Journal of Bahria University Medical and Dental College <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 <a href=";id=912636#journal_result">Higher Education Commission of Pakistan</a> (HEC)</strong></p> <p><strong>There are no processing and publication charges for article processing and publication.</strong></p> Bahria University Medical and Dental College en-US Journal of Bahria University Medical and Dental College 2220-7562 <p><em><strong>Journal of Bahria University Medical &amp; Dental College</strong></em> is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit <em><a href="" target="_blank" rel="noopener"></a></em> <img src="" alt="" width="88" height="31" /></p> Esthetic and Cost Effective Management of Young Female with Moderate Fluorosis Using Microabrasion; <p><span class="fontstyle0">Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics or dental pain.<br>Discolorations have significant social and esthetic effects. Fluorosis is one of the most common cause. It is prevalent in<br>different areas of Pakistan. Microabrasion was selected for treatment of discoloration in this case report. Microabrasion<br>was performed using slurry made by combining 37% phosphoric acid and pumice. This slurry was applied on the labial<br>tooth surface and mechanically rubbed with a prophylaxis brush in a slow hand piece for a minute, with gentle pressure.<br>The cycle was performed thrice followed by fluoride application. The results of this conservative treatment were satisfactory<br>and patient was satisfied with the esthetic outcome.</span> </p> Umeed Jawaid Muhammad Rizwan Nazeer Ayesha Jawed Meisha Gul Copyright (c) 2022 Umeed Jawaid, Muhammad Rizwan Nazeer, Ayesha Zafar, Meisha Gul 2022-04-01 2022-04-01 12 02 112 114 10.51985/JBUMDC2021119 Air Pollution and Health Hazards: A Menacing Situation in Pakistan <p><span class="fontstyle0">With the increasing urbanization and industrialization<br>around the globe, the problem of air pollution is also<br>increasing exponentially. At one end it is causing depletion<br>of ozone layer and global warming and on the other side<br>responsible for health related issues</span> </p> Iqbal Hussain Udaipurwala Copyright (c) 2022 Iqbal Hussain Udaipurwala 2022-04-01 2022-04-01 12 02 66 67 10.51985/JBUMDC2021108 Lack of Awareness About Obstetrics Physical Therapy in Pakistan <p><span class="fontstyle0">This letter aims to explain the role of obstetrical physical<br>therapy in pregnancy to highlight the awareness related to<br>physical therapy in Pakistan</span> </p> Rabia Khan Muhammad Usman Ghousia Shahid Copyright (c) 2022 Rabia Khan, Muhammad Usman, Ghousia Shahid 2022-04-01 2022-04-01 12 02 115 115 10.51985/JBUMDC2021105 Effects of Chemical Composition of Cholesterol and Pigment Stones on the Gallbladder Mucosa <p><span class="fontstyle0">Objective</span><span class="fontstyle1">: To compare the effect of chemical composition of cholesterol and pigment stones on gallbladder mucosa.<br></span><span class="fontstyle0">Study design &amp; setting: </span><span class="fontstyle1">This comparative cross-sectional study was conducted in the Department of Anatomy, BMSI,<br>JPMC, Karachi, Pakistan, from April to September 2021.<br></span><span class="fontstyle0">Methodology</span><span class="fontstyle1">: Total n= 120 gallbladder specimens were collected after cholecystectomies in 10% formalin. Gross<br>morphological features of gallbladder and stones were observed. Specimens were processed and 5µm sections from fundus,<br>body &amp; neck of gallbladder were stained and examined for microscopic changes. Chemical analysis of stones was carried<br>out to differentiate between cholesterol &amp; pigment stones.<br></span><span class="fontstyle0">Results</span><span class="fontstyle1">: We evaluated different histomorphological alterations in gallbladder with reference to both type of gallstones.<br>Muscular wall thickness in pigment stone group was noted to be (143.89±78.66) and in cholesterol group (158.37±83.95).<br>Both pigment and cholesterol stone showed increased tendency of muscular hypertrophy. Mucosal ulceration, chronic<br>inflammatory cell infiltration, capillary congestion and hyperplasia (p-value: 0.04) were observed in both type of stones.