bluuebunny/crossref_metadata_2025_split huggingface dataset:
Frequency and Risk Factors of Meconium Aspiration Syndrome in Babies Delivered to Mothers with Meconium Stained Amniotic Fluid
Authors: Tanveer Sidra , Basheer Faisal , Khushdil Arshad , Motlaq Fady MA , Nawaz Raazia , Javed Maria 
Published: December 2022

Objective
To determine the frequency and risk factors of meconium aspiration syndrome in babies delivered to mothers with meconium stained amniotic fluid attending neonatal unit of tertiary care hospital.
Study design
Prospective cross sectional study
Place and duration of study
Neonatal Unit “Pak Emirates Military Hospital”, Rawalpindi from 1st January to 30th September 2018
Patients and methods
All pregnant women with cephalic presentations with either spontaneous vaginal delivery (SVD) or lower segment cesarian section (LSCS) mode of delivery and having light-yellow to thick dark-green color liquor after spontaneous or artificial rupture of membrane were enrolled. Meconium aspiration syndrome along with risk factors like gestational age, weight, gender, mode of delivery, grades of meconium, and mortality was noted.
Results
Of 384 patients, meconium aspiration syndrome was observed in 37 (9.6%) patients. Meconium aspiration syndrome was 2.97 times higher among patients with >36 weeks of gestation (AOR: 2.97, 95% CI: 1.12-7.89), 61% higher among patients with ≤3 kg weight (AOR: 0.39, 95% CI: 0.19-0.85), 89% higher among females (AOR: 1.89, 95% CI: 0.91-3.95), 83% higher among patients with SVD (AOR: 1.83, 95% CI: 0.89-3.75), 4.12 times higher among patients with grade III (AOR: 4.12, 95% CI: 0.51-33.45) and 8.65 times higher among patients with grade II color liquor (AOR: 8.65, 95% CI: 1.11-67.45).
Conclusion
Meconium aspiration syndrome frequency was found considerably higher. In particular, newborn having higher gestational age, increased weight, female gender, SVD as the mode of delivery, grade III and grade II meconium were reported as the significant risk-factors.
Spinal Dysraphism: A Three Year Experience at Armed Forces Institute of Radiology and Imaging
Authors: Nasir Hina , Nisar Uzma , Slehria Atiq Ur Rehman , Iftikhar Ammara , Halim Aliya , Nisar Shahana 
Published: December 2022

Objective: To review all the patients of spinal dysraphism referred to our center over a three year period in order to identify the most typical neuro-radiological appearances on Magnetic Resonance Imaging.
Study Design: Cross sectional study.
Place and Duration of Study: Armed Forces Institute of Radiology and Imaging, Rawalpindi from Jan 2016 to Dec 2018.
Methodology: MR spine reports of 144 patients of spinal dysraphism were retrospectively analyzed. Age, gender, indication for MRI, operative status, and neuro-radiological features (including site and type of lesion) were recorded for these patients.
Results: Congenital spinal malformations were more frequent among females87 (60.4%) and between 0-20 years 135 (93.9%) of age. Tethered cord 97 (67.4%) was the most common congenital spinal abnormality followed by spina bifida, diastematomyelia, vertebral segmentation anomalies, myelomeningocele, menigocele. Lip-myelomeningocele, lipoma of filum terminale, and sacral agenesis. Frequently observed associated abnormalities included scoliosis 61 (42.4 %), syrinx 47 (32.6%) and dural ectasia 40 (27.8 %).
Conclusion: Congenital spinal malformations are usually complex with variable radiological appearances. Modern high resolution MRI screening is the examination of choice for identification, preoperative evaluation, and long term follow up of such congenital anomalies.
Comparison Between Cephalometric Measurements Derived from Cone Beam Computed Tomography and Lateral Cephalogram
Authors: Khan Mehwish , Khan Azhar Bangash , Amin Erum , Ejaz Fatima , Tariq Sana , Akhtar Faheem Nake 
Published: December 2022

