bluuebunny/crossref_metadata_2025 huggingface dataset:
A Rare Case Report: Hemodynamic Responses and Exercise Capacity Before and After Becoming a Non-Biological Live Liver Donor
Authors:   Department of Kinesiology, NC A&T SU, Greensboro, USA, Saghiv Moran Sciamama , K Thomas ,   Department of Exercise Physiology, University of Mary, Bismarck, ND, USA
Published: January 2021

Background: According to the United States Department of Health and Human services 8,497 liver transplants were accomplished in the United States in 2016. Of those transplants, only 345 (4.1%) of the transplants came from a live donor and only 9 (0.03%) of the live donor transplants came from a nonbiological paired donor [1]. Very little published data exists regarding Living Donor Liver Transplant (LDLT) influences on the live donor’s responses to exercise post-surgery. Purpose: To study the acute and prolonged effects of exercise and LDLT on heart rate, blood pressure, Lactate, Glucose, estimated maximal aerobic capacity, muscular strength, and the responses during submaximal exercise testing (6MWT and/or submaximal Bruce protocol). Methods: A single female subject, age 53 years, volunteered to participate in this study after already agreeing to become a live liver donor. Data was obtained once prior to the procedure and every month thereafter, for a total of eight months post-surgery. Conclusions: There was minimal changes in aerobic capacity and strength due to lack of consistency with an exercise program. Findings of this case report cannot be generalized to all LDLT donors. However, the information on the recovery of an LDLT donor in respect to exercise testing may be beneficial to clinicians and professionals in prescribing an exercise program for similar patients in similar circumstances.
Isolated Sinus Bradycardia as a Cardiac Manifestation of COVID -19
Authors:   Department of Internal Medicine, Medical Group, Riyadh, Saudi Arabia, Alruwaili Lubna , Al-Habib Sulaiman ,   Department of Internal Medicine, Medical Group, Riyadh, Saudi Arabia, Alnemer Khalid ,   Department of Internal Medicine, Al-Imam Mohammad Ibn Saud Islamic University, Cardiac science division, Riyadh, Saudi Arabia, Alamro Faisal Mohammed ,   Department of Internal Medicine, Riyadh, Saudi Arabia
Published: January 2021

Novel coronavirus-19 disease (COVID-19) is associated with significant cardiovascular morbidity and mortality. These two-case report suggest that transient sinus bradycardia is a possible manifestation of COVID-19 and an important for close surveillance [1]. These cases were presented with isolated symptomatic primary sinus bradycardia which was transient and disappear by the recovery of the COVID-19 infection.
Acute Myocardial Infarction in Young Adults: Prevalence, Clinical Background and In-Hospital Outcomes with Particular Reference to Socio-Economic Influences a Middle Eastern Tertiary Center Experience
Authors:   Zagazig university,Egypt, King Abdullah Medical City, Makkah, Saudia Arabia, Shalaby Ghada
Published: January 2021

Background: Acute myocardial infarction in young individuals can cause death and disability in early life and has serious consequences for the patients, their family causing an increased economic burden on health system. Identifying the risk factors for acute myocardial infarction in this group of people is necessary for risk factor modification and developing cost-effective secondary prevention strategies as young. The aim of this study was to determine the prevalence, clinical background and in-hospital outcome of AMI among young (age ≤45 years) adults and its socioeconomic burden. Results: All Acute myocardial infarction patients during the period from 2016-2019 were divided into two groups: young adults (age≤45) and older adults (age>45). Age data were available for 3081 patients admitted with acute myocardial infarction. Out of these 593 (19%) patients were young adults with mean age of 39±6.2 whilst 2488 (80.7%) were older adults with mean age of 60±9. Young adult Patients were more of male gender (92% vs 82%, p<0.001) more smoker (47% vs 30 %, p<0.001) and had more prevalence of obesity (BMI ≥30 34% vs 27%, p<0.001) but were less diabetics (43% vs 57%, p<0.001) and less hypertensive (35% vs 58 %, p<0.001).Young adult patients had higher level of LDL (120±47 vs. 112.9±41.6, P=0.02), total cholesterol (189.2±54.4 vs. 173.9±47.7, P<0.001) and triglycerides (157.7±104.4 vs. 126.6±91, P<0.001).Young adult patients had more extensive thrombus and frequently required thrombus aspiration (16 % vs. 11%, p=0.003) but less common left main disease (0.9% vs 4%, p<0.001) and 3 vessels disease (8% vs 18%, p<0.001). Young adult patients had less deterioration of left ventricular function (EF 42.4±10.4 vs. 41.1±10.6, P=0.04). There was highly significant negative correlation between left ventricular ejection fraction (LVEF) and age (P<0.001) but positive correlation between age and length of in hospital stay (p=0.02).In-hospital complications including pulmonary edema, cardiogenic shock, cardiac arrest and mortality were similar in the two groups. Age, female gender and diabetes were found to be the independent predictors for in-hospital mortality among our patients (P=0.003, 0.05 and 0.05 respectively)
The Effect of Various Fatty Acids on Activity of G6pase-A and Pdk4 in Hepg2 CellA
Authors:   Associate Professor Clinical Laboratory Science Department Winston-Salem State University 601 S Martin Luther King jr Drive Winston-Salem, NC 27110 336-750-8339, USA, Maness Lisa
Published: January 2021

