bluuebunny/crossref_metadata_2025_split huggingface dataset:
FREQUENCY AND RISK FACTORS FOR CHORONIC HCV IINFECTION:A COMMUNITY BASED STUDY
Authors: Tahir Muhammad , Khan Muhammad Babar , Abbas Hassan Burair , Mustafa Ghulam 
Published: February 2023

Objectives: It was a community based, cross sectional study undertaken to access the frequency of HCV infection and to find out risk factor accociated with its spread..
Results: The frequency of HCV was found to be 53.6%.The most important risk factore associated with the transmission of HCV infection was unsafe injection therapy with contaminated equipment.
Knowledge, Attitude, and Practice of Young Paediatricians About Chelation Therapyin Transfusion-Dependent Thalassemia Major Children
Authors: Fakih Misbah , Basheer Faisal , Ateeq Saad , Ikram Farooq , Asad Hafsa , Khan Qamar uz Zaman 
Published: February 2023

Objective: To determine the knowledge, attitude, and practice of young paediatricians about chelation therapy in transfusiondependent thalassemia major children.
Study Design: KAP survey
Place and Duration of Study: Six different hospitals in Rawalpindi and Islamabad Pakistan, from Jul 2019 to Jan 2020.
Methodology: We study enrolled a sample of 98 doctors. The study included all residents (R1, R2, R3, and R4) and senior registrars of the six hospitals, while those on leave for any reason like maternity or others were excluded. A pre-validated questionnaire was used to collect the data.
Results: Out of 98, maximum residents were of third-year (R3) 27(27.6%), followed by the second-year resident (R2) and senior registrar (SR) 19(19.4%). About 52(53.1%) residents reported that they did not have any thalassemia centre in their facility,with a maximum from Rawalpindi 65(66.3%). The study revealed that 61.2% study population had fair knowledge and attitude towards chelation therapy, while 22(22.4%) had poor and 16(16.3%) had satisfactory scores. The study revealed varied practices except for combination therapy, where 82.7% preferred it. The study showed a significant association between different categories of knowledge and attitude with professional levels, (p-value = 0.014).
Conclusion: The majority had a fair knowledge and attitude towards chelation therapy, while the practice varies mostly,except for the maximum preferred combination therapy for chelation. The study further concluded that with an increase in professional experience, knowledge, attitude and practice improved towards better treatment.
Clinical Course of SARS CoV-2 Infection in Hospitalized Pregnant Patients
Authors: Ansari Asma , Siraj Asifa , Khan Sumaira , Jalil Rabiya , Choudary Abeera , Khalil Hafsa 
Published: February 2023

Objective: To determine the clinical course and outcome of hospitalized pregnant patients with laboratory confirmed SARS CoV-2 (COVID-19) infection
Study Design: Prospective longitudinal study
Place and Duration of Study: Obstetrics Units of Pak Emirates Military Hospital and Combined Military Hospital, Rawalpindi Pakistan, from May to Jun 2020.
Methodology: All patients reporting for childbirth were tested for SARS-CoV-2, and those testing positive were included. The primary outcome was virus clearance time and categorization according to the severity of the disease into asymptomatic,mild, moderate, severe and critical. Furthermore, a comparison was made between the presence of comorbid conditions and symptoms in the category of COVID-19. In addition, neonatal sample evaluation for SARS-CoV-2 was done.
Results: Out of the 881 women giving birth, 41(4.6%) tested positive for SARS Cov-2. Majority were asymptomatic 28(68.3%)followed by mild 8(19.5%), moderate 4(9.8%) and severe 1(2.4%) category. There was a significant association of the COVID categories with symptoms (p-value<0.005) and comorbid condition (p-value<0.001). The mean virus clearance time was 8.20±1.66 days. During hospital stay 34(82.9%) delivered. All 34(100%) delivered babies had no evidence of vertical transmission.
Conclusion: Pregnant women with COVID-19 infection have a nearly similar clinical course to non-COVID women in this study. There is also no evidence of vertical transmission to the neonate.
Outcome of Primigravida with Unengaged Fetal Head at Term or Onset of Labour
Authors: Haroon Mariyam , Baqai Shehla , Choudry Abeera , Gul Mahwish , Ahmed Madiha 
Published: February 2023

