Journal of Liaquat University of Medical & Health Sciences

A Systematic Review on the Role of Advanced Glycation End-products (AGEs) in the Development of PCOS

Thu, 26 Dec 2024 00:00:00 +0500

This review was done to investigate the research done globally and in Pakistan about the role of AGEs in developing PCOS. Literature was searched at any time by using Google Scholar and PubMed. Keywords used were “PCOS”, “polycystic ovarian syndrome”, “Advanced glycation end-products”, “AGEs”, and “Pakistan”. Inclusion criteria were original research on humans, animals, or cell culture, showing the effect of AGEs on ovarian tissue. No research was found in Pakistan, emphasizing the point that Pakistan does not take the issue of AGEs seriously. All that was found was the relationship of AGEs with cardiovascular diseases or the prevalence of PCOS in Pakistani women. The original research done elsewhere globally was included in this review. Eighteen research studies have been conducted since 2000, including the relationship of AGEs with PCOS. Five studies found higher levels of AGEs in the blood and ovaries of patients with PCOS compared to controls. Three studies showed that dietary AGEs were directly associated with PCOS. Five animal (rats/mice) studies showed the effect of a diet high in AGEs on the ovaries of mice. Three cell line studies also showed a relationship between AGEs and ovarian tissues. Almost all human, animal, or cell-line studies showed the relationship of AGEs on the morphology or functioning of ovarian tissue. An easier way to prevent PCOS might be to control the AGE content in the diet.

Glomerulonephritis among Saudi Children: Current Status Evaluation

Shehab Ahmed Alenazi — Thu, 26 Dec 2024 00:00:00 +0500

Glomerulonephritis (GN) is a common renal problem affecting children and is manifested by hematuria, proteinuria, fluid retention, and hypertension with altered glomerular filtration. This condition may be primary or developed secondary to other systemic diseases, immune disorders, infections, or drugs induced with different histopathological patterns and a wide range of clinical manifestations. The current study helps record and comprehend GN's epidemiology in Saudi Arabia. Additional research is recommended that includes a more thorough examination of the prognostic factors, therapies, illness progression, and outcomes. While there are several advantages to having a GN registry that collects data in the future, resource constraints frequently prevent the establishment of comprehensive registries. Expanding research endeavors will play a significant role in fostering a healthy society and may provide insight into the underlying pathology of fascinating glomerulopathies.

Risk Factors for Lag Screw Cut Out in Intertrochanteric Hip Fractures Treated with Dynamic Hip Screw (DHS) in a Tertiary Care Hospital: A Case-Control Study

Faaiz Ali Shah, Naeemullah, Mian Javed Iqbal, Mian Amjad Ali — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To determine the risk factors for Lag Screw cut out in intertrochanteric hip fractures treated with Dynamic Hip Screw(DHS).

METHODOLOGY: This case-control study was conducted in the orthopedic division of Lady Reading Hospital Peshawar. The medical records of all patients fulfilling the inclusion criteria and operated on between January 2019 and March 2024 were collected from the hospital's Health Management Information System. All patients with DHS lag screw cut-outs were cases, while those without cut-outs were controls in a 1:1 ratio. Lag screw cut-out was tested for any association with other independent variables by calculating the Odds Ratio(OR), Confidence Interval(CI) and P-value. Multivariate analysis utilizing logistic regression was performed for all statistically significant independent variables (P<0.05) on univariate analysis.

RESULTS: The data of 33 patients with lag screw cut out was compared with 33 patients without lag screw cut-outs. TAD more than 25 mm was associated with a 5-fold increased risk of cut-out (P=0.001, aOR=5.32,95% CI=2.10-3.32). Superior and lateral lag screw position was associated with 4-fold (P=0.02, aOR=4.33, 95% CI=4.51-7.62) and 3-fold (P=0.01, aOR=3.20, 95% CI=0.07-0.08) increased risk of lag screw cut-out respectively. Poor fracture reduction was associated with a 2-fold increased risk of lag screw cut-out (P=0.01, aOR=2.40, 95% CI=0.02-0.06).

