bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF SEVOFLURANE VERSUS PROPOFOL FOR TRACHEAL INTUBATION IN CHILDREN
Authors: Ali Zulfiqar , Hussain Azhar , Malik Aamer Mahmood , Ahmed Arslan , Saqib Mohammad , Qadri Anjum 
Published: July 2021

Objective: To compare the quality of intubation and hemodynamic response in children undergoing endotracheal intubation facilitated with propofol versus sevoflurane.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Anesthesia, Combined Military Hospital Multan, from Aug 2018 to Apr 2019.
Methodology: A total number of 112 children planned for tracheal intubation were included in this randomized controlled trial. Patients were randomly allocated into two equal groups. In group P (propofol) patient’s 2.5-3.0 mg/kg propofol was given before insertion of endotracheal tube and in group S (sevoflurane) patients 8.0% sevoflurane with 100% O2. Quality of intubation was assessed in all children at the time of intubation. Hemodynamic response of patients was also noted before induction of anesthesia, immediately after intubation and after 5 minutes of intubation.
Results: Mean age of children included in this study was 2.11 ± 0.80 years. Quality of intubation was excellent in 51 (91.1%) patients in propofol group and in 38 (67.9%) patients in sevoflurane group (p-value 0.009). Mean HR after 5 minutes of intubation in group S and group P 111.98 ± 5.43 beats/min versus 109.05 ± 5.99 beats/min with p-value 0.008. Mean arterial pressure after 3 minutes of intubation mean arterial pressure in group S and P was 74.58 ± 4.45 mmHg versus 71.0 ± 3.90 mmHg with p-value <0.001. After 5 minutes of intubation mean arterial pressure in group S and P was 73.16 ± 4.13 mmHg versus 68.61 ± 4.07 mmHg with p-value <0.001.
Conclusion: Sevoflurane was found to be associated.........
FREQUENCY OF STRESS HYPERGLYCEMIA AND MORTALITY IN PATIENTS WITH HYPERGLYCEMIA IN MEDICAL INTENSIVE CARE UNIT
Authors: Satti Shahzeb Ahmed , Khattak Abdul Latif , Tariq Abdul Moueed , Majoka Sultan Mehmood , Naeem Arshad , Din Rafi Ud 
Published: July 2021

Objective: To assess the frequency of stress hyperglycemia and mortality in patients with hyperglycemia admitted in medical Intensive Care Unit.
Study Design: Cross-sectional study.
Place and Duration of Study: Medical Intensive Care Unit, Combined Military Hospital Quetta, from Nov 2018 to Jun 2019.
Methodology: A total of 150 adult patients of age between 18-80 years, of both genders, with Intensive Care Unit stay >24 hours, who were treated in medical Intensive Care Unit during study period, were included in the study. Those patients with duration of stay <24 hours, paediatric patients, surgical and pregnant patients and those who were on chronic steroid therapy and those who were given TPN and dextrose infusions were excluded. The blood sugar fasting was measured daily and blood sugar random was measured on admission and twice daily. The patients were segregated into three groups: Normoglycemia, Diabetes mellitus and Stress hyperglycaemia. The frequency of patients and outcome of patients in terms of death was observed in all groups.
Results: The mean age of study population was 55.02 ± 18.14 years, with 99 (66%) were males while 51 (34%) were females. Among study population 77 (51.3%) had normoglycemia, 46 (30.7%) had Diabetes Mellitus while 27 (18%) had stress hyperglycaemia. Out of 77 patients with normoglycemia 10 (12.9%) died, while number of deaths in patients with diabetes mellitus and stress hyperglycaemia was 21 (45.6%) and 15 (55.5%) respectively. The mean maximum blood glucose in those who survived and died was 214.39 ± 100.69 mg/dl and 295.26 ± 122.60................
THE USE OF MICRO-OSTEOPERFORATION CONCEPT FOR ACCELERATING DIFFERENTIAL TOOTH MOVEMENT
Authors: Ahsan Zoyia , Khan Mehwish , Jan Abdullah , Shah Tooba Ishtiaq , Naeem Saad 
Published: July 2021

