bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of Intralesional Purified Protein Derivative for Cutaneous Warts: A Meta-analysis
Authors: Obbus Sarah Faye V. , Barit Jay-V James G. , Yap-Silva Claudine 
Published: January 2021

Introduction. Intralesional purified protein derivative (PPD) is an affordable therapeutic option that has been studied for cutaneous warts. However, the lack of good evidence precludes its widespread use.
Objective. To determine the efficacy and safety of intralesional PPD in the treatment of cutaneous warts. Methods. A systematic search for controlled clinical trials comparing intralesional PPD and placebo or any conventional therapy was conducted using electronic databases. The included studies were assessed for risk of bias, and data such as clearance rate of target and distant lesions, recurrence rate, and adverse events were extracted. Analysis was done through RevMan v5.3
Results. Four controlled clinical trials composed of 205 patients were included. All of the studies compared intralesional PPD to placebo as comparator. Intralesional PPD had a significantly higher clearance rate of target wart (RR=0.43[0.22,0.84], P=0.01) and a significantly higher clearance rate of distant lesions (RR=0.59[0.41,0.85], P=0.005) as compared to placebo. However, there was no significant difference in the recurrence rate (RR=0 [-0.07,0.07], P=0.98). Adverse events reported were only considered minor.
Conclusion. Intralesional PPD is an effective and safe treatment option for cutaneous warts. However, more well-structured RCTs with longer follow-up period and those comparing it with conventional treatment are needed to further support its use.
AMOR ENTRE AMORAS: A VIVÊNCIA LÉSBICA NOS CONTOS DE NATALIA BORGES POLESSO
Authors: LEITE Karoline Alves , OLIVEIRA Rita Barbosa de 
Published: January 2021

Neste artigo, propõe-se traçar e analisar o percurso de vivência lésbica em três contos do livro Amora (2015), de Natalia Borges Polesso, dando ênfase às fases de descoberta, aceitação e exploração da afetividade lésbica. Pretende-se refletir a respeito da representação contemporânea da homossexualidade das mulheres na literatura e da afetividade lésbica por meio das personagens dos contos “Minha prima está na cidade”, “Como te extraño, Clara” e “Amora”, que nomeia o livro. Atrelado a isso, discute-se sobre o modo de narrar da escritora e o seu espaço no âmbito literário. Para tanto, emprega-se como aporte teórico as discussões teóricas de Judith Butler, Michel Foucault, bem como os estudos de Tania Navarro-Swain e de Lúcia Facco.REFERÊNCIAS:BUTLER, Judith. Problemas de gênero: feminismo e subversão da identidade. Trad. Renato Aguiar. Rio de Janeiro: Civilização Brasileira, 2003.BRITTO, Milena. Escritas e escritoras: modos de narrar a si mesmo no séc. XXI. Revista Estudos Linguísticos e Literários, nº 59, Jan.-Jun., Salvador, 2018, pp. 100-108. Disponível em: https://portalseer.ufba.br/index.php/estudos/article/viewFile/28860/17069 Acesso em: 26 dez. 2018.DALCASTAGNÈ, Regina. Literatura brasileira contemporânea: um território contestado. Vinhedo, Editora Horizonte. Rio de Janeiro: Editora da Uerj, 2012.FACCO, Lúcia. As heroínas saem do armário: literatura lésbica contemporânea. São Paulo: Edições GLS, 2003.FOUCAULT, Michel. História da sexualidade I: A vontade de saber. Trad. Maria Thereza da Costa Albuquerque e J.A. Guilhon Albuquerque. Rio de Janeiro: Edições Graal, 1988.NAVARRO-SWAIN, Tânia. O que é lesbianismo. São Paulo: Brasiliense, 2004.POLESSO, Natalia Borges. Amora. Porto Alegre: Não Editora, 2015.______. Geografias lésbicas: literatura e gênero. Revista Criação Crítica, n. 20, 2018, p. 3-19. Disponível em:https://doi.org/10.11606/issn.1984-1124.v0i20p3-19 Acesso em: 5 jan. 2019.SANTOS, Claudiana Gois dos; INÁCIO, Emerson da Cruz. A bruta flor do querer: amor, performance e heteronormatividade na afetividade lésbica. Seminário Internacional Fazendo Gênero 11 13th Women’s Worlds Congress (Anais Eletrônicos), Florianópolis, 2017. Disponível em: http://www.en.wwc2017.eventos.dype.com.br/resources/anais/1498785683_ARQUIVO_ABrutaFlordoQuererClaudianaGois13MundodeMulheres.pdf Acesso em: 2 dez. 2018.ENVIADO EM 10-05-19 | ACEITO EM 02-09-19
EVALUATION OF ORTHOSTATIC HYPOTENSION BY USING HUTT
Authors: Khan Qurban Hussain , Asad Muhammad , Baloch Waqas , Naseem Mian Muhammad Amer , Shabbir Muhammad , Hayat Azmat 
Published: January 2021

