Journal of Islamabad Medical & Dental College 2022-07-19T10:43:25+05:00 Prof. Dr. Syed Shoaib Hussain Shah Open Journal Systems <p>The Journal of Islamabad Medical &amp; Dental College (JIMDC) is a new quarterly Journal of Islamabad Medical &amp; Dental College. <strong>Its is recognized By Pakistan Medical and Dental Council (PMDC</strong>) <strong>and Higher Education Commission of Pakistan</strong>. It includes original research papers, reviews, case reports<strong>,</strong> and short communication related to health, medicine and dentistry. Submitted manuscripts must be original, written in English, and will be accepted for publication with the understanding that it has not been submitted simultaneously to any other journal, not published or under consideration elsewhere and has not been published previously. The manuscripts will be reviewed through double-blind peer review process.&nbsp;</p> The Impending threat of Monkeypox: Responsiveness of Pakistan’s Health System 2022-06-30T13:46:46+05:00 Muhammad Ahmed Abdullah 2022-06-30T11:48:12+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Impact of Extroversion on Oral Health-Related Quality of Life in Prosthodontic Patients 2022-07-06T11:28:27+05:00 Waleed Ishaq Hira Riaz Muhammad Aamir Ghafoor Chaudhary Rida Anjum Salman Ahmad Sara Bano <h1><sub>Background: Oral health-related quality of life (OHRQoL) is a compound model comprising individualized evaluation of one’s emotional, functional and oral health. It is easily influenced by multiple variables including oral problems, cultural differences and personality traits. Where other personality traits negatively influence OHRQoL, extroversion exhibits a positive association. Contrarily, conflicting results have been reported in literature. The inconsistent results, insufficient local data and cultural differences make it imperative to further investigate. The objective of the study was to determine a correlation between extroversion and OHRQoL in prosthodontic patients.</sub></h1> <h2><sub>Methodology: This cross-sectional study was conducted in Prosthodontics Department of Islamic International Dental Hospital, Islamabad from May 2018 to April 2019. Sample size was calculated to be 270 with 5% significance level and Spearman correlation coefficient of 0.17. However, 305 patients were included in this study. After obtaining informed consent and recording demographic data, Oral Health Impact Profile-14 (OHIP-14) and Eysenck Personality Questionnaire–Revised Short-scale (EPQ-RS) were used to collect the required data and categorize patients.</sub></h2> <h2><sub>Results: The bivariate correlation analysis revealed extroversion to be negatively associated (r = -0.220) with OHIP score. It depicts that the more extrovert an individual, the lower the OHIP score (better OHRQoL) and vice versa. Effect modifier analysis revealed inconsistent correlation results for extroversion.</sub></h2> <h2><sub><a name="_Toc50673849"></a><a name="_Toc38816728"></a><a name="_Toc37947142"></a>Conclusion: A positive correlation has been established between Extroversion and OHRQoL, with inconsistent results after controlling effect modifiers.</sub></h2> 2022-06-30T11:51:50+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Post-traumatic stress disorder and Post-traumatic Growth among Police officials; Role of Coping Self Efficacy and Hope 2022-07-06T11:25:51+05:00 Azra Azeem Nelofar Kiran <p>Background: Post traumatic stress disorder in the after math of trauma is common. The objective of this study was to find correlation between Post-traumatic stress disorder and contributing factors of growth after trauma in active duty officials of police having direct exposure of trauma during war against terror in Pakistan.</p> <p>Methodology: The cross-sectional study was done on active-duty police officials from Federally Administered Tribal Areas (FATA) of Pakistan in three years duration from Jan, 2019 till December 2021. Non probability purposive sampling technique was used for selection of participants. Post-Traumatic Stress Diagnostic Scale (PDS-5), short form of Comprehensive trauma inventory, Adult Hope Scale and Perceived coping self-efficacy scale were used for data collection. SPSS version 21 was used for data analysis. After descriptive analysis, correlation of variables was checked by Pearson correlation and moderation analysis was done.