bluuebunny/crossref_metadata_2025 huggingface dataset:
Leadership Development Programs: Effectiveness from the Participants
Authors: Kazemzadeh Hochghan Mohammad , NajafBeigi Reza , Mirsepasi Naser
Published: June 2024

Leadership development programs are pivotal in shaping effective leaders across various sectors. However, the effectiveness of these programs often varies based on the participant's perspective, which is crucial yet underrepresented in existing research. This study aims to explore and document the perceived impacts of leadership development programs on their participants, focusing on personal and professional growth, skill application, and organizational influence. This qualitative study utilized semi-structured interviews to collect data from 18 participants who had completed leadership development programs within the last five years. Participants were selected using purposive sampling to ensure a diverse range of industries and leadership experiences were represented. Data analysis was conducted using thematic analysis to identify key themes and subthemes, and theoretical saturation was achieved to ensure the comprehensiveness of the collected data. The analysis identified five main themes representing the impacts of leadership development programs: Personal Growth, Skill Acquisition, Professional Development, Application of Skills, and Organizational Impact. Each theme comprised several categories and concepts, such as enhanced self-awareness, leadership techniques, professional networking, practical application of skills in the workplace, and strategic organizational contributions, illustrating the multifaceted benefits of these programs. The study concluded that leadership development programs significantly contribute to enhancing individual competencies and organizational capabilities. These programs are instrumental in fostering not only the necessary leadership skills but also in promoting personal growth and strategic thinking, which are essential for effective leadership and organizational success.
Prevalence of Hyperventilation Syndrome among Covid-19 Recovered Patients
Authors: Aneeqa Sultan  , Sumat Tariq  , Jamil Usama , Fatima Choudhury  , Muhammad Rehan Amjad  , Salman Akram  , Maqbool Sania , Amna Maqsood
Published: June 2024

Background: Coronavirus causes respiratory impairment in humans. In the post-acute care of COVID-19 survivors, persistent cardiorespiratory problems, such as tachycardia, dyspnea, muscle weakness, exercise intolerance, and hypocapnia due to Hyperventilation Syndrome (HVS), have been reported. Other symptoms include depression, anxiety, arthralgia, headache, and palpitations.
Objective: The objective of this study was to determine the prevalence of Hyperventilation Syndrome among COVID-19 recovered patients.
Methods: This cross-sectional descriptive study was conducted using a sample size of 377 participants, calculated via Raosoft. Non-probability convenience sampling was employed. Data were collected using the Nijmegen Questionnaire (NQ) and a demographic form. Participants were recruited through social media platforms and the University of South Asia (Lahore Cantt). Eligible participants were aged 17-60 years, both male and female, who had tested positive for COVID-19 and recovered. Exclusion criteria included any history of respiratory complaints such as asthma, chronic obstructive pulmonary disease, pneumonia, and chronic bronchitis. Data analysis was performed using SPSS version 25.
Results: Out of 377 participants, 148 (39.26%) were male and 229 (60.74%) were female. The mean age was 29.92 years (SD = 9.734). Among the participants, 240 (63.66%) were found to have Hyperventilation Syndrome, while 137 (36.34%) did not exhibit HVS. The most frequently reported symptoms included feeling of anxiety (41.91%), palpitations (20.95%), feeling of confusion (13.26%), feeling tense (11.41%), dizzy spells (10.88%), and blurred vision (37.93%).
Conclusion: Hyperventilation Syndrome is a significant post-COVID-19 complication that affects a substantial proportion of recovered patients, leading to breathing impairments and affecting their quality of life. The study highlights the need for continued monitoring and targeted interventions for managing respiratory symptoms in COVID-19 survivors.
Prevalence of Overweight and Obesity among Primary School Children's in Rural Areas of Pakistan
Authors: Bibi Afrooz , Sultan Amir , Usama Siddique  , Ullah Naveed , Naveed Ullah  , Shuaib Nazia , Malik Momena , Khan Sheraz
Published: June 2024

Background: Childhood obesity is a growing global epidemic affecting both children and adults. According to the World Health Organization, 43 million children under five are overweight worldwide, a concern that extends into adulthood with almost 1.5 billion affected individuals.
Objective: The aim of this study was to assess the prevalence of overweight, obesity, and underweight among primary school children in district Swat, Pakistan.
Methods: This cross-sectional descriptive study was conducted from August 2023 to February 2024, encompassing 707 primary school students selected through multi-cluster sampling. Measurements adhering to CDC guidelines were recorded. Data analysis was performed using SPSS 22, employing descriptive and inferential statistics, including chi-square tests for associations and independent t-tests and ANOVA for group differences.
Results: The cohort comprised predominantly male students (88%, 622 students), with the most common age being 11 years (31.8%, 225 students). Overall, 71.9% (508 students) were categorized as healthy, 15.3% (108 students) as overweight, 8.8% (62 students) as underweight, and 4.1% (29 students) as obese. Significant differences were observed across gender (p=0.003), age (p<0.001), and class (p<0.001), but not school type.
Conclusion: The study highlights a significant prevalence of overweight and obesity among primary school students in rural Pakistan, emphasizing the urgent need for tailored obesity prevention strategies and interventions in these areas.
The Assessment of Knowledge Regarding Anemia in Primigravida In Tertiary Care Hospital
Authors: Sayd Shahnaz , Shameem Barket  , Humaira Saddique  , Rubina Jabeen
Published: June 2024

