bluuebunny/crossref_metadata_2025 huggingface dataset:
The Factors Affecting Exports of Gum Talha after changing the Gum Arabic Specifications in 1998 Using ARDL Model
Authors: Hassan Elnasikh Sara
Published: October 2022

This research aimed to identify the most important factors affecting the exports of gum Talha after changes in gum arabic specifications in 1998. Secondary data covered the period 1999-2018 was used. A co-integration analysis is performed using the autoregressive distributed lag (ARDL) bounds test approach. The study demonstrated the significant long-run relationship between exports of gum Talha and gum Talha FOB with an elasticity of (-1.67),  gum Hashab’s FOB with an elasticity of (1.33) and lagged exports of gum Hashab with an elasticity of (1.34). Also, it demonstrated the significant short-run relationship between exports of gum Talha and gum Talha FOB (-0.96), gum Hashab FOB (.75), lagged exports of gum Hashab (0.14) and abolishment of monopoly using dummy variables (1.81). The demand for gum Talha export and Hashab gum FOB price indicated cross elasticity which was significantly elastic in the long run but insignificantly inelastic in the short run. The study concluded that there is an increase in the global demand for Sudan gum Talha but gum Talha and gum Hashab are not alternative export commodities.
Epistemophily and Women’s Temporality in Jeanette Winterson’s Sexing the Cherry
Authors: DÜZGÜN Şebnem
Published: October 2022

Jeanette Winterson’s Sexing the Cherry (1989) offers a feminist interpretation of history by using epistemophilic language and a circular time structure as alternatives to epistemological patriarchal language and linear temporality. Epistemophilic language is used in the novel to argue that history is cyclical, fluid, and continuous, and there are not strict divisions between private and public histories, or between the past, present, and future. Winterson evaluates the personal histories of characters within the public history to remove the hierarchy between the private, which is associated with the feminine, and the public, which is associated with the masculine. Moreover, she depicts history as a subjective notion as each character reinterprets and re-evaluates history from their own perspectives. Characters that deviate from the dominant epistemologies emphasise the subjectivity of history by looking at history from a subjective, feminine perspective. In the light of the discussions on epistemophily and women’s temporality, mainly referring to the arguments of Julia Kristeva, this study aims to demonstrate that Winterson’s Sexing the Cherry challenges patriarchal epistemological language that favours singularity and linear temporality based on separation and divisions by describing history as a subjective recreation of the past which flows into the present and future.
Fan Tokens as A Financial Source and Digital Marketing Tool in Football: An Analysis with The Entropy-Based Waspas Method
Authors: DEMİRTAŞ Mehmet Can , ORÇUN Çağatay
Published: October 2022

Considering that the revenues of the five most important leagues in Europe reached 15.6 billion euros in the 2020-2021 season (Deloitte, 2022), it is clear that the competition in football, whose global economic weight is gradually increasing, is no longer just limited to the sporting field but has expanded to include financial and marketing efforts. The concept of "token" is taken as a tool that can display fan-oriented experiential and financial efforts combined in the context of current developments, which will be seen as the reflection of the digitization process on football. This study analyzes the activities of 'fan tokens' belonging to thirty-six different football clubs listed on the coinmarketcap.com crypto asset instant information platform, in terms of market value, 90-day return, change from the highest value (1 Year), number of exchanges traded and watchlist. (watch list)”, it aims to analyze by using Entropy in the determination of criterion weights and WASPAS methods in the multi-criteria decision-making process. The global reach of the football economy and the extent of the audience it appeals to reveal the necessity of studies to be carried out in the relevant field. Therefore, as a result of this study, which was prepared with the aim of contributing to the literature for current practices, the fan token with the highest efficiency value belongs to the 'Paris Saint-Germain' club, and the related club is followed by the 'Lazio' and 'Santos' clubs; it has been determined that the club with the lowest efficiency value is 'Bayer 04 Leverkusen'.
A Comparison between the Outcomes of Wound Closure by Primary and Secondary Healing after Mandibular 3rd Molar Impaction Surgery
Authors: Shad Nayab , Javed Maryam , Saad Ui Hasan Muhammad , Abbas Zafar , Fatima Sayyeda Tatheer
Published: October 2022

Background: The one of the most frequently performed procedure by the surgeon in the oral and maxillofacial surgeries is removal of mandibular third molar. Objective: The study aimed to compare the process of primary and secondary wound closure outcomes after the surgical removal of impacted mandibular third molar. Study design: It is a comparative study conducted at Armed Forces Institute of Dentistry, Rawalpindi for the duration of six months from Jan 2022 to June 2022. Material and Methods: The 65 patients visited the oral and maxillofacial surgery department of hospital were included in the study. According to the inclusion criteria, these patients had impacted their third molar and they were medically fit and ready to come for follow ups after the operation as well. The patients were divided into two groups. The group A had 33 patients, the average age of these patients was 30 years and proportion of male and female among these 33 patients was 40% male (13) and 60% female (20). Group B had 32 patients and among those 32 patients there were 46% male (14) and 53% female (18) and the average age of the participants was 27. Results: The percentage incidence of swelling and pain was higher in the group A. The values was statistically significant. The mouth opening was highly observed in the group B patients. The post-operative pain was measured at first day, third day and 7th day by making use of the visual analog scale. The comparison was made. The mean pain score on third day was 4.9 and 3.5 and on the seventh day the mean pain score was 3.2 and 1.5 respectively for group A and B. the overall variation in pain scores were significantly high. Conclusion: In this study, the conclusion is made that the secondary closure was a suitable option then the primary closure for the post-operative pain and swelling. There was no variation found in case of periodontal healing irrespective of the closure procedure used, but the risk of infection and food impaction is more in case of secondary closure. Therefore, if patients have poor hygiene conditions secondary closure is not suitable for them. Keywords: wound closure, healing type and mandibular third molar.
Frequency of Depressive Illness among Caregivers of Drug Addicted Patients
Authors: Khan Muhammad Amin , Amjad Naeem , Qamar Iram , Sarrfraz Farrukh , Saifullah Muhammad
Published: October 2022

