bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress and prospects of medical education research in Asian Countries
Authors: Meo Sultan Ayoub , Sattar Kamran , Habib ullah Chaudhary , Alnassar Sami , Hajjar Waseem , Hajjar Waseem , Usmani Adnan Mahmood 
Published: October 2019

Background and Objectives: Medical education has a profound impact on health care system. Progress in achieving medical education research goals varies over time and across countries. This study aimed to investigate the medical education research ambience in Asia during the period 1965-2015.
Methods: We investigated the bibliometric indicators of 49 Asian states in medical education research from 1965-2015. The data about Asian countries, their per capita GDP, expenditure on R&D, universities and indexed scientific journals were collected. We recorded medical education related research documents published in Institute of Scientific Information (ISI) Web of Science, Thomson Reuters during the period 1965-2015.
Results: Asian countries collectively published 12721799 research articles, among them 40628 (0.31%) publications were in medical education. China contributed total of 3351565 articles among which 5414 (0.16%) research articles were in medical education; India added 1328725 papers with 4563 (0.34%) in medical education; Japan produced 3080257 papers with 4199 (0.13%) in medical education; Israel 561531 with 3848 (0.68%) in medical education; and lastly, Georgia contributed a total of 296532 research articles with 2565 (0.86%) in medical education.
Conclusions: In Asia, the top five countries in medical education research are China, Georgia, Israel, Japan and India. The countries at low ranking are Yemen, Palestine, Myanmar, Kazakhstan, Syria and Armenia. In Asian states, the overall performance in medical science research needs policies to enhance its impact globally. Medical universities should offer research programs for learning and understanding the challengeable issues in medical education research.
doi: https://doi.org/10.12669/pjms.35.6.1147
How to cite this:Meo SA, Sattar K, Habib-Ullah C, Alnassar S, Hajjar W, Usmani AM. Progress and prospects of medical education research in Asian Countries. Pak J Med Sci. 2019;35(6):1475-1481. doi: https://doi.org/10.12669/pjms.35.6.1147
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.
Can hematological parameters in type 2 diabetes predict microvascular complication development?
Authors: Onalan Erhan , Gozel Nevzat , Donder Emir 
Published: October 2019

Objective: To examine potential associations between neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, mean platelet volume (MPV), HbA1c and microvascular complications in diabetic patients from a cost-effectiveness perspective.
Methods: One hundred patients with type 2 diabetes attending our outpatient unit between May 2018 and October 2018 were included, and 100 healthy individuals served as the control group. A retrospective file search was performed to collect information on hemoglobin, mean platelet volume (MPV), glycosylated haemoglobin (HbA1c), hematocrit (Hct), neutrophil and lymphocyte count, neutrophil/lymphocyte ratio (NLR), platelets (Plt), platelet/lymphocyte ratio (PLR), and microvascular complications (neuropathy, retinopathy, nephropathy).
Results: Demographic and laboratory data were retrospectively controlled between diabetes (n=100) and healthy control (n=100) groups. The mean age in diabetic patients and healthy controls was 56.34 and 36.68 years, respectively. The mean NLR in diabetics and healthy controls was 2.48 and 2.11, the difference in NLR being significant (p=0.002). MPV in diabetics and controls was 8.54 and 8.53, respectively, and the difference was not significant (p=0.93). PLR was also similar, i.e. 149.7 and 145.3 in diabetics and healthy controls (p=0.067). With respect to microvascular complications, retinopathy was found to be significantly associated with MPV and NLR (p=0.015, and p=0.051), and nephropathy showed a significant association with NLR (p=0.027) among diabetics. In contrast with the two other microvascular complications, no significant association between neuropathy and NLR could be detected, while PLR and neuropathy was significantly associated (p=0.003).
Conclusion: Microvascular complications may be associated with certain hematologic parameters, as suggested by comparisons both between diabetics and healthy individuals and within the group of diabetic individuals. We believe that hematologic parameters such as hematocrit, MPV, NLR, and PLR, which can be obtained through a simple complete blood count, may be utilized as cost-effective predictors of diabetic microvascular complications. Further prospective studies with larger sample size are required to better delineate these associations.
doi: https://doi.org/10.12669/pjms.35.6.1150
How to cite this:Onalan E, Gozel N, Donder E. Can hematological parameters in type 2 diabetes predict microvascular complication development? Pak J Med Sci. 2019;35(6):1511-1515. doi: https://doi.org/10.12669/pjms.35.6.1150
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.
Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema
Authors: Meng Weizhe , Li Ronghua , Xie Xiufen 
Published: October 2019

