bluuebunny/crossref_metadata_2025_split huggingface dataset:
CHALLENGES FACED BY VASCULAR SURGEONS IN ACCEPTANCE OF THEIR SPECIALTY BY MEDICAL COMMUNITY OF PAKISTAN
Authors: Jamil Muhammad , Jamil Brekhna , Aman Aaiza , Usman Rashid 
Published: January 2022

Objective: To determine the challenges being faced by vascular surgeons in acceptability of their specialty by the medical community of Pakistan.
Study Design: Qualitative case study.
Place and Duration of Study: Various training institutes & teaching hospitals all over the Pakistan, from Sep 2019 to Feb 2020.
Methodology: Semi structured interview format comprising of a series of open ended and broad questions to get maximum relevant information, were sent to 13 surgeons (vascular and part time vascular surgeons) practicing vascular surgery at least for the last five years in various training institutes and teaching hospitals of Pakistan. Interviews were audio recorded on telephone and in persons. The data was transcribed, cleansing was done, and analyzed through inductive and thematic content analysis.
Results: Handful of qualified vascular surgeons, inadequate vascular training program, part time vascular surgery and unawareness/misconceptions/myths about vascular diseases, were the major challenges being faced by the vascular community for their separate identity.
Conclusion: The vascular community is facing great challenges of shortage of qualified vascular surgeons and technicians, inadequate training centers, part time vascular surgery and misconceptions/myths/unawareness about vascular diseases.
ULTRASOUND MEASUREMENTS OF ROTATOR CUFF TENDONS IN MALE ADULTS
Authors: Hassan Khawaja Muhammad Baqir , Slehria Atiq Ur Rehman , Hassan Tathir Baqir , Sarwar Shakil , Sheen Irfan Najam , Manzoor Shamaila , Bokhari Syed Aown Raza Shah 
Published: January 2022

Objective: To establish the normative ultrasound values of tendons of rotator cuff muscles in local healthy male population.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Radiology, Combined Military Hospital Malir, from Oct 2019 to Mar 2020.
Methodology: The sample of study was 456 shoulders of 228 patients. All the patients went under ultrasound shoulder in standard positions. Data analyzed with statistical analysis program (‘Statistical Package for the Social Sciences” version 23).
Results: In right dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were tendon 4.63 ± 0.45 mm, 3.90 ± 0.73 mm, 4.55 ± 0.74 mm and 3.55 ± 0.54 mm respectively. The acromio-humeral interval was 12.63 ± 2.005 mm. In left dominance the mean thickness of the supraspinatus, infraspinatus, subscapularis and biceps tendons were 4.88 ± 0.69 mm, 4.17 ± 0.63 mm, 5.04 ± 0.26 mm and 3.62 ± 0.45 mm respectively. The acromio-humeral interval was 13.65 ± 2.98mm.
Conclusion: The study showed that there was insignificant difference between the dominant and non-dominant shoulders.
TABOOS AND MYTHS REGARDING BREASTFEEDING PRACTICES IN PREGNANT POPULATION
Authors: Ibrar Faiza , Khursheed Naila , Qamar Saima , Masud Atikka , Ifthikhar Bushra , Gul Seema 
Published: January 2022

Objective: To determine the taboos and myths regarding breastfeeding practices in our pregnant population.
Study Design: Cross-sectional study.
Place and Duration of Study: Obstetrics and Gynecology Department, Fauji Foundation Hospital, Rawalpindi Pakistan, from May to Oct 2018.
Methodology: A total of 100 pregnant women attending antenatal clinics were included in the study using non-probability purposive sampling technique. Taboos and myths regarding breast feeding practices were determined using self-administered questionnaire on 2-point Likert scale (1=agree & 2=disagree).
Results: A total of 100 pregnant women participated in the study. Mean parity was 2.89 ± 1.75 and gravidity was 4.17 ± 2.04. Most of the mothers (90%) were house wives and received information regarding breast feeding from family members (81%). Mothers were aware of the nutritious value of breast milk as compared to formula milk. However, there were myths that were not evidence based. These include: breasts sag with breast feeding (48%), it is not necessary to breast feed the baby during night time (43%), breast milk alone was not sufficient to satisfy the child (51%), small size breast produce insufficient milk (27%).
Conclusion: Participants of this study are aware of the importance of breast feeding. However, there are certain taboos and myths prevailing in our population which are not proven scientifically.
STRATEGIES FOR ANESTHESIA MANAGEMENT OF CESAREAN DELIVERIES WITH ABNORMAL PLACENTAL PLACEMENT–ANESTHETIST’S PERSPECTIVE
Authors: Ahmad Maqsood 
Published: January 2022

