Life and Science

Air Pollution: A Challenge to Public Health and Healthcare Systems

Wasim Alamgir, Hina Shan — Mon, 15 Jan 2024 00:00:00 +0500

Air pollution in Pakistan, and the region at large, has become one of the greatest environmental risks to health.
Three major cities of Pakistan, Lahore, Karachi, and Peshawar, have been declared the worst in the world for
their Air Quality Index and PM air pollution. The population residing in these cities is facing adverse health 2.5
effects. Children, with developing lungs and geriatric patients with chronic diseases are the worst affected. The
impact of short-term and long-term exposure to air pollution includes premature mortality, exacerbated
chronic heart and lung disease, lung cancer, decreased lung function in children as well as school absenteeism
and restricted activity days.¹ Hospitals and healthcare facilities are facing the increasing burden of a growing
number of hospitalizations and emergency department visits. Alarmingly, a recent global analysis from 116
countries has described an association between PM_2.5 and clinical antibiotic resistance.² The profound impact of air pollution has been seen recently in Lahore, where school and business closures have hindered the normal
functioning of society's education system and economic activities.

Air pollution ranks among Africa and Asia's top ten risk factors for disability-adjusted life-years (DALYs). The
combined effect of exposure to fine particles in ambient (outdoor) and household air pollution is associated
with 7 million premature deaths annually.¹ Globally, air pollution is the leading cause of death, killing 600,000
children under the age of 15 every year. Ambient air pollution is estimated to have caused 4.2 million premature
deaths worldwide; 89% of those deaths occurred in low- and middle-income countries, notably in Asia and
Western Pacific Regions.² In Pakistan, it has been estimated that the average lifespan is reduced by 3.9 years due to air pollution, whereas in Lahore, life expectancy is reduced by seven years.

The main sources of air pollution are industrial emissions, traffic-related pollutants, coal power plants, smoke
from brick kilns, crop burning, dust from construction sites, household biomass combustion, and indoor
pollutants from chemicals and tobacco. The toxic contaminants in the air include particulate matter (PM),
ozone (O₃ ), nitrogen dioxide (NO₂ ), carbon monoxide (CO), and carbon dioxide (CO₂ ). PM includes inhalable
particles measuring 10 microns or less in size. PM₁₀ & PM_2.5 are proxy indicators for air pollution with the level of risk and adverse health effects varying with the size of the particles. Fine particulate matter of 2.5 microns or
less, including diesel-derived PM, is among the most dangerous airborne pollutants because of its small size
and ability to stay airborne longer. Burning fossil fuels, such as gasoline and coal, significantly contributes to air
pollution, releasing pollutants like nitrogen oxides and volatile organic compounds into the atmosphere. The
interaction of sunlight with nitrogen oxides and volatile organic compounds in the atmosphere creates ground-level ozone, a greenhouse gas and a principal constituent of smog.

Exposure to PM, lead, and the gaseous pollutants CO and SO₂ have reported pro-arrhythmic effects resulting in
heart failure, ischemia, and atrial and ventricular arrhythmias.³ It is now widely recognized that PM is _2.5
associated with enhanced atherosclerosis development, premature aging of blood vessels, build-up of calcium
in the coronary artery, and blood coagulability.³ At ground level, ozone causes breathing difficulties, coughing,
throat irritation, asthma, and COPD. Ultra-fine PM can penetrate the bronchial epithelial barrier and enter the
bloodstream, causing systemic inflammatory changes and oxidative stress, leading to metabolic disorders,
dysbiosis, neurodegeneration, and dementia. Research has found links between air pollution exposure and
genetic and epigenetic changes that can be inherited across generations. Poor air quality is linked to immune
dysregulation, allergic rhinitis, allergic conjunctivitis, and other stronger allergic reactions.

Socially and economically marginalized vulnerable populations, outdoor workers, and professionals like
construction workers, athletes, and traffic wardens are more likely to be adversely affected by toxic air.
Increased air pollution during outdoor activities has brought into question the public health perspective
advocating outdoor exercise as a preventative measure for various health issues, from heart problems to
mental well-being.

The focus of COP28 held in December 2023 revolved around critical objectives such as reducing greenhouse gas
emissions. "Beginning of the end" of the fossil fuel era, the United Nations Climate Change Conference (COP 28)
signalled the need to move away from fossil fuels for the first time. However, a significant challenge arises for a
country like Pakistan, where the swift implementation of green technology is hindered by the substantial costs
associated with its adoption. The urgency of addressing climate change is apparent; however, the economic
constraints faced by Pakistan make the immediate achievement of fossil fuel reduction targets a complex and
formidable task.

Healthcare providers, public health workers, and academia should promote planetary health and advocate for
embracing individual responsibility in mitigating the impact of greenhouse gas emissions. A pressing need
exists for prioritizing public policies to safeguard individuals from air pollutant exposure, enforce stringent
regulations and penalties for polluters, promote sustainable practices, and invest in low-cost carbon sinks like
the urban green and blue spaces. Concerted efforts to address this crisis are paramount for our children's future survival.

