Journal of Islamabad Medical & Dental College 2021-10-05T16:20:01+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> Polymers, An Infrangible part of our life. 2021-10-05T16:20:01+05:00 Taimoor Hassan Chao Zhou Sana Saeed 2021-09-30T11:27:36+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Effects of Dried Aloe Vera Gel and Diclofenac on Sodium and Potassium Homeostasis: An Experimental Study on Hypertensive Rats 2021-10-05T16:19:49+05:00 Nadeem Yaqoob Abdul Qudoos Arain Mufakhara Fatimah Samina Kausar Sadia Chiragh <p><strong>Background: </strong>Anti-inflammatory role of <em>Aloe vera</em> gel is well established. Diclofenac is extensively used for acute and chronic inflammation. The present study was conducted to compare dried <em>Aloe vera</em> gel and diclofenac effects on sodium and potassium balance in hypertensive rats.</p> <p><strong>Material and Methods: </strong>This experimental study was conducted at Sargodha Medical College from May to November 2016. Twenty-four healthy male Sprague Dawley rats 7-8 weeks of age were included in study. Any unhealthy-looking rat was excluded from the study. Rats were equally and randomly divided into four groups Normal control (group A), Model control (group B), <em>Aloe vera</em> (group C) &amp; Diclofenac (group D). Hypertension was induced by a 20 % sucrose diet in all groups except group A in 8 weeks’ time. Group B, C &amp; D received distilled water and <em>Aloe vera</em> dried gel 400 mg/kg &amp; diclofenac powder 12 mg/kg body weight respectively orally between 8 to 10 weeks. Serum and urine analysis was performed for hematocrit, sodium, and potassium concentrations at zero, eight and ten weeks. Twenty-four-hour urinary sodium excretion was calculated. Data was analyzed using Graph Pad Prism version 6.</p> <p><strong>Result: </strong>After 2-week administration of <em>aloe vera</em> and diclofenac powder, serum potassium significantly decreased in Group C (p &lt;0.001) while increased in Group B and D (<em>p</em> &lt;0.001) as compared to group A. Urinary sodium concentration and excretion increased significantly in Group C (<em>p</em> &lt;0.01) as compared to Group A whereas result of Group D was insignificant. No significant change in serum sodium and hematocrit of any group was observed.</p> <p><strong>Conclusion: </strong><em>Aloe vera</em> causes less sodium retention than diclofenac but decreases serum potassium contrary to the effect of diclofenac in hypertensive rats.</p> 2021-09-30T11:29:15+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Frequency of Isolation of Coagulase Negative Staphylococcus from Blood Cultures and its Antibiogram 2021-10-05T16:19:39+05:00 Nadia Aslam Nazma kiran Naima Mehdi <p><strong>Background: </strong>Coagulase-negative Staphylococci are members of stable skin inhabitants. They are frequent contaminants in blood cultures and can lead to unnecessary exposure of patients to antimicrobial drugs and excess hospital costs. This study aims to estimate the frequency of Coagulase-negative Staphylococci in blood cultures and their antibiograms.</p> <p><strong>Materials and Methods: </strong>This cross-sectional study was performed in a tertiary care hospital over one year from April 2018 to March 2019. Blood cultures received in the laboratory were processed to isolate Coagulase-negative Staphylococci. Susceptibility to various antimicrobial drugs was detected by disc diffusion method and E-strips.</p> <p><strong>Results:</strong> A total of 13802 blood cultures were processed in one year. 1750 blood cultures yielded bacterial growth and 374 blood cultures were positive for Staphylococci. Out of these 374 blood cultures, 97 were categorized as Staphylococcus aureus and 277 were Coagulase-negative Staphylococci. Out of 13802 total blood cultures performed during study period, 277 blood cultures positive with Coagulase negative Staphylococcus means contamination rate of 2% out of total blood cultures. 277 Coagulase negative Staphylococcus positive cultures out of 1750 positive blood cultures means contamination rate of 15.8% out of positive blood cultures. Among Coagulase-negative Staphylococci, 68.2% isolates were resistant to Cefoxitin, 95.3% to Penicillin, 85.1% to Erythromycin, 37.5% to Ciprofloxacin, 59.6% to Gentamicin, 68.6% to Fusidic acid, 3.6% to Teichoplanin, and 1.4% to Linezolid. All isolates were sensitive to Vancomycin.</p> <p><strong>Conclusion: </strong>The rate of blood culture contamination was 2% out of total blood cultures and 15.8% out of positive blood cultures.</p> 2021-09-30T11:31:26+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Vaccination Status and Clinical Spectrum of Children with Pyogenic Meningitis in A Tertiary Care Hospital of Hazara Division, Pakistan 2021-10-05T16:19:31+05:00 Bibi Aalia Syed Sajid Hussain Shah <p><strong>Background</strong>: Pyogenic meningitis is one of the serious causes of mortality and morbidity in children. It is more prevalent in third world countries with poor vaccination coverage. This study was done to determine the vaccination status and clinical spectrum of pyogenic meningitis in children presenting to a tertiary care hospital.