Dow University Of Health Sciences Research Articles

Comparison of efficacy of intraoperative intravenous 5% dextrose versus intravenous ringer lactate for prevention of postoperative nausea and vomiting in patients undergoing elective laparoscopic cholecystectomy.

Objective: To assess the effectiveness of intraoperative intravenous 5% dextrose in contrast to intravenous Ringer lactate for averting postoperative nausea and vomiting among individuals undergoing elective laparoscopic cholecystectomy at a Tertiary Care Hospital in Karachi. Study Design: Randomized Control Trial. Setting: Department of Anesthesia, Dow University of Health Sciences, Located at Civil Hospital in Karachi. Period: 25-09-20 to 25-03-21. Methods: Patient data was collected in a prospective manner following verbal consent. A total of 60 patients, meeting the diagnostic criteria, were incorporated in the study. A concise medical history was obtained, and demographic details were recorded in the performa. Data was all variables were collected and analysed using SPSS version 22. Results: This study encompassed a total of 60 patients. In the dextrose group, the mean age, duration of surgery, length of hospital stay, height, weight, and BMI were 48.21±6.24 years, 2.54±1.78 hours, 4±2.54 days, 147±4.21 cm, 71.7±7.25 kg, and 28.9±5.14 kg/m2, respectively. Conversely, in the ringer lactate group, these values were 49.48±8.41 years, 2.97±1.56 hours, 4±1.89 days, 158±5.28 cm, 78.7±9.87 kg, and 29.6±4.91 kg/m2. The efficacy for preventing postoperative nausea and vomiting was 80% for the dextrose group and 36.7% for the ringer lactate group in our study. Conclusion: Administering preoperative fluid supplementation with dextrose resulted in a reduced occurrence of postoperative nausea and vomiting (PONV) in comparison to ringer lactate.

To Determine how the Severity of Pain Relates to the Quality of Sleep Following Tube Thoracostomy

Background: Tube thoracostomy (TT) is a prevalent procedure in the management of various thoracic conditions, including pneumothorax, pleural effusion, and chest trauma. Despite its widespread use, TT is associated with significant complications such as pain and impaired sleep quality, which can affect patient recovery and overall health outcomes. Objective: This study aims to explore the relationship between pain severity and sleep quality following tube thoracostomy and to assess the impact of pain management on postoperative recovery. Methods: A descriptive, prospective, cross-sectional study was conducted at Dr. Ruth K. M. Pfau Civil Hospital Karachi and Dow University of Health Sciences from September 28, 2022, to March 27, 2023. The study included adults aged 18 to 70 who underwent TT for any indication. Patients were excluded if they withheld consent, had a history of substance use, psychological disorders, or were victims of poly-trauma. Pain severity was assessed using a visual analogue scale (VAS) and sleep quality was evaluated using the Richards-Campbell Sleep Questionnaire (RCSQ). Data were analyzed using SPSS version 25, employing descriptive statistics and Spearman correlation tests. Results: The study involved 77 participants with a mean age of 28.33 ± 10.50 years. The mean pain scores on postoperative days 1, 2, and 3 were 8.08 ± 0.66, 6.92 ± 0.99, and 4.92 ± 1.37, respectively. Corresponding sleep quality scores were 17.50 ± 7.53, 36.67 ± 9.84, and 57.50 ± 10.55. A significant negative correlation was found between pain scores and sleep quality scores on day 3 (r = -0.744, p < 0.001). Conclusion: The findings suggest a significant association between lower pain scores and improved sleep quality among patients undergoing tube thoracostomy. Effective pain management may enhance sleep quality and facilitate recovery, highlighting the need for comprehensive postoperative care strategies in these patients.

Isotretinoin's Effect on Fasting Lipid Profile in Acne Patients.

