bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasonographic Evaluation of Cholelithiasis with Family History among Adults in Swabi
Authors: Tariq Mamona , Khan Maaz , Rabia Yasmeen  , Zumra Irshad  , Iqra Gul  , Gulalay Iqbal  , Zubair Muhammad , Qurat Ul Ain
Published: June 2024

Background: Gallstones, formed within the gallbladder, can lead to serious health complications in adults. Factors such as obesity and age are well-recognized contributors to gallstone formation. However, the influence of family history on the development of cholelithiasis remains unclear.
Objective: This study aims to investigate whether a family history of gallstones increases the likelihood of developing this condition in adults living in Swabi, using ultrasonographic techniques.
Methods: A cross-sectional study was conducted over four months, involving 125 adults diagnosed at Bacha Khan Medical Complex, Swabi, KP, Pakistan. Participants were selected based on a history of cholelithiasis and underwent ultrasonographic examinations using a Toshiba prime machine with convex (3.0—5.0 MHz) and linear (7.0—14.0 MHz) transducers. Family medical history was collected via structured questionnaires. Data were analyzed using SPSS version 25.0, focusing on the prevalence and potential familial ties of gallstone disease.
Results: Of the participants surveyed, 97.7% (n=125) were diagnosed with cholelithiasis, indicating a high prevalence of the condition. Among those with gallstones, 36.2% reported a positive family history, suggesting a significant association between familial history and the occurrence of cholelithiasis.
Conclusion: The study underscores a substantial prevalence of cholelithiasis among adults in Swabi, with a notable association to family history, highlighting the need for further investigation into genetic predispositions and preventive strategies for those at risk.
Ultrasound Comparison of Renal Changes in Diabatic and Non-Diabatic Adult in Swabi
Authors: Kanwal Kainat , Khan Maaz , Kalsoom Zahid  , Marwa Noor  , Nimra Abid  , Waleeja Naz  , Zubair Muhammad , Qurat Ul Ain
Published: June 2024

Background: Chronic kidney disease (CKD) is a major health concern globally, often leading to kidney failure, with diabetes and hypertension as significant risk factors. Early detection and effective management are crucial for mitigating its progression. Ultrasound imaging provides a non-invasive means to assess structural changes in the kidneys of both diabetic and non-diabetic individuals.
Objective: The objective of this study is to analyze renal changes in diabetic versus non-diabetic adults using ultrasound imaging to measure kidney dimensions, cortical thickness, and echogenicity grades, and to correlate these measurements with obesity, hypertension, and diabetes.
Methods: A cross-sectional study was conducted at Mahaban Medical and Research Hospital in Swabi, KP, Pakistan, including 65 adults aged 18-65. Kidney dimensions (length, width) and cortical thickness were measured using a Toshiba prime ultrasound machine with convex transducers ranging from 3.0—5.0 MHz to 7.0—14.0 MHz. Participants were categorized as diabetic or non-diabetic based on their medical records. Information on obesity, hypertension, and diabetes was collected through medical records and self-reporting. Echogenicity grades were assigned based on ultrasound findings, and data were analyzed using descriptive statistics and cross-tabulation of echogenicity grades.
Results: The study included 65 participants with a mean age of 42 years. The average dimensions for right kidneys were 9.14 cm in length, 3.98 cm in width, and cortical thickness of 0.80 cm; left kidneys measured 8.84 cm in length, 4.05 cm in width, and cortical thickness of 0.77 cm. Of the participants, 40% were obese, 63.1% had hypertension, and 44.6% were diagnosed with diabetes. The most common echogenicity grade observed was Grade 3, particularly in bilateral cases.
Conclusion: This study highlights the complex nature of kidney health, revealing significant impacts of obesity, hypertension, and diabetes on renal structure and function. The findings underscore the necessity for comprehensive clinical assessments and targeted interventions to prevent and manage CKD effectively.
Assessment of Uterine Fibroids in Pre and Post Menopausal Women by Transabdominal Ultrasound
Authors: Ain Qurat Ul , Noor Huma , Shehzeena Shahid  , Haseeba Bibi  , Hira Akbar  , Laiba Zulfiqar  , Malika Qazi  , Zubair Muhammad , Maaz Khan
Published: June 2024

Background: Uterine fibroids are common benign tumors of the uterus, affecting a significant proportion of women, particularly during their reproductive years. These growths can lead to symptoms such as heavy menstrual bleeding, pelvic pain, and reproductive issues, thus impacting women's quality of life.
Objective: The objective of this study was to evaluate the prevalence of uterine fibroids in pre- and post-menopausal women and to assess the sensitivity of transabdominal ultrasound in diagnosing these fibroids.
Methods: This cross-sectional study was conducted over six months in the Radiology Department of District Headquarter Hospital, Swabi, KP, Pakistan. The study included pre- and post-menopausal women presenting with abnormal vaginal bleeding or diagnosed with symptomatic uterine fibroids, excluding those with known endometrial hyperplasia, adenomyosis, pelvic inflammatory disease, gynecologic malignancies, adnexal pathology, or pregnancy. Transabdominal ultrasound was performed with patients in a supine position and a filled urinary bladder, using both longitudinal and transverse sections. Data were collected on demographic information, clinical presentation, and ultrasound findings, and were analyzed using SPSS version 25.
Results: A total of 112 women participated in the study. Among these, 94 (83.9%) reported pelvic pain, while 18 (16.1%) did not. The locations of fibroids identified were anterior (44, 39.3%), fundal (25, 22.3%), and posterior (43, 38.4%). Intramural fibroids were present in 61 (54.5%) patients, submucosal fibroids in 32 (28.5%), and subserosal fibroids in 19 (17.0%). Premenopausal women had a higher prevalence of fibroids (80) compared to postmenopausal women (32).
Conclusion: Transabdominal ultrasound is a sensitive and reliable diagnostic tool for detecting uterine fibroids. It should be considered the primary imaging modality for evaluating abnormal uterine bleeding across different age groups, providing accurate and non-invasive diagnosis.
Effectiveness of Manual Compression and Stretching for The Myofascial Trigger Points in Upper Trapezius and Levator Scapulae in Office Workers
Authors: Umair Ahmed , Ghafoor Imran , Malik Shaelyn , Sajjad Shahzaib , Chohdary Aleena , Javed Usama
Published: June 2024

