bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Vitamin D Levels in Children with Recurrent Respiratory Tract Infections with Normal Children
Authors: Zaman Saeed , Ahmed Umama , Shah Sajid Ali , Munir Misbah , Nawaz Sadaf , Goheer Lutfullah 
Published: December 2022

Objective: To compare Vitamin D levels in children with recurrent respiratory tract infections with normal children.
Study Design: Case-control study.
Place and Duration of Study: Department of Paediatrics, Combined Military Hospital, Kharian, from Nov 2018 to Dec 2019.
Methodology: Sixty children fulfilling the inclusion criteria from the indoor department of Paediatrics, Combined Military Hospital, Kharian were included in the study. Thirty patients were in the recurrent respiratory tract infections-group (cases), while 30 were in the normal children- group (control). The blood sample was drawn from all the children included in the study to analyze serum 25 (OH) D levels. Data regarding Vitamin D levels were noted from both groups as per operational definition on an especially designed proforma.
Results: The mean age of cases was 5.63 ± 2.82 years, and controls were 5.66 ± 2.44 years. In cases-group, 20 (66.7%) cases had low vitamin D levels, and 10 (33.3%) cases had normal vitamin D levels, while in control subjects, 11 (36.7%) children had low vitamin D levels and 19 (63.3%) children had average vitamin D level. Cases with low vitamin D levels were statistically higher than controls, with the p-value of 0.02 with a significant odds ratio = 3.455 (95% CI: 1.95–9.99).
Conclusion: This study concludes that children with recurrent respiratory tract infections had low vitamin D levels compared with normal children.
Effect of Patient Understanding of Diabetes Self-Care on Glycemic ControlA Hospital Based Cross Sectional Analytical Study
Authors: Riaz Sidra , Nisar Shazia , Anwer Wasif , Palwa Abdur Rahim , Saeed Farrukh , Hussain Mehmood 
Published: December 2022

Objective: To study the effect of patient understanding of diabetes self-care on glycemic control.
Study Design: Hospital-based cross-sectional analytical study.
Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jul 2019.
Methodology: A standardized questionnaire comprising nine questions to gauge understanding of diabetes self-care was applied to 216 patients with Diabetes Mellitus (DM) at Pak Emirates Military Hospital, Rawalpindi. Linear regression analysis was conducted to examine the effect of diabetes-related self-care understanding on glycemic control.
Results: 138 patients were males (64%) and 78 females (36%) with a mean age of 40 ± 8 years (range: 18-68 years). The mean duration of having diabetes mellitus was 12 ± 2 years. Patients with a high score on the self-care understanding questionnaire had better average glycemic control than those with lower scores.
Conclusion: Patients' understanding of self-care for diabetes has a significant impact on their glycemic control. This asks physicians to educate patients about their role in disease management for better clinical outcomes.
Burden of Depression, Anxiety and Stress; The Psychiatric Burden in COVID-19 Patients at a Tertiary Care Hospital in Pakistan
Authors: Kakar Muhammad Siddique , Sadiq Noman , Rauf Shehzad , Ahmad Asrar , Khattak Haroon , Awais Muhammad 
Published: December 2022

Objective: To assess the levels of depression, anxiety and stress in patients diagnosed with COVID-19.
Study Design: Cross-sectional study.
Place and Duration of Study: COVID isolation ward of PNS Shifa Hospital, Karachi Pakistan, from May to Jun 2020.
Methodology: A total of 110 patients whose COVID-19 PCR tests were positive were selected. They had a history of at least one-week admission to the hospital, and all of them were stable or had mild symptoms. Depression, Anxiety and Stress scale (DASS 21) was administered to all the patients through a video call.
Results: The study revealed that 30 (27.3%) of the COVID-19 patients had depressive features, whereas 37 (33.6%) were found to be anxious, and 13 (11.8%) were under stress during this time. Depressive features were more common in the female gender affecting 9 (56.2%) out of 16 females (p=0.011) and unemployed patients affecting 12 (54.5%) out of 22 unemployed patients (p=0.006). Anxiety was more common in the female gender affecting 11 (68.7%) out of 16 females and married patients, affecting 26 (27.6%) out of 94 married patients (p=0.01). Stress was found to be more in females, affecting 8 (50%) out of 16 females (p=0.01).
Conclusion: This study showed that the diagnosis of COVID-19 can lead to psychological effects, and patients should be monitored for depression, anxiety and stress.
Accuracy of Rapid Diagnostic Test for Malaria Compared to Microscopy
Authors: Shah Sanober , Waris Jamal , Mushtaq Hina , Khan Imran , Ali Mashooque , Afridi Nighat 
Published: December 2022

