bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Hydrocortisone on Reducing severity of Post Dural Puncture Headache after Spinal Anesthesia for Elective Caesarean Section
Authors: Ashfaq Shumaila , Ali Liaqat , Zia Muhammad Ashraf , Khan Rizwan Ahmad , Butt Mehtash 
Published: May 2019

Spinal anesthesia is frequently used in pregnant female undergoing caesarean section due to its safety than general anaesthesia. Post dural puncture headache (PDPH) is commonly occurring problem associated with spinal anaesthesia and causes a considerable morbidity. PDPH depends on several factor and various methods have been used to reduce and treat the pain of PDPH. We evaluated effects of hydrocortisone on the treatment of PDPH in obstetrical patient. To compare mean decrease in Visual Analogue Scalepain score in patients who developed PDPH after elective caesarean section under spinal anaesthesia who were given conventional treatment versus conventional treatment plus hydrocortisone. Double blind randomized control trial. Study conducted in department of anaesthesia and obstetrics of Allama Iqbal Medical College, Jinnah hospital (tertiary care) conducted from13th June 2014 to 13th December 2014. Sample size was calculated 60 (30 each) cases using 95% confidence interval, 80% power of test. Patients who developed PDPH after spinal anaesthesia for elective caesarean section were divided into 2 group; Group A (Conventional Treatment) and Group B, (Conventional Treatment plus Hydrocortisone 100mg 8 hourly for 48 hours). Details were recorded regarding age; mean pretreatment and post treatment VAS after 6 hours. Mean decrease in pain VAS score was 3.30 + 1.2 in group A while 7.17+ 1.3 in group B. (P value 0.001). Intravenous hydrocortisone is more effective in reducing post dural puncture headache pain severity after spinal anaesthesia for elective caesarean section when given along with conventional treatment as compared to conventional treatment alone.
Hypertension and Pre-Hypertension with Associated Risk Factors Among MBBS Students of Shalamar Medical and Dental College, Lahore
Authors: Hanan Rana , Shafi Muhammad Waqar , Anwar Sumair , Nawaz Numrah 
Published: May 2019

Hypertension is a multifactorial chronic disease and a silent cause of high causalities around the globe. Both hyper and pre-hypertension affect all ages and professions, and are as common as flu infections by affecting 1 in every 5 persons. In order to determine frequency of hypertension and pre-hypertensionamong medical students and their association with various variable and fixed risk factors, this study was designed. The cross sectional study of 4 months was carried out on the students of Shalamar Medical and Dental College. Students were aged from 18-25 years and a sample of 100 students was enrolled by stratified random sampling after written consent. We recorded blood pressure at three different time points, one minute apart in sitting position after ten minutes of rest. The average of three measurements was considered as final reading. Data regarding related variables was entered and analysed using SPSS version 21. Out of 100 (43 males and 57 females), three students were hypertensive, 55 pre-hypertensive and 42 normotensive; among pre-hypertensive female students were more in number as compared to male students. Mean age was 21.6 years with increased frequency of pre hypertensive and hypertensive individuals in the first, second and final year class. A total of 64% pre-obese subjects were pre-hypertensive or hypertensive and 75% obese were also pre hypertensive or hypertensive. Frequency of intake of fast/junk food was higher among pre-hypertensive and hypertensive individual than normotensive and same among both genders. Median value of average sleep (hours) among pre-hypertensive subjects was lesser than of hypertensive subjects. Students expressed their concerns related to college timings and hectic routine and increased frequency of teaching sessions including assessments. Frequency of pre-hypertension was higher in the students especially in the first, second and final years of graduation (MBBS). Pre-hypertensive and hypertensive students were pre-obese or obese and had positive family history of hypertension, consumed fast/junk food in both genders. College timing and intensive routines were primary cause of irritation and aggression, which may result in hypertension.
Trends of Utilization of Family Planning Methods at Divisional Headquarter Hospital of Mirpur aj and k
Authors: Zubair Hina , Perveen Saima , Alam Saeed , Rafiq Akkad , Ejaz Sara 
Published: May 2019