Background: Anemia remains the most common nutritional deficiency worldwide, particularly among pregnant women. It significantly impacts maternal and fetal health, contributing to both morbidity and mortality. The problem is exacerbated by a general lack of awareness about the condition, its prevention, and management.
Objective: The objective of this study was to assess the level of knowledge regarding anemia among primigravida women attending a tertiary care hospital in Lahore, aiming to identify key educational gaps that could be addressed to improve health outcomes.
Methods: This descriptive cross-sectional study was conducted at the Gyne Out-Patient Department of a Public Hospital in Lahore. A total of 150 primigravida women were purposively sampled. Participants were excluded if they were visiting the labor room only or had a medical background. Data were collected through self-administered questionnaires, which included sections on demographic information and knowledge about anemia. Ethical approval was obtained from the institutional review boards, and informed consent was secured from all participants. Statistical analysis was performed using SPSS version 25, employing descriptive statistics and chi-square tests for categorical data.
Results: Out of the 150 participants, 41.3% demonstrated poor knowledge regarding anemia, 30% had moderate knowledge, and 28.7% exhibited good knowledge. Awareness of dietary sources of iron and the impact of dietary habits on iron absorption was notably low among the respondents.
Conclusion: The study revealed a significant lack of knowledge about anemia among primigravida women at the surveyed hospital, highlighting an urgent need for targeted educational interventions. Improving anemia awareness can potentially enhance maternal and fetal health outcomes.
Silent Danger: Uncovering Greater Omental Internal Herniation
Authors: Ayub Wahaj , Maroof Syed Asad , Khan Shahzeb , Ullah Sibghat , Bangash Abdul Mueed , Khan Muhammad Ayub , Wahab Abdul , Ahmed Tayyeb
Published: June 2024

Background: Internal hernias, though infrequent, are significant causes of intestinal obstruction, contributing to 0.2 to 4% of cases. Greater omental hernias, even rarer at 8%, predominantly affect older individuals, where senile atrophy often leads to omental defects.
Objective: This study aims to highlight the importance of considering internal hernias in the differential diagnosis for intestinal obstruction, particularly in patients without prior abdominal interventions or trauma.
Methods: We review a case of a 75-year-old female presenting with symptoms indicative of internal herniation, including the absence of significant historical abdominal insults. Diagnostic strategies involved physical examinations, imaging via X-ray and CT scans, and eventual surgical intervention.
Results: The patient's initial presentation involved subacute obstruction symptoms, progressing to complete obstruction on the second day of admission. Imaging failed to reveal a definitive transition point, but suggested small bowel obstruction. Surgical findings confirmed an intact herniated bowel loop, successfully treated without complications.
Conclusion: Internal hernias should be suspected in patients with intestinal obstruction symptoms, even in the absence of typical predisposing factors. Prompt recognition and treatment are crucial to prevent severe outcomes such as strangulation and necrosis.
A Comprehensive Review on Aflatoxin Contamination, Its Impact on Human Health and Management Strategies
Authors: Sultan Hafiz Muhammad , Sidra Nosheen  , Qurat-Ul-Ain  , Fizza Hafeez  , Usama Ahmed  , Muhammad Zubair  , Amina Bibi  , Fatima Irfan
Published: June 2024

Background: Aflatoxins are secondary metabolites produced by Aspergillus species, significantly impact global economic and health sectors, and contaminating key agricultural products such as maize, cotton, and groundnuts. The mycotoxins, particularly types B1 and B2, pose severe risks to animal and human health, leading to diseases like hepatic cellular carcinoma and liver cancer.
Objective: This review aims to analyze the prevalent impacts of AF contamination on human health and to evaluate current management strategies to mitigate this issue.
Methods: We utilize a comprehensive array of techniques to detect AF in agricultural products, including culturing, chromatography, immunochemical methods, and molecular assays. Our review also explores preventive measures during the pre-harvest and post-harvest phases of crop development, focusing on the efficacy of biopesticides in reducing contamination levels.
Results: AF contamination levels vary widely, with some regions recording levels as high as 35 ppb in crops, surpassing the maximum residue limits (5-20 ppb) set by many countries. The application of biopesticides has shown a reduction in toxigenic strain prevalence by up to 40%, demonstrating a significant decrease in AF levels in treated crops compared to untreated ones.
Conclusion: Effective management of AF contamination involves early detection and the strategic use of biopesticides to control fungal growth. Adopting these strategies can substantially reduce the health risks associated with AF exposure.
Efficacy of 10 IU Syntocinon versus 800 µg Misoprostol Sublingual in Active Management of 3rd Stage of Labour
Authors: Summera  , Malik Sania Ali , Wazir Nabeela
Published: June 2024

