bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Corneal Stromal Demarcation Line Depth in Epi-off and Epi-on Corneal CrossLinking Using Anterior Segment Optical Coherence Tomograph
Authors: Ul Ain Qurat , Zafar Omar , Basit Imran , Awan Manzoor 
Published: February 2023

Objective: To compare the corneal stromal demarcation line depth after Epithelium-On and Epithelium-Off corneal crosslinking in patients with keratoconus using anterior segment Optical Coherence Tomography (AS-OCT).
Study design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan from Jun 2018 to Jun 2019.
Methodology: This study included patients (60 eyes) with progressive keratoconus treated with procedure CXL (corneal cross linkage). There were 30 eyes in each group. Two different protocols of Corneal cross linkage were performed, and patients were divided into two groups according to protocol: 1) epithelium-on Corneal cross-linkage, 2) epithelium-off Corneal crosslinkage. In the First-Group, epithelium-on Corneal cross-linkage,corneal epithelium was not removed, riboflavin solution was instilled on the cornea for one hour, and the cornea was exposed to Ultraviolet A rays. In Epithelium off Corneal cross-linkage,after epithelium was removed by spatula, riboflavin solution was instilled for 30 minutes, and Ultraviolet-A rays were focused on the cornea. After one month of the procedure, Anterior segment Optical Coherence Tomography was performed.Demarcation line depth was measured in treated corneas in all patients from both groups, and findings were compared.
Results: The stromal demarcation line depth was similar in both groups, and there was no statistical difference between the groups. The mean value of demarcation line depth was 277.13±107.09 цm (p>0.05).
Conclusion: Corneal stromal demarcation line depth after both procedures was similar in both groups after one month of Corneal cross-linkage, so it was concluded that epithelium-on Corneal cross-linkage was comparable to epithelium-off Corneal cross-linkage.
.The Impact of Information Seminar on Breast Cancer Awareness among the Medical and Nursing Students
Authors: Nadeem Muhammad , Khan Nayab , Satti Iftikhar Ahmed 
Published: February 2023

Objective: To determine the impact of the information seminar on breast cancer awareness among the medical and nursing students of CMH institute of Medical Sciences (CIMS) Multan Pakistan.
Study Design: Prospective Comparative Study.
Place and Duration of Study: One-day seminar at CMH Institute of Medical Sciences (CIMS) Multan Pakistan.
Methodology: A one-day seminar on breast cancer awareness was arranged at CMH Institute of Medical Sciences Multan Pakistan for 3rd and 4th-year MBBS and 3rd-year BSc Nursing students. A total of 137 participants were recruited. Participants were selected by non-probability consecutive sampling. A validated 13-question questionnaire was designed to assess participants' basic knowledge of breast cancer and breast self-examination (BSE).
Results: The mean age of participants was 21.27±0.99 years. 30(21.9%) were males and 107(78.1%) were female students.Before the seminar, approximately half of the students were correct about the demographics and presentation of breast cancer which increased to more than 80% in all avenues post-seminar (p<0.001). The most significant improvement was the correct responses regarding the age at which BSE should begin. Its frequency and correct technique pre-seminar were 75(54.7%),51(37.2%) and 23(16.8%), which in post-seminar were 98(71.5%), 106(77.4%) and 75(54.7%) respectively (p<0.001).
Conclusion: This one-day educational seminar played a significant role in increasing awareness among medical and nursing students.
Analysis of Causes of Sudden Death on the Basis of Autopsy Findings-A Study of 40 Cases at Tertiary Care Hospital, Quetta Balochistan
Authors: Azam Muhammad , Asif Naveed , Nasir Shafia , Tashfeen Sunila , Quayuum Nida , Gul Imran 
Published: February 2023

Objective: To study the spectrum of sudden death cases at Combined Military Hospital (CMH), Quetta Pakistan.
Study Design: Case series study.
Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Jun 2014 to Jun 2019.
Methodology: The study included all the autopsies/postmortems carried out on the cases due to sudden death from June 2014 to June 2019 at Combined Military Hospital, Quetta Pakistan. Detailed postmortem, internal and external examination, and histomorphology of vital organs were done in all cases of sudden death.
Results: A total of 40 cases of sudden deaths were studied. The age of the study subjects ranged from 24 to 45 years. Maximum deaths occurred in the age group between 30 to 45 years. The cause of death in 22 cases (55%) was attributed to cardiac events,the most common cause being coronary artery disease (59.0%). The remaining 18 cases (45%) were due to other non-cardiac causes.
Conclusion: Sudden death is the most common cause seen in young adults, most of which are attributed to cardiac causes.This study highlights serious health issues in our setup and the necessity to create awareness among the young adults at risk so that sudden deaths can be averted and life expectancy can be improved.
Evaluation of Supraclavicular Brachial Plexus Nerve Block with Patient Controlled Intravenous Analgesia for Post-Operative Pain Management in Patients with Forearm Surgery
Authors: Ahmed Mushtaq , Ahmad Ashfaq , Ali Amjad , Tabani Kashif Iqbal , Tunio Muhammad Zaib , Shah Saqib 
Published: February 2023

