bluuebunny/crossref_metadata_2025 huggingface dataset:
GEOMETRIC AND KINEMATIC CHARACTERISTICS OF FEEDER AND THROWER OF MILLING AND ROTARY SNOWBLOWER
Authors: Aleshkov D. S.
Published: November 2018

Introduction.Questions of the maintenance of territories and road network in winter conditions are directly connected with timely and qualitative clearing of roads and territories of snow. Designing and creation effective milling and rotary snowblowers, which work includes some technological operations on snow cleaning, consist in a correct choice of geometrical and kinematic parameters of basic elements. At a design stage the technique, allowing to carry out a choice of the basic technological parameters of such vehicles is necessary and further it would allow to make optimization directly. The purpose of this paper is representation of dependences of the basic technological parameters of the milling and rotary snowblowers and sequence of their choosing.

Materials and methods. The paper presents analytical equations connecting geometrical and kinematic characteristics of the feeder, the thrower of milling and rotary snowblower from conditions of maintenance of identical productivity. Moreover, the analysis of the received equations and dependences by choice milling and rotary snowblower parameters is presented. Sequences of the basic geometrical and kinematic parameters’ influence on each other are revealed.

Results.As a result, the comparative estimation of the offered and existing equations is made. The character of dependence of angular speed of the throwing device rotation on translational speed of the milling and rotary snowblower and width of the rotor blade is established. On the basis of the received dependences the algorithm of the basic technological parameters’ choice on the milling and rotary snowblowers, proceeding from the minimization condition of the initial parameters’ task are considered.

Discussion and conclusion. The presented dependences allow to spend effectively outline designing of new constructions of milling and rotary snowblowers and to carry out optimisation of existing models of milling and rotary snowblowers.
ANALYSIS OF SOME APPROACHES IN CURRENT PRACTICE OF TRANSPORT MODELLING
Authors: Temnov E. S.
Published: November 2018

Introduction. The urgency of transport modeling, which is the basis for the implementation of various technical solutions aimed on the automated traffic control systems usage based on a new generation of road controllers, is noted. The circumstance according to which the transport modeling acquires essentially dynamic approach is specified. The aim and the problems of the study are formulated, consisting in the generalization and formalization of the tasks of transport modelling.

Materials and methods. To solve such problems the author uses methods of system analysis, theory of transport systems, as well as techniques that are widely used in the community of transport engineers, including various options for computational and experimental methods of modeling traffic flows and transport systems for the city or agglomeration.

Results. On the basis of generalization of information about stages of transport modeling the sequence of actions leading to obtaining the required transport model, by means of which it is possible to carry out the decision of a specific task, is offered. The list of the main tasks of transport engineering is formulated, the importance of the dynamic approach and the special role of the theory of transport macro systems are indicated, according to the provisions of which stochastic processes at the micro level lead to the deterministic behavior of transport systems at the macro level.

Discussion and conclusions. The main result of the research is the development of the control actions for the operation of the intelligent transport system that evenly distributes traffic flows through the network and prevents the occurrence of congestion in real time. The basis for it is the formulation and solution of various problems of transport modeling.
RESULTS OF PASSENGER RESOURCES EXAMINATIONS IN KYZYL CITY OF THE TYVA REPUBLIC
Authors: Shavyraa Ch. D.
Published: November 2018

Introduction.The paper considers the results of surveys taking into account the efficiency increase of passenger traffic in a small town. The need to regulate the work of carriers of various ownership forms, taking into account the characteristics of urban routes, determines the relevance of the research in this area. Therefore, the purpose of the survey is to clarify the total size of the movement of the zones and the city as a whole for the further projects’ development of the road network planning and for the passenger traffic development.

Materials and methods.The paper considers alternatives to passenger surveys, i.e. application of the most optimal variants of the transportation plan. The characteristics of the route and load on the routes of Kyzyl are also illustrated. The author uses the methodology of surveying the population transport needs in a small town, in particular, the counting of passengers.

Results.As a result, the author conducts the survey of passenger traffic, taking into account the city specific. The characteristics of the route and the load on the routes of Kyzyl are studied. It is important to use the methodology of the transport needs and transport services for population in a small town.

Discussion and conclusions. On the basis of the conducted surveys of passenger traffic, the average hourly volume of transportation on routes is revealed and the unevenness of traffic volume is calculated.
MANUFACTURING OF THE SIBERIAN FEDERAL DISTRICT REGIONS IN THE CONTEXT OF ECONOMIC SAFETY
Authors: Miller M. A.
Published: November 2018

Introduction.The article is devoted to the study of the regional manufacturing industry of the Siberian Federal District from the standpoint of economic security. The purpose of the article is to analyze the manufacturing industries on the basis of the proposed indicators group and in the context of ensuring economic security of the Siberian federal district.

Materials and methods.The scientific methods of logic, comparison, as well as the method of the statistical materials’ analysis are used in the research. The analysis of the manufacturing industry was carried out in two groups of indicators:

1)            indicators determining the socio-economic importance of the manufacturing industry for the region;

2)            indicators of the export potential of the regional manufacturing industries, contributing to the development of the region.

Results.The main results of the study are in identifying the regions of the Siberian Federal District, in which the manufacturing industry is the most important component in supporting the development of the region and maintaining its economic security. Moreover, special attention is paid to the contribution of manufacturing industries to the socio-economic stability of the Omsk region.

The paper touches upon the theoretical and methodological provisions related to the study of the role of manufacturing industry in the development of the country and its regions and in improvement of methods for assessing regional economic security. The author proposes the group of indicators that allow more accurately reveal the impact of manufacturing industry on the socio-economic condition of the region.

