bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of silver nanoparticles and two biological treatments to control soft rot disease in sugar beet (Beta vulgaris L)
Authors: Ghazy Nasr A. , Abd El-Hafez Omnia A. , El-Bakery A. M. , El-Geddawy Dalia I. H. 
Published: January 2021

Abstract
Background
Soft rot disease caused by Pectobacterium carotovorum was observed in various crops which lead to yield shortages and economic losses.

Main body
Therefore, both in vitro and in vivo experiments, aim to assess the effect of nanoparticles and biological treatments to control soft rot disease in sugar beet plant. The treatments comprised three silver nanoparticles (Ag NPs) concentrations (50, 75, and 100 ppm), three Spirulina platensis extract concentrations (50, 75, and 100%), and Bacillus subtilis (1 × 109 CFU ml) 100%. Under in vitro condation, results of the antibacterial activity showed that the zones of inhibition recorded 4.33 cm for 100 ppm Ag NPs, 0.43 cm for 100% algal extract, and 0.2 cm for bacterial treatments. Also, disease incidence % of bacterial soft rot was significantly decreased in all treatments in pot and field experiments. For resistant enzymes activity, B. subtilis 100% showed the most effect (84 mg min−1), followed by S. platensis extract 75%, (57 mg min−1), and Ag NPs 75 ppm (44 mg min−1), for poly phenol oxidase (PPO) at 81 days after sowing (DAS), but at 102 DAS revealed opposite results. On the contrary, peroxidase (PO) at 81 DAS showed different effects where treatment with S. platensis extract 100% increased it significantly (0.546 mg min−1) compared to control (0.535 mg min−1). The same trend was observed at 102 DAS. These results were reflected on sugar quality where Ag NPs 100 ppm treatment recorded the highest significant value (20.5%) followed by S. platensis 75% (19 %); however, the differences among them were not statistically significant.

Conclusion
This study indicated that the potential benefits of using silver nanoparticles and two biological treatments to control soft rot disease in sugar beet (Beta vulgaris L).
Endovascular treatment of arteriovenous graft dysfunction as a result of graft delamination and fracture
Authors: Chaurasia Aditi , Garg Tushar , Ahuja Rakesh , Ferra Michael 
Published: January 2021

Abstract
Background
Graft thrombosis due to fabric delamination is a rare cause of delayed failure of arteriovenous grafts. Graft delamination is primarily an imaging diagnosis and is confirmed with the help of ultrasound which shows the separation of graft fabric layers. Only two such cases have been described in the literature so far.

Case presentation
We present a case of upper extremity arteriovenous graft thrombosis in a 79 year old COVID-19 positive patient with end-stage renal disease. The diagnosis was established on ultrasonography which revealed separation of the graft fabric layers with thrombosis within the “false” and “true” lumen of the graft. The patient was managed with angioplasty and embolectomy of the clot material followed by stent-graft placement across the delaminated portion of the graft. Post-procedural angiography confirmed brisk flow across the graft and patient could successfully have subsequent hemodialysis sessions.

Conclusions
Identification of graft delamination as a cause of graft failure is important as its management differs from other conventional causes since it requires stent-grafts to cover the area of delamination to re-establish flow and salvage the AV graft. The recognition of this phenomenon is essential to provide quality care and successful reuse of the AV graft.

Level of evidence
Level 4, Case Report.
Endovascular approaches in pediatric interventional oncology
Authors: Shaikh Raja , Munoz Fernando Gomez 
Published: January 2021

AbstractThe demand for interventional oncological (IO) treatment of pediatric cancers is becoming increasingly common, at least at several tertiary care institutions. The data and techniques used in pediatric IO are largely extrapolated from experience in adult patients. The management of pediatric tumors differs from that in adults in several categories, such as, the curative intent of treatment, wide use of general anesthesia, aggressive pain management, potentially longer hospital stay, variation in chemotherapy dosing etc. Additionally, pediatric cancers are managed by protocols directed by national and international oncology groups such as the Children’s Oncology Group (COG). Consequently, the translation and adoption of these techniques is gradual, but there is a noticeable uptrend due to the growing need. This review will update the current endovascular IO treatments for common pediatric liver, renal, bone and soft tissue tumors.
A Novel Homozygous Missense Mutation in the YARS Gene: Expanding the Phenotype of YARS Multisystem Disease
Authors: Zeiad Rawah K H M , Ferren Edwin C , Young Denise D , De Lancy Shanelle J , Dedousis Demitrios , Schillaci Lori-Anne , Redline Raymond W , Saab Shahrazad T , Crespo Maricruz , Bhatti Tricia R , Ackermann Amanda M , Bedoyan Jirair K , Wood Jamie R 
Published: January 2021

