bluuebunny/crossref_metadata_2025_split huggingface dataset:
Upaya Meningkatkan Hasil Belajar Siswa Menggunakan Metode Field Trip Dalam Pembelajaran IPS Di SD Negeri 56 Aek Batu Kecamatan Torgamba
Authors: Simamora Rusmawati 
Published: January 2022

Penelitian ini bertujuan untuk mengetahui penggunaan metode field trip materi Sisitem Perekonomian Indonesia dapat meningkatkan hasil belajar siswa kelas IV SD Negeri 56 Aek Batu Kecamatan Torgamba. Penelitian ini adalah penelitian tindakan kelas dengan 2 siklus, setiap siklus terdiri 4 kegiatan yaitu perencanaan, tindakan, observasi dan refleksi yang diikuti oleh perencanaan pada siklus berikutnya dengan memanfaatkan hasil refleksi sebelumnya Subjek penelitian adalah siswa kelas IV SD Negeri 56 Aek Batu Kecamatan Torgamba Tahun Ajaran 2021/2022 sebanyak 40 orang. Temuan penelitian menunjukkan pembelajaran IPS dengan penerapan metode pembelajaran field trip dapat meningkatkan hasil belajar siswa dibuktikan dengan meningkatnya hasil belajar setiap siklus yaitu dari rata-rata 67,67 menjadi rata-rata 83,19.
ANXIETY AND DEPRESSION IN PATIENTS WITH TINNITUS
Authors: Khan Sikandar Ali , Raza Maqbool , Farooq Shahid , Tariq Muhammad , Chandio Muzafar , Rafique Atif 
Published: January 2022

Objective: To determine the presence and severity of depression and anxiety in patients with tinnitus.
Study Design: Cross sectional study.
Place and Duration of Study: This study was conducted at department of Psychiatry, Combined Military Hospital Multan in collaboration with ENT department, Combined Military Hospital Multan, from Sep 2019 to Mar 2020.
Methodology: All diagnosed cases of tinnitus in ENT out-patient department Tinnitus Handicap inventory (THI) was applied to assess the severity of tinnitus. Diagnosis of depression and Anxiety was done based on diagnostic criteria of ICD10 of WHO and symptom severity was assessed using Beck Depressive Inventory (BDI) for depression and Beck Anxiety Inventory (BAI) for Anxiety.
Results: A total of 88 participants were included in this study. Fifty-three (60.2%) were male, 35 (39.7%) were females. Twentythree (20.2%) ranged between 18-40 years of age, 65 (57.2%) participants ranged between 41-60 years of age. Seven (12.5%) participants scored less than 38 on tinnitus handicap inventory showing mild severity of tinnitus, 3 (5.3%) individuals scored moderate while 19 (33.9%) had severe level of tinnitus. Thirty-three (37%) participants had depression 55 (62%) out of total 88 participants had anxiety.
Conclusion: Studies show presence of anxiety and depression in patients with tinnitus so it seems prudent to screen all patients of tinnitus for psychiatric co morbidity. A multidisciplinary approach is required for the treatment of patients with tinnitus so that physical as well as psychiatric/psychological management of these patients is provided well in time.
MEDICAL VS SURGICAL TREATMENT FOR SYMPTOMATIC ENLARGED INFERIOR TURBINATE: A COMPARATIVE STUDY
Authors: Rehman Habib -Ur- , Wahid Fazal -I- , Zada Bakht , Javaid Muhammad , Haq Naseem Ul 
Published: January 2022

Objective: To determine the nasal patency after reducing the size of hypertrophied inferior turbinate with medication and surgery.
Study Design: Prospective comparative study.
Place and Duration of Study: Department of Ear, Nose, Throat, Head and Neck Surgery, Medical Teaching Institute, Lady Reading Hospital, Peshawar Pakistan, from Jan to Dec 2019.
Methodology: This study was conducted at the After-sample size calculation using an online sample size calculator (OpenEpi) and after obtaining informed consent patients were divided into two groups. Patients in group A were put on medicine only and in group B surgery was conducted to reduce the size of hypertrophied inferior turbinate. Data were analyzed using SPSS version 25 and p<0.05 was considered significant.
Results: This study comprised of total 86 patients, in the age range 15-55 years with mean ± SD age 33.47 ± 9.57 years. Males were 47 (54.7%) and females were 39 (45.3%) with male to female ratio of 1.2:1. In group A, males were 22 (25.25%), females were 21 (24.41%), while in group B males were 25 (29.1%) and females were 18 (20.3%). There was no statistically significant difference in nasal patency between the two groups before treatment (p=0.59) and after 10 days of treatment (p=0.69). However, at the end of one month, there was a statistically significant difference in nasal patency between the medically treated and surgically treated groups of patients (p=0.023).Conclusion: Surgical treatment is significantly effective than medical treatment alone.
CURATIVE BENEFIT OF SUBMUCOPERICHONDRIAL RESECTION OPERATION ON PULMONARY AR
Authors: Sheikh Nadeem Ahmed , Choudhary Azhar Ali , Nadeem Kanwal , Khursheed Areeba , Fatima Rida , Shah Syed Ausaf Ahmad 
Published: January 2022

