bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes of Neonates Born To Mothers Who Were COVID-19 Positive; An Observational Study from Pakistan
Authors: Ahmad Zeeshan , Khushdil Arshad , Waqar Talal , Ahmed Madiha , Haque Khalid N , Sultana Rashida , Sughra Umme e , Farooq Shoaib , Malik Qudrat Ullah 
Published: December 2022

Objective: To assess outcomes of neonates born to mothers who were COVID-19 positive.
Study Design: Prospective observational study.
Place and Duration of Study: Secondary and Tertiary Care Hospitals of the Armed Forces, Pakistan, from Apr to Aug 2020.
Methodology: We studied 106 pregnant women who tested positive for SARS-CoV-2. Stable asymptomatic newborn babies were kept in SARS-CoV-2 specified incubators, at specially designated areas for observation. Nasopharyngeal swabs were taken at first 24 hours and if negative, babies were handed over to clinically stable mothers who were educated regarding use of facemasks and proper hand washing. Neonates who tested positive for SARS-CoV-2 were evaluated for SARS-CoV-2 again at 48 hours and then every 48-72 hours, until found to be negative.
Results: Total 106 women were found to be SARS-CoV-2 positive during the study period. All the women delivered singleton babies. Of the 106 babies, 5 (4.71%) were found to be positive for SARS-CoV-2 at 24 hours and only 1 (0.94%) baby was found to be positive at 48 hours and then tested negative at 7th day.
Conclusion: Babies born to SARS-CoV-2 mothers were mostly asymptomatic and there was no increased risk of morbidity or mortality to the neonates suffering from the infection.
Efficacy of Alpha Keto-Analogues in The Management of Chronic Kidney Disease
Authors: Umar Saba , Sabir Sohail , Altaf Ashfaq , Raja Khalid Mahmood , Siddiqi Fuad Ahmed , Saleem Salman , Azam Malik Nadeem , Sabir Haroon 
Published: December 2022

Objective: To determine the efficacy of alpha keto-analogues in the management of chronic kidney disease at a tertiary care hospital.
Study Design: Quasi-experimental study.
Place and Duration of Study: Nephrology Department, Armed Forces Institute of Urology, Rawalpindi from Jul to Dec 2020.
Methodology: A total of 300 patients of chronic kidney disease stage 3 and 4, not dependent on hemodialysis were included in the study. They were divided into two groups with matched age, gender and duration of chronic kidney disease. Group-I received the routine treatment of chronic kidney disease with low protein diet while group-II received alpha keto-analogue in standard dose in addition to routine treatment of chronic kidney disease with low protein diet. Estimated glomerular filtration rate was assessed at the baseline and after six months.
Results: Out of 300 patients 151 (50.3%) were males while 149 (49.7%) were female patients. 110 (36.7%) patients had stage-3 disease while 190 (63.3%) had stage-4 chronic kidney disease. Mean difference of eGFR in group-I was 3.17 ± 3.19 mL/min/ 1.73m2 while mean difference of eGFR in group-II was 1.16 ± 1.52 mL/min/1.73m2 (p-value<0.001).
Conclusion: Alpha keto-analogues emerged as an efficacious short-term option in reducing the progression of chronic kidney disease in our study. Use of this option in addition to routine treatment and low protein diet was related to significant improvement in renal functions.
Vitamin D Status in Acute Ischemic Stroke: Relation To Initial Severity and Short-Term Outcome
Authors: Sarwar Natasha , Raja Khalid Mehmood , Uruj Sana , Khan Sarah , Hussain Amina 
Published: December 2022

Objective: To assess the vitamin D levels among patients presenting with acute ischemic stroke and relationship of these levels with short-term outcome and the severity of stroke.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi Pakistan, from Dec 2019 to Feb 2021.
Methodology: A total of 300 patients with ischemic stroke diagnosed by the consultant medical specialist or neurologist on the basis of clinical and neuro-radiological findings were included in this study. Serum Vitamin D levels were assessed along with other baseline investigations among the study participants. Severity of stroke was assessed via National Institutes of Health Stroke scale and short-term outcome was assessed by modified Rankin scale.
Results: Out of 300 patients of acute ischemic stroke, 183 (62.3%) were males while 117 (37.3%) were females. 151 (50.3%) of the patients had Vitamin D levels within range while 149 (49.7%) had deficient vitamin levels. On National Institutes of Health Stroke scale, 163 (54.3%) had mild, 87 (29%) had mild to moderately severe, 33 (11%) had severe and 17 (5.7%) had very severe symptoms. Statistical analysis revealed that short-term outcome and stroke severity had a statistically significant relationship (p-value <0.05) with Vitamin D deficiency among patients suffering from acute ischemic stroke.
Conclusion: Almost half of the patients presenting with acute ischemic stroke had vitamin D deficiency in our study. Those having vitamin D deficiency had more chances of having severe form of ischemic stroke and poor short-term outcome.
Epidemiology of SARS-CoV-2 with Implications of Reinfection Update After 01 Year of Ongoing Pandemic: Cross Sectional Study From Tertiary Care Hospital From Southern Region of Pakistan
Authors: Ahmed Abeera , Sana Fatima , Yasir M. , Jamal Hamid , Yousaf Shagufta , Khan Aysha 
Published: December 2022

