bluuebunny/crossref_metadata_2025_split huggingface dataset:
The comparison between total hip arthroplasty and hemiarthroplasty in patients with femoral neck fractures: a systematic review and meta-analysis based on 25 randomized controlled trials
Authors: Tang Xiumei , Wang Duan , Liu Ying , Chen Jiali , Zhou Zongke , Li Peifang , Ning Ning 
Published: December 2020

Abstract
Background
We performed an updated systematic review and meta-analysis which enrolled 25 prospective randomized controlled trials (RCTs) to compare the outcomes between total hip arthroplasty (THA) and hemiarthroplasty (HA) in patients with femoral neck fractures (FNFs).

Methods
We searched English databases which included PubMed, Embase (vis OvidSP), The Cochrane Library, and Web of Science, and Chinese databases Chinese National Knowledge Infrastructure (CNKI), VIP, Wang Fang, and China Biology Medicine Disc (CBM) in July 2020. The quality of each study was assessed according to the Cochrane Collaboration’s Risk of Bias. Risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were pooled with random-effects models. Data regarding baseline characteristics, hospital and surgery outcomes, clinical outcomes, patients’ quality of life, common complications, prothesis-related complications, mortality, and costs were reported.

Results
A total of 25 RCTs involving 3223 patients (1568 THA and 1655 HA) were included. THA had longer hospital length (WMD = 0.721, P < 0.0001) and surgery time (WMD = 20.044, P < 0.0001), and more blood loss compared with HA (WMD = 69.109, P < 0.0001). THA showed better ratings in the Harris Hip Score during follow-up periods between 1 and 5 years while no differences within 6 months and after 9 years. THA was associated with higher quality-of-life EuroQol-5 Dimension (EQ-5D) scores after 2 years of surgery but no difference within 1 year. There was no difference in common complications. THA had significant higher rate of dislocation (WMD = 1.897, P = 0.002) and lower acetabular erosion (WMD = 0.030, P = 0.001). For mortality, there was no difference during all the follow-up periods except for slightly higher 2-year mortality after surgery.

Conclusion
This meta-analysis demonstrates that THA has better medium-term functional results and quality of life and lower acetabular erosion rate, while HA shows better in reducing hospital stay, surgery time, and blood loss and also has lower dislocation rate.
Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study
Authors: Akalın Çağrı 
Published: December 2020

Objective: To examine the long-term outcomes such as recurrence, foreign body feeling and chronic pain of titanium-coated mesh (TCM) versus standard polypropylene mesh (PM) after Lichtenstein repair (LR).
Methods: In this retrospective cohort study, patients who underwent TCM and PM in LR were evaluated between May 2014 and January 2018 at Ordu University Training and Research Hospital in Turkey. Primary outcomes (age, gender, body mass index, smoking habits, comorbid diseases, American Society of Anesthesiologists score, hernia type, side of hernia, duration of hernia presentation and operative time) and secondary outcomes (surgical site occurence, recurrence, foreign body feeling and chronic pain) were analyzed. Patients were divided into two groups according to the mesh elected (TCM and PM); titanium group (TG) and polypropylene group (PG), respectively.
Results: In this study, 221 patients were analyzed; TCM was used in 72 (32.6%) patients and PM was used in 149 (67.4%) patients. No difference was found between groups in terms of primary outcomes (p>0.05). In the analysis of secondary outcomes, surgical site occurence was similar in both groups (p>0.05). Recurrence was observed in 1.39% (n=1) of TG and 2.01% (n=3) of PG. No difference was found between groups in terms of recurrence (p=0.606). Foreign body feeling was observed in 15.3% (n=11) of TG and 27.5% (n=41) of PG. Chronic pain was observed in 4.2% (n=3) of TG and 12.8% (n=9) of PG. Significant differences were found between groups in terms of chronic pain and foreign body feeling (p=0.046 and p=0.044, respectively).
Conclusion: The result of this study shows that in LR, TCM leads to less foreign body feeling and chronic pain than PM. However, there was no difference in terms of recurrence between these meshes.
doi: https://doi.org/10.12669/pjms.37.1.2694
How to cite this:Akalin C. Long-term outcomes after Lichtenstein repair using titanium-coated mesh: A retrospective cohort study. Pak J Med Sci. 2021;37(1):81-86. doi: https://doi.org/10.12669/pjms.37.1.2694
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.
Compliance of checking HbA1c in a tertiary care hospital of Pakistan
Authors: Aziz Abdul , Ahsan Ali Syed 
Published: December 2020

