bluuebunny/crossref_metadata_2025 huggingface dataset:
C.S. Lewis as a Central Figure in Formulating the Theistic Argument from Desire
Authors: Williams Peter S.
Published: January 2022

C.S. Lewis made various theistic arguments from the existence of a desire that he called “Joy”, “Romantic” longing or “Sehnsucht”. This paper evaluates Lewis’ contribution to this area of natural theology by situating it within an exploration of: a) the historical roots of such arguments, b) historic theological reflections upon desire, c) historic formulations of theistic arguments from desire, d) Lewis’ contemporaries who made theistic arguments from desire, and e) the contemporary philosophical discussion of theistic arguments from desire. With respect to the contemporary discussion, I focus upon my own defence of a cumulative argument from desire inspired by Lewis’ writings.
Pure Northerness – William Morris and C.S. Lewis
Authors: Mardar Andreea Mihaela
Published: January 2022

Having seen one of Rackham’s illustrations to Siegfried and the Twilight of the Gods in his youth, C.S. Lewis became instantly attracted to “pure ‘Northernness’”, a feature he would later associate with Scandinavian literature and mythology, Wagner’s music and William Morris’ romances. In a similar manner, Morris describes his reading of the Norse sagas as a momentous experience which influenced his later writings. However, the two authors seem to have responded to different aspects of the sagas: Morris to their realism of presentation and to their worship of courage, and Lewis to their use of magic and myth. Paradoxically, in spite of Morris’ paganism, his prose romances played an important part in Lewis’s conversion to Christianity.
The First Major Grammars of English and Romanian: A Comparative Approach
Authors: Doboș Daniela
Published: January 2022

If the history of the English language is the story of its written texts, the same holds true for the history of the Romanian language, and in both cases the first grammars played a major part in the shaping up of the respective vernaculars. The paper proposes a comparative approach to the beginnings of codified grammars in English and Romanian, with a focus on those that are deemed to be the first major works– Robert Lowth’s A Short Introduction to English Grammar (1762) and Samuil Micu and Gheorghe Şincai’s Elementa linguae daco-romanae sive valachicae (1780). This approach considers topics such as why grammars might have been desirable in the eighteenth century (the political factor), and the functions of ‘grammars’, which are relevant in both cases; what language was actually codified, as well as the role of Latin in this enterprise, since it is worth noting that while English and Romanian belong in different language families, Latin was a formative element in both, ever since the territories of the two respective countries marked the North-Western and South-Eastern borders of the Roman Empire.
The Iconography of John Ford's Westerns
Authors: Chirica Irina
Published: January 2022

This paper follows the way in which the filmography of the movie director John Ford presents cultural icons. We discuss the symbolism of these images and their cultural significance in the larger context of the West as a cultural area and American culture in general. Ford’s sensibility had one foot in 19th century American thought and feeling, and the other in the 20th century. We argue in favor of the idea that John Ford is a myth-builder and a visual image-maker whose contribution provided the foundation of a romantic, heroic America and the forging of American national character.
A Diachronic Perspective on the English Preposition TO and the Romanian Preposition LA
Authors: Zamfir Tania
Published: January 2022

The paper discusses the different evolution of the English preposition (P) to and the Romanian P la “at/to” which can be observed in the history of English and Romanian ditransitives. In Modern English (ModE), the preposition to can occur in configurations with (i) ditransitive predicates and (b) unaccusative predicates. Within ditransitives, the English to only functions in the prepositional frame and it has a narrow distribution; the to-dative is a genuine Goal or a Recipient with certain verb classes. The first focus of this paper is to investigate the presence of the to-dative in Old English (OldE). The investigation will reveal that the to-dative construction was neither rare nor restricted, but already present in OldE. By way of contrast, Romanian la has a richer distribution (Possessor Goal, Beneficiary, Maleficiary and Source) and it has shifted from a case marker to a [Person] marker and it has moved in the direction of inflectional dative. The second focus of the paper is to investigate the presence of la in OldR. I will show that Romanian la evolved from the Latin P ad; diachronically, Romanian has kept the analytical marking of the Dative which is realized through the P la “at/to”.
Religious Division and Otherness as Portrayed in 'Shame' and 'The Ministry of Utmost Happiness'
Authors: Zobaer Sheikh
Published: January 2022

After the partition of India in 1947, religion has become a major catalyst for division and othering in most of South Asia. Bangladeshi author and activist Taslima Nasrin was exiled from her country, primarily for revealing the mistreatment of the Hindu minorities in Bangladesh in her novel Shame. Indian author Arundhati Roy has also faced severe backlash due to her portrayal of the mistreatment of the Muslims in India in her novel The Ministry of Utmost Happiness. Religion has become an extremely fraught issue in South Asia, making almost any criticism of religious fundamentalism a highly perilous endeavor. Yet, both Nasrin and Roy had the courage to do that. This paper explores how the aforementioned novels expose the process of othering of the religious minorities in India and Bangladesh by highlighting the retributive nature of communal violence which feeds on mistrust, hatred, and religious tribalism – a cursed legacy that can be traced back to the violent partition of the Indian subcontinent based on the two-nation theory.
Yan Fu's Unfaithful Translation of Thomas Huxley's 'Evolution and Ethics'
Authors: Yuhan Qi
Published: January 2022

