bluuebunny/crossref_metadata_2025 huggingface dataset:
Entre prós e contras na defesa da liberdade no processo eleitoral: reflexões sobre o abuso de “poder religioso” e o posicionamento do Tribunal Superior Eleitoral face à “manipulação política da religião”
Authors: Almeida Larissa de Moura Guerra
Published: February 2025

O presente artigo traz reflexões quanto ao debate envolto ao “abuso de poder religioso” no processo eleitoral brasileiro. A influência de líderes religiosos tem se destacado em meio às multidões e alcançado representatividade política, com membros de denominações religiosas sendo candidatos e exercendo cargos políticos. Há questionamentos sobre como essa influência carismática pode afetar a isonomia da disputa, visto que esses líderes têm posição de destaque frente aos fiéis. Em anos eleitorais, debates sobre o possível “abuso” que ultrapassa os limites da liberdade religiosa e de expressão ressurgem, com argumentos de que tal abuso pode influenciar indevidamente os eleitores. Mediante a análise da legislação eleitoral aplicável aos abusos cometidos durante o ano do pleito e textos discutindo a matéria, além do exame de decisões relevantes da Justiça Eleitoral, aponta-se a pertinência em refletir sobre o tema, em meio à polarização política e investigações sobre atos antidemocráticos.
O espaço urbano de Arapiraca-AL: formação histórica, evolução urbana e tendências recentes
Authors: Neves Rafael Rust , Barros Alice de Almeida , Vasconcelos Ana Beatriz Catonio de , Silva Patricia Monick da
Published: February 2025

Os estudos sobre a evolução urbana têm possibilitado avançar na compreensão sobre como as cidades sugiram e como elas expandiram através do tempo, se constituindo em um relevante campo de conhecimento para a história urbana. Arapiraca é uma cidade de médio porte, localizada no Estado de Alagoas. Diversos trabalhos têm abordado a história da cidade, mas poucos têm colocado foco na evolução urbana. Este trabalho buscou analisar a formação histórica do espaço intraurbano de Arapiraca-AL e sua transformação ao longo do tempo, desde a emancipação do povoado até o contexto presente. Foram realizadas pesquisas bibliográfica e documental que possibilitaram a confecção de mapas apresentando a malha urbana em diferentes marcos temporais da história da cidade. Como resultados, o trabalho apresenta um mapa-síntese com a evolução da mancha urbana de Arapiraca entre 1924 e 2019, aponta os principais vetores de expansão e indica os processos espaciais urbanos em diferentes períodos da história da cidade.
Evaluation of the technical feasibility of replacing natural limestone aggregate by iron ore tailing in the production of adhesive mortar
Authors: Fagundes Júnia Toledo , Oliveira Yara Helena Correia de Araújo , Russo Mário Luís Cabello , Lima Rosa Malena Fernandes
Published: February 2025

In this study, the replacement of natural limestone (NLA), widely used in the manufacture of adhesive mortars, by iron ore tailings (IOT), an abundant and underutilized material with great potential for application in cement products, was analyzed. The detailed characterization of IOT and NLA was performed through physical, morphological, mineralogical and chemical tests, ensuring the understanding of the fundamental properties of both materials. Adhesive mortar formulations were developed with NLA replacement percentages for IOT of 0% (reference), 20%, 40%, 60% and 100%, following the specific Brazilian standards for adhesive mortars. The experimental results confirmed the technical feasibility of fully replacing natural aggregate with IOT, both in ACII and ACIII mortars, characterized by their high added value. This initiative reinforces sustainability in the mining and construction sectors, by promoting the reuse of waste and reducing the environmental impact associated with the inadequate disposal of these materials, contributing to the circular economy.
Desenvolvimento da plataforma Baurupédia: um aplicativo para conscientização sobre mamíferos no cerrado, Brasil
Authors: Gimenes Vinicius Augusto , Mello Caio Marinho , Dioro Gabriel Matos Fortes
Published: February 2025

O presente trabalho abordou a criação da plataforma digital "Baurupédia" como uma ferramenta de educação ambiental destinada a promover a conscientização sobre a diversificada fauna do Cerrado. O objetivo geral foi desenvolver uma plataforma web que reúna informações sobre a fauna de mamíferos do Cerrado, de uma maneira organizada e acessível. Utilizando linguagens de programação como HTML5, CSS e JavaScript, a plataforma foi projetada para proporcionar uma interface intuitiva e dinâmica, facilitando a interação dos usuários. Além disso, o GeoJSON foi empregado para representação de dados geográficos, permitindo a visualização da distribuição das espécies. A "Baurupédia" apresenta perfis detalhados de espécies, incluindo fotos, vocalizações e informações biológicas, além de utilizar mapas interativos, galerias de fotos e QR codes para tornar a experiência de aprendizagem mais envolvente e acessível. Conclui-se que a plataforma tem o potencial de promover a conscientização ambiental e a preservação da biodiversidade do Cerrado, contribuindo para uma sociedade mais informada e engajada na proteção do meio ambiente.
Influência de fatores abióticos enfrentados no levantamento e caracterização da entomofauna no Centro Universitário do Sagrado Coração (UNISAGRADO), Bauru, São Paulo
Authors: Dioro Gabriel Matos Fortes , Mello Caio Marinho , Correia Érika Cristina Souza da Silva , Scoton Edvaldo José , Gimenes Vinicius Augusto
Published: February 2025