Objective: To investigate the duration and course of labour, the need for intervention and feto-maternal outcome in a primigravida with an unengaged fetal head at term in labour.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jun 2018 to Oct 2019.
Methodology: This study was carried out on 150 term primigravida women with an unengaged head in labour. Informed consent, detailed history and examination were made along with ultra-sonographic and pelvic assessment.
Results: Deflexed head was a frequent cause 49(32.67%), cephalopelvic disproportion 24(16%), and loop of cord around theneck 8(5.34%), however, no cause was found 54(36%) women with unengaged fetal head. Ninety three patients (62%)continued with spontaneous labour, while the rest had to be induced. Vaginal deliveries were 100(66.67%), while 50(33.34%) were delivered via Lower Segment Caesarean Section. Out of the 57patients who received induction of labour, 25(43.86%) had vaginal deliveries, while 32(56.14%) underwent Lower Segment Caesarean Section. Five (3.34%) went into a postpartum haemorrhage. Grade 3 perineal tears were seen in 3(2%) patients, and one had a wound infection. APGAR score at ten minutes was between 7 and at ten minutes in 115(76.67%) neonates.
Conclusion: In primigravida at the onset of labour with an unengaged fetal head at term gestation, vaginal delivery is possible with watchful expectancy and appropriate intervention. However, there is a need to ensure that all inductions are strongly indicated.
Thrombocytopenia and its Relationship with Bleeding Manifestations in Dengue Patients-A Tertiary Care Hospital Experience
Authors: Shabir Mahtab , Nisar Shazia , Urooj Zobia , Sohail Mohina , Khan Muhammad Shahid , Khan Danish Hassan 
Published: February 2023

Objective: To explore the extent of bleeding among three different groups of patients based on their blood platelet count and identify the frequency of specific types of bleeding manifestations among the study groups.
Study Design: Comparative prospective study.
Place and Duration of Study: Pak-Emirates Military Hospital, (PEMH) Rawalpindi Pakistan, from Jul to Dec 2019.
Methodology: One hundred patients hospitalized with dengue fever and platelet count of less than 100,000 per microliter of blood were enrolled in the study. They were divided into three groups based on platelet count, i.e., <20,000 (Group-1), 20,000- 50,000 (Group-2), and >50,000 (Group-3) per microliter of blood and observed for different types of bleeds and were also categorized as no bleed, single-site bleed and multiple-site bleed.
Results: Group comparisons revealed that no patient from Group-1 versus 3(10.3%), patients from Group-2 whereas 11(19.3%) patients from Group-3 experienced single site bleed (p=0.05). In addition, patients belonging to Group-1 experienced significantly more petechiae as compared to Groups 2 and 3 (92.8% vs 65.5% vs 19.2%, p<0.001). Similarly, gum bleeding and purpura were more commonly observed in Group-1 than in two other groups (50% vs 44.8% vs 14.0%, p 0.001; 85.7% vs 44.8% vs 3.5%, p<0.001, respectively).
Conclusion: Bleeding complications among dengue patients has a positive relationship with platelet count, but some specific bleeds, e.g., melena, hematemesis, hemoptysis and per vaginal bleed, cannot be directly correlated with the number of platelets circulating in the blood.
Frequency of Respiratory Syncytial Virus Among Hospitalized Children with Acute Lower Respiratory Tract Infections
Authors: Hussain Murtaza , Malik Qudrat Ullah , Khan Qamar uz Zaman , Mumtaz Shaista , Abbas Muhammad , Bashir Junaid 
Published: February 2023

Objective: To determine the frequency of respiratory syncytial virus (RSV) among hospitalized children with acute lower respiratory tract infections (ALRI) and associated risk factors.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jul 2019 to Aug 2020.
Methodology: After approval from the Ethical Review Board, 126 children were included in the study. Nasopharyngeal aspirates were collected from children. The direct immunofluorescence method was utilized to detect intracellular viral antigens of the respiratory syncytial virus. In addition, the presence of symptoms and history for identification of the presence or absence of risk factors was recorded.
Results: 57(45.2%) patients were found to be respiratory syncytial virus positive, and 69(54.8%) were respiratory syncytial virus negative. Significant differences were found in symptoms between RSV-positive and negative children (p=0.001).
Conclusion: Respiratory syncytial virus was among the leading causes of children hospitalized with acute lower respiratory tract infections, with fever and recurrent wheezing as the most common symptoms.
Effect of Negative Pressure Wound Therapy for Soft Tissue Injuries of Foot and Ankle in Patients at a Tertiary Care Hospital
Authors: Khursheed Roqayyah Munawwer , Akhlaq Ali Khan Faisal , Ali Hyder , Zahid Zaara , Kiran Saba , Ullah Ansari Muhammad Kamran 
Published: February 2023

