bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of efficacy and safety of intramuscular magnesium sulphate with low dose intravenous regimen in treatment of eclampsia
Authors: Haq Aqsa Ikram ul , Naseem Ulfat , Sadiq Nadia , Batool Syeda Maryam , Khalid Tahira , Bashir Shama 
Published: July 2023

INTRODUCTION: Eclampsia contributes to maternal mortality in developing, underdeveloped world. Various drugs have been tried to treat eclampsia. Magnesium sulphate has become the drug of choice due to various advantages and is associated with adverse outcome for both mother and fetus if not used correctly.
OBJECTIVE: To compare the efficacy and safety of intramuscular magnesium sulphate with low dose intravenous regimen in treatment of eclampsia
STUDY SETTING: The study was conducted at Gynecology and Obstetrics Department unit II, Holy Family Hospital, Rawalpindi, from June 20, 2020 to December 20, 2020. Study design was Randomized Controlled Trial.
SUBJECTS & METHODS: Patients were randomly distributed into two groups, group-A (IM Group) and group-B (IV Group). Group-A patients received a loading dose of 4 gm IV MgSO4 over 5-10 minutes+10 gm MgSO4 deep intra-muscular injection (5 gm in each buttock) and a maintenance dose of 5 gm MgSO4 deep intramuscular injection in alternate buttock every 4 hourly. Group-B patients received MgSO4 4 gm slow IV over 5-10 minutes as loading dose and 1 gm MgSO4 per hour as continuous intravenous maintenance infusion. Clinical response to therapy for both drugs was calculated in terms of efficacy and safety. All the data were entered & analyzed by using SPSS v25.0. Both the groups were compared in terms of efficacy and safety by using Chi-Square test. A p-value less than 0.05 was taken as significant.
RESULTS: A total of 160 patients with eclampsia were enrolled for this study. Patients were divided into two groups i.e. Group-A (IM MgSO4) and Group-B (IV MgSO4). In group-A, there were 45(56.3%) in 18-30 years age group and 35(43.8%) in 31-40 years age group, while in group-B, there were 48(60.0%) in 18-30 years age group and 32(40.0%) in 31-40 years age group. In IM MgSO4 group, prevention from recurrence of seizure was noted in 74(92.5%) and 78(97.5%) in IV MgSO4 group, which is statistically insignificant with a p-value of 0.147.
CONCLUSION: Both IM and IV regimen are equally effective in controlling the recurrence of convulsions. IM Magnesium Sulphate is associated with a higher incidence of toxicity as evidenced by significantly higher incidence of loss of knee jerk reflex. Both IM and IV regimen are equally effective but IM Magnesium Sulphate is associated with a higher incidence of toxicity.
KEY WORDS: Eclampsia, Intramuscular MgSO4, Intravenous MgSO4.
Hamstring Shortness among Undergraduate Students, Using Knee Extension Angle Test
Authors: Ishaque Farhan , Bano Saira , Khan Hamna , Kumar Suneel , Qaiser Saeed , Khan Muhammad Asif 
Published: July 2023

Objective: To examine the causes and incidence of hamstring tightness/shortness among undergraduate physical therapy students. Cross-sectional study. Institute of Physical Medicine & Rehabilitation, DUHS during the period of Jan 2019 to Jun, 2019.
Material and Methods: The subjects sample size (n=248) was estimated by open EPI software. Male and female both are included. Hamstring muscle shortness was assessed by a gold standard assessment tool i.e. passive knee extension angle test. Descriptive statistical analysis was done by using SPSS version 24.
Results: The hamstring muscle tightness was measured by using knee extension angle test. It results conclude that among (248) students (62.90%) had hamstring muscle tightness / shortness and (37.10%) did not show any muscle shortness. Out of (216) females participants (136) have hamstring shortness. On the other hand out of (32) male participants (20) had hamstring shortness/tightness out of total (248) students. It was also evident from the study that 27% of physiotherapy students having low back pain was because of clinical exposure and tight hamstrings muscles.
Conclusion: Hamstring tightness/shortness is very much prevalent among the undergraduate physiotherapy students. The reason might be the prolong study durations and lack of physical activities. The result showed statistically significant difference between hamstring muscle extensibility in both male and female
Key words: Extension Angle, Flexion, Contracture, Fascitis
Comparison of Primary Simple Closure and Limberg Flap Technique in Pilonidal Sinus
Authors: Butt Hafiza Kiran Saleem , Nazir Aamna , Khan Muhammad Atif , Anwar Muhammad Idrees , Waris Hira , Maqbool Shahzaib 
Published: July 2023

