bluuebunny/crossref_metadata_2025_split huggingface dataset:
Role of Sonographic Measurement of Fetal Foot Length in Estimating Gestational Age: A Hospital Based Study in South Punjab
Authors: Nadeem Syed Farrukh , Babar Taimur Hussain , Khan Amir Ali , Asim Muhammad Umar , Malik Muhammad Jalil , Ahmad Muhammad Iftikhar 
Published: December 2022

OBJECTIVE: To highlight the usefulness of ultrasonographic measurement of fetal foot length in determining fetal gestational age.
STUDY DESIGN: Prospective validation study
PLACE AND DURATION OF STUDY: Radiology Department Combined Military Hospital Bahawalpur from 01July 2020 to 31Dec 2020.
METHODOLOGY: Women referred from our obstetrics OPD for antenatal ultrasound between 16 to 40 weeks were scrutinized through inclusion and exclusion criteria for selection in the study. Record of their age, parity, gestational age by LMP and sonographic measurement of fetal foot length were endorsed on a study proforma. After the end of study period, the data was entered in SPSS version 20 to measure Pearson correlation coefficient and R2 values for highlighting the correlation between two variables. P value < 0.01 is taken as significant.
RESULTS: A total of 153 patients were included in the study. Mean age of patients in our study is 28.64 years and second parity is most frequent being 41.8%. Data entered in SPSS version 20 for regression analysis. Pearson correlation coefficient (R) is 0.988 and R2 value is 0.977 (P- 0.000) which shows powerful linear correlation between our two variables.
CONCLUSION: The results of our study shows excellent reliable linear correlation between fetal foot length and gestational age by LMP. Therefore, the fetal foot length so measured by ultrasonography can be used confidently for determination of gestational age in routine or when other ultrasonographic measurement parameters become unreliable.
KEYWORDS: Fetal foot length, Gestational age, Ultrasonographic age estimation.
Comparison of Kangaroo Mother Care with Conventional Care in Newborns in Terms of Frequency of Successful First Breastfeeding and Time to Initiate Breast Feeding
Authors: Iqbal Amjad , Iqbal Tehreem , Bashir Faisal , . Bilqees , Aslam Shahid , Anjum Sehrish 
Published: December 2022

Objective: To compare kangaroo mother care with conventional care in newborns regarding the frequency of successful first breastfeeding and time to initiate breastfeeding.
Study Design: Quasi-experimental study.
Place and Duration of Study: Departments of Pediatrics and obstetrics CMH Bahawalpur from Feb 2019 to Jun 2020.
Methodology: 120 infant-mother couples were included in the study. Sixty infant-mother couples were randomly allocated to each group (120 infants). Group A was nursed with kangaroo mother care (KMC), and Group B was nursed with conventional care (CC). The frequency of the first successful feed was assessed, and the time taken to initiate breastfeeding was documented.
Results: There was no statistically significant difference in weight, gestational age and gender distribution between the two groups. 65 (54.25%) infants had successful first breastfeeding in the study population. 38 (63.3%) of the infants had first successful breastfeeding as per the Infant Breast feeding Assessment Tool (IBFAT) in group A (KMC) as compared to 27 (45%) in group B (Conventional Care). The difference between the two groups was statistically significant, with a p-value of 0.044. Mean time for first successful breastfeeding was significantly less for the KMC group as compared to the conventional group with a p-value of <0.001. Kangaroo mother care resulted in a higher frequency of successful first feed, and meantime for initiation of feeding was also less than conventional care.
Challenges Faced by Post-Treatment Childhood Cancer Patients and Families; The Children's Hospital, Lahore Experience
Authors: Kashif Muhammad , Faizan Mahwish , Zafar Huma , Saeed Maria , Shahid Fatima 
Published: December 2022