Objective: To determine the effect of Negative Pressure Wound Therapy (NPWT) in patients with foot and/or ankle injury compared with conventional dressing techniques.
Study Design: Randomized controlled trial (Trial No: NCT04569305).
Place and Duration of Study: Department of Plastic Surgery, Dr Ruth K.M. Pfau Civil Hospital, Karachi Pakistan, from Dec 2019 to Oct 2020.
Methodology: All patients with foot and ankle injury resulting in soft tissue injury with or without bones and tendons exposed were included. Thirty-five patients were randomized into the NPTW-Group and 35 into the Conventional Treatment Group using the lottery method. NPTW was applied to an injured foot and ankle area after debridement and cleaning the necrosed tissue. The effect of the technique was assessed by measuring the wound surface area covered with healthy granulation tissue measured in a centimetre square on follow-up.
Results: Mean wound grade at the start of treatment was estimated as 3.20±0.71 in the NPWT-Group and 3.14±0.73 in the Control-Group, and at the end of treatment as 1.20±0.53 in the NPWT-Group and 1.71±0.78 in the Control Group. The mean wound size at the start of treatment was estimated as 52.74±21.92 cm2 in the NPWT-Group and 54.08±23.28 cm2 in Controls.At the end of treatment, an average wound size was estimated as 21.61±13.46 in NPTW and 30.40±16.50 in controls. NPTW significantly reduced wound grade and size more effectively than the conventional technique (p<0.05).
Conclusion: Negative pressure wound therapy was more effective for soft tissue injury of the foot and/or ankle injury than the conventional............
A Comparison Between AH 26 and Sealapex for Post-Obturation Pain
Authors: Ahmad Rana Muzzamil Jamil , Rana Mehmood Ahmad , Alam Mafaza , Bangash Ajmal Yousaf , Bhangar Faisal , Munir Asma 
Published: February 2023

Objective: To find out the post-obturation pain with Sealapex and AH26 Sealers on the first, third and seventh day.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from May to Nov 2019.
Methodology: Three hundred eighty-eight patients of either gender, ranging from age 20 to 45, presenting in the OPD for root canal treatment were selected. Teeth were opened, cleaned and shaped properly with rotary HyFlex EDM files. Obturation was done with Sealapex sealer in half cases, and the rest were obturated using AH26. Post-operative pain was recorded with VAS scoring on the days 1,3 and 7.
Results: Of 388 patients reporting, 131(67.5%) were males, and 63(32.5%) were females. Comparative pain recording on the days 1, 3 and 7 showed post-operative pain for the AH Sealer-Group as 80(58%), 64(72.3%), 22(84.3%) and Sealapex SealerGroup as 58(42%), 24(27.7%) and 4(15.7%) respectively. The difference between post-obturation pain of both groups on all days was statistically significant, with an increased pain in the AH 26 Sealer-Group. There was a statistically significant relation between post-operative pain with gender distribution. Younger patients reported more pain as compared to older subjects.
Conclusion: The post-obturation pain for AH26 is more than Sealapex sealer which gradually decreases with each passing day.
Aetiologies of Central Nervous System Infections: A Study at Tertiary Care Hospital in Northern Punjab
Authors: Shafait Saima , Alamgir Wasim , Yousaf Ali , Hashmat Asif , Nawaz Khurram Haq , Nizami Asif 
Published: February 2023

