bluuebunny/crossref_metadata_2025_split huggingface dataset:
Awareness Regarding Breast Cancer, Perceptions and Compliance towards Mammography among Women Visiting Tertiary Care Hospitals in Rawalpindi
Authors: Hisam Aliya , Mashhadi Syed Fawad , Fatima Aliha , Saleem Remsha , Naseer Muhammad Awais , Tariq Hafiz Aleem , Shahid Muhammad Irfan 
Published: March 2023

Objective: To find out awareness about breast cancer, perceptions and compliance towards mammography in women reporting to tertiary care hospitals in Rawalpindi.
Study Design: Descriptive cross-sectional study.
Place and Duration of Study: Tertiary care hospitals in Rawalpindi Pakistan, from Nov 2021 to Apr 2022.
Methodology: A sample size of 120 women was calculated. Sampling technique was non-probability convenient sampling. The data collection tool consisted of demographic information, questions to assess awareness, perceptions and compliance towards mammography. Data were entered and analyzed in SPSS version 26.
Results: The survey was administered to 120 women in tertiary care hospital. The study showed that majority of population was well-aware of breast cancer. Out of 120, 104(86%) women believed that new breast masses should be evaluated at clinics.According to 113(94%) women breast cancer can be cured and 95(79.2%) had belief that breast cancer can be prevented. Fortyfour (36.6%) women were non-complaint towards mammography having higher barrier scores. There was high significance of occupation (p<0.001), education (p<0.001) in terms of individual compliance towards mammography. Significant association was found among the participants who were compliant towards mammography with respect to occupation (p<0.001) and education (p<0.001).
Conclusion: Most of women were well-aware of breast cancer and were more likely to participate in breast health activities.Majority had good perception regarding breast cancer and sufficient knowledge. Lesser women were non-complaint having barriers towards mammography.
Biological, Physical, Ergonomic, Chemical and Psychological Hazard Awareness among Health care and Non-Healthcare Workers
Authors: Hisam Aliya , Mashhadi Syed Fawad , Saqib Arsalan , Naveed Muhammad Saad , Sadiq Muhammad Rehan , Imtiaz Touseef , Ashraf Arslan 
Published: March 2023

Objective: To assess the level of awareness regarding various hazards among healthcare and non-healthcare workers.
Study Design: Analytical cross-sectional study.
Place and Duration of Study: Conducted in Rawalpindi over a 6-month duration from Nov 2021 to Apr 2022.
Methodology: The estimated sample size was 228. Sampling technique was non-probability convenient sampling. Healthcare group included individuals from medical field. Non healthcare group included persons from other fields. Non willing persons were excluded. A preformed questionnaire with some changes was used. Data was collected through Google forms and analyzed in SPSS version 26.
Results: The sample included 162 males and 66 females. Mean age was 21.10±2.76. Out of the total, 75.9% fell into healthcare group while 24.1% landed into Non healthcare group. In Healthcare group highest awareness was about contact with contaminated specimens among Biological hazards (78.6%), Radiations among Physical hazards (76.9%), standing for prolonged periods among Ergonomic hazards (69.9%), corrosives among Chemical hazards (74.0%), and stress among Psychosocial hazards (86.7%). In Non healthcare group highest percentages were of injuries among Biological hazards (72.7%), poor ventilation among Physical hazards (67.3%), standing for prolonged periods among Ergonomic hazards (70.9%) and stress among Psychosocial hazards (80%).
Conclusions: The study showed that for most of the hazards assessed the Healthcare workers are relatively more aware as compared to the Non healthcare group.
The Impact and Implications of ISO Certification on Patient Satisfaction-A Single-Centre Study.
Authors: Khan Muhammad Qaiser Alam , Shaheen Nasira , Sultan Mahmood , Khan Romesa Qaiser 
Published: March 2023

