The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i2.189

Authors: Farhan Saeed Vakani Sana Ali

Mentors often struggle to understand their mentees' needs and to determine effective support strategies that impact the mentor-mentee relationship. This is particularly common among medical faculty, who lack formal training and opportunities to discuss and share. In light of the current situation, we organized an open seminar titled “Empowering Medical Faculty as Mentors” on January 6, 2024, followed by a full-day workshop on February 3, 2024, at Dow University of Health Sciences. This research article aims to involve the medical faculty community of practice to discuss the challenges encountered and coming up with effective strategies in the realm of mentorship. Methods It was an exploratory case study. The event was attended by fifty-one faculty members from 18 medical and dental colleges in Karachi, Pakistan. They were selected based on their teaching experience, seniority, and age. The views and experiences of the participants were documented during discussions and validated through a thorough literature review. The collected data was analysed and coded into themes and subthemes, ultimately identifying strategies for effective mentor-mentee relationships. Results Twelve key strategies for effective mentor-mentee relationship were generated. They were identified as: socialised niceness; transformative capability; adapt a leadership style; psychological resources; manage high assumptions; self-assessment; build a positive connection; avoid pushing personal agenda; reward mentors; efficient time management; recognise gender as a social construct, and to build trust. These should be a valuable resource for new mentors and medical faculty members to be mindful of and consider while involved in the mentoring relationship. Conclusion Both mentor and mentee well-being have received more attention in recent years and is increasingly prioritized in higher education. The identified strategies establish a foundation for future research in health professions education and guidance for educators to be mindful of creating supportive professional relationships that benefit both mentor and mentee.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.421

Authors: Aamir Bashir

Background: Liver transplantation (LT) is the definitive treatment for end-stage liver disease, acute liver failure, liver tumors, and metabolic diseases. Re-exploration after surgery is associated with poor clinical outcomes and is considered a quality-of-care measure. Objective: To determine the frequency and risk factors of reoperation (early re-laparotomy) after hepatectomy in postoperative LDLT donors. Materials and Methods: A cross-sectional analytical study was conducted at the Pir Abdul Qadir Shah Jeelani Institute of Medical Sciences between December 2023 and May 2024. This study included 672 LDLT donors aged > 18 years old. Data on donor age, sex, blood group, operation time, and re-exploration were collected. The primary endpoints were the frequency and causes of re-exploration, and the secondary endpoints included the association of re-exploration with clinical outcomes. Statistical analyses were performed using SPSS 25.0, with the significance level set at P < 0.05. Blood group analysis revealed that 57.9% of reexplored donors had blood group B+. Results: The frequency of re-exploration was 2.8%. Among those requiring re-exploration, 42.1% were aged 21-28 years. The difference in re-exploration rates between male and female patients was statistically significant (P<0.001). Blood group analysis revealed that 57.9% of the reexplored donors had blood group B+. Bleeding was the primary cause of re-exploration in 73.7% of cases. The majority (57.9%) of re-explorations occurred in patients with operation times between 451-550 minutes. However, the significant sex disparity and high incidence of bleeding as a cause for re-exploration underscores the need for improved postoperative care. Conclusion: This study highlights a relatively low frequency of re-exploration (2.8%) among LDLT donors. However, the significant sex disparity and high incidence of bleeding as a cause for re-exploration underscore the need for improved postoperative care.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.289

Authors: Hafiza Habiba Asma Areeba Iftikhar

Background: Pleural diseases involve the parietal and visceral pleura. They can be of inflammatory or malignant origin. Pleural biopsy is advised for assessment and excluding infectious causes as tuberculosis or malignant disease, particularly malignant mesothelioma. Connective tissue disorders such as rheumatoid disease can also present with involvement of pleura, requiring pleural biopsy for diagnosis. Objectives: The aim of my study was to find out diagnostic outcomes of open pleural biopsy or differentiation between benign (noncancerous) and malignant (cancerous) disease, to diagnose viral, fungal and parasitic diseases of pleura. Materials and Methods: Non-random sampling was used for data collection from Gulab Devi hospital. To find out the clinical value of nonspecific pleural biopsy specimen and fluid malignant neoplasm and tuberculosis. Data was collected from the patients undergoing procedure at Gulab Devi hospital. The collected data consists of 160 patients included females and males of all age groups. Results: 160 patients were undergone biopsies. Out of 160 patients a nonspecific or normal result was found in 53(33.3%). Diagnostic of malignant neoplasm in 18(10.9%) and granulomatous disease in 28(17%). Tuberculosis was found in 46 (28.9%). Histopathologically, pnemonitis was found in 16 (10.1%). Conclusion: Open pleural biopsy is precise and gold standard investigative method for malignancy. Pleural biopsy is safe easily performed and useful in diagnoses of tuberculosis or malignancy.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.292

Authors: Unaiza Jawad Muhammad Saqib Rabbani Fatima Aslam Fariha Asghar Mujtaba Muhammad

Background: To determine the association of non-adherence to the various age groups and related sociodemographic factors, this study was conducted. Materials and Methods: In different departments of Services Hospital Lahore, a cross-sectional survey was conducted. 370 patients voluntarily participated in the study. The data was collected using a questionnaire. The data was analyzed using chi-square. The level of significance was 0.05%. Results: In this study, 33.3% of patients were below the age of 40 years and 46.3% of patients were above the age of 40 years and were not adherents because of the experience that they did not get benefit from the treatment. Similarly, 21.5% of patients below age 40 and 22.3% of patients above age 40 think that they do not need medicine. 38.5% of patients below age 40 and 54.3% of patients aged above 40 stopped medicine after becoming better. Conclusion: None-adherence found more prevalent among elderly patients.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.293

Authors: Wazir Ahmed Baloch Shahid Zafar Ihsan Ullah Muhammad Imran Khan Maher Sohail Yaseen Muhammad Kamran Ameer

Objective: Doxorubicin is presently a leading antineoplastic drug with promising efficacy. This study was designed to investigate the histological effects of doxorubicin toxicity on rat kidneys and how much protection is provided by Nigella Sativa. Materials & Methods: A randomized controlled trial conducted on thirty adult male wistar rats divided randomly into three equal groups. Group A served as a control. Group B was injected with weekly intraperitoneal injections of doxorubicin at a dose of 3mg/kg b.w. Group C rats received doxorubicin along with nigella sativa at a dose of 1000mg/kg b.w. orally daily. At the end of these interventions, animals were sacrificed and kidneys were removed for the purpose of histological staining. Renal glomerular and tubules related histopathological parameters were assessed qualitatively as mild, moderate & severe. Renal glomerular diameter was digitally measured by microscope. Ethical approval was taken from Ethical Committee, Jinnah Postgraduate Medical Centre (JPMC), Karachi. All the parameters were statistically analyzed. Results: Group B rats’ renal tissue was adversely affected by the drug showing marked necrosis of tubules and the glomeruli along with interstitial cells’ infiltration. Glomerular diameter was also significantly decreased in group B as compared to group A. These histological features in group C rats’ renal tissue were milder and glomerular diameter was close to that of group A. Conclusion: According to our study doxorubicin treatment proved noxious for the renal tissue, both tubules and glomeruli, while nigella sativa significantly competed against these pathological alterations.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.294

Authors: Muhammad Shoaib Mirza Muhammad Abdullah Atif Ullah

ABSTRACT Objectives: The objectives of research were to analyze the smoking behavior among the medical students and to examine the factors behind the prevalence of smoking among the students of Mohtarma Benazir Bhutto Shaheed Medical College while recommendations are made on study findings. Materials and Methods: Quantitative research design is used while nature of research is descriptive cross-sectional. Sample size of the study was 500 Medical Students (First year MBBS to final year MBBS). Non-probability convenience sampling technique was used to extract the sample. The data was collected through self-structured mixed questionnaire and analyzed by employing SPSS. Results: They faced difficulty in refraining the smoking stuff which might be the educational and socio-cultural pressures which they are expected to contain in the society. The knowledge and legislation were supported by the students as legislation should be carried out to ensure the smoke free environment in College. Conclusion: Students of Medical College Mirpur have been found addict to the smoking. However, they have been found conscious towards their smoking status while experiencing different brands.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.245

Authors: Muhammad Arif Aftab Kakar Ehsan Larik

COVID-19 is a new disease that is spreading very fast in Pakistan. Cases have been reported from all of the provinces including Balochistan. The first two confirmed cases in Pakistan had travel history by road from Iran to Balochistan, hence SIR model used to predict the magnitude of the disease in Balochistan from May 2020 on wards when lock down and other social distancing measures were loosen up by the government of Balochistan. Our Prediction model shows that about 30,00000 individuals in Balochistan will be infected by 5th of July 2020. Over all 25% of the total population of Balochistan will be affected by this disease with 98% (2940,000 ) recovery rate by the end of 15th July 2020.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.255

Authors: Atiq ur Rahman Muhammad Imran Zarmeena Yasmeen Muzammil Irshad

Objective: The objective of the study was to assess the effects of COVID-19 and lockdown on OPD services. Materials and Methods: A cross-sectional study was conducted at District Headquarter Hospital (DHQ) and Tehsil Headquarter (THQ) Hospitals of District Layyah. The data was collected from one DHQ hospital and six THQ hospitals. The OPD data of three years (the years 2018 to 2020) was extracted from District Health Information System (DHIS). Trends of outpatients’ flow during months of March and April of three years were taken. The data were analyzed using SPSS version 24. RESULTS: The COVID-19 pandemic was declared by World Health Organization (WHO) on March 11, 2020, and all countries started lockdown nationwide which imposed a major impact on all areas of life. Fear of coronavirus spread and lockdown resulted in significant reduction in number of patients at outdoor services. In our study, we analyzed outdoor services of seven hospitals of district Layyah - one DHQ hospital and six THQ hospitals. Conclusion: Fear of coronavirus spread and lockdown resulted in significant reduction in number of patients at outdoor services.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.185

Authors: Akhtar Hussain Naureen Tassadaq

Objective: To investigate the general health status in patients of Adhesive Capsulitis Study Design: Prospective study Place and duration: Occupational Therapy Unit of Rehabilitation Department of Fauji Foundation Hospital Rawalpindi from July 1, 2019 to September 30, 2019. Methodology: There were many patients suffering from shoulder pain. Among them, 52 patients who were suffering from adhesive capsulitis included. After the history of subjects, assessed for pain and restriction of range of motion in their affected shoulder. Lateral rotation, abduction, and medial rotation (LAM) test was performed. The inclusion criteria for subjects was symptomatic shoulder problems with restricted active and passive range of motion along with positive (LAM) test in ages between 30 to 80 years. The exclusion criteria was: (1) any neurological conditions affecting shoulder (2) any pathology other than adhesive capsulitis (3) any surgery of head, neck or upper limb. Data was analyzed using SPSS 25. Results: Our study showed that all 52 patients were suffering from a very acute state of pain, sleep cycle disturbance, difficulty in activities of daily living (ADLs) and recreational activities. Some patients were jobless due to acute shoulder pain of adhesive capsulitis. Conclusion: Adhesive capsulitis disturbs the daily life, sleep cycle, activities of daily living and difficulty in recreational activities. it is advocated that further researches must be conducted to point out the difficulties of such patients.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.291

Authors: Ambreen Chaudhry Aamer Ikram Mirza Amir Baig Muhammad Salman Tamkeen Ghafoor Zakir Hussain Mumtaz Ali Khan Jamil Ahmed Ansari Asif Syed Wasif Javed Ehsan Larik Muhammad Mohsan Naveed Masood Zeeshan Iqbal Khurram Akram

Introduction: COVID-19, a novel disease, appeared in December 2019 in China and rapidly spread across the world. Till the second week of April 2020, high incidence (2.9/100,000) and cases fatality rates (1.7%) were observed in Pakistan. This study was conducted to determine the temporal and spatial distribution of the first 100 deaths attributed to COVID-19 in Pakistan and their associated demographic factors. Method: A record review of the first 100 deaths reported among RT-PCR confirmed COVID-19 cases was conducted. Demographic, epidemiological, and risk factors information was obtained associated comorbidities and clinical signs and symptoms were recorded and frequencies were determined. Results: A total of 100 mortalities with an overall case fatality rate of 1.67% (CFR) were analyzed. The median age of patients was 64.5 years (IQR: 54-70) with 75% (n=75) males. Among all deaths reported, 71 (71%) cases had one or more documented comorbidities at the time of diagnosis. The most frequently reported co-morbidities were: hypertension (67%), followed by Diabetes Mellitus (45%) and Ischemic Heart Diseases (27%). The most frequent presenting symptoms were shortness of breath (87%) and fever (79%). The median duration of illness was eight days (IQR: 4-11 days), the median delay reaching hospital to seek health care was three days (IQR: 0-6 days) while the median duration of hospital stay was also three days (IQR: 1-7 days). Among all, 62% had no history of international travel. The most affected age group was 60-69 years while no death reported in the age group below 20 years.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.246

Authors: Bilqees Akhtar Malik Ambreen Shabbir Zeb Un-Nisa Asma Ambreen

Objective: In our part of the world poverty and illiteracy has adversely affected our core objective of pregnancy i.e. healthy mother and healthy child. Exploring the role of a routinely used drug in reducing the duration of labor could be a breakthrough. Present study was planned accordingly to evaluate the effect of phloroglucinol (PHL). Materials and Methods: It was a Randomized controlled trial conducted at Department of Obstetrics & Gynecology, Combined Military Hospital, Bahawalpur from January 2019 to June 2019. This study included 60 cases of age 18 to 40 years, having singleton pregnancy and in active first stage of uncomplicated labor. Patients with history of multiple pregnancies, obstetrical and surgical complications and cardiorespiratory diseases were excluded. The cases were placed randomly into Group A & Group B and given intravenous PHL and a placebo respectively. After this, duration of the first stage of labor was recorded in minutes from when there was 3-4 cm cervical dilatation with regular uterine contractions to complete cervical dilation i.e. 10 cm and descent of the presenting fetal part. Results: Mean duration of active first stage of labor in experimental group A (230.20 ± 52.96 minutes) was significantly higher than that of control group B (345.30 ± 50.57 minutes). Conclusion: This study concluded that intravenous PHL has efficiently reduced the duration of active first stage of labor in these randomly selected nulliparous and multiparous women. PHL is a useful drug serving the purpose of a spasmolytic, analgesic and labor augmentation at the same time.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.295

Authors: Zaemeena Yasmeen Abdul Basit Sidra Tahir

Anagallis arvesnsis belongs to family primulacae. It is a summer annual herb distributed worldwide or with a global spread abundantly found in Egypt, Palestine, a non-tropical region of South America, Taiwan, and India (more specifically Jammu & Kashmir). Different parts of plant contain variety of active constituents; such as glycosides, saponin, flavonoid, anthraquinone, alkaloids, rutin, kaempferol, oleananetriterpenes, anagalligenin, anagalligenone, stigasetrol, arvenin I, arvenin II, cucurbitacin B, D, E, I,L& Q, n-hexosamine, β-amyrin, sterols carbohydrates, lacceric acid. Anagallis arvensishas recognized medicinal values as an anti-mycotic, antimicrobial, molluscicidal, antioxidant, anti-inflammatory, anti-leishmania, antiviral, cytotoxic, and spermatogenesis. The present review will highlight thetraditional uses, phytoconstituents and pharmacological effects of Anagallis arvensis.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.144

Authors: Wajahat Hussain

Coronavirus disease 2019 (COVID-19) pandemic has produced a global health crisis that has had a deep impact on the way we perceive our world and everyday lives. Not only the spread rate of contagion and patterns of transmission endangered our sense of security, but the safety measures put in place to contain the spread of the virus also require social distancing by refraining from doing what is inherently human, which is to find comfort in the company of others. Within this context of physical threat, social and physical distancing, the role of the different mass media channels and social media in lives on individual, social and societal levels cannot be underestimated.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.5

Authors: Shafiq Ahmad Chudhary Shahid Imtiaz Nedal Iqbal

Since mid-December 2019, several cases of a pneumonia like disease (with symptoms including fever, difficulty in breathing, cough and invasive lesions on both lungs) of unknown cause have emerged in the central Chinese city of Wuhan. Chinese authorities made a preliminary determination that the causative agent is a novel coronavirus(2019-nCoV). Coronaviruses are enveloped RNA viruses belonging to Coronaviridae family and the order Nidovirales. This subfamily consists of four genera alphacoronavirus, betacoronavirus, gammacoronavirus and deltacoronavirus on the basis of their phylogenetic relationships and genomic structures. These subfamilies are broadly distributed for causing infections in humans and other mammals. The alphacoronaviruses and betacoronaviruses infect only mammals. The gammacoronaviruses and deltacoronaviruses infect birds, but some of them can also infect mammals. The source of betacoronavirus 2019-nCoV is still unknown, although initial cases have been linked with south Huanan seafood market. Viral infections already known to produce similar symptoms are influenza, parainfluenza, Middle East respiratory syndrome (MERS-CoV) and severe acute respiratory syndrome (SARS-CoV). Laboratory investigations reported raised plasma levels of L2, IL7, IL10, GSCF, IP10, MCP1, MIP1A, and TNF? in patients.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.83

Authors: Sana Iqbal Ayesha Aslam Sufyan Ahmed Nabeel Khan Mehwash Kashif Syeda Musira Kazmi

Objective: To evaluate the frequency, pattern, and etiology of mandibular fractures at a tertiary care hospital, in Karachi Study Design: Retrospective, cross-sectional study. Setting: Abbasi Shaheed Hospital, Karachi, Pakistan Methodology: The study was initiated in Outpatient Maxillofacial Surgery Department of Abbasi Shaheed Hospital Karachi. The duration of the study was 5 years and six months. Data of mandibular trauma was evaluated. In this retrospective, cross-sectional study the patients were recruited through convenience sampling and the inclusion criteria was patients from both genders suffered from mandibular trauma of mandibular region. Patients who suffered from the trauma of face other than mandible were excluded. The sample size of the study was 464. A questionnaire was designed to enquire into the demographic details like age, sex, etiology, and site of fracture. The data was analyzed on SPSS version 17.0. Results: The majority of patients were males i.e. 384 (82.8%) while 80 (17.2%) were females. The most common type of fracture was combination fractures followed by parasymphysis i.e. 142 (30.6%) and 79 (17%) respectively. Road traffic accident was the major cause of trauma i.e. 332 (71.6%) followed by fall 96 (20.7%). Cross tabulation was done between different variables. Association of gender with etiology and type of fracture revealed non-significant p-value while the association of age with etiology revealed significant p-value. The highest number of mandibular fracture cases due to RTA were reported in the year 2019. Conclusion: It has been concluded that the frequency of mandibular trauma is quite high with male dominance. The most susceptible site of trauma is the combination and parasymphseal region and the most common etiology were road traffic accidents.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i2.206