Background: Chronic cervical pain is a prevalent global health concern, frequently associated with myofascial trigger points in the levator scapulae and upper trapezius muscles. Comparing the efficacy of manual compression and stretching as treatments for these trigger points is essential for optimizing pain management strategies.
Objective: The objective of this study was to evaluate the comparative effectiveness of manual compression versus manual stretching on myofascial trigger points in the levator scapulae and upper trapezius among office workers suffering from cervical pain.
Methods: This randomized controlled trial included 100 patients with cervical pain, divided into two groups: Group A (n=50) received manual compression, and Group B (n=50) underwent manual stretching on myofascial trigger points in the levator scapulae and upper trapezius. Outcomes assessed were pain levels, range of motion (ROM), and quality of life, measured before and after the interventions. Statistical analysis was conducted using the Chi-square test for between-group comparisons.
Results: Post-intervention, both groups showed significant improvements in pain levels, ROM, and occupational functionality. Group A exhibited superior results with significant enhancements in cervical and shoulder ROM (p < .0001), compared to Group B. No significant differences were observed between the groups in terms of shortness of breath (p = .628).
Conclusion: Manual compression proved more effective than manual stretching in improving ROM and reducing pain among patients with cervical myofascial trigger points. Further studies with larger cohorts and longer follow-up are necessary to corroborate these findings.
Prevalence of Diabetic Nephropathy among Patients of Type 2 Diabetes at Tertiary Care Hospital Lahore
Authors: Munir Atif , Sehar Gulzar  , Ather Afzal  , M. Ali Zahid  , Moha Akram Khan  , Nadeem Ul Hassan Khan  , Tahmina Rehman  , Muneeb Arshad  , Manzoor Urooj
Published: June 2024

Background: Diabetic nephropathy is a significant complication of Type 2 Diabetes Mellitus, often leading to chronic kidney disease (CKD) and potentially progressing to End-Stage Renal Disease (ESRD). Approximately 90% of individuals with diabetes and hypertension may develop ESRD in the later stages of the disease.
Objective: The study aimed to determine the prevalence of diabetic nephropathy among patients with type 2 diabetes at a tertiary care hospital in Lahore.
Methods: This retrospective study included 100 reports from the chemical pathology and microbiology laboratory at Fatima Memorial Hospital, Lahore, covering renal function tests (RFT) such as Urea, Blood Urea Nitrogen (BUN), Creatinine, and estimated Glomerular Filtration Rate (eGFR), as well as HbA1c levels and Albuminuria. Data collection involved accessing electronic medical records (EMRs) to obtain comprehensive clinical data, including patients' medical history, duration of diabetes, glycemic control measurements, blood pressure, and prescribed medications. The study included patients with type 2 diabetes and kidney disease, excluding those without renal disease. Ethical approval was obtained from the Institutional Review Board (IRB) of FMH College of Medicine and Dentistry, adhering to the principles of the Declaration of Helsinki. Data were analyzed using IBM SPSS version 25, with categorical variables expressed as frequencies and percentages and continuous variables as mean ± standard deviation (SD). Correlation analysis was conducted, with a p-value of less than 0.05 indicating statistical significance.
Results: The study included 100 participants, with 53% being male and 47% female. The mean age was 59.19 years (SD = 18.812), ranging from 18 to 91 years. Albuminuria was present in 88% of participants. Elevated serum creatinine was observed in 93%, HbA1c levels >6.4% in 68%, high urea levels in 87%, and eGFR <60 in 14%. Correlation analysis showed a significant positive correlation between HbA1c and eGFR (Spearman's rho = 0.432, p < 0.001) and between urea and serum creatinine (Spearman's rho = 0.701, p < 0.001).
Conclusion: The high prevalence of albuminuria and elevated renal function markers among individuals with type 2 diabetes underscores the importance of early detection and comprehensive management. Regular screening for urinary albumin, stringent glycemic control, and optimal blood pressure management are crucial for preventing the progression of diabetic nephropathy.
The Grieving Process for Nurses: A Concept Analysis
Authors: Mir Safiah , Bakht Khush , Shah Syed Afzal
Published: June 2024

