bluuebunny/crossref_metadata_2025_split huggingface dataset:
Referral of obstetric cases: Reasons and outcome in a tertiary care setting in Sukkur, Sindh.
Authors: Hazooran Lakhan  , Farheen Shaikh  , Saima Lakhan  , Safia Maqsood  , Kausar Jahan Abro  , Bushra Noor Khuhro  
Published: January 2024

Introduction: The onset of pregnancy till its culmination is a critical care period for the mother because any negligence during the nine months can have dire consequences both for the mother and the child.
Objective: The objective of this study is to document the reasons for which women at the time of delivery are referred and their outcome for both mother and new born.
Methodology: A cross-sectional study was conducted in the Obstetrics and Gynaecology Unit 1, Department of a tertiary care teaching hospital in Sukkur, Sindh. Full-term pregnant females who were referred in the period of May 2018 to April 2019 were included. Total referrals accounted for n=99. Data was analysed on SPSS version 23. Frequencies and percentages were calculated for the reasons and the outcome. Kruskal Wallis test was applied for finding differences in mean gestational age among maternal and foetal outcomes. P-value less than 0.05 was taken as significant.
Results: Total n=99 females were referred during one-year period. The most prevalent medical reason for referral was postpartum haemorrhage (19%) and Eclampsia (18%). Anaemia as an indirect cause was seen in (41%) referrals. For the majority, the mode of delivery was Caesarean Section (49.5%). Maternal deaths were (12%) whereas Intra Uterine Deaths accounted for (41%).
Conclusion: The most common reason for referral was postpartum haemorrhage and eclampsia. Increase maternal mortality and intrauterine deaths are observed.
Keywords: Maternal outcome, foetal outcome, referrals, high-risk pregnancies, Anaemia.
Relationship of age and family factors with academic performance outcome of students getting higher education.
Authors: Alina Atif  
Published: January 2024

Introduction: Acquiring higher education has changed its dynamics since the beginning of this century. Covid-19 has added its transformation of remote learning, another dimension of distance learning. At this stage a number of factors seem to be responsible for continued higher education minimizing the chanced of drop outs. At the same time several factors have their impact on performance outcome. In this study we have tried to find the impact of these factors on performance outcome of the students getting higher education.
Objectives: To assess the relationship of age and family factors on academic performance output of students getting higher education.
Methodology: This cross-sectional study was conducted between January 4 – April 2, 2021. During this period 216 students; of either gender; getting higher education in institutes recognized by higher education commission were selected through cluster sampling. Students were approached through personal contact, email or WhatsApp.
Results: The study shows that gender, age and income status have a positive association with CGPA while degree enrolled in, source of Income, marital status and no of children shows a negative relationship with CGPA. Results also shows that age, degree enrolled in, marital status and income have significant relationship ( p= <0.05)with CGPA; while gender, no of children, and source of income have insignificant association ( p= > 0.05)
Conclusion: Gender, Age and Income Status have a positive association with good CGPA
Keywords: Academic performance, Higher Education, HEC recognized institutes
Frequency of premalignant lesions of oral cavity in Lyari Town, Karachi.
Authors: Allah Bux Mushtaq  , Abdul Waheed  , Ghulam Shabir Mahar  , Amrat Kumar  , Ashok Kumar  , Athar Khan  
Published: January 2024