Objective: To assess challenges faced by post-treatment childhood cancer patients and families in a developing country.
Study Design: cross-sectional study.
Place and Duration of Study: The Children's Hospital and the Institute of Child Health Lahore, from Jul to Dec 2020.
Methodology: 105 children and their parents were enrolled on OPD of the Department of Paediatric Hematology and Oncology. The parents were questioned regarding the duration of follow-up after treatment and the challenges they faced during this interval in association with socioeconomic dynamics, education and awareness of parents, travelling distance from the hospital, behavioural changes in children, toxicities/disabilities due to treatment, effect on other siblings, and various factors.
Results: In this study, the mean age of children was 9.40 ± 2.90 years. There were 55 (52.4%) males while 50 (47.6%) females. There were 35 (33.3%) children who had acute lymphocytic leukaemia, while 15 (14.3%) with Hodgkin Lymphoma, 12 (11.4%) with Wilms tumour, 10 (9.5%) with Non-Hodgkin Lymphoma, 9 (8.6%) with germ cell tumour and 7 (6.7%) with acute myeloid leukaemia. Mostly, 89 (84.8%) children received chemotherapy, while 12 (11.4%) children received chemotherapy as well as radiotherapy, and 4 (3.8%) children underwent surgery along with other treatments. The distance from the hospital was more than 50 km in >90 cases. Moreover, 42 (40.0%) children were found malnourished. Out of 105, 71 parents reported that the treatment affected their jobs, while 52 (49.5%) parents had to change their residence. The family's economic status wasaffected in 77 (73.3%) cases because of the treatment...........
The Burden of Gastrointestinal, Hepatobiliary and Pancreas Related Diseases and Their Causes at Tertiary Care Hospital in Karachi
Authors: Zakir Muhammad Fahad , Karim Shahid , Kalwar Hamid Ali , Wadhwa Rajesh kumar , Furqan Muhammad , Baloch Muhammad Hussain 
Published: December 2022

Objective: To determine the burden of gastrointestinal, hepatobiliary and pancreas-related disease, frequencies and their presentations.
Study Design: Cross-sectional study.
Place and Duration of Study: Gastroenterology Department, Liaquat National Hospital, Karachi from Oct 2020 to Jul 2021
Methodology: Patients aged ≥18 years, having diagnosis related to gastrointestinal, hepatobiliary and pancreas were included in the study. Demographic features, reasons for admission, and length of stay were recorded.
Results: A total of 2183 patients were enrolled. Nearly half of the patients were ≥60 years. 43% of patients were presented with abdominal pain. The most frequent diagnosis includes decompensated chronic liver disease followed by upper gastrointestinal bleed. The proportion of female patients was significantly higher for gastritis (p=0.009) and acute cholecystitis (p=0.036), while males with Hepatitis-B (p=0.019) and liver abscesses (p=0.018) were significant. Admissions through emergency were higher for gastrointestinal bleeding and decompensated chronic liver disease (p<0.001) in monitoring setup (p=0.034), ward admission via OPD were significant for upper gastrointestinal malignancy (p=0.011) and hepatocellular carcinoma (p=0.038). Extended length of stay and expiry was significant among acute liver failure (p=0.047) and gastric outlet obstruction (p=0.030).
Conclusion: Notably, highly evitable diseases are still a foremost reason of clinical importance, lack of awareness and low cure rate, especially in rural areas progress to high fatality as most patients do not seek medical assistance until significant manifestation. This appeals to more effective measures, including eradicating the potentially life-threatening disease.
Topical Betamethasone Valerate 0.1% W/V vs. Topical Ketoconazole 2% W/V: A Comparison of Efficacy in Patients of Seborrheic Dermatitis
Authors: Rizwan Muhammad , Ali Amanat , Ahmad Najia , Tahir Moizza 
Published: December 2022

Objective: To compare the efficacy of topical Betamethasone valerate 0.1% w/v and topical Ketoconazole 2% w/v in patients of seborrheic dermatitis.
Study Design: Comparative prospective study.
Place and Duration of Study: Department of Dermatology, Pak Emirates Military Hospital Rawalpindi Pakistan from Feb to Aug 2019.
Methodology: A total of 80 patients of both genders with seborrheic dermatitis were included. Patients were divided into two groups randomly, with 40 patients in each group. Group-A patients were given topical Betamethasone valerate 0.1% w/v, while patients in Group-B were given topical Ketoconazole 2% w/v for 12 weeks. Data regarding efficacy was assessed after 12 weeks per operational definition from both groups and noted.
Results: The mean age of patients in group A was 34.45 ± 6.73 years, and in the Group-B was 32.18 ± 6.07 years. The majority of the patients, 54 (67.50%), were between 15 to 35 years of age. Efficacy of Group-A (topical Betamethasone valerate 0.1%) was seen in 35 (87.50%) patients while in Group-B (topical Ketoconazole 2%) efficacy was seen in 25 (62.50%) patients (p-value = 0.010).
Conclusion: This study concluded that the efficacy of topical Betamethasone valerate 0.1% w/v is higher than topical Ketoconazole 2% w/v in patients with seborrheic dermatitis.
Association Between Oct-Based Microangiography Perfusion Indices and Diabetic Retinopathy Severity in Patients with Diabetes in Pakistan
Authors: Tahir Tooba Bint , Muzaffar Waqar , Ashraf Ammarah 
Published: December 2022