Editor-in-Chief

How to cite this: Alamgir W, Shan H. Air Pollution: A Challenge to Public Health and Healthcare Systems. Life and Science. 2024; 5(1): 1-2. doi: http://doi.org/10.37185/LnS.1.1.594

Assessment of Diagnostic Accuracy of Digital Breast Tomosynthesis in Distinguishing Malignant and Benign Breast Lesions

Kanza Afzal, Nadia Gul, Khalid Mehmood, Sobia Jawwad, Bushra Iqbal — Mon, 15 Jan 2024 00:00:00 +0500

Objective: The study aims to determine the diagnostic accuracy of digital breast tomosynthesis in diagnosing
malignant and benign lesions, keeping histopathology as the gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Diagnostic Radiology, POF
th th Hospital, Wah Cantt, Pakistan over a period of six months from 11^th July 2021 to 11^th January 2022.
Methods: A total of 200 women presenting with suspicion of breast malignancy were selected consecutively
from the outpatient department, and Digital Breast Tomosynthesis(DBT) was performed, followed by a biopsy
of the specimen to confirm the findings on histopathology.
Results: The average age of the sample was 48.3 + 7.1 years, ranging between 35 and 60 years. Palpable breast
lump was recorded in 44.5%, pain in 33%, and nipple discharge in 35.5%. Family history of breast Ca was present in 25.5. On Digital Breast Tomosynthesis (DBT), 58.5% of lesions were labeled as malignant, while 53.5% were labeled as malignant on follow-up histopathology. On applying the formulae for calculation, the sensitivity of DBT was found to be 86% and specificity 73.1%. The positive predictive value of the DBT is 78.6%, and the
negative predictive value is 81.9%.
Conclusion: In conclusion, Digital Breast Tomosynthesisis a significantly sensitive and specific tool for detecting
malignant breast lesions in women suspected of breast carcinoma.

How to cite this: Afzal K, Gul N, Mehmood K, Jawwad S, Iqbal B. Assessment of Diagnostic Accuracy of Digital Breast Tomosynthesis in Distinguishing Malignant and Benign Breast Lesions. Life and Science. 2024; 5(1): 3-8. doi: http://doi.org/10.37185/LnS.1.1.416

Awareness and Acceptability of Breast Reconstruction Among Women with Breast Cancer in Twin Cities of Islamabad and Rawalpindi

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the frequency of awareness and acceptability of breast reconstruction surgery among
women in the twin cities of Islamabad and Rawalpindi.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Plastic Surgery, Fauji Foundation
Hospital, Rawalpindi, Pakistan, from October 2022 to June 2023.
Methods: A total of 271 patients between 20-70 years of age with a diagnosis of breast cancer were included.
Demographic details, including marital status, education, residence, occupation, family history, awareness of
breast reconstruction, and source of information about breast reconstruction, were documented on a
proforma. All patients received information regarding breast reconstruction, and records of the frequency of
acceptability and contributing factors were made. Data analysis was carried out by using SPSS 25.0.
Results: The mean age of patients was 43.41 ± 8.98 years. Out of 271 patients, 114 patients (42.1%) had an
awareness of breast reconstruction. The primary source of information was the treating physician in 60 out of
114 patients (52.6%). Breast reconstruction acceptability was reported in 110 out of 271 patients (40.6%).
Family support was the most common reason for acceptance in 43 out of 110 patients (39.1%).
Conclusion: Efforts need to be made at the community level to educate the general population about breast
cancer treatment options, including breast reconstruction. Education was significantly associated with
increased awareness and acceptability for breast reconstruction. Better cosmetic outcomes and family support
were the factors for increased acceptability, while financial constraints and family pressures were reasons for
the vice versa.

How to cite this: Mehmood M, Aslam A, Ahmed W, Aman S, Ali A, Feroze H, Saleem N. Awareness and Acceptability of Breast Reconstruction Among Women with Breast Cancer in Twin Cities of Islamabad and Rawalpindi. Life and Science. 2024; 5(1): 9-15. doi: http://doi.org/10.37185/LnS.1.1.509

Clinical and Sonological Evaluation of Borderline Amniotic Fluid Index and Oligohydramnios-Its Correlation with Perinatal Outcomes

Saira Jamsheed, Khadijah Abid — Mon, 15 Jan 2024 00:00:00 +0500

Objective: To evaluate the correlation of low borderline amniotic fluid index and oligohydramnios with
perinatal outcomes among pregnant females presenting at the tertiary care hospital of Karachi.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Obstetrics and Gynecology,
Hamdard University, Karachi, Pakistan, from March 2021 to March 2022.
Methods: Females aged 18-45 years, with a gestational age of 20-42 weeks assessed on the last menstrual
period and a single fetus on ultrasound were enrolled. The final sample size for the study was determined to be
260 with 130 participants in each group, i.e., the females with Amniotic Fluid Value (AFI) value of ≤5 cm
considered as oligohydramnios (group-1) and AFI value of 5.1 to 8 cm considered as borderline AFI (group-2)
The amniotic fluid index value was determined in all the females using ultrasonographic reports by the
consultant physicians. Females were classified as having oligohydramnios if their amniotic fluid index value was
less than 5 cm and borderline amniotic fluid index between 5.1 and 8 cm. To evaluate the maternal and
perinatal outcomes, all females were monitored up to birth. Data was analyzed using SPSS version 23.
Results: The mean maternal age was 29.85±5.45 years, and the mean BMI was 29.78±5.62 kg/m . Most of the
females had gravida ≥1. Females with oligohydramnios had higher rates of low birth weight (84.6% vs. 51.5%,
p=0.001), IUGR (68.5% vs. 22.3%, p=0.001), meconium staining (42.3% vs 7.7%, p=0.001), low APGAR score
(50.8% vs. 13.8%, p=0.001), respiratory distress syndrome (72.3% vs 27.7%, p=0.001), birth asphyxia (65.4% vs
23.1%, p=0.001), NICU admission (73.8% vs. 43.1%, p=0.001), and neonatal death (21.5% vs. 5.4%, p=0.001)
than women with borderline amniotic fluid index.
Conclusion: This observational study demonstrates a significant correlation between oligohydramnios and
adverse perinatal outcomes, emphasizing the importance of vigilant monitoring and intervention in
pregnancies with low amniotic fluid.

