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 Psychological Impact of COVID - 19 Pandemic <p>The planet has been facing an unprecedented condition visible under the name of COVID-19 since December 2019. This viral infection was first documented in the domestically and globally spreading city of Wuhan1. Pakistan has had a series of survivors and this lethal virus has infected many patients. Since then the pandemic has spread all over the country. Sadly, the number of infected people and deaths caused by the disease is increasing constantly.</p> Mehwish Kashif Saqib Naqvi Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 67 68 Antihyperlipidemic Activity of Hydroxyl Methylglutaryl Coenzyme A Reductase Inhibitor on Lipid Profile in Secondary Hyperlipidemia <p>Objectives: To observe the variations in lipid profile in patients with secondary hyperlipidemia using HMG-CoA reductase inhibitor.<br>Methods: This study was done at private hospital in patients predominantly suffering from secondary hyperlipidemia. The duration of study was about 4 months. Body weight, height and blood pressure of subjects were assessed. The subjects were asked to answer the related question on cigarette smoking, health related complaints, detailed history of family, drug usage, and nutritional habits. Subjects were requested to make up a permission form before starting the research study. This case control study was performed at local private Hospital, located at Karachi from 1st April 2017 to 30th July 2017. The aim of research was to analyze the effects of HMG-CoA reductase inhibitor on lipid profile in patients of secondary hyperlipidemia. Age between 35 to 65 years and secondary hyperlipidemic<br>patients were included in the inclusion criteria. Lactating/pregnant women, renal, liver and established coronary artery diseases were included in exclusion criteria.</p> <p>Results: Sixty patients having deteriorated lipid profile were included in this research (age 30-60 years). Subjects were prescribed simvastatin orally 20 mg/day (international product) for 04 months. The total cholesterol, triacylglycerol, LDL and HDL were analysed using simvastatin (20mg/day) of international standard in the serum of secondary hyperlipidemic patients.<br>Conclusion: During this study it is observed that Simvastatin raises the HDL level and reduces LDL level and cholesterol level.</p> Naveed Ali Siddiqui Naheed Akhtar Ayesha Shahid Fatima Bint Taj Ayesha Ayaz Zulfiqar Ali Moosa Farooq Azeem Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-17 2020-09-17 25 2 69 75 Association of Serum Vitamin-D and Omentin-1 Levels in Post- Menopausal Female with Coronary Artery Disease <p>Objective: The objective of the present study was to investigate the association between serum vitamin- D (calcidiol, D2) and omentin-1 levels in pre- and post-menopausal female patients with coronary artery disease (CAD).<br>Methods: This cross-sectional, case-based study was conducted in the cardiac ward of Civil Hospital Karachi from July 2016 to June 2017. Total 110 diagnosed female patients of coronary artery disease were included randomly in the study, out of which, 42 women were pre-menopausal, whereas, 68 post-menopausal. The diagnosis was based on coronary angiography. Serum Vitamin-D and omentin-1 levels were determined by using enzyme-linked immunosorbent assay (ELISA) in Dr Abdul Qadeer Khan Institute of Biotechnology and Genetic Engineering (KIBGE). Serum vitamin-D concentrations were classed as sufficient ( 30 ng/mL); deficient (10 to&lt; 29 ng/mL); and insufficient ( &lt;10 ng/mL). Data were analyzed by SSPS version 16.<br>Results: From our study, we observed significant low levels of serum vitamin-D and omentin-1 in pre and post-menopausal females of coronary artery disease, however, severe deficiency of Vitamin-D (&lt;10 ng/L) was more associated with post-menopausal females. Vitamin-D deficiency (&lt;30ng/L) was found in 82.72% (n=96) of CAD females, moreover; 46.36% (n=51) patients were found with severe vitamin-D deficiency placed in group I, 40.90% (n=45) patients were found with a moderate deficiency (17.09 ± 4 ng/mL) in group II, whereas only 12.72% (n=14) had optimal serum vitamin-D levels placed in group III. Serum vitamin-D (calcidiol, D2) level was associated positively with omentin-1 in CAD patients after adjustment for potential confounding variables; basal metabolic rate, waist circumference, blood pressure and lipid profile in multivariable linear regression analysis.<br>Conclusion: Within the limits of the study, we concluded that low levels of vitamin-D and omentin-1 are associated with both pre and post-menopausal females with prevalent coronary artery disease (CAD). Further investigations are required in different ethnic groups and populations to confirm the findings.</p> Shazia Nazar Afshan Mehboob Sara Rafique Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 76 81 Frequency of Skin Diseases and its Associated Factors Among Patients Visiting a Dermatology Clinic <p>Objective: To determine the frequency of skin diseases and its associated factors among patients visiting a dermatology clinic in Karachi.