Objective: To compare the efficacy of supraclavicular brachial plexus block with patient-controlled intravenous analgesia (PCIA) for post-operative pain management in forearm surgery.
Study Design: Comparative Cross-Sectional Study.
Place and Duration of Study: Department of Anesthesia, Combined Military Hospital, Kharian Pakistan, from Sep 2018 to Nov 2019.
Methodology: Eighty-two adult patients, of ASA Class I and II, were enrolled and were randomly divided into two equal groups using computer-generated random numbers. General anaesthesia was administered to both groups. Additionally, Group-A (n=41) received supraclavicular brachial plexus block while Group-B (n=41) received patients-controlled analgesia. Post-operative pain was assessed using a 10 cm visual analogue scale (VAS). The pain scores were noted after complete recovery from general anaesthesia at 5 minutes, 6, 12 and 24 hours.
Results: The pain score was found to be significantly lower in Group-A (supraclavicular brachial plexus block) as compared to Group-B (patients-controlled analgesia) at 6, 12 and 24 hours (p<0.05) while the non-significant difference was noted at 5 minutes (p >0.05).
Conclusion: Significantly, better pain control was noted in supraclavicular brachial plexus block compared to patients’- controlled analgesia in post-operative pain management.
Comparison of Dexmedetomidine Plus Bupivacaine Versus Bupivacaine Alone for Spinal Anesthesia in Patients Undergoing Abdominal Hysterectomy
Authors: Ahmad Mirza Sijeel , Haider Syed Aftab , Adnan Ahmad , Sultan Atqua , Saleemi Muhammad Saleem , Khan Umer 
Published: February 2023

Objective: To determine the peri-operative analgesic efficacy and quality of block by adding Dexmedetomidine as an adjuvant to Bupivacaine for spinal anaesthesia in patients undergoing abdominal hysterectomy.
Study Design: Comparative cross-sectional Study.
Place and Duration of Study: Anesthesia Department, Nishtar Hospital, Multan Pakistan, Jan to Jun 2019.Methodology: A total of 100 women aged 30-65 years, who were planned for abdominal hysterectomy due to benign causes, and having ASA) status I-II were included. The patients were divided into two equal groups. In Group-B, 12.5mg of 0.5% hyperbaric diluted in 3ml normal saline was administered for induction of spinal anaesthesia. In contrast, in Group-B+D, 10µg Dexmedetomidine and 12.5mg 0.5% hyperbaric Bupivacaine diluted in 3ml normal saline were given. Time of sensory and motor block onset, total duration of the block, and analgesia were noted.
Results: The mean time of sensory and motor onset was significantly lower in the Group-B+D. The total duration of sensory block was 181.6±31.6 minutes in Group-B versus 345.2±23.5 minutes in Group-B+D (p-value <0.001). The total duration of the motor block was 142.9±8.6mins in Group-B versus 314.2±8.9mins in Group-B+D (p-value <0.001). Total analgesia duration was 129.4±8.3mins in Group- B versus 263.8±13.7mins in Group-B+D (p-value <0.001). A total of 2.54±0.35mg of rescue analgesia were required in Group- B versus 1.42±0.51mg in Group-B+D (p-value <0.001).
Conclusion: The use of Dexmedetomidine as an adjuvant to Bupivacaine for spinal anaesthesia shortens the onset and prolongs the duration of sensory and motor block and the total duration of analgesia.
Assessment of Nutritional Status of Patients on the Maintenance Hemodialysis at Tertiary Care Hospital using Malnutrition Inflammatory Score
Authors: Tahir Hasham Bin , Khan Malik Nadeem Azam , Tariq Rabia , Khan Raheel , Ahmed Bilal , Khan Hafiz Waleed 
Published: February 2023

