bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery
Authors: Ali Taimur Asif , Tariq Khuzaima , Salim Areej , Fatimi Saulat 
Published: September 2021

Objectives: In this study we determined the frequency of renal dysfunction and its outcomes in terms of morbidity and mortality in patients who underwent open heart surgery at the Aga Khan University Hospital, Karachi, Pakistan.
Methods: A total of 175 patients aged between 15-80 years having open heart Surgery(OHS) were included. Preoperative and postoperative serum creatinine (SCr) was noted and the glomerular filtration rate (GFR) calculated by Cockcroft-Gault equation. Their hospital course was charted and followed-up for 30-day.
Results: The mean age and mean BMI were 58.1±12.6 years and 26.4±4.3 kg/m2 respectively. Females were 18.3%, out of which 51.4% hypertensive, 46.9% diabetics, 45.1% had dyslipidemia, 2.9% had preoperative renal dysfunction and 40% had moderate ejection fraction. On follow up, 30.3% developed postoperative renal dysfunction within 30-days after OHS with mean SCr and GFR as 1.6±0.7 and 56.9±24.5, respectively. In RD group more patients showed positive outcomes i.e. prolonged inotropic requirement (75.5% vs. 18%, p-value <0.005), diuretic infusion usage (47.2% vs. 3.3%, p-value <0.005), dialysis/renal replacement therapy (17% vs. 0%, p-value <0.005), requirement for prolonged ventilation (35.8% vs. 6.6%, p-value <0.005), prolonged ICU and hospital stay (15.4% vs. 1.6%, p-value <0.005 and 41.5% vs. 17.2%, p-value <0.005), sepsis (20.8% vs. 1.6%, p-value <0.005) and death (9.4% vs. 2.5%, p-value 0.05).
Conclusion: Timely recognition of renal dysfunction, early renal replacement therapy, diuretics or dialysis and proper nutritional and inotropic support to maintain adequate hemostasis shows survival benefits.
doi: https://doi.org/10.12669/pjms.37.7.3865
How to cite this:Ali TA, Tariq K, Salim A, Fatimi S. Frequency of Renal Dysfunction and its effects on outcomes after open heart surgery. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3865
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.
Is diagnosing patients with Organic Acidurias and Aminoacidopathies enough? Conundrums of a low middle-income country
Authors: Majid Hafsa , Jafri Lena , Khan Aysha Habib , Zulfiqarali Zeb , Afroze Bushra 
Published: September 2021

Objective: This study was done to determine the factors responsible for non-treatment of inherited metabolic disorders (IMDs) requiring food for special medical purposes (FSMPs) in Pakistan.
Methods: A descriptive cross-sectional study was conducted by Departments of Pediatrics & Child Health and Pathology & Laboratory Medicine, Aga Khan University. Patients diagnosed with IMDs from January 2013 to December 2016 requiring FSMPs were surveyed after a year of initial diagnosis to collect the details of treatment advised, mortality status, and reasons of non-treatment, including not prescribed by physician, non-acceptance by family, non-availability or non-affordability.
Results: Over four years period, 311 patients were identified with IMDs; Median age of patients was 1.0 yrs (0.0.2-3.65) with 54% (n=168) being male. Of the total 38.2% (n=119) required FSMPs, 9% (n=28) patients were excluded due to unavailability of diagnostics information. Parents of 58 patients requiring FSMPs out of 119 participated in survey. The leading causes of non-treatment were, FSMPs not prescribed by physicians (n= 30, 51.7%) followed by non-affordability (n=23, 39.6%), families’ unacceptance in (n=9, 18%) patients, non-availability of FSMPs (n=2, 3.4%) and early death of patient (n=1, 1.7%).
Conclusion: The main factors responsible for non-treatment of FSMPs requiring IMDs were non-prescription by physician and non-affordability.
doi: https://doi.org/10.12669/pjms.37.7.3887
How to cite this:Majid H, Jafri L, Ali ZZ, Afroze B. Is diagnosing patients with Organic Acidurias and Aminoacidopathies enough? Conundrums of a low middle-income country. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3887
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.
Development & Validation of Urdu Receptive Language Scale (URLS)
Authors: Butt Ghazal Awais , Mumtaz Nazia , Saqulain Ghulam 
Published: September 2021

