bluuebunny/crossref_metadata_2025_split huggingface dataset:
Diagnostic Accuracy of Ultrasonography Versus Magnetic Resonance Imaging in the Detection of Endometrial Carcinoma Keeping Histopathology as Gold Standard
Authors: Ehsan Jovaria , Majeed Ayesha Isani , Haq M Ehsan ul , Riaz Ramish , Ehsan Asma , Ehsan Momna 
Published: September 2023

Objective: To calculate the diagnostic accuracy of Ultrasonography versus Magnetic Resonance Imaging in detecting endometrial carcinoma with histopathology kept as a gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Diagnostic Radiology, Pakistan Institute of Medical Sciences Hospital, Islamabad Pakistan, from Apr 2019 to Apr 2020.
Methodology: This study included patients of perimenopausal and post-menopausal age groups with abnormal uterine bleeding having a high index of suspicion for endometrial malignancy referred from the Gynecology department for an ultrasound examination. Patients having high suspicion for malignancy or inconclusive evidence on ultrasound were considered for Magnetic Resonance Imaging(MRI). All of them were followed for histopathological reports after surgical exploration. Clinical, sonological and Magnetic Resonance Imaging (MRI) findings, along with histopathological diagnosis, were documented.
Results: Mean age of the patients was 56.58±10.28. Of these eight patients, 8(21.1%) did not have carcinoma upon histopathology. The most common type of carcinoma was poorly differentiated endometrial adenocarcinoma. The diagnostic accuracy of ultrasound was found to be 47.35%, while that for Magnetic Resonance Imaging (MRI) was 71.05%. Sensitivity and specificity for Ultrasound versus Magnetic Resonance Imaging (MRI) were 53.33% versus 66.67% and 75% versus 87.50%, respectively. The mean endometrial thickness on ultrasound was 15.97±5.64 mm, while on MRI was 15.42±6.9 mm.
Conclusion: Magnetic Resonance Imaging (MRI) is a more accurate and sensitive modality in detecting endometrial carcinoma in patients with abnormal uterine bleeding.
Clinical Significance of Delta Neutrophil Index as Diagnostic Indicator for Patients in Sepsis
Authors: Sarwar Nozaif , Iqbal Muhammad , Sajjad Zunera , Shoaib Muhammad , Hussain Korejo Saqib , Chaudhary Umer 
Published: September 2023

Objective: To determine the clinical significance sof Delta Neutrophil Index (DNI) in diagnosing sepsis.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Pathology, Pakistan Navy Ship, Shifa Hospital, Karachi from Jan to Jun 2020.
Methodology: The study included one hundred and fifty patients with systemic inflammatory response syndrome (SIRS) sadmitted to the medical intensive care unit (ICU). Delta Neutrophil Index (DNI) is the difference in leukocyte sub-fractions recognized by myeloperoxidase reactive cells and nuclear lobularity channels. A specific blood cell analyzer measured DNI, and a cut-off of 2.7% was used to diagnose the sepsis. Positive blood culture was considered the gold standard.Results: The Delta Neutrophil Index (DNI) showed a sensitivity of 72.2% and a specificity of 97.6%, respectively. The area under the receiver operating characteristics curve (ROC) was determined to be 0.82(0.81–0.94). The threshold efficiency was 2.5 per cent for the highest diagnostic accuracy.
Conclusion: As an early diagnostic measure for evaluating patients with septicemia, the Delta neutrophil index can be a reasonable and effective indicator and should be encouraged in regular screening programs.Keywords: Delta neutrophil index, Immature granulocyte, Infectious disease, Systemic inflammation, Sepsis
Evaluating Skills and Confidence Status of House Officers in Managing Dental Patients: A Mixed Method Study in a Private Dental Institute of Karachi
Authors: Buksh Hudebia Allah , Usmani Ambreen , Shaikh Sirajul Haque 
Published: September 2023