CONCLUSION: Increase Tip Apex Distance(TAD), superior and posterior lag screw position and poor fracture reduction were the independent risk factors significantly associated with lag screw cut-out in patients of intertrochanteric fractures treated with Dynamic Hip Screw(DHS).

Comparison of Laparoscopic vs Open Cholecystectomy in Acute Cholecystitis Presenting within 5 days of Onset of Symptoms

Mudassar Murtaza, Mumtaz Ali, Warda Khalid, Aslam Javed, Guled Ahmad — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To compare the result of open and laparoscopic cholecystectomy in managing acute cholecystitis presenting within 5 days.

METHODOLOGY: This prospective comparative study was conducted at Government Teaching Hospital Shahdara Lahore from December 2020 to March 2023. Eighty patients with acute cholecystitis of 5 days or less duration and age >20 years were included and allocated into two groups, 40 in each. Non-probability convenient sampling was used. Group O was treated with open cholecystectomy, and Group L was treated with Laparoscopic cholecystectomy. Patients with empyema, common duct stones, liver failure and ASA grade >3 were excluded. Demographic data, operative time, complications, conversion rate to open surgery, hospital stay, and follow-up were recorded in proforma. Data entry and analysis were done using SPSS 24.

RESULTS: Group O and Group L's mean age was 43.27±13.33 and 44.07±12.77 years, respectively. Gender distribution differed between Group O (5 males, 35 females) and Group L (8 males, 32 females). Hospital stay was significantly more extended in Group O (5.15±0.92 days) compared to Group L (2.67±0.72 days), with a significant difference in mean operative time (Group O: 75.20mins, Group L: 60.15mins). Wound infection rates were higher in Group O (3 patients) than in Group L (1 patient), and 2 out of 40 patients in the laparoscopic group required conversion to open surgery.

CONCLUSION: Cholecystectomy, whether laparoscopic or open, is safe within 5 days of onset of acute cholecystitis with some benefit in laparoscopic surgery in terms of length of stay and recovery.

Qualitative and Biochemical Assessment of the Impact of Dietary Habits and Body Mass Index on Hemoglobin Levels in Female University Students

Hurma Tariq, Arisha Sohail, Shamim Akhter Qureshi — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To assess the body mass index, dietary habits, signs, symptoms, and biochemical parameters of anemia in female students.

METHODOLOGY: The present cross-sectional analytical study was conducted between August and December 2023 at Public Sector University in Karachi, Pakistan. The eligibility criteria were unmarried females aged 18-25 years. Participants with diagnosed hemoglobinopathy or bleeding disorders, nutritional deficiency anemia, previous anemia treatment, and chronic disease were excluded. The sample size was 393 with convenience sampling. Demographic variables, years of education, ethnicity, rural or urban setting, cultural background, monthly family income, Body Mass Index and folic acid/multivitamins supplements were assessed through a validated questionnaire. 5ml of venous blood was collected, and complete blood count and serum iron was measured. WHO criteria were used for anemia diagnosis. Data was analyzed using SPSS 28. T-test and Chi-Square test were used for categorical data.

RESULTS: The study found an equal proportion of normal and overweight participants (41%) followed by underweight (18%). Most females skip breakfast, consume vegetables less than three times a week, and consume fruits more than three times. 91% eat fish less than three days a week and consume fast food and soft drinks less frequently. The prevalence of anemia was 46%, followed by mild (13.6%) and moderate (31.8%) anemia, common symptoms experienced included unusual fatigue, weakness, confusion, a loss of focus, and feelings of sadness or depression.

CONCLUSION: The B.M.I. and inadequate dietary habits impact the general health and serum iron levels in female students, which can be improved by dietary intervention.

Incidence of Fodder Cutter (Toka) Hand Injury and their Management in D.I. Khan, Pakistan

Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: This study aimed to determine the incidence of toka hand injuries by age, gender, and occupation and their management in D.I. Khan.

METHODOLOGY: This descriptive study was conducted from January to December 2023 in the Department of Orthopaedics, DHQ Teaching Hospital, D.I. Khan, Pakistan. Sixty-six patients presenting to the hospital during 2023 with toka hand injuries were selected. Demographic variables were age, gender, and occupation. Research variables were the site of injury and mode of management. All data was analyzed using SPSS version 29.

