bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Teaching by Conventional Method and by using Cognitive Theory of Multimedia to Post Graduate FCPS Radiology Students
Authors: Durrani Misbah , Mahboob Usman , Inam Zainab , Haq Inam Ul , Manzoor Shamaila , Aliya Khushbakht 
Published: February 2022

Abstract:
Objective: Objectives of this study was to teach postgraduate radiology resident physics by both conventional method and by using cognitive theory of multimedia, comparing the results and to see if there was any improvement in their learning and performance.
Study Design: Comparative Experimental study
Setting and Duration of Study: This study was carried out at B.B.H. and Holy Family Hospital Rawalpindi from Oct to Dec 2019.
Methods: Two groups of PG FCPS students of first year and second year comprising of 10 students each were formed. Two groups had similar attributes. First of all Pretest is taken. Group one was taught through didactic lecture and post test was taken. Second group was taught by the use of cognitive theory of multimedia and post test was taken. Cross over was done. Pretest was taken as before. Group one was now taught by the use of cognitive theory of multimedia and post test was taken and group two was taught through didactic lecture and post test was again taken. Results of both groups were compared.
Results: Statistically these two groups were similar. At the end of first round mean pretest score in conventionally taught group I was 4.1 and mean post test score was 8.8. In group II taught by cognitive theory of multimedia the mean pretest score was 4.2 and mean post test score was 13.3. After cross over in group II taught conventionally the mean test score was 4.0 and post test score were 8.9. In group I now taught by cognitive theory of multimedia teaching group mean pretest score was 4.1 and mean post test score was 13.6.
Conclusion: Postgraduate, first and second year Diagnostic Radiology residents performed better in assessment once they were taught Physics by use of cognitive theory of multimedia as compared when taught by conventional method of teaching.
Keywords:
Didactic lecture, cognitive theory of multimedia, post graduate residents.
Quality of Sleep and its associated risk factors among maintenance Hemodialysis patients in Pakistan.
Authors: Yaseen Mahjabeen , Naqvi Shagufta , Saleem Amna , Nasreen Rida , Imran Rida , Mahmood Aysha 
Published: February 2022

ABSTRACT
Background: Chronic Kidney disease patients on maintenance hemodialysis have a poor and compromised life. Sleep quality and pattern is frequently impaired and leads to psychological and physical issues among them. The aim of this study is to determine the quality of sleep and its associated risk factors among maintenance hemodialysis patients.
Materials and Methods:
This Observational cross sectional study was carried out at the Hemodialysis units of Al Mustafa Medical Institute and Alamgir International Welfare Trust from March to August 2019.A total of 156 patients above 18 years of age were recruited in the study. Data was collected regarding demographic characteristics (age, gender, education, marital status, and employment), dialysis characteristics (duration, shift) renal disease characteristics (duration, etiology), smoking status, comorbidities like Cardiovascular Diseases, Hypertension, Diabetes Mellitus, Hepatitis B positive and Hepatitis C positive status. Sleep quality was assessed using Pittsburg Sleep Quality Index (PSQI) and sleep quality score was calculated according to that. Those with a scores of < 5 or 5 indicate good sleep quality, and scores of >5 indicate poor sleep quality. Data was analyzed using the Statistical Package for the Social Sciences version 25.0
Results: Total 156 patients undergoing hemodialysis completed the questionnaire. Majority of the participants (52.9%) were male while 47.1% were female. Out of 140 participants 89(57.1) had a poor quality of sleep while 67(42.9) had a good quality of sleep. A significant association was found between poor quality of sleep and increasing age, smoking and hepatitis B positive status (P<0.05).
Conclusion: Sleep quality is impaired in patients on maintenance hemodialysis. Associated risk factors were age, hepatitis B, smoking.
Key words: Sleep Quality, maintenance hemodialysis, Pittsburg Sleep Quality Index.
Frequency of Thyroid Dysfunction and Congenital Heart Defects in Subjects with Down Syndrome
Authors: Afzal Erum , Arshad Muhammad Sohail , Khan Waqas Imran 
Published: February 2022

