bluuebunny/crossref_metadata_2025 huggingface dataset:
Participatory Conservation of Sacred Natural Sites: A Study of Haritha Poonkavanam Project of Sabarimala, Kerala, India
Authors: Kamalahar R.
Published: October 2021

Biodiversity and the environment are inextricably linked to human cultural diversity. Traditional cultures have frequently preserved or kept untouched portions of their natural surroundings. Most of these civilizations regard some locations as holy, prohibiting most or all human activities. As evidenced by the sacred mountain environment and sacred vegetation, traditional culture plays an important role in biodiversity conservation. Sacred forests are part of a long-standing practise of protecting certain geographical regions with cultural and religious importance. A number of studies have shown that sacred forests are significant refuges for biological variety, particularly medicinal plants, amid highly anthropogenic environments, in addition to their cultural value. While sacred natural sites have been effective conservation sites in the past, there are various dangers to these ecosystems now, ranging from demands for the use of timber and other forest products to agricultural clearance and general changes in cultural practises as well pilgrimage to these sacred areas. The significance of natural sacred sites, particularly sacred groves, is gaining attention in international conservation organisations such as UNESCO and the IUCN, and has significant implications for the implementation of Article 8j of the Convention on Biological Diversity, which emphasises the utilisation of traditional knowledge and practises for conservation and long-term usage.

Keywords: Sacred natural sites, Cultural diversity, Biological diversity, Vana Samrakshana Samithi.
Recent Herbal Proprietary Preparations for Liver Diseases: A Comparative Study
Authors: Yadav Manish S. , Buram Praveen
Published: October 2021

Liver is considered to be one of the most vital organs that functions as a centre of metabolism and excretion of waste metabolites. A number of risk factors predispose an individual to hepatic injury and thus liver diseases. Total death worldwide due to liver diseases raised by 50 million per year over two decades, according first ever WHO Study of Liver Disease Mortality. In recent years Indian Traditional Medicines like Ayurveda, Siddha and Unani have gained importance and popularity because of their safety and efficacy in liver diseases. Several Ayurvedic proprietary liver preparations are being extensively used in Ayurveda for the management of liver diseases. About 600 commercial herbal formulations with claimed hepato protective activity are being sold all over the world. In India more than 93 medicinal plants are used in different combinations in the preparation of 40 patented herbal formulations in the form of liquid and tablet. But very little is known when and how these formulations are to be used in present practice.
Out of this easily available most commonly used liver preparations Adliv, Amlicure DS, Arkaliv, Ayuliv, Hepjaun, Kamilari, Kamilari plus, Liv Aid, Livercure, Livergen, Liv 52, Livobell, Livokin, Livomyn, Livpar, Nirocil, Stimuliv, Strongliv, Terfoliv and Vasuliv are taken for the study. These preparations are classified on various basis like available market form, Herbo-Herbomineral preparations etc. Kutaki is most commonly used single drug in maximum number of preparations followed by Bhringraj, Bhui Aamalaki, and Kalmegh. Individual drugs of the preparations are studied according to Rasa, Virya and Vipaka. Uses of individual drugs as well as of liver preparations are also studied in relations with liver diseases. Present study will definitely give a clue for standard herbal formulations based on physiopathology of liver disease which is a need of a day

Keywords: Liver, Hepato protective, Herbal, Formulations.
Optimization of Online Learning and Teaching Learning Activities on LMS (Learning Management System) Based Incentives Using Decision Support Systems
Authors: Yazid Ahmad
Published: October 2021

Based on data obtained from the E-Learning Bureau of University of Pembangunan Panca Budi, only about 20% of lecturers want to use LMS or e-Learning portal in the teaching and learning process. Some lecturers use other platforms that they find easier and some use email, WhatsApp Group and flash drives in data transfer or assign assignments to students on the other side. Universities are required to use an online learning platform that can be synchronized with the SPADA DIKTI page so that checking online teaching activities can be monitored or reported periodically and easily. This research will focus on assessing lecturers' activities on online learning at LMS using a Decision Support System where the criteria used are criteria that must be met in the study program accreditation form item. The goal is in addition to increasing the activities of lecturers through incentive giving also directly assisting the study program in the fulfillment of study program form documents. The results of this research will be a reference for the leadership in making policies related to the amount of incentive that will be given as well as other provisions that can stimulate lecturers in increasing teaching and learning activities in LMS or e-Learning portals.

Keywords: e-Learning, Learning Management System, Decision Support System, System Additive Weight, Online Learning System, Online Learning.
Web-Based Sales and Fundraising Information System at Beri Perubahan Indonesia Foundation
Authors: . Arpan , Arif Furqon Muhammad
Published: October 2021

This research departs from the problems faced by the management of Beri Perubahan Indonesia Foundation, namely (1) The absence of an information system that acts as a Transaction Processing System (TPS), (2) The absence of an information system that provides the best convenience and experience for users and donors in Beri Perubahan Indonesia Foundation equipped with payment gateways so that users are facilitated in every transaction they make. Based on these problems, researchers aim to solve existing problems. In this study researchers used descriptive qualitative research motto using primary data from unstructured interview results and secondary data derived from library studies, while to build the required system, researchers used one type of Agile method, namely Extreme Programming (XP).
Based on the results of the study, it shows that researchers successfully fulfilled the purpose of this study or in a sense, with this study Beri Perubahan Indonesia Foundation already has an information system that acts as a Transaction Processing System (TPS) to manage sales and also fundraising or crowdfunding, and there has been a system that provides convenience and a good experience for users and donors at Beri Perubahan Indonesia Foundation. But in the article management section, the system has not been able to login one door, so to enter the Content Management System (CMS) page of the article, must login again. In the end, the sales and fundraising information system created and designed by researchers has met the research objectives and meets the needs of Beri Perubahan Indonesia Foundation.

