bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Dexmedetomidine Hydrochloride on perioperative inflammation and postoperative lung infection in patients with spinal tuberculosis
Authors: Liu Yong-hui , Zhao Ye , Wang Xiang-yang , Cui Hong-xun 
Published: January 2021

Objective: To explore the effect of dexmedetomidine hydrochloride on perioperative inflammation and postoperative lung infection in patients with spinal tuberculosis.
Method: A double-blind control observation was conducted in spinal tuberculosis patients with the use of general anesthesia during the operation. A total of 171 spinal tuberculosis patients who received endotracheal intubation for general anesthesia in Henan University of Chinese Medicine from January 2017 to April 2019 were included. The concentration changes in serum TNF-α and IL-6 were recorded at one hour, six hour and one day after the operation. The incidence of postoperative pulmonary complications of patients were also evaluated.
Results: The results showed that in the experimental group compared with the control group, serum TNF-α and IL-6 concentrations one hour, six hour and one day after the operation were significantly lower (P<0.05). The rate of postoperative pulmonary complications was lower in the experimental group than that in the control group (P<0.05).
Conclusion: Dexmedetomidine hydrochloride has obvious anti-inflammatory effects and can reduce the incidence of pulmonary complications after surgery.
doi: https://doi.org/10.12669/pjms.37.2.2383
How to cite this:Liu YH, Zhao Y, Wang XY, Cui HX. Effect of Dexmedetomidine Hydrochloride on perioperative inflammation and postoperative lung infection in patients with spinal tuberculosis. Pak J Med Sci. 2021;37(2):520-524. doi: https://doi.org/10.12669/pjms.37.2.2383
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury
Authors: Li Huan-xia , Cui Jing , Fan Jing-shi , Tong Jian-zhou 
Published: January 2021

Objective: To examine the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen therapy in treating thoracolumbar vertebral fracture-induced acute spinal cord injury (ASCI).
Methods: From June 2015 to May 2018, 80 patients with thoracolumbar fractures and ASCI who were treated at Baoding First Central Hospital were selected. All patients underwent posterior laminectomy and screw fixation, and they were randomly divided into two groups using a random number table method. The control group received conventional postoperative treatment, while the experimental group was treated with riluzole combined with mannitol and hyperbaric oxygen on the basis of conventional treatment. The recovery of nerve function which included motor function and sensory function, and the changes of serum IL-6, CRP, BDNF, BFGF and other factors before treatment and four weeks after treatment of the two groups of patients were observed and evaluated.
Results: After treatment, the motor function scores and sensory function scores of the two groups of patients were improved compared with those before treatment (p<0.05). Compared with the control group, the experimental group improved significantly, and the difference was statistically significant (p<0.05). The levels of IL-6, BDNF and NFGF in the experimental group were significantly lower than those in the control group (p<0.05).
Conclusions: For patients with thoracolumbar fractures and ASCI undergoing laminar decompression and fixation, the comprehensive treatment plan of riluzole combined with mannitol and hyperbaric oxygen has certain advantages. Compared with the conventional therapy, it may significantly improve the movement and sensory functions of patients, relieve the inflammatory response of spinal cord, and promote recovery from the injury.
doi: https://doi.org/10.12669/pjms.37.2.3418
How to cite this:Li H, Cui J, Fan J, Tong J. An observation of the clinical efficacy of combining Riluzole with mannitol and hyperbaric oxygen in treating acute spinal cord injury. Pak J Med Sci. 2021;37(2):320-324. doi: https://doi.org/10.12669/pjms.37.2.3418
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Amid COVID-19 pandemic, are non-COVID patients left in the lurch?
Authors: Alam Laima , Kazmi Syed Kumail Hasan , Alam Mafaza , Faraid Varqa 
Published: January 2021

