bluuebunny/crossref_metadata_2025 huggingface dataset:
Frequency of absent BCG Scar in Babies Vaccinated with BCG
Authors: Sami Aqeela , Jalil Jawad , Sarfraz Muhammad , Hassan Jawad ul , Khawar Ruhma , Mumtaz Zahra
Published: October 2023

Objective; In a TB endemic country find the frequency and associations of absent BCG scar in babies vaccinated with BCG.

Study Design; Interventional prospective cohort study.

Palace and Duration of Study; Immunization centre at Paediatric department of Fauji Foundation Hospital, Lahore from Mar 2021 to Aug 2021

Methodology; Infants with age ranging from 1day-1month, born at term with no antenatal, natal or post natal complications were selected by non-purposive convenient sampling and vaccinated by a single vaccinator using only one strain of BCG. Presence or absence of BCG scar was checked on their following visits for vaccinations at 6, 10 and 14 weeks of age and evaluated against different variables.

Result; 540 infants were included in this study. 384 had a complete follow-up, of which 35(9.1%) did not develop a scar after vaccination. This absence of scar was evaluated against gender , birth weight , day of vaccination, type of feed and socio economic status and there was no statistically significant association as p-value was >0.05

Conclusion; Probability of developing a BCG scar is independent of gender , birth weight , day of vaccination , type of feed and socioeconomic status. We suggest that babies who do not develop a scar should be revaccinated if they show poor response to TST after 6 months of ageas it can give rise to cross-protection against micro-organisms that might be unrelated totarget disease.
Comparison of Short-Term Outcomes of Transcatheter versus Surgical Closure of Atrial Septum Defect at a Tertiary Cardiac Care Facility
Authors: Saleem Shoaib , Younas Muhammad , Asma Tauseef , Riaz Usman , Tousif Rubina , Maqbool Baqir
Published: October 2023

Objective: To compare the short-term outcomes of transcatheter versus surgical closure of atrial septal defect (ASD) at a tertiary cardiac care facility in South Punjab, Pakistan.

Study Design: Prospective comparative study.

Place and Duration of the Study: Department of Paediatric Cardiology and Paediatric Cardiac Surgery, Chaudhary Pervez Elahi Institute of Cardiology, Multan Pakistan, from Jul 2019 to Jun 2021.

Methodology: A total of 110 patients with moderate to large isolated secundum ASDs without severe pulmonary hypertension and planned to undergo closure of secundum ASD by either surgical approach or device closure were included. All surgical and transcatheter procedures were performed adopting standard techniques. Intra-procedural or post-procedural outcomes were noted.

Results: In a total of 110 patients, 59(53.6%) underwent transcatheter closure of ASD, while surgical closure was done in the remaining 51(46.4%) patients. Post-procedural complications were significantly more in the Surgical Closure Group in comparison to the Transcatheter Closure Group, [14(27.5%) vs 5(8.5%) (p=0.026)]. None of the cases in the Transcatheter Closure Group required inotropes in the post-procedure period in comparison to 24(47.1%) cases (p<0.001). The total cost of treatment was significantly higher in transcatheter closure patients compared to surgical closure patients (1504±60.4 US$ versus 1448±75.4 US$, p<0.001). Overall, successful closure was noted in 108(98.2%) cases. No mortality was recorded.

Conclusion: Overall, short-term outcomes of transcatheter ASD closure were comparable to the surgical approach, but patients with transcatheter ASD closure had significantly less duration of hospitalization and low rates of post-procedural complications.Keywords: Atrial septum defect, Mortality, Surgical closure, Transcatheter closure.
Impact of COVID-19 Pandemic on Outpatient Child and Adolescent Mental Health Service at a Tertiary Care Hospital of Pakistan
Authors: Ul Ain Hamdan Qurrat , Tameezud Din Nizami Asad , Umar Zarnain , Afzal Sara , Mazhar Mahpara , Yasir Saadia
Published: October 2023

Objective: to determine the impact of COVID-19 on mental health care service provision and the pattern of morbidity presenting to out-patient child psychiatry services in Pakistan.

Study Design: Cross-sectional study.

Place and Duration of Study: Child and Adolescent Mental Health Unit, Institute of Psychiatry, Rawalpindi Pakistan, Medical university, from Jan 2019 to Dec 2020.

Methodology: Hospital records for the years 2019 and 2020 were used to get data on the total number of Out-Patient Department (OPD) visits in both years, and Departmental OPD records were used to extract data on all new patients.

Results: Two thousand two hundred thirty-two OPD visits were recorded in 2019 versus 536 in 2020, a 76% decline. Eight hundred fifty-six new patients were seen in 2019 vs 259 in 2020. The detailed OPD record analysis revealed that the predominant age group reporting was adolescents in both years. 377(44%) patients reported with behavioural problems in 2019 vs 138(53.3%) in 2019. Pharmacological management plans were used in 138(16.1%) in 2019 vs 66(25.5%) in 2019. Common Diagnoses seen in both years were not significantly different, (p=0.087). OPD records were found to have an increase in the “not mentioned category”, thus reflecting declined quality of record keeping.

Conclusion: The COVID-19-related lockdown and pandemic led to a sharp decline in out-patient visits and deterioration and record-keeping quality. The number of children and adolescents presenting with behavioural problems increased, but the common diagnoses remained similar.Keywords: COVID-19, Child and adolescent mental health service, Child psychiatry, Pandemic, School closure.
Diagnostic Accuracy of 16 Slice Contrast Enhanced CT Scan for Detection of Malignancy in Patients with Complex Adnexal Masses on Ultrasonography (Taking Histopathology as Gold Standard)
Authors: Sharif Sana , Kiani Asma Afzal , Mushtaq Nazia , Khalid Fareeha , Uzair Muhammad , Sharif Unaiza
Published: October 2023

Objective: To determine the diagnostic accuracy of a 16-slice contrast-enhanced CT scan (CECT) for the detection of malignancy in patients with complex adnexal masses on Ultrasonography (USG) (taking histopathology as the gold standard).