Background: This study delved into the nuanced experience of grieving among nurses, shedding light on an essential yet often overlooked aspect of their professional and personal lives. Grief among nurses is a significant issue due to the frequent exposure to patient deaths and personal losses, which can profoundly impact their emotional and psychological well-being.
Objective: The objective of this study was to employ a structured approach to conceptualize and elucidate the multifaceted nature of nurses' grief. The study aimed to identify defining attributes, antecedents, consequences, and empirical referents of nurses' grieving process, providing a comprehensive understanding to inform targeted interventions.
Methods: This concept analysis used Walker and Avant's methodological framework, which includes eight steps: topic selection, establishing analysis goals, recognizing all possible uses of the concept, defining attributes, presenting a model case, identifying additional cases (e.g., borderline, contrary), determining antecedents and consequences, and describing empirical referents. A comprehensive literature review was conducted using databases such as PubMed, CINAHL, and PsycINFO. Data collection involved reviewing existing literature on the grieving process, emotional distress, burnout, self-care, and supportive interventions for nurses. The ethical principles outlined in the Declaration of Helsinki were followed, ensuring confidentiality and anonymity of all data sources.
Results: The defining attributes of the grieving process for nurses included intense emotions (sadness, anger, guilt, depression), physical and emotional pain, and the unique demands of the nursing profession. Antecedents identified were personal loss and exposure to patient deaths, while consequences included emotional distress, impaired work performance, and increased stress. Empirical referents were measurable indicators such as the frequency of crying episodes, reports of physical symptoms, changes in work performance, and use of coping strategies. The analysis found that 85% of nurses experienced significant emotional distress, 70% reported impaired work performance, and 60% utilized some form of support or coping strategy.
Conclusion: Understanding the grieving process among nurses is crucial for developing effective interventions and support systems. This study's findings underscore the importance of education, supportive interventions, self-care practices, and teamwork in promoting nurses' well-being and enhancing patient care outcomes. By providing a comprehensive understanding of nurses' grief, the study contributes valuable insights to nursing knowledge and practice, highlighting the need for targeted interventions to support nurses in coping with the emotional challenges of their profession.
Knowledge & Practice of Nurses Regarding Central Line-Associated Bloodstream Infection & Prevention
Authors: Shahbaz Komal , Sarwar Beenish , Hayat Umar , Sarwar Mehwish
Published: June 2024

Background: Central venous catheters (CVCs) are crucial in medical care but pose a significant risk for bloodstream infections, leading to increased morbidity, mortality, and healthcare costs. Effective knowledge and practices among nurses are essential for preventing central line-associated bloodstream infections (CLABSI).
Objective: To assess the knowledge and practices of nurses regarding the prevention of CLABSI at Sughra Shafi Medical Complex Narowal and identify factors influencing these practices.
Methods: This descriptive cross-sectional study involved 200 staff nurses selected from a population of 400 using a non-probability convenient sampling technique. Data were collected via a self-administered questionnaire covering demographics, professional experience, and specific knowledge and practices related to CLABSI prevention. The study was conducted over six months, and data analysis was performed using SPSS version 25, with chi-square and Fisher exact tests applied to determine associations between variables. Ethical approval was obtained, and all participants provided informed consent.
Results: The study included 200 nurses, predominantly female (90%), with ages ranging from 18 to 37 years (mean age 25 ± 3.9 years). Professional experience varied, with 36.5% having 1-5 years, 41% having 6-10 years, and 22.5% having 11-15 years of experience (mean experience 7.31 ± 3.0 years). Knowledge assessment revealed that 68.5% knew CVCs should be routinely replaced, and 88.5% were aware of disinfecting catheter insertion sites with 10% povidone-iodine. However, only 43% regularly performed hand hygiene before inserting a central line, and 48.5% used chlorhexidine for skin preparation.
Conclusion: While nurses demonstrated satisfactory knowledge regarding CLABSI prevention, their practices were inadequate, indicating a need for enhanced training and adherence to infection prevention protocols.
Unveiling the Pathophysiology of Osteoarthritis in Joint Anatomy
Authors: Ashraf Irfan , Khan Qurat Ul , Malik Farah , Asghar Sarah Sughra , Mansoor Afsheen , Mansoor Emaan
Published: June 2024

Background: Osteoarthritis (OA) is a prevalent and debilitating joint disorder characterized by the degeneration of articular cartilage and underlying bone. Understanding the pathophysiology of OA is essential for developing targeted therapies and improving patient outcomes.
Objective: To explore the underlying pathophysiological mechanisms of osteoarthritis within the context of joint anatomy, focusing on cartilage degradation, synovial inflammation, and subchondral bone changes.
Methods: This prospective study was conducted at private hospitals in Karachi from June 2022 to December 2022. Eighty patients aged 45 to 70 years, diagnosed with OA, were included. Detailed clinical evaluations were performed, including pain assessment using the Visual Analog Scale (VAS) and functional status assessment using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Radiographic analysis was conducted using the Kellgren-Lawrence grading scale. Biochemical analysis of serum and synovial fluid was performed to measure levels of collagen type II cleavage products (C2C), cartilage oligomeric matrix protein (COMP), and inflammatory cytokines such as interleukin-1β (IL-1β), tumor necrosis factor-alpha (TNF-α), and interleukin-6 (IL-6). Synovial fluid and tissue samples were collected during arthroscopy or joint replacement surgery for molecular pathway analysis. Data were analyzed using SPSS version 25, with correlations and regression analyses performed to identify predictors of disease progression.
Results: OA was associated with significant pain and functional impairment, with a mean pain score of 7.2 ± 1.3 on the VAS and WOMAC scores averaging 55 ± 10 for physical function and 30 ± 5 for stiffness. Radiographic analysis showed 25% of patients classified as grade II, 50% as grade III, and 25% as grade IV. Biochemical markers indicated elevated levels of C2C (serum: 150 ± 20 ng/mL; synovial fluid: 200 ± 25 ng/mL) and COMP (serum: 10 ± 2 µg/mL; synovial fluid: 15 ± 3 µg/mL). Inflammatory cytokines were also elevated (IL-1β: 50 ± 5 pg/mL; TNF-α: 75 ± 10 pg/mL; IL-6: 100 ± 12 pg/mL). A strong positive correlation (r = 0.85, p < 0.01) was observed between VAS pain scores and synovial IL-1β levels.
Conclusion: The pathophysiology of osteoarthritis involves a complex interplay of biomechanical, biochemical, and cellular factors. The findings from this study enhance the understanding of OA mechanisms and provide a foundation for developing more effective therapeutic strategies aimed at halting or reversing the progression of OA.
Assessing the Determinants of the Usage of Contraceptive in Family Planning in Punjab, Pakistan
Authors: Sarwar Usman , Zuhair Mutaz Zuhair Murad  , Mohsin Muhammad , Ayesha Saddiqua  , Hasnain Ghulam Nabi  , Miandad Muhammad , Rehman Abdul
Published: June 2024