Objective: To assess the relationship between capillary perfusion of retinal vessels and severity of diabetic retinopathy with the help of Optical Coherence Tomography angiography.
Study Design: Cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi Pakistan, from Feb 2020 to Apr 2021.
Methodology: Seventy-three eyes of 37 subjects suffering from diabetes had their imaging done with Rtvue Avanti OCT angio system. Socio-demographic and clinical data was gathered. Subjects were divided into three groups depending upon the severity of diabetes. The perfusion index (PI) was taken as percent area coverage by retinal vessels with the flow.
Results: Out of a total of 73 eyes, 31 (42.5%) had none to mild Non-Proliferative Diabetic Retinopathy, 19 (26%) with moderate to severe Non-Proliferative Diabetic Retinopathy and 23 (31.5%) with Proliferative Diabetic Retinopathy. The mean age of the participants was 58.09 ± 10.32 years, with best corrected visual acuity as 0.35 ± 0.35 and Blood Sugar Random as 200.46 ± 70.71. BCVA showed a significant positive correlation with Perfusion Index (p=0.026). No significant association/relationship was found between the severity of diabetic retinopathy and perfusion index in this data (p=0.26).
Conclusion: No statistically significant relationship was found between Perfusion Index (PI) and severity of diabetic retinopathy.
The Spectrum of Toxicological Analysis in a Tertiary Care Setting-Pakistan
Authors: Fatima Safia , Hafeez Ayesha , Aamir Muhammad 
Published: December 2022

Objective: To determine the frequency of opiate, cannabinoid, amphetamine, benzodiazepine, barbiturate, organophosphate, alcohol and related drugs of abuse poisonings in the tertiary care setting.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Toxicology & Therapeutic Drug Monitoring, Armed Forces Institute of Pathology, Rawalpindi, from Apr 2014 to Mar 2019.
Methodology: Random sampling was done, and specimens of blood in an EDTA bottle, urine in a plain container and gastric lavage in a syringe were collected for drugs of abuse (Opiate, Cannabinoid, Amphetamine, Benzodiazepine, Barbiturate, Organophosphate) and alcohol. The screening was done on fluorescence immunoassay and Microarray Technology, while confirmation was done on Liquid Chromatography-Mass Spectrometry/Mass Spectrometry (LC-MS/MS) for all drugs of abuse except alcohols and Gas Chromatography (GC-Head space) for alcohols.
Results: 146,601 toxicological tests were divided into two categories according to request forms; clinical toxicological cases 92,333 (63 %) and forensic toxicology 54,268 (37%). The maximum no of cases were routine toxicological analysis of blood, urine, and gastric lavage, 89,169 (60.8%) tests, and emergency toxicology cases were only 1,708 (1.2%) tests in clinical toxicology. Forensic toxicology included a maximum of no cases of routine workplace testing (two drug panel testscannabinoid and opiate) 43,850 (29.9%), and post mortem toxicology cases were only 6912 (4.7%). The frequency of benzodiazepine poisoning was maximum 1390 (28.5%) than cannabinoid and opiate poisoning, i.e., 180 (3.7%) and 210 (4.3%) respectively, in clinical toxicology cases. The frequency of benzodiazepine poisoning was still maximum 501 (22.2%) than Cannabinoid, Amphetamine and opiate poisoning, which were....
Determine the Effect of Tramadol Injection as Adjuvant Anesthetic and Analgesia Following Surgical Removal of Mandibular Third Molar
Authors: Khan Kaleem Ullah , Babar Adnan , Yasir Syed , Meraj Wajid 
Published: December 2022

Objective: To establish the efficacy of mean pain control after submucosal tramadol injection compared to placebo after surgical removal of the impacted third molar.
Study Design: Quasi-Experimental Study.
Place and Duration of Study: Department of Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Feb to Aug 2018.
Methodology: All the patients had symmetrical bilateral impactions of the third molar on an orthopantomogram. The surgical site was randomly selected, and those in Group-T received Tramadol injection submucosally adjacent to the extraction socket immediately after the first tooth extraction, and Group-P received Saline. After the second extraction, Group-T received a Saline injection, and Group-P received Tramadol in the same manner. Patients were followed 24 hours post-operative for pain grading at 2, 4 and 24 hours, frequency and concentration of analgesic intake and duration of anaesthesia.
Results: Mean age of participants was 23.80±2.80 years. Means of pain intensity of Group without Tramadol after 2, 4 and 24 hours of extraction are 8.40±0.90, 6.30±0.40 and 2.10 ± 0.40, respectively, and those with Tramadol are 5.90±0.50, 4.50±0.30 and 1.60±0.40 respectively.
Conclusion: Our study concluded that Tramadol was more effective in providing analgesia after third molar surgery than local anaesthesia alone.
Efficacy of Voided Urine Cytology Compared to Cystoscopic Findings in the Detection of Bladder Cancer- A Pakistani Perspective
Authors: Khizar Samina , Mirza Zahoor Iqbal , Ahmed Hussain , Murtaza Badar , Yasrab Muhammad , Shahzad Khubaib 
Published: December 2022

