bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of self-care in heart failure patients at a cardiac hospice in Peshawar, Pakistan.
Authors: Khan Awal , Dildar Muhammad  , Khan Afsha , Dewey Rebecca Susan 
Published: September 2022

Background: The significance of self-care in heart failure is yet to be demonstrated empirically; however, it's commonly believed that effective self-care delays the development of heart failure. This study aimed to assess the level of self-care among patients with heart failure attending a cardiac hospice center in Peshawar, Pakistan.
Methodology: A cross-sectional study design was used to examine self-care maintenance, self-care management, and self-care confidence in heart failure patients at Heart Hospice Center, Hayat Abad Medical Complex. A total of 195 heart failure patients were recruited using a convenient sampling method. Data were collected using the Self Care Heart Failure Index (SCHFI) version 6.2.
Results: The mean SCHFI score (comprising 22 items) across n=195 participants was 50 ± 28.9. A very low percentage (31.28%, n=61) scored an accepted level (≥70) of self-care. On the subscales of self-management, self-confidence, and self-maintenance, the mean scores were 50.0 ± 28.8, 46±26.6, and 50.0 ± 28.7, respectively. One hundred eighty symptomatic patients completed the self-care management subscale who was experiencing shortness of breath and ankle swelling.
Conclusion: Heart failure patients attending the Heart Hospice Center in Peshawar, Pakistan, did not portray a satisfactory level of self-care behavior. More effective nursing interventions are needed to manage heart failure patients in this center.
Prevention of Subsequent Hip Fractures among Geriatric Population with Use of Bisphosphonates.
Authors: Shah Syed Kamran Ali , Ghazi Muhmmad Arsalan , `Muhammad Sufyan  , Muhammad Mustafa  , Najjad Kazim Rahim , Peracha Asif 
Published: September 2022

Background: In the geriatric population, osteoporotic or fragility hip fractures hold a significant health burden and are scrupulously linked with a greater possibility of morbidity and mortality among this population group, even though there is an increased incidence of subsequent hip fractures. Bisphosphonates are extensively used in treating and preventing fragility hip fractures as prophetically.
Methodology: From March 2014 to February 2020, a total of 2430 patients were enrolled with their first hip fracture. After determining the second hip fracture, a comparison between non-compliant and compliant bisphosphonate users (Ibandronic Acid) was conducted. Medication Possession Ratio of more than 80% post first hip fracture treatment was defined as bisphosphonates compliant user.
Results: Among 2430 patients, 65.2 years was the mean age at the first hip fracture (ranging from 51 to 91 years). A total of 146 (6.0%) patients suffered from second hip fractures at a mean duration of 29.45 months post first hip fracture. 2nd hip fracture was observed in only 3.5% (30/860) of compliant bisphosphonate users compared to non-compliant users with 7.4% (116/1570).
Conclusion: Among the geriatric population, the use of bisphosphonate (Ibandronic Acid) has a significant impact on preventing subsequent hip fractures. Hence this emphasizes the need to use bisphosphonates in clinical practice to help to minimize the burden of hip fractures.
The efficacy of tamsulosin and solifenacin versus tamsulosin alone in double-J stent associated with lower urinary tract symptoms.
Authors: Asad Ullah Jan Hafiz  , Syed Wajid Ali  , Khalid Sana 
Published: September 2022

