045520   SHARMA N, SHARMA A (Obstetrics and Gynaecology Dep, Government Medical Coll, Jammu and Kashmir) : Histological correlation of karmans endometrial sampling with dilation and curettage in abnormal uterine bleeding. JK Sci 2020, 22(1), 29-31.

The study was done to compare the diagnostic efficacy of endometrial biopsy obtained by Karman suction cannula with conventional D&C following TVS in patients with AUB. 100 patients of AUB presenting in gynaecology OPD were studied with history, examination, laboratory investigations, TVS, endometrial aspiration using Karman cannula and endometrial curettage. It is concluded that endometrial aspiration is an effective, useful and minimally invasive procedure and can be used for the primary investigation of women with AUB along with TVS.

4 tables, 13 ref

045519   MAHAJAN R (Anaesthesiology and Critical Care Dep, Chintpurni Medical Coll and Hospital, Bungal, Punjab) : Comparison of sevoflurane and propofol for insertion of I-gel in patients undergoing minor elective surgical procedures under general anaesthesia. JK Sci 2020, 22(1), 24-8.

A popular method of providing anaesthesia for I-Gel insertion is with the use of propofol. However, bolus propofol has been associated with adverse effects such as hypotension, apnea and pain on injection. Hence, time is needed to search an alternative. We aimed to compare the induction characteristics, ease of I-Gel insertion, hemodynamic changes and complications with inhalation of 8 % sevoflurane vital capacity breath and propofol. A prospective randomized study of 60 American Society of Anaesthesiologists’ Grade I and II patients was conducted and distributed among two groups with 30 each undergoing minor surgical procedures under general anaesthesia. Group P received the injection propofol and Group S received sevoflurane. At the end point of induction, the I-Gel insertion was attempted. Scoring systems were used to grade the conditions for insertion of the I-Gel. Induction, I-Gel insertion characteristics and hemodynamic changes were assessed. Data were recorded and analysed. Comparison among the study groups was done with unpaired t-test, Mann–Whitney test and Chi square test. Sevoflurane took a longer time for induction and for I-Gel insertion than propofol. There was no statistically significant difference between the two groups, with respect to I-Gel insertion characteristics, heart rate, and mean arterial pressure. It is concluded that sevoflurane is associated with good hemodynamic stability and may prove useful in cases where propofol is to be avoided. However, the ease of insertion provided with propofol is better.

5 tables, 15 ref

045518   JAGGI R, MAGOTRA V , CHOUDHARY S, GUPTA S (PG Surgery and Radiodiagnosis Dep, Govt. Medical Coll Jammu, Jammu and Kashmir) : Use of palmer’s point in creation of pneumoperitoneum in patients of previous abdominal surgeries and to check efficacy of the visceral slide technique for detection of abdominal wall adhesions. JK Sci 2020, 22(1), 19-23.

In patients with history of previous abdominal surgery, creation of pneumoperitoneum during laparoscopic procedure involves risk of complications as there is association of underlying adhesions at the umbilicus site. Palmer’s point is alternative site of primary port insertion. For creating pneumoperitoneum, visceral slide technique is used to detect the movement of viscera immediately deep to the abdominal wall. This technique is reliable in identifying adhesion-free areas of the abdominal wall. This study was undertaken to evaluate use of Palmer’s point in creation of pneumoperitoneum in patients of previous abdominal surgeries and to check the efficacy of the visceral slide technique for detection of umbilical adhesions in these patients. This one-year study was conducted on 30 patients with previous history of abdominal surgery in the Government Medical College, Jammu. Visceral slide test was conducted using a real time ultrasonography machine with a 7.5 MHz abdominal transducer placed in a sagittal plane at the umbilicus and the ultrasound scan focused on the infraumbilical region between the anterior abdominal wall and the aortocaval complex. A normal visceral slide (positive test) is movement of the viscera more than 1 cm. An abnormal visceral slide (negative test) is defined as movement of the viscera less than 1 cm. At the end of the surgery, intra-operative, early and late complications were evaluated. Adhesions under the umbilicus were present and absent in 15 (50 %) patients each. The visceral slide technique was negative in 9 (30 %) and positive in 21 (70 %) patients. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of visceral slide technique was 60 %, 100 %, 100 %, 72 % and 70 % respectively. Definitive evidence of the efficacy of Palmer’s point in creation of pneumoperitoneum could not be established due to the small sample size and patients with limited spectrum of abdominal surgeries. Further studies in the form of multicenter randomized control trials are needed to verify the utility of Palmer’s point for creation of pneumoperitoneum and to evaluate the role of visceral slide technique in diagnosing intra-abdominal adhesions preoperatively.

2 tables, 15 ref

045517   SHARMA A, LONE A H, SHARMA M, CHAUDHRY M (Pathology Dep, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Haryana) : Significance of mentzer index and erythrocyte indices to evaluate erythrocyte morphology and spectrum of anemia in adult population in a tertiary care hospital in rural Haryana. JK Sci 2020, 22(1), 15-8.

Anemia, reduced red cell mass below normal range, results in reduction of oxygen carrying capacity of blood that results in tissue hypoxia. MCV, MCH, MCH and RDW represent a sensitive indicator to study erythrocyte morphology. Mentzer Index recommended MI13 for Iron deficiency anemia. 100 cases were analyzed prospectively over a span of 1 year at MMIMSR, Mullana. The study revealed 34 % of patients to be in age group of 21-30 years with (59 %) female predominance out of which majority of cases were of moderate anemia (73 %). Erythrocyte indices revealed pattern with majority of samples having MCV, MCH and MCHC to be in normal range while RDW showed increased values. Mentzer index came out to be >14 in 96 % of samples. To conclude evaluation of erythrocyte indices and Mentzer index aids in quatitative assessment of anemia and also to distinguish between iron deficiency anemia and thalassemia trait.

2 illus, 4 tables, 25 ref

045516   BANOO S (Health and Family Welfare Dep, Govt. Hospital, Sarwal, Jammu) : Results of internal iliac artery ligation in pelvic bleeding. JK Sci 2020, 22(1), 12-4.

Postpartum haemorrhage in obstetric patients, if not managed immediately can be fatal. When local packing, pharmacotherapy and even hysterectomy fail, ligation of internal iliac artery may be needed.This study was conducted on the patients who had significant postpartum bleeding, and in whom all other measures of arresting the bleeding failed. A detailed history, through general / systemic examination was contemplated, baseline investigations were sent in all the patients approaching labor. The cause of bleeding was recorded in both vaginal and caesarean delivery. Internal artery ligation was done either by the obstetrician or the vascular surgeon. 44 patients underwent internal artery ligation. Uterine atony, placenta praevia and post-partum haemorrhage were common indications for ligation. 36 patients had undergone caesarean section, 12 vaginal delivery and 8 hysterectomy. Women with atonic PPH at vaginal delivery or caesarean section were initially treated with conservative / pharmacotherapy. Iliac vessels were approached by transverse or midline approach. Bilateral ligations were done in 41 patients. There was no mortality. Pelvic bleeding after any mode of delivery, or surgery on uterus and ovaries can present with a grim phenomenon. Accurate diagnosis, and immediate precise surgical intervention decreases morbidity and mortality.

15 ref

045515   SINGH M, SACHDEV S (Physiology Dep, Govt. Medical Coll Jammu, Jammu and Kashmir) : Assessment of stress parameters and cognitive functions in different IQ-EQ groups. JK Sci 2020, 22(1), 7-11.

There is individual variation in response to same type of stress depending on the IQ-EQ level. Stress effects various parameters of higher mental functions such as attention, concentration, decision making, learning and memory. Even the cognitive functions vary depending upon the variation in general and emotional level of a person. This study was conducted on thirty-five healthy male volunteer students chosen randomly and after taking consent. The subjects were divided into four groups depending upon their IQ-EQ level. Parameters of stress and cognitive functions were assessed between groups. Significant differences in four groups were found for handgrip, ASS and serum cortisol. Low IQ high EQ and low IQ low EQ groups were most stressed out.

2 tables, 25 ref

045514   KOHLI A, ALI N, MIR I A (Cardiothoracic and Vascular Surgery Dep, Govt. Medical Coll, Jammu and Kashmir) : Esophagectomy for cancer of the esophagus- GMC Jammu experience. JK Sci 2020, 22(1), 1-6.

We retrospectively reviewed a data of 202 patients, who underwent esophagectomy for cancer of the esophagus over 12 years at GMC, Jammu. Out of 262 patients, 202 patients underwent esophagectomy, mean age was 53 years, ranging between 31-75 years. 160 patients had squamous cell carcinoma and 31 patients had adenocarcinoma. 148 patients underwent transhiatal esophagectomy (Orringer’s procedure), whereas 18 patients underwent McKeown’s three incision procedure and 10 patients underwent transthoracic esophagectomy (Ivor lewis) procedure. It was observed that mid third tumors accounted for 40 %, lower third tumors accounted for 55 % and GE junction tumors 5 % of the cases. Squamous cell carcinoma was the most common histology (79.5 %). The overall morbidity (significant complications leading to prolonged hospitalization) was 38 %. Perioperative mortality was 13(6.43 %). We hereby conclude that esophagectomy is a major surgical operation and gives palliation of dysphagia to patient and our experience with it has been with acceptable morbidity and with favorable short-term results.

4 tables, 15 ref

045512   PURI S, YAQOOB F (Obstetrics and Gynaecology Dep, ASCOMS & Hospital, Jammu- 180 017, Email: farhana.adnan@gmail.com) : Prevalence of human papilloma virus infection in females attending a tertiary care center. JK Pract 2020, 25(1-4), 12-5.

