bluuebunny/crossref_metadata_2025 huggingface dataset:
FIGHT AGAINST SUPERBUGS IN A BURN CENTRE: ARE WE DOING ENOUGH
Authors: Aslam Muhammad Rizwan , Rizvi Taokeer Ahmed , Munawar Muhammad Tariq , Hussain Muhammad Ashraf , Samuel Tabish
Published: January 2022

Objective: To determine the superbug infection in a burn centre, its impact on mortality/morbidity and to review all preventive/therapeutic steps taken to fight this menace.

Study Design: Retrospective cross sectional study.

Place and Duration of Study: Department of Burns & Plastic Surgery, Army Burn Centre, Combined Military Hospital Kharian, from Oct 2018 to Sep 2019.

Methodology: A detailed retrospective audit of departmental data was carried out. Parameters like direct admission vs transferred patient, percentage of burns (Total Burn Surface Area-TBSA%), records of all burns related deaths and all culture/sensitivity reports were analysed using SPSS-20. As a standard practice in our unit blood, tracheal secretions and pus culture specimens of all patients are collected at the time of admission and then periodically fresh samples are taken every week or earlier when-ever required.

Results: Out of 515 patients, 283 (54.95%) were children under the age of 12 years. The overall survival rate improved by 13.43% as compared to last year. Out of 584 bacteriology reports 396 (67.81%) were positive and 188 (32.19%) were negative. On culture 508 organisms were isolated, majority of which were Carbapenem Resistant Pseudomonas, Acinetobacter, Enterobacteriaceae and Methicillin resistant staphylococcus aureus.

Conclusion: Multi drug resistant superbug infection is a worldwide menace. The best clinical practices, strict contact isolation, enhanced environmental cleaning and judicious use of appropriate antibiotics are the main strategies in this war. Need for newer more effective antibiotics cannot be overemphasized.
PROTECTIVE EFFECT OF SOYBEAN OIL ON MICE LUNG TISSUE INJURY AND ALVEOLAR HEMORRHAGE INDUCED BY BISPHENOL A
Authors: Shaukat Sadia , Kundi Hina , Ullah Qazi Waheed , Waheed Nazish , Deeba Farah , Iftikhar Shazia
Published: January 2022

Objective: To evaluate histomorphological effects of Soybean oil supplementation on lung tissue injury and alveolar hemorrhage induced by Bisphenol A (BPA).

Study Design: Laboratory-based experimental study.

Place and Duration of Study: Anatomy department, Army Medical College, Rawalpindi and National Institute of Health, Islamabad, from Nov 2015 to Nov 2016.

Methodology: Forty (40) healthy BALB/c mice of 9-11 weeks of age, weighing between 30-37gm were housed in a controlled environment at National Institute of Health. Group 1 (10) was control group. Group 2 (10) was given a daily dose of 50 milligram/kilogram body weight of Bisphenol A and group 3 (10) was given a daily dose of 500 milligram of Soybean oil and group 4 (10) was concurrently given Bisphenol A and Soybean oil with daily doses of 50 milligram/kilogram body weight and 500 milligrams. After a period of 8 weeks, animals were dissected 24 hours after receiving the last dosage. Lung wet weight, animal weight and relative body tissue weight index (RTBWI) were calculated. Tissue processing & staining was done. Alveolar hemorrhage was histomorphologically and statistically analysed using SPSS-21.

Results: On microscopic examination, alveolar hemorrhage (AH) was observed in 10 (100%) group 2 specimens with increase in RTBWI and whereas only 5 (50%) of group 4 specimens had alveolar hemorrhage with slight improvement in relative body tissue weight index (RTBWI).

Conclusion: Bisphenol A (BPA) induced lung injury as evident by intraalveolar hemorrhage, blood vessel congestion and increased RTBWI ratio were ameliorated by concomitant administration of Soybean oil.
200 COCHLEAR IMPLANTS – A MILESTONES
Authors: Ali Adil , Khan Rusab Alam , Humayun Muhammad Bin
Published: January 2022

An event was held at Army Medical College on the 10th of June, commemorating the 200th successful cochlear implant at Combined Military Hospital(CMH) Rawalpindi. The Surgeon General, Lt. Gen Nigar Johar HI (M), DG MS (IS) was the chief guest of the occasion. The event was attended by high rankingofficers of Army Medical Corps, faculty members and cadets of Army Medical College, as well as by some recipients of cochlear implants with their families.
COMPARISON OF DELAYED CORD CLAMPING AND CORD MILKING EFFECTS ON NEONATAL APGAR SCORE AND HAEMATOCRIT
Authors: Sabir Ghulam , Raja Ayesha , Mahboob Saira , Shoukat Saima , Kashif Ali , Iffat Shazia
Published: January 2022

Objective: To assess the feasibility of umbilical cord milking as an alternative to delayed cord clamping during caserean section by comparing neonatal outcomes.

Study Design: Quasi experimental study.

Place and Duration of Study: Department of Anesthesiology, Combined Military Hospital, Okara, from Mar to Oct 2018.

Methodology: A total of 384 cases (n=192 in each group) were included in our study. In group A, the half-length of umbilical cord was milked thrice by the operating surgeon before clamping and cutting it. In group B the umbilical cord was cut 90 second after delivery of the baby. The outcomes were: APGAR score at one and five minutes after delivery, haemglobin and haematocrit 4 hours after delivery of baby. Requirement of oxygen and ventilatory support during the 24 hours after birth were also noted.

Results: Our two study groups didn’t vary in their demographic profile. The difference between the APGAR score at one and five minutes was not statistically significant, (p>0.05). The diffrence in haemoglobin and haematocrit levels of the neonates 4 hours after delivery were insignificant (p-value 0.27 and 0.14 respectively).

Conclusion: Milking of the umbilical cord can be used as an alternative to the recommended technique of delayed umbilical cord clamping, especially when immediate resuscitation of the newborn is needed.
A COMPARATIVE STUDY OF HIGH SENSITIVITY C-REACTIVE PROTEIN (HS-CRP) AND GLYCEMIC MARKERS IN TYPE 2 DIABETES MELLITUS
Authors: Imran Shehar Bano , Dildar Shabnam , Taj Sadia , Khanum Afshan , Ahmed Qasim
Published: January 2022

Objective: To determine the relationship between high sensitivity CRP (hs-CRP) and glycemic markers in samples of individuals with diabetes.

Study Design: Cross sectional study.

Place and Duration of Study: Fatima Memorial Hospital Lahore, from Feb to Aug 2019.

Methodology: Consecutive patients aged 18-65 years coming for screening of diabetes mellitus (DM) were included. Blood sample for plasma glucose and glycated hemoglobin (HbA1c), high sensitivity CRP (hs-CRP) were analyzed.

Results: Total 93 subjects were included, out of which 42 (45.2%) were males and 51 (54.8%) were females with the mean age of 48.3 ± 12 years and 42.6 ± 14 years respectively. Median concentration of hs-CRP in males and females was 0.7 (IQR1.2) mg/L and 0.6 (IQR1.4) mg/L (p-value=0.844) respectively. A significant positive correlation was observed between hs-CRP levels, HBA1c with r=0.205 (p=0.05) and fasting plasma glucose (FPG) with r=0.225 (p=0.03). However, no significant relationship was found between hs-CRP and age, BMI, waist circumference and systolic blood pressure (SBP) and diastolic blood pressure (DBP), cholesterol, LDL-cholesterol, triglycerides (TG), HDL-cholesterol.

Conclusion: HbA1c and fasting plasma glucose is significantly associated with hs-CRP. This implies a significant relation between inflammation and glycemic markers. This leads to the conclusion that patients with diabetes and high hs-CRP need further evaluation, follow-up and therapy for inflammation compared to those with low hs-CRP.
COMPARATIVE EVALUATION OF EFFECTIVENESS OF CASEIN PHOSPHOPEPTIDE AMORPHOROUS CALCIUM PHOSPHATE AND SODIUM FLOURIDE VARNISH IN DENTINE HYPERSENTIVITY
Authors: Abbas Beenish , Sattar Madeeha , Abbas Sana , Rahim Shoaib , Ishfaque Qamar , Wajahat Mehreen
Published: January 2022

Objective: To determine efficacy of casein phosphopeptide amorphous calcium phosphate and sodium fluoride varnish in managing dentine hypersentivity.

Study Design: Quasi-experimental study.

Place and Duration of Study: Foundation University College of Dentistry, Islamabad, from Jun to Nov 2020.

Methodology: Patients of both gender 20-60 years of age with ASA “American Society of Anesthesiologists physical status classification” status I (completely healthy fit patient) or status II (patient has mild systemic disease) diagnosed with dentine hypersensitivity of incisors, canines, premolars with clinical evidence of erosion, abrasion, gingival recession not requiring restorative treatment were enrolled in the study. At first visit baseline, dentine hypersentivity was recorded by means of tactile and evaporative stimuli, response was quantified using visual analogue scale. Patients were randomly divided in two groups 1-casein phosphopeptide amorphous calcium phosphate, 2-sodium fluoride varnish desensitizing agent was applied conferring to manufacturer instructions. Visual analogue scale readings were assessed at base line and post treatment valueswas recorded at 7th, 15th, 30th day.

Results: Total 80 patients enrolled in the study with a mean age of 36.26 ± 8.91 years and age-range of 21-60 years. Visual analogue scale results of group-1 (n=40) were recorded at baseline as 5.9 ± 0 .94, 7th day 1.9 ± 0.92, 15th day 1.4 ± 0 .81 and 30th day 1.0 ± 0.71. In case of group-2 Visual Analogue Score recorded to be 6.2 ± 1.24,3.2 ± 0.81, 3.0 ± 0.52 and 2.7 ± 1.12 at baseline, 7th, 15th, and 30th day respectively.

Conclusion: Casein phosphopeptide amorphous..................
DETERMINATION OF DIAGNOSTIC ACCURACY OF BIOCHEMICAL PARAMETERS (CRP, LDH & FERRITIN) IN THE DIAGNOSIS OF COVID-19 IN SUSPECTED COVID CASES
Authors: Ashiq Tayyaba , Sattar Abdus , Uddin Nasir , Bashir Qamar , Shaheen Sajida , Ijaz Aamir
Published: January 2022

Objective: To determine the diagnostic accuracy of the Lactate Dehydrogenase, C-Reactive Protein and Ferritin in suspected patients of COVID-19.

Study Design: Cross-sectional validation study.

Place and Duration of Study: Pathology department of Combined Military Hospital Lahore in the month of May 2020.

Methodology: We included 101 adult (>18 years) symptomatic suspected COVID-19 patients of both genders. Children, pregnant women and asymptomatic patients were excluded from study. Age, gender and results of Reverse Transcriptase Polymerase Chain Reaction, Lactate Dehydrogenase, C-Reactive Protein, ferritin were recorded.

Results: Lactate Dehydrodenase had highest sensitivity (75%) with positive predictive value of 71.6% and diagnostic accuracy of 65.3% among three biochemical parameters studied. Receiver Operator Characteristic curve was studied. Area under curve of Lactate Dehydrogenase (AUC=0.65) and Ferritin (AUC=0.59) reflected their ability to prognosticate the presence of COVID19 disease. However, C-Reactive Protein (AUC=0.42) appeared to be a poor predictor of the disease.

Conclusion: Raised serum Lactate Dehydrogenase (>490 U/L) and Ferritin (>152 ng/L) levels can be used to predict the Reverse Transcriptase Polymerase Chain Reaction positivity for COVID-19 in the population of suspected patients of COVID19. However, C-Reactive Protein is a poor predictor of COVID-19.
ASSOCIATION OF STEROID RECEPTOR EXPRESSION WITH THE CLINICAL AND HISTOLOGICAL FINDINGS IN PATIENTS WITH ENDOMETRIAL CANCER
Authors: Shahid Aisha , Haider Ghulam , Memon Paras , Beg Shumyla , Shahzadi Mehwish , Abbas Kiran
Published: January 2022

Objective: To determine the association of estrogen and progesterone receptor expression with the clinical and histological findings of endometrial cancer.

Study Design: Prospective observational study.

Place and Duration of Study: Jinnah Postgraduate Medical Centre, Karachi between Sep 2017 to Oct 2019.

Methodology: A total of 130 patients were diagnosed with endometrial carcinoma. Data from patient files were collected regarding tumour histology, grade, stage, tumour receptor expression, and the clinical characteristics: parity, menopausal status. The receptor expression profile was documented for each patient. Data were analyzed using SPSS version 25. The association between ER/PR expression categories and clinical/histological features were explored using the chi-square test.

Results: The estrogen and progesterone receptor expressions were significantly associated with low-grade (Grade I and II) tumours and with Stage I and Stage II endometrial carcinoma with p<0.001. About 34 (34.7%) cases of endometrioid histology were negative for both estrogen and progesterone receptors. The ER and PR negativity was strongly associated with Grade III endometrial cancer (p=0.003). The majority of the stage IV cancers were negative for both the ER and PR receptors with a p<0.001.

Conclusion: Estrogen and progesterone positivity was associated with endometrioid adenocarcinoma, well-differentiated, and less advanced stage of endometrial cancer at the time of diagnosis.
COMPARISON OF OVULATION INDUCTION LETROZOLE AND CLOMIPHENE CITRATE IN SUBFERTILE WOMEN WITH POLYCYSTIC OVARIAN SYNDROME
Authors: Shafiq Amna , Akbar Rabiya , Urooj Uzma , Zohra Sadaf , Afzal Shazia , Tanveer Madiha
Published: January 2022

Objective: To compare the ovulation induction of letrozole and clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.

Study Design: Quasi experimental study.

Place and Duration of Study: Combined Military Hospital Rawalpindi, from Jun 2018 to Aug 2019.

Methodology: A total of 116 married sub-fertile women with polycystic ovarian syndrome, 16-40 years of age were included. Patients with previous surgery related to genital tract, hypothyroidism and chronic renal failure were excluded. Letrozole 5.0mg daily from Day 5-9 of menstruation was prescribed to group A women and clomiphene citrate 100 mg daily from Day 5-9 of menses was given to group B women.

Results: In group A and in group B, mean age was 29.78 ± 4.71 years and 29.95 ± 4.22 years respectively. Most of the patients 59 (50.86%) were between 18-30 years of age. Mean duration since marriage was 4.23 ± 1.42 years. Mean body mass index was 29.71 ± 2.65 kg/m2. Frequency of ovulation of clomiphene citrate and letrozole in sub-fertile women with polycystic ovaries was 28 (42.28%) versus 42 (72.41%) respectively (p-value=0.008).

Conclusion: This study concluded that ovulation induction of letrozole is better than clomiphene citrate in sub-fertile women with polycystic ovarian syndrome.
VARIATIONS IN CLINICAL PRESENTATION, NEUROIMAGING AND EEG PATTERNS OF SUBACUTE SCLEROSING PANENCEPHALITIS
Authors: Wasim Areeba , Alvi Javeria Raza , Ghani Natasha , Khalily Athar , Rehman Zia Ur , Sultan Tipu
Published: January 2022

Objective: To determine the variations in clinical presentation, neuroimaging and electroencephalography patterns of subacute sclerosing panencephalitis.

Study Design: Cross-sectional study.

Place and Duration of Study: Children’s Hospital & Institute of Child Health, Lahore, Pakistan, from Jul to Dec 2020.

Methodology: We recruited children presented with clinical features suggestive of subacute sclerosing panencephalitis, along with positive anti-measles antibodies on cerebrospinal fluid. Association between variables was determined to formulate an early diagnosis of subacute sclerosing panencephalitis.

Results: Out of 47 children, 29 were males with a mean age of 6.54 ± 2.9 years. Only 23% were fully immunized against measles, 36.2% were unvaccinated and 40.4% received partial immunization. The mean age of measles infection was 1.49 ± 1.2 years; the mean interval between measles and onset of SSPE was 4.13 ± 3 years. Atypical clinical presentation was seen in 38.3% with intractable epilepsy (8.5%), focal deficit (8.5%) and extrapyramidal symptoms (8.5%) being commonest followed by coma (6.4%), visual loss (4.3%) and psychosis (2.1%). Neuroimaging was suggestive of cortical hyperintensities in 46.8% and was normal in 46.8%. Electroencephalography showed burst suppression in 55.3% and atypical findings in 19.1%. Younger age (1-1.5 years) of measles and unimmunized status were associated with early onset of SSPE with a p-value of 0.001 and 0.05 respectively. Non-immunized status was associated with atypical presentation of SSPE (p-value <0.05).

Conclusion: The younger age of measles infection and failure to receive complete immunization led to early onset of Subacute sclerosing panencephalitis with an atypical presentation.
DENTAL EDUCATION PAKISTAN (DEP) VISION 2025: A WAY FORWARD, TOWARDS PROGRESSION & GLOBALIZATION
Authors: Katpar Shahjahan , Almas Khalid
Published: January 2022

Abrahim Flexner, considered “Father of Modernday Medical Education” about a century ago revolutionized entire Health Education & Service Structure bypublishing his shivering report based on standards, resulted in closure of compromised academic institutes and transformed the entire USA/Canadian Health Sector, including Dentistry. His report strongly demanded, appropriate knowledge and skills application to avoid compromised patient care, as the most important aspect required for ailing humanity and this also includes oral/ dental health care. We feel that the current Dental Education Pakistan (DEP) also needs similarreports to attain excellence & “globalization” to be at par with international standards.
COMPLICATIONS OF INTRA ABDOMINAL DRAINS: A SINGLE CENTER EXPERIENCE
Authors: Azhar Muhammad , Memon Munawer Latif , Akhtar Naeem , Altaf Anam
Published: January 2022

Objective: To compare frequency of intra-abdominal complications in drainage and non-drainage group among patents who underwent intra-abdominal surgeries.

Study Design: Comparative prospective study.

Place and Duration of Study: Department of Surgery, Pakistan Ordinance Factory, Wah Cantt, from Mar 2018 to Jul 2018.

Methodology: There were 32 patients, 16 in each group. Patients were selected through the process of consecutive sampling. Patients were randomly divided into two groups (random number table method); group A patients underwent intra-abdominal drain while group B was non-drainage group. Patients were followed up for 7 days and observed for complications.

Results: Total 32 patients were included in the study. There were 14 (43.8%) males and 18 (56.3%) females. Mean age of patients was 43.2 ± 9.5 years. Drain group showed significantly low anastomosis leakage (p=0.02), wound infection (p=0.05), mortality (p=0.04), pulmonary complications (p=0.05) and bleeding (p=0.03) as compared to the non-drain group.

Conclusion: Intra-abdominal drains are associated with several complications. Anastomosis leakage is the most common complication following pulmonary complications and bleeding. However, drains help in early detection of complications and timely management of such complications leads to better outcome of a surgical procedure.
ENDOSCOPIC ENDONASAL DACRYOCYSTORHINOSTOMY: EXPERIENCE OF HUNDRED CASES
Authors: Shahid Muhammad , Awais Muhammad , Akram Amjad , Naqvi Syed Abid Hassan , Zafar Omar , Malik Tahir Mumtaz
Published: January 2022

Objective: To determine the success rate of Endonasal Endoscopic Dacryocystorhinostomy (Endo-DCR) in cases of chronic dacryocystitis secondary to primary acquired nasolacrimal duct obstruction (NLDO).

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Oculoplastic Surgery, Armed Forces Institute of Ophthalmology Rawalpindi, from Sep 2018 to Nov 2019.

Methodology: Endo-DCR under General Anaesthesia was performed on 100 patients of primary acquired nasolacrimal duct obstruction causing chronic dacryocystitis. Post-operatively these patients were checked on first post-op day, then on one week and finally four months after surgery. We removed silicone tubes of all the patients four months after surgery. To ensure patency of lacrimal passage, we did syringing and irrigation of lacrimal system of all cases, at conclusion of the study. We chose absence of epiphora and patent lacrimal system on syringing as indicators of successful procedure.

Results: Hundred patients (males 37; females 63) were recruited for this study. Mean age of our sample population was 51.1 ± 29 years. Right nasolacrimal duct obstruction cases were 56 whereas left nasolacrimal duct obstruction cases were 44. Subjective improvement i.e., absence of epiphora was found in 90% patients. We got successful irrigation of lacrimal passages (objective improvement) in 94% of patients.

Conclusion: Endo-DCR yields comparable results to external Dacryocystorhinostomy (Ex DCR). It offers additional benefits of esthetically better outcome, lesser complication rate and short surgery and patient recovery time.
THE EFFECT OF INTRAVENOUS MAGNESIUM SULFATE ON CHILDREN ADMITTED WITH ACUTE BRONCHIOLITIS IN A TERTIARY CARE HOSPITAL
Authors: Ara Andaleeb , Ikram Farooq , Ullah Hidayat , Asmat Shakila , Tareen Nadia
Published: January 2022

Objective: To assess the efficacy of using intravenous Magnesium Sulfate along with the conventional treatment in the management of acute bronchiolitis

Study Design: Quasi-experimental study.

Place and Duration of Study: Pediatrics department in Sandeman Provincial Hospital, Quetta, from Jan to Jul 2019.

Methodology: The study was approved by institutional ethical committee of Combined Military Hospital, Peshawar. Children, 2 months to 2 years of age, with acute bronchiolitis having clinical severity score of ≥5, presenting to the OPD and emergency department were enrolled in the study after getting informed consent from the guardian. They were randomly assigned group A receiving intravenous Magnesium Sulfate and group B receiving placebo along with the conventional treatment for both. Data was analysed with SPSS-21.

Results: Total 108 patients were included in the study with 54 (50%) in group A and 54 (50%) in group B. Mean age in the study was 12.02 ± 6.421 months. Mean age in group A and B was 11.17 ± 6.40 and 12.87 ± 6.38 months respectively. Out of 108 patients 50 (46.3%) were males while 58 (53.7%) were females. There was statistically significant difference in the efficacy of treatment between two groups with values being 48 (88.9%) and 37 (68.5%) for Magnesium Sulfate and control groups respectively (p=0.01).

Conclusion: From a clinical point of view, intravenous Magnesium Sulfate combined with conventional treatment is more effective than conventional treatment alone in the management of acute bronchiolitis.
EFFICACY OF 5% POTASSIUM HYDROXIDE VERSUS 10% POTASSIUM HYDROXIDE SOLUTION FOR THE TREATMENT OF MOLLUSCUM CONTAGIOSUM AT A TERTIARY CARE HOSPITAL
Authors: Baloch Hina Saleem , Ahmed Najia , Bari Arfan Ul , Farooq Omer , Qureshi Abdullah Ahmad Waqar
Published: January 2022

Objective: To compare the efficacy of 5% potassium hydroxide (KOH) and 10% potassium hydroxide (KOH) solution for the treatment of molluscum contagiosum at a tertiary care Hospital.

Study Design: Quasi-experimental study.

Place and Duration of Study: Dermatology Department, Tertiary Care Hospital Karachi, from Oct 2019 to Apr 2021.

Methodology: Sixty patients with molluscum contagiosum who fulfilled the inclusion and exclusion criteria were enrolled in the outpatient department of tertiary care hospital in Karachi. Patients were divided into two groups, A (5% KOH) and B (10% KOH) of 30 patients each. Potassium Hydroxide (KOH) solution was applied at home using the cotton-tipped applicator twice daily. Follow-up of patients was done at 2-weekly intervals for 12 weeks. Efficacy was measured based on the resolution of lesions or improvement from baseline.

Results: Complete response occurred in 23 (76.7%) cases in 10% KOH Group while 6 (20%) in 5% KOH Group, Partial response occurred in 6 (20%) in 10% KOH group while 15 (50%) in 5% KOH group, No response occurred in 1 (3.33%) in 10% KOH group and 9 (30%) in 5% KOH group (p<0.001).

Conclusion: 10% Potassium Hydroxide (KOH) is an efficient modality for the treatment of molluscum contagiosum compared to 5% Potassium Hydroxide (KOH).
ROLE OF INTERLEUKIN-6 AND PROCALCITONIN AS INFLAMMATORY BIOMARKERS IN EVALUATING COVID-19 DISEASE SEVERITY ON HRCT CHESTAN EXPERIENCE AT CMH QUETTA
Authors: Ayub Zeeshan , Ahmed Azeema , Afzal Farah , Bashir Saima , Iqbal Hamid , Nawaz Khurram Haq
Published: January 2022

Objective: To explore the relation of Interleukin-6 and Procalcitonin with COVID-19 severity on high resolution computerized tomogram (HRCT) chest.

Study Design: Randomized Control Trial (NCT04945811).

Place and Duration of study: Pathology Department, Combined Military Hospital Quetta, from April 2020 to May 2021.

Methodology: Serum Interleukin-6 and Procalcitonin of 100 consenting COVID-19 positive patients from April 2020 to May 2021 were assessed at Pathology department Combined Military Hospital Quetta and their levels were correlated with severity of lung involvement on HRCT Chest

Results: Serum Interlukin-6 levels were significantly raised in 97 patients with mean levels of 20.43 ± 19.66 (pg/ml). Serum procalcitonin levels were also significantly raised in 95 patients with mean levels of 0.43 ± 0.24 (ng/ml).

Conclusion: Interlukin-6 and procalcitonin are important biomarkers for diagnosis and predicting severity of COVID-19 pneumonia.
COMPARISON OF MICRODEBRIDER - ASSISTED TURBINOPLASTY VERSUS ENDOSCOPIC PARTIAL TURBINECTOMY IN CASES OF INFERIOR TURBINATE HYPERTROPHY IN ALLERGIC RHINITIS PATIENTS
Authors: Khan Muhammad Ahmed , Nawaz Faiz Ul Hassan , Tahir Muhammad , Mazhar Hina , Dawood Muhammad , Rahim Ejaz
Published: January 2022

Objective: To compare microdebrider-assisted turbinoplasty versus endoscopic partial turbinectomy in cases of inferior turbinate hypertrophy in allergic rhinitis patients in terms of relief/improvement of nasal obstruction, post operative bleeding, crusting and synechie formation.

Study Design: Quasi experimental study.

Place and Duration of Study: Combined Military Hospital Mardan and Combined Military Hospital Malir, from Jan 2019 to Jan 2020.

Methodology: A total of 90 patients of allergic rhinitis with severe nasal obstruction due to bilateral inferior turbinate hypertrophy fulfilling the inclusion exclusion criteria were selected. Cases were randomly divided into two groups of 45 each. Group A cases underwent microdebrider assisted turbinoplasty and Group B cases underwent partial turbinectomy via endoscpic approach. They were comparedin terms of post op bleeding, relief of nasal obstruction, post op crusting & synechie/adhesions. All the data was entered on SPSS-17 and analyzed.

Results: Out of 90 cases, there were 43 (47.8%) females and 47 (52.2%) males with age range from 15-65, mean age 37.68 ± 11.56 Years. There was only 1 case of post op bleeding after microdebrider assisted turbinoplasty requiring nasal packing in contrast to 6 cases of post op bleeding after endoscopic partial turbinectomy. On one month post op visit, there was no case of nasal crusting in turbinoplasty group in contrast to 7 of mild and 1 of moderate crusting & 3 synechie/adhesions in endoscopic partial turbinectomy group.

Conclusion: Microdebrider-assisted turbinoplasty is associated with less post operative bleeding and synechie formation as compared to endoscopic turbinectomy.
ROLE OF FIBRIN GLUE FOR BETTER SUCCESS RATE IN MYRINGOPLASTY
Authors: Aslam Sohail , Asghar Adnan , Bukhari Syed Muhammad Asad Shabbir , Akhtar Sunarays , Mumtaz Hamza , Waseem Muhammad Fahad
Published: January 2022

Objective: To see graft uptake success rate in platelet rich fibrin aided underlay myringoplasties using temporalis fascia graft compared to conventional underlay myringoplasties.

Study Design: Double blind randomized controlled trial study.

Place and Duration of Study: ENT department, Pakistan Naval Ship Shifa Hospital, from Jan to Jun 2019.

Methodology: Sixty cases with dry central tympanic membrane perforations were recruited. The patients suffering from sensori-neural hearing loss and co-morbidities like diabetes were excluded. The sampling technique was probability simple random. Patients were divided into two groups by lottery method. Statistical analysis was performed by using SPSS. The chi square test was applied to calculate p-value.

Results: Out of total 60 patients 38 were males and 22 were females. Study group’s (Fibrin) mean age was 31.77 ± 12.43 years and Control group’s mean age was 27.53 ± 11.41 years. All the patients in platelet rich fibrin group had successful graft uptake at 2 months follow-up. In control group with conventional technique 23 out of 30 patients had successful graft uptake and rest 7 patients had different issues leading to graft rejection.

Conclusion: In under lay myringoplasty procedure, application of platelet rich fibrin on temporalis fascia graft edge and perforation edges has significantly improved the successful uptake rate of graft.
Perfil clínico y angiográfico de las mujeres con infarto agudo al miocardio en un hospital nacional
Authors: Acuña-Román Andrés , Vindas-Villarreal Manuel Antonio , Salas-Segura Donato A.
Published: January 2022

Justificación: La cardiopatía isquémica es la principal causa de muerte de mujeres en Costa Rica, y su incidencia ha aumentado con los años. A pesar de esto, hay pocos estudios clínicos a este respecto en nuestro país. El objetivo del presente trabajo es presentar las principales características clínicas y angiográficas de un grupo de pacientes con infarto agudo del miocardio con la idea de establecer no solo sus particularidades sino permitir comparaciones con otras poblaciones.Métodos: Se trató de un estudio observacional, descriptivo y retrospectivo, de un periodo de cinco años, en el cual se incluyeron a las pacientes ingresadas con infarto del miocardio a la Unidad de Cuidados Intensivos. Se registraron datos demográficos, de evolución clínica, complicaciones, hallazgos angiográficos, tratamiento y desenlace. El análisis estadístico fue cuantitativo descriptivo, realizado con el programa informático SPSS v.21 (IBM Corp., EEUU) y éste consistió en cálculos de frecuencia, tendencia central, medidas de variabilidad de rango, percentiles, y chi-cuadrado. El protocolo de la investigación fue aprobado por el Comité Ético Científico del Hospital Rafael Ángel Calderón Guardia (DG-3380-2020).Resultados: De 190 pacientes se incluyeron un total de 54. La edad promedio fue de 60 años, con una mortalidad del 17,9%, la cual fue 5,4 % más alta que en los hombres. La mayor parte de las pacientes padecía de hipertensión arterial (74%), 24 (44,5%) eran tabaquistas y 23 (42,5%) tenían diabetes mellitus. Los síntomas más frecuentes fueron: dolor torácico, criodiaforesis y disnea. Se consideró que hubo dolor torácico atípico en 8 casos (15%). A 48 pacientes se le llevó a angioplastia coronaria y solo 35% la recibieron en tiempo oportuno. A 17 pacientes se les aplicó trombólisis farmacológica y solo en 3 pacientes fue exitosa. La arteria coronaria derecha y la arteria descendente anterior fueron los vasos responsables en la mayoría de los casos (19 casos (39,5%) cada uno de ellas.)Conclusión: Esta población tuvo síntomas isquémicos claros, con enfermedad coronaria severa y una mortalidad mayor que los hombres. En general la terapia farmacológica, así como la mecánica se aplicaron en forma tardía.
MATTI LUUKKAINEN 18.3.1937–18.5.2021 In memoriam
Authors: Keinästö Kari
Published: January 2022

Nachruf Prof. emer. Dr. Matti Luukkainen
Exploring the Efficacy of Anti-amyloid-β Therapeutics in Treating Alzheimer Disease
Authors:   Biochemistry, National University of Ireland, Galway, Downey Ciara
Published: January 2022

Alzheimer Disease (AD) is the most prevalent cause of dementia, characterized by initial memory impairment and progressive cognitive decline. The exact cause of AD is not yet completely understood. However, the presence of neurotoxic amyloid-beta (Aβ) peptides in the brain is often cited as the main causative agent in AD pathogenesis. In accordance with the amyloid hypothesis, Aβ accumulation initially occurs 15-20 years prior to the development of clinical symptoms. Current therapies focus on the prodromal and preclinical stages of AD due to past treatment failures involving patients with mild to moderate AD. Passive immunization via exogenous monoclonal antibodies (mAbs) administration has emerged as a promising anti-Aβ treatment in AD. This is reinforced by the recent approval of the mAb, aducanumab. mAbs have differential selectivity in their epitopes, each recognising different conformations of Aβ. In this way, various Aβ accumulative species can be targeted. mAbs directed against Aβ oligomers, the most neurotoxic species, are producing encouraging clinical results. Through understanding the process by which mAbs target the amyloid cascade, therapeutics could be developed to clear Aβ, prevent its aggregation, or reduce its production. This review examines the clinical efficacy evidence from previous clinical trials with anti-Aβ therapeutics, in particular, the mAbs. Future therapies are expected to involve a combined-targeted approach to the multiple mechanisms of the amyloid cascade in a particular stage or disease phenotype. Additional studies of presymptomatic AD will likely join ongoing prevention trials, in which mAbs will continue to serve as the focal point.
Museari: Art in a Virtual LGBT Museum Promoting Respect and Inclusion
Authors: Huerta Ricard
Published: January 2022

