bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hidden Hunger or Knowledge Hunger? an Interventional Study in a Public School of Rawalpindi
Authors: Mashhadi Syed Fawad , Khan Nazish , Maryam Zunera , Aamir Manal , Sahi Saman Sajjad , Amin Maira 
Published: October 2023

Objectives: To assess baseline micronutrient knowledge among adolescents in a school of Rawalpindi and to determine effect of educational intervention on micronutrient knowledge and food choices.
Study Design: Quantitative pre and post-intervention study
Replace and During of Study: A Public school of Rawalpindi Pakistan from Nov 2021-Apr 2022
Methodology: A sample size of 190 was obtained by using Raosoft sample size calculator. Considering 15% non-response final sample size of 230 was taken. Study participants included students of 9th–12th grades enrolled through non probability convenience sampling. A pre-test was taken to assess baseline micronutrient knowledge using standardized, pretested questionnaires. Five invalid responses were excluded, yielding a total of 225. Intervention was carried out via an interactive multimedia lecture on micronutrients. After eight weeks, 217 out of those students were reassessed via same questionnaire. Data was analysed using SPSS Version-25. Qualitative variables were expressed as frequency and percentages and quantitative variables as mean and S.D. Paired sample t-test (for continuous variables) and Chi-square test (for categorical variables) were applied.
Results: Out of 217 participants, 66(30%) were males and 151(70%) were females with a mean age 16.8±0.7 years. Significant improvement was seen on general micronutrient knowledge and knowledge of iron, vitamin A, vitamin D, zinc, calcium and folate (p-value < 0.05). There was a moderate improvement in food consumption in a frequency of 2-3 times/week.
Conclusion: The intervention improved micronutrient knowledge and positively impacted food choices. Thus, such knowledge-based programs are recommended.
Prevalence of Imposter Syndrome Among Medical Students of Rawalpindi, Islamabad and Lahore: A Cross-Sectional Study Investigating A Trending and Pragmatic Topic: we no Longer Have to Live in Pluralistic Ignorance
Authors: Mashhadi Syed Fawad , Khan Nazish , Khalid Rana Abdullah , Raza Hubab , Hassan Ateeq Ul , Younas Muhammad Fahad 
Published: October 2023

Objectives: To determine the prevalence of Imposter syndrome among medical students and to assess its association with various sociodemographic factors.
Study Design: Analytical cross-sectional study.
Replace and During of Study: Public and Private Medical Colleges of Islamabad/Rawalpindi and Lahore Pakistan, from Nov 2021-Apr 2022.
Methodology: An analytical cross-sectional study was carried out in Public and Private Medical and Dental Colleges of Islamabad/Rawalpindi and Lahore Pakistan, from Nov 2021 to Apr 2022. Three hundred ninety-nine eligible MBBS/ BDS students were enrolled through non probability convenience sampling. Data was collected Online through a 20 item Clance questionnaire. Data was analysed using SPSS Version-25. Qualitative variables were expressed as frequency and percentages and quantitative variables as mean and S.D. Chi-square test was applied.
Results: Out of 399 participants, 254(63.6%) were males and 145(36.3%) were females. Majority of the participants (71.4%) were in age range of 20-22 years. Three hundred and sixty-two (90.7%) participants were students of MBBS, while 37(9.3%)studied in BDS. Two hundred fifty (62.65%) participants suffered from imposter syndrome which showed a positive association with gender (p<0.001), age (p<0.001), year of Study (p<0.001) and academic performance in class (p=0.002).
Conclusion: Imposter syndrome is quite prevalent among the high achieving medical students and is associated with various sociodemographic variables. Further in-depth research is needed to confirm its association with mental health issues and its adverse effects on the normal functioning of individuals.
Antimicrobial Efficacy of Cefoperazone-Salbactam Plus Tigecycline versus Cefoperazone-Salbactam Against Respiratory Pathogens and Their Effect on Laboratory Indices
Authors: Shaukat Sundas , Irfan Zona , Arif Haseeba , Sadiq Sidra , Bakhtiar Shehnaz , Ismail Muhammad 
Published: October 2023

