bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency of congenital hypothyroidism in new born admitted with neonatal jaundice at tertiary care hospital peshawar
Authors: Ahad Abdul , Bibi Romana , Rehman Sijad Ur , Shah Majid Ali , Ullah Matea , Shahinda  
Published: July 2023

Neonatal jaundice is a common disorder worldwide affecting 30-70% of newborn infants. Severe neonatal jaundice and its progression to kernicterus is a leading cause of death and disability among newborns in poorly-resourced countries.
OBJECTIVES:
To determine the frequency of congenital hypothyroidism in new born admitted with neonatal jaundice at tertiary care hospital Peshawar.
METHODOLOGY:
Settings: removed for blind review
Duration: Period of 1 year from January 2020- January 2021.
Study Design: Descriptive (cross sectional) study.
Results:
In our study 489 mothers 386(79%) mothers were in age range 18-30 years while 103(21%) mothers were in age range 31-40 years. 279(57%) babies were male and 210(43%) babies were female. 303(62%) newborns had maternal gestation age ≤38 weeks and 186(38%) neonates had gestation age >38 weeks. 352(72%) newborns had duration of jaundice ≤14 days and 137(28%) newborns had duration of jaundice >14 days. Birth weight was analyzed as 200(41%) newborns had birth weight ≤2.5 kg and 289(59%) newborns had birth weight >2.5 kg. 15(3%) Mothers had positive history of hypothyroidism while 474(97%) mothers had negative history of hypothyroidism . 24(5%) mother had positive history of anti-thyroid drug intake while 465(95%) mothers had negative history of anti-thyroid drug intake. 5(1%) newborn had congenital hypothyroidism while 484(99%) newborn didn’t had congenital hypothyroidism.
Conclusion:
Our study concludes that the frequency of congenital hypothyroidism was 1% in new born admitted with neonatal jaundice at tertiary care hospital Peshawar.
Key words:
Hypothyroidism, Jaundice, kernicterus, bilirubin, morbidity, anti-thyroid drugs.
Clinical outcome of tetanus based on dakar tetanus severity score in paediatric intensive care unit of a tertiary care hospital
Authors: Jamil Anila , Sarwar Muhammad , Kausar Fareeha , Sultan Nighat , Aslam Ambreen , Azeem Umer Waqar 
Published: July 2023

Objective: To evaluate the validity of Dakar scoring system in predicting the outcome of tetanus in children of post neonatal age.
Method: A prospective single center study conducted at ICU (Intensive Care Unit) of –removed for blind review-- 131 children with diagnosis of tetanus from January 2020 to June 2021 by analyzing demographic and clinical parameters.
Results: Mean age of children was 8.11 ± 3.45 years with male predominance 91(69.5%). Major proportion of children were in range of 5-10 years comprising 65(50%). Period of onset of spasm was < 2 days in 92(70%) that correlate well with shorter incubation period (p-value <0.001). Mean duration of ICU stay was (18.81 ± 11.73) days. Only 14(10.7%) received three doses of vaccination but no one received booster dose. In majority of patients trauma due to road traffic accident 86(65.6%) was the predisposing factor followed by ear discharge 31(23.7%) and other causes 14(10.7%). Out of 131 patients 104(79.3%) received mechanical ventilation because of disease severity. Regarding outcome mild cases 2(1.5%), moderate 61(46.6%) and severe were 68(51.9%) according to Dakar scoring system and out of these severe cases 18(13.7%) expired (p-value < 0.001). However, 53(40.4%) discharged, 50(38.1%) shifted out to other wards after stabilization and 10(7.6%) left against medical advice. (p-value 0.001)
Conclusion: Dakar scoring system correlates well with disease severity and should be adopted to aid clinical triage and management as with effective and appropriate treatment patients can have good prognosis. However, preventive aspects should be emphasized regarding booster dose of tetanus.
Keywords: Tetanus, Outcome, Dakar scoring system
Association of hyperglycaemia at admission with in-hospital mortality and severity of illness among patients with COVID-19.
Authors: Zaman Sadaf , Khan Mujeeb , Khatana Arif , Rehman Fazal Ur , Umar Muhammad , Meraj Lubna 
Published: July 2023