Objective: To determine the prevalence of orthostatic hypotension in our patient population by using Head Up Tilt Test (HUTT).
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Cardiology & National institute of heart diseases, from Jan 2019 to Jan 2020.
Methodology: Head Up Tilt Test registry was used as a data collection tool which consisted of gender, age, symptoms, number of episodes, results, baseline blood pressure systolic, baseline blood pressure diastolic, mean blood pressure, baseline heart rate. All patients from age 20-80 undergoing Head Up Tilt Test examination were included while patients already diagnosed with orthostatic hypotension, vasovagal syncope, and cardiac myopathy were excluded from the study.
Results: Total 1587 individuals were enrolled in study, I1216 (76.6%) were males and 371 (23.4%) were females. The mean age of the study population was 45.63 ± 19 years. The results determined 67.6 (4.2%) were negative, 7(0.4%) had Vasodepressive Response of vasovagal reflex, 1435 (90.4%) had positive type 1; while 1 (0.1%) had positive type 2; and 4 (0.3%) had positive type 3; 62 (3.9%) had mixed vasovagal reflex, 1 (0.1%) had late orthostatic response and 10 (0.6%) had orthostatic hypotension.
Conclusion: Tilt-table testing is an effective method to diagnose orthostatic hypotension.
ANESTHETIC CONCERNS IN PAEDS CARDIAC CATHETERIZATION AT ARMED FORCES INSTITUTE OF CARDIOLOGY / NATIONAL INSTITUTE OF HEART DISEASES
Authors: Amna Dr , Niaz Naila , Farid Zainab , Younas Umair , Javaid Rehana 
Published: January 2021

Objective: To examine the types of procedures and analyze the frequency of anesthesia-related complications during pediatric cardiac catheterization.
Study Design: A prospective observational study.
Place and Duration of Study: Pediatric Cardiac Catheterization Lab at AFIC/NIHD Rawalpindi, from July 2019 to Nov 2019.
Methodology: Total 180 consecutive patients undergoing cardiac catheterization fulfilling inclusion criteria were studied. Demographic variables, diseases, type of procedure, variables and anesthesia-related complications were noted. All the data was analyzed using SPSS-23.
Results: The study included180 patients where 96 (53.3%) were male and 84 (46.7%) were female. Most of the patients in our study were between ages 1 to 3 years (85). 99 (55.0%) patients had diagnostic cardiac catheterizetion (CC), while 81 (45%) patients underwent interventional procedures. The overall complication rate noted as 18.9%, including arrhythmia in 11.1% followed by hypotension 4.4%, laryngospasm 3.9% and inotropic support requirement 3.3%, Mortality was 0.6%. Most of the patients presenting to the pediatric cardiac catheterization lab were for PDA device closure (16.6%). Age of child was found to be significant risk factor for cardiac catheterizetion associated complications with a p-value of 0.022.
Conclusion: Congenital and structural heart disease catheterization procedures are progressively increasing, especially due to the medical advances and complex interventional therapeutic procedures. A thorough preanesthesia assessment should be carried out to optimize before cardiac catheterization.
ANTICOAGULATION CONTROL AMONG PATIENTS WITH ATRIAL FIBRILLATION
Authors: Rauf Amer , Hayat Azmat , Shah Noor , Abbas Kumail , Khalid Waqas , Gilani Sayed Tanveer Abbas 
Published: January 2021

