bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the impact of performance appraisal on doctor’s task and contextual performance: A view of public sector hospitals in Karachi, Pakistan.
Authors: Bibi Munza , Ahmed Khan Rafique 
Published: February 2022

Background: Performance appraisal is an essential function implemented by the healthcare organization to gauge an individual's performance while delivering quality care. The present study aimed to evaluate the interrelationship between appraisal and the doctor’s task performance measures.
Methodology: A causal study was conducted on a sample of 270 doctors working at Dr. Ruth Pfau Civil Hospital and Jinnah Postgraduate Medical Centre (JPMC) in Karachi, using a deductive approach. An adapted questionnaire was used to examine the specified variables concerning appraisal, task and contextual performance. The collected data was examined using Analysis of Moment Structures (AMOS) and SPSS version 20.0.
Results: There was a significant impact of performance appraisal on doctor’s task performance and contextual performance as indicated by the study results. A moderate significant relationship was observed between performance appraisal and doctor’s task performance (r = 0.383; p<0.01), while a strong significant relationship was detected between performance appraisal and doctor's contextual performance (r=0.874; p<0.01).
Conclusion: It is concluded that the implemented performance appraisal practices influence doctor's task performance and contextual performance.
Spectrum of hematological disorders in bone marrow aspirate and biopsy at tertiary care hospital, Karachi
Authors: Arshad Fatima , Sajjad Mehwish , Mona Anum , Kousar Shaheen 
Published: February 2022

Background: Bone marrow analysis is an invasive practice applicable to identifying, staging, and pursuing tumours. The present study aimed to determine the frequency of malignant hematological disorders using bone marrow aspirate and biopsy at Dr. Ishrat ul Ebad Khan Institute of Blood Diseases (DIEKIBD).
Methodology: In this retrospective study, 756 patient records were examined for bone marrow analysis including both aspiration & biopsy, from January 2014 to December 2018. The posterior superior iliac crest was preferred for bone marrow sampling and aspiration was done with the help of a Salah bone marrow needle.
Results: It was observed that about half of the bone marrow examinations, i.e. 362 (47%), were carried out for tumour staging. Of which 260 (71.8%) were not compromised by primary diseases, while 102 (28.17%) cases contained primary diseases. Among non-malignant hematological disorders, megaloblastic anemia and mixed deficiency anemia were the most frequent, i.e. 24 (3.1%) each. In comparison, chronic myeloid leukemia and chronic lymphocytic leukemia were the most prevalent malignant hematological disorders 42(5.5%) each.
Conclusion: As per the study results, the pathological analysis of bone marrow via aspirate and trephine biopsy has comparatively more significant value in diagnosing and staging the malignant disorders than the non-malignant disorders.
Simulator based teaching of Trans-Urethral Resection of Prostate (TURP) skills in urology.
Authors: Somroo Kashifuddin Qayoom , Rajpar Zakir Hussain , Idrees Memon Imran , Shah Syed Azher Hussain , Jat Javed Altaf , Memon Shafique Ur Rehman 
Published: February 2022