<br>Methods: A cross sectional study was carried out from December 2018 to May 2019 at Baqai Institute of Health sciences, Baqai Medical University, Karachi. Available relevant data of all patients visiting a selected dermatology clinic in Karachi for a period of two years, from 1st January 2017 to 31st December 2018, were retrospectively gathered and recorded on the study questionnaire by the principal investigator. Statistical package for social sciences version 19.0 was used for analysis. Chi-square test was applied to check associations between the independent variables and the study outcome whereas the significance level was set at 0.05. The duration of the study was six months.<br>Results: The study findings revealed that the highest frequency of skin diseases among the patients was of psoriasis (25.3%), followed by dermatitis (23.3%), scabies (14.1%), fungal infection (11.9%), acne (9.0%), folliculitis (4.4%), atopic dermatitis (4.1%), keloid (3.2%), warts (2.8%) and vitiligo (1.9%). Moreover, 51.2% of the patients came in the summer season. The study results also showed that season was found to be significantly associated with the diagnosis of the patients both among patients aged 25-49 years (p&lt;0.001) and patients aged 50 years and above (p=0.002).</p> <p>Conclusion: The most commonly presented skin diseases in descending order of frequency were psoriasis, dermatitis, scabies, fungal infections, and acne. Moreover, the season was found to be significantly associated with the diagnosis of the patients in two of the study age groups. Due efforts by all stakeholders such as imparting health education to the general public, increasing their awareness regarding the modes of transmission of common skin diseases, promoting healthy skin habits and improvement in practices of environmental sanitation are recommended.</p> Sabika Jaffer Syed Muhammad Zulfiqar Hyder Naqvi Muhammad Zafar Iqbal Hydrie Syed Imtiaz Ahmed Jafry Iraj Jaffer Mudassir Hussain Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 90 96 Measuring Treatment Readiness Among Patients With Opioid Use <p>Objective: To measure treatment readiness in patients with opioid use in the form of problem reorganization, desire for help and taking steps.<br>Methodology: This was a descriptive and cross-sectional study, conducted at the Institute of Behavioral Sciences (IBS), Dow University of Health Sciences (DUHS), Karachi, Pakistan. The duration of the study was from 1st January 2018 to 1st June 2018. Those patients who fulfilled the criteria of the dependent on opioids as per the International Classification of Diseases version 10 (ICD-10) were enrolled in the study. Those who were using substances other than opioids such as Cannabis or having organic brain disorder such as dementia were excluded from the study. Treatment readiness was measured by The Stages of Change Readiness and Treatment Eagerness scale (SOCRATE). The collected data were analyzed by Statistical Package for the Social Sciences (SPSS) version 22.0.<br>Results: Of the 120 participants, 96 (80%) were males while 24 (20%) were females. Mean age of the patients was 31.57 ± 8.71 years. Among all 48 (40%) were married. Majority of patients 54 (52.9%) were employed. Almost two-thirds were in favour of the strongly agree option as per the Stages of Change Readiness and Treatment Eagerness Scale. While talking about ambivalence 54% strongly agreed that they were ambivalent about their addiction. Twenty-one per cent strongly agreed that they have taken steps to quit. Statistically age group, gender, marital status, educational status and occupational status were not significant.<br>Conclusion: As the Stages of Change Readiness and Treatment Eagerness scale, mostly opioids users<br>strongly agree for treatment as well as recognition of their problems and desire for change.</p> Washdev Washdev Muhammad Ilyas Jat Fatima Taufeeq Muhammad Tarique Arain Saba Yasein Shaoib Ahmed Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 97 103 Correction of Nasal Deformities with Open Approach Rhinoplasty, Our Experience. <p>For the correction of functional and asthetic nasal problems open rhinoplasty has gained enourmous popularity since last ten years. In our setup we chose open approach rhinoplasty in all cases and wanted to share its merits.</p> Fareya Usmani Mukhtar Ibrahim Syed Mosaddaque Iqbal Syed Iqbal Hussain Sohail Tirmizi Imran Munir Imran Munir Aftab Imtiaz Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 82 89 Large Antecubital Vein Versus Small Vein on Dorsum of Hand for Propofol Injection Pain: A Comparative Study <p>Objective: To determine the mean difference in pain scores between large antecubital vein compared to the small vein on hand dorsum for propofol injection pain in patients undergoing general anaesthesia surgery.