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;">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> en-US ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 1563-3241 Nutritional Needs of Corona Virus (COVID-19) Patients <p>Through your esteemed journal, we would like to draw readers attention to the nutritional needs of patients suffered from Covid-19.<br>Covid illness (Coronavirus), an irresistible infection, is a worldwide pandemic. It spreads through tarnished air-beads of contaminated people1. The endurance of infection is reliant on a superficial level and positive ecological conditions keeping it alive from a couple of hours to a couple of days2. The vast majority have a gentle illness and improve well. In understanding the course of the infection, we intend to expand the point of view to the nutritional needs of patients suffering from Corona Virus infection.</p> Mehwash Kashif Umm-e- Habiba Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-24 2021-03-24 25 4 69 70 Acceptance Rate of Post-Partum Intra-Uterine Contraceptive Device and Factors Affecting its Uptake in a Tertiary Care Hospital in Pakistan <p>Objective: To determine the frequency of acceptance of Post-partum Intra-Uterine Contraceptive Device and the factors affecting its uptake in a tertiary care hospital in Karachi.<br>Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology of large public tertiary care centre in Karachi. 160 women in their immediate postpartum period were selected via consecutive non-probability sampling and counselled about the insertion of post-partum intra-uterine contraceptive device. Their willingness and the factors affecting their acceptance or refusal were documented. Women aged 20-40 years in their 36-40 weeks of gestation carrying a singleton foetus in-utero were included in the study. Past users of intrauterine devices, complicated pregnancies and emergency obstetric cases were excluded. Likewise, women carrying multiple foetuses or mal-positioned foetuses were not included. The study was carried out after due institutional<br>approval.<br>Results: The acceptance rate for postpartum intrauterine contraceptive devices was 23%. About 86.49% of the women acknowledged that thorough counselling made them opt for this method. Other factors that favoured its uptake were long action duration with one-time placement (70.27%), husband's approval (59.46%) and accessibility (56.76%). The majority that refused (76.9%) rejected the device due to religious beliefs (57.72%), fear of side effects (56.10%) and lack of knowledge about contraception (46.34%).<br>Conclusion: The acceptance rate of postpartum intrauterine contraceptive devices remains low in our healthcare system. Healthcare workers and policy makers need to consider the factors responsible for its refusal for this means to be effectively utilized.</p> Aruna Hira Kumari Syed Muhammad Ashraf Jahangeer Mishan Shah Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-24 2021-03-24 25 4 197 203 Frequency of Anatomical Variations and Congenital Anomalies in Pancreatobiliary Tract through Magnetic Resonance Cholangiopancreatography <p>Objective: To determine the frequency of anatomical variations and congenital anomalies of pancreatobiliary tract in adults through the Magnetic Resonance Cholangiopancreatography (MRCP).<br>Methods: This cross-sectional observational study was done on patients suspected to have pancreatobiliary disease referred to MRI unit. MRCP was performed on a 1.5 Tesla in MR unit, using phased-array coil for signal detection. Heavily T2 weighted images were obtained with SSF-SE technique. Axial and coronal source images and reformatted images were evaluated together for the possibility of any anomaly and variation in pancreatobiliary tract. Analysis was done by SPSS version 20.<br>Results: Total no of 377 patients included in this study. The patients presented with epigastric pain, obstructive jaundice, pancreatitis and post-cholecystectomy epigastric pain and jaundice. MRCP was performed on these patients to examine the pancreatobiliary tract. In this study, 52% were females and 48% were males. The variations and anomalies were found in 24.93 and 75.07% had normal anatomy of pancreatobiliary tract. The most observed frequency was low insertion of cystic duct and least observed frequency was duct of Santorini. High insertion of cystic duct, absent gallbladder and aberrant hepatic ducts were not found in this study.<br>Conclusion: Majority of the patients in this study were found to be free from pancreatobiliary disease. It is important to clarify the anatomy of the pancreatobiliary tract by preoperative evaluation. Congenital anomalies and anatomical variation in pancreatobiliary tract present a complex spectrum, which are<br>worthy of alteration in both the clinical and surgical setting and are readily identified by MRCP.</p> Imran Ishaque Naveed Ali Siddiqui Mahveen Jay Keshan Sara Amber Illyas Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-24 2021-03-24 25 4 204 210 Changes in Hematological Parameters of Sprague Dawley Rats with Use of Cyclosporine and Nigella Sativa <p>Objective: The objective of this study was to observe the signs of Cyclosporine toxicity and to analyze the ameliorative effects of Nigella Sativa (NS or Kalonji) on body weight and haematological parameters.