bluuebunny/crossref_metadata_2025 huggingface dataset:
Increase in Intra-Ocular Pressure after Intravitreal Triamcinolone Acetonide in Non-Diabetics and Diabetic Patients
Authors: Iqbal Zafar , Ullah Khan Zubair , Iqbal Sidra Zafar
Published: March 2022

Objective: The objective of this research study was to find out the occurrence of raised IOP (Intra-ocular Pressure) following IVTA (Intra-vitreal Triamcinolone Acetonide) in the patients of diabetes and non-diabetics subjects suffering from different chorio-retinal complications. Methodology: This study was conducted in Benazir Bhutto Shaheed Teaching Hospital Abbottabad and the duration of this study was from May 2019 to April 2021. Total 237 eyes of one hundred and eighty patients were recruited with ninety patients in groups: diabetics & non-diabetics patient groups, in need of IVTA. We injected the IVTA 4.0mg/0.10 milliliter and measured the IOP at 7 days, one month, 3 months and 6 months in the patients of both groups. Results: In the group of diabetics, there were 47.80% (n: 43) males and 52.20% (n: 47) female patients, whereas in the group of non-diabetics, there were 62.20% (n: 56) male and 37.80% (n: 34) female patients. The average age of the patients in the 1st group was 52.21±9.60 years and in the patients of 2nd group was 51.13±10.75 years. Average pre-operative IOP was approximately 3.60±2.80mmHg and 14.10±2.40mmHg in first and second group correspondingly. In the patients of first group, average IOP with standard deviation was 16.40±4.90mmHg, 14.60±3.60mmHg, 17.60±9.70mmHg and 15.50±7.09mmHg at 7 days, one month, 3 months and 6 months after the injection. Whereas in the patients of second group, average IOP with standard deviation was 14.80±3.33mmHg, 15.90±4.2mmHg, 15.50±4.20 mmHg and 14.10±3.20mmHg at 7 days, one month, 3 months and 6 months during the follow up period. We observed an increase in one hundred and seventeen eyes (49.0%) in the patients of both groups, with 65.0% (n: 78) eyes in first group and 33.0% (n: 39) eyes in the patients of second group. Conclusions: After injecting the IVTA, there was a clear high rise in the level of IOP in the patients of diabetes as compared to the patients who were non-diabetics. Keywords: IVTA, IOP, complications, injection, standard deviation, average, mmHg, treatment.
Evaluation of the Clinical Application of Multi-Color Optical Coherence Tomography as a Diagnostic Tool for Different Retinal Pathologies
Authors: Khan Zubair Ullah , Iqbal Zafar , Iqbal Sidra Zafar
Published: March 2022

Objective: To assess clinical application of multi-color OCT (Optical Coherence Tomography) with the utilization of the CSLO (Confocal Scanning Laser-Ophthalmoscopy) in various pathologies of retina. Methodology: This study was conducted at in Benazir Bhutto Shaheed Teaching Hospital Abbottabad and the duration of this study was from April 2021 to June 2021. There were thirty-six patients in this research study who were suffering from various retinal pathologies as disorders of vitreomacular interface, diabetic retinopathy and macular degeneration related with age with the utilization of multi-color OCT as a tool of screening. Results: This study discovered that ophthalmologist were able to get high resolution images of CSLO reflectance because of the automatic tracking system of this particular tool (new version). Confocal optics may be used to avoid the scattering of light. Some of the differences were presence of hemorrhages and presences of pigment changes when comparison with the conventional CFP was performed. Approximately 20.0% patients with AMD, 37.50% patients with diabetes and 100% patients suffering from disorders of vitreomacular interface could have been missed easily with the utilization of CFP. Conclusions: The findings conclude that multi-color OCT is able to deliver information & figures far more confident was compared to conventional method of CFP, because it is much influenced by the media opacities. For the best interpretation of the Multi-color OCT, more watchfulness of the ophthalmologists is necessary with high level of comprehensiveness. Keywords: Retinal Pathologies, Multi-Color, Diabetic Retinopathy, Optical Coherence Tomography.
Effectiveness of Structured Rehabilitation Program on Pain and Function in Patients with Total Knee Replacement: A Randomized Controlled Trial
Authors: Arslan Hafiz Muhammad , Riaz Saima , Ashraf Abeel , Hashmi Zeest , Khan Rehan Ramzan , Rashid Sajid
Published: March 2022

Objective: To determine the effectiveness of the structured rehabilitation program on knee pain and function in patients with a total knee replacement. Methodology: A randomized controlled trial conducted at Horizon Hospital Lahore. Twenty six patients were randomly allocated to experimental and control group. Experimental group was treated with structured rehabilitation program and conventional exercises while control group was treated with conventional exercises alone. Outcome measuring tools were numeric pain rating scale, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and goniometer. All the patients received 16 sessions of treatment. Data was collected at baseline and at the end of 4th week. Results: Outcome measures numeric pain rating scale, Western Ontario McMaster Universities Osteoarthritis Index (WOMAC) and goniometer showed significant results (p<0.05) after treatment in both groups but mean values showed more improvement in experimental group treated with structured rehabilitation program. Conclusion: This study concluded that structured rehabilitation program had better effects on pain, function and range of motion in patients with knee arthroplasty. Keywords: Arthroplasty, Replacement, Knee, Knee osteoarthritis, Range of motion, exercise therapy
Antibiotic Sensitivity Pattern and Prevalence of Methicillin Resistant Staphylococcus Aureus in a Tertiary Care Hospital
Authors: Ayub Ahsan , Azam Muhammad , Adeel Bushra , Yasir M Alard , Rabbani Aftab
Published: March 2022

