bluuebunny/crossref_metadata_2025_split huggingface dataset:
Systematic evaluation and Meta-analysis of the efficacy and safety of different doses of tigecycline in ventilator-associated pneumonia caused by multiple resistant bacteria
Authors: Feng Changwen , Yang Xiaoshan , u Junlin L , Mo Qingming , Cai Zhaoxu , Zhu Wendian 
Published: June 2023

IntroductionIn this study, we conducted a systematic review and meta-analysis to evaluate the efficacy and safety of different doses of tigecycline in the treatment of VAP caused by multi-resistant bacteria.Material and methodsTo identify relevant studies, we conducted a comprehensive search of multiple databases including theThrough Cochrane libraryLibrary, Embase, PubMed, Chinese biomedical literature database, CNKI, Chinese JP, and WP, covering the period up to the database until December 2022. We assessed the quality of the included studies using the Jadad quality score, and performed a meta-analysis of the data using Stata software.ResultsThere was no clinical heterogeneity or statistical heterogeneity between studies, and a fixed-effect model was used to incorporate the effect size. The incidence of adverse effects in the observed group was not different from that of the control group. The clinical effect of the observation group was significantly better than that of the control group . Meta-analysis of the adverse effects showed that there was no clinical heterogeneity or statistical heterogeneity between studies, and a fixed-effect model was used to incorporate the effect size. The incidence of adverse effects in the observed group was not different fromsimilar to that of the control group.The included articles were tested for publication bias using funnel plot and Egger's test, and none of the four articles had adverse effects as effect indicators.ConclusionsHigh-dose duration of tigecycline treatment for ventilator-related pneumonia caused by multi-resistant bacteria has is associated with improved better clinical efficacy with noout an increase in adverse effectsand high safety.
OUTCOME OF LAPAROSCOPIC CHOLECYSTECTOMY IN PATIENTS WITH METABOLIC SYNDROME IN AN ADULT KASHMIRI POPULATION: A PROSPECTIVE HOSPITAL BASED STUDY.
Authors:   , Dar Hanief , Mir Gowher Ahmad , Salro Aasim Shafi , Awan Naseer Ahmad , Ahmad Mufti Mehmood 
Published: June 2023

Background: The prevalence of Gallbladder stones in India is 6.12 %. Metabolic syndrome is an important risk factor for gallstones. Patients with Metabolic Syndrome seem to be at higher risk of having perioperative complications. Aim: This research aims to study the intraoperative and postoperative complications, duration of hospital stay, and associated mortality in patients with Metabolic syndrome. Material and Methods: A prospective observational study was conducted in the Post Graduate Department of General Surgery, SMHS Hospital, Govt. Medical College, Srinagar on 52 patients with metabolic syndrome undergoing laparoscopic cholecystectomy for cholelithiasis from September 2020 to September 2022 following approval by an institutional ethical committee. All patients underwent laparoscopic cholecystectomy using the standard four-port technique and hospital room setup. Results: The female-to-male ratio in this study was 1.5:1. Hypertension was present in 48%, Diabetes Mellitus in 32.69% of the patients, and Hypothyroidism in 19.23% of the patients. 47 out of 52 (90.3%) of the patients exceeded the waist circumference cut-off for metabolic syndrome according to ATP III criteria. 43 patients (82.6%) had Serum Triglyceride levels exceeding 150mg/dl or were on treatment for the same, HDL ≤ 40mg/dl in men and ≤ 50mg /dl in women was found in a total of 39 (75%) patients, a total of 28 patients (53.8%) had blood pressure ≥ 130/85 mmHg or on antihypertensives. Blood Sugar ≥ 100mg/dl or on hypoglycemic drugs were 21 (40.3%) patients. A total of 2 patients (3.8%)were converted to conventional open cholecystectomy for difficult calots adhesions. 1 patient (1.9%) had a bile leak and 1 patient (1.9%) had post-operative bleeding, Port site hernia in 1 patient (1.9%) and 2 patients (3.8%) developed surgical site infection. Conclusion: Laparoscopic Cholecystectomy is an effective procedure with excellent functional outcomes in patients with Metabolic Syndrome.
A RETROSPECTIVE REVIEW OF OPEN PROSTATECTOMY IN A RESOURCE-CONSTRAINED SETTING.
Authors:   , Msibi Sifiso , Singh Avikar 
Published: June 2023

