bluuebunny/crossref_metadata_2025_split huggingface dataset:
Serologic and Cytokine Profiles of Children with Concurrent Cerebral Malaria and Severe Malarial Anemia Are Distinct from Other Subtypes of Severe Malaria
Authors: Sobota Rafal S. , Goron Abby R. , Berry Andrea A. , Bailey Jason A. , Coulibaly Drissa , Adams Matthew , Kone Abdoulaye K. , Kouriba Bourema , Doumbo Ogobara K. , Sztein Marcelo B. , Felgner Philip L. , Plowe Christopher V. , Lyke Kirsten E. , Thera Mahamadou A. , Travassos Mark A. 
Published: June 2022

ABSTRACT.
We used a protein microarray featuring Plasmodium falciparum field variants of a merozoite surface antigen to examine malaria exposure in Malian children with different severe malaria syndromes. Unlike children with cerebral malaria alone or severe malarial anemia alone, those with concurrent cerebral malaria and severe malarial anemia had serologic responses demonstrating a broader prior parasite exposure pattern than matched controls with uncomplicated disease. Comparison of levels of malaria-related cytokines revealed that children with the concurrent phenotype had elevated levels of interleukin (IL)-6, IL-8, and IL-10. Our results suggest that the pathophysiology of this severe subtype is unique and merits further investigation.
Efficacy of Paediatric Preinduction Anxiety Distraction Techniques During Oncologic Procedures
Authors: Almas Iqbal  , Huma Saleem  , Muhammad Taqi  
Published: June 2022

Introduction: Children undergoing oncologic procedures as part of their treatment may suffer from anxiety. It could be related to parental separation, pain/ bodily harm or a previous bad experience of procedure. Pre-procedure anxiety may result in adverse clinical outcomes such as emergence delirium, pulmonary complications and behavioral issues. Preoperative anxiety must be assessed to deal with using appropriate preinduction distraction techniques.
Aims & Objectives: The objective of audit is to determine efficacy of preinduction distraction techniques used in our clinical set up (to meet RCoA standards) in reducing anxiety and need of restrain for children at time of induction.
Place and duration of study: Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore Pakistan. 14th of January 2020 to 15th of March 2020 (8 Weeks).
Material & Methods: It is a prospective outcome-based audit study of 101 children (2-8 years) undergoing intrathecal chemotherapy and bone marrow biopsy at Shaukat Khanum Cancer Hospital, Lahore. All children had non- pharmacological preinduction distraction techniques (Parental/legal guardian presence and/or play car) to reduce anxiety, cry and need for restraint. Anxiety levels as assessed by modified Yale Preoperative Anxiety Scale (mYPAS), cry and restrain were benchmarked with Royal College of Anesthetists (RCoA) standards.
Results: A total of 101 children with a median age of 4 years (2-8 years), had 100% parental/legal guardian presence at induction. In our audit, 52% of children cried and 43% were found to be anxious. However, only 21% children required use of restraint (holding still in laps) by accompanying parent/legal guardian. This is acceptable for restraint but not for cry/ anxiety as per RCoA benchmark.
Conclusion: Preinduction distraction technique of parental presence and/or toy car, showed only limited benefit in terms of cry, restraint and anxiety levels. Our audited results met benchmark set by RCoA only in terms of restraint but not for anxiety/cry.
Colebrookea Oppositifolia Anti Arthritic Potential Vs Methotrexate in Pristane Induced Rat Arthritis
Authors: Maheen Fatima  , Moneeb Ashraf  , Urooj Fatima  , Muhammad Imran  , Amer Hassan Siddiqui  , Tafzeel Fatima  
Published: June 2022

Introduction: Rheumatoid arthritis (RA) is a chronic inflammatory disease of joints with 0.24% global prevalence. Numerous pharmacological agents are available for the management of RA, but they are associated with many adverse effects. Alternative therapies for disease management are urgently needed. Colebrookea oppositifolia (CO) is an important herb with various traditional uses and pharmacological actions. In the present study, anti-arthritic effect of ethanolic extract of Colebrookea oppositifolia (EECO) leaves was evaluated in pristane induced arthritic rats (PIA) and compared to methotrexate by assessing body weight, clinical score of inflammation and histopathology.
Aims & Objectives: To study anti-arthritic effect of C. oppositifolia on a rat model of pristane induced arthritis.
Place and duration of study: This experimental study was conducted in Animal House of Post Graduate Medical Institute, Lahore from March to September 2019.
Material & Methods: Total forty female Sprague Dawley rats were categorized into five equal groups (n=8). Group A (normal control), group B (disease control). Group C and D belonged to low dose (250mg/kg) and high dose (500mg/kg) EECO treated groups respectively, while group E was methotrexate treated group. Arthritis was induced within two weeks by single intradermal injection of pristane on day 0 in groups B, C, D and E. At Day 15, treatment was initiated and at day 28 paw joint sections were taken for histopathology. Data input and analysis was done by using IBM SPSS version

p value ?0.05 was considered significant.