Cervical cancer remains worldwide and the fourth most common cancer among women, around 528,000 new cases and 266,000 deaths are reported each year. To find the prevalence of HPV in females and to study the pattern of pap smear of these patients. Prevalence of HPV in this study was 30.4 %.This study showed 10 normal smear (8 %), 80 inflammatory smear (52.6 %), 5 atrophic smear (4 %), 9 squamous metaplasia (7.2 %), 6 ASCUS (4.8 %),12 LSIL (9.6 %), 2 HSIL (1.6 %),1keratinizing squamous cell carcinoma (0.8 %) Conclusion: If HPV testing is used as a screening method we can prevent the progression to higher cervical lesions and carcinoma cervix.

4 tables, 15 ref

045511   BHAT T, YOUSUF Q, WANI A A, NAIK M A, ROBBANI I, NAQASH M (General Medicine Dep, SKIMS MCH, Bemina, Srinagar, Email: muzafarnaik@gmail.com) : Early detection of smoking induced lung damage in patients with normal pulmonary function tests: Evaluation with high resolution computed tomogram (HRCT) chest. JK Pract 2020, 25(1-4), 6-11.

Spirometry is accepted universally to diagnose chronic obstructive pulmonary disease. However, many current and former smokers who do not meet the spirometric criteria for COPD may assume that they are disease free and may be having significant respiratory disease demonstrable by imaging.  It was a Cross-sectional observational study. To evaluate the possibility of detecting early COPD/smoking induced lung damage in current and former smokers having normal spirometry, by using HRCT chest.  Sixty-four patients either former or current smokers aged 40-70 years who had normal pulmonary function test were included in this study. The cases were subjected to detailed history, clinical examination including pulmonary function tests (PFT) and highresolution computed tomography (HRCT) chest. Out of 64 cases 57 were current and 7 were former smokers. Around 64 % of smokers had one or more respiratory related symptoms. Around 12.5 % of smokers with normal PFT had significant emphysema on quantitative CT (QCT) measurements. Around 4.7 % smokers with normal PFT had significant air trapping on QCT. Almost 12.5 % of smokers had other CT chest findings other than emphysema & air trapping. There was a significant correlation between CT documented emphysema with age, pack years ( > 35 pack years) & sputum production. Relying exclusively on pulmonary function tests to diagnose COPD/ smoking related lung disease may underestimate significant early smoking related lung diseases, hence it is imperative to supplement patient evaluation with HRCT for identifying early disease and thus motivating current smokers to quit smoking.

4 tables, 24 ref

045510   QAZI A, FIRDOSI M, JAN F, MAJEED A (St George's, Univ of London, London, Email: mudasirfirdosi@gmail.com) : psychological distress in Kashmiri diaspora due to total communication blockade in Kashmir. JK Pract 2020, 25(1-4), 1-5.

On 5th August 2019, India imposed a complete communication blockade in Kashmir including telephones, mobiles, and Internet services. Kashmiris living across the world were unable to communicate with families back in Kashmir. We conducted an online study using the HADS (Hospital anxiety and Depression) rating scale to measure the psychological distress in Kashmiri diaspora due to communication blackout and conflict in their country of origin. An online survey questionnaire using the HADS rating scale was circulated to consenting Kashmiri participants over 18 years of age using social networks. A total of 465 responses were anonymously received over 4 weeks. The results show very high scores for both anxiety and depressive symptoms across the whole sample. The results on the anxiety sub-scale showed 89 % of the sample scoring above the cut off for “caseness” or “abnormal”. The scores on the depression subscale showed that 88 % of the sample fell within the abnormal range. The consequences of conflict are far reaching and can cause significant psychological distress to the diaspora. Our study shows very high rates of both Anxiety and Depressive symptoms in the respondents, who were unable to contact their families due to information blackout. To the best of our knowledge, there is hardly any such study conducted before. Further research is needed to understand the full extent of such conflict situations and communication blackout on diaspora population.

3 illus, 25 ref

045509   MEHTA V, THOMPSON T, SHI R (Otolaryngology Dep, LSU Health Shreveport, Louisiana, USA, Email: dr.vikasmehta@gmail.com) : Predictors of survival in early-stage laryngeal cancer by treatment modality. Int J Head Neck Surg 2020, 11(4), 63-70.

Our investigation attempts to identify factors associated with improved survival for early-stage laryngeal cancer based on primary therapy using the National Cancer Database (NCDB). This is a retrospective cohort with data abstracted from the NCDB. Patients with T1 or T2N0M0 laryngeal cancer from 1998 to 2011 who received radiation only, laser surgery, or laser surgery with adjuvant radiation were included. The Chi-square analysis were used to assess the association between treatment and factors investigated. Overall survival was assessed via the Kaplan-Meier method. Log-rank methods were used to determine factors significant for survival, and a multivariable Cox regression model was performed. There were 14,276 patients from the NCDB eligible for this study. The majority (91.2 %) of patients received primary radiation, 4.7 % laser resection, and 4.0 % laser resection with radiation. Five-year survival for laser surgery was 78.8 % (95 % CI 75.5–82.1) vs 67.2 % (95 % CI 66.4–68.1 %) for radiation alone. The multivariate analysis demonstrated advanced age, increased comorbidities, public or uninsured, T2 stage, and supraglottic subsite to be independently associated with worse survival. Treatment with laser only and laser with adjuvant radiation demonstrated a hazard ratio of 0.77 (p = 0.055) and 0.65 (p = 0.001) when compared to primary radiation. Survival analysis on early-stage glottic patients in the NCDB showed multiple factors to be independently associated with survival. Outcomes based on treatment suggest an improved survival when utilizing endoscopic surgery as the primary treatment modality.

1 illus, 5 tables, 22 ref

045508   SONI A, GUPTA A K (ENT Dep, All India Institute of Medical Sciences, Raebareli, Uttar Pradesh, Email: Annanyasoni1986@gmail.com) : Sinonasal mucormycosis in a tertiary care center: A review of 30 cases. Int J Head Neck Surg 2020, 11(3), 55-7.

To report our experience in presentation, treatment, and outcome of rhino-orbito-cerebral mucormycosis in our institute. Retrospective, noncomparative analysis of medical records of 30 patients with mucormycosis seen over a period of 5 years. Data of 30 patients, 22 males and 8 females with a mean age of 47.3 (range 25–70 years), were analyzed. Total 25 patients had diabetes mellitus, 3 were post-renal transplant, and 2 were post-bone marrow transplant and on immunosuppressive drugs. Ophthalmic signs and symptoms were present in 12 patients, and intracranial involvement was present in 11 patients. Computed tomography/magnetic resonance imaging (CT/MRI) revealed involvement of paranasal sinuses in all patients. All were treated with amphotericin-B (3–7 g) and 29 patients underwent appropriate surgery. Posaconazole/caspofungin was started as adjuvant treatment in certain cases. Mucormycosis is a rapidly spreading fungal disease with high mortality and demands immediate management without delay and generous debridement.

3 illus, 2 tables, 8 ref

045507   BALEVI M (Neurosurgery Dep, Konya Numune Hospital, Konya, Turkey, Email: mbalevi@gmail.com) : Dolicho-arteriopathies (kinking, coiling, and tortuosity) of the carotid arteries: A study by magnetic resonance angiography. Int J Head Neck Surg 2020, 11(3), 50-4.

The aims and objectives of the present study were to document the dolicho-arteriopathies (DAs) of the common carotid artery (CCA) and internal carotid artery (ICA) and to estimate the external diameter of the segments of the ICA and CCA.Patients were divided into three groups according to contrast-enhanced magnetic resonance angiography (CEMRA) appearance of the CA: group I, normal; group II, the CCA with CA; and group III, the ICA with CA. The external diameters of CCA and ICA with or without DA were measured at the tree different parts, and mean diameters value were calculated. The most common DAs were tortuosity (75.5 %), followed by kinking (17.1 %) and coiling (7.4 %). Dolicho-arteriopathies were found in 134 (40.3 %) subjects, 89 (66.4 %) in females and 45 (33.6 %) in males older than 60 years (p < 0.001). Total 64 (47.8 %) subjects presented CCA with DA. Total 33 (24.6 %) presented the monolateral DA of CCA. Total 31 (23 %) subjects presented the bilateral DA of the CCA. Total 70 (52.2 %) subjects presented the ICA with DA. Total 29 (21.6 %) presented the monolateral DA of ICA. Total 41 (30.5 %) subjects presented the bilateral DA of ICA. The external diameters of CAA and ICA with DA were larger than without DA (p < 0.005).  Monolateral and bilateral DA of the CA have been frequently observed in females and over the age of 60 years. The external diameters of the CAA and ICA with DA were larger than without DA.

4 illus, 3 tables, 28 ref

045507   BALEVI M (Neurosurgery Dep, Konya Numune Hospital, Konya, Turkey, Email: mbalevi@gmail.com) : Dolicho-arteriopathies (kinking, coiling, and tortuosity) of the carotid arteries: A study by magnetic resonance angiography. Int J Head Neck Surg 2020, 11(3), 50-4.

The aims and objectives of the present study were to document the dolicho-arteriopathies (DAs) of the common carotid artery (CCA) and internal carotid artery (ICA) and to estimate the external diameter of the segments of the ICA and CCA.Patients were divided into three groups according to contrast-enhanced magnetic resonance angiography (CEMRA) appearance of the CA: group I, normal; group II, the CCA with CA; and group III, the ICA with CA. The external diameters of CCA and ICA with or without DA were measured at the tree different parts, and mean diameters value were calculated. The most common DAs were tortuosity (75.5 %), followed by kinking (17.1 %) and coiling (7.4 %). Dolicho-arteriopathies were found in 134 (40.3 %) subjects, 89 (66.4 %) in females and 45 (33.6 %) in males older than 60 years (p < 0.001). Total 64 (47.8 %) subjects presented CCA with DA. Total 33 (24.6 %) presented the monolateral DA of CCA. Total 31 (23 %) subjects presented the bilateral DA of the CCA. Total 70 (52.2 %) subjects presented the ICA with DA. Total 29 (21.6 %) presented the monolateral DA of ICA. Total 41 (30.5 %) subjects presented the bilateral DA of ICA. The external diameters of CAA and ICA with DA were larger than without DA (p < 0.005).  Monolateral and bilateral DA of the CA have been frequently observed in females and over the age of 60 years. The external diameters of the CAA and ICA with DA were larger than without DA.