Introduction
Pilonidal sinus is a disease affecting the intergluteal region. Many surgical techniques have been described for the treatment of this condition. The objective of this study was to compare Limberg flap technique and primary simple closure in terms of postoperative discharge.
Materials and methods
It was a randomized prospective study conducted at the Department of Surgery—removed for blind review-- from December 2018 to June 2021. Sixty male patients aged 15-30 years presenting with pilonidal sinus for the first time were included in the study. Patients with comorbidities and the American Society of Anesthesiologists (ASA) class three and above were excluded from the study. Patients were divided into two groups by lottery method. Data was entered and analyzed using Statistical Package for Social Sciences (SPSS) version 23.0. Chi-square tests were applied. A p-value of ≤ 0.05 was considered significant.
Results
The postoperative discharge was found in just five (16.3%) of the patients in group A (Limberg flap technique), while the discharge was present in 12 (40%) of the patients in group B (primary simple closure; p = 0.045).
Conclusion
Limberg flap technique is superior to primary simple closure in terms of postoperative discharge.
Comparison of open vs Plastibell techniques of circumcision for surgical outcomes and cosmetic satisfaction;A randomized control trial
Authors: Iqbal Muhammad , Ijaz Sadaf , Zafar Muhammad Hassan , Malik Naveed Akhtar 
Published: July 2023

Objective of the study: To compare the results of circumcision by open technique and the Plastibell
technique in male babies.
Methods: In this randomized controlled interventional study, 1440 babies whose circumcision
was done as religious rite were divided into two groups. Group A underwent circumcision by open
technique whereas group B underwent circumcision by Plastibell method.
Results: Majority 720 (50%) were in age group 6-8 weeks. Compared with open method,
significantly less number of patients in plastibel method experienced moderate pain (47.91% versus 35% p value .00001 and severe pain 31.94% versus 9.02% p value .00001.Rate of wound infection was significantly less in plastibell method 2.77% versus 4.86% p value .020. However more patients in plastibell technique needed re-do circumcision 4.02% versus 1.94% p value .0202. Overall greater parent’s satisfaction was attained with plastibel method.
Conclusion: Plastibell technique has many advantages over open method in terms less post op pain, wound infection, and greater cosmetic satisfaction however more patients will need re-do circumcision in this technique compared with conventional method.
Keywords: Circumcision, open technique, Plastibell, post-op complications
Common Organisms causing surgical site infection(SSI) in Postoperative patients in a tertiary care Hospital
Authors: Mustafa Fatima , Khan Mumtaz Ahmed , Mustafa Abdullah , Manzoor Asifa , Safa Safia , Khogyani Samiullah 
Published: July 2023

Objective:
To investigate the types and frequency of organisms causing surgical site infections in postoperative patients and their association with other factors.
Study Design:
Cross-sectional
Duration and Place of Study:
Surgical Unit-II of –removed for blind review---and from 1st March 2021 – 31st July 2021.
Patients and Methods:
There were 391 surgeries in this study, but only 27 patients met the inclusion criteria. A diagnosis of SSI was based on specific parameters, including the detection of two or three cardinal signs of inflammation and the surgeon's confirmation of the diagnosis. This data was analyzed using IBM SPSS 23.
Results:
Among 391 patients, 242 had elective surgeries (male:female, 1.6:1), and 149 had emergency surgeries (male:female, 1:3.4). The mean length of stay for elective surgeries was 2.19 ± 1.8 days and 4.2 ± 3.7 days for emergency procedures.
There were 98 abdominal procedures (65.77%) performed in emergency settings. Only 9 (3.71 %) elective procedures and 18 (12.08 %) emergency procedures reported surgical site infections. Escherichia coli was the most commonly isolated organism from SSI during the study. The rate of SSI in postoperative patients was 6.9%.
There was a statistically significant association between SSI and type of surgery (p=0.002). The mean length of stay (LOS) was longer for patients with SSI (mean=12.5, p=.000). Emergency cases had a longer LOS compared with elective cases (mean= 4.21 days vs 2.19 days, p=.000).
Conclusion:
According to our study, our unit's SSI were comparable to other developing countries. SSI are more frequent in emergency cases, men, and diabetics, and are the primary cause of longer hospital stays.
Keywords:
Surgical Site Infection; E.Coli; Length of stay;
Assessment of derangement in biochemical profile in primary open angle glaucoma patients presenting at a tertiary care hospital
Authors: Zuhra Fatima Tuz , Khattak Mehnaz , Nadeem Sana , Atzaz Noreen , Khalid Attika , Saeed Sami 
Published: July 2023

