bluuebunny/crossref_metadata_2025_split huggingface dataset:
PSYCHIATRIC DISORDERS IN CHILDREN: PATTERN AND CORRELATES AMONG THOSE REPORTING TO A TERTIARY CARE HOSPITAL
Authors: Amin Malik Awais , Kamran Muhammad , Rauf Shehzad , Bukhsh Sumaira , Gul Isbah , Tabassum Ahmed Shoaib 
Published: July 2021

Objective: To determine the pattern of psychiatric disorders among children reporting to the Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Psychiatry department Pakistan Naval Ship Shifa Hospital, Karachi, from Feb to Aug 2018.
Methodolgy: A total of 100 children, aged between 6-12 years of age, both male and female, meeting the selection criteria of the study, presenting to the Psychiatry department at Pakistan Naval Ship Shifa Hospital, were enrolled for this study. Informed consent was taken from the parents. The consultant psychiatrist interviewed the patients and diagnosed any psychiatric disorders based on international classification of diseases version 10. The data was recorded on the study proforma.
Results: Out of a total of 100 children, 66 (66%) were male, while 34 (34%) were female. The mean age of the participating children was 8.66 + 1.97 years. The most common psychiatric disorder was attention deficit hyperactivity disorder 44 (44%), followed by depression 30 (30%). Other diagnoses included oppositional defiant disorder 12 (12%), conduct disorder 9 (9%) and separation anxiety disorder 5 (5%).
Conclusion: Attention deficit hyperactivity disorder and depression are amongst the quite prevalent psychiatric disorders, than that was considered earlier.
EVALUATION OF MODIFIED CYTOSPIN SLIDE MICROSCOPY FOR DETECTION OF ACID FAST BACILLI IN BRONCHOALVEOLAR LAVAGE FLUID FOR DIAGNOSIS OF PULMONARY TUBERCULOSIS
Authors: Imtiaz Anam , Ikram Aamer , Zaman Gohar , Satti Luqman , Sana Fatima 
Published: July 2021

Objective: To evaluate the cytospin slide microscopy method for detection of acid fast bacilli (AFB) in bronchoalveolar lavage (BAL) fluid comparing it with concentrated smear microscopy.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi, from Dec 2016 to Sep 2018.
Methodology: BAL specimens from suspected tuberculosis patients who were sputum smear negative, submitted to AFIP for diagnosis were included in the study. Smears for microscopy were prepared with the modified cytospin method as well as the standard concentrated technique. The prepared smears from both methods were stained with Ziehl–Neelsen (ZN) staining method and examined under 100 × oil immersion lens. TB culture performed on BACTEC MGIT 960 automated culture system (Becton Dickinson, USA) was taken as gold standard for TB diagnosis. The two methods were compared in terms of sensitivity, specificity, positive predictive value and negative predictive value.
Results: Out of the 130 samples tested, 62 (47.7%) were positive on culture using MGIT 960 system. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the modified cytospin method for pulmonary TB diagnosis was found to be 68.3%, 100%, 100%, 77% and 84.6%, respectively.
Conclusion: The sensitivity of the modified cytopsin smear method was significantly higher than that of the concentrated method. The study concludes that this is a simpler and more accurate method for BAL fluid microscopy.
CLINICAL SPECTRUM AND OUTCOME OF PATIENTS WITH TUBERCULOUS MENINGITIS AT A TERTIARY CARE HOSPITAL OF PAKISTAN
Authors: Gilani Atifa , Hassan Zahid , Nawaz Khurram Haq , Khan Muhammad Babar , Arif Saeed , Kazmi Sakhawat 
Published: July 2021

Objective: To assess the clinical profile and outcome of patients admitted with the diagnosis of tuberculous meningitis (TBM) at neurology unit of a tertiary care teaching hospital of Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Neurology department, Pak Emirates Military Hospital Rawalpindi, from Dec 2018 to Jun 2019.
Methodology: This study was conducted on 69 patients of tuberculous meningitis admitted. Demographic profile included age, gender, and the symptoms with which the patient presented. Neurological complications were also documented among the target population. Outcomes included recovery, shifting to intensive care unit and death.
Results: A total of 69 patients admitted in neurology ward diagnosed and managed as tuberculous meningitis in the study duration time. Male to female ratio was 1.4:1. Mean age of patients diagnosed with tuberculous meningitis in our study was 34.23 ± 3.915 years. Most of the patients presented with the fever followed by headache. Out of 69 patients, 41 (59.4%) recovered, 22 (31.9%) were shifted to the intensive care unit and 6 (8.7%) died. Seizures were the commonest neurological complication faced by the patients followed by cranial nerve palsies.
Conclusion: Fever and headache were common symptoms with which patients of tuberculous meningitis presented in our study population. Most of the patients recovered in the ward but a high percentage required intensive care unit admission as well. Seizures and cranial nerve palsies were commonly experienced complication by patients included in our study.
FREQUENCY AND FACTORS OF NON-COMPLIANCE AMONG EPILEPTIC PATIENTS
Authors: Gilani Atifa , Nawaz Khurram Haq , Hassan Zahid , Yousaf Muhammad Ali , Hashmat Asif , Arif Saeed 
Published: July 2021

Objective: To determine the frequency of non-compliance among the patients of epilepsy and factors related to the presence of non-compliance at a tertiary care hospital of Pakistan.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Neurology department, Pak Emirates Military Hospital Rawalpindi, form Dec 2018 to Jun 2019.
Methodology: A total of 133 cases were included in the study, which were diagnosed as epilepsy for more than 6 months by a consultant neurologist. Medication and drug adherence was assessed by validated Urdu version of our-item Morisky Medication Adherence Scale. Relationship of age, gender, socio-economic class, duration of epilepsy, education, marital status and poly-pharmacy was assessed with the presence of non-compliance among the patients suffering from epilepsy.
Results: There were 53 (39.9%) patients were females while 80 (60.1%) were males. Out of 118 patients of epilepsy, 59 (44.4%) showed the presence of non-compliance while 74 (55.6%) had good compliance. After applying the logistic regression we found that duration of illness and poly-pharmacy had significant association with the presence of non-compliance among the patients of epilepsy.
Conclusion: Non-compliance emerged as a highly prevalent behavior or clinical condition among the patients of epilepsy in our target population. Before combining the pharmacological agents it is advisable to check the compliance of already prescribed drugs used to control the seizures. Patients with long standing illness or those who are put on multiple medications should be regularly screened for non-adherence.
ANATOMICAL VARIATIONS OF EXTRA HEPATIC BILIARY SYSTEM IN PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY IN CMH & PEMH RAWALPINDI
Authors: Muazzam Muhammad Ali , Hussain Syed Mukarram , Qureshi Muhammad Tanvir Ahmed 
Published: July 2021

Objective: To assess the frequency of anatomical variations of the extra-hepatic biliary tract in patients undergoing laparoscopic cholecystectomy in Combined Military Hospital & Pak Emirates Military Hospital Rawalpindi.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of General Surgery, Combined Military Hospital & Pak Emirates Military Hospital, Rawalpindi, from Mar to Aug 2017.
Methodology: A total of 136 patients of either gender with cholelithiasis of more than one month were included. Participants were distributed into equal number of groups for both hospitals by lottery method. All the participants had under gone laparoscopic cholecystectomy by consultant general surgeon or senior registrar under direct supervision. Structures mainly assessed for variations were gall bladder, cystic duct, common hepatic duct, supraduodenal part of common bile duct, cystic artery, and hepatic artery which were characteristically encountered during laparoscopy.
Results: Overall Extra hepatic biliary variations were 136 (23%), at Combined Military Hospital 68 (16%) and Pak Emirates Military Hospital 68 (29.4%). Gall bladder anomaly was seen in 3% patients, cystic duct anomaly 4.4%, supraduodenal part of common bile duct anomaly 0.7%, cystic artery anomaly 11% and hepatic artery anomaly was seen in 3.6% patients (p>0.05).
Conclusion: Anatomic variations were found to be not uncommon in our set up. Thus, there is a need for doctors to continuously refresh knowledge of normal anatomy and the variants of biliary tract.
GENITOURINARY INJURIES DURING WAR AGAINST TERROR: A SINGLE-CENTER EXPERIENCE
Authors: Khan Haroon Sabir , Kiani Faaran , Nawaz Muhammad , Alvi Muhammad Sarwar , Zafar Muhammad Rafiq , Mahmood Arshad 
Published: July 2021

Objective: To compare our experience of genitourinary injuries during the war against terrorism with the record of those in previous wars of the World.
Study Design: Cross sectional study.
Place and Duration of Study: Urology department, Combined Military Hospital Peshawar, from Jun 2011 to Aug 2014.
Methodology: We treated 89 (5.6%) cases of genitourinary injuries received in our tertiary care hospital in Khyber Pakhtunkhwa. The hospital was located at a distance of 2-3 hours of evacuation time by helicopter from the forward operational area.
Results: The frequency of genitourinary injuries among 1589 war casualties was (5.6%). Out of these 49 (55%) were due to sniper shots and 40 (45%) due to improvised explosive device. Kidney was the most common organ injured 30 (33.7%), followed by bladder 20 (22.5%) and urethra 14 (15.7%). Majority of renal and bladder injuries were afflicted in those soldiers who were not wearing the protective jackets. Associated injuries to other organs were identified in 81% cases. Salvage of all genitourinary organs was the aim; however, nephrectomy and orchiectomy had to be performed in 30% and 50% respectively.
Conclusion: Salvage of genitourinary war injuries poses a challenge to the trauma surgeon as lifesaving measures take precedence over organ preservation. Renal trauma in war was found to be the leading critical genitourinary injury.
FACULTY PERSPECTIVE ABOUT DIFFICULTIES IN IMPLEMENTATION OF NEWLY INTRODUCED INTEGRATED CURRICULUM FOR BASIC SCIENCES IN KING EDWARD MEDICAL UNIVERSITY
Authors: Cheema Khalid Mahmood 
Published: July 2021

Objective: To explore the perceptions of basic sciences faculty about the integrated curriculum.
Study Design: Sequential mixed method study.
Place and Duration of Study: King Edward Medical University Lahore, from Oct to Dec 2017.
Methodology: A 15-item survey was utilized as quantitative information collection device that gave the numerical depiction of the patterns, views or conclusions of the participants. In-depth interviews were done after survey as a tool of qualitative data collection to investigate beliefs and explore the attitudes.
Results: All ninety three faculty members of basic sciences in medical college were contacted and survey response rate was 96.77% (90/93). 97% of faculty members had awareness about curricular integration; but majority (56%) had concerns about its appropriate implementation. Majority agreed that integration was beneficial for students‟ learning. They were satisfied with its design and relevance. Major considerations were correct implementation and lack of coaching in adopting new teaching methods and educational approaches.
Conclusion: Curriculum integration is useful and essential in student‟s learning but training is necessary in its planning and execution. Current negative perceptions need to be addressed through further research.
COMPLICATIONS OF TRACHEOSTOMY AND LEADING FACTORS AMONG PATIENTS PRESENTING AT A TERTIARY CARE HOSPITAL, KARACHI
Authors: Wasim Muhammad Fahad , Riaz Naeem , Aslam Sohail , Bukhari Syed Muhammad Asad Shabbir , Mumtaz Humza , Ahmed Waseem 
Published: July 2021

Objective: To look for the complications of tracheostomy and factors correlated with presence of these complications at a tertiary care teaching hospital of Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: ENT department, Operation Theater, Emergency department and Critical Care Unit of Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Apr to Oct 2019.
Methodology: Sixty nine patients who underwent tracheostomy were included in the analysis. Final decision regarding offering the procedure of tracheostomy to the patient was made by consultant ENT specialist in liaison with the primary treating physician. Patients were assessed for the complications during the procedure, immediately after the procedure, 48 hours after the procedure and one week after the procedure.
Results: Out of sixty nine patients included in the study, 8 (11.6%) patients underwent emergency tracheostomy while 61 (88.4%) underwent elective tracheostomy. Ten (14.5%) had undergone percutaneous procedure while 59 (85.5%) had undergone open surgical procedure. Hemorrhage was the commonest complication reported followed by dislodgement. With Pearson chi-square test, we found that increasing age (45 years) and emergency tracheostomy had strong association with the presence of complications among the patients undergoing tracheostomy.
Conclusion: Tracheostomy emerged as a safe procedure with mostly minor self-limiting complications. Surgeon performing this procedure should be aware of these common complications and should give information care to the patients prior to the procedure. Patients who are elderly or undergoing emergency tracheostomy should be dealt with special care while doing this life saving procedure.
CONTRACEPTIVE PREFERENCES AND IMPROVED QUALITY OF LIFE
Authors: Baqai Shehla , Siraj Asifa , Urooj Uzma , Noor Nusrat , Tariq Humaira , Khan Sumaira 
Published: July 2021

