Journal of University Medical & Dental College 2021-12-13T03:57:37+00:00 Prof Dr. Muhammad Akram Malik Open Journal Systems <p>Journal of University Medical &amp; Dental College, JUMDC, is the official peer reviewed Journal of University Medical &amp; Dental College, constituent college of The University of Faisalabad. JUMDC is open access journal being published quarterly.<br><br>ISSN, 2221-7827<br>ISSN, 2310-5542</p> <p>Original research articles, review articles, practical updates, case reports, letter to editor of medical and allied health sciences are being evaluated by editorial board and peer reviewers before publication in the journal.</p> Contents 2021-12-10T06:27:30+00:00 editor 2021-11-27T00:00:00+00:00 Copyright (c) Bad experience repeated eleven times 2021-12-01T06:42:15+00:00 Aamir Shahzad 2021-10-21T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Give way to the ambulance; What we all need to do to facilitate ambulance in traffic? 2021-12-06T04:09:26+00:00 Saba Tariq Sundus Tariq Akram Malik 2021-11-24T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Kisspeptin and Spexin: lipid profile and sperm parameters in infertile and fertile male subjects 2021-12-03T07:46:45+00:00 Mohummad Hassan Mussarat Ashraf Sher Khan Nida Farooqui Arfa Azhar Rehana Rehman <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Kisspeptin (KP) and spexin (SPX)&nbsp;are neuropeptides that play a substantial role in metabolism and sexual function. Our objective is to explore the association of spexin and kisspeptin with sperm parameters and lipid profile in the infertile male population.</p> <p><strong>METHODOLOGY: </strong>The cross-sectional study was conducted from March 2017 till July 2018 in Aga Khan University Hospital, Karachi, Pakistan, after acquiring ethical approval (4813-BBS-ERC-17). Convenient sampling was applied to recruit 44 normozoospermic subjects as controls and 44 patients with abnormal sperm parameters”. Serum levels of kisspeptin and spexin were measured by enzyme linked immunosorbent assay and Cobas c111 analyzer was used for estimation of high and low density-lipoprotein, triglyceride and serum cholesterol levels. Mann-Whitney U tests and spearman’s rank correlation test were used to analyze quantitative variables, and data was presented by means, standard error (SE) and correlations coefficient, with a statistical significance set at p≤0.05.</p> <p><strong>RESULTS: </strong>The mean kisspeptin values of ‘altered sperm parameters’ males 13.23 ± 3.34 were lower than normal sperm parameters 31.89 ± 3.25 <em>(</em>p&lt;0.001). The mean spexin values of altered sperm parameters 383.57 ± 21.09 were less than compared to normal sperm parameters 502.76 ± 19.77 (p&lt;0.001). Correlation of KP and SPX levels was (r-value = 0.332, p= 0.002). There was no significant correlation was found between KP and SPX with lipid profile parameters.</p> <p><strong>CONCLUSION: </strong>Spexin and kisspeptin levels observed were higher in male subjects with normal sperm parameters and had a significant positive correlation with each other. There was no impact of spexin on lipid profile and obesity.</p> 2021-10-22T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Frequency of osteoporosis in patients with peptic ulcer disease 2021-12-03T07:47:31+00:00 Amber Amin Qaisar Farooq Rizwan Jameel <p><strong>BACKGROUND &amp; OBJECTIVE:</strong></p> <p>Peptic ulcer disease (PUD) is one of the common presentations in the medical as well as Gastroenterology clinics and it can end up in various short- and long-term complications among which osteoporosis is highly under rated. Therefore, the present study was designed to determine the frequency of osteoporosis in cases having PUD.</p> <p><strong>METHODOLOGY: </strong>A cross-sectional study was conducted at the Department of Medicine during 1<sup>st</sup> January 2020 to 30<sup>th</sup> June 2020 in Sheikh Zayed Hospital, Lahore. The diagnosed cases of PUD on the basis of history and endoscopic findings with the age range of 20 to 60 years were included. Osteoporosis was labelled as yes, where a T-score of ≤&nbsp;-2.5 on DEXA scan was noted.</p> <p><strong>RESULTS:</strong> In this study, there were a total of 139 cases, out of which 75 (53.95%) were males and 64 (46.05%) females. The mean age of the participants was 48.11±9.43 years. Osteoporosis was observed in 14 (10.07%) out of 139 cases. Osteoporosis was seen in 05 (6.67%) males vs 09 (14.06%) females in their respective groups with p= 0.148. Osteoporosis was observed in 4 (5.80%) cases with a duration of PUD up to 2 years and 10 (14.28%) cases with duration more than this with p= 0.096.</p> <p><strong>CONCLUSION:</strong> Osteoporosis is not uncommon in cases with Peptic ulcer disease, and there is no significant association with any of the confounders of this study.