bluuebunny/crossref_metadata_2025_split huggingface dataset:
AUDIOMETRIC ASSESSMENT IN POST COVID-19 PATIENTS: A CROSS-SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL OF KARACHI - PAKISTAN
Authors: Feroz Shanila , Mahmood Kausar , Udaipurwala Iqbal Hussain , Zain Syeda , Iqbal Mahveen , Azeem Muhammad Abdul 
Published: January 2022

Objective: To assess audiometry investigations in patients having complaint of tinnitus, vertigo or hearing impairment after recovery from COVID-19 disease, having no external or middle ear diseases.
Study Design: Cross-sectional study.
Place and Duration of Study: United Medical and Dental College, Creek General hospital, Korangi, Karachi Pakistan, from March to May 2021.
Methodology: A total of 60 patients were included in this study who had recovered from the primary COVID-19 infection and reported with the complaints of tinnitus, vertigo and hearing loss. Pure tone audiogram was assessed for sensorineural deafness, its severity and frequencies affected. Pearson Chi square test was used to see the relation of symptoms with severity of hearing loss.
Results: There were 42 (70%) males and 18 (30%) female patients with age range from 18-50 years with mean age of 28.4 ± 8.1 years. Tinnitus was the most common complaint (83.3%) followed by hearing loss (28.3%) and vertigo (23.3%) patients. None of the patients with complaint of hearing loss had normal pure tone audiogram in either right or left ear (p=0.000). Patients with all the three complaints had more hearing impairment where majority had moderate or severe hearing loss (p=0.000). All patients with isolated complaint of vertigo (9 patients) had normal audiogram in both ears (p=0.000).
Conclusion: Auditory and vestibular system involvement in reasonably common in COVID-19 patients. Tinnitus is the most frequent symptom and it should be investigated with full audiological investigations.
AESTHETIC SURGERY: IMPACT ON QUALITY OF LIFE
Authors: Khan Sikandar Ali , Ali Ghazanfar , Rehman Habib Ur , Tariq Muhammad , Raza Maqbool , Fareed Ghulam 
Published: January 2022

Objective: To determine the impact of aesthetic surgery on quality of life.
Study Design: Cross-sectional study.
Place and Duration of Study: The departments of Psychiatry, Plastic Surgery and ENT, Combined Military Hospital Multan, from Jan to Nov 2020.
Methodology: Seventy-four patients were enrolled for this study. They underwent aesthetic surgery. A standard questioner was designed for these patients and response was obtained before undertaking the procedure and then after six months postoperatively. The questions were designed keeping in mind the specific type of surgery. Questions on Life Satisfaction, and the Patient Health Questionnaire (PHQ-4) were asked. The data were collected and analyzed by using SSPS-25.
Results: There is high satisfaction postoperatively after aesthetic surgery. There are improvements in quality of life (p=0.03), physical well-being (Health) (p=0.03), body image (p=0.02), emotional stability (p<0.01) and emotional distress (Depression) (p=0.04 and anxiety (p=0.01) were noted to be reduced.
Conclusion: Aesthetic surgery leads to higher satisfaction in physical appearance, health, emotional stability and reduction of anxiety.
Thalassemia ENDOCRINOPATHIES IN THALASSEMIA PATIENTS
Authors: Touheed Umer , Maryam Samra , Murtaza Hafiz Muhammad , Sabir Muhammad Mujtaba , Goheer Lutfullah , Awan Aamir Aslam 
Published: January 2022