This paper analyses Yan Fu’s translation of the title and the key terms in Thomas Huxley’s Evolution and Ethics and shows that his unfaithfulness was mainly due to his personal intention to inspire the Chinese people to fight against foreign enemies and the feudal system in late nineteenth-century China. In his famous The Heavenly Theory of Evolution, the translation of Evolution and Ethics, Yan Fu added the traditional Chinese value of ‘heaven’ by translating ‘evolution’ as ‘heavenly evolution’ in order to make Darwin’s theory more acceptable and easier to understand by target readers. When he translated terms such as ‘competition’ and ‘natural selection’, Yan Fu borrowed the slogan of the Westernizing reform to explain the relationship linking evolution, competition and selection. Yan Fu wanted to arouse people’s attention to the theory of evolution and hoped they would use evolutionary thought as a theoretical weapon to save themselves and the country from a national crisis. His unfaithful translation appealed to the scholars to make them spread the theory through their social influence.
The American 'House of Cards' – A View from a Cultural, Political and Translation-Related Perspective
Authors: Imre Attila
Published: January 2022

The present article offers an introduction to the relationship between the entertainment and translation industry, arguing that dubbings and subtitles are by-products of the entertainment industry, directly contributing to the success of the show. It also deals with the translator’s competence, offering examples of translation challenges from the (in)famous American TV show, House of Cards, connected to terms and expressions pertaining to general knowledge of the world and of the United States. The Introduction offers an insight into audiovisual translation and its successful branches and explains binge-watching and binge-translation as well, also including several scholars’ analyses of the TV show. The Methodological Background describes how a collection of term bases came into being starting from the original English script and several Romanian subtitles of the episodes of official (DVD-release and Netflix) and amateur (freely available online) versions. This is followed by thirty examples in two sets, discussing the translation of terms belonging to general knowledge and US geopolitics in particular. The Conclusions section discusses the terms of ‘professional’ and ‘amateur’ translator irrespective of their qualifications, focusing instead on ‘quality assurance’, a rather subjective term. Certain corpus-based findings are also highlighted connected to the possibilities of relying on generalization, explicitation or calque referring to general culture and US politics focusing on the intelligibility of politicotainment, a term recently coined by Riegert.
Table of Contents
Authors: Administrator Site
Published: January 2022

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Outcomes of surgical treatment of Stanford type of aortic dissection at Hanoi Heart Hospital in the period 2015-2020
Authors: Minh Nguyen Thai , Thien Le Quang , Hien Nguyen Sinh , Ha Nguyen Hoang , Hung Nguyen Dang , Phong Nguyen Huu
Published: January 2022

Background: Stanford type A aortic dissection is a complex disease and a serious surgical emergency. The diagnosis is determined based on diagnostic imagines. Surgery is the mainstay of treatment, with high mortality and morbidity. This study aimed to comment on clinical and paraclinical characteristics and evaluate the results of surgical treatment of type A aortic dissection at Hanoi Heart Hospital within 5 years from 2015 to 2020.

Methods: Retrospective and descriptive study of patients diagnosed with type A aortic dissection who were surgically treated at Hanoi Heart Hospital from January 2015 to May 2020.

Results: 109 cases were included in the study with the mean age of 56.0 ± 14.4; 50 - 60 age accounted for the highest percentage (30.3%); men accounted for 67.9%. Classic type A aortic dissection in 95 cases (87.2%). Chest pain was the main clinical symptom (91.7%); 4.6% came to the hospital in a state of cardiogenic shock and circulatory arrest. The rate of Marfan phenotype was 13.8%. The most common surgery is replacing the ascending aorta (45.9%); total replacement of the aortic arch accounted for 17.4%; Total root replacement and aortic arch accounted for 3.7%. The average aortic pairing time was 120.7 ± 41.0 minutes, the mean running time was 179.7 ± 57.0 minutes. Re-operative bleeding accounted for 6,4%; cerebrovascular accident accounted for 2,8%. The early mortality rate after surgery was 9.2%. The mean follow-up time was 24.93 ± 16.13 months, the mean survival time was 52.0 ± 1.9 months, the survival rate was 88.1% after 1 year and 85.3% after 5 years.

Conclusion: Early mortality, postoperative complications and survival rate after follow-up were positive with surgical technique and conditions of anesthesia and resuscitation at Hanoi Heart Hospital.
Evaluate the results of veno-arterial extracorporeal membrane oxygenation for cardiogenic shock patient
Authors: Hoa Tran Thanh , Thuc Nguyen Van , Huong Ha Mai , Anh Vo Thi Ngoc , Dung Dao Xuan , Nam Dinh Hai
Published: January 2022

Background: Although there are many advances in the diagnosis and resuscitation of patients with cardiogenic shock, the mortality rate is still high, especially for patients with cardiogenic shock due to complications of acute myocardial infarction, the mortality rate can be up to 50 - 70%. Objective: "Evaluate the effectiveness of clinical, subclinical and complications of V-A ECMO in patients with cardiogenic shock". Method: Retrospective analysis of patients diagnosed with cardiogenic shock supported by V-A ECMO revascularization from October 2018 and June 2020; Analyze the significance of V-A ECMO with the clinical outcome prognosis and and complications of V-A ECMO. Results: There were 23 patients hospitalized for cardiogenic shock, they have used the V-A ECMO. The mean age was 53,5±17,6, the minimum age was 13, the oldest was 76. The shortest hospital stay time was 3.5 day and the longest treatment time is 32 days. There were 15 patients alive, accounting for 65.2%, 8 patients died, accounting for 35.8%. The percentage of patients living in the group of myocarditis reached the highest rate. Common complications in patients supported by V-A ECMO are left ventricular volume overload and infection. Conclusion: V-A ECMO is a treatment option for life-threatening cardiogenic shock that has not responded to other therapies.
Clinical characteristics, laboratory findings and anatomy of intracranial aneurysms in group of patients treated with flow diverter stent (Pipeline)
Authors: Van Hoang
Published: January 2022

Background: This study aim to report our experience with cerebral aneurysm, which may improve in the treatment with the flow diverter stent and follow up.