Objective: To assess adequacy of anticoagulation in Warfarin treated patients with atrial fibrillation
Study Design: Prospective observational study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, Rawalpindi, from Nov 2019 to Apr 2020.
Methodology: All individuals fulfilling the inclusion criteria were enrolled in the study after their consent. Based upon their serial International Normalized Ratio (INR) values, Time in Therapeutic Range (TTR) was calculated using Rosendaal method. A TTR>70% was a marker of adequate anticoagulation. Factors associated with TTR <70% were identified.
Results: Total 70 participants were included in the study. Mean age (± SD) was 51.43 (± 11.27) years. Thirty four (48.6%) were males and 36 (51.4%) were females. Twenty four (34.3%) had valvular atrial fibrillation while 46 (65.7%) had non-valvular atrial fibrillation. Overall, TTR>70% was observed in 29 (41.4%) of study participants. Poly-pharmacy and multiple co-morbidities were identified as statistically significant factors associated with subtherapeutic anticoagulation (TTR<70%).
Conclusion: Determined TTR of study population indicates poor anticoagulation control in majority of patients being anticoagulated with Warfar in highlighting the need for focused interventions such as dedicated anticoagulation clinics and patient education.
IMMEDIATE RESULTS OF PERCUTANEOUS TRANS-MITRAL COMMISSOROTOMY IN JUVENILE MITRAL STENOSIS
Authors: Beg Ahsan , Younas Muhammad , Mahmood Amjad , Shervani Mubashar , Fayaz Fakher -e- 
Published: January 2021

Objectives: Immediate result of PTMC in juvenile (5-12 years) rheumatic mitral stenosis.
Study Design: Observational descriptive and retrospective study.
Place and Duration of Study: Institute of Cardiology, Multan from 2009 to Jun 2020.
Methodology: This is an observational descriptive and retrospective study carried out at Institute of Cardiology, Multan from 2009 to Jun 2020. Patients with clinical evidence of significant mitral stenosis were undergone transthoracic echocardiography. Mitral stenosis was defined as mitral valve area <1.0 cm2 . Mean mitral valve gradient was calculated by mitral valve inflow velocities. Patients with Wilkins score <8 were included. Patients with significant MR, left atrial or atrial appendage clot, infective endocarditis, significant aortic regurgitation or any other indication for bypass surgery were excluded. Patients with Wilkins score >8 were also excluded from the study. Variables recorded on a performa were age, weight, left atrial size, mean mitral valve gradient, preprocedure MR. Reduction of mitral valve mean pressure gradients to less than <50% of the initial value was defined as success (without significant or moderate MR). After the procedure, variables recorded on performa were mean left atrial pressures in mmHg (on angio), mean mitral valve gradients and degree of MR (mild, mild to moderate, moderate or severe MR) on transthoracic echocardiography. Paired t-test of significance (p<0.05) was evaluated using SPSS (version 20).
Results: Forty three juvenile patients were included the in the study (2009 to June 2019). Mean age was 10.8 ± 1.4 (range 7-12) years. Mean weight was 28.9 ± 5.2 (20-37) kg. Mean mitral valve gradient (on TTE) before the procedure was 20 ± 6 mmHg. Mean left atrial size and mean area of mitral valve were 42 ± 5 mm and 0.8 ± 0.2 cm2 respectively. Balloon sizes used were 26 mm (n=19) and 24 mm (n=24). After PTMC, mean mitral valve reduced to 7 ± 2 mmHg (p<0.005) and left atrial pressure to 18 ± 7 mmHg. Post procedure transthoracic echocardiography showed 4.7% (n=2/43) patients developed moderate to severe or severe MR. So the success rate was 95.3% (n=41/43).
Conclusion: PTMC is safe and effective procedure for juvenile patients with mitral stenosis. Long term follow-up is needed to find out period of re-intervention/surgery free duration from the time of PTMC.
DOES AUTO TRANSFUSION OF UNPROCESSED RESIDUAL BLOOD IN THE CARDIOPULMONARY BYPASS CIRCUIT LEAD TO UNFAVORABLE OUTCOMES?
Authors: Siddiqeh Musfireh , Khan Imran , Zamir Ali Gohar , Janjua Asif Mehmood , Munir Beenish , Anjum Qudsia 
Published: January 2021