Background: Open prostatectomy is an important treatment modality for prostate disease in resource-constrained settings, where access to minimally invasive surgery is limited. We conducted a review of open prostatectomies at a South African hospital. Methods: We reviewed the medical charts of 54 patients who underwent open prostatectomy at St. Aidan’s Hospital in South Africa between 2015 and 2019. Data collected for each patient included demographic characteristics, comorbidity, prostate-specific antigen measurements, prostate volume measurements, preoperative catheterisation, indication for surgery, surgical approach, duration of surgery, postoperative length of stay, histological findings, and postoperative Clavien-Dindo complications. We analyzed the collected data with descriptive statistics. Results: The median age was 68.5 years old. Most patients were Black Africans (57.4%). Hypertension was the most common comorbidity (50.0%). Most patients (83.4%) had prostate-specific antigen levels of 10 ng/mL or less, and prostate volumes of 60-100 mL (57.4%). Preoperative catheterisation was common (77.8%). Lower urinary tract symptoms and failed medical therapy (74.1%) was the most frequent indication for surgery. All patients had surgery via the suprapubic approach, with surgery lasting >120 minutes for two-thirds of patients. Postoperative length of stay was 6-9 days for nearly half of the study sample (48.1%). Almost all patients had a histological diagnosis of benign prostate hyperplasia (94.4%). Postoperative complications were frequent and mostly minor (infection or blood transfusions). Conclusion: We confirm that open prostatectomy is still a relevant, safe, and effective method for managing prostate disease in resource-constrained settings. We recommend that open prostatectomy still be considered a primary treatment modality for prostate disease in developing countries until minimally invasive methods become more widely available.
Comparing the success rate of external dacryocystorhinostomy with anterior flap versus flap excision in managing chronic dacryocystitis
Authors: Mansour Hosam Othman , Hassan Riad Elzaher , Tharwat Ehab , Fekry Elgazzar Akram , Abd El-Salam Mohammed Eid , Ramadan Ezzeldin Ezzeldin , Osman Hussein Mostafa , Elmahdy Ahmed Gomaa 
Published: June 2023

Background: Nasolacrimal duct obstruction (NLDO) is characterized by epiphora and recurrent episodes of acute dacryocystitis. Despite the temporary effect of antibiotics in the acute phase, it is primarily managed by dacryocystorhinostomy (DCR). There is a new modification of external DCR that is performed without either anterior or posterior flaps. This study aimed to compare the outcomes of flapless and single-flap external DCR in adult patients with chronic symptomatic dacryocystitis secondary to NLDO.
Methods: In this retrospective, non-randomized, interventional, comparative study of patients with chronic dacryocystitis secondary to primary acquired NLDO, we compared the surgical outcomes and complication rates of flapless external DCR to those of external DCR with only anterior flap suturing. We excluded patients who declined participation and those with soft stops, nasal problems, lid margin abnormalities, lid malposition or laxity, previous lacrimal surgery, lacrimal fistula, trauma involving the lacrimal drainage system, lack of adequate follow-up, or severe septal deviation or turbinate hypertrophy. Anatomical and functional success rates were determined at the last follow-up visit and were compared. Postoperative complications were recorded and compared between groups.
Results: We included 53 patients with a male-to-female ratio of 16 (30.2%) to 37 (69.8%); 25 eyes underwent flapless DCR (group 1) and 28 eyes underwent anterior flap suturing DCR (group 2). The two groups had comparable demographic characteristics (all P > 0.05). Furthermore, anatomical (92.0% in group 1 and 92.9% in group 2) and functional (84.0% in group 1 and 92.9% in group 2) success rates at final follow-up were comparable between groups (both P > 0.05). At the one-month postoperative examination, premature tube extrusion was more often reported in group 1 (12.0%) compared to group 2 (7.1%). At the two-month follow-up examination, tube extrusion was noted in 4.0% in group 1 and 0.0% in group 2, yet the difference failed to attain statistical significance (P > 0.05).
Conclusions: We found that neither surgical method was superior in terms of anatomical or functional success rate at a maximum of one year after external DCR. Flapless DCR is a simple, effective, and reproducible alternative to the single anterior flap suturing technique for managing NLDO in adults with chronic dacryocystitis. However, further randomized clinical trials with larger sample sizes and longer follow-up periods are recommended before generalization can be justified.
Changes in anterior chamber biometry and intraocular pressure after uneventful phacoemulsification in non-glaucomatous eyes
Authors: Dawood Yousif Farhan , Issa Ammar Fouad , Mohammed Ali Sarmad Salah 
Published: June 2023