Background: The active management of the third stage of labor is crucial for preventing postpartum hemorrhage (PPH), a leading cause of maternal mortality. Syntocinon (oxytocin) and Misoprostol are prominent pharmacological agents used to manage this stage by inducing uterine contractions and minimizing blood loss.
Objective: This study aimed to compare the efficacy of 10 IU intravenous Syntocinon and 800 µg sublingual Misoprostol in the active management of the third stage of labor, focusing on maternal outcomes, blood loss, side effects, and the need for additional interventions.
Methods: A randomized controlled trial was conducted in the Department of Obstetrics and Gynaecology at Hayatabad Medical Complex from August 1, 2021, to February 1, 2022. A total of 284 women aged 18-40 years with singleton pregnancies were enrolled and randomized into two groups of 142 each. Group A received 800 µg of sublingual Misoprostol, while Group B received 10 IU intravenous Syntocinon at the delivery of the anterior shoulder of the baby. The third stage of labor was managed with early cord clamping and controlled cord traction. Blood loss was meticulously recorded, and patients were monitored for 24 hours postpartum. Data were analyzed using IBM SPSS Statistics version 25, with continuous variables expressed as mean ± standard deviation and categorical variables as frequencies and percentages. Post-stratification analysis utilized an independent sample t-test, with a p-value of ≤ 0.05 considered statistically significant.
Results: The mean age of participants was 29.507±3.24 years in the Misoprostol group and 28.352±3.77 years in the Syntocinon group. Blood loss was slightly lower in the Misoprostol group (242.4 ± 3.72 ml) compared to the Syntocinon group (249.176 ± 4.07 ml). The majority of participants were aged 18-30 years (69.7% in Group A and 71.1% in Group B). No statistically significant differences were observed in blood loss based on age, gestational age, or parity.
Conclusion: Misoprostol offers practical advantages in terms of ease of administration and stability at room temperature, making it a viable alternative, especially in low-resource settings. Both Misoprostol and Syntocinon are effective in managing the third stage of labor, with comparable efficacy in reducing blood loss.
Diphteric Myocarditis: A Case Report on Ecg and Cardiac Imaging Findings with the Levels of Cardiac Enzymes in a 17-Year-Old
Authors: Hayat Faisal Saleh , Samra Rehmat  , Shakeel Ahmed Memon  , Zeeshan Ikhtiar  , Ilyas Badshah  , Jamil Ahmad  , Muhammad Shoaib  , Ittehad Ul Mulk  , Muzzamil Samad  , Yawer Hayat
Published: June 2024

Background: Diphtheria, caused by Corynebacterium diphtheriae, remains a life-threatening infectious disease in regions with low vaccination uptake. Myocarditis, a severe cardiac complication of diphtheria, is a leading cause of mortality. Despite the success of vaccines in reducing diphtheria cases, sporadic cases continue to occur, leading to significant health complications.
Objective: This case report aims to present the clinical course, electrocardiogram (ECG) and cardiac imaging findings, and serial levels of serum troponin in a 17-year-old patient with diphtheritic myocarditis, and to discuss the management and outcomes.
Methods: This study was conducted at Lady Reading Hospital, Peshawar, Pakistan. Ethical approval was obtained from the hospital's ethical review board, and informed consent was acquired from the patient and guardians. A comprehensive diagnostic workup was performed, including clinical examination, laboratory tests, ECG, transthoracic echocardiography (TTE), and cardiac magnetic resonance imaging (MRI). The patient’s vital signs, blood pressure, pulse rate, and jugular venous pressure were recorded. Laboratory tests included leukocyte count, erythrocyte sedimentation rate (ESR), and serial serum troponin measurements. ECG findings were documented, and TTE was used to assess left ventricular ejection fraction (LVEF). Cardiac MRI was performed to identify myocardial edema and delayed enhancement. Treatment included intravenous diuretics, ACE inhibitors, SGLT2 inhibitors, benzylpenicillin, and corticosteroids. Data were analyzed using SPSS version 25.0.
Results: The patient presented with a blood pressure of 110/70 mmHg and a pulse rate of 88 bpm. Initial laboratory tests showed a normal leukocyte count, ESR of 45 mm/hr, and troponin levels of 25 ng/ml, which decreased to 21.85 ng/ml and then to 8 ng/ml. ECG revealed ST segment depressions in the precordial leads. TTE showed an initial LVEF of 50%, declining to 35% and then to 28% within a week. Post-treatment, LVEF improved to 44% and subsequently to 55% at four weeks. Cardiac MRI indicated myocardial edema in the apical anterior and apical septal walls, with intramyocardial and subepicardial delayed enhancement.
Conclusion: Diphtheritic myocarditis can lead to rapid and severe deterioration of cardiac function. Early diagnosis and aggressive treatment, including the use of advanced imaging techniques and comprehensive medical therapy, can result in significant improvement in cardiac function and patient outcomes. Public health initiatives to improve vaccination coverage are essential to prevent such life-threatening complications.
Estimation of Anxiolytic Efficacy of Carica Papaya L. Seeds using Experimental Animal Models of Anxiety
Authors: Osama Muhammad , Ikram Rahila , Wei Calvin R. , Nargis Khan  , Shumaila Shaikh  , Fahad Jibran Siyal  , Sumbul Masood  , Mohammad Umair Farooqui  , Raheela Saleem
Published: June 2024

