bluuebunny/crossref_metadata_2025 huggingface dataset:
Artrópodos venenosos y urticantes en el cultivo de café robusta en La Cauchera – Colón, Panamá
Authors: Collantes- González Rubén Darío , Santos-Murgas Alonso , Jerkovic Maricsa
Published: January 2025

El objetivo de la investigación fue identificar artrópodos venenosos y urticantes asociados al cultivo de café robusta (Coffea canephora) en La Cauchera – Colón, Panamá. Para ello, se realizaron ocho recorridos mensuales entre enero y agosto de 2017, en los cuales se escogió dentro de 2 ha de cultivo 30 plantas al azar por visita, inspeccionándose el tronco y follaje de las mismas. El estudio fue de naturaleza descriptiva, exploratoria y no hubo intervención para respetar el equilibrio en el agroecosistema, llevándose un registro fotográfico para su identificación apoyada en literatura especializada. De acuerdo con los resultados, entre los artrópodos venenosos y urticantes asociados al café destacaron el género Tityus (Scorpiones: Buthidae), adultos de Paederus ornaticornis (irritans) Sharp, 1891 (Coleoptera: Staphylinidae), Polybia occidentalis Olivier, 1791, Polistes sp. (Hymenoptera: Vespidae), larvas de Acharia nesea (Stoll, 1780) (Lepidoptera: Limacodidae), además de otras dos especies de Lepidoptera. Si bien algunos de los artrópodos encontrados representan un riesgo para la salud de las personas, desempeñan aportes importantes en el agroecosistema, en materia de control biológico de insectos fitófagos y polinización en sus formas adultas. En conclusión, se identificaron siete taxa de artrópodos venenosos y urticantes asociados al cultivo de café robusta en La Cauchera.
Bacillus subtilis y Trichoderma sp. como promotores de crecimiento y producción del tomate en un biohuerto urbano
Authors: Castillo - Nole Manuel Jorge , Vega - Ronquillo Manuel , Pechu - Santisteban Juan Manuel , Campos - Albornoz Miltao Edelio
Published: January 2025

El aprovechamiento de espacios urbanos, como es el caso de las azoteas de viviendas para ocupar en la producción de hortalizas es sin duda un desafío, porque se trata de manejar sistemas antropizados con mayor presencia de grupos sensibles al uso de pesticidas o agroquímicos; entonces se evaluó el efecto de los microorganismos promotores de crecimiento B. subtilis y Trichoderma sp. en los días a la floración, cosecha y rendimiento del tomate en un biohuerto urbano. En un diseño completo al azar, siendo los tratamientos la dosis máxima y mínima según recomendación técnica de los productos cuyo contenido fue el complejo de Trichoderma harzianum, T. viride, T. asperellum (84 g.L-1 y 42 g.L-1) y el producto que contiene Bacillus subtilis (36 mL.L-1 y 19 mL.L-1). Se ha evidenciado, que el complejo Trichoderma spp. aplicado a la dosis mayor influye significativamente en la precocidad de la floración del tomate con 49,11± 0,38 días, seguido de dosis menor con 51,56 ± 0,38 días a la floración, siendo el testigo sin aplicación el más tardío con 62,11 ± 0,38 días a la floración. Fue notorio la promoción en la cantidad de frutos por planta 20,10 ± 0,74 y 18,10 ± 0,74 frutos respectivamente.
Special issue: frontiers in recent advances on cancer diagnosis and treatment
Authors: Westermark Bengt , Heldin Carl-Henrik
Published: January 2025

‘Of all the processes that the student of pathology is privileged to study, none is as intriguing, fascinating, and perplexing as neoplasia.’

This statement, a quote from William Boyd’s Textbook of Pathology (1961), remains as thought-provoking today as when it was first written. Over the decades since Boyd penned these words, our understanding of the molecular mechanisms underlying tumorigenesis and the development of novel therapeutic approaches have advanced at a revolutionary pace. This special issue of UJMS on cancer exemplifies the remarkable progress in cancer research, reaffirming that Boyd’s perspective on the enigmatic nature of cancer endures.
Navigating Translation Rights: Expanding Access to Global Literature in Modern Education
Authors: Rustamova Nodira , Ruzieva Dilnoz , Sharaxmetova Umida , Burxanova Leyla , Makhmudxodjayeva Umida , Imomniyozov Doniyorbek , Ibrokhimov Azimjon
Published: January 2025

This study aims to explore the complexities surrounding translation rights in educational contexts, with a focus on finding a balance between copyright protection and the need for greater access to foreign literature for educational purposes. Background. Translation rights present a significant challenge in educational settings, where access to foreign literature is essential for fostering cross-cultural learning and global understanding. However, restrictive copyright laws often limit the availability of translated works, creating barriers for educators and students alike. This issue is particularly relevant in an increasingly interconnected world, where access to diverse knowledge sources is critical to educational outcomes. Research Methods. A mixed-methods approach was employed, combining comparative legal analysis of international copyright laws, case studies of specific educational contexts, and surveys of educators to assess the impact of translation rights on their teaching and research. The study also examined potential solutions such as alternative licensing models and the use of technology-facilitated translations. Results. The findings reveal significant disparities in translation rights across different countries, with stringent copyright laws in some regions severely restricting educational access to translated works. Educators reported frequent challenges in obtaining necessary texts, often hindering their ability to provide a comprehensive global education. Conclusion. The study concludes that reforming translation rights is crucial to promoting global educational equity. It proposes a model that balances authors' rights with educational needs, emphasizing the role of alternative licensing frameworks and technology to facilitate broader access to translated literature. Addressing these issues is vital for fostering cross-cultural understanding and ensuring equitable educational opportunities.
Seismic Evaluation of RC Asymmetric Building Consisting of Floating Column and Passive Device
Authors: Panchal Bhavika Rajendrakumar  , Mr. Jigar Zala
Published: January 2025

