bluuebunny/crossref_metadata_2025_split huggingface dataset:
ASSOCIATION OF IRON DEFICIENCY ANEMIA WITH ACUTE LOWER RESPIRATORY TRACT INFECTIONS IN CHILDREN
Authors: Nawaz Raazia , Hussain Shabbir , Khushdil Arshad , Tanveer Sidra , Javed Maria , Akram Saira 
Published: January 2022

Objective: To establish association between acute lower respiratory tract infection and iron deficiency anemia.
Study Design: Case-control study.
Place and Duration of Study: Pediatrics Department, Pak Emirates Military Hospital, Rawalpindi, from Dec 2017 to May 2018.
Methodology: A total of 100 children with age ranging from 6-60 months were selected for this study with 50 being in each group. Study group constituted of children presenting with acute lower respiratory tract infection and healthy children presenting to outpatient were taken as controls. Hemoglobin levels (<11g/dl), mean corpuscular volume (<70fl), Serum Ferritin (<30ng/ml) and red blood cell Morphology were used to determine iron deficiency anemia. Patients meeting the WHO criteria were labeled to have acute lower respiratory tract infection.
Results: The frequency of iron deficiency was found to be 40 (80%) in cases and only 34 (17%) in healthy controls. A significant association was found between iron deficiency anemia and acute lower respiratory tract Infection with an odds ratio of 7.76 and a significant p-value of <0.01.
Conclusions: Iron deficiency anemia has an increased association of up to seven times in children with acute lower respiratory tract infections as compared to healthy children thus highlighting it as a significant risk factor.
SEVERITY OF DEPRESSION AND ANXIETY AMONG CAREGIVERS OF CHILDREN WITH CEREBRAL PALSY AND THEIR CORRELATION WITH FUNCTIONAL CAPABILITIES OF THE CHILDREN
Authors: Khan Sikandar Ali , Saeed Fazal Ur Rahman , Ayaz Saeed Bin 
Published: January 2022

Objective: To evaluate the severity of depression and anxiety among caregivers of children having cerebral palsy and correlate severity with the type of cerebral palsy and functional capability of the child.
Study Design: A cross-sectional study.
Place and Duration of Study: Department of Psychiatry and Rehabilitation Medicine, Combined Military Hospital, Gujranwala, from Oct 2015 to Aug 2018.
Methodology: Through consecutive sampling, 186 caregivers diagnosed with anxiety and/or depression based on the diagnostic criteria of International Classification of Diseases version 10, and their cerebral palsy children were recruited. Symptom severity was assessed using Beck Depressive Inventory for depression and Beck Anxiety Inventory for anxiety. The functional capabilities of the children were assessed through gross motor function classification system (GMFCS). For correlation, Pearson’s chi square test was used using SPSS version 20.
Results: The mean age was 30 ± 3.3 years. Fourteen (7.5%) were fathers of cerebral palsy children and 172 (92.5%) were mothers of cerebral palsy children. Majority of the cerebral palsy children 74 (39.8%) had spastic diplegia and the functional level I of gross motor function classification system 53 (28.5%). Most of the caregivers had mild anxiety and minimal depression (33.9% and 38.7% respectively). Significant correlation existed among the gross motor functional capability and the level of anxiety but not with depression (p<0.01 and p=0.155 respectively). No statistical association was found between the type of cerebral palsy and the level of anxiety or depression (p=0.240 and p=0.102 respectively).
Conclusion: Most caregivers in our study had mild anxiety and minimal depression..............
SPECTRUM OF RHEUMATOID ARTHRITIS PATIENTS PRESENTING TO A TERTIARY CARE HOSPITAL IN PAKISTAN
Authors: Khan Muhammad , Mushtaq Muhammad Salman , Salim Babur , Mushtaq Sumera , Gul Haris , Samreen Saba 
Published: January 2022

