ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE <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> en-US ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 1563-3241 COVID-19 Pandemic: Critical Actions Needed Syed A Aziz Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 178 179 Laparoscopic Nephrectomy in Benign Renal Diseases- A Tertiary Hospital Experience <p><strong><u>ABSTRACT:</u></strong></p> <p>&nbsp;</p> <p><strong>&nbsp;</strong><strong>Objectives: </strong>&nbsp;The purpose of our study is to share experience of performing simple laparoscopic nephrectomy in benign cases.</p> <p>&nbsp;&nbsp;<strong>Study Design: </strong>Descriptive study.</p> <p>&nbsp;</p> <p><strong>&nbsp;Place &amp;</strong></p> <p><strong>Duration of</strong></p> <p><strong>Study:&nbsp; &nbsp; </strong>Department of Urology, Jinnah Postgraduate Medical Center (JPMC) Karachi, between Jan 2015 to Dec 2019 with minimal one and half year follow-up.</p> <p>&nbsp;</p> <p><strong>Methodology: </strong>Our inclusion criteria were benign symptomatic nonfunctioning kidneys requiring nephrectomy. Laparoscopic nephrectomy was performed under general anesthesia with oblique position with three or four port technique was used. The demographic data, operative and post- operative details were carefully noticed and recorded in SPSS software version 20.</p> <p>&nbsp;</p> <p>&nbsp;<strong>Results: </strong>Total 40 patients were included in the study. Twenty four were females and 16 were males. Age ranges from 20 to 62 years with mean age of 44.64 <u>+</u> 11.04 years. Left sided were 24 patients (60%) while the right sided in 16(40%). Flank pain was the most common presenting complaint seen in 92.50% patients. Renal stone disease representing the most common indication for nephrectomy (40%) followed by ureteric stone (22.5%), chronic pyelonephritis (17.5%) and PUJO (15%). Our mean operative time was 200.29<u>+</u>47.98. Six patients (15%) were converted to open surgery because of intraoperative complications in 10% of patients including hilar vascular injury and gut injury and failure to progression in two (5%). Among the post- operative complications, early included low grade fever (10%) and wound infection (7.5%) while late included port site hernia (5%) and abscess at renal bed (2.5%). Chronic pyelonephritis was the most common histopathological report representing 45% of total cases. Our success rate was 85%.</p> <p>&nbsp;</p> <p><strong>Conclusion: </strong>The role of laparoscopic nephrectomy in benign non-functioning kidneys is a better alternate to open nephrectomy in terms of pain, post-operative recovery and cosmetic results. The operative time and conversion rate can minimize after passing through adequate learning time and experience</p> Muhammad Mansoor Yaqoob Arif Ali Suhail Dilawar Shahzad Ali Saeed Ahmed Khan Shahid Hussain Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 180 185 Divalent Metal Ions; Key factor towards Pulmonary Tuberculosis <p><strong>ABSTRACT</strong></p> <p><strong>&nbsp;</strong></p> <p><strong>Introduction: </strong>In tuberculosis disease infection, trace elements perform a significant role as their insufficiencies may be related to weakened immunity. The purpose of this study was to compare demographic profile and divalent metal Ions in Tuberculosis and Non-Tuberculosis individuals.</p> <p><strong>Methodology: </strong>This case control study was carried out on 345 subjects. Patients were grouped into two categories i.e. Pulmonary Tuberculosis (cases group) with 115 patients and without Pulmonary Tuberculosis (control group) with 230 subjects. Demographic and dietary profile was recorded through already designed proforma. 4 to 5 ml sterile gel tube was used to collect blood samples. The samples, which were then centrifuged, and the serum were examined to check the levels of iron and copper. Data was evaluated using SPSS version 25.</p> <p><strong>Results:</strong> Male patients are more likely to have TB in comparison of female patient. In comparison of patient with normal serum copper, patient with serum copper below normal are less likely for TB and patient with serum copper above normal are more likely to develop TB. Patient with serum iron below normal are also more likely to develop TB in comparison of patients with normal serum iron.</p> <p><strong>Conclusion: </strong>Male patients in productive age groups were commonly affected with tuberculosis. In Tuberculosis patients, we found low serum iron concentrations along with significantly high concentration of serum of copper when compared to healthy controls. Subsequently, low iron concentrations synergistically with increased serum copper levels may increase the human susceptibility to the infection of mycobacterium tuberculosis</p> <p><strong>Keywords</strong>: Mycobacterium tuberculosis, Iron, Copper ,BMI,&nbsp; Nutritional status.</p> Ahsan Ashfaq Taseer Ahmed Khan sadia fatima Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 186 191 Comparison Of Outcome Between Simple Polypectomy Versus Endoscopic Sinus Surgery <p><strong>Objective: </strong>Nasal polyps are smooth, soft tissue, pale or yellow shining bulges that can block nasal cavity, sinuses and brings persistent state of rhino sinusitis influencing quality of life. The objective of this study was to compare outcomes of simple intranasal polypectomy versus Endoscopic sinus surgery after removing nasal polyps.