ABSTRACT:
Background: Down syndrome (DS) is the most common chromosomal abnormality with prevalence of 1 in 700-1500 live births. Its manifestations may include congenital heart defects(CHD), thyroid dysfunctions, hematopoietic disorders, early-onset Alzheimer disease, gastrointestinal disorders, neuromuscular weakness, hearing and visual problems, characteristic facial and physical features. The prevalence of thyroid disorders and congenital heart diseases are higher in DS patients than in general population.
Objective:To explore the frequency, and types of congenital heart defects (CHD) and Thyroid disorders in children with Down syndrome (DS) in the children hospital and the institute of child health (CHICH) Multan.
Study design: Descriptive cross sectional
Setting: Outpatient department (OPD) of CHICH Multan
Method:A total of 158 down syndrome (DS) patients of 0 to 15 years of age, of both genders were included in this study from October 2019 to October 2020. DS was diagnosed by specific clinical features and karyotyping. Age, sex and mother’s age was noted. Blood samples of all the patients were sent for karyotyping and serum T4 and Thyroid stimulation hormone (TSH). For patients more than 36 months, blood samples were also sent for Antithyroglobulin and antithyroid peroxidase antibodies. Echocardiography of all the patients was done. Data was collected and analyzed by using SPSS version 16.0.
Results:Out of 158 DS children most presented below 6months of age, with male to female ratio of 1:1.4. Mostly mothers were between 20 to 40 years of age. Karyotyping revealed non disjunction in 97% of cases. Cardiac abnormalities were found in 48% of DS children. Most common Type was VSD (10.9%), Thyroid abnormalities were detected in 24% of DS patients, subclinical hypothyroidism (13.9%) was most common.
Conclusion: CHD and Thyroid disorders must be ruled out in all DS patients,to start early management.
Keywords: Down syndrome, Congenital heart disease, hypothyroidism.
Prevalence and Associated factors Of Temporomandibular Joint Dysfunction among Young Adults in Karachi
Authors: Ahmed Hamza , Yasmeen Samreen , Ishaque Farhan , Naz Anum , Khan Fazila , Iqbal Samreen 
Published: February 2022

ABSTRACT
Objective: The objective of the study was to determine the prevalence and associated factors for temporomandibular joint dysfunction among young adult in Karachi.
Material and Methods: A cross-sectional study was carried out in (n=383) subjects with (n=165) males and (n=218) females aged between 18–30 years. The subjects were requested to answer Fonseca’s questionnaires, consisted on ten questions. The collected data sets were analyzed statistically through using the SPSS version 22.
Result: A total (n=383) participants, the prevalence of TMD is 66.6%. The participant with TMD (66.6%) show 54.0% mild TMD, 12.0% moderate and 0.5% severe. Women with 61% showing TMD, as compare to men 73.93%. When considering only severe TMD, only women are affected 0.5%. Participant with any level of TMD show marked characteristics: 12.53% considered themselves tense people; 17.5% reported to clench or grind their teeth; 8.88% reported clicking of the temporomandibular joint; 24.28% reported frequent headache.
Conclusion: The result of the study concluded that the TMD a high prevalence among young adult in Karachi, among participant with TMD most of the participants had mild TMD which reveals that in young population about half of the participants presented with mild TMD.
Key Points: Temporomandibular disorders (TMDs), Mastication, Helkimo's indexes, Fonseca anamnestic Index (FAI)
Comparison of the Effect of Administration Time of Prophylactic Antibiotics on Post-Operative Wound Infection after Caesarean Section
Authors: Mushtaq Maryam , Rizwan Humaira , Kousar Shermeen , Akram Ayesha , Irshad Samina , Irshad Nasim 
Published: February 2022

Objective: To compare the post-operative wound infection rate after cesarean section in women receiving prophylactic antibiotics before skin incision with women receiving antibiotic after cord clamping of baby.
Study design: Randomized controlled trial
Place and Duration of Study: Department of Obstetrics and Gynecology, Holy Family hospital, Rawalpindi from October 2017 to April 2018.
Materials & Methods: 356 patients pregnant female of age 20-45 years who were at term undergoing elective cesarean section for any indication were enrolled. All the patients were randomly divided into two groups. Group A (study group) was comprised of patients who received prophylactic antibiotic dose 15-60 min before the start of surgery. Group B (control group) was comprised of patients who received the antibiotic after the cord clamping of the baby. The wound infection was noted for both the groups. All the patients were followed up for 8 days to assess infection. Data was analyzed using SPSS version 22.
Results: Mean maternal age of the total study population found to be 28.6±5.3 years. Mean gestational age in all the enrolled patients found to be 37.7±1.2 weeks. Wound infection was noted in 28.4% (n=101) of total study population. Out of 101 total patients who presented with wound infection, 63 patients (62.4%) were of control group while only 38 (37.6%) patients belonged to study group. The difference was statistically significant (P<0.05).
Conclusions: Prophylactic antibiotic are useful for controlling post cesarean wound infection.
KEY WORDS: Cesarean delivery, Ceftriaxone, Wound infection
Hypoglycemic status in low birth weight neonates during first 24 hours of life after birth
Authors: Khan Sundus , Ashraf Sohail , Siddiqa Somaya , Noor Sobia , Saleem Munazza 
Published: February 2022

