bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Creatinine, Cystatin C and Combined Creatinine-Cystatin C for Renal Function Assessment in Patients with Diabetes
Authors: Umar Saba , Sabir Sohail , Azam Nadeem Malik , Aamir Muhaamad , Bibi Afshan , Altaf Ashfaq , Siddiqui Faud Ahmed , Sabir Haroon , Raja Khalid Mehmood , Butt Batool 
Published: December 2022

Objective: To compare the estimated glomerular filtration rate (eGFR) assessed through the CKD-EPI equations based on creatinine, Cystatin C and creatinine-Cystatin C levels for estimating kidney function among patients with diabetes.
Study Design: Cross-sectional analytical study.
Duration and Place of Study: Nephrology Department, Armed Forces Institute of Urology, Rawalpindi Pakistan, from Aug 2020 to Mar 2021.
Methodology: A total of 70 patients were recruited. Serum samples were collected for creatinine and Cystatin C levels and 24 hours of urine for creatinine clearance. The eGFR values were calculated using the creatinine, Cystatin C and combined creatinine-Cystatin C CKD-EPI equations and compared with 24 hours of urinary creatinine clearance.
Results: A total of 22 (31.4%) patients had early stage, while 48 (68.6%) had late-stage chronic kidney disease (CKD). The highest Spearman correlation coefficient was found for eGFR CKD-EPIcr-cys (rho=0.844), followed by CKD-EPIcys (rho= 0.835) and CKD-EPIcr (rho=0.709).
Conclusion: CKD-EPIcr-cys is the most accurate, recommended method of calculating eGFR.
The Comparison of Hand Sewn and Stapled Anastomoses
Authors: Hussain Tanweer , Jabbar Abdul , Ahmed Naveed , Shah Naqeeb , Zulfiqar Mujahid , . Anita 
Published: December 2022

Objective: To compare hand-sewn and stapled sutures and the influence of intestinal excision on postoperative complications.
Study Design: Retrospective comparative study.
Place and Duration of Study: General Surgery Department of CMH Peshawar, from Jan 2020 to Jan 2021.
Methodology: Once receiving consent, all individuals hospitalized in the medical facility for ileostomy closure were included in our investigation. In a questionnaire, postoperative complications were documented.
Result: This study involved a total of 60 subjects. Individuals were scheduled for surgery after receiving clearances and a loopogram distally. Thirty patients had their wounds hand-sewn shut, while 30 others had their wounds stapled shut. The mean operating time for the hand-sewn method was 2.46 ± 0.29 hours, compared to 1.86 ± 0.17 hours mean for the stapled method. In both categories, the anastomotic leak was comparable. Thirty patients in the hand-sewn group took a mean of 2.42 ± 0.25 days to return bowel sounds after surgery, whereas it took 1.83 ± 0.20 days to return bowel sounds.
Conclusion: The stapler method greatly decreases the duration of surgery, promotes rapid recovery, and has a lower fatality rate. Stapling is a simple procedure that can be performed in inaccessible locations, such as a low colorectal anastomosis. In elective gastrointestinal procedures, stapler anastomosis can be utilized safely and successfully.
Examination Stress During COVID-19 and Its Coping Interventions Used by Medical Students of Pakistan
Authors: Sadaf Sana , Ishtiqa Sania , Jahan Musarrat , Farooq Fareeha , Mushtaque Saher , Sukhia Dr 
Published: December 2022

Objective: To determine the examination stress and anxiety score during COVID-19 pandemic and to identify coping mechanisms adapted by medical students.
Study Design: Cross-sectional study.
Place and Duration of Study: Sir Syed College of Medical Sciences for Girls, Karachi, from Apr-May 2021.
Methodology: A total of 250 students were recruited in the study and validated questionnaire was used for data collection. Test anxiety scores were calculated from a previous study scale by Nist and Diehl (1990). Data was analyzed by using SPSS-23.
Results: The mean age of students was 20.1 ± 0.6 years. 74 (29.6%) students felt stress sometimes, 40 (16.0%) students felt always and 30 (12.0%) students never felt stressed before examination. Students who reported improved performance during the examination due to stress were 121 (48.4%). 76 (30.4%) students reported decrease in performance and 53 (21.2%) reported that their stress did not affect their performance. Students were inquired regarding the methods to cope the stress. 78 (31.2%) students reported that they took study break, 66 (26.4%) students spent time with family and friends, 49 (19.6%) found solace in sleep, 30 (12.0%) students listened to music, 13 (5.2%) used beverages (tea, coffee), 11 (4.4%) used numerous combinationsof methods, and only 3 (1.2%) students exercised. It was found that 158 (77%) students experienced healthy anxiety, 68 (27.2%) unhealthy anxiety, and 22 (8.8%) students were anxiety-free.
Conclusion: Examination stress among medical students has increased during COVID-19 and various coping methods are used by the students to prevent anxiety. College.....
Frequency of Different Neuropsychiatric Manifestations of Systemic Lupus Erythematosus at a Tertiary Care Hospital in Pakistan
Authors: Ullah Naeem , Adnan Saqib , Mustafa Syed Hassan , Khan Suleman , Hussain Ibrar , Ullah Saleem 
Published: December 2022