<br>Statistical analysis showed that large cholesterol stones produce significant histopathological changes (p-value: 0.004);<br>greater the size of stone, more profound was the mucosal hyperplasia. Rokitansky-Ashcoff sinuses were predominant in<br>gallbladders with cholesterol stone.<br></span><span class="fontstyle0">Conclusion</span><span class="fontstyle1">: Gallstones cause series of histopathological changes ranging from chronic cholecystitis to pre-malignant and<br>malignant changes. Hyperplasia was observed to be more frequent with long standing, large cholesterol stones</span> </p> Sanum Ali Shahid Rasul Surrendar Dawani Sarah Zahid Sehrish Hussain Ovais Sarwar Tanweer Fatima Zainab Tariq Copyright (c) 2022 Sanum Ali, Shahid Rasul, Surrendar Dawani, Sarah Zahid, Sehrish Hussain, Ovais Sarwar, Tanweer Fatima, Zainab Tariq 2022-04-01 2022-04-01 12 02 68 72 10.51985/JBUMDC202195 Frequency of Esthetic and Periodontal Complications in Patients of Metal Ceramic Fixed Dental Prosthesis <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To determine frequency of complications in patients with fixed metal-ceramic dental prosthesis<br></span><span class="fontstyle0">Study Design &amp; Setting: </span><span class="fontstyle2">A cross-sectional study was designed and conducted on 141 post-treatment patients of Fixed<br>Dental Prosthesis (FDPs) at Armed Forces Institute of Dentistry, Rawalpindi, Pakistan from Sept 2019 to Feb 2020.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">This study analyzed the results of 141 patients whose records were completed during study duration of 06<br>months at Department of Prosthodontics, Armed Forces Institute of Dentistry, Rawalpindi. Patients were called at three<br>months follow up after provision of fixed dental prosthesis. Intraoral examination for presence of esthetic and periodontal<br>complications was done by inspection, palpation and probing. Complications were graded according to severity.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Esthetic complications with FPDs were observed in 13.47% (n=19) of the subjects, periodontal complications<br>were encountered in 9.2% (n=13) and 77.3% (n = 109) showed no complications at all. No significant difference was<br>observed in terms of type of complication encountered between males and females or between different age groups.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Complications in patients of metal-ceramic FDPs were observed in 22.7% patients only, of which 13.47%<br>were esthetic and 9.2% were periodontal complications.</span> </p> Moiza Ijaz Saira Ibrahim Ammara Sharafat Sameena Younis Ayesha Satti Abdul Rehman Copyright (c) 2022 Moiza Ijaz, Saira Ibrahim, Ammara Sharafat, Sameena Younis, Ayesha Satti, Abdul Rehman 2022-04-01 2022-04-01 12 02 73 76 10.51985/JBUMDC2021104 Anatomical Variations of Vermiform Appendix on Plain MDCT and Its Association with Acute Appendicitis in Adult Urban Population of Karachi, A Tertiary Care Hospital Experience <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To evaluate the anatomical positions of vermiform appendix and its association with acute appendicitis on<br>Multidetector computed tomography (MDCT).<br></span><span class="fontstyle0">Study design and setting: </span><span class="fontstyle2">A cross sectional study based on hospital database was carried out in Department of Anatomy<br>in collaboration with Department of Radiology, Liaquat National Hospital.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">A total of three hundred and six 306 adult urban patients CT axial images were evaluated retrospectively<br>over period of 6 months from March 2021 to August 2021 who had abdominal MDCT scan for acute abdomen after getting<br>approval from ethical committee to find out anatomical variations of position of vermiform appendix in a tertiary care<br>hospital among adult urban Karachi population and its association with appendicitis. Data was analyzed using SPSS version<br>25. All categorical variables were summarized as frequencies and percentages.