Objective: To compare the mean craniofacial linear and angular measurements derived from cone beam computed tomography synthesized lateral cephalogram and those obtained from conventional cephalogram.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Armed Forces Institute of Dentistry (AFID), Rawalpindi Pakistan, from Feb 2017 to Nov 2018.
Methodology: Sample size was 32. Following linear measurements were evaluated; anterior facial height, right side and left side of mandibular length, nasal spine length, Upper and lower incisors to A-Pog distance. These measurements were obtained by both means i.e., conventional cephalogram and cone beam computed tomography synthesized cephalogram. Each of the measurement were taken twice by the single operator with a difference of two weeks.
Results: No significant difference was found among measurements obtained through lateral head film cephalograph and cone beam synthesized cephalograph except for mandibular length (for which p=0.04).
Conclusions: Cone beam computed tomography synthesized lateral cephalogram can be suggested as a substitute to conventional lateral cephalogram. Especially in conditions when cone beam computed tomography is already required for treatment planning thus reducing supplementary x- ray exposure and expenditure of an additional x-ray.
Comparison Between Ferguson's Technique and Mitchelle Bank Technique for Inguinal Herniotomy in Children
Authors: Rehman Shafqat , Ahmed Iftikhar , Awan Safdar Hussain , Anwar Zahid , Saleem Muddasir , Afzal Tamoor 
Published: December 2022

Objective: To assess the safety of the Mitchelle bank technique for herniotomy in children by comparing its recurrence rate with conventional Ferguson's technique.
Study Design: Quasi-experimental study.
Place and Duration of Study: Paediatric Surgery Department, Pak Emirates Military Hospital, Rawalpindi Pakistan, from Sep 2018 to Sep 2019.
Methodology: Children below the age of 6 years coming to Paediatric Surgery Outpatient Department with inguinal hernia were included in the study. The patients were divided into two groups. Group-I underwent herniotomy by Mitchelle bank technique (MBT-group) while Group-II by Ferguson's technique (FT-group). The demographic characteristics of the studied population, operative time, and intra-operative and post-operative complications were recorded.
Results: The mean age of the patients was 25.94 ± 17.06 months in Ferguson's technique-group and 24.76 ± 16.63 months in the Mitchelle bank technique-group. The mean operative time was less in the Mitchelle bank technique-group (13.17 ± 1.47 minutes) as compared to Ferguson's technique-group (16.23 ± 1.51 minutes) (p<0.05). Early complications such as hydrocele, seroma and hematoma were seen in 5 (2.3%), 6 (2.6%) and 3 (1.3%) cases in Ferguson's technique-group, and 15 (6.9%), 8 (3.7%), and 9 (4.1%) cases in the Mitchelle bank technique group, respectively. Late complications such as orchitis, testicular atrophy, and recurrence were seen in 5 (2.3%), 6 (2.6%), 2 (0.9%) in Ferguson's technique group, and 6 (2.6%), 4 (1.8%), and 3 (1.3%) in the Mitchelle bank technique group (p>0.05).
Conclusion: Mitchelle bank technique is safe for herniotomy in children with less operative time and no increase in...
Comparison of Fetal Outcome in Patients of Gestational Diabetes Treated with Met Formin and Insulin
Authors: Sajjad Fatima , Usman Shaheera , Choudhry Abeera , Baloch Shaheen Aslam , Aslam Qurat Ul Ain , Shahid Ghana 
Published: December 2022

Objective: To compare frequency of fetal outcome in patients of gestational diabetes being managed with Metformin and Insulin.
Study Design: Comparative prospective Study.
Place and Duration: Department of Obstetrics and Gynecology, Pak Emirates Military Hospital, Rawalpindi, from Apr to Dec 2016.
Methodology: This study involved 286pregnant women aged between 18-40 years presenting after 24 weeks of gestation and diagnosed with gestational diabetes which were randomly allocated into two treatment groups. Patients in Group-A were treated with met for min while those in Group-B were treated with Insulin. Outcome variables were various fetal outcome measures which were noted and compared between the study groups.
Results: The mean age of met for min group (32.71 ± 6.54 years) and Insulin groups (32.85 ± 6.10 years) was comparable. Mean APGAR score was similar between met for min and Insulin groups at 1 minute (7.56 ± 1.12 vs. 7.40 ± 1.13; p=0.229) and 5 minutes (8.34 ± 0.60 vs. 8.24 ± 0.67; p=0.231) after birth. The frequency of good APGAR (≥7) was significantly higher in met for min group at 1 minute (82.5% vs. 69.2%; p=0.009). Frequency of hyper-bilirubinemia (8.4% vs. 11.9%; p=0.327), respiratory distress syndrome (18.9% vs. 25.9%; p=0.156) and Neonatal Intensive Care Unit (NICU) admission (16.1% vs. 16.8%; p=0.873) showed no significant association with treatment method.
Conclusion: The efficacy of met for min and Insulin was found to be comparable in the management of pregnancy with diabetes. Metformin was as safe as Insulin in treating gestational diabetes considering the fetal outcome.
Efficacy of Oral Doxycycline in Reducing the Size of Pterygium lesions
Authors: Rabbani Shafaq , Akram Amjad , Yaqub Amer , Ashraf Ammara , Khan Fatima 
Published: December 2022