Objectives: To develop “Urdu Receptive Language Scale (URLS)” for Urdu speaking Pakistani children of age 0-6 years.
Methods: This exploratory study was done at mainstream schools and day care centers on children with normal language development between the ages of 0-6 years from 1st March 2016 to 31st August 2016, by using convenient sampling technique. Firstly, the items for the questionnaire were constructed from four sources: literature review, experts, parents and direct observation of 384 Children of same age. Secondly the constructed test items were sent to the field experts (SLP’s) for the purpose of improvement. Thirdly, after incorporation of suggestions, the improved items were securitized by Urdu experts and finalized. In the next step, these items were tested for Relevance, Ambiguity, Clarity and Simplicity from field experts. The developed scale was then analyzed for reliability and validity by SPSS Version-18.
Results: Study resulted in a 59 items Urdu Receptive Language Scale with each age range having different test items distribution. The mean of the relevance, clarity, simplicity, and ambiguity of test items was 3.89. The Item content validity index value was one for each of the 59 items. The content validity index for the entire scale was also one. The Cronbach’s alpha was 0.948, which indicates a high level of internal consistency.
Conclusion: The developed 59 Item Urdu Receptive Language Scale is reliable and valid tool for language assessment of Urdu speaking Pakistani children of 0-6 years age.
doi: https://doi.org/10.12669/pjms.37.7.3928
How to cite this:Butt GA, Mumtaz N, Saqulain G. Development & Validation of Urdu Receptive Language Scale (URLS). Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.3928
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 short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients
Authors: Karacaer Cengiz , Demirci Taner , Cengiz Hasret , Varim Ceyhun , Tamer Ali 
Published: September 2021

Objectives: We aimed to determine the effect of short-term intensive insulin therapy (SIIT) on long-term glycemic control in newly-diagnosed Type-2 diabetes mellitus (nT2DM) patients.
Methods: In this retrospectively study conducted at Sakarya University Medical Faculty Training and Research Hospital Outpatient Clinic between 2016 and 2019, 65 nT2DM patients were enrolled soon after their SIIT was initiated and were followed for at least a year. Intensive insulin treatment was discontinued after three or 12 months in a total of 65 (23–73-year-old) patients who had been newly diagnosed with T2DM. Intensive insulin therapy was discontinued when glycemic control and the target Glycated Hemoglobin (HbA1c) level had been attained, after which oral anti-diabetic drug (OAD), long-term insulin, and diet therapies were pursued.
Results: There was a significant decrease in mean HbA1c from 11.25±1.96% to 6.67±1.07%. Fasting plasma glucose (FPG) was found to be an independent predictor of whether intensive insulin therapy could be discontinued after three months in a model that included FPG, HbA1c, and body mass index measured at baseline. Patients with FPG >13.8 mmol/L were 7.6 times more likely to require intensive insulin therapy beyond three months. There were significant decreases in HbA1c and low-density lipoprotein-cholesterol concentration, but no change in C-peptide between baseline and 3 months of therapy.
Conclusion: These results demonstrate that in nT2DM patients, intensive insulin therapy could be effective on long-term glycemic control and high FPG prior to three months of SIIT may predict poor long-term glycemic control.
doi: https://doi.org/10.12669/pjms.37.7.4013
How to cite this:Karacaer C, Demirci T, Cengiz H, Varim C, Tamer A. The effect of short-term intensive insulin therapy in newly-diagnosed Type-2 diabetic patients. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4013
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.
Comparison of preoperative and postoperative Lipid Profile changes in obese and morbidly obese patients after mini gastric bypass surgery
Authors: GUZEL Kerim , IKIZEK Mustafa 
Published: September 2021

