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Background: Testicular torsion (TT) is a medical emergency that requires immediate attention to prevent testicular injury. It is crucial for parents to be aware of this condition, as early recognition and timely medical attention can significantly improve the outcome for affected individuals. This study aimed to assess the level of awareness and knowledge of TT among parents in the Aseer region of Saudi Arabia using a survey-based approach. Methods: The survey included questions about the participants' awareness of TT, its symptoms, risk factors, and recommended management. The findings of the study revealed a significant lack of parental awareness and knowledge regarding TT in the Aseer Region of Saudi Arabia. Results: The survey showed that 62.9% of parents were unsure and unable to differentiate a normal testicle. However, the majority (82.0%) believed that society needs to be more aware of TT and 75.6% expressed concern about the possibility of their child experiencing TT. Conclusion: Efforts should be made to educate parents about the condition, its symptoms, and the importance of timely intervention to prevent testicular damage. Increasing awareness can lead to early recognition and appropriate medical care, reducing the risk of complications associated with TT. [ABSTRACT FROM AUTHOR]

Background: Besides knowing the prevalence of urinary incontinence (UI), it is also vital to know its risk factors and how many patients will seek treatment. UI affects women's quality of life considerably, but the severity and impact on quality of life differ significantly. Postpartum urinary incontinence (p-UI) reported a wide range ranging from 3% to 40%. It is essential to estimate the prevalence of postpartum incontinence accurately. Methods: We conducted a cross-sectional study of consented females of childbearing age with previous delivery and complaints of p-UI from August to December 2022. Experts developed a questionnaire form after a literature review of similar articles. Data have been collected from attendants of obstetrics and gynecology departments at three leading hospitals in the region after obtaining consent for direct interviews and answering the questionnaire. Results: One hundred and seventy-six females with UI agreed to be included in the study. Participants age ranged from 18 to 50 years old, with a mean of 32.1 ± 6.8 years. Of 103 (58.5%) had previous 1–3 deliveries and 33 (18.8%) had previous deliveries of 6 times or more. The most reported type of delivery was normal vaginal delivery (NVD) among 115 (65.3%), whereas 24 (13.6%) had both NVD and cesarean section. Exact 44.3% of the females complained of urinary frequency. Furthermore, 37.5% felt an urgent need to empty the bladder, and 35.2% had frequent lower abdomen pain. Urgency was reported by 34.1% of the females, and 26.7% complained of experiencing a minimal amount of urinary incontinence (urine drops). Conclusions: The prevalence of p-UI about one-third of the participants in southern Saudi Arabia with mixed UI was the most common type. Moreover, old age, multiparity, and high BMI were significant risk factors. [ABSTRACT FROM AUTHOR]

Objective: To evaluate total mechanical gastroesophageal anastomosis in patients with carcinoma of esophagus. Study Design: Cross sectional study. Place and Duration of Study: Department of Surgery, Bolan Medical University, from Jan 2020 to Jun 2021. Methodology: Total of 75 patients were included consecutively in this observational cross sectional study involving patients diagnosed with esophageal cancer and awaiting to undergo esophagiectomy with mechanical anastomosis in-between 18 to 60 years and were ASA I and II were included. Patients that were ASA III or IV and having any systemic disorder and those that refused to participate were excluded. SPSS version 23.0 was used for data analysis keeping p-value <0.05 as significant. Results: Mean age of patients was 58.31 ± 6.2 years wherein 42(56%) males and 33(44%) females. 29 (38.7%) of patients were ASA I while 46 (61.3%) were ASA II. Mean operative time of patients was 240 ± 65.2 minutes while mean blood loss was 205 ± 32.3 ml. Regarding anastomotic leakage, minor (type I) leakage was observed in 05(6.7%) of patients while major (type II or III) leakage was seen in 03(4%) of patients. Anastomotic dilatation, stricture formation and death were reported in 01(1.33%) patient each. Conclusion: Total mechanical gastro-esophageal anastomosis was found to have safe, less time consuming and with minimal post-operative anastomotic leakage or stricture formation and morbidity. [ABSTRACT FROM AUTHOR]