Discussion and conclusion. The conducted research allows supplementing the existing scientific directions with the approach, which clarifies the assessment of the manufacturing industry with an analysis of its export potential indicators, in order to expand the comprehensive understanding of the most problematic points of regional development from economic security point of view.
Pollination ecology in the 21st Century: Key questions for future research
Authors: Mayer Carolin , Adler Lynn , Armbruster W. Scott , Dafni Amots , Eardley Connal , Huang Shuang-Quan , Kevan Peter G. , Ollerton Jeff , Packer Laurence , Ssymank Axel , Stout Jane C. , Potts Simon G.
Published: November 2018

To inspire new ideas in research on pollination ecology, we list the most important unanswered questions in the field. This list was drawn up by contacting 170 scientists from different areas of pollination ecology and asking them to contribute their opinion on the greatest knowledge gaps that need to be addressed. Almost 40% of them took part in our email poll and we received more than 650 questions and comments, which we classified into different categories representing various aspects of pollination research. The original questions were merged and synthesised, and a final vote and ranking led to the resultant list. The categories cover plant sexual reproduction, pollen and stigma biology, abiotic pollination, evolution of animal-mediated pollination, interactions of pollinators and floral antagonists, pollinator behaviour, taxonomy, plant-pollinator assemblages, geographical trends in diversity, drivers of pollinator loss, ecosystem services, management of pollination, and conservation issues such as the implementation of pollinator conservation. We focused on questions that were of a broad scope rather than case-specific; thus, addressing some questions may not be feasible within single research projects but constitute a general guide for future directions. With this compilation we hope to raise awareness of pollination-related topics not only among researchers but also among non-specialists including policy makers, funding agencies and the public at large. download Appendix
The breeding system and effectiveness of introduced and native pollinators of the endangered tropical tree Goetzea elegans (Solanaceae)
Authors: Caraballo-Ortiz Marcos A. , Santiago-ValentÃ­n Eugenio
Published: November 2018

The impact of introduced species on native organisms is one of the main conservation concerns around the world. To fully understand the effect of introduced pollinators on native plants, it is important to know the reproductive biology of the focal species, especially its pollination biology. In this study we examined the breeding system of the endangered tree Goetzea elegans (Solanaceae), and compared pollination effectiveness of the two main floral visitors, Coereba flaveola (an avian nectarivore), and Apis mellifera (the introduced European Honeybee). We assessed the breeding system of G. elegans by applying several pollination treatments to flowers of cultivated trees to test fruit set, seed set, and seed viability. We also examined the pollination efficiency of A. mellifera and C. flaveola , and compared all the treatments with positive and negative controls. Our results indicate that the introduced honeybee A. mellifera is as efficient as the native bird C. flaveola in pollinating the flowers of G. elegans. This study also showed that G. elegans requires crossâ€“pollination for fruit and seed set, and to obtain high seed viability rates. Despite the fact that many studies report exotic species as detrimental for native organisms, we document a case where an introduced insect has a beneficial impact on the reproductive biology of an endangered tropical tree.
Foraging dynamics and pollination efficiency of Apis mellifera and Xylocopa olivacea on Luffa aegyptiaca Mill (Cucurbitaceae) in southern Ghana
Authors: Mensah Ben , Kudom Andreas
Published: November 2018

As a result of different levels of pollination efficiency of pollinators, knowledge on appropriate pollinators of a plant has become important, especially in the management and conservation of both the pollinators and the plants. In this study, the pollination efficiency of Apis mellifera and Xylocopa olivacea, important pollinators of Luffa aegyptiaca, were assessed in the southern coastal part of Ghana from June 2009 to September 2010. Pollination efficiency of A. mellifera and X. olivacea was estimated in terms of fruit set and fruit size. Further, data on daily and seasonal nectar dynamics of Luffa aegyptiaca were collected. In the early mornings (0600-0700), X. olivacea was the most frequent visitor (0.47 min-1) on the female flowers compared to A. mellifera (0.13 min-1). The mean nectar (sugar) concentration in the dry season was 36.58 ± 0.55 %, which was higher than the 34.03 ± 0.38 % obtained for the rainy season (F = 14.986; df = 2; P < 0.0001). Total amount of sugar in the early mornings was 1.88 ± 0.37 mg which was higher than 0.28 ± 0.04 mg in the mid mornings (χ2 = 14.33, df = 1, P < 0.0001). Fruits that developed from flowers that had received a single visit from X. olivacea had a mean weight of 428.7g and were 1.5 times heavier than fruits from flowers visited by A. mellifera (286.76 g). X. olivacea was more efficient than A. mellifera in terms of number of fruit set per single visit. This study has provided some knowledge on pollination ecology of L. aegyptiaca, which can be exploited to improve fruit production in commercially grown vine crops.
Causal Modeling for Cybersecurity
Authors: Abel Suchitra , Xiao Licheng , Wang Hairong
Published: November 2018

Causal modeling is very useful in the pursuit of cybersecurity since it often helps us to execute actions leading to fruitful results, without performing unnecessary computations that might affect the values of other variables. The causative factors that are necessary and sufficient, are explored, with the help of modeling a real-life example taken from 2017, United States cybersecurity case. One can recommend future company policies, based on the causal modeling results. It also makes us understand how an event such as a breach of cybersecurity occurs, and how it can be dealt with.
Pertumbuhan Planlet Stroberi (Fragaria ananassa D) Var. Dorit pada Beberapa Variasi Media Modifikasi In Vitro di Balai Penelitian Jeruk dan Buah Subtropika (BALITJESTRO)
Authors: Nofrianinda Vida , Yulianti Farida , Agustina Eva
Published: November 2018