Study Design: Cross-sectional study.

Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Jul to Dec 2020.

Methodology: Seventy-five patients with adnexal masses were included. All patients had 16-slice contrast-enhanced CT scans. All the patients then had exploratory laparotomy, followed by histopathology as the gold standard. The diagnostic accuracy of CECT (contrast-enhanced computed tomography) was detected by determining sensitivity, specificity and diagnostic accuracy.

Results: 16-slice contrast-enhanced computed tomography showed a sensitivity of 92.2%, specificity of 93.4%, and diagnostic accuracy of 93.1%.for correctly diagnosing adnexal malignancy.

Conclusion: Due to its high sensitivity, specificity and diagnostic accuracy, 16 slice contrast-enhanced CT scan is a reliable test for diagnosing malignancy among patients with unexplained adnexal masses on USG.
Association of Hypertensive Disorders of Pregnancy with variations in Serum Sodium and Potassium Concentration
Authors: Yaqub Umairah , Khattak Irfan , Naseem Samina , Imran Ayesha , Kamal Khawar , Niazi Abbas
Published: October 2023

Objective: To study the variation in Serum Sodium and Potassium concentration in Pre-eclampsia and Normotensive pregnant ladies.

Study Design: Cross-sectional study.

Place and Duration of the Study: Combined Military Hospital, Kharian District Gujrat Pakistan, from Jun 2020 to Jan 2021.

Methodology: The study population Comprosed of 80 pre-eclamptic and 80 normotensive pregnant women recruited consecutively at their first, third trimester, and prenatal visits. Serum Sodium and Potassium were analysed using Ericson Photometer.

Results: When the two Groups were compared, in the Normotensive Group, the mean Sodium concentration of 132±4.490 mEq/dl was significantly less than the Pre-eclampsia Group of 139.1±3.909 mEq/dl. On the contrary, mean Serum Potassium concentration was significantly less in Pre-eclampsia 3.54±0.511 mmol/L compared to the Normotensive Group to 4.0±0.513 mmol/L.

Conclusion: High levels of Sodium and low level of Potassium were observed in the Pre-eclampsia Group. There may be a causal relationship between electrolyte fluctuations and Pre-eclampsia.Keywords: Electrolytes, Hypertension, Potassium, Pre-eclampsia, Sodium.
Clomiphene Supported Ovulation Induction in Subfertile Polycystic Ovary Syndrome Women: Role of Different Insulin Sensitizers
Authors: Parveen Shagufta , Iram Nabila , Saeed Bushra Zahid , Yaqub Umairah , Niazi Najmusaqib Khan
Published: October 2023

Objective: To compare Clomiphene Citrate, ovulation induction efficacy following using insulin sensitises, Metformin versus Myo-inositol in subfertile women with polycystic ovary syndrome.

Study Design: Prospective comparative study.

Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital, Kharian Pakistan, from Jun to Nov 2021.

Methodology: A total of 316 patients with polycystic ovary syndrome and infertility who were included in the study. Group-A was administered Metformin, whereas Group-B as given Myo-inositol. Both groups were given clomiphene citrate for ovulation induction and were followed for six months.

Results: There were 316 patients (158 in each Group). The mean age was 29.2±0.5 years, and the BMI of 23.2±1.7 Kg/m2 in both. Ovulation recorded in Group-A (Metformin) was 141(44.6%) versus Group-B (Myo-inositol), 103(32.6%). The pregnancy test was positive 33(21.1%) patients of Group-A versus 29(18.4%) of Group-B. The common complaints seen in both groups were nausea and vomiting 2(0.6%), while headache 1(0.3%) and dizziness 2(0.6%) occurred only in Group-B.

Conclusion: Clomiphene citrate with Metformin, as first-line therapy for sub-fertile women with polycystic ovary syndrome, improved ovulation and had fewer side effects than Myo-inositol.
Antibiotic Prescription Trends Among the Paediatric Population Admitted in Tertiary Care Hospitals of Rawalpindi
Authors: Iqbal Sana , Azam Naila , Ikram Farooq , Feroz Shizan Hamid , Khan Abid , Ranjha Waqas
Published: October 2023

Objective: To demonstrate the antibiotic usage and trends among paediatric patients admitted to the tertiary care hospital of Rawalpindi.

Study Design: Cross-sectional analytical study.

Place and Duration of Study: Paediatric In-Patient Department of two Tertiary Care Hospitals, in Rawalpindi Pakistan, from May to Dec 2021.

Methodology: After rigorous inclusion and exclusion criteria, 395 admitted patients of the paediatric ward were included in the study from two tertiary care hospitals in Rawalpindi through simple random sampling.

Results: A total of 395 patients were included; the mean age was 3.35±4.07 months, ranging from 0 to 45 months. 132(33.4%) patients from Hospital-A and 263(66.6%) from Hospital-B. Out of 395 patients, 35(8.7%) patients were given no Antibiotic, 240(60.8%) were given one antibiotic, 84(21.3%) patients were given two antibiotics, 33(8.3%) patients were given three antibiotics and 3(0.9%) patients were given four antibiotics. Of 360, 340(94.4 %) were given IV antibiotics, and 20(5.6%) were advised oral antibiotics.

