bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improved support vector machine algorithm based on the influence of Gestational Diabetes Mellitus on the outcome of perinatal outcome by ultrasound imaging
Authors: Liu Hehua , Liu Jie 
Published: September 2021

Objectives: In order to understand the incidence and epidemiological characteristics of gestational diabetes mellitus, the ultrasound imaging of support vector machine processing algorithm was used to clarify the outcome of maternal and neonatal gestational diabetes mellitus.
Methods: This study selected clinical data of 12,190 pregnant women who were hospitalized for delivery, and were divided into diabetic group (1268 cases) and control group (10922 cases) according to the diagnosis of gestational diabetes. The study was conducted from January 1, 2012 to December 31, 2019. Colour Doppler ultrasound was performed to record fatal umbilical artery and brain the middle arteries and uterine arteries which are effective indicators of measuring fatal intrauterine conditions. Chi-square test was used to compare the rates between groups, and multivariate logistic regression was used for labour outcomes.
Results: The incidence of diabetes during pregnancy is about 10.4% (1268/12190). Senior citizens and women suffering from obesity increase the risk of gestational diabetes, maternal hypertension disorders in pregnancy, premature rupture of membranes, oligohydramnios, fatal distress, multiple births, malpresentation risk increased significantly (P<0.05) than the control group. In gestational diabetes caesarean section rate was significantly higher (61.0% vs46.4%). Caesarean new born 5-minute Apgar score was significantly lower than the control group (P<0.05).
Conclusion: In maternal gestational diabetes in high risk pregnancies, complications of pregnancy significantly increase the importance of enhancing weight management and blood glucose monitoring to reduce complications.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4855
How to cite this:Liu H, Liu J. Improved support vector machine algorithm based on the influence of Gestational Diabetes Mellitus on the outcome of perinatal outcome by ultrasound imaging. Pak J Med Sci. 2021;37(6):1625-1629. doi: https://doi.org/10.12669/pjms.37.6-WIT.4855
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.
Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications
Authors: Liu Na 
Published: September 2021

Objective: This study used phased array imaging algorithm to explore the epidemiological characteristics of endoscopic treatment of upper gastrointestinal foreign bodies to provide a basis for nursing intervention.
Methods: We collected data on the age, sex, cause, type of foreign body, success rate of removal, retention location, time and complications of patients with foreign bodies in the upper gastrointestinal tract who were treated in the emergency department of the Digestive Endoscopy Center in our hospital. The study was conducted from January 2018 to December 2020 and we also performed statistical analysis.
Results: The high incidence of foreign bodies in the upper digestive tract was in 45 years old to 74 years old patients. The foreign body types were mostly food balls and sharp foreign bodies, accounting for 37.0% and 44.2%, respectively. The cause was misuse and the most accounted for 52.1%, followed by oesophageal pathological stenosis which accounted for 45.5%. The oesophagus in the retention site accounted for up to 80.0%, and the success rate of foreign body extraction was 96.4%. The complications of patients with foreign body retention within twenty four our retention were mainly esophageal scratches and traumatic esophagitis, accounting for 48.5%. 39.6%.
Conclusion: There are high risks in the treatment of foreign bodies in the upper digestive tract. Targeted, prospective, and streamlined nursing interventions can provide patients with fast and professional medical care services and minimize patient pain.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4858
How to cite this:Liu N. Endoscopic Image-guided treatment of Upper Gastrointestinal foreign body and nursing care of complications. Pak J Med Sci. 2021;37(6):1636-1640. doi: https://doi.org/10.12669/pjms.37.6-WIT.4858
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 effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm
Authors: He Naxin , Shi Liang 
Published: September 2021

