bluuebunny/crossref_metadata_2025 huggingface dataset:
Floristic Diversity of Invasive Weeds in Shirpur Taluka of Dhule District, Maharashtra State, India
Authors: Rajni Kant Thakur  , Kumar Ambrish
Published: October 2023

The present study was aimed to document the floristic diversity of invasive weeds in the Shirpur and its adjacent area (Dhule, Nashik, Maharashtra, India). A total of 111 species of weeds belonging to 81 genera and 35 families was recorded in present study. Out of total recorded families, 31 were dicotyledons and 4 monocotyledons. Fabaceae was the dominant family followed by Convolvulaceae, Euphorbiaceae, Malvaceae, Amaranthaceae, Asteraceae, Poaceae, Commelinaceae, Cucurbitaceae, Solanaceae, Apocynaceae, and Boraginaceae. Ipomoea (with 8 species) was the largest genus followed by Euphorbia (5 species), Indigofera, Phyllanthus, Sida (3 species of each), Alternanthera, Amaranthus, Boerhavia, Calotropis, Commelina, Cynotis, Leucas, Ludwigia, Oxalis, Physalis, Portulaca and Senna (2 species each).
Review on LC-NMR Hyphenated Technique
Authors: Nikhila Vadladi  , Mamidi Adarsh  , B Lakshmi Kalyani  , J. Raga Swatha
Published: October 2023

A hyphenated technique refers to the integration of two distinct analytical methodologies to facilitate seamless interfacing. Typically, this involves the combination of chromatographic techniques with spectroscopic methods. LC-NMR, an influential analytical tool, has been instrumental in resolving intricate mixtures. LC-NMR, a hyphenated system that merges liquid chromatography (LC) with nuclear magnetic resonance (NMR), is a meticulously organized analytical approach extensively applied across various domains. These applications encompass the analysis of metabolites, profiling drug impurities, elucidating molecular structures, identifying volatile oils, scrutinizing pesticides, and investigating other natural products.
Mineralización, control estructural y modelado 3D de clavos mineralizados en la veta Julieta, distrito Casposo (Cordillera Frontal, San Juan, Argentina)
Authors: Palma Diego , Jovic Sebastián , López Luciano , Guido Diego , Páez Gerardo , De Martino Facundo , Sotarello Gustavo , Rolando Pablo
Published: October 2023

The Casposo District is located in the Cordillera Frontal, in the center-west of San Juan Province, Argentina. It is characterized by the presence of a low sulfidation epithermal system hosted in volcanic rocks of the Choiyoi Group, where the Mercado-Kamila and Julieta are the more important sectors, concentrating the largest resources of the district. Julieta consists of a quartz-calcite (Au-Ag) vein system, with colloform-banded and brecciated textures, as well as lattice-bladed replacements. In this study, a detailed analysis of the mineralogy and textures of the Julieta Vein system identifies 9 pulses grouped into 4 main events, 3 hydrothermal and 1 tectonic-hydrothermal. Pulses P1, P2 and P3 are barren and carbonated in nature. Pulses P4 and P5A are of chalcedony composition with a colloform-banded texture, where the last one shows cream-colored adularia bands and black ginguro bands, to which high Au (5,5 g/t) and Ag (52 g/t) values are associated. Pulse P5B is of silicic nature as well, although with a brecciated texture, whereas pulse P6 is siliceous carbonate. The composition of these pulses migrates to carbonates represented by P7 and P8, both of brecciated texture. Finally, the system closes with the tectonic-hydrothermal pulse P9. Julieta Vein has a dominant NW-SE strike, with minor subveins of E-W and N-S orientation, that can be divided into 3 segments: North, Central and South. The greater thicknesses, as well as the greater inclinations and high precious metals values are associated with inflections between the 3 segments. Concerning the ore shoots geometry, the structure has a main lithologically controlled subhorizontal ore shoot, while the secondary subvertical ore shoots are structurally controlled. Differences in the rheology of the host rock would control the vein morphology, forming a vertical jog. Factors such as the evolution of the mineralizing events, the vein morphology, and the precious metals distribution, allowed us to identify the importance of the lithological and structural controls in the development of mineralization in the Julieta Vein.
EXPERIÊNCIA DE USO DE SUBSTÂNCIAS PSICOATIVAS E FATORES ASSOCIADOS A DEPRESSÃO E ANSIEDADE ENTRE ACADÊMICOS DE ENFERMAGEM
Authors: Barbosa Douglas Miranda , Nascimento Rafaela Ferreira , Rangel Weverton Gonçalves , Simões Jeremias Campos
Published: October 2023

Introdução: O uso de substâncias psicoativas afeta a saúde dos indivíduos de diversas formas, principalmente a saúde mental. Objetivo: Traçar o perfil sociodemográfico, descrever o padrão de consumo de substâncias psicoativas (SPA’s) e investigar os fatores de depressão e ansiedade entre acadêmicos de enfermagem de um centro universitário. Material e Métodos: Estudo transversal, descritivo, de abordagem quantitativa, realizado com 196 acadêmicos de enfermagem, de ambos os sexos. Foram utilizados o questionário sociodemográfico, o ASSIST para avaliar o padrão de consumo de SPA’s e a Escala HADS para avaliar o nível de ansiedade e depressão. Para análise dos dados utilizou-se o programa SPSS Statistics 23.0 e o Coeficiente de Correlação de Spearman. Resultados: Quanto ao perfil dos estudantes foi identificado predominância de adultos jovens (73,3%), do sexo feminino (80,61%) e se declararam pardo 50%. No que diz respeito ao uso de álcool e outras drogas, verificou-se que o álcool (78%), tabaco (32%) e maconha (31%) foram as Substâncias Psicoativas mais consumidas. Ademais, verificou-se correlação estatisticamente significativa (p <0,05), porém fraca entre as seguintes variáveis: “Dependência ao tabaco” e “Ansiedade” (r = 0,151), “Uso de bebidas alcoólicas nos últimos três meses” e “Ansiedade” (r =0,149), “Uso de hipnóticos/sedativos nos últimos três meses” e “ansiedade” (r =0,226) e, por fim entre as variáveis “dependência de hipnóticos/sedativos” e “ansiedade” (r = 0,176). Conclusão: A pesquisa revelou que o álcool é a substância psicoativa mais consumida, refletindo o padrão de consumo nacional. Isso destaca a necessidade de uma abordagem pedagógica voltada para a população acadêmica, pois os indicadores de ansiedade, depressão, uso de álcool e outras drogas podem estar associados às práticas acadêmicas ou surgir delas.
Evaluation of the Effect of Nano and Micro Hydroxyapatite Particles on the Impact Strength of Acrylic Resin: In Vitro Study
Authors: Ahmed Abdulameer Abduljabbar  , Firas Abd kati  , Ayad I. Haddad  , Ihtesham Rehman
Published: October 2023