Insetos são componentes de vital importância nas comunidades bióticas. Eles constituem o grupo metazoário mais diversos do planeta, compreendendo cerca de 70% das espécies conhecidas. Além disso, possuem elevadas densidades populacionais e ocupam os mais diversos habitats e nichos ecológicos, em decorrência das suas características estruturais e fisiológicas. Este estudo teve como objetivo realizar um levantamento entomofaunístico, a fim de fornecer informações que contribuam para o manejo e conservação/manutenção das populações de insetos. O levantamento ocorreu nas dependências do campus do Centro Universitário Sagrado Coração, durante as estações de verão e de inverno, com o auxílio de armadilhas do tipo Moericke e Pitfall. Os insetos capturados foram etiquetados, triados, contados e identificados. Foram registrados, 490 indivíduos distribuídos em diferentes grupos taxonômicos: Diptera: Simuliidae; Coleoptera: Dermestidae, Carabidae; Hymenoptera: Formicidae, Apoidea, Vespidae; Blattodea: Rhinotermitidae e Hemiptera: Pentatomidae. A diversidade de insetos detectada pode ser associada ao número significativo de plantas de grande e pequeno porte presentes na área amostrada, fazendo com que haja um equilíbrio, possibilitando que os insetos habitem o local.
Defasagem tecnológica de pulverizadores agrícolas, produzidos na Europa e América do Sul, induzida por legislação específica
Authors: Veliz Rubén Darío Collantes , Moya Emilio Gil , Schlosser José Fernando , Rodrigues Henrique Eguilhor , Garcez Natália do Nascimento
Published: February 2025

Os pulverizadores são equipamentos utilizados no processo produtivo agrícola tanto na agricultura Europeia quanto na América do Sul. São máquinas fundamentais para o sucesso da produção, todavia representam um risco significativo de contaminação meio ambiental e intoxicação dos operadores, quando mal utilizadas ou com falhas de projeto. Estes problemas podem ser reduzidos com aporte de recursos tecnológicos que evitem os problemas de contaminação humana e dos recursos naturais. Vários países e organizações desenvolvem legislações, para evitar os acidentes de trabalhos e os danos ambientais. O objetivo do trabalho foi avaliar a conformidade de vinte modelos de pulverizadores agrícolas fabricados na Europa e América do Sul, com normas aplicáveis na Comunidade Europeia. Foi criado um índice, baseado em ponderação e contrastado com as características dos pulverizadores da amostra. Como resultado verificou-se que os pulverizados agrícolas produzidos na América do Sul não atendem os mesmos requisitos exigidos aos que se comercializam na Europa, principalmente quanto ao depósito de pulverização e sistema de limpeza do equipamento. Por consequência, esses equipamentos não poderiam ser certificados e comercializados na Europa. A adoção das normativas europeias como a ISO 16119 e a Diretiva 2009/127/CE poderiam fomentar e garantir que os pulverizadores agrícolas produzidos na América do Sul, se tornassem adequados tecnicamente, além de mais seguros para a saúde humana e menos perigosos ao meio ambiente.
Penerapan Konsep Sekolah Alam untuk Pembentukan Karakter dan Soft Skill pada Anak Berkebutuhan Khusus (ABK) di Jogja Green School
Authors: Widyastuti Esa Amelia , Gita Apriliana  , Fingka Wahyu Anggraini  , Tantri Pramadita  , Saputra  , Taufik Muhtarom
Published: February 2025

This research aims to evaluate the implementation of the nature school concept at Jogja Green School in supporting character development and soft skills in children with special needs. This study uses a qualitative approach with observation and interview methods, observing the interactions of students, teachers, and nature-based activities such as gardening and farming. The subjects of this research number 25 individuals, and the data analysis technique used is the Miles and Huberman analysis technique, with data collection techniques through interviews and observations. The results of the study showed that the activity was effective in teaching responsibility, discipline, empathy, and other social skills. In addition, nature-based learning has been shown to improve students' understanding of the subject matter in a more concrete and interactive way. Despite the challenges in adapting materials for students with diverse needs, the flexibility of learning methods at Jogja Green School provides opportunities for ABK to develop according to their abilities. This study concludes that the concept of nature schools can be an effective model in inclusive education, with a focus on character development and soft skills that are important for ABK in facing life's challenges.
Students’ Perception Towards Integrating Quizizz Application in Basic English Grammar Lesson
Authors: Anggraini Katili Yayu
Published: February 2025

This study aims to describe the students’ perceptions on using Quizizz, a tool for online gamified quiz, in Basic English Grammar lesson for the first-semester students of English Education Department, State University of Manado. This research uses a qualitative descriptive method by collecting data using observation and closed ended questionnaires with 30 students. It explores students' views on the effectiveness, ease of use, and motivational impact of Quizizz. The findings show that most students have positive opinions about the application, with many agreeing that Quizizz enhances their grammar learning, makes lessons more enjoyable, and is user-friendly. Quizizz was also found to encourage independent learning and facilitate engagement with the material. Despite the overall positive feedback, some students expressed concerns about the tool’s applicability to subjects beyond grammar. These results suggest that while Quizizz is effective for teaching Basic English Grammar, further adaptation may be needed to expand its use in other areas of study. Overall, Quizizz proves to be a valuable educational tool.
The Influence of The Project Based Learning (PjBL) Learning Model on Students' Spatial Thinking Abilities on The Subject of Geography
Authors: Ristiani Ristiani
Published: February 2025