Methods: This study was conducted in consecutive series of 23 patients. 23 procedures were performed for treating these patients in Ha Noi heart hospital from January 2019 to January 2020. 23 flow diverter stents (Pipeline) were used. Aneurysm morphology, stent patency and cerebral parenchyma before and after intervention were analyzed on images of digital subtraction angiography (DSA), computed tomography (CT) and magnetic resonance (MR). The follow-up data after 3–6 months and 12 months were recorded.

Results: In 23 patients (8 men, 15 women), aneurysms of internal carotid artery were mostly common (95.7%), especially in cavernous segments. 13 cases (74%) had saccular aneurysms, and 2 cases (9%) had multiple aneurysms, and only 3 cases (13%) had fusiform aneurysms. Endovascular treatment was successfully performed at rate of 100%. Mortality and morbidity rates were 0% and 0%, respectively. MRI and MSCT follow-up at 3 months showed complete or incomplete occlusions of aneurysms was 26.1% or 34.8%, respectively.

Conclusion:  Unruptured intracranial aneurysms are often detected incidentally on screening imaging in high risk patients, such as women, middle age, estrogen deficiency, and hypertension. The aneurysm is usually small in the cavernous segment of the anterior cerebral artery.
Prognostic factors of cerebral revascularisation in acute ischemic stroke at Hanoi Heart Hospital
Authors: Nga Vu Quynh , Hoa Tran Thanh , Hoa Pham Thi , Thao Le Thi
Published: January 2022

Background: Considering the effectiveness of treatment for acute ischemic stroke (AIS)patients, the most expected method is immediate revascularization using intravenous thrombolysis or mechanical thrombectomy, or both methods. Objective: “Find factors related to post-treatment outcomes of acute ischemic stroke patients undergoing cerebral revascularization”. Method: Cross-sectional, prospective, descriptive analysis with convenient sample size. Results: From February 2018 to August 2021, 83 patients were hospitalized with a diagnosis of acute ischemic stroke or acute ischemic stroke and had cerebral revascularision either by thrombolysis or mechanical devices or both. 6.02% of them had cerebral thrombosis with mechanical devices and stenting of cerebral/carotid arteries. Mean age was 66.37±11.82 (range 31to 91 years). Mean NIHSS score was 12.57±6.70. The rate of complete recanalization was 91.56%. The mRS score of 0-2 points accounted for 48.19% at the time of discharge and 54.21% at 30 days after discharge. The rate of death or severe illness at discharge accounted for 14.45%. 30 days all-cause mortality after discharge accounted for 25.3%. Conclusion: The rate of complete reperfusion in patients with acute cerebral infarction at Hanoi Heart Hospital and good recovery rate is quite high. Factors that  related to the treatment efficacy of patients with acute ischemic stroke were NIHSS score, ASPECT score, occlusion site, pre-reperfusion parenchymal damage and the selection of appropriate reperfusion measures.
Use of the HAS-BLED Score in Risk Stratifying Patients on Dual Antiplatelet Therapy After Coronary Stent
Authors: Hung Pham Nhu , Loan Nguyen Thi Thanh
Published: January 2022

Objectives: Use of the HAS-BLED score in risk stratifying patients on dual antiplatelet therapy after stent placement.

Methods & Results: 304 patients who underwent stent placement from June, 2018 to December 2018. There is 6,57% patients with medium & severe bleeding. Area under the curve of HAS-BLED score (AUC); PRECISE-DAPT score and CRUSADE were sequential 0.59; 0,79 and 0,84 (p=0,0001) at post-PCI procedures; were sequential 0,72; 0,94 và 0,88 (p=0,00001) at less than 6 months after PCI procedures, and were sequential 0,87; 0,73 và 0,70 (p=0,0068) at more than 6 months after PCI procedures.    

Conclusion: the HAS-BLED score was most useful for predicting bleeding in patients on on dual antiplatelet therapy after stent placement at more than 6 months after PCI procedures. PRECISE-DAPT score was most useful for predicting bleeding at less than 6 months after PCI procedures and CRUSADE score was most useful for predicting bleeding at post procedure.
Characteristics of postoperative pain after mini invasive and conventional mitral surgery in Hanoi Heart Hospital
Authors: Anh Phung Thi Hai , Huy Dang Quang , Ngoc Nguyen Minh , Thien Le Quang , Huyen Nguyen Thi Hoang , Duong Ngo Thi , Thu Phan Thi , Ngoc Luu Thi Nguyen
Published: January 2022

Introduction: Mini invasive mitral valve surgery had some advantages over conventional surgery in recovery and cosmestic results. Postoperative pain was an interested factor for comparing these two methods, with reported results remained unclear. We realized this study for evaluate the characteristics of postoperative pain between mini invasive and conventional mitral surgery in Hanoi Heart Hospital.

Methods: A cross sectional study on patient underwent mitral valve replacement with mini invasive and conventional sternotomy approach.

