Research Report 2021

AT-HOME MANAGEMENT STRATEGIES ADOPTED BY ORTHODONTIC PATIENTS DURING COVID-19 RELATED CLOSURE OF ORTHODONTIC CLINICS Hana Pervez, Maria Khadija Siddiqui, Anam Sattar, Hareem Sultan, Taskeen Khan, Rabiya Haqqui JPDA Vol. 30 No. 02 Apr-Jun 2021 Objective: The vast spread of COVID-19 not only affected the major businesses of the world but also the health care facilities like dentistry. Due to the unprecedented closure of dental services, on-going orthodontic patients also suffered the brunt. The aim of this study was to assess the at-home management approaches used by the patients to tackle the complications associated with orthodontic treatment. Methodology: It was a cross-sectional questionnaire-based study carried out from June 15 to September 15, 2020 in orthodontic OPD of Jinnah Medical and Dental College, Karachi. A total of 300 orthodontic patients, 208 females and 92 males between ages from 15 to 35 years completed a questionnaire on the complications faced by them and management techniques adopted by them during COVID-19 related office closures. Convenient sampling method was used for data collection. Results: The majority of patients reported in this study were females. Approximately 69.33% (n = 300) of the responders were females and 31% were males. The highest numbers of complications reported during the lockdown period were loose brackets, loose bands and poking of archwire. The most common at-home hack used was removing the loose bracket/ bands and cutting of free end of archwire with nail cutter like instrument. Conclusion: It is the responsibility of the clinician to keep in touch with their patients during pandemic like situation through telemedicine portal. In case of emergencies, patients should be provided with an adequate amount of information to tackle any complications with ease and without hurting themselves. Keywords: COVID-19, Pandemic, Orthodontic Emergencies 31

EARLY RESPIRATORY SYMPTOMS OF WATER-PIPE (SHISHA) SMOKING IN MEDICAL STUDENTS OF KARACHI Komal Kiran Galaria, Nadia Younus, Rahat Zubair, Malik Balaj Khan, Sameen Abid Rehman, Safa Shahab, Syed Muhammad Ishqaue Annals of Abbasi Shaheed Hospital, Karachi Medical and Dental Ccollege, 26(4), Pg. 225-231, 2021 Objective: The aim of this study was to assess the frequency of early respiratory symptoms in relation to the severity and duration of water-pipe smoking in the medical students of Karachi. Methods: This cross-sectional study was conducted in medical colleges of Karachi. A selfadministered questionnaire collected information about smoking habits and respiratory symptoms from students. A sample size of 296 was calculated. Purposive judgmental sampling technique was used to collect the data. Those who smoked shisha, either once or in continuum were included in the study, irrespective of the gender. All non-medical and diagnosed-asthmatic students were excluded from the study. The questionnaire was designed to be precise inclusive of close ended questions. Participants were asked to fill the questionnaire. Results: Out of 250 participants, 68.8 % (n=172) were short term smokers. 31.6% (n=79) reported to have smoked shisha monthly. The main reason of smoking shisha for 26% (n=65) was just to fill in the free time with friends. 39.4% (n=88) intend to quit shisha smoking in future. 32.4% (n=81) of the students experienced shortness of breath, 30.4% (n=76) Dry cough, 30.4% (n=76) Scratchy sensation in the throat, 23.6% (n=59) rapid breathing, 20% (n=50) chest tightness and 13.6% (n=34) hoarse voice after shisha consumption. The association of these symptoms with duration and severity of shisha exposure remained insignificant. Conclusion: The results of this study show that smoking shisha can bring about the early respiratory symptoms. Education is important in creating awareness about water-pipe smoking hazards. Keywords: Water-pipe; Shisha; Smoking; Medical students; Respiratory symptoms 32

PROTECTIVE EFFECT OF ZINGIBER OFFICINALE ON MOBILE PHONE INDUCED RAT BRAIN INJURY Syed Alamdar Raza Zaidi, Mohammad Fawad Saeeduddin, Aisha Qamar, Shabnam Khan, Rozina Khan, Syed Meesam Iftikhar Hussain Rizvi Professional Med Journal, 28(12), Pg.1797-1803, 2021 Objective: To observe the protective effect of zingiber officinale against radio frequency (RF) radiation-induced oxidative stress on rat brain due to 3G mobile phone. Study Design: Prospective Experimental study. Setting: Department of Anatomy, BMSI, JPMC, Karachi. Period: January to March 2018. Material & Methods: Twenty four healthy, adult, Albino rats, 3-4 months of age, weighing 150-300 gm were acquired. They were sorted into four groups. Group A was marked as control, Group B was exposed to 3G mobile phone 2100MHz radiation 24 hours daily, Group C was exposed to same dose of radiation as group B along with zingiber officinale 250mg/kg/day orally, and Group D was given same dose of zingiber officinale as in group C. The rats were euthanized at end of study period after recording their final weight. Brain of rats was removed and weighed. It was processed for haematoxylin and eosin stain to observe general morphology of cerebellum. Results: The data displayed an insignificant increase in final body weight and absolute brain weight in group B animals as compared to control, whereas an insignificant increase and insignificant decrease was observed in body weight and absolute weight of brain when group C was compared with group B respectively. Microscopic examination of cerebellum in H & E stained sections revealed distortion of cellular architecture in group B as compared to control. Tissue sections from group C demonstrated significant restoration of cerebellar architecture. Results of group D were similar to control. Conclusion: Cell phones emit radiation causing damage to brain, especially cerebellum, however, concurrent use of ginger significantly ameliorates this damaging effect. Keywords: Brain, Cell Phone, Radiation, Zingiber Officinale. 33

ASSOCIATION OF LOCATION OF CYST WITH THE FAMILY HISTORY AND MUTATED GENE AMONG PATIENTS OF MYELOMENINGOCELE Urooj Fatima, Sabahat Gul, Imran Ishaq, Sahrish Mukhtar, Iram Quddus, Syed Hussain Mehdi Pakistan Journal of Medical & Health Sciences, 15(10), Pg. 2543-2545, 2021 Aim: To determine association of location of cyst with the family history and mutated gene among patients of myelomeningocele. Methodology: This cross-sectional study consists of fifty diagnosed cases of myelomeningocele and ten healthy individuals taken as controls. The cases were collected from Jinnah Postgraduate Medical Center (JPMC) for a period of six months. The research was conducted in Dow Diagnostic and Research Laboratory (DDRL) (DUHS). Majority of the patients included in the study were neonates. Patients were examined for the presence and site of the cyst. Family history of the patients was also recorded. After taken informed consent from the patient’s attendants, blood was drawn by a trained phlebotomist. DNA was extracted from whole blood followed by PCR amplification of VANGL1 gene. Results: We found that among fifty individuals five patients showed mutation in VANGL1 gene. Mutation was absent entirely from the controls. The cyst was mostly (92%) present in the lumbar region. Only 2% patients showed positive family history. The association between site of the cyst and family history was statistically significant. Conclusion: It is concluded that all mutation of VANGL1 gene was present at lumbar region. There was a strong relation between location of cyst and family history. Keywords: Myelomeningocele, cyst, VANGL1 gene, PCR, mutation. 34

THE RELIABILITY OF GINGIVAL CREVICULAR BLOOD AS A DIAGNOSTIC TOOL FOR DIABETES BY USING GLUCOSE SELF-MONITORING DEVICE IN PATIENTS WITH PERIODONTAL DISEASE WITH AND WITHOUT DIABETES Farhan Butt, Marium Iqbal, Saima Hanif, Mohsin Ghiraj, Faisal, Mudassir Hussain Pakistan Armed Forces Medical Journal Vol 71 No 3 (2021): June DOI: https://doi.org/10.51253/pafmj.v71i3.2942 Objective: To assess the reliability of gingival crevicular blood as a diagnostic tool for diabetes in patients with periodontal disease with and without diabetes. Study Design: Cross sectional study. Place and Duration of Study: Department of Periodontics, Jinnah Medical and Dental College, Karachi, Pakistan, from Jul 2017 to Jul 2018. Methodology: Forty patients with diabetes and 60 patients without diabetes with mild to moderate gingivitis or periodontitis in either the upper or lower anterior region were included. Gingival crevicular blood (GCB) was collected and was assessed by glucometer. The same patient underwent finger stick blood (FSB) and intravenous blood glucose level (IV). Plaque Index (PI), Periodontal Pocket Depth (PPD) and Gingival index were also recorded. Results: A positive correlation (r) was detected between glucose levels of Gingival crevicular blood with finger stick blood with the value of coefficient correlation ‘r’=0.849. The mean values of Gingival index in patients without diabetes is 1.53 ± 0.97mm, patients with newly diagnosed diabetes is 1.87 ± 0.920mm and without diabetes is 2.13± 0.94mm. Conclusion: Blood glucose level can be assessed with the help of Gingival crevicular blood as this technique was found easy and non-invasive to the patient and it can help in diagnosing diabetes during regular periodontal treatment. Keywords: Diabetes mellitus, Finger stick Blood, Glucometer, Periodontitis. 35

THE RELATIONSHIP OF DIFFICULTY AND DISCRIMINATION INDICES WITH PHYSIOLOGY TEACHING AND LEARNING Sadaf Fatima, Syed Tousif Ahmed, Shazia Hashmat, Afshan Iftikhar, Touqeer Alam Hashmi Pakistan Journal of Medicine and Dentistry, 10(2), pp 109-113, 2021 Background: Item analysis, a valuable process conducted after the examination, gives information regarding the reliability of scores and validity of items tested. Difficulty index (P) and Discrimination index (DI) are two parameters, which aid in analyzing the standard of Multiple Choice Questions (MCQs). The study was aimed to find the relationship of difficulty and discrimination indices with teaching and learning in Physiology. Methods: Students (n=100) included were MBBS 1st year from September 2017 to March 2018. The MCQs of Physiology semester II courses were analyzed in two Continuous Assessment Tests (CATs). CAT I included Respiratory: 15/50 and CAT II Hemopoietic: 14/60 and Semester Exam 40/80. The items were examined for difficulty index (p-value) and discrimination index (DI). Items having p-value between 0.3 to 0.7 and DI > 0.2 were considered as having good difficulty and discrimination indices respectively. Results: Out of 15 items in Respiratory CAT, 73% had a mean p=0.3 -0.7 and 27% had mean p= 0.23. The mean DI value was 0.31. Out of 14 items in CAT of Hemopoietic, 85% had a p-value between 0.3 -0.7 and 15% had mean p=0.2. The mean DI value was 0.41. Out of 40 items in Semester exam, 82% items had p value b/w 0.3– 0.7 and 18 % items had mean p=0.18. Overall mean DI value was 0.28. Conclusion: The item analysis of majority of one best type MCQs of CATs and semester exam in Physiology had good difficulty and discrimination indices and matched teaching and learningstrategy in Physiology. Keywords: Difficulty Index; Discrimination Index; Physiology; Teaching; Learning. 36

