Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University <p>The Annals of Pakistan Institute of Medical Sciences (APIMS) is the Official quarterly and open access journal of Shaheed Zulfiqar Ali Bhutto Medical University (SZABMU), Pakistan. Previously two separate medical journals of this institute were being published, namely, JPIMS started from 1990 and the Journal of Surgery 1991. They were officially merged into one journal APIMS in 2005. Annals of PIMS is recognized by Pakistan Medical and Dental Council (PMDC), Higher Education Commission of Pakistan ( Y category), CPSP <a href="" target="_blank" rel="noopener">(</a> index in EBSCO Host &amp; Base from Germany. </p> en-US <p><a href="" rel="license"><img style="border-width: 0;" src="" alt="Creative Commons License" /></a><br />This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.</p> (Prof. Tanwir Khaliq) (SZABMU) Mon, 15 Nov 2021 18:41:46 +0000 OJS 60 Red Blood Cell Distribution Width as a Surrogate Marker of Disease Activity in Patients with Rheumatoid Arthritis <p><strong>Objective:</strong> To determine the association between red blood distribution width and disease activity in patients with rheumatoid arthritis and to compare the red blood distribution width in patients of rheumatoid arthritis with that in healthy subjects.</p> <p><strong>Methodology:</strong> This comparative case-control observational study was conducted at Pakistan Institute of Medical Sciences, on rheumatoid arthritis patients visiting the (Out Patient Departments) OPDs between September, 2020 and March, 2021. Study subjects were selected by non-probability convenient sampling and a control group comprising of healthy subjects was similarly selected from general medical OPDs. Complete blood picture and erythrocyte sedimentation rate were obtained for each patient and disease activity score was calculated for rheumatoid arthritis patients. Statistical Package for Social Sciences (SPSS) version 26 was used for data analysis. Data was checked for normality by using the Kolmogorov Smirnov test. An independent samples t-test was used for comparing means and Pearson’s correlation coefficient for establishing an association between variables. P value less than 0.05 was considered significant.</p> <p><strong>Results:</strong> Of the total 140 patients, 60 (85.7%) in each group were female and 10 (14.3%) were male. The mean age was 39.23 years and 36.87 years in the case and control groups respectively. The mean disease duration of rheumatoid arthritis was 6.63 years. RDW was significantly elevated in patients with rheumatoid arthritis (16.82%) as compared to the control group (14.47%) and strong positively correlated with disease activity score (p 0.00038).</p> <p><strong>Conclusion:</strong> Red blood cell distribution width is strongly related to disease activity in patients of rheumatoid arthritis and may help in monitoring disease activity in rheumatoid arthritis patients.</p> Saleha Farrukh, Fatima Khan, Wajahat Aziz, Uzma Rasheed, Shazia Zammarrud Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Comparison of Alveolar Osteitis (AO) occurrence after impacted mandibular third molar removal with and without post-extraction socket irrigation <p><strong>Objective:</strong> We wanted to see whether impacted third mandibular molar extractions resulted in Alveolar Osteitis if post-extraction socket irrigation was used or not.</p> <p><strong>Methodology:</strong> A randomized control experiment on 70 patients study was conducted from July 2019 to January 2020 at Islamabad Dental Hospital's OMFS department. Patients presenting with the mandibular third molars fulfilling the inclusion criteria had their teeth extracted with and without socket irrigation using the computer lottery method. In cases of dry socket, clinical diagnosis was made between the 3rd, 5th, and 7th postoperative days.</p> <p><strong>Results:</strong> 70 patients/sockets were evaluated with 35 having been irrigated and 35 non-irrigated. The age range was 16-50years with a mean of 29.49 and most patients were between the 16-35 age group. There were 48.6% males and 51.4% females. Dry Socket was evaluated on the 3rd, 5th, and 7th day between groups (A=irrigation, B=Non-irrigation). On the 3rd postop day, 14 (40%) patients in group A and 15(42.9%) patients were diagnosed as dry Sockets. A similar number of patients in both groups (20%) exhibited symptoms of dry socket on the fifth and seventh postoperative days, as did 5 (14.3 %) in group A, 3 (8.6 %) in group B, and 1(2.9 %t) in group A, all on the fifth postoperative day.