bluuebunny/crossref_metadata_2025_split huggingface dataset:
RISK FACTORS AND OUTCOMES OF NEW ONSET ARRHYTHMIA IN SURGICAL INTENSIVE CARE UNIT: A RETROSPECTIVE STUDY
Authors: Hanif Sadaf , Shamim Faisal , Sohaib Muhammad 
Published: January 2022

Objective: To assess the frequency of new-onset cardiac arrhythmias among patients admitted in surgical intensive care unit as well as associated risk factors.
Study Design: Retrospective observational study.
Place and Duration of Study: Surgical Intensive Care Unit, Aga Khan University Hospital, Karachi, from Jan 2018 to Dec 2019.
Methodology: The medical record numbers of all patients admitted in surgical intensive care unit were obtained from Surgical intensive care unit case log entries and reviewed. Patients` and healthcare providers` identification were kept confidential. Data was analyzed using SPSS version 19.
Results: Only 13/1076 patients included in the study had cardiac arrhythmias during their stay in Surgical intensive care unit. Among all patients with arrhythmias (n=13), atrial fibrillation was the most common type of arrhythmia 7 (53.8%). The study found higher occurrence of arrhythmias among the patients in the age category of 66 years or above 8 (4.6%) and when compared to younger patients with age categories 18-40 years 2 (0.3%) and 41-65 years 3 (0.3%) respectively (p-value<0.05). Similarly, arrhythmias were higher among patients who had relatively prolong intensive care unit stay and post-operative status as the primary cause of intensive care unit admission.
Conclusion: Occurrence of cardiac arrhythmias is relatively low among patients admitted to surgical intensive care patient population. Patients age (>65 years), prolong intensive care unit stay, post-operative status are positively associated with development of cardiac arrhythmias among critically ill patients admitted in surgical intensive care unit.
EXPERIENCE WITH DOLUTEGRAVIR IN HIV PATIENTS AT A PUBLIC SECTOR HOSPITAL IN KARACHI, PAKISTAN
Authors: Batool Farzana , Manzoor Sohaima , Dhiloo Azizullah Khan , Ismail Humera Muhammad , Shaikh Shah Muhammad , Baqi Shehla 
Published: January 2022

Objective: To study the tolerability and efficacy of dolutegravir in naïve and experienced patients, their management and outcome.
Study Design: Cross sectional study.
Place and Duration of Study: Ruth KM Pfau Civil Hospital, Karachi Pakistan, from Apr 2018 to Apr 2020.
Methodology: In this study all treatment-naïve and experienced HIV infected patients were included and started on integrase strand-transfer inhibitor dolutegravir (DTG) containing fixed dose combination at Sindh AIDS Control Program (SACP) was conducted. We documented virological suppression, defined as a viral load of <1000 copies/ml, immunological and clinical outcomes.
Results: Eighty-two patients, of whom 53 (64.6%) were ARV naïve and 29 (35.4%) experienced, were started on DTG. Fifty six (68.3%) were males. The median age was 31.6 ± 9. Of 82, 61 returned for their first follow-up visit for assessment and viral load determination. Of 61, adverse effects to DTG were reported in 12 (19.6%), including 9 with pruritis. Of 35 naive patients, 30 achieved virological suppression by 3.3 ± 0.7 months and 1 at 8 months. All 26 experienced patients achieved virological suppression by 4.5 ± 0.9 months. Overall, of 61 patients, 57 (93.4%) achieved virological suppression, of whom 1 had immunelogical failure and none had clinical failure after 6 months of DTG. Three (3.6%) patients died within the first two months ofinitiating DTG.
Conclusion: Dolutegravir has good tolerability, with virological suppression achieved in the majority, including in highly ARV experienced patients.
ASSESSMENT OF MEAN DISTANCE OF MANDIBULAR INCISIVE CANAL USING CONE BEAM COMPUTERIZED TOMOGRAPHY; A CROSS-SECTIONAL STUDY
Authors: Sharif Mubashir , Haroon Nighat , Alam Muhammad Anwaar , Durrani Adil Umar , Hussain Talib , Anwar Khawar 
Published: January 2022