Results: At week 4, significant increase (approximately 16%) in body weight was observed in all treated groups as compared to disease control. A significant reduction (more than 50%) in clinical score of arthritis was observed in all treated groups compared to diseased control group in which clinical score was 14.50±0.2. All extract and MTX treated groups showed significant improvement (p<0.001) in total histological score of arthritis (no rat was having severe disease) as compared to disease control group (75% of the rats were having severe disease).
Conclusion: This study supported anti-arthritic effect of EECO as illustrated by reduction in inflammatory and histopathological score.
Nigella sativa Seeds Protective Ability in Pyrazinamide Induced Hyperuricemia in Mice
Authors: Amtul Hafeez  , Abdul Mudabbir Rehan  , Zunera Hakim  , Attiya Munir  , Rabia Naseer Khan  , Aamna Khokhar  
Published: June 2022

Introduction: Hyperuricemia results in an increased level of blood uric acid, a prerequisite of gout. Commonly prescribed agents for the treatment of hyperuricemia include allopurinol, febuxostat, and probenecid. Multiple adverse effects like hypersensitivity, gastrointestinal upsets and hepatotoxicity limit their use.
Aims & Objectives: To evaluate the serum uric acid lowering effects of Nigella sativa seeds on pyrazinamide induced hyperuricemia in mice.
Place and duration of study: This study was carried out at research facility for animals of NIH, Islamabad and Pharmacology Department of Islamic International Medical College, Rawalpindi from April to June, 2017.
Material & Methods: Sixty-eight male mice (Swiss Albino) were separated into four groups. Group A mice were labelled as negative control and mice in this group were given chow & glucose water. Group B mice received 500mg/kg Pyrazinamide (PZA) added in glucose water once daily. Group C mice were given low dose Nigella sativa seeds powder in a dose of 500 mg/kg suspended in the glucose water accompanied by PZA in a dose of 500mg/kg. The mice in group D received high dose of Nigella Sativa seeds powder 1000 mg/kg suspended in glucose water along with 500mg/kg of PZA. All the doses of Pyrazinamide and Nigella sativa seeds suspension were given orally for six weeks. Blood sample was collected three times from each group. On day 0, sample from two mice from each group was taken for baseline uric acid levels and of five mice from all groups in mid of study to check uric acid levels. On 42nd day, the blood from remaining 10 mice in each group was taken to check the serum uric acid levels. Analysis of data was done using Graph Pad Prism Version 8, p value <0.05 was considered significant.
Results: Acute pyrazinamide administration caused a rise in uric acid levels in group B as compared to group A (from 5.94±1.94 to 28.03±15.52 mg/dl). The Nigella sativa seed powder extract suspended in glucose water in a dose of 500mg/kg and 1000mg/kg reduced the rise in uric acid levels in pyrazinamide treated group C and D (10.47±3.32 mg/dl & 7.53±1.78 mg/dl).
Conclusion: Nigella sativa possesses antihyperuricemic effect and showed a significant reduction in serum uric acid levels in a dose of 500mg and 1000 mg/kg.
Variations in Symptomatology of Migraine Among Local Population of Pakistan
Authors: Sana Qanber Abbasi  , Zahid Bashir  , Shafeen Zulfiqar  , Ghazal Mansoor  , Qurat-ul-Ain  , Sana Javaid  
Published: June 2022

