bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison Between Intra-Articular Steroid Injection And Ultrasound Therapy in Management of Chronic Knee Osteoarthritis
Authors: Rashid Maimuna , Iqbal Waseem , Butt Amir Waheed , Jamshed Omer , Noor Musab Bin , Mehdi Syed Aoun Abbasi 
Published: December 2022

Objective: To compare the mean pain score and range of motion in chronic knee osteoarthritis patients treated with intraarticular Steroid injection versus ultrasound therapy.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Rehabilitation Medicine, Combined Military Hospital, Pano Aqil Pakistan, from Oct 2020 to Apr 2021.
Methodology: Patients were divided into two groups (50 patients in each group). One group received ultrasound therapy for six weeks, with three sessions per week. The second group received a single 80mg intraarticular Triamcinolone Acetonide. Patients in both the groups were monitored for six weeks to assess the pain score and range of motion.
Results: A total of one hundred (100) patients with knee pain due to chronic osteoarthritis were included in the study. The mean age in the ultrasound group was 54 ± 4.8 years and in the intra-articular group, the mean age was 54 ± 4.7 years. The mean reduction in pain score and mean improvement in the range of motion were compared between two groups and statistically significant difference was observed (p-value <0.001).
Conclusion: According to our findings, intra-articular Corticosteroid injection is more effective in comparison to ultrasound therapy. However, there were statistically significant reductions in pain scores and improvements in the range of motion in both groups.
Post Covid-19 Sino-Orbital Mucormycosis: A Therapeutic Challange
Authors: Adnan Muhammad , Shahid Muhammad , Awais Muhammad , Naqvi Syed Abid Hassan , Ghani Muhammad Usman , Ijaz Umer 
Published: December 2022

Objective: To determine the frequency of sino-orbital mucormycosis outcomes in diagnosed patients of COVID-19 and its association with the duration of the disease.
Study Design: Case series.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Pak Emirates Military Hospital, Rawalpindi, from Feb to Jul 2021.
Methodology: A sample size of 20 was calculated using WHO calculator. Diagnosed patients of COVID-19 who fulfilled the inclusion criteria were selected through consecutive sampling technique. The mode of presentation, in-depth imaging findings, associated co-morbidities and management/follow up details were collected.
Results: Total 20 patients were included in study. There were 12 (60%) male and 8 (40%) female. Mean age of patients was 60.4 ± 9.8 years. Outcomes of study were treatment, still of follow up, mortality and mortality with sepsis, survival and exenteration (15%, 15%, 25%, 5%, 25% 15% respectively). Among all the patients, 2(10%) patients showed intraconal and extraconal orbital involvement, 9 (45%) showed left, 8 (40%) showed right and 1(5%) showed both orbits involvement. Outcomes of sino-orbital mucormycosis showed significant association with COVID-19 duration (p=0.03).
Conclusion: Sino-Orbital mucormycosis is a common and potentially life-threatening complication of COVID-19. Early initiation of anti-fungal treatment as well as surgical intervention are key to decrease both the mortality and morbidity associated with the disease.
Comparison of Bupivacaine Wound Infiltration with Bupivacaine Caudal Block on Postoperative Pain in Pediatric Open Inguinal Herniotomy
Authors: Saleem Muhammad Mudasir , Riaz Azmat , . Javed-Ur-Rehman , Ahmed Naveed , Rehman Shafqat , Anwar Zahid , Afzal Tamoor 
Published: December 2022

Objective: To compare the effectiveness of Bupivacaine local wound infiltration with Bupivacaine caudal block on postoperative pain in children undergoing open inguinal hernia repair.
Study Design: Quasi-experimental study.
Place and Duration: Department of Paediatric Surgery, Pak Emirates Military Hospital Rawalpindi, from Jan to Sep 2019.
Methodology: 60 patients (30 each in two groups) fulfilling the inclusion criteria who underwent open inguinal herniotomy were included in this study. Patients in group-A received caudal block with 0.25% Bupivacaine 1 ml/kg body weight, while Group-B received local wound infiltration of 0.5% Bupivacaine 2 mg/kg body weight after the completion of surgery. The post-operative pain score was calculated using Hannallah's objective pain scale at 30 minutes, one, two, four, six and eight hours following the procedure. A total pain score of 3 requiring the rescue analgesia in the form of oral Paracetamol (10 mg/kg body weight) was considered the endpoint.
Results: Mean post-operative pain score was 8.20 ± 1.54 in group-A compared to 7.20 ± 1.88 in Group-B with the p-value of 0.02, which showed a statistically significant difference between the two groups.
Conclusion: We concluded that local infiltration with Bupivacaine after open herniotomy in children is safe, highly effective and easy to perform the procedure, which results in excellent post-operative analgesia compared to caudal Bupivacaine block.
Is an Energy-Based Vessel Sealing Device more Effective Than the Conventional Clamping and Knot Tying Technique in Thyroid Surgery? A Quasi-Experimental Study
Authors: Malik Shahzar , Ibrahim Taseer , Morgan Justin , Law Nick 
Published: December 2022