Geography is one of the important subjects in the education curriculum in Indonesia. The ability to think spatially is one of the important skills that students must master in learning geography. Teachers need to apply appropriate learning models to train students' spatial thinking skills, such as project-based learning models. This research uses a literature review method of 9 (nine) articles to analyze the influence of the project based learning model on students' spatial thinking abilities in geography subjects. The source of data for this research is scientific articles published in various journals and indexed in the google scholar repository data. Data analysis is carried out qualitatively with the stages of data reduction, data presentation, and conclusion drawing. The results of the analysis show that the project based learning model has a significant influence on students' spatial thinking abilities in geography subjects. The application of the PjBL learning model has been proven to improve students' spatial thinking skills which are needed in studying spatial concepts in geography.
Effectiveness of Aromatherapy on Pain and Anxiety among Burns Patients at Public Hospital of Karachi
Authors: Haider Amir , Micah Sineer , Raja . , Khan Ameer Ullah , Kumar Santosh , Bibi Afsha
Published: February 2025

Aromatherapy is a safe supplement to reduce the pain and anxiety among burn patients. Objective: To determine the effectiveness of aromatherapy on pain and anxiety among burn patients at a public tertiary care teaching Hospital, Karachi, Pakistan. Methods: A quasi-experimental design was employed, on participants of both genders aged between 18-54 years and had burns that were less than 40% Total Body Surface Area. The sample size for this study was calculated through Open Epi version 3.0 with a proportion formula and the calculated sample size was 88. Two open accessed questionnaires Pain and Anxiety Symptom Scale (PASS-20) and Visual Analogue Scale (VAS) was used to collect the data. Wilcoxon signed-rank test was used to test the effect of the intervention (8.00 to 5.75). Results: The results showed that aromatherapy significantly reduced post-intervention pain (p-value0.001). The sub-scale “cognitive”, “escape avoidance”, and the global PASS score was significant after intervention with P-values <0.0001, 0.039, and 0.025 respectively. The mean scores of PASS in all sub-scales and the global score was significantly decreased after the intervention with a large effect size (r>0.5) using Cohen's (1988) criteria. Conclusions: The findings suggested that aromatherapy was a safe supplement to reduce the pain and anxiety among burn patients. Nurses can use at the clinical practice to enhance the use of aromatherapy by which the pain and anxiety can reduce among burn patients.
Evaluation of Use of Intensive Care Unit (ICU) Scoring Systems among Healthcare Professionals
Authors: Jahangir Aneela , Saba Noor-Us- , Raza Madiha , Hyder Furkan , Sultan Syed Farjad
Published: February 2025

The prognosis of patients in the Intensive Care Unit (ICU) is a matter of worry for critically ill patients, their families, and healthcare personnel. However, predicting the chances of recovery in the ICU can be challenging. Scoring systems serve as standardized instruments utilized in critical care research to determine which patients should be included in a study and to establish the comparability of different patient groups. Objective: To determine the frequency of use of Scoring Systems to predict the outcome of critically ill patients in the intensive care units of  Pakistan. Methods: This cross-sectional study was conducted in all the healthcare institutions of Pakistan that are recognized by CPSP for fellowship in ICU training, from 10th April 2018 till 10th October 2018. Forty-one ICU physicians were included. Pre-designed questionnaires were sent to these physicians. Results: Out of 41 physicians, 33 (80.5%) of them used and 8 (19.5%) did not use ICU scoring systems. Only 3 consultants reported the use of Anatomical scoring systems. GCS was the most used Disease Specific Scoring System (97.5%), followed by Child Pugh’s Score (80%) and Ranson’s Criteria (70%). 50% reported the use of Sequential Organ Failure Assessment (SOFA) and 42% used Multiple Organ Dysfunction Score (MODS). 63% used Acute Physiology and Chronic Health Evaluation (APACHE). 93% did not use any Therapeutic Weighted Score. 77.5% used Richmond Agitation-Sedation Scale (RASS) and 25% used Ramsey’s. Conclusion: It was found that 80.5% physicians used ICU scoring systems to assess mortality and severity of illness.
Enhancing Neonatal Sucking Reflex: A Study on the Efficacy of Magnesium Sulphate in Severe Birth Asphyxia
Authors: Akram Muhammad , Malik Abdur Rehman , Ahmad Munir , Arshad Rana Tashfeen
Published: February 2025

One of the main causes of prenatal deaths and a known factor in neuromotor disabilities is perinatal asphyxia. Objectives: To compare the efficacy of magnesium sulphate on the appearance of a good sucking reflex in cases of birth asphyxia with controls (without magnesium sulphate). Methods: This randomized controlled trial was conducted at the Department of Neonatology, The Children’s Hospital and the Institute of Child Health, Multan, from January 2024 to June 2024. A total of 80 full-term newborns of both genders with severe birth asphyxia admitted within six hours of life were randomly assigned to either the study group or the control group. The study group received 3 doses of magnesium sulphate 24 hours apart by intravenous infusion at 250 mg/kg/dose, and the control group did not receive this treatment. Supportive care was given to both study groups. Both groups were examined for sucking reflexes. Results: 46 (57.5%) were male, while 43 (53.8%) had a body weight of ≥2.5 kg. The mean age at the time of presentation was 3.2 ± 1.5 hours. Overall efficacy was observed in 48 (60.0%) babies. The distribution of efficacy in terms of the appearance of a good sucking reflex was significantly better in the magnesium sulphate group versus the control group (75.0% vs 45.0%, p=0.0062). Conclusions: It was concluded that magnesium sulfate was found to significantly improve the appearance of a good sucking reflex among newborns with severe birth asphyxia, highlighting its potential as a neuroprotective intervention in neonatal care.
Comparison of the Side Effects of Chlorhexidine and Honey Mouthwash among Dental Patients: A Randomized Controlled Trial
Authors: Abid Muhammad , Rauf Rabia , Siddiq Afshan , Mazhar Samreen , Zaidi Hasan Afaq , Zafar Urooj
Published: February 2025

