Dow University Of Health Sciences Research Articles

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.

Home Isolated COVID-19 Patients Adhering To Recommended Guidelines: A Cross Sectional Survey In Karachi.

To assess compliance level of coronavirus disease-2019 patients with recommended isolation guidelines. The cross-sectional phone-based survey was conducted in Karachi, from March to October 2020 after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised patients of either gender who had been tested positive and were advised home isolation due to mild/asymptomatic nature of their infection. Data was collected using a predesigned 42-item questionnaire in the light of the guidelines issued by the National Institutes of Health, Islamabad, Pakistan. Data was analysed using SPSS 20. Of the 450 patients approached, 305(68%) responded; 176(57.7%) females and 129(41.1%) males. The overall mean age was 35.16±14.15 years (range: 13-78 years). Of the total, 9(2.95%) patients did not isolate themselves at all, 51(16.7%) came into contact with other people, 75(24.6%) broke the home isolation and 69(22.6%) were sharing their rooms with other family members. Overall, 260(85.2%) participants were keeping themselves updated with the changes in the guidelines through conventional and social media. Coronavirus disease-2019 patients who were advised home isolation adhered to some but not all of the recommendations.

Analysis of Root Angulation of Maxillary Central Incisor Using Cone Beam Computed Tomography (CBCT)

Background: Variance in anatomical morphology is influenced by the axial inclination of the tooth. When looking at the axial tilt of the crown, it's common to assume that it follows the same axis as the root. This study aims to use Cone Beam Computed Tomography (CBCT) to determine the root angulation correlation in maxillary central incisors. Methods: This cross-sectional observational research was performed at Dow University of Health Sciences (DUHS). The CBCT scans of patients who matched the inclusion criteria were done by skilled radiography technicians and primary investigators on ROTOGRAPH EVO 3D. For statistical analysis, one-way ANOVA was utilized to examine the Root Angulation (RA) with different root positions. p-value &lt;0.05 was considered significant. Results: This study examined n=152 CBCT images. Mean age was 27.2 + 5.9 years, with 32(42.1%) men and 44(44.1%) females. Buccal subtype I was most prevalent (59, 38.8%) in maxillary central incisors, while buccal subtype III was least common (5, 3.3%). The root angulations varied significantly between root location classifications (p=0.007). These were intermediate root location (14.9 2.6 degrees) and buccal subtype III (14.28 2.25 degrees). The palatal root type had the least angle (3.73 1.5 degrees). Conclusion: The buccal root position was shown to be the most common root location. Buccal subtype I was by far the most common. Buccal subtype III and middle root location had the maximum root angle. The palatal root position had the smallest angle.

Evaluation of risk factors and clinical outcomes of acute respiratory failure from post renal transplant recipients: A five-year data of a single center

Acute Respiratory Failure (ARF) requiring Intensive Care Unit (ICU) admission is a common complication following renal transplant and is a diagnostic and therapeutic challenge. This study aimed to evaluate etiological factors and clinical outcomes of ARF following a renal transplant. This was a retrospective observational study. Data was recruited from last five –years’ records of Renal Transplant Unit of Dow University of Health Sciences, Karachi, Pakistan. Patients who developed ARF after renal transplantation whether requiring hospitalization (both in ICU or in ward) were included and their severity, etiologic diagnosis, and clinical outcomes were evaluated. During past five years (June 2017 till June 2023) a total of 450 kidney allografts were done and 35 patients (7.8%) developed ARF. Out of which 15 patients were shifted to the ICU. Mortality of female patients was higher as compared to males (26.1% versus 20.4%). Hypertension was found to be the most common comorbidity whereas glomerulonephritis was the most common cause of End Stage Renal Disease (ESRD). Acute rejection was observed in 20.89% (n = 94) of recipients. Bacterial pneumonia was the most common cause of ARF, one patient needed on mechanical ventilation whereas two patients were dialysis dependent survivors. ARF following renal transplant is associated with higher mortality and loss of graft function because of compromised immunity. Anti-bacterial prophylaxis and early intensive management appears to help in improving the outcome while integrating the graft function.

