bluuebunny/crossref_metadata_2025_split huggingface dataset:
Requirement of artificial intelligence technology awareness for thoracic surgeons
Authors: Darbari Anshuman , Kumar Krishan , Darbari Shubhankar , Patil Prashant L. 
Published: July 2021

Abstract
Background
We have recently witnessed incredible interest in computer-based, internet web-dependent mechanisms and artificial intelligence (AI)-dependent technique emergence in our day-to-day lives. In the recent era of COVID-19 pandemic, this nonhuman, machine-based technology has gained a lot of momentum.

Main body of the abstract
The supercomputers and robotics with AI technology have shown the potential to equal or even surpass human experts’ accuracy in some tasks in the future. Artificial intelligence (AI) is prompting massive data interweaving with elements from many digital sources such as medical imaging sorting, electronic health records, and transforming healthcare delivery. But in thoracic surgical and our counterpart pulmonary medical field, AI’s main applications are still for interpretation of thoracic imaging, lung histopathological slide evaluation, physiological data interpretation, and biosignal testing only. The query arises whether AI-enabled technology-based or autonomous robots could ever do or provide better thoracic surgical procedures than current surgeons but it seems like an impossibility now.

Short conclusion
This review article aims to provide information pertinent to the use of AI to thoracic surgical specialists. In this review article, we described AI and related terminologies, current utilisation, challenges, potential, and current need for awareness of this technology.
Association of Kidney Function With NMR-Quantified Lipids, Lipoproteins, and Metabolic Measures in Mexican Adults
Authors: Aguilar-Ramirez Diego , Alegre-Díaz Jesus , Herrington William G , Staplin Natalie , Ramirez-Reyes Raúl , Gnatiuc Louisa , Hill Michael , Romer Frederik , Torres Jason , Trichia Eirini , Wade Rachel , Collins Rory , Emberson Jonathan R , Kuri-Morales Pablo , Tapia-Conyer Roberto 
Published: July 2021

AbstractContextChronic kidney disease (CKD) and diabetes are associated with dyslipidemia, metabolic abnormalities, and atherosclerotic risk. Nuclear magnetic resonance (NMR) spectroscopy provides much more detail on lipoproteins than traditional assays.MethodsIn about 38 000 participants from the Mexico City Prospective Study, aged 35 to 84 years and not using lipid-lowering medication, NMR spectroscopy quantified plasma concentrations of lipoprotein particles, their lipidic compositions, and other metabolic measures. Linear regression related low estimated glomerular filtration rate (eGFR; &lt;60 mL/min/1.73 m2) to each NMR measure after adjustment for confounders and for multiplicity. Analyses were done separately for those with and without diabetes.ResultsAmong the 38 081 participants (mean age 52 years, 64% women), low eGFR was present for 4.8% (306/6403) of those with diabetes and 1.2% (365/31 678) of those without diabetes. Among both those with and without diabetes, low eGFR was significantly associated with higher levels of 58 NMR measures, including apolipoprotein B (Apo-B), the particle numbers of most Apo-B containing lipoproteins, the cholesterol and triglycerides carried in these lipoproteins, several fatty acids, total cholines and phosphatidylcholine, citrate, glutamine, phenylalanine, β-OH-butyrate, and the inflammatory measure glycoprotein-A, and significantly lower levels of 13 NMR measures, including medium and small high-density lipoprotein particle measures, very low-density lipoprotein particle size, the ratio of saturated:total fatty acids, valine, tyrosine, and aceto-acetate.ConclusionsIn this Mexican population with high levels of adiposity and diabetes, low kidney function was associated with widespread alterations in lipidic and metabolic profiles, both in those with and without diabetes. These alterations may help explain the higher atherosclerotic risk experienced by people with CKD.
Outcome of proximal femur shaft fractures in school going children treated with locking compression plates
Authors: Shah Faaiz Ali , Ali Mian Amjad , . Naeemullah 
Published: July 2021

