ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc <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 annalskmdc2013@gmail.com.</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 editor@annals-ashkmdc.org (Prof. Dr. Syed Mahmood Haider) Tue, 14 Jan 2020 08:50:58 +0000 OJS 3.1.2.1 http://blogs.law.harvard.edu/tech/rss 60 At a glance: Pancreatitis and Obesity http://annals-ashkmdc.org/index.php/ashkmdc/article/view/190 <p>Acute pancreatitis (AP) is an inflammatory condition of the pancreas, involving tissue injury and necrosis leading to variable degrees of glandular dysfunction. The capricious nature of AP begins at the diverse factors contributing to the development of pancreatitis and extends into the disease process with regards to complications or resolution. The global pooled incidence of AP averages at 34 cases per 100,000 general population per year with no gender differences, however, geographical variability in incidence remains fairly inadequate due to the limited research performed in this area. In 2011, a study done in Japan facilitates in highlighting the emergency that AP presents with a 180% increase over a decade in its diagnosis1.</p> Muhammad Jamaluddin, Hajrah Hilal Ahmed, Raiya Mallick Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/190 Fri, 17 Jan 2020 06:09:29 +0000 Immunohistochemical Expression of Programmed Death Ligand-1 in Tumour Milieu of Oral Cancer http://annals-ashkmdc.org/index.php/ashkmdc/article/view/164 <p>Objectives: To determine the immunohistochemical expression of PD-L1 in oral squamous cell carcinoma and to correlate it with clinicopathological parameters.<br>Methods: This cross-sectional study comprised of 140 cases diagnosed with oral squamous cell carcinoma (OSCC), which were recruited by purposive sampling technique. Demographic details and clinical features were acquired through a questionnaire and consent was taken prior to the selection of cases. The diagnosis of OSCC was confirmed by biopsy and immunohistochemical staining was done by applying the PD-L1 antibody. The positive expression of PD-L1 was defined as at least 5 % of tumour cells exhibiting membranous staining at any intensity. The obtained data were then analysed statistically through SPSS version 25.<br>Results: Mean age of the participants was 48.91 ± 11.7 years. A majority of them were males(103; 74%) as compared to females (37; 26%). Most of the participants (64; 46%) belonged to the Urdu speaking ethnic group. Majority of them were habitual of using chewable tobacco products i.e. Pan, Gutka and Betel nut (89; 64%). The most common site affected by OSCC in the study was buccal mucosa (75; 54%). Majority of the cases had histologically moderately differentiated grade of OSCC (86; 61%). Out of 140 samples, PD-L1 positivity was observed in (87; 62.1%) of cases. A statistical significance was noted for PD-L1 with moderate differentiation of the tumour. (P-value: 0.006). The association of PD-L1 with other variables such as age, gender, ethnicity, sites or habits was statistically non-significant.<br>Conclusion: PD-L1 positivity was observed in OSCC patients, which is a subject of cancer immunotherapy in modern-day oncology. Its significance with tumour grade is indicative of progressing tumour severity; although further studies need to be conducted in this domain to draw definitive<br>conclusions.</p> Moomal Aslam Khan, Serajuddaula Syed, Noor Ul Wahab, Saima Akram Butt Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/164 Tue, 14 Jan 2020 05:42:13 +0000 Effect of Maternal Colonization with History of Prolonged Rupture of Membrane on Neonatal Colonization and Early Onset Sepsis http://annals-ashkmdc.org/index.php/ashkmdc/article/view/165 <p>Abstract<br>Objective: To determine the effect of maternal colonization with history of PROM on neonatal colonization and early-onset sepsis.<br>Methods: A descriptive cross-sectional study was carried out at a single tertiary care hospital of Karachi from June 1st 2018 to May 31st 2019. A total of 155 patients' full-term new-borns between 37 to 41 weeks of gestation with a history of rupture of membranes more than 18 hours duration was selected by convenience sampling method. A high vaginal swab was collected from all full-term pregnant women with a history of PROM. After delivery of their new-borns, all babies were kept in the nursery under closed observation for 72 hours duration and their blood cultures, CRP (C- Reactive Protein) and CBC (complete blood count) was sent within 24 hours of delivery.