bluuebunny/crossref_metadata_2025_split huggingface dataset:
EVALUATION OF SUCCESS OF RESIN INFILTRATION TECHNIQUE IN SUPERFICIAL PROXIMAL CARIOUS LESIONS OF POSTERIOR TEETH
Authors: Mahmood Faisal , Munir Muhammad Bader , Altaf Ali , Yousaf Ajmal , Bhangar Faisal , Hussain Syed Muzammil 
Published: January 2022

Objective: To determine the effectiveness of resin infiltration technique in arresting superficial proximal carious lesions of posterior teeth.
Study Design: Quasi experimental study.
Place and Duration of Study: Operative dentistry department, de’ Montmorency College of Dentistry Lahore, from Oct 2018 to Mar 2019.
Methodology: Meeting inclusion criteria were selected. Informed consent was obtained. After application of rubber dam; etchant gel was applied to superficial proximal carious lesions in these patients; water-rinsed and air-dried for 30 sec; resin was then infiltrated into each lesion. Patients were recalled after 6 months for follow up.
Results: Total patients were 30 out of which 18 (60%) were males and 12 (40%) were females. Mean age of patients was 25.77 years ranging from 16-35 years. Success of resin infiltration technique in superficial proximal carious lesions in posterior teeth was 86.7% measured by bitewing radiograph taken on follow up after 6 months to see any progression of carious lesion.
Conclusion: Resin infiltration was effective in 86.7% patients in arresting progress of superficial proximal carious lesions with no significant difference for age and gender. Hence it is suggested that resin infiltration being promising micro invasive approach should be considered in addition to non-operative and operative treatment approaches.
ULTRASOUND GUIDED FOAM SCLEROTHERAPY AS A PREFERRED TREATMENT OPTION FOR VARICOSE VEINS IN TERMS OF SAFETY, EFFICACY AND COST EFFECTIVENESS
Authors: Jamil Muhammad , Usman Rashid , Khan Muhammad Irfan , Randhawa Muhammad Afzal , Aman Aaiza , Jamil Areesha 
Published: January 2022

Objective: To assess the safety, efficacy and cost effectiveness of ultrasound-guided foam sclerotherapy in superficial venous reflux in Clinical, Etiological, Anatomical and Pathological (CEAP) classification grade 2-6 disease.
Study Design: Retrospective observational study.
Place and Duration of Study: Combined Military Hospital Rawalpindi, from Sep 2018 to Feb 2020.
Methodology: One thousand and sixty-seven patients (1312 legs) with varicose veins were treated by ultrasound-guided foam sclerotherapy using 3% sodium tetradecyl sulphate for truncal veins and 1% for smaller veins in 1:4 ratio with air. After 7 days, leg was assessed clinically and radiologically with Duplex ultrasound for occlusion of veins and complications. Second, third and fourth sclerotherapy sessions were performed for residual/recurrence/new varicosities. Compression bandage was used for at least 3 months after treatment.
Results: The overall eradication of superficial venous reflux and healing of ulcers, was seen in 92.1% (1208 legs). It was 83.5% (1095 legs) after 1st session of UGFS. Second, 3rd and 4th session of UGFS further increases this percentage of benefitted patients Deep vein thrombosis developed post procedure in 2 (0.18%) patients and pulmonary embolus in one patient. Three (0.28%) patients had transient visual disturbances within half an hour of treatment. Retreatment was required due to formation of new superficial venous reflux in 39 (2.9%) legs and recurrence in 93 (7.1%) legs.
Conclusion: Ultrasound guided foam sclerotherapy is a better option of treatment in varicose veins in terms of safety, efficacy and cost effectiveness.
BACTERIAL SPECTRUM AND ANTIMICROBIAL PATTERN OF BLOOD STREAM INFECTIONS ASSOCIATED WITH NON-TUNNELED DOUBLE LUMEN CATHETER IN HEMODIALYSIS PATIENTS
Authors: Hussain Mehmood , Khan Malik Nadeem Azam , Rehman Khalid , Mirza Irfan Ali , Rehman Maryam , Riaz Sidra 
Published: January 2022