Objective: To explore the clinical efficacy of intravitreal injection of conbercept in combination with retinal laser photocoagulation in the treatment of diabetic macular edema.
Methods: Ninety patients with diabetic macular edema were selected and grouped into an observation group and a control group using random number table, 45 patients (45 eyes) each group. The control group was given retinal laser photocoagulation, while the observation group was given intravitreal injection of Conbercept on the basis of panretinal photocoagulation. The Best Corrected Visual Acuity (BCVA), thickness of retinal nerve fibre layer (RNFL) and macular thickness were measured through relevant examinations before and after treatment. The intraocular pressures of patients in the two groups were evaluated, and moreover the complications were recorded.
Results: The RNFL thickness and macular thickness of the two groups had no statistically significant differences before treatment (P>0.05) and decreased significantly after treatment; the decrease amplitude of the observation group was significantly larger than that of the control group (P<0.05). The BCVA of both groups significantly increased in the 1st, 2nd and 4th week after treatment (P<0.05); the increase amplitude of BCVA of the observation group was more significant than that of the control group at different time points after treatment (P<0.05). The intraocular pressure of the observation group was not significantly different with that of the control group in the 1st, 2nd and 4th week after treatment (P>0.05). There were no severe eye complications and systemic adverse reactions in both groups in the process of follow up.
Conclusion: Intravitreal injection of conbercept in combination with retinal laser photocoagulation performs better in improving the BCVA and central macular thickness of patients with diabetic macular edema compared to retinal laser photocoagulation and has high safety.
doi: https://doi.org/10.12669/pjms.35.6.512
How to cite this:Meng W, Li R, Xie X. Conbercept and Retinal Photocoagulation in the treatment of Diabetic Macular Edema. Pak J Med Sci. 2019;35(6):1493-1498. doi: https://doi.org10.12669/pjms.35.6.512
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 efficacy and tolerability of Gabapentinoids with current prescription patterns in patients with Neuropathic pain
Authors: Shaheen Abida , Alam Syed Mahboob , Ahmad Arsalan , Khan Moosa 
Published: October 2019

Objective: To investigate the current dosing regimens of gabapentinoids in Pakistani patients with neuropathic pain and to compare their clinical efficacy and tolerability in terms of pain relief and adverse effects using difference in pain score as a treatment outcome.
Methods: This observational, prospective study was conducted in 320 patients with neuropathic pain from August 2016 to March 2018 at Basic Medical Sciences Institute (BMSI), Karachi in collaboration with Shifa International Hospital and Benazir Bhutto Hospital, Islamabad. Demographic data, treatment-related adverse effects and pain intensity was documented at recruitment and follow up visits at two, four and eight weeks. Discontinuation due to adverse effects and lack of efficacy were also recorded. Data was entered and analyzed using SPSS version 22.
Results: Mean age of patients was 52.57±12.47 and the most common ethnicity were Punjabi speaking population (66%). Diabetic neuropathy (51%) was the most common etiology followed by radicular pain (25%). Mean dosages of pregabalin and gabapentin were 114mg and 470mg respectively. Mean pain score was significantly reduced by gabapentinoids (<0.001). Dizziness, drowsiness and somnolence were frequent adverse effects. Common dosages for pregabalin and gabapentin were 75 mg/day and 300 mg/day respectively.
Conclusion: Current dosing regimens of gabapentinoids in Pakistani patients with neuropathic pain were found to be efficacious at low dosages in comparison to international recommended dosages. Gabapentin and pregabalin were both similar in terms of reducing pain score but onset of pain relief was relatively faster with pregabalin. Dizziness, drowsiness and somnolence were frequently reported with both gabapentinoids; however, visual blurring, ataxia and weight gain were observed only with the use of pregabalin. Adverse effects are frequently observed with gabapentinoids which necessitates reverting back to low dosages or switching to other drugs for pain relief.
doi: https://doi.org/10.12669/pjms.35.6.652
How to cite this:Shaheen A, Alam SM, Ahmad A, Khan M. Clinical efficacy and tolerability of Gabapentinoids with current prescription patterns in patients with Neuropathic pain. Pak J Med Sci. 2019;35(6):1505-1510. doi: https://doi.org/10.12669/pjms.35.6.652
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.
Performance of Pediatrics’ residents as clinical teachers: A student-based assessment
Authors: Afzal Muhammad Faheem , Ashraf Ali Abrar , Hanif Asif 
Published: October 2019