Aims: The current study aimed to determine the effects of various fatty acids on the expression of glucose-6-phosphatase-α (G6Pase-α) and pyruvate dehydrogenase kinase 4 (PDK4). Methods: HepG2 cells were seeded in a 96-well plate with Dulbecco’s Modified Eagle Media, high glucose and bovine serum albumin with 25 µmoll of each fatty acid individually (butyric, politic, stearic, oleic, linoleic, linolenic, and arachidonic acids) for 24 hours at 37°C with and without 10 minute incubation of 100 nmol insulin. qPCR was performed using G6Pase-α and PDK4 primers; fold-changes in gene activity were determined. Results: Butyric (-2.0) and linoleic (-65.8) acids caused down regulations of G6Pase-α in the presence of insulin while linoleic (-96.6) acid caused a down regulation of PDK4 in the presence of insulin; all caused upregulations of both these genes in the absence of insulin. Conclusions: This study suggests that linolenic acid, which is present in soybeans, walnuts, and kiwi seeds, is beneficial to processing glucose and could increase insulin sensitivity through molecular influence in patients with metabolic syndrome or serve as prevention. Other fatty acids tested, with exception of butyric acid, did not show beneficial effects in the direction of decreasing glucose
Partial Orchiectomy: Towards the Demystification
Authors:   Urology Department Mohammed V Military Training Hospital, Mohammed V University Rabat, Morocco, M Tetou , A Slaoui ,   Urology B Department Ibn Sina Hospital Mohammed V University Rabat, Morocco, Y Boukhlifi ,   Urology Department Mohammed V Military Training Hospital, Mohammed V University Rabat, Morocco, M Tbouda ,   Department of Anatomical Pathology Mohammed V Military Training Hospital Mohammed V, University Rabat, Morocco, Y El Harrech ,   Urology Department Mohammed V Military Training Hospital, Mohammed V University Rabat, Morocco
Published: January 2021

Facing any testicular lesion one must practice a total orchiectomy. Or this principle has been the standard dogma for a long time, it is no longer today. However, the advancement of diagnostic and therapeutic means has highlighted conservative surgery over ablative surgery. In this paper, we report 2 clinical cases of 2 young men with testicular lesions in different contexts, and exposing our arguments and the difficulties faced during the course of care. We also share our results and also those reported in the literature.
The Role of Genetic Mutations in Gene LPIN2 in Majeed Syndrome
Authors:   Director of the Division of Medical Genetics and Molecular Optogenetic Research Medical Genetics-Harvard University, Asadi Shahin
Published: January 2021

Majeed syndrome is characterized by recurrent episodes of fever and inflammation in the bones and skin. The two main features of this condition are chronic recurrent multifocal osteomyelitis (CRMO) and congenital dyserythropoietic anemia (CDA). CRMO causes recurrent episodes of pain and joint swelling which can lead to complications such as slow growth and the development of joint deformities called contractures. CDA involves a shortage of red blood cells which can lead to fatigue (tiredness), weakness, pale skin, and shortness of breath. Most people with Majeed syndrome also develop inflammatory disorders of the skin, most often a condition known as Sweet syndrome. Majeed syndrome results from mutations in the LPIN2 gene. This condition is inherited in an autosomal recessive pattern
Ethno botanical of Medicinal Plants Conservation and Indigenous Knowledge for Utilization in Ethiopian Review
Authors:   Faculty of Agriculture and Environmental Sciences, Debre Tabor University, Debre Tabor, Ethiopia, Abera Melese Worku
Published: January 2021

Ethiopia is endowed with a huge potential of medicinal plants and their uses that make available extensive part to the treatment of human and livestock aliments. There was underprivileged employment and management of therapeutic undergrowth. Role of indigenous knowledge systems in the conservation of forest resources, that is extremely significant for medicinal plants willingness. Indigenous knowledge is the exceptional acquaintance restricted to a meticulous background or society. It is also acknowledged as home information, folk facts, working class understanding, long-established understanding, or long-established knowledge. This information is engendered and put out by community, more than time, in an exertion to muddle through with their own agro ecological and socio economic environment. It is generate through a methodical process of observe experimentation with explanation and readapting until that time recognized solution to customized ecological, socio-economic and technical situations. Home-based in sequence is conventional from generation to generation, more often than not by word of mouth and enlightening rituals, and has been the basis for agriculture, food groundwork and conservation, health care, education, and the wide range of other activities that maintain going at the social order and its background in countless parts of the world for many centuries. Indigenous information on traditional rules and regulations regarding sustainable management of medicinal forest resources should be well communicated, especially to the infancy and that administration should employ an incorporated approach within reach of that take into thoughtfulness technical and indigenous facts system to natural possessions organization. Traditional medicinal plants wrapped in strand fur area with group of people base preservation and inspiring the use of residence foundation for crop mounting of multitalented vegetation were required. Native populace and their community, and other restricted community, encompass a very significant position in management medicinal plants and expansion for the reason that of their facts and conventional practice
Nutraceutical Potential of Finger millet (Eleusine Coracana): Review
Authors:   Dayananda Sagar college of Engineering (Visvesvaraya Technological University), Kumarswamy layout, Bangalore India, 560078, Ramesh Vikil , Mathur Megha ,   Dayananda Sagar college of Engineering (Visvesvaraya Technological University), Kumarswamy layout, Bangalore India, 560078, S Kiran ,   Dayananda Sagar college of Engineering (Visvesvaraya Technological University), Kumarswamy layout, Bangalore India, 560078, N Rajeswari ,   Dayananda Sagar college of Engineering (Visvesvaraya Technological University), Kumarswamy layout, Bangalore India, 560078, Tidke Shashank A ,   Dayananda Sagar college of Engineering (Visvesvaraya Technological University), Kumarswamy layout, Bangalore India, 560078
Published: January 2021