Background: Lithotripsy procedures, especially, Ureterorenoscopy is considered instrumental in treating ureteral stones effectively. In endourological surgery, a pigtail ureteric stent is a widely used method to resolve or prevent ureteral obstruction, promote healing, and reduce the incidence of ureteral strictures. The current study aimed to compare the efficacy of Tamsulosin with Solifenacin and Tamsulosin alone in double-J stents associated with lower urinary tract symptoms using IPS-Score.
Methodology: This study was conducted at the Urology Department, Institute of Kidney Diseases (IKD) Peshawar, Pakistan, from Aug 30, 2018, to Feb 28, 2019. Patients with DJ stents were randomly assigned to two groups (Group A & Group B). Group A received Tab Tamsulosin and Solifenacin, while Group B received Tab Tamsulosin alone; the IPS score was calculated at baseline and after 14 days.
Results: A total of 100 subjects undergoing unilateral DJ ureteral stenting participated in this study. The post-treatment IPSS Irritative score suggested that Group A has an average IPS score of 4.38+1.77, while in Group B, 6.4+1.55, which was significant with a p-value of 0.000.
Conclusion: Post-treatment average IPSS Irritative score of Tamsulosin and Solifenacin combination was less than Tamsulosin alone in patients with unilateral DJ stent.
Non-invasive indicators of skin aging; A study on the population of Karachi using SCINEXA
Authors: Mirza Faizan , Fazal Amaila , Ahmed Sadaf 
Published: September 2022

Background: Skin, the most visible human entity, quickly displays emotional, physical, and psychological well-being. Research has shown a linear correlation between both types of skin aging within 30–69 years. Thus, the current research study aimed to highlight the use of SCINEXA, the novel skin aging score, in predicting accelerated biological aging.
Methodology: This cross-sectional study was conducted in Karachi, Pakistan, from 8th October 2021 to 4th December 2021. Both male and female subjects of age groups from 19 to 69 years were included. A novel skin aging score, 'SCINEXA' (Score of Intrinsic and Extrinsic Skin Aging), was used to assess skin aging. Both extrinsic and intrinsic signs were analyzed in terms of pigmented spots, coarse wrinkles, solar elastosis, telangiectasia, and laxity & seborrheic keratosis, respectively.
Results: The SCINEXA score indicated that 91.3% of participants had low aging signs and decreased pigmentation, while 2.9% had relatively high pigmentation on the forehead, cheek, forearm, and back of the hand. Coarse Wrinkles of grade 5 on the forehead were present among 19.7% of individuals, and 20.6% showed the same in the crow feet area. The skin aging symptoms are most significantly associated with age (p<0.05).
Conclusion: Accelerated biological aging is not found in the studied population using the SCINEXA tool; therefore, the studied population's skin has been found resilient to photo-aging.
Isolation and characterization of bacteriocin-like inhibitory substances producing lactic acid bacteria from indigenous food samples.
Authors: Mehmood Nayyar , Abdul Wahab  , Jamal Urooba , Mangi Waseem Ahmed , Syed Abdus Subhan  , Abbas Tanveer 
Published: September 2022

Background: Lactic acid bacteria (LAB) are generally found in nutrient-rich environments such as milk, dairy products, meat, vegetables, and fruits. The functions of LAB depend upon the sufficient number of bacteria being available in the intestines, and the actions of these bacteria are generally species and strain-specific. The challenges encountered in identifying and classifying lactic acid bacteria have complicated the research process. Despite encountered challenges, various benefits of lactic acid bacteria have been identified. The current study aimed to isolate and characterize indigenous LAB bacteriocins producers from local food sources using morphological, biochemical, and molecular methods.
Methodology: One thousand indigenous LAB were isolated and screened from local fresh and fermented foods in Karachi's retail markets for three years. 46 LAB isolates exhibited inhibitory activity against other LAB and non-LAB gram-positive bacteria in broth medium. Three of forty-six isolates were selected for further study of the nature and production of the inhibitory substance based on production in broth, bacteriocin nature of the substance, and relatively wide antibacterial spectrum.
Results: The three indigenous LAB producers were identified as Lactococci based on microscopy, catalase, biochemical and molecular characterization. Bacteriocin of the isolate C130 was heat tolerant at 100°C and produced during the late logarithmic phase of growth. There is still a need for investigation to identify the role of LAB, which might help prevent certain chronic illnesses and infections. Most beneficial impacts are known in constipation, hypocholesterolemic effects, urogenital infections, and colon cancer.
Conclusion: L. lactis C130 was found to be a thermostable bacteriocin producer with a fair antibacterial spectrum against various food spoilage.
Assessment of risk factors among female patients with various Acute Coronary Syndrome types presenting to Cardiology unit DHQ Kohat, Pakistan.
Authors: Khan Qaisar Ali , Khan Noman , Arif Mumtaz  , Naseer Ahmad  , Nowshad Asim  , Asmat Shaheen  , Ameena Arif  
Published: September 2022

