bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patterns of maternal nutritional status based on mid upper arm circumference
Authors: Bari Attia , Sultana Nighat , Mehreen Sana , Sadaqat Nadia , Imran Izza , Javed Rashida 
Published: February 2020

Objective: To determine the patterns of maternal nutrition status by using mid upper arm circumference (MUAC) and to examine the association of maternal nutritional status with the nutritional status of malnourished children under two years of age.
Methods: Descriptive study conducted at the Department of Pediatric Medicine of the Children’s Hospital, Lahore from January 2017 to March 2018. A total of 227 mother accompanying their children admitted for nutritional rehabilitation were included. Demographics of participants along with MUAC of every mother was taken. Data analysis was done by SPSS 22.
Results: Mean maternal age was 28.29±5.30 years and mean age of children was 9.22 ± 6.05 months. Mean maternal MUAC was 25.53±3.63 cm. Normal nutrition was present in only 70 (31%), 35 (15.4%) had moderate to severe under nutrition and 68 (30%) were overweight and 17 (7.5%) were obese. Maternal illiteracy was common 150 (66%) and 203 (89%) belong to poor social class. Majority 150 (75%) children had <-3SD WHZ score. Only 42 (18.5%) children were exclusively breast fed. Maternal malnutrition was significantly associated with severity of child’s undernutrition (p=0.045) and low rates of exclusive breast feeding practices (p=0.049).
Conclusion: Malnutrition, in the form of both under nutrition and obesity is prevalent in mothers of malnourished children belonging to lower social class. Maternal illiteracy and low income are the major contributor in maternal malnutrition which in turn has an impact on child nutrition and breast feeding practices.
doi: https://doi.org/10.12669/pjms.36.3.1331
How to cite this:Bari A, Sultana N, Mehreen S, Sadaqat N, Imran I, Javed R. Patterns of maternal nutritional status based on mid upper arm circumference. Pak J Med Sci. 2020;36(3):382-386. doi: https://doi.org/10.12669/pjms.36.3.1331
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.
Bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection
Authors: Zhao Yuqin , Dai Xuemei , Ji Jinzhi , Cheng Ping 
Published: February 2020

Objective: To investigate the clinical efficacy of bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection.
Methods: One hundred forty eight patients with severe pulmonary infection who were admitted to our hospital from October 2016 to December 2017 were included in this study. According to the random number table method, they were divided into a control group and an observation group with 79 patients each. The control group was given conventional treatment, while the observation group was given bronchoalveolar lavage with fiberoptic bronchoscopy on the basis of the treatment in the control group. The clinical efficacy of the two groups was compared, the duration of mechanical ventilation, antibiotic use and symptoms improvement of the two groups were recorded, and the respiratory mechanics parameters, serum procalcitonin (PCT) and transforming growth factor β (TGF-β) level were measured before and after treatment.
Results: The duration of mechanical ventilation, antibiotic use, respiratory failure correction, body temperature decline and white blood cell recovery in the observation group were significantly shorter than those in the control group (P<0.05). The total efficacy of the observation group was significantly higher than that of the control group (92.4% vs. 74.7%). The respiratory mechanics parameters of the two groups after treatment were higher than those before treatment (P<0.05) and the increase of the observation group was more obvious than that of the control group (P<0.05). The serum PCT and TGF-β levels of the two groups after treatment were lower than those before treatment (P<0.05), and the decrease level in the observation group was more obvious (P<0.05).
Conclusion: Bronchial lavage under fiberoptic bronchoscopy can improve the clinical efficacy, accelerate the improvement of clinical symptoms and respiratory mechanics parameters, significantly reduce the PCT and TGF-β levels, and promote the rapid recovery of patients in the treatment of severe pulmonary infection.
doi: https://doi.org/10.12669/pjms.36.3.1539
How to cite this:Zhao Y, Dai X, Ji J, Cheng P. Bronchial lavage under fiberoptic bronchoscopy in the treatment of severe pulmonary infection. Pak J Med Sci. 2020;36(3):396-401. doi: https://doi.org/10.12669/pjms.36.3.1539
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.
Association of liver biomarkers and cytokeratin-18 in Nonalcoholic fatty liver disease patients
Authors: Altaf Benash , Rehman Anam , Jawed Shireen , Raouf Abdul 
Published: February 2020

