Journal of University Medical & Dental College <p>Journal of University Medical &amp; Dental College, JUMDC, is the official peer reviewed Journal of University Medical &amp; Dental College, constitution college of The University of Faisalabad. JUMDC is open access journal being published quarterly.<br><br>ISSN, 2221-7827<br>ISSN, 2310-5542<br><br>ORIGIONAL 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> en-US Journal of University Medical & Dental College 2221-7827 <p><a href="" rel="license"><img src="" alt="Creative Commons License" border="0"></a><br>This work is licensed under a&nbsp;<a href="" rel="license">Creative Commons Attribution 4.0 International License</a>.</p> THE INDISPENSABLE SUNSHINE VITAMIN Sundus Tariq Copyright (c) 2019-12-06 2019-12-06 10 4 iv vi EFFICACY OF NILOTINIB IN PATIENTS WITH CHRONIC MYELOID LEUKEMIA <p>ABSTRACT:<br>MATERIAL AND METHODS: This study was conducted on 92 diagnosed cases of chronic myeloid leukemia at Department of Oncology, Jinnah Hospital Lahore from August 2016 to January 2017. Patients from either gender, between the ages of 20 to 60 years were included in the study while patients having diabetes and end stage renal disease with glomerular filtration rate less than 15 ml/min were excluded. Nilotinib treatment with the standard dose (300 mg twice daily) was given to patients with chronic phase of chronic myeloid leukemia (CP-CML). Patients were monitored as recommended by the current treatment guidelines. Treatment outcome of CP-CML in terms of efficacy was assessed at the end of 6 months of treatment.<br>OBJECTIVE: To determine the efficacy of nilotinib in patients of chronic myeloid leukemia, chronic phase, in terms of detection of BCR-ABL by FISH method. RESULT: The mean age of the patients was 38.84 ± 11.67 years, with male to female ratio of 1.04:1. The mean PH value of the patients was 17.05 ± 18.53 and efficacy was achieved in 36 (39.13%) patients.</p> <p>CONCLUSION: The efficacy of nilotinib was achieved in significant number of CML patients.<br><br><br></p> Sajid Ali Tahir Mehmood kausar Bano Muhammad Akram et al. Copyright (c) 2019-12-06 2019-12-06 10 4 1 4 CLINICAL RISK INDEX FOR BABIES (CRIB SCORE) AS A PREDICTOR OF NEONATAL MORTALITY <p>ABSTRACT:<br>OBJECTIVE: It is very important to predict the outcome among preterm and very low birth weight babies as mortality rates are quite high. CRIB score is used to predict the outcomes in preterm neonates. The objective of this study was to determine the strength of CRIB score in detecting neonatal mortality in babies presenting with very low birth weight.</p> <p>STUDY DESIGN: Cross-sectional study.</p> <p>SUBJECTS: A total of 254 newborns with birth weight of between 500 to 1500 grams and gestational age of ≤35 weeks were included. The study was conducted over a period of 6 months in neonatology department of Shifa International Hospital, Islamabad.&nbsp;</p> <p>METHODS: CRIB score was obtained through a prospective way in all neonates and its association was assessed with mortality during neonatal intensive care unit (NICU) stay. </p> <p>RESULTS: The percentage of male and female newborn subjects was 54.3% (n=138) and 45.7% (n=116) respectively. Mean gestational age was 33.3 weeks ± 1.04 and mean birth weight of study population was 1129.9 grams ± 210.6. Mean CRIB score among the study population was 6.3 ± 3.1 and overall mortality was found to be 54.7% (n=139). Mean CRIB score was found to be 8.27 ± 2.1 among mortality group and it was 3.87 ± 3.4 among newborns who were discharged (P&lt;0.05). Mortality was present in 4.3% (n=4) of neonates with CRIB score between 1-5, 87.1% (n=121) who had CRIB score between 6-10 and 100% (n=14) of neonates who had CRIB score between 1115 (P&lt;0.05).</p> <p>CONCLUSION: Significantly higher mortality was noted among neonates with higher CRIB scores.</p> Zarmast Khan Nasir Zulfiqar Hamid Mahmood et al. Copyright (c) 2019-12-06 2019-12-06 10 4 5 10 EDUCATIONAL EMPOWERMENT AND USE OF ANTENATAL SERVICES <p>ABSTRACT:<br>OBJECTIVE: The single most important factor that has long-lasting impact on lives of women is education. The study was conducted to determine the effect of women and partner's education on utilization of antenatal services in the urban slums.