</p> <p><strong>Conclusion:</strong> On the third, fifth, and seventh postoperative days, there was no significant difference in the result of Alveolar Osteitis between the groups.</p> Fatema Awan, Manahil Rahat, Muhammad Jamal, Saniya Sohail, Khalid Mahmood Siddiqi, Muhammad Mudassar Saleem Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Comparison of Radiation Dose in CT Examinations At PIMS with European Commission Reference Doses <p>OBJECTIVE - The purpose of this study was to assess the radiation dose levels from common computed tomography (CT) examinations performed in Radiology Department of Pakistan Institute of Medical Sciences (PIMS), and evaluate these according to diagnostic reference levels (DRLs) proposed by European Commission (EC) guidelines, and thus contributing towards the establishment of local and national DRLs. To the best of our knowledge, this is the first study of its kind to explore radiation doses from CT examinations in Pakistan.</p> <p>STUDY DESIGN - This was a quantitative study conducted at PIMS, Islamabad, spanning a duration of eight weeks. Scan parameters and dose profile data of 1506 adults undergoing examinations of head, neck, chest and abdomen-pelvis regions, comprising of single- and multi-phase, contrast-enhanced and unenhanced studies. Dose indicators utilized by EC guidelines for DRLs include volume CT dose index (CTDI<sub>vol</sub>) and Dose Length Product (DLP) for single slice and complete examination radiation doses, respectively.</p> <p>METHOD - Values of CTDI<sub>vol</sub>, DLP and scan lengths were extracted from the CT operators console. Other control variables included gender, contrast enhancement and phasicity of study. IBM SPSS package was used to obtain descriptive statistics such as mean and quartiles.</p> <p>RESULTS - DRLs calculated as 75<sup>th</sup> percentile of CTDI<sub>vol</sub>, DLP for various anatomical regions are by and far comparable to European DRLs.</p> <p>CONCLUSION – This study describes institutional diagnostic reference levels for common CT exams in Islamabad and provides benchmark values for future reference. Our DRL values are mostly comparable to European and international DRLs. Similar, albeit large scale, surveys are recommended for establishment of local and national DRLs, eventually contributing towards development of regional DRLs.</p> <p>KEYWORDS: CTDI<sub>vol</sub>, DLP, Diagnostic Reference Levels, Computed Tomography, Radiation Monitoring, Scan length</p> Fawad Yasin, Anum Rasheed, Muhammad Nauman Malik, Farheen Raza, Ramish Riaz, Ayesha Isani Majeed Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Dexamethasone Versus Ondansetron in Preventing Postoperative Nausea and Vomiting In Laparoscopic Surgery <p><strong>Objective:</strong> To compare the efficacy of dexamethasone 8mg versus ondansetron 4mg in preventing postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy</p> <p><strong>Methodology:</strong> This quasi-experimental study was conducted at the Department of Anaesthesia and Intensive Care, Holy Family Hospital from 29th July 2018 to 28th January 2019. Anesthesia was induced with propofol (2mg/kg IV) and Atracurium (0.5 mg/kg IV) was given to facilitate tracheal intubation. Nalbuphine (0.2mg/kg) was used as analgesic.Patients were randomly divided into two groups. Patients in Group A received 4mg ondansetron at end of surgery and Group B received 8mg dexamethasone at induction.</p> <p><strong>Results:</strong> A total of 90 patients were included according to the inclusion criteria of the study. The mean age (years) in the study was 37.11+10.60 years. Frequency and percentage of nausea (up to 24 hours) among both the groups was 28 (62.2) and 28 (62.2) respectively (p-value = 1.0) while the frequency and percentage of vomiting (within 24 hours after extubation) was 28 (62.2) and 27 (60.0) respectively (p-value = 0.829)</p> <p><strong>Conclusion:</strong> The study concluded that there was no significant difference dexamethasone and ondansetron in preventing postoperative nausea and vomiting.</p> Anum Malik, Arshad Shahani, Jawad Zahir, Hassam Zulfiqar, Tabassum Aziz Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Effect of Dilution of Propofol on Pain at Site of Injection: Comparison Between 1% vs. 0.33% Formulation <p><strong>Objective:</strong> To study the effect of propofol dilution on pain at injection site with formulations of 1% and 0.33%.