Objective: To assess the clinical teaching skills of Pediatrics’ residents as rated by final year MBBS students by using augmented Stanford Faculty Development Program questionnaire (SFDPQ) in a teaching hospital, Lahore.
Methods: This cross- sectional survey was conducted in the Department of Pediatrics, King Edward Medical University, Lahore in six months in 2016. Total of 265 students of final year MBBS, attending the teaching sessions organized by residents during their four weeks rotation in Pediatrics were included by non-probability purposive sampling. The augmented SFDPQ was emailed to the study participants after the completion of the clinical rotation, following several encounters with the resident. The data was entered in SPSS 22 for statistical analysis. Scores for each domain (learning climate, control of session, communication of goals, promoting understanding and retention, evaluation, promoting self-directed learning, teacher’s knowledge and teacher’s attitude) were also presented as mean and standard deviation. One-sample Kolmogorov-Smirnov test was applied to observe the normality of data. Where normality of data was observed, independent sample t-test was applied and where normality of data was not observed, Mann-Whitney U test was applied to compare the score between genders. Score of four was considered as cut off score for satisfactory results.
Results: Out of 265 students, 250 responded with response rate of 94.3%. Out of 250 medical students, 105 (42.0%) were male and 145(58.0%) were female. The internal consistency (Cronbach’s alpha) of this score was excellent (0.973). The mean score for all SFDPQ domains was also sub-optimal (2.90±0.611). The mean total score was sub-optimal for learning climate (3.39±0.69), control of session (3.25±0.77), communication of goals (3.26±0.86), promoting understanding and retention (3.26±0.77), evaluation (2.25±0.67), promoting self-directed learning (3.17±0.90), teacher’s knowledge (3.14±0.93) and teacher’s attitude (3.31±0.89), while it was good only for feedback (4.03±0.11). The mean total score for all SFDPQ domains in males and females was 3.05±0.54 and 2.79±0.64 respectively. Although sub-optimal in both the genders, the score was significantly higher in males with p-value 0.001.
Conclusion: We found suboptimal clinical teaching skills of Pediatrics’ residents as rated by final year MBBS medical students.
doi: https://doi.org/10.12669/pjms.35.6.830
How to cite this:Afzal MF, Ali AA, Hanif A. Performance of Pediatrics’ residents as clinical teachers: A student-based assessment. Pak J Med Sci. 2019;35(6):1499-1504. doi: https://doi.org/10.12669/pjms.35.6.830
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.
Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease
Authors: Ishfaq Nadia , Gul Naheed , Zaka Neelum 
Published: October 2019

Objective: To determine the outcome of early use of non-invasive positive pressure ventilation (NIPPV) in Pakistani patients with acute exacerbation of chronic obstructive pulmonary disease.
Methods: This descriptive study was conducted at Shifa International Hospital Islamabad from April 2015 to January 2017. A total of 120 patients with acute exacerbation of chronic obstructive pulmonary disease receiving NIPPV alongside standard therapy were included in the study. The patients were clinically assessed before starting on NIPPV. The parameters of respiratory rate, pH and paCO2 were monitored and NIPPV was given for six hours to evaluate clinical outcomes and analyze the factors predicting failure (requirement of mechanical ventilation and mortality). Frequency and percentages were calculated for qualitative variables while Mean and Standard Deviation for quantitative variables. Chi-square and t-test were used to see differences in pre and post NIPPV arterial blood gases.
Results: Patients’ mean age was 58.88±10.09 years. Males were 88 (73.3%) and females were 32 (26.7%). The mean respiratory rate was 24±1.45 per minute before and 17.96±1.35 per minute after NIPPV (p < 0.00001). The mean pH before NIPPV was 7.27±0.04 and afterwards 7.38±0.02 (p < 0.00001). The mean pCO2 was 61.87±9.60 mm of Hg before and 57.46±6.79 mm of Hg after NIPPV (P < 0.0003). Twenty Four (20%) patients required invasive ventilation of which 19 (15.8%) patients could not survive.
Conclusions: There was remarkable improvement in the arterial blood gases after NIPPV. However, the high mortality rate and significant number of COPD patients requiring mechanical ventilation necessitates further investigation into our population.
doi: https://doi.org/10.12669/pjms.35.6.857
How to cite this:Ishfaq N, Gul N, Zaka N. Outcome of early use of non-invasive positive pressure ventilation in patients with acute exacerbation of chronic obstructive pulmonary disease. Pak J Med Sci. 2019;35(6):1488-1492. doi: https://doi.org/10.12669/pjms.35.6.857
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.
Postpartum contraception utilization and its impact on inter pregnancy interval among mothers accessing maternity services in the public sector hospital of Hyderabad Sindh
Authors: Qureshi Prof. Seema Bibi , Shoukat Dr Anila , Maroof Dr Pir , Mushraf Sara 
Published: October 2019

