ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-09-02T11:57:40+00:00 Prof. Dr. Nargis Anjum 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;">Ordinary Processing:</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;1. Processing Fee: Rs. 2000/-<br>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;2.Publication Fee: Rs. 2000/- (per side of PDF)</p> <p style="font-weight: 400;">Fast Track Publication</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;1. Processing Fee Rs. 3000/-</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;2. Publication Fee Rs. 20,000/-</p> <p style="font-weight: 400;">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> Hair Dye (Kala-Pathar) Poisoning- A Lethal Toxin with Fatal Outcomes 2022-08-31T05:10:41+00:00 Saleemullah Khan <p>Seventy-three percent of suicides in the world occur in developing countries<sup>1</sup>. It is the third heavy cause of death in 15-44 years age-bracket<sup>2</sup>. In Southeast Asian countries, the practice of self-harm with poison ingestion is exceedingly common. Although pesticide poisoning being the most common, there has been an alarming increase in hair-dye ingestion in lower income countries like Pakistan, Bangladesh, Sri Lanka and India. The use of so-called Kala-Pathar aka Paraphenylenediamine (PPD) in making hair color is by and large confined to emerging nations specifically and is exceptionally rare in western world because of strict usage guidelines. On the contrary, the commonness of unintentional and self-destructive ingestion is more found in low financial regions where it is arising as a typical method for self-destruction especially Africa and Asia<sup>3</sup>. In our locale, Pakistan, reports have been received and recorded generally from Sindh and Punjab detailing the clinical signs and symptoms after (PPD) containing hair color ingestion<sup>4</sup>.</p> 2022-08-31T05:07:19+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Effect on Cardiovascular System by Hyperbaric Bupivacaine and Isobaric Ropivacaine Given By Sub-Arachnoid Block in Planned Lower Extremity Surgery 2022-08-31T05:10:42+00:00 Muhammad Naeem Pasha Sheeza Naeem Pasha Ayeza Naeem Syed Hurul Haque <p><strong>Objectives: </strong>Efficacy of two local anesthetic drugs such as Ropivacaine and Bupivacaine were compared when they were administered intrathecally during elective lower limb surgery. Furthermore, the side effects of both drugs were also studied in the similar research.</p> <p><strong>Methods: </strong>The study was done double-blinded, un-biased and a randomized control trial. Cardiovascular system parameters such as average heart rate and average systolic blood pressure were monitored after medication given. Decreased BP, nausea, vomiting, shivering and headache were the parameters used to assess the side effects on the patients receiving both the drugs.</p> <p><strong>Results: </strong>Action of these two drugs on cardiovascular system parameters were monitored and there was no valuable dissimilarity seen. No statistical significance was found in the duration of nausea, vomiting and headache. None of the patients reported bradycardia or backache. However, shivering was observed in the patients that were administered Bupivacaine as compared to Ropivacaine.</p> <p><strong>Conclusion: </strong>Ropivacaine is a better drug of choice as compared to Bupivacaine while considering the hemodynamic parameters as well as the different post-operative symptoms.</p> <p><strong>Clinical Trial Number: </strong>Reference number: 0031/14 (Authenticated by Ethical and Scientific Review Committee, Karachi Medical and Dental College)</p> <p>&nbsp;</p> 2022-08-30T05:30:37+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Clinicopathological Pattern of Gynecological Malignancies at Tertiary Care Teaching Hospital 2022-08-31T05:10:42+00:00 Shakira Perveen Jai Mala <p><strong>Objective:</strong> To view current clinicopathological pattern of gynecological malignancies at a tertiary care hospital in Karachi.</p> <p><strong>Methods:</strong> This is a retrospective research performed in the department of obstetrics and gynecology unit 1 from January 2020 to December 2021. All cases of gynecological malignancies irrespective of age, race and cast were included for study. Around 164 cases with clinical or radiological diagnosis of malignancy were admitted for gynecological malignancy work up. Out of them 42 were confirmed on histopathology of biopsy or resected specimen. Patients with gestational trophoblastic disease and metastatic malignancies from another primary site were excluded. Data of these confirmed 42 cases fulfilling exclusion and inclusion criteria was included for study. Relevant data on pre-designed Performa was tabulated and histopathology according to WHO histological classification system.</p> <p><strong>Results:</strong> Out of 164 cases of suspected gynecological malignancy 42 histopathological confirmed cases were selected for study. Frequency of gynecological malignancies out of 885 gynecological ad- mission is 4.7%. Ovarian cancers were commonest gynecological malignancy (54.7%), followed by cervical cancer (19.04%), uterine cancer (16.66%), and vulvar /vaginal cancers (9.5%). In ovarian can- cers epithelial cancers were (86.9%) and (13.04%) were non-epithelial. In epithelial (65%) serous, (15%) mucinous and (20%) were other less common types. In non-epithelial were dysgerminoma (66.66%) and (33.33) sex cord stromal cancers. In cervical (100%) were squamous cell carcinoma. In uterine (85.7%) were adenocarcinoma and (14.28%) were leiomyosarcoma. In vaginal cancers (50%) squamous cell carcinoma and (50%) was melanoma. In vulvar cancers all (100%) were squamous cell carcinoma.