<br>Methods: A randomized control trial was conducted at the Department of Anaesthesiology, Abbasi Shaheed Hospital, Karachi from May 2018 to November 2018. All patients aged 18-60 years of either gender undergoing scheduled elective surgery under general anaesthesia having ASA status I or II were consecutively enrolled. Group A was offered propofol through the antecubital vein and group B was given injection propofol through a small vein on the dorsum of the hand. The 2% lidocaine 1 ml admixture in 1% propofol 19 ml was administered to patients through the large antecubital vein and small dorsal<br>vein at hand. Anaesthesia induction was carried out as routine and as per the procedure. All patients were explained the use of VAS (Visual Analogue Scale) and were asked to report the intensity of the pain immediately after the injection propofol.<br>Results: Of 120 patients, the overall mean age and BMI of the patients was 40.92 ± 10.03 years and 27.11 ± 5.05 kg/m2 respectively. An insignificantly higher mean difference of age (p= 0.052) and body mass index (BMI) (p= 0.901) were observed in small vein group as compared to the antecubital group. There were 64 (53.3%) males and 56 (46.7%) females. There were 43 (35.80%) smokers, 52 (43.3%) hypertension (HTN), and 29 (24.2%) diabetes mellitus patients. The mean difference of pain was significantly lower in the antecubital vein group as compared to the small vein group, i.e. 2.48 ± 0.77 vs 5.67 ± 0.75 respectively (p&lt;0.001).<br>Conclusion: A significant difference in mean pain scores was observed between large antecubital vein versus small vein on hand dorsum for propofol injection pain among patients undergoing surgery for general anaesthesia. We recommend using larger veins for propofol bolus while inducing general anaesthesia patients.</p> Muhammad Arif Aftab Imtiaz Fareya Usmani Syed Hamid Ali Asim Masroor Rashid Atif Iqbal Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 104 109 Awareness Regarding Family Planning Methods Among Final Year Medical Students <p>A cross-sectional awareness survey was conducted among final year MBBS students of ISRA University, Hyderabad from May 2017 to November 2017. After checking eligibility and taking verbal informed consent, 100 participants were included in the study and interviewed using a self-administered questionnaire.<br>Data was analyzed on Statistical Package for Social Sciences version 21. The study results showed that 29 (29%) of the study participants got information about family planning methods from health care providers, 27 (27%) through social circle, 24 (24%) through mediawhile 20 (20%) through conference, meetings and events. Furthermore, 42 (42%) of the participants correctly identified all permanent family planning methods, 65 (65%) correctly identified temporary family planning methods, 47 (47%) correctly identified short-term family planning methods whereas 54 (54%) correctly identified long term family planning methods. Efforts by both public and private sector to enhance awareness regarding family planning methods among medical students are recommended</p> Nadia Somroo Syed Muhammad Zulfiqar Hyder Naqvi Syed Imtiaz Ahmed Jafry Paras Saleem Nazia Jameel Mudassir Hussain Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 110 114 Replacement of congenitally missing maxillary lateral incisor with ipsilateral canine: A case report <p><strong>Abstract</strong></p> <p>Congenital missing lateral incisor of maxilla is a common tooth anomaly. Its replacement can have many options. The choice ought to be understandable for patients or guardians hence effectively address the patient's issues. Regardless of canine replacement, solitary inserts, tooth-supported prosthesis are techniques for patients with missing maxillary missing lateral incisors, although numerous confront are engaged with acquiring and holding ideal outcomes.</p> <p>In this case, report a case of 16 year old boy was discussed which has the diagnosis of Class II division 1 with missing upper laterals and anterior open bite. Plan was &nbsp;to perform space closure by canine lateralization and retraction of upper anterior to reduce the overjet followed by extraction of lower 5s to alleviate anterior crowding, correct molar relationship, maintain lower anterior teeth position, finishing, and alignment followed by retention.</p> <p>&nbsp;</p> abdullah Alnazeh Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-17 2020-09-17 25 2 115 120 Pictorial Quiz <p>An 11-year-old girl came with the complaint of colicky right iliac fossa pain for 1 week and vomiting for 1 day. On examination abdomen was soft, tender at right iliac fossa, guarding present all over the right lower quadrant and rebound tenderness was positive. Digital rectal examination was unremarkable. Ultrasound whole abdomen was normal. Attached below is a picture of the operative findings of the patient.</p> Shameen Shoaib Muhammad Jamaluddin Sobia Majeed Copyright (c) 2020 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2020-09-16 2020-09-16 25 2 121 121