bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prognostic factors of cerebral revascularisation in acute ischemic stroke at Hanoi Heart Hospital
Authors: Nga Vu Quynh , Hoa Tran Thanh , Hoa Pham Thi , Thao Le Thi 
Published: January 2022

Background: Considering the effectiveness of treatment for acute ischemic stroke (AIS)patients, the most expected method is immediate revascularization using intravenous thrombolysis or mechanical thrombectomy, or both methods. Objective: “Find factors related to post-treatment outcomes of acute ischemic stroke patients undergoing cerebral revascularization”. Method: Cross-sectional, prospective, descriptive analysis with convenient sample size. Results: From February 2018 to August 2021, 83 patients were hospitalized with a diagnosis of acute ischemic stroke or acute ischemic stroke and had cerebral revascularision either by thrombolysis or mechanical devices or both. 6.02% of them had cerebral thrombosis with mechanical devices and stenting of cerebral/carotid arteries. Mean age was 66.37±11.82 (range 31to 91 years). Mean NIHSS score was 12.57±6.70. The rate of complete recanalization was 91.56%. The mRS score of 0-2 points accounted for 48.19% at the time of discharge and 54.21% at 30 days after discharge. The rate of death or severe illness at discharge accounted for 14.45%. 30 days all-cause mortality after discharge accounted for 25.3%. Conclusion: The rate of complete reperfusion in patients with acute cerebral infarction at Hanoi Heart Hospital and good recovery rate is quite high. Factors that related to the treatment efficacy of patients with acute ischemic stroke were NIHSS score, ASPECT score, occlusion site, pre-reperfusion parenchymal damage and the selection of appropriate reperfusion measures.
Use of the HAS-BLED Score in Risk Stratifying Patients on Dual Antiplatelet Therapy After Coronary Stent
Authors: Hung Pham Nhu , Loan Nguyen Thi Thanh 
Published: January 2022

Objectives: Use of the HAS-BLED score in risk stratifying patients on dual antiplatelet therapy after stent placement.
Methods & Results: 304 patients who underwent stent placement from June, 2018 to December 2018. There is 6,57% patients with medium & severe bleeding. Area under the curve of HAS-BLED score (AUC); PRECISE-DAPT score and CRUSADE were sequential 0.59; 0,79 and 0,84 (p=0,0001) at post-PCI procedures; were sequential 0,72; 0,94 và 0,88 (p=0,00001) at less than 6 months after PCI procedures, and were sequential 0,87; 0,73 và 0,70 (p=0,0068) at more than 6 months after PCI procedures.
Conclusion: the HAS-BLED score was most useful for predicting bleeding in patients on on dual antiplatelet therapy after stent placement at more than 6 months after PCI procedures. PRECISE-DAPT score was most useful for predicting bleeding at less than 6 months after PCI procedures and CRUSADE score was most useful for predicting bleeding at post procedure.
Characteristics of postoperative pain after mini invasive and conventional mitral surgery in Hanoi Heart Hospital
Authors: Anh Phung Thi Hai , Huy Dang Quang , Ngoc Nguyen Minh , Thien Le Quang , Huyen Nguyen Thi Hoang , Duong Ngo Thi , Thu Phan Thi , Ngoc Luu Thi Nguyen 
Published: January 2022

Introduction: Mini invasive mitral valve surgery had some advantages over conventional surgery in recovery and cosmestic results. Postoperative pain was an interested factor for comparing these two methods, with reported results remained unclear. We realized this study for evaluate the characteristics of postoperative pain between mini invasive and conventional mitral surgery in Hanoi Heart Hospital.
Methods: A cross sectional study on patient underwent mitral valve replacement with mini invasive and conventional sternotomy approach.
Results: There were 66 patients in the study, divided into 2 group: 43 patient underwent conventional surgery and 23 patient underwent mini invasive surgery. Mean age was 50,7 ± 9,3, female was 78,8% and mean BMI was 20,9 ± 2,7. Erector spinae plane (ESP) block was performed on 16 patients (24,2%) of conventional surgery group. The VAS score at 3 days, 7 days , and 1 month after surgery was 7,7 ± 1,2; 5,2 ± 1,5; 0,9 ± 1,1 in sternotomy group and 6,6 ± 1,6; 3,8 ± 1,5; 1,7 ± 0,9 in mini invasive group, respectively. In patients with ESP block, mean dose of morphine administered in first two days was 0 and 2,3 ± 5,0 mg/kg comparing to the dose of 19,7 ± 5,5 và 17,7 ± 7,1 in sternotomy patients without ESP block.
Conclusions: Postoperative pain reduction may not be an advantage of mini invasive mitral surrgery comparing to conventional surrgery, but the time for pain suffering in this group was shorter. ESP was an efficient method for early pain reduction after conventional surgery.
Elevated C-reative protein (CRP) as a surgical indication for appendicitis
Authors: Shahida Khatoon  , Mujeeb ur Rehman  , Sohail Ahmed Memon  
Published: January 2022