Background: Natural remedies have garnered global recognition for their therapeutic applications, supported by their unique nutritional and bioactive compositions. Among these, Carica papaya L., commonly known as papaya, has been historically valued not only for its nutritional benefits but also for its medicinal properties. The diverse chemical compositions of its leaves, seeds, and fruit contribute to their varied therapeutic uses.
Objective: This study aims to investigate the anxiolytic effects of aqueous extracts from Carica papaya L. seeds using various experimental animal models of anxiety.
Methods: Aqueous extracts of Carica papaya L. seeds were administered to Albino mice in a controlled laboratory setting. The anxiolytic effects were evaluated using four experimental models: the open field test, head dip test, cage crossing, and stationary rod test.
Results: The administration of papaya seed extract resulted in a statistically significant reduction in peripheral square crossings by 40% and cage crossings by 50% in the open field and cage crossing tests, respectively. The head dip test saw a decrease in head pokes by 45%, and the time to cross the stationary rod was reduced by 30% compared to controls.
Conclusion: The findings indicate that Carica papaya L. seeds possess pronounced anxiolytic properties, suggesting their potential utility as a natural adjunct therapy in managing anxiety disorders.
Exploring the Art of Critique: A Narrative Review Approach to Dissecting Health care Literature
Authors: Fazal Rahim  , Naseem Farhana  , Irfan Ullah  , Namra Javed  , Shah Faisal  , Mamoon Ur Rashid  , Muhammad Bilal  , Aiman Farooq
Published: June 2024

Background: A research critique or review of an article is the critical analysis of the strengths and weaknesses of a research paper through evidence-based practice, emphasizing the distinction between critique and criticism which helping post graduate students to defended their thesis. The literature review explores the advantages and disadvantages of methodological and statistical balancing in articles.
Objective: This narrative review article aims to dissolve the challenges faced by healthcare professionals while critiquing a quantitative research paper, thesis, or dissertation for the purpose to qualify the defense committee of concerns board of institutions.
Methods: The narrative review article was conducted by a systematic search of electric data bases, primarily Pub Med, Google scholar, and Scopus while referenced through Medley Software. There was no chronological constraint, but the focus was on thorough, current knowledge and foundational works that were well-known and frequently cited in the academic world. Included instructions and textbooks with thorough methods for evaluating quantitative works. Excluded articles with just qualitative critiques and publications written in languages other than English. The main principles for the in-depth analysis were taken from the step-by-step manual that Frances Ryan, Patricia Cronin, and Michael Coughian released in March 2007 and served as the cornerstone for the establishment of an organized method for research critique.
Results: Overall, several review guidelines resulted in the critiquing of writing style, title, abstract, literature review, logical consistency, statement of the phenomenon of interest, theoretical framework, instrumentation, sampling, study design, data collection, data analysis, philosophical underpinning, ethical consideration, discussion, conclusion, and references.
Conclusion: The art of critique offers guidance and tactics about critique in various domains effectively and educates readers on the hints of providing feedback thoughtfully particularly in healthcare profession.
Level of Participation in Daily Activities and its Association with Scoliosis among Hemiplegic Cerebral Palsy
Authors: Bibi Farzana , Ajmal Rabbia
Published: June 2024

Background: Cerebral palsy (CP) encompasses a spectrum of permanent movement disorders that originate in early childhood, leading to lifelong physical disabilities. Hemiplegic CP, the most prevalent subtype, features notable mobility but poses significant challenges in daily function and adaptation to everyday activities.
Objective: This study aims to evaluate the level of daily activity participation and its association with scoliosis in children with hemiplegic CP.
Methods: In this correlational study, data were gathered through non-probability convenient sampling from 110 hemiplegic CP children aged 4-18 years across various private and government hospitals and special education centers. The study excluded children with severe pain, impaired mobility, other neuromuscular diseases, or recent orthopedic surgery. Assessments included the Gross Motor Function Classification System (GMFCS), Manual Ability Classification System (MACS), and KIDSCREEN-10 for quality of life. The association of scoliosis with GMFCS and MACS was analyzed using the chi-square test on SPSS-22 software.
Results: The majority (60.9%) of participants were classified as GMFCS level II, while 46.4% ranked at MACS level I. There was a significant association between GMFCS levels and scoliosis presence (p < 0.05), but no significant relationship between MACS levels and scoliosis (p > 0.05). Scoliotic children exhibited poorer health outcomes, with 52% reporting poor health status.
Conclusion: While most children with hemiplegic CP were capable of handling objects, they faced limitations in mobility affecting their daily activities. Scoliosis was relatively uncommon but significantly associated with reduced gross motor function.
Perception of Caregiver on Physical Therapy Management for Pediatric Burn Patients
Authors: Ishfaq Aleena , Sadiq Samreen , Rizwan Shazia , Asim Hafiz Muhammad , Imdad Sana
Published: June 2024