<br>STUDY DESIGN AND SUBJECTS: This descriptive cross sectional study was conducted in urban slums of Bahawalpur City from January 2018 to December 2018 after taking ethical approval from hospital ethical committee. Women of reproductive age n=377, between 15 to 49 years, having at least one alive child less than one year of age and irrespective of current pregnancy were included in the study. Out of selected slum area sample was drawn by non-probability consecutive method. The preformed, pretested questionnaire with the help of lady health workers of the areas was used for collection of data.</p> <p>RESULTS: Mean age of the respondents was 28.26 ± 6.03 years. The age distribution showed that 31.1% respondents belonged to 30-34 years age group followed by 29.7% in 25-29 years, 19.1% in 20-24 years. The utilization of antenatal services was poor in 41.1% (n=155), fair in 24.9% (n=94) and good in 34.0% (n=128) women. The utilization of antenatal services was significantly higher in literate group (p &lt;0.001). Regarding husband's educational status the wives of educated husbands had better utilization (p &lt;0.001). The use of antenatal services among wives of uneducated and primary educated husbands was 67.8% and 61.5% respectively. The 52.1% women having graduate and above educational level of husband had good antenatal care use.</p> <p>CONCLUSION: Educational status significantly affect the utilization of antenatal services.</p> Muhammad Siddique Khan Qadr Huda Abbas Wajahat Hussain et al. Copyright (c) 2019-12-06 2019-12-06 10 4 11 15 FREQUENCY OF REMISSION AFTER TREATMENT WITH HYPER CVAD PROTOCOL IN NEWLY DIAGNOSED PATIENTS OF ACUTE LYMPHOBLASTIC LEUKEMIA PRESENTING TO JINNAH HOSPITAL LAHORE <p>ABSTRACT:</p> <p>OBJECTIVE: The objective of this study was to determine the frequency of complete and partial remission after 2 courses of hyper CVAD regimen in newly diagnosed patients of acute lymphoblastic leukemia (ALL).<br>MATERIAL AND METHODS: This study was conducted on 100 patients of ALL presenting to the oncology department of Jinnah Hospital, Lahore and fulfilling the inclusion criteria from 01-012016 to 30-12-2016. Patients were undergone treatment with hyper CVAD regimen according to the standard protocol. Complete or partial remission rate was checked after 2 session of hyper CVAD regimen. CT scan (chest and abdomen) was performed for confirmation of extramedullary disease.</p> <p>RESULTS: The mean age of study population was 35.68 ± 8.69 years. There were 48% male patients while female patients were 52%. Complete remission was present in 72% patients. Partial remission was present in 24% patients. There was no significant association between complete remission and age (p-value=0.497). No significant association was found between partial remission and age (p-value=0.103). Significant association was found between partial remission and complete remission with gender having p-value=0.001 and 0.01 respectively.</p> <p>CONCLUSION: The frequency of complete and partial remission after 2 courses of hyper CVAD regimen in newly diagnosed patients of ALL was 72% and 24% respectively. Effect modifiers have no significant influence except gender.<br><br></p> Muhammad Kashif Tahir Mehmood Kausar Bano et al. Copyright (c) 2019-12-06 2019-12-06 10 4 16 20 COMPARISON OF THE EFFICACY (IN TERMS OF STONE EXPULSION) OF TAMSULOSIN VERSUS NIFEDIPINE IN DISTAL URETERIC STONE <p>ABSTRACT:<br>INTRODUCTION: In western prosperous countries, a great research has been done on these two medicines in urolithiasis. Extent of disease is varying from developing countries to developed countries, specially due to late identification of diseases, late in examination which enhances the consequences of disease in ureteral stone or in any other disease.</p> <p>OBJECTIVES: To compare the efficacy (in terms of stone expulsion) of tamsulosin versus nifedipine in victims with distal ureteral stone. MATERIAL AND METHOD: All of 86 patients with distal ureteric stone, 20 to 50 years of both genders were included. Patients with proximal ureteric stricture, gross hydronephrosis, previous ureteral surgery and solitary kidney were excluded. After informed, written consent, all selected cases were divided in two groups by lottery method. In group A patients, tamsulosin was given while in group B patients, nifedipine was given. All patients were followed weekly by the researcher till 4 weeks and ultrasonography in both groups was done by the one consultant radiologist for evaluation of efficacy.</p> <p>RESULTS: Mean age was 32.29 ± 6.81 years. Out of these 86 patients, 53 (61.63%) were male and 33 (38.37%) were females with. Mean size of stone was 6.69±1.49 mm. Stone expulsion was seen in 37 (86.05%) patients in group A (tamsulosin group) and 25 (58.14%) patients in group B (nifedipine group) with p-value of 0.004.