Three-staged minimally invasive esophagectomy with end-to-end esophago-gastric anastomosis for thoracic esophageal cancers: An experience from a low middle-income country

BackgroundEsophageal cancer is on a steady rise and carries significant mortality and morbidity. Depending upon the clinical stage at presentation, either chemotherapy, radiotherapy with or without surgical resection is the treatments in practice. Traditionally, open esophagectomy was performed but over time, the importance of minimally invasive esophagectomy has been established. In this study, we aimed to report our data of totally minimally invasive esophagectomies performed for thoracic esophageal cancers in last four years. MethodologyA prospective cross-sectional study was conducted at the Department of Upper GI Surgery, Dow University of Health Sciences, Karachi. All diagnosed cases of esophageal carcinoma undergoing minimally invasive esophagectomy, from 2019 to 2022 were included in this study. Outcomes measured were operative time, intra operative complications, conversion rate to open, postoperative complications, number of lymph nodes harvested, margin clearance, in-hospital mortality and 90-days mortality. ResultsA total of 53 cases were included in the study, the most prevalent histological type was squamous cell carcinoma 42(79.2%) as compared to adenocarcinoma 8(15.1%). Most common tumor site was lower thoracic esophagus (30–38 cm) in 20 (56.6%) cases. Neo-adjuvant chemotherapy was given in all 53(100%) cases, whereas neo-adjuvant radiation therapy was offered to 49(92.5%) patients. There was a significant and favorable patient response to the neo-adjuvant treatment in 37(69.8%) cases, leading to a decrease in tumor size. Laparoscopic McKeown Esophagectomies were performed in 44 (83.0%) and 9(17.0%) were Robot-assisted Minimally Invasive esophagectomy (RAMIE). Intraoperative injuries (i.e., lung parenchymal injury and bleeding) were reported in only 2(3.8%) patients. Post-operative complications were recorded in 12(22.6%) patients. Margin clearance was observed in 53 (100%) of the patients. The 90-day mortality rate was 3(5.7%), one due to bleeding and other two mortalities were due to COVID related respiratory complications. ConclusionMinimally invasive esophagectomy was found to be safe and feasible technique with encouraging results in terms of decreased intraoperative and post operative complications as well as achieving the standard oncological surgery with acceptable lymph node yield and margin clearance and in hospital and 90 days mortality.

Apolipoprotein E Polymorphism And Dyslipidemia In Elderly Patients Of Calcific Aortic Stenosis

Objective: This study aimed to investigate the impact of the Apo E polymorphisms on plasma lipid profile and to identify the polymorphism of the apo-E gene as genetic predictor of calcific AS in Pakistani population. Methodology: This was a case control study conducted in Dow University of Health Sciences and National Institute of Cardiovascular Disease, Karachi. It included total of 100 individuals, 50 echocardiographically identified calcific AS cases and 50 age and gender matched controls. Apo E allele frequencies were computed, lipid profiles were estimated and Apo E gene polymorphism was identified by the techniques of polymerase chain reaction (PCR) and restriction fragment length polymorphism (RFLP). Result: Apo E 2, 3, and 4 allele frequencies were 16%, 52%, and 32% in calcific AS cases, and 10%, 52%, 28% in controls respectively (p=0.622). Out of 50 cases, 18% presented with mild AS, 22% moderate AS and 60% lied in severe calcific AS. It was observed that levels of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein (LDL) were higher in Apo E4 allele as compared to other genes in both cases and control. Conclusion: The findings of this study suggested that Apo E4 allele of Apo E gene is an impotent risk factors for dyslipidemia while Apo E4 allele is not associated with calcific AS contemplates distinctive genetic backgrounds of CAD and AS.

Correlation Between Perceived Stress and BMI Among Obstructive Sleep Apnea Individuals

Objective: To investigate the potential association between higher perceived stress levels and elevated Body Mass Index (BMI) in patients with obstructive sleep apnea (OSA). Methodology: This prospective study was conducted at the Pulmonology Department of Dow University Hospital, Dow University of Health Sciences, from July to October 2020. The study included adults aged 18 and above, of both genders, diagnosed with OSA through clinical evaluation and sleep studies. BMI was calculated using the formula BMI = kg/m², and the Perceived Stress Scale (PSS) was utilized to assess participants' perceived stress levels. The PSS questionnaire, comprising 10 items, was completed by participants, with each item rated on a 5-point Likert scale (ranging from 0 to 4). Higher scores indicated higher perceived stress. Relevant clinical data were recorded, and the Pearson correlation coefficient was calculated to determine the direction of the relationship. Results: The study included 160 OSA cases, with an average age of approximately 50.29 years. The majority of participants were male (59.4%), while females constituted 40.6% of the sample. BMI categories revealed that 13.8% were overweight, 85.0% were obese, and only two individuals had a normal BMI. Concerning stress levels, 41.3% experienced low stress, 45.6% reported moderate stress, and 13.1% reported high perceived stress. Importantly, the study found an insignificant association between BMI and perceived stress (p-value &lt; 0.278). Conclusion: The study identified a predominant occurrence of obesity among OSA patients. A positive correlation between elevated BMI and perceived stress was observed. The limited number of similar studies and the acknowledged limitations of the current study underscore the necessity for further research and interventions to explore the impact of BMI on stress in OSA.