Introduction: Usage of tobacco in any form and its related products is the chief avoidable reason of death around the globe based on reports published by WHO. Currently, approximately 6 million fatalities occur each year and majority of these deaths, almost 4 out of every 5 fatalities occur in less developed countries around the world.
Objective: To find out the frequency of premalignant lesion in oral cavity in persons consuming betel nuts and tobacco in Lyari town Karachi, Pakistan.
Methodology: After Institutional ethical committee approval, this cross-sectional survey was carried out in the routine camps at Bihar colony Lyari town under supervision of ENT and Oral Pathology Departments Sindh Government Lyari Hospital Karachi. Patients fulfilling inclusion criteria and given written informed consent were selected for the study.
Results: The demographic profile of study participants and it was seen that 15 (5.3%) of them were aged 20 to 30 years, 200 (70.4%) of them were males, 92(32.4%) of them had primary education, 109(38.4)of them were laborers 89(31.3%) of them were Sindhi. The overall frequency of premalignant lesions of oral cavity was found in 28 (9.86%) in study participants. Oral submucous fibrosis (OSF) was seen in 11 (39.3%) of the individuals, 8(28.6%) were having Lichen planus, 5(17.9%) were having leukoplakia, and 4(14.2%) were having erythroplakia.
Conclusion: Despite the fact that the study found a higher frequency of OPML than earlier studies in this demographic, the proportion of those who used tobacco in any form was significantly higher.
Keywords: Oral premalignant lesions, screening, risk factors, tobacco use, Betel Quid
Incidence of Adenomyosis and its association with other benign lesions in Hysterectomy with BSO.
Authors: Memon Ghulam Rasool , Siyal Abdul Rahim , Pathan Muhammad Iqbal 
Published: January 2024

Objectives: To determine the incidence of adenomyosis and to assess its association with co– existing benign lesions.
Methodology: This prospective cross section study carried out at the Department of Pathology, Muhammad Medical College Mirpurkhas Sindh Pakistan from 1st January 2016 to 31st December 2016. Total 53 cases of hysterectomies with BSO were assessed. All specimens were grossly examined in detail and processed through hematoxylin and eosin stains. All the sections were examined for adenomyosis and its associated co – existing benign lesions.
Results: Out of 53 specimens of hysterectomies with BSO, in 39.6% were found adenomyotic foci. The patients mean age was 40 years. Besides adenomyosis alone 14.2%, the associated co – existing benign lesion were ovarian cysts (57.1 %). Endometrial polyps and adenomyomatous Polyps
(19 %) and Leiomyomas (9.5 %).
Conclusion: Adenomyosis is common in middle aged women. The ovarian cysts are frequent co – existing benign lesions of adenomyosis.
Key Words: Adenomyosis, Bilateral Salpingo-oophorectomy, Hysterectomy.
Comparison of Immunochromatography test (ICT) with real time polymerase chain reaction (RT – PCR) in detection of HCV.
Authors: Memon Ghulam Rasool , Siyal Abdul Rahim , Pathan Muhammad Iqbal , Shah Irshad-ul-Haque 
Published: January 2024

Objectives: To compare ICT rapid test with RT- PCR.
Methodology: This study conducted at Pathological Laboratory Muhammad Medical College Hospital during July-August 2016 with collaboration of The Health Foundation District Sanghar at Goth Haji Khair Muhammad Junejo Kandiari Dist: Sanghar Sindh. 400 subjects from whole the population approximately 674 persons of Goth Haji Khair Mohammad Junejo taulka kandiari district Sanghar were selected in between the age of 10 years to 70 years. The purpose was to treat them if they are HCV positive. All the subjects were first screened for Anti – HCV on ICT method, and then all positive cases were confirmed on RT – PCR.
Results: This study conducted during the month of July and August 2016. Total 400 asymptomatic subjects from both male and female were screened by ICT method for Anti – HCV. Out of 400 subjects, 142 (35.5%) were positive. The serum of all 142 subjects positive on ICT, sent to Rawalpindi for HCV qualitative test on RT – PCR, HCV detected in 84 (59.16%) cases and 58 (40.84%) cases were negative. The ratio of variation (ICT: RT-PCR) was 1.44.
Conclusion: Rapid ICT method is less sensitive compare to RT – PCR. There is variation of results in between two methods. All positive cases on ICT must be confirmed on RT – PCR. There is false positivity in ICT method.