Results: There were 66 patients in the study, divided into 2 group: 43 patient underwent conventional surgery and 23 patient underwent mini invasive surgery. Mean age was 50,7 ± 9,3, female was 78,8% and mean BMI was 20,9 ± 2,7. Erector spinae plane (ESP) block was performed on 16 patients (24,2%) of conventional surgery group. The VAS score at 3 days, 7 days , and 1 month after surgery was 7,7 ± 1,2; 5,2 ± 1,5; 0,9 ± 1,1 in sternotomy group and 6,6 ± 1,6; 3,8 ± 1,5; 1,7 ± 0,9 in mini invasive group, respectively. In patients with ESP block, mean dose of morphine administered in first two days was 0 and 2,3 ± 5,0 mg/kg comparing to the dose of 19,7 ± 5,5 và 17,7 ± 7,1 in sternotomy patients without ESP block.

Conclusions: Postoperative pain reduction may not be an advantage of mini invasive mitral surrgery comparing to conventional surrgery, but the time for pain suffering in this group was shorter. ESP was an efficient method for early pain reduction after conventional surgery.
Elevated C-reative protein (CRP) as a surgical indication for appendicitis
Authors: Shahida Khatoon  , Mujeeb ur Rehman  , Sohail Ahmed Memon
Published: January 2022

Objective: Role of C-reactive protein value in the diagnosis of appendicitis by correlating with severity of appendicitis on histopathological findings.

Methodology: This descriptive study was conducted at the department of general surgery Unit-IV, Liaquat University Hospital Hyderabad from March 2016 to February 2017.

All cases above 12 years of age with severe appendicitis based on presenting signs and symptoms were included. The patient underwent routine laboratory investigations including abdominal plain x-ray in an erect position and ultrasound abdomen. The blood sample was taken from each patient for C-reactive protein and was send to Hospital diagnostic laboratory. During surgery, a specimen of each patient was sent to a diagnostic laboratory for histopathology. All the data were record on Performa.

Results: A total of 305 patients were studied; their mean age was 35.7+9.7 years. Males were found in the majority (73%). 75.41% of patients had leukocytosis. C-reactive protein was raised among 26.22% of patients. On histopathological findings, 04.91% of patients had a normal appendix, while 69.83% had gross inflammation of the appendix, 19.67% patients had gangrenous appendix, and 05.57% patients had perforation and peritonitis. Elevated C reactive protein (CRP) and leukocytosis were significantly associated with the severity of appendicitis, p value 0.001.

Conclusion: C-reactive protein is a non-invasive and reliable indicator for surgical treatment of appendicitis. C-reactive protein and white blood cells (WBCs) were significantly associated with the severity of appendicitis.
Perceptions of COVID-19 Disease Among Patients in Isolation Ward
Authors: S H Waqar  , Isbah Rashid  , Muhammad Raheem  , Nasim Akhtar  , Minhaj us Siraj
Published: January 2022

Objective: To explore the perceptions about COVID â€“ 19 disease among patients admitted in Isolation ward and to improve management ideas.

Methodology: This qualitative cross sectional interview based study was conducted at Isolation ward, Pakistan Institute of Medical Sciences Islamabad from April to June 2020. Patients who were reported positive for SARS COV-2 through nasopharyngeal or oropharyngeal swabs and were admitted for at least one day in isolation ward, were included in the study. Patients who were too ill to talk for the interview and those who could not survive the disease were excluded. After taking informed consent and following the standard operating procedures (SOPs) of Corona Isolation ward; data was obtained by conducting in depth interviews arranged as per patientsâ€™ convenience on mobile calls. Data was analyzed using Narrative Analysis. Themes were delineated and organized to groups for understanding.

Results: Twenty two patients participated with the mean age of 34.64Â±7.26 years. Majority of the patients had anxiety and fear for the COVID-19 disease however also were hopeful to face it. The delineated themes were anxiety & depression, fear, hopefulness & moving forward, health facilities & related issues, living in isolation and physiological disturbances like sleep, appetite, smoking or addiction, exercise.

Conclusion: Covid-19 patients depict mixed perceptions while admitted in Isolation ward and this provide us an insight to this catastrophic illness. Their experiences help the health authorities to address this issue.
Conventional Weight-Based versus Low-Dose Regimen of Heparin Administration to Achieve Target Activated Clotting Time on Cardiopulmonary Bypass in Pakistani Population
Authors: Musfireh Siddiqeh  , Wajahat Javed Mirza  , Javed Iqbal  , Imran Khan  , Ali R Mangi
Published: January 2022

Objective: A weight-based dose of heparin is calculated to achieve target ACT (Activated clotting time) for establishing CPB (cardiopulmonary bypass). Whether a target ACT can be achieved with lower dose of heparin in Pakistani population was the aim of this study.

Methodology: The cross-sectional comparative study was conducted at Rawalpindi Institute of Cardiology, Department of Cardiac Surgery from 1st January 2019 to 1st January 2020. Three hundred thirty-six (336) patients undergoing elective open-heart surgeries on CPB were included in this study. Patients receiving weight-based heparin dose were placed in Group-A, while those on low-dose heparin were placed in Group-B. ACT was considered to have reached the target value in range of 400-480 seconds, values between 481-1500 seconds were considered excessive, whereas ACT of >1500 was regarded as potentially high-risk for peri-operative bleeding .

