bluuebunny/crossref_metadata_2025_split huggingface dataset:
COMPARISON OF OPTICAL BIOMETRY AND A SCAN FOR CALCULATION OF INTRAOCULAR LENS POWER IN AGE RELATED NUCLEAR CATARACT AT TERTIARY CARE EYE HOSPITAL
Authors: Rafique Aisha , Zafar Omar , Khan Summaya 
Published: January 2022

Objective: To compare optical biometry and A-scan for calculating intraocular lens power in patients with nuclear cataract at tertiary care eye hospital.
Study Design: Cross sectional comparative study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Pak Emirates Military Hospital, Rawalpindi, from Jul to Dec 2018.
Methodology: In this study 70 eyes of 70 patients planned for cataract surgery by phacoemulsification underwent both optical biometry with intraocular lens master and ultrasound biometry applanation by A scan after informed consent. Intraocular lens power calculated by these two methods of biometry was compared. Phacoemulsification surgery was performed through a 2.3 mm superior temporal clear corneal incision. All patients underwent in the bag implantation of the same intraocular lens type.
Results: The mean age of the patients was 62.89 ± 6.69 years. A significant (p-value<0.001) difference in intraocular lens power calculation was noted (20.96 ± 1.76 vs. 22.03 ± 1.61) with optical biometry and A-scan respectively. Association on the basis of age groups showed a significant (p-value<0.001) difference in both strata that was among patients having age ≤65 years and patients having age >65 years.
Conclusion: Optical biometry was found efficient and safe method for calculation of intraocular lens power. Optical biometry is noncontact method having very less chance of infection and suitable for most of the eye types.
UNILATERAL PROPTOSIS - A DIAGNOSTIC DILEMMA
Authors: Yasin Ubaid Ullah , Yaqub Muhammad Amer , Naqvi Syed Abid Hassan , Shahid Muhammad , Habib Asad , Awais Muhammad 
Published: January 2022

Objective: To study epidemiology, presentation and management of cases with unilateral proptosis presenting at a tertiary care hospital.
Study Design: Case series.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Jan 2016 to Dec 2017.
Methodology: Retrospective analysis of hospital record of patients with unilateral proptosis was carried out. Data was entered and analyzed in SPSS version 22. Chi square test was used for statistical analysis.
Results: Thirty-three cases of unilateral proptosis with a mean age of 41.79 ± 3.87 years were included in the study. Pain was the most common association. Proptosis was mild in 42.4%, moderate in 48.5% and severe in 9.1% cases. In 61% cases, diagnosis was made on excisional or incisional biopsy and on the basis of radio imaging in 39% cases. Most common cause of proptosis found was pleomorphic adenoma (12%). Patients with axial and non-axial proptosis were 48.5% and 51.5% respectively. Fourteen cases (42.5%) were managed surgically and 2 cases (6%) were observed. Total of 22 cases (67%) improved after treatment, 8 cases (24%) went into remission, 2 (6%) deteriorated, and 1 (3%) died in the study period.
Conclusion: Unilateral proptosis is a diagnostic challenge. Pertinent history taking and detail examination is the key, but associated signs or symptoms not always point towards correct diagnosis. Tissue biopsy provides a conclusive diagnosis especially where radio imaging is doubtful.
ESSENTIAL LEADERSHIP DOMAINS AND STRATEGIES TO ENHANCE LEADERSHIP SKILLS AMONG UNDERGRADUATE MEDICAL STUDENTS: A MIXED METHODS STUDY
Authors: Abbas Syed Muslim , Ashar Abid 
Published: January 2022

Objective: To explore medical undergraduate students’ perceptions pertaining to the key domains of leadership and highlight strategies to enhance leadership skills in undergraduate studies.
Study Design: Mixed methods study.
Place and Duration of Study: Fatima Memorial Hospital College of Medicine & Dentistry, Lahore, from Sep to Oct 2019.
Methodology: A total of 207 medical students were recruited from the first and final year by purposive sampling to fill out a structured questionnaire. Three focus group discussions were conducted comprising of twelve students in each group. All focus groups were audio-recorded, anonymized and transcribed verbatim before the analysis by framework analysis technique.
Results: Total fifty percent of the first-year students were of the view that ensuring patient safety was an important component of the leadership domain of improving services whereas only 11% responded as critically evaluating as a component of this domain. The themes that emerged pertaining to the strategies to enhance leadership skills included increasing awareness, role models depicting change, cultural challenges, and supplementing existing practices.
Conclusions: The validated essential domains of leadership and its associated competencies should be streamlined strategically and prioritized in accordance with the level of training of the undergraduate medical students. A multicentre study is suggested to gather data at the national level which could inform further development of inclusion of leadership domains within undergraduate MBBS curriculum.
AWARENESS AND PRACTICE OF PHYSICAL ACTIVITY AMONG MALE MEDICAL UNDERGRADUATES AT MAJMAAH UNIVERSITY, SAUDI ARABIA
Authors: Farhan Muhammad Asad , Kazmi Syed Yousaf , Irfan Abdul , Sami Waqas , Faraz Ali , Ali Muhammad Imram 
Published: January 2022