Objective: To evaluate the skills and confidence status of house officers in managing dental patients.
Study Design: Mixed method (Sequential-explanatory) study.
Place and Duration of Study: Altamash Institute of Dental Medicine, Karachi Pakistan, from Mar 2019 to Mar 2020.
Methodology: A self-administered questionnaire was developed for the 1st phase of the study. After validation from the content experts, a pilot test was run on 18 house officers before administering the questionnaire. It included 46 dental procedures; participants rated their skills and confidence in performing them using a Likert scale of 1 to 5 points ranging from poor to excellent. In the 2nd phase, sixteen face-to-face interviews were conducted to explain the reasons for acquiring skills and confidence status.
Results: The response rate was 100%. Fifty-eight house officers filled out the questionnaire. Participants with multiple rotations reported significantly above average confidence status with multiple rotations of retainer insertion (81%), treatment of malocclusion using removable appliances (82%), fissure sealants (78%), anterior endodontic (80%), posterior amalgam (69%), oral hygiene (69%), and diagnosis of caries (67%), TMJ disorders (69%), rubber dam placement (71%) and properly prescribed recommended medicine (65%) when compared to the single rotation. The most important high-confidence status themes in evaluating skills were practising the procedures and internal motivation.
Conclusion: Multiple rotations with repeated practice sessions enhanced house officers' skills and confidence status.Procedures that were least practised scored the lowest in overall mean confidence.Keywords: Confidence status, Curriculum, Dental graduates, Dental procedures, Evaluation, House officers, Skills.
Comparative Assessment of Patient’s Acceptability between Hawley and Vacuum-Formed Retainer in Patients Treated with Fixed Orthodontics Appliance
Authors: Bibi Khadija , Jan Abdullah , Hameed Munza , Afgan Nimra , Alamzeb Haseeb , Malik Sundas 
Published: September 2023

Objective: To compare the acceptability of Vacuum-formed Retainers and Hawley Retainers in two groups of fixed orthodontics patients over three months.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Jan 2019 to Mar 2020.
Methodology: Eighty-two Patients treated with fixed orthodontics appliances in the department of orthodontics of Armed Forces Institute of Dentistry, who met the inclusion and exclusion criteria were recruited for the study. Patient acceptance was evaluated through a ten-question questionnaire regarding biting, fitting, hygiene, speech, swallowing, appearance, selfconfidence, gingival irritation, durability and comfort. Patients were evaluated on a 10cm long Visual analogue scale over three months in the post-orthodontics retention phase, after one week (T1), one month (T2) and three months (T3) of follow-up.
Results: The vacuumed-formed retainer was significantly better in terms of speech (p<0.01), appearance (p<0.001), durability (p<0.001), gingival irritation (p<0.001), swallowing (p<0.001), self-confidence, and comfort (p<0.001). There was no significant difference in terms of fitting, hygiene and biting.
Conclusion: The vacuumed-formed retainer was significantly better accepted in terms of speech, swallowing, appearance, self confidence, durability, gingival irritation and comfort.
Efficacy of L-Ornithine L-Aspartate in Recovery of Patients Suffering from Acute Viral Hepatitis
Authors: Bilal Ebtihal , Burney Shamaila , Sajid Muhammad Usman , Zulfiqar Asim , Farooq Muhammad , Shaukat Nabila 
Published: September 2023

Objective: To assess the efficacy of L-Ornithine L-Aspartate (LOLA) compared with non-LOLA Group in the recovery of patients with acute viral hepatitis.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of General Medicine, Railway Hospital, Rawalpindi Pakistan, from Aug 2020 to Jan 2021.
Methodology: All patients of either gender, aged >18 years with acute viral hepatitis were included. All patients were divided into two groups. LOLA-Group (Group-A) was given as an infusion over 24 hours at a dosage of 300 grams for three consecutive days. Whereas Group-B had patients to whom L-Ornithine L-Aspartate (LOLA) was not administered. The efficacy was defined as no signs and symptoms in comparison to baseline (clinical improvement), LFTs improved to more than half compared to baseline, and INR was <1.2 at seven days’ follow-up.
Results: Of 128 patients, the median age was 28 years (20-32). A significant median difference in total bilirubin on the seventh day (p-value 0.044) was observed for the L-Ornithine L-Aspartate (LOLA)-Group. In addition, the efficacy was found to be significantly higher among patients in the Control Group as compared to the patients in the Treatment Group, i.e., 54(84.4%) and 40(62.5%), respectively (p-value 0.005).
Conclusion: This study showed that the outcome of L-Ornithine L-Aspartate (LOLA) is not very effective in managing patients with acute viral hepatitis.
Ligament Reconstruction in Patients Operated Arthroscopically with Bone-Patellar Bone Graft Using Lysholm Score
Authors: Rehman Khalil Ur , Inam Shahzad , Rehman Atiq Ur , Javid Mohsin , Khan Idris , Akbar Syed Arsalan 
Published: September 2023