<br>Methods: This study was conducted in the Department of Anatomy, Baqai Medical University of Karachi during the month of February 2017. Thirty healthy male Sprague Dawley rats were selected from the Animal House of the university. After acclimatization, the animals were randomly divided into three groups, with 10 rats in each Group. Group A was the control group and received no intervention. Group B received treatment of oral Cyclosporine (15 mg/kg/day) in a single daily dose and Group C was given Cyclosporine (15 mg/kg/day) with Nigella Sativa seeds (450 mg/kg) as a protective agent. The bodyweight of rats in each group was measured at the start of the study period. The treatment was given for the duration of 21 days, after which the body weight was measured again. The rats were anaesthetized and blood was collected through cardiac puncture. Blood analysis for haemoglobin percentage, total leucocyte count and differential leucocyte count was done using haematology analyzer. Manual differential leucocyte was also done after staining the blood smear with Leishman's stain.<br>Results: Final body weight of rats in Cyclosporine treated Group B was decreased significantly p&lt;0.001 in comparison to control Group A and increased significantly p=0.001 in Nigella Sativa and Cyclosporine protected Group C. Blood parameters showed decreased mean haemoglobin p=0.03, decreased mean total leucocyte count p=0.003, increased mean neutrophil count p=0.27 and decreased mean lymphocyte count p=0.27 in Cyclosporine treated Group B while the mean values of these haematological parameters improved in Nigella Sativa protected Group C.<br>Conclusion: The present study demonstrated that Cyclosporine caused a decrease in animal weight and toxic changes in haematological parameters while Nigella Sativa was helpful in ameliorating them</p> Nadia Yonus Asma Basharat Ali Shaikh Sajjad Sahrish Mukhtar Aaqiba Rasheed Tayyaba Kazmi Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-29 2021-03-29 25 4 211 217 Evaluation of Orthodontists Knowledge About Maintenance of Oral Hygiene in the Course of Active Orthodontic Management <p>Objective: To assess orthodontist's knowledge about maintenance of oral hygiene in the course of active management in the sub-population performed in Saudi Arabia.<br>Methods: The cross-sectional plan, performed in multiple dental treatment facilities including governmental hospitals and private dental clinics in Abha City, KSA, between November 10, 2019 and December 29, 2019. A total of 500 individuals were selected according to the following inclusion criteria which was male and female during orthodontic treatment patients wearing fixed orthodontic appliances for at least 6 months which aged between 10-30 years. Sample size was calculated through Rao soft software. Data was collected through non probability purposive sampling. The exclusion criteria were uncooperative and unresponsive patients. A structured questionnaire assessed demographic characteristics of patients (age, gender) and orthodontists' knowledge about maintenance of oral hygiene of patients in the course of active management. They evaluated frequency of tooth brushing, tooth paste selection, usage of several fluoride supplements etc. For categorical data, mean and standard deviation were used, descriptive statistics was described as frequency and percentage. For<br>the evaluation of association among categorical variables, a Chi-square test was used. Statistically significant p &lt;0.05 was considered significant.<br>Results: About 500 patients participated in this study, 50% females and 50% males. 130 (26%) participants were treated in governmental facilities, while 370 (74%) were treated in private clinics. The association between orthodontists' awareness and orthodontist's age was found statistically significant "p=0.004". Statistically significant correlation among orthodontists' awareness and place of receiving orthodontic treatment "p=0.001" was also found.<br>Conclusion: The orthodontists' knowledge about maintenance of oral hygiene in the course of active management in subpopulation of Saudi Arabia is insufficient in patient's opinion and there is significant association between orthodontist's age and place of treatment.</p> Manal Nasser Aljahdal Laila Almashhour Renad Saleh Alshahrani Mohammad Alrwuili Muhammad Abdullah Kamran Tauseef Ahmed Abdulaziz Alsharani Abdullah A. Alnazeh Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-29 2021-03-29 25 4 218 224 Study of Serum FSH, LH and Prolactin in Female Albino Rats by Experimentally Creating Hypothyroidism <p>Objective: The current research was draft to contrast the variation in levels of Prolactin (PRL), Luteinizing Hormone (LH) and Follicle stimulating hormone (FSH) in female rodents by experimentally producing hypothyroidism.<br>Methods: The Animal House of Dow University of Health science was used for the purpose of doing this research which was almost completed in a period of 10 months. The total number of 30 rodents of Wistar Albino species were taken to use in this research. Only adult healthy female rodents weighing between 180-200 gm were included in the study and animals which were found to be slow and lethargic were excluded from the study. These rats were separated into two parts by dividing them into two groups of fifteen animals each. The primary group received the regular normal diet and routine tap water for six weeks and was labeled as the control group whereas the other group was forced to accept Carbimazole (Antithyroid drug) through feeding tube by mixing 0.02% / ml of regular drinking water for a period of six weeks. After six weeks all the rats were slaughtered. The cardiac puncture of animal was done in order to collect blood. Analysis of Follicle Stimulating Hormone, Luteinizing Hormone and Prolactin was carried out by using the ELISA kits on serum of animal which was centrifuged and separated.