Introduction:  Fatty Liver is a disease in which there is excess amount of fat stored in the liver. If the condition is not treated, it may lead to serious liver disease. This paper presents a case of a patient detected with non- alcoholic fatty liver disease (NAFLD) who was healed successfully using Yoga Prana Vidya (YPV) system of Healing protocols without the use of any medicines.

Material and Method: This is a detailed case study method analysing the pre and post healing medical reports of a 58-year-old male who was diagnosed with non-alcoholic fatty liver disease, who approached Yoga Prana Vidya healers for distant healing.

Results: After 2 months of daily healing, the test reports of the patient showed no signs of fatty liver.  A follow up test report after 2 years of the healing intervention also showed normal liver.

Conclusion: It is observed that Yoga Prana Vidya healing which is a no touch, no-drug healing modality, which includes distant healing, has been used effectively in the treatment of Non- alcoholic Fatty Liver Disease (NAFLD). YPV both as an alternative and complimentary medicine has been known to have successfully healed thousands of patients suffering from various ailments. This case is one of its kind as the ailment was treated completely without any other medication. There is a great scope for further research on this topic with appropriate sample sizes.

Anterior cruciate ligament injury is commonly seen in sports related trauma. Complete tear requires surgical reconstruction. During postoperative rehabilitation, because of arthrogenic muscle inhibition (AMI), the quadriceps muscle remains inactive and has reduced contraction. Various strategies were aimed at treating this AMI and/or improve quadriceps strength such as open chain (OKC) and closed chain kinetic (CKC) exercises, blood flow resistance training (BFRT), cryotherapy, and transcutaneous nerve stimulation (TENS). Of all these, CKC was better than OKC in improving the range of movements, weight bearing exercises provided quicker return to physical activity. Cryotherapy was found to be an effective way to counter AMI and improve knee function and reduce the pain. The BFRT and TENS were found to be ineffective. Single legged hop test at six months postoperatively was found to be reliable predictor of the quadriceps function at one year. Electromechanical dynamometry is the gold standard machine to assess the knee extension and provide exercise, handheld dynamometry is easy to use. Leg press, leg extension machine are other machines used to provide exercises.

Purpose: The purpose of this study was to measure the frequency of microorganisms in septic arthritis in children under the age of 10 years in Peshawar.

Method:After approval from hospital ethical board, patients fulfilling the inclusion criteria were enrolled From the indoor department of Orthopedic of the hospital. A written informed consent was taken from all study participants after explaining the purpose of study. Complete history was taken and physical examinations were done including careful and gentle examination of the affected joint as per protocol. The involved joint was aspirated under sterile precautions in a separate procedure room under ultrasound guidance. Data was recorded by the researcher himself on especially designed proforma (annexure 1). Data was entered and analyzed by using SPSS version 22.0.

Results: We included 171 patients with septic arthritis who met the inclusion criteria. Among 171 patients, 99 patients (57.9%) were males. The median age was 3. ). In our studies, 72 patients (42.1%) had staph. aureus on culture , 39 patients (22.8%) had group A streptococcus on culture, 34 patients (19.8%) had E.coli on culture, 17 patients (9.9%)  had streptococcus pneumoniae and 9 patients (5.2%) had other bacteria including  H.influenza , salmonella, P. auroginosa and N.gonorrhoea.

Introduction: Photophobia or swallowing phobia is a rarely studied clinical entity. Classified as a specific phobia by the DSM-V.

Through our clinical case, we highlight the diagnosis difficulty of this clinical entity and the interest of early therapeutic management appropriate to the age of the child.

Clinical observation: A 6-year-old female patient was hospitalized in pediatric surgery for esophageal caustic stenosis that required esophageal replacement. Thereafter, the persistence of swallowing disorders was observed while the organic etiological assessment was negative. Manifestations of phobic anxiety were identified starting the first psychiatric consultation. These manifestations were found to be linked to the memory of traumatic events that the patient experienced during the gastro esophageal fibro copy. The diagnosis of phobic disorder was retained and the treatment was essentially based on behavioral therapy. The evolution was globally favorable.

Discussion: Photophobia, or swallowing phobia, is an uncommon phobic disorder listed in the 11th edition of the International Classification of Mental Disorders and the DSM-5.

The important question before diagnosing this disorder is to determine its psychogenic basis. In most cases, the onset of the disorder follows a swallowing accident, which leads to swallowing phobia, which in turn is considered a particular form of post-traumatic stress disorder. It can also be associated with separation anxiety in children as in our case.

Conclusion: Swallowing phobia is considered a specific, non-developmental phobia. Swallowing phobia and other childhood anxiety disorders are closely correlated. Cognitive behavioural therapies have shown favourable responses in most cases.

Machete-cut injuries are not uncommon and are usually associated with severe soft tissue disruption and unusual bone fractures. This could result into a potentially life-threatening injuries that could pose challenges in management. Six patients seen and managed for machete-cut injuries over a period of 2years (From July 2020 to August 2022) at the Dental and Maxillofacial surgery unit of Usmanu Danfodiyo University Teaching Hospital Sokoto were presented. All the victims were males sustaining varying degrees of soft and hard tissue injuries, with no tissue avulsion. Four (4) cases of the series were treated under local anaesthesia and conscious sedation while the remaining two (2) cases were done under general anaesthesia. Open reduction and internal fixation were done in four (4) of the cases, splinting in one (1) case and only soft tissue repair in one (1) case. Facial nerve palsy, mental and buccal nerve anaesthesia were the observed nerve injuries. Early presentation, careful assessment of the injuries and meticulous planning will reduce morbidity and mortality associated with such injuries. There is need for preventive mechanisms such as providing education as well as reducing rate of unemployment in our society. 

Blindness secondary to odontogenic orbital infection is not uncommon. We report five (5) cases of severe odontogenic orbital cellulitis causing blindness. These patients were seen and managed over a 3-year study period (from July 2019 to August 2022) at the Dental and Maxillofacial surgery clinic of Usmanu Danfodiyo University Teaching Hospital Sokoto. There were 2 male children and a female child in the age range of 6-10years with a mean±SD of 7.7±2.1, a 37-year-old male and a 24-year-old female. Cancrum oris/osteomyelitis was the primary diagnosis in one child, right maxillary osteomyelitis in two children, buccal +temporal space abscess and buccal space abscess in the two adult (male and female) patients respectively. All patients had a preceding history of toothache before the onset of other symptoms. All the patients had visual acuity of no light perception in the affected eye. Additionally, they had a varying degree of proptosis and restricted ocular motility while one child presented with purulent discharge and disorganized globe. Aggressive medical and surgical treatment was instituted in consultation with the ophthalmologists, which resulted in the resolution of the disease in all the patients.

Background: Appendicitis is common problem treated surgically by open or laparoscopic appendectomy.

Objectives: To compare short term complications of open versus laparoscopic appendectomy.

Study design: Randomized control trial

Setting: Department of General Surgery, Mardan Medical Complex, MTI, Mardan.

Subjects: Total 110 patients of both gender aged 20 to 40 years undergoing appendectomy were enrolled.

Methodology: This study was done from 12^thJuly 2020 till 11^th January 2021 after approval from hospital ethical committee. Total 110 patients were enrolled and divided in open appendectomy and laparoscopic appendectomy and short term complications were noted.

Results: In our study total 110 patients were enrolled and divided in two groups. The mean age of patients was 32.65±4.8 years. There were 25.5% patients in younger age group and 74.5% in elder age group. In our study population there were 26.4% males and 73.6% female patients. The mean body mass index was 30.9±5.5 kg/m2. Mean duration of surgery was 1.4±0.4 hours in laparoscopic group and 1.5±0.4 hours in open appendectomy. The most common complication was wound infection in 12.7%, paralytic ileus in 10.9%, intra-abdominal abscess in 9.1% and vomiting in 6.4% patients. Complication rate was significantly increased in open appendectomy, p-value 0.032.

Conclusion: Laparoscopic is safer as compared to open appendectomy.

Cecal diverticulum presenting with acute abdomen is a rare entity, representing for surgeons a challenging preoperatory diagnosis, due to its low incidence and similarity with other frequent etiologies for abdominal pain. This is a case of a patient presenting to the emergency room with acute abdomen and absence of the risk factors described for this disease, with a successful management and outcome.

Introduction: Esophageal malignancy is among cancers of the gastrointestinal tract, and multidisciplinary team care and treatment approaches are used in treating gastric cancer. This paper presents a case of 52 years old house wife diagnosed with esophageal cancer who had undergone chemotherapy and used YPV healings as complementary medicine to recover speedily, and reduce pain and other side effects.

Methods: Case study method is used in this paper by going through the detailed medical records of the patient, healer’s record of healings rendered and feedback from the patient and her family.

Results: After 2 months of healings, the PETCT scan reports revealed normal and positive condition with no sign of cancer. After that, further radiation treatment was given by the doctor during March 2022, and accordingly the YPV healings were continued for one more month. A follow up after two months revealed that the patient was found in normal good health and feeling confident. She regained lost body weight as she was able to take normal diet. There was no pain or repulsiveness.

Conclusions:  There is immense scope for further research using appropriate sample size and research methodology to establish the results on a wider scale for helping people with less-expensive and effective treatment process of YPV. It is recommended that a working knowledge of YPV healings will be highly beneficial for medical personnel such as doctors and nurses and other frontline healthcare workers to holistically treat patients, and also include it effectively in disease prevention protocols.

Introduction: lockdown was experienced as a source of frustration for those who suffered from it.

The purpose of this survey is to assess well-being and psychological impact of lockdown on Moroccan medical students during COVID-19 pandemic.

Equipment and methods: This is an observational cross-sectional studyusing a self-questionnaire for medical students in Morocco. The Peri-traumatic Distress Inventory and the Warwick-Edinburgh Mental Wellness Scale were integrated into it. Statistical analysis were performed using SPSS software

Results: 505 medical students from Morocco participated. 

Univar ate and multivariateanalysisweredonerevealingseveralsignificantcorrelationsbetween the Warwick-Edinburg BEM score and the Peri-Trauma Distress Inventory and several parameters.

Discussion: A non-negligible proportion of medical students are suffering from depression, anxiety, burn-out and more generally, a sense of unease and psychological stress.

Anxiety and fear of social distancing drive students to consult social networks.

The Warwick-Edinburg BEM score was found to be significantly correlated with the time spent doing sports, creative activities, talking with relatives. Regarding eating habits, confinement is accompanied by negative emotions responsible for food restriction, emotional eating and hyperphagicfits. However, we did not find an increase in the consumption of addictive substances.

Conclusion: The novelty of the pandemic, caused by the COVID-19, has a psychological impact on the general population and specifically on medical students. There is a need to remain vigilant about the remote onset of psychological disorder samong medical students in Morocco

Background: Pulmonary function is an important marker of the effects of air pollution on the exposed population. Mild to moderate reductions of FEV₁/FVC, FEV₁, FEV₁%, PEF, and FEF_25–75 have been associated with the exposure to biomass burning in cross-sectional studies. Some hospital-based case-control studies, confirm that people exposed to biomass smoke have high risk for developing airflow obstruction with significant reduction of FEV₁ and FEV₁/FVC.

However, none of these studies has evaluated lung function parameters among charcoal smoke exposed food grillers.

Therefore this index study took a look at spirometric indices among food grillers exposed to charcoal smoke in Yenagoa, South-South Nigeria.

Methods: This was a comparative observational cross-sectional study of charcoal smoke exposed spirometric indices of food grillers compared to fruit sellers The Medical Research Council (MRC) Questionnaire was administered to participants and a “one-on-one” interview was conducted by the researcher using the questionnaires.Information obtained included socio-demographic characteristics such as age, gender, marital status and level of education. Spirometry was performed in accordance with the ATS/ERS using standard single reusable turbine spirometer (MIR Spirobank II Basic; manufactured by P & A Medical Limited).  Spirograms that met the ATS/ERS criteria for acceptability were used. Information obtained with the spirometer were FEV₁, FVC, FEV₁/FVC, PEF and FEF_25-75. A portable HANA analogue weight machine was used to weigh the study participants and a flexible plastic tape measure was used to measure the heights of participants

Results: A total of one hundred and sixty (160) participants made up of eighty (80) food-grillers and fruit-sellers (controls) respectively were recruited for this study. A normal lung function pattern was found in 60 (75.0%) of food-grillers and 72 (90.0%) of controls. This shows that more fruit-sellers had normal lung function pattern, and this was statistically significant (p = 0.013).  Obstructive pattern was found in 16 (20.0%) of food-grillers and 6 (7.5%) of controls (p = 0.022).

The mean lung function values for food-grillers compared to fruit sellers were: FEV₁=2.8±0.5L vs 3.2±0.5 (72.3±5.8% predicted); FVC=3.6±0.6L vs 3.9±0.8 (76.8±6.6% predicted), FEV₁/FVC=78.5±4.9 vs 85.3 ±5.3 (77.1±5.4% predicted); PEF=5.7± 1.2L/s vs 6.9 ±2.9 (81.6±7.3% predicted) and FEF_25-75=2.8±0.8L/s vs 3.0 (±0.4) (80.5±15.3% predicted).  The values were statistically different between food-grillers and controls (p < 0.001).

Conclusion:

1. Exposure to charcoal smoke is associated with the development of lung function abnormalities and reduction in lung function parameters.


2. Increasing exposure time to charcoal smoke increase the likelihood of lung function abnormalities.

Melanocytoma of the optic disc is a benign stationary tumor that is usually pigmented, asymptomatic and stable in size. Even though benign, it can cause vision loss and visual field defect due to compression on the optic nerve.

A 39-year-old male presented with a black shadow in the left eye which has been present for about 4 years. Fundus photo shows a darkly pigmented lesion of the optic nerve head of the left eye with a mild hemorrhage. B-scan ultrasonography shows a slightly elevated lesion at the optic nerve head. Fluorescein angiography shows hypofluorescence of the lesion.

Optic nerve melanocytoma (ONM) may often display clinical similarities to melanoma but with adequate diagnostic tools can be distinguished from one another. ONM can either remain stable or grow progressively slowly over many years. Annual monitoring for change is highly recommended.

Objective: To find out the frequency of surgical site infections in emergency appendectomy for complicated appendicitis

Method: This cross-sectional study was conducted at Khyber Teaching Hospital, MTI, Peshawar from November 20, 2021 to August 12, 2022. We included 131 patients, who had undergone emergency appendectomy for complicated appendicitis. The sampling technique was consecutive non-probability sampling. Confidence interval of 95% and 7% margin of error were considered. The patients with complicated appendicitis on appendicect-omy were included in the study. Demographic data (age, gender), history of active smoking or diabetes mellitus at admission, procedure duration, appendicitis-type according to surgical findings (grossly inflamed, gangrenous, perforated), BMI were noted. All the data were collected on a proforma (Annex 1). SPSS software (version 23.0) was used for data analysis.

Results: Out of 131 patients, 88 (67.2%) were males and 43 (32.8%) were females with mean age of 33±2.3 years and mean BMI of 26±5. Frequency of surgical site infections among clean, clean-contaminated, contaminated, and dirty wound infections were 5/17 (29%), 20/67 (30%), 13/30 (43%), and 8/17 (49%) respectively. The overall frequency of surgical site infection was 46/131 (35%). Out of these 46 cases, 25 (54.3%) were superficial SSIs, 14 (30.4%) were deep SSIs and 07 (15.2%) were deep/space occupying SSIs.

Conclusion: In our study, the frequency of surgical site infections is 35% which is higher compared to other studies conducted. So proper preoperative and postoperative cares should be taken to decrease the frequency or incidence of surgical site infection in the department.

Diabetes mellitus has over the years become a public health and a complex disease. It is characterized by chronic hyperglycemia. The present study was designed to determine the differential leukocyte ratios in type 2 diabetic patients compared to non-diabetic controls. A total of 240 subjects comprising 120 type 2 diabetic patients (60 males and 60 females) aged 20-25 years and 120 apparently healthy age and gender-matched controls were recruited for the study.  Blood samples (5.0ml) was collected from each subject for the analysis of the parameters using the Mindray 530 BC automated analyzer, Mindray, Japan.  The data was analyzed using T-test with level of significance set at p < 0.05.  The result revealed significant increase in the differential leukocyte ratios involving the Monocyte Lymphocyte Ratio (MLR) (0.38 + vs 0.15 +0.017) and the Neutrophil Lymphocyte Ratio (NLR) (3.15 + 3.57 vs 1.65 + 0.65) in the type 2 diabetic patients and the non-diabetic controls.  This finding demonstrates alterations in differential leukocyte ratios which supports occurrence of parainflammation in type 2 diabetic patients.