Journal of Liaquat University of Medical & Health Sciences

Knowledge, Attitudes and Perception towards Artificial Intelligence and Robotics in Dentistry- A Cross-Sectional Survey

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To evaluate dentists' knowledge, attitude and perception of robotics(R) and artificial intelligence (AI).

METHODOLOGY: Data were gathered for this cross-sectional survey from dental schools in Karachi that were both public and private. A total of 550 surveys were delivered through Google Forms. Dental students, graduates, postgraduates, and professionals of both sexes aged 20-70 years were included. Participants were chosen by convenience sampling using non-probability. Data were analyzed using descriptive analysis and the Chi-square test in SPSS version 22.0.

RESULTS: Of the 550 participants, men comprised 33% (n=181) overall, while women comprised 67%(n= 369). Despite having a great understanding of AI and R, the majority of participants, 55.1%(n=304), also have a strong point of view. However, only 42.5%(n=234) of respondents were aware of the difference between AI and R and 55.2%(n=304) have prior knowledge about AI and R. Nevertheless, 58% (n=319) of dentists thought it would be helpful for future dental procedures. Only 16%(n=88) of respondents believe artificial intelligence will eventually replace dentists. Some applicants, 55.2%(n=304), proposed employing AI/R for therapy, and 51%(n=281) agreed to get treatment.

CONCLUSION: By evaluating dentists' knowledge, attitudes, and perceptions of these technologies, it is possible to understand better the implementation of robotics and AI in clinical practice. More education and training programmes for dental professionals would be beneficial, and more studies would be able to determine the best ways to integrate robotics and AI to enhance patient results.

Review of non-ionized electromagnetic waves effects on human parasites: a systematic review

Zahra Eslamirad, Homa Soleimani — Mon, 01 Apr 2024 00:00:00 +0500

So far, various natural and synthetic compounds have been used to treat and control parasites and their diseases, but now researchers have turned to mechanical and physical methods. This study aimed to review and categorize studies in which non-ionizing electromagnetic waves were used to control or treat human parasites. A systematic search was conducted. All English or full Persian articles on the investigation of electromagnetic waves on worms (Helminths) and protozoan parasites worldwide (from 1970 to 2023) indexed in Google Scholar, Science Direct, PubMed, Scopus, Medline, Medlib, Scientific Information Database, ProQuest, IranMedex, IranDoc, Embase and Magiran were collected and reviewed. Finally, 53 articles were included in the study. Its information was extracted and organized in tables based on the kind of non-ionizing wave.
The results of this study categorized the information obtained from the articles based on the type of non-ionizing waves and parasites. The findings of this study may serve as a guide for researchers as they create and execute future studies. This review study exposed the capability of non-ionizing electromagnetic waves to inactivate, control and treat parasitic diseases. This review revealed gaps in this field of study, and a road map was provided to design and implement new projects.

Medicinal Properties of Illicium Verum Hook. F.

Asra Khan Pahore, Shagufta Khan, Nasim Karim — Mon, 01 Apr 2024 00:00:00 +0500

Medicinal plants have active elements that can be used for cures or making drug precursors. According to the World Health Organization, 80% of the world's population depends on these plants as traditional treatments to meet their health care needs. Illicium verum Hook. F. (star anise) is an extensively used spice in traditional Chinese cuisine as a flavoring agent or a historical medicine for vomiting, stomachache, flatulence, and rheumatism and is included in the Chinese Pharmacopoeia. Some active components of star anise are essential oil, anethole, trans-anethole, sesquiterpenoids, shikimic acid, lignans, etc., which possess anxiolytic, neuro-protective, antibacterial, antifungal, anti-inflammatory, antiemetic, anti-flu, antidiarrheal, antispasmodic, anti-diabetic, antioxidant, anti-thrombotic, and antitumour effects that are discussed in this review article.

