bluuebunny/crossref_metadata_2025_split huggingface dataset:
Disposal of Radioactive Waste Generated at the End of 18F- Fluorodeoxyglucose Production for Positron Emission Tomography - Computed Tomography (PET-CT) Scan at Armed Forces Institute of Radiology and Imaging, Rawalpindi
Authors: Bilal Rizwan , Mehdi Syed Ali , Slehria Atiq ur Rehman , Ullah Hidayat , Amin Zafar , Jamal Ali 
Published: December 2022

Objective: To find out the optimal timeline for the safe disposal of radioactive wastes generated at the end of normal and anomalous productions of 18F-Fluorodeoxyglucose for positron emission tomography-computed tomography scans.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi Pakistan, from Aug to Dec 2020.
Methodology: Wastes generated at the end of 18F-Fluorodeoxyglucose production were tested for residual radioactivity at 2, 12 and 24 hours after synthesis to ascertain the optimal timeline for discarding. The radiation dose at 5 cm from the surface of the container was also assessed.
Results: Fifty productions were included in the study, of which 46(92%) were normal, and 4(8%) were anomalous productions. The mean activity at 2 and 24 hours after the end of synthesis was 4.102±0.831mCi and 0.0047±0.00116mCi, respectively, in normal productions and 45.125±2.332mCi and 0.005±0.00026mCi respectively in anomalous productions. The mean radiation dose at 5cm from the surface of the container at 2 and 24 hours after the end of synthesis was 8.2107±1.665mSv/h and 0.00000966±0.00000212mSv/h in normal productions and 90.32±4.66mSv/h and 0.00975±0.0005-mSv/h respectively in anomalous productions.
Conclusion: The residual radioactivity in wastes was negligible 24 hours after the end of synthesis in both normal and anomalous productions. Radioactive wastes from 18F-Fluorodeoxyglucose production should, therefore, be conserved for at least 24 hours before their disposal to the environment.
Assessment of Anti-Ganglioside Antibodies in Patients Diagnosed With Guillain Barre Syndrome
Authors: Hassan Zahid , Gilani Atifa , Alamgir Waseem , Nawaz Khurram Haq , Ullah Hikmat , Kazmi Sakhawat 
Published: December 2022

Objective: To assess the frequency of patients positive for the presence of anti-ganglioside antibodies and factors related to it among the patients diagnosed with Guillian Barre Syndrome (GBS) at our hospital.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan to Jun 2019.
Methodology: Patients were included in the study once detailed assessment and investigations have been carried out by the consultant neurologist and he has declared the patient suffering from Guillian Barre Syndrome. Anti-ganglioside antibodies were performed on all the patients diagnosed with Guillian Barre Syndrome from the immunology department of the laboratory of our hospital. Factors like age, gender, preceding gastrointestinal infection; sensory involvement and need for mechanical ventilation were related with the presence of Guillian Barre Syndrome in our target population.
Results: A total of 30 patients were enrolled in the study. Out of these 22 (73.3%) were positive for the presence of antiganglioside antibodies while 08 (26.4%) did not show the presence of detectable levels of these antibodies in their serum. On fisher exact test preexisting gastrointestinal infection and sensory involvement were statistically significantly related to the presence of anti-ganglioside antibodies among the patients suffering from Guillian Barre Syndrome.
Conclusion: Relationship of presence of anti-ganglioside antibodies was strong with the Guillian Barre Syndrome among the patients enrolled in our study. It was even stronger in among the patients who presented with the sensory involvement or those who had a gastrointestinal infection prior to the onset of symptoms of...........
Application of Weight Estimation Formula in Emergency for Pakistani Pediatric Polulation: Advanced Pediatric Life Support or Luscombe
Authors: Ateeq Saad , Basheer Faisal , Ikram Farooq 
Published: December 2022