Objective: To compare the rate of accelerated tooth movement in canine retraction with micro-osteoperforation on one side and control on the other.
Study Design: Quasi experimental study.
Place and Duration of Study: Orthodontics department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jul 2018 to Jan 2019.
Methodology: A total of 30 patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed NiTi coil spring on both sides of the maxillary arch. Micro-osteoperforation was done on the right side and other side was a control side. The distance between the lateral incisor and the canine was measured on both sides before micro-osteoperforation. The same measurements were recorded after three weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test.
Results: The study included 17 males (56%) and 13 females (43%). The mean rate of tooth movement at experimental side of maxilla was 1.6 ± 0.52 mm and on control side was 0.66 ± 0.31 mm (p<0.05).
Conclusion: Micro-osteoperforation was an effective, comfortable, and safe procedure to accelerate tooth movement (1.6 times in accordance with this study). It significantly shorten the duration of orthodontic treatment.
FREQUENCY AND PREDICTORS OF ACCESS FAILURE IN PATIENTS UNDERGOING URETERORENOSCOPY FOR UPPER URINARY TRACT CALCULI
Authors: Rafi Ahsan , Aziz Wajahat , Ather Hammad 
Published: July 2021

Objective: To determine the frequency and factors responsible for access failure during primary ureteroscopy (URS).
Study Design: Cross-sectional study.
Place and Duration of Study: Aga Khan University, Karachi Pakistan, from Jan to Jul 2019.
Methodology: All patients undergoing Ureterorenoscopy for upper urinary tract urolithiasis were included. Ureterorenoscopy was performed with either semi rigid, rigid digital or fiber opticflexible ureterorenoscope as appropriate. Data was collected for demographics, history of stone passage, previous Ureterorenoscopy /double J stenting and history of stent placement. Preoperative imaging reviewed for stone location, size and number. Level of access failure (proximal/mid/distal ureter) was noted. Post-operative complications and need of ancillary procedure was noted.
Results: We included 250 participants undergoing ureteroscopy for the upper urinary tract calculi. Mean age of the patients was 44.15 ± 13.76 years. Mean stone size was 9.12 ± 4.23mm. Overall access failure rate was found to be 8% (20/250), all required an ancillary procedure. None of the patients with previous history of endoscopic intervention or stone passage had access failure. On univariate and multivariate analysis only stone location was found to be significant factor predicting access failure.
Conclusion: Failure to access is not uncommon during primary ureteroscopy. Access failure is more common in proximal ureteral stone and in patients with no previous episode of ureteral stones and procedure. Information from this study will help in counseling patients’ pre-operatively and may be a guide to urologists on pre stenting of selected patients at high risk of access failure.
COMPARISON BETWEEN HYPERBARIC BUPIVACAINE PLUS FENTANYL AND HYPERBARIC BUPIVACAINE ALONE IN SPINAL ANESTHESIA FOR CAESAREAN SECTION
Authors: Iqbal Fatima , Faridi Manzoor Ahmed , Saeed Aisha , Shah Inamullah 
Published: July 2021

Objective: To compare the result of the combination of hyperbaric bupivacaine plus fentanyl with hyperbaric bupivacaine alone in patients undergoing caesarean section in spinal anaesthesia.
Study Design: Comparative, cross-sectional study.
Place and Duration of Study: Department of Anesthesia, Fauji Foundation Hospital, Rawalpindi Pakistan, from Dec 2017 to Jun 2018.
Methodology: After consulting the institutional ethical review committees a total of 60 females between ages 18-40 years were enrolled for caesarean section delivery. They were divided into two groups. The study group (n=30) received a subarachnoid injection of 0.5% hyperbaric bupivacaine (10mg) 2ml with 25ug of fentanyl 0.5ml and control group (n=30) was injected 0.5% hyperbaric bupivacaine 12.5mg (2.5 ml) only. Pain experienced during the procedure was assessed by using 10-point visual analogue scoring method. The mean duration of analgesia, mean arterial blood pressure and heart rate after surgery were compared between two groups.
Results: The mean duration of analgesia was 206.5/min ± 6.4 in the study group and it was 163.6min ± 7.2 in the control group (p=0.001). Mean arterial BP after surgery was 92.3mmHg ± 3.8 in the study group and 88.7mmHg ± 4.1 in the control group (p=0.001). The mean heart rate recorded after surgery was 75.2/min ± 5.2 in the study group and it was 70.4/min ± 6.1 in the control group (p=0.001).
Conclusions: The mean duration of analgesia was significantly longer in the study group when compared with the control group with better mean arterial blood pressure and heart rate response after Caesarean section.
SKELETAL MATURATION EVALUATION USING MANDIBULAR SECOND MOLAR CALCIFICATION STAGES
Authors: Nizam Fakhira , Mengal Nasrullah , Tareen Mirza , Hayat Sumbal 
Published: July 2021

