ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE http://www.annals-ashkmdc.org/index.php/ashkmdc <p style="font-weight: 400;">The scientific journal, Annals of Abbasi Shaheed Hospital and Karachi Medical and Dental College is a quarterly peer-reviewed journal being published for over 20 years, recognized by PMDC, HEC (Y-Category) and cited on Emerging Sources Citation Index (Thomson Reuters), IMEMR, Pakmedinet. The Editor-in-Chief is a member of World Association of Medical Editors (WAME), Eastern Mediterranean Association of Medical Editors (EMAME), and Pakistan Association of Medical Editors (PAME).</p> <p style="font-weight: 400;"><strong>ARTICLE PROCESSING:</strong></p> <p style="font-weight: 400;">The articles can be submitted online via eJManager throughout the year and on an average, it takes maximum one year to print an article. For any queries please email at annalskmdc2013@gmail.com.</p> <p style="font-weight: 400;">Ordinary Processing:</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;1. Processing Fee: Rs. 2000/-<br>&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;2.Publication Fee: Rs. 2000/- (per side of PDF)</p> <p style="font-weight: 400;">Fast Track Publication</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;1. Processing Fee Rs. 3000/-</p> <p style="font-weight: 400;">&nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp; &nbsp;2. Publication Fee Rs. 20,000/-</p> <p style="font-weight: 400;">3.Publication Fee of Pictorial Quiz: Rs. 1000/-<br>...(Include processing and Publication Both):</p> <p style="font-weight: 400;">Subscription per issue:<br>In Pakistan: Rs.1000/-<br>In Karachi: Rs.800/-<br>Bangladesh &amp; India: Rs.1200/-<br>UK: £ 40<br>USA &amp; other Countires: $ 60</p> en-US ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 1563-3241 Resuscitation Ladder–An Innovative Method of Learning Resuscitation http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/542 <p>Learning resuscitation in emergency medicine is sought with many challenges like; recall, anxiety, stress and human factors. In the current editorial an innovative learning method has been proposed for LMICs to improve resuscitation outcomes through improve practice.</p> Shahan Waheed Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 1 2 Frequency of Self-Medication and Its Associated Factors among Outpatients http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/550 <p>Objectives: To assess the frequency of self-medication and its associated factors among outpatients.</p> <p>Methods: A cross-sectional study was conducted at the outpatient department of Fatima Hospital, Baqai Medical University, from May 2019 to September 2019. After checking eligibility, a total of 360 outpatients were included in the study using the convenience sampling technique. Being aged 18 years or above and belonging to either gender were the study's inclusion criteria, whereas refusal to give verbal informed consent was the exclusion criterion of the study. The data was collected by interviewing the study participants using a structured questionnaire. Statistical package for social sciences version 21 was used for data analysis, while inferential analysis was performed using univariate and multivariable binary logistic regression.</p> <p>Results: The study results showed that 118 (32.8%) of the participants were suffering from a chronic illness, 240 (66.7%) of them kept medicines at their houses, 235 (65.3%) of them self-medicated, whereas the mean duration of their self-medication was found to be 9.90 ± 8.51 years. Moreover, age, educational status, employment status, and keeping medicines at the house were significantly associated with self-medication of the participants were those who were aged 50 years or above (AOR,7.83; 95% CI,2.27-27.04; p=0.001), able to read and write (AOR, 4.36; 95% CI, 1.58-11.98; p=0.004) and kept medicines at the house (AOR, 46.35; 95% CI, 20.07-107.06; p&lt;0.001) had significantly higher odds of self-medication than those who were aged up to 30 years, were illiterate or did not keep medicines at house respectively whereas those who were employed/self-employed (AOR, 0.30; 95% CI, 0.10-0.88; p=0.028) had significantly lower odds of self- medication than those who were unemployed.</p> <p>Conclusion: Almost two-thirds of the participants were found to be self-medicating. Moreover, age, educational status, employment status, and keeping medicines at the house were significantly associated with the self-medication of the respondents.</p> Syed Muhammad Zulfiqar Hyder Naqvi Syed Imtiaz Ahmed Jafry Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 3 9 Subtrochanteric fractures treated with dynamic condylar screw http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/247 <p>Objectives: To assess the functional outcome of dynamic condylar screws to treat subtrochanteric fractures in adult patients.