bluuebunny/crossref_metadata_2025_split huggingface dataset:
Association of Absolute Eosinophil Count and Post-Bronchodilator Reversibility in the Chronic Obstructive Pulmonary Disease Patients
Authors: Naveed Muhammad , Azam Khan Malik Nadeem , Shah Syed Umer , Hussain Altaf , Khan Muhammad Shahid , Hussain Muhammad Zahid 
Published: May 2023

Objective: To look for the relationship between absolute eosinophil count and post-bronchodilator reversibility in chronic obstructive pulmonary disease patients at Pak Emirates Military Hospital, Rawalpindi Pakistan.
Study Design: Cross sectional study.
Place and During of Study: Pulmonology Department, Pak Emirates Military Hospital Rawalpindi (PEMH) from Jul to Dec 2019.
Methodology: The study was conducted on 150 patients suffering from chronic obstructive pulmonary disease admitted in the Medical Ward or reporting in the Outpatient Department. Lung function was assessed using spirometry pre- and postbronchodilation. The presence and severity of chronic obstructive pulmonary disease were assessed using modified Global Obstructive Lung Disease (GOLD) criteria. The presence of significant bronchodilator responsiveness was taken as ≥12% improvement in the forced expiratory volume (FEV) (1) or the forced vital capacity.
Results: Of 150 patients in the final analysis, 95 (63.3%) were male, and 55(36.7%) were female. The mean duration of COPD in our target population was 9.13±1.23 years. 68 (45.3%) had >12% improvement after bronchodilator administration, while 82(54.7%) had <12% improvement. The absolute eosinophilic count was <2% in 49(32.7%), while it was raised in 101(67.3%) patients.
Conclusion: Raised eosinophilic count emerged as a predictor of good response after administering bronchodilators among patients suffering from chronic obstructive airway disease. Screening patients for this simple blood component may predictresponse to the initial treatment and help in the tailoring of the treatment plan by the treating physician.Keywords: Chronic obstructive pulmonary disease, Eosinophils, Forced expiratory volume.
Effects of Critical Incident Stress Management on Nurses During COVID-19 Pandemic
Authors: Tariq Muhammad , Rasool Ayesha , Satti Iftikhar Ahmed , Ayaz Saeed bin , Sajid Muhammad Usman , Akhtar Khalid Ibrahim 
Published: May 2023

Objective: To analyze the effect of Critical Incident Stress Management on the mental health of nurses during COVID-19.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital, Jhelum Pakistan from Mar to Jun 2020.
Methodology: Forty-six nurses were consecutively recruited and evaluated regarding Knowledge about COVID-19, thoughts regarding its origin, emotional reactions, and coping mechanisms. The evaluation was followed by the provision of Critical Incident Stress Management sessions in March. Finally, in the second phase conducted in June, the participants were evaluated again to assess the effect of intervention regarding the above parameters.
Results: Results indicated a statistically significant shift in Knowledge from Social Media to Academic Resources (p<0.001). Thoughts regarding the origin of COVID-19 showed that ‘Religious Causes’ and belief in ‘Religious and Biological Causes both” significantly reduced (p=0.001 and p=0.003, respectively), while opinions regarding ‘Biological Causes’ increased in frequency (p< 0.001). Emotionally a significant reduction was seen in Confusion (p<0.001). A significant reduction was observed in Religious Rituals (p=0.002) for Coping Mechanisms. However, observing Safety Precautions and Distraction Strategies were insignificantly affected (p=0.668 and p=1, respectively).
Conclusion: Critical Incident Stress Management helped healthcare workers sublimate their emotional reactions and helped them cope with a productive mindset for better management of the pandemic.Keywords: COVID-19, Critical incident stress management, Paramedics, Psychological impact.
Frequency of Isolation of Methicillin-resistant Staphylococcus Aureus (MRSA) from Pus Samples and its Antibiotic Susceptibility
Authors: Rubab Fatima , Majid Muhammad , Zeb Anam , Shabbir Sundas , Ali Nayab , Ali Sakhawat 
Published: May 2023