Introduction: Staphylococcus aureus is a chief source of both community and nosocomial infections. Isolates of Staphylococcal aureus from tertiary hospitals are resistant to frequently used antimicrobials. The intrinsically established methicillin-resistant S. aureus (MRSA) has been related with increased mortality and morbidity in hospital patients. Aim: This analysis was performed to determine the susceptibility of antibiotic pattern of staphylococcal aureus isolates with particular emphasis on methicillin-resistant S. aureus. Place and Duration: In the Department of Medicine and Pathology, Islam Medical and Dental College Sialkot for six-months duration from April 2021 to October 2021. Methods: Clinical samples from the Medicine ward were analysed and all isolates of S. aureus were involved in the study. Identification of isolates was done using a typical laboratory technique. The susceptibility antibiotic pattern of all strains of staphylococcal aureus was assessed using the improved Kirby Bauer method of antibiotic susceptibility. Results: Out of 120 isolates of S. aureus, MRSA were found to be in 29 (26.12%). The multidrug resistance percentage was 6.09% for MSSA and 75.86% for MRSA. All isolates of staphylococcal aureus were penicillin resistant. Though, sensitivity of all strains to vancomycin was noticed. Conclusions: This analysis exhibited an augmented incidence of MRSA in a Tertiary Care Hospital. Consistent investigation of nosocomial infections and susceptibility of antibiotics are essential to reduce the incidence of MRSA in hospitals and its spread in society. This study clearly demonstrates that the 1st line treatment for infection with MRSA is vancomycin. To maintain its worth, the usage of vancomycin must be restricted and only directed when clearly necessary. Keywords: MSSA, MRSA, Vancomycin, Antibiotic susceptibility and Staphylococcus aureus
The Link Between Skull Fracture and Extradural Hematoma in Head Injury Patients who came to a Tertiary Care Hospital in Pakistan
Authors: Narejo Mumtaz Ali , Akbar Ali , Aslam Shaikh Muhammad , Munawar Ali Muhammad , Arain Safdar Hussain , Shaikh Khairunisa
Published: March 2022

Aim: The purpose of our current study is to see if there is any connection between skull fracture and extradural hematoma in head injury patients who came to the tertiary care hospital in Pakistan. Methods: From January 2020 to December 2021, this descriptive research was conducted at Chandka Medical College, Shaheed Mohtrama Benazir Bhutto Medical University Larkana. The research comprised those patients who have undergone extradural hematoma surgery during study period. Normal skull X-rays being taken, and the type and position of fractures were documented on the X-rays, CT scan, and during surgery. The frequency of skull fracture linked through extradural hematoma was studied in different ages. SPSS version 24.0 was utilized to investigate our current findings. Results: A sum of 130 individuals were operated on for extradural hematoma. In 70 cases, a linear fracture was seen, and in 18 individuals, a depressed skull fracture was seen. Another ten individuals with no radiologically evident fracture reported discovered to also have a fracture line intra-operatively. As a result, 87 (78 percent) of the participants suffered a skull fracture. Here remained no statistically important variation in occurrence of skull fracture among age ranges. Conclusion: Although there is a significant link between skull fracture and extradural hematoma, a normal X-ray does not rule out extradural hematoma. Keywords: Skull fracture, extradural hematoma, head injury, Tertiary Care Hospital, Larkana, Pakistan.
Effect of Iron Chelator on Renal Function in Thalassemia Patients who Undergo Regular Transfusion
Authors: Sadia Halima , Shah Furqan Ali , Rasool Rehana , Hafeez Amtul , Iftikhar Ayesha , Akbar Hafiz Sajid , Naseer Alia , Bangash Sudhair Abbas
Published: March 2022

Background: The thalassemia family of genetic disorders is characterized by an abnormal synthesis of the hemoglobin chain, resulting in chronic anemia in some people and clinically asymptomatic in others. There have been very few studies conducted on the effects of thalassemia on the kidneys, which typically included patients treated with deferoxamine having both glomerular and tubular dysfunction. Objective: This research aimed to determine whether kidney dysfunction is observed in young thalassemic individuals manipulating both conventional and primitive markers of kidney dysfunction, and to associate the results to the use of iron chelation therapy. Methods: We measured serum cystatin C (Cys C), tubular phosphorus reabsorption (TPRA), fractional sodium excretion (FNE), and 2-microglobulin, urine calcium, protein, and glucose levels in addition to the usual renal biochemistry. Results: A whole of 42 individuals, ranging in age from 4 to 23, were included in this study and were split into two groups for study (group A taking deferoxamine alone, and group B taking deferiprone coupled with deferoxamine). An increased Cys C level (36%) and proteinuria (24%) were seen in a large percentage of patients, as were tubulopathy with hypercalciuria (35.5 %) and point out 2-MG excretion (33.5 %). Conclusion: Patients with -thalassemia seem to suffer from renal dysfunction even when they are young, so it is important to monitor early signs of renal dysfunction. There is a need for further research into the effect of novel chelators on parameters tubular function. Keywords: Deferiporin, iron chelator, thalassemia, Peshawar, dfo
Frequency of Clinical Symptoms in Post Cholecystectomy Syndrome Patients our Hospital Experience: A Cross-Sectional Study
Authors: Yousfani Zubair Ahmed , Das Khenpal , Atta Jabeen , Rind Gulhamullah , Khatti Shah Nawaz , Zoya Moomal
Published: March 2022