</p> 2021-10-22T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Comparison of spirometry data and symptoms between male and female smokers with chronic obstructive pulmonary disease 2021-12-03T07:48:20+00:00 Rida Khan Hafiz Muhamamd Waseem Sadia Nazir Shumaila Doggar Mohsin Ali Cheema Khalid Parvez Lone <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Chronic Obstructive Pulmonary Disease (COPD) is a heterogeneous disease, showing the exaggerated response of airways to any injurious stimulus. It is no longer considered as the disease of men as it is becoming increasingly prevalent in females. Evidence suggests that gender affects the clinical presentation of the disease. The objectives of the study is to compare spirometry data between male and female smokers with COPD and to study the association of cough, sputum, and dyspnea with gender in smokers with COPD.</p> <p><strong>METHODOLOGY: </strong>This descriptive study was conducted at the University of Health Sciences Lahore. The study sample included 41 COPD patients with a history of smoking. After taking written informed consent, patients were recruited from the outpatient departments of tertiary care hospitals of Lahore by convenience sampling technique. A complete history was taken, and spirometry was done on each subject. The subjects were divided into male and female groups, followed by the comparison of Spirometry data between the groups and association of symptoms with gender using appropriate statistical techniques.</p> <p><strong>RESULTS: </strong>The results of this study demonstrated females were significantly younger and exhibited a greater decline of lung functions with similar pack-years history compared to male smokers with COPD. The most common presentation of females was breathlessness compared to male patients, who had sputum production as the most common presentation.</p> <p><strong>CONCLUSION: </strong>Significant differences were seen in spirometry and clinical presentation of the disease in male and female COPD groups, showing the onset and symptomology of the disease.</p> 2021-11-24T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Parental relationship with children during covid-19 lockdown in Punjab Pakistan 2021-12-03T07:49:13+00:00 Ahmad Bilal Saba Nawaz Shakeela Altaf <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> The Western studies had reported a change in parent child relationship during COVID-19 lockdown. The present study was conducted to assess the parental relationship with children during COVID-19 lockdown in Punjab province of Pakistan.</p> <p><strong>METHODOLOGY:</strong> The study involved correlational research design. 529 parents from the Punjab province were recruited using a Google Form based questionnaire, which also contained information about the nature of the study and informed consent. &nbsp;The study was conducted from March 2020 to May 2020. The study was duly approved by Research Ethics Committee at The Islamia University of Bahawalpur vide No. REC/B/G-3/2020-S. The participants were required to give their consent for participation in the online study. The Child Parent Relationship Scale (CPRS) was appended to a single questionnaire to collect the data. The Statistical Package for the Social Sciences, version 25, was used for statistical analysis. The correlation analysis, t-test, and analysis of variance were used to compute results.</p> <p><strong>RESULTS:</strong> The study found a statistically significant positive correlation between closeness and dependence and a positive significant but weak correlation of conflict with both closeness and dependence. The mothers had more closeness and dependence with their children as compared to fathers. There were found no age wise differences in a parental relationship for conflicts, closeness, and dependence.</p> <p><strong>CONCLUSION:</strong> The study concluded that mothers had more closeness and dependence with their children as compared to fathers. Moreover, the age of parents had no effect on their relationship with children.</p> 2021-10-22T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Glenoid fossa position in skeletal class-II malocclusion due to retrognathic mandible and skeletal class-I malocclusion in Pakistani population 2021-12-03T08:00:17+00:00 Rabia Tabassum Nazish Amjad Faiza Malik <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Different dental and skeletal abnormalities interact with each other to cause multiple malocclusions of various areas of the dentofacial region. Association of the mandible and cranial base influence the malocclusions in anteroposterior and vertical dimensions that influences the evaluation of the skeletal components of a particular patient, so the relationship of glenoid fossa to adjacent craniofacial components must be taken into account. This research is conducted for the comparison of glenoid fossa position in subjects presenting with class II skeletal malocclusion due to retrognathic mandible and class I skeletal malocclusion.