Objective: To describe the demographic, clinical, serological and radiological scores in patients with rheumatoid arthritis (RA) presenting in a tertiary hospital in Pakistan.
Study Design: Cross sectional study.
Place and Duration of Study: Department of Rheumatology, Fauji Foundation Hospital (FFH), Rawalpindi, from Sep 2018 to Feb 2019.
Methodology: The study included 52 female patients with RA between the ages of 18 and 80 years. Data were obtained from FFH Rawalpindi's outpatient department. Demographic details, reference data, and serological status were recorded. The joints involved in the onset of the disease, joint deformities, clinical disease activity index (CDAI) and overall functional status were evaluated. Extra-articular manifestations of rheumatoid arthritis have also been examined during a detailed physical examination. The patient's bone mineral density was calculated by the use of dual energy absorptiometry (DEXA scan). Radiological scores were evaluated using modified sharp score.
Results: Mean age of the patient was 55.08 ± 8.79 and mean duration of disease 9 .73 ± 7.54. The most common co-morbidity in rheumatoid arthritis patients was hypertension 20 (38.5%). Twenty four (11.7%) patients had osteoporosis. Wrist was the first joint involved in 17 (32.7%) patients. Ulnar deviation was the most common deformity in 12 (23.1%) patients. Sharp score for joint space narrowing was 61.09 ± 36.90 and sharp score joint erosions were 36.90 ± 42.41. Most common extra articular manifestation was anemia.
Conclusion: Rheumatoid arthritis as a variable spectrum of disease with different manifestations. Patients had radiological damage as demonstrated by high sharp score even before starting.................
COMPARISON OF NEONATAL APGAR SCORES AND PATIENT SATISFACTION LEVELS IN SPINAL VERSUS GENERAL ANESTHESIA IN ELECTIVE CESAREAN SECTIONS
Authors: Naseer Syed Khurram , Ali Aijaz , Feroz Shizan Hamid , Danish Dr , Sohail Amir 
Published: January 2022

Objective: To compare patients undergoing cesarean section under spinal and general anesthesia in terms of neonatal APGAR scores and patient satisfaction.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Departments of Anesthesia and Gynecology and Obstetrics, Combined Military Hospital Peshawar, for six months from Mar to Aug 2019.
Methodology: In this study, 120 females with a singleton pregnancy of 36-40 weeks, and requiring a non-emergency elective cesarean section were enrolled through consecutive sampling in the study. The patients were randomly allocated into two equal groups of 60 women each through random table numbers. Group A received spinal anesthesia and group B general anesthesia. APGAR score was assessed at 5 minutes after delivery, and score of ≥7 was taken as satisfactory. Patient's satisfaction level regarding anesthesia was recorded on a visual analogue scale of 0 (extremely unsatisfied) to 10 (completely satisfied), and score of ≥7 was taken as satisfactory.
Results: Women receiving general anesthesia were more satisfied as compared to receiving spinal anesthesia (95% vs. 78.3%; p-value 0.007). There was no significant difference in terms of APGAR scores in general anesthesia and spinal anesthesia (83.33% versus 90%; p-value 0.283).
Conclusion: After an elective caesarean section, more mothers were satisfied after receiving general anesthesia as compared to spinal anesthesia. However, both types of anaesthesia were found to be equally safe for babies born in terms of APGAR scores at 5 minutes.
ANAESTHESIOLOGY AS A FUTURE SPECIALTY
Authors: Mahmood Khalid , Shamim Asad , Khan Muhammad Umair , Alam Tasneem , Khalid Usman , Jaffery Asad Ullah 
Published: January 2022

Objective: To ascertain the various aspects directing the undergraduates at Quetta Institute of medical sciences towards anesthesiology as future profession/specialization.
Study Design: Cross sectional study.
Place and Duration of Study: Quetta Institute of Medical Sciences, Quetta Pakistan, from Mar to Apr 2019.
Methodology: Study was conducted among final year medical students with the help of a printed questionnaire consisting of 15 Multiple Choice Questions. The questionnaire provided the required database to explore various factors that influence undergraduates to select their future specialization based on demography and specialty preferences.
Results: A total of 65 undergraduates completed the response sheet. While 45 (68.8%) participants were females and 20 (31.2%) were males, 62 (95.4%) were single (unmarried or divorced) and had no children 63 (96.9%). Medicine proved to be the most favourate specialty with 20 (31.4%) student opting for it whereas anesthesiology was chosen by 4 (6.1%) students.
Conclusion: Anesthesiology still remains a less popular choice among the medical students of Pakistan particularly Quetta Institute of Medical Sciences due to multifaceted factors. Inferior prestige of the specialty was the most significant factor in deciding against anaesthesiology.
ASSOCIATION OF DENTAL CARIES AND ORAL HEALTH RELATED QUALITY OF LIFE (OHRQOL) IN DISABLED CHILDREN
Authors: Jawed Rubab , Khan Zohaib , Younus Maryam , Abid Khadijah , Saleem Momina , Kibria Zeeshan 
Published: January 2022