Keywords: Agile, Crowdfunding, Payment Gateway, Content Management System.
Experimental Brain Injury Induced by Acute Hypobaric Hypoxia Stimulates Changes in mRNA Expression and Stress Marker Status
Authors: Tahir Muhammad Shoaib , Almezgagi Maged , Zhang Yu
Published: October 2021

The present study was proposed to investigate the brain injury under acute hypobaric hypoxia following alteration in mRNA expression and stress markers in a time-dependent manner. SD clean graded male rats were randomly divided into four groups for this experimental brain injury, the control group at Xining (altitude, 2270m) and hypoxia treatment groups with different time exposure day1, day2, and day3 at (altitude, 7000m) in a hypobaric chamber. After day3 exposure, the brain tissues were collected. The level of mRNA expression of VEGF and HIF1-α was assessed using qRT-PCR. The oxidative stress level of superoxide dismutase (SOD) and malondialdehyde (MDA) were determined with commercial kits. AHH with time duration significantly increased the MDA level and decreased in the activity of SOD was seen in all hypoxia treated groups as compared to the control (P< 0.001). The mRNA expression level of HIF1-α and VEGF in day1, day2, and day3 AHH groups was markedly raised when it is compared to control (P< 0.05). Ultimately, in conclusion, such results indicate that AHH stimulates oxidative stress induces brain damage in rats.

Keywords: Acute hypobaric hypoxia, Brain injury, HIF-1α, Oxidative stress.
Decoding COVID-19: What Dentist Should Know?
Authors: Sriharsha Pudi , Shaik Naseemoon , Yadlapati Supriya
Published: October 2021

The outbreak of the Corona virus has rapidly escalated globally as a Pandemic. Due to the characteristic dental setup & procedures the risk of cross infection is sky high not only to the Dental health care personnel but also to the patients. During this time utilizing digital resources to assist patients can be of great advantage. Doing less invasive procedures with more protection and screening can be the finest way to battle the situation. This pandemic situation provides an unprecedented opportunity for the dental community to shift the practice towards the use of Teledentistry. Teledentistry may overcome the obstacle in providing sufficient oral health services comfortably during the current pandemic situation.
Although the world of Dentistry has many challenges the main aim is to provide value-based dental care and exploit the tremendous potential of Telecommunication services & other virtual and digital alternatives to confront the challenges that are faced due to infection control, lack of awareness etc.

Keywords: Artificial intelligence,COVID-19, Dentistry, Pandemic, Teledentistry.
Análisis del discurso y coaliciones políticas
Authors: Páez Gonzalo
Published: October 2021

Luego de la crisis política y la caída del gobierno de la “Alianza” UCR-Frepaso, el sistema político argentino sufrió un proceso de fuerte fragmentación y atomización de las fuerzas partidarias impidiendo que cualquier fuerza política pudiera llegar a conformar una mayoría nacional sin llevar a cabo una coalición. Además, el fuerte trauma que significó la caída de esta coalición dificulta, en la actualidad, la conformación de nuevas alianzas. Este es el tema principal del presente libro. Nos planteamos como objetivo realizar nuevos aportes al estudio de las coaliciones. Utilizaremos como herramienta la Teoría de la hegemonía de Ernesto Laclau, según la cual podremos comprender cómo los diversos particularismos que conformaron la Alianza realizaron esta articulación redefiniendo sus identidades y unificando la oposición alrededor de un “exterior constitutivo”, el “menemismo”.
THE SYSTEM OF BALANCED INDICATORS OF A BUDGET INSTITU- TION
Authors: Stukalova G.Yu.
Published: October 2021

The article is devoted to the problem of evaluating the effectiveness of the budget institution activities and the role of personnel in achieving the goals of the organization. For commercial organizations, key indicators and a system of balanced indicators are used. Until recently budget institutions have been away from the latest management technologies and evaluation of its effectiveness and quality. With the change in the principles of financing budgetary institutions associated with the need to attract extrabudgetary sources of funding, an important problem is to determine the degree of effectiveness of the management of a budgetary institution, including in order to attract funding from extrabudgetary sources.  It is proposed to develop a system of balanced indicators based on external and internal evaluation and in the context of the goals of the budget institution: economy and efficiency. Key indicators are set by ma nagement levels, since a budget institution has a complex branch network. The proposed system makes it possible to build a kind of rating on the basis of the given marks for the achievement of targets, reflected in the key performance indicators (efficiency and economy).
TO THE QUESTION OF USING A VOLUNTEER ACTIVITY IN THE RESOCIALIZATION PROCESS OF MINORS CONDEMNED TO PUNISHMENTS NOT RELATED TO IMPRISONMENT
Authors: Volkhovsky R.A. , Petrenko N.I. , Smirnova I.N.
Published: October 2021

The article analyzes certain issues of the implementation of measures of a resocializing nature in relation to convicts without isolation from society, who have not reached the age of majority, with the help of their active involvement in volunteer activities. Based on the results of the study, ways of expanding the practice of using volunteerism in the process of resocialization of minors are proposed, aimed ultimately at strengthening the interaction of subjects implementing the tasks of resocialization, and volunteer organizations, as well as spreading best practices in this area to as much as possible the number of territorial bodies of the Federal penitentiary service.
HISTORICAL DEVELOPMENT OF THE RUSSIAN ADVOCACY
Authors: Dmitriev D.S. , Dmitrieva D.S. , Gorodnova O.N.
Published: October 2021

The article analyzes the historical trajectory of the formation of the Institute of Advocacy at various stages of both the pre-reform and post-reform period of the development of law and legislation, taking into account various social and political events of that time.