Background: In non-glaucomatous eyes, many factors impact intraocular pressure (IOP) reduction following phacoemulsification. This study aimed to determine the relationship between changes in IOP and alterations in anterior chamber biometric measurements using the Pentacam Scheimpflug anterior segment imaging system before and after uneventful phacoemulsification in non-glaucomatous eyes.
Methods: This prospective interventional study included patients with ages of 20 – 80 years, no known systemic diseases, and visually significant cataracts necessitating phacoemulsification with posterior chamber intraocular lens implantation. The preoperative and two-month postoperative IOPs were measured using a Goldmann applanation tonometer, and the iridocorneal angle (ICA) in four quadrants (superior, inferior, nasal, and temporal), anterior chamber depth (ACD), and anterior chamber volume (ACV) were measured using the Pentacam.
Results: Forty-two eyes of 42 patients with a mean (standard deviation [SD]) age of 56.8 (10.7) years were included; 22 (52%) were men and 20 (48%) were women. The eyes demonstrated statistically significant changes in postoperative IOP, ACD, ACV, and in widening of the ICA (all P < 0.05), with a mean (SD) IOP reduction of 4.5 (2.7) mmHg, ACD deepening of 0.7 (0.6) mm, ACV increase of 33.2 (21.1) mm3, and ICA widening of 7.5o (6.4o), 12.4o (7.7o), 9.1o (7.1o), and 11.5o (6.1o) in the superior, inferior, temporal, and nasal quadrants, respectively. A significant positive correlation was detected between pre- and postoperative IOP (r = + 0.58; P < 0.001) and between pre- and postoperative ACD (r = + 0.50; P < 0.001). Significant negative correlations were detected between preoperative ACV and changes in ACV (r = - 0.42; P < 0.001) and between preoperative ICA and changes in ICA (r = - 0.02; P = 0.001). However, no significant correlations were observed between the changes in IOP and patient age (r = + 0.001; P = 0.957) and axial length of the eye (r = + 0.13; P = 0.221), or changes in ICA (r = - 0.01; P = 0.945), ACD (r = + 0.01; P = 0.945), and ACV (r = - 0.12; P = 0.599).
Conclusions: We observed a significant reduction in IOP, widening of the ICA, and increases in ACD and ACV after phacoemulsification; however, there was no significant correlation between changes in IOP and other biometric variables. Further studies are required to determine the exact mechanisms underlying these effects.
FACTORS RESPONSIBLE FOR DELAYED PRESENTATION & MANAGEMENT OF SYMPTOMATIC BLADDER CANCER IN PAKISTAN: A SINGLE CENTRE STUDY
Authors: AZFAR ALI  , NABEEL SHAFI  , ASAD ALI SHAH  , BASIT MASOOD  , MOHAMMAD HASSAM KHALID  , IRSHAD ALI  , MUHAMMAD SAFDAR KHAN  
Published: June 2023

Background: Carcinoma of bladder is a urological cancer which has the highest recurrence rate of any malignancy in Asia and America. In Pakistan bladder carcinoma is one of most common occurring cancer in men and number one urological malignancy in both sexes. Haematuria is the most common presentation of bladder cancer. Delay in treatment for bladder cancer resulted in in poor survival outcomes. Rationale of this study is to investigate the factors responsible for late presentation of symptomatic bladder cancer to a urologist, despite of alarming signs and symptoms. Materials and Methods: From 20-02-15 to 21-02-2017, A total number of 112 patients, 84 males, 28 females who presented first time for the treatment of bladder cancer and history of visible haematuria were enrolled and data was collected by researchers in Department of urology Services Hospital Lahore. Patient with recurrent bladder cancer and with history of XRT bladder were excluded. A proforma was filled which included personal details as age, education, social status, history of smoking, presenting complains, psycho-social barriers, time delay from symptom to definite treatment
Results: Out of 112 patients, 60(53.6%) were illiterate, 76(67.9%) belonged to rural areas, 79(70.5 %) belonged to low socio-economic status. 91(81%) males were smokers. 92.9% patients had history of multiple episodes of haeamturia. Median delay from first episode of haematuria to treatment (TURBT) was 118 (IQR 70-207)days, The main factors were for this patient delay were lack of awareness/ knowledge about disease in 68(60.7%).Delay due to General practitioner was 65.42±35 days in 76(67.8%) patients, while hospital delay was 13.3±7.27 days
Conclusion: Public education about bladder cancer with training of general physicians for early referral can prevent delayed presentation, resulting in prevention of disease's progression and mortality.
BREECH PRESENTATION: AN OVERVIEW OF PATIENTS VISITING SOUTHERAN PUNJAB
Authors: TAHIRA MALIK  , MAHWISH NAJAM  
Published: June 2023