</p> <p>Results: Age range of the participants was 33.6 ± 6.3 years. There was a significant strong positive correlation of Hope and Perceived self-efficacy with Post traumatic growth and negative correlation with Post Traumatic Stress Disorder. There was a significant increase in post-traumatic growth in presence of hope and perceived self-efficacy.</p> <p>Conclusion: Relationship between post-traumatic stress disorder and post-traumatic growth was moderated by perceived coping self-efficacy and hope.</p> 2022-06-30T11:53:49+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Effect of Replacement of Vit-D in Diabetic Painful Neuropathy among Chronic Type 2 Diabetic Patients 2022-06-30T13:46:46+05:00 Amna Ahmad Sehrish Jahan Asif Sumera Mushtaq murtaza gondal Beenish Azhar Tassawar Hussain <p>Background: Painful symptoms of diabetic neuropathy are more common in patients having type 2 diabetes. The objective in this trial was assessment of mean change in pain score upon giving Vit-D supplementation in patients with diabetic painful neuropathy.</p> <p>Methodology: This study was conducted from December 2019 to June 2020 in OPD of Fauji Foundation Hospital, Rawalpindi after the ethical approval. A total of 251 diagnosed cases of diabetes (both male and female patients), with high HbA1c and low Vit-D levels were included in the study. Patients having Vit-D deficiency and chronic diabetic neuropathy were given Vitamin supplementation and results were assessed after 1 month through change in pain score according to Douleur Neuropathique 4. A document of consent form was filled by patients who were recruited for this study. Data analysis was done on SPSS version 16.Paired sample t- test, was used to compare pain score where p value less than 0.05 was considered statistically significant.</p> <p>Results: Among the participants mean age was 48.22+17.06. There were 106 (42.2%) males and 145 (57.8%) female patients. A statistically significant (p&lt;0.05)mean reduction in pain score of 2.20±1.19 was observed, upon giving Vit-D supplementation in Vit-D deficient patients having painful diabetic neuropathy.</p> <p>Conclusion: Vit-D supplementation significantly reduced pain in patients having diabetic painful neuropathy.</p> <p>Keywords: Diabetes Mellitus, Diabetic Neuropathy, Vitamin D3</p> 2022-06-30T11:54:20+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Functional Outcome of Distal Femur Fracture Treated with Retrograde Nailing Technique 2022-06-30T13:46:47+05:00 Dr. Muhammad Azfar Khanzada Dr. Muhammad Tahir Lakho Dr. Zulfiqar Memon Dr. Syed Alam Zeb Dr. Bashir Ahmed Dr. Rajesh Kumar <p>Background: Management of distal femur fractures is always challenging for the surgeons. Retrograde interlocking nailing is one of the effective methods with minimal complications for treatment of such fractures. The objective of the study was to evaluate the functional outcome of retrograde interlocking nailing technique in patients with distal femur fractures.</p> <p>Methodology: This interventional study was conducted at the department of orthopedic surgery, Liaquat University Hospital, Hyderabad from March 2017 to December 2019. Patients of either gender, between 30 to 65 years age, who presented with acute fracture of distal femur, as a result of trauma within 12-96 hours, requiring surgical intervention were included. Lysholm Scoring System was used to evaluate the functional outcome of patients treated with retrograde interlocking nailing technique. Data was analyzed using SPSS version 24.</p> <p>Results: Total 102 patients gave consent of participation. The mean age of study participants was 43.50±7.26 with the age range from 40-65 years. Male patients were 76.47% and female 23.53%. In majority (63.73%) of cases, mode of injury was road traffic accidents. Statistically significant difference in functional mobility score between the age groups and gender (p &lt; 0.05) was found. Statistically significant (p &lt; 0.05) decline in mean Lysholm score was observed in participants who had been bearing full weight for 3 months. Excellent functional outcome was achieved by 49.02% patients while 34.31% patients achieved good functional outcome.</p> <p>Conclusion: Retrograde interlocking nailing for fracture of distal femur is an effective fixation surgical technique with minimal complications and excellent to good functional outcome.