Authors: Muhammad Aslamkhan

On December 31st 2019, Chinese Health Authorities in Wuhan city of their Hubei province, diagnosed 29 pneumonia cases of unknown etiology and informed WHO (World Health Organization). The unknown virus resembled SARS (severe acute respiratory syndrome), that occurred in China in November 2002, caused by a novel corona virus spilling over from an animal reservoir and transmitted by respiratory droplets. More than 8000 cases and 774 deaths were caused by SARS and circa US$20 billion coasted for its control.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.323

Authors: Muhammad Hassan Naveed Ghulam Mustafa Asim Muhammad Mohid Tahir

Background: Pakistan is one of the largest host of refugees. People in Pakistan have bad access to healthcare not only due to bad facilities but also due to discrimination based on their personal characteristics and possessions. The behavior not only damages the dignity of the people being targeted but also creates hindrances in further seeking professional medical help and follow-ups thus deteriorating the health status of the community as a whole. Health providers possess a moral commitment to encourage dignity and treat their patients without any kind of discrimination in their behavior. Patient experiences of discrimination result in delay in seeking healthcare, they do not stick to advice of professionals and ultimately poor health. The objective of this study is to identify sources of discrimination and its effects on patients' health status and their level of satisfaction. Methods: This descriptive study took place in Outdoor Patient Department, Mayo Hospital, Lahore. 170 patients were selected from all the patients coming to OPD with equal male to female ratio. Each patient was given a questionnaire containing relevant questions to know whether they faced any sort of discriminatory behavior or not. Results: 66% females and 49% males of the study sample experienced discrimination at some stage of their hospital visit. Conclusion: Our study concluded that females experienced more discrimination than males. Therefore, gender is the most important factor when it comes to discriminatory experiences. Moreover, people with the higher income had fewer incidents of discrimination than their counterparts.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.315

Authors: Jazib Andleeb Faiza Mehboob Sana Javaid Mudassar Ali Muhammad Imran Khan Qurat-ul-Ain

Background: Gestational diabetes mellitus (GDM) is associated with marked increase in insulin resistance. The objective of study is to determine the relation of gestational diabetes with serum leptin and serum insulin levels during pregnancy and postpartum period. Methods: This case control study conducted on total ninety samples that include cases and controls taken after 24 weeks of gestation. The case sample included 40 pregnant women with GDM and 10 women with GDM at postpartum stage. The control sample included 30 normal pregnant women with no GDM and 10 normal women at postpartum. Fasting serum leptin and fasting serum insulin were measured by ELISA. HOMA index was calculated by fasting serum insulin and fasting blood glucose. Results: Serum leptin (30.89 ± 1.35), serum insulin (27.67 ± 1.32) and HOMA index (8.33 ± 0.53) significantly high in gestational diabetic women than normal pregnant (p<0.05) during pregnancy. However, after delivery of fetus, serum leptin, serum insulin and HOMA index in gestational diabetics significantly decreased compared to during gestation period. Hence a positive correlation of GDM was determined against serum leptin and HOMA index. Conclusion: Serum leptin level is raised in GDM which has a positive correlation with insulin resistance. This study finds that the serum leptin levels may use as a marker to early screen and diagnose Gestational diabetes.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.324

Authors: Muhammad Nadeem Mansoor Abbas Qaisar Ali Hassan Al Hakami Fateh Sher Chattah Muhammad Muzammil Muhammad Kamran Ameer

Background: The mean arterial pressure serves as an expression of blood pressure in patients on chronic hemodialysis. Serum calcium phosphorus product is considered as a risk factor of vascular calcification that is associated with hypertension in the patients of end stage renal disease. The literature regarding this relationship is inconsistent therefore this study is designed to determine the correlation between calcium phosphorus product and mean arterial pressure among hemodialysis patients with end stage renal disease. Methods: A total of 110 patients of end stage renal disease on hemodialysis for at least one year, 20 to 60 years of age were included. Patients with primary or tertiary hyperparathyroidism, peripheral vascular disease, malignancy, hypertension secondary to any cause other than kidney disease were excluded. Mean arterial pressure was calculated according to the standard protocol in lying position. Blood samples for estimation of serum calcium and phosphorous were taken and was sent immediately to the laboratory for serum analysis. Results: Mean age was 44.17 ± 10.94 years. Mean calcium phosphorous product was 46.71 ± 7.36 mg/dl and mean arterial pressure was 103.61 ± 12.77 mmHg. The values of Pearson correlation co-efficient (r) were 0.863 for age group 20 to 40 years and 0.589 for age group 41 to 60 years. This strong positive correlation means that high calcium phosphorous product goes with high mean arterial pressure (and vice versa) for both the age groups. Conclusion: A strong positive relationship exists between the mean arterial pressure and calcium phosphorous product and is independent of patients’ age.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.329

Authors: Maria Ilyas Masooma Ahmad Huma Jawad Nazia Siddique Lubna Shahper Muhammad Hashim Ghouri

Background: Energy drinks (EDs) are commonly used to prevent fatigue, enhance physical, and cognitive performance. Its administration induces toxic effects in body. Omega-3 is an antioxidant and anti-inflammatory agent that helps in proper functioning of immune system. Objectives of this study were to evaluate the morphological effects of fish oil omega 3 fatty acids (Eicosapentaenoic acid / Docosahexaenoic acid) on energy drink induced ovarian cytotoxicity in adult female albino rats. Methods: The study was conducted at animal house, Anatomy department, Postgraduate Medical Institute, Lahore from January to march 2019. ARRIVE guidelines were followed for conduct of animal study. Ethical approval was obtained from PGMI, Lahore and Advanced Studies and Research Board of University of Health Sciences, Lahore. The study comprised 36 adult female albino rats divided into 3 groups i.e., control, energy drink and omega 3 treated. Rats were sacrificed, ovaries extracted, and sections were stained with H&E and PAS. SPSS version 21.0 were used. Results: Statistically significant difference was present in gross parameters between the control and experimental groups. Energy drink administration caused a decrease in diameter of mature graafian follicle and diameter of the oocyte. Disruption in basement membrane was more pronounced in Energy drink treated group. Conclusion: Energy drinks were found to cause cytotoxic effects on ovarian and oocyte morphology, ultimately leading to infertility. Omega 3 reduces the extent of damage caused by the intake of energy drinks.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.339

Authors: Nedal Iqbal Khubaib Shahid Muhammad Imtiaz Faiqua Yasser Ayesha Ashraf Muhammad Zain ul Abdin

Background: Human face is highly vascular region and vascularity to the skin and other organs is an important indicator of health and disease. Change in blood flow is affected by aging, diabetes, high blood triglycerides, cigarette smoking etc. With so many factors that can alter blood flow in the skin, normal blood flow is important to know for comparison to diseased state. Blood flow in superficial arteries of face has not yet been described, therefore this study was designed to establish baseline blood flow values in arteries of face. Materials and Methods: Blood flow of right and left side was assessed at level of facial and infraorbital artery. Categorical variables were presented in form of frequency and percentages was done by using Mann-Whitney U. Wilcoxon Signed Ranks test was used to compare left and right facial and infra orbital arteries. Results: Peak systolic velocity of right and left facial artery had a significant difference having right side mean of 67.02±12.48 and left side mean as 72.67±11.69. Facial artery diameter of right and left side also had significant difference with mean of 0.14±0.02 and 0.15±0.02 respectively. Conclusion: No difference was found between vascularity in male & female and left or right side. The study might be useful to establish normal baseline values of various parameters on both sides of face in male and female adults. This study may become important reference for future studies measuring blood flow and even progression of vascular diseases may be assessed by indexes developed on the basis of these studies.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.325

Authors: Zouina Sarfraz Azza Sarfraz Muzna Sarfraz Zainab Nadeem Hafiza Hussain Sarah Bakhsh Gaurav Patel Junaid Arshad Yasar Sattar

Primary percutaneous coronary intervention (PPCI) is a non-surgical procedure that requires catheterization to improve blood flow to the heart and is the recommended therapy for Acute Myocardial Infarction (AMI). The Coronavirus 2019 (COVID-19) pandemic has altered the course of reperfusion therapy for patients with ST-elevation myocardial infarction (STEMI). It is imperative to emphasize the awareness of timely PCI and the effects it has on improving patient outcomes. Based on the consensus statement by the American College of Cardiology (ACC), American College for Emergency Physicians (ACEP), and the Society for Cardiovascular Angiography and Interventions (SCAI), it is critical to inform the public to call the emergency medical system for AMI symptoms and obtain the appropriate level of care. Ultimately, COVID-19 has posed unprecedented challenges to public health. The immediate threat is linked to morbidity and mortality related to the infection, and the masked threat is the waning attention and resources utilized for the care of other diseases. First medical contact is the main time target, and reducing treatment delays to improve patient outcomes in AMI patients with STEMI should be the next immediate objective in healthcare systems worldwide.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.319

Authors: Tahir Iqbal Muhammad Usman Shahid Ishfaq Ahmad Shad Shahzad Karim Bhatti Syed Amir Gilani Zahid Siddique

ABSTRACT: BACKGROUND: A common surgical emergency is acute appendicitis. Various diagnostic tools are available to diagnosis acute appendicitis. Radiological investigations play an important role in making accurate and early diagnosis and thus preventing morbidity associated with the disease. OBJECTIVE: To determine the diagnostic accuracy of gray scale ultrasonography versus color Doppler in suspected cases of acute appendicitis. MATERIALS AND METHODS: The study was carried in the department of Radiology of Mayo Hospital, Lahore. A total of 75 patients were enrolled of age 18-40 years, both genders who were suspected cases of acute appendicitis. All patients underwent baseline investigations along with gray scale ultrasonography and color Doppler. All patients were subjected to surgery to confirm the diagnosis and findings were subjected to statistical analysis. RESULTS: The mean age of the patients was 23.25 ±10.55 and mean transverse diameter of appendix was 8.37 ±3.39. There were 62.7% males and 37.3%females. Findings of gray scale ultrasonography and color Doppler were then correlated with surgical findings to calculate the diagnostic accuracy of these modalities. The results revealed that gray scale ultrasonography sensitivity, specificity, positive predictive value, negative predictive value and accuracy was 92.7%, 94.32%, 95%, 91.4% and 93.3% respectively, whereas color Doppler had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 97.7%, 93.9%, 95.3%, 97% and 96% respectively. Diagnostic accuracy of both modalities together was 98.6%. CONCLUSION: Color Doppler has better diagnostic accuracy than gray scale ultrasonography for diagnosis of acute appendicitis and the combination of both modalities yields diagnostic accuracy that is similar to gold standard.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.356

Authors: Wajahat Hussain

The pandemic of coronavirus disease 2019 (COVID-19) is challenge of the century for humanity. Pre-pandemic normalcy is assumed to never return until a safe and effective vaccine becomes available and a global vaccination campaign is successfully introduced. To tackle the pandemic of Covid-19 safe and effective vaccines has been developed and pharmaceutical companies Pfizer/BioNTech, Moderna and AstraZeneca started to manufacture the vaccine and make it available in the market. Globally all the countries are in race to secure vaccine access for their populations but it is challenge for developing countries to make vaccine available for the population especially the poor and vulnerable groups. Pakistan is developing country which is facing the double burden of the communicable diseases like malaria, HIV/AIDS, tuberculosis and non-communicable diseases along with financial issues faced by the health system.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.312

Authors: Asmatullah Achakzai Muhammad Arif Achakzai Hameed Ullah Achakzai

Background: Our study aims to determine the effectiveness of tranexamic acid in decreasing the intraoperative blood loss during tonsillectomy. Materials and Methods: Study design was randomized double-blind control trial. This study was conducted from 1 November 2017 till 30 June 2019 in the department of ENT unit-II, the civil sandeman provincial teaching hospital Quetta. Ethical approval was taken from Ethical Review Board of the civil Sandeman provincial teaching hospital Quetta. A sample of 100 patients were surveyed, 55 men and 45 woman, 10-30 year age range, 1.2:1 men to female with a mean 20 year age. Patients who met the criteria for inclusion experiencing an elective tonsillectomy were randomly assigned to two groups. Every community has equivalent patients. An injection of 10 mg/kg body weight was given intravenously into group-A 5-10 minutes prior to surgery, and normal saline of the same amount was administered intravenously into group-B. Intraoperative bleeding was measured at Operation Theatre in both groups during surgery. In intraoperative blood loss, the effectiveness of tranexamic acid / placebo was determined by measuring loss of blood computed by Gravimetric method and blood obtained in suction jar by measuring. Results: In Group-A and Group-B patients, there was a significant difference in intra-operative loss of blood during tonsillectomy. In group A, intra-operatively, there was overall blood loss of 1404 ml and the average blood loss was 33ml. During surgery in group-B the blood loss was 3132 ml, and the average loss of blood was 62-64ml. As a result, group B was more intraoperative bleeding and consumed more time compared to group A. Conclusion: Study group patients receiving preoperative intravenous tranexamic acid have less intraoperative loss of blood and less time consuming than placebo patients who have not obtained tranexamic acid intravenous.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i1.314

Authors: Sajjad Ullah Sohail Ahmad Qaisar Ali Arshad Jamal Muhammad Zubair Yousaf Ahmed Bilal Waqar

Background: Hepatitis C virus is one of the significant causes of morbidity and mortality in the World. Surprisingly, despite national screening campaigns, new cases of HCV are still on the rise. Methods and Results: A total of 5914 healthy blood donors was included in this study after informed consent. Anti-HCV ELISA was used to check presence of antigen in participant’s plasma.using Monlisa HCV Antigen-Antibody Ultra kit. Final confirmation was done by using real time PCR considered as a gold standard. Results: 0.5% of anti-HCV ELISA negative samples showed presence of antigen in plasma, when checked through core Ag detection method. Conclusion: Our result suggested that HCV core antigen detection and/or combo testing are far safer screening methods for the detection of HCV and the use of these methods can avoid/reduce further spread of this deadly disease.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.335

Authors: Balakh Sher Zaman Muhammad Mohsin Ali Raza Gulzar Ameer Afzal

Background: Accidental parathyroidectomy during thyroid surgery can lead to temporary or permanent hypocalcemia and serious morbidity. Proper identification of parathyroid glands during surgery can be an effective way to prevent this complication. Methods: The keywords “parathyroid gland,” “preserve,” “protect,” “inadvertent or accidental parathyroidectomy,” “surgery,” and “dissection” were used to search Medline and Embase databases. A total of 133 articles were selected after preliminary review, of which 80 indexed papers were reviewed for subject relevance. Results: Imaging techniques, such as the use of carbon nanoparticles or indocyanine green angiography, and operative techniques, such as meticulous capsular dissection of the thyroid gland, were associated with significantly improved rates of avoidance of inadvertent parathyroidectomy. Conclusion: During thyroid surgery, the use of imaging and careful operative techniques can prevent parathyroid injury. This, in turn, can prevent complications resulting from hypoparathyroidism such as tetany, ECG changes, and neurological sequelae.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.342

Authors: Nazia Siddique Masooma Ahmad Maria Ilyas Muhammad Bahadur Baloch Attya Zaheer Rukhsana Jabeen

Background: The use of mosquito coils has increased exponentially, especially in the under developed countries. Many researches have been conducted over the past few years to advocate both the possible risks and potential benefits. These coils and the inhalation of their smoke have been proved to cause upper and lower airway tract infections. But still the possible side effects of inhalation of these coil smoke on other organ systems of the body were unclear. Methods: Adult male Wistar rats were divided into two groups each containing eight rats. Group A was control group while group B was allowed to inhale mosquito coil smoke for four week. The experimental group was exposed to MCS for 8 hours / day. Histopathological analysis of testis was carried out. Results: Histopathological studies of rats exposed to MCS revealed changes in parenchyma of testis. Decrease in the height of germinal epithelium and diameter of seminiferous tubules and increase in and vascular congestion was observed. Conclusion: The results of present study suggest that allethrin based mosquito coil smoke has harmful effects on testis

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.316

Authors: Mavra Naz Adil Umer Khan Muhammad Usama Aslam Muhammad Kamran Ameer Faiza Mehboob

Background: Prescribing errors are quite common and according to one estimate out of 100 patients admitted into UK hospitals 15 will have some form of prescribing error in their records. It is a general understanding that most of the time these errors are made due to lack of awareness. Severity of these errors can range from minor to major mistakes that can lead to fatal results. Materials and Methods: A simplified anonymous approach of identifying these errors and then using a step wise approach to educate the prescribers’ especially junior doctors can be quite fruitful in reducing these errors. Unfortunately there are not many studies or projects available to back our proposal however these seems a logical way forward and is exactly what we have shown in our study. Results: We performed a prospective snapshot study involving 100 inpatients to get baseline measurements. The errors and mistakes were identified and fed back to the junior doctors in an anonymous manner. Clear & legible writing, frequency of use, responsible consultant name, allergy box filled, VTE assessment, oxygen prescribing and labeling of medication discontinuation were the most common negligence identified. At the same time junior doctors were reminded of local prescription standards and guidelines which usually don’t form part of induction. Conclusion: Multiple deficient areas were identified during this audit like legible writing, dosage frequency, VTE prophylaxis and oxygen prescription. It was highlighted to junior doctors how important are these components as they play a key role in patient getting better after medical review. Above mentioned steps did improve prescription errors to an extent, but aim should be to achieve 100% results. Repeated reminders are important in this case as that helps to improve practice and avoid clinical accidents.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.332

Authors: Sania Wahid Muhammad Hussain Muhammad Afzal Syed Amir Gillani

Background: Education is the most hopeful discipline which provide pathway for a purposeful and productive life. The progress in any filed is achieved through education. Education is a complex process. Academic failure is the one of the main challenges which students face during academic years. Current study was conducted to identify the causes of academic failure among the nursing students and determine the correlation between these causes. Materials and Methods: A quantitative descriptive cross-sectional study design used to explore the causes of academic failure among the nursing students and correlation between these variables. A convenient sampling technique use to collect the data. Questionnaire distributed in 134 participants. SPSS version 24 was used for data analysis. Results: The mean score of question related to teacher behavior was 2.62 and the overall mean score was 2.62 ± 0.20. Lack of commitment to study was 2.23 and the overall mean score was 2.23 ± 0.22. Problem with learning environment mean 2.61 and the overall mean score 2.61 ± 0.26. The mean score of courses content and examination problem 2.52 and the overall mean score was 2.52 ± 0.32. The unsatisfying relation with family mean score 3.27 and the overall mean score was 3.27 ± 0.30. The future concerns related chosen field mean score was 2.64 and the overall mean score was 2.64 ± 0.20. Conclusion: Causes of student’s failure are the unsatisfied relation with the family and psychological problems of the students. There was positive correlation between all variables except the unsatisfied relation with family and future related concern to the chosen field of study.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.388

Authors: Zara Shirazi Usha Kumari Fakhar Abbas Keerthana Manjunath Sohail Bangash