Objective: To examine the relationship between skeletal maturity and mandibular second molar calcification stages and assessing mandibular second molar as a diagnostic tool for skeletal maturity evaluation.
Study Design: Cross sectional study.
Place and Duration of Study: Orthodontic department, Sandeman Provincial Hospital, Quetta, from Jan to Jun 2019.
Methodology: The sample size of the study 240 comprised of equal number of males and females. Inclusion criteria was defined to include the patients (male and female) with the age from 9-16 years; on the same time, patients without facial asymmetry and without prior history of facial or neck trauma/injury or surgery were considered for the present study. Exclusion criteria was defined to exclude those patients from the study hoe had the history of bone disease and major illness in past; known cases of muscular dystrophy; any congenital malformation of cervical vertebrae and tooth caries; Low quality x-ray with poor contrast.
Results: The study revealed association between Demirjian Index and Cervical Vertebrae Maturation Index stages (0.875) with the statistical significance. Demirjian Index Stage H indicated the greater percentage distribution at stage 4 and 6 of Cervical Vertebrae Maturation for males. Similarly, in females, demirjian index stages G and H showed the greater percentage at stage 4 and 6 of cervical vertebrae maturation index respectively.
Conclusion: Analysis indicated that cervical vertebrae maturation index and Demirjian Index (DI) occurred earlier in femalesthan males.
COMPARISON OF FREQUENCY OF ABNORMAL FETAL HEART RATE IN CONTINUOUS VERSUS DISCONTINUOUS USE OF OXYTOCIN INFUSION FOR AUGMENTATION OF LABOUR
Authors: Anjum Mehwish , Mustafa Nilofar , Mushtaq Qurratulain , Aslam Pakeza , Qamar Saima , Sarwar Riffat 
Published: July 2021

Objective: To compare the frequency of abnormal fetal heart rate in continuous versus discontinuous use of oxytocin infusion for augmentation of labour.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital Lahore, from Feb to Aug 2018.
Methodology: After fulfilling the inclusion criteria, 76 patients were equally divided in two groups A and B. In both groups, at 3 cm dilatation, intravenous infusion of 5 IU oxytocin in 500 cc normal saline was initiated at infusion rate 3.3mIU/minute Carditocography was initiated 10 minutes before infusion and then continued. An increment in infusion of 3.3mIU/minute was done every 20 minutes till 4 to 5 contractions in 10 minutes were achieved. After this, no more increment was done. The maximum rate was 30mIU/minute. Once cervix was 5 cm dilated, infusion was continued in group A and discontinued in group B for 2 hours. Fetal heart rate was noted on cardiotocography from 20 minutes before initiation of infusion till 2 hours after 5cm.
Results: Age of the patients was 25.4 ± 3.5 years in group A and 26.1 ± 2.4 years in group B. Mean gestation age was 39.2 ± 1.1 weeks in group A and 38.6 ± 1.3 weeks in group B. Group A had significantly more abnormal fetal heart rate compared to group B (p=0.016).
Conclusion: Discontinuous oxytocin infusion in labour showed significantly less abnormal fetal heart rate compared to continuous oxytocin infusion (p=0.016).
DEPRESSION AND ANXIETY IN CORRELATION TO BODY AREAS INVOLVED IN PATIENTS OF BURNS
Authors: Ali Ghazanfar , Khan Sikander Ali , Ahmed Muzzafar , Malik Muhammad Sheraz Afzal , Almas Danish , Majid Abdul 
Published: July 2021

Objective: To evaluate the severity of depression and anxiety among patients of burns and correlate depression and anxiety with areas of body involved in burns.
Study Design: A cross-sectional study.
Place and Duration of Study: The departments of Psychiatry and department of Plastic Surgery, Combined Military Hospital Multan, from Oct 2019 to Mar 2020.
Methodology: Through consecutive sampling, 56 patients of burns reporting to burns unit were assessed for anxiety and/ or depression based on the diagnostic criteria of International Classification of Diseases version 10. Symptom severity was assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety. Descriptive statistics like mean with standard deviation was calculated for age. Frequency along with percentages was calculated for sociodemographic variables, Anxiety and depression.
Results: Depression was present among 30 (53%) of participants out of which 16 (53.5%) had mild, 11 (37.9%) had moderate while only 3 (12.5%) had severe depression. Anxiety was seen among 50 (89%) of participants out of which sixteen (32.1%) had mild, 26 (51.7%) had moderate while 8 (16%) had severe anxiety. Significant correlation existed among the major area involved in burn with both anxiety and depression (p<0.01).
Conclusion: There is a very high prevalence of anxiety and depression among patients of burn. Significant positive correlation existed between the level of anxiety and the areas involved in burns.
EFFECTIVENESS OF SUPERVISED TOOTH BRUSHING EXERCISE ON THE ORAL HYGIENE STATUS OF SCHOOL GOING CHILDREN IN PESHAWAR
Authors: Nasir Samrina , Jawed Rubab , Kibria Zeeshan , Makhdoom Shazia , Khan Aiman , Saleem Momina 
Published: July 2021