4 illus, 3 tables, 28 ref

045506   VEERABHADRAIAH P, SHIVALINGAIAH P R, HANUMANTHAPPA K C, NAIR S S, PILLAI C R (Otorhinolaryngology Dep, RajaRajeswari Medical Coll and Hospital, Bengaluru, Karnataka, Email: pruthvirajjs@gmail.com) : Management of retrosternal goiter without sternotomy: A retrospective review in a tertiary care center. Int J Head Neck Surg 2020, 11(3), 47-9.

Retrosternal goiter (RG) is defined as a thyroid mass of which more than 50 % is located below the thoracic inlet. It can give rise to various compression symptoms like dyspnea and dysphagia, which necessitate the need for surgery. The aim of this study is to review the management of patients with retrosternal extension of goiter through a neck collar incision without sternotomy with minimal morbidity at a tertiary care center. A retrospective analysis of 224 patients who underwent thyroid surgery between January 2014 and August 2018, in Department of ENT in RajaRajeswari Medical College and Hospital, Bengaluru, Karnataka, was done. Total 21 patients had retrosternal extension of thyroid. The patients were evaluated with respect to their demographics, clinical symptoms, thyroid gland location, histopathological results, and postoperative complications. The median age was 51 years with range from 30 to 72 years. The ratio of thyroidectomies due to RG with respect to all thyroidectomies in this study population was 9.37 %. All the patients underwent thyroidectomy (hemi/total) through cervical approach without sternotomy. The most common presentation was neck swelling (76.19 %) followed by neck discomfort (23.80 %) and dyspnea (9.52 %). The final histopathological diagnosis in most of the patients was benign (80.95 %). Temporary postoperative complications occurred in five patients, which later resolved with treatment.  Majority of RG are benign but surgery should always be considered because of risk of symptoms related to compression, acute airway obstruction, and the possible risk of malignancy.

3 illus, 2 tables, 13 ref

045505   BASAVARAJ B, DEVINENI P, JANGA R P (ENT Dep, JSS Medical Coll, Mysuru, Karnataka, Email: jangarajendraprasad@gmail.com) : Our experience of bull gore injuries to neck: A case series. Int J Head Neck Surg 2020, 11(3), 43-6.

To describe our experience with bull gore injuries in the head and neck. A series of four cases, sustained with bull gore injury in the head and neck region, reported to Department of Emergency Medicine, JSS Hospital, Mysuru, from 2015 to 2016. Two cases had tracheal injury, and one case had internal jugular vein (IJV) thrombosis for which all three did not necessitate any active surgical intervention but close monitoring. But one case had internal carotid artery (ICA) rupture needed immediate exploration and ligation of ICA. Bull gore injury to the head and neck although uncommon can be life-threatening. The most common symptoms will be dysphagia, swelling in the neck, injury to laryngotracheal tree, and respiratory distress. Patients can be managed conservatively, and surgical intervention is required for vascular pathology. Underlying life-threating complications are retropharyngeal hematoma, IJV thrombosis, air embolism, and ICA rupture.

5 illus, 42 ref

045504   SATHYABAMA V, VEERABAHU M (Oral and Maxillofacial Surgery Dep, Ragas Dental Coll and Hospital, Chennai, Tamil Nadu, Email: satvarnan@gmail.com) : Secondary rhinoplasty on patients with cleft lip and palate: A review. Int J Head Neck Surg 2020, 11(2), 26-31.

The cleft lip and palate patients undergo a series of surgical procedures from the time of their birth, wherein the primary cleft lip correction procedure is carried out. The last in the series is rhinoplasty after the maxillary skeletal base has been set right in its dynamics with the mandibular base. The degree of deformity lies in the type of cleft and its accompanying features. The timing of correction at the primary lip closure stage, allowing a repositioning of the lateral nares, the detailed examination of the nose at the time of presentation ascertains the degree of augmentation necessary. The first mention of rhinoplasty dates back to the dates of Shusruta and his disciples who managed to reconstruct parts of the nose and ear, which were sliced as a part of criminal punishment. The Roman encyclopedist published the techniques of reconstruction, followed by the Europeans. By the 11th century, the Arabs converted Shushruta’s book into Sanskrit, and this spread to the Western atmosphere. Evidence for a free flap graft and a forehead graft that were adopted and published by Doctors Cruzo and Findlay in 1794 are the first steps to the modern rhinoplasty techniques. The correction of the nose at the primary surgery of the cleft lip was widely accepted to reduce the gross deformities that would manifest if the small corrections were not made appropriately the first time. The caudal resection of septae was identified as the reason for the growth deformities that happened secondarily. The secondary rhinoplasty was to be performed as a final procedure after the growth phase when all other surgical procedures were done and dealt with leaving an L-shaped strut of the septae at the dorsal, and the caudal end was advocated for a stable result of the septum without any buckling and further deformity.

12 illus, 2 tables, 28 ref

045503   NAIK S M, NAIK S S (ENT and Head and Neck Surgery Dep, The Oxford Medical Coll Hospital and Research Centre, Bengaluru, Karnataka, Email: sud223@gmail.com) : Transoral transtonsillar styloidectomy: A minimally invasive technique for stylohyoid syndrome. Int J Head Neck Surg 2020, 11(2), 23-5.

Transtonsillar styloidectomy is the most common surgical approach for symptom complex of styalgia. It is a minimally invasive procedure of excision of the symptomatic elongated process and remains the most preferred procedure.  Transoral transtonsillar styloidectomy done in 23 symptomatic cases had relief of symptoms with some needing adjuvant treatment with carbamazepine or gabapentin. Symptoms subside over a period of months and depend on the pathology of the syndrome, which is still to be investigated in detail. The symptoms depend of the effects of the elongated process on the nerves and over internal carotid artery rather than the length itself.

3 illus, 19 ref

045502   RASOOL S, PAMPORI R A, MAJID S, WANI H, FAROOQ R, PATIGAROO S (ENT Dep, Hamdard Institute of Medical Sciences and Research, New Delhi, Email: srb948@gmail.com) : Comparison between elisa and PCR for detection of epstein-barr virus in head and neck malignancies. Int J Head Neck Surg 2020, 11(1), 6-11.

This is a comparative prospective study conducted for a period of 2 years from December 2012 to December 2014 in the Postgraduate Department of Otorhinolaryngology, Head and Neck Surgery, Government Medical College, Srinagar, in collaboration with the Department of Biochemistry. A total of 118 subjects were enrolled in the study design, which included 98 histopathologically confirmed head and neck malignant cases and 20 healthy controls. The aim of the study was to compare the ELISA with polymerase chain reaction (PCR) for detection of Epstein-Barr virus (EBV) in head and neck carcinoma cases and compare such results with controls. Around 32.65 and 42.85 % of patients were positive for EBV with PCR and ELISA, respectively. When these results were compared with controls, it showed statistically significant results; only 5 % of subjects in controls were positive for EBV (p value = 0.015) with PCR while as many as 15 % with ELISA (p value = 0.049). The sensitivity and specificity of ELISA are 100 and 84.85 %, respectively, with diagnostic accuracy of the test 89.8 % (Cohens κ value = 0.7853).

3 illus, 8 tables, 42 ref

045501   KATHURIA B, DHINGRA H, MADHUR D, KAMBOJ V, HERNOT S, KADAM S , NITTALA R , PAREEK M (Otolaryngology and Head and Neck Surgery Dep, Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, Email: Kathuriabhushan56@gmail.com) : Epidemiological study of different syndromes in 300 deaf and mute children. Int J Head Neck Surg 2020, 11(1), 1-5.

To study the epidemiological aspects of syndromic hearing loss (HL) in deaf and mute children below 15 years of age. The study “Epidemiological study of different syndromes in 300 deaf and mute children” was conducted on 300 deaf and mute children below 15 years of age at Rohtak (Haryana) from August 2013 to July 2014. Three hundred deaf and mute candidates were included in the study from various schools for deaf and mute children in the Rohtak city and deaf and mute children attended the ENT outdoor at the Department of Otolaryngology and Head and Neck Surgery, Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India, for the evaluation of their deafness. Information regarding patient’s age, sex, religion, age of presentation, residence, family history of deafness, consanguineous marriage in the family, socioeconomical status of the family, literacy and occupation of the parents, and developmental history of the candidate was recorded from the parents and guardians using a standard questionnaire. Audiological tests were done to determine the type and the degree of HL. Out of 300 deaf and mute children, syndromic HL was found in 44 cases (14.66 %). Most common systems involved in syndromic HL were ocular in eight patients (18.18 %) followed by skeletal in four patients (9.09 %) and craniofacial malformation in four cases (9.09 %). Out of 300 deaf and mute cases, well-recognized syndromes were found in five cases (1.66 %) and the most common syndrome found was Waardenburg’s syndrome (2 cases). In the 44 syndromic HL cases, 36 patients were males (81.81 %) and 8 patients were females (18.18 %). Out of 44 syndromic HL cases, 42 (95.45 %) were Hindu by religion and 2 (4.54 %) were Muslim. Residence wise, 20 patients (45.45 %) were from a rural area and 24 patients (54.54 %) were from an urban area. Out of 44 syndromic HL cases, fathers were illiterate in 5 cases (11.36 %), while mothers were illiterate in 23 cases (52.27 %), while fathers were educated in 39 cases (88.63 %) and mothers were educated in 21 cases (47.72 %). By occupation, fathers were laborers in 25 cases (56.81 %) and mothers were housewives in 38 cases (86.36 %). Socioeconomically, 31 patients (70.45 %) were from the lower–middle and middle socioeconomical status, while 11 cases (13.63 %) were from the lower socioeconomical status. History of consanguineous marriage was present in two cases (4.54 %). Both these cases were Hindu by religion. Family history (genetic etiology) of HL was present in six cases (13.63 %) and acquired cases were found in nine cases (20.45 %). In 29 cases (65.90 %), no etiology was found. From the above results, we can see that syndromic HL is more common in the male urban child. Mothers who are illiterate and housewife are a risk factor for deafness. Syndromic HL is more common in the lower and lower–middle socioeconomical status families. Any newborn with ocular skeletal and craniofacial abnormalities should be urgently evaluated for deafness.

