bluuebunny/crossref_metadata_2025_split huggingface dataset:
Aetiological Factors of Periorbital Hyperpigmentation in Patients Presenting to the Hospital
Authors: Nasar Amna , Habib Aamir , Ud Din Qamar , Naeem Uzma , Mujahid Tanveer Ahmad , Jabeen Maeda 
Published: October 2023

Objective: To know the aetiological factors of periorbital hyperpigmentation in patients presenting to the Outpatient Department of Combined Military Hospital, Kharian Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Kharian Pakistan, from Nov 2020 to Sep 2021.
Methodology: We conducted a study of sixty patients with periorbital hyperpigmentation periorbital hyperpigmentation presenting to Skin OPD. A detailed history, clinical examination, and lab investigations like complete blood counts, thyroid function tests, and vitamin B12 and D levels were advised.
Results: Out of 60 patients, 2(3.33%) were male, and 58(96.66%) were females. The mean age of patients was 24.95 years ±6.48. 10(16.66%) had a family history of periorbital hyperpigmentation. Lack of adequate sleep was found in 18(30%) patients, and prolonged daily bright screen exposure was found in 28(46.66%). History of atopy was present in 18(30%). History of seasonal allergies was present in 17(28.33) % of individuals. Other associated pigmented conditions like melasma in 14(23.33%) and post-inflammatory hyperpigmentation were noted in 2(3.33%) patients. 8(13.33%) patients had anaemia, 4(6.66%) had subclinical Hypothyroidism, and low vitamin D levels were found in 6(10%). None of our patients had vitamin B12 deficiency.
Conclusion: Periorbital hyperpigmentation has multiple aetiological factors and associations. Correctable factors need to be addressed for better treatment outcomes. The presence of anaemia, subclinical Hypothyroidism, and low serum vitamin D levels indicate the need to screen periorbital hyperpigmentation patients for these conditions.
Comparison of COVID-19 Rapid Antigen Test Results with PCR Reactive/ Non-Reactive Cases
Authors: Zehra Nayab , Khan Muhammad Dilawar , Batool Hijab , Chughtai Omar Rasheed , Chughtai Akhtar Sohail , Shakeel Muhammad 
Published: October 2023

Objective: To evaluate the analytical accuracy of the COVID-19 Ag Rapid Test Device by Abbott PanbioTM using RT-PCR as the reference assay and to detect any false-positive/negative reactions to assess the specificity of this analytical procedure.
Study Design: Cross-Sectional analytical study.
Place and Duration of Study: Department of Chemical Pathology, Chughtai Institute of Pathology, Lahore Pakistan, from Feb to May 2021.
Methodology: This study was comprised of a total of 105 samples. The result of these nasopharyngeal specimens was already established by Reverse-Transcriptase Polymerase Chain Reaction (RT-PCR). Then the same (nasopharyngeal) specimens were analysed on Rapid Antigen Detection Test Device.
Results: Out of 105 specimens, we got 88(83%) PCR positive samples and 17(16%) PCR negative, which, when compared with the Abbott PanbioTM Rapid Antigen Test Device, showed 60(57%) positive and 45(42.8%) negative samples having a sensitivity of 75(86%) (CI 67.04%-83.32%) and specificity of 100%(80.49-100%). The accuracy of the test was found to be 78(95%). This assay was found convenient and more appropriate for outdoor settings.Keywords: COVID-19, RT-PCR, Rapid antigen test, Specificity, Sensitivity.
Joint Hypermobility and Musculoskeletal Pain in Paramedical Students and Staff at a Tertiary Care Hospital
Authors: Butt Nauman Ismat , Tareen Muhammad Qasim Khan , Ashfaq Fahmina , Butt Usman Ismat 
Published: October 2023

