bluuebunny/crossref_metadata_2025 huggingface dataset:
Sopron város és környéke feltalajának vizsgálata
Authors: Horváth Adrienn , Szűcs Péter , Kámán Orsolya , Németh Eszter , Bidló András
Published: February 2023

A városok elhelyezkedését és kialakulását alapvetően befolyásolták a táji adottságok és a környezeti tényezők. Nemcsak a környezet és a táj hat a városra, hanem a város is hatással van a tájra és környezetére, közöttük folyamatos az anyag-, energia- és információáramlás. Kutatásunk keretében arra kerestük a választ, hogy az antropogén tevékenységek milyen hatást gyakorolnak a városi talajokra és ez a hatás kapcsolatban van-e a város területén jelentkező tájhasználatokkal, illetve ezek között milyen összefüggések állapíthatók meg. A vizsgálatok során értékeinket térinformatikai módszerekkel digitális térképekre illesztettük. A pH adatok felvitele alapján az alapkőzet savanyúsága jól elkülöníthető mindkét szintben a város délnyugati részén fekvő erdős területeken, és megfigyelhető az ember tájátalakító tevékenységének köszönhetően a város területének – egyelőre csak kismértékű – ellúgosodása a környező területekhez képest. A minták mintegy negyedében nem találtunk szénsavas meszet, ezek a minták javarészt a várost övező hegyvidék tájegységéből származnak. A város belterületén a minták többségében volt szénsavas mész, ez elsősorban az építési törmelékek lerakására vezethető vissza. A vizsgált talajok felső rétege humuszban gazdag a növekvő tájhasználat és peremterületi táj szerkezet átalakításának ellenére. A legmagasabb humusz és összes nitrogénértéket a TV torony melletti erdő talajában mutattuk ki, az alsóbb szintben kevesebb a szerves anyag mennyisége. Szintén a városnak ezen a területén mértük a legalacsonyabb AL-oldható káliumértékeket is. Az AL-oldható foszfor és KCl-oldható kalcium, illetve magnézium esetében kiugró értékekkel a közlekedési zónákban vagy mezőgazdasági terület közelében találkoztunk. Magasabb vasértékeket főleg savanyú kémhatású erdős területről származó mintáknál találtuk, mangánértékek általában követik a vasértékek tendenciáit. A legmagasabb cinkértékek mindkét szintben, a belvárosi forgalmat bonyolító utak, illetve a buszpályaudvar közelében mentén mutathatók ki. A rézvizsgálatok szerint egyenletesen magas értékeket mértünk a Virágvölgy kistelkes övezetében több mintavételi ponton is, illetve a város több családi házas övezetében. Vizsgálatunk során megpróbáltuk a talajok állapota és a tájhasználat közötti kapcsolatot kimutatni, amely lehetővé tenné a talajok állapotának előrebecslését, illetve a szükséges javítási módszerek kidolgozását. Tapasztalataink alapján elmondható, hogy a város egyedi karaktere eltűnőben van, mely a peremterületek átminősülésével és többek között a sűrűsödő felszínbeépítettséggel járul hozzá a városi talajok tulajdonságainak átalakulásához.
A világ természetvédelmének története 1971 és 1975 között (védett területek alapítása)
Authors: Centeri Csaba , Gyulai Ferenc
Published: February 2023

Az előző elemzett időszakot (1966–1970) követően 1971 és 1975 között 3908 védett terület alapítása történt a világon. Ennek a területnek egyik harmada a III-as, másik harmada pedig a IV-es IUCN kategóriát gazdagítja. A cikkben közölt adatok az IUCN kategóriarendszerébe sorolt védett területekre vonatkoznak. Az IUCN adatbázisa szerint a legtöbb területet 1971 és 1975 között Ukrajna alapította (779 terület). Jelen esetben az előző öt évhez képest csökkenést tapasztalhatunk az 1971 és 1975 között létrehozott védett természeti területek számát tekintve, ami megtöri az eddigi növekvő trendet a területalapítások számának vonatkozásában. A vizsgált időszakban (1971 és 1975 között) 220 nemzeti kategória létezett. A területnagyságok közül a 0 és 99 ha közötti méretű volt a leggyakoribb (közel a létrehozott területek számának a fele), bár az összes védett terület kiterjedésének ez mindössze 0,015%-át adta. Magyarországról 14 védett természeti terület került fel az IUCN listájára. Az időszak fontos fejleménye, hogy ebben az időszakban, 1973-ban alakult meg hazánk első nemzeti parkja, a Hortobágy területén belül. Ebben az időszakban a természetvédelem történelmi eseményei közül kiemelkedik két védett terület alapítása, méreteik miatt. Az egyik ezek közül a North East Greenland Nemzeti Park, amelynek területe 97,2 millió hektár, de Ausztrália is ekkor hozza létre a Great Barrier Reef Tengeri Parkot 34,4 millió hektár területen. Megállapíthatjuk, hogy ez az időszak kiemelkedő volt a védett természeti területek területi növekedése szempontjából.
A csepeli Tamariska-domb országos jelentőségű védett természeti terület élőhely-rekonstrukciós eredményei
Authors: Gergely Attila , Tenk András
Published: February 2023

Tanulmányukban egy urbanizált környezetben lévő, nagy terhelésnek kitett védett természeti területet mutatunk be. Ez a Budapesten lévő Tamariska-domb Természetvédelmi Terület, amely 2012-ben kapott a helyi jelentőségű védettség után országos védelmet. A védettségi státusz megváltozása többek között annak köszönhető, hogy a területen több éve zajlik a helyi civilek által megkezdett természetvédelmi rekonstrukciós tevékenység. Ennek a munkának az eredményeként a terület fő botanikai értékét jelentő nyílt, évelő, mészkedvelő homokpusztagyep-állományok fokozatosan megerősödtek, az itt lévő lágy szárú inváziós fajok pedig lassan visszaszorultak.
A lébényi tölgy-erdő tájtörténeti kutatása
Authors: Selmeci Marianna , Höhn Mária , Saláta Dénes
Published: February 2023