Results: 14.1% (n= 28) of Group-A patients achieved target ACT, whereas 58.3% (n=116) exceeded the target of 480. In 25.1% (n=50), ACT values were beyond the measuring capacity of the assay machine i.e. >1500. Only 2.5% (n=5) required additional dosage of heparin. Target ACT in Group B was achieved in 19.7% (n= 27), 55.5% (n=76) had excessive ACT values, whereas in 16.8% (n= 23), it was >1500. 9.5% (n=13) required an additional dosage of Heparin.

Conclusion: In Pakistani population, a target ACT can be achieved with significantly lower dose than the conventional weight-based heparin dose. Larger studies, preferably randomized controlled trials are needed to determine the optimal heparin dose calculation for safe anti-coagulation during CPB.
Comparison of Outcome of two different Methods for the treatment of Intra-articular fracture of Distal Radius
Authors: Zaigham Habib  , Shuja Uddin  , Riaz Qadeer Niazi  , Muneeb Ur Rehman  , Abdul Qadir  , Muhammad Kamran
Published: January 2022

Objective: It is to compare the radiological and functional outcome of two different fixation methods for displaced intra articular distal radius fracture (DRF): open reduction and internal fixation with anatomical plate and closed reduction with percutaneous K-wires.

Methodology: A randomized controlled trial was conducted in Orthopaedics department, Shaikh Zayed Hospital, Lahore for one year; from April 2017 to March, 2018. Total 90 patients were selected in the study by â€˜non-probability, consecutive sampling techniqueâ€™ with 45 patients in each group of the study; Group-A (fixation method: Open reduction with internal fixation with volar plate) and Group-B (Fixation method: Kirschner-wire known as K-wire).

Results: The mean age in the group A and group B was 53.7 Â± 11.8 years and 55.2 Â± 12.3 years respectively. There were 58 male and 32 females in the study. The differences in volar tilt, radial inclination, radial length and modified Mayo score were significantly better in group A than group B (p-value < 0.05). The differences were not significantly different for articular step off in the two study groups (p-value > 0.05).

Conclusion: Open reduction with internal fixation using volar locking plates yielded significantly better radiological and functional outcomes than percutaneous fixation using K-wire in the 6 monthsâ€™ postoperative period.
Confronting our mistakes: A comprehensive evaluation of radiographic errors in digital chest radiography among adult population in a public sector hospital
Authors: Liaqat Rabia , Majeed Ayesha Isani , Malik Muhammad Nauman , Shafi Aqeel , Shah Syeda Zakia , Liaqat Bushra
Published: January 2022

Objective: To find out the various types of radiographic errors in digital chest radiography and their effect on image quality leading to image rejection.

Material and Methods: This cross-sectional study was carried out in Radiology department of Pakistan Institute of Medical Sciences for a period of One month, September 2019. The study included 1560 digital Chest X-Rays, reaching the Picture Archive and Communication System (PACS), fulfilling the inclusion criteria. All these X-rays were analyzed by two radiology residents for the presence of radiographic errors in them. The various radiographic errors were then classified as: Positioning error, poor collimation, Artifacts, improper exposure, motion blur and mislabeling. The frequency of each radiographic error was measured along with their implication on image quality resulting in three major image categories: ACCEPT, JUST ACCEPTABLE and REJECT. The SPSS was adopted for inferential statistical analysis.

Results: The study included 1013 (64.9%) male patients and 547 (35.1%) female patients. The mean age came out to be 36 +/- 15 years. Out of 1560 X-rays, 964 (61.8 %) had radiographic errors in them while 596 (38.2%) were completely devoid of radiographic errors. Positioning error (44.5 percent) was the most frequently encountered error followed by poor collimation (29.8%), artifacts (14.9%), Improper exposure (8%), motion blur (2.2%) and mislabeling (0.5%). The rejection rate came out to be 16.5 %. The major cause of image rejection was anatomy cutoff, especially the cut-off of cardio phrenic (CP) angle.

Conclusion: Positioning errors represent the commonest cause of image rejection in chest radiography. The main identified pitfall was lack of radiographerâ€™s education and training in performing an examination and indicates a need to improve their performance.

Key words: Digital Radiography, Chest X ray, Radiographic error, Image reject
Prevalence of Diabetic Retinopathy and Correlation with HbA1c in Patients Admitted in Khyber Teaching Hospital Peshawar
Authors: Khan Hurriya , Jadoon Shah Muhammad Khan , Akhunzada Muhammad Aftab  , Ashfaq Haris , Ali Adnan , Mustafa Adeela
Published: January 2022

Objective: To determine the prevalence of diabetic retinopathy in patients admitted in Khyber Teaching Hospital Peshawar and to correlate different stages of diabetic retinopathy with HbA1C levels.
Methodology: This cross sectional study was conducted at Department of Ophthalmology, Khyber Teaching Hospital, MTI, Peshawar from December 2019 to May 2020. All patients over the age of 15 years who were diagnosed with diabetes mellitus were included in the study while patients with cataract or retinopathy due to other pathologies were excluded. All diabetic patients were admitted through outpatient department. In the ward their blood pressures were recorded and HbA1c levels were also measured. Visual acuity (VA) was checked. Screening for diabetic retinopathy was done by a consultant ophthalmologist by Optos Ultrawide Field Imaging of retina and Optical Coherence Tomography (OCT) of macula to establish stages of diabetic retinopathy and presence of diabetic macular edema respectively.
Results: A total of 103 diabetic patients were included. Their retina was photographed, viewed and analyzed. Diabetic retinopathy, irrespective of the type, was found in 69 patients with a prevalence of 66.9%. Patients with lower ranges of HbA1c (below 6%) showed no evidence of DR. The clustering of majority of patients with diabetic retinopathy with HbA1c levels of 8 to 12 %, showed a significant relationship between high blood sugar levels and severity.
Conclusion: In our study the higher frequency of retinopathy is alarming by considering it one of the leading causes of blindness in working class. It is highly recommended that routine ophthalmologic examination may be carried out along with optimal diabetic control.
Physical Exercise Activity to Increase The Handgrip Strength in Elderly Populaiton During Covid-19: A Prospective Study
Authors: Hamid Mehmood  , Muhammad Yaqoob  , Ejaz Mahmood Ahmad Qureshi  , Saleem Rana  , Syed Amir Gilani
Published: January 2022