Objectives: 1) To explore the possible impact of the pandemic on the health seeking behavior of the patients, 2) To explore the relation of socio-demographics on the utility of health-care facilities.
Methods: This cross-sectional study was conducted by enrolling all patients ≥15 years of age presenting to the Out-Patient-Department of three main public-hospitals after obtaining ethical committee approval. A questionnaire with validated Urdu translation was filled by each participant that included socio-demographic data, pre-Covid and Covid-19 era health seeking behaviors and the impact of the pandemic on the utilization of healthcare facilities. Data was analyzed using SPSS V.19.
Results: A total of 393 patients were enrolled with a male preponderance (72%) and a median age range of 31-45 years. Fifty-eight percent of the study population was unemployed and 47.3% were seeking follow up care. The frequency of ER and multiple (>4 times) OPD visits were significantly decreased in the Covid-19 times whereas, the laboratory and radiology services were largely unaffected. A significant number of patients were not satisfied with the current healthcare facilities that was seen irrespective of the socio-demographic status. Emergency Room and radiology services were largely unaffected whereas, elective procedures and laboratory facilities were reported to be severely affected or delayed in relation to socio-demographic variables.
Conclusions: Healthcare inequalities have widened and depression has shown a sharp rise during this pandemic. The over-burdened healthcare facilities at the verge of collapse may miss out on the chronic non-Covid patients which would ultimately lead to increased morbidity and mortality.
doi: https://doi.org/10.12669/pjms.37.2.3536
How to cite this:Alam L, Kazmi SKH, Alam M, Faraid V. Amid COVID-19 pandemic, are non-COVID patients left in the lurch? Pak J Med Sci. 2021;37(2):576-581. doi: https://doi.org/10.12669/pjms.37.2.3536
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Analysis of Cesarean Sections using Robson’s Ten Group Classification System
Authors: Parveen Rashida , Khakwani Mehnaz , Naz Anum , Bhatti Rabia 
Published: January 2021

Objective: To analyze trends of CSs and evaluating them according to Robson’s Ten Groups Classification System (TGCS) at a leading government tertiary care hospital of South Punjab, Pakistan.
Methods: This cross-sectional study was conducted at Department of Obstetrics and Gynaecology, Nishtar Medical University Hospital, Multan Pakistan, from October 2019 to March 2020.The study population included a total of 167 women who underwent CS in the hospital during the specified study period. For each case, we collected data regarding maternal characteristics and pregnancy-related information. The dependent variable was Robson classification group.
Results: Overall, mean age was 26.53+5.1 years. Majority of the women, 116 (69.5%) belonged to urban areas of residence, 74 (44.3%) gestational aged between 37-42 years while 108 (64.7%) had history of cesarean section. Most of the patients, 85 (50.9%) turned out to be from TGCS Group-10. Group-5 and Group-1 were the 2nd and 3rd most common group, accounted for 24 (14.4%) and 19 (11.4%) cases respectively. Previous cesarean section (20.4%) and fetal distress (19.8%) were found to be most common indications leading to cesarean section.
Conclusion: As per Robson’s Ten-Group Classification, Group-10 and Group-5 were found to be the most contributing among deliveries done. Previous cesarean section and fetal distress were the most common indications of cesarean section.
doi: https://doi.org/10.12669/pjms.37.2.3823
How to cite this:Parveen R, Khakwani M, Naz A, Bhatti R. Analysis of Cesarean Sections using Robson’s Ten Group Classification System. Pak J Med Sci. 2021;37(2):567-571. doi: https://doi.org/10.12669/pjms.37.2.3823
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
If we can't get to theatre, we can't learn to operate
Authors: James HK , Fisher JD , Griffin DR , Pattison GTR 
Published: January 2021

This is a qualitative research study using in-depth, semi-structured interviews with CT1–ST3 trainees in trauma & orthopaedics (T&O) to characterise the factors that affect core surgical trainees’ access to the operating theatre for training. There were significant reported difficulties in accessing the operating theatre among core surgical T&O trainees in our study sample. The considerable service provision demands of the administrative and routine daily ward work, much of which offers negligible educational value in this group of trainees, is in direct conflict with the need to gain operative experience to meet the learning objectives of the curriculum. These results merit attention as the consequence of being unable to access the appropriate training environment threatens preparedness for registrar practice at ST3, and may serve to exacerbate the known morale issues, career dissatisfaction and burnout in this group.
Impact of COVID-19 on UK orthopaedic training
Authors: Bodansky D , Thornton L , Sargazi N , Philpott M , Davies R , Banks J 
Published: January 2021