Objective: We aimed at establishing a correlation between deviated nasal septum and pulmonary artery hypertension in patients reporting in Otorhinolaryngology (ENT) clinic at Combined Military Hospital Quetta, and evaluating the beneficial impact of sub mucoperichondrial resection (SMR) operation on right heart myocardial function, primarily related to Pulmonary Arterial Pressures of these patients of longstanding nasal septal deviation.
Study Design: Descriptive; hospital-based cross-sectional survey.
Place and Duration of Study: Departments of Otorhinolaryngology & Cardiology, Combined Military Hospital, Quetta, from Sep 2019 to Apr 2021.
Methodology: Electrocardiographic and 2-Dimensional Echocardiographic parameters of 87 randomized patients suffering from symptomatic longstanding deviated nasal septum (DNS) who had consented to undergo sub mucoperichondrial resection (SMR) operation were compared and studied for any change in status of probability of pulmonary arterial hypertension before and two months after their surgery. Probability of pulmonary hypertension was estimated using probability criteria from updated European Society of Cardiology Pulmonary Hypertension Guidelines 2019. Patients were classified into low, intermediate and high probability depending upon the number of criteria fulfilled by echocardiographic parameters.
Results: Two (2.3%) patients suffering from deviated nasal septum presented with p-pulmonale. Twelve (13.8%) reported with right bundle branch block, and 7 (8%) patients demonstrated right axis deviation on electrocardiography. Overall high probability to develop pulmonary hypertension was discovered in 2 (2.3%) patients. We observed a significant improvement in pulmonary artery pressures in patients suffering from long term upper airway obstruction, two months following sub mucoperichondrial resection operation, in terms of maximum velocity and peak tricuspid regurgitation, right ventricle/left..........
ENDOSCOPIC CARTILAGE TYMPANOPLASTY. OUR TECHNIQUE AND EXPERIENCE OF 157 CASES
Authors: Najam Muhammad Atif , Sarwar Urwa , Raza Maqbool , Khan Khalid Azam , Saleem Humaira , Niazi Najm u Saqib , Rashid Muhammad , Riaz Naeem 
Published: January 2022

Objective: To assess the graft take rate and hearing gain in trans-canal endoscopic tympanoplasty Study
Design: Descriptive study.
Place and Duration of Study: Pakistan Naval Ship Hafeez, Islamabad Pakistan, form Dec 2015 to Jun 2018
Methodology: All patients with dry central perforations of >3 months history were included in the study. All Patients with perforations of pars tensa were booked for endoscopic cartilage tympanoplasty. All perforations were divided into four types small, medium, large and subtotal or total based on size of the tympanic membrane perforations. Small perforations involving <25% area of Pars Tensa. Medium perforation are Perforations involving 25-50% of Tympanic membrane. Large perforations include Perforations involving 50-75% of pars tensa. Subtotal or total perforations are defined as perforations with >75% perforation of the tympanic membranes. Wet Ears and perforations involving the Pars Flacida were excluded from the study. Preoperative Audiogram was carried out for all patients and A-B Gap were noted for all groups separately so as the demographic data including age and gender. Success was defined as complete closure of Tympanic membrane perforation at 3 months. All patients were operated with 0 Degree 3mm, 14cm rigid endoscope under general anesthesia.
Results: Mean age of patients was. 37 years and standard deviation was 12.34 (range 12-58 years). Out of total 157 cases 81 patients male were males (51%) and 76 patients were females (49). Out of 157 ears operated 146 Perforations healed completely an overall success rate of 92%. Patients with small perforations had 100 percent success.....
CUSTOM MADE INTERNAL AND EXTERNAL NASAL SPLINTS : A COST EFFECTIVE ALTERNATIVE
Authors: Waleem Sheikh Saadat Ullah , Ayub Muhammad Waqas , Ahmad Manzoor , Maqbool Shahzad , Raza Maqbool , Rahim Ejaz 
Published: January 2022

