bluuebunny/crossref_metadata_2025 huggingface dataset:
Network Automation: Enhancing Operational Efficiency Across the Network Environment
Authors: Datta Anirban , Imran A. T. M. Asif , Biswas Chinmay
Published: March 2023

Network automation has evolved into a solution that emphasizes efficiency in all areas. Furthermore, communication and computer networks rely on a platform that provides the necessary technological infrastructure for packet transfer through the Internet using routing protocols. Border Gateway Protocol (BGP) is a standardized gateway protocol that exchanges routing information across autonomous systems (AS) on the Internet. The traditional technique to configure BGP is inefficient compared to the network automation concept. Network automation helps to assist network administrators in automating and verifying the BGP configuration using scripting. This paper implemented network automation using Ansible to configure BGP routing and advanced configuration in the live network environment. This study is focused on automated scripting to configure IP Addresses to the interfaces, BGP routing protocol, configuration backup. Ansible ran the scripting on Network Automation Docker and pushed the configurations to the routers. The network automation controller communicated with other routers via SSH. The findings show that Ansible has successfully deployed the configuration to the routers with no errors. Ansible can help network administrators minimized human mistakes, reduce time-consuming and enable device visibility across the network environment. This study can help network administrators minimized human mistakes, reduce time-consuming and enable device visibility across the network environment. Implementing different types of authentication and hardening process can enhance the network security level for future
A Review on Online Learning During Covid-19
Authors: Hajoary Deepak
Published: March 2023

Challenges faced by education institutions during Covid-19 are inevitable and cannot be avoided. The shift from traditional to online learning mode poses new challenges for these organizations which need innovative solutions quickly or else they will lose out on students entirely a lot of them! This article describes how theoretical research was done about this topic so that we can see what kind of problems arise when implementing e-learning systems into classrooms.
Fetal Outcome in Pregnancy with Oligohydramnios
Authors: . Aneela , Unar Asma , Jatoi Shazia Ahmed , . Maria , Zaheen Zakia , Irum Fozia , Aamir Kiran , Naz Aasma
Published: March 2023

Objective: The purpose of this study was to calculate the frequency of adverse fetal outcomes in oligohydramnios pregnancies. Study Design: Descriptive study Place and Duration: Department of Obstretics and Gynaecology,PUMHS Nawabshah Hospital. August 2018-February 2019 Methods: A total of 164 pregnant women with oligohydromnios were included in this study. Diagnosis was established after detailed history and abdominal examination. An extensive obstetric ultrasound was performed to verify the presence of alcohol, the baby's viability, the presence of two congenital defects, and the presence of the fetal heartbeat using Doppler ultrasonography. Information will then be filled in the performa. SPSS 22.0 was used to analyze all data. Results: The average age of the women was 25.76±4.18 years. Out of 164 cases, fetal growth retardation was observed in 39.02%, low birth weight 34.15%, NICU admission 30.5%, birth axpysia 27.44%, respiratory distress syndrome 12.8%, Apgar scores <7 at1 minutes 43.35% and at 5 minutes 23.2%, meconium aspiration syndrome 4.27% and perinatal mortality was observed in 4% . Conclusion: Assessment of AFI in the first part of the third trimester helps to identify women who need greater antepartum surveillance, and hence, correct care, to enhance perinatal outcome. Keywords: Oligohydramnios, Birth axpysia, Low birth weight
Evaluate the Results of Closed Interlocking Nail Shaft of Femur Vs. Open Interlocking Nail
Authors: Rehman Shams Ur , Sardar Syed Bakht , Saeed Kamran , Askari Raza , Saeed Fazl Ur Rahman , Ali Irfan
Published: March 2023

Objective: The purpose of this research is to evaluate the efficacy of closed versus open interlocking nails in treating femur shaft fractures. Study Design: Retrospective cohort study Place and Duration: This Retrospective cohort study was conducted at MTI Lady Reading Hospital Peshawar and Khyber Teaching Hospital Peshawar in the duration from 1st March, 2022 to 31 August, 2022. Methods: This research involved 108 cases with age 20-72-year had femoral shaft fracture were included. After informed written consent, age, sex, body mass index, and fracture reason were computed. Patients were equally divided in two groups. Group I utilized open interlocking nails, whereas group II used closed. Post-operative radiological and surgical results were evaluated for union, non-union, and delayed union. Calculated infection prevalence for both groups. Flynn's criterion assessed functional results. SPSS 24.0 analyzed all data. Results: In group I operation time was higher as compared to group II with p value <0.004. Closed group union time was 17.3±6.51 weeks compared to open group 27.8±6.20 weeks. Group II had 51 (94.4%) unions, whereas group I had 45 (83.3%). Group I had 12 (22.2%) delayed unions while group II had 5 (9.3%). Closed interlocking nail performed better than open approach with p value <0.03. The closed interlocking group had fewer complications as compared to open approach (p <0.02). Conclusion: This study found that closed interlocking nails for the femur shaft were superior to open interlocking nails in terms of radiographic and functional success. In addition, patients who were given a closed interlocking nail experienced less complications after surgery. Keywords: Surgery, Femur Shaft, Complications, Closed/Open interlocking nail, Functional Outcomes
Comparison of Hydrogel and Papaya Dressings in the Treatment of Diabetic Foot Ulcers
Authors: Rizwan Muhammad , Rasheed Zahid , Mirza Natasha Kanwal , Naz Gul , Sayyed Sauleha , Jameel Muhamamd Khurram , Hameed Fawad
Published: March 2023

