bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF SUBCOSTAL TRANSVERSUS ABDOMINIS PLANE BLOCK WITH PORT SITE INFILTRATION OF LOCAL ANAESTHESIA IN LAPAROSCOPIC CHOLECYSTECTOMY
Authors: Majeed Kaukab , Shaukat Nazish , Muazzam Muhammad Ali , Khalid Usman , Zafar Junaid , . Sajid 
Published: May 2021

Objective: To compare the efficacy of ultrasound guided subcostaltransversus abdominis plane block and port site infiltration of local anaesthesia in patients undergoing laparoscopic cholecystectomy.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Anesthesiology department, Pak Emirates Military Hospital, Rawalpindi, from Jan to Jun 2019.
Methodology: A sample size of 62 patients calculated by World Health Organization calculator were randomized in a doubleblind study to undergo Sub costal transversus abdominis plane block or port site infiltration by non-probability, consecutive sampling into two equal groups. Group A received sub costal transversus abdominis plane block and group B local anaesthetic. Postoperative pain perception was measured using visual analogue scale.
Results: The mean age of patients in group A was 33.39 ± 8.91 years and in group B was 33.77 ± 8.45 years. Out of 62 patients 38 (61.29%) were males and 24 (38.71%) were females. Mean pain score in group A (ultrasound guided sub costal transversus abdominis plane block) was 1.61 ± 0.91 while in group B (port site infiltration of local anaesthetic) was 3.61 ± 1.05 (p-value 0.0001).
Conclusion: The mean pain score was less following use of ultrasound guided sub costal transversus abdominis plane block in patients undergoing laparoscopic cholecystectomy as compared to port site infiltration of local anaesthesia.
HAEMATOLOGICAL DISORDERS DIAGNOSED IN ONE HUNDRED AND ONE SUCCESSIVE BONE MARROW EXAMINATION AT A TERTIARY CARE CENTRE IN QUETTA, BALOCHISTAN
Authors: Tashfeen Sunila , Asif Naveed , Nasir Shafia , Azam Muhammad , Irshad Zareen 
Published: May 2021

Objective: To determine the frequency of haematological disorders diagnosed by bone marrow examination at a tertiary care centre in Quetta, Balochistan.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Jan 2018 to May 2019.
Methodology: A total of 101 one patients, who underwent bone marrow examination, were included in the study. Brief history, clinical examination and indication of procedure were also endorsed in a questionnaire designed for the study.
Results: Bone marrow of one hundred and one patients, included in the study, were evaluated. Mean age of the patients was 32.3 ± 18.4 years. There were 68 males (67%), while 33 were females (33%) with 2:1 male to female ratio. Pyrexia of unknown origin (PUO) was the most common indication for bone marrow examination with frequency of 20.7%. Nutritional anaemia was the most prevalent benign disorder (17%), whereas Acute Lymphoblastic leukaemia (ALL) accounted about 6.8% which is highest in malignant disorders.
Conclusion: This study has concluded that bone marrow examination is a useful technique and findings of bone marrow can modify the treatment. Thus procedure has a great diagnostic value. Both bone marrow aspiration (BMA) and bone marrow biopsy (BMB) are the complimentary techniques and supremacy of one method on other depends on the disorder.
IS RIGHT DONOR NEPHRECTOMY SAFE? OUR EXPERIENCE IN ARMED FORCES INSTITUTE OF UROLOGY
Authors: Khan Haroon Sabir , Mahmood Arshad , Bhatti Ahsin Manzoor , Sabir Sohail , Alvi Sarwar , Kiani Faaran 
Published: May 2021

Objective: To identify any adversities in the intraoperative and early postoperative outcome of right live-related donor nephrectomy.
Study Design: Cross sectional study.
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2013 to Jul 2015.
Methodology: A total of 143 successive patients underwent open live donor nephrectomies (right=41). Perioperative outcome for both sided procedures were analyzed to identify any difference as regard the intraoperative (warm ischemia time, total duration of surgery, peroperative complications) and early postoperative parameters (days of hospitalization, complications).
Results: No statistically significant difference was found in studied parameters like total operative time, the warm ischemia time, duration of hospital stay and the intra- and early postoperative complications amongst both the groups. The mean warm ischemia time was 86 ± 12 seconds (Rt) versus 90 ± 12 seconds (Lt). The mean time for surgery was 110 ± 18.1 minutes (Rt) versus 121 ± 18.2 minutes (Lt). There were only five minor complications and one major complication.
Conclusion: Right live-related donor nephrectomy is equally safe and feasible option with similar intra-and postoperative complications as for left side. Therefore, whenever required, it is safe to leave the donor with a better functioning kidney.
PAX8 EXPRESSION AND ITS ASSOCIATIONS IN PRIMARY RENAL CELL CARCINOMA: A CROSS SECTIONAL STUDY
Authors: Zamir Ahmed , Akhtar Farhan , Waqar Samina , Hanif Aminah 
Published: May 2021