Mutational Analysis of EZH2 in the Germinal Centre Type of Diffuse Large B Cell Lymphoma

Wed, 03 Apr 2024 00:00:00 +0500

OBJECTIVE: To determine the Frequency of Germinal Center B (GCB) type Diffuse Large B Cell Lymphoma (DLBCL) in Karachi, Pakistan, and to screen the DLBCL patients for EZH2 mutation.
METHODOLOGY: A cross-sectional study was conducted on DLBCL patients, and IHC analysis, PCR, and sequencing of the EZH2 gene were used. This study was conducted from August 2016 to July 2020. Surgical specimens received in the histopathology section of DDRRL centrally and from different collection units throughout Sindh having been diagnosed with DLBCL were collected. Three markers (CD10, BCL6, and MUM1) were used for subtyping. DNA was manually extracted from the FFPE Blocks of DLBCL cases using phenol: chloroform: isopropanol alcohol. Polymerase chain reaction (PCR) was performed, and samples were sent from Dow University to Korea (Macrogen) for sequencing. The amplified product was 189bp. Primers were used for EZH2 to flank the region containing the tyrosine domain on exon 16 and exon 18.
RESULTS: Out of 116 cases, 60.3% and 39.7% were male and female, respectively. The mean age was 49.73±16.38 years. The mean survival duration of cases diagnosed with GCB was 8.21±7.39 months. Polymorphism of EZH2 mutation (Tyr 701 Asn) was found to be positive in GCB-DLBCL for three samples (16.6%).
CONCLUSION: In the current study, Sanger sequencing was used to detect any mutation in the coding region of EZH2, and a unique mutation was reported (Tyr701Asn).

The Prediction of Mortality Using APACHE II Score in Patients Presenting with Peritonitis and Undergoing Emergency Exploratory Laparotomy

Hira Ashfaq, Raheel Ahmed, Dileep Kumar, Erum Kazim, Sundas Dastagir, Aisha Gul — Wed, 03 Apr 2024 00:00:00 +0500

OBJECTIVE: To Predict mortality using the APACHE II score in patients presenting with peritonitis and undergoing emergency exploratory laparotomy.

Methodology: The prospective study was conducted in Civil Hospital Karachi's surgery department from April to September 2021, with a non-probability sampling technique. A total of 84 patients of either sex between the age of 16-70 years who met the diagnostic criteria of peritonitis were included consecutively. Patients with incomplete laboratory records and uncorrectable preoperative comorbidities were excluded. The APACHE II score was categorized into three groups, and demographic details and outcomes were calculated using SPSS version 20 for the data analysis. Post-stratification Chi-square test was applied, taking a p-value of < 0.05 as statistically significant.

RESULTS: Out of 84 patients, 38 (45.2%), 37 (44%) and 09 (10.7%) had APACHE score < 10, 11-20 and ? 20 respectively. The total in-hospital mortality rate was 8.3%. In the patients with the lowest APACHE score < 10, a mortality rate of 2.6% was recorded. A mortality of 5.4% was recorded in patients with APACHE II group 2, while group 3 with APACHE II score > 20 had the highest mortality rate of 44%. The difference was statistically significant. (p=0.001).

CONCLUSION: The results of the APACHE II score obtained in patients classified them into three different groups based on the severity of conditions in patients with peritonitis, which validated the Prediction of increased mortality with higher scores.

Fetal Outcome among Women with Postdate Pregnancy

Wed, 03 Apr 2024 00:00:00 +0500

OBJECTIVE: The study aimed to determine the mode of delivery and fetal outcome among women with postdated pregnancies.

METHODOLOGY: This cross-sectional study was conducted from July to December 2020 in the Department of Gynecology, Hayatabad Medical Complex, Peshawar. A total of 287 women with postdated pregnancies (beyond 41 weeks) were selected through a convenient sampling technique for the study and followed to detect expected fetal outcomes. All women of age 20-45 with no signs of labor onset and cepahlic presentation of singleton pregnancy were included, while women with retained placenta detected by ultrasound, women with a medical disorder like coagulopathies (Haemophilia, Von Willebrand disease, Thrombocytopenia, DIC, Protein S deficiency, Protein C deficiency) detected by the specific investigation were excluded from the study. Data was analyzed using SPSS version 20.

RESULTS: The mean age of the sample was 30.5 years, with a standard deviation of 6.1 years. The mean parity of the sample was 2.1±1.5. The mean BMI of the sample was 26.1±3.8kg/m2. On follow-up, fetal distress in 16%, macrosomia in 18.5%, birth asphyxia in 18.1%, meconium aspiration in 8.4% and NICU admission in 9.1%. None of the neonates died in this study.