How to cite this: Jamsheed S, Abid K. Clinical and Sonological Evaluation of Borderline Amniotic Fluid Index and Oligohydramnios-Its Correlation with Perinatal Outcomes. Life and Science. 2024; 5(1): 16-21. doi: http://doi.org/10.37185/LnS.1.1.378

The Binding Occupancy of Pro-Hypertrophic Transcription Factors among Cardiac Developmental Enhancers

Rabail Zehra Raza, Irfan Hussain, Fatima Akhtar, Sara Mumtaz — Mon, 15 Jan 2024 00:00:00 +0500

Objective: To check which of the eight pro-hypertrophic transcription factors bind in abundance to a set of 140
functionally confirmed cardiac enhancers aiming to identify potential therapeutic targets for delaying the onset
of cardiac hypertrophy.
Study Design: Bioinformatics, in-Silico Study.
Place and Duration of Study: The study was conducted at the Department of Biological Sciences, National
University of Medical Sciences (NUMS), Rawalpindi, Pakistan, from January 2022 to December 2022.
Methods: For experimentally verified human and mouse noncoding regions with gene enhancer activity
measured in transgenic mice, VISTA Enhancer Browser was used to obtain 140 cardiac-specific functionally
confirmed enhancers. Among these enhancers, transcription factor binding sites were computationally
mapped to assess transcription factor occupancy. The binding sites for all eight transcription factors were
screened in the collective set of 140 cardiac enhancers via an in-house script.
Results: In this study, among a small set of eight pro-hypertrophic transcription factors, occupancy of
transcription factor HAND (Heart- And Neural Crest Derivatives-Expressed Protein) was found to be maximum
in the collected pool of functionally confirmed cardiac enhancers.
Conclusion: The transcription factor HAND was found to have maximum binding occupancy among a set of
experimentally confirmed cardiac enhancers.

How to cite this: Raza RZ, Hussain I, Akhtar F, Mumtaz S. The Binding Occupancy of Pro-Hypertrophic Transcription Factors among Cardiac Developmental Enhancers. Life and Science. 2024; 5(1): 22-26. doi: http://doi.org/10.37185/LnS.1.1.464

The Effect of Uterine Artery Embolization on Heavy Menstrual Bleeding in Patients with Leiomyomata

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To compare the effect of uterine artery embolization and medical management on heavy menstrual
bleeding in patients managed for uterine fibroids.
Study Design: Comparative Cross-sectional Study.
Place and Duration of Study: The study was conducted at the Department of Gynecology and Obstetrics, Pak
Emirates Military Hospital (PEMH) Rawalpindi, Pakistan fromAugust 2021 to March 2023.
Methods: Women between the ages of 35 and 50 years who presented with heavy menstrual bleeding and
were diagnosed with leiomyomata were included in this study. They were divided into two groups via block
randomization. Group-I underwent uterine artery embolization while group-II received medical treatment
(gonadotropin-releasing hormone (GnRH) antagonist). Clinical factors like shrinkage in the size of fibroids, rise
in hemoglobin levels, and pelvic pain scores were compared in both groups at the end of three months.
Results: Out of 160 women recruited in the study, 52 (32.5%) were pre-menopausal, while 108 (67.5%) were
peri menopausal. The mean age of patients who presented with heavy menstrual bleeding due to leiomyomata
was 45.23 ±12.70 years. The mean rise in hemoglobin (p-value-0.007) and mean shrinkage size (p-value<0.001)
were statistically significantly found more in patients who underwent uterine artery embolization as compared
to those who took medical treatment. The mean pain score (p-value-0.01) was also found to be more in a group
of patients who underwent uterine artery embolization.
Conclusion: Uterine artery embolization emerged as an effective procedure for women managed for heavy
menstrual bleeding due to uterine fibroids. Medical management via gonadotropin-releasing hormone (GnRH)
antagonist was inferior in efficacy in terms of mean rise in hemoglobin and fibroid shrinkage.