Objective: To understand the contraceptive preferences of women of reproductive age group and to know from where they get the knowledge of it and how quality of life of contraceptive users and non-users is affected.
Study Design: Cross-sectional study.
Place and Duration of Study: Gynecology and Obstetrics department, Pak-Emirates Military Hospital Rawalpindi, from Sep 2017 to Aug 2018.
Methodology: Pre-tested self-administered questionnaires were used to assess the usage of contraception, role of health care providers social/family influences, and print/broadcast media, to provide sample size calculation, ethics approval, knowledge and access to various contraceptive methods. The quality of life indicators used were anemia and feeling of general well-being.
Results: A total of 1050 participated in the study. Out of those who have knowledge, only 497 (47.33%) practiced contraception and 530 (50.47%) not using it 23 (2.1%) were not clear about their views regarding contraceptive usage. Out of those who were using contraception, 161 (54.20%) women used barrier methods, 93 (18.71%) used intrauterine contraceptive devices, implanon 52 (10.46%), natural methods 61 (12.27%), oral/injectable 99 (19.91%) and male contraception was used by 31 (6.23%) couples. Anemia was less in contraceptive users 84 (17%) as compared to non-users 164 (31%).
Conclusion: Family planning is the strongest tool which can improve the health of mother and children as well as it’s a development indicator for overall social and economic status of a society. By understanding its prevalence and factors influencing its usage, maternal and child health can be improved in near future.
THE EFFECT OF OVARIECTOMY ON WOMEN’S PERIODONTAL STATUS: A PILOT STUDY
Authors: Sohail Kanwal , Zafar Mahrukh , Zulfiqar Maham , Kiyani Amber 
Published: July 2021

Objective: To determine the effect of bilateral oophorectomy on the periodontal status of otherwise healthy women when compared with normal controls.
Study Design: Mixed-method study.
Place and Duration of Study: Riphah International University, Islamabad, from Apr to Sep 2016.
Methodology: A total of 24 women with and without oophorectomy procedures were recruited. Twelve women who has undergone radical hysterectomies at least 6 months prior to the evaluation were recruited for this investigation. These women underwent a comprehensive oral examination with detailed documentation of their periodontal status following a thorough medical/dental history. An age- and sex-matched control population underwent a similar examination.
Results: Statistically significant results were noted for probing, color, consistency, texture and contour of gingiva with the p-value of 0.007, 0.001, 0.002, 0.005 and 0.037 when the results were compared with the control population.
Conclusion: Bilateral oophorectomy does not compromise the periodontal health of otherwise healthy women.
AWARENESS REGARDING USE OF LINING UNDER POSTERIOR COMPOSITE RESTORATIONS AMONG GENERAL DENTISTS OF LAHORE
Authors: Khan Salman Ashraf , Bajwa Obaid , Khalid Naima , Khan Nissa 
Published: July 2021

Objective: To evaluate awareness among the General Dentists of Lahore regarding the use of lining materials under posterior resin restorations.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted in Lahore, from Sep 2019 to Jan 2020.
Methodology: Non-probability consecutive sampling technique was used. A sample size of 271 was calculated. The questionnaires were distributed by 2 surveyors to the general dentists of Lahore, Pakistan.
Results: The response rate was 100%. Amongst these dentists, 191 (63.87%) affirmed that they use lining materials in initial depth cavities, 248 (82.94%) used lining material under moderate depth restorations and 285 (95.31%) used lining materials under advanced depth cavities with calcium hydroxide being the most commonly used material.
Conclusion: The findings of the present study indicate that general dentists of Lahore are unaware of the contemporary concepts regarding the placement of cavity liners and tend to place liners in initial and moderate depth cavities under posterior resin restorations.
SPECTRUM OF RENAL ALLOGRAFT BIOPSY FINDINGS IN RENAL TRANSPLANT PATIENTS AT A TERTIARY CARE CENTER IN RAWALPINDI, PAKISTAN
Authors: Mansoor Khurram , Osama Muhammad , Ishaque Muhammad , Sabir Sohail , Din Hafeez ud , Asif Muhammad , Sabir Haroon 
Published: July 2021