Introduction: Addictions and mental sickness are among the foremost expensive diseases in the world, according to a Worldwide Burden of Illness research, but they often go unnoticed. There's a coordinate correlation between substance use disorder (SUD) and destitute treatment compliance, course and result, more vagrancy, more unemployment, criminal offenses, suicide and more awful overall functioning among individuals with mental sickness. A few large epidemiological studies have been conducted in industrialized countries to look at the predominance of SUD among individuals with mental sickness Objective: To find out the frequency of depressive illness among carers of drug addicted patients Material and Methods Study design: Quantitative cross sectional Settings: Niazi welfare foundation teaching Hospital Sargodha Duration: Four months i.e. 1st January 2022 to 30th April 2022 Data Collection procedure: Cross sectional study was conducted on 100 patients. Each patient demographic profile was recorded. Psychiatrists and psychologists took the interview and explained the purpose of study. Caregivers of patients with drug addicted were rule out for anxiety and depression. Results: The total number of patients was 100 in which 82 were males and 18 females. BMI of the patients was 24.5+ 12.7 and the mean age was 35.5+ 7.5. Majority of the patients belong to poor socioeconomic status as 68%. The living area of patients are 45% in urban and 55% in rural. The patients having depression percentage is 84% and anxiety 80%. Conclusion: This study highlighted the findings that carers of patients who used psychoactive substances shown serious sadness. On the one hand, the seriousness of medication-related challenges is clearly connected to the advancement of uneasiness and discouragement to others. Keywords: Depression, Anxiety, Psychoactive, drug, Caregivers
Reluctance in Clinicians to Start Clozapine Treatment: A Heavy Toll in Clinical Outcome in Schizophrenia
Authors: Hassan Ghulam , Sarwar Muhammad Ali Awab , Javed Benazir , Mudassar Umair
Published: October 2022

Objective: Purpose of our study is to determine the frequency of treatment with clozapine among patients with treatment resistance schizophrenia. Study Design: Cross sectional study Place and Duration: Sughra Shafi Medical Complex Narowal. April 2020-October 2020 Methods: Total 23 patients of both genders had age 25-50 years were presented. All the patients had treatment-resistance schizophrenia and admitted to hospital for treatment.Only 4 patients were on clozapine while 19 patients were on other Antipsychotics. Patients were enrolled after taking informed written consent for detailed demographics. SPSS 22.0 was used to analyze all data. Results:Among 23 patients, 17 (73.9%) were males and 6 (26.1%) cases were females.Mean age of the the patients was 34.16±8.30 years and had mean BMI 24.2±6.37 kg/m2. Majority patients 15 (65.2%) had poor socio-economic status and 13 (56.5%) cases had urban residency. Only 4 (17.4%) patients received clozapine treatment. Psychiatristswere hesitating to provide clozapine among 19 (82.6%) cases. Reasons for hesitance to prescribe clozapine included concerns about major adverse effects and patients' lack of adherence, as well as difficulties in finding appropriate patients, service fragmentation, and a lack of familiarity with the drug. Conclusion:Clozapine continues to be under prescribed for individuals with treatment-resistant schizophrenia owing to several hurdles relating to the physician, the system of care, and technology. In order to overcome these obstacles, it is suggested that prescriber expertise and training be enhanced, integrated care be implemented, and technology be used to provide continuous, real-time monitoring of blood tests. Keywords:Treatment-resistance Schizophrenia, Clozapine, Complications, Antipsychotics
Clinical Presentation and Outcome of Congenital Thoracic Malformations in Children Beyond Neonatal Period
Authors: Soomro Shazia , , Anjum Misbah , Kulsoom Shazia , Bibi Safia , Ali Pervez , Naeem Bilquis
Published: October 2022