Poly (methylmethacrylate) is considered the basis material for a denture base. However, such substance has some drawbacks such as poor impact resistance, which is thought to be the primary cause of fracture of denture base resins. The purpose of the study was to determine how Nano and Micro hydroxyapatite particles affected the impact strength of acrylic resin. Thirty specimens were constructed of heat-cured acrylic resin and were divided into three groups: Ten specimens for the control, 10 for 1%nano hydroxyapatite, and 10 for micro hydroxyapatite. Acrylic samples were subjected to an impact strength test via a Charpy-type. Data were then analysed using SPSS v20.  The ANOVA test was used for comparison among the groups. Highly statistically significant differences among all studied groups (P-value <0.0001). Both 5% Micro hydroxyapatite and 1% Nano hydroxyapatite had a higher mean value than the control. Incorporating Nano and Micro hydroxyapatite into PMMA improved the impact strength of acrylic resins.
A CASE REPORT OF EXTERNAL OPHTHALMOMYIASIS A RARE ENTITY
Authors: Hanif Muhammad Kashif , Islam Qamar ul , Ansari Uzma
Published: October 2023

Myiasis is the infestation of tissues or organs of animals or man by fly larva1. The common sites are skin wounds. Eyes, nose, nasal sinuses, throat, and urogenital tract are rare sites. Ocular involvement occurs in about < 5% of all cases of human myiasis2. Oestrus ovis is the most common cause of ophthalmomyiasis externa worldwide3.The severity of myiasis depends on the location of the infestation. External ophthalmomyiasis is mostly benign and self limiting. However, in cases of internal ophthalmomyiasis caused by larvae from other species such as Hypoderma, the larvae can penetrate the sclera and burrow into subretinal space leading to iridocyclitis, endophthalmitis or loss of vision4. Ocular myiasis is more frequent in tropical than temperate regions5
Psychometric Analysis of Eating Behaviors and BMI through TFEQ (Three Factor Eating Questionnaire) on Medical Students
Authors: Arif Junaid , Shahzad Asima , Latif Abdul Rafey , Moeez Abdul , Saleem Hamza , Rahman Zainab , Junaid Ayesha
Published: October 2023

Objective: To assess effects of eating behaviors on BMI using the three-factor eating questionnaire on medical students.

Study Design: It was a quantitative analytical cross-sectional study.

Replace and Duration of Study: The study was carried out among medical students of Rawalpindi and Islamabad Pakistan,from Jan till Apr 22.

Methodology: A validated questionnaire (TFEQ) consisting of 51 questions was used to collect data online on 357 participants’ cognitive restraint, disinhibition, and hunger. Sample size was calculated using WHO sample size calculator keeping 95% CI.The participants in the study were students from various medical universities of Rawalpindi and Islamabad Pakistan. We calculated BMI values from the demographics (age, sex, and weight), and divided participants into 4 groups.

Results: Rigid control and disinhibition both were positively related to BMI for the entire sample. There was a positive relationship between BMI and rigid control in females, while in male BMI was more positively related to disinhibition.Students characterized by both high disinhibition and high rigid control had significantly higher BMI than those by both low disinhibition and low rigid control. Hunger was also positively associated with BMI and effected both control and disinhibition (p≤0.000).

Conclusion: The results show that all three eating behaviors i.e., disinhibition, hunger, and cognitive restraint, affect the BMI scores of students. High levels of restraint lead to higher disinhibition, which leads to increased weight. Rigid control also results in increased hunger which causes bouts of relapse eating (increased disinhibition)–all leading to increased BMI.
Prevalence of Screen Addiction Based on Content Among University Students of Rawalpindi and Islamabad
Authors: Shahzad Asima , Rehman Hassnain , Hamid Farzeen , Zaheer Usman , Nasir Aafia , Toor Sohail Khan , Khan Inam Ullah
Published: October 2023

Objective: To determine the prevalence of Screen Addiction & to compare the addiction scores with respect to type of content most consumed
Study Design: Quantitative Analytical Cross-sectional study
Place and Duration of Study: Universities of Rawalpindi and Islamabad Pakistan, from Jan 2022-Apr 2022
Methodology: The research was conducted over a sample size of 343 participants, studying in universities of Rawalpindi Islamabad Pakistan aging 18-30 years. Individuals having access to electronic devices were included while individuals with terminal illness were excluded. SA –SV (Smart phone addiction Scale-Short Version) was used to assess screen addiction while an Open and Close ended questionnaire, “Questionnaire to assess Screen Usage Behavior and Content Consumed” helped in assessing the type of content through google forms.
Results: Screen addiction value was 3.7 on the six-point SAS-SV Likert scale. Sample size was 343. Screen addiction was present in 70% (240 participants). The commonest screen used were smartphones/tablets (68.2%) while social media (67%) was the major reason behind the use. WhatsApp (35.9%) and Facebook (24.5%) were used most frequently. About 50% individuals agreed the reason for over usage was to relax and 29.74% spent more than 3 hours continuously on the screen. Our study shows prevalence of screen addiction to be significant (p<0.01).
Conclusion: Our findings reveal that most people are suffering from screen addiction and the content they’re most addicted to is, social media. Attention needs to be drawn towards this issue given to the increasing social and psychological problems.,
Assessment of Heart Attack Management and Awareness Among Non-Medical Subjects
Authors: Ghafoor Ayesha , Iqbal Fakeha , Ali Syed Hani , Tahir Mahnoor , Tahir Umar , Dawood Muhammad , Qamar Khadija
Published: October 2023