</p> <p><strong>Methodology: </strong>This comparative cross-sectional study was conducted at Department of ENT in Civil Hospital, Hyderabad from April 2020 to June 2020. After ethical approval, 60 adult patients of either gender ranging from 14 to 40 years, with Sino nasal Polyposis were randomly selected. The collected data was analyzed using SPSS version 17. Categorical variables like all complications were presented as frequency and percentage.</p> <p><strong>Result: </strong>Out of 60 patients, 37(61.6%) males and 23 (38.4%) female, and mean age 28.87 ± 7.69 years, the post-operative complications like bleeding was observed in 6.7%, crusting 10%, Synechiae formation 10% of patients after 6 weeks, recurrence in 13.3% after 3 months, while intraorbital complications i.e. orbital swelling in 13.3% patients following simple intranasal polypectomy. In contrast, bleeding 10%, crusting 16.7% with orbital swelling 3.3% was reported up to 2 weeks following surgery. Synechiae formation 16.7% up to 3 months was observed following Endoscopic sinus surgery.</p> <p><strong>Conclusion: </strong>Post-operative complications of endoscopic sinus surgery have been quite lesser as compared to simple nasal polypectomy along with low recurrence rate. Fortunately, intra cranial complications were not observed, only intra orbital swelling was seen in both types of surgeries.</p> Amrat Kumar Abdul Waheed Ghulam Shabbir Mahar Zafar Mahmood Junaid Hussain Nosheen Wasee Adnan Anwar Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 192 197 Rise Of Intraocular Pressure After Nd: YAG Laser Capsulotomy <p><strong>Objective: </strong>Posterior capsule opacification (PCO) after cataract is a common complication of extra capsular cataract extraction with or without intraocular lens implantation. Aim of this study was to evaluate changes in intraocular pressure after Nd-Yag laser posterior capsulotomy for PCO.</p> <p><strong>Methodology: </strong>This retrospective study using convenient sampling technique was done at Eye Department of Shaheed Mohtarma Benazir BhuttoMedical College Lyari, Sindh Government General Hospital, Karachi for six months (1<sup>st</sup> January 2020 to 30<sup>th</sup> June 2020. After ethical approval and informed permission from patients and guardian, data was collected and analyzed by SPSS version 20 and presented by calculating mean and standard deviation for quantitative data and frequency and percentages for qualitative data.</p> <p><strong>Results: </strong>Total 50 patients (20 males and 30 females) were studied where 22 right and 28 left eyes. Mean age was 59.08 years. Mean pre-operative IOP was 13.28 and 13.12 mmHg of right and left eye respectively (Table I). At 2 hours mean IOP was 16.84±3.63 mmHg and after one week 12.48±2.0 mmHg. Base line pre-laser IOP was measured by Goldman Applanation Tonometer (GAT) and slit lamp examination. Pupils were dilated using 1% tropicamide eye drops. IOP was evaluated immediate post-procedure, two hours post–procedure and one week from date of laser.</p> <p><strong>Conclusion: </strong>Nd –Yag laser capsulotomy is treatment of choice for PCO and associated with complications like Raised Intraocular Pressure (IOP), Intraocular lens pitting, cystoid macular oedema, retinal detachment. Raised IOP is most common complication and prescribing anti-glaucoma drugs in order to decrease intraocular pressure.</p> Asma Shams Narain Das Jai Kumar Beenish Khan M. Nasir Bhatti Anas Bin Tariq Adnan Anwar Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 198 203 Prevalence Of Pica Among Pregnant Females of Low-Income Population: A Hospital Based Study <p>&nbsp;Back ground: pica is craving and compulsive eating of non nutritive substances and it is public health concern because of its deleterious consequences. The condition is particularly associated with pregnancy and incidence varies differently across the world. Pica has been thought to develop in response of some underlying nutritional deficiencies particularly iron and zinc but further evidences and researches are required to confirm this. Engagement in pica behavior can be dangerous for both mother and growing fetus and can lead to growth retardation preterm deliveries and intra uterine death and is usually observed in low income and less educated population , however&nbsp; tradition , culture and religion also has a great&nbsp; influence&nbsp; on this habit.</p> Aliya nasim Akhter Fasiha Fatima Mohammad Abbas Suleman Sobia Khurram Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 204 211 An Assessment of Pattern of Distribution of Cleft Lip and Palate Patients Reported to A Tertiary Care Hospital in Karachi, A Retrospective Study <p><strong>Abstract</strong></p> <p><strong>Objective: </strong></p> <p>To evaluate the&nbsp; patterns of cleft lip and palate by its type, side, gender, laterality and extent of involvement of hard and/or soft palate in patients reported to a tertiary care hospital in Karachi.