Objective: This study was conducted to determine incidence of breech presentation, etiology, mode of delivery and fetal outcome.
Methodology: Retrospective cohort study was conducted in Sheikh Zayed Medical hospital, Rahim Yar Khan from period of January 2013 to December 2015. 685 patients with breech presentation in Southern Punjab were included in our study. Demographic data like age, parity, gestational age and previous mode of delivery was determined. Type of breech presentation was checked by ultrasonography. Etiology was determined for breech presentation. Mode of delivery in present pregnancy was determined in the form of vaginal delivery and cesarean section. Fetal outcome was compared in both groups.
Results: Incidence of extended breech was higher 98.9%, where flexed breech was in 6.5% and footling breech was in 3.5% of cases. Most of cases with breech presentation was in primigravida (303) 44.2%, 277 (40%) were multi and grand multiparous, 8.6% with preterm breech, 28 women(4%) breech presentation was found in first twin, fetal anomalies were in 1.45%, uterine anomalies in cases and placenta previa in 03 patients. 173 (25.2%) were delivered by vaginal breech delivery and 512 (74.7%) were delivered by lower segment cesarean section. Perinatal morbidity and mortality was lower in cesarean section group as compared to vaginal delivery group. But statistically there was no significant difference.
Conclusion: Proper selection of patient for mode of delivery will be helpful in improving fetomaternal outcome. Regular drills in maternity units will enhance expertise and in the presence of skilled personals vaginal breech delivery will be safe mode of delivery.
COMPARE THE CLINICAL EFFICACY OF AZITHROMYCIN WITH CIPROFLOXACIN IN TREATMENT OF TYPHOID FEVER IN CHILDREN
Authors: FARYAD HUSSAIN  , ADEELA KHAN  , ZAINAB FATIMA  , ARIF ZAHEER  , AGHA SHABBIR ALI  
Published: June 2023

Objective: To compare the clinical efficacy of Azithromycin with ciprofloxacin in treatment of typhoid fever in children.
Setting: The study was conducted in Paediatric department Lahore General Hospital/PGMI Lahore from 11-12-2012 to 11-02-2012
Methodology: After permission from hospital ethical committee and informed written consent taken from attendants of patients of inclusion criteria, data was collected on data collection Performa. Patients fulfilling the criteria were admitted in Paediatric department, Lahore General Hospital. Patients were divided by lottery method into two groups A and B. Group A was given ciprofloxacin 15mg/kg/dose BD orally for 7 days. Group B was given azithromycin 10mg/kg/dose OD orally for 7 days. Both groups were kept under close observation for 7 days. Monitoring of patient during stay was done by researcher. The cost of medicine was beard by hospital.
Results: In our study, 65%(n=65) in Group-A and 52%(n=52) in Group-B were between 3-8 years of age while 35%(n=35) in Group-A and 48%(n=48) in Group-B were between 9-14 years of age, mean+sd was calculated as 7.07+3.25 and 8.27+3.03 years respectively, 48%(n=48) in Group-A and 55%(n=55) in Group-B were male while 52%(n=52) in Group-A and 45%(n=45) in Group-B were females. Comparison of efficacy of oral azithromycin versus Ciprofloxacin in children with enteric fever shows that 72%(n=72) in Group-A and 85%(n=85) in Group-B were treated effectively, p value was calculated as 0.02 showing a significant difference.
Conclusion: We concluded that the clinical efficacy of Azithromycin is significantly higher when compared with ciprofloxacin in treatment of typhoid fever in children.
COMPARATIVE STUDY OF SECOND GENERATION ANTI HISTAMINE (Cetirizine Hydrochloride 10mg) ALONE VERSUS ANTIHISTAMINE IN COMBINATION WITH LEUKOTRIENE RECEPTOR ANTAGONISTS (Montelukast Sodium 10mg) IN THE TREATMENT OF ALLERGIC RHINITIS
Authors: MUHAMMAD ILYAS  , FASIHA TARIQ  , MAZHAR IFTIKHAR  , NAJAM UL HUSSNAIN KHAN  
Published: June 2023