The abrupt slip on a fault that causes earthquakes causes the ground to tremble. Earthquakes have been happening frequently all around the planet over the past several decades. Nearly all earthquakes cause direct damage to the buildings, which results in the destruction of life and property. Due to lack of following structural guidelines which lead to collapse, so carried out modern seismic reduction techniques base isolation, shear wall, dampers, which helps in earthquake resistant structures for better performance during seismic events. The energy dissipation devices are easy to installed in existing or new building with low construction cost.So past studied has been done on fluid viscous damper, Tune mass damper, viscous damper with multi storied regular building. In present study comparing with fluid viscous damper in RC Asymmetric layout C & H shape having G+12storey building with consisting Floating column at alternative floor. Time-History analysis has been done by using two different earthquakes taken from PEER ground motion having high and low Pga value. To learn the analytical effects like change in Axial force, Bending moment of Floating column with fluid viscous damper at different location. Also, Optimization of Damper position has been carried out using parameters like storey displacement, storey drift, storey stiffness
Prediction of the Financial Stock Market: A Comprehensive Analysis of Artificial Intelligence
Authors: MD Shadman Soumik
Published: January 2025

Since the inception of stock trading, scholars and investors have searched for reliable methods to forecast the course of stock values the next day. Since there are several variables that might influence the stock values of the next day, forecasting stock prices is a challenging undertaking. Stock Market Forecasting (SMF) is a forward-looking process anticipating future stock values, allowing to make sound financial decisions. In order to create predictions, academics and investors have started using machine learning approaches in conjunction with technical indicator analysis. However, the precision of the predictions is lacking. One of the progress in applying ML, particularly LSTM networks, to stock market forecasting lies in automating this process. Human bias implies that the same predictions can be misleading and contribute to the fact that they need to use ML and AI technology. The data used was fetched from finance.yahoo.com, and for confidence in the data, it took steps such as lemmatisation, null value management and deletion of duplicates. A total of four different ML prediction methods were utilised: LSTM is also being used ANN, CNN, K-Nearest Neighbour and many other algorithms. The model's performance was evaluated using measures including F1-score(Fs), recall(Rc), accuracy(Acc), and precision(Pr). Outcomes showed that the models were not all equally successful; however, the LSTM model had the best accuracy at 93%. Future attempts might consider other categorisation strategies and improving preprocessing methods to improve model performance and forecast Acc
Change Management in the Implementation of the Independent Curriculum in Sekadau District Secondary Schools
Authors: Vinawuli Tabais Yesi , Novianti Iluminata , Emakulata Maria , Radiana Usman
Published: January 2025

The implementation of the Merdeka Curriculum in secondary schools in Sekadau Regency, represents advancement in addressing globalization and technological progress, with the objective of fostering a more flexible, student-centered education that enhances student competency and engagement. This study seeks to examine change management during the introduction of the Independent Curriculum in secondary schools within Sekadau Regency. This study employs qualitative methodologies, using data gathering via semi-structured interviews and direct observation. Interviews were performed with school principals, educators, and administrative personnel to understand the problems and tactics employed in the curriculum modification process. Field observations were conducted to assess the implementation of the curriculum in classroom activities. The findings identify five principal barriers: the necessity for teacher retraining, technological and infrastructure constraints, cultural resistance, teacher fatigue during the shift, and insufficient training. This study underscores the significance of ongoing training, enhancement of technology infrastructure, and systematic change management within context. Proactive support from government and educational leadership is crucial for the effective implementation of the Independent Curriculum and the enhancement of educational quality in Sekadau Regency.
Sistem Skala Kegunaan Untuk Meningkatkan Fitur User Pada Website Ryzenrekber Dengan Evaluasi Kemudahan Pengguna
Authors: Haqiem Alief Lukman , Nurdiawan Odi
Published: January 2025

Website Ryzenrekber adalah platform yang digunakan untuk mendukung transaksi jual beli akun game online, termasuk PUBG Mobile. Keberhasilan website ini sangat bergantung pada tingkat kemudahan penggunaan (usability) dan kepuasan pengguna. Penelitian ini bertujuan untuk mengevaluasi usability website Ryzenrekber untuk meningkatkan pengalaman pengguna melalui pengembangan fitur yang lebih optimal. Pendekatan penelitian dilakukan menggunakan metode System Usability Scale (SUS), yang merupakan instrumen standar untuk mengukur usability berdasarkan persepsi pengguna. Penelitian ini memaparkan pentingnya usability dalam mendukung keberhasilan transaksi online di platform seperti Ryzenrekber. Masalah yang ditemukan adalah kurang optimalnya beberapa fitur yang dapat menyebabkan pengalaman pengguna yang tidak memuaskan, seperti navigasi yang kompleks, kecepatan akses, dan efektivitas fitur pencarian. Pengumpulan data melalui kuesioner dan didapatkan 151 responden yang disebarkan kepada pengguna aktif website digrup telegram ryzenrekber. Responden diminta untuk memberikan penilaian terhadap 10 pernyataan dengan skala Likert 1-5, yang kemudian dianalisis dan dilakukan perhitungan untuk menghasilkan skor usability. Hasil analisis menunjukkan bahwa website Ryzenrekber memperolehrata-rata skor SUS sebesar 69, yang berada di bawah ambang batas standar usability sebesar 70. Penelitian ini menyimpulkan bahwa evaluasi usability menggunakan metode SUS efektif untuk mengidentifikasi kekurangan website Ryzenrekber. Implementasi perbaikan yang didasarkan pada temuan penelitian ini diharapkan dapat meningkatkan kepuasan pengguna dan keberhasilan transaksi di platform tersebut.
 