Introduction: Migraine is considered one of the most disabling neurological disorders worldwide. Migraine has recently been shown to effect population with a severe cascade of symptoms. With still a huge gap in understanding of pathogenesis of migraine, knowledge regarding migraine symptomatology is mandatory for effective diagnosis and treatment.
Aims & Objectives: To compare symptoms of migraine between two groups migraineurs (M) and migraineurs with high blood pressure (MBP).
Place and duration of study: The study was conducted at Shaikh Zayed Postgraduate Medical Institute, Department of Physiology and Lahore General Hospital, from January 2015 to June 2015.
Material & Methods: It was a cross-sectional comparative study. The study population was 35 diagnosed migraine patients (M) and 29 migraine patients with high blood pressure (MBP). Patients were questioned about various migraine symptoms based on the standard criteria for diagnosing migraine and the responses were recorded in written on a predesigned proforma. Collected data was studied and interpreted by using SPSS 23 , p value ? 0.05 was taken as significant.
Results: Symptoms of migraine were compared between two groups, migraineurs (M) and migraineurs with high blood pressure (MBP). The mean age of the patients was 25±7years in migraineurs (M) and 38±6 years in migraineurs with high blood pressure (MBP). The incidence of vomiting was significantly higher in patients who had both migraine and high BP, (p-value = 0.008). Collected data was studied and interpreted by using SPSS 23. The difference in the rest of the symptoms was nonsignificant between the two groups studied by using One Way Anova and T-test frequency and percentages. Chi- square test was applied using cross-tabulation to check the association of family history of migraine which was statistically non-significant.
Conclusion: Migraine is a female dominant disorder mostly affecting people in their 30's. There was no significant difference in major diagnostic migraine symptoms in both groups. However, among minor diagnostic symptoms, the frequency of vomiting was higher in patients with migraine with high BP.
Frequency of Leukoerythroblastic Picture and Hematological Parameters in COVID-19 Patients and Association With Disease Severity
Authors: Sindhu Rehman  , Sobia Ashraf  , Shahid Mehmood  , Hafsa Malik  , Rahat Serferaz  , Saeed Ahmed  
Published: June 2022

Introduction: Patients infected by COVID-19 can present with severe lung damage and acute respiratory distress syndrome (ARDS) and have a significant mortality risk involving all body system such as cardiovascular (CVS), gastrointestinal (GIT), neurological (CNS), immune system and haemopoietic system.
Aims & Objectives: To determine frequency of Leukoerythroblastic picture, compare complete blood counts and cell ratios (NLR, PLR, LMR) of positive COVID-19 patients with suspected COVID-19 patients and their association with severity as stratified by mode of admission and clinical status.
Place and duration of study: King Edward Medical University, Mayo Hospital Lahore from December 2020 to January 2021.
Material &Methods: 75 RT-PCR confirmed COVID-19 and 75 suspected patients of both genders and aged above 18 years were included. Severity was classified by mode of admission and patient status. CBC samples of all patients were analyzed for counts, differential and LE picture on Sysmex XE-1000 automatic blood analyzer. NLR, LMR and PLR were calculated in both groups. Peripheral smear findings were noted for leukoerythroblastic picture in all patients.Data was analyzed using SPSS version 25, p value ?0.05 was considered significant.
Results: Each group consist of equal (75) number of patients with male predominance. Mean age of patient in confirmed and suspected groups were 58±14 and 61±15 respectively in both groups. Majority were admitted in HDU and ICU compared to isolated wards (P: .000). Frequency of LE picture in both groups was (2.7%) (P:0.12) by Chi-square. Mean± SD were determined, of hematological parameters and ratios in confirmed and suspected groups. ANC (P:0.022), ALC (P:0.032), NLR (P:0.002) were significantly different when compared in both groups.
Median (IQR) of Hb (p: 0.05), WBC (P: 0.000), platelet (P: 0.008), ANC (P: 0.000), NLR (P: 0.000), LMR (P: 0.016)
were significantly correlated with severity, when analyzed by independent-sample Kruskal Wallis Test.
Conclusion: Leukoerythroblastic picture is not associated with severity in COVID-19. Neutrophil to lymphocyte ratio is important prognostic factor in suspected and confirmed COVID-19 patients.
Blood Transfusion Practices in Dengue Fever: A Cross Sectional Single Center Study During a Dengue Outbreak in Pakistan
Authors: Asma Nasir  , Madiha Sarwar  , Mavra Fatima  , Hareem Noor  , Ayisha Imran  , Noman Aslam Malik  , Omar Rasheed Chughtai  , Akhtar Sohail Chughtai  
Published: June 2022