Background & Objective: Obesity has become a serious health problem that has become increasingly important in recent years. Since patients with high levels of obesity have dyslipidemia and an unbalanced lipid profile, they have a high risk of both diabetes mellitus and cardiovascular disease. This study aimed to evaluate the short (3 months) and long term (12 months) effects of mini-gastric bypass surgery from the current bariatric surgical techniques on the lipid profile.
Methods: Of the patients undergoing Mini-gastric bypass operation between January 2016 to December 2018 at the General Surgery Clinic of Private Samsun Büyük Anadolu Hospital, demographic data and changes in lipid concentrations at 3 and 12 months were analyzed. Patients were grouped according to age, sex, body mass index (BMI), cardiologic risk groups, bypass lengths, and obesity classes. Total cholesterol, triglyceride, LDL-cholesterol, and HDL cholesterol values of the patients were examined at the time of admission to the outpatient clinic before the operation, at the postoperative third month and at the post-operative twelfth-month. Patients who did not go for a checkup during the one-year follow-up and whose data could not be reached or missing were excluded from the study.
Results: There was no significant difference in terms of age, sex, and cardiovascular risk (p>0.05). Although the HDL-C level was initially low (p<0.001), it significantly increased 12 months after surgical treatment (p<0.001). While serum concentrations of LDL cholesterol, total cholesterol, and triglycerides were high preoperatively, they significantly decreased at 12 months postoperatively (p<0.001). When compared with values in the 3rd- and 12th-month, there was a significant decrease in the class-3 obesity group but not in the class-2 obesity group. When serum HDL cholesterol concentrations were compared with preoperative baseline and postoperative 12th-month those, no statistically-significant difference was found in serum concentrations in the 3rd month, although there was a significant increase in both class 2 and 3 obesity groups.
Conclusion: In patients undergoing mini-gastric bypass surgery, serum LDL cholesterol, total cholesterol, and triglyceride concentrations decreased in the 12th postoperative month, but serum HDL cholesterol concentrations increased.
doi: https://doi.org/10.12669/pjms.37.7.4123
How to cite this:Guzel K, Ikizek M. Comparison of preoperative and postoperative Lipid Profile changes in obese and morbidly obese patients after mini gastric bypass surgery. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4123
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 Impact of implementing multisource feedback on behaviors of young doctors
Authors: Ahmad Nasir , Sethi Ahsan , Khan Rehan Ahmed 
Published: September 2021

Objectives: Multisource feedback (MSF) is a workplace-based assessment tool that offers 360-degree evaluation of the trainee doctor. Little is known about its receptiveness among stakeholders in Pakistan. This study explores house officers’ perceptions regarding MSF since its implementation in Eye Unit-II, Institute of Ophthalmology, King Edward Medical University/ Mayo Hospital, Lahore.
Methods: A qualitative case study was conducted from July 2019 to February 2020 in Eye Unit II. A purposive (maximum variation) sample of 12 house surgeons was taken. Two focus group discussions were conducted. Data were transcribed and analyzed thematically.
Results: The study identified the impact of MSF on house surgeons. Most participants reported positive experiences. The feedback they received increased their motivation, management skills and team working. A number of factors affecting the receptiveness of MSF were also identified which mainly included characteristics of raters and emotional response to MSF.
Conclusion: Multisource Feedback is a useful tool for feedback that impacts the young doctors in many ways. It contributes to increasing their sense of responsibility, management skills and self-directed learning. The improvement in individual abilities and teamwork also helped in improving patient care.
doi: https://doi.org/10.12669/pjms.37.7.4155
How to cite this:Ahmad CN, Sethi A, Khan RA. Impact of implementing multisource feedback on behaviors of young doctors. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4155
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.
Comparison of intra operative hemorrhage by blunt and sharp expansion of uterine incision at cesarean section
Authors: Faiza Faiza , Sadaf Farhadia , Ameena Behzar , Khan Nadia Rashid 
Published: September 2021