Background: After the introduction of simulators in urology, urology education has evolved significantly. The development of Transurethral Resection of Prostate (TURP) skills has shifted to simulator-based learning from being directly on patients. We evaluated the outcome of simulation-based teaching of TURP procedural skills on virtual reality simulator and objectively assessed the operative skills on the Global Rating Scale (GRS).
Methodology: In this prospective comparative study, high fidelity (VirtaMed | UroSim™) simulator was used. A total of 17 participants were enrolled in this study, 4 were urology faculty members, and 13 were post-graduate urology trainees. All participants performed five attempts of real-time TURP complete procedure and were allowed to resect the maximum possible prostate tissue (goal ≥ 85%). Skills were assessed in terms of resection, bleeding control and safety parameters. Objective assessment of simulative operative skills was done on GRS score sheets by faculty, based on the Global Rating Index for Technical Skills (GRITS) and OSATS. The data from the 1st and 5th attempts of all participants was analyzed on SPSS version 22.0.
Results: There was statistically significant difference in the mean resection score at 1st attempt between faculty and trainees i.e. 112±8.6 and 86.69±9.95, respectively (p<0.01), while the scores were comparative by the 5th attempt. All the enrolled members resected >80% of prostate volume (40 score points). Similarly, for the parameters associated with bleeding control, there was a significant difference in the bleeding control, lost blood and remaining bleeders between trainees and faculty members (p<0.01) at 1st attempt while on 5th attempt, the outcomes were comparative in both groups. The objective assessment of operative skills of the trainee’s displayed improvement in all 5 parameters including tissue injury, movement and time, instrument application, surgical process and surgical details.
Conclusion: Simulation-based TURP teaching significantly improves simulative operative skills in resection, bleeding control and safety parameters. GRS is an effective tool in assessing simulative operative skills and may evaluate endo-urological procedural training in urology trainees periodically.
Magnetic Resonance Spectroscopy: Role in clinical decision making and accurate diagnosis of the brain lesions
Authors: Kalhoro Aurang Zeb , Sattar Abdul Basit , Abdul Sattar M Hashmi  , Rajper Sanam B 
Published: February 2022

Background: Magnetic Resonance Spectroscopy (MRS) combined Magnetic Resonance Spectroscopic Imaging (MRSI) can diagnose brain lesions and help manage several diseases. It has the advantage of differentiating neoplastic brain lesions from non-neoplastic brain lesions based on metabolic changes of the brain. The present study focuses on Magnetic Resonance Spectroscopy (MRS) assessment accuracy in the diagnosis of brain lesions.
Methodology: A prospective, non-probability, consecutive sampling study was conducted at the Neurospinal & Cancer care institute, Karachi-Pakistan, from June 2017 to September 2020. A total of 161 patients with brain space-occupying lesions shown on MRI brain contrast and associated with clinical symptoms of headache, fits, or limb weakness was included in the study. The single voxel method was used for MRS; after contrast. MRI was used to localize the pathology in the brain, and the voxel was used in the area of heed interest.
Results Spectroscopy interpretation showed that 114(70.8%) patients were diagnosed with a brain tumour, 41 (25.46%) had a non-neoplastic entity, and 6 (3.72%) were reported as non-specified. MR Spectroscopy reported non-neoplastic entities in 41 (25.46%) patients by spectroscopy. among them, 39(95.12%) patients had decreased choline, NAA and creatinine peaks, raised lactate peak 16(39.02%), lipid peaks 20(48.78%), while in 4 (9.75%) patients the peaks were absent.
Conclusion: This study recommends that MR spectroscopy has a high accuracy for the diagnostic purpose of neoplastic and non-neoplastic, which is 91.33% which can affect the course of the treatment plan and it can help to avoid unnecessary delay in management.
Identification of correlation between human papillomavirus and prostate cancer: Bradford Hill Criteria Based Evaluation.
Authors: Muhammad Usman  , Ahmad Mukhtiar , Hameed Yasir , Ahmed Hamad , Hussain Muhammad Safdar , Jalil ur Rehman  , Arshad Rizwan , Muhammad Atif  
Published: February 2022

Background: Human papillomavirus (HPV) association has effectively been decoded in prostate cancer (PC) worldwide with controverting conclusions. Though the different groups of researchers explored the potential association of HPV with PC using meta-analysis but it still remains controversial due to the major limitations. Therefore, the present study was designed to investigate the potential link of HPV with PC using Bradford Hill criteria.
Methodology: Initially using PubMed, we extracted studies that associated HPV to PC. Then, to assess the potential association of HPV with PC, an examination of the available data on HPV in PC, normal/benign samples was conducted using all the major Bradford Hill criteria postulates. Furthermore, to improve the authenticity of the present study, we have also critically evaluated the methodologies of the identified studies to check the possibility of false-negative and false-positive results.
Results: After a careful assessment of the previous studies against Bradford Hill criteria postulates, we observed that all the major postulates were not fulfilled, including strength, temporality, consistency, plausibility, biological gradient, experiment, specificity, and analogy.
Conclusion: The findings of this systematic review suggest no casual association of HPV with PC.
Role of COVID-19 Genotype in Pathogenesis
Authors: Tanveer Mehnaz , Syed A. Aziz  
Published: February 2022