Objective: To evaluate the effectiveness of the energy-based vessel-sealing device versus the conventional clamping and knot tying technique in thyroid surgery by comparing postoperative complications, operative time and hospital stay.
Study Design: Quasi-experimental study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, Royal Free Hospital London and South mead Hospital Bristol between Jan 2016 to Jan 2020.
Methodology: A total of 100 patients that underwent total thyroidectomy were included in the study. Half of these patients having thyroid surgery with energy-based vessel sealing devices were allotted into group-1. While, the other half with conventional clamping and knot tying technique were included in group-2. The demographical characteristics and surgical outcomes of both the groups were compared using statistical analysis.
Results: There were 93 females and 7 male patients. The mean age was 44.6 ± 17.33 years. The mean duration of surgery was significantly shorter in group-1 than group-2 (p-value = 0.001). There was no statistical difference in clinical hypo calcemia, recurrent laryngeal nerve injury, and hospital stay. However, more patients 27 (54%) in group-1 had laboratory hypo calcemia, compared to 19 (38%) group-2, (p-value = 0.02).
Conclusion: Thyroid surgery by an energy-based vessel-sealing device is an effective technique as it reduces the operative time; however, higher laboratory hypo calcemia levels were observed.
Motorcycle Accidents in Punjab: A Critical Analysis
Authors: Rana Asghar , Nasrullah Faran , Hameedi Shahlisa , Janjua Nadeem Iqbal 
Published: December 2022

Objective: To determine existing occurrences of motorcycle accidents, to identify the causes of accidents and to suggest measures to prevent these accidents from minimizing the undue loss of life and property.
Study Design: Cross-sectional study.
Place and Duration of Study: Emergency Departments of CMH Rawalpindi, CMH Lahore and CMH Kharian, from Aug 2018 to Jul 2019.
Methodology: A total of 384 individuals, who underwent motorcycle accidents and reported to the Emergency Department, were included in the study. A pretested questionnaire was used for all the relevant information on demographic, social, motorcycle, and accident-related parameters.
Results: The mean age of accident victims was 34.4 ± 10.92 years. Motorcyclists having 6-10 years of driving experience, riding daily between 11-20 km, were most commonly involved in accidents. 67.9% drivers had a motorcycle driving license, while most of them (65.8 %) were not wearing a helmet at the time of the accident. Wet road was the most common cause of accidents (35.6%). Collisions mainly occurred with another car (31.7%). The head (26.8%) was the most common injury site, followed by the back/abdomen (24.2%).
Conclusion: Road traffic accidents place a significant economic burden, especially in a developing country like ours. Observance of safety precautions, strict adherence to traffic rules and regulations, and the Pakistan Highway Code knowledge are mandatory to avoid any possible accident. A national effort is required for the prevention of accidents to conserve human life and the financial resources of the country.
Comparision of Distal Uniplanar Locking with Biplanar Distal Locking in Intramedullary Interlocking Nailing of Fractures Distal Shaft of Tibia
Authors: Ahmad Rana Shahbaz , Amin Muhammad Suhail , Rathore Muhammad Omar , Hassan Bushra , Iqbal Javaid , Qamar Adeel 
Published: December 2022

