bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strain and strain rate echocardiographic imaging predict occurrence of atrial fibrillation in post-coronary artery bypass grafting patients
Authors: Abdelrazek Gomaa , Mandour Kareem , Osama Mohammad , Elkhashab Khaled 
Published: July 2021

AbstractBackgroundAtrial fibrillation (AF) occurs very frequently after coronary artery bypass grafting (CABG); it occurs in about 20–edictors can be used for the dedicatio40% of patients. It is associated with several adverse events. This study aimed to extrapolate a predictor for postoperative atrial fibrillation (POAF) occurrence which is reproducible and simple to be a part of routine echocardiography screening before CABG. This study included 89 patients scheduled for isolated coronary artery bypass surgery. History, clinical examination, and complete 2D echocardiography with LA speckle tracking analysis were done preoperatively. Patients were then followed up post-surgery for incidence of AF till discharge from the hospital. The patients were divided into 2 groups according to POAF occurrence.ResultsPatients who developed postoperative AF had older age (P= 0.0032) and longer hospital stay (P= 0.021) and higher stroke incidence but statistically non-significant (14.3% vs 3.3%). The POAF patients showed less peak atrial longitudinal strain (PALS) value than non-POAF patients. The left atrial strain rate values showed a significant difference with the lower left atrial systolic strain rate and less negative (higher) early diastolic strain rate and late diastolic strain rate. After multivariate logistic regression analysis, the independent predictors for POAF were PALS (OR 0.770, 95% CI 0.627–0.946), late LA diastolic strain rate (LASRa) (OR 3.476, 95% CI 1.207–12.186), and age (OR 1.181, 95% CI 1.011–1.379).ConclusionPreoperative LA global strain assessed by 2D speckle tracking analysis could be helpful as a predictor for AF post-CABG surgery, and identification of these patients may reduce its morbidity and mortality. The study suggested PALS value less than 29.8 to be a predictor for the occurrence of POAF.
Frequency and assessment of Nutritional Status of school going children in rural areas of Islamabad
Authors: Farhin Shehla , Jaffry Tamkeen , Zafar Sadia , Rashid Farah 
Published: July 2021

Background and Objectives: Nutritional status is considered a significant and positive health indicator. It determines anthropometric measurements of preschool children, the height of children at the time of school entry and prevalence of low birth weight. The objective of the study was to determine the frequency of nutritional status and socio-demographic factors influencing under nutrition among school children of rural Islamabad.
Methods: A cross-sectional study was conducted among school children of the age (4-16 years) from January 2017 to September 2019. The Sample size was 1710. Schools were selected through convenient sampling technique. Frequency and percentages were calculated and inferential statistics were computed to analyze the association of health status with categorical variables by using chi-square by keeping the level of significance <0.05 through SPSS version 20.
Results: The mean age of the sample was 9.38±4.14 with the maximum number of children (49.1%) in the age bracket of 5-9. Out of 1710 children, 54.4% had normal weight for age, 25.3% were underweight, 7.5% overweight and 12.8% were found to be obese. Stunting was found to be 26%. Prevalence of being underweight was higher than overweight /obesity particularly in younger and higher age groups as indicated by p-value of 0.000. Comparing with females, male students had significantly higher frequency of being underweight and stunted as reflected by p-value of 0.004 and 0.000 respectively. Univariate analysis also showed a strong association between age and nutritional status as mean weight increased from 39.22±5.21 to 63.50±4.66 and height from 35.67±5.76 to 113.73±29.22 with advancing age.
Conclusions: Undernutrition remains an ongoing health problem in school going children of rural Islamabad; particularly in male students of younger age groups. School health programs and nutritional interventions need to be strengthened particularly in rural areas of Islamabad.
doi: https://doi.org/10.12669/pjms.37.5.3773
How to cite this:Farhin S, Jaffry T, Zafar S, Rashid F. Frequency and assessment of Nutritional Status of school going children in rural areas of Islamabad. Pak J Med Sci. 2021;37(5):1475-1479. doi: https://doi.org/10.12669/pjms.37.5.3773
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.
Guiding significance of intraoperative frozen section for range of judging incisal edge of Esophageal Carcinoma
Authors: He Fei , Wang Chen , Liu Weichao , Shi Gongning 
Published: July 2021

Objective: To explore guiding significance of intraoperative frozen section for judging incisal edge range of esophageal carcinoma.
Methods: A retrospective descriptive research design was used to collect the clinical and pathological data of 205 patients with esophageal cancer who were treated in Huaihe Hospital of Henan University from March 2012 to July 2015. Among them, 46 patients’ esophageal margins were made into intraoperative frozen sections.
Results: In the 205 cases, nine cases were diagnoses with upper incisal edge cancerization, accounting for 4.39%, and five cases were diagnosed with lower incisal edge cancerization, accounting for 2.4%. There were 14 cases in total, accounting for 6.83%. four cases showed positive residual end of intraoperative frozen section.
Conclusion: The cancerous focus residue of incisal edge in esophageal carcinoma is not uncommon. Intraoperative frozen section is helpful to judge the proper excision length of esophageal carcinoma.
doi: https://doi.org/10.12669/pjms.37.5.3910
How to cite this:He F, Wang C, Liu W, Shi G. Guiding significance of intraoperative frozen section for range of judging incisal edge of Esophageal Carcinoma. Pak J Med Sci. 2021;37(5):1499-1503. doi: https://doi.org/10.12669/pjms.37.5.3910
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.
Non-operative treatment versus appendectomy for acute uncomplicated appendicitis: A randomized controlled trial
Authors: Sajjad Muhammad Nadeem , Naumeri Fatima , Hina Sehrish 
Published: July 2021

Objectives: To compare the outcome of non-operative treatment (NOT) with antibiotics versus surgical management of uncomplicated appendicitis in children.
Methods: This randomized clinical trial (NCT 04030741) was carried out in Pediatric Surgery Department, Mayo Hospital from September 2018 to September 2019. Total sample size was 180, and after informed consent patients were randomly allocated in two groups. All children between 5 and 15 years of age and having pediatric appendicitis score (PAS) ≥7 were included. Patients with previous abdominal surgery, peritonitis, appendicular mass, or intra-abdominal abscess were excluded. Children in NOT group (Group A) were given intravenous Meropenem and Metronidazole for 48 hours and after starting oral, antibiotics were continued orally for 7 days. In Group B, children underwent appendectomy. Failure of NOT was labeled if there was abscess formation or peri-appendiceal fluid collection on ultrasound, development of peritonitis or recurrence of appendicitis.
Results: In Group A, mean age was 9.56±1.8 years and in Group B 10.11±1.8 years. There were 123 male and 57 female patients. Group B had 100% successful outcome. NOT (Group A) had successful outcome in 75 patients (83.3%) and failure was noted in 15 (16.7%). Five needed operation within 48 hours, all had appendicolith, and 10 patients presented within 6 months. Raised total leukocyte count (p value < 0.0001) and C reactive protein (p value < 0.04) levels were noted with failure of NOT.
Conclusions: In this study, success of NOT was 84% so a trial of NOT in cases of uncomplicated appendicitis should be considered in children.
doi: https://doi.org/10.12669/pjms.37.5.4016
How to cite this:Sajjad MN, Naumeri F, Hina S. Non-operative treatment versus appendectomy for acute uncomplicated appendicitis: A randomized controlled trial. Pak J Med Sci. 2021;37(5):1276-1281. doi: https://doi.org/10.12669/pjms.37.5.4016
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 practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country
Authors: Abrar Saida , Razzak Lubna , Rizvi Raheela Mohsin 
Published: July 2021