Background and Objectives: The prevalence of diabetes mellitus worldwide was 171 million one and half decade ago, while the prediction is 366 million patients by 2030 and more than 640 million people by 2040. HbA1c value represents average blood glucose over the past 2-3 months and accounts for both pre-prandial and post-prandial blood glucose levels. A link between HbA1c and diabetic complications has been confirmed. In general, patients with controlled diabetes mellitus should have at least biannual testing, while patients with uncontrolled diabetes mellitus or unmet glycemic targets should be tested every three months. The objective was to see compliance of checking HbA1c in tertiary care hospital of a developing world.
Methods: This was a retrospective observational study done from 1st February 2019 to 31st March 2019 in the Department of Medicine and Surgery, The Aga Khan University Hospital, Karachi. All patients of age 18 years and above, admitted with a diagnosis of diabetes mellitus (DM) from 1st February 2019 to 31st March 2019 were included. If HbA1c was less than 7% the patients were labelled as having controlled DM, otherwise, uncontrolled DM. If HbA1c of patients with controlled DM was not checked in last six months and if HbA1c of patients with uncontrolled DM was not checked in last three months then it was labelled as non-compliance of checking HbA1c.
Results: Out of 1732 diabetic patients only 94 patients fulfilled inclusion criteria. Out of these 94 patients 43 (45.7%) were male. Mean HbA1c was 7.90% (1.4) and 69 (73.4%) patients had uncontrolled diabetes mellitus. Overall, the compliance of checking HbA1c was 58.5%. In uncontrolled diabetes mellitus patients, the compliance of checking HbA1c was 45% and in controlled diabetes mellitus patients the compliance was 96%.
Conclusion: The compliance of checking HbA1c is inadequate in diabetic inpatients. The considerable prevalence of diabetes and the benefits of timely interventions in diagnosed patients to prevent complications suggest the need for a comprehensive awareness among the doctors for checking HbA1c.
doi: https://doi.org/10.12669/pjms.37.1.2814
How to cite this:Aziz A, Ali SA. Compliance of checking HbA1c in a tertiary care hospital of Pakistan. Pak J Med Sci. 2021;37(1):142-145. doi: https://doi.org/10.12669/pjms.37.1.2814
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.
Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques
Authors: Sharobaro Valentin , Alimova Sekina , Telnova Anna , Shamanaeva Liudmila 
Published: December 2020

Objective: To develop a clinical technique for objective estimation of exact location and degree of participation of face and neck soft tissues in age-related deformations for determine effective mini-invasive treatment techniques.
Methods: Ultrasound examination was performed in 2017-2019 at 63 patients with age-related face changes. Examination was done in the vertical position for determine the role, exact location and participation degree of different soft tissues of the face and neck in age-related changes.
Results: Great diagnostic value of ultrasound examination of involutional changes in soft tissues of lower third of face and neck was noted to determine all causes of contour age-related deformities. These results were used to choose effective minimally invasive methods for correction.
Conclusion: Ultrasound examination is a non-invasive, harmless, clinically available, inexpensive examination that allows to determine exact localization and degree of participation of different soft tissues of face and neck in age-related changes. That is very important for planning and use different minimally invasive techniques for facial and neck rejuvenation.
doi: https://doi.org/10.12669/pjms.37.1.3034
How to cite this:Sharobaro V, Alimova S, Telnova A, Shamanaeva L. Ultrasound diagnosis of age-related involutional changes in the lower third of face and neck to determine treatment techniques. Pak J Med Sci. 2021;37(1):272-276. doi: https://doi.org/10.12669/pjms.37.1.3034
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.
Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem
Authors: Çarkçı Engin , Polat Ayse Esin , Öztürkmen Yusuf , Tüzüner Tolga 
Published: December 2020

