor socioeconomic status. Only 4 women were booked (23.52%). The rest 13 women (76.47%) were unbooked. Conclusion: Most of the causes of maternal deaths are preventable if timely identified and treated by skilled health care professionals. Key Words: Maternal Mortality, Haemorrhage, Eclampsia
oai:ojs2.localhost:article/113
2022-09-12T07:54:40Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/113
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 209
Changes in Serum Lipid Profile Among Patients Suffering From Chronic Liver Disease.
Mehboob, Fatima
Ranjha, F A
Masud, S
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/113
en_US
Objective: to find changes in lipid metabolism among patients suffering from chronic liver disease. Design: Hospital based observational study. Setting: Medical Unit-II Sheikh Zayed Medical College, Rahim Yar Khan. Duration: January to July 2007. Patients and Methods: About 160 Patients admitted in Medical Unit-II with a diagnosis of chronic liver disease were included in the study. Fasting lipid profile was done in all cases. Micro Lab 300 chemistry analyzer performed lipid Profile by end point kit method. Results and Observations: There were 102 (63.75%) male and 58 (36.25%) were female patients. Total cholesterol was markedly decreased in 24 (15%) patients. Low to normal range was present in 132 (82.5%) patients. Hypercholesterolemia was seen in 4 (2.5%) patients. Hyper triglyceridemia was seen in one patient. Serum triglyceride levels were low to normal in 101 (63.13%) patients. HDL-c was below normal in all cases. LDL was low in 141 (88.13%) patients, normal in 12 (7.50%) patients and high in 7 (4.38%) patients. Conclusion: Dyslipidemia is a common finding in chronic liver disease. Lipid profile should be done in all cases with advanced liver disease. Key wards: Dyslipidemia, LDL-c, HDL-c, Cholesterol, Triglycerides.
oai:ojs2.localhost:article/114
2022-09-12T07:54:40Z
annals:ART
driver
v2
https://annalskemu.org/journal/index.php/annals/article/view/114
2022-09-12T07:54:40Z
King Edward Medical University
Vol. 13 No. 3 (2007); 212
Outcome of Delayed Minimally Invasive Plate Osteosynthesis in Firearm Injuries of Femoral Shaft
Hanif, Muhammad
Azhar, S
Syed, M K
Bhutta, I A
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments publications@kemu.edu.pk
url:https://annalskemu.org/journal/index.php/annals/article/view/114
en_US
Objectives: To evaluate the results of bridge plating in comminuted femoral shaft fractures in adults due to high velocity firearm injuries. Study Design: A cross-sectional observational study. Patients & Subjects: A total of 30 Patients with fracture of femoral shaft from high velocity firearm injury were studied, who met the inclusion criteria. Methods: The patients were admitted through Emergency Department after completing the initial protocol. Multiple debridements were done if needed and subsequent fixation was done in 02 to 03 weeks of initial injury. Results: We achieved union in all the cases. The average time to union was 20 weeks and 6 days. Male to female ratio was 4:1. There were 02 cases (6.7%) of delayed union & 01 case (3.31%) of nonunion. Infection occurred in 04 pts (13.4%), 02(6.7%) with superficial and 02 (6.7%) with deep infection. Hardware pain was experienced by 03 patients (10%). Conclusion: The comminuted fracture of the femoral shaft due to high velocity firearm injuries can be managed with excellent results using the minimally invasive plate (biological) fixation. The key to success is debridement of devitalized tissue and hence eradication of infection before fixation.
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