Objective: To compare the antimicrobial efficacy of cefoperazone plus tigecycline versus cefoperzone and their effect on biochemical indices.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Pathology, Rehman Medical Institute, Peshawar Pakistan, Nov 2022 to May 2023.
Methodology: Patients of either gender with age >20 years having intensive care unit stay of >72 hours having clinical and radiological evidence of hospital acquired respiratory infection were included in the trial. A non-randomized convenience sampling technique was employed. Group CT patients received a combination of cefoperazone-sulbactam plus tigecycline intravenously while Group C participants received only cefoperazone-salbactam. Demographics, inflammatory markers,pathogens, treatment effectivity were recorded.
Results: Mean age of participants in Group CT was 57.59±6.08 years as compared to 56.37±6.87 years in Group C. Pseudomonas aeruginosa was the most common pathogen identified in 30(23.8%) patients. CRP, WBC’s and PCT was significantly reduced after antibiotic treatment in both groups with a p-value of <0.01 and significant decrease in the serum levels of these markers was observed in Group CT as compared to Group C with a p-value of <0.05. Overall, the treatment effectivity was observed in 57(90.5%) participants in Group CT as compared to 46(73%) in Group C.
Conclusion: Cefoperazone-salbactam plus tigecycline offers superior antimicrobial activity as compared to cefoperazonesulbactam in patients with hospital acquired respiratory tract infections.
Iron Deficiency Anemia in Children Under One Year of Age
Authors: Akram Saira , Ikram Farooq , Awan Amir , Akram Aneeqa , Nawaz Raazia , Rahman Asbah 
Published: October 2023

Objective: To determine the association of Iron Deficiency Anemia with demographic factors in children under one year of age.
Study design: Cross-sectional study.
Place and Duration of Study: Pak Emirates Medical Hospital, Rawalpindi Pakistan from Jan to Oct 2020.
Methodology: All children of less than one year of age, of either gender who attended Out Patient Department with the complaint of acute illness like upper respiratory tract infections were consecutively enrolled. The detailed analysis for haematological parameters, means corpuscular volume <70 fl, serum ferritin <30 mcg/L, and transferrin saturation <16% were performed.
Results: Of three hundred and fifty-four children, the frequency of Iron Deficiency Anemia was found to be in 200(56.5%). The frequency of Iron Deficiency Anemia in children more than 8 months of age was higher (70.6%) in comparison to children less than 8 months of age (29.4%). Multiple variables were found to significantly contribute to Iron Deficiency Anemia, the father's educational status, the mother's educational status and socioeconomic status. At the same time, Iron Deficiency Anemia was significantly lower among children with first or second childbirth orders and in breastfed infants.
Conclusion: A higher proportion of Iron Deficiency Anemia was noted among children under one-year-old who complained of acute illness.
Comparison of Volumetric Modulated Arc Therapy and Fixed Field Intensity Modulated Radiotherapy for Radical Treatment of Early Prostate Cancer using Hypofractionated Radiotherapy
Authors: Alvi Zeeshan Ahmed , Hussain Sameed , Khan Wajid Muhammad Imran , Riaz Omer , Khan Muhammad Yousaf , Maqsood Talha , Khan Khurram 
Published: October 2023

Objective: To investigate the dosimetric advantages of volumetric modulated arc therapy over intensity-modulated radiation therapy for radical treatment of early-stage prostate cancer.
Study Design: Retrospective longitudinal study.
Place and Duration of Study: Department of Radiation Oncology, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2019.
Methodology: Two treatment plans; one volumetric modulated arc therapy and other intensity-modulated radiation therapy, were made for 13 patients undergoing radical radiotherapy for early prostate cancer. Conformity index, Homogeneity index, the volume of rectum and bladder receiving a dose of 50 Gy or more, monitor units employed and treatment delivery time were compared between both techniques.
Results: Volumetric modulated arc therapy plans showed statistically better conformity index and Homogeneity index with significantly lower doses to the rectum and bladder than intensity-modulated radiation therapy plans. The number of monitor units (MUs) employed and treatment delivery time were also reduced significantly with volumetric modulated arc therapy.
Conclusion: Volumetric modulated arc therapy generates dose-metrically better radiotherapy plans than intensity-modulated radiation therapy and can deliver the required dose faster.Keywords: Hypofractionated radiotherapy, Intensity-modulated radiation therapy, Prostate cancer, Volumetric modulated arc therapy.
Knowledge and Perception Regarding Infertility Among Infertile Couples Reporting to Combined Military Hospital Mardan
Authors: Khan Sumaira , Akram Umbreen , Parveen Shakila , Urooj Uzma , Khattak Samina Naseem , Zohra Sadaf 
Published: October 2023