Objective: To determine the frequency of different neuropsychiatric manifestations of systemic lupus erythematosus
Study Design: Cross-sectional study.
Place and Duration of Study: Division of Rheumatology Lady Reading Hospital, Peshawar Pakistan, from Sep 2020 to Feb 2021.
Methodology: 31 patients who fulfilled the 2019 ACR/EULAR criteria for SLE diagnosis were included in the study. Different features of neuropsychiatric manifestations of systemic lupus erythematosus were recorded on a proforma.
Results: Our study sample included 27 females and four males. Most of the patients were young, with a mean age of 23.12 ± 10.74 years. All patients had positive Anti-nuclear antibodies (100%), while anti-double standard DNA antibody was found in 21 patients (67. 74%). Seizures were the most common neuropsychiatric feature, i.e., found in 18 patients (58%), followed by headache (25.8%), acute confusional state (25.8%) and CNS demyelinating disease (19.3%).
Conclusion: We found that seizures, headache and acute confusional state were the most common neuropsychiatric manifestations of systemic lupus erythematosus.
Association of Time-Lines of COVID-19 Seropositivity with Antibody Ratio Levels
Authors: Mushtaq Saadiya , Din Nasir Ud , Shah Abid Hussain , Riaz Omair , Azam Khalid , Khan Sara Waqar 
Published: December 2022

Objective: To determine the persistence of IgG antibodies against SARS-CoV-2 and the association of timelines of COVID-19 seropositivity with antibody ratio levels.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Lahore, from Apr to Sep 2020.
Methodology: The serum of 250 patients recovered from COVID-19 was collected to detect anti-SARS-COV-2 IgG antibodies. Anti-SARS Cov-2 IgG was measured by Semi-Quantitative Enzyme-Linked Immuno-Sorbent Assay (ELISAs), and the association of timelines of COVID-19 seropositivity with antibody ratio levels was determined.
Results: Out of 250 study participants, males were 220 (88%) while females were 30 (12%), mean age being 35.25 years ± 9.096 years. In the timeline of 31-60 days after the first positive COVID-19 PCR, 27 out of 44 (61%) were seropositive. In the 61-90 days’ timeline, 79 out of 155 (51%) were seropositive, in the timeline of 91-120 days after the first positive PCR, 52 out of 76 (68%) were seropositive, and in the timeline of 121-150 days, 12 out of 15 (80%) of the study participants were seropositive for COVID-19.
Conclusion: Serological IgG immune response against SARS-CoV-2 persists up to five months after active COVID-19 infection in most individuals in the Pakistani population.
Association of Hypertension with Raised Serum Homocysteine Levels
Authors: Ikram Hasan , Jaffar Syed Raza , Hayat Asma , Kahttak Mehnaz , Ellahi Ayesha , Naeem Afnan 
Published: December 2022

Objective: To study the association of hypertension with raised serum homocysteine levels.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Army Medical College Rawalpindi in collaboration with Armed Forces Institute of Pathology and Military Hospital Rawalpindi, from Mar to May 2021.
Methodology: Total study participants were four hundred in number. Two hundred patients with hypertension aged between 35-55 years were included in Group-1, whereas two hundred non-hypertensive patients with the closest possible age and sex matching were included in Group-2. Strict adherence to inclusion and exclusion criteria was ensured.
Results: The mean age of patients with hypertension (Group 1) was 42.60 ± 9.95 years, and without hypertension, i.e., healthy participants (Group 2), was 42.26 ± 10.03 years. Systolic BP was 157.92 ± 8.07 mmHg among Group 1 (hypertensive subjects) and 114.60 ± 4.58 mmHg among Group 2 (healthy participants). Mean diastolic blood pressure in patients with hypertension (Group 1) was 104.95 ± 5.87 mmHg, whereas it was 74.20 ± 4.74 mmHg among non-hypertensive healthy participants (Group 2). Mean serum homocysteine level was significantly correlated with hypertension (p-value <0.001, r=0.804 for systolic and p-value <0.001, r=0.792 for diastolic blood pressure) and was higher in Group 1(20.64 ± 4.40 µmol/L) than that of healthy Group 2(9.48 ± 2.38 µmol/L).
Conclusion: Our study concludes that serum homocysteine had a significant positive correlation with hypertension and can be used as an early marker for hypertension assessment in addition to regular blood pressure measurements.
Predictive Value of Plasma Hematocrit Level in Early Diagnosis of Pre-Eclampsia
Authors: Saeed Saira , Akram Hina , Awan Shazia Mahmood , Murtaza Badar 
Published: December 2022