How to cite this: Khan S, Ahmad M, Mirza ZA, Sheraz A, Tariq M. The Effect of Uterine Artery Embolization on Heavy Menstrual Bleeding in Patients with Leiomyomata. Life and Science. 2024; 5(1): 27-32. doi: http://doi.org/10.37185/LnS.1.1.475

Assessment of Post-Traumatic Stress Disorder and Role of Spirituality Amongst Caregivers of Pediatric Cancer Patients in Pakistan

Mon, 15 Jan 2024 00:00:00 +0500

Objective: This study examined the levels of Post-Traumatic Stress Disorder (PTSD) in pediatric cancer
caregivers and the impact of spirituality on PTSD in Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Oncology, Shaukat Khanum
Memorial Cancer Hospital & Research Centre, Peshawar, Northwest General Hospital & Research Centre,
Peshawar in Khyber Pakhtunkhwa (KPK), Pakistan Institute of Medical Sciences, Islamabad and Quaid-e-Azam
International Hospital in Islamabad, Pakistan from January 2023 to March 2023.
Methods: The study comprised 153 Caregivers of pediatric cancer patients aged One month –12 Years using
convenience sampling. The PTSD Checklist-Civilian Version (PCL-C) and Caregiver's Spirituality Scale (CSS-10)
were used to collect data.
Results: Results of the study found that 81 caregivers (52.94%) had high PTSD, and 96 (62.74%) had high
spirituality. Females reported higher PTSD and spirituality than guys. Graduates have more PTSD and
spirituality than illiterates and matriculate. PTSD and spirituality had a negative Pearson's Correlation
Coefficient.
Conclusion: The study emphasizes spirituality as a caregiver's mental health protector. Healthcare practitioners
caring for pediatric cancer patients can use the findings to lessen PTSD symptoms by targeting caregivers'
spiritual needs. Convenience sampling and self-report measurements decrease generalizability. Future study is
needed to investigate the association between PTSD and spirituality in caregivers of pediatric cancer patients.

How to cite this: Bashir N, Ain Q, Karim N, Niazi H, Khan MI, Asghar AK. Assessment of Post-Traumatic Stress Disorder and Role of Spirituality Amongst Caregivers of Pediatric Cancer Patients in Pakistan. Life and Science. 2024; 5(1): 33-40. doi: http://doi.org/10.37185/LnS.1.1.440

Diagnostic Accuracy of Serum Cystatin C for Early Detection of Kidney Damage in Patients with Type II Diabetes Mellitus: Bahawalpur, Pakistan

Iqra Sajid, Rabia Saeed, Arfa Goheer, Sameen Asghar, Sara Saqib, Fareeha Bashir — Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the diagnostic accuracy of serum Cystatin C for early detection of kidney damage
taking albumin Creatinine Ratio as a reference standard among people of Bahawalpur having diabetes mellitus
type 2.
Study Design: A cross-sectional study.
Place and Duration of Study: The Study was conducted at the Department of Pathology in collaboration with
th th Kidney Center, Bahawalpur Victoria Hospital, Bahawalpur, Pakistan from 27 August 2021 to 26 February
2022.
Methods: There was a total of 200 patients having diabetes mellitus type 2 with GFR between 60-90ml/min
with an age range from 40-60 years were selected. Study participants with a history of steroid intake,
hypothyroidism, chronic liver disease, AIDS, and hypertension were not included in the study. For assessment
of diagnostic accuracy of Cystatin C to evaluate the renal damages in early stages, microalbuminuria was
evaluated. As per the guidelines provided by the respective manufacturers, individuals exhibiting two albumin
creatinine ratio (ACR) levels exceeding 30 mg/g were classified as having diabetic nephropathy (DN).
Results: The overall sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic
accuracy of serum Cystatin C for the early detection of kidney damage, with albumin-to-creatinine ratio used as
the reference standard among individuals with type 2 diabetes mellitus, were 90.98%, 78.21%, 86.72%,
84.72%, and 86.0%, respectively.
Conclusion: The findings of this investigation indicate that serum cystatin C (CysC) exhibits a considerable level
of diagnostic accuracy in the early detection of kidney damage among individuals with type 2 diabetes mellitus,
utilizing the albumin-to-creatinine ratio as a reference standard.

How to cite this: Sajid I, Saeed R, Goheer A, Asghar S, Saqib S, Bashir F. Diagnostic Accuracy of Serum Cystatin C for Early Detection of Kidney Damage in Patients with Type II Diabetes Mellitus: Bahawalpur, Pakistan. Life and Science. 2024; 5(1): 41-47. doi: http://doi.org/10.37185/LnS.1.1.559

Comparison of Efficacy between Myo-Inositol versus Metformin in Women with Polycystic Ovary Syndrome

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To compare the effectiveness of myo-inositol versus metformin in treating women with polycystic
ovary syndrome.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Gynae Unit II, Dr. Ruth. K.M. Pfau
th th Civil Hospital Karachi, Pakistan from 7 February 2019 to 6 August 2019.
Methods: All eligible patients who visited the hospital were enrolled. The group-Aincluded females who
received myo-inositol (n=35), whereas the group-B included females who received metformin (n=35). Females
in the myo-inositol group were administered 1 gram of myo-inositol twice daily, while those in the metformin
group were administered 500 mg of metformin twice daily. Regular follow-up visits were scheduled every two
months, and the efficacy of the treatment was assessed after six months. Efficacy was evaluated in terms of the
normalization of menstrual cycles and the achievement of ovulation.
Results: The mean age in the myo-inositol and metformin groups was 23.92±3.70 and 23.68±4.23, respectively.
The mean weight in the myoinositol and metformin groups was 59.23±2.07 and 61.79±5.92, respectively.
Notably, the efficacy rates for the myo-inositol and metformin groups were 68.57% and 20%, respectively with
p-value=0.001.
Conclusion: Myo-inositol was found to demonstrate significant superiority over metformin in the treatment of
polycystic ovary syndrome.

