bluuebunny/crossref_metadata_2025 huggingface dataset:
TOXINA BOTULÍNICA COMO ALTERNATIVA TERAPÊUTICA PARA O BRUXISMO: REVISÃO INTREGATIVA
Authors: Santos Juliane Vaz , Viegas Nayane Silva Sousa , Gomes Millena M. Ferreira , Fonteneles Amanda de O.
Published: December 2024

Bruxism is a disorder that affects people of all ages, especially young adults, and can be classified as sleep bruxism and awake bruxism. This involuntary condition involves grinding or clenching the teeth, resulting in problems such as orofacial pain, dental wear, and sleep disorders, impacting the quality of life of those affected. With the increasing prevalence of bruxism, it is essential to find effective treatments. This study explored botulinum toxin (BT) as a therapeutic alternative for bruxism, evaluating its effectiveness in reducing symptoms and comparing it with other treatment modalities. The results of the study indicated the effectiveness of using the toxin for the therapeutic management of bruxism, with the purpose of reducing the symptoms caused by this parafunction. It was concluded from the reviewed articles that this substance can bring relief to the problem, relieving tension and its symptoms.
PSEUDOMONAS AERUGINOSAS EM INFECÇÃO HOSPITALAR
Authors: Dantas Vanessa Diefenthaeler , Lazaretti Waleska
Published: December 2024

Este artigo de revisão especifica que a Pseudomonas aeruginosa é um patógeno oportunista associado a sepse hospitalar. Este agente está entre os microrganismos que mais frequentemente associam o processo infeccioso e a taxa de mortalidade em pacientes imunocomprometidos. Dada a alta taxa de resistência a antibióticos e a capacidade de formação de biofilmes, o tratamento é dificultado. O objetivo deste artigo foi revisar os fatores de virulência, mecanismos de resistência a antibacterianos bem como quais os métodos para controle e prevenção de P. aeruginosa. A metodologia deste estudo baseia-se em uma análise teórica e qualitativa, fundamentada em uma revisão bibliográfica sobre os mecanismos de resistência e fatores de virulência da Pseudomonas aeruginosa em ambientes hospitalares. Conclui-se que a compreensão dos fatores de virulência e mecanismos de resistência é essencial para o desenvolvimento de estratégias mais eficazes de controle e tratamento, contribuindo para a redução das infecções hospitalares associadas a esses patógenos.
Biomimicry as a Pathway to Sustainable Development - An Overview
Authors: Tsu Sarah
Published: December 2024

Human activities have significantly transformed Earth’s ecosystems and biodiversity, with over 75% of ice-free land altered due to habitation and land use. The 2023 planetary boundaries framework update indicates that six out of nine critical boundaries for Earth’s health have been breached, highlighting the urgent need to reduce anthropogenic environmental impacts. The United Nations’ 17 Sustainable Development Goals, adopted in 2015, aim to protect the environment and promote prosperity through innovations, infrastructure improvements, and sustainable urban development. Biomimicry, a multidisciplinary field drawing inspiration from nature, offers a promising pathway to minimize environmental impacts and advance these goals. This paper provides an overview of biomimicry, highlighting its impact on various sectors including architecture, healthcare, transportation, agriculture, engineering, and technology. By emulating nature’s efficient designs and processes, biomimicry fosters sustainable innovations and practices, such as energy-efficient building design inspired by termite mounds, self-repairing concrete modeled after human bones, and healthcare innovations like microneedles and biodegradable surgical glues. To realize its full potential, it is necessary to incorporate biomimicry into educational curricula to bridge the gap between natural systems and classroom learning, foster environmental stewardship, and drive progress toward a more sustainable future.
Los coleópteros acuáticos y semiacuáticos de la comarca de El Bierzo (León, NO de España) (Coleoptera: Gyrinidae, Haliplidae, Noteridae, Hygrobiidae, Dytiscidae, Helophoridae, Georissidae, Hydrochidae, Hydrophilidae, Hydraenidae, Scirtidae, Dryopidae, Elmidae, Heteroceridae) - Reunión del Balfour~Browne Club, 25-30 junio 2015
Authors: Valladares Luis F. , Benetti Cesar J. , Garrido Josefina
Published: December 2024

The list of aquatic and semi-aquatic beetle species collected at the meeting of the Balfour~Browne Club in Villafranca del Bierzo (León, Spain) in 2015 is reported here. It includes a list of 139 species and subspecies of the families Gyrinidae, Haliplidae, Noteridae, Hygrobiidae, Dytiscidae, Helophoridae, Georissidae, Hydrochidae, Hydrophilidae, Hydraenidae, Scirtidae, Elmidae, Dryopidae and Heteroceridae, of which 23 are new records for El Bierzo region. Including the previous records, the number of known species to El Bierzo raise to 184. Some of the most interesting species from a conservation perspective are discussed. We can highlight the great species richness of El Bierzo. The high value of species richness in El Bierzo is highlighted. Although most of the species have a wide distribution, we also found a great number of Iberian endemic species (20%), most of them related to mountain streams. We also discuss the high conservation interest of this area for aquatic beetles and the wide coverage of protection of their habitats
Valor nutrimental de una receta basada en la “Dieta de la Milpa”: Tortitas de quelites. Hacia una alimentación saludable y sostenible.
Authors: Pérez Islas Juana Emelia , Cruz-Jaime Sandra , Fernández-Cortés Trinidad Lorena
Published: December 2024