A Hanság keleti peremén fekvő, természetvédelmi oltalom alatt álló lébényi Tölgy-erdő mind természeti, mind kultúrtörténeti értékekben gazdag terület. Két veszélyeztetett élőhely található területén: az alföldi gyertyános-tölgyes (Circaeo-Carpinetum) és a szigetközi tölgy-kőris-szil ligeterdő (Pimpinello majoris-Ulmetum). Tanulmányunk célja a Tölgy-erdő tájtörténetének feltárása és erdőhasználatának rekonstruálása. Irodalmi forrásokat, levéltári dokumentumokat és a helybéli lakosok adatközléseit feldolgozva kronologikusan rendszereztük az erdő használatának történetét és a terület időbeli változásait. A kapott eredményeket történeti térképek és légifotók segítségével támasztottuk alá, amely munkából kiemelendő az erdészeti üzemtervek összevetése az archív légifotó anyaggal. Az erdő állapotának jelentős változása 1952 után indult meg, majd az 1970-es években ez a folyamat felgyorsult. Irodalmi és saját adatok alapján elkészítésre került a terület fajlistája, amely 108 tételt tartalmaz. A területen azonosított 6 élőhelytípust, a növényzet mai állapotát élőhelytérképen ábrázoltuk. Megállapítottuk, hogy a leginkább természetközeli, bolygatatlan élőhelyek az erdő nyugati, északnyugati részén találhatóak.
Az ökológiai és konvencionális művelés alá eső nyírségi talajok mikrobiológiai és talajkémiai vizsgálatai
Authors: Demeter Ibolya , Makádi Marianna , Aranyos Tibor , Ferenczy Antal , Posta Katalin
Published: February 2023

A talajok termékenységének fenntartása az élelmiszertermelés alapja. A termékenység nem csak a felvehető tápanyagok mennyiségét jelenti, hanem szoros kapcsolatban van a talajok mikrobiális aktivitásával, kémiai és fizikai tulajdonságaival is. A talaj mikroorganizmus közösségét -mennyiségét és diverzitását- azonban jelentősen befolyásolja az alkalmazott gazdálkodási rendszer, és változása a talaj termékenységére is hatást gyakorol. Munkánk célja a nyírségre jellemző homok és emellett kisebb területi kiterjedésben található réti talajok mikrobiológiai sajátosságainak és szervesanyag dinamikájának, illetve az ezek közötti összefüggéseknek a vizsgálata volt ökológia és konvencionális gazdálkodási rendszerekben. Különböző mélységből származó talajminták invertáz, kataláz enzim aktivitását és talajkémiai tulajdonságait (pHKCl, szén- és nitrogéntartalom, humusztartalom, nitrit-nitrát-N tartalom), valamint a közöttük fennálló összefüggést vizsgáltuk. A 2012-es év mérési eredményei alapján megállapítható, hogy az invertáz és kataláz enzimek aktivitása, valamint a szén- és nitrogéntartalom a talajban csökkent a mélységgel. Az eltérő talajtípusok és művelési módok jelentős hatással voltak mindkét enzim aktivitására. Homoktalajoknál az ökológiai gazdálkodású, míg a réti típusú talajoknál a konvencionális gazdálkodás alá eső területeken jelentkezett magasabb enzimaktivitás és C, N tartalom.
Tájváltozás vizsgálat múltbéli és jelenkori fényképfelvételek alapján a Fertő tájon
Authors: Tirászi Ágnes , Terpó Veronika , Konkoly-Gyuró Éva
Published: February 2023

A Fertő-táj egyes jellemző részletéről 1860-tól készült fényképfelvételek 2012-ben történt újrafotózása és ezek összevetése segítségével mutatunk be néhány az utóbbi évszázadban végbement tipikus tájváltozási folyamat. A 18 kiválasztott fényképpár segítségével a térség jellemző tájalakulási tendenciáit követhetjük nyomon és mutathatjuk be a nagyközönség számára is. E módszer a térképeken azonosítható tájalakulás mellett számos, csak a vizuális érzékelés révén felismerhető változás feltárására ad módot.
Penerapan Standar Pelatihan Basic Trauma Cardiac Life Support di Bawah Pengampuan Balai Pelatihan Kesehatan Semarang
Authors: Agustina Catur Setyaningrum
Published: February 2023

Penelitian ini bertujuan mendapatkan gambaran tentang penerapan standar pelatihan Basic Trauma Cardiac Life Support (BTCLS) di bawah pengampuan Balai Pelatihan Kesehatan Semarang tahun 2021. Penelitian ini mengkaji hasil temuan pelaksanaan Quality Control(QC) Eksternal. Hasil penelitian menunjukkan masih adanya temuan baik pada komponen penyelenggaraan, peserta, tempat penyelenggaraan, penyampaian materi, pelatih, pengendali pelatihan, evaluasi peserta, evaluasi penyelenggaraan, pelaksanaan QC internal dan pelaksanaan protokol Kesehatan. Temuan terbesar adalah pada komponen penyelenggaraan pelatihan. Rekomendasi untuk pelatihan BTCLS selanjutnya adalah memperhatikan proses perencanaan pelatihan sehingga pelaksanaan dapat sesuai dengan standar yang ditetapkan
Bildgebung in den Neurowissenschaften
Authors: Heinrichs Jan-Hendrik , Caspers Svenja , Schnitzler Alfons , Seitz Frederike
Published: February 2023

Mithilfe der Neurobildgebung können vielfältige Informationen über Vorgänge im menschlichen Gehirn gesammelt werden. Dieser Sachstandsbericht informiert über die Grundlagen und Einsatzmöglichkeiten von bildgebenden Verfahren in den Neurowissenschaften, beleuchtet einschlägige rechtliche Normen und Regelungen und erörtert die ethischen Herausforderungen, die sich in Bezug auf den Einsatz von bildgebenden Verfahren im Rahmen der medizinischen Heilbehandlung und klinischen Forschung sowie im Kontext des Strafrechts stellen.