</p> <p><strong>Methodology:</strong> A randomized controlled trial was conducted for 24 months at the Department of Anaesthesia and Critical Care, Pakistan Institute of Medical Sciences Islamabad. A total of 100 patients were included in the study. Patients were divided into two equal groups: group C received 1% propofol while patients of group D received 0.33% formulation diluted with distilled water. Patients received propofol at the start of anesthesia before any premedication. A 5ml volume was injected over a period of 5s in an 18G cannula over dorsum of hands. Behaviourial pain scale was used and descriptive data analysis was done.</p> <p><strong>Results:</strong> Then mean age of patients was 37.36±14.77 with 46 males and 56 females. Pain at the injection site was experienced in 20 (40%) patients of group C whereas 16 (32%) patients experienced pain in group D. There was no association of pain with a strength of propofol solution (p value 0.405). <br /><strong>Conclusion:</strong> Strength of propofol solution has no association of pain at the injection site and dilution has no better effect in terms of pain score</p> Khawaja Kamal Nasir, Rashid Hussain, Arshad A Shahani, S.H. Waqar , Zunaira Tahir Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Incidence and Attributing Factors of Impaired Blood Glucose in Non-Diabetic Patients on Steroid Therapy <p><strong>Objective: </strong>To determine the incidence and attributing factors of impaired blood glucose in non-diabetic patients on steroid therapy.</p> <p><strong>Methodology: </strong>This descriptive study was conducted at the Department of Medicine, Sheikh Zayed Hospital Lahore during 6 months from April 2019 to September 2019. Patients of both genders with age of 18-70 years and receiving steroid therapy (at least 1 pulse) were included. After taking ethical approval, 371 patients were counseled and explained the details of the study. A bolus of 1 gram Methylprednisolone was given and blood was drawn after 2 hours and blood glucose levels were measured. All the labs were acquired from same lab (Hospital lab) and glucometer to eliminate bias and confounding variables were controlled by exclusion. Data was collected via study proforma.</p> <p><strong>Results: </strong>The average age of the patients was 43.75 ± 14.33 years with a range of 18 to 70 years. There were 42% males and 57%.1 females with a male to female ratio of 1:1.3. Average BMI of patients 27.34±3.72kg/m2. Impaired blood glucose was observed in 55% of patients after steroid pulse therapy. Frequency of impaired blood glucose after steroid pulse therapy was statistically insignificant according to age and BMI (p-&gt;0.05). Positive family history was significantly higher in a patient with impaired blood glucose after pulse therapy (p-0.001).</p> <p><strong>Conclusion: </strong>Impaired blood glucose level was observed to be highly prevalent among non-diabetic patients receiving steroid pulse therapy. Female gender and positive family history of diabetes observed as attributing factors.</p> Hafsa Farooq, Muhammad Awais Abid, Hamna Farooq, Madiha Fazil, Ayesha Irshad, Ambreen Butt Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Role of Zinc Supplementation in Reducing Relapses in Steroid Sensitive Nephrotic Syndrome <p><strong>Objective:</strong> To evaluate and compare the effectiveness of zinc and B-Complex supplementation to prevent the recurrence of nephrotic syndrome in the cases priory responsive to corticosteroid therapy.</p> <p><strong>Methodology</strong> It is a randomized controlled trial conducted at OPD Pediatric medicine, Shaheed Zulfiqar Ali Bhutto University, PIMS Children Hospital Islamabad from October 3, 2016 to April 2, 2017. 192 patients (96 in each group) were included in the study after obtaining informed consent from parents or guardians taken before determining the population. Patients were randomly assigned to two groups (Group 1: Zinc and Group 2: B-Complex) to receive oral zinc sulphate (10 mg / day) or B-Complex using a random number table. The patients were followed up after 4 months. All data were collected by the researchers themselves in a structured form.</p> <p><strong>Results:</strong> The age of 192 participants of the trial averaged 6.38±3.42 years of age ranging from 1-12 years. There were 88 (45.8%) men and 104 (54.2%) women cases. In group 1, there were 22 (22.9%) and in group 2, there were 47 (49%) cases that had been pardoned. The recurrence of nephrotic syndrome was significantly higher in group 1 than group 2 (p = &lt;0.001).</p> <p><strong>Conclusion:</strong> The findings of this study suggest that Zinc supplementation is more preferrable to B-Complex supplementation as the rate of continuous remission was higher in the zinc group, so in the future may be added to the treatment regimen to treat steroid-sensitive nephrotic syndrome.