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, 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> en-US <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> (Editor,) (Dr. Muhammad Akram Malik) Fri, 10 Jul 2020 00:00:00 +0000 OJS 60 Contents Editor Copyright (c) Fri, 10 Jul 2020 00:00:00 +0000 ETHICAL CHALLENGES FOR HEALTHCARE WORKERS DURING COVID-19 PANDEMIC Dr Alam Sher Malik Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 10:00:41 +0000 DIAGNOSTIC ACCURACY OF SALINE HYSTEROSONOGRAPHY IN DETECTING ENDOMETRIAL HYPERPLASIA IN PATIENTS WITH POST MENOPAUSAL BLEEDING <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Saline hysterosonography is a simple and cost-effective method with high sensitivity to detect uterine abnormalities causing postmenopausal bleeding. The objective of this study was to evaluate the diagnostic accuracy of saline hysterosonography in detecting endometrial hyperplasia in women with postmenopausal bleeding by taking histopathology as a gold standard.</p> <p><strong>METHODOLOGY:</strong> A hundred and twenty (120) cases were enrolled from the outpatient and inpatient department of obstetrics and gynecology. Proper history and relevant examination of the patient was done. Then preparations were made for the procedure. The patient was counseled and the technique explained to her. Then Foley catheter no 12 was passed in cervix and sonography was done while instilling normal saline through a cervical catheter and scan pictures were frozen and results were given by expert gynecologist of Allied Hospital, Faisalabad. Histopathology specimen was sent to the pathology lab.</p> <p><strong>RESULTS:</strong> Sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of saline hysterosonography in detecting endometrial hyperplasia was recorded as 96.15%,91,49%,75.76%,98.85%, and 92.5% respectively.</p> <p><strong>CONCLUSION:</strong> Saline hysterosonography has high sensitivity to detect uterine hyperplasia. It can be used as a cost effective alternative to hysteroscopy in many units in Pakistan.</p> Benish Yousuf, Hira Ambreen, Tahira Mariam, Abdul Raouf, Ambreen Yaseen, Rabia Aslam, Muhammad Ahsan Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 10:08:19 +0000 EFFECT OF BREAKFAST SKIPPING ON BODY MASS INDEX IN ADOLESCENT UNIVERSITY GIRLS <p><strong>ABSTRACT</strong></p> <p><strong>BACKGROUND &amp; OBJECTIVE:</strong>&nbsp; Breakfast is considered as important meal of the day and it should provide 25 % of total energy intake including all five food groups. Breakfast skipping is common in adolescents and it is associated with changes in Body Mass Index (BMI) and cognitive abilities. Breakfast skipping enhances appetite throughout the remaining day which leads to over eating resulting in overweight and obesity. Addition of breakfast is useful plan of action to improve satiety, reduced food motivation and improve diet quality. Eating breakfast regularly has association between both with less mental distress and healthy life style. For this purpose, this study was designed to determine the prevalence of breakfast skipping in adolescent’s university girls and its effect on their Body Mass Index (BMI).</p> <p>&nbsp;<strong>METHODOLOGY:</strong> For the current research, 200 individuals were selected from different departments of The University of Faisalabad. Questionnaire was developed and height, weight and dietary history were measured. The data obtained from the study was tabulated and statistically analyzed by applying Analysis of Variance (ANOVA) and Least Significant Difference (LSD).</p> <p><strong>RESULTS: </strong>Skipping of breakfast has significant effect on increasing the Body Mass Index (BMI) in university adolescent girls.</p> <p><strong>CONCLUSION</strong>: Breakfast skipping resulted in increased BMI in university adolescent girls.</p> <p>&nbsp;</p> Noor Fatima, Zirwa Noor, Swaira Shafique Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 00:00:00 +0000 SURGICAL AUDIT - LAPAROSCOPIC CHOLECYSTECTOMY IN A FREE CAMP AT PRIVATE SECTOR HOSPITAL <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> Laparoscopic Cholecystectomy is usual method for the treatment of gall bladder stone disease and is practiced all over the world due to many benefits like fasten the recovery time. Furthermore, it reduced the post-operative pain and period of hospital stay. To conduct Surgical Audit and evaluate safety of Laparoscopic cholecystectomy.</p> <p><strong>METHODOLGY:</strong> This prospective study was conducted in a private hospital at Hyderabad during free camps of Laparoscopic Cholecystectomy. Four camps were arranged in 2016 - 2019. Total number of 190 patients&nbsp; underwent Laparoscopic Cholecystectomy during the study period. The patient's age falls between 12–65 years. A detailed history, relevant investigation and Cardiac fitness were evaluated. All patients underwent four ports Lap-Chole. Data was collected assessed and audit was performed and safety was evaluated.</p> <p><strong>RESULTS:</strong> Total 190 patients operated females 88.45% and males 11.55%. 