Background: There is limited literature regarding the risk factors associated with acute coronary syndrome among female patients of the region, while none was previously reported from Kohat, Pakistan. Therefore, the present study aims to assess the risk factors among female patients with various types of Acute Coronary Syndrome (ACS).
Methodology: A descriptive cross-sectional study was conducted from June 2021 to February 2022. A total of 500 female patients with ACS admitted to the Cardiology Unit at DHQ Kohat were enrolled, and data were collected using a structured questionnaire. The risk factors were determined with respect to ACS types. The patient's electrocardiography (ECG) and cardiac biomarkers were assessed, and blood samples were obtained to estimate lipid parameters.
Results: The mean age of enrolled ACS females was 54.20 ± 9.20 years. Of the total, 74.6% were diagnosed with non-ST segment elevation myocardial infarction (NSTEMI), ST-segment elevation myocardial infarction (STEMI) was present among 6.0% of the enrolled cases, and 19.4% had unstable angina. Hypertension was the most prevalent risk factor (53.2%), followed by diabetes (51.4%). The studied risk factors mean age, blood pressure, body mass index (BMI), past medical history, and family history of ACS were significantly different among the different ACS types (p<0.05).
Conclusion: In conclusion, age, blood pressure, BMI, past medical history (presence of diabetes and hypertension), and family history of ACS among female patients are significantly associated with various ACS types.
Frequency of H. pylori in liver cirrhosis patients with overt Hepatic encephalopathy at tertiary care hospital, Karachi.
Authors: Shaista Ahmed  , Siddiqui Afshan , Sadia Iqbal  , Rma Waqas  , Jamal Ara  , Kidwai Aneela Altaf 
Published: September 2022

Background: Ammonia is detoxified in the liver, and hepatic insufficiency due to cirrhosis leads to raised ammonia, causing symptoms of Hepatic Encephalopathy (HE). Studies proclaim that Helicobacter pylori (H. pylori) accelerate ammonia production. The study objective was to establish the frequency of H. pylori in liver cirrhosis patients with overt HE.
Methodology: This cross-sectional study was conducted in Medical Unit-I Abbasi Shaheed Hospital, Karachi, from May to November 2018. Liver Cirrhosis patients between the ages of 31-60 years were selected via non-probability sampling. Patients of any sex suffering from liver cirrhosis for six months, as proved by ultrasound and overt HE diagnosed using West Haven Criteria, were included in the study. Stool samples were collected from patients in a sterile manner. Results of stool for H. pylori antigen were recorded. Data were analyzed using SPSS version 16.0.
Results: Out of 135 patients with Liver Cirrhosis with overt HE, 42 (31.1%) suffered from H. pylori infection while 93 (68.9%) patients did not. The mean age of patients was 44.14 ± 8.49 years. Stratification of the age of patients with H. pylori infection showed significant results (p=0.00). The mean disease duration was 4.72 ± 1.24 years. Stratification based on disease duration with H. pylori infection revealed significant results (p=0.00). Stratified findings based on Child-Pugh classification and H. pylori infection were insignificant (p=0.50).
Conclusion: Our study reveals there is less frequency of H. pylori infection amongst liver cirrhotic patients. However, amongst those infected, many had a longer duration of disease. Our study indicates more cases of H. pylori infection with increasing age of liver cirrhosis patients. Furthermore, the relation between H. pylori infection and the Child-Pugh classification indicates that overt HE may be attributed to factors other than H. pylori infection.
Frequency of renal mass complexities among patients undergoing partial nephrectomy associated with perioperative blood loss.
Authors: Haris Jameel  , Mehnaz Jabeen  , Rabeea Saleem  , Pardeep Kumar  , Asad Shahzad Hassan  
Published: September 2022

