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The study was done to evaluate the accuracy of Demirijian Method when used for age determination in Pakistani children A retrospective study was carried out at the department of orthodontics. Forty patients of 8.5-17 years of age having normal morphology of teeth and willing to participate were included in the study and patients with missing teeth (extracted or naturally missing) or having any medical disorder were excluded. The mandibular left quadrant excluding 3rd molars was assessed. Central incisor to second premolar teeth were examined in OPG and a separate score was given to each tooth according to the stage of its development seen from the available tables The mean dental age ± SD evaluated by using Demirjian's method for the boys was 11.97± 2.38(8.5 to 16 years) whereas for the girls was 12.78 ± 2.64 (9 to 17 years).Dental age measured using Demirjian's technique for the female subjects was significantly over-estimated in the 9 year and 13-17 year age groups. It was concluded from the results of this study that Demirijian Method resulted in over-estimation of age when compared to chronological age of the subjects. [ABSTRACT FROM AUTHOR]

Objective: To determine the pattern of Biopsy Proven Renal Diseases (BPRD) in a single tertiary care centre in Islamabad, Pakistan. Study Design: Cross-sectional study. Place and Duration of Study: Department of Nephrology, KRL Hospital, Islamabad Pakistan, from Mar 2016 to Nov 2020. Methodology: The archival records of all native renal biopsies performed in adults (>18 years) were retrospectively analyzed. The biopsies were performed according to standard indications and evaluated by light microscopy and immunofluorescence. Results: A total of 134 renal biopsies were studied. Among these, 85(61.1%) were males, and 49(36.5%) were females. The mean age was 44.70±14.63 years. Primary glomerulonephritis's were the predominant group of diseases found in 93(69.4%) cases. Membranous nephropathy (MN) was the most common lesion in 52(38.8%), followed by focal segmental Glomerulosclerosis (FSGS) in 22(16.4%) cases. Chronic tubulointerstitial nephritis (Ch. TIN) 12(9.0%) was the third most common lesion among all biopsies. Other diagnoses included lupus nephritis (LN) 10(7.5%) and IgA nephropathy (IgAN) 9(6.7%). One sample one-sided t-test was used to estimate the minimum proportion of occurrence of different biopsies in our concerned population. The estimated minimum proportion of membranous nephropathy (MN) was 0.31, with a p-value of 0.034. Conclusion: We concluded that primary Glomerulonephritis (PGN) is the most common renal disease, and membranous nephropathy is the most common biopsy-proven Glomerulopathy in our concerned population. [ABSTRACT FROM AUTHOR]

Solid polymer electrolytes (SPEs) are the best choice to replace liquid electrolytes in supercapacitors, fuel cells, solar cells and batteries. The main challenge in this filed is the ionic conductivity and thermal stability of SPEs which is still not up to mark, therefore more investigations are needed to address these issues. In this study, PVA/salt based SPEs was fabricated using both solution cast and electro-spinning methods to probe the effect of different salts such as (NaCl, KCl and KI) and their concentrations on the ionic conductivity. Scanning electron microscopy (SEM) x and Fourier Transform Infra-Red (FTIR) have been employed to study the morphology as well as the different functional groups of SPEs, respectively. It was noted that small addition of NaCl, KCl and KI salts in SPEs dramatically increased the ionic conductivity to 5.95×10−6, 5.31×10−6 and 4.83×10−6 S/cm, respectively. Importantly, the SPEs obtained with NaCl via electro-spinning have higher ionic conductivity (5.95×10−6 S/cm) than their casted SPEs (1.87×10−6 S/cm). Thermal stability was also studied at two different temperatures i.e. 80 °C and 100 °C. The weight loss percentage of electrospun SPEs have zero percent weight loss than the solution based SPEs. The combined results clearly indicated that the nature of salt, concentration and fabrication process play a vital role in the ionic conductivity. Also, the NaCl salt with low molecular weight at low concentrations shows an enhanced ionic conductivity. [ABSTRACT FROM AUTHOR]

Objective: To assess the frequency of pain and withdrawal movements after injection of rocuronium and effects of pre-treatment with lignocaine. Study Design: Double blind study. Duration of Study: This study was of six months duration and was carried out from March 2004 to September 2004. Setting: Combined Military Hospital Kharian. Patients and Methods: One hundred and twenty unpremedicated patients with ASA grade I and II, aged between 18-60 years and of both sexes were enrolled in the study. Patients were randomly divided into two groups of 60 patients each. After induction of anaesthesia with thiopentone, patients in group A received 3 ml of lignocaine plain while those in group B, received 3 ml of normal saline as pre-treatment before injection of rocuronium. Their effects on pain on injection and withdrawal movements of the arm were studied. Results: Out of total of 120 patients, only 17 patients (14%) developed withdrawal movements of the arm or wrist. In Group A, who received lignocaine plain before rocuronium injection, only 3 patients out of 60 patients had withdrawal movements while in Group B, who received normal saline as pre-treatment fourteen out of 60 patients developed withdrawal movements of the arm or wrist. Only one patient belonging to Group B experienced pain. Conclusions: Pretreatment with lignocaine plain greatly reduces the chances of withdrawal movements and pain on injection of rocuronium. [ABSTRACT FROM AUTHOR]