Conclusion: The youngest children received the most antibiotic prescriptions, progressively decreasing as they aged. irrational use of antibiotics is a significant risk factor to cause antimicrobial resistance.
Computed Tomography Scan Head Findings in Patients With Various Glasgow Coma Scales Presenting with Head Injury in Emergency of a Tertiary Care Hospital
Authors: Rizwan Muhammad Hamza , Saddiqa Amina , Khan Maria , Khan M Asad Sultan , Mughal Sikandar Bakht Khan , Pervaiz Tamkeen
Published: October 2023

Objective: To associate the findings of CT scan with the Glasgow coma scale (GCS) of cases presenting with head trauma in the Emergency Department.

Study Design: Cross-sectional study.

Place and Duration of Study: Emergency Department, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2021.

Methodology: Ninty head injury cases of either gender, aged 12-60 years were included using non-probability consecutive sampling. The severity of the head injury was determined via GCS. CT scan findings were noted.

Results: The mean age was 22.21±11.10 years. The highest frequency of patients was noted in the age group of (13-29 years).The most common cause of head injury in men was road traffic accidents n=39/58(67.24%). As per GCS scoring, 63.3% of patients had mild brain injury. A strong association was observed between GCS and CT scan findings in cases with brain oedema (p=0.002), skull fracture (0.018) and no findings on CT scan (p-value≤0.001). No association between findings on CT scan and GCS scoring was noted in cases with epidural, subdural hematoma, cerebral contusions, intracranial and subarachnoid haemorrhage.

Conclusions: There is a lack of association between brain injury based on GCS scoring and CT scan findings. Using GCS scoring only for assessing the degree of brain injury is insufficient.Keywords: Computed tomography (CT) scan, Glasgow coma scales (GDS), Head injury.
Effectiveness and Safety of Suprachoroidal Injection of Triamcinolone in Patients with Resistant Macular Edema
Authors: Naeem Saquib , Malik Noureen , Ahmad Jawwad , Rauf Abdul , Janjua Teyyeb Azeem , Naimat Khalid
Published: October 2023

Objective: To assess the effectiveness and safety of suprachoroidal injection of triamcinolone acetonide for treatment of resistant macular edema.

Study Design: Non-randomized, pre-post experimental study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan and Combined Military Hospital, Bahawalpur Pakistan, from Nov 2020 to Jul 2021.Methodology: Patients with age of 18 years and above, either gender, diagnosed for macular edema due to diabetic macular edema, choroidal neovascularization, pseudophakic macular edema were included in the study. Triamcinolone acetonide 40 mg/ml, 0.1 ml was administered into suprachoroidal space as study intervention and post procedural follow-ups for week 1, week 4 and week 8 were performed.

Results: There were 37 total patients enrolled, 30(81.1%) were males while 7(18.9%) were females with mean age of 54.65±14.8 years. At baseline, the mean value of visual acuity was 0.84±0.33, which improved to 0.77±0.35 on week-1 follow up, 0.61±0.38 on week-4 and 0.58±0.44 at week-8 follow up. At baseline mean central macular thickness was 449.4±117.2μm, which decreased to 400.5±93.9μm, 365.1±95.1μm and 354.9±92.1μm at week 1, 4 and 8 follow up. It was observed that 16(43.2%) patients reported to experience pain at injection, while remaining 21(56.8%) did not experience pain.

Conclusion: It is concluded that single dose of triamcinolone injection administered via suprachoroidal route of administration is found to be safe and effective treatment modality for patients suffering with resistant macular edema.Keywords: Central Macular thickness macular edema, Suprachoroidal administration, Triamcinolone acetate.
Frequency of Dental Injuries in Patients Reporting to the Armed Forces Institute of Dentistry
Authors: Rana Nadeem Ahmed , Abbasi Qurat ul Ain , Maryum Dr Areeba , Ullah Mohib , Tu Zahra Syeda Fatima , Yousaf Ajmal
Published: October 2023

Objective: To determine the frequency, cause and type of dental injury in patients reporting to Armed Forces Institute of Dentistry.

Study design: Cross-Sectional Survey.

Place and Duration of Study: Department of Operative Dentistry Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from Sep 2021 to Sep 2022.

Methodology: A questionnaire was filled out for 357 patients reporting dental injury, including the extent of hard and soft tissue injuries. The cause and place of injury occurred; investigations, the treatment provided by the treating dentists ranging from restoration to root canal, type and duration of splint were also recorded.

Results: In the current study, 189(52.9%) out of 357 children got injury due to falls to the playground and other places. Maxillary incisors were mostly affected, and 163(45.7%) children had complicated crown fractures. Rigid splinting was done in 39(70.9%) of root fracture cases, while flexible splinting was done in 162(53.6%) patients with complicated crown fracture cases and 81(26.8%) complicated crown fracture cases. In 72(88.8%) cases of uncomplicated crown fracture, indirect pulp capping was done, and in 67(41.1%) cases of complicated crown fracture, root canal treatment were done. Apexification was done in 28(68.3%) of avulsion cases.

Conclusion: Our survey showed that most injuries occurred at school and the roadside. Maxillary incisors are primarily involved with complicated crown fractures, which are effectively managed.Keywords: Avulsion, Complicated crown fracture, Dental injury, Splinting.
How good can HDL Cholesterol be? Recent Evidence and way forward for Clinical Practice
Authors: Khan Sikandar Hayat
Published: October 2023

The science of “Lipidology” is flourishing in endless ways. The services included under the lipid testingdo not provide generalised risk assessment for possibleatherosclerotic cardiovascular disease (ASCVD) butprovide specialised services, including genomic andmolecular biomarkers for personalised care. The seminal discovery of lipoprotein fractions seems like a stepnext door in the much wider cosmos of metabolomicsand proteomics, where knowledge of lipoprotein subfractions as villains or saviours seems like the trailer ofthe Larger Amphitheatre. Low-density lipoproteins(LDL) though differently defined in the literature, werecategorised as “large buoyant LDL” (lbLDL) and“small dense LDL” (sdLDL).1 Over time, the knowledge base evolved to incorporate different fractionsamong lipoproteins based upon size and density withhigh-density lipoproteins (HDL) to incorporate nascentHDL, HDL2 and HDL3
Frequency of High Cup to Disc Ratio amongst Healthy Young Population of Central Punjab Province of Pakistan
Authors: Parveen Shagufta , Muzaffar Waqar , Saeed Muhammad Kamran , Babar Zaheer Uddin , Tanveer Hira
Published: October 2023