CONCLUSION: Postdated pregnancy carries a high risk of fetal distress, macrosomia and birth asphyxia. We recommend more large-scale surveys as well as trials to determine the efficacy of induction before pregnancy enters the postdate period and reduce the morbidity and mortality due to postdate pregnancies.

Patient Satisfaction Level and Vision-Related Quality of Life: A Comparison between Trifocal and Diffractive Extended Depth of Focus (EDOF) IOLs

Wed, 03 Apr 2024 00:00:00 +0500

OBJECTIVE: To compare patient satisfaction level and vision-related quality of life after Trifocal and EDOF implants to treat cataracts among the population of Southern Punjab.

METHODOLOGY: This comparative practice-based study was conducted at the Sight Centre of Bahawalpur City of Southern Punjab from August 2022 to July 2023. Informed consent was obtained from all the subjects. A total of n=120 eyes were operated in two EDOF and Trifocal treatment cohorts. VR-QOL was assessed for near, intermediate, and distant vision. The data was analyzed on SPSS version 27. The p-value < 0.05 was considered statistically significant.

RESULTS: There were n=29 (48.3%) males and n=31 (51.6%) females. The majority n=21 (35%) of subjects were aged 40-49. It was revealed that trifocal IOL demonstrated improved mean rank for near and intermediate vision. Statistically, a significant difference was found between putting thread into the needle and the mobile phone's utility at p-values of 0.047 and 0.040, respectively. Trifocal IOLs frequently generated the halo photic effect for light scattering at a P-value of 0.0001. Significant improvement was revealed in the VA of both eyes. The vision improved (100%) with Trifocal and EDOF group treatment options. Both treatment cohorts were satisfied with the final surgical outcome.

CONCLUSION: VA was improved after implanting Trifocal and EDOF IOLs. Trifocal IOL demonstrated better performance at near & distant vision. The halo photic effect was generated more frequently by the trifocal IOLs. Patients were equally satisfied with the surgical outcome of both treatment options.

Frequency of Anemia in Patients with Newly Diagnosed Pulmonary Tuberculosis Presenting at Dr Ruth KM Pfau Civil Hospital Karachi

Sana Muhammad Hussain, Amanullah Abbasi, Bader Faiyaz Zuberi, Anoshia Fahad — Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To determine the frequency of anemia in patients with newly diagnosed pulmonary Tuberculosis (PTB) presenting at Dr Ruth K M Pfau Civil Hospital Karachi (CHK).
METHODOLOGY: This cross-sectional study was conducted at Dr Ruth KM Pfau CHK from July to August 2023. Newly diagnosed pulmonary tuberculosis cases of either gender, between 14-40 years, were included, while patients with a history of PTB, malnutrition, blood loss, HIV, pregnant females, autoimmune disorders, anemia before the diagnosis of PTB, chronic illness and malignancies were excluded. PTB patients were labeled anemic if the hemoglobin level was <13g/dl in males and <12g/dl in females. Quantitative and qualitative variables were presented as descriptive statistics, giving mean, standard deviation, and frequency and percentages. Correlation and regression analysis of hemoglobin
with age, gender and employment status was done. A P-value of ?0.05 as significant.
RESULTS: Out of 150 patients, 91(60.7%) were male and 59(39.3%) were female. The frequency of anemia in males and females was 55.4% and 44.6%, respectively, which was not statistically significant (p = .865). A strong positive correlation of anemia with increasing age, with the highest frequency of anemia at 66.8% in age groups of >38 years compared to 6.8% in the 18-30 age group (p <.001) was present. Regression analysis showed age, gender and employment status were responsible for a 29.4% change in hemoglobin levels.
CONCLUSION: Anemia is common in patients with PTB and more common in patients with advancing age. Females had lower hemoglobin levels than males in PTB patients.

Clinical and Demographic Characteristics of Dengue Patients in Public Sector Hospital

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To determine the patterns of demographics, clinical presentation, and outcome among dengue patients treated at Dr. Ruth K.M. Pfau Civil Hospital, Karachi.

METHODOLOGY: This retrospective cross-sectional study comprised 1003 suspected dengue cases presented at Dr. Ruth K. M. Pfau Civil Hospital, Karachi, between September 2019 and February 2020. Medical records of 328 patients who tested positive for dengue infection on immune chromatographic technique (ICT) for recombinant NS1 antigen and/or IgM serology were included in the analysis.