We present a rare case of a child with penetrating cardiac injury (PCI) with a knife and its successful repair. A 10-year-old boy was brought to the emergency department with penetrating injury under the nipple on the left side of the chest, with entrance sized 1x0.5 cm, in a hemodynamically unstable condition. Physical examination showed findings suggestive of cardiac tamponade and shock. Focused Assessment with Sonography in Trauma (FAST) and echocardiography visualized pericardial effusion, and chest X-ray showed left pleural effusion. Needle thoracentesis was performed, followed by urgent sternotomy. Right ventricular tear of size 1x1cm visualized and repaired. The left pleura was drained blood up to 800 milliliters. The pericardium was closed with sutures. We then placed retrosternal and pericardial drains and sealed the chest with wire sutures at the sternum. During the induction of anesthesia, the patient underwent cardiac arrest, immediate cardiopulmonary resuscitation revived the patient and surgery was performed. Here, expertise lies in performing the procedure on a pumping heart without cardiac bypass. In addition, the most common cause of PCI is an intentional gunshot injury in adults. In contrast, our case presents the accidental nature of injury in children by knife, which makes this interesting. Therefore, we documented our experience of this rare finding. In addition, we present a literature review about penetrating injury to the heart, focused on the pediatric population and survival, morbidity, and mortality of the condition with and without access to the hospital.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.343

Authors: Syed Zahid Hussain Shah Shoaib Saleem Khan Muhammad Aamir

Background: Abnormal CSF accumulation within ventricles of brain leading to raised intracranial pressure is a potentially life-threatening state that is commonly seen in neurosurgical patients. Aim of this study is to assess the efficacy of endoscopic third ventriculostomy (ETV) in treatment of pediatric hydrocephalus in pediatrics. Materials and Methods: A total of sixty-two patients were included in this prospective study. Patients were generally discharged from the hospital on the 2nd or 3rd postoperative day unless some complication arose. All the information was recorded in a pre-structured proforma, and data were analyzed by SPSS. Statistical significance was defined as p-value less than or equal to 0.05. Results: At follow up, clinical improvement and radiological findings did not necessarily correlate with each other, as ventricular size was reduced in only 42 (67.7%) out of 62 patients. Remaining 20 (32.3%) patients had no change in the size of ventricles. The difference was not statistically significant. However, as observed by cine PC MRI, CSF flow was observed in all the patients. Conclusion: In non-communicating hydrocephalus, ETV is a simple technique and safe and effective treatment if done by an expert surgeon correctly. It is a reasonable alternate of VPS due to its simplicity and effectiveness.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.355

Authors: Uzma Arshad Shehla Qadir Muhammad Kamran Adil Muhammad Ahmad Amjad

Background: This is a report from Multan Medical and Dental College about obesity among lady doctors and factors associated with it. Methodology: A cross sectional descriptive study was carried out in Multan medical & dental college and hospital from 1st January 2020 to 30th March 2020 after taking approval from institutional review board. Closed ended questionnaire was used to collect data from 159 lady doctors of age from 22 to 60 years including both married and unmarried females using simple random sampling technique. Results: Obesity was seen more in married lady doctors i.e. 64 (83.1%) as compared to 13 (16.88%) unmarried lady doctors and highest frequency of obesity was seen in 50 to 60 years age group i.e. 22 (88%) obese as compared to 3 (12%) non obese. The results were statistically significant. P=0.000. Conclusions: There is alarming rate of obesity among married lady doctors and also in upper age group i.e., 50 to 60 years.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.385

Authors: Aamir Javid

Background: Cerebrovascular ischemic cases are 3rd leading cause of fatality and neurologic dysfunction in adults. Atherosclerotic lesions outside the carotid cranial circulation are main cause of cerebral ischemia in almost 10-20 percent cases and carotid endarterectomy (CEA) has been proved beneficial for patients with severe carotid artery stenosis to prevent acute cerebrovascular events. Current study is conducted to assess the short-term outcomes of carotid endarterectomy among patients in terms of morbidities and mortalities at our institution during the study period. Material and Methods: This cross-sectional analytical study was carried out at Combined Military Hospital, Rawalpindi during August 2019 to July 2021 to analyze the short-term outcomes of carotid endarterectomy (CEA) with primary closure. All the patients who underwent carotid endarterectomy (CEA) with primary closure during study duration were included in the study. Patients who received selective shunting if Electro Encephalogram (EEG) changes noted were excluded from study. Data was collected after taking verbal consent by using preformed questionnaire. Frequency of morbidities like bleeding, infection, stroke, transient ischemic attacks (TIA), myocardial infarction, repeat operation and revision with stent were noted within postoperative period of one month. Frequency of mortalities in one-month postoperative period among patients undergoing carotid endarterectomy was also calculated. Data was entered and analyzed by using SPSS version 22. Results: Total 198 patients who underwent carotid endarterectomy with primary closure during study duration were included in the study. Age range of the study participants was between 35 to 80 years. Male patients were 107 (54.04%). The comorbidities evaluated in the study participants showed that 172 (86.87%) patients were hypertensive and 73 (36.87%) has diabetes mellitus. The most frequent postoperative morbidities among patients were bleeding and repeat operation. Conclusion: It is concluded that carotid endarterectomy with primary closure is a safe and effective surgical means of stroke prevention.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.334

Authors: Tahira Gul Lubna Amir Sophia Abbasi Hazrat Bilal Shazia Gul

Background: An Uncontrolled Novel COVID-19 started from Wuhan city of China in Late 2019 and spread worldwide has called for unprecedented measures, to prevent it Pakistan government Imposed lockdown on the entire country. Lockdown has a huge impact and affected on mental health of population. The present study aims to assess the effect of COVID-19 on mental health of population and identify the coping strategies to overcome this mental health issues caused by pandemic. Methods: An online survey was administered from 26 May-14 June 2020 to 398 participants. Post Hoc test was performed to examine the associations between general health questionnaire GHQ-12 and socio-economic variables. Results: Losing jobs due to pandemic and lockdown situation and using negative coping strategies were the factors associated with psychological disorders.This study shows high rates of anxiety and stress in younger population specifically in young women with higher odds of endorsing a worst mental health outcome. Outcomes were associated with a number of COVID-19 related risk factors such as challenging family relations, loss of job, no physical activity, financial burden, experiencing stress full events and suicidal ideation. Conclusion: The present situation requires awareness in public media which could be helpful to deal with this and this present article provides details of COVID-19 pandemic situation on mental health of younger population.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.368

Authors: Hamza Shahzad Hira Jabeen Hafiz Rana Muhammad Arslan Muhammad Hashim Ghouri Subhan Ali Gondal Muhammad Umar Muhammad Arif Saima Bibi

Background: People nowadays have developed a new passion of weightlifting. Weightlifting focuses on vigorous muscle development. But injuries are also common in weightlifting. This study aims to compare the injury rates among supervised and non-supervised weightlifters. Methods: A group of 138 weight lifters was divided into two groups i.e. who did training under supervision and the other who did training without any supervision. Injuries related to musculoskeletal system were identified using Nordic musculoskeletal questionnaire. Data was analyzed using SPSS. Chi square test was used to see the association of musculoskeletal pain among weightlifters with or without supervision. Results: Significant association found between musculoskeletal injuries and supervision. Injuries lesser in number among supervised weightlifters as compared to unsupervised weightlifters. Mean age of weight lifters under supervision and without supervision was 21.99 (SD 3.81) and 24.64 (SD 5.01) respectively. Mean workout days /week among weight lifters under supervision was almost same i.e. 5.67 (SD .63) and was 5.62 (SD .81). Out of 51 participants who work-out for 46-60 min, 30 were not under supervision while 31 weightlifters who work-out for 61-90 min were working out under supervision. Injury rate was more in the region of shoulder in both groups supervised and unsupervised groups while hip/thigh region was less involved in both supervised and unsupervised groups. Conclusion: Overall results showed significant association between musculoskeletal injuries and supervision. Injury rate was more among weightlifters who work without supervision as compared to those who work under supervision. Care should be taken and weight lifting and exercises must be performed under expert’s supervision.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.317

Authors: Muhammad Shoaib Mirza Muhammad Abdullah Kanwal Sharif

Background: Childhood Recurrent Abdominal Pain results in the one of the adulthood complications i.e., irritable bowel syndrome, which is a gastro-intestinal disease. The stomach’s acidic environment is the growth site for Helicobacter Pylori, a pathogenic Gram-negative bacterium with rod shape. It is the main reason for chronic gastritis, gastric adenocarcinoma, peptic ulcers, non-ulcer dyspepsia and mucosa-associated lymphoid tissue (MALT) lymphoma. According to one estimate, 50% of people in world are infected with Helicobacter Pylori. Currently the developing countries are on the hit list of Helicobacter Pylori. The objective of this study was to determine the frequency of Helicobacter pylori infection in the children having recurrent abdominal pain. Materials and Methods: It was a cross-sectional study. This research was carried out during 1.1.2018 to 1.6.2018 in the D.H.Q hospital Mirpur AJK. The sample was consisted of 200 participants among them the proportion of Helicobacter was 8% in patients with Recurrent Abdominal Pain. Results: The mean age of the patients was 12.43 ± 1.23 years. Mostly the age of the sample group was between 8 to16 years. The 4.23 ± 0.47 months was the mean time period of abdominal pain. Helicobacter pylori was found in 47% of patients. Conclusion: In paediatric population, Helicobacter pylori is very common with Recurrent Abdominal Pain. It is a severe problem in children and further study is recommended to explore the risk element associated with this increase trouble of Helicobacter Pylori.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.370

Authors: Ayesha Noreen Muhammad Aslam Javed Sadaf Amin Zouina Sarfraz Vishal farid Raza Tariq Rashid

This study aimed to assess the cosmetic outcomes of shave excision for the treatment of acquired melanocytic nevi in a Pakistani tertiary care setting. In total, 120 patients were enrolled in this study. All patients underwent shave excision upon being administered with intra-lesional local anesthesia (2% lignocaine with adrenaline). The lesion was shaved with a 15 number Bald Parker blade. Hemostasis was secured by pressure and 20% aluminum chloride solution. The final cosmetic outcomes (excellent, acceptable, or poor) were assessed three months post-shave excision. Statistical analysis was performed using SPSS, v22. Data were evaluated using chi-square tests, and the phi coefficient. A P value of less than 0.05 was considered statistically significant to determine associations of age and gender to cosmetic outcomes. The mean age of included patients was 29.7±7.4 years. There were 30 (25%) male and 90 (75%) female patients. Out of these, 35 (29.2%) patients had excellent outcomes, 75 (62.5%) patients had acceptable and 10 (8.3%) patients had a poor outcome. The associations of gender and age to dermatological outcomes post-excision were significant (P<0.001). Sufficient evidence was collated to determine a relationship between age (Pearson Chi-Square = 113.94) and gender (Pearson Chi-Square = 97.143) to cosmetic outcomes (P<0.001). The phi (?) coefficient also confirmed the significance of positive associations between the cosmetic outcomes to gender and age (?= 0.974). Shave excision presents as an exceedingly useful and inexpensive method for the removal of acquired melanocytic nevi especially in a low and middle-income country like Pakistan.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.341

Authors: Muhammad Azeem Gulzar Muhammad Raza Salma Parveen Anum Shahid Sana Naseem

Background: This study was conducted to evaluate the feasibility of local anesthesia (LA) instead of general anesthesia (GA) in upper gastrointestinal abdominal procedures including open gastrostomy, gastrojejunostomy, gastroduodenal disjunction, jejunostomy and traction esophageal stenting. Materials and Methods: This study was conducted at Thoracic surgery department, Nishtar Hospital Multan, Pakistan from September,1st-December,31st,2020. Out of 147 patients 80 and 67 patients were operated under LA and GA respectively. Age, BMI, gender, procedure performed, etiology, mean time, stay in recovery, PONV, postoperative pain at 4, 8, 12 hours, postoperative sedation and discomfort, within 3-and 7-days postoperative mortality were documented and compared between the two groups. Results: Mean age of the patients in group LA was significantly higher as compared to group GA(p<0.001). Procedure time was 30.06±12.01minutes and 34.42±11.76minutes (p=0.029), mean duration of stay in recovery was 2.31±5.68minutes and 18.80±6.40minutes(p<0.001) in group LA and GA, respectively(p=0.029). Postoperative discomfort was also higher in group GA as compared to group LA(p=0.001). The incidence of PONV was 12.5% and 35.8% in group LA and GA, respectively(p=0.001). Complaint of postoperative pain was 16.2% and 37.3% at 4 hours(p=0.004); 18.8% and 35.8% at 8 hours(p=0.020); and 21.2% and 26.9% at 12 hours(p=0.426) in group LA and GA, respectively. Conclusion: For performing various upper abdominal procedures, LA is safe for the patients who are medically unfit for GA. Moreover, LA is associated with lesser adverse effects as compared to GA. Patient is more comfortable and there is better pain relief in early postoperative period.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.344

Authors: Khalid I. Alqumaizi Manal Aledaili Khalid M. Aladaili Ibrahim Z. Bin-Hussain Sami A. Alshammari Shahad A. Alqahtani

Integrated health care has the ability to provide adequate care system in different modalities of medical care. Saudi Arabia is going through major transformation in its health care services in order to provide sufficient resources. A 12-dimension SCIROCCO online self-assessment tool, was extracted from the B3-MM, was used for the scaling up of health intervention and for assessing the maturity level of integrated care within different regions. SCIROCCO tool assess a step wise scaling up technique to evaluate how to scale up integrated care during heath transformation. By having knowledge of the factors which make this strategy difficult to implement this study evaluates to what extent SCIROCCO technique was applied. The SCIROCCO tool was used to assess the maturity of systems of Jazan, Saudi Arabia for integrated care system and for the evaluation of factors affecting scaling up. Data was collected from Stakeholders from multiple disciplines including decision-maker, healthcare professional, IT specialist by self-assessment method. The outcomes of the self-assessment process were visually captured in the form of spider diagrams. All three fundamental steps of the scaling up procedure were executed with satisfactory devotion. Integrated heath transformation in Jazan yielded 18 points out of 60 on spider diagram according to SCIROCCO tool. Majority of the dimensions have no more than 3 score. Digital Health care transformation in Jazan needs to be improved in most of the aspects. This study assesses maturity level of integrated care in Jazan and concludes that An ICT infrastructure to support integrated care has been agreed together with a recommended set of technical standards but there are Still local variations or some systems in place are not yet standardized. Learning about integrated care and change management was in place but not widely implemented.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.392

Authors: Zair Hassan Abdul Moiz Sahito Usha Kumari

Dear Editor, Temporary cardiac pacing is an artificial method of electrical cardiac stimulation to treat a bradyarrhythmia (BA) or tachyarrhythmia until resolution or initiation of long-term treatment. The goal of this temporary stimulation is to restore circulation and normal hemodynamics that has been significantly compromised by abnormal heart rate (1). Temporary artificial pacing is recommended in a variety of circumstances, most notably in individuals with severe BA such as second- or third-degree atrioventricular block (AVB), or severe symptomatic bradycardia irrespective of the cause. Furthermore, temporary pacing can be used as an overpass while awaiting placement of permanent pacemaker (PPM) in patients (2). Temporary pacemakers (TPM) are used to treat emergencies in individuals with severe symptomatic BA and for elderly patients who are hemodynamically unstable and refractory to medical treatment. TPM is a critical emergency tool for saving lives in such situations, which is why it is highly concerning that the people of Khyber Pakhtunkhwa (KPK) can avail this vital therapy only at the province's four tertiary care hospitals (TCH). For people residing in peripheral areas, it takes more than 4-5 hours on average to reach TCH, which is dreadful in face of an emergency. This discrepancy in availability of TPM often causes thromboembolism, stroke and in many cases culminating in the patient's death before reaching the hospital. According to the American Heart Association (AHA), if left untreated, severe or prolonged bradycardia can lead to a variety of problems, including heart failure, hypotension, and hypertension. For certain situations, bradycardia can be followed by a rapid heartbeat, known as tachycardia. When these two conditions occur simultaneously, they are referred to as Bradycardia-Tachycardia or Tachy-Brady syndrome. This is a form of sick sinus syndrome that can be linked with the heart rhythm disease atrial fibrillation, increasing the risk of consequences such as stroke and sudden death, or cardiac arrest (3). As of 2019, almost 15 million Pakistanis were over the age of 60 years, accounting for 7% of the country's total population (4). This is concerning since research shows that conduction abnormalities increased with age. According to a study done in Pakistan, the incidence of conduction defects rose with age, with the highest frequency (28%) seen between the ages of 61 to 70. Third-degree heart block was common (75%) among conduction abnormalities in the investigated group. It was also determined that the rate of pacemaker placement increased with age (5). Therefore, the need for an unprecedented demand for TPM is crucial. It is high time to take steps towards widespread availability of TPM all over KPK at the District Head Quarters (DHQs) level. It is also critical to appoint appropriate allied health professionals for TPM placement, who could deal with the situation without immediate supervision by the cardiologist. With this letter, we call for action to the concerned health care sector authorities in KPK and in Pakistan to supply the requisite quantity of TPM in all KPK health care institutions including smaller set-ups such as DHQs. This would safeguard the preservation of valuable lives while also help reduce mortality and morbidity owing to the scarcity of TPM. To conclude, there is an urgent need for TPM to be made available in all the province's hospitals to prevent the vulnerable population from the life-threatening consequences of BA.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.389

Authors: Usha Kumari Keerthana Manjunath Zair Hassan Fakhar Abbas

Since the outbreak of coronavirus (COVID-19) in December 2019, understanding regarding coronavirus symptoms has been evolving. Medical issues in pregnancy usually resolve after delivery. Similarly, pregnant ladies with COVID-19 pneumonia had improvement in their condition after giving birth. However, in this case, the patient tested positive for "SARS-Cov-19 antigen PCR" and intended for vaginal birth, which was unsuccessful and resulted in a caesarean surgery. After the healthy baby was delivered, she experienced a life-threatening cytokine storm that necessitated elective intubation and mechanical breathing, as well as anti-viral medication. She was extubated after two weeks and then discharged on recovery. Previously, the Middle Eastern Respiratory Syndrome Coronavirus (MERS-SARS) and the Influenza virus (H1N1) were the most well-known viruses for generating potentially fatal results in pregnancy. This is first reported instance in Pakistan of a pregnant lady developing severe COVID-19 pneumonia. This research fills a vacuum in the medical literature and alerts obstetricians and clinicians to the likelihood of life-threatening postpartum, COVID-19 pneumonia complications.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.407

