bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence
Authors: Wu Ya-ru , Shen Dan , Zhang Yan-qiao , Cui Zhen-yu , Yang Wenzeng 
Published: September 2021

Objectives: To investigate the efficacy and postoperative complications of lattice carbon dioxide laser in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence.
Methods: A total of 30 postmenopausal female patients with mild to moderate stress urinary incontinence, recruited from the Affiliated Hospital of Hebei University from September to November 2019, were selected as the study subjects and treated with lattice carbon dioxide laser therapy. Treatment was given at intervals of one month. The degree of urinary incontinence, the urinary incontinence questionnaire (ICI-Q-SF) score, and the urinary incontinence quality of life scale (I-QOL)) Score, surgical satisfaction, one hour pad test and postoperative complications before treatment and after each treatment of all patients were respectively recorded and compared.
Results: Compared with those before treatment, the grade of urinary incontinence and ICI-Q-SF scores of these 30 patients after each treatment were lower, and their I-QOL scores were higher. The difference of one hour urine pad test was statistically significant (P<0.05), but the follow-up data of three months after the third treatment was close to that of one month after the first treatment. The satisfaction rate of these 30 patients was 76.67% (23/30). After treatment, only one patient presented vaginal itching discomfort on the first day after surgery and the symptoms disappeared three days later. No obvious complications occurred in the other 29 patients.
Conclusion: The treatment of mild and moderate postmenopausal patients with stress urinary incontinence with lattice carbon dioxide laser can effectively reduce the incidence of incontinence and improve the quality of life.
doi: https://doi.org/10.12669/pjms.37.7.4077
How to cite this:Wu Y, Shen D, Zhang Y, Cui Z, Yang W. Efficacy evaluation of Lattice Carbon Dioxide Laser Therapy in the treatment of postmenopausal patients with mild to moderate stress urinary incontinence. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4077
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.
Clinical effects of Apatinib combined with DOS neoadjuvant chemotherapy regimen in neoadjuvant chemotherapy for LAGC
Authors: Zhou Peng-zhe , Gao Lei , Wu Wei , Hao Ying-xia 
Published: September 2021

Objective: To evaluate the clinical effects of apatinib combined with DOS regimen in the neoadjuvant chemotherapy for locally advanced gastric cancer (LAGC).
Methods: Eighty patients with LAGC admitted to Baoding first Central Hospital from January 2018 to October 2020 were randomly divided into two groups (n=40, respectively). The control group received DOS chemotherapy regimen alone. The experiment group additionally orally took apatinib mesylate tablets. The changes in CEA, CA19-9 and other tumor markers, RO resection rate, incidence of operative complications, adverse reactions, and other indicators were compared between the two groups.
Results: The overall response rate (ORR) of the experimental group was 72.5%, which was significantly better than that of the control group (50%) (p=0.03). After the treatment, the CEA and CA19-9 in the experiment group were significantly lower than those in the control group (p=0.00). The Ro resection rate was 77.5% in the experiment group and 57.5% in the control group (p=0.03). The operation time was shortened and amount of bleeding decreased in the experiment group, and the differences were statistically significant (p=0.00). The incidence of surgical complications in the experimental group was 17.5%, significantly lower than that in the control group (37.5%) (p=0.04).
Conclusion: Apatinib combined with DOS regimen is effective for patients with LAGC without significantly increasing adverse reactions. Meanwhile, tumor markers are reduced significantly. Besides, the Ro resection rate and the incidence of operative complications are obviously superior to the DOS neoadjuvant chemotherapy regimen alone.
doi: https://doi.org/10.12669/pjms.37.7.4265
How to cite this:Zhou P, Gao L, Wu W, Hao Y. Clinical effects of Apatinib combined with DOS neoadjuvant chemotherapy regimen in neoadjuvant chemotherapy for LAGC. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4265
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.
Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly
Authors: Alam Laima , Khan Jawad , Alam Mafaza , Faraid Varqa , Ajmal Fahad , Bahadur Laila 
Published: September 2021