Objective: To determine the effects of supervised tooth brushing exercise on the oral hygiene status of school going children in Peshawar.
Study Design: Prospective observational study.
Place and Duration of Study: This study was conducted at a girl’s government school in university town, Peshawar, from Jul to Dec 2018.
Methodology: All girls between age 7-10 years with mixed dentition, minimum plaque index score 2 and gingival index score 0 were included in the study. Sixty four girls were allocated into group A (intervention) and group B (control) using computer generated random numbers. Intervention group (32 subjects) was exposed to video plus supervised tooth brushing on a cast model while control group (32 subjects) only exposed to video on brushing technique. The plaque index score was recorded for oral hygiene status as outcome measure of intervention after one month.
Results: The mean age of the participants was 9.53 ± 1.08 years. There was statistically significant difference in the plaque scores of interventional and control group after one month (0.3125 ± 0.470 vs. 1.312 ± 0.644, p<0.001) as compared to baseline data (1.90 ± 0.296 vs. 2.0 ± 0.00, p=0.83). The difference for frequency of tooth brushing between the two groups was not statistically significant (p=0.088). Parental watch during tooth brushing between the two groups was statistically insignificant (p=0.055).
Conclusion: Supervised tooth brushing improved the oral hygiene status of the children therefore oral health education was effective in establishing good oral health among school children.
SINGLE CENTRE, OPEN-LABEL & NON RANDOMIZED CLINICAL TRIAL TESTING LMWH EFFICACY ON PERINATAL OUTCOME INLATE SECOND TRIMESTER OLIGOHYDRAMNIOS CASES
Authors: Iftikhar Bushra , Shahid Aysha , Akram Nuzhat Aisha , Afsheen Afeera , Mushtaq Rabia , Ehsan Ambreen 
Published: July 2021

Objective: To find out low molecular weight heparin (LMWH) efficacy inlate second trimester oligohydramnios cases.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Malir, from Jan to Jun 2017.
Methodology: A total of 30 patients having amniotic fluid index (AFI) <8 on ultrasound scan during their late second trimester phase were enrolled in the study after informed consent. Exclusion criteria included congenital anomalies on U/S, PPROM, and drug-induced oligohydramnios. Personal, medical and obstetric history was obtained for age, parity and co-morbids like hypertension, antiphospholipid syndrome, and previous oligohydramnios. Low molecular weight heparin was started at dose of 0.5mg/kg of body weight subcutaneously for 8-12 weeks and stopped 24 hours prior to delivery. Rescan for amniotic fluid index and fetal bio-metry assessment done every 2 weeks till date of delivery. Fetal outcome in terms of maturity, mode of delivery, birth weight, APGAR score and need for NICU admission were measured.
Results: There were 28 live births and two intrauterine deaths. Twelve patients were delivered normally and 18 had elective LSCS. Of twenty eight cases, eight were premature low birth weight (LBW) babies. Twenty six patients showed significant improvement in amniotic fluid index. Average birth weight was 2.5kg. Neonates showed an average APGAR score of 7. Eight neonates admitted in NICU (for prematurity and/or low birth weight) and discharged within a week.
Conclusion: Low molecular weight heparin plays significant role in treating oligohydramnios in cases with or without risk factors. However further studies with large sample............
HIGH-RESOLUTION CT (HRCT) CHEST FINDINGS IN PCR POSITIVE PATIENTS OF COVID19 AT COMBINED MILITARY HOSPITAL RAWALPINDI
Authors: Khan Javed Ahmad , Asmat Faryal , Siddiqi Fuad Ahmad , Tareen Tariq Bashir , Hassan Fayyaz , Mehreen Sobia , Sultan Ayesha , Ejaz Amen 
Published: July 2021