Objective: To assess the mean Lysholm score after arthroscopic anterior cruciate ligament Anterior Cruciate Ligament (ACL) reconstruction with a bone-patellar tendon-bone graft.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Orthopaedic, Combined Military Hospital, Peshawar Pakistan, from Oct 2020 to Apr 2021.
Methodology: Arthroscopic anterior cruciate ligament reconstruction with bone-patellar tendon-bone graft was performed in 70 patients. Baseline characteristics were recorded, and patients were followed up for six months. Functional outcome was determined using the Lysholm score.
Results: The mean age of patients was 32.38±11.83 years. The majority, 59(84.3%) of the patients were males. Of the 70 patients, 36(51.4%) had a right knee involved. The mean Lysholm score at baseline was 50.46±6.93. At six months, a Lysholm score of 85.49±9.05 was recorded, and the mean difference was found to be statistically significant (p<0.001) using paired t-test.
Conclusion: Significant change in Lysholm score at six months was observed in the study sample. Reconstructing the anterior cruciate ligament with a bone-patellar-tendon bone graft improved the Lysholm score and, thus, functional outcome.Keywords: Anterior cruciate ligament reconstruction (ACL); Arthroscopy, Bone-patellar tendon-bone, Lysholm score.
Frequency of PDGFRA, PDGFRB and FGFR1 Gene Rearrangements in Patients with Eosinophilia and Their Clinico-Haematologic Parameters
Authors: Jalil Saniya , Robert Helen Mary , Saeed Hamid , Abbasi Asad Mehmood , Latif Aamna , Sardar Annum 
Published: September 2023

Objective: To determine the frequency and clinico-haematological features of PDGFRA, PDGFRB and FGFR1 gene rearrangements in patients with persistent Eosinophilia using Fluorescence in situ hybridization.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Dec 2018 to Dec 2019.
Methodology: All Patients who presented to AFIP having absolute eosinophil count >1.5x109/L persistent for over six months or with Myeloid or Lymphoid neoplasms with persistent Eosinophilia were studied. Patients having reactive Eosinophilia and those on treatment were excluded. Interphase FISH studies were performed. In addition, 2.5ml of sodium heparin blood was taken. After the denaturation of DNA, slides were set up according to standard protocol. FIP1L1/CHIC2/PDGFRA dual colour probe was applied for PDGFRA, 5q32 PDGFRA break apart probe for PDGFRB and XL FGFR1 break apart probe for FGFR1 gene rearrangement.
Results: A total of 60 patients were included in the study. Of these, 50(83.3%) were males, and 10(16.7%) were females, with an average absolute Eosinophilia count of 5.92±7.10x109/L. The only rearrangement detected in patients with Eosinophilia was FIPILI-PDGFRA gene fusion, detected in 20% of the patients. No other rearrangement was found.
Conclusion: PDGFRA, PDGFRB and FGFR1 mutations are rare yet most prominent in patients with clonal Eosinophilia. About 80% of eosinophilic patients were found to have idiopathic Eosinophilia, which requires further consideration to address the disease prevalence.
Pre-Hospital Delaying Factors in Patients of Acute Ischemic Stroke who are Candidates for Thrombolytic Therapy
Authors: Ali Kamran , Nawaz Khurram Haq , Hassan Wahaj Ul , Waqar Raja Muhammad 
Published: September 2023

Objective: To identify and statistically evaluate pre-hospital delaying factors for thrombolysis in Acute Ischemic Stroke (AIS).
Study Design: Cross-sectional study.
Place And Duration OF Study: Emergency/Neurology Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Dec 2020 to Mar 2021.
Methodology: Patients older than 18 years and who reported to the emergency/Neurology clinic with stroke symptoms were included in the study. The patients or their relatives were interviewed with a detailed questionnaire that recorded patients' National Institute of Health Stroke Scale and other socio-demographic variables. In addition, the patients were grouped based on time of arrival to the hospital: Early (<4.5 hours) and Late (>4.5 hours), and the variables recorded were compared with each other.
Results: Of 98 patients, 71(72.5%) arrived early, and 27(27.5%) arrived late. Seventy patients (72%) were male, and 28(28%) were female. Only 18 patients availed of the ambulance service, whereas the rest of the study participants reached the hospital using private transportation.
Conclusion: Female gender, NIHSS score of 10 or below and using transport other than ambulance adversely affect the hospital arrival time of acute ischemic stroke patients.
Comparison of Total Thyroidectomy with Ligasure Small Jaw Device and Harmonic Scalpel
Authors: Salamat Zaki Hussain , Majid Muhammad , Ali Liaquat , Ali Hafiz Asghar , Yasin Talha 
Published: September 2023