Objective: The study aimed to determine the frequency of hypoglycemia in low birth weight neonates during the first 24 hours of life after birth.
Materials and Methods: This cross-sectional study was conducted from 1st March 2016 to 31st August 2016 in the NICU and postnatal ward of POF Hospital, Wah Cantt. All the babies with birth weight less than 2.5 kg including preterm and term were included in the study. After the aseptic measure blood, sugar was checked and a value less than 45 mg/dl was labelled as hypoglycemia.
Results: Out of 96 neonates,51 (53%) were male and 45 (47%) were female. The minimum weight of the patient was 1.6kg and the maximum was 2.40 kg. Hypoglycemia was noted in 49 (51%) babies after 2 hours of birth whereas 36 (37.5%) had hypoglycemia at 4 hours and 13 (13.5 %) had at 24 hours. 68 (70.8%) babies included in the study were appropriate for gestational age (AGA) and 28 (29.1%) babies were small for gestational age (SGA). After 2 hours of birth, hypoglycemia was present more in SGA babies i.e.20 (71.4%) as compared to AGA babies i.e. 29 (42.6%) which had statistical significance also (p-value 0.01).
Conclusion: Neonatal hypoglycemia is a well-recognized complication in newborns and low birth weight infants are more susceptible to hypoglycemia. Early identification of vulnerable infants and the use of preemptive measures can result in better outcomes.
Role of Occiput Spinal Angle-A Novel Sonographic Index to predict the outcome of labour
Authors: Mughal Hina Hanif , Naqvi Saadat , Raja Riffat , Bhatti Hamza Waqar , Gohar Khansa , Ali Warda 
Published: February 2022

Introduction: The attitude (relationship of head of a fetus to the cervical spine) in the first stage of labour has a significant impact on the outcome of labour. Deflexion of the fetal head is determined by digital vaginal examination during labour. However, different ultra-sonographic indexes have been developed to predict labour outcomes. Occiput spine angle (OSA) is a novel ultra-sonographic marker which can be used to predict operative delivery.
Objective: To determine the effect of the occipital spinal angle measured through transabdominal ultrasound during the first stage of labour on the labour outcome.
Materials and Methods: This prospective cross-sectional study was carried out at Department of Obstetrics and Gynecology Unit 2, Holy Family Hospital, Rawalpindi from June 2020 to Dec 2020 which included 380 low-risk pregnant women in the first active stage of labour. Occipital-spine angle (OSA) was defined as the angle formed by the fetal occiput and the cervical spine on the sagittal plane at the transabdominal ultrasound. For each case, the angle was calculated twice and independently by the 2 radiologists who were unaware of labour outcome to minimize intra and inter-observer error. Data were analyzed using SPSS version 23.0. P-value ≤ 0.05 was considered significant.
Results: Incidence of operative delivery was 17.2%. A cut-off value of 1260125.50 of OSA had a sensitivity of 92.3% and specificity of 98.1% to predict operative delivery. Binary Logistic Regression showed that gestational age, OSA, and Head station are significant with the OR= 1.15, 0.711, and 0.32 respectively.
Conclusion: OSA is a good predictor of operative delivery at a cut-off value of 1260. It should be determined at routine ultrasound booking during pregnancy. More studies should be conducted to highlight its importance.
Antibiotic Resistance Pattern of Salmonella Species in Children in a Tertiary Care Hospital
Authors: Amber Wajeeha , Fatima Itrat , Khalid Qurat-ul-ain , Hameed Hira , Khan Imran Mahmood , Zulfqar Rubina 
Published: February 2022