Objective: To determine palmar grip force (PGF) in elderly population and its correlation with different parameters used in the usual practice of evaluation of nutritional status in elderly populaiton.
Methodology: It was obsevational, cross-sectional study. 300 elderly people over 65 years old, who were doing gym exercises at UFC gym and Structure gym, Lahore from December 2019 to July 2020. HS was obtained using the digital dynamometer model EH101, using the average of three measurements. The cutoff point considered for low muscle strength was HS < 27 kg for men and < 16 kg for women. The standard has been taken according to the 2019 consensus of the European Working Group on Sarcopenia in Older People (EWGSOP2, version 2019).
For the statistical analysis, the Statistical Package for Social Science 24.0 program was used and chi square test was applied, considering it significant when p <0.05.
Results: The sample consisted of elderly people with a mean age of 71.71 Â± 5.97 years, of which 28% were aged between 65 and 75 years and 51.66% were male. In the analysis of the HS, we found 57.9% of the elderly with loss of muscle strength due to non-exercise during COVID-19. The muscle circumference of the arm and tricipital skin fold indicators found the highest percentages of malnutrition, 44.1% and 57.8%, respectively. HS showed a positive association Â between age and handgrip test levels.
Conclusion: There was a high frequency of elderly people with impaired strength, but HS correlated only with APMT, not showing a direct relationship with other anthropometric parameters used in the routine practice of assessment with the elderly. Therefore, HS, or at least the evaluation of APMT, becomes indispensable for the evaluation and physical exercise training of elderly persons during COVID-19 pandemic.
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House Officersâ€™ Perspective of Leadership in Undergraduate Curriculum: A Qualitative Study
Authors: Sultana Rashida , Abid Ashar
Published: January 2022

Objective: To explore the house officersâ€™ perspective about leadership skills and their development during undergraduate training.
Methodology: This qualitative study was conducted in September 2019. Two audio-recorded focus groups discussions were conducted with house officers; each comprised of six participants. Purposeful maximum variation sampling was used with equal coverage of gender including low and high scorers based on their academic records. Open-ended questions were asked with short follow-up questions. Verbatim transcription of the entire discussion was done, followed by content analysis. The findings were described using quotes, and illustrations. Member checking and triangulation with the frequency of quotes was used for validation.
Results: Leadership skills identified by the study participants were the same as priori themes given in â€œNHS-Medical Leadership Competency Frameworkâ€ namely â€œdemonstrating personal qualitiesâ€ 47 (38.84%) (Self-management, self-awareness, acting with integrity), working with others 37 (30.58%) (Communication skills, teamwork), improving services 16(13.22%) (Empathy, ensuring patient safety), management skills 12(9.92%) (Time management, resource management, managing critical situations) and setting direction 9 (7.44%) (Setting and achieving targets, decision making). The process of leadership development was explored in three dimensions i.e. contributing factors, potential obstacles, and suggested improvements to enhance leadership skills. The most common theme in all these domains was faculty-related followed by environment-related and student-related factors.Â 
Conclusion: â€œFaculty-related factorsâ€ was the most emerging theme in contributing factors, potential obstacles as well as in suggested improvements for leadership development.
Immature Platelet Fraction in Patients with Chronic Liver Disease, A Marker for Evaluating Cirrhotic Changes.
Authors: Muhammad Javaid Iqbal  , Muhammad Usman  , Mubarak Ali Anjum  , Yasir Yaqoob  , Ghulam Mujtaba Nasir  , Haroon Rashid Khan
Published: January 2022

Objective: To evaluate the role of Immature platelet fraction in patients with chronic liver disease, a marker for evaluating cirrhotic changes.

Methodology: This case control study was conducted at department of Pathology, Aziz Fatima Medical and Dental College, Faisalabad, over a period of Seven months from June 2020 to January 2021. A total of 126 participants were included in the study consisting of 63 patients with chronic liver disease in group A and 63 participants without any known disease in group B as control. The IPF master program in combination with XE-2100 multiparameter automatic hematology analyzer was used to measure the immature platelet fraction. Ethylene diamine tetraacetic acid was used to collect the blood sample for IPF measurement and was maintained till analysis on room temperature. Ten repeated analyses, immediately and after 24 hours were done for reproducibility of IPF%.

