bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of the Impact of Topical Chlorhexidine Versus Methylated Spirion Umbilical Cord Sloughing Time in Neonates
Authors: Hussain Irshad , Wahid Sughra , Qureshi Maliha Akhtar , Hashmi Fasih ul Islam , Fahim Muhammad 
Published: December 2022

Objectives: To study the impact of applying topical Chlorhexidine compared with Methylated spirit on umbilical cord sloughing time in neonates.
Study Design: Quasi-experimental study.
Place and Duration of Study: Paediatric Department, KRL Hospital, Islamabad Pakistan from Oct 2018 to Mar 2019.
Methodology: A total of 100 neonates were enrolled in each Group, i.e., Chlorhexidine and Methylated spirit. After taking informed consent from the parents, the treatment was applied twice daily for five days. Parents had telephonic interviews about the signs of umbilical cord infection on day two following enrollment in the study, and then babies were examined for signs of omphalitis during each hospital visit on days-7, 14 and 21. Umbilical cord sloughing time was noted.
Results: Both Groups were independent (statistically insignificant) with respect to neonatal birth weight, gestational age, neonatal sex, mode of delivery and type of feed with p-values of 0.258 and 0.17, 0.066, 0.304 and 0.143, respectively. The result showed that the mean rank of cord sloughing time with the Methylated spirit was significantly less than Chlorhexidine, with the p-value of 0.001.
Conclusion: Based on our results, we concluded that the application of Methylated spirit on the umbilical cord shortens the sloughing time compared to Chlorhexidine, but both treatments have comparable efficacy in preventing omphalitis.
Comparative Study of Detection of Diabetic Neuropathy by Clinical Assessment and Nerve Conduction Study in Type 2 Diabetes Mellitus Patient
Authors: Sarwar Natasha , Raja Khalid Mehmood , Khan Sarah , Uruj Sana , Hussain Amina , Tariq Maria 
Published: December 2022

Objective: To compare the detection of diabetic neuropathy by clinical assessment and nerve conduction study in type 2 diabetes mellitus patients.
Study Design: Prospective comparative study.
Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi Pakistan, Jan 2020 to May 2021.
Methodology: A total of 300 patients having type 2 diabetes mellitus for more than ten years were included in the study. Revised neuropathy disability score was calculated by the consultant medical specialist on all the patients to make a clinical diagnosis of neuropathy. Nerve conduction studies were performed in the Department of Neurology. Findings of both methods to diagnose the patterns of diabetic neuropathy were compared.
Results: Out of 300 patients suffering from type 2 diabetes mellitus, 188 (62.7%) were males, while 112 (37.3%) were females. The mean age of the study participants was 53.33±4.55 years, and the mean duration of diabetes mellitus was 11.22±5.71 years. Symmetrical neuropathy, motor polyneuropathy and sensory neuropathy had a statistically significant diagnostic pattern when assessed from clinical method and nerve conduction study (p-value <0.05).
Conclusion: Neuropathy had been a common finding among patients suffering from type 2 diabetes mellitus for more than ten years. A significant difference existed in diagnosing various patterns and types of neuropathies when clinical methods were compared with nerve conduction studies.
Hemodialysis Access Outcome in Elderly Population and its Association with Mortality
Authors: Arif Anum , Bhatti Ahsin Manzoor , Sohail Aima , Jamil Usman , Nofil Sabih , Riaz Bismah 
Published: December 2022

Objective: to determine the outcome of arteriovenous fistula in the elderly compared to the younger age group and its association with mortality so that the best approach to hemodialysis access can be defined.
Study Design: Prospective longitudinal study
Place and Duration of Study: Department of Vascular Surgery, CMH, Lahore Pakistan, from Jan 2020 to Aug 2021.
Methodology: All the Patients who presented to access the Surgical Clinic were categorized into three groups according to their age. Outcome variables like fistula maturation, complications and mortality were compared according to age groups.
Result: A total of 184 patients were recruited. We found that in the age group >70 years, there was male predominance (12, 54.5%), three-quarters of them were on hemodialysis at the time of access surgery, only half of them were functional at one year of follow-up, and 6 (27.3%) were not alive at the time of contact. In addition, the pseudo aneurysm was the most common complication in this group, which was the most dreadful of all access-related complications and further put the already frail at risk.
Conclusion: No single optimal approach can be expected to meet the needs of all, and an extensive patient-centred case-based discussion is required for each patient in the hope that optimal dialysis access can be created. Age cannot be defined as an independent risk factor for access creation.
The Co-Existence of Anaemia in Chronic Psychiatric Disorders: A Study at Tertiary Care Hospital
Authors: Nageen Ayesha , Nisa Zaib un , Tauheed Sidrah , Ara Jamal 
Published: December 2022

Objective: To study the frequency of anaemia in various chronic psychiatric disorders in an adult population.
Study Design: Cross-sectional study.
Place and study duration: Creek General Hospital, Karachi Pakistan, from Feb to May 2021.
Methodology: Two hundred and six patients were enrolled in the outpatient clinics after informed consent. Adult patients of 18 to 50 years who were clinically diagnosed with a psychiatric disorder by a certified psychiatrist and had no organicity were included in the study. Anaemia was defined as haemoglobin less than 13 gm/dl for males and less than 12 gm/dl in females. The severity of anaemia was classified into mild, moderate and severe according to the haemoglobin range by WHO criteria. The type of anaemia was categorized into microcytic, normocytic and macrocytic according to the value of mean corpuscle volume.
Results: The overall frequency of anaemia in patients suffering from psychiatric disorders was 126 (61.2%) out of 206 persons. Among the anaemic, 20 (58.8%) had schizophrenia; depression was present in 35 (63.6%), generalized anxiety disorder in 39 (57.4%), somatoform disorders in 20 (62.5%) and 12 (70.6%) in bipolar subjects. Among those who were anaemic, a normocytic value was found in 28 (13.6%) adults, microcytic in 95 (46.0%) patients and macrocytic in 4 (1.9%). The severity of anaemia among anaemic was highest in the mild group. Sixty-nine males (53.6%) and 89 females (65%) were anaemic. (p=0.078). Anaemia was found highest in the 40-50 years age group.
Conclusion: Anaemia was frequently found in adults suffering from chronic psychiatric disorders.
Urinary Sodium and Pregnancy Induced Hypertension; A Unsolved Mystery
Authors: Khattak Muhammad Irfan , Shahid Rana , Khattak Samina Naseem , Khan Jamal Azfar , Naveed Asma , Akram Umbreen 
Published: December 2022

Objective: to know the connection between Sodium intake/urinary Sodium excretion and the tendency to develop hypertension during pregnancy.
Study design: Prospective longitudinal study.
Place and Duration of Study: Combined Military Hospital Kharian, District Gujrat Pakistan from Jul 2019 to Dec 2020.
Methodology: The included population was divided into two equal Groups (Normotensive and hypertensive). Blood pressure was measured at a pre-determined interval starting from the initial prenatal visit before 18 weeks of pregnancy to the 36th week of gestation. Urinary Sodium secretion was determined in 24-hours urine accumulated at three stages between 18 and 36 weeks of gestation. The main outcome actions were the implication of the difference in mean between urinary Sodium and alterations in maternal BP.
Results: The mean age of our study population was 32 years ± 6.96 years, and it ranged from 31 to 48 years. The mean urinary sodium was 141.00 ± 24.879, 140.00 ± 29.73 and 139.00±15.17 mEq/day in the normotensive group, which was 142.00 ± 21.90, 143.00 ± 32.03 and 139.00 ± 14.27 mEq/dl in the hypertensive group. In the hypertensive group, systolic Blood pressure was also high with mean systolic BP of 143.00±12.10, 141.00±12.47 and 148.00±16.82 respectively during the three trimesters. As expected, it was normal in the second group.
Conclusion: There was no significant association between sodium intake and pregnancy-induced hypertension.
Comparison of the Outcome of Intramedullary Nailing Versus External Fixator Fracture Repair in Gustilo Type IIIA Tibio Fibular Fracture
Authors: Ali Pervez , Jatoi Fahad , Hussain Muzafar , Muhammad Dost , Matlo Ejaz , Khoso Riaz Ellahi , Sajjad Mian , Kumar Suresh , Baloch Muzafar , Murtaza Kashif 
Published: December 2022