Objective: To determine the frequency of protein energy wasting among end stage renal disease patients on maintenance hemodialysis.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Nephrology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from May 2019 to Mar 2020.
Methodology: Two hundered patients diagnosed with end-stage renal disease on maintenance hemodialysis were included in the study. Protein-energy wasting was assessed using the Malnutrition inflammatory score comprising four x components: medical history, physical examination, laboratory parameters and body mass index. Malnutrition inflammatory score was used to categorize protein-energy wasting.
Results: Out of 200 patients with ESRD on maintenance hemodialysis, 73(36.5%) patients had mild, 120(60.0 %) patients had moderate, and 7(3.5%) patients had severe protein-energy wasting. The advanced age group, multiple comorbid (diabetes mellitus, hypertension, ischemic heart disease), and duration of hemodialysis (> 2 years) had a statistically significant association with the protein energy wasting (p-value < 0.05). Protein-energy wasting was also more prevalent in patients with low monthly income (p-value 0.04).
Conclusion: Protein-energy wasting is common among patients with end stage renal disease on maintenance hemodialysis.Old age group, multiple comorbid, and duration of hemodialysis are important risk factors.
Comparison of Distally Based Sural Fasciocutaneous Island Flap with a nd without Inclusion of Sural Nerve
Authors: Samuel Tabish , Hameed Shahid , Majid Abdul , Naqvi Shahid Hussain , Faisal Shah , Mehmood Farman 
Published: February 2023

Objectives: To compare the inclusion and exclusion of the sural nerve in fascio-cutaneous flap repair for lower extremity reconstruction in terms of flap survival, flap size, recovery of skin sensation and complications.
Study Design: Prospective comparative study
Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital, Rawalpindi Pakistan, from Jul 2017 to Mar 2020.Methodology: A total of 54 patients (27 in each Group) requiring distal lower limb flap reconstruction and meeting the inclusion and exclusion criteria were included. Patients with a higher probability of flap complications and those with complications during the procedure were excluded. Group-A patients underwent fascio-cutaneous flap repair with sural nerve preservation, while Group-B patients underwent the same technique, but the sural nerve was transected and raised with the flap. All patients were followed for flap survival, flap size and degree of sensory recovery and flap-related complications.
Results: Varying degrees of return of sensation were seen in 25(92.6%) patients of Group-A after six months, which was 23(63.1%) in Group-B (p<0.001). Flap survival was comparable in both groups: 26(96.3%) and 25(92.6%) patients in Groups A and B, respectively (p=0.552). The complications were also comparable, 4(14.8%) in Group-A and (25.9%) in Group-B, which was not statistically significant (p=0.209).
Conclusion: Preservation of the sural nerve results in little or no sensory loss in the lateral part of the foot, with complication rates and flap survival comparable to cases where the nerve is sacrificed.Keywords: Distally based sural fascio-cutaneous Flap, Distal lower limb flap coverage, Sural nerve preservation.
Anaemia in Post-Menopausal Women-A Hidden Hunger
Authors: Shah Syed Umer , Hafeez Muhammad , Naveed Muhammad , Hussain Altaf , Khan Muhammad Shahid , Shahbaz Shanzah 
Published: February 2023

Objective: To determine the factors of iron deficiency anaemia among the post-menopausal women in our population.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Aug 2019 to Jan 2020.
Methodology: A total of 300 post-menopausal women were included in this study. Menopausal status was taken as one year after the last menstrual period. Iron deficiency anaemia was diagnosed, based on haemoglobin and ferritin levels. In addition,the relationship of age, age at menopause, comorbid medical illnesses and duration of menopause was assessed with the presence of iron deficiency anaemia among the post-menopausal women participating in this study.
Results: Out of 300 post-menopausal women studied in the given period, 124(41.3%) had no anaemia, while 176(58.7%) had the iron deficiency anaemia. Furthermore, 225(75.0%) had menopause after the age of forty, while 75(25.0%) had menopause after the age of forty. After applying the binary logistic regression analysis, we found that advancing age, longer duration since menopause and presence of medical comorbidities had a statistically significant association with anaemia in the target population.
Conclusion: This study showed a high frequency of iron deficiency anaemia among post-menopausal women. In addition, women with longer duration since menopause, advanced age and other medical illnesses were more at risk of having iron deficiency anaemia s compared to other women.
Aetiology and Outcome of Acute Kidney Injury Patients at the Nephrology Unit of Pak Emirats Military Hospital Rawalpindi
Authors: Ali Asif , Azam Khan Malik Nadeem , Ali Imran , Hussain Muhammad Zahid , Khan Muhammad Shahid , Sajid Yasmeen 
Published: February 2023