Objective: To determine the diagnostic accuracy of the Rapid Diagnostic Test in the detection of malaria by taking routine microscopy as a gold standard.
Study design: Cross-sectional study.
Place and Duration of Study: Department of Haematology, Pakistan Naval Ship Rahat Hospital, Karachi Pakistan, from Aug 2018 to Jan 2019.
Methodology: Patients diagnosed as a case with malaria were included. Malaria was confirmed by using a Rapid detection test and microscopy. Mean and standard deviations were calculated for the quantitative variables like age. Frequencies and percentages were calculated for the qualitative variables like gender. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy were calculated.
Results: Out of 175 patients in the study, the mean age was 39.30 ± 11.29 years. 85 (48.6%) were male, and 90 (51.4%) were female. Out of 175 patients, sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of the rapid diagnostic test for malaria, keeping microscopy as the gold standard was found to be 87.2%, 74.15%, 67.34%, 85.71% and 80.57% respectively.
Conclusion: Rapid immune-capture tests can have excellent applicability in malaria diagnosis. Field workers can reliably read such tests without any supervision. It appears to satisfy the desired criteria of being rapid, easy to perform, interpret and reasonably accurate.
Outcomes of Patients with Stage I Germ Cell Tumour; Adjuvant Chemotherapy vs Surveillance; A Single Institutional Experience
Authors: Khan Shafquat Ali , Azhar Musa , Hanif Muhammad Rashid , Wahab Abdul , Raza Ishaq , Yasmeen Samia , Siddiqui Neelam , Sheikh Rizwan Masood , Baker M Abu 
Published: December 2022

Objective: To determine five-year survival and stratify risk factors for disease relapse in the clinical stage I germ cell tumour post orchiectomy.
Study Design: Retrospective longitudinal study.
Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital and Research Centre Lahore Pakistan, from 2008 to 2013.
Methodology: We analyzed overall survival and disease-free survival in patients with stage 1 Germ cell tumours who either received chemotherapy or were kept on active surveillance after higher orchiectomy. In addition, risk factor stratification for recurrence was determined using the clinical, radiological and histopathological parameters.
Results: Of 88 patients, 51 (58%) received chemotherapy, while 37 (42%) patients were kept on surveillance post orchiectomy for stage I germ cell tumours, including seminoma and non-seminoma histologies. Five-year overall survival and disease-free survivals were 99% and 92%, respectively, for all patients with stage 1 Germ cell tumours. Subgroup analysis showed that DFS was better in the adjuvant chemotherapy arm than the surveillance arm in both subtype histologies; however, five-year overall survival was comparable. Lymph vascular invasion and tumour size (T) was identified as risk factor for disease relapse.
Conclusion: This institutional report suggests that while identifying risk factors, active surveillance post orchiectomy can be an effective treatment option for clinical stage I germ cell tumours and is comparable with adjuvant chemotherapy. Two important factors determining survival in our study were Lymph vascular invasion and T staging.
Comparing Oral Moxifloxacin and Ciprofloxacin Ear Drops Versus Ciprofloxacin Ear Drops Only in Patients with Active Mucosal Chronic Otitis Media
Authors: Khan Amir Ali , Asim Muhammad Umar , Rehman Syed Tehmina , Nadeem Syed Furrukh , Rafique Usman , Khan Muhammad Ahmed 
Published: December 2022