Diabetes mellitus is the most common metabolic problem all over the world. Over 150 million people worldwide, are affected with this problem.1, 2 In Pakistan, the prevalence of diabetic patients are between 7.6% to 11%.3. Objective and Methodology: The aim of this study is to compare the relative efficacy of hydrogel and papaya dressings for diabetic foot ulcers. Patients from the General Surgery Department at Mayo Hospital in Lahore were 114 in total. Patients were randomized into: group H, who received hydrogel dressings, and group P, who received papaya dressings. Both dressings were done in ward for 20 days, every 48 hours and if wound healing occurred earlier and slough decreased then dressings were stopped and patient was discharged. The wound was assessed by photographic wound assessment tool (PWAT). Results: In Group P, mean age of patients was 52.98±8.90 and in Group H, mean age of patients was 50.98±9.62. In Group P, 34(59.6%) patients were male and 23(40.4%) were female. While in Group H 29(50.9%) patients were male and 28(49.1%) were female patients. We used Wound Assessment tool “PWAT” to compare the efficacy of these two treatment regimes. As per final “PWAT” score hydrogel dressing is more effective as compared to Papaya dressing for diabetic wound healing. i.e. Group P (Papaya dressing): 5.09±1.65 vs. Group H (hydrogel Dressing): 6.02±1.78, p-value=0.005 Conclusion: Depending upon the outcomes of this research, it can be concluded that hydrogel dressing is more useful than papaya dressing for treating diabetic wound. Although papaya dressing also have a beneficial effect on diabetic wound but still its efficacy is less as compared to hydrogel dressing Keywords: Papaya, Hydrogel, Dressing, Diabetic Foot, Wounds, Ulcer.
Incidence of Βeta-Thalassemia Minor among Healthy Blood Donors
Authors: Bibi Mehwish , Malik Saira Nasr , Afridi Aizaz , Rehman Zakia , Abedien Zain Ul , Khattak Aamer Ali
Published: March 2023

Background: Disorders with a markedly slowed rate of globin chain synthesis are referred to as thalassemia. Hemoglobinopathy is a word used to describe diseases that cause structurally aberrant hemoglobin. Iron deficiency is seen in beta-thalassemia minor, which may change the typically increased HbA2 levels. According to World Health Organization (WHO) statistics, 7% of the global population carries a hemoglobin problem. Thalassemia is the most prevalent of the hemoglobinopathies, which are significant genetic issues in Pakistan. The prevalence of -thalassemia in Pakistan is around 5%, whereas the prevalence of hemoglobin S or E is between 0.5% and 1%. The purpose of the study was to determine how common beta thalassemia minor was among blood donors. Methods: A total of 500 individuals were recruited in this cross-sectional study who were referred for hemoglobin electro-phoresis between September 2015 and March 2016 were the subject of this investigation. A thorough clinical history was taken, including information on the patient's age, sex, cast, family history, history of blood transfusions, and physical findings such as splenomegaly. Hb Electrophoresis tests were performed on all blood samples. Results: Out of total 500 patients, male were 83.1% (n=79) while female were 16.9% (n=16). Among total individuals, 18.3% (n=94) were found positive cases on Hb electrophoresis technique while remaining 406 patients were observed negative. All recruited individuals were categorised in four (04) different groups based on age; highest number of individuals were found in 18-30 years of age group with 69 patients, followed by 31-40 years of age group (n=19), 41-50 years of age group (n=5.3), and 51-60 years of age group (n=01). 94 (18.3%) had abnormal hemoglobin and beta thalassemia minor. Of them, 79 (84.4%) were men and 16 (17.2%) were women. Conclusion: Many groups in Pakistan continue to struggle with hemoglobin problems. Preventive interventions, such as pre-marriage carrier status identification and screening for beta thalassemia minor, are required to lower the incidence of beta thalassemia major by forcing couples with beta thalassemia minor to abort their pregnancies. Keywords: Hemoglobin Disorders, Thalassemia, β-Thalassemia, Healthy Blood Donors, Hemoglobinopathy
Assessment of the Factors That Can Predict the Occurrence of Diabetic Ketoacidosis in Type 1 Diabetic Patients
Authors: Dayo Abdul Rashid , Wassan Shafi Muhammad , Shahid Qurrat Ul Ain , Soomro Abdul Hafeez , Ahmed Niaz , Humaira Mona
Published: March 2023

Background: Diabetes ketoacidosis (DKA) is a common acute complication seen in patients with diabetes mellitus (DM) type 1. It is avoidable by following a good management plan. The risk factors that have been previously identified for DKA are female gender, age, illiteracy, low socio-economic status, infection, poor metabolism, psychological issues, and poor compliance with the treatment. Objective: The present study aims at the determination of age, gender, socio-economic status, DKA at the time of initial diagnosis of DM type 1, parental education regarding the disease, psychological issues, infection, metabolic control, and poor compliance with insulin treatment as the predictive factors of DKA occurrence. Study design: A retrospective cohort study Place and Duration: This study was conducted at GMMC Teaching Hospital Sukkur from November 2021 to November 2022 Methodology: The present study was conducted by using the medical records of patients with DM type 1. The mean age of the patients was 18.2±5.31 with a range of 0-21 years. The data were assessed for the predictive factors of DKA. The dependent variable in the study was DKA occurrence. The independent variables were, compliance with the treatment with insulin, DM type 1, age, infection, psychological issues, metabolic control, parental education, socio-economic status, and diagnosis of DM type 1 on a DKA attack. Logistic regression analysis was done the determination the factors that seemed to increase the incidence of DKA. Results: A total of 42 patients with DM type 1 were included in the study. The incidence of DKA was 27 (64.29%) and 4 (9.52%) of these patients died. Multivariate analysis showed that infection and diagnosis of DM type 1 at the time of DKA were the most significant predictive factors for DKA. Conclusion: Diagnosis of DM type 1 at the time of DKA and infection are the most important factors for increasing the incidence of DKA. Keywords: Diabetic ketoacidosis, type 1 diabetes mellitus, infection, predictive factors
Prevalence and Determinants of Depression Among Multi Drug Resistant (MDR) TB Cases
Authors: Ayub Muhammad , Khan Aliya , Kumari Darshana , . Saifullah , Huma Zile , Habib Muhammad Saqib
Published: March 2023