Objective: To find out the particulars regarding contraceptive practices in the postpartum period and to see its impact on prolonging interpregnancy interval (IPI).
Methods: A cross sectional observational study was conducted in the Department of Obstetrics & Gynecology Unit 3, Liaquat University Hospital Hyderabad from 1st July to 31st December 2018. Out of 2100 total deliveries, 398 postpartum women with second or higher order births were included. Pregnant women, primiparas and those who were not willing to participate were excluded. They were interviewed face to face by principal investigator and her team members and required information was collected on predesigned Performa. Outcome variable was interpregnancy interval in months. Chi-square test was used to see association
Results: Postpartum contraception utilization (PPC) was 24.6%(n=398). Most of the women choose condoms as contraceptive method (n=41, 10.3%) followed by oral contraceptive pills (n=18, 4.5%) and intra uterine contraceptive device (n=16,4%). Method related issues were the chief reasons for discontinuation while desire to have another child soon and spouse/family disapproval were among the reasons mentioned largely by non-utilizers of modern methods of family planning. The average interpregnancy interval was 16.4±1.45. Significant association was observed between interpregnancy interval and postpartum contraception use, particularly in the users of long acting reversible contraceptive methods (P-Value 0.0001).
Conclusion: Uptake and continuation of modern methods of contraception was low after last birth culminating in short interpregnancy interval. Optimal IPI was observed in those utilizing modern methods of family planning, with marked effect in users of long acting reversible contraceptive methods.
doi: https://doi.org/10.12669/pjms.35.6.914
How to cite this:Bibi S, Shoukat A, Maroof P, Mushraf S. Postpartum contraception utilization and its impact on inter pregnancy interval among mothers accessing maternity services in the public sector hospital of Hyderabad Sindh. Pak J Med Sci. 2019;35(6):1482-1487. doi: https://doi.org/10.12669/pjms.35.6.914
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.
ANALISIS WILLINGNESS TO PAY PENGGUNA HIPPAM CANGAR TERHADAP MATA AIR GEMULO
Authors: Ningrum Hardian Cahya 
Published: October 2019

ABSTRAKPenurunan kualitas dan kuantitas air disebabkan oleh pemanfaatan mata air secara berlebihan sehingga akan berdampak pada ketersediaan air dalam jangka panjang. Jika hal itu terjadi air sebagai aset lingkungan akan mengalami kenaikan harga dan tidak lagi dapat dikonsumsi secara bebas. Mata air Gemulo merupakan satu-satunya sumber air yang dimanfaatkan oleh masyarakat Dusun Cangar melalui jasa HIPPAM Cangar. Untuk menjaga kelestarian mata air Gemulo diperlukan suatu sistem insentif, yaitu dengan penerapan harga air yang tepat (the right price) dan kelembagaan yang benar (the right institution). Tujuan penelitian ini adalah: menghitung besarnya nilai Willingness To Pay (WTP) dan total nilai WTP, dan menganalisis variabel-variabel yang mempengaruhi nilai WTP pelanggan HIPPAM Dusun Cangar sebagai pemanfaat mata air Gemulo. Analisis yang digunakan adalah Contingent Valuation Method (CVM) dan regresi linier. Hasil penelitian menunjukkan bahwa: Perkiraan nilai WTP adalah Rp 17.950 KK per bulan dan nilai total WTP adalah Rp 8.243.050 per bulan; Variabel-variabel yang berpengaruh terhadap nilai WTP masyarakat Dusun Cangar adalah jumlah kebutuhan air (KA) dan biaya kebutuhan air (BA).Kata kunci: kelestarian mata air, pengelolaan HIPPAM, contingent valuation method, Willingness to Pay
ANALISIS EFEKTIVITAS TRANSMISI MONETER GANDA TERHADAP PERTUMBUHAN EKONOMI INDONESIA
Authors: Wibowo Muhammad Ghafur , Mubarok Ahmad 
Published: October 2019