Objective: To identify demographic patterns and etiologies of CNS infections and to identify the clinical presentations, diagnostic accuracy, and clinical outcomes of various CNS infections in hospitalized patients in a tertiary care hospital.
Study Design: Cross sectional study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Oct 2019 to Jun 2020.
Methodology: A total of 97 adult patients presenting with clinical features of Central Nervous System (CNS) infection were enrolled for this in-hospital study. Cerebrospinal fluid (CSF) was collected for a routine examination, bacterial culture, and viral Polymerase Chain Reaction (PCR) test. Human Immunodeficiency Virus (HIV) serology and neuroimaging were done in all cases. The diagnosis was established based on World Health Organization guidelines for infectious diseases. Infections were classified into four major categories for analysis purposes.
Results: Of 97 enrolled patients, the mean age was 38.8±18.5 years. CNS tuberculosis was the most common infection seen in 46(47.4%) cases, 25(25.7%) patients had viral encephalitis, and 17(17.5%) had bacterial meningitis. The rest of the patients (n=9) had fungal (3%) or parasitic infections (4%). In contrast, two patients were found to have focal cerebritis, one due to Brucella and the other due to Salmonella typhi.
Conclusion: Tuberculosis is the most common (CNS infection in this region. First, patients with CNS infections, especially chronic ones, present very late in our setting, leading to increased morbidity and mortality. Secondly, Molecular diagnosis is obtainable in only a small percentage of cases for various reasons.
Post-Operative Pain Intensity After Using Different Instrumentation Techniques for Canal Preparation
Authors: . Avinash , Sheikh Abubakar , Ali Muhammad , Rashid Saqib , Atkary Gulrukh , Atkary Hussain 
Published: February 2023

Objective: To measure the intensity of post-operative pain after using two techniques for root canal treatment.
Study Design: Quasi-experimental study.
Place of Study and Duration: Operative Dentistry Department, Fatima Jinnah Dental College, Karachi Pakistan, from May to Oct 2019.
Methodology: The study was conducted on 60 patients referred to the Department of Endodontic, Fatima Jinnah Dental College. Enrolled patients were randomly divided into two groups (A and B) using the sealed envelope technique. Two different root canal file systems were used to assess the post-operative pain intensity in both groups.
Results: The post-operative pain intensity considerably decreased in both groups. The difference between the rotational and reciprocal techniques was found to be statistically insignificant (p=0.86) in the 6 hours (p=0.73) and 24 hours’ periods (p=0.147) between the instrumentation techniques. However, pain experienced in the 48 hours was statistically different between the two groups (p=0.03).
Conclusion: Post-operative pain is a consequence of both instrumentation techniques, which should be thoroughly investigated and assessed.Keywords: Instrumentation, Post-operative pain, Pro-taper, Root canal treatment, Wave-one.
Efficacy and Safety of Intense Pulsed Light in Patients of Inflammatory Acne Vulgaris
Authors: Sajid Fatima , Rizwan Muneeza , Sheikh Saleha Saeed 
Published: February 2023

Objective: To assess the efficacy and safety of IPL in patients with inflammatory Acne Vulgaris.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Dermatology, Pakistan Air Force Hospital, Fazaia Medical College, Islamabad Pakistan, from Aug 2019 to Jan 2020.
Methodology: Ninety patients with inflammatory facial acne were enrolled and received four Intense Pulsed Light (IPL) sessions at two weeks intervals with fluence 25J/cm2 and 420nm cut-off filter. The duration of treatment for each patient was two months. Clinical improvement was assessed using the Global Acne Grading System score (GAGs score).
Results: Mean age of the patients was 18.5±3.3years, of which nine were males (10%), and 81 were females (90%). IPL was effective in 42(46.7%) patients with inflammatory acne vulgaris. The median GAGS score before treatment was 20(22–19), and after treatment was 10(12-9), with a significant p-value(<0.001). Only 8(9%) developed erythema, and 1(1%) patient developed post-inflammatory hyperpigmentation.
Conclusions: Intense Pulsed Light was a significantly effective and safe treatment for inflammatory acne of all grades, ages,and genders.Keywords: Efficacy, Inflammatory acne vulgaris, Intense pulsed light, Safety, Treatment.
Association of Body Mass Index with the Severity of SARS-COVID-19 Pneumonia in Hospitalized Patients
Authors: Zafar Zara , Alamgir Wasim , -Humayun M. Zill-e , Rehman Aayesha , Ain Qurat Ul , Ilyas Sumaira 
Published: February 2023