Objective: To examine the impact of the international organization for standardization (ISO), the challenges faced in its implementation and the implications of the process on patient care in the long-term accreditation in a tertiary care hospital in Kharian.
Study Design: Cross-Sectional Study
Place and Duration of Study: Combined Military Hospital, Kharian Pakistan, from Jan to Dec 2019.
Methodology: Patient satisfaction questionnaires were given to 1600 patients presenting to the Indoor, Outdoor, Accidents & Emergency, Pharmacy, Radiology Department and Laboratory of Combined Military Hospital, Kharian Pakistan, as a part of a routine ISO audit annually for 2019. Responses were analyzed and tabulated.
Results: The upward trend in patient satisfaction was attributed to administrative intervention policies based on patient complaints and suggestions incorporated into the questionnaires’ comment boxes. There was a significant difference between the response rates of patients in departments (p=0.016). It indicates that the satisfaction rate was higher among different departments.
Conclusion: Patient satisfaction is directly proportional to interventional measures based on patient feedback. When utilised positively, these feedback loops can lead to an increase in the hospital's overall efficiency index and the standard of care.
Raised Serum Uric Acid as a Predictor of Perinatal Outcome in Parturient with Pregnancy Induced Hypertension
Authors: Zaineb Sadia , Akbar Amina , Mahboob Saira 
Published: March 2023

Objective: To evaluate the association of increased uric acid in pregnancy-induced hypertension with adverse perinatal outcomes.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Departments of Anesthesia, Gynecology & Obstetrics, Combined Military Hospital, Okara Pakistan, from Mar to Sep 2018.
Methodology: After approval of the Hospital Ethical Committee, 106 patients with pregnancy-induced hypertension were included in our study (n=53 in each group). Group-A had patient with raised uric acid, whereas Group-B had normal uric acid. Perinatal outcomes were monitored prospectively.
Results: There was no difference in demographic profile of the two study groups. Raised uric acid was shown to be associated with a higher cesarean mode of delivery (p=0.014); preterm delivery (0.001); intrauterine growth retardation (0.038); and low APGAR at 5mintues (0.008). Raised uric had a sensitivity greater than 65% and specificity greater than 50% for perinatal outcomes.
Conclusion: Raised uric acid is associated with adverse perinatal outcomes in neonates.
Comparison of Efficacy of Resin-Modified Glass Ionomer and Composite Restoration in Inhibition of Secondary Caries in Primary Molars
Authors: Khalid Maira , Saghir Tehreem , Yousaf Ajmal , Hussain Syed Muzammil , Daud Zobia , Sultan Umair 
Published: March 2023

Objective: To evaluate and compare clinical performance and caries inhibition of Resin modified glass ionomer cement and composite restoration in primary molars
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Feb 2019 to Jan 2020.
Methodology: Eighty-three patients fulfilling the selection criteria having at least one carious mandibular primary molar on both sides were divided by split-mouth design. Resin-modified Glass ionomer restorations were done on one side and termed Group-A, and Composite Restorations were done on the other side and termed Group-B. Each restoration was clinically evaluated regarding the appearance of secondary caries at 3, 6 and 12 months after placement by the same operator who performed the treatment.
Results: A total of 166 conventional restorations were placed in the 83 children having carious mandibular primary molars, at least one on each side of the arch. The assessment of restorations, performed after six months, showed an 89.2% success rate of Resin modified Glass ionomer restorations and a 66% success rate of Composite Restoration. One year of follow-up showed an 80% success rate for Resin modified Glass ionomer restorations and 60% for Composite Restoration, as regards secondary caries; statistically significant differences were found in both groups.
Conclusion: The study results showed that Resin modified Glass ionomer cement used to restore primary molars affected by caries performed better clinically than composite in assessing secondary caries.
Nitrous Oxide Influence on Induction of Anaesthesia with Sevoflurane
Authors: Ul Haq Ihtisham , Zahoor Muhammad Umar , Afshan Jelani Farhat 
Published: March 2023

