Journal of Bahria University Medical and Dental College 2022-10-06T22:14:55-06:00 Prof. Dr. Iqbal Hussain Udaipurwala Editor JBUMDC Open Journal Systems <p>The Journal of Bahria University Medical and Dental College (JBUMDC) is a peer-reviewed, multidisciplinary biomedical Journal of Basic, Clinical and Allied Health Sciences (Print ISSN: 2220-7562 and Online ISSN:2617-9482 CODEN: JBUMB7). It was established in 2011 with the main aim to promote and disseminate high-quality research papers among the healthcare research community. It is published quarterly in January, April, July, and October.</p> <p><strong>It is recognized by Higher Education Commission of Pakistan (HEC) </strong></p> <p><strong>for Year <a href=";id=912636#journal_result">2021-22</a></strong></p> <p><strong>for Year <a href=";id=1021571#journal_result">2022-23</a></strong></p> <p><strong>There are no processing and publication charges for article processing and publication.</strong></p> Emotional Intelligence: A Valued Workplace Competency 2022-10-06T01:09:50-06:00 Kiran Fatima Ijaz Lateef <p>Some employees may exhibit emotional symptoms such as<br>work pressure, agitation, anxiety, depression and irritability<br>.<br>1These symptoms are related to the various dimensions of<br>the emotional intelligence (EI)</p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Dilemma of Dantrolene: A life-saving drug unavailable in Pakistan 2022-10-06T06:20:24-06:00 Tahir Ali Habib Feroz Kapadia <p><span class="fontstyle0">Malignant hyperthermia (MH) is brought on by a number<br>of anaesthetic drugs, primarily succinylcholine and inhalation<br>anesthetics.</span><span class="fontstyle0">1 </span><span class="fontstyle0">It is a hypermetabolic reaction in those who<br>are genetically predisposed</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Drug Resistance due to Elaboration of Beta Lactamases and the Role of CTX-M in Enterobacteriaceae 2022-10-06T05:30:53-06:00 Rida Sohail Yasmeen Taj Luqman Satti Shaista Bakhat <p><span class="fontstyle0">The </span><span class="fontstyle2">Enterobacteriaceae </span><span class="fontstyle0">family are the most common pathogens associated with hospital and community acquired infections<br>worldwide. These bacteria are treated with broad spectrum antibiotics especially 3</span><span class="fontstyle0">rd </span><span class="fontstyle0">generation cephalosporins. Over the<br>period of time due widespread and rigorous use of these medications, </span><span class="fontstyle2">Enterobacteriaceae </span><span class="fontstyle0">has developed antibiotic resistance<br>(AMR). Among all, the most compelling antibiotic resistance mechanism is production of -lactamases enzymes by this<br>microorganism. Over the course of time -lactamase has evolved more than 1300 distinct enzymes. Amongst these most<br>deleterious is extended spectrum beta lactamases (ESBL). ESBL producing </span><span class="fontstyle2">Enterbacteriacaeae </span><span class="fontstyle0">are responsible for a<br>high number of deaths worldwide. These enzymes are considered challenging as they are difficult to be identified in the<br>laboratory wShich cause delay in diagnosis and administration of appropriate antimicrobial therapy. The coexistence of<br>ESBL with other antibiotic resistance gene is another therapeutic challenge rendering empirical antibiotic treatment<br>ineffective.</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Determining the Effect of Intrathecal Dexmedetomidine on Postoperative Pain Relief after Cesarean Section 2022-10-06T01:15:17-06:00 Ayesha Shahid Huda Shafqat Salman Maqbool Ahsan Ali Rehana Feroze <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To analyze efficacy of intrathecal Dexmedetomidine as adjunct to hyperbaric Bupivacaine in terms of postoperative analgesia after caesarean section.<br></span><span class="fontstyle0">Study Design &amp; Setting</span><span class="fontstyle2">: This randomized controlled trial was conducted at Department of Anesthesia, Rawal Institute<br>of Health Sciences, Islamabad from20</span><span class="fontstyle2">th</span><span class="fontstyle2">, October 2018 to 20</span><span class="fontstyle2">th</span><span class="fontstyle2">April 2019 after taking Ethical board approval from the<br>Institute. (letter no RIHS-REC/030/18, dated, 18th October 2018).<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Total n=120 patients having ASA status I, II undergoing elective cesarean section were randomly divided<br>into 2groups (60 each) by lottery method. Group-A, was given hyperbaricBupivacaine (0.5%) 12mg alone and group-B,<br>was given hyperbaricBupivacaine (0.5%) 12mg along with injection Dexmedetomidine 4ug in intrathecal space respectively.<br>Patients were followed in postoperative period for onset of pain and requirement for rescue analgesia in first 6 hours.