Objective: To determine the mean distance of mandibular incisive canal from the mental foramen in patients reporting to a tertiary care centre using Cone Beam Computerized Tomography for placement of dental implants in the anterior/interforaminal region.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Prosthodontics, Foundation University College of Dentistry Rawalpindi, Jun to Nov 2019.
Methodology: A total of 70 patients participated between the age of 20-45 years. Cone Beam Computerized Tomography (the investigation was carried out and measurements of the mandibular incisive canal from mental foramen were recorded with the help of measuring tools in the software and noted down on the proforma. Data were analyzed using SPSS-20.
Results: The number of patients selected for this study was 70. Out of these 70 patients, 33 (47.1%) were males and 37 (52.9%) were females. The mean age of patients in this study was 36.31 ± 6.38 years. The mean distance/extension of the mandibular incisive canal from left mental foramen and right mental foramen in all patients was recorded to be 14.49 ± 6.31 mm and 14.97 ± 7.10 mm respectively.
Conclusion: Within the limitations of this study, it is concluded that a maximum distance of 22mm of the incisive canal from the mental foramen was observed using cone-beam computerized tomography.
PROCEDURAL TECHNICALITIES AND OUTCOME OF TRANSCATHETER CLOSURE OF ATRIAL SEPTAL DEFECT USING OCCLUTECH DEVICE IN TERTIARY CARE CENTRE
Authors: Kanwal Asma , Shiekh Abdul Malik , Azim Kiran , Khattak Khushal Khan 
Published: January 2022

Objective: To determine the safety and efficacy of transcatheter closure of atrial septal defects and to evaluate the initial, midterm and long-term results of the treatment.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Paediatric Cardiology, Rawalpindi Institute of Cardiology, Rawalpindi, from Jul 2017 to Jun 2018.
Methodology: Sixty-four patients underwent transcatheter closure of atrial septal defect. Size of the defect was measured by Transoesophageal/Transthoracic. Follow up was carried out at twenty-four hours, one month, six months and at twelve months. Early, Midterm and late complications after device occlusion were analysed using SPSS-22 statistical software.
Results: Minimum size of atrial septal defect on echocardiography was 7 mm and maximum size was 31 mm with mean of 18.3 ± 5.7 mm. The procedure was successful in 96.8% cases. There was only one device embolization (1.56%). Cobrahead” configuration malformation of the device occurred in one case (1.56%). Mitral valve regurgitation did not occur in any of the case. There was no residual shunt across the device in the present study. ECG abnormalities associated with transcatheter closure did not occur in any of the patient. In intermediate and long-term follow up, no complication like cardiac erosion was seen in all cases under study.
Conclusion: Transcatheter occlusion of ASD with device was found effective and safe procedure with minimal complication rate, short hospital stay, good short, intermediate and long-term results.
THE ROLE OF DIAGNOSTIC OESOPHAGO-GASTRODUODENOSCOPY (OGD) AND COLONOSCOPY IN CANCER OF UNKNOWN PRIMARY
Authors: Ismail Muhammad , Khan Rao Saad Ali , Saeed Farrukh , Yusuf Muhammed Aasim 
Published: January 2022

