bluuebunny/crossref_metadata_2025 huggingface dataset:
Clustering-Based Analysis of Meibomian Gland Morphology for Automated Assessment of Meibomian Gland Dysfunction Using the MGD-1k Dataset
Authors: Krishnan Anantha , Sarkar Salman , Badavath Laxman
Published: February 2025

Purpose: To develop a clustering-based framework for automated categorization of Meibomian gland morphology, addressing subjectivity in Meibomian Gland Dysfunction (MGD) diagnosis.
Methods: The MGD-1k dataset of 1,000 infrared meibography images was analyzed using k-means clustering to classify gland areas into three groups: low (Cluster 1), medium (Cluster 2), and high (Cluster 3). Pixel-based segmentation determined white pixel counts as a surrogate for gland area. Statistical validation, including ANOVA, was performed, and results were visualized with scatter plots, bar charts, and box plots.
Results: Clustering identified 417, 358, and 225 images in Clusters 1, 2, and 3, comprising 41.7%, 35.8%, and 22.5% of the dataset, respectively. Mean pixel counts were 39,123.99 (SD = 4,213.89), 23,960.30 (SD = 5,930.49), and 54,413.95 (SD = 6,378.15). ANOVA confirmed significant inter-cluster differences (p < 0.0001).
Conclusions: This framework objectively quantifies gland morphology, enabling severity stratification. The approach offers scalable diagnostic support and could be integrated with clinical tools or AI models. Future validation on diverse datasets is needed to confirm its broader applicability.
Evaluation The Effect Cytotoxicity and Program Cell Death of Bauhinia variegata Volatile Oil
Authors: Awaed Asawer T. , Habeeb Hadeel M.
Published: February 2025

Lung cancer is the most prevalent type of cancer found in the world, and it remains a significant global health concern, despite advancements in diagnostic and therapeutic techniques. The exploration of new anti cancer agents derived from plants has emerged as a promising trend in scientific research. Phytochemicals are considered selective in their effects and are generally less harmful to normal cells compared to conventional cancer treatments. In the present study, flowers of Bauhinia variegata were gathered from Baghdad in the spring of 2024, and volatile oil was extracted by using Clavenger. Cytotoxic effects of volatile oil were assessed through MTT assay against lung cancer cell lines A549 and REF normal cell line at 24,48and 72 h, and using four different concentrations. The result showed that the highest cytotoxicity of volatile oil at 100 μg/ml was 86.1% at 72h. While the lowest inhibition rate was 11.25% in the 25 μg/ml after 24 h of treatment. In contrast, it could hardly inhibit the proliferation of normal cells although volatility oil had slight inhibition on them as its max inhibition rate (11.7%) at 72 h was only obtained when attend with volatile oil of 100 μg/ml and min inhibition rat was also low (2.266%) at 24 h when attend with volatile oil of 25 μg/ml. A validated of reducing cell viability was down by using AO/EtBr, which means apoptosis was induced in A549cell treated with volatile oil  but there is no react in REF cell. At the gene expression level, the flow cytometery technique was used to determine the increase in gene expression of P53 and so it coincided with apoptosis occurring in cancer cells exposed to the volatile oil. The volatile oil didn’t cause the P53 gene to express in REF cells. activity of mitochondria was examined using Rh 123 dye during flow cytometry testing with volatile oil in the treatment of cancer cells. mitochondrial membrane potential was reduced efficacy, leading to cell death, as evidenced by the dimmer fluorescence caused by cancer cell the programmed cell dead process. Conversely, in REF cells, the mitochondria remain vibrant and active regardless of volatile oil treatment.
Big Data and Blockchain Synergies in Healthcare: Opportunities for Enhanced Decision-Making and Operational Management
Authors: Waghodekar Pranati , Bewoor Mrunal S.
Published: February 2025

Healthcare can only benefit from the integration of Big Data and Blockchains that improve decision making, operational management and data security. This research examines how Big Data analytics and AI driven algorithms can improve patient care, resource allocation, and predictive modeling as well as Blockchain technology to assures data lapses, integrity, privacy, and supply chain security. Four healthcare data analysis focused approaches, i.e., Federated Learning, Time-Series Prediction, Deep Learning and Smart Management Information Systems were implemented. By using the proposed model, the accuracy on disease prediction, fraud detection and medical supply chain management are achieved 95.4, 87.6 and 92.3 respectively, and are better than existing centralized systems. Related work comparative analysis reveals that solutions leveraging Blockchain into Big Data have better security, scalability, and real time processing when compared to standard Big Data. Finally, the study shows that privacy preserving AI models integrated with decentralized blockchain ledgers can decrease data breach by 74.2 percent and optimize the decision making of medical problems by 89.5 percent. While faced by regulatory impediments and interoperability difficulties, the findings emphasize the big data and Blockchain synergy as a potent means to revolutionize the healthcare managements. The focus in future research should be on scalability improvements, regulations for cross border data sharing and optimization of the Blockchain for real time processing in order to take full advantage of this technology.
The Impact of Interactive Game-Based Media on Enhancing Positive Discipline in Preschool Children
Authors: Dwi Utami Rahayu , Yufiarti Yufiarti , Hapidin Hapidin
Published: February 2025