Authors: Iqra Tabassum Sidrah Saleem Irfan Ahmad Usman Arshad

Background: Microorganisms are turning out to be greatly resistant to existing antibiotics, specifically gram-negative rods which shows resistance to currently accessible antibiotics. Beta-lactam antibiotics are the main therapeutic option to treat infections of gram-negative microorganisms i.e., ESBL and Carbapenemase producers. Saussurea lappa herb is a medicinal herb use since many times. Basically, the roots of S. lappa herb were used as medicines. Current study was conducted to find out activity of various fractions of S. lappa herb against multidrug resistant gram-negative rods. Methods: Crude extracts of ethanol, methanol and water and fractions of n-hexane, chloroform, and methanol from S. lappa herb were used. Total of sixty multidrug resistant organisms were included in which thirty were ESBL and thirty were carbapenemase producing organisms. Mean MIC and comparative analysis of various extracts and fractions have been evaluated. Results: The mean MIC value of crude extracts of ethanol, methanol, n-hexane, chloroform and methanol fractions and water extract from S. lappa against ESBL producing organisms were 109.33± 6.915 mg/ml, 154.67± 5.164 mg/ml, 150.00± 5.345 mg/ml, 55.33±5.164 mg/ml, 178.00±6.103 mg/ml, 64.00± 7.701 mg/ml respectively. Similarly, the mean MIC value against carbapenemase producing organisms were 100.67± 8.683 mg/ml, 158.67± 3.519 mg/ml, 150.67± 5.936 mg/ml, 54.67±5.164 mg/ml, 176.67±14.223 mg/ml, 64.33± 9.353 mg/ml respectively. Conclusion: This study suggests that extracts and fractions of S. lappa herb can form the basis to develop novel broad-spectrum formulation for antimicrobial drugs as it contains compounds that has novelty to perform its action against multi-resistant mechanisms.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.391

Authors: Sana Awan Mustafa Bin Ali Zubairi Anfal Atif Safia Awan Zouina Sarfraz Omar Irfan Ali Bin Sarwar Zubairi

Background: In light of the COVID-19 pandemic, the Government of Pakistan issued safety measures in an effort to mitigate the rising number of cases, the effectiveness of which depends on people’s response and behavior. This study investigates the knowledge, attitude and practices towards COVID-19 pandemic among residents of Karachi, Pakistan. Methods: An online survey of 764 residents of Karachi was conducted between 15 September and 20 November 2020. Popular social media and authors’ networks with the residents were utilized for the successful recruitment of these responses. A self-developed online KAP questionnaire was developed with 9 questions on knowledge, 7 on attitude, and 5 on practices. Results: Out of 764 participants, 60.6% were female, 37.2% had university degrees and 20.8% were white collar workers. Social media was the most popular information source (52.9%) and a trend to update daily on the news was observed (69.6%). Preventative measures were well known; washing hands with soap and water (97.4%), wearing facemasks (91.5%) and using hand sanitizer (89.4%). Majority (86.7%) were aware of social distancing. Favorable practices were observed; with 83% using masks, 71.6% limiting social interaction, 74% staying at home, 95% ensuring extra hygiene and 73% authenticating information from trusted sources. Conclusion: Most residents of Karachi were knowledgeable regarding mitigation measures and had optimistic attitude and appropriate practices during the initial period of the COVID-19 outbreak. Future interventions in low and middle-income countries ought to prioritize interventions to develop a community-centered approach, targeting vulnerable subgroups in rural areas.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.420

Authors: Muhammad Shoaib Akhtar

Prof. Dr. Muhammad Aslamkhan died peacefully on February 20, 2023, in Lahore, Pakistan. Prof. Aslamkhan was the founding head of the Human Genetics and Molecular Biology Department of the University of Health Sciences Lahore (UHS). He was also a Director of Sports and cocurricular activities at the UHS. His services to UHS were brought by the Higher Education Commission’s project entitled “strengthening of basic medical sciences at UHS, ” commonly known as SBMS as a project director. This project not only brought a lot of funding for the establishment of research facilities at the UHS but also employment opportunities for young people. Prof. Aslamkhan received his Doctorate of Science (D.Sc.) in Genetics and Anthropology from Johannes Gutenberg University in Mainz, Germany, in 1963, after his master's degree from Punjab University (1953). He was among the founding fellows of the Biological Society of Pakistan (1956) and the Zoological Society of Pakistan (1968). In 1968, he was awarded the Fellowship of the Royal Society of Tropical Medicine and Hygiene, London. Later, the Pakistan Academy of Medical Sciences awarded him a fellowship in 1985. His professional services include academic and research affiliations with the provincial bodies of Punjab, Khyber Pakhtunkhwa, and East Pakistan (now Bangladesh). He served as Deputy Chief for the Division of Medical Entomology of the International Center for Medical Research and Training (ICMRT) at the Pakistan Medical Research Center, Lahore. Later, he became the Chief of Malaria Vector Research at ICMRT. This was the time when he studied the bionomics of mosquito species in Pakistan, which serves as a reference (1). While affiliated with the University of Maryland School of Medicine, he extended his research towards vector-borne diseases of public health importance (2-10). After retirement from the University of Maryland, he worked as an independent consultant for several national and international bodies. Later, he joined the Higher Education Commission’s project SBMS as Project Director. During this affiliation, he also launched the first department of Human Genetics in the country at UHS Lahore. This department is still operational and produces many PhDs in human genetics, working at various reputable organizations in and outside the country. The department’s objective was to study the basics of genetic diseases in the country, and it has been doing very well until today. Prof. Aslamkhan’s research on genetic diseases has mainly focused on the role of consanguinity in gene pooling in the Pakistani population (11-13). Over the past several years, he has also voluntarily offered genetic counselling to patients with hemoglobinopathies at Sundas Foundation Lahore. He also studied the public health dynamics of blood donors at the Sundas Foundation in addition to genetic counselling (14, 15). He was also recognized as an Eminent Professor of Genetics by Higher Education Commission. In 2017, he founded The International Journal of Frontier Sciences and became its first editor-in-chief until he died last year. I am publishing this obituary at his first death anniversary on February 20, 2024, praying for his eternal peace. I wish him to rest in peace in his life in hereafter. Ameen!

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.397

Authors: Saleh Khurshied Nawal Khurshid Madiha Khurshid Muhammad Azeem Khizer Hammad Ahmed Arshad Khushdil

Wolcott-Rallison syndrome (WRS) is a rare autosomal recessive, neonatal or infancy onset disease that is non-autoimmune insulin-dependent diabetes and is associated with skeletal dysplasia and liver failure. It results in the death of the patient, mainly due to multi-organ failure. Less than 60 cases have been described in the literature so far. Here, we present a very rare case of WRS, which was diagnosed by genetic testing for EIF2AK3 mutations with typical findings of the disease, except skeletal dysplasia, which eventually died due to multi-organ failure. To the best of our knowledge, this is the first case report of WRS in Pakistan.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.411

Authors: Wajahat Hussain Roomana Anwar Muhammad Tariq Choudhry Muhammad Arif Khan

Background: To make basic sciences easy and accessible to enhance their clinical importance. Objective: basic sciences in medical education have a pivotal role in forming foundation of a medical students. However, students have become disinterested because of the inaccessibility of the study system and methods. Through this study, an attempt was made to highlight this problem and find a suitable solution. Material and Methods: Data were collected from 265 students. Data were collected using a questionnaire that was analyzed using SPSS version 20 (IBM, Chicago, IL, USA). Descriptive statistics were used for categorical and quantitative variables. The total scores on each subscale pertaining to basic science subjects, anatomy, physiology, and biochemistry were calculated. Results: Medical students reported mixed responses on the clinical significance of anatomy (moderate) and physiology (low to moderate), while biochemistry was reported to be the most clinically useful. More than 50% of the respondents considered the syllabus of the basic medical sciences to be vast, in contrast to their limited clinical usefulness. Traditional teaching of basic medical sciences as individual disciplines, unrelated to each other and other clinical subjects (7), made them very difficult to recall and applicable in clinical years of the students, included in our survey Conclusion: The majority of the respondents in our study were of the view that the knowledge of basic medical sciences is very important in order to become a good clinician, but the majority also thought that only working knowledge of these subjects is required in clinical years. Therefore, there is no need for deeper understanding of structures and functions.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.418

Authors: Sara Khan Sibgha Bashir Ayesha Siddiqa Rizwan Hafeez Anum Iftikhar Urwah Ehsan

Objectives: The current study is conducted to compare serum 25-hydroxyvitamin D concentrations and total testosterone in young, physically fit adult males. Study Design: the study was based on cross sectional design. Study Settings: The research was conducted in Department of Pathology, Shahida Islam Medical and Dental College situated in District Lodhran between 1st July, 2023 and December, 2023. Methods: This cross-sectional research, which took place at the Department of Pathology at Shahida Islam Medical and Dental College in Lodhran from July 1, 2023, to December 31, 2023, had 176 young male volunteers, all between the ages of 18 and 35. Each participant was given questionnaires to fill out on their prior medical history, food habits, and rigorous exercise levels. Every participant had their blood drawn following a 12-hour fast and a 24-hour period without physical exercise. Separating serum was done with a centrifuge. The blood concentration of LH, FSH, total testosterone, and 25-hydroxyvitamin D were measured by electrochemiluminescence (ECLIA). Results: A total of 176 individuals in good health were registered, with a mean age of 26.62±5.20 years. The presence of vitamin D of less than 10 ng/ml, between 10–20 ng/ml, and greater than 20 ng/ml were reported in 70 (39.8%), 76 (43.2%), and 30 (17.0%) individuals, accordingly. The mean hormone levels (TT, FSH, and LH) in the three 25(OH)D groups did not vary statistically. Our findings showed that there existed no statistically substantial relationship in the categories under study between 25(OH)D and LH, FSH, and TT. Conclusion: We found little variation in the condition of the 25(OH)D concentration and the average hormonal measurements (LH, FSH, and TT). Based on these data, we concluded that in young, healthy guys, there is no relationship between testosterone concentrations and deficient or inadequate 25(OH)D level.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.413

Authors: Maryam Zafar Aiman Shaikh Maliha Mohsin

Background: Pediatric dental anomalies refer to irregularities or abnormalities in the development, structure, or positioning of the teeth in the oral cavity of children. These anomalies can encompass a wide range of conditions that affect the number, size, shape, and structure of teeth. In Karachi, there is limited evidence regarding the prevalence of dental anomalies in children. Objective: This study investigated the prevalence of dental anomalies in the pediatric population of the Abbasi Shaheed Hospital, Karachi, Pakistan. Material and Methods: A cross-sectional study was conducted among 278 children aged between 3 and 12 years. The socio-demographic and thorough medical history were recorded on a predesigned performa. The diagnosis of all dental anomalies was based on clinical interpretation using sterilized mouth mirrors, probes, or tongue depressors. Difficult cases were addressed by senior faculty members. Data analysis was conducted using SPSS version 19. Descriptive statistics were used to present the frequency and Mean ± SD. Result: The prevalence of dental anomalies was 7.4%. in the study area. Male-to-female ratio was 2.2:1. Boys exhibited a higher prevalence of 10.05% compared to girls (4.3%). Peg Lateral Incisors and Fusion/Gemination were the most common anomalies among both genders. Dilaceration, Dentinogenesis Imperfecta, Amelogenesis Imperfecta, Talon Cusp, Anodontia, and supernumerary Tooth (disto-molar) were not identified in either boys or girls. The highest number of dental anomalies was recorded at ages 11 and 12 years. Conclusion: The prevalence of dental anomalies was high in the study area, underscoring the significance of early diagnosis and careful management to prevent complications.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.416

Authors: Atta ur Rehman Khan Sarwat Rasheed Malik Fahad

Introduction: Children with posterior fossa tumors (PFT) often have hydrocephalus, which can be treated via endoscopic third ventriculostomy (ETV) before the tumor is removed, thereby improving surgical outcomes. Additionally, a scoring system that forecasts ETV success can help with this procedure's decision-making. The purpose of the research is to assess the effectiveness of electrotherapy (ETV) in treating PFT-related hydrocephalus and the predictive validity of the ETV effectiveness score. Materials and Methods: A retrospective analysis was conducted on patients aged < 18 years who received ETV prior to PFT resection between 2022 and 2023. For every patient, the ETV success score was acquired retroactively, and its ability to forecast success contrasted with the actual success was noted. Results: In the first six months after ETV, a worldwide success rate of 61.7% was observed in 40 surgical patients. For patients who were reviewed a year after surgery, this percentage decreased to 52.8%. The histological level of the tumor and the age of the victim did not correlate with the recovery rate. At both time periods, the ETV effectiveness score showed adequate accuracy (AUC = 0.671 at six months, AUC = 0.649 at one year). Conclusion: In summary, ETV has been shown to be a safe treatment that may effectively cure hydrocephalus in individuals with PFT. In addition, the ETV efficacy score can be a valuable tool for predicting the likelihood of successful endoscopic surgery.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.417

Authors: Atta ur Rehman Khan Sarwat Rasheed Malik Fahad

Introduction: Malformation of the central nervous system (CNS) typically leaves the family in chaos and medical team helpless. The strict use of preventative measures has significantly decreased the frequency of congenital abnormalities in industrialized nations. Materials & Methods: At Dera Ghazi Khan Medical College conducted this Cross-sectional analytical study was conducted from January 2023 to December 2023 to evaluate the epidemiological profile and management CNS malformations. All cases of CNS malformations treated in the neurosurgery department were included in the study. The data were analyzed using SPSS version 25.0. Results: Total 61 cases were included in the study. The patient’s age ranged from 1 d to 70 years old. Six (9.8%) patients with CNS abnormalities had prenatal diagnoses. There were 34.8% CT scans, 1.7% MRIs (7 after CT), and 23.7% ultrasound scans, among other tests. In 49 instances (80.32%), there was a surgical rationale: 20 cases (40.81%) could be treated, whereas 29 cases (59.18%) did not. In 11 cases (18%), the surgical rationale was not maintained. Conclusion: CNS abnormalities were frequent in our study. They cause numerous neurological aftereffects and permanent impairments, and are not usually amenable to surgical treatment. Therefore, it is imperative that the DG Khan region concentrates on enhancing preventative measures.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v7i1.410

Authors: Maryam Zafar Aiman Sheikh Sufyan Ahmad

In this case report, we present a case of non-ossifying fibroma in the mandible of an eleven-year-old girl who reported to the Oral and Maxillo-Facial Surgery Department with facial asymmetry and painless swelling on palpation over the lower right mandibular region. In this paper, we review the radiographic features, clinical presentation, and histopathological features of non-ossifying fibromas. Non-ossifying fibromas present with a unique extra-gnathic appearance in the skull. It is usually asymptomatic and has diverse histological features. Co-related histological, radiological, and clinical features differentiate it from other odontogenic and non-odontogenic tumors and cysts of the oral cavity. Ortho-pantogram revealed a well-demarcated, expansile radiolucency with pronounced sclerotic borders with striations reaching the anterior and superior regions and thus slowly approaching a multilocular stage. The treatment plan comprised of excisional resection with curettage under general anesthesia. After excisional biopsy of the lesion, the specimen was sent for histopathological evaluation in neutrally buffered 10 % formalin solution, which confirmed it to be a Non-Ossifying Fibroma. Prior to surgery, informed consent and written permission to collaborate with a case report encompassing her findings were obtained from the patients’ guardians. Confidentiality of patient has been taken care of before documenting the report. A meticulous literature review of previous case reports on non-ossifying fibromas revealed typical behaviors and characteristics of this lesion.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.71

Authors: Malik Liaqat Ali Jalal Muhammad Shaukat Farooq Atta-ur-Rehman Khan Muhammad Yousaf Muhammad Rizwan Saima Faiz

Objective: to investigate the role of CT and MRI in diagnosis of Arnold chiari malformation of hydrocephalus and its treatment with VP shunt along with complications. Study Design: Prospective study Place and duration: Department of Neurosurgery, DG Khan Medical College from May 4, 2018 to May 4, 2019. Methodology: Fifty patients of congenital hydrocephalus who were not treated previously were selected. Detailed history about disease and clinical examination of patients was performed. Follow ups were done at neurosurgery OPD. SPSS software for data analysis was used and mean ± SD, frequency and percentages were calculated for variables. P value ?0.05 was considered as significant. Results: Treatment in case of congenital hydrocephalus as VP shunt, intra-aneurysmal coiling, excision of meningomyelocele with VP shunt and suboccipital craniectomy + upper cervical laminectomy (scucl) were observed as 10%, 6%, 8% and 8% respectively. Twelve percent of patients were not treated. Conclusion: CT and MRI are the main diagnostic tools for diagnosis of Arnold chiari malformation and VP shunt is the treatment of choice. Among complications of VP shunt infection of shunt and shunt block are the main complications.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.60

Authors: Areeba Iftikhar Muhammad Arif Asif Hanif

Background: The etiology of sleep disruption in intensive care unit is poorly known and often ignored complication. It is caused by the environmental factors especially pain, noise, diagnostic testing and human interventions that cause sleep disruption. Light, medications and activities related to patient care interfere with patient’s ability to have good sleep. There are multi-factorial environmental etiologies for disruption of sleep in ICU. Objective: The objective of this study was to evaluate the factors disturbing the sleep quality in intensive care unit (ICU) admitted patients. Methodology: A cross sectional study was designed involving 150 patients admitted in intensive care unit and high dependency unit of Gulab Devi Chest Hospital. The duration of study was from September 2015 to March 2016. The questionnaire was made and filled with the help of patients. The data was analyzed using SPSS version 16.00. Results: Mean age of patients was 50.46+10.96 with maximum age of 65 and minimum age of 30 years. There was 53.33% male patients and 46.67% females participating in this study. The sleep quality was significantly poor in ICU than at home. After analysis, 54.67% patients were with poor quality of sleep due to pain and 48.67% were due to noise of environmental stimuli. The other factors were alarms, light and loud talking. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable. Conclusion: Current study shows that reduced sleep quality is a common problem in ICU with multi-factorial etiologies. Patient reported the poor sleep quality in ICU due to environmental issues that are potentially modifiable.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.74

Authors: Sana Iqbal Sufyan Ahmed Zahid Ali Mehwash Kashif Ayesha Aslam

Background: Oral and Maxillofacial Surgery department is a diverse field in dentistry. Record maintenance has been established as one of the key factors in the success and integrity of health care institutes.Objective: The objective of the study was to evaluate the records of oral and maxillofacial surgery cases reported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD of Karachi Medical and Dental College.Methods: Cross sectional study was conducted in at ASH and KMDC from July 2019 to September 2019. The data from January 2017 to July 2019 was retrospectively noted through electronic surgical record of ASH and records of the Oral Surgery OPD of KMDC. Inclusion criteria was patients records of both genders of 5–70 years age, having complaint of any oral or dental pathology or pathologies, trauma and impactions. Data was calculated manually by calculating frequencies and percentages for the trauma, impaction and pathology cases of patients.Results: In 2017, 239 cases were treated under general anesthesia from which trauma 11. 45% (n=11), followed by 48. 11% (n=115) cases of oral pathologies, total 11.7% (n=28) cases of complicated exodontias. In 2018, among 211, 51.1% (n=108) cases were trauma followed by 39.3% (n=83) cases of oral pathologies, whereas, total 9.4% (n=20) complicated exodontias cases were observed. During 2019 (January to July), 168 cases 36.2% (n=62) cases were diagnosed as trauma, in oral pathology, overall 36.2% (n=62) cases were surgically excised. Total 23.2% (n=39) complicated exodontias. In 2017, 25122 cases were reported in Surgery OPD of Karachi Medical and Dental College. Total 36.2% (n=9097) teeth were extracted from which 1.93% (n=486) cases were surgical impaction. On the other hand, 1.65% (n=416) patients were treated through minor oral surgeries. In 2018, 29008 cases were reported in Surgery OPD. Total 42.7% (n=12377) teeth were extracted from which 0.92% (n=268) cases were surgical impaction. On the other hand, 0.71% (n=208) patients were treated through minor surgeries. In 2019, January till July 13028 cases were reported in Surgery OPD. Total 42.6% (n=5559) teeth were extracted from which 0.66% (n=87) cases were surgical impaction. On the other hand, 0.68% (n=89) patients were treated through minor surgeries.Conclusion: It has been concluded that evaluation of the records of oral and maxillofacial surgery cases reported to oral and maxillofacial surgery department, Abbasi Shaheed Hospital and oral surgery OPD of Karachi Medical and Dental College were high and appropriate measures should be taken in order to manage these problems timely and effectively.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.69