Stroberi (Vragaria ananassa Dutch) Var. Dorit merupakan buah yang populer di masyarakat dunia dengan ciri khas rasa buahnya yang asam manis dan segar. Penyediaan benih stroberi selama ini dilakukan secara konvensional dengan menggunakan stolon, sehingga volume perbanyakan relatif lebih sedikit dan tidak bebas penyakit. Oleh karena  itu  diperlukan metode  kultur jaringan untuk budidaya stroberi. Kultur jaringan tanaman merupakan suatu teknik pengisolasian dan pemeliharaan sel atau potongan jaringan tanaman yang ditumbuhkan pada media buatan yang sesuai dan dalam keadaan aseptik. Medium yang dipergunakan pada kultur in vitro tumbuhan ada bermacam-macam. Medium yang digunakan dalam percobaan ini yaitu media MP yang merupakan kombinasi dari larutan MS (Murashige and skoog) dan pupuk cair. Dalam hal ini pupuk yang digunakan merupakan produk dari Balitjestro yang tentunya mengandung beberapa nutrisi dengan konsentrasi yang tepat untuk petumbuhan tanaman. Percobaan ini dilakukan untuk  mengidentifikasi pengaruh berbagai modifikasi media MP serta mengidentifikasi konsentrasi kombinasi media MP yang sesuai terhadap pertumbuhan stroberi varietas dorit. Percobaan ini  menggunakan Rancangan Acak Kelompok (RAK) dengan perlakuan MP1: MS 25% + pupuk 75%, MP2: MS 50% + pupuk 50%, MP3: MS 75% + pupuk 25%, MP4: pupuk 100%, Percobaan di ulang 5x, sehingga diperlukan 20 unit percobaan. Setiap unit percobaan ditanam 5 planlet. Pertumbuhan tanaman stroberi varietas dorit yang ditanam pada media MP1, MP2, MP3 dan MP4 menunjukkan pengaruh perbedaan yang signifikan terhadap pertumbuhan akar, pertumbuhan tunas dan pertambahan jumlah daun. Tanaman tersebut menunjukkan respon pertumbuhan yang paling cepat pada media MP3 karena mengandung konsentrasi larutan MS lebih banyak sehingga jumlah nitrogen yang dibutuhkan untuk pertumbuhan lebih tercukupi
Isolasi Bakteri Pengakumulasi Logam Berat Timbal (Pb) Pada Saluran Pembuangan Limbah Industri Kabupaten Gowa
Authors: Hasyimuddin Hasyimuddin , Nur Fatmawati , Indriani Indriani
Published: November 2018

Salah satu komponen perekonomian penting yang ada di Indonesia adalah perindustrian. Perkembangan perindustrian yang ada di Indonesia mengalami peningkatan yang begitu cepat. Percepatan pertumbuhan industri dapat mengakibatkan masalah bagi lingkungan. Limbah yang berasal dari Industri mengandung logam berat merupakan salah satu masalah yang bisa berdampak pada kesehatan manusia. Beberapa mikroorganisme diketahui mampu meremediasi logam berat seperti Bacillus sp dan Pseudomonas sp. Penelitian ini bertujuan untuk mengetahui jenis bakteri pengakumulasi logamberat timbal (Pb) pada saluran pembuangan limbah industry kabupaten gowa. Sampel tanah berasal dari saluran pembuangan limbah pabrik tali rafia PT. Intra Polyplast Palangga, pabrik beton PT. Cipta Beton Sinar Perkasa. Sebanyak 6 isolat bakteri berhasil diisolasi dari limbah industri dan di uji kemampuan pengakumulasi logam berat timbal (Pb) menggunakan AAS (Atomic Absorpsion Spectrophotometer), dan isolat (1mTR) bergenus Bacillus yang mampu mengakumulasi logam sebesar 7 mg/l, isolat (5mTR) bergenus Pseudomonas yang mampu mengakumulasi logam sebesar 7 mg/l, isolat (10mTR) bergenus Bacillus yang mampu mengakumulasi logam sebesar 8 mg/l, isolat (1mPB) bergenus Bacillus yang mampu mengakumulasi logam sebesar 9 mg/l, isolat (5mPB) bergenus Bacillus yang mampu mengakumulasi logam sebesar 11 mg/l, dan isolat (10mPB) bergenus Bacillus yang mampu mengakumulasi logam sebesar 9 mg/l.
Potency of Curculigo capitulata and Curculigo latifolia Fruit Based on Nutrient Content (a Case for Preservation Need in Kebonharjo)
Authors: Briliani Marbelisa , Perdana Mayang Christy , Perwirasari Imerda Yuan , Setiyaningrum Ika Feni , Giyarsih Sri Rum , Haryono Eko
Published: November 2018

C.capitulata and C.latofilia are recognized as a medical plants in Asia, especially for ancient India and China. In Indonesia, i.e Kebonharjo (a village in Samigaluh District, Kulon Progo, Yogyakarta), people use it as a sweetener replacing sugar. Phenol, neonorlignan, and protein inside these plants had been examined by some researchers. However, the nutrient content inside the fruit are rare or slight recorded. This study aims to reveal the composition of minerals (Ca, Fe, Mg, K), carbohydrate compound (glucose, fructose, sucrose) and Vitamin C in their fruit, therefore, the development to preserve these species can be concerned due to the plan of “Bedah Menoreh” program, a program of road construction connecting between New Yogyakarta International Airport (NYIA) and Borobudur Temple. The method for finding out the nutrient content is by laboratorium analysis. Result showed that both fruit contained potentially high of mineral, especially Ca (calcium), but C.capitulata and C.latifolia contained no sucrose and glucose respectively.
Türkiye’de Gıda Sektöründe Faaliyette Bulunan Markalar Üzerine Bir Etkinlik ve Verimlilik Analizi
Authors: ŞAHİN Esen , ŞAHİN İbrahim Erem , KARA Sümeyye Nur
Published: November 2018