<br></span><span class="fontstyle0">Result: </span><span class="fontstyle2">In present study 159(52%) were males and 147(48%) were females with mean age of 32.97 years. The subcecal<br>anatomical position of vermiform appendix on MDCT was most common n=85(27.8%), followed by postileal n=78(25.5%),<br>pelvic n=61(19.9%), postcecal n= 36(11.8%), preileal n=29(9.5%), ectopic n=17(5.6%). The association between appendicitis<br>with anatomical position of vermiform appendix and age was analyzed by chi- square and was statistically significant (p<br>=0.05). There was no significant association between position of vermiform appendix on MDCT and gender.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">The subcecal position of vermiform appendix is most common on MDCT and the postileal position was more<br>frequent in the inflamed group of vermiform appendix</span> </p> Lubna Faisal Rizwan Ajmal Fatima Rehman Zia ul Islam Sadia Abdul Qayyum Saima Athar Copyright (c) 2022 Lubna Faisal, Rizwan Ajmal, Fatima Rehman, Zia ul Islam, Sadia Abdul Qayyum, Saima Athar 2022-04-01 2022-04-01 12 02 77 82 10.51985/JBUMDC2021118 The Effect of an Educational Intervention on COVID-19 Awareness, Preventive Behaviors, and Risk Perceptions among Secondary School Students <p><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To determine the impact of an educational intervention on secondary school students' Covid-19 awareness<br>and risk perception, as well as their preventive practices.<br></span><span class="fontstyle0">Study design and settings: </span><span class="fontstyle2">A quasi-experimental study conducted in private secondary schools</span><span class="fontstyle3">.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">The study duration was two months. Students who gave consent and didn’t have COVID-19 infection in<br>past were included by non-probability purposive sampling. Raosoft sample size calculator was used to calculate the sample<br>size and it came out to be 385 but a total of 380 students could be enrolled. Among these, 37 responses were invalid making<br>the total sample size to be 343. Ethical approval was taken from the institutional ethical review committee with approval<br>letter number i.e. ERC/ID/126. SPSS version 25 was used for the analysis of data. Frequencies and percentages were<br>calculated. Paired samples T-test was applied to see the difference in participants’ scores before and after the intervention.<br>A p-value = 0.05 was taken as significant.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The knowledge of students were improved from moderate to high level and the total percentile score from 74.86%<br>to 89.76% after intervention. Their practicing preventive behaviors were at a low level with scores of 69.37%. Their risk<br>perceptions remained at moderate levels and did not see any improvement.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">Participants practicing preventive behaviors were at a low level. Their knowledge scores improved from<br>moderate to high level after intervention but their risk perceptions remained at moderate levels and no change was seen</span> </p> Sadia Ibrar Khan Mohi Ud Din Syed Fawad Mashhadi Shamaila Mohsin Samreen Misbah Muhammad Mushtaq Ahmed Khan Copyright (c) 2022 Sadia Ibrar Khan, Mohi Ud Din, Syed Fawad Mashhadi, Shamaila Mohsin, Samreen Misbah, Muhammad Mushtaq Ahmed Khan 2022-04-01 2022-04-01 12 02 83 87 10.51985/JBUMDC202205 Association of Resistin with Components of Metabolic Syndrome in Our Local Population <p><span class="fontstyle0">Objective: </span><span class="fontstyle2">To investigate the association of resistin with components of metabolic syndrome (MetS) in our local population.<br></span><span class="fontstyle0">Study design &amp; setting: </span><span class="fontstyle2">Case-control study, Medical OPD; Lyari General Hospital Karachi (from 15</span><span class="fontstyle2">th </span><span class="fontstyle2">July 2020 till 15</span><span class="fontstyle2">th<br></span><span class="fontstyle2">December 2020).