Analysis of C- Shaped Root Canal Morphology in Mandibular Second Molar using Cone Beam Computed Tomography

Objective: To analyse the C-shaped canal configuration in the mandibular second molar in a Pakistani subpopulation using cone beam computed tomography (CBCT).&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of Radiology, Dow University of Health Sciences, Karachi Pakistan, from Feb to Jul 2020.&#x0D; Methodology: Cone-beam computed tomography (CBCT) scans of the mandibular second molar that were taken for some other purpose were included in the study. One hundred fifty mandibular second molar teeth were assessed for C-shaped canal morphology. The c-shaped canal was then further examined at three different levels classifying according to Fan criteria, a modification of Melton's classification. Differences between gender left and right sides, unilateral and bilateral, were determined.&#x0D; Results: Out of 150 mandibular second molars, a C-shaped canal was found in 13(8.7%) of the teeth examined, in which 9(69.2%) were in females, and 4(30.8%) were in males. Bilateral distribution was found to be 11(92.3%).&#x0D; Conclusion: A high frequency of C-shaped canal in the mandibular second molars was observed in the present study. Therefore the variations in the morphology of the root canal system of the mandibular second molars should be considered when performing root canal treatment.

Trans-Arterial Chemoembolization for the Treatment of Hepatocellular Carcinoma: A Single Tertiary Care Institute Experience

Introduction: Trans-arterial chemoembolization (TACE) is a mainstay therapeutic option indicated in early-stage non- resectable hepatocellular carcinoma (HCC) and has been shown to be associated with survival improvements. This study aimed to evaluate the radiological and clinical response of those who underwent TACE. Aims &amp; Objectives: We aimed to evaluate the radiological and clinical response in patients who underwent Trans- arterial chemoembolization. Place and Duration of Study: This study was conducted in the Vascular Interventional Radiology Department, Dow Institute of Radiology, Dow University of Health Sciences, Ojha Campus Karachi for a period of 18 months between January 2021 and June 2022. Material &amp; Methods: HCC patients (n=181) who underwent TACE as their primary treatment at Dow Hospital Ojha Campus Karachi between January 1st, 2021, and June 30th, 2022 were included. Inclusion criteria followed the Barcelona Clinic Liver Cancer (BCLC) and Child-Pugh staging systems. Tumor response was evaluated using “modified Response Evaluation Criteria in Solid Tumors (mRECIST)”, and patients were categorized into complete response (CR) or partial response (PR) groups. The study compared background, clinico-laboratory, and radiological features between these groups, including HCC sizes and CT scan findings before and after TACE. The retrieved data was entered and analyzed using SPSS version.21. Results: Of the total 118 patients, 51.70% showed CR to the TACE, while PR was noted in 48.30%. Age, sex, viral hepatitis, and co-morbids showed no intergroup differences. However, Child-Pugh stage and BCLC were significantly associated with tumor response. Similarly, laboratory parameters revealed significant mean differences between the two groups (p&lt;0.001), except international normalized ratio and alanine transaminase. Those who had achieved CR had a mean number of tumor less than that of PR. Similarly, tumor size significantly decreased post-TACE (p&lt;0.0001). Moreover, arterial-phase enhancement and portal venous and delayed phases washout tumors before TACE were reported in 76.30%. Over half of the patients had no residual tumor tissue after TACE. Tumors with arterial-phase enhancement and portal venous and delayed phases washout were highly susceptible to TACE.Furthermore, Child-Pugh classA had a greater estimated mean survival than class B (p&lt;0.001). Conclusion: Over half of the patients showed complete response to the TACE. BCLC staging (B), Child-Pugh (stage A), and small tumors had a favourable effect on the radiological and clinical response in the early-stages of HCC. Tumors with an arterial-phase enhancement and portal venous and delayed phases washout were more susceptible to TACE.