Objective: To describe the clinical spectrum of presentation and outcome of children with congenital thoracic malformations beyond neonatal age. Methodology: Cross sectional study conducted at inpatient department of National institute of child health from Jan-Dec 2021. All patients hospitalized in study duration with diagnosis of congenital thoracic formations from 1 month till 12 years of age were enrolled. History, examination, laboratory tests, treatment and outcome were recorded. Results: Total 44 children were enrolled with mean age of 7.7+10.8 months. Common congenital thoracic malformations were congenital diaphragmatic hernia 24(54.5%), congenital cystic adenomatoid malformation 6(13.6%), congenital lobar emphysema5(11.4%) and eventration of diaphragm 4(9.1%). Three (6.9%) patients had associated cardiac anomalies. Surgical intervention was done in 33 (75%) patients with a postoperative survival rate of 95.4%. Conclusion: Congenital diaphragmatic hernia and cystic adenomatoid malformation are common congenital thoracic malformations that present beyond neonatal age and are associated with good postsurgical outcome. Keywords: congenital diaphragmatic hernia, congenital cystic adenomatoid malformation, beyond neonate
Effectiveness, Safety, and Tolerability of Esomeprazole and Domperidone in Gastroesophageal Reflux Disease
Authors: . Quratulain , Azam Sheeraz , Muhammad Hafiz Ali , Javed Waseem , Farooq Omer
Published: October 2022

Objective: The purpose of this study was to examine the clinical efficacy, tolerability, and safety of Esomeprazole 20 mg + sustained release (SR) Domperidone 30mg delivered once daily in adult patients for the symptomatic alleviation of dyspepsia associated with GERD. Study Design: Prospective Study Place and Duration: PIMS Hospital Islamabad. Dec 2021- May 2022 Methods: Total 97 patients of both genders had symptomatic dyspepsia associated with GERD were presented in this study. Patients were aged between 20-75 years. Informed written consent of all the patients were taken for detailed demographics. Patients were given a fixed-dose combination of Esomeprazole 20 mg and sustained-release (SR) Domperidone 30 mg once day for two weeks. Treatment efficacy was determined by whether or not patients' symptoms improved and whether or not they were happy with the care they received. Physical tests determined the level of safety and tolerability. SPSS 22.0 was used to analyze all data. Results: Among 97 patients, 56 (57.7%) patients were males and 41 (42.3%) were female patients. Mean age of the patients was 38.22±16.49 years. 52 (53.6%) patients were from urban areas and 58 (59.8%) patients were literate. Most common symptoms were heart burn, epigastric pain, acid regurgitation and belching among all cases. Post-treatment, we found significantly reduction in severity of symptoms among all cases with p value <0.002. Frequency of satisfaction rate among all cases was 91 (93.8%). Adverse events were found only in 8 (8.2%) patients. Conclusion: According to the results of this study, a combination of sustained-release (SR) domperidone 30 mg and fixed-dose esomeprazole 20 mg may be an effective and well-tolerated therapy option for the management of symptomatic relief of dyspepsia associated with GERD in adult patients. Keywords: Domperidone, Esomeprazole, Dyspepsia, GERD, Outcomes
Management and Therapy of Venous Thromboembolism in Inflammatory Bowel Disease
Authors: Kazmi Syed Anam Noor , Aslam Zeeshan , Ubaid Muhammad , Tariq Abubakar , Khan Raja Altaf Ahmed , Hashmi Hajra
Published: October 2022

Aim: Venous thromboembolism (VTE) guidelines issued by American College of Chest Physicians do not address individuals having inflammatory bowel illness, the class that is at extreme danger of both VTE also gastrointestinal hemorrhagic complications. Individuals with inflammatory bowel disease (IBD) should follow our guidelines for prevention and treatment of the VTE. Methods: VTE in IBD samples were reviewed by a comprehensive literature review. As per the Grading of suggestion analysis, formulation, and analysis methodology, the methodological quality and the strength of recommendations were graded. The occupied committee of general and specialty gastroenterologists in addition to thrombosis experts finalized and voted on the principles after they remained established concluded an iterative online platform. Results: Patients suffering with the IBD have just a roughly 3-fold extreme danger of VTE than non-IBD patients. The illness of this disease causes more danderous effacyts tan anyother disease. Anticoagulant thrombo prophylaxis remains suggested for IBD individual whom remain hospitalized having severe IBD flares but no active bleeding, but it remains also indicated once the bleeding is not serious. Anticoagulant thromboprophylaxis is recommended in outpatient clinics through the record of VTE caused through an IBD flare or an senseless VTE, but not or else. The period of anticoagulation afterward the first VTE is determined by existence of inciting variables. There are special considerations for preventing and treating VTE in pediatric in addition pregnant IBD individuals. Conclusion: By following the principles of American College of Chest Physicians as the framework, researchers used findings from IBD research to generate key suggestions for therapy of VTE in our current massive population. Keywords: VTE guidelines, American College of Chest Physicians, inflammatory bowel illness.
Evaluation of the Psychological Status of Infertile Women
Authors: Taj Urfa , Jabeen Shazia , Pervaiz Mahwish , Fiaz Huma , . Faheema
Published: October 2022