Gingivitis, primarily caused by bacterial plaque buildup, was managed through mechanical removal, though this requires consistency. Chemical agents like chlorhexidine mouthwash were effective but have notable side effects. Honey, with its antibacterial properties, offers a potential alternative with fewer adverse effects. Objective: To compare the side effects of 0.12% chlorhexidine gluconate and 10% honey mouthwash to determine which offers a safer and more comfortable option for oral hygiene in young adults. Methods: This randomized controlled trial was conducted from June 2020 to December 2020 to compare the side effects of two oral care solutions, 0.12% chlorhexidine gluconate and 10% honey mouthwash, among young adults. Sixty subjects were recruited from the Department of Periodontology at a tertiary care hospital in Karachi. The primary focus of the study was to observe and document any side effects associated with each mouthwash during and after three weeks of usage for plaque removal and gingival health. Results: The study revealed that participants in Group A (chlorhexidine) reported a higher incidence of adverse effects, including a pronounced bad taste, numbness in the mouth, and noticeable tooth discoloration. In contrast, Group B (honey) participants generally reported a pleasant taste, with significantly fewer and milder side effects. Conclusions: Honey mouthwash offers a more comfortable user experience with fewer negative side effects, including a pleasant taste. This makes it a promising alternative for individuals seeking an effective and gentle approach to maintaining oral health.
Comparison of Perception and Academic Outcome of Final Year BDS Students Regarding Lecture-Based Learning and Problem-Based Learning
Authors: Khalil Aamna , Afreen Ammarah , Amjad Sadaf , Afreen Zara , Siddiqui Muhammad Omer , Iqbal Qudsia
Published: February 2025

This study explores the differences in student perception and academic outcomes between traditional lecture-based learning and problem-based learning methods in an educational setting. Objective: To find the effectiveness of Problem-Based Learning (PBL) versus Lecture-Based Learning (LBL) in enhancing academic performance and student satisfaction. Methods: Comparative cross-sectional study was carried out among final year BDS students at Watim Medical and Dental College Rawalpindi. The study evaluated lecture-based learning (LBL) versus problem-based learning (PBL) in Prosthodontics and Operative dentistry. LBL consisted of interactive lectures with clear objectives, while PBL involved group-based problem solving over two months. Academic outcomes were assessed via class tests, with feedback gathered through a structured questionnaire. Data were analyzed using SPSS version 21.0. Results: A total of 131 final year BDS students were included. Both genders were considered however majority were females (74%). Mostly participants appreciated both teaching methodologies (58%), a significant proportion favored lecture-based learning (26%) over problem-based learning (11.5%). Perceptions varied on the effectiveness of each method in fostering understanding, self-learning habits, and analytical skills. Many participants expressed dissatisfaction with resource availability and syllabus coverage in PBL sessions, despite positive views on facilitator training. Exam results showed a higher pass rate with PBL (76.3%) compared to LBL (56.5%), but satisfaction with PBL did not significantly influence exam outcomes (p>0.05). Conclusions: The study concluded that future research should focus on optimizing educational methodologies in dental education to effectively prepare students for the complex demands of healthcare through innovative and balanced approaches.
Frequency of Erectile Dysfunction among Smokers and Non-Smoker Men Visiting Tertiary Care Hospital Nawabshah
Authors: Chandio Sadia Ayoub , Bhalar Zahoor Ahmed , Zardari Inayat Ali , Ali Shar Zulfiqar , Toor Habib-Ur-Rehman , Ghumro Altaf Hussain
Published: February 2025

Epidemiological studies have shown that cigarette smoking is the independent risk factor for erectile dysfunction (ED), with smokers 1.5–2 times more likely to develop ED than nonsmokers. Additionally, long-term research has shown that quitting smoking improves erectile function, with noticeable improvements even within 24 hours of cessation. Objective:  To determine the frequency of erectile dysfunction among male smokers and non-smokers at PMC Hospital Nawabshah. Methods: This research was conducted at the Department of Urology, Peoples Medical University Hospital, Nawabshah. A formal written consent /agreement was obtained from every subject/individual who fulfilled the inclusion criteria and then decided to participate. The measure divides ED into four groups based on IIEF-5 scores: mild to moderate (12–16), mild (17–21), no ED (22–25), moderate (8–11), and severe (1–7). Data were being analyzed by computer software statistical package for social sciences version 23. Frequency and percentage were computed for variables. 85.9% are confirmed to have some degree of ED, and 14.1% are found not to have ED. Results: Among the smokers, 39(27%) had mild ED, but in non-smokers, 53(37%) had mild ED. Among the smokers, 50(35%) had moderate ED, and in non-smokers, 51(36%) had moderate ED. In smokers, 64(45%) had severe   ED, and in non-smokers, 38(27%) had severe ED. Conclusions: Smoking tremendously affects the erection of patients. Whereas non-smokers had a little bit less effect on erectile function.
Adverse Perinatal Outcomes: Their Association with Maternal Anemia
Authors: Aziz Amna , Parveen Shahida , Khan Bushra , Sultana Hajra , Akhtar Asma , Raza Kanwal
Published: February 2025

