Volume 8 Issue-3 2019

  • Editorial
  • Original Article
  • Critical Research Periodical
  • Review Article
  • Kap Study
  • Case Reports
  • Student Corner
  • Medical Education

 

The articles for the PJMD Volume 8 Issue 4 2019 are listed below. The articles are in PDF Format which requires Adobe Acrobat Reader for viewing.

EDITORIAL

THE INVISIBLE WOMEN IN MEDICAL WORKFORCE: TIME FOR ACTION

With the advent of social media, a number of platforms are available for medical graduates to connect with each other in order to engage in formal and informal discussions related to the profession. There are many close groups managed by associations, institutions as well as there are ones privately managed by individuals and teams. Among privately created groups what stands out for me are the ones for female medical doctors from Pakistan.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Zarrin Seema Siddiqui
    • VinUniversity – Health Sciences Project Vietnam, the University of Western Australia, Australia.

ORIGINAL ARTICLE

ASSOCIATION OF HIGH RISK HUMAN PAPILLOMA VIRUS (HPV-16/18) WITH P16 PROTEIN IN ORAL PREMALIGNANT LESIONS AND ORAL SQUAMOUS CELL CARCINOMA

Background:

Oral cancer is a major problem globally. The strong causal association with tobacco, prevalent in Pakistan makes it imperative to know the role of molecular events in oral oncogenesis. We aim to evaluate high risk HPV 16/18 and p16 in oral premalignant lesions (OPL) and oral squamous cell carcinoma (OSCC). We further analyze the association between high risk human papilloma virus (HR-HPV16/18) and p16 in OPL and OSCC.

Methods:

A total of 100 OSCC and 50 OPL cases were included. Demographic data along with habitual exposure to smoked and chewable tobacco, betel and gutka etc., was noted. We evaluated p16 in OPL and OSCC by immunohistochemistry, HPV was detected by polymerase chain reaction. Data was entered and analyzed using SPSS 21. Chi square and Fisher exact were applied to determine the association of HPV and p16 with different variables.

Results:

Out of 50 OPL, 14% were positive and 86% were negative for p16 whereas out of 100 OSCC, 18% were positive and 82% were negative. Out of 50 OPL, HPV was detected in 6% whereas out of 100 OSCC, 15% were positive. Highly significant co expression of HPV with p16 was observed in all 15 (100%) HPV positive OSCC cases (p = 0.001). However, 3 out of 18 cases, which showed p16 expression, did not show HPV infection.

Conclusion:

Role of p16 as a surrogate marker for HPV in OSCC can be supported in the present study. Moreover a Chemical carcinogen like tobacco is considered as major associative risk factor with p16 and HPV in concert.

Keywords:

Human Papilloma Virus (16/18); P16; Oral Premalignant Lesions; Oral Squamous Cell carcinoma.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Saadia Akram
  • Asma Shabbir
    • Department of Pathology, Sindh Medical College, Jinnah Sindh Medical University, Karachi,
  • Talat Mirza
    • Dean of Research Department, Dr. Ziauddin Hospital and University, Karachi, Pakistan.

ASSOCIATION OF MULTI-MORBIDITIES WITH SEPSIS IN ADULT PATIENTS ADMITTED IN A TERTIARY CARE HOSPITAL, KARACHI

ABSTRACT

Background:

Multi-morbid chronic diseases are increasingly placing a greater burden on individuals, communities and health care services. With advancing medical facilities, a growing proportion of the population is surviving longer with multiple chronic diseases. Sepsis is a life threatening infection with multiple organ dysfunctions leading to very high morbidity and mortality. Treating patients with multi-morbidities have always been more difficult when compared to patients with no co-morbid conditions. Hence, data from this study will empower us in exhibiting effective plans in the management of multi-morbidities with sepsis in our region. The study is aimed to determine the association of multi-morbidities with sepsis in adult patients admitted in a tertiary care hospital.

Methods:

This is a case-control study conducted in the Medicine Wards and Intensive Care Unit of a tertiary care hospital in Karachi during the period of May 2018 to October 2018.

Results:

In this study, 52 patients were enrolled. The mean age of patients was 59.35 ± 6.17. Socioeconomic Status showed significant association (p-value 0.034). The mean Sequential Organ Failure Assessment (SOFA) Score was 2.13 ± 1.86. The odds ratio of having cancer [OR: 3.10 (0.10 – 80.1), p-value 0.50] and other multimorbidities like rheumatoid arthritis [OR: 3.30 (0.30 – 33.6), p-value 0.32] in cases of sepsis respectively were more than in controls but the data was not statistically significant. The mean length of hospital stay was 4.71 ± 2.08.