Objective: To assess the association of dental caries and oral health related quality of life in mentally or physical disabled children studying in schools of Karachi.
Study Design: Cross sectional study.
Place and Duration of Study: Public and private sector special needs schools of Karachi, from Sep to Nov 2017.
Methodology: This study was conducted on 196 disabled children (mental/physical) in Karachi Pakistan. Children aged 6-18 years and having a disability was included in the study. We calculated the prevalence of dental caries through an examination of the oral cavity using the Decayed, missing and filled teeth index. Data were analyzed in SPSS version 20.
Results: Dental caries was found in 114 (58.2%). “Oral symptoms” score was (4.46 ± 0.85 vs. 4.95 ± 0.79; p<0.001), “functional limitation” (4.12 ± 1.0 vs. 4.63 ± 0.82; p<0.001), “emotional wellbeing” (4.40 ± 0.92 vs. 4.97 ± 0.70; p<0.001) and “parental distress and family function” (3.65 ± 0.97 vs. 4.03 ± 0.96; p<0.001) in children with and without dental caries respectively. All the oral health related quality of life score domains showed statistically significant association between mentally and physical disabled children with and without dental caries.
Conclusion: All the oral health related quality of life related domains had a significant negative impact on the quality of life in mentally and physical disabled children
REPRODUCTIVE OUTCOMES AFTER ABDOMINAL MYOMECTOMY
Authors: Fatima Yasmin , Amir Mumtaz 
Published: January 2022

Objective: To determine the frequency of reproductive outcomes after abdominal myomectomy in infertile women.
Study Design: Case series.
Place and Duration of Study: at Combined Military Hospital, Multan Pakistan, from Sep 2015 to Feb 2017.
Methodology: This study included 60 women who underwent myomectomy to retain their capabilities of reproduction. Inclusion criteria were infertile women with uterine fibroids. Routine investigation was done to all patients like ultrasound and hysterosalpingogram before and after the procedure. The procedure of abdominal myomectomy was done under general anesthesia. All fibroids were enucleated and large blood vessels were tied. Vicryl no.1 was used to close the uterine defect. All patients were followed up for 3, 6 and 12 months interval and data was collected for conception, spontaneous conception, and conception with assisted reproductive technique, live birth and miscarriage.
Results: In this study mean age was 27.33 ± 4.03 years, mean number of fibroid was 1.366 ± 0.48 and mean size of fibroid was 7.06 ± 1.64 cm. Twenty eight (46.7%) women had conceived after myomectomy, in which 92.9% had spontaneous conception and 7.1% by assisted reproductive technique.
Conclusion: Abdominal myomectomy should be the standard treatment of infertile women with uterine fibroids if no other underline cause of infertility. Moreover, this study results also showed that younger patients might be benefited more in term of reproductive outcomes after abdominal myomectomy.
PREVALENCE, ASSOCIATED FACTORS AND AWARENESS OF BULLYING AMONG STUDENTS OF PUBLIC AND PRIVATE SCHOOLS OF LAHORE, PAKISTAN
Authors: Salman Fariha , Sharjeel Muhammad , Abdullah Mohammad Salman 
Published: January 2022

Objectives: To find out prevalence of bullying, its associated factors and extent of awareness against bullying among th students of public/private schools of Lahore and to compare them.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Study was carried out in different schools of Lahore, Pakistan, from May to Nov 2019.
Methodology: A total of 294 students of public/private schools (8-10th grade students) of Lahore were recruited in study by purposive sampling. The students filled a pretested and pre-structured questionnaire consisting of questions about bullying, number of bullies, forms of bullying, its causes and consequences, reaction of students towards bullying and if anybody was informed about it.
Results: A higher frequency of bullying was reported in public schools (54%) than in private (46%). Students mostly suffered bullying in the form of humiliating remarks (56.3%) and verbal abuse (25.3%). Causes of bullying in public schools were physical appearance (48.9%), illness (19.1%) and imbalance of power (19.1%) whereas in private schools, physical status (45.0%), imbalance of power (25.0%) and low socioeconomic status (22.5%) were common. Bullying was associated with loss of concentration on studies (19.5%) and behavioral changes (18.4%). The students usually reported bullying incidents to teachers (36.8%) and parents (28.7%). A majority of students walked away from the bully (45.4%).
Conclusion: Bullying is relatively more prevalent in public schools and predominantly manifested in the form of humiliating remarks & verbal abuse. Majority of students show no appropriate resistance towards the bully while bullying causes a critical psychological distress inthem.
COMPARISON OF ENDOTRACHEAL INTUBATION VERSUS SUPRAGLOTTIC AIRWAY DEVICE IN PATIENTS UNDERGOING CORNEAL TRANSPLANTATION UNDER GENERAL ANAESTHESIA
Authors: Abbas Sana , Zafar Omar , Abbas Beenish , Mehmood Basit , Hayat Umer , Javaid Hassaan 
Published: January 2022