Objective: To determine the knowledge and perception regarding infertility among infertile couples reporting to Combined Military Hospital, Mardan.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital, Mardan Pakistan, from Jan to Aug 2021.
Methodology: A total of 144 infertile couples participated in this study. Age, gender, occupation, education, marriage duration, awareness about the fertile period, frequency of sexual intercourse, and willingness to perform tests were recorded on pre-designed questionnaires.
Results: One hundred forty-four infertile couples participated in this study. The mean age was 33.4 years. In 144 women, the prevalence of homemakers was 138(95.83%). Most of the participants were middle passed 125(43.4%). When asked about infertility, 88(61.1%) had irregular menstrual cycles, 56(19.4%) were separate living cases, obesity 25(8.7%), and the evil spirit was considered cause of infertility in 19(6.6%) cases.
Conclusion: Our study concluded that there is a lack of awareness regarding infertility among infertile couples. There are misconceptions and beliefs regarding infertility. Our study found that irregular menstrual cycles and a couple of separate living were the key parameters for infertility.
Unilateral Subcostal Transversus Abdominis Plane Block in Laparoscopic Cholecystectomy for Pain Control Comparison with Conventional Port Site and Peritoneal Infiltration
Authors: Rashid Muhammad , Imran Muhammad , Qureshi Kamil Hussain , Majeed Kaukab , Khalid Usman , Rehman Habib Ur 
Published: October 2023

Objective: To compare image-guided unilateral subcostal transversus abdominis plane (STA) block with infiltration of local anaesthetic both port site and peritoneal for post-operative analgesia for laparoscopic gall bladder surgery.
Study Design: Quasi-experimental study
Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Quetta Pakistan, from Nov 2018 to Apr 2019.
Methodology: The study sample (n=80) was divided into two Groups, one for image-guided subcostal transversus abdominis plane block and the other for peritoneal and port site infiltration of local anaesthetic. Anaesthesia was induced with intravenously administered propofol, atracurium, nalbuphine, and intraoperative non-opioid analgesia with ketorolac following which endotracheal intubation was done. The level of abdominal pain was assessed.
Results: The mean opioid consumption at the 24th post-operative hour was 22.75±8.55 in Group-A and 43.20±11.80 in GroupB. Mean total opioid consumption was 111.40±35.99 and 218.90±63.91 in Group-A and B, respectively. The mean VAS score at the 24th post-operative hour was 1.20±0.96 in Group- A and 3.12±1.63 in Group-B. The results showed a significant mean difference between opioid consumption and VAS pain score at the 24th hour (p<0.05).
Conclusion: The unilateral Subcostal transversus abdominis plane block proved a superior alternative to port site and peritoneal infiltration combined for laparoscopic cholecystectomy.
Cognitive Development in Bottle Versus Breastfed Children up to Two Years: A Comparative Study from Islamabad
Authors: Bilal Arshia , Afzal Asifa , Malik Iqra Zaheer , Ishtiaq Faryal , Ahmad Ayesha , Rashid Ayesha , Fatima Insha , Waheed Anaam 
Published: October 2023

Objectives: To evaluate the proportion of exclusively breastfeeding and to determine the association of various types of feeding with cognitive development in children up to two years of age.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Outpatient Department of Pediatrics, Pakistan Air Force Hospital, Islamabad Pakistan, from Jan to Aug 2019.
Methodology: Mothers of children under two years of age visiting the hospital were recruited by systematic sampling. The data was collected through interviews using a semi-structured questionnaire. A score of each child has dichotomized into satisfactory and unsatisfactory cognitive development overall and separately for each domain viz communication, fine motor, gross motor, problem-solving and personal social skills.
Results: Out of 192 children, less than half, 77(40.1), were exclusively breastfed. Feeding practices had a statistically significant effect on overall cognitive development (p<0.002) and also individually on communication (p<0.006), fine motor (p<0.022), gross motor (p<0.001) and problem-solving skills (p<0.011) of children under two years of age. Exclusive breastfeeding showed better cognitive development (p<0.003).
Conclusion: Promoting breastfeeding practices is necessary as it leads to better children's cognitive development. This research revealed that the longer duration of exclusive breastfeeding was a more satisfactory cognitive development.Keywords: Breastfeeding, Cognitive development, Feeding practices.
Strabismus Surgery with Adjustable Suture Technique in Patients with Horizontal Strabismus
Authors: Hassan Shadab , Noorani Sorat , Jabeen Sidra , Zaheer Naima , Sadiq Muhammad Usman 
Published: October 2023

