bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Dexmedetomidine and Fentanyl for Blunting Hemodynamic Response to Intubation
Authors: Khan Abid , Feroz Shizan Hamid , Iqbal Sana , Khan Zafarullah , Yaseen Talha , Khan Shahum 
Published: December 2022

Objective: To compare the effects of Dexmedetomidine and Fentanyl on the blunting of the hemodynamic response to intubation.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Combined Military Hospital Peshawar Pakistan, from Jan to Aug 2021.
Methodology: This study was conducted on 908 patients who were ASA grades I and II and underwent general anaesthesia for any surgical procedure. Group-A received Dexmedetomidine, while Group-B received Fentanyl and routine preanaesthetic medications. Hemodynamic responses in both groups were recorded and compared in heart rate and mean arterial pressure at baseline, 2, 5, and 10 minutes after the intubation.
Results: Out of 908 patients equally divided into two groups, 579 (63.7%) were males, while 329 (36.3%) were females. The mean age of patients included in our study was 33.445 6.363 years. A significant increase in heart rate was found at 2, 5 and 10 minutes in the group who took Fentanyl compared to the group who took Dexmedetomidine (p-value 0.001). ignificant increases in mean arterial pressure were found at 2 and 5 minutes (p-value 0.019 and 0.007, respectively) in the Fentanylgroup, while no significant difference was found at 10 minutes in either group (p-value 0.914).
Conclusion: In this study, Dexmedetomidine was found to be a better agent in providing hemodynamic stability during and after the process of intubation compared to Fentanyl.
Role of Rebound Tenderness and Other Parameters in the Evaluation of Acute Appendicitis Using Alvarado Score
Authors: Khan Rashid Iqbal , Malhi Ayub Ashraf , Mehmood Khalid , Bajwa Khurram Sarfaraz , Gul Uzma Javed , Ayaz Bilal 
Published: December 2022

Objective: To determine the role of rebound tenderness in Alvarado score compared to other parameters in evaluating acute appendicitis.
Study Design: Cross-sectional study.
Place and Duration of the Study: Surgical Emergency Unit, Combined Military Hospital, Rawalpindi, Pakistan, from Jul 2021 to Jan 2022.
Methodology: All the patients aged 18 to 70 years suspected of acute appendicitis were consecutively enrolled. An appendectomy was conducted, and an appendix specimen was sent to confirm the histopathology diagnosis. Rebound tenderness and other Alvarado score parameters were noted. Alvarado score≥7 was labelled as acute appendicitis.
Results: Of 165 patients, the mean age of the patients was 29.09 ±6.63 years. The majority of the patients were males (119, 72.1%). Rebound tenderness was observed in 93 (56.4%) patients, migration of pain in 158 (95.8%), anorexia in 140 (84.8%), nausea/vomiting in 97 (58.8%), right lower quadrant tenderness in 54 (32.7%) cases, elevated temperature in 95 (57.6%), leukocytosis count ≥10 x 103/mm3 in 105 (63.6%), and neutrophil count >75% in 67 (40.6%) patients. A significantly higher association of rebound tenderness was observed with histo pathological findings (p-value <0.001), Alvarado score of >7 (pvalue <0.001), and its other parameters (p-value <0.05). The diagnostic accuracy of rebound tenderness and Alvarado score, taking histopathology as the gold standard, showed a sensitivity of 98.92%.
Conclusion: The study findings have shown that rebound tenderness is the most important sign of acute appendicitis compared with other Alvarado score parameters.
Comparison of Outcomes Following Syndactyly Release with Grafts and Without Grafts
Authors: Mansoor Palwasha , Ahmed Rao Saood , Hameed Shahid , Aslam Muhammad Rizwan , Butt Muhammad Wajih Uddin , Khadim Rehana 
Published: December 2022

