bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Predictive Value of CHADS-VASC Score in No-Reflow Phenomenon in Primary Percutaneous Coronary Intervention
Authors: Farahe Ali , Samore Naseer Ahmed , Ali Azhar , Shafique Hafiz Muhammad , Tariq Muhammad Naeem , Shabbir Saddaf , Kamran Javeria , Azad Naseem 
Published: December 2022

Objectives: To determine the role of CHADS-VASc Score in predicting No Reflow phenomenon in STEMI patients undergoing primary PCI.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: This study was carried out at a Tertiary Cardiac Care Center from Feb to May 2022.
Methodology: A total of (n = 320) patients who underwent PPCI at Armed Forces Institute of Cardiology from 4th February to 3rd May 2022 were enrolled in this study. Patients were divided into 2 groups, Comparision group with no NRP and NRP group. Descriptive statistics was run to present the categorical data in frequencies and percentages and continuous data in Mean±SD. Chi square test was applied to compare both groups regarding categorical and continuous variables. CHADS-VASc score was also compared in both groups.
Results: Out of (n=320) patients, 80(25%) patients developed NRP. Age, Diabetes, LV EF, history of stroke or TIA, peripheral arterial disease, TIMI thrombus grade, total stented length and CHADS-VASc score were found to be significantly associated with NRP. Binary logistic regression analysis revealed diabetes, LV EF, TIMI thrombus grade, total stented length and CHADSVaSc score to be independent predictors of NRP.ROC analysis revealed a cutoff CHADS-VaSc score of 3 to be a good predictor of NRP (sensitivity 65% and specificity 82%).
Conclusion: CHADS-VASc score can be an important pre PCI tool to predict NRP during primary PCI.
Patterns of Left Ventricular Hypertrophy and Late Gadolinium Enhancement onCardiac Magnetic Resonanace in Patients with Hypertrophic Cardiomyopathy
Authors: Mehreen Sobia , Ahmed Adeel , Sidiqqui Abdul Hameed , Maken Ghulam Rasool , Jokhio Abdul Rehman , Shiram Syed Ali , Kamran Javeria , Saeed Nazish , . Waqar , Khan Ismail Ahmed 
Published: December 2022

Objective: To evaluate the patterns of left ventricular hypertrophy (LVH) and late gadolinium enhancement (LGE) inhypertrophic cardiomyopathy.
Study Design: Analytical cross-Sectional Study.
Place and Duration of Study: Tertiary Cardiac Care Center, Rawalpindi Pakistan from 01 June 2020 to 30 Dec 2021.
Methodology: This study was carried out at a tertiary cardiac care center retrospectively from 1 June 2020 to 31 December 2021. Patients having LV hypertrophy due to aortic stenosis, hypertension, athlete’s heart, and infiltrative disorders were excluded from study. Cases were included using nonprobability consecutive sampling. Sample size estimated by taking 0.2- 0.5 % (1 in 200-500) prevalence of hypertrophic cardiomyopathy using open epi sample size calculator was (n=38) taking 99.99% confidence interval. For the purpose of study all patients with confirmed HCM undergoing CMR during given period were included in study.Approval from the ethical review committee with IERB (IERB letter # 9/2/R&D/2022/179) was sought. CMR was performed using MRI 3 Tesla. Data analysis was done on SPSS version-26. Quantitative variables were expressed as Mean±SD. Qualitative variables were expressed as frequencies and percentages. ANOVA and student t-test (95% CI and 5% margin of error) was applied to compare the study variables. p-vale <0.05 was considered statistically significant.
Results: Majority 77(86.7%) of patients were males. Most common pattern of involvement for LV hypertrophy was asymmetrical septal hypertrophy in 47 (52.8%) followed by apical HCM in 29(32.6%). LVOT obstruction was observed in 30(33.7%) of patients. Mean maximum LV wall thickness was 22mm±5.47.
Conclusion: Our study shows association, between the extent of Late Gadolinium Enhancement and LV wall thickness, myocardial mass index in HCM patients.
Echocardiographic Findings in Hemodialysis Patients in a Tertiary Care Hospital
Authors: Balqees Nayab , Hussain Sajjad , Yusuf Rizwan , Din Mir Jalal-ud- , Ali Jahanzab , Muzaffar Tabasum , Khalil Hafsa , Naseem Shaista , Sana Ayesha 
Published: December 2022