Objective: To determine whether hematocrit level is associated with pre-eclampsia and assess its predictive value in diagnosing pre-eclampsia.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Department of Obstetrics and Gynecology, CMH Quetta, from Jul 2019 to Jan 2020.
Methodology: A total of 561 pregnant women with a singleton pregnancy were included in the study. The diagnosis of preeclampsia was made as per operational definition. The samples were collected by non-probability consecutive sampling. Pregnant females with a parity of 0-4, gestational age > 16 weeks on last menstrual period (LMP) and singleton pregnancy on ultrasound were included in the study. In addition, data on plasma hematocrit findings and incidence of pre-eclampsia (positive/negative) were recorded.
Results: The age range in this study was from 18 to 40 years, with a mean age of 28.805 ± 2.41 years, mean parity of 1.258 ± 1.07 and mean gestational age was 11.352 ± 2.22 weeks. Plasma hematocrit findings predict 26 (4.6%) patients, and the incidence of pre-eclampsia was in 35 (6.2%) patients. Plasma hematocrit findings had shown a sensitivity of 60%, specificity 99%, diagnostic accuracy by 97%, PPV 80.7%, NPV 97.3%, (p<0.001) in diagnosis of preeclampsia.
Conclusion: Haematocrit can be valuable as a screening test for the timely diagnosis of pre-eclampsia in health centres. Women with a hematocrit above the cut-off of 38% must be scrutinized prudently for the signs of pre-eclampsia.
A Comparative Study of Negative Pressure Dressing with and without Silver Alginate to Promote Faster Wound Healing in Chronic Wounds
Authors: Ali Mehak , Ali Hyder , Akhlaq Faisal , Adil Faraz , Naseem Aiman , Ali Urooj 
Published: December 2022

Objective: To determine the effectiveness of negative pressure dressing with silver alginate hydro-fibre dressings in managing chronic wounds compared to negative pressure dressing without silver alginate hydro-fibre dressings.
Study Design: Cross-sectional analytical study.
Place and Duration of the Study: Department of Plastic and Reconstructive Surgery at Dr Ruth K.M. Pfau Civil Hospital Karachi, from Jan to Jul 2021.
Methodology: All patients above 18 years of age of either gender presented with more than six weeks of wound duration, hemoglobin levels more than 10 g/dl, platelet count above 150 x 10E9/L, and size of the wound more than 10*10cm were consecutively enrolled. Negative pressure dressings with and without hydro-fibre dressings were applied. A team of plastic surgeons monitored the wound site to assess granulation tissue by noting the size of the wound and pain severity. The outcome was assessed at four weeks.
Results: Of 62 patients, the median age was 43 (32.5-56.7) years. There were 37 (59.67%) males and 25 (40.32%) females. The outcome assessment at four weeks showed that overall pain was observed in 34 (54.83%) patients. Pain severity (p-value <0.001) and low granulation score (p-value 0.025) were found significantly higher in patients who received negative pressure dressing without silver alginate as compared to the patients who received negative pressure dressing with silver alginate. A significant median difference in granulation days was observed between groups (p-value <0.001).
Conclusion: Combining negative pressure dressings with silver alginate dressing has positive effect on the chronic wound compared to using negative pressure dressings alone.
Why do Patients Refuse Pre-Prosthetic Procedures? A Qualitative Study in a Private Sector Dental Teaching Institute
Authors: Sana Aleeza , Saleem Tayyaba , Aziz Anbreen , Abbas Maira 
Published: December 2022