Objective: To assess the efficacy of oral Doxycycline in reducing the size of pterygium lesions in a Pakistani population
Study Design: Quasi-experimental study.
Place and Duration of Study: Armed Forces Institute of Ophthalmology, Rawalpindi, from Sep 2018 and May 2019.
Methodology: Sixty patients above 20 years of age were enrolled in the study. Oral Doxycycline 200m/day was given for thirty consecutive days. Photographs of the lesions were taken at the time of recruitment and at the end of the study for assessment of pterygium size. Difference between pre-treatment and post-treatment size was analysed and comparison was made with age, gender and initial lesion size.
Results: Twenty-two females and thirty-eight males were examined. The mean age of the participants was 48.8 ± 13.8 years. The mean size of the pterygium lesions before commencing the treatment was 12.24 ± 6.28 mm2. The mean size of the lesions after the treatment was 11.24 ± 5.39 mm2. The mean difference size was 1.00 ± 1.62 mm2 (p <0.001). The relative change in size (i.e. post-treatment size divided by pre-treatment size) was 0.94 ± 0.09 which was found to be statistically significant (p<0.001). There was correlation between larger initial lesion size and greater relative reduction in size (r = -0.42, p = 0.001).
Conclusion: The change in the size of pterygium lesions produced by Doxycycline was found to be statistically significant but was not deemed clinically significant. Therefore, oral Doxycycline is not recommended for the treatment of pterygium in our population.
Smoking Cessation Advice“The Best Time to Quit Smoking was the Day you Started, the SecondBest Time to Quit is Today”
Authors: Abbas Sana , Abbas Beenish , Khan Faisal Nawaz , Ehsan Hafiz Rabi Ul , Malik Ahsan , Malik Sadia Munir 
Published: December 2022

Objective: To decide the mindfulness and competency of dental and clinical experts in offering smoking discontinuance guidance.
Study Design: Cross-sectional study.
Place and Duration of Study: Tertiary Care Teaching Institute, Rawalpindi Pakistan, from Oct 2019 to Feb 2020.
Methodology: A pilot study carried out at 15-20 participants for questionnaire validation and reviewed by independent experts for face validity. A final questionnaire comprised of ten multiple-choice questions in addition to demographic profile. The minimum sample size required for the study was 261, where the national prevalence of smoking was 21.6%.
Results: A total of 550 participants participated in the study and data were extracted from their responses. There were 335 (61.0%) males and 215 (39.0%) females in the study group, with a mean age of 32.4 ± 4.3 and the age range 25 – 44 years. Among total respondents, 380 (69%) were qualified dental and medical practitioners whereas 170(31%) were medical and dental students. Only (40%) respondents were confident in rendering cessation advice whereas (60%) were not. Only (15.5%) participants declared that they received formal training to counsel for quitting smoking. Among the total 234 (100%) males were confident in giving in advice whereas none of the females were sure enough p value <0.001.
Conclusion: Despite smoking is of immense concern regarding Public Health, Medical and dental professionals are not proficient enough in smoking cessation counselling. A major fraction of mortality and morbidity is attributable to it; therefore, importance is to be enlightened as a preventable cause of death
The Effect of Phototherapy on Serum Calcium and Magnesium Level in Newborns Gestational Age 36 Weeks and Above
Authors: Ishfaq Hadia , Kafi Nisreen 
Published: December 2022

Objective: To investigate the phototherapy effect on serum calcium and magnesium levels of children with gestational age 36 weeks or above.
Study Design: Cross-sectional analytical study.
Place and Duration of Study: Department of Pediatric, King Fahad Armed Forces Hospital, Jeddah from Jan to Sep 2019.
Methodology: Total of 200 participants were recruited into the study after obtaining informed consent. Patients’ characteristics were obtained from medical record file. Their mothers were interviewed. Before phototherapy, laboratory investigations were done. Phototherapy was performed with conventional method 410-417mm wave length was maintained and patients was kept at distance of 20cm. After phototherapy completion, laboratory investigations were repeated and difference was noted.
Results: Out of 200 patients, 54% were males and 46% were females. Average age of patients was 1.85 ± 0.96 days with range 0-5 days. Decrease in calcium and magnesium levels was observed in 64 (32%) and 49 (24.5%) patients respectively following phototherapy completion. There was statistically significant mean difference in calcium and magnesium levels after phototherapy and bilirubin was also significantly decreased.
Conclusion: Decrease was observed in calcium and magnesium levels following phototherapy. Phototherapy may lead to decrease levels of calcium and magnesium, hence frequent assay warranted. Further investigations should be conducted inour region enrolling only neonates to confirm phototherapy induced hypocalcaemia and hypomagnesaemia.
Association of Carotid Artery Disease with Various Risk Factors Among Patients Presenting with Ischemic Stroke
Authors: Nizami Muhammad Asif , Yousaf Muhammad Ali , Liaqat Jahanzeb , Nawaz Khurram Haq , Hashmat Asif 
Published: December 2022