Objective: To determine the frequency of isolation of methicillin-resistant Staphylococcus aureus from pus samples and the invitro efficacy of commonly used antimicrobial drugs against them.
Study Design: Cross-sectional study
Place and Duration of Study: Department of Microbiology, Army Medical College, National University of Medical Sciences,Rawalpindi, from May 2018 to Apr 2019.
Methodology: The pus samples were subjected to standard microbiological procedures. The Kirby Bauer disc diffusion method was used to determine the antibiotics susceptibility pattern of the isolates, and results were interpreted according to Clinical and Laboratory Standards Institute (CLSI) guidelines-2018.
Results: Of the total 499 Staphylococcus aureus, 214(42%) were Methicillin-Resistant Staphylococcus aureus. The resistance against antibiotics were found in penicillin 214(100%), Trimethoprim/Sulfamethoxazole 205(96%), Erythromycin 177(82.7%),Ciprofloxacin 160(75.3%), Chloramphenicol 131(61%), Gentamicin 88(40.9%), Tetracycline 52(24%), Fusidic Acid 35(16%),Clindamycin 33(15.3%), Minocycline 11(5.2%), Vancomycin and Linezolid (0%).
Conclusion: There is a high frequency of MRSA in our setup with very limited treatment options.
Association of Urinary Tract Infection with Preterm Labor in Gravid Females in a Tertiary Care Hospital
Authors: Baqai Shehla , Jaffery Humaira Osman , Ashraf Viqar , Hameed Sidra 
Published: May 2023

Objective: To compare the frequency of preterm labour in pregnant patients with and without urinary tract infection in a tertiary care hospital in Punjab.
Study Design: Cross-sectional comparative study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Combined Military Hospital, Lahore Pakistan, from Jul 2019 to Jan 2020.
Methodology: Three hundred and eighty-five pregnant women were inducted into the study. The midstream urine sample was collected from patients between 24-28 weeks of gestation with complaints of burning micturition and was sent for microscopic examination. Urinary tract infection was diagnosed on the urinalysis report. Patients were followed till delivery.Patients were labelled as preterm who delivered neonates <37 weeks of gestation.
Results: In this study, the mean age of the patients was 25.2±3.0. The majority of the patients were para 1-2. The mean body mass index was 25.3±1.9 kg/m2. Urinary tract infection was found in 12 patients (3.2%), and preterm labour occurred in 52 patients (13.5%). The mean birth weight of neonates was 3.0±0.5kg. A comparison of preterm labour in patients with and without urinary tract infections revealed that patients with urinary tract infections were associated with preterm labour (p<0.001).
Conclusion: Urinary tract infection during pregnancy significantly impacts pregnancy outcomes, mainly preterm labour and low birth weight.
Impact of General Anaesthesia Versus Combined Epidural and General Anesthesia on Postoperative Complications and Mortality in Elective Abdominal Aortic Aneurysm Surgeries
Authors: Yaqub Khan Muhammad , Saeed Muhammad , Yasin Bilal , Ameer Khalid , Noor Nusrat 
Published: May 2023

Objective: To determine the impact of general anaesthesia versus combined epidural and general anaesthesia on postoperative complications in elective abdominal aortic aneurysm surgeries.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jun 2018 to Sep 2020.
Methodology: A total of 100 patients from both genders undergoing elective open abdominal aortic aneurysm surgery under general anaesthesia enrolled in the study after random distribution to drug and control groups in equal proportions. The primary determinants were postoperative complications. Additionally, it determined the impact on postoperative mortality rate.
Results: Of 100 participants, 54% of patients were from ASA status II, and 46% were from ASA status III. Among postoperative complications, bowel ischemia was recorded in 16% and 2% among Group-A and Group-B, respectively (pvalue 0.01). Postoperative dialysis was required in 18% of patients in Group-A, whereas among Group-B, only 4%went through it (p-value 0.02). Pulmonary complications variation was not statistically different between the two groups, with 54% and 46% (p-value 0.42) frequencies in Group-A and Group-B, respectively. However, surgical reintervention within 30 days was notable, 36% in Group-A and 14% in Group-B (p-value 0.01).
Conclusion: Combined general and epidural anaesthesia, when compared with general anaesthesia alone, significantly impacts the reduction of postoperative complications after elective open abdominal aortic aneurysm surgeries without increasing morbidity and mortality.
Outcome Of Non-Elective Covid Positive Orthopaedic Injury Procedures In Two Tertiary Care Hospitals
Authors: Anwar Syed Faraz , Mushtaq Ahmed , Faraz Syed Sheheryar 
Published: May 2023

