bluuebunny/crossref_metadata_2025_split huggingface dataset:
FREQUENCY AND RISK FACTORS OF MICROSCOPIC COLITIS AS A CAUSE OF CHRONIC WATERY DIARRHOEA
Authors: Sabhita Shabir Shaikh  , Khalid Raheela , Bukhari Uzma , Shaikh Hafeezullah , Ijtaba Rizvi Syeda Aamna , Shabbir Alveena 
Published: October 2024

Background: Microscopic colitis (MC) is one of the most underdiagnosed conditions leading to chronic watery diarrhoea in patients worldwide. This is the first study of this kind in Pakistan and we aimed to calculate the frequency as well as study the risk factors behind the disease. Methods: This was a prospective cross-sectional study in a tertiary care hospital in Pakistan. A total of 58 participants with chronic watery diarrhoea who had normal colonoscopy were recruited for the study and biopsies were obtained for diagnosing MC. Results: 2 participants out of 58 (3.4%) had biopsy proven microscopic colitis; one patient had a lymphocytic colitis variant and the other had a collagenous colitis variant. The average score based on the MC scoring system was 7.53 in the entire study group. The patient with lymphocytic colitis had a score of 06 while the patient with collagenous colitis had a score of 8. Conclusion: The frequency of microscopic colitis was found to be 3.4% of all cases of chronic watery diarrhoea. A link between MC and autoimmune diseases was also observed. However, we had a limited sample size and encourage future studies to employ a larger sample size in order to get a multifaceted look at the disease process.
BONY LESION ANALYSIS IN CARCINOMA PROSTATE: M.D.P. BONE SCAN VS. GALLIUM-68 PSMA-11 PET/CT
Authors: Haider Ali  , Syed Rashid Ul Amin  , Abdul Hai  , Noureen Nizar  
Published: October 2024

Background: Prostate cancer is the cause of the highest cancer-related death in males, 5-year survival is 31% in metastatic disease, and bone is a common site of metastases. Bone scintigraphy is a routinely used imaging modality for detecting skeletal metastases. It has variable sensitivity of 52-100%, whereas PSMA PET/CT scans have better sensitivity approaching 100%, so we determined the diagnostic accuracy, sensitivity, and specificity of planar M.D.P. (methylene diphosphonate) bone scintigraphy. Methods: This analytical cross-sectional study was conducted at the N.M. & molecular imaging department of S.I.U.T. Karachi. Bone scans and PSMA-PET/CT scans of all patients who were visited from Janury-2018 to January 2023 were reviewed and interpreted by a nuclear physician& radiologist team. Inclusion criteria were histopathology-proven prostate cancer patients who had a bone scan and PSMA PET/CT scan within one month and had not received any treatment between scans. Results: Among 70 scans, 38 (54.2%) were positive for bone lesions. A total of 18 (47%) patients had positive bony lesions on both PSMA-PET/CT and Bone scintigraphy. Among 38 bone lesions positive patients, in eleven patients, bone lesions were detected only on PET/CT scans, whereas nine were positive only on Bone scans. The mean S.U.V. max of all bony lesions was 19.15 (range 3.2-57.5). The bone scan's sensitivity, specificity, and accuracy were 62.07%, 78.05%, and 62.87%, respectively. Conclusion: PSMA-PET/CT is better than bone Scintigraphy for detecting skeletal metastases. However, outcomes of bone scintigraphy may be improved when Tc-PSMA receptor bone scintigraphy is used.
FUNCTIONAL OUTCOME OF BRISTOW-LATARJET PROCEDURE IN POST-TRAUMATIC RECURRENT ANTERIOR SHOULDER INSTABILITY
Authors: Haseeb Saqlain Bajwa  , Uddin Shuja , Zia Uddin  , Hafiz M. Umar  , Rizwan Ul Haq  , Ahmed Umair Asad Khan  
Published: October 2024