Introduction Drastic restructuring of the UK’s National Health Service was undertaken in response to the COVID-19 pandemic with alterations to service delivery introduced from March 2020. This has affected surgical training programmes. This study quantifies the impact of the pandemic on postgraduate orthopaedic training. Methods A prospective study was undertaken between 16 March and 3 May 2020 to capture alterations to training activity. Data were collected regionally by all trauma and orthopaedic specialty registrars in the West sector of the North West School of Surgery using a live online proforma. Results A total of 1,018 entries were analysed from 10 hospitals with a median of 21 entries per trainee (interquartile range: 17.5–26). Overall, 382 elective and 169 trauma lists were cancelled during the study period in addition to 155 elective and 132 fracture clinics. Seven trainees self-isolated during this period, losing 39 sessions. All nine candidates who were due to sit their FRCS exit examinations had them cancelled. Trainees were redeployed to other specialties in 231 entries (22.7%), with altered duties undertaken in intensive care (24.4%), accident and emergency (25.1%), and general medicine (50.3%). Trainees had no assigned alternative duties in 192 sessions (18.9%), and provided 90 extra fracture clinics and 70 extra trauma lists. Teaching and administration were logged for the remaining eight entries. Conclusions The COVID-19 pandemic has resulted in an overall 43% reduction in training opportunities, which must be addressed in order for trainees to achieve their Certificate of Completion of Training competences.
Think before you cut! Is surgery about ‘doing’ or about ‘thinking’?
Authors: Grounds R 
Published: January 2021

Is surgery about ‘doing’ or about ‘thinking’? The question is pertinent, because only if we know what we are trying to achieve can we hope to use the right educational method to reach our goal! It could be argued that surgery is an inextricable combination of doing, thinking and interacting with others. Educational theory teaches us that there are three main models of teaching: behaviourism (learning by ‘doing’), cognitivism (learning by ‘thinking’) or social constructivism (learning by ‘interacting’). Furthermore, most education systems advocate the models to be used in that order, with behaviourist techniques for the novice and constructivism reserved for the expert. Yet on reflection, today's medical students start their learning in a lecture theatre, spend core training years revising for exams and only the last few years of training actually ‘doing’ surgery – quite the opposite of what educational theory mandates. If the expert surgeon ‘does’ while the novice only ‘knows’, then is it not time to start teaching in reverse? Rather than surgical training beginning with a period of ‘thinking’ in isolation, an integrated curriculum incorporating ‘doing’ from the outset should allow trainee surgeons to reach their goal of ‘doing’ more efficiently and effectively.
Association between SOX2 and OCT4 expression and the chemoradiation therapeutic response in undifferentiated non-keratinizing nasopharyngeal carcinoma
Authors: Rachmadi Lisnawati , Kusmardi  , Miranda Monik Ediana , Vianney Maria Mayella 
Published: January 2021

BACKGROUND Self-renewal ability of cancer stem cells (CSS) is one of the possible causes for nasopharyngeal carcinoma (NPC) to relapse and metastasize. SOX2 and OCT4 are markers for expression of the embryonic stem cells and crucial for the progression of various malignancies. This study was aimed to analyze the association between SOX2 and OCT4 expression and chemoradiation therapeutic response in undifferentiated non-keratinizing NPC.
METHODS This cross-sectional study used archival data from Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Cipto Mangunkusumo Hospital from January 2014 to December 2016. The outcomes were classified into good-response (complete and partial response) and poor-response groups (progressive and stable disease) based on response evaluation criteria in solid tumors (RECIST). SOX2 and OCT4 immunohistochemistry staining was performed using the initial specimen (before chemoradiation therapy) and positively expressing tumor cells were counted. Staining intensity was graded as: strong, moderate, weak, and negative. Strong and moderate staining was considered positive expression.
RESULTS 33 males and 8 females were included; 48% were ≥50 years old. Most of the patients had stage IV (n = 35) and several patients had stage II (n = 3) and III (n = 3). More cells expressed OCT4 in the good-response group than the poor-response group (61.3% versus 37.0%, p = 0.009). Meanwhile, there were less cells expressing SOX2 in the good-response group than the poor-response group (36.3% versus 61.1%, p = 0.097).
CONCLUSIONS This study suggests that OCT4 is a potential predictive marker for therapeutic response in patients with NPC.
The impact of sleep quality and duration on leptin, appetite, and obesity indices in adults
Authors: Muhammad Harry Freitag Luglio , Pratama Satwika Arya , Sulistyoningrum Dian Caturini , Hartono Maya Nurfitriani , Huriyati Emy , Lee Yi Yi , Muda Wan Abdul Manan Wan 
Published: January 2021