Controlling the population growth is one of the most feasible solutions to reduce burden on the country and it can be achieved by effective use of contraception. This study was designed to analyze the trends of utilization of different family planning methods in relation with socio-demographic factors at divisional headquarter hospital in a year time. A retrospective study was performed by analyzing one year records from family planning clinic at divisional headquarter hospital. At family planning centers, a total of 920 individuals attended the Reproductive Health Services from April 2015 to March 2016. Among them, 92% individual utilized temporary methods and only 8% utilized permanent methods. Regarding temporary solutions, a total of 299 (33%) selected intrauterine device, 233 (25%) had used injectable, 191 (21%) adapted oral contraception pills and 121 (13%) selected Barrier methods (condoms). Among permanent solutions, atotal of 76 (8%) had bilateral tubal ligation and no vasectomy. Investigations highlighted that males were not convinced to adapt male sterilization owing to social pressure of family. Findings of this study showed that the majority of the individuals are comfortable with the use of intrauterine contraception devices; howeverneed of the hour is to introduce awareness compaigns to educate general public for better use of contraception especially male partner as it is less invasive compared to female partner.
Career Aspiration and Life Satisfaction of Final Year Medical School Students
Authors: Zahid Uzma 
Published: May 2019

The aim of this study was to assess career aspiration and its three subscales (leadership, achievement, educational) and their relationship with life-satisfaction in final year medical school students of both genders. This cross-sectional study was carried out in final year students of a medical college in Rawalpindi,Pakistan using 24 items revised English Version of Career Aspiration Scale (CAS) and 5 items Satisfaction with Life Scale (SWLS). This study was conducted on total 88 final year medical school students, among them 44 were males and 44 were females. Findings show significant correlation of career aspiration with lifesatisfaction, as well as of its educational subscale and life satisfaction. There was a non-significant correlation of achievement and leadership subscales of career aspiration with life-satisfaction. Medical students who are more aspired towards their career seem to be more satisfied in their life. Moreover, medical students were more interested in getting more and more education but there is lack of aptitude towards achievement and leadership, signifying the need of mentoring amongst medical students. Practical steps should be taken to develop achievement and leadership aspects of medical students, which can ultimately enhance their career aspirations.
First Experience of Implementation of Kangaroo Mother Care in Punjab- Pakistan to Reduce Morbidity and Mortality in Preterm Infants
Authors: Rasul Noreen , Rashid Madeeha , Abbas Aqeela , Sohail Rubina 
Published: May 2019

The study was planned to assess the effect of Kangaroo Mother Care on preterm and stable neonates in reducing neonatal morbidity and mortality. This is a case series design of 121preterm and low birth weight neonates, weighing less than 2500 gram, enrolled from 1 August 2016 till31 January 2017.Kangaroo Mother Care is initiated after birth, after performing early essential newborn care practices. Weight gain of 20-30 gram for three consecutive days, establishment of breast-feeding for 20-30 minutes every two hourly and maintenance of body temperature at 37 degree centigrade is the discharge criteria. During the periodof six months, total number of deliveries was 6459, out of them spontaneous vaginal deliveries were 52.2% (3372) and caesarean sections were 47.7% (3087). In 55.4%neonate’s(both preterm and term)early essential newborn care was practiced.Total preterm were 290 (4.5%), out of them 121 (2%) neonates were kept inKangaroo Mother Care position and 129 (44%) were shifted to neonatal intensive care unit. 14% parents refused for KMC position and discharged. Mortality in preterm newborn in neonatal unit was 29.4% (without KMC) but no mortality occurred after 3 months follow up in KMC babies. All the neonates from KMC unitwere discharged in satisfactory condition and called for follow up investigations. All Kangaroo Mother Care babies had exclusive breast-feeding. Taken together, the results indicate that prolonged skin-to-skin contact and exclusive breast feeding reduces neonatal mortality and morbidity in birth weight 1.5 to 2.5 kg in stable neonates in hospital. However KMC is limited to SHL at present. Workshops are being conducted to teach other doctors and nurses for early essential newborn care and kangaroo mother care. They are still facing controversies and challenges in initiation of KMC in many hospitals. However it is essential to strengthen KMC services in healthcare facilities as it significantly reduces neonatal mortality.
Frequency of Anemia and Obstetric Outcome in Young Primigravida
Authors: Sajid Abida , Sajid Aqsam 
Published: May 2019