Objective: To assess the changes in high sensitivity C Reactive protein (hs-CRP), serum cholesterol, uric acid, creatinine, bilirubin and ALT in patients of primary open angle glaucoma.
Material and methods: Comparative cross-sectional study conducted between April 2021 and October 2021 at departments of Ophthalmology and Pathology, --removed for blind review----44 POAG patients and 54 healthy controls volunteered to participate in the study. POAG was diagnosed as per criteria. Venous blood was drawn for analysis of serum cholesterol, uric acid, creatinine, bilirubin, ALT and hs-CRP. hs-CRP was performed on ELISA plate reader Platos R496 while spectrophotometric analysis of serum uric acid, creatinine, and cholesterol was carried on Beckman Coulter AU-700.
Results: Mean hemoglobin (Hb), Total leukocyte count (TLC), serum urea, creatinine, uric acid, ALT, bilirubin, cholesterol and HbA1c were 12.80 ±1.50g, 8.88±1.92 mm3, 5.95±5.47 µmol/l, 92.19±21.81 µmol/l, 305.85±79.92 mmol/l, 34.31±18.26 IU/L, 9.26±3.11 µmol/l, 5.18±0.96 mmol/l,6.70±1.28 %respectively whereas the Mean IOP in POAG patients was 28mmHg, mean CCT was 516.6 µm, and mean vertical CDR was 0.6.
High frequency of hs-CRP positivity (50 percent) was reported in our patients. Significantly lower uric acid levels were observed in primary open angle glaucoma patients versus controls ie 305.85±79.92 mmol/l vs 344.36±37.24 mmol/l (P value < 0.05). Serum creatinine was significantly different between mild and severe groups i.e. 88±14.7 vs 113.1±32.4. (p value <0.001*)
Conclusion: High frequency of hs-CRP positivity and low uric acid levels suggest the presence of para inflammation in patients of POAG.
Key words:
Primary open angle glaucoma (POAG), intraocular pressure (IOP), high sensitivity CRP (hs-CRP), uric acid (UA)
PSYCHOSOCIAL ILLNESS IN CHILDREN WITH THALASSEMIA: A CASE-CONTROL STUDY
Authors: Afzal Erum , Sheikh Muhammad Aslam , Bhaba Sajjad Hussain , Ahmed Tanveer , Iqbal Imran , Iqbal Muhammad Khalid 
Published: July 2023