Currently, modernization has had a negative effect on Mexican culinary traditions and this has an impact on the environment. The Milpa diet is a traditional Mexican food pattern that uses beans, corn, chili and pumpkin as a base, and also integrates the consumption of other local and traditional foods such as a wide variety of vegetables. One of these vegetables is quelites, it is a type of edible leaves, which provide an important source of vitamins and minerals. Rescuing the consumption of these foods is of utmost importance for a sustainable and healthy diet. Therefore, the objective of this study is the nutritional value of a recipe based on the “Milpa Diet”: Quelites pancakes. To inform about the relevance and health benefits of consuming this type of recipes.
Performance and Social Drama in Improvisational Theater
Authors: Felicio Carvalho José Luis
Published: December 2024

The article was guided by the objective of analyzing how improvisational theater can add to the resistance against the domination imposed by colonialism, particularly with regard to the conflict inherent to social drama, in line with the work of Victor Turner. The anti-racist show “Swag Hat”, improvised by the African American collective BlackOut during the most traditional festival of its kind in Europe, was chosen as a case study.
Semantically Enhanced Frequent Events Mining in Electronic Health Records
Authors: Boytcheva Svetla
Published: December 2024

This paper proposes context based approach for frequent events mining (FEM) in Electronic Health Records (EHR). The majority of FEM methods do not take in consideration the context information of the analyzed dada. EHRs contain rich context information like demographic data, encounters, vital parameters, diagnoses, lab tests values, and prescribed therapy. Such information is crucial for proper interpretation of the complex temporal clinical events. Some applications in comorbidity identification, risk factors analysis and patients phenotyping are presented to illustrate the proposed method. Experiments were run on large collections of pseudoanonimized reimbursement requests submitted to the Bulgarian National Health Insurance Fund in 2010-2016 for more than 5 million citizens yearly. Effective explication of comorbidities and characterization of risk factors can fill knowledge gaps and assist informed clinical decision-making.
Suggestions for Improving the Country’s Master Plan for the Disabled People with Life-Sustaining Limitations
Authors: Karaatmaca Ceren , Altinay Zehra , Altinay Fahriye
Published: December 2024

Individuals who are restricted in some movements, senses or functions for physical or mental reasons constitute a group of the society. In North Cyprus, these individuals and/or their familes are directly or indirectly confronted with various problems in society. Today this phenomenea can be perceived in areas like education, health, transportation accomodation, technology, informatics, social security, etc. The developmental level of a country is directly related to the efforts to solve the mentioned problems. The main aim of this study is to examine a conceptual framework for suggestions to increase the quality of services for the disabled in this context as well as putting forward action plans for the process of development and necessary changes. In this respect, all the studies done in the workshops after 2013 in North Cyprus to improve the services provided for the disabled with life-sustaining limitations are summarized and reported. In addition, the guidance in designing a detailed framework for the protection of the rights of the disabled and the suggestion of action plans to carry out their responsibilities are provided. Consequently, this study suggests the framework for participant planning process to support necesarry developments.
Empirical Null Distribution of -2log(lambda)
Authors: Shamshad Bushra , Siddiqi Junaid Saghir
Published: December 2024

Approximation of Non-central Chi-square distribution as an empirical distribution of log-likelihood ratio test statistics (-2logλ; abbreviated as LRT) has been a concern in the field of structural equation modeling. Under extremely severe misspecification (Chun & Shapiro, 2009) reported that non-central Chi-square is not a good choice. In this paper, we have used a bootstrap sampling procedure to investigate the empirical null distribution of LRT specifically in the context of a latent class model (LCM) via frequentist framework (that is, EM algorithm). We used two types of data sets. The first type includes those sets of data on which LCM had been carried out (published results; named as “training data”). The other type is that of those data sets which are not published earlier (i.e. “real” collected data; named as “test data”). Non-central χ2 distribution with degrees of freedom equals to the expected value of bootstrap LRT and non-centrality parameter equals to inverse of the variance of bootstrapped LRT is found to be very well fitted empirical null distribution of LRT in case of LCM. These results will help in obtaining the significance value of LRT for deciding on the number of classes present in a latent variable.
Semantic Reading in the Context of the History of Mathematics
Authors: Naziev Aslanbek
Published: December 2024

Coming soon.
Neutrosophic Modal Logic
Authors: Smarandache Florentin
Published: December 2024

We introduce now for the first time the neutrosophic modal logic. The Neutrosophic Modal Logic includes the neutrosophic operators that express the modalities. It is an extension of neutrosophic predicate logic and of neutrosophic propositional logic.
Differences in Sensorimotor Skills between Badminton Players and Non-Athlete Adults
Authors: Hromčík Adam , Zvonař Martin , Balint Gheorghe
Published: December 2024