BACKGROUND Poor sleep duration and quality were previously reported to increase the risk of obesity. This study was aimed to evaluate the impact of sleep quality and duration on leptin, appetite, and adiposity in Indonesian adults.
METHODS This cross-sectional study recruited adults in Yogyakarta, Indonesia, in 2016. Sleep quality was assessed using the Pittsburgh sleep quality index, appetite was evaluated using the community nutrition appetite questionnaire, and dietary intake was assessed by interviews using the semi-quantitative food frequency questionnaire. Sleep duration was also asked. Obesity indices were measured using the body mass index (BMI), waist-hip circumference, and percentage of body fat. Leptin was analyzed using the enzyme-linked immunosorbent assay. A Spearman analysis was done to evaluate the correlation between sleep quality, sleep duration, anthropometric measures, dietary intake, appetite, and leptin.
RESULTS 244 adults participated in this study. This study showed that lower sleep quality and duration was significantly correlated with higher body weight (r = 0.129, p = 0.043 and r = −0.228, p<0.001), BMI (r = 0.176, p = 0.006 and r = −0.202, p = 0.001), and waist circumference (r = 0.179, p = 0.005 and r = −0.254, p<0.001). There was a correlation between poor sleep quality and higher leptin concentration (r = 0.186, p = 0.004). Sleep quality and duration were not associated with appetite (r = 0.109, p = 0.109 and r = −0.043, p = 0.500).
CONCLUSIONS This study found that lower sleep quality was correlated with higher BMI, higher leptin concentration, but not appetite.
Comparison of a set of cognitive ability screening test for primary school-aged children in Indonesia
Authors: Togas Meitha , Gunardi Hartono , Sekartini Rini , Pudjiati Sri Redatin Retno , Hogervorst Eef 
Published: January 2021

BACKGROUND Monitoring children’s intellectual development is important to align their educational needs. This study compared nonverbal intelligence subtest of the cognitive test battery for Individuals with or without intellectual disability (CIID) to measure visual logical reasoning, verbal intelligence subtest (verbal fluency [VF]–animal test) to assess vocabulary and semantic memory, and the modified Indonesian version of Hopkins verbal learning test (IHVLT) to assess learning ability and episodic memory, against the Wechsler intelligence scale for children (WISC) as an alternative cognitive screening tool in school-aged children.
METHODS A cross-sectional study was conducted in 145 grade 1–6 elementary school students in Jakarta between March and May 2017. Performance on the CIID subtest, VF, and modified IHVLT was assessed by a pediatrician, and the WISC test was performed by a psychologist. The associations between variables were evaluated using nonparametric Spearman’s rank correlations, regressions, and box plots.
RESULTS The correlation between total intelligence quotient (IQ) WISC and CIID was 0.42 (p<0.001) and 0.34 (p<0.001) for both IHVLT and VF. Box plots suggested possible discriminative capacity of CIID but insufficient specificity. However, CIID was associated with stunting (height) and health (weight) independent of age, sex, father’s education, or income.
CONCLUSIONS The CIID subtest series, VF, and modified IHVLT correlated with total IQ WISC. However, CIID may be better to test predictors of poor cognitive performance in primary school-aged children than an IQ screening test.
Self-medication among health care workers in a tertiary hospital in Southern Nigeria: knowledge, attitude, and practices
Authors: Tobin Ekaete Alice , Erhazele Jovita , Okonofua Martha , Nnadi Chinelo , Nmema Eucharia Ezenwanyi , Odigie George 
Published: January 2021