Background: Corona viruses are not new to us, and there are 15 different variants known to us. In the last 20 years, this is the fourth coronavirus outbreak, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seems to be the deadliest among all, with the ability to continue producing more contagious variants. In this mini-review, we highlighted the genotypic variance of the pathogenesis of COVID-19.
Methodology: The article tracks the history and the genotypic variance of Corona virus. The literature was searched using the terms COVID-19, SARS-CoV-2, Corona virus, genotypic variance etc. via Google Scholar, and PubMed.
Results: Comparative modelling and molecular studies revealed some essential variations in the intermolecular interaction between Angiotensin-converting enzyme 2 (ACE-2) alleles and SARS-CoV-2 spike protein. This shows an interesting result for two ACE-2 alleles, rs73635825 (S19P) and rs143936283 (E329G), their low binding affinity and lack of some of the critical residues in the complex formation with SARS-CoV-2 spike protein. This may be suggestive of intrinsic resistance to some scale against the SARS-CoV-2 infection.
Conclusion: The SARS-CoV-2 S protein appears to be a promising immunogen for protection, but its role in preventing transmission is still unclear.
Functional recovery of neurological deficit among patients with Orbital Fracture due to Craniofacial Traumas
Authors: Khimani Vashdev , Raja Riaz Ahmed , Shahzad Ghazala , Aziz Peer Asad , Aziz Qureshi Pir Abdul Ahad , Nasir Zeeshan 
Published: February 2022

Background: With recent development in imaging and bone fixation technology, the orbital fracture is now considered an emerging reconstruction technique for the fixation of even the most severe injuries. This study aims to explore the success rate of functional recovery through different orbital approaches in orbital fractures and reconstruction in patients having craniofacial injuries with clinical and neurological deficits.
Methodology: This observational study was conducted from 2016 to 2018, at the Department of Neurosurgery, Liaquat University of Medical & Health Sciences (LUMHS). A total number of 30 patients were enrolled through consecutive sampling. The patients with any clinical and neurological deficit were included in this study, while the patients with craniofacial fractures with comorbidities were excluded. The evaluation of clinical and neurological deficits in the admitted patients was noted pre-operatively and re-assessment of the same deficit postoperatively was done during the tenure of 1-6 months. All orbital floor fractures were approached via a sub-ciliary or transconjunctival incision with a supraciliary approach used for all supra orbital injuries. The reconstruction of the fracture was done within 5 to 10 days of admission.
Results: A total of 30 patients underwent surgery for the repair of an orbital floor fracture. The mean age observed was 32.09±10.36 years. The patient age range was 20-50 years. Among the patients 22 (73.3.0%) were male and 8(26.7%) patients were female. The improvement of symptoms observed after surgical intervention includes sub-ciliary approach that resides the recovery of diplopia (95%), paraesthesia (75%), enophthalmos (100%) and vertical Dystopia (100%). On the other hand, trans-conjuctival approach resides in the recovery of diplopia (95%), paraesthesia (100%), enophthalmos (100%) and vertical Dystopia (100%).
Conclusion: It is concluded that the surgical treatment of orbital fracture shows promising results in the recovery of neurological deficit among patients with crani-o-facial injuries. Moreover, the trans-conjuctival approach holds much promising results in the improvement of infra-orbital para-aesthesia (100%) as compared to the sub-ciliary approach (75%).
Screening of depression in chronic kidney disease patients undergoing haemodialysis.
Authors: Muhammad Fahad  , Kandhro Abdul Hafeez , Khan Sher Wali 
Published: February 2022