Objective: To find out if the addition of Nitrous Oxide to Sevoflurane significantly reduces induction time and to study the effect of Nitrous Oxide on the frequency of adverse events during induction.
Study Design: Quasi-experimental study
Place and Duration of Study: Operation Theatre Complex, PAF Hospital Mushaf Sargodha Pakistan from Jul to Sep 2018.
Methodology: One hundred adult indoor patients undergoing elective surgeries were included in the study. Their ages were from 18 to 34yrs, and all fell in ASA I and II category. In Group-A, 43 and Group- B, 57 patients were enrolled. Sevoflurane at a high concentration of 8% was given to all patients for induction. In Group-A, 100% oxygen was used as a vehicle, while in Group-B, 70% Nitrous Oxide and 30% oxygen were used as vehicles. Induction time was measured from switching Sevoflurane to when the patients’ arms fell horizontal. We documented adverse effects, including coughing, laryngospasm,bronchospasm, fall in SpO2 <94%, apnea, excitation (head or limb movements), bradycardia and arrhythmias were documented.
Results: Mean induction time was 59.00±13.00s and 58.00±8.00s in Groups A and B, respectively. The difference was statistically insignificant (p-value=0.874). Similarly, there was no significant difference in adverse events between the two groups.
Conclusion: We concluded that adding Nitrous Oxide has no clinically significant advantage in the induction of anaesthesia with Sevoflurane in adults.
Assessment of Risk to Healthcare Workers During the COVID-19 Pandemic: A Tertiary Care Facility Based Cross-sectional Study in Pakistan
Authors: Awan Bushra Ameer Saeed , Mohsin Shamaila , Mashhadi Syed Fawad , Nisar Shazia 
Published: March 2023

Objective: To assess the risk of COVID-19 to healthcare workers (HCWs) in Tertiary care hospitals and its association with demographic factors.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Tertiary Care Hospital, Rawalpindi Pakistan, from May to Dec 2020.
Methodology: Healthcare workers working in a designated COVID-19 Tertiary care hospital were included in the study. A modified "Risk assessment and management of exposure of HCWs in the context of COVID-19 tool" was distributed. HCWs were categorized as "high risk" and "low risk" of COVID-19 infection. Frequency and percentages were computed for demographic variables.
Results: A total of 182 healthcare workers were included, and 167(91.7%) returned the study questionnaire. Most of them were nurses (n=65, 40.1%) working in the medical unit (n=99, 61.1%). Low risk HCWs were 73.5%( n=119) and only 26.5%( n=43)were high risk. Gender (p-value: .02) and type of HCWs (p-value: .01) were significantly associated with the risk of COVID-19.
Conclusion: One-fourth of HCWs were at high risk of COVID-19 virus infection. Female gender and nurses were more likely to acquire COVID-19 infection.
Janitorial Services of Tertiary Care Hospitals, a Critical Analysis
Authors: Khan Nafeesa , Azam Naila , Shahzad Asima , Rathore Mommana Ali , Mashhadi Syed Fawad , Tariq Naseer Alam 
Published: March 2023

Objective: To identify the existing system of janitorial services in the army hospitals, and to give recommendations for standardized policy formulation in military hospitals.
Study Design: Cross-sectional study.
Place and Duration of Study: Tertiary Care Hospitals, namely Hospital A, B and C, at Rawalpindi Pakistan, from Oct 2019 Jan 2020.
Methodology: Responses from 401 Healthcare Administrators (HCAs), Nurses and Janitorial staff were collected through a validated questionnaire, and hospitals' documents/ SOPs, cleaning audit reports, feedback process documents, communication mechanisms and training schedules were reviewed.
Results: Out of 401 respondents, the majority were females (54.4%, 5 were HCAs, 143 were Nurses, and 70 were Janitorial staff). The availability of SOPs was associated with cleaning functional areas of hospitals (p=0.001). Awareness of the risk of infection among healthcare workers was associated with Hepatitis B vaccination (p=0.03). Knowledge of hospital areas regarding cleanliness among hospital workers was linked to providing cleanliness training according to job requirements (p=0.001).
Conclusion: Hospital A performed admirably in most areas but was found to need more human resources, with staff shortages, high turnover, and a lack of adherence to SOPs. To achieve optimum performance, existing and emerging technology must be integrated with sanitary worker preparation and career development; costs must be reduced.Keywords: Hospital environment, Infection control and disinfectants, Janitorial service, Training
Study of the Effect of Treatment of Helicobacter pylori Infection in Rheumatoid Arthritis Patients
Authors: Haq Umer Ul , Haq Sara , Nawaz Haq , Haq Rida , Hakim Farzana , Ud Din Qazi Ali Mohay 
Published: March 2023