Objective: The objective of this study was to assess the awareness level of heart attack and its management among nonmedical students.

Methodology: It was a cross sectional study and took place from Mar to Apr 2022. 301 non-medical consenting students (aged 16-25 years) responded to our online questionnaire, and their responses were compared to standard answers to estimate awareness. This data was analysed using SPSS version 25.1

Results: 49(16.3 %) students were male and 252(83.7 %) were females. 265(88 %) of the participants were aware of the term heart attack. 211(70 %) showed good knowledge of risk factors for heart attack.

Conclusion: Overall, the subjects showed a good knowledge of heart attack symptoms and risk factors. There was however little awareness about emergency management in case of heart attack.
A Longitudinal Study on Covid-19 Confinement and Impact on Physical Activity of Medical Students of Rawalpindi
Authors: Mashhadi Syed Fawad , Rasool Faizan , Malick Sohaib Abdul , Ishtiaq Mehroze , Mukhtar Muhammad Omar , Ayub Tahira , Shahid Maheen
Published: October 2023

Objectives: The objectives of the study were to assess the impact of COVID-19 confinement on different aspects of physical activity and sedentary time of medical students with special emphasis on gender.

Study Design: This was a longitudinal study in which two samples were taken, one during the confinement period and one after it, to assess the differences between the time spent on physical activity and sedentary time.

Place and During of Study: This study was conducted on a total of 300 medical students from two medical colleges of Rawalpindi. The study extended from Apr till Jun 2021 over a period of two months.

Methodology: Modified International Physical Activity Questionnaire (IPAQ) was used as a data collection tool. The respondents filled the questionnaire twice. First during COVID-19 confinement and the second, after the confinement ended.

Results: A total of 300 individuals were selected to fill in the questionnaire, 200 of them filled in the first questionnaire. The second questionnaire was, however, filled by only 146 individuals and the rest were lost to follow-up.The 146 participants in our study were all students in medical schools in Rawalpindi/Islamabad Pakistan. Out of the total 43.2%(63) were male, while 56.8%(83) were female. The mean age was 20.18±1.72. Post confinement, the amount of time spent on moderate and vigorous activities by all the individuals increased by 26.7% and 82.5%, respectively. In addition, walking time was increased by 82%, sedentary time was also reduced by 36.4%.

Conclusion: Physical activity of both men and women was found to be reduced during COVID-19 confinement along with increased sedentary time as compared to their normal routine.
Covid-19 Vaccination and Routine Childhood Vaccinations: Comparison of Hesitancy among Parents
Authors: Mashhadi Syed Fawad , Khan Nazish , Ilyas Ubaida Bin , Farooq Omer , Waseem Aashir , Cheema Abdullah , Murtaza Sahab
Published: October 2023

Objectives: To assess perceptions of parents regarding vaccinating their children against COVID-19 and to assess the prevalence of COVID-19 vaccine hesitancy as compared to routine childhood vaccinations.

Study Design: Analytical, cross-sectional, quantitative study

Place and Duration of Study: Study was conducted in Rawalpindi/Islamabad Pakistan, from Nov 2021 to Apr 2022.

Methodology: Parents having children of either gender, 12 to 18 years of age, residents of Rawalpindi/Islamabad Pakistan were included in the study. Study was conducted online using Google forms. Sample size of 303 was taken and participants were enrolled through non probability convenience sampling. Modified Vaccine Hesitancy Scale (VHS) was used. Parental attitudes towards routine childhood vaccinations versus COVID-19 vaccines were compared using paired sample T test.

Results: Among 303 parents, 196(64.5%) were willing to vaccinate their child with COVID-19 vaccine. Reasons for COVID-19 vaccine hesitancy included insufficient vaccine safety information (16.8%), avoidance of vaccines/ medications in general (8.9%), inconvenient / painful vaccine administration (7.9%), perceiving child as not at high risk of developing complications of he gets infected by COVID-19(6.3%) and concerns of getting COVID-19 through the vaccine (4.6%). An encouraging attitude was seen among parents for routine childhood vaccination as compared to COVID-19 vaccination with higher mean VHS 2.68±0.44 vs. 2.52±0.43 respectively (p<0.001).

Conclusions: A large proportion of parents were hesitant regarding the COVID-19 vaccine as compared to routine childhood vaccines. Relying on the national authorities regarding the immunization information is a much better option to limit hesitancy.
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Authors: . Pafmj
Published: October 2023

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Short-term Efficacy and Safety of Secukinumab in Pakistani Patients with Ankylosing Spondylitis and Psoriatic Arthritis
Authors: Ghani Sumera , Saeed Muhammad Ahmed , Malik Tashia , Din Zia ud , Raja Sumaira Farman , Ahmad Nighat Mir
Published: October 2023

Objective: To determine the short-term efficacy and safety of Secukinumab in Pakistani patients with ankylosing spondylitis and psoriatic arthritis in regular clinical practice.

Study Design: Case series.