Abstract
Aminoacyl-tRNA synthetases (ARSs) are crucial enzymes for protein translation. Mutations in genes encoding ARSs are associated with human disease. Tyrosyl-tRNA synthetase is encoded by YARS which is ubiquitously expressed and implicated in an autosomal dominant form of Charcot-Marie-Tooth and autosomal recessive YARS-related multisystem disease.
We report on a former 34-week gestational age male who presented at 2 months of age with failure to thrive (FTT) and cholestatic hepatitis. He was subsequently diagnosed with hyperinsulinemic hypoglycemia with a negative congenital hyperinsulinism gene panel and F-DOPA positron-emission tomography (PET) scan that did not demonstrate a focal lesion. Autopsy findings were notable for overall normal pancreatic islet size and morphology. Trio whole exome sequencing identified a novel homozygous variant of uncertain significance in YARS (c.611A &gt; C, p.Tyr204Cys) with each parent a carrier for the YARS variant. Euglycemia was maintained with diazoxide (max dose, 18 mg/kg/day), and enteral dextrose via gastrostomy tube (G-Tube). During his prolonged hospitalization, the patient developed progressive liver disease, exocrine pancreatic insufficiency, acute renal failure, recurrent infections, ichthyosis, hematologic concerns, hypotonia, and global developmental delay. Such multisystem features have been previously reported in association with pathogenic YARS mutations. Although hypoglycemia has been associated with pathogenic YARS mutations, this report provides more conclusive data that a YARS variant can cause hyperinsulinemic hypoglycemia. This case expands the allelic and clinical heterogeneity of YARS-related disease. In addition, YARS-related disease should be considered in the differential of hyperinsulinemic hypoglycemia associated with multisystem disease.
Continuous Glucose Monitoring to Diagnose Hypoglycemia Due to Late Dumping Syndrome in Children After Gastric Surgeries
Authors: Chesser Hannah , Abdulhussein Fatema , Huang Alyssa , Lee Janet Y , Gitelman Stephen E 
Published: January 2021

Abstract
Gastrostomy tubes (G-tubes) and Nissen fundoplication are common surgical interventions for feeding difficulties and gastroesophageal reflux disease in children. A potential yet often missed, complication of these procedures is dumping syndrome. We present 3 pediatric patients with postprandial hypoglycemia due to late dumping syndrome after gastric surgeries. All patients received gastrostomy tubes for feeding intolerance: 2 had Nissen fundoplication for gastroesophageal reflux disease, and 1 had tracheoesophageal repair. All patients underwent multiple imaging studies in an to attempt to diagnose dumping syndrome. Continuous glucose monitoring (CGM) was essential for detecting asymptomatic hypoglycemia and glycemic excursions occurring with feeds that would have gone undetected with point-of-care (POC) blood glucose checks. CGM was also used to monitor the effectiveness of treatment strategies and drive treatment plans. These cases highlight the utility of CGM in diagnosing postprandial hypoglycemia due to late dumping syndrome, which is infrequently diagnosed by imaging studies and intermittent POC blood glucose measurements.
A Rare Case of SARS-CoV-2 Infection Associated With Pituitary Apoplexy Without Comorbidities
Authors: Ghosh Ritwik , Roy Dipayan , Roy Devlina , Mandal Arpan , Dutta Aloke , Naga Dinabandhu , Benito-León Julián 
Published: January 2021

Abstract
Pituitary apoplexy is a medical and surgical emergency caused by hemorrhage or infarction of the hypophysis, which typically occurs within a pituitary adenoma. It is usually characterized by severe (often thunderclap) headache, visual disturbances, cranial nerve impairments, and hormonal deficiencies. We herein report a case of a previously healthy woman with severe acute respiratory syndrome coronavirus 2 infection associated with pituitary apoplexy. The plausible pathophysiological mechanisms of pituitary apoplexy in infectious coronavirus disease 2019 are discussed.
Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial
Authors: Ashfaq Rabia , Riaz Huma 
Published: January 2021

