ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-09-15T05:42:07+00:00 Prof. Dr. Muhammad Jamaluddin Open Journal Systems <p style="font-weight: 400;">The scientific journal, Annals of Abbasi Shaheed Hospital and Karachi Medical and Dental College is a quarterly peer-reviewed journal being published for over 20 years, recognized by PMDC, HEC (Y-Category) and cited on Emerging Sources Citation Index (Thomson Reuters), IMEMR, Pakmedinet. The Editor-in-Chief is a member of World Association of Medical Editors (WAME), Eastern Mediterranean Association of Medical Editors (EMAME), and Pakistan Association of Medical Editors (PAME).</p> <p style="font-weight: 400;"><strong>ARTICLE PROCESSING:</strong></p> <p style="font-weight: 400;">The articles can be submitted online via eJManager throughout the year and on an average, it takes maximum one year to print an article. For any queries please email at</p> <p style="font-weight: 400;">1.Processing Fee: Rs. 1500/-<br>2.Publication Fee: Rs. 1000/- (per side of PDF)<br>3.Publication Fee of Pictorial Quiz: Rs. 1000/-<br>...(Include processing and Publication Both):</p> <p style="font-weight: 400;">Subscription per issue:<br>In Pakistan: Rs.1000/-<br>In Karachi: Rs.800/-<br>Bangladesh &amp; India: Rs.1200/-<br>UK: £ 40<br>USA &amp; other Countires: $ 60</p> Never Waste a Good Crisis' (Machiavelli) 2021-09-14T08:31:54+00:00 Shama Mashhood <p>Impact of pandemic COVID 19 affected the whole world especially the educational institutions suffered a lot1. UNESCO has reported that 'more than 1.5 billion students and youth across the planet are or have been affected by school and university closures due to the COVID-19 pandemic'2. The crises have highlighted the fragility of the educational system1. The crisis creates not only challenges but opportunities and innovations as well. The whole world has learnt different lessons from the COVID-19 pandemic. To manage the educational crisis contingency plan should be designed with smart objectives, develop a system of evaluation,<br>remain in continuous communication with internal and external stakeholders by quick response feedback and set timelines. This will help out in the early detection of loopholes and resolution of issues.</p> 2021-09-14T06:08:44+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Assessment of Oral Health Behaviour & Self Practice among Hazrat Bari Sarkar Medical & Dental Students using the Hiroshima University - Dental Behavioural Inventory (HU - DBI) 2021-09-14T08:31:54+00:00 Ahmad Usman Yusuf Qurat-Ul-Ain Shazia Sarwat Iqbal Mudassir Hussian Farhan Butt Syed Tariq Ali Adnan <p>Objectives: To assess oral health behaviour &amp; self-practice among HBS undergraduate medical &amp; dental students in Islamabad, Pakistan &amp; to evaluate the variations in oral health behaviour &amp; self-practice based on age, gender, academic program (MBBS/BDS) &amp; education year.<br>Methods: Hiroshima University Dental Behaviour Inventory (HU-DBI) questionnaire in English version consisting of 20 dichotomous responses (Agree/Disagree) was self-administered among 300 undergraduate medical &amp; dental students of HBS Medical &amp; Dental College in Islamabad. Three hundred medical and dental students were selected by convenience sampling. This cross-sectional study was conducted in the month of October 2019 &amp; 38 questionnaire forms were excluded from the study which was incomplete &amp; data was analysed on 262 (51 from dental &amp; 211 from medical students) student's responses using SPSS Version 24 and statistical significance was set at P &lt; 0.05.<br>Results: The mean age of students who participated in the study was 21.26 ± 1.90 years with a total number of 109 males &amp; 153 females. A significantly higher HU-DBI score was observed among students from higher years of education only (p-value of 0.015). The majority of students (80.1%) brush their teeth daily. About 64.5% of students mentioned that they use toothbrushes &amp; 15.6% used miswak on daily basis for cleaning their teeth. About 88.6% of students did not use mouthwash &amp; toothpicks regularly.<br>Conclusion: It can be concluded from the results that students belonging to higher years of education showed improved oral health behaviour and attitude as compared to the early years of education. Overall health behaviour observed was adequate.