Background: A significant number of patients are treated by doctors in the emergency room due to the rising incidence of catastrophic chest injuries. For the treatment of pneumothorax, hemothorax, and hemopneumothorax resulting from chest trauma, a tube thoracostomy is a vital life-saving procedure. Objective: To outline potential issues with Thoracostomy tube insertion and typical pitfalls in managing the underwater seal system. Methodology: This retrospective study was carried out at General / Thoracic Surgery Department of Hayatabad Medical Complex Peshawar between July 2020 and December 2021. Total 300 patients were included in this study. Complications related to the thoracostomy tube insertion and mistakes practiced by the medical staff regarding the management of thoracostomy tube and its system were documented and analyzed. Results: There were 22 (7.3%) complications were related to tube insertion, 13 (4.3%) iatrogenic lung injuries occurred during the insertion process, followed by diaphragmatic injury 4 (1.3%), intercostal vessel injury 3 (1%) & liver injury 2 (0.7%) respectively. There were total 118 (39.3%) pitfalls were observed, amongst which the most common was clamping the chest tube 29 (9.7%), followed by intrathoracic malposition 22 (7.3%), loose fixation 18 (6%), improper handling of suction system 15 (5%), vent covering 12 (4%), improper filling of the bottle 9 (3%), subcutaneous position 7 (2.3%), improper insertion site 6 (2%) respectively. Conclusion: The trocar was the cause of all chest tube insertion-related issues. It is common to make mistakes when working with the tube and its system. All surgeons, especially general surgery residents and paramedical staff should complete specialised training in chest tube management and care. [ABSTRACT FROM AUTHOR]

Recently food shortage has become the major flagging scenario around the globe. To resolve this challenge, there is dire need to significantly increase crop productivity per unit area. In the present study, 24 genotypes of rice were grown in pots to assess their tillering number, number of primary and secondary branches per panicle, number of grains per panicle, number of grains per plant, and grain yield, respectively. In addition, the potential function of miR156 was analyzed, regulating seed sequence in rice. Furthermore, OsSPL14 gene for miR156 was sequenced to identify additional mutations within studied region. The results demonstrated Bas-370 and L-77 showed highest and lowest tillers, respectively. Bas-370, Rachna basmati, Bas-2000, and Kashmir Basmati showed high panicle branches whereas, L-77, L-46, Dilrosh, L-48, and L-20 displayed lowest panicle branches. Bas-370 and four other studied accessions contained C allele whereas, L-77 and 18 other investigated accessions had heterozygous (C and T) alleles in their promoter region. C-T allelic mutation was found in 3rd exon of the OsSPL14 gene. The sequence analysis of 12 accessions revealed a novel mutation (C-T) present ~2bp upstream and substitution of C-A allele. However, no significant correlation for novel mutation was found for tillering and panicle branches in studied rice accessions. Taken together present results suggested novel insight into the binding of miR156 to detected mutation found in 3rd exon of the OsSPL14 gene. Nevertheless, L-77, L-46, Dilrosh, L-48, and L-20 could be used as potential breeding resource for improving panicle architecture contributing yield improvement of rice crop. [ABSTRACT FROM AUTHOR]

In the new era of advanced technology, Wireless Sensor Networks (WSN) and Wireless Body Area Sensor Networks (WBASN) have enormous applications in various disciplines. Wireless Sensor Networks (WSN) have been used in many fields for different purpose like health care, assisting senior citizens, wireless communication, tracking, monitoring, predictive maintenance, enhanced safety and security, improve productivity, energy saving smart grid, smart home etc. to assist peoples. Wireless Body Area Sensor Networks (WBASN) in health care strongly utilized for continuous real time health monitoring of a human health as well as in animal husbandry without creating noise in their normal daily life activities. Wireless Sensor Networks (WSN) and Wireless Body area sensor networks (WBASN) provide opportunities for wireless tracking and monitoring of animals remotely. Remotely sensing systems bring another level of observing into several businesses as well as for agriculturist farmers. In this paper, survey reviewed of different cases of wireless sensors for cattle and pet animals tracking and monitoring. Classify them into different categories according to their types, domain and functionalities. [ABSTRACT FROM AUTHOR]