İnsanoğlunun yaşamsal faaliyetlerini yerine getirmesi ve canlılığın
devamı için gıda tüketimi kaçınılmazdır. Gıda sektörünün çeşitliliği,
tüketicilere bu mecburiyetin yanı sıra istek ve ihtiyaçlarına uygun farklı
seçenekler arasından seçim yapma imkânı da sağlamaktadır. Firmalar gerek ürün
çeşitliliğine gerek pazarlama kampanyalarına yaptıkları yatırım ve harcamalar
ile markalarının tercih edilmesini sağlama yönünde çaba sarf etmektedirler. Bu
kapsamda marka değeri kavramı, tüketicilerin tercihlerini, sadakatlerini
sağlama başarısı olarak açıklanmaktadır. Literatürde marka eşitliği, marka
denkliği, marka sermayesi, marka özvarlığı gibi kavramlarla da ifade edilen
marka değeri, pazarlama alanının en değerli yapıtaşlarından biri olan markanın
varlığı için yadsınamayacak derecede önemli bir kavramdır. Bu bağlamda
çalışmanın amacı, marka danışmanlık şirketi olan Brand Finance tarafından her
yıl yayınlanan Türkiye’nin en değerli 100 markası listesindeki gıda
markalarının, marka değerlerinin etkinliğini, kantitatif yöntemlerden veri
zarflama analizi ile ölçerek ardından Malmquist Toplam Faktör Verimliliği
Endeksi yardımıyla yıllar itibariyle gösterdikleri gelişmeyi değerlendirmek ve
yorumlamaktır. Bu doğrultuda çalışmanın literatür kısmında marka ve marka
değeri kavramlarına ve Veri Zarflama Analizi ile Malmquist Toplam Faktör
Verimliliği Endeksi uygulaması aşamalarına değinilmiştir. Çalışmanın uygulama
kısmında ise, 2016 yılına ait değerli markalar listesindeki gıda markalarının
son dört yıllık marka değeri etkinlikleri ve verimlilikleri veri zarflama
analizi ve Malmquist Toplam Faktör Verimliliği Analizi yöntemi ile ele alınıp,
irdelenmiş ve yorumlanmıştır.
Bağımsız Denetim ve Muhasebe Meslek Etiği: Bağımsız Denetçilerin Etik İlkelere Yaklaşımları Üzerine Bir Araştırma
Authors: GÜMRAH Özlem , YILMAZ Baki
Published: November 2018

Tüm dünyada olduğu
gibi ülkemizde de muhasebe ve denetim mesleğinin önemi gün geçtikçe
artmaktadır. Dolayısıyla denetim faaliyetini gerçekleştiren denetçilerin
mesleğin gerektirdiği önem ve özen doğrultusunda meslek etiği kurallarına uygun
hareket etmeleri önem arz etmektedir. Bu önem doğrultusunda çalışma Ankara,
Konya ve Karaman illerinde faaliyette bulunan bağımsız denetçilerin meslek
etiği ilkelerine olan yaklaşımlarını tespit etmeyi amaçlamıştır. Çalışmanın
birinci bölümünde denetim ve bağımsız denetim kavramları ele alınmış, ikinci
bölümde etik, muhasebe ve denetim meslek etiği kavramları teorik çerçevede
anlatılmıştır. Çalışmanın son bölümü olan uygulama kısmında Ankara, Konya ve
Karaman illerinde faaliyet gösteren meslek mensuplarının bağımsız denetim etik
ilkelere olan yaklaşımlarını tespit etmek amacıyla anket uygulaması
yapılmıştır. Anket formları yüz yüze yapılan görüşmeler ve söz konusu illerdeki
meslek odaları aracılığı ile bağımsız denetçilere ulaştırılmıştır. 150 anketin
geri dönüşü sağlanmış olup, 100 tanesi Ankara, 38 Konya ve 12 tanesi Karaman
ilinde faaliyet gösteren meslek mensuplarına aittir. Elde edilen veriler
bilgisayar ortamına aktarılarak SPSS-16 programı yardımıyla analiz edilmiş
ulaşılan sonuçlar yorumlanmıştır.Çalışma sonucunda bağımsız denetçilerin
“Meslek Etiği” kavramı hakkında bilgi sahibi oldukları ve faaliyetleri
sırasında “Tarafsızlık” ilkesine uymaları gerektiğini düşündükleri tespit edilmiştir.
Ayrıca bağımsız denetçilerin, bağımsız denetçi unvanını aldıkları sınavlar,
mesleki deneyimleri ve 3568 sayılı meslek yasasına göre unvanları ile meslek
etiği ilkelerinin uygulanmasına yönelik görüşleri arasında anlamlı bir görüş
farklılığı tespit edilemezken, eğitim düzeyleri, faaliyette bulundukları il,
yaşları, denetim alanındaki unvanları ve çalışma şekilleriyle meslek etiği
ilkelerinin uygulanmasına yönelik görüşleri arasında anlamlı farklılaşma tespit
edilmiştir.
Analisis Keputusan Pembelian Jasa Penambangan PT Berau Coal kepada PT Bukitmakmur Mandiri Utama (BUMA)
Authors: Sitio Arifin , Rasjid Beni
Published: November 2018

This study aims to find out the influence of the quality of services, people, processes and physical evidence on the decision to purchase mining services by PT Berau Coal to PT BUMA. In this study, data collection was carried out through survey methods by distributing questionnaires to respondents within the company organization PT Berau Coal starting from the position of supervisor /engineer to general manager. The number of samples taken in this study was 50 people. Thetechnique sampling used in this study is Simple Random Sampling. Data analysis method uses multiple regression analysis with SPSS 23.0. The results of data processing show that the variable quality of services, people, processes and physical evidence affect the decision to purchase mining services. Parameters for testing the effect of service quality on service purchasing decisions show a t value of 3.191 (sig = 0.003), the influence of people on the decision to purchase services shows a t value of 2.341 (sig = 0.024), the effect of the process on the decision to purchase services shows a t value of 2.400 ( sig = 0.021), and the effect of physical evidence on the decision to purchase services shows a t value of 2.797 (sig = 0.008).Keywords:Quality of services, people, processes and physical evidence, service purchasing decisions
CHILDHOOD BRONCHIAL ASTHMA
Authors: Maheshwari Nathumal , Khemani Omperkash , Chand Siri , Hingorjo Bilawal , Shaikh Mehmood , Rehman Anjum
Published: November 2018