 
Kata kunci: Usability testing, Website, System Usability Scale
Antracycline Induced Early Onset Chronic Cardiotoxicity in Cancer Patients
Authors: Idrees Ibtisam , Ahmad Riaz , Nadeem Muhammad , Khan Amjad , Gilani Atifa , Khattak Rahimullah
Published: January 2025

Objective: To assess the patients for early onset chronic cardiotoxicity who have been taking anthracyclines as part of their cancer treatment.
Study Design: Comparative cross-sectional study.
Place and Duration of Study: Oncology department, Combined Military Hospital, Rawalpindi Pakistan, from Dec 2020 to May 2021.
Methodology: One hundred patients with solid or hematological malignancies taking anthracyclines for more than three months and less than a year were included in the study. They underwent 2 dimensional echocardiography by consultant cardiac physician to look for cardiotoxicity. Cardiotoxicity was defined as left ventricular ejection fraction less than 60%. Age, gender, duration of anthracyclines use and presence of comorbid illness were correlated with presence of early onset chronic cardiotoxicity in our study participants.
Results:  Out of 100 cancer patients using anthracyclines for more than three months and less than 12 months included in the study, 55(55%) were males while 45(45%) were females. Sixty-nine (69%) had ejection fraction more than 60% on echocardio-graphy while 31(31%) had <60%. Chi-square test revealed that presence of comorbidities (type 2 DM/ Hypertension) had statistically significant association with presence of cardiotoxicity in our study (p-value 0.002).
Conclusion: Cardiotoxicity emerged as a significant adverse effect related to anthracycline use among patients suffering from various types of malignant conditions. Patients with preexisting medical conditions like diabetes or hypertension were more at risk of developing cardiotoxicity with these agents.
Efficacy of Oral Racecadotril in Children with Acute Watery Diarrhea
Authors: Tahir Rida , Nadeem Muhammad Tariq , Javed Hira , Ijaz Maryam
Published: January 2025

Objective: To determine the efficacy of Racecadotril in treating acute watery diarrhea among children under 5 years of age attending Combined Military Hospital, Rawalpindi Pakistan.
Study Design: Quasi-experimental study.
Place and Duration of Study: Department of Pediatrics, Combined Military Hospital, Rawalpindi Pakistan, from Jul to Dec 2022.
Methodology: All patients aged 6 months to 5 years with acute watery diarrhea were consecutively enrolled. All children were randomly divided into a control group (Oral Rehydration Supplement) and a study group (Racecadotril 1.5 mg/kg every eight hours). Racecadotril administration lasted until diarrhea symptoms improved or five days after the start of the treatment. From day 1 to day 5, the quantity and consistency of stool were noted. On day 5, clinical effectiveness was indicated by three stools or fewer per day.
Results: Of 90 children, the overall efficacy was 61(67.8%). A significant association of efficacy was observed with the treatment group (p <0.001), degree of dehydration (p <0.001), and mother’s educational status (p 0.015). The efficacy was 4.82 times higher among children who received Racecadotril (aOR: 4.82, 95% CI 1.48-15.76), 3.21 times higher among intermediate or higher mothers’ education (aOR: 3.23, 95% CI 1.32-7.91), 2.84 times higher among below matric mothers’ education (aOR: 2.84, 95% CI 1.24-6.48) while 94% lower among children with severe dehydration (aOR: 0.06, 95% CI 0.01-0.27).
Conclusion: Racecadotril's efficacy was higher in treating children with acute watery diarrhea than Oral Rehydration Supplement alone in children under 5 years old.
Effect of Smoking on Antiplatelet Action of Clopidogrel in Patients with Ischemic Heart Disease
Authors: Nawaz Usman , Noor Mudassar , Khan Waqar Aslam , Bakhtiyar Salman , Nawaz Amina
Published: January 2025

Objective: To explore relationship between smoking and antiplatelet action of Clopidogrel in patients with ischemic heart disease (IHD).
Study Design: Quasi-experimental study
Place and Duration of Study: Department of Pharmacology, Army Medical College, National University of Medical Sciences, Rawalpindi, Pakistan from Aug 2015 to Dec 2019.
Methodology: The quasi experimental study was carried out on 390 patients with IHD recruited through convenience sampling. Patients were placed in two groups. Group-1 included smokers while group-2 patients were nonsmokers. Blood samples of smokers (n=151) and nonsmokers (n=239) IHD patients were taken. Platelet function testing of all the samples was done through light transmission aggregometer (LTA) using adenosine diphosphate (ADP) as an agonist.
Results: Among patients of IHD 82.12% of the smokers on Clopidogrel therapy were Clopidogrel responders and 17.88% were Clopidogrel resistant, while in nonsmoker group 70.71% patients were Clopidogrel responders and 29.29% were Clopidogrel resistant. There was a significant difference in Clopidogrel response status between smokers and nonsmokers, p=0.011. Furthermore, mean platelet aggregation of smokers was significantly lower than that of nonsmokers, p=0.004.
Conclusion: Smoking can enhance antiplatelet effect of Clopidogrel in IHD patients with greater platelet inhibition and lesser chances of Clopidogrel resistance.
Evaluation of the Role of Losartan in the Prevention of Benign Prostate Hyperplasia in Rats
Authors: Shahid Arooj , Waheed Akbar , Ali Shabana , Farhat Kulsoom , Mehmood Sikandar , Amin Mehwish
Published: January 2025