</p> <p>CONCLUSION: This survey concluded that efficacy (in terms of stone expulsion) of tamsulosin is better as compared to nifedipine in distal ureteric stone</p> Mudassar Saeed Pansota Sharmeen Shafqat Shafqat Ali Tabassum et al. Copyright (c) 2019-12-06 2019-12-06 10 4 21 25 COMPARISON OF INTRAVENOUS LABETALOL AND ORAL NIFEDIPINE IN MANAGEMENT OF BLOOD PRESSURE IN PATIENTS WITH SEVERE PREGNANCY INDUCED HYPERTENSION <p>ABSTRACT:<br>It is estimated that 6-12% of all the pregnancies are complicated by hypertension and even all improvements pre eclempsia is a significant reason of maternal and perinatal morbidity and mortality worldwide. Nifedipine, Labetalol and hydralazine are mostly being used in acute management of hypertension in pregnancy but so far there is no evidence that anyone drug is more effective.</p> <p>OBJECTIVE: To compare the mean time to achieve blood pressure control of oral Nifedipine with intravenous Labetalol for management of severe pregnancy induced hypertension.</p> <p>METHODOLOGY: This randomized control trial was done in Obstetrics and Gynaecology department of Hilal-e-Ahmer hospital, Faisalabad over a period of 6 months from 01-07-2016 to 31-12-2016. Total 100 patients (group-A and group–B having 50 in each) were included in study. In group A, females were given 40mg oral Nifedipine and in group, females were given 20ml intravenous Labetalol. Time at administration was followed in the ward for assessment of blood pressure control. Blood pressure was noted after every 10 min. The total donation time to achieve B.P was noted (as per operational definition).The collected data was analyzed by using SPSS version 17.0. Baseline blood pressure were presented in the form of mean+SD. Both groups were compared for mean time to achieve blood pressure control by applying t- test and consider significant at p value &lt;5%.<br>RESULTS: Patients were ranged between 20-40 years. Mean age of the patients was calculated as 26.98+4.54 and 27.36+4.43 years in group-A and B respectively. Gestational age shows that 64%(n=32) in Group-A 74%(37%) in Group–B were between 20-30 weeks of gestation while 36%(n=18) in Group-A were between 31-40 weeks of gestation mean±SD was calculated as 28.92+4.91 and 28.94+4.72 weeks in Group-A and B respectively. Mean time to achieve B.P control in group A was 31.24+5.62 and in group B 45.5+4.63 with p value &lt;0.05.</p> <p>CONCLUSION: Mean time to achieve blood pressure control was shorter with oral Nifedipine when compared to I/V Labetalol for management of female presenting with severe pregnancy induced hypertension.&nbsp;</p> Tehseen Aslam Nuzhat Parveen Shakeela Irfan Uzma Riaz Amin Anjum Copyright (c) 2019-12-06 2019-12-06 10 4 26 30 DURAL TEAR: A FEARED COMPLICATION IN LUMBAR SPINE SURGERY <p>ABSTRACT:<br>OBJECTIVE: The objective of this study is to determine the incidence of dural tear in lumbar spine surgeries and associated risk factors. MATERIAL AND METHODS: In this descriptive cross sectional study, 117 Patients were studied in the department of Neurosurgery, Naseer Teaching Hospital Peshawar from February 2013 to December 2016. All patients with either gender or age who needed spinal surgery for lumbar disc disease, spinal stenosis, and re-do surgery were included in study while those with trauma, tumor and infection were excluded. Data was collected regarding the age of patients, co-morbid conditions, lumbar spine disease, level of involvement, type of operation, occurrence of dural tear, site of dural tear and complications were recorded on a predesigned proforma. Data was analyzed using SPSS version 20.0.</p> <p>RESULTS: Out of 117 patients 63(53.8%) were male and 54(46.1%) were female. Male to female ratio was 1.2:1. In our study the age of patient ranged from 16 to 80 years with mean age 38 + 2.34 years Dural tear occurred in 15(12.8%) of patients, among these 5 (4.2%) dural tear in lumbar disc prolapsed , 8(6.8%) in spinal stenosis and 2 (1.7%) in surgery for recurrent disc disease. The complication rate was 19(16.2%), among these the most common complication was cerebrospinal fluid leak (CSF) in 7(5.9%), delayed wound healing in 5(4.2%), discitis in 4(3.4%) and others in 3(2.5%) of patients.</p> <p>CONCLUSION: Dural tear (DT) is not uncommon complication during spinal surgery and represent a serious challenge for both surgeon and patients. Female, obese, older age, re-do surgery are the major risk factor for dural tear.</p> Sohail Amir Bilal Khan Aurangzeb Khaleeq-Uz-Zaman Copyright (c) 2019-12-06 2019-12-06 10 4 31 35