Objective: To study the role of gastrointestinal procedures, namely oesophago-gastroduodenoscopy (OGD) and colonoscopy, in helping to establish a definitive primary tumour site in cancer of unknown primary.
Study Design: Prospective observational study.
Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan, from Jan 2018 to Jan 2019.
Methodology: A total of 115 patients included in the study were those, who underwent OGD and a colonoscopy for the diagnosis of a cancer of unknown primary. Data collected included demographics, baseline clinical characteristics, definitive diagnosis, tissue diagnosis and immune-histochemical stains. Primary outcome was the attainment of a definitive diagnosis via OGD and/or colonoscopy.
Results: A total of 115 patients underwent a diagnostic gastrointestinal procedure. Of these 70 (61%) were males. Mean age was 63 ± 12.6 years (range 22-88 years). Abdominal pain comprised the most common presenting complaint, found in 61 (53%). The most common tissue diagnosis of the metastatic sites was adenocarcinoma 81 (70.45%). Tumour markers including carcinoembryonic antigen, alpha-fetoprotein and carbohydrate antigen 19-9 were checked in 90 (78.2%), 46 (40%) and 69 (60%) patients respectively. No patient reached a definitive diagnosis by means of OGD and/or colonoscopy.
Conclusion: OGD and colonoscopy when done collectively as diagnostic procedures to look for a primary tumour, have no value in the evaluation of patients with cancer of unknown primary.
CYTOGENETIC ANALYSIS OF PATIENTS WITH AMBIGUOUS GENITALIA
Authors: Zaidi Sara Ali , Mahmood Asad , Mahmood Rafia , Latif Aamna , Robert Helen Mary , Fatimah Sarah 
Published: January 2022

Objective: To determine the magnitude and classification of cases of ambiguous genitalia presenting to our setup.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Haematology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, from Aug 2018 to Feb 2019.
Methodology: All the patients with ambiguous genitalia referred for cytogenetic analysis, were included in the study. The patients were subjected to a detailed history and physical examination. The record of radiological investigations was were obtained. Cytogenetic analysis was performed using the conventional G-banding technique. Hormonal testing included 17- hydroxyprogesterone (17-OHP) levels was also performed.
Results: Fifty-one cases of ambiguous genitalia were studied. The median age was 15 months. Thirty-three patients (64.7%) had a 46XY karyotype, 17 (33.3%) had a 46XX karyotype while 1 (1.9%) had 45X/46, XY mosaic karyotype. Thirty patients (58.8%) were products of consanguineous marriage. Congenital adrenal hyperplasia was diagnosed in 12 cases (70.5%) of 46 XX karyotype and in 3 cases (9%) of 46XY karyotype.
Conclusion: Ambiguous genitalia, currently categorized as disorders of sex development, are not uncommon in our populartion. Increased awareness and early diagnosis are crucial to prevent life threatening complications of congenital adrenal hyperplasia, to determine sex of rearing, and to counsel the parents or patients.
PATTERNS OF MYOINVASION IN ENDOMETRIOID ADENOCARCINOMA OF ENDOMETRIUM
Authors: Shakeel Mehroosh , Mushtaq Sajid , Akhtar Noreen , Rana Iftikhar Ali , Muhammad Raza 
Published: January 2022

Objective: To assess the patterns of myoinvasion of endometrial endometrioid adenocarcinoma, their frequencies in our hospital and to correlate these patterns with survival.
Study Design: Retrospective observational study.
Place and Duration of Study: Department of Pathology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, from Aug 2019 to Apr 2020.
Methodology: All cases of endometrial endometrioid adenocarcinoma between 2015 and 2017 were retrieved from the archives, independently reviewed by two researchers, all key reporting parameters recorded in addition to the pattern of myoinvasion as per their operational definitions described by Cole and Quick. The follow-up of 3-5 years was obtained from archives and through telephonic contact for outside hospital patients. Disease free survival and relapse-associated mortality were represented through Kaplan-Meier curves.
Results: Eighty cases of myoinvasive endometrial endometrioid adenocarcinoma were reviewed. We found that infiltrating irregular gland pattern was the most frequent in all the age groups. Thirty-five (43.75%) cases showed this type of invasion, followed by broad front pattern 23 (28.75%), Microcystic Elongated and Fragmented (MELF) pattern 15 (18.75%) and adenomyotic pattern 6 (7.5%). One case showed a combination of the last two patterns, whereas adenoma malignum pattern was not seen. Follow-up of these patients showed 8 (10%) patients with relapse related mortality including 5 (62.5%) infiltrating irregular glands, 2 (25%) adenomyosis-like and 1 (12.5%) broad front pattern of myoinvasion. Seventy-two (90%) patients had recurrence free survival.
Conclusion: Frequency of infiltrating irregular pattern of myoinvasion in endometrial endometrioid adenocarcinoma is high and associated with recurrence related mortality. Recognition....................
THE IDEAL PROFILE (INCREASE IN B-LINES/DELTA B-LINES) ON LUNG ULTRASOUND FOR DIAGNOSING WEANING INDUCED PULMONARY EDEMA IN VENTILATED PATIENTS
Authors: Rasheed Ghulam , Shad Zahid Siddique , Mehreen Tooba , Kharadi Nusrat , Ramzan Moazma , Abdullah Azmat , Abbas Kiran 
Published: January 2022