Objective: To compare the outcome of intramedullary nailing versus external fixator fracture repair in patients presenting with Gustilo Type IIIA tibiofibular fracture.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Orthopaedics, Jinnah Postgraduate Medical Center, Karachi Pakistan, from Feb to Nov 2020.
Methodology: A total of 200 patients were included. Patients were divided into two Groups. In Group-1, intramedullary nailing was done. In Group-2, uniplanar external fixation was done. Both Groups were followed up for six months for assessment of bone union.
Results: The mean age in the Intramedullary Nailing (IMN) Group was 39.21+6.24 years and in the External Fixator (EF) Group mean age was 37.48+8.41 years. In our study, it was found that 81(81%) patients in the EF-Group showed bone union, while 92 patients in the IMN-Group showed bone union. Malunion occurred in 10 in the EF-Group, while only six in the IMN Group. Non-union of bone was unfavourable in the 18 patients of EF- Group and 7 in the IMN-Group. The infection rate was also higher (16%) in patients treated with EF. We noted a significant association between union, non-union, infection and mode of treatment with the p-value of 0.023, 0.019 and 0.046, respectively.
Conclusion: Bone union outcome of Gustilo IIIA open tibial shaft fractures appear superior when treated by Intramedullary Nailing technique compared to External Fixation.
Effect of Supplementation of Acacia Honey and Pioglitazone on Blood Glucose Levels in Streptozotocin-Induced Type 2 Diabetic Rats
Authors: Khan Mahvash , Khan Umar Ali , Asad Munazza , Ashfaq Mehvish , Riaz Bushra 
Published: December 2022

Objective: To determine the effect of combined supplementation of Pioglitazone and Acacia Honey on blood glucose levels in Streptozotocin-induced type 2 diabetic rats.
Study Design: Laboratory-based animal study.
Place and Duration of study: Al-Nafees Medical College, in collaboration with the National Institute of Health, Islamabad Pakistan, from Jan 2016 to Jun 2017.
Methodology: The study was conducted on 150 male Sprague Dawley rats, divided into five groups with 30 rats. Group-I was the control Group. Groups II-V were given Streptozotocin 65 mg Streptozotocin intraperitoneally to make them diabetic. Group II was diabetic control. Group-III was given acacia honey for three weeks. Group-IV received an intraperitoneal injection of Pioglitazone (oral hypoglycemic) 15 mg/kg body weight per day plus Acacia honey, and Group-V was given Pioglitazone intraperitoneally for the same dose and duration. Fasting blood glucose levels were measured after three weeks of supplementation.
Results: After three weeks of supplementation, the blood glucose levels were significantly (p-value <0.001) lower in all Groups (Group- III: 228.33±40.60 mg/dl, Group-IV: 132.50±22.67 mg/dl and Group- V: 120.73±14.19 mg/dl) as compared to Group-II (Diabetic Controls) (290.13±52.60 mg/dl).
Conclusion: Combined supplementation of Acacia honey and Pioglitazone reduces blood glucose levels in Streptozotocin-induced type 2 diabetic rats.
Designing Cast Partial Dentures in Relation to Partial Edentulism
Authors: Aslam Samina , Khan Imran , Sharif Mubashir , Bangash Azhar Ali , Afzal Muhammad , Khan Mansoor 
Published: December 2022

Objective: To determine the pattern of partial edentulism and the cast removable dental prosthesis design in relation to the Classes recorded.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Prosthodontics, Armed Forces Institute of Dentistry (AFID), Rawalpindi Pakistan, from Apr to Sep 2021.
Methodology: A total of 67 partially dentate male and female patients presenting to the Prosthodontics Department requiring partial cast dentures were included in the study. Visual inspection of the master casts and partial denture frameworks was carried out in the laboratory. Kennedy's Classification, modification areas, type of major connector, direct retainer, rest and use of indirect retention were recorded.
Results: The most prevalent Class of partially dentate arch was Kennedy Class-II in maxilla 10 (45.5%) and Class-I and III in mandible 15 (33.3%) each. Major connectors most frequently encountered were anteroposterior palatal strap (59.1%) and lingual bar (57.8%). Circumferential clasp (35.8%) was the most used retainer type in Classes II and III, whereas RPI was mostly found in Classes I and II (32.1%). Occlusal rests were most commonly used (72.4%). Indirect retention was mostly used in Class-I and II denture frameworks (95.9%).
Conclusion: The most commonly encountered partial edentulism pattern was Kennedy's Class I and II. Following basic principles of RPD design can help elevate the standards of removable denture treatment.
Burnout Among Basic Sciences Faculty; A Mixed Method Research
Authors: Ayub Ayesha , Choudry Zafar Ali , Ehsan Sumera Badar , Farooq Hafiz Umer , Tahir Muhammad Munaim 
Published: December 2022