FREQUENCY AND ASSOCIATION OF MAXILLARY ECTOPIC CANINE WITH INCISOR ROOT RESORPTION AND DENTAL AGENESIS Nasreen Iqball Nagani, Imtiaz Ahmed, Sadia Rizwan, Hana Pervez, Taskeen Khan, Tahira Arif JPMA, Vol. 71, No. 1-B, Page number 277-280, January 2021 Objective: To assess the frequency of maxillary ectopic canine both buccally and palatally displaced with incisor root resorption and dental agenesis. Methods: The cross-sectional study was conducted from April 8 to June 29, 2019, at the Department ofOrthodontics, Dr. Ishrat UlEbad Khan Institute of Oral Health Sciences, and Dow Dental College, Dow University of Health Sciences, Karachi, and comprised orthodontic patients diagnosed with maxillary ectopic canine eruption. Root resorption and agenesis were diagnosed on panoramic films. Root resorption was further confirmed by periapical radiographs. Data was analysed using SPSS 21. Results: Of the 98 subjects, 86(87.8%) had buccally displaced canines of which 38(44.2%) were associated with root resorption, while 12(12.2%) patients had palatally displaced canines of which 10(83.3%) had root resorption (p=0.011). Overall, 30(30.6%) lateral incisors were resorbed, 7(7.1%) both central and lateral incisors, 5(5.1%) premolars, and 6(6.1%) both lateral incisors and premolars were resorbed. Agenesis was detected in 10 (10.2%) subjects (p=0.62). Conclusion: There was found to be no association of maxillary ectopic canines with incisor root resorption and dental agenesis. Keywords: Root resorption, Agenesis, Ectopic canine, Buccally displaced canine, Palatally displaced canine 37

COMPARISON BETWEEN TRADITIONAL, RECORDED AND ZOOM ONLINE PHYSIOLOGY TEACHING IN UNDERGRADUATE MEDICAL STUDENTS DURING THE COVID-19 PANDEMIC Sadaf Fatima, Sulail Fatima, Sara Rafique, Sassi Kanwal, Rabeea Rizwan, Kiran Zehra Pakistan Journal of Physiology, 17(4), pp 51–4, 2021 Background: Due to COVID-19 educational institutions remained closed for traditional teaching, and online teaching methods were implemented. The recorded physiology lectures were forwarded to students, and teaching was conducted online. The objective of this study was to compare online, recorded, and face-to-face physiology teaching in undergraduate medical students during COVID-19 pandemic. Methods: This cross-sectional study was conducted from April to June 2021 at Jinnah Medical and Dental College, Karachi, Pakistan. The study participants included 84 undergraduate 2ndyear medical students. The questionnaire included 21 items regarding zoom online, recorded, and traditional teaching. The students selected the preferred teaching method. The data were presented in terms of percentage for individual items, preference in theory, tutorial, and overall preferred teaching method. Results: The medical students believed that presence of teacher (86.9%), asking queries to teacher (87%), giving feedback to teacher (81.2%), and interest in learning (83.8%) were more important elements to consider for traditional teaching. Regarding the recorded lectures, understanding the lecture (51.4%), and studying at own pace (52.7%) were found to have high percentage. In relation to preference of teaching method for theory (73.5%), tutorial (76.9%) overall preferred teaching method (78.2%), majority of the students selected traditional teaching method. Conclusion: The majority of undergraduate medical students had a preference for traditional teaching methods in Physiology. Among online teaching during COVID-19 pandemic, the students preferred recorded sessions over zoom online classes. Keywords: COVID-19, Physiology, Traditional, Online, Teaching, Recording 38

URINARY TRACT INFECTIONS IN PREGNANCY AND ITS COMPLICATIONS IN NEWBORNS Mahjabeen Yaseen, Sadia Rashid, Shagufta Naqvi, Uzma Salman Rawal Medical Journal 2021; 46(3): 363-639 Objective: To determine the association of fetal complications like low birth weight and preterm birth with UTI in pregnancy. Methodology: This retrospective cross-sectional study was based on secondary data of outpatients Obstetric Clinics at Jinnah Medical College Hospital, Karachi, Pakistan from January to December 2017. Relevant Data of all the pregnant females were included. Data were analyzed by SPSS version 25. Results: Out of 564 females, 48 (8.50%) had UTI sometime during pregnancy. Majority of patients (54.2%) (n=26) were infected with E. coli. Out of 438 normal weight babies (>2.5kg), only 13 were born to mother with UTI. In contrast, 35 out of 126 low birth weight babies were born to mothers with UTI. The observed correlation coefficient (r) is -0.105, which suggest negative and very low correlation. It suggests that with increasing age of the mother gestational period decreases. Conclusion: UTI in pregnancy was associated with low birth weight of neonates and preterm delivery. In order to avoid these complications, UTI should have to be addressed and treated appropriately in all pregnant females irrespective of their symptoms and gestational week. Keywords: Urinary tract infection, newborns, pregnancy. 39

DEPRESSION AND ANXIETY IN HEMODIALYSIS PATIENTS Mahjabeen Yaseen, Shagufta Naqvi, Muhammad Ali Rawal Medical Journal 2021; 46(4): 838-843 Objective: To explore the magnitude of depression and anxiety in hemodialysis patients. Methodology: This cross sectional study was carried out from March to August 2019 at the hemodialysis units of Al Alamgir International Welfare Trust and Karachi Institute of Kidney Disease. All patients >18 years on hemodialysis for more than 6 months were included in the study. Patient with known psychiatric illness or neurological illness, on antidepressant and antianxiety medication, with any kind of addiction (Alcohol, illicit drugs) were excluded. Hospital anxiety depression scale (HADS) was used to assess the presence of anxiety and depression and their severity. A score 11-21 was considered abnormal disorder, a score of 8-10 borderline abnormal and a score 0-7 normal and indicated absence of disorder. Results: Total 156 patients completed the questionnaire. Majority of the participants (52.9%) were male while (47.1%) female. About 43.6% were undergoing hemodialysis in morning, 39.1 % in afternoon and 17.3% in evening. Only (17.3%) of the participants were smokers while rest of the patients had no history of smoking. Out of 156 participants 50.6% of the participants had anxiety (14.74% had borderline anxiety and 35.9% had abnormal anxiety) while 55.8% had depression (26.3% had borderline depression and 29.5% had abnormal depression). Female participants were more anxious than male (p<0.004) and married had statistically significant anxiety (p<0.032). Conclusion: Depression and anxiety is frequently found in patients with hemodialysis. Screening for symptoms of depression and anxiety should be part of routine care in patients with hemodialysis as timely diagnosis and management helps in improving the quality of life. Keywords: Hemodialysis, depression, anxiety 40

TRANS ABDOMINAL VERSUS TRANSVAGINAL ULTRASOUND IN ASSESSMENT OF POLYCYSTIC OVARY Shazia Kadri, Safia Izhar, Nazia Azeem, Sadia Rashid, Zafreen Naz Gudaro The Professional Medical Journal Vol. 28 No. 02 (2021): VOL. 28 No. 02 Objective: The main objective of our study is basically to compare transabdominal and transvaginal ultrasound in assessment of polycystic ovaries. Study Design: Cross Sectional Comparative study. Setting: Jinnah Medical College and Hospital Karachi. Period: January 2016 to January 2017. Material & Methods: 200 married females were selected with complaints of irregular menses, hirsutism, obesity and infertility and age group 18-45 years. Patients with already diagnosed polycystic ovaries or on hormonal treatment were excluded. Results: Out of 200 patients, 54 patient shows poly cystic ovaries both on trans abdominal and Trans vaginal ultrasound, 16 patients on Trans vaginal ultrasound only but not on trans abdominal ultrasound in which 13 patients were very obese. Rest of the patients had normal ovaries on both types of ultrasound examinations. The prevalence of polycystic ovaries noted by transabdominal ultrasound is 27% (54/200) overall and by TVS ultrasound is 35% (70/200). Conclusion: PCOS is quite a common endocrine complaint. Our results suggest that prevalence of PCO is 27% by trans-abdominal u/s and 35% by TVS. The Mean volume of ovary is greater in women with polycystic ovaries but there is no significant difference seen in prevalence of polycystic ovaries diagnosed by both ultrasound examinations. Although it has been observed that TVS is better than transabdominal U/S in detection of PCO but our study shows that the two methods are almost analogous except in obese patient where TVS displayed better results. Keywords: Polycystic Ovaries, Transabdominal, Transvaginal Ultrasound 41

ASSOCIATION OF VITAMIN D BINDING PROTEIN WITH INTERLEUKIN-6 LEVELS IN PATIENTS WITH PERIODONTITIS Sara Rafique, Shazia Nazar Askari, Muhammad Mansoor Majeed, Afshan Mehboob Khan, Sassi Kanwal, Faiza Abdul Sattar Rawal Medical Journal, 46 (3), pp 620-624, 2021 Objective: To compare Interleukin-6 (IL-6) levels with severity of periodontitis and to find the association of Vitamin D Binding Protein (DBP) with Interleukin-6 (IL-6) in healthy controls and periodontitis cases. Methods: This case control study was conducted at Dow University of Health Sciences (DUHS). Periodontal examination was performed according to the probe pocket depth (PPD) and clinical attachment loss (CAL). Serum IL-6 and DBP levels were measured by enzyme-linked immunosorbent assay (ELISA). Results: Median serum levels of IL-6 were 12.5 (IQR=38.8), 3.5 (IQR=71) and 21.2 (IQR=70.5) ng/l. There was no significant difference in median of IL-6 levels with severity of periodontitis (p>0.05). Statistically significant correlation was observed between DBP and IL-6 levels in cases (r=0.76, p<0.01). Conclusion: Although levels of serum IL-6 were not statistically significant with the severity of the periodontal disease among cases but a significantly strong positive correlation of DBP with IL-6 levels was observed in patients with periodontitis. Keywords: Periodontitis, serum, vitamin D binding protein. 42