Objective: To compare the effects of Oral Moxifloxacin and topical antibiotic ear drops in patients with active mucosal chronic otitis media.
Study Design: Comparative prospective study.
Place and Duration of Study: Combined Military Hospital Bahawalpur, from May 2018 to Apr 2020.
Methodology: A total of 100 patients with Active (mucosal) Chronic Otitis Media were included in the study. These patients were divided into two groups. The first group received oral Moxifloxacin and topical Ciprofloxacin ear drops, while the second group only received topical ciprofloxacin ear drops. Clinical success was compared in both groups regarding patients becoming asymptomatic and having a dry ear on examination.
Results: 45(90%) patients in combined treatment while 35 (70%) in the topical ciprofloxacin ear drops group became asymptomatic. The Chi-square test was applied (6.25). The p-value was .124. We found that oral Moxifloxacin, in addition to topical Ciprofloxacin ear drops, is a superior treatment option in decreasing the symptoms of tubotympanic chronic otitis media (COM) than the topical ciprofloxacin ear drops when used alone.
Conclusion: Moxifloxacin is an effective drug in controlling symptoms of tubotympanic chronic supportive otitis media, and its combination with topical ciprofloxacin ear drops is superior to the ciprofloxacin ear drops when used alone.
Doctors' Communication Skills in Military Hospitals–A Critical Analysis
Authors: Hussain Zakir , Rehman Muneeb Ur , Khan Muhammad Alamgir 
Published: December 2022

Objective: To assess the level of communication skills of doctors in military hospitals and compare their own and patient perceptions. We also aimed to determine factors affecting doctors' communication skills and suggest recommendations for improving doctors' communication skills.
Study Design: Cross-sectional study.
Place and Duration of Study: CMH Lahore, CMH Gujranwala and CMH Chunian and Armed Forces Institute of Cardiology, Rawalpindi, from Oct 2016 to Jun 2017.
Methodology: Through non-probability consecutive sampling, questionnaires were distributed to 100 physicians and 100 patients inquiring about various aspects of doctors' communication skills and factors affecting them.
Results: Doctors were asked to judge the overall level of their communication skills, and more than half of them (53%) opined that their communication skills were very good. However, the perception of doctors' communication skills was better by doctors themselves compared to patients' perception. More than half of the doctors strongly agreed that increased workload, use of the hospital management system and extra commitments were major impediments to effective communication skills.
Conclusion: The perception about the communication skills of doctors is not as high as that of the doctors themselves. There is a striking disparity between the physicians' and patient responses. The communication skills of doctors can be improved by formal training of physicians in the form of workshops. In addition, the workload on doctors should be reduced by minimizing extra commitments.
Teratogenic Effects of Bisphenol A Exposure During Maternal Pregnancy and Lactation on Developing Rat Pups Testes
Authors: Khurshid Tooba , Ali Shabana , Ali Hussain , Bano Maleeha , Cheema Hira Waqas , Hussain Nabiha 
Published: December 2022

Objective: To study the teratogenic effects of Bisphenol A exposure during maternal pregnancy and lactation on the testicular histology of developing rat pups.
Design of Study: Laboratory-based experimental study.
Place and Duration of Study: Department of Anatomy, Islamic International Medical College Rawalpindi in collaboration with the National Institute of Health (NIH) Islamabad Pakistan from Sep 2018 to Sep 2019.
Methodology: Eight weeks old, ten pregnant female rats were divided into groups, each comprising five pregnant rats. Pups were born by spontaneous vaginal delivery. Control group A consisted of 15 male rat pups delivered from 5 pregnant rats, fed on a standard diet during pregnancy and lactation till the 21st day. Experimental group B consisted of 15 male rat pups delivered from 5 pregnant female rats who were administered subcutaneous Bisphenol A at a dose of during their pregnancy and lactation till the 21st day.
Results: Significant deterioration of quantitative parameters in testes of the experimental group was seen. The seminiferous tubule diameter in group B was 81.99 ± 10.88 compared to group A which was 111.59 ± 8.36. The germinal epithelial height in group B was 10.47 ± 2.34 compared to 30.41 ± 2.43 in group A. The number of Leydig cells in group B was 17 ± 3.45 compared to 47 ± 4.44 in group A. The number of rounded spermatids in group B was 10 ± 3.74 compared to 38 ± 4.02 in group A.
Conclusion: Bisphenol A has teratogenic effects on testicular histology of developing rats............
Diagnostic Accuracy of CHROMagar MRSA for Detection of Methicillin-Resistant Staphylococcus Aureus (MRSA) from Screening Swab Specimens
Authors: Ahmed Farooq , Hussain Wajid , Mirza Irfan Ali , Ali Saad , Khurshid Umar , Sarwar Mariam 
Published: December 2022