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings.
Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017.
All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa.
Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001.
Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis.
Perceptions of COVID-19 Disease Among Patients in Isolation Ward
Authors: S H Waqar  , Isbah Rashid  , Muhammad Raheem  , Nasim Akhtar  , Minhaj us Siraj  
Published: January 2022

Objective: To explore the perceptions about COVID â€“ 19 disease among patients admitted in Isolation ward and to improve management ideas.
Methodology: This qualitative cross sectional interview based study was conducted at Isolation ward, Pakistan Institute of Medical Sciences Islamabad from April to June 2020. Patients who were reported positive for SARS COV-2 through nasopharyngeal or oropharyngeal swabs and were admitted for at least one day in isolation ward, were included in the study. Patients who were too ill to talk for the interview and those who could not survive the disease were excluded. After taking informed consent and following the standard operating procedures (SOPs) of Corona Isolation ward; data was obtained by conducting in depth interviews arranged as per patientsâ€™ convenience on mobile calls. Data was analyzed using Narrative Analysis. Themes were delineated and organized to groups for understanding.
Results: Twenty two patients participated with the mean age of 34.64Â±7.26 years. Majority of the patients had anxiety and fear for the COVID-19 disease however also were hopeful to face it. The delineated themes were anxiety & depression, fear, hopefulness & moving forward, health facilities & related issues, living in isolation and physiological disturbances like sleep, appetite, smoking or addiction, exercise.
Conclusion: Covid-19 patients depict mixed perceptions while admitted in Isolation ward and this provide us an insight to this catastrophic illness. Their experiences help the health authorities to address this issue.
Conventional Weight-Based versus Low-Dose Regimen of Heparin Administration to Achieve Target Activated Clotting Time on Cardiopulmonary Bypass in Pakistani Population
Authors: Musfireh Siddiqeh  , Wajahat Javed Mirza  , Javed Iqbal  , Imran Khan  , Ali R Mangi  
Published: January 2022

Objective: A weight-based dose of heparin is calculated to achieve target ACT (Activated clotting time) for establishing CPB (cardiopulmonary bypass). Whether a target ACT can be achieved with lower dose of heparin in Pakistani population was the aim of this study.
Methodology: The cross-sectional comparative study was conducted at Rawalpindi Institute of Cardiology, Department of Cardiac Surgery from 1st January 2019 to 1st January 2020. Three hundred thirty-six (336) patients undergoing elective open-heart surgeries on CPB were included in this study. Patients receiving weight-based heparin dose were placed in Group-A, while those on low-dose heparin were placed in Group-B. ACT was considered to have reached the target value in range of 400-480 seconds, values between 481-1500 seconds were considered excessive, whereas ACT of >1500 was regarded as potentially high-risk for peri-operative bleeding .
Results: 14.1% (n= 28) of Group-A patients achieved target ACT, whereas 58.3% (n=116) exceeded the target of 480. In 25.1% (n=50), ACT values were beyond the measuring capacity of the assay machine i.e. >1500. Only 2.5% (n=5) required additional dosage of heparin. Target ACT in Group B was achieved in 19.7% (n= 27), 55.5% (n=76) had excessive ACT values, whereas in 16.8% (n= 23), it was >1500. 9.5% (n=13) required an additional dosage of Heparin.
Conclusion: In Pakistani population, a target ACT can be achieved with significantly lower dose than the conventional weight-based heparin dose. Larger studies, preferably randomized controlled trials are needed to determine the optimal heparin dose calculation for safe anti-coagulation during CPB.
Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius
Authors: Zaigham Habib  , Shuja Uddin  , Riaz Qadeer Niazi  , Muneeb Ur Rehman  , Abdul Qadir  , Muhammad Kamran  
Published: January 2022