Positive discipline strategies are crucial for fostering healthy behavioral development in preschool children. Concurrently, the integration of interactive game-based media in educational settings has surged, offering innovative approaches to early childhood education. However, the effectiveness of these digital interventions in promoting positive disciplinary behaviors remains underexplored. This study aims to evaluate the effectiveness of interactive game-based media in enhancing positive discipline among preschool children. It further seeks to identify specific game elements that contribute to behavioral improvements. Utilizing a quasi-experimental design, the study involved 120 preschool children aged three to five years from diverse socioeconomic backgrounds. Participants were randomly assigned to either the intervention group, which engaged with specially designed interactive educational games focused on positive discipline principles, or a control group receiving traditional behavioral guidance methods. The intervention spanned eight weeks, with sessions conducted three times weekly. Data on positive discipline behaviors were collected through observational checklists and parent/teacher questionnaires administered pre-and post-intervention. Statistical analyses, including ANOVA and regression models, were employed to assess the impact of the game-based media. The intervention group demonstrated a significant increase in positive disciplinary behaviors compared to the control group (p < 0.01). Specific game elements, such as interactive storytelling and reward systems, were strongly associated with improvements in self-regulation and cooperative behaviors. Qualitative feedback indicated enhanced engagement and motivation among children interacting with the game-based media. Interactive game-based media effectively enhance positive discipline in preschool children, offering a viable complement to traditional behavioral strategies. These findings suggest that incorporating thoughtfully designed digital tools into early childhood curricula can support educators and parents in fostering desirable behavioral outcomes. Future research should explore long-term effects and the applicability of such interventions across diverse cultural contexts.
The Impact of Interactive Game-Based Media on Enhancing Positive Discipline in Preschool Children
Authors: Maria Ilga , Yufiarti Yufiarti , Sumantri Syarif
Published: February 2025

This study investigates the effectiveness of interactive educational games in enhancing social competence among preschool-aged children. Social competence, encompassing skills such as communication, cooperation, and empathy, is fundamental for early childhood development and long-term academic and social success. Traditional teaching methods often struggle to engage young learners and effectively foster these essential skills. To address this challenge, an experimental design was employed involving 150 preschool children aged three to five years from diverse socioeconomic backgrounds. Participants were randomly assigned to either an intervention group, which engaged in a series of structured interactive educational games designed to promote social skills or a control group that participated in standard preschool activities without the game-based interventions. Over 10 weeks, social competence was assessed using validated observational checklists and standardized behavioral assessments administered before and after the intervention. Quantitative analysis revealed that children in the intervention group demonstrated significant improvements in key areas of social competence, including enhanced communication, increased cooperative behavior, and more excellent empathetic responses, compared to the control group (p < 0.01). Qualitative feedback from educators and parents supported these findings, highlighting observable positive changes in children's interactions and peer relationships. These results suggest that integrating interactive educational games into preschool curricula can effectively bolster social competence, offering a promising alternative to conventional teaching methodologies. The study contributes to the field of early childhood education by providing empirical evidence for the use of gamified learning tools to develop essential social skills, with implications for curriculum design and educational policy. Future research should explore the long-term impacts of such interventions and their applicability across diverse educational settings.
Digital Health Tools in Pediatric Medicine: Transforming Diagnosis, Monitoring, and Treatment Approaches
Authors: Shekhawat Shubham , Pathak Prithu , Barik LalBihari , Bhatia Nitish , Masih Daljeet , Gupta Abhilasha , Kumar Arun , Kumar Ritesh
Published: February 2025

The integration of digital health tools in pediatric medicine is revolutionizing how healthcare is delivered to children, significantly enhancing the processes of diagnosis, monitoring, and treatment. These technologies, which include mobile health applications, telehealth platforms, and wearable devices, are being increasingly adopted for their ability to provide real-time data, ensuring timely intervention and better patient outcomes. Digital tools facilitate accurate diagnosis by leveraging artificial intelligence and machine learning algorithms to analyze complex datasets, thus improving diagnostic accuracy and reducing the incidence of misdiagnoses. Additionally, remote monitoring solutions empower caregivers and clinicians to track children's health metrics consistently, leading to proactive management of chronic conditions. As these digital innovations continue to evolve, they also foster improved communication between healthcare providers and families, promoting engagement and adherence to treatment plans. Furthermore, the accessibility provided by telemedicine expands the reach of specialized care, particularly for underserved populations. These abstract outlines the transformative potential of digital health tools, emphasizing their role in enhancing pediatric healthcare delivery while focusing on improved patient outcomes and satisfaction.
Correlation between Core and Hip Abductor Endurance in Overweight and Obese Students with Flexible Flat Feet
Authors: Palekar Pramod J. , Karimjee Luvai M. , Palekar Tushar J.
Published: February 2025