Aim: To determine the frequency of different clinical symptoms in (PCS) Post Cholecystectomy Syndrome patients, at a secondary care facility Study Design: A cross-sectional study Place and Duration: This study was conducted at Liaquat University of Medical Health Sciences Jamshoro, Pakistan from May 2020 May 2021. Methodology: For the purpose of this study, 100 patients were selected. Only those individuals were selected who qualified against an inclusion criterion which was set based on the patients’ history of cholecystectomy. For this purpose, a questionnaire was made. The patients that were selected had to go through CT (computed tomography) scans and sonographic tests. Blood testing was also done and sera were prepared for in-depth laboratory tests. Data from the research were analyzed by using SPSS version 19. Results: Most common clinical symptom after post-surgery was right upper quadrant pain (114 patients). Epigastric discomfort was present in 97 patients. Fever was third in line (73 patients) with jaundice being fourth (23 patients). Abdominal tenderness (19 patients) was followed by bile leakage (7 patients), fluid in the peritoneal region (19 patients), CBD dilation (39 patients), recurrent stone in CBD (12 patients), retained stone in CBD (19 patients), dysfunctioning of Oddi sphincter (37 patients) and remnants of the cystic duct stump was present in 41 patients. Conclusion: The results of this study show that post cholecystectomy symptoms and conditions vary among patients and all of them need to be kept in while proposing proper follow-up treatment Keywords: post cholecystectomy syndrome, bile leak, sonography, CT scan
Comparison of Severity of Disease and ICU Stay among Vaccinated and Non-Vaccinated Covid 19 Patients
Authors: Babur Waseem , Khan Naveed Noor , Abdullah Muhammad Bilal
Published: March 2022

Objective: The purpose of this study is to examine the severity of illness and length of ICU stay in covid-19 patients who have received vaccination vs those who have not received vaccination. Study Design: A Retrospective/ Comparative study Place and Duration: King Salman Armed Forces Hospital Tabuk KSA. Nov 2021-July 2021 Methods: This research included 160 individuals of both sexes who had coronavirus illness. Patients were between the ages of 18 and 75. After obtaining informed written permission, demographic data on patients, such as age, gender, BMI, place of residence were gathered. It was determined that the coronavirus was present in all instances by RT-PCR. Two sets of patients were admitted to COVID 19 ward, and they were subsequently separated. Both groups were underwent for X-ray of chest. Two groups were formed: one with 80 vaccinated patients and the other with 80 unvaccinated individuals. In both groups, the prevalence of co-morbidities was evaluated. Both groups' recovery and results were assessed by looking at things like mortality and the severity of the condition. Complete data was analzsed using SPSS 22.0. Results: Among 160 cases, 100 (62.5%) were males and 60 (37.5%) females in this study. There was no any significantly difference between both groups related to age and body mass index. We found severity of disease among non-vaccinated patients was significantly high with p value <0.05.Diabetes mellitus and hypertension were the most common comorbidities among all cases. Frequency of interstitial infiltrates was found in 55 (68.8%) in group I and 60 (75%) in group II. In both groups, fever, cough, and dyspnea were the most prevalent symptoms. Frequency of discharged patients in group I was greater 66 (82.5%) as compared to non-vaccinated 29 (36.3%). ICU stay and mortality was significantly higher in group II 16 (20%),24 (30%) as compared to group I with p value <0.05. Conclusion: This research found that immunization against coronavirus illness is both effective and useful in lowering the severity of the condition. However, vaccination may lower the incidence of bad outcomes (ICU stay) and people should be made aware of the necessity of being vaccinated immediately. Keywords: Mortality, COVID 19, Vaccination, ICU stay
Frequency of Urological Carcinomas in Patients with Gross Haematuria
Authors: Rashidullah Mohammad , Rahman Sami Ur , Khan Noor Shad , Khan Asif , Elahi Fazal , Ali Shah Syed Mumtaz
Published: March 2022

Objective: The aim of this study is to determine the frequency of urological carcinomas in patients with gross haematuria. Study Design: Prospective study Place and Duration: Swat Urology Ward Saidu Group of Teaching Hospital, Swat for the duration of six months from 1st April 2021 to 31st September 2021. Material and Methods: There were one hundred and forty five patients with ages 20-55 years were presented in this study. All the included patients had blood in urine.After receiving informed written permission, detailed demographic information about the recruited patients, including age, gender, body mass index, and causes of haematuria, was compiled.Urine cytology and microscopy were used to rule out the presence of malignant cells in haematuria. Every time a cystoscopy or computed tomography (CT) scan was needed to monitor the health of our patients, we sent them for an ultrasound.Frequency of urological carcinomas was calculated. SPSS 22.0 was used to analyze all of the data in the study. Results:There were 90 (62.1%) males and 55 (37.9%) females in our study. Mean age of the patients was 41.8±5.54 years with mean BMI 24.5±4.76 kg/m2. 80 (55.2%) patients were literate. Most common cause was urinary tract infection found in 50 (34.5%) cases, trauma in 45 (31.03%), urolithiasis in 30 (20.7%) cases and smoking in 20 (13.8%) patients. Prevalence of urological carcinoma was found in 27 (18.6%) cases. Conclusion:We found a significant incidence of urological carcinomas in our research. Gross haematuria was most often caused by urinary tract infection or trauma. Keywords: Urological carcinomas, Gross haematuria, Urinary tract infection
Outcomes and Complications of Buccal Mucosa Graft for Hypospaedia Repair
Authors: Khan Asif , din Nizamu , Rahman Sami Ur , Khan Noor Shad , Zia Qamar , Ullah Mohib
Published: March 2022