</p> <p><strong>Conclusion:</strong> Ovarian cancer is commonest gynecological malignancy in our study. Common age group, parity, clinical presentation and histopathology is comparable with studies. Majority of cases came late in advanced stage of disease.</p> 2022-08-30T05:36:30+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Frequency of Orthopedic Trauma in Patients Attending Khalifa Gul Nawaz Teaching Hospital: A Retrospective Analysis 2022-09-02T11:57:40+00:00 Alamzeb Khan Israr Ahmed Gul Sher <p><strong>Objective:</strong> The present study aimed to assess the frequency of orthopedic trauma injuries in patients admitted to the Orthopedic Department at Khalifa Gul Nawaz Teaching Hospital in Bannu.</p> <p><strong>Methodology:</strong> This retrospective snapshot study was conducted at the Orthopaedic &amp; Traumatology Department of K.G.N. Hospital in Bannu, KPK. Data were extracted from hospital records of 380 patients admitted for emergency orthopedic surgery due to fractures, lacerations, and/or fractures with lacerations. The frequency and etiologies of orthopedic diagnoses were recorded.&nbsp;</p> <p><strong>Results:</strong> Out of the 380 cases admitted during the study, the majority were males (76.05%). Furthermore, these orthopedic trauma injuries were more common in individuals aged 21 to 50 years (66.83%) than the other age groups. Road Traffic Accidents (RTA) were the major etiological factor (49.21%), followed by falls from height (31.84%). Upper limb fractures were diagnosed in 46.27% of patients, and 53.63% had lower limb fractures. Isolated radius (14.47%) and femoral fractures (23.94%) were the most frequent diagnosis.</p> <p><strong>Conclusion: </strong>The present study provides a brief overview of the major etiologies and diagnoses for orthopedic emergencies. It is essential to identify the risk factors and strategize a prevention plan that should be the priority of the healthcare system to avoid morbidities and mortalities associated with orthopedic traumas.</p> 2022-08-30T05:43:43+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Assessment of Common Problems of Post Graduate Students Pursuing F.C.P.S and M.D.S in Orthodontics and Dentofacial Orthopedics, Due To COVID 19 Lockdown 2022-08-31T05:10:43+00:00 Erum Behroz Sarvaich Kumar Danish Ali Mottani Hafiz Zuhair Ahmed Ayesha Bibi` Sohail Khan <p><strong>Abstract </strong></p> <p><strong>Objective:</strong> To assess the common concerns of FCPS and MDS trainees in Orthodontics due to COVID-19 lockdown.</p> <p><strong>Methods:</strong> This cross-sectional study was conducted in different institutes of Sindh which offered FCPS/MDS training in Orthodontics. The study was carried out after approval from the ethical commit- tee. A questionnaire was designed comprising of 15 questions. Each question aiming to assess the difficulties faced by trainees due to the imposition of lockdown. The questionnaire was distributed amongst 80 participants/trainees in the training year 2 to 4.</p> <p><strong>Results:</strong> The average age of study participants was 29 years with range of 27 to 38 years. In this study a large number of subjects said that they were unsure regarding completion of cases due to lockdown i.e; n=63,(77.8%). Approximately half of the study subjects thought that there will be mas- sive patient burden after resuming to the normal practice i.e 40(49.4%). Nearly quarter of them were puzzled that due to lockdown it was difficult to focus on thesis and research work i.e 18(22.2%). Few of them also responded that after resuming to the normal practice there would be pressure from su- perior authorities for academic works i.e; n=9,(11.1%).</p> <p><strong>Conclusion:</strong> This study analyzed those major concerns were non-availability of basic materials for procedures, fear of completion of cases due to lockdown and massive patient burden in clinics after uplifting of lockdown. Therefore, Covid-19 lockdown has in many ways affected the academic and clinical activities of the post-graduate students. The uncertainty to tackle this surprise situation is still an unanswered question.</p> <p>&nbsp;</p> 2022-08-30T05:54:33+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Students and Faculty Perspective of Effective Feedback Analyzed in an Outcome Based Medical Education System of KSA 2022-08-31T05:10:44+00:00 Nida Gulzar Zeb Nusrat Zareen Ahmed Almutairi Sana Malik Farhat Humayun Naseer ud din Sheikh Kamran Afzal <p><strong>Objective:</strong> To evaluate and compare the students’ and faculty’s perspectives of feedback &amp; its values in an outcome-based medical education system.</p> <p><strong>Methods:</strong>&nbsp; This was a cross-sectional, self-evaluated questionnaire-based observational study con- ducted on the students (group A) and faculty members (group B) of the College of Medicine, Majmaah University by convenience sampling technique. Prior to taking the feedback, consent was taken from the students and faculty members.&nbsp; The responses were recorded on a scale of 1-5 and the data was analyzed using SPSS version (25). The relationship between categorical variables was analyzed using the Chi-square test and a p value of 0.05’ was considered significant.