Background: Burn injuries are among the most severe types of child injuries, leading to significant functional, social, and psychological disabilities. Physiotherapy plays a crucial role in the rehabilitation of pediatric burn patients, and caregivers are essential in facilitating the treatment process. Understanding caregivers' perceptions and adherence to physiotherapy treatment can inform better care strategies.
Objective: This study aimed to assess the perceptions of caregivers towards physiotherapy treatment for pediatric burn patients and to evaluate adherence to prescribed exercise regimens.
Methods: A descriptive cross-sectional study was conducted from June 2023 to December 2023. Data were collected from caregivers at two public hospitals and one private rehabilitation center using a non-probability convenience sampling method. The sample included 53 caregivers of children aged 1-5 years with burn injuries covering more than 20% of their total body surface area and who had been undergoing physiotherapy for 3-4 weeks. Exclusion criteria were caregivers not actively involved in daily care, those unable to communicate in English or Urdu, and patients without a caregiver. Data were collected using a semi-structured questionnaire based on the Measure of Processes of Care (MPOC). The questionnaire was validated and had a Cronbach’s alpha of 0.703. Data were analyzed using SPSS version 25, with descriptive statistics presented as frequencies, percentages, means, and standard deviations.
Results: Among the caregivers, 64.2% were mothers, 15.1% were fathers, and 20.8% were other relatives. A total of 81.1% of caregivers agreed and 18.9% strongly agreed that the physiotherapist encouraged active participation in decision-making. Comfort in discussing concerns was reported by 69.3% agreeing and 18.9% strongly agreeing. Emotional and social aspects were adequately addressed according to 39.6% of caregivers, with 41.5% neutral and 15.5% disagreeing. Clear communication of treatment plans was reported by 75.5% agreeing and 24.5% neutral. Adherence to exercise routines varied, with 47.2% often, 32.1% always, and 20.8% sometimes helping with exercises. However, 39.6% reported that the child always refused to do exercises, and 64.2% noted the child always complained of pain during therapy.
Conclusion: The study concluded that caregivers generally have a positive perception of physiotherapy for pediatric burn patients and actively participate in their care. Challenges such as pain during exercises and time constraints highlight the need for enhanced support and communication to improve adherence and outcomes.
Effectiveness of 5% Dextrose Water (D/W) versus Corticosteroid Injection for Pain Management of Sacroiliac Joint Dysfunction
Authors: Baig Muhammad Imran , DrWaqas Ashraf Chaudhary  , Hamza Shahzad  , Muhammad Fakhar Ikram Kalair  , Sadia Ghafoor  , Hanan Azfar  , Tamjeed Ghaffar  , Imtiaz Rafia
Published: June 2024

Background: Corticosteroid injections have been a cornerstone in the management of sacroiliac joint dysfunction (SIJD)-related pain. Recently, alternative approaches to pain management have garnered attention, particularly the use of 5% dextrose water (D/W) injections, which are believed to promote tissue healing and regeneration.
Objective: The purpose of this study was to evaluate the efficacy of 5% dextrose water (D/W) compared to corticosteroid injections for pain management in patients with sacroiliac joint dysfunction (SIJD).
Methods: This experimental study was conducted at Chaudhary Muhammad Akram Teaching and Research Hospital, Lahore, from October 2023 to May 2024. A total of 120 participants aged 18-65 years with clinically diagnosed SIJD were randomly assigned to two groups. Group A (N=60) received three weekly injections of 5% D/W solution, while Group B (N=60) received corticosteroid injections administered weekly over six weeks. Participants were excluded if they were pregnant, breastfeeding, had a history of allergy to the treatment components, or had received SIJ injections within the last three months. Pain intensity, functional disability, and quality of life were assessed using the Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and a standardized quality of life questionnaire, respectively. Data were analyzed using SPSS version 25, with within-group comparisons made using the Wilcoxon Signed Ranks Test and between-group comparisons using the Mann-Whitney U Test.
Results: Significant improvements were observed in both groups. The VAS scores in the dextrose water group decreased from 5.28 ± 1.71 to 2.58 ± 0.94 (p < 0.001) and in the corticosteroid group from 5.57 ± 1.85 to 3.15 ± 1.33 (p < 0.001). ODI scores improved from 34.27 ± 1.26 to 17.02 ± 3.15 in the dextrose water group (p < 0.001) and from 34.17 ± 1.12 to 19.95 ± 6.11 in the corticosteroid group (p < 0.001). Quality of life scores also showed significant enhancement, improving from 14.43 ± 1.79 to 7.64 ± 0.99 in the dextrose water group (p < 0.001) and from 14.57 ± 1.85 to 8.49 ± 1.98 in the corticosteroid group (p < 0.001).
Conclusion: Both 5% dextrose water and corticosteroid injections significantly reduced pain and improved function and quality of life in patients with sacroiliac joint dysfunction. While corticosteroid injections demonstrated a slightly greater benefit, 5% dextrose water injections are a promising alternative with fewer potential side effects. Further research is recommended to explore long-term outcomes and compare these treatments with other emerging therapies.
Enhanced Detection of Lamotrigine Through HPLC Methodology in Bioanalysis
Authors: Sehar Zahid  , M. Yar Khuhawar  , Qamar-Un-Nisa Shumaila
Published: June 2024