Place and Duration of Study: Department of Rheumatology, National Hospital and Medical Centre, Lahore Pakistan from Aug 2019 to Feb 2021.

Methodology: Patients diagnosed with ankylosing spondylitis according to assessment of spondyloarthritis International Society criteria and psoriatic arthritis according to classification criteria for psoriatic arthritis (CASPAR), who were started on Secukinumab, were enrolled. Disease activity scores and adverse events were recorded in the 12th and 24th weeks. The primary outcomes were remission and low disease activity, and the secondary outcomes were the recording of Adverse events on each visit.

Results: There were 42 patients registered. The mean duration of disease was 11.86±7.31 years for AS and 9.19±4.87 years for PsA patients. At 24 weeks of follow-up, 10% of patients discontinued treatment, 73.7% of AS patients, and 94.7% of PsA patients achieved complete remission or low disease activity. No significant AEs were noted at 24 weeks, except for upper respiratory tract infections. One patient developed a lower respiratory tract infection after 24 weeks of treatment, and one died during treatment (possible myocardial infarction).

Conclusion: Secukinumab was effective and safe in patients with Ankylosing Spondylitis and Psoriatic Arthritis in this study,despite advanced disease with long disease duration.Keywords: Ankylosing spondylitis, Efficacy, Psoriatic arthritis, Safety, Secukinumab.
Short-Term Efficacy and Safety of Subcutaneous Tocilizumab in Rheumatoid Arthritis Patients in Pakistan: A Real-World Experience
Authors: Malik Tashia , Saeed Muhammad Ahmed , Ghani Sumera , Butt Nauman Ismat , Raja Sumaira Farman , Ahmed Nighat Mir
Published: October 2023

Objective: To determine the real-world efficacy and safety of subcutaneous Tocilizumab in patients with rheumatoid arthritis.

Study Design: Case series.

Place and Duration of Study: Department of Rheumatology, National Hospital and Medical Centre, Lahore Pakistan, from Aug 2019 to Dec 2020.

Methodology: In this study, 33 patients receiving subcutaneous Tocilizumab 162 mg every two weeks as monotherapy or with conventional synthetic disease modifying anti-rheumatic drugs were followed per standard study protocol. Increasing or decreasing the dosing interval was allowed according to disease activity at the discretion of the treating rheumatologist. The primary outcome was patients achieving Low Disease Activity as per Clinical Disease Activity Index (>2.8-10.0) and Disease Activity Score-28(>2.6-3.2). The secondary outcome was a clinically meaningful improvement in Disease Activity Score -28 (reduction of ≥1.2 units in Disease Activity Score-28 score). Adverse events were recorded at each follow-up visit.

Results: Of the 33 patients, 25(75.8%) were biologics-naive, 9(27.2%) patients achieved the target of Low Disease Activity as per Clinical Disease Activity Index (2.9-10.0) and 8(24.2%) patients achieved Low Disease Activity as per Disease Activity Score-28(2.7-3.2). At six months, the proportion of patients achieving clinically meaningful improvement (decrease ≥1.2) in Disease Activity Score -28 was 13(54.2%). Overall, 14(42.4%) patients developed adverse events and 3(9.1%) patients discontinued Tocilizumab owing to adverse events.

Conclusion: Tocilizumab has been seen to be an effective biologic in only one-third of patients, and it was tolerated in twothirds of the patients.Keywords: Conventional synthetic disease modifying anti-rheumatic drugs, Efficacy, Rheumatoid arthritis, Safety, Subcutaneous tocilizumab.
Comparison of HRCT Chest Findings of COVID-19 Patients Having Clinical Co-morbid to Those Without Co-morbid Disease
Authors: Qayyum Adil , Adil Ruqqayia , Balooch Salahuddin , Khan Sara , Amin Zafar , Mahmood Rashid
Published: October 2023

Objective: To determine the severity of High-Resolution Computed Tomography Chest findings of COVID-19 patients having co-morbid in comparison to those without co-morbid.

 

Study Design: Comparative cross sectional study.

Place and Duration of the Study: Radiology Department Combined Military Hospital, Multan Pakistan, from Mar to Sep 2020.

Methodology: Data was collected through the medical record system of positive COVID-19 tests. Patients were divided into patients with no co-morbidities and others having co-morbidities. Two radiologists interpreted High-Resolution Computed Tomography chests independently to assess the disease severity in these two Groups. Co-morbidities included diabetes mellitus, hypertension, chronic renal disease, heart disease, Chronic Obstructive Pulmonary Disease and liver diseases.

Results: A total of 200 patients were included. Out of 121 male patients, 85 had co-morbidities (71 had moderate to severe lung involvement; 14 had mild lung involvement); while 36 had no co-morbidities (5 had moderate to severe lung involvement; 31 had mild lung involvement). Out of 79 female patients, 47 had co-morbidities (15 had moderate to severe lung involvement; 32 had mild lung involvement); while 32 had no co-morbidities (3 had moderate to severe lung involvement; 29 had mild lung involvement).

Conclusion: The severity of lung involvement was remarkably higher in patients with associated co-morbidities compared to no co-morbidities. Older age male patients having co-morbidities pose a risk factor for the severity of disease progression as compared to younger age female patients having no co-morbidities
Impact of COVID-19 Pandemic on the Medical Oncology Department of a Tertiary Care Hospital
Authors: Mehmood Faisal , Ali Shehrbano , Ashraf Amna , Khattak Abdul Latif , Mashhadi Syed Fawad , Murtaza Muhammad Murad
Published: October 2023

Objective: To assess the degree of impact the pandemic had on the Oncology Department regarding patient visits and elective procedures.

Study Design: Comparative pre-post analysis study.

Place and Duration of Study: Medical Oncology Department of Combined Military Hospital, Lahore Pakistan, from Oct to Dec 2019 before the pandemic, and then 2020 during the pandemic.