Background: Due to its lack of bony support, the shoulder joint has the broadest range of motion out of all the joints in the body. Instead, one of the joints that dislocate most frequently is the shoulder joint. Multiple pathologic abnormalities, including the traumatic separation of the anterior-inferior capsule-labral complex from the glenoid rim, are caused by repeated anterior glenohumeral dislocation. The objective of the study is to ascertain the Bristow-LATARJET procedure's efficacy in situations of recurrent post-traumatic anterior shoulder instability. Methods: From 31 January 2020 to 31 July 2020, a descriptive case series was undertaken in the orthopaedic surgery department of the Lahore General Hospital. For this study, 71 patients who met the inclusion and exclusion criteria were recruited, and all interventions were conducted while the patients were lying in a beach chair while under general anaesthesia. The Delto-pectoral incision surgical technique was applied. For 12 weeks, all patients underwent clinical follow-up, and the results were documented. Results: There were 50(70.4%) males and 21(29.6%) females in this study & the mean age of the patients were 34.64±10.73. There were 37(52.1%) patients among them the outcome of treatment (Rowe Scale at 12th week) was excellent, among 21(29.6%) it was good, among 8(11.3%) it was fair and among 5 (7.0%) it was poor. There was a significant association between the outcome of treatment (Rowe scale at 12th week) and age groups (p-value: 0.000). Conclusion: The Bristow-LATARJET procedure is deemed to be a very productive, safe, and problem-free procedure for curing post-traumatic reoccurring traumatic anterior shoulder instability
TO DETERMINE THE SURVIVAL OF PATIENTS WITH BRAIN METASTASES AFTER PALLIATIVE WHOLE-BRAIN RADIOTHERAPY - AN EXPERIENCE FROM A SINGLE INSTITUTE
Authors: Misbah Dawood , Muhammad Fawad-Ul-Qamar  , Khaleeq Nadia , Zaidi Alina , Ali Shah Syed Zarak , Sajjad Kashif 
Published: October 2024

Background: Brain metastases are a common complication of cancer and approximately 20% of cancer patients develop them over time. Presently palliative whole-brain radiotherapy is used as a palliative treatment for brain metastases because of its cost-effectiveness and easy availability, especially in patients with multiple metastases who are not candidates for surgery or Stereotactic radiosurgery. This study aims to determine the survival in patients who have received palliative whole-brain radiotherapy for brain metastases and to evaluate some of the prognostic factors determining survival in patients with brain metastases. Methods: It was a cross-sectional study conducted in Shaukat Khanum Memorial Cancer Hospital and Research Centre and all the patients with brain metastases who had completed palliative whole-brain radiotherapy between July 2015 and July 2020 were included. Data was retrospectively collected and analyzed using SPSS 21.0. Overall survival was calculated using the Kaplan-Meier method, taking into consideration the period from the date of diagnosis of brain metastases until death or to the date of last follow-up, whichever was applicable. p-value of <0.05 was regarded as statistically significant. Results: Almost half (45%) of the brain metastases were secondary to breast cancer followed by lung and genitourinary cancers at 16.3% and 15.5% respectively. The median overall survival was lowest in breast carcinoma patients at 5 months followed by lung carcinoma at 7 months. The median overall survival was 5 months in patients having extracranial disease as compared to 12 months in those having no extracranial disease or those in whom the disease status was unknown. Conclusions: Our study revealed that the most common tumour to metastasize to the brain was breast cancer. The younger age group had a poorer prognosis because most of them had breast cancer with triple-negative disease. Controlled extracranial disease significantly prolonged overall survival in patients with brain metastases.
EXPLORING THE LINK BETWEEN OBESITY AND HYPOTHYROIDISM
Authors: Saqib Malik  , Sadia Rehman  , Farhat Naz  , Rehman Najma , Zainab Syed  
Published: October 2024

Background: Obesity and hypothyroidism are two common clinical conditions that are often connected. This connection is now more important because of an exceptional rise in the prevalence of obesity around the world. Both of these conditions have a noteworthy impact on human health and well-being. The main objective of this study was to determine the frequency of hypothyroidism in obese patients presenting at Ayub Teaching Hospital, Abbottabad. Methods: This cross sectional study was carried out on 242 patients in the Department of Medicine of Ayub Teaching Hospital, Abbottabad from 1st March to 31st August 2022. SPSS version 23.0 was used for data analysis. Result: In this study 242 obese patients were included. Mean age of the patients was 39.55±9.361 years. Mean BMI was 41.62±8.099kg/m2 ranging from 31 to 61kg/m2, mean TSH level was 3.04±2.604mU/l, mean T4 level was 8.53±2.215pmol/L and mean T3 level was 1.2195±0.35795nmol/L .Out of total 242 patients, 34(14.0%) were male and 208(86.0%) were female patients. Patients found with overt hypothyroidism were 11(4.5%), subclinical hypothyroidism were 31(12.8%) and euthyroid were 200 (82.6%) Conclusion: The proportion of hypothyroidism among the obese patients was quiet less in our setup and not significantly associated with age and gender of the patients.
PHARMA, PHYSICIAN NEXUS -A PERIL IN THE OFFING
Authors: Yousafzai Abdul Wahab , Fatimah Saeed  
Published: October 2024