Objective: To compare the effects of Cranio cervical flexion training with and without pressure biofeedback on deep cervical muscular endurance in patients with mechanical chronic neck pain.
Methods: A randomized control trial was conducted at Railway General Hospital Rawalpindi, from May to December 2019. It consisted of thirty participants with the age ranging from 25 to 40 years, and having chronic mechanical neck pain. The participants were randomly allocated into two groups Group-A received Craniocervical flexion training with pressure biofeedback and Group-B received Craniocervical flexion training without pressure biofeedback. The intervention was applied for four weeks (3 sessions per week). Assessments were taken at Pre, Post intervention and after six weeks of follow up. Data analysis was done using SPSS-21 version.
Results: The mean age of Group-A and Group-B was 29.40±3.08 and 31.33±4.95 respectively. Between-group analyses has shown statistically and clinically significant improvement in Group-A regarding deep neck muscles endurance (p<0.05). Whereas within group analysis of both groups A & B showed a statistical and clinically significant difference (p=0.00) for deep neck muscles endurance.
Conclusions: Cranio-cervical flexion training with Pressure Biofeedback has proven to be more effective in improving endurance of deep cervical flexors in patients with mechanical neck pain.
doi: https://doi.org/10.12669/pjms.37.2.2343
How to cite this:Ashfaq R, Riaz H. Effect of Pressure biofeedback training on deep cervical flexors endurance in patients with mechanical neck pain: A randomized controlled trial. Pak J Med Sci. 2021;37(2):550-555. doi: https://doi.org/10.12669/pjms.37.2.2343
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 culture implications on safe work practices and work place exposure incidents in Operation Theater
Authors: Hameed Tahira , Bashir Eitezaz Ahmed , Khan Abdul Qadeer , Ahmad Murtaza 
Published: January 2021

Background & Objectives: The study was undertaken to estimate the prevalence of body and blood fluid exposure incidents such as needle stick injuries, direct contact, splashes, and cuts among health care personnel (HCP) in operation theaters (OTs). The study objective was to investigate perception of safety culture and potential challenges faced by HCP in Pakistani context.
Methods: An analytical cross-sectional survey was conducted in four tertiary care hospitals of Rawalpindi and Islamabad that were Akbar Niazi Teaching Hospital (ANTH), Fauji Foundation Hospital (FFH), Benazir Bhutto Hospital (BBH) and Holy Family Hospital (HFH) during March, 2019 to June, 2019. The data of the current study was collected from surgical staff in OTs at four tertiary care teaching hospitals including nurses, house officers, post graduate trainees, registrars, consultants, and technicians in the twin cities i.e., Rawalpindi and Islamabad.
Results: In our findings (N=367) there was a high prevalence of exposure incidents in past six months, 45% had had got a needle injury, 36% have got a splash, 28.8% had direct contact and 35.6% had a cut once respectively in past six months, the occurrence of exposure incidents twice, thrice and more is also enormous.
Conclusion: The study reflected a dire need of trainings at hospitals so that very strategically the importance of safety being a priority and value of HCP is inculcated on daily basis.
doi: https://doi.org/10.12669/pjms.37.2.2946
How to cite this:Hameed T, Bashir EA, Khan AQ, Ahmad M. Safety culture implications on safe work practices and work place exposure incidents in Operation Theater. Pak J Med Sci. 2021;37(2):379-383. doi: https://doi.org/10.12669/pjms.37.2.2946
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.
Muscle weakness assessment in non-hypoxemic COPD out-patients at tertiary care hospitals
Authors: Zuberi Faisal Faiyaz , Zuberi Bader Faiyaz , Ali Faiza Sadaqat , Bader Nimrah 
Published: January 2021