Flexible flatfoot is a common foot deformity that can lead to altered biomechanics and excessive pronation during weight-bearing activities. Prior studies have linked proximal weakening of the hip abductor muscles and core to flatfoot. Additionally, a greater incidence of flatfoot deformity and decreased hip and core strength have been connected to obesity. Nevertheless, not much research has been done on the connection between obesity, flatfoot, hip abductor endurance, and core endurance.
The aim of this study was to analyse the correlation between core muscular endurance and hip abductor endurance among overweight and obese students between 18-25 years of age with flexible flatfeet.
This was an observational study carried out in a tertiary health care centre. Convenience sampling was used for selecting a sample of 75 overweight and obese college students, ages 18 to 25, who had flexible flatfoot (navicular drop ≥10mm, positive Jack’s test and Tiptoe Standing test). The Biering-Sorensen test, the Plank hold test, and the Side Plank hold test were used to measure core endurance. The Hip Abductor Isometric Endurance Test was used to assess hip abductor endurance. Pearson's correlation coefficient was used to examine the relationship between core and hip abductor endurance measures. Mean differences between overweight and obese groups were compared. 
In obese students with flexible flatfoot, positive correlations were observed between hip abductor endurance and all core endurance tests (Biering-Sorensen, Plank Hold, Side Plank Hold). However, there was a negative correlation seen in the overweight flatfoot group between hip abductor and core endurance. No statistically significant differences in mean core or hip endurance were noted between the overweight and obese cohorts.
The findings suggest that proximal muscular endurance impairments among individuals with flatfoot deformity may be exacerbated by increased obesity levels. Assessing hip and core function may aid in determining risk factors and directing exercise programs intended to prevent musculoskeletal issues in this population.
To Evaluate Importance of Coagulation Factors and Septic Screen Parameters in Prognosis of Surgical Necrotizing Enterocolitis
Authors: Tinwala Hafeza Nazimhusein , Gupta Pradeep , Kumar Chopda Ashok , Kumar Khare Atul
Published: February 2025

Background: Necrotizing enterocolitis is an ongoing acquired inflammatory disease condition affecting the entire gut especially during the neonatal period, particularly preterm and low birth weight infants. NEC is notorious for its rapid onset, diagnostic challenges, and high mortality rate, posing a severe threat to neonatal life. 
Aims-Relating parameters of coagulation and septic screen at the time of NEC diagnosis undergoing different surgical interventions and its applicability in further prognosis and outcome.
Methods and materials: A prospective observational study done in the department of pediatrics surgery, SMS Medical college Jaipur, in 70 patients from April 2023 to April 2024 with patients living between day1 to live day 28 were included. All had preoperative clinical -radiological features consistent with NEC and with intraoperative findings of NEC, were initially resuscitated, were taken a detailed history with demographic data and investigated with baseline and specific coagulation profile and sepsis screen and then were operated. An analysis of outcome and prognosis was done based on altered specific/predictive parameters taken into consideration.
Results: a total of 70 patients that underwent surgical procedure it was found that not only platelets count, but PT INR, APTT, CRP and D-DIMER were independently associated with surgical NEC. APTT and D-DIMER could be identified raised high significantly in poor prognostic neonates with 90 % specificity, 91 % sensitivity and 54.50% specificity 68.6% sensitivity respectively. Coagulopathy was found in almost 90% of cases of surgical NEC and 92% of those dyed to NEC.
Conclusion: Coagulation profile and septic screen parameters at the time of surgical NEC, are facilitative in predicting poor prognosis and likely deaths related to NEC. Hence, they should be scrutinized closely and can be used in future as conducive decision-making tools of surgical management and predict whether the outcome would be bad or good irrespective of intervention.
Azoles, A Potential Anti Diabetic Agents as α- Glucosidase Inhibitors: Past, Current & Future Prospects
Authors: Sharma Deepanshu , Prasad Mishra Ganesh , Chandra Sharma Mukesh
Published: February 2025

Diabetes is a chronic disordered metabolism disease, indicated by Elevated blood glucose level. Various methods such as Fasting plasma glucose level Oral glucose tolerance test (OGTT) and HbA1c test , have been used to diagnose elevated blood glucose level in the body.  A better medication is the only solution to control this disease. For this at present, α-Glucosidase inhibitors are recently used as a first line drug with safer efficacy. During study many previous study it was found that various chemical moieties were involved in the synthesis of α-Glucosidase inhibitors for the treatment of diabetes. Compound bearing azole moiety were one of them. This article compiled various recent researches which involved various types of compounds, having azole in their structure. Our main objective of this article is to focus on such facts, which can be used to design and synthesis of α- Glucosidase inhibitors bearing azole moiety, related to, which will further direct to the researchers in future.
Innovative Approaches in Developing an Animal Model for Gonococcal Conjunctivitis: A Preliminary Stud
Authors: Aldy Fithria , Zaitun Hasibuan Poppy Anjelisa , Dewi Sari Masitha , Mahmud Amin Mustafa , Indriaswati Luki , Pardianto Gede , Sari Siregar Dewi Indah , Ilmiati Fujiati Isti
Published: February 2025

Neisseria gonorrhoeae, the causative agent of gonorrhoea, is a major public health concern due to its widespread prevalence and rising antibiotic resistance. In addition to genital infections, N. gonorrhoeae can cause gonococcal conjunctivitis, an ocular infection that can lead to severe complications such as blindness. To better understand the pathogenesis of gonococcal conjunctivitis and investigate potential therapeutic strategies, this study aimed to establish a reliable animal model using the Wistar rat (Rattus norvegicus). Six rats were divided into six groups, each receiving six doses of N. gonorrhoeae (1.5 × 10⁶ CFU/mL) applied to the conjunctiva at 10-minute intervals. The rats were monitored for bacterial colonization at four time points: Days 1, 3, 5, and 7. Bacterial load was assessed using colony-forming unit (CFU) counts on Thayer-Martin agar, and molecular confirmation was performed via polymerase chain reaction (PCR) targeting N. gonorrhoeae DNA. Gram staining was also performed to verify bacterial morphology. Bacterial colonization progressed significantly over time, peaking on Day 5, with some rats exhibiting bacterial clearance by Day 7, while others showed persistent colonization. These results highlight the variability in host immune responses and the potential for chronic infection. The Wistar rat model offers valuable insights into the dynamics of N. gonorrhoeae infections in ocular tissues and serves as a platform for future studies on therapeutic and preventive interventions.
Poeira adiada: cuidado invisível e humildade na manutenção de nossos espaços
Authors: Bennett Sam
Published: February 2025

Ao considerar a poeira e humildes vassouras - por meio de imagens como, por exemplo, gravuras do artista estadunidense Charles Henry White ou do mexicano José Guadalupe Posada -, podemos reconhecer o valor da manutenção e refletir sobre nossas próprias responsabilidades de cuidar e de preservar os espaços que habitamos.
THE MAIN DIRECTIONS OF IMPROVING THE RESULTS OF SPRINT SWIMMERS AND THE DYNAMICS OF RECORDS IN 25.50 METER POOLS
Authors: Avtandilyan V. S. , Tiratsuyan A. G. , Mare-Gasparyan N.
Published: February 2025

The efforts of many specialists are aimed at discovering new means and methods of elite sprint swimmers’ optimal load, both in water and on land.
The improvement of sprint swimming in 50-meter freestyle in 25.50-meter pools can be judged by the dynamics of top sprint swimmers’ records.
For many years, high-volume training in the pool has been the traditional method of training. At the same time, as a rule, no distinction was made in the training of stayers and sprinters, and due attention was not paid to the strength training of swimmers on land.
In the era of widespread use of swimming suits, the increase in swimming speed has raised the bar of world records to an incredible height. In order to further improve the athletic performance of sprinter swimmers, there is a need for extensive training in gyms.
Improving the strength training and special endurance of swimmers specializing in sprint distances, studying the experience of using modern methods of training high-class swimmers all over the world, is extremely crucial. To achieve maximum speed, swimmers need to use modern techniques, which will ensure improved results at sprint distances
The purpose of the research is to study some issues of the training process of sprinter swimmers and demonstrate the dynamics of the strongest swimmers world records specializing in the 50-meter chest crawl in 25.50 meter pools.
Research problem is to identify modern concepts of the training process of elite sprint swimmers and to reveal the dynamics of record results at a distance of 50 meters in the crawl method in 25.50 meter pools for men and women.
One of the main directions for improving the results of sprint swimmers is the need to develop explosive power, grip the swimmer's body with water, rowing with straight arms, hypoxia, footwork efficiency, which ensures body retention on the surface of the water, high power and maximum speed of the swimmer.
In the process of preparing and improving the training of sprint swimmers, it is necessary to develop the following components ensuring high speed at sprint distances: a) explosive power b) hypoxia c) body adhesion to water
Dynamics of world record growth among women, women's pool - 25 m, 35 years, 1.85 seconds, pool - 50 m, 35 years, 1.12 seconds.
Dynamics of world record growth among men, men's pool - 25 m, 32 years, 1.55 seconds, pool - 50 m, 37 years, 2.03 seconds.
PHYSIOLOGICAL INDICATORS OF THE FUNCTIONAL STATE OF ATHLETES ENGAGED IN VARIOUS SPORTS
Authors: Aghababyan H.R. , Arakelyan A.N. , Danielyan K.G.
Published: February 2025

Any sports activity is accompanied by changes in the functional state, the most informative ones being the indicators of the cardiovascular system. Therefore, knowledge of the features of the degree of tension of regulatory systems based on the analysis of cardiovascular system indicators, taking into account the individual typological characteristics of the athlete, will optimize the training process.
The purpose of the study was to investigate changes in athletes’ physiological parameters during physical activity, taking into account their neurodynamic properties.
The study involved 2nd and 3rd year ASIPCS students engaged in cyclic and acyclic sports, previously tested to determine extraversion and neuroticism degree. Physical performance was determined using the Roufier-Dixon PWC method. The studies were conducted twice: before workout (physiological norm) and after workout. The Harvard step test was used as a physical activity. Athletes' heart rate, blood oxygen saturation and blood pressure were measured.
According to the testing results, 80% of athletes involved in acyclic sports are extroverts with an average level of neuroticism, 20% are ambiverts. Introverts with low rates of neuroticism dominate among athletes engaged in cyclic sports (73%). After carrying out the step test, athletes engaged in cyclic sports have a significant increase in heart rate and an increase in blood pressure, blood oxygen saturation decreases by only 1 unit. Athletes engaged in acyclic sports have identical changes in the parameters of the cardiovascular system. Only the indicator of blood oxygen saturation decreases by 3 units, which is a fairly significant change.
An increase in the values of heart rate and blood pressure in representatives of cyclic and acyclic sports under conditions of physical activity is shown, indicating an increase in the tension of the regulatory systems of the body. High excitability and neuroticism contribute to a decrease in the adaptive capabilities of the body, which can adversely affect the recovery processes. The data obtained showed that due to low neuroticism, athletes with marked introversion adapt to load conditions with lower energy consumption.
FEATURES OF PHYSICAL AND TECHNICAL TRAINING OF YOUNG HANDBALL PLAYERS
Authors: Mikaelyan G. J. , Melkonyan H.H. , Davtyan Y.L.
Published: February 2025

Modern handball is a highly training and competitive workload, it is constant tension, direct contact with the opponent, uncompromising competition. In order to withstand the game load, to have a constant advantage over the opponent, the athlete must have great physical fitness, master a large number of techniques, various tactical actions and have high moral qualities [2,8]. ].
The purpose of the research is to study the dynamics of the results of physical and technical training of young handball players in the training process.
To carry out the research, we carried out a study and analysis of literary sources, pedagogical testing, mathematical and statistical analysis.
The study was carried out in two stages, involving 24 first-class athletes aged 11-12 from Vanadzor and Yerevan. The first stage took place in September-October 2022, and the second stage was held in March-April 2023.The following pedagogical tests were used in the study
The comparison of the results from the first and second stages revealed that nearly all participants showed improvement, except in the 20-meter dribbling run. Among the boys from Vanadzor, there was a decline in performance during the second stage: the average result decreased from 8.65 seconds to 9.23 seconds. Among their peers from the Yerevan specialized handball school, a poor result was recorded in the shuttle run 5x20 meters during the second stage.
The lowest results in the exercises were observed among the goalkeepers and wing defenders.
In the training process of young handball players, you should choose such training methods that will allow you to develop all aspects of training. To effectively manage the process of physical training, it is necessary to rationally plan the training process taking into account the stage of training, age and functional state of Sportsmen, optimally organize and program training in macro-, meso- and microcycle. The study Revealed that goalkeepers achieved low results in almost all exercises, which indicates their rather low physical fitness.
Comparative Efficacy of Diclofenac Sodium and Gabapentin against Post-Operative Pain as Pre-Emptive Analgesia in Laparotomy
Authors: Hussain Saud , Ali Ahmad , Jawaid Tauseef , Ahmed Atif , Ali Wajid , Azhar Shaheer
Published: February 2025

Background: To assess the relative effectiveness of diclofenac sodium and gabapentin as preventive analgesics for post-operative pain management in patients having laparotomy.

Study Design: Present study was a comparative controlled trial conducted at random.

Methodology: Current comparative controlled trial was conducted at random fashion in different surgical and pharmacology departments of Pakistan from December 2022 to June 2023. There were a total of 100 individuals having laparotomy therefore 600 mg capsule of Gabapentin and 100 mg sustain released combination therapy was given to the every patient one hour before to going into the procedure room under doctors direct supervision. All patients were put to sleep using the conventional general anesthetic approach. The patient was moved to the recovery area next to the operating theater once the procedure and extraction were finished and their pain was measured 1to 31 minutes. Finally, all patients were shifted to the ward where the intensity of their pain were measured 60, 121, 241 and 361 minutes respectively. The intermediate time of admission and operation were noted regularly. The bio-statistic version SPSS 2020 were applied for the description of raw data.

Results: The mean standard deviation levels of age, gender, BMI, surgery duration and average anesthesia time in both Group-X and Group-Y individuals with gabapentin and diclofenac sodium were (57.18±18.04, 58.21±1.03), (67.11±01.02, 67.11±01.01), (33.10±01.04, 33.10±01.04), (28.10 ± 1.01), (27.11 ±1.01), (118.01±01.01), (128.01±02.02) showed a significant (P≤ 0.05) change. The pain ratings for gabapentin was (9.01±04.01) and diclofenac sodium was (15.25±02.03) for the 361-minute interval. 12-hour period or 721 minutes Compared to Diclofenac sodium, which exhibits a pain intensity of (14.61±04.05), gabapentin showed a considerable decline in pain.

Conclusion: The study's findings showed that administering a single oral dosage of gabapentin as a preventive analgesic to patients having major abdominal operations is beneficial for managing post-operative pain since the medication's effects linger longer and decrease the need for rescue analgesics.

Keywords: Gabapentin, Laparotomy, Anticonvulsants, glycopyrrolate, analgesics, surgery, abdominal, gynecological.
Evaluation of Efficacy of Arginine Calcium Carbonate Versus Potassium Nitrate Paste in the treatment of Dentinal Hypersensitivity
Authors: Wisal Khan Zoha , Ahmad Sana , Iqbal Ayousha , Mansoor Saad , Fatima Nida , Javed Zainab
Published: February 2025

Background and Aim: Dentin hypersensitivity (DH) is a frequent oral health condition that affects one or more teeth in many adults characterized by a severe pain of exposed dentin to an external stimulation. The present study aimed to assess the efficacy of arginine calcium carbonate versus potassium nitrate paste in the dental hypersensitivity treatment.

Materials and Methods: This randomized controlled trial was carried out on 56 subjects in the Department of Dentistry of a Tertiary Care Hospital from January 2021 to December 2022. All the subjects were divided into two groups: Group-I as test group (toothpaste containing 8% arginine and calcium carbonate and toothpaste containing 5% potassium nitrate) and Group-II as control group. Schiff Cold Air Sensitivity scale was used for recording the air blast stimuli at baseline and DH scores were used for tactile stimuli on visual analog scale immediately post scaling after desensitizing paste application. Subjects were followed-up for 1 month. SPSS version 27 was used for data analysis.

Results: The subjects in test-group had decreased sensitivity values 2.52± 0.31 at baseline to post scaling after desensitizing paste application value of 1.87 ± 0.28. The sensitivity further reduced to 1.12 ± 0.39 after paste use for one month and 1.07± 0.42 after one month cessation of its use. Both tooth pastes significantly alleviated dental hypersensitivity. The arginine and calcium carbonate presented better clinical response than potassium nitrate paste after 1 month assessment.

Conclusion: The arginine and calcium carbonate showed better clinical response than potassium nitrate paste in terms of long-term reduction in dentinal hypersensitivity symptoms.

Keywords: Dentinal hypersensitivity, Arginine and calcium carbonate, Potassium nitrate, Efficacy, Dental Pulp.
An Experience in Tertiary Care Unit: Comparison between Efficacy of Caffeine Versus Aminophylline in Apnea of Prematurity
Authors: Batool Raza Afsheen , Zulfiqar Ameez , Nawaz Nadia
Published: February 2025

Objective: To compare the efficacy of caffeine versus aminophylline in the treatment of Apnea of Prematurity amongst neonates in tertiary care unit.

Methods: The comparative cross-sectional research was conducted at Pediatric neonatology unit of The Children’s Hospital & UCHS Lahore from October, 2020 to October, 2021. A total of 60 premature newborn babies fulfilling the selection criteria were enrolled after taking written informed consent from parents and were randomly divided into two groups of equal number i.e. 30 each. Non-Probability Consecutive Sampling. One group received intravenous aminophylline and the other group received intravenous caffeine when first episode of apnea was observed on clinical parameters. Patients were followed for up to 10 days during admission and efficacy was assessed.

Results: The mean gestational age of the premature newborn babies in aminophylline versus caffeine group was 29 1.51 versus 30 1.84 weeks. Efficacy of caffeine versus aminophylline was 87% versus 63% (p=0.037), need of oxygen was in 27% versus 57% (p=0.018), need of ventilation was 3% versus 17% (p=0.085), rate of complications was 16% versus 30% (p=0.819) and rate of mortality was 3% versus 20% (p=0.044) respectively.

Conclusion: In AOP, caffeine was superior in efficacy than aminophylline in terms of reduction in recurrence of apneic spells, oxygen requirement and mortality rates and were similar in efficacy in terms of need of ventilation and side effects.

Keywords: Apnea of prematurity, Efficacy, Caffeine, aminophylline
Diagnostic Accuracy of Transvaginal Ultrasound in Diagnosis of Endometrial Carcinoma among Women with Post-Menopausal Bleeding Taking Histopathology as Gold Standard
Authors: Tul Kubra Khadija , Hussain Fozia , Imran Andrabi Wajeeha , Bakht Faraz , Raza Asia , . Samina
Published: February 2025

Background: Endometrial carcinoma is a significant cause of morbidity among post-menopausal women. Early detection through non-invasive methods like transvaginal ultrasound (TVUS) is essential, but its diagnostic accuracy varies compared to histopathology, the gold standard.

Objective: To assess the diagnostic accuracy of transvaginal ultrasound (TVUS) in detecting endometrial carcinoma in postmenopausal women with bleeding, using histopathology as the gold standard.

Study Design: cross-sectional study

Study Setting: The study was carried out Gynaecology & Radiology Department of Lahore Medical and Dental College, Lahore from April 2023 to September 2023.

Methodology: A total of 120 postmenopausal women with bleeding were enrolled. Each underwent transvaginal ultrasound (TVUS) to assess endometrial thickness, followed by an endometrial biopsy. An endometrial thickness threshold of 4 mm was used on TVUS. Histopathological findings were compared with TVUS results to determine sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).

Results: The mean endometrial thickness was 7.6 ± 3.2 mm. TVUS demonstrated a sensitivity of 83.3%, specificity of 33.3%, PPV of 29.4%, NPV of 85.7%, and an overall diagnostic accuracy of 45.8%. While effective in excluding malignancy, TVUS exhibited a high false-positive rate.

Practical Implication: Transvaginal ultrasound can serve as a valuable non-invasive screening tool for early detection of endometrial carcinoma in women with postmenopausal bleeding, aiding in timely diagnosis and management.

Conclusion: TVUS is a valuable screening tool with high sensitivity in detecting endometrial carcinoma. However, its low specificity highlights the need for histopathological confirmation to ensure accurate diagnosis.

Keywords: Diagnostic accuracy, Endometrial carcinoma, Histopathology, Post-menopausal bleeding, Sensitivity, Specificity, Transvaginal ultrasound (TVUS).
Evaluation of Relationship between Neutrophil to Lymphocyte Ratio and Rheumatoid Arthritis Severity
Authors: Anwar Shazia , Khan Adil , Ammar Khan Muhammad , Abdul Nabi Zafar , Khan Salman , Muhammad Wassan Shafi
Published: February 2025

Background: Persistent inflammation and progressive joint damage characterize autoimmune arthritis (RA), a long-term inflammatory condition

Objective: To assess the association between the neutrophil-lymphocyte index and the severity of autoimmune arthritis, evaluating its potential as a marker of disease activity

Study Design: Cross-sectional observational study.

Study Setting: The study was conducted at Fatima Memorial Hospital, Lahore over 6 months duration.

Methodology: This study included 140 RA patients, all fulfilling the 2010 ACR/EULAR classification criteria. Data on demographics, clinical features, and laboratory results, such as CBC, were recorded. NLR was calculated, and the DAS28 score was used to determine disease severity.

Results: The mean neutrophil to lymphocyte ratio (NLR) among all RA patients was 3.21 ± 1.85, with a significant increase across disease activity groups: 2.14 ± 1.02 in remission, 2.78 ± 1.23 in low, 3.42 ± 1.72 in moderate, and 4.51 ± 1.98 in high disease activity (p < 0.01). NLR was positively correlated with RA severity (r = 0.32, p < 0.01). Additionally, ESR and CRP levels were significantly elevated in patients with higher disease activity, further supporting the relationship between NLR and systemic inflammation.

Conclusion: NLR was found to be a significant biomarker for assessing RA severity. Its simplicity and accessibility make it a useful tool for clinical monitoring subjects diagnosed with RA, though further studies are required to validate its predictive value.

Keywords: Biomarker, Inflammation, Neutrophil to Lymphocyte Ratio, Severity, Rheumatoid Arthritis.
Comparison of Point-of-Care Hemoglobin A1c testing with Central Laboratory methods for screening and monitoring Diabetes Mellitus in Resource-Constrained Settings
Authors: Batool Tayyaba , Ahmad Ashfaq , . Asya , Hameed Unaiza , Ahmed Faiz Faiz , Ikram Ul Haq Muhammad
Published: February 2025

Background: Hemoglobin A1C (HbA1c) is often used for evaluating long term glycemic control in patients suffering from diabetes. In resource-constrained settings, the availability and accessibility of diagnostic facilities are often limited. Point-of-care (POC) testing for HbA1c has emerged as a potential solution to overcome these barriers

Methodology: A cross-sectional study conducted at Bahawal Victoria Hospital in Bahawalpur from May 2022 to October 2022 for a period of six months following ethical review committee permission. This research includes 173 subjects. On the same visit, blood samples were taken for HBA1C measurement using both a centralized laboratory approach (Turbidimetric Inhibition Immunoassay, TINIA) and a point-of-care testing (POCT) method (Biohermes A1C EZ 2.0). Patients were placed into three groups based on their HBA1C levels: Group A (less than 5.6%), Group B (5.6%-6.7%), and Group C (more than 6.7%). Group C was divided into two categories: diabetics with adequate glycemic control (HBA1C < 7%) and diabetics with poor glycemic control (HBAIC > 7%). Data was analyzed by using SPSS version 24.0. P-values of ≤0.05 will be considered statistically significant

Results: The result has shown that study sample consisted of 173 individuals with a mean age of 51.2 years (±SD 5.4) with 98 males (56.64%) and 75 females (43.36%). The participants had an average BMI of 28.3 (±SD 5.6). Group A has 32, Group B has 44, Group C with good control has 52 and Group C with poor control has 45 participants. The mean TINIA measurement for these groups were 5.1 ± 1.13, 6.0 ± 0.93, 6.8 ± 1.40 and 10.3 ± 2.31 respectively. While the POCT results for these groups A, B,C with good and poor control were 5.2 ± 0.41, 6.1 ± 0.23, 6.7 ± 0.83 and 10.9 ± 1.78 respectively. The comparison results of these methods using the Spearman test (non-parametric data), a correlation coefficient (r) of 0.75, p<0.001 was obtained.

Conclusion: The findings of this study support the integration of point-of-care HbA1c testing into diabetes screening and monitoring programs in resource-constrained settings, offering a pragmatic approach to contain the growing burden of diabetes in Pakistan.

Keywords: Hemoglobin, Immunoassay, HbA1c, Diabetes, Correlation, Coefficient.
The Role of Hormonal changes in Recurrent Urinary Tract Infections among Postmenopausal Women. A Clinical Perspective Study
Authors: Bint Karim Sadia , Mustafa Ghulam , Jabeen Asma , Azam Parveen , Nawaz Minhas Ibtisam , Zafar Saba
Published: February 2025

Aims and Objectives: The objectives of the study were to understand the urinary tract infections (UTIs) and their importance in postmenopausal women, associated with estrogen deficiency, alterations in vaginal microbiota and urogenital susceptibility.

Methodology: The role of hormonal and non-hormonal interventions in reducing UTI recurrence was tested in a prospective multicenter cohort. Six hundred postmenopausal women were stratified into three groups: hormone replacement therapy (HRT), non-hormonal interventions (e.g., probiotics, D-mannose), and a control group. Demographic, clinical history, biomarkers and outcomes were analyzed.

Results: Results showed a 45% and 38% reduction in UTI recurrence rates for HRT and non-hormonal groups compared to controls. Intervention groups showed improved lactobacillus abundance and vaginal pH, improved quality of life. These findings highlight how these interventions are effective in management of recurrent UTIs without adverse effects on antimicrobial resistance. Given this, further research is recommended to investigate long term efficacy and to integrate behavioral factors to promote comprehensive prevention strategies.

Conclusion: Interventions, both hormonal and non-hormonal, including hormone replacement therapy, probiotics, and D-mannose, substantially decrease recurrent UTIs in postmenopausal women and address concerns about antimicrobial resistance. These findings underscore the need for individualized, preventive strategies to promote clinical outcomes and quality of life.

Keywords: Hormone, Urinary tract infection, Postmenopausal, Antimicrobial, Probiotics.
Frequency of Eyelid Lesions in Patients Presenting at Ophthalmology Department of a Tertiary Care Hospital
Authors: Parvez Mohammad , Anwar Bhatti Shahid , Nawaz Faisal , Waseem Muhammad , Munim Abdul , Ahmad Naseer
Published: February 2025

Background: Approximately 5 percent of all skin cancers are eyelid tumors, which is also among the most prevalent location for head and neck neoplastic diseases. If diagnosed too late, malignant eyelid tumors necessitate more extensive surgery.

Objective: The aim of this study was to find out the Eyelid Lesions Frequency in patients presenting at Ophthalmology Department of a Tertiary Care Hospital

Methodology: The current study was conducted at the department of ophthalmology Ophthalmology Muhammad college of Medicine Peshawar from February 2022 to December 2022 after taking permission from the ethical board of the hospital. Overall 154 individuals who had surgery for eyelid abnormalities at the ophthalmology were included. Participants with eyelid lesions that may or may not be spreading to other tissues were enrolled in the research. Age, gender, lesion type, lesion location, histopathology assessment, therapy, and follow-up were among the details provided. Data was entered was Microsoft Excel sheet and present in tables in the form of frequency and percentage.

Results: A total of 154 individuals of both genders and different aged groups with lesions on their eyelids were examined in this study. There were 77 benign tumors and a similar amount of malignant ones. The most often diagnosed malignant lesion on the lid was carcinoma of squamous cells 46 (59.7%). Older men, farmers, and laborers with a history of prolonged sun exposure constituted the majority of those affected. It was followed by a benign lesion called epidermal inclusion cyst 26 (33.76%). Malignant lesions were seen in individuals older than 50, but benign lesions were found among individuals younger than 30. Of the 154 lesions, 26 (16.88%) had exenteration and 128 (83.11%) had excision biopsy. A biopsy was done on all 77 (100%) of them. Each of the 77 (100%) benign and 52 (67.5%) malignant lesions had a biopsy. Exenteration was done on 25 (32.4%) of the malignant tumors.

Conclusion: Our study concluded that squamous cell carcinoma and epidermal inclusion cyst are the most common eyelid lesions among individuals presenting to ophthalmology department.

Keywords: Frequency; Eyelid Lesions: malignant tumors
Frequency of Pseudophakic Glaucoma in a Tertiary Care Hospital of Pakistan
Authors: Anwar Bhatti Shahid , Parvez Mohammad , Nawaz Faisal , Waseem Muhammad , Munim Abdul , Ahmad Naseer
Published: February 2025

Background: Glaucoma after cataract surgery with intraocular lens inserting is known as pseudophakic glaucoma and its prevalence varies greatly around the world.

Objective: The aim of this study was to find out the Pseudophakic Glaucoma Frequency in a Tertiary Care Hospital.

Methodology: The current study was conducted at the department of ophthalmology Ophthalmology Muhammad college of Medicine Peshawar from April 2022 to November 2022 after taking permission from the ethical board of the hospital. A total of 216 Pseudophakic individuals’ with age range of 50–70 who had intraocular lens implantations in the anterior and posterior chambers within a minimum of 6 weeks and a maximum of 5 years after surgery were included in this study. An eye examination was performed. Snellen's chart was used to measure visual acuity. Intraocular pressure (IOP) was measured using applanation tonometry. Angle was measured with gonioscopy's assistance. A thorough fundoscopic examination of the RNFL and disc was conducted. To diagnose glaucoma perimetry and optical coherence tomography was done. When a patient had previously undergone cataract surgery, pseudophakic glaucoma was diagnosed. SPSS version 20 was used for data analysis.

Results: Over all 216 individuals took part in this research. 30 individuals (13.8%) of them were found to have pseudophakic glaucoma. Ten (33.33%) people had phacoemulsification, and twenty (66.0%) had extracapsular cataract extraction. Eight patients (23.33%) had anterior chamber intraocular lenses, while 22 patients (73.33%) had posterior chamber intraocular lenses. After cataract surgery, the average presentation time was 2.7 ± 2.6 years. Posterior capsular rupture was the most common cause of pseudophakic glaucoma 17 (56.66%) followed by UGH 3 (10.%) & pupillary block 5 (16.66%) . Retained lens matter 1 (3.33%) and YAG, or laser capsulotomy 2 (6.66.1%) were less frequent. The primary cause for pseudophakic glaucoma at the time of surgery was a posterior capsular rupture.

Conclusion: The current study came to the conclusion that anterior chamber intraocular lenses have a stronger connection to pseudophakic glaucoma than sulcus-implanted posterior chamber lenses.

Keywords: Anterior chamber; Pseudophakic glaucoma; Posterior chamber
Sanal Evren Turizmi Turizm İşletmeleri ve Destinasyonları için Bir Tehdit mi, Fırsat mı?
Authors: Pajo Aykut
Published: February 2025

Sanal evren, fiziksel dünyanın bir simülasyonudur. Kullanıcılar sanal, artırılmış ve karma gerçeklik teknolojilerini kullanarak katıldıkları sanal evrende, avatarları aracılığıyla temsil edilmektedirler. Son yıllarda turizm amaçlı kullanımı artan sanal evrende; konaklama, hava yolu, kongre, konser ve fuar hizmetleri sunan turizm işletmeleri yer almaktadır. Bu işletmeler daha çok turistik ürün tanıtımı, satış, turistik deneyim sunma, gibi kullanıcıların beklentilerine yönelik kişiselleştirilmiş faaliyetlerde bulunmaktadırlar. Sanal evren kullanımının turizm işletmeleri ve turizm destinasyonlarının geleceğini nasıl etkileyeceği ise merak ve endişe konusu olmaktadır. Dolayısıyla nitel araştırma yöntemlerinden doküman analiziyle gerçekleştirilen bu çalışmada, öncelikle yeni kavramlar olarak öne çıkan; sanal evren turizmi ve sanal evren turisti kavramları açıklanmıştır. Ayrıca sanal evrendeki turizm işletmelerinin faaliyetleri anlatılmış ve sanal evrenin turizm işletmeleri ile turizm destinasyonlarının geleceğine etkileri ortaya konulmak suretiyle tehdit oluşturup oluşturmayacağı tartışılmıştır. Araştırmada sanal evrendeki turizm işletmelerinin sayısında artış olduğu, destinasyonlar için tehdit oluşturmadığı, deneyimsel pazarlama amacı ile kullanılması durumunda destinasyon pazarlaması için fırsat oluşturabileceği sonucuna varılmıştır.