Background: Abnormally adherent placenta is a condition in which all or part of the placenta is adherent to the uterine wall because of myometrial invasion by chorionic villi. In majority of cases chorionic villi are in contact with the myometrium i.e. placenta accretes. Objective: To detect the prevalence of morbidity adherent placenta and its outcome in terms of maternal morbidity and mortality. Period: Over one year from October 2006 to October 2007. Setting: Gynaecology Unit-II, Nishtar Hospital, Multan. Material and methods: All women who had pregnancy complicated by morbidity adherent placenta were identified and their case notes retrieved. Information was collected on a prescribed Performa designed for this purpose. Results: There was 2114 deliveries during the study period in labour ward of Nishtar Hospital, Multan. Eight women fulfilled the study criteria. The prevalence was found to be 0.4%. Complications were PPH, acute renal failure, depression, cellulities of wound site and UTI. Conclusion: Due to rising rate of LSCS in present era, the prevalence adherent is also on raise. [ABSTRACT FROM AUTHOR]

Abstract: Effect of Pr–Ni substitution on structural and magnetic properties of Ca0.5Ba0.5−x Pr x Ni y Fe12−y O19 (x=0.00–0.10 and y=0.00–1.00) prepared by the sol–gel auto combustion method were investigated. The XRD analysis confirmed the single phase M-type hexa-ferrite structure. The lattice parameters were found to increase as Pr–Ni content increases, which is attributed to the ionic size of the implicated cations. The Pr–Ni seems to be completely soluble in the lattice. Transmission electron microscopy reveals that the grain size decreases with increase of Pr–Ni substitution. The coercivity and remanent magnetization ranges from 1511 to 1925 (Oe) and 21.4 to 26.5 (emu/g), respectively. The coercivity values of all the samples fall in the range of M-type hexa-ferrites. [Copyright &y& Elsevier]

Objective: The study aimed to document the impact of interpersonal communication (IPC) activities on increasing volume of family planning clients, new users, long term contraceptive uptake, post-partum, and post abortion family planning uptake at the associated health facilities of the Sabz Sitara Network., Methodology: A comparative secondary analysis of retrospective programme service delivery data from two groups of providers was performed. The exposure variable is defined as receipt of IPC. The six outcome variables are volume of: family planning (FP) clients, FP clients less < 25 years, intra-uterine device (IUD) insertions, post-partum FP clients (PPFP), users, and post-abortion FP (PAFP) clients., Results: The increase in client volume in IPC supported providers is significant for all the FP outcomes when adjusted for provider qualification and location. The adjusted model shows a significant increase of 10 more FP clients, 2 more youth clients and IUD insertions each, 3 more new users, and 1 more client for post abortion services., Conclusions: The IPC intervention has a positive and significant impact on increasing client volume for all related FP outcomes at the associated provider facilities. Location and qualification of providers seem to moderate the impact. Considering qualification, and geo-social demographics of the area to tweak intervention intensity and design will help amplify the associated beneficial outcomes and minimize underperformance. To maximize return on investment, subsequent evaluations should help determine the ideal time frame required to achieve and sustain the positive results.

Objective: Combination of beneficiary and supply side factors for determining what influences Postpartum family planning use in Sindh and Punjab provinces of Pakistan., Methods: A facility-based survey was conducted among 1690 married women of reproductive age (MWRA - i.e. married women between the ages of 15 and 49 years) visiting public facilities in six districts across Sindh and Punjab provinces of Pakistan., Results: Half (53%) of the interviewed women used postpartum contraceptives. Participants who used PPFP were: 55% more likely to be from Punjab than Sindh, 39% more likely to be between 25 to 34 year of age than under 25 years. After adjusting for all variables in the model, women who delivered in the private sector remained to have lower odds of PPFP use compared to those who delivered in public facilities. Women who had four or more sons were nearly 20 time more likely to use PPFP compared to women with no sons, and the PPFP use increases with the number of sons. On the contrary, women who had four or more daughters were 16 times less likely to use PPFP compared with women with no daughters., Conclusions: Postpartum women are among those with the greatest unmet need as a result of a combination of beneficiary and supplier side factors. The health system's response to meet the contraceptive needs of postpartum women should work along the continuum of care from pregnancy to postpartum, with expanded method choice and alternative service delivery outlets.