Background: Lamotrigine, an anticonvulsant drug, requires sensitive detection methods in biological and pharmaceutical matrices. Current methods struggle with interference and sensitivity, necessitating the development of improved analytical techniques.
Objective: This study aims to develop and validate a highly sensitive HPLC method enhanced by salicylaldehyde derivatization for detecting lamotrigine in pharmaceutical and biological samples, and to differentiate it from Piracetam when co-administered.
Methods: A reverse-phase HPLC method was employed, utilizing salicylaldehyde as a derivatizing agent to induce a bathochromic shift in lamotrigine from 315 nm to 415 nm. Optimization of the derivatization reaction included adjustments of pH, reagent concentration, temperature, and time. The standard addition method was applied to evaluate the recovery rates from spiked samples.
Results: The optimized method demonstrated a linear calibration range of 1-5 µg/ml with a determination coefficient (R²) of 0.998. Recovery of lamotrigine from pharmaceutical preparations averaged 96.5%, while recovery from deprotonated serum and urine samples of healthy volunteers was 96% with a relative standard deviation (RSD) of 6%.
Conclusion: The developed method offers a robust and highly sensitive approach to detect and distinguish lamotrigine in the presence of Piracetam, proving effective for both pharmaceutical and biological sample analysis.
A Male Surgical Contraceptive Method Based on Recommendations and Techniques Used in Vasectomy
Authors: Binish Asma , Tufail Javaria , Mukhtar Iqra , Arif Aqsa , Bano Hamra , Arif Mahnoor , Nisa Bushra , Shaista Jabeen  , Ejaz Rabea
Published: June 2024

Background: Vasectomy is a well-established method of male sterilization, offering a reliable and permanent contraceptive solution. Despite its effectiveness, the procedure remains underutilized due to limited counseling and awareness among patients.
Objective: The objective of this study was to evaluate the efficacy and safety of a standardized vasectomy technique based on the 2012 American Urological Association (AUA) guidelines and to identify factors influencing postoperative outcomes and patient satisfaction.
Methods: This prospective cohort study was conducted at the Department of Zoology, Rawalpindi Women University, from January 2022 to December 2023. A total of 150 male patients aged 25 to 50 years seeking permanent contraception were enrolled. Preoperative evaluations included detailed medical history, physical examination, and baseline semen analysis. The vasectomy procedures involved isolation, division, and management of the vasal ends using techniques such as proximal fascial interposition and thermal luminal fulguration. Postoperative care included instructions on scrotal support, avoidance of strenuous activities, and use of alternative contraception until azoospermia was confirmed through post-vasectomy semen analysis (PVSA) conducted at three months post-procedure. Data were analyzed using SPSS version 25, with statistical significance set at p < 0.05.
Results: The mean age of participants was 37.5 years (range: 25-50 years). The overall efficacy rate was 98.7%, with 140 participants (93.3%) achieving azoospermia and 8 participants (5.3%) having less than 100,000 non-motile sperm/mL at three months post-procedure. Complications included infection (1.3%), hematoma (2.0%), chronic pain (2.7%), and sperm granuloma (0.7%). The mean VAS scores for pain were 2.3 at one week, 1.1 at one month, and 0.5 at three months post-procedure. Patient satisfaction was high, with 95% of participants reporting satisfaction with the procedure.
Conclusion: This study demonstrated that vasectomy, when performed using standardized techniques, is a highly effective and safe method of male sterilization with high patient satisfaction and low complication rates. Enhanced preoperative counseling and follow-up are essential to optimize outcomes and increase the utilization of vasectomy as a contraceptive method.
Electrical Activity of Heart During ECG For EMF And Non– EMF Trails.
Authors: Haneef Ubed  , Farman Ali Mangi  , Zubeda Bhatti  , Assadullah  , Zahoor Ahmed
Published: June 2024

Background: The ubiquitous use of mobile phones has raised concerns about potential health impacts, particularly regarding the effects of electromagnetic fields (EMF) on the human brain and heart. Heart rate variability (HRV) is a critical measure of heart health, influenced by brain function and susceptible to disruption by mobile phone radiation.
Objective: This study aims to investigate the influence of mobile phone EMF on HRV, utilizing higher-order spectral analysis of ECG data to determine the functional relationship between the heart and brain under EMF exposure.
Methods: Twenty healthy subjects from the University of Sindh, Jamshoro, participated in this experiment. The subjects, with an average age of 27 years, underwent ECG and EEG recording under varying conditions of EMF exposure. Each session involved comparisons of EMF effects over different durations and positions relative to the heart.
Results: Statistically significant differences were observed in bicoherence values for chest positions V1 and V2, with non-EMF trials showing higher values compared to EMF trials. Coherence between ECG and EEG indicated significant changes in the 16-30 Hz frequency band during EMF exposure. Extended exposure of 40 minutes correlated with notable variations in HRV.
Conclusion: The findings suggest that mobile phone EMF can significantly affect HRV parameters, particularly with prolonged exposure and when the EMF source is close to the heart. These results underscore the importance of developing guidelines for safe mobile phone usage.
Prevalence of Fibromyalgia among Ischemic Heart Disease Patients in Lahore
Authors: Chohdary Aleena , Nimra Riaz  , Zainab Riaz  , Tayyaba Maqsood  , Hadia Zulfiqar  , Aasma Noor
Published: June 2024