Objective: To determine the common endocrine complications found in children having thalassemia major.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Pediatric Medicine, Combined Military Hospital Multan, from May to Nov 2019.
Methodology: A total of 160 Children with thalassemia were taken in this study. Once registered, venous blood sample was taken and sent to the laboratory for endocrine profile. SPSS-21 was applied for analysis of collected data.
Results: Out of 160 study cases, 100 (62.5%) were boys while 60 (37.5%) were female patients. Mean age of our study cases was 8.58 ± 1.98 years. Mean duration of disease was 5.28 ± 3.29 years. Parental consanguinity was positive in 122 (76.3%) and only 47 (29.4%) were taking chelation therapy. Mean HbA1C level was 6.23 ± 1.18% mg/dl and diabetes was noted in 41 (25.6%) of our study cases. Mean FT4 was 0.98 ± 0.13 ng/dl and hypothyroidism was noted in 24 (15%) of our study cases.
Conclusion: Diabetes and hypothyroidism were the common endocrine complications noted in our study among children having thalassemia. All physicians treating such patients should always screen such patients for early diagnosis and timely management in order to reduce burden of related morbidities and enhance quality of life of these patients.
MOTIVATIONAL FACTORS AND USER AWARENESS IN PATIENTS USING SKIN LIGHTENING CREAMS REPORTING TO DERMATOLOGY OUT PATIENT DEPARTMENT IN COMBINED MILITARY HOSPITAL RAWALPINDI
Authors: Malik Sakina Sadiq , Mashhood Asher Ahmed , Tahir Moizza , Minhas Irfan Jamil , Sadiq Sunniya 
Published: January 2022

Objective: To check the motivational factors behind the usage of skin lightening creams and users’ awareness in our setup by constructing a validated questionnaire.
Study Design: Cross-sectional study.
Place and Duration of Study: Outpatient Department of Dermatology, Combined Military Hospital Rawalpindi, from Oct to Nov 2020.
Methodology: Two fifty patients who were using skin-lightening creams (SLC) were recruited after the informed consent. Questionnaire was made following seven steps as mentioned in AMEE (Association for Medical Education Europe) guide 87. Data was analyzed by SPSS version 21. Reliability was be checked by Cronbach@. Descriptive statistics of responses including frequencies and percentages were calculated. Exploratory factor analysis of questionnaire was made.
Results: Skin lightening cream users had age range from 16-56 years, majority 190 (76%) were females. Out of 158 (63.2%) were married, 180 (72%) well educated and 146 (58.4%) had Fitzpatrick skin type 3-5 predominate. Cronbach alpha of our questionnaire was 0.802. The 5-point likert scale was used to record users’ perceptions in the domains i.e., motivational factors, awareness about product and intentions. Majority, 89 (35.6%) used the product on social media recommendation. Out of 201 (80.4%) developed side effects with telangiectasia and skin thinning being the commonest ones. Out of 88 (35.2%) were using other skin whitening practices besides these creams.
Conclusion: False perceptions about fairness and lack of user’s awareness govern the skin lightening practices in our society resulting in increased usage and side effects experienced by users. A mass educational awareness program regarding “skin lightening.........
COMPARISON OF NUTRITIONAL STATUS OF DOCTORS IN SERVICES HOSPITALS WITH THAT OF EQUIVALENT SOCIAL STRATA IN RELATION TO THEIR EATING HABITS AND PHYSICAL ACTIVITY
Authors: Sukhera Asif Mumtaz , Roshan Rukhsana , Sajjad Sadia , Tanvir Sarah , Mashhadi Syed Fawad 
Published: January 2022

Objective: To compare the nutritional status of doctors and non-doctors in relation to their eating habits and physical activity
Study Design: Cross sectional study.
Place and Duration of Study: Combined Military Hospital/Military Hospital Rawalpindi, from Sep 2018 to Mar 2019.
Methodology: Anthropometric measurements like weight for age, height for age, weight according to height along with BMI were used as indicators of nutritional status. Data collection tool was built upon food frequency questionnaire and comprised of sociodemographic variables followed by major portions related to general health of respondents, nutritional assessment, dietary patterns and physical activity.
Results: Out of 200 respondents, 100 were physicians working in services hospitals of Army while rest hundred were serving officers non-doctors of similar social status. Mean age of the participants was 35.00 ± 7.57 years. There was no significant difference between self-perceived health status of both groups (p>0.05). Dietary habits of physicians were significantly healthy as compared to their counterparts (p=0.01) while physical activity patterns were better amongst non-doctors (p=0.001). Physicians had unhealthy dietary habits, but intake was bit less and cautious as compared to their counterpart group.
Conclusion: Doctors have better dietary patterns, but worse physical activity practices as compared to individuals with similar social strata. Risk factors and nutritional indicators were not different for both groups.
OVERVIEW OF PATIENT PREFERENCES IN THE SURGICAL MANAGEMENT PLAN OF EARLY BREAST CANCERS
Authors: Khan Ayesha , Mushtaq Afroz , Naqvi Syeda Rifaat Qamar , Bano Razia , Khan Fahad Ali , Begum Ruqia , Zaman Said , Mushtaq Sana 
Published: January 2022