</p> <p><strong>Results:</strong> The questionnaire responses from the A and B groups were recorded. Three important elements were examined: efficacy, value, and the technique for recording constructive feedback. Both groups believed that positive feedback is essential. While there was agreement on various aspects, a substantial difference was also noticed between the perceptive of the two groups in a few areas. Generally, students were observed of being responsive and perceptive, but the instructor’s responded oppositely. There was a considerable disparity in the extent/quantity of input supplied. While the teachers thought it was acceptable, the students did not.</p> <p><strong>Conclusion:</strong> The observed differences between the two stakeholders could create a barrier in the effectiveness of feedback and hence the learning process. The comparison in perspective helped in to understand that students and faculty members approve and understand the effectiveness and value of feedback. Encouraging and utilizing this mode to improve learning is required to strengthen students’ education and teaching environment. There were a few conflict areas in accepting, encouraging, and utilization of feedback in the learning process. The medical education department may play a role in abolishing these conflicts to best utilize the affectivity of feedback.</p> 2022-08-30T06:05:10+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Clinical Features, Laboratory Characteristics, and Outcome of Patients Admitted With COVID-19 Infection; A Single-Center Experience 2022-08-31T05:10:44+00:00 Saima Mehboob Syed Hamid Hussein Banori Zahir Ullah <p><strong>Objective:</strong> To determine the clinical features, laboratory variants, and outcome of patients with Corona virus Dis- ease-2019 (COVID-19) infection.</p> <p><strong>Methods:</strong> A descriptive, single-center case series was conducted between October to December 2020. It included patients diagnosed with COVID-19 infection via Polymerase Chain Reaction (PCR). Patients were recruited through non-probability convenience-based sampling. After history and detailed examination of the patients, their demographic and clinical characteristics, including complete blood count (CBC), renal &amp; electrolytes profile, inflammatory markers like C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, and D-dimers were recorded using a structured questionnaire. Patients were managed according to the severity of the disease and disease progression was monitored regularly. Treatment offered to these patients was based on their presentation and severity of the disease.</p> <p><strong>Results:</strong>&nbsp; Out of 1092 patients, 77% were males. Most of them were diabetic (71.0%) and aged between 51-70 years (58.97%). Furthermore, 1051 of the total enrolled cases were symptomatic and had shortness of breath (94.32%), dry cough (91.20%), anorexia (91.20%), fatigue (90.65%), and etc. Among the laboratory parameters, raised C-reactive protein (CRP) was found in 96.24% of patients while leukocyte count, Alkaline phosphatase (ALP), D-dimers, ferritin and lactate dehydrogenase (LDH) levels were elevated in 89.37%, 71.61%, 68.77%, 56.86%, and 44.04% respectively. Hyponatremia was also observed in 53.75% patients. Most patients (32.60%) had oxygen saturation between 80 to 89%, while it was&nbsp;&nbsp; 80% among 20.42% patients. Moreover, 31.05% patients were categorized as having mild disease, 23.68% had moderate severity, and 24.84% had severe disease on the basis of clinical criteria. About 20.42% were critical and had respiratory failure. The recovery rate was high (96.0%), and the mortality rate was only 4.0%.</p> <p><strong>Conclusion:</strong> We observed dynamic changes in the clinical and laboratory features of the COVID-19 patient’s ad- mitted at District Health Quarter in Charsada, highlighting the significance of each of these parameters for individual patient’s recovery and survival.</p> 2022-08-30T08:29:11+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE An Outbreak Of Delta Variant in Pakistan 2022-08-31T05:10:45+00:00 Umm e Habiba Shajee Naveed <p>According to reports, Pakistan has very res- trained facts available on the situation of covid-19 variations, and simplest the first model alpha has been said because of the precept circulating ancestors1. At a few degrees with inside the cutting-edge has a glance at, an entire of two thousand two hundred and seventy-four samples have been examined on PCR for the presence of sars-Cov-2 from the month of May additionally 14 to 31 May 2021, and amongst the ones, and almost 17% have been tested positive, even as eighty-three percent of the samples showed a failure of the spike gene purpose (sgtf). Of the strong samples, 22 were processed for whole- genome sequencing, the delta version times had been cautioned typically from Islamabad (63%) accompanied via way of means of Peshawar and Azad Kashmir (13%). Beta model times originated from Islamabad (56%), Peshawar (22%), Azad Kashmir, and Rawalpindi (11%). Drastically, the characteristic mutation e484q was also found in delta version b.1.617.22</p> 2022-08-30T06:34:37+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE COVID Story; Pandemic Was A Universal Challenge 2022-08-31T05:10:45+00:00 Ayesha Abbasi <p>The SARS-CoV-2 epidemic in recent years has fundamentally altered how people live. SARS-CoV-2 poses a significant hazard to healthcare workers, including doctors, nurses, and paramedics working as front-line personnel in emergency rooms, clinics, wards, and intensive care units in Pakistan due to the country’s low middle-income status and restricted healthcare and resource availability.</p> 2022-08-30T06:21:34+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE Pictorial Quiz 2022-08-31T05:10:45+00:00 Minal Sharmeen 2022-08-30T06:27:33+00:00 Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE