bluuebunny/crossref_metadata_2025_split huggingface dataset:
REMISSION RATE OF PRE-B ALL (ACUTE LYMPHOBLASTIC LEUKEMIA) AFTER INDUCTION CHEMOTHERAPY FOLLOWING UNITED KINGDOM ACUTE LYMPHOBLASTIC LEUKAEMIA 2011 (UKALL 2011) TRIAL PROTOCOL
Authors: Murtaza Hafiz Muhammad , Ghafoor Tariq , Iqbal Muhammad Shaheen 
Published: May 2021

Objective: To find out the rate of remission of Pre-B Acute Lymphoblastic Leukaemia in children at the end of induction treatment with United Kingdom Acute Lymphoblastic Leukaemia (UKALL) 2011 chemotherapy protocol.
Study Design: Prospective observational study.
Place and Duration of Study: Paediatric Oncology Unit, Combined Military Hospital Rawalpindi, from Nov 2017 to Oct 2018.
Methodology: Data of newly diagnosed patients of Pre-B Acute lymphoblastic Leukaemia, between 1 and 15 years of age was analysed. Patients were divided into low and high-risk groups and treated with United Kingdom Acute Lymphoblastic Leukaemia 2011 induction chemotherapy on regimens A and B respectively. Bone marrow aspiration was performed at the end of induction therapy (28 days), to document their remission status. Patients having ≤5% of blast cells were categorized to be in remission state and those with >5% blast cells were not considered in a state of remission.
Results: A total of 79 patients, 45 (57%) male and 34 (43%) females were enrolled. The mean age was 5.79 ± 3.59 years. Fever (86.1%) and pallor (77.2%) were the most common presentations. Fifty-three (67.1%) patients were treated with regimen A and 26 (32.9%) had regimen B chemotherapy. Febrile neutropenia and myopathy were the most common complications seen in 73 (92.4%) and 54 (71.1%) patients respectively. Eight patients (10.1%) died during induction chemotherapy. Bone marrow aspiration done at the end showed a 100% rate of remission for both regimens A and B.
Conclusion: Risk-based treatment of paediatric Acute lymphoblastic Leukaemia............
CHOROIDAL THICKNESS IN PATIENTS WITH DIABETIC MACULAR EDEMA
Authors: Aqil Amash , Moin Muhammad , Abid Khadijah , Mehmood Ahsan 
Published: May 2021

Objective: To evaluate central macular thickness and choroidal thickness in patients with macular edema due to diabetic retinopathy versus controls.
Study Design: Cross-sectional comparative study.
Place and Duration of Study: Department of Ophthalmology, Lahore General Hospital, Lahore, from Jan to Jul 2018.
Methodology: A retrospective data of 100 eyes from 50 patients having with diabetic macular edema associated with diabetic retinopathy was extracted from hospital registry. Additionally, 100 eyes of 50 individuals without any preexisting ocular conditions, comprising a control group was included in the study. Choroidal thickness measurements were made from the posterior edge of the retinal pigment epithelium to the choroid/sclera junction at subfoveal level using optical coherence tomography. Central macular thickness was also measured for all the enrolled patients.
Results: One hundred patients fulfilling the inclusion criteria were enrolled in our study. The mean age was 56.27 ± 14.41 years. The mean Central macular thickness of all the patients were reported as 270.49 ± 72.38 μm, while the choroidal thickness was 284.89 ± 96.51 μm. There was statistically significant difference in central macular thickness between both healthy and diabetic retinopathy with diabetic macular edema groups (p=0.001), whereas insignificant difference existed between the two groups forchoroidal thickness (p=0.735).
Conclusion: In patients with diabetic macular edema no significant change in choroidal thickness was observed compared with healthy controls, while the thickness of the retina was high in patients with macular edema due to diabetes.
EFFECTS OF THREE ORAL ANALGESICS ON POSTOPERATIVE PAIN FOLLOWING ROOT CANAL PREPARATION: A CONTROLLED CLINICAL TRIAL
Authors: Islam Shahid , Ali Muhammad , Shaikh Abubakar , Rashid Saqib , Hosein Tasleem , Baloch Jiand 
Published: May 2021

Objective: To compare the effect of single dose of three analgesics on postoperative endodontic pain following pulpectomy in teeth with irreversible pulpitis.
Study Design: A quasi-experimental study.
Place and Duration of Study: Endodontics Department, Fatima Jinnah Dental College Hospital Karachi, from Jan to Oct 2018.
Methodology: In this Double Blind placebo controlled study, 120 subjects coming with the complaint of irreversible pulpitis in any one tooth were randomly allocated into 4 groups. Each group took either naproxen sodium (550mg), ibuprofen (400mg), tramadol (100mg) or placebo medication (multivitamin tablet) immediately after the pulpectomy appointment. A questionnaire was designed to assess the experienced pain based on VAS scale at 6, 12 and 24 hours postoperatively. KruskalWallis test was applied followed by post-hoc analysis to compare the VAS scores by taking p-value ≤0.05 as significant.
Results: Pain levels were significantly lower in experimental groups as compared to placebo (p<0.001) but there was no statistically significant difference between the effectiveness of naproxen, ibuprofen and tramadol at 6, 12 and 24 hours postoperatively.
Conclusion: Naproxen, Ibuprofen and Tramadol were found to beequally effective in reducing pain after instrumentation in teeth with irreversible pulpitis.
TO DETERMINE EFFICACY OF GRANISETRON VERSUS PLACEBO FOR REDUCING SHIVERING IN PATIENTS UNDERGOING LOWER SEGMENT CAESAREAN SECTION UNDER SPINAL ANAESTHESIA
Authors: Abbas Sana , Yasin Bilal , Khan Basit Mehmood , Hayat Umer , Hanif Rashid , Fayyaz Mohsin 
Published: May 2021

Objective: To determine the efficacy of granisetron versus placebo (saline) for reducing shivering in patients undergoing lower segment caeserian section under spinal anaesthesia.
Study Design: Comparative cross - sectional study.
Place and Duration of Study: Department of Anaesthesia, Combined Military Hospital Rawalpindi, from Apr to Sep 2019.
Methodology: Total 178 patients undergoing lower segment ceaserian section under spinal anaesthesia with age ranges from 18-40 years of American Society of Anaesthesiologists status I & II with full term pregnancy scheduled for elective caesarean section under spinal anaesthesia. Group A (n=92) received an intravenous bolus of 1 mg granisetron in a 10ml syringe and Group B (n=86) received intravenous bolus of normal saline in a 10ml syringe, drugs were administered immediately before spinal anaesthesia by anaesthetist as coded syringes. Heart rate, blood pressure, core body temperature and shivering scores were measured at 0 minutes, 30 minutes and 60 minutes, average surgery time recorded to be 60 minutes.
Results: None of the patients in group A (drug group) exhibited appreciable post spinal shivering whereas 25 (29%) in group B (placebo) had clinically significant shivering necessitated administration of other established pharmacological agents to abort shivering in order to ensure patient comfort and satisfaction with statistically significant p-value of <0.05.
Conclusion: Prophylactic injection granisetron was efficacious against post spinal shivering, moreover provides worth while relief of nausea and vomiting which is dilemma with most of the drugs employed for control of post spinal shivering.
RELATIONSHIP BETWEEN RED BLOOD CELL AND PLATELET INDICES IN IRON DEFICIENCY ANEMIA
Authors: Rabbani Sahar , Farooq Muhammad , Naeem Samina , Naeem , Muhammad Abdul , Uddin Nasir , Zubair Muhammad 
Published: May 2021

Objective: To find out the correlation between the red blood cell and platelet indices in patients presenting with iron deficiency anemia at a tertiary care hospital of Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Hematology, Combined Military Hospital Lahore, from Sep 2018 to Mar 2019.
Methodology: The patients of age 1-70 years of either gender presenting with IDA were included in the study. The blood sample of patients were sent to laboratory to assess the red blood cell and platelet indices. SPSS-23 was used to analyze data.
Results: Two hundred and seven patients fulfilling the inclusion criteria were included in this study. The mean age was 25.6 ±17.8years. Correlation was weak and insignificant between haemoglobin and packed cell volume (r=-0.385**, p<0.01), haemoglobin and mean cell volume (r=-0.225**, p<0.01), packed cell volume and mean cell haemoglobin (r =0.263**, p<0.01), & mean cell haemoglobin and mean platelet volume (r=0.143*, p<0.05). Correlation was moderate and significant between platelet distribution width and mean platelet volume (r=0.511**) & platelet distribution width and platelet large cell ratio (0.502**, p<0.01). Correlation was strong between mean platelet volume and platelet large cell ratio (r=0.759**, p<0.01).
Conclusion: In conclusion, there was significant relation between red blood cell and platelets indices in iron deficiency anemia. Furthermore, haemoglobin and packed cell volume are weekly correlated, platelet distribution width and mean platelet volume are moderately correlated and mean platelet volume and platelet large cell ratio are strongly correlated.
CHRONIC DIARRHEA IN SOLDIERS; FACTS
Authors: Hafeez Muhammad , Saeed Farrukh , Qureshi Zafar , Khan Saad Ali , Siddiqi Fuad Ahmad 
Published: May 2021

Objective: To find out the underlying causes of chronic diarrhea in soldiers and how it differs from general population.
Study Design: Prospective comparative study.
Place and Duration of Study: Combined Military Hospital (CMH) Multan and Pak Emeritus Military Hospital (PEMH) Rawalpindi, from Dec 2017 to Jan 2020.
Methodology: All soldiers in active service, having diarrhea more than 4 weeks in study and non-soldiers of the same age were included in the control group. There were inquired in details about the diarrhea symptoms and investigations carried out accordingly to find out the underlying cause. The two groups were compared to find out any differences. The data were analyzed by SPSS version 22.
Results: Seventy one in study and 50 patients in control had their mean ages of 34.61 ± 8.35 and 32.42 ± 10.28 years. Mean duration of symptoms were 18 and 15 months in study and control groups respectively. Irritable Bowel Syndrome (IBS) was more common in both groups i.e. 14 (20%) and 20 (40%) in study and control groups respectively but frequency was more in second one. Seropositive celiac disease 13 (18.5%), seronegative villous atrophy 10 (14%) in study and Inflammatory Bowel Disease IBD 6 (12%) in control group were second most common conditions.
Conclusions: Irritable bowel syndrome is common in this age group. Celiac and seronegative villous atrophy is second common conditions in the study group.
EVALUATION OF CHONDROPROTECTIVE EFFECTS OF INTRA ARTICULAR PIROXICAM IN POST-TRAUMATIC OSTEOARTHRITIS MODEL OF RAT
Authors: Ishaq Noaman , Ali Shabana , Haider Qurra Tul Ain , Qaisrani Muhammad Abdul Basit , Malik Komal Mumtaz , Khan Muhammad Wasiullah 
Published: May 2021

Objective: To evaluate the chondroprotective effect of piroxicam in post-traumatic osteoarthritis model of rat.
Study Design: Laboratory based experimental study.
Place and Duration of Study: Pharmacology department, Army Medical College, Rawalpindi, from Apr to Jun 2019.
Methodology: Project included sixteen rats of Sprague Dawley breed. Osteoarthritis was induced in anesthetized rats by surgical removal of medial meniscus and anterior cruciate ligament resection. After that rats were randomly allocated in two groups with eight rats in each group. Rats of group I were positive control that received 0.2 ml saline intra articularly once weekly for four weeks. Meanwhile rats of group II (treatment group) received 50 µl piroxicam intra articularly once weekly for four weeks. One week after the drug intervention, radiograph of the right knee joint of all rats were taken. Animals were then sacrificed with inhaled chloroform and part of proximal tibia was obtained for histopathological analysis.
Results: Comparison of radiographs of both groups depicted a significant p-value of <0.01. Meanwhile mean histopathological score of control group and treatment group were 11.50 ± 1.195 and 6.50 ± 1.195 respectively with a p-value of <0.01.
Conclusion: Intra articular administration of piroxicam in post-traumatic Osteoarthritis model of rats resulted in improvement in radiographic grades and histopathology scores.
ASSESSMENT OF STROMAL AND INTRA-EPITHELIAL TUMOR INFILTRATING LYMPHOCYTES IN COLORECTAL CARCINOMA AT ARMED FORCES INSTITUTE OF PATHOLOGY
Authors: Ameer Amna , Akhtar Farhan , Ud Din Hafeez , Ahmed Rabia 
Published: May 2021