Objective: To determine patient preferences in the surgical options of early breast cancers and surgeon’s role in the decisionmaking.
Study Design: cross-sectional study.
Place and Duration of Study: Breast Surgery Department, Combined Military Hospital Rawalpindi Pakistan, from Nov 2020 to May 2021.
Methodology: Patients having early carcinoma breast were studied, i.e., clinical stage 1 or 2, and their surgical preference was recorded. The cases were discussed in multidisciplinary meetings, and a discussion session with patient conducted and then final decision taken from the patient was recorded again, and the results compared.
Results: A total of 28 patients were included in this study and their surgical preferences recorded. Of these patients 22 (78.5%) agreed to breast conservation initially, whereas one of the patients wanted mastectomy. Five (17.8%) patients were undecided between the two. After multidisciplinary team recommendation and discussion with surgeon, only one patient opted for mastectomy (3.6%).
Conclusion: Patients with early breast cancer when offered a surgical decision between breast conservation and mastectomy mostly opt for breast conservation; those who select mastectomy do so because of the fear of recurrence.
FREQUENCY OF PROTEUS MIRABILIS INFECTION IN RHEUMATOID ARTHRITIS
Authors: Saleem Muhammad Hasan , Nisar Shazia , Saleem Muhammad Zulqurnain , Saleem Husnain , Mukhtar Shoaib , Anjum Muhammad Ali 
Published: January 2022

Objective: To assess the frequency of proteus mirabilis infections in patients of rheumatoid arthritis.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Jul 2018 to Jan 2019.
Methodology: A total of 100 cases of rheumatoid arthritis with urinary tract infection were enrolled. Freshly voided urine samples were obtained and sent to the pathology lab. The serotypes of proteus mirabilis were evaluated by enzyme-linked immunosorbent assay (ELISA) and immunoblotting and presence of proteus mirabilis was noted.
Results: A total of 100 cases of rheumatoid arthritis with urinary tract infection were recruited. The mean age of patients was 61.22 ± 10.18 years. There were total 67 (67%) females and 33 (33%) were males. About 79 (79%) patients had sedentary lifestyle while 21 (21%) had active lifestyle. There were 41 (41%) patients had positive urine culture with proteus mirabilis while 59 (59%) had other organism involved in urine infection.
Conclusion: The high frequency of proteus mirabilis infection has been detected and the frequency was of females with complaint of urinary tract infection was high.
MAGNITUDE OF VANCOMYCIN RESISTANT ENTEROCOCCUS FECAL COLONIZATION AND BACTEREMIA IN PATIENTS WITH HEMATOLOGICAL DISEASES AT TERTIARY BONE MARROW TRANSPLANT CENTRE RAWALPINDI
Authors: Sabir Nargis , Satti Luqman , Ahmed Abeera , Zaman Gohar , Iftikhar Raheel , Din Nasir Ud 
Published: January 2022