Objective: To assess Bacterial spectrum and antimicrobial pattern of Blood Stream Infections associated with non-tunneled double lumen catheter in hemodialysis patients.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Nephrology, Pakistan Emirates Military Hospital Rawalpindi Pakistan; Armed Forces Institute of Pathology Rawalpindi, Pakistan, from May 2019 to Apr 2020.
Methodology: A total of 753 patients underwent placement of non-tunneled double lumen catheter (457 femoral, 296 Internal Jugular). Patients with clinically suspected bloodstream infections had their catheters removed with tips being sent for culture along with 2 sets of peripheral blood cultures. Patients were labelled as having bloodstream infection if growth of organism was detected in catheter tip and at least one peripheral blood culture. Susceptibility testing was done for available antimicrobials.
Results: One hundred and thirty six (18.06%) incidences or 5.48 bloodstream infections per 1000 catheter days, with confirmed growth on blood cultures were identified. Gram positive infections were seen in 76 (55.88%) individuals with most common organism being coagulase-negative Staphylococcus (28.68%), followed by Staphylococcus aureus (21.32%). These organisms had low resistance rates to Vancomycin (0%), Tigecycline (0%), Doxycycline (6.6%) and Linezolid (9.5%). Gram negative infections were seen in 60 (44.11%) patients with Klebsiella pneumoniae (13.24%) being the most commonly identified pathogen followed by Acinetobacter baumannii (12.50%) and had relatively higher degree of antimicrobial resistance.
Conclusion: Gram positive organisms were the most common cause of bloodstream infection in this study and were found susceptible to vancomycin and doxycycline whereas gram-negative organisms had high rates of antimicrobial......
EXPOSURES AND RISK FACTORS OF CORONA VIRUS AMONG HEALTH CARE WORKERS AND NEED FOR PREVENTIVE MEASURES IN COMBINED MILITARY HOSPITAL RAWALPINDI
Authors: Siddiqi Fuad Ahmad , Mehreen Sobia , Ahmed Adeel , Bashir Tariq , Ahmad Javed , Hassan Fayyaz , Mahmood Fatima 
Published: January 2022

Objective: Prospective To determine the various risk factors and exposures for spread of Corona Virus Disease 2019 (COVID19) among health care workers working at Combined Military Hospital Rawalpindi.
Study Design: Cross sectional study.
Place and Duration of Study: Combined Military Hospital, Rawalpindi, from Apr to Jul 2020.
Methodology: A total of 134 health care workers who were infected with COVID-19, were included in study. A structured questionnaire was attained after informed consent and approval from hospital ethical committee. Data was analyzed using SPSS-19 statistical software.
Results: Overall, 134 of 2591 Health care workers (Health care workers) in Combined Military Hospital Rawalpindi tested positive for COVID-19 during the study period. The infection rate was 5.17%. Among them 25 (18.7%) were women and 109 (81.3%) were men. There was not statistical difference in infection rate between male and female health care workers p=0.156). The infection rate in clinical category was significantly higher than non-clinical category (p<0.001. The infection rate in nursing assistants was significantly higher than the doctors (p=0.021). Personal protective equipment was optimally provided to health care workers except for goggles and face shields whose provision and use were both lacking.
Conclusion: Health care workers are at high risk of developing COVID-19. There is need for extensive training, easy availability of personal protective equipment and strict compliance to infection control policies.
THE IMPACT OF ISOLATED OLIGOHYDRAMNIAS AT TERM ON PERINATAL OUTCOME: A COMPARATIVE STUDY
Authors: Zafar Bushra , Arif Nadia , Arif Ayesha , Ahmed Raja Qaseem , Shahzad Farrukh 
Published: January 2022

Objective: To study the impact of isolated oligohydramnios at term on mode of delivery and perinatal outcome.
Study Design: Prospective comparative study.
Place and Duration of Study: Combined Military Hospital Okara, from Aug 2019 to Aug 2020.
Methodology: A total of 250 patients were recruited in the study. They were divided in 2 groups. In group A there was 123 patients, with isolated oligohydramnias at term, amniotic fluid index of ≤5cm, while in group B 127 patients, with normal liquor volume were included through lottery method. Demographic parameters, Intrauterine fetal demise, mode of delivery, perinatal out comes like meconium stained amniotic fluid, low birth weight, APGAR score at 1 and 5 minutes, of two groups were compared.
Results: A total of 57 (46.3%) patients in group A delivered through cesarean section and 27 (21.3%) in group B. Meconium staining of liquor was in 56 (45.5%) in group A versus 13 (10.2%) in group B. As compared to group B the patients in group A lower birth weight babies 2.6 ± 0.34 kg versus 3.0 ± 0.33 kg were delivered. Mortality in group A, intrauterine fetal demise was 4 (3.3%) and still birth was 2.3%. There were no perinatal mortality in controlled group B.
Conclusion: Isolated oligohydramnias at term is not associated with adverse perinatal outcome. Umbilical cord compression, potential utero-placental insuffiency and increased incidence of meconium stained liquor possibly explains the increased perinatal morbidity. The delivery should be routinely advocated as in otherwise uncomplicated pregnancy with appropriately grown fetus.
ASSESSMENT OF EFFICACY OF ELECTRONIC VACUUM ASPIRATION WITH INTRAVENOUS ANALGESIA
Authors: Afsheen Afeera , Shahid Aisha , Iftikhar Bushra , Anwar Rabiah , Nosheen Javaira , Tariq Amera 
Published: January 2022