Objective: To conduct a morphological evaluation quantitatively of two types of tumor-infiltrating lymphocyte populations, including those located in the stroma and intraepithelial cancer structures, in patients with colorectal cancer.
Study Design: Cross sectional study.
Place and Duration of Study: Armed Forces Institute of Pathology, Rawalpindi, from Jan to Jul 2019.
Methodology: Three levels of infiltration in the stroma by tumor infiltrating lymphocytes were determined. Level 1 was weak meaning (0-20% of stromal TILs), level 2 was moderate meaning (>20-50% of stromal TILs); and level 3 was strong meaning (50-90% of stromal TILs). TILs within tumor cells were divided into two groups. 0 meaning absent (no TILs present) and 1 meaning present (≥TILs in tumor cells) 1.
Results: Out of 30 cases 22 were males and 8 females. Ages ranged between 25-83 with a mean of 57 years and a standard deviation of ± 16.4 years. All of the cases were diagnosed cases of adenocarcinoma. The levels of stromal tumor infiltrating lymphocytes was weak in 1 case, moderate in 18 cases and strong in 11 cases whereas intraepithelial lymphocytosis was seen in 22 cases.
Conclusion: These results confirm that the infiltration of tumor infiltrating lymphocytes into the tumor in patients with colorectal carcinoma serves an important role in the invasion and progression of the disease, and should be considered in routine examinations.
PREGNANCY OUTCOMES DO INFLUENCE BY EXTREMES OF BODY MASS INDEX
Authors: Razzaq Lubna , Devi Ramna , Tariq Sana , Seetlani Anchal , Jamshed Saira 
Published: May 2021

Objective: To investigate whether extreme of body mass index (BMI) is associated with pregnancy outcomes.
Study Design: Retrospective cohort study.
Place and Duration of Study: Hamdard University Hospital, Karachi, Pakistan, from Feb 2019 to Jan 2020.
Methodology: We conducted a retrospective cohort study of 1000 women delivered in between February 2019 to January 2020. BMI is categorized into four groups according to the Asian-Pacific cutoff points as underweight (<18.5 kg/m2), normal weight (18.5–22.9 kg/m2), overweight (23–24.9 kg/m2), and obese (>25 kg/m2). Maternal outcomes measured were pre-eclampsia, gestational diabetes, delivery by cesarean section, instrumental delivery, anemia, postpartum hemorrhage and fetal outcome included small for gestational age and large for gestational age. Logistic regression model was used to adjust the confounder. Maternal outcomes were evaluated with relative risks and 95% confidence intervals.
Results: In results, 13%, 54%, 22%, 9% and 2% were underweight, normal body mass index, overweight, obese and morbidly obese categories respectively. The gestational diabetes, pre-eclampsia, labour induction, frequency of cesarean section, postpartum hemorrhage increased linearly with increasing body mass index and expressed as adjusted odds ratio (95% confidence interval) respectively: 10.0 (95% CI 3.5, 28.7), 5.3 (95% CI 2.0, 14.1), 2.7 (95% CI 1.1, 6.8), 4.9 (95% CI 2.8–8.8), 2.5 (95% CI 0.31– 20.6). The anemia and small for gestational age were found in underweight group with adjusted odd ratio2.47 (95% CI 1.6– 3.6), 4.6 (95% CI 2.6, 8.1) respectively........
ETHICAL DILEMMA OF CESAREAN SECTION ON MATERNAL REQUEST (CSMR)
Authors: Choudary Abeera , Siraj Asifa , Tariq Humaira , Chughtai Faiqa , Urooj Uzma 
Published: May 2021

Objective: To study the demographic characteristics of pregnant ladies and factors contributing towards rise in cesarean section on maternal request to aid the obstetricians in decision making.
Study Design: Cross sectional analytical survey.
Place and Duration: Gynecology Department of Pak Emirates Military Hospital, Rawalpindi, from Nov 2019 to Mar 2020.
Methodology: One hundred and fifteen women of child bearing age requesting cesarean section were included in the study. Demographic details were noted. A study proforma was filled for determinants of primary and secondary tocophobia and factors that may be improved for vaginal delivery.Results: A total of 115 patients with mean age of 27.99 years were included. Amongst them, 88 (76.5%) were Punjabi with 92 (80%) living in rural area. Primigravida were 11 (9.6%), 83 (72.2%) had previous lower segment cesarean section and 3 (2.6%) had vaginal delivery. For primary tocophobia, 22 ( 24.4%) experienced anxiety. Fear of labor pains was seen in 20 (19.2%) and lack of control in 27 (26%). For secondary tocophobia, 15 (37.5%) were fearful of prolonged labor and 5 (22.5%) of sub optimal birth outcome. In women with previous one cesarean section, 13 (14.8%) correlated negatively with birth experience and 20 (22.7%) found timed cesarean section convenient. For vaginal delivery, pain relief was preferred by 19 (20.2%) and 31 (33%)wanted pain relief and attendant.
Conclusion: Better understanding of fears behind maternal request for cesarean section can lead to improved attitudes towards vaginal delivery. The negative perceptions of pregnant ladies should be addressed in antenatal.........
FEEDBACK: DIFFERENT CONCEPTS AND PRACTICES IN A CULTURALLY DIFFERENT ENVIRONMENT-FACULTY PERCEPTIONS
Authors: Malik Ahsan , Kiran Faiza , Farooq Fareeha 
Published: May 2021