Mekanisme perubahan kebijakan moneter hingga memengaruhi pertumbuhan ekonomi disebut sebagai mekanisme transmisi kebijakan moneter. Indonesia menganut dual banking system yaitu bank syariah dan bank konvensional. Bank Indonesia selaku otoritas moneter mempunyai instrumen mekanisme transmisi syariah dan mekanisme transmisi konvensional.Tujuan penelitian ini untuk menganalisa efektivitas mekanisme transmisi ganda melalui jalur syariah yaitu pembiayaan dan bagi hasil, sedangkan jalur konvensional yaitu kredit dan suku bunga dalam mendorong pertumbuhan ekonomi. Dalam penelitian ini metode yang digunakan adalah Vector Eror Correction Model (VECM). Penelitian ini menggunakan data dengan periode 2008-2015. Proses pengujian data menggunakan uji stasioneritas, uji kointegrasi, uji stabilitas, uji kausalitas, analisis Impulse Response Function (IRF), dan Forecast Eror Variance Decomposition (FEVD).Hasil penelitian ini menemukan variabel jalur syariah yaitu pembiayaan efektif dalam mendorong pertumbuhan ekonomi. Variabel bagi hasil dan SBIS tidak efektif dalam mendorong pertumbuhan ekonomi. Variabel jalur konvensional yang terdiri dari total kredit dan SBI tidak efektif dalam mendorong pertumbuhan ekonomi, sedangkan variabel suku bunga kredit efektif dalam mendorong pertumbuhan ekonomi.
UMKM Dalam Perspektif Pembiayaan Inklusif Di Indonesia
Authors: Syamsulbahri Darwin 
Published: October 2019

Kajian ini di latar belakangi oleh pentingnya peranan UMKM di satu sisi, namun di sisi lain posisi UMKM sebagai representasi ekonomi mayoritas rakyat masih sangat lemah. Salah satu sumber masalah yang menghambat perkembangan UMKM adalah ketidakadilan akses pembiayaan usaha terutama dari pihak perbankan yang faktanya lebih dominan memberikan kredit pada segelitir pelaku usaha yakni kelompok usaha menengah dan besar dibandingkan untuk UMKM. Kajian ini di tujukan menggambarkan kondisi UMKM dan pembiayaannya serta masalah-masalah yang menyertainya yang diharapkan menyediakan input bagi otoritas pembangunan/pemerintah yang pada gilirannya memberikan kesadaran dan kepedulian yang memadai. Metode analisis kajian ini merupakan deskriptif-kualitatif yang dapat menjelaskan kondisi UMKM dan pembiayaannya serta permasalahannya, yang selanjutnya dilengkapi rekomendasi bagi perbaikan kondisi tersebut. Sebagai mayoritas usaha, UMKM memiliki akses yang terbatas terhadap modal terutama kredit dari lembaga keuangan Bank, dimana hanya memperoleh sekitar seperenam pangsa kredit nasional. Bahkan dilihat “usaha mikro” (98,77 persen dari pelaku usaha) tahun 2013 hanya memperoleh pangsa kredit sekitar 3 persen saja. Upaya pengembangan skim kredit/pembiayaan UMKM yang disebut sebagai bagian dari “financial Inclusion” sangat diperlukan dalam mempercepat pembagunan berkualitas. Struktur PDB yang dikuasai sedikit orang merupakan ancaman bagi tujuan pembangunan dan tujuan keberadaan Negara. Oleh karena itu sangatlah perlu dan segera adanya prioritas kebijakan dan implementasinya untuk memperbesar kemampuan UMKM berkontribusi pada PDB nasiohal sehingga dapat disimpulkan perlunya pembinaan UMKM untuk bertambah kapasitasnya menuju sektor formal dan secara simultan perlu pula sistem pembiayaan mikro bergerak ke arah tempat pertemuan/inteseksi antara kapasitas pemenuhan syarat formalitas UMKM dan syarat-syarat minimal sistem pembiayaan mikro bisa dipenuhi.