Objective: To study the effects of distal uniplanar locking and distal bi planar locking on union times in uncomplicated fractures distal shaft of tibia managed with an intramedullary interlocking nail.
Study Design: Comparative prospective study.
Place and Duration of Study: Department of Orthopedics and Trauma Combined Military Hospital Rawalpindi from Jan to Nov 2020.
Methodology: Fifty-three patients having fractures distal shaft of tibia managed with intramedullary interlocking nail were studied. Twenty-nine patients were managed using two interlocking screws distally (uniplanar) in coronal plane (group-1). Twenty-four patients were managed with three bi planar screws comprising two coronal and one sagittal distal interlocking screw (group-2). Patients were followed every 4 weeks, and bone union time was assessed. Isolated closed fractures treated with closed reduction were included.
Results: Patients treated with distal bi planar locking (group-2) had significantly reduced union time in weeks (11.25 ± 1.42) compared to uniplanar distal interlocking (group-1) (15.79 ± 1.80) (p<.001).
Conclusion: Union time for distal tibia shaft fractures is significantly reduced when treated with distal biplanar locking; it can be attributed to increased stability of the construct.
Correlation of Placental Thickness Measured Sonographically with the Gestational Age Estimated by Fetal Growth Parameters in Normal Singleton Pregnancy
Authors: Jadoon Rizwan Abdul Malik , Anwar Javed , Khattak Abdul Latif , Khan M Babar , Azam Muhammad khalid , Afzal Farah 
Published: December 2022

Objective: To correlate the mean placental thickness with the gestational age estimated by fetal growth parameters in normal singleton pregnancy.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Quetta Pakistan, from Feb to Aug 2020.
Methodology: All patients who fulfilled the inclusion criteria at the Department of Radiology, Combined Military Hospital Quetta were included. After taking informed written consent and history, transabdominal-ultrasonography using a low frequency 3-5 MHz curved array transducer was done to assess the outcome.
Result: A total of 100 women with a singleton pregnancy were included. The mean age of women was 28.100 ± 3.349 years. The mean placental thickness (PT) was 29.785 ± 5.700 mm. A significant positive correlation of placental thickness was noted with gestational age with a Pearson Correlation of 0.985 and p-value of 0.001.
Conclusion: Placental thickness has a linear relationship with gestational age. Placental thickness in millimeters can be an essential parameter for estimating gestational age.
Factors Determining Survival of Patients with Germ Cell Tumor (Single Institutional Experience)
Authors: Khan Shafquat Ali , Azhar Musa , Hamdani Syed Abdul Mannan , Ahmad Umair , Hanif Muhammad Rashid , Iftikhar Jhanzeb , Awan Umme Kalsoom , Siddiqui Neelam , Sheikh Rizwan Masood 
Published: December 2022

Objective: To determine the 5-year overall survival of all the germ cell tumour stages and to identify prognostic factors affecting advanced and metastatic disease outcomes in our institution.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan, from 2008 to 2013.
Methodology: We analyzed the overall survival (OS) of the whole study population and sub-analyzed metastatic disease according to the International germ cell cancer group (IGCCCG), and their overall survival was calculated. Clinical, radiological, biochemical, and histopathological evaluation was used to identify risk factors determining disease outcome.
Results: After analysing 186 male patients with germ cell tumours, 5-year overall survival for stages I, II, and III was 99%, 72%, and 62%, respectively. IGCCCG subgroup analysis showed that five-year overall survival for seminoma was slighter worse than non-seminoma. Five-year overall survival for reasonable risk and intermediate-risk seminoma was 68% and 46%, respectively. For non-seminoma, good, intermediate, and poor-risk categories carried five-year OS as 94%, 61%, and 49%, respectively. The presence of liver/brain metastasis, size of residual disease, primary mediastinal tumour, and tumor marker failure to decline post-chemotherapy were poor prognostic factors for metastatic disease.
Conclusion: While identifying stages in germ cell tumours and classifying metastatic patients according to IGCCCG, individual factors including the location of the primary tumor, brain/ liver metastasis, a failure of tumor markers to decline less than 20% after the first chemotherapy cycle and size of residual disease are considered poor prognostic signs.
Awareness of Dengue Fever in Non-Medical University Students in Punjab
Authors: Ahmed Moeez , Mehmood Mohsin , Tahir Muhammad Junaid , Javed Hashir , Ahmed Shahid 
Published: December 2022

Objective: To assess the awareness and knowledge of dengue virus infection in the non-medical university students of Punjab.
Study Design: A cross-sectional survey.
Place and Duration of Study: Rawalpindi and Lahore region from May to Jun 2020.
Methodology: The survey was based on a structured questionnaire, covering general information about dengue fever, its transmission, common symptoms, treatment, prevention and vector control.
Results: A total of 208 students from the engineering and IT graduate programs participated in our study. The mean age of the participants was 21.6 ± 1.8 years. 122 (58.7%) participants knew that dengue fever was a viral disease. 57 (27.4%) had the correct knowledge about breeding places of Aedes egypti. Most of the students knew that headache, fever and body aches were the common symptoms of dengue fever. About 151 (72%) thought every patient with dengue fever was a serious patient and should be taken to the hospital. Out of 200 (96%) students were aware that anti-mosquito measures could prevent the disease. There was no statistically significant difference in the responses of male and female students.
Conclusion: Considering the education level of our participants, we noted some gaps in the important knowledge, such as the timing of the mosquito bite, avoidance of Aspirin and some misconceptions regarding the management of infection. We need to bridge these gaps by making health education campaigns more effective.
Effectiveness of Intratympanic Dexamethasone with Lidocaine for Alleviation of Tinnitus
Authors: Ayub Zeeshan , Ahmed Azeema , Afzal Farah , Latif Majid , Malik Muhammad Sheraz Afzal , Ahmed Naveed 
Published: December 2022