Objective: To probe the level of awareness and practice of the WHO recommendation for physical activity among male medical undergraduates at Majmaah University, Saudi Arabia.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: College of Medicine, Majmaah University, Kingdom of Saudia Arabia from Oct to Dec 2018.
Methodology: The study was conducted amongst 150 undergraduate medical students using a self-validated questionnaire.
Results: A total of 53 (35.33%) participants were found to be physically inactive while only 18 (12%) participants were adherent to WHO recommendations of physical activity for health benefits. Only 31 (20.66%) participants were correctly aware of the WHO guidelines for physical activity with health benefits. Football (n=47) and table tennis (n=20) were the sports played by the majority i.e., in 67 (44.66%) participants. The physically active participants encouraged peers for physical activity and preferred social media as a mean of spreading awareness about physical activity.
Conclusion: The awareness and the level of adherence of our male medical undergraduate students of physical activity according to the WHO’s guidelines are at par with the results of the national studies but much lower than the developed countries like the USA.
DENGUE FEVER OUTBREAK IN TWIN CITIES; A TERTIARY CARE CENTER EXPERIENCE
Authors: Khan Taimoor Ashraf , Nisar Shazia , Qureshi Muhammad Mahad , Samiullah Muhammad , Israr Muhammad 
Published: January 2022

Objective: To characterize the clinical presentations and laboratory markers (as disease predictors and markers) and severity of disease in patients admitted with dengue fever.
Study Design: Prospective observational study.
Place and Duration of Study: Department of Infectious Diseases, Pak Emirates Military Hospital Rawalpindi, from May to Oct 2018
Methodology: In our study, we included the patients treated for dengue fever. Data were recorded on predesigned proforma and analyzed using Microsoft excel 365 and Social Package for Statistical Sciences version 23.
Results: A total of 160 patients were included in this study, all were males. All cases were positive for Nonstructural Protein 1 Antigen. Symptoms seen in abundance were fever with rigors, chills, backache, retro-orbital pain, nausea and vomiting. Manual platelet count at admission ranged from 15-396 x 103 (mean 107.5 ± 6.8 x 103). Platelet count on discharge ranged from 102-577 x 103 (mean 207.9 ± 95.4 x 103). A total of 34 (21.25%) patients out of 160 confirmed and admitted dengue fever cases had Dengue Hemorrhagic Fever (Nonstructural Protein 1 Antigen positive, thrombocytopenia and leukopenia) and 2 patient went into dengue shock syndrome. The derangement in alanine aminotransferase and alkaline phosphatase levels were shown in 98 (61.2%) and 62 (31.2%) of patients. All these patients were immunoglobulin M and Nonstructural Protein 1Antigen positive.
Conclusion: Raised serum alanine aminotransferase and alkaline phosphatase levels along with early positive Nonstructural Protein 1 Antigen is a marker of disease severity.
EVALUATION OF CHANGES IN VISUAL ACUITY AND CONTRAST SENSITIVITY IN PATIENTS WITH KERATOCONUS AFTER CORNEAL COLLAGEN CROSS-LINKING
Authors: Javaid Hassaan , Zafar Omar , Akram Seemal , Khan Asfandyar , Abbas Sana , Rafique Aisha 
Published: January 2022