Objective: In this study we aimed to investigate the long-term clinical and radiological results, revision rates and causes, and the rate of implant survival in total hip arthroplasty performed using CLS® expansion cup and Spotorno® cementless femoral stem.
Methods: Clinical results of total hip arthroplasty performed on 131 hips of 114 patients in Istanbul Training and Research Hospital between 1993 and 2003 were retrospectively evaluated according to the Harris Hip Score. Revision rates were determined and implant survival rates were identified using the Kaplan-Meier estimator.
Results: Of the patients, 39 were males and 75 were females. The average age of the patients at surgery was 48.7±11.3 years. Patients were followed up for a mean period of 13.9±2.4 years. The mean Harris Hip Score was 34.35±6.09 preoperatively and 88.20±7.11 at the final follow-up (p<0.001). The Kaplan-Meier survivorship estimate for the cup at 13.9 years, taking revision for any reason as the end point was 95.6% (95% CI), while the 15th and 17th year survival rates were 90% and 85%, respectively.
Conclusion: In total hip arthroplasty using a cementless expansive acetabular cup, a 95.6% survival rate is achieved after an average of 14 years, whereas the rate decreases to 85% after 17 years. Even if the incidence of cup breakage is reduced with proper implantation, particle disease and periacetabular osteolysis remains a problem for the long-term survival.
doi: https://doi.org/10.12669/pjms.37.1.3089
How to cite this:Carkci E, Polat AE, Ozturkmen Y, Tuzuner T. Long-Term results of total Hip Arthroplasty performed using a cementless expansive Acetabular Cup and Spotorno Femoral Stem. Pak J Med Sci. 2021;37(1):52-58. doi: https://doi.org/10.12669/pjms.37.1.3089
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.
Reliability and validity test of VES-13 and analysis of influencing factors for the vulnerable condition of patients with advanced castration-resistant prostate cancer
Authors: Feng Jia , Sun Qian , Li Jing , Li Ting-ting 
Published: December 2020

Objectives: To study the relationship between the reliability and validity of VES-13 and the influencing factors of the vulnerable condition of patients with advanced castration-resistant prostate cancer, so as to provide a reference for the health management and nursing of elderly inpatients.
Methods: By means of convenience sampling, 150 vulnerable patients with advanced castration-resistant prostate cancer who were admitted to the Department of Oncology of the Affiliated Hospital of Hebei University from April 2019 to March 2020 were selected. General data questionnaire, simple mental state checklist, anxiety self-assessment scale, and the vulnerable elders 13 survey (VES-13) were used in this study. The reliability and validity were tested by SPSS 20.0.
Results: For this group of patients, VES-13 Cronbach’s α was 0.832, living function was 0.778, body function was 0.846, and the correlation coefficient between items was between 0.401 and 0.823 (P<0.01); the retest reliability was 0.831 (P<0.05), and the correlation coefficient was0.504 (P<0.05). The average time to fill in each scale was 4.53±1.32 Minutes, and general indicators such as economic status and education level were significantly correlated with vulnerability. The clinical indicators of prostate-specific antigen levels, multiple bone metastases, and bone pain were significantly correlated with vulnerability.
Conclusion: VES-13 scale had high level of reliability and operability, and was straight forward to understand and use; it can be used as an effective tool for the assessment of vulnerability in patients with advanced prostate cancer. The vulnerability of patients with castration-resistant prostate cancer showed significant correlation with economic status, education level, prostate-specific antigen level, multiple bone metastases, bone pain and other indicators. Nursing staff should pay close attention to the relevant factors of inpatients and give targeted advance intervention measures to facilitate rapid recovery of elderly inpatients.
doi: https://doi.org/10.12669/pjms.37.1.3095
How to cite this:Feng J, Sun Q, Li J, Li TT. Reliability and validity test of VES-13 and analysis of influencing factors for the vulnerable condition of patients with advanced castration-resistant prostate cancer. Pak J Med Sci. 2021;37(1):137-141. doi: https://doi.org/10.12669/pjms.37.1.3095
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.
Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years
Authors: Ahmad Hafiz Mahmood , Naumeri Fatima , Saud Usama , Butt Ghazala 
Published: December 2020