Objectives
The association between hyperglycemia at admission and COVID-19 severity and in-hospital mortality is an area of active medical research. Our study aims to explore this association across diabetics and hyperglycemic patients while keeping normoglycemic patients as control.
Methods
This retrospective cohort study involved a total of 90 patients with confirmed diagnosis of COVID-19 infection. Patients were divided into three equal groups based on their history and BSR levels (diabetics, hyperglycemic, normoglycemic). Various laboratory parameters and inflammatory markers were compared across the study groups using Kruskal Wallis test. Finally, chi-square test was use to assess the association of severity and mortality across the study groups.
Results
Out of 90 patients, 38 (42.2%) were males with a mean age of 57.1 ± 14.7 years. Serum ferritin, LDH and lymphocyte levels were significantly higher in diabetics and hyperglycemic patients than in normal COVID-19 patients (p<0.05). hyperglycemia at admission was significantly associated with disease severity (p=0.03) but not with in-hospital morality (p=0.07).
Conclusion
Patients with diabetes and stress hyperglycemia have increased levels of inflammatory markers than normoglycemic patients. Hyperglycemia at admission is associated with poor COVID-19 severity. More studies a required to validate and further explore this relationship.
Practice of standard Cross Infection Protocol in Private Dental Clinics of Khyber Pakhtunkhwa, Pakistan: A cross-sectional study
Authors: Maqbool Hassan , Sajid Khadija , Rizwan Zarnab 
Published: July 2023

Background: Infection control, which is considered to be the backbone of dentistry, has become a particularly essential piece of dental training because both the dentists and patients are at an expanded danger of cross-contamination. Dental clinical settings represent a high organic hazard of spreading a wide scope of microorganisms. The objective of this study is to gather information of different dentists regarding their practice of standard cross infection protocols and how can they improve the same in their private practices.
Materials and Methods: This cross-sectional study was conducted in dental clinics of Khyber Pakhtunkhwa, KPK from January 2020 to July 2020 by distributing a questionnaire among dentists. It was a pre-designed questionnaire that was circulated in Google forms through Whatsapp and emails. The questionnaire was divided into 2 sections. Data was compiled and statistical tests were applied using the Statistical Package for Social Sciences SPSS® ver.23.0
Results: Regarding cross infection control measures, maximum dentists seem to have knowledge of cross infection control techniques. A significant difference was found (p= 0.05) between male & female dentists in disposing dental waste from clinical set up properly. A significant difference was also found between male & female dentists about rubber dam isolation (p=0.02).
Conclusion: The result of this study showed that practice of dentists in KPK is not up to standard protocols of cross infection control. In this way, the need of great importance is to authorize and execute better proportions of infection control to improve dental practice in KPK.
Key words: Infection control, Dental practice, Sterilization
Comparison of intra-articular lidocaine versus intravenous sedative and analgesic for reduction of anterior shoulder dislocation in terms of mean pain reduction using vas score
Authors: Akhtar Rahman Rasool , Qammar Muhammad Umair , Ahmed Riaz , Arif Adnan , Khan Armaghana Qamar , Liaquat Maria 
Published: July 2023

INTRODUCTION:
The most common dislocation presenting to emergency department is anterior shoulder dislocation. Posterior dislocations and inferior dislocations are rare. Dislocations of the anterior shoulder mostly occur with the position of the arm is abducted and externally rotated. This results in injury of the humeral head, labrum, capsuloligamentous structures and glenoid. Such patients experience severe pain, therefore prompt reduction is necessary to ameliorate the pain. Intravenous analgesia combined with sedation or intra-articular lidocaine injection can be used for closed reduction of anterior shoulder dislocation. Due to its side effects, Intra-articular lidocaine (IAL) is recommended for use as a probable alternative to intravenous sedation-analgesia especially for patients with contraindication to intravenous sedation-analgesia.
OBJECTIVE:
To compare intra-articular lidocaine versus intravenous sedative and analgesic for management of anterior shoulder dislocation in terms of mean pain using VAS during reduction of shoulder joint.
STUDT DESIGN:
Randomized controlled trial (RCT).
SETTING:
Removed for blind review
DURATION:
6 months (November 22nd, 2017 to May 21st, 2018)
SAMPLE SIZE:
60 patients (30 in each group)
RESULTS:
We included sixty patients in my study. 19 (31.7%) were females and 41 (68.3%) were male patients. Out of all the patients 38 (63.3%) had right sided shoulder dislocation, while the rest 22 (36.7%) patients had left sided shoulder dislocation.
Patients mean age was 33.27±10.535 years and mean pain score of all the patients was 4.966±1.930. The mean pain score in Group A was 4.200±1.648, while the mean pain score in Group B was 5.733±1.910 (p value = 0.002. Stratification was done according to gender and age group of the patients, and post-stratification t-test was applied.
CONCLUSION:
Intra-articular lidocaine is better option in pain control during reduction of anterior shoulder dislocation.
KEY WORDS: Intra venous analgesia, Intra-articular lidocaine, shoulder dislocation.
Hemodynamic Comparison between modified saddle block and subarachnoid block for Transurethral Resection of Prostate
Authors: Anjum Waqas , Zareen Abeera , Siddique Faisal , Anwar Muhammad Haroon , Rehman Abdul 
Published: July 2023