Objectives: To compare the effectiveness and complications of Burch colposuspension and Mid Urethral Slings (MUS) for the treatment of Stress Urinary Incontinence (SUI).
Methods: We conducted a cross-sectional study of 162 patients who underwent surgery for SUI with Burch colposuspension (n=40), tension free vaginal tape (TVT) (n= 59) or transobturator tape (TOT) (n=63), from 2006 to 2014 at the Aga Khan University Hospital- Karachi. All three groups were assessed in terms of demographics, cure rates, intraoperative and postoperative complications at one and five years using incontinence impact questionnaire-short form-7 (IIQ-7) and urogenital distress inventory -short form-6 (UDI-6).
Results: Mean age of the participants in Burch, TVT and TOT group was 44.1 ± 7.4, 48.3 ± 8.9, 53.0 ± 9.4 respectively. Majority of patients in TVT group were premenopausal (59.3%) and postmenopausal in TOT group (53.9%). Most abdominal hysterectomies were done in Burch group (40) while vaginal hysterectomies and anterior and posterior colporrhaphy in TOT group (55). All the procedures had both subjective and objective cure rate of more than 82% at one year, with TVT having the highest success rate of 96.61%. The objective cure rate in Burch, TVT and TOT group at five years was 74.19%, 90.30% and 81.25% respectively. Intraoperative complications included hemorrhage in one patient during Burch procedure and bladder perforation in two cases of TVT, with no significant difference in short or long-term complications with either procedure.
Conclusions: All the three procedures have equal efficacy and complication rates. Even though TVT is the new gold standard but in view of current debate regarding mesh related complications, there is a need to readdress Burch colposuspension for treatment of SUI.
doi: https://doi.org/10.12669/pjms.37.5.4017
How to cite this:Abrar S, Razzak L, Mohsin R. The practice of Burch Colposuspension versus Mid Urethral Slings for the treatment of Stress Urinary Incontinence in developing country. Pak J Med Sci. 2021;37(5):1359-1364. doi: https://doi.org/10.12669/pjms.37.5.4017
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.
Atorvastatin calcium tablets on inflammatory factors, hemorheology and renal function damage indexes in patients with diabetic nephropathy
Authors: Li Ronghua , Shi Tianting , Xing Enpeng , Qu Hongcui 
Published: July 2021

Objectives: To investigate the effect of atorvastatin on inflammatory factors, hemorheology, and renal function damage in patients with diabetic nephropathy (DN).
Methods: One hundred and six DN patients who were treated in our hospital between June 2018 and August 2019 were selected and randomly grouped into observation group and control group, 53 each group. Patients in the control group were given the conventional treatment; patients in the observation group were given atorvastatin treatment on the basis of the conventional treatment. They were treated for three months. The hemorheology indexes (whole blood viscosity, erythrocyte aggregation index, and fibrinogen (FIB)), renal function damage indexes (macrophage migration inhibitory factor (MIF), vascular cell adhesion molecule (VCAM)-1, Secreted frizzled-related protein-5 (SFRP5), and mAIb/Cr) and inflammatory factor related indexes (C-reactive protein (CRP), interleukin-1 (IL-1), and tumor necrosis factor-α (TNF-α)) were compared between the two groups before and after three months of treatment.
Results: After three months of treatment, the hemorheology indexes, renal function damage indexes, and inflammatory factors related indexes in the two groups changed. Compared with the control group, the whole blood viscosity, erythrocyte aggregation index, FIB, MIF, VACM-1, mAIb/Cr, CRP, IL-1, and TNF-α levels in the observation group significantly decreased, while the levels of SERP-5 significantly increased; the differences were statistically significant (P<0.05).
Conclusion: Atorvastatin can effectively alleviate the renal function damage in patients with DN, reduce the level of serum inflammatory factors, and improve hemorheology, which has a good clinical application value for DN patients.
doi: https://doi.org/10.12669/pjms.37.5.4045
How to cite this:Li R, Shi T, Xing E, Qu H. Atorvastatin calcium tablets on inflammatory factors, hemorheology and renal function damage indexes in patients with diabetic nephropathy. Pak J Med Sci. 2021;37(5):1392-1396. doi: https://doi.org/10.12669/pjms.37.5.4045
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.
Ramadan Fasting: Perception and maternal outcomes during Pregnancy
Authors: Hossain Nazli , Samuel Mahwish , Mughal Saba , Shafique Kashif 
Published: July 2021