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires.
Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by â€˜non-probability, consecutive sampling techniqueâ€™ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire).
Results: The mean age in the group A and group B was 53.7 Â± 11.8 years and 55.2 Â± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05).
Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 monthsâ€™ postoperative period.
Confronting our mistakes: A comprehensive evaluation of radiographic errors in digital chest radiography among adult population in a public sector hospital
Authors: Liaqat Rabia , Majeed Ayesha Isani , Malik Muhammad Nauman , Shafi Aqeel , Shah Syeda Zakia , Liaqat Bushra 
Published: January 2022

Objective: To find out the various types of radiographic errors in digital chest radiography and their effect on image quality leading to image rejection.
Material and Methods: This cross-sectional study was carried out in Radiology department of Pakistan Institute of Medical Sciences for a period of One month, September 2019. The study included 1560 digital Chest X-Rays, reaching the Picture Archive and Communication System (PACS), fulfilling the inclusion criteria. All these X-rays were analyzed by two radiology residents for the presence of radiographic errors in them. The various radiographic errors were then classified as: Positioning error, poor collimation, Artifacts, improper exposure, motion blur and mislabeling. The frequency of each radiographic error was measured along with their implication on image quality resulting in three major image categories: ACCEPT, JUST ACCEPTABLE and REJECT. The SPSS was adopted for inferential statistical analysis.
Results: The study included 1013 (64.9%) male patients and 547 (35.1%) female patients. The mean age came out to be 36 +/- 15 years. Out of 1560 X-rays, 964 (61.8 %) had radiographic errors in them while 596 (38.2%) were completely devoid of radiographic errors. Positioning error (44.5 percent) was the most frequently encountered error followed by poor collimation (29.8%), artifacts (14.9%), Improper exposure (8%), motion blur (2.2%) and mislabeling (0.5%). The rejection rate came out to be 16.5 %. The major cause of image rejection was anatomy cutoff, especially the cut-off of cardio phrenic (CP) angle.
Conclusion: Positioning errors represent the commonest cause of image rejection in chest radiography. The main identified pitfall was lack of radiographerâ€™s education and training in performing an examination and indicates a need to improve their performance.
Key words: Digital Radiography, Chest X ray, Radiographic error, Image reject
Physical Exercise Activity to Increase The Handgrip Strength in Elderly Populaiton During Covid-19: A Prospective Study
Authors: Hamid Mehmood  , Muhammad Yaqoob  , Ejaz Mahmood Ahmad Qureshi  , Saleem Rana  , Syed Amir Gilani  
Published: January 2022

Objective: To determine palmar grip force (PGF) in elderly population and its correlation with different parameters used in the usual practice of evaluation of nutritional status in elderly populaiton.
Methodology: It was obsevational, cross-sectional study. 300 elderly people over 65 years old, who were doing gym exercises at UFC gym and Structure gym, Lahore from December 2019 to July 2020. HS was obtained using the digital dynamometer model EH101, using the average of three measurements. The cutoff point considered for low muscle strength was HS < 27 kg for men and < 16 kg for women. The standard has been taken according to the 2019 consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2, version 2019).
For the statistical analysis, the Statistical Package for Social Science 24.0 program was used and chi square test was applied, considering it significant when p <0.05.
Results: The sample consisted of elderly people with a mean age of 71.71 Â± 5.97 years, of which 28% were aged between 65 and 75 years and 51.66% were male. In the analysis of the HS, we found 57.9% of the elderly with loss of muscle strength due to non-exercise during COVID-19. The muscle circumference of the arm and tricipital skin fold indicators found the highest percentages of malnutrition, 44.1% and 57.8%, respectively. HS showed a positive association Â between age and handgrip test levels.
Conclusion: There was a high frequency of elderly people with impaired strength, but HS correlated only with APMT, not showing a direct relationship with other anthropometric parameters used in the routine practice of assessment with the elderly. Therefore, HS, or at least the evaluation of APMT, becomes indispensable for the evaluation and physical exercise training of elderly persons during COVID-19 pandemic.
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House Officersâ€™ Perspective of Leadership in Undergraduate Curriculum: A Qualitative Study
Authors: Sultana Rashida , Abid Ashar  
Published: January 2022