Background: Contraceptive use is pivotal for managing birth rates, particularly in regions with high fertility such as Pakistan. This study highlights the role of family planning in controlling population growth by assessing the determinants affecting contraceptive usage in Punjab, a province characterized by diverse demographic and socio-economic conditions.
Objective: The research aims to evaluate the impact of education, age, residential area, residential status, and media access on contraceptive use among ever-married women in Punjab, Pakistan.
Methods: Data from the 'Annual Contraceptive Performance Report 2019-20' by the Pakistan Bureau of Statistics were analyzed. A total of 78,563 ever-married women were sampled using random stratified techniques. Multiple statistical tests, including logistic regression, chi-square, and independent sample t-tests, were applied to identify key factors influencing contraceptive usage.
Results: Educational level, residential area, status, wealth index quintiles, and media access were significantly associated with contraceptive use across Punjab. Statistical analysis showed that women's age and the number of children significantly affected contraceptive use. Key predictors identified include media access, reproductive history, and residential characteristics, with media access and residential area being particularly impactful.
Conclusion: This study confirms that socioeconomic and demographic factors significantly influence contraceptive usage in Punjab. Enhanced focus on education and targeted media campaigns could improve family planning outcomes. Effective interventions should consider local cultural and social contexts to increase contraceptive uptake.
Cultivating Pharmaceutical Potential: Optimising Triacontanol Application to Enhance Linseed’s Attributes under Drought Stress
Authors: Javed Warda , Hafsa Razzaq  , Sundas Iftikhar  , Amin Khalid  , Safora Muhammad Shafique
Published: June 2024

Background: Triacontanol (TRIA) has been identified as a potent plant growth regulator, demonstrating significant benefits under various stress conditions. However, its specific impact on Linum usitatissimum L. (flax) under drought stress conditions remains underexplored. This study investigates the effects of TRIA on the growth, physiology, and biochemistry of two flax genotypes subjected to drought stress, aiming to enhance our understanding of its potential as a biostimulant for improving crop resilience and productivity.
Objective: The primary objective of this study was to evaluate the effects of different concentrations of TRIA on the growth, physiological, and biochemical responses of two flax genotypes under drought stress conditions. We aimed to determine whether TRIA application could mitigate the adverse effects of drought and enhance plant performance.
Methods: This study was conducted using two flax genotypes, G-20888 and G-22186. Plants were grown under controlled conditions and subjected to drought stress by maintaining soil moisture at 50% field capacity. TRIA was applied in three concentrations: 0 M (control), 10^-6 M, and 10^-7 M. A completely randomized design was used with three replications for each treatment. Plant growth parameters, including root length, shoot length, plant height, and shoot fresh weight, were measured. Physiological parameters such as chlorophyll content, relative water content (RWC), and electrolyte leakage were assessed. Biochemical analyses included the estimation of antioxidant enzyme activities (superoxide dismutase, catalase, and peroxidase). Data were statistically analyzed using SPSS version 25.0.
Results: TRIA application significantly improved root length, shoot length, plant height, and shoot fresh weight in both flax genotypes under drought stress. For genotype G-20888, root length increased from 5.1 cm (control) to 6.8 cm (TRIA 10^-7 M). Shoot length showed a similar trend, with increases from 8.3 cm (control) to 10.1 cm (TRIA 10^-7 M). In G-22186, plant height increased from 70 cm (control) to 82 cm (TRIA 10^-7 M). Chlorophyll content increased by 15%, and RWC by 18% in TRIA-treated plants compared to controls. Antioxidant enzyme activities were also enhanced, with catalase activity increasing by 25% and peroxidase by 30%.
Conclusion: TRIA application significantly mitigated the adverse effects of drought stress on flax genotypes by enhancing growth, physiological, and biochemical parameters. The findings suggest that TRIA could be an effective biostimulant for improving drought tolerance in flax, potentially leading to better crop resilience and productivity.
Patients' Perception and Understanding Towards Anesthesia and Anesthetists at Tertiary Care Hospitals of District Mardan: A Cross-Sectional Study from Mardan KP
Authors: Zafar Hamza , Khan Asad , Jan Aamir , Ullah Kamran
Published: June 2024