Background: Due to increasing urbanization and mechanization of life style incidence of road traffic accidents has increased. Because of these road traffic accidents the incidence of traumatic diaphragmatic injuries also increases. Our study was to evaluate retrospectively the etiology, associated injuries and surgical management of blunt diaphragmatic injuries. The present study was conducted to evaluate retrospectively the etiology, associated injuries and surgical management of blunt diaphragmatic injuries. Methodology: This retrospective case study was conducted from January 2016 to January 2019 jointly by Thoracic surgery ward Medical Teaching Institute LRH Peshawar Pakistan and Medical Teaching Institute Hayatabad Medical Complex Peshawar Pakistan. Patients with any age and either sex with diaphragmatic injury post blunt trauma received in emergency or OPD or shifted from other ward were included in study. Patients with penetrating diaphragmatic injuries and congenital diaphragmatic hernias were excluded from the study. All the clinical presentations, demographic data, base line investigations and specific investigations were recorded on a proforma and analyzed. Results: Total number of patients included in the present study were Thirty Five, out of these 35 patients 24 patients presented to emergency department, 07 patients presented late to our OPD with history of trauma and four patients were shifted to us from other wards. The age range in the present study was from 07 years to 62 years. Most of the patients in this study were in the age group of 18-48 years (68.9%). Male were 24(68.57%) and female 11(31.42%). Thirty one patients had left sided injury and 4 patients had right sided. Out of 35 patients 21 had road traffic accident. Seven patients who came to OPD were diagnosed delayed. Morbidity was 3 (8.57%). There was no mortality in the present study Conclusion: Urbanization and mechanization has increased the incidence of road traffic accidents and increase diaphragmatic injuries as evident from this study. Early diagnosis and surgical repair has got good results. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the anatomic location of cysts, operative characteristics of intrathoracic extrapulmonary hydatid cyst and to determine the outcome of aggressive surgical interventions. Study Design: Case series. Place and Duration of Study: Thoracic Surgery Unit Lady Reading Hospital Peshawar from 1st July 2008 to 30th June 2011. Methodology: All patients admitted to Thoracic unit from July 2008 to June 2011 with intra thoracic hydatid cysts were evaluated prospectively as to age, sex, symptoms, diagnostic procedures, anatomic location of cysts, surgical procedures, complications, and outcomes. Chest radiography, computed tomography, and thoracic and abdominal ultrasonography had been performed preoperatively in all of them. Bronchoscopy and spirometry was also performed in all patients for assessment and operability. Echocardiography had been used in 2 patients to determine the contiguity of the cyst to the pericardium. Cystectomy and wide resection were the chief operative procedures. Most of the patients were having cysts in the pulmonary parenchyma only 10 patients had intrathoracic cysts in extrapulmonary locations. This group of patients was included in the study. We excluded patients who had a parenchymal cyst that had perforated to the pleura, myocardial hydatid and patients who had experienced transdiaphragmatic transmission. Results: Total of 149 patients were operated for hydatid cystectomy, out of these 139 patients had pulmonary hydatid and 10 patients had intrathoracic extrapulmonary hydatid cysts. These 10 patients constitute our study group; out of these 7 were men and 3 women whose mean age was 39.14 ± 16.8 years (range, 16-69 years). Eight (80%) of these were symptomatic, most commonly with chest pain, two patients were asymptomatic. There were 2 (20%) mediastinal hydatid, 2 (20%) diaphragmatic, 2 (20%) pericardial, 2 (20%) oblique fissure, and 1 (10%) each in chest wall and pleural hydatid in our study. Albendazole (10 mg/kg) was prescribed to all patients for as long as 3 months postoperatively. No complication, recurrence, or death occurred during the follow up period of 13 ± 15.4 months (range, 2-36 months). Conclusion: The extrapulmonary location of Hydatid cysts within the thorax is very rare. This rarity may cause difficulties in diagnosis. To avoid recurrence, it is necessary to resect the affected tissues completely and an anthelmintic medical regimen post operatively. [ABSTRACT FROM AUTHOR]