Objective: To assess the aetiology and outcome of patients admitted with acute kidney injury at the Nephrology Unit of Pak Emirates Military Hospital (PEMH).
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Nephrology Unit, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2019 to Jun 2020.
Methodology: Patients admitted with AKI were included in the study. The Kidney Disease: Improving Global Outcomes(KDIGO) clinical practice guidelines were used to diagnose acute renal injury based on creatinine level or urine output.
Results: A total of 300 patients were admitted to the Nephrology Unit with AKI during the study period. Sepsis was the commonest aetiology for acute kidney injury among the target population, followed by injury. 155(51.4%) patients were discharged, 53(17.7%) were stable in the ward, 70(23.4%) patients were shifted to the Critical Care Unit, and 22(7.3%) died.Long duration of hospital stay and the presence of multiorgan failure had a statistically significant relationship with poor outcomes in our study.
Conclusion: This study gives an insight into the aetiology and outcome of acute kidney injury among acute kidney injury patients admitted to the nephrology ward. Sepsis and injury were the commonest causes affecting renal function. Most of the patients had a good outcome. Patients with long hospital stays and multiorgan failure should be given special attention as they were more at risk of poor outcomes in our study.
Comparison of Post-Operative Pain in Mandibular and Maxillary 1st and 2nd Molars after Pulp Capping with Biodentine and Endosequence Root Repair Material as Pulp Capping Agent
Authors: Rana Muzammil Jamil , Rana Mehmood Ahmed , Islam Sadaf , Bangash Ajmal Yousaf , Bano Sara , Hamdani Sara 
Published: February 2023

Objective: To analyze and compare the response of human pulpal pain with Bio-dentine and Endo-sequence root repair material as pulp capping agents.
Study Design: Quasi-experimental study.
Place and Duration of Study: Operative Dentistry Department, Armed Forces Institute of Dentistry, Rawalpindi Pakistan,from Feb 2019 to Aug 2020.
Methodology: This study was performed on 100 maxillary and mandibular vital permanent molars with symptoms of reversible pulpitis. Patients were divided into two groups, with 50 patients in each group. In Group-A, Bio-dentine was used as a pulp capping agent whereas Endo-sequence root repair material was used for pulp capping in Group-B. Patients of both groups were then recalled after one week, one month and three months. A visual analogue scale was used to record the intensity of pain.
Results: In a sample size of 100 patients, 16% were maxillary first molars, 4% were maxillary second molars, 26% were mandibular second molars, and 54% were mandibular first molars. Between Groups A and B, four patients from Group-A (8%) and three patients from Group-B (6%) complained of pain of mild category (1-3), according to VAS. The rest of the patients remained asymptomatic at 1 and 3-months follow-up (p-value=0.695). Hence no significant difference was found in the post-operative pain following pulp capping with Bio-dentine and Endo-sequence root repair material.
Conclusion: Bio-dentine and Endo-sequence root repair material has comparable effectiveness. Hence, they can be used as suitable pulp capping agents.
Comparative Analysis of Outcome Between Extravesical and Transvesical Repair for Vesicovaginal Fistula
Authors: Ali Adnan , Shehzad Khubaib , Mirza Zahoor Iqbal , Ahmed Hussain , Tabassum Shazia , Changezi Nisarefatima 
Published: February 2023

Objective: To compare the surgical outcome of extravesical and transvesical repair of Vesicovaginal fistula.
Study Design: Prospective comparative study.
Place and Duration of Study: Armed Forces Institute of Urology, Rawalpindi Pakistan, from Jul 2019 and Jul 2020.
Methodology: Forty-two patients with vesicovaginal fistula were included in the study. The causes of the development of vesicovaginal fistula were evaluated. Half of the patients underwent extravesical and remaining transvesical repair. The results were compared regarding operative time, mean blood loss, complications and recurrence.
Results: The vesicovaginal fistula was secondary to prolonged obstructed labour 27(66%), with an iatrogenic cause 15(34%).Mean operative time for extravesical repair was 83.00±20.00 minutes and for transvesical repair was 60.00±20.00 minutes.71% patients undergoing extravesical repair experienced bladder spasms compared to 47% in the transvesical Group. Three cases suffered prolonged illeus in case of extravesical repair. The mean hospital stay for extravesical repair was 6.00±1.08 days,relatively more than transvesical, which was statistically significant (p-value <0.001)
Conclusion: Transabdominal approach for managing vesicovaginal fistula is the most preferred successful technique.
Determination of Lipid Derangements in Human Immunodeficiency Virus Patients Undergoing Anti-Retroviral Therapy
Authors: Bashir Qamar , Haroon Zujaja Hina , Asif Naveed , Alam Khan Muhammad Qaiser , Ghani Eijaz , Jaffar Syed Raza 
Published: February 2023