Objective: To investigate the association of gold standard liver biomarkers with serum cytokeratin 18 (CK18), serum Alanine aminotransferase (ALT) and serum aspartate (AST).
Methods: This was cross sectional study. It was conducted at Mayo Hospital from January 2016 to December 2017. It comprised of 148 non-alcoholic fatty liver disease subjects of age 40-60 years. After written informed consent, study anthropometric measurements (age, height, waist circumference and hip circumference) were taken and serum AST, ALT and CK-18 were estimated by sandwiched ELISA technique. Data was analyzed using SPSS 21.0. Descriptive were presented as mean and standard deviation. Association between CK18, serum AST and ALT were analyzed by regression analysis and are presented as beta coefficient. P-value ≤ 0.05 was taken as significant.
Results: Study comprised of 148 subjects with mean age 44.81±6.2. Of total population 29.1% were male and 70.9% were female. Significant positive association of CK18 was found with serum ALT (P-value 0.005*). However, no association was found between AST and serum CK18. (P-value 0.29).
Conclusion: Significant positive association was found between Serum CK18 and serum ALT.
doi: https://doi.org/10.12669/pjms.36.3.1674
How to cite this:Altaf B, Rehman A, Jawed S, Raouf A. Association of liver biomarkers and cytokeratin-18 in Nonalcoholic fatty liver disease patients. Pak J Med Sci. 2020;36(3):387-390. doi: https://doi.org/10.12669/pjms.36.3.1674
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.
Safety evaluation of preoperative stent insertion and clinical analysis on comparison of outcomes between preoperative stent insertion and emergency surgery in the treatment of obstructive left-sided colorectal cancer
Authors: Han Lijiang , Song Xinjiang , Yu Bin , Zhou Mingliang , Zhang Liping , Sun Guogang 
Published: February 2020

Objective: To evaluate the safety of preoperative stent insertion and compare the short- and long-term outcomes between preoperative stent insertion and emergency surgery in the treatment of obstructive left-sided colorectal cancer.
Methods: The clinical data of 302 patients who underwent surgery for obstructive left-sided colorectal cancer from January 2009 to May 2014 were retrospectively analyzed. They were divided into two groups according to whether to receive stenting for the success rate and complications of stent insertion in colonic lumen by colonoscope, and the number of cases of primary resection and anastomosis, and short-term complications such as incision infection, anastomotic leakage, spleen tear and abdominal abscess as well as mortality and survival rate during hospitalization were compared.
Results: The success rate of endoscopic nitinol alloy memorial stent insertion in colonic lumen was 97.62%, and the overall incidence of complications was 14.5%, of which the incidence of serious complications (perforation, stent migration) was 4.76%. The primary anastomosis rate was significantly higher in the stent insertion group (85.71%) than that in the emergency surgery group (36.24%). The overall complication rate in the stent insertion group (14 cases) was significantly lower than that in the emergency surgery group (102 cases). There was no significant difference between survival curves (P>0.05).
Conclusion: Preoperative stent insertion in colonic lumen by colonoscope for decompression is an ideal auxiliary method in the treatment of obstructive left-sided colorectal cancer, and may increase primary anastomosis rate, avoid neostomy, reduce short-term complications, and improve the long-term survival compared to emergency surgery.
doi: https://doi.org/10.12669/pjms.36.3.1707
How to cite this:Han L, Song X, Yu B, Zhou M, Zhang L, Safety evaluation of preoperative stent insertion and clinical analysis on comparison of outcomes between preoperative stent insertion and emergency surgery in the treatment of obstructive left-sided colorectal cancer. Pak J Med Sci. 2020;36(3):376-381. doi: https://doi.org/10.12669/pjms.36.3.1707
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.
The development of mouthwashes without anti-gonococcal activity for controlled clinical trials: an in vitro study
Authors: Van Dijck Christophe , Cuylaerts Vicky , Sollie Piet , Spychala Anna , De Baetselier Irith , Laumen Jolein , Crucitti Tania , Kenyon Chris 
Published: February 2020