Objective: To determine the diagnostic accuracy of CHROMagar MRSA for detecting MRSA from screening swab specimens keeping the Cefoxitin disk diffusion test as the reference method.
Study Design: A cross-sectional validation study.
Place and duration of study: Department of Microbiology, Armed Forces Institute of Pathology (AFIP), Rawalpindi Pakistan, from Mar to Aug 2019.
Methodology: A total of 243 screening swab specimens, e.g., axillary, nasal and web swabs, each of hospitalized patients and healthcare workers (HCW) submitted for MRSA screening were included in the study and were processed simultaneously on blood agar, MacConkey agar and CHROMagar MRSA. The agar plates were incubated at 35°C ± 2°C for 18-24 hours in ambient air. The cefoxitin disk diffusion test followed the isolation and identification of MRSA according to the latest Clinical and Laboratory Standards Institute (CLSI) guidelines. In CHROMagar MRSA screening, after incubation, plates were examined for the presence of mauve colonies (MRSA detected), and the results were obtained and validated against the reference method of Cefoxitin disk diffusion.
Results: Overall, the diagnostic accuracy of CHROMagar MRSA for detecting MRSA was 97.53%. Diagnostic accuracy of CHROMagar MRSA was 95.1%, 97.5% and 100% in axillary, nasal and web specimens, respectively. The rate of MRSA detection was maximum in axillary swabs, i.e., 40.7%, followed by 29.6% and 9.8% in nasal and web swabs, respectively.
Conclusion: CHROMagar MRSA is found to be accurate for the detection of MRSA. It is reliable, easy to perform, less timeconsuming, and cost-effective. It is an affordable alternative to the conventional..............
Determination of Serum Inhibin-A Levels in Differentiating Pre-Eclampsia and Gestational Hypertension
Authors: Shah Shahrukh , Aamir Muhammad , Haroon Zujaja Hina , Bibi Afshan , Akber Rabiya , Khalid Usama Bin 
Published: December 2022

Objective: To determine the association of serum Inhibin-A levels in differentiating Pre-eclampsia and gestational hypertension.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology (AFIP) Rawalpindi, in collaboration with the Gynaecology and Obstetrics Department at Combined Military Hospital (CMH), Rawalpindi Pakistan, from Jul 2020 to Jun 2021.
Methodology: Nulliparous women with single pregnancy in the third trimester admitted to evaluate high blood pressure in the Department of Gynaecology and obstetrics CMH Rawalpindi were selected after getting their informed written consent. Forty women with pre-eclampsia, forty with gestational hypertension, and 40 normotensive pregnant healthy women receiving routine antenatal care were matched for parity, age, and gestational age.
Results: The concentration of inhibin A [Median (IQR)] in women having preeclampsia were significantly higher [1745 pg/ ml (1601.2–1821.7)] than subjects with gestational hypertension [895 pg/ml (834.5-977.5)] and normotensive pregnant women [637pg/ml (589-684.7)] with p-value 0.001. Further, Women with severe preeclampsia had a considerably greater serum concentration of inhibin A [Median (IQR)] [1895 pg/ml (1827.2-1955.7)] than those with mild preeclampsia [1686 pg/ml (1537.5-1762.7)].
Conclusion: As per our study, median serum Inhibin A concentrations were higher in pre-eclampsia subjects than in gestational hypertension. In clinical situations, serum Inhibin A levels may be used to differentiate between pre-eclampsia and gestational hypertension.
The Correlation of Platelet Indices; Platelet Count, Mean Platelet Volume (MPV), Platelet Distribution Width (PDW) and Platelet-Large Cell Ratio (P-LCR) with Mortality in Patients Admitted to PICU
Authors: Nadeem Muhammad Tariq , Hassan Syed Arsalan , Basit Abdul , Siddiqui Abdul Wahab , Awan Aamir Aslam , Ahdi Saher Gul 
Published: December 2022

