bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimasi Penerapan Data Analytics Untuk Akselerasi Tranformasi Digital di Lembaga Pelatihan
Authors: Kamal Mustofa
Published: February 2023

Setiap instansi pemerintah harus bertransformasi digital. Kompetensi penggunaan data analytics menjadi keniscayaan. Riset data analytics belum mengungkap penggunaan data analytics dalam Lembaga pelatihan. Sementara, Pusdiklatwas BPKP belum optimal menggunakan data analytics, potret kesenjangan digital belum ada dan ada sinyalemen 41,22% peserta belum yakin dengan penerapan data analytics. Penelitian ini mempunyai tujuan untuk mengungkap gambaran penerapan teknik data analytics dan mengungkap kesenjangan digital yang mempengaruhi keyakinan peserta pelatihan tentang penerapan data analytics. Pendekatan penelitian kuantitatif digunakan dengan studi literatur, studi eksplorasi dan penerapan teknik data analytics, berupa; teknik statistik dan teknik visualisasi. Objek penelitian berupa 169 peserta pelatihan data analytics for audit. Hasil penelitian menunjukkan empat tipe data analytics dapat diterapkan di lembaga pelatihan. Analisa deskriptif digunakan untuk mengungkap insight ketidakselarasan profil peserta dengan keyakinan peserta pelatihan. Analisa diagnostik dapat mengungkap variabel kesenjangan digital berkorelasi kuat dan sangat kuat dengan kelas keyakinan peserta. Analisa prediksi dengan decision tree mengungkap akurasi 55,71%. Kombinasi kesenjangan digital pada kelas keyakinan peserta. Akar pohon keputusan yang utama berupa jenis kelamin, pemahaman statistik&/TIK, dukungan laptop yang dimiliki. Analisa preskriptif dengan text analytics mengungkap 10 peringkat kata perlu menjadi perhatian untuk pengembangan pelatihan berikutnya. Hasil penelitian ini berimplikasi menjadi sumbangsih akademik dan akselerasi tranformasi digital di penyelenggara pelatihan.
Implementasi Program Merdeka Belajar PNS
Authors: Ladiatno Samsara
Published: February 2023

Pendahuluan: Merdeka belajar menekankan pada kebebasan Aparatur Sipil Negara (ASN) untuk belajar dimana saja dan kapan saja. Sehingga proses pengembangan kompetensi tidak memengaruhi kinerja pegawai. Akan tetapi, dalam konteks kebebasan belajar, ada rambu-rambu khusus untuk menyejajarkan kebutuhan pengembangan kompetensi individu dengan kebutuhan pengembangan kompetensi organisasi

Tujuan: Menggambarkan keselarasan konsep merdeka belajar dengan pengembangan kompetensi individu dan pengembangan kompetensi organisasi.

Rumusan Masalah: Bagaimana menyelaraskan kebutuhan pengembangan kompetensi individu dengan kebutuhan pengembangan kompetensi organisasi dalam kerangka Merdeka Belajar

Metode: Deskriptif Kualitatif dengan desk study analisis

Kesimpulan: Merdeka belajar dalam pengembangan kompetensi memperhatikan koridor kebutuhan pengembangan kompetensi organisasi. Keselarasan kebutuhan pengembangan kompetensi individu dengan pengembangan kompetensi organisasi tedapat di analisis kebutuhan pengembangan kompetensi.  Selain itu, knowledge management menjadi bagian penting untuk mewujudkan merdeka belajar
Corporate University Sebagai Implementasi ASN Merdeka Belajar Bagi ASN Milenial
Authors: Silalahi Mustar Antonius
Published: February 2023

The need for training in Ministry of Tourism and Creative Economy is very much needed, especially for millennial ASN’s who are already fluent in the use of technology and familiar with the term of Merdeka Belajar. The purpose of this study is to determine the needs of Corporate University (CorPu) strategies for competency development. The method used is a qualitative method using questionnaires and interviews. The results of this research were that 86.7% of respondents stated that they needed Corporate University-based training and 13.3% stated that strategy of Corporate University do not need to be implemented within the Ministry of Tourism and Creative Economy.
Persepsi Pegawai Terhadap Knowledge Sharing Dalam Mendukung Corpu Badan Meteorologi Klimatologi dan Geofisika (BMKG)
Authors: Jaumil Achyar DS
Published: February 2023

Kondisi yang serba disruptif menuntut sebuah organisasi mampu beradaptasi untuk mengatasi tantangan. Ilmu pengetahuan menjadi penting untuk menyikapi secara tepat semua perubahan yang terjadi. Pengetahuan milik organisasi harus dikelola secara baik sehingga semua personel organisasi dapat memanfaatkan melalui KS. Kerangka kerja KS menjadi penting disusun agar KS dapat menjadi kebiasaan di organisasi. Persepsi pegawai terhadap KS menarik untuk diteliti sehingga pengetahuan sebagai aset organisasi dapat termanfaatkan dengan optimal.

