LIAQUAT MEDICAL RESEARCH JOURNAL

A comprehensive analysis of urological surgical procedure at Dow University hospital in Karachi- A retrospective study

Malik Amna Khatoon — 2024-12-31

The objective of this study was to investigate the indications and the variety of urological surgical procedures conducted at DOW University Hospital in Karachi, Pakistan over a two-year period. This retrospective observational study was conducted from April 2021 to April 2023 including 1773 patients, recruited by using non-probability consecutive sampling technique. Information was obtained from the clinical notes of patients, records of emergency department, and the main electronic database of the hospital. A total of 1773 patients fulfilling the inclusion criteria were included in the present study, with a mean age of 38.73±16.09 years. The majority of the participants were males. The most frequently detected diagnosis in this study was Renal Calculi (28.3%), followed by BPH (11%), and ureteral stones (8%). Among the day-case surgeries, DJ removal was the most common procedure (19%). The most often encountered diagnoses and indications for surgery were renal and ureteral calculi and benign prostatic hyperplasia (BPH). Implementing a dedicated day surgery center and hiring additional specialized healthcare personnel, would improve the caliber and volume of urological services offered at Dow University Hospital.

Impact of Respiration on Stuttering

Wusqa Ahmed Ahmed — 2024-12-31

Stammering is a speech problem that causes disturbances in speech flow. It affects a person's social and professional life and creates communication difficulties. It was an observational cross-sectional study conducted from February 2023 to July 2023, to evaluate the impact of respiration on stuttering. The sample size was 343. A purposive sampling technique was employed, individuals with stammering of any severity, both gender and willing to participate were included. A self- administered structured questionnaire was used for data collection. Out of the 343 participants 55% were males and 51% of respondents were between the ages of 5 and 20 years. 62% of people had stammering for 1-5 years. Changes in their breathing patterns were reported as; faster (28%), shallower (33%), and held breaths (21%). 60% sought out interventions, highlighting the psychological effects of stammering on people. A significant percentage (34%) believed that respiratory problems were a factor in stammering. The most common factor was found to be public speaking (54%), which was followed by stress (12%). 26% of respondents reported that stammering get worse with irregular breathing and 25% reported that it gets better with deep breaths whereas 48% of respondents found no connection between the two. Conscious breathing helped 23% of participants stammer. Stammering had a substantial and moderate impact on 49% and 32% individuals’ quality of life. 34% have reported that stammering was alleviated by addressing breathing patterns, 38% reported it to be of somewhat help, and for 25% it did not make a difference. Coexisting respiratory or speech-related symptoms were reported by 42% of respondents. This study highlights the relationship between breathing and stammering, highlighting the necessity of tailored therapies that target speech and breathing patterns for comprehensive care. The results provide important new information on the causes of stammering and possible therapeutic options for those who experience it.

The Changing Trends Amongst Patients with Colorectal Carcinoma Presenting at Medical Oncology Department, JPMC

Sorath Bhutto — 2024-12-31

Colorectal cancer (CRC) is the second leading cause of death This cross sectional study was conducted including biopsy proved adenocarcinoma of colon and rectum patients at outpatient unit of oncology department at Jinnah Post Graduate Medical College (JPMC), Karachi, Pakistan. The mean age of the patients was 40 years (IQR ± 16 years). Majority were males patients accounting for 66%. Majority reported to have frequent vegetable intake (89.8%) and comparably lower processed food intake (69.9%). 92% patients reported to have sedentary lifestyle, 58% were smokers, and 8% were alcohol abusers. Majority of patients (96.6%) had no family history of colorectal cancer. Rectal adenocarcinoma is identified in majority of patient between age 18-40 years (n 70; 65.4%, p=0.004) and this age group often present with Grade III (n=45; 83%,p<0.001) and Stage III of cancer ( n 58; 66.7%, p= <0.001). More patients of the age group of 18-40 years had poorly differentiated cancer (n 48; 44%, p<0.001). Few patients in this age group were smokers (n=47; 46%, p 0.005) and had history of alcoholic intake (n 5; 35%, p = 0.038). In our study population the age group 18 years to 40 years had considerably higher rate of colorectal cancer as compared to older age groups. People younger than 40 years are being diagnosed with relatively more advanced and aggressive disease. This study also identified smoking as a potential risk factor in younger adults.