Finger millet is gaining the status as an ingredient in the production of function food. It promotes eating enriched food that is closed to their natural state rather than taking dietary supplements. It is highly suitable as cereal grain in human diet. It has high nutritive values; it is non-glutinous, non-acidic and easy to digest. The contents like phytic acids and phytate makes it a versatile crop. Finger millet provides phosphorus which plays a vital role in the structural development of body cells and bones. It is also well balanced with Essential amino acids along with vitamin A and vitamin B. The utility of finger millet crop for food applications is set out. Its content of calcium and iron are also important from nutraceutical viewpoint. In addition the biotic properties of • Flavonoids, carotenoids, and polyphenols add worth to the formulation. In finger millets the polyphenols play an important role as an antioxidant. The important antioxidant which finger millet acquires are vitamin C, vitamin E and beta-carotene. Fermented finger millet food or ragi soups are a good source of nutrition. Patents filed for upheaval in products and operations have received popularity and gives assurance for the future of finger millet industry
Diagnosis of the Syndrome of Excessive Bacterial Growth of the Small Intestine in Patients with Bauhinia Insufficiency and After its Surgical Correction (First Results)
Authors:   Headquarters of the State Educational Establishment of the City of Nizhny Novgorod, Russia, Martynov Vladimir Leonidovich , Kazarina Natalia Vladimirovna ,   Headquarters of the State Educational Establishment of the City of Nizhny Novgorod, Russia
Published: January 2021

Objective: To determine the syndrome of excessive bacterial growth in the small intestine (SIBO) in patients with insufficiency of the bauhinia valve (NBZ) and after its surgical correction. Methods of examination: Patients of the studied groups were examined using direct and indirect methods of diagnosis of SIBO. Bacteriological examination of ileal aspirate and other surgical material was performed. All patients underwent a hydrogen respiratory test with a load of lactulose and performed a qualitative reaction of urine to indican. Characteristics of the material: 50 patients were examined, of which 30 were included in the main group, who underwent surgical correction of NBZ - Bauginoplasty; 20 patients are included in the control group in which the ileocecal valve is consistent. Patients of the main group were examined before surgery and on the 7th and 45th day after Bauhinoplasty. Main results: All patients of the main group had SIBS of varying severity, in 80% of patients SIBS was localized in the distal small intestine. Patients with normal function of ileocecal valve syndrome of excessive bacterial growth did not suffer. Intraoperatively, 76% of patients showed signs of mesenteric mesentery of the small intestine, and the fact of bacterial translocation in SIBO was also confirmed. After 7 days after surgical correction of the Bauhinia valve, the normalization of peak and background excretion of hydrogen was observed in 37% of patients. For 45 days in all patients the hydrogen curve corresponded to the norm. Conclusions: the deficiency of the bauhinia valve is obligately accompanied by the syndrome of excessive bacterial growth in the small intestine, surgical correction is an effective method for correcting the syndrome of excessive bacterial growth in patients with NBD.
Post-transplant Lymphoproliferative Disorders: Single Center Case Series and Literature Review
Authors:   Adult Hematology & HSCT divisions, Oncology Department of Oncology. King Abdul-Aziz Medical City. Riyadh. KSA, Altamimi Sumayyah , Al Shuaibi Mohamed ,   Adult Hematology & HSCT divisions, Oncology Department of Oncology. King Abdul-Aziz Medical City. Riyadh. KSA, Alnahdi Mohamed ,   Adult Hematology & HSCT divisions, Oncology Department of Oncology. King Abdul-Aziz Medical City. Riyadh. KSA, Altheaby Abdulrahman ,   Organ Transplant Centre and Hepatobiliary Sciences Department, King Abdul-Aziz Medical City. Riyadh. KSA, Almutairi Hanouf ,   Nephrology Section, Internal Medicine Department, King Abdul-Aziz Medical City. Riyadh. KSA
Published: January 2021

Post-transplant lymphoproliferative disorders (PTLD) are referred to lymphoid and/or plasmacytic proliferation which occur as result of immunosuppression therapy in patient underwent solid organ or allogeneic hematopoietic stem cell transplantation. Among solid organ transplant recipients, it accounts approximately 20% of all cancers. Epstein-Barr virus (EBV) has been linked to the pathogenesis of PTLD when EBV was identified in the tumor biopsies. In most affected patients, PTLD occurs as a result of proliferation of EBV positive B cell following immunosuppression and impaired Tcell immune activity. EBV negative PTLD has been documented but no clear etiology has been confirmed, however theories of previous exposure to EBV which is completely cleared at the time of PTLD is diagnosed, different viruses or chronic antigenic stimulation all been considered as provoking factors for tumor development. Clinical symptomatology at presentation of patients with PTLD is usually indistinct from de novo lymphoproliferative disorders and chemotherapy protocols in this group of patients are generally similar to the standard of care of lymphoma treatment according to the subtype in addition to cessation or dose reduction of immunosuppressive therapy. We report our experience and outcome analysis in PTLD management among 23 patients from our institution treated between 2011 and 2019.
Effects of Aqueous Extract of Neem Leaves (Azadirachta indica) on Light Microscopic Features of Hepatic Lobule of Adult Albino Rats
Authors: Mudassir Sitwat
Published: January 2021

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Frequency of Surgical Site Infection after Emergency Abdominal Surgeries; an Audit of 200 Cases at a Tertiary Care Unit
Authors: Ghous Fareeha
Published: January 2021

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Outcome of Laparoscopic Appendicectomy and Assessment of the Learning Curve
Authors: Ahmad Farooq
Published: January 2021

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Choose Well, Cut Well and Get Well Living Donor Liver Transplants
Authors: Naz Sumbul
Published: January 2021

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Correlation of Serum Calcium and Magnesium with Preeclampsia
Authors: Haleema Sadia
Published: January 2021

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Morphological & Biochemical Effects of Aqueous Extract of Neem (Azadirachta indica) on Liver of Adult Albino Rats
Authors: Mudassir Sitwat
Published: January 2021