RESULTS: Among 1003 suspected cases, 328 cases were laboratory-confirmed dengue fever; 82.3% (n=270) presented with acute dengue infection as they were positive for NS1 antigen only. 13.1% (n=43) of the patients were IgM-positive, whereas 0.9% (n=3) were positive for IgG. 3.6% (n=12) of the laboratory-confirmed dengue patients were positive for both NS1antigen and IgM. The majority of the dengue patients were from the district of South Karachi. Among all in-patients, 77 % (n=94) of the patients presented uncomplicated dengue fever, while 21.3% (n=26) of hospitalized dengue patients presented with dengue hemorrhagic fever. However, 1.6% (n=2) of hospitalized patients presented with dengue shock syndrome. Mortality was 1.6% (n=2).

CONCLUSION: We conclude that the epidemiology of dengue infection and seasonal disease variability in Pakistan's urban settings has not changed over the last decade but warrants continuous monitoring due to climate change. The disease is still more prevalent among young males with a classic presentation of dengue fever. Dengue hemorrhagic fever is relatively less common, while very few patients develop dengue shock syndrome, contributing to mortality.

Effectiveness of triamcinolone Acetonide Injection for the treatment of Non-infectious Intermediate and Posterior Uveitis

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To assess the efficacy of posterior sub-tenon injection (PSTI) of Triamcinolone Acetonide (TA) in patients with Uveitis.

METHODS: This prospective study was conducted from July 2022 to May 2023. A total of 160 eyes were comprehensively examined at the Kulsoom Bai Valika Social Security Site Hospital and Sindh Government Qatar Hospital. Purposive sampling was employed for participant selection, focusing on the eye with poor vision in patients with Uveitis in both eyes. The sample was stratified into non-infectious posterior Uveitis and non-infectious intermediate Uveitis, maintaining a 1:1 ratio. Statistical analysis was performed using SPSS (version 25.0).

RESULTS: The median duration of Uveitis was 20.5 weeks (interquartile range, IQR: 17-25). The median best-corrected visual acuity before treatment was 0.5 (IQR: 0.4-0.7). After one week, it improved to 0.2 (IQR: 0.1-0.3), and after three months, it further increased to 0.12 (IQR: 0.1-0.18), showing a statistically significant difference (p-value < 0.01) between baseline and one week after treatment. The difference between one week and after 12 weeks remained consistent. Two-way analysis also revealed a significant difference (p-value < 0.01).

CONCLUSION: Posterior sub-tenon injection of triamcinolone acetonide is effective and safe for treating non-infectious Uveitis. The intraocular pressure did not show an increase following the injection, and visual acuity significantly improved after PSTI.

Haematological Manifestations in Children with Extended Drug-Resistant Salmonella Typhi Infections in a Tertiary Care Hospital

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To analyze the haematological parameters in children affected by extended drug-resistant salmonella typhi (XDR S. typhi) infections in a Tertiary care hospital.

METHODOLOGY: This Descriptive Cross-Sectional study was carried out at the Department of Haematology at PNS SHIFA Hospital, Karachi, from November 2021 to October 2022. Seventy children with XDR S. Typhi on blood culture were selected using a consecutive sampling technique. The study focused on haematological parameters, i.e., haemoglobin (Hb), WBC count, and platelet count. Descriptive statistics were expressed as mean ±SD, and the Chi-square test was applied. A p-value ?0.05 was considered statistically significant.

RESULTS: Out of the total of 70 children (under 12 years of age) included in the study, 41 (58.6%) were male and 29 (41.4%) were female. The mean age was 8.17±2.92 years. Anaemia was observed in 51% percent of cases. Leucopenia and thrombocytopenia were noted in 44% and 54% of cases. Seventeen children had bicytopenia, while pancytopenia was seen in only two children.

CONCLUSION: XDR S. Typhi infection causes significant cytopenias. Therefore, patients with a history of sustained fever with cytopenias should be worked up for possible XDR S. Typhi infection.

Postural Discomforts in Children due to Heavy Backpack

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To find the postural discomforts in school-going children due to heavy backpacks.