Objective: To evaluate the outcomes of squint surgery with adjustable sutures in patients with horizontal Strabismus.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Pediatric Ophthalmology and Strabismus, Al-Shifa Trust Eye Hospital, Rawalpindi Pakistan, from Jul 2016 to Jun 2018.
Methodology: Adult patients with horizontal Strabismus and co-operative enough were selected for squint surgery with adjustable sutures. Squint surgery was performed under general anaesthesia. The recessed muscle was attached to the insertion site with hang back technique with a bow tie knot if required adjustment (further recession or advancement) was performed on the first post-operative day under topical anaesthesia. Preoperative, pre and post-adjustment and final postoperative orthoptic assessment were recorded.
Results: One hundred thirty-two patients were selected for strabismus surgery with adjustable sutures. Eighteen patients (13.6%) had a history of previous strabismus surgery. 75(56.8%) patients required post-operative adjustment of sutures. Orthophoria was achieved in 107(81.1%) and residual exotropia of less than 10pd in 25(18.9%) patients. Desired surgical outcome of orthophoria or the residual squint of less than 10 prism diopters was achieved in 100% of patients.
Conclusion: A positive surgical outcome was observed in our patients, and the second surgery for residual or consecutive squint was avoided.
Efficacy of Dexmedetomidine Combined with Bupivacaine in Supraclavicular Block Versus Bupivacaine alone in Upper Limb Surgery
Authors: Ahmed Maira , Hussain Akhtar , Majeed Kaukab , Akhter Amim , Qureshi Sajjad , Ahsin Arooj 
Published: October 2023

Objective: To compare the efficacy of Dexmedetomidine combined with Bupivacaine in supraclavicular block versus Bupivacaine alone in upper limb surgeries
Study Design: Quasi-experimental study
Place and Duration Of Study: Anaesthesia Department, Combined Military Hospital Quetta, Pakistan, from Sep to Feb 2022.
Methodology: Patients planning to undergo plating of radius fractures were included. The patients were divided into two equal sets (n=20) by purposive sampling and marked as Group-A and Group-B. Patients in both groups received supraclavicular block under ultrasound guidance and general endotracheal anaesthesia followed by that. In the first Group,Bupivacaine plain (0.125%) was used to block the brachial plexus, and in the second Group, Bupivacaine (0.125%) with adjuvant Dexmedetomidine (1ug/kg) was given respectively. The visual analogue scale was used to measure pain perception in both groups.
Results: The duration of analgesia in the Dexmedetomidine Group was 10 ±0.925 hours and 5.68 ±0.471hours in Bupivacaine Group, which holds statistical significance (p-value<0.001). The demographics, surgery-related parameters (duration and type of surgery), block related parameters (onset of block and time taken to block) were similar in both study groups.
Conclusion: We concluded that Dexmedetomidine prolongs the duration of analgesia significantly when used as an adjuvant Bupivacaine in supraclavicular brachial plexus block.
Frequency of absent BCG Scar in Babies Vaccinated with BCG
Authors: Sami Aqeela , Jalil Jawad , Sarfraz Muhammad , Hassan Jawad ul , Khawar Ruhma , Mumtaz Zahra 
Published: October 2023