Background: The birth of progeny is one of the most satisfying events. The infertility is one of the major concerns of the modern world. Although there are variable physical causes of infertility but the psychological stress is considered as one of the main causes of infertility. Objective: The fertility problem inventory was used to evaluate the psychological status of the infertile women. The relationship between psychological problems and characteristics of infertility was also assessed. Study design: It is a prospective and questionnaire-based study conducted for the duration of one year on the women attended the gynecology and obstetrician department of Allama Iqbal Memorial Teaching Hospital Sialkot. The study was conducted from June 2021 to May 2022. Material and Methods: A two-month prospective, quantitative, descriptive, questionnaire-based study was conducted on women undergoing infertility therapy with the approval of the institution's ethical committee. The stress level were analyzed by Fertility Problem Inventory Questionnaire. Excel and Microsoft was used for tabulation of data. The collected data was stratified by statistical analysis. The SPSS was used for the analysis. For the categorical variables the t-test was performed. Results: The average age of the twenty three patients included in the study was 30 years. The severe level of infertility-related stress was observed in the almost 75% of the included patients. The other 25% were suffering from the moderate level of stress. Conclusion: The serious psychological morbidity was observed in approximately two-third of the participants. Psychological evaluation of the patients taking infertility therapy could be a consideration. Keywords: Psychological problems and infertility therapy.
A Research Study on use and Importance of the Diagnostic Radiology Reference Values
Authors: Aslam Zeeshan , Hamza Farooq Hafiz Muhammad , Ghayour Mahwish , Hashmi Hajra , Ahmed Khan Raja Altaf , Mumtaz Banday Ahmad
Published: October 2022

Aim: References values (RVs) remain being utilized for the radiation quantities from specific bits of radiography apparatus to doses from comparable equipment evaluated in nationwide reviews. RVs optional through American Connection of Physicists in Medicine were established from General Assessment of X-ray trends review, which was conducted by government radiation defense services through understanding and also encouragement of United States Food and Drug Government, Symposium of Radioactivity Control Program Executives, and also American College of Radiology. The RVs used by the American Association of Physicists in Medicine approximate 90th percentile of questionnaire results. As a result, hardware that exceeds the RVs uses higher radiation doses than 90% of apparatus in studies. Radioactive quantities for precise projects should be monitored yearly using standardized ghosts, as suggested through USA College of Radiology. Whenever RVs remain reached, medical physicist must examine source too, in collaboration through radiologist in charge, evaluate if such dosages are warranted or even if the imaging equipment must be adjusted to decrease individual radiation quantities. RVs remain important instruments for likening individual radiation exposures across the UK and giving details concerning radiography performance and reliability. Keywords: Diagnostic radiology, Reference Values, Importance, impacts.
Cross Infection Control Practices in Dental Clinics: A Patient Perspective
Authors: Asim Naeem , Ahmed Nashida , Khoso Muhammad Hassan , Aslam Reema , Nisa Zaka Un
Published: October 2022

Objective: To assess the knowledge, attitudes and practices of cross-infection control measures at dental clinics in Islamabad, Pakistan. Study Design: A cross-sectional study was designated to assess the knowledge, attitudes, and practices of cross-infection control measures. Place and Duration: The study was carried out in dental clinics in Islamabad for six months. Methodology: A pretested questionnaire comprised of thirty questions was administered to respondents. The sample size comprises patients who visited the dental hospitals of Islamabad and Rawalpindi. The data were analyzed using SPSS statistical software. Results: Most of the respondents (69.8%) showed poor knowledge. However, among respondents 85.6%presented a positive attitude towards infection control measures. Concerning self-reported practices, approximately 16% and 17% of patients ask the dentist to wear gloves and a face mask. Only 12% ask the dentist whether instruments are sterilized or not. A significant difference was seen between the education of patients and knowledge towards cross-infection control measures. Among respondents with a high level of education, 87.7% showed good knowledge, whereas the medium (58.6%) and low level of education (9.8%) showed good knowledge towards infection control measures, respectively. Conclusion: In conclusion, our results showed poor knowledge and practice regarding cross-infection control measures; however, most respondents demonstrated a positive attitude. Keywords: Infection control, Dental patient, Emerging disease, Risk, Knowledge, Attitude.
Malignant Breast Lesion Detection with MRI and its Accuracy
Authors: Iqbal Muhammad Wasif , Ali Moazem , Ashraf Rabia , Noor Amina
Published: October 2022

Objective: Using histology as the gold standard, this study aims to determine whether or not magnetic resonance spectroscopy can reliably diagnose malignant breast lesions. Study Design: Cross-sectional Place and Duration: Conducted at department of Radiology Central Park Medical College, Lahore. Duration was 6 months from October 2021 to March 2022. Methods: This research included 75 females. Malignancy-suspicious palpable lesions were included. Patients completed a consent form admitting the hazards before any data was gathered. The kinematics and morphology of dynamically enhanced magnetic resonance (MRS) images were studied. MRS's choline peak (Cho) was utilized to detect cancer. Single-voxel technique was employed to evaluate MRS' diagnostic accuracy in cancer. MRS and biopsies were compared. Data was analyzed using SPSS 24.0. Results: Malignant lesions were found in 65 (86.7%) of the patients by MRS, and in 58 (77.3%) of the cases according to the histological findings. Malignant lesions by MRS most frequently showed a ductal enhancement or a peripheral enhancement morphology. The results of MRS showed a 78% specificity, 85% accuracy, 90% sensitivity, 75% NPV, and 91% PPV. Conclusion: MRS must be employed because of its better specificity, sensitivity, and accuracy in characterizing breast lumps. MRS is a specific, sensitive, and effective diagnostic technique for breast cancer. Keywords: Accuracy, Magnetic resonance spectroscopy (MRS), Malignant breast lesion, Histopathology,
Effects of Artificial Sweeteners Aspartame and Sucralose on the Size of Hepatocytes in Rat Liver
Authors: Haq Nadia , Saqib Sadia , Tafweez Raafea , Ali Irfan , Syami Ahmad Fawad
Published: October 2022