Key word: ICT (Immunochromatography test) RT – PCR (Real time polymerase chain reaction) RIA
(Radio immunoassay) ELISA (Enzyme linked immunosorbent assay) EIA (Enzyme immunoassay).
Evaluating the impact of baby-friendly Hospitals on mother’s knowledge and practices regarding breastfeeding in Karachi, Pakistan
Authors: Khalid Shafi  , Faryal Nawab  , Rozina Jabeen  , Waseem Jmalvi  
Published: January 2024

Introduction: Breastfeeding is a natural way of feeding to a new born baby. World Health Organization launched a Baby Friendly Hospital initiative in 1992, to strengthen maternity practices to support breast-feedings. Currently, about 19250 hospitals world wide have achieved Baby Friendly Status. To evaluate the role of Baby Friendly Hospital Initiative on feeding and weaning practices of mothers in improving health status of children under five years of age
Methodology: Cross sectional comparative study was done at baby friendly hospital (BFHI) and non-baby friendly hospital (Non BFHI) Karachi. A total of 784 mothers were selected through convenient sampling and grouped according to place of birth.
Results: Feeding practices in BFHI group was better in some respects. Among them 81% mothers did not give any pre-lacteal feeds, 79% mothers reported that their babies were exclusively breast fed up to four months of age and 31% reported that they initiated breast feeding within one hour after the delivery.
Conclusions: Baby Friendly Hospital initiative has a beneficial effect on feeding practices of mothers and duration of exclusive breastfeeding. But some areas of optimal breastfeeding practices are not taken care well. Initiation of breastfeeding within ½ to 1 hour needs attention.

Key words: Breast feeding, Baby Friendly Hospital Initiative, weaning, exclusive breast feeding
Patients Perceptions of Doctors Empathy in MMCH.
Authors: Aiman Mustafa  , Zafar Muhammad Zeeshan , Khan Muhammad Asad 
Published: January 2024

Patients Perceptions of Doctors Empathy in MMCH
*Aiman Mustafa, **Muhammad Zeeshan Zafar, ***Muhammad Asad Khan
*Muhammad Medical College, Mirpurkhas, **Rashid Latif Medical College, ***Kind Edward Medical University.

Abstract
Introduction: Empathy is defined as understanding of patient’s experiences, concern and perceptive, combined with a capacity to communicate and intention to help. Patient takes doctors empathy as his good will for successful treatment of his patient while understanding his misery. This study was designed to in investigate the perception of patients regarding doctor empathy and to examine their satisfaction and personal interest or indications of patient compliance.
Methodology: A cross-sectional survey was conducted between August 1, 2015 50 August 26, 2015. 100 patients selected purposively from OPD and ward. A self-administrated Likert styled questionnaire originally developed by Hojat et al at Jefferson school of Medicine with Urdu translation was administered. The data was analyzed using SPSS version 16.
Results: Among the total of 100 patients, 98%patients accept that their Doctor has been taking care of them, 74% patients were satisfied that the Doctor explain the reason for any test, 94% thought that their Doctor explained things clearly to them, 96% strongly agreed that their doctor had knowledge and skills, 100% were satisfied with the care their doctor provided, while 82%claimed that their doctor encourage them to explain the disease to him, 94% wanted their doctor to be present in any medical emergency.
Conclusions: This study reveals a high degree of patient’s satisfaction with empathy of Doctors of MMCH, although some improvement is still possible.

Key words: Patient, empathy, concern, satisfaction, MMCH
In Celiac disease: Type 3a, 3b and grade BI is more frequent on Marsh Modified (Oberhuber) / Corraza classification.
Authors: Memon Ghulam Rasool , Major Amir Iqbal Ali  , Mairaj Muhammad  
Published: January 2024

Introduction: Histopathological alterations in celiac disease (CD)are villous atrophy, intraepithelial lymphocyte infiltration and crypt hyperplasia. It is caused by gluten in genetically predisposed persons. Duodenum and proximal part of jejunum are most commonly involved. Various classifications are used to define histopathological features of CD, but it is easier to define on Marsh modified (Oberhuber) Corraza classification.
Objective: The object of study is to differentiate histopathogical feature of celiac disease on Marsh modified (Oberhuber) and Corraza classifications
Methodology: This retrospective study of 66 cases of CD carried out at Muhammad Medical college Mirpurkhas Sindh Pakistan between January 2016 to December 2017. Fresh slides prepared and dually observed. All observations denoted and systemized on Marsh modified (Oberhuber) Corraza classification. There are many mimics of CD, they should be excluded for the proper approach to diagnosis.
Conclusion: Histopathogical finding are helpful in CD if they are carefully classified. Typing and grading system of Marsh modified Corraza classification is easier to define and is supportive to observe the features in diagnosis and prognosis of disease.