<br>Results: In our study, out of 155 PROM cases 58 (37.4) were growth positive and 50 (32.3) neonates had positive blood C/S at delivery. Out of 58 cases with suspected growth positive PROM mothers 51 had gram-negative organisms in HVS while only 7 mothers were gram-positive in HVS. Of all neonates with positive blood C/S at delivery 44 cases were gram-negative organisms in their blood.<br>Conclusion: In our study organisms found in a high vaginal swab of the mother are similar to the organisms found in the blood culture of their new-born with early-onset sepsis.</p> M. Hanif Memon, Shahina Hanif, Farhan Saeed, Muhammad Iqbal, Muhammad Athar Khan, Fatima Siraj, Aisha Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/165 Tue, 14 Jan 2020 05:54:06 +0000 Oral Health Impact Profile-14 as an assessment tool for quality of life in Secondary Burning Mouth Syndrome patients http://annals-ashkmdc.org/index.php/ashkmdc/article/view/180 <p>Abstract<br>Objective: To investigate the impact of burning mouth syndrome on the quality of life by means of Oral Health Impact Profile 14 (OHIP-14) and to compare the OHIP-14 scores in different underlying conditions.<br>Methods: The study was executed at the Department of Oral Diagnosis, Ziauddin College of Dentistry, Ziauddin University from June 2018 until June 2019. Fifty-four individuals suffering from BMS were included in this study out of which 33 were females and 21 were males aged between 18 and 60 years. The individuals were required to fill out a form which included details of their demographics, any known systemic conditions that they were suffering from and details of any medications being taken. The patients were then distributed into different groups according to any comorbid condition or any medications they were taking. The conditions according to which the patients were grouped were diabetes, postmenopause, gastroesophageal reflux disease, Sjogren's syndrome, intake of anti-hypertensives or psychological factors. In addition, patients were interviewed using the Oral Health Impact Profile 14(OHIP-14). For the statistical analysis, frequencies and percentages were used for categorical data and means and standard deviations were employed for the numerical data. Kruskal-Wallis test was applied to see if associated conditions had an effect on the severity of BMS measured in terms of Oral Health Impact Profile 14.<br>Results: The scores for the domains of physical pain and physical disability were highest whereas the lowest scores were observed in the categories of psychological discomfort and psychological disability. The data was not homogenous; therefore, the non-parametric test Kruskal-Wallis test was carried out to<br>find if there was any significant difference in the OHIP scores in the different groups namely diabetes, post-menopause, Gastroesophageal Reflux Disease, Sjogren's syndrome, intake of anti-hypertensives or psychological factors. A p-value of 0.169 was calculated indicating that there were no significant differences<br>observed in the OHIP-14 scores among the different groups.<br>Conclusion: Burning mouth syndrome has a negative impact on the quality of life according to the OHIP-14 scores. However, associated comorbid or other underlying conditions namely diabetes, post-menopause, Gastroesophageal Reflux Disease, Sjogren's syndrome, intake of anti-hypertensives or psychological factors did not alter the OHIP-14 results significantly.</p> Jaimala Kishore, Fouzia Shaikh, Adnan Mustafa Zuberi, Sana Mirza, Sana Ikram, Muhammad Arslan Raffat Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/180 Tue, 14 Jan 2020 05:58:10 +0000 Effect of Obesity and Family History of Cardiovascular Diseases and Diabetes Mellitus on Levels of C-Reactive Protein in Young Male http://annals-ashkmdc.org/index.php/ashkmdc/article/view/166 <p>Abstract<br>Objective: Objective of the current study was to investigate the effect of obesity and positive family history&nbsp; of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) on plasma C reactive protein (CRP) levels in apparently healthy young individuals.<br>Methods: Young male Saudi students were interviewed for their personal medical and family history of Cardiovascular Disease (CVD) and Diabetes Mellitus (DM). Anthropometric parameters, height, weight, waist and hip circumference were measured. In-addition they answered perceived stress scale(PSS-14) questionnaire; Finally, Plasma C-reactive protein level was examined in all participants.