CASE-CONTROL STUDY FOR ASSESSMENT OF FACTORS ASSOCIATED WITH PERIODONTITIS AMONG ADULTS ATTENDING A UNIVERSITY HOSPITAL IN KARACHI, PAKISTAN Sara Rafique, Sadaf Khan, Shahbaz Ahmed, Masood Anwar Qureshi, Rafat Amin Journal of Pakistan Medical Association, 71 (1-B), pp 252-256, 2021 Objective: To compare the physiological and biochemical markers in healthy and periodontitis subjects, and to relate these markers with the periodontal health condition. Methods: The case-control study was conducted at the Dow University of Health Sciences, Karachi, from April 2017 to March 2018, and comprised systematically healthy controls and periodontitis cases. Periodontal probing depth, clinical attachment loss, oral hygiene indices, educational status and body mass index were recorded for all the subjects. Serum levels of biochemical markers, including calcium, phosphate and interleukin-6, were also measured. Data was analysed using SPSS 16. Results: Of the 150 subjects, 75(50%) each were in the case and control groups. The overall mean age was 31.23• } 3.7 years (range: 22-42 years). The cases had relatively poor oral hygiene indices and educational status compared to the controls (p<0.05). Serum calcium level was lower, whereas mean body mass index was higher in the cases compared to the controls (p<0.05). No significant difference was found in interleukin-6 and phosphate levels (p>0.05). Clinical attachment loss showed significant correlation (p<0.05). Conclusion: Low serum calcium and educational levels, higher body mass index and poor oral hygiene were found to be the risk factors for the progression of periodontitis. Keywords: Periodontitis, Serum calcium, BMI, Oral hygiene, Clinical attachment loss. 43

ASSESSMENT OF ASSOCIATION OF FOLATE AND HOMOCYSTEINE LEVELS WITH DEVELOPMENT OF PRE-ECLAMPSIA AMONG PREGNANT WOMEN Saira Ghafoor, Nazish Ali, Fehmida Salah, Syeda Fariha Hussain, Sumaira Zareen Isra Med J. Vol 13. Issue 2. Pp92-95, 2021 Objective: To determine the association of folate and homocysteine with pre-eclampsia and to ascertain the consequences of pre-eclampsia on foetal birth weight. Study Design: A cross-sectional, case-control study. Place and Duration: From 3th May 2019 to 3rd October 2019 at the Gynecology Department of Jinnah Medical & Dental College in Karachi. Methodology: A total of 76 women with pre-eclampsia were randomly selected after establishing diagnostic criteria on blood pressure and proteinuria. Serum folate and Homocysteine levels were determined by collecting antecubital vein blood and running the assays. Based on the assay results, the study participants were divided into three groups: severe pre-eclampsia, mild pre-eclampsia, and normotensive women. Women were also evaluated for gestational age, maternal age, infant birth weight, and body mass index. Results: Homocysteine was found substantially higher in maternal serum in severe pre-eclampsia than in the mild pre-eclampsia population and controls (p=0.02). However, homocysteine levels were not important in differentiating the control groups from moderate pre-eclampsia (p>0.05). No significant variation was noted in folic acid (p>0.05). Additionally, pre-eclampsia was significantly correlated with gestational age and the child's birth weight (p>0.05). Conclusion: The study's findings indicated homocysteine is significantly associated with the development of pre-eclampsia and could act as a potential biomarker in its detection. Keywords: Pre-eclampsia, Fetal outcome, Obstetric complications, Homocysteine level, Folic acid, Gestational age 44

EVALUATION OF UPPER AIRWAY DIMENSION IN ALL FOUR FIRST PREMOLAR EXTRACTION CASES Hana Pervez, Sara Shah, Rabia Haqqui, Anita Naseer, Faiza Azam, Warisha Ahmed Journal of Liaquat University of Medical & Health Sciences Vol. 20 No. 02 (2021): Objective: To find out any noticeable size difference in the superior airway at the end of premolar extraction treatment and to find out the effects of extraction on axial inclinations of anterior teeth. Methodology: It was a retrospective quasi-experimental study that consisted of 30 orthodontic patients in which all four first premolars were extracted. The orthodontic treatment of the participants was done at Department of Orthodontics, Jinnah Medical and Dental College, Karachi. The data was collected from January 2020 to March 2020. Sampling technique selected was consecutive which is a non- probability type of sampling. The cases included in this study were skeletal and dental class I having class I molar relationship with crowding that required all four first premolar extractions. Patients having syndromes or in need of orthognathic surgery were excluded from this study. The analysis was done on Lateral Cephalometric radiograph which was captured in the beginning and another one once treatment was completed. On these radiographs, changes in the soft palate and upper airway widths were measured. Results: No appreciable alterations observed in the superior airway and soft palate widths. The difference observed in the upper incisors inclination was significant when compared to their pretreatment values. Conclusion: No appreciable change has been noted in the airway dimensions after extraction of premolars. The extractions done as a part of orthodontic treatment results in a great improvement in the correction of proclinations of anterior teeth and reduction of lip procumbency. Keywords: Premolar extractions, Lateral Cephalogram, Airway 45

MYELOPEROXIDASE: INDICATOR OF CARDIOVASCULAR DISEASE IN CHRONIC KIDNEY DISEASE PATIENTS OF TERTIARY CARE HOSPITAL OF KARACHI Sabeela Noor, Faiza Alam, Fasiha Fatima, Shehryar Orakzai The Journal of the Pakistan Medical Association, 71(4), 1128-1132 Objective: To estimate the levels of myeloperoxidase in various stages of chronic kidney disease, and to correlate them with an inflammatory marker and lipid profile. Method: The cross-sectional study was conducted at the Biochemistry Department, Basic Medical Sciences Institute, in collaboration with the Nephrology Department, Jinnah Post Graduate Medical Centre, Karachi, from January 2013 to September 2014, and comprised chronic kidney disease patients and healthy controls. Serum cholesterol, triglycerides, high-density lipoprotein, C-reactive protein and myeloperoxidase levels were noted. Data was subjected to statistical analysis. Results: Of the 150 subjects, 84(56%) were cases and 66(44%) were controls. Weight, body mass index, triglycerides, very low-density lipoprotein, C-reactive protein and myeloperoxidase levels were significantly higher among the cases compared to the controls (p<0.05). Serum myeloperoxidase had a significantly positive association with C-reactive protein (p<0.01), cholesterol (p<0.01), triglycerides (p<0.01), low-density lipoprotein (p<0.01) and very low-density lipoprotein (p<0.01), and had a negative correlation with high-density lipoprotein (p<0.01). Conclusions: Myeloperoxidase concentration had association with lipid profile and C-reactive protein. Keywords: Myeloperoxidase, Cardiovascular, Chronic kidney disease, Lipid profile. 46

PRE AND POST ORTHODONTIC TREATMENT CHANGES IN THE SAGITTAL AND VERTICAL SKELETAL DIMENSION FOLLOWING ALL FOUR FIRST PREMOLAR EXTRACTIONS Hana Pervez, Imtiaz Ahmed, Erum Behroz, Sadia Rizwan The Professional Medical Journal Vol. 27 No. 12 (2020): VOL. 27 No. 12 Objectives: To determine mean change in sagittal and vertical skeletal dimension in patients undergoing orthodontic treatment with all four first premolar extractions. Study Design: Quasi-experimental study design. Setting: Department of Orthodontics, Dr. Ishrat-Ul-Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi. Period: Six months from 18th August 2015 to 18th February 2016. Material & Methods: 50 cases treated with all first premolar extractions were included in this study. The analysis was done on pretreatment cephalogram taken at time of enrolment and post treatment lateral cephalogram taken after 12 months of orthodontic treatment and then their measurements were compared to find out changes in the sagittal and vertical dimension. Results: Pre and post mean SNA, SNB, ANB and Pog-Nperp was not significant while mean A-Nperp was significantly changed after 12 month treatment (p=0.002). Regarding angular measurement, pre and post mean SNMP, FHMP, MMA, Go-OP, SN-OP, Y axis was not significant while mean SN-PP, UI_SN, IMPA was significantly reduced after 12 month treatment. Similarly vertical measurement, pre and post mean LAFH, PFH was not significant while mean UAFH and, TAFH was significantly reduced after 12 months of treatment. Conclusion: Sagittal and vertical skeletal dimension showed no significant change in patients undergoing orthodontic treatment with all four first premolar extractions. Some degree of extrusion was noted in all orthodontic patients who have undergone all four first premolar extractions. Keywords: Cephalogram, Crowding, Facial Profile. 47

USE OF ENDOSCOPE IN TEACHING OF OTOLARYNGOLOGY RESIDENTS ABOUT SITE AND SIZE OF TYMPANIC MEMBRANE PERFORATION AND ITS IMPACT ON DEGREE OF HEARING LOSS IN ADULT PATIENTS: A CROSS SECTIONAL STUDY Muntazir Hussain, Muhammad Wasif, Muhammad Sohail Awan, Shayan Khalid Ghaloo, Zeeshan Sheikh, Haissan Iftikhar J Pak Med Assoc 2020 Dec;70(12(B)):S14-S17 Objective: To determine the association between site and size of perforation of the tympanic membrane and the level of conductive hearing. Methods: The cross-sectional study was conducted from November 2015 to October 2016 at Aga Khan University Hospital Karachi and comprised patients with tympanic membrane perforation without any other middle-ear disease. Karl-Storz Rigid Endoscope attached to a camera was used to take pictures of the tympanic membrane. Site of the perforation was determined using a vertical line to divide the membrane into two anterior and posterior halves. Size of the perforation was calculated as a percentage of the total membrane using Image J software. Data analysis was done using Stata 12. Results: Of the 55 patients, 29(53%) were males and 26(47%) were females. The overall mean age was 33+/-15 years. With every 5% increase in the size of perforation, the hearing loss increased by 1 decibel. A difference of 5.5 decibels was noted between anterior and posterior perforations of similar size. Conclusion: Hearing loss increased with increase in the size of perforation. 48

VOLUNTEERING ACTIVITY AS A SOURCE OF LIFE SATISFACTION AMONG MEDICAL AND DENTAL STUDENTS OF KARACHI, PAKISTAN Shaista Emad, Faiza Nasir, Ayesha Akhlaq, Syed Raheel Pasha, Mohd Jahanzaib Noor, Rubina Ghani Pakistan Journal Of Medicine And Dentistry 2021, VOL. 10 (01) Background: Community Service is an integral component of undergraduate medical education. A volunteer is an individual who, without pay, reaches out beyond the confines of their normal responsibilities; freely and willingly contribute in different ways. Volunteering and serving others can help decrease tension, mentally empower volunteers and offer purpose in life. This study aimed to assess the motivation behind volunteering activities among medical students. Methods: A cross sectional study was conducted comprised of a total of 450 students of different private and government sector medical colleges of Karachi, Pakistan. A volunteer functional inventory (VFI) questionnaire was used for the study. Predictability of motivation behind volunteerism was analyzed by student’s t-test through SPSS software. Results: Out of the 450 participants in this study, 286(64%) of respondents were found to be volunteers and 164(36%) were non-volunteers, the largest respondents constituting 154 (66.7%) had been volunteering for 1-5 months, 63(14%) spent time in volunteering for 6-10 months. It was found that 228(50%) of the students were influenced by their friends to start the act of volunteering. About 72(42%) of respondents were involved in community volunteering in health and emergency services. The various variables of the motivation (protective factor, value factor, career factor, social factor, understanding factor and enhancement factor) among medical students were determined significant (p< 0.05). Conclusion: Medical students can effectively contribute in the training and healthcare initiatives. To the best of our knowledge, the involvement of healthcare volunteering is beneficial both at a personal and academic level for medical students. Keywords: Community Service; Depression; Health; Medical Emergencies; Stress. 49