Objectives: Determine serum cholecalciferol in childhood bronchial asthma andits association with asthma severity. Study Design: Cross sectional study. Place and Duration:Department of Paediatrics, Layari General Hospital, Shaheed Muhtrama Benazir Bhutto MedicalCollege Karachi from January 2015 – November 2016. Subjects and Methods: 100 diagnosedcases of childhood bronchial asthma and 100 controls were included. 5 ml venous blood wasused for the full blood counts and sera were used for the serum cholecalciferol and IgE. Datawas analysed on statistical software (SPSS v 22.0, IBM, Incorporation, USA) at 95% confidenceinterval (P ≤ 0.05). Results: Mean ± SD age of controls and cases was noted 8.23±1.84 and9.40 ±0.54 years. Low serum cholecalciferol was noted in the cases compared to the controls(25.7±14.5 vs. 38.3±15.5 ng/dl) (p=0.0001) with a rise in blood eosinophil, absolute eosinophilcounts and serum Ig E. Serum cholecalciferol shows negative correlation with serum IgE, bloodeosinophil and absolute eosinophil counts. Conclusion: The present study reports low serumcholecalciferol in childhood bronchial asthma. Cholecalciferol shows negative association withseverity of asthma.
FISTULA FIRST INITIATIVE
Authors: Fatima Tanveer , Ashraf Sania , Afzal Aurangzeb
Published: November 2018

Background: Although AV fistula is considered as a gold standard for initiatinghemodialysis in patients with ESRD, the incidence is quite low in our population. Aim: Theaim of this study is to find out the incidence of permanent AV access i.e. AV fistula at the timeof first dialysis and causes leading to failure of this protocol. Study Design: Cross-sectionalstudy. Setting: Hemodialysis unit of Lahore General Hospital. Period: August-September,2017. Method: Patients undergoing hemodialysis in dialysis center of Lahore GeneralHospital. Results: Out of 82 patients recruited, only 4 patients were found to have their firsthemodialysis with AV fistula, remaining 78 patients had temporary double lumen catheter foremergency hemodialysis who were later on counselled to have AV fistula. Reasons include lackof counselling/awareness/education of disease in patients 71.79%, emergency HD in patientswith hypertensive emergencies 14.1%, and delay in maturation (7.6%) and failure (6.4%) ofAV fistula. Conclusion: To increase the incidence of fistula first initiative integration of differentprofessional teams are required as well as education and awareness should be instilled inpatients to help them in taking decisions.
ESTROGEN RECEPTORS
Authors: Shah Munawar Hussain , Mahmood Rana Khalid , Samad Afra , Khalid Muhammad Abubakre , Shah Mohammad Usama , Saeed Muhammad Sulaiman
Published: November 2018

Objectives: Purpose of study is to determine Estrogen receptor status ininflammatory and neoplastic lesions of human gallbladder and to determine any relation ofER status with age, sex and histological grades of gallbladder carcinoma. Study Design:Retrospective observational study. Setting: Pathology Department Nishtar Medical CollegeMultan. Period: March 2016 to March 2017. Methodology: In this study total no. of 50 cases ofdifferent gallbladder diseases were included. Out of these 50 cases 30 were of neoplastic lesionsand other 20 were of non-neoplastic inflammatory lesions of gallbladder. The gallbladdersslides of these 50 cases were randomly selected from the records of Pathology Department.Demographic variables like age and gender were calculated and analyzed. Estrogen positivitywas the outcome variable of this study. Data was analyzed using computer software SPSSversion 23. Chi square Test was applied to check the association between different variables.Results: In this study, 100% (n=50) diagnosed cases of human gallbladder diseases includinginflammatory and neoplastic lesions were subjected to immunohistochemical staining for ERexpression. 100% (n=20) cases of inflammatory lesions and 100% (n=30) cases of neoplasticlesions were included, in this study. Estrogen positivity was noted in 36.7% (n=11) cases ofneoplastic lesions, while it was 25% (n=5) in inflammatory lesions cases. No association wasfound between estrogen positivity in groups, (÷2=0.751, p=0.386). (Table1).Histological typesof gallbladder carcinoma was noted as adenocarcinomas (well differentiated) in 60% (n=18)cases, adenocarcinomas (moderately differentiated) in 16.7% (n=5) cases, adenocarcinomas(poorly differentiated) in 13.4% (n=4) cases, mucinous adenocarcinomas in 1% (n=3.3) cases,adenosquamus carcinoma in 1% (n=3.3) cases and squamous cell carcinoma in 1% (n=3.3)cases. (Table2).No association was found between gender (p=0.780), stratified age (p=868)and estrogen positivity (p=0.386), after applying the chi-square. Conclusion: In this study itwas concluded that statistically no significant difference has been found between ER positivitywith age, gender and histological type of carcinoma. Presence of ER raises questions regardingthe role of estrogen in various gallbladder diseases and whether this hormone is functional ornot in neoplastic lesions is also questionable. Techniques more modified may be tried in searchof better and more reliable results. It is therefore too early to consider anti-estrogen trials ingallbladder carcinoma until the role of these steroid binding proteins is well characterized.
MITRAL ANNULAR PLANE SYSTOLIC EXCURSION (MAPSE)
Authors: Qureshi Azmat Ehsan , Ullah Najeeb , Chaudhary Farid Ahmed
Published: November 2018

Background and Objectives: Assessment of left ventricle function is the singlemost common indication for transthoracic echocardiogram. Out of different indicators of LVfunction, ejection fraction is the most validated one. MAPSE has promised recently to be a reliableand easily obtainable indicator for LV function even in inexperienced hands but its value in caseof left ventricle hypertrophy (LVH) is questionable. Study Design: Cross-sectional comparativestudy. Setting: Rehmatul-lil-Alameen Institute of Cardiology, Lahore. Period: January 2015and March 2015. Methods: 100 consecutive patients presenting for echocardiography atRehmatul-lil-Alameen Institute of Cardiology, Lahore. Patients were divided into two groups onthe basis of presence of left ventricle hypertrophy (LVMI >115 g/m2 in males and > 95 g/m2in females) and further subdivided according to LVEF into those with preserved (EF>55%) anddepressed EF (EF<55%). EF was calculated by visual quantification (eyeballing). MAPSE wasmeasured using M-mode at all four mitral annular sites-medial, lateral, anterior and posteriorand values averaged. Results: Among 100 patients; 66(66%) were without LVH while 34(34%)were having LVH. Without LVH group had 43 (65%) patients with preserved LVEF (EF>55%)while 23 (35%) had depressed LVEF (EF>55%). In LVH group 22 (64.7%) had preservedLVEF while 12 (35.3%) had depressed LVEF. Mean EF (%), without LVH and preserved LVEF(61.6±3.6), LVH with preserved LVEF (61.9±3.6). Mean EF (%); without LVH and depressedLVEF (41.1±6.4), LVH with depressed LVEF (42.9±5.4), p=0.663. Mean MAPSE score (mm);without LVH with preserved LVEF (13.2±1.7), LVH with preserved LVEF (10.6±0.9), p<0.001.Mean MAPSE score (mm); without LVH and depressed LVEF (9.17±0.9), LVH with depressedLVEF (7.4±1.5), p=0.002. Mann Whitney U test was applied to compare the MAPSE score ofgroups and it showed statistically significant difference in MAPSE score of patients with andwithout left ventricle hypertrophy with values much lower in the presence of LVH. Conclusion:Statistically significant difference exists in values of MAPSE in patients with and without leftventricle hypertrophy irrespective of LV function.
EXTRAPERITONIAL HERNIA REPAIR
Authors: Aziz Waqas , Siddiq Ghulam , Khizar Samina , Choudry Usama Khalid , Haider Muhammad Ijlal , Vaqar Syed , Sattar Furqan
Published: November 2018

Objectives: To explore the learning curve associated with laparoscopic totallyextraperitoneal repair of inguinal hernia, procedure being carried out by single surgeon attertiary care hospital. Study Design: Prospective cohort. Place and Duration: It was conductedat Shifa International Hospital Islamabad from October 2014 to March 2016. Patients andMethods: Consecutive patients undergoing Laparoscopic TEP repair for unilateral or bilateralinguinal hernia from October 2014 to March 2016 were included in the study and divided in twogroups: group 1 of first 50 and group 2 consisting of the next 50 patients. Results: A total of100 patients divided in two groups (50 in each) were included in the study. Group I includedfirst 1 to 50 cases with mean age of 46.6 years (SD +14.81) including 46 (92%) male and 4 (8%)female with similar distribution in group II which consisted of 51 to 100 cases with mean age45.3 years (SD +14.43) including 44 (88%) male and 6 (12%) female. The mean operative timein group I was 78 min (SD +32.30) while in group II the mean operative time was 41.2 minutes(SD+15.99). Conclusion: Although our results are from single centre and single surgeon study,we believe that at least 20 to 30 laparoscopic TEP hernia operations are required to help youngsurgeon familiarize with the anatomy of the region. The learning curve for TEP according to ourstudy is 50 cases.
NEUROLOGICAL PROFILE
Authors: Mughal Shaheen Ahmed , Lakhiar Muslim Ali , Larik Awais Bashir , Memon Abdul Qayoom
Published: November 2018

Objectives: To determine the Neurological profile of patients residing in therural areas of Sindh during their visit to a tertiary care hospital in Nawabshah. Study Design:Retrospective observational study. Setting: Outpatient Department of Neurology at the PeoplesUniversity of Medical & Health Sciences for Women (PUMHSW), Nawabshah. Period: From14.4.2014 to 31.3.2015. Methods: A questionnaire regarding different Neurological disorderswas developed and data about patients presenting in OPD were registered. The data collectedwas tabulated and analyzed using SPSS 19. Results: A total of 861 patients were registered.Out of these 409 (47.5%) were male and 452 (52.5%) were females with male to female ratio of0.9. The age ranged from 06 months to 90 years and the mean age was 31.57± SD 16.7 7. Out of861 patients 477 (55.4%) visited neurology OPD on their own, 314 (36.47%) on the advice of theirfamily and friends and only 70(8.13%) were referrals by the general practitioners. Majority of thepatients 475 (55.17%) were the residents of villages and small towns while 386 (44.83%) wereresiding in the city of Nawabshah. The frequency of major category of neurological disordersincluding Headache, Epilepsies, Stroke, Neuromuscular disorders, Movement disorders,Spinal cord disorders, Dementias, Psychiatric disorders and Miscellaneous group was 33.%,19.%, 7%, 9%, 4%, 1%, 2%, 16% and 9% respectively. Conclusion: Neurological diseases arecommon among patients residing in the rural areas of Sindh. Headaches, epilepsies, stroke,psychiatric, neuromuscular and miscellaneous disorders were frequent presentations. Lack ofadequate referrals by the general physicians needs to be addressed emphatically. This studyprojects the burden of neurological problems in the under served areas.
SUICIDE AND DEPRESSION
Authors: Daidano Jeando Khan , Yusfani Nazia Azam , Daidano Bilqees
Published: November 2018