Objective: To study the burnout and its associated factors among the faculty of basic sciences in Faisalabad.
Study Design: Mixed-method research.
Place and Duration of Study: Basic sciences faculty of Public and Private Sector Medical Institutes of Faisalabad Pakistan, from Sep to Dec 2021.
Methodology: Oldenburg Inventory was used to assess burnout among the faculty of basic medical sciences after taking the authors' permission. SPSS version 23:00 was used to analyze data, and those who had shown a higher level of burnout were interviewed. Recorded interviews were later own transcribed, and thematic analysis was done.
Results: The mean exhaustion score for the whole basic sciences faculty was 2.35 ± 0.27, while for disengagement from work, it was 2.24 ± 0.24. Value was 0.62 and 0.144 for exhaustion and disengagement, respectively, showing no difference between the burnout level of faculty members in public and private sectors in both domains. Lack of acknowledgement, Lack of resources, Motivational factors and Lack of progress system were the main themes that emerged after an in-depth exploration of faculty members.
Conclusion: The faculty from basic sciences are facing burnout, and the major causes are lack of acknowledgement and appreciation, decreased number of faculty, inadequate resources and ambiguity about future growth in basic sciences. The faculty member advocated the need to develop faculty training, mentoring and post-graduation programmes for the survival and strengthening of basic sciences.
Comparison between Desarda's Inguinal Hernia Repair and Lichtenstein Hernioplasty in terms of Complications, Operative time and Cost-effectiveness
Authors: Ali Aamir , Bukhari Syed Usman Shah , Awan Saeed Akhtar , Ahmed Umair , Ahmed Ali , Babar Malik Waseem 
Published: December 2022

Objective: To compare Desarda tissue-based repair with the traditional Lichtenstein hernioplasty in terms of complications, operative time and cost-effectiveness.
Study Design: Comparative Cross-sectional Study.
Place and Duration of Study: Surgical Department Combined Military Hospital, Mailsi Pakistan, from Dec 2019 to Dec 2020.
Methodology: Lichtenstein (Group-I) and Desarda (Group-II) were randomly allocated to 140 patients with inguinal hernia, 70 in each Group, respectively. Both Groups were compared in terms of postoperative complications, cost evaluation and operative time.
Results: The mean operative time in Group-I was 54.5±4.09 minutes, whereas in Group-II, it was 70.24±5.30 minutes. The mean cost estimated in Group-I was 4400±225 rupees, while in Group-II, it was 850±150 rupees, respectively. Desarda's repair was comparable to Lichtenstein's hernioplasty in terms of postoperative complications.
Conclusion: Desarda's hernia repair is more cost-effective than the Lichtenstein procedure for treating inguinal hernia. Reduced surgical time, faster restoration to normal gait, and return to work are all the possible benefits of the Lichtenstein repair. Furthermore, Lichtenstein hernioplasty is a better option in patients with weak external oblique aponeurosis.
Small Dense Low-Density Lipoprotein Cholesterol as a Novel Biomarker of Coronary Heart Disease
Authors: Saleem Iffat , Aamir Muhammad , Haroon Zujaja Hina , Yasir Afshan , Munir Muhammad Usman , Anwar Muhammad 
Published: December 2022

Objective: To compare serum small dense low-density lipoprotein cholesterol levels in coronary heart disease (CHD) patients and healthy controls.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, in collaboration with AFIC Rawalpindi from Feb to Dec 2021.
Methodology: A total of 220 participants were selected for the study, 120 healthy controls and 100 CHD patients. Fasting blood samples after 12 hours of fast were collected for lipid profile and small dense low-density lipoprotein cholesterol (sdLDL-C) levels. SdLDL-C levels were analyzed by automated, standardized enzymatic assay on Siemens Advia 1800 automated chemistry analyzer using Ex Denka Seiken kits.
Results: Among the total participants, 154 (70%) were males, and 66(30%) were females. The median age of all participants was 55(IQR: 52 -56) years, while their median sdLDL-C was 0.93 (IQR: 0.56-1.08) mmol/L. Results showed that small, dense LDL cholesterol serum levels were significantly raised in CHD patients compared to healthy controls (p-value <0.05).
Conclusion: The current study showed that patients with CHD had elevated small, dense LDL-C levels compared to the healthy control group.
Significance of Immature Platelet Fraction in Diagnosed Patients of the Immune Thrombocytopenic Purpura
Authors: Haider Mohammad Shabih , Mahmood Asad , Bozdar Manzar , Zahir Saima , Muzafar Saadia , Bukhari Maliha Batool 
Published: December 2022