<br>Results: The result observed for control group showed a mean value ± standard deviation(SD) of 5.13 ± 1.39 mIU/ml for Follicle Stimulating Hormone. In the same group the mean value ± SD observed for Luteinizing Hormone was 8.38 ± 16.02 mIU/ml and for PRL was 0.40 ± 0.05 ng/ml respectively. The second group that is the hypothyroid group revealed a mean value ± (SD) of 5.89 ± 1.63 mIU/ml for Follicle Stimulating Hormone. For Luteinizing Hormones in hypothyroid group, the mean value ± SD turned out to be 9.30 ± 13.34 mIU/ml whereas the mean value ± SD observed for Prolactin in hypothyroid group was 0.62 ± 0.12 ng/ml. The information was entered on SPSS version 16. This information was analysed by applying an independent sample t-test in between the two groups to compare the levels of Follicle Stimulating Hormone, Luteinizing Hormone and PRL. The p-value was observed which turned out to be insignificant for Follicle Stimulating Hormone and Luteinizing Hormone but quite remarkable for Prolactin.<br>Conclusion: Hypothyroidism created by an antithyroid drug (Carbimazole) leads to a remarkable rise in the levels of PRL regardless of the changes in levels of gonadotropins which may lead to the sterility in females.</p> Amber ILyas Urooj Fatima Syed Taffazul Hyder Zaidi Fatima Abid Asma Shabbir Ghulam Sarwar Qureshi Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-29 2021-03-29 25 4 225 230 Intra-Abdominal Solid Visceral Injuries in Adult Patients Presenting with Blunt Abdominal Trauma <p>Objective: To determine the frequency of intra-abdominal solid visceral injuries in adults presenting with blunt abdominal trauma (BAT) at a public sector tertiary care hospital in Karachi<br>Methods: The current descriptive cross-sectional study was carried out at Department of Surgery Abbasi Shaheed Hospital during March 2016 to September 2016 after acquiring ethical approval from Hospital Committee. Total 165 patients were recruited into the study using non-probability consecutive sampling technique. Trauma was managed according to Advance Trauma Life Support (ATLS) guidelines. Laboratory and imaging investigation were done to make diagnosis and manage patients. Patients' characteristics including demographic details such as age, gender and clinical features were recorded on pre-designed profroma.<br>Results: Out of 165 recruited patients, 133 (80.6%) were males and 32 (19.4%) were female. Average age of study participants was 35.77 ± 13.95 years. Most of the cases occurred in patients having a low socioeconomic status (n=78, 47.3%). In a majority of the cases, mode of injury was road traffic accidents (n=92, 55.7%). 50(30.30%) patients got injury due to fall from height and 23(13.93%) cases occurred due to assault. The most common injured organ was kidney (n=60, 36.36%) followed by liver (n=57, 34.54%), spleen (n=47, 28.48%) and pancreas (n=34, 20.61%).<br>Conclusion: Careful attention to physical findings and proper sequencing of diagnostic tests is helpful in the appropriate decision making which may prevent associated morbidity and mortality in accordance with Advance Trauma Life Support (ATLS) guidelines.</p> Aqsa Ismail M. Hassan -Ul-Haque Muhammad Jamaluddin Bushra Tasneem Saima Sagheer Rizwan Ahmed Khan Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-29 2021-03-29 25 4 231 237 Antibiotic Sensitivity to Methicillin and Methicillin Plus Macrolide- Lincosamide-Streptogramins Resistant Staphylococcus Aureus <p>This study was conducted from May 2018 to Oct 2019 to determine the culture and sensitivity pattern of Methicillin resistant Staphylococcus aureus (MRSA) and MRSA with Macrolide Lincosamide and Streptogramin-B (MLS-B) antibiotics in a tertiary care hospital of Nowshera. A total of 235 isolates were studies and 86 samples showed MRSA. The prevalence rate of MRSA was 89/235 (37.87%). Out of 86 isolates with MRSA, 19 (22.09%) were also resistant to MLS-B antibiotics.<br>Regarding gender specification, 52 (60.5%) were females and 34 (39.5%) were males. The mean age with standard deviation of patients was 29 + 6.8 years. The sensitivity pattern to MRSA was; Vancomycin 100%, Linezolid 100%, Rifampicin 86.04%, Clindamycin, 73.25%, Fusidic acid 60.46%, Erythromycin 44.18%., Doxycyclin 32.55%, levofloxacin 16.27%, Gentamycin 13.95% and Ciprofloxacin 11. 62%. Sensitivity of Vancomycin &amp; Linezolid was 100% in MRSA and MLS-B resistant isolates, and should be kept reserved for MRSA cases to avoid misuse of antibiotics and to reduce resistance.</p> Hamzullah Khan Fazli Bari Sahibzada Fawad Adnan Masood Irfan Khan Khushaal Khan Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-24 2021-03-24 25 4 238 241 Pictorial Quiz <p>A 12 year old female child came with c/o swelling at outer canthus of right eye, for 10 years. It does not cause her pain, no discharge and its size remained same.<br>O/e: swelling is around 1 x 1.5cm, non-tender, round, smooth, margin yield to the pressure and do not slip away, not attached to skin or underlying tissues, cough impulse negative, fluctuation positive but translucency negative. Following is the picture.</p> Sobia Majeed Muhammad Jamaluddin Copyright (c) 2021 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2021-03-24 2021-03-24 25 4 242 242