Background: The oropharynx plays a major role in the development and spread of antimicrobial resistant Neisseria gonorrhoeae among men who have sex with men. Trials are currently assessing the efficacy of bactericidal mouthwashes as possible therapeutic or preventive options against these pharyngeal gonococcal infections. Controlled clinical trials require the use of a placebo mouthwash without anti-gonococcal activity. So far, no such placebo mouthwash has been described. We describe the development of a mouthwash for this purpose. Methods: The in vitro anti-gonococcal activity of Corsodyl®, Listerine Cool Mint®, Biotene®, phosphate buffered saline and six in-house placebo mouthwashes was evaluated. Three gonococcal isolates from patients with pharyngeal infection were exposed to the mouthwashes for a duration ranging from 30 seconds to 60 minutes. Isolates were then plated in duplicate onto blood agar (5% horse blood) and incubated for 24 hours (5-7% CO 2, 35 ± 2°C). Growth of N. gonorrhoeae was scored on a five-point scale (0 = no growth, to 4 = confluent growth of colonies). Results: Corsodyl® and Listerine Cool Mint® were bactericidal to all isolates. For the other mouthwashes, the median growth score after 60 minutes of exposure was 4 (interquartile range 4-4) for phosphate buffered saline; 1 (interquartile range 1-3) for Biotene®; and ranged between 0 and 2 for the in-house composed mouthwashes. An in-house composed mouthwash (Placebo 6) performed best, with a growth score of 2.5 (interquartile range 1-3). Conclusions: All the evaluated potential placebo mouthwashes were bacteriostatic after gonococcal exposure of 30 to 60 minutes. In-house composed Placebo 6 showed less inhibition on gonococcal growth than Biotene® and the other in-house placebos and demonstrates, in our opinion, a good trade-off between anti-gonococcal properties and taste.
“But you have to start somewhere….”: Nurses’ perceptions of what is required to provide quality neonatal care in selected hospitals, Kenya
Authors: Nyikuri Mary , Kumar Pratap , Jones Caroline , English Michael 
Published: February 2020

Background:Kenya has one of the highest rates of neonatal mortality in the world at 22/1,000 live births. Improving the quality of newborn care would greatly improve survival rates. There is an increasing consensus that strong health systems are key to achieving improved health outcomes. However, there is significantly less agreement on what to strengthen in low and middle-income countries such as Kenya. As nurses are the main caregivers in many inpatient settings, efforts aimed at improving the quality of facility care for sick newborn babies need to take into account nurses views and opinions. Our intent in this paper is to describe the current state of the nursing environment and what would be required to improve the quality of those environs from nurses’ perspectives.Methods: Between January 2017 and March 2018, we collected data through non-participant observations, unsolicited conversations and review of admission registers. We also conducted 29 individual in-depth interviews with nurses working in the newborn units (NBU) of a public sector hospital (n=10), a private sector hospital (n=11) and a faith-based hospital (n=8). The interviews were digitally audio recorded, transcribed verbatim and, together with observation notes, analysed using thematic content analysis.Results:Nurses as frontline care givers and intervention intermediaries, irrespective of their work contexts, have similar aspirations, needs and expectations from the health systems of how they should be supported to provide quality inpatient care for newborns. These are about the structure of the work environment, especially human resources for health, and the consequences of inadequate structure. They are also about how care is organised and systems that respond to emergencies.Conclusion:Interventions and investments to improve quality need to be directed towards experienced based co-design where we listen to the problems that nurses experience.
Peri-implantitis: an Unusual Presentation
Authors: Barclay Craig W , Foster-Thomas Emma 
Published: February 2020