To determine the isotretinoin's effect on fasting lipid profile in patients with acne. Observational study. Place and Duration of the Study: Outpatient Department of Dermatology, Dow International Medical College, Dow University of Health Sciences, Karachi, Pakistan, from 22nd June to 21st December 2022. Patients of clinically moderate and severe acne were selected and prescribed a dose of 0.5mg /kg cap isotretinoin for 6 months. They were advised to get a fasting lipid profile at the baseline and then after two months of isotretinoin therapy. National Cancer Institute Common Terminology Criteria for Adverse Events v5.0 grading system and Adult Treatment Panel III were used for the grading of abnormalities. McNemar Bowker test was used to assess the difference in variables [serum triglycerides (TGs), cholesterol, high-density lipoproteins (HDL), and low-density lipoproteins (LDL)] at the baseline and after 2 months follow-up. A total of 214 patients were evaluated. After 2 months of isotretinoin therapy, TGs and cholesterol levels were elevated to higher grade in 2% of the patients. Likewise in 1% of patients, LDL levels rised to higher grade. Moreover, HDL levels declined to lower grade in 2% of the patients taking isotretinoin. Insignificant alterations in the various serum lipid parameters were observed in acne patients during isotretinoin therapy. It is advisable to obtain a baseline fasting lipid profile in all acne patients on isotretinoin and repeated in those with baseline abnormal levels and in patients with a clinical sign of metabolic syndrome and a family history of dyslipidemias. Acne, Hyperlipidemias, Isotretinoin, Laboratory monitoring.

Comparison of the effect of propolis and Gluma desensitizer on the management of dentin hypersensitivity: a randomized controlled trial

Objective: To compare the effect of propolis and gluma desensitisers on the management of dentin hypersensitivity. Method: The single-blind, randomised controlled trial was conducted at the Department of Operative Dentistry, Dr Ishrat ul Ebad Khan Institute of Oral Health Sciences, Dow University of Health Sciences, Karachi, from October 2020 to September 2021, and comprised patients with dentin hypersensitivity who had pain scores of at least 2 on the visual analogue scale. The teeth were randomised into propolis group A and Gluma group B. Baseline pain scores were assessed using visual analogue scale and Schiff's sensitivity scores and compared with scores immediately after the intervention, and then after one week and one month of the intervention. Data was analysed using SPSS 23. Results: Of the 22 patients, 12(54.5%) were females and 10(45.4%) were males. Of the 80 teeth, there were 40(50%) in each of the 2 groups. Significant reduction was observed in dentin hypersensitivity immediately after the application of the desensitising agents (p<0.05). However, after one month, Gluma was more effective than propolis (p<0.05). Conclusion: Both Gluma and propolis were found to be effective desensitising agents, but the effectiveness of propolis decreased over one month. Clinical Trial Number: Clinical Trials.gov: NCT04819867. Key Words: Dentin hypersensitivity, Desensitizing agent, Gluma desensitiser, Propolis.

Are We Providing Enough Information to the Pathologists? An Audit of Filling of Histopathology Request Forms for Surgically Resected Tumours.

To analyse quantitatively the adequacy of demographics of clinical information and highlight specific areas of neglect, by assessing the adequacy of filling out histopathology request forms. Clinical Audit. Place and Duration of the Study: Department of Pathology, Dow University of Health Sciences (DUHS), Karachi, Pakistan, from January to September 2021. A retrospective audit was carried out on the request forms of surgically resected tumours and biopsies. The recorded details of the patients' demographics and biopsy, clinical history and examination, and intraoperative findings were analysed. Out of 175 forms, patients' names were written in 174 (99.4%) while medical record numbers were written in 113 (64.6%). The doctors' names were given in 172 (98.3%) forms and phone numbers in 34 (19.4%). A clinical diagnosis was provided in 164 (93.7%) forms, while 152 (86.9%) forms correctly entered the biopsy site. Sixty-seven (38.3%) forms included the correct nature of the biopsy. Relevant operative details were provided in half of the forms. Symptoms and their duration were mentioned in 144 (82.3%) and 100 (57.1%), respectively. The form-filling rate was the same for both benign and malignant tumours. This study shows that in a significant proportion of cases, complete relevant information is not provided to the histopathologists on request forms for logistics. Histopathology, Request forms, Tumours, Audit.