Objectives: Aim of current study is to determine the outcomes of buccal mucosa graft in Hypospaedia repair. Study Design: Retrospective Study. Place and Duration: The study is conducted at Urology ward Saidu Group of Teaching Hospitals, Swat for duration of six months form 1st July 2020 to 31st December 2020. Methods: This research includes 60 hypospaedia reconstruction patients in total. After obtaining written agreement from the patient's attendants/parents, demographic information such as age, sex, and domicile was collected. A surgeon on site performed physical exams on each participant. All patients had buccal mucosa grafts performed in two stages. There were reported complications on follow-up visits one week, three week and six weeks later. We used SPSS 22.0 version to analyze complete data. Results: In our study mean age of the patients was 6.56±7.51 years in which most of the patients 38 (63.3%) had age >5years. After the first stage surgery, there were no complications. At postoperative follow-up after two stage procedure complications were found in 10 (16.7%) cases in which wound infection and urethrocutaneous fistula were mostly. Post-operative success rate was found in 53 (88.3%) cases. Conclusion: After careful consideration, it should be concluded that buccal mucosa transplant in Hypospaedia correction provides superior functional and aesthetic benefits with a lower incidence of problems. Keywords: Fistula formation. Buccal Mucosa Graft, Hypospaedia Repair,
Assessment of Biochemical Variables of Medical Importance in Patients of Oral Sq. Cell Carcinoma (OSCC) Using Betel Nuts
Authors: Ali Hania , Tahir Farah Naz , Tariq Iqra , Ahmed Atiq , Iqbal Waseem , Iqbal Javeid , Rana Muhammad Asim , Hafeez Mansoor
Published: March 2022

Background: Betel nut is considered one of the leading causes of oral cell carcinoma. After caffeine, alcohol and tobacco, the betel nut mastication is the fourth most used drug in the world. Aim: To evaluate the fluctuating levels of oxidative stress markers in patients of oral squamous cell carcinoma (SCC) using betel nuts. Study design: Case control study Place and duration of study: University of Lahore Teaching Hospital, Lahore from 21st January 2021 to 10th July 2021. Methodology: One hundred participants recruited and divide into two groups. First group consisted of confirmed cases of oral SCC on histopathological evidence and fifty age and sex matched normal healthy subjects were taken as a control in group B. Oxidative stress markers malondialdehyde (MDA), Isoprostanes, 8- hydroxy deoxyguanosine (8-OHdG), and 4-hydroxynonenal (4-HNE) were measured in both groups by using ELISA and TBRAS methods. Results: Significant difference in oxidative stress markers in oral cell carcinoma patients and control group. The p value differed significantly for MDA, Isoprostanes, 8-OHdG and 4-HNE in serum (p= 0.021, 0.033, 0.001, and 0.000 respectively) as well as in saliva samples (p= 0.011, 0.021, 0.011 and 0.001 respectively). Conclusion: The oxidative stress markers like MDA, Isoprostanes, 8-OHdG and 4- HNE are significantly elevated in patients of oral squamous cell carcinoma as compared to the normal healthy individuals. Key words: Betel nuts, Oxidative stress marker, Oral cells carcinoma, MDA, 8-OHdG, Isoprostanes, 4-HNE
Determine the Frequency of Hepatitis B and C in Patients Undergoing Hemodialysis
Authors: Atif Baig Muhammad , Ahmed Ansari Tanveer , Mugheri Ali Hyder , Jamali Abdul Hameed , Mushtaq Fahad , Ali Shoukat
Published: March 2022

Aim: To determine the frequency of hepatitis b and c in patients undergoing hemodialysis. Study Design: Descriptive study. Place and duration of study: Department of Gastroenterology, Chandka Medical College Hospital/Shaheed Mohtarma Benazir Bhutto Medical University Larkana & Dialysis Unit, Chandka Medical College Hospital, Larkana from 1st October 2020 to 30th September 2021. Methodology: One hundred patients undergoing hemodialysis were tested for hepatitis B and C after their informed written approval gain. The age, gender and clinical history were recorded. Each patient 5cc blood was withdrawn and EDTA was added for creating whole blood which was then stored at 4ºC for a day and tested. The blood was first tested before hemodialysis start and then after every month until 6 months of hemodialysis was tested for presence of hepatitis B and C through polymerase chain reaction (PCR). Results: The mean age was 51.27±12.0 years with 14-77 years of patients enrolled for hemodialysis. Majority of the patients were men with a percentage of 52% while women as 48% in the total cases. The serological results showed that hepatitis B positive was presented as 8% and hepatitis C positive as 4% in total hemodialysis cases. Hepatitis B was more common in those cases where blood transfusion was performed more than 5-10 times or more. Conclusion: Prevalence of HBV was higher in hemodialysis patients who had more blood transfusions. Keywords: Frequency, Hepatitis B, Hepatitis C, Pakistani population
Evaluation of Common Pediatric Infections: An Annual Survey
Authors: Ahmed Imran , Haroon Kazi Naheed , Bhand Sikandar Ali , Memon Yasirarfat , Khan Momna , Hussain Khadim
Published: March 2022