Objectives: To see perception and knowledge of women about Ramadan fasting and maternal effects of fasting.
Methods: The study design was prospective, case-controlled. This study was conducted at Holy Family Hospital from 1st May 2020 to July 2020. Pregnant women with spontaneous conception and singleton pregnancies, who fasted for seven or more days, were cases, and those who did not fast were taken as controls. Questionnaire was filled regarding perception of women about maternal fasting. Primary maternal outcomes included preterm delivery, pregnancy induced hypertension, and gestational diabetes mellitus. The analysis was conducted using Statistical Package for Social Sciences version 16.0.
Results: A total of 215 women were included in the study, 123 women fasted, and 92 women did not fast. Only 2.8% of women knew that fasting is forbidden in pregnancy. Sixty five percent of women reported weakness as the main reason for not fasting. The rate of gestational diabetes, pregnancy induced hypertension and preterm delivery was higher among women who fasted (17% vs 14%, 7% vs 2%, 9% vs 9%) respectively, compared to non-fasting women, but were not found statistically significant. There was no difference in anthropometric measurements of newborn, among both groups.
Conclusion: Ramadan fasting does not affect maternal outcomes during pregnancy.
doi: https://doi.org/10.12669/pjms.37.5.4109
How to cite this:Hossain N, Samuel M, Mughal S, Shafique K. Ramadan Fasting: Perception and maternal outcomes during Pregnancy. Pak J Med Sci. 2021;37(5):1262-1267. doi: https://doi.org/10.12669/pjms.37.5.4109
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.
Behaviors of Turkish pregnant women towards gestational diabetes screening
Authors: Aydoğmuş Hüseyin , Aydoğmuş Serpil , Tıraş Halil Ibrahim , Cankaya Zeynep 
Published: July 2021

Objectives: Although gestational diabetes is the most common metabolic disease in pregnancy some pregnant women still refuse to undergo oral glucose tolerance test (OGTT). The purpose of this study was to evaluate the behavior of pregnant women undergoing OGTT, and to compare perinatal results between women who undergo and refuse OGTT.
Methods: This retrospective cohort study was performed by evaluating the data of Izmir Katip Celebi University Gynecology and Obstetrics outpatient clinic between 2012-2017. Data of 2079 pregnant were evaluated retrospectively. Among 373 women who refused OGTT were evaluated as the study group, while remaining 1706 women who underwent OGTT were considered as the control group. The groups were compared with regard to perinatal results.
Results: Sixty-two point four percent of the group who refused OGTT had a C-section, while 56.3% of the control group had a C-section (p<0.05). Intrauterine growth retardation, fetal distress, amniotic fluid pathologies, macrosomia, gestational hypertension and perinatal death were slightly higher in pregnant women who did not undergo OGTT compared to the control group, however, the difference was not statistically significant.
Conclusion: Maternal complications and poor pregnancy results were found slightly higher in pregnant women who refused OGTT. These results might be explained by assuring glycemic control in pregnant women who refused OGTT by a series of fasting and postprandial blood sugar measurements in our center.
doi: https://doi.org/10.12669/pjms.37.5.4176
How to cite this:Aydogmus H, Aydogmus S, Tiras HI, Cankaya Z . Behaviors of Turkish pregnant women towards gestational diabetes screening. Pak J Med Sci. 2021;37(5):1486-1490. doi: https://doi.org/10.12669/pjms.37.5.4176
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.
Polycystic Ovarian Syndrome roots needs to be rooted out at the outset: Will early screening help?
Authors: Khan Sikandar Hayat , Arooj Uzma 
Published: July 2021