Objective: To assess the disease activity after treatment of Helicobacter pylori infection in rheumatoid arthritis patients at a tertiary care hospital of Rawalpindi.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Rheumatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun to Nov 2021.
Methodology: A total of 197 adult patients diagnosed with rheumatoid arthritis and with symptoms of dyspepsia were inducted into this study. First, the disease activity was measured considering parameters such as clinical swollen and tender joints count, disease activity scores 28(DAS-28), visual analogue scale (VAS) and laboratory parameters like erythrocyte sedimentation rate at the start as the baseline. Then, these were repeated after six months, and the differences between the two groups were compared.
Results: At the start of the study, patients who were positive for H. pylori had markedly more swollen and tender joint counts and raised ESR values than those in the negative group. In addition, the disease activity score of 28 and pain scores was markedly raised in the positive group. After H. pylori eradication, the H. pylori-positive patients differed significantly (p<0.001) from patients group negative for H. pylori infection in terms of improvement in DAS-28 score, visual analogue score and clinically. Laboratory indices like ESR showed significantly decreased values (p<0.001) in the H. pylori-treated group compared to those not infected with H. pylori.
Conclusion: From our results, it is suggested that H. pylori infection has a role in the pathogenesis of rheumatoid arthritis.
Comparison of Efficacy of Double Dose Oral Terbinafine versus Itraconazole in the Treatment of Dermatophyte Infections of Skin
Authors: Ali Umar Abdul , Iftikhar Nadia , Malik Naveed Akhtar , Hafeez Javeria , Bashir Uzma , Shahid Muhammad Waseem 
Published: March 2023

Objective: To compare the efficacy of double-dose oral Terbinafine and Itraconazole in treating dermatophytic infections.
Study Design: Randomized controlled trial (ClinicalTrials.gov: NCT04880980).Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Mar 2021 to Mar 2022.
Methodology: One hundred and twenty patients with dermatophyte infections of the skin (i.e., tinea corporis and cruris) diagnosed by clinical presentation and KOH mount were included in this study. After randomization, patients were divided into two groups. Group-A was managed with double-dose oral Terbinafine, while Group-B was managed with double-dose oral Itraconazole. Clinical response and side effects were seen and recorded initially at two weeks and then at four weeks.Efficacy and adverse effects were compared in both groups at the end of four weeks.
Results: Out of 120 patients with dermatophyte infections of the skin included in the study, 59(49.2%) took double-dose oral Terbinafine while 61(50.8%) took double-dose oral Itraconazole after randomization. It was revealed that Itraconazole was more efficacious in achieving cure at the end of 4-weeks as compared to double dose Terbinafine (p-value=0.001), while adverse effects studied were not statistically significant or different in both the groups (p-value>0.005).
Conclusion: This randomized controlled trial showed that double dose oral Itraconazole was more efficacious in treating dermatophyte infections of the skin (i.e., Tinea corporis and cruris) compared to double dose oral Terbinafine. Adverse effects were minimal in both groups and were not specially related to any of these medications.
Superadded Bacterial Infections in COVID–19 Patients; Antimicrobial Susceptibility and Association with Serological Markers
Authors: Afzal Raja Kamran , Ali Saad , Ahmad Farooq , Salim Saira , Hanif Waqas , Saeed Muhammad Qamar 
Published: March 2023