Introduction: Dengue fever (DF) is a global health problem in tropical and subtropical regions across the globe. Pakistan has become one of the countries which are hit by its outbreaks for the past two decades with the first outbreak reported in 1994.It is a mosquito-borne infection which is transmitted to humans from the mosquito bite. Characteristics of dengue fever are thrombocytopenia, coagulopathy and increased capillary permeability. The disease spectrum ranges from mild fever to life threatening hemorrhagic shock syndrome; hemorrhagic manifestations are the most feared complications of the disease. Guidelines regarding fluid management in dengue fever have been established by Center for Disease Control (CDC) and local national bodies in Pakistan however comprehensive data regarding blood product usage is lacking. Understanding the rationale use of blood products can reduce burden on blood bank inventories as well as reduce unnecessary blood product exposure to the patients in dengue outbreak.
Aims & Objectives: Assessment of compliance of physicians and transfusion provision authorities regarding blood products usage with local and international guidelines in managing dengue outbreak.
Place and duration of study: This study was conducted at Chughtai Institute of Pathology, Lahore from September 2021 to November 2021.
Material & Methods: It was a cross sectional study. Total 107 patients who were non-structural antigen1(NS1) positive confirmed dengue infection presented at Chughtai Blood Bank for request of any blood product were included in the study; individuals with existing cytopenia (known cases) unrelated to Dengue (NS1 antigen positive) were excluded. Data was recorded on a pre-designed Performa/questionnaire. Statistical analysis was performed using SPSS 23.0. Frequencies were calculated and expressed as percentages.
Results: Mean Age of 107 patients was 53 years (±19.05) out of which 63(58.9%) were males and 44(41.1%) were females. Blood products requested were platelets in 93(86.9%) patients, platelets and fresh frozen plasma in 3(2.8%), platelets and whole blood in 9(8.4%) and whole blood in 2(1.9%) patients. Therapeutic platelet transfusions were done in 35(32.7%) patients and prophylactic platelet transfusions were done in 72(67.3%) patients.
Conclusion: Lack of practicing evidence-based guidelines and inappropriate usage of blood products during dengue epidemic overburdens health care facilities and adds to the stress and panic. A well-coordinated centralized management system for dengue outbreak can play pivotal role in guiding rationale use of blood products.
Morphometry of Foramen Magnum: An Anatomical Study
Authors: Alvia Batool  , Maryam Fatima  , Shamaila Doggar  , Faeza Rauf  , Samina Munawar  , Fatima Inam  , Samar Iqbal  
Published: June 2022

Introduction: The knowledge of foramen magnum dimensions is important for clinicians to highlight the malformations like Arnold Chiari malformation and Achondroplasia. Its morphometry is helpful for neurosurgeons and for forensic experts as well. Foramen magnum (FM) is a large oval opening in the occipital bone of skull that transmits part of brain stem, spinal cord and many related structures
Aims & Objectives: To determine the variations in transverse and antero posterior diameters of foramen magnum and foramen magnum index in dry skulls of adults in Pakistani population.
Place and duration of study: The study was conducted at FMH College of Medicine & Dentistry, Lahore in December 2021 on 99 dry human skulls.
Material & Methods: The foramen magnum of 99 dry skulls of human adults of unspecified gender and of unknown exact age, from the collection of Anatomy Department in FMH college of Medicine and Dentistry, Lahore, Pakistan, was examined to evaluate the dimensions of FM. Digital caliper was used to measure the antero-posterior diameter (APD) and transverse diameter (TD) of foramen magnum (FM) in dry skulls of human adults and then foramen magnum index FMI was calculated by dividing APD by TD.
Results: The mean values of transverse and antero posterior diameters of foramen magnum in dry human skulls were found as23.18+7.68 and 29.22+7.52 respectively. The mean value of foramen magnum index was 1.30+0.22.
Conclusion: Our study determined variations in diameters of FM and FMI in the skulls of Pakistani population. Antero posterior diameter of foramen magnum is more than its transverse diameter and majority of skulls show oval shaped FM. The results of this study may help the neurosurgeons, anthropologists, morphologists, clinical anatomists and forensic experts.
Perception of MBBS Students about Effectiveness of Modified Unobserved Anatomy OSPE Due to COVID-19 Restrictions
Authors: Saba Saleem  , Mahrukh Malik  , Noor Ijaz  , Saba Amjad  , Syed Hussain Raza Zaidi  , Nabila Kaukab  
Published: June 2022