Objective: To share the epidemiological, clinical and laboratory -based evidence of severe acute respiratory syndrome Corona Virus-2 with focus on the cases of re-infection; an update after one year of the ongoing pandemic.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Pathology, in collaboration with Department of Medicine, Combined Military Hospital, Malir, from Mar 2020 to Feb 2021.
Methodology: Total 5190 nasopharyngeal swabs were collected and transported to the laboratory in viral transport media for severe acute respiratory syndrome Corona Virus-2, from all symptomatic patients with a history of exposure/traveling from endemic areas and those requiring admission in hospital and were screened for COVID-19 as per hospital standing protocols.
Results: 561(10.8%) patients were PCR positive for severe acute respiratory syndrome Corona Virus-2. The mean age of patients was 39.45±31.9 years and a majority of patients were males 426 (76%). The most common symptoms were fever and dry cough followed by myalgia and shortness of breath. 37 (9%) patients died due to the severity of the illness. Total 6 (1.46%) cases of laboratory-confirmed reinfection of severe acute respiratory syndrome Corona Virus-2 were reported. 2(33%) cases of reinfection were observed in health care workers, mortality was seen in a single patient associated with old age and comorbidities.
Conclusion: In our study, the severity of the disease was directly related to the age of patients and underlying comorbidities. Reinfection was associated with increased viral load and exposure to the infected environment.
Evaluating Prediction Score For Success of Trial of Labor After Cesarean (TOLAC)
Authors: Baqai Shehla , Afroze Sadaf 
Published: December 2022

Objective: To determine the success rate for trial of labor after cesarean section in women with good prediction score.
Study Design: Cross sectional (analytical) study.
Place and Duration of Study: Department of Obstetrics and Gynecology, PEMH Rawalpindi, from Dec 2017 to Jun 2018.
Methodology: A total of 141 women with previous delivery by caesarean section, planned for trial of labor with good prediction score of ≥8 were included in the study. All patients were then allowed to labor spontaneously. Data was collected for success rate after trial of labor
Results: Age range in this study was from 18-35 years with mean age of 29.234 ± 2.13 years, mean gestational age 38.531 ± 0.99 weeks, mean weight 63.290 ± 9.97 Kg, mean height 1.532 ± 0.08 meter and mean BMI was 27.097 ± 4.59 Kg/m2. Success rate was seen in 86.5% patients.
Conclusion: In conclusion, a prediction model was proposed that can provide useful insights to envisage VBAC success rate for the pregnant women having history of caesarean delivery at the time of admission.
INTER-OBSERVER VARIABILITY IN GLEASON SCORING SYSTEM F0R HISTOLOGICAL GRADING OF ADENOCARCINOMA PROSTATE
Authors: Ahsan Farah , Khan Ahmed Ahson , Asif Muhammad , Aslam Maria , Hamayun Saba , Din Hafeez Ud 
Published: December 2022

ABSTRACT
Objective: To evaluate the reproducibility of the Gleason scoring system and to compare its inter-observer variability for histological grading of prostatic adenocarcinoma.
Study Design: Prospective double-blind study.
Place and Duration of Study: Histopathology department of Armed Forces Institute of Pathology (Jan-Jul 2020).
Methodology: A total of 128 pathology slides of prostate biopsies from patients with prostate cancer were re-evaluated. The International Society of Urological Pathology 2005 modified Gleason grading system with Epstein’s modification was used. Two pathologists, blinded to each other and to the initial pathology report, performed the pathological evaluation. To determine inter-observer concordance, the kappa coefficient test was used.
Results: Concordance rates between the two observers for Gleason pattern sums were 67% (Ꝁ=0.556, 95% CI 0.40-0.59), respectively. Best concordance was at Gleason sum 7 (n=30/128).
Conclusion: The agreement between observers on the Gleason sum was moderate. It can be greatly reduced if better trained uropathologists employ the Gleason scoring system resulting in less variability and more conformity.
Comparison of Hand Grip Strength Among Chefs and Non-Chefs
Authors: Mazhar Fatima , Amjad Fareeha , Ahmad Ashfaq 
Published: December 2022