Background: The excessive use of artificial sweeteners now a days just to lose weight and to remain fit and due to other reasons without knowing its effects on liver gave me a thought to conduct this study to see whether they are safe or not for liver health. Aim: To see the effects of artificial sweeteners Aspartame and Sucralose on the size of rat hepatocytes and to compare their effects to choose relatively safe artificial sweetener for routine use. Methods: Fifty adult Wistar albino rats used in this study were randomly divided into five groups. Group I (control group) animals were given drinking water by oral gavage. The animals of group II and III were given low (40mg/kg body weight) and high doses (1000mg/kg body weight) of Aspartame respectively. Similarly, animals of group IV and V were given low (5mg/kg body weight) and high doses (1000mg/kg body weight) of Sucralose respectively. Doses were given by oral gavage once daily, six days a week for a total duration of eight weeks. At the end of the experiment histological observation of liver in all animal groups was made. Results: Microscopic examination revealed that hepatocytes of group III animals (high dose group of Aspartame) had largest size with the mean value of 20.86±2.00µm as compared to the control group hepatocytes having mean value of 16.46±1.74µm. Conclusion: The increase in the size of hepatocytes was seen in high dose groups of Aspartame and Sucralose whereas changes seen in low dose groups of Aspartame and Sucralose were not significant. Keywords: Artificial sweeteners, Histology of rat liver, Size of hepatocytes.
Diagnostic Accuracy of Sonosalpingography for Assessing Tubal Patency in Women with Infertility Taking Laparoscopy as Gold Standard
Authors: Khan Naheed , Rehana Kanwal , Saeed Sidra , Gul Hina , Nawab Kalsoom , Shoaib Irsa
Published: October 2022

Background: Infertility is defined as the failure to conceive after 1 year of unprotected sexual intercourse in women less than 35 years of age and 6 months in women older than 35 years [1, 2]. It affects 10 to 15 % of the couples [1]. Abnormalities of fallopian tubes account for 35 to 40 % of the cases of infertility [3]. Sonosalpingography is a non-invasive, safe and cost- effective diagnostic technique which provides reliable diagnosis of tubal patency [4]. Objective: To evaluate the diagnostic validity of Sonosalpingography as a tubal patency test in infertile women using laparoscopy as gold standard. Methodology: This study was carried out at the Radiology Departments of Khyber Teaching Hospital and Kuwait Teaching Hospital in Peshawar. We used the WHO method for sample size by taking the prevalence of tuboperitoneal factors as 30%, sensitivity 72.9%, specificity 81.22%, margin of error 12%, and 95% confidence interval. It was a cross-sectional study that lasted for 6 months and assessed a total of 178 patients. Additionally, a non-probability, sequential sampling strategy was utilized to acquire the sample. Results: Our patients aged between 18-45 years, out of which 30% of the participants aged 18 to 25years, 55% were between 26 and 35years, and 15% were between 36 and 45years. Standard deviation was 1.26, with a mean age of 27. The data collected from both the diagnostic tests was analyzed, diagnostic accuracy of Sonosalpingography was calculated as a sensitivity of 81%, specificity of 76%, positive predictive value of 90%, negative predictive value of 60%, and diagnostic accuracy of 79%. Conclusion: According to the results of our study, sonosalpingography is a very helpful supplemental diagnostic tool for evaluating tubal disease in patients with infertility, though direct laparoscopic assessment is the gold standard. Sonosalpingography and laparoscopy can be used to evaluate patients with secondary infertility. This spares the patient from being exposed to radiations and the discomfort of contrast administration in HSG. Keywords: Diagnostic Accuracy, Sonosalpingography, Tubal Patency, Infertility, Laparoscopy
Colony Forming Bacterial Count in Dental Unit Water Lines of Rehman College of Dentistry, Peshawar
Authors: Anees Wahaj , Shaikh Moiz Ahmed , Zardari Munir Hussain , M Arif Lubna , Kumar Hans , Akber Ather
Published: October 2022

Bacterial invasion of dental unit water lines is a global issue, which if left untreated, leads to formation of a bacterial biofilm within the water lines. The aim of this study was to determine the number of colony forming units (CFU) in dental unit waterlines of Rehman college of dentistry. Samples from air-water syringes of 44 different dental units in various departments of the dental hospital were collected. Tip of each air-water syringe was heated using direct flaming to eliminate any bacteria residing therein. The samples were collected in 100ml sterile bottles and labelled according to the unit number and department name. The bottles were sent for bacteriological analysis to public health food analysis laboratory, Peshawar. The results concluded that according to the WHO standards of water contamination, all samples fall in category B (1-10cfu/ml) and were deemed fit for drinking. Keywords: Colony forming units, dental unit water lines (DUWL), dental unit water system (DUWS), Peshawar, Pakistan, bacterial load.
Evaluation of Condylar Morphology Using Orthopantomogram among Patient Reporting at Sandeman Provincial Hospital Quetta
Authors: Ali Syed Ahsan , Mengal Nasrullah , Butt Mehreen , Baloch Jiand Malik , Ali Zaid
Published: October 2022