</p> <p><strong>METHODOLOGY: </strong>Standardized lateral cephalograms of 130 patients were selected according to inclusion criteria from the orthodontic department. These radiographs were traced, and different angular and linear measurements were recorded. Then the position of glenoid fossa was compared in subjects of class II malocclusion with retrognathic mandible and class I malocclusion. SPSS version 17 was used for data analysis. Cephalometric measurements were analyzed, and glenoid fossa position was compared in both groups by using student’s t-test. Statistical level of significance using student t test was p&lt; 0.05</p> <p><strong>RESULTS: </strong>Position of glenoid fossa in subjects with class II malocclusion is more distal and posterior as compared to the subjects with class I malocclusion. The effective parameters for the measurements of glenoid fossa are GF-S on FH, GF-Ptm on FH, and GF-FMN with p value 0.0001.</p> <p><strong>CONCLUSION: </strong>A distally and posteriorly placed glenoid fossa is an important diagnostic feature of Class II skeletal malocclusion with the retrognathic mandible.</p> <p>&nbsp;</p> 2021-11-13T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Pre-operative pyuria predicts tumor recurrence in patients undergoing transurethral resection of bladder tumor with post-operative instillation of BCG 2021-12-03T08:01:02+00:00 Khizar Hayat Gondal Majed Saeed Syed Atif Hussain Rana Atta Ur Rehman Ali Shandar Durrani Muhammad Raheem Sajjad <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>In Pakistan, urinary bladder cancer is one of the top ten malignancies. The most important concern after its treatment is tumor recurrence. Recent literature claimed that pre-operative pyuria in patients undergoing transurethral resection of bladder tumor was associated with significantly higher frequency of recurrence. However, there was controversy in existing literature and no such local published material was available which necessitated the present study. To determine the frequency of pre-operative pyuria in patients undergoing transurethral resection of bladder tumor for non-muscle invasive bladder cancer (NMIBC) with post-operative instillation of Bacillus Calmette Guerin (BCG) and to compare the frequency of tumor recurrence in patients with and without pre-operative pyuria.</p> <p><strong>METHODOLOGY: </strong>It was a comparative study. This study involved 280 patients of both genders aged between 20-80 years. Pre-operative pyuria was diagnosed if early morning midstream urine specimen showed ≥10 white blood cells/HPF. Outcome variable was frequency of recurrence after 12 weeks of treatment on check cystoscopy.</p> <p><strong>RESULTS: </strong>The mean age of the patients was 57.1±8.5 years. There were 236 (84.3%) male and 44 (15.7%) female patients in the study. 155 (55.4%) patients were tobacco smoker. Pre-operative pyuria was diagnosed in 127 (45.4%) patients while tumor recurrence was observed in 183 (65.4%) patients. The frequency of tumor recurrence was significantly higher in patients with pre-operative pyuria (85.8% vs. 48.4%; p&lt;0.001).</p> <p><strong>CONCLUSION: </strong>Pre-operative pyuria was a frequent finding in patients with non-muscle invasive bladder tumor and was associated with higher frequency of tumor recurrence which warrants routine screening of such patients for pyuria and increased frequency of tumor recurrence.</p> 2021-11-13T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Clinopathological assessment of epulis lesions from Sindh Pakistan 2021-12-06T09:13:40+00:00 Arhama Surwaich Surwaich Ali Channa Waqas Iqbal Abdul Majid Arsalan Ahmed Fida Baloch Naeem Bukhari <div><strong>BACKGROUND &amp; OBJECTIVES:&nbsp;</strong> Gingival enlargement is a common characteristic of gums infection.&nbsp; Enlargement of the gums can possibly occur due to numerous factors, comprising of inflammatory disorders as well as certain meditational side effects. Pyogenic granuloma expresses as red, small erythematous papules on pedunculated or rather sessile base. The current study aims to evaluate the cases of epulis and to grade histological types of epulis.</div> <div><strong>METHODOLOGY:</strong> This descriptive cross-sectional study was carried out at oral surgery OPD ISRA Dental College for a six-month duration. The diagnosis of epulis was made on the basis of clinical and histological examination. The research data was recorded on pre-designed proforma, and data were analyzed using SPSS version 22.0 (IBM, Corporation).&nbsp;</div> <div><strong>RESULTS:</strong>&nbsp; Out of 150 study subjects, 90 (60%) patients were female, while 60 (40%) were male. Majority of the cases in our study were found with a maxillary site (n=93, 62.0%). Most had a size of 2cm-3cm (n=132, 76%). Coral Pink color was the most common in (n=90, 60%) patients, followed by red color (n=45, 30%) and pale color was found in (n=15,10%) of the cases. The histological findings proved pyogenic granuloma was most common in (n=75, 50%) of the cases followed by fibrous epulis (n=63, 42%), peripheral giant cell granuloma (n=6, 4%) and Peripheral ossifying fibroma (n=6, 4%).