Authors: Salahuddin Bari Ehsan Qadir Muhammad Adeel Saad Bahussein

Background: Malnutrition is a health problem affecting growth and development of young children. Children under 15 years of age are the main victims of malnutrition. Malnutrition is attributed to a series of diverse etiological factors. Objective: To determine the nutritional status of the children of various age groups of school going children of Army Public School and to find out the association of socio-demographic variables and dietary habits with nutritional status. Methodology: It was a descriptive cross-sectional study conducted at Army Public School, Okara. Sample was selected through non-probability consecutive sampling. Duration of study was 6 months (Dec 2017 to May 2018). The study was conducted after getting formal approval from Institutional Ethical Review Board AFPGMI. The children were randomly selected for study from the enrollment register available in the principal’s office. Participation in the study was voluntary with guaranteed confidentiality. The participants were given full right to quit study without mentioning reason at any time during data collection. After ruling out the exclusion criteria, 500 children fulfilling inclusion criteria were selected for study. An informed written consent was obtained from all selected children and their parents to take part in the study. Data for the assessment of nutritional status was obtained using anthropometry, biochemical laboratory test and eating habits / food preferences of the children. Results: In our study, mean age of children included in the study was 9.58±1.72 years. Out of 500 children, 252 (50.2%) were male while 248 (49.8%) female. The mean height of children was 134.88±11.69 cm. The mean weight of children was 30.25±8.47 kg. The mean OFC of children was 51.43±1.75 cm. Out of total 500 children, 85 (17%) were having BMI less than 18.5, 338 (67.6%) were having BMI within 18.5–24.9 while 77 (15.4%) children having BMI within 25-29.9. None of child was observed with BMI of ?30. Among 85 children with below normal BMI, 63 had mild malnutrition (BMI between 17-18.4), 19 had moderate malnutrition (BMI 16-16.9) while 3 had severe malnutrition (BMI < 16) Conclusion: Malnutrition is a significant public health problem among preschool and school going children. And improving socio-economic condition along with literacy of mothers and preventing infections through personal hygiene might help in improving the nutritional status of children.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.63

Authors: Huda Abbas Samina Badar Zunera Javed Mohammad Ahmed Abdelmoneam Ramdan

Objective: The objective of study was to find out serum uric acid level in normal andpreeclamptic pregnant women of third trimester visiting outpatient department of obstetrics and gynecology of Bahawal Victoria Hospital, Bahawalpur. Methodology: It was a cross sectional descriptive study conducted form July 2018 to June 2019. All primigravida women of age 18-35 years in third trimester of singleton pregnancy attending in Obstetrics and Gynecology Outpatient Department of Bahawal Victoria Hospital in study duration were included in the study. Statistical analysis was performed by using SPSS version 14. Chi-square test was performed to find the statistical difference regarding uric acid distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Out of total 1212 women 84.6% were normal and 15.4% had preeclampsia. In our study out of 187 preeclamptic women, 63.6% had raised serum uric acid level and out of 268 normal pregnant women uric acid level was raised in only 39.5%. Results were found statistically significant. Conclusion: Results of our study suggest that serum uric acid level in pregnant women can be used as a useful and inexpensive marker in prediction of preeclampsia and preventive measures can be taken accordingly.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.72

Authors: Ghayas Ud Din Dar Muhammad Imran Qadeer Shafique Ahmed Chudhary Dania Aijaz Shahid Imtiaz Tahir Naveed

Background: The impact of dialysis modality on the rates and types of infectious complications has not been well studied. The aim of the present investigation was to evaluate the rates of hepatitis C virus and hepatitis B virus infections in hemodialysis patients in three general hospitals of Azad Kashmir. In dialysis patient, if left unaddressed these may lead to very fatal consequences at the individual and national level. Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections represent significant public health issues globally. These infections are important causes of morbidity and mortality in hemodialysis patients. Patients with HBV/HCV co-infection have a higher risk of progression to cirrhosis and decompensated liver disease and have an increased risk of hepatocellular cancer (HCC). Because the two hepatotropic viruses share same modes of transmission, co-infection with the two viruses is not uncommon, especially in areas with a high prevalence of HCV infection and among people at high-risk for parenteral infection. Objective: The present work was aimed to determine the frequency of hepatitis B and C among dialysis patients in Azad Kashmir dialysis centers. Design: Cross-sectional descriptive study. Settings: Pathology laboratory of Abbas Institute of Medical Sciences, Muzaffarabad, Azad Jammu & Kashmir. Participants: A representative sample of 110 patients of dialysis from all Azad Kashmir dialysis centers including both males and females was studied between August and December 2016. BMI was calculated after measuring weight and height followed by measurement of hepatitis B and C in dialysis patients. Results: In this study, out of 110 patients: 52.72% dialysis patients were hepatitis C positive and 13.63% dialysis patients were hepatitis B positive. Conclusion: Our findings revealed ongoing HCV incidence and high HCV/HBV prevalence among HD patients in Azad Kashmir. But incidence and prevalence appear to be declining year by year. About one-fifth of HD patients are chronic carriers of HCV infection, in need of HCV treatment, and potentially can transmit the infection to other HD patients. In context of rapidly growing HD patient population, these findings highlight the need to improve standards of infection control during dialysis in Azad Kashmir.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.57

Authors: Muhammad Shoaib Akhtar Muhammad Aslamkhan

The International Journal of Frontier Sciences just completed its three years of publication. Start of a journal is always challenging for editors especially if journal is not an official publication of some institute or professional society. However, completing three years also has been a very learning experience for editorial team. From the start, TIJFS team is focused to catch indexation in EMBASE, MEDLINE, PubMed, Scopus and Web of Science. However, starting years of the journal are always challenging. Journal editors are continuously improving practices to achieve these milestones at earliest. In scope, journal is transdisciplinary mainly covering life and environmental sciences. Starting from Pakistan, it was very difficult to run an internationally covered journal, however, our international editorial team putting its continuous efforts to do this. In last year, journal started its indexing process and just became a part of WHO’s Index Medicus. Also, editors started to generate digital object identifiers (DOIs) of all manuscripts published. Currently, journal is in process of indexation in prestigious international bodies including Web of Science etc. Journal editors hope to be a part of many international indices during the current volume year. Also, its worth to mention that journal is following ethical guidelines by Consolidated Standards of Reporting Trials, Committee of Publication Ethics, International Committee of Medical Journal Editors and World Association of Medical Editors. Current volume contains original articles, clinical audit and a report covering broad spectrum domains of life sciences especially medical science including topics of clinical chemistry, dentistry, gynaecology, neurosurgery, nutrition, pain medicine, public health, rehabilitation, sleep medicine, surgery and virology.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.70

Authors: Sadia Nawaz Ayesha Baber Kawish Qandeel Tahir

Objective: The objective was to study the muscle imbalance, restrictive motility in unlike gazes and the outcomes of the scleral buckling surgery for rhegmatogenous retinal detachment. Study design: Prospective follow-up study Settings and duration: The study was conducted at Al-Shifa Trust Eye Hospital Rawalpindi from Aug 2015 to Jan 2016. Methodology: The patients were checked prior to surgery and two follow up visits were done afterwards. Thorough history was taken along with full orthoptic assessment and ocular motility in all four main gazes including elevation, depression, adduction and abduction. Vision, type and position of explants, site of detachment, and risk factors of detachment were also observed. Results: A total of 48 eyes of 46 patients were taken. Mean age of the study participants was 37.16±20.37 years. Horizontal, vertical and combined deviations were observed in study population. Exo deviation was most common deviation among patients. Most reported risk factors of retinal detachment included trauma, pseudophakia, aphakia and myopia. Motility limitations of all four gazes was observed and it was found out that after buckling the squint and restriction is been increased up till two months. Conclusion: Ocular restriction among the patients was observed over a period of 2 months and it depicted that encircling with sclera buckling elicited an increase in restrictive ocular motility from pre-operative to 1 week and 2 months after surgery.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.59

Authors: Hajrah Ahsan Talha Kareem Salma Tanveer Muhammad Farrukh Aftab Bahawal Zeb Ahmed Kabir

Objective: To compare the efficacies of neurological physical examination, neurothesiometer and PainDETECT questionnaire in diagnosing diabetic neuropathy. Study Design: Prospective cross-sectional Place and Duration of Study: Department of General Medicine, Nishtar Hospital Multan, Pakistan from 1st December 2018 to 10th March 2019. Materials and Methods: One hundred and four patients of both type 1 and type 2 diabetes visiting the outdoor department were included in this study. They were assessed by lab results of glycosylated hemoglobin, fasting and random blood sugar levels and neurological physical examination. Results: The physical examination with Michigan Neuropathy Screening instrument showed that around 29 of the patients were having established neuropathy. The PainDETECT questionnaire on the other hand showed about 42 patients having a definitive neuropathy while the neurothesiometer showed that 79 of the total patients had varying degrees of neuropathy. Conclusion: The neurothesiometer is a better diagnostic tool for diagnosing diabetic neuropathy in patients.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.64

Authors: Zahra Wasim Saima Arif Uzma Ameer Malik Faiza Mehboob

Background: Cervical dysplasia is the most common gynecological disorder of modern era. It initiates around the squamocolumnar junction of the cervix commonly due to the infection of human papilloma virus. Large loop excision of transitional zone is globally a standard procedure of choice both for diagnosing and treating cervical dysplasia. Pap smear is a fast and easy assessment tool for detecting cervical lesions, but it is relatively unreliable. Methodology: Fifty patients of age group 35 to 65 years patients having normal looking cervix with abnormal pap smear or suspicious looking cervix with or without abnormal pap smear, were selected for the study after informed consent. The procedure for LLTEZ was performed under strict aseptic measures in the procedural room and the biopsy specimen was sent for histopathological examination. The pathological findings were presented as percentages. Results: 66% cervical biopsy specimens were suggestive of chronic cervicitis and 24% samples were suggestive of chronic cervicitis with squamous metaplasia. Mild dysplasia in 4% samples, moderate and severe dysplasia were seen in 2% samples. Conclusion: LLETZ is an efficient procedure to deal with cervical dysplasia. It must be recommended for the work-up of uncertain gynecological presentations. The expertise of professionals must be improved through training to obtain maximum benefits.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.67

Authors: Ali Siftain Mamoona Chaudhry Taiba Zulfiqar Syed Ali Kaunain Muhammad Sher Zaman

Background: Viral infection of the respiratory tract is a common illness syndrome in humans. Human respiratory tract is infected by large number of viruses. Self-constraining infections are caused by most of them e.g. normal chilly and intense bronchitis. Seriousness of illness relies upon specific infection and furthermore on host factors. Flu influences all age gatherings; an extensive number of bleakness and mortality happens in high hazard gathering e.g. elderly patients with chronic disease. Methodology: The research was completed in Shujabad, Multan. A prospective study was conducted for a period of three months in order to define burden of flu among cases of influenza-like illness as they visited emergency department of the THQ Hospital Shujabad, Multan. Data was analyzed by using SPSS software with 95% confidence interval. Chi-square test was used to measure the association of risk factors. CI (cumulative incidence) of disease (influenza) was calculated by standard formula. Results: There were 16332 patients visited emergency department of the hospital for the treatment different health issues. Total numbers of influenza like illness patients enrolled in current study were 244 and cumulative incidence was calculated to be 1.49%. Among these 244 ILI patients, 12 patients were hospitalized in the emergency department for advance respiratory care which was 4.9% of the ILI patients and 3 patients died among the 12 hospitalized patients due to the severe respiratory attack which was (1.2%) of ILI while rest of the patients were discharged as they were stable. All of the 244 ILI patient samples were sent to the laboratory for PCR and results was showing that 35 were influenza positive which was 14.3% of the ILI cases presented in emergency department of the hospital. Conclusion: It was concluded that Influenza virus strains are circulating in general public of the Tehsil Shujabad, District Multan. This study therefore indorses the need for continuous surveillance of influenza as an important public-health issue. It also raises the question of rational vaccination policy for influenza. Finally, there is the question of clinical diagnosis where specific treatment/antiviral treatment is available.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v4i1.62

Authors: Zunaira Fatima Areeba Iftikhar Muhammad Imran Yousaf

Background: Pulmonary rehabilitation (PR) is beneficial for patients with COPD, with improvement in exercise capacity and health-related quality of life. Despite these overall benefits, the responses to PR vary significantly among different individuals. It is not clear if PR is beneficial for patients with COPD and normal exercise capacity. Although it is believed that longer pulmonary rehabilitation programs can provide better results, most of the evidence comes from short-term programs. Objective: The objective of this analysis was to determine the effectiveness of respiratory services provided in the hospital or community by respiratory therapists (RTs) in reducing health care utilization and improving patient outcomes. The aim was to evaluate the outcomes of a comprehensive pulmonary rehabilitation (PR) in chronic obstructive pulmonary disease. Methodology: All 65 Pakistani patients who met the inclusion criteria with ages between 40 to 65 years, including both male and female, with mild to severe COPD were enrolled in the study on the basis of convenient sampling. Informed consent was taken from each patient starting about the study and their rights to withdraw from study. A demographics detail (name, age, sex) was noted along with the necessary medical history. A questionnaire was made to see the effects of pulmonary rehabilitation in patients with COPD. All necessary tests were performed to evaluate the patient betterment completely. Results: The mean FEV1 in the subjects was 1.29 ± 0.47 L/min, 64.8 ± 23.0% of predicted. Clinically there is a little effect on CXR pattern, FEV1 and FEV1/FVC after pulmonary rehabilitation. But overall quality of life improved after pulmonary rehabilitation. Mainly improvement occurs in peak expiratory flow rate, BORG dyspnea scale, 6 mint walk test distance (meters) and Oxygen saturation after rehabilitation. Conclusion: These results showed that patients with COPD had benefited from a comprehensive PR program in an out-patient setting regardless of disease severity. Exercise training can result in significant improvement in health-related quality of life, exercise capacity, respiratory muscle strength, and exertional dyspnea in subjects with COPD and normal exercise capacity.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.12

Authors: Muhammad Rashid Iqbal Bano Asif Hanif

Background: Infectious diseases are common causes of presenting in emergency having severe signs and symptoms. Having significant mortality and morbidity are on the rise in Pakistan. The objective of the study was to determine the prevalence of infectious diseases in paediatric population.Methodology: We studied 200 consecutive patients from 1 month to 12 years of age presenting with infectious diseases. Their detailed history was then taken including symptoms at presentation and the type of infection was assessed with the help of history and laboratory investigations. Following are the common infectious diseases including pneumonia, meningitis, enteric fever, malaria, measles, tuberculosis, acute watery diarrhoea.Results: Frequency wise infectious diseases are pneumonia (63.5%), meningitis (20%), acute watery diarrhoea (8.5%), enteric fever (4%), malaria (2%), tuberculosis (2%), and no measles case found. Infectious diseases are more common in rural areas than urban areas and success after treatment is more (49.5) than death (2%) but a bad impact is that (48.5%) patient went without treatment.Conclusion: This data is taken in winter season that is why Pneumonia is most common infectious disease, second most common infectious disease is meningitis, and others are acute watery diarrhoea, enteric fever, malaria and tuberculosis in our patients. The awareness of risk factors amongst the public is low. Thus, there is an urgent need to create more and more awareness about the preventive aspects and healthier life style behaviour in our community.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.16

Authors: Hamna Rao

Obstructive Sleep Apnoea is an emerging sleeping disorder affecting much population around the world due to obesity and other medical conditions. My literature review will explain the current status of OSA worldwide and what betterments are being made in this area of advancement to provide better health and life quality.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.13

Authors: Muhammad Abdul Ghaffar Muhammad Asif Naveed Rehma Dar

Background: The complete blood count is one of the most common routine tests. This study aimed to evaluate possible effects of the antioxidant taurine on the complete blood count of whole blood stored at room temperature and at 4°C over three days.Methods: Venous blood samples of 15 healthy males were distributed into two sets of tubes with each set of three tubes containing 50 ?L of solutions with zero, 5 g/L, 10 g/L taurine. The tubes were kept at room temperature or at 4°C. Complete blood counts were performed on three successive days. The mean percentage changes [? = (mean value – mean baseline value) / mean baseline value x 100] were calculated and compared.Results: Complete blood count parameters exhibited different patterns of behaviour which were affected by the storage temperature, time and taurine concentration. Taurine at room temperature significantly enhanced the stability of: the platelet count over three days (?3 at 5 and 10 g/L taurine were 6.18, and 2.53 x 109 cells/L, respectively); the red blood cell count over three days (?3 at 5 and 10 g/L taurine were 2.59, and 1.39 x 1012 cells/L, respectively); mean corpuscular haemoglobin over three days (?3 at 5 and 10 g/L taurine were,-0.62 and -0.52 fl respectively); and red cell distribution width over two days (?2 at 5 and 10 g/L taurine were 1.30% and -0.1%, respectively). No additional stabilizing effects of taurine were reported for the mean corpuscular volume, mean corpuscular haemoglobin, mean corpuscular haemoglobin concentration, haematocrit and haemoglobin, while it negatively affected the white blood cell stability.Conclusion: Complete blood count parameters exhibited variable stability patterns in respect to temperature, time and taurine concentration.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.11

Authors: Muhammad Usman Rafique Qandeel Rubnawaz Ammar Hameed Khan Muhammad Shoaib Akhtar