Pregnancy and childbirth is an event celebrated worldwide. During pregnancy physiological changes and increasing demand causes fall in hemoglobin level leading to anemia and adverse pregnancy outcome especially in young girls. Anemia is a major public health problem. Around 58.27 million women worldwide are anemic during pregnancy 95% of whom live in countries that are developing. To know the frequency of anemia, and obstetric outcome in terms of preterm delivery, low birth weight and rate of caesarean section in young Primigravida. It was a cross sectional study, conducted in the department of Gynae & Obstetric unit 5 King Edward Medical University Lahore during a period of one year from May2013 April 2014. All primigravida young 15-24years with anemia enrolled for the study. Anemia is defined as hemoglobin< 10.5g/dl (WHO Criteria), Iron deficiency Anemia is defined as serum ferritin level less than 12 micro gram per ml and on Red Blood Cell indices, i.e. decrease in MCV, MCH and MCHC, and Microcytic Hypochromic cells in Peripheral Smear. Megaloblastic anemia was labeled when Macrocytic Hypochromic cells seen. Obstetric outcome in terms of Preterm delivery defined as delivery at <37 weeks of gestation (36 +6 weeks) and birth weight <2500g mand a need for operative delivery. Patients fulfilling the selection criteria as per operational definition were included in the study after taking informed consent using non probability consecutive sampling technique. Data was collected on a pre-designed questionnaire. A total of 3855 deliveries during study period in which 1318 were primigravida. Mean age in study group was 15 to 24 years. We observed mild anemia in 46% of woman, moderate anemia in 41% and severe anemia in 13% in young primigravida. Preterm delivery was noted in 25% of the females and low birth weight babies were noted by 33% in teenage and young primigravida. Statistically significant relationship was found between maternal age, education and socio economic status. Anemia in pregnancy nowadays is still a common problem in adolescent and young primigravida and associated with adverse pregnancy outcome. Prompt measure should be taken by the stake holders at local and national level to prevent and treat this problem in order to reduce morbidity and mortality associated with it.
Risk Factors of Leptospirosis in Rice Cultivators as Compared to non Rice Cultivators in Punjab, Pakistan
Authors: Khan Muhammad Athar , Latif Muhammad Zahid , Gilani Syed Amir , Bukhari Ifrah 
Published: May 2019

Leptospirosis is a global zoonotic infectious disease having alarming public health concerns. Generally this is an occupation related disease and the victims belong to animal slaughtering, owners of pet shops, farm workers, handlers of meat, sewerage and agriculture workers. Leptospirosis affect multiple organs in human body and may lead to myocarditis, renal failure, respiratory distress and hypotension. This disease is an emerging infectious problem in many developing countries like Pakistan. A total of 250 subjects were selected from five different rice growing districts of Punjab, Pakistan after the approval of institutional ethical review board (IERB), 250 subjects were selected for this comparative cross sectional study. Multiple stage probability technique was used for sampling. In the first stage one union council was selected from each district randomly. In the second stage, 25 subjects involved in rice cultivation from the last 10 years wereselected from each union council. Similarly 25 subjects who never worked in the rice paddy field were also randomly selected from each union council as controls. The serum sample of each subject was tested against each of the five antigens against the serovars. A total of 250 subjects were included in the study. Out of these, 125 subjects were exposed to the rice paddy water where as 125 were not exposed to rice paddy water. The cumulative seropositivity among the exposed is (83.2%) as compared to (42%) among the non exposed to rice paddy field water. The calculated cumulative odds ratio is 6.7 which represent a strong association of the risk for the development of disease among the exposed than the non exposed subjects. Leptospirosis is a public health zoonotic disease which is widely present in tropical and sub tropical areas. This study concludes that there is a strong association of rice cultivation with Leptospirosis. It is recommended that rice cultivators should protect their body parts with gloves or boots as prevention is the most appropriate way to control any disease.
Frequency of Impaired Glucose Tolerance in Obese Patients
Authors: Ahmad Mian Sajjad , Iqtadar Somia , Mumtaz Sami Ullah , Niaz Zafar , Waheed Iqra , Abaidullah Sajid 
Published: May 2019