Objectives: To determine the clinical and radiological outcome of proximal femur shaft fractures in school going children treated with locking compression plates (LCP).
Methods: This descriptive study was conducted in Orthopaedic Division Lady Ready Reading Hospital Peshawar from 25th June 2018 to 25th September 2020. Children of either gender and age 6 to 12 years old with subtrochanteric and proximal one third femur factures fulfilling the inclusion criteria were enrolled in this study. Open reduction and internal fixation with 4.5 mm narrow locking compression plates (LCP) were done in all. Post operative clinical outcome was evaluated by using Flynn scoring system and graded as excellent, satisfactory and poo results. Radiological assessment of fracture union was done through anteroposterior (AP) and lateral X-ray radiographs.
Results: A total of 60 children with mean age 9.01±1.61 SD (range 6 to 12 years) were included in our study. Oblique fractures were present in 23(38.3%) children, spiral in 20(33.3%), transverse in 11(18.3%) and comminuted in 6 (10%) children. The radiological union time was 13.3±1.2 weeks (range 9.4 to 18 weeks). Majority (88.3%, n=53) of children had excellent clinical outcome according to Flynn’s scoring system while satisfactory outcome was noted in 7(11.6%) children. No cases of delayed union, mal union, nonunion and implant failure was reported.
Conclusion: The results of our study indicated that proximal femoral shaft fractures in school going children treated with locking compression plates had excellent clinical and radiological outcome. We therefore recommend locking compression plate as the implant of choice to fix proximal femoral shaft fractures in school going children.
doi: https://doi.org/10.12669/pjms.37.5.3938
How to cite this:Shah FA, Ali MA, Naeemullah. Outcome of proximal femur shaft fractures in school going children treated with locking compression plates. Pak J Med Sci. 2021;37(5):1353-1358. doi: https://doi.org/10.12669/pjms.37.5.3938
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.
Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies
Authors: Waqar Tariq , Ansari M. Zubair Ahmed , Khan Kamran 
Published: July 2021

Objective: To compare the early operative outcome of TOF repair with three contemporary repair strategies of RVOTO repair i.e. TAP, Mono-cusp construction (MC) in TAP and pulmonary valve repair.
Methods: Study is performed at Punjab Institute of Cardiology, Lahore from May 2016 to April 2020. Retrospective analysis of data was performed for patient who underwent TOF repair by three different strategies of RVOT repairs during TOF surgery based on z scoring for pulmonary valve annulus. Group-I underwent trans-annular patch repair, while Group-II and III underwent Mono-cusp repair with autologous pericardium and pulmonary valve repair respectively. Analysis of Variance (ANOVA) and Pearson Chi-Square (PCS) statistics were used to compare the three groups for numeric and categorical variables respectively. Post-hoc t-test and Bonferroni correction were performed for numeric data to compare two groups with each other. Chi-square test was used to perform comparison between groups for categorial variables.
Results: ANOVA for aortic cross clamp time, total CPB time, Post-operative mechanical ventilation time, ICU stay and hospital stay showed statistical difference among all three group with p-value less than 0.05 however post hoc T-test showed this variation is limited to post-operative mechanical ventilation only when groups compared with each other. PCS showed there was difference for incidence of difficult weaning from CPB when all three groups compared while there was no difference in operative mortality with p-value of 0.15. However, Group-II comparison with Group-I showed that weaning from CPB was superior in-Group-II with p-value of 0.016. Group-III showed the best statistics for all operative outcome variables among all three groups. Comparison of incidence of post-operative moderate pulmonary regurgitation before discharge between Group-II and Group-III showed significant difference with p-value of 0.0052.
Conclusion: PV repair strategy should be employed for RVOT repair of TOF whenever feasible. MC repair showed fewer hours of postoperative mechanical ventilation and higher incidence of easy weaning from CPB when compared to TAP, however its impacts over ICU stay, Hospital stay and operative mortality is not profound in our TOF repair population.
doi: https://doi.org/10.12669/pjms.37.5.3961
How to cite this:Waqar T, Ansari MZA, Khan K. Clinical outcome of right ventricle outflow tract management for repair of Tetralogy of Fallot with three contemporary surgical strategies. Pak J Med Sci. 2021;37(5):1313-1318. doi: https://doi.org/10.12669/pjms.37.5.3961
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.
Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study
Authors: Khokhar Abdul Rehman , Cheema Abdul Majeed 
Published: July 2021

Objectives: The study objective was to establish serum TSH cut off value for diagnosis of new case of congenital hypothyroidism and to estimate frequency of Congenital Neonatal Hypothyroidism.
Methods: A case control study was conducted at DHQ Teaching Hospital of DG Khan Medical College, Dera Ghazi Khan during 2020 to establish reference values of TSH and T4 for study population. Sample size was calculated by classical sample size calculation formula Cochran WG 1977 sampling technique. A group of 30 neonates of normal, healthy, euthyroid mothers was taken as Neonatal Control Group to estimate levels of TSH and total T4 in normal neonates. Neonatal Study Group was neonates of hypothyroid mothers (n=75). Simple random sampling technique was applied.
Results: Mean (mean ± SD) Serum TSH levels of Neonatal Control Group were found to be 3.58 ± 03.09 mIU/l. Mean Serum TSH levels among Neonatal Study Group were found to be 6.88 ±12.95 mIU/l and serum total T4 were found to be 16.78 ± 6.96ug/dl on 3-7 days of life. Serum total T4 (mean ± SD) levels of Neonatal Control Group were 9.73 ± 03.39 ug/dl. Neonatal serum TSH more than 15mIU/l was taken as cut off value to diagnose a case of CNH. So, frequency of CNH was 8% among neonates of study group.
Conclusions: The TSH cut off value of >15mIU/l was established for case detection of CNH. Our findings of CNH in district Dera Ghazi Khan (8%) are the highest frequency of CNH reported so far in Pakistan.
doi: https://doi.org/10.12669/pjms.37.5.4086
How to cite this:Khokhar AR, Cheema AM. Higher frequency of Congenital Hypothyroidism among Newborns, District Dera Ghazi Khan-Punjab, Pakistan: A case control study. Pak J Med Sci. 2021;37(5):1419-1424. doi: https://doi.org/10.12669/pjms.37.5.4086
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Comparison of safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification
Authors: Kamal Zahid , Jamil Ahmad Zeeshan , Khokhar Hira Shuja , Huma Farah 
Published: July 2021

Objectives: To compare safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification
Methods: This observational cohort study was conducted in Department of ophthalmology, Sahiwal Medical College, Sahiwal from November 2019 to August 2020. There were 600 patients who underwent uncomplicated phacoemulsification with intraocular lens implantation. Patients were allocated into two groups. Group-I comprised of patients with convenient day follow-up during the first post-operative week. Group-II comprised of the patients with conventional first day follow-up. Rate of complications, number of visits during the first month and final visual acuity were recorded.
Results: In Group-I post-operative complications were noted in 12.67% cases on first follow up visit and in 2.67% cases on first month follow up visit. In Group-II post-operative complication were noted in 22 % cases on first follow up visit and in 4% cases on first month follow up visit. Common postoperative complications were corneal oedema, anterior segment intraocular inflammation, residual lens matter in anterior chamber and intraocular lens subluxation. There was no difference in presenting and postoperative visual acuity between the two groups. Mean follow-up visits were 2.23 ± 0.42 in Group-I and 3.55 ± 0.50 in Group-II.
Conclusion: Convenient day follow-up is as safe as conventional first day follow-up. Convenient day follow-up significantly reduces the number of post-operative visits. This would translate into cost reduction both for the patients and the health care facility.
doi: https://doi.org/10.12669/pjms.37.5.4121
How to cite this:Kamal Z, Jamil AZ, Khokhar HS, Huma F. Comparison of safety and number of post-operative visits of patients in convenient day versus conventional first day follow-up after phacoemulsification. Pak J Med Sci. 2021;37(5):1440-1444. doi: https://doi.org/10.12669/pjms.37.5.4121
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.
Perceptions of Lady Health Workers and their trainers about their curriculum for implementing the interventions identified for Essential Package of Health Services for Pakistan
Authors: Sohail Shaherzad , Wajid Gohar , Chaudhry Saima 
Published: July 2021