HR PRACTICES AND ORGANIZATIONAL PERFORMANCE: WHAT ROLE DOES EMPLOYEE SATISFACTION PLAY? Dr. Shahzad Nasim, Dr. Musarrat Shamshir, Dr. Samina Sabir International Review of Management and Business Research Vol. 10 Issue.1 March 2021 Maintaining employee safety and satisfaction can result in increased sales, lower costs, and a stronger bottom line. Employees often support the company's mission and work hard to help it achieve its goals when they believe the company has its best interest at heart. Hence, the study aims to examine the role of employee satisfaction between HR practices and organizational performance. A quantitative research methodology and a deductive research approach are used to assess the relationship between variables. HR practices, such as selection, training, compensation, performance evaluation, and employee engagement, were used as independent variables, and their effect on organizational performance, the dependent variable, was measured, with employee satisfaction as a mediating variable. The primary data was obtained from Pakistani bank employees using a 5-point Likert scale questionnaire, and the data was analyzed using smart PLS. According to the results of this study, HR practices are found to be substantially and positively linked to organizational success. In the present study organizational performance and employee satisfaction and have been assessed as unidirectional measures in the context of the impact of HR practices on the performance of the banking industry. In the future, the addition of secondary data will add value to the findings of the present study. The study's findings would also act as effective guidance for other organizations in terms of the value of HR practices that result in profit maximization. Keywords: HR Practices, Banking Industry, Employee Job Satisfaction, and Organizational Performance. 50

THE MEDIATION ROLE OF E-TRUST TOWARDS WEBSITES QUALITY AND SATISFACTION OF E-CUSTOMERS Zaibunnisa Siddiqi, Dr. Shahzad Nasim, Dr. Musarrat Shamshir International Review of Management and Business Research March 2021 Online purchasing is a valuable opportunity for the new generation in Pakistan. The use of the internet and smartphones is rapidly increasing day by day due to several reasons one of them is emergencies in COVID-19. However, recently the majority of consumers prefer the traditional way of purchasing goods and services instead of online shopping. Hence, numerous studies identified that there is a lack of trust and security in online shopping in the perception of customers. Therefore, the scholar aims to investigate the role of e-trust in the relationship between website quality and e-customer satisfaction in online shopping. The quantitative research technique, the judgmental sampling technique, and the adopted questionnaire are used for the data collection from e-consumer. The findings of the study indicated that through the mediating effect of e-trust, website quality has a significant impact on ecustomer satisfaction. Besides, e-trust serves as a primary mediating factor between website quality and e-customer satisfaction. To satisfy the shopper in online purchasing through websites, the development of trust is the crucial factor because of cybercrimes that harm the e- consumers. Keywords: Website Quality, E-customer Trust, E-customer Satisfaction. 51

NEXUS BETWEEN HUMAN CAPITAL, TECHNOLOGY AND ECONOMIC GROWTH: THE ROLE OF STAGES OF ECONOMIC DEVELOPMENT IN ASIAN COUNTRIES Samina Sabir, Sagher Suleria, Amena Sibghatullah, Musarrat Shamshir JISR management and social sciences & economics 2021, VOL. 19, NO. 2 This paper explores the effect of human capital and technology on economic growth in Asian countries while considering economic development. The paper expands the Solow Growth model by further incorporating the import of machinery and equipment reflecting total factor productivity. Panel data for 30 Asian countries has been used over 1995-2015. Due to the endogeneity problem in human capital and other variables, the System Generalized Method of Moment (GMM) is used to address this problem. Empirical results reveal that human capital and technology have increased economic growth in the total sample of Asian countries. Furthermore, the sample has been disaggregated into highincome (HI) and low-income (LI) Asian countries. Our findings determine that human capital and technology are reflecting a positive and statistically significant role in enhancing economic growth in both samples of countries. However, the magnitude of the impact is high in HI Asian countries relative to LI Asian countries, respectively. When the import of machinery and equipment are replaced with patents, a positive and insignificant results are obtained for LI countries because these countries have lacked legal systems, but a positive and statistically significant relationship is observed for HI Asian countries. Keywords: economic growth, technological progress, human capital, generalized method of moment 52

PHARMACY STUDENTS’ PERCEPTION FROM THEIR CURRENT HOSPITAL WARD ROTATIONS Najia Rahim, Shagufta Nesar, Sarah Jameel Khan, Sabahat Jabeen, Sadaf Naeem5, Sharonia Butt, Shazia Naz, Mehwish Rizvi, Sabiha Gul, Tayyaba Mumtaz, Zeeshan Wasti Latin American Journal of Pharmacy. 40 (4): pp. 907-14. 2021 The aim was to investigate the perception of final year pharmacy students regarding the effectiveness and utilization of their hospital ward rotations (HWRs) and to understand the obstacles to learning. A cross-sectional study was executed during October to December 2018 using a survey tool containing 25 items to acquire perception of the final year undergraduate pharmacy students studying in different universities of Karachi, Pakistan, who experienced hospital rotation. The obtained data was analyzed using SPSS Version 22.0. HWRs were perceived to be useful in the development of knowledge and skills among pharmacy undergraduates (mean score ranged 3.49-4.11). Students believed that HWRs are effective in gaining communication skill (70.7%), however, not sufficiently effective in acquiring presentation skill (57.8%) and managerial skill (60.9%). Statistical association reveals significant association of frequency of HWRs with their response to the questions in which they were asked about effectiveness of HWRs in developing professional maturity and responsibility in order to contribute to patient care (p = 0.0001), getting sound knowledge of basic sciences (p = 0.0001) and building therapeutic knowledge base and disease processes (p = 0.0001). Their response to item asking about value of their HWRs in developing their ability to interview patients was also significantly associated with their gender (p = 0.038), their university type (p = 0.041) and frequency of HWRs (p = 0.002). The decent majority of Pharm.D students who completed the survey were “moderately satisfied” with their hospital rotations. The views of pharmacy students may give valuable insight to the senior administrators of the pharmacy council and academic institutions offering the Pharm-D program to take initiatives to improve the effectiveness and quality of HWRs. Keywords: hospital ward rotations, Pharm. D, pharmacy students. 53

SELF-MEDICATION IN THE COVID-19 PANDEMIC: SURVIVAL OF THE FITTEST Kiran Rafiq, Shagufta Nesar, Humaira Anser, Qurat-ul-Ain Leghari, Alisha Hassan, Alina Rizvi, Aleeza Raza, Zafar Saied Saify Disaster Medicine and Public Health Preparedness. doi: https://doi.org/10.1017/ dmp.2021.173. 2021 Objective: After the World Health Organization (WHO) declared coronavirus disease 2019 (COVID19) a pandemic, intense efforts to combat the novel coronavirus were undertaken, with many fatalities in most regions of the world. The high fatality rate and socioeconomic collapse affected the health of uninfected individuals because healthcare measures and scheduled clinical and hospital visits were avoided by people in an attempt to reduce their exposure to the contagion. The general population began self-medication practices as means to safeguard against exposure to the virus. Methods: The present study investigated the effectiveness of self-medication compliance among the general population. For this purpose, a questionnaire on the Zenodo scale was developed and adults and teen respondents were asked to complete it, after providing consent. The data gathered were analyzed using IBM SPSS Statistics Version 26. Results: The study amazingly found high compliance with selfmedication among the focused population during the period of COVID-19. Estimated results showed a highly significant correlation of 0.000, P < 0.05, between the adaptation of self-medication and pandemic situation, which was estimated from chi-squared and Fisher test results. Conclusions: However, the fear of coronavirus made the practice, or malpractice, a survival of the fittest, innate ability of human nature. Keywords: COVID-19; coronavirus; self-medication; Zenodo scale survival of fittest; pandemic 54

MANAGEMENT OF GESTATIONAL DIABETES MELLITUS WITH RISK FACTORS AND TRANS-GENERATIONAL PREVENTION Sabiha Gul, Kiran Rafiq, Shagufta Nesar, Syed Waleed Ahmed Bokhari, Muhammad Azhar Mughal, Hafiza Tania Naveel, Muhammad Idrees RADS Journal of Biological Research & Applied Sciences. 12(2):146-153. 2021 Background: Gestational Diabetes mellitus (GDM) has become a pervasive health issue of today’s era, leading to be a complicated disorder globally. It has also been proved to be highly accountable for causing an undesired impact on maternal health of patient as well as progeny. The high number of reported cases with consequent complications need appropriate medical care and timely attention. Objectives: The present study was intended to display the real figure of a high rise in GDM in Pakistan, with all involved parameters, to rectify thereal factors either socioeconomic or domestic, accountable for the jeopardizing of disease. Methodology: The study was conducted in different maternity hospitals of Karachi, Pakistan. Association between GDM with age, family history, co-morbid complications, fetal complications and others were analyzed by Pearson chi-square test using SPSS. Results: More than 50% of participants belong to the age bracket of 31-45 years and 31.2% having a positivefamily history of diabetes. No known risk factor regarding GDM was present in 40.6% of women. GDM was observed prevalent and associated with poor health management of mother, and found to increase with elderly mothers (i.e. age of mother at the time of conception) in Pakistan. Conclusion: GDM should be considered as primary health care for the trans-generational prevention of diabetes and needs to be addressed as a public health issue in order to cure the mother and fetus during pregnancy and to prevent long term effects of this disease. Keywords: Fetal complication, Gestational, Hyperlipidemia, Insulin Resistant, Overweight, GDM. 55