Objective: To ascertain the ideal number of B-lines on lung ultrasound for the diagnosis of weaning induced pulmonary edema in ventilated patients.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Medicine, Shifa International Hospital, Islamabad, from Jan to Aug 2020.
Methodology: All the patients over the age of 18 years who were on mechanical ventilation in a medical intensive care unit were included in the study. The patients were given spontaneous breathing trials as a protocol for weaning from mechanical ventilation. Lung ultrasound was performed on 4 points of anterior chest wall before and after spontaneous breathing trials. Before and after spontaneous breathing trials counting of B lines was done on ultrasound of lung and comparison of increase in B lines (Delta-B-lines) was done with reference diagnosis of weaning induced pulmonary edema diagnosed by intensivist who was blinded to the results of lung ultrasound.
Results: The study included 42 patients including 23 (54.8%) men and 19 (45.2%) women. 14 cases failed spontaneous breathing trials. Seven cases (16.7%) had weaning induced pulmonary edema. Delta-B-lines ≥6 diagnosed weaning induced pulmonary edema with 100% accuracy. Out of the remaining seven patients with weaning failure but without weaning induced pulmonary edema, 6 (28.6%) had Delta-B-lines ≥6. The ultrasound lung technique had a 100% sensitivity profile to detect weaning induced pulmonary edema and a specificity of 77.78%.
Conclusion: The study indicates that Delta-B-lines ≥6 diagnosed the weaning induced pulmonary edema with the best accuracy.
EXPERIENCE OF SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS-2 (SARS-COV-2) - COVID-19 AT A TERTIARY CARE HOSPITAL IN QUETTA, BALUCHISTAN
Authors: Asif Naveed , Satti Shahzeb Ahmed , Younas Alveena , Gilani Mehwish , Shaikh Waqas , Ain Qurat Ul 
Published: January 2022

Objective: To share the experience of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2)-COVID-19 at a tertiary care hospital in Quetta, Baluchistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Pathology, Combined Military Hospital Quetta, from Mar to Dec 2020.
Methodology: This study included 14,741 study participants presenting to CMH Quetta with signs and symptoms of Coronavirus Disease-19 (COVID-19) and others undergoing COVID-19 PCR for screening purpose. Nasopharyngeal swab collected from these study participants were tested for COVID-19 viral RNA by real-time Reverse Transcription Polymerase Chain reaction (RT-PCR) assay.
Results: Out of these 14,741 study participants, 1886 (12.7%) were found to be SARS-CoV-2 PCR positive. Among 1886 study participants, 1503 (80%) were males while 383 (20%) were females. Mean age of the study participants was 36 ± 14 years. Most frequent clinical presentations were body aches (96.5%), fever (94.1%), cough (66.8%) and loss of appetite (68.2%). Around 67 (3.5%) positive study participants were asymptomatic.
Conclusion: In this study, we observed male predominance but severity of signs and symptoms among female study participants. SARS-COVID-19 caused disease with wide range of clinical spectrum and disease can be fatal as well.
COMPARISON BETWEEN TRAGAL CARTILAGE WITH PERICHONDRIUM AND TEMPORALIS FASCIA GRAFT BY UNDERLAY ENDOSCOPIC TYMPANOPLASTY
Authors: Tahir Muhammad , Abbass Asim , Nawaz Faiz Ul Hassan , Shabir Syed Asad , Rafique Atif 
Published: January 2022