3 illus, 10 tables, 14 ref

045495   MEHRA A, KUMAR P (Veterinary Anatomy Dep, Lala Lajpat Rai Univ of Veterinary and Animal Sciences, Hisar- 125 004, Email: drashumehra@gmail.com) : Age related histological and histochemical studies on the crop of chickens. J Cell Tissue Res 2020, 20(1), 6833-7.

The present study was undertaken to elucidate the histology and histochemistry of crop of birds at different age groups. The study was conducted on 30 broiler chickens of one week to 42 days age. The tissues were collected after post-mortem examination at 7, 14, 21, 28, 35 and 42 days of age. The crop was lined by stratified squamous keratinized to partly non-keratinized epithelium. The lamina propria mucosae have loose irregular connective tissue and comprised of few collagen, reticular and elastic fibers and fine blood capillaries. The crop was devoid of mucous glands. The PAS reaction was generally absent in all the tunics except a very weak positive reaction was observed in the blood capillaries and blood vessels. Similarly no reaction was observed for presence of cysteine. The lamina muscularis mucosae drastically reduced in thickness as compared to cervical oesophagus and interrupted in nature. The tunica sub-mucosa has less amount of loose irregular connective tissue however at few places a wider tunica submucosa was also observed. The tunica muscularis was comprised of an inner circular and an outer longitudinal layer. The inner circular layer wasthicker and almost double in thicknessthan that of outer longitudinal layer of smooth muscles. Sub-mucosal and myenteric plexuses were also observed. The outer most tunica adventitia was observed, having loose irregular connective tissue and fatty tissue along with a few small sized blood vessels and nerve bundles.

7 illus, 14 ref

043988   ASLAM S, UMBREEN G, JAHANGIR F, BANO R, AKHTAR Z (Health Sciences Lahore Univ, Punjab, Pakistan, Email: gul123kbc@gmail.com) : Food safety knowledge and practices among food handlers in food street Lahore. Int J Med Res Health Sci 2020, 9(5), 81-8.

Food safety can be defined as the confidence degree that the food will not cause any harm or sickness to the consumer when it is prepared, served and consumed based on its intended use. A secure food is a food that is physically, chemically and biologically ready to be consumed when it is prepared according to its main purpose and does not loses its nutritional value. The purpose of this study to assess the knowledge and practices regarding food safety among the food handlers. Method: A descriptive cross sectional survey based study was conducted in Food Street, ShahiQilaha, Lahore. Convenience sampling technique was used to collect the data from respondents. Closed ended questionnaire was used. Data was gathered from food handlers working in Food Street, Shahi Qilaha, Lahore. SPSS version 20 was used to analyze the data and descriptive statistics applied. Result: In our study, almost all of the food-handlers were aware of the critical role of general sanitary practices in the work place, such as using gloves (88.0 %). On disease transmission, 56.0 % of the food- handlers had knew that Salmonella is a food borne pathogens and 74.0 % were known that hepatitis A is a food borne pathogen, 44.0 % respondents knew about the AIDS transmitted by food. Only 56.0 % participants knew the temperature of 65 ° should keep for ready food and this knowledge with their experience. In generally the food handlers have satisfactory knowledge in the areas of food safety, personal hygiene and sanitation procedures. But they do not use strict hygienic practices during processing and handling food products. The most important issues are the lack of knowledge regarding refrigeration temperatures, lack of knowledge concerning cross-contamination and its control.

1 illus, t2ables, 28 ref

043987   IQBAL J, SHAHBAZ R Y, FIDA S, USMAN A, MALIK I, HASSAN G U (Medicine Dep, CMH Lahore Medical Coll, Lahore, Pakistan, Email: Samm.doc@hotmail.com) : Efficacy of doxycycline as peluridising agent in cases of malignant pleural effusion (MPE). Int J Med Res Health Sci 2020, 9(5), 77-80.

To determine the efficacy of doxycycline as pleuridising agent in cases of malignant pleural effusions (MPE). This was a descriptive case series that was conducted at Medical and Pulmonology Department of Combined Military Hospital Lahore from January 2018 to August 2018. In this study, the cases of malignant pleural effusion assessed on history and proven by histopathology on any biopsy of either gender falling in range of 30 years or more were included. The pleural fluid was drained by appropriate size intercostal chest tube (ICT). These cases then underwent pleurodesis with Doxycycline. For pleurodesis 10 capsule of Doxycycline each carrying 100 mg in it were taken and mixed with 50 ml of normal saline. A repeat chest X-ray and USG chest was done to see for presence of fluid, complete absence of fluid was labelled as efficacious pleurodesis. In this study, there were total 60 cases of malignant pleural effusion (MPE) included, out of which 35 (58.33 %) were females and 25 (41.67 %) females. The mean age of the subjects was 57.32 ± 7.28 years. There were 29 (48.33 %) cases with CA breast, 22 (36.67 %) with CA lung and 9 (15 %) had the other miscellaneous malignancies. The efficacy of pleurodesis with Doxycycline was seen in 26 (43.33 %) of cases. There was significant better efficacy (p=0.001) in cases that had pleural effusion less than 1 liter at presentation where it was seen in 14 (63.64 %) of cases as compared to 12 (31.58 %) cases that had effusion less than 1 liter. There was no significant difference in terms of duration of pleural effusion with p=0.21. Doxycycline is efficacious in almost half of the cases and it is significantly better in cases that had effusion less than 1 liter

2 tables, 13 ref

043986   SHETTY K, ALDEREA E W, ALTAF R W, SUQATI E A, SINDI M A (IBN Sina National College of Medical Sciences, Jeddah, KSA, Email: drkarun16@gmail.com) : Comparison and evaluation of marginal accuracy of provisional restoration by 3 different materials in vitro study. Int J Med Res Health Sci 2020, 9(5), 68-76.

Provisional Restoration plays a vital role in the long term Success of fixed partial restorations. A provisional restoration is a transitional restoration that provides protection, stabilization and function before Fabrication of the definitive prosthesis. A poorly adapted provisional restoration encourages plaque accumulation which can lead to periodontal conditions ranging from gingival Inflammation to periodontal support breakdown, this being especially true in cases where finish line margins are placed equigingivally or subgingivally. Aim of this in vitro study to compare the vertical marginal discrepancy of provisional restorations fabricated using light polymerized composite resin by direct technique. Ivorine teeth (mandibular right and left 1st molar) were attached to the Typodont. Putty index was prepared Putty for each Ivorine tooth and prepared for a full crown restoration with a 1mm shoulder finish line and a uniform height of 6 mm of all the axial surfaces. After tooth preparation, impression was made with heavy body and light body using putty wash technique. Impression was immediately poured with die stone. Altogether sample size was 48. Provisional crowns fabricated using direct technique and cemented using Freegenol luting cement. They were divided into 3 groups, i.e. sixteen for each material. Die hardener was applied to the remaining part of the stone dies to prevent distortion of the die stone during aging process of the specimen. Each group was further divided into 8 depending on the type of aging process the specimens were subjected to: Pepsi, Tea and Arabian coffee and soaked for 54 hours. After immersion, the specimens were washed in distilled water, dried with filter paper, and subjected to marginal accuracy by Stereo microscope. Data obtained in the present study was subjected to statistical analysis using one-way ANOVA and inter group comparison was done with PostHoc Bonferroni’s correction SPSS Version 21. Comparison of the buccal marginal discrepancies in the 3 materials used for temporary crowns using ANOVA showed significant changes when dipped in the 3 beverages. Significant buccal and lingual marginal discrepancy of all 3 temporary crowns was observed when immersed in tea compared to coffee and Pepsi as well as coffee with Pepsi by Post-Hoc Bonferroni’s correlation. Within the limitations of this study, it was concluded that, all the three temporary crowns fabricated from different materials showed significant marginal discrepancy when dipped in three different beverages.

4 illus, 6 tables, 26 ref

043985   POLEVOY G G (Physical Education Dep, Vyatka State Univ, Kirov, Russia, Email: g.g.polevoy@gmail.ru) : The development of balance in school children using the exercise classic’s. Int J Med Res Health Sci 2020, 9(5), 63-7.

To study the impact of the exercise «Classic’s» on the general coordination abilities of school children and their ability to balance. The main method of studying the issue is a pedagogical experiment. In the course of the study exercise, «Classics» supplemented the standard program of physical education. Second-graders from the regular school took part in the study. The change performance of the general coordinating abilities of junior school children and their ability to balance. Children in CG, the improvements were not significant, but in the EG the indices improved significantly in both the control tests. Insufficient motor and coordination activity of younger school children is a problem. New ideas should complement the existing physical education program at school. If perform the exercise «Classic’s» in the classroom for physical culture at school, it will improve the performance of not only coordination abilities, but also the ability to balance the school children 8-9 years, increase interest in physical education lessons at school.

2 tables, 21 ref

043984   ELAMIN M O, SANHOURI M , MOHAMED H R (Umm Al-Qura Univ, Saudi Arabia, Email: mohsm7l@yahoo.com) : Study of knowledge, attitudes and practices among sanitary workers regarding medical waste management in khartoum locality teaching hospitals, 2019. Int J Med Res Health Sci 2020, 9(5), 53-62.