Pharmaceutical companies and healthcare professionals have long been a subject of scrutiny, as their collaboration plays a pivotal role in advancing medical research, promoting evidence-based practices, and fostering dialogue among healthcare practitioners. Together, they have pushed the boundaries of scientific innovation, paving the way for groundbreaking medical advancements. However, ethical concerns arise when such collaborations cross the line into lavish sponsorships for physicians, including all-expenses-paid trips to international conferences and seminars. The opaque ties between the pharmaceutical industry and Physicians cast a shadow on the sanctity of impartial medical practice, particularly in a nation like Pakistan where regulatory frameworks are a work in progress. While the undeniable benefits of collaboration between pharmaceutical companies and medical practitioners are evident, it is imperative to address the ethical implications when such partnerships tread perilously close to the line between ethical collaboration and ethically questionable practices.
EFFECT OF TAMOXIFEN ON PLASMA LIPID PROFILE IN PATIENTS OF BREAST CANCER
Authors: Bhunisha Mahadev  , Haider Ghulam , Shaikh Zoya , Kumar Pavan , Memon Paras , Rahul Raja , Parkash Jai , Nouman Maryum , Khalil Mehar  , Shaikh Mehwish Roshan 
Published: October 2024

Background: To evaluate the effect of Tamoxifen on plasma lipid profile in breast cancer patients presenting at tertiary care hospital. Methods: It was a longitudinal study conducted at the department of oncology of Jinnah Postgraduate Medical Center from December 2018 to November 2019. Eighty-eight females of age 26-66 years diagnosed with breast cancer were included in the study using non-probability consecutive sampling technique. Detailed gynaecological and clinical investigations and detailed history were taken. The blood samples of all the patients were collected and plasma lipid profile was measured before initiation of Tamoxifen treatment and three- and six-months post treatment at clinical laboratory. The plasma lipid profile includes the measurement of Total cholesterol (mg/dl), Triglyceride(mg/dl), High density Lipoprotein (mg/dl) & Low-density Lipoprotein (mg/dl). SPSS version 23 was used to analyse data. Results: After treatment there was significant reduction in serum cholesterol & Low-density Lipoprotein level by 20.54 mg/dl & 16.46 mg/dl at 3 months (p<0.05), moreover there was significant increase in Triglyceride by 22.14 at 3 months (p<0.05). No significant difference was observed in High density lipoprotein level at 3-months after using Tamoxifen. At 6 months there was significant reduction in serum cholesterol & Low-density lipoprotein by 32.29mg/dl and 24.11 mg/dl at 6 months (p<0.05), moreover there was significant increase in Triglyceride level by 42.19 mg/dl at 6 months (p<0.05). No significant difference was observed in High density lipoprotein level at 6 months after using Tamoxifen. Conclusion: Total cholesterol and Low-density Lipoprotein levels showed significant reduction over the period of six months from the baseline with the use of Tamoxifen. Hence Tamoxifen should be considered to have an added advantage on lipid metabolism and therefore, can reduce the risk of cardiovascular events.
STONE CLEARANCE AND COMPLICATION RATE OF MICRO PERCUTANEOUS NEPHROLITHOTOMY AND RETROGRADE INTRARENAL SURGERY FOR LOWER POLE RENAL STONE: A RANDOMIZED TRIAL
Authors: Sajjad Kumail , Maisam Ali Shahid  , Mazhar Ali  , Khizar Hayat  , Muhammad Nazir  
Published: October 2024