Objectives: To compare original Advanced Pediatric Life Support (APLS) and Luscombe & Owen (LO) formula with weight on scale in Pakistani pediatric population.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Pediatric Unit, Pak Emirates Military Hospital Rawalpindi Pakistan, from Jan to Jun 2018.
Methodology: A total of 1059 patients were subjected to weight scale and different formulas for weight estimation i.e., original APLS and LO. A pre-designed Performa was used to extract the data. SPSS v.25.0 was used as statistical analysis, where t-test was used to measure the significant difference.
Results: The mean age of 1059 children was 4.55 ± 2.96 years with 55.1% males and 44.9% females. A total of 683 (64.4%) children were below or of 5 years of age. The mean scale weight was recorded as 16.71 ± 6.34 kg while for APLS and LO estimation mean was 17.13 ± 5.935 kg and 20.62 ± 8.88 kg respectively. The difference in means of scale weight with APLS and LO estimation was -0.42 kg and -3.92 kg respectively. Independent sample t-test was used for comparison of scale weight with original APLS and LO, p-value of 0.115 and <0.001 were recorded for both respectively, revealing that no difference in means of scale weight and APLS.
Conclusion: Pakistani pediatric population of young age utilizing age-based estimation methods, APLS weight estimation tool is much better than LO estimation.
Comparison of Breast Biopsy Pathology Reporting with Breast Imaging Reporting and Data System (Bi-Rads) Categories-An Institutional Study
Authors: Humayun Saba , Asif Muhammad , Khadim Muhammad Tahir , Din Hafeez Ud , Anwar Madeeha , Rashid Farhat 
Published: December 2022

Objective: To determine concordance and discordance between radiological and pathological findings of palpable breast lesions.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Oct 2018 to Mar 2019.
Methodology: Imaging and histopathologic reports of a total of 170 female patients with breast lumps were analyzed. Concordance and discordance rates were estimated by comparing histopathology and imaging findings. All the reports were divided into four categories. Malignant concordant lesions showed malignant features and benign concordant lesions showed benign features on both imaging and histopathology. Malignant discordant lesions were those lesions, which were reported benign on imaging but proved to be malignant on histopathology and benign discordant lesions were those showing malignant features on imaging but turned out to be benign on histopathology.
Results: Overall concordance was observed in 138 (81.2%) cases with a discordance rate of 18.8% (15.3% benign discordant and 3.5% malignant discordant). All malignant discordant cases (n=6, 3.5%) were reported as Breast Imaging Reporting and Data System category III on imaging and all came out to be invasive ductal carcinoma on histopathology. All benign discordant cases (n=26, 15.3%) were reported as Breast Imaging Reporting and Data System category IV on imaging.
Conclusion: A higher discordance rate between imaging and histopathologic findings was observed in the present study as compared to what cited in the literature. Discordant cases should be followed by repeat biopsy for confirmation of diagnosis
PREVALENCE AND DEMOGRAPHIC CORRELATES OF DEPRESSION, ANXIETY, AND STRESS AMONG UNIVERSITY STUDENTS
Authors: Shafiq Sameera , Fatima Zainab , Bano Zakia 
Published: December 2022

Objectives: To study the prevalence and demographic correlates of depression, anxiety and stress among university students.
Study Design: Correlational Research Design
Place and Duration of Study: Data was collected from University of Gujrat, Gujrat between 6 February, 2019 to, 5 April 2019.
Material and Methods: A sample of 400 students selected by random sampling technique were approached from two departments namely Psychology and Environmental Sciences which were randomly selected from Faculty of Social Sciences and Faculty of Sciences respectively. Depression, Anxiety, Stress Scale-42 (DASS-42) along with demographic sheet and informed consent forms were administered.
Results: Prevalence of moderate to extremely severe level of depression, anxiety, and stress as 54.8%, 73.5%, and 44.3% respectively was found among university students. Depression, anxiety, and stress were found to be positively and significantly related, having high Cronbach’s Alpha Reliability coefficients. Among demographic variables, type of study group significantly predicted level of depression, anxiety, and stress among students. Age and income significantly predicted level of depression, while the former also contributed in anxiety. However, gender was significant predictor of stress only among university students.
Conclusion: The prevalence of depression, anxiety and stress was high among university students in Gujrat. There is a need for launching of counseling and preventive interventions to halt psychiatric disorders at early stages among university students.
Plasmapheresis in Neurological Disorders: Frequency and Type of Adverse Effects Associated with this Procedure in Atertiary Care Hospital in Pakistan
Authors: Kazmi Syed Sakhawat , Alamgir Waseem , Hashmat Asif , Yousaf Ali , Nawaz Khurram Haq , Hassan Zahid 
Published: December 2022