Background: Depression is a common psychiatric disorder among chronic kidney disease (CKD) patients, and it has affected the morbidity & mortality rate of CKD patients. This study aims to determine the frequency and severity of depression in CKD patients on hemodialysis.
Methodology: This cross-sectional study was conducted at the Department of Nephrology, Abbasi Shaheed Hospital, Karachi. A total of 251 patients of age between 18-60 years admitted with End-Stage Renal Disease ESRD and getting maintenance haemodialysis were included. Patients diagnosed with psychiatric, neurological illnesses and taking antidepressants were excluded from the study. Demographic and clinical characteristics of CKD patients were obtained on the structured questionnaire, and the Hospital Anxiety and Depression Scale (HADS) was utilized.
Results: Of the total, 127 (50.6%) were males, and 124 (49.4%) were females, with a mean age of 53.94 ± 14.67 years. Approximately 65% of ESRD patients were suffering from depression. Among these, the patients who were receiving maintenance dialysis were suffering from a mild form of depression (33.1%) (HADS 5-9), 22.3% had moderate depression (HADS 10-14), and 9.6% had severe depression (HADS>15). Moreover, a significant difference has been observed between age and creatinine levels.
Conclusion: Around 10% of the patients had severe depression, which enhances the attention towards it. Multicenter studies should be conducted across Pakistan to identify the extent of the problem.
Analysis of SARS-CoV-2 and factors predicting next spillover of its more contagious variant.
Authors: Syed A. Aziz  , Shad Kaneez Fatima 
Published: February 2022

Background: At the beginning of 2020, the world has started experiencing the epidemic of a novel coronavirus; by the mid of March 2020, it has been declared a pandemic. The disease has been named COVID-19, and the virus is labelled as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on the type of infection it is causing. Coronaviruses are not new to us, and there are 15 different coronaviruses known to us. In the last 20 years, this is the fourth coronavirus pandemic, and SARS-CoV-2 seems to be the deadliest among all, with the ability to continue producing more contagious variants.
Methodology: In this review, we used EMBASE, MEDLINE and PubMed database search engines (retrieval systems) for the words SARS-CoV-2, its origin, transmission, tropism, zoonotic, vaccines, and the factors that contribute to its contagious and virulent nature.
Results: Accumulating evidence indicated that the pandemic might have a massive impact on both physical and mental health, particularly on those predisposed to COVID-19. Approved vaccines are in use around the globe, they may show different effects in future. We observe signs of constant mutation of SARS-CoV-2, recently SARS-CoV-2 variants such as delta and C.1.2.
Conclusion: In this review, we endeavour to reveal the factors which can impede the ability of this highly lethal virus to reproduce into more contagious variants.
Assessing the functional outcome after fixation of distal femoral fractures with DF-LCP: A prospective study.
Authors: Muhammad Naseem  , Kanwal Rahila , Moton Rahat Zahoor , Munshi Naseem , Samreen Saleha 
Published: February 2022

Background: Management of distal femoral fractures remains a real challenge due to the involvement of unique and vital anatomical structures. These are usually treated with operative measures. Distal femoral locking compression plate (DF-LCP) has gained popularity due to favorable biological insertion and minimal periosteal damage, but locally little is known about it. Therefore, the present study aimed to identify the functional outcomes after fixation of distal femoral fractures with DF-LCP.
Methodology: This prospective cohort study, including 21 patients with distal femoral fractures, was conducted at Abbasi Shaheed Hospital from Jan 1, 2017, to Dec 31, 2018. All enrolled patients were treated with DF-LCP. The postoperative clinical and radiological outcomes were evaluated for one year. The data were statistically analyzed using SPSS version 22.0.
Results: There were 21 patients with distal femur fractures with a mean age of 46.6 ± 19.2 years. The majority of the fractures were due to road traffic accidents (RTA), i.e., 57.1%, followed by ground-level fall (33.3%). The mean time for fracture union was 20.2 ± 11.1 weeks, and the mean range of motion of the knee was 108.5 ± 18.5º (at one-year follow-up). The complications were minimal; superficial infection and stiffness of knee joint were observed in 2 patients each while there was 1 case each of non-union, delayed union, and implant failure.
Conclusion: DF-LCP is an effective treatment for distal femoral fractures as it permits stable fixation and early mobilization. Satisfactory to excellent functional and radiological outcomes were achieved.
Epidemiological assessment of mutational capabilities in common seasonal viruses.
Authors: Burney Syed Tooba , Shar Nisar Ahmed 
Published: February 2022