&nbsp;</div> <div><strong>CONCLUSION:</strong> Pyogenic granulomas are the most prevalent reactive lesion. The lesions were more common in females in maxilla portion, and they were mostly found in the second to third decade of life.&nbsp;</div> 2021-10-22T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Morphological changes in liver of methimazole treated rats, a pilot study 2021-12-03T08:05:25+00:00 Maira Bhatti Waqas Iqbal Butt Shahnaz Fatima Fouzia Perveen Sabeen Arjumand Amna Iqbal Butt <p><strong>BACKGROUND </strong><strong>&amp; </strong><strong>OBJECTIVE: </strong>Thyrotoxicosis is a disease in which thyroid hormones are raised, and we have seen multiple patients suffering from this ailment in Pakistan. Methimazole is an anti-thyroid drug for thyrotoxicosis<strong>. </strong>Hepatotoxicity and liver ailments were common with methimazole prescribed for hypothyroid patients. Hypothyroidism, a common side effect of this drug, has been seen in a majority of patients, but liver toxicity remained unaddressed. So, in this study, we have observed histological changes in the liver after methimazole administration.</p> <p><strong>METHODOLOGY: </strong>The pilot study was carried out in the University of Health Sciences (UHS), Lahore, and was ended in twenty-one days. We divided animals in 2 groups. Each group comprises 12 animals. Group-I was negative control, and water was given through the oral route for 21 days. Group-II was administered methimazole orally 60mg/kg/day for twenty-one days. At the end;S animals were dissected, and livers were removed for histological examination.</p> <p><strong>RESULTS: </strong>The histological picture of the liver showed 75% severe disruption in liver architecture, inflammation, and fatty change in group 2, indicating liver damage.</p> <p><strong>CONCLUSION: </strong>Methimazole, hepatotoxic with discernable damage to its architecture, epithelium, and inflammatory changes.</p> 2021-10-22T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Evaluation of oral hygiene knowledge and practices among patients visiting a public Dental Institute 2021-12-06T04:37:24+00:00 Naveed Irfan Agha Taymoor Ali Suneel Kumar Punjabi Mowaffaq Abdullmomen Al Absi Talha Asad Khan Arsalan Ahmed <p><strong>BACKGROUND &amp; OBJECTIVE: </strong>Knowledge regarding oral hygiene and routine practices of maintaining that hygiene contributes to good oral and overall health of a person. The objective of the study was to evaluate the oral hygiene perception and practices among patients belonging to rural and urban areas visiting a public dental institute.</p> <p><strong>METHODOLOGY: </strong>A descriptive cross-sectional study was conducted at the dental outpatient department (OPD) of the Institute of Dentistry Liaquat University Jamshoro Sindh from June-December 2019. All patients who reported the dental OPD during the duration of the study belonging to either gender and age 18-70 years were included in the study. While those who reported in emergency with painful conditions and chronic diseases like diabetes mellitus, hypertension, etc., were excluded. A written questionnaire was used to collect participant’s information including socio-demographic details and information related to oral hygiene perceptions and practices. Data was analyzed by SPSS version 24.0.</p> <p><strong>RESULTS: </strong>The mean age of participants was 28.94±9.84 years, with an age range of 19-58 years. There was a statistically significant difference (p&lt;0.05) between female and male participants regarding knowledge and perception of the role of oral cleaning in decay prevention, different methods of preventing dental problems, and the role of remnants of sweet food in damaging teeth. While statistically significant difference (p&lt;0.05) in the type of toothbrush used, brushing technique, and frequency of changing toothbrush was demonstrated between participants belonging to rural and urban regions.</p> <p><strong>CONCLUSION: </strong>Knowledge and routine practices regarding oral hygiene are much lower in residents of the rural region compared with the urban region.</p> 2021-11-13T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Dietary intake of patients with acne vulgaris in Karachi: an observation study 2021-12-03T08:07:40+00:00 Badder Hina Afnan Sadaf Ahmed Asim Mehreen Amer Sahar Soomro Areesha Khan Rabiya khan Meeraal Kaikaus <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> The pathology of acne is vaguely understood to date, current epidemiologic evidence in Eastern populations indicates that consumption of chocolate, milk intake, fatty products, and glycemic load may be involved. Previously little research has been conducted highlighting the possible relationship between diet and acne among patients in Pakistan. The objective of this study was to identify the association of acne vulgaris and dietary intake patterns.