Objective: To assess the condylar morphology using orthopantomogram among adult patient. Study design: Cross sectional study Place and duration of study: Department of Orthodontics, Dental Section, Sandeman Provincial Hospital, Quetta, from June 2020 to December 2020. Material and methods: All patients presented to orthodontic department who fulfilled inclusion criteria were included in this study. One hundred and eighty candidates were included and underwent Orthopantomogram. Reports were assessed and condylar shape was noted. Data was analyzed by using SPSS. Vs. 20. Results: The mean age of candidates was 25.5 ± 5 years. There were 90 (50%) males and 90 (50%) females. In left side, the condylar shape was oval in 101 (56.0%) while in right side, condylar shape was oval in 100 (55.6%) cases. In left side, the condylar shape was bird beak like in 32 (18.0%) while in right side, condylar shape was bird beak like in 33 (18.3%) cases. In left side, the condylar shape was diamond like in 26 (14.4%) while in right side, condylar shape was diamond like in 27 (15.0%) cases. In left side, the condylar shape was crooked finger like in 21 (11.7%) while in right side, condylar shape was crooked finger like in 20 (11.0%) cases. Conclusion: Thus in our population, the most common condylar shape was observed to be oval type followed by bird beak type. Keywords: Condylar morphology, Orthopantomogram, Orthodontics
Causes of Hearing Impairment Observed in Clinical/Hospital Setting
Authors: Babar Mehreen , Usman Fatima , Shinwari Wajih Ud Din , Nagra Sajid Rashid , Ahmed Salman Aftab
Published: October 2022

Objective: Aim of current study was to determine the causes of hearing impairment among patients visited to hospital. Study Design: Observational study Place and Duration: Frontier medical college, Abbottabad, May, 2021 to April, 2022. Methods: Total 122 patients of both genders had complained of hearing impairment were included. After obtaining informed written consent detailed demographics were recorded. An extensive history, thorough E.N.T. examination, and pertinent radiological and audiological tests were performed. Frequency of causes for hearing impairment was assessed. SPSS 20.0 was used to analyzed all data. Results: Among all cases, 68 (55.7%) patients were males and 54 (44.3%) were females. Mean age of the patients was 17.5±11.50 years. 72 (59.02%) cases were from rural areas and 75 (61.5%) cases had poor socio-economic status. We found that conductive hearing loss was the most common found in 63 (51.6%) cases, followed by mixed hearing loss in 35 (28.7%) cases and sensorineural hearing loss found in 24 (19.7%) cases. Chronic Suppurative Otits Media was the most common cause of hearing impairment found in 61 (50%) cases, followed by infection, physical trauma, prenatal causes, postnatal causes, drug related and other problem. Conclusion: We concluded in this study that COSM was the most common cause of hearing impairment among all cases. Most common hearing loss was conductive, mixed and sensorineural. It is possible to reduce the incidence of sensorineural hearing loss by preventing variables that occur both during and after pregnancy. Keywords: Hearing Loss, Hearing Impairment, COSM, SNHL
Maternal Outcomes of Pregnancy in Women with Previous One C-Section in Qazi Hussain Ahmad Medical Complex, Nowshehra
Authors: Neelam Shahzadi , . Sumayya , Khalil Adeeba Akhter , Nawaz Tayyaba , Bakhtawar Abgina , Rahman Sami Ur , Khan M. Mohsin
Published: October 2022

Objective: This prospective study was conducted to find the maternal outcomes of pregnancy in women with a previous one C-Section in terms of mode of delivery and maternal complication Material & Methods: This prospective cross sectional study was carried out in QHAMC Nowshera from July 2018 to June 2019. A convenient sample of 180 women, all booked and unbooked, with gestational age 37 weeks or more, singleton fetus and cephalic presentation that came to Gynae OPD with history of previous one C/section were included . Informed consent was taken after explaining risks and benefits of planned repeat c/section and VBAC .While those having IUD, placenta previa, breech presentation or gestational age less than 37 weeks were excluded. Data was obtained on pre- designed structured proforma .SPSS 17 software was used for statistical purposes. Results: Results showed that of the total participants 71.1 % had undergone C-section again, and 28.8 % delivered as VBAC. 34.3% of the total C-sections were emergency lower segment C-sections and 65.6% were planned repeat C-sections. Conclusions: It is concluded from our study that VBAC is a safe option for patient with previous one scar with minimal morbidity and no mortality but required good antenatal assessment one to one care and vagilant monitoring with quick resumption to emergency csection when required
Cross Sectional Study; Identifying Physical Activity Barriers Amongst Teenagers Who Are Obese/Over Weight by Appearance in Islamia College for Boys and Jinnah College for Women Peshawar
Authors: Amin Anam , Farman Ghazi , Amjad Aalia , Ahmad Awais , Arif Shahmir , Jamil Mashal
Published: October 2022