RESULTS: Out of 66 patients, Toka injuries were predominant in females 39(59.09%). Most patients, 51(77.27%), were aged below 30 years, and 42(63.64%) were non-professional by occupation. The most common site of injury was distal to the wrist 33(50%), while it was 27(40.91%) at the wrist level, and 6 (9.09%) were proximal to the wrist. Debridement and stump formation was done in 40(60.60%) while 26(39.40%) patients underwent fixation and stabilization.

CONCLUSION: Toka machine injuries mainly result in hand amputations. Safety features must be identified in this region, workers must be adequately educated, and work-related ergonomics must be ensured. Further advancements in management are also needed.

Dominant Factors Affecting Maternal Resilience Scores in Children with Down Syndrome

Aries Abiyoga, Zamzaliza Bt Abdul Mulud — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To determine the Leading Factors Affecting Maternal Resilience Scores in Children with Down Syndrome

METHODOLOGY: A cross-sectional study was conducted between February and April 2024 at the Association of Parents of Children with Down's Syndrome in East Kalimantan, Indonesia. The sample size was determined based on a total population of 209 POTADS. Using Rao-soft calculations with a margin of error of 5% and a confidence level of 95%, 135 respondents were recommended as the sample size. The Par-DD-QoL questionnaire, which consists of 18 items overall, was modified from the Par ENT survey to assess parents' quality of life. The respondents were selected using nonpurposive sampling. Microsoft Excel entered the collected data, and SPSS 26 was used for analysis.

RESULTS: The study found that social support, caregiver burden, and quality of life significantly affected maternal resilience in parents of children with Down syndrome. Those with higher quality of life and social support were more likely to have higher resilience levels. These findings emphasize the importance of addressing physical and psychological well-being to promote resilience in this population. Thus, addressing both physical and mental well-being is essential for fostering resilience in children with Down syndrome.

CONCLUSION: Providing support and resources for parents and caregivers is crucial for resilience in children with Down syndrome. A holistic approach that considers an individual's quality of life and the social support system is critical to enhancing resilience, which comes with the job by concentrating on these factors.

Proportional Hazards Model for Predictors of Type 2 Diabetes Mellitus among the Elderly

Marjes N Tumurang, Indra Elisabet Lalangpuling — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To find the prevalence and prognostic characteristics of type 2 diabetes mellitus (T2DM) in older adults.

METHODOLOGY: This study's quantitative observational approach utilized the Cox proportional hazards model. This study was conducted from January to June 2024 in Manado City's urban regions. Data was collected at nearby community health centres and senior care institutions to guarantee participant accessibility and convenience.

This study included older adults aged 60 or older living in urban settings. Based on power estimates, a sample size of 550 participants was chosen to guarantee adequate statistical power to identify significant correlations between predictive factors and the occurrence of T2DM. Medical examination (BMI, HbA1c and fasting plasma glucose) and structured interviews were used. The participants willing to provide informed consent were included, while exclusions included severe comorbidities and cognitive impairment. The studies were conducted using SPSS version 25.

RESULTS: In the study population, T2DM was prevalent in 45% of cases. The key prognostic factors discovered included dietary habits, degree of physical activity, body mass index, and family history of Diabetes. T2DM was found to be predicted by unhealthy eating habits (HR = 1.62, 95% CI: 1.10-2.39), low physical activity (HR = 1.54, 95% CI: 1.02-2.33), high body mass index (HR = 1.87, 95% CI: 1.25-2.80), and a family history of Diabetes (HR = 2.15, 95% CI: 1.42-3.25).

CONCLUSION: The high incidence of Diabetes in older adults makes it essential to intervene in diet, physical activity and weight control.

Correlating Estradiol Levels with Folic Acid and Cobalamin Supplementation: Dynamics of the Rat Oestrus Cycle

Barkat Ullah Khan Awan, Ayesha Irfan; Sara Abid, Muaz Bin Nauman — Thu, 26 Dec 2024 00:00:00 +0500

OBECTIVE: To examine the effects of supplementary doses of Folate and Cobalamin on the oestrous cycle of female Sprague Dawley rats concerning serum estradiol levels.