Dabei werden insbesondere die Risiko-Nutzen-Bilanz, die Autonomie von Patient:innen, der Schutz ihrer Privatsphäre sowie allgemeinere Überlegungen zur Gerechtigkeit in der klinischen Forschung in den Blick genommen.
Course clustering based on the phylogenic tree of students’ grades in architectural degree
Authors: García-Escudero Daniel , Bardí Milà Berta , Fayos Vallés Francisco , Valls Dalmau Francesc
Published: February 2023

A large-scale correlational analysis was conducted on the grades of the students who completed their studies in the 1994 curriculum in the Barcelona School of Architecture. The study included the passing grades of a total of 3910 students corresponding to all 47 compulsory subjects, as elective courses were excluded. The objective of the research was to explore whether courses with related content were associated with the corresponding grades at an aggregate level, and identify similarities and dissimilarities in their clustering. The correlation between the grades in all courses was computed pairwise, and used as a distance measure to quantify the grade of affinity between them. Using this distance metric, the results were processed using hierarchical cluster analysis producing a tree structure according to this similarity/dissimilarity measure. The clustering results were visualized in a phylogenic tree, identifying the optimal number of clusters and coloring the results accordingly. The visualization of this tree matched very closely the grouping of courses according to departmental divisions, indicating a strong association between the grades obtained and specific areas of knowledge. The lowest marks were also found to be concentrated in the first years and among the graphic and design subjects. These results reinforce previous studies that have investigated the relationship between academic performance during the degree course and the entry grade. The great discontinuity between them and the fact that PBL is characteristic of the degree course and less common in secondary school could be the reasons for these results.
Analyzing student-teacher interactions in challenge-based learning
Authors: Doulougeri Karolina , Vermunt Jan D. , Bombaerts Gunter , Bots Michael
Published: February 2023

Challenge-based learning (CBL) exposes students to the complexities of openended and real-life challenges and encourages them to be in the lead of their learning. The role of teachers remains important but shifts from being the expert to the role of a coach who gradually scaffolds students into becoming independent learners. Accordingly, the interplay between teachers' and students' regulation of teaching and learning can result in friction and influence students' learning experience. This study explores incidents of constructive or destructive friction between student and teacher regulation during a 9-week CBL course for first-year engineering students. Thematic analysis is employed to identify critical incidents of friction during students' learning via analyzing students' weekly learning portfolios. Results suggest that students' experience in CBL is not linear, and there is a constant interplay between students' ability to regulate their learning and teachers' scaffolding. Initial exposure to CBL was characterized by friction in student and teacher interactions. Several students increased their self-regulated learning skills by resolving the initial friction by adopting a more proactive approach to their learning by actively asking questions and feedback from their teachers. The findings of this study are particularly relevant for CBL, where much attention is paid to students' autonomy, self-directedness, and collaboration. Building on the insights of this research, we make recommendations for further research and educational practice.
Digital technology in freight
Authors:   Parliamentary Office of Science and Technology, Johnson Liam , Christie Lorna , Walker Alan
Published: February 2023

Technology and data enabled opportunities are key priorities in the Department for Transport’s Future of Freight Plan. This POSTnote reviews digital technologies that support freight, including their impact on the labour force, potential environmental benefits and technical barriers.
Dupilumab (Dupixent) for Eosinophilic Esophagitis and Prurigo Nodularis
Authors:   Editors from The Medical Letter
Published: February 2023

The FDA has approved the subcutaneously injected interleukin (IL)-4 receptor alpha antagonist dupilumab (Dupixent – Sanofi/Regeneron) for treatment of eosinophilic esophagitis (EoE) in patients ≥12 years old who weigh ≥40 kg and treatment of prurigo nodularis in adults.
Table: Inhibitors and Inducers of CYP Enzymes, P-Glycoprotein, and Other Transporters
Authors:   Editors from The Medical Letter
Published: February 2023

Inhibitors and Inducers of CYP Enzymes, P-Glycoprotein, and Other Transporters
Awareness and Practices Regarding Crimean-Congo Haemorrhagic Fever among Animal Handlers in Peri-urban Karachi and Rural Areas of Sindh
Authors: Murad Qadir  , Tanzil Jamali  , Khurshid Nadir
Published: February 2023

Objective: To assess  the  awareness  and  practices  among  animal  handlers  regarding  Crimean-  Congo haemorrhagic fever and compare the awareness and practices among different groups of animal handlers in Sindh, Pakistan.

Methods: Cross-sectional study conducted among  150  animal  handlers  with  the  response  rate  of  93%, including sellers, butchers, transporters, caretakers and  veterinary  doctors  in  peri-urban  Karachi and rural areas of Sindh. Quota sampling technique was adopted to select the study population. The duration of the study was three months from August 2016 to October 2016; this period includes selling of animals of sacrifice for Eid-ul-Azha in temporary established markets. Data  was  entered  into  Epidata 3.1 and analysed using SPSS version 23.

Results: A total of 150 participants enrolled in the study. The mean age of the study participants was

35 ± 7.5 years. Among the subjects, 48% were  uneducated.  Overall,  52%  of  the  participants  were  aware about the Crimean-Congo fever. The hygiene practice among animal handlers was found to be washing; 40.7%, bathing; 27.3% and tick removal; 11.3%. The  awareness  of  Crimean-Congo  fever  among animal caretakers was 50%, animal sellers; 43.3%, transporters; 36.7% and butchers; 30% (p<0.001).

Conclusion: The awareness among animal handlers was on the lower side among animal sellers, transporters, butchers and animal care taker and there is  a  need  to  improve  the  awareness  level  among these groups regarding practices, hygiene of the animal as well as handling procedures.
Post-Electric Burn Blisters in a Child: A Case Report
Authors: Mawra Shahid  , Ayesha Khan  , Hira Khalid Zuberi  , Aisha Ikram
Published: February 2023

Electrical burn injuries are few of the most devastating injuries seen in the emergency room. We report the case of a 4-year-old child, weighing 15 kg who presented in the Paediatric Emergency Room  of Abbasi Shaheed Hospital with loss of consciousness. He had a history of touching a broken electric wire of unknown voltage and fell to the ground few hours before being taken to the hospital. Central nervous system examination showed a  Glasgow  Coma  Scale  score  of  10/15,  bilateral  mute  planters and decreased tone in all four limbs. Upon local  examination,  4  small  black-yellow  lesions  almost 2 cm in size and in the form of blisters were seen on his left palm. The child was successfully managed in the Paediatric Intensive Care Unit of Abbasi Shaheed Hospital. This case is noticeable as its complications are disastrous. Our case study highlights the importance of early diagnosis and proper management which is vital to prevent long term damage in electrical burn victims.
Froin's Syndrome due to Spinal Paraganglioma - A Case Report
Authors: Nazish Iqbal  , Muhammad Waqaruddin Sheroze  , Abdul Ali Khan
Published: February 2023

Yellow coloured, i.e. xanthochromic cerebrospinal fluid,  with  hypercoagulability  and  high  protein  con- tent is pathognomic of Froin's syndrome. We present a  case  of  Froin's  syndrome  in  a  patient  with  spinal paraganglioma.

A 55-year-old male patient presented with urinary hesitancy, numbness in lower limbs and difficulty in walking. During spinal anaesthesia, the anaesthetist  noticed  xanthochromic  spinal  fluid.  Upon  mag-  netic resonance imaging lumbosacral,  an  intradural  focal  lesion  of  abnormal  signal  intensity  extend-  ing from T12-L1 vertebral  level  was  seen.  Laminectomy  with  excision  of  the  mass  was  performed  and a fleshy encapsulated mass was excised. Histopathology report showed the specimen to be a neoplastic lesion, and immuno-histochemical studies confirmed the mass to be a paraganglioma.

This case emphasizes that in  case  of  Froin's  syndrome,  one  should  think  of  spinal  cord  tumours  while evaluating the patient. A magnetic resonance imaging of the spine should also be done to look for spinal pathology along with other investigations.
Frequency of Degree of Depression in Relation to the Duration of Diabetes Mellitus in a Tertiary Care Hospital in Patients Aged 20-55 Years
Authors: Hira Muzaffar  , Jamal Ara  , Syeda Wajiha Anwar  , Quratulain Saleem
Published: February 2023

Objective: To  determine the frequency of depression and the relation of duration of diabetes with degree of depression.

Methods: A cross-sectional study was carried out at Abbasi Shaheed Hospital,  North  Nazimabad,  Karachi, Pakistan. The duration of the study was six months from December 2017 to May 2018. It  comprised of male and female patients between the  age  brackets  of  20-55  years  of  age  who  had  been pre-diagnosed with diabetes for at least 5 years and were currently not on any anti-depressants and did not have history of any other psychiatric illness. Demographic data including the age, sex,  education level, marital status, occupation and religious belief of the participants along with the duration of diabetes for each individual was recorded. The ICD-10 major depression inventory was translated into Urdu and validated in the same institution before this study was conducted  and  was  administered during face-to-face interviews. ICD here refers to the International  Classification  of  Dis- eases (ICD) which is the international  standard  diagnostic  tool  for  epidemiology,  health  management and clinical purposes. A minimum score of 4 or  5  in  two  of  the  first  three  items  plus  a  score  of  at least 3 on two or three of the last seven items means that the person is mildly depressed and as the score increases so does the severity of depression .

Results: Of the 378 people who were assessed 216 (57.1%) were depressed. Data analysis showed that out of the 216 depressed patients, 25.7% had mild, 26.2% had moderate, 4.2% had severe and 1.3% had major depression. On performing chi-square  test  there  was  a  relation  between  the  increase in duration of diabetes and the degree of depression.

Conclusion: Results of our sample show that a higher degree of depression is  related  to  a  longer duration of diabetes.
Outcomes of Laparoscopic Appendectomy; A Prospective Study Focusing On Gender Wise Comparison of Complications of the Surgery
Authors: Paras Mahesh  , Raheel Ahmed  , Nargis Anjum  , Adnan Anwar
Published: February 2023

Objective: To assess the postoperative outcomes of laparoscopic appendectomy in terms of  compli- cations and to compare them on gender basis.

Methods: This was the prospective observational study conducted at department of General Surgery Chandka Medical College Hospital Larkana with non-probability convenient sampling technique. The duration of study was one year  from  January  2013  till  December  2013.  150  patients  were  selected  that were diagnosed with acute appendicitis. Patients were followed up for 2 weeks and their compli-  cations were observed. All data was entered  and  analysed  on  SPSS  version  20.  Inferential  analysis was performed using chi-square test whereas the significance level was set at 0.05.

Results: The study results showed that 14 male (18.7%) and 16 female (21.4%) patients developed complications (p=0.094). 5 male (6.6%) and 8 female (10.6%) patients  developed  paralytic  ileus  (p=0.384). 5 male  (6.6%)  and  3  female  (4%)  patients  developed  urinary  retention  (p=0.471)  whereas 2 male (2.6%) and 6 female (8%) patients complained to have wound infection (p=0.146). The overall frequency of patients that did not develop any  complications  among  150  patients  was  121  (80.6%)  while 13 (8.6%), 8 (5.3%) and 8 (5.3%) were reported to develop paralytic ileus, urinary retention and wound infection respectively.

Conclusion: Laproscopic appendectomy is safer and  clinically  advantageous  technique.  The  differ-  ence in the complications of the laproscopic appendectomy with  respect  to  the  gender  was  insignifi- cant. However, significant difference existed on visual analogue pain scale.
Cadaver Prosection Significance in Medical Field: Analytical Survey of Anatomy Pedagogy
Authors: Nadeem Baig  , Syed Meesam Iftikhar
Published: February 2023

Objective: To determine the effectiveness of dissection as a useful pedagogy in the field of anatomy  through assessment of views of respondents.

Methods: A cross-sectional study was carried out in the anatomy department of a private and a public sector college for a period of twelve weeks during the year 2018.A total of 135 participants were re-    cruited in this survey. The nature of participation (regular or irregular) in comparison was used as the predictor variable. The average scores for each item were calculated and compared between the par- ticipants at dissections using Mann-Whitney's U test.  Likert-style  survey  was  designed  for  evaluation. The IBM SPSS statistics version 21 was used for the analysis of data.

Results: A large number of participants overall strongly supported  the  version  that  a  dissection  pro- gram should be essentially inducted into the  curriculum;  viewed  non-participation  at  dissection  ses-  sions as to be disadvantageous in terms of their learning repertoire. Seventy eight percent  stated  it deepens understanding of anatomy as a subject. Around 80%  of  the  participants  preferred  dissection over other tools of learning, whereas 67% agreed that it develops 3-dimensional structural approach;       also agreed with the time allocated for dissection is sufficient for learning (57%). Besides this, a mi-      nority of respondents put up  a  negative  perception  in  terms  of  dissection  being  time  consuming  (36%), stress inducing (18%), boring (20%), and difficulty in finding out structures was also reported (43.3%).

Conclusion: The use of dissection in undergraduate medical education as part of anatomy pedagogy     may develop a useful  golden  opportunity  for  students  to  work  on  additional  learning  objectives  such as professionalism, manual dexterity, ethics, teamwork, self- and peer evaluation.
Intra-Abdominal Gossypiboma found during Cholecystectomy, 12 years after Lower Segment Caesarean Section
Authors: Omama Sumbul Islam  , Hajra Hilal Ahmed  , Muhammad Jamaluddin
Published: February 2023

Retained Surgical Foreign Bodies (RSFBs) is an uncommon  event  in  the  surgical  practice.  Most  of  them occur after intra-abdominal and pelvic surgeries. They usually present within days after surgery        but their incidental discovery after decades has also been reported.We present a case of a 44-year-          old obese and diabetic female patient who presented with clinical and radiological findings of chronic calculus cholecystitis. She had past surgical history of Lower Segment Caesarean Section (LSCS) 12   years back, followed by a negative laparotomy. During her  open  cholecystectomy  procedure,  a  hard mass was found between the small bowel loops. When removed and examined, it was found to be a retained surgical sponge which was most likely left in her body during prior LSCS procedure. Asymp- tomatic, uncomplicated  and  (ultrasonographically)  undetected  nature  of  RSFB  in  our  case  suggests  its consideration and careful search if there is past history of intra-abdominal or pelvic surgery.
Serum Sodium and Potassium Concentration Imbalance in Patients with Benign Prostatic Hyperplasia following Transurethral Resection of the Prostate (TURP)
Authors: Syed Farhan Ahmed  , Imran Idrees Memon  , Muhammad Rashid  , Muhammad Asim  , Waqas Ahmed  , Aziz Abdullah
Published: February 2023

Objective: The aim of the present study was to calculate the mean differences in serum sodium and potassium concentration levels in  patients  with  Benign  Prostatic  Hyperplasia  undergoing  TURP  pre  and post-operation.

Methods: A cross-sectional and observational study was conducted at the  Department  of  Urology,  Liaquat National Medical College and Hospital, Karachi, Pakistan. Purposive, convenience sampling technique was used. A total of 75  male  patients  undergoing  transurethral  resection  of  the  prostate  were included in the study. Data was analysed using SPSS version 20.0. A p-value of less than 0.05 was considered to be significant.

Results: Out of a total of seventy-five patients, the mean age was 59.59 ± 7.02 years. After surgery,      1.3% (1) patient had hyponatremia (<135 mmol/L), 97.3% (73) patients had normal sodium level (135-145 mmol/L) and 1.3% (1) patient had hypernatremia (>145 mmol/L). In contrast, only 1 (1.3%)  patient had hypokalaemia, 66.7% (50) patients  had  normal  potassium  levels  and  32%  (24)  patients  had hyperkalaemia (p-value 0.001).

Conclusion: We reported a significant increase in serum levels  of  potassium  in  post-surgery  evaluation. Therefore, the monitoring of  serum  electrolyte  concentration  following  transurethral  resection  of  the prostate (TURP) is highly recommended.
Recurrent Angiosarcoma on the Back in a Young Male: A Case Report
Authors: Aqeel Areeba , Jamaluddin Muhammad , Aqeel Shahmeen
Published: February 2023

AbstractAngiosarcoma is a malignant disease of the inner lining of the blood vessel which can occur at any age and anywhere in the body like skin, liver, breast, bone, soft tissues cardiac tissues and after radiotherapy or from chronic lymphatic obstruction.It usually occurs between 60-70 years of age1. In this case, it occurred in a young male, which was previously excised but recurrence occurred and presented as a lump of 20×15 cm, which was non-tender, gradually increasing in size, firm in consistency however other systemic findings were unremarkable. Haematological workup was done which was within normal limits. Ultrasound Doppler of swelling showed multiple vascular channels with fat and soft tissue suggestive of a haemangioma. Excision and biopsy were done under general anaesthesiaand histopathology report showed fibro-fatty tissue with vascular malformation. In view of recurrence, it suggested angiosarcoma, which is treated by surgery followed by chemotherapy and its definitive diagnosis can only be made by biopsy.
Evaluation of Serum Uric Acid as a Marker of Non-Alcoholic Fatty Liver Disease
Authors: Rehman Sadia , Mehboob Fatima , Anjum Nargis , Salahuddin Huma , Kumar Winay , Wasee Nosheen
Published: February 2023

Objective: The objective of this study is to evaluate the correlation of radiologically diagnosed non-alcoholic fatty liver disease (NAFLD) with serum uric acid (SUA) levels.Methods: It is a case control study conducted in private sector tertiary care hospital. A total of 200 subjects were involved in this study after calculation of sample size. The study participants were recruited from the medicine ward while the healthy controls were taken from the general population. Non probability consecutive sampling technique was employed. Inclusion criteria was patients who were diagnosed with fatty liver through abdominal ultrasonography. Exclusion criteria was patients suffering from any other chronic illness that can lead to an echogenic liver on ultrasound (viral hepatitisand diabetes) and history of alcohol consumption. Ethical approval for the study was taken from IRB. Data were entered and analysed using IBM SPSS version 23.0. Mean with standard deviation for age, BMI, SBP, DBP and SUA were reported between two study groups.Results: Highly significant results were observed between two groups; diseased and controls. Mean uric acid levels were found to be significantly higher in NAFLD (non-alcoholic fatty liver disease)cases as compared to controls, with serum uric acid showing an affirmative and positive linear relationship with fatty liver. An increase in BMI and systolic and diastolic blood pressures was also seen in NAFLD group as compared to controls which indicates that BMI is a comorbid for cardiac complications among the NAFLD patients.Conclusions: The study determined that uric acid levels elevate with progression of non-alcoholic fatty liver disease. This finding brings a new insight of uric acid in clinical practice. Increase in serum uric acid levels might serve as a trigger for physician to screen for NAFLD. An increase in BMI and systolic and diastolic blood pressure in NAFLD patients indicates underlying causes leading to cardiovascular complications in these patients.
Correction of Nasal Deformities with Open Approach Rhinoplasty, Our Experience.
Authors: Usmani Fareya , Ibrahim Mukhtar , Iqbal Syed Mosaddaque , Hussain Syed Iqbal , Tirmizi Sohail , Munir Imran , Munir Imran , Imtiaz Aftab
Published: February 2023

For the correction of functional and asthetic nasal problems open rhinoplasty has gained enourmous popularity since last ten years. In our setup we chose open approach rhinoplasty in all cases and wanted to share its merits.
Psychological Impact of COVID - 19 Pandemic
Authors: Kashif Mehwish , Naqvi Saqib
Published: February 2023

The planet has been facing an unprecedented condition visible under the name of COVID-19 since December 2019. This viral infection was first documented in the domestically and globally spreading city of Wuhan1. Pakistan has had a series of survivors and this lethal virus has infected many patients. Since then the pandemic has spread all over the country. Sadly, the number of infected people and deaths caused by the disease is increasing constantly.
The investigative methodology to confirm Alcohol consumption in all suspects at a tertiary care Hospital at Karachi
Authors: Ahmed Khan Dr. Iqbal , Talpur Dr. Mir Ghulam Ali , Qadri Dr. Naved Ali , Alam Dr. Syed Perwez , Ram Dr. Hari , Ahmed Hajrah Hilal , Jamaluddin M.
Published: February 2023

Background: Various health problems occur due to alcohol consumption and particularly heavy drinking which contributes to a major burden of diseases globally.

 

Objective: To identify the investigative methodology carried out by medicolegal officer for the subjects’ evaluation who are brought by the Police in order to confirm the suspected consumption of alcohol.

Methods: In this observational cross sectional study, data related to the subjects who were evaluated for suspected intake of alcohol was analyzed. Statement of Police related to the reason for suspecting the alcohol consumption, subject’s statement who were accused, findings from the examination conducted by the medicolegal officer (MLO), particulars regarding the body fluids chemical evaluation, and conclusive final report of MLO was retrieved.

Study design: Observational Cross sectional study

Results: - In our study total 53 patients were included. All were male, with the mean age of 33.94+10.018 years. The most common age group involved was of 22 to 40 years. Most of the patients belonged to Karachi and Hyderabad and were 54.7% and 22.6% respectively. On chemical analysis, all of the patients were found to have alcohol in blood, while 10 (19%) were found to have alcohol in urine.

Conclusion: Significant correlation was found between the doubt of police regarding alcohol consumption of subjects and opinion of MLO which was based on clinical and laboratory findings. In usual cases, medicolegal officers do not operate under the standard operating procedures.
Management of Placenta Previa with Accreta: A Case Series in Public Tertiary Care Hospital
Authors: Rashid Shaista , Munim Tazeen Fatima
Published: February 2023

Placenta previa with accreta is a rare cause of major obstetric hemorrhage resulting in maternal morbidity and mortality. A case series of 08 patients of placenta previa with accreta presented at Abbasi Shaheed hospital Gynecology unit 1 from January 2018 to December 2018. Seven (07) patients were delivered by Caesarean Section and one vaginally. In 05 patients placenta was left in situ and injection methotrexate was given. Removal of placenta during Lower Segment Caesarean Section (LSCS) and bilateral internal iliac artery ligation was done in 02 cases. Febrile illness occurred in 02 patients. One patient required laparotomy on fifteenth postoperative day due to uterine scar dehiscence. Two cases required obstetrical hysterectomy due to torrential hemorrhage. Conservative management in women with placenta previa with accreta has proven to be successful in carefully selected cases at tertiary care hospital with multi-disciplinary team.
Visual Outcome of Ocular Trauma and its Medicolegal Interpretation in a Tertiary Care Hospital, Karachi
Authors: Rasool Raffat , Shahid Erum , Ehsan Roohi , Ahmed Hira , Fehmi Shazia , Sheikh Arshad
Published: February 2023

Objective: To evaluate the visual outcome of ocular trauma and its medicolegal interpretation in a tertiary care hospital, Karachi.Methods: This was a prospective, cross-sectional observational study conducted at Abbasi Shaheed Hospital, Karachi. Data was collected through nonprobability consecutive sampling technique. The study duration was 12 months, from 14 September 2014 to 15 September 2015. Inclusion criteria were patients of both genders aged between 18 - 60 years, presenting with ocular trauma in the outpatient department or admitted through an emergency in the department of Ophthalmology. The exclusion criterion was patients suffering from all extraocular injuries. Patients were followed up for a period of 6 months. Statistical analysis was done through SPSS version 20.0Results: There were 99 patients, with a mean age of 31.6 ± 18.5 SD years. Males were 74.7% and 82 (82.2 %) were unskilled. Closed globe injury was seen in 54 (54.5%) and the open globe in 45 (45.5%). Nine percent of the patients were assault cases and 90.9% cases were accidental. The corneal injury was seen in 43 (71.6%) and scleral injury in 5 (8.3%) of the patients. At the time of trauma 39.4% of patients presented with 6/60 visual acuity, in the early post-op period 50.5% were 6/6, whereas at six-month follow-up 90.9% patients were with 6/6 visual acuity. Wilcoxon Signed Ranks Test showed P-value less than 0.01.Conclusion: It was concluded that the major outcome of ocular trauma was impaired visual acuity, which improved significantly on regular follow-ups. Medicolegal interpretation of ocular trauma is imperative and should be accounted for properly. It should be exercised by the medicolegal officer, to not give the final report before at least 6 months of follow-up in case of poor visual outcome. Moreover, educate the person to demand compensation during this period.
Study of Serum FSH, LH and Prolactin in Female Albino Rats by Experimentally Creating Hypothyroidism
Authors: ILyas Amber , Fatima Urooj , Hyder Zaidi Syed Taffazul , Abid Fatima , Shabbir Asma , Qureshi Ghulam Sarwar
Published: February 2023

Objective: The current research was draft to contrast the variation in levels of Prolactin (PRL), Luteinizing Hormone (LH) and Follicle stimulating hormone (FSH) in female rodents by experimentally producing hypothyroidism.Methods: The Animal House of Dow University of Health science was used for the purpose of doing this research which was almost completed in a period of 10 months. The total number of 30 rodents of Wistar Albino species were taken to use in this research. Only adult healthy female rodents weighing between 180-200 gm were included in the study and animals which were found to be slow and lethargic were excluded from the study. These rats were separated into two parts by dividing them into two groups of fifteen animals each. The primary group received the regular normal diet and routine tap water for six weeks and was labeled as the control group whereas the other group was forced to accept Carbimazole (Antithyroid drug) through feeding tube by mixing 0.02% / ml of regular drinking water for a period of six weeks. After six weeks all the rats were slaughtered. The cardiac puncture of animal was done in order to collect blood. Analysis of Follicle Stimulating Hormone, Luteinizing Hormone and Prolactin was carried out by using the ELISA kits on serum of animal which was centrifuged and separated.Results: The result observed for control group showed a mean value ± standard deviation(SD) of 5.13 ± 1.39 mIU/ml for Follicle Stimulating Hormone. In the same group the mean value ± SD observed for Luteinizing Hormone was 8.38 ± 16.02 mIU/ml and for PRL was 0.40 ± 0.05 ng/ml respectively. The second group that is the hypothyroid group revealed a mean value ± (SD) of 5.89 ± 1.63 mIU/ml for Follicle Stimulating Hormone. For Luteinizing Hormones in hypothyroid group, the mean value ± SD turned out to be 9.30 ± 13.34 mIU/ml whereas the mean value ± SD observed for Prolactin in hypothyroid group was 0.62 ± 0.12 ng/ml. The information was entered on SPSS version 16. This information was analysed by applying an independent sample t-test in between the two groups to compare the levels of Follicle Stimulating Hormone, Luteinizing Hormone and PRL. The p-value was observed which turned out to be insignificant for Follicle Stimulating Hormone and Luteinizing Hormone but quite remarkable for Prolactin.Conclusion: Hypothyroidism created by an antithyroid drug (Carbimazole) leads to a remarkable rise in the levels of PRL regardless of the changes in levels of gonadotropins which may lead to the sterility in females.
Pattern and Burden of Road Traffic Accidents in Tertiary Care Public Hospital, District Central, Karachi from 2016 to 2018
Authors: Mughal Rehan Ahmed , Iqbal Hydrie Muhammad Zafar , Islam Sana Adeeba , Ali Jafry Syed Imtiaz , Shaikh Munir Ahmed , Hyder Naqvi Syed Muhammad Zulfiqar
Published: February 2023

Objective: To assess the burden of trauma during the last three years (2016-18) caused by road traffic accidents presenting to the trauma centre of tertiary care public hospital in district central, Karachi.Methods: All the accident cases presenting in the trauma center of the hospital in last three years who were defined as accidents occurring on a public road and involving at least one moving vehicle were included in the study. Those with incomplete medical records were excluded. This was a crosssectional study where records of a total of 2857 individuals were retrospectively collected and their socio-demographic information, history of road traffic crashes, clinical history and examination was noted. Data was analyzed through SPSS while descriptive statistical analysis of continuous and categorical variables was performed.Results: The mean age of patients admitted to the trauma centre was 29.3 ± 16.7 years with no significant difference between both gender. Out of 2857 patients with road traffic accident injuries, around 80.9% were males. The most prevalent age group was 16-30 years of age, which was over 40.2%, followedby subjects of 31 - 45 years age group which was 21%. The study results further showed that over 51.3% of the road traffic accident patients were discharged normally, followed by 46.7% subjects who left against medical advice. Overall death rate was 2% (n=57).Conclusion: This study helps to identify the latest accident burden and pattern of injuries to develop plans aimed at prevention of road traffic accidents. Looking at the burden, the most affected was the younger subjects (16-30 years) highlighting the need for targeting this population for educational programsand policies about safe driving. Among the road traffic accidents cases the subjects who left against medical advice cases was gradually decreasing from 2016 to 2018 suggesting better healthcare facilities at the tertiary care hospital and corresponding increasing patient's confidence in them.
Emergence of COVID-19 Infection and Healthcare Workers in Karachi, Pakistan
Authors: Naveed Shabnam , Shobha Luxmi  , Syed Masroor Ahmed  , Zeeshan Ali  , Syed Adnan Ali
Published: February 2023

Background: The Healthcare workers (HCWs) are at the forefront of care-giving and hence understanding of the knowledge, attitudes and practices among HCWs is necessary to identify potential risk factors of COVID-19 dissemination. Objective: The objective of the study was to investigate the knowledge, attitude and practice (KAP) regarding novel coronavirus disease 2019 (COVID-19) among healthcare workers in Karachi Pakistan. Material and Methods: This was a cross-sectional study using a self-reported questionnaire which enrolled all the HCWs (doctors, nurses, pharmacists and technicians) in hospitals of Karachi from March to May 2020.Binary logistic regression analysis was performed to estimate the odds ratio with 95% confidence interval for KAP of HCWs regarding COVID-19. P-values less than 0.05 were considered statistically significant. Results: The total of 547 participants included in study. HCWs gross category and clinical setting were found to be statistically associated with overall KAP (P<0.001 and P=0.048, respectively). Upon logistic regression analysis, KAP scores statistically differed across genders (? coefficient=2.115, SE =0.179 and P<0.001), age groups (? coefficient=2.098, SE =0.138 and P<0.001) and HCWs gross category (? coefficient=2.053, SE =0.135 and P<0.001). The nurses and technicians were found less likely for good KAP with reference to COVID-19 as compared to doctors and pharmacists. These results were found to be statistically significant with P-value less than 0.05; the odds for nurses and technicians were 0.35 and 0.10, respectively. Conclusion: The study demonstrated that HCWs had good knowledge, optimistic attitude and decent practice towards recent COVID-19 pandemic. However, their source of information regarding COVID-19 is not reliable and can adversely influence the KAP.

Keywords: KAP; COVID-19; Outbreak; Pandemic; Healthcare Workers
Evaluation Of Heat Shock Protein-27 Levels as A Predictor of Diabetic Nephropathy in Early Diabetics
Authors: Muhammad Irfan  , Shabir Ahmed  , Adil Ramzan  , Nosheen Wasee  , Nuvair Zia  , Nargis Anjum
Published: February 2023

Objective: The current study objective is to find out the levels of heat shock protein-27 in diabetes patients with and without diabetic nephropathy, and to appraise the functional role of HSP-27 as an early diagnostic biomarker in progressive diabetic nephropathy.

Study Design: Case control study.

Place and Duration of Study:  The current study was conducted in physiology department, Basic Medical Science Institute (BMSI), Jinnah Post-Graduate Medical Center (JPMC), Karachi from March 2019 to September 2020.

Methodology: A total 105 participants between 30-50 years of age were separated into three groups: Group A (n=35) diabetic-patients with history of diabetes < 5 years without any sign of DN; Group B (n=35) diabetic patients with history of diabetes >5 years duration of diabetes and microalbumin levels < 30 mg/dl in urine and Group C (n=35) healthy individuals. All this study participants were gone through detailed history, anthropometric measurement, BMI, serum blood sugar, serum urea, serum creatinine, BUN, urinary albumin, and serum HSP-27 were estimated.

Results: Elevated levels of HSP-27 were seen in group-A patients as compared to group-C (p<0.001). Elevated levels of HSP-27 were presented in group-B as compared with group-C (p<0.001) which signify early renal parenchyma injury. Strong association had been seen for HSP-27 with creatinine (r=0.69; p < 0.001), and HbA1c (r =0.72; p <0.001) and urea (r = 0.72; p <0.001) in all these participants. While statistical highly significant and strong positive association were reported for HSP-27 with microalbumin (r = 0.86; p< 0.001) in all participants.

Conclusion: Elevated levels of HSP-27 with progression of renal injury with or without declining of renal function is seen in current study. These findings perhaps suggest and recognizing HSP-27 as key diagnostic marker for diabetic nephropathy in early diabetics.

KEYWORDS: Diabetes Mellitus, Diabetic Nephropathy, HSP-27.