Background: The operative treatment of cardiac diseases remains associated with systemic inflammation and a suboptimal outcome in many patients. These inflammatory changes are manifested by systemic hypotension, myocardial failure, increased vascular permeability and consequent dysfunction of organs such as the lungs, gut and brain. In general terms, sympathetic innervations of the small arteries and arterioles allows vasoconstriction, thereby increasing resistance to blood flow, whereas innervations of the large arteries and veins decreases the volume in these vessels, resulting in the redistribution of blood volume. This study was conducted to determine the effect of vasodilator drugs on duration of vasodilatation in patients undergoing coronary artery bypass grafting (CABG) with Cardiopulmonary bypass (CPB).Methods: We evaluated prospectively the effect of vasodilator medications before CABG surgery on hemodynamic variables and use of vasoactive drugs. We studied 30 patients with good left ventricular function allocated randomly to continue vasodilator drugs before cardiac surgery. Arterial pressure, Cardiac output, systemic vascular resistance and use of vasoactive drugs were recorded during anaesthesia, perioperative and in the early postoperative period.Results: Patients who using vasodilator drugs before cardiac surgery had not significant relationship between vasodilator drugs and vessels reactivity (vasoconstriction & vasodilatation). However, these patients required more vasodilator drugs to control hypertension after CPB and in the early postoperative period.Conclusion: There was no difference in hypotension at the onset of CPB or in the use of vasodilator drugs before cardiac surgery. We conclude that vasodilator drugs before cardiac surgery did not have sufficient effect to be recommended routinely.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.18

Authors: Farkhanda Noureen Abdur Rehman Asif Hanif

Background: Tuberculosis is a global pandemic which affects millions of people every year. The treatment of tuberculosis consists of simultaneous use of several drugs for a prolonged period of time, therefore anti-tuberculosis treatment induced toxicity is a real problem. It is the most common side effect leading to interruption of therapy. Wide variations have been found in the reported incidence of hepatotoxicity during short-course chemotherapy. This study was conducted to determine the frequency of ATT induced hepatotoxicity in pulmonary TB patients.Methodology: This descriptive, cross-sectional study was conducted at Gulab Devi Chest Hospital Lahore from November 2015 to January 2016. Total 137 pulmonary TB patients were included in this study according to inclusion and exclusion criteria. Data of patients was collected by Questionnaire. Blood samples were taken and LFTs were done. Data was analyzed by using SPSS version 16.Results: Data of 137 patients was taken in the study. Out of which 60 (43.8%) were male and 77 (56.2%) were female. The mean age was 40.59±16.57. 45 (32.8%) patients out of 137, develop hepatotoxicity while 92 (67.2%) shows normal patterns of liver function. 22 (16.1%) patients out of 137 showed elevation of serum bilirubin levels.Conclusion: ATT induced hepatotoxicity is a frequent complication in Pulmonary Tuberculosis patients. So, all patients put on ATT must be followed up for at least the initial month. The patients and the treating physicians must be well-educated about the adverse effects of the ATT, its early recognition and management.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.25

Authors: Zarnab Tariq Majid Kaleem

AbstractBackground: To compare between the outcomes of streptokinase and primary PCI in acute myocardial infarction. The inappropriate treatment, misdiagnosis, contraindications of procedures can result in complications of procedures and increased mortality of patients. The present study aimed to compare between the outcomes of streptokinase and primary percutaneous coronary intervention in acute myocardial infarction patients to minimize the death rates in MI patients.Methodology: The descriptive study was conducted at Gulab Devi Chest Hospital. All the samples were collected from cardiac department. A Performa was designed for recording the risk factors, ST elevation, clinical findings and lab results of the patients.Results: In this cross-sectional study of 100 patients, the mean age was 51.02+ 10.956. Male gender was predominant. There were more chances (67.00%) of acute LVF in streptokinase and less chances (21.00%) in primary PCI. According to this study, there was more chances (67.00%) of cardiogenic shock in streptokinase and less chances (21.00%) in primary PCI. In this study, there were equal chances of stroke in streptokinase and primary PCI. In this study there were more chances (28.00%) of bleeding from any site in streptokinase and less chances (0%) in primary PCI. According to results there were chances (24.00%) of renal failure in streptokinase and less chances (0%) in primary PCI. There were more chances (9.43%) of rescue PCI in streptokinase and less chances in primary PCI. In this study, there were more chances of arrhythmias (26.41%) in streptokinase patients and less chances in primary PCI. In this study, there were also more chances of death (1.92%) in streptokinase and less chance in primary PCI. So according to my study primary PCI was better than streptokinase with less complications.Conclusion: Primary PCI was better than streptokinase to cure the myocardial infarction and better to minimize the complications after procedure.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.21

Authors: Dur e Shehwar Lubna Zubair

Abstract:Background: Ectopic pregnancy is the implantation of a fertilized ovum anywhere outside the uterine cavity. Around 95% of ectopic pregnancies occur in the Fallopian tubes. Most of these are occurring in the ampulla region. Other sites include the interstitial or the corneal region of the myometrium, cervix, ovary, peritoneal cavity (abdominal pregnancy) and in caesarean section scars. The objective of this study was to see the association of different risk factors of ectopic pregnancy.Methodology: It was a case-control study. The data was collected from Obstetrics & Gynaecology department Jinnah Hospital, Lahore and the study was completed at Gulab Devi PGMI, Lahore. For the analysis of data, SPSS version 16.00 was used.Results: 180 pregnant females were taken in which 90 were cases and 90 were controls. 16 females were more than 35 years in age of which 16% females had ectopic pregnancy. There were 3 females had history of smoking in which 3% females had ectopic pregnancy. There were 82 females who had history of pelvic surgery in which 43% female had ectopic pregnancy. There were 17 females have had history of previous ectopic pregnancy of which 14% were having ectopic pregnancy. There were 6 females have had history of IUCD (Intra uterine contraceptive device) of which 6% females were having ectopic pregnancy. There were 23 females who had history of PID (Pelvic inflammatory disease) of which 26% females were having ectopic pregnancy. There were 2 females have had history of tubal disease and had ectopic pregnancy. There were 21 females who had history of ART (Assisted reproductive technique) in which 3% females were presented with ectopic pregnancy. There was 1 female who had history of endometriosis in which 2% females were presented with ectopic pregnancy.There were 16 females have had history of low socioeconomic status of which 9% females were presented with ectopic pregnancy. There was 1 female who had history of tuberculosis and having ectopic pregnancy.Conclusion: In the present study age more than 35 years, smoking, previous ectopic pregnancy, insertion of IUCD, PID, assisted reproductive technique, tubal disease, history of pelvic surgery, endometriosis and tuberculosis had a great association with ectopic pregnancy.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.19

Authors: Taslim Rubab Asif Hanif Abdur Rehman

Background: Diabetes Mellitus is an important risk factor for Pulmonary Tuberculosis (PTB). Diabetes and Tuberculosis often present together and complicate each other at many levels. There is inadequate data on the frequency of diabetes mellitus in TB patients in Pakistan. Implementation of bidirectional screening for both diseases in patients with tuberculosis will not only ensure early case detection but also better management of diabetes at the same time. The study was conducted to assess the frequency of diabetes in patients presenting with pulmonary tuberculosis.Material and Methods: In this cross-sectional study, 137 sputum positive TB patients were selected by non-probability (purposive) sampling technique and data was collected using a questionnaire. All cases of tuberculosis, more than 18 years of age, were screened for diabetes. Diabetes was confirmed by determining fasting blood sugar level using cut-off value of 126mg/dl.Results: The frequency of diabetes among pulmonary T.B patients in this study is was found to be 34.3% of which 29.9% were known DM cases and 4.4% were newly diagnosed.Conclusion: This study concludes high frequency of Diabetes mellitus in pulmonary tuberculosis. Diabetes is a common co-morbidity in people with TB, screening TB patients with fasting blood sugar estimation will help in early detection of diabetes.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.17

Authors: Muzammil Irshad

China-Pakistan Economic Corridor (CPEC) is a bond of bilateral cooperation between China and Pakistan to enhance economic growth of both the countries. As far as Pakistan is concerned, CPEC is one of the supreme strategies to modernize Pakistani infrastructure and to empower Pakistani economic growth in terms of transportation, energy, and numerous industrial reforms. Economic growth is considered a determinant of population health. It has been noted, “Wealthier nations are healthier nations” as they spend more on preventive medicine and on healthcare delivery. Hence, economic gains from CPEC development can flow into health gains as well.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.20

Authors: Aqsa Rasheed Majid Kaleem

AbstractBackground: Coronary artery disease is the most common and life threatening cardiac emergency presenting to a hospital. Having significant mortality and morbidity are on the rise in Pakistan. The objective of the study is to examine the association of elevated level of serum uric acid with ischemic heart disease among adult population, to guide planning for primary and secondary prevention of this disease in community.Subjects and Methods: This cross-sectional study studied 110 consecutive patients from 20-80 years of age presenting with IHD (Myocardial infarction, unstable angina). All the subjects who were approached to participate in the study, gave their consent. Face-to-face interviews were conducted using a structured questionnaire followed by laboratory tests.Results: Association of serum uric acid were lined up as gender, smoking, hypertension, diabetes mellitus, menopause, dyslipidemia, family history and obesity. In this study, out of 110 patients 35 (32%) were females and 74 (68%) were males. Minimum Age of patients in this study was 30 years and maximum age was 70 years This study revealed that chest pain was the most occurring symptom which was observed in 39 patients which are 35.45% of the total patients and the second most occurring symptom was Dyspnea which was observed in 32 patients which 29.09% of the total patients. The study reveals that the major risk factor observed in CAD patients is ‘HTN’ which was found in 81 patients which are 73.64% of the total patients. However, ‘Smoking’ and ‘DM’ are proximate in occurrence and were found in 59 (53.64%) and 56 (50.91%) patients respectively. The study revealed that hyperuricemia was more in males that was 34(22.67) than in females.Conclusion: This study concluded that there was no significant association between hyperuricemia with ischemic heart disease.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i2.26

Authors: Muhammad Rashid

Introduction: Pakistan is vulnerable to many hazards due to its geography and climate condition, like floods, earthquakes, droughts and landslides. Some manmade hazards also provoking us like, road traffic accidents, fire, structural collapse, radiological and chemical spills etc. Pakistan have faced many of these which affects us badly at every perspective of life for example health, communication, water and sanitation and infrastructure.This study focused on health problems experienced by pregnant females during any type of disasters. Females faced so many problems because of very sensitive issues like unavailability of health facilities, lack of food, and unavailability of clean water, accommodation and transportation.Methodology: This is the descriptive cross-sectional study. The objective of the study was to identify health problems faced by the pregnant females during disasters. Annual disaster report of National Disaster Management Authority Pakistan and Pakistan Red Crescent Society is employed to identify these problems.Discussion: Unexpected environmental events cause natural disasters which affect entire communities and are likely to endanger life and property. In addition to causing casualties and economic losses, exposure to natural disasters can precipitate transient and more enduring somatic and psychological symptoms that relate to posttraumatic stress disorder and depression.Conclusion: Pakistan is exposed to different hazards due to its geography and climate situation. Catastrophic incidents, both natural and manmade, bring about heavy loss of human lives and livelihoods, damage to property and infrastructure. Such episodes can also aggravate natural processes, such like sudden tectonic movements, which promote earthquakes and tsunamis, resulting in frequent cyclones, continuous dry conditions cause prolonged droughts, severe storms, unexpected heavy rains, excessive snowfalls, floods, landslides, and avalanches, etc. The country is also vulnerable to manmade disasters, for example industrial hazards, bomb blasts, building fires, armed conflicts and nuclear and radiological events.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.32

Authors: Muhammad Shafquat Amin Inayat Thaver Muhammad Imran

AbstractBackground: Vaccination prevents significant amount of childhood deaths around the globe. Pakistan is vaccinating children through EPI since 1978 against 10 diseases. Pakistan is facing difficulties in achieving goal of vaccine coverage due to multiple factors. Researches reveal that human resource, poor equipment and training of health care personnel are important for successful immunization programme. Current study was conducted to assess the routine immunization coverage among children of age 12-23 months in Rahimyar Khan district, Punjab, Pakistan and to identify factors that affect uptake of routine immunization in Rahimyar Khan district, Punjab, Pakistan.Materials and Methods: It was a cross sectional study which was conducted in Rahimyar Khan from Oct 2016-Jan 2017. A total of 378 mothers having children of age 12-23 months were interviewed through structured questionnaire. Total 12 (six rural and six urban) Union Councils of district Rahimyar Khan were selected through random sampling. For household selection, random area of union council was selected, and bottle was rotated to select first house, then every Nth (5th) house were approached for sample until required sample size was obtained. Data was analysed by SPSS 22.0. Chi Square test was used to explore association between independent variables and outcome variable.Results: A total of 378 mothers of children age 12-23 months were interviewed. About 66.10% children were found fully immunized. Measles- II vaccine coverage was 60.8% while 78% were immunized against BCG vaccines. Mother’s educational status, occupation and father’s educational status, occupations were observed to the significantly affect the immunization coverage of children. The monthly household income, age of children and area of residence also significantly affected the immunization coverage of children. Other factors such as the child gender, ethnicity, religion, type of family and number of children did not significantly affect the immunization coverage. Majority of respondents’ perception were place of delivery and community health workers play role to enhance the vaccination coverage.Conclusion: The study concluded that the majority (66.10%) of children were completely immunized within recommended time. The reasons of vaccine refusal and lower immunization coverage areas can be countered by overcoming the factors such as place of delivery, theory of knowledge, general public motivation and well-planned infrastructure at National and local level.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.28

Authors: Qandeel Rabnawaz Muhammad Usman Rafique Usman Ali Rehman Sami Ullah Bhatti

Background: Diabetic foot disease (DFD) is a major challenge for the healthcare system, with enormous economic consequences for people living with diabetes, their families and society and it affects both quality of life and quality of care in the diabetic patients. This study was conducted to know about the knowledge, attitude and practices about diabetic foot disease in diabetic patients.Methodology: The study of knowledge, attitude and practices about DFD was done at the different areas in Lahore and at Bhutta Clinical Lab, Multan. Duration of this study was about 6 months. Questionnaire was designed and filled. Sample size of this study was 380. Data was collected and analysed by using SPSS.Results: In this study, 67.9% diabetic patients had poor knowledge, 30% had satisfactory knowledge whereas only 2.1% patients had good knowledge. Regarding attitude towards the DFD, 98.7% patients had good attitude, 1.3% patients had satisfactory attitude and poor attitude had not showed by any patient. In practices score, 47.4% were doing satisfactory practices, 42.9% patients were doing good practices and 9.7% patients were doing poor practices regarding DFD.Conclusion: In this study, awareness of the diabetic foot disease in diabetic patients was poor that may cause increase in the frequency of the diabetic foot disease that may ultimately cause amputation of the lower limb and even cause death due to sepsis. But attitude towards the disease was good in majority of the diabetic patients and practices regarding disease were also satisfactory therefore by increasing the knowledge regarding disease and knowledge of the good practices, reduction of the severe cases of disease and prevention of the disease should be done.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.34

Authors: Hamna Rao

Today’s health workforce is constantly engaged to enhance the standards of healthcare services and ensuring comprehensive healthcare standards to the community. Queensland’s health workforce is Australia’s second largest health workforce (1) and serving proportionately in all areas of QLD, making efforts to make health better by making research, surveys and developmental planning in rural and regional areas. Aged Care is currently the most concerned health issue among OECD countries (2) as aged population continues to grow and it’s challenging for Australian health sector to meet the standards of quality care in provision of aged care health services. As per Australian Institute of Health and Welfare statistics it is projected that Australia will constitute 22% of aged population in next 30 years (AIHW).

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.27

Authors: Muhammad Shoaib Akhtar

Primary and Secondary Healthcare Department of Punjab Government, Pakistan owns 25 district headquarter hospitals, 100 tehsil headquarter hospitals and a number of rural health centres and basic health units. Currently, the department started process of revamping in hospitals and other healthcare delivery centres. In first phase, revamping of infrastructure and services of 25 district headquarter and 15 tehsil headquarter hospitals was started. For better care to patients and service delivery, services of janitorial and security were outsourced to private service providers. Now, the department plans to improve diagnostic services in these hospitals. For this purpose, laboratory and radiology services were planned to outsource. Islamabad Diagnostic Centre and Northshore Medical Labs are the two service providers who are to provide clinical laboratory services in selected hospitals. Islamabad Diagnostic Centre (Private Limited) is a leading diagnostic centre in Islamabad (Federal capital of Islamic Republic of Pakistan) which is ISO 151589:2012. While, Northshore Medical Labs is an American laboratory located and registered in New York State Department of Health and accredited by College of American Pathologist. It is expected to enhance clinical laboratory services standard by outsourcing of these laboratory services. First such laboratory became functional in District Headquarter Hospital Chakwal last month. Although the contract between outsourced laboratory and department describes upraising of services and quality standard by following MSDS and departmental proficiency testing.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.33

Authors: Muhammad Rashid

Abstract:Introduction: Disasters are the catastrophic events which affects human lives, infrastructure and economy at significant scale. Pakistan is vulnerable to disasters due to its climate change and geography. Climate change causes much more complications and disasters. So, there should be focus on climate change adaptations to reduce disaster risks. If country spends 1 dollar on DRR it saves 5 to 7 dollars to be spent on same population if disaster strike. So, development for disaster risk reduction is much more important. Making the communities resilient and reduces vulnerability environmental sustainability is very important. After the Millennium Development Goals recommendations, Pakistan is also trying to gain environmental sustainability but more in papers instead of practically. So, the need is to make sure practical implementations of these plans and efforts. The objective of this study was to overview the sustainable environmental development and disaster risk reduction in the context of Pakistan.Methodology: This is the descriptive cross-sectional review study.Conclusion: As Pakistan is vulnerable for natural disasters due to its geography and climate change like floods, landslides, droughts and Tsunamis. These impact communities according to vulnerability level of the community. Impacts of these disasters on communities can be reduced by reducing their vulnerability and increasing their resilience level.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.31

Authors: Qudrat Ullah Anam Parvaiz Usman Ali Rehman Asif Hanif Sami Ullah Bhatti

Abstract:Background: Lymph node are located throughout the lymphatic system, they are concentrated in certain areas of the body including head and neck. Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to several different pathological conditions including tumours, infection and inflammation.Methodology: The Povidine-iodine and chlorhexidine for preoperative skin preparation in cervical lymph node biopsy procedure were used in this study and patients were asked for follow up after a week. On follow up day their wounds were checked, assessed and withdraw all stiches and complications were recorded accordingly and analysed them. It was discussed and showed that which one of Povidine-iodine and chlorhexidine is best to use for preoperative skin preparation in cervical lymph node biopsy procedures to reduce surgical site infection and economical one.Results: Out of 150 patients, 46% (69) were males and 54% (81) were females that had cervical lymphadenopathy after skin preparation by chlorhexidine antiseptic solution showed frequency of infection in total of 150 patients 16.67% (25) were infected while the other 83.33%(125) were not infected. Out of 150 patients who were underwent cervical lymphadenopathy after using povidine iodine skin preparatory antiseptic solution, 42% (63) were males and 58% (87) were females and among those frequency of infection showed 44.67% (67) were infected while the others 55.33% (83) were not.Conclusion: Preoperative scrubbing of the patient’s skin with chlorhexidine–alcohol is better than scrubbing with povidone–iodine for preventing surgical-site infection after cervical lymph node biopsy.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.40