<br>Results: Results showed that the majority of our participants are overweight with mean BMI 27.113 ± 0.343 Kg/m2, but are non-stressed (24 ± 0.29). Around fifty-four per cent of participants have a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM). Average Plasma CRP level was (0.267 ± 0.016 mg/dl) with 26.75% of the participants in the high-risk category. Moreover, participants that are overweight/obese and with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) showed Significantly (P&lt;0.0001) higher levels of Plasma hs-CRP, compared to the normal weight and with negative family history. A significant correlation was also observed between hs-CRP and BMI and WC. However, stress scores were not significantly different among different groups.<br>Conclusion: Obesity, particularly in association with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) or one of the two diseases is a strong predictor of low-grade systemic inflammation indicated by high plasma hs-CRP level.</p> Syed Najamuddin Farooq, Ammad Ahmed, Abdul Halim S Serafi, Saeed H Halawani, Muhammad Amir Mustafa, Muhammad Irfan Safi Rizvi Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/166 Tue, 14 Jan 2020 06:08:17 +0000 Congenital Anomaly of Gall Bladder Assessed Through Magnetic Resonance Cholangiography in Relation to Its Clinical Relevance http://annals-ashkmdc.org/index.php/ashkmdc/article/view/167 <p>Abstract<br>Objective: The overall incidence of Phrygian cap is about 04%. It is an anomaly of gall bladder found congenitally. It can be a misguided pathological diagnosis often seen mimicking a liver mass on imaging of the hepatobiliary tree. Although Phrygian cap is a congenital anomaly, it does not show any pathological significance, In light of this condition, the purpose of this research was to find out the congenital anomalies of the gallbladder through magnetic resonance cholangiopancreatography (MRCP) along with its clinical significance.<br>Methods: A total of 377 patients were selected with a number of 192 females and 185 males, with ages ranging from 16-90 years, with a mean age of 48 years, who had undergone MRCP for diagnosed stone in gallbladder or bile duct on a clinical basis, carcinoma of pancreas and inflammatory changes of pancreatic and/or bile ducts. The patient's imaging was done using a 1.5-T superconductive magnet which was four-channel phase-arrayed body coil and breath-holding technique was utilized, using multi-sliced T2-weighting half-Fourier acquisition single-shot turbo spin-echo (HASTE), MIP reconstruction, and also single-shot T2-weighted turbo-spin-echo sequence rapid acquisition with relaxation enhancement (RARE) having a varying thickness of slices.<br>Results: The MRCP imaging results demonstrated extra hepatic biliary tract anomalies in 94 out of the 377 patients which represented a frequency of 24.93%. However, a Phrygian cap was found to be present in 6 patients with a frequency of 1.6% with 4 females and 2 males.<br>Conclusion: From the results that we achieved, it was made quite apparent that congenital anomalies can be classified as a complex spectrum of variations that have a propensity to occur on a regular basis, emphasizing their value for attention in clinical as well as surgical settings along with the need to be readily identifiable with MRCP.</p> Imran Ishaque, Urooj Fatima, Naveed Ali Siddiqui, Nadeem Baig, Amber Illyas, Naheed Gohar Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/167 Tue, 14 Jan 2020 06:14:02 +0000 Assessment of Depression and Its Associated Factors among Dental Outpatients http://annals-ashkmdc.org/index.php/ashkmdc/article/view/168 <p>Abstract<br>Objective: To assess depression and its associated factors among patients coming to the dental OPD of a public and a private dental college of Karachi.<br>Methods: A cross-sectional study was carried out in public and a private dental college of Karachi from November 2018 to May 2019. The inclusion criterion of the study was being 18 years of age or above whereas those who refused to give written informed consent were excluded from the study. After checking eligibility and taking written informed consent, a total of 250 participants were included in the study using systematic random sampling. These dental outpatients were interviewed by the principal investigator with the help of a pretested structured questionnaire that contained questions about socio-demographic information, dental risk factors and questions from Patient Health Questionnaire-9. Data were analyzed on the statistical package for social sciences version 21. Inferential analysis was performed using chi-square test whereas the significance level was set at 0.05.