Background: Fibromyalgia (FM) is a chronic pain disorder often coexisting with other conditions, complicating diagnosis, and management. Ischemic heart disease (IHD) patients may exhibit FM symptoms, which can affect their overall health and treatment outcomes. Understanding the prevalence and severity of FM in IHD patients can improve clinical approaches and patient care.
Objective: To determine the prevalence of fibromyalgia among ischemic heart disease patients in Lahore and to assess the severity of associated somatic symptoms.
Methods: This cross-sectional study included 158 participants diagnosed with ischemic heart disease, recruited through non-probability sampling from the Punjab Institute of Cardiology. The age range of participants was 30-60 years, with a mean age of 2.2595±0.75865. Both genders were included, with 62 males (39.2%) and 96 females (60.8%). Participants were categorized into three age groups for analysis. Data collection involved administering a fibromyalgia screening questionnaire to participants who provided informed consent. Exclusion criteria included diabetes, autoimmune diseases, immunosuppressive diseases, liver diseases, cancer, and history of substance abuse. Ethical approval was obtained according to the Declaration of Helsinki. Data were analyzed using SPSS version 25.0, with descriptive statistics (means, standard deviations, frequencies) and inferential statistics employed to explore associations between fibromyalgia and ischemic heart disease.
Results: Among the 158 IHD patients, 61.4% reported fibromyalgia symptoms, while 38.6% did not. Fibromyalgia symptoms were reported in the upper extremities by 93.7% of patients, in the lower extremities by 86%, in the face by 50%, in the front areas by 64.6%, and in the upper and lower back by 61.4%. Additionally, 62.7% of IHD patients reported somatic symptoms beyond musculoskeletal pain. Severity of symptoms included 55% reporting moderate to extreme fatigue, 58% reporting moderate to extreme difficulty waking refreshed, and 30% reporting slight cognitive changes.
Conclusion: The study identified a significant prevalence of fibromyalgia symptoms among ischemic heart disease patients, with considerable severity of symptoms and additional somatic complaints. These findings highlight the importance of screening for fibromyalgia in IHD patients to improve diagnosis and treatment strategies, ultimately enhancing patient outcomes.
The Outcome of Use of Intravenous Iron Carboxymaltose on the NYHA Class and the Six-Minute Walk-Test in Patients with Heart Failure: Assessing Functional Improvement
Authors: Khan Muhammad Zubair , Waqas Ahmad Jan  , Kheraj Mal  , Deepak Lal  , Rahid Ayaz  , Syed Muhammad Nayab Ali
Published: June 2024

BACKGROUND: Chronic heart failure (CHF) significantly impairs quality of life and exercise capacity, often exacerbated by concurrent iron deficiency. Intravenous ferric-carboxymaltose (FCM) has shown promise in addressing these deficiencies, improving both biomarkers of iron status and functional outcomes.
OBJECTIVE: To evaluate the effects of intravenous ferric-carboxymaltose on functional class and exercise capacity, as measured by the six-minute walk-test (6MWT), in patients with iron-deficient chronic heart failure.
METHODS: This prospective, single-arm study was conducted from April to September 2023 at the Cardiology unit of Frontier Corps Teaching Hospital, Shakas Peshawar, and Mardan Medical Complex, Mardan, Pakistan. Participants underwent baseline evaluations including demographic information, medical histories, physical examinations, and functional tests such as the 6MWT. Follow-up evaluations after three months of FCM therapy assessed changes in functional indicators. Statistical analyses included tests for significance and descriptive statistics.
RESULTS: Sixty patients participated, with a mean age of 55.87 ± 13.22 years and a mean BMI of 28.14 ± 9.71 kg/m^2. Initial assessments showed a mean LVEF of 33.54 ± 6.68%, with 75% classified as NYHA class III. Baseline 6MWT completion was 10 laps. Initial mean hemoglobin was 11.82 g%, MCV 78.48 fl, TSat 20.43%, and serum iron 50.55 mcg/dL. After treatment, hemoglobin increased to 13.65 g%, MCV to 80.23 fl, TSat to 23.05%, and serum iron to 55.40 mcg/dL. Participants completed 19 laps in the 6MWT, with 63.34% improving to NYHA class II. P-values were <0.0001 for these changes, indicating statistical significance.
CONCLUSION: Intravenous ferric-carboxymaltose significantly enhances functional capacity and iron status in patients with CHF and iron deficiency, irrespective of anemia status. Future research should explore how comorbid conditions like hypertension, diabetes, and renal failure influence treatment outcomes.
Extended Balloon Inflation Technique for Primary Percutaneous Coronary Intervention for ST-Segment Elevation Myocardial Infarction during Stent Deployment
Authors: Shah Muhammad Rafeeq , Khalid Naseeb  , Muhammad Nauman Khan  , Asif Hussain  , Tahir Saghir
Published: June 2024

Background: Primary percutaneous coronary intervention (PPCI) is the preferred method for treating ST-segment elevation myocardial infarction (STEMI), but the no-reflow phenomenon remains a significant challenge. This study investigates the efficacy of prolonged balloon inflation during stent deployment to reduce the incidence of no-reflow.
Objective: To assess whether extending the duration of balloon inflation during stent deployment in PPCI reduces the incidence of the no-reflow phenomenon compared to the conventional rapid inflation and deflation strategy.
Methods: This randomized controlled trial enrolled 122 patients at the National Institute of Cardiovascular Diseases, Pakistan, from February 2023 to January 2024. Patients were randomly assigned to either prolonged balloon inflation (PBSG) or conventional deployment (CDSG).
Results: The mean age in the PBSG was 59.83±10.10 years, and in the CDSG, it was 60.39±10.16 years. Male participants comprised 51.6%. The PBSG showed significantly lower immediate TIMI flow grades less than 3 (4.9% vs. 26.2%, P = 0.00), no-reflow incidence (0% vs. 26.2%, P = 0.00), corrected TIMI frame counts (36.96±4.25 vs. 46.13±6.82, P = 0.00), and higher ST-segment resolution ≥50% (77.0% vs. 57.4%, P = 0.02). Additionally, 59.0% in the PBSG achieved an MBG of 3 compared to 16.4% in the CDSG (P = 0.00).
Conclusion: Prolonged balloon inflation during stent deployment in PPCI significantly reduces the no-reflow phenomenon and improves myocardial perfusion in patients with STEMI.
Detection of Early Gastric Cancer and Lesion Segmentation Based on Deep Learning
Authors: Gul Rahid , Hania Akbar  , Ali Sadaqat , Khan Muhammad Amjad , Sardar Noor , Alam Intikhab , Iqbal Nusrum , Ahmad Younas
Published: June 2024