Objective: To determine the effectiveness of Intratympanic Dexamethasone with Lidocaine in control of idiopathic tinnitus.
Study Design: Randomized control trial (Clinical Trials. gov Identifier: NCT04798391).
Place and Duration of Study: ENT Department, PAF Hospital, Sargodha Pakistan, from Apr 2017 to Jul 2019.
Methodology: 264 consenting patients with idiopathic unilateral tinnitus presenting at ENT Department PAF Hospital Sargodha were assessed for tinnitus severity using the modified tinnitus handicap inventory. The scores were recorded and subsequently administered intra-tympanicaly 2.0ml (milli-liter) of Dexamethasone and Lidocaine (1.5 ml Dexamethasone ± 0.5 ml 1% Lidocaine). The dose was repeated twice at weekly intervals. All the patients were reassessed on the modified tinnitus handicap inventory two weeks after the third Intra-tympanic administration, with patients divided into responsive and noresponsive groups depending on ten points or more improvement in tinnitus score.
Results: Mean modified tinnitus handicap inventory score pre-therapy was 29.6 ± 5.68, and post-therapy was 17.1 ± 7.45. Independent-sample T-test applied showed a p-value of <0.001.
Conclusion: Intratympanic Dexamethasone with lidocaine has a definitively positive outcome on tinnitus improvement.
COVID-19 Vaccines: Community Myths Vs Facts
Authors: Abbas Syed Waqar , Zareen Syeda Fatimah , Nisar Shazia , Farooq Aliya , Rasheed Abdul , Saleem Muhammad Umer 
Published: December 2022

Objective: To determine the reasons for hesitancy regarding COVID-19 vaccines.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi Pakistan, from Feb to Jun 2021.
Methodology: After Ethical Committee approval, 100 respondents were recruited, regardless of vaccination status, and requested to respond to 27 different myths and queries circulating about COVID-19 vaccines.
Results: Mean age of participants was 36.25 ± 5.77 years, ranging from 15-80 years. Fifty-three were males and 47 females. 41% of subjects trusted the Sino-pharm vaccine, and 25% preferred Pfizer Bio N Tech, while 34% could not answer due to the lack of knowledge. 55% subjects showed concern about catching the infection from Vaccination. 54% considered vaccines unsafe for pregnant and breastfeeding women. 29% believed it unsafe for the elderly and those with comorbidities. 14% believed it could cause autism in children and infertility in adults. 62% individuals acknowledged that vaccines have no nano chips to track patients. 46% opined that vaccines were rushed through trials and had doubtful efficacy. 11% individuals thought vaccines could alter DNA, while most were aware of this false concept. 28% considered that vaccines were needless because recovery from COVID-19 was excellent, while 63% emphasised the need for Vaccination. 23% deemed the side effects of vaccines more dangerous than the disease itself. 85% individuals favoured use of mask and social distancing after getting the vaccine.
Conclusion: Strong efforts are needed to support the COVID-19 vaccine and to eliminate negative propaganda on media outlets.
Molecular Diversification and Frequency of mecA Gene in the MRSA Infections of Hospitalized Patients at Islamabad, Pakistan
Authors: Rasheed Yasir , Yasmine Raheela , Gul Ambreen , Imdad Kaleem , Ahmad Aashi , Burair Hassan 
Published: December 2022