Museari is an online museum dedicated to upholding human rights and sexual diversity through art, history, and education. Museari was born in 2015 and since then more than 70 exhibitions have been presented. This paper analyzes Museari's interest in teacher training, something that has been especially positive during the Covid-19 pandemic. The objective of the research is to reflect on the opportunity to use a virtual museum to address issues of art and education. For data collection, we used assessment instruments specific to the case study, such as diagnoses, discussions, focus groups, and participant observation. We highlight museum’s positive reception by the students, particularly the role it plays in overcoming stereotypes and conventional taboos to achieve inclusive environments.
The Potential of Friendship: A Case for Social Resilience and New Care Optics
Authors: Kulpa Roberto , Ludwin Katherine
Published: January 2022

In this article, we call for greater recognition of friendship as a basic social relation that should play a pivotal role in re-imagining social resilience if it is to be future-proof in the face of social upheaval, such as the current pandemic. Drawing on existing research and early scoping of emergent information about the impact of the Covid-19 pandemic, we suggest that friendship is an important component of heterogenic social realities. The specific focus of our discussion is twofold. Firstly, attention is paid to the narrow lens of social policy that privileges particular familial set-ups and living arrangements, and in doing so marginalises groups which are already disenfranchised; secondly, we consider the dangers of nationalism and Eurocentrism as they relate to these issues. We suggest that thinking in terms of friendship can open up new avenues of academic and political imagination, offering strategies with greater potential for building socially resilient communities.
A Litany of Saints: Remembering the Early Years of HIV/AIDS Activism in the First Year of a New Pandemic
Authors: Foltz Mary , Shanker Adrian , Bradbury Liz , Leipert Kristen
Published: January 2022

With the emergence of COVID-19 in the U.S., many LGBTQ people found ourselves reflecting upon the early years of HIV/AIDS and how our communities responded to the lack of robust federal and state response to this preceding public health crisis. As the leaders of the Bradbury-Sullivan LGBT Community Center (BSC) in eastern Pennsylvania became a central resource for our community sharing up-to-date information about COVID-19 and organizing vaccine clinics, they also recognized the historic nature of this moment as many elders in our community consistently tried to make sense of the current crisis by contemplating their past AIDS activism and organizing. In March of 2020, BSC staff and archivists received grant funding to conduct an oral history project called "40 Years of Public Health in the LGBTQ Community: Collecting and Curating Local LGBTQ Health Experiences From HIV/AIDS to COVID-19," which recorded both timely commentary on the impact of COVID-19 on LGBTQ people and memories of HIV/AIDS organizing that seemed urgent and relevant to our contemporary moment. Offering excerpts from oral histories collected in 2020, this piece explores how COVID-19 spurred LGBTQ people in the Lehigh Valley to share stories about communal grief, health inequity, political responses to pandemics, and organizing to support the health of minoritized communities.
Queer Indiscipline, Decolonial Revolt: The Production of Undisciplined Knowledges in the Neoliberal Age
Authors: Fritschy Tyna
Published: January 2022

As an intervention into a domesticated academic knowledge production and an increasingly normative queer theorizing, Queer Indiscipline, Decolonial Revolt asks for the proliferation of other modalities of thinking and writing. The context of such interrogation is the neoliberal restructuring of the university which comfortably accommodates criticality. Where criticality has lost its sting, this paper calls for a daring indiscipline opposing political, public, and scientific disciplining. This brings practices of doing knowledge and not the knowledges as such into attention. An intimacy between the queer and the undisciplined is established by referencing the resistance to assimilationist politics and practices as queer theory’s principal asset. Yet, undisciplined know¬ledges are not only geared towards challenging the bounds of the discipline(s), but also, and more broadly, towards decolonial futures. Queer Indiscipline, Decolonial Revolt explores various moments of concomitant unlearning and improvisation on and beyond the academic stage. The piece conducts three non-linear explorations. The first part analyzes the making of a hierarchical knowledge machine as part of capitalist modernity and revisits moments of queer and black queer theorizing that challenge the dividing lines between high/low, sensible/nonsensical, intellectual/corporeal, theory/practice, speech/chatter, etc. The second part discusses the masterful subject as the agent of knowledge. While the persistence and the pervasiveness of such master fantasy gets acknowledged, the verve of this paper is oriented towards the modality of queer dispos¬session. The final section gives way to the sabotage inherent in the unruly rhythm of life. Such sabotage is tested to counteract the frameworks, formats and concepts which articulate intellectuality on a more fun¬damental level. This advances the deconstruction of intellectuality to the terrifying and beautiful point where intellectuality is co-extensive with the social.
OH and HO2 radicals chemistry at a suburban site during the EXPLORE-YRD campaign in 2018
Authors: Ma Xuefei , Tan Zhaofeng , Lu Keding , Yang Xinping , Chen Xiaorui , Wang Haichao , Chen Shiyi , Fang Xin , Li Shule , Li Xin , Liu Jingwei , Liu Ying , Lou Shengrong , Qiu Wanyi , Wang Hongli , Zeng Limin , Zhang Yuanhang
Published: January 2022