How to cite this: Latif N, Rajar S, Yousuf M, Imtiaz S, Abbas S, Jamali Z. Comparison of Efficacy Between Myo-Inositol versus Metformin in Women with Polycystic Ovary Syndrome. Life and Science. 2024; 5(1): 48-53. doi: http://doi.org/10.37185/LnS.1.1.486

Retinal Nerve Fiber Layer Thickness (RNFLT) in Myopic & Hypermetropic Eyes in a Subset of Pakistani Population

Mon, 15 Jan 2024 00:00:00 +0500

Objective: This study aimed to evaluate retinal nerve fiber layer (RNFL) thickness in healthy individuals with
myopic and hypermetropic eyes, using optical coherence tomography (OCT).
Study Design: A cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Ophthalmology, Dr. Akil bin
Abdul Qadir Institute of Ophthalmology, Karachi, Pakistan from January 2015 to June 2015.
Methods: In this study, 300 eyes were included were examined using standard protocols by a single examiner.
Subjects with a history of diabetic or hypertensive retinopathy, raised intraocular pressure (> 21mmHg), and
previous intraocular or laser surgery were excluded from the study. The mean retinal nerve fiber layer thickness
was calculated in both myopic and hypermetropic eyes.
Results: The mean global retinal nerve fiber layer thickness (RNFLT) in myopic eyes was found to be 93.98 ± 8.57 μm. In hypermetropic eyes, it was found to be 101.00 ± 6.58. This variation was found to be statistically
significant with p-value of 0.001.
Conclusion: We concluded that individuals with myopic eyes had significantly reduced retinal nerve fiber layer
thickness whereas those with hypermetropic eyes showed an insignificant increase in RNFLT compared to
emmetropic eyes.

How to cite this: Mukhtar S, Hassan N, Lakhani M, Fatima U, Shaheen S, Raza I. Retinal Nerve Fiber Layer Thickness (RNFLT) in Myopic & Hypermetropic Eyes in a Subset of Pakistani Population. Life and Science. 2024; 5(1): 54-60. doi: http://doi.org/10.37185/LnS.1.1.480

The Efficacy of Levofloxacin-Based Triple Therapy over Standard ClarithromycinBased Therapy for Eradication of Helicobacter Pylori

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To compare a first-line Clarithromycin-based triple therapy to Levofloxacin-based triple therapy for
eradicating H.Pylori.
Study Design: Comparative analysis.
Place and Duration of Study: The study was carried out at the Department of the Gastroenterology of Pakistan
Institute of Medical Sciences (PIMS), Islamabad, Pakistan, from June 2021 to December 2021.
Methods: A total of 200 patients were enrolled in this comparative study, conducted in the outpatient
Department of Gastroenterology. A pretested questionnaire was used to gather the required information; a
group was allocated to each patient, and a response was sent to each treatment group after random sampling.
The primary outcome was a negative Urea Breath test 4 weeks after completion of treatment.
Results: Out of 200 patients, 58 % (n=116) were males, and 39% (n= 84) were females. The mean age was 40.02
± 24.4 years. Predominant presenting complaints were Retrosternal burning in
41 % (n=82), and pain and/or discomfort in the upper abdomen 34% (n=68). The response rate in the
Clarithromycin based therapy group was 84% (n=84) out of 100 patients, while the response rate was 94% (n=
94) out of 100 in the Levofloxacin-based therapy group.
Conclusion: Levofloxacin-based therapy is superior to Clarithromycin-based therapy in every age group and
gender.

How to cite this: Noor H, Virk KA, Abbasi HW, Virk ST, Shahid S, Erfan M. The Efficacy of Levofloxacin Based Triple Therapy over Standard Clarithromycin Based Therapy for Eradication of Helicobacter Pylori. Life and Science. 2024; 5(1): 61-67. doi: http://doi.org/10.37185/LnS.1.1.462

Maternal Hypothyroidism-Induced Impaired Development of Neurons in Rat Offspring: Insights for Antenatal Care

Tayyaba Fahad, Shabana Ali, Tayyaba Qureshi, Noor Fatima Khan — Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the effect of maternal hypothyroidism on the development of neurons in the motor
cortex of rat pups by using light microscopy.
Study Design: Laboratory-based experimental study.
Place and Duration of Study: The study was carried out in collaboration with the National Institute of Health
(NIH) Islamabad and the Department of Anatomy, Islamic International Medical College, Riphah International
University, Islamabad, Pakistan from March 2023 to May 2023.
Methods: In this study, 24 females and 12 male Sprague dawley rats were sorted into control and hypothyroid
groups. The control group received a standard diet and plain drinking water throughout the study. In contrast,
the hypothyroid group had 4.5mg of propylthiouracil administered per rat per day, mixed into their drinking
water. This treatment started a week before mating and continued until three weeks after delivery. Once
successful mating was confirmed via vaginal plugs, gestation proceeded, and newborn pups were born after
nd three weeks, having full access to maternal lactation for 21 days. On the 22 day after birth, dissection took
place, and the brains of the pups were carefully removed. Coronal sections of the motor cortex were then
obtained for subsequent examination.
Results: The control group displayed a typical pattern of neurogenesis, characterized by the normal structure of cortical neurons. On the other hand, intracellular vacuolation, glial cell necrosis, and reduced Nissl rim
thickness were statistically significant in hypothyroid group which collectively pointed to atypical neurogenesis.
Conclusion: This study highlights the adverse effects of maternal hypothyroidism on the structural integrity of
cortical neurons. It focuses on increasing awareness and implementing thorough prenatal healthcare
strategies.