Relation of Intima Media Thickening of Carotid Arteries with Parameters of Lipid Profile in Chronic Hepatitis C Patients

Objective: To find out the relation between carotid intima media thickening (CIMT) and lipid profile in HCV seropositive patients. Study Design &amp; Setting: Descriptive, cross sectional study. Methodology: Study was conducted in the Institute of Basic Medical Sciences of Dow University of Health Sciences. Duration of study wsd 13 months. After ethical approval, a total of ninety participants including thirty (n=30) control (Group A) and sixty (n=60) HCV sero-positive patients (Group B) were inducted in the study from the hepatitis clinic of Ruth Pfau Civil Hospital, Karachi, Those with history of smoking, hypertension, alcohol, pregnancy, ascities, coinfection with other hepatitis viruses and not willing to participate were excluded. After consent, demographic and anthropometric data were recorded. Blood samples were taken for fasting blood glucose and lipid profile estimation. CIMT was estimated by carotid doppler ultrasound. Data entered and analyzed by SPSS version 20.0. and presented as frequency (n; %) and mean ±SD. Student “t” test and Pearson’s correlation test were applied where appropriate. A p-value of &lt;0.05 was considered as statistically significant. Results: Demographic and anthropometric characteristics of HCV sero-positive participants showed non-significant difference compared to control. FBG and CIMT were found to be significantly raised in HCV infected patients while lipid profile parameters showed insignificant difference. Pearson’s correlation test revealed insignificant relation of lipid profile parameters with CIMT (p &gt; 0.000). Conclusion: HCV seropositive patients had significantly raised CIMT with non-significant relation with parameters of lipid profile

Confronting Challenges: An Inductive Thematic Analysis Of Barriers And Solutions To Undergraduate Medical Research In Pakistan.

To qualitatively analyse the barriers in pursuing undergraduate research, and to propose solutions for the problems identified. The qualitative study was conducted from May to October 2021 after approval from the institutional ethics review board of the Dow University of Health Sciences, Karachi, and comprised undergraduate students of either gender at various public and private medical universities across Pakistan having some level of research experience and good communication skills. Data triangulation was employed to collect qualitative data through open-ended survey, face-to-face interviews and focus group discussions. Using the information of one method to inform the rest, linked trajectories were established that allowed validation of information at each level. Data was coded manually by two researchers independently. Data was subjected to inductive thematic analysis. Of the 33 subjects, 17(51.5%) were males, 17(51.5%) were from private medical colleges, 18(54.5%) were from Karachi, and 11(33.3%) were in the final year of medical school. Overall, 13(39.4%) students completed the open-ended survey, 6(18.2%) completed face-to-face interviews, and 14(42.4%) participated in focus group discussions. Thematic analysis showed that students were interested in research to improve their career prospects, but not all were passionate about it. Students were not satisfied with the quality of research being conducted in the country. Dearth of motivated faculty, unavailability of well-maintained and digitalised data registries, ineffective research methodology teaching and lack of access to medical journals and research software were the major barriers in undergraduate research. Time constraint was a projecting problem which challenged the students. Frequent research workshops and conferences, strong networking, reorienting curriculum to provide early exposure to research and student-led initiatives were suggested to improve undergraduate research in Pakistan. Students' lack of initiative coupled with administrative and faculty-related issues pose a serious threat to the future of evidence-based medicine. Proposed solutions offer a ray of hope to the future of undergraduate research in Pakistan.

Short Term Side Effects Of Inactivated COVID-19 Vaccines Among Pakistani Population: A Survey-Based Cross-Sectional Study.