Antimicrobial resistance pattern of Uro-Pathogens emphasizing non-lactose fermenting gram negative bacilli

Objectives: To identify various species of non-lactose fermenting gram-negative bacilli involved in urinary tract infections, and to determine their antimicrobial resistance pattern. Method: The retrospective, descriptive, cross-sectional study was conducted from January 1 to April 1, 2022, at the Dow University of Health Sciences, Karachi, and comprised data from the institutional diagnostic laboratory that was related to urine samples regardless of age and gender from January 1, 2020, to December 31, 2021. Data was analysed using SPSS version 25. Results: Of the 103,887 urine samples, 41,280(39.7%) were positive, 51,146(49.2%) showed no bacterial growth, 11,000(10.6%) had non-significant bacterial growth and 461(0.4%) had mixed bacterial growth. Of the positive samples, 18359(44.5%) were positive in 2020, and 22,921(55.5%) in 2021. Gram-negative lactose fermenting bacteria included escherichia coli 23,123(22.3%) and klebsiella pneumoniae 2,993(2.9%), gram-negative non-lactose fermenting bacteria included pseudomonas aeruginosa 1,110(1.07%), and gram-positive bacteria included enterococcus 8,008(7.7%). Pseudomonas aeruginosa was most resistant against tobramycin 880(79.3%) and least resistant against piperacillin-tazobactam 146(13%). Conclusion: Piperacillin-tazobactam was highly sensitive drug against non-lactose fermenting uro-pathogens. Key Words: Antimicrobial resistance, Non-lactose fermenting, Gram-negative bacteria, Urinary tract infection.

Comparison of light microscopy and digital microscopy for learning oral pathology practicals among second year dental students

Background/purposePrevious studies have shown that digital microscopy is an indispensable tool for teaching oral pathology laboratory course. Despite this, our institute relies solely on recommended/reference book images for oral pathology practicals, neglecting both light and digital microscopy methods. Gathering students' feedback on these methods is essential before considering digital microscopy as part of the oral pathology curriculum. Therefore, this study aimed to compare the usefulness of light and digital microscopy among second-year dental students. Materials and methodsThe study was conducted from December 6 to December 7, 2023, in the Department of Oral Pathology, Dr. Ishrat-ul-Ibad Khan Institute of Oral Health Sciences, Dow University of Health Sciences. The study involved the selection of five cases from the oral pathology course, followed by feedback on students' diagnostic skills, learning impact and acceptance rate of light and digital microscopy using an online questionnaire. Mann–Whitney U test was used to compare students' responses and P-value < 0.05 was set as statistically significant. ResultsThere was a statistically significant difference in diagnostic scores between light microscopy and digital microscopy (P < 0.05). Statistically significant differences favoring digital microscopy were observed in various aspects, including interpreting variations, diagnosis, time efficiency, and image clarity. ConclusionAlthough diagnostic scores were lower, digital microscopy was perceived as a useful method for enhancing diagnostic skills among dental students. Both light microscopy and digital microscopy are viable options for oral pathology practicals, however, digital microscopy was preferred by students due to its time efficiency and clear image quality.

Oxidative stress in polycystic ovary syndrome: a case-control study.

To compare the serum levels of biochemical and oxidative stress markers i.e., malondialdehyde (MDA) and paraoxonase-1(PON1) in polycystic ovary syndrome (PCOS) patients and healthy female individuals of reproductive age group (18-40 years). This case-control study was conducted in Dow University of Health Sciences (DUHS), Karachi from June 2019 to October 2020. Seventy Subjects including 35 PCOS patients that have primary subfertility problem (cases) and 35 healthy and fertile females (controls) were recruited. Serum samples were collected for analysis of insulin, sex hormone-binding globulin, testosterone, fasting blood glucose and lipid profile. PON 1 and MDA levels were estimated by ELISA. Comparison between the two groups was done using independent t-test. The patients had significantly increased mean body mass index (28.5+4.6 kg/m2 vs 25.7+4.5 kg/m2, p=0.014), systolic (129.6±13.9 mm of Hg vs 113±7.7 mm of Hg, p<0.001) and diastolic (78.7±8.8 mm of Hg vs 74.6±6.7 mm of Hg, p=0.032) blood pressures compared to controls. The high-density lipoprotein cholesterol levels were significantly lower in PCOS (42.2±8.6mg/dl) than controls (48.8±11.8mg/dl, p=0.009, p=0.009). Serum insulin (14.3±5.8 uIU/mL) vs (10.0±5.2 uIU/mL), p=0.002 and testosterone levels (1.3±0.9 nmol/L) vs (0.82±0.3 nmol/L), p<0.001 were significantly higher whereas sex hormone binding globulin (SHBG) levels (35.2±19.7nmol/L vs 58.8±31.0 nmol/L) were significantly lower in patients than healthy controls (p<0.001). Both oxidative stress markers, paraoxonase 1 (7.7±2.4 vs 6.4±2.6 μg/mL, p=0.04) and malondialdehyde (2.5±1.0 vs 1.9+0.51μg/mL, p=0.034) levels were significantly elevated in PCOS patients than controls. No significant correlation was found between dietary habits and life style between cases and controls. The study reported significantly elevated levels of oxidative stress markers in PCOS patients.