</p> 2021-09-14T06:05:51+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Ginseng Holds Promise Against Obesity 2021-09-14T08:31:55+00:00 Rabia Rehan Mahrukh Kamran Ayesha Abdul Haq Sahar Mubeen Maria Khan Hira <p>Objectives: To determine the effects of ginseng on obese albino rats.<br>Methods: This study was intended to correlate the role of ginseng in reducing body weight, liver weight and size as well as fatty accumulation in hepatocytes of male albino rats weighing between 110g to 140g. This experiment was designed to study the morbid anatomy of an animal model. It was conducted in Animal house of Dow University of Health Sciences. Fifty male Albino Wistar rats were divided into 5 groups. Group1 (Gp 1) was on normal balanced diet (control), Group 2 (Gp 2) was on high fat diet (HFD), Group 3 (Gp 3) on HFD plus ginsenoside 100 mg/kg body wt., Group 4 (Gp 4) on HFD plus ginsenoside 200mg/kg body wt., and Group 5 (Gp 5) on HFD plus 400mg/kg body.<br>Results: Weight was increased to 146 g (Gp1) and 236g (Gp 2). Group 3 reduced weight from 236g to 211g. Group 4 to 192g and Group 5 to 171g. Liver weight is also increased by HFD from 4.7g (Gp1) to 9.3 g (Gp 2). Liver weight decreased from 9.3g to 7.2g (Gp 3), 7.6 g (Gp 4) and 5.3 g (Gp 5). Due to deposition of fat in liver, cells enlarged and number of hepatocytes decreased per unit area of reticule. Number of hepatocytes in group 1 was 78.5, in group 2 WAS 38.3, in group 3 was 47.4, in group 4 was 53.8 andin group 5 was 67.7. Random blood sugar (RBS) was altered to 74.3 mg/dl in Gp1, 148 mg/dl in Gp2, 91 mg/dl in Gp3, 92 mg/dl in Gp4 and 69 mg/dl in Gp5.<br>Conclusion: The results of this study revealed that HFD is a major cause of obesity and it should be prevented by introducing ginseng as an anti-obesity in our life. This study concluded that ginseng root extract proves to be more potent as anti-obesity, anti-hyperlipidemic, anti-hyperglycemic and anti-oxidant.</p> 2021-09-14T06:04:14+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Adverse Effects of HMG CoA Reductase Inhibitor and Garlic on Renal Function in Patients with Diabetic Dyslipidemia 2021-09-15T05:42:07+00:00 Naveed Ali Siddiqui Imran Ishaque Yousra Rahat Naheed Akhtar Umaya Tehreem Rafia Javed Rayyan Ali <p>Objectives: To analyze the adverse effects of HMG CoA reductase inhibitor (statin) and garlic (Allium sativum) on renal function in diabetic dyslipidemic patients.<br>Methods: This clinical trial was conducted at Surgeon Munawar Memorial Hospital, Karachi from 1st March 2019 to 30th August 2019. Total of 60 patients of 30-70 years of age with abnormal lipid profile were enrolled for this study after a written consent. The study was conducted to assess the side effects of statin (20 mg/day) and garlic (300 mg/day) in diabetic dyslipidemia patients. The study period consisted of six months. Blood pressure, body weight and height of subjects were assessed. The patient answered the questionnaire on health complaints, smoking, social role, drug usage, family history and dietary pattern. The initial inclusion criteria of the patient were 1) Age between 30-70 years old of either sex, 2) Patients with diabetic dyslipidemia. The exclusion criteria were 1) Pregnancy or lactation, 2) Patients with liver diseases, 3) Patients with renal diseases. Detailed medical history and physical examination of all patients were carried out.<br>Results: This study included 60 patients with an abnormal lipid profile of age 30-70 years. Internationalstatin product (20 mg/day) and local garlic product (300 mg/day) for 08 weeks were used for oral administration in patients. Urea and creatinine levels in the serum of diabetic dyslipidemic patients were measured before and after treatment with an international statin (20 mg/day) and a local garlic product (300 mg/day).</p> <p>Conclusion: According to the findings of this study, statins increase the serum level of urea and creatinine while garlic has no effect on urea and creatinine serum level.</p> 2021-09-14T00:00:00+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Lateral Sphincterotomy Under Local Anaesthesia; A Safe and Time- Efficient Alternative Without Compromising Patient Satisfaction 2021-09-14T08:31:56+00:00 Syed Ali Haider Muhammad Abid Owais Sidra Abbas Saeed Ahmed Akram Rajput Khalid Ahmed <p>Objective: The objective of this study was to find out whether Lateral Internal Sphincterotomy (LIS) can be carried out using Local Anaesthesia (LA) hence, lowering down the cost and anaesthesia related complications in patients without compromising operative easiness or final result.