</p> <p><strong>Methods:</strong> This cross-sectional study was carried out from August, 2017 till January, 2020 over 2.5 years. Records of children who got admitted in pediatric B ward, of either gender between ages of 1 month to 14 years diagnosed as case of pyogenic meningitis were included. Records of vaccination status along with signs of meningeal irritation, complications and outcome during hospital stay were documented. Data was analyzed by SPSS 20 and chi square test applied. P value &lt; 0.05 was taken as significant.</p> <p><strong>Results: </strong>There were 117 patients, 78 males and 39 females. Age ranged from 1 month to 14 years with mean age of 5.51± 4.19 years. Patients who were vaccinated up to date were 49.6% and 37.6% were not vaccinated at all. Main presenting feature was fever and seizures especially under one year of age. There was significant association between seizures and age group with p value of 0.001. Signs of meningeal irritation (neck stiffness, brudzinski sign, kerning sign) and paradoxical irritability were present in 85 (72.6%) patients mostly above 1 year of age. There was significant association between signs of meningeal irritation and age group (5 years and above) with p value of &lt;0.001. 110 (94%) got discharged and one (0.9%) patient was referred while 6 (5.1%) patients expired. There was significant association between stay duration and vaccination status. (p = 0.018)</p> <p><strong>Conclusion:</strong> Fever was the most common presentation and vaccinated children with pyogenic meningitis had shorter stay in hospital.</p> 2021-09-30T11:32:02+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Psychological Impact of COVID-19 Pandemic on Pregnant Women 2021-10-05T16:19:22+05:00 Rashida Sultana Anees Fatima <p><strong>Background: </strong>Covid-19 pandemic has spread throughout the world in a short period of time. It has adversely affected the physical, mental and social well-being of communities including pregnant women. This study is aimed to determine the frequency, severity and associated factors of depression, anxiety and stress among pregnant women during COVID-19 pandemic.</p> <p><strong>Material and Methods:&nbsp; </strong>This cross-sectional study was conducted in Sharif Medical City Hospital, Lahore, from August to September 2020.Data was obtained on structured proforma comprised of two sections. Section one consisted of sociodemographic and obstetric components while second two was based on Urdu Version of DASS-21. Data was analyzed using SPSS-23.</p> <p><strong>Results:</strong> Total number of women was 350. Their mean age was 27.47 <strong>±</strong> 4.72 while mean duration of their pregnancy was 26.33±9.17weeks.&nbsp; Mean DASS-21 score of depression, anxiety, and stress was 8.00±2.89, 5.80±3.10 and 9.18±2.80 respectively. It was observed that depression was present in 123(35.1%) ranging from mild to moderate, anxiety in 127(36.3%) ranging from mild to very severe and stress in only 20(5.7%) women and was mild.</p> <p>Education was significantly associated with all three domains.&nbsp; The women who were infected themselves or any other family member affected with COVID-19 showed positive association for depression (p=0.00) and stress (p=0.00). &nbsp;Stress was higher in young age groups (p=0.04) and in women with higher monthly income (p=0.00) while parity also showed association with anxiety (p=001). &nbsp;Anxiety and depression were more in house wives (p=0.00) while stress in working women (p=0.00).</p> <p><strong>Conclusion: </strong>&nbsp;Frequency of depression and anxiety was notable varying from mild to very severe however for stress it was low and mild. Educational level was significantly associated with depression, anxiety, and stress.&nbsp;</p> 2021-09-30T11:32:38+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Assessment of Agility in Elderly Population of Islamabad 2021-10-05T16:19:13+05:00 Maheen Khan Sana Bashir Humaira Hussain Tayyaba Saman Rida Fatima Hina Shafi <p><strong>Background: </strong>Agility is considered as one of the important components of physical fitness. In older adults, it is of utmost importance in response to any stimulus. The objective of this study was to determine normative values of agility in elderly population of Islamabad.</p> <p><strong>Methods:</strong> A Cross-Sectional Survey was conducted in community settings of Islamabad from February–July 2019 after approval by the Ethical Review Committee of Foundation University Islamabad.&nbsp; The calculated sample size was found to be 267, but due to missing data, analysis was done on 250(100 females and 150 males).