Key words: Celiac disease, Intraepithelial lymphocytes, villous atrophy. Histopathology, serology
Impact of Virtual Simulation to Teach EMS Personnel Respiratory Failure Management During the COVID-19 Pandemic
Authors: Walker Ayanna , McNally Keegan , Ganti Latha , Elahi Nubaha , Van Dillen Christine , Patel Parth , Vera Ariel 
Published: January 2024

Objective This study presents a unique way to provide simulation education to paramedics during the Coronavirus pandemic, without some of the logistical concerns that accompany traditional in-person simulation. Methods Our county EMS personnel were divided in groups of 3-6 for the virtual simulation conducted by a physician facilitator who was remotely broadcasted to the EMS team performing tasks on a mannequin. A post-simulation survey was conducted to determine how the simulation affected their comfort level with managing respiratory failure in both suspected COVID-19 and non-COVID-19 patients. Results The 42 EMS personnel responding to the survey felt an increased comfort level in managing respiratory failure in a suspected or known COVID-19 patient after the virtual simulation. There was an increase in “extremely comfortable” responses from 24% to 43% before and after the simulation, and a decrease in “somewhat uncomfortable” responses from 10% to 0%. Respondents had extensive prior EMS experience, with 95% stating 2+ years working in EMS, and 33% with more than 10 year’s experience. Only 12% of the responders stated they underwent simulation training once a month or more, with 64% stating “a few times per year”. 86% of the responders felt the video platform was easy to use. The most common technical difficulty involved audio problems. Conclusions EMS personnel undergoing a virtual simulation and debrief in the management of respiratory failure in the setting of the COVID-19 pandemic felt more comfortable in their management of these patients after their sessions. The majority recommended continuing this type of training in the future.
Integrating Telemedicine Training into the Graduate Medical Education Curriculum
Authors: Elahi Nubaha , McNally Keegan , Ganti Latha , Lebowitz David , Macintosh Tracy , Plamoottil Cherian , Gonzalez William 
Published: January 2024

Objectives The primary objective of this study was to examine current emergency medicine resident knowledge of telemedicine, expose residents to standardized telemedicine patients virtually, and analyze the effectiveness of telemedicine training on completing a successful encounter. Methods emergency medicine residents first underwent a virtual standardized telemedicine encounter using the ZoomTM telecommunications application without prior training in telemedicine. Standardized patients were then queried on resident success during this untrained encounter using a survey with aspects of a successful telemedicine encounter. The following session involved a lecture by a telemedicine physician. After this intervention, the residents underwent a repeat virtual encounter, with standardized patients responding to the same questions on the fundamental aspects of a successful interview. Residents also underwent a post-survey on their experiences with the training. Results Statistically significant differences were noted on aspects of the encounter related to obtaining informed consent (0% vs. 61%, p = 0.00012), asking about privacy in the patient’s environment (6% vs. 87%, p <0.00001), verifying name and/or date of birth (29% vs. 94%, p =0.00014), explaining the telehealth process and expectations to the patient (0% vs. 94%, p <0.00001). No statistical significance was seen with: resident introducing themselves (94% vs. 100%, p =.31732), asking focused questions about medical condition (100% vs. 100% p = 1), closing the encounter by explaining care plan (94% vs. 94%, p = 1). Conclusions Overall, emergency medicine residents had significant improvement on aspects of an encounter with a standardized patient that were unique to telemedicine after undergoing training from an expert in the field. Similar training could easily be utilized across the country in emergency medicine residencies. This training could prove to be essential in the future because of the global health crisis of the COVID-19 pandemic, but also for rural emergency patient care and remote educational programs.
COMMUNITY EMPOWERMENT WITH STUNTING FILTERS TO CREATE HEALTHY FAMILIES
Authors: Solikhah Fitriana Kurniasari , Astuti Erlina Suci , Ernawati Naya , Arif Taufan , Tyas Maria Diah Ciptaning , Hamarno Rudi , Wiyono Joko , Subekti Imam 
Published: January 2024