Objective: To assess efficacy of elecrtonic vacuum aspiration in evacuation of retained product of conception with intravenous analgesia.
Study Design: A prospective observational study.
Place and Duration of Study: Department of Gynaecology and Obstetrics, Pakistan Naval Ship Shifa Hospital, Karachi Pakistan, from Jan to Jun 2018.
Methodology: All patients who were intended to undergo Electronic Vacuum Aspiration due to retained products of conception, early fetal demise, septic induced abortions and molar (all upto 12 weeks of gestation) were enrolled in this study after obtaining informed consent. Outcome measures of study were efficacy (defined as completeness of the evacuation procedure confirmed by ultrasound), occurrence of complications like uterine perforation, excessive bleeding >200ml and sepsis (diagnosed clinically or biochemically).
Results: A total of 1080 patients underwent Electronic Vacuum Aspiration during the study period. Complete evacuation was achieved in 1026 (95%) cases. Four (<1%) patients experienced post procedure infection while none had uterine perforation. Average blood loss was <100ml while 18 (1.6%) patients had blood loss of >200ml.
Conclusion: Electronic vacuum aspiration is a safe and efficacious method of uterine evacuation. It does not require special equipment. It is easy to learn and is readily available as well as cost effective. Hence it’s a very lucrative alternative to manual vacuum aspiration using I pass or medical termination of pregnancy in resource poor settings.
FREQUENCY OF CUTANEOUS MANIFESTATIONS IN COVID-19
Authors: Sundus Madiha , Akhtar Aisha , Aslam Asim , Iftikhar Nadia , Anjum Muhammad , Suhail Nawal 
Published: January 2022

Objective: To provide an insight into the frequency of cutaneous manifestations in patients with Corona Virus Disease of 2019 COVID-19), along with an association of these findings with the severity of the disease.
Study Design: Cross-sectional study.
Place and Duration of Study: Tertiary care hospital, Rawalpindi Pakistan, from May to Jul 2020.
Methodology: We collected data from 412 confirmed cases of COVID-19 patients directly who were >12 years of age. The data included names of patients, their genders, ages, dates of admission, severity category, presence or absence of symptoms and cutaneous findings along with description of cutaneous findings if present. The data was evaluated using Statistical Package for the Social Sciences (SPSS) version 23.
Results: Eleven out of the total 412 patients with COVID-19 included in our study were found to have cutaneous findings. The frequency of cutaneous manifestations associated with COVID-19 was calculated to be 11 (2.7%). Increasing age proved to be positively correlated with increasing severity of the disease whereas no association was found between gender and severity of the disease.
Conclusion: Infection with COVID-19 may result in dermatological manifestations with various clinical presentations, which may aid in better understanding and management of the disease.
EVALUATION OF A NOVEL LIQUID CHROMATOGRAPHY TANDEM MASS SPECTROMETRY BASED METHOD FOR VITAMIN D ANALYSIS IN BLOOD
Authors: Naz Sehrish , Aamir Muhammad , Haroon Zujaja Hina , Kirmani Sobia Irum , Ahmed Nisar , Ali Sadiq 
Published: January 2022

Objective: To evaluate a novel liquid chromatography tandem mass spectrometry based method for serum 25 hydroxy vitamin D (D2 and D3 metabolites) analysis.
Study Design: Cross sectional validation study.
Place and Duration of Study: Department of Chemical Pathology and Endocrinology, Armed Forces Institute of Pathology, Pakistan, from Mar 2019 to Mar 2020.
Methodology: Samples were extracted and 25 OH vitamin-D was separated by means of chromatography and finally quantified via mass spectrometer. A quadrupole- tandem mass spectrometer with Electron spray Ionization coupled to high performance liquid chromatography was adopted for detection and quantitation of 25-hydroxyvitamin D2 and D3 in serum.
Results: Limit of detection (LOD) was at the level of 2.49 ng/ml and limit of quantitation (LOQ) was estimated to be 3.9 ng/ml for both the metabolites. The correlation coefficient was 0.99. For D3 observed recovery was 98% and 97.5% respectively while for D2 the recovery was calculated to be 97% and 98%. Percentage relative standard deviation (RSD) was 0.8% and 1.3% respectively. This method has an advantage of less matrix effects, minimal cross-reactivity with 24, 25 hydroxy vit D and 25, 26 di-hydroxy vitamin D metabolite than the routinely used antibody-based assays.
Conclusion: This LC-MS/MS methodology is sensitive, specific and can quantitate Vitamin D2 and D3 quite efficiently. This method may be employed for vitamin D analysis in clinical laboratories.
WHAT DRIVES YOUNG WOMEN TO JOIN THE PAKISTAN ARMED FORCES? AN EXPLORATORY STUDY OF MOTIVATIONAL FACTORS
Authors: Mustafa Nazia , Kiani Shoaib 
Published: January 2022