INTRODUCTION: Thalassemia is the most common hemolytic autosomal recessive disorder. Pakistan has significant number of thalassemic children .The children with chronic disorders like thalassemia are prone to develop psychosocial illness including depression, anxiety, intellectual and behavioral issues.
OBJECTIVE: To assess the psychosocial illness in children with thalassemia and to compare these problems in children with and without Thalassemia
PLACE & DURATION: The Children’s Hospital and the institute of child health, Multan. From January to September 2021.
STUDY DESIGN: Case-control
MATERIAL AND METHOD: In this study 50 children with Thalassemia and 50 normal children were enrolled as case & control according to inclusion and exclusion criteria. After approval from institutional ethical committee, detailed history ,Socioeconomic status, educational status of parent and child, age of diagnosis of disease, and whether thalassemia is well controlled or not and complications were noted. A Pediatric Symptom Checklist was used for psychosocial problems in all children. Data was analyzed by using SPSS version 22. Mean and standard deviation for quantitative data, while frequencies and percent for qualitative data was calculated. P-value was calculated by Chi square test. Prevalence ratio (ODDS ratio) with 95%confidence interval of all variables were calculated.
RESULTS: Out of 100 patients 50 were in case group (Thalassemia) and 50 control (non-thalassemic.Male female ratio was 1.2:1. 60 %( n=30) cases, 78 %( n=39) control patients were age ranges between 5 to 10 years. Educational level of parents of 40%(n=20),and 56%(n=28) was below matric,42%(n=21) and 90%(n=45) patients were going to school in case and control group respectively.82%(n=41) patients belonged to low socioeconomical status in each group. Regarding characteristics of thalassemia 74 %( n=37) patients were diagnosed within 1st year of life, while 26 %( n=13) after 1st year.64 %( n=32) had well controlled and 36 %( n=18) poor controlled disease. 20%(n=10) had developed Diabetes mellitus,2%(n=1) heart failure,74%(37) growth failure,76%(n=38) hemolytic facial features and 72%(n=36)skin discoloration. Psychosocial problems were statistically significant in children with Thalassemia as compared to healthy ones (p-value<0.001).Poorly controlled thalassemia and complications of heart and growth failure were found statistically significant risk factors.
CONCLUSION: Psychosocial problems are common in children with thalassemia as compared to healthy ones. So these patients must be referred for detailed psychological evaluation and management along with medical treatment.
VARIATION IN INTERNAL CAROTID ARTERY PROTRUSION AND DEHISCENCE IN A SUBSET OF KARACHI POPULATION
Authors: Lakhani Mubina , Raza Iffat , Mohiuddin Maria , Khan Rosheena Nabeel , Sidhwani Santosh Kumar , Hassan Nuzhat 
Published: July 2023

Objective: To find out the frequency of protrusion of Internal Carotid artery in sphenoid sinus and dehiscence of carotid canal in a subset of Karachi population.
Study design: This was a Cross-sectional study conducted at Radiology department of Ziauddin university.
Methodology: We analyzed 270 head and neck CT scans 270 Head and neck CT scans (540 sides) were analyzed. CT was performed on a 16 slice Toshiba Alexion at Ziauddin Hospital, Karachi —removed for blind review---. SPSS version 20 was used for data analysis.
Results: Out of 270 CT scans analyzed, 28 (10.3) scans showed protrusion of ICA in sphenoid sinus. Out of 45 (16.6) of the subjects showed dehiscence of carotid canal. Out of total dehiscence present unilateral cases were more frequent as compared to bilateral. Unilateral protrusion was also more common as compared to bilateral protrusion of ICA.
Conclusion: Knowledge of dehiscence and protrusion related to ICA and sphenoid sinus anatomy is essential to avoid complications in endoscopic sinus surgery.
Early Breast-Feeding Initiation Using Point of Care Quality Improvement Model at Tertiary Care Hospital in AJK
Authors: Khan Aftab Hussain , Khan Mumtaz Ahmed , Akbar Abrar , Mumtaz Sehrish , Abbasi Yasira , Meraj Lubna 
Published: July 2023

ABSTRACT: Urgency and solely utility of breast feeding for six months is better for the provision of a healthy start to newborn and reduces infant mortality and morbidity. The prevalence of late lactation and other ways to formula or animal milk feeding the neonate in Pakistan is often observed other than the WHO recommendations. Early initiation of breast feeding is one of the indicators to express quality of Care in Maternal, and newborn Health. Among many approaches, point of care Quality improvement initiative (POCQI) is a simplified tool for learning the basics of quality improvement in the health care facilities. This study aimed to assess the prevalence and associated factors of early initiation of breastfeeding among mothers in a tertiary care hospital in AJK, where POCQI has been piloted.
Methods: A quality improvement, cross sectional study before and after the implementation of POCQI model on two independent samples was carried out from August to November 2019. A total of 100 women (50 before intervention and 50 after intervention) who delivered neonates of 0-7 day’s age were included in study by using non-probability convenience sampling technique. The relevant information was gathered by using questionnaire. Mothers who did not start breast feeding within first hour did not receive any health education during antenatal visits. such women lack knowledge about benefits of colostrum. Hence an intervention was introduced by Researcher jointly in collaboration with POCQI team of the hospital by using Plan-Do-Study-Act (PDSA) cycle. Slogans and health education messages for promotion of early initiation of breast feeding were developed and message was spread to pregnant mothers who visited hospital for antenatal care or came for delivery in labor room.
Results: A total of 100 women (50 before intervention and 50 after intervention) who delivered newborn babies of 0-7 day’s age were selected purposively. Before POCQI intervention out of fifty only eleven (22 %) women breastfed their new born within one hour after birth. After POCQI intervention, out of fifty, thirty-seven women (74%) exclusive breastfed their new born within one hour. Thus, total increase in term of percentage was 54%.
CONCLUSION: The study gives evidence for more needs to enhance breastfeeding uptake in AJK. The prevalence of EIBS was low before implementation of POCQI model but it improved significantly after its application
A rural community-based investigation to assess mHealth for family planning advice in district Multan
Authors: Farooq Naveen , Alvi Nadia Rehman , Mangrio Sana , Rahim Syed Aftab , Riaz Zunaira 
Published: July 2023