Background: Research on the correlation between personality and students' specialty choice is helpful in their career counselling process and in predicting the future distribution of the specialties in a country. Aims: This study is the first of its kind in the Arab world. The research questions were: (1) What is the influence of gender on the personality profiles of medical students? (2) What are the personality profiles of students categorized according to their preferred specialist choices? (3) What are the preferred career choices of students categorized according to the stage of their medical education? Method: A cross-sectional study was performed at King Khalid University Medical School including 590 students during the academic year 2010-2011. A long version of the Zuckerman-Kuhlman personality questionnaire measuring five personality factors was used. Students were also asked for their specialty interests. Students were asked by means of a written questionnaire. Results: Study response was 92.5%. Surgery was the single most popular specialty amongst both male and female students. Males had significantly higher scores on the 'impulsive sensation seeking' scale and students preferring a surgery specialty had the highest score on the 'impulsive sensation seeking', 'neuroticism-anxiety', 'aggression-hostility' and 'sociability' scales. Hospital-based, surgical and primary care specialties became more popular as students progressed through their undergraduate years. Conclusions: Different personality types have distinct preferences in medical students' choice of careers. Personality and specialty choice research can enhance career counselling of medical students and fresh graduates. This also has implications for predicting the specialty distribution of the future health careers. [ABSTRACT FROM AUTHOR]

On October 8th, 2005 Kashmir earthquake, the emergency response to Allai and its surrounding areas was severely affected by the hazard generated due to Sohbat Charra slide zone. Keeping in view the earthquake disasters of the October 2005 due to land sliding, in this study the stability of slopes at Sohbat Charra slide zone at Allai District Battagram have been evaluated by taking soil and rock samples from the site and testing them in the laboratory. The input parameters needed for the analysis mainly included, the shear strength parameters i-e cohesion, angle of internal friction and unit weight of the formation materials, which were obtained from laboratory tests. Software Slope/W part of GeoStudio, 2004 and standard charts have been used for the analysis of slope. On the basis of soil properties and slope stability analysis of the site, suitable measure has been suggested for stabilizing the Sohbat Charra slide zone and thus to mitigate future problems due to earthquakes scenario in the area. [ABSTRACT FROM AUTHOR]

Background: Diabetes is the most prevalent disease in Saudi Arabia having vast health and economic implications. Hence, it is important that all measures must be undertaken to prevent and control the disease., Objectives: This study was performed to assess the diabetes-care practice and related awareness of patients of type 2 diabetes attending the outpatient department of a diabetes care center at a tertiary care hospital in southwestern Saudi Arabia., Methods: A descriptive cross-sectional approach was used wherein patients attending the outpatient department of the diabetes treatment center of a tertiary hospital in the southern region of the Kingdom of Saudi Arabia were surveyed, using a predesigned pretested questionnaire covering the study variables., Results: The study included 287 individuals with type 2 diabetes in the age range 25 years to 90 years (mean age = 55.5 years). Around 57% of the participants were females while the rest were males., Conclusion: The present study showed that awareness about diabetic complications among the study population is good, especially among young educated patients who adhere to regular medical follow-up. Attending physicians were a major source of awareness for the patients., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Family Medicine and Primary Care.)