BACKGROUND:
Spinal anesthesia is often the mode of anesthesia in transurethral resection of prostate (TURP) albeit with risk of hypotension. However, hemodynamic derangement is often less pronounced in saddle block. This study was conducted to compare the mean fall in Mean arterial Pressure (MAP) and Heart rate (HR) between modified saddle block and subarachnoid block for TURP.
OBJECTIVE:
To compare the mean fall in MAP and HR between modified saddle block and subarachnoid block for TURP.
METHODS:
In this randomized controlled trial 120 patients undergoing elective TURP were included and divided into two groups. Group A Patients received subarachnoid block and Group B received modified saddle block. Baseline hemodynamics were recorded before and then at 5 minutes after anesthesia. All the collected data was entered into SPSS version 22 and analyzed. Quantitative data like age, BMI, ASA-PS score, duration of surgery and baseline hemodynamics were presented as means and standard deviations. The fall of mean arterial pressure (MAP) & heart rate (HR) were compared among groups by independent t test and P value < 0.05 was considered as statistically significant.
RESULTS:
Mean fall in MAP was 8.98±1.28 mmHg and 3.13±0.68 mmHg (p<0.001) in group A and B, respectively. Mean fall in HR was 7.17±0.98 and 2.78±0.59 (p<0.001) in group A and group B, respectively.
CONCLUSION:
Modified saddle block resulted in significantly decreased fall in MAP and HR as compared with subarachnoid block for TURP.
KEY WORDS:
Modified Saddle Block; Subarachnoid Block; Mean Arterial Pressure
Pattern of Thrombocytopenia In Pregnancy At Teaching Hospital Of Rahim Yar Khan, Pakistan
Authors: Ghafoor Muhammad Bilal , Sarwar Faiza , Durrani Tahira Afzal , Azher Zainab Quratulain , Jabeen Saleha , Ali Khan Muhammad Haris 
Published: July 2023

Background: Platelet count less than 150 × 109 / L is referred to as thrombocytopenia, which is the second common blood disorder in pregnancy after anemia. Although pregnancy is related with physiological variations in platelet count, however, several pathological conditions also cause thrombocytopenia showing significant impact on health of mother and her baby. The prevalence of thrombocytopenia during pregnancy is 7 to 11%. The physiological thrombocytopenia is multifactorial, related to hemodilution, increased platelet consumption and increased platelet aggregation.
Objective: To determine the pattern of thrombocytopenia during third trimester of pregnancy in Rahim Yar Khan.
Methodology: This cross-sectional study was carried out at Teaching Hospital of Rahim Yar Khan with effect from May 16, 2022 to September 30, 2022. Five hundred (500) pregnant females in their third trimester were the part of this study. All the study subjects were selected from the department of gynecology and obstetrics at Sheikh Zayed Hospital, Rahim Yar Khan which is a renowned teaching hospital of the region attached with Sheikh Zayed Medical College. Data collection was done on a pre-designed questionnaire. Sample of blood was taken in EDTA and Gel containing vacutainers by convenient sampling technique.
Results: The frequency of thrombocytopenia during pregnancy was found 10.4%. Gestational thrombocytopenia was the most common type among thrombocytopenic pregnancies with frequency of 63.46% in comparison to pre-eclampsia 30.76%, HELLP Syndrome 3.80% and immune thrombocytopenic purpura 1.90%. The mean age of pregnant women was observed 27.53±5 years. There is no significant difference in number of thrombocytopenic patients from rural and urban areas (p=0.2). Conclusion: The frequency of thrombocytopenia during the third trimester of pregnancy is observed high, so the regular screening is necessary to avoid any adverse outcome. Specially the patients with Pre-eclampsia and HELLP syndrome should be monitored critically.