</p> <p>Key words: &nbsp;Accidents, Femur Fractures, Fracture Fixation, Functional Performance</p> 2022-06-30T11:54:48+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Clinical Presentation and Outcome of Covid-19 Infection in Patients Undergoing Maintenance Hemodialysis 2022-07-06T11:31:24+05:00 Muhammad ali shafique ahmed Abdul Manan Junejo Ayesha Ejaz Hina Iram Heer Gul <p>Background: WHO declared Covid-19 a pandemic disease; although 80% of patients with CoV-2 infection have no or mild symptoms, the remaining 20% of patients develop complications. In patients undergoing dialysis, mortality could be higher than that in the general population. This study was conducted to assess the frequency, clinical presentation, and outcome of COVID-19 infection in patients of end-stage renal disease (ESRD) on maintenance hemodialysis.</p> <p>Methodology: This Cross-sectional study was conducted at Department of Nephrology, Jinnah Postgraduate Medical Centre, Karachi, from April to September 2020. This study included 130 patients of either gender of End-Stage Renal Disease on maintenance hemodialysis for at least 3 months. Two Samples for COVID-19 PCR were taken through nasal swab. Blood samples were collected for hemoglobin level, total and differential leucocyte count, platelet count, intact Parathyroid hormone, vitamin D level, Urea, Creatinine, ferritin, transferrin saturation, procalcitonin, D-Dimer, C-reactive proteins, and lactate dehydrogenase. &nbsp;Radiological assessment was done by X-ray Chest. Urea reduction ratio and single pool Kt/V was used for assessment of adequacy of hemodialysis.</p> <p>Results: Out of 130 patients on hemodialysis, COVID-19 was detected in 52 patients, of which males were 69.2% and females were 30.8%. The most common presentation was shortness of breath (28.8%), followed by cough (19.2%). Home isolation was advised to 38.5% while noninvasive ventilation was given to 34.6%. Mechanically ventilated patients were 26.9%. There were 63.5% patients who recovered and were discharged from the hospital or home-isolated, while 19 patients died (36.5%).</p> <p>Conclusion: COVID-19 pandemic has high chances of infection with increased mortality in people with chronic diseases, especially those having ESRD on hemodialysis. This spreading of infection can be hampered with standard measures of disinfection in centers, social distancing in patients, and the use of a face mask.</p> <p>Keywords: Covid-19, Cough, Hemodialysis, Home isolation, Ventilation</p> <p>&nbsp;</p> 2022-06-30T11:55:15+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Future Trends in the Treatment of MRSA in Pakistan 2022-07-06T11:32:49+05:00 Muhammad Noorulamin Noorulamin Dr. Zarafshan Badar Zarafsah Dr. Ayesha Janjua Azhar Iqbal Dr. Sobia Humerah Dr. Pakeeza Arzoo Shaiq <p>&nbsp;</p> <p>Background: The Methicillin resistant Staphylococcus aureus (MRSA) is accountable for community and hospital acquired infections. Due to over and misuse of antibiotics, MRSA isolates are becoming multidrug resistant even with linezolid and vancomycin. The objective of this study was to determine recent antimicrobial profile of MRSA, isolated from different clinical samples and current treatment options for MRSA, other than vancomycin and Linezolid.</p> <p>Methodology: This cross-sectional study was conducted at Foundation university medical college from Jan 2019 to Dec 2020. Total 918 samples of blood, pus swab, throat swab, tracheal swab, wound swab, endotracheal tube (ETT) tips, Catheter tips, axillary swab and suction tips received by using aseptic techniques, for culture and sensitivity in different hospitals of Rawalpindi and Islamabad, were taken. Isolated pathogens were identified using standard protocols and susceptibility testing was done by Kirby-Bauer disc diffusion method.</p> <p>Results: Out of 918 samples, MRSA was isolated in 96 (10.4%) samples and most frequently observed in 27% (n=26) blood samples. The mean age of enrolled patients was 52.02 (SD±16.1) years, the infection was largely seen in age group 46-55(24%) and in 57% (n=52) male population. MRSA showed higher resistance to levofloxacin 78.1% (n=75), ciprofloxacin 75% (n=72), erythromycin 70.8% (n=68) and gentamycin 62.5% (n=60).&nbsp; The susceptibility of older drug chloramphenicol and Trimethoprim-sulfamethoxazole was found 61% &amp; 49% respectively. MRSA isolates were highly susceptible to vancomycin (96.8%), linezolid (89.5%) and teicoplanin (70.85%). Alarmingly, 2.1% (n=2) MRSA isolates showed resistance to vancomycin.