Objectives: To evaluate the usability and effectiveness of tailor made internal and external nasal splints after nasal surgery.
Study Design: An observational study.
Place and Duration of Study: Combined Military Hospital Kohat, from Nov 2015 to Aug 2017.
Methodology: the study was carried out on 523 patients who underwent nasal surgery by the same team of surgeons. Custom made free of cost internal and external nasal splints were used as required. Complications pertaining to the use of nasal splints were recorded.
Results: The custom made splints were found to be an excellent and cost effective alternative of commercially available expensive splints. The benefits and pitfalls were comparable.
Conclusion: Where these free of cost splints does the job they as well save a lot of money and can be used as an effective alternative to commercially available splints.
CHOLESTEATOMA PRESENTATION TRENDS IN KOHAT DIVISION
Authors: Ayub Muhammad Waqas , Waleem Sheikh Saadat Ullah , Afzal Mahrukh , Maqbool Shahzad , Raza Maqbool , Abbas Asim 
Published: January 2022

Objective: To discuss the presentation stages of Cholesteatoma in patients of various areas of Kohat division.
Study Design: Case series study.
Place and Duration of Study: Combined Military Hospital Kohat, from Nov 2015 to Nov 2017.
Methodology: A total of 60 patients having Chronic Suppurative otitis media with Cholesteatoma were selected from outpatient department. Disease process was evaluated by otomicroscopy as well as radiologically. Perioperative disease spread pattern was also assessed and documented.
Results: Out of 28 patients with pars tensa cholesteatoma 28.5% were in stage II and 53.5% were in stage III disease. Out of 32 patients with pars flaccid cholesteatoma, 3.1% presented with stage 1 disease, 37.5% with stage II disease, 50% with stage III disease and 9.3% with stage IV disease.
Conclusion: Appropriate measures should be taken for training of general physicians as well as otologists at National level to help early diagnosis and better outcome.
COMPARISON OF ISOCONAZOLE NITRATE VERSUS NYSTATIN FOR TREATMENT OF OTOMYCOSIS
Authors: Khan Muhammad Ahmed , Anwar Bushra , Akram Sumera , Ahmed Attique , Akhtar Sunarays , Raza Maqbool 
Published: January 2022

Objective: To compare isoconazole nitrate versus nystatin for treatment of otomycosis.
Study Design: Quasi experimental study.
Place and Duration of Study: Combined Military Hospital Bahawalpur and Combined Military Hospital Mardan, from Jan to Dec 2018.
Methodology: Total 204 cases fulfilling the inclusion criteria were selected from outpatient department of Combined Military Hospital Bahawalpur and Mardan. They were divided into 2 groups of 102 each using random number tables. Group A cases were given Isocona-zole nitrate for application in external auditory meatus and group B cases were given Nystatin. All the cases were examined two weeks later and outcome was compared in terms of clinical improvement and symptoms resolution.
Results: Out of 204, 125 patients were females and rest 79 were males. Age range was from 12-87 years with mean age 31 ± 2.4. Both groups were identical in terms of gender. In group A patients, 74 (72.5%) showed marked improvement after two week, 15 (14.7%) showed moderate improvement and 13 (12.7%) showed minor improvement. However, in group B, 55 (53.9%) showed marked improvement after two week, 23 (22.5%) showed moderate improvement and 24 (23.5%) showed minor improvement. Group A treatment was found significantly better than group B treatment (p=0.021).
Conclusion: Isoconazole nitrate ointment was found significantly more effective for treating otomycosis than nystatin.
OCULAR SURFACE DISEASE AMONG PATIENTS WITH OPEN ANGLE GLAUCOMA USING TOPICAL ANTI-GLAUCOMA MEDICATIONS
Authors: Javaid Hassaan , Zafar Omar , Akram Seemal , Abbas Sana , Khan Ikram Ullah , Javaid Haroon 
Published: January 2022