Background: Anesthesia is integral to patient care during the peri-operative period. Despite advancements, public knowledge about the anesthesiologist's extensive responsibilities and critical role in healthcare remains limited. This study explores the understanding and perceptions of anesthesia and anesthetists among patients at Mardan Medical Complex.
Objective: To assess patients’ perceptions and understanding of anesthesia and anesthetists’ roles, identifying factors influencing their knowledge levels.
Methods: A cross-sectional study was conducted at Mardan Medical Complex, KP, from June to September 2023. Participants were interviewed using a structured questionnaire that collected socio-demographic data, knowledge about anesthesia, and perceptions of anesthetists. The chi-square test was utilized to explore associations between categorical variables.
Results: A total of 309 participants were enrolled, with a response rate of 100%. The demographic breakdown was 159 males (51.5%) and 150 females (48.5%). Only 84 participants (27.2%) demonstrated an understanding of anesthetists’ roles, and 87 (28.2%) claimed knowledge of anesthesia. Significant associations were found between levels of education (p<0.001) and occupation (p<0.001) and the knowledge of anesthesia.
Conclusion: There is a marked deficiency in knowledge and understanding of anesthesia and the pivotal role of anesthetists among the patients surveyed. This underscores the need for targeted educational initiatives to enhance patient and public awareness of anesthesiology’s critical functions in healthcare.
A Qualitative Study on Nurses' Experiences Working in Burn Units in South Punjab, Pakistan.
Authors: Saba Nazeer  , Sajida Manzoor  , Zaibu un Nisa  , Anna Rana  , Adeela Qayyum
Published: June 2024

Background: Nurses play an integral role in the multidisciplinary team managing care for burn patients. Their unique insights and experiences in such high-stress environments are crucial yet often underexplored. This study aims to illuminate the challenges and experiences of nurses in burn units within tertiary care hospitals in South Punjab, Pakistan.
Objective: To explore and document the experiences of nurses working in burn units, focusing on the challenges they face and the coping mechanisms they employ.
Methods: A qualitative study was conducted in 2022 using purposeful sampling to select 16 nurses from burn units at tertiary care hospitals in South Punjab, Pakistan. Data were collected through semi-structured, in-depth interviews and analyzed using thematic analysis to identify key themes and sub-themes.
Results: Analysis of the interview data revealed four main themes and sixteen sub-themes. The main themes identified were Workload, Spiritual Beliefs in Patient Care, Nursing Education Services in Hospitals, and Work-Life Balance. These themes encompass the physical, emotional, and spiritual challenges faced by nurses, as well as their educational needs and the impact of their work on personal life.
Conclusion: Nurses in burn units encounter numerous challenges that affect both their professional duties and personal lives. There is a critical need for better support structures, including modern facilities, continuous training, and more attentive administrative practices. Enhancements such as increased staffing, unit rotation, and provisions for financial and motivational incentives are necessary to improve care for burn patients and support the well-being of nurses.
Assessment of Adequate Blood Culture Incubation Time to Accentuate Clinically Relevant Results from Blood Culture Instrument and Media System in a Tertiary Care Hospital Lahore
Authors: Aslam Mehwish Saba , Farooque Muhammad Abid , Malik Irfan , Khawaja Aneela , Yunus Namra , Mehmmod Ammarah
Published: June 2024

Background: Bloodstream infections necessitate rapid identification and management. Automated blood culture systems have revolutionized diagnostic microbiology by expediting pathogen detection and enabling effective clinical interventions. This study assesses the optimal incubation period for blood cultures in a tertiary healthcare setting, aiming to enhance diagnostic accuracy and support antibiotic stewardship.
Objective: To evaluate the adequacy of incubation times in blood cultures for producing clinically significant results using an automated system in a tertiary care setting.
Methods: This cross-sectional descriptive study was conducted at the Microbiology Section of Combined Military Hospital, Lahore, from October 2022 to March 2023. All patient blood samples processed through the Bactec/Alert system were studied. Positive samples were cultured on Blood and MacConkey agar and incubated at 35 ± 2°C for 24 hours. Positivity rates, contamination, and patient demographics were analyzed using the Laboratory Information Management System.
Results: Of the 8,216 blood culture bottles processed, 490 (5.96%) were flagged as positive. Early detection within the first 24 hours was noted in 41.63% (n=204) of cases, with subsequent detections on the second day at 58.65% (n=258), the third day at 5.30% (n=26), and the fourth day at 0.20% (n=1). The isolated pathogens included gram-positive organisms (16.32%, n=80), gram-negative organisms (80.20%, n=393), and Candida spp. (3.46%, n=17).
Conclusion: Timely and effective blood culturing is crucial for the diagnostic confirmation of bacteremia, enabling appropriate pathogen identification and antimicrobial therapy. Shortening detection times can significantly impact clinical outcomes, reduce healthcare costs, and promote antimicrobial stewardship.
Frequency of Knowledge of Risk and Complications of Cigarette Smoking among Female Smokers
Authors: Ali Mehak , Shaikh Bashir Ahmed , Ali Imdad , Ali Zahid , Kumar Aneel , Zulfiqar Zunaira , Lal Sham , Haider Iqra
Published: June 2024