Objective: To compare the efficacy of voided urine cytology with findings of cystoscopy and histopathology of biopsy specimens in the diagnosis of bladder cancer.
Study Design: Comparative cross-sectional study
Place and Duration of Study: Armed forces Institute of Urology (AFIU), Rawalpindi Pakistan from Jan 2019 to Jan 2020.
Methodology: All patients presenting to the urology clinic with complaints of haematuria, visible and non-visible, and any radiologic evidence of bladder growth were included in the study after informed consent. Urine cytology was performed for all patients, followed by cystoscopy under anaesthesia, transurethral resection was conducted, and biopsy was taken where needed.
Results: 170 patients were included in the study134 (78.8%) were males, while 36 (21.2%) were females. The mean age was 54 ± 9.47 years (range 36 to 73 years). The overall sensitivity of voided urine cytology was 46.7%, while specificity was 79.2%. The positive predictive value was 85.1%, and the negative predictive value was 36.9%.
Conclusion: Bladder cancer is a disease which demands an early diagnosis, prompt treatment, and long-term follow-up. Cystoscopy remains the gold standard for this purpose; urine cytology can be used as a supplement as it is non-invasive, more specific and cost-effective.
Post-Operative Infection Rate Between Single Dose Versus Multiple Dose Antibiotic Therapyin Patients Undergoing Laparoscopic Cholecystectomy
Authors: Haider Rehan , Masud Mannan , Hasnain Mohammad Rashhid , Khan Muhammad Tariq , Wyne Adeel , Ehsan Ayesha , Kazmi Zahra , Raza Syed Asim 
Published: December 2022

Objective: To compare the frequency of post-operative infection rate between single dose versus multiple dose antibiotic therapy in patients undergoing laparoscopic cholecystectomy.
Study Design: Comparative prospective study.
Place and Duration of Study: Surgical Department, Combined Military Hospital, Lahore Pakistan from Oct 2017 to Feb 2020.
Methodology: Patients of both genders undergoing laparoscopic cholecystectomy for simple cholelithiasis were included. Group-A patients underwent laparoscopic cholecystectomy using single-dose prophylactic antibiotic therapy with 2-gram 3rd generation cephalosporin at the time of induction of anaesthesia. In contrast, Group-B patients underwent laparoscopic cholecystectomy using 2-grams of 3rd generation Cephalosporin intravenously at the time of induction of anaesthesia followed by intravenous 1-gram Ceftriaxone two doses 12 hours apart. All patients were followed up on the first postoperative day, and then 1-week and 2-week follow up were done for any surgical site infection.
Results: Patients in Group-A had a mean age of 37.12±6.53 years, while patients in Group-B had a mean age of 37.74±6.40 years. The post-operative infection rate in Group-A (single dose antibiotic therapy) was seen in 08 (4.28%), while in Group-B (multiple dose antibiotic therapies) was seen in 18 (9.63%) patients (p-value = 0.042).
Conclusion: This study concluded that the single-dose prophylactic antibiotic is as good as multiple-dose antibiotic therapy used as prophylaxis for the prevention of post-operative infection rate among patients with cholecystectomy done via the laparoscopic method.
Comparison of Respiratory Complications of COVID-19 among Patients with Rheumatological Conditions Taking Biological Disease-Modifying Anti-Rheumatic Drugs and Conventional Synthetic Disease-Modifying Antirheumatic Drugs
Authors: Cheema Ahmed Ammar , Fakhr Amer , Khan Muhammad Shahid , Shahbaz Shanzah , Ahmed Syed Nazir , Hussain Muhammad Zahid 
Published: December 2022