Objective: To find out the echo abnormalities in a south Asian cohort on maintenance hemodialysis in a tertiary care hospital.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Combined Military Hospital Abbottabad, from Feb 2022 to Apr 2022.
Methodology: 57 adult patients on maintenance hemodialysis had a non-contrast transthoracic echocardiographic study recording parameters of left and right ventricular systolic and diastolic function.
Results: We had 57 patients. 71.9% (n=41) were male, and females 28.1% (n=16), diabetics 47.4 % (n=27), hypertensives 84.2%(n=48), smoking 28.1% (n=16); 15.8%(n=9) had some form of ischemic heart disease. Left ventricular hypertrophy was noted in 78.9% (n=45) of the entire patient population. 84% (n=48) of hypertensive patients had LVH. Overall, 82% (n=47) of hypertensive patients had some degree of diastolic dysfunction compared to non-hypertensive patients (p<0.0001). Diastolic dysfunction of Grades I, II, III was seen in 35.1%(n=20), 29.8%(n=17), 17.5% (n=10). Mean E/e' ratio was 24.9±15, with 40.3%(n=23) having a value ≥15. The LV systolic dysfunction noted was: Mild 26.3%(n=15), Moderate 19.3%(n=11), Severe 1.8%(n=1). For the medial mitral annular systolic velocity(s’) 19.3%(n=11) had normal s’, while 80.7%(n=46) had reduced s’.The mean Pulmonary artery acceleration time (PA-AT) was was <100 ms in 68.4%(n=39). The mean tricuspid plane systolic excursion (TAPSE) was < 17 mm in 19.3%(n=11) of patients indicating RV systolic dysfunction. The Minimum PASP was 16, max 64, mean 41.5±14mm Hg.
Conclusion: In our study of CKD patients on regular hemodialysis, we found high rates of LVH, DD, LV systolic dysfunction,RV systolic function, and pulmonary hypertension. This creates a case for a larger scale study of these patients in a south Asian cohort as well as institution of a screening program in CKD patients on hemodialysis.
Comparison of Two Techniques of Measuring Activated Clotting Time During Cardiac Surgery
Authors: Alam Waqas , Hussain Syed Aqeel , Ali Muhammad , Akram Muhammad Adnan , Farooq Muhammad Umar , Masroor Rehan , Khalil Hafsa , Sana Ayesha 
Published: December 2022

Objective: To compare two techniques of activated clotting time (ACT) measurement by two different devices to evaluate the correlation and agreement between these techniques at different points of time during cardiac surgery.
Study Design: Comparative Cross-sectional Study.
Study settings: Cardiac Anesthesia Department, Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi Pakistan, from Feb 2022 to Apr 2022.
Methodology: 100 patients undergoing CABG surgery on pump were included by non-probability consecutive sampling technique. Two devices operating on different techniques of measurement were used to measure ACT at four different points of time during surgery. Same sample was used to measure ACT from both devices. Data was collected and analysed by SPSS V.20.0. Pearson's chi square test and paired sample t-test were applied to measure the significance. Linear regression analysis was done to find correlation and Bland Altman plot was used for checking agreement between ACT values from both devices.p-value less than 0.05 was considered significant.
Results: Out of 100, male patients were 79 and female patients were 21. Their mean age was 54.18±11.91 years and mean weight was 79.06±18.49 kg. Moderate positive correlation was found with Pearson r value of 0.55. There was poor agreement between the ACTs measured by two devices. On average Hem R measures ACT 63.54±50.83 seconds higher than Hem JSP. Average mean and median values for Hem R group are 400.03±59.39 sec and 397.75sec respectively and for Hem JSP group are 336.49±44.63 sec and 340.5 sec respectively.
Conclusion: There is moderate positive correlation but poor agreement between the values of ACT measured by Hem R and Hem JSP due to different techniques of measurement so these should not be used interchangeably.
Pre-operative N-Acetyl Cysteine for Prevention of Atrial Fibrillation After CABG Surgery in Pakistan
Authors: Shah Syed Ali Raza Ali , Hasan Kirmani Syed Muzaffar , Hussain Syed Aqeel , Khalil Hafsa , Naqvi Syeda Sarah , Zahra Kirmani Syeda Khursand 
Published: December 2022