Background: Partial nephrectomy has emerged as a standard treatment for managing small renal masses. RENAL Nephrometry score (RNS) is a widely used tool for assessing tumors, minimizing bias, and improving clinical outcomes. This study aimed to determine the frequency of various renal mass complexities based on the RENAL nephrometry score in patients undergoing partial nephrectomy and to compare the mean blood loss in these patients.
Methodology: The cross-sectional study was conducted at the Department of Urology, Sindh Institute of Urology & Transplantation, Karachi- Pakistan. Perioperative blood loss after partial nephrectomy was observed in all cases, and patients had their RENAL nephrometry score determined before surgery. The patient's baseline demographic data, including age, gender, and body mass index (BMI), was recorded using a pre-designed Proforma.
Results: According to the RNS, there were 33(52.4%) patients with moderate complexity, followed by 19(30.25%) and 11(17.4%) who had severe and mild complexity, respectively. Furthermore, there was a significant difference in the mean blood loss among the three groups (p=0.025). Among the cofounders, age, BMI, and male gender significantly affected mean blood loss in different RNS groups (p<0.05).
Conclusion: There was a high frequency of moderate renal complexity among the studied patients based on the RNS. A significant difference in the mean blood loss was observed among the patients with mild, moderate, and severe complexity.
The experience of cranioplasty outcome, management and its complication in neurosurgery
Authors: Kalhoro Aurangzeb , Lal Rehman  , Panezai Abdul Samad , Sher Hassan  , Farrukh Javeed  
Published: September 2022

Background: Head trauma is the most common case encountered in neurosurgery, and it is on the rise daily; head trauma sometimes requires the removal of skull bone which leads to another set of complications and associated issues related to cranioplasty. The study's objective was to share the single-center tertiary care hospital experience of cranioplasty, including outcomes, management, and associated complications.
Methodology: Patients who underwent reconstructive cranioplasty at the study site from 2015-2020 were examined in this retrospective descriptive study conducted at the department of neurosurgery, Jinnah postgraduate medical center, Karachi. Patients aged 18 to 60 years were considered for cranioplasty procedures, preceded by the decompressive post-craniotomy for brain trauma, skull fracture, intractable intracranial hypertension, brain tumor, and infected post-craniotomy bone flaps were included in the study.
Results: A total of 68 patients who presented to the study center with cranial defects were included in this study. The frequent cause of cranioplasty was the traumatic injury to the brain in 38(55.88%), followed by brain tumors in 321(0.4%) and cerebrovascular injury in 9(13.23%) cases. In our study, no patient required more than one cranial procedure. The anatomical regional wise division of defects was temporal 29(42.64%), frontal 15(22%), and parietal 24(35.39%).
Conclusion: Indications for cranioplasty, type of bone graft, associated comorbidities, and complications have been addressed that are potentially preventable.
Left atrial appendage clot with severe mitral stenosis, responders and non-responders with anticoagulation, a prospective cohort study.
Authors: Tariq Ashraf  , Kanwal Fatima Aamir  , Asif Nadeem  , Shirjeel Murtaza  , Parveen Akhtar  , Samra Yasmin  , Rahmat Ghaffar  , Mahmood ul Hassan  , Fateh Ali Tipoo  
Published: September 2022