The Age Standardized Remission Rate of Acute Myeloid Leukemia in Adults

Sana Hashmat — 2024-12-31

This study was conducted to determine demographic distribution of Acute Leukemia (AL) among the adult patients in Pakistan. This was a cross-sectional survey conducted between September 2023 and February 2024 from the Department of Oncology at Jinnah Post-graduate Medical Center, Karachi Pakistan. This department receives cancer patients from all over the province of Sindh as well as from other provinces. A total of 130 adult patients with diagnosis of acute leukemia were included in this study. Participants were selected using convenient sampling technique. The median age of male AL patients was significantly higher as compared to females i.e. 30 years ;IQR=18 versus 24 years; IQR=21.25 years (p value= <0.05).There was statistically significant difference in the age distribution among AL patients between males and females. This study found male: female ratio of 1.8:1 among AL patients. No statistically significant difference was observed in the socio-demographic and disease-related characteristics among male and female. The current study concludes that acute leukemia demonstrates male predominance. The average age of presentation was comparatively lower among females as compared to males. However, sociodemographic and disease characteristics does not appear to be influenced by gender. Large scale studies are required to evaluate its influence on clinical outcome.

Experiences of Women during Post-Partum Period: A Phenomenological Study in Karachi, Pakistan

Shaneela Khowaja — 2024-12-31

Postpartum is a significant transitional period in a woman’s life that can be internalized by only those who have undergone the experiences of motherhood. Therefore, it is imperative to recognize and understand women’s worldviews and expectations regarding postpartum care. The present study aims to describe and understand women’s perceptions and experiences during postpartum. The phenomenological qualitative methodology design was used to understand this phenomenon. Approval for conducting the study was obtained from the Ethical Review Committee (ERC) of the Aga Khan University (AKU), Karachi. Eight women participated in individual in-depth; audio-taped interviews. Data was analyzed using a thematizing process of the phenomenological method. Results: Bodily transformation, sense of fear/joy, momentous of customary value system, and connecting to faith were the emergent themes related to the notion of “transition to motherhood”. The study demonstrates the fact that the postpartum period is not just a simple process being experienced by mothers, but it is a great time and process of transition for a mother.

Antioxidant, antimicrobial, enzyme inhibitory and cytotoxic effect of Taverniera couneifolia plant mediated Silver nanoparticles

Rahmat Khan — 2024-12-31

This study was conducted to evaluate antioxidant, anticancer, enzyme inhibitory and antimicrobial potential of methanolic extract and AgNPs of T. couneifolia. The (DPPH) 1,1-diphenyl-2-picrylhydrazyl, (ABTS) 2,2-azinobis-(3-ethylbenzothiazoline-6-sulfonic acid), metal chelating, phosphomolybdenum, hydrogen peroxide scavenging and (FRAP) ferric reducing antioxidant power activities, antibacterial potential against Klebsiella pneumonia, Escretia coli, Acetobacter, Staphylococcus aureus and Staphylococcus epidermidis, antifungal against Aspergillus niger and Aspergillus flavus and enzyme inhibitory including alpha amylase and acetyl cholinesterase were used to evaluate the methanolic extract and the synthesized AgNPs' antioxidant potential. T AgNPs displayed the highest enzyme and radical scavenging capabilities in comparison to the plant extract. Additionally, the BSL test was used to measure the cytotoxicity activity. Our findings unequivocally demonstrated that biosynthesized AgNPs had antimicrobial, antioxidant, enzyme inhibitory and cytotoxic action and reduced the growth capability.

Automated Facial Animation Using Marker Point for Motion Extraction

Mehran Syed — 2024-12-31

In this research work, an automated 3D face expression generation technique is presented, which is extracted from real life video of face motion. The face expression is extracted from real human face using Huff-transform algorithm to gate the value of x coordinate and y coordinate, Covariance Matrix for detecting face marker points and Mahalanobis Distance to calculate the distance of each marker points within frames. The technique of tracking points on face uses markers placed on key positions of face muscles, then by getting its position from all frames of pre recoded face video using the distance algorithm the movement of each face muscle is detected and measured. The face muscles are marked with particular tracking markers that are detected and tracked by the system. This tracking occurs by using color segmentation, where we detect color of points and track the location and distance of each tracker points. The original and translated position values of each marker points are obtained and recorded in text file in vector values. The tracked values will be transferred in a 3D Animation software like MAYA and applied on a pre-Rigged 3D model of Human face. The 3D face will be rigged using joints to emulate the face muscle behavior.