Conclusion:

Despite our study limitations, a strong association of socioeconomic status with cases and controls in admitted patients was seen and among them, the upper income groups were the most. Although, an association of cancers and multimorbidities like rheumatoid arthritis with cases and controls has been identified, it requires to be researched further. Consensus regarding the definition of multimorbidity should be made.

Keywords:

Multimorbidities; Sepsis; Age; Socioeconomic Status; SOFA Score; Cancers; Rheumatoid Arthritis; Length of Hospital Stay.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Shan-Ul-Haq Siddiqui
  • Ejaz Ahmed Vohra
    • Department of Medicine, Dr. Ziauddin Hospital, North Nazimabad Campus, Karachi
  • Farah Ahmad
    • Department of Community Health Science, Ziauddin Medical College, Ziauddin University.

HIGH FREQUENCY OF OSTEOPENIA IN YOUNG ADULTS OF KARACHI

ABSTRACT

Background:

Osteopenia or low bone density, generally considered the disease of the old, is now sneaking around the younger generation. The increase in frequency of low trauma fractures is raising an alarm. This study was aimed to explore the frequency of osteopenia amongst young adults in Karachi, Pakistan.

Methods:

Non-probability consecutive sampling was used to choose 116 subjects at Ziauddin University, Karachi, in January 2018. After informed consent participants underwent bone scans for measurement of bone mineral density on their calcaneus (bone in heel). Tocategorize osteopenia T-score between -1.0 and -2.5 was evaluated. All participants with T-score of -2.5 or below were identifiedas osteoporotic. The data were entered on IBM SPSS statistics version 20.0 and descriptive analysis was done.

Results:

Osteopenia was detected in 57 (49.1%) of the participants [42 (36.2%) male and 15 (12.9%) female] of which 38 (32.8%) belonged to aged 21 to 35 years. Osteoporosis was found in 20 (17.2%) of this group. In the older participants’ frequency of osteopenia and osteoporosis was 12.2% and 42.9% respectively. Chi square test indicated no significant association between age and bone scan results (p=0.432). Frequency of osteopenia was higher in males (56%) compared to females (36.6%) whereas, osteoporosis was higher in females (53.7%) than males (12%). Results showed statistically significant association (p>0.01) with gender and bone scan results.

Conclusion:

Almost half the young adults in our study classified for osteopenia. Lifestyle modification factors are hypothesized to play an important role towards this high frequency. Further studies should evaluate risk factors for osteopenia in younger population.

Keywords:

Osteopenia; Osteoporosis; Bone Mineral Density.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Moazzam Ali Shahid
    • Department of Research, Ziauddin University
  • Asma Niaz Khan
    • Department of Anatomy, Mohi-ud-Din Islamic Medical College, Mirpur, Azad Jammu and Kashmir (AJK)
  • Maheen Nisar
  • Mustafa Ali Shah
  • Preet Roshan
    • Student, Ziauddin University
  • Saeeda Baig
    • Department of Biochemistry, Ziauddin University, Karachi, Pakistan

SILORANE INCORPORATED WITH HYDROXYAPATITE AND FLUOROAPATITE –TO INVENT A NEW BIOACTIVE RESTORATIVE MATERIAL

ABSTRACT

Background:

There were a number of restorative materials, which were fulfilling the requirements of a dental restorative material partially or somewhat completely with some limitations. 3M ESPE recently introduced a new dental restorative material, Filtek™ Silorane, which was claimed to fulfil the main objective completely, which was even confirmed by the recent studies. In order to make the best available dental restorative material an ideal restorative material it has to be bioactive. This study has been planned for the invention of a Silorane based bioactive material. It was proposed to incorporate the known bioactive materials (Hydroxyapatite and Fluoroapatite) in Silorane and analyze its chemical characterization. The main objective of a restorative dental material is to restore the function and aesthetics of the dental patient.

Methods:

Hydroxyapatite and Fluoroapatite were synthesized and incorporated in Silorane by 5, 10, 40, 50 and 60% weight ratio. The resultant samples were chemically analyzed by FTIR and Raman Spectroscopy.

Results:

The incorporation of synthesized Hydroxyapatite and Fluoroapatite into Silorane resulted in the innovation of a new bioactive restorative material. The resultant FTIR and Raman spectra shows that the Silorane incorporated by 40, 50 and 60% hydroxyapatite and fluoroapatite were altering the chemical structure of Silorane while spectrum of the samples with 5 and 10% of hydroxyapatite and fluoroapatite shows the apatites presence without changing the chemical structure of Silorane.