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">There was statistically significant difference in mean onset of postoperative pain among both the groups-A and<br>B (178.18 ± 12.51 versus 364.07± 35.58min respectively with p value 0.000), as well as, postoperative analgesic requirement,<br>in first 6 hours, 39 (65.0 %) versus 31 (51.7 %) with p-value 0.000 respectively. However, on stratification, considering<br>effect modifiers, like age (20-30 years and 30-40 year and previous history of cesarean section), there was statistically<br>significant difference in mean onset of pain in both groups, but no significant difference was found regarding rescue<br>analgesic requirement in both groups.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Intrathecal Dexmedetomidine along with hyperbaric Bupivacaine was better than hyperbaric Bupivacaine<br>alone in controlling postoperative pain in caesarean section.</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Clinical Outcome of Preterm Neonates with Respiratory Distress Syndorme on Continuous Positive Airway Pressure 2022-10-06T01:21:17-06:00 Sijad-Ur- Rehman Quratul Ain Wahid Ali Romana Bibi Sohail Ashraf Kulsoom Iqbal <p><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To evaluate the clinical course in preterm neonates with Respiratory Distress Syndrome on bubble Continuous<br>Positive Airway Pressure along with their outcome during stay in hospital.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">A descriptive case study at the NICU was carried out at Bacha-Khan Medical Complex Swabi<br>from December 2020 to December 2021.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Respiratory Distress Syndrome was diagnosed by following the criteria: tachypnea (&gt; 60 breaths/min),<br>subcostal retraction and saturation &lt;92%. Clinical course was assessed by mean length of hospital stay from the day of<br>admission to the day of discharge. Outcome was assessed by means of switching the baby to mechanical ventilation by<br>failing CPAP therapy by not maintaining O</span><span class="fontstyle2">2 </span><span class="fontstyle2">saturation &gt; 92% and tachypnea &gt; 60 breaths/min on 10cm maximum pressure<br>of H</span><span class="fontstyle2">2</span><span class="fontstyle2">O. CPAP response were noted.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Total of 100 patients enrolled in our study, 56 patients were male and 44 patients were female. Mean age was<br>1.24+0.04days. Mean gestational age of babies was 31.18+0.170weeks. Mean weight of babies was 2.035+0.023kg. Mean<br>hospital stay was 15.05+0.237days. Out of 100 patients included in study 76% babies needed ventilatory support during<br>hospital stay and 24% babies recovered from respiratory distress syndrome without need of ventilator support.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Respiratory Distress Syndrome is a fatal complication in Preterm neonates in Neonatal Intensive Care Unit.<br>Respiratory assistance done through continuous positive airway pressure has shown encouraging results in management<br>by preventing complications, mechanical ventilation need, less hospital stay and preventing mortality</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Correlation of Uroflowmetry with Prostate Volume and International Prostatic Symptom Score (IPSS) 2022-10-06T01:33:23-06:00 Iffat Raza Nausheen Jamshed Mubina Lakhani Maria Mohiuddin Syeda Bushra Ahmed Sahrish Mukhtar <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To correlate Uroflowmetry with Prostate volume and International Prostatic Symptom Score in BPH patients<br>and healthy adults in a subset of Karachi Population.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">This is a crossectional study carried out at Ziauddin Hospital, Karachi over a period of 6<br>months.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">In this study 100 Samples were taken through non probability convenience sampling. Inclusion criteria<br>includes 40years and above. Sample initially was taken on the basis of International Prostatic Symptom Score i.e., less<br>than 8 and greater than 8 score. Ultrasonography was performed. 65 Individuals with International Prostatic Symptom<br>Score &gt; 8 and Prostate volume &lt;25 and individuals having symptom index &lt; 8 and Prostate volume &gt; 25ml went for<br>Uroflowmetry. Mean and standard deviation was taken out for quantitative variables. Univariate analysis and Multiple<br>Linear Regression applied to assess relationship between Uroflowmetry with Prostate volume and International Prostatic<br>Symptom Score.