Health care waste is considered as a risk or dangerous to public health and the environment. The exposure of patients, staff, waste handlers, visitors and the community to medical waste is due to bad management practices in hospitals and health care centers. This cross sectional descriptive study was carried out in in Khartoum Locality Teaching Hospitals with the aim to assess knowledge, attitudes and practices among the health sanitary workers towards medical waste management. Total 210 respondents were participated in the study; the study uses questionnaires, interviews and observations as tools for data collection. The collected data were analyzed by Software Package for Social Sciences (SPSS) and the result was presented in text, figures and tables. The study revealed that 42.4 % of the respondents have excellent knowledge about hazardous waste. Nearly half, 45.2 % of the respondents have excellent and very good knowledge concerning waste transmitting diseases. 95.2 %, 82.9 %, 66.2 %, 22.8 % and 53.8 % have favorable attitudes towards wearing gloves, wearing an apron, wearing masks, wearing boots, wearing gloves during the work respectively. 83.3 % wash their hands after the work, but only 33.3 % use soap. This study showed that females were significantly more knowledgeable, having favorable attitude, and better practices towards medical waste than males. The Study recommended that the Occupational Health Department in State Ministry of Health should apply programs to encourage the health workers to use the personal protective equipment..

10 illus, 4 tables, 20 ref

043983   ALRESHIDI F S , ALSHAMMARY E M , ALSHAMMARY F M , ALSHAMMARI M M , ALSHAMMARI F M , ALRESHIDI F F , ALMUGHAIS E S , ALRASHDI M K, AHMED H G (Histopathology and Cytology Dep, Khartoum Univ, Sudan, Email: hussaingad5@gmail.com) : Saudi parents perceptions towards some child abuse and neglect related factors. Int J Med Res Health Sci 2020, 9(5), 46-52.

The impact of childhood abuse and neglect may remain beyond adulthood. This study aimed to assess Saudi parent’s perceptions towards some child abuse and neglect related factors. This was a descriptive study involved a cross-sectional survey of 400 Saudi parents. The sample was collected during Feb 2019 to Feb 2020. All responded parents were at the age of 20 years or older. When manipulating parent’s gender and perception towards child abuse associated factors, fathers were more aware of child abuse and neglect related factors than mothers. Saudi parent’s perceptions towards child abuse and neglect related factors are high. Mothers, particularly younger ones need more efforts to improve their awareness towards some child abuse and neglect related factors.

3 illus, 3 tables, 12 ref

043982   ALRESHIDI F S (Family Medicine Dep, Ha’il Univ, Kingdom of Saudi Arabia, Email: hussaingad5@gmail.com) : The familiarity of medical students at clinical years about the influence of ionizing radiations doses. Int J Med Res Health Sci 2020, 9(5), 39-45.

Since the medical students at the clinical phases increasingly becoming more close to the patient’s diagnosis and treatment is very important to be aware of radiation dose. Therefore, this study aimed to assess the familiarity of Medical students at clinical years about the influence of ionizing radiation doses. Methodology: In this cross-sectional study, 443 medical students at clinical phases of the study (4^th, 5^th, and 6^th years) were randomly selected from three medical colleges in 3 universities (Hail, Jouf, and Tabuk). A purposeful questionnaire was designed and distributed electronically to collect the desired data. Results: Out of the 433 students, 339/433 (78.3 %) knew that a person’s body weight is an important determinant of radiation dose, whereas, the remaining 94/433 (21.7 %) claimed that weight has no role. Correct radiation dose for Bone scan (>300 mSv), Spine MRI (0 mSv-1 mSv), Abdominal x-ray (10 mSv-50 mSv), Abdominal US (0 mSv-1 mSv), PET Scan (10 mSv-50 mSv), PET/CT scan (10 mSv-50 mSv), Mamo (2 views) (5 mSv-10 mSv), and Thyroid scan (10 mSv-50 mSv), constituting 16/433 (3.7 %), 129/433 (29.8 %), 49/433 (11.3 %), 144/433 (33.3 %), 48/433 (11 %), 50/43 (11.5 %), 115/433 (26.6 %), and 55/433 (12.7 %), in that order. Conclusion: Medical students in the late clinical years have inadequate knowledge of ionizing radiation doses in Northern Saudi Arabia Medicine College, which necessitates further interventions in this context, at the level of general curriculum as well as, at the training in the late clinical years

3 illus, 5 tables, 11 ref

043981   JAT M A, MEHMOOD Y, JAWAID A R (Surgery Dep, Northern Border Univ, Arar, Saudi Arabia, Email: dr.ayubjat@yahoo.com) : Feasibility and safety of day case laparoscopic cholecystectomy for symptomatic gallstones. Int J Med Res Health Sci 2020, 9(5), 33-8.

To evaluate the feasibility, safety and outcome of day case laparoscopic cholecystectomy in patients with symptomatic gallstones. Materials and methods: This prospective cross-sectional study was conducted at Department of Surgery, Northern Medical Tower, in the Northern Border region of Saudi Arabia from Jan 2018 to Dec 2019. Two hundred forty six patients with uncomplicated symptomatic gallstones were selected according to inclusion and exclusion criteria. They were admitted electively on the same day and operated on in the morning hours and discharged by the surgeon 6-8 hours later in the evening. The variables of this study were overnight stay, rate of conversion to open surgery and perioperative complications. Results: Out of 246 patients, 221 (90 %) were female and 25 (10 %) were male with a ratio of 9:1. The age of the patients ranged from 20-50 years with a mean age of 35 years. In this series 209 patients (85 %) were discharged successfully after observation of 6-8 hours in the day surgery unit (DSU) whereas 37 patients (15 %) stayed overnight. Factors responsible for overnight stay included excessive postoperative nausea and vomiting in 5 cases (2 %), drain placement in 27 cases (11 %) and three patients (>1 %) refused to discharged. Two patients (<1 %) required conversion to open laparoscopic cholecystectomy. Umbilical port site infection was noted in 4 cases (2 %). Conclusion: Day-case laparoscopic cholecystectomy is safe and feasible with high success rate in carefully selected patients with uncomplicated symptomatic gallstones.

3 tables, 25 ref

043980   SHETTY S, SRIGIRI S K, SHEIKH K H (Dentistry Dep, IBN Sina National College of Medical Sciences Jeddah, KSA, Email: drshreyak@gmail.com) : A comparative clinical, microbiological and biochemical evaluation of guided periodontal pocket recolonisation (GPR) using synbiotics as an adjunct to scaling and root planing in patients with chronic periodontitis: A pilot project. Int J Med Res Health Sci 2020, 9(5), 20-32.

With increase in the resistance to antibiotics, the paradigm of periodontal treatment in recent years is slowly shifting from specific bacteria elimination to altering bacterial ecology by probiotics. With this objective in mind, the present study was carried out to assess the use of a symbiotic preparation as a guided pocket recolonisation (GPR) procedure in patients with chronic periodontal disease. Materials and methods: Total 180 patients with chronic periodontitis with presence of true periodontal pockets; 4 mm-6 mm in depth involving minimum 3 or more quadrants were selected and divided into 3 groups wherein the first group only scaling and root planing was done without GPR application; in the 2nd group, GPR was carried out as a single application following SRP and in the 3rd group, multiple applications of GPR with SRP was done. Clinical measurements; microbiological analysis of periodontal pathogens by anaerobic culture and biochemical assessment of alkaline phosphatase and interleukin-6 using ELISA and spectrophotometry was carried out at baseline, 3 and 6 months respectively. All the 3 groups showed significant changes in clinical (p<0.05) as well as in microbiological and biochemical parameters (p<0.05) within the groups. Intergroup comparisons revealed significant changes in group 2 and 3 with biochemical parameters. Positive correlation was observed with clinical parameters and alkaline phosphatase levels and P. intermedia counts in group 1 and 3. Within the limitations of the present study, it could be concluded that symbiotic therapy may have some additional benefit to Scaling and root planing.

5 tables, 45 ref

043979   ALATAWI A (Nursing Dep, Tabuk Univ, Tabuk, Saudi Arabia, Email: asalatawi@ut.edu.sa) : The determinants and risk factors of bronchial asthma in Saudi Arabia: Online community survey. Int J Med Res Health Sci 2020, 9(5), 10-9.

Bronchial Asthma is most common of the greatest public main chronic illnesses and for many, has a considerable influence on the quality of life. There are a great environmental difference in asthma severity, and mortality. The main goals of this study were included, assess prevalence rate of asthmatic disease, determents of risk factors of asthma and to identify to specific asthma symptoms among the children and adults having bronchial asthma in Tabuk city in Saudi Arabia. This study was quantitative, questionnaire based on online survey. A total of 400 asthmatic participants (aged 12-50 years) in Tabuk city in Saudi Arabia, completed the survey (have Social Media during two months (period of data collection) and diagnosis with Bronchial Asthma more than 24 months. The researcher used online survey based-questionnaire has a standardized script of close-ended questions. Descriptive statistics were performed for categorical and continuous variables by used SPSS program version 22. Four hundred participants participated in this study. 58.3 % from participants were male (294/400). More than half of the participants 55 % have prevalence of asthma and 45 % don’t have asthma. 70.5 % from participants cooking with liquefied petroleum gas (LPG) and 14 % cooking with solid fuel have asthma but 45.6 % no self-cooking and 19.4 % cooking with solid fuel from participants don’t have asthma. Also, there are significant differences raise in pets in home with asthma, 76.4 % from participants have asthma that found pets in home and 46.7 % from participants don’t have asthma that found pets in home. There are significant differences according to car exhaust smoke cause to breathe, 50 % from participants have asthma that show car exhaust smoke cause to breathe. More than half of the participants have of asthma. The main determent of asthma in this study was cooking with liquefied petroleum gas (LPG). Also, smoking was the main risk factor of asthma and found pets in home.

7 tables, 24 ref

043978   AL-MUHTASEB N, AL-KAISSI E, ALMOHTADI A (Medicinal Chemistry and Pharmacognosy Dep, Petra Univ, Amman, Jordan, Email: ealkaissi@uop.edu.jo) : Protective antibodies to bovine milk fat globule and to xanthine oxidase levels in jordanian patients with acute myocardial infarction. Int J Med Res Health Sci 2020, 9(5), 1-9.