Objective: To determine the effect of NAC in prevention of post-operative atrial fibrillation in patients undergoing CABG.
Study Design: Quasi experimental study.
Place and Duration of Study: Adult Cardiac Intensive Care Unit, Armed Forces Institute of Cardiology & National Institute of Heart Diseases (AFIC&NIHD) Rawalpindi during 6 months.
Methodology: 146 patients of both gender undergoing elective CABG were included in the study, having age between 30-70 years. However, any patient with history of arrhythmia including AF, thyroid dysfunction, ejection fraction less than 25%, any valvular lesion, dilated left atrium, dilated left ventricle, dilated right atrium, dilated right ventricle or having right atrial tear during surgery were excluded from the study. By using non-probability consecutive sampling, patients were divided into two groups by using envelope method. One group was given standard treatment (control group) while other group was named as NAC group (experimental group). Data analysis was performed using SPSS version-23. Descriptive statistics were reported as Mean±SD. Categorical variables were reported as frequency and percentage. Chi square test and T-test was used to determine association between different variables.
Results: A total of 146 patients with mean age 55.27±7.3 yrs. 127(87%) were male and 19(13%) were females. 28(19.2%) patients had atrial fibrillation while 11(7.5%) patients had ventricular premature contractions (VPC). There was no statistically significant difference between ages (p=0.784), gender (p=0.461), AF (p=0.207) and VPC (p=0.347). Out of 73 (50%) patients from each group; the mean age of NAC group was 55.41±7.3 yrs and of control group was 55.08±7.1 yrs (p=0.784). Gender wise distribution of NAC group had 8(11%) females and 65(89%) males while in control group 11(15%) females and 62(85%) were males. AF was found to be 11(15%) and 17(23.3%) in NAC and control group respectively. In NAC group, VPC was 4 (5.5%) and in control group it was 66 (90.4%).
Conclusion: This study shows that NAC decreases the frequency of post-operative atrial fibrillation and ventricular premature contractions, but the decrease is statistically insignificant in Pakistani population. However, keeping in view other beneficial effects of NAC, we would recommend more studies on this subject in Pakistani population.
Frequency of Delirium Associated with Dexmedetomidine and Propofol in Post CABG Patients: A Comparative Study
Authors: Ain Noor-Ul- , R Hasan Kirmani Syed Muzaffar , Siddique Ayesha , Siddique M Umer , Javaid Rehana , Khan M Aamir 
Published: December 2022

Objective: To find out the frequency of delirium associated with peri-operative use of dexmetedomidine and propofol in post CABG patients.
Study Design: Comparative Cross-sectional study.
Place and Duration of Study: Adult Intensive Care unit, Department of Cardiac Anesthesiology and Intensive Care, Armed Force Institute of Cardiology, Rawalpindi Pakistan from Feb to Jun 2022.
Methodology: All post CABG patients who have undergone elective surgery were included through non-probability consecutive sampling technique. All the delirious patients amongst them were subjected to a modified version of ICU-CAM to establish post-operative delirium (POD) caused by either dexmedetomidine or propofol. POD in both the category of patients was compared.
Results: A total of 179 CABG patients were included in our study. 140(78.2%) of the patients were subjected to the use of dexmedetomidine throughout their surgery while 39(21.8%) of the patients were given propofol. After subjecting the patients to our exclusion criteria which aimed to eliminate the confounding causes of POD in post-CABG patients, only 30(16.8%) had delirium while 149(83.2%) didn’t develop delirium (p-value=0.003). Majority of the delirious patients were given dexmedetomidine (n=29; 20.77%) in the operation theatre while only a fraction (n=1; 2.58%) were given propofol. Average duration of ICU stay in our study population was 5 days. 15(8.4%) cases out of our total study population underwent reintubation and re-ventilation because of low cardiac output or respiratory distress.
Conclusion: Dexmedetomidine could possibly be associated with POD in patients undergoing cardiac surgery. Propofol on the other hand is considerably safe in this regard and doesn’t cause POD.
Recording the Door-To-ECG Time for Patients Presenting with Acute Chest Pain to a Cardiac Emergency Unit: A Clinical Audit and Quality Improvement Project
Authors: Sami Ashar , Maqsood Sarah , Iqbal Usman , Safdar Haadia , Khalil Hafsa , Yasir Saad Bin , Khan Aleena , Shafique Hafiz Muhammad , Javaid Rehana , Sana Ayesha 
Published: December 2022