Background: Hydatid cyst disease is a parasitic disease caused Echinococcus granulosus. Hydatid cysts of 10 cm or greater in diameter are called "giant" cysts and traditionally have been considered to be more difficult to treat surgically often requiring pulmonary resection. In this study we reviewed our experience with pulmonary hydatid cysts., Methods: This study was carried out in Thoracic surgery unit Lady Reading Hospital Peshawar, from 1st June 2007 to 31st May 2012. Patients admitted with intra-thoracic hydatid cysts were evaluated. Patients were divided into 2 groups, i.e., patients who had cysts < 10 cm (group A) and those who had large cysts which were 10 cm (group-B). Data regarding age, sex, symptoms, diagnostic procedures, anatomic location of cysts, surgical procedures, complications, and outcomes were collected and analysed., Results: Total of 224 patients underwent hydatid cystectomy. Group A comprised 190 patients (85%), Group-B comprised 34 patients (15%). Large cysts were more common in younger patients. The most frequent complaints were cough, chest pain, and dyspnea. Patients with large cysts were more often symptomatic at presentation. In both groups, lower-lobe locations predominated. Parenchyma-saving operations were almost uniformly performed for each group; however, a higher percentage of patients in group B required anatomic resection (5.8% vs. 1%). Cystic rupture occurred more frequently in group-B than in group-A (26% vs. 12%). There were no deaths in either group, and the morbidity was 23 (12%) in (group-A) and 6 (17.6%) in (group- B)., Conclusion: Large hydatid cysts of the lung occurred more often in younger patients and were more often symptomatic at presentation. Regardless of size, the cysts could usually be surgically treated without lung resection, and size did not appear to influence short-term post-perative outcomes.

Background: Penetrating chest trauma is common in this part of the world due to present situation in tribal areas. The first line of management after resuscitation in these patients is tube thoracostomy combined with analgesia and incentive spirometry. After tube thoracostomy following surgery or trauma there are two schools of thought one favours application of continuous low pressure suction to the chest tubes beyond the water seal while other are against it. We studied the application of continuous low pressure suction in patients with penetrating chest trauma. This Randomized clinical controlled trial was conducted in the department of thoracic surgery Post Graduate Medical Institute Lady Reading Hospital Peshawar from July 2007 to March 2008. The objectives of study were to evaluate the effectiveness of continuous low pressure suction in patients with penetrating chest trauma for evacuation of blood, expansion of lung and prevention of clotted Haemothorax., Methods: One hundred patients who underwent tube thoracostomy after penetrating chest trauma from fire arm injury or stab wounds were included in the study. Patients with multiple trauma, blunt chest trauma and those intubated for any pulmonary or pleural disease were excluded from the study. After resuscitation, detailed examination and necessary investigations patients were randomized to two groups. Group I included patients who had continuous low pressure suction applied to their chest drains. Group II included those patients whose chest drains were placed on water seal only. Lung expansion development of pneumothorax or clotted Haemothorax, time to removal of chest drain and hospital stay was noted in each group., Results: There were fifty patients in each group. The two groups were not significantly different from each other regarding age, sex, pre-intubation haemoglobin and pre intubation nutritional status. Full lung expansion was achieved in forty six (92%) patients in group I and thirty seven (74%) in group II. Partial lung expansion or pneumothorax was present in three (60%) in group I and 10 (20%) in group II. One patient in group I and three (6%) patients in group II had no response. The mean time to removal of chest drains were 8.2 +/- 3.14 days in group I and 12.6 +/- 4.20 days in group II. The length of hospital stay was 7.2 +/- 2.07 days and 12.4 +/- 3.63 days in group I and II respectively. Clotted Haemothorax requiring surgery developed in three (6%) patients in group I and 8 (16%) patients in group II., Conclusion: Placing chest tubes on continuous low pressure suction after penetrating chest trauma helps evacuation of blood, expansion of lung and prevents the development of clotted Haemothorax. It also reduces the time to removal of chest drains, the hospital stay and the chances of surgery for clotted Haemothorax or Empyema.