115 (60.50%)were in&nbsp; the range of 30-35 years followed by 55 (28.95%)patients in the range of 40-50 years.8 (4.20%) patients were converted to open cholecystectomy, 4 due to bleeding from liver bed, 3 patients due to difficult dissection in calots triangle and 1 due to Empyema of gall bladder.10 patients (5.50%) had Trocar site bleeding, 10 patients (5.50%) had gall bladder injury, in 4 cases had spillage of stones and 72 patients (38.50%) developed umbilical port site infection 1 patient develop port site hernia. No mortality was recorded in this study.</p> <p><strong>CONCLUSION:</strong> Our Surgical Audit proves that Laparoscopic Cholecystectomy is a safe procedure on the basis of only 4.2% intra operative and 5.5% postoperative complications and gaining wide spread popularity among our population due to less pain, less hospital stay. We recommend other private hospitals to extent such services to our poor population with symptomatic cholelithiasis.</p> Abdul Ghani Soomro, Tufail Ahmed Baloch, Moin-ul-Islam, Mairaj Muhammad Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 10:05:28 +0000 COMPARISON OF THE SUCCESS OF EXTRACORPOREAL SHOCK WAVE LITHOTRIPSY (ESWL) WITH AND WITHOUT DJ STENTING IN PROXIMAL URETERIC STONE <p><strong>BACKGROUND &amp; OBJECTIVE:</strong> There is disagreement in the use of ureteral double-J stent before the extracorporeal shock wave lithotripsy (ESWL), although most of the urologists suggest using stent in shock wave lithotripsy technique for stones bigger than 20mm, for preventing the risk of developing steinstrasse. To compare the success of ESWL with and without DJ stenting in proximal ureteric stone. METHODOLOGY: A total of 60 patients form both genders, between 15 to 55 years of age, with a single proximal ureteric stone, were included. Patients with solitary functioning kidney, multiple stones, pregnancy, pyonephrosis and sepsis were excluded. In Group-A, ESWL without DJ stenting was completed while in Group-B, ESWL with DJ stent placement was done. In all patients, at least 4 sessions were done fortnightly. Patients were followed regularly and final success was noted after one month of completion of ESWL sessions.</p> <p><strong>RESULTS:</strong> The mean age was 36.85 ± 8.61 years. From 60 patients, 29 (48.33%) were men and 231 (51.67%) were women.Mean body mass index (BMI) was 28.30±2.20 kg/m . The average size of the stone was 12.47 ± 2.57 mm. Success (according to stone removal) of Group-A (ESWL without DJS) was seen in 26 (86.67%) patients while in Group-B (ESWL with DJS) was seen in 16 (53.33%) patients with P-value of 0.005.</p> <p><strong>CONCLUSION:</strong> This study concluded that success (in terms of stone clearance) of extracorporeal shock wave lithotripsy (ESWL) without DJ stenting is higher compared to with DJ stenting in upper ureteric stone.</p> Mudassar Saeed Pansota, Sharmeen Shafqat, Shafqat Ali Tabassum Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 00:00:00 +0000 HCV GENOTYPES AND ITS ASSOCIATION WITH RESPONSE TO TREATMENT <p style="text-align: justify;"><strong>BACKGROUND &amp; OBJECTIVE:</strong> primary Hepatitis C is a serious public health problem and is the cause of liver cirrhosis, hepatocellular carcinoma (HCC), and numerous end-stage liver disease manifestations. The management of hepatitis C is to preclude liver cirrhosis, lessen the risk of hepatocellular carcinoma or hepatoma, and curing the extra hepatic diseases. Initially, interferon was the cornerstone for treating hepatitis C, but due to its cumbersome complications, route of administration, and limited treatment access, many patients showed noncompliance. New therapies for chronic hepatitis C have been introduced based on direct antiviral effects. Several genotypes of hepatitis C have been discovered and they are responsive to different antiviral therapies. Our objective was to assess the genotypic distribution of HCV in our local setup and their pattern of response to different combination of anti-viral therapies by assessing the sustained viral response (SVR) after 12 weeks post-treatment. To determine the most prevalent genotype of hepatics C virus in our population and pattern of the response of multiple genotypes to different antiviral regimens.</p> <p style="text-align: justify;"><strong>METHODOLOGY:</strong> It is a cross-sectional study conducted for duration of six months and recruited those patients whose polymerase chain reaction (PCR) was found positive for hepatitis C virus at Islamabad Diagnostic Center. We analyzed 100 patients, both children and adults. Patients were assessed for different genotypes and then different combinations of antiviral treatments were administered. Their clinical data, hematological parameters and viral load before and after treatment were also analyzed.</p> <p style="text-align: justify;"><strong>RESULTS:</strong> In a total of 100 positive hepatitis C virus-infected patients, 55% were females and 45% males. The frequencies of genotypes observed were 91 %, 06%, and 03% of genotype 3, 1a, and 1b respectively. 