Objective: To compare endotracheal intubation versus Suraglottic airway device in patients undergoing penetrating keratoplasty under general anaesthesia.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Jan 2018 to Mar 2020.
Methodology: Total 28 patients enrolled with a mean age of 42.82 ± 7.86 years and age-range of 18-55 belonging to American Society of Anesthesiology I, II & III undergoing penetrating keratoplasty under general anaesthesia. The airway was secured with I–Gel and Endotracheal tube in group A (n=14) and group B (n=14) respectively. Pre anaesthesia assessment along with informed written consent performed. General Anesthesia is given and patients monitored as per standard protocols. Postextubation incidence of cough, sore throat, bronchospasm, stridor and blood on device recorded in addition to surgery and recovery duration.
Results: Twenty-eight patients were enrolled in the study with a mean age of 42.82 ± 7.86 years. There were 9 (32.1%) females and 19 (67.9%) males in the study group. The recovery time was significantly lower for group A as compared to group B (72.64 ± 5.06 vs 80.43 ± 3.75, p<0.001). Similarly, a significantly lesser number of patients experienced post-extubation complications i.e. cough, among group A as compared to Group B [1 (7.1%) vs 8 (57.1%) p0.005].
Conclusion: I-Gel provides smooth recovery with reduced mean recovery time and decreased potential of raised intraocular pressure, when compared with endotracheal intubation in patients undergoing penetrating keratoplasty under general anaesthesia.
DIAGNOSTIC ACCURACY OF C-14 UREA BREATH TEST FOR DETECTION OF HELICOBACTER PYLORI IN PATIENTS WITH GASTRITIS
Authors: Dar Zaigham Salim , Butt Suniya Arshad , Mir Khurram Hayat , Hussain Fida 
Published: January 2022

Objective: To evaluate the diagnostic accuracy of C-14 Urea Breath Test for detection of helicobacter pylori infection in patients with gastritis.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, from Feb to Aug 2016.
Methodology: After fulfilling inclusion and exclusion criteria, 110 patients of both genders, aged between 18-50 years, were enrolled. Prior written informed consent was obtained from each patient. First, they were assessed by C-14 Urea Breath Test, followed by endoscopic biopsy and histopathology. Results of C-14 Urea Breath Test were compared to histopathology diagnosis which was taken as gold standard.
Results: Patients’ ages ranged from 18-50 years with a mean ± SD of 37.45 ± 10.21 years. Seventy four (67.3%) of them were males and 36 (32.7%) were females. Sixty four (58.2%) patients were suspected of helicobacter pylori on C-14 Urea breath test. However, histopathology of endoscopic biopsy confirmed helicobacter pylori in 66 (60%) patients yielding 64 true positive, 44 true negative and 2 false negative cases. Calculated sensitivity was 96.97%, specificity 100% and accuracy was 98.18% for C-14 Urea Breath Test with negative and positive predictive values of 95.65% and 100% respectively.
Conclusion: C-14 Urea Breath Test is highly accurate, sensitive and specific test for detection of helicobacter pylori infection, irrespective of patient’s age and gender.
DETERMINATION OF NORMAL THYROID TECHNETIUM-99M UPTAKE VALUE IN A SINGLE CENTRE PAKISTANI POPULATION
Authors: Malik Asad , Hussain Fida , Ashraf Muhammad , Seher Saima , Jamal Ali , Akbar Shahzad 
Published: January 2022