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Comparative Study of Uncaria tomentosa Leaves & Bark Extracts on Lung Smooth Muscle Hyper Responsiveness in a Mouse Model
Authors: Saghir Gulpash
Published: January 2021

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Effects of Ficus carica Leaf & Fruit Extracts on Cardiac Enzymes in Doxorubicin Induced Cardiotoxicity
Authors: Awan Sadia Maqsood
Published: January 2021

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Demographic Distribution and Staging at Presentation of Patients Presenting with Obstructive Jaundice of Malignant Origin at Tertiary Care Level in Pakistan
Authors: Salim Adnan
Published: January 2021

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Comparative Anti-Arthritic Study of Cassia fistula with Naproxen in Rheumatoid Arthritis Murine Model
Authors: Farooq Hassan
Published: January 2021

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Lens Extraction for Primary Angle Closure Glaucoma. A Case Series
Authors: Amir Muhammad Mateen
Published: January 2021

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Comparison of Vitamin D Levels in Obese and Normal-BMI Individuals
Authors: Al-Aqmer Noora Hassan Hezam
Published: January 2021

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Prophylactic Role of Curcumin against Aspirin Induced Congestion of Blood Vessels in Kidneys of Adult Female Albino Rats
Authors: Amjad Saba
Published: January 2021

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Comparative Study of Serum Magnesium and Lipid Profile in Normal Weight, Over-Weight and Obese Young Adult Males
Authors: Iqbal Sabiha
Published: January 2021

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Barriers Towards Research Among Medical Students
Authors: Khan Paras
Published: January 2021

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Comparison of Rate of Port Site Wound Infection in Patients Undergoing Arthroscopy Port Closure by Stitch Versus Steri-Strips
Authors: Khan Zeeshan Ali
Published: January 2021

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Treatment of High Fat Diet-Induced Hyperhomocysteinemia with Pyridoxine, Cinnamon and Pitavastatin in Young Male Albino Rats
Authors: Mansoor Maryam
Published: January 2021

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The Spectrum of Cerebral Venous Thrombosis Presenting at a Tertiary Care Centre: A Case Series
Authors: Ussaid Ahmad
Published: January 2021

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Splenogonadal Fusion, Rare Cause of Scrotal Mass in Children A Case Report
Authors: Sheikh Muhammad Ali
Published: January 2021

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Prophylactic role of curcumin against tubular astrophy caused by aspirin in kidneys of adult albino female rats
Authors: Ahmad Saba
Published: January 2021

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National nutrition survey of Pakistan, 2011 A critical appraisal
Authors: Tanveer Afifa
Published: January 2021

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Protective effects of Ajwa fruits on nicotine induced changes in rat body and ovarian weight with relative tissue weight index
Authors: Rauf Faeza
Published: January 2021

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Histopathological Evaluation of GastroHepatoprotective Effect of Cassia fistula versus
Naproxen in Rat Model of Rheumatoid Arthritis
Authors: Farooq Hassan
Published: January 2021

Introduction: Rheumatoid arthritis (RA) is a debilitating disease leading to incapacitation and deformity due
to side effects of anti arthritic drugs and chronic need to use these drugs, patients often switch to and prefer
phytotherapy. Aims & Objectives: The present study was the histopathological evaluation of gastrohepatoprotective effect of Cassia fistula compared to naproxen in rheumatoid arthritis murine model. Place
and duration of study: This three month study was conducted at the Animal House, University of Veterinary
and Animal Sciences, Lahore. Material & Methods: Ninety six male rats were randomly sorted into 12
groups (n=8). CFA injection (0.2 ml) was administered in the right hind paw of all groups except Group 1
(negative control). Group 2 (positive control) and groups 3-7 (prophylactic groups) were administered orally
BD on 3 consecutive days 1,2 &3, naproxen (25mg/kg), anthraquinone (250mg/kg and 500mg/kg) and
methanolic (250mg/kg and 500mg/kg) extracts of Cassia fistula respectively, the first dose given 30min prior
to CFA injection .Groups 8-12 (therapeutic groups) were given naproxen, anthraquinone and methanolic
extracts orally BD respectively in the same doses on 3 consecutive days 9, 10 and 11. On Day 15,
histopathology of stomach & liver was done. Results: Oral anthraquinone and methanolic extracts of Cassia
fistula 500mg/kg vs 250mg/kg BD, in prophylactic groups normalized histology of gastric and liver tissue
more as compared to the therapeutic groups and to naproxen gastrohepatic damage . Conclusion: Cassia
fistula anthraquinone and methanolic extracts exhibited greater prophylactic than therapeutic, dose dependent
gastrohepatoprotection as compared to naproxen damage to these organs in the CFA rheumatoid arthritis rat
model.
Key words: Cassia fistula, Complete Freund’s Adjuvant (CFA), naproxen, gastrohepatoprotective
Hepatoprotective Effect of Ajwa Date Seed and
Simvastatin in Non Alcoholic Fatty Liver Disease
(NAFLD) Murine Model of Butter Fed Dyslipidemia
Authors: Sultan Farooq
Published: January 2021