Objective: To determine the frequency of ocular surface disease among patients with open angle glaucoma using topical antiglaucoma medications presenting at a tertiary care eye hospital.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from May 2019 to Jan 2020.
Methodology: One hundred and eighty patients aged 18 or more, with open angle glaucoma using any of the topical antiglaucoma medications including preparations of dorzolamide, brimonidine, timolol, levobunolol, betaxolol, latanoprost, travoprost, bimatoprost or a combination of these for more than six months took part in the study. Ocular surface disease index was used to assess the presence and severity of ocular surface disease.
Results: Out of 180 patients of glaucoma managed with topical anti-glaucoma medications, 83 (46.1%) did not show presence of ocular surface disease when ocular surface disease index was administered. Twenty-nine (16.1%) patients had mild symptoms, 17 (9.4%) had moderate symptoms while 51 (28.3%) patients reported severe symptoms of ocular surface disease. Advancing age and longer duration of treatment with topical anti-glaucoma medications had statistically significant association with the presence of ocular surface disease (p-value <0.05).
Conclusion: Presence of ocular surface disease was a common finding among patients using topical agents for the management of glaucoma. Advancing age and prolonged use of anti-glaucoma medication emerged as risk factors statistically related to the presence of ocular surface disease.
DETERMINANTS OF QUALITY OF LIFE AMONG UPPER LIMB PROSTHESIS USERS PAKISTAN: A MULTICENTER STUDY
Authors: Sethi Faiza , Mumtaz Nazia , Saqulain Ghulam 
Published: January 2022

Objective: To determine the quality of life among users of upper extremity prosthesis.
Study Design: Cross sectional study.
Place and Duration of Study: Day’s Medical Engineering and Artificial Limbs Center Multan and Pakistan Institute of Prosthetic and Orthotic Sciences, Peshawar, Pakistan, from Jul to Dec 2018.
Methodology: A sample population of 276 users of upper extremity prosthesis was recruited employing convenience sampling including both genders aged 20-50 years. Demographic sheet, 36- Item Short Form Health Survey (SF-36) and Quick Disabilities of the Arm, Shoulder and Hand questionnaire (Quick-DASH) were used to collect data followed by analysis using SPSS-22.
Results: Mean score on Quick Disabilities of the Arm, Shoulder and Hand questionnaire was 49.2+25.4. The mean scores of 36- Item Short Form Health Survey revealed highest values in the domains of emotional wellbeing (55.8 ± 17.7) and energy/ fatigue (54.0 ± 14.3) while lowest values were noted in the role limitation due to emotional problems (38.9 ± 33.5) and General Health (43.8 ± 19.6) domains.
Conclusion: The study findings concluded that the overall quality of life of upper limb prosthetic user was low along with significant association of demographic features with SF-36 and Quick DASH.
AUDIT OF MANAGEMENT OF ADULT CHOLEDOCHAL CYSTS
Authors: Nasir Ammad Ud Din , Khan Muhammad Shoaib , Saif Anas Bin , Butt Qasim , Abbasi Hanif 
Published: January 2022

Objective: To analyze the complexity and diversity of type, surgical management and complications in adult choledochal cysts presenting to a Hepatobiliary unit of a tertiary care hospital.
Study Design: Case series.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan 2017 to Dec 2019.
Methodology: All the patients diagnosed with choledochal cyst and underwent surgical procedure between Jan 2017 to June 2019 were analyzed. The clinical features, types, operative procedure and outcomes of the patients in terms of post-operative morbidity and mortality were assessed. Calvin Dindo classification was used to assess complications.
Results: A total of 17 patients were studied, out of which, 13 were females (76.5%) and 4 were males (23.5%) with mean age of 37.41 ± 16.96 years. There were 13 type I (76.5%), 2 type IVa (11.8%) and 1 type II (5.9%) choledochal cysts according to Todani’s classification. Extrahepatic cyst excision with a Roux-en-Y hepatico-jejunostomy was performed on all 17 patients. There was no mortality in the series. Post-operative complications occurred in 4 (23.5%) patients, 2 were grade II, 1 was grade I and 1 grade III according to Clavin Dindo scale. Long-term follow up revealed recurrent cholangitis in 3 (17.6%) patients which settled on antibiotic regime. The median follow up time was 1.5 years.
Conclusion: The total extra-hepatic excision with Roux-en-Y hepaticojejunostomy is the treatment of choice for adult choledochal cyst. The procedure has low morbidity and very low mortality.
NEGATIVE APPENDECTOMIES ARE MORE COMMON IN FEMALES OF REPRODUCTIVE AGE GROUP
Authors: Ali Zahid , Khan Muhammad Rahil , Memon Riyasat Ahmed , Ujjan Ikram Din , Hussain Fida , Nisar Zainab 
Published: January 2022