Background and Objectives: Lady Health Workers (LHWs) form the central cadre of community-based health workers in Pakistan. They must be trained well for implementing community-based interventions identified for Essential Package of Health Services (EPHS) by the government of Pakistan. This study aims to explore the perceptions of LHWs and their trainers about their existing curriculum and identifies gaps in the curriculum for effective implementation of the interventions identified in EPHS.
Methods: In this qualitative study, perceptions of 45 LHWs were taken through focus group discussions and their six trainers were interviewed as well. In addition, three experts analyzed the LHWs training curriculum to identify its relevance with achieving the community-based interventions as described in the EPHS by the government of Pakistan.
Results: Thematic analysis of the information gathered by the interviews of trainers and focus group discussions from LHWs, was performed. Most participants were satisfied with their curriculum but suggested the addition of topics on emerging health issues, neonatal resuscitation, mental health and rehabilitation. Participants felt a deficiency in practical skills, communication skills and leadership skills. Experts identified gap in the current LHWs curriculum to address the recently identified community-based interventions.
Conclusions: The current curriculum of LHWs need reforms to make it compatible with Essential Package of Health Services for Pakistan. The suggested areas for improvement include knowledge of emerging health issues, neonatal resuscitation, adolescent problems, mental health and rehabilitative services.
doi: https://doi.org/10.12669/pjms.37.5.4175
How to cite this:Sohail S, Wajid G, Chaudhry S. Perceptions of Lady Health Workers and their trainers about their curriculum for implementing the interventions identified for Essential Package of Health Services for Pakistan. Pak J Med Sci. 2021;37(5):1295-1301. doi: https://doi.org/10.12669/pjms.37.5.4175
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.
Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes
Authors: Khaskheli Dr. Meharunnissa , Baloch Dr Shahla , Baloch Dr Aneela Sheeba , Shah Syed Ghulam Sarwar 
Published: July 2021

Objectives: To observe the effects of vaginal discharge during pregnancy on maternal and fetal outcomes.
Methods: This observational study was undertaken form June 2018 to 31 May 2019 period in the Department of Obstetrics and Gynaecology at Liaquat University of Medical and Health Sciences hospital Jamshoro Unit IV. Data were collected from a convenience sample of 85 pregnant women. All the pregnant women with vaginal discharge were included in the study, while the women with bleeding and other medical disorders during pregnancy were excluded. Data was analyzed.
Results: Women’s mean age as 27.4 (±4.7) years and most were 28-35 weeks pregnant (n=29, 34%) and primigravida (n=35, 41%). Seventy six women (89%) presented with vaginal discharge while nine women (11%) reported no vaginal discharge. Of those with vaginal discharge,53 women (69.7%) had vaginal infections: bacterial vaginosis (n=21, 39.6%), vaginal candidiasis (n=17, 32.1%) and vaginal trichomoniasis (n=15, 28.3%). Pathological vaginal discharge (PVD) was associated with vaginal irritation (n=30, p<0.0001), vaginal pain (n=50, p<0.0001), fever (n=12, p=0.015), uterine contractions (n=31, p<0.0001), premature membrane rupture (n=29, p<0.0001), abortion (n=13, p=0.009), pre-term delivery (n=24, p<0.0001) and post-partum endometritis (n=19, p=0.0006). PVD was associated with neonatal outcomes i.e. low birth weight (n=24, p<0.0001), low Apgar score at birth (n=22, p=0.0001), neonatal respiratory distress syndrome (n=21, p=0.0002), neonatal intensive care hospitalisation (n=20, p=0.002) and early neonatal death (n=16, p=0.003).
Conclusion: Pathological vaginal discharge (PVD) during pregnancy is more frequent and is associated with adverse maternal and perinatal outcomes.
doi: https://doi.org/10.12669/pjms.37.5.4187
How to cite this:Khaskheli M, Baloch S, Baloch AS, Shah SGS. Vaginal discharge during pregnancy and associated adverse maternal and perinatal outcomes. Pak J Med Sci. 2021;37(5):1302-1308. doi: https://doi.org/10.12669/pjms.37.5.4187
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.
Effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy
Authors: Khan Rehan Ramzan , Riaz Saima , Rashid Sajid , Sulman Muhammad 
Published: July 2021