doi: https://doi.org/10.12669/pjms.37.5.4509
How to cite this:Khan SH, Urooj U. Polycystic Ovarian Syndrome roots needs to be rooted out at the outset: Will early screening help? Pak J Med Sci. 2021;37(5):1254-1255. doi: https://doi.org/10.12669/pjms.37.5.4509
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.
Medical Teaching Institutions Reforms Act: Facts and Fictions
Authors: Kamal Zahid , Aleem Muhammad , Aziz Nauman , Amjad Hafiz Muhammad 
Published: July 2021

doi: https://doi.org/10.12669/pjms.37.5.4551
How to cite this:Kamal Z, Aleem M, Aziz N, Amjad HM. Medical Teaching Institutions Reforms Act: Facts and Fictions. Pak J Med Sci. 2021;37(5):1252-1253. doi: https://doi.org/10.12669/pjms.37.5.4551
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.
Interfacial technology for enhancement in steel fiber reinforced cementitious composite from nano to macroscale
Authors: Zhou Ao , Wei Huinan , Liu Tiejun , Zou Dujian , Li Ye , Qin Renyuan 
Published: July 2021

Abstract
The rapid construction of innovative structures and megastructures is pushing the development of steel fiber reinforced cementitious composite (SFRCC). The interfacial enhancement technology from nano to macroscale for improving global properties of SFRCC is summarized here, including nanomaterials reinforcement of cementitious matrix, physical arrangement and nanomaterials modification of steel fiber. The interfacial bonding strength of SFRCC can be enhanced more than 150% via these approaches. To evaluate the effect of local interfacial technology on global mechanical properties of SFRCC, the structural performance of SFRCC with interfacial modification is reviewed. The energy absorption capacity of SFRCC can be improved over 20% through interfacial enhancement technology. The multi-scale mechanisms behind these approaches are illustrated through macroscale characterizations and molecular dynamics modeling. Furthermore, the key challenges and future prospects of enhancement approaches are also discussed from the perspectives of bottom-up system, nanoscale reinforcement, and durability properties in SFRCC, which are expected to inspire further improvement in interfacial performance and promote the application of SFRCC in practical engineering.
Combination of Interscalene Brachial Plexus Block with General Anesthesia Attenuates Stress and Inflammatory Response in Arthroscopic Shoulder Surgery
Authors: Lin Daowei , Han Zhixiao , Fu Yanni , Zhu Xiaoqiu , Li Jin , Xu Hui , Wen Jing , Wang Fei , Guo Mingyan 
Published: July 2021

Abstract
In arthroscopic shoulder surgery, general anesthesia (GA) is the common method of anesthesia. Recently, the combined usage of interscalene brachial plexus block with general anesthesia (ISB/GA) was reported to have a lower incidence of adverse side effects than GA alone. However, to date, no study has compared stress and inflammatory responses between these two methods. Since stress and inflammatory responses are critical on intraoperative management and postoperative recovery, we integrated the laboratory and clinical methods and compared the stress and inflammatory factors, such as epinephrine, norepinephrine, glucose, lactate, inflammatory factors tumor necrosis factor α (TNF-α) and interleukin 6 (IL-6), as well as the clinical outcomes to determine whether ISB/GA provides an advantage on stress and inflammatory inhibition. Data showed that ISB/GA resulted in significantly lower epinephrine, norepinephrine, and glucose levels perioperatively. Six hours after operation, the TNF-α and IL-6 levels were also significantly lower in the ISB/GA group. ISB/GA patients had lower blood pressure, a more stable heart rate, lower visual analog scale score, and less opioid consumption during and after surgery. Our results indicate that ISB/GA is a better choice for arthroscopic shoulder surgery, owing to less stress and inflammatory responses during and after operation, which provides better clinical outcomes. Therefore, we recommend ISB/GA as a preferred anesthesia method for arthroscopic shoulder surgery.