How to cite this: Fahad T, Ali S, Qureshi T, Khan NF. Maternal Hypothyroidism-Induced Impaired Development of Neurons in Rat Offspring: Insights for Antenatal Care. Life and Science. 2024; 5(1): 68-74. doi: http://doi.org/10.37185/LnS.1.1.525

Dengue Fever Perception and Knowledge for Endemicity Control among University Students of Karachi

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the knowledge and the risk perception regarding dengue fever among the educated
population along with their behaviors towards prevention in the backdrop of rising cases of dengue at the
national level.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Departments of Electrical, Software Engineering, Computer Sciences and Geophysics of Bahria University, Karachi Campus, Pakistan, from October 2021 to March 2022.
Methods: With an observational analytical study design, 333 students were recruited through convenient
sampling. Data were collected using a structured questionnaire. The socio-demographic traits and general
information about dengue fever spread and prevention were presented in frequencies and percentages while
dengue fever knowledge, risk perception, and behavior of respondents were compared using a chi-square test
with the significance level set at 0.05.
Results: It was found that 79.8% of the students recognized that transmission of dengue is through mosquitoes, whereas only 17.4% identified the correct species of dengue infection. Twenty-two percent knew that dengue is a viral illness. Sixty-eight percent marked contaminated water as a mosquito breeding site, while 52.8% believed it to be trash/garbage. Eighty-nine, sixty-nine and fifty-two percent reported the use of window
screens, bed nets/mesh, and insect repellents as protective measures, respectively. Fifty-seven percent of
participants considered dengue a fatal illness. Eighty-eight and seventy-five percent recognized dengue as a
preventable and curable disease, respectively.
Conclusion: Educated participants in this study were misapprehensive that they had satisfactory knowledge,
risk perception, and behavior toward dengue fever. Very few had the correct knowledge regarding transmission
mode and spread and protective and preventive strategies. Information regarding transmission mode and
spread, as well as protective and preventive strategies, were insufficient.

How to cite this: Qureshi FM, Bari SF, Wazir SM, Wazir M, Zehra S, Khalid A. Dengue Fever Perception and Knowledge for Endemicity Control among University Students of Karachi Life and Science. 2024; 5(1): 75-82. doi: http://doi.org/10.37185/LnS.1.1.373

Role of Prophylactic Antibiotics in Preventing Stroke-Associated Pneumonia in Patients with Ischemic Stroke

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To compare the frequency of stroke-associated pneumonia in patients given prophylactic antibiotics
versus those not given prophylactic antibiotics.
Study Design: Comparative Cross-sectional study.
Place and Duration of Study: The study was carried out at the Department of Internal Medicine, Combined
st st Military Hospital (CMH), Peshawar, Pakistan from 1 August 2022 to 31 January 2023.
Methods: We included 250 ischemic stroke patients and divided them into groups A, “Prophylactic group,” and
B, “no prophylactic antibiotics group.” Patients were assessed at 7 days after admission for presence of “stroke
associated pneumonia (SAP)” through clinical examination and chest X-rays. Data were analyzed using a
statistical package for social sciences 22. For qualitative variables, frequency and percentages were used,
whereas for quantitative data, the median (IQR) was used as the data were not normally distributed and
contained outliers; using the median and IQR can be more appropriate for describing the central tendency and
spread of the data compared to the mean and standard deviation.
Results: In our study, the median age of the patients was 68(46-83) years. 61 (24.40%) of the patients were male
while 189(75.60%) were female. The median BMI was 31 (19-44) kg/m2. Diabetes was present in 123 (49.20%)
patients and 96(38.40%) had hypertension. We found that in the the “prophylactic antibiotics” group (A), 9
(7.20%) patients developed SAP, while in the “no prophylactic antibiotics” group (B) frequency of SAP was 34
(27.20%) (p< 0.001).
Conclusion: Prophylactic antibiotics used in “ischemic stroke” patients provide better outcomes by reducing
the incidence of “stroke-associated pneumonia”. Therefore, it should be given to all patients admitted to the
hospital with ischemic CVA.

How to cite this: Aslam MJ, Amir M, Sayed TM, Hashmat A, Hussain M, Fatima M.Role of Prophylactic Antibiotics in Preventing Stroke Associated Pneumonia in Patients with Ischemic Stroke. Life and Science. 2024; 5(1): 82-88. doi: http://doi.org/10.37185/LnS.1.1.465

The Effects of Alpha Lipoic Acid on Oxidative Stress, Lipid Profile, and Blood Glucose Levels in Type 2 Diabetic Male Sprague Dawley Rats