Objective: to determine the frequency of joint hypermobility in paramedical students and staff at National Hospital Lahore.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Rheumatology, National Hospital and Medical Center, Lahore Pakistan, from Mar to Sep 2021. Methodology: Two hundred fifty paramedical students and staff of either gender, aged between 16 years to 35 years were enrolled. Localized Joint Hypermobility was defined as <3 Score and generalized Joint Hypermobility were defined as >4 scores on the Beighton Score Scale. Demographic information was obtained from each participant, and joint hypermobility was assessed by using the Beighton score.
Results: Mean age of the study participnats was 26.6±4.6 years with 146(58.24%) females. Mean BMI was 23.9±4.0 kg/m2. Generalized Joint Hypermobility was seen in 51(20.4%), and 31(12.4%) had localized hypermobility. Out of 250 participants, 33 (13.2%) had musculoskeletal pain, while among 51 patients with generalized hypermobility, 12(23.5%) had musculoskeletal pain.
Conclusion: One out of every five young healthy paramedics enrolled had generalized joint hypermobility. One-third of subjects had at least one clinically documented hypermobile joint. Almost every fourth person with generalized joint hypermobility has musculoskeletal pain compared to 1 in 10 persons without generalized hypermobility.
Keywords: Beighton score scale, Generalized joint hypermobility, Localized joint hypermobility, Musculoskeletal pain.
Frequency of Thyroid Disorders in Rheumatoid Arthritis Patients and its Association with Disease Activity: A Hospital Based Study
Authors: Qureshi Safina Hameed , Shah Syed Fahd , Khaliq Taqdees , Qureshi Sania Hameed , Qureshi Aisha Hameed , Shafqat Syed Hassan 
Published: October 2023

Objective: To establish the frequency of thyroid disorders among Rheumatoid Arthritis patients and its association with disease severity measured by DAS28-ESR.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Rheumatology, Federal Government Policlinic Hospital, Islamabad Pakistan, from Jan to Jun 2021.
Methodology: The study included 87 consecutive patients either gender with Rheumatoid Arthritis visiting Rheumatology OPD. Thyroid profile and DAS28-ESR were performed in all the patients.
Results: Out of 87 patients, 73(83.9%) were females, and 14(16.1%) were males. The mean age was 45.54±13.50 years. The mean DAS28-ESR was 4.45±0.68, with a minimum DAS28-ESR of 1.25 and a maximum of 8.40. The Disease severity calculated by DAS28-ESR was mild in 19(21.8%), moderate in 44(50.6%) and severe in 24(27.6 %) patients. The thyroid gland was abnormal in 23(26.1%) patients. 18(78.2%) of 23 patients with thyroid disorders belonged to the moderate to severe Rheumatoid arthritis disease activity group.
Conclusion: Thyroid disorders are very common in Rheumatoid Arthritis patients. Thyroid workup should be part of investigations of Rheumatoid Arthritis for early detection of thyroid disorder and better disease control.
Assessment of Osteoporosis with Aspartate Aminotransferase to Platelet Ratio Index Score in Patients of Chronic Liver Disease
Authors: Sher Farrukh , Ali Khan Rao Saad , Akram Sumeera , Khan Muhammad Ahmed , Iqbal Qaiser , Haider Fahd Bin , Hayat Khurram 
Published: October 2023

Objective: to assess Osteoporosis with APRI score (aspartate aminotransferase to platelet ratio index) in patients with chronic liver disease.
Study Design: Cross-sectional study.
Study Setting and Duration: Pak Emirates Military Hospital Rawalpindi, Pakistan from Jan to Dec 2021.
Methodology: All Adult patients aged 18 years and above with clinical and imaging features suggestive of chronic liver disease were included in the study. APRI score calculated as the ratio of aspartate aminotransferase to platelet based on the laboratory analysis of Aspartate aminotransferase (AST) and platelet levels was done. Furthermore, a bone density scan (DEXA scan) was also carried out for all the study participants.
Results: One hundred and sixty patients fulfilling the inclusion criteria were included. Of the total 160 cases, 53(33.1%) had normal bone density on DEXA scans, 43(26.9%) had Osteopenia and 64(40%) had Osteoporosis. Twenty-nine cases of chronic liver disease cases (25%) had APRI scores <0.3, 40(25%) had APRI scores>0.3 and<0.5, 37 cases (23.1%) had APRI scores>0.5 and <1.5, 30 cases (18.8%) had APRI score >1.5 and <2 and 24 patients (15%) had APRI score >2. The significant (p<0.001) association was observed between APRI score and bone density, showing bone density decreased with the progression of the disease.
Conclusion: Patients with chronic liver disease almost invariably develop Osteoporosis with the progression of the disease. Early recognition and treatment are pivotal to lessen morbidity and mortality associated with Osteoporosis.
Keywords: Aspartate aminotransferase, Chronic liver disease, Hepatitis C, Osteoporosis, Osteopenia, Platelet.
Association of Paclitaxel Induced Neuropathy with Quality of Life of Patients with Non-Metastatic Breast Cancer
Authors: Masood Masaba , Nadeem Muhammad , Masood Amna , Ali Aamira , Tufail Muhammad Umair 
Published: October 2023

Objective: To look for an association of Paclitaxel induced neuropathy with the quality of Life of patients with non-metastatic breast cancer.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Oncology Department, Combined Military Hospital, Rawalpindi Pakistan, from Nov 2021 to Feb 2022.
Methodology: The study included one hundred and twenty patients with diagnosed non-metastatic breast cancer taking Paclitaxel chemotherapy for more than one month. Peripheral neurotoxicity was assessed by a consultant oncologist based on the Eastern Cooperative Oncology Group (ECOG) score. In addition, quality of Life was recorded with the help of the World Health Organization Quality of Life (WHOQOL)-BREF scale in all the study participants and associated with the presence and severity of neuropathy.
Results: Out of 120 non-metastatic breast cancer patients using Paclitaxel for more than one month included in the study, 113 (94.2%) were female, while 7(5.8%) were male. 52(48.3%) had good quality of Life, while 68(51.7%) had poor quality of Life. 34(28.3%) had Grade-0 neuropathy, 54 (45%) had Grade-I, 30(25%) had Grade-II, and 2(1.6%) had Grade-III neuropathy.Statistical analysis showed that the presence and severity of neurotoxicity had a statistically significant relationship with poor quality of Life (p-value=0.001).
Conclusion: Many patients having breast cancer using Paclitaxel had the presence of neuropathy. The presence and severity of neuropathy are strongly associated with poor quality of Life in patients included in our study.Keywords: Breast cancer, Neurotoxicity, Paclitaxel, Quality of life.
Development and Validation of Body Dysmorphic Disorder Scale for Screening General Population
Authors: Shafiq Sameera , Kiran Faiza , Batool Maryam 
Published: October 2023

Objective: To develop a reliable and valid Urdu indigenous Body Dysmorphic Disorder Scale (BDDS) for the Pakistani community.
Study Design: Cross-sectional study
Place and Duration of Study: Department of Psychology, University of Gujrat, Gujrat Pakistan, from Jun to Dec 2020.
Methodology: Based on the literature review, DSM-V criteria and semi-structured interviews conducted with psychologists clinical psychologists, and psychiatrists, an item pool of 78 items was generated for BDDS. A panel of five experts evaluated these items for content and revised them based on judgemental remarks. In the pilot study, 40 individuals were purposively selected, and 78 items were administered, yielding 0.94 Cronbach Alpha. Pilot study-I was conducted on 350 participants for Inter-item correlations and Exploratory Factor Analysis (EFA). Pilot study II selected 120 participants conveniently, and Dysmorphic Concern Questionnaire (DCQ) along with a Scale of Adjustment Problems for Adults (SAPA) and BDDS were administered to analyse the validation of BDDS. In the main study, 200 conveniently selected individuals were given BDDS for Confirmatory Factor Analysis (CFA).
Results: Exploratory Factor Analysis yielded three factors with 77 total items of BDDS, each having 19 (Behavioural Slants), 14 (Relational Sensitivity) and 44 (Self-Criticism) items, showing Cronbach Alpha of 0.98 on the present sample. Convergent validity and discriminant validity DCQ and SAPA were satisfactory, respectively. CFA on 200 conveniently selected general population youth yielded 18 items screening BDDS.
Conclusion: Body Dysmorphic Disorder Scale is a reliable and valid indigenous tool developed in Pakistan. Confirmatory factor analysis confirmed to screen the general population.
Association of Modic Changes with Low Chronic Low Back Pain
Authors: Shah Akbar , Ishfaq Asim , Malik Muhammad Jalil , Akmal Muhammad , Javed Amna , Haider Adnan 
Published: October 2023

Objective: To determine the association of Modic changes with chronic low back pain in the adult population
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital, Lahore Pakistan, from Jan to Mar 2022.
Methodology: All the patients who were diagnosed with chronic low back pain by Neurosurgeon were included in the study.Detailed history and physical examination were conducted on all the patients diagnosed with chronic low back pain. MRI spine was performed on all the study participants for Modic changes. Relevant socio-demographic factors were associated with different types of Modic changes in patients included in our analysis.
Results: Out of 300 patients managed for chronic low back pain during the study period, 201(67%) were male, while 99(33%) were female. 172(57.3%) had no Modic changes, 33(11%) had Type-I changes, 80(26.7%) had Type-II changes, and 15(5%) had Type-III Modic changes. Advancing age, female gender and presence of comorbid illness had a statistically significant relationship with Modic changes in study participants (p-value<0.05).
Conclusion: Modic changes were commonly seen in patients with low back pain. Type II Modic changes were most frequently seen in these patients. Elderly and female patients were more at risk of Modic changes than young and male patients. Comorbid medical illnesses also increase the chances of having Modic changes.
Neonatal Outcome of Pregnancies with Oligohydramnios and Polyhydramnios
Authors: Sami Aqeela , Jalil Jawad , Sarfraz Muhammad , Hassan Jawad ul , Khawar Ruhma , Mumtaz Zahra 
Published: October 2023

