bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patients Eagerness for 2nd Eye External Dacryocystorhinostomy after the Satisfactory Surgery of 1st Eye in Tertiary Care Hospital of Islamabad Suburbs
Authors: Matloob Afia , Akhtar Waseem , Yousafzai Erum 
Published: December 2022

Objective: To determine patient satisfaction with successful external dacryocystorhinostomy for one eye and patients' preference time for second eye dacryocystorhinostomy after the first surgery.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Ophthalmology, HBS General Hospital, Islamabad Pakistan, from Jan 2018 to Dec 2020.
Methodology: A sample of 37 patients was calculated. All selected patients underwent bilateral external dacryocystorhinostomy and were followed for six months. Patient satisfaction was measured using a treatment satisfaction scale.
Results: A total of 37 patients were included in the study. The mean age of patients was 33.5 ± 3.1 years. Satisfaction with 1st eye external DCR was extremely satisfied in 14 (37.8%), satisfied in 14 (37.8%), neutral in 2 (5.4%), dissatisfied in 6 (16.2%) and extremely dissatisfied 1 (2.6%). 31 (83.8%) prefer second eye surgery in ≤1 year after first eye DCR, while 6 (16.2%) prefer second eye surgery after more than one year of first eye DCR surgery. The majority of females prefer ≤1 year duration for second eye DCR surgery as compared to males 25 (67.7%) vs 6 (16.2%), (p=0.03). Anatomical success and functional success were insignificantly associated with satisfaction of first eye DCR surgery of patients (p=0.793 and p=0.482)
Conclusions: High satisfaction with first eye dacryocystorhinostomy and greater preference for second eye dacryocystorhinostomy was found in patients coming to tertiary care hospital in Pakistan.
Prolotherapy Improves Anatomical and Clinical Outcomes in Monosodium Iodoacetate Induced Model of Osteoarthritis
Authors: Zahid Aqsa , Qamar Khadija , Qamar Abdullah , Faisal Tayyaba , Iftikhar Zubia , Saleem Saba 
Published: December 2022

Objective: To assess the ameliorative effects of Prolotherapy on the pain score of the gait cycle in Monosodium Iodoacetate (MIA) induced osteoarthritis in the rat knee joint.
Study Design: Laboratory-based experimental study.
Place and Duration of Study: Department of Anatomy, Army Medical College, Rawalpindi in collaboration with the National Institute of Health (NIH), Islamabad and Pathology Lab Pak Emirates Rawalpindi, Pakistan, from Aug to Nov 2021.
Methodology: Thirty male Sprague Dawley rats were randomly divided into three groups (n=10 in each group). The control group was Group-A. To induce osteoarthritic changes in Group-B, a single dose of 1mg Monosodium Iodoacetate was injected intra-articularly into the right knee. Group-C received a single dose of 1mg Monosodium Iodoacetate injection in the right knee intra articularly to induce osteoarthritic changes, and was followed by 0.1ml Prolotherapy (3ml of 25% dextrose, 2ml of 2% Xylocaine, 1ml of injection thiamine, and 1ml of injection Methylcobalamin) at 2, 6 and 10 weeks intra articularly into the right knee joint. Before euthanasia, Pain scoring schemes for gait in rats of all groups were done at 0, 2 and 14 weeks.
Results: The present study concluded that prolotherapy improved the gait cycle pain score in experimental group C (p-value 0.001 on the intergroup comparison at two weeks and 14 weeks while p-value 0.001 when compared pain score within the Group C at 0, 2 and 14 weeks).
Conclusion: Prolotherapy had ameliorative effects on the pain score of the gait cycle in experimental Group C on Monosodium Iodoacetate......
Pneumothorax and Intrapulmonary Hemorrhage in CT-Guided Transthoracic Biopsy
Authors: Iftikhar Ammara , Zafar Saerah Iffat , Slehria Atiq Ur Rehman , Awan Aamir Aslam , Rahim Raza , Sheraz Atif 
Published: December 2022

