bluuebunny/crossref_metadata_2025 huggingface dataset:
Artificial Intelligence Optimization Algorithms in the Finance Sector
Authors: MUTLU YILDIRIM Filiz , ONUR Burçin , KUNDURACI Sıraç Ömer
Published: March 2023

Increasing efficiency and security expectations with the technological developments in the financial sector have necessitated more effective solutions in issues such as financial failure prediction, portfolio selection, market analysis, risk assessment, and stock price estimation. At this point, artificial intelligence optimization algorithms come to the fore in terms of lower cost, higher data storage capacity, and transaction volume, performing the same operations in similar problems and creating an effective order to prevent problems that may occur in the future. For this purpose, the use of artificial intelligence optimization algorithms in the finance sector is discussed in this study. To guide their use in decision-making and problem-solving processes, Artificial Bee Colony Algorithm, Tabu Search Algorithm, Flower Pollination Algorithm, Shark Smell Optimization Algorithm, and Differential Evolution Algorithm were explained and examples from their application areas were shared. As a result of the study, the advantages of artificial intelligence optimization algorithms were revealed and their importance in the finance sector was emphasized. This study is especially widely used in the solution of engineering problems; however, it contributes to the literature in terms of explaining algorithms whose applications in the finance sector are still limited.
License to Work: A National Study of Burdens from Occupational Licensing
Authors: Knepper Lisa , Deyo Darwyyn , Sweetland Kyle , Tiezzi Jason , Mena Alec
Published: March 2023

This document is a compendium of License to Work: A National Study of Burdens from Occupational Licensing, 3rd Edition published by the Institute for Justice. License to Work provides an updated snapshot of licensing’s breadth and burdens for 102 lower-income occupations across all 50 states, the District of Columbia, and, in a first for this edition, Puerto Rico. It also presents an overview of major changes in licensing requirements for the 102 occupations that have been tracked since the 2017 edition. The compendium is focused on Puerto Rico and features all the information on occupational licenses on the Island included in the report. The purpose is to provide readers with a quick reference guide on the situation of occupational licenses in Puerto Rico.
License to Work: Un estudio nacional de las cargas de las licencias ocupacionales
Authors: Knepper Lisa , Deyo Darwyyn , Sweetland Kyle , Tiezzi Jason , Mena Alec
Published: March 2023

Este documento es un compendio de License to Work: A National Study of Burdens from Occupational Licensing, 3rd Edition publicado por el Institute for Justice. License to Work proporciona una instantánea actualizada de la amplitud y las cargas de las licencias para 102 ocupaciones de bajos ingresos en los 50 estados, el Distrito de Columbia y, por primera vez en esta edición, Puerto Rico. También presenta una descripción general de los principales cambios en los requisitos de licencia para las 102 ocupaciones que se han rastreado desde la edición de 2017. El compendio está enfocado en Puerto Rico y presenta toda la información sobre licencias ocupacionales en la Isla incluida en el informe. El propósito es brindar a los lectores una guía de referencia rápida sobre la situación de las licencias ocupacionales en Puerto Rico.
Role of Non-Hepatotropic Viruses in Acute Sporadic Viral Hepatitis and Acute-on-Chronic Liver Failure in Adults
Authors: Huq Moeen Ul , Rehman Rizwan Ur , Mohsin M. Nabeel , Usman Fahad , Jativa Paula , Heredia Maria Jose
Published: March 2023

Background and Aim: Viral infections, drugs, metabolic disorders, and autoimmune processes can cause hepatitis, which is a diffuse inflammatory condition of the liver. Hepatitis E (HEV) and hepatitis A (HAV) viruses are the most common causes of acute viral hepatitis (AVH). AVH and chronic liver failure (ACLF) patients were studied to determine whether they were infected with various hepatotropic and non-hepatotropic viruses. Patients and Methods: This prospective study was conducted on 186 adult patients with ACLF and AVH in the Department of Gastroenterology, DHQ Teaching Hospital and Mufti Mahmood Memorial Hospital, Dera Ismail Khan from September 2020 to August 2022. Our study included consecutive patients with acute viral hepatitis who had a definite viral etiology, a fever or jaundice that developed after 3 weeks, and an ALT that was 2x the upper limit of normal. There were three serological tests performed for all the patients: hepatitis (A, B, C, D, and E), Epstein-Barr virus (EBV), and non-hepatitis (CMV). Data analysis was carried out in SPSS version 26. Results: Of the total 186 samples investigated, the incidence of ACLF and AVH was 60 (32.3%) and 126 (67.7%) respectively. The prevalence of confirmed etiology such as HEV, HAV, HBV, and HCV was 98 (52.7%), 29 (15.6%), 20 (10.8%), and 2 (1.1%) respectively. The mixed viral etiology and Epstein-Barr virus was present in 18 (9.7%) and 19 (10.2%) respectively. The most prevalent cause of infection was HEV found in 76 (60.3%) AVH and 42 (70%) ACLF cases. The mortality rate among AVH patients was significantly lower 2.4% (n=3) than ACLF 23.3% (n=14). As compared to ACLF patients, AVH patients had significantly higher infections caused by non-hepatotropic viruses (24 vs. 3, p=0.001). There were significantly more mixed infections in AVH as opposed to ACLF (28 vs. 4, p<0.001). Conclusion: The present study concluded that both AVH and ACLF patients were susceptible to HEV-associated hepatitis. There were significant numbers of patients with AVH being infected with non-hepatotropic viruses including CMV and EBV. These viruses are much less common in patients with ACLF. Keywords: Epidemiology, Non-hepatotropic virus, Acute viral hepatitis, Acute chronic liver failure
Utilization of Mentzer Index to Discriminate Between Beta Thalassemia Minor and Anemia of Iron Deficiency, Followed by HPLC
Authors: Idrees Muhammad , Khan Jibran Umar Ayub , Riaz Huma , Shah Munawar Ali , Shah Hamidullah , Haris Syed Mohammad
Published: March 2023

Objective: Aim was to evaluate the sensitivity and specificity of Mentzer index in differentiating beta thalassemia minor from anemia of Iron deficiency. Materials and Methods: A cross-sectional study conducted in Hematology unit of Hayatabad Medical Complex .Sampling was done non-consecutively. A total of 860 cases with value of Hemoglobin less than 11 Gm/DL were counted. In all the selected cases full blood count were checked and Mentzer Index mean corpuscular volume [MCV] per RBCs count )was calculated. Value of <13 suggests the diagnosis of β Thalassemia minor/trait while more than 13 value is more indicative of Iron deficiency anemia (IDA). Confirmation of diagnoses was made by hemoglobin study using HPLC. Values for specificity and sensitivity for Mentzer Index were calculated for the two differentials of microcytic hypochromic anemia presenting with microcytosis and hypochromia. Results: Mean hemoglobin level of patients was 9.01±1.85. Minimum and maximum hemoglobin value was 2.90 and 11 g/dl. Mean RCB count was 4.66±4.59 minimum and maximum RCB count was 1.07 and 136. Mean MCV value was 63.89±9.01. Minimum and maximum MCV value was 39.40 and 92.10 respectively. Men Mentzer index was 15.70±7.68. Minimum and maximum Mentzer index value was 7.80 and 10.7 respectively. Based on Mentzer index criteria 489(56.86%) patients had iron deficiency anemia and 371(43.14%) patients had higher suspicion of beta thalassemia. Conclusion: It was concluded that for differentiation among Beta thalassemia minor and anemia of iron deficiency , Mentzer Index can be beneficial to discriminate with a high sensitivity as well as specificity percentage and thus through a cost effective way, only suspected cases of beta thalassemia trait/minor can be further confirmed by Hb Electrophoreses. Keywords: Mentzer Index, iron deficiency Anemia, beta Thalassemia minor
Effectiveness of Early Versus Delayed Open Reduction and Internal Fixation for Isolated Mandibular Fractures
Authors: Khan Muhammad Irfan , Parkash Oam , Irshad Farah , Zaidi Syed Aijaz Ali , Nankani Sonam , Ahmed Khursheed
Published: March 2023

Introduction: Mandibular fractures are common maxillofacial injuries that can cause significant functional and esthetic impairments. Objectives: The main objective of the study is to find the effectiveness of early versus delayed open reduction and internal fixation for isolated mandibular fractures. Material and methods: This study is a retrospective analysis of patient conducted in Govt Lady Reading Hospital, Medical Teaching Institution, Peshawar, during January 2022 till December 2022 and data collected from medical records. The study compares the outcomes of early and delayed ORIF for isolated mandibular fractures. All patients who underwent ORIF for isolated mandibular fractures at a single institution over a two-year period were included in the study. Patients were excluded if they had associated injuries or comorbidities that could affect their outcomes or if they underwent surgery at another institution. Results: A total of 150 patients who underwent ORIF for isolated mandibular fractures were included in the study. Of these, 75 patients underwent early ORIF (within 72 hours of injury), and 75 patients underwent delayed ORIF (more than 72 hours after injury). The two groups were similar in terms of age, sex, and fracture type. Functional and esthetic outcomes were assessed using the Facial Disability Index and the Glasgow Benefit Inventory. The early ORIF group had a mean score of 75.2 on the Facial Disability Index, while the delayed ORIF group had a mean score of 68.9 (p < 0.05). Conclusion: In conclusion, this study suggests that early ORIF for isolated mandibular fractures may lead to better functional and esthetic outcomes compared to delayed ORIF, without increasing the risk of complications or healthcare costs.
To Compare the Blood Loss in Bipolar Diathermy Versus Suture Ligation for Hemostasis in Patients Presented with Chronic Tonsillitis
Authors: Rehman Anees Ur , Mangrio Salman Ahmed , Bhutta Muhammad Farooq , Ullah Ikram , Rana Ashfaq Hussain , Tahir Muhammad
Published: March 2023

Objective: To compare the blood loss in bipolar diathermy versus suture ligation for hemostasis in patients presented with chronic tonsillitis Material and methods: We conducted this randomized controlled at ENT Department Sheikh Zayed Hospital Rahim Yar Khan from April, 2022 to September, 2022. Total 70 patients presenting with chronic tonsillitis divided in two groups equally. Patients were treated with two procedures bipolar diathermy and ligation. Mean blood loss and operative time was compared between both groups. T-Test was used for comparison keeping P < 0.05 as statistically significant. Results: Mean age of the patient was 22.86±9.31 years in group A and 22.89±7.29 years in group B. The mean blood loss in group A and group B was 27.71±7.10 ml vs 43.40±16.63 ml. Procedure time in group A and group B was 7.69±1.85 mins vs 9.91±2.09 mins. Conclusion: We conclude that bipolar diathermy group had statistically lower amount of blood loss and post-operative time when compared with ligation group. Keywords: bipolar diathermy, ligation, chronic tonsillitis, hemostasis
Effect of Bilateral Nasal Packing on Systemic Blood Pressure in Patients Treated with Septoplasty
Authors: Ullah Ikram , Mangrio Salman Ahmed , Bhutta Muhammad Farooq , Rana Ashfaq Hussain , Rehman Anees Ur , Ahmed Maqbool
Published: March 2023

Aim: The primary aim of this research was to assess the impact of bilateral nasal packing on systolic blood pressure in individuals undergoing septoplasty. Study Design: Retrospective study. Place and Duration: This study was conducted at Hospital Dow International Medical College, Dow University of Health Sciences Karachi and Shahida Islam Medical College, Lodhran during in the period from March, 2022 to August, 2022. Methods:152 patients who had a clinically determined nasal septoplasty were included in this study. Patients in this ranged in age from 18 to 50. The patients were randomly split in two groups. Seventy-six patients were assigned to Group I, where no nasal packing was utilized, and Group II, where conventional anterior nasal packing was applied. One may say that there was a 50/50 split between the two groups. Before to and throughout septoplasty, all patients underwent round-the-clock ambulatory blood pressure monitoring. Statistical analysis was performed on all data using SPSS 24. Results: 90 (59.2%) of the 152 patients were male, and 62 (40.8%) of the patients were female. The patients which were under the age of 30 are 59(38.8 percent) of the total patients, 55 (36.2 percent) were between the ages of 31 and 40, and 38 (25 percent) were above the age of 40.50% of the patients are comprised of rural locale. Study participants in Group II were found to have higher mean blood pressure (p-Value 0.05) following septoplasty therapy than those in Group I (P-Value >0.05). Group II patients had bleeding, vestibulitis, and septal perforations as a result of their nasal packing procedure. Conclusion: The study determined that bilateral nasal packing was linked with the preferment in either systolic or diastolic blood pressure in individuals who had septoplasty treatment. There is no statistical significance change showed up with the patients who did not get nasal packing from the rest of the group. Keywords: Septoplasty, Bilateral Nasal Packing, systemic blood pressure
Outcomes of Patients who Received Bailout Thrombectomy for Primary Percutaneous Coronary Intervention
Authors: . Osama , Mansoor Badr , Shah Syed Mohammad Ali Zain , Ahmad Massiha Gulzar , Mustafa Ahmad , Ali Faraz , Khan Muhammad Ali , Ahmad Gulzar
Published: March 2023

Objective: The purpose of this study was to compare outcomes among patients undergoing primary percutaneous coronary intervention with and without bailout thrombectomy. Study Design: Observational/ cross sectional study. Place and Duration: This observational/cross sectional study was conducted at Interventional Cardiology, National Institute of Cardiovascular Diseases, Karachi, Pakistan in the period from March,2022 to August, 2022. Methods: Total 140 patients of both gender had ST elevation myocardial infarction were presented for primary percutaneous coronary intervention. Patients were included after getting informed written consent for detailed demographics such as gender, age, comorbidities and history of CAD. We divided patients into two groups. Group I received only PPCI in 70 cases and 70 cases of group II received only PPCI with bailout thrombectomy. After PPCI comma results of both groups were compared. To analyzation of data, we use SPSS 18.0. Results: Among all presented cases, 80 (57.1%) were male patients and 60 (42.9%) were females. The patients mean age in group I was 53.17±11.62 years and in group II mean age was 55.9±10.94 years. Diabetes mellitus was the most common comorbidity found among both groups 35(50%) in group I and 27(38.6%) in group II followed by hypertension 21(30%) in group I and 24(34.3%) in group II. Family history of coronary artery disease (CAD) in group I was 19(27.1%) and in group II was 23(32.9%).There was no significance difference found in both groups in terms of mortality. There was significant higher number of renal impairment, stroke, heart failure, excess bleeding and renal infarction in group II as compared to group I with p value<0.05. Hospital stay was also higher in group II as compared to group I with p value<0.04. Conclusion: It is determined that patients who underwent bailout thrombectomy for percutaneous coronary intervention (PCI) had a significant risk of comorbidities. Between the two groups, there was no discernible variation in mortality. Those who underwent bailout thrombectomy, however, had higher rates of post-procedure stroke and renal impairment. Keywords, Bailout thrombectomy, Outcomes, ST-segment elevated myocardial infarction, PPCI.
Assessment of the Understanding of Ergonomics Role in Triggering Musculoskeletal Pain Amongst Dentists of Karachi, Pakistan
Authors: Afzal Asra , Zafar Shaista , Ashfaq Faiqa
Published: March 2023

Obective: The purpose of the study is to assess the understanding of ergonomics role in triggering musculoskeletal pain amongst dental professionals in Pakistan. Methodology:A cross-sectional survey was carried out in hospitals and private clinics in Karachi. A total of 230 dentists were recruited in the study, 121 were males and 109 were females. Dentists aged between 27 years to 60 years with a clinical experience of minimum 5 years and no hereditary musculoskeletal disorder were included in the study. The questionnaire was divided into three segments recording; practice details, understanding of the work-related MSD and attitude towards WMSD. The collected data were computed and analyzed in SPSS.21.0. Results:According to the study 169 (73.5%)dentists claimed to have to experienced musculoskeletal disorder pain. Lower back [4.77± 2.31] and neck[4.74± 2.23] followed by shoulder pain[ 4.93± 2.46]were the most common complaints. With respect to pain in different parts, female practitioners consistently reported more pain in every zone compared to males, irrespective of age. However, back pain reported the highest frequency with increasing BMI and decreased with age. Conclusion: The study showed a significant association of musculoskeletal pain with torsion/cervical flexion of the neck, employing for better approach during the procedures; however, with an increase in clinical experience the pain site changed from the lower back to wrist and hand, with respect to gender. Keywords: Dental rofesionals, Ergonomics, Lower back pain, Musculoskeletal pain.
Impact of Multimodal Therapy on Margin Status on Overall Survival for Patients Undergoing Adrenalectomy for Localized Adrenocortical Carcinoma
Authors: Ali Rashid , Asif Muhammad , . Haleemullah , Niazi Abdul Basit , Bumbia Hira Anis , Ammar Muhammad
Published: March 2023

Introduction: Adrenocortical carcinoma (ACC) is a rare and aggressive malignancy that arises from the adrenal cortex. It is a challenging disease to manage due to its rarity, variable presentation, and lack of effective systemic therapy options. Objectives: The main objective of the study is to find the impact of multimodal therapy on margin status on overall survival for patients undergoing adrenalectomy for localized adrenocortical carcinoma. Material and methods: The aim of this study was to investigate the impact of multimodal therapy on margin status and overall survival in patients who underwent adrenalectomy for localized adrenocortical carcinoma (ACC) between March 2022 till November 2022 at a single tertiary care center. Results: Based on the analysis of 300 patients who underwent adrenalectomy for localized adrenocortical carcinoma (ACC) between 2000 and 2022 at a single tertiary care center, the study found that multimodal therapy may improve margin status and overall survival in this patient population. Of the 300 patients included in the study, 150 received multimodal therapy (adjuvant radiation therapy and/or chemotherapy) and 150 received observation after surgery. The median follow-up time was 48 months. Conclusion: In conclusion, the findings of this study suggest that multimodal therapy may be an effective treatment option for patients undergoing adrenalectomy for localized adrenocortical carcinoma. Multimodal therapy was found to be associated with a significantly higher overall survival rate compared to observation alone.
Knowledge and Attitude of Nurses towards Hepatitis B and C Prevention and Transmission
Authors: Jabeen Sumera , Ghani Mansoor , Kausar Samina , Mushtaq Rahila , Khalid Asma , Hanif Misbah
Published: March 2023

Background: Nurses are considered a key member of health care delivery system who are providing essential care to their clients. Aim: To assess knowledge and attitude of charge nurses, working in tertiary care hospitals of Lahore. Study Design: Cross-sectional descriptive study. Methodology: A sample size of 272 staff nurses working in four tertiary care hospitals of Lahore were enrolled by using method of non-probability convenient sampling. Data was collected by adopted questionnaire. Data was analyzed by SPSS software, version 23. Results were compiled and presented as frequencies and percentages. Frequencies were computed for categorical variables. Chi-square / Fisher’s exact test was used to determine the association of knowledge and attitude. A p-value ≤ 0.05 was taken as significant. Results: The result revealed that 36.4% nurses had good level of knowledge and 9.6% nurses had excellent knowledge related to Hepatitis B and C prevention and transmission. Majority of the participants 76.5% depicted positive attitude. Practical Implication: Nurses are the primary source of information for the public, so it's critical to assess their knowledge and attitudes about these disorders. A better understanding of health workers' knowledge and attitudes about the risk of liver disease, particularly among nurses, will aid in the creation of suitable preventative initiatives for this demographic. This study helped in Program planning for monitoring and improving the nursing care services at health care setups. Conclusion: We concluded that beside a sub optimal level of knowledge of viral Hepatitis B and C, nurses have been willingly providing care to their clients with positive attitude. Keywords: Patient Satisfaction, Nursing Care, Prevention and Knowledge.
Obesity: A Risk Factor of Hypertension in Adult Male Population
Authors: Aziz Asia , Qamar Misbah Ul , Tufail Nadia , Abbas Huda , Hussain Wajahat , Mufti Maria
Published: March 2023

Aim: To determine the association between obesity and hypertension among adult male population. Study design: Cross sectional analytical Place and duration: Conducted from June 2022 to December 2022 in Medical wards of BVH, Bahawalpur. Methodology: 1124 adult male between 20-40 years of age admitted in medical wards without any illness were included. Results: Mean age of the patient was 27.1±3.6 yrs. Mostly were between the ages of 26-30 yrs i.e. 51%. Number of patients with hypertension was 19.4% and in obese persons was higher as compared to non-obese group i.e. p<0.01. Conclusion: Hypertension is higher in obese persons when comparing with non-obese subjects. Keywords: Body mass index, Adults, Hypertension
Ethical Awareness among Undergraduate Nursing Students of Khyber Pukhtankhwa
Authors: Jamal Haseen , . Shabana , . Shakirullah , Khan Sheraz , Sultan Amir
Published: March 2023

Aim: To identify the academic ethical awareness among the undergraduate nursing students of Khyber Pukhtankhwa Pakistan. Methodology: The study was conducted in October – November 2022 in Nursing Institutes of Khyber Pukhtankhwa while using descriptive cross-sectional design through purposive sampling technique. The data was collected through valid and reliable questionnaire having chronbach of 0.95. Data was analyzed through Microsoft excel and SPSS 20 after ethical approved by institutional review board. Results: The ethical awareness mean score of male students were 2.4±0.91 higher than female students 2.01±0.76. Furthermore the mean score of 7th semester students were higher 2.7±0.91 than other semester students. The overall means score regarding ethical awareness among nursing students was 2.32±0.89. Conclusion: Study concludes that the level of awareness improves with advancement to next semesters and is significantly associated with gender, age and semester. Implications: The findings will help the nursing educators to assess the current ethical practices of undergraduate nursing students and to improve further the academic and clinical ethical practices among nursing students. Keywords: Undergraduate nursing students, academic ethics, ethical practices
CBCT as a novel pre-op non-invasive method to determine the location of Greater Palatine Foramen
Authors: Warraich Usman Manzoor , Maqbool Maha , Javed Sittara , Ataullah Khurram , Khan Zubair Ahmad , Mahmood Asad
Published: March 2023

Aim: To determine the greater palatine foramen position with reference to Maxillary molar teeth among patients presenting in a tertiary care hospital in Lahore by using cone beam computed (CBCT). Method: In this cross sectional studywhich was conducted at Fatima Memorial Hospital located in Lahore, in which a total of 80 patients were included. Informed consents and demographic details were noted. Cone beam computed tomography was taken in Planmeca Promax 3D Mid (60-120 kV; 9-33 s; 200 um voxel size) of all subjects. As per operational definitions, linear measurements for location of greater palatine foramen were measured. All the information was recorded in a specifically designed form. Results: Onaveragethe age ofpatients in this study was 39.35±11.19 years, 38(47.50%) patients were male. On left and right side the most common position was between middle and mesial face of third molar noted in 45(56.25%) and 43(53.75%) patients respectively. Conclusion: The most common position both sides was the position between middle and mesial face of third molar followed by position between distal face and middle of third molar in patients reporting in a tertiary care hospital located in Lahore by using cone beam computed tomography (CBCT) Keywords: Greater palatine foramen, cone beam, CT,
Knowledge of Pakistani Nurses about Theory Practice Gap in Nursing
Authors: Hameed Alina , Abdullahi Kabir Ozigi , Yaqoob Adnan
Published: March 2023

Aims: To evaluate the knowledge of the participants about theory practice gap and to determine the association of knowledge with demographic variable like age and educational level of the participants. Methodology: A cross sectional study design was used to conduct this study. This study was conducted at Government and private Universalities or Hospitals Lahore. Approximately 09 months after the approval of synopsis from Research Ethical Committee (REC). Sample size of 192 cases is calculated with 95% confidence interval, 7% margin of error and convenient sampling was used. Target population of the present study was nursing instructors and clinical nurses. SPSS version 21.0 was used for data analysis. Quantitative variables mean and standard deviation was be used. For categorical variables frequency and percentage was used.Chi-square test was be used. P-Value ≤ 0.05 was being considered statistically significant. The study was conducted in private and public sector in Lahore. Results: In out of 192 respondent about 65.63% having score less than 13.8 and 34.38% scored between 13.8-18.4. However non of the participents have score greater than > 18.4. Its mean that most of the study particepents fall in the poor knoweledge score. It further illustrated that regarding to assess the knowledge level of the participents about theory practice gap; show that there were no awearness regarding the thory practice gap in nursing. The finding of this study as helpful for the future researcher and educational institute how to reduce this theroy prectice gap. Conclusion: It is not enough to have good knowledge about the existence of the gap; efforts must be made to minimize it in order to close the theory-practice gap. The theory-practice gap can be reduced or minimized through effective collaboration, improved knowledge acquisition, continuous education, periodic curriculum updates, and the incorporation of evidence-based practices into the curriculum of learning. Keywords: Theory-Practice Gap, Knowledge, Pakistani Nurse, Educators, Private and Government Institute
Association between High Serum Uric Acid Level and Good Outcome in patients of Ischemic Stroke
Authors: Wajid Maria , Rathore Rabia , Butt Nasir Farooq , Iqbal Adil , Alatif Hina , Abbas Madiha
Published: March 2023

Aim: To determine the relationship of raised levels of uric acid and good prognosis in patients presenting with acute onset ischemic stroke Study design: A cross-sectional descriptive study. Place & duration of study: The research was done at Medical Emergency, Departments of Neurology and Medicine Mayo Hospital Lahore from April, 2019 to March 2020. Methods: Total 230 patients fulfilling selection criteria were enrolled. Serum uric acid levels were measured at the time of admission. The technique used to assemble data was consecutive non-probability convenience sampling. Patients were divided into two groups Group A (115 patients - having uric acid more than or equal to 7 mg/dl) and Group B (115 patients - having uric acid less than 7 mg/dl). After 5 days, Modified Rankin score (mRS) was noted and link between raised uric acid levels and mRS was determined. Results: Total 230 (115 Group A/ 115 Group B) patients were selected for this study. Among Group A, mean age was 57.2±10.4 years and 58.8±10.1 years among Group B. Among Group A, there were 72(62.6%) males and 43(37.4%) females, while 79(68.7%) males and 36(31.3%) females among Group B . By comparing good outcome between groups, it was found that percentage of good outcome was 42.6% with high uric acid level and 16.5% with normal uric acid level. The difference was significant (p=0.00001) and with odds ratio as 3.751. Conclusion: There is an association between high serum uric acid level and good outcome in patients presenting with stroke. Patients with high serum uric acid level have significant chances to have good outcome. Keywords: Serum Uric Acid, Acute Ischemic Stroke, modified Rankin Score
To Find the Frequency of Cirrhotic Cardiomyopathy in 100 patients of Chronic Liver Disease
Authors: Sulehria Sohail Bashir , Khan M. Ahmad , Tariq Anum Arooj , Faisal Abdul Wajid Khan , Shahid Mushtaq A. , Elahi Nayyer M. , Khan Afzal
Published: March 2023

Aim: To find the frequency of cirrhotic cardiomyopathy in patients of chronic liver disease. Study design: It was a pure cross sectional type of study. Duration: After approval of synopsis, it consisted of six months i.e., from 12/04/2018 to 11/10/2018. Methods: This study was consisted of 100 patients of both sex, having age range of 16-70 years & have cirrhosis of liver assessed at least half year previously. All of them underwent transthoracic echocardiography to look for cardiomyopathy to be assessed by looking at diastolic dysfunction (i.e. increase in ratio of E/A more than 1). Each individual enrolled in current study is asked for written consent. Results: Mean age of patients was found to be 51.9±9.8 years. There were 61 males (61%) & 39 females (39%) have man to woman ratio of 1.6:1. Mean BMI was 26.5± 3.7 Kg/m2 and mean duration of cirrhosis of liver was 22.0±10.9 months. Majority (n=49) of them (49%) were of Child Pugh Class C followed by 39% of Class B & then 12% of Class A. Cardiomyopathy with cirrhosis of liver was seen in 41%. No significant difference was seen statistically in frequency of cardiomyopathy with cirrhosis of liver across all groups based on age (p value less than 0.928), sex (p value less than 0.997), BMI (p valueless than 0.983) Practical implication: If all chronic liver disease patients are screened for cardiomyopathy by echocardiography early, then we can improve quality of life for these patients & hence can survive longer. Conclusion: Cardiomyopathy associated with cirrhosis of liver was seen in a large percentage of cirrhosis liver cases and was found to be more frequent in those with more severe illness which guide us for doing transthoracic echocardiography to screen all these to timely identify and manage this complication to improve case outcome. Keywords: Cirrhosis Liver, Cardiomyopathy, Child-Pugh Class
Comparison of Ligasure versus Bipolar Diathermy Tonsillectomy
Authors: Saleem Wahid , Khan Saeed , Ali Shahid , Ilyas Muhammad , Niaz Adeel , Hussain Shehbaz
Published: March 2023

Aim: To compare the operational time, blood loss and consequences of tonsillectomy with Ligasure versus bipolar diathermy. Methods: A total of 106 individuals were randomized to have their Tonsillectomy done with either Ligasure or bipolar diathermy in this prospective trial. The length of procedure, amount of blood lost during it, degree of post-operative pain and the outcomes all were documented and studied. Results: In total, 106 cases were studied, with 53 cases in to the Ligasure Group and 53 cases to Bipolar Tonsillectomy Group. During surgery, bipolar diathermy group lost more amount of blood. The Ligasure group had an average operative time of 4 minutes less. Both groups had similar degrees of postoperative pain. Despite the fact that the Ligasure group had less postoperative hemorrhages than the diathermy group, there was no statistically significant difference. Conclusions: Study concluded that tonsillectomies using ligasure took longer than those with bipolar diathermy. Both groups had similar perioperative hemostasis. The rate of postoperative bleeding was higher than anticipated. Keywords: Ligasure, bipolar diathermy hemorrhage, hemostasis, blood loss during surgery
Effects of the Covid-19 Pandemic on Primary Education System of Lahore, Pakistan
Authors: Shahzad Laila , Yousaf Sadia , Riaz Nimra , Hayyat Muhammad Umar , Ghafoor Gulzareen
Published: March 2023

Background: The pandemic of Covid-19 impeded all socio-economical, pedagogic, and recreational activities. Pakistan is facing an intensified educational crisis due to previous educational differences, so the era of the pandemic has shown difficulties in the educational framework. Aim: Awareness among parents and students to combat challenges of pandemic. Method: The current study is based on random quantitatively study which gathered data from 300 respondents assembled from different areas of Lahore, Pakistan from June 2020 to July 2021. The responses were collected from students, teachers, and parents that how homeschooling compromises student’s physical, psychological, and emotional health. Results: About 76% of the students favoured traditional classes over online classes whereas only 20% of the students found the online session interactive. In the other section, only 15.33% of the teachers were satisfied by the online results and they complained about the poor performance and interaction with the students. Overall, 81.67% parents agreed that there is a decline in the physical activity of their children. The results of this study suggested that social distancing and the emerging challenges associated with Covid- 19 have entirely changed the education system that has caused number of problems for children, parents, and teachers in Pakistan. Practical implication: This study highlights pros and cons of online study; such studies give students and teachers a way to prepare for future challenges. Conclusion: Considering all outcomes of study, it is highlighted that policy-level interventions were needed, along with well-designed interactive courses. Hence, integrated approaches based on the mental as well as physical capabilities of the students must be executed, and e-tools must also be practiced in traditional classes to fill the gap of homeschooling. Keywords: Covid-19, Homeschooling, Friendly Tool, Psychological Pressures, Policy-level Intervention
Prophylactically Given Tamsulosin in Preventing Postop Urinary Retention in Surgery Under Spinal Anaesthesia
Authors: Gautam Nishchal , Islam Shamas Ul , Paudel Sadhana , Nasrullah Fawad
Published: March 2023

Aim: To determine effect of tamsulosin in the prevention of post operative urinary retention in patients undergoing spinal anesthesia Study design: Randomized control trial Place and duration of study: Urology Department, Mayo Hospital, KEMU, Lahore February 2020- February 2021 Methodology: Only 106 patients (53 individuals in each group) were included in the study with non probability purposive sampling. The patients undergoing surgery under spinal anaesthesia were either given tamsulosin in one group and not given tamsulosin in other group. Postoperatively patients were monitored for urinary retention. SPSS-26 was used for analyzing the data. Result: Incidence of postoperative urinary retention was significantly higher in placebo group as compared to Tamsulosin group. i.e. (overall result of 26.42 vs 3.77%, p-value=0.001 and 26% vs 2.5% in hernia group and 33.3 vs 7.7 % in hydrocele group) Conclusion: Prophylactically given tamsulosin helps in preventing postoperative urinary retention in patients undergoing surgery under spinal anaesthesia. Keywords: Postoperative urinary retention, Tamsulosin, Spinal Anaesthesia
JOHN LOCKE’TA MÜLKİYET, SİVİL YÖNETİM VE HOŞGÖRÜ
Authors: ERDOĞAN Nalan Yeşim
Published: March 2023

Siyasî iktidarın işlevini özgür ve eşit bireylerin doğal haklarının korunması ile sınırlayan ünlü siyaset filozofu Locke siyasî toplumun meşruiyetini bireylerin rızasına dayandırır. İktidarın kaynağı ne hükümdarın ilahî hakları ne de herhangi bir üstün otoritedir. Siyasî iktidar bireylerin tabiat halinde sahip oldukları haklarını koruma yetkisini devretmeleri sonucunda doğmuştur. Tabiat hali herkesin hayat, hürriyet ve mülkiyet hakkına sahip olduğu doğal yasalarla desteklenen bir durumdur. Siyasî topluma doğa durumundaki bazı anlaşmazlıkların barışçıl biçimde çözülmesini ve haksızlıkların telâfi edilmesini sağlayacak tarafsız bir hakem arayışı nedeniyle geçilmiştir. Oybirliği ile kurulan sivil toplumun siyasî yönetimi bireylerin tabiat halinde sahip oldukları haklarını gözetmekle ve doğanın yasasına tâbi olmakla yükümlüdür. Siyasî iktidar doğal hukuka uymayan yasalar çıkaramaz, uyruklarının hayatları, özgürlükleri ve mülkiyetleri üzerinde keyfî ve baskıcı bir otorite kuramaz. Aksi halde toplumun, son çare olarak, siyasî iktidara şiddet yoluyla direnme ve yönetme yetkisini ondan geri alma hakkı doğar.
GEÇİŞ EKONOMİLERİNDE GELİR EŞİTSİZLİĞİ İLE EKONOMİK KÜRESELLEŞME ARASINDAKİ İLİŞKİ
Authors: AKDAĞ Hatice , BOZDAĞLIOĞLU E.yasemin
Published: March 2023

Birçok gelişmiş ve gelişmekte olan ülkede gelir eşitsizliğinin artmasının nedeni olarak küreselleşmenin önemli bir rol oynadığı düşünülmektedir. 1980’li yıllarla birlikte, gelişmekte olan ülkelerin çoğu kısıtlayıcı ve ithal ikamesi politikalarını terk ederek, yerine ihracat ve ithalatı serbestleştirmeye dayalı politikalar uygulayarak, ticaretin serbestleştirilmesinin önünü açtılar. Bu nedenle, ekonomik küreselleşme, refah devletlerini şekillendiren mevcut ekonomik ortamı ve ülkeler arasındaki somut ekonomik değişimlerin artmasını içermektedir. Literatürdeki bazı çalışmalar hem gelişmiş hem de gelişmekte olan ülkelerde gelir eşitsizliğini azaltan iyimser bir görüşe sahip olup, bazı çalışmalar da küreselleşmenin her zaman gelir eşitsizliğini artırdığı yönünde karamsar bir bakış açısına sahiptir. Bu çalışmanın amacı da küreselleşme ve gelir eşitsizliği ilişkisinin yönünü Geçiş Ekonomileri özelinde incelemektir. Geçiş ekonomilerinin 1991-2019 dönemi için gelir eşitsizliği ve küreselleşme ilişkisi güncel panel veri modelleri kullanılarak incelenmektedir. Ekonometrik analiz sonuçlarına göre, geçiş ekonomilerinde gelir eşitsizliği ve küreselleşme, ticari açıklık ve ekonomik büyüme arasında uzun dönemli ilişkilerin varlığı kanıtlanmıştır.
Bölgesel Güven(siz)likten Küresel Güven(siz)liğe Doğu Akdeniz Sorunu
Authors: GÜVEN Mehmet Emin , TEKİN Fatih
Published: March 2023

Neo-fonksiyonalist yaklaşımdaki yayılma etkisi, bir alanda ortaya çıkan işbirliği süreçlerinin diğer alanlara sirayet etmesini ifade etmektedir. Dolayısıyla yayılma etkisi işbirliği alanlarının genişlemesiyle bir uyum ortamı yaratmaktadır. Bu durumun tersi de mümkündür. Yani kriz durumlarında da olumsuz bir yayılma etkisi ortaya çıkabilir. Ekonomik alanda başlayan bir işbirliği nasıl ki siyaset, güvenlik ve kültür alanlarında bir yayılma etkisi yaratabiliyorsa bölgesel bir krizin tırmanması, silahlanma yarışının artması, kamplaşmalar ve büyük güçlerin krizi tırmandırıcı etkileri de tersine yayılma etkisi yaratmaktadır. Bu çalışmada Doğu Akdeniz’deki krizin tersine yayılma etkisi (reverse spill-over) yarattığı ele alınmakta ve bu güvensizliğin gelecekte küresel güvenliği de tehdit edecek çıktıları olacağı tartışılmaktadır. Yakın zamanda bölgesel bir nitelik taşıyan Doğu Akdeniz’de yaşanan sorunların dinamiğini de güvenlik konusu oluşturmaktadır. Doğu Akdeniz’de kıta sahanlığı ve sınır güvenliğinden ticaret yolları ve enerji güvenliğine kadar birçok sorunun nedeni, bölgesel ve küresel aktörlerin güvenlik ihtiyaçları çerçevesinde şekillenmektedir. Bölgesel aktörlerin deniz yetki alanları ve hidrokarbon rezervleri konusundaki anlaşmazlıkları ve paylaşım sorunlarının çözümsüzlüğü, küresel aktörlerin bölgeye müdahale potansiyelini artırmaktadır. Bu durum, bölgesel güvensizliğin küresel güvensizliğe dönüşmesine yol açmaktadır. Bölgesel sorunların çözüme kavuşturulması, küresel aktörlerin müdahale potansiyelinin azalmasında etkilidir. Bölgesel güvenliğin tesis edilmesi küresel güvenliğe katkı sağlanmasında önemli bir faktördür.
NONALCOHOLIC FATTY LIVER DISEASE AND RISK OF INCIDENT HYPERTENSION: A SYSTEMATIC REVIEW
Authors: Rossiyah Nella
Published: March 2023

NAFL, or Non-Alcoholic Fatty liver, is a disorder characterized by the presence of steatosis; steatosis, an inflammation and expansion of liver cells with or without liver fibrosis (NASH, Non-Alcoholic Steatohepatosis); and cirrhosis. If more fibrosis or cirrhosis develops, the potential risk of liver cancer will grow. Current epidemiological research indicates that around 49.5% of people with hypertension also have NAFLD. In addition, the prevalence of hypertension is significantly higher in patients with NAFLD than in the general population. It has been proven that both the presence of NAFLD and the severity of the illness are significantly associated with higher risks of a broad spectrum of extrahepatic effects, including cardiovascular disease (CVD) and type 2 diabetes mellitus. Hypertension is a disorder characterized by multiple medical issues. In the majority of patients, the pathophysiological cause is unknown (essential or primary). Primary hypertension is incurable but can be managed. Another group with a low percentage has a unique cause, which is known as secondary hypertension. Endogenous and exogenous causes of secondary hypertension are numerous. If the source of secondary hypertension can be discovered, these patients' hypertension may be curable. All studies demonstrate that persons with NAFLD are more likely to have hypertension than those without NAFLD.
PENYAKIT TROFOBLAS GANAS PADA WANITA USIA 50 TAHUN : SEBUAH LAPORAN KASUS
Authors: Porman Surtana Siahaan Hatsari Marintan , Hendra  , Faisyar Ahmad
Published: March 2023

Salah satu jenis dari penyakit trofoblas ganas adalah koriokarsinoma. Penegakan diagnosis koriokarsinoma ditegakkan dengan pemeriksaan radiologi, biopsi endometrium, dan pengukuran kadar serum beta-human chorionic gonadotropin (hCG). Kami melaporkan seorang wanita usia 50 tahun P2A0 dengan keluhan muntah lebih dari 4x, dengan nyeri perut dirasakan pasien setiap muntah. Kasus ini menarik karena pasien memiliki keluhan utama dispepsia, yang bukan merupakan gejala khas koriokarsinoma. Pada pemeriksaan vagina ditemukan ostium uteri eksternum tertutup, uterus teraba membesar seukuran tinju dewasa. Pemeriksaan ultrasonografi abdomen ditemukan gambaran uterus membesar dengan cystic degeneration component myometrium, dengan kesan uterine choriocarcinoma. Pasien didiagnosis dengan koriokarsinoma, kemudian dilakukan pemeriksaan beta hCG, dan dilakukan kuretase. Jaringan yang terkumpul diambil untuk di lakukan pemeriksaan histopatologi. Pasien kemudian dianjurkan untuk dirujuk ke RSPAD Gatot subroto saat kontrol.
Cartoon Violence, Aggression And Imagination: In-Depth Interview With The Reference Of Two Girls
Authors: Pant Swati , Kumar Pal Dr. Arvind
Published: March 2023

Children’s life without cartoons are impossible. Big eyes, wired smile, unstoppable action and so on, these are enough to attract any kid. Children need someone they can relate to in today's world where everyone is busy achieving their ambitions. Cartoon viewing has an impact on a child's behavior, including their likes and dislikes, walking and talking patterns, and interactions with other children and adults. This research study is explorative. It mainly focuses on two girls who are heavy viewer of cartoon. Both respondents were interviewed and observed by their parents during covid scenario. For study purpose psychologist is also approached. “Behavior assessment scale for children with reference of aggression” (BASC aggression) test was done. The major findings shown both respondents highly impacted with cartoons. They are very reserve and scared of new people or world.
Challenges of University-Industry cooperation in Albania
Authors: Qosja Ermira , Mijo Çabiri Ketrina
Published: March 2023

Purpose: Albanian universities have a rigid experience especially when it comes to their effort to become competitive and respond to market demands. Today, it is a necessity for Albanian universities to become dynamic academic units, to go on an entrepreneurial path and to affect innovation in the region. This paper aims to measure the perception of university management staff regarding the challenges and barriers that appear in university-industry cooperation. It shed light to the identification of factors that motivate the academic staff toward such cooperation

 Study design/methodology/approach: This paper implies a qualitative based methodology and relies on the methods used by the ERASMUS + CBHE ‘KALCEA’ project. Questionnaires used on KALCEA Project collect data from universities, businesses and research centres. The questionnaires pose a set of standard questions as well as a set of tailored questions for each of the three categories. The questionnaire was completed by the high management staff of universities in the period June-July 2022. From 39 universities and higher education colleges established in Albania, the questionnaire was sent to 22 institutions and were received answers from 16. Respondents are positions of rector/vice-rector/dean.

Findings: One of the great challenges of the current high education system is to demonstrate capacity in adapting itself to the societal changes and its new emerging economic demands. Nowadays, in higher education institutions in Albania, the biggest challenges are internationalization, connection with industry, commercialization of knowledge and academic entrepreneurship.

Originality/value: Findings of the paper have interest for universities, industry, and politicians in Albania. They go in line and add value to the new Albanian law on HEIs (2015) which provides more authonomy to Departments and poses challange for them to cooperate with industry and act entreprenerially
Competence Needs of Modern Virtual Community Members
Authors: Langesee Lisa-Marie , Helleken Tom , Hobe Nils
Published: March 2023

Purpose: This paper examines necessary competencies in virtual communities in Higher Education. Therefore, we explore which competencies are needed to participate in a virtual community and how these competencies can be captured and developed.

Study design/methodology/approach: A systematic literature review (SLR) was conducted to achieve the research objectives.

Findings: As a result, five core competencies were identified: digital competencies, (inter)cultural competencies and language, social and communication competencies, self-motivation and self-management, and collaboration. Consequently, a self-assessment test for virtual community members was designed to capture existing competencies.

Originality/value: The Covid-19 pandemic as a driver of digitization has led to virtual collaboration being more prevalent than ever. This research paper contributes to the topic of virtual collaboration by informing about the necessary competencies and by developing an intuitive tool for self-assessing. Thus, preparing team members to become more successful in virtual teamwork.