Objective: To determine the frequency of high cup-to-disc ratio amongst the healthy young population of the Central Punjab province of Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Eye, Combined Military Hospital Lahore, from Jun 2022 to Feb 2023.
Methodology: One hundred fifteen candidates who presented for medical fitness examinations were enrolled; they all belonged to the Central Punjab province of Pakistan. All the participants underwent thorough ocular examination, including visual acuity testing, slit lamp bio-microscopy, fundoscopy and tonometry. Candidates with a cup-to-disc ratio >0.6 were further investigated to rule out glaucoma using pachymetry, visual field (VF) testing and spectral-domain optical coherence tomography.Results: The mean age of participants of the study was 18.97±2.60 years. There were 72(62.6%) males and 43(37.4%) females.The mean intraocular pressure was 13.08±2.40 mmHg. The mean cup-to-disc ratio was calculated to be 0.34±0.11. It was found that 7 out of 115(6.1%) participants have a cup-to-disc ratio of more than 0.6, whereas the remaining 108(93.9%) participants had less than 0.6 cup-to-disc ratio.
Conclusion: The screened population revealed a high cup-to-disc ratio in 6.1% of the candidates.
Pre-Emptive Analgesia by Intraperitoneal Instillation of Lignocaine in Laparoscopic Cholecystectomy
Authors: Akhtar Muhammad Talha , Akhtar Muhammad Usama , Hussain Syed Mukarram , Ammad-ud-din Nasir  , Abbas Tanveer , Akram Rabia
Published: October 2023

Objective: To compare the effects of preemptive intraperitoneal instillation of local anesthetic (lignocaine) with conventional instillation after the removal of gall bladder in elective laparoscopic cholecystectomy.
Study Design: Quasi-experimental study.
Place and Duration of study: General Surgical ward, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Apr 2018.
Methodology: Patients fulfilling the inclusion criteria were randomly assorted into two groups. Group A received intraperitoneal lignocaine at the conventional timing where was in Group B local anesthetic was instilled preemptively at the time of insertion of trocar. Post operatively pain was measure on visual analogue scale at 3,6 and 12 hours.
Results: Total of 184 patients were followed up post-operatively. Mean age of patients in Group A was 44.5±13.57 years and in Group B was 46.2±13.9 years. Mean post-operative pain on visual analogue scale score for Group A was 2.53±0.73 and that for Group B was 2.0±0.66 with p-value<0.01.Conclusion: The use of preemptive instillation of local anesthetic intraperitoneal was found better as compared to conventional timing of instillation in reducing the post-operative pain in elective and uncomplicated cases of laparoscopic cholecystectomy.
Safety and Effectiveness of Percutaneous Endoscopic Gastrostomy in Children
Authors: Saleem Zeeshan , Lodhi Munir Akmal , Hashmi Muhammad Almas , Zahra Fatima tuz , Hassan Shamama
Published: October 2023

Objective: To determine the safety and effectiveness of percutaneous endoscopic gastrostomy in Paediatrics population.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Pediatric Gastroenterology, Pak Emirates Military hospital, Rawalpindi Pakistan, from Mar 2014 till Dec 2017.
Methodology: Total 40 children who underwent percutaneous gastrostomy at the Paediatric gastroenterology department were included in the study. Patients were followed up for a period for 6 months. Demographic data, indications, weight gainand complications were noted for 6 months after the procedure.
Results: Forty patients were enrolled and there were 23(57.5%) males with mean age of 39.8±20.2 months. Swallowing difficulty 23(47.5%) was the major indication followed by poor weight gain 10(25%), prolonged nasogastric tube feeding8(20%) and frequent aspirations 3(7.5%). Majority 32(80%) had underlying diagnosis of cerebral palsy. In six months follow up, 38(95%) children had an increment in weight (mean weight gain 1.89±1.0Kg). Early feed at 6 hours after procedure was tolerated by 38(95%) of patients. The majority of children did not have any complications and only few were observed to havewound infection, vomiting, and irritability in 3(7.50%), 1(2.50%) and 3(7.50%) respectively.
Conclusion: Percutaneous endoscopic gastrostomy placement is a minimally invasive, safe and effective feeding technique for neurologically impaired children, especially cerebral palsy patients requiring long term assisted feeding.
Frequency of Post Dural Puncture Headache with Median Versus Para-Median Approach of Spinal Anaesthesia in Patients Underwent Cesarean Section
Authors: Aijaz Ali  , Danish  , Khalique Abdul , Syed Khurram Naseer  , Suhail Amir
Published: October 2023

Objective: To compare the frequency of post dural puncture headache with median versus para-median approach of spinal anaesthesia in females undergoing cesarean section.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Anesthesiology and Obstetric departments, Combined Military Hospital, Badin Pakistan, from Oct 2018 to Apr 2019.
Methodology: Total 128 females undergoing cesarean section, fulfilling the inclusion criteria were included randomly in two equal groups. Group-A received spinal anaesthesia with 25 G Quincke spinal needle by median approach while Group-B received by paramedian approach. Post-dural puncture headache was assessed by using visual analogue scale. Pain of any severity was taken as positive. All patients were followed by researcher for presence or absence of post-dural puncture headache.
Results: Post dural puncture headache occurred in 21(32.81%) patients with median approach versus 4(6.25%) patients complained headache after para-median approach with p-value=0.0001, frequency was statistically significant.
Conclusion: This study concluded that more frequency of headache after dural puncture in median approach compared to para-median approach in cesarean section patients.
Frequency of Hypothyroidism in Patients with Beta-Thalassemia Major
Authors: Javed Sehrish , Tariq Ghafoor  , Shabbir Hussain  , Farooq Ikram  , Raazia Nawaz
Published: October 2023