Key words: Platelet Count, Thrombocytopenia in Pregnancy, Types of Thrombocytopenia, Pre-Eclampsia
FREQUENCY OF OCULAR SYMPTOMS IN COVID-19 PATIENTS
Authors: Zubair Maria , Hafeez Nida , Rasool Wajeeha , Abbasi Kanwal Zareen , Seher Ain Us , Niazi Fuad A.K. 
Published: July 2023

Objective: To determine the frequency of ocular symptoms in COVID 19 patients and its association with systemic symptoms in active COVID 19 patients.
Methods: This is a cross sectional observational study of laboratory confirmed COVID-19 patients who were admitted in isolation wards for a period from Dec 16, 2020 to Jan 15, 2021. A structured form was used to extract the data from electronic medical records. Data collected included sociodemographic characteristics, presenting symptoms, systemic signs and symptoms, ocular symptoms, past medical history, RT-PCR and chest radiographic findings.
Results: A total of 44 patients (30 (68.2%) males and 14 (31.82%) females) were admitted to the isolation wards during the study period. The mean age (+ SD) age was 55.75 + 14.53 with median range 57.50 (14-92). Age <30 years i.e. 4.5%, 30-50 i.e. 27.3% and >50 i.e. 68.2%.Ocular symptoms were present in 17 patients (38.6%).
Conclusion:
We conclude from our study that Ocular symptoms were present in 17 patients (38.6%) out of 44 (Total number of patients) However, these symptoms were mild, had no fixed pattern of occurrence, neither associated with the severity of the systemic disease nor associated with any serious ocular outcome
Effectiveness of clean intermittent self catheterization in patients with recurrent urethral stricture post visual internal urethrotomy
Authors: Ullah Naqib , Nawaz Jamshid , Shoaib Muhammad , Khan Asif , Din Nizam ud , Fareed Tauheed 
Published: July 2023

OBJECTIVE :
Objective of the study is to determine the effectiveness of CISC in management of recurrent urethral strictures after visual internal urethrotomy.
METHODOLOGY :
This study performed in department of urology Saidu teaching hospital Swat from June 2016 to July 2019 on 215 patients who were diagnosed as having urethral stricture disease. Patients were counseled for CISC after removal of catheter 2 times a day for 8 weeks and at 8th week cystourethroscopy performed along with detail evaluation of symptoms of urethral stricture to know recurrence of stricture.
RESULTS:
81.39% patients have no urethral stricture on cystourethroscopy and symptomatic evaluation at 8th week post visual internal urethrotomy while 18.60% patients have recurrent urethral stricture . Length of urethral stricture is the most important prognostic factor, stricture of less than 1 cm has success rate of 62.39% while stricture of more than one cm length has success rate of 20% as shown in table IV.
CONCLUSION:
In this study it has been confirmed that CISC is safe ,cost effective procedure and most of the patients can do it in home with out any complications.
Emergency Peripartum Hystrectomy and Postnatal Depression
Authors: Khalid Tabinda , Nawaz Sobia , Ahmed Malik Irfan , Malik Saima Nawaz , Salim Ruqyyah , Manzoor Shahla 
Published: July 2023

Objective: to investigate postnatal depression after emergency peripartum hysterectomy versus controls. Material and methods: This case control study was conducted at District headquarters teaching hospital Rawalpindi between July 2020 and June 2021.We compared postnatal depression among patients who underwent emergency peripartum hysterectomy (EPH)versus control group where surgical procedures other than hysterectomy (B-Lynch, uterine artery ligation or internal iliac artery ligation) were performed. Results: A total of 88 patients were included, 44 in hysterectomy group and 44 in non hystrectomized/control group. The scores on Edinburgh post-natal depression scale were high in hysterectomy group (11.61±2.48) , compared to non hysterectomy group(6.79±2.13) which was statistically significant. ( p=0.001).Uterine atony, Placental abruption, placenta previa and accrete, were identified as main reasons for surgical intervention in both groups. Emergency peripartum hysterectomy is a  traumatic birth event with serious physical, emotional and psychological consequences. It is empirical to not only screen the women in immediate postpartum period, but a long term follow up in community is required.
Prevention of Ovarian Hyper stimulation Syndrome by using gonadotrophic releasing hormone analogue to induce final ovulation trigger in invitro fertilization cycles
Authors: Sultana Safia , Sultana Misbah , Ashraf Shazia , Khan Muhammad 
Published: July 2023