Objective: To compare the results of syndactyly release with or without graft in patients with simple syndactyly of hand.
Study Design: Prospective comparative study.
Place and Duration of Study: Department of Plastic Surgery, Combined Military Hospital Rawalpindi Pakistan, from Jul 2017 to Jun 2019
Methodology: Forty-five patients with simple syndactyly were included in this study. Group-1 had 20 patients whose syndactyly was released without using a skin graft. Group-2 had 25 patients whose soft tissue was covered with a fullthickness skin graft between the flaps post syndactyly release. Both groups were compared based on operative time, wound healing time, and when physiotherapy was started post operatively.
Results: The results of our study showed that the mean operative time for the first group was 47.1 ± 4.5 minutes (range 35-60 minutes) and for the second group 90.5 ± 10.0 minutes (range 72-108 minutes) with a p-value <0.001. The wound healing time for the first group was 15.2 ± 1.3 days (12-18 days’ range) and for the second group was 22.5 ± 5.1 days (range 14-30 days) with a p-value <0.001. Post-operative physiotherapy was started earlier in the first group with an average of 20.6 ± 1.3 days (18-22 days’ range) as compared to the second group whose average time of the start of physiotherapy was 27.7 ± 4.4 days (range 20- 35 days) with p-value <0.001.
Conclusion: Syndactyly release without a skin graft has a lesser operative time, early wound healing and an earlier start of physiotherapy than syndactyly release with......
Saliva as a Non-Invasive Sample for Molecular Detection of SARS- CoV-2
Authors: Ghani Eijaz , Ahmed Faraz , Niazi Saifullah Khan , Noor Misbah , Shakoor Noman , Hussain Hammad 
Published: December 2022

Objective: To evaluate the Saliva specimen as a non-invasive sample for molecular detection of SARS-CoV-2 compared with Nasopharyngeal Swab.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Virology Armed Forces Institute of Pathology (AFIP), Rawalpindi, in Oct 2020.
Methodology: Forty-eight patients were included in this study from SARS-CoV-2 Outdoor Clinic in Pak Emirates Military (PEMH), Rawalpindi. Out of 48 patients, 28 known SARS-CoV-2 positives by Real-Time Polymerase Chain Reaction (RT-PCR) and 20 known SARS-CoV-2 RT-PCR negative patients were included in this study. Paired samples of Nasopharyngeal swabs and Saliva samples were collected from forty-eight patients. Samples were transported to Virology Department AFIP in Viral Transport Medium (VTM) and subjected to SARS-CoV-2 RT-PCR simultaneously. The sensitivity and specificity of the Saliva specimen for SARS-COV-2 RT-PCR were compared with Nasopharyngeal Swab.
Results: A total of 48 patients were included in this study, of which 28 (58%) patients were positive for SARS-CoV-2 on NPS by RT-PCR. Among the 28 positive cases, 18 (64.3%) were positive by RT-PCR using saliva specimens. The sensitivity and specificity of saliva specimens compared with NPS were 64.3% and 95%, respectively.
Conclusion: Saliva specimen has much lower sensitivity as compared to NPS in our study. Therefore, it cannot be implemented for the diagnosis of COVID-19 as it can compromise the results of a highly sensitive test like RT-PCR.
Variegation in the Number of Islets of Langerhans in the Pancreas of Rats Fed on Sodium Cyclamate
Authors: Kundi Hina , Waseem Naureen , Qamar Abdullah , Bilal Ruqqia , Qureshi Saima , Yousaf Maria 
Published: December 2022

Objective: To observe the effects of an artificial sweetener (sodium cyclamate) on a rat's pancreas and glucose levels.
Study Design: Laboratory-based experimental study.
Place and Duration of Study: Army Medical College Rawalpindi, in association with the National Institute of Health, Islamabad, Pakistan from Jun 2014 to Jan 2015.
Methodology: Forty Sprague Dawley rats (male and female housed separately to avoid mating and pregnancy) were involved in the experiment. Twenty rats in each control and experimental group. C served as control and E for the experimental group. A normal laboratory diet was fed to control Group-C for two months, whereas through an oral gavage needle, artificial sweetener 60mg/kg/day (sodium cyclamate) was fed to experimental animals for two months. During the two months after twelve-hour fasting, rats' blood glucose level was recorded weekly. At the commencement and completion of these two months, the weight of the animals was noted.
Results: Fasting blood sugars of experimental group was found to be statistically significant from week 3 to 9 with p-values of 0.034, <0.001, <0.001, 0.002, 0.001, <0.001, <0.001 respectively. Number of islets of Langerhans was significantly higher 13.70 ± 1.87μm in experimental group compared with control group with the p-value of <0.001.
Conclusion: Sodium cyclamate not only affected the glucose metabolism but also disturbed the normal histology of the endocrine pancreas.
Vestibular Rehabilitation with Intratympanic Drug Therapy in Meniere's Disease
Authors: Ayub Zeeshan , Ashfaq Ahmed Hasan , Khan Amir Ali , Butt Kamran Ashfaq Ahmed 
Published: December 2022