Objective: To evaluate the outcome of COVID-positive orthopaedic injury patients operated as emergency cases regarding overall disease progression, laboratory parameters and fracture healing.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi and Combined Military Hospital Malir Karachi Pakistan, from Apr to Nov 2020.
Methodology: All the orthopaedic injury patients with no other injuries who tested positive for COVID-19 were included in the study. The demographic data, time of injury and surgery, co-morbidities and values of inflammatory markers such as Creactive protein (CRP), Total Leukocyte Count (TLC), Serum Ferritin and Neutrophil percentage were noted pre-op and on the fifth-day post-operation. The bone fracture, its severity, and the type of orthopaedic intervention were also noted.
Results: A total of 17 patients were included in the study, out of which 12 were males (70.6%), and 5 were females (29.4%),with a mean age of 49.06±18.78 years. There were 9(52.9%) cases of mild COVID-19, 3(17.6%) cases of moderate and 5(29.2%) cases of severe disease among orthopaedic injury cases. The most common fracture was of the femur in 12(70.6%) patients,followed by tibia/fibula in 3(17.6%) and 2(11.8%) cases of radius and ulna. In addition, there were 2(11.8%) cases of non-union and 5(29.4%) delayed union. Only 2(5.2%) health professionals developed mild COVID.Conclusion: Orthopedic emergency operations of COVID-19-positive patients can be performed safely following strict COVID-19 protocols.
Correlation Between Resistive Index and Serum Creatinine in Patients with Diabetic Nephropathy
Authors: Khan Amir , Ahmed Aliya , Bhutta Muzammil Rasheed , Zafar Ibtesam , Khan Muhammad Nasir Naeem , Ehsan Jovaria 
Published: May 2023

Objective: To evaluate the renal resistive index (RI) and serum creatinine correlation in patients with diabetic nephropathy.
Study Design: Cross-sectional study
Place and Duration of Study: Department of Radiology, Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Nov 2020 to Apr 2021.
Methodology: This study was conducted on 80 patients. Doppler renal artery sonography was carried out, and for all the individuals with controlled blood pressure, gender, age, urinary protein, serum creatinine and HBA1c were recorded.
Results: In our study, 42(52%) patients were females, whereas the remaining 38(48%) were males. The mean age was observed to be 49.15±11.91 years. A significant positive correlation (r=0.53) was found between Resistive Index and Serum Creatinine.The correlation co-efficient values between Resistive Index and Serum Creatinine in female and male patients were r=0.58 and r=0.47, respectively.
Conclusion: The present study concluded that RI had no significant statistical correlation with albuminuria, proteinuria and HbA1c levels. However, a statistical correlation between RI and creatinine level was reported.
Acceptance of COVID-19 Vaccine Among Undergraduate Students
Authors: Abid Muhammad Ali , Buzdar Muhammad Ashraf , Junejo Shizma , Karim Nasim 
Published: May 2023

Objective: To assess the acceptance of the COVID-19 vaccine among medical and non-medical undergraduate students and compare the COVID-19 vaccine receptivity differences between medical and non-medical undergraduate students.
Study Design: Cross-sectional study.
Place and Duration of Study: Bahria University Medical & Dental College, and Bahria University Karachi Campus Pakistan, from Mar to Jun 2021.
Methodology: In this study, a total of 392 participants, were selected by non-probability convenience sampling. Students aged 19-26 years were enrolled. Participants were required to sign a voluntary consent form prior to participation. The questionnaire included 21 questions inclusive of demographic characteristics, insight regarding COVID-19 disease, prior EPI vaccine exposure, attitude towards COVID-19 vaccine, including the importance of vaccine to end the pandemic, acceptance of vaccine along with reasons and non-acceptance and sent by email as a Google form to participants.
Results: There were 171(43.6%) males and females 218(55.6%). The mean age of participants was 20.7±2.29 years. 217(55.4%) students were from the MBBS programs, and 175(44.6%) were from non-MBBS programs. COVID-19 vaccine acceptability was better amongst medical students, with 182(83.9%) considering it safe for use in contrast to 5(2.8%) non-medical students who considered it safe.
Conclusion: The comparison of knowledge and attitudes towards accepting the COVID-19 vaccine between medical students and non-medical students revealed better acceptance amongst undergraduate medical students than non-medical undergraduate students.
Diagnostic Accuracy of Ultrasound and Computed Tomography in Differentiating Transudate from Exudate in Patients with Pleural Effusion
Authors: Rasheed Bhutta Muzammil , Majeed Ayesha Isani , Zafar Ibtesam , Khan Amir , Azad Hina , Din Shams Ud 
Published: May 2023