Objective: To compare the respiratory complications of COVID-19 among patients with rheumatological conditions taking bDMARDs and csDMARDs at Pak Emirates Military Hospital Rawalpindi.
Study Design: Comparative prospective study.
Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan from Mar to May 2020.
Methodology: Patients diagnosed with COVID-19 on polymerase chain reaction having previously rheumatological conditions managed either with bDMARD or cs DMARD were included in the study. They were followed up for three weeks after the positive polymerase chain reaction. Complications leading to the use of oxygen or ICU support or death were compared in both groups of patients.
Results: A total of 82 patients with any rheumatological condition managed either with bDMARD or csDMARD tested positive for covid-19 on polymerase chain reaction and were included in the final analysis. 30 (36.6%) patients were taking bDMARDs while 52 (63.4%) were taking csDMARD. In addition, 4 (4.8%) low dose oxygen therapy, 5 (6.1%) required moderate dose oxygen therapy, while 5 (6.1%) required severe dose oxygen therapy or intensive care unit support. 2 (2.4%) patients died within the three weeks. The requirement of moderate or severe dose oxygen and intensive care unit support was found statistically significantly more in the group taking csDMARDS.
Conclusion: The presence of complications of COVID -19 and the requirement of oxygen and intensive care unit support were present in some of the patients taking DMARDs. Among the DMARDs, bDMARDs were less linked with complications, but large studies with better design required better results.
Comparison of Outcomes in Primary Extensor Tendon Repair of Hand Treated in a Tertiary Care Hospital
Authors: Khursheed Roqayyah Munawwer , Akhlaq Ali Khan Faisal , Ali Hyder , Kumar Suneel , Zahid Zaara , Ansari Muhammad Kamran Ullah 
Published: December 2022

Objective: To determine different treatment outcomes of early extensor tendon repair according to the zone of injury.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Plastic Surgery, Dr Ruth K.M. Pfau Civil Hospital, Karachi Pakistan, from Jun 2019 to May 2020.
Methodology: Seventy-four patients, more than 17 years of age and either gender, presenting to the emergency department of a tertiary care hospital for repair of lacerated extensor tendons of hand were enrolled in the study. All the procedures were performed in an operating room under general or local anaesthesia by a consultant plastic surgeon with experience of 5 years. Tendon repairs were performed using modified Keisler's technique. After wound closure, hand splinting was provided for six weeks. Outcomes were assessed per Miller's Classification at six weeks, two months, and three months post repair and classified as excellent, good, moderate and bad.
Results: The mean age of study participants was reported as 30.69±12.86 years. Zone II (36.4) and VI (47.2) were the most common location of laceration. Of all patients with Zone II lacerations, 33.3 achieved excellent outcomes, and 29.5 achieved a good outcome. Further, in patients with zone VI, 68.5 of the patients achieved good to excellent outcomes.
Conclusion: According to Miller's Classification, the study showed excellent results with zone IV and II injuries. Zone V and 8 had good outcomes, whereas zone I and II showed moderate to bad outcomes. There was no statistical association between the proportions of outcomes and zone of injury.
Coronary Artery Ectasia in Patients with and Without Diabetes: A Study from Northern Pakistan
Authors: Saleem Qaiser Mehmood , Bari Abdul Mannan , Mushtaq Muhammad Salman , Ahmed Bashir 
Published: December 2022

Objectives: To determine the association of coronary artery ectasia in terms of its severity and vessels involved in diabetes patients and non-diabetes patients.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Cardiology, PAEC General Hospital, Islamabad Pakistan from Jun 2018 to Jun 2020.
Methodology: All patients who underwent coronary angiography were included in this study. Two hundred patients (100 patients having diabetes and 100 patients not having diabetes) who presented with chest pain and chest heaviness were diagnosed with coronary artery ectasia on coronary angiography included in this study.
Results: Two hundred patients, 100 patients had diabetes, and 100 patients had no diabetes. 71 (35.5%) of the patients were males, and 29 (14.5%) were females. The left anterior descending artery alone was responsible for 23% of Coronary Artery Ectasia, followed by the right coronary artery (16%) in diabetic patients. In patients with diabetes with multiple vessels, the left anterior descending artery and left circumflex artery were most frequently (21%) involved vessels, while left anterior descending and right coronary artery were observed to have Coronary artery ectasia in 16% of diabetes patients.
Conclusion: No significant difference in the severity of coronary artery ectasia was noted among diabetes and non-diabetes patients. Left anterior descending was most frequently involved vessels in diabetes patients and right coronary artery in nondiabetes patients. Left anterior descending and left circumflex artery both had coronary artery ectasia in most of the diabetes patients and non-diabetes patients.