Objective: To discover the frequency of vancomycin resistant enterococci (VRE) fecal colonization and subsequent bacteremia in patients with hematological diseases in a bone marrow transplant center.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), in collaboration with Armed Forces Bone Marrow Transplant Center, Rawalpindi, from Jan 2016 to Dec 2019.
Methodology: Stool specimens/anal swabs from all enrolled patients were collected aseptically and transported to the laboratory without delay. Blood cultures were collected aseptically from only those enrolled patients who developed signs and symptoms of bacteremia. Stool and blood cultures were processed as per standard microbiological protocols. Enterococci were identified to species level by colony morphology and biochemical tests. Modified Kirby Bauer disc diffusion method and VITEK-2 system (Version-8.01 bio Merieux, France) were used to perform antimicrobial sensitivity of each isolate.
Results: A total number of 246 patients were studied. Among them, 67 (27%) patients had fecal colonization by vancomycin resistant enterococci. We report a statistically significant association of recent hospitalization, prolonged exposure to antimicrobial therapy, chemotherapy exposure and use of indwelling devices during the hospital stay with vancomycin resistant enterococci colonization. Vancomycin resistant enterococci bacteremia was detected in 57 (23%) patients. Among these 57 patients, 53 (93%) were vancomycin resistant enterococci colonizers. Vancomycin resistant enterococci colonization was significantly associated with vancomycin resistant enterococci bacteremia.
Conclusion: A considerable burden of vancomycin resistant enterococci fecal colonization exists among patients with hematological diseases. vancomycin resistant enterococci colonization poses a considerable risk of vancomycin........
OUTCOMES OF VIDEO ASSISTED THORACOSCOPIC DECORTICATION VERSUS CONVENTIONAL OPEN DECORTICATION IN PATIENTS WITH STAGE II OR STAGE III EMPYEMA
Authors: Baloch Ibrahim , Umair Bilal , Asghar Asif , Khan Muhammad Imtiaz , Hanif Muhammad Shoaib , Bilal Azfar 
Published: January 2022

Objective: To compare outcomes of video assisted Thoracoscopic Decortication (VATD) with conventional open decortication (COD) in patients with stage–II or stage–III empyema thoracic.
Study Design: Prospective comparative study.
Place and Duration of Study: Department of Thoracic Surgery, Combined Military Hospital, Rawalpindi, Pakistan, from Jun 2018 to May 2019.
Methodology: A total 60 patients underwent in this study. Patients of both gender who reported for decortication of empyema thoracic were evaluated. All patients diagnosed to have Stage II or III empyema with age 25-50 years were studied for outcomes. All patients were evaluated for operative time, blood loss, post-operative pain, pneumonitis, duration of airleak and post-operative drainage, duration of chest drains and length of hospital stay.
Results: Mean operative time in group-1 was 133.63 ± 8.55 min and in group-2 was 147.83 ± 10.36 min (p-value 0.037). Mean blood loss in group-1 was 296.66 ± 46.11 while in group-2 was 207.30 ± 53.81. Post-operative pain score on VAS for pain was 5.8 ± 1.7 for group-1 and 4.06 ± 1.4 for group-2 (p-value 0.032). Chest tubes were retained for an average of 5.58 ± 0.8 days in group-1 while 3.86 ± 0.8 days in group-2 (p-value <0.001).
Conclusion: Video-Assisted Thoracoscopic Surgery Decortication is superior to open decortication in operative management of Stage II and Stage III Empyema thoracic in terms of post op pain, duration of chest intubation, air leak and hospital stay of the patient.
EFFECTS OF NOISE STRESS ON THYROID STIMULATING HORMONE IN ADULT RATS
Authors: Safdar Saba Saleem , Qamar Khadija , Mehboob Khadija , Faisal Tayyaba , Atta Fahad , Ambreen Aisha 
Published: January 2022