Objectives: To find out occurrence of ovarian hyperstimulation in patients who were hyper responders in in vitro fertilization cycles. Secondary outcome was to assess number of metaphase II oocyte and fertilization rate, cleavage rate and pregnancy outcome when GnRHa is used for final maturation and triggering ovulation.
STUDY DESIGN, SIZE, and DURATION: This is retrospective descriptive analysis of cases managed at single center from June 2017 till May 2018.
PATIENTS & METHODS: Twenty patients were identified as hyper responders based on baseline, ovarian reserve characteristics, that is antral follicle count, (AFC) > 25, AMH > 4ng/ml and on day of trigger, follicles >-25 in number of ≥ 11mm were administered GnRHa trigger and 1500IU hCG on oocyte retrieval day while luteal phase was supported with daily vaginal progesterone and twice daily estradiol valerate. Sixteen patients underwent fresh transfer while four patients had their embryos frozen.
MAIN RESULTS: Twenty patients were identified as high risk and their baseline characteristics were, mean age 31.7 ± 4.50, mean antral follicle count 25.7 ± 5.01, Anti Mullerian hormone level mean 4.64 ± 2.52 and PCOS was present in 35% cases. Peak estradiol level mean 13455-± 6632pmol/l and mean follicles count of 25.45 ± 8.78 confirmed a high response. Oocyte yield was 11.45+ Metaphase oocyte retrieved were 85.5% and cleavage rate of 93%. No case of early onset OHSS was identified. Only one patient developed moderate OHSS. Pregnancy rate was 31.25%. Miscarriage rate was 6.3% and ongoing pregnancy was 25%.
CONCLUSION: This small retrospective descriptive analysis supports the view of current literature that GnRH trigger not only prevents early onset OHSS also achieves increase of M11 oocytes. In addition, pregnancy outcome is not statistically different to those cycles where hCG is used as trigger.
In vitro efficacy of fosfomycin against E. coli and prevalence of MDR and XDR E. coli isolates from UTI Patients
Authors: Nasir Farhina , Kashif Shahida , Uddin Fakhar , Khalid Muhammad , Memon Ishtiaque , Samreen Talat 
Published: July 2023

Objective: The efficacy of fosfomycin against ESBL and/or carbapenem-resistant E. coli isolated from urine samples was determined.
Methodology: Three hundred fifty (350) urine samples were collected from the patients having UTI visited to the department of Urology, JPMC, Karachi. The CLED agar was used for the primary isolation of uropathogens. Regular antimicrobial sensitivity testing was conducted in accordance with CLSI standards, and the minimum inhibitory concentration (MIC) of fosfomycin was assessed using E-strips.
Results: Out of 350 urine samples 213 (60.85%) were E. coli. Patients with E. coli had an average age of 38.75 15.01 years. Females are more prone to have UTI 146(68.54%). E. coli was highest among uropathogens having frequency of 213(60.85%). E. coli manifest highest resistance to ampicillin 187(87.79%) and low resistance to meropenem 12(5.63%), imipenem 15(7.51%) and fosfomycin 21(9.85%). The overall carbapenem resistant E. coli was 9(6.4%) and majority of (61.5%) fosfomycin resistant E. coli, MIC value was >1024µg/ml. Isolates were categories in the non-MDR, MDR and XDR. Most of the isolates were MDR (53%), followed by the non-MDR (35%) and XDR (11%).
Conclusion: In conclusion present study suggests that fosfomycin is still effective against E. coli. More than 50% E. coli isolates were MDR and it’s an alarming situation for urologist.
The Prevalence & Severity of Depression in patients with chronic obstructive airway disease
Authors: Awan Shomaila , Ambreen Asma , Zaheer Nabila , Sabir Asma , Daud Sara , Athar Rizwan 
Published: July 2023

Objective: To determine the Prevalence & Severity of depression in Chronic Obstructive Airway Diseases (COPD) patients.
Background: Chronic Obstructive Airway Disease is a chronic heterogeneous disease that is also progressive. Depression is a common entity in chronic diseases. COPD causes long-term respiratory symptoms and depression is commonly found in these patients. The symptoms of these two diseases are overlapping and depression in COPD patients’ needs to be diagnosed and adequately treated. Untreated patients lead to poor control of respiratory symptoms and further deterioration of the illness. Our study aimed to determine prevalence and severity of depression in COPD patients using HAM-D score.
Material and Methods: This study was conducted in Medicine & Pulmonology OPD, Fuji Foundation Hospital, Rawalpindi from August 2019 to February 2021. Using a cross sectional study design, a total of 169 cases of COPD were recruited and tested for the presence of absence of depression using the HAM-D rating scale and observations were recorded.
Results: Total 169 patients recruited in this study with female & male percentage of 59% and 47% respectively. The Mean duration of illness was 11.5 years ± 6.48. The incidence of Anxiety & Depression was high (45% and 36%) in moderate to severe disease with total prevalence of 54 % among participants in the study.
Conclusion: Anxiety & depression is commonly prevalent in COPD patients. Female patients are found to have more psychological disturbance irrespective to their COPD severity. Psychological impairment must be carefully evaluated in patients having COPD.