To assess the short-term adverse effects of two inactivated coronavirus disease-2019 vaccines, and the demographic factors associated with such events. The cross-sectional study was conducted in Karachi from August to October 2021 after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised adults of either gender who had received at least one dose of either Sinopharm or CoronaVac vaccine. Data was collected using online and printed survey forms. The questionnaire investigated the symptoms experienced by the participants after the administration of the vaccine dose. Data was analysed using SPSS 22. Of the 1000 survey forms filled, 896 were analysed; 505(56.4%) women and 391(43.6%) men were included in the study. Most of the participants were aged 18-30 years 644(71.9%). Overall, 581(64.8%) subjects had received Sinopharm vaccine, and 315(35.2%) received CoronaVac. The incidence of side effects after the first and second dose respectively was 63.3% (368 out of 581) and 55.2% (239 out of 433) for Sinopharm and 65.4% (206 out of 315) and 61.4% (89 out of 145) for CoronaVac. The factors associated with a higher risk of side effects were female gender and young age (p<0.05). Most of the reported symptoms were minor in nature, like pain at the injection site, and women and those of young age reported such symptoms more than men and the elderly.

Comparison of complete nasal packing with and without integrated airways.

To compare the effects of nasal packing using a Nasopore nasal packing with and without an airway tube on postoperative pain, SpO2, nasal obstruction, and difficulty in breathing complaints. This comparative study was conducted at Dow University of Health Sciences (DUHS), DMC Civil Hospital Karachi between September 18, 2021, to May 19, 2022. A total of 70 patients who underwent septoplasty for septal deviation and chronic hypertrophic rhinitis were equally divided into two groups. Group-A patients received nasal packing using a Nasopore nasal packing with an airway tube, and Group-B patients received nasal packing using a Nasopore nasal packing without an airway tube. Post-operation Nasal pain sensations were measured using the Wong-Baker Faces Pain Rating Scale at 2 and 12 hours. SpO2 was measured at 30 minutes pre-operatively with an O2 saturation monitor and 12 hours post-operatively during sleep. The postoperative pain at two hours and 12 hours was compared between the two groups, and a significant difference was observed. In Group-A, the average SpO2 decreased > 4% from baseline in 5.7% patients, and 37% in Group-B. A significant difference was observed in the severity of nasal obstruction and difficulty breathing, P-value < 0.05. It is concluded that septoplasty followed by applying nasal packing with integrated airway reduces postoperative pain and improves oxygen saturation compared to nasal packing without integrated airways.

Significant Role of Professional Development Center in Healthcare Setup in the Provision of Quality Education, Advance Learning and Patient Care

Objective: To define the significant role of Professional Development Center (PDC) at Dow University of Health Sciences in provision of quality education, learning and patient care.&#x0D; Study Design: Retrospective cohort study.&#x0D; Place and Duration of study: Professional Development Center, Dow University of Health Sciences, Karachi Pakistan, from 2018 to 2022.&#x0D; Methodology: Study was conducted through non-probability convenience sampling technique to include all CME workshops and seminar records of PDC. Further feedback forms were also collected from the participants after each training session to analyze their feedbacks.&#x0D; Results: As per the five year, records a total of 728 CME workshops and 635 CME seminars were conducted by PDC from the 2018 to Feb 2023. Major focus areas of the CME lectures and workshops was Medicine and Allied Health sciences, continuously for the last five years. However, when major focus area of CME workshops was assessed it was that they were mainly related to basic life support where, most of the workshops were conducted to train the students of Dow Institute of Medical Technology. When participants’ feedback was taken regarding the organization and impact of workshop, it was found that most of them agreed that handouts were helpful (77.25%) and questions were adequately responded (77.25%), respectively.&#x0D; Conclusion: It was found that PDC significantly played its role in enhancing knowledge and skills of the healthcare professionals in healthcare setup, thereby providing quality education, learning and patient care.

The Relationship Between Prostatic Volume And Serum Estrogen In Obese Versus Non Obese Males With Benign Prostatic Hyperplasia

Background: Old age, obesity and androgens are more vulnerable to prostatic disorders. Benign Prostatic Hyperplasia (BPH) is a common problem for adults. Objectives: To determine the morphological changes of prostate gland and effects of Estrogen levels in obese versus non-obese males with BPH. Methods: A cross sectional study was conducted on sixty patients in an emergency clinic of Dr. Ruth Pfau, Dow university of Health Sciences, Karachi from 17th May 2019 to 15th February 2020(IRB-1182/DUHS/approval/2019). All selected patients have BPH and assessed by Global prostate side effect score &gt;7. Patients with BPH were divided into two groups obese and non-obese, as indicated by Body Mass Index (BMI) and waist circumference (WC). Group A (obese) had BMI ≥ 25; WC ≥ 90cm and group B (non-obese) had BMI &lt; 25; WC &lt; 90cm. Trans rectal ultrasound and estimation of serum Estrogen was performed to analyzed the length, width, diameter and volume of prostate. Results: The mean prostate volume was higher in the obese group 36.13±3.673ml while in non-obese group it was 31.21±6.771 ml, which was found to be statistically significant (p = 0.001). The mean Estrogen levels in obese group were 328.21±115.05pmol/l, while in non-obese group it was 309.72±73.62pmol/l (p=0.462). Significant positive correlation was observed (r = 0.279, p- =0.031) between prostate volume and serum Estrogen levels in study participants. Conclusion: Obesity and serum Estrogen levels had significant effect on the prostate volume as compared to non-obese participants within same age group which showed significant moderate positive correlation with prostate volume in obesity.