Objective: To determine the association of body mass index with the severity of COVID-19 pneumonia in hospitalized patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, form May to Jun 2021.
Methodology: Patients diagnosed with COVID-19 pneumonia on PCR and chest imaging and admitted to our hospital were included in the study. Body mass index was calculated on the first day of hospital admission, and they were followed up for two weeks during the disease. Increased oxygen demand, duration of admission, CT severity score and use of non-invasive ventilation were compared in patients with normal and increased body mass index.
Results: A total of 800 COVID-19 patients admitted to the hospital were included in the final analysis. The mean age of the study participants was 41.36±4.55 years. Out of 800 patients, 337(42.1%) had normal BMI, 420(52.5%) were classed in the category of overweight and 43(5.4%) were obese. Furthermore, it was seen that increased demand for oxygen, high CT severity score and longer duration of hospital admission had a statistically significant relationship (p-value<0.05) with high body mass index.
Conclusion: More than half of the patients admitted after diagnosis of COVID-19 had higher than normal body mass index. A significant association was found between increased demand for oxygen, high CT severity score, longer hospital admission duration, and high body mass index.Keywords: Body mass index, COVID-19, Outcome.
Diagnostic Value of Rapid COVID-19 Antigen Test (Panbio, Abbott) Compared to RT- PCR in Suspected Cases of SARS-CoV-2 Infection at a Tertiary Care Center
Authors: Riaz Muhammad Omair , Din Nasir Ud , Khan Sara Waqar , Mushtaq Saadiya , Parveen Bushra 
Published: February 2023

Objective: To determine the diagnostic value of rapid COVID-19 antigen test (Panbio, Abbott) in comparison with Reverse Transcriptase Polymerase Chain Reaction (RT-PCR) in suspected community cases of SARS-CoV-2 infection at a tertiary care center in Pakistan
Study Design: Cross sectional study.
Place and Duration of Study: Pathology Department, Combined Military Hospital, Lahore Pakistan, from Jun 2020 to Jun 2021.
Methodology: The diagnostic value of the Panbio®COVID-19 Antigen Rapid Test (Panbio, Abbott), was determined in comparison with RT-PCR in suspected community cases of SARS-CoV-2 infection at a tertiary care center on samples taken simultaneously. 200 individuals reporting to the hospital with signs and symptoms of potential COVID infection or history of significant contact exposure (>1 hour without masking and social distancing) to a RT-PCR positive COVID patient and concurrently requiring a rapid COVID antigen test due to an underlying health condition were included in the study by consecutive sampling.Results: Out of 200 individuals, 53(26.5 %) were COVID positive by RT–PCR whereas 147(73.5%) were clearly negative with no cases of indeterminate viremia on RT PCR. 32(60.3%) out of 53 RT-PCR positive COVID cases were also found to be positive by COVID-19 Antigen Rapid Test, whereas 21(39.6%) were negative. Out of 147 RT-PCR negative COVID cases,146(99.3%) were negative by COVID-19 Antigen Rapid Test as well whereas 1(0.68%) was positive.
Conclusion: COVID-19 Antigen Rapid Test is suitable adjunct to RT-PCR testing in suspected cases in emergent settings in early days of admission.
Increase Mortality Rate in Sepsis Patients with qSOFA Score Greater than Two
Authors: Waqar Khan Raja Muhammad , Mahmood Asad , Qayyum Mohsin , Younas Zahid 
Published: February 2023

Objective: To look for patients of sepsis with a qSOFA score of more than two and an association of a high qSOFA score with mortality and other socio-demographic factors.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Medicine, Combined Military Hospital, Sialkot Pakistan, from Nov 2021 to May 2022.
Methodology: All baseline and relevant investigations were carried out at the time of initial clinical assessment, and the qSOFA score was calculated by a consultant medical specialist for all the patients diagnosed with the septic condition. Patients were followed up for two weeks to look for mortality.
Results: A total of 500 patients, managed for sepsis during the study period were included in the study. Of them, 298(59.6) were males, while 202(40.4) were females. Out of all the patients in the study, 379(75.8) had a qSOFA score of two or less than two, while 121(24.2) had a qSOFA score of more than two. Increased mortality, patients with more than 50 years and comorbid illnesses were found statistically significantly more in the group having a qSOFA score of more than two (p-value<0.001).
Conclusion: Mortality was significantly high in patients with sepsis who had a qSOFA score greater than two at the time of initial assessment compared to those with a score of two or less.