<br>Results: The study results revealed that 70 (28.0%) participants had minimal depression, 99 (39.6%) had mild depression, 45 (18.0%) had moderate depression, 28 (11.2%) had moderately severe depression whereas 8 (3.2%) had severe depression. Moreover, among demographic characteristics, only monthly income (p=0.037) and family history of depression (p&lt;0.001) were found to be significantly associated with severity of depression whereas, regarding dental risk factors only frequent dental pain (p=0.014), increased sensitivity (p=0.001) and presence of any systemic morbidity (p=0.001) were found to be significantly associated with severity of depression.<br>Conclusion: The study results revealed that almost a third of the dental outpatients had moderate, moderately severe or severe depression. Moreover, low monthly income, positively family history of depression, frequent dental pain, increased sensitivity and presence of any systemic morbidity were identified as factors associated with depression among the study participants</p> Shazia Sarwat Iqbal, Syed Muhammad Zulfiqar Hyder Naqvi, Syed Imtiaz Ahmed Jafry, Muhammad Zafar Iqbal Hydrie, Mudassir Hussain, Tariq Ali Adnan Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/168 Tue, 14 Jan 2020 06:16:54 +0000 Evaluation and Comparison of Lipid Profile in Pregnancy and Preeclampsia http://annals-ashkmdc.org/index.php/ashkmdc/article/view/170 <p>Abstract<br>Objective: The objective of the study is to evaluate and compare the lipid profile in normotensive pregnancy and in pre-eclamptic pregnant women.<br>Methods: The study was a case-control study, conducted from January 2018 to June 2018. The sample size was 90. Participants were recruited after fulfilling the selection criteria out of which, 45 were normal pregnant females and 45 were pregnant females with Preeclampsia (PE). Participants were placed in two groups namely A and B. Group A were 45 healthy pregnant females and group B were 45 preeclamptic pregnant women. The biophysical parameters included age, weight, height and BMI. Blood pressure was recorded through standard protocols. Blood was taken for lipid profile which includes Cholesterol, Triglyceride and HDL-C, measured through enzymatic colorimetric (CHOD-PAP) method, Glycerol-3- Phosphate Oxidase Phenol Aminophenanzone (GPO-PAP) method and Cholesterol Oxidase-Phenol Aminophenazone (CHOD-PAP) method respectively, however; LDL-cholesterol was calculated through Friedewald's formula. Urinary protein was measured through URS Strips through semi-automated analyser CYBOW reader 300. Data were statistically analysed through IBMSPSS software version 20 with the help of one-way analysis of variance (ANOVA) analysis, Tukey'sHSD test, independent sample t-test and Pearson correlation analysis by considering p-values 0.05 as a significant.<br>Results: The results of the study revealed a significant rise in the lipid profile of pregnant women with preeclampsia than in normotensive pregnant women including cholesterol, Triglyceride, HDL-C and LDL-C.<br>Conclusion: The study concluded that dyslipidaemia or hyperlipidaemia in early pregnancy could be one of the<br>reasons for developing preeclampsia in late pregnancy and risk of being hypertensive in advanced age.</p> Naseema Ahmed Jan, Nosheen Wasi, Raana Mahmood, Naila Ahmad Jan, Nargis Anjum, Huma Salahuddin Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/170 Tue, 14 Jan 2020 06:19:10 +0000 Oral Health Related Knowledge, Attitude and Practices and Their Associated Factors Among 3rd Year Dental Students http://annals-ashkmdc.org/index.php/ashkmdc/article/view/171 <p>Abstract<br>Objective: To assess oral health-related knowledge, attitude and practices and their associated factors among 3rd year BDS students in public sector dental colleges of Karachi.<br>Methods: A cross-sectional survey was carried out to assess oral health-related knowledge, attitude and practices among 3rd year BDS students from November 2018 to April 2019. 3rd year BDS students of either gender in public sector dental colleges of Karachi were included in the study whereas those refusing to give verbal informed consent were excluded from the study. After checking eligibility, a total of 372 3rd year BDS students from five public sector dental colleges of Karachi were included in the study by using a convenience sampling technique. Data were collected by the principal investigator using a pre-tested structured questionnaire. Data were entered on Statistical Package for Social Sciences version 19. After checking normality, the inferential analysis was carried out using the Mann Whitney U test whereas the significance level was set at 0.05.