Objective: To determine the frequency and type of adverse effects associated with plasmapheresis among the patients with neurological disorders at a tertiary care hospital in Pakistan.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2019.
Methodology: The sample population comprised 150 patients with various neurological disorders requiring plasmapheresis at a tertiary care hospital in Rawalpindi, Pakistan. The consultant neuro physician diagnosed the underlying disorder, and a management plan of plasmapheresis was given after the departmental meeting. The presence of adverse effects was observed during the session of plasmapheresis till 48 hours after the session.
Results: Out of 150 patients with neurological illness undergoing plasmapheresis at our department, 18 (12%) developed one or more adverse effects due to the procedure, while 132 (88%) did not experience any adverse effects. The mean age of the patients was 30.2 ± 2.698 years. GB syndrome 61 (40.6%) was the commonest disease for which plasmapheresis was done. Allergic reaction 4 (2.6%) was the commonest side effect among the patients undergoing plasmapheresis, followed by abdominal pain 3 (2%). 146 (97.4%) patients were shifted toward, and 4 (2.6%) required intensive care unit admission after the procedure due to complications. Mortality due to this procedure was nil in the given period.
Conclusion: Plasmapheresis is a relatively safe procedure for neurological illnesses with an immunological basis. Patients should be told about the common adverse effects they could face during the procedure especially allergic reactions and...
Determination of Diagnostic Accuracy of Aspartate Aminotransferase/Alanine Aminotranferase in Patients with Hepatic Cirrhosis Presented at Tertiary Care Hospital of South Punjab Pakistan
Authors: Younas Amna , Hanif Waqas , Sheikh Muhammad Ali Ahmad , Younas Muhammad , Ellahi Sana , Ain Qurat ul 
Published: December 2022

Objective: To determine the diagnostic accuracy of Aspartate aminotransferase/Alanine aminotransferase ratio in hepatic cirrhosis keeping liver biopsy as a reference standard.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Medicine, Nishtar Hospital, Multan and Combined Military Hospital, Multan Pakistan, from Dec 2019 to Mar 2020.
Methodology: Two hundred and fifty (250) patients were consecutively picked according to inclusion and exclusion criteria after approval of the institutional review board. Blood Samples were collected from patients for serum alanine aminotransferase and serum aspartate aminotransferase after informed consent who had undergone liver biopsy and Batt Ludwig was the staging system used to stage liver cirrhosis. They were interpreted at Nishtar Hospital Multan Pakistan and analyzed in Combined Military Hospital Multan Pakistan by using the Spectrophotometry technique by IFCC certified enzymatic method. Aspartate aminotransferase/Alanine aminotransferase ratio was derived which represents hepatic cirrhosis keeping liver biopsy as a reference standard.
Result: 230 patients out of 250, fulfilled the inclusion criteria. Kolmogorov smirnov test showed data is non-parametric. The Aspartate aminotransferase/Alanine aminotransferase ratio for diagnosing hepatic cirrhosis in patients with hepatic cirrhosis, its sensitivity, specificity, negative predictive value, positive predictive value and accuracy were 72%, 68%, 89%, 41%, and 69% respectively. The receiver operating curve proclaims that Aspartate aminotransferase/Alanine aminotransferase of 1.7 with an area under the curve was 0.795 which is consistent with histopathological findings of hepatic cirrhosis in liver biopsy.
Conclusion: To conclude, Aspartate aminotransferase/Alanine aminotransferase may be wielded as an incredible diagnostic tool for patients suffering from viral...
Significance of Elevated Synovial Fluid Lactic Acid and Lactate Dehydrogenase Levels in Differentiating Between Septic Arthritis, Inflammatory Arthritis and Non-Inflammatory Arthritis
Authors: Erum Uzma , Umer Tahira Perveen , Arain Shafiq-ur Rehman , Ahmed Muhammad Rashid , Nazir Lubna 
Published: December 2022