Obesity is a state of excess body adipose tissue. Impaired glucose tolerance is a risk factor for developing diabetes Mellitus & is associated with hyperglycemia and insulin resistance. To determine the frequency of impaired glucose tolerance in obese patients. This Cross Sectional study was carried out in North Medical Ward, King Edward Medical University/ Mayo Hospital Lahore for 6 months i.e. January to June 2014. Total 160 obese patients visiting outpatient department of North Medical Ward, Mayo Hospital Lahore for 6 months were included by non-probability purposive sampling. Patients aged 15-70 years of either gender were included. Oral glucose tolerance (OGTT) was done in each patient with unrestricted carbohydrate diet for three days and avoiding coffee, smoking and heavy exercise six hours before the test. Fasting sample was taken then 75g oral glucose was given. Sample after two hours was sent to KEMU clinical lab. A positive result of the patient was labeled as IGT. The patients mean age was 46.3±13.4 years. Out of 160 patients, 78 (48.8%) were males and 82 (51.2%) females.116 (72.5%) patients were obese grade 1 and 44 (27.5%) patients were obese grade 2. The mean BMI (Normal BMI=18.5-22.9kg/m2) of the patients came out to be 29.1±13.6 kg/m2.There were 116 (72.5%) patients of obese-1 and 44 (27.5%) patients of obese 2. There were 140 (87.5%) patients normal and 20 (12.5%) patients were impaired OGTT. In obese-1 type patients, 112 (70%) patients had normal OGTT and 4 (2.5%) patients had impaired OGTT. In the obese-2 type patients, 28 (17.5%) patients had normal OGTT and 16 (10%) patients had impaired. Impaired glucose tolerance is commonly found in obese patients.Therefore adequate measures like dietary restrictions, physical exercise & drugs should be taken to control obesity.
Comparison of Serum Probrain Natriuretic Peptide (ProBNP) Levels in Migraineurs and Hypertensive Migraineur Patients
Authors: Abbasi Sana Qanber , Ahmed Ejaz , Sattar Rabia 
Published: May 2019

Migraine being one of the common and disabling causes of headaches, has been described by World Health Organization as close to quadriplegia and dementia.Among the headache complaint visitors in the emergency department, the most common are those suffering from migraine. (1) Alinear correlationhas been found between rising serum pro BNP levels and Cardiovascular pathologies especially those involving left ventricular dysfunction which may depict a probable association between migraine and CVD. To compare the levels of serum pro Brain natriuretic peptide (pro BNP) between migraineurs and hypertensivemigraineurs. It was a cross sectional comparative study in which serumpro BNP levels were measured in migraine patients and hypertensive patients with migraine. A blood sample of 3 cc was drawn from the median cubital vein after securing aseptic measures. The blood sample was allowed to clot for 30 minutes and serum was separated. The serum was then centrifuged andpro BNP levels were estimated by ELISA using Human pro BNP kit. Patients’ history and recorded blood pressure was documented on a questionnaire. The results were analyzed using SPSS 21. One way ANOVA and Independent sample T test were applied to compare the proBNP levels. A P-value of < 0.05 was taken as significant. Serum pro BNP levels were raised in migraine patients and also in hypertensive patients with migraine (p-value 0.00). Serum pro BNP levels were found to be raised in both migraineurs and hypertensive migraineurs but the increase was not equal.
Quality of Life and Marital Satisfaction in Parents of Children with Leukemia
Authors: Masood Afsheen , Musarrat Rubab , Mazahir Shama , Ashraf Adeela 
Published: May 2019