</p> <p>Conclusion:Vancomycin resistant MRSA is a matter of great concern, because of unawareness among health administrative departments and public, self-medication, lack of surveillance system and non-availability of antibiotic policy. &nbsp;</p> <p>Keywords: Antibiotics, MRSA, Vancomycin, Chloramphenicol</p> <p>&nbsp;</p> 2022-06-30T11:55:49+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Evaluation of Dental Caries and Periodontal Health Status in Children with Autism: a Case Control Study 2022-07-19T10:43:25+05:00 Ahmed Bin Khalid Khan Seeme Nigar Naseer Ahmed Anum Tanwir Chander Kumar Sara Altamash <p><strong>Background: </strong>Dental problems are common in autistic children due to poor oral hygiene. During the dental treatment, main challenge is reduced ability of autistic kids to communicate. The objective of this study was to investigate about the oral health status of autistic children and to compare the risk of dental caries and periodontal disease between children with autism and healthy controls.</p> <p><strong>Methodology: </strong>This case-control study was conducted at the Milestone Charitable Trust and Defense Housing Authority (DHA), Sheikh Khalifa Bin Zayed School, for the duration of 04 months (1<sup>st</sup> Dec 2019 – 30<sup>th</sup> March 2020). Among cases, 67 autistic children and among controls,67 healthy children, of age 7 to 17 years, of either gender, were included. All the participants were examined and assessed for presence or absence of any carious lesions, and periodontal health. Data analysis was done using SPSS version 23.</p> <p><strong>Results: </strong>The overall mean age of included children was 12.51±2.99 years. Of 134 children, 53.7% were males and 46.3% females. The odds of periodontal disease were 5.52 times higher in autistic children as compared to healthy children (p &lt; .001). The odds of dental caries were 3.43 times higher in autistic children as compared to healthy children (p &lt; .001). In both age groups (&lt;=10 years and &gt;10 years), the risk of periodontal disease and dental caries was higher among autistic children as compared to normal children. While, according to gender, the risk of dental caries was higher among male autistic children as compared to normal children.</p> <p><strong>Conclusion: </strong>The odds of dental caries and periodontal disease were higher among autistic children as compared to healthy controls.</p> <p><strong>Keywords: </strong>Autism Spectrum Disorder, Dental caries, Periodontitis</p> 2022-06-30T11:56:18+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College The Diagnostic Accuracy of Magnetic Resonance Imaging (MRI) For Detection of Spinal Tuberculosis (TB) 2022-06-30T13:46:47+05:00 Maryam Ehsan Khokhar Nighat Haroon Khan Saira Bilal Saima Ameer <p>Background: Diagnosis of spinal tuberculosis is a major challenge. It is usually made using a blend of, laboratory , imaging investigations, clinical and none of these are 100% confirmatory. The objective of this study was to determine the diagnostic accuracy of magnetic resonance imaging (MRI) for detection of spinal tuberculosis (TB)</p> <p>Methodology: This cross-sectional study was conducted in the department of Radiology, Lahore General Hospital, on 150 patients, with suspicion of spinal TB from January,2020 to August,2020.&nbsp; Patients having Backache for &gt;6 months, loss of appetite, loss of weight &gt;10% in previous one month, raised ESR &gt;15 mm/hour, and positive sputum results for AFB were included. The patients underwent full spinal MRI scan. MRI was done using 1.5 Tesla MR for diagnosis of spinal TB. The diagnosis of spinal TB was then confirmed on histopathologic reporting.</p> <p>Results:Mean age of study participants was 47.83±9.65 years. There was male predominance with 93 (62.0%) males and 57 (38.0%) female patients. The mean duration of spinal TB symptoms was 11.52±3.12 months. On accuracy of MRI, there were 83 (55.3%) true positive cases, 10 (6.67%) false positive, 08 (5.33%) false negative and 49 (32.67%) true negative. The sensitivity of MRI was 91.2%, specificity 83.1%, positive predictive value (PPV) 89.2% and negative predictive value (NPV) 86.0%.</p> <p>Conclusion: Sensitivity of MRI was 91.2% and specificity 83.1%.MRI is an ideal non-invasive imaging modality for the diagnosis of spinal TB.</p> <p>Keywords: Magnetic resonance imaging, Spinal, Tuberculosis.</p> 2022-06-30T11:56:45+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Reference range of Amniotic Fluid Index (AFI) in primigravidae with gestational age from 37 to 42 weeks in a local (Pakistani) population. 2022-06-30T13:46:47+05:00 Khurram Khaliq Bhinder Abdur Raheem Rayyan Pervez Raheela Aqeel Sanam Soomro Aisha Jang <p><strong>Background: </strong>Amniotic fluid index (AFI) is a key element in fetal biophysical profile that predicts pregnancy outcome especially near term in primigravidae. The objective of the study was to determine a reference range of AFI in primigravidae of a local population having gestational age from 37 to 42 weeks.