Objective: To discuss problems faced in the management of emergency and elective cesarean sections with known or unknown abnormal placental placement and their management.
Study Design: Retrospective observational study.
Place and Duration of Study: Different Hospitals for the last 7 years from 2013 to 2020.
Methodology: This retrospective observational study of 120 cases was selected for data collections that underwent anesthesia. Variables under study were age, weight, type of abnormal placenta, fluid, blood/blood products given during surgery, hysterectomy done, general surgeon help required, anesthesia type, and redo of operations.
Results: A total of 120 patients were operated having abnormal placentation. The frequency of placenta previa 90 (75%), and accreta was 30 (25%). Primigravida patients were 19 (15.8%) and multigravida patients were 101 (84.1%). hysterectomy was done in 28 (23.3%) patients. Spinal anesthesia was given in 50 (41%) patients while 70 (58.3%) patients have general anesthesia. The spinal anesthesia was later on converted to general anesthesia in 32 (26.6%) patients out of 50 (41%). Only 12 (10%) patients were reopened for uncontrolled bleeding and 4 (3.3%) patients were sent to tertiary care hospital for further management. The general surgeon was called for help in 24 (20%) of patients and bladder injury occurred in 25 (20.8%) patients. No mortality was found during this period.
Conclusion: Abnormal placental placement is a threat to mother life as well fetus and team of dedicated doctor is required to deal with this emergency. Use of inotropes can help to save the precious lives.
DIAGNOSTIC ACCURACY OF PANBIO COVID-19 RAPID ANTIGEN METHOD FOR SCREENING IN EMERGENCY CASES
Authors: Afzal Raja Kamran , Ali Saad , Ahmad Farooq , Nasir Shafia , Younas Muhammad , Ahmad Taiba 
Published: January 2022

Objective: To determine the diagnostic accuracy of PANBIO COVID-19 rapid antigen method in nasopharyngeal swab, for screening of COVID-19 infection in emergency cases.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Multan, from Jan to Mar 2021.
Methodology: After taking approval from institutional ethical review committee, total 1539 patients were included in this study according to sample size. With informed consent, nasopharyngeal swab specimens were taken for PANBIO COVID-19 rapid antigen method from each patient presenting as emergency medical/surgical case to Combined Military Hospital Multan as well as for Polymerase Chain Reaction for SARS CoV-2 RNA. PANBIO COVID-19 rapid antigen method and polymerase chain reaction for SARS CoV-2 RNA were performed simultaneously on swabs. Polymerase chain reaction for SARS CoV-2 RNA was considered to be the gold standard for comparison with the PANBIO COVID-19 rapid antigen method.
Results: A total of 21 patients had SARS CoV-2 RNA detected by polymerase chain reaction indicating COVID-19 infection. Out of polymerase chain reaction positive patients, PANBIO™ COVID-19 Ag test was able to detect 19 cases. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy was calculated and found to be 90.47%, 100%, 100%, 99.8% and 99.8% respectively.
Conclusion: PANBIO™ COVID-19 rapid antigen method was found to have excellent diagnostic accuracy in detection of COVID-19 infection. It can provide as a good alternate test for screening of masses with a short turn around time of only 15 minutes.
CORRELATION BETWEEN SERUM LEVELS OF FOLLICLE STIMULATING HORMONE AND GRAAFIAN FOLLICLE VASCULARITY ON DOPPLER IN INFERTILE FEMALES OF LAHORE
Authors: Iqbal Amjad , Gilani Syed Amir , Hanif Asif 
Published: January 2022

Objective: To determine correlation between serum levels of Follicle Stimulating Hormone and Graafian Follicle vascularity on Doppler ultrasound in infertile females of Lahore, Pakistan.
Study Design: Cross sectional study.
Place and Duration of Study: Prime Ultrasound center, 2-Shalamrar Link Road, Mughalpura, Lahore, Pakistan From Mar 2018 to Sep 2019.
Methodology: A total of 100 infertile females using simple random sampling were taken. All the married women of reproductive age and married for >12 months who have not conceived despite regular unprotected intercourse, having no other uterine and endometrial or ovarian pathology were taken. The patients who fail to provide serum hormone laboratory reports were excluded. Transvaginal ultrasonography was done for all females and graafian follicle vascularity on Doppler was measured on day 12 of the cycle.
Results: The Median age of females was 28 (30-25) years range from 19 and 46 years. The median Follicle Stimulating Hormone levels at day 12 was 6 (8.25-5.22) mlU/ml with minimum and maximum FSH values as 3.20 and 40 mlU/ml. The median follicle size was 13.65 (16.04-10.84) (mm) with minimum and maximum size as 10 mm and 26 mm. There were 61% females who had Grade–1 perifollicular vascularity, 24% females had grade-2 and 15% females had grade-3 of perifollicular vascularity. There was significant positive correlation between perifollicular vascularity grades and Follicle-stimulating hormone levels day 12 (mm) i.e., r=0.309, p-value <0.001.
Conclusion: It is concluded that perifollicular vascularity was found to correlate with serum Follicle-stimulating hormone levels, so graafian follicle vascularity on.......
EFFECTIVENESS OF MISWAK AS COMPARED WITH TOOTHBRUSH: A CROSS-SECTIONAL STUDY
Authors: Mir Hassam Anjum , Sharif Mubashir , Asif Ali , Shamim Maleeha , Qureshi Maaz , Akhtar Aqsa 
Published: January 2022