Objective: To compare the handgrip strength among chefs and non–chefs.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Different restaurants and hotels of Lahore, from Apr to Sep 2018.
Methodology: Thirty-one chefs and 31 non-chefs (waiters and managers) were included in the study. We used a standard method for measuring the handgrip strength of the dominant and non-dominant hand. Handgrip strength was measured with the help of an electronic hand dynamometer (Model EH101).
Results: The mean handgrip strength of the dominant hand of the chefs was 39.90 ± 8.50 kg, with the range 22.76 kg-55.30 kg, whereas among non-chefs, the mean handgrip strength of the dominant hand was 38.54 ± 7.85 kg, with the range 21.06 kg52.86 kg. The mean handgrip strength of the non-dominant hand of the chefs was 38.36 ± 7.97 kg, with the range 24.20 kg-56.66kg, whereas, among non-chefs, the mean handgrip strength of non-dominant hand was 37.15 ± 7.26 kg, with the range 23.03kg-51.60 kg.
Conclusion: Handgrip strength of chefs and non-chefs was the same in the dominant and non-dominant hands. There was no significant statistical difference in the handgrip strength among chefs and non-chefs.
Determination of Medians of Biochemical Serum Markers in First Trimester of Healthy Pregnant Women in Tertiary Care Setup
Authors: Kanwal Shamsa , Asif Naveed , Baqai Shehla , Ijaz Aamir , Bahadur Kulsoom , Nida Sumbal 
Published: December 2022

Objective: To determine medians of pregnancy-associated plasma protein-A (PAPP-A) and free β subunit of Human Chorionic Gonadotropin (hCG-β) in the first trimester of healthy pregnant women visiting tertiary care hospital.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) from May 2018 to May 2019.
Methodology: Healthy pregnant women with a singleton pregnancy reported for an antenatal checkup in Obstetric OPD, Pak Emirates Military Hospital (PEMH) and Combined Military Hospital (CMH) Rawalpindi were included in the study. PAPP-A level was determined by enzyme-linked immunosorbent assay (ELISA) method using PR 4100 Microplate Reader®, and serum hCG-β were analysed on random access IMMULITE 2000®.
Results: A total of 135 pregnant women were enrolled in the current study. The mean age of subjects was 27.66 ± 4.24 years, mean maternal weight was 59.91 ± 8.87 kgs and mean gestational age was 10.37 ± 1.16 weeks. Median value of PAPP-A was 1289.43 mIU/L (range: 510.8-5965.99) and hCGβ was 120985 mIU/ml (range: 23592-290000).
Conclusion: Median values of PAPP-A and HCGβ can be used to calculate (Multiple of Medians) MoM during the first trimester in tertiary care setup.
Ineffective Transition of Patients During Shift Handover Process of Nurses in Private Sector Tertiary Care Hospital of Peshawar, Pakistan
Authors: Khan Asghar , Ali Sardar , Bhatti Joius , Hayat Nasar 
Published: December 2022

Objective: To explore the factors hindering the shift handover process of nurses and the types of training in a private tertiary care hospital of Peshawar, Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: Northwest General Hospital, Peshawar Pakistan, from Nov 2016 to Aug 2018.
Methodology: The sample population comprised 112 registered nurses with at least one year of experience. A structured questionnaire was used for data collection.
Results: Of the participants, 6 (54.5%) were males, and 51 (45.5%) were females. The mean age of the participants was 27.86 ± 4.57 years. The most prominent alarming factor was messy record 100 (89.3%). 94 (83.9%) participants described interruption by parents' relatives, 97 (86.6%) participants identified staff shortage, difficulty in recognizing essential information was described by 92 (82.1%) study participants and long-working hours was identified by 89 (79.5%) participants. No significant association was found between gender and the working environmental factors.
Conclusion: There are multiple factors that affect the process of shift handover. The health care organizations must ensure proper training of the nursing staff and provide an appropriate environment during shift handover to maintain patient safety.
Success Rate Comparison of Nasolacrimal Duct Probing with and without Assistance of Nasal Endoscope in Congenital Nasolacrimal Duct Obstruction
Authors: Hussain Irshad , Khan Shafaq Pervez , Alam Masood , Abbas Asim , Khan Faisal Aziz 
Published: December 2022