Objectives: To assess the satisfaction of trainees towards different attributes of their training programs.
Methods: This cross-sectional survey was carried out by enrolling trainee doctors currently working in Medical, Surgical, Dental and Allied specialties of the country by sending a validated and piloted questionnaire through email. Data collection was done from 1st to 31st January 2021 after taking ethical approval from the concerned authorities. Data was analysed using SPSS v. 19.0.
Results: A total of 516 completed responses were received from 15 major cities of the country. The overall perceived satisfaction towards clinical skills (42%), teaching skills (31.4%), personal growth and development (23.6%), research (21%) and supervisor’s role (44.2%) were considerably low with the most common causes for non-satisfaction being poor work-life balance (59%), financial instability (54.5%), poor research facilities (53%), poor career guidance (44%) and poor skill development (42.4%) in descending order. Senior years of residency, government and private set-ups, less than four and greater than 13 residents on average with less than three supervisors per department, excessive duty hours and financial instability in-lieu of not doing locums were statistically related to poor satisfaction across majority of the facets of residency as well the overall satisfaction towards training programs.
Conclusion: There is a tremendous scope for improvement in the recognized and partially acknowledged attributes of our training programs. Yearly feedback surveys involving residents is essential for enlightening the authorities and mitigating the trainees’ grievances.
doi: https://doi.org/10.12669/pjms.37.7.4297
How to cite this:Alam L, Khan J, Alam M, Faraid V, Ajmal F, Bahadur L. Residents’ perspective on the quality of postgraduate training programs in Pakistan – the good, the bad and the ugly. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4297
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.
Observations on the clinical efficacy of rhaFGF combined with Vitamin B complex for patients with Severe Recurrent Aphthous Ulcer
Authors: Sun Hui , Gao Jie , Li Dan , Li Bing 
Published: September 2021

Objectives: To observe the therapeutic effect of rha FGF combined with vitamin B complex on severe recurrent aphthous ulcers (RAUs).
Methods: Ninety patients with severe RAU (grade III and IV) admitted to Chinese PLA General Hospital from May 2018 to May 2019 were selected and divided into two groups using a random number table, 45 patients/group. Patients in the control group gargled with a mixture of vitamin B complex (250 ml of 9% normal saline +250 ml of vitamin B complex +160,000 U of gentamicin +25 ml of lidocaine) after oral cleaning; patients in the observation group gargled with a mixture of the same ratio after oral cleaning and then sprayed rhaFGF on their oral ulcers. The clinical symptoms and treatment effects of the 2 groups within 1 week of medication were compared.
Results: The total effective rate of treatment was 97.78% in the observation group and 82.22% in the control group; the difference was statistically significant (P <0.05). The time to ulcer pain disappearance and eating recovery and the ulcer healing time in the observation group were significantly shorter than those in the control group (P <0.05).
Conclusion: rhaFGF combined with vitamin B complex has a significant therapeutic effect for patients with severe RAU; it can relieve pain and illness faster and shorten the healing time of ulcers.
doi: https://doi.org/10.12669/pjms.37.7.4364
How to cite this:Sun H, Gao J, Li D, Li B. Observations on the clinical efficacy of rhaFGF combined with Vitamin B complex for patients with Severe Recurrent Aphthous Ulcer. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4364
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.
Challenges of COVID-19 Vaccination Delivery in Pakistan
Authors: Tariq Shahan , Hamid Muhammad Ammar Bin 
Published: September 2021

doi: https://doi.org/10.12669/pjms.37.7.4489
How to cite this: Hamid MAB, Tariq S. Challenges of COVID-19 Vaccination Delivery in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4489
Models of teaching medical errors
Authors: Gohal Gassem 
Published: September 2021

Medical errors are relatively common causes of preventable iatrogenic adverse events. We have focused on teaching models in certain courses of study that have been reported to have significant positive impacts on the outcomes of teaching about medical errors. All healthcare organizations must establish suitable models of teaching about patient safety and medical errors as a preventive measure and as an early intervention strategy. Teaching undergraduate medical students and physicians in training how to manage and disclose medical errors helps them develop lifelong skills that can effectively reduce such errors.The literature search was conducted in international databases such as PubMed/MEDLINE and Google Scholar search engine using English equivalent keywords, from 1998 up to April, 2020. The search strategy used the following subject headings terms: “Medical error(s)” AND “Teaching”. Out of 40 Studies included, 6 studies were selected to have evaluated models of health care training and simulation based teaching of medical errors and patient safety in undergraduate and postgraduate medical education.
doi: https://doi.org/10.12669/pjms.37.7.4506
How to cite this:Gohal G. Models of teaching medical errors. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4506
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.
Spontaneous Detorsion of Sigmoid Volvulus in a patient with Nineteen-Volvulus episode history: A rare outcome of an extremely rare clinical entity
Authors: Atamanalp Sabri Selcuk , Disci Esra , Tatar Atamanalp Cansu , Atamanalp Refik Selim 
Published: September 2021

Sigmoid volvulus (SV) recurrence more than 10 times is an extremely rare clinical entity and spontaneous detorsion is a rare outcome of SV. In this paper, we report a case with 19 previous SV attacks, in last of which spontaneous detorsion occurred. Such a multiple-episode history as well as an unexpected recovery was unique in a 1,036-case clinical profession of Ataturk University with SV over a 54.5-year period.
doi: https://doi.org/10.12669/pjms.37.7.4703
How to cite this:Atamanalp SS, Disci E, Tatar Atamanalp C, Atamanalp RS. Spontaneous Detorsion of Sigmoid Volvulus in a patient with Nineteen-Volvulus episode history: A rare outcome of an extremely rare clinical entity. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4703
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.
Eliciting public values on health inequalities: missing evidence for policy windows?
Authors: McHugh Neil 
Published: September 2021