Objective: To study the frequency of pneumothorax and intrapulmonary haemorrhage in computed tomography (CT) guided transthoracic needle lung biopsy (NLB) and the factors that affect the development of these complications in Pakistan through a representative limited data obtained from a tertiary care centre.
Study Design: Cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi, from Jan 2018 to Feb 2019.
Methodology: A total of 68 patients who underwent CT-guided transthoracic biopsy were evaluated for intra- and immediate (within 04 hours) post-procedural pneumothorax and pulmonary haemorrhage. The factors affecting the development of these complications were evaluated.
Results: Complications developed in 30 patients with the frequency of pneumothorax at 26.5 % and frequency of pulmonary haemorrhage at 19.1%. Significant risk factors for the development of pneumothorax were small lesions less than 2.5 cm in diameter (p-value <0.05), increased needle track path within the lung tissue of more than 21 mm (p-value = 0.05), and presence of emphysema in the surrounding lung tissue (p-value <0.05). In addition, smaller lesion size (p-value <0.05) and increased traversed lung parenchyma (p-value <0.05) were also significant factors in the development of intrapulmonary haemorrhage.
Conclusion: Significant risk factors for pneumothorax and intrapulmonary haemorrhage are smaller lesion size and length of puncture path. The presence of emphysema is related to the development of pneumothorax.
Effect of Posterior Subtenon Triamcinolone Acetonide in Refractory Diabetic Macular Edema
Authors: Habib Muhammad Kashif , Shafqat Rubab , Oozeerkhan Zeeshan Khan , Gul Anwar Ahmed , Jabeen Nighat , Sadiq Muhammad Usman 
Published: December 2022

Objectives: To see the effect of Posterior Subtenon Triamcinolone Acetonide (PSTT) injection in refractory Diabetic Macular Edema (DME).
Study Design: Quasi-Experimental Study.
Place and Duration of Study: Retina Clinic, Al-Shifa Trust Eye Hospital, Rawalpindi, from Jun to Dec 2018.Methodology: Patients with Clinically Significant Macular Edema (CSME), with Central Macular Thickness (CMT) >300 microns and those who did not respond to three consecutive Intra-Vitreal Bevacizumab (IVB) injections were included. Posterior Subtenon Triamcinolone Acetonide (PSTT) was administered by a single retina fellow using the same protocol. Each patient’s best-corrected visual acuity (BCVA), Intra-ocular pressure (IOP) and Central Macular Thickness (CMT) were evaluated on the day of Posterior Subtenon Triamcinolone Acetonide (PSTT) injection and again at 1, 3 and 6 months.
Results: Out of 52 patients (104 eyes), 16 females and 36 males were present. The mean age was 57.67±9.35 years. Out of 52 right eyes, the mean Central Macular Thickness (CMT) at the first visit was 388.83±172.04 µm, 332.81 ± 144.69 µm after one month, 292.81±147.59µm after six months of Posterior Subtenon Triamcinolone Acetonide (PSTT) Injection. Similarly, for 52 left eyes mean Central Macular Thickness (CMT) at the first visit is 375.79±160.81 µm, 364.52 ± 167.95 µm after one month and 323.37±155.74 µm after six months. Similar results were observed for IOP and BCVA.
Conclusion: Posterior Subtenon Triamcinolone (PSTT) injections are effective in diabetic macular oedema, which does not respond to intravitreal anti-VEGF (IVB) therapy.
Comparison of Recurrence of High Trans-Sphinteric Anal Fistula After Vaaft and Tight Setons in Military Hospital Rawalpindi
Authors: Akbar Muhammad Haroon , Bashir Umar , Shabbir Hassan , Ans Muhammad , Majeed Farhan Ahmed , Abbasi Shahzad Ahmed , Khan Attayaba , Amjad Muhammad Ammar 
Published: December 2022

Objective: To compare the recurrence rate in patients undergoing fistulectomy using tight setons with those using videoassisted anal fistula treatment (VAAFT).
Study Design: Comparative prospective study.
Place and Duration of Study: Department of General Surgery, MH Rawalpindi, Pakistan from May 2018 to Dec 2021.
Methodology: We included 200 patients with high trans-sphincteric anal fistula (simple or complex) of age 18 to 60 years, having ASA I or II. Group- A comprised patients undergoing treatment with VAAFT, while Group- B included patients undergoing treatment with Tight Seton in conventional surgery. Patients were followed for three months after the procedure. Patients having a history of discharge around or in the vicinity of the previous external opening of the anal fistula were labelled as having a recurrence. Recurrence was confirmed on MRI Fistulogram.
Results: The mean age of patients in Group-A was 42.10±8.26 years, and in Group-B was 42.17±7.91 years (p=0.95). There were 58 male patients in Group-A and 55 male patients in Group-B (p=0.67). The mean duration of the fistula was 5.30±1.64 months in Group-A and 5.22±1.61 months in Group-B (p=0.72). Recurrence was diagnosed in 24 patients in Group-B and only 06 patients in Group-A (p<0.001).
Conclusion: Video-assisted anal fistula treatment (VAAFT) has a lower recurrence rate than Tight Setons in conventional surgery in treating high trans-sphinteric anal fistula.
Diagnostic Accuracy of Ultrasound for Small Bowel Obstruction in Paediatric Population Undergoing Laparotomy Keeping Surgical Findings as the Gold Standard
Authors: Liaqat Rabia , Majeed Ayesha Isani , Liaqat Bushra , Shafi Aqeel , Riaz Ramish , Akhtar Samina 
Published: December 2022