Objectives: To compare the effect of blunt and sharp incision of uterus at cesarean section on intra-operative haemorrhage.
Methods: This trial was conducted at the Department of Obstetrics and Gynaecology, Pakistan Ordinance Factory Hospital, Wah Cantt from 14th January to 13th July 2012. Total 80 women planned for lower segment cesarean section through Pfannensteil incision were randomized to either blunt uterine incision (Group-A, n=40) or sharp uterine incision (Group-B, n=40). The fall in Haemoglobin and HCT was compared in two groups and analyzed with help of SPSS version 10.
Results: Both groups were similar in terms of demographic features like age, parity, gestational age and indication for cesarean section. The participants in Group-A reveled significantly less drop of mean Hb concentration as compared to Group-B (1.47±1.08 and 1.95±0.85 respectively, P value 0.031). Similarly, the fall in mean HCT was significantly less in Group-A in comparison to Group-B (3.21±1.3 and 4.21±2.17 respectively, P-value 0.015)
Conclusion: Blunt expansion of uterine incision during caesarean section is associated with less fall in Haemoglobin and HCT as compared to sharp expansion.
doi: https://doi.org/10.12669/pjms.37.7.4159
How to cite this:Faiza, Sadaf F, Ameena B, Khan NR. Comparison of intra operative hemorrhage by blunt and sharp expansion of uterine incision at cesarean section. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4159
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.
Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes
Authors: Jan Iftikhar Ahmad , Hassan Mokhtar , Shalaan Ikram , Alshehhi Muna Ahmed 
Published: September 2021

Background: We wish to share our outcome of single median raphe scrotal incision orchiopexy (SMRSO) regarding safety & feasibility of technique by evaluating ease of access, conversion rate, duration of surgery, success rate, complications, and the need for redo-surgery.
Methods: We retrospectively analyzed data of 277 orchiopexies performed in our department on 224 patients operated on between June 2016 to June 2019. SMRSO was considered for palpable testes that can be brought to the upper limit of the scrotum under anesthesia. The conventional inguinoscrotal approach was used for high lying testes. A median raphe incision was made to access & mobilize the testis on either side, ligation of processus vaginalis performed, and the testes secured in the scrotal pouch. The approach was utilized for both unilateral and bilateral orchiopexies. Follow-up done at one week, one month & six months to evaluate the outcome.
Results: A total of 277 orchiopexies were performed in 224 patients. 237 (86%) orchiopexies were via the median raphe scrotal approach in 184 patients. Out of these, 53 cases had bilateral orchiopexies. 30 (11%) performed via a conventional inguinoscrotal approach and 10 (4%) by laparoscopic approach. The mean duration of surgery for SMRSO was 24 minutes for unilateral and 42 minutes for bilateral cases. Immediate postoperative complications included scrotal hematoma in three (1.6%) cases, Hematoma of the abdominal wall in one case, and scrotal edema in 4 (2%) patients. All complications were treated conservatively & resolved. No wound infection or testicular atrophy was reported. Long-term complications included testicular ascend in three cases [1.6%].
Conclusion: Single-incision Median Raphe Scrotal orchiopexy is an attractive alternative to the standard inguinoscrotal orchiopexy for palpable low lying undescended testes with a better cosmetic outcome.
doi: https://doi.org/10.12669/pjms.37.7.4261
How to cite this:Jan IA, Hassan M, Shalaan I, Alshehhi MA. Single Median Raphe Scrotal incision Orchiopexy: A safe & feasible approach for fixation of Palpable Undescended testes. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4261
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.
Perceived effectiveness of learning methods among preclinical medical students - role of personality and changes over time
Authors: Ali Arain Shoukat , Alhadid Daeya Ahmad , Rasheed Shahzad , Alrefaai Maram Mansour , Alsibai Tarek M. Ahyaf , Meo Sultan Ayoub 
Published: September 2021