The incidence of anemia during the third trimester of pregnancy correlates with a heightened risk of negative postnatal outcomes. Objective: To access the relationship between hemoglobin levels in laboring women and perinatal outcome. Methods: A prospective cohort study was done at Department of Obstetrics and Gynecology, Nishtar Hospital, Multan from September 2020 to December 2021 using non-probability purposive sampling technique. A total of 135 anemic pregnant women (Group A) fulfilling inclusion and exclusion criteria was recruited for the study from labour room plus 135 non-anemic women were also recruited as control group (Group B). The data was recorded and explored. Results: 135 anemic laboring pregnant ladies were taken in this study having mean age 25.63 ± 4.53 years (range; 19-37 years) and 85.2% had ages less than 30 years. Cesarean section deliveries were noted to be in 50.4% in group A (anemic women) versus 48.1% in group B (non-anemic women). Preterm birth was noted to be 29.6% in group A versus 6.7% in group B. Small for gestational age was 53.3% in group A versus 12.6% in group B. Low birth weight was 54.8% in group A versus 16.3% in group B. Still birth was 7.4% only in anemic women while it was not observed in control group.  Conclusions: The results of this study supported strong relationship of low haemoglobin in mothers with untoward perinatal outcome; growth retarded babies, preterm, Low birth weight and cesarean section rate. Strong media awareness campaigns should be launched for awareness for iron supplementation among targeted population.
Diagnostic Accuracy of Fine Needle Aspiration Cytology in Salivary Gland Lesions: A Comparative Study with Histopathology as the Reference Standard at Bahawal Victoria Hospital, Bahawalpur, Pakistan
Authors: Afzal Asmah , Shaheen Uzma , Khalid Fatima , Iqbal Firdous , Akhtar Azra
Published: February 2025

Fine-needle aspiration cytology (FNAC) is one of the most widely used diagnostic tools for evaluating salivary gland lesions. However, its diagnostic accuracy is uncertain due to certain factors. Objective: To analyze the diagnostic accuracy of FNAC in salivary gland lesions compared to histopathological examination in a clinical setting. Methods: This cross-sectional study was conducted from October 2021 to June 2022 at Bahawal Victoria Hospital, Bahawalpur, Pakistan. A total of 75 patients, aged 18 to 75 years, were included in the study who were previously clinically diagnosed with salivary gland lesions. Every patient included in the study underwent the FNAC, and the outcomes were compared to the histopathological analysis of the excised biopsies. The results are analyzed in terms of sensitivity, specificity, NPV, PPV, and diagnostic accuracy. Results: Among the 75 patients, the mean age was 42.5 ± 14.3 years, with a male-to-female ratio of 1:1.08. FNAC results showed 7 non-neoplastic lesions (9.3%), 61 benign (81.3%), and 7 malignant neoplasms (9.3%). A histopathological analysis identified 63 benign, 5 malignant, and 7 non-neoplastic neoplasms. FNAC showed a 96.0% overall diagnostic accuracy, with sensitivity, specificity, Positive predictive value (PPV), and Negative Predictive Value (NPV) of 97.0%, 88.9%,98.5%, and 80.0% respectively. Two false-negative instances (2.7%) and one false-positive case (1.3%) were found in the study. Conclusion: FNAC is an extremely sensitive and accurate diagnostic tool especially when it is required to distinguish between benign and malignant neoplasms. However, its low specificity increases the risk of false-negative results where histopathological confirmation becomes an integral part of the diagnosis especially the cases where clinical suspicions are high.
Relationship of Hypoalbuminemia in Colistin-Induced Acute Kidney Injury (AKI) among Adult Intensive Care Patients
Authors: Memon Sughandh Umer , Samad Saima , Misbah Nazish , Muzaffar Saima , Ishaque Sadia , Kamran Shumaila
Published: February 2025

Acute kidney injury incidence ranges from 30-60% among critically ill patients and stands as the primary death cause within this population. A serious concern is a global rise in major drug-resistant-gram-negative organisms among hospital-acquired infections. Objectives: To determine the incidence of colistin-induced acute kidney injury in intensive care patients receiving colistin therapy and to investigate its relationship with albumin levels. Methods: It was a follow-up prospective cohort study executed at Shaheed Mohtarma Benazir Bhutto Institute of Trauma Pakistan in an adult intensive care unit over 6 months. The study end-point was an injury in intensive care injury at the end of colistin therapy. A total of 250 patients were studied. The median age of patients was 40 (IQR=22-48) years with an age range of 18-70 years. The majority of patients were male (75.2%). Median colistin dosage was 4 (IQR=3.5-4.5) MIU. In univariate analysis, the risk of developing injury in intensive care was significantly increased with increased age, use of nephrotoxic drugs, and increasing colistin dosage whereas injury in intensive care risk was decreased with increasing albumin levels. In a multivariable model, only colistin dosage was found to be significantly associated with increasing injury in intensive care risk with increasing colistin dosage. Conclusions: It was concluded that the present study analyzed a higher burden of acute kidney injury incidence following colistin therapy. Albumin levels were not found to be linked to acute kidney injury incidence in the multivariable model. Acute kidney injury incidence was significantly related to increasing colistin dosage.
Perceptions of Medical Students towards Artificial Intelligence
Authors: Rizwan Shazia , Rizwan Shahveir , Rizwan Maheer , Hashim Ali , Nawal . , Batool Saima
Published: February 2025