Objective: To explore the factors leading to patient non-compliance toward pre-prosthetic mouth preparation.
Study Design: Qualitative exploratory study.
Place and Duration of Study: Prosthodontic Department of Islamabad Dental Hospital, Bara khau Islamabad Pakistan, from May to Jul 2020.
Methodology: Semi-structured interviews were conducted from purposively selected fifteen partially dentate patients who were advised but had refused to get pre-prosthetic mouth preparation. Five content experts validated interview questions. After thematic analysis, the authors developed a consensus regarding themes and subthemes of factors that cause noncompliance of patients toward pre-prosthetic mouth preparation.
Results: Eight themes emerged. Patients were afraid of extraction and scaling and were concerned about cross-infection control, and they were short of time due to busy schedules and lengthy procedures. Few diabetic patients could not go for extraction of their teeth immediately. Patients also refused due to financial constraints and lack of awareness regarding treatment protocols. Some believe myths that removing the teeth results in other diseases such as cancer. Few quoted previous bad dental experiences and were not willing for any pre-prosthetic procedure. In addition, patients were not satisfied with the treatment plan and the associated treatment cost.
Conclusion: Fear or anxiety related to extraction or scaling, time and financial constraints, fear of delayed wound healing, and improper guidance regarding treatment protocols were central factors in refusing pre-prosthetic procedures. Patient counselling must be done regardless of patient refusal, and patient concerns should be addressed.
Outcome of COVID-19 Patients Receiving 6mg vs 12mg Dexamethasone at a Tertiary Care Hospital in Pakistan
Authors: Bari Saba , Naseem Arshad , Khan Asad Zaman , Sajjad Kaswar , Ali Muhammad , Shehzad Farrukh 
Published: December 2022

Objective: To compare the outcome in COVID 19 patients on oxygen managed with 6mg and 12 mg Dexamethasone at Pak Emirates Military Hospital Rawalpindi.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi Pakistan, from Aug 2020 to Aug 2021.
Methodology: Patients diagnosed with COVID-19 on PCR and were oxygen-dependent but not mechanical ventilation dependent were included in the study. They were randomly divided into two groups. Group-I received 6mg Dexamethasone, while Group-II received 12 mg Dexamethasone for ten days. They were followed up for 30 days to look for the outcome (prolonged admission, high dependency unit admission, intensive care admission, death). The difference in outcome in both groups was studied using the Pearson chi-square test.
Results: Out of 600 patients included in the study, 401 (66.8%) were male, while 199 (33.2%) were female. The mean age of the study participants was 47.81 ± 8.716 years. 306 (51%) were given 6mg of Dexamethasone for ten days, while 294 (49%) were given 12mg of Dexamethasone for a similar time. prolonged admission (p-value-0.178), high dependency unit admission (pvalue-0.409), intensive care admission (p-value-0.176) and mortality (p-value-0.588) were not statistically significantly different in both the groups.
Conclusion: All the outcome variables, including mortality and admission to the critical care unit, were not statistically significant in groups taking 6mg or 12 mg of Dexamethasone, so it could be concluded that a high dose of this medication is not superior in terms of efficacy when compared to the low dose.
Discordance of Diagnostic Core Biopsy and Final Histopathology Performed after Surgical Resection of Breast Cancer
Authors: Khan Said Zaman , Qamar Syeda Rifaat , Nadeem Muhammad Sohaib , Khan Ayesha , Mushtaq Afroz , Jan Maria Mir 
Published: December 2022

Objective: To determine the frequency of discordance of receptor status in our breast cancer patients, find out its causes, and suggest remedial measures.
Study Design: Retrospective longitudinal study.
Place and Duration of Study: Breast clinic and Radiation Oncology Department of Combined Military Hospital Rawalpindi Pakistan from Jan 2018 to Nov 2021.
Methodology: Estrogen Receptor, Progesterone Receptor and Her2 Neu status differences between diagnostic tru-cut biopsy and surgical specimen were compared.
Results: Receptor status between initial core biopsy and final histopathology of 63 patients were compared. Discordance rates of 05 (7.90%), 13 (20.60%) and 12 (19%) were noted for Estrogen receptor, progesterone receptor and Her2, respectively. The highest discordance noted was for the progesterone receptor, followed by the HER2 receptor and the Estrogen receptor.
Conclusion: The highest discordance noted was for the progesterone receptor, followed by the HER2 receptor and the Estrogen receptor. Further studies are required to know more about the causes of receptor status discordance, its impact on treatment decisions and its impact on disease progression and survival.
COMPARISON OF MEAN PLATELET VOLUME IN NEONATES WITH AND WITHOUT SEPSIS
Authors: Ayub Ammara , Usman Najmi , Batool Ayesha , Shakeel Usman , Ahmed Shoaib , Shafiq Muhammad Faisal 
Published: December 2022