Objective: To evaluate the preventive role of Losartan in testosterone-induced Benign Prostate Hyperplasia in an adult rat model.
Study Design: Laboratory-based experimental study.
Place and Duration of Study: National Institute for Health, Islamabad Pakistan, for four weeks in Oct 2021.
Methodology: A total of ninety (n=90) rats were divided into three equal Groups, having thirty rats each. In group-A, no active intervention was carried out. In groups B and C, subcutaneous injections of testosterone were administered daily for 28 days to induce a Benign Prostate Hyperplasia model. In group-C, Losartan was administered daily. Animals were sacrificed after the study period of 4 weeks. The animal and prostatic weights were measured to calculate the prostatic index. Blood samples were taken to assess Prostate-Specific Antigen levels, and prostate samples were preserved for histo-pathological analysis.
Results: Mean prostatic weight, prostatic index and serum Prostate-Specific Antigen showed a statistically significant decrease in group-C, where Losartan was given, compared to the disease control group-B (p-value <0.001). Moreover, histo-pathological features like glandular and stromal hyperplasia and the formation of intra-luminal papillary folds were significantly reduced in the drug-treated group-C compared to group-B.
Conclusion: Losartan is an effective drug for the prevention of Benign Prostate Hyperplasia.
Effect of Physical Training on Oxygen Saturation at Very High Altitude in Young Males
Authors: Raza Syed Hassan , Satti Shahzeb Ahmed , Arshad Abdur Rehaman , Chaudry Azhar Ali , Imran Muhammad , Iftikhar Raheel
Published: January 2025

Objective: To determine the effect of physical training on oxygen saturation at very high altitude in young male individuals.
Study Design:  Prospective longitudinal study.
Place and Duration of Study: Department of Pulmonology PEMH Rawalpindi from Jun–Jul 2022.
Methodology: The study was done on 250 young individuals arriving at a height of 11,820 feet for the very first time. All individuals were made to stay at the same height for the study period of 28 days. Individuals were tasked to walk 100 meters daily at a steady pace to ensure physical activity. Oxygen saturation was measured, before and after walking 100 meters at a height of 11,820 feet on day 0, day 7, day 14 and day 28 respectively.
Results: Mean age of the study participants was 28.08±4.82 years. On day 0, post walk average oxygen saturation was 91.53±1.80%. After a stay of 28 days at a height of 11, 820 feet post walk average oxygen saturation increased to 92.24±2.18%.  
Conclusion: The oxygen saturation of young individuals improved over a period of 28 days stay after physical training. Human body adapts to physical training at high altitude by undergoing a large number of physiological processes resulting in improved exercising capacity and increase in oxygen saturation over a period of time.
Does Participation in Peer Assisted Learning Programs as a Tutor Lead to an Increase in Teaching Skills Domains? A Quasi-Experimental Study
Authors: Khan Ayub Ahmed , Hussain Kinza , Asif Anam , Khan Mustafa
Published: January 2025

Objective: To evaluate the effectiveness of a training program for tutors in peer-assisted learning using objective structured teaching evaluation scores.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Lahore Medical College and Institute of Dentistry, Lahore Pakistan, from Jul 2022 to Oct 2022.
Methodology: Peer-assisted learning was introduced for fourth-year MBBS students rotated in the Ear, Nose, and Throat Department. Twenty-two students, demonstrating strong academic performance and a willingness to teach, were chosen as peer-assisted learning tutors. A series of workshops was conducted to equip these tutors with effective peer-assisted teaching and learning strategies. To gauge the influence of the training on the tutors' teaching abilities, data were collected using 12 stationed Objective Structured Teaching Evaluation scores, both pre-and post-workshop series.
Results: Of the 22 students, 16(72.73%) were females, while 6(27.27%) were males. Their ages ranged from 21 - 24 years, with a mean age of 22.45±0.73 years. The study revealed a significant improvement in total Objective Structured Teaching Evaluation raw scores for Peer-assisted learning tutors. The Pre-Objective Structured Teaching Evaluation median score was 35(IQR: 9), exhibiting a substantial increase to 61(IQR: 5.75) Post-Objective Structured Teaching Evaluation, with a statistically significant change (p<0.001).
Conclusion: The research results indicate that training Peer-Assisted Learning Tutors in teaching and learning principles significantly enhanced their teaching skills.
Co-Existence of Uterine Myomas and Endometriosis in Women Undergoing Myomectomy/Hysterectomy
Authors: Arwa Fatima  , Yazdani Tehreem , Zafar Bushra , Shafqat Hira
Published: January 2025

Objective: To determine the frequency of coexistence of myomas and endometriosis in patients undergoing myomectomy or hysterectomy.
Study Design: Cross-sectional study.
Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, Pakistan from Sep 2022 to Sep 2023.
Methodology:  Seventy (70) patients undergoing above mentioned myomectomy/hysterectomy were visually examined for the presence of endometriosis. The Chi-square test and Fisher's exact test were used in SPSS-20 to determine the significance of the relationship between the two conditions. Categorical data were expressed as descriptive statistics through frequency percentile. Analysis of continuous variables was carried out through the one-way ANOVA.  Results were considered significant at p≤0.05.
Results: In this study, 13 out of 70(18.57%) of the patients operated for myomectomy/ hysterectomy were found to have coexisting uterine myomas and endometriosis. Statistically non-significant (p=0.08) association between these two ailments was noted. Age, parity and body weight were not found to influence the existence or coexistence of these ailments. Pain was a significant finding 13(18.57%) in cases of endometriosis and coexisting uterine myomas (p=0.00).  Abnormal uterine bleeding was found significantly (p=0.02) associated with uterine myomas 54(77.14%). Subfertility though a predominant feature was not found to have a significant association with both the conditions and their coexistence (p=0.35, p=0.34 & p=0.44).
Conclusion:  A non-significant association between uterine myomas and endometriosis. Pain was a significant finding where the two diseases coexisted.
Pattern of Skin Diseases in Children Attending Dermatology Outpatient Department of a Tertiary Care Hospital
Authors: Habib Aamir , Aamir Reham Binte , Nazeer Hafsa , Ahmed Asfa , Ansari Mohsin Mehmood , Basra Arslan Ahmed
Published: January 2025

Objective: To determine the pattern and frequency of skin disorders in children attending Dermatology Department of a Tertiary Care Hospital.
Study Design: Cross-sectional study.
Place and Duration of Study: Dermatology Department, Combined Military Hospital Bahawalpur, from Mar to Aug 2023.
Methodology: Three thousand eight hundred and eleven (3811) children reporting to dermatology outdoor department with skin diseases during the study period were included in this study. All cases were diagnosed by a consultant dermatologist.  Data regarding patient age and sex was collected for each patient. Diseases were categorized into various groups depending on aetiology and cutaneous structure affected by the disease.
Results: The mean age of patients was 8.03+4.40 years. Most common diseases were infections (n=1607, 42.2%), followed by parasitic diseases (n=843, 22.1%), dermatitis and eczematous disorders (n=497, 13.0%) and inflammatory dermatoses (n=136(3.6%) in descending order of frequency. Together, these groups comprised 80.1% of total patients (n=3083). Infections and infestations were found in 64.3 % (n=2445).
Conclusion: Infections and infestations are the most commonly encountered disease groups. Scabies followed by pyodermas, dermatophytoses and atopic dermatitis were the four commonly encountered paediatric dermatoses in descending order of frequency, accounting for 54.3% of total number of paediatric patients.
Enhanced Recovery after Planned Gynaecological Surgery: A Study on Gut Motility and Hospital Stay
Authors: Saleem Uzma , Nadia Arif
Published: January 2025

Objective: To evaluate the effectiveness of chewing gum in ameliorating post-operative ileus, reducing hospital stay and improving patient satisfaction after planned gynecological surgery.
Study Design: Quasi-experimental study.
Place and Duration of Study: Combined Military Hospital Kharian, Pakistan from Aug 2022 to Mar 2024.
Methodology: The quasi-experimental study was conducted on a total of 400 patients satisfying the inclusion criteria. Patients were divided into two groups.  Group-A had 243 patients while group-B had 157 patients. Patients in the group-A were made to start chewing gum 8 hours post surgery for 15 minutes thrice a day, whereas group-B did not chew any chewing gum. The outcome measures were time to first bowel sounds, passage of flatus, bowel opening, nausea, vomiting, abdominal distension, length of hospital stay and patient satisfaction.
Results: Mean age of patients in groups A and B was 44.0 and 40.0 years respectively. The median time to first audible gut sounds and passage of flatus in group-A were 19.0(17.0-22.0) and 24.0(23.0-28.0) hours versus 23.0(21.0-24.0) and 28.0(27.0-28.5) hours in group-B, p≤0.001. Mean time of first liquid intake and bowel opening in group-A was 28.0(28.0-31.0) and 40.0(37.0-42.0) hours as opposed 31.0 (30.0-42.0) and 44.0(42.0-48.0) hours in group-B, p≤0.001. Mean length of hospital stay in group-A and B was 44.0(42.0-46.0) and 52.0(47.0-56.0) hours with a p-value ≤0.001. There was significantly less nausea and improved patient satisfaction in group-A.
Conclusion: Gum chewing following surgery enhances post-operative Bowel function recovery, patient satisfaction and shortens hospital stay.
Clinical Response of Meropenem versus Meropenem and Azithromycin in Extensively Drug-Resistant Salmonella
Authors: Muhammad Ameen  , Ali Sundus , Ashraf Jawad , Ikram Naaz , Siddiqi Ayesha , Naseer Asif
Published: January 2025

Objectives: To compare the clinical response of Meropenem versus a combination of Meropenem and Azithromycin in Extensively Drug-Resistant Salmonella.
Study Design: Quasi-experimental study.
Place and Duration of Study: Tertiary Care Hospital, Malir Pakistan, from Mar to Sep 2023.
Methodology: A total of 100 patients (50 in the Meropenem group and 50 in the Meropenem and Azithromycin group) who were diagnosed with typhoid fever secondary to extensively drug-resistant salmonella were included. The duration of hospital stay, post-therapy C-reactive protein, time for defervescence, and complete clinical response were compared between the groups.
Results: Median age was 29(49–16) years. There were 78(78%) males and 22(22%) females. Median weight of patients was 75(90–55) kg. Median duration of fever was 6(14–1) days. Median baseline C-reactive protein was 44(167–13) mg/dl. Complete clinical response in Meropenem alone group 49(98%) was significantly higher as compared to Meropenem + Azithromycin group 38(76%), (p=0.001). Similarly, duration of hospital stay and time to defervescence were also significantly shorter in the Meropenem alone group (p<0.001).
Conclusion: Meropenem alone is better than the combination of Meropenem + Azithromycin, with a shorter hospital stay, lesser time to defervescence, and better clinical response.
Comparison of Age, Gender, and Bacteria Isolated with Antibiotics Resistance Patterns on Urine Cultures
Authors: Amir Mumtaz , Malik Ahmed Hassaan , Saleem Muhammad Rehan
Published: January 2025

Objective: To compare age, gender, and bacteria isolated from urine cultures with antibiotic resistance patterns.
Study Design: Cross-sectional study.
Place and Duration of Study: Surgery and Pathology Department Combined Military Hospital, Bannu Pakistan, from Jan 2023 to Apr 2024.
Methodology: Three hundred and eighty-six patients aged 1 to 80 years with urinary tract infection symptoms were included. Patients having recurrent urinary tract infections, immunocompromised patients already taking antibiotics, and those with multiple co-morbid conditions were excluded. Urine cultures were evaluated, and the sensitivity/resistance pattern was compared with gender, age, and bacteria isolated in positive cases.
Results: Forty-six samples were culture positive (11.9%). Escherichia coli was the most frequently isolated organism, obtained from 32 samples (69.6%), while Pseudomonas aeruginosa was isolated from 8 samples (17.4%), Klebsiella pneumoniae from 4(8.7%), Enterobacter from 1(2.2%) and Serratia liquefaciens from 1(2.2%) sample.  Resistance to Ampicillin was found in 30 samples (88.2%), Amoxicillin/Clavulanic acid 24(85.7%), Ciprofloxacin 23(74.2%), Ceftriaxone 18(69.2%), Levofloxacin 10(66.7%), Co-trimoxazole 21 samples (65.6%), Cefepime 9(36%), Gentamicin 7(33.3%), Meropenem 10(27%), Piperacillin/Tazobactum 3(14.3%), Fosfomycin 4(13.8%), Amikacin 4(10.5%), and Nitrofurantoin 3 samples (7.5%) respectively. No statistically significant difference was found for gender, age, or type of bacteria with antibiotic sensitivity/resistance profiles (p>0.05).
Conclusion: Urinary tract bacteria resist most prescribed antibiotics, including Ampicillin, Amoxicillin/Clavulanic acid, Ciprofloxacin, Levofloxacin, Ceftriaxone, and Co-trimoxazole.
Frequency of Adjunctive Treatments Requiring Referrals among Patients at Prosthodontics Department in Pakistan
Authors: Qureshi Ali Waqar , Sunny Adnan , Waleed Babar Sardar , Ahsan Areesha , Hasan Idris Shujaat , Khan Natasha
Published: January 2025

Objective: To report the frequency and types of adjunctive treatments requiring referral for patients in the Prosthodontics Department in Pakistan.
Study Design: Cross-sectional study.
Place and duration of study: The study was conducted in Prosthodontics Department, Peshawar Dental College, Peshawar from April 2020 to October 2020.
Methodology: The study involved 218 patients reporting to the outpatient department of the Prosthodontics department, both genders, with no prior prosthodontic experience. Following the establishment of the diagnosis, and treatment plan via history taking and examination, a decision for referral for adjunctive treatment required was made and noted in the patients’ record file, and this data was collected in a pre-structured proforma.
Results: In total, 218 patients who attended the Department of Prosthodontics were evaluated. The referrals made to the Departments of Operative Dentistry and Endodontics were of 97(44.49%) patients, Oral and maxillofacial Surgery (OMFS) were 61(27.98%) patients, followed by Periodontology were 58(26.60%) patients, while Orthodontics for only 2(0.92%) patients. A statistically significant association of these referrals was observed with the gender as well as the oral hygiene status of the patients with a p-value of 0.001 and 0.021. However, the association of these referrals with the socioeconomic status of the patients was statistically insignificant with a p- value of 0.604.
Conclusion: Referrals needed to the Operative/Endodontics Department were more followed by Oral And Maxillofacial and Periodontics Department. The least referrals were those of Orthodontics.
Electrothermal Vessel Sealing a Time Saving Alternative to Classic Suturing in Total Abdominal Hysterectomy; A Retrospective Study
Authors: Zohra Sadaf , Firdos Chohan Shazia , Najeeb Wajeha , Komal Naima , Mohsin Rabia , Islam Abida
Published: January 2025

ABSTRACT
Objective: To analyze efficacy of Electrothermal Vessel Sealing in comparison to Conventional Suture Ligation in Total Abdominal Hysterectomy.
Study Design: Quasi-experimental study
Place and Duration of Study: Department of Obstetrics and Gynecology, Pakistan Emirates Military Hospital Rawalpindi, Pakistan from Aug 2022 to Aug 2023.
Methodology: The quasi-experimental study included one hundred and sixty six participants divided into two groups, Group-I had 83 patients while 83 patients were placed in group-II. Group-I received Ligasure and group-II received conventional suturing while undergoing total abdominal hysterectomy. Primary outcomes included estimated blood loss, pedicle securing time, surgery duration, post-operative NPO and hospital stay. Secondary outcomes involved need for suture ligation in surgeries with Ligasure.
Results: Median age was for group I was 49(7) for Ligasure and 48(5) for conventional suture. Both groups had median BMI of 25(4) and median parity of 4(1). In the Ligasure group, 58(69.9%) participants had TAH, and 25 (30.1%) had TAH and BSO, while in the conventional suture group, 63(75.9%) had TAH and 20(24.1%) had TAH plus BSO. In the Ligasure group, 49.4% of the participants had AUB as the most common indication, whereas in the conventional suture group, 42.2% had leiomyoma. Notably, there was significantly lower blood loss with Ligasure (90 vs. 200 ml, p-value 0.001), as well as a shorter duration of surgery (35 min vs. 65 min, p-valu
Conclusion: Ligasure was found to be advantageous over conventional suture in terms of perioperative surgical outcomes for total abdominal hystrectomy.
Challenges and Barriers Towards Medical Research Among Medicaland Dental Students of Public Sector Medical College
Authors: Omer Umme Ammarah , Abbasi Muhammad Ali , Razzaq Ayan-ur- , Qureshi Shaista Noor , Tiwana Madeeha , Zahid Khaula
Published: January 2025