Objective: To explore the motivational factors for women to join Pakistan army.Study Design: Exploratory study design.
Place and Duration: The study was conducted at Army selection and Recruitment Centre on the female graduates from various universities of Islamabad/Rawalpindi who were coming for induction in army, from March 2018.
Methodology: The study was conducted in two phases; in phase I, Semi-structured interviews of 10 lady officers were carried out to gauge the motivational factors to join Army. In phase II, data of 792 female graduates from various universities of Islamabad/Rawalpindi was collected through socio-demographic form and the checklist about motivational factors developed during phase I to join armed forces.
Results: Results revealed that maximum individuals (22%) graded “Patriotism” as prime reason to join Army while a minor segment (1%) cited financial incentive as driving factor. Percentages of other factors, in order of precedence are; “Feeling Proud” (18%), “Strong Social Standing” (16%), “Quality of Life” (10%), Charm of Uniform (8%), Bright Career (6%), Job Security (5%), Family Lineage (5%), Adventurous Job (5%) and Marriage (4%). Further to this, there were differences in women’s motivation to join Army from various professions.
Conclusion: Motivation for opting military career is a complex phenomenon of inter-related factors. Therefore, we should consider all these factors together to select highly motivated, skilled/qualified and loyal individuals.
VENTILATOR ASSOCIATED PNEUMONIA IN TRAUMA PATIENTS; ASSOCIATED RISK FACTORS, MICROBIAL ETIOLOGY AND OUTCOME
Authors: Manzoor Sohaima , Batool Farzana , Sayeed Muneeba Ahsan , Dhiloo Azizullah Khan , Ismail Humera Muhammad , Baqai Shehla 
Published: January 2022

Objective: To assess the incidence, risk factors and outcome of ventilator associated pneumonia in trauma patients.
Study Design: Prospective observational study.
Place and Duration of Study: Shaheed Mohtarma Benazir Bhutto Institute of Trauma, Karachi, from Jul to Dec 2019.
Methodology: All trauma patients, above 12 years, placed on mechanical ventilation in the emergency room or intensive care unit, were enrolled. Patients that developed a clinical pulmonary infection score of less than 6 were diagnosed with ventilator associated pneumonia.
Results: A total of 113 patients were enrolled in this study. Mean age was 32.9 ± 14.4 years. Thirty eight (33.6%) developed ventilator associated pneumonia. Patients with ventilator associated pneumonia, compared to non-ventilator associated pneumonia, had a longer emergency room stay of 7.8 ± 10.1 vs. 4.7 ± 7.4 days (p-value=0.013), greater ventilator days of 18.5 ± 12.6 vs. 7.9 ± 5.5 (p-value=0.001), longer hospital stay of >14 days in 65.8% vs. 33.3% (p-value=0.001) and higher mortality of 65.8% vs. 56% (p-value=0.213). Nurse to patient ratio and infection control measures for prevention of ventilator associated pneumonia were significantly reduced in emergency room compared to intensive care unit (p-value=0.001). Out of 43 respiratory isolates in 38 ventilator associated pneumonia patients, 40 (93%) were gram negatives of which 23 (57.5%) were multidrug resistant with polymyxins as the only therapeutic option.
Conclusion: There was a high incidence of ventilator associated pneumonia in patients with trauma. Prolonged retention in the emergency room is a significant risk factor for ventilator associated pneumonia, due to understaffing..................
AWARENESS REGARDING DIABETES AND ITS MANAGEMENT AMONGST PATIENTS VISITING TERTIARY CARE HOSPITALS AND ITS IMPACT ON GLYCEMIC CONTROL
Authors: Khan Anum , Arshad Abdul Rehman , Farooq Asif , Raashid Sheharyar 
Published: January 2022