Objectives: To determine the effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy.
Methods: A quasi experimental trial was conducted from April to September 2020 among sixty patients of chronic lumbosacral radiculopathy at Ibn-e-Siena Hospital, Multan. Participants were divided into two groups. Group-A (Supine) participants received lumbar traction in supine lying along with conventional treatment. Group-B (Prone) underwent the same treatment except the lumbar traction being applied in prone lying position. Participants were evaluated twice: at pre- treatment (week 0) and at the post treatment (week 2). Oswestry Disability Index and Numeric Pain Rating Scale were used as outcome measure. Data was analyzed on SPSS 23.
Results: The mean (±S.D) age of the patients was 39±5.7 vs. 40±5.3 years in supine vs. prone group respectively. Mean ODI score was 25.2±6.13 vs. 26.0±6.26 at the start of treatment in supine vs. prone position respectively while it was 19.45±7.12 vs. 11.05±4.40 at end of treatment in supine vs. prone position respectively. Mean NPRS score was 7.73±1.23 vs. 7.67±0.96 at start of treatment in supine vs. prone position respectively while it was 4.63±0.89 vs. 3.13±0.90 at the end of treatment in supine vs. prone position respectively.
Conclusion: Lumbar traction in prone lying position is more effective than lumbar traction in supine lying position for the treatment of chronic lumbosacral radiculopathy.
doi: https://doi.org/10.12669/pjms.37.5.4200
How to cite this:Khan RR, Riaz S, Rashid S, Sulman M. Effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy. Pak J Med Sci. 2021;37(5):1451-1455. doi: https://doi.org/10.12669/pjms.37.5.4200
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.
Frequency of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus and its associated risk factors
Authors: Kanwal Shaista , Ghaffar Tahir , Aamir Azizul Hasan , Usman Khalid 
Published: July 2021

Objective: Non-Alcoholic Fatty Liver Disease (NAFLD) is emerging as a major public health problem globally especially in patients with Type-2 Diabetes mellitus (T2DM). This study aimed to assess the frequency of NAFLD in patients with T2DM and to study its associated risk factors.
Methods: This descriptive study was conducted from April 2020 to October 2020 at the Hayatabad Medical Complex, Peshawar. Adult patients with T2DM were included in the study and underwent abdominal ultrasound for the identification of NAFLD. All the relevant clinical and biochemical characteristics were measured.
Results: Out of 384 participants, 236 patients (61.5%) had NAFLD on ultrasound. Patients with NAFLD had higher mean BMI, higher HbA1c, increased waist circumference, raised ALT, higher triglyceride, and low HDL. Logistic regression analysis revealed a statistically significant association with central obesity (OR = 5.448, 95% CI = 1.416-20.959, p = 0.014), higher BMI (OR = 4.435, 95% CI = 2.127-9.246, p < 0.0001), higher HbA1c [> 11%] (OR = 3.602, 95% CI = 1.438-9.019, p = 0.006), and elevated ALT (OR = 3.211, 95% CI = 1.509-6.835, p = 0.002). The highest odds for NAFLD were found for hypertriglyceridemia (OR = 11.624, 95% CI = 5.405-24.998, p < 0.0001) and low HDL (OR = 11.543, 95% CI = 2.590-51.439, p = 0.001), respectively.
Conclusions: High frequency of NAFLD along with its associated clinical and laboratory risk factors were revealed. This underpins the significance of screening T2DM patients for NAFLD and assessment for and modification of its associated risk factors in routine clinical practice.
doi: https://doi.org/10.12669/pjms.37.5.4211
How to cite this:Kanwal S, Ghaffar T, Aamir AH, Usman K. Frequency of non-alcoholic fatty liver disease in patients with type-2 diabetes mellitus and its associated risk factors. Pak J Med Sci. 2021;37(5):1335-1341. doi: https://doi.org/10.12669/pjms.37.5.4211
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.