HISTOPATHOLOGICAL FINDINGS OF GALL BLADDER SPECIMEN AFTER CHOLECYSTECTOMY Bushra Tasneem, Aisha Tasneem, Fauzia Lateef, Saba Jamal, Rahil M Rehman, Abdullah Muttaqi Pak J Surg 2021; 37(2):94-99 Objective: Cholecystitis is a generally widespread problem in adult population. Multiple findings have been found in gross and microscopic examination of gallbladder. Existence of stones is one of the known causative factors that lead to histopathological changes in gallbladder. It is also responsible for the development of gallbladder carcinoma. The purpose of this study was to find out the histopathology of gall bladder specimens following surgical intervention. Study design: Observational study Place and duration of study: Th is study was conducted at Surgery Department of Abbasi Shaheed Hospital and Pathology Department of Ziauddin Hospital, from January 2017 to February 2020. Material and Methods: Th is observational study included 2,320 patients with acute orchroniccholecystitis secondary to gallstones that were admitted through the outpatient Department. Non-probability convenient sampling technique was used. Written and informed consent was taken from all the participants. Data was analyzed using SPSS version 20. Descriptive analysis was performed. Results: A total of 2,320 gallbladder specimens that presented for histo-pathological examination during the study period were included into the study, with male to female ratio of 1:3. The highest prevalence was found in the age group of 31-50 years. Th e results of histopathological examination of these gallbladder specimens showed that chronic cholecystitis was found in 1353 (58.3%), acute cholecystitis in 469 (20.2%), Gangrenous cholelithiasis 33 (1.4%) and cholestrolosis in 333 (14.3%) patients. Dysplasia was found in 8 (0.34%) patients, and gall bladder carcinoma was detected in 16 (0.69%) patients. Th ere were 2181(94%) cases of calcular-cholecystitis. On morphological analysis, the commonest gall stones were made up of cholesterol and the most common lesion was chronic cholecystitis by histopathology. Conclusion: Th is study concludes that the chronic calcular-cholecystitis was dominant in our population. It is assumed that routine histopathological examination following cholecystectomies essential for all gallbladder specimens even in the non-existence of macroscopic signs of carcinoma, which was the case in our patients. Keywords: Gall bladder, histopathology, cholecystitis, cholecystectomy, Gangrenous cholecystitis, Dysplasia, cholestrolosis, gall bladder carcinoma 56

TO COMPARE THE RESULTS OF PRIMARY CLOSURE OF PILONIDAL SINUS WITH OR WITHOUT REDIVAC DRAIN Bushra Tasneem, Aisha Tasneem, Aqsa Ismail, Rahil M. Rehman, Abdullah Muttaqi Pak J Surg 2020; 36(3):221-226 Objective: Th e objective of this study was to assess the outcomes of primary closure of pilonidal sinus and compare it with and without placement of redivac drain. Material and Methods: Th is prospective study by convenient sampling technique was carried out at Abbasi Shaheed Hospital, Karachi, from January 2016 to February 2020, after taking the approval. Patients of any age of either gender with confirmed diagnosis of Pilonidal Sinus through clinical observation of the symptoms including intermittent pain, swelling and discharge at the base of the spine were included in the study. Patients were divided into two groups i.e. Group-I comprised of patients (n=24) who were not treated with redivac drain while Group-II included the patients (n=24) who were treated with redivac drain during the surgery. Data was analyzed using (SPSS) version 20. Results: Th e mean age of patients of group-I was 30.58• }4.53 years where as in group-II, themean age was found to be 31.25• }3.98 years. Healing time was 6.08• }3.57 weeks in group-I while it was 3.0• }1.76 weeks for group-II (p<0.001). In group-I, 11 (45.8%) patients showed infection and in groupII, less number of patients showed infection 4(16.7%) with significant difference (p=0.029). Satisfactory wound healing in group-I was observed in 14(58.3%) where as in group-II the frequency was higher as 20 (83.3%) patients showed satisfactory wound healing. In group-I only 2(8.3%) patients showed the formation of pus in their wounds while it was absent in patients of group II (p=0.149). Conclusion: It was predicted that ideal outcome of primary closure after excision was achieved by using redivac drain and the frequency of complications, abscess formation and healing time was reduced in comparison to the patients treated without drain. Furthermore it was revealed that satisfactory wound healing was much higher in patients with drain. Keywords: Pilonidal sinus, Primary closure, Excision, Redivac drain 57

DIETARY HABITS, PERCEPTIONS AND BARRIERS AMONG GOVERNMENT AND PRIVATE COLLEGE INTERMEDIATE STUDENTS IN KARACHI: A CROSS-SECTIONAL SURVEY Sabeela Noor, Mariam Rashid, Khadija Abdus Salam, Ramsha Irfan, Ayesha Siddique JBUMDC Vol. 11 No. 2 (2021) Objective: To determine differences in eating practices, perceptions, and perceived barriers among intermediate students of government and private sectors in Karachi. Study design and setting: A cross-sectional study was conducted in six intermediate colleges of Karachi from October to December 2018. Methodology: Total N=390 students aged 16-24 years were selected via non-probability convenience sampling. The study team developed a questionnaire to assess the dietary habits and barriers among the students. Results: Mean BMI of government college students was 20.41 ± 4.15 kg/m2 while that of private college students was 22.25 ± 5.43 kg/m2 . The proportion of underweight participants was higher (36.8%) in government college students, and overweight students being higher in private (23.8%). Similar responses were recorded for daily meals and weekly fast- food and fruit consumption. Skipping meals was found out to be a common practice among students. Breakfast was most commonly skipped meal among both groups (23.9% & 39.2%, respectively). Watching television during meals was common in both groups (58.7% & 67.7% respectively). The majority of the students from both groups did not familiar with the term body mass index BMI (84.6% & 82.5%, respectively). Smoking was more common among the private sector, 16.9%, compared to 3.5 % of the government sector. Fruit juice was considered a healthier option (58.7% & 52.9%, respectively). Similarly, white bread against bran bread was perceived healthier by the majority in both groups (70.1% & 59.3%, respectively). Carbohydrate was reported as a major nutrient in the diet by (51.7% & 57.1% respectively). Factors like educational stress, time, will-power to maintain the diet, availability of junk food, and climate were some of the significant influencers of diet/lifestyle recorded. Conclusion: Students from both groups shared similar eating and lifestyle practices irrespective of their educational institutes’ status. Keywords: Barriers, College Students, Dietary Habit, Perceptions. 58

PERINATAL OUTCOME IN RELATION TO HIGH RISK PREGNANCIES IN TERTIARY CARE SETTINGS Shazia Aftab, Saadia Rashid, Aliya Waheed, Aasha Mahesh, Fariha Hussain, Samina Ayaz Pak J Surg 2021; 37(3):200-205 Introduction: Pregnancy is defined as high risk when it is complicated by one or more medical or obstetric problems and there is likelihood of adverse outcome to the women or her fetus that is greater than the incidence of that outcome in the general population. Pakistan is a developing country with limited resources andaveryhigh maternalandperinatalmortality. 70%ofPakistaniwomen,mostlyfrom rural areas, donotreceive antenatalcare, which directly contributes to adverse perinatal outcome. Objective: The aim of our study is to determine the perinatal outcome of high risk pregnancies, in terms of perinatal mortality, still birth, early neonatal death, APGAR score and birth weight. Material andMethods: Itwas adescriptive case series studyconducted in Department of Gynaecology andObstetrics at Jinnah Medical College Hospital,Karachi between January 1, 2020 and June 2020 in duration of six months, 287 patients with high risk pregnancies were included. Perinatal outcome was assessed in terms perinatalmortality, still birth and earlyneonataldeath.Following deliveryApgar score was noted at 5 min and birth weight was measured. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Data is compiled and results were carried out by SPSS version 23. Results: Out of total 287 patients, mean maternal age and mean gestational age in our study was 32.56±3.91 years and 34.78±3.05 weeks respectively. Perinatal outcome out of 287 high risk pregnancies was found to be perinatal mortality 30 (10.5%), still birth 33 (11.5%), early neonatal death 27 (9.4%),Apgar score <7 at 5 min 20 (7%) and birth weight <2.5 kg 24 (8.4%) respectively. Conclusion: Provision of safe motherhood services including antenatal care, clean and safe delivery, and emergency obstetric and neonatal care services at the door step of women will help in reducing the perinatal death. Keywords: High risk pregnancies, perinatal mortality, still birth, Apgar score. 59

DETECTION OF NOVEL MUTATION IN VANGL1 GENE INDICATING GENETIC ASSOCIATION OF MYELOMENINGOCELE Urooj Fatima, Syed Meesam Iftikhar, Sabahat Gul, Farrukh Mustafa Memon Pakistan Journal of Medical & Health Sciences Vol. 15, NO.8, AUG 2021, Aim: To detect the novel mutation in VANGL1 gene indicating genetic association of Myelomeningocele. Methodology: The study design was cross sectional. It comprises of sixty individuals, of them fifty were diagnosed cases of myelomeningocele and ten were healthy individuals taken as controls. The cases were collected from Jinnah Postgraduate Medical Center. The study was carried out in Dow Diagnostic and Research Laboratory (D.D.R.L.). Most of the patients were less than one year of age. The cases were evaluated for various other parameters like site and size of cyst and associated features like presence of hydrocephalus in the individuals. Since folic acid deficiency is the key component in the causation of the disease so mothers were also asked about the consumption of folic acid. Blood was drawn from patients after a written permission from the parents of the concerned patient. It was followed by the conduction of PCR to seek for any mutation in VANGL1 gene. Results: We found a rare mutation in VANGL1 gene revealing substitution of valine to serine at position 239 i.e. V239S. Hydrocephalus being the associated anomaly was present in 32% of the patients. Most of the affected individuals were males. 98% mothers of the sufferers did not take folic acid during pregnancy. In most of the patients, lump was present on the lumbar region. Conclusion: Myelomeningocele is a congenital birth defect with lifelong complications. Its prevalence can be decreased by taking certain measures. Periconceptional intake of folic acid has been established to lessen the risk of the disease. We identified a rare mutation in VANGL1 gene that may result in the causation of myelomeningocele. Keywords: Neural tube defects, mutation, myelomeningocele. 60

HISTOMORPHOLOGICAL EFFECTS OF WITHANIA SOMNIFERA ROOT EXTRACT AGAINST CISPLATIN INDUCED RENAL LESIONS IN RATS Aaqiba Rasheed, Nadia Younus, Nausheen Adnan, Naureen Waseem, Lubna Faisal, Tayyaba Kazmi, Mohammad Mohtasheem Ul Hassan, M. Omar Shamim, Munair Badshah P J M H S February 2021 Aim: To analyze the nephroprotective effects of W. Somnifera root extract against cisplatin induced nephrotoxicity in albino Wistar rats through gross and histopathological parameters. Methodology: This experimental study was carried out at the Baqai Medical University, Karachi from November 2018 till February 2019. Eighty adult male Albino Wistar rats were divided in to equal four groups. Group A served as control, group B received inj. Cisplatin 1mg/kg intraperitoneally for 7 days, while group C was given W. Somnifera root extract 500mg/kg orally for 15 days before cisplatin treatment and thereafter concurrently with cisplatin for last 7 days. Group D received only W. Somnifera root extract 500mg/kg orally for 22 days. Their initial and final body weights were recorded. On 8th day of experiment group B and on 23rd day group A, C & D were sacrificed. Results: Albino rats of cisplatin treated group B showed significant (p<0.05) reduction in final body weight as compared to group A and D whereas insignificant (p>0.05) change was recorded in WS+CP treated group C. Similarly there was a significant (p<0.05) increase of absolute & relative kidney wt. of group B. However, no significant (p>0.05) change in kidney weight of others groups were recorded. Stained section of group B showed significant (p<0.05) hisopathological alterations in renal parenchyma. Degenerative changes were more marked in renal corpuscle and proximal convoluted tubule (PCT). However there was preservation of renal architecture of group C (p>0.05). Conclusion: It is concluded from our study that pretreatment with W. Somnifera has prevented the cisplatin mediated tubular damage in kidney. Keywords: Cisplatin, W. Somnifera, renal corpuscles, proximal convoluted tubules, nephrotoxicity. 61