Introduction: In COVID-19 pandemic, whole of the medical education faced a paradigm shift. Majority of the medical schools shifted their academics online but fair conduction of assessments was still in question. Around the world, many techniques were applied and one was followed at University Medical and Dental College, Lahore (UCMD).
Aims & Objectives: To assess the perception of students about modified version of OSPE (displayed on multimedia) so that to implement the same protocol in future by meeting the SOPs without affecting the academics.
Place and duration of study: The study was carried out at UCMD, Lahore in year 2021 and was of 6 months duration. Material & Methods:150 students each from first and second year MBBS classes participated in this study. After following the strict SOPs of COVID-19, the students were settled in an auditorium and OSPE was displayed on multimedia screen instead of moving from one station to another as done previously. Feedback was taken from the students after the exam.
Results: Response from the students was recorded and percentages were calculated which showed that majority of the students appreciated this modified version of OSPE.
Conclusion: This study proved that modified Anatomy OSPE was an effective tool to grade the students without academic disturbance which was imminent in global pandemic and this method can be adapted henceforward.
Association of Left Ventricular Hypertrophy on Echocardiography with Hemorrhagic and Non-Hemorrhagic Stroke
Authors: Fahad Ali  , Qazi Abdul Saboor  , Faryad Ali  , Talha Mahmud  , Syed Ahmad Ali Hassan  , Athar Iqbal  
Published: June 2022

Introduction: Left ventricular hypertrophy (LVH) is related to increased risk of stroke. However, very few studies analyzed association of LVH assessed by Echocardiography (Echo) in ischemic and hemorrhagic stroke separately.
Aims & Objectives: To determine the association of left ventricular hypertrophy on echocardiography with hemorrhagic or non-hemorrhagic stroke.
Place & Duration of Study: Study was done in Department of Cardiology Shaikh Zayed Hospital Lahore for six months from 01-01-2019 to 30-06-2019.
Material & Methods: Total 190 patients, fulfilling inclusion and exclusion criteria were selected. All patients underwent for echo and LVH was noted. Left ventricular posterior wall (PW) and inter ventricular septum (IVS) thickness>11mm in males and >10mm in females labeled as LVH.
Results: Results of this study showed that risk of LVH was 1.66 times higher among patients who presented with Hemorrhagic: 57.9% vs Non-hemorrhagic stroke: 34.7%. Elderly age group patients (RR: 1.85), female patients (RR:2.53), overweight patients (RR:2.38), longer duration of stroke (RR:2.42) and diabetic patients had higher association with LVH in hemorrhagic stroke.
Conclusion: It was observed in this study that patients having hemorrhagic stroke had higher association of left ventricular hypertrophy (LVH) as compared to Non- Hemorrhagic stroke. Further studies are needed in this domain to address the association between LVH and hemorrhagic stroke.
OPEN REDUCTION AND INTERNAL FIXATION BY A TRADITIONAL BONE SETTER AND QUACKS - A CASE REPORT AND REVIEW OF LITERATURE
Authors: Abang Innocent E. , Anisi Chukwuemeka , Asuquo Joseph , Agweye Pius U. , Diderot Charle T , Ikpeme Ikpeme A. 
Published: June 2022

Purpose: Open reduction and internal fixation of fractures is surgical procedure guided by standard principles and often performed by Orthopaedic specialists. Unfortunately, some quacks now dabble into performing these complex procedures resulting in several complications. However, it has becoming a serious public health concern in that a traditional bone setter in collaboration with some health workers (quacks who were community health extension workers) engaged in performing an open reduction and internal fixation for a femoral fracture in our index patient with very severe complications.
Methodology: We present this case of open reduction and internal fixation by traditional bone setters and quacks to illustrate the extent of malpractices by traditional bone setters aided by quacks who have either been assisting Orthopaedic surgeons in the theatre or have been watching these procedures as they are frequently been carried out in the operating room.
Results: This index patient, a university undergraduate presented via our outpatient clinic having been mismanaged by a traditional bone setter in collaboration with a Community health extension work. An informed consent was duly taken from the patient concerning the reporting of the case and he was fully clerked, investigated and managed until he left against medical advised due to financial constraints.
Unique contribution to theory, practice and policy: We strongly recommend legislation and enforcement of laws that restrict traditional bone setters to limit their practices within their capacities under supervision if they must be allowed for any reason to practice management of simple fractures. The Community Health Extension Workers(CHEW) are to be under strict regulation by the Medical councils to prevent this unwholesome practices.