Objective: To evaluate changes in visual acuity and contrast sensitivity in patients with keratoconus after corneal collagen cross-linking.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, Pakistan, from May 2019 to Apr 2020.
Methodology: A total of 48 eyes of 30 patients with progressive keratoconus were included in this study. Baseline uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity were recorded, following which transepithelial corneal collagen cross-linking with topical riboflavin and ultraviolet A light was performed. Uncorrected distance visual acuity, corrected distance visual acuity and contrast sensitivity measurements were repeated and recorded 6-months postoperatively.
Results: Mean preoperative uncorrected distance visual acuity was 0.56 ± 0.27 logarithm of the minimum angle of resolution which improved to 0.51 ± 0.26 at 6 months after the procedure (p=0.002). Mean corrected distance visual acuity was 0.30 ± 0.19 preoperatively, improving to 0.24 ± 0.18 (p=0.001) at 6 months after corneal collagen cross-linking, thereby depicting a statistically significant improvement. Treated eyes also showed a significant improvement in contrast sensitivity (p=0.001) of 0.05 ± 0.08 logarithmic units of contrast sensitivity, from a mean preoperative contrast sensitivity of 1.72 ± 0.10 to 1.77 ± 0.09 when evaluated 6 months after corneal collagen cross-linking.
Conclusion: Corneal collagen cross-linking is a promising advancement in the treatment of keratoconus. It was found effective in significantly improving visual acuity as well as contrast sensitivity, thus enhancing visual outcomes in keratoconus.
EXPERIENCE OF SURGICAL TRACHEOSTOMY IN COVID-19 HOSPITAL
Authors: Niazi Saleem Asif , Riaz Yausra , Maqbool Shahzad , Khan Zafar Ullah , Sharif Asjad , Aasim Muhammad Umar , Sajjad Kaswar , Zaman Shafaq 
Published: January 2022

Objective: To share our experience of tracheostomy in COVID-19 positive patients.
Study Design: Prospective observational study.
Place and Duration of Study: Pak-Emirates Military Hospital, Rawalpindi Pakistan, from Apr to Jul 2020.
Methodology: A total of 94 COVID-19 positive cases admitted to the Intensive Care Unit of this hospital, placed on ventilatory support and who ultimately underwent tracheostomy (whether percutaneous or surgical) were included in the study. Patients were included irrespective of any age group or gender.
Results: Out of 94 patients placed on ventilator, tracheostomy was performed only in 17 patients. Male predominance was 13 (76%), with mean age of patients as 55.59 ± 12.93 in 12 patients, surgical tracheostomy was performed (70.58%) whereas in 5 (29.4%) cases percutaneous tracheostomy was done. On post-operative follow-up 8 out of 17 (47%) patients recovered and were successfully decannulated whereas 9 (52.9%) patients could not survive. Tracheostomy was successfully performed as early as 8th day of mechanical ventilator support. Health Care Workers (HCWs) involved were subjected to RT-PCR and remained negative for SARS- CoV-2. There was statistically significant association between the type and indication oftracheostomy, p=0.002.
Conclusion: Tracheostomy, in COVID-19 positive patients, being aerosol- generating procedure remains a medical hazard for the HCWs. By following strict safety protocols according to the medical resources available and training of the HCWs, it can be performed with complete safety. It can be done as early as 8th day of ventilator support.
MAINTENANCE OF ANTI-RETROVIRAL THERAPY (ART) TO HIV PATIENTS AND THEIR PREVENTIVE PRACTICES AGAINST COVID-19 PANDEMIC - A SYNDEMIC PERSPECTIVE FROM A HIV CENTER IN PAKISTAN
Authors: Maroof Saira , Mahmood Humaira , Nigar Hira , Mashhadi Syed Fawad , Arshad Syma , Iftikhar Asma 
Published: January 2022

Objective: To see the implementation of designed strategy for uninterrupted supply of HIV treatment at time of COVID-19 Pandemic along with the knowledge and preventive practices regarding COVID-19 among HIV positive patients to have baseline data for future interventions to control HIV-COVID-19 syndemic.
Study Design: Cross sectional study.
Place and Duration of Study: HIV Center at Benazir Bhutto Shaheed Hospital, Karachi Pakistan, from Mar to May 2020.
Methodology: 100 patients who visited the center for medicines were interviewed. Participants were inquired about the availability of Antiretroviral Therapy (ART) during lockdown, discontinuity in treatment suffered during this pandemic, their preventive behaviour against COVID-19, most adopted prevention and source of information for this behavior.
Results: Among all the participants 72% have achieved viral suppression. As far as multi month dispensing was concerned 10% received ART for one month, 64% for 2 months and 18% for 3 months as per the strategy devised by Pakistan AIDS control in collaboration with UNAIDS. Out of 11% developed symptoms but later on tested negative on PCR test. Most commonly adopted personal protection adopted was face mask among 68% participants followed by hand washing and social distancing. All the participants were of the opinion that they received sufficient information regarding COVID-19, its prevention and mode of spread. The source of information was TV 60%, HIV center 30% and both TV and HIV center 10%.
Conclusion: It was found that all the patients got uninterrupted supply of anti-retroviral medicines. Despite sufficient knowledge regarding disease they couldn’t comply with........
EFFECT OF SINGLE-DOSE PREGABALIN ON POSTOPERATIVE PAIN IN DACRYOCYSTORHINOSTOMY SURGERY
Authors: Abbas Sana , Naeem Saquib , Akram Amjad , Abbas Beenish , Iqbal Rashid 
Published: January 2022