Background and Objectives: Active learning methods are vital in inculcating skills of critical thinking, lifelong learning and effective communication. Personality may influence learning method preferences and academic performance. The aim of this cross sectional study was to examine the relationship between students’ personality and their predilection for learning methods and academic performance.
Methods: Perceived effectiveness of learning methods was assessed over time. Second- and third-year medical students (n=112) completed a questionnaire consisting of Big Five Inventory to measure the personality dimensions, and evaluated lecture, problem-based learning (PBL) and team-based learning (TBL) for their helpfulness in learning. Grade point average (GPA), PBL and TBL grades were obtained. Correlation coefficients were calculated between personality traits and learning method effectiveness scores, and grades. Learning methods effectiveness was compared between second- and third-year students.
Results: Positive correlations were identified between conscientiousness and lecture (r = 0.30), agreeableness and lecture (r = 0.20), and agreeableness and TBL (r = 0.23). Likewise, positive correlations were seen between extraversion and PBL grade (r=0.20), and conscientiousness and GPA (r = 0.23). In third year, significant decline in perceived effectiveness of lecture was seen (81% vs 57%; p = 0.006), while increased perceived effectiveness for PBL (38% vs. 50%) was not statistically significant (p = 0.22).
Conclusions: The findings provide an evidence for modest correlations between personality and perceived effectiveness of learning methods. Remarkably, perceived effectiveness decreased for the lecture and increased for the PBL over time. The findings may help educators in better implementing active learning modalities. Besides, an earlier introduction may help students becoming acquainted with and getting the most out of PBL.
doi: https://doi.org/10.12669/pjms.37.7.4355
How to cite this:Arain SA, Alhadid DA, Rasheed S, Alrefaai MM, Alsibai TMA, Meo SA. Perceived effectiveness of learning methods among preclinical medical students - role of personality and changes over time. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4355
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.
Prevalence of Fibromyalgia in chronic kidney disease pre-dialysis patients: Experience from a Tertiary Care Renal unit in Pakistan
Authors: Khan Zara , Naqvi Rubina 
Published: September 2021

Background and Objective: Fibromyalgia syndrome (FMS) is a well-established medical problem which gives rise pain at various sites, fatigue, sleep disturbances, poor memory and definitely affects quality of life. Its prevalence in chronic kidney disease (CKD) is scarcely reported, thus we aimed to assess this condition and report its prevalence in our population.
Methods: The current study was carried out in all adult CKD stage III and IV patients registered from January 2020 to July 2020 at outpatient department of a tertiary care renal institution in Karachi, Pakistan. This is a cross sectional study where prevalence of FMS was assessed by interviewing and examining patients according to established criteria for FMS. All data and laboratory parameters were recorded on a proforma and statistical analysis was done on SPSS version22.0.
Results: During the study period of six months, 161 patients with CKD stage III and IV were registered. Among these 81 male and 80 were females. Mean age was 47.12±9.27 (range 21-60) years. There were 22 (13.66%) patients found to have FMS. Mean Widespread Pain Index (WPI) score was 5.68±4.36 (range 1-16), while severity scale (SS) 2a was 3.17±1.78 (range 1-9) and SS2b 2.04±0.96 (range 1-5) was recorded.
Conclusion: From Pakistan prevalence of FMS has never been published. As this syndrome affects quality of life of patients, its recognition and proper management is immensely required.
doi: https://doi.org/10.12669/pjms.37.7.4474
How to cite this:Khan Z, Naqvi R. Prevalence of Fibromyalgia in chronic kidney disease pre-dialysis patients: Experience from a Tertiary Care Renal unit in Pakistan. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4474
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.