Rehabilitation with dental implants is not without post-placement complications, one of which is peri-implantitis. Peri-implantitis is a progressive inflammatory disease which affects the hard and soft tissues around a dental implant. The consequent bone resorption and reduced osseointegration significantly affects the long-term viability of the implant fixture. Without treatment, peri-implantitis can progress in an accelerating, non-linear pattern. The aetiology of peri-implantitis is debated in the literature. Consequently, over the last ten years there have been numerous consensus meetings debating this topic and various guidelines have been written and updated by experts in the field. There is extensive, sometimes conflicting, literature on the subject in the scientific journals. The aetiological factors involved and the management of the condition remains up for debate… In 2011, a new patient attended the University Dental Hospital of Manchester with nine Xive implants (Dentsply Sirona), four maxillary and five mandibular. For various reasons the maxillary implants were all restored, however, only three of the mandibular implants were restored and two were left buried. In 2016, the patient returned with signs and symptoms of peri-implantitis around the most mesial buried implant (LL6 region). The potential reasons why this may have occurred were investigated and forms this case report. CPD/Clinical Relevance: Peri-implantitis may be associated with apparently buried implants.
Fear Factor: Anxiety - a Cause of Delayed Presentation of Oral Cancer
Authors: Nandra Sukbir , Aiyegbusi Oluwatoyin 
Published: February 2020

If oral cancer is diagnosed at an advanced stage, 5-year survival prognosis can be particularly poor. The existing literature indicates that patient anxiety is a contributing factor to patient delay in oral cancer diagnosis. CPD/Clinical Relevance: This article explores the causes of delay in oral cancer diagnosis and encourages practitioners to play an active role in the early diagnosis of oral cancer. Practitioners should appreciate the need to take a holistic approach to patient management and understand that treatment of patients must be tailored to account for their general or specific anxiety issues.
Case Study: Management of Failing Maxillary Bridgework
Authors: Gray David 
Published: February 2020

The current trend, and often gold standard, for replacement of missing teeth is implant-retained fixed or removable prostheses. These, however, are not always suitable, whether due to financial constraints, or the patient wishing to avoid the associated surgical treatment. Utilizing crowns as retainers for partial removable dental prostheses in such cases can provide a favourable aesthetic and functional outcome, whilst avoiding many of the retentive pitfalls that patients fear are associated with a removable appliance. CPD/Clinical Relevance: A systematic approach is required when approaching failing bridgework in order to overcome the unique challenge involving unpredictable abutment status, which often cannot be appraised until the bridgework is dismantled.
Surgical Wound Healing in the Oral Cavity: a Review
Authors: Shah Raunaq , Domah Farya , Shah Nirmal , Domah Javed 
Published: February 2020

Wound healing is a fundamental survival mechanism, largely taken for granted. It consists of four intricately tuned phases: haemostasis, inflammation, proliferation and remodelling. Successful wound healing only occurs if each phase occurs in the correct sequence and timeframe. Moreover, the oral cavity serves as a unique and remarkable setting whereby wound healing takes place in a saliva-filled environment containing millions of micro-organisms. Many local and systemic factors can impair oral wound healing. This article provides an overview of the wound healing process, with a discussion of these respective local and systemic factors, along with the potential cellular and/or molecular mechanisms involved. CPD/Clinical Relevance: On a daily basis, dentists perform procedures such as exodontia and implant placement that rely on adequate wound healing. An improved understanding of the local and systemic factors that can impair oral wound healing can help clinicians to control these factors more accurately, resulting in improved patient outcomes.
Odontogenic Infections with Cutaneous Involvement in Children: a Case Series
Authors: Monteiro Joana , Johnson Adèle , Kandiah Pathanjali , Anand Prabhleen , Fayle Stephen 
Published: February 2020

Cutaneous involvement of dental sepsis is a rare occurrence in children. It often presents as a diagnostic dilemma, especially in the absence of oral symptoms, with initial presentation to non-dental professionals. This article discusses three cases of children presenting with cutaneous involvement of odontogenic origin to two paediatric dentistry departments in the UK. All cases had delayed presentations and were initially submitted to ineffective treatment, with significant impact on the children’s well-being. Final management included antibiotic therapy, drainage and extraction of the septic tooth. These three cases highlight the importance of considering a dental aetiology for localized inflammatory and purulent skin lesions of the mandible. Prompt diagnosis and early treatment are determinant for early resolution and avoidance of systemic or psychological complications. CPD/Clinical Relevance: This article discusses diagnosis and management of three different presentations of odontogenic sepsis with cutaneous involvement in children.
Unusual Presentation of a Pyogenic Granuloma in a 6-Year-Old Child
Authors: Agel Mona , Ahluwalia Meera 
Published: February 2020