Conclusion:

A novel bioactive restorative material was invented by the incorporation of synthesized nano-Hydroxyapatite and Fluoroapatite into Filtek™ Silorane. The chemical characterization showed that bond was formed between the apatites and siloxane functional groups which results in the best available dental restorative material.

Keywords:

Silorane; Hydroxyapatite; Fluoroapatite; FTIR Spectroscopy; Raman Spectroscopy.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Shoaib Khan
    • Department of Science of Dental Materials, Ziauddin College of Dentistry,
  • Madiha Pirvani
    • Department of Science of Dental Materials, Dow International Dental College, Dow University of Health Science,
  • Saad Bin Irfan
    • Department of Operative Dentistry, Ziauddin College of Dentistry,
  • Saima Akram
    • Department of Oral Pathology, Ziauddin College of Dentistry,
  • Mariam Qidwai
  • Mohammad Asif Nathani
    • Department of Science of Dental Materials, Altamash Institute of Dental Medicine, Karachi, Pakistan.

PREVALENCE OF CARBAPENEM-RESISTANT ACINETOBACTER BAUMANNII (CRAB) IN MEDICAL AND SURGICAL INTENSIVE CARE UNITS (ICUS) OF JPMC, KARACHI

ABSTRACT

Background:

Antimicrobial resistance is one of the research priorities of health organizations due to increased risk of morbidity and mortality. Outbreaks of nosocomial infections caused by carbapenem-resistant Acinetobacter Baumannii (CRAB) strains are at rise worldwide. Antimicrobial resistance to carbapenems reduces clinical therapeutic choices and frequently led to treatment failure. The aim of our study was to determine the prevalence of carbapenem resistance in A. baumannii isolated from patients in intensive care units (ICUs).

Methods:

This cross-sectional study was carried out in the Department of Microbiology, Basic Medical Sciences Institute (BMSI), Jinnah Postgraduate Medical Centre (JPMC), Karachi, from December 2016 to November 2017. Total 63 non-repetitive A. baumannii were collected from the patients’ specimens, admitted to medical and surgical ICUs and wards of JPMC, Karachi. The bacterial isolates were processed according to standard microbiological procedures to observe for carbapenem resistance. SPSS 21 was used for data analysis.

Results:

Out of the 63 patients, 40 (63.5%) were male. The age of the patient ranged from 15-85 year, with average of 43 year. 34.9% patients had been hospitalized for 3 days. Chronic obstructive pulmonary disease was present in highest number with average of 58.7% for morbidity. Number of patients on mechanical ventilation was highest (65.1%). All isolates were susceptible to colistin. The resistance to ampicillin-sulbactam, ceftazidime, ciprofloxacin, amikacin, piperacillin- tazobactam and meropenem was 82.5%, 81%, 100%, 87.3%, 82.5% and 82% respectively. Out of 82% CRAB, 77% were obtained from ICUs.

Conclusion:

This study has revealed the high rate of carbapenem resistance in A. baumannii isolates in ICUs thus leaving behind limited therapeutic options.

Keywords:

Acinetobacter Baumannii; Carbapenem Resistant; Nosocomial Infections.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Zahida Shaikh
    • Department of Pathology, Liaquat University of Medical and Health Sciences, Jamshoro,
  • Rabia Arshad
    • Department of Pharmacology, Altamash Institute of Dental Medicines,
  • Fakhur Uddin
    • Department of Microbiology, Basic Medical Sciences Institute, Jinnah Post Graduate Medical Center, Karachi,
  • Mohammad Asif Durrani
    • M. Islam Medical College, Sialkot, Pakistan.

OVARIAN CANCER: MOST FREQUENTLY SEEN GYNAECOLOGICAL MALIGNANCY IN ZIAUDDIN HOSPITAL, NORTH NAZIMABAD

ABSTRACT

Background:

The prevalence of genital tract malignancies is rising worldwide making it one of the most common malignancies in females after breast cancer. Despite cervical cancer being the most commonly occurring cancer globally, a multitude of studies in Pakistan have identified ovarian cancer as the most commonly occurring malignant tumor. The morbidity and mortality rates from genital tract tumors are considerably higher in developing countries. In developed countries, screening tests for early diagnosis of a malignancy followed by effective treatment are readily available. The objective of this study is to study the pattern and relative frequency of the malignancies involving the genital tract among women admitted to Ziauddin Hospital in 2015.

Methods:

The study is a retrospective, observational analysis of the case files of female patients admitted into Ziauddin University Hospital, North Nazimabad. The patients coming to the OPD have been followed for the last 3 years to check for the suspected presence of a genital tract malignancy.