&nbsp; &nbsp;Participants were selected by convenient sampling. Physically independent participants were included and diseased population (severe musculoskeletal, neurological, and cardiopulmonary disorders), decreased functional status affecting hearing, vision, memory recall was excluded from the study. PAR-Q was utilized in uncovering any possible health risks linked to exercise. For evaluation of agility, the American Alliance for Health, Physical Education, Recreation, and Dance (AAHPERD) Agility Test was performed. Agility scoring is based on time in seconds, with higher score representing less agility, and agility score of less than 62 represents good agility. Data were analyzed through SPSS version 21.</p> <p><strong>Results: </strong>The mean age, BMI and agility score of participants were 60.7±5.81 years, 26±4.30 kg/m² and 22.42±5.2 respectively. There was significant difference (P&lt;0.001) in agility between males and females, with the mean agility score higher in females as compared to males. Similarly, Agility score was significantly high in females as compared to males in BMI range of 18.5 to &gt;30 and all age categories.</p> <p><strong>Conclusion: </strong>Elderly population of Pakistan has good agility score</p> 2021-09-30T11:33:32+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Parotidectomy and Facial Paralysis, A Retrospective Review at A Tertiary Care Hospital 2021-10-05T16:19:05+05:00 Israr ud Din Muhammad Junaid Imran Khan Arshad Aziz Sakhawat Khan Aafia Afridi Ihtisham ul Haq <p><strong>Background:</strong> Facial Nerve is in close proximity with parotid gland and encountered during parotid surgery. &nbsp;Facial nerve &nbsp;&nbsp;paralysis &nbsp;&nbsp;has &nbsp;&nbsp;15 to 66% occurrence rate after parotidectomies. The objective of this study was to find out the frequency of facial paralysis resulting from superficial or total parotidectomies done for various parotid tumors.</p> <p><strong>Material and Methods:</strong> This retrospective study was conducted at the Department of ENT, Khyber Teaching Hospital, Peshawar from January 2018 to May 2020. A total of 203 patients were reviewed for data on demographics, parotidectomies, histopathology and facial paralysis. The information on facial paralysis was compared against various parameters.</p> <p><strong>Results:</strong>&nbsp; &nbsp;The mean age of&nbsp; &nbsp;the participants was 46.12 ± 11.11 years. The most common parotid tumor was pleomorphic adenoma (68.9%) followed by mucoepidermoid carcinoma. 57 (28.07%) patients showed facial paralysis with a higher rate of occurrence in total parotidectomy (40.90%). Among 57 patients with facial paralysis, 6 (10.53%) showed permanent facial paralysis.</p> <p><strong>Conclusion:</strong> Tendency of permanent facial paralysis is high with total parotidectomies. Female population and elderly have a slightly higher rate of facial paralysis. The duration of procedure has no effect on the occurrence of facial paralysis.</p> 2021-09-30T11:34:08+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Audiometric Characteristics of Presbycusis: A Hospital-Based Study 2021-10-05T16:18:55+05:00 Ghulam Saqulain Gul Zahra Nazia Mumtaz <p><strong>Background:</strong> Presbycusis is related to degenerative changes of aging resulting from deficient cochlear microcirculation. It is characterized by bilateral, symmetrical, sensorineural hearing loss (SNHL) in which recruitment and speech discrimination is affected in the absence of noise exposure. The objective of this study was to analyze the pure tone audiogram characteristics in Presbycusis.</p> <p><strong>Methods:</strong> This descriptive study recruited n=192 cases of presbycusis of both genders, aged 50 to 80 years with convenience sampling technique. The study was conducted at Yusra General Hospital and the National Institute of Rehabilitation Medicine, Islamabad from1st July 2017 to 30th September 2017. Pure tone audiometry was used to collect audiometric data. SPSS-24 was used for data analysis. Chi-square and Pearson’s correlation were used to determine association between variables with p &lt; 0.05 taken as significant.</p> <p><strong>Results:</strong> Pure tone audiometry revealed 58 (30.2%) right and 65 (33.9%) left ears with high frequency gently sloping audiogram, while the second commonest configuration being high frequency steeply sloping curve in 51(26.6%) right and 52(27.1%) left ears. There was a significant correlation between the configuration of the audiogram and age with p=0.000, while no significant correlation with gender (p=0.71). The majority,77 (40.10%) right and 71(36.98%) of left ears had moderately severe hearing loss, while severe hearing loss was second commonest with 60(31.25%) right and 70(36.46%) left ears affected. The severity of hearing loss had a significant (P=0.000) positive correlation with age but no significant relationship with gender.</p> <p><strong>Conclusion:</strong> &nbsp;High frequency gently sloping audiogram was the commonest configuration followed by high frequency steeply sloping curve. Moderately severe hearing loss was most commonly seen followed by severe hearing loss.