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the effect of Alpha Lipoic Acid (ALA) on blood glucose, lipid profile, and oxidative stress
in streptozotocin-induced type II diabetic male Sprague Dawley rats.
Study Design: Laboratory-based experimental study.
Place and Duration of the Study: The study was carried out at the Physiology Research Lab, Army Medical
College, Rawalpindi, Pakistan, from 20^th January 2021 to 24^th June 2021.
Methods: Thirty Sprague Dawley (SD) rats were divided into three equal groups. Group I was given a normal
standard rat diet. In Groups II and III after feeding a diet rich in fat and calories for 2 weeks, after feeding a diet
rich in fat and calories for 2 weeks, a single low dose of streptozotocin was injected for Type 2 Diabetes Mellitus
(T2DM) induction. Alpha Lipoic Acid 30 mg/kg body weight/day was administered intraperitoneally in Group III
for 01 weeks after the development of T2DM.
Results: The blood glucose, lipid profile, and serum Malondialdehyde levels were deranged in the diabetic
group. After Alpha Lipoic Acid supplementation, the blood glucose levels, Serum MDA, and levels of
triglycerides, cholesterol, and Low Density Lipoproteins decreased, whereas High Density Lipoproteins level
were significantly raised (p <0.001) in group III as compared to the diabetic group II.
Conclusion: Treatment with Alpha Lipoic Acid reduces oxidative stress and improve reduces oxidative stress
and improves glycemic and lipid profiles in T2DM rats.

How to cite this: khan BU, Arshad S, Ikram F, Yousef I, Naizi I, Ismaeel M. The Effects of Alpha Lipoic Acid on Oxidative Stress, Lipid Profile and Blood Glucose Levels in Type 2 Diabetic Male Sprague Dawley Rats. Life and Science. 2024; 5(1): 89-94. doi: http://doi.org/10.37185/LnS.1.1.405

Evaluation of Restless Leg Syndrome in Patients with Non-Dialysis Dependent Chronic Kidney Disease at Fatima Memorial Hospital Lahore: A Cross-sectional Study

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the occurrence of restless leg syndrome in individuals with non-dialysis-dependent
chronic kidney disease.
Study Design: A descriptive cross-sectional study.
Place and Duration of Study: The study was carried out at the Outpatient Department (OPD) of Fatima
Memorial Hospital, Lahore, Pakistan, from March 2020 to August 2020.
Methods: A total of 280 CKD patients not dependent on dialysis were included in the study. The data were
collected through interviews containing questions from international restless leg syndrome study group
(IRLSSG). Patients were stratified into different stages according to the estimated glomerular filtration rate
(eGFR). Restless leg syndrome was diagnosed by analyzing the responses of the interview marked by the
examiner.
Results: Among 280 patients, 15.7% (n=44) of chronic kidney disease patients were noted to have restless leg
syndrome. The syndrome was significantly more frequent in females and was associated with higher CKD stages (Stage V > Stage III and IV). There was no association with either age or BMI.
Conclusion: Restless leg syndrome is more common in chronic kidney disease stage V as compared to lower
chronic kidney disease stages (III & IV). If untreated, it can affect patients' quality of life and increase the risk of
cardiovascular activities.

How to cite this: Basit MB, Sabir O, Shahid AH, Kanwal A, Qadri GA, Rizvi N. Evaluation of Restless Leg Syndrome in Patients with NonDialysis Dependent Chronic Kidney Disease at Fatima Memorial Hospital Lahore: A Cross-sectional study. Life and Science. 2024; 5(1): 95-100.doi: http://doi.org/10.37185/LnS.1.1.516

Comparison of Early and Delayed Feeding after Elective Gut Anastomosis

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To compare the effects of early and delayed feeding after elective gut anastomosis in relation to a
mean number of days of audible bowel sounds.
Study Design: A cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Surgery, Combined Military
th th Hospital (CMH), Rawalpindi, Pakistan, from 11^th May 2019 to 10^th November 2019.
Methods: A total of 60 individuals undergoing gut anastomosis were divided into two groups. In group A, the
NG tube was removed within 6 to 24 hours of surgery, and clear oral liquids (30ml/hour) were started. Oral fluids, including juices and soups on the other day after surgery, tailed by semisolid food at 3^rd day, then regular food at 4 day and finally discharge at the 5 day. In group B, the NG tube was detached three to five days after the procedure, observing NG tube output <30-50cc daily. Then, patients were followed up in post-surgical
wards for 48 hours. Patients were noted and informed of the time when bowel sounds were audible, the first
flatus passed, and the first stool passed.
Results: The mean age in group A was 40.23 ± 15.66 years, and in group B was 37.93 ± 15.23 years. Most of the
patients, 31 (51.67%), were between 16 to 30 years of age. Out of 60 patients, 36 (60.0%) were males and 24
(40.0%) were females, with male to female ratio of 1.5:1. The mean number of days of audible bowel sounds in
Group A (early feeding) was 1.57 ± 0.63 days while in Group B (delayed feeding) was 3.90 ± 0.76 days (p-value =
0.0001).
Conclusion: This research established that the outcome of early feeding is better than the outcome of delayed
feeding after elective gut anastomosis.