Objective: To determine the frequency of hypothyroidism in patients with beta-thalassemia major in Paediatric department of Pak Emirates Military Hospital, Rawalpindi Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Paediatric Medicine Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Nov 2018 to Oct 2019.
Methodology: All transfusion dependant beta-thalassemia major (BTM) patient sir respective of age and gender were consecutively enrolled. For the assessment of thyroid function, a random sample of 3 ml venous blood was drawn. The presence of increased thyroid stimulating hormone and normal T4, T3 were labelled as compensated, increased thyroid stimulating hormone, decreased T4 and/or T3 as uncompensated.
Results: Of 73 patients, the mean age of the patients was 7.0±3.87 years. All the patients were getting iron chelation therapy. The mean serum ferritin level was 3911.68±2017.36 ng/mL. Twenty-eight (38.4%) cases were hypothyroid. Subclinical hypothyroidism was documented in 25(89.3%) while clinical hypothyroidism in 3(10.7%) patients. Patients with age >8 years (p=<0.001), >2 years of age at the time of 1st blood transfusion (p<0.001)>8 numbers of blood transfusion (p<0.001) and >4000ng/dl serum ferritin levels (p<0.007) were noted as factors significantly associated with hypothyroidism.
Conclusion: A considerable number of patients were affected with hypothyroidism. Moreover, high serum ferritin level and a high number of blood transfusions were found to be significant determinants.
Association of Dietary Habits in Esophageal Cancer–A Case-Control Study from Pakistan
Authors: Shahid Hussain  , Zahoor Saima , Hayat Mohammad , Ayesha Shahid  , Nouman Maryum
Published: October 2023

Objective: To see the association between dietary habits in the development of oesophageal carcinoma.
Study Design: Case control study.
Place and Duration of Study: Department of Medical Oncology at Jinnah Postgraduate Medical Centre, Karachi Pakistan,from Feb 2019 to Dec 2019.
Methodology: Patients from age 15-80 years of either gender were included in the study. All the patients presenting to hospital OPD with histopathologically confirmed of oesophagus carcinoma were included. Controls were the healthy attendants coming at the same hospital. The data was collected through pre-designed questionnaire.
Results: Total of 173 cases and 173 controls were included in the study. The mean age of the cases and controls were reported as 48.07±14.13 years and 48.86±15.32 years. After adjusting odds in multivariate analysis family history of cancer (OR=3.76; 95% CI: 1.76-7.90, p<0.05), the consumption of chicken (OR=5.22; 95% CI: 3.01-9.056, p<0.05), red meat (OR=5.06; 95% CI: 2.70- 9.46, p<0.05) & smoked food (OR=3.36; 95% CI: 1.76-6.44, p<0.05) more than three times per week remained positively associated with oesophagus carcinoma.
Conclusion: The study showed association between consumption of chicken, red meat, hot drinks & smoked food with oesophageal carcinoma.
Assessment of the Risk Factors of Hypertension Among Adults in Pakistan
Authors: Tariq Muhammad , Muhammad Aleem Ud Din  , Mustafa Zia Ul , Shafait Ali Rana  , Kazmi Ramla , Qamar Adeel , Ahmed Moiz , Abbas Kiran
Published: October 2023

Objective: Toevaluate the distribution of risk factors and determined their association with hypertension in Pakistani population.
Study Design: Prospective longitudinal study.
Place and Duration of the Study: The study was conducted in different hospitals in Punjab and Sindh , Pakistan from Dec 2018 to Jun 2019.
Methodology: Data of subjects between the ages of 18-75 were included in the study using non-probability convenience sampling technique. A questionnaire was used to record socio demographic information and risk assessment was done. Weight and blood pressure measurements were also recorded. Bivariate analysis was used for analysis to identify risk factors associated with hypertension.
Result: A data of 350 subjects was recorded with a mean age±SD of 43.7±10.5 years. The prevalence of hypertension was recorded to be 26%. Prevalence of current smoking, and passive smoking was 57(16%) and 11(3%) respectively. Gender, smoking, level of education, physical inactivity, were each significantly associated with increased risk for hypertension.
Conclusion: Our study demonstrates that in Pakistan, increasing age, marital status, level of education, poor dietary habits, smoking, obesity, and other modifiable factors are contributing to the increased risk and prevalence of hypertension.
Skeletal Maturity on Evaluation by using Dental Calcification as Diagnostic Tool
Authors: Nizam Fakhira , Nasrullah Mengal  , Sumbal Hayat
Published: October 2023

Objective: To determine the correlation of skeletal maturity with chronological age by using the dental calcification.
Study Design: Cross sectional study.
Place and Duration of Study: The Department of Dentistry, Sandeman Provincial/Civil Hospital, Quetta Pakistan from Jun to Dec 2019.
Methodology: Fifty individuals with permanent mandibular teeth, either gender was included. Chronological age was noted and dental maturity was assessed by using dentalx-ray tooth (Ortho-pantomogram) having calcification first and second premolartoothas per Demirjian criteria. Pearson’s correlation coefficient was calculated with p-value≤0.05 kept as significant.
Results: The mean chronological age of individuals was 43.71±22.31 years. There were 28(56%) males while 22(44%) females.The mean dental calcification age was 42.90±22.05 years. There was significantly strong positive correlation between dental calcification & chronological age i.e. r=0.995 (p<0.001).Conclusion: Thus dental calcification can be applied to determine the chronological age, especially for identification offorensic cases or autopsy cases.
Association between Pain and Level of Disability in Patients with Degenerative Supraspinatus Tendinopathy
Authors: Rasheed Rida , Ashfaq Ahmad  , Fariha Khalid  , Syed Amir Gillani  , Faiza Sharif  , Abeera Babur
Published: October 2023