Objectives: In this study we will assess the risk factor of suicide in thosepatients who have attempted suicide with OPP. Design: Descriptive and Retrospective. Setting:Department of Medicine PUMHS Nawabshah. Period: June 2016 to November 2017. Methods:Study was done using questionnaire on Performa. Patients admitted with history of suicidal OPPpoisoning. Exclusion criteria were poisoning by other methods, not interested to participate forthe study. Psychiatric assessment was made by using BDI Scale criteria. Statical analysis wasanalysed by software SPSS 15 version. Results: 116 patients were enrolled for this study. Malewere 43 and females were73. Age range 14 years to 45 years mean age=22-+4. Educationlevel. Depression Level: 94 patients were in severe depression, 7 patients were in extremedepression and 15 patients were in moderate depression. Conclusion: Patient of Suicide withopp should be screened for psychiatric disorder. Majority of the patients and their relatives aftertreatment think that now patient is normal. Education about risk of suicide shoud be explainedto patient and relatives. Psychiatric detailed history and treatment is compulsory to preventreattempt.
NEONATAL SEPSIS
Authors: Hussain Muhammad , Aurakzai Ahmad Ali , Irshad Mohammad , Ullah Ihsan
Published: November 2018

Objectives: To study the frequency of different types of bacteria causing sepsisin neonates, their sensitivity and resistance to various antibiotics in common practice at a tertiarycare hospital. Study Design: Prospective cross-sectional study. Stetting and Duration of study:The study was conducted in Neonatal unit, Lady Reading Hospital, Peshawar, Pakistan fromJanuary to October 2017 (10 months duration). Material and Methods: Blood culture positiveneonatal sepsis patients admitted to the Nursery C, LRH during 10 months were analyzed forbacteria and their sensitivity/ resistance pattern. Results: During study period total 115 bloodculture proven neonatal sepsis causes were found. Only 3 pathogens were isolated, where E.Coli was the most frequent organism found in 85 cases. Staphylococcus aureus (25Cases) wasthe second frequently occurring organism while Klebsiella spp. was the third pathogen causingsepsis in my study (7 cases). Amikacin (88% sensitive against E. Coli), vancomycin (100%sensitive against Staphylococcus aureus) were found most sensitive than commonly usedantibiotics. As the organisms were mostly resistant to ampicillin (76.23%) Amoxicillin (82.48%),Cefotaxime (93.75%) and Ceftriaxone (66.29%), Ceftazidime was comparatively less resistant(55.80%). Conclusion: E. Coli was found to be the major cause for neonatal sepsis followed byStaphylococcus aureus in admitted neonates at Lady Reading Hospital. An alarming increasein the resistance pattern of empirically used antibiotics was observed. So, there is dire needfor continuous monitoring/ surveillance of this alarming resistance of commonly used drugs.Moreover, an effective infections control program is needed to limit the spread of resistantstrains of these pathogens.
POLYHYDRAMNIOS
Authors: Zulfiqar Maryam , Khan M. Imran Hasan , Shakeel Salman , Naz Farhat
Published: November 2018

Background: Polyhydramnios is a condition characterized by excessiveamniotic fluid around the baby. The most widespread causes of severe Polyhydramnios are fetalanomalies often linked with a primary genetic anomaly. However, gestational diabetes, multiplepregnancies and idiopathic factors are commonly related with milder cases. So, we designedthis study to see the association of polyhydramnios and perinatal outcome. Objectives: Tocompare the Perinatal outcomes in patients with explained and unexplained Polyhydramnios.Study Design: Cohort study. Setting: Obstetrics & Gynaecology Department and Diabetesclinic of Postgraduate Medical Institute, Lahore General Hospital. Period: 6 months From Jan2014 to June 2014. Material & Methods: 300 females were included through Non probabilitypurposive sampling. Informed consent and Demographic history was recorded. The patientswere divided into two groups. Those having congenital anomalies and diabetes mellitusdetermined by ultrasonography and laboratory investigations were included in Group ‘I’ andpatients with no detectable cause of polyhydramnios were included in Group ‘II’. All the data wasrecorded in well-defined proforma. Data was entered and analyzed through SPSS 20. Relativerisk was calculated to see any association between perinatal outcomes in both study groups.RR > 1 was considered as statistically significant. Results: The mean age of the patients wasnoted as 29.37±5.37 years. The mean gestational age was noted as 34.82±2.09 weeks. In thisstudy, Macrosomia was observed in 60 (20%) cases whereas Malpresentation was observedin 51 (17%) cases. Malpresentation was observed in 51 patients out of which 14 (27.5%) werefrom explained Polyhydramnios and 37 (72.5%) were from unexplained Polyhydramnios group.Statistically there is significant difference between the study groups i.e. RR=3.181. Macrosomiawas observed in 60 patients out of which 18 (30%) were from explained Polyhydramnios groupand 42 (70%) were from unexplained Polyhydramnios group. Statistically there is significantdifference between the study groups i.e. RR=2.852. Conclusion: It was concluded throughresults of this study that unexplained Polyhydramnios has more risk of developing adverseperinatal outcome.
PERMANENT MANDIBULAR SECOND MOLARS
Authors: Ansari Asma Saher , Shaikh Amynah Tariq , Zaidi Syed Jaffar Abbas , Ansari Zairah Muqaddas , Kazmi Shakeel
Published: November 2018

Objectives: Tooth morphology plays an important role in dental anthropology& forensic odontology. This study was conducted to determine the frequencies of variationsin occlusal surface patterns in permanent mandibular second molars in a subset of Pakistanipopulation. Data Source: 500 medical and dental students of Dow University of Health Sciencesand healthy volunteers visiting the dental OPD with age range from 17 to 25 years. Design ofStudy: Cross-sectional analytical Study. Setting: Department of Oral Biology, Dr. IshratulIbadKhan Institute of Oral Health Sciences, Dow University of Health Sciences. Period: May 2017till August 2017. Materials & Methods: This analytical study was conducted in the departmentof Oral Biology at Dr Ishratul Ibad Khan Institute of Oral Health Science. Five hundred dentalcasts after interoral exam and impression taking were studied for the variations in the frequencyof of cusps and their relative groove and fissure pattern. Statistical analysis was performed byDescriptive analysis and Chi Square. Results: Out of the fivbe hundred casts that were analysed,51% were of males and 49% were of females. The four-cusped variety of mandibular molars withpresence of distal fovea and distal marginal ridge was the most frequent (95.4%) while the mostprevalent occlusal groove form was “+” shape (88.4%). Frequently present occlusal patternwas the “+4” form (85.4%). Conclusion: The occlusal configurations of mandibular molarsshowed high degree of variability. The most frequently occurring pattern of occlusal surface ofmandibular second molars in this subset of Pakistani population was determined to be “+4”form. These findings can be used for forensic, teaching & clinical purposes by providing aPakistani database for morphological characteristic of mandibular molars.
TYPE 2 DIABETIC PATIENTS
Authors: Hussain Mazhar , Qureshi Muhammad Arshad , Arain Abdul Qudoos , Rehman Habib-Ur-
Published: November 2018