Results:

A total of 55 patients over the last three years were confirmed to have some form of genital tract malignancy. Ovarian cancer accounted for 49% of the outcome, with around 23.6% of the cases diagnosed at stages 3 and 4. Endometrial cancer was the second most common cancer, with 27.2% being diagnosed at stage 1. Cancers of the cervix and vulva accounted for 3.6% and 1.8% respectively. No cancer of the vagina was documented.

Conclusion:

The most common genital tract malignancy in female patients at Ziauddin University Hospital is ovarian cancer, in contrast to the vast majority of developing countries where cervical cancer is the leading cause of genitourinary malignancies.

Keywords:

Cancer of Cervix; Endometrial Carcinoma; Malignancy; Ovarian Cancer.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Shama Chaudhry
  • Hina Rajani
  • Rubina Hussain
    • Department of Obstetrics and Gynecology, Ziauddin University Hospital,
  • Azlaan Naqvi
    • Student, Ziauddin University, Karachi, Pakistan.

ANTI HYPERGLYCEMIC AND ANTI DYSLIPIDEMIC EFFECTS OF FLAX SEEDS (LINUM USITATISSIMUM) EXTRACT IN DIABETIC RATS MODEL

ABSTRACT

Background:

Herbal medications, due to their various biologically active components and less toxic profile, have been popular amongst researchers since decades. One good example is Linum usitatissimum (Lu) commonly known as Flaxseeds. The aim of present study was to assess the anti hyperglycemic and anti dyslipidemic activities of ethanolic extract of flax seeds (Linum usitatissimum) in streptozotocin induced diabetic rat model.

Methods:

The ethanolic extract of flax seeds (Linum usitatissimum) at a dose of 200 mg/kg and 400mg/kg were given to the streptozotocin-induced diabetic rats for the period of 28 days. FBS, insulin, HbA1c, lipid profile and serum amylase were evaluated and were compared with positive and negative controls and standard drugs like Glimepiride 0.1 mg/kg b.w., Metformin 10mg/kg b.w. and Rosuvastatin 10mg/kg/day b.w.

Results:

Both doses of flax seeds 200 mg/kg and 400 mg/kg (Linum usitatissimum) extracts demonstrated significant (p<0.001) decrease in FBS of diabetic rats. Mainly Linum usitatissimum at the dosage of 400 mg/kg b.w. showed good efficacy in declining fasting blood glucose levels which was comparable with standard anti hyperglycemic drugs. Both doses of herbal extracts also showed significant decline in triglycerides, total cholesterol, and low-density lipoprotein (LDL-C), very low-density lipoproteins (VLDL-C), and serum amylase levels with prominent improvement in HDL-C levels in diabetic rats compared to positive controls.

Conclusion:

This study reveals that the flax seeds (Lu) at the dose of both 200mg/kg and 400mg/kg have noteworthy potential to reduce hyperglycemia and dyslipidemia associated with diabetes, therefore may be it is useful in the management of Type-2 diabetes mellitus.

Keywords:

Diabetes Mellitus; Dyslipidemia; Hyperglycemia; Flax Seeds.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Jabbar Ahmed Qureshi
  • Zahida Memon
  • Kauser Ismail
    • Department of Pharmacology, Ziauddin Medical College, Ziauddin University, Karachi,
  • Shanza Agha
    • Department of Obstetrics and Gynecology, Dr. Ruth KM Pfau Civil Hospital, Karachi,
  • Fizza Saher
    • Department of Oral Biology, Ziauddin Dental College, Ziauddin University, Karachi,
  • Vanita Motiani 
    • Student Ziauddin College of Medicine, Ziauddin University, Karachi, Pakistan.

EFFECTIVE DOSE OF STREPTOZOTOCIN FOR INDUCTION OF DIABETES MELLITUS AND ASSOCIATED MORTALITY RATE IN WISTAR ALBINO RATS

ABSTRACT

Background:

To understand severity and complications of diabetes mellitus and to analyze effects of drugs, it is necessary to create diabetic animal model. There are different doses of streptozotocin to induce diabetes mellitus in rats that may be associated with mortality or may be insufficient for induction of DM. The objective of our study was to optimize the dose of streptozotocin to create a diabetic animal model with sustained hyperglycemia and to document the toxic dose at which there may be high mortality rate.

Methods:

This experimental animal study was conducted at animal house, faculty of pharmacy Ziauddin University Karachi in April 2019. The sample size included 30 albino wistar rats divided into five Groups A, B, C, D and E “with 6 rats each group”. Group A was the control, while streptozotocin at different concentrations was administered intraperitoneally in Group B, C, D and E respectively. Blood sample was drawn from lateral tail vein of animals and hyperglycemic profile was checked on 2nd, 4th, 6th, 8th and 10th day.