<br></span><span class="fontstyle0">Result: </span><span class="fontstyle2">Mean age of patients was found to be 58±6 years. Mean International Prostatic Symptom Score was 11±4. Mean<br>Prostate Volume was 28ml±5, mean Qmax was 14ml/s ±4. The correlation between Qmax and International Prostatic<br>symptom score was found to be negative (-0.78) and statistically significant. No correlation was found between Prostate<br>volume and Qmax.<br></span><span class="fontstyle0">Conclusion</span><span class="fontstyle2">: Qmax and International Prostatic Symptom Score are reliable tool for assessing Benign Prostatic Hyperplasia<br>patients concluding that as Symptom Score increases Qmax decreases. Qmax showed no correlation with Prostate volume</span><span class="fontstyle0">.<br></span><span class="fontstyle2">Prostate volume assessed on Ultrasonography is not an authentic parameter for diagnosing BPH patients</span><span class="fontstyle0">.</span></p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 The Effectiveness of Submucosal Dexamethasone after Third Molar Extraction. A Single Blind Randomized Clinical Trial 2022-10-06T01:38:22-06:00 Saeed Ullah Shah Nameera Agha Abhishek Lal Rahima Yousofi Resham Nadeem Naseer Ahmed <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To evaluate the efficacy of dexamethasone in alleviating pain and trismus of the patients who underwent<br>extraction of the third molars.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">A total of 120 patients took part in this randomized, controlled trial. The wisdom teeth of patients were<br>surgically extracted under local anesthesia. The patients were randomly assigned to one of two group and study control<br>with 60 patients in each group. Preoperative and Postoperative measurements of edema, trismus and pain were analyzed.<br>In study group, dexamethasone was immediately given after extraction. However, in control group, no dexamethasone was<br>given to the patients. The paired t-test was carried out to compare the means scores of pains and trismus and. A p value<br>of = 0.05 was judged significant.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The pain scores of patients in group 1 were mostly pain-free on the third post-operative day after dexamethasone<br>administration, with complete pain resolution in all patients on the seventh post-operative day. About trismus in post<br>operative phase almost all of the patients belonging to group 1 did not report to suffer from trismus with just two patients<br>complaining of mild trismus. Whereas, on the 7</span><span class="fontstyle2">th </span><span class="fontstyle2">post-operative day, all of the group 1 patients free from trismus. About<br>the comparison of trismus, pain and Edema in study groups, a significant difference p&lt;0.05 was found.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Inflammatory complications are frequently associated in the post operative phase of extraction of third molars.<br>Dexamethasone has been proven to be useful in reduction of pain, trismus and edema experienced by the patients when</span></p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Frequency and Determinants of Postpartum Depression among Mothers Living in Karachi 2022-10-06T01:43:53-06:00 Fareeha Shahid Quratulain Javaid Umama Shakeel Ahmed Fatima Farooq Neelam Kumari Qalandar Shah <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To determine the frequency of Postpartum Depression (PPD) among mothers living in Karachi and to find out<br>the determinants of predispose mothers to Postpartum Depression.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">The study was cross sectional analytical and was carried by online survey of mothers living<br>in Karachi<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Total duration was six months from 1st January, 2020 to 31st July, 2020. The calculated sample size of<br>study was 369. The study was approved by the Ethical Review Committee of Bahria University Health Sciences Campus,<br>Karachi. Random sampling technique was used to recruit subjects. 294 participants were part of the research. Mothers with<br>previous history of depression and those who had given birth to healthy babies were included in the study. Mothers who<br>have had miscarriage or pre-mature babies were excluded. Questionnaires in both English and Urdu languages were used<br>for the research. PPD was assessed by the help of Edinburgh Post Natal Depression Scale (EPDS). The score of greater<br>than 12 was considered to be indicative of PPD.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">A total of 294 mothers were enrolled in the study, 187 mothers had an EPDS score &gt;12 giving prevalence of PPD<br>as 63.6%. This study showed that mothers with PPD were more likely not to breastfeed their child (p=0.01), had lack of<br>family support (p=0.00) and had previous history of depression as well (p=0.00).