Stunting is a condition where a child experiences growth disorders, so that the child's height does not correspond to his age, as a result of chronic nutritional problems, namely lack of nutritional intake for a long time (Ministry of Health, 2020). The results of the 2018 Regional Health Research (Riskesdas 2018) show that toddlers in Indonesia aged 0-23 months still experience shortness of breath or very shortness of breath. This shows that there is a bright spot in the implementation of intervention programs in accelerating the reduction of stunting rates which cannot be separated from the cooperation of every existing element. The difference in the average knowledge of pre- and post-education cadres providing education to improve care for low birth weight babies was obtained by a mean pre-education value of 2.60 and a mean post-education value of 1.40. The standard deviation value for pre-training is 0.308 and post-training is 0.40. The Wilcoxon z value is -4.102. The statistical test results of the Wilcoxon signed rank test obtained a value of p = 0.000 (p < 0.05). Thus, it can be concluded that there is a significant difference between before and after training in cadres' knowledge about early detection of stunting in toddlers. The community service program to assist families at risk of stunting is a new breakthrough in determining effective and integrated, community-based strategies to reduce the risk of stunting.
Impact de la COVID-19 sur les services de prévention du VIH et de prise en charge des personnes vivant avec le VIH dans la ville de Bukavu : une étude mixte séquentielle explicative
Authors: Kajiramugabi François Maneraguha , Chirimwami Patrick Murhula , Côté José , Mouala Christian , Rothan-Tondeur Monique , Margat Aurore 
Published: January 2024

Introduction : Depuis son apparition fin 2019 en Chine, les mesures de riposte contre l’infection à COVID-19 ont perturbé la prestation des services de santé primaires dont ceux liés au virus de l’immunodéficience humaine (VIH). En République démocratique du Congo, l’effet des mesures anti-COVID-19 (confinement) sur l’utilisation des services de prévention du VIH et de prise en charge des personnes vivant avec le VIH (PVVIH) reste peu décrit à ce jour.
Objectif : Comparer et comprendre l’effet des mesures anti-COVID-19 sur l’utilisation des services préventifs du VIH et de prise en charge des PVVIH dans les Centres de traitement ambulatoire (CTA) de Bukavu avant (octobre 2019 à février 2020) et pendant (mars à juillet 2020) la période des mesures anti-COVID-19.
Méthodes : Étude mixte multisite avec un devis séquentiel explicatif réalisée à Bukavu entre juillet et septembre 2021. La phase quantitative est observationnelle, descriptive, rétrospective et basée sur des données programmatiques issues des CTA. La phase qualitative, guidée par les résultats quantitatifs, est basée sur 31 entretiens semi-structurés avec les soignants et les PVVIH.
Résultats : Par comparaison avec la période pré-COVID-19, les mesures anti-COVID-19 ont entrainé une baisse de 11 à 20% des services de prévention du VIH et de prise en charge des PVVIH. Elles ont également induit les ruptures de stock d’antirétroviraux et de tests VIH, la réorganisation des services VIH, la contamination de certains soignants à la COVID-19 et le décès d’autres, ainsi qu’une baisse de l’utilisation des services VIH.
Discussion et conclusion : À Bukavu, les mesures anti-COVID-19 ont eu un impact négatif sur le parcours de soins des personnes à risque et infectées par le VIH. Elles ont entravé les progrès vers les objectifs : 95% des personnes dépistées au VIH, 95% des PVVIH sous traitement et 95% des PVVIH avec une charge virale supprimée.
β‐Cell Dysfunction in Type 2 Diabetes
Authors: Utzschneider Kristina M. , Kahn Steven E. 
Published: November 2003

AbstractThe pathogenesis of type 2 diabetes is complex, typically involving both insulin resistance and β‐cell dysfunction, with both defects being present well before the development of frank hyperglycemia and the clinical diagnosis of diabetes. This chapter reviews the abnormalities in β‐cell function observed in impaired glucose talerance and type 2 diabetes and elucidates some of the hypotheses regarding possible mechanisms responsible for the progressive failure of the β‐cell over time.