Objective: To evaluate vertigo control and auditory rescue in patients with Meniere's disease treated with intratympanic Gentamicin and Dexamethasone.
Study Design: Randomized Control Trial (Clinical Trials. gov Identifier: NCT05355610).Place and Duration of Study: ENT Departments CMH Quetta and Benazir Bhutto Hospital Rawalpindi Pakistan from Apr 2020 to Mar 2022.
Methodology: Ninety-three cases of unilateral Meniere's disease meeting the inclusion criteria were treated with intratym-panic Gentamicin and Dexamethasone. Pre and post-treatment vertigo was assessed on Vestibular Deficit Index. Speech discrimination scores for auditory impact were also recorded pre and post-treatment.
Results: In the Ninety-three treated cases, there was a statistically significant improvement in the Vestibular Deficit Index (with a p-value of 0.001). Although all patients had a reduced speech discrimination score, it was not statistically significant (p value=0.08).
Conclusion: Control of vestibular symptoms can be achieved with intratympanic Gentamicin, and at the same time, the auditory system can be rescued with Dexamethasone.
Skills and Attitudes of Students which Affect Fostering of Critical Thinking in Undergraduate Medical Students
Authors: Muqeem Ahmad , Arshad Syma , Sajid Sadaf , Ahmad Abdullah 
Published: December 2022

Objective: To identify students' skills and attitudes which affect fostering critical thinking in undergraduate medical students.
Study Design: Modified Delphi Study.
Place and Duration of Study: University of Lahore, Lahore Pakistan, from Oct 2018 to Apr 2019.
Methodology: This study was carried out to develop consensus. Participants were selected through purposive sampling. A draft questionnaire was developed on Google Forms and sent to five experts for pilot study, construct validation and cognitive pre-testing. Wait Time, rating on the Likert Scale and Consensus criteria of 80% were defined before the start of the study. A new questionnaire was sent to participants in each round.
Results: The study enrolled 27 experts, of which only 14 participated in all the three rounds. Experts initially identified 18 factors related to students' skills and attitudes. The consensus was achieved for 14 out of the final 16 factors. Pre-medical education through Matric/FSc. rote memorization, lack of logical and rational thinking, no active participation in interactive sessions and strategic learning by students hamper fostering critical thinking. On the other hand, students from O/A level possess better critical thinking skills because they were trained to criticize and question during class activities.
Conclusion: Individual skills/attitudes of students affect fostering of critical thinking among undergraduate medical students. They should be addressed primarily in pre-medical schools for better critical thinking abilities in medical school.
Multiple Myeloma-Clinicopathological Features and Risk Stratification
Authors: Hussain Mohsin , Mahmood Asad , Mahmood Rafia , Iqbal Hamid , Khurshid Ayesha , Khan Nabeela 
Published: December 2022

Objective: To evaluate the clinic pathological features and to risk stratify patients of multiple myeloma in our population.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Hematology, Armed Forces Institute of Pathology (AFIP) Rawalpindi Pakistan, from Jan to Jun 2019.
Methodology: Patients that were newly diagnosed multiple myeloma on the basis of International Myeloma Working Group (IMWG) 2014 criteria were included in the study. Blood counts, peripheral film examination, bone marrow aspirate and trephine were examined. Biochemical profile, serum protein electrophoresis and skeletal survey was assessed.
Results: A total of 65 newly diagnosed Multiple Myeloma patients were included. Of these, 43 (66.2%) were males and 22 (33.8%) females. Mean age of the patients was 58.5 years with a range of 36-76 years. The most common presenting symptom was bone pain in 33 (50.8%) patients, followed by backache in 32 (49.2%) patients. Mean percentage of plasma cell on bone marrow examination was 40.89% ± 23.2. On risk stratification based on International staging system, 20 (30.7%) patients were in stage I, 19 (29.1%) patients were on stage II while 26 (40.2%) patients were in stage III.
Conclusion: Bone pain and backache along with anemia were found the predominant complaints of patients presenting with multiple myeloma in our setup with male predominance. Risk stratification of multiple myeloma according to ISS revealed that stage III was the most predominant in our population.
The Relation Between Non-Carious Cervical Lesions and Possible Etiological Factors – A Study from a Tertiary Care Setting of Pakistan
Authors: Alam Mafaza , Shah Syed Muzammil Hussain , Alam Laima , Shah Pir Jawad Ali , Bibi Afshan 
Published: December 2022