Objective: The study used the optimized nuclear regression reconstruction algorithm to explore the value of three-dimensional perineal ultrasound evaluation of the effect of caesarean delivery and caesarean section on the anal sphincter complex of primipara.
Methods: This study performed three-dimensional perineal ultrasound scanning of the anal sphincter complex of 157 primiparas 42 days after delivery. Among them, 77 were in caesarean delivery (spontaneous delivery group) and 80 were in caesarean section (caesarean delivery group) from September 2018 to December 2020 in our hospital. The thickness of the end plane, the middle plane, the distal plane and the distal plane of the external anal sphincter at 3, 6, 9, 12 o’clock direction, and measure the thickness of the central plane of the pubic rectum muscle at 4, 8 o’clock direction. At the same time, the study used tomography and volume contrast imaging to observe the morphology and integrity of the anal sphincter complex.
Results: The thickness of the distal anal sphincter at the 12 o’clock direction, the proximal anal sphincter at 6, 12 o’clock, and the central plane at 9 and 12 o’clock in the obstetric group were smaller than those in the caesarean section group (all P < 0.05). There were no significant differences in the thickness of the remaining anal internal and external anal sphincter and puborectalis muscles between the two groups in different directions (all P>0.05). In the obstetric group, a perineal sphincter defect was found via three-dimensional perineal ultrasound.
Conclusion: The delivery method has a certain influence on the shape of the anal sphincter complex. The thickness of the internal and external anal sphincter of the primiparous women in a certain direction is significantly smaller than that of caesarean section. Transperineally three-dimensional ultrasound can clearly show the morphological characteristics and integrity of the anal sphincter complex, and diagnose the defect of the anal sphincter complex.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4859
How to cite this:He N, Shi L. The effect of vaginal delivery and Caesarean section on the anal Sphincter complex of Primipara based on optimized three-dimensional ultrasound image and nuclear regression Reconstruction Algorithm. Pak J Med Sci. 2021;37(6):1641-1646. doi: https://doi.org/10.12669/pjms.37.6-WIT.4859
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.
Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants
Authors: Wang Chunying , Shi Yunlong , Ji Jianwei 
Published: September 2021

Objectives: The paper uses block matching method combined with echocardiography to explore the value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in predicting symptomatic patent ductus arteriosus (PDA) in preterm infants.
Methods: We selected premature infants born between February 2019 and March 2020, gestational age ≤32 weeks, and echocardiography within 48 hours to determine the presence of arterial ducts as the research object, monitor their clinical manifestations, and detect serum at three and five days after birth The level of NT-proBNP was checked with echocardiography, and the children were divided into PDA group and asymptomatic patent ductus arteriosus (aPDA) group according to the clinical manifestations and echocardiographic.
Results: The area under the ROC curve of PDA predicted by serum NT-proBNP level at 3 days after birth was 0.949, the cut-off value was 27035pg/mL, the sensitivity was 92.3%, and the specificity was 94.6%; serum NT-proBNP level at 5 days after birth predicted the ROC curve of PDA The lower area is 0.924, the critical value is 6411 pg/mL, the sensitivity is 92.3%, and the specificity is 92.9%.
Conclusion: NT-proBNP may be a quantitative indicator of arterial duct shunt; the detection of serum NT-proBNP levels at 3 and 5 days after birth is helpful for early prediction of PDA.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4864
How to cite this:Wang C, Shi Y, Ji J. Application of block matching method-based Echocardiography combined with serum NT-PROBNP level detection in the early prediction of PDA in premature infants. Pak J Med Sci. 2021;37(6):1657-1661. doi: https://doi.org/10.12669/pjms.37.6-WIT.4864
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.
Neurological safety of spinal surgery for nucleus pulposus removal under spinal endoscopic imaging guided by inter laminar spine
Authors: Chen Bin , Du Zengfeng 
Published: September 2021

Original Article
Bin Chen1, Zengfeng Du2
ABSTRACTObjective: To explore the technical points, approach selection and short-term clinical efficacy of PELD through the intervertebral foramina or interlaminar approach in the treatment of highly shifted LDH. Methods: From September 2018 to June 2020, 19 patients with highly shifted LDH were treated with PELD in The First Hospital of Yulin. It included, 10 males and 9 females; aged 34 to 69 years, with an average of 48 years. Thirteen cases were shifted to the caudal side, and six cases were shifted to the head side. The responsible segments included L3/41 cases, L4/511 cases, and L5/S17 cases. All patients had symptoms of low back and leg pain. The Sowerby dysfunction index (ODI) was 63.5%±10.7% before surgery. The visual analogue scale of pain (VAS) was low back pain (5.2±2.1) and leg pain (7.1±2.4). 14 cases used transforaminal approach, and 5 cases used translaminar approach. Results: All cases completed the operation successfully, the operation time was 60~110min, with an average of 70 minutes. The follow-up time ranged from 6 to 42 months, with an average of 20.8 months. At the last follow-up, ODI was 10.8%±6.8%, VAS back pain score (2.1±1.1) and leg pain score (1.8±0.9). Compared with preoperative, ODI and VAS scores were significantly decreased (P<0.05). The results of Mac Nab method were 14 excellent, four good, and one fair. During the follow-up period, one patient’s leg pain symptoms recurred seven days after operation. No further hernia was found under intervertebral foramen. The symptoms disappeared after two weeks of symptomatic treatment such as swelling and analgesia, and he was discharged. No perioperative complications such as infection and nerve root injury occurred. Conclusion: When PELD is used to treat high-displacement LDH, the choice of transforaminal approach or interlaminar approach needs to be personalized according to the LDH segment and the direction of displacement.
KEYWORDS: Spinal Surgery, Spinal Endoscopic Imaging, Inter Laminar Spine, Nucleus Pulposus Removal.
doi: https://doi.org/10.12669/pjms.37.6-WIT.4880How to cite this:Chen B, Du Z. Neurological safety of spinal surgery for nucleus pulposus removal under spinal endoscopic imaging guided by inter laminar spine. Pak J Med Sci. 2021;37(6):1667-1671. doi: https://doi.org/10.12669/pjms.37.6-WIT.4880
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.
Medical Image and Physics Analysis of Human Physiology and Dysfunction
Authors: Wu Shaofei , Li Hailong 
Published: September 2021