Objective: To determine the normal value of thyroid Technetium-99m uptake value in a single centre Pakistani population.
Study Design: Cross-sectional study.
Place and Duration of Study: Nuclear Medical Centre, Armed Forces Institute of Pathology, Rawalpindi, from Feb 2019 to Apr 2020.
Methodology: A total of 90 patients who presented to Nuclear Medical Centre for parathyroid dual radiopharmaceutical scintigraphy were included in study and selected by non-probability consecutive sampling technique. Thyroid uptake studies were calculated via gamma camera acquisition. Pre injection counts were taken from the Technetium-99m pertechnetate filled syringe, thyroid counts were taken from the anterior thyroid image 20 minutes post injection and to look for any residual radiopharmaceutical counts of the empty syringe were also taken.
Results: Out of total of 90 patients, 32 (35.6%) were male while 58 (64.4%) were female with male to female ratio of 1:2. The mean age was 38.4 ± 12.7. Mean Thyroid Stimulating Hormone values were 1.6 ± 0.8 and mean T4 values were 11.9 ± 3.5. The 5th-95th percentile range was 0.4-2.2% and median was 1.2%. The interquartile range was calculated to be 0.9-1.5%.
Conclusion: Normal value of thyroid Technetium-99m uptake value in a single centre Pakistani population values varies significantly as compared to global figures i.e. 0.3-4.5% and is different than the one used in our own department i.e. 0.5-2.0%.
ROLE OF DOPPLER INDICES IN THE PREDICTION OF ADVERSE PERINATAL OUTCOME IN PREECLAMPSIA
Authors: Tabasam Shakra , Malik Zaib , Siraj Asifa , Afroz Sadaf 
Published: January 2022

Objective: To determine diagnostic accuracy of systolic/diastolic ratio and cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia.
Study Design: Cross-sectional validation study.
Place and Duration of Study: Department of Obstetrics and Gynaecology, Pak Emirates Military Hospital, Rawalpindi, from Jun to Dec 2017.
Methodology: A total of 191 patients with preeclampsia were included. Doppler ultrasound (including doppler wave forms obtained from free floating portion of umbilical artery and doppler waveform from middle cerebral artery at the level of circle of Willis) examination was done after gestational age 30 weeks and Doppler study repeated at 2-4 weeks interval depending on severity of preeclampsia and abnormalities of waveform. Cases were followed and results of last Doppler examination within 10 days of delivery were considered and perinatal outcome noted.
Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of systolic/diastolic ratio in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 82.35%, 86.52%, 87.50%, 81.05% and 84.29% respectively. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia, keeping actual adverse perinatal outcome as reference standard was 78.67%, 92.24%, 86.76%, 86.99% and 86.91% respectively.
Conclusion: The diagnostic accuracy of systolic/diastolic ratio, cerebro-placental index in predicting adverse perinatal outcome among patients in preeclampsia is quite high.
COMPARISON OF EFFECTIVENESS OF INTRAARTICULAR INJECTIONS OF HYALURONIC ACID AND CORTICOSTEROIDS IN THE TREATMENT OF PATIENTS WITH KNEE OSTEOARTHRITIS SYMPTOMS
Authors: Tirmizi Syed Haider , Fakhr Amer , Amer Ahmed , Yusuf Rizwan , Sajjad Kaswar , Khan Shah Muhammad 
Published: January 2022

Objective: To compare the effectiveness of intraarticular injections of hyaluronic acid and corticosteroids in the treatment of patients with knee osteoarthritis symptoms.Study Design: Prospective comparative study.Place and Duration of Study: Rheumatology/General Medicine department, Pak Emirates Military Hospital Rawalpindi, from May 2019 to Jun 2020.Methodology: Patient of knee osteoarthritis with active symptoms of pain and stiffness who fulfilled American college of rheumatology criteria of 1997 were included in the study. They were randomly divided into two groups with group A receiving intraarticular hyaluronic acid. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was administered before and three months after the management to assess the efficacy of treatment in both the groups. Student ttest was applied to ascertain that the difference in the WOMAC scores before and after the management has been statistically significantly different in both groups.
Results: A total of 150 patients of osteoarthritis of knee joint were included in the study. Mean age of the study participants was 58.439 ± 7.35. 85 (56.7%) patients were female while 65 (43.3%) were male. 81 (54%) received the intraarticular hyaluronic Acid while 69 (46%) received the intraarticular steroids. Mean difference before and after the management in WOMAC score in corticosteroids group was 9.295 ± 1.24 while in hyaluronic Acid group was 5.41 ± 4.556 (p-value <0.01).
Conclusion: Both hyaluronic Acid and corticosteroids were effective to reduce the symptoms of osteoarthritis knee in our target population, but intraarticular steroids emerged as the better option from the two in terms of.......