Objective: To evaluate outcome of diagnostic kidney biopsy in patients with renal allograft dysfunction at a tertiary care hospital.
Study Design: Retrospective observational study.
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi, from Jan 2014 to Jan 2020.
Methodology: A consolidate registry review was carried to formulate this study. The registry data exists at our center containing information about the graft dysfunction (manifesting as proteinuria, deranged urea and creatinine or urine sediment abnormalities) and other major indications which warrant probing with biopsy. The histopathological diagnosis of these biopsies is confirmed from the nephro-pathology registry before finalization of diagnosis.
Results: A total of 94 diagnostic kidney biopsies were performed in patients with graft dysfunction. Out of 94 biopsies, 80 (85.1%) patients were male while 14 (14.9%) were female patients. The most frequent single cause for graft dysfunction was Cell Mediated Rejection (n 12, 24.5%) followed by Interstitial Fibrosis and Tubular Atrophy/Acute Tubular Injury. The most common cause among the glomerulonephritis was Membranoproliferative Glomerulonephritis (n 3, 6.1%) followed by others. The most common cause for mixed pathology remainedcell mediated rejection with Interstitial fibrosis and tubular atrophy (n 8, 17.8%).
Conclusion: Cell mediated rejection is thecommonest pathology responsible for renal allograft dysfunction both as a single lesion as well as part of mixed pathology.
PERCEPTION OF ALTERED SMILE ESTHETIC AMONG DENTISTS, STUDENTS AND LAYPERSONS USING DIGITAL PHOTOGRAPHS: A COMPARATIVE STUDY
Authors: Amin Erum , Khan Mehwish , Siddiqui Mohmmad Omer , Babar Adnan , Hassan Fatima , Ejaz Wajeeha 
Published: July 2021

Objective: To investigate whether there is any difference in the perception of altered smile esthetics among dentist, students and layperson.
Study Design: Comparative cross sectional study.
Place and Duration of Study: Armed Forces Institutes of Dentistry Rawalpindi, from Jan to Jun 2019.
Methodology: A total of 120 individuals were selected among which 40 were dentists, 40 were students and 40 lay persons to evaluate smile on given questioner. An individual was photographed in frontal posed smile using a digital camera at natural head position. The photograph was digitally manipulated with minor changes and only desired area of face was framed using Adobe Photoshop CC 2018 software to generate a control and ideal smile. Series of photographs were generated by doing modifications to evaluate five variables including Smile arc, Gingival display, Buccal corridor, Midline shift and Midline diastema. The each group was also asked to rate attractiveness each picture on 5 points Visual Analog Scale (VAS) from 1- Most attractive to 5- Least attractive.
Results: The p-value was for midline diastema and midline shift was <0.01. Most of the study population was females 75 (62.5%) and the mean age of participants was 27.51 ± 5.42. Significant difference was observed at VAS in flat smile arc, nil buccal corridor, mid-line shift and midline diastema by study groups.
Conclusion: Perception of midline diastema and midline shift differs significantly among dentists, students and lay persons.
EFFICACY OF INTRA-ARTERIAL LIDOCAINE FOR PAIN CONTROL RESULTING FROM TRANSARTERIAL CHEMOEMBOLIZATION OF HEPATOCELLULAR CARCINOMA
Authors: Abbas Ghulam , Sheraz Atif , Rahim Raza 
Published: July 2021

Objective: To assess the efficacy of intra-arterial lidocaine in peri & post-procedural pain control and the dose of narcotic analgesic required in hepatocellular carcinoma patients undergoing transarterial chemoembolization.
Study Design: Comparative prospective study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging Rawalpindi, from Jan to Jun 2019.
Methodology: A total of 60 patients included in this study where 42 males and 18 were females, age range 45-85 years who underwent transarterial chemoembolization for hepatocellular carcinoma, were included in the study. patients were equally divided into two groups, group a (30 patients) who underwent transarterial chemoembolization, received 60 mg of intraarterial lidocaine each and group b (30 patients) who underwent transarterial chemoembolization, intra-arterial lidocaine was substituted with normal saline.degree of post-procedural pain was assessed using a subjective method (visual analogue scales score) and an objective method (amount of post-procedural analgesics).
Results: Average peri-procedure visual analogue scale score was 5.06 in group A patient versus 7.2 for those in group B patients (p=0.037). Post-procedure visual analogue scale score in the group A was 2.7 ± 0.520 and that for group B was 4.2 ± 0.761 (p=0.025). Mean of total dose of nalbuphine in group A was 4.96 ± 0.764 mg versus 8.3 ± 1.34 mg for patients in group B (p=0.036). Average length of post procedure hospital stay was 0.9 ± 0.203 and 1.41 ± 0.373 days for group A and group B respectively (p=0.002).Conclusion: Intra-arterial administration of lidocaine before infusing the embolization particles for transarterial chemoembolization.....................