Investigating the prevalence of halitosis and its associated factors amongst the general population of Karachi, Pakistan.

To assess the prevalence of halitosis among the general population of Karachi, and to identify factors contributing to its occurrence. The cross-sectional study was conducted from March to July 2022 in Karachi after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised the adult population of Karachi. Data was collected online using a questionnaire that was piloted before its link was distributed through social media platforms. The questionnaire evaluated the association of demographic features with self-perceived halitosis on the basis of which factors predictive of halitosis were determined. Data was analysed using SPSS 26. Of a total of 342 subjects, 182(53%) were females and 160(47%) were males. There were 141(41$) subjects aged 18-25 years, and 166(48%) were graduates. Overall, 240(70%) subjects reported to have self-perceived halitosis. Age, monthly household income, niswar and tea consumption, irregular use of dental floss and tongue cleaning were associated with higher incidence of halitosis (p<0.05). Carrying water bottle while outside was associated with decreased halitosis (p=0.007). Symptoms of gastroesophageal reflux disease, sinusitis, asthma, diabetes, hypertension and mental stress were associated with halitosis (p<0.05). Higher monthly household income and daily use of dental floss predicted lower odds of halitosis (p<0.05). Maintaining good oral hygiene and hydration reduced, while comorbid conditions increased the probability of halitosis.

Impact of Brain derived Neurotrophic factor gene polymorphism on its peripheral levels in schizophrenic patients.

To determine serum levels of brain-derived neurotrophic factor and its polymorphism rs12291063 in schizophrenic patients. The case-control study was conducted from January1, 2020, to May 15, 2021, at Dr Abdul Qadeer Khan Institute of Behavioural Sciences, Dow University of Health Sciences, Karachi, and comprised schizophrenia cases aged 14-60 years who were diagnosed using Diagnostic and Statistical Manual of Mental Disorders-V criteria, and healthy controls without any psychiatric illness. Positive and negative syndrome scale score was used to assess disease severity. The genomic deoxyribonucleic acid of the subjects was isolated from peripheral blood, followed by polymerase chain reaction, gel electrophoresis and sequencing of the amplicons. The sequences were analysed using MEGA X software for genotyping. Serum brain-derived neurotrophic factor levels were assessed using enzyme-linked immunosorbent assay. Data was analysed using SPSS 21. Of the 100 subjects, 50(50%) were cases; 36(72%) males and 14(28%) females (p<0.05) with mean age 34.34±10.32 years. There were 50(50%) controls; 32(64%) males and 18(36%) females (p=0.391) with mean age 30.886±8.88 years. Among the cases, the mean age at schizophrenia diagnosis was 25.14±9.54 years, and there was a significant association with positive family history for psychiatric disorders (p<0.05). Sequencing revealed no T>C substitution. Serum brain-derived neurotrophic factor levels were significantly higher in cases compared to controls (p<0.001). There was a weak negative correlation between brain-derived neurotrophic factor levels and positive and negative syndrome scale score (p<0.05). Higher brain-derived neurotrophic factor levels were found to be associated with schizophrenia, while no association of rs12291063 T>C was found with schizophrenia.

Serum Leptin levels in newly diagnosed Epileptic Patients.

To compare leptin levels in newly-diagnosed treatment-naive epileptic patients and healthy controls. This case-control study was conducted from January 10 to September 15, 2022, at the Dow University of Health Sciences, Karachi, and comprised newly-diagnosed epileptic patients age 12-35years who had no comorbidity. The subjects were enrolled from the Neurology out-patient department of Civil Hospital, Karachi. Healthy individuals matched for age, gender and body mass index were also enrolled as controls. Blood samples were collected between 8am and 10am for the evaluation of serum leptin levels using enzyme-linked immunosorbent assay. Data was analysed using SPSS 26. Of the 100 subjects, 64(64%) were males and 36(36%) were females. There were 50(50%) cases with mean age 19.34±5.65 years, and 50(50%) controls with mean age 19.76±5.67 (p=0.614). 100% of 50 individuals in control group did not have any family history of epilepsy,while 18% of cases (9) reported a positive family history. Mean leptin level in cases was 31.03±19.37 compared to 5.25±4.03 in the controls (p<0.05). Serum leptin levels were elevated in newly-diagnosed epileptic patients compared to healthy controls.