Objective: To determine the recent antibiotic resistance patterns of Salmonella species in children in a tertiary care hospital.
Materials and Methods: This descriptive cross-sectional study was conducted in the Department of Pediatrics of Akbar Niazi Teaching Hospital, Bhara Kahu, from 18th March 2020 to 31st January 2021. A total of one hundred and seventy-eight (n=178) patients of either gender having age between 1 month to 12 years who had signs and symptoms of enteric fever and positive blood culture report of Salmonella species were enrolled in this study through non-probability, consecutive sampling. The demographic characteristics of patients along with the antibiotic sensitivity pattern of the Salmonella species were recorded on the predesigned proforma and analyzed through SPSS version 25.
Results: Out of the total of 178 patients, reports of blood cultures of 164(92.1%) patients showed Salmonella Typhi while those of 14(7.9%) patients showed Salmonella Paratyphi. Out of the total of 178 Salmonella cases, 11(6.2%) were extensively drug-resistant and 58(32.6%) were multidrug-resistant. All XDR cases were of Salmonella Typhi. Out of 14 Salmonella Paratyphi, 2(14%) were MDR but no XDR Salmonella Paratyphi was found. Nalidixic acid had the highest resistance (96.4%) followed by sulphamethoxazole (65.5%). Azithromycin had the least resistance (0%) followed by imipenem (1.8%), piperacillin-tazobatam (1.9%), and meropenem (2%). Resistance of ceftriaxone was 20.8% and that of ciprofloxacin was 28.2%.
Conclusion: No resistance of Salmonella species against azithromycin was found in our study. The presence of XDR typhoid fever cases and the rising resistance of Salmonella species to ceftriaxone and carbapenems are very alarming. To prevent this resistance, we should reserve carbapenems for complicated cases of resistant typhoid fever only. Minocycline and pipercillin-tazobactam are two other good cost-effective drugs in resistance to typhoid fever.
Home Chaos and Self-Regulation: Moderating Role of Gender between Home Chaos and Effortful Control
Authors: Shakeel Aqsa , Khan Safina , Sabah Syeda Shamama-tus- 
Published: February 2022

Objective: To explore the relationship between home chaos and Self-regulation (effortful control) among young children including other dimensions of temperament (Surgency and Negative affect).
Place and Duration of the Study: The study was conducted from January 2015 to September 2016 in Rawalpindi.
Materials and Methods: This is a descriptive correlational study. The sample consisted of 100 children (3-7 years) and their mothers. The sample was selected from different private and government schools. For children who were less than 4 years, the mothers were contacted at their homes directly. A purposive sampling technique was used to collect data. To assess temperament and home chaos Children’s Behavior Questionnaire Very Short Form (CBQ) and Confusion, Hubbub, and Order Scale (CHAOS)-Urdu Version were used respectively. To collect demographic information for sample selection according to sampling criteria the forms were sent to parents through children.
Results: The results showed significant negative association between home chaos and children’s effortful control (ꞅ = -.21*, p<.05), non-significant positive association between home chaos, negative affect(ꞅ = .06, p>.05) and surgency (ꞅ = -.16, p>.05).. Home chaos was also found to be a significant predictor of effort among children. In addition, it was found that gender moderated the relation between home chaos and effortful control. Boys get affected more than girls and show poor effortful control in chaotic homes [t (96) = 2.39, p<.05].
Conclusion: Home chaos is a significant predictor of effortful control, one dimension of temperament among young children. Boys showed fewer self-regulation skills in chaotic homes as compared to their counterparts.
Kinesiophobia and its association with balance and mobility in knee osteoarthritis patients in Rawalpindi & Islamabad
Authors: Shaukat Saman , Mazhar Maheen , Javed Maria , Naeem Maryam , Naeem Aamer , Kayani Shoaib 
Published: February 2022