Objective: To compare the diagnostic accuracy of Computed Tomography and Ultrasonography in differentiating trans-dative and exudative pleural effusion.
Study Design: Cross-sectional study.
Place and Duration of Study: Radiology Department of Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Jul to Oct 2021.
Methodology: Patients suffering (n=80) from pleural effusion were involved, and all were assessed with ultrasound and computed Tomography along with diagnostic thoracocentesis. In addition, we investigated pleural thickening, pleural nodules, and loculations along with the USG signs and Computed Tomography attenuation values to detect transudate and exudate in individuals suffering from pleural effusion.
Results: Participants had a mean age of 36.20±6.67 years, ranging from 25 to 49 years. Out of 80 patients, 50(62.5 %) were males, and 30(37.5%) were females. Of the eighty patients with pleural effusion, 29 were transudative 36(25%), and 51 were exudative 63(75%). Overall, USG showed better results for loculations, while CT showed better results for pleural thickeningand nodules.
Conclusion: Attenuation values of Computed Tomography play an essential role in differentiating the type of pleural effusion. In addition, ultrasound is a supporting non-invasive imaging modality that helps define the characteristics of pleural effusion.
Computed Tomography Severity Score in COVID-19: Association with Inflammatory Markers and Patient Outcome
Authors: Mehmood Faisal , Hassan Ali , Ashraf Amna , Baig Zahid Farooq , Bukhari Karamat Hussain Shah , Khattak Abdul Latif 
Published: May 2023

Objective: To associate CT severity score with inflammatory markers and to determine outcomes of COVID-19 patients admitted to CMH Lahore.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Lahore Pakistan, from Mar to Jun 2021.
Methodology: Patients of COVID-19 age 18 and above, with a positive RT-PCR, were included in the study Clinical and radiological data of 200 patients was retrieved and analysed from the hospital registry.
Results: In the present study, we studied the role of inflammatory markers in predicting the severity of COVID-19. We have compared the levels of LDH, CRP, IL-6 and serum Ferritin between the two groups. LDH (p=0.015), IL-6 (p=0.001) and Ferritin (p=0.001) were significantly different between the two groups, but CRP was not (p=0.811) significant.
Conclusion: CT severity score associates well with the COVID-19 clinical severity. Our data suggest that the chest CT scoring system can predict the severity of COVID-19 disease and significantly associates with inflammatory markers.
Comparative Study of 35% Glycolic Acid (GA) Peel versus 15% Trichloroacetic Acid (TCA) in Patients Primed with 4% Hydroquinone and Sun Block for the Treatment of Melasma
Authors: Javed Zaaraa , Khan Qamar Uddin , Naeem Uzma , Zafar Hunzala 
Published: May 2023

Objective: To compare the effects of 35% Glycolic acid (GA) peel versus 15% Trichloroacetic Acid (TCA) in patients primed with 4% Hydroquinone and sunblock for Melasma treatment.
Study Design: Quasi-experimental stud.
Place and Duration of Study: Department of Dermatology, Combined Military Hospital, Jhelum Pakistan, from Jul to Nov 2020.
Methodology: Forty-eight melasma patients were included and divided randomly into two groups; Group-A patients were treated with 15%Trichloroacetic Acid (TCA), while Group-B patients were treated with 35% Glycolic Acid (GA). Peeling was performed fortnightly in 4 sessions. Melasma area and severity index (MASI) scoring was calculated before and after peeling.
Results: In our study, we found that pre-treatment MASI score in Group-A Trichloroacetic Acid (TCA) was 9.25±3.11 and in Group-B Glycolic Acid(GA), the pre-treatment MASI was 18.42±7.24, (p<0.001). The post-treatment MASI score in Group- A (TCA) was found to be 4.52±2.77and in Group-B (GA), it was 8.67±4.30, (p<0.001). TCA was associated with more burning, frosting, and skin cracking, while Glycolic Acid (GA) was associated with a scale of no to mild pain and mild burning.
Conclusion: Both the peeling agents, 35% Glycolic Acid (GA) peel and 15%Trichloroacetic Acid (TCA), in patients primed with 4% Hydroquinone and sunblock, are effective in reducing MASI scores. However, TCA showed better results.
Impact of Cardiopulmonary Bypass Time and Aortic Cross Clamp Time on Immediate PostOperative Outcomes in Patients with Congenital Heart Disease Undergoing Open Heart Surgery
Authors: Alisher Nazish , Khokhar Rajab Ali , Rehman Mujeeb Ur , Shaikh Abdul Sattar , Bux Korejo Hussain , Sangi Rumana 
Published: May 2023