</p> Fatima Hashmi, Shahzadi Sumbal Ghazi, Hassan Mumtaz, Maryum Amjad, Nahdia Zaman, Shahzaib Ahmad Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 The Preferred Learning Styles Among the Undergraduate Dental Students at Foundation University College of Dentistry, Islamabad <p><strong>Objective:</strong> To determine the preferred learning styles of undergraduate dental students at the Foundation University College of Dentistry, Islamabad.</p> <p><strong>Methodology:</strong> A cross sectional study was conducted at Foundation University College of Dentistry, Islamabad in January 2020 over a period of 2 weeks. On the basis of VARK questionnaire, learning styles of first to final year undergraduate dental students were analysed. The questionnaire consisted of 16 items and identified four different learning styles: visual, aural, reading/writing and kinaesthetic. A total of 132 students were included in this study. The filled out questionnaires were scored according to the VARK tool and then statistically analysed to determine the distribution of different learning styles among students.</p> <p><strong>Results: </strong>A total of 126 students out of 132 responded with the response rate of 95.5%. The results showed that the frequency of a single learning style (unimodal) in the study population was 63.5% while the frequency of a combination of different learning styles (multimodal) was 36.5%. The frequencies of bimodal, trimodal and quadmodal learning styles were 26.1%, 6.9% and 3.5% respectively. Among the unimodal learning style kinaesthetic topped the list with a frequency of 27.9% while among the bimodal learning styles auro-kinaesthetic was more frequent accounting for 10.9%.</p> <p><strong>Conclusion:</strong> The predominant learning style in our study population was unimodal and had a frequency of 63.5% with kinaesthetic being the chief preference making a major chunk of 27.9% followed by aural learners making up to 20.4%. In bimodal learning styles the most frequent in our study population was auro-kinaesthetic with a frequency of 10.9%.</p> Falahat Nasir, Faiza Gulfam, Ali Ayub, Zainab Abdullah, Salwan Ghani, Hidayat Ullah Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Efficacy of Nasal Continuous Positive Airway Pressure versus Heated Humidified High-Flow Nasal Cannula as a Primary Mode of Respiratory Support in Preterm Infants with RDS <p><strong>Objective:</strong> To determine the efficacy of nasal continuous positive airway pressure (NCPAP) versus heated humidified high-flow nasal cannula (HHHFNC) as a primary mode of respiratory support in preterm infants with respiratory distress.</p> <p><strong>Methodology:</strong> This randomized controlled trial study was conducted at in-patient department of neonatology (Nursery &amp; NICU) of Pakistan Insitute of Medical Sciences (PIMS) from July 2020 to Dec 2020. A total of 280 neonates randomly divided (140 in each study group) of both genders, with gestational age between 28-34 weeks and having mild-to-moderate respiratory distress within 1st 6 hours of birth requiring non-invasive ventilation were enrolled. Neonates in NCPAP Group (n=140) were given NCPAP whereas neonates in HHHFNC Group (n=140) were given HHHFNC. The efficacy of both groups were compared on the basis of treatment failure within 1st 3 days, total duration (hours) of non-invasive ventilator (NIV) required and total duration (hours) of supplementary oxygen required.</p> <p><strong>Results:</strong> Overall, mean gestational age was noted to be 30.0+6.4 weeks. There were 144 (51.4%) neonates with birth weight between 1 to 1.4 kg, 90 (32.1%) between 1.5 to 1.9 kg and 46 (16.4%0 between 2.0 to 2.4 kg. Treatment failure was noted in 67 (47.6%) neonates in NCAP group while HHHFNC group reported 73 (52.4%) neonates with treatment failure (p=0.4733). No significant difference was observed in mean total duration of NIV support required (p=0.2598) or mean total duration of supplementary oxygen (p=0.1946) in between study groups.</p> <p><strong>Conclusion:</strong> HHHFNC had similar efficacy when compared to NCPAP among neonates with RDS. In comparison to NCPAP, HHHFNC could be a simple, well-tolerated and effective alternative in terms of respiratory support. No major difference in terms of complication was observed between both treatment approaches.