The previously reported circulating human antibodies against the Bovine Milk Fat Globule Membrane (BMFGM) were found to primarily target xanthine oxidase (XO) enzyme that produces uric acid and reactive oxygen species. It is suggested that XO could potentially be implicated in the pathogenesis of acute myocardial infarction. Methods: In this study, anti-BMFGM and anti-XO IgG, IgM and IgA antibodies were assayed in the sera of acute myocardial infarction patients and healthy control from the Jordanian population using the highly sensitive Enzymelinked immunosorbent assay (ELISA). Results: Serum high in antibodies against xanthine oxidase was used as a reference serum to standardize the assay. The levels of anti-BMFGM IgM antibodies were found to be higher in male controls than myocardial infarction male patients in contrast to female group, but no significant differences were observed in the levels of IgG and IgA antibodies. The levels of anti-xanthine oxidase IgM and IgG antibodies were significantly higher in myocardial infarction patients when compared with their corresponding controls. Conflicting results were obtained when different personnel measured the IgM antibody titres, likely due to infarction factors of IgM aggregation within the assay. Results from this study demonstrate significant differences in the levels of antiMFGM and anti-XO IgM antibodies between myocardial infarction patients and controls. Conclusion: Collectively, the data suggest that XO may be a risk factor in myocardial infarction patients and the presence of antibodies may act as a protective factor.

4 tables, 35 ref

043977   PERVEZ N , HAQ Z U , KHAN I, UMAR M (Pulmonology Dep, Lady Reading Hospital Peshawar, Pakistan, Email: drumar98@gmail.com) : To determine the frequency of successful outcome of multi-drug resistant tuberculosis treated as outpatient in a tertiary care center. Int J Med Res Health Sci 2020, 9(4), 61-6.

To determine the frequency of successful outcome of multidrug-resistant tuberculosis treated as outpatient in a tertiary care center This was a descriptive cross-sectional study done from 13 April, 2018 to 13 Oct, 2018. All the patients fulfilling inclusion criteria having age 20-60 years of either gender under treatment of MDR-TB for more than six months were enrolled in study the from Programmatic Management of Drug Resistance Tuberculosis (PMDT) site at Department of Pulmonology. Informed consent was taken from patients. Strictly exclusion criteria i.e. patients having neurological or psychological problems before diagnoses of MDR-TB (as per medical record in history), co-infection with HIV, was followed to exclude potential confounder and biases. Education status was evaluated and the response of treatment was checked in matriculate & under matric patients, also socioeconomic status was evaluated by asking about monthly salary whether below or above 12000, and subsequently their effect on treatment outcome. HIV screening is done through ICT method and DST for tuberculosis done on sputum of the patients in the Provincial Reference Lab in Hayat Abad Medical Complex Peshawar for diagnosis. A total of 151 patients were included in this study, among which males were 94, and females were 57. The mean age was 41 years and S.D 10.82. As per the results, 110 (72.84 %) patients were having a successful outcome. This study concludes that the out-patient treatment strategy success rate was 72.84 % and it is feasible and safe for the treatment of MDR-TB patients.

5 tables, 25 ref

043976   AHMED S Z , DHAHI M A R, GHADHBAN J M (Medical Microbiology Dep, Al Nahrain Univ, Baghdad, Iraq, Email: dr_maysaa@yahoo.com) : Molecular quantification of epstein-barr virus nuclear antigen gene and DNA methylation patterns of human tumor suppressor genes p16 and e-cadherin in relation to infection with helicobacter pylori as early prognostic biomarker for gastric tumorgenesis in patients from Baghdad. Int J Med Res Health Sci 2020, 9(4), 50-60.

To investigate the association between EBV viral infectious dose, infection with EBV and/or H. pylori and histologically different gastric diseases and cancer. Also, to study the association between EBV and/or H. pylori infection with DNA methylation patterns of human tumor suppressor genes p16 and CDH1 in progression of primary gastric diseases to neoplasia. The current prospective cross-section study included a total of 94 GTPs taken from patients suffering from gastro-duodenal manifestations recruited to Gastro-Endoscopy Department at Gastroenterology and Hepatology Teaching Hospital, Baghdad, Iraq, from November 2017 to October 2018. Two gastric tissue biopsies (GTBs) were collected from those patients. Genomic DNA was extracted from fresh GTPs. Direct molecular identification of H. pylori in extracted DNA was performed by amplification of species-specific urea. Identification of Epstein-Barr nuclear antigen 1(EBNA1) in extracted DNA was performed using nested PCR. DNA samples positive to EBNA1 were submitted for viral load estimation using quantitative real time PCR. Methylation patterns of p16 and CDH1 promoters were detected in modified DNA samples by sodium sulfate using MS-PCR. Of total samples, 39 (41.5 %) of DNA samples were positive for H. pylori and 18 (19.15 %) DNA samples were positive for EBNA-1. Studying EBV load, 8/23DNA samples were showed infectious dose of EBV. Studying methylation patterns of p16 and CDH-1 promoters, 21/42 and 19/42 DNA samples were provide results for MSPPCR, respectively Epstein-Barr virus and H. pylori infection may have a synergistic effect in developing different gastric diseases and that enable the clinician to choose the suitable treatment regime.

2 illus, 3 tables, 61 ref

043975   MANIAGO J D, ALBOUGAMI A S , ORTE C J S, FELICIANO E E , MALABANAN M C , BOSHRA A Y , GONZALES F M, AND CAJIGAL J V (Nursing Dep, Majmaah Univ, Al Majmaah, Kingdom of Saudi Arabia, Email: je.maniaga@mu.edu.sa) : Stakeholders’ quality framework of nursing education: A brief report. Int J Med Res Health Sci 2020, 9(4), 44-9.

Stakeholders play an important role in generating criteria that will identify variables in evaluating nursing education. This brief report focuses on stakeholder’s involvement in perceiving and formulation of quality framework s in nursing education which is conducted in one of the state universities in the Philippines that offers a nursing program. Survey questionnaires, Focus Group Discussion (FGD) working papers, rubrics of responsiveness were used among 410 involved participants to identify the contributing factors towards stakeholder’s quality framework in nursing education. Content analysis was utilized for its qualitative results and simple frequencies and averages were applied for its quantitative descriptions. Results showed that stakeholders defined quality education utilizing resources, practices, and outcomes with 7 elements namely: 1) Administration, 2) Curriculum and instructions, 3) Faculty, 4) facilities, 5) Student services, 6) Research and 7) Community extension. For the perspectives, meanings, and values of stakeholders’ revealed difference when it comes to limitations in achieving goals but participants believed that nursing education is the production of a system for its input-process-output model. It also showed that provision of quality education and services pertaining to community development matters in terms of attaining institutional goals.These findings likewise contribute to the definition of stakeholder’s quality framework that affects the delivery of nursing education which contains bearing when it comes to attaining its institutional goals, vision, and mission.

2 tables, 8 ref

043974   ALJUDAIE A A, ALAMRI A A, ALANZI M S , ALGHAMDI A A , ALANZI A M , ALSUGHIER F H , ALTHUBAITI A M, AND ALFARHAN A I (King Saud bin Abdulaziz Univ for Health Sciences, Riyadh, Saudi Arabia, Email: mjeedafaadhel@hotmail.com) : Patient satisfaction with emergency department care at a care center in Saudi Arabia. Int J Med Res Health Sci 2020, 9(4), 36-43.

Patient satisfaction plays a crucial role in assessments of the effectiveness of healthcare delivery. It is of absolute importance in the quality assessment as its comprehensive analysis can highlight both well-functioning and problematic aspects of a hospital. This descriptive cross-sectional study aimed to assess the satisfaction of 375 patients admitted to the emergency department (ED) of King Abdulaziz Medical City in Saudi Arabia between December 2016 and September 2017 and to determine the related factors. The patients, selected through non-randomized convenience sampling, completed a validated questionnaire in two phases: August-September and December-January. The mean (standard deviation) score of overall satisfaction was 57.59 (8.69) (range: 19-70). The domain that had the highest “excellent” score was admission (171; 45.8 %), while that with the highest “poor” score was nursing care (141; 37.6 %). Most participants rated their level of satisfaction as good (96; 50.8 %). Those who had been hospitalized in the three days prior to filling out the questionnaire and those who waited longer to see the doctor were significantly less satisfied (p=0.007 and p<0.001, respectively) compared with the other patients. Higher satisfaction levels were observed among patients who were treated in the main ED, were admitted during the morning shift, visited the ED during the slower season (August-September), and had experienced less waiting time to see the doctor. Patients were mostly satisfied with admission and least satisfied with nursing care.

3 tables, 22 ref

043973   ALRESHIDI F S , ALSWAYDA S H S , ALASSAF O M , ALOMAIM H Y, ALANAZI Z H K , ABDULLAH FATHULDEEN A A A , ALSHMMRI M A , GAZALAH F N A, AHMED G (Histopathology and Cytology Dep, Khartoum Univ, Sudan, Email: hussaingad5@gmail.com) : Association between physical activity and some comorbidity in a series of saudi volunteers. Int J Med Res Health Sci 2020, 9(4), 30-5.

The purpose of this study was to appraise the association between Physical Activity and T2DM, hypertension, hypercholesterolemia, and other comorbidities in a series of Saudi volunteers. The present study investigated 304 healthy Saudi volunteers for reported chronic illness and the status of physical activity. Out of the 144 individuals, 62/144 (43 %) were males and 82/144 (57 %) were females. About 64/304 (21 %), 75/304 (24.7 %), and 21/304 (7 %) of the participants practicing physical activity for one hour, 2-5 hours, and ≥ 6 hours, in this order. PA rates are relatively lower among Saudi people in Northern Saudi Arabia. PA was found to be an effective factor in reducing diverse comorbidities including hypertension, T2DM, hypercholesterolemia, CVDs, asthma, and other comorbidities.

