bluuebunny/crossref_metadata_2025_split huggingface dataset:
Cystobiliary Fistula in Hepatic Hydatid Cyst Disease; A Case Report and Literature Review
Authors: Ahmad Ashar , Tania Mahar  , Abdul Manan  , Irfan Ahmad  , Abdul Qadir  , M. Usman  , M. Waseem  
Published: November 2023

Objectives: To evaluate the level of physical activity among menopausal women in Nawabshah.
Methods: This cross-sectional study was conducted during November 2019 to January 2020among menopausal women in Nawabshah. Participants were approached through convenience sampling technique, and comprised of 200 menopausal women. Data was collected from houses, hospitals and OPDs from different areas of Nawabshah. Data was collected through standardized questionnaire that is related to physical activity. Moreover, a demographic proforma was used to obtain demographic information of all participants.
Result: Among the population of 200 menopausal women in Nawabshah, 98 (49%) were inactive and 102 (51%) were active. Moreover, 17.5% were engaged in vigorous activity, 40% were engaged in moderate physical activity, while 41% were engaged in walking. It was found that the mean age is 54.32 years (age range 45-70 years). Majority of women were married 73.5% and unemployed (77%).
Conclusion: On the basis of results, we found that the level of physical activity among menopausal women is higher than the physical inactivity.
Frequency of Deranged Coagulation Profile in Patients having Pregnancy Induced Hypertension
Authors: Rehman Rabia , Siddiq Shazia , Rehman Asiya , Irshad Rao Shahid 
Published: November 2023

Objective: To evaluate the frequency of deranged coagulation profile in patients having pregnancy induced hypertension.
Study Design: Descriptive cross sectional Study
Place and Duration: Department of Obstetrics and Gynecology, Nishtar Hospital Multan, from 10 July 2016 to 31 December 2017
Methodology: A total number of 540 patients were involved in the study. Sample was collected with the help of non-probability consecutive sampling technique. Patients were divided into three groups, pregnancy induced hypertension, preeclampsia and eclampsia. Following variables were calculated and assessed, age, gravidity. Parity, gestational age, diagnosis of eclampsia or preeclampsia, platelet count, prothrombin time, activated partial thromboplastin time, serum fibrinogen and serum albumin. Data thus obtained was subjected to statistical analysis which was performed by a computer software SPSS version 23. Frequency and percentage was calculated for qualitative variables while mean and standard deviation was calculated for quantitative variables. Chi square test was applied to assess the association among different variables and p value less than or equal to 0.05 was taken as significant.
Results: Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in PIH group was 45.7%, 4.3%, 2.9% and 2.9% respectively. Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in preeclampsia group was 39.4%, 8.7%, 5.1% and 4.2% respectively. Frequency of low platelet count, low serum fibrinogen level, prolonged PT and prolonged aPTT in eclampsia was 52.8%, 12%, 7.5% and 5.1% respectively.
Conclusion: This study concludes that derangement in clotting profile occurred in certain percentage of patients suffering from preeclampsia and frequency of derangement was significant.
Surgically Induced Astigmatism after Phacoemulsification with Clear Corneal 3.2 Mm Incision While Using Superior versus Temporal Approach
Authors: Farhan Ali  
Published: November 2023

Objective: is to assess incidence of surgically induced astigmatism followed by phacoemulsification with clear corneal 3.2mm incision while using temporal and superior approach. Study Design: Quesi Experimental trial. Place and duration: study was conducted at ophthalmology department of Ghazi medical collage Dera Ghazi Khan from December 2021 to November 2022 in one year period.
Methodology: Patients were enrolled in two groups, temporal approach with clear corneal incision and superior approach with clear corneal incision was used. Main variables of study were astigmatism (D) after cataract surgery through phacoemulsification. For outcome measure at 1st postoperative day keratometery was performed and after that followed up at 2 weeks and 8 weeks period. SPSS versio 24 was used for data analysis.
Results: Overall, 250 patients were included in our study. The Group I included 125 patients had 130 eyes. The Group II included 125 patients had 132 eyes. The average age of Group I and Group II was 56.45±3.92 years and 57.97±3.61 years, respectively. (p=0.275). The sex distribution of both the group was almost equal, (p=0.893). Whereas, the mean astigmatism of Group I was less than Group II, as 0.51±0.22 and 0.85±0.29, respectively, (p<0.001).
Conclusion: Clear corneal incision 3.2 mm and temporal approach induces less surgical astigmatism, even it can be used in against the rule astigmatism cases where horizontal meridian is steeper.
Serial Measurement of Lipid Profile In patients with Acute Myocardial Infarction
Authors: Ramzan Faisal , Noshad Javed  , Yasin Tahir , Hanzlah Shahid Hafiz Muhammad , Ali Khan Ansar 
Published: November 2023