Background: Peripheral neuropathic pain is a devastating complication intype 2 diabetic patients with significant morbidity and mortality. Objectives: To investigate theeffect of oral vitamin D supplementation on symptoms of peripheral neuropathic pain in type 2diabetic patients. Study Design: Prospective randomized placebo controlled trial. Setting:Diabetic Clinic of Sheikh Zayed Medical College/Hospital Rahim Yar Khan. Period: Overa period of 6 months from Jan-July 2017. Methods: 116 vitamin D deficient type 2 diabeticpatients with symptoms of peripheral neuropathic pain were divided in to two groups toprescribed either oral vitamin D3 capsule 50000IU weekly or Placebo capsule for a periodof 12 weeks. Symptoms of diabetic neuropathic pain were assessed by neuropathysymptoms score (NSS) and neuropathy disability score (NDS) while Vitamin D status wasestimated by measuring the serum total 25(OH) D concentration. The primary end pointwas changes in NSS and NDS while secondary end point was changes in HbA1C and 25(OH) D concentrations from baseline. Results: After 12 weeks of vitamin D therapy, vitaminD improved its own level in interventional group (28.5±12.5 to 48.2±15.6) vs placebo group(30.6±16.2 to31.5±12.6) with p-value (0.001). This rise was accompanied by improvementin HbAIc (8.2±1.8 to 7.5±2.2) vs Placebo (7.8±1.5 to 8.0±1.8) with p-value (0.004) and NSSscore (6.02±1.5 to 4.52±0.8) vs placebo (5.82 ±1.8 to 5.65±1.5) with p-value (0.002). Howeverno significant changes were seen in NDS in both study groups. Conclusion: Oral vitamin D3therapy has positive impact on its own status as well as symptoms of peripheral neuropathicpain in type 2 diabetic patients.
DEPRESSION
Authors: Nagi Muhammad Luqman Farrukh , Manan Shafia , Shaheen Arjumand , Amjad Maheer , Farooq Maryam , Kazmi Syed Tehseen Haider
Published: November 2018

Background: Chronic Liver Disease is frequently related with psychiatricco morbidity disorders like depression and anxiety. Psychological disorders are a directmanifestation of Hepatitis C infection. Objectives: The objective was to assess the frequency ofdepression among patients of CLD presenting to the Shalamar Hospital, Lahore a tertiary careprivate institution. Study Design: Cross-sectional study. Setting: Shalamar Hospital Lahore,Pakistan a tertiary care private institution. Period: Four months period (June till September2015). Methods: It was carried out on a convenience sample of 200 patients admitted inShalamar Hospital, Lahore. The HADS questionnaire was used to assess the frequency ofdepression among the patients suffering from chronic Liver Diseases. The selected participantswere meticulously briefed and signed informed consent was acquired. Selected patients werefurther comprehensively briefed about the study and confidentiality, anonymity and privacy ofthe participants was preserved. Ethical approval was sought from Institutional Ethical ReviewBoard of Shalamar Institute of Health Sciences. The data entry and statistical analyses weredone using SPSS version 20. Results: The response rate was 97%. Amongst all, 53% (n =102) were males and 47% (n = 91) were females. About 80% (n = 155) were married whereas 20% (n = 38) were unmarried. Among all patients of chronic liver disease 65% (n = 124)were positive for Hepatitis C Virus Antibody, while 25% (n = 49) were positive for Hepatitis BS Antigen. Of all the participants 32% (n = 61) received blood transfusions and almost 58% (n= 111) had a close family member who suffered from Hepatitis C. About 53% (n = 102) of thepatients were suffering from borderline or clinical depression (p < .000), whereas 56% (n = 108)of the participants suffered from borderline or clinical anxiety (p < .000). Conclusion: Patientssuffering chronically with Hepatitis C have higher than normal occurrence of depression andanxiety symptoms.
URINARY BLADDER STONE
Authors: Laghari Mubeena , Murtaza Shazia , JalbanI Rafique Ahmed
Published: November 2018

Objective: To analyze the biochemical composition and biochemical types ofurinary bladder stones in children. Study design and setting: Observational study, Departmentof Pediatric Surgery, Liaquat University of Medical and Health Sciences, Jamshoro/Hyderabad.Place and Duration: One year duration from January to December 2006. Materials &Methods: A sample of 30 children was selected according to criteria of inclusion of age <10years of urinary bladder stones without any anomaly. Urinary bladder stones were washed indistilled H2O deionized to remove contaminations. Urinary bladder stones were dried at 1000C for overnight in an oven. The urinary bladder stones cut into pieces were used for the FTIRspectroscopy analysis, carried out on “Nicolet Avatar 330 FTIR spectrophotometer”. Data wasanalyzed on SPSS 22.0 at 95% confidence interval. Results: Of 30, 6 (20%) were female and24 (80%) were male. The male dominancy was noted with male to female ratio of 4:1. Mean±SD age was noted as 4.839 + 2.819 years. Urinary stones of pure and mixed biochemistrywere noted in 5 (16.6%) and 25 (83.3%) respectively (P=0.0001). Most frequent urinary bladderstone found was the calcium oxalate monohydrate - ammonium hydrogen urate. Conclusions:Most frequent type of urinary bladder stones was the calcium oxalate monohydrate–ammoniumhydrogen urate type in the children.