Abstract. The first OH and HO2 radical observation in Yangtze River Delta, one of the four major urban agglomerations in China, was carried out at a suburban site Taizhou in summer 2018 from May to June, aiming to elucidate the atmospheric oxidation capacity in this region. The maximum diurnal averaged OH and HO2 concentrations were 1.0 × 107 cm−3 and 1.1 × 109 cm−3, respectively, which were the second highest HOx (sum of OH and HO2) radical concentrations observed in China. HONO photolysis was the dominant radical primary source, accounting for 42 % of the total radical initiation rate. Other contributions were from carbonyl photolysis (including HCHO, 24 %), O3 photolysis (17 %), alkenes ozonolysis (14 %), and NO3 oxidation (3 %). A chemical box model based on RACM2-LIM1 mechanism could generally reproduce the observed HOx radicals, but systematic discrepancy remained in the afternoon for OH radical, when NO mixing ratio was less than 0.3 ppb. Additional recycling mechanism equivalent to 100 ppt NO was capable to fill the gap. The sum of monoterpenes was on average up to 0.4 ppb during daytime, which was allocated all to α-pinene in the base model. Sensitivity test without monoterpene input showed the modelled OH and HO2 concentrations would increase by 7 % and 4 %, respectively, but modelled RO2 concentration would significantly decrease by 23 %, indicating that monoterpene was an important precursor of RO2 radicals in this study. Consequently, the daily integrated net ozone production would reduce by 6.3 ppb if without monoterpene input, proving the significant role of monoterpene on the photochemical O3 production in this study. Besides, the generally good agreement between observed and modelled HOx concentrations suggested no significant HO2 heterogeneous uptake process during this campaign. Incorporation of HO2 heterogeneous uptake process would worsen the agreement between HOx radical observation and simulation, and the discrepancy would be beyond the measurement-model combined uncertainties using an effective uptake coefficient of 0.2. Finally, the ozone production efficiency (OPE) was only 1.7 in this study, a few folds lower than other studies in (sub)urban environments. The low OPE indicated slow radical propagation rate and short chain length. As a consequence, ozone formation was suppressed by the low NO concentration in this study.
Assessing the consequences of including aerosol absorption in potential Stratospheric Aerosol Injection Climate Intervention Strategies
Authors: Haywood Jim , Jones Andy , Johnson Ben , Smith William McFarlane
Published: January 2022

Abstract. Theoretical Stratospheric Aerosol Intervention (SAI) strategies model the deliberate injection of aerosols or their precursors into the stratosphere thereby reflecting incident sunlight back to space and counterbalancing a fraction of the warming due to increased concentrations of greenhouse gases. This cooling mechanism is known to be relatively robust through analogues from explosive volcanic eruptions which have been documented to cool the climate of the Earth. However, a practical difficulty of SAI strategies is how to deliver the injection high enough to ensure dispersal of the aerosol within the stratosphere on a global scale. Recently, it has been suggested that including a small amount of absorbing material in a dedicated 10-day intensive deployment might enable aerosols or precursor gases to be injected at significantly lower, more technologically-feasible altitudes. The material then absorbs sunlight causing a localised heating and ‘lofting’ of the particles, enabling them to penetrate into the stratosphere. Such self-lofting has recently been observed following the intensive wildfires in 2019–2020 in south east Australia, where the resulting absorbing aerosol penetrated into the stratosphere and was monitored by satellite instrumentation for many months subsequent to emission. This study uses the fully coupled UKESM1 climate model simulations performed for the Geoengineering Model Intercomparison Project (GeoMIP) and new simulations where the aerosol optical properties have been adjusted to include a moderate degree of absorption. The results indicate that partially absorbing aerosols i) reduce the cooling efficiency per unit mass of aerosol injected, ii) increase deficits in global precipitation iii) delay the recovery of the stratospheric ozone hole, iv) disrupt the Quasi Biennial Oscillation when global mean temperatures are reduced by as little as 0.1 K, v) enhance the positive phase of the wintertime North Atlantic Oscillation which is associated with floods in Northern Europe and droughts in Southern Europe. While these results are dependent upon the exact details of the injection strategies and our simulations use ten times the ratio of black carbon to sulfate that is considered in the recent intensive deployment studies, they demonstrate some of the potential pitfalls of injecting an absorbing aerosol into the stratosphere to combat the global warming problem.
Modelling the artificial forest (Robinia pseudoacacia L.) root–soil water interactions in the Loess Plateau, China
Authors: Li Hongyu , Luo Yi , Sun Lin , Li Xiangdong , Ma Changkun , Wang Xiaolei , Jiang Ting , Zhu Haoyang
Published: January 2022

Abstract. Plant root–soil water interactions are fundamental to vegetation–water relationships. Soil water availability and distribution impact the temporal–spatial dynamics of roots and vice versa. In the Loess Plateau (LP) of China, where semi-arid and arid climates prevail and deep
loess soil dominates, drying soil layers (DSLs) have been extensively
reported in artificial forestland. While the underlying mechanisms that cause DSLs remain unclear, they hypothetically involve root–soil water interactions. Although available root growth models are weak with respect to simulating the rooting depth, this study addresses the hypothesis of the involvement of root–soil water interactions in DSLs using a root growth model that simulates both the dynamic rooting depth and fine-root distribution, coupled with soil water, based on cost–benefit optimization. Evaluation of field data from an artificial black locust (Robinia pseudoacacia L.) forest site in the southern LP positively proves the model's performance. Further, a long-term simulation, forced by a 50-year climatic data series with varying precipitation, was performed to examine the DSLs. The results demonstrate that incorporating the dynamic rooting depth into the current root growth models is necessary to reproduce soil drying processes. The simulations revealed that the upper boundary of the DSLs fluctuates strongly with infiltration events, whereas the lower boundary extends successively with increasing rooting depth. Most infiltration was intercepted by the top 2.0 m layer, which was the most active zone of infiltration and root water uptake. Below this, the percentages of fine roots (5.0 %) and water uptake (6.2 %) were small but caused a persistently negative water balance and consequent DSLs. Therefore, the proposed root–water interaction approach succeeded in revealing the intrinsic properties of DSLs; their persistent extension and the lack of an opportunity for recovery from the drying state may adversely affect the implementation of artificial afforestation in this region as well as in other regions with similar climates and soils.