OBJECTIVE: To study the association of carotid artery disease with various risk factors among patients presenting with ischemic stroke
STUDY DESIGN: Analytical study
SETTING: Department of neurology Pak Emirates Military Hospital Rawalpindi
DURATION OF STUDY: Eight months, from 1st July 2019 to 29th February 2019
PATIENTS AND METHODS: A total of 300 patients with ischemic stroke diagnosed by the consultant neurologist were included in this study. A consultant radiologist assessed the presence of clinically significant carotid artery stenosis by performing an ultrasound examination of carotid region. Relationship of age, gender, presence of diabetes mellitus, presence of hypertension and tobacco smoking was assessed with the presence of carotid artery stenosis among the patients of ischemic stroke.
Results: Out of 300 patients of stroke assessed through ultrasound Doppler, 171 (57%) showed the presence of significant carotid artery stenosis while 129 (43%) had no clinically significant stenosis. Statistical analysis revealed that presence of diabetes mellitus and hypertension had a statistically significant relationship (p-value <0.05) with presence of significant occlusion in the carotid arteries of stroke sufferers.
Conclusion: Conclusion of this single center study is that carotid artery disease should not be missed among the patients of ischemic stroke as a large number of patients harbor this phenomenon. Patients with diabetes mellitus and hypertension may be at more risk of developing the carotid artery disease as compared to others.
Screening of Subclinical Hypothyroidism in Antenatal Women and its Impact on Pregnancy Outcomes
Authors: Razzaq Kashif , Anwar Rabiah , Noor Nusrat , Tariq Amera , Imran Ayesha , Iftikhar Bushra , Anwar Sobia 
Published: December 2022

Objectives: To screen subclinical hypothyroid cases in antenatal checkups and to assess the impact of this condition on the fetomaternal outcome.
Study Design: Prospective cohort study.
Place and Duration of Study: Department of Gynecology and Obstetrics, Pakistan Naval Ship Shifa Hospital Karachi Pakistan, from Jun 2019 to May 2020.
Methodology: During the study period, all singleton pregnant women with no comorbid, having booking visits during the first trimester of pregnancy were included. Three thousand four hundred fifty obstetric patients fulfilled the inclusion criteria. Their serum TSH and free T4 and T3 were sent along with routine antenatal investigations. Pregnancy specific first-trimester normal reference values of TSH (0.03-2.3µU/ml) and free T4 (0.8-1.8ng/dl) were used to classify pregnant women into euthyroid (controls) and overt and subclinical hypothyroid (cases). Comparison of antenatal complications (gestational diabetes, gesta tional hypertension, pre-eclampsia, and preterm labour), mode of delivery (vaginal delivery, cesarean section) and perinatal outcome (intrauterine growth restriction, intrauterine fetal death, low APGAR score at 5 min) was made among both the groups.Results: Hypothyroid women had significantly increased risk of gestational hypertension (RR= 4.795% CI=2.902 to 7.773, p<0.0001), preeclampsia (RR=4.07, 95%CI=2.315 to 7.197, p<0.0001), preterm delivery (RR= 4.1, 95% CI=2.128 to 7.89, p<0.0001), cesarean section rate (RR=2.3611, 95% CI=1.7106 to 3.2591, p<0.0001) and risk of IUGR (RR=8.000, 95% CI= 1.869 to 34.227, p=0.005) as compared to euthyroid women.Conclusion: Subclinical hypothyroidism is associated with gestational hypertension, pre-eclampsia, intrauterine growth restriction, preterm delivery and increased cesarean section rate.
Plastibel Circumcision: Safest Technique in the Infants with the Experienced Hands: A Single Centre Experience
Authors: Rahman Habib -Ur- , Iftikhar Hina , Ali Ghazanfar , Khoso Mujahid Ali , Ahsan Arooj , Ahmed Naveed 
Published: December 2022