Objective: To evaluate the analgesic potential of pregabalin in ambulatory dacryocystorhinostomy surgeries under general anaesthesia.
Study Design: Quasi-experimental study.
Place and Duration of Study: Tertiary Care Hospital Rawalpindi, from Nov 2019 to Sep 2020.
Methodology: A total of 110 patients undergoing ambulatory dacryocystorhinostomy surgery at our hospital were included in the study. Participants were divided into two groups, group A (n=55) were administered 150 mg oral pregabalin, while a placebo was given to participants of group B (n=55). Post-operative pain was assessed at recovery, four and eight hours after surgery with the help of the visual analogue scale.
Results: Mean age of participants was 43.05 ± 7.5 years. Gender wise distribution showed 62 (56.4%) males and 48 (43.6%) females. At recovery, four and eight hours after surgery the mean pain scores in group A (pregabalin) vs group B (placebo) were (2.98 ± 0.8 vs 4.98 ± 0.8, p<0.001, 2.67 ± 0.6 vs 5.02 ± 0.8, p<0.001 and 1.49 ± 2.9 vs 2.95 ± 0.8, p<0.001 respectively). Opioid administration frequency in trial versus placebo group was [11 (20%) vs 32 (58.2%), p<0.001].
Conclusion: Pregabalin has analgesic potential moreover decreased postoperative consumption of opioids and associated adverse effects such as nausea and vomiting. Hence making it a suitable agent for pain relief in ambulatory surgeries.
EFFECT OF PART-TIME PATCHING THERAPY ON VISUAL OUTCOME IN PATIENTS WITH ANISOMETROPIC AMBLYOPIA VISITING AFIO RAWALPINDI
Authors: Ashraf Ammarah , Masud Hannan , Rabbani Shafaq , Noor Palwasha 
Published: January 2022

Objective: To determine the effect of amblyopia patching therapy on visual outcome in young and adults at 6th and 12th week.
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology Rawalpindi, Pakistan, from Sep 2018 to Jan 2020.
Methodology: Out of 110, follow up was successfully completed by 91 eyes. Subjects were divided into young and adult based on age. Age ranging from 5-12 years included in the young group and adult group included those ranging from 13-20 years. Anisometropic amblyopia was considered. Amblyopia due to any other disease were excluded. Subjects were advised patching therapy daily for 4 hours in the affected eye. Follow up was 3 weekly for 12 weeks and the effect of patching therapy was assessed by visual improvement. Statistical analysis was done with SPSS version 21.
Result: Out of 91 eyes with amblyopia, 51 (56.6%) were included in the young group while 40 (43.4%) were included in the adult group. In the young group, visual improvement was seen in 40 (78.4%) while in the adult group 24 (60%) showed improvement in vision. Mean visual improvement in young was 1.66 ± 1.099 while 1.03 ± 0.944 in the adult group. Maximum visual improvement in both groups was seen till the 6th week of patching.
Conclusion: Patching therapy is effective even at later ages too. However, continuing patching for more than 6 weeks doesn’t show much improvement in vision.
IMPACT OF ENDEMICITY OF ASCARIASIS ON DIAGNOSIS OF ACUTE APPENDICITIS
Authors: Ahmed Naveed , Gul Mian Sarfraz , Pervaiz Hafiz Khalid , Ahmed Iftikhar , Ali Mujahid Zulfiqar , Ali Shafaqat 
Published: January 2022