METHODOLOGY: This experimental study was conducted at the Physiology and Anatomy department's research laboratory at CMH Multan Institute of Medical Sciences, Pakistan. One hundred twenty female Sprague Dawley rats, aged 5-6 months and weighing 150-300g, obtained from the University of Lahore, sampling technique was non-probability convenience sampling. The rats were divided into groups A(Control) and B1, B2, and B3 (Experimental), with thirty rats each. Group A received a daily oral gavage of 2ml/100g of pure distilled water for four weeks. For four weeks, the experimental animals B1, B2, and B3 were given 0.2 mg/kg of Folic Acid, 45µg/kg of Cobalamin, and 0.2 mg/kg of Folic Acid and 45µg/kg of Cobalamin orally via gavage. Every day, vaginal smears were taken. PAP smear slides were prepared. After completion of the study at four weeks, all the animals were euthanized by chloroform inhalation. Blood was obtained to evaluate biochemical parameters using the cardiac puncture method. Serum estradiol levels were measured in pg/ml. Data was analyzed by applying SPSS version 26.

RESULTS: The animals in experimental groups B1 and B3 exhibited an atypical oestrus cycle. Following the comparison between groups, a p-value of 0.000 was obtained, which was statistically significant.

CONCLUSION: Present research indicates that administering a prolonged supplemental dose of Folic Acid results in an extended oestrous cycle in Sprague Dawley rats, accompanied by elevated serum estradiol levels.

Immunoexpression of Nestin and Ki-67 in Astrocytoma in a Single Tertiary Health Care Centre

Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To evaluate the prognostic significance of Nestin and Ki-67 expression in Astrocytoma across different grades.

METHODOLOGY: A retrospective cross-sectional analysis was conducted at the Histology Department, Basic Medical Sciences Institute, JPMC Karachi, between October 2019 and September 2022. In this study, Nestin and KI-67 immunohistochemistry expression was assessed in 60 Astrocytoma, and its expression was seen with different degrees of Astrocytoma.

RESULTS: Nestin positivity was found in 86.7% of cases of Astrocytoma. The immune-reactive score for Nestin staining in different stages of Astrocytoma was shown to have a significantly significant P-value. 41.7% of cases of Astrocytoma were found to have a KI-67 labeling index; all high-grade Astrocytoma had a high labeling index of Ki-67. It was demonstrated that the immune-reactive score for Ki-67 staining at various phases of Astrocytoma had a statistically significant P-value.

CONCLUSION: We discovered that Nestin and Ki-67 were expressed in Astrocytoma and that the expression of both immune markers rose with tumor grade. Nestin and Ki-67 serve as a helpful marker for assessing the Astrocytoma's prognosis. These findings may be used to determine the best course of action for Astrocytoma therapy.

Radiographic Assessment of Periodontal Ligament and Root Pulp Visibility in Lower Third Molars as a Tool for Chronological Age Estimation

Mahwish Sami, Sarwat Memon, Fizza Saher, Qudsia Hassan — Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To assess chronological age by radiographic assessment of root pulp visibility and periodontal ligament visibility of lower third molar teeth through stage classification in a subset of the Pakistani population.

METHODOLOGY: A cross-sectional study was conducted using digital orthopantomograms (OPGs) of 260 lower third molar teeth aged 18-40 years, using a non-probability consecutive sampling technique from the Department of Orthodontics, Ziauddin University Hospital and Karachi X-rays Center taken between the year 2020 to 2022. The OPGs were studied using Clear Canvas software. The OPGs with good contrast, good quality image and good morphology with complete root formation were included; OPGs with missing required teeth, teeth with fillings, inflammation or anomaly were excluded.

RESULTS: A significant association was seen between stages of RPV and PLV with chronological ages. For both sexes, the mean ages for RPV at stages 0, stage 1 and stage 2 were found to be 24.26 years, 29.71 years and 32 years, respectively and mean ages for PLV at stages 0, stage 1 and stage 2 were found to 24.16 years, 28.31 years and 32.44 years respectively.