</p> <p><strong>Methodology: </strong>This study was carried out from January 2019 to December 2019 after approval from Institutional Review Board and Ethical Committee at Shifa International hospital, Islamabad, Pakistan. Applying inclusion and exclusion criteria, a sample of 272 was selected. AFI was calculated for each subject using ultrasound and recorded on a data collection sheet. For the sake of simplicity and clinical relevance, the population was further stratified as term pregnancy (gestational age 37-39 weeks) and postdates pregnancy (40-42 weeks). The reference range of AFI was then calculated using mean ±two standard deviations.</p> <p><strong>Results: </strong>The reference range of AFI for gestational age of 37-42 weeks (population as a whole) was 6.8- 17.2 cm. For term pregnancy, it was 7.5- 17.5 cm, and for postdate pregnancy, it was 5.8 to 15.4 cm.</p> <p><strong>Conclusion: </strong>The reference range of AFI for gestational age of 37 to 42 weeks in Primigravida women was 6.8 to 17.2 cm. There is a decreasing trend in AFI as pregnancy advances from term to postdate.</p> <p><strong>Keywords:&nbsp; </strong>Amniotic Fluid Index, Gestational age, Primigravida, Reference Range.</p> 2022-06-30T11:57:21+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College COVID 19 Vaccination Related Misconceptions and Myths 2022-07-06T11:21:08+05:00 Dr Tamkeen Nishat Jaffry Dr Hina Shan Dr Rehma Gillani Dr Uzma Hassan Dr Bismillah Sehar Rubab Zulfiqar <p><strong>Background:</strong> Mass vaccination is the most effective way to fight against COVID 19 but a significant number of people are unwilling to be vaccinated, mainly due to misinformation and false beliefs, associated with this drive. The objective of this study was to identify these misconceptions and myths and associate them with sociodemographic factors.</p> <p><strong>Methodology: </strong>This cross sectional survey was conducted on 562 residents of Rawalpindi and Islamabad from July 2021 to November 2021. Data was collected through structured questionnaire both in English and Urdu, analysed by SPSS version 23. χ2-test was used to check the association of categorical data with sociodemographic factors.</p> <p><strong>Results</strong>:&nbsp; Out of all the participants, 328 (58.4%) had received COVID19 vaccination. Among these vaccinated individuals, 81.8% were graduates or above and 74.2% had family income more than Rs.50,000. Out of total, 40.7% respondents believed that, vaccine is harmful for diabetics, hypertensive and heart patients, 40.6% agreed that it is not safe for pregnant or lactating women and 40.4% assumed that they have acquired immunity through natural infection. A strong association of misconceptions and myths was found with residence (p value 0.0001), educational level (p value 0.0010) and monthly income (p value 0.0001).</p> <p><strong>Conclusion: </strong>Several misconceptions and myths are related with COVID 19 vaccination, strongly influenced by various socio demographic. Hence, there is a need to launch various campaigns regarding the safety and effectiveness of vaccination.</p> <p><strong>Key words: </strong>COVID-19, Misinformation, Vaccine</p> 2022-07-06T11:21:08+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College Inflammatory Myofibroblastic Tumour of Lung, A Rare Entity 2022-06-30T13:46:48+05:00 Bilal Umair sohail saqib Rashid Husnain Raheel khan Farhan Ullah <p>Inflammatory fibroblastic tumour of lung is a rare mesenchymal tumour usually affecting the children and young adults. It is usually considered as a benign entity however it has high potential for recurrence and local invasion. Exact pathogenesis of tumour is not known. Complete surgical excision is the treatment of choice. Due to high chance of recurrence, patients are usually kept on close follow up. Here we present a case of inflammatory myofibroblastic tumour of lung , who presented with history of pain and shortness of breath.She was diagnosed&nbsp; a case of inflammatory myofibroblastic tumour with the help of CT scan chest and CT Guided biopsy.She underwent &nbsp;right sided pneumonectomy and remained symptom free on follow up.</p> <p><strong>Key Words<em>.</em></strong> Inflammatory, Myofibroblasts, Pneumonectomy, Tumour.</p> <p>&nbsp;</p> 2022-06-30T11:58:42+05:00 Copyright (c) 2022 Journal of Islamabad Medical & Dental College