The incorporation of technological advancements, particularly Artificial Intelligence has transformed healthcare systems globally, especially post-COVID-19. Medical education faces challenges in incorporating AI due to instructor shortages and high software costs. Understanding medical students' attitudes towards AI is crucial for its successful integration into medical practice and education. Objective: To evaluate the attitude of medical undergraduate students towards AI in medicine. Methods: A descriptive, online cross-sectional study was executed among undergraduate medical students utilizing a non-probability convenience sampling. The questionnaire, distributed to 340 participants, included demographic details, perceptions towards artificial intelligence, and its effect on medical education. A total of 252 responses were received, receiving a 74% response rate. Data analysis was executed through SPSS version 26.0. Results: Demographic characteristics of 252 subjects revealed a mean age of 23.5 years, with a majority being female (74.2%) and in their first to third year of study (58.3%). Participants generally had intermediate computer literacy (75.7%) and used technology consistently for learning (57.5%). Regarding perceptions of AI, most students strongly agreed that AI will significantly impact healthcare (48.8%) and that all medical students should be educated about it (31.3%). Additionally, a substantial majority believed that integrating AI into medical education would enhance its quality (66.6%) and facilitate the learning experience (57.9%). Conclusions: It was concluded that students have positive perceptions regarding AI systems, demonstrating enthusiasm for expanding their knowledge of AI within their medical education.
Impact of Team-Based Learning on Medical Students Academic Performance
Authors: Abdullah Zainab , Khan Marina , Asfandyar Amber , Aman Khaliq , Asim Behram , Haris Sobia
Published: February 2025

The effectiveness of different educational strategies in medical education is still essential to students’ academic performance and satisfaction. Objectives: To determine the effect of Team-Based Learning versus Small Group Discussion (SGD) on academic outcomes for students in a medical curriculum. Methods: The study design was a quasi-experimental non-equivalent control group design involving 100 medical students divided into two groups of 50 for Team-Based Learning and 50 for Small Group Discussion. Data collection comprised pre-test and post-test scores, changes in scores, and levels of satisfaction measured using structured surveys. Statistically, independent t-tests were used to compare academic performance and satisfaction between the two groups. Results: The Team-Based Learning group had significantly higher post-test scores, 76.42 ± 9.14 as compared to the Small Group Discussion group, 68.00 ± 9.45. The difference in change scores was significant: 16.56 ± 7.50 for Team-Based Learning versus 9.24 ± 6.50 for Small Group Discussion, p<0.0001. Satisfaction levels were also higher in the Team-Based Learning group at 4.14 ± 0.88 than in the Small Group Discussion group at 2.94 ± 0.79, with a statistically significant difference p<0.0001. Conclusions: It was concluded that Team-Based Learning versus Small Group Discussion generated significant differences in the academic performance and satisfaction levels of medical students. Team-Based Learning appears to be a more effective teaching-learning strategy compared to Small Group Discussion in enhancing engagement and better learning outcomes in medical education.
Correlation of Clinical Frailty Scale Assessment and in-Hospital Mortality in Elderly Critically Ill Patients Admitted to Intensive Care Units of Private Sector Tertiary Care Hospital
Authors: Muzaffar Saima , Hashmi Madiha , Rasheed Ghulam , Jamil Araj , Umer Sughand , Kamran Ali
Published: February 2025

Frailty is a complex geriatric condition marked by increased vulnerability to adverse health events. In intensive care unit patients, there is a clear correlation between the Clinical Frailty Scale and higher short- and long-term mortality rates. Objectives: To evaluate the prognostic importance of frailty, measure the risk of death in the Intensive Care Unit for all Clinical Frailty Scale scores, and methodically evaluate the association between frailty and Intensive Care Unit mortality. Methods: This cross-sectional study was conducted over 1 year (Jan 2023 to July 2023) at the Department of Medical Intensive Care Unit of Ziauddin University Hospital, Karachi Pakistan. Irrespective of gender, all patients of age more than 60 years admitted to the Medical Intensive Care Unit were included. In this study, individuals ≥60 years of age had their pre-admission frailty and hospital mortality compared using the Clinical Frailty Scale. Results: The median age was 75 years. The overall mortality rate was 9.9%. The Clinical Frailty Scale score indicated that 29.7% of patients were classified as non-fragile, 18.7% as vulnerable or pre-fragile, and 51.6% as frail. A significant association of Clinical Frailty Scale assessment was observed with gender, age, outcome, Acute Physiology and Chronic Health Evaluation score and invasive (mechanical ventilation). According to multivariate logistic regression, patients on mechanical ventilators have a higher mortality rate. Conclusions: It was concluded that the findings demonstrated a strong correlation between mortality and the Clinical Frailty Scale among critically sick patients admitted to the intensive care unit.
Sleep Disorders and Quality of Life in Children with Cerebral Palsy
Authors: Bahalkani Ubedullah , Bharo Mumtaz Ali , Haque Tayyaba , Bhanbhro Bakhtiar Ahmed , Ali Kamran , Ali Faiza Kamran
Published: February 2025

Sleep disorders are common in children with Cerebral Palsy (CP) and can adversely affect their health and quality of life. Objective: To investigate the factors associated with sleep disorders in children diagnosed CP with age ranged from 5 to 10 years. Methods: A cross-sectional study was conducted for six months from March 2024 to August 2024, with 150 children aged 5 to 10 years diagnosed with CP at Department of Pediatrics, Khairpur medical college Khairpur Mir’s. Data on demographics, type of CP, motor function levels (GMFCS), epilepsy presence, physiotherapy intensity, co-sleeping practices, and sleep disorder prevalence were collected. Odds Ratios (OR) and Adjusted Odds Ratios (Adjusted OR) were calculated using chi-square tests and multivariate analysis. Results: Participants were predominantly aged 8 to 10 years (53.3%), with spastic CP being the most common type (56.7%). Significant associations were found between sleep disorders and several factors: type of CP (OR = 2.57, P = 0.004), GMFCS levels III and IV (OR = 2.94, P = 0.001), epilepsy (OR = 2.67, P = 0.01), and low physiotherapy intensity (OR = 3.11, P < 0.001). Multivariate analysis confirmed that the type of CP (Adjusted OR = 2.45, P = 0.007) and motor impairment severity (Adjusted OR = 3.10, P = 0.001) were significant risk factors for sleep disorders. Conclusion: The study highlighted a high prevalence of sleep disorders among children with CP, emphasizing the need for targeted interventions addressing specific risk factors to improve sleep quality and overall well-being.
Comparative Analysis of Host and Virus-Driven Variables Affecting Response to Ribavirin and Interferon Therapy in Hepatitis C Patients
Authors: Jamal Iffat , Aslam Rind Muhammad , Nazir Maria , Saleem Muhammad , Shah Madiha , Rajput Asma
Published: February 2025