Objective: To determine the correlation of platelet indices; platelet count (PC), mean platelet volume (MPV), platelet distribution width (PDW) and platelet large cell ratio (P-LCR) with mortality in patients admitted to PICU.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Pediatric Intensive Care Unit (PICU) of CMH Lahore from Jun 2019 to May 2020.
Methodology: Cases (mortality group) were the 81 consecutive patients who died in the PICU during the study period and fulfilled inclusion criteria. The control group comprised 81 surviving patients admitted to PICU contemporarily. Both groups' mean values of platelet indices (PC, MPV, PDW and P-LCR) were compared.
Results: The mortality rate was 10.42%. Infants were the largest sub-group (45.68%) in the mortality group. Mean platelet counts were significantly low, while mean MPV, PDW and P-LCR were significantly higher in children in the mortality group compared to the control group (p-value <0.001). The correlation coefficient 'r' was -0.682,0.598,0.671 and 0.355 for platelet count, PDW, MPV and P-LCR, respectively, showing a negative correlation between platelet count and positive correlation of mean platelet volume (MPV), platelet distribution width (PDW) and platelet-large cell ratio (P-LCR) with mortality.
Conclusion: Deranged platelet indices, as manifested by lower platelet count and higher values of MPV, PDW and p-LCR, were significantly correlated with higher mortality in children admitted to PICU and can be used to predict/anticipate the severity of illness.
Comparison of Sphenopalatine Block and Intravenous Paracetamol for the Treatment of Post-Dural Puncture Headache
Authors: Khan Abid , Feroz Shizan Hamid , Iqbal Sana , Sultan Muhsan , Munir Sajid , Ahmed Waqas 
Published: December 2022

Objective: To compare the effect of topical sphenopalatine block and intra venous Paracetamol in the management of post-Dural puncture headache.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Peshawar Pakistan, from Jan to Aug 2021.
Methodology: This experimental study was conducted on 153 patients who underwent lumbar puncture for any procedure and then suffered from post-Dural puncture headaches. Patients were randomized into two groups. Group A received the topical sphenopalatine block, while group B received the intravenous Paracetamol three doses 12 hours apart. Headache was recorded on Numeric pain score (NPS) 24 hours after the surgical procedure. Comparison in pain relief was compared in both groups at 1 hour, 12 hours, 24 hours and 48 hours.
Results: Out of 153 patients randomized into two groups, 76 (49.7%) were categorized into Group-A, and 77 (50.3%) were categorized into Group-B. 63 (41.2%) were male, while 90 (58.8%) were female. The mean age of patients included in our study was 34.34 ± 4.33 years. Gynaecological/obstetric procedures 70 (45.7%) were the most common indication for lumbar puncture in our study. At 1, 12, 24 and 48 hours, pain relief was statistically significantly better in Group-A than in Group-B (p- value<0.005).
Conclusion: Sphenopalatine ganglionic block emerged as a better option for pain relief among patients suffering from post-Dural puncture headache than intravenous Paracetamol. In addition, immediate and short-term relief was better among patients who used sphenopalatine block.
Perception of Undergraduate Medical and Health Sciences Students Regarding Online Formative Assessments During COVID-19
Authors: Ain Noor Ul , Jan Sadiq , Yasmeen Rahila , Mumtaz Hassan 
Published: December 2022

Objective: To look into the experience of undergraduate medical and health sciences students regarding perceptions of online formative assessments.
Study Design: Online cross-sectional survey.
Place and Duration of Study: Riphah International University, Islamabad Pakistan, from Aug to Dec 2020.
Methodology: Three hundred fifty-one pre-clinical and clinical students of disciplines including MBBS, BDS, and Pharm-D participated in the study. Data was collected through a convenient sampling technique. An online questionnaire containing 22 closed-ended questions with a three-point Likert scale on five themes related to online formative assessments and one openended question was used.
Results: 86 (24.5%) students agreed that online formative assessments improved their learning. The motivation for learning was increased in 120 (34.2%) students. 214 (61%) students felt that online formative assessments were stressful, and the majority were well aware of the use of technology except for connectivity and login issues highlighted by the students. Regarding the question paper, the majority were comfortable with the construct of online formatives. 158 (45%) students were not satisfied with the allotted time to complete the formative assessments. 163 (46.4%) students were satisfied with the feedback provided, yet 258 (73.5%) students recommended formal feedback provided on the same day to improve their learning by knowing their deficiencies.
Conclusion: The study results support the contention that well-designed online formative assessments have considerable untapped potential to assist learning by motivating students. Their problems and challenges need to be addressed to improve the online assessments that help in the learning of undergraduate students.