<br>Methods: One hundred patients who were diagnosed clinically as anal fissure patients and were scheduled for LIS were randomly distributed into two treatment arms. Non-probability consecutive sampling approach was employed. In the first group, LIS was carried out using LA while in the second group LIS was performed in spinal anaesthesia (SA). Age, gender, BMI, procedure time, post-operative complications like pain, post-operative nausea and vomiting (PONV), bleeding, headache, incontinence, urinary retention and patient satisfaction were the main outcome variables which were studied.<br>Results: Out of 100 patients who were treated with LIS, 50 of these patients had SA whereas, the rests of the 50 patients were given LA. We found no statistically significant difference in the post-operative pain, PONV, bleeding, incontinence, and overall patient satisfaction but duration of surgery and post-operative complications like headache and retention of urine were considerably less in the LA group. The difference between the two groups dictated that LIS under local anaesthesia (Group A) took 13.46 minutes (SEM 0.808) lesser than Group B which was statistically significant. But the Mean postoperative pain scores of patients in both groups were not significantly different on statistical analysis nor pain scores at 12 hours from surgery and 24 hours from surgery separately i-e 'p-value<br>&gt;0.05'<br>Conclusions: LIS under LA is less time-intensive, safe and has a comparable patient satisfaction rate to SA. Besides, the advantage of significant cost benefit, duration of surgery, exemption of the requirement of an anaesthetist, and less post-operative headache and PONV, LA also shows no noteworthy difference in the post-operative complications in comparison with SA.</p> 2021-09-14T05:56:02+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Quality Of Life Satisfaction Among Caregivers Of Schizophrenic Patients 2021-09-14T08:31:57+00:00 Rahat Usman Anum Haider Zoobia Ramzan Shafi Mansoori <p>Objective: This study is aimed to determine the Quality of Life (QOL) satisfaction among caregivers of schizophrenic patients attending Outpatient department of Psychiatry, Abbasi Shaheed Hospital, Karachi Medical and Dental College.<br>Method: The cross-sectional study was conducted among 150 caregivers of Schizophrenic patients from November 2015 to March 2016 attending out patient department of Psychiatry, Abbasi Shaheed Hospital, Karachi Medical and Dental College, Pakistan. The Caregivers were intimate family members who had spent their significant time (at least 2 years) with the schizophrenia patients. The self administered WHO QOL-BREF (validated Urdu version) scale which has 26 items, was used to measure the Quality of Life (QOL). Quality of life Satisfaction was labeled as positive if QOL score was &gt;75% of the total score.<br>Result: Out of 150 patients, the mean age of the caregivers was 45.36 ± 3.85 years. Most of the caregivers 95 (63.3%) were males and had care giving role of father 49 (32.6%). Most of them were unsatisfied of their QOL, 81 (54%). While only 69 (46%)of the caregivers were satisfied with their QOL. Their QOLwas<br>found to be significantly associated with age of the patient (p-value &lt;0.00 1) and caregiver (p-value &lt;0.002), employment status (p-value 0.040), monthly family income (p-value &lt;0.001), presence of physical illness of caregiver (p-value &lt;0.001) and his/her relationship with the patient (p-value 0.048).<br>Conclusion: Majority of caregivers of Schizophrenia patients were not satisfied with their Quality of Life. However, there are certain sociodemographic factors such as the age of patient and caregiver, employment and economic status, relationship with the patient and presence of physical illness of caregiver which were found to affect their satisfaction with QOL. Hence focusing those factors in the management plan may improve caregiver's satisfaction level.