Note form the Guest Editors
doi: https://doi.org/10.12669/pjms.37.6-WIT.5005
How to cite this:Wu S, Li H. Medical Image and Physics Analysis of Human Physiology and Dysfunction. Pak J Med Sci. 2021;37(6):1550-1552. doi: https://doi.org/10.12669/pjms.37.6-WIT.5005
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.
Hospital readmissions in Internal Medicine Specialty: Frequency, associated factors and outcomes
Authors: Fatima Samar , Shamim Sara , Riffat Simra , Tariq Muhammad 
Published: September 2021

Objectives: Hospital readmission has become a focus of national attention as a potential indicator of healthcare quality and has a significant financial impact on healthcare system. Limited data is available regarding readmissions to Internal Medicine specialty from our sub-continent. It is, therefore, essential to determine the frequency and factors leading to readmissions, in order to avoid preventable readmissions and improve quality of healthcare provision.
Methods: This retrospective study reviewed adult discharges from Internal Medicine specialty between October 2018 and February 2019 at Aga Khan University Hospital. Out of 1,835 discharges, 491 were randomly selected after excluding expiries. The frequency, factors and outcomes of readmission were noted. The studied outcomes included length of stay and in-hospital mortality.
Results: Out of 491 patients, 15.3% were readmitted within 30-days of their discharge. Most of the readmitted patients were females (56%) and elderly with a mean age 67.1±14.9 years. Majority of the patient who got readmitted had multi-morbidities (68%) and were of functional Class-II (39%).The mean length of stay for index and readmission was between 4-7days. Eighty-percent readmissions were discharged as planned, 13% on request and seven-percent left against medical advice in their index admission. The most common causes of readmission were persistence of symptoms (43%) and nosocomial infection (29%). Avoidable causes included hospital-associated pneumonia, urinary tract infections and septic shock. Mortality in readmitted patients was 12%.
Conclusions: The causes of readmission is multi-factorial, including advanced age, multi-morbidities, persistence of symptoms and nosocomial infections. Early follow-ups should be advised to prevent avoidable readmissions.
doi: https://doi.org/10.12669/pjms.37.7.3575
How to cite this:Fatima S, Shamim S, Raffat S, Tariq M. Hospital readmissions in Internal Medicine Specialty: Frequency, associated factors and outcomes. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3575
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.
Procalcitonin as a biomarker of bacterial infection in critically ill patients admitted with suspected Sepsis in Intensive Care Unit of a tertiary care hospital
Authors: Bibi Afshan , Basharat Nida , Aamir Muhammad , Haroon Zujaja Hina 
Published: September 2021

Objective: To compare the diagnostic accuracy of procalcitonin (PCT), C- reactive protein (CRP), total leukocyte count (TLC) and lactate in critically ill patients admitted with suspicion of sepsis.
Methods: It was a cross sectional study conducted at the department of Chemical Pathology and Endocrinology AFIP, Rawalpindi, in collaboration with Medical and surgical intensive care units (ICU) of CMH Rawalpindi from January 2019 to December 2019. A total of 126 patients of both genders with age above 18 years and fulfilling the inclusion criteria of systemic inflammatory response syndrome (SIRS) were inducted in the study.
Results: Out of 126 patients 82 (65%) patients have positive blood culture results. Male predominance was noted in patients with positive blood culture. Out of 82 patients with positive blood culture results 69(84%) patients have positive PCT results as well whereas 13(15%) patients with positive blood culture results have negative PCT values. 57(69%) patients had Gram negative bacterial infection and 25(30%) patients had Gram positive bacterial infection. Significant difference was noted between the medians of PCT in blood culture positive and blood culture negative group (p value< 0.05) whereas no significant difference was found between medians of CRP, TLC and lactate between blood culture positive and blood culture negative patients (p value > 0.05). ROC curve analysis of PCT, CRP and TLC were done, keeping blood culture as reference standard, PCT showed largest area under the curve (AUC) and clearly outperformed TLC and CRP. PCT showed AUC of 0.781 as compared to CRP and TLC, which was 0.568 and 0.617 respectively. PCT showed sensitivity of 93.9%, specificity of 47.7%, positive predictive value (PPV) of 77% and negative predictive value (NPV) of 80.8%.
Conclusion: Higher NPV makes it a reliable marker for screening out sepsis in suspected cases.
doi: https://doi.org/10.12669/pjms.37.7.4183
How to cite this:Bibi A, Basharat N, Aamir M, Haroon ZH. Procalcitonin as a biomarker of bacterial infection in critically ill patients admitted with suspected Sepsis in Intensive Care Unit of a tertiary care hospital. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4183
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.
Correlation of Serum Vaspin, Omentin-1, and adiponectin with metabolic phenotypes in Type-2 diabetes mellitus patients
Authors: Baig Mukhtiar , Gazzaz Zohair J , Bakarman Marwan A , Alzahrani Sami H 
Published: September 2021