<br><strong>METHODOLOGY:</strong> An observational study enrolled 246 participants, both genders, 16 to 40 years of age, diagnosed with Acne Vulgaris recruited from a tertiary-care hospital out-patient clinic in Karachi. The structured questionnaire consisted of various methods for assessing nutritional parameters. Statistical analysis was carried out using SPSS, the association of Acne was tested with dietary habits using Pearson-Chi Square test. Food items with a p-value less than 0.05 in the Chi Square test were considered in Binary logistic regression for estimating the risk for Acne with a 95% confidence interval (C.I.).<br><strong>RESULTS:</strong> Fifty-two percent of participants were found with mild acne, use of yogurt, ice cream butter, margarine, French fries, chocolate, bakery chips, white bread, vegetable, fruits, cake dates, and pickles give a significant association with severity of acne using Fisher's Exact test p&lt;0.05. Logistic regression showed that butter gave more risk for acne with an odds ratio of 1.11 and 95% C.I. (1.0, 9.2). <br><strong>CONCLUSION:</strong> It can be stated that dairy products, high glycemic index, and fatty foods are associated with acne aggravation in our population. As patients are always concerned about dietary advice, suggesting that they reduce these products would help them maintain their skin.</p> 2021-11-13T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Self-disclosed oral hygiene habits from students of Bahria University Medical and Dental College, Karachi campus 2021-12-13T03:57:37+00:00 Rabiya Ali Nadia Khalid Fareeha Shireen Jawed Naila Masood Fatima Syed <p><strong>BACKGROUND</strong><strong> &amp; OBJECTIVE:</strong> &nbsp;&nbsp;Dental hygiene reflects the overall health and impacts the quality of life. The present study was designed to assess knowledge, attitude, and practices regarding oral hygiene among medical and dental undergraduate students and to compare the oral hygiene habits among male and female students</p> <p><strong>METHODOLOGY</strong>: A cross-sectional study was conducted among medical and dental students of Bahria University Medical and Dental College, Karachi (BUMDC) from December 2018 to January 2019. Ethical approval was taken from the ERC committee of Bahria University Medical and Dental College (ERC/2/2018). Students (n= 332) of MBBS and BDS from first to final year were enrolled by non-probability convenience sampling technique. A self-structured questionnaire &nbsp;was used to obtain data.&nbsp; Percentages were determined for each response. The Chi-Square test was used to check the association of oral hygiene outcomes with respect to gender.</p> <p><strong>RESULTS:</strong> The study comprised 332 male and female students, out of which 189 (56.9%) were dental and 143(43.1%) were medical. The majority of students (71.4%) were female. The mean age of participants was 20.8± 1.3 years, 44.6% used toothbrushes, 33.7% used toothbrush and floss, and 21.4% used toothbrush and miswak, 61.4% of respondents have brushed their teeth twice a day, 5.1% of respondents were reported bad smell from their teeth, 58.1% were complaining sore jaws. Dental hygiene was significantly associated with gender (p≤ 0.05). Females have better practices and a positive attitude toward oral hygiene.</p> <p><strong>CONCLUSION</strong>: Female students had better oral hygiene knowledge and practices with more positive attitude as compared to male counterparts.</p> 2021-11-24T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College Giant urethral stone with diverticulum; a case report 2021-12-07T10:18:49+00:00 Asad Ramzan Adeen Akram Farhan Jamshed Nauman Khalid <p>Urethral calculi are rare and represent 1-2% of all urinary stone diseases. Rarely, calculus grows to large size and are labeled as a "giant urethral calculus". A 75-year-old male came to the OPD of Madinah Teaching Hospital Faisalabad with a chief complaint of suprapubic pain, penile pain, and hard mass on the left side of the scrotum and anterior perineum. The patient had a significant history of undergoing debridement for Meleney's and Fournier's gangrene, along with suprapubic cystostomy done about 1.5 years back. Physical examination revealed a solid mass with dimensions 6x7 cm on the left side of the scrotum and anterior perineum (left periurethral area). Open surgery was performed. A huge stone, 6x6cm, was removed. Diverticulae were excised, and urethroplasty was performed. A catheter was removed on the 21<sup>st</sup> postoperative with a satisfactory urinary stream.</p> 2021-11-24T00:00:00+00:00 Copyright (c) 2021 Journal of University Medical & Dental College