</p> <p><strong>Methods:</strong></p> <p>This retrospective study was conducted from January 2016 to January 2017 at Saifee hospital Karachi. It includes patient’s data from December 2014 till December 2015. Total 198 patients with diagnosed cleft lip and /palate anomaly were included in the study.&nbsp; Data was collected by patient record forms and relevant findings were recorded on a predesigned proforma. Data was tabulated and analyzed using SPSS 17.00.</p> <p><strong>Results: </strong></p> <p>&nbsp;Out of 198 patients 117 patients were males (59%). Total 54(27.27%)) cases of isolated cleft lip were observed, isolated cleft palate cases were 34(17.17%)&nbsp; while mixed cleft lip and palate cases were 110 (55.55%). Out of 54 cases of isolated cleft lip 43(79.62%) cases were unilateral, in which 26(48.14%) were left sided and 17(31.48%) were right sided while 11 (20.37%) cases were bilateral. Among mixed cleft lip and palate patients 82(74.54%)&nbsp; were unilateral having 48(43.63%) left sided&nbsp; and 34(31%) were right sided while 28(25.45%)&nbsp; were identified as bilateral. Total unilateral cases were 125(63.13%). Total left sided cases were 74 (37.37%) and right sided&nbsp; were 51(25.75%). Total bilateral cases were 39(19.69%). Cases of isolated cleft palate were divided into mix hard and soft palate cleft which were 21(61.76%) while soft palate clefts were 13(38.23%).</p> <p><strong>Conclusion:</strong> I the&nbsp; clefts of mixed lip and palate was most common type, unilateral cleft lip and clefts of left side of both lip and palate comprised of major segment of cleft patients and&nbsp; incomplete clefts of both lip and palate are more common in terms of extent in a tertiary care hospital of Karachi.</p> <p><strong>Key words:</strong>&nbsp; Cleft Lip Palate, Tertiary Care, .</p> <p><strong>&nbsp;</strong></p> Zubair Ahmed Abbasi Syeda Arzoo Azeem Shazia Sarwat Iqbal Syed Mahmood Shah Zafar Abbas Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 212 216 Influences of Coronavirus on Societies <p>Coronavirus disease 2019 (COVID-19) is a tiny self replicated agent that is peculiarly found in humans and animals. A total of seven human Coronavirus types have been well-known to cause infectious disease in humans. They are known to infect the neurological, throat, respiratory and hepatic systems. The first human Coronavirus identified in mid 1960's and then have seen widespread outbreaks in the form of Middle East respiratory syndrome Coronavirus (MERSCoV) and severe acute respiratory syndrome related Coronavirus (SARS-CoV). In spite of that, we see the emergence of another outbreak due to a new virus called the SARS-CoV-2 virus. This COVID-19 novel diseases infected people first time in Wuhan, China. As the number of infected cases rises, it is clear that these pandemics pose a threatening impact on social and economic sectors. The general overview of virus, Coronavirus will be explained in this review article and it also enlightened some of significant social and economical factors influenced by the novel COVID-19.</p> Salwa Iqbal Kashif Raffat Sheikh Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 217 224 Early Respiratory Symptoms of Water-Pipe (Shisha) Smoking in Medical Students of Karachi <p><em>Objective:</em></p> <p>Water pipe smoking WPS (Shisha) is becoming increasingly acceptable in the youth and is contributing to the burden of respiratory diseases. The aim of this study was to assess the frequency of early respiratory symptoms in relation to the severity and duration of WPS smoking in the medical students of Karachi.</p> <p><em>Methods:</em></p> <p>This cross-sectional study was conducted in medical colleges of Karachi. A self-administered questionnaire collected information about smoking habits and respiratory symptoms from students. &nbsp;</p> <p><em>Results:</em></p> <p>Out of 250 participants, 68.8 % (n=172) were short term smokers. 31.6% (n=79) reported to have smoked shisha monthly. The main reason of smoking shisha for 26% (n=65) was just to fill in the free time with friends. 39.4% (n=88) intend to quit shisha smoking in future. 32.4% (n=81) of the students experienced shortness of breath, 30.4% (n=76) Dry cough, 30.4% (n=76) Scratchy sensation in the throat, 23.6% (n=59) rapid breathing, 20% (n=50) chest tightness and 13.6% (n=34) hoarse voice after shisha consumption. The association of these symptoms with duration and severity of shisha exposure remained insignificant.&nbsp;</p> <p><em>Conclusion: </em></p> <p>The results of this study show that smoking shisha can bring about the early respiratory symptoms. Education is important in creating awareness about WPS hazards.</p> <p><em>Key words:</em></p> <p>Water-pipe; Shisha; Smoking; Medical students; Respiratory symptoms</p> Komal Kiran Galaria Nadia Younus Rahat Zubair Malik Balaj Khan Sameen Adib Rehman Safa Shahab Syed Muhammad Ishaque Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 225 231 Pictorial Quiz Tahera Ayub Wajiha Zia Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-12-31 2021-12-31 26 4 232 232