Objective: To compare the results of tragal cartilage with perichondrium versus temporalis fascia graft in endoscopic tympanoplasty using underlay technique.
Study Design: Comparative prospective study.
Place and Duration of Study: Study conducted in Tertiary Care Hospital, Karachi, from Jul 2018 to Feb 2020.
Methodology: Overall, 34 patients having permanent unilateral tympanic membrane perforations were included in this study, in whom underlay endoscopic tympanoplasty was performed. Group A patients underwent temporalis fascia graft while group B received a tragal cartilage with perichondrium graft. The success rate between groups was compared in respect of reduction in postoperative air-bone gap and healing of perforation.
Results: The success rate of graft was 88% (30/34) in group A and 94% (32/34) in group B after 6 months follow-up, the difference was not found to be statistically significant (p=0.368). Hearing improvement in the form of closure of air bone gap in group A was from 24.52 ± 1.73 dB (decibel) to 13.56 ± 5.67s dB and in group B it was from 19.76 ± 3.47dB to 11.94 ± 3.9dB, the difference was not significant statistically (p=0.333).
Conclusion: Keeping in view the results of our study, we conclude that both tragal cartilage with perichondrium and temporalis fascia graft are considered equally successful in endoscopic tympanoplasty.
MAGNITUDE OF DIABETES MELLITUS IN PATIENTS OF SUDDEN SENSORINEURAL HEARING LOSS AND ITS EFFECT ON CORTICOSTEROID THERAPY
Authors: Sajid Tahira , Sajid Fatima , Sajid Zara , Naqvi Syeda Rifaat Qamar , Ali Syed Maisam , Shah Muhammad Imran 
Published: January 2022

Objective: To determine the magnitude and effects of diabetes mellitus in patients of sudden sensorineural hearing loss and on the final outcome of therapy.
Study Design: Cross sectional study.
Place and Duration of Study: ENT unit of Medical Teaching Institution Abbottabad, from Jul 2018 to Jun 2020.
Methodology: A total of 84 patients presented who had idiopathic sudden sensorineural hearing loss by using non probability consecutive sampling enrolled in the study. Basic parameters, age, diabetes mellitus and hearing loss were used for data collection. The data was analyzed by using SPSS version 23.
Results: Out of total 52 (61.9%) were male and 32 (38.1%) were female, mean age was 45.62 ± 14.12 years from 14-85 years. A large number of patients presented within one week of onset of hearing loss 57 (67.86%). In our patient group 18 patients (21.4%) had diabetes mellitus and 66 patients (78.6%) did not have diabetes mellitus at presentation. Initial Hearing loss at presentation was significantly more in patients who had diabetes mellitus p=0.006 and there was statistically strong association between the final hearing improvement and diabetes mellitus p<0.001.
Conclusion: Diabetes mellitus is associated with more severe hearing loss at initial presentation and poorer final outcome in patients with Idiopathic sudden sensorineural hearing loss. As glycemic control does not affect the result so corticosteroid therapy must be given to all patients of sudden sensorineural hearing loss with diabetes mellitus.
HYPOCALCEMIA IN TOTAL VERSUS SUBTOTAL THYROIDECTOMY
Authors: Sajid Tahira , Naqvi Syeda Rifaat Qamar , Sajid Zara , Sajid Fatima , Akbar Ismail , Mallhi Muhammad Ayub Ashraf 
Published: January 2022