The Relationship Between Prostatic Volume And Serum Estrogen In Obese Versus Non Obese Males With Benign Prostatic Hyperplasia

Background: Old age, obesity and androgens are more vulnerable to prostatic disorders. Benign Prostatic Hyperplasia (BPH) is a common problem for adults. Objectives: To determine the morphological changes of prostate gland and effects of Estrogen levels in obese versus non-obese males with BPH. Methods: A cross sectional study was conducted on sixty patients in an emergency clinic of Dr. Ruth Pfau, Dow university of Health Sciences, Karachi from 17th May 2019 to 15th February 2020(IRB-1182/DUHS/approval/2019). All selected patients have BPH and assessed by Global prostate side effect score &gt;7. Patients with BPH were divided into two groups obese and non-obese, as indicated by Body Mass Index (BMI) and waist circumference (WC). Group A (obese) had BMI ≥ 25; WC ≥ 90cm and group B (non-obese) had BMI &lt; 25; WC &lt; 90cm. Trans rectal ultrasound and estimation of serum Estrogen was performed to analyzed the length, width, diameter and volume of prostate. Results: The mean prostate volume was higher in the obese group 36.13±3.673ml while in non-obese group it was 31.21±6.771 ml, which was found to be statistically significant (p = 0.001). The mean Estrogen levels in obese group were 328.21±115.05pmol/l, while in non-obese group it was 309.72±73.62pmol/l (p=0.462). Significant positive correlation was observed (r = 0.279, p- =0.031) between prostate volume and serum Estrogen levels in study participants. Conclusion: Obesity and serum Estrogen levels had significant effect on the prostate volume as compared to non-obese participants within same age group which showed significant moderate positive correlation with prostate volume in obesity.

TO COMPARE THE EFFECTIVENESS OF TRUNK STABILIZATION EXERCISE AND GENERAL EXERCISE IN NON-SPECIFIC CHRONIC LOW BACK PAIN-A COMPARATIVE STUDY

Aim of study: To identify the effectiveness of particular trunk stabilization versus a general exercise in low back pain management. Methodology: An experimental study was conducted at the physiotherapy department of Dow University of Health Sciences, 52 participants with low backache were enrolled and assessed for pain intensity using Visual Analog Scale (VAS) and disability by using the Modified Oswestry Low Back Disability Index (MOLBDQ-I). Through equal randomization one group got their low back pain treated through trunk stabilization exercises while the other with general exercises, 3times/week* 4weeks. Data were analyzed using SPSS version 25.0 by applying non-parametric Mann-Whitney U-test. Results: This study demonstrated that males and females are equally affected by chronic low back pain. Trunk stabilizing and general exercise regimes both significantly reduced the pain and disability in the study population but the effectiveness of trunk stabilizing exercises were significantly superior in reducing pain. Limitations and Future Implications: Study did not include a control group that received no intervention. It would be valuable to assess the cost-effectiveness of trunk stabilization exercises compared to general exercises or other interventions. Originality: Trunk stabilizing exercises are superior in reducing pain, disability, and restoring functional mobility than general exercises in chronic back pain. Conclusion: Trunk stabilizing exercises are superior in reducing pain, disability, and restoring functional mobility than general exercises in chronic back pain.

Association of Mitochondrial HVS-I Region Variants with Type 2 Diabetes in Pakistani Diabetic Subjects.