Background:There is a widening health divide in the UK despite health inequalities being a longstanding subject of policy and research. New types of evidence are needed.
Key points for discussion:Knowledge of public values for non-health policies and their associated (non-)health outcomes is currently missing from decision-making processes. Eliciting public values using stated preference techniques can provide insights on what the general public would be willing to give up for different distributions of (non-)health outcomes and the policies that can achieve them. To understand the role this evidence could have in decision-making processes, Kingdon’s multiple streams analysis (MSA) is used as a policy lens to explore how evidence of public values could affect policy processes for ways to tackle health inequalities.
Conclusions and implications:This paper outlines how evidence of public values could be elicited through the use of stated preference techniques and suggests this could facilitate the creation of policy windows for tackling health inequalities. Additionally, Kingdon’s MSA helps make explicit six crosscutting issues when generating this new form of evidence. This suggests the need to explore reasons for public values and how decision makers would use such evidence. With an awareness of these issues, evidence on public values has the potential to support upstream policies to tackle health inequalities.
Implementing trachoma control programmes in marginalised populations in Tanzania: A qualitative study exploring the experiences and perspectives of key stakeholders
Authors: Tsang Kaki , de Wildt Gilles , Mwingira Upendo , Mtuy Tara B. 
Published: September 2021

Background
Despite aspects of the SAFE strategy for reducing trachoma in Tanzania have been somewhat successful, the disease still persists in marginalised communities even with repeated trachoma control interventions. This study aims to understand the facilitators and barriers associated with implementing trachoma control programmes in these communities, from the perspective of non-governmental organisations (NGOs).

Methods
Participants were the representatives of NGOs who had knowledge and experience in the implementation of trachoma control programmes. Data was collected using in-depth, semi-structured interviews guided by a topic guide, which was updated after each interview using a constant comparative method. Interviews were audio-recorded and then transcribed verbatim. Thematic analysis was done inductively. Codes were generated from the transcripts and then clustered into themes.

Findings
The context within marginalised communities often acted as a perceived barrier to successful implementation of control programmes. This included poor environmental cleanliness, lack of trust, poor disease knowledge and traditional lifestyles. Community values could either be a facilitator or a barrier, depending on the scenario. The anatomical location of the disease and the poor understanding of the disease progression also served as barriers. Considerations affecting decision-making among NGO’s include financial feasibility, community needs and whether the quality of the intervention could be improved. NGOs felt that the collaboration and the opportunity to learn from other organisations were beneficial aspects of having different actors. However, this also resulted in variability in the effectiveness of interventions between districts.

Conclusion
NGOs should focus on behaviour change and health education that is tailored to marginalised communities and seek innovative ways to implement trachoma intervention programmes whilst being minimally intrusive to the traditional way of life. Partners should also implement ways to ensure high quality programmes are being provided, by increasing staff accountability and compensating volunteers fairly.
Assessing quality of family planning counseling and its determinants in Kenya: Analysis of health facility exit interviews
Authors: Ontiri Susan , Kabue Mark , Biesma Regien , Stekelenburg Jelle , Gichangi Peter 
Published: September 2021

Background
Available evidence suggests that provision of quality of care in family planning services is crucial to increasing uptake and continuation of use of contraception. Kenya achieved a modern contraceptive prevalence rate of 60% in 2018, surpassing its 2020 target of 58%. With the high prevalence, focus is geared towards improved quality of family planning services. The objective of this study is to examine the quality of family planning counseling and its associated factors in health facilities in Kenya.

Methods
We conducted a secondary analysis of the 2019 Kenya Performance Monitoring and Action, client exit data of women who had received family planning services. Quality of counseling was assessed using the Method Information Index Plus. We conducted a multivariable ordinal logistic regression analysis of data from 3,731 women to establish determinants of receiving quality family planning services.

Results
The Method Information Index Plus score for higher-quality counseling was 56.7%, lower-quality counseling 32.4%, and no counseling 10.9%. Women aged 15–24 years (aOR = 0.69, 95% CI = 0.56–0.86, p = 0.001) had lower odds of receiving better counseling compared to women aged 35 years and above. Those with no education (aOR = 0.52, 95% CI = 0.33–0.82, p = 0.005), primary (aOR = 0.56, 95% CI = 0.44–0.71, p<0.001) and secondary (aOR = 0.79, 95% CI = 0.65–0.98, p = 0.028) were less likely to receive better counseling compared to those with tertiary education. Women who received long acting and reversible contraception methods (aOR = 1.75, 95% CI = 1.42–2.17, p<0.001), and those who were method switchers (aOR = 1.24, 95% CI = 1.03–1.50, p = 0.027), had a higher likelihood of receiving better quality of counseling as compared to those on short-term methods and those who were continuers, respectively.