Objective: To determine the association between pain and level of disability in participants with degenerative supraspinatus tendinopathy.
Study Design: Cross-sectional study
Place and Duration of Study: Outpatient Departments of Jinnah Hospital and Lahore General Hospital, Lahore Pakitan, from Jun 2019 to Feb 2020.
Methodology: A total of 168 diagnosed participants of degenerative supraspinatus tendinopathy with age range of 30 to 60 years were included through consecutive sampling and questioned using Quick Disabilities of Arm, Shoulder and Hand (DASH) and Numeric pain rating scale. The categorical data like age and Quick Disabilities of Arm, Shoulder and Hand scores were recorded as mean and standard deviation while numerical data like gender and Numeric Pain Rating Scale readings were described as frequencies and percentages, using SPSS version 25.0. Linear relationship of association between pain and level of disability was found through Pearson coefficient (r).
Results: Quick Disabilities of Arm, Shoulder and Hand (DASH)showed a mean of 3.55 and standard deviation of 0.94, while with Numeric Pain Rating Scale 7 participants (4.2%) described their level of pain as "hurts little bit", 31(18.5%) "Hurts little more", 63(37.5%) "Hurts even more", 55(32.7%) "Hurts whole lot" and 12(7.1%) "Hurts worst”. Results of the study showed that level of disability was significantly correlated with pain and there was a moderate positive correlation between them.
Conclusion: This study concluded that intensity of pain can cause disability in participants with degenerative supraspinatus tendinopathy and impairs the Quality of Life in such patients.
Post-Operative Benefits of Nasogastric Tubes in Patients with Gut Resection and Anastomosis: Myth or Reality?
Authors: Ayaz Muhammad Ahsan , Muhammad Qasim Butt  , Muhammad Mohsin Ayaz  , Maryam Abbas  , Saqib Islam  , Zainab Qasim Butt
Published: October 2023

Objective: To analyze the post-operative benefits of nasogastric tubes among patients undergoing gut resection and anastomosis at our surgical unit.
Study Design: Prospective comparative study.
Place and Duration of Study: Surgical Department, Combined Military Hospital, Rawalpindi Pakistan, from Jun 2019 to Mar2020.
Methodology: This study was conducted on 80 patients who underwent gut resection and anastomosis due to localized cause at surgical unit of our hospital. With block randomization method half of the patients received nasogastric (NG) tube after the surgery while half did not. Presence of nausea or vomiting, pain abdomen, return of bowel sounds and electrolyte imbalance were compared in both the groups.
Results: Out of 80 patients included in the final analysis 50(62.5%) were male and 30(37.5%) were female. Mean age of patients put who underwent the gut resection and anastomosis procedure in our study was 41.34±5.147 years. Chi-square test revealed that all parameters included in the study did not differ significantly among patients with and without nasogastric tube after the surgery.
Conclusion: Administration of nasogastric tube did not prove any better in reducing the post-operative abdominal pain, nausea and vomiting. It also did not prove to be effective in preventing the electrolyte imbalance and helping in returning the bowel sounds early. Patients with and without nasogastric tube had equal chance of having any of the complications.
Optimum Perioperative Analges ia in Radical Nephrectomy, Multimodel Approach with Nalbuphine and Ketamine
Authors: Ahmad Maqsood , Fatima Wajahat  , Amna Wajahat
Published: October 2023

Objective: to find perioperative analgesic effectiveness of low dose Ketamine in radical nephrectomy operations and comparing its anodyne potency with Nalbuphine Hcl (Nalbin).
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed forces institute of urology from Sep 2016 to June 2019.
Methodology: The 60 randomly selected surgical patients for radical nephrectomy were divided into two groups in a random manner. The Anaesthetic technique used in both groups (K and N) was standard along with 10 mg injection Nalbin given to both groups at induction. Group-K (n=30) patients had IV Ketamine bolus 0.3 mg /kg followed by 0.1 mg/kg/h infusion at induction till completion of surgery. Group-N (n=30) received a similar volume of saline in bolus as well as an infusion. The pain score (VAS) at different intervals and total Nalbin consumed in 12 hours were recorded for each group. Patient satisfaction and complications were recorded during this period.
Results: The effective intraoperative analgesia was achieved with an infusion of low dose Ketamine which continued till completion of surgery as seen in group K which has reduced Nalbin requirement 8.8± 3.5 mg (Group N 25±5 mg). There was a statistically significant reduction in overall pain scores and Nalbin demand (P≤0.05) in the Ketamine group (p≤0.00, 0.036, 0.286, 0.257, 0.253 respectively). Patient satisfaction was better in the Ketamine group but few patients in this group had delayed recovery.
Conclusion: Intraoperative low-dose Ketamine infusion provides good postoperative analgesia while reducing the need for opioid analgesics, which must be con
Association between Histopathologic Type of Ovarian Cancer and Serum CA-125 Level
Authors: Perveen Hina , Haider Ghulam , Kerio Perwasha , Zahoor Saima , Mahar Khalil , Memon Paras
Published: October 2023