Objective: To measure the door-to-ECG time of patients presenting with chest pain at a Cardiac Emergency Unit.
Study Design: Descriptive Cross-Sectional.
Place and Duration of Study: Armed Force Institute of Cardiology/National Institute of Heart Disease, Emergency Department (ER) from Feb2022 to Apr 2022.
Methodology: A total of 170 patients presenting to the ER with chest pain were reported. Their demographics were entered alongside the nature (cardiac/non-cardiac) and duration of their chest pain after which the time the first ECG strip was drawn till the time it was interpreted by a doctor (Door-To-ECG time) was recorded on a questionnaire. The patients were categorized in 4 different groups based on their ECG findings and were followed till their clinical decisions (PCI/Admission/Discharge/Referral) within the ER were made.
Results: Out of 170 patients, 101(59.4%) had a door-to-ECG time within 10 minutes. Amongst these 101 patients, 23(22.7%)patients were diagnosed with STEMI and shifted for PCI, 15(14.8%) had NSTEMI and were admitted for management,41(40.6%) had cardiac chest pain without ECG changes and were admitted for workup while 22(21.8%) had non-cardiac chest pain and were discharged with out-patient follow-up or referred elsewhere. Non-availability of a bed in the emergency department accounted for the majority (49.3%) of the patients whose door-to-ECG time was more than 10 minutes while a higher ratio of patients that needed to be attended by doctors was identified as the second most common cause of delay(31.9%).
Conclusions: Our findings suggest that the door-to-ECG time recorded for patients at our setup was almost 10 minutes....
Effect of Moderate Exercise Training on Vitals and Peak VO2 in Different Age Categories of Adults in COVID-19 Pandemic
Authors: Saleem Nayab , Sana Ayesha , Murtaza Farah , Ahmed Hina , Saleem Mahrukh , Agha Sharmen , Malik Mubina , . Alveena , Azad Naseem 
Published: December 2022

Objective: To determine the effect of moderate exercise training on vitals i-e., Blood pressure (Systolic and diastolic), Pulse Rate(PR), Respiratory Rate(RR) and Peak VO2 in different age categories of adults during COVID-19 pandemic.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: This study was carried out at a tertiary cardiac care center from Feb 2021 to May 2021.
Methodology: It was a descriptive cross sectional study conducted generally for 6 months in tertiary care center. A total of 104 participants were included and divided into three groups i-e., Young adults (17-30 years), Middle age adults (31-45 years) and Old age (>45 years) Participants were selected through non-probability convenient sampling technique and allocated in groups based on their age. Participant, after meeting inclusion criteria were supervised during moderate exercise training which includes walking for 23 minutes, cycling for 23 minutes and stepping for 5 minutes. Participants were assessed Pre and Post through Manual sphygmomanometer for BP, NMQ for muscle discomfort. Borg scale was used to assess exertional level and 6 Minute Walk test to assess Peak VO2.
Results: Post intervention between the groups showed the significant effect on all three assessment factors of VO2,Borg Scale and SBP with Kruskal Wallis test (p<0.05). Post intervention within the group showed significant effect on all three assessment factors of SBP,DBP,PR,RR,VO2 and Borg RPE scale with Friedman test (p<0.05). Post assessment of muscle discomfort shows highest frequency i-e 13.8(4%) in shoulder, thigh, upper and lower back region.
Conclusion: This study reported that disturbed vitals and reduced VO2 due to inactivity because of COVID-19 pandemic. Post COVID-19 affects can be recovered through 6 weeks of moderate training. Furthermore, this study reported that participants belonging to old age showed maximum improvement in vitals in response to training while showed maximum muscle discomfort frequency in shoulder, thigh, lower and upper back
Frequency of Subclinical Atherosclerosis in Patients of Psoriasis
Authors: Awan Sobia , Kiyani Asma , Aman Pooner Fiaz , Fatima Syeda Midhat , Siddiqui Abdul Hameed , Rehman Farid-Ur- 
Published: December 2022