Despite severe health and economic consequences that women face because of the negative attitude of healthcare providers towards safe abortion and post-abortion care (SA/PAC), no psychometric tool has yet been validated for assessing the attitude towards SA/PAC. Only a handful of studies have attempted to assess healthcare providers' attitude towards safe abortions in Pakistan. Therefore, this study aimed to develop and validate a psychometric scale to assess attitude towards safe abortions in Pakistan. The study collected data from 106 workers of an NGO that provides SA/PAC through an online and anonymous survey using the organisation's network. The study used factor analytic techniques and structural equation modelling to validate the factor structure and a final hierarchical model. A final scale of seven items relating to attitude towards elective abortions and moral attitude towards safe abortions was validated. The scales were highly reliable with both factors having reliability indicators greater than 0.7. The scale can be easily implemented to assess providers' attitude towards safe abortions. This will allow programmers to screen healthcare providers with a negative attitude, and evaluate the efficacy of their Value Clarification and Attitude Transformation (VCAT) programmes that are aimed at transforming providers' attitude towards safe abortions.

Background: Pakistan has had a low contraceptive prevalence rate for the last two decades; with preference for natural birth spacing methods and condoms. Family planning services offered by the public sector have never fulfilled the demand for contraception, particularly in rural areas. In the private sector, cost is a major constraint. In 2008, Marie Stopes Society - a local NGO started a social franchise programme along with a free voucher scheme to promote uptake of IUCDs amongst the poor. This paper evaluates the effectiveness of this approach, which is designed to increase modern long term contraceptive awareness and use in rural areas of Pakistan., Methodology: We used a quasi-experimental study design with controls, selecting one intervention district and one control district from the Sindh and Punjab provinces. In each district, we chose a total of four service providers. A baseline survey was carried out among 4,992 married women of reproductive age (MWRA) in February 2009. Eighteen months after the start of intervention, an independent endline survey was conducted among 4,003 women. We used multilevel logistic regression for analysis using Stata 11., Results: Social franchising used alongside free vouchers for long term contraceptive choices significantly increased the awareness of modern contraception. Awareness increased by 5% in the intervention district. Similarly, the ever use of modern contraceptive increased by 28.5%, and the overall contraceptive prevalence rate increased by 19.6%. A significant change (11.1%) was recorded in the uptake of IUCDs, which were being promoted with vouchers., Conclusion: Family planning franchise model promotes awareness and uptake of contraceptives. Moreover, supplemented with vouchers, it may enhance the use of IUCDs, which have a significant cost attached. Our research also supports a multi-pronged approach- generating demand through counselling, overcoming financial constraints by offering vouchers, training, accreditation and branding of the service providers, and ensuring uninterrupted contraceptive supplies.

A rare case of parapharyngeal abscess caused by Streptococcus pneumoniae presenting as neck abscess is reported. The patient had 20 days history of cough, fever and swelling behind right ear. He had not responded to multiple antibiotic treatments given earlier. On the basis of clinical examination and CT scan finding, he was diagnosed as having parapharyngeal abscess pointing in the neck. The abscess was drained and the patient was treated with injectable Ceftriaxone, due to identification of penicillin - resistant Streptococcus pneumoniae.

Objective: To determine clinico-pathological profile and outcome of inhalational burns in a specialized burns treatment unit., Study Design: Case-series., Place and Duration of Study: The Department of Plastic Surgery and Burns Centre Unit, Combined Military Hospital, Kharian Cantonment in March 2005., Methodology: Patients of inhalational burns were included and evacuated within 30 hours of accident to the specialized burns centre after immediate resuscitation. Total Body Surface Area (TBSA) involved in burns was calculated. Complete blood count and renal profile along with serum albumin and total proteins was obtained. Portable chest radiographs and bronchoscopic examination was conducted. Escarotomies were carried and wounds were covered with split thickness skin grafts. Ventilatory support was used as needed. Comparison of the clinico-pathological profile of surviving and fatal cases was done for significance using t-test., Results: There were 19 patients of inhalational burns, 8 (42%) of whom expired. The mean percentage of TBSA in 11 surviving patients was 50+/-10.87 and 70+/-15.46 in fatal cases. The mean haemoglobin (Hb) on admission was 15.8+/-1.6 g/dL and after fluid resuscitation it became 11.4+/-1.5 g/dL. The mean Total Leucocyte Count (TLC) in surviving patients was 9.6+/-6.1 x 10(9)/L and 1.5+/-2.3 x 10(9)/L in fatal cases (p=0.001). The mean platelet count of surviving patients was 205+/-63 x 10(12)/L while in fatal cases was 58+/-48 x 10(12)/L (p=0.05). The serum urea levels in surviving patients was 4.3+/-2 mmol/L while in fatal cases was 8.6+/-0.9 mmol/L (p=0.05). The serum creatinine levels were 98.2+/-16.5 micromol/L in the survivor group and 249.5+/-76 micromol/L in the mortality group (p=0.05). The serum total protein in surviving patients was 63+/-8 g/dL while in mortality cases it was 57+/-7 g/L. Serum albumin in the survivor group was 36.7+/-5 g/L and 35+/-4 g/L in fatal cases. Significant in Hb, protein and albumin levels. All the expired patients had acute respiratory distress syndrome while acute renal failure with multi-organ failure co-existed in 6 patients., Conclusion: Inhalational burns injury cases multi-system injury with high mortality. Body area involvement, total leucocyte count, platelet count, serum area and serum creatinine are important indicators of survival.