Objectives: To investigate adipocytokines’ (vaspin, omentin-1, and adiponectin) correlation with metabolic phenotypes in type 2 diabetes mellitus (T2DM) patients.
Methods: This case-control research was done at the Diabetic Clinic in Jeddah, Kingdom of Saudi Arabia (KSA), from November 2018 to March 2019. Seventy-five T2DM patients and 75 gender, age, and BMI-matched healthy subjects were recruited for this research.
Results: In DM patients, the concentrations of serum vaspin and omentin-1 were substantially lower (p<0.001) than in the control group. A significant positive relationship between vaspin concentration and DBP (p<0.001), BMI (p<0.001), and waist circumference (p<0.001) was found in patients and control subjects, while FPG (p<0.016), serum insulin (p<0.001), HOMA-IR (p<0.001), TC (p<0.001), TG (p<0.001), and LDLc (p<0.001) were significantly interrelated among patients. Serum concentrations of omentin-1 and ADN were significantly negatively correlated with serum insulin, HOMA-IR, and TG among the DM group. Serum vaspin and ADN levels were significantly higher in the cases and control groups with BMI>25, and no gender-wise variance was observed in adipocytokines levels. Binary logistic regression analysis showed a significantly negative predictive relationship of vaspin and omentin-1 with DM.
Conclusion: The DM group displayed substantially lower serum vaspin and omentin-1 levels. However, there was no consistent relationship observed between these adipocytokines and metabolic phenotypes.
doi: https://doi.org/10.12669/pjms.37.7.4330
How to cite this:Baig M, Gazzaz ZJ, Bakarman MA, Alzahrani SH. Correlation of Serum Vaspin, Omentin-1, and adiponectin with metabolic phenotypes in Type-2 diabetes mellitus patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4330
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.
Analysis of choroidal thickness in patients with proliferative diabetic retinopathy by optical coherence tomography angiography
Authors: Ren Qian , Yu Hua , Sun Zhaohui , Li Li 
Published: September 2021

Objectives: This study aimed to evaluate the changes in choroidal thickness at different parts in patients with stage IV-V diabetic retinopathy (DR) treated by Panretinal Photocoagulation (PRP) or its combination with anti-vascular endothelial growth factor (VEGF) therapy using optical coherence tomography angiography (OCTA).
Methods: Patients with proliferative DR (stage IV-V) diagnosed in Shijiazhuang People’s Hospital between January 2016 to January 2020 were selected and treated with conventional PRP or combined with anti-VEGF therapy. OCTA was performed before treatment and one three and six months after treatment to observe and compare subfoveal choroidal thickness (SFCT), perifoveal choroidal thickness at 500 um (M500) and 1500 um (M1500).
Results: A total of 76 patients (133 eyes) were included. Six months later, re-examination showed effective treatment in 122 eyes (91.72%) and ineffective treatment in 11 eyes. Before treatment and one week, three months and six months after treatment, the choroidal thickness was observed and compared by OCTA. SFCT, M500 and M1500 increased one week after treatment, were significantly thinner 3 months after treatment than those before treatment, and further decreased six months after treatment.
Conclusion: OCTA presents a good evaluation of perifoveal choroidal thickness in patients with proliferative DR. It provides a basis for treatment selection and efficacy determination of proliferative DR.
doi: https://doi.org/10.12669/pjms.37.7.4357
How to cite this:Ren Q, Yu H, Sun Z, Li L. Analysis of choroidal thickness in patients with proliferative diabetic retinopathy by optical coherence tomography angiography. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4357
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.