Background: Allergic rhinitis is an inflammatory disease of the nasal mucosa, induced by an immunoglobulin Emediated reaction in allergen-sensitized subjects. Allergen avoidance and pharmacotherapy are the cornerstones of allergic rhinitis management. Pharmacotherapy is individualized to the patient based on type of symptoms, their duration and severity, co-morbidities, response to prior treatment and patient preference. Classes of drugs used to treat allergic rhinitis include antihistamines, corticosteroids, mast cell stabilizers, decongestants, nasal anticholinergics, and leukotriene-receptor antagonists.
Objective: The objective of the study was to compare the Second Generation Antihistamine (Cetirizine) alone versus Antihistamine with Leukotriene Receptor Antagonist-LTRA (Montelukast Sodium) in the treatment of Allergic Rhinitis AR.
Method: It was single blind hospital-based study in which 200 patients were included. The patients were divided into two equal groups (Group-A and Group-B). Group-A was treated with Cetirizine hydrochloride 10mg/day alone while Group-B was treated with Cetirizine hydrochloride 10mg/day along with Montelukast Sodium 10mg/day.
Results: Among 100 Group-A patients, 35.0% were 15-20 years old and among 100 Group-B patients, 34.0% were 15-20 years old. 57.0% Group-A and 55.0% Group-B patients had seasonal allergy. Among Group-A patients, 26.0% had nasal mucosa pale on revisit and 79.0% patients had any remarkable sedation with dispensed medicine. But among Group-B patients, only 5.0% had nasal mucosa pale and swollen on revisit and only 5.0% patients had any remarkable sedation with dispensed medicine.
Conclusion: Study concluded that combination of cetirizine hydrochloride 10mg/day & montelukast sodium 10mg/day is more efficacious in the treatment of allergic rhinitis than cetirizine hydrochloride 10mg/day alone.
DIAGNOSTIC ACCURACY OF FASTING BLOOD GLUCOSE LEVEL VS GLUCOSE CHALLENGE TEST IN DIAGNOSING GESTATIONAL DIABETES
Authors: ZAHRA SAFDAR  , AMNA SHAHID  , SHABNAM TARIQ  , SANA NAZIR  
Published: June 2023

Objective: The objective of this study is to determine the diagnostic accuracy of fasting blood sugar level and glucose challenge test for screening of gestational diabetes mellitus, taking oral glucose tolerance test (OGTT) as gold standard.
Design: This cross sectional study was carried out in Department of Obstetrics and Gynaecology,OPD of Unit-I, Lahore General Hospital, Lahore for a duration of six months from 1-1-2016 to30-6-2016 . The non-probability purposive sampling technique was used in this study. Women were asked to come on next day early in morning before breakfast with 12 hours fast. The fasting blood sample was obtained. Then women underwent 50 g non-fasting GCT(Glucose challenge ) test on the same day. In both tests, reports were assessed and noted. The patients were labeled as positive or negative for GDM (Gestational Diabetes Mellitus). Then females received 75 g OGTT(Oral glucose tolerance test) one week later on next visit and gestational diabetes was confirmed by OGTT. Reports of gold standard were compared with diagnostic tests.
Results: In our study the sensitivity of FBS was 96.77% with specificity of 98.36%, PPV was 98.59%, NPV was 96.26% and diagnostic accuracy was 97.5% taking GTT as gold standard.-96+30. In this study the sensitivity of GCT was 97.7% with specificity of 98.36%, PPV was 98.6%, NPV was 97.3% and diagnostic accuracy was 98% taking GTT as gold standard.
Conclusion: This study results concluded that Fasting Blood Sugar is a highly accurate test, as is the glucose challenge test for screening of Gestational diabetes mellitus and can be done as a routine screening test as it is easy, one step and cost effective.
MALNUTRITION IN CHILDREN FROM 6-59 MONTHS AT LGH
Authors: KHURRAM KHALIQ BHINDER  , AMEENA  
Published: June 2023

Introduction: Malnutrition in children below the age of 5 years is a significant problem and has been identified by the World Health Organization (WHO) as the most lethal form of malnutrition, indirectly or directly causes an annual death of at least 5 million children worldwide.
Study Design: A community based cross-sectional study was conducted to assess the prevalence of malnutrition and associated factors among children aged 6- 59 months.
Study Duration: The study was conducted from 15th April to 30th May, 2016 Objective: To assess prevalence of malnutrition and associated factors among children aged 6-59 months at Lahore General Hospital, Lahore.
Methods: A community based cross sectional study was conducted on 100 children aged 6-59 months from April 15th to May 30th, 2016 at Lahore General Hospital. Multistage sampling method was used to select the subjects. Anthropometric measurements and structured questioners were used. Bivariate and multivariate logistic regressions were used to identify associated factors of malnutrition.
Results: The analysis this study revealed that 45 (45%) children were malnourished while 55 (55%) were normal. The main associated factors of malnourishment were found to be child age, family monthly income, and children were received butter as pre-lacteal feeding and family planning.
Conclusion: From the findings of this study, it is concluded that malnutrition is still an important problem among children aged 6-59 months. Therefore, especial attention should be given on intervention of malnutrition.