Objective: To compare our experience with the LigaSure small jaw device and Harmonic scalpel in total thyroidectomy regarding operative time and major complications associated with surgery.
Study Design: Prospective comparative study.
Place and Study Duration: General Surgery Department, Pak Emirates Military Hospital, Rawalpindi and Combined Military Hospital, Kohat Pakistan, from Oct 2017 to Apr 2020.
Methodology: This study included 150 patients diagnosed with simple/toxic multinodular goitre, thyroid carcinoma, and diffuse thyroid enlargement. Eighty-one patients were randomly assigned to the LigaSure Group and 69 to the Harmonic Group who underwent total thyroidectomy. Mean operative time and major complications like blood loss, hematoma, hypocalcemia, recurrent laryngeal injury, and surgical site infection were compared.
Results: Median (IQR) operative time of the LigaSure small jaw device was 55.00(11) minutes, and that of the Harmonic scalpel was 60.00 (11) (p<0.001). The postoperative hematoma formation in the LigaSure small jaw device was 1(1.2%), and that in the Harmonic scalpel Group was 0(0%) (p=0.35). There was no bilateral nerve injury in both Group. The percentage of hypocalcemia (second postoperative day to seventh postoperative day) in the LigaSure small jaw device was 2(2.5%), and that in the Harmonic scalpel Group was 2(2.9%) (p=0.9).
Conclusion: The mean operative time of Thyroid surgery with a LigaSure small jaw device is less than that with a Harmonic scalpel. There is no difference in intraoperative blood loss and postoperative complications between them.
Sonographic Relation between Adnexal Masses and Endometrial Thickness in Infertile Females with Hormonal Imbalance
Authors: Yousaf Farooq Syed Muhammad , Gilani Syed Amir , Tul Sughra Syeda Khadija , Iqbal Amjad , . Mahjabeen , Abidin Syed Zain ul , Jallad Lina Khaled 
Published: September 2023

Objective: To determine the sonographic relation between adnexal masses and endometrial thickness in infertile females with hormonal imbalances.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Radiology, Gilani Ultrasound Center, Jamiat Hospital & Green Town Clinic, Lahore Pakistan, from Mar 2019 to Jan 2020.
Methodology: In this study, 150 infertile females with adnexal masses, aged 18 to 45, were included. Data were collected according to the age, adnexal masses, endometrium thickness, and type of infertility hormonal levels. The endometrium thickness was measured in the sagittal plane at the thickest echogenic area from one basal endometrial interface across the endometrial canal to the other basal surface.
Results: The mean age was 32.55±6.33 years. Out of 150 patients, 97 patients with abnormal and 53 were with normal hormonal levels. Follicular cysts (33%), Polycystic ovarian syndrome (29.9%) and 23.7% hemorrhagic cysts were found with abnormal hormonal levels.
Conclusion: There was a significant correlation between adnexal masses and endometrial thickness in infertile females with abnormal hormonal levels.
Evaluation of Serum Estrogen, Progesterone, Prolactin and Testosterone in Patients of Melasma
Authors: Kanwal Shamsa , Rehman Farid ur , Qureshi Sana Waqar , Khan Rab Nawaz , Jehanger Amna , Yousaf Muhammad Javad 
Published: September 2023

Objective: To evaluate the estrogen, progesterone, Prolactin and testosterone serum levels in melasma patients.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Dermatology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from Jul to Dec2020.
Methodology: A total of 40 patients with melasma and 40 without melasma were included in this study. The study comprisedfemale melasma patients aged 20 to 50 years old. All participants were tested for serum estrogen, progesterone, Prolactin andtestosterone levels using immunoassay in the follicular phase (9th day) of the menstrual cycle.
Results: The statistically significant increase in serum progesterone (p=0.001) was found in patients with melasma. Asignificant decrease in prolactin levels (p=0.0001) was found in patients with melasma. No association was found betweenGroup-1 and Group-2 regarding serum estradiol and testosterone (p=0.070 and p=0.461 respectively)
Conclusion: Patients with melasma have increased progesterone levels and decreased serum prolactin levels.
Diagnostic Accuracy of Elastography to Differentiate Between Benign and Malignant Lymph Nodes of Head and Neck Region taking Histopathology as the Gold Standard
Authors: Rasheed Bhutta Muzammil , Majeed Ayesha Isani , Khan Amir , Zafar Ibtesam , Azad Hina , Akhtar Samina 
Published: September 2023

Objective: To estimate the diagnostic accuracy of Elastography to distinguish between benign and malignant lymph nodes of the head and neck region; taking histopathology as the gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: Radiology Department, Pakistan Institute of Medical Sciences, Islamabad Pakistan, from Jul to Oct 2021.
Methodology: Elastography, Color Doppler and B-mode ultrasound were used to examine fifty participants with enlarged cervical lymph nodes. Elastographic forms (1–5) were characterized based on the hard area in the cervical lymph nodes. In addition, the shear wave elastography of cervical lymph nodes was evaluated. Outcomes of diagnostic sono-elastographic parameters were matched with the histopathology of lymph nodes as a reference of standard.
Results: The mean age of patients was 30.50±8.95 years. Out of 50 patients, 31(62%) were men, and 19(38%) were women. Out of 50 patients enrolled, 29(58%) showed benign lymph nodes, while 21(42%) showed malignant lymph nodes on elastography.All 50 patients underwent a biopsy for histopathology.
Conclusion: Ultrasound elastography has high diagnostic accuracy in differentiating benign from malignant lymph nodes. Therefore, it can be used as a reliable and non-invasive modality for diagnosing lymphadenopathy in the cervical region.Keywords: Cervical, Elasticity imaging techniques, Elastography, Lymph nodes, Lymphadenopathy, Neck, Ultrasound
The relationship between the medial longitudinal arch and lower back disability among vocational school dancer
Authors: Ni Putu Diyah Ayuningtiyas  , Made Hendra Satria Nugraha  , Anak Agung Gede Angga Puspa Negara  , Ni Komang Ayu Juni Antari  
Published: September 2023

Background: Gianyar is one of the districts in Bali, Indonesia, that still maintain customs and traditions in ceremonies and rituals carried out as an implementation of culture. To support these activities, the performing arts commonly presented are traditional dance. The various foot movements in traditional dance will undoubtedly be a problem if there is a deformity in the foot. There is a phenomenon where abnormalities in the shape of the arch of the foot can potentially cause lower back disability. Deformities in the arch of the foot can affect the gait cycle, leg length, and the arrangement of the pelvic bones, which can trigger lower back pain.
Objective: The purpose of this study was to determine the relationship between the medial longitudinal arch and lower back disability in traditional dancer
Methods: This study is an analytical observational study with a cross-sectional research design conducted in December-January 2023. The study subjects were 74 students from Vocational School 3 of Sukawati. Majoring in traditional dance, aged 15 to 18 years, with a non-probability sampling technique using purposive sampling.
Results: The researchers conducted anamnesis and examination according to inclusion and exclusion criteria and then observed the presence of a flat foot by measuring the Clarke angle value. The analysis used was bivariate analysis with the Spearman correlation test. The bivariate analysis results showed a significant relationship (p=0.000) between the medial longitudinal arch and lower back disability in traditional dancers at Vocational School 3 of Sukawati, with a muscular correlation strength and negative correlation coefficient value of -0.705.
Conclusion: There is a significant relationship between the medial longitudinal arch and lower back disability in traditional dancers at Vocational School 3 of Sukawati.
Relationship between a sitting position and complaints of nonspecific low back pain among the Buton Sorong weavers
Authors: Zulima Zainul Muhlisi Mahfud , Utama Anak Agung Gede Eka Septian , Saraswati Putu Ayu Sita , Andayani Ni Luh Nopi 
Published: September 2023

Background: Weaving has risk for experiencing nonspecific low back pain (LBP) that caused by bad posture and prolonged sitting duration. Poor sitting position causes musculoskeletal disorders, one of which is pain. Complaints of pain that is felt in the waist, causing functional limitation of movement when moving due to postural errors, are called nonspecific LBP. Weavers with good body positions have a low risk of nonspecific LBP complaints and increased productivity. This study aimed to determine the relationship between sitting position and nonspecific LBP complaints in Buton Sarong weavers in Baubau City.
Methods: This study used an analytic observational research design with a cross-sectional approach. The research subjects were taken using probability and purposive sampling techniques. The independent variable measured was the sitting position using the rapid entire body assessment (REBA). The dependent variable measured was nonspecific LBP using a physiotherapy history-taking process.
Results: There were 63 weavers in this study, 51 people (81%) had a low sitting position, and 12 (19%) had medium risk. The Spearman's rho non-parametric analysis test showed no relationship between sitting position and nonspecific LBP complaints in this population (p=0.819).
Conclusion: There is no significant relationship between sitting position and nonspecific LBP complaints.