Objective: To explore the house officersâ€™ perspective about leadership skills and their development during undergraduate training.
Methodology: This qualitative study was conducted in September 2019. Two audio-recorded focus groups discussions were conducted with house officers; each comprised of six participants. Purposeful maximum variation sampling was used with equal coverage of gender including low and high scorers based on their academic records. Open-ended questions were asked with short follow-up questions. Verbatim transcription of the entire discussion was done, followed by content analysis. The findings were described using quotes, and illustrations. Member checking and triangulation with the frequency of quotes was used for validation.
Results: Leadership skills identified by the study participants were the same as priori themes given in â€œNHS-Medical Leadership Competency Frameworkâ€ namely â€œdemonstrating personal qualitiesâ€ 47 (38.84%) (Self-management, self-awareness, acting with integrity), working with others 37 (30.58%) (Communication skills, teamwork), improving services 16(13.22%) (Empathy, ensuring patient safety), management skills 12(9.92%) (Time management, resource management, managing critical situations) and setting direction 9 (7.44%) (Setting and achieving targets, decision making). The process of leadership development was explored in three dimensions i.e. contributing factors, potential obstacles, and suggested improvements to enhance leadership skills. The most common theme in all these domains was faculty-related followed by environment-related and student-related factors.Â
Conclusion: â€œFaculty-related factorsâ€ was the most emerging theme in contributing factors, potential obstacles as well as in suggested improvements for leadership development.
Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.
Authors: Muhammad Javaid Iqbal  , Muhammad Usman  , Mubarak Ali Anjum  , Yasir Yaqoob  , Ghulam Mujtaba Nasir  , Haroon Rashid Khan  
Published: January 2022

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes.
Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%.
Results: The mean age of liver disease patients was 52.35 Â± 13.64 years and in control group the mean age was 51.62 Â± 11.27 years. There was no significant (p-value > 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value < 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value < 0.05) less in cases group (163.5 Â± 90.4 vs 233.4 Â± 54.5 (x10*3/Âµl). The mean value of immature platelet fraction (IPF%) was significantly (p-value < 0.05) raised in cases group (5.62 Â± 2.92 vs 3.06 Â± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value < 0.05) association with chronic hepatis as compared to other liver related diseases.
Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients.
Role of the Uterine Artery Ligation (UAL) In Control of Postpartum Hemorrhage
Authors: Najma Bano Shaikh  , Maria Shabir Shaikh  , Farhana Shaikh  , Nabila Hassan  , Sajida yousfani  , Shabnam Shaikh  
Published: January 2022

Objective: To determine the efficacy and safety of uterine artery ligation (UAL) in control of Postpartum Hemorrhage.
Methodology: This case series study was conducted at Department of Gynecology and Obstetrics Peoples University of Medical & Health Sciences for Women Nawabshah. All the women age between 20-45 years, gestation duration at and beyond 34 weeks, antepartum hemorrhage; intraoperative atonic postpartum hemorrhage and discovery of a placenta accreta; or an adherent placental part after piecemeal removal of the placenta, with bleeding from the placental site were included. After failure of treatment from medical measures, the initial surgical approach of uterine artery ligation (UAL) was done. Efficacy was defined as positive when patient improves or clinically doesnâ€™t develop any complication throughout admission after UAL. Safety was assessed by appearance of side effects if any occurred after procedure. Data was recorded via study proforma and analysis was done by using SPSS version 20.
Results: Out of 76 patients admitted of postpartum hemorrhage mean age was 58 years. Most of the patients 59.2% were multiparous and 40.8% were primiparous. The most common cause of postpartum hemorrhage was uterine atony 56.5% and adherent Placenta accreta 43.42%. Most of the patients 81.6% had no postoperative complications except for 11 patients, who had developed gaping of the wound from which they recovered and discharged. The patients required hysterectomy due to intractable hemorrhage and 2.3% mortality was observed due to DIC.
Conclusion: Uterine devascularization by bilateral uterine artery ligation is a simple, effective and the safest initial surgical option with less blood loss and less surgical time for controlling postpartum hemorrhage during cesarean section. It should be used as the first surgical step of choice after medical managements fail in controlling postpartum hemorrhage due to minimal rate of complications and mortality.