Results: The mean age of liver disease patients was 52.35 Â± 13.64 years and in control group the mean age was 51.62 Â± 11.27 years. There was no significant (p-value > 0.05) difference between both groups based on age and gender. The hemoglobin level and red cell count was found to be significantly (p-value < 0.05) reduced in cases group. While white blood cells count was comparable in both groups. The mean platelet count was significantly (p-value < 0.05) less in cases group (163.5 Â± 90.4 vs 233.4 Â± 54.5 (x10*3/Âµl). The mean value of immature platelet fraction (IPF%) was significantly (p-value < 0.05) raised in cases group (5.62 Â± 2.92 vs 3.06 Â± 1.87). The multivariate discriminant analysis (MDA) score showed a significant (p-value < 0.05) association with chronic hepatis as compared to other liver related diseases.

Conclusions: In chronic liver disease patients, there is an inverse relationship between platelet count and IPF% with decreased platelet count and increased IPF%. The proposed MDA function can be used to identify the cirrhotic changes in liver disease patients.
Role of the Uterine Artery Ligation (UAL) In Control of Postpartum Hemorrhage
Authors: Najma Bano Shaikh  , Maria Shabir Shaikh  , Farhana Shaikh  , Nabila Hassan  , Sajida yousfani  , Shabnam Shaikh
Published: January 2022

Objective: To determine the efficacy and safety of uterine artery ligation (UAL) in control of Postpartum Hemorrhage.

Methodology: This case series study was conducted at Department of Gynecology and Obstetrics Peoples University of Medical & Health Sciences for Women Nawabshah. All the women age between 20-45 years, gestation duration at and beyond 34 weeks, antepartum hemorrhage; intraoperative atonic postpartum hemorrhage and discovery of a placenta accreta; or an adherent placental part after piecemeal removal of the placenta, with bleeding from the placental site were included. After failure of treatment from medical measures, the initial surgical approach of uterine artery ligation (UAL) was done. Efficacy was defined as positive when patient improves or clinically doesnâ€™t develop any complication throughout admission after UAL. Safety was assessed by appearance of side effects if any occurred after procedure. Data was recorded via study proforma and analysis was done by using SPSS version 20.

Results: Out of 76 patients admitted of postpartum hemorrhage mean age was 58 years. Most of the patients 59.2% were multiparous and 40.8% were primiparous. The most common cause of postpartum hemorrhage was uterine atony 56.5% and adherent Placenta accreta 43.42%. Most of the patients 81.6% had no postoperative complications except for 11 patients, who had developed gaping of the wound from which they recovered and discharged. The patients required hysterectomy due to intractable hemorrhage and 2.3% mortality was observed due to DIC.

Conclusion:  Uterine devascularization by bilateral uterine artery ligation is a simple, effective and the safest initial surgical option with less blood loss and less surgical time for controlling postpartum hemorrhage during cesarean section. It should be used as the first surgical step of choice after medical managements fail in controlling postpartum hemorrhage due to minimal rate of complications and mortality.
ENT manifestations in HIV infected patients in PIMS Islamabad.
Authors: Khan Manza Maqsood , Ansab Hasnain  , Altaf Hussain  , Jawad Faisal  , Hasnain Naqvi  , Mehak Husnain
Published: January 2022

INTRODUCTION

HIV is a global pandemic with estimation of 38 million active cases around the world according to WHO HIV data and statistics 2019. Despite of advancement in medical field the disease has not been tamed uptil now. In this modern era HIV is still considered a taboo in Pakistan, people are reluctant about disclosure of disease, screening of their partners and its treatment which is due to lack of awareness and socio-economic constraints.

OBJECTIVE

The aim of this study is to see the incidence of Ear, Nose and Throat (ENT) manifestations in HIV infected people presented in tertiary care hospital of Islamabad.

MATERIAL AND METHOD

A one-year observational cross-sectional study conducted in Pakistan Institute of Medical Sciences (PIMS) Islamabad between January 2019 to December 2019. All the HIV infected patients who presented with ear, nose and throat manifestations were recruited in the study. Detailed history and examination were conducted after taking written consent. Analysis included calculations of mean values of quantitative association between ENT symptoms and demographic characteristics. Statistical analysis was estimated using either Chi-square test or t-test.  

RESULTS

Majority of the patients presented with Otological manifestation of which the most common was chronic suppurative otitis media (14.28%). Most common Rhinological/Oropharyngeal manifestation included epistaxis (12.24%) and oral candidiasis (8.16%) respectively. Among neck manifestations cervical lymph adenopathy (18.16%) showed the highest percentage.

CONCLUSION

The study shows a local trend of ENT manifestation in which the patient presented in later stage (WHO III) which resembled to the studies carried out in other developing countries showing ineffectiveness of current national HIV/AIDS programme.
Immediate Procedural Success of Primary Percutaneous Intervention in Patients with Acute ST Segment Elevation Myocardial Infarction
Authors: Bandeshah Akhtar Ali , Liaqat Ali Rind  , Abid Saeed  , Ather Mehmood  , Muhammad Aamer Niaz
Published: January 2022

Objective: To determine the frequency of immediate procedural success of Primary PCI in patients with Acute ST segment elevation Myocardial infarction.
Methodology: This observational study was conducted at Cardiology unit of P.I.M.S, Islamabad from April 2018 to October 2018. Study included 43 patients with STEMI. All of them had primary PCI. The main outcome variable was frequency of procedural success which was described as frequency distribution table.
Results: Procedural success was achieved among all (100%) patients.Â  There were 16.3% patients who developed contrast induced nephropathy (recovered), they all were diabetics. There were 4.6% patients who developed hematoma. No other complications seen
Conclusions: Immediate procedural success of primary PCI is high (almost successful in every case) and should be offered to the patients with STEMI whenever the facility is available.
Keywords: ST-segment elevation myocardial infarction; primary percutaneous coronary intervention.
Studies on Pruning Cuts and Wound Dressings for Oak Wilt Control
Authors: Camilli Kim , Appel David , Watson W. Todd
Published: January 2022