Objective: To determine the frequency of PAX8 expression in cases of primary renal cell carcinoma (RCC) and its association with patient demographics and tumor type.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi, from Jun 2016 to Jun 2017.
Methodology: After ethics approval, 57 cases were selected by non probability consecutive sampling. Inclusion criteria was diagnosis of primary renal cell carcinoma of all histological types, in both genders, among adults aged >18 years. Exclusion criteria were poorly fixed specimens and metastatic renal cell carcinoma. The main outcome measure was PAX8 frequency in renal cell carcinoma. The secondary outcome measure was correlation of PAX8 expression with age, gender, tumor type and grade. Data was entered and analyzed on Statistical Package for the Social Sciences.
Results: Out of 57 cases, majority were males 37, (64.9%). The mean age was 55.35 ± 12.60 years. Clear cell carcinoma was the most frequent histopathologic variant in 47 (81%) cases followed by papillary carcinoma in 6 (10.2%), chromophobe cell carcinoma 2 (3.5%), sarcomatoid renal carcinoma 1 (1.75%) and mucinous tubular and spindle cell carcinoma 1 (1.75%). PAX8 expression was positive in 52 (91.2%). No significant difference was found in the frequency of PAX8 expression across age (p=0.321), gender (p=1.00) and tumor type (p=1.00). There was significant difference seen across tumor grade p=0.03.
Conclusion: PAX8 is an important additional diagnostic marker for renal cell carcinoma. It can be recommended for inclusion in immunohistochemical panel for diagnosis..............
AMELIORATIVE EFFECT OF BERBERIS VULGARIS FRUIT EXTRACT AGAINST GENTAMICIN INDUCED NEPHROTOXICITY IN ALBINO RATS
Authors: Faisal Lubna , Islam Zia -Ul- , Athar Saima , Iqbal Sadia , Rehman ```Fatima , Ullah Syed Shariq 
Published: May 2021

Objective: To observe the nephroprotective role of berberis vulgar is on renal parenchyma against microscopic and morphometric changes induced by Gentamicin in albino rats.
Study Design: Lab based experimental study.
Place and Duration of Study: It was conducted in Baqai Medical University in collaboration with department of Anatomy Liaquat National Hospital and Medical College, from Jan to Jul 2017.
Methodology: A total of 40 male adult albino rats were used in the study. Four groups were made. Each group contained 10 rats. Group A was a control group, group B received only berberis vulgaris fruit extract orally per day for 21 days, group C received Gentamicin 100 mg/kg/day intraperitonially daily for 21 days. Group D received Gentamicin 100 mg/kg/day intraperitonially along with berberis vulgaris fruit extract 100 mg/kg/day orally. Both kidneys were removed. H&E and PAS stains were used for observing histological alterations and protective role of berberis vulgaris fruit extract.
Results: Glomerulus and proximal convoluted tubules were observed histologically in all 4 groups. Microscopy of group B showed parameters nearly similar to control group. Microscopy of group C showed significant derangement in all parameters when compared with control group. Group C showed decrease glomerular, proximal convoluted tubular count was noted. Glomerular diameter increases and there was glomerular hypertrophy and tubular necrosis. Microscopy of group D showed significant improvement due to berberis vulgaris which restored normal renal architecture.
Conclusion: Berberis vulgaris has a nephroprotective effect and it can be used as a new medicine against nephrotoxic drugs like Gentamicin.
CLINICOPATHOLOGICAL PATTERN OF TESTICULAR TUMORS A 3-YEARS EXPERIENCE AT A TERTIARY CARE UROLOGY CENTER
Authors: Murtaza Badar , Zafar Muhammad Rafiq , Mirza Zahoor Iqbal , Akmal Muhammad , Ahmad Hussain , Sajid Muhammad Tanveer , Din Hafeez Ud 
Published: May 2021