METHODOLOGY: The study was designed as a cross-sectional descriptive study. This study was conducted in private schools in Lahore. Data was collected using a purposive sampling technique from September 2021 to February 2022. A sample size of 196 students was selected for this study. A nordotic musculoskeletal questionnaire was used. The children were chosen using the purposive sampling method. Students in grades 5 through 10 are included, carrying bags with one or both shoulders. Students of all genders were included with independent standing on the weighing scale. The study excluded students with metabolic abnormalities or musculoskeletal complaints caused by pathological, orthopedic, or hereditary factors. SPSS 21.0 was used for analysis.

RESULTS: The result shows that about 107(54.6%) students have neck pain due to wearing backpacks. About 160(81%) students have pain in both shoulders. Only 3(1.5%) students had pain in hand/wrist. 109(55.6%) students had pain in the upper back. 121(61.7%) students had pain in lower back, 107(54.6%) students experienced pain in upper back, 69(35.2%) students had pain in the hip/thighs, 54(27.6%) students had pain in their knees. 78(39.8%) students had pain in ankle/feet.

CONCLUSION: Children's shoulders, necks and backs can get chronically strained from carrying a hefty backpack, resulting in pain. The backpack's weight, how it is worn, and other factors all impact how stable a student's posture is, which leads to the conclusion that a child wearing a backpack has postural impacts on their body posture.

Reliability and Validity of Urdu Version of the Dynamic Gait Index in Pakistani Geriatric Population

Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To translate DGI into Urdu and examine its reliability and validity in the Pakistani geriatric population.

METHODOLOGY: This cross-sectional study was conducted in Faisalabad from April to September 2021. The English version of DGI was translated into Urdu and culturally adapted. The DGI-U was administered by convenience sampling; a sample size of 56 geriatric patients enrolled based on predefined inclusion criteria. Participants with a minimum age of 65, walking without aids for at least 6 meters, falling at least once in the last year, and subjectively examining balance disorder were included. Patients who could not understand the DGI instructions had lower limb injuries/had undergone knee/hip reconstruction during the past three months were excluded. Test-retest reliability was determined by administering the DGI-U twice, and inter-rater reliability was determined by administering it alone on the same day by two raters. Internal consistency was reported using Cronbach's alpha. Pearson's correlation analysis was used to examine the concurrent validity of the Urdu version of the DGI with the TUG and Berg Balance Scale (BBS).

RESULTS: Internal consistency (Cronbach's alpha = 0.97) of the Urdu version of DGI was excellent. DGI-U reflected high inter-rater reliability (ICC=0.959; 95% Cl (0.931-0.976) and intra-rater reliability (ICC=0.952 95% Cl (0.915-0.973). The DGI-U was correlated positive moderate with TUG (r = .716, p .0001) and BBS (r = 0.692, p .0001)

CONCLUSION: The study provided adequate evidence for the validity and reliability of the Urdu version of DGI for use in the elderly Pakistani population.

Exploring the Lived Experience of Early Hypertension: Insights from Traditional Medicine Perspectives

Aidin Aryankhesal, Roshanak Ghods, Asie Shojaii — Fri, 05 Apr 2024 00:00:00 +0500

OBJECTIVE: To elicit symptoms, risk factors, and habits existing before or right after blood pressure elevation in newly diagnosed patients with hypertension from the traditional Persian medicine perspective.

METHODOLOGY: This was a concurrent nested mixed-method study conducted in 2018. We included newly diagnosed cases of hypertension (BP?140/90 mmHg in two consecutive screenings) in the study. In contrast, those who had a history of hypertension or used anti-hypertension medication were excluded. The participants were surveyed and interviewed to identify their temperament and extract their recent experiences with hypertension. The sampling followed the criterion-based purposive technique, and the sample size was defined based on qualitative data saturation. The recorded interviews were transcribed and coded according to Persian medicine until no new code emerged.

RESULTS: Twenty participants were interviewed, and two themes were extracted: (i) primary or predisposing factors, such as warm temperament, change of residence, improper eating habits, abrupt cessation of exercise, psychological factors, and irregular sleep patterns, and (ii) early symptoms that occur at the first sign of rising blood pressure, including digestive complaints and changes in body excretion, psychological manifestations, and unclassifiable general symptoms.

CONCLUSION: Physicians are advised to pay attention to these items when taking a history from patients to prevent hypertension and treat it at its early stages.