Methodology: Data was collected from the Department regarding the number of outpatient visits, indoor admissions, new cases diagnosed, chemotherapies administered, blood transfusions, and various procedures like lumbar puncture, ascitic fluid paracentesis, pleural fluid drainage, etc.

Results: Our study showed an overall decrease in all the study parameters. The average monthly Outpatient visits fell by 395 patients (55.6%). The new cases decreased by 25 patients (36.2%). The indoor admissions also came down by 17 patients (42.5%). Furthermore, the procedures performed in the Oncology department were also observed to have decreased.

Conclusion: Oncology has suffered dramatically in the face of the COVID-19 pandemic, with fewer patients visiting the hospital for their consultations, follow-ups, as well as treatments. This has resulted in a delay in diagnosis and treatment and has had a severe adverse psychological impact on the patients.Keywords: COVID-19, Elective procedures, Pandemic, Oncology.
Comparison of Dynamic Hip Screw and Proximal Femoral Nail in Cases of Unstable Intertrochanteric Fractures of the Femur, in Terms of Blood Loss and Operative Time: Experience in a Tertiary Care Hospital
Authors: Khan Ahmed Mustaq , Anwar Syed Faraz , Saif Anas Bin , Jaffary Asad Ullah , Rathore Muhammad Omar
Published: October 2023

Objective: To compare Dynamic Hip Screw with Proximal Femoral Nail in unstable Inter Trochanteric femur fractures.

Study Design: Quasi-experimental study.

Place and Duration of Study: Department of Orthopaedic Surgery, Combined Military Hospital, Malir Pakistan, from Dec 2020 to Aug 2021.

Methodology: This study comprised patients aged 40 to 80 years with unstable inter Trochanteric proximal femoral fractures (AO Classification 31A2, 31A3). These patients were randomised into two Groups. Group-A patients underwent Dynamic hip screw fixation, and Group-B patients were subjected to Proximal Femoral Nailing. Follow-up was done at 2,6,12 weeks postoperatively. Two variables, namely operative time and blood loss, were evaluated.

Result: Thirty patients were recruited in this study, with 18 patients in each Group. The average blood loss for Group-A Dynamic Hip Screw was measured to be 193.3±29.10 ml, and for Group-B Proximal Femoral Nail was 79.44±17.98 ml (p< 0.001). Group-A (DHS) scored an average operative time of 51.56±7.76 min, and Group-B Proximal Femoral Nail was 36.89±3.66 min (p<0.001).

Conclusion: Proximal femoral nailing is a better choice in unstable proximal femoral fractures regarding operative time and blood loss.Keywords: Blood loss, Dynamic hip screw, Intertrochanteric fractures, Operative time, Proximal femoral nail.
Comparison of Extraglycemic effects of Dapagliflozin and Empagliflozin
Authors: Aziz Haroon , Noor Mudassar , Ahmad Bilal , Ali Shabana , Farhat Kulsoom , Siddiqi Fuad Ahmad
Published: October 2023

Objective: To compare extra glycaemic effects of dapagliflozin and empagliflozin in Type 2 Diabetes mellitus.

Study Design: Quasi-experimental study.

Place and Duration of Study: Pharmacology Department, Army Medical College, in collaboration with Endocrine Department, Pak Emirate Military Hospital, Rawalpindi Pakistan, from Sep 2021 to Jan 2022.

Methodology: One hundred and twenty diabetic patients were recruited strictly according to inclusion and exclusion criteria. They were randomly alienated into two groups (A & B) by lottery method and were prescribed oral dapagliflozin and empagliflozin 10 mg/day each for four weeks, respectively. Serum uric acid, erythropoietin levels, and weight were recorded on day 0 and after four weeks of treatment.

Results: There were statistically significant differences in weight (p-value=0.004) and erythropoietin levels (p-value=0.027). However, an inconsequential variance was observed in serum uric acid levels Uric Acid (p-value=0.365) between the two groups after four weeks of treatment with dapagliflozin and empagliflozin.

Conclusions: Dapagliflozin and empagliflozin have significantly improved weight, erythropoietin and serum uric acid levels. Moreover, Dapagliflozin is superior to Empagliflozin in improving weight and erythropoietin levels and has almost equivalent efficacy in improving uric acid levels in T2DM patients.Keywords: Dapagliflozin; Empagliflozin; SGLT2 inhibitors; Type 2 diabetes mellitus.
Epidemiological Trends of Lung Tumours on Endobronchial Biopsy in Patients Presenting to Tertiary Care Hospital
Authors: Anjum Naveed , Mirza Muhammad Zill -e- Humayun , Satti Shahzeb Ahmed , Ahmed Sohaib , Raza Hassan , Mughal Zulqarnain Mustafa
Published: October 2023

Objective: To determine the epidemiological trends of lung tumours on endobronchial biopsy in patients presenting to our hospital.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Pulmonology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Nov 2021 to Jun 2022.

Methodology: Two hundred eighty-seven patients who exhibited clinical and/or radiological signs of a lung mass were enrolled in this study. Bronchoscopy was done to identify endobronchial lesions, followed by endobronchial biopsies submitted for histopathology and immunohistochemistry to diagnose the exact type of tumour. Patients who underwent bronchoscopy for some other indication but were found to have an endobronchial mass incidentally were also included in the study.

Results: Squamous cell carcinoma was the most common 107(37.3%), followed by small cell carcinoma 76(26.5%). Adenocarcinoma was diagnosed in 75 patients (26.1%). Diagnosis of carcinoid tumour was made in 6 patients (2.09%). There were 5 cases (1.7%) of poorly differentiated carcinoma and metastatic adenocarcinoma each. Large cell carcinoma was present only in 2 cases (0.7%). Strangely, two patients (0.7%) had small and Squamous cells simultaneously, and one had adenosquamous carcinoma. Other tumours, including mantle cell lymphoma, Rhabdomyosarcoma, mucoepidermoid carcinoma, neuroendocrine tumours, spindle cell carcinoma and sarcomatoid carcinoma, were found in 8 cases (2.8%).