Objective: To study High resolution computed tomography chest findings in polymerase chain reaction (PCR) positive patients of COVID-19.
Study Design: Cross sectional study.
Place and Duration of Study: Combined Military Hospital Rawalpindi, from May to Jun 2020.
Methodology: Study included high resolution computed tomography chest of 200 patients admitted to COVID ward who were polymerase chain reaction positive. Patients having previously diagnosed Interstitial lung disease were excluded. Informed consent from patients were taken. Different findings on High resolution computed tomography chest were summarized as percent of total cases. British society of thoracic imaging (BSTI) classification was used to classify high resolution computed tomography chest patterns of COVID-19 pneumonia.
Results: Out of 200 patients included in study, 7 had previous changes on their chest imaging and were excluded. 193 patients (145 males and 48 females) enrolled had a median age of 52 years. One hundred and two patients (52.9%) showed classical pattern for COVID-19, 81 patients (41.9%) had indeterminate changes, 3 patients (1.6%) had atypical changes while 7 (3.6%) had normal high resolution computed tomography chest. Four had pleural effusions while 5 had mediastinal lymphadenopathy. One hundred and eight nine (97.9%) patients had bilateral lung involvement, 145 (75.1%) had central and peripheral while 48 (24.9%) had peripheral invol-vement only. One hundred and forteen (59%) patients had ground glass opacities while 70 (36.3%) had ground glass opacities with consolidation. Nine (4.7%) patients presented with consolidation only.
Conclusion: High resolution computed tomography chest and COVID polymerase chain reaction done at the same time.........
USING FLIPPED CLASSROOM FOR TEACHING PROCEDURAL SKILL IN RESIDENCY SPECIALLY DERMATOLOGY–A SYSTEMATIC REVIEW
Authors: Malik Sakina Sadiq , Yasmeen Rahila , Naveed Ayesha , Naveed Tehseen , Saleem Sadaf 
Published: July 2021

Objective: To review the available literature investigating effectiveness of flipped classroom (FC) in context to teaching of procedural skills in residency in various medical fields especially in dermatology.
Study Design: Systematic review.
Place and Duration of Study: Flipped classroom meeting out inclusion criteria published in 9 years from 2012 to 2020.
Methodology: Flipped classroom meeting out inclusion criteria published in 9 years from 2012 to 2020 were reviewed by the authors and co-authors as per their feasibility and discussion done by video conferencing by mobile software apps.
Results: To review of 25 full-text articles. Strategic organization of course material, wise choice of pre-class activities, usage of Virtual learning environment, class time utilization tailored to learners needs, adherence to timelines, proper training of staff and proper evaluation; are required for successful implementation of flipped classroom. Students had positive perceptions about this technique.
Conclusion: Flipped classroom is an effective teaching method for procedural skills training in post graduate medical training.
CORRELATE BETWEEN BIOFILM FORMATION AND AZOLE ANTIFUNGAL SUSCEPTIBILITY AGAINST PLANKTONIC AND SESSILE CANDIDA ALBICANS CLINICAL ISOLATES
Authors: Salim Saira , Afzal Raja Kamran , Hassan Shahzad , Ikram Aamir , Hussain Amir , Khan Maria 
Published: July 2021

Objective: To assess the correlation between biofilm formation and azole antifungal susceptibility against plank tonic and sessile clinical isolates of C.albicans.
Study Design: Prospective observational study.
Place and Duration of Study: Combined Military Hospital Peshawar, from Jun 2016 to Sep 2017.
Methodology: All standard microbiological procedures were carried out according to latest Clinical & laboratory standard institute (CLSI) guidelines. After gram staining and presumptive identification on CHRO Magar Candida, the isolates were biochemically identified by API AUX Candida as C.albicans. Planktonic antifungal susceptibility was carried out by Kirby Bauer disk diffusion method on 300 C.albicans isolates. Broth microdilution method was used to determine Minimum inhibitory concentration (MICs) of plank tonic cells and micro titer assay was used for assessment of biofilm formation by C.albicans.
Results: In planktonic antifungal susceptibility, fluconazole was susceptible against 195 (65%) and voriconazole against 241 (80%) C. albicans isolates. C. albicans was found susceptible dose dependent (SDD) to fluconazole in 28 (9%) and to voriconazole in 21 (7%) isolates. Seventy-seven (26%) and 38 (13%) C.albicans isolates were found fluconazole and voriconazole resistant, respectively. Sessile antifungal susceptibility was carried out through broth micro dilution method in which 160 (53%) were susceptible, 42 (14%) were susceptible dose dependent SDD and 98 (33%) were resistance to voriconazole, and 161 (54%) were susceptible, 36 (12%) were SDD and 103 (34%) were found resistant to fluconazole. Biofilm forming isolates of C.albicans were observed to be 285 (95%).The p-value is highly significance i.e. <0.01 between......