<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">A total of 164 subjects (83 cases &amp; 81 controls) between the age ranges of 35-65 years were selected.<br>Subjects with metabolic syndrome were included in concordance with International Diabetes Federation criteria. Serum<br>resistin levels in both cases and controls were compared. SPSS 20 was used for statistical analysis. Eighty-three patients<br>with metabolic syndrome were enrolled and compared with 81 healthy unmatched controls. Obesity indices, blood pressure,<br>lipid profile, fasting blood sugar, insulin resistance and serum resistin levels were evaluated. Predictive values of resistin<br>for MetS were analyzed using odds ratios.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">Significantly elevated levels of resistin were found in subjects with metabolic syndrome compared to healthy<br>controls (8.23±4.43 vs 6.82±3.64 ng/mL, p&lt;0.05). The odds ratio (95% confidence interval) for metabolic syndrome in<br>subjects having higher resistin were: males:2.62[1.11–6.19], females: 2.81[1.05–7.49], all P</span><span class="fontstyle2">trend</span><span class="fontstyle2">&lt;0.05.For individual<br>components of metabolic syndrome, we found the odds ratio to be greatest for hypertension, fasting blood sugar, and insulin<br>resistance; 2.64, 4.83, 2.85, respectively, all P</span><span class="fontstyle2">trend</span><span class="fontstyle2">&lt;0.05.<br></span><span class="fontstyle0">Conclusion: </span><span class="fontstyle2">The present study suggests significant association of resistin with components of metabolic syndrome such<br>as hypertension, fasting blood sugar, and insulin resistance. Compared to healthy controls, subjects with MetS had significantly<br>higher resistin levels. Further research is required to incorporate this biomarker in clinical setting.</span> </p> Mozaffer Rahim Hingorjo Muhammad Noman Rashid Naila Parveen Lubna Riaz Riaz Ahmed Shahid Zainab Hasan Copyright (c) 2022 Mozaffer Rahim Hingorjo, Muhammad Noman Rashid, Naila Parveen, Lubna Riaz, Riaz Ahmed Shahid, Zainab Hasan 2022-04-01 2022-04-01 12 02 88 92 10.51985/JBUMDC2021131 Efficacy of Prophylactic Phenylephrine in Prevention of Hypotension in Parturient Undergoing Spinal Caesarean Section <p><span class="fontstyle0">OBJECTIVE:<br></span><span class="fontstyle1">To determine the hemodynamic (pulse, blood pressure) stability of prophylactic bolus dose of phenylephrine in caesarean<br>section under spinal anaesthesia.<br></span><span class="fontstyle0">Study design &amp; Setting: </span><span class="fontstyle1">Interventional study was done from 13</span><span class="fontstyle1">th </span><span class="fontstyle1">Feb 2021 to 07</span><span class="fontstyle1">th </span><span class="fontstyle1">Oct 2021 at Islam Teaching Hospital,<br>Sialkot.<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle1">Study approval was taken vide letter no.2021-05/AN dated 26-3-2021, issued by Chairman Ethical Review<br>Board, Islam Medical College, Sialkot. Statistical software(version. with (prob of 0.80, critical </span><span class="fontstyle1">2 </span><span class="fontstyle1">value 15.08),<br>was employed and sample size calculated to be 200 cases i.e. groups-I (injection phenylephrine 100µgm) and group-II<br>(placebo) divided by lottery method into 100 each given at spinal neuraxial block. Primary study variable being heart rate<br>and blood pressure variations. Spearman’s Rank correlation statistical test was used to check interdependence between the<br>two variables i.e., systolic blood pressure and pulse rate. SPSS version 21 was used.<br></span><span class="fontstyle0">Results</span><span class="fontstyle1">: In group-II, in 36% cases atropine was given as compared to 24% cases in group-I, thus 150 % more anti-cholinergic<br>was used in group-II. In group-II, in 33% cases top-up of injection Adrenaline 10 microgram was used whereas given in<br>24% cases in group-I, thus 137.5 % more top-ups of vasopressors in group-II. In group-I, heart rate decreased by value<br>of 9.02 % with respect to baseline value, while comparable reading noted was 3.42% decline in pulse rate in group-II<br>respectively.