Authors: Nabila Bashir Ali Ahmed Hashim Raza Muhammad Imran

Background: Typhoid fever is an important cause of morbidity and mortality in many parts of the world including Pakistan. Resistance to the first line anti typhoid drugs viz chloramphenicol, cotrimoxazole and ampicillin has aggravated this situation. Quinolones are currently used as the first line antityphoid drugs, instead. Fluoroquinolones are currently recommended for patients infected with Typhi. The fluoroquinolones have shown good in vitro as well as clinical activity against Typhi infections.Materials and Methods: It was a comparative cross-sectional conducted at Department of Microbiology UHS, Lahore, Pakistan within one year (January 2011-December 2011). A total of 100 clinical isolates of Typhi were evaluated. ATCC 9150 Paratyphi A was used as a standarad strain. The bacterial isolates were preserved in microbanks (Pro-Lab Diagnostics, UK) and stored at-70?C during a period of (2007- 2011). Data was analysed through SPSS version 22.Results: Of the 100 isolates, 45 strains were showing MIC ? 1µg/ml which means that they were susceptible while 55 strains were intermediate having MIC 2µg/ml. No strain was however, found resistant to ciprofloxacin according as per the CLSI 2011. As per the CLSI 2012 revised ciprofloxacin break points for disc diffusion and MIC for salmonella species. According to CLSI 2012 interpretive criteria, on disk diffusion testing 13 isolates were sensitive, 13 were resistant and 74 were intermediate to ciprofloxacin. On MIC, 55 strains were resistant showing MIC ?1µg/ml and 45 isolates were intermediate showing MIC 0.125-0.5µg/ml. No isolate was found sensitive to ciprofloxacin according to CLSI 2012 interpretive criteria.Conclusion: In conclusion, the present study showed the value of nalidixic acid susceptibility as an indirect but a certain marker of ciprofloxacin susceptibility. Nalidixic acid resistant showed increased minimum inhibitory concentration (MIC) by agar dilution method.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.39

Authors: Syeda Hina Zahra Qudrat Ullah Usman Ali Rehman Asif Hanif Sami Ullah Bhatti

Abstract:Background: To compare between opioids and wound infiltration to reduce post-operative painin abdominal surgery in first 6 hours, in appropriate treatment, contraindications of treatment and increase mortality of patients. This article presents novel approach to surgical site infiltration techniques and intravenous opioids for abdominal surgery to reduce pain. The main aim of this study is optimal patient comfort rather than reduce pain intensity, reduction offside effects is also an important goal in pain management.Methodology: Data was collected from surgical department of Gulab Devi Chest Hospital. Duringabdominal surgery bupivacaine was given to some patients while other were managed by postoperative opioids and by using designed performa it is concluded that which one of them is better method for post-operative pain management.Results: This is the descriptive study conducted in Gulab Devi Hospital Lahore.in this study, inthis study minimum age of the patients was 14 and maximum age of the patients was 80. The mean age was 32.16+12.32 years. In this study out of total 100 patients, 18(18.00%) were male patients and 82(82.00%) were females. Female gender predominated in this study. in this study, p-value is 0.00 (<0.05%) so pain relieving chances of bupivacaine infiltration as moderate pain scale were 84% and in distracting pain scale chances in bupivacaine infiltration were 16%.But pain relieving chances of opioids as moderate pain scale were 12.24 % and in distracting pain scale chances in opioids were 87.75%.so peri-operative pain management by bupivacaine infiltration is better than post –operative opioids management in patients undergoing abdominal surgery.Conclusion: According to my research bupivacaine wound infiltration is better method for postoperative pain management in abdominal surgeries. Our study was conducted at Gulab DeviHospital and Services Hospital in an area of pain management by opioids and infiltration, whichmay limit the applications of our findings in area of pain management by opioids and infiltrationprevalence.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.41

Authors: Hamna Rao

In the last decade technology has advanced tremendously in all fields and health sector is equally benefited. Healthcare is more likely known as e-health in this era of information and technology because of its advancements and opportunities given to health sector. E-health proposes more convenient and approachable accessibility for the health providers and patients. Information technology and electric health together have made the health sector more updated and idealized for individuals. Health devices, appliances and wearables are kind of recent innovations in healthcare. With the trend of health devices and health wearables there have been certain challenges in healthcare sector as well when it comes to clinical acceptance and practice. This literature review aims to define current health scope of wearables, challenges and future if wearables in health industry.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.37

Authors: Riffat Saba Qudrat Ullah Usman Ali Rehman Asif Hanif Sami Ullah Bhatti

Background: A facility within a hospital where surgical operations are carried out in a sterile environment is an operating theatre also known as an operating suite, operation theatre or operation suite. In past, the operation theatre was a place where there was an educational setting have had raised tables or chairs at the centre for performing operations surrounded by several rows of seats for students and other spectators to observe the case in progress. The objective of this research is that to better the efficacy of sterilization of operation theatre to reduce the surgical site infection and contamination at highest level.Methodology: Data was collected from surgical department of Gulab Devi Chest Hospital. Carbolization was employed to disinfect operating room and fumigation to sterilize. After neutralization with ammonia, culture swabs were collected from OT table, OT light, OT floor, OT wall, anaesthesia machine and OT trolley. Efficacy of fumigation was concluded using statistical tools.Results: There were no positive results prior and even after the fumigation.Conclusion: There was no organism growth in OT. There was no evidence of Escherichia coli,Proteus Mirabilis, Proteus vulgaris, Pseudomonas aeruginosa, Staphylococcus aureus, Streptococcus spp., E. faecalis, Coagulase negative staph and Salmonella choleraesius.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.36

Authors: Qudrat Ullah Usman Ali Rehman Asif Hanif

Background: There are many experiences in the operation theatre professionals to get Hepatitis B virus, Hepatitis C virus and Human immunodeficiency virus during their profession in operating room due to accidental needle pricks or through cut by any sharp. The objective of this study is to find out the Frequency of parenteral exposure and seroprevelence of HBV, HCV and HIV among operating room personnel.Methodology: Frequency of parenteral exposure and seroprevalence of HBV, HCV and HIV among operating room personnel was found using ICT method.Results: All 108 (100 %) operating room personnel were HBV, HCV and HIV negative, none of them showed positive results. Among these 108 operating room personnel to complete my research, among these 58 (53.7%) were male and 50 (46.3%) were female.Conclusion: It is concluded by the study that there are no positive cases of HBV, HCV and HIV among operating room personnel in Gulab devi hospital and Masood hospital.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.35

Authors: Muhammad Imran

One of the most effective and valuable principles to promote health in all countries has been adoption of Primary Health Care (PHC) as a fundamental strategy. In September 1978, an international conference was held in Alma-Ata, whose great achievement was declaring PHC as a roadmap for “Health for All” by the year 2000 (HFA 2000). Indeed, as a new approach beyond the traditional system of health care, PHC insisted on justice in the delivery and distribution of services in the health sector (1).

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i2.38

Authors: Waqas Ahmed Qudrat Ullah Mughees Ahmed Asif Hanif

AbstractBackground: Obstructive lung disease (OLD) is one of the main causes of mortality and morbidity worldwide. Obstructive lung disease is the narrowing of bronchioles mainly due to excessive smooth muscle contraction. The objective of this study is to evaluate the Frequency of HIV in obstructive lung disease patients.Methodology: Samples were collected randomly, and study was completed in almost six months. 100 samples were taken with an informed consent taken from all the patients. EDTA and Clotted blood was collected for HIV ELISA and HIV screening.Results: In this study, 69% Males and 31%Females, 34% Smokers, 26% patients were Hypertensive, 10% patients were diabetic, 3% patients were diagnosed HIV positive by screening and ELISA.Conclusion: The frequency of HIV in obstructive lung disease patients in this research is not very high as compared to the previous researches, showing high frequency and relationship between HIV and obstructive lung disease patients. The reason behind low frequency is due to low sample size so by increasing the sample size we can get better understanding of frequency of HIV in obstructive lung disease patients. Another reason of insignificant results is low prevalence of HIV in Pakistan as compared to the previous researches in certain countries.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.42

Authors: Muhammad Shoaib Akhtar

Today’s society is full of disease that are of different natures including genetic, infectious and metabolic etc. Every disease has its own mechanisms of affecting humans and different prevention mechanisms as per disease nature. These factors are included in epidemiology of disease. Other factors include prevalence and incidence of diseases in different populations. Exactly knowing about disease epidemiology helps governing authorities to prevent the disease. Unfortunately, under-developed and developing nations are not focusing on diseases epidemiology. On the other hand, all developing nations developed best public health practices based on diseases epidemiology data. These studies may vary from basic epidemiological surveys to identification of microorganism strains etc.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.43

Authors: Nadeem Hafeez Qudrat Ullah Asif Hanif Zaheer Akhtar Muhammad Umar Rukhma Rafaqat

Abstract: Background: Gastroesophageal reflex is known as an acid reflex, is long term condition where stomach contents back into the oesophagus resulting in either symptoms or complications. GERD disease is caused by weakness or failure of the lower oesophageal sphincter. Symptoms include the acidic taste behind the mouth, heart burn, chest pain, difficult breathing and vomiting. Complication includes esophagitis, oesophageal strictures and barrettes oesophagus. Objective: The aim of this research was to introduce the symptoms of GERD disease in asthmatic patients and how these symptoms worsen the symptoms of asthma disease and what clinical pictures present with the asthmatic disease. Methodology: A designed performa was used to collect the data and after filling the performa, results were drawn and conclusion through the facts and the information given by patients. Results: In the present study among all 164 asthmatic patients, 70 (42.7%) patients showed dyspepsia, 58 (35.4%) were with chest burning, 23 (14%) were asking about chest pain, with acidic mouth taste were 39 (23.8%), 22 (13.4%) were feeling sore throat and 44 (26.8%) showed regurgitation reflex. Among these 164 patients 16 (9.8%) were smokers and 148 (90.2 %) were non-smokers. 47 (28.7%) were males and 117 (71.3%) were females. Conclusion: It is concluded that gastroesophageal reflux disease in asthmatic patients present symptoms of acidic mouth taste, chest burning, chest pain, dyspepsia, regurgitation reflex and sore throat.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.49

Authors: Muhammad Aslamkhan

Water is a chemical compound made up of two elements, Hydrogen gas, which is combustible and Oxygen gas, which causes to burn. But the union of two atoms of Hydrogen and one atom of Oxygen results in a colourless and odourless liquid, known as water, which extinguish fire.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.45

Authors: Madiha Iftikhar Zabinfat Ulhaq Qudrat Ullah Sana Saleem Asif Hanif

Abstract: Background: Acute infectious enteritis remains one of the commonest causes of death among infants and children in developing countries. Acute enteritis is defined as a loss of stool consistency with pasty or liquid stools, and/or an increase in stool frequency to more than three stools in 24 hours with or without fever or vomiting. Human survival depends on the secretion and reabsorption of fluid and electrolytes in the intestinal tract. The objective of the study is to evaluate the risk factors of diarrhoea in children under age of 5 years. Methodology: It was an observational study. Study was completed in about six months. Non-probability purposive sampling technique was used. In this study, 270 samples were taken from Diarrheal ward of The Children Hospital Lahore, Pakistan. Results: In this study, out of 270 patients, 58.52% were males and 41.48% were females. 90.37% patients were vaccinated. 54.81% had weaning history. 91.85% patients had feeding history. 29.26% had blood in stool. 96.67% patients were dehydrated. 95.56% patients had loose watery diarrhoea. 62.96% patients used boiled water. 58.52% patients consumed less than half litre of water, 30.00% patients consumed 1 litre of water and 11.48% patients consumed > 1 litre of water. 49.18% patients had proper hygiene. 38.15% mothers of patients were well educated. 40.37% patients had model household condition. 57.41% patients lived in rural area and 42.59% patients lived in urban area. Conclusion: The variation in the level of diarrheal morbidity was well explained by maternal education, income, personal hygiene, refuse disposal system and the effect of health extension programme.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.44

Authors: Ruhamah Yousaf Muhammad Arif Qudrat Ullah Saima Rafique Asif Hanif Mustansar Ali

Abstract: Background: The significant reason for anguish as well as incapacity is chronic obstructive pulmonary disease (COPD). Activities of daily living might be relentlessly curbed among patients with COPD and appraisal needs evaluation regarding influence of infirmity and detriments on day-to-day living. The primary objective was to know the daily activity associated quality of life in COPD adults. The secondary objective was to analyze demographical profile, such as gender and age of COPD subjects as well as evaluate the physical activity related breathlessness in COPD patients. Methodology: This study was executed at Gulab Devi Chest Hospital. We used cross sectional study design to collect the data. For collecting the statistics of 150 subjects aged 40-60 years of either gender Saint George’s Questionnaire was liable. It included the patient’s biodata, effect of COPD on physical activities and limitations in routine work. Results: The ages of 150 COPD patients selected were between 40 and 60 years. Patients were classified into two categories on the basis of disease severity according to GOLD criteria 71 (47.3%) were with moderate severity and 79 (52.7%) were with severe severity. 113 (75.3%) patients were smokers while 37 (24.7%) patients were non-smokers. 110 (73.3%) COPD patients were active smokers in comparison 40 (26.7%) COPD patients were passive smokers. COPD patients with current smoking status were 79 (52.7%) and with past smoking status were 71 (47.3%). 19 (12.7%) COPD patients felt breathlessness while sitting and lying. 53(35.3%) COPD patients felt breathless while getting washed or dressed. 85(56.7%) COPD patients felt breathless while walking around the home. 114 (96%) COPD patients discerned breathlessness while walking up a flight of stairs. 145 (96.7%) COPD patients had breathlessness while playing sports or games. 146 (97.3%) COPD patients experienced difficulty in breathing during activities like carrying load. 88 (58.7%) COPD patients discerned breathlessness during entertainment or recreation. 88 (58.7%) COPD patients discerned breathlessness during entertainment or recreation. 7 (4.7%) COPD patients felt breathlessness while moving from bed or chair. Conclusion: As with the progression of COPD impairment in activities become worse due to breathlessness causing decline in patient’s ability making them unable to complete their task to fulfill the needs of life and ultimately become bed bound due to shortness of breath.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.48

Authors: Qudrat Ullah Ayesha Shahnawaz Usman Ali Rehman Asif Hanif Sami Ullah Bhatti Zabinfat Ulhaq

Abstract: Background: Postoperative nausea and vomiting are common and distressing postsurgical symptoms. These symptoms are of particular concern in outpatient surgery because they may require additional direct resources, such as supplies and antiemetic drugs, and may delay discharge. The objective of this study was to measure the frequency of factors which can cause nausea and vomiting under general anaesthesia after chest surgery. Methodology: This descriptive case series evaluated frequency of predisposing factor of nausea and vomiting in patients of anaesthesia department of Gulab Devi Hospital Lahore. Questionnaire is made and patients were asked about their age, fever, previous surgery, NPO status, smoking history and hospital stay. This study included 140 patients with post-operative nausea and vomiting. Results: In this study, 140 patients were taken in which 65 (46.43%) were female and 75 (53.57%) were male. In 140 patient 134 (95.7%) were NPO and 6 (4.3%) were not NPO, 25 (17.9%) were obese and 115 (82.1%) were not obese, 88 (62.9%) patients were suffering fever and 52 (37.1%) were not suffering fever, 80 (57.1%) were infected and 59 (42.1%) were not infected, 53 (37.9%) patients had previous surgery and 87 (62.1%) had no previous surgery, 94 (67.1%) patients had received nitrous oxide and 46 (32.9%) didn’t, 97 (69.3%) received volatile gases and 43 (30.7%) not received, 29 (20.7%) received ketamine and 111 (79.3%) not received, 87 (62.1%) received suxamethonium and 53 (37.9%) not received, 119 (85.0%) received propofol and 21 (15.0%) not received, 110 (78.6%) received naluphine and 28 (20.0%) not received. Out of 140 patients, there were 122 (87.1%) who were suffering from pain and 18 (12.9%) were not. 91 (65.0%) patients had gastric distention and 49 (35.0%) patients didn’t. Opioids were given to 34 (24.3%) patients and not given to 106 (75.7%) patient. Conclusion: It is concluded that the nausea and vomiting after surgey under genral anesthesia is due to patient related factors in which most frequent is NPO. Drug related factors include propofol and nalbupin administration. Post operative factors include pain. In whole study of 140 patients, the most frequent is patient related factor (NPO) other than drug related factors and post-operative factors.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.55

Authors: Wajahat Hussain Samina Badar Huda Abbas Muhammad Imran Muhammad Arif Khan Muhammad Ramzan Soomra

Background: Obesity is a major epidemic of developed world that is now extending to developing countries and is the risk factor of pre-eclampsia which is the major contributor to maternal and foetal morbidity & mortality. Objective: To determine the frequency of preeclampsia in obese primigravida women visiting the Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan. Methodology: This cross-sectional descriptive study was conducted in Obstetrics and Gynaecology Outpatient Department of Bahawal Victoria Hospital, Bahawalpur, Pakistan from January 2018 to December 2018. All the Primigravida women with singleton pregnancy of gestational age ? 26 weeks assessed by ultrasound between 20-35 years of age were included in the study by non-probability consecutive method. After obtaining ethical approval from hospital ethical committee and informed written consent from all the study subjects, relevant data were documented in a predefined data sheet and body mass index (BMI) was calculated by using the formula: Weight (kg) / Height2 (m). Women having blood pressure (BP) of 140/90 mmHg or above in third trimester of gestation measured on at least two occasions, 6 hours or more apart accompanied by proteinuria of 300 mg per 24 hours or above in previously normotensive were labelled as preeclampsia and first-time pregnant women having BMI ? 30 were taken as obese. Statistical analysis was performed by using computer-based software, Statistical Package for Social Science (SPSS) for windows version 17.0. Mean and standard deviation was calculated for numerical data like age. Frequencies and percentages were calculated for categorical variables. Chi-square test was performed to find the statistical difference regarding preeclampsia distribution between groups and ‘p’ value <0.05 was considered as a lowest level of significance. Results: Mean age of the respondents in the study was 27.08±3.59 years. Majority of the women were between the ages of 26-30 years (53.30%). The mean gestational age of the respondents was 34.50±4.33 weeks and most of the women had gestational age ? 36 weeks (46.70%). Frequency of obesity in pregnancy was 15.4% and frequency of preeclampsia in obese primigravida was 55.3%. Conclusion: It is concluded that frequency of preeclampsia is higher in obese primigravida compared to non-obese primigravida.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.54

Authors: Mehwish Ishaq Qudrat Ullah Usman Ali Rehman Sami Ullah Bhatti Asif Hanif Zabinfat Ulhaq Rifat Saba Syeda Hina Zahra Anam Parvaiz