How to cite this: Jabbar G, Ahmed MS, Malik AS, Akhtar S, Minhas FS, Makshoof MT, Shahid Z. Comparison of Early and Delayed Feeding After Elective Gut Anastomosis. Life and Science. 2024; 5(1): 101-106. doi: http://doi.org/10.37185/LnS.1.1.411

Ameliorative Effect of Vitamin D on Articular Cartilage Thickness in Arthritic Rat Model

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the protective effect of vitamin D on the articular cartilage of formalin-induced
arthritis in rats.
Study Design: Lab–based Experimental study.
Place and Duration of Study: The study was carried out at the Department of Anatomy, Islamic International
Medical College from September 2020 to September 2021.
Methods: We randomly split thirty adult male albino rats weighing between 250 and 300 grams into three
groups. (10 in total). On days 1 and 3 of the experiment, formaldehyde was subcutaneously injected into the
right paw of every animal, with the exception of those in group A. The usual rat food was given to the rats in
Groups A and B. Throughout the trial, Rats in group C were given vitamin D 4000IU/kg orally by adding
cholecalciferol (Vitamin D3) injection in a standard diet for 28 days. All of the animals were dissected after the
experiment, and the right hind leg was taken out, processed, and stained with H&E for a microscopic
assessment of the thickness of the unclarified cartilage. Version 21 of SPSS was used to analyze the results.
Results: The oral administration of vitamin D exhibited a significant increase in unclarified cartilage thickness
on intergroup comparison.
Conclusion: Vitamin D is an effective antiarthritic agent in ameliorating the thickness of articular cartilage
thickness in arthritic rat models.

How to cite this: Shahid A, Beenish H, Khurshid T, Rashid A, Shahid U, Khan M. Ameliorative Effect of Vitamin D on Articular Cartilage Thickness in Arthritic Rat Model. Life and Science. 2024; 5(1): 107-112. doi: http://doi.org/10.37185/LnS.1.1.570

Effect of Body Mass Index and Ankle Dorsiflexion in Planter Fasciitis Patients; Performance Perspective

Mon, 15 Jan 2024 00:00:00 +0500

Objective: To determine the effects of body mass index and ankle dorsiflexion in patients with plantar fasciitis.
Study Design: A cross-sectional.
Place and Duration of Study: The study was carried out at the Department of Physical Therapy of the two
leading tertiary care centers, Advance Orthopedic & Reconstructive Institute & Dr. Ziauddin Hospital
Karachi, Pakistan from August 2022 to June 2023.
Methods: Sixty-Four participants were recruited from the physical therapy departments of two tertiary care
centers in Karachi by convenience sampling. The study focuses on the impact of demographics on the
performance of plantar fasciitis patients. The measurement tools used in this are BMI (Body mass index), NRS
(Numeric rating scale), LEFS (Lower extremity functional scale), and Goniometer. The data were analyzed by
SPSS version 23.0.
Results: Our findings show that plantar fasciitis is more common in the obese-II category with reference to BMI, females are more affected than males with reference to gender, the middle age group is more affected with reference to age and dorsiflexion angle of patients is less than normal range shows the directly proportional of demographics with the performance of patients with plantar fasciitis.
Conclusion: Our study showed the positive effect of ankle dorsiflexion angle and BMI, gender, pain, and age on
the physical performance of plantar fasciitis patients.

How to cite this: Lata P, Hayat S, Kumar V, Hassan MF, Batool S, Sandeela KA, Jamil K. Effect of Body Mass Index and Ankle Dorsiflexion in Planter Fascitis Patients; Performance Perspective. Life and Science. 2024; 5(1): 113-119. doi: http://doi.org/10.37185/LnS.1.1.461

Effectiveness of Postoperative Analgesia with Rectal Placement of Diclofenac Sodium in Patients Undergoing Gynecological and Obstetrical Surgeries under General Anesthesia

Tue, 16 Jan 2024 00:00:00 +0500

Objective: To determine the frequency of need for postoperative intravenous analgesia after rectal diclofenac
suppository in patients undergoing lower abdominal gynecological or obstetrical surgery under general
anesthesia
Study Design: Cross-sectional study.
Place and Duration of Study: The study was carried out at the Operation Theater and Postoperative Ward of
Sheikh Zayed Hospital, Lahore, Pakistan from January 2021 to July 2021.
Methods: A total of 245 women undergoing gynecological and obstetrical surgeries under general anesthesia
were enrolled in the study using non-probability consecutive sampling. All the participants were recruited after
obtaining informed consent and meeting the inclusion criteria. All subjects had a single 100mg diclofenac
suppository inserted rectally after undergoing general anesthesia, and their Visual Analog Scale (VAS) scores for
postoperative analgesia were recorded immediately after surgery and again at 1, 6, and 24 hours.
Results: The mean age of the patients was 37 years, with a standard deviation of 6.2. The mean VAS (Visual
Analog Scale) scores at 1, 6, 12, and 24 hours were 3 (±1.24), 5 (±1.46), 7 (±1.93), and 6 (±2.14), respectively. The
need for rescue analgesia was reported in 15.9% of cases at 1 hour, 37.1% at 6 hours, 82% at 12 hours, and
68.2% at 24 hours.
Conclusion: The administration of diclofenac via rectal placement led to a notable decrease in Visual Analog
Scale scores and a lower incidence of needing additional pain relief within the first 6 hours after surgery.

How to cite this: Saeed R, Mahboob A, Ali SM, Latif A, Ammar T, Kakepotto IA. Requirement of Postoperative Analgesia after Per Rectal Placement of Diclofenac Sodium in Patients Undergoing Gynecological and Obstetrical Surgeries under General Anesthesia. Life and Science. 2024; 5(1): 120-125. doi: http://doi.org/10.37185/LnS.1.1.515