Background: One of the most frequently observed valvular heart lesions is Mitral stenosis (MS), characterized by left ventricular inflow tract obstruction at the mitral valve level caused by different etiologies. Early detection of symptomatic mitral stenosis with a thrombus in LAA, not responding to anticoagulation in due course of time are sent for Mitral valve replacement rather than undergoing PTMC. The current study aims to see the anticoagulation response in different types of left atrial appendages so that non-responders can be referred for surgery on the first TEE and Cardiac CT.
Methodology: The current study will observe the frequency of left atrial appendage (LAA) thrombus resolution after three months of anticoagulation in patients with severe MS. It will assess the response rate in different morphologies of LAA so that non-responders can be referred for surgery on the very first TEE and Cardiac CT. Consecutive MS patients with thrombus in LAA detected via transesophageal echocardiography will be included in the study. According to the standard procedure, TEE followed by Cardiac CT will be performed after obtaining informed consent from the patients.
Discussion: Detecting the anticoagulation response using follow-up TEE in different types of left atrial appendages might be helpful for the non-responders that can be referred for surgery after TEE and Cardiac CT on first examination and TEE only at the end of three months.
Trial registration number: The trial was registered on ClinicalTrials.gov (NCT05186649).
Makine Yağı İçimi Sonrası Görülen Bir Lipoid Pnömoni: Nadir Bir Olgu Sunumu
Authors: AYSAN Nurten , SATICI Celal , ARPINAR YİĞİTBAŞ Burcu , ERİNÇ Ayşegül , KÖYBAŞI Gizem , KOŞAR Filiz 
Published: September 2022

Amaç: Lipoid pnömoni akciğere yağ bazlı sıvı aspirasyonu sonrası ortaya çıkan klinik ve radyolojik bir
tablodur. Bu vakada rezorbe olmayan pnömoninin bir nedeni olarak kaza sonucu makine yağı içimine
bağlı gelişen ekzojen lipoid pnömoni olgusu sunulması amaçlanmıştır.
Olgu: Altmışiki yaşında erkek hasta, 20 gün önce kazara makine yağı içtiğini ifade ederek göğüs hastalıkları
polikliniğine aldığı tedavi sonrası kontrol muayene amacı ile başvurdu. Pnömoni ön tanısı ile
ayaktan antibiyotik başlanmış olup kontrollerinde radyolojik düzelme olmadığı öğrenildi. Özgeçmişinde
benign prostat hiperplazisi ve hipotiroidizm tanıları mevcut idi. Hastanın toraks bilgisayarlı tomografisinde
sağ akciğer orta lobda hava bronkogramı, yağ dansitesinde odaklar olan ve buzlu camın eşlik
ettiği lezyon olduğu görüldü. Ayrıca yapılan bronkoalveolar lavaj örneğinde %38 polimorf nüveli lökosit,
%27 lenfosit, %29 alveolar makrofaj tespit edildi. Lipoid pnömoni tanısı ile metilprednizolon 32 mg/gün
peroral başlandı. Tedavi sonrası akciğer grafisinde radyolojik olarak iyileşme görülen hasta ayaktan
takibe alındı.
Sonuç: Lipoid pnömoni, klinik ve radyolojik olarak diğer pnömoni tipleriyle karışması nedeniyle tanısı
atlanabilmektedir. Sonuç olarak iyileşmeyen pnömonilerin ayırıcı tanısı yapılırken hasta anamnezi,
kliniği ve görüntülemeleri dikkatlice değerlendirilmeli ve izlenmelidir
COVID-19 Aşı Geliştirme Çalışmalarına Tıp Fakültesi Öğrencilerinin Yaklaşımı ve Bilgi Düzeyi
Authors: BOLLUCUOĞLU Keziban , KESER Mevlüt , DOĞRU Batuhan , YILMAZ Büşra , KENDİRLİ Kahraman , YİRMİBEŞ Büşra , ÇALIŞKAN Selenay , DOĞAN Koray , KAHRAMAN Rıdvan Emir , YAVUZER Yağmur Gizem , AKGÜL Muhammed Emin , BAŞTUĞ Mine , GÜLBAHÇE Efe , AKTAN Latife Melis 
Published: September 2022