3 illus, 2 tables, 25 ref

043972   ALSANIE W F (Clinical Laboratories Science Dep, Taif Univ, Saudi Arabia, Email: w.alsanie@tu.edu.sa) : Role of rituximab in the treatment of different hematological disorders. Int J Med Res Health Sci 2020, 9(4), 22-9.

Rituximab (anti-CD20 antibody) has been approved as a treatment for B-cell associated hematological disorders. CD20 expression and its complement regulatory proteins and membrane binding structures play a crucial role in rituximab efficacy. Complement-dependent cytotoxicity and antibody-dependent cellular cytotoxicity are the major mechanisms by which rituximab eliminates B cells. The efficacy of anti-CD20 varies in different diseases. Rituximab was approved as a successful treatment in diseases such as non-Hodgkin lymphomas, particularly diffuse large B-cell lymphoma and follicular lymphoma. In addition, rituximab has recently shown promising results with several autoimmune diseases; it was approved for rheumatoid arthritis as well as being used for other diseases such as systemic lupus erythematosus. Likewise, rituximab was successfully used for incompatible ABO organ transplantation instead of the invasive splenectomy procedure. This review will discuss the use of rituximab for different hematological diseases.

42 ref

043971   DAS D, SRIDHAR R V, CHANDAR M (General Medicine Dep, Shri Sathya Sai Medical Coll and Research Institute, Kancheepuram, Nellikuppam, Tamil Nadu, Email: donaa35@gmail.com) : Diabetes and deteriorating lung function based on spirometry: A narrative review. Int J Med Res Health Sci 2020, 9(4), 16-21.

Many pulmonary dysfunctions are noted in both type 1 and 2 diabetes. This dysfunction can be mechanical in terms of muscle tone or strength, functional in terms of diffusion capacity or gaseous exchange and chemical with regards to mediators. Many hypothesis or mechanisms were proposed and changed along the course of time to support the issue. The studies have shown an increased evidence of lung dysfunction changes in diabetes, both at a time or during the course of time. So the lung complications should also be considered among micro vascular complications to actively search for a better prognosis. To study the association of diabetes and lung function based on spirometry. Materials and methods: We identified all studies in English Language that evaluated the association of diabetes mellitus and lung function using keywords like “diabetes, lung volume, lung function, diabetes micro angiopathy, spirometry” across various published research articles using Google Scholar Data Base. From our narrative review, a conclusion was made that both varieties of diabetes, type 2 and type1 have reduced lung functions as reviewed by spirometry not only due to adverse events like pneumonia but also due to the extensive period of consequence of diabetes which may be because of micro angiopathy or diminished elastic recoil capability of lungs.

1 table, 44 ref

043970   HASSAN A O A , ALSHAMMARI K F , ALKHATEEB A A , ALTAMIMI A D , SHAMMARI A K A , ALHARBI M S , ALMARSHEDY S M, AHMED H G (Histopathology and Cytology Dep, Khartoum Univ, Sudan, Email: am.hassan@uoh.edu.sa) : Knowledge and attitude towards vitamin D deficiency in ha’il region: A community-based study. Int J Med Res Health Sci 2020, 9(4), 8-15.

Vitamin D deficiency represents a major health problem in Saudi Arabia. Therefore, this study aimed to assess the Knowledge and attitude towards vitamin D deficiency in Ha’il Region (Northern Saudi Arabia). A total of 500 Saudi volunteers living in the city of Ha’il and surrounding towns were included during the period from January 2020 to March 2020. Adults aged 15 years or older were randomly selected regardless of gender, occupation or marital status. Results: Out of the 500 study subjects, 214 (42.8 %) did previous vitamin D testing (72/207 (34.8 %) males and 142/293 (48.5 %) were females). Females were significantly better for testing their vitamin D status than males (p=0.0032). Vitamin D deficiency is highly prevalent in Ha’il Region. Although there is a relatively higher awareness level towards vitamin D sources, vitamin D testing, as well as knowledge about vitamin D deficiency-related disorders are poor among Saudi living in Ha’il Region.

3 illus, 5 tables, 21 ref

043969   ALMARSHAD F, BHILAL B M (Anatomy Dep, Shaqra Univ, Saudi Arabia, Email: dr_beo@yahoo.co.in) : Does BMI affect academic performance? Study among undergraduate medical students of Saudi Arabia and India. Int J Med Res Health Sci 2020, 9(3), 64-73.

To study whether BMI as a single influencing factor has any impact on college student academic performance.  Methods: 540 (214 females, 326 males) university-level undergraduate medical students from the region of India and Saudi Arabia were studied for one year. Their BMI was calculated and compared with academic aggregate marks. The majority of the students had normal BMI. On comparing grades of underweight, overweight, and obese students with normal weight students we found that there was no significant difference in their academic performance (p=0.899). Gender-wise comparison also showed an insignificant relationship between BMI and academic performance (females p=0.539, males p=0.622).  Weight did not show any influence on academic performance when the BMI alone is compared with the academic performance of the students for a short duration (one year), irrespective of gender (male/female).

7 tables, 13 ref

043968   REZK M Y, ELKATTAWY H A, FOUAD R A (Medical Physiology Dep, Zagazig Univ, Zagazig, Egypt, Email: myr777777777@yahoo.com) : Plasma asprosin levels changes in pregnant and non-pregnant rats with and without gestational diabetes. Int J Med Res Health Sci 2020, 9(3), 54-63.

We hypothesized that asprosin might be increased during pregnancy and gestational diabetes (GD) suggesting a potential role in food intake stimulation during pregnancy and suggesting a role in prediction of GD so, we analyzed changes in plasma asprosin levels in pregnant and non-pregnant rats with and without gestational diabetes. 40 female rats divided into 4 groups; control non-pregnant, normal pregnant, untreated GD and insulin-treated GD groups. In all groups, body weights (BW), body length, body mass index (BMI) and food intake, levels of asprosin, estrogen, progesterone, serum levels of insulin, glucose and lipid profile were measured. HOMAIR and HOMA-B were calculated. Asprosin levels were found higher in pregnant, GDM and insulin-treated groups in comparison with control group (p ≤ 0.001, p ≤ 0.0001 and p ≤ 0.0001 respectively). Asprosin levels were higher in GDM group during early and late pregnancy in comparison with the pregnant group (p ≤ 0.0001). Asprosin levels decreased in insulin-treated group compared with GDM group (p ≤ 0.0001). Asprosin levels correlated positively with body weight (r=0.821, p<0.05), body mass index (p<0.05), food intake, serum glucose (r=0.9958, p<0.00001), HOMA-IR, cholesterol, triglycerides, LDL-c and VLDL and negatively correlated to HOMA-B, HDL, estradiol and progesterone levels. asprosin levels were significantly elevated during normal pregnancy suggesting that asprosin may have a physiological role during pregnancy as it may participate in stimulation of appetite and food intake commonly occurring during pregnancy. GD rats were found to have significant higher asprosin compared to pregnant group. Asprosin may be a potential factor predicting diabetes mellitus during pregnancy

5 tables, 32 ref

043967   CHAUDHRY K A, JAMIL F, BATOOL T, FAROOQ P, AYUB A, SUMBAL R (Statistics Dep, Kinnaird Coll for Women, Lahore, Pakistan, Email: Tahirabatool021@gmail.com) : An assessment of eating disorder among adolescents and young adults. Int J Med Res Health Sci 2020, 9(3), 48-53.

Young males and females are highly concerned about their body image and physical appearance. They refrain themselves from eating that effect the physical and social well-being. This study aims at identifying the presence of eating disorder and to explore as well as confirm four factor solution of eating disorder among adolescents and adults. The study is conducted obtaining data from a sample of 600 adolescents and young adults studying in private and public educational institutions using EDE-Q questionnaire. Chi-square test has revealed the relationship between age and eating concern scores. Pearson correlation test suggested that age is related with global score whereas all the eating disorder scores are inter-related. No gender-wise difference between shape concern and global score is found whereas the global scores and shape concern scores are significantly different with respect to type of institution. Global score and shape concern scores are same for adolescents and young adults. Mean ranks are higher for males compared to females whereas there is significant difference among restraint scores gender-wise however shape concern, weight concern and restraint scores were significantly different in private and public institutions. Mean ranks for young adults are higher for restraint, shape concern, weight concern and eating concern scores compared to adolescents whereas the significant difference was observed between young adults and adolescents for restraint scores. EFA has identified four-factor solution for the EDE-Q subscales whereas CFA has also confirmed it. The four factor solution is weight and shape concern, fear of gaining weight, restraint and eating concern.

5 tables, 24 ref

043966   ARNOUT B A, AL-DABBAGH Z S , EID N A A , EID M A , AL-MUSAIBEH S S , AL-MIQTIQ M N, ALAMRI A S, AL-ZEYAD G M (Psychology Dep, Zagazig Univ, Egypt, Email: prof.arnout74@gmail.com) : The effects of corona virus (COVID-19) outbreak on the individuals’ mental health and on the decision makers: A comparative epidemiological study. Int J Med Res Health Sci 2020, 9(3), 26-47.

The results of epidemiological studies help in developing protective and treatment plans for community members, and identifying the psychological support services that individuals need to reduce the negative effects of these stressful conditions. Therefore, this study aimed to detect the effect of the outbreak of the deadly COVID-19 on the mental health of individuals. A survey descriptive design was used in this study to detect the level of psychological problems and to determine the differences in psychological problems due to nationality, age, sex, social status, learning level, and income. Method: A random sample consists of 5611(3423 Egyptians and 2188 Saudis) participants was chosen, their ages ranged between (16 to more than 50) year. The study sample was divided into sub-groups according to nationality, age, sex, social status, learning level, income level. The researchers in this study prepared psychological problems symptoms inventory that has been applied online to the sample. Results: The findings indicated that the increased prevalence of COVID -19 has a negative effect on the mental health of individuals, as the level of psychological problems were increased, and the results also found differences in the prevalence of psychological problems symptoms due to demographic variables. Conclusion: The study results emphasized the importance of prevention and treatment of psychological problems symptoms caused by the outbreak of the deadly COVID-19. As well as, these findings stressed on the role of counseling and therapy via the internet as well as, cross-cultural counseling and treatment.