Objective: To investigate the effect of acute myocardial infarction (AMI) on the levels of lipid profile and inflammatory markers. Study Design: Prospective study. Place of study: Choudhary Pervaiz Elahi institute of Cardiology in one year duration from May 2020 to April 2022.
Methodology: Patients admitted within 24 hours of onset of symptoms were enrolled in study and their total cholesterol, triglycerides, high density and low density lipoprotein was assessed. SPSS version 23 was used for data analysis. Tests of significance were applied and o value less than or equal to 0.05 was taken as significant.
Results: The mean total cholesterol, triglyceride, low density lipoprotein cholesterol, high density lipoprotein cholesterol, TC / HDL-C, LDL-C / HDL-C, high sensitive C-reactive protein, interleukin-6 and interleukin-10 of the control patients was 169.02±6.69 mg/dl, 152.27±3.59 mg/dl, 108.18±4.22 mg/dl, 50.93±4.81 mg/dl, 3.97±0.49, 2.48±0.64, 0.96±0.48 mg/dl, 14.31±4.68pg/dl and 13.98±2.53pg/dl, respectively.
Conclusion: Early treatment of lipid changes provides advantages and treatment line for clinical decisions and lipid lowering therapy. Therefore, within 24 hours of onset of symptoms serum lipid values should be assessed. within 24 hours of onset of symptoms serum lipid values should be assessed.
CRP versus Alvarado Score in Appendicitis Diagnosis
Authors: Haider Zeshan 
Published: November 2023

Objective:To evaluate whether C-reactive protein (CRP) level results on admission could aid the diagnostic accuracy of Alvarado score in patients with suspected appendicitis. Study Type: cross sectional study. Study Place and Duration: January to December 2019 in the Surgical Unit, Nishtar Hospital, Multan.
Material and methods: Total 230 patients participated in the study with suspected acute appendicitis. Patient’s Alvarado score, age of the patients, sex, length of period of complaint for abdominal pain and level of CPR were recorded on the time of admission. Descriptive statistics for study data included mean, median, standard deviation, minimum and maximum frequency and ratio values. Quantitative data was examined using Mann-Whitney U test. On the other hand a receiver operating characteristic curve was used for effects and cut-off values.
Results: The mean C-reactive protein of AA complicated and AA uncomplicated patients was 40.61±9.59 mg/L and 38.25±9.08 mg/L, respectively. The difference was statistically insignificant, (p=0.905). The mean Alvarado score of AA complicated and AA uncomplicated patients was 7.51±1.72 and 7.75±2.08, respectively. The difference was statistically insignificant, (p=0.248).
Conclusion: Serum levels of C-reactive protein when assessed alone are not adequate enough in making a diagnosis of acute appendicitis. When combined with Alvarado score, they increase the overall diagnostic value. Moreover these levels in serum also help in differentiation of uncomplicated and complicated acute appendicitis.
Management of liver trauma after blunt trauma abdomen
Authors: Abdul Manan  , Khan Ashar Ahmad , Ahmad Irfan , Qadir Abdul , Usman Muhammad , Athar Saim 
Published: November 2023

Objective: is to investigate the better management plan for liver injury after blunt trauma abdomen according the latest classification system.
Methodology: Prospective study was conducted at department of general surgery Nishtar hospital Multan from 31st July 2022 to 30th June 2023 in one year duration. A total of 70 patients with liver injury diagnosed intraoperatively or by CT scan were enrolled in the study. Main variables of study were Moore score, Mirvis score, mechanism of injury, organ affected and type of injury according to classification. SPSS version 23 was used for data analysis.
Results: Frontal car accident was the most common trauma mechanisms in type A patients 51.6% and complex traffic accident was the most common trauma mechanisms in type B patients 38.5%. High-energy trauma in type A and type B patients was 80.6% and 89.7% patients respectively. Further, demographic and baseline characteristics of type A and type B patients were almost equal, (p>0.010).
Conclusion: The management of liver injury has shift towards a more individualized approach depending on the localization of parenchymal disruption (damage to the liver tissue) and may correlate with the mechanism of trauma. Type of injury is the correlation with necessity of surgical management.
Comparison of ultrasound guided aspiration versus incision drainage in breast abscess
Authors: Muhammad hassaan anwar  , Maham Ubaid  , Humayun Amjad  , Muzaffar  Aziz  , Aleena Tahir  
Published: November 2023