Objective: To assess factors affecting disease awareness in diabetics, and its association with glycemic control.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Medicine, Pak Emirates Military Hospital Rawalpindi from Jan to Apr 2019.
Methodology: Outdoor patients with type-II diabetes mellitus were selected using a consecutive sampling technique. Disease awareness was assessed with a modified Diabetes Knowledge Questionnaire, with scores >70% considered satisfactory. Recent HbA1c levels were used to determine glycemic control (<7% reflecting good glycemic control). Demographic data, including age, gender, level of education, residence, duration of diabetes, mode of treatment, smoking status and co-existing hypertension, were also recorded.
Results: There were 212 patients with equal gender distribution and mean age of 55.90 ± 11.96 years. Of these, 117 (55.18%) lived in rural areas, 77 (36.32%) were educated, 34 (16.03%) were smokers and 121 (57.07%) had co-existing hypertension. The mean duration of diabetes was 81.72 ± 71.67 months (range 3-360 months) and mean HbA1c levels were 9.55 ± 2.56%. Higher HbA1c levels were associated with poorer DKQ scores. The level of education and the duration of diabetes significantly predicted DKQ scores.
Conclusion: Lack of disease awareness leads to poor glycemic control. Better education and longer disease duration impact the understanding of diabetes.
EFFECTIVE THERAPEUTIC INTERVENTIONS TO PROMOTE RECOVERY FROM FIRST PSYCHOTIC EPISODE AND MINIMIZE ITS RELAPSE: A QUALITATIVE STUDY FROM PAKISTAN
Authors: Khalil Rehana , Naeem Zahid , Jameel Nazia , Talib Uroosa 
Published: January 2022

Objective: To explore effective therapeutic strategies to promote recovery from first episode of psychosis and minimize its relapse.
Study Design: Qualitative study.
Place and Duration of Study: Karwan-e-Hayat Psychiatric Care and Rehabilitation Center, Karachi, from Mar to Jun 2019.
Methodology: Seventeen participants were recruited through purposive sampling and data was collected through in-depth interviews. Qualitative thematic content analysis was done through generation of a coding scheme.
Results: Almost half i.e., 8 (47%) had experience of 10 years, while 7 (41%) had 15 years’ experience, and 2 (12%) had 30 years’ experience as psychiatrists. Analysis of the interview transcripts revealed three main themes related to psychiatrists’ views on interventions for first episode of psychosis to prevent relapse: (1) duration of first episode of psychosis (2) compliance and rate of recovery after first episode (3) effective interventions for first episode psychosis.
Conclusion: The effective interventions to promote recovery from first psychosis episode and minimize its relapse included multiple combinations of integrated stage-specific approaches necessitating antipsychotics (pharmacological) and psychosocial support (non-pharmacological).
EARLY VERSUS DELAYED ORAL INTAKE IN PATIENTS AFTER CESAREAN SECTION UNDER REGIONAL ANESTHESIA
Authors: Hassan Laiqa , Tufail Shazia , Aslam Farheen , Mustafa Nilofar , Ahmed Arub , Qamar Saima 
Published: January 2022

Objective: To compare the outcome in early versus delayed oral intake in patients after cesarean section under regional anesthesia.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Obstetrics and Gynecology, Combined Military Hospital Lahore, from Dec 2017 to May 2018.
Methodology: A total of 352 women undergoing elective cesarean section under regional anesthesia, nil by mouth for at least 8 hours before surgery were divided in 2 groups. In group 1, patients were given sips of clear oral fluid (water) <5 hours after cesarean section and in group 2, patients received sips of water 8 hours following surgery. Bowel motility was assessed after surgery on hourly basis. Data about time interval to first bowel movement and ileus were noted.
Results: Mean age of patients was 32.329 ± 3.44 years and 33.051 ± 3.64 years in group 1 and 2 respectively. Mean gestational age and body mass index was 38.50 ± 0.93 weeks and 29.824 ± 4.97 kg/m2 in group-1 versus 37.937 ± 0.98 weeks and 27.779 ± 2.81 kg/m2 in group 2. Mean duration of surgery was 47.096 ± 6.65 minutes in group-1 and 47.647 ± 8.76 minutes in group 2. Ileus was seen in 17% patients in group-1 and 34.1% in group-2 (p<0.001). Mean time interval for first bowel movement was 8.323 ± 1.20 hours in group-1 and 13.034 ± 2.54 hours in group 2 (p<0.001).
Conclusion: Early feeding after an uncomplicated cesarean section has reduced rate of ileus symptoms and mean time interval for bowel......