</p> Qaiser Zaman, Syeda Shireen Gul, Muhammad Hayat Khan, Sehrish Noor Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Fri, 19 Nov 2021 00:00:00 +0000 Role of Short Duration Double Phototherapy in The Treatment of Unconjugated Hyperbilirubinemia <p><strong>Objective:</strong> To determine the role of short duration double phototherapy in the treatment of unconjugated hyperbilirubinemia<strong>.</strong></p> <p><strong>Materials and Methods: </strong>This prospective cases series study was conducted at pediatric department of CMH hospital at Malir Karachi. All the neonates diagnosed with unconjugated hyperbilirubinemia admitted to the neonatal ward were included. All the cases underwent short duration double phototherapy. Babies were observed for side-effects of phototherapy, like skin reaction and dehydration. Serum bilirubin was checked by bilirubinometre after 6 hourly of the treatment. Al the data was collected via study proforma. Data was analyzed by using SPSS version 20</p> <p><strong>Results:</strong> Total 74 neonates were studied, most of the neonates presented within 48-72 hours after birth. Majority of the term babies as 59.5% had history of 37-40 weeks of gestation and 28.4% had gestational age history &gt;40 weeks. Out of all, males’ babies were 58.1% and female babies were 41.9%. Neonatal bilirubin level was significantly decreased from bassline 18.35<u>+</u>0.97 after 6 hours of double phototherapy as 14.66<u>+</u>1.18 with mean difference of 3.68<u>+</u>1.37 (p-value 0.001).</p> <p><strong>Conclusion: S</strong>hort duration double phototherapy found to be the effective, reliable and safe for skin reaction in the treatment of unconjugated hyperbilirubinemia.</p> <p><strong>Key words: </strong>Hyperbilirubinemia, double phototherapy, six hours </p> Benish Fatima, Syed Taqi Hassan Zaidi, Ameena Saba Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Quality of Life in Patients with Stoma <p><strong>Objective:</strong> To determine the quality of life of patients with stoma at tertiary care Hospital.</p> <p><strong>Methodology:</strong> This prospective study has been conducted at the general surgery department, Pakistan Institute of Medical Sciences hospital Islamabad (PIMS). The study was conducted from September 2019 to February 2020. All the patients having age more than 12 years, underwent intestinal stoma formation and either gender were included for study. Patients were interviewed regarding their routine activities after stoma and the impact of it on their social life including working status, sexual activities and life satisfaction. All the information of patients including demographic data was documented via self-derived proforma. Analysis of data was done by SPSS version 20.</p> <p><strong>Results:</strong> Total 46 patients were studied having a stoma and were interviewed regarding their quality of life. The patient's mean age was 44.93+6.78 years. Out of all 34.8% were working currently and rest of the patients were still on bed rest. 34.8% were satisfied with sexual life. 71.7% were depressed after stoma surgery and 52.2% were hopeful about their future. 63% were socialised with peoples as before, 58.7% replied that stoma has affected their recreational activities and 52.2% answered that they can’t travel in any way. However according to overall satisfaction, 32.6% of patients were disagreeing, 34.8% were agreeing and 30.4% were undecided.</p> <p><strong>Conclusion:</strong> It was concluded that almost half of the patients were satisfied and they are performing social and daily life activities however almost half of the patients needed psychological, financial, and relative support.</p> <p><strong>Key words: </strong>Stoma, Quality of life</p> Abeer Irshad, Muhammad Fahim Ahsan, Mumtaz Ahmed Khan , Isbah Rasheed, Muhammad Asif Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Correlation of Hepatocellular Carcinoma with Different Levels of Alpha-Fetoprotein in Pakistani Population <p><strong><u>Objective:</u> </strong>To assess pathological, biochemical and clinical parameters in HCC patients with low, normal and high AFP levels.</p> <p><strong><u>Methodology:</u> </strong>This comparative analytical study was conducted in Liver and Gastric Clinic, Holy Family Hospital, Rawalpindi from June 2019-June 2020.Sample size was calculated as 225 by WHO sample size calculator . Non randomized convenient sampling was used. Patients were divided into three groups according to AFP values; &lt;200 ng/ml, 200-400ng/ml and &gt;400 ng/ml. Patients demographic details, medical history, clinical symptoms and signs, biochemical parameters and pathological findings on ultrasonography and CECT were assessed. Data was analyzed by SPSS version 21. Descriptive statistics were calculated for categorical variable. p Value less than 0.05 was considered significant<u>.