Objective: is to compare the outcomes of ultrasound guided needle aspiration technique with traditional incision and drainage technique in breast abscess.
Methodology: Study was randomized controlled trial conducted at general surgery department of Nishtar Hospital; Multan from 9th may 2023 to 8th November 2023 in 6 months’ duration. A total of 228 patients were enrolled in study and divided into two groups A and B. Group A include 143 patients aspirated with ultrasound guided needle aspiration and in group B 85 patients treated with incision and drainage method. Main outcomes were hospital stay, pain intensity, location and size of abscess, parity and demographics.
Results: The mean duration of pain in Group A and Group B was 5.79±2.18 days and 7.01±2.38 days, respectively, (p<0.001). Further, the mean duration of fever, volume of pus, size of USG was almost equal in both the groups, (p>0.050). The distribution of site of abscess of both the groups were shown in figure. I. The difference was statistically significant, (p<0.001).
Conclusion: Needle aspiration of a breast abscess with ultrasonographic guidance combined with antibiotics is a commonly used and effective approach in the treatment of breast abscesses. This method is especially valuable when dealing with abscesses of small size.
Comparing Pain and Quality of Life Measures after Anatomic Lung Resection Using Either Thoracoscopy or Thoracotomy
Authors: Shahid Hussain  , Hamid Mehmood  , Hira Asad  , Syed Ali Abbas Rahat  , Faiza  , Amna Khan  
Published: November 2023

Objective: is to compare the pain score and quality of life between thoracoscopy and thoracotomy in lung resection surgery.
Methodology: Randomized controlled trial was conducted at National Institute of cardiovascular diseases (NICVD) during 1st September 2022 to 30th August 2023. A total of 60 patients were enrolled and dived into two groups 35 patients in thoracoscopy and 25 in thoracotomy groups. Patients were compared in terms of quality of life and pain score. Eight pints scoring scale was for quality of life assessment and Brief pain index scale for pain measurement.
Results: The comorbidities in both the groups were almost equal. Adenocarcinoma were noted 20 (80.0%) and 22 (62.9%) in thoracotomy and VATS group, respectively. Further, the mean length of stay of thoracotomy and VATS group was 5.61±2.11 days and 6.31±2.47 days, respectively. The differences were statistically insignificant in both the study groups, (p>0.050). The comparison of life quality score at baseline, postoperative, 4th month, 8th month & 12th month of mental and physical component summary was shown in table. II. The differences were almost equal in thoracotomy and VATS group, (p>0.050).
Conclusion: Patient-reported Physical Component Summary (PCS) and pain scores were similar in the first 12 months following in two different surgical procedures Video-Assisted Thoracoscopic Surgery (VATS) and thoracotomy.
Monkey pox Knowledge Assessment among the Undergraduate Nursing Students of Hyderabad
Authors: Irum Qureshi  , Victoria Samar  , Shaneela Khowaja  , Sabiha Sarwar  , Hafsa Bibi  , Farzana Parveen  
Published: November 2023

Objective: The study objectives were to measure baseline knowledge, assess familiarity with disease spread concepts, evaluate awareness about diagnosis and preventive measures, and explore attitudes among nursing students.
Methodology: The study employed a descriptive cross-sectional approach, using a questionnaire comprising 19 binary-scale questions related to Monkeypox. This study conducted at People School of Nursing LUMHS, Jamshoro, aimed to assess the knowledge of 162 undergraduate nursing students in Hyderabad regarding Monkeypox and communicable diseases. Data collected during the period of May 15,2023 to June 10,2023. Convenience Sampling technique was used and participants filled an adopted questionnaire
Results: Revealed that 54.3% of participants had prior knowledge of Monkeypox, yet only 13% demonstrated good knowledge. A significant 51.9% exhibited poor knowledge, and 35.2% had very poor knowledge about the disease.
Conclusion: The findings underscored a substantial lack of knowledge among the participants, highlighting the urgency to enhance educational awareness on communicable diseases, their epidemiology, prevention, and treatment. Empowering medical and nursing students with this knowledge is crucial, enabling them to actively contribute to community efforts in controlling communicable diseases. Strengthening the knowledge base of healthcare professionals, including nursing students, is vital in the collective global effort to prevent and manage emerging infectious diseases like Monkeypox.
Comparison of antibiotic therapy versus appendectomy in patients with Acute appendicitis
Authors: Muhammad hassaan anwar  , Maham Ubaid  , Humayun Amjad  , Muzaffar Aziz  , Muhammad Osama Rauf Hiraj  
Published: November 2023