</p> 2021-09-14T05:43:37+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Visual Inspection of Cervix with Acetic Acid (VIA): An Effective Method of Screening for Cervical Cancer 2021-09-14T08:31:58+00:00 Fauzia Ali Tazeen Fatima Munim Shabnam Nadeem Aisha Khatoon Naz Shaukat <p>Objective: To assess diagnostic accuracy of visual inspection of cervix with 3-5% acetic acid(VIA) as a screening method for early detection of cervical intraepithelial neoplasia and early cervical cancer.<br>Method: This cross-sectional study was conducted at Gynecology &amp; Obstetrics Department Unit-1, Abbasi Shaheed Hospital, Karachi, from April 2017 to September 2018. Participants were included in the study through non-probability convenience sampling technique. Married, non-pregnant and sexually<br>active women aged between 21-50 years were included in the study. Demographic information and relevant history was taken followed by the procedure for VIA. Acetowhite changes were noted after application of 5% acetic acid on the cervix. The result of the test was documented as positive or negative. Colposcopy was done in all VIA positive cases and suspicious cases with abnormal looking cervix. Biopsy of the cervix was taken for histopathology to assess the results of VIA. SPSS version-20 was used for statistical analysis.<br>Results: There were 323 subjects with a mean age of 35.5 ± 7.6.Out of 323 participants only 6 were found VIA positive (1.86). On histopathology, only two cases were found positive (0.62%), one early invasive cervical cancer and one CIN1. Sensitivity, specificity, positive predictive value and negative predictive value of visual inspection of cervix after acetic acid application was 100%, 57%, 40%, 100%respectively and the diagnostic accuracy was 66.7%.</p> <p>Conclusion: Visual inspection of cervix with 3-5% acetic acid is highly sensitive, screening method for cervical cancer. It is quite simple, affordable and better screening modality for detecting cervical cancer at an early stage.</p> 2021-09-13T08:18:38+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Prevalence of Risk Factors for Thyroid Hormone Imbalance 2021-09-14T08:31:59+00:00 Saleha Sadeeqa Amna Zaka Iram Arif Maham Saba Nasir Pakiza Bint Zakreya Fatima Amin <p>This study was aimed to assess the frequency of thyroid hormone imbalance risk factors. A cross-sectional survey was conducted using the convenience sampling technique, from July-2018 to September-2018 in different cities of Punjab, Pakistan. A total of 150 patients, having thyroid hormone imbalance with or without any comorbidity were included and the subjects having normal thyroid levels were excluded. Thyroid hormone imbalance was more frequent in females having 40-60 years of age. Gender was significantly associated with 'pregnancy or delivery in last six months' (p=0.029) and iodine deficiency (p=0.036). Marital status was significantly associated with 'symptoms observed' (p=0.009), 'radioactive iodine exposure' (p=0.001), 'autoimmune disease' (p=0.050), 'smoking' (p=0.014) and 'stress' (p=0.040). Family income was significantly associated with 'family history of disease' (p=0.039) and 'iodine deficiency' (p=0.049). Residential area was significantly associated with 'autoimmune disease' (p=0.050), 'smoking' (p=0.036) and 'stress' (p=0.029). Use of iodized salt and stress were prevalent risk factors and disease was common among females, especially age group 40-60 years.</p> 2021-09-14T00:00:00+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Healthcare Waste: An Overview from Generation to Disposal 2021-09-14T08:31:59+00:00 Shikoh Naz Syed Muhammad Zulfiqar Hyder Naqvi Saima Asim <p>Madam, waste resulting from healthcare activities consists of a diversity of substances like used syringes, soiled dressings, diagnostic samples, biochemical<br>substances, pharmaceutical products, medical devices, radioactive materials, and body parts1</p> 2021-09-14T08:24:44+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Pictorial Quiz 2021-09-14T08:31:59+00:00 Fatima Iqbal Muhammad Jamaluddin <p>My patient 30 years of age G3P2 with 30 weeks of gestational amenorrhea came with complain of abdominal distension, relative constipation and multiple episodes of vomitings for 3 days. She had history of eating hairs for 3 years. On examination, abdomen was distended and tense overall. Gutsounds inaudible. Digital rectal examination was unremarkable. X-ray Erect abdomen showed multiple air fluid levels. Attached below is the picture of operative finding.</p> 2021-09-14T00:00:00+00:00 Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE