The menace of self citation: An audit of two years from journals of Khyber Pakhtunkhwa.

Objective: To assess the author and journal self-citation amongst journals of Khyber Pakhtunkhwa. Methods: This is a cross-sectional study conducted from January 2021 to July 2021. In total, manuscript published in 10 journals of Khyber Pakhtunkhwa, either recognized by the Higher Education Commission or Pakistan Medical Commission, in the years 2018 and 2019 were included in the present research. All types of manuscripts were analyzed using a pre-designed data extraction table. Results were extracted, analyzed and appropriate statistics were applied. Results: About 1235 manuscripts published in 68 issues over a period of two years' time were analyzed. The majority of manuscripts were 1039 (84.1%) original articles followed by case reports 90 (7.3%). Author self-citation came out to be 11.26% and journal self-citation was 6.5%. The same institute's author affiliation came out to be 40.6%. Conclusion: The trend of author self-citation was found to be high while that of journal self-citation was low when compared with already prevalent literature.

An Episode of Psychosis After Nitrous Oxide Abuse During a Pandemic: A Case Report.

The abuse of inhalants like nitrous oxide (N2O), readily available worldwide, has remained a prominent public health problem during the last few decades. Literature reveals increased use during the previous pandemic, particularly regarding recreational use. There is limited evidence-based data available to relate the abuse of N2O with psychosis. Therefore, this case report of a 22-year-old adult with no previous psychiatry history, reportedly abusing 75-100 canisters of N2O per day during the last pandemic COVID-19 lockdown, highlights the relationship between (N2O) abuse and the symptoms evolved including delusions, auditory hallucinations, and disorganized cognition. All the laboratory findings and results from imaging modalities were inconsistent for any organic cause of the symptoms. The case then underwent treatment with antipsychotic medications and a multidisciplinary model, which improved the symptoms gradually. The case, in particular, discusses N2O abuse, which is widespread in European Union countries, including the UK and the Republic of Ireland, and its chronic use puts one at a higher risk of developing psychosis, personality changes, affective lability, anxiety, depression, cognitive impairment, and myeloneuropathy. The sale of N2O for its psychoactive properties is prohibited in many countries, including the Republic of Ireland, as per legislation. However, N2O is not a controlled drug, meaning it is not a crime to possess N2O. This case report manifests the psychopathy caused by abuse of N2O, which would further attract specialists in the field to conduct epidemiological studies for prevention at the primary level.

Translating and Validating PRISMA-7 Questionnaire in Urdu: A Screening Tool to Identify Frail Individuals.

Frailty is a condition in which the affected individual is more prone to both external and internal stressors and has a higher risk of succumbing to chronic diseases. The aim of this research was to translate and validate the PRISMA-7 questionnaire in the Urdu language. This is a validation study conducted in a hospital in Khyber Pakhtunkhwa, Pakistan. PRISMA-7 Questionnaire was translated into Urdu language using forward and backward translations and was then piloted on a sample of 151 subjects, aged 60 and above, and validated by applying reliability and validity statistics. Amongst the sampling population, frailty was found to be 63.26%. All the items in the questionnaire were significantly different from each other, however, the correlation between each was found to be low. Cronbach's alpha was found to be 0.322. Urdu translated version of PRISMA-7 is not a valid and reliable tool for screening frailty in the elderly population of Khyber Pakhtunkhwa, Pakistan. Key Words: Frailty, Validation, Translation, Frail elderly, Urdu.

Septic arthritis, osteomyelitis, and cellulitis in a neonate: A case report and discussion of diagnosis and management.

INTRODUCTION: Septic arthritis, osteomyelitis, and cellulitis are rare but life-threatening conditions in neonates. This case report emphasizes the significance of early diagnosis and intervention in such cases. PRESENTATION OF CASE: We present a case of a male neonate, who developed septic arthritis, osteomyelitis, and cellulitis following trauma from a fall. The patient presented with fever, swelling, and limited joint movement. Diagnosis was based on clinical evaluation, laboratory investigations, and imaging studies. Treatment involved intravenous antibiotics for three weeks, followed by oral antibiotics for two weeks, resulting in complete recovery. DISCUSSION: Neonatal septic arthritis and osteomyelitis are challenging to diagnose due to nonspecific symptoms. Early initiation of antibiotics is crucial to prevent long-term complications. Surgical intervention may be required in cases of inadequate antibiotic response or significant joint effusion. This case underscores the importance of prompt recognition and tailored management. CONCLUSION: Septic arthritis, osteomyelitis, and cellulitis pose serious threats to neonates. Timely diagnosis, appropriate antibiotics, and, if needed, surgical intervention are vital for favorable outcomes. Individualized treatment plans should consider clinical condition and local protocols.

The Effectiveness of Online Learning in Improving the Electrocardiogram Interpretation Skills of Junior Medical Trainees: A Mixed Methods Observational Study.

Introduction The COVID-19 pandemic hindered medical education and limited access to clinical skills training for trainee medical doctors, including electrocardiogram (ECG) interpretation. These restrictions prompted a shift towards virtual training environments and online learning. In this study, we assessed the impact of the pandemic on trainees' confidence and their perceived difficulty in independently interpreting ECGs. Additionally, we examined the effectiveness of two online learning approaches, namely lectures and case-solving webinars, in improving their skills. Methods The study was a mixed methods observational study conducted in three phases. In the first phase, a cross-sectional study was conducted to subjectively assess the trainees' confidence levels and the perceived difficulty independently reading ECGs. The second phase involved a cohort study where an online learning module consisting of eight lecture-based sessions was implemented. This module covered all the topics recommended in the foundation doctor training curriculum. The third phase also involved a cohort study where an online case-based discussion learning module with two problem-solving webinars was introduced. We assessed the outcomes on a 1 to 10 Likert scale for confidence and perceived difficulty in independently reading ECGs. Results Sixty-five trainees participated in the initial cross-sectional study. Among them, 100% of the participants reported substantial difficulty in interpreting ECGs (scoring 6 or more on the Likert scale), and 76.5% of the participants did not feel enough confidence to read ECGs independently (scoring 6 or less). Ten trainees attended the second phase. Online lectures significantly increased the mean confidence score by 1.9 points (t(9) = 2.82, p = 0.02, 95% confidence interval (CI) [0.38-3.42]) and significantly reduced the mean of the perceived difficulty score by 2.7 points (t(9) = 5.71, p < 0.001, 95% CI [1.63-3.77]). Compared to the online lectures, the online problem-solving sessions significantly increased the mean of the composite score of confidence and perceived difficulty in reading ECGs (-0.8 vs. 4 points, 95% CI [1.49, 8.26], p = 0.011). Conclusion The COVID-19 pandemic negatively affected the ECG reading skills of junior medical trainees. However, the online teaching approach effectively improved their confidence and the level of difficulty they experienced in ECG interpretation. Applying online case problem-solving was found to be superior to the lecture-based approach in enhancing these parameters.

Fake news stance detection using selective features and FakeNET.

The proliferation of fake news has severe effects on society and individuals on multiple fronts. With fast-paced online content generation, has come the challenging problem of fake news content. Consequently, automated systems to make a timely judgment of fake news have become the need of the hour. The performance of such systems heavily relies on feature engineering and requires an appropriate feature set to increase performance and robustness. In this context, this study employs two methods for reducing the number of feature dimensions including Chi-square and principal component analysis (PCA). These methods are employed with a hybrid neural network architecture of convolutional neural network (CNN) and long short-term memory (LSTM) model called FakeNET. The use of PCA and Chi-square aims at utilizing appropriate feature vectors for better performance and lower computational complexity. A multi-class dataset is used comprising 'agree', 'disagree', 'discuss', and 'unrelated' classes obtained from the Fake News Challenges (FNC) website. Further contextual features for identifying bogus news are obtained through PCA and Chi-Square, which are given nonlinear characteristics. The purpose of this study is to locate the article's perspective concerning the headline. The proposed approach yields gains of 0.04 in accuracy and 0.20 in the F1 score, respectively. As per the experimental results, PCA achieves a higher accuracy of 0.978 than both Chi-square and state-of-the-art approaches.

Link between COVID-19 vaccines and myocardial infarction.

BACKGROUND: Vaccines for coronavirus disease 2019 (COVID-19) include ChAdOx1-SARS-COV-2 (AstraZeneca), Ad26.COV2.S (Janssen), mRNA-1273 (Moderna), BNT162b2 (Pfizer), BBIBP-CorV (Sinopharm), CoronaVac (Sinovac), and Bharat Biotech BBV152 (Covaxin). AIM: To find the association between COVID-19 vaccines and myocardial infarction (MI). METHODS: This is a systematic review that involved searching databases such as MEDLINE, EMBASE, and PakMediNet after making a search strategy using MeSH and Emtree terms. Eligibility criteria were set, and studies having no mention of MI as a complication of COVID-19 vaccination, protocols, genetic studies, and animal studies were excluded. Data was extracted using a predesigned extraction table, and 29 studies were selected after screening and applying the eligibility criteria. RESULTS: The majority of studies mentioned AstraZeneca (18 studies) followed by Pfizer (14 studies) and Moderna (9 studies) in subjects reporting MI after vaccination. Out of all the studies, 69% reported MI cases after the first COVID-19 vaccination dose and 14% after the second, 44% reported ST-segment elevation MI, and 26% reported non-ST-segment elevation MI. The mortality rate was 29% after MI. CONCLUSION: In conclusion, many studies linked MI to COVID-19 vaccinations, but no definitive association could be found.

Strength of Motivation among Public and Private Dental Students for the Field of Education: A Comparative and Correlational Study.

OBJECTIVE: To compare and correlate the strength of motivation for the field of education among public and private dental students of Khyber Pakhtunkhwa. STUDY DESIGN: Cross-sectional analytical study. Place and Duration of the Study: Khyber College of Dentistry (KCD), KMU Institute Dental Science (KIDS), Peshawar Dental College (PDC), and Dental Section, Women Medical College (DS,WMC) from October to December 2019. METHODOLOGY: A multi-staged proportionate random sampling was used to enrol a calculated study population of 398 students. After following set criteria and taking informed written consent, a pre-designed performa including demographics and strength of motivation for medical school-revised (SMMS-R) questionnaire was distributed. Extracted data was analysed using SPSS version 25.0, where descriptive and inferential statistics were applied. RESULTS: The mean age of the sample (398) was 19.24 ± 0.941 years, in which public and private sector students were 207 (52%) and 191(48%) respectively. Gender ratio was 1:5.4 for males and females. The intermediate score mean was 877 ± 75.6. The SMMS-R score had no significant difference in public and private sector with median of 3.3 (3.0-3.7) and 3.3 (2.9-3.5), respectively (p=0.883). SMMS-R was significantly correlated with ''willingness to sacrifice'' and had a maximum correlation coefficient (r=0.841). CONCLUSION: There was no significant difference in the strength of motivation between public and private sector dental students. Furthermore, in overall correlational aspects, significant results were recorded. The study also showed no impact of last educational institute attended on motivational powers. Key Words: Motivation, Students, Dental, Strength of motivation for medical school - revised (SMMS-R), Public institute, Private institute.

CMakeCatchTemplate: A C++ template project.

CMakeCatchTemplate (https://github.com/MattClarkson/CMakeCatchTemplate) is a project to provide a starting structure for C++ projects configured with CMake, that can be customised to work in a variety of scenarios, allowing developers to deploy new algorithms to users in a shorter timeframe. Main features include a SuperBuild to build optional dependencies; unit tests using Catch; support for CUDA, OpenMP and MPI; examples of command line and GUI applications; Doxygen integration; Continuous Integration templates and support for building/deploying Python modules.

Uremic Pruritus: Prevalence and Impact on Quality of Life and Depressive Symptoms in Hemodialysis Patients.

Background End-stage renal disease (ESRD) is a major public health problem with many associated symptoms. Uremic pruritus (UP) develops in 40% of patients on hemodialysis and has major effects on the patient's life. It is also an independent risk factor for increased mortality, and its psychiatric implications remain poorly characterized in our local setup, where it tends to be underdiagnosed and undertreated. Objectives and rationale The study aims to report the prevalence of uremic pruritus in our study population and associate it with various patient parameters, which may define a subset of patients at high risk for this pruritus. We also assess the effects of uremic pruritus on the patient's quality of life (by using the Dermatology Life Quality Index; DLQI) and depressive symptoms (by using the Public Health Questionnaire; PHQ-9). Materials and methods It was a descriptive, cross-sectional study conducted in the nephrology unit of the multi-organ failure (MOF) center of the Holy Family Hospital (HFH), Rawalpindi, Pakistan, from February 2019 to June 2019, during which 173 male patients on hemodialysis were selected. Informed consent was taken from patients and other skin-related causes of pruritis were excluded. Uremic pruritus was defined as pruritis lasting for at least three months after the onset of ESRD. The 5-D, PHQ-9, and DLQI questionnaires were used to assess pruritis, depressive symptoms, and quality of life, respectively. Their Cronbach's Alpha values for 73 responses were 0.83, 0.81, and 0.71, respectively. The descriptive analysis was performed using SPSS v23.0 (IBM Corp, Armonk, NY, US). Spearman's rank-order correlation, independent samples t-test, and one-way analysis of variance (ANOVA) were used to analyze study variables. Results The prevalence of uremic pruritus was 49.1%, with many patients having generalized itching. Unemployment and longer disease duration predisposed the patients towards uremic pruritus, as the mean 5-D score in this subset were greater (p<0.05 in the independent samples t-test). The results of one-way ANOVA were significant (p<0.05), indicating higher 5-D scores in worsening categories of depressive symptoms and quality of life. Spearman's correlation matrix showed that 5-D, PHQ-9, and DLQI scores were strongly correlated with each other. Conclusions The prevalence of uremic pruritus among male hemodialysis patients is high, at 49.1%. It significantly contributes to depressive symptoms and a lower quality of life, which are associated with worse prognosis in hemodialysis patients. Thus, a clinician must keep in mind the psychiatric implications of uremic pruritus and treat it effectively to optimize the patient's medical care.