Objective: To determine frequency of Muscle Weakness in Non-Hypoxemic COPD out-patients and Comparison with age matched non-COPD Controls.
Methods: This cross-sectional study was conducted at OPD of Ojha Institute of Chest Diseases and Medicine, Dow University of Health Sciences, Karachi, Pakistan, during the period 8th September 2019 till 30th May 2020. Patients of both genders aged 25-70 years who were satisfying GOLD criteria for COPD and having SpO2 ≥ 94% were included. An age matched control group was added as control. Hand Grip Strength (HGS) and Chair to Stand time (CST) were recorded.
Results: Two hundred fifty-six patients were inducted with aged and BMI matched group of non-COPD Control patients in ratio of 1:2 (n = 128). Comparison of HGS between Control and COPD Groups showed significant weakness in COPD group. Significant weakness in lower limbs in COPD Group with longer timings to complete the task. Mean FEV1 had significant low values in COPD Group. Age correlated negatively with HGS & positively with CST. BMI correlated positively with FEV1 and CST but negatively with HGS. HGS correlated positively with FEV1 and no correlation was found with CST. No correlation was found of CST with FEV1.
Conclusion: Muscle weakness in COPD patients was shown by simple validated bedside tools. The older COPD patients had less HGS and were slower in doing CST whereas those COPD ones who had higher FEV1 had more HGS.
Abbreviations:COPD: Chronic Obstructive Pulmonary Disease, BMI: Body Mass Index, FEV: Forced Expiratory Volume in first second, GOLD: Global Initiative for Chronic Obstructive Lung Disease, HGS: Hand Grip Strength, CST: Chair to Stand Time.
doi: https://doi.org/10.12669/pjms.37.2.3127
How to cite this:Zuberi FF, Zuberi BF, Ali FS, Bader N. Muscle weakness assessment in non-hypoxemic COPD out-patients at tertiary care hospitals. Pak J Med Sci. 2021;37(2):536-542. doi: https://doi.org/10.12669/pjms.37.2.3127
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.
Health-promoting lifestyle and its association with the academic achievements of medical students in Saudi Arabia
Authors: Al-Momani Mohammed Mahmoud 
Published: January 2021

Objective: This study aimed to assess health-promoting lifestyles among university medical students and to investigate whether such lifestyles are associated with students’ academic achievement.
Methods: A cross-sectional descriptive investigative study was performed on 576 medical college students of King Saud University (KSU) in March 2019. Data were collected using the Health-Promoting Lifestyle Profile II (HPLP II) scale, which includes six dimensions (health responsibility, spiritual growth, physical activity, interpersonal relationships, nutrition, and stress management). The data were analyzed using descriptive and inferential statistics at a significance level of P < 0.05.
Results: A mean score of 3.39 for total health-promoting behaviors was reported. The highest mean score was reported for spiritual growth (3.75) and the lowest was reported for health responsibility (3.23). The mean body mass index (BMI) of the students was 24.9 ± 6.4 kg/m2. An analysis of variance identified an association between a student’s GPA and the spiritual growth dimension (P = 0.014). Based on the Pearson matrix correlation coefficient, there was a statistically significant and positive relationship between the HPLP II dimensions (P < 0.05).
Conclusion: Since the HPLP scores were good, there is a need to enhance and promote healthy behaviors in students. The BMI data indicated that one-third of male students were overweight or obese; thus, health program planning, particularly involving physical activity and nutrition, is recommended.
doi: https://doi.org/10.12669/pjms.37.2.3417
How to cite this:Al-Momani MM. Health-promoting lifestyle and its association with the academic achievements of medical students in Saudi Arabia. Pak J Med Sci. 2021;37(2):561-566. doi: https://doi.org/10.12669/pjms.37.2.3417
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.
Impact of COVID-19 pandemic on the residency programs of the country: A multicentre study
Authors: Alam Laima , Alam Mafaza , Kazmi Syed Kumail Hasan , Kazmi Syed Ashoor Hasan 
Published: January 2021