Aim: We aimed this study to find the prevalence of depression among multi drug resistant (MDR) TB patients and its related determinants. Material and methods: An observational cross-sectional study was conducted at Jinnah Postgraduate Medical Center Karachi hospital, we enrolled 107 MDR-TB patients using non-probability consecutive sampling. Patients were evaluated for depression using Patient Health Questionnaire-9 (PHQ-9). Prevalence of depression along with its determinant were assessed. We used Chi Square test for association between depression and its determinants keeping P value < 0.05 was taken as statistically significant. Results: Patients’ mean age was 32.10±6.19, male patients were higher in number as compared to female patients. In our study we found that depression was present in 52 (48.6%) patients. Depression had significant association with financial issues, family problems, treatment duration and increasing age. Practical implication: Current study assess the determinants of depression in TB patients and spreads public awareness in community about Multidrug resistance in TB and ways to avoid TB in local population. Conclusion: From our study we conclude that 52 (48.6%) patients had depression in MDR-TB patients which is an alarming situation. Financial issues, family problems, treatment duration and increasing age were found to the determinants of depression in MDR-TB patients. Keywords: Tuberculosis, Multi Drug Resistance, Depression, Truenat, Xpert, Mental disorders, psychiatric comorbidity
Differential Diagnosis of Flank Pain in the Emergency Department
Authors: Hilali Kadhim A. Al- , Taie Amer M Al- , Jobouri Ahmed Sarhan Al- , Meteab Rafea Qadri , Karim Al-Obaedi Zainab Abdul
Published: March 2023

Background: flank pain is a well-recognized and common complaint among attendants to the emergency department’ worldwide’ and demands careful evaluation and proper management to relief patient’s discomfort Objective: the study was intended to determine the causes of flank pain for patients attending the emergency department Patients and methods: Through a period of seven months (450) patients with flank pain were enrolled in the study in the emergency department. Two hundreds of them were female and (250) were males, their ages ranged from (12-70) years with an average of (38± 8 SD). All of them underwent full evaluation, including detailed history, physical examination and the available investigations, then statistical analysis was done and the results were recorded. Results: The total number of patients in the sample of study was (450), males were (250) and females were (200), with a male to female ratio of (1.25:1). Most patients (nearly 61%) were in the age group (21-40)years . Patients with renal colic due to urolithiasis constituted more than (53%) with male predominance, male to female ratio was (1.7:1). Urinary tract infection made (8.4%) of the total cases of flank pain. Female predominate by (2.8:1), other cases are shown in the accompanying tables. Conclusion: the results showed that most patients with flank pain (61%) were young subjects (21-40) years old. Urolithiasis constituted more than (53%) of the causes of flank pain with a male Predominance by(1.7:1) , while urinary tract infection made more than(8,4%) of the total number of causes , with female predominance (2,8:1). In about (5,6%) of cases no definite cause could be identified Keywords: flank pain, emergency department, urolithiasis, urinary tract infection, Miscellaneous
Factors Affecting Pregnancy Rate in Infertile Women Underwent in Vitro Fertilization / Intracytoplasmic Sperm Injection Cycle
Authors: Al-Jubouri Wafaa Mohammed , Al-Obaidi Manal Taha , Hussaini Huda Ali
Published: March 2023

Intracytoplasmic sperm injection is more being used for non-male factor indications, although it was developed for overcoming infertility of males because pregnancy rate of in vitro fertilization is still < 40%. This work aims at evaluating the vitro sperm injecting cycle fertilization/ Intracytoplasmic efficiency in infertile women and the factors that predicting clinical pregnancy rate. Al-Nahrain University at the High Institute for Infertility Diagnosis and Assisted Reproductive Technologies, we conducted a randomized clinical trial from 1st Sep. 2018 to 1st Sep. 2020. 40 women complaining from infertility underwent IVF / ICSI protocols were sampled for this work. Positive serum βhCG test were used to evaluate pregnancy r, two weeks following transferring embryo. In this study, 12 infertile women got pregnant with pregnancy rate of 30%. Duration of stimulation, number of mature eggs, fertilized eggs, and grade I transferred embryo, and changes in percentages in endometrial zone at day of pickup in comparison with that at day of hCG were significantly higher (P < 0.05) in pregnant women than those who were not pregnant. Failure rate of pregnancy is still high and the most important factors that associated with failure of IVF/ICSI outcome were short duration of gonadotropin stimulation, few number of mature eggs and embryos, and suboptimal endometrial receptivity. Keywords: IVF, ICSI, infertility, pregnancy rate, predictors, Iraq.
Comparison of Single Versus Multiple Doses of Fluoroquinolone (Levofloxacin) for Prophylaxis in Prostate Biopsy
Authors: Nasim Iqbal , Khalid Faraz , Khan Faraz Basharat , Shaikh Aatif Hassan , Ali Rajab , Bumbia Hira Anis
Published: March 2023