Resilience, coping and Personal Factors of medical students at a Public University; Karachi, Pakistan.

To assess resilience levels of medical students, identify factors associated with it, and explore association between coping styles and resilience level among medical students. The analytical, cross-sectional study was conducted at the Dow Medical College, Dow University of Health Sciences, Karachi, from February to June 2022, and comprised medical students regardless of gender and the academic year. Data was collected using self-administered socio-demographic form, Brief Resilience Scale and Brief Cope. Data was analysed using SPSS 28. Out the 301 participants, 197(65.4%) were females and 104(34.6%) were males. The overall mean age was 20.7±1.849 years. Of the total, 132(43.9%) students had low resilience, with males having better resilience compared to females (p<0.001). Higher resilience was seen in year 1 students compared to those of clinical years (p=0.029). There was a significant positive correlation between high resilience and problem-focussed coping, while a significant negative correlation was found between resilience and avoidant and emotionally focussed strategies (p<0.05). There was a significant negative correlation between resilience levels and age (p<0.025). There was a significant difference in resilience scores with respect to the last grade point average, sleep hours, and hours spent studying (p<0.05). More than one-third medical students demonstrated low resilience, and the majority reported adopting emotion-focussed coping style.

Role of zinc in chronic telogen effluvium in serum and hair of patients with alopecia.

To determine the levels of zinc in hair and serum samples of chronic telogen effluvium patients. The case-control study was conducted at the Dow University of Health Sciences, Karachi, from April 2017 to May 2018, and comprised diagnosed cases of chronic telogen effluvium in group A, and healthy controls matched for age and gender in group B. Hair pull test was done, and level of zinc in hair and serum samples was determined using atomic absorption spectrophotometer. Data was analysed using SPSS 21. Of the 100 subjects, 50(50%) were in group A; 28(56%) females ad 22(44%) males with mean age 27.46±4.98 years. There were 50(50%) subejcts in group B; 26(52%) males ad 24(48%) females with mean age 28.34±4.92 years (p>0.05). Significantly low levels of zinc were observed in serum as well as hair samples in group A compared to group B (p<0.05). A positive significant association was observed in the level of zinc in hair with their concentration in the serum of subjects in both the groups (r=0.310, p<0.05). Low levels of zinc in hair and serum were found to be associated with chronic telogen effluvium.

Modulation of Apoptotic and Akt/PI3K/mTOR pathways to target Glioblastoma Cells using synthetic compound PGEA-AN.

To investigate the anticancer potential of a novel synthetic derivative of a naturally occurring diterpenoid against glioblastoma. The in vitro study was conducted at the Ojha Campus of Dow University of Health Sciences, Karachi, from February to December 2021, and comprised U87 cells. The 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay was used to determine the growth inhibitory effect of 16(R and S) - phenylamino-cleroda3, 13(14) Zdiene- 15, 16 olide and standard drug temozolomide against glioblastoma cells, and half-maximal inhibitory concentration was calculated. Microscopy and immunocytochemistry were used to investigate apoptotic morphology and active caspase-3 and B-cell lymphoma 2 (Bcl-2) expression. Quantitative real time polymerase chain reaction was used to investigate the expression of proliferation markers. Data was analysed using SPSS 21. Both the synthetic derivative and the standard drug significantly inhibited growth of U87 cells (p<0.001) with half-maximal inhibitory concentration of 19μM and 185μM, respectively. Apoptotic morphology and upregulation of active caspase-3 protein expression was observed in cells treated with half-maximal inhibitory concentration doses of both the synthetic derivative (p<0.05) and the standard drug (p<0.001), and Bcl-2 was downregulated in both the synthetic derivative (p<0.01) and the standard drug (p=0.05). However, no significant difference was observed in the expression of proliferation markers (p>0.05). The synthetic diterpene derivative PGEA-AN showed growth inhibitory actiity against glioblastoma.

Medical Students' Perceptions at Dow University of Health Sciences using Dundee Ready Education Environment Measure Inventory.