Introduction: Non-alcoholic fatty liver disease (NAFLD) is a dangerous complication of hyperlipidemia
which may lead to life threatening hepatitis and hepatic cirrhosis. Internationally, Prevalence of non-alcoholic
fatty liver disease (NAFLD) is 20% in general population while 75% in the obese population of USA.1 Side
effects of allopathic drugs have led the research towards natural products to find out their potential for
treatment of NAFLD. Aims & Objectives: Aim of this study was evaluation of hepatoprotective effects of
Ajwa date seed and Simvastatin against NAFLD. Place and duration of study: Study was conducted at
animal house of UHS, Lahore and completed in 6 months. Material & Methods: 40 rats were procured and
segregated into 5 groups with 8 rats in each group. Group 1 was healthy control and group 2 was disease
control. Group 3, 4 and 5 were administered Simvastatin 10mg/kg/day, aqueous Ajwa date seed extract
(ADSE) 8ml/kg/day and combination of Simvastatin 5mg/kg/day and aqueous ADSE 4ml/kg/day
respectively. Total study duration was 36 days. First 15 days were for induction of hyperlipidemia while
treatment was given for remaining 21 days. Serum total cholesterol (TC), triglycerides (TG) and liver
functions tests (Serum ALT, AST and ALP) were performed at day 0, 15 and 36 of study. Data was entered
on SPSS 23.0 software and analyzed by one way ANOVA and post hoc tuckey’s tests. P-value of less than
0.05 was considered significant. Results: Aqueous Ajwa date seed extract (ADSE), Simvastatin and their
combination showed significant TC and TG lowering and hepatoprotective effects against NAFLD. However,
individual drugs were more effective than the combination. Conclusion: Ajwa date seed can be used for the
treatment of NAFLD.
Key words: Ajwa date seed, Hyperlipidemia, Simvastatin
Facial and Hand Scars Appearance after Autologous Nanofat Grafting in Patients with Post Burn Scars
Authors: Rafique Mirza Muhammad Ali
Published: January 2021

Introduction: Management of unsightly post -burn scars has changed tremendously in current era of cosmetic awareness. 5-12% of all worldwide injuries are burn injuries and approximately 11 million patients need hospital care. Multiple treatment methods for scar improvement including fat grafting are under investigation. Nano fat Grafting is newer modality of fat grafting for improving scar quality.

Aims & Objectives: The aim of this study was to assess the outcome of facial and hand scars appearance after autologous Nanofat grafting in patients with post burn scars.

Place and duration of study: The study was performed in Plastic Surgery Department of Shaikh Zayed hospital, Lahore Pakistan from October 2018 to September 2019.

Material & Methods: 30 patients with post-burn scars of face and hands were included; age range was 18 to 43 years. Skin type 2 to 4 (Fitzpatrick skin type) . Patients with skin graft, hypertrophic scars, contractures, or keloids were excluded. Scars were assessed by the patients and observer on a scale “POSAS” (Patient and Observer Scar Assessment Scale), the observer was a plastic surgeon. Scar was assessed before surgery using the POSAS scar scale. Fat was taken from the abdomen using 3mm cannulas with side holes of 1- 2mm under tumescent conditions and transferred to 10 cc syringes with luer-lock. Nano fat obtained after emulsification by passing 30 times from one syringe to another through luer-lock. The follow up was on 7th day, at 3 months and at 6 months.

Results: The mean POSAS score of observer decreased significantly from admission 35.8±4.0, at 3 months 31.3± 3.8 and 6 months to 27.5± 3.0, p value < 0.05. The mean POSAS score of patients also significantly decreased, p value < 0.05 over the same time period from admission at 42.4±5.2, to 3 month 37.3±4.0 and 6 month to 32.2±3.2.

Conclusion: Nano fat grafting results in improvement in scar appearance and is an effective approach towards the management post burn scar of face and hands.
Correlation of HER-2/neu Status with Estrogen (ER) & Progesterone (PR) Receptor in Breast Malignancies
Authors: Rasheed Asma
Published: January 2021

Introduction: Prognosis and management of breast cancer are influenced by the classic variables such as histologic type and grade, tumor size, lymph node status, status of hormonal receptors- i.e. estrogen receptor (ER) and progesterone receptor (PR) of the tumor, and, more recently, HER-2/neu (Human Epidermal Growth factor Receptor-2) overexpression. Expression levels of the estrogen, progesterone and HER2/neu receptors which characterize clinically distinct breast tumours have been shown to change during disease progression and in response to systemic therapies. The interrelationship of ER, PR, and HER -2 has come to have a crucial role in the management of breast cancer.

Aims & Objectives: To determine the ER, PR and HER2/neu status in breast malignancies.

Place and duration of study: The study was conducted at Department of Histopathology, Federal Postgraduate Medical Institute, Shaikh Zayed Hospital Lahore, for the period of Six months.

Material & Methods: 30 samples of diagnosed breast cancer were included in study. Formalin fixed paraffin embedded wax block were taken for immunohistochemical staining of ER, PR & HER-2/neu.

Results: Out of 30 cases, racially 29 were Punjabi and 1 was Pakhtun. There were 23 mastectomy samples and 7 needle core biopsies. Out of 30 cases, 29 were Infiltrating Ductal Carcinoma. Grade I, II, III 13.3%, 66. 7% and 20% respectively and only one case was of Carcinosarcoma (p<0.01). Overall immunoexpression for ER, PR and HER-2/neu were 33.3% (p<0.01), 56.7% (p<0.05) and 73.3% respectively. Triple positive (TP) cases were 23.3% and triple negative (TN) were 10 %. Regarding ER expression in infiltrating ductal carcinoma, 63.3% were ER negative and 33.3% were ER positive and comparison was statistically highly significant (p<0.01) .PR expression in infiltrating ductal carcinoma showed 56.7% PR positive and 40% PR negative which was statistically significant (p<0.05).There is negative correlation of HER-2/neu positive and ER positive and positive correlation of HER-2/neu positive and PR positive cases.

Conclusion: There is inverse correlation of HER-2/neu positive and ER positive and positive correlation of HER-2/neu positive and PR positive cases.
The Potential Role of ACEi and ARBs in COVID-19; A Perspective
Authors: Hassan Ahmad Hammad
Published: January 2021

ABSTRACT. COVID-19 pandemic has caused significant morbidity and mortality around the world. The disease severity ranges from mild upper respiratory infection to severe lower respiratory and cardiac illness. Acute respiratory distress syndrome (ARDS) is the most serious complication and results in diffuse inflammatory alveolar damage, respiratory failure, and death. Components of the Renin -Angiotensin-Aldosterone -System (RAAS) are involved in an inflammatory reaction in the lungs. Various studies have shown that blocking RAAS peptides in the lungs especially angiotensin-converting enzyme (ACE) and type-1 angiotensin receptor (ATR1) reduces lung injury, improves respiratory function and is associated with better clinical outcomes in the COVID-19 patients. We suggest that angiotensin-converting enzyme inhibitors (ACEi) and angiotensin receptor blockers (ARBs) – drugs that block RAAS peptides – be considered for a repurposed use in COVID-19 induced lung injury.
Self Medication and Associated Health Care Seeking Amongst Mothers of Children Aged Under 5 with Diarrhea and Respiratory Tract Infections in an Urban Slum
Authors: Sarwar Rabbiya
Published: January 2021

Introduction: Self-medication practice in childhood illnesses is quite common in developing countries. Self-medication practices are found to be influencing healthcare seeking behavior in developing countries.

Aims & Objectives: To assess self-medication practices and its association with health care seeking in mothers of children aged under 5 with diarrheal and respiratory illness episodes residing in an urban slum.

Place and duration of study: A cross-sectional analytical study conducted in Samsani-khui, an urban slum in district Lahore, from September 2016- February 2017.

Material & Methods: 422 mother-child units (only one child aged under 5 years) were recruited through systematic random sampling. Responses were recorded on a structured, self-constructed questionnaire about self-medication practices of mothers for the selected child during last 6 months in acute episodes of diarrhea or respiratory illness. Data was entered and analyzed on SPSS version 21. Fisher’s exact test was applied.

Results: Mean age of mothers was 26.81 ± 4.744 years, 16% were illiterate, 44.3% had attained primary education and 92.65% were housewives. 70.62% children included in study were boys. 61.8% mothers never practiced self-medication in their child whereas 38.2% administered medicines occasionally, frequently or every time the child got ill. 92.5% of the mothers practicing self-medication admitted that self-medication is responsible for delay in health care seeking. Out of these mothers, 59% sought formal health care without delay for their child suffering from diarrhea or RTI during last 6 months. 70.8% children recovered completely after practicing self-medication, as reported by mothers. While 23.0% reported late recovery, 3.1% reported complications and 3.1% reported hospitalization after self-medication. A highly significant association was found between practice of self-medication and health care seeking behavior (p=.001).

Conclusion: Practice of self-medication is present in one third of mothers of low income, literacy poor families. Mothers of this stratum showed poor perception about self-medication and as well as treatment delay. Self-medication practice strongly affects health care seeking behavior.
Initial Experience with Laparoscopic Nephrectomy at Services Hospital Lahore
Authors: Farooq Muhammad
Published: January 2021

Introduction: Nephrectomy means removal of kidney. Laparoscopic nephrectomy is an effective way to remove a diseased or cancerous kidney. Nephrectomy is performed to treat malignant or benign tumors of the kidney and symptomatic non functioning kidney. Laparoscopic nephrectomy is performed through transperitoneal or retroperitoneal approach.

Aims & Objectives: To determine the initial experience of laparoscopic nephrectomy.

Place and duration of study: Department of Urology, Services Hospital, Lahore from 1st January 2018 to 30th June 2019.

Material & Methods: A total of 50 patients who underwent laparoscopic nephrectomy were included. The demographic data like age, gender, site of operation, operative time, conversion rates, postoperative complications and postoperative hospital stay were recorded. Data was analyzed using SPSS 20.0 and reported as mean± s.d, frequencies and percentages.

Results: There were 28 (56%) female patients and 22 (44%) male patients. Six (12%) patients were ages <25 years, 20 (40%) were ages 25 to 40 years, 18 (36%) were ages 41 to 55 years and 6 (12%) were ages above 55 years. Non-functional kidney due to stone disease was the most common indication 35 (70%). Mean operative time was 170.43+8.45 minutes. Conversion rate was in 1 (2%) patients. Mean hospital stay was 4.32+1.45 days.

Conclusion: It is concluded from this study that laparoscopic nephrectomy is safe and better technique with very low rate of complications.
Small Group Discussion; Medical Students Perspective
Authors: Humayun Lubna
Published: January 2021

Introduction: Small group discussion teaching is a key instructional strategy being incorporated in medical education and is aimed at enhancing the personal, social and cognitive skills of students. Learning in small groups helps the students to enhance the acquisition, processing and retention of the medical knowledge.

Aims & Objectives: To assess medical student’s perception about small group discussion at a medical college.

Place and duration of study: September 2019 at the University College of Medicine and Dentistry, University of Lahore.

Material & Methods: This cross- sectional survey was conducted during September 2019 at University College of Medicine and Dentistry, University of Lahore. Convenient sampling technique was used to obtain a sample of 322 students from the first three years of MBBS. A pre validated questionnaire was distributed and the students were asked to record their experience about small group discussion using a 5-point Likert scale. Data was analyzed by using SPSS22 and reported as percentage distribution and mean± s.d.

Results: Regarding quality of these small group discussion sessions, 25.8% of the students appeared satisfied, 24.8% of the students were neutral, whereas, 49.4% of the students remained unsatisfied. When asked about being clear of their role in a SGD session, 55.9% of the students agreed, 22.7% were unclear and 21.4% neutral. As regards the benefits from small group sessions, majority (35.1%) agreed that activities taught lifelong learning, 8.7% strongly agreed. 27% remained neutral with 16.5% disagreeing and 12.75% strongly disagreeing. With reference to assessment of tutors, majority of students found SGD facilitators enthusiastic about process with 13.4% strongly agreeing and 36.3% agreeing, 28% stayed neutral while 9.6% disagreed and 12.75% strongly disagreed. Majority of students, (35.1% agreed, 13.4% strongly agreed) to that tutors just gave mini lecture, 27.6% responded neutral to statement while 11.2% disagreeing and 12.7% strongly disagreeing to the enquiry.

Conclusion: The study reveals that majority of the students are clear about their role in small group discussion sessions and majority (35.1%) also agreed that activities taught them lifelong learning. Tutors are helpful and enthusiastic, however, they provide plenty of information and need retraining for conducting a small group learning session.
Chances of Pneumothorax and Malpositioning of Central Venous Catheters in Internal Jugular Vein Versus Subclavian Vein Routes
Authors: Saeed Riffat
Published: January 2021

Introduction: Central venous catheterization (CVC) is being done all over the world. It has specific indications and should be reserved for the patient who has the potential to benefit from it. Catheter related infections are an important cause of morbidity and mortality worldwide. All complications and side effects are dependent on vascular access route. International data shows malpositioning and pneumothorax related to malpositioning to be the most common complications of central venous cannulation. However there is paucity of local data regarding which of the two, IJV or SCV routes are more prone to develop these complications.

Aims & Objectives: To compare the incidence of pneumothorax and malpositioning with internal jugular vein (IJV) and subclavian vein (SCV) routes of central venous catheters.

Place and duration of study: This randomized control trial was conducted at Department of Anesthesia, Shaikh Zayed Hospital, Lahore, from 8-12-2014 to 7-6-2015.

Material & Methods: The non-probability purposive sampling technique was used in this study. After the approval of Hospital Ethical Committee, 290 patients were included in this study and informed consent was obtained. Demographic profile was also obtained. Patients were randomly divided in two groups by using lottery method. In Group A, CVC was inserted through internal jugular vein while in Group B, CVC was inserted through subclavian vein. During the procedure, malpositioning and pneumothorax were monitored immediately and after 36 hours and were labeled. Patients were shifted to the ward after procedure and were followed-up there. During first 36 hours, chest x-ray for placement of tip of catheter and development of pneumothorax was carried out. Chi-square was used to compare complications in both groups taking p value <0.05 as significant.

Results: Malposition was found in 18 cases, (6 from IJV group and 12 from SCV group) (p-value 0.144). Pneumothorax was seen in 12 cases (3 from IJV and 9 from SCV group) (p-value 0.077).

Conclusion: Our study results concluded that IJV showed fewer incidences of pneumothorax and malpositioning than SCV technique. However, the difference was not statistically significant.
A Detailed Study of Antimicrobial Sensitivity Pattern of Penton Valentine Leucocidin Gene Positive and Negative Staphylococcus aureus from Pus Samples
Authors: Izhar Mateen
Published: January 2021

Introduction: Staphylococcus aureus harboring Panton Valentine Leucocidin gene are emerging and spreading worldwide. PVL gene was first identified by Noel Panton and Francis Valentine in 1932 who IC Pakistan only limited data is available regarding the effect of PVL gene on sensitivity pattern of Staphylococcus aureus. Therefore, this study was conducted to understand the antimicrobial sensitivity pattern of both PVL positive and negative Staphylococcus aureus isolates.

Aims & Objectives: This study was conducted to understand the antimicrobial sensitivity pattern of both PVL positive and PVL negative Staphylococcus aureus isolated from pus samples received from various indoor and outdoor departments of a tertiary care hospital of Lahore.

Place and duration of study: Microbiology and Molecular Biology Laboratory Shaikh Zayed Hospital Lahore. Duration of study is one year after the approval of research topic.

Material & Methods: A total of 384 Staphylococcus aureus isolates from skin and soft tissue infections were identified and selected. Their antimicrobial sensitivity testing was done by Kirby disc diffusion method using Muller Hinton agar.

Results: Frequencies of PVL gene in MRSA and MSSA were 51% and 44% respectively. Frequency of PVL gene was also found to be high in Ciprofloxacin sensitive, Gentamicin sensitive, Erythromycin resistant and fusidic acid resistant isolates.

Conclusion: Almost half of Staphylococcus aureus isolates were found PVL positive. They were mostly multidrug resistant. The PVL positive Staphylococcus aureus isolates showed high resistance against antibiotics than PVL negative isolates
Role of Prophylactic Dimenhydrinate Versus Ondansetron as an Adjunct to Dexamethasone on Post-Operative Nausea and Vomiting in Laparoscopic Abdominal Procedures
Authors: Niazi Aaifa Khalid
Published: January 2021

Introduction: Post-operative nausea and vomiting (PONV) is a common complication in patients undergoing surgery. Anti-emetic prophylaxis is recommended for all high risk patients. Combination therapy is considered superior to single dose prophylaxis however its efficacy in varied laparoscopic abdominal surgical situations has not been investigated.

Aims & Objectives: To compare the post-operative nausea and vomiting with Dimenhydrinate plus Dexamethasone versus Ondansetron plus Dexamethasone in patients following laparoscopic abdominal procedures.

Place and duration of study: Operation Theatre, Shaikh Zayed Hospital Lahore, for one year (1st April 2015 – 31st March 2016).

Material & Methods: 464 patients were placed in two groups of 232 each. Group A received prophylaxis with Dexamethasone 8 mg I/V + Dimenhydrinate 50mg I/V and Group B received prophylaxis with Dexamethasone 8 mg I/V + Ondansetron 4 mg I/V. Efficacy was judged with absence of nausea and vomiting in first 24 hours after surgery. Data was analyzed in SPSS version 27.

Results: The frequency of nausea was 6% with Dimenhydrinate while was 9% with ondansetron. Similarly, vomiting was 18% vs. 24% respectively. The efficacy of Dimenhydrinate was 88% while and Ondansetron achieved efficacy in 65% cases, which was statistically significant (p<0.05).

Conclusion: The combination Dexamethasone & Dimenhydrinate was more efficacious in preventing PONV than the combination Dexamethasone & Ondansetron
Взаимосвязь между полиморфизмом LYS198ASР гена Эндотелин-1 и хронической обструктивной болезнью легких у пациентов узбекской популяции
Authors: Абдуганиева Э.А. , Ливерко И.В. , Бобоев А.Т.
Published: January 2021

В статье с целью выявления роли мутаций и полиморфизмов гена эндотелина-1 Lys198Asn в развитии ХОБЛ авторами были исследованы 49 пациента с установленным диагнозом ХОБЛ. Группу контроля составили 46 практически здоровых пациента, сопоставимых с основной группой по возрасту и полу. Исследование мутаций и полиморфизма гена эндотелина-1 Lys198Asn проводилось методом ПЦР, статистический анализ проводился с использованием статистических программ “ОpenEpi,Version 2,9”. В результате обнаружено что гетерозиготный генотип Lys/Asp гена эндотелина-1 Lys198Asn встречался в группе ХОБЛ в 1,25 раза чаще по сравнению с группой контроля. Установлено, что мутационный генотип Asp/Asp – встречался в группе ХОБЛ в 1,9 раза чаще в сравнении с группой контроля (RR 1,9, OR – 2,3; χ2=0,4), что опосредованно показывает значимость изменений данного гена в  развитии ХОБЛ, так и ее течении. Оценено влияние наличия генотипической предраположенности к дисфункции эндотелия с ее фенотипическими проявлениями.
Evaluación de la relación de los signos y síntomas durante el período de erupción de los dientes primarios
Authors: Bastos de Holanda Teixeira Rangel , Gonçalves Ferreira do Amaral Lorena de Alencar , Romão Dayse Andrade , Alencar Nemezio Mariana
Published: January 2021

Introducción: La erupción dentaria es un proceso fisiológico que consiste en la migración del diente de su posición intraósea en la mandíbula o el maxilar hacia la cavidad bucal. Se asocia a algunos signos y síntomas como irritabilidad, irritación gingival, aumento de la salivación, sueño agitado, diarrea, pérdida de apetito y fiebre. Objetivo: Evaluar si las madres relatan la presencia de signos y síntomas durante la erupción de los dientes primarios y si las actitudes tomadas por los responsables en relación a la sintomatología interfieren en la condición del niño. Materiales y Métodos: Se recogieron datos de niños (n=50) entre 5 y 24 meses de edad. Los signos y síntomas observados por las madres durante la Originalerupción de los dientes primarios y las actitudes tomadas por los responsables en relación a la sintomatología, fueron evaluados por medio de cuestionario. Resultados: La prueba de Chi-cuadrado (0,010) reveló haber asociación de las signos y síntomas con la emergencia de los dientes primarios. Para actitudes tomadas por los responsables en relación a la sintomatología, la prueba del Chi-cuadrado fue de 0,009 mostrando una influencia significativa en la muestra. Conclusión: Se puede afirmar que las madres relatan la aparición de signos y síntomas durante la emergencia de los dientes primarios y actitudes tomadas por los responsables en relación a la sintomatología contribuyen a mejorar la condición de los niños.
RELIEF IN THE ENVIRONMENTAL ANALYSIS OF THE COREAÚ RIVER HYDROGRAPHIC BASIN, CEARÁ, BRAZIL/O RELEVO NA ANÁLISE AMBIENTAL DA BACIA HIDROGRÁFICA DO RIO COREAÚ, CEARÁ, BRASIL
Authors: VIEIRA TORRES MARCELIA , FALCÃO SOBRINHO JOSÉ
Published: January 2021

Esse artigo constitui uma das etapas do projeto de pesquisa que trata da bacia hidrográfica do Rio Coreaú, localizado no Estado do Ceará, Brasil. Na oportunidade, abordaremos as características naturais da área objeto de estudo, enquanto elementos norteadores para as atividades humanas. Isto posto, o relevo é uma base para as discussões elucidadas. O amparo teórico e metodológico recai no entendimento da natureza de forma sistêmica e integradora dos elementos do ambiente. Na oportunidade foi possível identificar as particularidades de cada ambiente geomorfológico e, estes incidindo na dinâmica etransformação das unidades ambientais.
Uso de los videojuegos en básica primaria: una revisión sistemática
Authors:   Universidad de La Sabana. Colombia, MENDEZ Maribel , BOUDE Oscar ,   Universidad de La Sabana. Colombia
Published: January 2021

Se muestra los resultados de una investigación desarrollada en la Universidad de La Sabana, con el objetivo de identificar los usos que se han dado a los videojuegos en educación primaria en el mundo. Se realizó una revisión sistemática de literatura publicada en revistas científicas entre el 2000 y 2019. Los resultados muestran que el área de mayor uso de videojuegos son las ciencias naturales, y que su uso favorece la interacción y la innovación de las prácticas educativas.
Contribution of the implementation of an alternative teaching model in the teaching of mathematics: solving arithmetic problems in primary basics
Authors:   Metropolitan University of Education, Science and Technology, Panama, SALAZAR Carlos A. , CANTILLO Cristina I. ,   Metropolitan University of Education, Science and Technology, Panama, MUÑOZ H. ,   Metropolitan University of Education, Science and Technology, Panama
Published: January 2021

This article is the product of the research process carried out within the framework of doctoral thesis research entitled, "Alternative teaching model for the resolution of arithmetic problems in primary basic". Which seeks to provide the education system with a new alternative composed of a series of consecutive steps, with the general objective of "Strengthening the basic mathematical competencies of primary school students through a teaching model that facilitates the resolution of arithmetic problems".