Results:

When compared to control Group A, hyperglycemic profile (blood glucose level >180) was achieved in Group B, C, D and E after 48 hours. High mortality rate was observed in Group E followed by Group D. Group C had persistent hyperglycemia while Group B had reversible hyperglycemic profile.

Conclusion:

Intraperitoneal dose of streptozotocin 60 mg/kg created diabetic animal model with persistent hyperglycemia. However, dose above increased the mortality rate and below failed to create diabetic animal model.

Keywords:

Dose Optimization; Streptozotocin; Diabetic Animal Model; Persistent Hyperglycemia.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Akhtar Ali
  • Zahida Memon
  • Shehla Shaheen
  • Kauser Ismail
    • Department of Pharmacology, Ziauddin Medical College, Ziauddin University,
  • Farah Ahmed
    • Department of Community Health Science, Ziauddin Medical College, Ziauddin University,
  • Shanza Agha
    • Department of Obstetrics and Gynaecology, Dr. Ruth KM Pfau, Civil Hospital Karachi, Pakistan.

TYPE II DIABETES MELLITUS: A WARNING SIGN FOR DEPRESSION

ABSTRACT

Background:

People with type 2 diabetes compared to those without seem to have more chances of developing depressive symptoms. Diabetes leads to depression or vice versa, remains an unsolved puzzle. Diabetes and depression together leave deep psychological and physical imprints on their victims leading to functional limitation, poor quality of life and raised mortality rate. Diabetic patients should be warned by the physicians to keep a watch for the development of depressive symptoms in them. The study aimed to investigate the relationship between type 2 diabetes mellitus and depression.

Methods:

The cross sectional study was conducted at Ziauddin University Hospital over a period of six months. Sample size of 100 was taken. Details of participant’s demographics along with Body Mass Index were recorded. Questionnaires were filled by researchers. SRQ 20 depression scale was used to diagnose depression. Data was entered and analyzed by version 20 of SPSS.

Results:

Different demographic and social variables were assessed in this study. 100 patients with HbA1c <6.5% were taken and 100 with ≥ 6.5%. 73 (36.5%) patients out of the total sample were depressed, almost from the good glycemic control group. Only a quarter of patients that had normal HbA1c levels became depressed however 48% patients with poor glycemic control suffered depression.

Conclusion:

Research concludes that co-morbid diabetes and depression is not a rare finding. Risk factors must be ruled out and the chances to develop depression should be identified at an earlier stage before complications worsen the condition.

Keywords:

Depression; Type 2 Diabetes Mellitus; Risk Factors.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Aisha Khan Jadoon
  • Fasiha Sohail
  • Arzu Jadoon
  • Misbah Vaqar Patoli
  • Faisal Ziauddin
  • Sumera Nawaz Qabulio
    • Ziauddin University, Karachi,
  • Amber Aamir
    • Fazaiya Medical College, Islamabad, Pakistan.

CRITICAL RESEARCH PERIODICAL

IS tRNA DRIVING BREAST CANCER PROGRESSION?

ABSTRACT

This critical research periodical is mainly based on critical review of research article titled ‘Modulated Expression of Specific tRNAs Drives Gene Expression and Cancer Progression published in Cell by Goodarzi et al1. According to Globocan, 2008 report2, breast is among the leading site of new cancer cases and deaths (691,300/268,900) in females of developing countries and second leading site in USA (Globocan, 2012)3. The extensive research is in progress on different aspects of molecular mechanism of driving forces and different treatment modalities to ease this burden. The above mentioned research article is also part of this effort.

Keywords:

tRNAArgCCG; tRNAGluUUC; tRFs; MDA-LM2; CNLM1a.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Zil-e-Rubab
    • Departmentof Biochemistry, Ziauddin University, Karachi, Pakistan,
  • Sema Yilmaz
    • Department of Pediatric Hematology/Oncology, Kartal Lutfi Kirdar Research and Education Hospital Istanbul, Turkey