Objective: To analyze the diagnostic accuracy of ultrasound in small bowel obstruction in the paediatric population and compare it with surgical findings.
Study Design: Cross-sectional study.
Place and Duration of Study: Radiology Department, Pakistan Institute of Medical Sciences, Islamabad Pakistan from Jun 2018 to Jun 2019.
Methodology: This study enrolled 84 paediatric small bowel obstruction cases who underwent exploratory laparotomy at the Pakistan institute of medical sciences from Jun 2018 to Jun 2019. The clinically suspected cases of small bowel obstruction were referred by paediatric surgery to the Radiology department, where an ultrasound abdomen was performed by a senior resident, exclusively targeting the bowel. The clinical, sonological, and per-operative findings were recorded on a proforma.
Results: The mean age in our study was 3.5±2.7 years. A male gender predominance was noted. The most consistent greyscale feature favouring bowel obstruction was dilated bowel loops, found among 98.7% (76 out of 77) of surgically confirmed cases of bowel obstruction. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of ultrasound were 98.7%, 71.4%, 97.4%, 83.4% and 94.6% respectively. The sonological cause of obstruction was readily demonstrated among 51 (67%) out of 76 true positive cases. The most common site of obstruction was the distal ileum, with intussusception being the leading cause found among 32% of true positive cases.
Conclusion: The overall diagnostic accuracy of ultrasound in revealing small bowel obstruction is high among the paediatric population.
Effect of Melasma on Quality of Life of Patients using Dermatology Life Quality Index
Authors: Amar Ali , Nida Sumbal , Mudassir Muhammad 
Published: December 2022

Objective: To assess the effect of melasma on the Quality of Life (QoL) of patients using the Dermatology Life Quality Index (DLQI).
Study Design: Cross-sectional study.
Place and Duration of Study: Department of dermatology PAF Hospital, Jacobabad Pakistan, from Jun 2019 to 2020.
Methodology: A total of 103 patients with melasma were enrolled in the study from the dermatology outpatient department after written informed consent. Patients of either gender aged 15 years and above were included in the study. Melasma Area and Severity Index assessed melasma severity. In addition, the impact on Quality of Life was assessed using the Dermatology Life Quality Index questionnaire.
Results: Among the 103 patients, 67 (65%) were females, and 36 (35%) were male. The mean age of patients was 29.50±7.94 years and included 78 (75.7%) married and 25 (24.3%) unmarried individuals. Mean Melasma Area and Severity Index was 22.04±11.23, including 36 (35%) patients with mild, 43 (41.7%) moderate and 24 (23.3%) patients with severe disease, respectively. Overall mean Dermatology Life Quality Index of the sample was 11.25±7.78, while mean scores for the mild, moderate and severe diseases were 5.89±.58, 10.33±5.75 and 20.96±6.62, respectively (p=0.001), indicating that Quality of Life is significantly more impaired with increased disease severity.
Conclusion: Melasma significantly affects the Quality of Life of the patients as measured by Dermatology Life Quality Index. The impact on Quality of Life is directly proportional to the severity of melasma assessed by the Melasma Area Severity Index.
Pulmonary Embolism at High Altitude: Analysis of Risk Factors
Authors: Khan Naimat Ullah , Adil Muhammad , Zaman Muhammad , Palwa Abdul Rahim , Tahir Muhammad , Nawaz Muhammad Rameez 
Published: December 2022

Objective: To analyze the risk factors for pulmonary embolism stationed at high altitudes with high altitude as one of the determinants.
Study Design: Retrospective longitudinal study.
Place and Duration of Study: Combined Military Hospital Skardu Pakistan, from Jan 2016 to Jan 2020.
Methodology: A total of 25 consecutive cases with pulmonary embolism reported to this hospital during the study period were enrolled. Medical records of all patients were retrospectively analyzed to determine the risk factors. In addition, patient demographic data, clinical features, and laboratory and radiological findings were recorded.
Results: Mean age of the patient was 30.68±5.37 years with a range from 23 to 40 years, the mean height of deployment was 17223.00±3577.00 feet, while the mean duration of stay was 53.92±44.76 days. Dyspnoea (84%) was the commonest clinical presentation followed by palpitation, chest pain, headache and haemoptysis. Most patients (88%) were non-smokers, while no patient had known significant risk factors. Thrombophilia and vascultitic screening were negative for all patients. In the absence of any significant hereditary or acquired risk factor, high altitude remains the only thrombogenic risk factor patients deployed at heights.
Conclusion: Stay at a high altitude is a major risk factor for pulmonary embolism in young patients without any other known risk factor.
Diagnostic Accuracy of Non-Invasive Hepatic Ultrasound Score for Non-Alcoholic Fatty Liver Disease Keeping Computed Tomography as a Gold Standard
Authors: Waheed Sidra , Slehria Atiq Ur Rehman , Tahir Sadia , Ali Dilshad , Nisar Uzma , Raja Waseem 
Published: December 2022