<br></span></p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Magnetic Resonance Imaging of Lumbar Spine in Lower Backache: A Comparative Study on Gender Basis 2022-10-06T02:23:01-06:00 Nazia Azeem Muhammad Anwar Shazia Kadri <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To compare the clinical features of lower backache with Magnetic Resonance Imaging (MRI) findings on<br>gender basis.<br></span><span class="fontstyle0">Study design &amp; Setting: </span><span class="fontstyle2">A cross-sectional descriptive study was carried out among male &amp; female patients with a backache<br>at Sir Syed Hospital, Karachi. This study conducted from 1</span><span class="fontstyle2">st </span><span class="fontstyle2">Jan 2020 to 1st June 2020. We studied 90 patients by using<br>the non-probability convenient sampling technique.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Lower backache is a common problem that creates disability. MRI lumbar spine without contrast were<br>reviewed with clinical complaints. Performa was used after the ethical approval from Institutional Research and Ethical<br>committee. Components focused during the study in MRI findings at different spinal levels were disc bulging, neural<br>foraminal compromise, nerve root compression, ligamentum flavum and facet joint hypertrophy.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The results showed that the mean age of 90 patients was 44.64 years. On MRI imaging 46(86.8%) males and<br>26(70.3%) females had disc desiccation but multi-level disc osteophyte complexes were demonstrated more in females<br>11(29.7%). Diffuse disc bulge is more in males at L4-5 and L5-S1 level 49(92.5%) than in females 34(91.9%) at L4-5<br>and 33(89.2%) at L5-S1 level with mild to moderate spinal canal stenosis. The narrowing of Neural foramen is almost<br>similar at L4-5 level in both gender but more at L5-S1 in females 35(94.6%) as compared to males 49(92.5%) with nerve<br>root compression. Overall male patients tended to have slightly more disc degenerative changes than females.<br></span></p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Outcome of Indoor Covid Cases with Moderate to Severe Disease; Convalescent Plasma Transfusion vs Conventional Therapy 2022-10-06T02:27:49-06:00 Lubna Meraj Muhammad Usman Nadia Shams Muhammad Umar Sidra Tahir Nasim Akhtar Muhammad Khalid Mehmood Randhawa Asif Majid Ashar Alamgir <p><span class="fontstyle0">Objectives: </span><span class="fontstyle2">Global COVID-19 epidemic has been therapeutic challenge. Convalescent plasma is observed to improve<br>clinical outcomes. This research aims to study whether convalescent plasma therapy reduces the mortality and duration<br>of hospitalization in moderate to severe Covid.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">This interventional study was conducted after ethical approval at RIUT COVID-19 center<br>from1</span><span class="fontstyle2">st</span><span class="fontstyle2">June-30</span><span class="fontstyle2">th </span><span class="fontstyle2">Nov 2020.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Hundred Covid patients included; Total 100 hospitalized adult SARS Cov-2 PCR positive with moderate<br>to severe disease who agreed for convalescent plasma transfusion were included. Fifty in plasma transfusion group and<br>fifty in conventional therapy group. T</span><span class="fontstyle3">hose with </span><span class="fontstyle2">contraindications for plasma transfusion, delayed presentation, indoor stay<br>&lt;5 days were excluded. Convalescent plasma was obtained from donors with prior documented SARS CoV-2 infection<br>meeting donor eligibility criteria. 50 cases received convalescent plasma and50 received conventional therapy. Hospital<br>stay and outcome documented.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Amongst 100 Covid cases; 44 females and 56 males; mean age 57.88+11.95 years, 74% had moderate covid and<br>26% severe. Fifty cases received conventional therapy for Covid and 50 received plasma transfusion. Both groups comparable<br>for gender, age, smoking, obesity, and disease severity. Invasive ventilation administered in 25% and was associated with<br>mortality (p=0.004). Mortality observed in 29 cases; 20(69%) in plasma transfusion group Vs. 09(31%) in conventional<br>therapy group (p=0.015). The hospital stay was comparable between two groups The relative risk ratio was 2.22 with 95%<br>CI (1.12-4.39).<br></span><span class="fontstyle0">Conclusions: </span><span class="fontstyle2">There was no therapeutic benefit in Covid patients treated with convalescent plasma as compared to<br>conventional treatment.</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Urological Injuries in Obstetrical and Gynaecological Surgery at Tertiary Care Hospital 2022-10-06T04:45:45-06:00 Shazia Naseeb Piranka Kumari Shaista Rashid <p><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To determine the frequency of urological injuries in obstetrical and gynaecological surgery.