Background: Physical activity is defined as any bodily movement that requires the use of energy, where it is recommended, that teenagers get 60 minutes of moderate to severe physical activity. However, almost majority of the teenagers around the globe are getting inadequate physical activity. Objectives: • To analyze social, cultural and religious factors that aﬀect physical activity. • To identify diﬀerent personal factors such as body image, self esteem and their eﬀects on physical activity. • To identify ecological and academic factors leading to decrease physical activity and its associated comorbidities. • To identify the role of government in evaluating the availability of sports centres and other facilities for adolescents /teenagers. Study Design: A cross sectional study Place and Duration: Conducted Jinnah College Peshawar and Islamia College Peshawar, during from the period March 2018 to May 2018. Methodology: Sample under study was based on teenage students (16 to 19 years) with a total size of 150 students that were part of bachelor program (BS Botany) , who were obese or over-weight by appearance. The students were given standardized questionnaires randomly, regardless of gender. Collected data obtained from questionnaire were analyzed. Results: According to the results, 94.41% students had barriers to physical activities while 5.68% had none. 75 students (50%) said that they did not have any previous bad experiences with their appearance while 30 students (21.7%) said that they did. More- over, 59 students (39.3%) said that their reduced activity was due to lack of time while 55 students (36.7%) felt that the lack of safe places was the causative factor. 60 students (40%) students felt that they needed a partner while 57 students (38%) just felt de-moti- vated. Conclusion: On the basis of this study, we conclude that majority of the students have various barriers regarding their physical activities. 94.31% of the students reportedly have barriers while 5.69% had no barrier whatsoever, and they were well aware of the consequences such as obesity, diabetes etc. Keywords: Physical activity, Barriers, Over-weight, Obese.
Association of Obesity with Increased Rate of Postoperative Superficial Sternal Wound Infection after Coronary Artery Bypass Grafting Surgery
Authors: Abbas Amna , Yunus Aftab , Aftab Hina , Akram Muhammad Athif , Saeed Yahya
Published: October 2022

Objective: The objective of this study was to find association of obesity with postoperative superficial sternal wound infection after CABG. Study Design: This was a prospective comparative study. Place and Duration: This study was conducted at the Cardiac surgery Department, PIC, Jail Road, Lahore from 1st July 2020 to 31st Dec 2020. Methodology: Non probability / purposive sampling technique was used. A total of 140 patients (70 in each group) following inclusion criteria were enrolled in this study. Quantitative and qualitative variables were filled to the predesigned performa. A detailed social and demographic profile (age, gender, height, weight, BMI). Clinical history, i.e. (Diabetes Mellitus, Smoking, Hypertension) and clinical trials were assessed, i.e. preoperative EF (percent) was calculated. Using SPSS Version 24.0.0, statistical analysis was carried out. Qualitative variables such as gender, risk factors such as DM, HTN, smoking, and superficial sternal infection were represented as percentages, whereas quantitative variables such as age, height and weight were described as mean ± standard deviation. Chi-square test was used to determine the association of obesity with infection of sternal wound. P value≤0.05 was considered as significant. Results: The mean age of cases in this study in obese and non-obese group was 47.80 ± 9.79 years and 51.23 ± 9.36 years. There were 70(50%) obese patients and 70(50%) non-obese patients in our study. There were 59(84.29%) cases in obese group and 15 (21.43%) case in non-obese group who had developed post-operative infection, p-value was <0.001 which was highly significant showing strong association between postoperative infection and obesity. Conclusion: Sternal wound infection was a significant outcome in our research. We found strong association of obesity with post-operative sternal wound infection. Keywords: CABG, Diabetes, Obesity, Post-operative infection
Association of early Post-Operative Outcomes with Metabolic Syndrome after Coronary Artery Bypass Grafting
Authors: Kibriya Ghulam , Abbas Amna , Aftab Hina , Akram Muhammad Athif , Saeed Yahya , Iqbal Omar , Iqbal Azhar
Published: October 2022

Objective: The objective of this study is to find out the association of metabolic syndromewith early outcomesafter CABG. Study Design: This was a comparative study. Place and Duration: This study was performed from the first of July 2020 to the first of January 2021 at the Cardiac Surgery Department, PIC, Jail Road, Lahore Methodology: The approach of non-probability sampling was applied. After obtaining consent on a consent form, 172 Patients (86 in the exposed group and 86 in the non-exposed group) were included. Results: The average age of the participants in this study was 55.30 ± 8.77 years; there were 130 cases (75.6%) of men and 42 cases (24.4%) of women. There were 56 (65.12%) men and 30 (34.88%) women in the exposed group, compared to 74 (86.05%) men and 12 (13.95%) women in the non-exposed group. There were 5(5.8%) cases in the exposed and 1(1.2%) case in the non-exposed group of post-operative stroke found with a p-value of 0.096. Postoperative pneumonia occurred in 9(10.2%) of the exposed and 2(2.3%) of the non-exposed group (p-value 0.05). Mortality was found in 11 (12.8%) patients in the exposed and 6 (7%) in the non-exposed group (p-value = 0.20). Conclusion: Because many MetS syndrome factors are under our control, it is important to prevent it early especially in cases of CABG, to get better outcomes. Post-operative pneumonia was significantly greater in the exposed groups, with a p-value of 0.05, while stroke and mortality were found statistically insignificant, with a p-value of >0.05, the current study's findings were quite different and unexpected. It is suggested that larger-scale studies be conducted. Keywords: CABG, Lipid Profile, Diabetes, Obesity, Mortality
Psychological Challenges and Coping Strategies Adopted by ICU Nurses during COVID-19 Pandemic in Lahore, Pakistan
Authors: Sarfraz Sharoon , Ghani Mansoor , Kausar Samina
Published: October 2022