Objective: To investigate and compare the risk factors of Non carious cervical lesions in relation to demographics, dietary, social and hygiene maintaining habits in Pakistani population presenting to Armed Forces Institute of Dentistry Rawalpindi.
Study Design: Cross sectional analytical study.
Place and Duration of Study: Department of Operative Dentistry, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Dec 2018 to May 2019.
Methodology: Two hundred patients of both genders ranging from age 12 to 70 years with a mean age of 46.4 ± 12.4 were studied for Non carious cervical lesions presence on convenience sampling technique. Questionnaires regarding their diet, acidic food consumption, social habits, frequency and pattern of brushing were being filled. Chi square statistics were used to compare groups and results were noted.
Results: Old age (55.4 ± 0.8 years), vegetarian diet (p≤0.001), consumption of acid foods (p≤0.001), bruxism (p≤0.001), harder tooth brushes (p≤0.001) with variable movements (p≤0.001) showed higher incidence of non-carious cervical lesions. Whereas use of fluoridated toothpastes (p≤0.001) and xylitol gums (p=0.02) demonstrated protection against the occurrence of these lesions.
Conclusion: The presence of Non carious cervical lesions was linked with the use of harder toothbrushes, variable vigorous pattern for tooth brushing, consumption of a vegetarian diet, and greater consumption of acidic food and bruxism. Effective policies should be developed for oral health and awareness of such conditions.
Role of Intravenous Magnesium Sulphate in Acute Status Migranous
Authors: Hassan Zahid , Kazmi Sakhawat , Gilani Atifa , Alamgir Waseem , Liaqat Jahnzeb , Hashmat Asif 
Published: December 2022

Objective: To look for the role of intravenous magnesium sulphate in acute status migranous among the patients reporting at neurological emergency.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan to Jun 2019.
Methodology: A total of 51 patients were enrolled in the study presenting with acute headache in the neurological emergency and diagnosed as suffering from acute status migranous by the consultant neurologist. Pain was measured by using the visual analogue scale (VAS 10) at the time of arrival and other symptoms were also noted. 1gm Intravenous Magnesium sulphate was administered over 15 minutes and pain and other symptoms were noted again after half an hour of administration of magnesium sulphate.
Results: 20 (39.2%) patients were males and 31 (60.8%) were females. Mean age of the patients was 34.2 ± thirty minutes after the infusion of magnesium sulphate was 2.31 ± 1.113. There was a statistically significant difference in the visual analogue scale score before and after the administration of intravenous magnesium sulphate.
Conclusion: Magnesium sulphate emerged as an effective tool when administered intravenously with a dose of 1gm for relieving the symptoms of acute status migranous. It not only worked for headache but also proved to be effective for the associated symptoms.
Subtypes of Post–COVID-19 Condition: A Review of the Emerging Evidence
Authors: Basharat Sinwan , Chao Yi-Sheng , McGill Sarah C. 
Published: December 2022

Post–COVID-19 condition is a growing health concern and has been associated with more than 200 possible symptoms. The diverse and varied ways the condition presents clinically creates challenges for developing standard diagnostic criteria, and for health systems aiming to provide effective treatment and management supports for people.
To support health care, decision-makers and clinicians understand the different clinical presentations of the condition, we scanned the evidence base to examine early approaches being used to characterize and describe subtypes of post–COVID-19 condition. Subtypes can be developed with many different disease features and patient factors, but for this report we specifically reviewed potential subtypes based on symptoms and clinical presentation.
We found that some of the early approaches used to develop subtypes are based on statistical methods that group together patterns of symptoms. These studies are beginning to reveal potential subtypes based on severity of symptoms, type and co-occurrence of symptoms, and symptoms affecting different organ systems.
Many reported symptoms of post–COVID-19 condition are similar to previously characterized health conditions. In some cases, subtypes of post–COVID-19 may be manifestations of those other conditions. For example, certain subtypes may present with symptoms similar to myalgic encephalomyelitis/chronic fatigue syndrome or pulmonary fibrosis. It is uncertain whether those subtypes share the same or distinct pathophysiology and whether they may benefit from similar treatments.
Early evidence comparing the variant of infection and its association with potential subtypes of post–COVID-19 condition is emerging, but the findings are currently mixed. Some studies suggest that variants such as Delta and Omicron may result in different clinical presentations, while other studies have not found significant differences. Further research assessing the association between variants and subtypes is likely needed.
This review provides some implications and considerations for health systems should emerging research further characterize and validate proposed subtypes. These implications may be important for improving the diagnosis, treatment, and management of post–COVID-19 condition. With estimates in Canada suggesting that more than a million people could be affected by the condition, monitoring ongoing research on subtypes may help support the development of effective and tailored treatments, and guide health systems planning across the country.
Administrative management in the collection of property tax in the municipality of Condorcanqui, Peru
Authors: Neira Cruz Rosita Maribel , Delgado Fernández Victoria , Puican Rodriguez Victor Hugo , Vargas Espinoza Jorge Luis , García Escalante Michael Raúl 
Published: December 2022