Objective: To compare the negative appendectomy in the females of reproductive and non-reproductive age groups.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Pathology, Diagnostic and Research Laboratory, Liaquat University of Medical and Health Sciences, Hyderabad, Pakistan, from January 2018 to December 2019.
Methodology: A total of 1126 appendectomy specimens were enrolled irrespective of age and gender. The biodata of patients was retrieved from the database. Statistical analysis was done using SPSS version 22.
Results: Out of total 1126 reported cases, 787 (69.9%) were males and 339 (30.1%) were females. The mean age was calculated to be 24.43 ± 12.42 years ranging from 2-94 years. Histopathological examination revealed cases of acute appendicitis 374 (33.2%), acute appendicitis with peri-appendicitis 478 (42.5%), fibrous obliteration 28 (2.5%) and parasitic infestation 7 (0.6%). Overall negative appendectomies were 219 (19.4%) and were prominent in females 100 (29.5%) than males 119 (15.1%). Also it was higher in females of reproductive age group 77 (30.4%) than in non-reproductive age group 23 (27.9%).
Conclusion: In our study negative appendectomy in females of reproductive age groups was found to be higher than expected. Clinical scoring systems, biochemical markers, imaging modalities, and second opinion from other specialties like internal medicine, gynae and obstetric have been introduced to substantiate the diagnosis of acute appendicitis and thereby decreases the negative appendectomy.
EFFICACY OF METHOTREXATE VERSUS LEFLUNOMIDE VERSUS COMBINATION OF BOTH IN ACTIVE RHEUMATOID ARTHRITIS
Authors: Tirmizi Syed Haider , Fakhr Amer , Amer Ahsan , Sajjad Kaswar , Nawaz Khurram Haq , Sharif Abid 
Published: January 2022

Objective: To determine the efficacy of Methotrexate versus Leflunomide versus combination of both among patients managed at Pak Emirates Military Hospital with active rheumatoid arthritis.
Study Design: Prospective comparative study.
Place and Duration of Study: Rheumatology/General Medicine Department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to June 2020.
Methodology: Patient of active rheumatoid arthritis who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into three groups with group A receiving Methotrexate, group B receiving Leflunomide while group C received the combination of both Methotrexate and Leflunomide. Disease activity was assessed by using the Disease Activity Score-28 in all the three groups after three months of treatment.
Results: Mean age of the study participants was 36.919 ± 6.85 years. One hundred and fifty (83.3%) patients were female while 30 (16.7%) were male. Out of 160 (88.9%) patients achieved remission according to Disease Activity Score-28 score at the end of three months while 20 (11.1%) did not achieve remission. Pearson chi-square test revealed that none of the factors studied including the treatment option had any statistically significant relationship with presence of remission among the target population (p-value 0.386, 0.815, 0.194 and 0.145 for age, gender, duration of symptoms and type of treatment respectively).
Conclusion: Remission rate among the rheumatoid arthritis patients in response to treatment was overall good in the study. In terms of efficacy for symptoms of rheumatoid arthritis and achieving remission, after three months of treatment all the three options..................
CROSS-REACTIVITY OF COVID-19 IGG ASSAY WITH KNOWN IMMUNE-MEDIATED AND INFECTIOUS DISORDERS
Authors: Zehra Nayab , Khan Muhammad Dilawar , Batool Hijab , Chughtai Omar Rasheed , Chughtai Akhtar Sohail , Usman Muhammad 
Published: January 2022

Objective: To assess the cross-reactivity of COVID-19 IgG assay with known immune-mediated and infectious disorders and evaluate for any false-positive reactions to determine the specificity of the serological assay.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Chemical Pathology, Chughtai Institute of Pathology, Lahore Pakistan, from Sep to Oct 2020.
Methodology: A total of 116 samples were included in the study of both males and females. Diagnosed cases of typhoid fever, viral hepatitis, systemic lupus erythematosus (SLE), syphilis, multiple connective tissue disorders (MCTD), varicella-zoster infection, rabies, toxoplasmosis, epstein-barr virus (EBV) infection, rubella, rheumatoid arthritis, AIDS, cytomegalovirus (CMV) infection and dengue fever were included in the study. Three samples of multiparous women aged more than 40 years were also included in the study. IgG antibody levels were measured against SARS-CoV-2 with a cut-off index of 1.4.
Results: Out of 116, only 3 (2%) samples were reactive for IgG against SARS-CoV-2. The categories showing cross-reactivity were typhoid, hepatitis C, and CMV. All specimens showing cross-reactivity were of females. Assay under consideration showed a specificity of 97.4%.
Conclusion: Cross-reactivity was seen in pre-pandemic cases of infectious diseases with COVID-19 IgG antibody assay. Medical lab professionals must verify the serological assays before use in the clinical laboratory to avoid false-positive results.