The current research study investigated the differences in reported quality of life and perceived marital satisfaction in parents of children with leukemia with that of normal cohort. Case control study design was used. The sample consisted of N=120 parents out of which n=60 were the parents of children with leukemia and n=60 were the parents of normal children, , taken as normal cohort and drawn through non-probability purposive sampling procedure. Both cohorts were matched on the basis of the age and income level of the parents. Quality of Life Scale WHOQOLS and Marital Satisfaction Scale were used to collect the data from Anmol and Sundus Foundation and Fatmeed Foundation, Lahore. The results from independent sample t- test revealed that the quality of life and marital satisfaction of parents of children with leukemia was significantly lower than the parents of normal cohort. Further it was indicated by the correlation analysis that better greater satisfaction was associated with better quality of life. The findings carry significant implications for clinical professionals, health psychologists, community workers and the future researchers.
Level of Awareness of Hepatitis ‘C’ Among Primary Grade: A School Health Intervention
Authors: Jamshed Aneeza , Gillani Syed Amir 
Published: May 2019

There is a lack of awareness about hepatitis C due to poverty, involvement of quacks and less penetration of mass media. To develop the awareness of hepatitis C among primary grade students. A total of 150 students of primary grade among 300, of Government sector Middle School Lahore were selected throughmultistage cluster sampling. A quasi-experimental study was conducted in the time period of 6 months from April 2014 to Sep 2014. Data analysis was done with SPSS 20. After describing the important variables, average percentages were used to find out the difference between pre and post awareness performances andt score and p value was calculated. All the students (150) were boys, 98% belonged to a lower middle class family with the age of 9-12 years. During pre-testing evaluation, students were never given the knowledge about hepatitis C, its source of transmission (contaminated syringes) and its secondary prevention. Only3% knew that it can be prevented. About 61% thought that it is a disease of adults. Only 21.1% students thought it can be cured. In post awareness assessment after 3 sessions of interactive learning, 92% students understood the prevention of hepatitis C disease, its transmission (syringes 88.7%, blood transfusion 91%),signs (effects on liver 92.9%), symptoms (88%), prevention in high prevalent areas (sterilized syringes and screened blood transfusion 86.5%) and management (88.7%). This study showed that it may be an important school health based intervention to educate students about the transmission, prevention and management of hepatitis C, which may help in declining the disease burden. Hepatitis C, Unsterilized syringes, Hepatitis C Awareness, Prevention of Hepatitis C.
Exergaming Improves Executive Functions in Patients With Metabolic Syndrome: Randomized Controlled Trial
Authors: Wu Shanshan , Jo Eun-Ah , Ji Hongqing , Kim Kyung-Hee , Park Jung-Jun , Kim Bo Hyun , Cho Kyoung Im 
Published: May 2019

Background
Recent studies indicate that participation in exercise-related games can improve executive function, attention processing, and visuospatial skills.

Objective
The aim of this study was to investigate whether exercise via exergaming (EXG) can improve executive function in patients with metabolic syndrome (MetS).

Methods
A total of 22 MetS patients were recruited and randomly assigned to an EXG group or a treadmill exercise (TE) group. The reaction time (RT) and electrophysiological signals from the frontal (Fz), central (Cz), and parietal (Pz) cortices were collected during a Stroop task after 12 weeks of exercise.

Results
During the Stroop congruence (facilitation) judgment task, both the EXG and TE groups showed significantly faster RT after 12 weeks of exercise training. For N200 amplitude, the EXG group demonstrated significantly increased electrophysiological signals from the Fz and Cz cortices. These changes were significantly larger in the EXG group than in the TE group. Separately, for the P300 amplitude, the EXG groups presented significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices, whereas the TE group showed significantly increased electrophysiological signals from the Cz and Pz cortices only. During the Stroop incongruence (interference) judgment task, both the EXG and TE groups showed significantly faster RT. For P300 amplitude, the EXG group had significantly increased electrophysiological signals from the Fz and Cz cortices only, whereas the TE group had significantly increased electrophysiological signals from the Fz, Cz, and Pz cortices.

Conclusions
EXG improves executive function in patients with MetS as much as normal aerobic exercise does. In particular, a unique benefit of EXG beyond increased aerobic capacity is the improved selective attention among cognitive functions. Thus, EXG could be recommended to someone who needs to improve their brain responses of concentration and judgment as well as physical fitness.

Trial Registration
ClinicalTrials.gov NCT04015583; https://clinicaltrials.gov/ct2/show/NCT04015583