Abstract

This study is focusing on the badminton top players vs. regular adult population. In our previous study on adolescents, variances showed the impact of puberty on timing skills (Hromčík & Zvonař, 2018). The timing in training is topical these days (Forner-Cordero, Quadrado, Tsagbey, & Smits-Engelsman, 2018), and also brain specifics and learning anticipation skills (Wang, Dong, Wang, Zheng, & Potenza, 2018). We added some new insight in this theme and tried to determine the dynamics in the accuracy of sensorimotor skills, which plays an essential role in ball games. Only boys from one club were tested. Subjects have undergone a special PC test with a length of about 45 minutes to test their response and timing of movement with number of tasks in which they tried to hit a moving target, which appeared on the screen at 3 different angles (0°, 15° and 30°) and at different speeds (accelerating, decelerating, constant). Everything happened at unpredictable intervals in 45 minutes rotation. We compared these outcomes with our measurements from last year through specific timing hits and missed shots, and in the terms of sport season. Predictive motor timing suggests that the cerebellum training plays the relevant role in integrating incoming visual information with the motor output reaction.
A New Perspective Analysis of Variations in Cockroach Motion Kinematics Using Precision Kinematic Image Processing
Authors: Khajeh Arash , Mashhadi Mahmoud Mosavi , Koma Aghil Yousefi
Published: December 2024

The ability of insects with sticky legs in moving on vertical and horizontal surfaces can be related to adhesion properties of their legs. Despite the key role of the mechanical mechanism of the body and leg movements of insects during adhesion, this mechanism has not been fully still understood. This study aimed at investigating the mechanism of leg movements in movement cycles from the start to restart of the movement of the same leg on a straight path. Irregularity in the acceleration-time graph of the center of mass (COM) can be partly related to this assumption on the sequence difference of leg movements during insect motion. Unlike current assumptions on repetitive movement cycles in the simulation of cockroach motion kinematics, our results revealed a difference in cockroach motion in each cycle. This finding can evolve the mechanism of simulated robots inspired by insects. Due to the low average weight of the American cockroach (0.83±0.5 g), the use of accelerometer sensors leads to measurement errors and deformation of the mechanism. Furthermore, the problem with frame-by-frame image processing time during movement cycles can be solved by the method used in this study.
Resolution of Brain-Based Consciousness as a Quantum Information Field
Authors: Erol Mustafa
Published: December 2024

This work resolves the brain-based consciousness as an Open Quantum Information Field, created and influenced via the environmental sensory information and operating under the full control of quantum mechanics. The external sensory information, modelled as quantised electromagnetic waves, is assumed to feed the cortical neurons and eventually construct the brain-based consciousness Hamiltonian. Any external energy/information, instantly reaching to the Hamiltonian of brain-based consciousness, is taken into account as a perturbation. In order to obtain instantaneous wave functions and probability amplitudes well known time dependant perturbation theory is employed. Quantum field theory is finally used to resolve the overall brain-based consciousness and some important conclusions are underlined.
Application of High-Speed Algorithms for Training Neural Networks for Forecasting Financial Markets
Authors: Karlov Dmitry N. , Zueva Viktoria N. , Trukhan Dmitry A. , Belykh Alexey A.
Published: December 2024

The article discusses the use of artificial neural networks in financial markets, due to the fact that this direction is very promising. Neural networks are well suited for tasks in which there are a large number of influencing factors, both known and unknown. The existing methods of neural networks training are considered, their pros and cons are noted. The use of neural networks in forecasting financial time series in real time is faced with the problem of the duration of the learning process of the neural network and the selection of significant inputs of the neural network. This problem can be solved by using the high-speed method of teaching the perceptron. The high-speed method of training allows for a much smaller number of iterations to train a multilayer perceptron on a given set of examples compared to the method of back propagation of the error. The high-speed method of training a multilayer perceptron allows us to assess whether it is possible to reach a given learning error of the neural network or not. This method of training is proposed to be used as an evaluation in the case of critical tasks before applying the method of back propagation of the error, in the case of non-critical tasks, the results of the neural network trained by this method can be used directly.
Study of the Metacognition Technique in Reducing the Desire for Opioid Dependence
Authors: Sedghi Maryam , Heydardoust Simin , Hashtroudi Samira Vaez
Published: December 2024

The aim of this study was to determine the effectiveness of the technique of meta-cognitive effect in reducing desire Addicts in the city of Ardabil. Semi-experimental study. The population consisted of all patients referred to one of the centers in the city of Ardabil in 2016 is addiction. For Sample, 50 people with opiate dependence according to criteria of inclusion and exclusion and obtain the certificates necessary medical certification that the leave be available were selected and randomly divided into two groups of 25 experimental and control have been. The experimental group received eight sessions on techniques of meta-cognitive control group spent their daily routine. Using a desire scale anticipated return was gathered and demographic Wright. Information obtained using analysis of covariance and variance MANOVA and multiple variable was analyzed using SPSS software. The results showed that meta-cognitive learning techniques to reduce desire Addicts in Ardabil significant effect (0.01> P). The overall results showed that the technique of meta-cognitive training can reduce the desire in consumer consumption of opioid use.
Relationship between Service Blue Print Dimension and Customer Satisfaction in the Insurance Industry in Kenya
Authors: Chege Catherine Njoki , Wanjau Kenneth Lawrence , Nkirina Severina
Published: December 2024

The Insurance industry has lately been associated with financial steadiness, security of government programs, enhancing trade and overall growth of a national economy. The industry however continues to experience very low penetration. Kenya has a penetration rate of 2.3% compared to South Africa’s rate of 7.6%. Insurance firms in Kenya are under considerable pressure from their customers and the regulator to invest in service blue print as a measure of analysing the impact of their service quality which is a result of their service innovations and enhanced processes or systems which are supposed to improve customer satisfaction and hence profitability. This study analysed the relationship between service blue print dimension and customer satisfaction in the insurance industry in Kenya. The study adopted a causal research design. The unit of analysis was 17 licensed composite insurance companies in Kenya with a unit of observation of 400 policy holders sourced from insurance company records. Primary data was collected using a semi-structured questionnaire which was self-administered. R-Gui was the main statistical software. The study applied the linear mixed-effect models of structural equation modelling (SEM) considering the multi-level structure of the data collected. A significant fixed effect coefficient estimate of 0.154 was established, implying that increasing the levels of service blue printing as perceived by a customer by one unit would result into an increase in the level of Customer Satisfaction by 0.154. The study concluded that a client who perceives efficient and effective service processes from his/ her insurer is bound to have higher satisfaction than a customer who does not perceive efficient and effective service processes from their insurer. Service blue printing however, does not significantly affect the variations of customer satisfaction between the insurance companies. The study recommends that insurance industry firms invest in service blue prints as a strategy of achieving maximum customer satisfaction. Service blue print will improve interactions between customers and service providers by acting as a service lens and they should be developed as a service innovation technique that may enable discovery of potential innovations that may have otherwise been overlooked. The insurance company can adopt service blue print as a benchmark for accreditation standards.
ON THE EFFECTIVE DEVELOPMENT OF THE STRUCTURE OF GENERATION POWERS IN THE ELECTRICAL POWER SYSTEM
Authors:   Azerbaijan Scientific-Research and Project-Research  Energy Institute,  Baku, Azerbaijan, BALAMETOV A B
Published: December 2024

Giving extreme preference to green energy in the production structure of energy systems is not a very simple matter. Currently, the efficiency of wind and solar power plants is lower than expected, and the schedules for many projects are not justified. Forecasts of the expansion of the nuclear energy potential in the world are being considered. Rapid development of nuclear energy production and long-term continuation of this trend is expected. The state of efficient use of energy sources is considered, taking into account their impact on the environment. The Azerbaijan EES is being investigated for development directions related to the share of power plants in the production of electricity by 2050. As a result of this, due to the rational distribution of distributed generation sources, stability in the grid system will be improved, and the guarantee of reliable supply of electric power to the regions will increase.
DESIGNING THE CONTROL SYSTEM OF THE GENERATOR THROUGH THE PID CONTROLLER
Authors:   Azerbaijan State Oil and Industry University, AGHAYEV U G
Published: December 2024

In modern times, the main driving forces of the economy of every country are closely related to the production of electricity. In this sense, the proper organization of the operation of syn¬ch-ronous generators, which are the main equipment in power plants where electricity is pro¬du¬ced, as well as providing consumers with uninterrupted, stable, high-quality and safe electrical ener-gy, is considered one of the main issues. In the article, information about the need to regulate the voltage at the outputs of generators connected to the network with a PID controller is mentioned.
INVESTİGATİON OF OPTİMAL OPERATİNG MODES İN ELECTRİCAL NETWORKS BASED ON VOLTAGE REGULATİON
Authors:   Azerbaijan State Oil and Industry University, MURADOVA R A , ISKENDEROV M M ,   Azerbaijan State Oil and Industry University
Published: December 2024

From the point of view of efficiency, the methods for optimal regulation of voltage in electrical networks and systems are defined in this work. Optimal options for regulation were selected and saving of power losses was recommended. Optimization methods related to voltage regulation were investigated and a favorable method was determined. Appropriate measures have been taken to provide consumers with quality power.
DETERMINATION OF THE HEAT TRANSFER COEFFICIENT DURING CONVECTION HEAT TRANSFER
Authors:   Azerbaijan State Oil and Industry University, PİRİYEV H S
Published: December 2024

The article is devoted to determining the heat transfer coefficient during convective heat transfer. Convective heat transfer or heat transfer is the process of heat transfer between the surface of a solid and the surrounding medium (gas or liquid). In this case, heat transfer occurs due to the combined action of thermal conductivity and convection. The process of heat transfer in liquids and gases is determined by the heat transfer coefficient and temperature gradient, as in solids. The process of heat transfer during convective heat exchange is closely related to the transfer of the medium itself. Therefore, the convection process occurs only in liquids and gases, the particles of which move easily.
DESIGNING THE ORIENTATION OF SOLAR PANELS
Authors:   Azerbaijan State Oil and Industry University, RASHIDOV S G , GOCHUYEVA A F ,   Azerbaijan State Oil and Industry University
Published: December 2024

The present paper examines the design of solar panel orientation as a complex issue. This project involves several engineering and physical principles. In addition to reporting and analysis, simulation programs are used to perform the research. Also, the control and management systems, detailed analysis and proper management of the regulation principles of the solar panel orientation project were studied depending on other parameters.
Etiology and Presentation of Ocular Trauma at District Head Quarter Teaching Hospital Bannu
Authors: Mahsud Hidayat Ullah , Muhammad Irfan Wazir  , Shafqat Ali Shah  , Sana Ullah  , Sher Zameer
Published: December 2024

Purpose: To study the clinical presentation and etiology of ocular trauma so as to plan resources accordingly.
Material and Methods: This prospective observational descriptive study which included two thousand seven hundred and ten patients was conducted at the Department of Ophthalmology DHQTH, Bannu from 1st Jan 2015 to 31st Dec 2016.
RESULTS: Total 2710 patients with trauma were attended in this two-year period. Male and females were 1316(48.56%) and 1125(41.51%) respectively, while children comprised of 269 cases (9.93%).Closed globe injuries were more  prevalent with 1025 patients (37.82%) followed by  open globe injuries which were 870 patients (32.10%) and chemical injuries comprised of 815 patients(30.07%).The most common place of injury was home ,877patients,(32.36%), followed by assault, 864 patients (31.88%).The causative agent in most cases was burns, 408 patients(15.05%) followed by stones 365 patients (13.46%). 815 patients had chemical injuries.
Conclusions: Increased public health awareness should be created which will prevent inadvertent incidences of ocular emergencies in the community.
The Role of Hypoglycaemic Agent; Dipeptidyl Peptidase–4 and Its Relation with Biochemical Parameters in Patients With Type–2 Diabetes: A Three Months Trial
Authors: Naghma  , Taj Rohila , Shah Faridullah , Sohail Shaukat , Shah Asma , Hashir Ahmad Mohammad , Tayyab Ahmad Mohammad , Ahmed Zahoor
Published: December 2024

Objective: This study was undertaken in order to find out the hypoglycemic control of DPP–4 on the diabetic patients and to evaluate the other related problems.
Methodology: A total of 320 type 2 diabetes patients were included in this study. They were treated with oral hypoglycemic drugs. Random  as well as fasting blood samples were taken in all hygienic conditions. HbA1c, RBS, FBS, RFTs, serum electrolytes and lipid profiling was carried out by colorimetric methods using kits on Macro Lab 200. The kits were obtained from Elitech, Spain. Fried Wald’s formula was used to determine LDL–c.
Results: FBS, HbA1C and urea were significantly different (p < 0.05) when compared with base line data while opposite results (p > 0.05) were obtained for RBS, serum total cholesterol, creatinine and TG and serum electrolytes.
Conclusion: Risk factors related to diabetes can be reduced by using anti–hyperglycemic agents (DPP–4) on regular basis for a period of three months or more.
Association between Increased Carotid Intima Media Thickness and Nonalcoholic Fatty Liver Disease
Authors: Kayenat Khan  , Muhammad Osama Tariq Butt  , Muhammad Salman Rafique  , Sana Kundi  , Asma Maqsood  , Mohammad Nafees
Published: December 2024

Objective: The aim of the study was to determine the association between increased carotid intima media thickness and nonalcoholic fatty liver disease.
Methodology: This Case Control Study was carried out in Outpatient Department of Diagnostic Radiology, PAF Hospital Islamabad. It included all patients presenting in department of radiology. US examination was done to detect the presence of NAFLD. CIMT was measured in both the patient groups with and without NAFLD.
Results: The mean age of all subjects was 49.38 ± 0.59 years while the mean age of cases and controls was 50.04 ± 0.8 and 48.72 ± 0.87. In cases there were 83(53.55%) male and 72(46.45%) female cases while in controls there were 75(48.39%) male and 80(51.61%) female cases. Among cases and controls there were 29(18.7%) and 16(10.3%) subjects who had raised CIMT, with significant association, p-value < 0.05, and OR = 2.00 (1.037-3.854). 
Conclusion: In our study, CIMT was significantly raised in NAFLD group as compared to control groups. This study will help the primary care physicians to better understand the role of measuring CIMT, hence avoiding future CVD complications & deaths in NAFLD patients.
Role of Arterial Phase Imaging In Assessing Venous Anatomy and Venous Anomalies in Multi-Detector Row CT Angiography of Living Related Renal Donors
Authors: Asma Maqsood  , Muhammad Salman Rafique  , Sana Kundi  , Muhammad Haseeb Iqbal  , Asad Bashir  , Umar Farooq
Published: December 2024

Objective: To determine the role of arterial phase imaging in assessing venous anatomy and venous anomalies in multi-detector row CT angiography of living related renal donors
Methodology: This retrospective study was conducted in the Radiology Department of Pakistan Kidney and Liver Institute and Research Center, Lahore (PKLI & RC). After institutional review board approval, we evaluated MDCT images of 56 consecutive renal donors. Two consultant radiologists independently assessed the renal venous anatomy on the arterial and venous phase images. The sensitivity of detection of accessory renal veins, gonadal veins and lumbar veins was determined. Interobserver agreement was assessed using Cohen’s kappa.
Results: Both radiologists characterized renal venous anatomy variants correctly on arterial and venous phases. Circumaortic left renal vein (n=4) and retro aortic left renal vein (n=4). The sensitivity of detection of the accessory renal veins, right gonadal and left lumbar veins on arterial phase images was 97% each whereas that for left gonadal vein was 100%. Cohen’s kappa showed a substantial inter-observer agreement (kappa coefficient: 0.9; p<0.005).
Conclusion: The renal venous anatomy, including the detection of anatomic variations, can be assessed on arterial phase MDCT images alone in renal donors, excluding the venous phase from the protocol in renal donor evaluation.
COPING STRESS IN NEUROSURGERY OR
Authors: AMIR SOHAIL
Published: December 2024

ABSTRACT:
Stress is a natural aspect of life and can be characterized as mental, emotional, or bodily strain or tension. Humans need stress to perform at their best, but unnecessary, extended stress is eventually unsustainable and, over time, may cause an individual's mental and physical health to deteriorate. The neurosurgical operating room (OR) is a challenging workplace where the team typically cares for critically ill patients who are hemodynamically and neurologically unstable. In a neurosurgical operating room, where the surgeon works on the brain and different arteries and nerves nearby, operating room hours are also lengthy. The neuro-anesthesiologist is often alert and prepared to handle any emergency, which is unsettling and draining. Burnout can result from the delivery of critical care because it causes physical, psychological, and emotional weariness in the healthcare professional.
Frequency of Mortality in Children admitted with status Epilepticus in King Abdullah Teaching Hospital Mansehra
Authors: Ameena Saba  , Shaista Jalil  , Aneela Farhat  , Wafia Affan  , Wajeeha Amber  , Itrat Fatima
Published: December 2024

Objectives: To determine the frequency of in-hospital mortality in children admitted with convulsive status epilepticus and to analyze the relation of age, gender, seizure duration and etiology with mortality.  
Methodology:  This descriptive case series was conducted at Pediatric department of King Abdullah Teaching Hospital Mansehra from 1st September 2020 to 30th October 2021 after taking ethical approval from institutional ERC (ERC approval no. 2915/PED). Total 114 children aged 1-13 years diagnosed with status epilepticus were enrolled after taking informed consent from their caregivers. Their demographic features (age, gender, address, seizure duration, etiology and response to therapy) were recorded. The children were managed as per Canadian pediatric society guidelines. The final outcome, mortality and its associations were recorded on a proforma during a maximum of 14 days hospital stay.
Results: The overall mortality was 8.77%. The most common cause of status epilepticus was idiopathic status epilepticus (28.95%), followed by encephalitis (25.44%). The mean ±SD duration of seizures was 17.10±6.77 minutes with a range of 6-28 minutes. There was no statistically significant association between mortality and age, gender, cause of status epilepticus and duration of seizures (p > 0.05).
Conclusion: Status epilepticus is frequently encountered medical emergency in pediatric population with a diverse etiopathogenesis. Despite advances in medicine, the morbidity and mortality associated with status epilepticus still remain very high.
To Investigate the Frequency of Non-O Blood groups in Patients with Coronary Artery Disease ;A Cross Sectional Study
Authors: Muhammad Tahir Younas  , Sabeeha Yousaf  , Sana Younas  , Hira Niazi  , Asif Niaz
Published: December 2024

Objective: To investigate the frequency of non-O blood groups among coronary artery disease patients.
Methodology: A cross-sectional study in the inpatient clinical areas of the Department of Medicine was conducted at a large tertiary care hospital in Islamabad, Pakistan, from June to November 2021. A non-probability sampling technique was employed and the inclusion criteria included patients aged from 25-60 years and patients of coronary artery disease with greater than or equal to 25% narrowing in any of the epicardial vessels on coronary angiography.
Results: The total sample size was 111 in the present study. 85.6% of the study population were aged between 41-60 years, while a family history of coronary artery disease was present in 45.1% of patients. The most common blood group in the study population was the O blood group (36%) followed by those with blood group B (31.5%). 64% patients had a non-O blood group. On stratification age, gender and family history of coronary artery disease was not significant.
Conclusion: von Willebrand factor had been found to be in a higher level among non -O blood groups providing a possible explanation for the increased burden of coronary artery disease in this group.
Generalised Anxiety Disorder in Consultants versus Postgraduate Trainees in Tertiary care hospital, Peshawar
Authors: Shahzadi Saima Hussain  , Shandana Bawar  , Saida Abrar
Published: December 2024

Objective: To compare the frequency of anxiety in consultants versus post-graduate trainees.
Methodology:  A descriptive cross-sectional study was conducted at Medical Teaching Institute Lady Reading Hospital from September to November 2022, and ethical approval was obtained.  non-probability convenient sampling technique was used. In this study, 252 consultants and post-graduate trainees of all levels working in different specialties were included with their consent, house officers and nurses were not included in this study.  Data was collected regarding basic demographic features like age, gender, marital status, year of training/experience, and probable contributing factors to anxiety, and a 7-item anxiety scale (GAD-7) questionnaire was used. A total score of 8 was used to diagnose anxiety (cutoff values were used for the level of anxiety too). 
Results: In this study, out of 252 participants, the frequency of anxiety was 129 (51.19%) among trainees while among consultants it was 40 (15.87%). Among all participants, 152 (60.3%) were aged 20-30, and they were found to have moderate anxiety (GAD-7 score 10.38 ± 4.8) while the rest had a mild anxiety disorder, females were having moderate anxiety (GAD-7 score 11.72 ± 4.74) compared with mild anxiety disorder in males. Unmarried doctors showed moderate anxiety (GAD-7 score 10.14 ± 4.8) while married had a mild anxiety disorder.
Doctors in Obstetrics and Gynaecology were found to have the highest GAD-7 score 13.26 ± 4.6 followed by Ophthalmology and General Surgery. Unsatisfaction with duty hours, patient overload, shortage of equipment, and unsafe workplace were major contributing factors.
Conclusion: Generalized anxiety disorder is present in a significant number of our doctors, especially young postgraduate trainees. Large-scale studies are needed to identify the magnitude and effect of GAD on healthcare workers and remedial measures should be implemented.
Ophthalmoscopy is Way to Diagnosis
Authors: Noman Nargis , Zafar Danish , Faiza Akram  , Nighat Jamal
Published: December 2024

Objective: The aim of this study was to evaluate the basic knowledge and skills of doctors regarding ophthalmoscopy, working in tertiary care hospital, dealing mostly with patients having systemic diseases which can affect the retina.
Methodology: Quantitative cross sectional study was conducted in Ayub Teaching Hospital Abbottabad. Workshop has been conducted for medical post graduate trainees and few of the faculty members by ophthalmology department to promote learning of direct ophthalmoscopy and to create awareness about systemic diseases leading to retinal diseases. Pre workshop basic information about direct ophthalmoscopy was gathered through a questionnaire after obtaining consent of the participants. Data response was saved and evaluated in terms of percentages of responses. Excel sheet in SPSS version 25 were used to calculate the result. Percentages were calculated for every question evaluating ophthalmoscopy skill and need for making diagnosis.
Results: 46 participants attended the workshop 36 were male and 10 were female. 32 participants (69 %) agreed to have basic knowledge of ophthalmoscopy, but 65 % mentioned that they said that they can not perform distant direct ophthalmoscopy. In addition 61 % of participants responded that they can not perform near direct ophthalmoscopy and 71 % of participants responded with No option for focusing the disk. All these numbers suggest that direct ophthalmoscopy skills were not good enough for most of the participants. 90% of participants responded that they are not able to pick major pathologies e.g. DR and HTN.
Conclusion: Direct ophthalmoscopy is simple and important skill to be learned for improves clinical practices. This is much underused tool, which can help a lot to make diagnosis and manage accordingly in time. Every medical student should know the basic skills of ophthalmoscopy to make him/her a better future physician.  
Keywords: DR (diabetic retinopathy), HTN (Hypertension), DM (Diabetes mellitus), association of university professor in ophthalmology (AUPO)
Incidence of hepatitis C virus in chronic kidney disease patients on long term hemodialysis
Authors: Ahmad Armughan , Karmani Jais Kumar , Nadeem Muhammad , Arshad Naveed
Published: December 2024

Objectives: The objective of the study was to find the frequency of hepatitis C virus in patients with chronic kidney disease on long term hemodialysis and its associated factors.
Methodology: Descriptive cross-sectional study was done in Pakistan Institute of Medical Sciences (PIMS), department of Nephrology, from September to December 2021. All patients on regular hemodialysis aged more than 12 years, having at least 20 cycles of hemodialysis were included in the study by consecutive sampling. Qualitative detection of Anti-HCV antibodies was carried out/to detect hepatitis C-infection. A self-structured questionnaire was designed and all the data was entered on that questionnaire. Data was analyzed on SPSS version 25.
Results: Total 200 patients were enrolled in the study, and males were 121 (60.5%), females 79 (39.5%) and the mean age was 57.6±9.8 years. Out of 200 patients, 36% patients were seropositive for hepatitis C. It was significantly associated with duration of hemodialysis, surgery history and blood transfusion (p ≤ 0.05).
Conclusion: Hepatitis C virus prevalence is very high among patients on long term hemodialysis and it is associated with dialysis duration, surgery history and blood transfusion.
Bacteriological profiling of burn wound infections at the national burn care centre of Pakistan
Authors: Muhammad Rehan  , Tariq Iqbal  , Nimra Ghaffar  , Naima Komal  , Muhammad Shais Khan
Published: December 2024