Objective: to find an association between the serum CA-125 level and the histopathological type of ovarian tumor.
Study Design: Cross-sectional study.
Place and Duration of Study: Medical Oncology, Jinnah postgraduate Medical Center, Karachi Pakistan from Jan 2018 to Dec 2019.
Methodology: This study included 107 patients presenting with epithelial ovarian cancer. In each case, histological type, pathological stage, degree of differentiation and serum CA-125 was evaluated. The association between preoperative CA-125 and histopathological type of tumor were evaluated.
Result: About 107 ovarian cancer patients were included. The mean age in our study was 50.80±10.16 years. Raised CA-125 level was found in most of the patients with serous histology 46(56.1%).
Conclusion: Serum level CA-125 elevated in most patients with serous histology. A statistically non-significant association was found between raise CA-125 levels and histological types of ovarian cancer.
Four Petal Evisceration Inphthisical Eyes
Authors: Murtaza Sameen  , Muhammad Shahid  , Muhammad Awais  , Muhammad Adnan  , Teyyeb Azeem  , Hussnain Abbas
Published: October 2023

Objective: Four Petal Evisceration Inphthisical Eyes.
Study Design: Retrospective Study.
Place And Duration of Study: Armed Forces Institute Of Ophthalmology, Rawalpindi Pakistan, from Jan 2022 to Apr 2022.
Methodology: A total of 20 subjects underwent evisceration with four petal technique. The record was collected from record room and data was analyzed. After 360º conjunctival peritomy, a larger orbital implant was placed for good cosmesis and to achieve maximum ocular motility. Axial length (AL) of normal eye was measured and compared with AL of atrophic eye. An orbital implant 3mm smaller than the axial length of the normal eye was placed. Implant was closed with 4 coverings to prevent extrusion. SPSS version 22.0 was used for data analysis.
Results: Out of n=20 patients with atrophia bulbi, females 11(55%) and males 9(45%). About 12(60%) were right eyes and 08(40%) were left eyes. Mean SD age of patient was 35.1±17.01 years. An implant of 18mm, 20mm and 22mm were used after calculation of axial length. Axial length of normal eye was used for the selection of size of implant. However, follow up was done from 4-18 months respectively.
Conclusion: Evisceration with four petals remains the procedure of choice due to better cosmesis and good motility.
The Effect of Artificial Tear Treatment on Central Corneal Thickness in Dry Eyes
Authors: Khan Umair Naeem , Humayun Fakhar , Naeem Saquib , Butt Waqas Rahim , Khan Taimoor Ashraf , Qadir Abdul
Published: October 2023

Objective: To evaluate the role of artificial tear treatment on central corneal thickness in patients with dry eyes coming to a tertiary care eye hospital.
Study Design: Quasi-experimental study.
Place and Duration of Study: Tertiary Care Eye Center, Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from May to Nov 2022.
Methodology: The study included central corneal thickness of 210 eyes (n=210) of 110 patients with dry eye disease measured before and after treatment with continuous use of artificial tear drops one month apart, patients were diagnosed on the presence of symptoms such as burning, dryness, pain, irritation, grittiness followed by slit lamp examination for marginal tear meniscus(<0.25mm) or absent, tear film BUT of <10 seconds , Schrimer test 2 of <6mm after 5 minutes and ocular surface staining score of >1 with fluorescein. Central corneal thickness was measured using corneal topography (Galleli G6 Ziemer).
Results: A total of two hundred and twenty eyes of 110 individuals having dry eyes were included in our study. Median CCT before treatment with artificial tears was 522(75)µm while median CCT after 1 month treatment with artificial tears was 547(22.25)µm this showed a percentage increase of 3.79% in central corneal thickness after one month treatment with artificial tears (p-value <0.001) therefore treatment with artificial tears was significantly associated with an increase in central corneal thickness in dry eye disease.
Conclusion: Central corneal thickness is substantially related to dry eyes.
As consequências da Covid-19 para a alfabetização de crianças
Authors: Santana Yasmin Nogueira , Osti Andréia
Published: October 2023

A pandemia de Covid-19 fez com que o ensino passasse a ser mediado por tecnologias digitais e pelo ensino remoto, contudo, não houveram as estruturas necessárias para tal mudança, dificultando o processo de alfabetização de alunos, sobretudo os de escola pública. O objetivo deste estudo foi compreender as consequências da pandemia para a alfabetização de crianças. A metodologia é de natureza qualitativa. Foi feita uma revisão bibliográfica direcionada para trabalhos que constam no banco de dados do Google Acadêmico. Os resultados mostraram que a falta de planejamento prévio, formação docente necessária, o acesso desigual às aulas remotas e outras condições impostas pela pandemia, deixaram marcas que continuam desafiando a educação mesmo depois da retomada de aulas presenciais. Concluiu-se que é necessário priorizar esforços na elaboração de maior equidade nas aulas e na construção de estratégias e políticas que considerem os impactos da pandemia, assegurando um ensino de qualidade a todos.
KORPUSBASIERTE EXTRAKTION VON (MEHRWORT-) TERMINOLOGIEKANDIDATEN: EINE STUDIE ANHAND DER JURISTISCHEN FACHSPRACHE DES DEUTSCHEN
Authors: TARLOYAN ASTGHIK , ELBAKIDZE TAMAR , LIPATELIANI MAIA , OSEPASHVILI NINO , HOVSEPYAN HAYK , KHACHATRYAN GOHAR , DALLAKYAN MERI , STRAUBE ANNIKA , BABYCH BOGDAN , ATAYAN VAHRAM
Published: October 2023