Ceratocystis fagacearum causes the destructive tree disease called oak wilt. One means of pathogen spread is by insect vectors (Nitidulidae) that transmit spores into fresh wounds on healthy trees. Experiments were conducted in central Texas on native live oaks (Quercus fusiformis) to test pruning methods and paints on disease development. Three treatment combinations were tested on 30 trees (10 trees/treatment): flush cut unpainted, flush cut painted, and unpainted pruning cuts made according to the Shigo method. Unpainted puncture wounds were made on the lower trunks of an additional 20 trees as controls. C. fagacearum spores were applied to the pruning cuts and half of the puncture wounds (positive controls) after treatment, whereas the other half of the punctures received distilled water as negative controls. Oak wilt symptoms first appeared in the flush cut unpainted treatment 31 days after inoculation. Infection rates, in decreasing order, were; positive control (70%), flush cut unpainted (60%), Shigo pruning method (40%), flush cut painted (20%), and negative control (10%). Pruning wounds, regardless of method, were effective infection courts for the oak wilt pathogen. Fewer trees became infected when pruning cuts were painted, but differences among infection rates for pruning cuts were not statistically significant. Tree diameters and stem aspect ratio had no bearing on infection rates. The Shigo method is recognized as a superior method for pruning, but there is no reason to change current recommendations to paint fresh wounds on susceptible oaks in high-hazard oak wilt areas.
Using Organic Amendments to Decrease Bulk Density and Increase Macroporosity in Compacted Soils
Authors: Rivenshield Angela , Bassuk Nina
Published: January 2022

Samples of compacted sandy loam and clay loam soil were amended with organic matter: sphagnum peat or food waste compost. Amendments were incorporated into the soil samples at 0%, 10%, 33%, 50%, and 75% on a volume-to-volume basis. Changes in bulk density and macroporosity resulting from amendation were measured. In every permutation but one, macroporosity increased and bulk density decreased to below root-restricting thresholds. These results held true for the half of the samples that were manually recompacted. Differences between the amendments were not significant. Amendation with sufficient amounts of sphagnum peat or food waste compost alleviates compaction, creating an environment more conducive for root growth.
Tree Lilac (Syringa reticulata) Cultivars Tested As Street Trees: Second Report
Authors: Gerhold Henry
Published: January 2022

Through the Municipal Tree Restoration Program, cooperators planted three tree lilac (Syringa reticulata) cultivars in 13 Pennsylvania and New York, U.S. communities for evaluation as street trees, comparing two in each community. Standardized measurements in years 1, 2, 3, 6, 9, and 12 revealed that ‘Ivory Silk’, ‘Regent’, and ‘Summer Snow’ grew well and remained healthy at all locations. Average heights of the cultivars in the 12th year ranged from 4.8 to 5.1 m (15.8 to 16.8 ft). Differences in average height and crown width were small. In one community, the tallest cultivar, ‘Ivory Silk’, attained an average height of 6.4 m (21.1 ft) in the 12th year. ‘Summer Snow’ grew more slowly in height initially, and ‘Regent’ had narrower crowns. Foliage health ratings were somewhat lower than those of other species in some years, probably reflecting earlier yellowing of leaves in the autumn. If the tree lilac cultivars continue to grow at the same rate, they would not grow into overhead utility wires until the 18th year or later.
Effect of Biopesticides on Foliar Diseases and Japanese Beetle (Popillia japonica) Adults in Roses (Rosaspp.), Oakleaf Hydrangea (Hydrangea quercifolia), and Crapemyrtle (Lagerstroemia indica)
Authors: Mmbaga M.T. , Oliver J.B.
Published: January 2022

This study evaluated efficacy of biopesticides for reducing foliar diseases and feeding damage from Japanese beetle adults on hybrid T rose (Rosa spp.), oakleaf hydrangea (Hydrangea quercifolia), and crapemyrtle (Lagerstroemia indica). The materials tested included household soaps with Triclosan active ingredient (Equate® and Ajax®), kaolin clay (Surround®), neem seed oil extract (Triact 70® and Neem Gold®), potassium salt of fatty acids (M-Pede®), horticultural oil (UltraFine® Sunspray oil), and bicarbonate salt (Armicarb®) applied to plants grown under greenhouse, shadehouse, and field conditions. Two fungicides, trifloxystrobin (Strobilurin) and triadimefon (Triazole), and the insecticide carbaryl were included for comparison. All materials tested were effective in controlling black spot (Marssonina rosae, anamorph Diplocarpon rosae) and powdery mildew (Sphaerotheca pannosa) of roses. Kaolin was effective in reducing disease severity of bacterial leaf spot (Xanthomonas campestris) on oakleaf hydrangea and powdery mildew of crapemyrtle. Based on data from repeated trials, the biopesticides were as effective as conventional fungicides in suppressing foliar diseases. Kaolin clay was as effective as carbaryl in controlling Japanese beetle adult feeding damage on oakleaf hydrangea, roses, and crapemyrtle, but other products were not effective. Results from this study indicate kaolin clay may be an alternative product to conventional pesticides in foliar diseases and insect pest management for roses, oakleaf hydrangea, and crapemyrtle.