Background & Objective: In children younger than two years, most surgeons perform the inguinal herniotomy superficially through the external ring, a technique known as Mitchell-Banks’ Herniotomy (MBH) while in older children, commonly Ferguson and Gross Herniotomy (FGH) is performed which involves opening of inguinal canal. Our aim was to compare the FGH and MBH in terms of recurrence in boys with inguinal hernia.
Methods: Boys with inguinal hernia presenting to Pediatric Surgery, Mayo Hospital Lahore from Dec 2016 to January 2018 were included in the study, if older than two years and younger than 14 years and without palpable deep ring (2 cm or more in width) or strangulation of inguinal hernia or malnutrition. They were randomly allocated in 2 groups after obtaining informed consent from parents, and underwent MBH (Group-A) and FGH (Group-B). Children were called for follow up after 1 week and at 6 months to assess for recurrence.
Results: Total 260 patients with inguinal hernia were enrolled (NCT:03392636). The mean age of boys in Group-A was 5.2±3.0 years and in Group-B was 5.9±3.1 years. Mean operating time in Group-A (26.65±3.22 minutes) was longer than Group-B (15.92±4.22 minutes), and scrotal oedema was noted in 38 (29.2%) cases in Group-A, while 7 (5.4%) cases in Group-B. Testicular atrophy was noted in one patient of Group-B. Recurrence occurred in 1(0.8%) patient in Group-A, and in 8(6.2%) patients in Group-B (p-value 0.018).
Conclusion: Mitchell-Banks’ herniotomy has lower recurrence rate than Ferguson and Gross Herniotomy in boys older than two years.
doi: https://doi.org/10.12669/pjms.37.1.3216
How to cite this:Ahmad HM, Naumeri F, Saud U, Butt G. Comparison of Ferguson and Gross herniotomy with Mitchell Banks’ herniotomy in boys older than two years. Pak J Med Sci. 2021;37(1):40-44. doi: https://doi.org/10.12669/pjms.37.1.3216
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.
Spectral Domain – Optical Coherence Tomography findings in Triple-A Syndrome – A case series from Pakistan
Authors: Nasir Javeria , Javed Anum , Arshad Muhammad Owais , Chatni Muhammad Hanif 
Published: December 2020

Triple A Syndrome is an autosomal recessive entity involving multiple systems usually characterized by adrenal insufficiency, alacrimia and achalasia. The disease features include variable degrees of neurological and neuro-ophthalmic manifestations. Protein ALADIN encoded by the AAAS gene is found to be defective in Triple A Syndrome. Here we discuss a case series of five patients diagnosed as Triple A Syndrome. Clinically there was variable degree of optic atrophy in all the cases, which was further confirmed with spectral domain Optical Coherence Tomography The aim of this study was to publish the OCT based ONFL graphs of these unique cases, so that being an ophthalmologist we can take a multidisciplinary approach and decisions accordingly.
doi: https://doi.org/10.12669/pjms.37.1.3310
How to cite this:Nasir J, Javed A, Arshad O, Chatni MH. Spectral Domain – Optical Coherence Tomography Findings in Triple-A Syndrome – A case series from Pakistan. Pak J Med Sci. 2021;37(1):267-271. doi: https://doi.org/10.12669/pjms.37.1.3310
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.
X-ray patterns of COVID-19 in patients presenting to Lady Reading Hospital, Peshawar, Pakistan
Authors: Nishtar Tahira , Noor Nosheen , Khan Shandana Latif 
Published: December 2020