Objective: To determine the frequency and antimicrobial susceptibility pattern of pathogens responsible for superadded bacterial infection in COVID-19 patients and correlate the association of these infections with serological markers.
Study Design: Cross-sectional study.
Place and Duration of study: Department of Pathology, Combined Military Hospital, Multan Pakistan, from Jan to Dec 2021.
Methodology: A total of 290 patients having positive RT-PCR for SARS CoV-2 were included. All samples were processed per Clinical Laboratory Standard Institute (CLSI) protocols. API 20E and API 20NE were used for the identification of Gramnegative rods. Antimicrobial susceptibility testing was performed by the modified Kirby Bauer disc diffusion method.Serological markers, including C-reactive protein (CRP), total leucocyte count (TLC) and serum Ferritin, were determined and compared for significance in positive and negative culture cases.Results: A total of 75 patients had positive bacterial cultures. Among these, 42(56%) were blood culture, 26(35 %) were respiratory culture and 7(9%) were urine culture. Commonly isolated organisms were Acinetobacter baumannii, Klebsiella pneumoniae, Staphylococcus aureus and Pseudomonas aeruginosa, i.e., 23(31%), 20(27%), 13(17%), and 12(16%) respectively. CRP, TLC and S. ferritin were markedly raised in superadded bacterial infection compared to patients with COVID-19 infection only.
Conclusion: The frequency of superadded bacterial infections in COVID-19 patients is high. The pathogens isolated in these cases were multidrug-resistant, reflecting mostly hospital-acquired flora. The association of serological markers in depicting superadded infection is statistically significant and may be used to screen for superadded bacterial infection in COVID-19 patients.
Temporary hard labor prisons in the penitentiary system of Russia at the beginning of the 20th century
Authors: Белова Н.А. 
Published: March 2023

В статье исследуется комплекс вопросов, связанных с местом и ролью временных каторжных тюрем в отечественной пенитенциарной системе начала ХХ века. Предметом исследования является деятельность данного вида тюремных учреждений в рассматриваемый хронологический период. Цель настоящей публикации – изучение истории создания и особенностей функционирования временных каторжных тюрем в начале ХХ столетия. Методологическую основу статьи составили принципы историзма и объективности, философские, общенаучные и специальные исторические методы: диалектический, системный, анализ, синтез, обобщение, историко-генетический, историко-сравнительный, ретроспективный, хронологический, типологический. В результате проведенного исследования прослежена эволюция системы временных каторжных тюрем, функционировавших на территории Европейской России в изучаемый период, выявлены специфика и динамика развития данных пенитенциарных учреждений, особенности содержания в них политических и уголовных арестантов каторжного разряда, проанализированы основные проблемы, с которыми сталкивались эти тюрьмы, а также способы их решения. Сделан вывод о необходимости изучения исторического опыта деятельности временных каторжных тюрем, имеющего как теоретическую, так и практическую значимость.
The article examines a set of issues related to the place and role of temporary hard labor prisons in the domestic penitentiary system of the early twentieth century. The subject of the study is the activity of this type of prison institutions in the chronological period under consideration. The purpose of this publication is to study the history of the creation and features of the functioning of temporary hard labor prisons at the beginning of the 20th century. The methodological basis of the article was the principles of historicism and objectivity, philosophical, general scientific and special historical methods: dialectical, systemic, analysis, synthesis, generalization, historical-genetic, historical-comparative, retrospective, chronological, typological. As a result of the study, the evolution of the system of temporary hard labor prisons that functioned on the territory of European Russia in the period under study was traced, the specifics and dynamics of the development of these penitentiary institutions, the features of keeping political and criminal prisoners of the hard labor category in them were identified, the main problems these prisons faced were analyzed, as well as ways to solve them. It is concluded that it is necessary to study the historical experience of the activities of temporary hard labor prisons, which has both theoretical and practical significance.