Objective: To evaluate the clinical presentation of testicular tumors and their histological pattern present in our setup.
Study Design: Case series.
Place and Duration of Study: Armed Forces Institute of Urology (AFIU) Rawalpindi, from Jul 2016 to Jun 2019.
Methodology: The documents of all the cases of testicular tumors presenting in the last 3 years were retrieved and their relevant clinical detail: age, clinical presentation, side of involvement, operative procedure conducted and the histopathology report were documented.
Results: Thirty two patients of testicular tumors were documented over a period of three years, making 10.66 cases reporting per year. The mean age was 30.10 ± 15.42 years, with the youngest 3 months old infant and the eldest being 58 years of age. The tumors were commonest on the right (59.3%) with 81.2% presentation as swelling of testis. Radical orchiectomy was performed in 90.6% of the cases and retro peritoneal lymph node dissection (RPLND) in 6.2%. Germ cell tumors were found in 71.8% cases with mixed germ cell tumorbeing the commonest histopathology seen in 31.2% of the cases followed by the seminoma (25%) and non-Hodgkin lymphoma (12.5%).
Conclusion: Testicular tumors were relatively uncommon in our part of the world with a limited number of cases presenting to a tertiary care urology center. The presentation was variable but a rising trend in non-Hodgkin lymphoma results in a decrease in the overall number of germ cell tumors.
COMPARISON OF CLINICAL FAILURES OF LINGUAL RETAINERS BONDED WITH PRIMERLESS FLOWABLE ADHESIVES VERSUS CONVENTIONAL BONDING ADHESIVES
Authors: Akhtar Faheem Nake , Jan Abdullah , Tariq Sana , Khan Mehwish , Saeed Munazza 
Published: May 2021

Objective: To compare the frequency of clinical failure of lingual retainers bonded with primerless flowable adhesives and conventional bonding adhesives.
Study Design: Quasi experimental study.
Place and Duration of Study: Department of Orthodontics, Armed Forces Institute of Dentistry Rawalpindi, from Jul 2017 to Jun 2018.
Methodology: As per selection criteria, 76 patients were selected by non-probability consecutive sampling technique. Patients were divided into two groups: the conventional bonding adhesive and the primerless flowable adhesive group with 38 patients in each group. Retainers were bonded using standardized procedure with conventional bonding adhesive in one group and primerless flowable adhesive for bonding in the other group. After bonding of retainers, patients were recalled after 3 months and any bonding failures were recorded.
Results: Failure rate with conventional bonding adhesive was 10.5% while on the other hand, failure with primerless flowable adhesive was 31.6% with a p-value of 0.047 which showed a statistically significant difference.
Conclusion: There was a statistically significant difference of clinical failure rate of lingual retainers bonded with conventional bonding adhesive versus primerless flowable adhesive with greater failure rate of the primerless flowable adhesive.
POSTPARTUM HEALTH-RELATED QUALITY OF LIFE AMONG MOTHERS: AN ANALYTICAL CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL OF RAWALPINDI
Authors: Ramzan Nadia , Misbah Samreen , Baqai Shehla , Mashhadi Syed Fawad , Sharif Imtenan , Ali Mommana 
Published: May 2021

Objective: The study was conducted to assess the maternal health related quality of life and its affecting factors in postpartum period.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: The study was done in a tertiary care hospital, Rawalpindi, from Mar to Jun 2019.Methodology: By using non-probability purposive sampling technique, sample of 268 women in post-partum period were interviewed. A validated short form-36 (SF-36) Questionnaire was administered to women aged 15-49 years, who had spontaneous vaginal delivery or cesarean section, and were within six weeks up to six months of postpartum period. Data was analyzed by using SPSS-22. A p-value of ≤0.05 was taken as significant.
Results: Highest median scores were reported in physical functioning 75 (55, 90) and social functioning 75 (75, 62). Lowest median scores were reported in energy fatigue 37 (31, 50) body pain 45 (22, 62) and general health 45 (30, 60). Health-related quality of life scores showed significant difference (p-value <0.05) among subgroups of time since delivery, mode of delivery, education of women, husband’s education and antenatal visits.
Conclusion: The study showed that health related quality of life score of postpartum women was moderately affected; where in physical and social functioning domains strongly contributes in better quality of life. Energy/fatigue, body pain and general health are the weakest domains adversely affecting quality of life. Women in subacute postpartum phase, with cesarean section, lower educational status and less than 04 antenatal visits are associated with poorer HRQOL.
EFFICACY OF SACCHAROMYCES BOULARDII IN THE MANAGEMENT OF ACUTE WATERY DIARRHEA
Authors: Munir Misbah , Shah Sajid Ali , Zaman Saeed , Goheer Lutfullah , Bushra Sana , Khan Sajjad Ahmad 
Published: May 2021