REVIEW ARTICLE

INTERVERTEBRAL DISC DEGENERATION LINKED TO STRUCTURAL GENE VARIATIONS

ABSTRACT

During the recent past focus has shifted from identifying intervertebral disc degeneration as being caused by physical exposure and strain to being linked with a variety of genetic variations. The objective of this review is to provide an up to date review of the existing research data regarding the relation of intervertebral disc degeneration to structural protein genes and their polymorphisms and thus help clearly establish further avenues where research into causation and treatment is needed. A comprehensive search using the keywords “Collagen”, “COL”, “Aggrecan”, “AGC”, “IVDD”, “intervertebral disc degeneration”, and “lumbar disc degeneration” from PubMed and Google Scholar, where literature in the English language was selected spanning from 1991 to 2019. There are many genes involved in the production of structural components of an intervertebral disc. The issues in production of these components involve the over-expression or under-expression of their genes, and single nucleotide polymorphisms and variable number of tandem repeats affecting their structures. These structural genes include primarily the collagen and the aggrecan genes. While genetic and environmental factors all come into play with a disease process like disc degeneration, the bulk of research now shows the significantly larger impact of hereditary over exposure. While further research is needed into some of the lesser studied genes linked to IVDD and also the racial variations in genetic makeup, the focus in the near future should be on establishment of genetic testing to identify individuals at greater risk of disease and deliberation regarding the use of gene therapy to prevent disc degeneration.

Keywords:

Intervertebral Disk Degeneration; Collagen; Aggrecan.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Shahzad Shoukat Nayani
    • Department of Community Health Sciences, Ziauddin University
  • Saeeda Baig
    • Department of Biochemistry, Ziauddin University, Clifton, Karachi, Pakistan.

HAZARDS IN DENTISTRY – A REVIEW

ABSTRACT

The comprehensive and multidisciplinary approach of occupational health has the aim of protecting and promoting worker’s health. Workers live productive lives when they have assurance of their physical, social and mental wellbeing. The profession of dentistry has many occupational hazards. Different risks associated with dental medicine and dental surgery includes biological, chemical, physical, biomechanical and psychological factors. Biological risk factors may include viruses, bacteria, prions and fungi, which may cause various infections ranging from less harmful to life threatening. Health affecting chemical factors includes dental materials, medicines and disinfectants, which can cause allergies, hypersensitivity reactions, skin diseases, burns and injuries. Ionizing and non-ionizing radiation, noise, artificial lighting and dental filling curing lights are some of the physical hazards in dentistry that threaten workers lives and can cause sight and hearing problems along with other disorders. Improper posture during work, repetitive movements, prolonged mechanical straining, vibrations, etc. are some biomechanical factors, which can lead to musculoskeletal disorders, disorders of the neurological system and other health problems etc. In order to reduce such occupational perils, it is necessary to create awareness among dental workers through different awareness programs including seminars, workshops etc.

Keywords:

Occupational Hazards; Dental Professionals; Needle Stick Injuries; Ergonomics, Musculoskeletal

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Angabeen Anjum,
  • Saima Akram Butt,
  • Fizza Abidi
    • Department of Oral Pathology, Ziauddin College of dentistry, Ziauddin University, Karachi, Pakistan

KAP STUDY

ASSESSMENT OF DENTAL ANXIETY IN PRE AND POST DENTAL TREATMENT

ABSTRACT

Background:

Dental anxiety is an affecting condition that aid normal persons to protect themselves in opposition to multiplicity of threats and pressure. The study aimed to assess the prevalence of dental anxiety in pre and post dental treatment.

Methods:

A total of 210 patients were selected who are first and/ or second visited for any dental complain. The selected patients were divided into two groups. Group I: pre-treatment Group II: post-treatment. In pretreatment 42.8 % male and 3.2% female was selected for the study. While 20.9 % male and 23.8 % female were selected for study in post-treatment. Corah’s Dental Anxiety Scale (DAS) is used to assess the anxiety among the study population. Anxiety level is categorized into moderate, high and severe anxiety score.

Results:

The research found significant results in moderate, high and severe anxiety score in pre treatment group while severe anxiety score was observed in post-treatment group. Significant mean differences were observed in pre and post treatment anxiety group when compared with control while no changes were observed between pre and post treatment. A strong but negative correlation was observed in 15-20 years (male) with anxiety score in pretreatment group while negative strong correlation was observed in (female) 20-30 years anxiety post treatment group. A strong negative correlation was observed in unmarried / married male and female in pretreatment group. While positive strong correlation was observed in married female in post-treatment group.

Conclusion:

The results of this study are not representative of dental anxiety subjects during pre and post treatment. The prevalence of dental anxiety is obvious in married female however; it may be controlled by the positive attitude and behavior of dentists.

Keywords:

Dental Anxiety; Pre Treatment; Post Treatment; Anxiety Scor

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Shafaq Noori
  • Sundas Aasim
  • Abdur Rehman
  • Amaan Ullah Siddiqui
    • Muhammad Bin Qasim Medical and Dental College, Karachi, Pakistan.