51 out of 91 patients with type 3 genotype, who were on antiviral therapy of sofosbuvir and ribavirin, all of them achieved SVR. 30 out of 91 patients with type 3 genotype were treated with sofosbuvir alone, the percentage of failure to achieve SVR in them was 6.7%. Treatment failure percentage of 10% was observed when a combination of Interferon (INF) alpha and ribavirin was used in type 3 genotype. Remaining six patients with type 1a and three patients of type 1b genotype achieved SVR with different regimens used.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> Although the increased load of HCV in our setup is an alarming situation the prevalence of type 3 genotype is a blessing in disguise. The success of sustained viral response after various combinations of direct antiviral therapy and interferon-free treatment is hope for the ultimate cure of the disease and avoidance of debilitating side effects related to interferon.</p> Aftab Ahmad Khan, Naghmi Asif, Rizwan Uppal, Gul E Rehan Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 00:00:00 +0000 COMPARISON OF MINI CHOLECYSTECTOMY VERSUS OPEN CHOLECYSTECTOMY IN PATIENTS WITH CHOLELITHIASIS <p><strong>BACKGROUND &amp; OBJECTIVES</strong><strong>: </strong>The goal of this study is to compare the results of mini cholecystectomy with open conventional cholecystectomy in the management of cholelithiasis.</p> <p><strong>&nbsp;</strong><strong>METHODOLOGY</strong><strong>: </strong>A total of 100 cases; 50 cases in each group was included in the study. 100 patients were admitted from OPD of Teaching Hospital Dera Ghazi Khan fulfilling inclusion criteria. Demographic information was recorded. All admitted patients were diagnosed after taking history and performing clinical examination. Written consent was obtained. Statistical data input and scrutiny done with the help of SPSS 11.&nbsp; All the Information was inspected by the proposed investigation plan.</p> <p><em>&nbsp;</em><strong>RESULTS: </strong>Mean age of all patients was 39.96±3.84 years. Age range of patients was 30-48 years. In Group-A (Mini Cholecystectomy Patients) mean hospital stay was 5.38±1.15 and in Group-B (Conventional Cholecystectomy Patients) mean hospital stay was 3.02±0.58 days respectively. At 1st visit 14(28%) patients in Group-B and only 1(2%) patient in Group-A had wound infection. According to p-value wound infection was significantly correlated with treatment group. Patients in Group-A had less infection rate in comparison to Group-B patients. i.e. (p-value=0.000) whereas at 2nd visit 8(16%) patients in Group-B and 3 patients in Group-A suffered from wound infection. At 2nd visit wound infection was statistically same in both treatment groups. i.e. (p-value=0.110). It was observed that in Group-B 44(88%) of the patients had severe pain whereas only 12(24%) of the patients in Group-A had severe pain. Keeping in mind this results rate of severe pain at 12th hour was high in Group-B patients in contrast to Group-A patients. i.e. (p-value=0.000).</p> <p><strong>CONCLUSION:</strong><strong>&nbsp; </strong>Mini cholecystectomy is effective and related with less patient’s uneasiness in terms of post-operative pain and infection as well as with less hospital stay.</p> Uzair Karim Qasrani, Muhammad Faizan, Zarnab Siddique, Muhammad Khalid Copyright (c) 2020 Journal of University Medical & Dental College Mon, 13 Jul 2020 10:16:36 +0000 ESTIMATES OF THE SEVERITY OF COVID-19: A COMPARISON OF PAKISTAN WITH OTHER DEVELOPED COUNTRIES <p>The number of confirmed cases of COVID-affected patients are 1,123,000 and counting while more than 59,000 corroborated mortalities have occurred around the globe, as depicted by the data gathered through Johns Hopkins University. More than 228,000 people have reportedly recovered from COVID-19 till April 4 2020. Italy has the second highest deaths of COVID-19 in the world. There is dire need to evaluate the pattern of COVID-19 in Pakistan and compared with other developed countries. World Health Organization has developed website to provide latest data in form of new reported cases, mortality and recoveries.&nbsp; In Pakistan, mortality rate was found less than other developed countries and this hypothesis may be wrong that Pakistan neither will nor effected with virus due to climate conditions.</p> <p>The presented study had two objectives. The first was to describe the latest situation if COVID-19 in Pakistan and other developed countries. Second objective was to determine the latest situation about mortility rate in Pakistan and other developed countries. Comparative data was sketched and presented in the form of graph for 5 countries including Pakistan. All the data was obtained form WHO websites and from Pakistan government officials websites. Data was collected from Jan-2020 to 4 April-2020.</p> Yasir Mehmood, Zafar Latif Awan, Adnan Afzal, Muhammad Saleem Akhtar, Fawad Hussain, Muhammad Imran Ashraf Copyright (c) 2020 Journal of University Medical & Dental College Fri, 10 Jul 2020 10:15:15 +0000