Objective: Transfusion of residual blood left in the cardiopulmonary bypass circuit is recommended. Whether this blood should be processed or not before transfusion is not known.
Study Design: A prospective non-randomized case control study.
Place and Duration of Study: A tertiary care heart center, from Jan 2016 to Dec 2018.
Methodology: A prospective non-randomized case control study was designed. Consecutive patients operated at a tertiary care hospital were included in the study who underwent different open-heart procedures on cardiopulmonary bypass. Patients were divided into two groups. Those who received the unprocessed residual blood transfusion, residual volume retransfused at the end of cardiopulmonary bypass and those who did not, residual volume not retransfused (RVNR). Important perioperative data was collected from the hospital database andanalyzed using IBM SPSS-statistics 23.0 (IBM, SPSS Inc., Chicago, IL).
Results: Of the 120 patients, 56 patients were included in the RVR group and 64 in the RVNR group. Mean age in the RVR group was 49.41 ± 14.38 years and in the RVNR group 49.27 ± 16.36 years (p=0.96). Female patients were 9 (16.07%) in the RVR group and 20 (31.25%) in the RVNR group. Residual blood left in the circuit was 271.43 ± 52 ml in the RVR group and 264.06 ± 54.5 ml in the RVNR group (p=0.45). Hemoglobin measured in ICU was 10.5 ± 1.12 gm/dl in the RVR group and 9.97 ± 1.25 gm/dl in the RVNR group (0.02). Blood products were needed in 27 patients in RVR group and 21 patients in RVNR group (p=0.57). There was no significant difference between the two groups with respect to total drainage in the first 24 hours (p=0.89). Similarly, the re-exploration rates were not different between the two groups (p=0.50).
Conclusion: Re-transfusion of residual blood left in the CPB circuit is a safe practiced. If this blood is transfused in an unprocessed form, it does not lead to adverse outcomes.
PREVALENCE OF CONGENITAL HEART DISEASE IN UMERKOT
Authors: Saif Mohsin , Fatah Abdul , Akhtar Waqas , Javed Farah , Tahir Ali Mujtaba , Hussain Muhammad 
Published: January 2021

Objective: To study the prevalence and the pattern of distribution of congenital heart disease.Study Design: Descriptive cross-sectional study.Place and Duration of Study: The study was conducted at outpatient department (OPD) of CMH Chhor and DHQ Umerkot, Sindh (Pakistan), from Dec 2019 to Mar 2020.Methodology: All the children (<12 years age) presenting to Paediatric OPD of the two hospitals were enrolled into study. Any patient with either a history or clinical examination pointing towards a suspected congenital heart disease was referred to Paediatric Cardiologist for 2-D echocardiogram. Details of the patient were recorded on designated proforma.
Results: A total of 273 patients were diagnosed with congenital heart disease. Out of these, 114 (41.7%) were female and 159 (58.2%) were male (male: female of 1.4:1). The age of the children was ranging from 2 months to 12 years, 153 (56.04%) had simple heart defects, while 120 (43.9%) had complex or multiple congenital heart anomalies. Amongst the 273 patients, 25.3% were cyanotic and 74.7% had acyanotic heart disease. Most common lesion identified was ventricular septal defect (29.6%), followed by Tetralogy of Fallot in 20.8%.
Conclusion: Acyanotic heart defects confirms to the major bulk of congenital heart defects with male preponderance.
COMPARISON OF INTRACORONARY VERAPAMIL VS ADENOSINE FOR RESTORATION OF CORONARY BLOOD FLOW POST PERCUTANEOUS CORONARY INTERVENTION (PCI) IN PATIENTS WITH NO-REFLOW
Authors: Saif Mohsin , Rahman Obaid -Ur- , Amin Muhammad Umar , Khan Hamid Sharif , Maken Ghulam Rasool , Bhatti Qamar-Uz-Zaman , Aziz Zohair , Janjua Anam Fatima , Aziz Sohail 
Published: January 2021