Objective: To compare the occurrence of hypocalcemia in patients undergoing subtotal and total thyroidectomy.
Study Design: Comparative prospective study.
Place and Duration of Study: Surgical departments of Ayub Teaching Hospital, Abbottabad and Combined Military Hospital, Rawalpindi, from Mar 2018 to Feb 2020.
Methodology: A total of 171 patients were selected for this study and they were divided into 2 groups. Group 1 consisted of 95 patients undergoing Total thyroidectomy whereas group 2 had 76 patients undergoing Subtotal thyroidectomy. It was a comparative prospective study and the groups were made by convenience sampling. The data was analyzed by SPSS-23.
Results: In total thyroidectomy group Hypocalcemia was detected after 48 hours in 34 patients (35%) while in subtotal thyroidectomy group hypocalcemia was detected in 20 patients (28%). Tests for hypocalcemia were also done after two months of surgery and low levels were detected in 7 patients (7.5%) who had total thyroidectomy and in 2 patients (5%) in the group undergoing subtotal thyroidectomy. There was no significant difference in hypocalcemia after 48 hour (p=0.22) and 2 months postoperatively (p=0.6) between patients of Total Thyroidectomy and Subtotal Thyroidectomy.
Conclusion: Total thyroidectomy is not associated with increased risk of permanent hypocalcemia as compared to Subtotal thyroidectomy. Because of its advantages Total thyroidectomy should be the preferred surgical procedure for patients presenting with benign euthyroid multi nodular goiter.
EFFICACY OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY(FESS) IN TREATMENT OF POST NASAL DRIP (PND) AS AN ANCILLARY PROCEDURE: A COMPARATIVE STUDY
Authors: Niazi Saleem Asif , Maqbool Shahzad , Khan Zafar Ullah , Hakim Abdul , Aasim Muhammad Umair , Maqsood Shahid , Riaz Yousra 
Published: January 2022

Objective: To assess efficacy of functional endoscopic sinus surgery (FESS) in treatment of postnasal drip (PND) as an ancillary procedure to Septoplasty with Turbinoplasty.
Study Design: Quasi experimental study.
Methodology: Sample size was n-200, Patients were placed in two groups Group A (n-126) had septoplasty with turbineplasty. Group B (n-74) included patients with Septoplasty and Turbinoplasty combined with functional endoscopic sinus surgery. Post operative results regarding postnasal drip were compared amongst the Two groups.
Results: Data was analysed in SPSS-17, Septoplasty along with turbinectomy was performed in n-126 patients (group A). And septoplasty, turbinectomy along with functional endoscopic sinus surgery was performed in n-74 patients (group B). Post nasal drip was significantly reduced in group B at 3 months follow up (p<0.046). More significant difference was noted at 6 months follow up (p<0.003).
Conclusion: Patients having Chronic rhinosinusitis with postnasal drip as predominant symptom, should undergo functional endoscopic sinus surgery as an ancillary procedure to conventional nasal surgery.
Exploration Of Knowledge And Attitudes Of Remang Fish Skin Cracker Producers Related To Food Labeling In Indramayu Cracker Industry Area
Authors: Najdain Mia Aunillah , Sufyan Dian Luthfiana , Maryusman Taufik , Puspareni Luh Desi 
Published: January 2022

As many as 20 out of 30 producers who sell remang fish skin crackers with incomplete food labels and consumers still pay less attention to the food labels on the product packaging. This study aims to explore the knowledge and attitudes of remang fish skin cracker producers on food labels in the Indramayu Cracker Industrial Area. In-depth interviews with 16 producers were conducted using a case study approach with 5 (five) domains, namely knowledge of food labels, attitudes towards food labels, skills to making food labels, perceptions of food labels (images), and marketing strategies. The results showed that based on the knowledge, attitudes, and skills of remang fish skin cracker producers on food labels, it was stated that the producers were able to make food labels.