<br></span><span class="fontstyle0">Conclusion</span><span class="fontstyle1">: Prophylactic phenylephrine at time of spinal injection resulted in stable blood pressure and pulse rate values<br>in caesarean spinal delivery.</span> </p> Muhammad Salman Maqbool Copyright (c) 2022 Muhammad Salman Maqbool 2022-04-01 2022-04-01 12 02 93 99 10.51985/JBUMDC2021113 Are Patients Satisfied with Healthcare Services in Hospitals? Which Dimensions Influence it? <p><span class="fontstyle0">Objectives: </span><span class="fontstyle2">To determine the patient satisfaction with health care services provided in hospitals, disregard of whether<br>private or public<br></span><span class="fontstyle0">Methodology: </span><span class="fontstyle2">A cross-sectional online survey was conducted from January to October 2020 who had utilized health<br>services from private or public hospitals. A questionnaire was used for assessing the satisfaction in various dimensions;<br>Likert scales were used for quantifying the level of satisfaction. A formal approval of ERC from the parent institution and<br>informed consent was sought. The sample size was 384 keeping the expected satisfaction at 50%; non-probability sampling<br>was done. Multiple variables were used to assess patient satisfaction. They were grouped into four thematic areas, and a<br>mean score was given to each.<br></span><span class="fontstyle0">Results: </span><span class="fontstyle2">The mean age of participants was 25.19 ± 6.99</span><span class="fontstyle0">. </span><span class="fontstyle2">More than half of the participants (59.9%) visited a private<br>hospital compared to only 27% visiting a government hospital. Overall, 257 (88.9%) participants were satisfied with their<br>previous visit. The satisfaction levels varied with various dimensions; with quality of doctor 73.2%; the environment and<br>basic facilities 76.8%; the process of seeking care - 57.4%; and with medicine and diagnostic facilities 67.4%.<br></span><span class="fontstyle0">Conclusion</span><span class="fontstyle2">: Three-quarters of the study population were satisfied with their last hospital visit. The perceived quality of<br>doctors, the ambiance and hospitals' general facilities make a difference in patients' satisfaction. The follow-up visits and<br>compliance with the treatment are influenced by how satisfied one is with the last visit.</span> </p> Neelam Jawed Qureshi Inayat Hussain Thaver Omer Shahid Manahil Khalid Zuhaib Arshad Munza Yusuf Mashal Sarwar Hafiz Hussain Wara Fatima Copyright (c) 2022 Neelam Jawed Qureshi, Inayat Hussain Thaver, Omer Shahid, Manahil Khalid, Zuhaib Arshad, Munza Yusuf, Mashal Sarwar, Hafiz Hussain, Wara Fatima 2022-04-01 2022-04-01 12 02 100 105 10.51985/JBUMDC202131 Angry Gut: Irritable Bowel Syndrome <p><span class="fontstyle0">Irritable bowel syndrome (IBS) is a functional disorder of the intestine characterized by abdominal pain and altered bowel<br>habits. At present, no biological marker has been identified. Hence, the disease is clinically assessed on the basis of the<br>symptoms according to </span><span class="fontstyle2">ROME </span><span class="fontstyle0">IV criteria. Epidemiological data revealed that the prevalence of IBS varies widely around<br>the world, and more thorough research is needed to pinpoint any discrepancies that may exist between countries, as well<br>as possible reasons. Both pharmacological and non-pharmacological therapy is being used in order to treat IBS. There is<br>no specific treatment for irritable bowel disease that has come across the patients and only possible measures have been<br>taken to treat the severity of symptoms. Symptomatic treatment with spasmolytic agent like mebeverine has been considered<br>a standard therapy to relieve pain but to deal with constipation and diarrhea different treatment modalities have been adopted<br>by the physician</span> </p> Izrum Shafi Rajput Syed Ijaz Hussain Zaidi Muhammad Sajid Abbas Jaffri Syed Wajahat Hasib Kashif Razaq Copyright (c) 2022 Izrum Shafi Rajput, Syed Ijaz Hussain Zaidi, Muhammad Sajid Abbas Jaffri, Syed Wajahat Hasib, Kashif Razaq 2022-04-01 2022-04-01 12 02 105 111 10.51985/JBUMDC2021112