Objective: To determine the diagnostic accuracy of non-invasive hepatic ultrasound score for the diagnosis of non-alcoholic fatty liver disease (NAFLD) by keeping computed tomography. (CT) as the gold standard.
Study Design: Cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging Rawalpindi from Dec 2017 to May 2018.
Methodology: All patients from any ethnicity and gender with more than 18 and less than 60 years of age were considered for the study. Hepatic ultrasound score based on the anteroposterior diameter of the right lobe of the liver, deep beam attenuation was calculated, and results were compared with CT scan findings.
Results: A total of 101 patients were included. A total of 69 patients had a total Ultrasound score of 2 or more, fulfilling the study’s criteria to be labelled as Non-Alcoholic Fatty Liver Disease. On a CT scan, 71 patients fulfilled the criteria to be labelled as having Non-Alcoholic Fatty Liver Disease. Keeping the Computed Tomography scan gold standard, 59 patients were true positive, and 10 were false positive. The sensitivity and specificity of this score were 83.09 % and 66.67%, respectively. The hepatic ultrasound score had a Positive Predictive Value of 85.50% and a Negative Predictive Value of 62.5%.
Conclusion: Ultrasound score based on hepatic attenuation and the anteroposterior diameter of the right hepatic lobe is a reliable, reproducible and accurate tool for diagnosing Non-Alcoholic Fatty Liver Disease.
Hla-B27 Allele Connotation Amongst Individuals Conjectured of Spondyloarthritis (SPA) In Pakistan
Authors: Javed Annam , Fakhar Amir , Ashraf Nadeem , Ahmed Bilal , Atif Khaula , Javed Amna 
Published: December 2022

Objective: To define the link of HLA-B27 with Spondyloarthritis (SPA) among the study population.
Study Design: Cross-sectional study.
Place and Duration of Study: Rheumatology Department Pak-Emirates Military Hospital (PEMH) Rawalpindi Pakistan, from Jun 2019 to Jan 2020.
Methodology: Patients assumed to be suffering from spondyloarthritis (Spa), reporting for routine follow-up at subject OPD, were enrolled. Socio-demographic and clinical variables were measured with HLA-typing.
Results: Among 550 subjects; age and BMI scores were 31.15±10.399 (18-63 years) and 23.39±4.19 (17.2-35.0 kg/m2), respectively. 391 (71.1%) patients were found positive for HLA-B27, which was significantly more amongst 20-40 years aged (p=0.003), those with non-professional education (p=0.003), associated with raised CRP(C-reactive protein, p<0.001) and ESR(erythrocyte sedimentation rate, p<0.001), with 3-6 years since the onset of symptoms (p<0.001), up to 2 years delay in diagnosis(p<0.001), peripheral arthritis(p 0.008), having co-morbidities (p=0.011), less DAL (daily activities of life, p<0.001) with no significant impact of gender, SEC (socio-economic class), pain severity, co-morbidities and formal exercise. Severe pain was stated more by females (p=0.008), low SEC (p=0.003) and overweight patients with BMI 25-29.9 (p=0.001)
Conclusion: There is a strong association between HLA-B27 and spondyloarthritis (Spa), predominance in the 2nd and third decade, and no gender predilection. Auxiliary exploration would be valuable to recognize the predominant subtypes of the HLA-B27 allele in Pakistani patients with spondyloarthritis (Spa).
Is Sevelamer Carbonate Better Than Calcium Acetate in ControllingChroni Kidney Disease-Mineral Bone Disease in Dialysis Patients
Authors: Tahir Taleah , Raja Khalid Mahmood , Azam Malik Nadeem , Butt Batool , Mir Abdul Wahab , Ahmed Naveed 
Published: December 2022