Conclusion: Squamous cell carcinoma is the most common centrally arising tumour in our population in both genders, followed by small cell carcinoma and adenocarcinoma.Keywords: Epidemiology, Endobronchial mass, Lung cancer, Squamous cell carcinoma.
Diagnostic Accuracy of Bedside Index for Severity in Acute Pancreatitis and Modified Computed Tomography Severity Index in Determining the Severity of Acute Pancreatitis using Revised Atlanta Classification as the Gold Standard
Authors: Khattak Muhammad Bilal , Ali Khan Rao Saad , Khan Rao Zaid Ali , Din Rafi Ud , Shabbir Khawar , Karim Rahida , Munir Arshia
Published: October 2023

Objective: To determine the diagnostic accuracy of modified computed tomography severity index (CTSI) and Bedside index for severity in acute pancreatitis (BISAP) scoring system in predicting severity in acute pancreatitis, keeping the Revised Atlanta Classification (RAC) as the gold standard.

Study Design: Prospective longitudinal study.

Place and Duration of Study: Department of Gastroenterology, Pak Emirates Military Hospital, Rawalpindi Pakistan, Pakistan from Jan to Jul 2022.

Methodology: This study was conducted on 100 patients with acute pancreatitis, both genders and ages. Patients with chronic pancreatitis, pancreatic calcifications, dilated pancreatic duct, areas of atrophy and pseudocysts were excluded. Detailed history and physical examination, and laboratory investigations were performed. Modified CTSI, BISAP and RAC were calculated. RAC was used as the gold standard. Sensitivity, specificity and other diagnostic parameters were calculated using R programme.

Results: The mean age was 42.42±18.07 years. The males were 53%, and the females were 47%. CTSI was sensitive at 100%, specific at 58.43%, and overall diagnostic accuracy at 63%. BISAP was sensitive at 100%, specific at 68.54%, and overall diagnostic accuracy at 72%.

Conclusion: BISAP and modified CTSI can assess severe acute pancreatitis (SAP) at primary and secondary care levels, enabling early triage and referral to higher centers.
Comparison of Early Versus Delayed Oral Feeding after Resection and Anastomosis of Gut
Authors: Siddiqi Ubaid Ullah , Nasir Ammad Ud Din , Ilyas Sohail , Sarfraz Khurram , Farooq Muhammad Omar , Rehman Shafqat
Published: October 2023

Objective: To compare the outcomes of early versus delayed postoperative oral feeding in patients undergoing resection and anastomosis of the gut.

Study Design: Quasi-experimental study

Place and Duration of Study: Surgical Department of Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2020 to May 2021.

Methodology: A total of 30 patients fulfilling the selection criteria were enrolled after taking written informed consent and were randomly divided into two groups of equal numbers. Patients in Group-A received early oral feeding, and in Group-B had delayed oral feeding postoperatively, and the outcome measures were assessed till the patients were discharged.

Results: The mean duration of hospital stay in Group-A versus Group-B was 50.94 days vs. 60.74 days (p=0.005), the mean time to passage of the first flatus was 30.61 days vs. 50.48 days (p<0.001), and the mean time to passage of the first stool was 40.59 days vs. 50.48 days (p<0.001), respectively.

Conclusion: Early oral feeding following gut resection and anastomosis was significantly associated with the early passage of flatus and stool and shorter hospital stay than delayed oral feeding postoperatively.
Effect of Anterior Chamber Depth and Axial Length on Corneal Endothelial Cell Density After Phacoemulsificatio
Authors: Iqbal Atiya , Naeem Saquib , Khan Taimoor Ashraf , Ahmad Jawwad , Humayun Fakhar , Naimat Khalid
Published: October 2023

Objective: To assess the average amount of corneal endothelial cell density reduction in patients with various anterior chamber depths and axial lengths after phacoemulsification.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jul 2022 to Dec 2022.

Methodology: Ninety-four patients with cataract who underwent uneventful phacoemulsification surgery with IOL Implantation were included in the study. Patients were divided into two groups on the basis of anterior chamber depth and axial length values. All patients underwent surgery, and corneal endothelial cell density was measured and compared pre and post-operatively at pre-specified time points.

Results: A significant decrease in the number of corneal endothelial cells was found between both the groups at pre and postop measurements. The mean CED decreased to 2420.04±296.73 post-operatively from 2608.44±237.22 (p<0.001) among patients belonging to group 1, while for group 2 the mean CED decreased to 2484.02±254.89 from 2646.19±205.52 (p<0.001), post and pre-operatively respectively. There was no significant difference found between postoperative reduction in mean CED value between group 1 and 2.

Conclusion: In current study we conclude that there is a reduction in endothelial cell density after phacoemulsification surgery for cataract, but we failed to support the fact that anterior chamber depth or axial length can be used as potential predictors to predict the loss of endothelial cells post-operatively.
Comparative Analysis of Human Cystatin C Levels in Migraine without Aura and Healthy Controls
Authors: Mariyam Khan  , Maham Tahir  , Sunia Hameed  , Muhammad Umar Ali Khan  , Mehwish Qamar  , Mamoona Shafiq
Published: October 2023

Objective: To compare the levels of human cystatin c (novel biomarker) as well as the association of other parameters in migraine patients without aura and healthy controls.

Study Design: Cross-sectional, comparative study.

Place and Duration of Study: The research was conducted at IMBB Physiology Department, University of Lahore, Lahore Pakistan, from May 2021 to Jun 2022.