Objective: to find out the impact of cardiopulmonary bypass time (CPBT) and aortic cross-clamp time (ACCT) on immediate post-operative outcomes in patients with congenital heart disease (CHD) undergoing open heart surgery at a tertiary care centre.
Study Design: Prospective longitudinal study.
Place and Duration of the Study: Department of Paediatric, Cardiac Intensive Care Unit, National Institute of Cardiovascular Diseases (NICVD), Karachi Pakistan, from Jul to Dec 2021.
Methodology: We enrolled 104 patients of both genders up to any age with CHD undergoing open heart surgeries. At the time of admission, age, gender, body weight, presence of cyanosis and types of CHDs were noted. Duration of mechanical ventilation, pediatric cardiac intensive care unit (PCICU) stay, and mortality was recorded. Baseline characteristics and postsurgery parameters were compared about CPBT and ACCT.
Results: Of 104 patients, 58(55.8%) were males. Overall, the mean age was 7.9±5.1 years. Cyanosis was noted in 34(32.7%) cases. Mean CPBT was 74.6±42.9 minutes, while the mean ACCT was 43.5±29.5 minutes. Most types of CHDs were noted to be tetralogy of Fallot (ToF) 28(26.9%). An increase in the duration of CPBT and ACCT was found to have a significant association with post-surgical morbidity (p<0.001).
Conclusion: Increased cardiopulmonary bypass time and aortic cross-clamp time were found to have a significant association with post-surgical morbidity and outcomes among cases undergoing open heart surgeries for congenital heart diseases.
Impact of Fetal Echocardiography on Altering Course of Action Following A Prenatal Diagnosis of Congenital Heart Disease-A Thought Analysis
Authors: Khalil Adiba Akhtar , Ara Andaleeb , Akhtar Khurram , Khan Sumaira , Yaqub Umairah , Akhtar Joodi kizilwarda 
Published: May 2023

Objective: To assess the impact of fetal echocardiography in altering the course of action for neonatal cardiac expertise and services available in Pakistan following an antenatal diagnosis of congenital heart defect (CHD).
Study Design: Cross-sectional study.
Place and Duration of Study: Pediatric Cardiology Unit, Armed Forces Institute of Cardiology & National Institute of Heart Diseases, Rawalpindi Pakistan, from Feb 2020 to Sep 2021.
Methodology: Fetuses aged 18 to 38 weeks of gestational age referred to the Pediatric Cardiac Unit due to risk of or suspicion of congenital heart disease underwent fetal cardiac echo. Data were collected and reviewed retrospectively to seek any impact of the antenatal diagnosis on post-natal planning.Results: The mean age of the mothers was 29.79±5.24 years (range, 17-47 years), and the mean gestational age at which the fetal echocardiography examination was performed was 27.29±4.47weeks (range: 12–38 years). Of the 609 pregnancies, fetal echocardiogram evaluation was performed, and sixty-three (10.3%) fetal echocardiograms were abnormal. Of the 63, only 06(9.5%) returned to the neonatal cardiac unit for follow-up and treatment in the first ten days of life.
Conclusion: The real impact of fetal echocardiography is possible only with the availability of well-developed, readily accessible fetal and neonatal cardiac services. Poverty and a struggling healthcare infrastructure confound the benefits.
PERBANDINGAN KINERJA PEGAWAI SEBELUM DAN SEMASA PANDEMI COVID-19 (Studi Kasus Pegawai Dinas Perhubungan Kota Yogyakarta)
Authors: Subandiyah Asih Endah , Gaudensia Sura Benedikta 
Published: May 2023

Performance Employee can certainly be relied on by internal and external factors, external factors such as the Covid-19 Pandemic certainly affect the resulting performance and cause differences in work results. Therefore, it is necessary to conduct a performance appraisal using clear and measurable indicators which are used as a reference for performance appraisal, so that we can know what needs to be changed and what is necessary from the existing situation so that it can help improve employee performance in the future.
The purpose of this study was to see if there were differences in the performance of the Department Transportation of Yogyakarta before and during the pandemic Covid-19 and whether the results of the employee performance at the Department Transportation of Yogyakarta before the pandemic Covid-19 were better according to the pandemic Covid-19.
This research method is comparative with a quantitative approach. The sample used was 51 respondents. The data used in this study are primary data obtained from the distribution of questionnaires of 51 copies, to respondents with the sampling was simple random sampling technique. The data analysis technique used is the validity test, reliability test, normality test, homogeneity test and paired difference test (Paired Sample T-test).
The results of this study indicate that the performance of the Yogyakarta City Transportation Department employees before and during the Covid-19 pandemic. Other results indicate that employee performance rewards are productivity and work pressure.