</u></p> <p><strong><u>Results:</u> </strong>Out of 256 patients, 161 (62.9%) were males and 95 (37.1%) were females.The mean age of patients was 60.5 years ± 10.5. 94.4% of patients with HCC had Hepatitis C. Anorexia, jaundice and abdominal distension, hepatomegaly and splenomegaly were more frequent in patients having high AFP level. Serum bilirubin, tumor size, number of lesions, BCLC staging and other pathological parameters associated with HCC worsens as AFP levels increase.</p> <p><strong><u>Conclusion:</u> </strong>Alpha-fetoprotein levels are significantly associated with clinical and pathological parameters of hepatocellular carcinoma thus can be used as a better diagnostic and prognostic tool.</p> Muqadas Munir, Mishal Maqbool, Jahanzeb Ayyaz, Salwa Anis, Sonaina Maqbool Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 ENT manifestations in HIV infected patients in PIMS Islamabad. <p><strong>INTRODUCTION</strong></p> <p><strong>HIV</strong> is a global pandemic with estimation of 38 million active cases around the world according to WHO HIV data and statistics 2019. Despite of advancement in medical field the disease has not been tamed uptil now. In this modern era HIV is still considered a taboo in Pakistan, people are reluctant about disclosure of disease, screening of their partners and its treatment which is due to lack of awareness and socio-economic constraints.</p> <p><strong>OBJECTIVE</strong></p> <p>The aim of this study is to see the incidence of Ear, Nose and Throat (ENT) manifestations in HIV infected people presented in tertiary care hospital of Islamabad.</p> <p><strong>MATERIAL AND METHOD</strong></p> <p>A one-year observational cross-sectional study conducted in Pakistan Institute of Medical Sciences (PIMS) Islamabad between January 2019 to December 2019. All the HIV infected patients who presented with ear, nose and throat manifestations were recruited in the study. Detailed history and examination were conducted after taking written consent. Analysis included calculations of mean values of quantitative association between ENT symptoms and demographic characteristics. Statistical analysis was estimated using either Chi-square test or t-test.&nbsp;&nbsp;</p> <p><strong>RESULTS </strong></p> <p>Majority of the patients presented with Otological manifestation of which the most common was chronic suppurative otitis media (14.28%). Most common Rhinological/Oropharyngeal manifestation included epistaxis (12.24%) and oral candidiasis (8.16%) respectively. Among neck manifestations cervical lymph adenopathy (18.16%) showed the highest percentage.</p> <p><strong>CONCLUSION</strong></p> <p>The study shows a local trend of ENT manifestation in which the patient presented in later stage (WHO III) which resembled to the studies carried out in other developing countries showing ineffectiveness of current national HIV/AIDS programme.</p> Manza Maqsood Khan, Ansab Hasnain, Altaf Hussain, Jawad Faisal, Hasnain Naqvi, Mehak Husnain Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000 Immediate Procedural Success of Primary Percutaneous Intervention in Patients with Acute ST Segment Elevation Myocardial Infarction <p><strong>Objective:</strong> To determine the frequency of immediate procedural success of Primary PCI in patients with Acute ST segment elevation Myocardial infarction.</p> <p><strong>Methodology:</strong> This observational study was conducted at Cardiology unit of P.I.M.S, Islamabad from April 2018 to October 2018. Study included 43 patients with STEMI. All of them had primary PCI. The main outcome variable was frequency of procedural success which was described as frequency distribution table.</p> <p><strong>Results:</strong> Procedural success was achieved among all (100%) patients. There were 16.3% patients who developed contrast induced nephropathy (recovered), they all were diabetics. There were 4.6% patients who developed hematoma. No other complications seen</p> <p><strong>Conclusions:</strong> Immediate procedural success of primary PCI is high (almost successful in every case) and should be offered to the patients with STEMI whenever the facility is available.</p> <p><strong>Keywords:</strong> ST-segment elevation myocardial infarction; primary percutaneous coronary intervention.</p> Akhtar Ali Bandeshah, Liaqat Ali Rind, Abid Saeed , Ather Mehmood , Muhammad Aamer Niaz Copyright (c) 2021 Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University Mon, 15 Nov 2021 00:00:00 +0000