Objective: To determine if the traditional chewing stick Miswak was as effective in cleaning teeth as Toothbrush.
Study Design: Cross sectional study.
Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi, from Aug 2020 to Jan 2021.
Methodology: A total of 300 subjects were included which were divided in two groups on the basis of whether they used miswak or toothbrush as a cleaning aid. Group A was toothbrush users and group B was Miswak user. Plaque Index was used to determine the cleanliness of teeth. The scores were recorded and data analyzed using SPSS-23.
Results: The means and standard deviations of Plaque Index score for group A and B were 0.96 ± 0.58 and 0.98 ± 0.56 respectively. The comparison of Plaque Index score for both groups was insignificant with the p-value of 0.083.
Conclusion: Within the limitations of this study, it is concluded that, no significant difference was found in the effectiveness of traditional miswak and tooth brush. It is recommended that if the technique of teeth cleaning is good then any of the abovementioned means of teeth cleaning can be used.
ROLE OF THE CULTURAL CONTEXT IN DETERMINING THE USE OF PATIENT SAFETY; A MIX METHOD STUDY
Authors: Saqib Khan Najm Us , Hafeez Assad , Khadim Rehana , Haider Anam , Hisam Aliya , Butt Tahir Mahmood 
Published: January 2022

Objective: To compare the role of the cultural context in determining the use of patient safety by participants from private and public sector hospitals of Karachi, Pakistan.
Study Design: Mix method study.
Place and Duration of Study: In two tertiary care hospitals (one private and one public sector) of Karachi from Nov 2016 till Nov 2017.
Methodology: A sample size of 153 was enrolled by consecutive convenient sampling technique. The role of the cultural context of both hospitals was compared by asking questions from the hospital's staff. Data were collected by the researcher using an open and closed-ended questionnaire.
Results: Data of 153 successful and filled questionnaires were analyzed. Out of 153, 78 (51%) cases were for private hospitals and 75 (49%) cases were for public hospitals. The role of the cultural context in determining the use of the patient safety concept was not sufficiently understood by participants of both hospitals, and most of the participants gave vague answers.
Conclusion: Cultural context is one of the key factors in patient safety as with collective mindfulness about safety issues, and health care can be delivered safely.
EVALUATION OF CHONDROPROTECTIVE EFFECTS OF HYALURONIC ACID IN A RAT MODEL OF OSTEOARTHRITIS
Authors: Ishaq Noaman , Ali Shabana , Aslam Khan Muhammad Waqar , Farhat Kulsoom , Ata Nausheen , Mehdi Quratulain 
Published: January 2022

Objective: To evaluate the chondroprotective effects of hyaluronic acid in a rat model of osteoarthritis.
Study Design: Laboratory based experimental study.
Place and Duration of Study: Department of Pharmacology, Army Medical College, Rawalpindi, in alliance with National Institute of health, Islamabad and Department of Pathology, Army Medical College Rawalpindi, from Apr to Jun 2019.
Methodology: Sixteen (16) rats of Sprague Dawley breed were procured in this study. Osteoarthritis was induced in right knee joint of rats by surgical resection of medial meniscus and anterior cruciate ligament. They were allocated into two (02) groups with eight (08) rats in both groups. Group-I was control group that was treated with 0.2 ml intra articular saline once weekly for four weeks. While group-II was treatment group that was intra particularly administered with 0.2ml hyaluronic acid once weekly for four weeks. One week after the last dosage, gait pattern of the animals was scored. Then animals were sacrificed and a part of proximal tibia was obtained for histopathologic analysis.
Results: Mean gait score of control group and treatment group was 3.25 ± 0.707 and 1.00 ± 0.756 respectively with a statistically significant p-value of <0.001, while mean histopathological Modified Mankin score of control and treatment group was 11.5 ± 1.195 and 5.50 ± 1.195 respectively with a significant p-value of <0.001.
Conclusion: Intra articular viscosupplementation of hyaluronic acid in rat model of osteoarthritis resulted in improved gait pattern and histopathology.
EVALUATION OF CHOROID THICKNESS CHANGES AFTER UNEVENTFUL PHACOEMULSIFICATION SURGERY USING SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY AT A TERTIARY CARE EYE HOSPITAL
Authors: Rafique Aisha , Zafar Omar , Khan Summaya , Javaid Hassaan 
Published: January 2022