BMKG merupakan organisasi yang sudah berkembang, tentunya memiliki aset pengetahuan tacit dan explicit. Demi peningkatan kinerja organisasi, pengetahuan tersebut dikelola dan dimanfaatkan pegawai melalui KS.  Persepsi pegawai BMKG terhadap KS dinilai berdasarkan survei terhadap responden terpilih sebanyak 51 orang.  Sebagian besar responden menyatakan bahwa KS perlu untuk dilaksanakan di BMKG demi peningkatan kapabilitas pegawai untuk kemajuan organisasi.
Hubungan Capaian Jam Pelajaran Pengembangan Kompetensi Dengan Kinerja Pegawai Aparatur Sipil Negara
Authors: Sudewo Perdhana Ari , Bintang Aruan Sulastri
Published: February 2023

Pengembangan kompetensi pegawai seharusnya memberikan dampak yang tinggi terhadap peningkatan kinerja sumber daya manusia. Pegawai Negeri Sipil yang diwajibkan minimal 20 Jam Pelajaran setiap tahun mengikuti pengembangan kompetensi pegawai perlu dilakukan evaluasi apakah kewajiban tersebut telah efektif berkontribusi terhadap pencapaian dan peningkatan kinerja pegawai. Studi ini bertujuan untuk mengetahui korelasi antara pencapaian Jam Pelajaran pengembangan kompetensi pegawai dengan penilaian kinerja pegawai, sekaligus evaluasi implementasi kebijakan pembinaan kompetensi dan manajemen kinerja pegawai. Penelitian menggunakan pendekatan metodologi kuantitatif untuk mengetahui hubungan korelasional antara kedua variable, dilakukan terhadap 104 unit kerja di salah satu Lembaga Pemerintah yang merupakan seluruh populasi penelitian. Dengan analisis korelasi Pearson Product Moment diperoleh nilai signifikansi korelasi sebesar 0.004, artinya terdapat korelasi yang signifikan antara capaian Jam Pelajaran pengembangan kompetensi pegawai dengan hasil penilaian kinerja pegawai. Meskipun demikian, nilai koefisien korelasi sebesar r = 0,278 dengan nilai negatif menunjukkan korelasi yang rendah dan saling berkebalikan. Dengan hasil penelitian tersebut, perlu dikembangkan sistem agar pegawai ngembangankan kompetensi yang tepat sesuai kebutuhan organisasi dan pegawai, dan integrasi program pengembangan kompetensi dengan manajemen kinerja pegawai.
Pengukuran Produktivitas Dengan Menggunakan Model Omax( Objective Matriks ) Sebagai Bahan Evaluasi Usaha Peningkatan Produktivitas Di “Cv. Mkb” Kabupaten Tuban
Authors: Kurnia R Ayu , Lutfiani Bella
Published: February 2023

Usaha peningkatan produktivitas perusahaan merupakan suatu kebutuhan, seiring dengan situasi perekonomian yang bersaing. Untuk dapat bertahan saat ini diperlukan suatu usaha yang sungguh-sungguh dalam meningkatkan produktivitasnya. Sebagai langkah awal usaha peningkatan produktivitas maka perlu dilakukan suatu pengukuran produktivitas. Pengukuran produktivitas sendiri merupakan suatu cara untuk meningkatkan produktivitas.CV.MKB merupakan perusahaan yang memproduksi berbagai produk dengan bahan dasar beton. Sampai saat ini perusahaan belum mengetahui produktivitas yang dicapai saat selama ini. Karena selama ini perusahaan belum mempunyai perangkat dalam mengukur produktivitas. Pengukuran produktivitas yang dilakukan diperusahaan dengan menggunakan metode objective matrik (OMAX) yaitu suatu pengukuran dalam bentuk matrik didalamnya terdapat kriteria-kriteria produktivitas yang penting bagi kemajuan perusahaan yang sesuai dengan kepentingan dan sasaran yang ingin dicapai oleh perusahaan.Berdasarkan hasil pengukuran dan evaluasi produktivitas terlihat bahwa peningkatan dan penurunan produktivitas secara total terjadi pada seluruh kriteria produktivitas. Perencanaan perbaikan dilakukan agar produktivitas agar lebih baik atau meningkat dari periode sebelumnya tanpa harus memberatkan anggaran. Faktor-faktor yang berpengaruh pada tingkat produktivitas adalah jumlah output produk, jumlah produk cacat, dan jumlah absensi karyawan.
SysCityML: Uma técnica para modelagem de aplicações no contexto de Cidades Inteligentes
Authors: Siqueira Rodrigo do Nascimento , Viana Davi
Published: February 2023

Cidades Inteligentes são cidades urbanas caracterizadas pela utilização generalizada de tecnologias para melhoramento da qualidade de vida de seus cidadãos, sua economia e o desenvolvimento humano e social. A modelagem de software é uma das atividades que levam à implementação de um bom sistema, o mesmo vale para sistemas de Cidades Inteligentes, porém, a modelagem deve considerar as características próprias destes sistemas. O objetivo desta pesquisa é desenvolver uma nova técnica para modelagem de sistemas para Cidades Inteligentes, o SySCityML, uma extensão do SysML. Decidiu-se realizar um mapeamento sistemático da literatura, para ter-se uma base para a proposta, que será avaliada. No mapeamento sistemático, identificaram-se lacunas não abordadas em outros trabalhos, auxiliando e dando base para a proposta do SySCityML.
Gustaf Gründgens
Authors: Höch Kristina
Published: February 2023

Der 1899 in Düsseldorf geborene Gustaf Gründgens ist bis heute eine der bekanntesten und kontrovers diskutierten deutschen Persönlichkeiten im Film- und Theaterbereich. Nach Kriegsende absolvierte er seine Schauspielausbildung bei Gustav Lindemann und Louise Dumont, worauf Engagements an deutschen Bühnen folgten, bis es ihn zu Max Reinhardt an das Deutsche Theater in Berlin verschlug. Schnell wurde auch der Film auf ihn aufmerksam – sein Oeuvre umfasst unter Berücksichtigung von Regie- und Schauspieltätigkeiten insgesamt 33 Filme.

Zwar setzte er sich in der NS-Zeit couragiert für gefährdete Kolleg*innen ein und war selbst durch seine homophilen Liebschaften gefährdet, profitierte aber dennoch von seinen Beziehungen und trug auf kultureller Ebene zum Erfolg eines menschenverachtenden Systems bei.

