bluuebunny/crossref_metadata_2025 huggingface dataset:
Elemental and Phytochemical composition of Pratia begonifolia (Wall.) Lindl. by using GF-AAS, SEM-EDAX, FTIR, GC-MS and HR-LCMS.
Authors: Deliza Hidangmayum , Ningombam Dollyca , Maibam Damayanti
Published: June 2023

Pratia begonifolia (Wall.) Lindl. belongs to the Campanulaceae family, which is traditionally used for treating kidney stones. The present study investigates the elemental, functional groups and bioactive compounds of Pratia begonifolia (Wall.) Lindl. using Graphite Flame Atomic Absorption Spectrometer (GF-AAS), Scanning electron microscopy with energy dispersive X-ray spectroscopy (SEM/EDAX), Fourier Transform Infrared Spectroscopy (FT-IR), Gas Chromatography-Mass Spectrometry (GC-MS) and High-Resolution Liquid Chromatograph Mass Spectrometer (HR-LCMS). The elemental analysis using GF-AAS revealed the presence of Chromium as the highest concentration (1.46±0.001ppm). The weight percentage of 5 elements was identified by SEM/EDAX analysis, which shows that Potassium has the highest weight percentage. In FT-IR analysis, 9 functional groups of the compounds present in the plants were identified with the wavelength of the dominant peak obtained from absorption spectra. GCMS analysis of the methanol extract revealed the presence of 12 compounds, Cyclotrisiloxane, Hexaphenyl; Methyl 11,14-Octadecadienoate; Phytol; Methyl 11,14,17-Eicosatrienoate; D-fructose,1,3,6-trideoxy-3,6-epithio-; Methyl 10-methyl-undecanoate; Beta. -d-lyxofuranoside, o-nonyl-; Ascaridole epoxide; Z, Z-6,28-Heptatriactontadien-2-One; 2,4,4-Trimethyl-1-Pentanol; Beta. -D-Mannofuranoside, 1-O-(10-Undecenyl)-; Chloroacetic Acid, 2,2-Dimethylpropyl Ester; among them Cyclotrisiloxane, Hexaphenyl (4.8%) was found to have the highest percentage area. Chloroform extract revealed the presence of 17 compounds viz. Pentacosane; Eicosane, 2-Methyl-; Hexacosane; Pentatriacontane; Dotriacontane; Phytol; Z, Z-6,28-Heptatriactontadien-2-One; Dotriacontane; Squalene; Triacontane; Eicosane; Hentriacontane; Octadecane, 2,6,10,14-Tetramethyl; Tritetracontane; Octatriacontane, 1,38-Dibromo-; 1 Octadecanoic Acid, 2-Oxo-, Methyl Ester; Eicosane, 2,6,10,14,18-Pentamethyl- and Phytol and Squalene, which have anti-bacterial properties, were also present. HR-LCMS analysis revealed the presence of Hydroxysalmeterol; 2’,4’-dihydroxychalcone; Ipecac (methylpsychotrine); Rhoifolin; Genkwanin; Anabasamine; Cuscohygrine; Eicosanedioic acid; Docosanedioic acid; Oleamide; Khayanthone as a positive ion. 2-Isoprenylemodin; Quinalizarin; Luteoline; Isoeugenitol; Ensulizole; O-Desmethylquinidine; Descarboethoxyloratadine as negative ion.
KRİPTO PARALAR VE MUHASEBELEŞTİRİLMESİ ÜZERİNE BİR İNCELEME
Authors: DOĞAN Saime , DİLEK Şerif
Published: June 2023

Geleneksel para sisteminden farklı kendi işleyiş kurallarına sahip olan, kriptografi ile yüksek güvenliği tesis edilmiş ve merkeziyetsiz yapısıyla kripto paralar dünya çapında büyük ilgi görmüştür. Sunduğu potansiyel fırsatların yanında taşıdığı risklerden dolayı şüpheli yaklaşılan kripto paraların operasyonel işlemlerde kullanılması bunların muhasebeleştirilmesini de etkilemektedir. Farklı boyutları ile ele alınan ve piyasada yoğun bir şekilde mali işleme konu olan kripto paraların, muhasebenin kamuya bilgi sağlama sorumluluğu gereği raporlanması ve muhasebe boyutunun da incelenmesi önem taşımaktadır. Kripto paraların muhasebe literatüründeki diğer varlıklardan farklı olması, bu varlıkların muhasebeleştirilmesi konusuna yönelik kamu otoriteleri ile düzenleyici ve denetleyici kuruşlar tarafından henüz kesin bir düzenleme yapılmamış olması farklı yaklaşımların benimsenmesine neden olmuştur. Çalışmada kripto paralar ele alınarak, kripto paraların muhasebeleştirilmesine yönelik benimsenen farklı yaklaşımlar açıklanmış ve muhasebe kayıtlarında ne şekilde ele alınması gerektiği yönünde öneriler sunulmuştur.
Varicella zoster virus cerebral vasculopathy without rash accompanied by mucous and bloody diarrhea successfully treated with intravenous acyclovir: A case report
Authors:   Clinical Center of Serbia Dr Suboticastarijeg 611000 Belgrade, Serbia, Ristic Aleksandar J
Published: June 2023

Introduction: In recent years it has become evident that Varicella Zoster Virus (VZV) reactivation can present as ischemic and hemorrhagic stroke or Gastrointestinal (GI) symptoms in immunocompetent and immunocompromised patients. Both VZV cerebrovascular and visceral manifestations may appear in the absence of a cutaneous rash.
Case report: Delayed onset of Guillain-Barre syndrome following SARS-CoV-2 infection
Authors:   New York Medical College School of Medicine 40 Sunshine Cottage Road, Valhalla, Hirani Rahim
Published: June 2023

To date, little is known about the rare complications of SARS CoV 2 infection. Here, we report a case of delayed onset of Guillain Barre Syndrome (GBS) after such infection in a 40-year-old who was presented to the emergency department with fever and shortness of breath with no previous chronic condition
Metastatic hip fracture in a patient with severe coronavirus disease 2019: Case report
Authors:   Hospital Universitario Virgen de Valme, Avenida Sevilla Cadiz 548,9km, 41014, Seville, Spain, Gabarrell M Peirau
Published: June 2023

Background: During the 1st Alarm State in Spain due to the Coronavirus Disease 2019 pandemic the screening for cancer was suspended and in the following months the routine diagnosis suffered delays, which is supposed to hold up the final diagnosis and probably affect overall survival.
Congenital duodenal windsock deformity simulating midgut volvulus and treated with innovative minimal invasive technique and duodenoplasty
Authors:   Santa Casa de Tatui General Hospital, 3R. Cel. Lucio Seabra, 960 Centro, Tatui  SP, 18270 240, Brazil, Correia Rafael Cavalcante
Published: June 2023

We present a 3200 gm female term neonate born by spontaneous vaginal delivery with uneventful antenatal scans and perinatal period who had passed normal meconium, breast fed for 6 days and presented with bilious vomiting simulating neonatal midgut volvulus
Squamous cell carcinoma of scrotum- A confounding entity amongst benign lesions: A case report
Authors:   Kaushalya Hospital, Kulkarni baug lane 4, College Road, Nashik 422005, Maharashtra, India, Shinde Priyanka
Published: June 2023

Introduction: Squamous cell carcinoma of the scrotum is a rare entity, the current incidence being 1 per million males year. It was among the first occupational malignancies identified.
Spindle cell sarcoma of the heart and severe coronary artery disease following successfully treated colon cancer
Authors:   Rajaie Cardiovascular Medical and Research Center, Niayesh highway, Tehran, Iran, Bahramnejad Alia
Published: June 2023

Spindle cell sarcoma (SCS) of the heart is a rare tumor which has malignant course, that could be primary tumor or metastasis.
Toxic Megacolon leading to bowel perforation: A rare adverse effect of bortezomib
Authors:   Rochester General Hospital, Rochester Regional Health, Rochester, NY, USA., Bhalla Varun
Published: June 2023

Bortezomib is a chemotherapeutic drug used in the treatment of multiple myeloma and amyloidosis. The major dose limiting adverse effect is neuropathy.
Hypothyroidism presenting with left sided Brown’s syndrome
Authors:   Southport and Ormskirk NHS Trust, Ormskirk, UK., Ng Sze May
Published: June 2023

An 11 year old female presents with a 6-week history of double and blurred vision associated with headaches and neck swelling. Thyroid function tests demonstrated antibody negative hypothyroidism. In addition, connective tissue disorder screening was negative. The patient was commenced on thyroid hormone replacement (levothyroxine).
The problem of COVID-19: Yesterday, today and tomorrow
Authors:   Institute of Higher Nervous Activity and Neurophysiology Russian Academy of Sciences, Moscow 117485 Butlerova, Reutov Valentin
Published: June 2023

The article analyzes the dynamics of the development of the Covid-19 problem in the world. The most contagious viral strain Delta currently poses the greatest danger.
Cardioverter defibrillator placement in a young woman with Brugada syndrome: A case report and review
Authors:   Universidad Autonoma de Coahuila. Torreon, Coahuila, Mexico, Martinez Javier Moran
Published: June 2023

Brugada Syndrome (BS) is a hereditary disorder characterized by a primary electrical abnormality, absence of structural heart disease, an elevated risk of sudden death, polymorphous ventricular tachycardia, and ventricular fibrillation, which mainly affects young men
Let’s know systemic lupus erythematosus
Authors:   Gujarat Adani Institute of Medical Sciences, Trivedi Jayesh
Published: June 2023

Systemic Lupus Erythematosus (SLE) is an autoimmune disease with a wide spectrum of disease expression, with aberrant host innate and adaptive immune response, and chronic inflammation.
Benefit of inpatient rehabilitation care in management of acute demyelinating syndrome in children
Authors:   JNMC, DMIMS (DU), India, Prakash Datta Anand
Published: June 2023

Background: Guillian Barre Syndrome (GBS) is the most common cause of minor flaccid paralysis in the world and post-polio eradication is the most common cause on the Indian subcontinent as well. It affects 0.6 4 people per 1 lakh people per year
Rowell’s syndrome: A paediatric case
Authors:   Ibn Rochd Hospital University, Casablanca, Morocco, Rkia Ajaaouani Rkia
Published: June 2023

Rowells syndrome is a rare disease, combining Lupus Erythematosus (LE) and Erythema Multiforme (EM) like lesions with a characteristic immunological pattern, including a speckled pattern of Antinuclear Antibodies (ANA), positive anti Ro SSA or anti La SSB antibodies and positive Rheumatoid Factor (RF)
An unusual failed reverse shoulder arthroplasty: Case report
Authors:   Zile State Hospital, Turkey, Demir Mahircan
Published: June 2023

Shoulder arthroplasty is a surgical method used to relieve pain and restore functionality in cases of primary and secondary degenerative joint diseases and post-traumatic proximal humeral fractures [1].
es-Sünne kable’t-tedvîn, Muhammed Acâc el-Hatîb (Beyrut: Dâru’l-fikr, 2009), 352 sayfa.
Authors: DEMİR İbrahim
Published: June 2023

Bu kitap tanıtımı; giriş, beş bölüm ve sonuçtan oluşan bir yüksek lisans tezi olarak hazırlanıp basılan Dr. Acâc el-Hatîb’in es-Sünne kable’t-tedvîn isimli eserini ele almaktadır. Sünnetin resmî olarak yazıya geçirilmeden önce nasıl muhafaza edildiğini ve aktarıldığını ihtiva eden kitap, sünnetin devlet eliyle yazıya geçirilmeden önce de ferdi olarak yazıldığını savunmakta ve aksi görüşleri çürütmeye çalışmaktadır. Sünnetin tedvinin Ömer b. Abdulazîz’den daha önce babası Abdulazîz b. Mervân tarafından Mısır valisi olduğu dönemde başlatıldığına dair veriye ulaştığını ifade eden yazar, bu konu etrafında kapsamlı çalışmalar yapılmasının önemli olduğunu vurgulamaktadır.
المهارات التدريسية للمعلم البارع في تدريس اللغة العربية للناطقين بغيرها من وجهة نظر معلميها
Authors: ربابعة إدريس محمود
Published: June 2023

هدفت هذه الدراسة إلى التعرّف إلى المهارات التدريسية لدى المعلم البارع في تدريس اللغة العربية للناطقين بغيرها، وتكونت عينة الدراسة من بعض أعضاء هيئة التدريس في مراكز ومعاهد تعليم اللغة العربية للناطقين بغيرها في الأردن والسعودية للعام الدراسي (2023-2022) والبالغ عددهم (46) عضوًا، منهم (19) ذكرًا، و(27) أنثى، اختيروا بالطريقة القصدية، واعتمد الباحث المنهج الوصفي المسحي التحليلي، وأعد استبانة للتعرّف على المهارات التدريسية للمعلم البارع، وتكونت الأداة من (36) فقرة موزعة على ثلاثة مجالات، وبعد التأكد من صدق الأداة وثباتها، طبقت على عينة الدراسة، وأظهرت النتائج أن مجال (التخطيط وتنفيذه) حاز المرتبة الأولى، بمتوسط حسابي (3.96) وبمستوى عالٍ، وحصل مجال (مهارات التقويم) على المرتبة الثانية بمتوسط حسابي (3.70) وبمستوى عالٍ، وحصل مجال (المعرفة الأكاديمية والبيداغوجية) على المرتبة الأخيرة، بمتوسط حسابي (3.49) وبمستوى متوسط وأظهرت النتائج عدم وجود فروق ذات دلالة إحصائية بين المهارات التدريسية للمعلم البارع تعزى إلى متغير الجنس والخبرة. وأوصت الدراسة بمجموعة من التوصيات في ضوء نتائجها.
Comparison of Odontogenic Space Infection in Diabetic and Non-Diabetic Patients
Authors: . Haroon , Ch. Asif Nazir , Khaliq Fahad , Shams Husna , Chauhdry Wajeeha , Kulachi Waqar Hussan
Published: June 2023

Objective: This study aimed to assess and compare the etiology; odontogenic spaces involved, and associated complications between diabetic and non-diabetic patients. Methodology: A cross-sectional study was conducted at the Nishtar Institute of Dentistry, Multan, between October 2021 and March 2022. The study population included 37 participants selected through consecutive non-probability sampling. Eligible participants were individuals of both sexes, aged 18 to 60, with an odontogenic infection. Exclusion criteria comprised localized dental abscesses without fascial space involvement, infections unrelated to odontogenic origin, and unwillingness to participate. Data on demographic characteristics and clinical findings were collected using a self-structured questionnaire. Statistical analysis was performed using SPSS version 20.0, calculating the mean, standard deviation, frequency, and percentages. Statistical significance was set at p < 0.05. Results: The study enrolled 37 patients diagnosed with odontogenic maxillofacial space infections. Among them, 15 (40.5%) were female, and 22 (59.5%) were male, with a mean age of 31.51 years (SD 9.642). Of the participants, 23 (62.2%) had diabetes, while 14 (37.8%) were non-diabetic. Conclusion: The results of this research suggest that diabetic patients are more susceptible to odontogenic infections, specifically dental caries. Additionally, diabetic patients demonstrated a higher prevalence of multiple involved spaces and an increased likelihood of developing complications. Keywords: odontogenic infection, diabetes mellitus, odontogenic space, complications
Analyses of Trace Elements, Arsenic (As), Boron (B), Lead (Pb), Strontium (Sr) and Zinc (Zn), in Human Body and their Correlation with Immune Status Against Viral Infections
Authors: Ijaz Tabinda , Ahmad Fayyaz , Atif Muhammad , Ullah Sajjad , Waqar Ahmed Bilal
Published: June 2023

Background: Trace elements have been used since ancient times as a therapeutic agent. However, until recently its use in modern medicine has been restricted to the treatment of a limited number of parasitic infections, but now some evidence is there that they can be helpful in the treatment of a variety of diseases. Aim and Objective: This research was organized to investigate the concentration of trace metals in human blood and their positive effects against viral infection. Methods: Instrumental analysis of the elevated level of metal concentration was performed by Inductively Coupled plasma-optical emission spectroscopy (ICP-OES) and the presence of virus antibodies by Enzyme linked immunosorbent assay (ELISA) and viral load analysis by Real time Polymerase chain reaction (RT-PCR). Results: The Mean±SD of As, B, Pb, Sr and Zn in negative RT-PCR samples of H1N1 were (141.9±47.3), (417.6±119.3), (149.1±37.5), (6.2±1.6), (535.6±104.7) ppb respectively, the Mean±SD of As, B, Pb, Sr and Zn in negative RT-PCR samples of HIV were (12.5±0.9), (169.8±35.2), (138.2±34.5), (8.12±1.3), (421.4±40.1) ppb respectively, the Mean±SD of As, B, Pb, Sr and Zn in negative RT-PCR samples of HBV were (122.3±21.6), (160.7±23.6), (40.9±8.5), (53.7±7.7), (1459.4±90.1) ppb respectively, the Mean±SD of As, B, Pb, Sr and Zn in negative RT-PCR samples of HCV were (4.9±1.8), (3.7±1.34), (123.2±31.7), (60.9±22.5), (180.2±55.6) ppb respectively. The As, B, Pb, Sr, Zn concentrations in all the RT PCR negative samples were above the permissible limit, and also, we found a positive correlation between As levels and viral immunity in HCV patients (≤0.05). Conclusion: These results indicated that an accumulation of metals, especially As, in the body for a long time provides immunity against many viral diseases (H1N1, HIV, HBV, and HCV). Keywords: Immune status, Immune Response, Toxicity, Metals
Association of Total Serum Calcium Level with Obesity Markers (Body Mass Index and Waist Circumference) among Healthy Young Saudis
Authors: Mohieldein Abdelmarouf H. , Moshawah Sami Ali Al- , Elhabiby Mahmoud I , Mustafa Ayman Abu
Published: June 2023

Background & Objective: The pathophysiology of obesity and comorbid diseases may be associated with the levels of intracellular and extracellular calcium. This study aimed to investigate the association between overweight/obesity measures and the total serum calcium level in young Saudis. Methods: This was a cross-sectional observational study that involved 121 healthy young Saudi participants of both genders. Venipuncture was performed to obtain blood samples of 4 ml. Serum specimens were extracted and aliquoted into Eppendorf tubes, then preserved at a temperature of -20°C until the time of analysis. Anthropometric Measures (BMI and WC) were measured. SPSS software was used for statistical analysis. The measurement of total serum calcium was conducted through the utilization of a Human Diagnostics kit (Wiesbaden, Germany) on a hospitex Diagnostics Eos-bravo Autoanalyzer. The statistical analysis was conducted using the SPSS software. Results: The sample population consisted of 87.6% males, 27.3% smokers, 57% students, and 66.9% individuals with a university degree or higher. Nearly 50% of participants were 15–23 years old. Obese subjects had considerably lower total serum calcium than normal weight subjects. BMI and WC inversely correlated with calcium levels. Conclusion: The present study confirms the inverse relationship between total serum calcium level and obesity in the Saudi healthy population. Calcium supplementation could lower obesity-related chronic disease mortality and morbidity and hence reduce healthcare expenses and increases healthy life years. Keywords: calcium; obesity; overweight; waist circumference; body mass index; Saudi Arabia.
Incidence of Intestinal Parasites in Government and Private School Going Children
Authors: Fida Asim , Aslam Muhammad , Samoon Bushra , Kumari Lata , Najmi Latif
Published: June 2023

Background: Intestinal parasites not only pose a public health risk worldwidely, but also particularly prevalent in developing countries. They are among the least recognized infectious diseases in the world. The occurrence of intestinal parasites among children attending school is a matter of particular concern because they are at a critical stage of development, and their health can have a negative impact on their growth and academic performance. Study design: This cross-sectional study was conducted at Akhtar Saeed Medical College, Rawalpindi for duration of six months from September 2022 to February 2023. Material and Methods: Data from 25 private school children and 25 government school children was examined and it was found that there were 10 positive cases of intestinal parasites found among government school children and there were 4 cases positive among private school children. Results: The highest percentage of parasite that was found was E.histolytica (22%) followed by G.lamblia (19%). There were 8% cases where hookworm was found to be the cause of intestinal issues. Parasite distribution based on type of school showed that there were 71% cases positive cases found in the government sector schools whereas 28% positive cases were from the public sector schools Conclusion: This study analyzed the incidence of intestinal parasites in private and government school-going children and found that government school children are more exposed to unhygienic conditions leading to intestinal parasite infections. The study highlights the importance of addressing the underlying factors contributing to the high incidence of intestinal parasites in the region and underscores the need for a coordinated and sustained effort to tackle this public health issue. Keywords: intestinal parasite, sanitation, infection and school children.
Investigations of Phytochemical, Analgesic, Anti-Inflammatory and Antipyretic Effects of Ixora Pavetta Andrews Leaf
Authors: Najmi Latif , Rafiq Shafaq , Raza Syed Hyder , Nazish Gul-E-
Published: June 2023

Background: The aim of this study was to evaluate the effect of ethanol extract of I.pavetta Andrews leaf on acute toxicity, anti-inflammation, antipyretic and analgesic effect in albino rats. Methodology: The plant leaves I.pavetta were taken and obtained materials were washed, shade dried into coarse powder using a mechanical grinder and then to prepare ethanol extract. The different phytochemical compounds such as alkaloids, saponins, glycosides and tannins were present in the ethanol extracts. The total number of rats was 30 which included male and female albino rats. The age range was 160-240g. All data was analyzed by SPSS 21. Results: The results indicated that the extract's LD50 is greater than 3000 mg/kg, p.o., and that no mortality was seen at this dose for 14 days. In terms of analgesic activity, the use of different doses of ethanol extract (600, 800mg/kg) show significantly reduced; p<0.0001*** the number of writhes and caused the highest analgesic effect than compared to the reference drug group (Aspirin 100mg/kg). The carrageenan induced hind-paw oedema in rats were used to explore the anti-inflammatory effects, and the study's findings showed that the use of different dose of extract at (600 and 800 mg/kg) had shown significantly; p<0.001** reduced inflammatory and pain effects in rats as compared to reference drug (phenylbutazone 100mg/kg). The yeast-induced pyrexia in rats was used to test the antipyretic efficacy, and the different dose of extract significantly; p<0.001** decreased body temperature at doses of (600 and 800 mg/kg) than compared to the acetylsalicylic acid (100mg/kg). Conclusions: The ethanol extract of plant leaf I. pavetta have shown greater analgesic efficacy, anti-inflammation and antipyretic activities. Keywords: Acetic acid, analgesic effect, anti-inflammation.
Current Sensitivity Pattern of Salmonella Species in Children Presenting at a Tertiary Care Hospital
Authors: Rafique Muhammad , Nasir Sharmeen , Kamran Amber , Jamalvi Waseem , Jamal Ammarah
Published: June 2023

Background: Enteric fever is a common and treatable pediatric bacterial infection, but emerging drug resistance has been a real challenge for treating physicians. Since 2016, Pakistan is facing the epidemic of Extensively drug resistant (XDR) salmonella typhi. Objective: To determine the clinical presentation and current pattern of sensitivity of salmonella species in children diagnosed with enteric fever. Study Design: Descriptive, Cross sectional Place and Duration of Study: Pediatric department of Dr. Ruth K. M. Pfau Civil Hospital Karachi, from July to December 2022. Methods: Medical records of patients 1 month to 12 years of age, diagnosed as enteric fever on positive blood culture for salmonella, were inducted into the study by non-probability convenient sampling. The clinical manifestations of patients and sensitivity and resistance patterns of salmonella were recorded. Data was analyzed using SPSS version 22. Results: A total of 140 children had enteric fever, out of which 60.7% were male. Mean age of the patients was 4.48+2.47 years. Most common symptom was fever in 140 (100%), followed by anorexia in 97 (69.2%) and abdominal pain in 70 (50%). Blood culture reports showed Extensive drug resistance in 105 (75%), Multi drug resistance in 3 (2.14%) and Non-resistance in 7 (5%). Salmonella Typhi isolates were sensitive to Carbapenems in 140 (100%), Azithromycin 139 (99.2%) and Piperacillin/Tazobactam in 60 (42.8%). Conclusion: XDR enteric fever is still the most common resistance pattern identified in admitted patients with enteric fever. Large scale public health measures and antibiotic stewardship are required to fight this disease. Keywords: Typhoid fever, Salmonella Typhi, Drug resistance, Infection, Epidemic
Frequency and Clinical Characteristics of Young Onset Parkinson’s Disease at Chandka Medical College Hospital Larkana
Authors: Shaikh Nagina , Shaikh Abu Bakar , Aghani Suhail Ahmed , Majeed Sameena , Abbasi Irfana , Ali Muhammad Munwar , Siddiqui Alam Ibrahim
Published: June 2023

Background: One of the most prevalent forms of neurodegenerative illness, Parkinson's is characterised by a loss of postural response, stiffness, and tremor at rest. Young-onset Parkinson's disease occurs between the ages of 21 and 50 on average, however it begins much younger in 3 to 5 percent of people. Objective: To determine frequency of Young onset Parkinson’s disease in Parkinson’s patients. Methodology: This research was conducted from May 2022 and October 2022 at the Chandka Medical College Hospital in Larkana. The World Health Organization's online calculator determined that 73 people would be used for the study. Permission and ethical review forms were filled out. The data was analysed using SPSS. The significance level of 0.05 was considered crucial. Results: The total number of female patients were 31(42.5%) while male were 42(57.5%) The duration of disease was from 6 months to 22 years. Majority of the patients were in stage 2 and 3 according to Hoehn and Yahr rating scale. The frequency of Young Onset Parkinson’s disease in Parkinson’s patients is 24.7%. Overall prevalence of Parkinson’s disease was seen more in male patients, this even increases in YOPD, (38% VS 62%).Almost all patients in both age categories have bradykinesia and rigidity while 6 patients out of 73 have absent tremors. Loss of postural reflex was seen in 33 patients, every second (51%) patient in idiopathic Parkinson’s disease and every third (38%) in YOPD. Dystonia was seen more in YOPD, total 8 patients have dystonia, 4(28%) in YOPD and 4(8%) in Idiopathic Parkinson’s disease. Dyskinesia was not seen in YOPD while it was frequent in Idiopathic Parkinson’s disease. Family history was positive in total 9 patients, 50% of cases YOPD, while it was positive 5.8% in idiopathic Parkinson’s disease. Conclusion: YOPD is unique subgroup among patients of Parkinson’s disease, it burden is much more than ever reported, this calls for shared decision making , the possibility of genetic counseling and appropriate multidisciplinary treatment options. Keywords: Parkinson’s disease, YOPD (Young onset Parkinson’s disease, bradykinesia, rigidity, tremor, dystonia, postural reflex. Dyskinesia.
Perception of Faculty Members as Role of Medical Facilitator in Private Sector Medical College
Authors: Saleem Qasim , Aslam Fatima , Usman Muhammad , Sarfraz Farrukh , Ain Noor-Ul- , Sarfraz Fahad
Published: June 2023

Introduction: Teachers are supposed to give students really good education that helps them get ready for the tough situations they may face in their medical careers. Teachers should know and be good at what they are teaching, and they should use ways that help students to learn and understand what they are being taught. Teachers are supposed to help and guide students, especially when they are learning how to take care of patients. They should be ready to help students who are having a hard time with school or any personal issues. Objective: To understand the perception of faculty members as role of medical facilitator in Private sector medical college Study design: Quantitative cross sectional Settings: Bakhtawar Ameen medical college Duration: Four months i.e. 1st August 2022 to 31st December 2022 Data Collection procedure: A pre validated questionnaire was used. Study was carried out at Bakhtawar Ameen Medical & Dental College, Multan. The total numbers of faculty members were 30 who participated after taking the informed consent. The study was done by simple random sampling technique. 12 items questionnaire were used. Google link form was used to collect the data. Results: There were 30 participants who were responded through google online link form. The twelve roles further subdivided into six dimensions. In this study there were 18 males and 12 females. All percentages regarding each attribute for twelve roles of medical teacher were very high. This study highlighted the various six dimensions in which all twelve roles of medical teachers grouped. This study highlighted most important role as facilitator 94% and least 89% as assessor. Conclusion: The success of any educational program hinges on the presence of an effective teacher. There is a shift in the teacher's role within the educational process. It is essential for teachers to evaluate their own performance in order to evolve from being mediocre to good, good to exceptional, and exceptional to the very best. Keywords: perception, medical teacher, facilitator, students, college
Evaluating Types of TAPVR on Echocardiography and CT Angiography in Paediatric Patients Admitted in Tertiary Care Hospital: A Comparative Study
Authors: Sangi Rumana , Ahsan Aliya Kemal , Akhtar Parveen , Shaikh Abdul Sattar , Mumtaz Saba , Alisher Nazish , Kamran Amber , Sandano Musarat Nazir
Published: June 2023

Objective: To evaluate the types of TAPVR on Echocardiography and CT Angiography in Paediatric Patients Study design: A comparative study Place and Duration: Pediatric cardiology department and CT Angiography department of the National Institute of Cardiovascular Diseases (NICVD) Karachi from January 2019 to December 2021 Methodology: Patients who have TAPVR confirmed by CT angiography and detected by echocardiography were included in the research. Cases having anomalies in the systemic veins were eliminated. Demographic variables (age, gender, weight, etc.), echocardiographic results (such as type of TAPVR, obstructive and non-obstructive), and CT angiography findings were collected for the study using a preset structured proforma. We evaluated the diagnostic disparity between the two modalities. Results: In the present study there were 107 patients, 67.3% were male gender, 56.1% with age less than 6 months, the median age was 6 months, median weight was 4.5 kg. On echocardiography, there were 83.2% non-obstructive, 47.7% supracardiac and 36.4% cardiac TAPVR. On CT angiography, there were 66.4% were non-obstructive, 53.3% supracardiac and 23.4% cardiac TAPVR. Of the associated cardiac diseases, in common 86.9% were found with atrial septal defect, 13.1% were persistent left superior vena cava, 12.1% were patent ductus arteriosus, 8.4% were a ventricular septal defect, 6.5% were of pulmonary atresia, and 3.7% were complete endocardial cushion defect. Conclusion: As compared to echocardiography, CT angiography is more reliable for the detection of obstructive and mixed types of TAPVR. Detection of the supracardiac type of TAPVR is also almost the same as on echocardiography and CT angiography. As compared to CT angiography, echocardiography over diagnoses the non-obstructive type of TAPVR. CT angiogram is also useful in detecting other associated lesions such as heterotaxy, abnormal coronaries, presence of bilateral superior vena cava and coronary sinus. Keywords: TAVPR, echocardiography, CT angiography, cardiac disorders
Effect of Preoperative Steroid Injection on Wound Drainage after Modified Radical Mastectomy
Authors: Iqbal Muhammad Nasir , Aftab Sommayya , Ali Mansab , Azeem Syed Muhammad Mohsin , Najeeb Wafa , Usman Amir ,
Published: June 2023

Background: After surgery for breast cancer, there is a risk of increased wound drainage and seroma formation. Various treatments are utilized to overcome this issue with variable effectiveness. Objective: To compare the outcome of a single preoperative dose of intravenous steroid injection versus control group on wound drainage in patients undergoing modified radical mastectomy (MRM) for stage I and II breast cancer. Methodology: It is a randomized control trial conducted over a period of 6 months. Total 60 patients who underwent MRM for carcinoma of breast were included. They were divided into 2 groups with each group having 30 cases. In group-A 120 mg (3 ml) of injection depomedrol was given one hour before surgery while in group B, 3 ml of normal saline was used, and MRM was performed and two drains were placed. At the time of drain removal, drainage volume was assessed in both groups. Results: Mean age of the patients was 47.3±7.89 and the mean drainage volume in group A versus B was 672±117.63 and 1020±159.9 respectively. Among the patients, 51.7% had stage I and 48.3% had stage II breast cancer. The two groups had statistically significant difference in terms of mean drainage volume (p value =0.048). Conclusion: In patients who underwent MRM, prophylactic steroid injection was associated with significant reduction in mean drainage volume compared to normal saline. Keywords: Modified Radical Mastectomy, Steroid, Seroma Formation
Recurrent Anaplastic Meningioma with Metastasis
Authors: Saeed Uzma , Mazhar Naveed , Saeed Zeeshan
Published: June 2023

Meningioma is the commonest primary intracranial tumor in adults, with the majority being benign. Malignant meningioma is exceedingly rare and carries a poor prognosis because of its tendency for local recurrence and distant metastasis. We present the case of a 53 years old male with anaplastic malignant meningioma, which recurred after excision and radiotherapy and later metastasised to pleura, bones and brain. Keywords: Metastatic meningioma, Anaplastic meningioma, Pleural metastasis, Intracranial tumor, Extracranial metastasis
Diagnostic Accuracy of Admission C Reactive Proteins in Predicting Severity of Acute Pancreatitis Keeping CT Scan as Gold Standard
Authors: Ullah Samid , Iqbal Wajid , Saeed Muhammad Ibrahim , Hawa Sana , Ismail Faisal Wasim
Published: June 2023

Introduction: Acute pancreatitis is common, with an alarming rise in the global incidence. The clinical course of AP is highly variable, ranging from mild, self-limiting symptoms to multiple organ dysfunction and/or death. Objective: To evaluate the diagnostic accuracy of admission C reactive proteins in predicting the severe acute pancreatitis keeping computed tomography as gold standard. Material and methods: This Cross-sectional study was conducted at Department of Gastroenterology, Aga khan hospital, Karachi from 19-06-2019 till 19-06-2020. Data was prospectively collected from patients after taking a verbal consent. 181 patients who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Sensitivity, specificity, positive and negative predictive values and diagnostic accuracy was calculated. Results: A total of 181 patients who met the inclusion and exclusion criteria were included in this study. Mean age, duration of symptoms, BMI, height, weight and CRP in our study was 49.48±10.36 years, 14.88±4.87 hours, 29.8±4.74 kg/m2, 146.5±10.41 cm, 78.9±8.58 kg and 110.9±28.54 mg/L. Sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of CRP for diagnosis of severe acute pancreatitis by taking CT scan as gold standard was found to be 88.8%, 81.5%, 94.7%, 65.9% and 87.2%. Conclusion: CRP it is an inexpensive alternative to the conventional severity assessment methods for the prediction of severity and outcome of patients with acute pancreatitis and can serve as an early indicator of the progression of acute pancreatitis into a serious state. Keywords: Severe acute pancreatitis, C reactive protein and CT scan.
Evaluation of Percutaneous Peritoneal Drainage Among Patients with High Risk Perforated Peritonitis in Tertiary Care Hospital
Authors: Nawaz Shahid , Hassan Raza , Pathan Sanaullah , Rehman Sarah , Hussain Mubarak , Hassan Naseer
Published: June 2023

Objective: This study aimed to share our experience in treating various types of injection-induced peripheral nerve injuries and explore numerous problems that are related to this category of peripheral nerve injuries. Study Design: Retrospective study Place and Duration: Department of Neurosurgery, Gomal Medical College DI Khan in the duration from October, 2022 to March, 2023. Methods: Total 130 patients of both gender with age 8-70 years were included. Patients with post-operative peripheral nerve injuries were following intramuscular injections, brachial nerves block procedures, subclavian and jugular venous cannulation procedures for central line placements, and routine intravenous injections in the peripheral veins of the limbs. Frequency of peripheral nerve injuries and its management among all cases were assessed. SPSS 22.0 was used to analyze all data. Results: In all 130 patients, 82 (63.1%) cases were males and 48 (36.9%) patients were females. 45 (34.6%) patients had age 8-15 years, 30 (23.1%) cases had age 16-25 years, 33 (25.4%) cases had age 26-35 years and 22 (16.9%) patients had age >35 years. Mean duration of peripheral nerve injury was 2.4±7.38 months. Most common reason was intramuscular injection found in 104 (80%) cases. Most common affected nerve was sciatic nerve in the gluteal region, the radial nerve in the arm and axillary nerve in the shoulder region. Non-functional status among all cases were found in 58 (44.6%) cases. Six (4.6%) of the patients in our series experienced neurological impairment following surgery in the form of motor weakness. The best outcomes, 115 (88.5%), were reported with the repair of the radial nerve after surgery. Conclusion: We came to the conclusion that a quick referral to a specialized peripheral nerve center, an early intervention, and early diagnosis are just a few crucial elements that can lead to a positive outcome and reduce the frequency of medicolegal lawsuits. By having in-depth anatomical understanding and providing patients with adequate counseling before to the treatment, the problem can be avoided in the vast majority of cases. Keywords: Peripheral nerve injury, Surgery, Improvement, Injection
Effects of Scapular Proprioceptive Neuromuscular Facilitation Technique on Scapular Dyskinesis
Authors: Altaf Iqra , Maqbool Anam , Maqbool Ayesha , Akram Aisha , Iqbal Saba , Ali Zain
Published: June 2023

Background: Scapular dyskinesis is termed as improper control of resting position and movement pattern of the scapula having connections with shoulder pain. PNF techniques are the methods of hastening the response of a neuromuscular mechanism through stimulation of proprioceptors. Objective: To find out the effect of scapular proprioceptive neuromuscular facilitation techniques in the treatment of scapular dyskinesis. Methodology: A randomized clinical trial was conducted comprising of 26 patients recruited from District Headquarter Hospital and Aziz Fatimah Hospital, Faisalabad. Patients were randomly allotted into 2 groups. Group A received scapular proprioceptive neuromuscular facilitation and Group B received conventional treatment group. Scapular dyskinesis was assessed through lateral scapular slide test. Visual Analogue Scale and Shoulder pain and Disability Index were used as outcome measures. The treatment was given for four weeks and there were 3 sessions per week. The data was collected at baseline and 4th week post treatment. The data was analyzed by using SPSS software version 23. Results: Within group analysis showed that improvement was observed for pain and shoulder disability in both group A (p=0.000) and group B (p=0.000). Between group analysis revealed significant improvement in pain from 8.23 +1.48 at baseline to 4.08 + 1.60 (p=0.000) and shoulder disability from 97.46+9.19, to 97.46+9.19 (p=0.000) at 4th week post treatment in scapular PNF group. Conclusion: Significant improvement in VAS and SPADI was observed in scapular PNF group as compared to conventional treatment. Keywords: Scapular Dyskinesis, Proprioceptive Neuromuscular Facilitation, Shoulder Pain, Visual Analog Scale
Feasibility of Implementing Mini-Clinical Evaluation Exercise (Mini-CEX) as a Formative Assessment Tool in Postgraduate Surgical Training
Authors: Siddiqui Faisal Ghani , Saleem Omema , Malik Mujeeb Ur Rehman , Pirzada Muhammad Taqi , Habiba Umme
Published: June 2023

Background: Mini-CEX (Mini Clinical Evaluation Exercise) is extensively used in the west as a Workplace-based Assessment (WPBA) tool. However, its utility remains an infrequent in postgraduate medical training in Pakistan. Methods: Forty-eight mini-CEX sessions involving 11 faculty members and 15 postgraduate trainees were conducted over a 3‐month study period. Standardized American Board of Internal Medicine Mini‐CEX evaluation form was used to evaluate the students. The faculty and trainees were asked to provide feedback for these sessions on questionnaires consisting of close‐ and open‐ended questions. Results: Faculty satisfaction with mini-CEX was high, with all agreeing that it was an appropriate method of trainees’ assessment and teaching, and that it should be included in the curriculum. However, two-third of the faculty felt that it was not possible to assess students through mini-CEX more frequently. All trainees agreed that the sessions made them aware of their weaknesses and strengths. However, majority (73.3) complained that they were not given a chance to give reflection on their performance during the feedback session. Both residents and faculty suggested to incorporate Mini‐CEX in curriculum. Conclusion: It is feasible to use mini‐CEX for formative assessment of residents. Keywords: Workplace-based assessment, mini-clinical evaluation exercise, feedback
A Cross-Sectional Study on Histological Pattern of Primary Glomerular Diseases among Adult Patients
Authors: Khan Samee Ullah , Elahi Irfan , Muhammad Hamza , Mushtaq Aysha , Ahmed Rizwan Munir , Noor Huzaifa
Published: June 2023

Background and Aims: Primary glomerulonephritis (GN) is the major cause for end-stage renal disease (ESRD) and considered to contribute in 52% cases. Kidney biopsy is an essential tool in nephrologists' clinical practice for determining diagnosis, prognosis, and therapy of a variety of glomerular conditions. The purpose of the present study was to determine the primary glomerular diseases histopathological pattern among adult patients. Patients and Methods: A total of 94 suspected primary glomerular disease (GD) patients were investigated in this cross-sectional study conducted in the Nephrology Unit of Medicine department of Mayo Hospital, Lahore from 21st January 2021 to 20th February 2022. Individual’s demographic details, diagnostic tests, clinical presentation, kidney biopsy indications, and post-biopsy complications were recorded on pre-designed questionnaire/pro-forma. Data analysis was done using SPSS version 27. Results: Out of 94 patients, about 76 (80.9%) patients had primary glomerular disease diagnosed on native kidney biopsies. The overall mean age was 38.4± 6.2 years. Out of 94 primary glomerular disease patients, there were 48 (51.1%) male and 46 (48.9%) females. The incidence of nephrotic syndrome and unexplained renal parameters elevations were 47.4% (n=36) and 31.6% (n=24) respectively. The prevalence of Primary focal segmental glomerulosclerosis (FSGS), membrano-proliferative glomerulonephritis (MPGN), minimal change disease, and IgA nephropathy was 30.3% (n=23), 25% (n=19), 17.1% (n=13), and 6.6% (n=5) respectively. Kidney biopsy post-complications were found in 8 (10.5%) cases. Conclusion: The present study observed that MPGN and FSDS were the most prime causes for primary glomerular disease. The most prevalent indication of kidney biopsy was nephrotic syndrome. Keywords: Glomerular disease, kidney biopsy, histopathological pattern, adult patients
Association of Serum Ferritin with C Reactive Protein in Iron Deficiency Anaemia
Authors: Aamir Kiran , . Sidrah , Ahmed Safian , Alam Haji Muhammad Aftab , Devi Durga , Junejo Aqsa , Ramzan Aamir , Shaikh Farhan Ahmed
Published: June 2023

Objective: The purpose of this study was to determine whether or not individuals with iron deficiency anemia and an underlying inflammatory condition had a connection between serum ferritin as an acute phase reactant and C - reactive protein. Study Design: Cross-sectional/Prospective study Place and Duration: Liaquat university of Medical and health sciences jamshoro Hyderabad. January 2022 to December 2022 Methods: This research comprised 136 individuals who were suffering from iron deficiency anemia. After getting informed written consent detailed demographics of enrolled cases were recorded. Using an automated hematology analyzer (Mindray BC-5000), the parameters of the blood were analyzed. Serum ferritin levels were used to classify each patient into one of three categories. Serum ferritin levels were divided into three groups: Group I (serum ferritin <10 μg/L), Group II (11–150 μg/L), and Group III (>150 μg/L).SPSS version 23.0 was used to analyze the data. Statistical analysis was conducted using Pearson's correlation tests. Results: In current study patients mean age was 31.13±6.75 years and had mean BMI 24.6±3.52 kg/m2. There were majority 74 (54.4%) males and 62 (45.6%) females in this study. Majority of the patients 81 (59.6%) were had low ferritin <10 μg/L, followed by normal ferritin 11–150 μg/L in 45 (33.1%) cases and 10 (7.4%) cases had high ferritin >150 μg/L. We found strong co-relation of C reactive protein and high level of serum ferritin with p value <0.002. Serum ferritin levels were negatively correlated with hemoglobin. Conclusion: We concluded in this study that levels of serum ferritin was positively associated with C-reactive protein (CRP). In patients with underlying deficiency of iron, secondary inflammation may increase the level of ferritin in serum. Keywords: Ferritin, Haemoglobin, Iron Deficiency Anaemia, C-Reactive Protein
Prevalence of Sinew String in Patients Coming to a Tertiary Care Hospital: A Descriptive Cross-Sectional Study
Authors: Tanveer Talha , Jabeen Bushra , Omer Syed Ahmed , Islam Sana Adeeba , Naureen Humaira , Azfar Marium
Published: June 2023

Background: The aim of this study to evaluate the dentulous and edentulous maxillae in the microstructure of the incisive canals and their surrounding bone in order to show the structural qualities. Study Design: The study was cross sectional being conducted at the Dental Department of DOW International Dental College, Karachi for six month from July 2022 to December 2022. Methodology: A total number of patients was N=240. The right and left sides of each patient were classified as either edentulous or dentulous. After receiving written consent, the patients who were monitored on both were checked to see if sinew string was present or not. The data was analyzed by SPSS 21. Results: There were 240 patients in all, 130 of whom were men and 110 of them were women. Males (54.1%) and females (46%) made up the edentulous and dentulous group. The patients with the greatest ages were 21- 51 years old. The patients' average age was 38 ± 15 years. The sinew string frequency was similar with respect gender. There was significant difference between edentulous and dentulous; p<0.005** on both sides observed by using simply seen, pushing on the oblique line and pulling the cheek sideways. Conclusion: Sinew string was attempted to maintain and control buccal mucosa movement and block the mouths posterior vestibule. The occurrence of sinew strings was greater than usual. Keywords: Sinew strings, Dentulous, Edentulous, mandibular.