Objective: To explore the faculty perceptions regarding the phenomenon of feedback and its‟ practices in a traditional undergraduate dental college in Pakistan.
Study Design: Qualitative following principles of phenomenology.
Place and Duration of Study: Rawal Institute of Health Sciences, Islamabad from Feb to Apr 2017.
Methodology: Purposive sampling was done, and data was gathered using semi-structured individual interviews of 12 BDS faculty members. Data was organized using qualitative software package Atlas.ti 8.0 and analyzed using thematic framework analysis.
Results: Feedback practices were found to be informally practiced in traditional BDS curriculum. Perceptions regarding purpose and beliefs on oral and written feedback were explored. The essence of the phenomenon under focus is described in terms of five domains denoted by five emergent themes: 1) „Understanding Feedback‟ through participants‟ response to/use of the term, 2) highly variant experiences of information exchange, 3) modes and forms of feedback, 4) factors affecting feedback and 5) methods achieving learning progression.
Conclusion: Faculty in our culturally different learning environment is devoid of formally instituted feedback practices, have understandings and practices that are both similar and dissimilar in nature to those often described in western-centric literature. Education about the phenomenon of feedback and faculty training to use it appropriately may help streamline the educational process in this context.
MUCOSECTOMY IN COMPLICATED APPENDICITIS
Authors: Naqvi Syeda Rifaat Qamar , Khan Fahad Ali , Khan Ayesha , Sultan Babar , Haider Anam , Khadim Rehana , Khan Palwasha , Qureshi Zaheer Ud Din 
Published: May 2021

Objective: To describe the technique and results of mucosectomy; A surgical technique that is easy to perform, and has a lower morbidity and complication rate as compared to standard appendectomy in cases of complicated appendicitis.
Study Design: Quasi-experimental study.
Place and Duration of Study: Surgical - A Unit, Ayub Teaching Hospital, in Abbottabad, from Mar 2017 to Mar 2019.
Methodology: Patients included were those who presented with appendicular mass, phlegmon, recurrent appendicitis, appendicitis in uncommon locations, presence of adhesions, those cases of appendicular mass and phlegmon which was either not responding to medical treatment, or diagnosed per operatively being clinically not palpable or not seen on ultrasound. Per operative and post-operative variables were documented and analyzed. In mucosectomy, thesubserosal portion of the appendix i-emuscularis and mucosa of the appendix was dissected out from the serosa after ligation of the appendicular base, or ligation done after delivering the appendix out of the serosa. The serosa that was adherent to the surrounding gut, omentum or other viscera was left intact.
Results: A total of 192 patients were included in this study, half of which underwent standard appendectomy and a mucosectomy was performed on the rest. The mean time of surgery was 30 ± 1.2min as compared to the standard appendectomy group (55min ± 3.6). More than half of the patients undergoing standard appendectomy required extension of the incision (56.2%), only 8% required so from those on whom mucosectomy was performed. Per operative hemorrhage was seen in 32.2%, however inmucosectomy group only 1%.
REASONS OF CONFLICTS IN TERTIARY CARE HOSPITAL: A CROSS SECTIONAL STUDY
Authors: Sardar Tahir , Khan Muhammad Alamgir , Akhtar Muhammad Naveed , Gul Arshad 
Published: May 2021

Objective: To assess the reasons of conflicts in tertiary care hospital Rawalpindi.
Study Design: Cross sectional study.
Place and Duration of Study: Tertiary care hospital Rawalpindi, from Aug 2008 to Jul 2009.
Methodology: Hospital staff comprising of health administrators, clinicians, nurses and paramedics working in tertiary care hospital Rawalpindi were included in the study.
Results: These questions were asked to assess the general understanding of the respondents regarding the subject of conflicts to deduct their possible response in conflict situations. As per "Traditional" view conflict was considered as dysfunctional, destructive and irrational. The "Human relations view" describes conflict as natural, suggests tolerating it whereas the latest “inter-actionist view” defines conflict as a means for keeping us viable and creative, and suggests encouraging it. Average 44% of the respondents, mainly administrators and clinicians have fair idea regarding current concept of conflict.
Conclusion: Clinical and administrative staffs of hospitals are like parts of a train track. The irrational relationship between them will result in distortion and lower quality of services. Therefore, effective strategies to decrease staffs‟ experience of conflict need to be developed. This might create a healthier and more productive work environment which positively affects the care quality.