Objective: To compare antibiotic therapy versus appendectomy in patient with acute appendicitis.
Methodology: Study was randomized controlled trial conducted at general surgery department of Nishtar Hospital; Multan from 9th may 2023 to 8th November 2023 in 6 months’ duration. After obtaining written informed consent after detailed description, using lottery method, patients were divided into two groups antibiotic therapy and appendectomy. Using visual analogue scale pain scores were obtained from 0 no pain to 10 severe worst possible pain. Starting from the day they presented until the patient had VAS score of = 2, duration of pain was measured.
Results: The mean pain experienced of Group A and Group B was 3.53±0.88 days and 3.65±0.87, respectively. The difference was statistically insignificant, (p=0.404). The mean length of stay in hospital of Group A and Group B was 4.51±2.19 days and 4.94±1.77 days, respectively. The difference was statistically insignificant, (p=0.155).
Conclusion: Findings of this study reveal that patients that fall in the antibiotic treatment group i.e conservative group were not in need of surgical appendectomy during the six-month follow-up period. This suggests that antibiotic treatment was effective in managing the condition in these patients.
New Data on the Expression of the Early Eocene Hyperthermals in Northern Bulgaria: Riben Section Revisited
Authors: Stoykova Kristalina , Koleva-Rekalova Elena , Vennemann Torsten , Ivanov Marin 
Published: November 2023

We present new lithologic, nannofossil biostratigraphic and benthic carbon and oxygen isotope records for a marly-rich, 11 m thick Paleocene-Eocene section, now exposed at an old quarry at Riben Village, northern Bulgaria. The occurrence of NP9, NP10 and NP11 nannofossil zones is evidenced by detailed high-resolution nannofossil biostratigraphy. The carbon dissolution interval is marked by the abrupt drop of CaCO3 content and deposition of a clay interval at the onset of the Paleocene-Eocene Thermal Maximum (PETM). Stable isotope analyses of δ13C and δ18O were performed on benthic-foraminiferal tests. An unusual two-fold carbon isotope excursion (CIE) in the PETM interval is documented (total negative shift of 2.89‰). Moreover, three paired negative excursions: two in the Paleocene within the PETM interval, upper NP9 zone, and one within the early Eocene, NP11 zone are identified. The most prominent negative carbon isotope excursion (4.90‰ negative shift) is related with ETM3 (or “X” event), 52.84 Ma ago.
Integration of nannofossil biostratigraphy, benthic stable isotope data sets and lithology unravel two separate early Eocene hyperthermal events: the PETM (= ETM1) and the ETM3 (= “X” event), recorded at Riben section.
Numerical Simulation of Liulin-MO Instrument for Measuring Cosmic Radiation Onboard ExoMars Trace Gas Orbiter
Authors: Krastev Krasimir , Semkova Jordanka , Koleva Rositza 
Published: November 2023

We present the results from numerical simulation of Liulin-MO instrument for measurement of the space radiation on board Trace Gas Orbiter (TGO) satellite of ExoMars-2016 mission during its transit to Mars in April-September 2016 [Semkova J., T. Dachev, St. Maltchev, B. Tomov, Yu. Matviichuk} et al. (2015) Radiation environment investigations during ExoMars mission to Mars – objectives, experiments and instrumentation, C. R. Acad. Bulg. Sci., 68 (4), 485–496] [Semkova J., R. Koleva, V. Benghin, T. Dachev, Yu. Matviichuk et al. (2018) Charged particles radiation measurements with Liulin-MO dosimeter of FREND instrument aboard ExoMars Trace Gas Orbiter during the transit and in high elliptic Mars orbit, Icarus, 303, 53–66], using the Geant4 package. The methodology for calculating galactic cosmic rays (GCR) linear energy transfer (LET) is described. A methodology for screening false signals in the deposited energy spectra in the Liulin-MO detectors and correspondingly LET spectra is proposed. The contribution of the individual components of the spectrum of GCR in the LET spectrum is estimated. The calculated average radiation quality factor of GCR using the cleaned from false signals LET spectrum is compared with the experimental results obtained during the transit to Mars and a reasonable agreement is observed.
Relationships between Heavy Metal and Metalloid Contents and Major Soil Characteristics in Soils around the Former Kremikovtsi Metallurgical Plant Following Its Closure in 2009
Authors: Nenova Lyuba , Atanassova Irena , Stoykova Mariela , Dimitrov Emil , Kirilov Ivailo , Benkova Maya , Simeonova Tsetska , Harizanova Milena 
Published: November 2023