A 6-year-old girl was referred for assessment of an oral soft tissue swelling in the anterior maxilla. An asymptomatic, large, erythematous soft tissue mass developed on the alveolar ridge following the loss of the deciduous upper central incisor. Following excision of the lesion, a diagnosis of pyogenic granuloma was confirmed. This case demonstrates the unusual presentation of a pyogenic granuloma in a younger child. These lesions can arise as a reactive response to various stimulating factors and can grow rapidly. Management often involves excision but recurrence risk can be high. CPD/Clinical Relevance: Dentists should not only be aware of the common oral soft tissue changes but should also familiarize themselves with lesions that can occur atypically in children.
The Management and ‘Fate’ of Palatally Ectopic Maxillary Canines
Authors: Seager Leonie , Shah Jinesh , Burke FJ Trevor 
Published: February 2020

With the exception of third molar teeth, the maxillary canine is the most frequently impacted tooth, with the majority of these being palatally ectopic. When patients present with impacted canines there can often be several treatment options available to them. These could include interceptive treatment, exposure and alignment of the canine, extraction of the impacted tooth or acceptance of the deciduous canine. It is important that treatment decisions determining the ‘fate’ of palatally impacted canines should be taken on a case-by-case basis. CPD/Clinical Relevance: The clinician should understand that several options might be available to the patient presenting with a palatally ectopic maxillary canine, in order to allow an informed choice of treatment.
Localized Juvenile Spongiotic Gingival Hyperplasia : a Case Series
Authors: Saunsbury Thomas , Hodgson Tim , Carey Barbara 
Published: February 2020

Localized juvenile spongiotic gingival hyperplasia is a relatively new histopathological diagnosis, presenting as a localized erythematous lesion of the anterior attached gingivae. Presenting in a peri-pubertal age, this condition is often misdiagnosed as ‘puberty gingivitis’. Here, two cases presenting to the Joint Paediatric-Oral Medicine clinic at the Eastman Dental Hospital are discussed.CPD/Clinical Relevance: Localized juvenile spongiotic gingival hyperplasia is a novel diagnosis, and one that is currently under-reported. Increased awareness of this condition is required for appropriate patient management.
Estudio de Revisión de las ventajas e inconvenientes de los Sistemas Personalizados de Dosificación (SPD) y evaluación de su adecuación al perfil del paciente y tipo de farmacia
Authors: Maestre Hernández Ana Belén , Gonzalez Valdivieso María , Arasa Josep , López Pintor Elsa 
Published: February 2020

Los Sistemas Personalizados de Dosificación (SPD) son una herramienta útil para mejorar la adherencia terapéutica desde la farmacia comunitaria. Sin embargo, existen en el mercado multitud de sistemas con características diferenciadoras que es necesario conocer para poder seleccionar la que mejor se adapte al servicio de SPD. El objetivo de este trabajo ha consistido en realizar una revisión de los diferentes tipos de SPD que existen, analizar las ventajas e inconvenientes de cada uno y evaluar su adecuación en función del uso deseado, perfil de paciente y tipo de farmacia. Para dar respuesta a estos objetivos, se ha realizado una revisión de la información por diferentes fuentes y métodos. Se han identificado tres tipos de SPD: manuales, semiautomáticos y automáticos, diferenciándose fundamentalmente en el cierre del blíster, el tipo de sellado, la duración, el personal implicado y la velocidad de elaboración.La selección del SPD depende fundamentalmente del volumen previsto y características del paciente. En general, para una farmacia que desee iniciarse se recomienda un SPD manual no reutilizable por la facilidad de manejo y coste mínimo. En función del nivel de elaboración y las disponibilidades de inversión, podría plantearse un SPD semiautomático. Los robots deberían reservarse para grandes volúmenes de elaboración por suponer una inversión elevada difícilmente amortizable para el actual nivel medio de elaboración de las farmacias españolas.