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">The Cross Sectional Study was conducted at Department of Obstetrics &amp; Gynaecology, Jinnah<br>Postgraduate Medical Center, Karachi for duration of 6 months from 31st December 2020 to 30th June 2021.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">A total of 142 patients selected between the ages of 25 to 55 years of age were included. In this study all<br>patients were included who fulfilled the inclusion criteria undergoing obstetric(cesarean section) &amp; gynecological surgeries<br>(laparatomies &amp; hysterectomies). They were enrolled after taking written and informed consent. Risk factors for urological<br>injuries were assessed in terms of indication (risk for surgery), site of urologic injury, duration of surgery and time interval<br>after surgery. Patients having urological injury from other than obstetric and gynecologic surgeries and those who did not<br>give consent were excluded.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Age range in this study was from 25 to 55 years with mean age of 40.20 ± 6.92 years. Majority of the patients<br>77 (54.23%) were between 41 to 55 years of age. Mean duration of surgery was 62.16 ± 14.52 minutes. Mean time interval<br>after surgery was 37.51± 13.89 hours. In this study, frequency of ureteral injury, urinary bladder injury and mixed injury<br>in obstetrical and gynaecological surgery was found in 01 (0.70%), 19 (13.38%) and 01 (0.70%) patients respectively.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">This study concluded that knowledge of pelvic anatomy, careful dissection and patience in difficult cases are<br>the key factors to anticipate and prevent injury</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Impact of Clinical Expertise on Inferior Alveolar Nerve Block Anaesthesia Resulting in Transient Facial Nerve Palsy; A Cross-sectional Study Amid Pakistani Dental Graduates 2022-10-06T05:02:43-06:00 Rehan Ahmad Sabeen Masood Jehan Alam <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">The purpose of the study is to observe the impact of clinical expertise on inferior alveolar nerve block (IANB)<br>anaesthesia resulting in transient facial nerve palsy (FNP) in dental operators having different levels of clinical experience.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">This observational cross-sectional study was conducted in the Department of Dentistry, Jinnah Postgraduate<br>Medical Center. The study was conducted over a period of six months, starting from September 2021 and lasting till<br>February 2022. The patients who required IANB for any dental treatment in lower posterior teeth were divided into three<br>groups between dental operators: Undergraduates (Interns), Graduates (House Officers), and Postgraduate trainees, having<br>100 cases in each group. A structured questionnaire was administered through convenience sampling to dental operators.<br>Data was analyzed by using SPSS version 24.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">A total of 300 cases were part of the study. According to the results, 28% (n=84) of patients suffered from transient<br>facial nerve palsy following IANB. Out of this 84%, 15% (n=45 of total cases) were by Undergraduates (Interns), 10%<br>(n=30 of total cases) were caused by Graduates (Interns), and only 3% (n=9 of total) incidences happened following IANB<br>by Postgraduate trainees.<br></span><span class="fontstyle0">Conclusions: </span><span class="fontstyle2">The incidence of IANB-related facial nerve palsy (FNP) is comparatively more in junior dental operators,<br>which depicts their lack of clinical experience</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 An Assessment of Asymptomatic Bacteriuria During Pregnancy and Antimicrobial Resistance to its Common Bacterial Isolates in the Urine 2022-10-06T05:07:22-06:00 Sana Noor Ejaz Mahmood Noor Shahid Arooj ul Hassan Saba Noor <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">The objective of this study is to assess asymptomatic bacteriuria during pregnancy and its antimicrobial resistance<br>to the common bacterial isolates in the urine.<br></span><span class="fontstyle0">Study Design and Setting: </span><span class="fontstyle2">The cross-sectional study was carried out in the Antenatal Clinic, Obstetrics and Gynaecology<br>Unit of Avicenna Medical and Dental Hospital, Lahore, Pakistan.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">This descriptive, cross-sectional study lasted for nine months and information was collected with the help<br>of a self-designed questionnaire using non-probability random sampling. The frequency distribution of socio-economic<br>and demographic factors of 167 pregnant women was observed while the cultural examination was performed on urine<br>samples of diagnosed cases of asymptomatic bacteriuria through microscopy to find out antimicrobial resistance against<br>bacterial isolates.