15 illus, 16 tables, 19 ref

043965   ARNOUT B A , ALMOIED A A (Psychology Dep, Zagazig Univ, Egypt, Email: beahmad@kku.edu.sa) : Enjoying life and health status among young adults and elderly: A comparative study in light of the globalization effects on the human being of the 21^st century. Int J Med Res Health Sci 2020, 9(3), 18-25.

The enjoying life and health status, consider one of the determinants of active adulthood and successful aging. Hence the importance of this study represented in investigate these variables, especially in the light of globalization, which left its negative effects clearly on the individual of this century as deep scarves, which positive psychology seeking to strengthen the positive and treat the negative aspects to achieve well-being. This descriptive study aimed to examine the relationship between enjoying life and health status among adults and the elderly, and to detect the differences in enjoying life and health status due to age, education, and sex. The sample consisted of 380 adults and elderly persons selected randomly. Data were collected by enjoying life scale and health status questionnaire which prepared by researchers in this study. The results showed that there was a significant statistical relationship between enjoying life and health status, and there were significant statistical differences in enjoying life and health status due to age, education, and sex. Level of enjoying life and health status was high in participants who are elderly, educated and females. These findings emphasized the importance of developing the enjoying life among young adults and the elderly to enjoy with health status and to achieve active adulthood and successful aging.

4 tables, 26 ref

043964   NJOKU C, UMEGO A , OKPARA H, NJOKU A (Obstetrics and Gynecology Dep, Calabar Univ, Nigeria, Email: njokucharlesobinna@gmail.com) : Human immunodeficiency and hepatitis b viral co-infection in women attending antenatal care clinic in a tertiary health institution in Nigeria. Int J Med Res Health Sci 2020, 9(3), 8-17.

Human immunodeficiency virus (HIV) and Hepatitis B virus (HBV) infections are major global health problems with common modes of transmission. To determine the prevalence, demographic characteristics, risk factors and liver dysfunction among antenatal women with HIV and HBV co-infection. A crosssectional study of 586 pregnant women. Socio-demographic data were collected and blood samples were collected and tested for HBsAg and HIV infection. The liver function test was conducted on those who tested positive to HBV alone and have HIV/HBV co-infection. Data were analyzed using SPSS version 18 statistical program. Result: The prevalence of patients with HIV and HBV co-infection was 0.3 %. They are single and in the age group of 21-24. The mean value of total bilirubin and unconjugated bilirubin of the patients with HBV/HIV co-infection were significantly higher (p=0.037) than in those with hepatitis B virus infection alone. The study showed low HIV/HBV co-infection amongst antenatal women and confirmed the assertion that co-infection leads to significant impaired liver function. This should be kept very low or eradicated to reduce devastating complications of HIV/HBV co-infection.

1 illus, 4 tables, 32 ref

043963   SUHAIL N, ALSEL B T A, BATOOL S (Medical Laboratory Technology Dep, Northern Border Univ, Arar, KSA, Email: nsuhail123@gmail.com) : Prevalence and association of thyroid dysfunction with anemia/body iron status among northern border saudi population. Int J Med Res Health Sci 2020, 9(3), 1-7.

To find the prevalence and association of thyroid dysfunction with anemia/body iron status among Northern Border Saudi population. The present cross-sectional study included 150 male and female participants visiting the out-patient clinic in Arar Central Hospital, Arar, Saudi Arabia. Blood samples were collected for estimation of thyroid hormones, RBC count, hemoglobin, MCV, MCH, TIBC, serum iron and ferritin.Thyroid disorders were detected in 61.33 % of the studied population and hypothyroidism (73 cases out of 92) was more prevalent than hyperthyroidism (19 cases out of 92) with higher prevalence observed among female participants (60.27 %) as compared to males (39.72 %). Higher prevalence of anemia (60.27 %) and iron deficiency (49.31 %) was observed among hypothyroid group as compared to hyperthyroid and euthyroid group which was characterized by significantly lower values of erythrocyte indices (RBC count, hemoglobin, MCV, MCH) and iron parameters (serum iron, ferritin, transferrin saturation) in hypothyroid group as compared to hypothyroid and euthyroid group. Erythrocyte indices and iron parameters correlated positively with FT4 and negatively with TSH. The study demonstrates a high prevalence of thyroid abnormalities particularly hypothyroidism, accompanied by increased prevalence of anemia and iron deficiency indicating symbiotic relationship between thyroid gland function and body iron status. Future studies should be done in large samples and should include thyroid antibodies profile and urine iodine to identify the underlying mechanism and the etiological factors contributing to the development of thyroiditis‑induced anemia.

2 illus, 5 tables, 24 ref

043962   AWWAD W M, ALSHUNAIFI A I, ABUALRAS M M, MUMTAZ R (Orthopaedic Surgery Dep, King Saud Univ, Riyadh, Saudi Arabia, Email: dr.rohail@gmail.com) : Paraspinal ganglioneuromain an adolescent with painless scoliosis: Case report and literature review. Int J Med Res Health Sci 2020, 9(2), 54-7.

Adolescent scoliosis secondary to ganglioneuroma is a rare entity with a clinical presentation mimicking adolescent idiopathic scoliosis that can lead to delayed or misdiagnosis. We present this case with a literature review to illustrate the importance of careful evaluation of the clinical and radiological findings in reaching a proper, timely mannered diagnosis. Clinical and radiological evaluation with a keen eye for signs of the atypical curve and radiological abnormalities on plain films and getting more detailed imaging with CT and MRI would lead to earlier diagnosis of secondary causes of scoliosis and direct proper treatment plan.

2 illus, 19 ref

043961   AHMED M, AHMED I , GULFAM H , SUBHANII M K, MAHMOOD Z (Surgery Dep, Khawja Safdar Medical Coll, Sialkot, Pakistan, Email: leo_conner53@yahoo.com) : Effectiveness of early versus late dressing removal in contaminated and clean surgical wounds. Int J Med Res Health Sci 2020, 9(2), 49-53.

This study was conducted to assess the effectiveness of early versus late dressing removal in contaminated and clean surgical wounds. A Prospective non-randomized study. In the Surgical Unit of AllamaIqbal Teaching Hospital, Sialkot from March 2018 to March 2019. Method: Sixty patients age eighteen or above (planned surgery and emergency surgery) were enrolled in the study, admitted in hospital and operated. All surgical wounds met the criteria of contaminated and clean surgical wounds. Thirty patients were included in each group with early and late dressing removal. In the early removal group, within 48 hours, the surgical dressing was removed and in the late group 48 hours after surgical intervention. The incidence of deep and superficial surgical site (SSI) infection was studied in these two groups. Additional subordinate factors such as dehiscence of wound incidence and secondary suturing were too assessed. Thirty patients were included in each group with early and late dressing removal for final scrutiny. The occurrence of superficial surgical sight infection was lower expressively in the early dressing removal group. The time required for full recovery (days) (8.60-10.70; p=0.734) was shorter considerably in the early dressing removal group. In the early dressing removal group, there was the significantly shorter postoperative hospital stay (days) (10.50 vs. 15.0; p ≤ 0.001). Early dressing removal considerably decreases the superficial SSIs incidence in contaminated and clean surgical wounds. It also considerably decreases the time of full wound healing and facilitates short hospital stay as compared to late dressing removal.

1 illus, 2 tables, 14 ref

043960   IJAZ F, AHMAD A , TAUSEEF A , RASHID H , AFTAB R R , KAMRAN R , AFTAB R K, JAWED S (CMH Lahore Medical Coll, Lahore, Pakistan, Email: farhat_khurram_rana@cmh.edu.pk) : Role of inflammation and serum creatine phospho kinase in seizures. Int J Med Res Health Sci 2020, 9(2), 43-8.

Epilepsy which is a disorder with an extensive variability of symptomatology and multifactorial origins is categorized by emergent and recurrent seizures. Numerous studies showed that seizures are triggered by hyperactivity of the neurons of the brain which may be atypical and synchronous. Our study was aimed to find out the association of inflammation in terms of total leukocyte count (TLC) and serum creatine phosphokinase (CPK) concentration in epilepsy and their comparison with pseudo-seizures and healthy controls. Methodology: We conducted this study in Mayo Hospital, Lahore with the collaboration of the Physiology Department of King Edward Medical University, Lahore after approval from Advanced Studies and Research Board of KEMU, Lahore. The sample size was ninety and they were divided equally into three groups, 30 patients of GTCS, 30 patients with a history of pseudoseizures and 30 healthy subjects of comparable age. p< 0.001 was taken as significant. Statistical analyses were done using SPSS 21. Results: Mean total leukocyte count (TLC) in Pseudo-seizures groups was 8216.3 ± 2195.8 cu.mm, in the epileptic group was 13219.9 ± 2686.8 cu.mm and in the control group, the mean TLC was 6832.1 ± 1154.9 cu.mm. Mean serum CPK in pseudo-seizure groups was 130.1 ± 74.3 IU/100 ml, in the epileptic group was 257.7 ± 24.6 IU/100 ml and in the control group, the mean CPK was 79.9 ± 27.7 IU/100 ml. Conclusion: Total leukocyte count (TLC) and CPK were higher in the epileptic group as compare to the pseudo-seizure groups as well as the control group. Elevated WBC levels may be a result of continuing inflammatory progressions in the pathogenesis of epilepsy. Therefore it was concluded that serum CPK and TLC may serve as a differentiating marker between epileptic generalized tonic-clonic seizures (GTCS) and pseudo seizers.

2 illus, 2 tables, 22 ref