Objective: To find out how common subclinical atherosclerosis is in psoriasis patients.
Study Design: Descriptive cross-sectional study
Place and Duration of Study: Dermatology unit of Fauji Foundation, Rawalpindi Pakistan, from Jan 2020 to Jun 2020.
Methodology: After receiving informed consent, 314 cases that met the selection criteria were enrolled. Psoriasis was diagnosed depending on physical examination the family history of patients. Ultrasonography high-resolution B mode was opted to assess carotid atherosclerosis (Xario color Doppler probe frequency 5 to 7mHZ.). If the (IMT) was less than 0.9mm, it was regarded normal; values greater than 0.9mm were termed thickened intima, while digits greater than 1.5mm were considered atherosclerotic plaque. SPSS version 21.0 was used for data analysis.
Results: Age of patients was from 18 to 70 years old, with a Mean±SD (44.00 ±12.12) years. Males made up 47(15%) of the population, while females made up 267(85%). There were 33(10.5%) smokers and 281(89.5%) non-smokers. The mean IMT was 0.84±0.61, with 0.1mm and 2.05mm as the minimum and maximum, respectively. Subclinical atherosclerosis was found in 96 patients (30.6%) (p<0.05). SPSS 21 was used to enter and evaluate the data. Age, BMI, IMT, and disease duration were all expressed as a Mean±SD. Other parameters like gender, smoking, subclinical atherosclerosis be measured by frequency and percentage.
Conclusion: Subclinical atherosclerosis is significantly higher in patients of psoriasis. Early detection and management can help to reduce risks of cardiovascular complications.
KEPERCAYAAN DAN PERILAKU PENCEGAHAN DEMAM BERDARAH DENGUE PADA IBU RUMAH TANGGA BERDASARKAN HEALTH BELIEF MODEL
Authors: Febriasari Sri Gusni , Kusumawardhani Dianti Endang 
Published: December 2022

Dengue Hemorrhagic Fever (DHF) is a public health problem in the world. Dengue control and prevention highly depend on vector control, Aedes Aegypti since no vaccine has been found for prevention. Effective, sustained community participation for dengue prevention remains a challenge in Jagakarsa District. This study explored perceptions of DHF preventive behavior as well as preventive behaviors among mothers in Jagakarsa District. The finding may be used to develop messages for improving DHF preventive behavior. This study uses descriptive study design by collecting data qualitatively through semi-structured interviews using the basic theory of the Health Belief Model (HBM). This research was conducted in September-October 2018. The finding of the study is the percieve of barriers that were greater than the perceive of benefits among mothers in Jagakarsa Subdistrict making mothers have a likelihood not to perform DHF preventive behavior such as don’t clean water container regularly and hanging used clothes outised cupboard. The conclusion of this study is intervention needed in giving messages by considering perceive of benefits and barriers as well as giving messages via mobile phone channels (WhatsApp applications) that can improve DHF preventive behavior.
GAMBARAN PERSEPSI GURU BIMBINGAN KONSELING LULUSAN PENDIDIKAN STRATA SATU BIMBINGAN KONSELING TERHADAP KOMPETENSI DALAM BERPERAN SEBAGAI GURU BK DI JAKARTA SELATAN
Authors: Ariani Rini , Shanti Theresia Indira 
Published: December 2022

Guru Bimbingan dan Konseling (BK) merupakan guru yang berwenang dalam memberikan bantuan psikologis terhadap siswa secara ilmiah dan profesional di sekolah. Namun peran yang ditampilkan guru BK saat ini tampak belum maksimal kerena masih ditemukannya berbagai keluhan mengenai kompetensi yang ditampilkan guru BK baik dari pimpinan sekolah, guru BK sendiri, maupun dari siswa yang menerima layanan. Tujuan penelitian ini adalah untuk memahami gambaran persepsi guru BK lulusan pendidikan strata satu Bimbingan Konseling terhadap kompetensi dalam berperan sebagai guru BK yang bekerja di Kota Jakarta Selatan.Penelitian ini berupa deskriptif dengan metode kombinasi (mixed methods) tipe explanatory design. Pengumpulan data kuantitatif dilakukan dengan pengisian kuesioner yang disusun peneliti untuk memperoleh data numerik. Terdapat satu kuesioner yang digunakan yaitu persepsi terhadap kompetensi guru BK (91 item, α=0.986). Teknik sampling incidental digunakan saat pengumpulan data kuantitatif terhadap 100 orang guru BK dan teknik homogeneous sampling saat pengumpulan data kualitatif terhadap 3 orang dari perwakilan kategori.Hasil penelitian menunjukkan bahwa umumnya guru BK mempersepsikan bahwa kompetensi yang dimilikinya berada pada taraf sedang dalam berperan sebagai guru BK di Jakarta Selatan. Hasil analisis data primer berupa pengolahan deskriptif didapatkan hasil bahwa terdapat satu sub domain dari area pengetahuan dan lima sub domain dari area keterampilan yang masih membutuhkan penguatan berupa pelatihan. Data kualitatif menunjukkan hal yang serupa. Hal ini berarti bahwa guru BK masih memiliki pandangan bahwa kompetensi yang dimilikinya masih berada ditaraf cukup, namun masih membutuhkan berbagai pengembangan untuk memaksimalkan kualitas pemberian layanan bimbingan konseling di sekolah.