The relevance of studying the history of the development of the bar is due to the fact that a detailed analysis of historical phenomena and events that took place throughout the evolutionary path of the formation of the Russian bar is a necessary step that will avoid mistakes and adverse phenomena made in the past, and will also act as a preventive factor that makes it possible to carry out a more progressive development of the modern bar.

The article examines the emergence and formation of judicial representation in Russia during the judicial reform of 1864, analyzes the essence of advocacy in the revolutionary period of 1917, describes the organization of advocacy in 1920 and 1980, as well as the post-Soviet period.
THE USE OF THE DEATH PENALTY AS A FORM OF PUNISHMENT IN THE ZAPOROZHYE COSSACK ARMY (XVI–XVIII centuries)
Authors: Parshina N.V.
Published: October 2021

The article is devoted to the analysis of the norms of customary law in the Zaporozhye cossack army. The author pays special attention to the issue of the use of the death penalty for committing a crime. With the use of formal legal, historical-legal and comparative-legal methods, the analysis of law enforcement practice concerning the regulation of the legal life of the Zaporozhye cossacks was carried out. The author came to the conclusion that the legal customs of the army, which was located in a certain historical period on the territory of the Grand Duchy of Lithuania, and then the Polish-Lithuanian Commonwealth, were formed under the influence of the Lithuanian Statute as amended in 1529, 1566 and 1588. After the Zaporozhian Sich became a Russian citizen in 1654, cossack customs regarding the use of the death penalty ran counter to tsarist legislation (in 1744, this type of punishment was banned in the Russian Empire). However, the judicial authorities of the Zaporozhye army continued to impose such a sanction for certain categories of crimes until the final inclusion of the cossacks in the system of regular troops of the Russian Empire in the last quarter of the XVIII century as part of the Black Sea cossack army.
THE ESTABLISHMENT AND DEVELOPMENT OF THE INSTITUTE OF CRIMINAL LIABILITY OF MINORS FOR EXTREMISM IN RUSSIA
Authors: Sirotkina T.G.
Published: October 2021

The article examines the historical aspects and prerequisites for the emergence and development of criminal responsibility for extremism. The author draws attention to the fact that the definition of extremism in the science of criminal law causes certain difficulties, since it is close to terrorism and terrorist activity in its content, which does not allow distinguishing these crimes.

The analysis of social and legal grounds for criminalization of this social phenomenon is presented. The author conducted a historical and legal analysis of the legislation of the USSR times and the current criminal law, considered the features of sentencing minors, raised the question of the age of criminal responsibility. The study concluded that there are similar measures of responsibility for crimes directed against the foundations of the state structure, extremist and terrorist manifestations. The author notes that the criminal liability of minors for a long historical period of time is unchanged. The only difference is the age of bringing persons to criminal responsibility in the conditions of the development of law and society.
Etica academică în contextul pandemiei Covid 19: metode eficiente utilizate la nivel instituţional
Authors: GIURGIUMAN Tünde , DEACONU Marius , VÂTCĂ Sorin Daniel
Published: October 2021

În contextul situației pandemice provocate de Covid 19, etica şi valorile academice au avut de suferit în ceea ce privește informarea, promovarea și diseminarea normelor de conduită academică și profesională. Toate instituţiile publice au la bază fie codul de etică și deontologie, fie regulamente de conduită profesională pentru a contracara problemele unui comportament inadecvat. Prin urmare, au fost necesare noi metode de promovare adaptate comunicării online. Noile metode utilizate au facilitat transmiterea informaţiilor, care vizează drepturile şi obligaţiile studenţilor, normele de comportament și conduită ale personalului academic şi auxiliar, facilitând astfel respectarea standardelor de etică şi conduită acceptate și impuse de mediul universitar. Lucrarea de faţă abordează problematica metodelor utilizate în această perioadă, în care mediul on-line a constituit sfera de desfăşurare a tuturor acţiunilor întreprinse. E-mail-urile de informare și promovare, întâlnirile individuale sau în grup, dezbaterile pe diverse teme, şedinţele de consiliere şi-au găsit un teren propice de manifestare în mediul virtual. Aşadar, unei universităţi, care în societatea actuală are rolul de a reprezenta un pol de excelenţă cu funcţie de formator de opinie şi atitudine la toate nivelurile ei, îi revine dificila sarcină de a promova și veghea asupra valorilor morale şi etice
Research Ethics in Universities
Authors: VÂTCĂ Sorin Daniel , DÎRJA Marcel , SALCĂ ROTARU Cristina Mihaela , GIURGIUMAN Tunde
Published: October 2021

The ethically process in research is time consuming because we also find a difficulty when judging different problems seeing that many regulations have ambiguous meaning. For ethics commission members it appears to be a burden when it comes to analyze the research ethics issues. The main reason is represented by the increased subjectivism and also the differences between an institutions to another or even between different countries. This study aim is concentrated around the ethics problems that appear in the research field. Each researcher must be informed about the research ethics and make an individual effort to find the appropriate information that fits to his personal interest regarding all possible ethics issues that can appear in his interest domain. A specialist with integrity and common sense it is supposed to act with active and politically correct conscience during his research activity especially in experimentation systems and afterwards when results dissemination is prepared for publishing. The intellectual property is the most important set of exclusive rights granted to original creations or extraordinary research results. The ethics commissions around the world would appreciate, protect and encourage all the politically correct behavior in this vast domain.
Fundamentul moral al dreptului în Roma antică
Authors: MURZEA Cristinel Ioan
Published: October 2021

Normativitatea sistemului social politic este un postulat al genezei și al organizării statului, privit ca un sistem de sisteme în care evident subsistemul dreptului apare în conținut și formă ca o realitate obiectivă ce-și are fundamentul în preceptele morale ale societății respective. Pe aceste coordonate între normele juridice Jus și cele de ordin moral FAS a existat o congruență perfectă în cadrul societății antice romane arătându-se în mod explicit că principiile dreptului roman se definesc prin principii de ordin moral precum – honestevivere, alterum non laedere, suum cuique tribuere.
Deontologia muncii în echipă în contextual actual al muncii la domiciliu
Authors: MANEA Laura , CARVALHO FIGUEIREDO Frederigo de
Published: October 2021

Omul ca ființă socială se integrează în colective diferite, în funcție de activitate, și își adaptează comportamentul în funcție de rolul pe care îl ocupă în grupul formal sau informal în care se regăsește. În cazul muncii în echipă, este necesară o anumită coordonare a activităților individuale, stabilirea unor restricții și/sau competențe care să conlucreze la cooperarea membrilor echipei, în condițiile în care în mod individual fiecare membru să fie stimulat spre performanța echipei. Începând cu anul 2020, translatarea activităților angajaților în mediul casnic (munca la domiciliu sau telemuncă) a determinat pe de o parte securizarea personalului din punct de vedere al sănătății, dar distanțarea socială a generat anumite rupturi în cazul activităților derulate în echipe de lucru și preluarea unor activități suplimentare de către unii membri ai echipei, fie din motive tehnice (dotările de acasă nu permit desfășurarea anumitor activități), fie din motive organizatorice. Cercetarea din prezentul studiu urmărește să identifice, în cadrul legal actual al muncii la domiciliu, măsurile prin care angajatorii pot modifica atribuțiile angajaților în cursul derulării raportului de muncă, respectiv cadru legal care permite sau impune angajatorului să opteze pentru munca la domiciliu/telemunca
Gall stones in the pediatric population in Pakistan: Causes and Consequences
Authors: Ahmed Armaghan , Hussain Abid , Irshad Faiza , Mahmood Tahir , Akram Muhammad Usman , Ijaz Samia
Published: October 2021

Aim: To investigate the causes of incidence of gallstones in case of children and response to treatment via ursodeoxycholic acid (UDCA) Methods: 42 children suffering from cholelithiasis were selected, and gallstones were scanned using ultrasonography. The findings of scan of these children were recorded in Performa. Study duration 18 months Children's Hospital and the Institute of Child Health Lahore Results: The most common risk factor in case of incidence of gall stones was a family history. By the aid of UDCA treatment many children showed positive response especially in first six months where as children suffering from hemolytic diseases were failed to depict any response to UDCA. Treatment Conclusion: UDCA treatment proved to be beneficial to patients with asymptomatic profile before surgery in case of children suffering from cholelithiasis and having no hemolytic pathologies. Keywords: Cholecystectomy, Gallstone, Ursodeoxycholic acid.
Comparison of Cuffed vs. Uncuffed Endotracheal Intubation efficacy in Cleft Palate Surgery procedure in children
Authors: Nishat Mufassar , Ahmad Khaleel , Tabassam Sumara , Durrani Naveed Ahmed , Haq Usman ul , Haqu Faheed ul
Published: October 2021

Background: From several decades, in case of pediatric oral surgeries, Uncuffed endotracheal tubes are preferred due to insufficient availability of evidences, Aim: To compare morbidity post-operatively after using uncuffed and cuffed endotracheal tubes in case of children undergoing surgery of cleft lip-palate. Methods: This study was carried out on children aging from 3 to 10 years. About 40 candidates participated and divided into two groups according to the list generated via computer. The comparison was made between sore throat, extubation stridor, regaining of normal voice and first oral intake postoperatively between two members of groups. Results: In case of uncuffed group of candidates, the sore throat was evident more P value > 0.005 as compared to members belonging to cuffed group postoperatively . In case of cuffed members, regaining normal voice and first oral intake was earlier significantly as compared to members belonging to uncuffed. Conclusion: Cuffed Et depicted lesser prevalence of sore throat as compared to members belonging to uncuffed , after following standard protocols .Moreover, regaining of normal voice as well as first oral intake was also earlier in case of uncuffed group as compared to cuffed group postoperatively. Keywords: Cleft palate, cuffed, postoperative morbidity, preformed tracheal, uncuffed
Efficacy of micro pcnl for renal stones in pediatric age group
Authors: Zaheer Muhammad , Rauf Abdul , Khan Fazal-ur-Rehman , Rehman Rana Atta-ur- , Rasool Saba , Shokat Zeeshan
Published: October 2021

Background: Renal calculi is mineral deposit in the renal calyces and pelvis that are found free or attached to the renal papillae. Management of kidney stone disease in pediatric population is a challenging condition in urology practice. While the incidence of kidney stone is increasing in those group, technological innovations have contributed to the development of minimally invasive treatment of urinary stone disease such as mini-percutaneous nephrolithotomy (mini-PCNL), micro-PCNL, ultra mini-PCNL. Aim: To find the frequency of stone clearance and post op hematoma after micro PCNL in pediatric patients with renal stones. Place and duration of study: Department of Urology, Shaikh Zayed Hospital, Lahore from 25-01-2020 to 25-07-2020. Methodology: After approval from the hospital ethical committee, 60 all the children of 18 years presenting in Department of Urology fulfilling the inclusion criteria were included. An informed consent was obtained from patients. Before performing micro PCNL renal stone was confirmed on CT-Scan KUB plain. After proper selection of the patients, they were prepared for surgery. After preparation patients were put on list for micro-PCNL. Surgery was performed. Post operatively CT-Scan KUB plain was performed to see the stone clearance four weeks after surgery. Post hematoma was noted according to Clavien Grading Scoring. Results: Out of 60 patients, 19(31.7%) were in group ≤10 years of age whereas 41(68.3%) in were in group 11-18 years of age, mean age was calculated as 12.90±3.16 years. There were 44(73.3%) were male whereas 16(26.7%) were females. Frequency of stone clearance was 56(93.33%) and post op hematuria was 4(6.66%) after micro PCNL in pediatric patients with renal stones. Conclusion: We found that, after Micro PCNL in pediatric patients with renal stones there were good stone clearance rate and less hematuria. So micro PCNL is good technique for stone clearance and less complications occurred. Keywords: Urinary tract stone, PCNL, Renal Calculi.
Frequency of Organophosphate Poisoning and its Outcome in SKBZ AK CMH Muzaffarabad
Authors: Ishfaq Sidra , Nazir Munazza , Bukhari Sajid , Ahmed Naeem , Ubaid Muhammad Furqan , Farooq Humza
Published: October 2021

Background: Organophosphate toxicity is a worldwide problem as this is equally easily available in rural and urban areas. Furthermore, the complications and outcome of the organophosphate poisoning was also examined. Aim: to determine the frequency of organophosphate poisoning and its outcomes in this region with limited laboratory and ICU facilities. Place and duration of study: SKBZ/AK CMH Muzaffarabad from January 2019 to December 2019. Methodology: This observational, prospective analytical study was planned in Department of Medicine, SKBZ/AK CMH Muzaffarabad. A total of 110 suspected poisoned patients were included having age between 12-60 years. Patients who had taken more than one poison were excluded from the study. The organophosphate poisoning was identified through pupil size, increased secretion and Glasgow Coma Scale. Results: The average age of the patients was 24.38±6.35 years. The male to female ratio was 1:1.69. Majority 77 (70%) of the patients were single and resident in rural areas 59 (53.6%). The incidence rate of organophosphate poisoning was 90 out of 110 (81.81%). There were at least 75% cases of organophosphate poisoning among all poisoned cases with p value 0.03. The survival rate was 93.3% (84 out of 90). The most important factor affecting survival rate was the time lag between ingestion of the poison and initiation of specific therapy with p value 0.022. Conclusion: Organophosphate poisoning has high incidence although has good prognosis and not a very problematic death rate. We also concluded that the survival rate can be improved through reduction in time lag before start the treatment. Keywords: Cause of poisoning, Organophosphate poisoning, Complication of Organophosphate poisoning
Radiological and Functional Outcomes of Hybrid External Fixator Treated Schatzker Type V-Vi Tibial Plateau Fractures
Authors: Amjad Usman , Sattar Anum , Zarnab Khalid Kiran , Shakoor Muhammad Abdul , Imtiaz Waleed , Ali Shah Syed Wasif
Published: October 2021

Background: Complex proximal tibial fractures caused by high energy trauma classified as Schatzker type V and VI pose a management challenge due to associated extensive soft tissue damage.Though open reduction and dual plating is considered a gold standard treatment option in these fractures but associated with wound breakdown and infection. Aim: To evaluate the radiological and functional outcomes of percutaneous hybrid fixator as alternative treatment option in these fractures. Methodology: This study designed as prospective case series was conducted in Sheikh Zayed Hospital Lahore between May 2019 to May 2021.Twenty four patients fulfilling the inclusion criteria were operated using a hybrid external fixator in schatzkerV and VI tibial plateu fractures with compromised soft tissue.On follow upradiological and functional outcomes were being evaluated. Results: At Six months follow up after surgery Rasmussen knee score was graded as excellent in 13, good in 8, fair in 3 and poor in 0 patients.In radiological outcome mean time to bony union was 13.5 weeks.One case of varus malunion and no case case of non union was observed in our study. Conclusion: Hybrid external fixator is a well found fixation alternative as compared to conventional open reduction and internal fixation in Complex tibial plateau fractures with extensive soft tissue disruption achieving satisfactory radiological and functional outcomes. Keywords: Schatzker, Tibial plateau, Hybrid fixator.
Comparison of Outcomes of Nailing Versus Plating in Humeral Diaphyseal Fractures in Adults
Authors: Amjad Usman , Zarnab Khalid Kiran , Sattar Anum , Imtiaz Waleed , Shakoor Muhammad Abdul , Ali Shah Syed Wasif
Published: October 2021

Background: Humeral shaft fracture accounts for approximately 3% of all the types of fractures and is the most common type of fracture occurring in adults. A surgical intervention for a humeral shaft fracture is controversial whether as to intervene or not but for other types of fractures like multiple fractures, severely displaced fractures, a comminuted fracture and fractures where there is vascular and nerve injury surgical intervention is definitely required. Aim: Outcomes of comparison between I/M interlocking nail and plating in fractures of humerus shaft in adult patients. Methodology: A randomized clinical trial was conducted at the Department of Orthopedic Surgery, Sh. Zayed Hospital, Lahore over a period of six months. 190 patients (divided in two equal groups by lottery method) were included. Informed consent was taken. Demographics like age, gender, duration of fracture were obtained. In group A patients underwent surgery by using IMN fixation. In group B, patients underwent surgery by using plate. Patients were followed-up in OPD of 10 days. Then patients were followed-up further in OPD for 24 weeks. If union achieved in 24 weeks, then success was labeled. Results: Total of 190 patients, mean age was calculated as 39.57±8.09 years in group A and 40.01±8.79 years in group B. There were 62(32.6%) males whereas 48(25.3%) were females in group A and that 63(33.2%) were male whereas 32(16.8%) were females in group B. Frequency of success was 94(49.5%) in group A and 92(49.4%, in group B. Frequency of infection was 1(0.5%) in group A and 2(1.1%) in group B Conclusion: It is concluded that there was no significant difference in both groups. Intramedullary nail and plate provides good outcome with no complications in the treatment of humerus shaft fractures. Keywords: Humerus shaft Fracture, Intramedullary nail, Plate.
Beliefs Perceptions and Knowledge among Alopecia Areata patients: A Cross-Sectional Study in the University of Lahore
Authors: Malik Aisha , Hasnain Kazmi Syed Atif
Published: October 2021

Background: Alopecia areata (AA) is a wide spread and chronic skin condition of unknown origin. It affects the patient's quality of life. This study was designed to assess the perception of the disease in patients with AA. Aim: To determine the belief, perception and knowledge among alopecia areata patients visiting the university of Lahore teaching hospital. Study design: Descriptive cross-sectional study. Place and duration of study: Dermatology OPD, University of Lahore Teaching Hospital Lahore from September 2019 to February 2020. Methodology: This was a description cross-sectional study from September 2019 to February, 2020 and carried out in Out- Patient Department of Dermatology at University of Lahore Teaching Hospital. The study included all the patients in the age range of 20 to 42 years of age with patchy alopecia. The duration of the study was six months, total participants were 67. A questionnaire was designed for the collection of data in the data base, such as age and gender, the onset of the disease, level of education, and is based on the knowledge, beliefs and behaviors regarding alopecia areata. The data was analyzed by using the version SPSS 25. Results: Result shows that mean age of the participant’s was 29.5±4. About 77.6 participants were married and 23.4 were unmarried. The 85.6% participants of study give yes response that alopecia areata affected the people result showed 38% considered it a serious health issue. The 76.1% participants of study give yes response that alopecia areata participants have serious financial problem. About causative factors, almost half (28%) of the participants believed that germs and viruses causes Alopecia Areata. Keywords: Alopecia areata (AA), Knowledge, Perception, Belief.
Awareness Regarding Occupational Hazards and its Prevention among Dentist in Twin Cities of Pakistan
Authors: Zara Batool , Siddique Sohaib , Shahid Fatima , Malik Aymen , . Dilruba , Arshad Farheen
Published: October 2021

Aims: The main purpose of this study is to assess the different occupational hazards faced by the dental professionals and important precautionary measures undertaken in twin cities of Pakistan. Material and method: A cross sectional questionnaire based study was conducted among the dental professionals in twin cities of Pakistan. The targeted sample size was 150-200 individuals. The survey gathered information regarding age, designation, demographic details and knowledge related to physical, chemical, psychosocial hazards and the preventive measures taken in clinics. Results: Most common hazards faced by dental practitioners are of Musculoskeletal pain and fatigue. However, Personal protective equipment and instrument sterilization were declared as most effective means of infection control Conclusion: Awareness regarding various occupational hazards among the dentists in twin cities of Pakistan is good among specialists compared to house officers and students which requires a need to spread awareness among students and house officers so that they can identify and avoid these problems. Keywords: Occupational hazards, preventive measures, twin cities of Pakistan.
Early outcomes of Intra-Aortic Balloon Pump in Patients Undergoing Coronary Artery Bypass Grafting (CABG) Surgery
Authors: Farogh Ajwad , Bashir Gohar , Gull Saira , Ahmad Naseem , Hassan Asama , Waqas Hafiz M. , Afshan Shamila
Published: October 2021

Background: Care of heart patients especially after coronary artery bypass graft (CABG) surgery can be difficult to manage especially in postoperative phase due to decreased cardiac output. Inotropes used to increase cardiac output during the peri or postoperative may cause harmful effects. Mechanical circulatory support devices, such as an intra-aortic balloon pump can be beneficial in such patients. Objective: To compare early outcomes of Intra-Aortic Balloon Pump (IABP) in Patients Undergoing Coronary Artery Bypass Grafting (CABG) Surgery Methods: Systematic random samples of 134 patients were registered from the department of cardiac surgery of Punjab Institute of Cardiology (PIC), Lahore undergone open heart surgery from December 2019 to May 2020. High-risk patients with hemodynamically stable undergoing scheduled CABG were included. The patients were divided into two groups. All information including gender and age were obtained using a structured questionnaire. Death and other complications were compared between two groups. Data was entered and analyzed using SPSS. Statistical test like chi- square and Independent t-tests were applied to obtain the required results and percentages. Results: Total 134 patients enrolled and equally divided into two groups. Group A (with IABP) have mean age was 47.58± 2.0 compared with Group B (without IABP) mean age 48.43± 4.31.There were 79(63.2%) males and 46(36.8%) were females enrolled. Hypertension, diabetes mellitus, smoking, Prior CVA, recent AMI and congestive heart failure remained statistically insignificant as p-value > 0.05. The duration of IABP, respiratory failure, renal dysfunction and length of ICU stay showed statistically significant p-value < 0.05. Reoperation for bleeding, acute AMI, pneumonia, stroke, wound infection and surgical mortality are statistically insignificant as pvalue > 0.05. Conclusion: In high-risk patients of coronary artery bypass graft, early implantation of an intra-aortic balloon pump improves the outcomes by reducing ICU stay and death; increased post-insertion creatinine levels have been proven to be an indication of approaching mortality. Keywords: Intra-aortic balloon pump, Coronary artery bypass graft, Creatinine levels, Low Cardiac Output Syndrome
Gender Differences in Ways of Coping among Cardiovascular Disease’s Patients
Authors: Mehmood Hamid , Muazzam Amina , Gul Butt Mirrat , Jabeen Bushra , Zareen Gul , Afshan Shamila
Published: October 2021

This study explores the coping ways of the patients suffering from cardiovascular disease (CVD). Six diagnosed patients participated in the study; they were 3 men and 3 women. A detailed semi structured interview was conducted. For this qualitative research the sample was taken from the Cardiology departments of Civil Hospital, Sahiwal and Ittefaq Trust Hospital, Lahore, Punjab. The Interpretive Phenomenological Analysis (IPA) method was applied to analyze the results. It was found that male patients use more problem focused coping and emotion based coping, whereas the female patients limit their ways of coping and use avoidance, denial, and prefer to cope with their disease alone. Keyword: CVD (cardiovascular diseases.) coping strategies,
To investigate which antihypertensive drug is the most popular prescription amongst Physicians
Authors: Farooq Khan Mohammad Mustafa , Mumtaz Muhammad Talha , Mohydin Mahnoor , Asim Shazia , Haider Zaidi Wali
Published: October 2021

Background:Globally, hypertension has been recognized as a main health problem for under developed as well as developed countries. It can also be defined as a non- transmittable illness due to its high rate of death and delay in early diagnosis, it is called “silent killer”. There are limited research findings available in Pakistan forassessing it’sprevalenceand no latest researches are carried out. Objective: The main goal of current research is to investigate which antihypertensive drug is the most popular prescription amongst Physicians. Material and Methods:It was a cross sectional descriptive studyperformed at the pharmacologysection, Lahore Medical and Dental College (LMDC). All adult participants (20 ≥ 50 ≤ years) for the period of11thto 20th April 2017.After taking informed permission from all the participants were enrolled. A questionnaire was used to collect the dataand analyzed by using SPSS 20. A comparative test was used to compute results. Results:50 participants were interviewed for the survey. There were 25(50%) males and 25(50%) females in this research. The average age of the subject was 32.15±2.63 years. There were 22(44%) married subjects, 15(30%) hypertensive and 11(22%) smokers in this research. 28(56%) study subject were suffering from genetically inherited hypertension. .Hypertensive patients were treated with one drug therapy 35(70%) as compare with multi drug 15(30%). Prescribed drug groups of ACE Inhibitors & Beta-Blockers as 21(42%) and Diuretics given as 6(15%). Most popular drug prescribed by physicians in single drug was Captopril 11(22%) and in multi drug Spirolactone medicine was 12(24%). Conclusion:There are several recommendations and pharmacologic treatments available for decreasing the morbidity and mortality associated with the disease. The most essential part of treatment hypertension, regardless of whatever medication is used, is lowering blood pressure. Physicians, other healthcare workers, and patients must communicate effectively for management of hypertension. Key Words: ACE Angiotensin-converting enzyme LMDC Lahore Medical and Dental College
Comparison of Efficacy of Azithromycin and Levamisole in Combination with Azithromycin in Patients of Moderate to Severe Acne
Authors: Hussain Shabir , Mustafa Amjad , Mumtaz Arif , Soban Mohammad , Shaheen Ghazala , Ahmad Shafiq
Published: October 2021

Objective: To compare the efficacy of azithromycin plus levamisole versus azithromycin in the treatment of moderate to severe acne. Design: It was a randomized controlled trial. Study Settings: This study was conducted at Department of Pharmacology over 1 year from March 2020 to March 2021 at Khalifa Gulnawaz Teaching Hospital, Bannu, Khyber Pakhtunkhwa & DHQ Teaching Hospital, Bannu, Khyber Pakhtunkhwa. Material and Methods: Sixty (120) patients of acne having either gender age between ≤18 to ≥28 years who meet the inclusion criteria were include in this study. Randomly patients were divided into two groups, in group A patients (n=60) were administered azithromycin (500 mg daily for 3 days in a week) plus levamisole (150 mg daily for two days in a week) for 8 weeks. In group B patients (n=60) patients were administered azithromycin 500 mg daily for 3 days for 8 weeks. “Acne Global Severity Score” was used for grading in patients who respond to treatment after 08 weeks therapy. Results: A total of 120 patients were enrolled in this study In Group-A Azithromycin + Levamisole, 19 males (31.66%) and 41 females (68.33%) and in Group-B (only Azithromycin) 23 males (38.33%) and 37 females (61.66%) were enrolled. Efficacy was noted in 52(86.66%) in patients of group-A receiving azithromycin plus levamisole combination where it was noted in 29(48.33%) in patients of group B receiving azithromycin (p=0.0031). Conclusion: It is concluded that for treatment of moderate acne vulgaris to severe acne vulgaris combination of azithromycin plus levamisole therapy proved more effective than azithromycin. However, there is need to conduct further comparative studies to measure efficacy in moderate acne vulgaris to severe acne vulgaris. Keywords: Azithromycin, Levanisole, Acne Vulgaris, Efficacy, Moderate Acne, Efficacy
Assessment of Knowledge, Awareness and Attitude of COVID-19 among Pakistani Dental Students: A Cross-Sectional Study
Authors: Siddique Sobia , Maqbool Shahida , Hasan Ali Muhammad Abul , Ijaz Sumera , Akhtar Obaid , Shami Sarah
Published: October 2021

Objective: To assess the knowledge, awareness and attitude of covid-19 among Pakistani dental students. Design of the Study: It’s a cross-sectional study. Study Settings: This study was carried out at HBS Dental College, Islamabad & Rawal Institute of Health Sciences (RIHS), Islamabad from August 2020 to January 2021. Material and Methods: For collection of data, a validated close-ended questionnaire was used. Response of dental students was taken using an electronic based questionnaire distributed through E-mails, Whatsap and Google forms. A total of 305 dental students completed the questionnaire. The questionnaire contained of three demographic features, 21 questions about knowledge, seven items about attitudes, and seven items about preventive measures, adapted from an earlier published questionnaire about corona virus. Convenience sampling technique was applied for collection of data and a response of respondents was presented as %. Data was entered and analyzed using SPSS V-23 taking value of p<0.05 as significant. Results of the Study: Present study included a total of 305 participants out of which 120 dental students (39.34%) were males and 185 (60.65%) were females. The majority of the participants i.e., 160 of them belonged to the age group of 17-24 years (52.40%). Almost 60.65% respondents correctly answered about statement of incubation period “2-14 days”, and 83.60% replied that COVID-19 might be present without symptoms. Out of 305 students 97.70% have replied that frequent washing of hands with soap or alcohol mixed hand sanitizer are satisfactory methods to avoid transmission of Corona virus. Conclusion: In this study dental students are satisfactorily aware from the pandemic and its promising consequences. However in this study fear of transferring the COVID-19 infection to their families and friends was a significant concern. Majority of the dental students looked to have adequate awareness about corona virus and precautionary steps taken to avoid from COVID-19 transmission for both patients and dental students. Keywords: COVID-19, corona virus, awareness, knowledge, dental students, questionnaire.
Pattern of Congenital Heart Diseases and Associated Risk Factors among Children at a Tertiary Care Hospital
Authors: Iqbal Shahid , Fareed Khan Muhammad , Imtiaz Ahmed Raja , Saidullah Shahab , Ahmed Nisar , Ali Khan Muhammad Amir
Published: October 2021

Objective: To find out the pattern of CHD and associated risk factors among children presenting at a tertiary care hospital. Study Design: A case-control study. Place and Duration of the Study: The Department of Pediatrics and Department of Cardiology, Sheikh Khalifa Bin Zayed Al Nahyan Hospital, Rawlakot from July 2020 to June 2021. Material and Methods: A total of 207 children of both genders, screened by ECG along with chest x-ray and further confirmed with the diagnosis of CHD through echocardiography were enrolled as cases. Same number of healthy controls (n=207) were recruited from immunization center of the study institution. Among cases, types of CHD were noted. For cases and controls, demographic, antenatal and maternal risk factors including maternal age, gender of the child, history of consanguinity, history of febrile illness in pregnancy, use or multi-vitamin or folic acid in pregnancy, bad obstetrical history and maternal diabetes mellitus were noted. Results: In a total of 414 children (207 cases and 207 controls), there were 219 (53.8%) male. In terms of CHD types among cases, VSD was the most noted in 62 (30.0%), ASD 35 (16.9%), TOF 33 (15.9%) and PDA in 30 (14.5%). Cases were found to have significant association with younger age (78.3% cases below 1 year of age vs. 64.7% in controls, p=0.0085), bad obstetrical history (p=0.0002), history of febrile illness in 1st trimester of pregnancy (p=0.0229) and lack of multivitamins and folic acid in the 1st trimester of pregnancy (p=0.0147). Conclusion: Majority of the children with CHDs were male and aged below 1 year. VSD, ASD, TOF and PDA were the most frequent types of CHD. Younger age, bad obstetrical history, history of febrile illness in 1st trimester of pregnancy and lack of multivitamins and folic acid in the 1st trimester of pregnancy were found to have significant association with CHDs among children. Keywords: Congenital heart disease, echocardiography, ventricular septal defect.