Objectives: This study aims to identify challenges and attitudes of undergraduate medical students during research engagement and propose strategies to overcome them.
Study Design: The study is a cross-sectional study.  
Place and Duration of Study: The study was conducted in the Medical and Dental departments of Army Medical College Rawalpindi. Duration of the research spanned from March 2023 to May 2023, following approval from the Ethical Review Committee of Army Medical College (ERC/ID/264 Dated: 03 March 2023).
Patients and Methods: A 29-item questionnaire for the quantitative cross-sectional study was adopted from another study and was further validated by a panel of 06 experts in the field of medical education and research. A pilot test was conducted to verify the construct of the adopted tool. A random sampling technique was employed to select the participants. The inclusion criteria were undergraduate medical students who have studied medical research modules. Non-respondents and unwilling participants fall under the exclusion criteria of the study. Analysis was conducted using the Statistical Package for Social Sciences (SPSS) program, Version 26.
Results: Out of a total of 135 participants, 94.1% belonged to MBBS and 5.9% were in the BDS training program. Female turnover was 59.3% and male participants were 40.7%. Common barriers reported by the participants were “lack of information” (28.1% strongly agree, 38.1% agree
Conclusion: Despite barriers, a significant proportion of participants actively engaged in research, with high publication rates (81.5%) and recognition (76.3%). While the majority recognized the importance of medical research (88.1%),
The Spectrum of Malignant Tumours at a Tertiary Care Hospital in Rawalpindi
Authors: Khadim Muhammad Tahir , Parveen Bushra , Din Hafeez Ud , Ameer Amna , Arif Ayesha
Published: January 2025

Objective: To determine the frequency of malignant tumors seen in our practice and to provide a foundation for building a comprehensive cancer care strategy.
Study Design: Cross-sectional study.
Place and Duration of Study: Histopathology Department, Armed Forces Institute of Pathology Rawalpindi, Pakistan from 2009 to 2018.
Methodology: All malignant tumors reported from 2009-2018 were retrieved from our tumor registry. This data was analyzed for overall frequency gender distribution, age groups and type/site relationship. Present data was also compared with recent and previous such analyses done both nationally and worldwide, in similar settings and demographics.
Results: Total 37793 malignant tumors were diagnosed and registered. Out of this, 22077(58.4%) were males and 15716(41.5%) were females. The most common cancer reported was breast (14.3%) followed by urinary bladder (8.7%), oral (6.7%), lymph nodular (5.5%) and prostatic (5.3%). Malignant tumors in pediatric age group (0-14 years) were found to be 3.4%. Most malignancies were reported in 6th decade of life.
Conclusion: There was increase in the total number of the malignant tumors during 2009-2018, as compared to the previous 10 years’ data.  Male to female ratio was 1.4:1. The five most common sites in male were urinary bladder, prostate, skin, lymph nodes and oral cavity and pharynx.  Whereas in females these were breast, skin, oral cavity, female genital organs (ovary) and lymph nodes.
Induction with Taxane/Platinum Based/5-Fu (TPF) Chemotherapy as a Predictor of Response to Definitive Concurrent Chemo Radiotherapy (CCRT) in Locally Advanced Inoperable Head and Neck Cancers
Authors: Memon Batool Aslam , Haider Ghulam , Ather Tooba , Ashfaq Maliha , Aslam Muhammad , Sehar Sana
Published: January 2025

Objective: To evaluate the effect of induction with Taxane/platinum based/5-FU chemotherapy as a predictor of response to definitive concurrent chemoradiotherapy in inoperable locally advanced squamous cell carcinoma of head and neck.
Study Design: Interventional study.
Place and Duration of Study: Medical Oncology Department, Jinnah Postgraduate Medical Center Karachi, Pakistan, from Oct 2019 to Oct 2020.
Methodology: A total of 71 patients aged 18 years or more with inoperable, locally advanced squamous cell carcinoma of the head and neck were included. Patients were given three cycles of induction therapy with injection Docetaxel 75 mg/m2 day 01, injection Cisplatin 75 mg/m2 intravenously (IV) day 01 and 5-Fluorouracil 1000 mg/m2 IV day one-four every three weeks. CT scan was repeated after the last cycle to check response. All patients irrespective of response to induction received concurrent chemoradiotherapy, which included administration of weekly Carboplatin AUC-2 with radiotherapy 5 days per week. Response was assessed according to revised Response Evaluation Criteria in Solid Tumors (RECIST v1.0) criteria.
Results: The mean age of our respondents was 48.46±12.74 years. Of 71 patients, 26(36.6%) had achieved partial response after concurrent chemoradiotherapy, 24(33.8%) had achieved complete response, 10(14.1%) had stable disease and 11(15.5%) had progressive disease. There was a statistically significant association between response to concurrent chemoradiotherapy and response to induction chemotherapy (p=0.001).
Conclusion: The response of induction chemotherapy can be used as a guide to select patients for definitive concurrent chemoradiotherapy versus palliative treatment.
Acute Liver Failure in a Neonate; A Case Report
Authors: Fakih Misbah , Tariq Sidrah , Shoaib Muhammad , Ikram Farooq , Asad Hafsa
Published: January 2025