Objective: To asses’ factors associated with neonatal outcome of pregnancies with oligohydramnios and polyhydramnios.
Study Design: Comparative Cross-sectional Study.
Place and Duration of Study: Department of Pediatrics and Gynecology, Fauji Foundation Hospital, Lahore Pakistan, from Oct 2020 to Sep 2021
Methodology: A prospective comparative study was conducted on the babies born to mothers diagnosed witholigohydramnios and polyhydramnios during the course of pregnancy. Neonates were evaluated by neonatologist within first 24 hours of birth. The cases were admitted and well babies were handed over to parents. The neonatal outcome parameters were observed in all these babies for first two weeks of life. Those who lost follow up they were excluded from study. Age of mother, gestational age of baby, maternal hypertension and maternal diabetes were associated with presence of complications among these babies.
Results: Two thousand One hundred and Twenty-nine deliveries took place in given duration. About 322 had either polyhydramnios or oligohydramnios. About 150 cases could be followed completely. Fifty-five (36.7%) showed presence of one or more complications, of which 29(41.4%) cases had oligohydramnios and 26(32.5%) had polyhydramnios. Maternal age and presence of maternal diabetes and maternal hypertension had statistically significant association with complications in neonates (p-value <0.005).
Conclusion: Complications rate was high among neonates born to mothers with oligohydramnios or polyhydramnios. Advanced maternal age, presence of diabetes mellitus and hypertension were factors association with presence of complications in neonates included in our study.
Predictors of Academic Performance among Potential Medical Students: A Cross-Sectional Study from Rawalpindi
Authors: Mustafa Nazia , Shehzadi Kiran , Kiani Shoaib 
Published: October 2023

Objective: To compare the potential medical students regarding cognitive intelligence, emotional intelligence, social intelligence and academic performance.
Study Design: Cross-Sectional study
Place and Duration of Study: Army Medical College, Rawalpindi Pakistan, in October 2020.
Methodology: The sample of the study comprised 512 male potential Medical students who completed their High School Education and came for the Entry test at Army Medical colleges with an age range of 17-21 years. All participants were assessed through the group administration of an assessment pack comprised of all tests.
Results: Results revealed that among all 512 students, 390 were finally recommended as selected candidates, and the rest, 122 were finally not recommended. A comparison between recommended and not-recommended groups on study variables was drawn. And result revealed significant mean differences in the variables of Cognitive Intelligence (t=-3.592 and p<0.001) and Emotional intelligence (t=-3.969 and p<0.001) and non-significant differences in the variable of social intelligence and academic performance (t=-1.609; p<0.001; t=-0.900; p<0.001).
Conclusion: Hence, academic performance is proven to be associated with emotional intelligence, IQ and personality characteristics. Better emotional regulation enables the students to develop better peer relations and invest energies in demanding academics owing to their cognitive and non-cognitive skills.
Comparison Between Efficacy and Safety of Oral Azithromycin (250mg) vs Oral Doxycycline (100mg) in Treatment of Meibomian Gland Dysfunction (MGD)
Authors: Yousuf Waseem , Humayun Fakhar , Janjua Teyyeb Azeem , Khan Taimoor Ashraf , Sarfraz Muhammad Haroon , Mehboob Mohammad Asim 
Published: October 2023