ASSOCIATION BETWEEN LACK OF SEX EDUCATION AND WATCHING OF ADULT THEMED CONTENT AMONGST YOUNGSTERS IN PAKISTAN

ABSTRACT

Background:

Sex education is based on addressing the issues relating to human sexuality or other sexual activity includes reproductive health, emotional relations, reproductive rights and responsibilities, abstinence, consent and birth control. Youngsters, a vulnerable age group, experiment and engage in risky activities such as seeking information from adult themed content and pornography sources. Since, no study has addressed this subject thus; our study aims to see if there is an association between watching of pornography and lack of sex education among youngsters in Pakistan.

Methods:

The sample 151 at 95% confidence level consisted of both male and female participants (ages of 16-24 years). The data collection tool used in this study was an online questionnaire. Chi square was used to develop an association between lack of sex education and watching of adult themed content. All tests were significant when p<0.05.

Results:

Out of 151, only 46 (30.5%) had sex education. Options regarding what the person was told or taught to learn about sex education, 12 (7.9%) marked ‘puberty and adolescence’, while 116 (76.8%) were not comfortable asking their parents or guardians about sex education. A majority 102 (67.5%) participants have watched adult themed content. Additionally, 50 (33.1%) were introduced to adult themed content through their friends whereas, 46 (30.5%) by watching movies.

Conclusion:

The findings of our study show that young people want to learn about their sexual health and that lack of proper sex education does lead to a buildup of curiosity, which is satisfied by going on the internet, most often misleading the seeker towards pornography and other adult themed content.

Keywords:

Sex Education; Adult; Reproductive System; Pornography.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Syed Muhammad Ehsan
  • Sana Ahmed
  • Areebah Asim
  • Madhuri Devi
  • Farah Ahmad
    • Ziauddin Medical College, Ziauddin University, Karachi, Pakistan.

CASE REPORT

ROLE OF RETINOL AND TOCOPHEROL IN COMBATING SMOG CAUSED ILLNESS AMONG YOUNG WOMAN

ABSTRACT

Retinol and Tocopherol are commonly known as fat soluble Vitamin A and D. This research was undertaken with the objective to study Vitamin A and D’s effect in combating smog caused illness among females. This case report highlights diseases caused among young woman of Lahore due to smog. Hypothesis formulated for this study was accepted after testing that intake of daily-recommended amount of Vitamin A and D by females helps them in fighting diseases caused by smog. An intervention based on Food and Nutrition Board’s Recommended Dietary Allowances (RDAs) was planned. After the analysis of data by SPSS and excel, it was indicated that women could fight smog caused diseases better by including Vitamin A and D in their daily diet. It was also found that a strong positive correlation existed between good health condition among females and intake of Vitamin A and D.

Keywords:

Retinol; Tocopherol; Smog; Public Health; Smog Caused Illness.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Bisma Laeeque
  • Asma Akmal
    • College of Home Economics, Lahore,
  • Zirgham Masood
    • University of Central Punjab, Lahore,
  • Laeeque Chaudhary
    • District Health Officer, Kasur, Punjab,
  • Zainab Jamil
    • Lahore College for Women University, Jhang, Punjab, Pakistan.

DUODENAL TUMOR IN GASTROINTESTINAL STROMAL TUMORS: A RARE CASE

ABSTRACT

Gastrointestinal stromal tumors are commonly developed in gastrointestinal tract but in duodenum is less than 3% of all gastrointestinal neoplasm. The early diagnostic criteria are very difficult in these tumors in worldwide and being a challenge for medical team due to difficult anatomical structure of duodenum. The study’s aim is to know the incident rate of duodenal gastrointestinal stromal tumors. The average age of these tumors is more than 40 years but in the current case, 19-years old female patient present with complaint of melena and anemia. Her family history was negative. She was diagnosed by scope test of oral gastric duodenum with biopsy, abdominal x-rays, computerized tomography scan and histopathology. The patient was treated by Classic Whipple’s procedure. According to the oncologist, patient has low risk of duodenal tumor from gastrointestinal stromal tumor. These tumors have no need to treat with adjuvant therapy: chemotherapy (Glavic) and radiation therapy after surgical resection.

Keywords:

Gastrointestinal Stromal Tumors; Duodenum; Neoplasm; Hemoglobin.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Naseem Akhtar
  • Hajra Sarwer
  • Muhammad Afzal
    • Lahore School of Nursing, the University of Lahore
  • Awais Jamil
    • Shaukat Khanum Hospital and Research Center, Lahore, Pakistan.

STUDENT CORNER

MUSCULOSKELETAL PAIN AMONG UNDERGRADUATE PHYSICAL THERAPY STUDENTS: SINGLE CENTERED SURVEY FROM LAHORE

ABSTRACT

Background:

Musculoskeletal discomfort not related by a syndrome is very communal in juvenile and puberty getting lifetime prevalence as great as 40%. It affects student’s quality of life and their productivity in education. So, the main objective of current study was to access musculoskeletal pain among undergraduate physical therapy students.