IMMUNOHISTOCHEMICAL EXPRESSION OF ALPHA (Α) A CRYSTALLIN IN SENILE DEGENERATIVE AND NON-CATARACT LENSES Shabnam Khan, Bushra Wasim Khan, Madeeha Sadiq, Fawad Rizvi, Faraz Ahmed Baig, Rehan Ahmed Siddiqui P J M H S Vol. 15, No.10, OCT 2021 Aim: Comparative immunohistochemical study of expression of α A Crystallin in non-cataract lenses and age-related cataract lenses in humans. Methodology: This was an observational cross sectional study. There are two groups in this study. Group A comprised of 121 senile degenerative cataract lenses from diagnosed patients. Group B included of 10 non-cataract lenses from patients who underwent surgeries for enucleation due to trauma and retinoblastoma. Lenses were fixed in 10% Buffered Neutral Formalin and processed to make paraffin blocks. Immunohistochemistry (IHC) staining was performed on sections using primary antibody for α A crystallin. Data was analyzed through SPSS software version 24. Results: Immunohistochemical staining of group A showed 80.2% Strong Positive expression while 19.8% showed Intermediate Positive expression of α A Crystallin. 100% Strong Positive expression of α A Crystallin was seen in group B. Comparison of expression of α A Crystallin in two groups showed significant decrease (p<0.001) in expression. Conclusion: Decreased expression of α A Crystallin in IHC stained senile cataract lens indicates the role of structural alterations of lens fibers in pathogenesis of senile cataract. If mechanism involved in causing these alterations can be identified and targeted so that progression of senile cataract maybe delayed. Keywords: Immunohistochemistry, α A crystallin expression, senile cataract, Human eye Lens, Lens Fiber. 62

PREVALENCE OF SECOND MESIO-BUCCAL (MB2) CANAL IN PERMANENT MAXILLARY FIRST MOLAR Huma Sarwar, Meshal Muhammad Naeem, Syed Ali Raza, Sanam Faheem, Amir Akbar Shaikh, Ujala Mushtaque P J M H S Vol. 15, NO. 7, JUL 2021 Objective: The aim of this study is to determine the prevalence of second mesio-buccal canal in permanent maxillary first molars. Study Design: Cross sectional study. Place and Duration: Dr Ishrat ul Ebad Khan Institute of Oral Health Sciences, Karachi during the period from February 2020 to January 2021 Patients and Methods: Three hundred and fifty cases of both genders were presented in this study. Patients were aged between 18-60years. Patients’ detailed demographics including age, sex and body mass index were recorded after taking written consent. Local anesthesia was given for isolation of rubber dam. The pulp chamber floor was clearly visualized and the access cavity was ready. The location of the MB2 channel in three phases was done. Complete data was analyzed by SPSS 22.0 version. Results: Mean age of the patients were 30.14±17.47 years with mean BMI 25.61±8.25 kg/m2. Among 350 cases, Majority of the patients 225 (64.3%) were male while the rest 125 (35.7%) were females. Majority of the patients were from age group 20-30 years and less patients were between 51-60 years old. Frequency of second mesiobuccal canal was found in 280 (80%) patients. Conclusion: We concluded in this study that prevalence of MB2 channel was reported in 80% in the initially permanent maxillary molars. Most MB2 canal apertures are distal from the main MB channel and most MB2 apertures are palatal. Keywords: Permanent maxillary first molar, MB2 canals, Frequency 63

IDENTIFICATION OF E-EXAMINATION AND E-LEARNING ENVIRONMENT RELATED FACTORS DURING COVID-19 AND ITS ASSOCIATION TO ACADEMIC FAILURE IN DENTAL STUDENTS OF A DEVELOPING COUNTRY: A CASE-CONTROL STUDY Fareeha Farooq, Saher Mushtaque, Ujala Mushtaque, Ahsan Malik, Hebah Mushtaque, Hr Sukhia P J M H S Vol. 15, No.12, DEC 2021 Background: During COVID-19 all universities have shift their face to face teaching pattern to elearning. Objective: This study explores various factors of E-exams and learning associated to academic failure during Covid-19. Material and Methods: A case-control study was conducted in March, 2021 among 225 dental undergraduate students out of which 75 were cases (failed) and 150 were controls (passed). Online questionnaire consisted of 24 items was filled by BDS students’ from first year till final year. Hence, odds ratio was calculated by using SPSS version 23. Results: The results of the study revealed that the rate of failure among the dental students from first year till final year was (60%), (11.1%), (13.9%) and (19.0%) respectively (p= 0.000). Significant Eexam related factors associated to academic failure were effort and time required to attempt exams (p=.000, OR=1.8), online OSPE/OSCE (p= .001, OR=2.7), technical IT skills (p= .009, OR=2.1), Student’s presentation marks (p=0.05, OR=1.7) and cheating (p=0.03, OR=1.8), whereas lower risk factors were MCQ’s (p=0.06), synchronous oral viva (p=0.5), internet connectivity issues (p=0.2), assignments (p=0.3) and online quizzes (p=0.7). Factors associated with highest risk of failing were pre-recorded didactic online lectures (p=0.03), less responsibility of learning online (p=0.04), dissatisfied bedside clinical skills (p=0.02) and poor attendance (p=0.05). Conclusion: The results of the study conclude that faculty training is immediately required to conduct fair online E-assessments, OSCE/OSPE using appropriate technology and include presentation marks. While designing E- courses, interactive virtual sessions should be conducted to improve student engagement and attendance. Keywords: Academic failure, Dental students, Remote E-exams, Undergraduate 64

ASSOCIATION OF DIETARY INTAKE OF VITAMIN-C WITH PERIODONTITIS AMONG ELDERLY POPULATION OF KARACHI, PAKISTAN Ujala Mushtaque, Muhammad Zohaib Younus, Yasir Raza, Hariza Surani, Hijab Fatemah, Jaweria Yousfani P J M H S DOI: https://doi.org/10.53350/pjmhs2115123828 Vol. 15, No.12, DEC 2021 Backgrounds: Vitamin- C plays a major role to prevent the spread of various diseases. Hence Vitamin-C is associated with periodontal disease. Objectives: This study was conducted to evaluate the relationship between the dietary intake of Vitamin-C and periodontitis among the elderly population of Karachi, Pakistan. Study Design: Cross-sectional study Place and Duration of Study: The study was conducted among the elderly population of Sir Syed Hopistal, Karachi from June till November 2021. Material and Method: A total of 384 elderly patients were taken by using convenience sampling technique belonging to age group (60-85) who were admitted in the Hospital at that time. The status of periodontits was assessed by using periodontal index. Twenty four-hour dietary intake of VitaminC was recorded along with other confounders such as age, gender, regarding the use of tooth brush, flossing, visits of dentist, alcohol consumption, smoking and other diseases. A multivariable logistic regression was applied. Results: The participants who have taken dietary intake of vitamin C inadequately suffered from periodontitis by 1.16 times more than those participants who took adequate dietary intake of vitamin C (adjusted odds ratio [aOR]= 1.16, 95% confidence interval = 1.04±1.29). Conclusion: The results of our study revealed that inadequate intake of dietary Vitamin-C was associated with the disease name periodontitis among the elderly population of Karachi. On the contrary adequate intake of dietary vitamin C has become essential to promote the periodontal health among the elderly patients. Keywords: Ascorbic acid; Gingivitis; Periodontal disease; Periodontitis; Vitamin C 65

AWARENESS OF PERIODONTAL LIGAMENT INJECTION AMONG HOUSE OFFICERS AND POST GRADUATE TRAINEES- A CROSS SECTIONAL STUDY Saima Hanif, Sameer Ahmed, Shaista Khan Pakistan Oral & Dental Journal, Vol. 41, No.2, 2021 The objective of this research was to assess how aware house officers and post graduate trainees are about periodontal ligament injections. 150 questionnaires were distributed but only 105 responses were received. The questionnaire consisted of 10 questions in which participants were asked basic questions about injection technique for extractions and knowledge about periodontal ligament injection. All 105 responses were sent for statistical analysis. Out of 105 participants; 49.5% used nerve infiltration, 35.2% used nerve block, 13.3% used both and 1% used periodontal ligament injection for extraction. The technique used for effective anesthesia for extraction of tooth was nerve block 82.8%, periodontal ligament injection 7.6%, 6.7% Nerve infiltration, 2.9% pulpal injection. It is concluded that many house officers and post graduate trainees know about the PDL injection but they apply this method of anesthesia in circumstances when the routine infiltration and block (IANB) fail to be effective. Keywords: Periodontal ligament injection, extraction, nerve infiltration 66

THE COMPARISON OF PHYSIOLOGY LEARNING IN UNDERGRADUATE MEDICAL AND DENTAL STUDENTS Sadaf Fatima, Syed Tousif Ahmed, Shazia Hashmat, Huma Salahuddin, Kevin Joseph Jerome Borges, Syed Nudrat Nawaid Shah Medical Forum, 32(2), pp 50-54, 2021 Objective: To study the difficulties and problems associated with learning of Physiology in undergraduate medical and dental students in integrated curriculum. Study Design: Cross sectional study. Place and Duration of Study: This study was conducted at the Ziauddin Medical College and Ziauddin Dental College, Ziauddin University, July 2017 to June 2018. Materials and Methods: The study participants included 1st, 2nd, 3rd year medical students and 1st and 2nd year BDS students. There were 225 participants, 147 MBBS and 78 BDS students. A questionnaire was distributed to each medical and dental student. There were 23 items included in the questionnaire from why is Physiology hard for students to learn? The items were related to subject, teaching and learning of Physiology. The medical and dental students were asked to select a response for each item on like rt scale from 1 to 5. Results: Regarding the Physiology learning responses, the comparison was done between MBBS and BDS students. A significant difference was found in factors including basic concepts (<0.001), use of scientific terms (0.01), covering large content in one lecture (0.01) and integration (0.002). Conclusion: The medical and dental students identified the factors causing difficulties and problems in learning physiology and the reasons of these difficulties. Keywords: Physiology, Teaching, Learning 67