Objective: To determine the molecular diversification and frequency of mecA Gene in MRSA infections of hospitalised patients at Islamabad, Pakistan.
Study design: Cross-sectional study.
Place and Duration: Pakistan Institute of Medical Science, Islamabad, Pakistan, from Sep 2017 to Sep 2018.
Methodology: To explore the occurrence of pathogenic S. aureus in the hospitalised patients of Islamabad, 500 samples were collected. All the isolates were further characterised by gram staining, catalase test and DNAse media analysis validating the presence of S.aureus. The overall frequency of S.aureus was 19.5% in all the isolates. Six highly distinguished colonies were further evaluated through colony PCR by 16S r RNA analysis, and results revealed 99.9% homology of isolates with S.aureus. The degree of resistance was further evaluated for 12 isolates based on the previous MRSA resistance pattern. The extraction and concentration of DNA were done by the CTAB and Nanodrop methods. Then primers were designed for the presence of the mecA gene of S. aureus.
Results: Results showed 51 (52.7%) MSSA and 45 (47.4%) MRSA among all the isolates. Colony PCR by 16S r RNA analysis results revealed 97 (99.9%) homology of isolates with S.aureus. PCR of all the twelve extracted DNAs of isolates showed the frequency of the mecA gene in all the isolates.
Conclusion: The study is the first report the presence of resistance mecA gene in the hospitalised patients of Islamabad. It has depicted a resistant gene's presence and showed the rising trend of resistance in pathogenic S. aureus.
The Pattern of Diagnosis in NICU Population Presenting With Respiratory Distress
Authors: Ullah Hakeem , Maqbol Asad , Razzaq Asma , Rehman Romisa , Ullah Ihsan , Awais Muhammad 
Published: December 2022

Objective: To evaluate the etiology, frequency, and results of respiratory distress in newborns in the intensive care unit.
Study Design: Descriptive cross sectional study.
Place and Duration of Study: Neonatal Intensive Care Unit, Combined Military Hospital (CMH) in Peshawar, from Aug 2020 to May 2021
Methodology: It included neonates admitted to the Neonatal Intensive Care Unit between the ages of 0 and 28 days
Results: The study included 182 neonates, 107 (58.6%) of whom were boys and 75 (41.4%) were girls. The average age was 68.47 ± 98.60 hours, the average gestational age was 32.6 ± 23.52 weeks, and the average weight was 2.50 ± 2.6 kg. All (100%) of the neonates had a respiratory rate >60 breaths per minute. Regarding symptoms and signs, 110 (60%) reported grunting, 182 (100%) reported nasal flaring and subcostal retractions, and 72 (40%) reported cyanosis. Respiratory distress syndrome, meconium aspiration syndrome, pneumonia, transient tachypnea of the newborn, sepsis, and birth asphyxia was observed in 42 (22.8%), 30 (16.6%), 32 (17.6%), 26 (14.1%), 32 (18.04%), and 20 (10.8%) newborns, respectively. The number of 60 (33.2%) neonates were suffering from respiratory distress.
Conclusion: High frequency of respiratory distress among the neonates was observed along with high rates of mortality in those having respiratory distress, especially in low birth weight and pre-term neonates.
Association of Nrf2 gene polymorphism (rs6721961) with semen parameters in primary male infertility cases in Pakistani population
Authors: Rehman Bushra , Rahim Amena , Afzal Muhammad , Tazarrat Aqsa , Kashif Humaira , Qayyum Sadia 
Published: December 2022

Objective: To determine an association of single nucleotide polymorphism of the NRF2 gene (RS6721961) with semen parameters of primary male infertility patients in the Pakistani population.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Department of Biochemistry, Islamic International Medical College, Rawalpindi, in collaboration with two private infertility clinics (American Infertility Center, Rawalpindi and Mother and Child International Hospital and Research Institute, Mirpur, AJK) from Oct 2020 to Sep 2021.
Methodology: A total of 288 participants were included in this study. There were 144 diagnosed cases of primary male infertility and 144 healthy fertile males, age and ethnicity matched controls. Blood samples were collected from participants after obtaining written informed consent. DNA was extracted by the Chelex TM Methodoogy. Multiplex PCR was done to determine the respective allelic frequencies of NRF2 (RS6721961) genotypes using specific primers.
Results: There was no significant association between NRF2 genotypes and semen volume and semn colour in infertile males (p-value 0.32 and 0.84, respectively). Out of 144 cases, 111 (77%) had normal sperm count, 29 (20.1%) had oligospermia, while 4 (2.7%) patients had azoospermia. A significant association was observed between NRF2 genotypes and sperm concentration of infertile males (p-value <0.001). Out of 144 cases, 80 (55.5%) had normal motility, 57 (39.5%) had asthenospermia while 7 (8.4%) patients had necrospermia. A strong association was observed between NRF2 genotypes and sperm motility in infertile males (p-value <0.001).
Conclusion: Single nucleotide polymorphism (RS6721961) of the NRF2 gene is significantly associated with sperm concentration and......