Objective: To evaluate the safety and efficacy of circumcision done by plastibel technique in infants up till six months of age.
Study Design: Cross-sectional study.
Place and Duration of Study: Department of Surgery, Combined Military Hospital, Multan, from Aug 2019 to Jul 2020
Methodology: The Department of surgery, Combined Military Hospital, Multan, from 2019 to 2020. A sample size of 140 patients was calculated via the EpiTools epidemiological calculator while keeping the significance level at 5% and a confidence level of 95%.
Results: A total of 140 infants were circumcised with the plastibel technique. The age of the infants ranged from 21 days to six months with the mean age of 32.2 ± 10.5 days. Maximum circumcisions were done between 30-90 days of life. The best part of the circumcision was that no complication was observed during the study period.
Conclusion: Plastibel circumcision can be done under local anaesthesia with the best possible safety in infants younger than six months of age.
The Comparison of Efficacy of Platelet Rich Plasma (PRP) with Methylprednisolone in Patients with Tennis Elbow
Authors: Memon Iftikhar A. , Junejo Sadaf , Khan Kashif Mahmood , Ali Zulfiqar , Butt Siraj A. , Memon Faheem A. 
Published: December 2022

Objective: To study the efficacy of platelet-rich plasma with Methylprednisolone in patients with tennis elbow.
Study Design: Prospective longitudinal study.
Place and Duration of Study: Department of Orthopedics, Jinnah Postgraduate Medical Centre, Karachi, Feb 2019 to Sep 2020.
Methodology: All the patients with chronic lateral epicondylitis with the onset of symptoms of greater than three months were grouped into two groups. Seventy-six patients in each group were treated. Group-A received an injection of 5ml Platelet-rich plasma. Group-B was administered 1 ml of Methylprednisolone (dosage; 4-30 mg). The severity of pain using the visual analogue scale was evaluated at baseline.
Results: In the PRP group, significant changes in pain perception were observed. The mean baseline VAS score in the PRP group was 6.9 ± 1.7, which decreased to 3.4 ± 2.9, 1.7 ± 0.3, and 1.2 ± 1.4 at four weeks, 12 weeks, and 52 weeks follow-up visit, respectively. Similarly, in group-B (Methylprednisolone), there was a significant change from baseline to 52 weeks postprocedure (p<0.001). It was found that the efficacy of Platelet free plasma was significantly higher than methylprednisolone (77.6% versus 48.7%, <0.005).
Conclusions: The study concluded that Plasma rich platelet therapy was significantly more effective in relieving the pain and improving the functional outcomes in patients with elbow epicondylitis than Methylprednisolone.
Bevacizumab for the Treatment of Patients With Brain Radionecrosis
Authors: Hill Shannon , MacDougall Danielle 
Published: December 2022

This review identified limited evidence regarding the clinical effectiveness and safety of bevacizumab for patients with symptomatic brain radionecrosis after radiosurgery. These identified studies had several limitations, most notably due to the limited number of studies with control groups; therefore, the findings related to the effectiveness and safety in this population are uncertain.
For adult patients with symptomatic brain radionecrosis, treatment with bevacizumab may be associated with radiographic responses, a reduction in volumetric outcomes, an improvement in overall clinical and neurologic symptoms, an improvement in functional outcomes, and a reduction in corticosteroid use.
Limited evidence from 1 study suggests that treatment with bevacizumab may be associated with greater radiographic response, a reduction in volumetric outcomes, and clinical symptom improvement compared to treatment with corticosteroids. The recurrence of brain radionecrosis for patients who received bevacizumab compared to corticosteroids was similar between groups.
Commonly reported adverse events after patients with symptomatic brain radionecrosis were treated with bevacizumab included hypertension, proteinuria, edema, pulmonary embolism, and various thromboembolic events.
Pengaruh Ikatan Emosi, Atmosfer Kenyamanan Toko, Dan Harga Khusus Terhadap Customer Retention
Authors: Prasetyo Nur Ahmad 
Published: December 2022

Customer retention merupakan bagian dari perilaku pembeli, semakin banyak pelanggan yang membeli kembali di toko yang sama maka akan meningkatkan pendapatan toko tersebut. Penelitian ini dirancang untuk menguji pengaruh ikatan emosional, atmosfer kenyamanan toko, dan harga khusus terhadap customer retention.
Teknik yang digunakan dalam pengambilan sample pada penelitian ini adalah convenience accidental sampling. Jumlah sampel yang digunakan sebanyak 50 sampel. Metode pengumpulan data diperoleh melalui pembagian kuesioner kepada para responden. Hasil dari data survey selanjutnya diolah dengan analisis regresi yang dijalankan dengan bantuan program SPSS.
Hasil penelitian menunjukkan bahwa semua variabel independen (ikatan emosional, atmosfer kenyamanan toko, dan harga khusus) yang diajukan berpengaruh positif dan signifikan terhadap customer retention.