Background: The use of unhealthy food and a sedentary lifestyle increases daily health problems. Renal stones are one among others. Endourology promises the minimum complications and the highest stone clearance rate. Indications of the two procedures overlap micro-PCNL and RIRS. The objective was to evaluate stone clearance and complication rate of micro-PCNL and RIRS for lower pole renal stones. Methods: The research design of this study was a randomized trial and was done after approval of the ethical review committee. The sampling technique was consecutive sampling at the Urology department. Patients included in the study according to inclusion criteria were 96 in number. Randomization into two groups (RIRS vs micro-PCNL) was done by even odd method. All the procedure was done by a single senior urologist. Results: Their ratio among males and females was 2:1. Mean LOS in the RIRS group was 2.89±0.86 days and in the micro-PCNL group 2.58±0.65 days (p=0.047). The complication rate in the RIRS group was 6.2% and 8.3% in micro-PCNL (p=0.695). Mean post-operative haemoglobin was 12.30±1.07 g/dL among the RIRS group and among the micro-PCNL group it was 11.21±1.08 g/dL (p<0.001). There was an average haemoglobin drop in the micro-PCNL group of 1.09±0.01 g/dL. 75% clearance of stone after one session was achieved in the RIRS group while 79.2% was achieved in the micro-PCNL group (p=0.627). Conclusion: Length of hospital stay (LOS) and stone clearance rate (SFR) were similar in both groups with insignificant statistical differences. There is a need to conduct more studies with a large number of study participants and involving multi-centers.
A REVIEW OF MRI APPEARANCES OF LIPIODOL IN CONVENTIONAL TACE (cTACE) TREATED HEPATOCELLULAR CARCINOMAS
Authors: Rauf Maria , Atif Iqbal Rana  , Maria Rauf  , Jamshaid Anwar  , Haider Ali  , Ahmad Ammar Afzal  
Published: October 2024

Background: The global burden of patients affected by chronic liver disease (CLD) has shown a steady rise over the last few decades and is now considered the 11th most frequent cause of death globally. In addition, as the world population is facing increased obesity rates coupled with alcohol consumption, these rates are predicted to continue to rise. The Objective was to assess the appearance of Lipiodol retention upon different MRI sequences with a special focus on non-contrast sequences. Lipiodol Trans-arterial chemoembolization (TACE) has become the standard treatment for unresectable hepatocellular carcinoma (HCC) without vascular invasion. However, data regarding Lipiodol TACE imaging via MRI is limited and results are not familiar to radiologists for regular assessment of treatment response. Methods: After IRB and EC approval, we included all those patients who underwent TACE treatment with Lipiodol and chemotherapeutic agent; having both 4-6-week post-treatment CT and MRI imaging. This criterion was fulfilled by a total of 25 patients. Only lipiodol-containing areas within the lesion were noted for signal intensities on all MRI sequences and labelled as hyperintense, isointense, hypointense and mixed intensity. Data was entered and analyzed by SPSS v27. Frequencies and percentages were calculated for qualitative data. Results: The most sensitive sequence in detecting Lipiodol retention was Fat suppressed T1 imaging sequence, with low signal intensity seen on T1 weighted fat-suppressed sequences in up to 76% of lesions. While on non-fat suppressed T1 weighted images, 60% of Lipiodol retention areas appeared hyperintense. 52% of lesions showed a hypointense appearance on the T2 weighted sequence. A much more variable appearance was seen in Diffusion-weighted imaging sequences demanding cautious interpretation. MR patterns were clearer in patients having more than 50% lipiodol retention on CT and lesion size more than 2 cm. Conclusion: While MRI is deemed as a reliable and most useful imaging modality for assessing HCC's following lipiodol TACE it requires cautious interpretation with knowledge of variable signal appearance seen on different imaging sequences.
ORAL PROTOZOA ENTAMOEBA GINGIVALIS AND TRICHOMONAS TENAX AMONG PERIODONTITIS AND GINGIVITIS PATIENTS IN PERIODONTOLOGY DEPARTMENT DENTAL SECTION QUETTA
Authors: Abdul Samad Gichki  , Maryam Mooen  , Muhammad Tariq Hasni  , Daud Ghilzi  
Published: October 2024