Background: Influenza vaccine composition is reviewed prior to every flu season since influenza viruses frequently evolve through antigenic variations. Vaccine strains are selected in expectation of the upcoming influenza season to allow sufficient time for production. The aim of the present study is to assess the use of computational models for predicting the evolution of influenza based on the association of genetic mutations and antigenic traits of circulating viruses that may apprise vaccine strain assortment decisions.
Methodology: This study also focuses on the correlation of viruses with spread rate using statistical methods. For this method, we have worked on four different viruses Influenza, Ebola, Measles and Dengue. The year-wise mutation rate was correlated with the epidemiological data to see the impact of mutations on the disease spread.
Results: We highlight the efficiency of this approach by analyzing the mutation rate and correlating it with its spread rate to find out either mutation in viruses causes disease spread or not. Our study identified mutations in viruses get high before the outbreak of disease through which we can assess the upcoming outbreak. We can set a threshold value for nucleotide differences that can predict the next outbreak of viral disease.
Conclusion: The concept of correlation between the genomic data and epidemic spread leads to the research analysis that mutations do not follow any pattern. Though most of the mutations are random. Our research concluded that some mutations may suppress the virus outbreak, and some mutate to become more resistant than the existing strain that causes an outbreak.
Optimalisasi Peran Bidan Dalam Tata Laksana Awal Preeklampsia Di Pekanbaru
Authors: Suhaimi Donel , Novri Dhini Aiyulie , Savira Maya 
Published: February 2022

Eclampsia and pre-eclampsia are the leading causes of death in pregnancy in Indonesia. Midwives are the first-line providers of maternal and child health services. Therefore, the knowledge and skills of a midwife regarding the initial management of pre-eclampsia and eclampsia are very important in order to reduce maternal mortality. Activities to optimize the role of midwives as first-line health providers in the initial management of preeclampsia and eclampsia cases are held online. This seminar was successfully held on September 25, 2020, with 417 participants. Most of the participants came from cities in Riau, but there were also those from the east such as Makassar and Denpasar. The series of events were in the form of a pretest, delivery of material by experts (obstetricians and gynecologists), post-tests, and question and answer sessions. There is an increase in the knowledge of midwives about the diagnosis and initial management of preeclampsia cases through this seminar which is assessed through increasing score of pretest to the post test. Eklampsia dan preeklamsia merupakan penyebab utama kematian pada kehamilan di Indonesia. Bidan merupakan pemberi pelayanan kesehatan ibu dan anak lini pertama. Oleh karena itu, pengetahuan dan keterampilan bidan mengenai tata laksana awal preeklamsia dan eklampsia sangat penting dalam menurunkan angka kematian ibu. Kegiatan untuk mengoptimalkan peran bidan sebagai tenaga kesehatan lini pertama dalam penanganan awal kasus preeklamsia dan eklampsia ini dilakukan secara daring. Seminar ini diselenggarakan pada tanggal 25 September 2020 dengan jumlah peserta 417 orang. Sebagian besar peserta berasal dari kota-kota di Riau, namun ada juga yang berasal dari timur seperti Makasar dan Denpasar. Rangkaian kegiatan terdiri dari sesi berupa pre-tes, penyampaian materi oleh para ahli (dokter kandungan dan ginekolog), post-test, dan sesi tanya jawab. Terdapat peningkatan pengetahuan bidan tentang diagnosis dan tata laksana awal kasus preeklamsia melalui seminar ini yang dinilai melalui peningkatan skor pada saat pre-tes ke post-tes.