Methodology: After taking history, a detailed clinical examination was conducted of participants in both cases and controls of the study. A proforma was filled and a non-probability convenience sampling technique was used. The blood samples weredrawn, centrifuged to isolate serum and analyzed concentration of serum cystatin C levels were measured by using enzyme linked immunosorbent assay (ELISA). SPSS version 22 was used for statistical analysis. Mann-Whitney U test was used to determine the median IQR values of both groups and p-value<0.05 was considered significant.

Results: Among cases 19(47.5%) were male and 21(52.5%) were female. Mean age of cases and controls was 25.57±5.93 and 26.15±7.19 years. The most frequent occupation among cases and controls was student, doctors, nurses and house wives. Among cases only 3(7.5%) patients were currently smokers while among controls 3(7.5%) were currently smokers. Among cases body mass index of 11(27.5%) patients were 30 and 4(10%) participants in controls had body mass index as 30. The most frequent symptom was photophobia followed by nausea, phonophobia, vomiting and atypical features. All these features were significantly higher

Conclusion: Study concluded that patients with migraine without aura have elevated levels of cystatin C in their
Self-Directed Learning Versus Traditional Learning in Clinical Setting: A Study at Armed Forces Institute of Ophthalmology
Authors: Omar Zafar
Published: October 2023

Objective: To compare the outcome of self directed learning to the traditional learning in terms of academic performance in clinical setting by using diabetic ocular fundus findings among fourth year MBBS students.

Study Design: Quasi-experimental study.

Place and Duration of Study: Armed Forces institute of Ophthalmology, Rawalpindi Pakistan, from May to Nov 2019.

Methodology: After taking consent, data was collected from 50 students through multiple choice questions based pre-test and post-test by non probability convenient sampling. The data was analyzed using SPSS version 22.0.

Results: Out of total students, 28 (56%) students were male and 22 (44%) were females. Mean age was 22.15±3.26 years. Both the groups showed improvement in their academic performance as p-value <0.001, but SDL group showed more improvement as compared to the traditional learning group.

Conclusion: Self directed learning is better as compared to the traditional teaching as it promotes conceptual learning so it is important to work on this issue.
Comparison of Percutaneous A1 Pulley Release versus Steroid Injection in Terms of Mean Pain Score in Trigger Digits
Authors: Inam Shahzad , Muahmmad Ali Bashir  , Rehana Islam  , Muhammad Rehan Saleem  , Mubashir Ahmad Bajwa  , Wajahat Ali Nadeem
Published: October 2023

Objective: To compare percutaneous A1 pulley release and steroid injection in terms of mean pain score in trigger digit.
Study Design: Comparative cross- sectional study.
Place and Duration of Study: Orthopedic Department Combined Military Hospital, Rawalpindi Pakistan, from Mar to Aug 2018.
Methodology: Patients with trigger finger diagnosed clinically in Out Patient Department meeting inclusion and exclusion criteria were included in the study. Patients were randomly allocated to Group A & B by lottery method. Group A had percutaneous release of A1 pulley using a surgical blade 11, after preparation of the skin and injection of 1ml 2% plain Lidocaine. Group B had injection with corticosteroid. Both procedures were carried out in Out Patient Department under strict aseptic measures. Visual analogue score at start and end of the study was recorded.
Results: A total of 185 patients were included in this study, 122(66%) were males and females were 63(34%). The mean age of patient was 37.80±11.80 years with range from 15-60 years. Mean score of Group A was 39.16±12.22 years and the mean age Group B was 38.93±10.98 years. 56(30.3%) patient had mild visual analogue score, 96 (51.9%) had moderate visual analogue, 33(17.8%) had severe visual analogue.
Conclusion: Percutaneous release was found better option for the treatment of the trigger digit with a high success rate. Surgery should be reserved only for cases refractory to steroid injection technique.
Type & Frequency of Lymphomas: Single Institution Experience
Authors: Shahid Hussain  , Ghulam Haider  , Zahoor Saima , Hayat Mohammad , Maryum Nouman  , Ravisha Bai
Published: October 2023

Objective: To see the type and frequency of lymphomas.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Medical Oncology at Jinnah Postgraduate Medical Centre, Karachi from Jan 2019 to Dec 2019.
Methodology: Total of 150 patients with histopathological diagnoses of lymphoma of 17 to 71 years of age of either gender were included in the study using non-probability consecutive sampling technique. Prior to initiation of study ethics review committee has approved the study (NO.F.2-81-IRB/2019-GENL/10261/JPMC). The data regarding lymphoma type, histology, stage of disease, site, involvement of bone marrow, presence of B-symptoms were recorded.
Results: Majority of the patients were male i.e., (n=104, 69.3%) with the mean age of 45.29±17.76 years. Non-Hodgkin’s Lymphoma presented as the most common type of lymphoma i.e., (n=107, 71.3%) whereas Hodgkin’s lymphoma (HL) contributed for (n=43, 28.7%) cases. Assessment of clinicopathological features of lymphomas revealed that (n=58, 38.7%) cases had bone marrow involvement. B-symptoms appeared in (n=102, 68%) cases, (n=61, 40.7%) cases were stage IV and the most common site were Neck lymph nodes (n=82, 58.3%), followed by abdomen (n=20, 13.3%). There was statistically significant difference between type of lymphoma with respect to age (p=0.001) and gender(p=0.015)
Conclusion: Among lymphomas the most common type of lymphoma was Non-Hodgkin’s Lymphoma, most common in patients >45 years of age showing relationship of its occurence with age and..
Renal Wasting of Electrolytes: Effect of Amikacin Used to Treat Infections - Tip of Iceberg for the Physicians
Authors: Butt Batool , Raja Khalid , Ismail Ahmed
Published: October 2023