BACKGROUND Self-medication is linked to the inappropriate and irrational use of medicines. This study aimed to determine the knowledge, attitude, and practice of self-medication among health care workers (HCWs) in a tertiary hospital in Southern Nigeria.
METHODS In a cross-sectional study carried out between June 2018 and December 2018 at Irrua Specialist Teaching Hospital, Edo State, 206 consenting HCWs were interviewed using validated questionnaires on their knowledge (assessed as good, fair, and poor), attitude (positive and negative), and practice of self-medication. Data analysis was performed using SPSS version 21 (IBM Corp., USA). Bivariate analysis was carried out using chi-square. Statistical significance was set as p<0.05.
RESULTS Prevalence of self-medication in the last 4 months was 89.3%, and significantly decreased with increasing age (p = 0.04) and holding a positive attitude toward self-medication (p<0.01). Knowledge of self-medication was fair for the majority 111 (53.9%). Most of the medications were used for headache (92.4%), fever (81.5%), diarrhea (75.0%), and respiratory infections (61.4%). Common drugs self-medicated included antimalarials (91.3%), analgesics (81.0%), and antibiotics (71.2%). 39 subjects (21.2%) self-medicated with tranquilizers. Familiarity with the treatment options was the main reason for self-medication for 60.9% of the respondents.
CONCLUSIONS Self-medication was prevalent among HCWs in the study area. Concerted efforts are needed to educate HCWs on responsible self-medication. On a broader scale, restrictions should be enforced on the sale of prescription drugs, such as antibiotics and sleeping pills, and drug dispensers should provide effective counseling before dispensing.
EL DERECHO AL ACCESO A LA INFORMACIÓN: ¿CONTINGENCIA O PANDEMIA? SUS EFECTOS JURÍDICOS. CASO COVID-19
Authors: Leal Espinoza José Luis , De la Vega Daniel Garza 
Published: January 2021

El aspecto jurídico de una pandemia (crisis sanitaria mundial del COVID-19) puede ser estudiada desde el ámbito de aplicación sustantiva del acceso al derecho a la información, además del debate sobre la efectividad con la que el gobierno mexicano protege a sus ciudadanos del Estado para no generar caos, desestabilización socialy permear un estado de derecho efectivo-positivo. En este artículo, la interpretación de la ley desde la aplicación en el campo del rigor formal ayudará a los expertos a tomar decisiones inmediatas con el propósito inherente de salvaguardar la vida de los ciudadanos del Estado Mexicano. Para ello, se requiere un verdadero acceso a la información, armando un equipo interdisciplinario para la toma de decisiones, para evitar el miedo, el estrés, el cansancio, la frustración, el pánico, la depresión, la ansiedad entre otros.
SOVRANITÀ DEI TECNOCRATI, MECCANISMO EUROPEO DI STABILITÀ E L’EMERGENZA DA COVID-19
Authors: Salmoni Fiammetta 
Published: January 2021

Il 9 aprile 2020, a Bruxelles, l’Eurogruppo ha raggiunto l’accordo sintetizzato nel Report on the comprehensive economic policy response to the COVID-19 pandemic, nel quale si dichiara che “è necessaria una strategia coordinata e globale per far fronte alle esigenze dell’emergenza sanitaria, sostenere le attività economiche e preparare il terreno per la ripresa”, una strategia che “dovrebbe combinare iniziative a breve, medio e lungo termine, tenendo conto delle ricadute e delle interconnessioni” tra le diverse economie degli Stati dell’Eurozona, considerando altresì la “necessità di preservare lafiducia e la stabilità”. Tra queste iniziative, si distingue, per la sua rilevanza, ma anche per la sua problematicità e la conflittualità che ha scatenato tra le forze politiche nazionali e finanche all’interno della stessa maggioranza di governo, il ricorso al Meccanismo europeodi stabilità (MES) sotto la forma di una speciale linea di credito, denominata Pandemic Crisis Support (PCS), che dovrebbe basarsi sull’esistente Enhanced Conditions Credit Line (ECCL) e “adjusted in light of this specific challenge, as a relevant safeguard foreuro area Member States affected by this external shock”.