Objective: To assess the efficacy of Levofloxacin 500 mg orally for prophylaxis in transrectal prostate biopsy guided by ultrasonography compared to three dosages. Study design: A comparative study Place and Duration: this study was done in Murshid Hospital and Health Care Centre Karachi from September 2021 to September 2022 Methodology: A total of 615 patients having the typical indications for prostate biopsy performed under transrectal ultrasonography guidance (increased PSA, abnormal digital rectal examination) were included in this study. Overall 425 patients were considered qualified for participation; using Graph Pad Prism 6.0, patients were assigned to one of two groups using random assignment, 205 individuals in Group A were given one oral dosage of 500 mg of levofloxacin 60 to 120 minutes before the procedure, Likewise, 220 patients in Group B received Levofloxacin (500 mg) once per 24 hours for two days before to the procedure as well as the day of it. Results: Patients in Group A were given orally a single dose of levofloxacin 500 mg there were 205 patients in this group. These individuals were diagnosed with diabetes mellitus (DM) at a rate of 43.9%, febrile urinary tract infections at a rate of 4.3%, and sepsis at a rate of 0.97%.In this group, 65.80cc,was the average prostate volume, and 90.17% were overweight.A total of 220 patients in groupB who received orally three doses of levofloxacin 500 mg, with an average age of 67.45 years and a PSA mean of 21.26 ng/mL; 31.8% of patients had diabetes mellitus, & 4.45% had a febrile urinary tract infection (FUTI). In this group, no patients had sepsis, 75.61 cc was the mean prostate volume, and 72.74% of the patients were overweight, as in Group A. Conclusion: Because of how effective it is, a single dose of levofloxacin containing 500 milligrams is an excellent option for prophylaxis in patients who are going to have a transrectal prostate biopsy. Keywords: transrectal biopsy, flroquinolone, prophylaxis
Mitochondrial Ferritin in Erythroid Cells from patients with Myelodysplastic Syndrome
Authors: Ali Zulfiqar , Akbar Afsheen , , . Nida , Huda Sidra Tul , Habib Faiza , Habib Aamna
Published: March 2023

Background: The Myelodysplastic syndrome (MDS) is extremely fatal illness whither anaemia is insensitive to any medical management. Aim: In present research, effect of levels of ferritin in serum lying on prospects and continued existence was scrutinize in MDS subjects with no previous record of blood transfuse. Study design: Retrospective. Methods: These cases (MDS) were alienated into two groups, according to their serum ferritin levels. Sample size of 58 cases of MDS calculated according to online service “Select Statistical Services Ltd” comparing two means. Results: The time of endurance mean was 5.09 years ± 4.8 months. Median ferritin levels of serum ferritin were 358 ng /ml. The plasma ferritin level is related with higher rate of mortality with levels as 500 ng/ml. The ROC part for Serum ferritin was 0.721 by means of a cut-off range of 401; susceptibility and explicitness. were 71.7% and 69.1%, correspondingly) P=0.002. In attendance were 33 subjects with value of ferritin is ≥ 500 ng/ml. Patients with serum ferritin values ≥ 500 ng/mL had lower survival expectancy. Ferritin ≥ 500 ng/mL be related with seven folds augmented death rates (P = 0.001). Practical Implication: In MDS iron chelation is not well-known, for that reason the overall survival is not good. The iron chelation might encompass a favorable outcome on survival of MDS. Conclusion: Even though 1000ng/ml ferritin value in the beginning of chelation therapy is adequate, reduced survival expectancy will be associated with high levels of serum ferritin. Keywords: Myelodysplastic syndrome, ferritin, chelation, ring sideroblast, isoniazid, penicillamine
Comparison of Efficay and Safety of First-Line Drugs (Imatinib Vs Nilotinib) in Newly Diagnosed pts of Ch Myeloid Leukemia
Authors: Rahman Ayesha , Durrani Sundus , Azhar Hajra , Khalid Nida , Hafeez Najma , Matloob Hafiz Muhammad
Published: March 2023

Background: Tyrosine kinase inhibitors (TKI’s) revolutionized the treatment of chronic myeloid leukemia (CML). Aim: To compare the efficacy and safety between two Tyrosine Kinase Inhibitors among Pakistani population. Study Design: Randomized control trial. Methodology: Patients (n=124) were enrolled through simple random sampling. Prognostic scores were calculated for each patient. The institutional ethics committee of HFH approved this study protocol. Written informed consent was taken. Patients were randomly assigned to nilotinib 600 mg or imatinib 400 mg. The first analysis was done at 12 months of treatment. The second analysis was conducted after patients completed 24 months of therapy with TKIs. A consent form was signed by the participant before taking data. The basic end point was the rate of complete cytogenetic response (CCyR; 0% Ph+ metaphases by cytogenetics) at 12 months. Data was evaluated by using SPSS version 23. Chi-square test was applied with p-value of less than 0.05 was considered significant. Results: Nilotinib proved superior over imatinib in achieving complete cytogenetic response (94% vs 79%) with significant p-value. Both drugs showed similar risk profile to those from other international studies. Conclusion: It was concluded that Nilotinib proved clear benefit over imatinib in achieving higher rates of cytogenetic response in our study. The risk of events was comparable with imatinib and nilotinib; but each one showed different kinds of adverse events. Keywords: Chronic Myeloid Leukemia, Tyrosine Kinase Inhibitors and Cytogenetic Response.
Frequency of breast cancer in palpable breast lump
Authors: Nafees Afshan , Ghayasuddin M. , Shabbier Saima , Fatima Kinza , . Wahbnoorzia, , Farwa Umm E , Zaidi S. Alisha Ali , Hasan Muhammad
Published: March 2023

Background: Breast cancer is one of the most common types of cancer in women. In the past few decades, its prevalence has increased exponentially. Aim: To evaluate the frequency of breast cancer in our setup. Method: A descriptive cross-sectional study was conducted at K.V.S.S. SITE Hospital, Karachi for the period of 6 months from January 2022 to June 2022. The sample size for this study was 95 patients.The tru-cut biopsy was performed, using a tru-cut gun on patients with BI-RADS 3 clinically suspicious and family history positive.The data obtained was analyzed on the latest version of the SPSS Statistics version 26 (IBM Corp., Armonk, NY, USA). The frequency and percentages of the categorical variables were calculated. Result: A total of 95 female patients presented with palpable breast lumps. The age group presented most commonly with the lump was 32-42 years (40%).The variables like smoking, drinking, raised BMI, history of any cancer, family history of breast or any other cancer, and oral contraceptive use were found to be statistically significantly associated with the malignancy related to the breast (p <0.001). Practical implicaion: This study provides the incidence of the breast cancer which will help the doctors assess every women presenting with the breast lump and provide the required treatment early so that worst outcomes can be avoided. Conclusion: The palpable breast lump should be assessed on an immediate basis and further workup should be conducted in such patients for early diagnosis and improved treatment of the breast cancer. Keywords: Breast lump, Breast cancer, Breast biospy, frequency of breast lump, young women, family history
Role of Magnetic Resonance Spectroscopy in Supratentorial Brain Lesions
Authors: Qadir Rubab , Rehman Lal , Bokhari Iram , Shah Rukan Alamuddin , Qasim Arfa , Arooqi Yousrah Atiff , Hasan Mohammad
Published: March 2023

Aim: To identify the specificity and the sensitivity of MRS in diagnosing supratentorial brain lesions and will help the surgeons to rely on the respective diagnostic modality Method: A cross-sectional study was conducted in the Neurosurgery Department, at Jinnah Postgraduate Medical Center. The patients with conventional MR imaging showing space-occupying lesions which show a malignant diffusion restriction and enhancement were included. The histopathological diagnosis and the metabolites of the brain were detected by MR Spectroscopy were recorded. To find the association of the ratios of the brain metabolites, the chi-square test was used where a p-value of <0.05 was considered significant. The sensitivity and specificity of the MRS were evaluated then. Result: Overall, 112 patients were included in our study. 76(67.9%) patients were male. Headache (34.8%) was found to be the most common symptom. 39(34.8%) patients were diagnosed with Oligodendroglioma on histopathology. The Cho/Cr ratio >2 was found in 70(82.4%) patients diagnosed with neoplastic lesions. In 62(72.9%) patients diagnosed to have a neoplastic lesion on histopathology reported increased lipid peak and 67(78.8%) with the neoplastic lesion showed to have increased Cho/NAA ratio on MRS. The Cho/Cr ratio was found to be significantly associated with the neoplastic lesions with a significant p-value of <0.001. The MRS was determined to be 82.4% sensitive and 70.4% specific in the diagnosis of supratentorial brain lesions. This study will be quite beneficial as it will help surgeons rely on the more accurate method of diagnosing brain lesions and provide an outlook of a non-invasive method to diagnose the lesions. Conclusion: The study concludes that MRS has high diagnostic accuracy in diagnosing neoplastic and inflammatory lesions and is Keywords: Spectroscopy, brain lesions, medical resonance imaging
Effect of Peer-Led and Professional-Led Oral Health Education on KAP of Child Bearing Age Females - A Randomized Controlled Trial
Authors: Awais Faiza , Kamal Muhammad Mohsin , Ijaz Sara , Salahuddin Muhammad Behzad , Rathore Ehsan
Published: March 2023

Aim: To compare the effect of peer led and professional led oral health education on knowledge, attitude and practicesof child bearing age females. Methods: The design for this study was a randomized controlled trial in which changes in knowledge, attitude and practices were compared after providing peer and professional-led education.480 females of child bearing age in BHU Raiwind and 500 in Araiyaan were randomly selected for the study. Brushing frequency, brushing timing and fluoride prevention outcomes were compared statistically. Results:The results indicated that brushing twice a day after intervention in peer group increased to 24% from 16% (baseline) but again dropped to almost 15% at follow-up. Brushing twice a day in professional-led group was 17% at baseline which increased to 36% after intervention; though it reduced to 31% at follow-up.It was found out in peer-led group that at baseline 24.6% considered fluoride helpful in preventing oral diseases, this increased twofold in intervention visit but again dropped at follow up (still more than that at baseline). While in professional group 24.1% (same as in peer-led) thought fluoride helpful in preventing dental diseases but here in intervention visit this increased more than three times (82%) and dropped to 40% which is still more than baseline data. Conclusion:Professional led Health education significantly played an important role in adopting healthy oral hygiene habits among females of child bearing age. Health Education provided by the peers also improved the oral health conditions. Keywords: Health Education, Oral Health Education, Oral health Awareness, Professional led health Education.
Effect of Intravenous Lignocaine vs Placebo on Hemodynamic Responses during Direct Laryngoscopy
Authors: Najjad Nasir Ali Rahim , Mohsin Salman , Mughal Tooba , Rizwan Zara , Malik Shakil
Published: March 2023

Aim: To determine the effect of placebo vs intravenous lignocaine pre-intubation on hemodynamic responses during direct laryngoscopy. Study design: Randomized control trial Place and duration of study: Department of Anaesthesia, Indus Hospital, Karachi from 1st March 2017 to 31st August 2017. Methodology: One hundred and twenty patients were included and divided into two groups. In one group, lignocaine arm (1.5mg/kg I/V lignocaine) was given while placebo arm was given (6ml normal saline pre-intubation) in group two. In both groups after arrival at the operation theatre, base-line parameters like the heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure was measured non-and later hemodynamic assessment was done before giving lignocaine, prior and post intubation and after 3,5 and 10 minutes of intubation. Results: Fifty six (46.15%) were male while 64 (53.85%) were females. No patients were found to have asthma, COPD, ischemic heart disease, TB, CHF, Cushing syndrome, phenochromcytoma, and drug allergy. No significant association was found between the two groups when comparing the gender, BMI, comorbids, ASA grade and Mallampati grade. The systolic blood pressure at 3,5 and 10 minutes was significant in the two groups, while diastolic was not significantly associated. The pulse rate at3 and 10 minutes was found to have a significant association while at 5 minutes was insignificant. MAP showed no significant association between the two groups. Conclusion: Hemodynamic stability is only affected in terms of systolic blood pressure, while other parameters are not significantly affected. Keywords: Lignocaine, Hymodynamic changes, Laryngoscopy
Comparative Effects of Whole Stevia Leaf and Rebaudioside A on Oxidative Stress in Male Obese Sprague Dawley Rats
Authors: Mubarak Sadia , Faruqi Amna , Riaz Bushra , Naureen Tallat , Ali Ujala , Yousufzai M. Irfan-ul-Akbar
Published: March 2023

Background: Obesity is a dilemma nowadays for increasing percentage of people worldwide. Obesity induced oxidative stress due to increased tissue lipid levels, threatened redox state of cell and increased free radical formation leads to tissue oxidative stress. Fatty liver disease is a very common disorder related with obesity resulting in storage of fat goblets in the liver tissues leading to altered redox state called oxidative stress. Aim: To relate the outcome of Stevia and Rebaudioside A on Oxidative stress (MDA, SOD) in Obese Sprague Dawley Rats. Place and duration of study: Physiology Department of Islamabad Medical and Dental College, Islamabad, in collaboration with National Institute of Health (NIH) from 1st January 2020 to 30th June 2022. Methodology: One hundred and twenty healthy male Sprague Dawley rats were included. The animals were divided randomly into four groups of 30 rats each by simple randomization technique. Group 1 was given normal diet while the other three groups were given high fat diet. Stevia leaves and Rebaudioside A (rebiana) were further added for six weeks in the diet of Group 3 and 4 respectively. All animals were sacrificed at the end of study. Results: High fat diet induced oxidative stress in obese group was restored to approximate normal values of SOD (0.001) and MDA (0.001) by treatment with stevia and rebiana both (0.899). Conclusion: Stevia and Rebiana both cause improvement of oxidative stress unrewarding of expensive extraction procedures. Keywords: Stevia rebaudiana, Rebaudioside A, Sprague Dawley rats, Oxidative stress, NAFLD
Diagnosis of Vaso-Invasive Hepatocellular Carcinoma Involving the Medial Hepatic Vein and Right Portal Vein in a man presenting with Upper Gastrointestinal Bleeding and Melena
Authors: Haq Furqan Ul , Ali Muhammad , Hassan Sani Ul , Kumar Daneet , Ali Yasir , Islam Farooque , Hamid Tanveer , Hussain Syed Sadam , Shah Waqar Ali , Ullah Aman
Published: March 2023

Background: Hepatocellular carcinoma (HCC) is one of the most fatal malignant tumors of the gastrointestinal tract in men as compared to women. It develops in the setting of chronic inflammation and cirrhosis. Major risk factors are hepatitis B and hepatitis C, alcoholic cirrhosis, and non-alcoholic fatty liver disease. It metastasizes to lungs, bones, portal vein and regional lymph nodes. Melena and hematemesis are the common presentations. Methodology: Case report study done in Swat Medical College, Rahman Medical Institution laboratory and Swat Medical Complex. Case: We have a confirmed case of HCC initially presenting with coffee color emesis and the previous 06 episodes from August to September 2022 with melena. Computed tomography (CT) abdomen with contrast showed a mass of irregular margins with vascular invasion. Histopathology showed HCC. The rationale of this case report is that we report a HCC case with vascular invasion. This patient is a candidate for systemic therapy, which would be guided by the assessment of financial factors, performance status and other comorbidities. Practical Implications: This study is going to prove the importance of finding out why the prognosis of HCCa becomes poor when vascular invasion such as hepatic veins, vena cava, portal veins or hepatic artery is present, in this study the invasion was in medial hepatic vein extending to right portal vein, that’s why his prognosis is considered to be poor as the disease has vascular invasion, if vessel were not invaded than there was a possible of local chemo and radiotherapy to target the tumor site and patient could have survived normal life. Results and conclusion: HCC is amongst the most lethal carcinomas with various causes, including hepatitis B and C virus infection, alcohol consumption, non-alcoholic fatty liver disease, etc. The risk of HCC recurrence increases many fold in macrovascular invasion as compared to microvascular invasion even after orthotopic liver transplant. Patients diagnosed with HCC should be thoroughly investigated for vascular invasion as it is one of the major factors in making decisions regarding treatment options. Keywords: Hepatocellular carcinoma, Vaso Invasion, Alpha-Fetoprotein, Cirrhosis, hepatitis B and C, liver masses,
Early Diagnosis Of Postoperative Delirium in Patients Who Underwent General Surgery
Authors: OLUŞ Fatih , GÜNDÜZ Emel , ARICI Ayşe Gülbin
Published: March 2023

ABSTRACT

Objective: Postoperative delirium (POD) is a common postoperative complication. This study aimed to diagnose POD early primarily in patients who underwent General Surgery.

Material and Method: Data of 303 patients at the age of 18 and above who were operated by General Surgery Clinic between March 2018 and May 2018,who received general anesthesia were included in the study.

Patients’ demographic data, occupation, educational status, income level, additional diseases, ASA (American Society of Anesthesia) score, previous surgeries, history of a psychiatric or neurological disease, history of alcohol, cigarette, or drug use, and memory problems were recorded. Mini Mental State Examination (MMSE) was used to identify preoperative mental levels of the patients.

Diagnosis of the patient, name, duration and features of the surgery to be performed, whether the surgery was urgent or elective, drugs used, type of catheterization recorded. The diagnosis of POD in patients was evaluated with Confusion Assessment Method (CAM).

Results: POD developed in 2-6% (8 patients) of the patients. Results showed that the risk of delirium decreased as the education levels of the patients increased. A significant relationship was recorded between delirium and only midazolam among anesthetic agents used.

Conclusion: Diagnosing POD with CAM in an early postoperative period was advantageous. The treatment planning of the patients for POD could be done in the early period. By doing this, increase in mortality, morbidity and cost as a result of missing the diagnosis of POD was prevented.

Key Words: Postoperative Delirium, General Surgery, Cognitive Disorders
UPAYA MENINGKATAN HASIL BELAJAR PKN MELALUI METODE DISKUSI UNTUK MATERI SISTEM PEMERINTAHAN DESA DAN KECAMATAN PADA SISWA KELAS IV SD NEGERI SOTOI TAHUN PELAJARAN 2021/2022
Authors: Kolo Mikhael
Published: March 2023

Masalah dalam penelitian ini adalah: Bagaimana cara menerapkan metode diskusi dalam pembelajaran PKn pada materi sistem pemerintahan desa dan kecamatan ? dan bagaimana pengaruh penerapan metode diskusi pada materi sistem pemerintahan desa dan kecamatan dalam upaya meningkatkan hasil belajar siswa ?

Berdasarkan rumusan masalah di atas maka tujuan yang akan dicapai adalah menerapkan metode diskusi dalam pembelajaran PKn terutama materi Sistem Pemerintahan Desa dan Kecamata, mengetahui pengaruh penerapan metode diskusi pada materi Sistem Pemerintahan Desa dan Kecamatan dalam upaya meningkatkan hasil belajar siswa.

 Sebelum perbaikan pembelajaran dari 31 siswa yang tuntas belajar hanya 6 siswa atau 19 % dan 25 siswa atau 81 % belum tuntas. Hal ini menunjukkan kegagalan dalam pembelajaran.

 Pada perbaikan pembelajaran siklus I menggunakan metode diskusi yang setiap kelompok terdiri dari 6-7 siswa. Hasil evaluasi yang diperoleh dari 31 siswa ada 15 siswa yang mendapat nilai 75 ke atas atau 48 % siswa tuntas belajar, sedangkan 16 siswa atau 52 % siswa masih belum tuntas belajar. Nilai rata-rata yang diperoleh pada perbaikan pembelajaran siklus I dibanding dengan sebelum perbaikan pembelajaran ada peningkatan, dari 55,5 menjadi 67,9 atau ada kenaikan nilai sebesar 12,4.

 Pada siklus II peneliti menggunakan metode diskusi dengan jumlah tiap kelompok diskusi adalah 5 siswa. Selain itu peneliti juga menggunakan media seperti makanan cepat saji, soft drink, dll. Hal ini sesuai dengan pendapat para ahli tentang penggunaan media pembelajaran atau alat peraga dapat membantu siswa dalam proses pembelajaran.

Peneliti memperoleh hasil pada perbaikan pembelajaran siklus II. Dari 31 siswa semua siswa sudah tuntas belajar, dengan nilai 75 ke atas, dan nilai rata-ratanya adalah 81,8. Melihat hasil yang telah diperoleh maka peneliti tidak melakukan perbaikan pembelajaran siklus III pada mata pelajaran PKn kelas IV dengan materi Sistem Pemerintahan Desa dan Kecamatan di SDN Sontoi.

 Kata Kunci : Diskusi, Hasil Belajar
El Bildungsroman femenino en El verano de los peces voladores (Marcela Said, Chile, 2013)
Authors: Diaz-Zambrana Rosana
Published: March 2023

La perspectiva infanto-juvenil en la cinematografía latinoamericana asume funciones significativas

no sólo al revelar los intersticios del joven en desarrollo, sino como alegoría de la problemática en la construcción de imaginarios nacionales. A partir de las pautas y temáticas que provee la historia de formación—Bildungsroman—,la producción de Marcela Said, El verano de los peces voladores (2013), explora la experiencia de aprendizaje y rebelión del sujeto juvenil en el contexto de choques culturales, sociales y raciales entre la clase media chilena y la población marginal mapuche. Sin embargo, esta trayectoria educativa da cuenta de un potencial fracaso en la esfera personal. Mediante un estilo sugestivo y evocador, Said consigue reproducir los niveles de incertidumbre, postración e inhabilidad de la mujer adolescente para luchar contra el sistema sociocultural, patriarcal y burgués

al que pertenece.
Prensa argentina y noticia policial (1976-1983). Los casos de Diario Popular y La Prensa
Authors: Gago María Paula
Published: March 2023

El presente artículo propone analizar el tratamiento informativo que realizaron los diarios argentinos La Prensa y Diario Popular en torno a los hechos delictivos ocurridos durante la última dictadura militar argentina (1976-1983). Del análisis realizado se desprende que, si bien durante

los años 1976-1978 se utilizó una retórica propia del género policial para informar sobre la

represión ilegal, hacia 1982 el encuadre cambió y los acontecimientos policiales eran interpretados

por la prensa en clave política.
Tarifa Zero, segregação e desigualdade social
Authors: Costa Gonçalves Cristiane , Santini Daniel
Published: March 2023

O presente artigo parte da premissa de que a cobrança direta da tarifa no sistema de transporte público coletivo é um elemento segregador, que compromete o direito à mobilidade de populações mais vulneráveis. Trata-se da realização de um estudo de caso específico, do Programa Tarifa Zero, em Mariana (MG), com o objetivo de verificar em que medida políticas públicas de Tarifa Zero contribuem para promover a inclusão social, garantir igualdade de oportunidades e ampliar o acesso ao sistema de Transporte Público Coletivo, em especial para a população mais vulnerável. A pesquisa demonstra que o aumento do fluxo de passageiros após a implementação em fevereiro de 2022 aconteceu principalmente nas regiões mais vulneráveis, identificadas com base no número de pessoas inscritas no Cadastro Único para Programas Sociais do Governo Federal (CadÚnico). O levantamento também dimensiona a demanda reprimida na cidade, estabelecendo uma comparação com o número de viagens no município de Ouro Preto (MG), usado como grupo de controle para melhor identificar o nível de variação de pessoas transportadas relacionado à Tarifa Zero, no contexto da pandemia de Covid-19.
Avaliação da sustentabilidade ambiental, social e econômica de uma bacia hidrográfica do semiárido brasileiro
Authors: De Medeiros Eudilena Laurindo , Oliveira Camila Tâmires Alves , Henry-Silva Gustavo Gonzaga
Published: March 2023

O objetivo do presente estudo foi avaliar a sustentabilidade ambiental, social e econômica da bacia hidrográfica do rio Apodi/Mossoró (RN), semiárido brasileiro. A bacia foi dividida em quatro trechos: alto curso, médio curso superior, médio curso inferior e baixo curso. Os locais de amostragens foram distribuídos ao longo da bacia hidrográfica para obtenção dos valores das seguintes variáveis limnológicas: oxigênio dissolvido, nitrogênio total, fósforo total e coliformes termotolerantes. As informações relacionadas aos indicadores econômicos e sociais foram adquiridas junto ao Instituto Brasileiro de Geografia e Estatística – IBGE. A sustentabilidade foi avaliada por meio do modelo conceitual implementado com o auxílio do software Multisectorial, Integrated and Operational Decision Support System for Sustainable Use of Water Resources at the Catchment Scale (MULINO mDSS). Na bacia hidrográfica do rio Apodi/Mossoró o trecho mais sustentável foi o baixo curso, com menor amplitude de variação entre os escores das dimensões econômica, ambiental e social. Este trecho foi considerado como potencialmente sustentável, apresentando melhor desempenho nas dimensões social e econômica, no entanto, comparativamente, exibiu menor escore para a dimensão ambiental do que os demais trechos da bacia hidrográfica. Isto evidencia que o trecho de baixo curso possui maior desenvolvimento econômico e social, entretanto, apresenta mais problemas ambientais. O trecho de alto curso foi classificado como de baixa sustentabilidade. Já o trecho de médio curso superior se destacou na dimensão ambiental, mas por não apresentar escores proporcionais nas dimensões social e econômica, o seu índice geral foi de baixa sustentabilidade. O trecho de médio curso inferior apresentou média sustentabilidade. Assim, foi evidenciado que ambientes que são mais desenvolvidos economicamente tendem a apresentar mais problemas ambientais, entretanto, ainda podem ser considerados mais sustentáveis devido ao maior desenvolvimento econômico e social.
Participação social e retrocessos na proteção da vegetação de restinga no Brasil no período entre 1965 e 2021
Authors: Dos Santos Claudia Regina , De Freitas Rodrigo Rodrigues , Medeiros João De Deus
Published: March 2023

As restingas estão localizadas ao longo de todo o litoral brasileiro, tendo um papel crucial na proteção das cidades costeiras aos eventos climáticos extremos. As ameaças a este ecossistema se intensificaram com o desmonte da legislação ambiental e dos órgãos colegiados de regulamentação, a exemplo do Conselho Nacional de Meio Ambiente (CONAMA). Este artigo investiga as implicações da alteração na composição do CONAMA e os reflexos na proteção legal da vegetação de restinga. Os dados foram obtidos por meio de pesquisa de fontes documentais e legislação, coletados entre março de 2020 a maio de 2021. Os avanços e retrocessos na proteção legal da vegetação de restinga foram identificadas no período de 1965 a 2021, tendo como marco histórico a Lei nº 4.771/1965. Os dados levantados foram analisados a partir de quinze princípios-chave da Gestão de Base Ecossistêmica. A participação social no CONAMA foi comprometida com a edição do Decreto nº 9.806/2019, que reduziu o número de conselheiros titulares de 108 para 23, ficando restrito aos ministérios, confederações, um representante do Ministério Público e um representante da sociedade. Após a reestruturação dos conselheiros foi aprovada a Resolução CONAMA nº 500/2020, que revogou a Resolução CONAMA nº 303/2002, a qual protegia a restinga na faixa de 300 metros medidos a partir da linha de preamar máxima. A subversão do princípio democrático da participação popular gerou perda de proteção legal na vegetação de restinga, afastando o Brasil dos compromissos estabelecidos em convenções internacionais, além de trazer riscos à conservação de ambientes frágeis, dinâmicos e instáveis.