Objective: To analyze the effects of uneventful phacoemulsification surgery on choroidal thickness using spectral domain optical coherence tomography.
Study Design: Prospective comparative study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jun 2018 to Jun 2019.
Methodology: In this prospective study, 300 eyes of 300 patients undergoing phacoemulsification surgery were included. All patients underwent detailed ophthalmologic examination, including measurement with optical biometry, intraocular pressure and choroid thickness. The choroidal thickness was measured perpendicularly at the fovea using spectral domain optical coherence tomography preoperatively and 1 month postoperatively. Changes in intraocular pressure and choroid thickness after surgery were evaluated.
Results: There was a statistically significant increase in the choroid thickness in early postoperative period (p-value <0.01). This increment was prominent in sub foveal regions. The intraocular pressure decreased significantly 1 month after surgery (p-value <0.01). The change in intraocular pressure was correlated with the choroid thickness change at sub foveal region.
Conclusion: Uncomplicated phacoemulsification induces non-pathologic increase in sub-foveal choroid thickness probably due to the inflammatory insult of the surgery. Long-term follow-up of eyes having phacoemulsification surgery may provide further insight into the effects of cataract surgery on the choroid.
OUTCOME OF PATIENTS TREATED WITH BLADDER PRESERVATION PROTOCOL IN UROTHELIAL CARCINOMA OF URINARY BLADDER
Authors: Hussain Sameed , Syed Abdus Samad , Samad Fouzia Abdus 
Published: January 2022

Objective: To explore trimodality treatment with neoadjuvant chemotherapy followed by concurrent chemoradiotherapy as an alternative approach to neoadjuvant chemotherapy followed by radical cystectomy, for the treatment of non-metastatic muscle invasive bladder carcinoma.
Study Design: Retrospective observational study.
Place and Duration of Study: Combined Military Hospital Rawalpindi Pakistan, from 2006 and 2015.
Methodology: A total of 122 patients were evaluated in a retrospective manner. Primary endpoint was overall survival. Patients received four courses of neoadjuvant chemotherapy followed by radical concurrent chemoradiotherapy with Cisplatin as radiation sensitizer.
Result: 5-year overall survival was 80 (66%) in this population and a complete response following completion of treatment was seen in 93 (76.3%) patients. Subset analysis showed markedly increased 5-year overall survival of around 104 (85%) in patients having complete response after neoadjuvant chemotherapy.
Conclusion: The study concludes that bladder preservation is an acceptable alternative to radical cystectomy in selected population especially among those who had a complete response to the initial four courses of chemotherapy.
EFFECTIVENESS OF COMPREHENSIVE CAMPAIGN FOR DENGUE CONTROL IN SOUTHERN PUNJAB, PAKISTAN - AN EXPERIENCE OF 2 YEARS
Authors: Younas Muhammad , Aziz Muhammad Asif , Afzal Raja Kamran , Iqbal Hamid , Hussain Mohsin , Mir Rabia Salar 
Published: January 2022

Objective: To determine the effect of comprehensive campaign for dengue control in Southern Punjab, Pakistan.
Study Design: Cross sectional study.
Place and Duration of the Study: Station Health Organization Multan and Departments of Pathology, Combined Military Hospital Multan, from Mar 2019 to Dec 2020.
Methodology: This study was conducted by implementing a comprehensive campaign by involvement of public health workers in high risk dengue area of Multan. There were five phases of this campaign; awareness, situation analysis, vector surveillance, indoor residual sprays where vector was found and contact tracing of dengue fever cases. The system was developed in 46 Mohallas/localities of Multan. Hot spot for mosquitoes breeding were identified at 15 places. Total of 23 health workers were recruited including 3 female workers. Insecticide spraying was carried out by indoor residual spray pumps & thermal foggers in a cyclic pattern.
Results: During 2019, 42 larvae were identified followed by insecticide sprays & follow up visits; 26 cases of dengue fever were diagnosed and treated at CMH Multan in a dedicated dengue ward. Contact tracing was carried out and indoor residual sprays were carried out in 20 houses around residence of these cases. In 2020, 5 larvae were identified followed by sprays & follow up visits; 2 cases of dengue fever were diagnosed and treated.
Conclusion: Comprehensive campaign against dengue fever was quite successful to control spread of dengue fever.
EXPLORING THE KNOWLEDGE AND PRACTICES OF AUSTRALIAN MEDICAL STUDENTS REGARDING INFECTION PREVENTION AND CONTROL IN HOSPITALS: A PILOT STUDY
Authors: Pervaz Iqbal Maha , Uebel Kerry , Islam Md. Saiful , Jabbour Victoria , Jabbour Dr. Victoria , Hall John , Chughtai Abrar A 
Published: January 2022