Background: Globally, Pakistan is the 5th populous country. To increase the use of family planning services by public private business model, Punjab Population Innovation Fund selected “Connect4fp” project implemented by International Rescue Committee organization. The purpose of this research was to determine the impact of mobile health(mHealth) advice on family planning in project area. This project was implemented in 9 Union councils of district Multan, Pakistan. The innovative idea of this project was the use of mobile phones to spread family planning knowledge among community in the form of Interactive Voice Response (IVR) as well as Short Message Service (SMS) (i.e., text messages).
Methods: A cross-sectional study targeted 197 men as well as women (mostly married women of reproductive age) receiving mobile messages or recorded robocalls from the project area. The purpose was to assess their family planning knowledge and awareness by using structured Likert scale questionnaire. Secondly the viewpoint about mHealth and its effect on family planning was determined from 40 private providers and 27 Family planning Champions (who were part of the project) by telephonic interviews. Their response was quantified by using Likert scale. Descriptive statistics were calculated of the study’s main variables. The association of family planning knowledge of community members was determined to their contraceptive use by using Chi square.
Results: The results specified that 60% community members included in this study told that their family planning knowledge is increased due to this mHealth program. 36% Private providers while 75% FP Champions were agreed that family planning patients are increased due to this mHealth program.
Conclusion: Mobile messages and robocalls about family planning sent in local language positively contributed to increase FP knowledge and awareness in community. This may trigger communication about family planning within couples, as a result increase use of family planning services.
Effectiveness of Tocilizumab in reducing inflammatory response associated with COVID-19 pneumonia at Islamabad Medical Complex, Islamabad
Authors: Naeem Abdul , Meraj Lubna , Shams Nadia , Rizvi Mehr Fatima , Kamal Muhammad , Amir Muhammad 
Published: July 2023

Objective: To determine the effectiveness of Tocilizumab in covid-19 related severe pneumonia.
Introduction: COVID-19 is a global health problem causing respiratory infection. This is triggered by IL-6 characterized by raised inflammatory markers that is called cytokine release storm. Severe disease leads to hospitalization, oxygen requirement and poor outcome.
Methods: This interventional study (descriptive analytic) was conducted from July-December 2021 at Intensive Care Unit, after ethical approval. Seventy cases of COVID-19 pneumonia with cytokine storm were included. Twenty cases were dropped either refusal to tocilizumab, pregnancy or having contraindication to tocilizumab, leaving 50 study participants. The patient’s demography, clinical, laboratory and radiological findings, timing and response variables of tocilizumab were recorded. The temporal readings of inflammatory markers, oxygen requirement and clinical status were compared at admission and after tocilizumab. SPSS version 25 was used for data analysis. Chi-square test was applied with significant p-value < 0.05.
Results: There was male predominance of 66% with mean age of 58.6±14.8 years. Mean day of illness and hospital stay was 8th day and 17.56 days respectively. C-reactive protein levels improved in all cases 50(100%) (p <0.0001), ferritin in 31(62%) (0.019), D dimers in 28 (56%) (p0.014), LDH in 30(60%) (p 0.02) and interleukin-6 in 32(64%) (0.017. Survival benefit with tocilizumab was significant in patients that received within 10th day of illness (p 0.021). At discharge, 66.6% were off oxygen and 33.3% required domiciliary oxygen.
Conclusion: COVID-19 Pneumonia with cytokine release storm bears high mortality. Significant improvement in inflammatory markers like CRP, ferritin, D-dimers and LDH shows effectiveness of tocilizumab. Early administration within 10 days of illness has survival benefits.