Objective: To measure prospectively the effect of treatment with the Amikacin on renal magnesium, potassium and phosphate wasting in patients with extrarenal infections.
Study Design: Case series.
Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan from Jul toDec 2019.
Methodology: A total of 40 cases were included in this study in liaison with other departments who were put on Amikacinstandard dose. Urinary electrolytes including potassium, magnesium and phosphate were measured at day 4 after the use of Amikacin. Factors like age, gender, cause for which Amikacin was used, day 1 creatinine and day 4 creatinine were correlated with presence of electrolyte wasting in the target population.
Results: Mean age of study participants was 39.1±12.56 years. 25(62.5%) were males while 15(37.5%) were females. Commonest cause for the use of Amikacin was drug resistant tuberculosis followed by fractures. Mean urinary magnesium was 39.1±12.56 mmol/24 hours, while potassium was 26.1±15.60 meq/24 hours. Mean phosphate was 66.4±53.55 mg/24 hours. Pearson chi-square test revealed that advanced age and day 4 creatinine were strongly linked with the presence of urinary electrolyte wasting among the patients receiving Amikacin for extra-renal infections with p-value<0.05.
Conclusion: Electrolyte wasting emerged as a common finding in the patients put on Amikacin suffering from extra renal infections. Patients with advancing age put on Amikacin should be given special attention and screened for electrolyte wasting at priority. ..
Titanium Mesh versus Autologous Bone Graft Cranioplasty
Authors: Shamim Babar , Awais Ali Khan  , Mushtaq Muhammad Junaid , Amjad Saeed Abbasi  , Ali Ahmed  , Maria Shahzadi
Published: October 2023

Objective: To compare the efficacy of titanium mesh to autologous bone grafting in cranioplasty and assessing complications like seroma and abscess formations and subjective measures of pain.
Study Design: Comparative cross-sectional study
Place and Duration of Study: Neurosurgery Department, Combined Military Hospital, Rawalpindi Pakistan from Aug 2017 to Dec 2018.
Methodology: Twenty patients (Women=12, Men=8) were randomly assigned to Titanium Mesh (TM) group and 20 patients (Women=7, Men=13) to Autologous Bone Graft (ABG) group. All were subjected to cranioplasty using Titenium Mesh and Autologous Bone Graft procedures to assess cranial seroma and abscess formation and pain.
Results: Comparison of pain on day 3 showed 7(35%) patients in titenium mesh group experienced pain compared to 14(70%) patients in the autologous bone graft group, which was statistically significant (p<0.001). Similarly, a comparison on day 7, revealed that pain in the titenium mesh group reduced to 5(25%) patients compared to 11(55%) patients in the autologous bone graft group, which again was statistically significant (p<0.001). Four(20%) patients in titenium mesh group and 7(35%) patients in autologous bone graft group developed seroma on day 3 and the difference was significant (p<0.001). Two(10%) patients in titenium mesh group and 5(25%) patients in autologous bone graft group developed abscess, which was significantly different (p<0.001).
Conclusion: Cranioplasty using titenium mesh is better than autologous bone graft because complications like seroma, abscess and pain are attenuated in surgical cohorts.
The Diagnostic Performance of the Circumpubertal Dental Maturation Phases for the Identification of Individual Specific Skeletal Maturation Phase using Mandibular Canine
Authors: Hayat Sumbal , Nasrullah Mengal  , Fakhira Nizam  , Munaza Saeed
Published: October 2023

Objective: To determine the correlation between circumpubertal dental maturation phase using mandibular canine and skeletal maturation phase for correct prediction of specific maturation phase in adults.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Dentistry, Sandeman Provincial Hospital, Quetta Pakistan, from Jun to Dec 2019.
Methodology: Fifty individuals with permanent mandibular canine, either gender were included. Dental maturity was measured by applying the estimation of calcification phases of the mandibular canines by using Demirjian et al., criteria. The skeletal maturity was determined by using method of maturation phase of cervical vertebra on lateral cephalograms.
Results: The mean age of individuals was 12.34±6.55years. There were 11 males and 39 females. There was significantly strong correlation observed between skeletal maturity and dental maturation of mandibular third molar i.e., r=0.633 (p<0.001).
Conclusion: Circumpubertal dental maturation phase is appropriate way for identification of individual specific maturation phase using mandibular canine.
Disturbed Quality of Sleep in Patients with Rheumatoid Arthritis: Reality or Myth?
Authors: Ahmed Ammar Cheema  , Amer Fakhr  , Hussain Muhammad Zahid , Shanzah Shahbaz  , Syed Uzair Maqsood  , Muhammad Mehtab Shabir
Published: October 2023

Objective: To determine the quality of sleep and factors associated with poor sleep quality among patients suffering from rheumatoid arthritis.
Study Design: Cross sectional study.
Place and Duration of Study: Rheumatology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug2019 to Apr 2020.
Methodology: Patient of rheumatoid arthritis who fulfilled American College of Rheumatology criteria of 2010 were included in study. Quality of sleep was determined in all the patients with the help of Pittsburgh sleep quality index (PSQI). Age gender, duration of rheumatoid arthritis and residual pain symptoms were correlated with the presence of poor quality of sleep.
Results: Mean age of the study participants was 33.37±7.822 years. 56(22.4%) patients were male while 194(77.6%) were female. 106(42.4%) patients had good sleep quality when assessed on Pittsburgh sleep quality index while 144(57.6%) had poor sleep quality. Binary logistic regression analysis revealed that long duration of illness and residual pain symptoms had a statistically significant association with poor sleep quality the patients suffering from rheumatoid arthritis (p-value <0.05).
Conclusion: Poor sleep quality was a consistent finding among patients of rheumatoid arthritis which is usually not part of routine symptoms screened in rheumatology clinics. Patients without adequate response to treatment and having residual symptoms were more at risk of having sleep problems in addition to those with long standing illness.