Objective: To compare the success rate of nasal endoscopic assisted probing and simple probing in congenital nasolacrimal duct obstruction.
Study Design: Quasi-experimental study.
Place and Duration of Study: Eye department, Combined Military Hospital, Malir Cantt, Karachi, from Feb 2018 to Jun 2019.
Methodology: A total of 100 children were randomly divided into two groups. Each child in both groups underwent probing of the nasolacrimal duct. In one group, simple probing was performed, and patency was confirmed with metal on metal touch. In the second group, a nasal endoscope was employed to visualize probe passage through the opening of the nasolacrimal duct in the inferior meatus. In fracture of the inferior turbinate was performed in every case when a nasal endoscope was utilized. In the simple probing group, in fracture was performed if the inferior meatus was narrow. The rate of epiphora resolution was recorded in both groups at 1-month postoperatively.
Results: The success rate of epiphora resolution was 96% (48 out of 50) in the nasal endoscopic assisted probing-group and 82% (41 out of 50) in the simple probing-group (p=0.02). The simple probing-group had a 40% (20 out of 50) significant nasal bleed, and in the nasal endoscopic-group, the significant nasal bleed was 20% (10 out of 50) (p=0.02).
Conclusion: Nasal endoscopic assisted probing of the nasolacrimal duct has a higher success rate than simple probing in congenital nasolacrimal duct obstruction.
Awareness of Medical Professionals about Common Disinfectants in a Tertiary Care Hospital Against Corona Virus
Authors: Fahim Qanita , Shah Bukhari Karamat Hussain , Khattak Abdul Katif , Uddin Nasir , Sattar Nadia , Malik Nasir Javed 
Published: December 2022

Objective: To assess the working knowledge of health care workers (HCW) regarding the appropriate use of disinfectants against Coronavirus in hospital care settings using a questionnaire.
Study Design: Cross-sectional study.
Place and Duration of Study: Combined Military Hospital Lahore, Pakistan, from Apr 2020.
Methodology: Two hundred health care workers were consecutively selected and divided into two groups, irrespective of gender. Each participant had to fill a structured proforma containing twenty-five close-ended questions.
Result: Group-1 participants were 126 (63%) and group 2 participants were 74 (37%). 117 (92.8%) group-1 participants were 20–30 years of age and degree holders while 40 (54%) group-2 participants were 31-40 years old and diploma holders. Significant awareness (p<0.001) regarding disinfectants was observed in group-1 (102 81%); all the degree holders were well aware of disinfectants and required less training. In contrast, in group-2, 44 (59%) were fully aware of disinfectants; the rest did not qualify and needed proper training. Participants with a good educational status and work experience of >10 years were the high achievers in both groups.
Conclusion: This study revealed that majority of the participants knew about the correct usage of disinfectants and they were fully prepared to handle the ongoing pandemic. Another finding was that awareness was directly related to relevant education, prolonged work experience and age
Association of Fear of Childbirth with the Preference for Cesarean Section; A Cross Sectional Study
Authors: Ansari Asma , Irum Samina 
Published: December 2022

Objective: To determine the fear of childbirth (FOC) amongst pregnant women and its association with preference for cesarean section.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Obstetrics and Gynecology Pak Emirates Military Hospital, Rawalpindi from Jan 2018 to Jun 2018.
Methodology: Demographic and reproductive data of the patients including mode of delivery, was noted. The intensity of fear of childbirth was measured by Wijma delivery expectancy/experience questionnaire (W-DEQ), and a score was allotted. The total sum of scoring ranged from 0 to 165. A score of >85-99 indicated an intense fear of childbirth, and ≥100 indicated very intense fear. The frequency of requests for cesarean section in women suffering from fear of childbirth was calculated.
Results: A total of 335 patients were included. The mean age was 28.74 ± 3.58 years, and the mean gestational age was 39.50 ± 1.43 weeks. The mean W-DEQ score was 94.59 ± 9.86. The fear of childbirth calculated by W-DEQ in the third trimester of pregnancy showed no fear in 233 (69.55%) participants, intense fear in 42 (12.54%) and very intense fear in 60 (17.91%) women. The requests for cesarean section in women suffering from intense fear were made by 5 (11.90%) women and in women suffering from very intense fear of childbirth was 19 (31.67%) (p-value <0.001).
Conclusion: This study concluded that the intensity of fear of childbirth calculated by W-DEQ amongst pregnant women in the third trimester of pregnancy was relatively high, with a much higher rate ...
Periodontal and Gingival Health of Pregnant Women in Comparison to Non-Pregnant Women
Authors: Butt Hira , Khan Nauman , Tahir Fizza , Piracha Maila Habib 
Published: December 2022