Neonatal hemochromatosis is a rare disorder that poses significant mortality and morbidity risks. It is one of the causes of acute liver failure in neonates. We report a case of a 15-day-old girl with complaints of jaundice and progressive liver failure; a family history of 3 early neonatal deaths with similar complaints led to the strong suspicion of Gestational Alloimmune Liver Disease. Clinicians should consider Gestational Alloimmune Liver Disease in cases of fetal demise, stillbirth, and neonatal acute liver failure, as treatment is available and effective for subsequent pregnancies.
Assessing the Therapeutic Role of Oral Gastrografin in Subacute Intestinal Obstruction
Authors: Zubair Muhammad , Noman Syed Muhammad , Nasir Ammad ud Din , Malik Arsalan Sharif , Naz Faheem Ullah , Ramzan Amna
Published: January 2025

Objective: To assess the therapeutic role of gastrografin in patients with subacute intestinal obstruction.
Study Design: Quasi-experimental study.
Place and Duration of Study: Surgical Department, Combined Military Hospital, Rawalpindi, Pakistan from Jul to Dec 2019.
Methodology: A total of 112 patients who presented to Combined Military Hospital, Rawalpindi with subacute intestinal obstruction were included. Fifty-six patients were each allotted into group-A and group-B. Group-A were controls and received conventional treatment, whereas group-B, which was the study group received addition of 100 ml gastrografin meal. Patients were followed up with variables like operative rates, hospital stay during the admission and further readmissions with similar complaints were also assessed in next 3months time.
Results: Surgical operation was performed in 14(25%) of the non-gastrografin group (group-A), for whom conservative treatment failed. In contrast, surgery was required in 5(8.9%) patients from the gastrografin group (group-B). The length of hospital stay showed a significant reduction from 5.02±1.61 days to 3.2±0.72 days for groups A and B, respectively. Readmission rate between groups was not statistically significant (p=0.151).
Conclusion: We concluded that the gastrografin administration in subacute intestinal obstruction has a definite advantage in terms of lower surgery rate and reduced hospital stay.
Factors Associated with Post Stroke Dysphagia Recommendations in Pakistan: Compliance by Caregivers Perspective
Authors: Shakeel Rimsha , Mumtaz Nazia , Saqulain Ghulam , Shakeel Maryam , Ahmad Nadeem
Published: January 2025

Objective: To determine factors associated with primary care givers’ compliance to post stroke dysphagia and provide recommendations in Pakistan.
Study Design: Cross sectional survey
Place and Duration of Study: Armed Forces Institute of Rehabilitation Medicine Rawalpindi, Pakistan from Jun 2019 to Apr 2020.
Methodology: The study included 92 caregivers which were recruited through purposive sampling. The caregivers were assisting post stroke dysphagia patients of either gender above 18 years of age. Data collection was done using Caregiver Mealtime and Dysphagia Questionnaire (CMDQ). Demographic data was obtained using a basic demographic sheet.
Results: Study revealed association of Caregivers compliance to dysphagia recommendations with Patient’s Occupation (p=0.001), Income (p=0.005) and Time Since Onset of Stroke (p=0.050). While no association was noted for Age, Gender, and Education of Patient and Caregiver; Occupation and Income of Caregiver; Type of Palsy and Number of Episodes; Individual Disabilities; Caregiver’s relation with Patient, Time Spent with Patient, Frequency of visits, Marital Status and Area of Origin.
Conclusion: There was association of caregivers’ compliance to speech language pathologist’s dysphagia recommendations with Occupation and Income of the patient and Time Since onset with no association with other socio-demographic and clinical characteristics.
Educational Environment in A Medical College: Exploration of Strengths, Weaknesses and Improvement Strategies
Authors: Hassan Mahmood Ul , Ashar Abid
Published: January 2025

Objectives: To assess the Dundee Ready Education Environment Measure (DREEM) score of the college environment with identification of strengths and weaknesses and suggesting remedial measures.
Study Design: Mixed method sequential explanatory study.
Place and Duration of Study: Peshawar Medical College, Peshawar Pakistan, from Feb to Apr 2019.
Methodology: Dundee Ready Education Environment Measure (DREEM) questionnaire was used to quantitatively assess the educational environment of the college while in the qualitative part of the study, interviews were conducted to find out remedial measures to overcome the weaknesses and to further improve identified strengths.
Results: In the quantitative part of the study, the overall DREEM score of the college was calculated to be 130.576. Taken separately, 1st year, 3rd year and final years had scores of 128.38, 131.97 and 131.40 respectively, which were rated as more positive than negative. This study identified that students feel overburdened with studies and feel stressed. In the qualitative part of the study, thematic analysis of interviews identified that stress and time management workshops at regular intervals, establishing student support groups, strengthening mentorship programs, frequent formative assessment and involvement of students in the curricular forums are possible remedial measures.
Conclusion: Oue student’s perception of college educational environment is positive. Overburdening with studies and stress in medical students were identified as problem areas. Identified improvement measures included establishing support groups for the students, arranging stress management workshops and strengthening mentorship programs.