Background: Despite the significant role of smoking in causing preventable diseases, many women smokers lack an understanding of the associated risks. Gaining insights into their knowledge levels is crucial for designing effective health interventions that promote smoking cessation and enhance overall public health.
Objective: To assess the level of awareness regarding the risks and complications of cigarette smoking among female smokers.
Methodology: A cross-sectional study was conducted at the Outpatient Department of Medicine, Shaheed Mohtarma Benazir Bhutto Medical University, Larkana, Pakistan, from July to December 2023. The study involved 126 female smokers. Data were collected using a 15-item questionnaire to evaluate the participants' knowledge about the risks and complications of smoking. The responses were categorized as low, moderate, or high knowledge. Statistical analysis was performed using SPSS version 26.0.
Results: The participants' average age was 31.25 years (SD = 13.55 years). Knowledge levels about smoking risks among the participants were distributed as follows: 54.8% had low knowledge, 30.2% had moderate knowledge, and 15.1% demonstrated high knowledge of smoking risks and complications.
Conclusion: Over half of the female smokers surveyed exhibited low awareness of the dangers associated with smoking. This underscores the need for targeted educational and health-related activities to effectively reduce smoking levels among women.
Frequency of Unilateral Versus Bilateral Medial Tibial Stress Syndrome in Novice Footballers
Authors: Kousar Ayesha , Hamid Khizra , Mannan Rafia , Sadiq Samreen , Asim Hafiz Muhammad , Amjad Rabia
Published: June 2024

Background: Medial tibial stress syndrome (MTSS) is a common overuse injury characterized by pain along the distal two-thirds of the medial tibial border. It predominantly affects athletes engaged in weight-bearing activities, including football players. Despite its prevalence, there is limited research focusing on MTSS specifically within the context of football, particularly in relation to unilateral versus bilateral occurrences and the implications of limb dominance.
Objective: The study aimed to measure the frequency of unilateral versus bilateral MTSS in footballers and to provide insights into the relationship between MTSS and limb dominance.
Methods: This comparative cross-sectional study was conducted over six months from July 2021 to December 2021 across various football clubs in Lahore, Pakistan. Ethical approval was obtained from the Lahore College of Physical Therapy, and permissions were secured from club administrations. The sample comprised 140 recreational footballers aged 20-29 years, selected using non-probability convenience sampling. Participants were diagnosed using the MTSS criteria established by Marinus Winters in 2017, which included history taking and physical examination. Data collection involved a detailed questionnaire covering demographics, medical history, and sporting history. The study excluded individuals with previous surgical history, systemic diseases, or tumors. Data analysis was performed using SPSS version 25, employing descriptive and inferential statistics to examine relationships between variables.
Results: The mean age of participants was 21.3 years (SD = 2.97), with a mean weight of 62.2 kg (SD = 8.1) and mean height of 5.5 feet (SD = 0.39). The sample included 97 males (69.3%) and 43 females (30.7%). MTSS was reported unilaterally in 82.2% of participants, with 67.9% (n = 95) experiencing symptoms in the right leg and 14.3% (n = 20) in the left leg. Bilateral MTSS was observed in 17.9% (n = 25) of participants.
Conclusion: The majority of athletes reported unilateral MTSS, with the right leg being more commonly affected than the left. These findings suggest the need for comprehensive bilateral assessment in the diagnosis and treatment of MTSS in footballers to optimize performance and prevent recurrence.
Ultrasonography in Detecting the Posterior Segment Pathology in Pre-Operative Cataract Patient
Authors: Karim Samina , Hamid Rehman  , Nazullah
Published: June 2024

Background: Cataract is the leading cause of blindness globally, accounting for approximately 47.8% of blindness worldwide and 51.5% in Pakistan. The opacity of the lens in cataract patients obstructs the visualization of the posterior segment, making it challenging to predict visual outcomes post-surgery. Ultrasonography, particularly B-scan, plays a crucial role in identifying posterior segment pathologies before cataract surgery, aiding in surgical planning, and improving postoperative visual prognosis.
Objective: This study aimed to evaluate the effectiveness of B-scan ultrasonography in detecting posterior segment pathologies in patients with dense cataracts, thus assisting in preoperative planning and predicting visual outcomes.
Methods: This descriptive cross-sectional study was conducted at the Outpatient Department of Ophthalmology, Hayatabad Medical Complex, Peshawar, from August 15th, 2019, to February 15th, 2020. A total of 260 eyes from patients with dense cataracts were included. Patients of all age groups and both sexes, including those with traumatic and non-traumatic cataracts, were examined. Exclusion criteria included transmittable ocular surface infections, penetrating ocular trauma, previous glaucoma or vitreoretinal surgery, and siliconized eyes. B-scan ultrasonography was performed using an 8-10 MHz frequency probe. The eye globe was assessed in axial, longitudinal, and transverse positions. Data were recorded and analyzed using SPSS version 25. Ethical approval was obtained from the institutional review board, and the study adhered to the Declaration of Helsinki.
Results: Out of 260 eyes examined, 97 (37.3%) were right eyes, 105 (40.4%) were left eyes, and 58 (22.3%) had bilateral involvement. Normal findings were observed in 215 eyes (67.8%), while 32.2% showed posterior segment pathologies. The most common pathology was posterior vitreous detachment (PVD), found in 24 eyes (7.6%). Retinal detachment and vitreous hemorrhage were each observed in 15 eyes (4.7%). Other findings included asteroid hyalosis (18 eyes, 5.7%), vitreous inflammation (11 eyes, 3.5%), intraocular foreign body (3 eyes, 0.9%), persistent hyperplastic primary vitreous (1 eye, 0.3%), and posterior staphyloma (2 eyes, 0.6%).
Conclusion: B-scan ultrasonography is an effective tool for detecting posterior segment pathologies in preoperative dense cataract patients, significantly influencing surgical strategies and postoperative visual outcomes. Routine use of ultrasonography in cataract patients can enhance surgical planning and improve patient counseling and prognosis.
Postoperative Complications of Laparoscopic versus Open Varicocelectomy
Authors: Usman Muhammad , Muhammad Shah  , Shehzad Akbar Khan  , Ramzan Khan  , Farrukh Ozair Shah
Published: June 2024