Objective: To provide an insight on the disruption of multiple facets of residency programs in a multi-centre study.
Methods: This cross-sectional survey was carried out by enrolling the available residents from three teaching hospitals of the country by sending a questionnaire through email. The questionnaire comprised of three parts; 1) basic demographics, 2) effect on multiple facets of training and 3) the use of smart learning with the support provided by the hospitals. Data collection was started during the first week of June 2020 after acquiring ethical approval from the concerned department and the total duration of the study was one month. Data was analysed using SPSS v. 19.0.
Results: A hundred-and-five completed responses were obtained with a response rate of 42%. Fifty-nine percent of the participants were female residents. Majority of the residents (69%) belonged to the age group 25-30 years. Fourth year residents (38%) showed maximum participation and the mean number of work days per month were 22±5.4. All of the aspects of training suffered complete or severe reduction except for the multi-disciplinary team (MDT) meetings, elective rotations and e-log book entries. Sixty seven to sixty-nine percent of the residents felt complete clinical, educational and psychological desertion in their departments, 59% used telemedicine and 90% reported non-availability of smart learning facilities.
Conclusion: Overall, our study confirmed that the COVID-19 pandemic has substantially affected the clinical skills, teaching and personal growth of many trainees. There is a decrease in exposure to almost all of the aspects of training with no alternative in the form of smart learning provided to many. Clinical, educational and psychological support, although an extremely important part of healthcare staffing and management, has been largely neglected as well.
doi: https://doi.org/10.12669/pjms.37.2.3496
How to cite this:Alam L, Alam M, Kazmi SKH, Kazmi SAH. Impact of COVID-19 pandemic on the residency programs of the country: A multicentre study. Pak J Med Sci. 2021;37(2):367-372. doi: https://doi.org/10.12669/pjms.37.2.3496
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.
Fondaparinux-associated Thrombocytopenia
Authors: Malik Jahanzeb , Javed Nismat , Kamin Matiullah 
Published: January 2021

Heparin-induced thrombocytopenia (HIT) is an immune-mediated condition causing thrombocytopenia and paradoxical thrombosis after exposure to heparin or low-molecular-weight heparin. It has been rarely reported by Fondaparinux, an artificial pentasaccharide similar to heparin. This manuscript presents a case of HIT associated with fondaparinux use.
doi: https://doi.org/10.12669/pjms.37.2.3522
How to cite this:Malik J, Javed N, Kamin M. Fondaparinux-associated Thrombocytopenia. Pak J Med Sci. 2021;37(2):598-599. doi: https://doi.org/10.12669/pjms.37.2.3522
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.
Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience
Authors: Safdar Rabia Saleem , Mehar M Faisal , Asghar Afsheen , Buzdar Nusrat 
Published: January 2021

Objectives: To find out frequency, clinicopathological features, response of treatment and outcome among children with primary focal segmental glomerulosclerosis (FSGS).
Methods: This retrospective, non-interventional medical charts review study was conducted from a period of January 2011 to January 2020 at Pediatric Department of Nishtar Medical University Hospital, Multan, Pakistan. During the nine years study period, children of both genders, aged less than 16 years, with renal biopsies proven FSGS were included. Patient’s demographic along with clinical and laboratory data, urine dipstick for proteinuria, renal functions, 24 hours urinary protein and ultrasonography findings of kidneys, ureters and bladder (KUB) were noted from case records. Response rates of various treatment options and their outcome like remission, partial remission, no remission with stable kidney disease & no remission with progression of kidney disease were noted.
Results: During the study duration, out of 307 renal biopsies performed in glomerulonephritis cases, 124 (40.4%) had primary FSGS. In 124 primary FSGS cases, mean age was 8.83±3.05 years while most of the children, 70 (56.5%) were above 10 years of age. Majority of the cases, 64 (51.6%) were male. Mean follow up duration was noted to be 28.35+18.47 months. Most of the cases, 68 (54.8%) were found to have complete remission, 22 (17.7%) partial remission while 11 (8.9%) progressed to ESKD.
Conclusions: Among children, frequency of primary FSGS was high at our setting. Most of the cases achieved sustained remission rates with the help of immunosuppressive drugs. Cyclosporine and tacrolimus were found to be the most effective drugs.
doi: https://doi.org/10.12669/pjms.37.2.3535
How to cite this:Safdar RS, Mehar MF, Khan AA, Buzdar N. Focal Segmental Glomerulosclerosis in Paediatric Population of South Punjab Pakistan: A Tertiary Care Hospital Experience. Pak J Med Sci. 2021;37(2):510-514. doi: https://doi.org/10.12669/pjms.37.2.3535
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.