Objective: To determine the pattern of COVID-19 on chest radiograph in patients presenting to Lady Reading Hospital, Peshawar, Pakistan.
Methods: This prospective observational study was conducted on 178 consecutive swab positive COVID-19 patients presenting to Lady Reading Hospital, Peshawar, Pakistan from 15th March to 15th June 2020. Patients of all ages and both genders were included. Chest X-rays performed by portable radiography unit were viewed for different patterns by two consultant radiologists independently and results were analyzed using IBM SPSS 20.
Results: Out of 178 patients 134 were male. Mean age was 55.67 years. Radiographic patterns observed were ground glass haze without or with reticulation and/or consolidation (45.5 % and 33.2% respectively) and predominant consolidation either alone or in combination with ground glass haze or other findings (27.1% collectively). Peripheral distribution pattern was seen in 69.1% of patients with bilateral findings in 84.3%. Further categorization was based on pulmonary zonal demarcation with changes most commonly involving four zones (33.1%) i.e., the lower and mid zones bilaterally.
Conclusion: Portable chest radiography is an essential supporting tool for assessing different patterns in COVID-19 infection. The most common pattern observed is alveolar opacities with predominant peripheral distribution either unilateral or more frequently bilateral, starting from the lower and mid zones extending to the upper zones and becoming diffuse with disease progression.
doi: https://doi.org/10.12669/pjms.37.1.3435
How to cite this:Nishtar T, Noor N, Khan SL. X-ray patterns of COVID -19 in patients presenting to Lady Reading Hospital, Peshawar, Pakistan. Pak J Med Sci. 2021;37(1):28-33. doi: https://doi.org/10.12669/pjms.37.1.3435
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.
Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures
Authors: Al Aali Khulud , Alhamdan Rana , Maawadh Ahmed M , Vohra Fahim , Abduljabbar Tariq 
Published: December 2020

Objective: To evaluate marginal fit and internal adaptation of three-unit Zr frameworks fabricated from four Zr CAD/CAM milling systems.
Methods: Fixed partial denture models were replicated (40 stone models) using Polyvinyl Siloxane impression material (PVS) and type IV stone for Zr framework fabrication. FPDs were milled with four CAD/CAM systems, Group-II: LAVA™ Zirconia milled by LAVA™, Group-2: Vita In-Ceram YZ milled by Cerec®, Group-3: Zirconia milled by GM1000 and Group-4: Zirconia milled by DWX-50N. Twelve marginal gap measurements per framework were performed at pre-established points, with a metallurgical microscope (Zeiss, Germany) at 500X magnification. Eight measurements of cement space per section were performed for adaptation. Data was analyzed using ANOVA and Tukey post hoc test.
Results: Zirconia FPD frameworks exhibited gaps ranging from 16 to 50.1 µm for marginal fit and 26.8 to 102.5 µm for internal adaptation. Group-3 [20.8 (8.3) µm & 50.3 (11.4) µm] and Group-4 [16.0 (4.0) µm & 40.2 (8.8) µm] specimens showed significantly lower marginal fit and internal adaptation gaps compared to Group-I [50.1 (13.4) µm & 100.5 (16.7) µm] and Group-2 [38.9 (8.2) µm & 102.5 (13.4) µm] specimens respectively.
Conclusions: Different CAD-CAM systems for fabrication of Zr FPD frameworks displayed a significant influence on marginal fit and internal adaptation of restorations.
doi: https://doi.org/10.12669/pjms.37.1.3490
How to cite this:Al-Aali KA, Alhamdan RS, Maawadh AM, Vohra F, Abduljabbar T. Influence of contemporary CAD-CAM milling systems on the fit and adaptation of partially stabilized Zirconia fixed partial dentures. Pak J Med Sci. 2021;37(1):45-51. doi: https://doi.org/10.12669/pjms.37.1.3490
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.
Challenges during Colonoscopy in Women with a Prior Hysterectomy
Authors: Kamani Lubna , Butt Nazish , Khemani Hanisha 
Published: December 2020

doi: https://doi.org/10.12669/pjms.37.1.3856
How to cite this: Kamani L, Butt N, Khemani H. Challenges during Colonoscopy in Women with a Prior Hysterectomy. Pak J Med Sci. 2021;37(1):295. doi: https://doi.org/10.12669/pjms.37.1.3856