Soils around the former metallurgical plant Kremikovtsi were subject of continued interest due to the environmental problems resulting from the plant's activities and especially heavy metal pollution. The aim of the present study was to investigate the contamination of the studied soils by metals and metalloids, several years after the closure of the plant (2009) and to relate their concentrations to basic soil parameters, pH, electrical conductivity, cation exchange capacity, clay content and total organic carbon, which will contribute to better assessment of their behaviour and remediation strategies. Total concentrations (aqua-regia) of the elements Al, B, Ba, Cd, Co, Cr, Cu, Fe, Li, Mn, Mo, Ni, Pb, Zn and As were determined. Elevated levels of the heavy metals Pb, Cd, Zn, and the metalloid arsenic (As) were found at the studied sites. Lead (Pb) exceeded maximum permissible concentrations (MPC), regulated by Bulgarian legislation for arable lands between 2 and 15 times, cadmium (Cd) between 3 and 5 times, arsenic (As) between 3 and 6 times, and zinc (Zn) was higher than MPC in three of the sampled sites. Soil pH values were in significant correlation with EC (R** = 0.805), CEC R** = 0.781), B (R* = 0.638), Cu (R* = 0.669), Fe (R** = 0.766) and Mn (R*** = 0.916) contents. Aluminium, cadmium, lithium and lead concentrations were related to the content of the clay fraction in soil. Positive correlation was obtained in multiple regression models between Pb, Al, Cd, TOC and soil pH, and negative relationship was observed with electrical conductivity (EC). The obtained results showed complex relationships between soil characteristics and the metals and metalloids, which emphasize the need for their simultaneous assessment, remediation and careful use for agricultural purposes.
Evaluation of pulmonary computed tomography angiography protocols: A multicenter audit in Togo
Authors: Gbande Pihou , Tchaou Mazamaesso , Dagbe Massaga , Bode Atcha Mousbaou , Sonhaye Lantam , Agoda-Koussema Lama Kegdigoma , Adjenou Komlanvi 
Published: November 2023

Introduction : Pulmonary CT angiography is among the most challenging protocols to execute, with significant inter-center variability in image acquisition protocols and iodinated contrast media injection. This study aimed to ascertain whether the use of iodinated contrast media (ICM) and acquisition protocols are optimized during pulmonary CT angiography procedures.
Materials and methods : This multicentric cross-sectional study, descriptive and analytical with a prospective data collection was conducted in three radiology departments in Togo. It encompassed all pulmonary CT angiography examinations carried out from March 1st to June 30th, 2023.
Results : In total, 89 patients, of which 52 were females (58.43%), were registered. The average age was 59.97±14.34 years. The average volume of injected ICM was 67.08±14.21 ml. The mean iodine dose was 0.31±0.07 gI/Kg. Catheters of 20 G (44.94%) and 18 G (43.82%) were most frequently used. The mean injection rate was 4.22±0.64 ml/s. The bolus test technique was the most employed (75.28%). The average acquisition delay was 17.77±12.26 seconds, while the average acquisition duration was 10.56±2.56 seconds. The average dose-length product (DLP) was 390.09±236.69 mGy.cm, and the average volumetric computed tomography dose index (CTDI_vol) was 12.31±11.69 mGy. Vascular enhancement was insufficient in 7.87% of cases. No statistically significant difference was found on the rate of insufficient enhancement and optimization factors. Similarly, there was no enhancement difference between bolus test and bolus tracking techniques.
Conclusion : The vast majority of examinations allowed for optimal opacification of the pulmonary arteries. However, the optimization measures for the use of iodinated contrast media are not consistently applied.