Objective: To determine lipid derangements in HIV-positive patients receiving anti-retroviral therapy (ART).
Study Design: Comparative cross-sectional study.
Place and Duration of study: Chemical Pathology Department, in cooperation with the Department of Virology at Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Mar 2019 to Mar 2020.
Methodology: In this study, two groups were made. In Group-1, lipid profile estimation was done in HIV patients without treatment. In contrast, lipid profile estimation was done after one year of treatment with anti-retroviral drugs in Group-2.
Results: One hundred and two HIV-positive subjects were included in our study. Of these patients, 88(86.27%) were males,and 14(13.73%) were females. Independent sample t-test revealed a statistically significant difference (p-value<0.05) in serum cholesterol, serum triglycerides, serum high-density lipoprotein (HDL-c), low-density lipoproteins (LDL) and very lowdensity lipoproteins (VLDL) between the two groups.
Conclusion: Hyperlipidemia in HIV patients getting anti-retroviral therapy (ART) exposes them to a high risk of coronary artery diseases and myocardial infarction. Hence lipid profile of patients getting ART must be regularly monitored, and hyperlipidemia, if present, should be managed.
Evaluation of Gram Stain Error Rates of Clinical Specimens
Authors: Sajjad Rabia , Zaman Gohar , Mirza Irfan Ali , Hussain Wajid , Khurshid Umar , Shehzad Asim 
Published: February 2023

Objective: To determine important errors in initial Gram staining of clinical specimens and evaluate the types of Gram-stain errors.
Study Design: Cross-sectional study.
Place and Duration of Study: Microbiology Department, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019.
Methodology: Gram staining and culture inoculation of all specimens were performed per recommended guidelines. The Gram stain results on day-0 were compared with the results of the culture on day-2. There was no discrepancy if similar organisms were obtained on culture as on Gram stain. Nevertheless, if the Gram stain and culture results were not similar, it was termed a discrepancy. The consultant microbiologist reviewed all discrepant slides, and if not resolved, possible causes of error were sought, and the results documented.
Results: Of the total 300 clinical specimens, errors were observed in the initial gram staining of 29 specimens (9.7%), whereas 271(90.3%) specimens were error-free. Upon evaluating these 29 errors, 11(38.0%) were observer errors which were resolved when reviewed by a consultant microbiologist. 14(48.0%) were technical errors, and 4(14.0%) results were discrepant due to the presence of anaerobic organisms, missed on initial aerobic cultures.
Conclusion: The frequency of Gram stain errors in our study (9.7%) is not very high; nevertheless, it can have severe consequences in critical samples from seriously ill patients if wrong empirical antimicrobial treatment is begun based on a wrong initial Gram stain result.
Comparison of Recurrence of Wrist Ganglion Following Aspiration and Injection of Steroid Versus Surgical Excision
Authors: Shah Syed Naqeeb Ullah , Panni Adnan , Bhatti Tanveer , Awan Malik Saeed , Ahmed Umair , Khattak Faheem 
Published: February 2023

Objective: To compare the frequency of recurrence after surgical excision versus aspiration and injection of Steroids of wrist ganglion
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of General Surgery at Combined Military Hospital, Kohat Pakistan, from Sep 2018 to Aug 2019.
Methodology: Seventy patients reported to the Outpatient Department, Combined Military Hospital, Kohat Pakistan, with complaints of ganglion and wanted treatment. Patients were randomly allocated into two Study Groups 1 and 2, by lottery method. Group-1 was treated by aspiration of the cyst contents followed by Steroid injection, while Group-2 was by excisionof the ganglion surgically under a local anaesthetic agent. The patient was followed up after three months to look for recurrence in both groups.
Results: The frequency of recurrence was 34.29% in Group-1 and 5.71% in Group-2, (p-value was less than 0.001).
Conclusion: Surgical excision results in lesser recurrence when compared with simple aspiration and Steroid injection for ganglion of the wrist.