Objective: To assess the knowledge and practice of medical students regarding standard precautions in an Australian undergraduate medical programme.
Study Design: Cross sectional study.
Place and Duration of Study: University of New South Wales, Australia, duration of study was six-years.
Methodology: Fifty medical students who were involved in clinical practice, were invited to complete a comprehensive questionnaire on standard precautions.
Results: The majority of participants agreed that hand hygiene was the most important factor in infection control. Only 32 (16%) knew to use a full personal protective equipment for Ebola. Regarding sharps disposal, 46 (92%) students always disposed used needles in the recommended bin, 27 (54%) indicated they sometimes recapped used needle while 25 (20%) sometimes bent used needles.
Conclusion: This study showed that there is a gap between knowledge and practice of medical students regarding hand hygiene and other infection control measures. There is a need for standardized and regular student training in the use of standard precautions in infection prevention and control.
IN SILICO CHARACTERIZATION OF HUMAN INTERFERON ALPHA/BETA RECEPTOR 2 (ISOFORM A, B AND C) PROTEIN
Authors: Javed Ambreen , Trali Gulshan Ara , Abbas Hassan Burair , Sadiq Alia 
Published: January 2022

Objective: To predict the tertiary structure of human interferon alpha/beta receptor 2 protein.
Study Design: Structure prediction by using bio informatics tools.
Place and Duration of Study: Department of Biochemistry, Swat Medical College (STMC), Saidu Shareef, Swat, Pakistan, from Aug 2019 to Dec 2019.
Methodology: All protein sequences of human interferon alpha/beta receptor 2 (isoforma, b and c) (IFNAR-2) were retrieved through the BLAST search (The Basic Local Alignment Search Tool) from available databases ‘NCBI’ (National Centre for Biotechnology Information) and ‘Uni Prot KB’ (The Universal Protein Resource). Sequence alignment was conducted by using Clustal Omega, to get the consensus sequence for IFNAR-2 protein. Consensus protein sequence of human IFNAR-2 was used for the prediction of the three-dimensional structure by employing Swiss-Model Server. Moreover, subcellular localization analysis was also performed by using CELLO2GO program.
Results: Structural model of human IFNAR-2 protein was predicted and evaluated by Ramachandran dimension. Cellular localization of tertiary topological domains of the predicted models were revealed probability of localization of IFNAR-2 protein (isoform a, b & c) is highest in the plasma membrane due to the presence of the transmembrane alpha helical regions.
Conclusion: This study predicted the tertiary structural dimensions of human IFNAR-2 protein, including the specific topological domains that contribute towards the subcellular compartmentalization and functional characteristics.
DEPRESSION AND ANXIETY AMONG PATIENTS SEEKING RHINOPLASTY
Authors: Khan Sikandar Ali , Ali Ghazanfar , Raza Maqbool , Tariq Muhammad , Adeel Imran , Butt Ahsan Masood 
Published: January 2022

Objective: To evaluate the presence and relation of depression and anxiety among patients seeking rhinoplasty
Study Design: A cross-sectional study.
Place and Duration of Study: Departments of Psychiatry, department of Plastic Surgery and ENT, Combined Military Hospital Multan, from Jan 2019 to Mar 2020.
Methodology: A total of 102 patients were recruited that reported to Plastic surgery and ENT unit. Patients were divided equally in two groups of 51 each. One group included patients seeking rhinoplasty while other group included those patients that reported in Plastic surgery and ENT unit for reasons other than rhinoplasty. Symptom were assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety.
Results: A total of 102 participants were included in the study, of these 51 were patients seeking rhinoplasty and 51 were controls. Significant correlation exist between anxiety and depression (p<0.00).
Conclusion: There is a very high frequency of anxiety and depression among patients seeking Rhinoplasty along with significant positive correlation.