The general objective was to determine how administrative management affects property tax collection in the municipality of Condorcanqui, Peru. A quantitative and qualitative approach was used, with a non-experimental transectional design, of a descriptive-correlational type, the techniques used were the survey and documentary analysis, as instruments were the documentary analysis guide and the questionnaire, which was applied to 92 taxpayers of the municipality of Condorcanqui, Peru. The results revealed that the administrative management reached 54.3% in the deficient level and on the collection of the property tax it was observed that in the first semester from January to June, of the years 2018 and 2020 present a drop in the collection of 44% and 45% respectively, only in 2019, it reached an increase of 47%. On the other hand, in the second semester from July to December 2017, it is evident that 2019 obtained a drop of 23%, on the other hand, in 2018 had a slight increase of 15% and in 2020 13%, in addition, they achieved a Spearman's Rho of 0.671 and a bilateral sigma of less than 0.05. It is concluded that the impact of administrative management is direct linear moderate with the collection of property tax, thus demonstrating that, if an efficient administrative management is carried out, according to the requirements of the entity then the collection of property tax in the municipality of Condorcanqui, Peru can be significantly increased.
Cogeneración eléctrica a través de turbina de gas: una visión desde los empresarios en Manabí
Authors: Ulloa-de Souza Raúl Clemente , Reyna-Tenorio Luis Jheovanny , Chere-Quiñónez Byron Fernando 
Published: December 2022

El objetivo de este artículo de investigación fue el análisis de cogeneración eléctrica a través de turbina de gas: una visión desde los empresarios en Manabí. Metodología: para alcanzar estos objetivos se empleó una investigación descriptiva, de diseño no experimental; la población estuvo conformada por 50 empresarios pertenecientes a Manabí. No hubo selección de muestra en virtud de los accesible y finita de la población. Las técnicas empleadas fueron la observación y la encuesta y el instrumento cuestionario de opciones de respuesta cerradas. El análisis de los datos se realizó a través de la estadística descriptiva. Resultados: El 64% de los empresarios emplean gas natural como fuente de energía, seguido de biogás. El 40 % de los empresarios que pertenecen a industrias diversas emplean turbinas a gas, seguido por el sector servicios (30%). El tipo de tecnología de cogeneración es la turbina a gas (40%) seguida de la turbina a gas y combustión interna. Conclusión: La utilización de turbinas de gas para generación de energía en empresarios de Ecuador-Manabí ha ido adquiriendo una importancia creciente, y puede decirse que se trata de una tecnología relativamente bien establecida. La cogeneración es una estrategia que resulta eficiente que la producción de electricidad y calor por separado.
Análisis del internet de las cosas para la automatización del campo agrícola: estudio de caso Milagro – Ecuador
Authors: Martillo Alchundia Ivette , Gómez Pereira Sonnia Viviana , Lozano Sacoto Alberto Yitzak 
Published: December 2022

El Internet se constituye en uno de los fenómenos más importante que de forma conjunta con la evolución de aparatos tecnológico, ha demostrado que las personas puedan controlar y monitorear las cosas desde otros lugares. Todo esto ha permitido que quienes se dedican a la agricultura, piensen en incorporar estos elementos en la labor agrícola para la mejora de la calidad y productividad de sus cultivos. El siguiente análisis, se trata de demostrar la factibilidad del uso del internet en los sistemas operativos del sector agrícola con el uso de sensores que a través de la programación en la placa NodeMCU, la cual envía datos a una plataforma gratuita de Internet of Things o IoT (por sus siglas en inglés), y con la ayuda de un bot creado en Telegram, la persona puede recibir mensajes sobre el estado del suelo de la plantación y realizar el riego cuando sea necesario a través de esta programación de comandos. Además, se realizó una investigación documental con el propósito de dar un fundamento teórico, así como se realizó encuesta a 50 agricultores y 10 empresas que distribuyen insumos y aparatos tecnológicos para el campo agrícola, con la intención de conocer si están utilizando IoT y automatización de procesos.