</p> <p>Methods: The prospective descriptive study was conducted at the department of orthopedic surgery, Dr. Ruth KM Pfau civil hospital Karachi, Pakistan, from March 2016 to October 2019. A total of 47 patients of 18 to 60 years of either gender with subtrochanteric fractures treated with dynamic condylar screw were included in the study. After consent and counseling, patients were operated on by a consultant orthopedic surgeon and fixed with a dynamic condylar screw. Postoperatively patients were regularly followed at 2nd, 6th, 12th, 16th, 20th weeks, and onwards monthly for at least one year. Functional outcomes such as infection, union, failure of fixation were observed in all patients. SPSS software version 23 was used to analyze data. Mean and SD was reported for numeric variables, whereas frequency and percentage were reported for categorical variables. A Chi-square test was used to assess the association between variables.</p> <p>Results: The mean age was estimated as 37.53±12.31 years. Most of the patients were male (74.5%), and 25.5% were females. About 27 patients had a fracture on the right side (57.4%) and 20 on the left side (42.6%). Out 47 cases, 3 were lost to follow, 33 patients showed excellent outcomes, 6 cases had a good outcome, 3 cases had fair outcomes, and 2 cases had poor functional outcomes. During the follow-up, 42 cases showed union, 3 lost to follow-up, 1 died, and 1 patient had implant break. About 2 patients had infections in post- operative duration because of fracture.</p> <p>Conclusion: Subtrochanteric femur fractures are challenging to operate, especially in our society where extensive trauma becomes more frequent. Dynamic condylar screws showed overall acceptable results. It is simple, locally made, readily available, and cheap, with almost the same result as other implants around proximal femur fractures.</p> Badaruddin Sahito Javed Hussain Khaskheli Dileep Kumar Muhammad Tahir Lakho Muhammad Younis Arsalan Khalil Ayub Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 10 15 Experience of Women after Immediate Postpartum Insertion of Intrauterine Contraceptive Device (PPIUCD), a Long-Acting Reversible Contraception http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/310 <p><strong>ABSTRACT</strong></p> <p><strong>Objective: </strong>To assess the experience (during and post procedure) of women after immediate postpartum and post placental Insertion of intrauterine contraceptive device (IUCD), a long acting reversible contraceptive (LARC).</p> <p><strong>Methods: </strong>This prospective and longitudinal study was conducted during February 2019 to September 2019 in Gynae and Obstetrics department Unit 1 at Abbasi Shaheed Hospital. All 141 booked and non-booked patients who delivered in the hospital and received immediate postpartum intrauterine contraceptive device (PPIUCD),either post placental, intra cesarean or within 48 hours after delivery were included in the study regardless of the mode of delivery either intra-cesarean or spontaneous vaginal delivery. Written consent was taken for the contraceptive device insertion and verbal consent was taken to fill the proforma which included basic demographic information, their overall experience with postpartum intrauterine contraceptive device. Immediate experience was measured by assessing the pain during procedure and post insertion period. Further all participants were followed at six weeks and 6 months to collect information about any complains removal of IUCD and overall experience.</p> <p><strong>Results: </strong>The mean age was 27.3 years with a standard deviation (SD) of 4.42. Among all the participants, 77(54.6%) had Cesarean section and 64(45.4%) had vaginal delivery. During procedure only 5(3.5%) had complain of mild pain and no immediate post procedural complains was recorded.&nbsp; 86(73.5%) participants at 6 weeks and 78(69.03%) participants at 6 months had no complained. Overall experience was found satisfactory in 86(73.5%) participants.</p> <p><strong>Conclusion: </strong>Postpartum intrauterine contraceptive device (PPIUCD) provided satisfactory experience to majority of the women. So we recommend its use for better maternal and child health.</p> Fauzia Ali Tazeen Fatima Munim Shabnum Nadeem Aisha Khatoon Zubaida Masood Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 16 22 Quality of Life among Youths having Repaired Non-syndromic Cleft Lip and Palate in Karachi http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/535 <p><strong>Abstract</strong></p> <p><strong>Objective: </strong>To compare general quality of life of youths having repaired non-syndromic CLP with controls using a generic quality of life instrument, Youth Quality of Life – Research Version (YQOL-R).</p> <p><strong>Methods: c</strong>ase control study was conducted from January, 2017 to December, 2018. Inclusion criteria was patients having repaired non syndromic Cleft Lip and Palate, age 15 to 29 years, of either gender while controls were healthy individuals of similar age. Quality of life was measured using validated YQOL-R instrument. Data of 62 cases and 107 healthy controls, consented for study was analysed using statistical software, SPSS version 20.