Background: Varicocele, characterized by the dilation and swelling of testicular veins, significantly impacts male infertility and semen quality, affecting 10-15% of the male population. Surgical intervention is essential to alleviate these effects, with various techniques available, including laparoscopic and open subinguinal varicocelectomy.
Objective: This study aimed to compare postoperative complications between laparoscopic and open subinguinal varicocelectomy to determine the superior approach in terms of patient outcomes and complications.
Methods: A randomized controlled trial was conducted, involving 130 patients admitted to Hayatabad Medical Complex, Peshawar, from November 10, 2021, to July 31, 2022. Participants, presenting with symptoms of scrotal heaviness, testicular swelling, pain, and infertility, were randomly assigned to either the laparoscopic (Group L, n=70) or open subinguinal (Group O, n=60) varicocelectomy groups. Preoperative assessments included medical history, clinical examination, and necessary tests. Informed consent was obtained from all participants. Exclusion criteria included patients with malignancy, diabetes (BSR > 200 mg/dl), or unstable hemoglobin levels (Hb < 10 mg/dl). Postoperative complications, including wound erythema, hydrocele, epididymitis, and bruising, were documented and analyzed using SPSS version 25, with a significance level set at P ≤ 0.05.
Results: The mean age of Group L was 27.3 years (±2.3), and Group O was 25.2 years (±3.5) (P = 0.042). Postoperative complications were significantly lower in Group L compared to Group O. Wound erythema was observed in 1.42% of Group L and 8.3% of Group O (P = 0.05). Hydrocele occurred in 2.8% of Group L versus 10% of Group O (P = 0.04). Epididymitis was found in 1.42% of Group L and 6.5% of Group O (P = 0.03). Bruising was noted in 1.66% of Group O, with no cases in Group L (P = 0.05).
Conclusion: Laparoscopic varicocelectomy resulted in fewer postoperative complications compared to open subinguinal varicocelectomy, making it the preferred surgical approach for varicocele treatment. Further studies with larger sample sizes and long-term follow-up are recommended to validate these findings.
Investigating the Diagnostic Significance of Neutrophil Percentage to Albumin Ratio (NPAR) in Patients with Infectious Meningitis
Authors: Bughio Rabia , Depar Khalida , Ghani Amber , Depar Fida , Ahmed Etizaz , Depar Atif
Published: June 2024

Background: Meningitis, characterized by inflammation of the meninges, typically presents with fever, headache, and neck rigidity. Despite the availability of numerous diagnostic techniques, determining the etiology of infectious meningitis remains challenging, often leading to diagnostic delays and increased mortality. The neutrophil percentage-to-albumin ratio (NPAR) is a novel biomarker for systemic infection and inflammation.
Objective: To assess the neutrophil-to-albumin ratio in cases of infectious meningitis.
Methods: Following REC approval (05/01/REC-206-2020), this cross-sectional study included 78 patients with clinical findings consistent with meningitis. Data on age, gender, fever, headache, neck rigidity, and Glasgow Coma Scale (GCS) were collected. NPAR was calculated by dividing the neutrophil percentage by serum albumin levels. Statistical analysis was performed using SPSS 22.0 for T-test (two-tailed) and Pearson Correlation. Results were presented as mean±SD (95% CI) with a significance level of p<0.05.
Results: The mean age of patients was 27 years. The mean GCS score was 11±1.59, serum albumin levels were 3.44±0.5 mg/dl, neutrophil percentage was 75.6±7.2%, and the neutrophil-to-albumin ratio (NPAR) was 0.22±0.03. Common symptoms such as fever, neck rigidity, and headache were present in all cases, while seizures were observed in 36 cases.
Conclusion: The study indicated a significant correlation between elevated NPAR levels and cases of infectious meningitis, suggesting NPAR as a potential diagnostic marker.
Comparative Efficacy of Posterior Subtenon Kenacort Compared to Standard Surgical Treatment for Macular Hole Closure
Authors: Rehman Mujjaddad , Faheem Rabia , Ullah Saif
Published: June 2024

Background: Macular holes cause significant vision loss, particularly in older adults. Although standard surgical treatment (SDT) has been successful, there is increasing interest in less invasive treatments that might offer better outcomes, especially in terms of best-corrected visual acuity (BCVA) and macular hole closure.
Objective: This study aimed to determine the effectiveness of posterior subtenon Kenacort (SBT) in closing macular holes and to compare its efficacy with standard surgical treatment (SDT). Additionally, the study examined the impact of macular hole classification on treatment outcomes in both groups.
Methods: An interventional study was conducted at Al-Shifa Trust Eye Hospital in Rawalpindi, involving 60 subjects aged 45 to 65 years with idiopathic macular holes. Participants were selected using non-probability sampling. Group A (30 eyes) received two SBT injections three months apart, while Group B (30 eyes) underwent SDT, which included pars plana vitrectomy with internal limiting membrane (ILM) peeling and gas tamponade. OCT imaging and logarithm of the minimum angle of resolution (LogMAR) measurements were obtained for all subjects before treatment, with follow-up assessments conducted six months post-treatment. Data analysis was performed using SPSS version 25.0, with quantitative variables expressed as mean ± SD and inferential statistics explored using ANOVA and paired sample t-tests. A p-value ≤ 0.05 was considered statistically significant.
Results: Both treatment groups had thirty patients each with similar average macular hole sizes (SBT: 436 ± 126 µm, SDT: 439 ± 127 µm). In the SBT group, average BCVA improved from 1.48 to 0.846, while in the SDT group, it changed from 1.44 to 1.25. Macular hole classification significantly affected post-treatment BCVA scores in both groups (p < 0.001). The SBT group showed significantly greater BCVA improvement compared to the SDT group.
Conclusion: Posterior subtenon Kenacort effectively closed macular holes and improved BCVA more than standard surgical treatment. Macular hole classification influenced post-treatment BCVA scores in both treatment groups, highlighting its importance in predicting treatment outcomes.
Prevalence and Knowledge of Urinary Incontinence and Awareness about Physical Therapy Treatment among Young Females of Lahore
Authors: Masood Zainab , Mushtaq Maida , Aiman Javed  , Mahnoor Shafi  , Rabia Majeed
Published: June 2024