Current guidelines advocate for individualized treatment approaches for the management of Hepatitis C, that incorporate baseline assessments of viral genotype, host comorbidities, and socioeconomic factors to maximize therapeutic success. Objectives: To analyze the impact of host and virus-driven variables on treatment response in patients receiving ribavirin and interferon therapy. Methods: This prospective cohort study was conducted on 138 patients aged 18–65 with confirmed chronic HCV infection who were eligible for interferon and ribavirin therapy. The patients were followed up to a 24-week post-treatment to assess recovery measured in terms of sustained virological response (SVR). The host-driven factors included age, gender, BMI, and the presence of IL28B polymorphism while virus-driven factors included HCV genotype and baseline viral load. Results: The study sample predominantly consisted of male (55.1%), and genotype 3 virus accounted for 68.1% of participants. A high proportion (76.1%) of participants achieved SVR. Factors associated with better treatment outcomes included younger age (90.7% in the 31–45 age group), gender (89.5% of male), normal BMI (91.2% of those with a BMI of 18.5–24.9), and the favorable IL28B polymorphism CC genotype (91.8%). Low baseline viral load was observed in 60.1% of patients, and those with genotype 3 had better SVR rates. Conclusions: It was concluded that younger age, male gender, normal BMI, favorable IL28B polymorphism along with low baseline viral load, and genotype 3 were positively associated with achieving SVR.
Plastic Surgery Awareness and Perceptions among Healthcare Professionals: A Single Centre Study at Liaquat University Hospital
Authors: Sanober Aamna , Siddiqui Afaq Saleem , Sheikh Shahzad , Irshad Samra , Sangrasi Hira , Qureshi Pir Naveed Ahmed Ahsan
Published: February 2025

Plastic surgery encompasses both reconstructive and aesthetic procedures, addressing functional and cosmetic needs. Misconceptions about its scope are common, even among healthcare professionals, underscoring the need to evaluate their awareness and perceptions. Objectives: To assess the level of awareness and perceptions of plastic surgery as a speciality among healthcare professionals at Liaquat University Hospital, Hyderabad and Jamshoro. Methods: A cross-sectional questionnaire-based study was carried out at Liaquat University Hospital, Hyderabad, and Jamshoro. Participants included 108 house officers and postgraduate residents working in nonsurgical specialities. The study excluded doctors from other specialities related to surgery and dermatology due to overlaps in the scope of practice with plastic surgery.  Results: A majority of participants (79.6%) recognized that cosmetic surgery was a component of plastic surgery, while 12% considered them to be the same, and 3.7% disagreed. In terms of the origin of the term "plastic surgery," 82.4% of participants did not know the reason behind the term. Regarding the aesthetic procedures, participants reported rhinoplasty as done by plastic surgeons (61.1%), with 37% favouring ENT surgeons. Non-surgical procedures such as Botox were mostly attributed to dermatologists (51.9%), with 40.7% selecting plastic surgeons. Conclusions: It was concluded that the study revealed significant gaps in both awareness and perceptions regarding plastic surgery among healthcare professionals. There was a noticeable misunderstanding regarding the appropriate speciality for aesthetic procedures, such as liposuction and breast reduction, where other surgeons were preferred over plastic surgeons, indicating a need for improved education and awareness in the medical community.
Clinical Pattern of Limb Loss in Electrical Burn Injuries
Authors: Sanober Aamna , Siddique Afaq Saleem , Shaikh Shahzad , Irshad Samra , Ahsan Qureshi Pir Naveed Ahmed , Sangrasi Hira , Memon Rabia
Published: February 2025

Electrical burn injuries are severe and often lead to significant morbidity, including amputations, especially in high-voltage cases. These injuries commonly occur in occupational settings and can result in prolonged hospitalization and complications. Studying clinical patterns in electrical burn injuries is crucial to identifying risk factors, improving early interventions, and guiding effective treatment plans. Objective: To analyze the clinical pattern of amputation in electric burn patients at Burns Unit, Liaquat University Hospital, Hyderabad. Methods: This prospective observational study was conducted at Liaquat University Hospital, Hyderabad, from Nov 2023 to May 2024. A total of 84 patients, of all ages and both genders who presented with electrical burn injuries were included. While those with scald burns, dry flame burns, contact burns, thermal burns, or uncontrolled diabetes mellitus were excluded. Data collection involved recording demographic details and clinical parameters like the type of burn, total body surface area affected, cause and place of burn, duration of hospital stay, mortality rate and surgical intervention. Results: Among all, 54.8% (n=46) required amputations, with 35.7% involving a single limb and 19% multiple limbs. Upper limb amputations were more common (60.9%) compared to lower limb amputations (39.1%), with an 11.9% mortality rate. High-voltage burns were significantly associated with severe total body surface area involvement, prolonged hospitalization, fasciotomies, and multiple limb amputations. Conclusion: It was concluded that the study reported a high frequency of limb loss (due to amputation) i.e. 54.8% (n=46) among patients with electric burn.
Association of Physical Activity With Perceived Stress and Well-Being in the Third Trimester of Pregnancy
Authors: Ahmed Waqar , Akhter Parveen , Soomro Fatima , Channar Husan Bano , Ahmed Waheed , Raza Saad , Qudoos Abdul
Published: February 2025