ONLINE PHYSIOLOGY TEACHING AND ASSESSMENT IN UNDERGRADUATE MEDICAL STUDENTS DURING COVID-19 PANDEMIC Sadaf Fatima, Fadieleh Sohail, Sulail Fatima, Sara Rafique, Mohammad Sultan and Abdul Aziz Medical Forum, 32(5), pp 49-52, 2021 Objective: To study the perceptions of medical students on online Physiology teaching-learning during COVID-19 pandemic and to evaluate the preference of medical students on online teaching, traditional teaching or both. Study Design: Cross sectional study Place and Duration of Study: This study was conducted at the Jinnah Medical and Dental College, January to March 2021. Materials and Methods: The study participants included 62 MBBS 2nd year students. A questionnaire was distributed to each student. The questionnaire included 22 items regarding online teaching and online assessment. The medical students were asked to select a response for each item on the questionnaire including the preferred teaching method from online, traditional or both. The online recorded lectures were uploaded on student portal of JMDC website during COVID 19 pandemic period. The data was presented in terms of percentage for individual item, for preference in theory, practical, tutorial, assessment and the overall preferred teaching method. Results: The medical students were of the opinion that presence of teacher (74.2%), presence of colleagues (67.7%), asking the queries to teacher (71%) giving feedback to teacher (71%) were more important aspects for traditional teaching. Regarding the online recorded lectures getting enough time to understand the lecture (53.2%) and studying at own pace (54.8%) were found to be more important. In the preference of teaching method for theory (53.2%), practical (77.4%) tutorial (48.4%) and assessment (54.8%) the majority of students selected traditional method. The overall percentage of traditional method (56.5%) was higher as compared to online (27.4%) and both (16.1%). Conclusion: The majority of 2nd year medical students had a preference for traditional teaching methods in Physiology. Keywords: COVID 19, Physiology, Traditional Teaching, Online teaching 68

THE DIFFERENCE BETWEEN ZOOM ONLINE AND TRADITIONAL PHYSIOLOGY TEACHING IN UNDERGRADUATE PHYSICAL THERAPY AND BIOTECHNOLOGY & BIOLOGICAL SCIENCES STUDENTS DURING COVID-19 PANDEMIC Sadaf Fatima, Sulail Fatima, Sara Rafique, Sassi Kanwal, Mohammad Sultan, Abdul Aziz Medical Forum, 32(9), pp 33-37, 2021 Objective: To find the students’ preference between zoom online and traditional face to face Physiology teaching in undergraduate physical therapy and biotechnology & biological sciences during the COVID-19 pandemic. Study Design: Cross Sectional study Place and Duration of Study: This study was conducted at the Sohail University from April 2021 to June 2021 for a period of 02 months. Materials and Methods: The study participants included 100 Physical therapies and 94 Biotechnology & Biological sciences students. A questionnaire was distributed to each student. The questionnaire included 17 items regarding online and traditional teaching. The students were asked to select a response for each item on the questionnaire including the preferred teaching method from zoom online, traditional, or both. The data were presented in terms of percentage for the individual items, preference in theory, and the overall preferred teaching method. Results: The students gave the opinion that the presence of teacher (82.1%), asking the queries to the teacher (80.2%), giving feedback to the teacher (78.3%), and interest in learning (76.4%) were more important aspects for traditional teaching. Regarding the zoom online lectures, accessibility to the internet hindered online teaching (84%) and online teaching led to more distraction (67.9%). Moreover, a high majority of students (79.2%) preferred the traditional method for theory. The overall preference for the traditional method (83%) was higher as compared to online (2.8%) and both methods (14.2%). Conclusion: The majority of physical therapy and Biotechnology & Biological sciences students had a preference for traditional teaching methods in Physiology. Keywords: COVID - 19, Physiology, Traditional Teaching, Online teaching 69

THE COMPARISON OF ASSESSMENT SCORES BETWEEN MODULES TAUGHT FACE TO FACE AND ONLINE IN UNDERGRADUATE MEDICAL STUDENTS DURING COVID19 PANDEMIC Sulail Fatima, Sadaf Fatima, Fadieleh A. Sohail, Sassi Kanwal, Kiran Zehra, Saqib Kamran Medical Forum, 32(5), pp 6-9, 2021 Objective: To study the comparison of the Physiology test score and overall test scores between modules taught face to face and online. Study Design: Cross sectional study Place and Duration of Study: This study was conducted at the Jinnah Medical and DentalCollege, Karachi from Jan 2021 to March 2021. Materials and Methods: The study participants included 2nd year medical students. There were total 96 MBBS students. Out of 96, 90 students attempted the Neuroscience module test and 88 attempted the Endocrine module test. The Neuroscience module was taught face to face on campus before the lockdown for COVID 19 pandemic was implemented. For the endocrine module, online recorded lectures were sent to students. In both the modules, test was conducted online. The Physiology test scores as well as the overall test scores were compared. Results: The Physiology test score was higher (54.64±20.12) in Neuroscience module that was taught face to face as compared to (31.42±26.00) in Endocrine module that was taught online. Regarding the overall module test score, Neuroscience has a higher score (62.12±13.45) as compared to Endocrine (52.06±16.81). The overall passing percentage was (74%) in Neuroscience module and (48%) in Endocrine module. Conclusion: The medical students had a higher test score in module taught by face to face teaching method as compared to the module taught online. Keywords: COVID 19, Physiology, Traditional Teaching, Online teaching, Online assessment 70

ASSESSMENT OF OLIGOHYDRAMNIOS IN PREGNANT WOMEN: OUTCOME OF HYDRATION THERAPY Sadia Rashid, Samia Perwaiz Khan, Safia Izhar, Shazia Kadri, Saira Ghafoor, Nazish Ali Medical Forum monthly 32(2):115-119, Feb 2021 Objective: The study was designed to determine the role of ultrasound as a tool in assessing of low amniotic fluid index (AFI) or Oligohydramnios and perinatal outcomes. Determination of improvement in low AFI on Hydration therapy. Study Design: Case-Control study Place and Duration of Study: This study was conducted at the tertiary care hospitals from May 2019 to May 2020. Data was collected from Obstetrics & Gynecology and Sonology departments (Jinnah Medical and Dental College Hospital JMDCH and Medicare Cardiac & General Hospital) for period of one year. Four hundred pregnant women were included in the study. Materials and Methods: Total two hundred pregnant women with oligohydramnios were included as cases and equal normal pregnant women as controls were included in study with no other medical issue. All those with any associate medical issue were excluded from this study. Amniotic fluid volume was measured by amniotic fluid index (AFI) or single deepest pocket (SDP) in pregnant women. Amniotic fluid index 5 cm was considered to be oligohydramnios and cause of number of complications such as preterm labour, low Apgar score, birth weight, infections and even causefetal demise were recorded. Results: Out of total, 200 pregnant women had the ultrasound finding of oligohydramnio. AFI less than 5 cm were oligohydramnios and between 5.1 to 7cms were borderline. Delivery before 37 weeks in 134 (69%) oligohydramnios cases and 30(15%) were normal controls. Birth weight less than 2.5 kg in 44 (22%) cases and 34 (17%) controls. Low APGAR scores calculated in cases both at 1 minute was 178(89%), at 5 min 22(11%) . NICU admission were done for 22(11%) neonates as compared to 14(7%) neonates from normal pregnancies. Hydration therapy improved the amniotic fluid index (AFI) and outcome of pregnancies. Conclusion: Oligohydramnios increases the risk of early delivery with low birth weight, APGAR score and increase risk of NICU admissions. Hydration therapy improved the amniotic fluid index (AFI) Keywords: Amniotic fluid index, Oligohydramnios, Ultrasound, Hydration therapy. Amniotic fluid volume, Single deep pocket. 71

PRE-ECLAMPSIA AND PREGNANCY OUTCOME: A POPULATION BASED CASE CONTROL STUDY IN KARACHI PAKISTAN Sadia Rashid, Safia Izhar, Shazia Kadri, Saira Ghafoor, Asma Abdullah Medical Forum monthly 32(6):104-106, June 2021 Objective: To determine the pregnancy outcomes in women presented with severe pre-eclampsia in Karachi Pakistan. Study Design: Case control/Prospective study. Place and Duration of Study: This study was conducted at the Medicare Cardiac & General Hospital Karachi during from July 2016 to June 2018. Materials and Methods: One hundred and ten patients with ages 18 to 45 years presented with preeclampsia were included in this study. Patients detailed demographic including age, parity, gestational age, and body mass index were recorded after taking written consent. Patients complete blood picture was examined. Complications associated with preeclampsia were examined. Results: Twenty-two (20%) were ages <20 years, 48 (43.64%) were ages 20 to 30 years, 36 (32.72%) were ages 31 to 40 years and 4 (3.64%) were ages above 40 years. 42 (38.18%) were prim gravida while 68 (61.82%) were multigravida. Mean gestational age was 33.45±4.68 weeks. HELLP syndrome found in 20 (18.18%) patients, 10 (9.09%) patients had eclampsia, and 14 (14.55%) patients had placental abruption, coagulopathy found in 3 (2.73%) patients, 2 (1.82%) patients developed acute renal failure and 2 (1.82%) patients were died. Conclusion: Pre-eclampsia is highly associated with major maternal complications such as HELLP syndrome, eclampsia, placental abruption and maternal mortality. Keywords: Pre-eclampsia, HELLP Syndrome, Placental Abruption, Eclampsia, Mortality 72