Objective: Burn wound infection is the second most important cause of death in burn patients.  The current study goal was to assess the prevalence of burn wound infection including burn types and burn-related infections, in the national burn care centre.
Methodology: This was a prospective investigation of all burn patients (n=371) admitted to Burn Care Centre, Shaheed Zulfiqar Ali Bhutto Medical University, Pakistan Institute of Medical Sciences, Islamabad, Pakistan, between November 2021 to April 2022. Patients with less than 24 hours of hospital stay and those with incomplete records were excluded (n=23). Analysis was performed using a data-collection sheet to record demographic, microbiological, and burn data. No randomization was necessary as all patients were included. Results were deemed significant when the p-value was < 0.05.
Results: In total, 348 burn patients were included. The mean age was 17.81 years. The common burns were scald burns in the paediatrics age group while in the adult age group, flame burns were the most common. The mean total burned body surface area (TBSA) was 48.64%, while the mean length of stay in the hospital was 21.4 days for swab culture-positive patients while 13.6 for remaining individuals. The most common isolated organism was Pseudomonas aeruginosa (68.60%), followed by Klebsiella pneumoniae (32.55%), and Methicillin-resistant Staphylococcus aureus (16.27%).
Conclusion: Our burn patients were most commonly infected with P. aeruginosa.  Surveillance and management of these microorganisms must be instigated to reduce the rate of morbidity and mortality of burn patients with infections.
Indications, complications and outcomes of patients undergoing endoscopic retrograde cholangio pancreatography at Rawal institute of health sciences, Islamabad
Authors: Anwar Hussain Abbasi  , Aleena Shahid  , Hina Andaleeb  , Khawaja Ashfaq Ahmed  , Nadeem Yousuf
Published: December 2024

Objective: To explore indications, complications, and outcome of endoscopic retrograde cholangiopancreatography (ERCP) procedure in a tertiary care hospital.
Methodology: This retrospective study was conducted between July 2021 & December 2021 in the Department of Gastroenterology & Hepatology, Rawal Institute of Health Sciences, Islamabad. All the adult patients, male and female, undergoing ERCP procedure due to any indication were included in this study.
Results: The study was conducted on 900 patients and their mean age was 45±25 years. 567 (63%) females and 333 (37%) were males. Choledocholithiasis was most common indication (610, 68%) followed by malignant obstruction (115, 12.7%). The total rate of complication was 9% (81 patients). Acute pancreatitis most common complication (54, 6%). Overall success rate was 83.55%.
Conclusion: ERCP is considered safe and effective. Success rate and indications, as well as mortality and morbidity are acceptable.
Post-traumatic stress disorders and perceived social support in patients with burn injury: a study of pak italian modern burn center Multan
Authors: Muhammad Naveed  , Muhammad Anwar  , Zafar Iqbal
Published: December 2024

Background: Approximately 265,000 people each year lose their lives due to burns, making this a major public health concern worldwide. It is generally recognised that burn injuries are associated with higher rates of mortality and morbidity, but information on the mental health effects of these injuries are very limited.
Objective: The purpose of this research was to explore the pervasiveness of PTSD and the level of social support experienced by patients in who had suffered burn injuries.
Methodology: This cross-sectional research was conducted at Pak Italian Modern Burn Center Mutlan. Eighty burn injury patients were questioned using a specialised questionnaire that contained demographic questions as well as those from the Impact of Events Scale-Revised (IES-R) and the Multidimensional Scale of Perceived Social Support (MSPSS). Hundred people were included in the analysis; 70 were women and 30 were men. Many subjects reported high levels of ego resilience, high levels of perceived social support from friends and high level of PTSD scores. No noteworthy disparity found in the percentages of participants who described high levels of social support, total social support, or symptoms of arousal.
Results: Our results demonstrate a significant prevalence of PTSD symptoms and low levels of social support among the patients we studied who had sustained burn injuries. When these things occur, the patient's physical injury may worsen, which in turn slows down their mental and physical recovery.
Comparison of Effect of Prophylactic Aminophylline, Dexamethasone and Placebo in Prevention of Post Dural Puncture Headache
Authors: Sehrish Mehmood  , Yasmeen Afridi  , Farah Naz  , Rana Imran Sikandar  , Suresh Kumar  , Naheed Fatima
Published: December 2024

Objective: To compare the preventive effect of prophylactic aminophylline, dexamethasone and placebo in the prevention for postdural puncture headache in adult patients undergoing below umbilicus surgery.
Material and Methods: This randomized clinical trial was done at department of anesthesia and Critical care at PIMS hospital, Islamabad from January 2018 to June 2018. Adult cases of 18 -45 years of both genders undergoing below umbilicus surgery were included. All the patients were divided in 3 groups. Group A (Aminophylline) patients received 1.5 mg/kg of IV Aminophylline over 10 minutes, group B (Dexamethasone) patients received 0.1 mg/kg of IV Dexamethasone whereas group C (Placebo) patients received IV saline, 15 minutes before the end of the surgery. The frequency of post dural puncture headache along with complications of therapy was noted at 24 hours and 48 hours of surgery and compared in all three groups. Chi-square test was employed to compare the occurrence of PDPH in all three groups and P-value ≤0.05 was considered as significant.
Results: At 24 hours headache was present in 2% of patients in group A, 2% in group D and 10.8% of patients in group P. The frequency of headache was similar in group A and D, but was significantly lesser than placebo group (P = 0.003) at 2 hours.  At 48 hours no patient in group A reported headache while headache was present in 7.8% (n=8) of patients in group B and 12.7% (n=13) of patients in group C. The frequency of headache was significantly lesser in group A as compared to group B and C (P = 0.001).
Conclusions: Post-dural puncture headache observed to the significantly lesser in patients treated with Aminophylline and Dexamethasone compared to placebo group at 24 hours, while headache was significantly lesser in patients treated with Aminophylline as compared to Dexamethasone and Placebo group.