Objective:
The purpose of this study was to evaluate the relationship of fear avoidance belief or kinesiophobia with balance and mobility in knee osteoarthritis patients.
Materials and methods:
This cross-sectional correlational study was conducted in Fauji Foundation Hospital, Benazir Bhutto Hospital and Holy Family Hospital, Rawalpindi/Islamabad from January 2019 to June 2019. A total of 64 knee osteoarthritis patients (both male and female) between the ages of 40- 60 years were included in this study. They were selected using the Kallgren Lawrence Classification system (Grade I, II and III) and American College of Rheumatology criteria. Fear avoidance belief questionnaire was used to identify fear avoidance belief/kinesiophobia, Step-up test and Functional Reach test were used to measure balance and timed up and go test was used to measure mobility. Statistical analysis was carried out using SPSS version 21. Kolmogorov-Smirnov test was applied to find out the normal distribution. The relationship between fear avoidance belief and balance and mobility was examined using Spearman’s test of correlation.
Results:
Results showed a weak negative correlation between fear avoidance belief and functional reach test (r= -0.259, P= 0.039), and a weak positive correlation between fear avoidance belief and timed up and go test (r= 0.26, P= 0.841).
Conclusion:
Balance and mobility are negatively affected by fear avoidance beliefs in knee osteoarthritic patients. Thus, fear avoidance belief is an important psychological construct to be considered in the assessment and treatment of knee osteoarthritic patients to prevent balance impairments and fall risk.
Frequency of Capillary leak syndrome in Dengue fever Patients
Authors: Qureshi Safina Hameed , Qureshi Sania Hameed , Shah Syed Fahd , Shah Farid Ullah , Shah Syed Zubair , Shah Syed Hussain 
Published: February 2022

Abstract
Background: Dengue fever is the world’s fastest spreading mosquito borne viral infection. It is prevalent throughout both subtropical and tropical region if the world. The severe form of dengue fever with bleeding manifestations called as dengue hemorrhagic fever. Some of the Dengue fever patients developed capillary leak during critical period of illness. This study aims at determining the frequency of capillary leak syndrome in hospitalized dengue fever patients of tertiary care hospital.
Patients and Methods: The study was conducted over a period of one month from 1st October to 30th October 2019 at department of Medicine Federal Government Polyclinic Post Graduate Medical Institute, Islamabad. This cross sectional study comprising 200 consecutive hospitalized (≥14 years of both gender) dengue fever patients.
Results: Capillary leak syndrome found in 75 patients of Dengue fever. All of them were Primary Dengue Patients. Both ascites and effusion was present in 31 patients. Ascites only found in 25 patients, Pleural effusion bilateral in 7, Right sided pleural effusion in 11 and Left sided in 1 patient. None of the patient had pericardial effusion.
Conclusion: It is concluded that capillary leak syndrome is common in primary dengue fever patients and its early diagnosis helps us in better management during critical phase of illness with better outcome.
Key Words: Dengue Fever, Capillary Leak Syndrome, Dengue Shock
Clinical Profile and Spectrum of Complications of Malaria in Hospitalized Children at a Tertiary Care Hospital
Authors: Waris Rehmana , Aurengzeb Brekhna , Raza Syed Hashim , Waris Aimen , Riaz Ramish 
Published: February 2022

Background: In children, clinical profile of malaria may vary from nearly asymptomatic disease to febrile illness leading to life threatening complications. The mortality among children is largely due to complications like cerebral malaria, severe anemia and pulmonary complications. The current study was conducted to study the clinical profile of malaria, its complications and factor associated with its complications.
Methodology: This observational study was conducted at Children Hospital, PIMS from March 2018 to March 2021. All patients with positive immunochromatographic test and needing hospitalization due to unsettled fever or other troublesome symptom were included. Total 53 patients were included in the study. All patients underwent routine investigations which included ICTMP, complete blood picture, ultrasound abdomen, chest x rays, and routine urinary analysis. Severe malaria was characterized upon WHO guidelines. Patients were treated with chloroquine while those resistant to chloroquine were given artemisinin-based therapy. Data was analyzed by applying appropriate statistical tests via SPSS v 20.
Results: Mean age of the patients was 5.80±3.5 years with male predominance (n=32, 60.4%). Majority of the patients had P.vivax (n=45, 84.9%) infection followed by P.falciparum (n=5, 9.4%), while 3 patients (5.7%) had positive immunochromatographic test for both P.vivax and P.falciparum. Severe malaria developed in 17 (32.1%) of the patients. Most common complication was severe anemia (n=10, 18.8%) followed by black water fever, ADEM disease, pneumonia and convulsions Patients with P.falciparum infection had higher risk (OR=8.00, P-value=0.07) of developing complication compared to P.vivax one.
Conclusion: Rate of severe malaria was found to be 32.1% in children of current study which is quite high. Therefore, every child with malaria should be properly investigated for complications and treated accordingly.