</p> <p><strong>Results:</strong>. Mean age was 22.09<u>+</u>5.04. Cronbach’s alpha for domains of sense of self was 0.630, relationship domain (0.795), environmental domain (0.826) and general quality of life domain was 0.688 and for YQOL-R was 0.866. Significant difference was observed for self care domain (63.10 vs. 73.50; p-value = 0.001), relationship domain (79.5 vs. 83.73; p-value = 0.013), environmental domain (70.89 vs. 84.60; p-value = 0.001), general quality of life domain (79.80 vs. 86.04; p-value = 0.012) and percent score of total perceptual score between cases and controls (73.32 vs. 81.97; p-value = 0.001).&nbsp;&nbsp;</p> <p><strong>Conclusion: </strong>Compared to cases healthy controls had a better quality of life as they have significantly better results in self care, relationship, environment and general quality of life domains along with mean perceptual percentage.</p> Syeda Arzoo Azeem Syed Mahmood Haider Zubair Ahmed Abbasi Zafar Abbas Hoor u lain Iqbal Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 23 30 Comparison of Antioxidant Effect of Crocus Sativus and Vitamin E on Amakicin Induced Nephrotoxicity in Albino Rats http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/522 <p><strong>ABSTRACT</strong></p> <p>Objectives: The present study evaluated the protective effect of Crocus Sativus against Amikacin-induced Nephrotoxicity.</p> <p>Methods: The prospective descriptive study was conducted at the department of orthopedic surgery, Dr. Ruth KM Pfau Adult laboratory albino rats of the Wistar strain were used in this experimental study. In this study, 75 albino rats were subdivided into 3 groups, including experimental groups B and C. The control group (A) received normal saline intraperitoneally, group (B) received Amikacin 30mg/kg body weight intraperitoneally and Group (C) received Crocus sativus 50 mg/kg body weight orally and vitamin E orally in a dose of 50mg/kg of body weight. Kidneys of rats obtained after dissection were processed, sectioned, and stained in PAS Hematoxylin and Gomoris Methenamine Silver stains. The present study was conducted at Dow University of Health Sciences in the Institute of Biomedical Sciences and Animal House of Dow University and Dow Diagnostic Research and Reference Laboratory. The duration of the study was Three months. Inclusion criteria were Albino rats of both sexes, kidneys of either side (right &amp; left), rats with an approximate weight of 140 to 180 grams were included in the study. Exclusion criteria were overweight rats and pregnant rats.</p> <p>Results: A significant increase in kidney weight was observed in group B. A considerable addition was observed in proximal tubular in groups B and C. A considerable increase was also observed in the number of intact proximal tubule nuclei and the nuclear diameter of groups B &amp; C.</p> <p>Conclusion: The study provides evidence that Crocus Sativus has protective effects in Amikacin-induced nephrotoxicity, comparable to widely used Antioxidant Vitamin E. The study recommends the addition of Crocus Sativus in dietary supplements after further evaluation in human subjects.</p> Muhammad Kamran Naheed Khan Hina Jabeen Nasrul Huda uda Sadia Iqbal Ashhad Mazhar Siddiqi Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 31 39 Effect of Ascorbic Acid on Methylphenidate Induced Decreased Spermatogenesis in Albino Rats http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/531 <p>Objectives: This study aimed to evaluate the anti-oxidative potential of ascorbic acid on methylphenidate induced decreased spermatogenesis and decreased testosterone levels in male Albino rats.</p> <p>Methods: This experimental study was performed on twelve-week-old Albino male rats selected through randomized sampling technique divided into three groups. Only healthy male rats of the same age and weighing between 180 to 200 gms were included, and any rat was appearing sick or had less weight than 180gms and aged less than 12 weeks were excluded. Control group A received 2 ml of normal saline for 50 days. Group B was given 2mg/day methylphenidate per oral for 50 days, and Group C received 2mg /day methylphenidate for 50 days, then ascorbic acid 50mg/day for 10 days. After 60 days, rats were dissected, testes were removed and histologically examined for spermatogenesis by Johnson's scoring, and blood samples were collected to evaluate testosterone levels.</p> <p>Results: On histological examination, the testes of animals of Group B showed a statistically significant decrease in Johnson's score (p-value &lt; 0.001) with disruption of germinal epithelium and absence of mature sperms. These findings were associated with reduced levels of serum testosterone in this group. Administration of Ascorbic acid (AA) to group C showed statistically improved Johnson score and testosterone levels compared to group B.