http://hdl.handle.net/123456789/6389 2026-08-14T19:19:01Z http://hdl.handle.net/123456789/21550 The Legitimacy of Hiring Professional Medical Writers: Balancing Ethics and Scientific Progress Udaipurwala, Iqbal Hussain 2025-04-01T00:00:00Z http://hdl.handle.net/123456789/21555 Transcatheter Palliative Balloon Pulmonary Angioplasty in Symptomatic Patients with Tetralogy of Fallot and its Outcome at Tertiary Care Setting Ahsan Ali Shaikh; Nadeem Sadiq; Muhammad Rashid Hasnain; Imrana Ata; Naseem Ullah; Saqlain Anwar Objective: To analyze transcatheter palliative balloon angioplasty's safety, efficacy, and clinical outcomes by a single operator in symptomatic Tetralogy of Fallot (TOF) patients in tertiary care. Study Design and Setting: This is a case series study. It was carried out at the Pediatric Cardiology Department PNS SHIFA Karachi and the Armed Forces Institute of Cardiology (AFIC/NIHD) Rawalpindi, Pakistan, from November 2022 to May 2024. Methodology: This study selected patients from the pediatric database using non-probability consecutive sampling. A sample size of n=30 was taken. Symptomatic infants of TOF requiring palliation for (right ventricular outflow tract) RVOT obstruction were included and infants with predominant valvular narrowing and those not fulfilling the criteria of TOF were excluded. Data was entered and analyzed by using SPSS version-24:00. In descriptive statistics, Mean ± SD was calculated for continuous variables while frequency (%) for categorical variables. The Chi-square test was used to find out the association between categorical variables, p-value of <0.05 was taken as statistically significant. Results: Out of 30 patients, 11(37%) were males and females were 19(63%). The median age was 24 months. Immediate improvement in saturation was noted in all patients and transient arrhythmias 5(16%) was the most encountered complication. Conclusion: Transcatheter palliative balloon angioplasty is becoming the first line of treatment for patients with Tetralogy of Fallot due to its physiologic improvement in blood flow to the lungs and reciprocal increase in saturation. It is safe and requires much less hospital stay in a professionally sound environment. 2025-04-01T00:00:00Z http://hdl.handle.net/123456789/21552 Comparison of Hemodynamic Response to Laryngoscopy / Intubation: Intravenous Lidocaine vs Repeat Dose Propofol Muhammad Salman Maqbool; Hasnain Ameer Hamza; Fahad Zubair; Kainat Irshad; Affifa Saleem Objectives: The contrast of effectiveness of repeat dose propofol with lidocaine efficacy before laryngoscopy in maintaining stable hemodynamic(pulse and mean blood pressure)pressure values following endotracheal intubation. Study design and setting: Randomized controlled interventional(purposive sampling) study by the Anesthesia Department at Farooq Hospital Islamabad, ASMC (Rwp)from 21-06-2024 to 04-10-2024. Methodology: The study was authorised by the Research Committee; Akhtar Saeed Medical College, Rawalpindi on 14th June 2023 Sample size was calculated by sample size calculator(statistics kingdom) employing a normal distribution, with margin of error 0.04, confidence level of 0.80(z-score of 1.28) and standard deviation of 0.24, the sample size was calculated to be 60 total subjects. Random sampling was used and bunched in two groups using the lottery method; patients had co induction and inj. dexamethasone 4mg, propofol 1.5mg/kg, inj. cisatracurium 0.15mg/kg as muscle relaxant for intubation in both groups. In group A and B, patients also received 0.5mg/kg propofol thirty seconds and 1.5 mg/kg lidocaine three minutes before laryngoscopy respectively. Cardiovascular parameters, i.e. (pulse, blood pressure) were monitored. Paired sample T test employed with a confidence interval (of 95%)analysing heart rate and mean blood pressure values with determination of significant P-value greater than 0.05. SPSS v 26 was used. Results: In group-A, 90% of cases more stable heart rate was noted as compared to group-B with a value of (63.3%). No incidence of bradycardia was noted in group-A, whereas in group-B it was 6.7%. Concerning mean blood pressure, raised values were noted in 23.3% cases and 30% cases in Group A and B respectively and stable systolic blood pressure values were seen in 80% and 66.7% cases in Group A and B respectively. Conclusions: The propofol repeat dose before intubation showed stable hemodynamic (pulse and mean blood pressure) values as compared to lidocaine following laryngoscopy in general anaesthesia. 2025-04-01T00:00:00Z http://hdl.handle.net/123456789/21553 Assessment of Necessity of Retrograde Filling during PCNL Tract Dilatation Jaffry, Syed Ali Raza; Jat, Javed Altaf; Memon, Waqar Ahmed; Ghangro, Abdul Qayoom; Arain, Ahsan Ali; Tamoor Jatoi Objective: To investigate the impact of retrograde filling on tract dilatation and associated outcomes among patients presenting at a tertiary care hospital, Pakistan. Methodology: A prospective cohort study was conducted at a tertiary care hospital's urology department from February 2022 to February 2023. A total of 126 patients undergoing elective PCNL were included, categorized into exposed (retrograde filling utilized) and unexposed (standard PCNL without retrograde filling) groups. Patient demographics, stone characteristics, and procedural details were recorded. Comparative analyses were performed to assess ease of tract dilation and infection rates using appropriate statistical tests. Results: The use of retrograde filling did not significantly influence the ease of tract dilation during PCNL. Moreover, the exposed group exhibited a significantly higher rate of post-procedure infections (55.4%) compared to the unexposed group (36.5%). Multivariate logistic regression analysis, controlling for potential confounding variables, confirmed that retrograde filling was associated with a substantial increase in the odds of post-operative infection (adjusted odds ratio of 2.48). Conclusion: Retrograde filling during PCNL is associated with risk of post-procedure infections and does not provide significant benefits in terms of ease of tract dilation. Moreover, the study emphasizes the economic and logistical implications of incorporating retrograde filling, including increased costs and the need for additional personnel. Therefore, urologists are advised to carefully consider the potential drawbacks and benefits before deciding on the adoption of retrograde filling in PCNL procedures. 2025-04-01T00:00:00Z