Objectives: To explore the psychological challenges faced by Intensive Care Unit (ICU) nurses during COVID-19 pandemic and to determine the coping strategies which were used by ICU nurses to combat psychological and emotional stress during the health crisis. Study Design: Qualitative phenomenological approach was used to explore the insights of ICU nurses. Study Subjects: Data were collected from 12 ICU nurses till data saturation. Place and Duration: This study was completed in between August 02, 2021 to January 01, 2022 and was conducted at University of Health Sciences Lahore in collaboration with four tertiary care hospitals of Lahore. Results: Results of this study revealed that the situation was very chaotic. ICU nurses were prone to stress, fear and anxiety because they were more exposed to coronavirus than any other health care professional. The responses of the COVID-19 ICU nurses were categorized into three main themes. Psychological impact of the pandemic in the early stages, social effects of the pandemic and coping strategies. Conclusion: This study concluded that COVID-19 pandemic had a great impact on the psychological well-being of ICU nurses. Despite of adverse conditions, nurses had adopted certain strategies such as family support, religious support and infection prevention protocols which helped them to reduce their stress and fear during the COVID-19 outbreak. Key words: Coronavirus, pandemic, COVID-19 outbreak, psychological experiences, coping strategies, ICU Nurses
Outcome of Hypertonic Saline Versus Normal Saline in Children with Acute Bronchiolitis
Authors: Shahid Sidra , Javeed Asif , Wamiq Saba
Published: October 2022

Objective: To compare outcome of hypertonic saline (HS) versus normal saline (NS) among children aged 2 to 24 months with acute bronchiolitis. Study design: An open label randomized controlled trial. Place and Duration of the Study: Department of Pediatric Medicine, Ibn-e-Siena Hospital, Multan from 1st September 2021 to 31st March 2022. Methodology: A total of 220 children (110 in each group) of both genders aged 2 to 24 months reporting to emergency department with acute bronchiolitis with a disease spanning less than 5 days were included. In HS group, children were nebulized with 4 ml of 3% HS while in NS groups, all children were nebulized with 4ml 0.9% saline solution. In both groups, children were given respective treatment with interval gap of 4 hours. Clinical severity score and need for hospitalization after 24 hours was noted. Results: In a total of 220 children, 126 (57.3%) were males and 94 (42.7%) females. Overall, mean age was 7.9±5.3 months while 170 (77.3%) children were aged between 2 to 12 months. Residential status of 132 (60.0%) children was rural. Monthly family income of 165 (75.0%) children was below 25,000 Pakistani Rupees (PKR). Maternal educational status of 91 (41.4%) children was illiterate. Mean baseline clinical severity score was calculated to 7.28 ± 1.47. HS group, post-treatment mean clinical severity score was 4.29±2.83 in comparison to 5.99±2.64 in NS groups. There were 28 (25.5%) children in HS group who required hospitalization in comparison to 56 (50.9%) in NS group (p=0.0001) Conclusion: In comparison to nebulization with normal saline, nebulization with hypertonic saline solution was found to be significantly more effective in reducing clinical severity score and need for hospitalization among children aged up to 2 years with acute bronchiolitis. Keywords: Hypertonic saline, normal saline, acute bronchiolitis, clinical severity score.
Barriers of Contraception Uptake in South Punjab, Pakistan
Authors: Ashraf Saima , Khosa Arooj Fatimah , Fayyaz Asiya , Bano Fatima
Published: October 2022

Objective: To determine the frequency of barriers to contraception uptake in women visiting outpatient department of a tertiary care hospital of South Punjab, Pakistan. Study Design: A cross-sectional study. Place and Duration: Department of Obstetrics & Gynecology, Nishtar Medical University Hospital, Multan Pakistan from September 2021 February 2022. Methodology: A total of 249 pregnant women between 18-35 years having parity >2 and willing to be part of this research were included. Basic demographic features like age, weight, parity, socioeconomic status, education status, rural/urban residential status, willingness or barriers about various contraceptive measures were recorded and analyzed by SPSS 23. Results: In a total of 249 women, mean age was 30.56±4.74 years. Residential status of 204 (81.9%) women was urban. Mean parity was 3.85±1.07. Educational level was illiterate in 125 (50.2%) women. There were 114 (45.8%) women who belonged to low socio-economic class. There were 36 (14.5%) women who were willing to use contraceptive measures while remaining 213 (85.5%) women had some sort of barriers about contraception uptake. Husband’s disapproval accounted for the most frequent barrier to contraception uptake noted in 73 (29.3%) women while ignorance, ‘against culture’, side effects and misinformation was reported by 54 (21.7%), 34 (13.7%), 34 (13.7%) and 18 (7.2%) women respectively. Educational level (p=0.008) and socio-economic class (p<0.001) were found to have significant association with barriers to contraception uptake. Conclusion: Very high proportion of women was unwilling to contraception. Husband’s disapproval for contraception was the biggest barrier behind unwillingness to contraception uptake while ignorance and ‘against culture’ were the other most frequent barriers behind unwillingness to contraception uptake. Illiteracy and low socio-economic status were found to have significant association with barriers to contraception uptake. Keywords: Culture, contraception, illiteracy, misinformation, side effects.