Die vorliegende Untersuchung stellt eine Pilotstudie zur Terminologieextraktion dar. Die zentrale Zielsetzung der Studie besteht darin zu klären, wie weit die Ergiebigkeit von automatischen Terminologieextraktionsmethoden auf der Basis der Schlüsselwortidentifikation im Vergleich zu einfachen rein strukturbasierten Extraktionen verbessert werden kann. Als fachsprachliches Korpus der Studie werden die Entscheidungen des Bundesgerichtshofes herangezogen, aus denen rechtliche Ein- und Mehrworttermini extrahiert werden sollen. Dabei sollen zwei relativ einfache Verfahren zur Terminologieextraktion getestet werden. Zum einen sollen Mehrwortverbindungen nach einem rein syntaktischen Muster extrahiert werden, zum anderen die Schlüsselwörter des Bundesgerichtshofkorpus als Terminologiekandidaten und als Ausgangspunkt für die Identifikation von Mehrworttermini ausgewertet werden. Die beiden Verfahren sollen im Hinblick auf die Präzision (Precision) und die Sensitivität (Recall) getestet werden. Zur Bestimmung beider Maße wird auf manuelle Annotation von Termini in der jeweiligen Kandidatenliste zurückgegriffen, die als Goldstandard für die Studie gilt.
«BROT/ՀԱՑ» ՍՆՆԴԱՆՈՒՆՈՎ ԴԱՐՁՎԱԾՔՆԵՐԻ ՀԱՄԵՄԱՏՈՒԹՅՈՒՆԸ ԳԵՐՄԱՆԵՐԵՆՈՒՄ ԵՎ ՀԱՅԵՐԵՆՈՒՄ / CONTRASTIVE ANALYSIS OF PHRASEOLOGICAL UNITS WITH THE COMPONENT "BREAD" IN GERMAN AND IN ARMENIAN
Authors: PAPOYAN SIRANUSH , GHAZARYAN ELIZA
Published: October 2023

The article is devoted to the study of phraseological units with the component "bread" in German and Armenian. The comparison shows that the component "bread" in the phraseological units of both languages displays many connotative meanings, both implicitly and explicitly. In both languages, "bread" is considered primarily a means of subsistence and is associated with a good or a bad financial condition or status a person. But in both languages, the meanings of phraseological units basically do not coincide, and this is due to geographical distance, different mentality, including linguistic mentality and different world perceptions of these peoples.
Multimodal imaging in radiation retinopathy following orbital metastasis
Authors: Sanjay Srinivasan , Acharya Isha , Srinivasan Priya , Mahendradas Padmamalini
Published: October 2023

Background: Radiation retinopathy is a major cause of vision loss in patients receiving radiotherapy to the head and orbit. Diabetic retinopathy is included in the differential diagnosis owing to similar clinical features, including microaneurysms, cotton-wool spots, hard exudates, and macular edema. The only significant pathological difference is that radiation retinopathy spares pericytes, unlike diabetic retinopathy. Multimodal imaging helps diagnose and predict the prognosis of radiation retinopathy, which is presented in this case report.

Case Presentation: A 55-year-old woman diagnosed with stage-4 metastatic breast carcinoma presented with gradual diminution of vision in the left eye (OS) over 5 months. Vision in the right eye was lost because of orbital radiotherapy for orbital metastasis. The patient underwent multiple sessions of chemotherapy and radiotherapy. Examination of the left eye revealed a best-corrected distance visual acuity (BCDVA) of 20/30. Fundus examination of the OS revealed multiple cotton-wool spots and retinal hemorrhages. Fundus fluorescein angiography (FFA) showed diffuse macular leakage with capillary nonperfusion. Multicolor imaging (MCI) with Spectralis™ revealed black dots in the blue and green reflectance images, corresponding to capillary dilatation on FFA. Darker dots were more evident in the infrared images. BCDVA improved to 20/20 in OS after tapering the dose of oral steroids for 2 months, with improvements in hemorrhages and cotton-wool spots. Focal laser photocoagulation was recommended for the treatment of persistent macular edema. The patient declined further treatment, was lost to follow-up, and passed away 6 months later.

Conclusions: This case highlights the importance of multimodal imaging for the identification and classification of radiation retinopathy. MCI using SpectralisTM has been described for the first time in radiation retinopathy and can be used to complement existing imaging modalities. Future studies involving more patients and a longer follow-up duration may provide better results for the applicability of these imaging modalities in the clinical setting.
Grammatical Interpretation in The Book (Al-Tayseer Fil-Tafseer), By Abi Hafs Al-Nasafi, “Al-Marfou’at” As A Model
Authors: Hadi Abdul-Adheem Qais , Al Shammari Ali Hussain Khudair
Published: October 2023

This study seeks to identify the (grammatical interpretation of Imam Omar bin Muhammad Abi Hafs Al-Nasafi (d. 537 AH) in his book: (Al-Tayseer fil-Tafseer) Al-Marfu’at as a model), and to shed light on his distinctive methodology that he followed in his book and to show the extent to which this interpretation accommodates the grammatical interpretation. And its impact in directing the meaning, as well as the value shown by this aspect in the interpretation, as Abu Hafs Al-Nasfi reviews in his book many of the Qur’anic readings that were received from the scholars of readings; In addition to his grammatical interpretation of these readings, and to achieve the purpose of this study, its course has been divided into issues preceded by an introduction, and followed by a number of matters that we consider to be of importance.
The Effect of Aquarium Strategy on Developing Creative Thinking in Geography Subject
Authors: Hassan Shaker Mahmood , Al-Khalid Ghassan Ahmed
Published: October 2023

The research aims to evaluate the efficiency and effectiveness of the aquarium strategy as one of the active education strategies for increasing students' academic achievement and developing creative thinking. The research was conducted on a school in Anbar Governorate, west of Al-Iraq. To accomplish this research, the researcher used a sample of seventy students, who were equally divided into two groups (control and experimental). After completing the research requirements, the results of academic achievement and creative thinking of tests specially developed for students of both groups were analyzed using statistical methods and methods such as the T-test for the two independent samples. The results of the research showed that using the fish tank strategy significantly impacts students' skills in creative thinking and academic achievement compared to the usual method used. It is worth mentioning that the researcher conducted a questionnaire that includes and covers the geographical area of ​​the study area, and it was found that many teachers trust this modern strategy and that it has a significant role in improving students' skills in studying geography.