Gründgens Filme geben einen Querschnitt durch den deutschen Film, er arbeitete mit namhaften Persönlichkeiten wie Hans Steinhoff, Gustav Ucicky, Heinz Rühmann, Jenny Jugo, Willi Forst, Fritz Lang, Paula Wessely, Marianne Hoppe, Fritz Kortner, Werner Krauss oder Emil Jannings, die alle dazu beitrugen, den deutschsprachigen Film zu formen und zu prägen. So ist nicht nur seine persönliche Entwicklung und Positionierung zum Film von Interesse, sondern auch die Entwicklung des Mediums „Film“ selbst. Wie veränderten sich die Produktionsabläufe in Hinblick auf politische Gegebenheiten und wie sind Inhalte und Produktionsbedingungen historisch-gesellschaftlich einzuordnen? Wie wurde Gründgens im deutschsprachigen Raum und international rezipiert? Die Grundlage für die Betrachtung bilden Filme sowie Interviews, Aufsätze, Reden, Korrespondenzen, Filmbewertungen bzw. - beschreibungen in der Tages- und Fachpresse, Publikationen von und über Gründgens, Personalakten, Vorstandsprotokolle, Drehbücher, Pressematerialien, Filmprogramme, Zensurkarten, Werberatschläge und literarische Vorlagen.
О видској кореспонденцији неких негативно обојених глагола емоционалних односа у руском језику и њихових српских еквивалената
Authors: Balek Tijana
Published: February 2023

У раду се (без тежње за исцрпношћу) представљају видске особине глагола из емоционалне сфере, прецизније једног њеног дела — глаголи са значењем емоционалног односа, и то они код којих је дати семантички садржај негативно обојен. Из релевантне речничке (једнојезичне и двојезичне) и монографске литературе ексцерпирано је нешто више од 60 глаголских лексема у руском језику, које су потом класификоване спрам свог граматичког видског значења у неколико скупина, а две начелне обухватају недефектну (бинарну) и дефектну видску парадигму, која је, показало се, у анализираној грађи више заступљена. Паралелно су коментарисана дата својства и српских еквивалената, као и њихове уочене специфичности. Добијени резултати могу се користити у даљим истраживањима ове тематске класе како би се добио потпуни увид у њено функционисање и структуру.
Выход некоторых номинаций из произведений Дж. К. Роулинг за пределы сообщества ее поклонников
Authors: Shapirko Mariia
Published: February 2023

В данной статье рассматриваются лексические единицы, которые за счет своей выразительности вышли за пределы серии романов о Гарри Потте- ре, написанной британской писательницей Дж.К.Роулинг, и заняли свою нишу в современной картине мира русского читателя; также без внимания не останутся фразеологизмы, существующие в рамках субкультуры. Цель работы — объяснить феномен и выявить значение и потенциал выбранных номинаций сквозь призму сюжетных деталей. В исследовании особое внимание уделяется толкованию и возможностям окказиональных фразеологизмов, которые представлены на форуме поклонников, а также лексическим единицам, закрепившимся в речи не только почитателей поттерианы, но и других носителей русского языка. Ход анализа также позволяет установить, что потенциал подобных номинаций не является единичным; подобное явление сформировалось и благодаря другим небезызвестным произведениям в жанре фэнтези. На основе анализа настоящего материала делается вывод о том, что выбранные номинации из книг о Гарри Поттере, рассмотренные в статье, выступают как неотъемлемая часть русской фразеологии, которая является ценным материалом для исследования в данной области.
When problem-based learning becomes entrepreneurial - a facilitator's view on student challenges
Authors: Holgaard Jette , Du Xiangyun , Guerra Aida
Published: February 2023

Integration of entrepreneurship in current engineering education emphasises the need for engineers to initiate and drive innovation processes that transform ideas into societal value. Learnings from the history of engineering and the at times unsustainable impact of technology on society have drawn attention to user requirements and the societal context of technological innovations. In addition to this view, entrepreneurial education underlines the need to move beyond reactively addressing user requirements and societal developments to proactively creating opportunities and realising their potential to change societal patterns and trajectories. Grand challenges, such as climate change and the recent COVID-19 pandemic, have indeed confirmed the need for such abilities. This paper argues that when integrating entrepreneurship in engineering education, the pedagogical approach to how we teach entrepreneurial engineering will inevitably have to be revisited. The study aims to explore the facilitation of entrepreneurial projects in a problem-based learning (PBL) environment. Design-based research (DBR) was conducted to codevelop and test guidelines and models for entrepreneurial PBL based on existing PBL approaches. In this process, ten facilitators of entrepreneurial PBL projects were continuously challenged to change their perspective from being facilitators to students and from being practitioners to reflective practitioners. In this paper, we especially report on the part of the study investigating the following question: What challenges do students experience when PBL becomes entrepreneurial? The paper concludes with insights into the nuances of entrepreneurial PBL and closes with a short discussion on the need for more research to ensure integration and not the addition of entrepreneurship in engineering education.
Olopatadine/Mometasone (Ryaltris) for Allergic Rhinitis
Authors:   Editors from The Medical Letter
Published: February 2023

The FDA has approved Ryaltris (Hikma), a fixed-dose combination nasal spray containing the H1-antihistamine olopatadine hydrochloride (Patanase, and generics) and the corticosteroid mometasone furoate (Nasonex 24 HR Allergy, and generics), for treatment of seasonal allergic rhinitis symptoms in persons ≥12 years old.
In Brief: A New Indication for Dabrafenib (Tafinlar) and Trametinib (Mekinist) Combination Therapy
Authors:   Editors from The Medical Letter
Published: February 2023

The oral kinase inhibitors dabrafenib (Tafinlar – GSK) and trametinib (Mekinist – Novartis) have received accelerated approval by the FDA for use together for a fifth indication: treatment of unresectable or metastatic solid tumors with a BRAF V600E mutation in patients ≥6 years old who have progressed following prior treatment and have no satisfactory alternative treatment options.
Association of Serum Omentin-1 Levels with Coronary Artery Disease (CAD) in a local population of Karachi -	A Multicenter Study
Authors: Shazia Nazar  , Sheeba Farhan  , Uzma Tasneem
Published: February 2023

Objective: To  determine  the  association  between  circulating  levels  of  omentin-1,  a  novel adipocytokine and coronary artery disease in the local population of Karachi.

Methods: A total of 350 subjects were included  in  the  study  from  June  2016  to  December  2016.  About 250 patients, who had undergone coronary angiography in Karachi Institute  of  Heart  Disease (KIHD) and Civil Hospital Karachi (CHK) and 100 served as healthy controls. Serum concentrations of omentin-1 were measured by using enzyme-linked immunosorbent assay (ELISA) at Dr. A Q. Khan In- stitute of Biotechnology (KIBGE) and lipid profile, fasting  blood  sugar  were  done  at  KIHD  lab.  Coro- nary artery disease (CAD) and cardiovascular disease  risk  factors  were  evaluated  by  using  the  software SPSS 16. Independent sample t-test and chi-square tests were used to analyse the clinical and demographic characteristics  of  data.  Simple  logistic  regression  and  then  multivariate  analysis  were performed to evaluate correlations between CAD and all other parameters. P value less than

0.05 was considered statistically significant. This research is part of MPhil thesis and there  are  two research papers; (1) Serum Omentin-1 Levels with CAD (current paper) and (2) genetic polymor- phism/mutation of omentin-1 gene in  developing  CAD.  Latter  is  also  in  process  of  publication.

Results:  Serum omentin-1 levels were found to be lower in patients with CAD as compared to controls (456 ± 99 vs  739  ±  72;  p<0.01).  Serum  concentration  of  omentin-1  was  negatively  correlated with body waist circumference (39.95 ± 3.1  vs  30.95  ±  3.7;  p<  0.05),  whereas  positively  associated with serum High Density Lipoprotein (HDL) levels (25.9 ± 6.2 vs 42.3 ± 10; p< 0.05). Moreover, multiple logistic regression  analysis  demonstrated  that  serum  omentin-1  concentration  was  indepen-  dently correlated with CAD.

Conclusion: The current study has suggested that  serum  concentrations  of  omentin-1  might  be  re- lated to pathogenesis and progress of CAD.
Physiological Changes In Individual Leukocytes In Pregnancy
Authors: Hamzullah Khan  , Adnan Masood  , Anwar Khan Wazir
Published: February 2023

To determine the changes in individual types of leukocytes in third trimester of pregnancy,  a  cross  sectional study was conducted in the antenatal clinic of Gynaecology and  Obstetrics  Lady  reading  Hospital Peshawar, from 1st Aug to 10th Dec 2012. A Total of 152 pregnant ladies were included and necessary information was recorded on the questionnaire.

The age range of the patient was from 20 years to 49 years with mean age of 33 ± 3.4years. Out of total 27(18%) were prima gravida. Total leukocyte count was higher than normal in  68%  cases.  Re- garding effects of pregnancy on neutrophils, 60.7% of the pregnant women had neutrophil count > 68%. About, 46% had lymphocyte count >25%. No evident changes were seen in monocyte counts. Eosinophilia was present in 10.5% while 3.16% had basophilia.

It was evident from the data collected that  physiological  changes  were  present  in  individual  leukocytes. There was marked neutrophilia and lymphocytosis. Changes in monocytes, eosinophils and  basophils were not remarkable.
Complications of Veress Needle Insertion for Creation of Pneumoperitoneum
Authors: Omer Fateh  , Muhammad Samir Irfan Wasi
Published: February 2023

Objective: To determine the frequency of  major  and  minor  complications  associated  with  Veress  needle insertion method for creation of pneumoperitoneum  for  laparoscopic  cholecystectomy  procedure.

Methods: This is a descriptive study aimed to assess the complications caused by Veress needle in- sertion and to determine the safety profile of this procedure. In this  study  patients  undergoing  laparoscopic cholecystectomy in  Sindh  Government  Qatar  Hospital  were  selected  from  January  2014 to December 2015. Exclusion criteria were established and those patients  having  age  more  than  80 years, procedure converted to open surgery or having previous  history  of  upper  abdominal  surgeries were excluded. Complications occurring during creation of pneumoperitoneum by Veress needle were assessed. Complications were grouped as major and minor  complications.  Major  complications  in-  cluded injury to abdominal viscera and vascular  injuries,  including  injury  to  aorta,  inferior  vena  cava, iliac and mesenteric arteries. Minor injuries included injury to omentum and mesentery.

Results: Total of 377 cases of laparoscopic  surgeries  were  included  in  the  study.  In  these  laparoscopic surgeries 3 (0.79%) injuries were  recorded.  All  injuries  recorded  were  categorised  as  minor complications and included two omental injuries and one mesenteric injury.  No  major  complications were recorded including visceral or vascular injuries.

Conclusion: It was concluded in this study that Veress needle method for creation of pneumoperitoneum has  good  safety  profile,  being  less  prone  to  major  and  minor  complications,  along  with  being a time-saving procedure.
Malnutrition in Children: Analysis of Epidemiology, Risk Determinants and Advances in Management
Authors: Fehmina Arif  , Muzammil Shabana Ejaz  , Waseem Jamalvi
Published: February 2023

Malnutrition in children is one of the major health challenges faced worldwide but more frequently in South Asian countries including Pakistan. The objective of this review is to analyse the situation of malnutrition, its risk determinants, assessment and management strategies. This review is based on information collected from PubMed, Google scholar, Medline, World Bank, World Health Organization (WHO), United Nations Children's Fund (UNICEF) websites  and  books.  It  is  concluded  that  malnutri- tion status is improving but at  a  slower  pace.  Pakistan  has  a  high  prevalence  of  wasting,  stunting,  and micronutrient deficiencies.
Magnetic Resonance (MR) Abnormalities of the Lateral Pterygoid Muscle in Sideways and Rotational Disc Displacement of the Temporomandibular Joint
Authors: Umer Abdullah  , Rai Tariq Masood  , Ejaz Hussain Sahu
Published: February 2023

Objectives: The purpose of this study was to assess the magnetic  resonance  (MR)  changes  in  the lateral pterygoid muscle (LPM) in cases  of  sideways  (lateral  or  medial)  and  rotational  (antero-lateral and antero-medial) disc displacement of the Temporomandibular joint (TMJ).

Methods: A quantitative analysis of randomly selected MRI images of 61 patients over a period of six months was carried out who had either bilaterally normal TMJs or had rotational and/or sideways components of the disc displacement. Area and signal intensity of  superior  head  (SLPM)  and  inferior head (ILPM) of lateral pterygoid muscle of normal and disc  displaced  muscle  was  noted  and  com-  pared. Statistical analysis was carried out using Wilcoxon signed ranks test to determine  difference  between different muscle pairs.

Results: Area of the muscle of normal subjects was higher from all the other subjects. This was followed by the muscle area of tethered discs which was then followed by sideways, rotational and an-   teriorly displaced discs. Signal intensity of the SLPM of normal subjects was highest among the rest  followed closely by  anteromedial,  anterolateral  and  anterior  disc  displacements,  tethered  discs,  lat-  eral and medially displaced discs. Relatively same pattern was seen in the ILPM. Statistical analysis  showed that there were highly significant differences between different muscle pairs in their area and  signal intensity.

Conclusion: Abnormalities of both heads of lateral pterygoid muscle were seen in different disc place-  ment individuals. Muscles associated  with  rotational  and  anterior  disc  displacement  had  higher  sig-  nal intensity depicting any oedematous change in the muscle.
Effect of Structured Counselling on Women's Ch< oice of Anaesthesia for Elective Repeat Caesarean Section (ERCS) At Abbasi Shaheed Hospital: A Cross Sectional Comparative Survey
Authors: Rahila Imtiaz  , Samia Husain  , Rubina Izhar
Published: February 2023

Objective: To evaluate the effect of structured counselling on women's choice of obstetrical anaesthesia for elective caesarean section.

Methods: This was a cross-sectional comparative survey conducted at department of gynaecology (unit II), Abbasi Shaheed Hospital, Karachi, from 1st January, 2017 to 30th June, 2017. The study included 250 pregnant women at term ( ³37 weeks) with a prior caesarean section, planned for elective caesarean having no contraindications to spinal or general anaesthesia. Excluded from the study were women with obstetric emergencies like antepartum haemorrhage, cord prolapse, eclampsia, disseminated  intravascular  coagula-  tion, vertebral column deformities, foetal distress and obstructed labour. They were asked about the technique of anaesthesia they would prefer for their caesarean section. The women then received structured counselling  and  the  choice  was  assessed  again.  Chi-square  statistic  was  applied  to  assess  the   association between both choices taking p-value of £ 0.05 as statistically significant. Data were analysed using the SPSS software program, version 15.0 (IBM, Armonk, USA).

Results: Out of 250 women recruited, before counselling 116  (46.4%)  chose  general  anaesthesia,  94  (37.6%) women chose spinal anaesthesia whereas 40 (16%) had no particular preference. After receiving structured counselling 68 (27.2%) women chose general, 170 (68%) women opted for spinal and 12 (4.8%) women still remained undecided. The effect of structured counselling was assessed by cross-tabulating pre- counselling choice and post-counselling choice. The Chi-square test statistic was significant at p  < 0.001 showing a significant association of structured counselling on the choice of anaesthesia.

Conclusion: Women's choice is significantly altered by the counselling. Majority of  women's  beliefs  are  shaped by past experience and the information they  receive.  Significant  improvement  can  be  expected in near future if more consistent information is provided. Consistency can be ensured by use of patient informa-  tion leaflets.
Diagnostic Accuracy of Doppler Ultrasonography in the Antenatal Diagnosis of Abnormal Placental Invasion Secondary to Placenta Praevia
Authors: Huda Sajid  , Syed Mubarak Ali  , Roomi Mahmud  , Asma Javed  , Ameet Jesrani
Published: February 2023

Objective: To  determine the diagnostic accuracy of Doppler Ultrasonography in a tertiary care hospital, for the antenatal diagnosis of abnormal placental invasion secondary to placenta praevia, taking operative findings of caesarean section as gold standard.

Methods: This is a cross-sectional study carried out in the Department of Radiology, Liaquat National Hospital, Karachi, from 1st August 2013 to 31st July 2014. A total of 591  pregnant  women  (multipara) having placenta praevia were  included  in  this  study.  The  diagnosis  of  abnormal  placental  invasion  was made by Doppler USG and compared with operative findings of caesarean section as gold standard. A predesigned pro forma was used to document findings. SPSS version 17 was used for all sta-  tistical analysis.

Results: Sensitivity, specificity, positive and negative predictive value as well as accuracy of Doppler ultrasonography (USG) in the detection  of  abnormal  placental  invasion  was  found  to  be  84.8%,  93.9%, 91.8%, 88.5% and 89.95%, respectively.

Conclusion:  Any persistent placenta praevia, will benefit from antenatal Doppler USG studies to identify abnormal utero-placental vascular flow patterns and these findings clearly aid in the management of this most challenging obstetric complication.
Assessment of Pressurised Metered Dose Inhaler Technique of Nursing Staff in Different Government Hospitals of Karachi
Authors: Sundeep Sahitia  , Syed Imtiaz Ahmed Jafry  , Syed Muhammad Zulfiqar Hyder Naqvi  , Nargis Anjum  , Adnan Anwar
Published: February 2023

Objective: To assess pressurised metered dose inhaler technique of the nursing staff in different government hospitals of Karachi.

Methods: A cross-sectional study was carried out in four randomly chosen government hospitals  of Karachi. After checking for study criteria and obtaining written informed consent, a total of 120 nurses   were interviewed and then given a placebo inhaler to demonstrate their inhaler technique. The reference for assessment was the 12-step  inhalation  technique  suggested  by  the  American  College  of  Chest Physicians.

Results: The study results revealed that out of  the  12  steps  of  the  inhaler  technique,  only  3  steps were followed by a majority of the study participants i.e. taking the cap off (64.2%), putting the metered dose inhaler in mouth with lips sealed (59.2%) and breathing in slowly  by  pressing  down  the metered dose inhaler (62.5%). The mean inhaler technique score of the study participants was 3.18 ± 2.34 out of 12 and only 1 (0.8%) of them had correct inhaler technique. Furthermore, the mean inhaler technique score was significantly higher for higher education level (p=0.001) and greater experience (p<0.001).

Conclusion: The study results demonstrated the acute deficiency of knowledge  about  the  correct  in- haler technique among the study  nurses.  Appropriate  resources  should  be  directed  towards  educat-  ing nurses to make sure that their needed knowledge and skills stay updated.
Assessment of the Predictability of Pipelle Biopsy in Detecting Endometrial Pathology
Authors: Amna Begum  , Saadiya Aziz Karim  , Mehwish Wajid
Published: February 2023

Objective: To  assess the predictability of pipelle biopsy in detecting endometrial pathology in patients     with heavy menstrual bleeding and its verification by uterine histopathology at hysterectomy.

Methods: A validation study inclusive of 50 patients, aged 35-55 years, sampled through convenience sampling technique, diagnosed  with  abnormal  uterine  bleeding  and  belonging  to  the  peri-meno-  pausal age group was carried out in obstetrics  and  gynaecology  department  Karachi,  from  January  2015 to June 2015. The patients included in the research investigation, were scheduled for hysterec-     tomy, and got their endometrial  sampling  done  through  pipelle  technique.  The  data  collected  were  then sent for histopathology analysis. The final findings of histopathology were then verified by means         of histopathology report. Patients having previous experience of D&C within the last four weeks or with uterus size greater than sixteen weeks were excluded.  Inferential  analysis  was  performed  using  Wilcoxon signed sum rank test. Kappa analysis was also done to measure the degree of agreement between pipelle and histopathological outcomes.

Result:  The results of the study showed the mean age of sample as 45.94 ± 7.92 years. Medical his-      tory for the sample has been shown and revealed that 14% of the sample had menopause. KAPPA   analysis was conducted to compare the degrees of acknowledgement for histopathology and pipelle outcomes. The analysis showed that there was a 76.6% positive agreement observed in between the      two techniques, with p-value results significant (<0.01). The study reported 14% cases of proliferative endometrium, while 4% cases of endometrial hyperplasia and 4% cases of  endometritis  and  en-   dometrial polyps have been diagnosed in the given sample.

Conclusion: The results of the study has shown that pipelle biopsy is a significant methodology used         to assess the endometrial  pathology  among  the  patients  with  heavy  menstrual  bleeding,  as  verified  by histopathology reports after assessment through hysterectomy.
Prolongation of QT Interval in ECG: A Hidden Complication of Cirrhotic Liver Disease
Authors: Ajeet Kumar  , Syeda Urooj Riaz  , Rajesh  , Syed Hussain Mehdi Kazmi  , Rajesh Kumar  , Muhammad Ishaq Ghauri
Published: February 2023

Objective: To  determine frequency of QT interval prolongation in ECG of patients with decompensated  liver cirrhosis in a tertiary care hospital of Karachi, Pakistan.

Methods: A total of 60 patients with cirrhosis were included in this study. Clinical examination to see       the presence of ascites, liver span  and  encephalopathy,  and  related  investigation  such  as  liver func- tion tests, serum albumin, prothrombin time  and  ultrasound  abdomen  for  portal  vein  size  was  done  and they were labelled as suffering from cirrhotic liver disease. Two  12 lead ECG was done >5 min-        utes apart, when found same and QT interval calculated.

Results: The average age of the patients came out to be 45.37 ± 6.59 years. There were 36 (60%)        were male and 24 (40%) female. Frequency of QT prolongation in patients with decompensate  liver cirrhosis was observed in 12 (20%) cases.

Conclusion: This study demonstrates that cirrhotic cardiomyopathy is a common occurrence. The fre- quency of QT prolongation was 20% in patients with cirrhosis.This study demonstrates the direct rela- tionship of cirrhotic cardiomyopathy with the severity of liver disease. Therefore patients with cirrhosis should be investigated for prolonged QTc and the proper diagnosis and treatment.
Association of Posterior Nasal Spine (PNS) to Sella Turcica Measurement and Skeletal Malocclusions
Authors: Tahira Kulsoom  , Syed Shah Faisal  , Syed Sheeraz Hussain
Published: February 2023

Objective: To determine the association between a measurement from sella turcica to posterior nasal spine  (PNS) and skeletal malocclusion with subjects in normal vertical relationship.

Methods: It was analytical, measurement-based, observational design in  which  samples  from  122  patients were collected from department of orthodontics at the dental OPD of Karachi Medical and Dental College and Abbasi Shaheed Hospital, Karachi. Non-probability consecutive sampling technique was used. Sample selec-    tion was based on inclusion criteria that included, no previous history of orthodontic treatment, age limit start-     ing from 12 years of age till 30 years. The exclusion criteria for study included, any syndromic or cleft lip and  palate subjects, patients with history of trauma and patients with facial asymmetry. All the patients were exam- ined by the author. After thorough history and clinical examination for evaluating the inclusion and exclusion cri- teria patients were recruited for the study. Verbal informed consent was taken from the patients then the lateral cephalogram was recorded, taken in centric relation, was surveyed and classified by observation into the three categories of malocclusion on the basis of skeletal classification of malocclusion. All measurements were re- corded under ample light and comfortable position. All the findings were recorded by the primary author.

Result: One-way analysis of variance (ANOVA) was applied to see the association of PNS to sella and malocclusion. Mean value is 44.96, 45.21 and 49.00 for the class I, II and III of skeletal malocclusion patients respectively.  P-value is < 0.05 which that there is association between PNS to sella and vertical class malocclusion.

Conclusion: It has been established that there is a positive association between PNS to sellaturcica linear measurement and skeletal malocclusions. It is noted as that mean value of linear measurement from sella to posterior nasal spine (PNS) is 44.96mm, 45.21mm and 49.00mm for the class I, II and III of skeletal malocclusion cases respectively. This can help in diagnosis and treatment planning.
Dental Anxiety and its Associated Factors Among Patients Visiting Outpatient Department of Different Tertiary Care Dental Hospitals of Karachi
Authors: Syeda Zeenat Raza Rizvi  , Syed Muhammad Zulfiqar Hyder Naqvi  , Syed Imtiaz Ahmed Jafry  , Syed Mohsin Abbas Abidi
Published: February 2023

Objective: To assess dental anxiety and its  associated  factors  among  patients  visiting  OPD  of  differ- ent tertiary care dental hospitals of Karachi.

Methods: A cross-sectional study was conducted from April 2018 to November 2018 in two public and     two private dental colleges of Karachi namely Karachi Medical  and  Dental  College,  Dr.  Ishrat-ul-Ibal  Khan  Institute  of  Oral  Health  Sciences,  Hamdard  Dental  College  and  Baqai  Dental  College.  Being aged ³ 18 years of either gender were the inclusion criteria whereas refusal for a written informed consent was the exclusion criterion.After checking eligibility and taking written informed consent, a total of 247 participants were interviewed by the principal investigator using a questionnaire which  included  Corah's Dental Anxiety Scale and Dental Concerns Assessment. Data were entered and  analyzed  on SPSS version 20. Inferential analysis was performed using  chi-square  test  and  Mann-Whitney  U  test after checking normality. The significance level was kept at 0.05.

Results: The study findings revealed that 2.4%  of  the  patients  interviewed  were  severely  anxious,  8.1% were highly anxious, 37.2% were moderately anxious while 54.3% were not  at  all  anxious.  Moreover, patients with younger age and monthly household  income  between  16000  and  75000  ru- pees had significantly higher mean dental anxiety scores.

Conclusion: The study findings revealed that up to 45.7% patients were anxious up to some degree. There is a need for better understanding of factors potentially increasing anxiety in dental patients in order to avoid them as negative experiences in past are known to trigger dental anxiety in future.
Effect of Obesity and Family History of Cardiovascular Diseases and Diabetes Mellitus on Levels of C-Reactive Protein in Young Male
Authors: Farooq Syed Najamuddin , Ahmed Ammad , S Serafi Abdul Halim , H Halawani Saeed , Mustafa Muhammad Amir , Safi Rizvi Muhammad Irfan
Published: February 2023

AbstractObjective: Objective of the current study was to investigate the effect of obesity and positive family history  of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) on plasma C reactive protein (CRP) levels in apparently healthy young individuals.Methods: Young male Saudi students were interviewed for their personal medical and family history of Cardiovascular Disease (CVD) and Diabetes Mellitus (DM). Anthropometric parameters, height, weight, waist and hip circumference were measured. In-addition they answered perceived stress scale(PSS-14) questionnaire; Finally, Plasma C-reactive protein level was examined in all participants.Results: Results showed that the majority of our participants are overweight with mean BMI 27.113 ± 0.343 Kg/m2, but are non-stressed (24 ± 0.29). Around fifty-four per cent of participants have a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM). Average Plasma CRP level was (0.267 ± 0.016 mg/dl) with 26.75% of the participants in the high-risk category. Moreover, participants that are overweight/obese and with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) showed Significantly (P<0.0001) higher levels of Plasma hs-CRP, compared to the normal weight and with negative family history. A significant correlation was also observed between hs-CRP and BMI and WC. However, stress scores were not significantly different among different groups.Conclusion: Obesity, particularly in association with a positive family history of Cardiovascular Disease (CVD), Diabetes Mellitus (DM) or one of the two diseases is a strong predictor of low-grade systemic inflammation indicated by high plasma hs-CRP level.
Pictorial Quiz
Authors: Munir Saquib
Published: February 2023

A 75-year-old female came to the OPD with the complaint of swelling and discharge from the left breast for two to three years with no known comorbid. On examination, the left breast showed fungating growth of 10×15cm with ulcerating margins and blood-stained discharge. It was hard and fixed to the chest wall. No axillary and cervical lymphadenopathy was found. What is your diagnosis?
Impact of Education on Knowledge of Women Regarding Food Intake During Pregnancy: A Hospital Based Study
Authors: Akhtar Aliya Naseem , Jamil Rabia , Tariq Sanober
Published: February 2023

Objective: To assess the nutritional knowledge of pregnant women about food intake during pregnancy and to find out association between education level and nutritional knowledge.Methods: It was a cross-sectional study performed in Obstetrics and gynaecology outpatient department of private tertiary care centre Liaquat College of Medicine and Density and Darul-Sehat hospital from June 2016 to December 2016. The study was conducted among pregnant ladies who visited the antenatal clinics where they were interviewed regarding food intake and nutritional requirement in pregnancy using a pretested questionnaire. Their knowledge was then score into good, average and poor and then relation with educational level was calculated.Results: A total of 372 pregnant women with age range of 17-38 years and mean age of 27.45 ± 7.24 years were anticipated. The result showed that majority of the patients (213/372) 57% have some knowledge about increase requirement of food intake in pregnancy and (189/372) 50% had knowledge of increased iron intake. Limited knowledge of pregnant women regarding increase in water requirement is surprising. The misconceptions of hot and cold properties of food still exist in our society with a fear of abortion and contribute to avoidance of some important nutrition from diet during pregnancy.Those with education level of graduation were more knowledgeable and study also pointed towards direct association with socioeconomic status.Conclusion: The awareness regarding the increase intake of food and iron supplementation is sub optimal in our community and need better augmented campaigns and awareness programs. However there is strong co relation between educational level and information.
Pictorial Quiz
Authors: Iqbal Sana , Kashif Mehwash
Published: February 2023

A 60 year old male patient reported to the OPD with the complaint of pain in lower left first mandibular molar for 3 days. The pain was continuous, dull and radiated to the ipsilateral jaw and ear, it aggravated on chewing and was relieved by analgesics. He was a known diabetic and hypotensive and was on medication. Patient was habitual of betel quid and smoking since a long time. Past dental history showed a partial denture on lower anteriors.
Large Antecubital Vein Versus Small Vein on Dorsum of Hand for Propofol Injection Pain: A Comparative Study
Authors: Arif Muhammad , Imtiaz Aftab , Usmani Fareya , Ali Syed Hamid , Rashid Asim Masroor , Iqbal Atif
Published: February 2023

Objective: To determine the mean difference in pain scores between large antecubital vein compared to the small vein on hand dorsum for propofol injection pain in patients undergoing general anaesthesia surgery.Methods: A randomized control trial was conducted at the Department of Anaesthesiology, Abbasi Shaheed Hospital, Karachi from May 2018 to November 2018. All patients aged 18-60 years of either gender undergoing scheduled elective surgery under general anaesthesia having ASA status I or II were consecutively enrolled. Group A was offered propofol through the antecubital vein and group B was given injection propofol through a small vein on the dorsum of the hand. The 2% lidocaine 1 ml admixture in 1% propofol 19 ml was administered to patients through the large antecubital vein and small dorsalvein at hand. Anaesthesia induction was carried out as routine and as per the procedure. All patients were explained the use of VAS (Visual Analogue Scale) and were asked to report the intensity of the pain immediately after the injection propofol.Results: Of 120 patients, the overall mean age and BMI of the patients was 40.92 ± 10.03 years and 27.11 ± 5.05 kg/m2 respectively. An insignificantly higher mean difference of age (p= 0.052) and body mass index (BMI) (p= 0.901) were observed in small vein group as compared to the antecubital group. There were 64 (53.3%) males and 56 (46.7%) females. There were 43 (35.80%) smokers, 52 (43.3%) hypertension (HTN), and 29 (24.2%) diabetes mellitus patients. The mean difference of pain was significantly lower in the antecubital vein group as compared to the small vein group, i.e. 2.48 ± 0.77 vs 5.67 ± 0.75 respectively (p<0.001).Conclusion: A significant difference in mean pain scores was observed between large antecubital vein versus small vein on hand dorsum for propofol injection pain among patients undergoing surgery for general anaesthesia. We recommend using larger veins for propofol bolus while inducing general anaesthesia patients.
Antihyperlipidemic Activity of Hydroxyl Methylglutaryl Coenzyme A Reductase Inhibitor on Lipid Profile in Secondary Hyperlipidemia
Authors: Siddiqui Naveed Ali , Akhtar Naheed , Shahid Ayesha , Bint Taj Fatima , Ayaz Ayesha , Moosa Zulfiqar Ali , Azeem Farooq
Published: February 2023

Objectives: To observe the variations in lipid profile in patients with secondary hyperlipidemia using HMG-CoA reductase inhibitor.Methods: This study was done at private hospital in patients predominantly suffering from secondary hyperlipidemia. The duration of study was about 4 months. Body weight, height and blood pressure of subjects were assessed. The subjects were asked to answer the related question on cigarette smoking, health related complaints, detailed history of family, drug usage, and nutritional habits. Subjects were requested to make up a permission form before starting the research study. This case control study was performed at local private Hospital, located at Karachi from 1st April 2017 to 30th July 2017. The aim of research was to analyze the effects of HMG-CoA reductase inhibitor on lipid profile in patients of secondary hyperlipidemia. Age between 35 to 65 years and secondary hyperlipidemicpatients were included in the inclusion criteria. Lactating/pregnant women, renal, liver and established coronary artery diseases were included in exclusion criteria.

Results: Sixty patients having deteriorated lipid profile were included in this research (age 30-60 years). Subjects were prescribed simvastatin orally 20 mg/day (international product) for 04 months. The total cholesterol, triacylglycerol, LDL and HDL were analysed using simvastatin (20mg/day) of international standard in the serum of secondary hyperlipidemic patients.Conclusion: During this study it is observed that Simvastatin raises the HDL level and reduces LDL level and cholesterol level.
Transformation of PMDC to PMC
Authors: Iqbal Shazia Sarwat , Jamaluddin Muhammad , Mudassir Maria Saleem
Published: February 2023

In Pakistan, medical professions are controlled and regulated by a body for proper function. Initially, it was Pakistan Medical and Dental Council (PMDC) but now it has become Pakistan Medical Commission (PMC). The Pakistan Medical Council Ordinance 1962 established the present-day Pakistan Medical and Dental Council as a statutory body in 1962 and all provincial councils were dissolved then. Three amendments were passed after the establishment of PMDC known as (Amendment)Act in 1973, 1999, and 20121. Now the PMC was established on 24th September 2020 for the regulation and control of the medical profession to increase the basic and higher medical education and practice in both medical and dental sections2.