Objective: To assess pregnant women's periodontal and gingival health compared to non-pregnant women.
Study Design: Cross-sectional comparative study.
Place and Duration of the Study: Department of Gynecology, Sharif Medical and Dental College, and Raiwind Polyclinic Lahore (Outreach program of the Sharif Medical and Dental College, from Mar 2019 to Aug 2019.
Methodology: The periodontal and gingival health of 44 pregnant and 52 non-pregnant females was evaluated using the community periodontal index of treatment needs and gingival index.
Results: A total of 44 pregnant and 52 non-pregnant were evaluated. The periodontal health and pregnancy status were significantly associated (p=0.008). The periodontal health and the trimester of pregnancy were not significantly associated (p=0.787). There was no significant association between the gingival health of the females with the status of pregnancy (p=0.773). Maximum calculus deposition in the oral cavity of pregnant women was during the third trimester (36.4%).
Conclusion: The pregnant females had a higher percentage of bleeding gums, while calculus deposition was higher in non-pregnant females. Pregnant females had more periodontal pockets of 4-5 mm, while pocket depths of 6mm or more were seen in non-pregnant females only.
Relation of Days on Ventilatory Support to Total Days of Illness in COVID-19 Patients
Authors: Ameer Khalid , Khan Burki Ahmed Mujadid , Khan Rao Ali Shan , Ghani Usman , Yaqub Khan Muhammad , Butt Nabeel Tahir 
Published: December 2022

Objective: To determine the relation between days on ventilatory support and overall mortality to total days of pre- ventilator illness in COVID-19 patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi Pakistan, from Mar to Aug 2020.
Methodology: A total of 140 admitted patients within the prescribed time frame were observed in the established COVIDIntensive Care Units of Pak Emirates Military Hospital, Rawalpindi. The criteria for inclusion in the study were patients of any age and gender on ventilatory support with a confirmatory diagnosis of SARS-CoV-2 both by RT-PCR, and radiological evidence on HRCT Chest.
Results: The mean age of patients was 59.39 ± 13.517 years. Patients who presented with a confirmed diagnosis of COVID-19 and more than ten days of illness with respiratory compromise had a higher occurrence to be placed on mechanical ventilation. There was a strong linear and positive correlation between the total days of illness on presentation and the total days on ventilatory support (p-value <0.01). This linear relationship consequently translated into overall mortality of 78.6% with a 21.4% survival rate.
Conclusion: To conclude, the total days of illness in critical COVID-19 patients had a linear relationship to days on ventilatory support and overall mortality.
EVALUATION OF PATIENT SATISFACTION LEVEL WITH DIFFERENT OUTPATIENT DEPARTMENT SERVICES: A SITUATIONAL ANALYSIS IN A TERTIARY CARE HOSPITAL
Authors: Qureshi Farhan Muhammad , Bari Samira Faiz , Siddiqui Hamid Jamal , Tahir Muhammad , Khalid Kanwal , Rizwan Saba 
Published: December 2022

Objective: To evaluate satisfaction of outpatients with respect to administrative services and the level of satisfaction towards the various facilities available in an outpatient department of a tertiary care hospital.
Study Design: Hospital based transverse situational analysis.
Place and Duration of Study: Combined Military Hospital, Malir Cantt, from Nov 2018 to Dec 2019.
Methodology: Data was collected from 756 participants, using an “Outpatient Feedback Form” to evaluate the satisfaction level of patients. Nonprobability, convenient sampling technique was used to select study participants. Data was analyzed in Statistical Package of Social Sciences, version 22.
Result: The patient satisfaction was present in 388 (51%) followed by 235 (31%) participants graded the Outpatient department facilities (OPD) as excellent and good respectively. However, only 16 (3%) were disgruntled with the present OPD administrative and medical service of the hospital.
Conclusion: Overall the study showed a good satisfaction level of patients with OPD services received from the hospital. Hospital administration has managed to deliver excellent quality services towards betterment in every discipline and created an example for other hospitals to become an effective part of the healthcare delivery system.