Objective: To determine the Efficacy of probiotic (saccharomyces boulardii) in children (2 months to 5 years) with acute watery diarrhea.
Study Design: Comparative cross sectional study.
Place and Duration of Study: This study was carried out in the department of pediatrics, Combined Military Hospital, Quetta, from Jan 2017 to Jun 2018.
Methodology: All children (2 months to 5 years) with acute watery diarrhea presenting within 24 hour of illness with no dehydration and some dehydration were enrolled and divided into two groups, study group and control group. Efficacy was assessed by reduced frequency of stools(less than 3 per day) and duration during the study period.
Results: Mean age of the children in probiotic saccharomyces boulardii group was 3.42 ± 1.36 years, while mean age in control group was 3.91 ± 1.16 years (p-value 0.002). Significant difference was also observed in duration of stool and frequency of stool at day 1-5 (p-value <0.05). Statistically significant difference was observed among children in probiotic sacchramyces boulardii group 114 (53%) as compared to controls 101 (47%) (p-value 0.021).
Conclusion: The Efficacy of probiotic (saccrharomyces boulardii) was found satisfactory in children (2 months to 5 years) with acute watery diarrhea. In children with acute watery diarrhea saccrharomyces boulardii may be recommended for better outcome.
ACUTE PANCREATITIS IN PATIENTS WITH DIABETIC KETOACIDOSIS PRESENTING AT A TERTIARY CARE UNIT
Authors: Hassan Zubia , Fazal Imran , Ashraf Nadeem , Hayat Arshad , Sajjad Kaswar , Zaman Asad 
Published: May 2021

Objective: To determine the frequency of acute pancreatitis among the patients diagnosed with diabetic ketoacidosis at our tertiary care hospital.
Study Design: Co-relational study.
Place and Duration of Study: Medicine department, Pak Emirates Military Hospital Rawalpindi, from Jun to Dec 2019.
Methodology: A total of 40 cases presenting with diabetic ketoacidosis were included in our study. Diabetic ketoacidosis was diagnosed by consultant medical specialist. All patients underwent baseline investigations including serum amylase, lipid profile and CT scan abdomen in order to diagnose acute pancreatitis. Relationship of age, gender, duration of diabetes mellitus and triglyceride levels was assessed with the presence of acute pancreatitis among the patients of diabetic ketoacidosis.
Results: A total of forty patients were managed as diabetic ketoacidosis in our hospital during the study period. Out of them 8 (20%) had acute pancreatitis while 32 (80%) were not diagnosed with acute pancreatitis. Confusion (55%) was the commonest presenting complaint followed by abdominal pain (25%). With binary logistic regression analysis, we found that female gender and raised triglyceride levels had a statistically significant relationship with presence of acute pancreatitis among the patients of diabetic ketoacidosis included in this study.
Conclusion: Considerable number of patients were diagnosed with acute pancreatitis who presented with diabetic ketoacidosis. Special attention should be paid towards female patients and those with raised triglyceride levels to look for the sign and symptoms of acute pancreatitis in order to diagnose and manage this condition.
EARLY VS LATE CAFFEINE THERAPY IN PRETERM INFANTS: ANALYSIS OF CLINICAL OUTCOME
Authors: Niaz Hafsa , Jalil Jawad , Adil Muhammad , Basheer Faisal , Akhtar Shahzad , Hamid Naila 
Published: May 2021

Objective: To study clinical outcome of early versus late caffeine therapy in preterm infants.
Study Design: Prospective comparative study.
Place and Duration of Study: Neonatal Intensive Care Unit, Pak Emirates Military Hospital, Rawalpindi, from Jan to Jul 2018.
Methodology: A total of 40 preterm infants with gestational age <32 weeks and birth weight <1500 grams were randomly divided into two groups on the basis of initiation of caffeine therapy i.e. group A (early caffeine group) and group B (late caffeine group). Infant’s demographic data and clinical outcomes were compared between both groups using SPSS IBM software.
Results: Mean gestational age was 29.9 ± 1.19 weeks with male to female ratio of 1.5:1 Mean birth weight was 1165.3 ± 316 grams. Half (50%) of the infants were delivered by cesarean section while surfactant was given in 29 (72.5%) infants. While comparing both groups we observed that early caffeine shortens duration of Neonatal Intensive Care Unit stay (p<0.05) whereas caffeine therapy initiation timings didn’t influence the risk of development of Respiratory Distress Syndrome or need of mechanical ventilation.
Conclusion: Early caffeine therapy in preterm infants is associated with decrease duration of Neonatal Intensive Care Unit stay. However further work is needed in this regards to establish its efficacy and safety.
BACTERIOLOGICAL PROFILE OF DIABETIC FOOT INFECTIONS AND ITS EFFECTS ON LIMB SALVATION
Authors: Zulfiqar Muhammad Umair , Ghani Umer Fayyaz , Mallhi Ayub Ashraf , Mahmood Khalid , Iqbal Maria , Ans Muhammad 
Published: May 2021