Physical inactivity is considered a worldwide pandemic that leads to numerous health problems. The World Health Organization advises pregnant women to participate in at least 150 minutes of moderate exercise each week to enhance health outcomes. As in the last trimester of pregnancy, considerable physical, hormonal, and psychological changes at this stage need further exploration. Objectives: To determine the association between physical activity, perceived stress, and well-being in the third trimester of pregnancy. Methods: A cross-sectional study of 245 third-trimester pregnant mothers was conducted at a local healthcare center using non-probability purposive sampling from June 2024 to  November 2024. The Pregnancy Physical Activity Questionnaire (PPAQ) was used to quantify physical activity, stress levels were measured with the Perceived Stress Scale-04 (PSS-04), and well-being was assessed using the WHO-5 Well-Being Index. Spearman correlation analysis and descriptive statistics were used to investigate the connections among stress, physical activity, and well-being. Results: Increased physical activity is associated with decreased levels of stress, based on the data, It demonstrated a strong inverse relationship between physical activity and perceived stress (ρ=-0.342, p<0.01). Additionally, there was a positive correlation between well-being and physical exercise (ρ=0.232, p<0.01). Conclusions: It was concluded that physical activity decreased stress and improved well-being in the third trimester of pregnant women. This implies that medical professionals should recommend physical activities in prenatal care, especially in various cultural needs programs. More research is needed with larger, diverse groups.
Association of Plateletcrit Value with Gestational Diabetes Mellitus: A Case Control Study in A Tertiary Care Setting
Authors: Chaudhary Saima , Kausar Zanjbila , Khan Rodaba , Farhan Eeshah
Published: February 2025

Gestational Diabetes Mellitus (GDM) is linked to numerous maternal and fetal complications. Typically diagnosed in the third trimester with OGTT, early detection could prevent many adverse outcomes. Emerging evidence highlights the role of platelets in GDM pathogenesis, suggesting platelet indices, including plateletcrit, might aid early diagnosis. Objective: To determine the association between GDM and elevated plateletcrit levels. Methods: A case-control study was conducted over six months (May - October 2024) in Gynaecology and Obstetrics Unit 1, Sir Ganga Ram Hospital, Lahore. After ethical approval, 100 pregnant women meeting the inclusion criteria were enrolled. At 24–28 weeks’ gestation, all participants underwent a 75g OGTT. Based on results, they were divided into Group A (controls with normal OGTT) and Group B (cases with deranged OGTT). Plateletcrit values from the second trimester were obtained retrospectively from medical records. Quantitative variables were analyzed using Student’s t-test (P ≤ 0.05 deemed significant), while qualitative variables were expressed as percentages. Results: Group B (GDM patients) had significantly higher mean plateletcrit values (0.24 ± 0.08) compared to Group A (non-GDM) (0.14 ± 0.03) (P = 0.000). Conversely, the mean platelet count was higher in Group A than Group B (P = 0.000). Conclusion: Pregnant women with GDM exhibited higher plateletcrit values and lower platelet counts compared to non-GDM women, suggesting plateletcrit as a potential marker for early GDM diagnosis.
Mortality Associated with Tuberculosis Meningitis in HIV Infected Patients and Non-HIV Infected Patients
Authors: Haji Salma , Afzal Munir , Akram Waseem , Ahmed Atif , Memon Beenish , Kumari Monika
Published: February 2025

Human Immunodeficiency Virus (HIV) infection significantly worsens Tuberculosis meningitis (TBM) outcomes, leading higher mortality rate in HIV-positive patients compared to HIV-negative individuals. Objectives: To find out the frequency of HIV Infected Patients with TBM and their outcome as mortality and to compare their mortality of TBM without HIV infection. Methods: This cross-sectional-observational study was conducted at Jinnah Postgraduate Medical Center Karachi, from September 2020 to October 2024. All patients diagnosed with TBM on clinical findings and Cerebrospinal Fluid analysis as TBM were admitted an HIV test was carried out and a CD4 cell count was done in HIV-positive patients. Treatment with Anti-Tuberculosis Therapy and Antiretroviral Therapy was done, the outcome as mortality was recorded up to 1 year and results were analyzed by SPSS version 26.0. Results: A total of 260 patients were enrolled who presented with TBM. The mean age was 39 ± 12.7 years. 20/260 (7.69%) were HIV positive and 240/260 (92.3%) were HIV negative TBM patients. 130/240 (54.16%) were male and 110/240 (45.93%) were female in HIV-negative and HIV-positive TBM 12/20 (60%) were male and 8/20 (40%) patients were female. age in HIV-positive patients was 32.5 ± 5.5 and 38.5 ± 6 in HIV-negative patients. 13/20 (65%) HIV-positive patients expired and 55/240 (22.9%) of HIV-negative patients expired. Conclusions: It was concluded that HIV Infected patients in our setup were increasing and had a high mortality rate as compared to HIV-negative patients of TBM and TBM patients presented in stage 3 had high mortality in both HIV-positive and HIV-negative patients.