Background: a group of eukaryotic organisms that are either free-living or parasitic and feed on organic matter, such as microorganisms or organic detritus. This group is referred to as a polyphyletic classification. They can be found in a wide variety of patterns and sizes, ranging from an amoeba, which can vary its shape, to a paramecium, which has a fixed shape and a complicated structure. The objective was to find out the occurrence of Entamoeba gingivalis and Trichomonas among Dental Patients visiting the Periodontology Department Dental Section, Sandeman, Provincial Hospital Quetta. Methods: The study design was randomized cross-sectional and conducted in the Department of Periodontology Dental Section, Sandeman Provincial Hospital Quetta, from March 2022 to February 2023. A total of 110 known cases of periodontitis and gingivitis were recruited in this study, and further to laboratory work the bacterial biofilm samples were collected from both gingivitis and periodontitis patients. The dental plaque was placed on individual glass microscope slides and a drop of saline and mixed and covered with a coverslip. The wet smear was examined immediately under 40X, and the objective for the presence and absence of motile amoebae or flagellated protozoa was recorded. Results: out of 110 known cases of periodontitis and gingivitis 91 (83%) patients were males and 19 (17%) were females among 110 patients, 40 (36%) patients were periodontitis and 70 (64%) patients were gingivitis. Among 40 (36%) periodontitis patients 3(7.5%) were Entamoeba gingivalis and 4(10%) were Trichomonas Tenax while 70 (64%) cases of Gingivitis 20 (28%) of Entamoeba gingivalis and 1(1%) Trichomonas tenax was recorded. No patient had both species of protozoa were seen in this study. Conclusion: The results of this study revealed the frequency of occurrence of E. gingivalis and T. tenax and the state of periodontitis and gingivitis. The prevalence of E. gingivalis was higher than T. tenax. We recommended further research with a higher number of patients and may use more advanced and reliable laboratory techniques such as PCR and electron microscopy.
MORTALITY AND PROGNOSTIC FACTORS IN PATIENTS OPERATED FOR ACUTE EPIDURAL HEMATOMA
Authors: Khalid Shah , Shahbaz Ali Khan  , Abbasi Tariq , Khan Ahsan Aurangzeb , Faiza  , Abdul Majid Khan  
Published: October 2024

Background: Epidural hematoma is one of the most common surgical emergencies encountered in neurosurgery. This study was conducted to determine the mortality and prognostic factors in patients operated for traumatic intracranial epidural hematoma in a resource-constrained setting from a developing country. Methods: This retrospective study was conducted in the Department of Neurosurgery at Ayub Teaching Hospital Abbottabad from 1st January 2019 to 31st Dec 2021. Inclusion and exclusion criteria were created. The medical record of 116 patients admitted and operated on for traumatic extradural hematoma was retrospectively reviewed. Information was recorded using a standardized structured questionnaire. The outcome was measured in terms of the Glasgow coma outcome score. Results: Out of 116 patients, 93 were male and 23 were female.19 (16.4%) patients were in the age range 0-5 years, 42 (36.2%) were in the age range 6-15, 35(31.0%) were in the age range 16-30, 11 (9.5%) were in the age range 31-45 years, 7 (6.0%) were in the age range 46-60 years while only one patient included in this study was above 60 years. Overall mortality was 4.3%. Mortality was higher in females and in those aged less than 5 years (3.4%). 4 out of 16 patients died with GCS less than 8, while none of the patients died when GCS was above 12. Mortality was significantly higher in the presence of associated lesions (4.4% vs. 0%) and anisocoria (2.6% vs.1.7%). Patients who operated within 6 hours of trauma resulted in better outcomes with a mortality rate of 0.0% and functional recovery of 57.8 % while for those who operated after 6 hours, mortality was significantly higher (4.3%) and functional recovery was significantly low (15.5%). Conclusion: Good surgical outcomes can be achieved with early operative intervention if indicated. Female gender, low preoperative GCS score, presence of pupillary dilatation, presence of associated lesions, delayed surgical intervention and age less than 5 years are significant predictors for poor outcomes.
MANAJEMEN KINERJA APARATUR SIPIL NEGARA (ASN) BERBASIS BEKERJA DARI RUMAH (WORK FROM HOME)
Authors: Rawinarno Tjahyo , Setyoko Haryo , Widiarto Agus , Alynudin Suhud 
Published: October 2024

Sebanyak hampir 50% Aparatur Sipil Negara (ASN) yang tidak melakukan pekerjaannya pada tiga bulan pertama pandemi karena mulai diterapkannya sistem Bekerja dari rumah (Work From Home) di Indonesia pada lembaga pemerintahan. Sehingga, untuk menghadapi situasi pasca Covid-19, pemerintah perlu memperhatikan kembali kinerja para aparat publik tersebut. Salah satunya dengan menggunakan model manajemen kinerja yang terintegrasi menurut Zainal (2014) yang secara garis besar terdiri dari perencanaan, pelatihan dan evaluasi. Metode penelitian yang digunakan yaitu melalui studi kepustakaan literatur, seperti dokumen lembaga resmi pemerintah maupun sumber lainnya yang relevan. Merujuk Peraturan Pemerintah No. 30 Tahun 2019 tentang Penilaian Kinerja Pegawai Aparatur Sipil Negara, yang mana sudah memuat bagian dari model manajemen kinerja yakni Sasaran Kinerja Pegawai (SKP).