Objective: To ascertain the efficacy of Sevelamer Carbonate as a better phosphate binder for controlling mineral bone disease biochemical parameters in dialysis patients of a tertiary care centre compared to calcium acetate.
Study Design: Prospective Quasi-experimental study.
Place and duration of the study: Dialysis unit of Pakistan Emirates Military Hospital Rawalpindi Pakistan from Aug to Dec 2020.
Methodology: The sample population comprised 91 patients undergoing maintenance thrice weekly haemodialysis patients treated with Sevelamer Carbonate or Calcium Acetate. CKD-MBD was assessed by serum calcium, phosphorus, ALP, albumin and PTH at the start of the study and then at the end of three months after being treated with phosphate binders.
Results: Both Groups had reduced serum phosphorus significantly from baseline to 12 weeks but Sevelamer slightly more than calcium acetate. (Group-1 from 6.90±1.35 to 5.10±1.21, while Group-2 from 7.00±1.31 to 5.90±1.48). The mean Calcium × Phosphorus product was also significantly reduced (p<0.005), decreases after 12 weeks, with 50.0 ± 16.0 in the Sevelamer Hydrochloride Group and insignificantly reduced (52.20±5.20mg2/dl) in the calcium acetate Group. The mean serum calcium increased significantly in the calcium acetate Group from 9.55±0.47 to 10.50±0.90) p=0.003 but was unchanged in the Sevelamerhydrochloride Group (9.56±0.60 to 9.57±0.67; p=0.94).
Conclusions: CKD-MBD and its sequelae need special medication, and early detection of biochemical abnormalities and timely intervention with phosphate lowering therapy can abridge the disease burden, thus revamping the quality of life and ultimately abatement of cardiovascular morbidity and mortality.
Clinico-Immunological Profile of Systemic Lupus Erythematosus Patients in Pakistan and Their Correlation
Authors: Khan Zafar Ayub , Mushthaq Samina , Sameera Saba , Salim Babur , Ahmed Syed Nazir , Zahid Pir Muhammad , Gul Haris 
Published: December 2022

Objective: To see the clinical and immunological profile of systemic lupus erythematosus (SLE) patients and their correlation with the central nervous system and renal involvement.
Study Design: Cross-sectional study.
Place and Duration of Study: Fauji Foundation Hospital Rawalpindi from Sep 2019 to Sep 2020.
Methodology: One hundred forty patients were selected according to SLE ACR (American College of Rheumatology) criteria. Detailed history and examination, including dermatological examination, were done, and blood samples were taken for baseline investigations and SLE-related autoimmune profile. Statistical analysis was done using SPSS 23 to determine the correlation between skin, central nervous system and renal involvement.
Results: In our study, among the lupus-specific lesions, photosensitivity was most frequent 119 (85%) finding followed by oral ulcers 114 (81.4%), alopecia 112 (80%) and malar rash 81 (57.9%). Among the immunological profile, antinuclear antibody (ANA) was the most frequent 116 (82.9%) finding, followed by anti-double stranded antibody 71 (51.7%). Hypocomplementemia and anti-Sm antibody was significantly associated with lupus nephritis (p-value <0.05). There was no correlation between skin and neuropsychiatric involvement and skin and nephritis.
Conclusion: This study depicts the clinical immune profile of SLE patients in Pakistan. In our patients, autoimmune profile and complement levels could predict renal involvement.
Effect of the COVID-19 Pandemic on Antenatal Care
Authors: Khalil Adiba Akhtar , Amin Nabila , Akhtar Joodi Kizilwarda , Amir Muhammad Ayhan , Amir Suha , Gul Uzma 
Published: December 2022

Objective: To assess how the antenatal population of a hospital was affected by the COVID -19 Pandemic.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Antenatal Clinic of Government Hospital, Rawalpindi Pakistan, for the month of August 2020.
Methodology: The population in the antenatal clinic of a hospital were given a questionnaire with simple directed questions after consent.
Results: All (150, 100%) of the antenatal population received their COVID-19 pandemic information from television. Most 147 (98%) did not feel embarrassed if they contracted COVID-19 infection, and 147 (98%) took precautions against it. The majority, 146 (97%) of women, had an antenatal check-up. Out of the total, 126 (84%) had a private check-up, but only 36 (24%) had more private visits than prior pregnancies. A significant number, 56 (37%), had to spend more than in prior pregnancies, but only 28 (18.6%) had fewer antenatal visits than before. Most 141 (94%) of women wanted a higher frequency of antenatal visits than the recommended 08 visits by the WHO.
Conclusion: The COVID-19 pandemic did not affect antenatal care because of a well-established private health care system. The patients in prior pregnancies were already using the private sector.