FREQUENCY OF ACUTE KIDNEY INJURY AMONG SEPTIC CHILDREN, ADMITTED AT A TERTIARY CARE HOSPITAL Meher Afroze, Maryam Haider, Uzma Arshad, Nadeem Noor, Shagufta Naqvi, Sameer Saleem Tebha Medical Forum Monthly 2021;32(7):107-111 Objective: The objective of our study was to determine the frequency of acute kidney injury (AKI) among septic patients admitted at a tertiary care hospital. Study Design: Descriptive / observational study Place and Duration of Study: This study was conducted at a Tertiary Care Hospital of Karachi from 1 st July 2015 to 31st December 2015. Materials and Methods: Total 237 patients who were diagnosed as having sepsis with age 1 to 144 months were included in the study. These patients were monitored till the development of acute kidney injury (AKI). The frequency and percentages were calculated for qualitative variables i.e. gender, and age group, while mean and standard deviation was calculated for quantitative variables i.e., age, baseline serum creatinine, maximum serum creatinine and hospital stay. P-value ≤0.05 was considered as significant. Results: Total 237 patients were included in study with age 1 to 144 months 61.93(±33.510). Out of 237 patients 62 i.e. (26.2%) developed Acute Kidney Injury (AKI). A significant association of acute kidney injury was observed with hospital stay (p<0.001) and male gender (p=0.045). No significant association of acute kidney injury was observed with age (p=0.737) and baseline serum creatinine (p=0.104). Conclusion: Development of Acute kidney injury is common in septic children and is significantly associated with increased hospital stay. This study provides statistics of sepsis induced AKI in the local population. In addition, the results emphasize on early identification of AKI among septic children to prevent further morbidity and mortality. Keywords: Acute Kidney Injury, Risk factors of Acute Kidney Injury, Pediatric sepsis, Sepsis induced Acute Kidney Injury. 73

MATERNAL AND FETAL OUTCOME IN CARDIAC PATIENTS: A CROSS-SECTIONAL STUDY AT TERTIARY CARE SETTING Sadia Rashid, Humera Ismail, Lumaan Sheikh Pakistan Journal of Medical and Health Sciences. Vol. 15, NO. 3, 835-838, March 2021 Background: The presence of cardiac diseases in pregnancy is a high-risk condition and poses a threat to both mother and child. This study aimed to determine maternal and fetal pregnancies in women with cardiac disease at a tertiary care hospital. Methodology: This was a retrospective study conducted in the Department of Obstetrics and Gynecology, Aga Khan University Hospital, Karachi, from January 2013 to December 2015. All pregnant women with cardiac diseases were enrolled in the study. Mean (SD) was used for continuous variables, while percentages were calculated for categorical variables. Chi-square test was applied to compare the maternal and fetal outcome with the severity of functional class. A pvalue of less than 0.05 was considered significant. Results: The average maternal age was 29.8 ± 5.2 years. Rheumatic heart disease was present in 47% and congenital heart disease in 28.8% of pregnant women. Almost 80% of women belonged to NYHA functional class I and II. Overall maternal complications were GDM, Preeclampsia, pulmonary edema, PPH, CCF, Arrhythmias, Cardiogenic and septic shock. GDM, preeclampsia, pulmonary edema mainly occurred in congenital heart disease patients. Perinatal outcomes included 93.2% live births, 3% neonatal, and 3% intrauterine deaths. Significant associations were found between pulmonary edema, use of Digoxin & Diuretics, and NYHA functional class. Conclusion: The current study indicates that cardiac diseases are associated with adverse maternal and fetal outcomes. These women require aggressive monitoring and time management. Therefore, such patients should be regularly followed and counseled. Keywords: Cardiac disease, pregnancy, maternal complications, fetal complications. 74

MATERNAL AND NEONATAL OUTCOMES IN PREGNANT WOMEN PRESENTED WITH OR WITHOUT COVID-19 DISEASE Nazish Ali, Sadia Rashid, Zaib-un-Nisa Quraishi, Aliya Waheed, Saira Ghafoor, Fehmida Saleh Medical Forum 2021;32(6):112-115 Objective: To compare the maternal and neonatal outcomes in patients with or without coronavirus disease. Study Design: Prospective/observational study Place and Duration of Study: This study was conducted at the Obstetrics & Gynaecology department, Liaquat College of Medicine and Dentistry Darul Sehat Hospital, Karachi for duration of six months April, 2020 to September, 2020. Materials and Methods: One hundred eighty patients with ages 18 to 35 years and gestation age >24 weeks were included. Patient’s demographical detail including age, residence, education and socioeconomic status were recorded. All the patients were divided into two groups; Group A consists of 90 patients presented with COVID-19 and Group B with 90 patients without COVID-19. Maternal outcomes were recorded. Neonatal outcomes such as admission to NICU, birth weight, Apgar score and mortality were recorded. Results: There were no significant difference in term of age between Group A and B 28.5 years and 28.76 years. Mean BMI in group A was 25.85±2.65 kg/m2 and in group B it was 26.89±2.48 kg/m2 .In group A frequency of C- section was higher 56 (62.22%) and in group B it was 24 (26.7%). Frequency of preterm in group A was 22 (24.44%) while in group B was 10 (11.11%). In Group A 33.3% neonates need to NICU. Low birth weight was 26 (28.89%) higher in Group A patients. 4.44% neonatal death was recorded in Group A while none in Group B. Conclusion: The pregnant women with COVID-19 disease had more complications and higher rate of lower segment cesarean section and preterm delivery as compared to normal pregnant women. Keywords: C-sections, Maternal outcomes, Neonatal, Morbidity, Mortality 75

COVID’S IMPACT ON MEDICAL STUDENTS’ PERFORMANCE Nabeeha Asif, Sidra Sohail Pakistan Journal of Medical & Health Sciences, Vol. 15, No.12, 2021 Objective: To find out the impact of COVID-19 on the mental health of medical students and its repercussions on academic achievement. Methodology: Present cross-sectional study was carried out amongst the medical students of Islamabad, Karachi, and Lahore. A sample size of 123 medical students filled a questionnaire-based survey of 21 questions, which were specifically designed to find the relationship between COVID-19, mental health, and its effect on medical education. The data was analysed using SPSS version 23. Results: Out of all the participants, 70.7% received their education online. 67.6% had a negative impact on their mental health during the pandemic, and 26.8% had a mixed response of both positive and negative impacts. A total of 80.5% of students documented that their learning experience worsened over the last two years, and 48.8% of participants had a poor academic performance. 26.8% of the medical students experienced mixed academic performance, showing both improvements and decline. Out of the 26.8%, 45.4% of the students experienced challenges adapting to the new medium of learning, and 54.6% had reduced motivation and focus. There is a strong association between mental health and academic prowess, and the new medium of learning, lack of motivation, and declined focus are contributing factors to poor academic performance. Conclusion: It can be concluded that there is a strong relationship between mental health, learning experience, and academic achievement in medical students. The pandemic and isolation led to increased levels of mental stress, which then affected medical studies. For the majority of the students, there was a decline in mental health, academic learning, and academic performance. Keywords: COVID-19, mental health, stress, medical students, pandemic 76

ABO BLOOD GROUP SYSTEM AND COVID-19 SUSCEPTIBILITY IN DIFFERENT ETHNIC GROUPS OF MEDICAL STUDENTS IN KARACHI Noorulain Thebo, Shah Jabeen, Asma Shahid, Muhammad Athar Khan, Sassi Kanwal, Shahida Kashif Annals of Jinnah Sindh Medical University, 7 (2), pp 55-59, 2021 Objectives: To determine the frequency of blood groups in different ethnicities among medical students of Karachi and the association of blood groups with Covid-19 susceptibility Methodology: A cross sectional study was conducted among medical and dental students of Liaquat College of Medicine and Dentistry from January 1st to October 30, 2019 after taking Institutional Review Board's approval. Data was collected from students of different ethnicities. Blood group was determined by mixing the blood with antisera and observing the agglutination by antigen and antibody reaction. Screening for Covid 19 was carried out by reverse transcription polymerase chain reaction real-time (RTPCR) Result: In our study, data was collected from 220 medical students, out of whom 89 (40.5%) were male. Their ages ranged from 17-22 years with mean age of 19.5±2.39 years. Among 220 students, group B was the most common blood group, accounting for 77 (35%) participants. Screening, the most susceptible blood group for Covid 19 virus was found to be blood group B (61%). Conclusion: According to ethnicity, blood group B was the most common group in Punjabi and Urdu speaking populations while among Sindhis, A and 0 were the pre'11ent groups. The Rh positive group was found to be more susceptible to Covid-19 virus and blood type B was revealed to be in higher association with it. Keywords: ABO blood group, Blood group, Covid-19, Ethnicity, Medical students 77

PRE AND POST ANALYSIS OF STRESS REDUCTION FOLLOWING PILATES EXERCISE AMONG UNDERGRADUATE STUDENTS OF PHYSICAL THERAPY Noman Ahmed, Nasir Mehmood, Ghazala Noor Nizami Medical Forum, 32(10), pp.224-227. 2021 Objective: Stress is a widespread issue with all students facing some level of stress. We conducted a study to assess if Pilates exercise can reduce stress among undergraduate students of Physical Therapy. Study Design: Longitudinal study Place and Duration of Study: This study was conducted at the Isra Institute of Rehabilitation Sciences and Karachi University from January 2019 to May 2020. Materials and Methods: A Pilates expert was hired to do sessions of Pilates 3 times a week for six weeks. Pre and Post assessment of stress was carried out using the Perceived Stress Scale (PSS14), a five-unit scale used to measure perceived stress. Data were then analyzed using SPSS Version 21.0 by applying paired t-test and setting the statistical significance at P ≤0.05. Results: A significant difference (P≤0.05) in perceived stress was shown before and after the students took part in Pilates exercise. Conclusion: Pilates showed to be a reliable method in reducing stress among undergraduates of Physical Therapy. Pilates should be used more widely among different populations in reducing stress. Keywords: Celebrex, nephroprotective, chemoprotective, PGE 78

MENTAL HEALTH ISSUES IN FEMALE POPULATION DURING COVID-19 PANDEMIC Syeda Fariha Hussain, Shazia Aftab, Huma Baloch, Naila Qamar, Maryam Masood, Zakia Bano Pakistan Journal of Medical & Health Sciences 15(10):3370-3374, 2021. Background: Female population can be affected by various psychological factors that can have adverse effects on the woman’s mental health. Pandemics are one such times which can have negative effect on the mental health. Therefore, this study was conducted to determine the status of depression and anxiety and factors associated with it in the female population (pregnant and nonpregnant women) during the outbreak of COVID-19. Methods: This descriptive-analytical cross-sectional study was performed on 345 women coming to a tertiary care hospital in Karachi, Pakistan. The data was collected using the socio-demographic characteristics questionnaire and the GAD-7 and PHQ-9 questionnaires. Regression analysis was done to determine the association between various factors with depression and anxiety. Results: Mean age of the participants was 27.9 years Depression and anxiety symptoms were observed in 32.7, 32.7, and 43.9% of the participants, respectively The mean score of depression was found to be 3.72 (3.80) whereas of anxiety was 3.5 (4.006). The overall prevalence of depression was 30.5% and that of anxiety was 18.55%, with varying degrees from mild to severe. Conclusions: Females in general and pregnant women specifically need special attention of the health care policy makers and this group should be given importance especially in times of such pandemics and all necessary measures should be taken to provide mental and psychological support. Keywords: COVID-19, Pregnancy, Prevalence, Depression, Anxiety, Stress 79