</p> 2021-09-30T11:34:47+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Sero-Prevalence of Brucellosis in Occupationally High-Risk Groups in Three Different Districts of Khyber Pakhtunkhwa, Pakistan 2021-10-05T16:18:47+05:00 Aman Ullah Hamaad Ali Falak Niaz Muhammad Umair Khan Muhammad Asif Zeb Noor Rehman <p><strong>Objectives: </strong>Brucellosis is a neglected zoonotic disease in Pakistan, but it causes immense impact on livestock and public health.&nbsp; This study was done to determine the prevalence of Brucellosis in occupationally high-risk groups encompassing butchers, milkers, and cattle caretakers in district Swabi, Mardan, and Peshawar of Khyber Pakhtunkhwa, Pakistan.</p> <p><strong>Methods</strong><strong>: </strong>In this descriptive cross-sectional study, 300 blood samples were collected through a non-probability purposive sampling technique from occupationally high-risk groups including butchers, milkers, and cattle caretakers at district Swabi, Mardan, and Peshawar from December 1, 2017, to March 31, 2018. All the blood samples were centrifuged and the serum was separated for further testing. Serum agglutination test was used for the detection of Brucellosis and the reagents used for this method were purchased from Biosciences PTE Ltd, Singapore.</p> <p><strong>Results: </strong>Out of 300 blood samples, 111 samples were positive and the overall prevalence of Brucellosis was 37% in occupationally high-risk groups. The overall 37% prevalence of Brucellosis comprised of 70% of <em>B. abortus</em>, 21.6% of <em>B. melitensis, </em>and 8.1% of both <em>B. abortus</em> and <em>B. melitensis </em>simultaneously. The prevalence of Brucellosis in butchers was 27.6%, milkers 13.3%, and cattle caretakers 45.7% while prevalence in males was 33% and in females 39.6%. The prevalence of Brucellosis in district Swabi was 45%, Mardan 33.3%, and Peshawar 30%. The socio demographic factors including age group, occupation, and locality showed statistically significant results.</p> <p><strong>Conclusion: </strong>&nbsp;The prevalence of Brucellosis is considerably higher in occupationally high-risk groups in district Swabi, Mardan, and Peshawar, Pakistan.</p> 2021-09-30T11:35:20+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Oral Manifestations of a Patient Suffering from a Rare Gilbert’s Syndrome: A Case Report 2021-10-05T08:13:59+05:00 Hira Abbasi Abhishek Lal Rizwan Jouhar <p>Gilbert's syndrome is a rare genetic disorder characterized by abnormal glucuronidation of bilirubin in the liver, presenting as unconjugated hyperbilirubinemia in the absence of hepatocellular injury or hemolysis. Diagnosis of this pathology is primarily made during routine examination described as the presence of a yellowish tinge in the eyes and skin in general. Normally, the oral manifestations of Gilbert's syndrome are present but mostly go unnoticed as the teeth are minimally affected which are visible to the patient and surrounding mucosa in the oral cavity, where yellow discoloration can be appreciated. Dental treatments are smoothly carried out for such patients like extractions, root canal treatment, cleaning prophylaxis. The patient in this case safely underwent the root canal treatment after being diagnosed with irreversible pulpitis without any unusual discomfort. Local anesthesia can also be safely administered to such patients such as infiltration and inferior alveolar block anesthesia.</p> 2021-09-30T11:35:55+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Adenosquamous Carcinoma of Gallbladder – A Case Report 2021-10-05T08:16:39+05:00 Nosheen Nabi Aamer Mehmood Naseer Ahmed <p>Gallbladder cancer is an uncommon malignancy and majority of these carcinomas are adenocarcinomas. Adenosquamous carcinoma of gallbladder is a rare histopathological subtype of gallbladder carcinoma. It usually presents with symptoms of cholelithiasis like epigastric pain, nausea and bloating. On clinical examination, tenderness is usually present. Radiologically in most of the cases, gallstones are found leading to the diagnosis of cholelithiasis for which cholecystectomy is done. Gallbladder carcinomas are found mostly as an incidental finding on microscopic examination of cholecystectomy specimen. This disease is curable if diagnosed earlier but in most of the cases they present at advanced stages when resection is not possible and prognosis is poor. As this disease is extremely rare so published information is largely based on the case reports and case series. This is a case of 60 years old female patient who underwent cholecystectomy for cholelithiasis with incidental finding of Adenosquamous carcinoma on histopathology report.</p> 2021-09-30T11:36:36+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College Radiological Images 2021-10-05T08:23:49+05:00 Department of Radiology 2021-09-30T11:37:05+05:00 Copyright (c) 2021 Journal of Islamabad Medical & Dental College