Background: Pediatric patients are the most frequent population visiting the out patent department with various illnesses round the year. Infections are among the most common reason for illness in this population. Aim: To evaluate the different paediatric infections Study design: Cross-sectional study Place and duration of study: Department of Pediatric, Muhammad Medical College, Mirpur Khas Sindh from 1st January 2018 to 31st December 2018. Methodology: Five hundred and ninety five pediatric patients were enrolled. Results: The male proportion of patients dominated over female proportion with 370(62.18%) and 225(37.82%) respectively. Most cases were of age under 1 year 335(56.30%) followed by age between 1-5 years 134(22.52%) and age group above 5 years was the least affected group 125(21%). Gastroenteritis cases were most common followed by respiratory tract infections and non-infectious diseases. Conclusion: Gastrointestinal infections (gastroenteritis, dysentery and typhoid) were found to be more common in pediatric patients followed by respiratory infections Keywords: Respiratory tract infections (RTIs), Urinary tract infections (UTIs), Meningitis
Presentation, Diagnosis and Treatment of Mixed Vaginitis
Authors: Perveen Safia , Shah Fatima , Zaman Salma , Mahmood Fizza , Suleman Azhar Muhammad , Mahmood Usama
Published: March 2022

Background: Mixed vaginitis is commonly observed in many women at their fertility age which brings negative impact on women well-being. Aim: To analyze the presentation, diagnosis and treatment scheme of mixed vaginitis. Study Design: Cross sectional analytical Place and duration of study: Department of Obstetrics & Gynaecology, DHQ/Teaching Hospital Sahiwal from 1st January 2021 to 30th June 2021. Methodology: Eighty females suffering from more than one type of vaginitis were enrolled as study participant after their complete diagnosis. High vaginal swabs, culturing requiring gram staining and lab testing through PCR was performed. Results: The mean age of 26.3±3.5 years. There were 11.25% cases with aerobic vaginitis, 43.75 % of bacterial vaginitis, 25% of vulvovaginal candidiasis, 11.25% allergic vaginitis and 8.75% of trichomoniasis in a mixed presentation. 75% of cases were treated with tropical anti bacterial or antifungal agents and 33% those cases treated with metronidazole in a combination with other drugs as well. Conclusion: Mixed vaginitis is treated on basis of its presentation with various diagnosis protocols. Keywords: Presentation, Treatment, Mixed vaginitis
Frequency of Poor & Good Coronary Collateral Circulation in patients of Non-ST Segment Elevation Myocardial Infarction & to compare mean Platelet –Lymphocyte ratio with good & poor coronary collateral circulation
Authors: Raza Ahmad , Sharif Asma , Fayyaz Zafar Muhammad , Azeem Shahzad , Aslam Muhammad Arslan
Published: March 2022

Background: Coronary collateral circulation (CCC) is a secondary source of blood supply to an ischemic myocardial area in coronary artery disease. One of the most important protective responses of the cardiac against ischemia is the development of CCC. Recently, platelet to lymphocyte ratio has emerged as a major inflammatory marker & a new predictor of serious unfavorable cardiovascular outcomes. Aim: To find the frequency of poor & good coronary collateral circulation in patients of Non-ST Segment Elevation Myocardial Infarction & to compare mean platelet–lymphocyte ratio in patients with poor & good coronary collateral circulation of Non-ST Segment Elevation Myocardial Infarction. Methodology: This cross Sectional study was conducted in Cardiology Department, Mayo Hospital Lahore After taking informed consent 150 patients meeting inclusion criteria was taken in this study. The patients were enrolled from Department Cardiology, Mayo Hospital Lahore. Their basic demographical information like age, gender and contact detail was obtained. Patients were labeled as according to CCC, one with Poor CCC and second with good CCC [as per operational definition]. All procedure was done by consultant cardiologist having more than 5 years of experience after post-graduation. Venous blood was collected from patients in sterilized manners by experienced staff nurse and was sent to hospital laboratory for analysis of PLR. PLR was compared in cases with good and poor CCC. Results:1The average age of cases was 52.41 ± 18.12 years with minimum and maximum age of 20 and 80 years. There were 96(64%) male and 54(36%) female cases in this study. A total of 33 (22%) cases had poor and 117(78%) cases had good CCC. The mean Platelet-to-lymphocyte ratio (PLR) was 122.16 ± 30.10 with minimum and maximum PLR was 80.64 and 201.60. The mean PLR in cases with poor and good CCC was 165.95±21.93 and 109.81 ± 18.21 respectively, the mean PLR was highly significant in cases with Poor CCC when compared with good CCC, p-value < 0.0001. Conclusion: This study concludes that cases with poor CCC have higher PLR when compared to good CCC, so in future cases with higher PLR at admission can be predict for high risk patients for poor CCC. Using PLR (inexpensive and readily available) test we can hence, patients with NSTEMI can be prevented from morbidity & mortality by early and appropriate medications or interventions. Keywords Cardiology, Angiography, coronary artery disease, Low ejection fraction, coronary collateral circulation.
Spectrum and Antibiotic Sensitivity Pattern of Bloodstream Bacterial Isolates from Septicemic Neonates
Authors: Mahmood Tahir , Ali Wahid , . Quratulain , Butt Rabia Waseem , Iqbal Kulsoom , Kamran Taiba
Published: March 2022

Aim: To evaluate the etiology of neonatal sepsis. We aimed to explore the antimicrobial sensitivity patterns among neonates. Methodology: This observational-based study was conducted in POF hospital Wah Cantt from September 2020 to March 2021. We selected 300 sepsis patients based on the WHO neonatal sepsis screening tool. Blood samples were collected by trained laboratory technicians using the aseptic technique. Laboratory technicians prepared a 5cm (in diameter) patch of skin over the proposed site of venipuncture. We drew one ml sample of blood from a fresh venipuncture site. This blood was added to a bottle containing 5–10 mL of blood Agar culture media. Results: We observed that babies with less than 5 Apgar scores reported a high risk of neonatal sepsis. We observed gram-positive bacteria in 49 (55.7%) cases while 39 (44.3%) were reported gram-negative bacteria. At the time of diagnosis, we observed that 67.3% of cases of gram-positive bacteria were highly reported in the LONS group. Around 23 (63.3%) gram-negative bacterial isolates were from EONS. Regarding bacterial pathogen, we observed 22 (25%) cases of Coagulase-negative staphylococcus aureus and 18 (20%) were of E. coli which results in neonatal sepsis. Conclusion: Our results concluded that third-line antimicrobials can be a beneficial treatment for managing neonatal sepsis. However, failure of irst two antimicrobials was observed due to high utilization before an accurate diagnosis of neonatal sepsis. Keywords: Antimicrobial, Sensitivity Patterns,. Neonatal sepsis
Relationship of Self-esteem with Depression, Anxiety and Stress among Pakistani medical students
Authors: Rizwan Hufsa Chandni , Rahman Saeed ur , Habib Osama , Khan Muhammad Ashar Waheed , Malik Saad Bashir , Minhas Iftikhar Ahmed
Published: March 2022

Background: Previous research on self-esteem highlights that low self-esteem is related to higher levels of anxiety, depression and stress. However, this relationship has not been clearly demonstrated in Pakistani adolescents and young adults. Aim: To explore the relationship between self-esteem and the prevalence of anxiety, depression and stress in Pakistani medical students. Methods: The study was conducted at Shalamar medical and dental college (SMDC) from August to September 2016. 273 students participated in this study which was approved the ethical review board at SMDC. Depression, anxiety and stress scale (DASS) was used to asses stress, anxiety and depression and Rosenberg self-esteem scale (RSES) was used to assess self-esteem. Results: A significant inverse relationship was found between self-esteem and the prevalence of anxiety depression and stress i.e. higher levels of self-esteem tended to correlate significantly with lower prevalence of anxiety, depression and stress in our study population. Conclusions: It is important to assess self-esteem among individuals who present with symptoms of anxiety and depression. Training on how to boost one’s self-esteem can be one of the strategies used to treat and prevent depression and anxiety, especially among students and young adults. Keywords: self-esteem, depression, anxiety, stress, Pakistani Medical students
Acceptance and Rejection of Covid-19 Vaccine among Pregnant and Breast Feeding Women – a survey conducted in Outpatient Department of a tertiary care setup
Authors: Akhtar Omema , Khan Sarah , Shahnawaz Shizra , Ismail Shafaq , Khan Saba , Yasmin Haleema
Published: March 2022

Aim: To ascertain the frequency of acceptance and rejection of covid-19 vaccination and the reasons behind their choices among pregnant and breast feeding women visiting outpatient department of a tertiary care setup. Methods: This cross-sectional study was conducted in the Department of Obstetrics and Gynaecology, Jinnah Postgraduate Medical Centre, Unit -1 for a period of one month. All women attending outpatient department during the study, fulfilling the inclusion criteria and willing to participate in the study were included after informed consent. A questionnaire designed to acquire general information about the study participant was filled by the researcher. Data was entered and analyzed using SPSS vr 21.0. Results: Out of 500 enrolled women, 249(49.8%) women were pregnant and 251(51.2%) were breast feeding. 171(34.2%) were vaccinated and 329(65.8%) were unvaccinated. There is a significant association between the concept regarding unavailability of significant data regarding safety during pregnancy and breast feeding or vaccine being harmful during pregnancy and breast-feeding for mother & baby and acceptance of vaccine (p-value < 0.001) Conclusion: Safety concerns regarding the vaccine for pregnant and breast-feeding mothers still hold them from getting vaccinated. Obstetricians and Gynaecologists of the country need to play a vital role in building up the confidence of this population over vaccination and should strongly recommend pregnant and breast feeding women following up in clinics to get vaccinated. Keywords: Covid vaccination, pregnancy, breast-feeding and covid vaccine, Covid pandemic.
Comparison of Seroma Formation with Harmonic Scalpel Versus Monopolar Electrocautery in Axillary Dissection following Modified Radical Mastectomy
Authors: Zahid Abrar , Javed Tehreem , Kaleem Muhammad , Imran Andrabi Wajeeha , Jamil Talha , Qureshi Sidra Shoaib , Rabbani Shaukat , Andrabi Syed Imran Hussain , Butt Hasnat Ahmad
Published: March 2022

Background: Breast cancer is cancer that forms in the cells of the breasts. Despite of the emergence of the breast conservation technique modified Radical Mastectomy still remains the most commonly performed surgery for CA Breast. The Harmonic scalpel is a surgical instrument used to simultaneously cut and cauterize tissue. Aim: To compare the frequency of seroma formation with harmonic scalpel versus monopolar electrocautery in axillary dissection following modified radical mastectomy. Methods: This randomized control trial was conducted in the Department of General Surgery, Lahore General Hospital and Ghurki Trust Teaching Hospital, Lahore. 60 patients were enrolled. Two groups were made by applying lottery method. One group is treated with hormonic scalpel and other with electrocautery. All surgeries were done under general anesthesia by two surgical teams. After surgery, patients shifted in post-surgical wards and will be followed- up there for 7 days. Seroma formation was noted. All the collected data was entered and analyzed on SPSS version 21. Results: The mean age in harmonic scalpel group was 49.87± 8.67 years and in electrocautery group was 49.87± 8.67 years. The seroma formation in harmonic scalpel group was noted in 5(16.7%) patients whereas the seroma formation in electro cautery group was found in 11(36.7%) patients (p-value=0.080). Conclusion: This study concluded that the harmonic scalpel group showed lower rate of seroma formation than to electrocautery group, however statistically both groups are equally effective Keywords: Harmonic Scalpel, Seroma Formation, electrocautery
Septic arthritis of the hip joint by Salmonella typhi; A Case Report and Review of Literature
Authors: Tariq Hira , Izhar Mateen , Aslam Khichi Muhammad , Ahmad Nazia , Tariq Anam , Rasheed Muhammad Rizwan , Hammad Maryam
Published: March 2022

We report a case of septic arthritis of hip joint in a 10-year-old boy with enteric fever. The clinical diagnosis was confirmed by Salmonella typhi isolation from joint aspirate obtained by FNAC. Treatment with intravascular Imipenem injections was successful. Keywords: Salmonella typhi, septic arthritis, hip joint
Impact of the COVID-19 pandemic on whole blood donation: Perspective of a Portuguese Hospital Blood Bank
Authors: Martins Pereira Filipa , Moura Luís , Fonseca Liliana , Brito Arnaldo , Lobo Filipe , Palmira Amaral Ana , Costa Marina
Published: March 2022

Aims: COVID-19 brought shortages in blood stocks worldwide. To try to understand the distribution of the number of donations throughout the pandemic, we carried out a study to assess our donors’ sense of security and fear.

Methods: Retrospective study that includes all blood donors in our blood bank between July and August 2021. We surveyed the number of blood donations at our center since 2015 and applied a questionnaire to assess motivation, fear, feeling of security, and satisfaction in the implemented security measures and in the access to information about COVID-19 and donation.

Results: A total of 558 donors were included in the study, most were men (313), and the median age was 41 years. There was a drop in the number of donations in March and April 2020, but no differences were found in the total number of donations over the years and in 2020. Some donors (n=136) reported being afraid to donate blood during the pandemic. Seventy-one participants had COVID-19 and 425 were vaccinated. Donors felt safer and less fearful after vaccination or illness. Overall donors felt safe during blood donation.

Conclusion: Although donors overcome the fear of donating blood during COVID-19 pandemic and feel safe with the implementation of procedures to prevent the transmission of infection, we must implement and review donor safety measures that increase their trust in the blood bank and guarantee their return.
Improved PERC Solar Cell Design by TCAD Simulation
Authors: Rehman Atta Ur , Siddiqui Amna , Nadeem Muhammad , Usman Muhammad
Published: March 2022

In this work, we aim to identify the performance limiting factors and consequently improve the performance of PERC solar cells through extensive TCAD based device simulation and modelling. Initially, a simplified planar PERC solar cell structure is simulated in Silvaco (Athena/Atlas), where the device geometry is selected according to an experimentally fabricated cell with an efficiency of 17.86%. The J-V curves and solar cell parameters such as Jsc, FF, Voc and efficiency (η) of the simulated cell are then fitted to the experimental performance parameters by incorporating relevant models as suggested by the literature. These include: carriers’ generation-recombination, mobility, statistics and bandgap narrowing. A good agreement is obtained, where the average percentage difference between simulated and experimental performance parameters is 0.65%. The solar cell performance is then improved to 21.52% by optimising the anti-reflective coating stack composition and thickness, and adding surface texturing. This increase in efficiency is attributed to lower surface recombination and reduced reflection due to light trapping. In addition, a textured front surface enhances the path-length of light, causing it to undergo multiple internal reflections which further increases light trapping, thus increasing Jsc by 7.31 mA/cm2.
Добри практики при изготвяне на психологична оценка на развитието при деца в ранна и предучилищна възраст
Authors:   New Bulgarian University, Колчева Надя , Стайкова Светла
Published: March 2022

Monitoring child’s development in the early and preschool years is of utmost importance as this is a period of great plasticity, during which children respond best to therapy and to stimulation. Psychological assessment in this period of life is an important part of the process of early identification of developmental problems. The result of it could help parents to choose timely an appropriate intervention program. This paper aims to present the basic principles of good practices for psychological assessment of development in early and preschool children. The authors discuss validated and proven models that meet professional standards and ethical requirements.
Pragmatic Foundations of Religious Experience in Wittgenstein’s Philosophy
Authors:   Ivan Franko National University of Lviv, Synytsia Andrii
Published: March 2022

The article shows that in matters of philosophy of religion, when the sphere of interest of Wittgenstein went beyond logical and linguistic analysis, he attached special importance to a pragmatic approach to the interpretation of religious experience. Wittgenstein’s philosophico-religious studies were largely inspired by the events of his own life , as well as the ideas of individual thinkers, including the pragmatic philosopher William James. In Wittgenstein’s work one can find both a substantiation of the originality of religion and its impossibility of analysis from the standpoint of science, and a conviction in the expediency of religious experience in human life. It is revealed how Wittgenstein, analyzing the main manifestations of religious experience, pragmatically eliminated contradictions in the comprehension of knowledge about God (as unspeakable), pointed out the importance of transition from skepticism to belief as a basis for experience of absolute safety, took into account socio-practical aspects of various ethico-religious experiences such as feeling guilty. The author finds out how Wittgenstein interpreted the practical value of religious experience, analyzed the language of religion, as well as revealed its socio-psychological and ethical aspects.
Ricoeur and Foucault on Tragedy and Truth
Authors:   Autonomous University of the State of Mexico, Garduño Comparán Carlos
Published: March 2022

The purpose of this text is to confront some Paul Ricoeur’s and Michel Foucault’s significant reflections on Greek tragedy, in order to discuss their interpretation of its truth and the knowledge it makes possible. Ricoeur supposes that tragedy implies a theology that, though it is not explicitly developed, points to the knowledge of the self, his conflicts with others, and even to a possible redemption. For his part, Foucault determines that in tragedies a set of discourses opposing against each other is at stake, without the possibility of overcoming their conflict in a higher knowledge. Does tragedy allows knowledge through the spectacle and the emotions aroused? Is the truth of tragedy manifested in the confrontation and intensification of passions, but cannot be developed as knowledge of the self and his reconciliation with others?
The Choice of Love and the Numinous: Existential and Gender Contexts
Authors:   National Academy of Sciences of Ukraine, Khamitov Nazip , Krylova Svitlana ,   National Pedagogical Dragomanov University, Romanova Olena ,   National Pedagogical Dragomanov University
Published: March 2022

The authors of the article analyze the influence of the numinous as an existential state and the structure of the unconscious, which causes sacred amazement and fear in a person on the choice of love in its gender-based manifestations. On the basis of the methodological strategy of metaanthropology, the choice of love is conceptualized in the ordinary, the ultimate and the transcendent existential dimensions of human being, which correspond to the ordinary, the personal and the philosophical worldview. In the methodological coordinates of C. Jung's psychoanalysis, the manifestations of the numinous in the archetypes of Anima and Animus and their influence on the decisive manifestation of love in the life of a man and a woman during the formation of a worldview are investigated. The actualization of the philosophical worldview, in which there is a free maturation of ideals, values, the destruction of outdated worldview attitudes and the establishment of a new being, leads to the integrity of the personality and the unity of individuals in love and co-creation. Under the influence of this, the emphasis in the numinous changes from horrible to sacred. This leads to worldview freedom in the choice of love, which becomes truly humanistic and constructive.
Saúde do Trabalhador na Atenção Básica: (des)conhecimento, fragilidades e potencialidades segundo profissionais da Atenção Básica no município de Iguatu/CE
Authors: Gonçalves Ariel Barbosa , Cidade Elívia Camurça , Araujo Ana Carolina da Costa , Silva Thales Fabricio da Costa e
Published: March 2022

A Política Nacional de Saúde do Trabalhador e da Trabalhadora (PNSTT) constitui uma importante estratégia de vigilância, promoção e assistência em saúde do trabalhador, especialmente por considerar o trabalho um elemento determinante no processo saúde-doença. As particularidades de cada processo de trabalho também devem ser consideradas no contexto de saúde, o que suscita à realização de pesquisas sobre a experiência de profissionais que implementam a PNSTT. Nesse sentido, o artigo tem como objetivo analisar a execução das ações da PNSTT pelos profissionais da Atenção Básica no município de Iguatu/CE. A pesquisa se configura como estudo de caso realizado no território de abrangência de duas unidades de saúde: Flores e Cohab. Foram realizados dois grupos focais, que integraram um total de 12 profissionais de saúde. Os resultados são apresentados a partir de cinco categorias: ações realizadas no cotidiano da Atenção Básica; compreensão sobre a PNSTT; ações de Saúde do Trabalhador; fragilidades e potencialidades para a efetivação da PNSTT; e sugestões para melhoria das ações de Saúde do Trabalhador na Atenção Básica. Conclui-se que há a necessidade de ampliar a reflexão sobre a temática entre as equipes de saúde, tendo em vista que há um grande desconhecimento por partes de seus profissionais sobre a PNSTT, limitando a efetivação de ações e a descontinuidade do cuidado.
Wind Power Penetration and Integration in Rwanda
Authors:   Open University of Tanzania, Niyonzima Celestin
Published: March 2022

Wind energy is the current “star” in the field of renewable energy for electrical production. Still, the power generated from available wind over time is characteristically uneven due to the unpredictable nature of their primary source of power. This only increases the problems inherent to the integration of a great number of wind technologies into power networks, making their contribution rather difficult to manage (regulating voltage and frequency, wind-station operation, etc.). The integration of wind power in the Rwandan electrical system is now an issue in order to optimize the utilization of the resource and in order to continue the high rate of installation of wind generating capacity, which is necessary in order to achieve the goals of sustainability and security of supply. This paper presents and is intended to analyse wind power penetration and integration in the country, impact and challenges that are associated with the integration of wind power into power systems and analyse barriers to wind power penetration and integration in Rwanda. These impacts include effects of wind power on the electrical system, capacity of national grid to accommodate wind power (stability of grid). In addition, the paper suggests the solutions that should be offered to improve the management of wind power generation and increase its penetration in the overall electrical energy production. Keywords: Wind power potential, Wind power penetration, Barriers to wind power penetration, National grid of Rwanda, Integration.