<br>Results: The study results showed that the knowledge and attitude regarding oral health of dental students were overall satisfactory, however their practices were not found to be satisfactory. Moreover, it was found that the mean rank of knowledge score was significantly different across various categories of age 'p=0.001' whereas the mean rank of practice score was significantly different across various categories of gender 'p=0.005'.<br>Conclusion: It was concluded that knowledge score was significantly different across categories of age while practice score was significantly different across categories of the gender of the students. Serious efforts are recommended to be taken by all stakeholders in order to motivate dental students so that they can translate their adequate knowledge and positive attitude regarding oral health into appropriate practices.</p> Mudassir Hussain, Nazia Jameel, Syed Imtiaz Ahmed Jafry, Syed Muhammad Zulfiqar Hyder Naqvi, Shazia Sarwat Iqbal, Tariq Ali Adnan Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/171 Tue, 14 Jan 2020 06:21:25 +0000 Recurrent Angiosarcoma on the Back in a Young Male: A Case Report http://annals-ashkmdc.org/index.php/ashkmdc/article/view/173 <p>Abstract<br>Angiosarcoma is a malignant disease of the inner lining of the blood vessel which can occur at any age and anywhere in the body like skin, liver, breast, bone, soft tissues cardiac tissues and after radiotherapy or from chronic lymphatic obstruction.It usually occurs between 60-70 years of age1. In this case, it occurred in a young male, which was previously excised but recurrence occurred and presented as a lump of 20×15 cm, which was non-tender, gradually increasing in size, firm in consistency however other systemic findings were unremarkable. Haematological workup was done which was within normal limits. Ultrasound Doppler of swelling showed multiple vascular channels with fat and soft tissue suggestive of a haemangioma. Excision and biopsy were done under general anaesthesia<br>and histopathology report showed fibro-fatty tissue with vascular malformation. In view of recurrence, it suggested angiosarcoma, which is treated by surgery followed by chemotherapy and its definitive diagnosis can only be made by biopsy.</p> Areeba Aqeel, Muhammad Jamaluddin, Shahmeen Aqeel Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/173 Tue, 14 Jan 2020 06:23:45 +0000 Prevalence and Management of Tooth Plaque Among University Students http://annals-ashkmdc.org/index.php/ashkmdc/article/view/174 <p>Abstract<br>Dental plaque is a biofilm of microbes which has a cross-linkage with the host tissues. The study objective was to assess the prevalence and management of dental plaque among university students. An observational study was conducted from July-2018 to September-2018, at different departments of Punjab University and Lahore College for Women University, Lahore, Pakistan. A total of 300 students with tooth plaque and age between 18-25 years were included in the study. The results showed that tooth plaque was more prevalent between 24-25 years of age. A significant association was found between the following: 'importance of oral hygiene' and gender( p=0.025) and economic status (p=0.001), 'yellowing of teeth' and age (p=0.001) and economic status (p=0.001), 'inherent characteristics' and economic status (p=0.01), 'brushing daily' and age (p=0.015) and economic status (p=0.003), 'type of toothpaste used' with gender (p=0.001) &amp; economic status (p=0.016) and finally between 'visits to dentist' and age (p=0.03) &amp; economic status (p=0.005). Tooth plaque was more prevalent in people with low economic status.</p> Saleha Sadeeqa, Saba Yousaf, Iram Nawaz, Aiman Imtiaz, Amna Kulb, Zabeen Zafar Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/174 Tue, 14 Jan 2020 06:26:02 +0000 Letter to Editor http://annals-ashkmdc.org/index.php/ashkmdc/article/view/192 Ayesha Aslam, Mehwash Kashif, Sana Iqbal Copyright (c) 2020 http://annals-ashkmdc.org/index.php/ashkmdc/article/view/192 Wed, 22 Jan 2020 00:00:00 +0000 Pictorial Quiz http://annals-ashkmdc.org/index.php/ashkmdc/article/view/185 <p>A 75-year-old female came to the OPD with the complaint of swelling and discharge from the left breast for two to three years with no known comorbid. On examination, the left breast showed fungating growth&nbsp;of 10×15cm with ulcerating margins and blood-stained discharge. It was hard and fixed to the chest wall. No axillary and cervical lymphadenopathy was found. What is your diagnosis?</p> Saquib Munir Copyright (c) 2019 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://annals-ashkmdc.org/index.php/ashkmdc/article/view/185 Tue, 14 Jan 2020 08:47:35 +0000