Objective: To determine the efficacy of intracoronary verapamil vs adenosine in restoration of coronary blood flow, post PCI in patients with No-Reflow.
Study Design: Double blind (patient/operator blind) randomized control trial.
Place and Duration of Study: Cath lab of AFIC & NIHD Rawalpindi, from Feb 2019 to Aug 2019.
Methodology: A total of ninety (n=90) patients of either gender between age 25-80 years of age who underwent angioplasty for STEMI/NSTEMI demonstrating No-Reflow (thrombolysis in myocardial infarction 0,1,2) post PCI were enrolled and were randomized into two groups. Group A received verapamil 500 µg in 10 ml heparinized saline, given slowly over 1 minute and group B received adenosine 60 µg in 10 ml of heparinized saline, given quickly. After the administration of both drugs repeat angiogram was carried out and thrombolysis in Myocardial Infarction flow was assessed. Restoration of blood flow was defined as achievement of thrombolysis in myocardial infarction 3 grade.
Results: Efficacy (restoration of thrombolysis in Myocardial Infarction grade 3) was better with intracoronary administration of verapamil when compared with intracoronary administration 2 of adenosine (84.4% vs 80%). The difference was, however, not statistically significant (p=0.581).
Conclusion: Efficacy (restoration of thrombolysis in myocardial infarction grade 3) was not statistically significant between intracoronary administration of verapamil and adenosine in no-reflow cases after PCI in patients with STEMI/NSTEMI.
FREQUENCY OF RIGHT VENTRICULAR INFARCTION AND IN-HOSPITAL OUTCOME AFTER PRIMARY PERCUTANEOUS CORONARY INTERVENTION (PPCI) IN ACUTE INFERIOR MYOCARDIAL INFARCTION (MI)
Authors: Saif Mohsin , Safi Shoaib Iqbal , Samin Ariz , Rahman Fahd -ur- , Bukhari Jasia , Khan Sajid 
Published: January 2021

Objective: To determine the frequency of Right Ventricle infarction and in-hospital outcome after primary percutaneous coronary intervention in patients with acute inferior MI.
Study Design: Descriptive Cross Sectional Study.
Place and Duration of Study: Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Dec 2018 to Jun, 2019.
Methodology: Non-probability consecutive sampling technique was used. Permission was sought from hospital ethical committee and informed consent was taken from participants of the study. Patients presenting with acute inferior MI who underwent Primary Percutaneous Coronary Intervention were assessed for presence of Right Ventricle infarct. All the patients’ data and variables of the study was recorded in the data collection sheet. Patients underwent venous blood sampling for Complete blood count, Renal function tests, Liver function tests, Blood glucose random, Troponin-I, cardiac enzymes and Coagulation profile at presentation in emergency department.
Results: Total 261 patients were included according to the inclusion criteria of the study. Mean age (years) in the study was 58.0 ± 12.59 whereas there were 183 (70.1) male and 78 (29.9) female patients who were included in the study. Frequency of right ventricular infarction and in-hospital outcome (mortality) after Primary Percutaneous Coronary Intervention in patients with acute inferior MI was assessed in the study which was 73 (28.0) and 20 (7.7) respectively.
Conclusion: The study concluded that frequency of in-hospital mortality is substantial due to major adverse cardiac events in patients with right ventricle infarction.
IMPLANTABLE CARDIAC DEVICE INFECTION - A CLINICAL AUDIT
Authors: Asad Muhammad , Khan Qurban Hussain , Baloch Mir Waqas , Khan Kumail Abbas , Naseem Muhammad Amer , Hayat Azmat , Shah Noor 
Published: January 2021