Conclusion
The quality of family planning counseling in Kenya is still sub-optimal considering that some women receive no form of counseling at service delivery point. There is need to review the existing FP guidelines and training packages to increase focus on the quality of counseling services offered by health providers. Social accountability strategies that empower women to demand quality services should be included in community-level family planning interventions.
Attitudes of Spanish hospital staff towards COVID-19 vaccination and vaccination rates
Authors: Mena Guillermo , Blanco Beatriz , Casas Irma , Huertas Antonia , Sánchez María-Araceli , Auñón Mario , Viñas Jordi , Esteve María 
Published: September 2021

Background
COVID-19 vaccine hesitancy seems to be universal across countries and subgroups, and so are its determinants. We studied the willingness and factors associated with the decision to be vaccinated against COVID-19 in healthcare workers (HCW) in a Spanish tertiary hospital. Furthermore, we compared the percentage of willingness to vaccinate against COVID with actual vaccination rates among HCW in our hospital.

Methods
From December 21, 2020 to January 4, 2021, before initiation of the COVID-19 HCW vaccination campaign at Germans Trias i Pujol University Hospital (HUGTiP), an anonymous self-administered questionnaire was administered to HCW. Univariate and multivariate logistic regression of the association of variables with the outcome “intention to receive the COVID-19 vaccine as soon as possible” was conducted. Vaccination rates were extracted from the hospital information systems.

Results
Forty-four percent of HCW included in the study declared a willingness to be vaccinated against COVID-19 as soon as possible. This was associated with male sex [1.66 (95%CI 1.13–2.43); p = 0.009], older age [1.02 (95%CI 1.00–1.03); p = 0.014], belonging to the occupational groups “physician” or “other” [5.76 (95%CI 3.44–9.63) and 2.15 (95%CI 1.25–3.70); p<0.001], respectively, and reporting influenza vaccination during the last three seasons or at least one of the last three seasons [3.84 (95%CI 2.56–5.75) and 2.49 (95%CI 1.71–3.63); p<0.001]. One in ten hospital workers reported they were unwilling to receive COVID-19 vaccination. Actual COVID-19 vaccination uptake among HCW was higher (80.4%) than the percentage of willingness to vaccinate estimated from the questionnaire. Physicians not only had the highest vaccination rate, but also the highest correlation between the reported intention to vaccinate and the final decision to receive COVID-19 vaccination.

Conclusions
COVID-19 vaccination uptake was higher than previously estimated according to the stated intentions of HCW. Doubts and fears must be addressed, particularly in persons less inclined to be vaccinated: females, younger people and those not vaccinated against influenza in recent seasons. The study of barriers and strategies aimed at promoting COVID-19 vaccination must be adapted in relation to occupational groups’ attitudes, understanding their idiosyncrasies with respect to this and other vaccines.
Diagnostic accuracy of the Xpert MTB/RIF assay for tuberculous pericarditis: A systematic review and meta-analysis
Authors: Yu Guocan , Zhong Fangming , Shen Yanqin , Zheng Hong 
Published: September 2021

Objective
The purpose of this study was to evaluate the diagnostic efficacy of Xpert MTB/RIF for tuberculous pericarditis (TBP).

Methods
We searched relevant databases for Xpert MTB/RIF for TBP diagnosis until April 2021 and screened eligible studies for study inclusion. We evaluated the effectiveness of Xpert MTB/RIF when the composite reference standard (CRS) and mycobacterial culture were the gold standards, respectively. We performed meta-analyses using a bivariate random-effects model, and when the heterogeneity was obvious, the source of heterogeneity was further discussed.

Results
We included seven independent studies comparing Xpert MTB/RIF with the CRS and six studies comparing it with culture. The pooled sensitivity, specificity, and area under the curve of Xpert MTB/RIF were 65% (95% confidence interval, 59–72%), 99% (97–100%), and 0.99 (0.97–0.99) as compared with the CRS, respectively, and 75% (53–88%), 99% (90–100%), and 0.94 (0.92–0.96) as compared with culture, respectively. There was no significant heterogeneity between studies when CRS was the gold standard, whereas heterogeneity was evident when culture was the gold standard.

Conclusions
The sensitivity of Xpert MTB/RIF for diagnosing TBP was moderate and the specificity was good; thus, Xpert MTB/RIF can be used in the initial diagnosis of TBP.