Objective; In a TB endemic country find the frequency and associations of absent BCG scar in babies vaccinated with BCG.
Study Design; Interventional prospective cohort study.
Palace and Duration of Study; Immunization centre at Paediatric department of Fauji Foundation Hospital, Lahore from Mar 2021 to Aug 2021
Methodology; Infants with age ranging from 1day-1month, born at term with no antenatal, natal or post natal complications were selected by non-purposive convenient sampling and vaccinated by a single vaccinator using only one strain of BCG. Presence or absence of BCG scar was checked on their following visits for vaccinations at 6, 10 and 14 weeks of age and evaluated against different variables.
Result; 540 infants were included in this study. 384 had a complete follow-up, of which 35(9.1%) did not develop a scar after vaccination. This absence of scar was evaluated against gender , birth weight , day of vaccination, type of feed and socio economic status and there was no statistically significant association as p-value was >0.05
Conclusion; Probability of developing a BCG scar is independent of gender , birth weight , day of vaccination , type of feed and socioeconomic status. We suggest that babies who do not develop a scar should be revaccinated if they show poor response to TST after 6 months of ageas it can give rise to cross-protection against micro-organisms that might be unrelated totarget disease.
Comparison of Short-Term Outcomes of Transcatheter versus Surgical Closure of Atrial Septum Defect at a Tertiary Cardiac Care Facility
Authors: Saleem Shoaib , Younas Muhammad , Asma Tauseef , Riaz Usman , Tousif Rubina , Maqbool Baqir 
Published: October 2023

Objective: To compare the short-term outcomes of transcatheter versus surgical closure of atrial septal defect (ASD) at a tertiary cardiac care facility in South Punjab, Pakistan.
Study Design: Prospective comparative study.
Place and Duration of the Study: Department of Paediatric Cardiology and Paediatric Cardiac Surgery, Chaudhary Pervez Elahi Institute of Cardiology, Multan Pakistan, from Jul 2019 to Jun 2021.
Methodology: A total of 110 patients with moderate to large isolated secundum ASDs without severe pulmonary hypertension and planned to undergo closure of secundum ASD by either surgical approach or device closure were included. All surgical and transcatheter procedures were performed adopting standard techniques. Intra-procedural or post-procedural outcomes were noted.
Results: In a total of 110 patients, 59(53.6%) underwent transcatheter closure of ASD, while surgical closure was done in the remaining 51(46.4%) patients. Post-procedural complications were significantly more in the Surgical Closure Group in comparison to the Transcatheter Closure Group, [14(27.5%) vs 5(8.5%) (p=0.026)]. None of the cases in the Transcatheter Closure Group required inotropes in the post-procedure period in comparison to 24(47.1%) cases (p<0.001). The total cost of treatment was significantly higher in transcatheter closure patients compared to surgical closure patients (1504±60.4 US$ versus 1448±75.4 US$, p<0.001). Overall, successful closure was noted in 108(98.2%) cases. No mortality was recorded.
Conclusion: Overall, short-term outcomes of transcatheter ASD closure were comparable to the surgical approach, but patients with transcatheter ASD closure had significantly less duration of hospitalization and low rates of post-procedural complications.Keywords: Atrial septum defect, Mortality, Surgical closure, Transcatheter closure.
Impact of COVID-19 Pandemic on Outpatient Child and Adolescent Mental Health Service at a Tertiary Care Hospital of Pakistan
Authors: Ul Ain Hamdan Qurrat , Tameezud Din Nizami Asad , Umar Zarnain , Afzal Sara , Mazhar Mahpara , Yasir Saadia 
Published: October 2023

Objective: to determine the impact of COVID-19 on mental health care service provision and the pattern of morbidity presenting to out-patient child psychiatry services in Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Child and Adolescent Mental Health Unit, Institute of Psychiatry, Rawalpindi Pakistan, Medical university, from Jan 2019 to Dec 2020.
Methodology: Hospital records for the years 2019 and 2020 were used to get data on the total number of Out-Patient Department (OPD) visits in both years, and Departmental OPD records were used to extract data on all new patients.
Results: Two thousand two hundred thirty-two OPD visits were recorded in 2019 versus 536 in 2020, a 76% decline. Eight hundred fifty-six new patients were seen in 2019 vs 259 in 2020. The detailed OPD record analysis revealed that the predominant age group reporting was adolescents in both years. 377(44%) patients reported with behavioural problems in 2019 vs 138(53.3%) in 2019. Pharmacological management plans were used in 138(16.1%) in 2019 vs 66(25.5%) in 2019. Common Diagnoses seen in both years were not significantly different, (p=0.087). OPD records were found to have an increase in the “not mentioned category”, thus reflecting declined quality of record keeping.
Conclusion: The COVID-19-related lockdown and pandemic led to a sharp decline in out-patient visits and deterioration and record-keeping quality. The number of children and adolescents presenting with behavioural problems increased, but the common diagnoses remained similar.Keywords: COVID-19, Child and adolescent mental health service, Child psychiatry, Pandemic, School closure.