Objective: To determine the effect of noise stress on Thyroid Stimulating Hormone in adult rats.
Study Design: Laboratory-based experimental study.
Place and Duration of Study: Department of Anatomy Army Medical College, Rawalpindi in collaboration with National Institute of Health, Islamabad, from Jan to Dec 2020.
Methodology: A total of 30 adult Sprague Dawley rats were distributed into three groups as ten rats/group. Group A served as the control group, rats in group B were exposed to 100 dB noise for continuous 4 hours/day for four months, and the rats in group C were exposed to 100 dB noise for continuous 6 hours/day for four months. At the end of the study, serum samples were collected from the rats’ tail veins. Thyroid-stimulating hormone levels were compared among the groups.
Results: At the start of the study, mean serum thyroid stimulating hormone level of control group A rats was 0.34 ± 0.15 µIU/ml. Mean serum thyroid stimulating hormone level of experimental groups B and C rats at the start of the study was 0.46 ± 0.18 µIU/ml and 0.41 ± 0.14 µIU/ml, respectively Mean serum thyroid stimulating hormone of rats did not differ statistically significantly between the group p=0.26, By the end of study mean serum thyroid stimulating hormone level of control group. A rats was 0.6 ± 0.2 µIU/ml. Mean serum thyroid stimulating hormone levels of experimental groups B and C rats at the end of the study were 1.32 ± 0.35 µIU/ml and 1.86 ± 0.67 µIU/ml, respectively.......
A COMPARATIVE STUDY REGARDING PAIN PERCEPTION AMONG MALES AND FEMALES OF UNIVERSITY STUDENTS IN PUNJAB, SINDH & BALOCHISTAN
Authors: Tasmeera Saiyida , Akhtar Tanvir , Kiani Shoaib , Afaq Yasir Masood , . Naveeda 
Published: January 2022

Objective: To compare gender differences on pain perception in Pakistani culture.
Study Design: Cross-sectional study.
Place and Duration of Study: Public and private universities of Rawalpindi, Islamabad, Gujrat, Karachi, and Quetta, from Mar to May 2019.
Methodology: A scale of religious identity was developed (n=300). Additionally, participants (n=240) were assigned to pain condition and no pain condition (control condition). Pain condition made them aware of headaches, while the control condition made them aware of death. Participants in both conditions were informed to jot down their emotions. They were also pro-vided Positive and Negative Affect Schedule (PANAS), a distractor task in the form of a story followed by a religious identity scale to compare the difference in percentages of males and females in pain and no pain perception on religious identity.
Results: The alpha reliability of the religious identity scale was 0.60 depicting a moderately internally consistent scale. Furthermore, the findings of the present study showed significant gender differences on pain perception. Mean values indicated high score for females (226.39 ± 28.43) than males (216.39 ± 31.73) in pain condition and similar was the case of no pain condition for females (130.81 ± 23.27) and males (133.35 ± 20.06). Whereas, males 33 (63.04%) were high on religious identity as compared to females 35 (56.06%) in pain condition whereas females 34 (50.84%) were high in no pain condition on religious identity as compared to males 22 (37.31%).
Conclusion: Findings suggested that significant differences exist between males and females in perceiving pain.
LOCAL ANAESTHETIC SYSTEMIC TOXICITY AWARENESS AMONG CLINICAL PRACTITIONERS
Authors: Abbas Sana , Akram Amjad , Abbas Beenish , Fayyaz Mohsin , Mehmood Basit , Hayat Umer 
Published: January 2022

Objective: to assess comprehension of local anaesthetic systemic toxicity among clinical practitioners.
Study Design: Cross-sectional study.
Place and Duration of Study: Tertiary Care Institute, from Dec 2019 to Mar 2020.
Methodology: Methodology constituted of a web-based questionnaire. A pilot study carried out at 15-20 participants forquestionnaire validation and reviewed by independent experts for face validity, a final questionnaire comprised of 10 multiple-choice questions in addition to demographic profile.
Results: A total of 950 participants participated in the study and data was extracted from their responses. Out of 738 (77.8%) participants declared that they are unaware of local anaesthetic systemic toxicity complication, 26 (2.7%) encountered local anaesthetic systemic toxicity and 185 (19.5%) never experienced. Ninety (9.5%) were aware of the availability and utilization of 'Lipid Emulsion' therapy to treat ‘Local Anaesthetic Systemic Toxicity’ (LAST).
Conclusion: Although clinicians have significant awareness level regarding local anaesthetic toxicity but unfortunately compliance with management of this life-threatening complication is deficient.
EVALUATION OF PROGNOSTIC FACTORS IN PATIENTS WITH RELAPSED HODGKIN’S LYMPHOMA UNDERGOING AUTOLOGOUS STEM CELL TRANSPLANT
Authors: Iftikhar Jhanzeb , Sarwar Hafiz Abubakar , Sheikh Fareeha , Shah Mohammad Iqbal , Khan Shafqual Ali , Bakar Muhammad Abu , Siddiqui Neelam 
Published: January 2022