Objective: To determine the lactic acid and lactate dehydrogenase levels in synovial fluid and differentiate between inflammatory and non-inflammatory arthritis.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Rheumatology, Liaquat National Hospital, Karachi, from Feb to May 2019.
Methodology: All patients of age >18 years, of either gender, who presented with knee joint effusion were enrolled in the study. Synovial fluid aspiration for the analysis of lactate and lactate dehydrogenase (LDH) was done for all patients.
Results: Seventy-seven patients were enrolled, of which 75 were included in the analysis. Two patients were excluded as one had lymphoma and the other had recent joint trauma. 31 (41.3 %) patients had non-inflammatory, or osteoarthritis, and 44 (58.7 %) had inflammatory arthritis. The mean value of synovial LDH in inflammatory and non-inflammatory arthritis was 737.38 ± 102.76 mmol/L and 265.5 ± 17.43 mmol/L, respectively, (p<0.001). The mean value of synovial lactate in inflammatory arthritis (32.16 ± 2.84 mmol/L) was higher than the mean value of synovial lactate in non-inflammatory arthritis (19.81 ± 1.08 mmol/L) (p<0.001). There mean plasma LDH in inflammatory arthritis and non-inflammatory arthritis was 495.77 ± 41.67 mg/dl and 437.90 ± 30.99 mg/dl, respectively (p>0.05). The plasma lactate in inflammatory arthritis and noninflammatory arthritis was 12.84 ± 0.59 mg/dl and 12.97 ± 0.78 mg/dl, respectively (p>0.05).
Conclusion: Synovial fluid lactic acid and synovial LDH can serve as rapid diagnostic and cost-effective tests to differentiate between non-inflammatory and inflammatory arthritis.
Submental Flap as a Reconstructive Option for Reconstruction in Oral Cancer
Authors: Ahmed Tahir Masood , Qayyum Muhammad Umar , Tahir Umamah , Tahir Yumna , Zahra Rubbab , Tahir Maliha 
Published: December 2022

Objective: To demonstrate the advantages and oncological safety of the submental flap.
Study Design: Case series.
Place and Duration of Study: Department of Plastic and Reconstructive Study, Combined Military Hospital Rawalpindi, Multan and Peshawar Pakistan, from Jul 2014 to May 2020.
Methodology: Twenty patients underwent flap reconstruction with a submental flap. The patients were diagnosed with squamous cell carcinoma, basal cell carcinoma and verrucous carcinoma at different sites of the head and neck. Only patients with no cervical lymph node metastasis were included.
Results: We operated a total of 20 patients, out of which 11 (55%) were male and 9 (45%) were female. The mean age was 62.75 years (range: 47-80 years). Thirteen (65%) patients were diagnosed with Squamous cell carcinoma, 5 (25%) with Basal cell carcinoma and 2 (10%) were diagnosed with Verrucous carcinoma on histopathology. Two (10%) patients reported back with regional recurrence and were given postoperative radiotherapy. One (5%) patient had complete flap loss while 2 (10%) had distal tip necrosis.
Conclusion: In carefully selected cases submental flap is a viable option, without the risk of occult metastasis.
Significance of Ratio of the Neck Circumference and Thyromental Distance as a Predictor of Difficult Intubation in Obese Patients
Authors: Qureshi Sajjad , Khan Amanat , Malik Nazir Ahmed , Mughal Muhammad Saeed 
Published: December 2022

Objective: To ascertain the diagnostic accuracy of raised neck circumference to thyromental distance ratio (NC/TMD) for difficulty in intubation among patients with obesity keeping grades III and IV of Cormack and Lehane's score as the gold standard.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Anesthesiology Department, Combined Military Hospital Rawalpindi, from Jul to Dec 2017.
Methodology: One hundred and thirty obese patients who had to undergo surgery under general anaesthesia were included in the study. All the patients underwent measurement of neck circumference to thyromental distance ratio, and raised neck circumference to thyromental distance ratio was noted. Difficult intubation was labelled according to the grades III and IV of Cormack and Lehane's score.
Results: In this study, 130 cases were included. Fifty-eight patients were males, and 72 were females. Diagnostic accuracy of raised neck circumference to thyromental distance ratio for difficulty in intubation among patients who were obese, was recorded where sensitivity was 83.87%, and specificity was found to be 91.92%, positive predictive value as 76.47%, negative predictive value as 94.79%, the accuracy rate was calculated as 90%.
Conclusion: Our study showed that difficulty in intubation is more frequent in patients who are obese and the neck circumference to thyromental distance ratio is a reliable method for foreseeing difficult intubation compared to other established predictors with cut off value of 5.0.
Improving the system of training students in the field of information security within the framework of the Strategy for the Development of the Information Society in the Russian Federation for 2017-2030 and the Concept for the Development of the Penitentiary System of the Russian Federation for the period up to 2030
Authors: Кравченко Андрей Сергеевич , Калач Андрей Владимирович 
Published: December 2022