CONCLUSION: The individuals found at stages 0 and 1 for radiographic RPV were at least 18 years of age, and for stage 2, individuals were 28 years and above. For radiographic PLV, the minimum age for stage 0 and stage 1 were at least 18 years, and for stage 2, the individuals were at least 20. Hence, RPV and PLV methods can be used to estimate age.

Evaluation, Comparison and Correlation of the Disease Activity and Damage Index among Patients of SLE with Healthy Controls through Echocardiography

Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To assess and compare echocardiographic findings in SLE patients with healthy controls and their correlation with disease activity and damage index.

METHODOLOGY: This cross-sectional study was undertaken in the Department of Medicine, Civil Hospital Karachi, an affiliated hospital of Dow University of Health Sciences (DUHS) Karachi, Pakistan, from January to July 2023. Forty-one patients with SLE and Thirty-nine healthy controls were enrolled, undergoing echocardiographic analysis for cardiovascular complications with the clinical and biochemical profile. Statistical differences among groups were assessed using the Chi-square test for qualitative variables and the independent sample t-test for quantitative variables. The correlation between disease severity and cardiovascular events was determined by Pearson correlation. P ? 0.05 was measured as statistically significant.

RESULTS: The most common valvular abnormality was mitral regurgitation (48.7%), then tricuspid regurgitation (21.9%), aortic regurgitation (17.7%), mitral stenosis (2.4%) and mitral valve prolapse (4.8%) in SLE, Left ventricular internal diameter end diastole [p 0.001], Intraventricular septal wall thickness, and end-diastolic left ventricular internal diameter end-systole [p 0.002] were found statistically significant among the groups. Left ventricular posterior wall end-diastole [p < 0.00001] and pulmonary artery systolic pressure [p < 0.00001] were also substantial among groups. Lupus nephritis positively correlated to ejection fraction (r=0.00013, p 0.56).

CONCLUSION: Cardiovascular complications are frequently reported in SLE, as assessed by echocardiographic findings. SLE severity is related to echocardiographic changes, and SLE with secondary Antiphospholipid syndrome (APS) significantly affects renal, haematological, and echocardiographic parameters.

Prevalence and Risk Factors of Scabies in Tando Muhammad Khan, Sindh: A Retrospective Study

Thu, 26 Dec 2024 00:00:00 +0500

OBJECTIVE: To assess the prevalence and risk factors associated with scabies in Tando Muhammad Khan, Sindh, Pakistan.

METHODOLOGY: A retrospective observational study was conducted at the dermatology outpatient clinic of Indus Medical College and Hospital, reviewing medical records from January to August 2024. A total of 300 patients' records were examined for documented cases of scabies based on physical assessments. Sociodemographic and dietary data were extracted from existing medical records and hospital databases. The collected data were then analyzed using SPSS, with the results presented in tables and graphs.

RESULTS: Among the 300 scabies cases, 49.1% were adult males, 32.3% were adult females, and 9.3% were teenagers and children. Adult males showed the highest Prevalence, with many cases linked to lower socioeconomic backgrounds. The mean Age for male patients was 42.71 years, and 53.3% were Sindhi. Most patients (86%) relied on surface water, and 81% were non-vegetarians. Crusted lesions were the most common, with 97% of patients exhibiting multiple lesions across various body areas.

CONCLUSION: The study reveals that overcrowding, poor hygiene, and limited access to clean water are major risk factors. Public health interventions focusing on hygiene education and better water access are crucial to reducing scabies in the region.

Medical Education Curricula in Pakistan Must Address the Consequences of Climate Change on the Health of the People and their Solution

Rano Mal Piryani, Suneel Piryani — Thu, 26 Dec 2024 00:00:00 +0500

The World Health Organization (WHO) has documented that "climate change has been intensifying public health problems and described climate change as one of the leading human health threats¹. In reality, climate change is now a public health emergency, as evident from the increased incidence of wildfires, extremes of heat waves, increased floods, and shifting patterns of infectious disease².