ABSTRACT
Objectives
To compare mean platelet volume (MPV) in neonates with and without sepsis.
Study design
Cross sectional descriptive study.
Place & duration of study
Neonatal Unit, Department of Paediatrics, Military Hospital, Rawalpindi from 2nd July 2017 to 22nd January 2018.
Material and Methods
140 neonates, of either gender with ages between 0-28 days, suspected of neonatal sepsis presenting with any two of the signs: core body temperature of > 38.5°C or < 36°C at time of presentation, pulse rate beyond the range of 100-200 beats/minute, leukocyte count beyond the range of 4000 to 30,000/mm3 or > 10% immature neutrophils on peripheral smear, tachypnea (>60 breaths/minute) and oxygen saturation (< 90%) on pulse oximeter, were included; while neonates having taken > 2 doses of antibiotics in last 48 hours as per history and clinical record were excluded. 3ml of blood was drawn and sent for culture, while another 3ml of blood sent for peripheral smear and MPV. All the data along with demographic details of the patients were noted. Same laboratory was used for all samples and the peripheral smear was done by the same pathologist each time to eliminate bias.
Results
31 neonates were culture positive for neonatal sepsis. Mean MPV(fl) was 7.31+0.92(fl). MPV was 8.52+0.51(fl) in septic neonates and 6.97+0.70(fl) in neonates without sepsis. The p value was significant (0.0001).
Conclusion
MPV was significantly raised in patients with sepsis.
KEYWORDS

Neonates, Sepsis, Mean Platelet Volume
Clinicopathological Analysis of Biopsy-Proven Glomerulonephritis in the Pediatric Patients : A Study from Tertiary Care Centre
Authors: Safdar Rabia Saleem , Khan Afsheen Asghar , Mehar Muhammad Faisal , Riaz Shazia , Hussain Nusrat , Abbas Kiran 
Published: December 2022

Objective: To evaluate the clinic-pathological characteristics and their association with biopsy-proven glomerulonephritis in pediatric patients.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Pediatric Department Nishtar Medical University, Multan Pakistan, from Jan 2014 to Dec 2019.
Methodology: During the study, a total of 211 renal biopsy reports of different age groups were studied and analyzed for clinic-pathological features and patterns of direct immunofluorescence.
Results: The mean age of 8.6±3.25 years was observed. The most common pathology was focal segmental glomerulo-sclerosis in 86 (40.76) of the patients, followed by mesangio-proliferative glomerulonephritis in 41 (19.43) of the patients. Minimal change disease was seen in 26 (12.32) cases. It was observed that the majority of the patients with diffuse proliferative glomerulonephritis were younger than 11 years old, whereas; 10 (11.2), patients with lupus nephritis, 11 (15.1) and membranous nephropathy, 10 (12.2) were comparatively older.
Conclusion: Glomerulonephritis presents a diversified group of diseases with overlapping clinic-pathological features. The present study has reported many significant characteristics which could help diagnose a particular disorder among the pediatric population.
Maternal Serum Uric Acid as a Marker of Predicting Low Birth Weight at Term Pregnancy: A Study Based in CMH Lahore
Authors: Ghaffar Sadia , Nawaz Qudsia , Shaheen Zubaida , Shakeel Shazia , Shafiq Sadia , Tufail Nazia 
Published: December 2022

Objective: To determine the association of hyperuricemia with adverse pregnancy outcomes in terms of low birth weight at term pregnancy registered at CMH Lahore.
Study Design: Prospective cohort study.
Place and Duration of Study: Department of Obstetrics and Gynecology of CMH, Lahore Pakistan, from Aug 2018 to Feb 2019.
Methodology: A total of 60 pregnant women with a singleton pregnancy were included in the study. Patients with serum uric acid levels greater or equal to 360 umol/L were included in Group-A or the at-risk Group, and Patients with serum uric acid levels less than 360 umol/L were included in Group-B or the control Group. All women were followed till the delivery. Data regarding adverse pregnancy outcomes (low birth weight) was noted.
Results: Mean Serum uric acid levels of 380.33±12.92 umol/L in the Exposed Group and mean Serum uric acid levels of 265.66±29.44 umol/L in the Control Group were noted. Low birth weight was seen 12 (40%) in Exposed Group as compared to 7(23.3%) in Unexposed Group (p=0.165) (RR=1.71).
Conclusion: Low birth weight at term was not associated with hyperuricemic pregnancy more than normouricemic pregnancy in our study, probably due to the small sample size.