В статье рассматриваются вопросы подготовки обучающихся образовательных организаций Федеральной службы исполнения наказаний по специальности 10.05.02 «Информационная безопасность телекоммуникационных систем». Раскрывается содержание подготовки в рамках стратегии развития информационного общества и мероприятий по научно-техническому развитию уголовно-исполнительной системы.
The article deals with the issues of training students of educational organizations of the Federal Penitentiary Service in the specialty 10.05.02 «Information Security of Telecommunication Systems». The content of training within the framework of the strategy for the development of the information society and activities for the scientific and technical development of the penitentiary system is disclosed.
Penerapan Rest Hour Berdasarkan Maritime Labour Convention 2006 Di Atas Kapal MV. Dewi Ambarwati
Authors: Mery Meryanti , Suhardono Ahmad , Herlambang Prananda 
Published: December 2022

This research was conducted to determine the application of rest hour on MV. Dewi Ambarwati. In addition, it is also to find out the obstacles in the application of the rest hour and efforts to overcome the obstacles in the application of Rest Hour on MV. Dewi Ambarwati. The method used in this research is descriptive research method. The data in this research were obtained from observations in MV. Dewi Ambarwati, the documents obtained when conducting research in MV. Dewi Ambarwati, and also got from the result of interviews. From the results of this research, it was found that the implementation of Rest Hour on MV. Dewi Ambarwati has used a program that has been provided by a company called Sea Manager. This program can automatically detect errors in the event of overtime or situations that are not in accordance with the 2006 MLC. Even though they have used the Sea Manager program, the application of rest hour still has some obstacles. The obstacles which are happens caused by the lack of rest hours, so it’s causing the performance of the crew will be decrease, the safety of the crew will be threatened, and also the health of the crew will be decrease. Therefore, several efforts were made to overcome existing obstacles, such as organizing working hours, supervising the implementation of work, making daily work procedures so that all crew members can carry out properly
Penelitian ini dilakukan untuk mengetahui penerapan rest hour diatas kapal MV. Dewi Ambarwati, mengetahui hambatan dan mengatasi hambatan dalam penerapan Rest Hourtersebut. Metode yang digunakandalampenelitian ini adalah metode penelitian deskriptif. Data yang ada dalam penelitian ini didapat dari hasil observasi di MV. Dewi Ambarwati, dokumen-dokumen yang didapat pada saat melakukan penelitian, serta dari hasil wawancara. Dari hasil penelitian tersebut, didapatkan data bahwa penerapan Rest Hour di atas kapal MV Dewi Ambarwati dalam pelaksanaannya telah menggunakan program yang telah disediakan oleh perusahaan bernama sea manager. Program ini dapat dengan otomatis mendeteksi kesalahan apabila terjadi overtime atau situasi yang tidak sesuai dengan MLC 2006. Walaupun demikian, dalam pelaksanaannya penerapan Rest Hour masih terjadi hambatan.Hambatan yang terjadi dalam penerapan Rest Hour terhadap crew kapal dikarenakan kurangnya jam istirahat sehingga menyebabkan kinerja awak kapal akan menurun, keselamatan kerja awak kapal akan terancam, dan kesehatan awak kapal akan menurun. Maka dari itu, dilakukan beberapa upaya untuk mengatasi hambatan yang ada, seperti dilaksanakannya pengorganisasian jam kerja, pengawasan terhadap pelaksanaan pekerjaan, dibuatnya prosedur kerja harian sehingga dapat dilaksanakan dengan baik oleh seluruh awak kapal.
Tezepelumab (Tezspire)
Authors: CADTH  
Published: December 2022

CADTH recommends that Tezspire should be reimbursed by public drug plans for the treatment of severe asthma if certain conditions are met.
Tezspire should only be covered to treat patients with severe asthma who are 12 years of age and older if their asthma is not controlled despite using a high dose of inhaled corticosteroids (ICSs) and at least 1 additional medication, and if they have experienced 2 or more asthma exacerbations (also called asthma attacks) that resulted in hospitalization or required treatment with systematic corticosteroids for at least 3 days in the past year.
Tezspire should only be reimbursed if prescribed by an allergist or respirologist with experience managing severe asthma and the cost of Tezspire is reduced. Tezspire should not be used in combination with other biologics.