To assess medical students' perceptions regarding learning, teachers, academics, atmosphere at campus and social self-perceptions at Dow University of Health Sciences using Dundee Ready Education Environment Measure (DREEM) Inventory. This cross-sectional observational study was conducted from March 1st, 2022 to September 30th, 2022. All medical students at Dow University of Health Sciences were offered to participate. All students were given the choice to respond to DREEM questionnaire via online Form or printed copy anonymously. The DREEM Inventory measures five domains of students' perceptions of a given institution. Comparison of responses between different years and institution was carried out by χ2 test. Means scores were compared by Student's t-test and ANOVA, p-value of ≤.05 was taken as significant. Total of 1054 out of 1750 (60.23%) students submitted fully completed forms and were included, out of these 632 (60.0%) belonged to Dow Medical College & 422 (40.0%) belonged to Dow International Medical College. The mean ±SD of total score of DREEM by DMC students was 100.07 ±31.46 and that of DIMC was 100.52 ±32.73. According to DREEM Global scoring both colleges scores fell into category of "many problems". Analysis according to domains showed that maximum score was given to 2nd domain of their "perception regarding teachers" and minimum score was allocated to 5th domain regarding "social self-perceptions". Overall Students perceived environment at DUHS as "many problems" category. This needs to be investigated for betterment of Educational Environment (EE) at campus.

Exploring the Role of Adult Wrist Circumference as a Potential Indicator of Obesity.

To explore the correlation of wrist circumference (WrC) with various obesity indices and to determine gender-specific optimal cut-off points of WrC for obesity. Cross-sectional study. Place and Duration of the Study: Dow University of Health Sciences, Karachi, Pakistan, from December 2021 to December 2022. Two hundred and eighty residents of Karachi, aged 30-60 years, participated in this research. Established methods were used to measure body mass index (BMI), waist circumference, hip circumference, neck circumference, WrC, visceral fat level, waist-hip ratio, abdominal volume index, and body roundness index. Correlation of WrC with all obesity markers was done and scatterplots were obtained. Receiver Operating Characteristic curves were plotted to find the gender-specific cut-off value of WrC. Of the total 280 subjects, 191 (68%) were females and 89 (32%) were males. The overall mean age was 42.04 ± 9.12 years (range: 28-65 years). The mean WrC in males and females were 16.32 ± 1.01 cm and 14.82 ± 1.03 cm, respectively. The WrC correlated best with neck circumference in males (r = 0.758; p<0.001) and BMI in females (r=0.615; p<0.001). The scatterplots obtained showed positive linear relationships between WrC and anthropometric variables. The cut-off values of WrC for adult males and females when compared to waist circumference were 15.45 cm and 13.95 cm, respectively. Measurement of the WrC can be a helpful indicator to identify excess weight in the general population. Its ease of measurement makes it applicable in both routine clinical practice and extensive epidemiological research. Wrist circumference, BMI, Waist circumference, Obesity.

Identification of specific codon 201 mutation of the DCC Gene in the colonoscopic specimen of colorectal cancer.

To identify the mutation in codon 201 of the deleted in colorectal cancer gene in colorectal cancer, and to correlate that mutation to the histopathological grading of colorectal cancer. The cross-sectional study was conducted from February 2019 to February 2021 after approval from the ethics review board of the Dow University of Health Sciences, Karachi, and comprised biopsy-proven colorectal cancer patients regardless of age and gender. After histopathological reporting, formalin-fixed paraffin-embedded tissue blocks of colorectal cancer were used for deoxyribonucleic acid extraction, followed by polymerase chain reaction optimisation and deoxyribonucleic acid Sanger sequencing for mutational analysis. Data was analysed using SPSS 25. Of the 100 biopsy specimens assessed, 45(45%) were selected. Of them, 13(29%) samples failed to show any band on gel electrophoresis. The remaining 32(71%) samples were used for Sanger sequencing. Of these, 1(3%) sample did not sequence, while 31(97%) showed sequencing. All the sequenced samples identified a mutation in codon 201 of exon 3 in the deleted in colorectal cancer gene; 30(97%) showed homozygosity, and 1(3%) showed heterozygosity. No significant association of point mutation was noted with various demographic and clinicopathological parameters (p>0.05). The deleted in colorectal cancer gene's missense mutation in codon 201 was frequently observed in colorectal cancer patients.