Objective: To identify the prognostic factors in relapsed Hodgkin’s Lymphoma patients with regards to their impact on the outcome of autologous hematopoietic stem cell transplant.
Study Design: Retrospective observational study.
Place and Duration of Study: Department of Medical Oncology, Shaukat Khanum Memorial Cancer Hospital & Research Center, Lahore, Jun 1999 to Jun 2019.
Methodology: Out of a total of 2061 Hodgkin’s Lymphoma patients, 37 (1.8%) patients with relapsed disease underwent autotransplant and were studied using the Hospital Information System. We obtained details of clinicopathological factors, treatment, and outcome. In our study, the outcome variable was event after transplant (relapse/disease progression/death).
Results: Among the 37 relapsed Hodgkin’s Lymphoma patients undergoing auto-transplant, 24 (64.9%) patients had an early relapse after first-line chemotherapy. In this early relapse group of 24 patients, 9 (37.5%) remained well after auto-transplant but 15 (62.5%) patients had an event. Out of 37 relapsed Hodgkin’s Lymphoma patients undergoing auto-transplant, a complete response on pre-transplant imaging was observed in 24 (64.9%) patients. In those 24 patients with a complete response on pre-transplant imaging, 16 (66.7%) patients remained well after transplant while 8 (33.3%) patients had a worse event. Twoyear progression-free and overall survival proportions were 56% and 77% respectively.
Conclusion: Complete metabolic response on pre-transplant imaging was associated with better overall survival. Adverse factors observed were initial short duration of complete response, bulky disease at relapse, variables comprising international prognostic score, B symptoms, and raised erythrocyte sedimentation rate at relapse.
THREAT OF COVID-19 AND PERCEIVED STRESS: THE MEDIATING ROLE OF CHALLENGE, UNCONTROLLABILITY AND STRESSFULNESS
Authors: Bilal Ahmad , Aamir Minahil 
Published: January 2022

Objective: To find out the mediating role of challenge, uncontrollability, and stressfulness in predicting perceived stress from threat during COVID-19 pandemic in the general public.
Study Design: Cross-sectional survey.
Place and Duration of Study: Bahawalpur City, from Mar to May 2020.
Methodology: A total of 360 participants (men=154, women=206) were recruited from different cities of Punjab province. The stress appraisal measure, perceived stress scale, and coping scale were administered through Google forms using social media platforms. The participation in the online survey implied signing the written informed consent available in the survey.
Results: The primary and secondary appraisals of challenge (IE=0.84, SE=0.27, 95% LL=0.31, 95% UL=1.40), uncontrollability (IE=1.03, SE=0.36, 95% LL=0.34, 95% UL=1.76), and stressfulness (IE=-0.28, SE=0.12, 95% LL=-0.56, 95% UL=-0.08) fully mediated the relationship between threat of COVID-19 and perceived stress. Additionally, there was statistically significant positive relationship between threat of COVID-19 and use of coping strategies (r=0.14, p<0.01). The statistics of women regarding appraisals of threat, uncontrollability, stressfulness and perceived stress (2.94 ± 0.88); (2.49 ± 0.84); (2.87 ± 0.73); (19.92 ± 6.08), were found to be slightly higher on as compared to men (2.76 ± 0.82); (2.25 ± 0.81); (2.58 ± 0.76); (18.41 ± 5.37) respectively with p=0.01, Cohen’s d=0.21); p=0.001, Cohen’s d=0.29); p=0.001, Cohen’s d=0.38); (p=0.01, Cohen’s d=0.26).
Conclusion: The threat of COVID-19 significantly led to the experience of perceived stress through the mediating role of primary and secondary appraisals of challenge, uncontrollability, and stressfulness.