Background: Hand hygiene is a general term referring to any action of hand cleansing by using water and detergent and for the removal of transient microorganisms from hands. Hand hygiene is recognized as the leading measure to prevent cross-transmission of microorganisms and to reduce the incidence of healthcare associated infections. There are many experiences that the lack of knowledge, attitude and poor practice in hand hygiene in healthcare workers transmit infection in patients and in other healthcare workers. Methodology: This descriptive study was conducted in Gulab Devi Chest Hospital. I had taken 100 healthcare workers to complete my research. The sampling technique of my research was cross-sectional sampling technique, use to collect the data. Results: In this research knowledge was not good in all HCWs, Overall knowledge of hand hygiene by all HCWs was less than 50%. The attitude in nurses and medical student in this research was moderate doctors and technologists have poor attitude in hand hygiene. The practices among HCWs in Gulab Devi Chest Hospital were also poor which was less than 50%. Conclusion: The HCWs in Gulab Devi Hospital had poor knowledge, practices on hand hygiene. However, attitudes of medical student and nursing had satisfactory.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.56

Authors: Muhammad Shoaib Akhtar Taslim Rubab Ummair Mehmood

Primary and Secondary Healthcare Department of Punjab, Pakistan has outsourced its clinical laboratory services at various secondary level hospitals in the province. Methodology adapted to outsource these facilities was based on phasing out the process. While methodology adapted to selection of service provider was on the basis of bidding. Two service providers contracted the procuring agency to deliver services to general public. In the first phase, clinical laboratory services of DHQ Hospital Chakwal were outsourced to a private laboratory service of the country. This communication aims on the methods adopted by Pathology Department of the hospital to evaluate the technical efficiency of the service.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.53

Authors: Saira Maroof Zubaida Rashid Imtenan Sharif Marukh Alam Rida Nawaz Salman Nawaz Maaz Amin Naseer ul Islam Syed Irshad Hussain Aimal Khan

Abstract Background: Use of the World Health Organization’s (WHO) Safe Childbirth Checklist (SCC) has been associated with a significant reduction of maternal mortality. Method: A descriptive cross-sectional survey conducted at a tertiary care hospital of Rawalpindi in labour room and postnatal ward from February 2018 to July 2018. A sample size of 359 was estimated using WHO sample size calculator and were enrolled using purposive sampling technique. A close ended WHO standardized questionnaire covering the 22 elements of WHO SCC was used. Frequencies and percentages were documented of variables and data was analysed using SPSS version 23. Results: Mean age of participants was 27 ± 4.25 years. On admission, it was observed that being centre of excellence and referral, there was 100% availability of gloves and supplies to clean hands before and after each vaginal examination. Just before pushing or caesarean, it was found that in 342 (95.3%) patients, assistant was identified to help at time of birth. Immediately after one hour of birth, it was noted that 79 (22%) patients were bleeding abnormally and were immediately addressed. We also found out that only 79 (22%) of the mothers were counselled regarding family planning. Almost half of the participant mothers 182 (50.7%) or their companions were counselled regarding danger signs and to seek care immediately which should have been 100%. Conclusion: Excellent adoption of some of the element up to 100% was observed while some of the elements of checklist were poorly adopted; noticeable was counselling regarding family planning options immediate postpartum.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.50

Authors: Wajahat Hussain

The competitive healthcare system and healthcare environment, modern hospitals with substantial investment, healthcare reforms, availability of specialized persons in hospital management, health services management, the success of quality management programs in developed nations and high interest of international health organizations like WHO has led the developing countries like Pakistan to pay due attention to quality in national healthcare system. Since the time of independence healthcare system in Pakistan is striving for improvements. Despite of the physical infrastructure and availability of qualified workforce for service delivery there are gaps in strategic and operational planning which resulted in poor quality health services. The leaders in healthcare has little awareness that the quality management is an organized specialty to improve the quality of healthcare. It is need of the hour that healthcare leaders in Pakistan must integrate quality improvement activities in strategic and operational planning process of healthcare system. This the only way to maximize the benefits of healthcare system and restore the rapidly deteriorating public trust.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.52

Authors: Madiha Shafi Humaira Mehmood Saeed Afsar Zoaib Raza Bokhari Saleem Abbasi

Abstract: Introduction: Globally it is documented that CVD has multi-factorial aetiology and many factors like increased BMI, hypertension (HTN), stress and diabetes determine the risk of CVD. The prevalence of risk factors for cardio vascular disease (CVD) is on increase in the developing nations of the world. Objectives: The purpose of the study was to find out the prevalence of cardiovascular disease and its risk factors among employees of Sindh Government in Karachi, Pakistan.Method: It was hospital based cross sectional study. A total of 150 subjects (govt employees of Sindh Government) were interviewed by using consecutive sampling technique. Data on serum cholesterol, BMI, blood pressure, history of hypertension, diabetes and cardiovascular diseases was collected, in addition to demographic data. Results: Out of 150 subjects interviewed, 20.6% reported to have CVD. The most prevalent risk factor was hypertension, found in 58% respondents. Other risk factors were diabetes (45%), sedentary life style (50%), obesity (28%), dyslipidaemia (30%), smoking (20%), positive family history (26%). In 6% of subjects, three major risk factors were present. The risk factors, strongly associated with CVD in our study were diabetes (p<0.01), hypertension (p<0.001) and family history of CVD (p<0.02). There is strong association of increasing age on risk of developing CVD (p< 0.001). Conclusion: The results show that there is high frequency of CVD risk factors in employees of health department in Karachi. The high prevalence of risk factors, especially hypertension, sedentary life style, obesity and diabetes should be of great concern.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i2.51

Authors: Saira Maroof Humaira Mehmood Saleh Khurshied Syeda Kinza Bukhari Muhammad Bilal Shabir Khizar Malik Kanwal Shan Usama Zameer

Abstract: Objectives: To assess the frequency of eye makeup use among female doctors and its association with ocular surface disease Index (OSDI). Study Design: Analytical Cross-Sectional Study Place and Duration of Study: It was conducted from Jan 2018 to May 2018 at a tertiary care hospital Rawalpindi. Materials and Methods: Sample size calculated using WHO sample size calculator was 272 with margin of error 5% and confidence level of 95%. A WHO Standardized OSDI Questionnaire was used to asses for the severity of ocular surface disease and frequency of application of eye makeup. Females were also inquired about adoption of safety guidelines while applying and removing eye makeup. Results were displayed as frequencies and percentages and Chi Square test was applied to assess statistical significance among frequency of makeup use and severity of ocular symptoms. Results: Frequency of Eye makeup use as stated by the participants was less than three times among 37% and it was more than three times a week among 63% participants. Once a week users were only 24.7%. Among users it was found that majority 49.3% had normal scores while 55(24.2%) had mild disease, 11.5% had moderate disease and only 15% had severe disease. Some questions were added in questionnaire to assess the safety practices regarding eye makeup use. It was quite satisfactory to know that 73.1% of the participants do check expiry date of products before use, don’t share their products with others 62.1% and take off makeup before going to sleep 78.4%. However, the situation was quite opposite in some other practices as only 42.3% do patch test before applying makeup and 34.8% check constituents before purchasing the make up as to some of the constituents they might be sensitive. Conclusion: This study shows the utilization of eye make-up is extensive and related to the perception of ocular discomfort. With such widespread use of these products, more research is needed to assess the effect on the ocular surface and tear film, which can be underestimated.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v2i1.30

Authors: Muhammad Imran Ayesha Baber Kawish Aamira Hashmi Muzammil Irshad Naila Azam

Background: Hepatitis C virus is a blood-borne virus where the most common modes of its transmission are unsafe injection practices, inadequate sterilization of medical equipment, and transfusion of unscreened blood and blood products. Approximately, 130–150 million people globally are suffering from chronic hepatitis C infection. A significant number of these chronically infected will develop liver cirrhosis or liver cancer subsequently. Approximately 500,000 people die of hepatitis C related liver diseases every year. This study aimed to describe personal characteristics, knowledge of respondents and to find out association of these factors with perceptions about Hepatitis C. The study also aimed to focus on perceptions (perceived susceptibility, severity and cues to action) of general population and finding association between their perceptions and health-related behaviors.Methods: A cross sectional study was conducted in Layyah city situated in Punjab province. Total of 423 male participants were selected through multistage sampling from general population of district Layyah. Structured questionnaire was used to collect data.Results: Out of 423 respondents, participants with the poor level of knowledge had right perceptions about hepatitis C (16.8%). 82.7% of the respondents were aware about the availability of hepatitis C treatment. Highest perceptions were observed in age group of 21-25 years old (39.7%), unmarried (73.0%), Saraiki (58.2%) and unemployed population (45.9%). People with less myth had the right perceptions about the hepatitis C.Conclusion: Increasing age, unmarried status and ethnicity were associated with right perceptions shown by respondents. Knowledge remained significant in showing association with perceptions about hepatitis C. General population perceived their susceptibility, severity of consequences and cues to actions were connecting them to show right perceptions overall. Relatives, colleagues and TV were common source of information about hepatitis C respectively.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.47

Authors: Muhammad Shoaib Akhtar Muhammad Aslamkhan Mian Sahib Zar Asif Hanif Abdul Rehman Haris

Abstract: Background and Objectives: Dichromacy, an X-linked recessive disorder is identified worldwide, more in males than females. In European Caucasians, its incidence is 8% in males and 0.5% in females. In India, it is 8.73% in males and 1.69% in females, and in Iran, it is 8.18% in males and 0.43% in females. Population based epidemiological data about dichromacy in different ethnic groups in Pakistan is not available. The aim of this study was to find out the population prevalence of inherited red-green dichromacy in a heterogenous population of the district of Chiniot, Punjab, Pakistan, and to determine the impact of consanguinity and ethnicity. Methods: In this cross-sectional study, boys and girls of the higher secondary schools were examined in the three tehsils of district Chiniot. Pseudoisochromatic Ishihara Test has been employed for detection of dichromacy in the study population. The sample size was calculated statistically as 260, which was expanded to 705 and divided by population density of the three tehsils. Results: Screening of 359 males and 346 females revealed 19 (5.29%) dichromat males and only 2 (0.58%) females. The study population belonged to 23 castes / isonym groups. The consanguinity found in the district of Chiniot is 84.82% and in the dichromat families, it is 85.71%, of which 52.37% are first cousin. Interpretation & Conclusion: The study has shown that the incidence of dichromacy could be reduced through genetic counseling

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v6i1.414

Authors: Muhammad Shoaib Akhtar Iffat Maab

By the beginning of the twenty-first century, the trend of digitalization has been widely appreciated. At first, digitalization became famous for social networks (e.g., Facebook, Twitter etc.), professional networks (e.g., LinkedIn, ResearchGate etc.), online banking, cryptocurrencies (e.g., Bitcoin etc.), education (e.g., Coursera etc.), and dating (e.g., Tinder etc.). Digitalization has been widely accepted by governments for state businesses. International chambers of commerce and multinational companies are utilizing digital means to access new markets and to operate and expand their businesses. A revolutionary shift in digitalization occurred in famous start-ups, such as Uber and Airbnb etc. The current COVID-19 pandemic has promoted digitalization on a mass scale, when social distancing has become a primary infection prevention measure (Qian and Jiang, 2020). Europe and the United States (US) have been points of origin for digital products, later extending to China, India, and the rest of the world. Digitalization has been a good management practice for developed economies but a challenge for developing countries. Usually, developing countries develop digitalization from foreign aid because of a lack of local funding and economic instability. Dependence on foreign aid usually limits independent policymaking because of the funding agency’s interests. In this editorial, we present digitalization in Pakistan as an example of sustainability challenges faced by developing countries.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.309

Authors: Liaqat Jalal Atta-ur-Rehman Khan Muhammad Shaukat Farooq Muhammad Tahir Nouman

Background: The outcome for this neurosurgical problem is still far from set target in many developing countries like Pakistan. Major proportion of cases presenting with EDH in hospital still has poor outcome. This poor outcome of EDH is attributed to many factors including weak health systems of most developing countries. Objective of study was to analyze factors influencing outcome among patients of head injury with an extradural hematoma before surgery admitted in neurosurgery department of Dera Ghazi Khan Medical College, Dera Ghazi Khan.
 Materials and Methods: This cross-sectional analytical study was conducted in neurosurgery department of Dera Ghazi Khan Medical College from January 2019 to December 2019 after ethical approval. All the patients with extradural hematoma of either gender admitted in the department during the study duration in which surgery was performed to evacuate extradural hematoma were included in the study. Data was collected by using preformed, pretested questionnaire. A vital signs and Glasgow coma scale record was maintained at thirty minutes interval. Computerized tomography was done in every patient. The EDH volume was calculated by using Peterson and Epperson equation a x b x c x 0.5. Data was entered and analyzed by using SPSS version 22. Chi square test was applied to observe any statistically significant difference between various strata if existed and p value <0.05 was taken as significant.
 Results: Total 237 patients with Extradural Hematoma (EDH) were admitted in neurosurgery department during the study period were included in study. More than half 136 (57.4%) patients were more or equal to the age of 18 years. Majority of the patients 218 (91.9%) in the study were male. Major cause of extradural hematoma among patients in this study was road traffic accident 154 (64.9%). The outcome of EDH was found to be significantly (p <0.001) associated with age of patients. More than ninety percent of the patients who were directly admitted to tertiary care hospital has good outcome as compared to 109 (60.2%) patients which were referred and difference in outcome was statistically significant (p<0.001). The volume of EDH is not significantly associated with the outcome (p=0.090). The GSC score of the patients at the time of admission is significantly associated with the outcome (p<0.001). Study findings showed that GCS score of the patients at the time of surgery was also found to be significantly associated with outcome of EDH (p<0.001).
 Conclusion: There is a strong association of outcome in extradural hematoma with age, gender and GCS of the patient. In higher GCS the outcome was excellent but in low GCS the outcome was poor.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.302

Authors: Mah Rukh Malaika Khalid Mahrukh Nadeem Mahreen Saeed Mahroo Mahroo Muhammad Hashim Ghouri

Background: Hepatitis is a major health issue. The aim of this study was to assess the knowledge, attitude and practices (KAP) of medical students regarding hepatitis B and C. Methods: A descriptive cross-sectional study conducted from March, 2018 to May, 2018. 310 medical students from Allama Iqbal Medical College participated. KAP towards Hepatitis B and C was assessed by using a pre-validated questionnaire. Association of gender and year of study was established with KAP of respondents. Also, associations of knowledge with attitude and practices were also established using Chi-square test taking ≤0.05 as standard p-value. SPSS version 21.0 was used. Results: 269 (86.77%) out of 310 distributed questionnaires were received. 116 (43.1%) respondents fell in age group 16-20, 150 (55.8%) in 21-25 years while 3 respondents (1.1%) were 25 year and above. 146 (54.3%) respondents were females and 123 (45.7) respondents were male. There were 54 (20.1%) respondents from first year, 59 (21.9%) respondents from second year, 53 (19.7%) respondents from third year, 55 (20.4%) respondents from fourth year and 48 (17.8%) respondents from final year. 132 (90.4%) female respondents and 98 (79.7%) male respondents had good knowledge regarding hepatitis B and C. No significant relationship was established between gender of respondents with their attitude and practices. As for relationship of knowledge of respondents with their attitude and practices, no significant association could be established.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v5i2.301

Authors: Zouina Sarfraz Azza Sarfraz Hafiza Hussain Fareeha Jabeen Arham Nadeem Shahar Bano Ramsha Kharal Farah Zulfiqar Sania Tariq Zainab Fatima Mehwish Zafar

Background: Pakistan established the Punjab healthcare commission to improve patient care catering to professional accountability in the public and private sectors. As per the World Health Organization, quality of care comprises of six dimensions where the care must be effective, efficient, accessible, patient-centered, equitable, and safe. Objectives: The objectives are to determine if patients are satisfied with the quality of services in public and private sectors, or if any neglect was present. Methods: The literature on patient care and satisfaction was compiled using a scoping review methodology. PubMed, CINAHL Plus, and Scopus were used to collate information. Duplicates were removed using Endnote X9. Results: Of the 467 abstracts and titles that were screened for relevance, 74 were considered for full-text review and potential inclusion in the scoping review. Out of 16 included studies, 7 (43.8%) of the included studies originated from Pakistan. The characteristics of included studies such as quality of care and patient satisfaction are tabulated. Conclusion: Current literature does not provide quality- and satisfaction- focused studies, and has methodological discrepancies. It is required that the medical profession adopt a sense of self-monitoring. Gaps in service provision must be addressed by healthcare managers, policymakers, and physicians in Pakistan.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v3i1.46

Authors: Husnain Shehzad Osheen Shehzad

Abstract: Background: Cleft lip and palate are congenital disorders which induce affected individuals medically, socially and psychologically. The objective of this study was to investigate the association of Single Nucleotide Polymorphism(SNP); rs2013162 of IRF6 Gene in Patient with Cleft Lip and Palate. Materials and Methods: Fifty patients with non-syndromic CL/P were included in present study alongwith fifty individuals with no psychiatric history as controls. In all of the these individuals, search for Single nucleotide polymorphism was carried out by designing sequence specific primers. The sequence was amplified by using Real time PCR and products were investigated by visualizing high resolution melting curve upon HRM-PCR. Results: The logistic regression and Hardy-Weinberg equilibrium were applied to investigate the association of IRF6 SNP rs2013162 with disease. Results revealed no association of this polymorphism with non-syndromic CL/P. Conclusion: We found no association of IRF6 SNP rs2013162 in patients with non-syndromic CL/P. Further study is required with larger sample size to validate the findings of the present study in Pakistani population and along with this SNP other polymorphisms of the same gene should be analyzed to find out the association with the non-syndromic CL/P.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.15

Authors: Muhammad Imran

Hundreds of thousands of research papers are published every year all over the world. Scientists give their best in the field of research. Every researcher has a valuable contribution to scientific knowledge and ultimate betterment of human being in different aspects of life. Every researcher is important for science and human being in terms of his/her contribution to research. Researchers put their brain, energy, time and resources they have. Researchers give their best to research and their contribution should be acknowledged. If researcher’s contribution is not delivered to the relevant individuals, it is useless for researcher as well as for the community. Every research needs proper platform for its recognition. Research is being recognized through conferences, seminars and publications. There are multiple platforms for this purpose.

The International Journal of Frontier Sciences doi: 10.37978/tijfs.v1i1.10

Authors: Imran Qadeer Muhammad Aslamkhan Muhammad Shoaib Akhtar Fazal Ellahi

Background: HBV, HCV, HIV and Syphilis are leading transfusion transmitted infections. Blood donors are screened against these infectious diseases before transfusion to patients.Methods: Data of general population and volunteer prisoner blood donors is retrieved from records of January 2007 to September 2009. Data is analysed using Epi Info version 3.5.1. Blood donors were screened using ELISA method against HCV, HBV, and HIV while VDRL method is used for screening against Syphilis.Results: Prevalence of HBV, HCV, HIV, and Syphilis in general population blood donors is 3.3%, 4.7%, 0.51% and 0.47% respectively. Prevalence of HBV, HCV, HIV, and Syphilis in prisoner blood donation is 7.81%. 15.42%, 1.17%, and 7.63% respectively.Conclusion: Prevalence of HBV, HCV, HIV and Syphilis is high in prisoners as compared to general population.