</p> <p>Conclusion: It has been concluded that administering Ascorbic Acid can improve decreased spermatogenesis and serum testosterone levels induced by methylphenidater</p> Sadia Iqbal Uzma Hameed Muhammad Kamran Lubna Faisal Sara Moeen Nasarul Huda Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 40 45 Comparative efficacy of the Antiplaque Effect of Natural Honey Mouthwash and Chlorhexidine Mouthwash. A randomized controlled trial http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/541 <p>Objectives: To compare the efficacy of natural Honey (10%) and chlorhexidine mouthwash (0.12%) on the dental plaque levels. Moreover, to evaluate the efficacy of natural Honey and chlorhexidine mouthwash on the level of dental plaque.</p> <p>Methods: This study was a single-centered randomized controlled trial conducted on participants attending the Dental OPD of Dar-ul-Sehat hospital in Karachi. A total of 60 participants were included in the trial from June 2020 to December 2020. The sample size was calculated using openepi after entering the mean and SD of the honey and chlorhexidine groups. The study included sixty male and female participants ranging in age from 18 to 25 years, and those with medical illness, missing teeth, and antimicrobial history were excluded from the study. The subjects were randomly assigned to two groups: Natural Honey or Chlorhexidine gluconate mouthwash. The data was collected at the baseline and 14th day; the plaque was revealed using a disclosing solution. Their scores were recorded at four sites per tooth using the Silness-Loe plaque index criteria. Later, statistical analysis was performed to compare the effects of the two groups. P ≤ 0.05 was considered statistically significant.</p> <p>Results: Our findings revealed that both groups effectively lowered the plaque score. However, it showed a more significant reduction in plaque indices in the honey group on Day 14 when compared to chlorhexidine mouthwash.</p> <p>Conclusion: Honey has been identified as a potent antibacterial agent with therapeutic properties. Based on the findings of this study, it is possible to conclude that gargling with the original honey 10% solution is effective in lowering dental plaque score. Honey can be used in relation to conventional treatments to protect dental plaque and gingivitis. More research will be needed to back up these preliminary findings. Moreover, the synergistic effect of Chlorhexidine with natural Honey must be investigated</p> Muhammad Abid Saima Quareshi Tazeen Zehra Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-03-04 2022-03-04 27 1 46 52 Age Related Homocysteine Serum Levels Elevate in Men with Epilepsy http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/544 <p><strong>Objective:</strong> The purpose of the present study was to determine the correlation of age with serum homocysteine (Hcy) levels in male nonobese epilepsy (Ep) patients and nonobese male control (C) subjects.</p> <p><strong>Methods:</strong> This case-control study was conducted in non-obese male epilepsy patients (Ep; n: 44; age: 26-40 years) having predominant grand mal (generalized tonic-clonic) seizures, and in control subjects (C; n: 42; age: 26-40 years). The Ep and C subjects were further subdivided into age-based subgroups: 26-30, 31-35, 36-40 years. Determination of serum Hcy was carried out by enzyme linked immunosorbent assay (ELISA). SPSS software version 24 was used for the purpose of data entry/ statistical analysis.</p> <p><strong>Results:</strong> The mean± SD values for serum Hcy (μmol/L) in male Ep (n:44) and male C subjects (n:42) were 12.34±3.34 and 9.16±3.38 respectively, that showed highly significant increase in the level of Hcy (p&lt; 0.001) in Ep compared to C subjects. Serum Hcy levels showed significant increased serum levels of Hcy, and positive linear correlation in all age groups (26-30, 31-35, 36-40, 26-40) in Ep subjects compared to control subjects. However, significantly elevated serum Hcy and lesser association (though significant) of Hcy with age in Ep group as compared to C subjects was found in the present report.</p> <p><strong>Conclusion:</strong> Present study provides evidence of the significant impact of age on serum homocysteine levels in nonobese epilepsy patients. However, it is essentially required to carry out well controlled studies comprising wider age range data, and large number of samples in each age subgroup to have better idea about the potential impact of Hcy in epilepsy, and to investigate the comparative effects of AEDs and dosages of AEDs on serum levels of Hcy and vice versa.</p> Zahir Hussain Shabbir Ahmed Abdulhalim S. Serafi Samir Mohammed Abdulfattah Attia Sumera Sohail Nuvair Zia Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 53 57 Pictorial Quiz http://www.annals-ashkmdc.org/index.php/ashkmdc/article/view/551 Bushra Zafar Sayeed Qazi Muhammad Akhtar Sayeed Copyright (c) 2022 ANNALS OF ABBASI SHAHEED HOSPITAL AND KARACHI MEDICAL & DENTAL COLLEGE 2022-02-28 2022-02-28 27 1 58 58