Objective: Cardiac Implantable Electronic Devices are being implanted more commonly now compared to the past. Due to the rise in implantation rate complication have also considered to increase. One of the dreadful complications is devices infection. This study was conducted to assess retrospectively the rate of device infection and risk factors associated with it.
Study Design: Observational study.
Place and Duration of Study: AFIC/NIHD, Rawalpindi, from Jan 2018 to Jan 2019.
Methodology: A total of 356 patients who underwent cardiac devices implantation. Their records were studied and all the patients who developed device infections were further reviewed in detail. Demographic details, clinical, laboratory data and imaging records were evaluated. Patients were classified into different categories of infections based on predefined criteria according to the guidelines. Risk factors were also taken into account.
Results: Out of 356 devices 14 got infected and infection rate was 3.9%. Generator site infection was seen in 6 followed by generator erosion in 5 while 2 had pocket site infection with bacteremia and 1 developed pocket site infection with lead/valvular endocarditis. Dual chamber permanent pacemakers were infected the most. Denovo devices had high infection rate compared to replacement. Microbes were identified in 3 patients.
Conclusions: Our findings suggest that the increasing incidence of Cardiac Implantable electronic devices infection in current clinical settings was multifactorial. Care should be taken at every step starting from preoperative, intraoperative to postoperative stage for prevention of device infection.
CLINICAL OUTCOME OF PATIENTS ADMITTED WITH ACUTE ANTERIOR VERSUS ACUTE INFERIOR WALL MYOCARDIAL INFARCTION
Authors: Khan Moazzam , Khan Imtiaz Ahmed , Samore Naseer Ahmad , Kamran Javeria , Janjua Anam Fatima , Mustafa Ahmed , Iqbal Rashid , Ahmed Usman , Ahmed Fiaz , Aziz Sohail 
Published: January 2021

Objective: To determine the clinical outcome of patients admitted with acute anterior versus acute inferior wall myocardial infarction.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: The study was conducted in emergency departments and adult cardiology wards of Armed Forces Institute of Cardiology/National Institute of Heart Diseases, from Aug 2019 to Nov 2019.
Methodology: This study was conducted on 340 patients (208 patients with Anterior wall myocardial infarction and 132 patients with inferior wall MI who presented with Acute ST-Elevation MI) to emergency department of Armed Forces Institute of Cardiology/National Institute of Heart Disease during specified period. Outcome was calculated using Electrocardiogram, Two-dimensional transthoracic echocardiogram, Troponin-I, baseline investigations and coro angiography Data was entered and analyzed with SPSS-23.
Results: Mean age was 59.38 ± 12.91 years in each group. In clinical symptoms chest pain was highest n=255 (71.4%) followed by diaphoresis 55 (15.4%) and breathlessness 51 (14.3%). The most common complications in patients with inferior wall MI were brady arrhythmia 8 (2.3%) whereas left ventricular failure 41 (12.1%) was more prevalent in patients with anterior wall MI after TVCAD. The results of cardiogenic shock 5 (1.5%),ventricular tachycardia 3 (0.8%) in inferior wall myocardial infarction were comparative to the results of cardiogenic shock 18 (5.3%) ventricular tachycardia 2 (0.5%) in anterior wall myocardial infarction. The number of stable patients was 91 (43.7%) in Anterior wall myocardial infarction and 51 (38.6%) in inferior wall MI.
Conclusion: The study shows the comparative clinical outcome of anterior wall myocardial infarction versus inferior wall myocardial infarction.
El desafío de la educación en una sociedad democrática
Authors: Llaña Mena Mónica 
Published: January 2021

La escuela contemporánea enfrenta inéditos desafíos. Asume inesperadas tensiones y debe resolver conflictos que impiden la consecución de sus fines potenciadores del desarrollo humano. Por ello, se sostiene en el texto la urgencia de fortalecer en los procesos formadores, las ciencias de la educación que apoyen en las nuevas generaciones de profesores, la comprensión de la compleja realidad en que se insertan los sistemas educativos en la sociedad contemporánea.
Comprensión que los lleve a articular marcos teóricos multidisciplinarios con la acción educativa en aula. Es decir, lograr la recurrente e indispensable conexión teoría–práctica.
En ese marco se analizan las profundas transformaciones socioculturales que constituyen el gran desafío para la educación y que afectan a sus actores principales: profesores y alumnos. Estos actores, al otorgar significados opuestos a su experiencia educativa, alimentan tensiones y conflictos que impiden el logro de una imprescindible y real equidad.