Background: Urinary incontinence (UI), defined as involuntary urinary dribble at rest or under slight stress, is prevalent among women, particularly those who are pregnant or have had vaginal deliveries. While various treatments, including medical and physical therapy, are available for UI, awareness and knowledge about these treatments among young females remain unclear. This study aims to evaluate the prevalence of UI and the knowledge of physical therapy treatment options among young females in Lahore.
Objective: To determine the prevalence and knowledge of urinary incontinence and the awareness of physical therapy treatment among young females in Lahore.
Methods: This cross-sectional study included 250 young females aged 16-35 years from Jinnah Hospital Lahore, Sheikh Zayed Hospital Lahore, Ittefaq Hospital Lahore, and General Hospital Lahore. Data were collected using a self-reported quantitative questionnaire, the "International Consultation on Incontinence Questionnaire – Short Form" (ICIQ-SF), which assessed awareness about UI and knowledge of treatment options. Participants were briefed on the questions to ensure accurate responses. Data were analyzed using IBM SPSS Statistics version 25, with results presented as frequencies and percentages.
Results: The study involved 250 females with an age range of 16-35 years, of whom 156 (62.4%) were single, and 94 (37.6%) were married. Obstetric data revealed that 16 (6.4%) were nulliparous, 81 (32.4%) were multiparous, 53 (21.2%) had normal labor deliveries, 49 (19.6%) had cesarean section deliveries, and 5 (2.0%) had experienced episiotomy. UI prevalence was found in 83 (34%) participants, with 63 (25%) affected moderately and 24 (10%) severely. Regarding health knowledge, 121 (48.4%) had never heard of UI, and 142 (56.8%) did not know about the presence of medical treatment. Moreover, 196 (78.4%) were unaware of the availability of physiotherapy treatment for UI.
Conclusion: The prevalence of UI among young females in Lahore was significant, but the knowledge about UI and its medical treatment was relatively low. Awareness of physiotherapy treatment options was particularly lacking. These findings highlight the need for enhanced educational efforts to improve the understanding and management of UI among this population.
Korlát és menedék – A társadalmi tőke szerepe a szegregációs és antiszegregációs folyamatokban
Authors: Méreiné Berki Boglárka
Published: June 2024

A társadalmi tőke szerepe a szegregációs és antiszegregációs folyamatokban
THE EFFECTIVENESS OF THE STORYTELLING METHOD USING FOLKTALES ON EARLY CHILDHOOD EMPATHY BEHAVIOR AT VILLA BETA KINDERGARTEN PADANG CITY
Authors: Muty risky fitriani  , Maisoni M Farhan Putra , Bakri Akmal , Prima Aulia
Published: June 2024

Storytelling provides opportunities for children to develop empathy for the world around them. This study was conducted with the aim of seeing the effectiveness of the storytelling approach on early childhood empathy behavior at Villa Beta Kindergarten, Padang City. Respondents in this study were 7 students of Villa Beta Kindergarten with 5 female respondents and 2 male respondents. The research design used in this study is an experimental design of the One-Group Pretest-Posttest Design type. Data collection was carried out using an empathy scale modified from Davis (1980), the empathy scale consists of four main aspects, namely perspective taking, fantasy, empathic concern, and personal distress. The resulting significance is p = 0.028 <0.05 so that the results obtained from this study are that there are significant differences in children's empathy behavior after treatment in the form of storytelling methods.
PENINGKATAN SIKAP GOTONG ROYONG PADA PEMBELAJARAN PPKn MELALUI COOPERATIVE LEARNING TIPE JIGSAW KELAS IV SEKOLAH DASAR
Authors: Hadirih Moh. , Rulyansah Afib , Kamal M. Mustofa
Published: June 2024

Tujuan penelitian ini adalah mengetahui peningkatan sikap gotong royong sebagai karakter Profil Pelajar Pancasila melalui pelaksanaan pembelajaran PPKn dengan model cooperative learning tipe jigsaw untuk siswa kelas IV Bilal di SD Khadijah Pandegiling Surabaya. Jenis penelitian ini ialah penelitian tindakan kelas (PTK). Metode pengumpulan data menggunakan lembar observasi sikap gotong royong dan lembar observasi pelaksanaan pembelajaran. Hasil penelitian menunjukkan adanya peningkatan persentase sikap gotong royong dari sebelum tindakan 8% dalam kategori baik, meningkat pada siklus I menjadi 29% dalam kategori baik, serta meningkat lagi sebesar 50 % dalam kategori baik dan 38 % dalam kategori sangat baik pada siklus II. Dapat disimpulkan bahwa penerapan model cooperative learning tipe jigsaw mampu meningkatkan sikap gotong royong siswa kelas IV Bilal di SD Khadijah Pandegiling Surabaya