Early surgical complications in kidney transplant recipients- A single center study

End-stage renal disease (ESRD) is becoming a significant global public health issue. The preferred course of treatment for people with ESRD is kidney transplantation, although its associated surgical complications raise serious doubts about the success rate of the procedure. Renal transplant surgical complications are frequently observed and can significantly affect graft performance, survival, and patient morbidity. This study aimed to analyze the frequency of early surgical complications, diagnoses, and treatment options in renal transplant patients. This retrospective cohort study included all transplanted patients with surgical complications from April 2017 to April 2022 at the Renal Transplant Unit of the Dow University of Health Sciences, Karachi, Pakistan. Out of 500 kidney transplant recipients, 86 patients (17.2%) experienced early post-transplant surgical complications. The most common complication was Lymphorrea (n=38, 7.6%) followed by wound infection (n=25 patients, 5%). The occurrence of these complications was associated with delayed graft function, indicating the need for careful monitoring and timely intervention in these cases. Future studies are needed to explore the predictors and risk factors of surgical complications in kidney transplantation and to identify strategies for reducing the incidence and improving the outcomes of these complications.

Comparison of Biometric Formulae for Intra Ocular Lens Power Calculation

Purpose:  To determine the accuracy of different biometric formulae for intraocular lens power (IOL) calculation in predicting a target postoperative refraction within ± 1.0 diopters in patients with long axial length undergoing phacoemulsification. Study Design:  Cross sectional study. Place and Duration of Study:  Department of Ophthalmology and visual sciences, Unit 1 Dow University of Health Sciences, Dr. Ruth KM Phau Civil Hospital Karachi from February 2019 to August 2019. Methods:  The study included 45 eyes with cataract and preoperative uncorrected visual acuity ranging from 6/60-6/12, axial length of 24.5 to 27.0 mm with no other ocular problem. IOL power was calculated with SRK-T, Holladay 1 and Haigis formula installed in optical biometer AL-Scan (Nidek Co, Ltd., Gamagori, Japan) and by Barrett universal 2 formula from http://www.apacrs.org/barrett_universal2/. Patients underwent phacoemulsification by single surgeon. Follow up included refractive status using Autorefractokertometer, URK-700 (Unicos Co., Ltd., Korea) at 6th week post-operatively. Deviation of actual postoperative refraction from the predicted target preoperative refraction were calculated and values within ± 1.0 diopter were considered accurate. Data was analyzed using SPSS version 22. Results:  Outcome in terms of postoperative refractive error (+1D to -1D) with respect to biometric formula showed 100% accuracy using Haigis formula, 90% accuracy using SRK-T formula, 72.72% accuracy using Barrett universal II formula and 66.67% accuracy using Holladay-1 formula. Conclusion:  Haigis formula proved to be more reliable and accurate than SRK-T, Holladay 1 and Barrett universal II formulae for calculation of intraocular lens power in eyes with long axial length.

Role Of Shear Wave Elastography In Assessment Of Placental Elasticity In Normal And High-Risk Pregnancies In Third Trimester.

To assess the elasticity of placenta using shear wave elastography in normal and high-risk pregnancies in the third trimester. The prospective, observational study was conducted at the Dow Institute of Radiology, Dow University of Health Sciences, Karachi, from September 15, 2022, to January 15, 2023, and comprised singleton pregnant women during 28-40 weeks of gestation who were referred from the obstetric department. The subjects were divided into normal pregnancy group A and high-risk pregnancy group B. Risk factors include gestational hypertension, gestational diabetes, intrauterine growth restriction, placenta previa, morbidly adherent placenta, old primigravida, teen age and morbid obesity were noted. All the patients underwent grey scale, Doppler ultrasonography and shear wave elastography. Data was analysed using SPSS 26. Of the 104 subjects, 78(75%) were in group A and 26(25%) were in group B. The overall mean age was 34.2±3.59 years. In group B, mean placental shear wave velocity was 2.34±1.17m/sec and elasticity was 24.41±25.51kPa compared to 1.42±0.55 m/sec and 13.6±10.23kPa in group A (p<0.05). Significant positive correlation was found between shear wave velocity and elasticity values in both groups (p<0.001). Shear wave elastography was found to be a useful technique in detecting placental stiffness, and can be used as an adjunct to the currently available ultrasonographic methods in high-risk pregnancies.