Objective: To compare the efficacy and safety of oral Azithromycin with oral Doxycycline in patients with Meibomian Gland Dysfunction.
Study Design: Quasi-experimental study.
Place and Duration of the Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Apr 2021 to Apr 2022.
Methodology: The sample population comprised 172 subjects, including 86 cases in the oral Doxycycline-Group and 86 oralAzithromycin-Group. Meibomian Gland Dysfunction was diagnosed by a consultant ophthalmologist by slit-lampexamination. Schirmer-I test and Tear Break Up Time were performed. Signs and symptoms of Meibomian Gland Dysfunction were assessed before treatment and at six months follow-up.
Results: The study recruited equal numbers of cases and controls. Symptoms scores for burning sensation (2.04±0.5 vs 1.9±0.7) and foreign body sensation (1.8±0.6 vs 1.5±0.8) were significantly higher in patients taking Doxycycline as compared to the Azithromycin-Group (p<0.05). On comparing the signs score between the two Groups, it was seen that total scores (pretreatment and post-treatment) were more significant in the Doxycycline-Group (p<0.05). Treatment with Doxycycline yielded more significant complications, such as diarrhoea (39.5%), nausea (46.5%), and cramps (48.8%). Headache was more associated with Azithromycin treatment (3.4%), whereas Rash (1.1%) and blurring of vision (1.1%) were seen in the Doxycycline-Group.
Conclusion: Meibomian Gland Dysfunction leads to tear film instability and direct damage to the ocular surface epithelium. This study supports the clinical efficacy and safety of oral Azithromycin and Doxycycline therapy for managing refractory or severe Meibomian gland disease.
Comparison of Metformin and Orlistat in Anovulatory, Overweight and Obese Women with Polycystic Ovarian Syndrome
Authors: Gul Uzma , Akhtar Sunarays , Tabassum Humaira , Khalil Adiba Akhtar , Nawaz Qudsia 
Published: October 2023

Objective: To compare the efficacy of Metformin and Orlistat in improving ovulation and reducing body mass index in anovulatory, overweight and obese women with polycystic ovarian syndrome.
Study Design: Quasi-experimental study.
Place and Duration of Study: Gynaecology and Obstetrics Department, Pakistan Air Force Hospital, Lahore Pakistan, Sep 2020 to Apr 2022.
Methodology: Eighty women having polycystic ovarian syndrome with anovulation and body mass index ≥25 were randomized to receive either Metformin (n=40) or Orlistat (n=40). Patients in Group-A received Metformin 500 mg thrice daily; Group-B received Orlistat 120mg twice daily for three months. Patients were also given dietary and lifestyle advice. Ovulatory status and body mass index were measured at baseline and after three months of treatment.
Results: Mean age of women was 26.9±5.1 years, and mean BMI was 29.9±2.57 Kg/m2. Ovulation was restored in 10 women (25%) in Group A and 12 women (30%) in Group B (p0.617). Compared to the baseline, women in both groups significantly reduced their BMI (p˂0.001). However, the difference in the change in BMI of both Groups was not statistically significant (p0.668). 26 women (65%) on Metformin experienced gastrointestinal side effects as compared to 11(27.5%) on Orlistat (p=0.001).
Conclusion: Metformin and Orlistat have equal efficacy in improving ovulation and reducing body mass index in women with polycystic ovarian syndrome having anovulation and body mass index ≥25.
Pre-operative Embolization of Meningioma Leads to Reduced Operating Time and Less Intraoperative Bleeding
Authors: Khan Awais Ali , Khan Habib Ullah , Bangash Khurshid Ali , Qasmi Shahzad Ahmed , Ahmed Syed Adeel , Hashmat Asif , Shamim Babar 
Published: October 2023

Objective: To determine the efficacy of pre-operative meningioma embolization in terms of operating time and intraoperative bleeding.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Neurosurgery, Combined Military Hospital, Rawalpindi Pakistan, from Jan to Dec 2020.
Methodology: Twelve diagnosed cases of intracerebral meningioma were included in the study. The patients were diagnosed cases of meningioma as per pre-operative signs and symptoms, radiological confirmation was done with magnetic resonance imaging, and all were subjected to pre-operative embolization of the tumour with catheter advancement in the arterial system and embolizing the target vessels with polyvinyl alcohol particles, followed by craniotomy and excision of the tumour.
Results: The mean age of the patients was 47±672. 24 years. The mean operating time (from the incision to closure) was 96.17±10.23 minutes. In contrast, the intraoperative blood loss was 325.33±15.43 ml. Six (50.00%) individuals had parasagittal meningioma, 4(33.33%) were of cerebral convexity, while 2(16.66%) had lesions at sphenoid wing.
Conclusion: Meningioma is a quite vascular tumour, and the operative outcome can be improved by pre-operative angioembolization. The reduced vascularity makes the resection easier by decreasing the per-op bleed and operating time.Keywords: Intraoperative bleed, Meningioma, Operating time, Pre-operative embolization.