Background: Early detection and precise identification of gastric cancer tumors significantly enhance patient outcomes. Conventional methods often rely on manual interpretation of endoscopic images, which can be time-consuming and subjective. Recent advancements in deep learning offer promising alternatives for automating and improving these diagnostic processes.
Objective: The primary objective of this study is to explore the effectiveness of a deep learning model in detecting early gastric cancer and segmenting lesions from endoscopic images.
Methods: This retrospective study was conducted at Khalifa Gul Nawaz Teaching Hospital /BMC Bannu, from December 2021 to November 2022. Medical records and endoscopic images from 180 patients with suspected or confirmed gastric lesions were analyzed. Images were diversified in terms of lesion types and characteristics. Preprocessing steps including standardization and enhancement techniques were applied to improve image quality for analysis.
Results: The deep learning model achieved an accuracy of 90% in identifying gastric cancer lesions, with a sensitivity of 85% and specificity of 92%. The area under the curve (AUC-ROC) was calculated to be 0.61, indicating a good discriminative performance of the model.
Conclusion: The deep learning model demonstrated significant potential for enhancing the detection and segmentation of early gastric cancer from endoscopic images, providing a valuable tool for gastroenterologists in the early diagnosis and treatment planning.
Exercise Therapy versus Arthroscopic Partial Meniscectomy for Degenerative Meniscal Tear in Middle Aged Patients
Authors: Aneesullah Sahibzada , Saud Abdul Munaf , Khan Amina Gul Shehzar , Raza Tauseef , Asim Hamdoon Suharwardy , Ahmed Altaf
Published: June 2024

Background: Degenerative meniscal tears are prevalent among middle-aged individuals, often leading to significant knee pain and functional impairment. The effectiveness of non-surgical interventions, such as exercise therapy, compared to arthroscopic partial meniscectomy (APM), remains a key area of research in managing this condition.
Objective: To compare the efficacy of exercise therapy versus APM in improving pain relief, functional outcomes, and patient satisfaction in middle-aged patients with degenerative meniscal tears.
Methods: This randomized control trial was conducted at Lahore General Hospital from May to November 2023, enrolling 80 patients aged 40 to 60 years with confirmed symptomatic degenerative meniscal tears via MRI. Participants were randomly assigned to receive either exercise therapy or APM. Outcomes were assessed using the visual analog scale (VAS) for pain and the Knee Injury and Osteoarthritis Outcome Score (KOOS) for functionality.
Results: The study included 80 participants, with mean ages of 52.09 ± 4.31 years in the exercise group and 52.98 ± 3.43 years in the APM group. Initial VAS scores were 6.5 and 6.7 respectively. Post-treatment, the exercise group reported a VAS score of 5.2, and the APM group 5.0 (p=0.345). KOOS scores were 80 in the exercise group and 82 in the APM group (p=0.421). The return to activity rates were 75% for the exercise group and 80% for the APM group (p=0.632).
Conclusion: Both exercise therapy and APM provided comparable pain relief, functional improvements, and high patient satisfaction in the treatment of degenerative meniscal tears in middle-aged patients.
Association of Nutritional Status with Gross Motor Function in Cerebral Palsy
Authors: Shams Maryam , Hassan Danish , Boota Mehwish , Naeem Ali Asad , Khalil Osama
Published: June 2024

Background: Cerebral palsy is a prevalent disorder characterized by severe disability in body structures, impacting physical activities and daily living. This condition is often accompanied by poor nutritional status due to its complex interaction with movement and posture disorders.
Objective: The study aimed to determine the association between nutritional status and gross motor function in children with cerebral palsy.
Methods: A cross-sectional analytical study was conducted at Khawaja Arshad Hospital, Sargodha from July to December 2020. Children aged 4-12 years diagnosed with cerebral palsy were included, excluding those with genetic, metabolic, or neurodegenerative diseases affecting growth. Nutritional status was assessed using the WHO ANTHRO PLUS calculator, and children were categorized into five levels of gross motor function based on the Gross Motor Function Classification System.
Results: The study consisted of 55% males and 45% females. Gross motor function assessments revealed that 25% of participants were in level I, 60% in levels II and III, and 15% in levels IV and V. Nutritional assessments indicated that 17% of the children were malnourished, 70% had normal nutrition, and 12% were overweight. Height for age percentile showed 30% malnutrition and 70% normal nutritional status.
Conclusion: There was a significant correlation between the severity of gross motor dysfunction and nutritional status in children with cerebral palsy, with higher levels of motor impairment associated with greater nutritional deficits.