A comprehensive analysis of urological surgical procedures at DOW University hospital in Karachi Pakistan - A retrospective study

Malik Amna Khatoon — 2024-12-31

Pattern of presentation of gliomas and clinical outcome - An institutional descriptive study

Arbaz Gul Abro — 2024-12-31

Gliomas are common brain tumours presenting with aggressive clinical behavior. There is limited literature available to evaluate clinical pattern and survival outcome in Pakistani population. The patients were retrieved from Cancer Research Database, (a complete set of clinical data of cancer patients from 2008 till 2023, prospectively established and regularly updated). There were 139 patients of primary brain tumors. Most common histological type of glioma was GBM (36%) and there was male preponderance. Majority of patients presented with high grade IV and stage 4 tumors. Surgery was frequently used primary therapy while radiotherapy was most frequently give second line therapy. Out of 79 patients 63 died because of disease, median survival time was 6 months, age and grade did not appear to show any significant influence on survival. Our study showed that glioma has male predominant tumour with aggressive clinical pattern and poor overall survival. Further studies to understand biology and genetic pattern of glioma and development of targeted therapy is recommended so that clinical outcome of these patients can be improved.

Antimicrobial resistance pattern and bacterial profile from ear cultures

Mehwish Sajjad Mehmood — 2024-12-31

Ear infections cause hearing loss, which is a hallmark of many diseases. Ear infections are more common in children than in adults. This study was conducted to isolate different pathogens from ear culture and to evaluate the antibiotic susceptibility pattern of these organisms. This was a retrospective study conducted in Diagnostic and Research Laboratory, Dow University of Health Sciences, Karachi, Pakistan. All case histories including respiratory culture and antibiotic susceptibility results were analyzed. Culture and antibiotic susceptibility reports of patient were retrieved from record files of the department from 1st January 2021 to 31st December 2021. A total of 691 ear pus samples were identified, most frequent bacterial isolate was Pseudomonas aeruginosa (n=249, 36%) followed by Staphylococcus aureus (n=140, 20%), CONS (n= 77, 11%) and Proteus mirabilis (n=58, 8%). Penicillin had 100% and 98% resistance against Staphylococcus aureus and Coagulase negative staphylococcus, respectively, while there was 100% susceptibility against vancomycin. Colistin has 100% susceptibility against gram negative rods in our study. Growing bacterial resistance is of great concern as it alters the clinical prognosis of ear infection. Further-more this study help in choosing the correct empirical therapy for ear infections.

Climate change and health challenges- A call for action in low middle income countries

Binafsha Manzoor Syed — 2024-12-31

Climate change is a global issue affecting quality of life and economy around the globe. The health affected by climate change has a number of pathways, including extremes of weather, air pollution making children and elderly population the most vulnerable. Recent event of smog in different regions of Pakistan, floods for past few years and extreme heat has badly affected human health and economy of the region. There is dire need to strategies to develop climate change resilience in these regions. The connection between climate change and public health is undeniable. As the planet warms, so too does the urgency to act. By addressing the root causes of climate change and investing in adaptive measures, we can protect both the environment and human health. The time to act is now for our planet, our health, and future generations.

Successful Live Related Renal Transplantation in a 13 year old girl complicated with limited vascular access and fungal infections: A Case Report.

Muhammad Tassaduq Khan — 2024-12-31

This case report illustrates a 13-year-old girl, a known case of hypertension (HTN) and End Stage Renal Disease (ESRD) secondary to Lupus nephritis (biopsy proven), who was commenced on maintenance hemodialysis twice weekly since two months. No permanent access was formed in the meantime as she had complicated vascular anatomy and multiple attempts leading to thrombosis. Arteriovenous Fistula (AVF) formation carried high risk of thrombosis, as well as the central access for hemodialysis was unattainable for long term use. She was admitted with central line bloodstream infection (CLABSI) and pneumonia which was non-responsive to IV antibiotics, her fungal markers showed elevated Galactomannan and beta D Glucan levels. These high levels necessitated the initiation of anti-fungal therapy and Voriconazole was started, which was later switched to Amphotericin B and Isavuconazole as no response was observed in earlier treatment. She underwent successful renal transplantation while her antifungal treatment was underway. This case reports a lifesaving transplant in a septic patient with limited central access for hemodialysis.

Unveiling the complexities: A case report on complications arising from propionic acidemia

Imran Uddin — 2024-12-31

Propionic acidemia is a rare inherited metabolic disorder caused by a defect in propionyl-coenzyme A (CoA) carboxylase, resulting in the accumulation of propionic acid. We present a case involving a 5-year-old male with a known history of propionic acidemia who presented to the emergency department with decreased oral intake, vomiting, and diarrhea. Despite initial interventions, the patient developed severe metabolic acidosis, respiratory distress, and gastrointestinal symptoms. The case highlights the varied complications of propionic acidemia, including cardiac complications, intellectual difficulties, and recurrent respiratory distress. The patient's course involved intensive care management, including mechanical ventilation and cardiac support. This report contributes to the understanding of the multifaceted challenges posed by propionic acidemia and emphasizes the importance of a multidisciplinary approach in the management of this rare metabolic disorder.