Objective: To determine the impact of endemicity of ascariasis in the manifestation of acute appendicitis.
Study Design: Prospective observational study.
Place and Duration of Study: General Surgery Department, Combined Military Hospital Skardu, from May 2012 to Apr 2015.
Methodology: Patients presenting with symptoms of acute appendicitis were included in the study. Patients were diagnosed after taking detailed history, clinical examination and blood chemistry. All the patients underwent open appendectomy under general anesthesia. Per-operatively presence of worms was assessed in terminal ileum and after that in the lumen of the appendix initially by palpation and then by opening its lumen after it was removed. Histopathologic diagnosis could not be confirmed due to its non-availability as the surgeries were performed in a remote and resource constraint area of the country.
Results: A total of 224 patients were included in the study. Out of these, 143 (63.8%) were male and 81 (36.1%) female patients. The mean age of patients was 22 ± 6 years. Per-operatively, 21 (9.3%) patients had worms in both ileum and appendicular lumen while 22 (9.8%) patients had worms only in the terminal ileum and there were no worms seen in either ileum or appendix in 181 (80.8%) patients.
Conclusion: There is a relation of parasitic infestation especially Ascaris lumbricoides in the manifestation of acute appendicitis in endemic areas.
A STUDY ON COMPARATIVE YIELDS OF STANDARD SHORT TERM ELECTROENCEPHALOGRAM AND LONG TERM ELECTROENCEPHALOGRAM RECORDING IN SUSPECTED EPILEPSY PATIENTS
Authors: Shafait Saima , Alamgir Wasim , Ahmad Imran , Arif Saeed , Liaqat Jahanzeb , Hashmat Asif 
Published: January 2022

Objective: To compare the yield of interictal epileptiform discharges on prolonged (1-2 hours) electroencephalogram (EEG) as compared to standard routine (30 minutes) electroencephalogram (EEG).
Study Design: Comparative observational study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi from Oct 2019 to Sep 2020.
Methodology: A total of 364 outdoor patients with suspected epilepsy were recruited for the study. Out of these 55 electroencephalograms were excluded after applying exclusion criteria and 309 were included for final analysis. Electro-encephalograms were recorded using a 10-20 international system of electrode placement. The duration of each standard electroencephalogram was 30 minutes. It was followed by recording for an extended period of 60 minutes at least. The time to the appearance of the first abnormal interictal epileptiform discharge was noted. For analytical purposes, epileptiform discharges were classified as “early” if they appeared within the first 30 minutes and as “late” if appeared afterward. All electro-encephalograms were evaluated independently by two neurologists.
Results: A total of 309 electroencephalograms were included for final analysis. Interictal epileptiform discharges were seen in 48 (15.6%) recordings. The mean time to appearance of first interictal epileptiform discharge was 14.6 ± 19.09 minutes. In 36 (11.7%) cases, discharges appeared early (within the first 30 minutes) whereas in the remaining 12 (3.9%) cases, discharges appeared late. This translates into a 33% increase in the diagnostic yield of electroencephalogram with an extended period of recording.
Conclusion: Extending the electroencephalogram recording time results in a significantly better diagnostic yield of outdoor electroencephalogram.
IMMUNOHISTOCHEMICAL EXPRESSION OF BRAFV600E IN MELANOMA CASES
Authors: Ch Muhammad Umer , Akhtar Farhan , Jamal Nighat , Ahmad Rabia , Bukhsh Sumaira , Mansur Hamza 
Published: January 2022

Objective: To evaluate the diagnostic value of Immunohistochemistry (IHC) for finding BRAFV600E mutation in melanoma patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Histopathology, Armed Forces Institute of Pathology, Rawalpindi Pakistan, Jan 2018 to Apr 2019.
Methodology: Hundred histologically confirmed cases of melanoma aged between 18-80 years were included over a period of one year. To create the tissue microarray and to conduct immunohistochemistry with VE1 antibody melanoma lesion samples were selected.
Results: Ninety-four cases out of 100, were melanoma positive for BRAFV600E detected on immunohistochemistry (IHC) using a monoclonal antibody. The skin was the primary site in seventy-nine (79%) patients, unknown (metastatic) in nineteen and uveal was only in two cases. The diagnostic significance of immunohistochemistry (IHC) for detecting the BRAFV600E mutation in melanoma patients was independent of age, site and stage at diagnosis (p-value <0.05).
Conclusion: Testing of BRAV600E mutation by immunohistochemistry is a rapid, reliable and cost-effective tool in melanoma patients which may further help clinicians in initiating targeted therapy for these patients.