Objective: Determination of significance of immature platelet fraction (IPF%) in diagnosed patients of Immune thrombocytopenic purpura (ITP).
Study Design: It was a cross-sectional study.
Place and Study Duration: Haematology department, Armed forces Institute of Pathology (AFIP), Rawalpindi Pakistan June 2021 to December 2021.
Methodology: Patients of all ages and genders diagnosed with ITP and platelets less than 100 x 109/L after a review of peripheral blood film were included in the study. Detailed history and examination were made, complete blood count (CBC) test was done on Sysmex XN-3000 automated haematology analyzer. Peripheral blood was stained with Leishman stain and examined under a microscope to rule out pseudo thrombocytopenia and the presence of abnormal cells and dysplasia. After adequate quality and control, the immature platelet fraction was performed on Sysmex XN 3000.
Results: Seventy-two diagnosed cases of immune thrombocytopenic purpura were part of the study. The mean age of the patients was 21.00±14.50 years. 34 (48%) patients were males, and 38 (52%) were females. The mean platelet count was 49.40±24.60. Mean IPF was 17.90±9.50 per microliter. Immature platelet fraction (IPF%) was raised in all the patients with immune thrombocytopenic purpura, confirming our hypothesis that IPF% was an independent predictor for the detection of ITP.
Conclusion: Immature platelet fraction is a unique parameter that can pick patients having thrombocytopenia due to peripheral destruction, including immune thrombocytopenic purpura.
Assessment of Patient-Centered Care with Reference to Minimum Service Delivery Standards in District Headquarter Hospitals of Azad Jammu Kashmir
Authors: Khalid Bilal , Babar Ayesha , Ahmad Sohail , Ayyub Fareeha , Bukhtawer Nadia 
Published: December 2022

Objective: To assess the existing healthcare and delivery services and to evaluate the factors that affect the effectiveness of the care of patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Seven Districts Headquarter Hospitals of Azad Jammu and Kashmir Pakistan from Dec 2020 to May 2021.
Methodology: The data were collected using a questionnaire based on the Material Safety Data Sheet (MSDS) set standards by Punjab Healthcare Commission (PHC) for monitoring and evaluating the services delivery at the hospitals. Data were collected by observing every department of the hospital, interviewing the concerned person of every department, and checking the medical record of the hospital.
Results: All the seven DHQ hospitals including DHQ Neelum, DHQ Hattian Bala, DHQ Pallandari, DHQ Bagh, DHQ Kotli, DHQ Bhimber, and DHQ Mirpur were working throughout the week and service delivery was ensured for 24 hours in all health facilities. It was observed in this study that the management of medication was the area with the highest degree of compliance (76.2%). On the other hand, the area involving patient rights and education showed the lowest level of compliance with an average score of 6 and a percentage compliance of 25%.
Conclusion: The compliance of health delivery services with respect to MSDS was very low in district headquarter hospitals of AJK. Targeted strategies are needed to improve the overall quality of the service delivery.
Frequency and Pattern of Thyroid Dysfunction in Patients with Polycystic Ovary Syndrome
Authors: Naz Sadaf , Khan Khurshid Ahmad , Umer Amina , Raza Muhammad Tabish , Nasir Khalid Mehmood , Hussain Imtiaz 
Published: December 2022

Objective: To determine the frequency and pattern of thyroid dysfunction in patients with polycystic ovary syndrome.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Endocrinology, Jinnah Hospital, Lahore Pakistan, from Jan from Jun 2017.
Methodology: Seventy-seven patients diagnosed with PCOS, based on Rotterdam criteria, were enrolled in the study. Thyroid function status was evaluated using measurement of serum thyroid-stimulating hormone (TSH), free T3, T4 and anti-thyroperoxidase (anti-TPO) antibodies.
Results: The mean age of the study population was 29.0±9.2 years. Out of 77 females with PCOS, 63(81.8%) were euthyroid, five (6.5%) patients were diagnosed with primary hypothyroidism, and nine (11.7%) were found to have subclinical hypothyroidism. Anti-TPO antibodies were detected in 18 patients (23.4%), including 12(19.0%) euthyroid females.
Conclusion: Thyroid dysfunction was found among patients with PCOS. Evidence of autoimmunity was seen even in euthyroid patients.