To analyse mitochondrial hypervariable segment I (HVS-I) variations in Pakistani type 2 diabetic subjects. Case-control study. Place and Duration of the Study: National Institute of Diabetes and Endocrinology, Dow University of Health Sciences, Karachi, Pakistan, between January 2019 to January 2021. DNA from whole blood was isolated, and mitochondrial HVS-I region (16024-16370) of 92 individuals, including 47 controls and 45 diabetics, was amplified, sequenced, and analysed. Ninety-two variable sites in the sequenced region were identified and individuals were classified into 56 different haplotypes according to phylotree 17.0 classifications, where major haplotype M5 was nearly 2-fold higher in diabetes. Fischer's exact test revealed variant 16189T>C significantly associated with diabetes (Odds ratio = 12.9, 95% CI = 0.6917 - 2400248) as compared to controls. The authors further analysed 1000 Genomes Project data of Pakistani Control subjects (i.e. PJL, n=96) and found that besides 16189T>C (Odds ratio = 5.875, 95% CI = 1.093 - 31.57, p<0.0339), 16264C>T (Odds ratio = 16, 95% CI = 0.8026 - 314.7, p<0.0310) also showed significant association with diabetic subjects. Comparing diabetic subject data with global control population data of the 1000 Genomes Project, significant associations of eight variants in the studied region were found. Based on the results of this case-control study, it can be concluded that specific variations in the mitochondrial hypervariable segment I (HVS-I) region are significantly associated with type 2 diabetes in the Pakistani population. The major haplotype M5 was found to be higher in diabetic subjects and variants 16189T>C and 16264C>T were significantly associated with diabetes. These findings suggest that mitochondrial DNA variations may play a role in the development of type 2 diabetes in the Pakistani population. Diabetes Mellitus, HVS-1 region, Diabetic subjects, Mitochondrial genomics, Pakistani population.

Awareness of Dietary Habits and Balanced Lifestyle Among Physical Therapy Students

Obesity has now-a-days became global epidemic and the fifth leading cause of death. A strong relation has been observed between obesity and mortality among the general population Objective: To observe the nutritional status of the food intake in physical therapy students to make a guideline to modify the dietary habits. Methods: A cross-sectional study conducted in January 2022 to June 2022 among the students at Dow University of Health Sciences (DUHS), Karachi. The minimum sample size was calculated as 75. A self-designed questionnaire was used to collect data from the students. IBM SPSS Version-26 was used for data analysis. Results: The average weight and height of the students was 52.8 ± 9.5 SD (kg) and 5.34 ± 0.27 SD (feet). The BMI was measured as (height)2 / weight. The mean BMI calculated was 20.4 ± 3.4 SD. Based on the BMI, the frequency of overweight students was 13 (8.2%) and obese were 2 (1.3%). Remaining 52 (32.9%) were under- weight. The majority of students i.e., 82.2% reported that they eat two to three meals per day. Consumption of fruits and vegetables was least common. Less than one-fourth of the students said that they intake fruits on regularly. Snack consumption other than regular meals was about 21.5% among students. Conclusions: Students were found to have normal weight. The current study indicates that most of the students were well aware and concerned of obesity and over-weight and they tried to maintain their body weight by controlling diet.

Does Lifestyle Behaviour Trigger Cardiovascular Risk Factors Among School-Going Adolescents In Pakistan?

To explore the association of gender with risk factors for cardiovascular diseases among adolescents. The cross-sectional study was conducted 2016-2019 in low-income schools in Karachi after approval from the ethics review board of Dow University of Health Sciences, and comprised adolescents of both genders aged 11-17 years. Anthropometric measurements and lifestyle behaviours were used to generate risk profile for cardiovascular diseases. Data was analysed using SPSS 16. Of the 1195 subjects, 468(39.2%) were boys and 727(60.8%) were girls. The mean age was 13.9±1.6 years. Mean family size was 5.9±3.64. Overall, 989(91.3%) participants consumed soft drinks, 44(4%) were smokers, 340(48.4%) consumed betel nut, 215(32.9%) Pan, 125(21.2%) Gutka and 9(1.7%) Bidi. Of the total, 867(83.3%) participants were physically less active than recommended, and daily screen time was >2 hours among 513(45.7%) participants. Body mass index and body fat percentage were significantly higher among girls (p<0.05). Higher rates of diastolic and systolic blood pressure and hand grip strength were observed in boys compared to girls (p<0.05). Interventional programmes in schools should emphasise the need for healthy lifestyle behaviours, increased physical activity, good eating habits and smoking cessation.