Objective: To assess the bacteriological profile of infected diabetic foot and its relationship with limb salvation among the patients treated for diabetic foot infection at a tertiary setup.Study Design: Correlational study.
Place and Duration of Study: Department of Surgery, Pak Emirates Military Hospital Rawalpindi, from Dec 2018 to Mar 2019.
Methodology: A total of 160 cases of infected diabetic foot were included in the study. Diagnosis of diabetic foot was made by the consultant surgeon and bacteriological analysis was done on the specimen by the microbiology laboratory of the same hospital. Relationship of bacteriological profile and other socio-demographic factors was assessed with limb salvation in these patients.
Results: There were 121 (75.6%) male patients while females were 39 (24.4%). Commonest organism found was Staphylococcus aureus 49 (30.6%) which was followed by pseudomonas 39 (24.4%). Out of 160 patients treated for the diabetic foot infection, 71 (48.4%) had to undergo the process of limb salvation while 89 (51.6%) were managed conservatively. Poly-microbial infection and raised body mass index (BMI) were significantly associated with limb salvation in the target populace (p-value <0.05).
Conclusion: This study depicted high frequency of patients undergoing limb salvation due to diabetic foot infections in our setup. Patients with raised body mass index and those with poly-microbial infection on the culture should be specially attended in order to avoid this irreversible damage to the patient in the process of saving his life from the infective process.
EFFECTIVENESS OF BOTULISM TOXIN IN THE TREATMENT OF ANAL FISSURE
Authors: Bashir Umar , Raza Ahmed , Zafar Afsheen , Majeed Farhan Ahmed , Shabbir Hassan , Mumtaz Moazzam 
Published: May 2021

Objective: To assess the effectiveness, feasibility and acceptability of botulinum toxin in healing chronic anal fissures in our population.
Study Design: Prospective observational study.
Place and Duration of Study: Combined Military Hospital, Multan, from Jan 2019 till Dec 2019.
Methodology: Eighty patients were enrolled in the study out of which 72 completed the study. 33 IU of botulinum toxin A was injected in the intersphincteric groove in the perianal region. Outcome measures for effectiveness included pain score and fissure healing rates at 2, 6, 16 and 24 weeks after the injection. Healing rate was calculated as percentage and pre and post injection pain scores were compared by using paired sample t-test. Patient acceptability was assessed based on the proportion of patients who accepted the treatment. The average treatment cost was also calculated.
Results: A total number of 250 patients were found to be eligible for the study. A purposive sampling technique was used. Eighty patients took part in the study with an acceptability rate of 32%. Seventy two patients completed the study with a completion rate of 90%. Amongst 72 patients, 47 (65.3%) were female and 25 (34.7%) were male. The complete healing rate after 3 months of botulinum toxin injection was 49 (68.1%). There was a significant reduction in pain scores at 2, 6, 16, and 24 weeks of study (p<0.01).
Conclusion: The study supports that Botulinum toxin is an acceptable and effective treatment for anal fissure.
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OVARIAN MASSES IN WOMEN: A RETROSPECTIVE ANALYSIS IN TERTIARY CARE CENTER
Authors: Urooj Uzma , Zohra Sadaf , Akbar Rabiya , Siraj Asifa , Khan Sumaira , Amin Fatima 
Published: May 2021

Objective: To describe the presenting signs and symptoms, clinic-pathological findings of ovarian masses and to establish diagnostic value of clinical examination, ultrasonography and its correlation with histopathological diagnosis.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi Jun 2017 May 2018.
Methodology: Women who underwent surgery for ovarian masses were included. Data was collected from hospital records including; age, presenting symptoms, duration of symptoms, changes in menstrual cycle, and the results of the physical examination. The preliminary diagnoses as well as the final diagnosis were noted.
Results: A total of 83 patients with ovarian masses, who underwent surgery over the period of a year, were included. The most common symptom was abdominal pain in 56 (67.5%) followed by abdominal distention 9 (10.8%), dysmenorrhea 8(9.6%). When both clinical and sonological diagnosis were combined, the overall sensitivity, specificity, positive and negative predictive value for diagnosis and discriminating benign and malignant ovarian neoplasms were 87.5%, 96.7%, 70%, and 98.88%, respectively.
Conclusion: In this study most, common symptom was abdominal pain both in benign and malignant ovarian masses. Whereas, abdominal distention was more common in malignant masses. Preoperative diagnostic approach should always include careful history taking, physical examination, imaging and evaluation of tumor markers. Early detection, thorough treatment and regular follow-up are the need of time to reduce the morbidity and mortality.