Amaç: Solunum yolu enfeksiyon semptomları gösteren yeni tip coronavirüs (Sars-Cov-2) hastalığı
ilk defa 2019 Aralık ayında Çin’in Wuhan eyaletinde görülmüş ve 11 Mart 2020’de pandemi olduğu
ilan edilmiştir. Çalışmamızda ülkemizdeki ve Kuzey Kıbrıs Türk Cumhuriyeti (KKTC)’ndeki tıp fakültesi
öğrencilerinin COVID-19 pandemisine yönelik geliştirilen aşılar hakkında güncel bilgi düzeyleri,
yaklaşımları ve gelecekteki endişelerini belirlemeyi amaçladık.
Gereç ve Yöntemler: Türkiye ve KKTC’deki tıp fakültesi I-VI. sınıf öğrencilerinden 632 kişinin
demografik özellikleri, COVID-19 enfeksiyonuna yönelik geliştirilen aşı çalışmalarına yaklaşımları ve
aşı çalışmaları ile ilgili bilgi düzeylerini içeren 26 sorudan oluşan anket verileri 2021 Ocak-Şubat ayları
içerisinde elektronik ileti yoluyla toplanmış ve değerlendirilmiştir.
Bulgular: COVID-19’un tedavisi için ilaç bulunması durumunda 632 öğrencinin %65,8’inin aşı olmak
istediği, %70,1’inin aşılama sonrası maskesiz hayata dönemeyeceklerini düşündükleri, %59’unun aşılanma
sonrası enfekte olmaktan endişe duydukları ve %93,7’sinin ise toplumun en az yarısının aşılanması
ile toplum bağışıklığının sağlanabileceğini düşündükleri tespit edilmiştir. Öncelikle 65 yaş üzerinin
aşılanmasını gerektiğini düşünenlerin oranı %61,7, medya haberlerinden etkilenmeyenlerin oranının
%60,4 olması ile beraber aşının enfeksiyondan daha tehlikeli yan etkilerinin olmadığını düşünenlerin
oranının % 64,6 olduğu görülmüştür.
Sonuç: Tıp fakültesi öğrencilerinin COVID-19 pandemisine yönelik geliştirilen aşılar hakkındaki güncel
bilgi düzeyleri, yaklaşımları ve gelecekteki endişelerini pandemi ile mücadelede atılan adımların
belirleyeceği kanısındayız.
Doktor ve Hemşirelerin İş Kazası Riskleri ile İş Sağlığı ve Güvenliği Eğitimlerinin İncelenmesi
Authors: TATLI YÖNDEM Mehpare , ÇAKMAK Ahmet Ferda 
Published: September 2022

Amaç: İş Sağlığı ve Güvenliği alanında önleyici stratejilerin geliştirilmesi, uygulanması ve başarısı her
şeyden önce mevcut durumun çok yönlü ve doğru değerlendirilmesini gerekli kılmaktadır. Bu araştırma
ile hem konu ile ilgili literatüre hem de uzun vadede etkili İş Sağlığı ve Güvenliği uygulamalarının
geliştirilmesine katkı sağlamak amaçlanmaktadır.
Gereç ve Yöntemler: Türkiye’de bir üniversite hastanesinde kolayda örnekleme yöntemiyle
yürütülen tanımlayıcı çalışmada, 2017 yılı Mayıs ayı içerisinde anket uygulanarak, hemşire (n=149)
ve doktorlardan (n=43) oluşan 192 sağlık profesyoneline ulaşılmıştır. Veri toplamak için katılımcıların
demografik özellikleri, son bir yıl içerisinde yaralanma ve enfeksiyon bulaşma riski taşıyan kaza
deneyimleri ve İş Sağlığı ve Güvenliği eğitimlerine katılımları ile ilgili soruları içeren bir anket formu
kullanılmıştır. Toplanan veriler SPSS Statistics 19 programında analiz edilmiştir. Çalışmanın hipotezleri,
%95’lik güven aralığında, p