Methods:

A Descriptive type of cross sectional survey was conducted at Lahore Medical and Dental College (LM&DC) for duration of almost six months from April 2018 to October 2018. Sample size recruited was 321 physical therapy students and they were included according to inclusion exclusion criteria. Assessment of Musculoskeletal pain was done using Nordic musculoskeletal questionnaire. An analysis was done using SPSS 21.

Results:

The findings showed that musculoskeletal pain among students was most commonly prevalent in lower back region constituting 65.4% (n = 210) followed by upper back 53.9% (n = 173) and neck region 48.6% (n = 156).

Conclusion:

Musculoskeletal pain was highly prevalent among medical students and most commonly found in lower back region.

Keywords:

Medical Students; Musculoskeletal Pain; Nordic Questionnaire.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Komal Nadeem
  • Zunaira Mehdi
  • Samreen Sadiq
  • Hafiz Muhammad Asim
    • Lahore Medical and Dental College (College of Physical Therapy), Lahore, Pakistan.

SERVICE QUALITY OF PUBLIC AND PRIVATE PHYSIOTHERAPY INSTITUTES: A COMPARATIVE STUDY IN LAHORE

ABSTRACT

Background:

Ever since quality of services is gaining importance in every industry as it is the indicator of consumer/customer satisfaction, it is of utmost importance to measure service quality of educational institutes to determine the satisfaction of students. Thus, the study aimed to determine the important factors in service quality dimensions which contribute to the satisfaction of students.

Methods:

This was a Comparative Cross Sectional study in which final year department of physical therapy (DPT) students were included from three private and three public physiotherapy institutes.

Results:

The largest mean Positive Gap scores for Public Physiotherapy Institutes was 0.18 for accessibility and affordability 0.18. The largest negative mean gap score for Private Physiotherapy domain was “Accessibility and Affordability” found to be -1.96.

Conclusion:

Students were satisfied with service quality of private institutes in all domains except for the “Accessibility and Affordability” whereas, in Public Institutes largest negative quality gaps were found in “Empathy” and “Assurance”.

Keywords:

Service Quality; Physical Therapy Institutes; Education.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Fatima Zahid
  • Roohi Abbas
  • Hafiz Muhammad Asim
    • Lahore Medical and Dental College (College of Physical Therapy), Lahore, Pakistan.

MEDICAL EDUCATION

TUTORIAL SESSION IN COMPARISON TO PROBLEM-BASED LEARNING IN UNDERGRADUATE CANDIDATES OF MEDICAL AND DENTAL COLLEGE

Background:

Tutor has an essential role in conducting tutorial sessions and encouraging effective learning in students. The tutor develops learning objectives, monitors and clarifies the queries of students. Whereas students learn to understand and teach each other by participating and this helps the students better understand the subject and gain deeper knowledge of the various topics of each module in medical curriculum. The advantage of these sessions is to improve students understanding of topic, allowing time for discussion, and making them, self-learners. Problem-based learning (PBL) is a tool in medical education to teach and learn basic and clinical concepts in medicine and become self-learner. Aim of the study was, to evaluate the significance of tutorials as effective learning tool and was compared to problem – based learning for medical and dental undergraduate students, for topic understanding, time required to understand the topic, filling in gaps in knowledge and improvement in examination scores.

Methods:

Tutorial sessions and PBL were conducted as small group learning in Department of Pharmacology, Jinnah Medical and Dental College, Karachi, Pakistan. In each class of undergraduate MBBS and BDS, students were distributed into 10-12 students groups. Students, from MBBS III year students and BDS II year, participated in this study and filled in questionnaires at the end of tutorial sessions. Comparison of tutorial and PBL sessions were evaluated by a second questionnaire by MBBS undergraduate students.

Conclusion:

The study participants were undergraduate students of MBBS and BDS. They found the tutorial sessions were effective tool. Although in comparison to tutorial, the students found problem-based learning more significant in understanding concepts of medical curriculum.

Keywords:

Tutorials; Problem-Based Learning; Knowledge, Small Group Learning; Interactive Session; Self-Learners.

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Volume 8 Issue-4 2019
ISSN : 2308-2593
Publisher Name : Ziauddin University
  • Samia Perwaiz Khan
  • Muhammad Ali Zubair
  • Marium Younus Paracha
    • Department of Pharmacology, Jinnah Medical and Dental College, Karachi, Pakistan.