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The prevalence rate of asymptomatic bacteriuria was 13.2%. The most common pathogen was </span><span class="fontstyle3">E. coli </span><span class="fontstyle2">followed<br>by </span><span class="fontstyle3">Klebsiella Pneumoniae </span><span class="fontstyle2">and </span><span class="fontstyle3">Staphylococci</span><span class="fontstyle2">. Resistance of urine pathogens was observed against Ampicillin, Amoxiclav,<br>Norfloxacin, and Piperacillin/Tazobactam.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle3">E. coli </span><span class="fontstyle2">was identified as the most predominant pathogen that showed higher resistance to Cefotaxime. History<br>of renal stone, trimester, parity, education and low-socio-economic status were the significant factors for ASB</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Helicobacter Pylori Infection and Frequency of Clarithromycin Resistance by qPCR 2022-10-06T05:25:14-06:00 Samia Perwaiz Khan Rubina Ghani Safia Izhar Ajeet Kumar Ambreen Irshad Shaista Emad Aemen Moeen Ayesha Abbasi Maham Sattar Syed Sohaib Hasan <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">Determine the frequency of Helicobacter pylori (H. pylori) infection in our population, the response to triplequadruple regimen and resistance to clarithromycin.<br></span><span class="fontstyle0">Study Design and Setting</span><span class="fontstyle2">: Study design is case-series, Medicare Cardiac &amp; General Hospital, Karachi- 2020-2021. All<br>patients (N=110) were selected from outpatient department (OPD) of the Jinnah Medical College Hospital (JMCH) and<br>Medicare Cardiac and General Hospital.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">Patients with nausea, abdominal pain, diarrhea and IgG positive were included, and ELISA was done for<br>detection of H. pylori infection.. IgG negative for H. pylori and having other gastrointestinal infections were excluded from<br>this study. Patients positive with infection were prescribed the initial </span><span class="fontstyle2">triple /quadruple </span><span class="fontstyle2">regimen (triple regimen therapy<br>including Proton pump inhibitor (PPI) 20 mg, Metronidazole 400mg, Amoxicillin 250 mg or Quadruple therapy by adding<br>Bismuth subsalicylate). In ten cases of relapse Sequential / Rescue therapy were continued after a gap of 6 weeks included<br>PPI 20 mg, metronidazole 400mg ciprofloxacin 200mg BD or Levofloxacin 400 mg OD. The qPCR was performed for<br>the detecting resistant to clarithromycin in patients with H. pylori IgG positive after therapy.<br></span><span class="fontstyle0">Result: </span><span class="fontstyle2">During the follow-up, 60 (54%) cases were recovered from initial triple regimen, whereas 40(36%) cases recovered<br>quadruple therapy and remaining 10 (7%) had clarithromycin resistance and were prescribed sequential therapy replacing<br>clarithromycin by fluoroquinolones.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">The study showed that majority of H. pylori infected patient in our population recovered from initial<br>triple/quadruple regimen. The alternate option with clarithromycin resistant was sequential and rescue therapy with high<br>eradication rate.</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022 Aesthetic Anxiety in a Child with Cleidocranial Dysplasia 2022-10-06T06:17:43-06:00 Ayesha Shahid Arooj Aman Amna Malik <p><span class="fontstyle0">Cleidocranial dysplasia (CCD) is a rare syndrome that affects the skeleton and teeth. It is characterized by absent or<br>hypoplastic clavicles, mobile shoulder girdles, patent fontanelles, supernumerary teeth, retained deciduous and delayed<br>permanent teeth. A 10 year old boy with CCD is reported with chief complaints of aesthetics and dental pain. The bullying<br>and social agony at a tender age were alarming as the patient was highly distressed regarding his missing teeth. Juvenile<br>aesthetic concerns and the psychosocial impact were emphasized in this case. He was treated with manual scaling, pulp<br>therapy, restoration, and a prosthesis to speedily replace his missing teeth. Long-term orthodontic treatment was suggested.<br>Due to the early diagnosis, a better prognosis exists for multidisciplinary treatment. Counselling was pivotal for dealing<br>with his aesthetic anxiety and oral health. Special attention should be given to the aesthetics and psychosocial state of<br>patients with syndromes in underdeveloped societies</span> </p> 2022-10-06T00:00:00-06:00 Copyright (c) 2022