bluuebunny/crossref_metadata_2025 huggingface dataset:
Milton Friedman and the road to monetarism: a review essay
Authors: Tavlas George S.
Published: November 2022

The objective of Ed Nelson’s two-volume book, Milton Friedman and Economic Debate in the United States, 1932-1972, is to provide an account of Friedman’s views in major monetary-policy debates during the period identified in the book’s title. Nelson tells the story of the development of Friedman’s monetary framework, from its Keynesian origins in the early-1940s, to its gradual absorption of monetary factors in the late-1940s, and, finally, to its monetarist character of the 1950s and after, through the windows of a selection debates that engaged Friedman. At the same time, Nelson places Friedman’s monetary contributions within the context of the modern macroeconomics literature. In this essay, I consider doctrinal issues related to Nelson’s account of the development of Friedman’s monetarist framework.
Are You Hooked to the ‘Gram’? Exploring the Correlation between Loneliness, the Fear of Missing Out, and Instagram Usage among Young Indians
Authors: Rajan Benson , Jose Lydia G. , Sundar Thejas
Published: November 2022

The amount of time spent on Instagram by young people in India has grown exponentially. This social media platform is a sea of visuals that reflect the activities people are engaging in. The constant viewing of other people’s lives can lead to a feeling of dissatisfaction about one’s own life. The Fear of Missing Out (FoMO) emerges when an individual who is unable to participate in or engage with the activities of others, experiences feelings of loneliness and isolation. This study aims to examine the association between the time spent on Instagram and its effect on FoMO and Loneliness. The study sample consisted of 401 participants, primarily 18–24 years old, collected via convenience sampling methods. The single item Fear of Missing Out short form (FoMOsf) and the three-item Loneliness scale were administered to participants to measure FoMO and loneliness, respectively. Descriptive and inferential statistics were used to analyze the data. A one-way analysis of variance was computed between the time one spends on Instagram and the variables of FoMO and loneliness. The analysis uncovered a statistically significant difference between the increasing amount of time spent on Instagram, that is, less than one hour, 1–2 hours, and three or more hours for FoMO [F (2,398) = 17.92, p < 0.05] and loneliness [F (2,398) = 3.57, p ≤ 0.029]. Therefore, more time spent on Instagram results in individuals experiencing significantly greater levels of FoMO and loneliness.
Una neonata dal "cuore matto"
Authors: Di Marco Serena , Rosati Sara , Controzzi Tiziana , Ghirri Paolo , Peroni Diego
Published: November 2022

The Authors describe a case of thyrotoxicosis in a newborn presenting with severe tachycardia. The diagnostic and therapeutic approach is also discussed.
Lezioni da una politica attiva co-progettata per disoccupati fragili
Authors: Baici Eliana , Cuttica Giovanni , Poy Samuele
Published: November 2022

La customizzazione degli interventi di politica attiva è al centro del dibattito scientifico e politico. In particolare, vi è molto interesse nel capire se esistono modelli efficaci per il reinserimento dei cosiddetti disoccupati fragili. In questo articolo, si discutono gli esiti di una politica attiva del lavoro co-progettata realizzata nel Novarese, rivolta a disoccupati fragili beneficiari di ‘buono spesa’. L’analisi evidenzia le peculiarità dell’approccio e ne discute gli esiti anche in relazione a fattori interni all’organizzazione ed esterni, incidenti sui medesimi. I risultati possono essere di interesse per policy maker interessati a realizzare interventi su target fragili.
L’accesso al Reddito di cittadinanza dei cittadini stranieri: criticità e proposte di riforma
Authors: Giuliano Giovannina , Gallo Giovanni , Rosano Aldo , di Padova Pasquale
Published: November 2022

Il lavoro, fondato sull’analisi di dati derivanti da un modello di microsimulazione che utilizza congiuntamente fonti amministrative e indagini socio-economiche, discute i problemi dell’accesso per gli stranieri al Reddito di cittadinanza dovuti in particolare al requisito di durata della permanenza e alla scala di equivalenza adottata. Per limitare la penalizzazione della popolazione straniera, che già sconta una maggiore diffusione e intensità della povertà, si illustrano gli effetti di una possibile riforma di questi due aspetti della misura sui beneficiari e sulla spesa pubblica.
Order Batching and the Bullwhip Effect Reduction in a Cross‐Docking Strategy
Authors: Benrqya Yassine
Published: November 2022

The purpose of this article is to analyze the effect of order batching on the bullwhip effect in a cross‐docking strategy. The model proposed uses simulation to analyze empirically the impact of order batching on the bullwhip effect in cross‐docking strategy compared to traditional warehousing. The study is based on a case study of a fast‐moving consumer goods company and a French retailer. In the model, a three‐stage supply chain composed of one supplier DC, one retailer DC, and 10 retailer stores is considered. The order‐up‐to (OUT) level policy is used to control inventory at each stage. The demand is forecasted using a simple moving average scheme. The empirical investigation shows that the use of cross‐docking leads to a bullwhip effect gain upstream in the supply chain in all cases and situations. Moreover, we show that there exists a high positive correlation between the physical volume of a product (measured by the number of items per pallet) and the bullwhip effect gain. Finally, the increase in lead time to the stores has little impact on the bullwhip effect gain upstream in the supply chain.
Quadriceps Avoidance After Total Knee Arthroplasty: Descriptive Study
Authors: Jamal, Muhammad Nauman , Hanif Ans , Saeed Sameen , Shabbir Sidra , Fatima Ishrat , Salman Shah
Published: November 2022

Background: Quadriceps avoidance is a reflex deficit disorder of quadriceps activation after total knee arthroplasty (TKA) that can lead to abnormal gait kinematics. It is patient apprehension due to pain, to prevent quadriceps activation that induces deforming forces at the knee joint. Aim: To describe the frequency of ‘quadriceps avoidance’ among patients after total knee arthroplasty. Study Design: Descriptive case series. Methodology: The study sample size comprised of 55 post-TKA patients (Male: 16; Female: 39), who were the ages of 40-80 years. Participants were recruited who had undergone unilateral total knee replacement and attended an outpatient physiotherapy clinic of Ghurki trust teaching hospital and Surgimed hospital Lahore. Participants were undergone ‘quadriceps avoidance gait’ testing at approximately 02 weeks and 01 month postoperatively by using a diagnostic observational questionnaire, designed according to the observational gait analysis. Data was evaluated by using SPSS version 23. All qualitative data was presented in frequency form and quantitative data was in the form of mean±SD. Results: Mean age of patients was 58.98 with range minimum of 40 years to a maximum of 80 years. Out of a sample size of 55, 25 (45.5%) patients were diagnosed with quadriceps avoidance after TKA, 11(20%) were male patients out of 16 and 14 (25.5%) were female patients out of 39 which showed ‘stiff knee gait’ pattern. Conclusion: It was concluded that quadriceps avoidance after total knee arthroplasty was one of major complication of abnormal gait pattern which can lead to knee joint deformities if left uncorrected. Keywords: Total knee arthroplasty, Quadriceps avoidance, Gait kinematics, Gait kinetic
Comparison of Manual Mode With Automatic Gas Control Mode for Sevoflurane Consumption in Maquet Flow-I Anesthesia Machine
Authors: Jamil Muhammad , Shahzad Salman , Hussain Shahbaz , Bukhari Hamza Ali , Huda Anwar Ul
Published: November 2022

Background: Inhalational anesthetic agents used for general anesthesia can have adverse effects on operation theater staff and environment. The innovative automated gas controller reduces inhalational anesthesia agent consumption. Aim: To compare sevoflurane consumption in manual mode versus automatic gas control (AGCTM) mode on Maquet Flow-i anesthesia machine in adult laparoscopic surgeries. Methods: This study was a randomized control trail conducted at Department of anesthesia, Security Forces Hospital Riyadh, Saudi Arabia and Pakistan Kidney and Liver Institute and Research Center, Lahore, Pakistan from December 2019 till December 2020. Sixty patients were randomly divided into two Groups A (Automatic Gas Control, AGCTM) and Group B (Manual Mode). Sevoflurane consumption and sevoflurane consumption rate was calculated in both groups. Data was analyzed using SPSS V.20. Results: Two groups were comparable in term of age, gender, and comorbidities. The mean sevoflurane consumption rate in group A was 23.92+4.6 as compared to 40.23+4.4 in group B (P=0.001). Similarly sevoflurane consumption rate is also statistically significant. (0.28 + 0.04 ml/min vs 0.47 + 0.02 ml/min, p=0.001) Conclusion: Sevoflurane consumption and sevoflurane consumption rate is lower in AGCTM mode as compared to manual mode of Maquet Flow-I anesthesia machine. Keywords: Sevoflurane, Maquet Flow-i, Automatic Gas Controller (AGCTM), Laparoscopic Surgeries
Role of Synchronized Lifestyle Modification Program and Physiotherapy in Peripheral Neuropathy in Insulin Dependent Type 2 Diabetics
Authors: Chaudhry Tayyaba Anis , Ali Shazia , Feroz Shagufta , Rameez Rubab , Zafar Ayesha , Iqbal Fatima , Fayyaz Humaira
Published: November 2022

Background: Distal symmetrical polyneuropathy is the most common form of diabetic peripheral neuropathy. Management of peripheral neuropathy through dietary modification and exercise synchronized with circadian rhythm optimizes metabolic parameters, thus restoring nerve functions. Aim: To determine the effect of Synchronized lifestyle modification program (SLP) and Physiotherapy on Michigan neuropathy screening instrument (MNSI), Fasting blood glucose (FBG), HbA1c, Lipid profile and Nerve conduction studies (NCS) in insulin dependent type 2 diabetic neuropathy patients. Study Design: Randomized Controlled Trial Place and Duration: Study was carried out in Physiology department of Islamic International Medical College (Riphah international University) in collaboration with Physiotherapy Department, Railway Hospital, Rawalpindi for a duration of 1 year from October 2020 to October 2021. Methodology: 120 Type 2 diabetic neuropathic patients on insulin were recruited after written informed consent. Baseline evaluation included; assessment of lifestyle pattern, MNSI, FBG, HbA1c, lipid profile and NCS. Patients were divided into Group A (Control) and Group B (Experimental). Group B was subdivided into Group B1 who received SLP, Group B2 received combined SLP and Physiotherapy and Group B3 received Physiotherapy for 12 weeks. Analysis of parameters was done by repeated measure ANOVA. p≤0.05 was considered as significant. Results: MNSI, FBG, HbA1c, serum cholesterol, TGs and LDLs were significantly improved in Group B2. HDL levels and Nerve conduction parameters were not found to be significant. Conclusion: Combined Synchronized Lifestyle Modification Program and Physiotherapy is more effective in type 2 diabetic neuropathy patients on Insulin. Keywords: Synchronized lifestyle modification programme, Diabetic peripheral neuropathy, Distal symmetrical polyneuropathy.
Assessment of Nurse’s Knowledge Regarding Management of Chest Tube Drainage at a Public Tertiary Care Hospital
Authors: Ullah Shakir , Naz Najma , Ullah Saeed , Khan Nasir , Rahman Shakir , Sultan Amir
Published: November 2022

Background: Chest tube insertion is a commonly performed surgical procedure in hospital practice, which is indicated in chest trauma, pneumothorax, or for use for draining of air, blood, or pus. Nurses play a role in the care of patients, like dealing with critical patients and resuscitation, so they should know about the management of chest tube drainage. Aim: To evaluate the knowledge, nursing role, and intervention of chest tube drainage. Methodology: The study design of a cross-sectional analytical study conducted in a saidu group of teaching hospitals from May 2021 to September 2021 had a sample size of 70 while using a convenient sampling technique for data collection of nurses working in the intensive care unit. Data was collected through a valid and reliable adopted questionnaire. The Chi-square test, independent sample t-test, and ANOVA were used to analyze the data. Results: Female participants (54.3%) were higher than male participants (45.7%), while the major age group was 26–30 (38.6%). The maximum nurse’s knowledge regarding chest tubes was poor (81.4%), followed by an average score (18.6%), and good was nil. In nurses' roles, the majority were poor (65.7%), while (34.3%) were average and good (nil). In nursing intervention, 68.6% were poor, the average was 31.4%, and none was good. As a result of an independent t-test, the male participants had scored higher in all three sections of the questionnaire than the female participants. Conclusion: The study concluded through ANNOVA that knowledge is highly significant (p-value 0.000) with qualification while not significant (p-value 0.225, 0.394, 0.799) with departments. Keywords: Assessment, Chest tube, Drain, Knowledge, Management, Nurses
Knowledge, Attitude and Practices of Dental Erosion related to Acidic Dietary Intake among Medical Undergraduates.
Authors: Hakeem Saman , Baqar Anum , Ilyas Farnaz , Mohsin Abid , Bana Kiran F. M. , Fahim M. Faisal , Zaidi S. A. Abbas , Kadri W. Baksh
Published: November 2022

Aim: To assess knowledge, attitude and practice of dental erosion related to dietary acidic intake among medical undergraduates. Methods: It was a cross sectional study conducted at Bahria University Medical and Dental College, Karachi from March-2019 to November 2019. The validated questionnaire was used to assess the study objectives. There were five sections in the study tool including demographic data, knowledge, self-reported signs and symptoms, attitude and practices of acidic dietary intake. The data was entered on SPSS version 23.0 for analysis. P-value <0.05 was considered as statistically significant. Results: From total of 500 subjects; 498 questionnaires were completed in all aspects; hence the response rate was 99.6%. Respondents comprised of both males and females having age range from 17 to 25 years with a mean age of 20.82+SD 1.76. Majority of participants (74.4%) had high level of knowledge regarding dental erosion. Statistically significant association was found (p-value=0.02) when compared to level of knowledge with attitude. While assessing the association between practice and self-reported sign/symptoms; significant association was found in regards to frequency and timing of acidic dietary intake at a p-value of 0.000. Conclusion: Majority of participants had high level of knowledge regarding erosion as related to acidic dietary intake and was positively reflected in their attitude. Overall, natural fruit juices were the highest consumed drinks followed by carbonated drinks. Keywords: Dental erosion, Dietary behavior, Medical Undergraduates, Carbonated drinks, Dietary habits.
Functional Outcome of Hybrid Illizarov Technique in patients with Complex Tibial Plateau Fractures
Authors: Jafree Syed Baqir , Siddiqui Waqas
Published: November 2022

Background:Tibial fractures are the most common long bone fracture, with approximately 25% being open. The majority of open tibial fractures result from a high velocity trauma, such as a motorcycle accident, or a low energy, torsional type injury, such as skiing. They are complex fractures to treat because of the lack of soft tissue coverage and blood supply of the tibial shaft. Aim: To determine the functional outcome of hybridillizarov technique in patients with complex tibial plateau fractures Study Design: Descriptive case series. Place of Study: Orthopedics Surgery Department, Jinnah Hospital, Lahore. Duration of Study: Study was carried out over a period of six months from 28-07-2021 to 28-01-2022 Methods: All the 73 patients fulfilling the selection with complex tibial plateau fractures of Schatzker's type V and VI were enrolled. Informed consent and demographic information were recorded. All the patients were evaluated for injuries, haemodynamically stabilized. Bone grafting and minimal internal fixation with cc screws was done in severely comminuted fractures. The functional results were measured by Rasmussen’s knee functional score (as per operational definition). Results: Distribution of the functional outcome of the patients was done, it showed that out of 73 patients 20(27.4%) were in excellent outcome, 41(56.2%) were in good outcome, 7(9.6%) were in fair outcome, 5(6.8%) were in poor. Conclusion: Based on our results, the use of hybrid illizarov fixation for the treatment of complex tibial plateau fractures is safe and effective in terms of low rates of complication and good functional results. Keywords: Functional outcome, Tibia plateau fracture, Hybrid ilizarov.
Cytotoxic Effect of Kigelia Africana Plant Extracts on Liver Cancer Cells
Authors: Rashid M. S. , Hadi Faheem , Muzaffar Zoya , Asif H. M. , Akhtar Naveed , Zahra Memoona , Sumreen Maqbool, L. , Shamim T. , Malik A.
Published: November 2022

Background: Various medicinal plants have much efficacious value as treatment of many fatal conditions including cancer. Kigelia africana has known therapeutic efficacy in different ailments and has been used as traditional medicine since ages. Aim: To evaluate anticancer property of any drug or plant extract including HepG2 cell line. Methodology: Anticancer activity of n-hexane and ethanolic extracts of Kigelia africana was checked. IC50 was evaluated via MTT assay, crystal violet assay was performed to check the viability of cells and trypan blue assay to count dead cells. Furthermore, muse analysis was performed using count and viability kit to count total living as well non-living cells. Results: Cancer cells of HepG2 cell line showed reduced viability and proliferation with increased apoptosis when treated with Kigelia extracts. Conclusion: Many drugs have been proved as anticancer but with severe side effects. Thus, phytoextracts have been tested in this study to evaluate their anti-cancer activity so minimize the side effect. Kigelia africana extracts were found to be effective against liver cancer cells. Keyword: Kigelia africana, HepG2, MTT, liver cancer, anticancer drug, plant based drugs.
Assessment of Quality of life among patients with hip osteoarthritis
Authors: Iftikhar Usman , Islam Farooq , Enderyas Gulraiz , Shahbaz Faisal , Raza Asim , Azam Sobia , Arshad Haroon
Published: November 2022

Aim: To assess quality of life in patients with hip osteoarthritis. Method: A hospital based cross sectional study was carried out involving hip osteoarthritic patients at District headquarter hospital Gujranwala. From May 2022 to Sep 2022.A total of 196 participants were included in the study. Data were collected from the patients who met the inclusion/exclusion criteria and were entered and analyzed in (SPSS) software version 24.36-Item (SF-36) was used to collect data from participants. Results: The results of the study showed that overall poor quality of life with mean scores physical functioning mean and standard deviationwas 31.13±9.73, role limitations due to physical health mean and standard deviation was 29.33±8.98, role limitations due to emotional problems mean and standard deviation was 22.60±9.31, energy/fatigue mean and standard deviation was 39.51±14.55, general health mean and standard deviation was 17.47±7.35. The goal of the study was to discover the effect of osteoarthritis on standard of living as well as their relationship with eight subscales of sf-36 as many people are not aware about their developed disease and my study will provide information regarding this disease in future. Conclusion: According to the findings of the study, Quality of life is significantly poor in hip osteoarthritis patients. Physical functioning, Role limitations due to physical health, General healthwere the most affected SF-36 subgroups. Keywords: Quality of life, Hip osteoarthritis, SF-36 Survey, Health related quality of life, rotational acetabular osteotomy
Oral Manifestations of Patients Diagnosed with Dermatological Diseases: A Cross-Sectional Study in Eastern Province, KSA
Authors: Ramadugula Venkata Subramanyam , Bokhari Syed Akhtar Hussain , Rashed Hazem Tarek , Alhujhuj Rakan Rafdan , Yousef Al-Abdullredha Essa , Al-Shuaibi Hesham Hamad
Published: November 2022

Background: It is not unusual for oral manifestations to occur in dermatological diseases. The aim of this study was to observe and evaluate oral manifestations in patients diagnosed with dermatological diseases. Methods: A cross-sectional study based on a convenient sampling technique was conducted among patients with dermatological conditions who visited the polyclinic of King Faisal University Polyclinic of Al-Ahsa, Saudi Arabia from Sep-Nov 2021. Results: Sixty-one percent were females, 50% were aged >30 years, 77% had higher education, 61% were unemployed, 82% were non-smokers, and 20% had some medical conditions. 14.5% suffered from immune-mediated skin disease, 25.3% had eczema, 21.7% showed dermatitis infections, 3.6% had Genodermatosis, 9.6% were with psoriasis and other keratinizing disorders, and 25.3% had miscellaneous skin conditions. 85.5% of skin patients did not have any oral manifestations; oral lesions were of perioral dermatitis (1.2%), melanotic macule (1.2%), fissured tongue (2.4%), oral lichen planus (2.4%), mucocele (2.4%), and one case of each with geographic tongue, herpes labialis, and hairy tongue. Practical ImplicationsThis study highlights the importance of integration of oral health into general health for management of oral diseases associated with other body diseases. Conclusion: The majority of the patients in this study sample with skin diseases did not show any oral manifestations. More females and aged patients had more skin conditions. Keywords: Prevalence, Oral manifestations, Dermatological conditions, Cross-sectional study
Evaluation of Participation Level of Adolescents with Cerebral Palsy
Authors: Javed Uzma , Fuad Maleeha , Mahmood Sajid , Rani Bushra , Latif Waqas
Published: November 2022

Background: Adolescence is a time of rapid development in many facets of an individual’s physiological, cognitive, and interpersonal traits, but it also comes with some complexities. Aim: To evaluate the level of participation in different domains of life situations in adolescents with Cerebral Palsy. Study design: Cross-sectional study. Methodology: Study conducted in adolescents with Cerebral Palsy between age 10 – 19, with motor impairment level I, II and level III on GMFCS. Sample size was 84 participants. Questionnaire of Young People’s Participation (QYPP) was used to evaluate participation in different activities and domains of life. Statistical analysis: Analysis of data was done by SPSS v.26. Results: The highest percentage score was observed for Autonomy followed by Getting on with other people, Home life, Reception and Leisure and School or College life. The least percentage score was seen for two domains i.e., Work life and Preparing for the future. It was observed that participants in higher age category had higher score except school or college life domain but no significant difference was evident as per p-value. Conclusion: It was concluded that overall frequency of participation levels proved inadequate in adolescents with CP in all the domains tested. Keywords: Adolescents, Cerebral Palsy, Personal Autonomy and Social Participation.
Assessment of Clinical Features Responsible for Ectopic Pregnancy
Authors: Tabassum Nisha , Mangi Paras , Ali Syeda Sana , Younas Bazla , Raja Ayisha , Shabbir Ambreen
Published: November 2022

Background: Ectopic pregnancy is a lethal condition and a gynecological emergency. It is associated with maternal morbidity and mortality with pregnancy loss. The incidence of ectopic pregnancy is increasing worldwide. The diagnosis of the ectopic pregnancy can be difficult without the suspicion of the condition. It is confused with the pelvic inflammatory disease and miscarriage. Objective: This study may help on formulating a guiding principle on the diagnosis and management of Ectopic pregnancies in this area. In this research the frequency of clinical presentations and factors responsible for ectopic pregnancy are determined. Methodology: This is a cross-sectional based study. This study was conducted at the Obstetricians and gynecology department of Murshid Hospital and health care Center Karachi. The 125 women diagnosed with ectopic pregnancy for the duration of six months from July 2021 to December 2021were included. Patients were examined for outcome variables (abdominal pain, vaginal bleeding, history of infertility, use of IUCD and previous ectopic pregnancy) noted in predesigned performa. Results: - The women mean age was 9m31 ± 6.6 years. There were 96 (78.4%) women observed with abdominal pain and 72 (57.6%) women with vaginal bleeding in which some of them had both clinical presentations. History of fertility 34 (27.2%), use of intrauterine contraceptive device 58 (46.4%) and previous ectopic pregnancy 33 (26.4%) were responsible for ectopic pregnancy. Conclusion: Majority of the patients attended the hospital were in acute condition. They were diagnosed with classical features of ruptured ectopic pregnancy. The most common clinical features were use of IUD, infertility history, and previous ectopic pregnancy. . For reducing the morbidity and mortality rates associated with the ectopic pregnancy the early diagnosis of the tubal rupture is an essential factor. Keywords: Ectopic pregnancy, vaginal bleeding, intrauterine contraceptive device
Effects of Artificial Sweeteners Aspartame and Sucralose on the Size of Hepatocytes in Rat Liver
Authors: Haq Nadia , Saqib Sadia , Tafweez Raafea , Ali Irfan , Syami Ahmad Fawad
Published: November 2022

Background: The excessive use of artificial sweeteners now a days just to lose weight and to remain fit and due to other reasons without knowing its effects on liver gave me a thought to conduct this study to see whether they are safe or not for liver health. Objectives: The objectives of the study were to see the effects of artificial sweeteners Aspartame and Sucralose on the size of rat hepatocytes and to compare their effects to choose relatively safe artificial sweetener for routine use. Methods: Fifty adult Wistar albino rats used in this study were randomly divided into five groups. Group I (control group) animals were given drinking water by oral gavage. The animals of group II and III were given low (40mg/kg body weight) and high doses (1000mg/kg body weight) of Aspartame respectively. Similarly, animals of group IV and V were given low (5mg/kg body weight) and high doses (1000mg/kg body weight) of Sucralose respectively. Doses were given by oral gavage once daily, six days a week for a total duration of eight weeks. At the end of the experiment histological observation of liver in all animal groups was made. Results: Microscopic examination revealed that hepatocytes of group III animals (high dose group of Aspartame) had largest size with the mean value of 20.86±2.00µm as compared to the control group hepatocytes having mean value of 16.46±1.74µm. Conclusion: The increase in the size of hepatocytes was seen in high dose groups of Aspartame and Sucralose whereas changes seen in low dose groups of Aspartame and Sucralose were not significant. Keywords: Artificial sweeteners, Histology of rat liver, Size of hepatocytes.
Undiagnosed Diabetes Mellitus in Acute Coronary Syndrome (ACS) Patients
Authors: Kazim Awais Hussain , Shahzad Muhammad , Rasheed Saima , Bilal Ahmad , Sadiq Noman , Sadiq Tahira
Published: November 2022

Introduction: Diabetes mellitus is a significant precursor of CAD. Patients hospitalised for suspected myocardial infarction had type 2 diabetes at higher rates than the general population, increasing the likelihood of cardiovascular complications. Hospitalized individuals with CAD have a worse prognosis if they also have diabetes mellitus. Objective: With this study, we want to quantify the prevalence of unrecognised diabetes mellitus among Acute Coronary Syndrome patients at a tertiary care hospital in Lahore. Study design: Cross sectional study Setting: Department of Cardiology, Bahria Town Hospital, Lahore Duration: Six months (09-2018 to 03-2019) Data collection procedure: One hundred forty patients who fulfilled the study's inclusion and exclusion criteria were included. Using a standardised questionnaire, we were able to collect information such as age, gender, and type of ACS (STEMI, Non-STEMI, or unstable angina). Diabetes was diagnosed by measuring fasting blood sugar and haemoglobin A1c in a serum sample of 3 cc. It was noted that untreated diabetes mellitus was present. Results: There were 110(78.6%) males and 30(21.4%) females in our study. The mean age of patients was 57.08±12.72 years. The mean height was 171.95±14.37 cm, mean weight was 80.70±11.23 kg and mean BMI was 26.89±3.64. There were 63(45%) patients with family history of diabetes. There were 60(42.9%) patients with Non-STEMI, 52(37.1%) with STEMI and 28(20%) with unstable angina. The mean HbA1c of the patients was 6.11±0.86. There were 10(7.1%) patients with undiagnosed Diabetes mellitus. Conclusion: 7 percent of ACS patients have diabetes mellitus that has not been diagnosed. Keywords: Undiagnosed Diabetes Mellitus, Acute Coronary Syndrome, type 2 diabetes, family history, STEMI,
Incidence of Lumbosacral Transitional Vertebrae in Patients with Low Back Pain
Authors: Shah Ali Raza , Farid Sana , Khan Fahim , Hafeez Sohail
Published: November 2022

Background: The lumbar spine's lumbrosacral transitional vertebrae (LSTV), a structural defect, have been variously linked to low back pain (LBP). Their presence can also lead to an incorrect pre-operative level identification. Objective: To examine the relationship between lumbosacral transitional vertebrae detected on plain radiographs and low back pain in patients. Study Setting: Department of orthopedics, Shifa international hospital, Islamabad Methods: The study design was prospective and descriptive. The study was conducted between July 2021 to December 2021. The radiographs of 100 patients with low back pain who met the inclusion/exclusion criteria were evaluated. The frequency of patients with low back pain and lumbosacral transitional vertebra (LSTV) was calculated using SPSS version 26. For the quantitative data presentation mean and standard deviation was utilized and for qualitative data frequencies were used. P value less than 0.05 was considered significant. Results: In a sample of 100 patients, 40 were men and 60 were women. 45 patients were diagnosed with axial type of lower back pain. The prevalence of LSTV was 27%, with males constituting the majority. No significant difference in the LSTV and Normal spine age distribution intervals was observed except, in the age interval of 51-60 years with a P-Value of <0.001. Conclusion: There is substantial evidence linking lumbosacral transitional vertebrae and low back pain.
The Risk Factors and Incidence of Perineal Tears among Pregnant Women
Authors: Mubashir Hafsa , Bano Nosheen , Naeem Ayesha , Tufail Nazia , Shafiq Sadia , Arooj Anum
Published: November 2022

Aim: To determine the risk factors and prevalence of perineal tear in low-risk pregnant females. Study Design: A retrospective cross-sectional study. Place and Duration: In the Obstetrics and Gynecology department of Khawaja Muhammad Safdar Medical College, Allama Iqbal Memorial Teaching Hospital Sialkot for one-year duration from January 2020 to December 2020. Methods: The females with perineal tear after birth included in this study. A total of 400 females were selected for this study. Results are articulated as adjusted odds ratio (OR) and <0.05 of P value is considered significant. Results: 400 total females had singleton vaginal delivery and perineal tears were noticed in 140 females. The episiotomy frequency for the total of 1st and 2nd degree, and 3rd and 4th degree (OASI) were 16.3%, 25%, and 1.5%, correspondingly. The perineal tear risk-factors are young mothers (teenagers OR = 5.6, 21-25 years OR = 4.3), primiparous women (OR = 12.6), gestational age less than 32 weeks OR = 0.175), received antenatal care (OR = 0.42), correspondingly. Primiparous females were 12.4 times more probable to have an episiotomy (OR = 12.4, 95% CI, 1.48-104.8, p = 0.02). A birth weight between 2.5-3.0 kgs and less than 2.5 kg (OR = 0.012 and 0.084, respectively) protects against Obstetric Anal Sphincter Injury. Conclusions: The perineal injuries risk factors are comparable to those formerly described in other researches. There is an urgent need to train the gynae staff and doctors in proper selection for episiotomy and better perineal care in order to improve obstetric services in the Gynecology department. Identifying those at danger can decrease obstetric perineal injuries. Keywords: Low risk pregnancy, episiotomy, low-risk pregnancy and Obstetric Anal Sphincter Injury.
Tele-Dentistry during Covid-19 Pandemic; Perceptions of Dentists in Pakistan
Authors: Khan Salman Ashraf , Khalid Naima , Bajwa Obaid , Tariq Amina , Naqvi Zainab
Published: November 2022

Objective: The aim of this study is to analyze the perception of Dentists in Pakistan towards Tele-Dentistry and its usefulness during Covid-19 pandemic. Materials & Methods: The study was conducted among general dentists of Lahore after taking approval from the Ethics and Research Committee of the institution. This descriptive cross-sectional study was completed over the period of three months. Non-probability snowball sampling technique was used. Results: The results revealed that most of the dentists (89.5%) perceived that Tele-Dentistry can be of help during COVID 19 Pandemic in Pakistan. Conclusion: Most of the dentists were aware of teledentistry, and its uses, advantages and disadvantages in Covid-19 pandemic. Keywords: teledentistry, Covid-19, dentistry, Lahore, perception, health care professionals
Continuous Versus Intermittent Nebulization of Salbutamol in Acute Severe Asthma
Authors: Gul Noor , Imran Mehr Muhammad , Ahmad Umair , Usman Umar , Hussain Hafiz Amjad
Published: November 2022

Introduction: Asthma exacerbation is one of the most common causes of hospitalization among children. It was observed that severe asthma exacerbation is increasing in children with asthma. Objectives: The main objective of the study is to find the continuous versus intermittent nebulization of salbutamol in acute severe asthma. Material and methods: This randomized control trial study was conducted pulmonology department of DHQ Hospital Faisalabad and the duration of this study was from January 2019 to July 2019. Data was collected with the permission of ethical committee of hospital. The data was collected through random sampling technique. Patients were allocated by means of random table to receive salbutamol either by continuous or intermittent nebulization. Results: The data was collected from 100 asthma patients of both genders. The mean age of patients continuous nebulization was 34.56±2.34 years and in intermittent nebulization 39.89±4.76 years. Hypoxemia was present in all patients with a mean PaO2 is 198±78 mmHg in continuous nebulization. Demographic and clinical values are presented in table 01. Practical implication: We can easily apply this method in hospital treatment of continuous and intermittent nebulization of salbutamol in acute severe asthma. Conclusion: It is concluded that there is no difference in continuous and intermittent nebulization of salbutamol in acute severe asthma. In this regard, repeated nebulizations of salbutamol at 20-minute intervals should be regarded as almost identical to continuous nebulization. keywords: Nebulization, Intermittent, Patients
Value of Maxillary Sinus Morphology in Identification of Gender by Using Digital Radiography
Authors: Khan Younas , Syed Sadia , Shamim Riffat , Bano Syeda , Orakazai Shabir Ahmed , Iqbal Zafar
Published: November 2022

Background: Human being recognition is significant for a variety of purposes, including for the humanitarian and sentimental needs for others, for relatives as well as for the court before rendering a decision. In forensic radiology, the radiographic tests and procedures that are relevant to the law or the courts are performed, interpreted, and then reported. Comparing radiography to three-dimensional (3D) cone beam computed tomography, radiography has the benefits of being more widely available, having a lower radiation dose, and having a lower cast. The systemic change in size or shape between individuals of varying sexes belonging to the same species is known as sexual dimorphism. Sexual dimorphism is reflected by different species' maxillary sinuses. The first paranasal sinus to develop in utero at the age of 10 weeks are the maxillary sinuses, which are two air-filled cavities found in the maxillary bone. They are the largest of the paranasal sinuses. Bones like the pelvis, skull, and femur are used in radiology to identify gender. Maxillary sinuses can be utilized for identification in mass tragedies like aero plane accidents, war, explosions, burnt, decomposing remains, and other calamities. In these situations, all the bones suffer severe damage, but the sinuses are left undamaged. Aim and objective: This research used digital radiography to identify gender based on the morphology of the maxillary sinus. Materials and Methods: From the radiographs (A.P view) of 128 subjects ( 64 males and 64 females), the morphometric characteristics of the maxillary sinus were assessed using microdicom software. Results: The right maxillary sinus average height and width in males was 28.15mm and 25.04mm whereas, in females it 22.39mm and 22.54mm respectively and was found statistically highly significant. Likewise, the left maxillary sinus average height and width in males was 28.91mm and 25.33mm and in females it was 22.39mm and 20.81mm respectively and was statistically highly significant. Conclusion: It was concluded from my study that the anteroposterior (AP) view of digital radiographs can be used to detect the gender based on the height and width of the maxillary sinuses. Keywords: Forensic radiography, maxillary sinus, sexual dimorphism, gender determination mass disaster.
Sensitivity of Pulsatility index of Uterine Artery on Doppler Ultrasound in Diagnosis of Polycystic Ovarian Syndrome
Authors: Qamar Roshna , Baig Muhammad Usman Farooq , Ashraf Rabia , Babar Maria
Published: November 2022

Objective: This study was planned to explore the sensitivity of uterine artery PI and RI. Method: This descriptive Observational study was carried out in Department of Radiology, Combined Military Hospital, Lahore, within six months after the approval of synopsis. Calculated sample size was of 120 females. The collected data was entered and analyzed by using software SPSS version 25.0. Man and standard deviation was calculated for PI and RI. Frequency and percentage was calculated for sensitivity of Pulsatility Index of uterine artery on 3D Doppler for polycystic ovarian syndrome diagnosis. Results: The accurate diagnosis of PCOs among patients was 80.83%. The results revealed that mean pulstility index of right uterine artery was 2.83±0.99 and for Left uterine artery, it was 1.37±0.69 whereas the combine mean was 2.1±0.84. Similarly, mean value of Resistive Index for right uterine artery was .83±.75 and for Left uterine artery, it was .59±.21 whereas the combine mean was 0.71±0.48. Conclusion: The accuracy of polycystic ovarian syndrome diagnosis is quite high with pelvic color Doppler which supports the usage of color Doppler for the diagnosis of polycystic syndrome in females. Keywords: Polycystic Ovarian Syndrome, Pulsatility Index, Resistive Index
REALISASI GOOD GOVERNANCE PADA AKUNTANBILITAS ALOKASI DANA DESA (STUDI KASUS : DESA GEJAGAN KECAMATAN LOCERET KABUPATEN NGANJUK
Authors: Zahrotin Fridania
Published: November 2022

In a village financial system that is shifted to the allocation of village funds to regional agencies to increase the APBN through regional original income. The case study carried out was at the Village Office location in Gejagan Village, Loceret District, Nganjuk Regency by monitoring the application system for processing and financial arrangements in allocating village funds to various activities in implementing existing activities in the village. Meanwhile, this village uses the application of a good governance system or in the Latin term meaning good government by linking an accountability of village funds into activities that have been designed since the planning system was created for a program to be carried out. Although in its implementation the village government is required to have an aspect of good governance, where one of the main characteristics or elements of good governance is accountability. Accountability itself is a form of responsibility for carrying out the organization's mission in achieving the goals that have been set through the medium of accountability which is carried out periodically. The allocation of village funds is basically financial assistance from the Regency Government, Provincial Government, and Central, City Government to the Village Government sourced from the APBN, Provincial APBD, Regency/Municipal APBD which is channeled through the village treasury in the context of implementing Village Governments that have events. specific in each village.
PENGARUH FRAUD PENTAGON TERHADAP TAX AVOIDANCE
Authors: Mundiroh Siti , Ningsih Fitria Eka
Published: November 2022

This study aims to determine the effect of Pentagon Fraud on Tax Avoidance. The type of research conducted is descriptive quantitative research with secondary data sources in the form of annual reports and the population of the Food and Beverages sub-sector manufacturing companies listed on the IDX for the 2016-2020 period. The data in this study were processed using Microsoft excel and Eviews 12. The number of samples in this study were 14 companies with 5 years of observation so that 70 observation data were obtained. The sampling technique used in this research is purposive sampling where the sample is taken based on certain criteria. The data analysis technique in this research uses panel data model test, descriptive statistics, classical assumption test, model accuracy test (coefficient of determination), and hypothesis testing, namely simultaneous test or F test and partial test, namely t test. The results of this study indicate that simultaneously all independent variables have an effect on Tax Avoidance. However, partially only the External Pressure variable has an effect on Tax Avoidance. Meanwhile, Arrogance, Competence, Financial Target, Ineffective Monitoring and Razionalization variables have no effect on Tax Avoidance.
Primena koncepta deficita znanja i veština u politici i planiranju obrazovanja - slučaj jedne tranzicione ekonomije
Authors: Despotović Miomir
Published: November 2022

The basic research problem in this paper is the reliability of knowledge and skills needs assessment provided by employers in transitional economies and the relevance of this assessment to educational policy and planning. Trends in employment and projected deficit of labour force have been analysed against the groups of occupations and the levels of qualification in 53 enterprises from the field of processing industry in Serbia. Analysis results show that knowledge and skills needs assessments provided by employers is pretty unreliable in transitional economies. The author concludes that educational policy cannot only be based on the identifications concept of local labour force deficit, knowledge and skills, but that at least two aditional factors need to be taken into account: a) employment trends regarding adquate profiles and knowldgw and skills requirements by the leading world companies in the specific fileds of work and b) active role of the education system in projection and development of the needs for knowledge and skills.
Osposobljavanje za ulazak u zanimanje - studija slučaja
Authors: Jovanović Ljiljana , Pejatović Aleksandra
Published: November 2022

The idea to study training for hairdressers as an occupation has resulted from the observed tendency where hairdressers who have already obtained a diploma in the formal education system often enter again the basic training course for hairedressers in an institution of non-formal education. We have tried to examine the reasons of this 'extended' training thtough the concept of educational needs. Needs have been divided into three groups: those related to the capacity to work, articulated career goals and the needs related to the reasons for inclusion and assesssment of the caracteristics of the institution organising the training. Data indicate that our interviewees feel competent to do the job in accordance with the requirements of the market only when they have completed formal education, continued to practice in the workplace beyond the regular practice timetable and completed the course for hairdressers in non-formal education. Broadly speaking, the data point to the necessity of cooperation between social partners in the area of vocational education of adults.
Expenditure and Utilization Patterns of Cancer Care in Kuwait
Authors: Abuhadida Salem , Alzaid Saud , Buresli Yousef , Alnusif Ahmad , Alhindal Barrak
Published: November 2022

#Introduction

Cancer is among the leading causes of morbidity and mortality worldwide. However. The trends in utilization of cancer services and related expenditures in Kuwait are poorly known. We aim to investigate the expenditure and utilization patterns of cancer care in Kuwait.

Methods

A three-year retrospective analysis study of expenditure and utilization pattern in KCCC was performed from 2015 to 2017 in MOH in Kuwait.

Results

We report a considerable variation of utilizations and expenditure levels over the three-year period. After adjusting the data, there was significant increase in utilization rates and expenditure in 2015-16 followed by significant decrease in year 2016-17. The expenditure was observed to increase by 1.1% in 2016 before it declined by 1.9% in 2017.

Conclusions

This study is the first of its kind in Kuwait. We report adequate utilization and expenditure of cancer care in Kuwait. However, we recommend heavy investments in precision medicine technology and patient outcomes research to improve overall financial and operational performance pertaining to cancer care in MOH in Kuwait.
Knowledge as Factually Grounded Belief
Authors: Piccinini Gualtiero
Published: November 2022

Knowledge is factually grounded belief. This account uses the same ingredients as the traditional analysis—belief, truth, and justification—but posits a different relation between them. While the traditional analysis begins with true belief and improves it by simply adding justification, this account begins with belief, improves it by grounding it, and then improves it further by grounding it in the facts. In other words, for a belief to be knowledge, it's not enough that it be true and justified; for a belief to be knowledge, it must be justified by the facts. This account solves the Gettier problem. Gettierized beliefs fall short of knowledge because, albeit true and justified, they are not grounded in the facts. This account also elucidates why knowledge attributions are sensitive to epistemic standards. It's because whether we take a belief to be grounded in the facts is sensitive to epistemic standards.